WorldWideScience

Sample records for twenty-year prospective community

  1. [Twenty years' review and prospect of modernization research on traditional Chinese medicine].

    Science.gov (United States)

    Zhang, Bo-li; Zhang, Jun-hua

    2015-09-01

    The modernization strategy of traditional Chinese medicine (TCM) has been implemented for 20 years, which has provided a strong impetus to the development of TCM and gained remarkable achievements in scientific research platform, research result, industry scale, clinical evaluation, internationalization and professionals training as well. The achievements of TCM modernization greatly improved the clinical service ability and level of TCM, broadened the scope of service, become the important foundation of the big health industry. TCM has played an irreplaceable role in the health care reform, benefiting people's livelihood, promoting industrial structure adjustment and cultivating strategic emerging industries. This article summarized the main achievements of the modernization of TCM and prospected the direction and tasks in the next 20 years in order to further promote the modernization process of TCM.

  2. DEVELOPMENT OF THE INFORMATION COMPETENCE OF THE ACADEMIC COMMUNITY: TWENTY YEARS AFTER

    Directory of Open Access Journals (Sweden)

    Glosiene, Audrone

    2006-12-01

    Full Text Available Twenty years ago, reading culture, library skills’ development used to be one of the core directions in research and teaching policy of the Department of Library Science at Vilnius University. Lateron, the topic was marginalized and today we return to the field that meanwhile has developed huge knowledge and experience base worldwide. A stimulus for the return was participation in BIBLIONOVA project. The aim of the article is to present a holistic approach towards information competency development in a modern academic institution. Prescriptive approach based on information literacy standards proved to be limited and not always effective in the academic environment.Information competency development is problem-specific, domain-specific, and disciplinespecific. It is interrelated with critical thinking, analytical skills as well as creativity and computerliteracy skills. Holistically, information competency development is an integral part of university’s life-long learning strategy. Critical success factors for information competency development areopen and problem-based learning and cooperative, inclusive strategies of the whole university. Academic libraries continue to play a major role in the process but the connections with faculty and administration in the process are of major importance.

  3. Early childhood behavioral inhibition, adult psychopathology and the buffering effects of adolescent social networks: a twenty-year prospective study.

    Science.gov (United States)

    Frenkel, Tahl I; Fox, Nathan A; Pine, Daniel S; Walker, Olga L; Degnan, Kathryn A; Chronis-Tuscano, Andrea

    2015-10-01

    We examined whether the temperament of behavioral inhibition is a significant marker for psychopathology in early adulthood and whether such risk is buffered by peer social networks. Participants (N = 165) were from a prospective study spanning the first two decades of life. Temperament was characterized during infancy and early childhood. Extent of involvement in peer social networks was measured during adolescence, and psychopathology was assessed in early adulthood. Latent Class Analyses generated comprehensive variables at each of three study time-points. Regressions assessed (a) the direct effect of early behavioral inhibition on adult psychopathology (b) the moderating effect of adolescent involvement in social peer networks on the link between temperamental risk and adult psychopathology. Stable behavioral inhibition in early childhood was negatively associated with adult mental health (R(2 ) = .07, p = .005, β = -.26), specifically increasing risk for adult anxiety disorders (R(2) = .04, p = .037, β = .19). These temperament-pathology relations were significantly moderated by adolescent peer group social involvement and network size (Total R(2) = .13, p = .027, β = -.22). Temperament predicted heightened risk for adult anxiety when adolescent social involvement was low (p = .002, β = .43), but not when adolescent social involvement was high. Stable behavioral inhibition throughout early childhood is a risk factor for adult anxiety disorders and interacts with adolescent social involvement to moderate risk. This is the first study to demonstrate the critical role of adolescent involvement in socially active networks in moderating long-lasting temperamental risk over the course of two decades, thus informing prevention/intervention approaches. © 2015 Association for Child and Adolescent Mental Health.

  4. Twenty Years of KSHV

    Directory of Open Access Journals (Sweden)

    Yuan Chang

    2014-11-01

    Full Text Available Twenty years ago, Kaposi’s sarcoma (KS was the oncologic counterpart to Winston Churchill’s Russia: a riddle, wrapped in a mystery, inside an enigma. First described by Moritz Kaposi in 1872, who reported it to be an aggressive skin tumor, KS became known over the next century as a slow-growing tumor of elderly men—in fact, most KS patients were expected to die with the tumor rather than from it. Nevertheless, the course and manifestations of the disease varied widely in different clinical contexts. The puzzle of KS came to the forefront as a harbinger of the AIDS epidemic. The articles in this issue of Viruses recount progress made in understanding Kaposi’s sarcoma herpesvirus (KSHV since its initial description in 1994.

  5. Impacts of twenty years of experimental warming on soil carbon, nitrogen, moisture and soil across alpine/subarctic tundra communities

    DEFF Research Database (Denmark)

    M. Alatalo, Juha; K. Jägerbrand, Annika; Juhanson, Jaanis

    2017-01-01

    High-altitude and alpine areas are predicted to experience rapid and substantial increases in future temperature, which may have serious impacts on soil carbon, nutrient and soil fauna. Here we report the impact of 20 years of experimental warming on soil properties and soil mites in three...... contrasting plant communities in alpine/subarctic Sweden. Long-term warming decreased juvenile oribatid mite density, but had no effect on adult oribatids density, total mite density, any major mite group or the most common species. Long-term warming also caused loss of nitrogen, carbon and moisture from...... be important for buffering mites from global warming. The results indicated that juvenile mites may be more vulnerable to global warming than adult stages. Importantly, the results also indicated that global warming may cause carbon and nitrogen losses in alpine and tundra mineral soils and that its effects...

  6. 中韩经济关系20年回顾与展望%China -South Korea Economic Relations for Twenty Years: Retrospect and Prospect

    Institute of Scientific and Technical Information of China (English)

    朱永浩

    2012-01-01

    中韩两国自1992年8月建交以来,双边经贸关系发展迅速,两国已互为对方重要经济合作伙伴。本文从贸易、直接投资和人员交流合作角度分析了过去20年来中韩经济合作取得的成果。展望未来,中韩之间经贸合作前景广阔。两国在增强政治互信、推进民间双向交流及国际化人才培养的基础上进一步推进经济合作机制建设,特别是促进中韩FTA早日签署将为双边经贸关系深入发展提供新动力。%Since the establishment of diplomatic relationship between China and South Korea in the August of 1992, the bilateral trade and economic relations are developing fast and they have become important economic co- operation partner of each other. In perspectives of trade, direct investment and personnel exchange and coopera- tion, achievements of the economic cooperation obtained in the past twenty years are analyzed. The two countries also have expansive prospect of trade and economic cooperation in the future. On the basis of strengthening political t:~t.,st, prompting non -government communication and internationalized talent training, they should further advance the construction of economic cooperation mechanism. driving force for the develooment of the bilateral trade Particularly, to sign the free trade agreement will pour new and economic relations.

  7. Outlook: The Next Twenty Years

    Energy Technology Data Exchange (ETDEWEB)

    Murayama, Hitoshi

    2003-12-07

    I present an outlook for the next twenty years in particle physics. I start with the big questions in our field, broken down into four categories: horizontal, vertical, heaven, and hell. Then I discuss how we attack the bigquestions in each category during the next twenty years. I argue for a synergy between many different approaches taken in our field.

  8. Impacts of twenty years of experimental warming on soil carbon, nitrogen, moisture and soil mites across alpine/subarctic tundra communities

    Science.gov (United States)

    Alatalo, Juha M.; Jägerbrand, Annika K.; Juhanson, Jaanis; Michelsen, Anders; Ľuptáčik, Peter

    2017-03-01

    High-altitude and alpine areas are predicted to experience rapid and substantial increases in future temperature, which may have serious impacts on soil carbon, nutrient and soil fauna. Here we report the impact of 20 years of experimental warming on soil properties and soil mites in three contrasting plant communities in alpine/subarctic Sweden. Long-term warming decreased juvenile oribatid mite density, but had no effect on adult oribatids density, total mite density, any major mite group or the most common species. Long-term warming also caused loss of nitrogen, carbon and moisture from the mineral soil layer in mesic meadow, but not in wet meadow or heath or from the organic soil layer. There was a significant site effect on the density of one mite species, Oppiella neerlandica, and all soil parameters. A significant plot-scale impact on mites suggests that small-scale heterogeneity may be important for buffering mites from global warming. The results indicated that juvenile mites may be more vulnerable to global warming than adult stages. Importantly, the results also indicated that global warming may cause carbon and nitrogen losses in alpine and tundra mineral soils and that its effects may differ at local scale.

  9. Educating the Ablest: Twenty Years Later

    Science.gov (United States)

    Culross, Rita R.

    2015-01-01

    This study examines the current lives of thirty-five individuals who participated in high school gifted programs twenty years ago. The research specifically looked at educational attainment and career goals in terms of expressed aspirations in high school, using social media and other Internet sources. Results indicated continued support for the…

  10. Twenty Years After: Armenian Research Libraries Today

    Directory of Open Access Journals (Sweden)

    D. Aram Donabedian

    2012-05-01

    Full Text Available Since achieving statehood in 1991, Armenia has faced major economic and political obstacles which have significantly affected the nation’s research libraries. This research paper will quantitatively and qualitatively examine the challenges facing Armenian research libraries just over twenty years after the collapse of the Soviet Union. Specifically, the authors analyze their interviews with five library administrators at five major institutions, respectively. These include Yerevan State University Library, the National Library of Armenia, the Fundamental Scientific Library of the National Academy of Sciences of Armenia, the Republican Scientific-Medical Library of Armenia, and the Papazian Library of the American University of Armenia. The instrument for the interviews consists of 73 questions based on the 2004 Association of College and Research Libraries Standards for Libraries in Higher Education and evaluates the following factors:• The library’s mission, goals and objectives• Public or user services• Instruction activities at the library• Resources (print, media, or electronic and collection development• Access to the library’s resources• Outcome assessment, or evaluation of the library• Staffing issues• Facility maintenance and plans for library development• Communication and cooperation both within the library and with the user community• Administration• BudgetIn addition, we will focus on the strengths and weaknesses of these libraries and investigate the growing open access movement in Armenia. Based on our findings, the authors wish to facilitate dialogue and consider possible approaches to help these libraries meet Armenia’s pressing information needs.

  11. Microdata Simulation Modeling After Twenty Years.

    Science.gov (United States)

    Haveman, Robert H.

    1986-01-01

    This article describes the method and the development of microdata simulation modeling over the past two decades. After tracing a brief history of this evaluation method, its problems and prospects are assessed. The effects of this research method on the development of the social sciences are examined. (JAZ)

  12. Colorectal cancer prognosis twenty years later

    Institute of Scientific and Technical Information of China (English)

    Luis; Bujanda; Cristina; Sarasqueta; Elisabeth; Hijona; Lander; Hijona; Angel; Cosme; Ines; Gil; Jose; Luis; Elorza; Jose; I; Asensio; Santiago; Larburu; José; M; Enríquez-Navascués; Rodrigo; Jover; Francesc; Balaguer; Xavier; Llor; Xavier; Bessa; Montserrat; Andreu; Artemio; Paya; Antoni; Castells; Gastrointestinal; Oncology; Group; of; the; Spanish; Gastroenterological; Association

    2010-01-01

    AIM:To evaluate changes in colorectal cancer(CRC) survival over the last 20 years.METHODS:We compared two groups of consecutive CRC patients that were prospectively recruited:Group Ⅰincluded 1990 patients diagnosed between 1980 and 1994.GroupⅡincluded 871 patients diagnosed in 2001.RESULTS:The average follow up time was 21 mo(1-229)for GroupⅠand 50 mo(1-73.4)for GroupⅡ.Overall median survival was significantly longer in Group Ⅱthan in GroupⅠ(73 mo vs 25 mo,P<0.001)and the difference was significant for all ...

  13. [The Gulf War Syndrome twenty years on].

    Science.gov (United States)

    Auxéméry, Y

    2013-10-01

    After Operation Desert Storm which took place in Iraq from August 1990 to July 1991 involving a coalition of 35 countries and a 700,000 strong contingent of mainly American men, some associations of war veterans, the media and researchers described a new diagnostic entity: the Gulf War Syndrome (GWS). GWS seems to be a new disorder which associates a litany of functional symptoms integrating the musculoskeletal, digestive, tegumentary and neurosensory systems. The symptoms presented do not allow a syndrome already known to be considered and the aetiology of the clinical picture remains unexplained, an increasing cause for concern resulting from the extent of the phenomenon and its media coverage. It quickly appears that there is no consensus amongst the scientific community concerning a nosographic description of GWS: where can all these functional complaints arise from? Different aetiopathogenic hypotheses have been studied by the American administration who is attempting to incriminate exposure to multiple risks such as vaccines and their adjuvants, organophosphorous compounds, pyridostigmine (given to the troops for the preventive treatment of the former), impoverished uranium, and the toxic emanations from oil well fires. But despite extremely in-depth scientific investigations, 10 years after the end of the war, no objective marker of physical suffering has been retained to account for the disorders presented. It would appear that the former soldiers are in even better objective health than the civil population whereas their subjective level of health remains low. Within this symptomatic population, some authors have begun to notice that the psychological disorders appear and persist associating: asthenia, fatigability, mood decline, sleep disorders, cognitive disorders and post-traumatic stress disorder (PTSD). Within the nosological framework, does GWS cause functional disorders or somatisation? Finally, 20 years after the end of the fighting, only PTSD has

  14. The Review and Reflection of the Development of Shanghai Community College in Recent Twenty Years%上海社区学院发展20年的回顾与思考

    Institute of Scientific and Technical Information of China (English)

    宋亦芳

    2013-01-01

    自1993年上海提出组建社区学院到现在已有20年的历程,伴随着上海社区教育和学习型社会建设的稳步推进,上海社区学院也经历了一段不平凡的发展过程,既面临体制与机制架构之难题,也经历功能定位之困惑,在不断探索与实践中逐步找到自己的位置并得到稳步的发展。在“完善终身教育体系,建设学习型社会”的新形势下,上海社区学院应怎样发展,应如何进一步发挥其作用,需要我们进一步探索和思考。%Since 1993 ,Shanghai proposed to set up community college till now for 20 years .With Shanghai community education and the construction of learning society ,Shanghai’s community college has gone through an extraordinary development process ,facied the problem of system and mechanism framework and experienced the confusion of functional localization .In the continuous exploration and practice gradually found their ow n positions and achieve steady development . In new situation “to perfect lifelong education system and build a learning society” ,it is necessary to further explore and think that the Shanghai community college should be how to develop and how to further play its role .

  15. Twenty years of physics at MAMI -What did it mean?

    Energy Technology Data Exchange (ETDEWEB)

    Mecking, B.A. [Thomas Jefferson National Accelerator Facility, Newport News, VA (United States)

    2006-05-15

    The development over the last twenty years of the physics program and the experimental facilities at the Mainz Microtron MAMI will be reviewed. Ground-breaking contributions have been made to the development of experimental techniques and to our understanding of the structure of nucleons and nuclei. (orig.)

  16. Twenty years of physics at MAMI --What did it mean?

    Energy Technology Data Exchange (ETDEWEB)

    Bernhard Mecking

    2006-06-01

    The development over the last twenty years of the physics program and the experimental facilities at the Mainz Microtron MAMI will be reviewed. Ground-breaking contributions have been made to the development of experimental techniques and to our understanding of the structure of nucleons and nuclei.

  17. Twenty years of energy policy: What should we have learned?

    Energy Technology Data Exchange (ETDEWEB)

    Greene, D.L. [Oak Ridge National Lab., TN (United States). Center for Transportation Analysis

    1994-07-01

    This report examines the past twenty years of energy market events and energy policies to determine what may be useful for the future. The author focuses on two important lessons that should have been learned but which the author feels have been seriously misunderstood. The first is that oil price shocks were a very big and very real problem for oil importing countries, a problem the has not gone away. The second is that automobile fuel economy regulation has worked and worked effectively to reduce oil consumption and the externalities associated with it, and can still work effectively in the future.

  18. Vinte anos de efeito SERS Twenty years of SERS

    Directory of Open Access Journals (Sweden)

    Dalva L. A. de Faria

    1999-07-01

    Full Text Available The Surface Enhanced Raman Scattering (SERS effect was observed for the first time in 1974, but it was only considered a new effect three years later, hence, nearly twenty years ago. Since its discovery, a significant amount of investigations have been performed aiming at to clarify the nature of the observed enhancement, to improve the surface stability and to establish applications which nowadays range from the study of biomolecules to catalysis. Some of the more relevant aspects of this effect which have been examined across the last two decades are summarized in this paper which presents the introductory aspects of SERS alongside with several of its applications.

  19. Uncertainties in sea level projections on twenty-year timescales

    Science.gov (United States)

    Vinogradova, Nadya; Davis, James; Landerer, Felix; Little, Chris

    2016-04-01

    Regional decadal changes in sea level are governed by various processes, including ocean dynamics, gravitational and solid earth responses, mass loss of continental ice, and other local coastal processes. In order to improve predictions and physical attribution in decadal sea level trends, the uncertainties of each processes must be reflected in the sea level calculations. Here we explore uncertainties in predictions of the decadal and bi-decadal changes in regional sea level induced by the changes in ocean dynamics and associated redistribution of heat and freshwater (often referred to as dynamic sea level). Such predictions are typically based on the solutions from coupled atmospheric and oceanic general circulation models, including a suite of climate models participating in phase 5 of the Coupled Model Intercompasion Project (CMIP5). Designed to simulate long-term ocean variability in response to warming climate due to increasing green-house gas concentration ("forced" response), CMIP5 are deficient in simulating variability at shorter time scales. In contrast, global observations of sea level are available during a relatively short time span (e.g., twenty-year altimetry records), and are dominated by an "unforced" variability that occurs freely (internally) within the climate system. This makes it challenging to examine how well observations compare with model simulations. Therefore, here we focus on patterns and spatial characteristics of projected twenty-year trends in dynamic sea level. Based on the ensemble of CMIP5 models, each comprising a 240-year run, we compute an envelope of twenty-year rates, and analyze the spread and spatial relationship among predicted rates. An ensemble root-mean-square average exhibits large-scale spatial patterns, with the largest uncertainties found over mid and high latitudes that could be attributed to the changes in wind patterns and buoyancy forcing. To understand and parameterize spatial characteristics of the

  20. Managing asbestos in Italy: twenty years after the ban.

    Science.gov (United States)

    Silvestri, Stefano

    2012-01-01

    Establishing an asbestos ban is not sufficient to achieve effective primary prevention. Twenty years after the Italian asbestos ban, the residual presence of asbestos-containing materials, estimated to be 80 percent of the quantity existing in 1992, may still be the cause of negative effects to the health of workers and the general population. The so called "asbestos way-out" at this rate of cleaning up, roughly 1 percent per year, is too slow, and new policy to re-discuss the entire process is needed. Encouragement of the owners with tax relief when the substitution of the asbestos roofs is performed with photovoltaic panels, as well as reducing the cost of removal planning local landfills may be the keys to accelerate the cleanup process.

  1. Increased Prevalence of Dental Fluorosis after Twenty Years

    DEFF Research Database (Denmark)

    Richards, Alan; Larsen, Mogens Joost; Maare, L.

    2006-01-01

    children, of similar ages, examined in the same area in 1984. Results: The prevalence and severity of fluorosis varied between tooth types so that the later in childhood the teeth are mineralized the higher the prevalence of dental fluorosis. When the data were compared to those collected 20 years...... in the (later formed) premolars and second molars. Conclusions: A significant increase in fluorosis prevalence has occurred over the last 20 years due to increased fluoride exposure of pre-school children. These findings may be explained by increased use of fluoride toothpaste by this age group from......0977   Increased Prevalence of Dental Fluorosis after Twenty Years A. RICHARDS1, M. LARSEN1, L. MAARE2, and H. HEDEBOE2, 1Aarhus University, Faculty of Health Sciences, Denmark, 2Præstø School Dental Service, Denmark Objectives: To describe the prevalence and severity of dental fluorosis among all...

  2. The Danish eID Case: Twenty years of Delay

    DEFF Research Database (Denmark)

    Hoff, Jens Villiam; Hoff, Frederik Villiam

    2010-01-01

    The focus of this article is to explain why there is still no qualified digital signature in Denmark as defined by the EU eSignatures Directive nor any other nationwide eID even though Denmark had an early start in eGovernment, and a high level of "e-readiness" compared to other nations. Laying out...... of intergovernmental coordination and lack of cooperation between public and private sector. However, with the recent tender on digital signatures won by the PBS and the roll-out of the NemID it seems that Denmark will finally - after twenty years of delay - have an eID which can be widely used in the public as well...

  3. Twenty years on: Poverty and hardship in urban Fiji

    Directory of Open Access Journals (Sweden)

    Jenny Bryant-Tokalau

    2012-09-01

    Full Text Available Through ‘official statistics’, academic and donor interpretations as well as the eyes of Suva residents, this paper presents an overview and case study of twenty years of growing poverty and hardship in the contemporary Pacific. Focusing on the past two decades, the paper notes how much, and yet so little, has changed for those attempting to make a living in the rapidly developing towns and cities. Changing interpretations of poverty and hardship are presented, moving from the ‘no such thing’ view, to simplification, and finally to an understanding that Pacific island countries, especially Fiji, are no longer an ‘extension’ of Australia and New Zealand, but independent nations actively trying to find solutions to their issues of economic, social and political hardship whilst facing challenges to traditional institutions and networks. Fiji is in some respects a very particular case as almost half of the population has limited access to secure land, but the very nature of that vulnerability to hardship and poverty holds useful lessons for wider analysis.

  4. Twenty years of minimally invasive surgery in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Miloslav Duda

    2011-03-01

    increased over the last twenty years, and the range of types of surgical therapies has enlarged.

  5. Understanding Contamination; Twenty Years of Simulating Radiological Contamination

    Energy Technology Data Exchange (ETDEWEB)

    Emily Snyder; John Drake; Ryan James

    2012-02-01

    A wide variety of simulated contamination methods have been developed by researchers to reproducibly test radiological decontamination methods. Some twenty years ago a method of non-radioactive contamination simulation was proposed at the Idaho National Laboratory (INL) that mimicked the character of radioactive cesium and zirconium contamination on stainless steel. It involved baking the contamination into the surface of the stainless steel in order to 'fix' it into a tenacious, tightly bound oxide layer. This type of contamination was particularly applicable to nuclear processing facilities (and nuclear reactors) where oxide growth and exchange of radioactive materials within the oxide layer became the predominant model for material/contaminant interaction. Additional simulation methods and their empirically derived basis (from a nuclear fuel reprocessing facility) are discussed. In the last ten years the INL, working with the Defense Advanced Research Projects Agency (DARPA) and the National Homeland Security Research Center (NHSRC), has continued to develop contamination simulation methodologies. The most notable of these newer methodologies was developed to compare the efficacy of different decontamination technologies against radiological dispersal device (RDD, 'dirty bomb') type of contamination. There are many different scenarios for how RDD contamination may be spread, but the most commonly used one at the INL involves the dispersal of an aqueous solution containing radioactive Cs-137. This method was chosen during the DARPA projects and has continued through the NHSRC series of decontamination trials and also gives a tenacious 'fixed' contamination. Much has been learned about the interaction of cesium contamination with building materials, particularly concrete, throughout these tests. The effects of porosity, cation-exchange capacity of the material and the amount of dirt and debris on the surface are very important factors

  6. Twenty Years of the European Information Systems Academy at ECIS

    DEFF Research Database (Denmark)

    Stein, Mari-Klara; Galliers, Robert D.; Whitley, Edgar A.

    2016-01-01

    While the information systems (IS) community is increasingly international, it is reasonable to expect that different regions might display different research approaches, interests and publication orientations. This paper contributes to the growing number of historical accounts in the IS field...... by further developing the profile of European IS research that was reported on in EJIS following the first 10 years of the European Conference on Information Systems (ECIS). On the basis of an analysis of all papers published in ECIS proceedings during the 10-year period 2003–2012, the paper highlights three...... these observed characteristics within broader historical and contextual features such as the changing European academic landscape, with increasing pressures to ‘publish or perish’ in order to be internationally competitive. Our contribution lies in providing a contemporaneous account of the dominant contextual...

  7. Twenty years' experience of a telehealth service in the UK.

    Science.gov (United States)

    Mansfield, Peter

    2005-01-01

    Since 1996 a small call centre has been operated to provide instant self-help, non-medical advice to members. Non-clinical advisers work under a medical director. The scheme grew to 1,200 member-families from a regional catchment area, peaking at 2,500 across the country. About 30-50 telephone calls are received each day and up to 1,000 Web visits per day; about 20-50 postal items are sent out daily to members. In a telephone poll during 2001, half of our current members said that they used the National Health Service about 70% less than before they joined, but a third said that they used complementary and alternative medicines 80% more. Half had gained in confidence by about 50% in managing their own health. Members most often join for alternative medical help with a specific problem, but stay if they begin to appreciate the help we can give them in regaining and keeping health in the round. Our retention of new members for a second year is only 10-20%. The 'barefoot' profession of telehealth adviser appears to meet a community need.

  8. Insights from twenty years of bacterial genome sequencing

    Energy Technology Data Exchange (ETDEWEB)

    Land, Miriam L [ORNL; Hauser, Loren John [ORNL; Jun, Se Ran [ORNL; Nookaew, Intawat [ORNL; Leuze, Michael Rex [ORNL; Ahn, Tae-Hyuk [ORNL; Karpinets, Tatiana V [ORNL; Lund, Ole [Technical University of Denmark; Kora, Guruprasad H [ORNL; Wassenaar, Trudy [Molecular Microbiology & Genomics Consultants, Zotzenheim, Germany; Poudel, Suresh [ORNL; Ussery, David W [ORNL

    2015-01-01

    Since the first two complete bacterial genome sequences were published in 1995, the science of bacteria has dramatically changed. Using third-generation DNA sequencing, it is possible to completely sequence a bacterial genome in a few hours and identify some types of methylation sites along the genome as well. Sequencing of bacterial genome sequences is now a standard procedure, and the information from tens of thousands of bacterial genomes has had a major impact on our views of the bacterial world. In this review, we explore a series of questions to highlight some insights that comparative genomics has produced. To date, there are genome sequences available from 50 different bacterial phyla and 11 different archaeal phyla. However, the distribution is quite skewed towards a few phyla that contain model organisms. But the breadth is continuing to improve, with projects dedicated to filling in less characterized taxonomic groups. The clustered regularly interspaced short palindromic repeats (CRISPR)-Cas system provides bacteria with immunity against viruses, which outnumber bacteria by tenfold. How fast can we go? Second-generation sequencing has produced a large number of draft genomes (close to 90 % of bacterial genomes in GenBank are currently not complete); third-generation sequencing can potentially produce a finished genome in a few hours, and at the same time provide methlylation sites along the entire chromosome. The diversity of bacterial communities is extensive as is evident from the genome sequences available from 50 different bacterial phyla and 11 different archaeal phyla. Genome sequencing can help in classifying an organism, and in the case where multiple genomes of the same species are available, it is possible to calculate the pan- and core genomes; comparison of more than 2000 Escherichia coli genomes finds an E. coli core genome of about 3100 gene families and a total of about 89,000 different gene families. Why do we care about bacterial genome

  9. High Temperature Superconductivity in the Past Twenty Years Part 1-Discovery, Material, and Theory

    Institute of Scientific and Technical Information of China (English)

    Jian-Xun Jin

    2008-01-01

    Twenty years after the discovery of high- temperature superconductors (HTSs), the HTS mate- rials now have been well developed. Meanwhile the mechanism of superconductivity is still one of the topical interests in physics. The achievements made on HTS materials and theories during the last twenty years are reviewed comprehensively in this paper.

  10. Twenty Years of Systems Engineering on the Cassini-Huygens Mission

    Science.gov (United States)

    Manor-Chapman, Emily

    2013-01-01

    Over the past twenty years, the Cassini-Huygens Mission has successfully utilized systems engineering to develop and execute a challenging prime mission and two mission extensions. Systems engineering was not only essential in designing the mission, but as knowledge of the system was gained during cruise and science operations, it was critical in evolving operational strategies and processes. This paper discusses systems engineering successes, challenges, and lessons learned on the Cassini-Huygens Mission gathered from a thorough study of mission plans and developed scenarios, and interviews with key project leaders across its twenty-year history.

  11. Twenty years of the national program of surveillance radiation of the atmosphere and terrestrial environment; Veinte anos del programa nacional de vigilancia radiologica de la atmosfera y medio terrestre

    Energy Technology Data Exchange (ETDEWEB)

    Rey del Castillo, C.; Luque Heredia, S.; Marugan Tovar, I.; Salas Collantes, R.; Serling Carmona, A.; Lorente Lorente, P.; Ramos Salvador, L.

    2013-07-01

    This paper presents a global basis the information provided by the program in twenty years of operation, describing the main changes introduced and analyzing how they have influenced the results. The use of program data to inform and in response to questions from individuals or incidents is reviewed. And finally the prospects and major milestones expected to address in the next twenty years are described. (Author)

  12. A competing-risk-based score for predicting twenty-year risk of incident diabetes: the Beijing Longitudinal Study of Ageing study

    Science.gov (United States)

    Liu, Xiangtong; Chen, Zhenghong; Fine, Jason Peter; Liu, Long; Wang, Anxin; Guo, Jin; Tao, Lixin; Mahara, Gehendra; Yang, Kun; Zhang, Jie; Tian, Sijia; Li, Haibin; Liu, Kuo; Luo, Yanxia; Zhang, Feng; Tang, Zhe; Guo, Xiuhua

    2016-01-01

    Few risk tools have been proposed to quantify the long-term risk of diabetes among middle-aged and elderly individuals in China. The present study aimed to develop a risk tool to estimate the 20-year risk of developing diabetes while incorporating competing risks. A three-stage stratification random-clustering sampling procedure was conducted to ensure the representativeness of the Beijing elderly. We prospectively followed 1857 community residents aged 55 years and above who were free of diabetes at baseline examination. Sub-distribution hazards models were used to adjust for the competing risks of non-diabetes death. The cumulative incidence function of twenty-year diabetes event rates was 11.60% after adjusting for the competing risks of non-diabetes death. Age, body mass index, fasting plasma glucose, health status, and physical activity were selected to form the score. The area under the ROC curve (AUC) was 0.76 (95% Confidence Interval: 0.72–0.80), and the optimism-corrected AUC was 0.78 (95% Confidence Interval: 0.69–0.87) after internal validation by bootstrapping. The calibration plot showed that the actual diabetes risk was similar to the predicted risk. The cut-off value of the risk score was 19 points, marking mark the difference between low-risk and high-risk patients, which exhibited a sensitivity of 0.74 and specificity of 0.65. PMID:27849048

  13. Twenty Years of Research on RNS for DSP: Lessons Learned and Future Perspectives

    DEFF Research Database (Denmark)

    Albicocco, Pietro; Cardarilli, Gian Carlo; Nannarelli, Alberto;

    2014-01-01

    In this paper, we discuss a number of issues emerged from our twenty-year long experience in applying the Residue Number System (RNS) to DSP systems. In early days, RNS was mainly used to reach the maximum performance in speed. Today, RNS is also used to obtain powerefficient (tradeoffs speed...

  14. 38 CFR 8.31 - Total disability for twenty years or more.

    Science.gov (United States)

    2010-07-01

    ... AFFAIRS NATIONAL SERVICE LIFE INSURANCE Appeals § 8.31 Total disability for twenty years or more. Where the Disability Insurance Claims activity has made a finding of total disability for insurance purposes... will not be discontinued thereafter, except upon a showing that such a determination was based on fraud...

  15. Quiet Riots: Race and Poverty in the United States. The Kerner Report Twenty Years Later.

    Science.gov (United States)

    Harris, Fred R., Ed.; Wilkins, Roger W., Ed.

    This book grew out of the national conference "The Kerner Commission: Twenty Years Later." The Kerner Commission found in its 1968 Report that America was moving toward two separate and unequal societies, divided along racial lines, and that major efforts to combat poverty, unemployment, and racism were mandated. The essays in this book…

  16. Seymour Sarason in Memorial: Prospects for Community and Social Change

    Science.gov (United States)

    Maton, Kenneth I.

    2012-01-01

    Seymour Sarason passed away on January 10, 2010 at the age of 91. He was the author of more than 40 books, including The Culture of the School and the Problem of Change (1971), The Creation of Settings and the Future Societies (1972), and The Psychological Sense of Community: Prospects for a Community Psychology (1974). His groundbreaking ideas…

  17. Twenty Years of Evolutionary Change in the Department of Defense’s Civil Support Mission

    Science.gov (United States)

    2013-05-23

    should include the foregoing statement.) ii ABSTRACT TWENTY YEARS OF EVOLUTIONARY CHANGE IN THE DEPARTMENT OF DEFENSE’S... gasping for air flooded television and print outlets across the globe. The casualty figures from the attack included twelve dead, fifty four...Biological Incident Response Force, II Marine Expeditionary Force, Indian Head, MD,” Marines: The Official Website of the United States Marine Corps

  18. A Brief Analysis of O. Henry’s Writing Characteristics in"After Twenty Years"

    Institute of Scientific and Technical Information of China (English)

    王忠林

    2014-01-01

    O. Henry was one of the three world’s masters of short stories. He was known as the father of the modern American short stories. Even till today O. Henry’s short stories still enjoy a lot of popularity. This article analyzes the writing characteristics of O. Henry’s short stories by probing into one of his short stories"After Twenty Years".

  19. [Discirculatory encephalopathy in liquidators of the Chernobyl nuclear power station: a twenty-year study].

    Science.gov (United States)

    Podsonnaia, I V; Shumakher, G I; Golovin, V A

    2009-01-01

    A comparative twenty-year study of 536 liquidators of the Chernobyl nuclear disaster and 436 patients without radiation anamnesis has been carried out. Discirculatory encephalopathy (DE) was more often developed in subjects exposed to radiation at the age 30 years. Compared to individuals from the general population, it is characterized by the earlier onset, malignant progression, rapid increase of signs of cerebral affection during the first two years after exposure to radiation, stability of clinical symptoms during the following 5-6 years and further progressive cerebral decompensation with early autonomic dysfunction, psychoorganic syndrome, epilepsy. Moreover, severe stroke is a common complication of DE in liquidators.

  20. Twenty years' application of agricultural countermeasures following the Chernobyl accident: lessons learned

    Energy Technology Data Exchange (ETDEWEB)

    Fesenko, S V [International Atomic Energy Agency, 1400 Vienna (Austria); Alexakhin, R M [Russian Institute of Agricultural Radiology and Agroecology, 249020 Obninsk (Russian Federation); Balonov, M I [International Atomic Energy Agency, 1400 Vienna (Austria); Bogdevich, I M [Research Institute for Soil Science and Agrochemistry, Minsk (Belarus); Howard, B J [Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LAI 4AP (United Kingdom); Kashparov, V A [Ukrainian Institute of Agricultural Radiology (UIAR), Mashinostroiteley Street 7, Chabany, Kiev Region 08162 (Ukraine); Sanzharova, N I [Russian Institute of Agricultural Radiology and Agroecology, 249020 Obninsk (Russian Federation); Panov, A V [Russian Institute of Agricultural Radiology and Agroecology, 249020 Obninsk (Russian Federation); Voigt, G [International Atomic Energy Agency, 1400 Vienna (Austria); Zhuchenka, Yu M [Research Institute of Radiology, 246000 Gomel (Belarus)

    2006-12-15

    The accident at the Chernobyl NPP (nuclear power plant) was the most serious ever to have occurred in the history of nuclear energy. The consumption of contaminated foodstuffs in affected areas was a significant source of irradiation for the population. A wide range of different countermeasures have been used to reduce exposure of people and to mitigate the consequences of the Chernobyl accident for agriculture in affected regions in Belarus, Russia and Ukraine. This paper for the first time summarises key data on countermeasure application over twenty years for all three countries and describes key lessons learnt from this experience. (review)

  1. Elevated dioxin levels in chloracne cases twenty years after the Seveso, Italy accident

    Energy Technology Data Exchange (ETDEWEB)

    Baccarelli, A.; Pesatori, A.C.; Consonni, D.; Bonzini, M.; Giacomini, S.M.; Bertazzi, P.A. [EPOCA Research Center, Univ. of Milan (Italy); Mocarelli, P. [Dept. of Lab. Medicine, Univ. of Milan-Bicocca, Desio (Italy); Patterson, D.G. Jr. [Centers for Disease Control and Prevention, Atlanta, GA (United States); Caporaso, N.E.; Landi, M.T. [Div. of Cancer Epidemiology and Genetics, National Cancer Inst., NIH, DHHS, Bethesda, MD (United States)

    2004-09-15

    In July 1976, an industrial accident contaminated a residential area surrounding Seveso, Italy, with high levels of 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD). The exposure was acute, relatively pure, and affected more than 45,000 men, women, and children. By February 1978, 193 chloracne cases, mostly children, had been identified in the exposed population. Twenty years after, we conducted a case-control study on subjects diagnosed with chloracne and control subjects, who had not developed chloracne after the accident, to evaluate their TCDD plasma levels, as well as the exposure-response relationship and possible determinants of susceptibility to TCDD effects in this population.

  2. Proceedings: Twenty years of energy policy: Looking toward the twenty-first century

    Energy Technology Data Exchange (ETDEWEB)

    1992-12-31

    In 1973, immediately following the Arab Oil Embargo, the Energy Resources Center, University of Illinois at Chicago initiated an innovative annual public service program called the Illinois Energy Conference. The objective was to provide a public forum each year to address an energy or environmental issue critical to the state, region and nation. Twenty years have passed since that inaugural program, and during that period we have covered a broad spectrum of issues including energy conservation nuclear power, Illinois coal, energy policy options, natural gas, alternative fuels, new energy technologies, utility deregulation and the National Energy Strategy.

  3. Twenty years of „post-communism”: the radiography of a political failure

    Directory of Open Access Journals (Sweden)

    Aurora Martin

    2011-11-01

    Full Text Available This empirical view on the current „state” of Romania has as main objective to emphasize that the contemporary economic crisis actually revealed some other escalated crises in the very heart of the Romanian society. The vicious circle determined by three crises – one political, another social-institutional and last, but not least, a cultural one, continuously weakened the state for the last twenty years. Romania will overcome the economic crisis but the key for walking out of the above-mentioned circle would be the real transformation of its core systems – political, institutional and educational.

  4. The role of AGG interruptions in fragile X repeat expansions: A twenty year perspective

    Directory of Open Access Journals (Sweden)

    Gary J. Latham

    2014-07-01

    Full Text Available In 1994 it was suggested that AGG interruptions affect the stability of the fragile X triplet repeat. Until recently, however, this hypothesis was not explored on a large scale due primarily to the technical difficulty of determining AGG interruption patterns of the two alleles in females. The recent development of a PCR technology that overcomes this difficulty and accurately identifies the number and position of AGGs has led to several studies that examine their influence on repeat stability. Here we present a historical perspective of relevant studies published during the last twenty years on AGG interruptions and examine those recent publications that have refined risk estimates for repeat instability and full mutation expansions.

  5. Twenty Years of Co-operation between Spain and France: Friends, Partners or Allies?

    Directory of Open Access Journals (Sweden)

    Laia Mestres i Camps

    2006-11-01

    Full Text Available The progress made in the relations between France and Spain at the 18th Spanish- French Summit, held in Paris on 10 November 2005, demonstrate that relations between France and Spain are passing through a good moment, and at the same time it allows us to go deeper into the analysis of the co-operation between these two neighbours over the past twenty years. This article aims to examine the evolution of relations between Spain and France, which must administer a dense bilateral agenda as neighbours and anothermultilateral agenda as European partners. In other words, it will analyse the extent to which French-Spanish relations can become a balanced, stable alliance.

  6. Twenty-Year Optical Variability of The Blazar PKS 1749+096: Exponential Outbursts?

    Science.gov (United States)

    Balonek, Thomas J.; Lam, M. T.; Patrick, P. A.; Scott, E. L.; Kaercher, A. J.; Rupert, J.; Taber, T.; Hegel, P.; Tam, Y. H. N.; Morin, A.; Levandowski, K.; Graber, E. L.; Quirk, T. S.

    2011-01-01

    We present the twenty-year R-band optical variability light curve for the BL Lac type quasar PKS 1749+096. We investigate the characteristic timescales and intensity of outbursts and flares by fitting exponential profiles to the variations. PKS 1749+096 underwent strong optical outbursts during the summers of 2007 and 2008, reaching its brightest optical level in two decades, and exhibited an inactive period during summer 2009. We compare these two outbursts with lower amplitude well-sampled variations in 2000 through 2003. Observations were obtained as part of the intensive blazar variability monitoring program at the Colgate University Foggy Bottom Observatory (FBO). We gratefully acknowledge support for student research through an REU grant to the Keck Northeast Astronomy Consortium from the National Science Foundation, the NASA / New York Space Grant, and the Justus and Jayne Schlichting Student Research Fund at Colgate University.

  7. [Development of health promotion in Brazil in the last twenty years (1988-2008)].

    Science.gov (United States)

    Buss, Paulo Marchiori; Carvalho, Antonio Ivo de

    2009-01-01

    This paper examines the institutionalization of health promotion (HP) in Brazil in the twenty years following the proclamation of the 1988 Brazilian Constitution. The legal and institutional foundations of HP are delineated, as well as its recent reassertion as a national policy. Moreover, the praxis of HP within the health system and other instances are analyzed, and the institutional capacity building - by means of research and training of human resources - is examined. Around 100 papers were revised, including institutional policy documents, decrees, laws, and annals of congresses and other events. The authors' personal experience in the ideational conception of the area and in the institutionalization of health promotion as a public policy in the country was also drawn upon. Finally, major restrictions to the theoretical and practical development of health promotion are criticized and a few ideas that might benefit such development are presented.

  8. [Comparison of 51 element contents in normal human lung tissue over twenty years].

    Science.gov (United States)

    Zeng, Jing; Ouyang, Li; Wang, Xiao-Yan; Liu, Ya-Qiong; Xie, Qing; Chu, Hong-Da; Wu, Quan; Fan, Ti-Qiang; Wang, Jing-Yu

    2008-05-01

    Changes in content and distribution of elements in human tissues may reflect changes in environmental backgrounds, and are closely related to human health. To investigate the change in element background in normal lung tissue in different stage, we used ICP-MS, ICP-AES and GFAAS to determine 51 element contents in normal human lung samples of 1982-83 year (n = 7) and compare with those of 2004-05 year (n = 16). Samples were from healthy male adults who died suddenly, and were treated with microwave digestion and wet digestion method. The results show that the contents of 23 elements (Na, Mg, P, K, As, Mo, Ag, Ba, Bi, Y, La, Ce, Pr, Nd, Sm, Gd, Tb, Dy, Ho, Er, Tm, Yb and Lu) are significantly higher, and 6 elements (Zn, Ga, Ge, Se, Au and Zr) are significantly lower in the 2004-05 samples than those in the 1982-83 samples. This difference would be related to the changes in environmental backgrounds and people's living habit during twenty years. The distinctive decrease in contents of the 2004-05 samples for most measured rare earth elements (REEs) may be due to more rational usage of REEs in present, while were the soil and corps were largely abused in 1980s in China. The significant increase in contents of some useful micro-elements (Zn and Se ) in the present samples maybe because of the increased intake of these elements as people own more health consciousness. Besides, the increased contents of heavy metal Pb, Cd, Cr and Ni in the present samples may be related to the deterioration of air quality as industrialization course. More than half of measured elements have been significantly changed over twenty years, indicating that some normal value ranges of element contents should be adjusted according to the difference.

  9. Twenty years of ecosystem response after clearcutting and slashburning in conifer forests of central British Columbia, Canada

    Science.gov (United States)

    Feller, Michael; Bradfield, Gary

    2017-01-01

    Forests are being clearcut over extensive areas of western North America, but plant community response to harvesting and slashburning under varying climatic conditions in central British Columbia, Canada is still largely unknown. Evaluation of resilience is hampered by the short history of logging, lack of long-term experiments and methodological limitations. To test the effect of clearcut logging, prescribed burning and reforestation on forest resilience, we recorded vascular plant cover repeatedly after treatment between 1981 and 2008 in 16 permanent research installations in three biogeoclimatic zones: Engelmann Spruce-Subalpine Fir, Interior Cedar-Hemlock and Sub-Boreal Spruce. We created a plant-trait dataset for the 181 recorded species to define plant functional types representing groups of plants that behave in similar ways and/or produce similar ecological outcomes. These plant functional types, along with taxonomic analysis of diagnostic and indicator species, were then used to evaluate plant community response to disturbance. Twenty years post-treatment, species diversity increased in all zones and plant abundance was greatest in the Interior Cedar-Hemlock. Cover of understory plant functional types associated with mature conifer forests increased in all zones, constituting a significant proportion (> 40%) of the vegetation community by year 20. Response patterns varied by zone and with time. Understory species diagnostic of mature forests were present in all zones by year 20, but we identified indicator species sensitive to slashburning or requiring more time for recovery, including white-flowered rhododendron (Rhododendron albiflorum) and devil's club (Oplopanax horridus). Overall, loss of compositional or functional diversity following harvest and site remediation was not detected, suggesting that montane and subalpine forests in British Columbia are resilient to this treatment. However, because these forests can be slow to recover from disturbance

  10. B. F. Skinner’s legacy twenty years after (1990-2010: Behavior analysis in Ibero-America

    Directory of Open Access Journals (Sweden)

    Wilson M. López López

    2010-01-01

    Full Text Available Twenty years after his death (August 18th 1990,B. F. Skinner leaves five major living legacies: 1radical behaviorism; 2 the experimental analysis ofbehavior; 3 applied behavior analysis; 4 the Skinnerbox; 5 the Horcones community (Mexico.Behavior analysis is recognized for its internationalactive presence. Its growth provides a set of opportunitiesfor knowledge and technology transferenceand reminds us the importance of working for thedevelopment of educational and research programsand the arrangement of contingencies which enableits advance. In Ibero-America, behavior analysis, asa Skinnerian legacy, has been an important traditionwithin psychology. In this article we will presenta current synthesis of the central Ibero-Americancontributions to Behavior analysis. The panoramaof Behavior analysis in Ibero-America will beanalyzed according to the following dimensions:1 the most relevant figures; 2 the academic communityrelated to the Behavior Analytic tradition;and 3 the most important research lines. Finally,some of the most general characteristics of Ibero-American Behavior analysis are included.

  11. Health of Europeans twenty years after the fall of Berlin wall.

    Science.gov (United States)

    Ginter, E; Simko, V

    2010-01-01

    The failure of central planning in the totalitarian systems of the USSR and its satellites adversely affected not only the economy and social relations but also the population health. While in the countries with established democracy (DEM) the general health and the life expectancy (LE) steadily improved, in countries declaring socialism (SOC) the LE was stagnant and in the USSR even decreased. Dramatic changes in Russia after the demise of Soviet Union resulted in an extraordinary destabilization of LE that reached a minimum in 1994. Remarkably, even twenty years after the breakdown of the Iron Curtain there persists a gap in the general health between the DEM and the SOC regions of Europe. Within the territory of the former Soviet influence there are additional differences in LE: Central Europe is much better off than Russia and its neighbours. Main cause of relatively high mortality in the post totalitarian Europe is the cardiovascular disease (CVD). Among females about 80% difference in LE between DEM and SOC countries is related to premature CVD mortality. In SOC males compared to DEM, about 50% of the higher mortality is caused by CVD, 20% is related to external factors (trauma, suicide) and 10% is oncologic disorders. The main suggested cause of such excess mortality, besides a low socioeconomic level and limited funding for health care, is an improper life style: alcoholism, smoking and inadequate intake of protective nutrients. Alcoholism, especially binge drinking is a prominent factor in Russia, Belarus, Ukraine and in the Baltic Republics (Fig. 6, Tab. 4, Ref. 20).

  12. [The first Obesity Unit in Czechoslovakia was established twenty years ago].

    Science.gov (United States)

    Hainer, V; Kunesová, M; Stich, V

    2009-01-01

    The first Obesity Unit in former Czechoslovakia was established at the Fourth Department of Internal Medicine of the Faculty of General Medicine and Faculty Hospital I twenty years ago. Both personal resources (physicians specialized in metabolism and obesity, psychologist, dietician, physiatrist and medical nurses trained in the care of obese patients) and diagnostic tools (body composition assessment by hydrodensitometry, determination of energy expenditure by indirect calorimetry, evaluation of energy and nutrient intake by PC assessment of dietary records, hormonal and biochemical examinations etc.) enabled comprehensive examinations of obese patients. Obesity unit included a specialized in-patient department where the patients with severe and complicated obesity underwent a comprehensive treatment programme which consisted of very low energy diet developed in collaboration with the Obesity Unit. The article summarizes not only clinical experiences of the unit but also its engagement in education on obesity, in research projects and international collaboration over the past 20-years period. Obesity unit succeeded to keep its continuity in spite of repeated moving between 1997-2002. Since 2002 Obesity Unit has been a part of the Institute of Endocrinology which provided additional modern facilities for hormonal and molecular genetic examinations.

  13. Twenty years of experience with the rabbit model, a versatile model for tracheal transplantation research

    Institute of Scientific and Technical Information of China (English)

    Margot Den Hondt; Bart M Vanaudenaerde; Pierre Delaere; Jan J Vranckx

    2016-01-01

    Pathologies comprising more than half the length of the trachea are a challenge to the reconstructive surgeon. Innovative tracheal transplantation techniques aim to offer the patient a curative solution with a sustained improvement in quality of life. This review summarizes the authors’ experience with the rabbit as a versatile model for research regarding tracheal transplantation. Because of the segmental blood supply of the trachea, it is not feasible to transplant the organ together with a well-defined vascular pedicle. As such, the key element of successful tracheal transplantation is the creation of a new blood supply. This vascularized construct is created by prelaminating the rabbit trachea heterotopically, within the lateral thoracic fascia. After prelamination, the construct and its vascular pedicle are transferred to the orthotopic position in the neck. This model has become gold standard because of the advantages of working with rabbits, the anatomy of the rabbit trachea, and the reliability of the lateral thoracic artery flap. In this paper, the key elements of surgery in the rabbit are discussed, as well as the tracheal anastomosis and the harvest of the lateral thoracic artery flap. Practical tips and tricks are presented. The data described in this review represent the fundaments of ongoing translational research in the center over the past twenty years.

  14. Twenty Years of Ablative Photodecomposition (Industrial Applications of Physics Prize Lecture)

    Science.gov (United States)

    Srinivasan, Rangaswamy

    2004-03-01

    It was a little over twenty years ago that two groups, one in the U.S. and another in Hull, U.K. working independently, reported that ultraviolet laser pulses of nanosecond duration were capable of etching organic polymer films without any need for further development.In 1982, our group at the IBM Research Center which studied this phenomenon at 193nm named the process "Ablative Photodecomposition". Dyer and his group in Hull reported similar results at 248nm and 308nm in 1983. We also showed that the process worked well in the etching of tissue and had the potential to be of use in surgery since there was no detectable heat damage around the exposed area. These reports led to a burst of activity from numerous groups all over the world which has not slowed down significantly to the present day. The driving force behind the activity was and continues to be the potential for applications in several areas of computer hardware technology as well as in corneal refractive surgery. Today these applications can be said to be firmly in place and well-accepted. Strangely, the science behind the process is still a subject for serious discussion. The reason for this is the mix of physicists, chemists, medical doctors and engineers who have stepped into the debate. The result is a true 'Babel' which will be pointed out.

  15. Twenty years of renewable energy law; 20 Jahre Recht der Erneuerbaren Energien

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Thorsten (ed.)

    2012-07-01

    The present volume was compiled as part of a project funded by the German Federal Ministry for Environment, Nature Conservation and Reactor Safety, one event under which was the seventh Wuerzburg conference on environmental energy law with the title ''Twenty Years of Renewable Energy Law'' which took place on 13/14 October 2010. It comprises 36 contributions which, from different scientific perspectives, take stock of the significance of renewable energies for climate protection and the energy supply, examine the developments of the past 20 years and draw conclusions for the future use of renewable energy. The authors are scientists from the areas of climate research, economics, political science, engineering, environmental psychology and jurisprudence who have dedicated their work to issues that directly or indirectly relate to the expansion of renewable energies. Together they have created an overall picture of renewable energies with its many different aspects and related topics, a picture that necessarily cannot be complete but which nevertheless provides many rich insights. The great majority of articles were written around the turn of the year to 2011, just after the granting of lifetime extension for German nuclear power plants. They thus only take sparse account of the diverse and for some part far-reaching changes in German energy policy that came about after the reactor disaster in Fukushima.

  16. Personal networks and mortality risk in older adults: a twenty-year longitudinal study.

    Directory of Open Access Journals (Sweden)

    Lea Ellwardt

    Full Text Available Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investigate whether effects on and pathways to mortality risk differ between functional and structural characteristics of the personal network. The objective is to inquire which personal network characteristics are the best predictors of mortality risk after adjustment for mental, cognitive and physical health.Empirical tests were carried out by combining official register information on mortality with data from the Longitudinal Aging Study Amsterdam (LASA. The sample included 2,911 Dutch respondents aged 54 to 85 at baseline in 1992 and six follow-ups covering a time span of twenty years. Four functional characteristics (emotional and social loneliness, emotional and instrumental support and four structural characteristics (living arrangement, contact frequency, number of contacts, number of social roles of the personal network as well as mental, cognitive and physical health were assessed at all LASA follow-ups. Statistical analyses comprised of Cox proportional hazard regression models. Findings suggest differential effects of personal network characteristics on survival, with only small gender differences. Mortality risk was initially reduced by functional characteristics, but disappeared after full adjustment for the various health variables. Mortality risk was lowest for older adults embedded in large (HR = 0.986, 95% CI 0.979-0.994 and diverse networks (HR = 0.948, 95% CI 0.917-0.981, and this effect continued to show in the fully adjusted models.Functional characteristics (i.e. emotional and social loneliness are indirectly associated with a reduction in mortality risk, while structural characteristics (i.e. number of contacts and number of social roles have

  17. Higher Alu methylation levels in catch-up growth in twenty-year-old offsprings.

    Directory of Open Access Journals (Sweden)

    Kittipan Rerkasem

    Full Text Available Alu elements and long interspersed element-1 (LINE-1 or L1 are two major human intersperse repetitive sequences. Lower Alu methylation, but not LINE-1, has been observed in blood cells of people in old age, and in menopausal women having lower bone mass and osteoporosis. Nevertheless, Alu methylation levels also vary among young individuals. Here, we explored phenotypes at birth that are associated with Alu methylation levels in young people. In 2010, 249 twenty-years-old volunteers whose mothers had participated in a study association between birth weight (BW and nutrition during pregnancy in 1990, were invited to take part in our present study. In this study, the LINE-1 and Alu methylation levels and patterns were measured in peripheral mononuclear cells and correlated with various nutritional parameters during intrauterine and postnatal period of offspring. This included the amount of maternal intake during pregnancy, the mother's weight gain during pregnancy, birth weight, birth length, and the rate of weight gain in the first year of life. Catch-up growth (CUG was defined when weight during the first year was >0.67 of the standard score, according to WHO data. No association with LINE-1 methylation was identified. The mean level of Alu methylation in the CUG group was significantly higher than those non-CUG (39.61% and 33.66 % respectively, P < 0.0001. The positive correlation between the history of CUG in the first year and higher Alu methylation indicates the role of Alu methylation, not only in aging cells, but also in the human growth process. Moreover, here is the first study that demonstrated the association between a phenotype during the newborn period and intersperse repetitive sequences methylation during young adulthood.

  18. Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital

    Directory of Open Access Journals (Sweden)

    Leonardo Augusto Miana

    2014-09-01

    Full Text Available Introduction: Cardiac transplantation remains the gold standard for end-stage cardiomyopathies and congenital heart defects in pediatric patients. Objective: This study aims to report on 20 years of experience since the first case and evaluate our results. Methods: We conducted a retrospective analysis of the database and outpatient follow-up. Between October 1992 and April 2012, 109 patients underwent 114 transplants. 51.8% of them being female. The age of patients ranged from 12 days to 21 years with a mean of 8.8±5.7 years and a median of 5.2 years. The underlying diagnosis was dilated cardiomyopathy in 61.5%, congenital heart disease in 26.6% and restrictive cardiomyopathy in 11.9%. All patients above 17 years old had congenital heart disease. Results: Survival rate at 30 days, 1, 5, 10, 15, and 20 years were 90.4%, 81.3%, 70.9%, 60.5%, 44.4% and 26.7%, respectively. Mean cold ischemic time was 187.9 minutes and it did not correlate with mortality (P>0.05. Infectious complications and rejection episodes were the most common complications (P<0.0001, occurring, respectively, in 66% and 57.4% of the survivors after 10 years. There was no incidence of graft vascular disease and lymphoproliferative disease at year one, but they affected, respectively, 7.4% and 11% of patients within 10 years. Conclusion: Twenty-year pediatric heart transplant results at our institution were quite satisfactory and complication rates were acceptable.

  19. Some Observations on Cultural Opposites in Contemporary China: Kunming and Beijing Twenty Years Later

    Directory of Open Access Journals (Sweden)

    Vesna Vučinić-Nešković

    2016-02-01

    Full Text Available This paper considers the cultural opposites observed in various segments of Chinese culture during the author's three stays in China over a period of twenty years. The first and second stay, in 1986 and 1989 respectively, coincided with the initial period of the implementation of modernization reforms in China, when their results were just beginning to be felt. The third stay was in 2009, towards the end of the third decade of reform implementation, at the time of an already developed marketoriented communism. The paper's main thesis is that most of the phenomena observed in present-day urban China can be assigned to opposite categories, namely Chinese-Western and traditional- contemporary. Cultural opposites have been observed in the sphere of tourism and the behavior of both Chinese and foreign visitors, in the use of Chinese and English in notices and signs in public places, and in the promotion of traditional and modern architecture. In addition, they have been noted in the presentation of arts and crafts and industrial products, in the manner of consumption of hot drinks, and in the combining of Chinese and foreign cuisine. They are also evident in a Beijing Opera performance adapted both to the modern Chinese and to foreigners, and in the traditional Chinese exercises and western dances performed in public parks. In conclusion, the paper suggests that the process of establishing connections between China and the West is being carried on in a moderate and controlled way. In the globalization process cultural opposites coexist and merge, imparting new features to Chinese culture.

  20. Twenty Years of Litter and Root Manipulations: Insights into Multi-Decadal SOM Dynamics and Controls

    Science.gov (United States)

    Wig, J.; Lajtha, K.; Nadelhoffer, K. J.

    2012-12-01

    Reforestation, reducing deforestation, and sustainable forest management are often recommended by policy makers to mitigate the greenhouse gas contributions of the forestry sector. However, underlying many of these policy recommendations is the assumption that increasing above-ground carbon stocks corresponds to long-term increases in ecosystem carbon stocks, the majority of which is stored in soils. We analyzed soil carbon and nitrogen dynamics in forest soils that had undergone twenty years of continuous manipulations of above- and below-ground organic inputs as part of the Detritus Input and Removal Treatment (DIRT) network. Although we expected that increased C inputs would correspond to significantly elevated C in surface mineral soils, our data suggest that increasing above-ground litter inputs has had a positive priming effect in this soil. Positive priming occurs when increased rates of litter addition to soil lead to disproportionate increases in microbial respiration rates of native soil C, resulting in a net decrease of soil C. Soil respiration rates in a year-long laboratory incubation support this theory: increased above-ground litter inputs led to decreased respiration rates, suggesting a relative deficit of labile organic matter. Removal of below ground inputs, either with or without above-ground litter inputs, also led to decreased respiration in laboratory incubations, demonstrating the importance of fresh root inputs to labile C. Trends in non-hydrolyzable C fractions, a proxy for the more stable C pool, agree with our respiration measurements. Data from sequential density fractionation are consistent with the hypotheses that priming has occurred in response to increased above-ground litter inputs and that root inputs are an important control of the labile C pool. The importance of roots inputs for C stabilization is well documented in the literature, and our hypothesis that increased above-ground litter inputs leads to priming is supported by

  1. Twenty -year post-treatment assessment of class II division 1 malocclusion treated with non-extraction approach

    Directory of Open Access Journals (Sweden)

    Ashok Karad

    2013-01-01

    This article describes twenty-year post-treatment assessment of a class II division 1 malocclusion case, treated in the late mixed dentition stage, with the non-extraction treatment approach - molar-inserted headgear along with a fixed appliance therapy.

  2. Conditioning of cooling water in power stations. Feedback from twenty years of experience with acid feeding

    Energy Technology Data Exchange (ETDEWEB)

    Goffin, C.; Duvivier, L.; Girasa, E. [LABORELEC, Chemistry of Water (Belgium); Brognez, J. [ELECTRABEL, TIHANGE Nuclear Power Station (Belgium)

    2002-07-01

    solution is no longer easily justifiable. The research efforts undertaken to better understand and control calcium carbonate precipitation and scale formation have paid off and have resulted in the standardisation of the treatment process and the control procedure of the cooling circuits by ELECTRABEL. The initial experience gained in the fossil power plants of AMERCOEUR (2 x 125 MW units) was finally successfully applied to plants 2 and 3 at TIHANGE. Since then, all of the conventional or combined cycle power plants have adopted the same treatment philosophy. Six units of between 125 and 1000 MW have been treated in this manner, some of them for over twenty years, without showing any signs of scale deposits. It is true that adaptations have had to be made in the control recommendations defined during the pilot trials, in order to allow for the impact of cathodic protections and certain cooling tower fills. (authors)

  3. Solar photochemistry - twenty years of progress, what`s been accomplished, and where does it lead?

    Energy Technology Data Exchange (ETDEWEB)

    Blake, D M

    1995-01-01

    It has been more than 20 years since the first oil embargo. That event created an awareness of the need for alternative sources of energy and renewed interest in combining sunlight and chemistry to produce the chemicals and materials required by industry. This paper will review approaches that have been taken, progress that has been made, and give some projections for the near and longer term prospects for commercialization of solar photochemistry.

  4. Community Water Fluoridation and Intelligence: Prospective Study in New Zealand.

    Science.gov (United States)

    Broadbent, Jonathan M; Thomson, W Murray; Ramrakha, Sandhya; Moffitt, Terrie E; Zeng, Jiaxu; Foster Page, Lyndie A; Poulton, Richie

    2015-01-01

    Objectives. This study aimed to clarify the relationship between community water fluoridation (CWF) and IQ. Methods. We conducted a prospective study of a general population sample of those born in Dunedin, New Zealand, between April 1, 1972, and March 30, 1973 (95.4% retention of cohort after 38 years of prospective follow-up). Residence in a CWF area, use of fluoride dentifrice and intake of 0.5-milligram fluoride tablets were assessed in early life (prior to age 5 years); we assessed IQ repeatedly between ages 7 to 13 years and at age 38 years. Results. No clear differences in IQ because of fluoride exposure were noted. These findings held after adjusting for potential confounding variables, including sex, socioeconomic status, breastfeeding, and birth weight (as well as educational attainment for adult IQ outcomes). Conclusions. These findings do not support the assertion that fluoride in the context of CWF programs is neurotoxic. Associations between very high fluoride exposure and low IQ reported in previous studies may have been affected by confounding, particularly by urban or rural status.

  5. Twenty years of society of medical informatics of b&h and the journal acta informatica medica.

    Science.gov (United States)

    Masic, Izet

    2012-03-01

    In 2012, Health/Medical informatics profession celebrates five jubilees in Bosnia and Herzegovina: a) Thirty five years from the introduction of the first automatic manipulation of data; b) Twenty five years from establishing Society for Medical Informatics BiH; c) Twenty years from establishing scientific and professional journal of the Society for Medical Informatics of Bosnia and Herzegovina "Acta Informatica Medica"; d) Twenty years from establishing first Cathdra for Medical Informatics on biomedical faculties in Bosnia and Herzegovina and e) Ten years from the introduction of "Distance learning" in medical curriculum. All of the five mentioned activities in the area of Medical informatics had special importance and gave appropriate contribution in the development of Health/Medical informatics in Bosnia And Herzegovina.

  6. Twenty Years of Schizophrenia Research in the Northern Finland Birth Cohort 1966: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Erika Jääskeläinen

    2015-01-01

    Full Text Available Birth cohort designs are useful in studying adult disease trajectories and outcomes, such as schizophrenia. We review the schizophrenia research performed in the Northern Finland Birth Cohort 1966 (NFBC 1966, which includes 10,934 individuals living in Finland at 16 years of age who have been monitored since each mother’s mid-pregnancy. By the age of 44, 150 (1.4% had developed schizophrenia. There are 77 original papers on schizophrenia published from the NFBC 1966. The early studies have found various risk factors for schizophrenia, especially related to pregnancy and perinatal phase. Psychiatric and somatic outcomes were heterogeneous, but relatively poor. Mortality in schizophrenia is high, especially due to suicides. Several early predictors of outcomes have also been found. Individuals with schizophrenia have alterations in brain morphometry and neurocognition, and our latest studies have found that the use of high lifetime doses of antipsychotics associated with these changes. The schizophrenia research in the NFBC 1966 has been especially active for 20 years, the prospective study design and long follow-up enabling several clinically and epidemiologically important findings. When compared to other birth cohorts, the research in the NFBC 1966 has offered also unique findings on course and outcome of schizophrenia.

  7. Detailed prospective peer review in a community radiation oncology clinic.

    Science.gov (United States)

    Mitchell, James D; Chesnut, Thomas J; Eastham, David V; Demandante, Carlo N; Hoopes, David J

    In 2012, we instituted detailed prospective peer review of new cases. We present the outcomes of peer review on patient management and time required for peer review. Peer review rounds were held 3 to 4 days weekly and required 2 physicians to review pertinent information from the electronic medical record and treatment planning system. Eight aspects were reviewed for each case: 1) workup and staging; 2) treatment intent and prescription; 3) position, immobilization, and simulation; 4) motion assessment and management; 5) target contours; 6) normal tissue contours; 7) target dosimetry; and 8) normal tissue dosimetry. Cases were marked as, "Meets standard of care," "Variation," or "Major deviation." Changes in treatment plan were noted. As our process evolved, we recorded the time spent reviewing each case. From 2012 to 2014, we collected peer review data on 442 of 465 (95%) radiation therapy patients treated in our hospital-based clinic. Overall, 91 (20.6%) of the cases were marked as having a variation, and 3 (0.7%) as major deviation. Forty-two (9.5%) of the cases were altered after peer review. An overall peer review score of "Variation" or "Major deviation" was highly associated with a change in treatment plan (P peer review. Indicators on position, immobilization, simulation, target contours, target dosimetry, motion management, normal tissue contours, and normal tissue dosimetry were significantly associated with a change in treatment plan. The mean time spent on each case was 7 minutes. Prospective peer review is feasible in a community radiation oncology practice. Our process led to changes in 9.5% of cases. Peer review should focus on technical factors such as target contours and dosimetry. Peer review required 7 minutes per case. Published by Elsevier Inc.

  8. No Memory, No Future: Memoirs of Sephardic Women Published in the Past Twenty Years

    Directory of Open Access Journals (Sweden)

    Romeu Ferré, Pilar

    2008-12-01

    Full Text Available Throughout the 20th century, as well as in these early years of the 21th, several memoirs, autobiographical novels and orally-transmitted testimonies by Sephardic Jews have been published. These people knew the traditional community lifestyle of the Ottoman Empire before living through the social, cultural and political changes around the turn of the 20th century which brought about the decomposition of their Sephardic communities. Later they recreate —often in the new countries where they settled— this world that disappeared. The author analyzes here more than a dozen of such works, published by Sephardic women between 1987 and 2006. She calls attention to the way these women reconstruct their past and their identity in evoking the lifestyle, manners and customs of their original communities. Their testimonies differ significantly from those of the men, especially with regard to subjects such as family and social relationships.A lo largo del siglo XX y en lo que va del XXI se han publicado muchos libros de memorias, novelas autobiográficas y testimonios de historia oral de judíos sefardíes. Son gentes que conocieron la vida tradicional de las comunidades del antiguo imperio otomano, experimentaron los cambios sociales, culturales y políticos del paso de los siglos XIX al XX y la descomposición de las comunidades. Hoy recrean —la mayor parte de las veces, desde los nuevos países de emigración— ese mundo ya desaparecido. En este artículo la autora analiza una docena larga de este tipo de obras, publicadas por mujeres sefardíes entre 1987 y 2006. Enfatiza cómo estas mujeres reconstruyen su pasado y su identidad, evocando la vida, los usos y las costumbres de sus comunidades. Sus descripciones difieren sustancialmente de las de los hombres, en especial en lo que atañe a las relaciones familiares y sociales.

  9. Twenty Years of Data Management in the British Atmospheric Data Centre

    Directory of Open Access Journals (Sweden)

    Sam Pepler

    2015-06-01

    Full Text Available The British Atmospheric Data Centre (BADC has existed in its present form for 20 years, having been formally created in 1994. It evolved from the GDF (Geophysical Data Facility, a SERC (Science and Engineering Research Council facility, as a result of research council reform where NERC (Natural Environment Research Council extended its remit to cover atmospheric data below 10km altitude. With that change the BADC took on data from many other atmospheric sources and started interacting with NERC research programmes. The BADC has now hit early adulthood. Prompted by this milestone, we examine in this paper whether the data centre is creaking at the seams or is looking forward to the prime of its life, gliding effortlessly into the future. Which parts of it are bullet proof and which parts are held together with double-sided sticky tape? Can we expect to see it in its present form in another twenty years’ time? To answer these questions, we examine the interfaces, technology, processes and organisation used in the provision of data centre services by looking at three snapshots in time, 1994, 2004 and 2014, using metrics and reports from the time to compare and contrasts the services using BADC. The repository landscape has changed massively over this period and has moved the focus for technology and development as the broader community followed emerging trends, standards and ways of working. The incorporation of these new ideas has been both a blessing and a curse, providing the data centre staff with plenty of challenges and opportunities. We also discuss key data centre functions including: data discovery, data access, ingestion, data management planning, preservation plans, agreements/licences and data policy, storage and server technology, organisation and funding, and user management. We conclude that the data centre will probably still exist in some form in 2024 and that it will most likely still be reliant on a file system. However, the

  10. Tlokoeng Valley Community's Conceptions of Wetlands: Prospects for More Sustainable Water Resources Management

    Science.gov (United States)

    Mokuku, Tšepo; Taylor, Jim

    2015-01-01

    This article explores prospects for community-based water resources management in Tlokoeng Valley, in the northern district of Lesotho. A qualitative survey was conducted to establish the pre-knowledge of the valley community. This provided a basis for a community education programme on wetlands conservation. Fifteen focus group interviews (FGIs)…

  11. Twenty years of children’s health monitoring: organization, results, conclusions

    Directory of Open Access Journals (Sweden)

    Aleksandra Anatol’evna Shabunova

    2015-05-01

    institution, the decrease in child population and the reduction in its quality characteristics. The second conclusion, according to the study results, is that we identify risk factors for child health empirically. The obtained data are used at the legislative level and are of great interest in the scientific community. On the example of certain families we show how the child’s health is affected by a lifestyle of his/her parents, conditions of education, welfare, medical activity, diet, housing conditions, environmental conditions. Nowadays all of these factors require careful attention of not only authorities, but also the parents. The child’s health monitoring also results in the further development of scientific areas and the formation of new thematic research units, such as the “Monitoring of reproductive health and behavior of the population” and the “Reproductive potential of the region” and later the “Reproduction of the population: trends and reserves”

  12. Serum concentrations and profiles of polychlorinated biphenyls in Taiwan Yu-cheng victims twenty years after the incident

    Energy Technology Data Exchange (ETDEWEB)

    Lung, S.-C. Candice [Research Center for Environmental Changes, Academia Sinica, Nankang, Taipei, Taiwan 115 (China); Guo, Y.-L.L. [Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Rd., Tainan, Taiwan 70428 (China); Chang, H.-Y.[Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Rd., Tainan, Taiwan 70428 (China)]. E-mail: h7154@mail.ncku.edu.tw

    2005-07-15

    In 1979, about 2000 people in central Taiwan were intoxicated via rice oil consumption that was contaminated with polychlorinated biphenyls (PCBs). This 'Yu-cheng' incident was one of the two known major human PCB intoxication episodes. Twenty years after the intoxication, serum samples of 435 Yu-cheng victims, 414 adults and 21 children, were collected. Sixteen PCB congeners were analyzed with a gas chromatograph-electron capture detector. We found the median concentration of total PCBs in the adult serum was 1500 ng/g lipid, still substantially higher than that of the general population in Taiwan (3.7-fold) and most seafood consumers in the world. Most of analyzed PCB congeners in children were below or around the detection limits. Congener no. 138, however, had the highest concentrations, approximately accounting for 55% and 29% in the child and adult groups, respectively. Given that PCBs are persistent organic pollutants and endocrine disruptors, the concentrations and congener-specific profiles regarding the Yu-cheng victims provide valuable information for the investigation of such chemicals in humans. - Total serum PCBs in the Yu-cheng adult victims twenty years after the incident were still higher than that of the general population in Taiwan.

  13. Twenty years of dendrotoxins.

    Science.gov (United States)

    Harvey, A L

    2001-01-01

    Dendrotoxins are small proteins that were isolated 20 years ago from mamba (Dendroaspis) snake venoms (Harvey, A.L., Karlsson, E., 1980. Dendrotoxin from the venom of the green mamba, Dendroaspis angusticeps: a neurotoxin that enhances acetylcholine release at neuromuscular junctions. Naunyn-Schmiedebergs Arch. Pharmacol. 312, 1-6.). Subsequently, a family of related proteins was found in mamba venoms and shown to be homologous to Kunitz-type serine protease inhibitors, such as aprotinin. The dendrotoxins contain 57-60 amino acid residues cross-linked by three disulphide bridges. The dendrotoxins have little or no anti-protease activity, but they were demonstrated to block particular subtypes of voltage-dependent potassium channels in neurons. Studies with cloned K(+) channels indicate that alpha-dendrotoxin from green mamba Dendroaspis angusticeps blocks Kv1.1, Kv1.2 and Kv1.6 channels in the nanomolar range, whereas toxin K from the black mamba Dendroaspis polylepis preferentially blocks Kv1.1 channels. Structural analogues of dendrotoxins have helped to define the molecular recognition properties of different types of K(+) channels, and radiolabelled dendrotoxins have also been useful in helping to discover toxins from other sources that bind to K(+) channels. Because dendrotoxins are useful markers of subtypes of K(+) channels in vivo, dendrotoxins have become widely used as probes for studying the function of K(+) channels in physiology and pathophysiology.

  14. Twenty-Year Reunion

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    A massive earthquake measuring 7.8 on the Richter Scale struck the city of Tangshan at 3:42 a.m. on July 28, 1976. The city, which had history of well over 100 years and a population of over one million people, was left in ruins. The violent earthquake killed 242,469 people, with 164,851 people sustaining injuries, 2,652 children under 16 years of age left as orphans and 885 elderly people as widowers. Some 96 percent of the city’s buildings and houses collapsed, with a direct economic loss of 10 billion yuan. Earthquake tremors spread over a two million square kilometer area, with hundreds of millions people placed in peril by the natural disaster.The Tangshan earthquake set a record as the world’s strongest earthquake of the century. The people of Tangshan have set a new record for the rate of reconstruction accomplished over the past 20 years. The support of the People’s Liberation Army and people across the nation combined with the unyielding efforts of survivors led to the establishment of a new Ta

  15. JFK: Twenty Years Later.

    Science.gov (United States)

    Parmet, Herbert

    1984-01-01

    The presidency of John F. Kennedy is assessed. Considered are J.F.K's positions on, and national and world leaders' reactions to, such issues as oil depletion allowances, the Civil Rights Bill, the Vietnam situation, and the Cold War missile gap. (RM)

  16. Risk indicators for referral during labor from community midwife to gynecologist : a prospective cohort study

    NARCIS (Netherlands)

    Schuit, Ewoud; Hukkelhoven, Chantal W P M; van der Goes, Birgit Y; Overbeeke, Ilanit; Moons, Karel G M; Mol, Ben W J; Groenwold, Rolf H H; Kwee, Anneke

    2016-01-01

    OBJECTIVE: To identify risk indicators for referral during labor from community midwife to a gynecologist in a prospective cohort of women with a singleton term pregnancy, starting labor with a community midwife between 2000 and 2007, registered in the Dutch national perinatal registry. MAIN OUTCOME

  17. Onset and Progression of Disruptive Behavior Problems among Community Boys and Girls: A Prospective Longitudinal Analysis

    Science.gov (United States)

    Farris, Jaelyn R.; Nicholson, Jody S.; Borkowski, John G.; Whitman, Thomas L.

    2011-01-01

    Attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder are the most common forms of psychopathology seen among community youth. This study investigated prospective symptomatology of these disruptive behavior disorders from ages 5 though 14 in an at-risk community-based sample of 170 boys and girls born to…

  18. Unreliable Bodies: A Follow-up Twenty Years Later by a Mother and Daughter about the Impact of Illness and Disability on their Lives.

    Science.gov (United States)

    Weingarten, Kaethe; Worthen, Miranda

    2017-03-01

    We are a mother and daughter, both health care professionals, who offer a follow-up to an article we published twenty years ago about the impact of each other's ongoing, serious medical problems on our relationship. In this article, we contribute a long-term perspective on the differences between having an illness that is well or poorly understood by medical professionals and the lay community. We also discuss health in the context of identity formation and life stage, as during this interval the daughter left home, graduated college, married, and had two children. Also in this period, the mother survived a third breast cancer and other life-threatening illnesses. We discuss the impact of these experiences on each other and in other important relationships in our lives. Current discourses on daughters of breast cancer survivors do not fit our experience and we speculate about why our story differs. We find that although we continue to contend with serious medical issues that impact our own, each other's, and our families' lives, nonetheless, our lives are rich, rewarding, and "appropriate" for our life stage. That is the news. © 2015 Family Process Institute.

  19. Contributions to Sustainability by Communities and Individuals: Problems and Prospects

    Energy Technology Data Exchange (ETDEWEB)

    MacGregor, D.; Tonn, B.E.

    1998-11-01

    This report examines relationships between a comprehensive set of definitions of and viewpoints on the concept of Sustainability and the abilities of communities and individuals in the United States to meet the behavioral prescriptions inherent in these definitions and viewpoints. This research is timely because sustainability is becoming a cornerstone of national and international environmental strategies designed to simultaneously achieve environmental, economic, and social goals. In the United States, many communities have adopted sustainability principles as the foundation for both their environmental protection efforts and their socioeconomic development initiatives. This research is important because it highlights serious problems communities and inviduals may have in achieving sustainability expectations, and illustrates how much work is needed to help communities and individuals overcome numerous considerable and complex constraints to sustainability.

  20. Visual impairment from uveitis in a reference hospital of Southeast Brazil: a retrospective review over a twenty years period

    Directory of Open Access Journals (Sweden)

    Luci Meire Pereira da Silva

    2013-12-01

    Full Text Available PURPOSE: To identify the frequency and causes of uveitis leading to visual impairment in patients referred to the Low Vision Service - Department of Ophthalmology - UNIFESP, over a twenty years period. METHODS: In a retrospective study, medical records of 5,461 patients were reviewed. Data from the first clinical evaluation at the Low Vision Service were collected, patient's age, gender and cause of visual impairment were analyzed. Patients with uveitis had their chart reviewed for anatomical classification and clinical diagnosis. RESULTS: The mean age of the patients referred to the Low Vision Service was 42.86 years and the mean age of patients with uveitis diagnosis was 25.51 years. Retinal disorders were the most common cause of visual impairment (N=2,835 patients; 51.9% followed by uveitis (862 patients, 15.7%. Uveitis was posterior in 792 patients (91.9% of uveitis and toxoplasmosis was the most common diagnosis (765 patients, 88.7%. CONCLUSIONS: In our study, uveitis represents the second cause of visual impairment in patients referred for visual rehabilitation and toxoplasmic retinochoroiditis was the most common clinical diagnosis. It affects a young working age population with a relevant social and economic impact, but the early diagnosis and treatment can improve the quality of life of these patients.

  1. A twenty-year follow-up survey of medical emergency education in U.S. dental schools.

    Science.gov (United States)

    Clark, Morris S; Wall, Benjamin E; Tholström, Tad C; Christensen, Edward H; Payne, Brandon C

    2006-12-01

    This article reports the results of a 2003 survey of medical emergency education taught in U.S. dental schools and compares the results to findings from surveys conducted in 1983 and 1992. A questionnaire was sent to the deans of all U.S. dental schools, requesting completion of the survey by the faculty member responsible for medical emergency education. Forty-three of fifty-four U.S. dental schools responded, and the data were compared to similar surveys conducted in 1983 and 1992. Special attention was given to changes in technology (pulse oximetry and automated external defibrillators), teaching methods (audiovisual, role-playing, and simulation), and subject matter (CPR, venipuncture, and endotracheal intubation) that affect medical emergency education. The study found a large disparity in number of hours dedicated to medical emergency training among dental schools. Surprisingly, CPR certification/recertification for both students and faculty was not provided at three of the reporting U.S. dental schools. Most schools included venipuncture and endotracheal intubation in their curriculum. Routine monitoring of vital signs remained fairly consistent over the past twenty years with a slight dip in the 1992 survey. A standardization of medical emergency education needs to take place to ensure an appropriate level of training for all dental students.

  2. Twenty-Year Survey of Scientific Literacy and Attitudes Toward Science: Students’ Acceptance of Astrology and Pseudoscience

    Science.gov (United States)

    Sugarman, Hannah R.; Impey, C.; Buxner, S.; Antonellis, J.

    2010-01-01

    Our survey used to collect data during a twenty-year long investigation into the science literacy of undergraduates (see Impey et al., this meeting), contains several questions addressing how students conceptualize astrology, and other pseudoscientific ideas. This poster presents findings from the quantitative analysis of some of these question responses from almost 10,000 undergraduate students enrolled in introductory astronomy courses from 1989 to 2009. The results from our data reveal that a large majority of students (78%) and half of science majors (52%) consider astrology either "very” or "sort of” scientific. Students performed comparatively better on all other pseudoscientific questions, demonstrating that belief in astrology is pervasive and deeply entrenched. We compare our results to those obtained by the NSF Science Indicators series, and suggest possible reasons for the high susceptibility to belief in astrology. These findings call into question whether our education system is adequately preparing students to be scientifically literate adults. You can help! Stop by our poster and fill out a new survey that will give us important parallel information to help us continue to analyze our valuable data set. We acknowledge the NSF for funding under Award No. 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS) Program.

  3. THE BENGWENYAMA TRILOGY: CONSTITUTIONAL RIGHTS AND THE FIGHT FOR PROSPECTING ON COMMUNITY LAND

    Directory of Open Access Journals (Sweden)

    Tracy-Lynn Humby

    2012-11-01

    Full Text Available SUMMARYAlthough developments subsequent to the judgment have undermined the value of the decision for the community involved, the Constitutional Court's judgment in the Bengwenyama matter provides a welcome precedent on the provisions of the Mineral and Petroleum Resources Development Act 28 of 2002 that deal with the existence of an internal appeal, the nature of consultation with interested and affected parties, the role of environmental considerations in the granting of prospecting rights, and the procedural obligations of the DMR in relation to the community preferent right to prospect or mine. However, its deliberations on the duty to consult and particularly the procedural implications of the community preferent right to prospect do not go far enough into the dynamics underlying the implementation of the law, or tackle the problematic linkages between the MPRDA, the law relating to communal land tenure, and the processing of land claims.

  4. A prospective study to evaluate a new residential community reintegration programme for severe chronic brain injury: the Brain Integration Programme.

    NARCIS (Netherlands)

    Geurtsen, G.J.; Martina, J.D.; Heugten, C.M. van; Geurts, A.C.H.

    2008-01-01

    PURPOSE: To assess the effectiveness of a residential community reintegration programme for participants with chronic sequelae of severe acquired brain injury that hamper community functioning. DESIGN: Prospective cohort study. SUBJECTS: Twenty-four participants with acquired brain injury (traumatic

  5. Preschool Predictors of Childhood Anxiety Disorders: A Prospective Community Study

    Science.gov (United States)

    Wichstrøm, Lars; Belsky, Jay; Berg-Nielsen, Turid Suzanne

    2013-01-01

    Background: Anxiety disorders are often present at preschool age. Research on older children and studies contrasting preschoolers with high versus low behavioral inhibition (BI) highlight several risk factors, but these have not been investigated in community samples of young children. Child, parent, and peer factors at age 4 were therefore…

  6. Outsourcing Student Housing in American Community Colleges: Problems and Prospects

    Science.gov (United States)

    Bekurs, Gray

    2007-01-01

    Today's community colleges are experiencing tremendous growth at a time when higher education is experiencing little success in the fierce battle for public funding. Administrators believe that providing housing on college campuses increases enrollment and improves access, but they are having difficulty meeting students' demands for both quantity…

  7. Preschool Predictors of Childhood Anxiety Disorders: A Prospective Community Study

    Science.gov (United States)

    Wichstrøm, Lars; Belsky, Jay; Berg-Nielsen, Turid Suzanne

    2013-01-01

    Background: Anxiety disorders are often present at preschool age. Research on older children and studies contrasting preschoolers with high versus low behavioral inhibition (BI) highlight several risk factors, but these have not been investigated in community samples of young children. Child, parent, and peer factors at age 4 were therefore…

  8. Twenty-Year Survey of Scientific Literacy and Attitudes Toward Science - Investigating the Relationship Between Students' Knowledge and Attitudes

    Science.gov (United States)

    Buxner, Sanlyn; Antonellis, J.; Impey, C.; CATS

    2010-01-01

    Data from a twenty-year investigation into the science literacy of undergraduates (see Impey et al., this meeting) was used to explore responses to questions, derived from policy driven projects (e.g. NSF Science Indicators). Responses from almost 10,000 undergraduate students enrolled in introductory astronomy courses from 1989 to 2009 have been analyzed based on students’ responses to forced-choice and open-ended science literacy questions as well as Likert scale belief questions about science and technology. Science literacy questions were scored based on work by Miller (1998, 2004). In addition, we developed an extensive emergent coding scheme for the four open-ended science questions. Unique results as well as trends in the student data based on subgroups of codes are presented. Responses to belief questions were categorized, using theoretically derived categories, remodeled and confirmed through factor analysis, into five main categories; belief in life on other planets, faith-based beliefs, belief in unscientific phenomena, general attitude toward science and technology, and ethical considerations. Analysis revealed that demographic information explained less than 10% of the overall variance in students’ forced-answer scientific literacy scores. We present how students’ beliefs in these categories relate to their scientific literacy scores. You can help! Stop by our poster and fill out a new survey that will give us important parallel information to help us continue to analyze our valuable data set. We acknowledge the NSF for funding under Award No. 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS) Program.

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

    NARCIS (Netherlands)

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

    2006-01-01

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  11. Reaching the Critical Mass: The Twenty Year Surge in High School Physics. Findings from the 2005 Nationwide Survey of High School Physics Teachers. AIP Report. Number R-442

    Science.gov (United States)

    Neuschatz, Michael; McFarling, Mark; White, Susan

    2008-01-01

    This report traces the growth of high school physics in American school over the past twenty years. Highlights of the report include: (1) Enrollments in high school physics continue to grow; (2) Increase in number and proportion of physics teachers; (3) Number of students taking honors, advance placement or second-year physics course has nearly…

  12. "Europe" as an Alibi: An Overview of Twenty Years of Policy, Curricula and Textbooks in the Republic of Cyprus--and Their Review

    Science.gov (United States)

    Philippou, Stavroula

    2012-01-01

    This article compares discourses on "Europe" in Greek-Cypriot policy, curricula and textbooks over approximately the last twenty years, from the early 1990s, when Cyprus applied for European Union (EU) membership, until 2011-12, the school year during which the recently revised curricula were gradually introduced to schools for…

  13. Prospective study of enteropathogens in two communities of Misiones, Argentina.

    Science.gov (United States)

    Vergara, M; Quiroga, M; Grenon, S; Pegels, E; Oviedo, P; Deschutter, J; Rivas, M; Binsztein, N; Claramount, R

    1996-01-01

    Children under five years of age, from two communities of different socio-economic strata (97 from Zaiman and 55 from Las Dolores) were examined epidemiologically during 2 years, by means of quarterly visits of the working team, who carried out the collection of faecal samples. During the study, one or more enteropathogens were identified in 73.9% of samples in children from Zaiman and in 58.3% of the samples from Las Dolores, being associated to diarrhoea in 70.5% and to asymptomatic infections in 65.7%. The number of diarrheic episodes was higher in Zaiman (15.45%) than in Las Dolores (12.35%), being more frequent in the spring-summer seasons. In Zaiman, the bacterial enteropathogen proportion was relevantly higher (p < 0.005) in children with diarrhoea, whereas the presence of parasites was more frequent in asymptomatic children (p < 0.01). Rotavirus had an even distribution within diarrheic and asymptomatic children. In Las Dolores, no relevant differences were found in the detection of enteroparasites between diarrheic and asymptomatic children. Mixed infections were detected; enterotoxigenic Escherichia coli (ETEC)-rotavirus and ETEC-parasites being the most frequent ones. ETEC was involved in 85% of these infections. These data, together with the high enteropathogen carriage, suggest an elevated level of environmental contamination. The latter plays an important role in diarrheic diseases, and added to the most extreme poverty, it affects children's lives.

  14. "The First Twenty Years," by Bernard J. Siegel. Annual Review of Anthropology, 22 (1993, pp. 1-34, Annual Reviews, Inc, Palo Alto

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    James A. Delle

    1995-05-01

    Full Text Available After twenty years as editor of the Annual Review ofAnthropology (ARA, Professor Siegel took on a daunting task with this article. In his words, he set out to "ponder the developments in the several subfields of anthropol­ogy over this period of time, as reflected in the topics selected for review in this enterprise" (p. 8. To this end Siegel, a cultural anthropologist, mined the collective knowledge contained within twenty years of the ARA. In his presentation, he considers the intellectual developments within each of the five subdisciplines separately (he includes applied anthropology, concluding with some brief remarks on the importance of maintaining a four or five field approach to anthropology. For our purposes here, I will limit my comments to his section on archaeology.

  15. A Twenty-Year Look at “Computational Geology,” an Evolving, In-Discipline Course in Quantitative Literacy at the University of South Florida

    OpenAIRE

    Victor J. Ricchezza; H.L. Vacher

    2017-01-01

    Since 1996, the Geology (GLY) program at the USF has offered “Computational Geology” as part of its commitment to prepare undergraduate majors for the quantitative aspects of their field. The course focuses on geological-mathematical problem solving. Over its twenty years, the course has evolved from a GATC (geometry-algebra-trigonometry-calculus) in-discipline capstone to a quantitative literacy (QL) course taught within a natural science major. With the formation of the new School of Geosci...

  16. Twenty Years of Interdisciplinary Studies: the "MEZA" Program's Contributions to Society, Ecology, and the Education of Postgraduate Students

    Directory of Open Access Journals (Sweden)

    César Vázquez

    2011-12-01

    Full Text Available Management of arid ecosystems (MEZA by its Spanish acronym is a Master of Science program that started in 1990 when very few interdisciplinary programs in environmental management existed in the world. Graduates and current students recognize the importance of a group of pioneers in multidisciplinary practice who have translated the scientific findings and insights of a diverse scholarly community into practical applications within the city in which the University of Baja California, El Sauzal campus, is located and its surrounding arid and coastal rural areas. Students and teachers have produced 20 ecosystem management plans, which have trained the students in practical teamwork. Most of these plans addressed an inquiry by a local community or government decision maker, which is considered to be the key origin of a project. In this paper, the MEZA program that the teachers designed is briefly described, and a series of projects are given as examples of their work. Two projects are more thoroughly explained because all of the coauthors (2009 and 2010 students participated in these projects and believe that it is a valuable experience to share with others.

  17. Religion and survival in a secular region. A twenty year follow-up of 734 Danish adults born in 1914

    DEFF Research Database (Denmark)

    la Cour, Peter; Avlund, Kirsten; Schultz-Larsen, Kirsten

    2005-01-01

    The aim of the study was to analyse associations of religiosity and mortality in a secular region. The sample consisted of 734 Danish, community dwelling elderly persons, living in a secular culture, and all aged 70 when primary data were collected. Secondary data consisted of a 20 year follow......-up on vital status or exact age of death. The study was designed to be highly comparable to studies conducted in more religious environments in order to compare results. Three variables of religion were investigated in relation to survival: importance of affiliation, church attendance and listening...... to religious media. Relative hazards (RH) of dying were controlled in models including gender, education, medical and mental health, social relations, help given and received, and health behaviour. The results showed significant and positive associations between claiming religious affiliation important...

  18. Stronger communities? Changing prospects for community-led strategic planning in New Zealand

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    Bruno Brosnan

    2010-12-01

    Full Text Available New Zealand’s Local Government Act 2002 ushered in a new phase in local government, a phase that is best characterised by the term ‘empowerment’. Not only were councils empowered to promote social, economic, environmental and cultural well-being, in contrast with previous more prescriptive legislation, but citizens were empowered to engage in community-led strategic planning. In many respects the new statute reflected contemporary international public management trends in which governance is increasingly being conducted via networks of public and private actors. However, with the change of government from a centre-left Labour-led coalition to a centre-right National-led government following the November 2008 general election, it is less certain that local government and communities will continue to experience a strengthening of the pluralisation of governance that has been a feature of the past decade. This article argues that the potential disempowerment of local government, and possible attenuation of community-led strategic planning in New Zealand, comes at a time when the momentum for devolution to local government and other communities is increasing elsewhere.

  19. Rates and predictors of remission in young women with specific phobia: a prospective community study.

    Science.gov (United States)

    Trumpf, Julia; Becker, Eni S; Vriends, Noortje; Meyer, Andrea H; Margraf, Jürgen

    2009-10-01

    This prospective study reports rates and predictors of remission in young women with specific phobia. Data came from a prospective community study, in which German women (aged 18-25 years) completed an extended version of the Anxiety Disorders Interview Schedule (ADIS-IV-L) at two time points. Of the 137 women with specific phobia at baseline, 41.6% were partially remitted and an additional 19.0% were fully remitted at follow-up, defined as absence of any specific fears. A remitting course of specific phobia was predicted by residual protective factors at baseline, especially participants' positive mental health and life satisfaction. Baseline levels of stress, coping skills, cognitive factors, psychopathology, and specific phobia characteristics did not predict remission. Results show that specific phobia in young women rarely takes a stable course at the full diagnostic threshold. The factors that influence remission of specific phobia are different from those that predict the incidence.

  20. Twenty years later: The war did (not begin at Maksimir an anthropological analysis of the media narratives about a never ended football game

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    Đorđević Ivan

    2012-01-01

    Full Text Available The aim of this work is an analysis of the media narratives about the never ended football match between Dynamo Zagreb and Red Star Belgrade on May 13 1990. The article focuses on the media coverage twenty years after the incident in the context of the game's acquired mythic status, symbolically marking the beginning of the war in former Yugoslavia. The object of the analysis are Serbian and Croatian media with the aim of revealing the strategies of representing this event in the period of the normalization of the relations in the region. [Projekat Ministarstva nauke Republike Srbije, br. 177026: Cultural Heritage and Identity

  1. ORIGINAL ARTICLE: Preparedness of Prospective Nurses to Work as Midwives in Hospital and Community

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    Pratibha A Chandekar

    2012-01-01

    Full Text Available Background: It is desirable to have skilled midwives to provide competent care in hospital and community setting. Aims and Objectives: The objectives were to assess curriculum adequacy, preparedness and job preferences of prospective nurses. Materials and Methods: A descriptive survey was used for the study. Thestudy was carried out at nursing institutes in Ahmednagar District, Maharashtra, India. The participants were the 200 prospective Nurses(final year Nursing students of General Nursing and B.Sc Nursing Programme, who had undergone midwifery examination. A semi structured questionnaire with self report technique method was used. Results: 20.57% and 89.1% students respectively felt that, thetheory input and allotted clinical hours were adequate. During the clinical posting, 29.7% felt that they did not get the opportunity to work in midwifery sections. 33.1% students expressed that they did not get cases as per the requirement prescribed by Indian NursingCouncil.13.7% and 33.7% students respectively agreed that they lacked confidence to perform abdominal palpation of antenatal cases & conduct deliveries independently. A few (26.2% expressed their inability to resuscitate the newborn. 89.1% said that they needed more experience to work independently as midwives. Everyone felt the need of in-service education and majority (77.2% felt that its duration should be either three months or more. Conclusion: Present study reveals that only 7% of the prospective nurses are ready to work in midwifery section. Only 13.7% of the prospective nurses are ready to work in rural area. Since there is a shortfall of 70.02% forspeciality of obstetrics and gynecology in rural health (GOI, 1997, and there are only 40 qualified nurse midwives per 100,000 births inIndia or only one midwife for 2500 births in rural areas, it is imperative to strengthen midwifery training to bridge this gap.

  2. Which Russia, twenty years later?

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    Carmen Claudín

    2011-12-01

    Full Text Available Russia is proud of its position among the emerging powers, of the strength provided by its ample energetic resources and its nuclear potential with which it can influence the world and always be taken into account. Nevertheless, the perception within the country is that stagnation has become Russia’s dominant characteristic at present. The objective of this article is to explore how this situation came about, analysing the evolution of domestic processes in Russia during both of its most defining periods: Yeltsin and Putin’s leadership, since the ephemeral presidency of Medvedev proved to be basically a continuation of the latter. During the eight years of Boris Yeltsin’s tenure, the state of crisis, latent or open, developed into the way that political processes are carried out in Russia. With Putin’s arrival, however, stability and State control are imposed, against the backdrop of economic growth, and they become values in themselves, far from the democratic discourse of the first years.

  3. Prospective policy analysis: how an epistemic community informed policymaking on intentional self poisoning in Sri Lanka

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    Anthony Zwi B

    2010-06-01

    Full Text Available Abstract Background Policy analysis is often retrospective and not well suited to helping policy makers decide what to do; in contrast prospective policy analysis seeks to assist in formulating responses to challenging public policy questions. Suicide in Sri Lanka is a major public health problem, with ingestion of pesticides being the primary method. Previous policy interventions have been associated with reduced mortality through restricting access to the most toxic pesticides. Additional means of reducing access are still needed. Methods The prospective policy analysis comprised two stages. The first used a consensus activity within a well defined policy community to generate and frame policy options. The second broadened the analysis to include other stakeholders. We report the consensus activity with seven actors from agriculture, health, and academia. Policy options were identified through two rounds of discussion along with ratings by each participant on their degree of support for each option. Data were analysed quantitatively and discussions analysed with Nvivo 8 to code prominent and recurrent themes. Results The main finding was the strong support and consensus for two proposals: further regulation of pesticides and the novel idea of repackaging pesticides into non-lethal doses. Participants identified several factors that were supportive of future policy change including a strong legislative framework, good links between agriculture, health and academia, and a collaborative relationship with industry. Identified barriers and potential threats to policy change included political interference, difficulties of intersectoral collaboration, acceptability of options to the community, difficulty of implementation in rural communities and the challenge of reducing mortality. Conclusions The development and consideration of policy options within this epistemic community reflected an appreciation and understanding of many of the factors that

  4. Prospective etiological investigation of community-acquired pulmonary infections in hospitalized people living with HIV

    Science.gov (United States)

    Figueiredo-Mello, Claudia; Naucler, Pontus; Negra, Marinella D.; Levin, Anna S.

    2017-01-01

    Abstract The study of the etiological agents of community-acquired pulmonary infections is important to guide empirical therapy, requires constant updating, and has a substantial impact on the prognosis of patients. The objective of this study is to determine prospectively the etiology of community-acquired pulmonary infections in hospitalized adults living with HIV. Patients were submitted to an extended microbiological investigation that included molecular methods. The microbiological findings were evaluated according to severity of the disease and pneumococcal vaccine status. Two hundred twenty-four patients underwent the extended microbiological investigation of whom 143 (64%) had an etiology determined. Among the 143 patients with a determined etiology, Pneumocystis jirovecii was the main agent, detected in 52 (36%) cases and followed by Mycobacterium tuberculosis accounting for 28 (20%) cases. Streptococcus pneumoniae and Rhinovirus were diagnosed in 22 (15%) cases each and influenza in 15 (10%) cases. Among atypical bacteria, Mycoplasma pneumoniae was responsible for 12 (8%) and Chlamydophila pneumoniae for 7 (5%) cases. Mixed infections occurred in 48 cases (34%). S pneumoniae was associated with higher severity scores and not associated with vaccine status. By using extended diagnostics, a microbiological agent could be determined in the majority of patients living with HIV affected by community-acquired pulmonary infections. Our findings can guide clinicians in the choice of empirical therapy for hospitalized pulmonary disease. PMID:28121925

  5. Total hip arthroplasty with cement and use of a collared matte-finish femoral component: nineteen to twenty-year follow-up.

    Science.gov (United States)

    Callaghan, John J; Liu, Steve S; Firestone, Daniel E; Yehyawi, Tameem M; Goetz, Devon D; Sullivan, Jason; Vittetoe, David A; O'Rourke, Michael R; Johnston, Richard C

    2008-02-01

    In the mid- to late 1970s, on the basis of laboratory and finite element data, many surgeons in the United States began using collared matte-finish femoral components and metal-backed acetabular components in their total hip arthroplasties. The purpose of this study was to evaluate the long-term results of the use of one such construct in arthroplasties performed by a single surgeon in a consecutive nonselected patient cohort. Between January 1984 and December 1985, 273 patients underwent a total of 304 consecutive nonselected total hip arthroplasties with cement and use of the Iowa femoral component (which is collared, has a proximal cobra shape, and has a matte finish) and a metal-backed TiBac acetabular component performed by a single surgeon. At nineteen to twenty years postoperatively, only two patients (two hips) were lost to follow-up. For clinical evaluation, we attempted to interview all living patients and the families of the patients who had died to verify the status of the hip prosthesis or any revisions. Radiographic evaluation consisted of analysis for loosening and osteolysis as well as wear of the acetabular component. At the time of the nineteen to twenty-year follow-up, the rate of revision of the arthroplasty for any reason was 10.5% (thirty-two hips) for all patients and 25% (twenty-three hips) for living patients. The rate of revision due to aseptic femoral loosening was 2.6% (eight hips). There was radiographic evidence of loosening of the femoral component in fifteen hips (4.9%), including those that were revised, and femoral osteolysis was seen distal to the trochanters in twenty-two hips (7.2%). The rate of revision due to aseptic loosening of the acetabular component was 7.9% (twenty-four hips), and there was radiographic evidence of acetabular loosening in forty-two hips (13.8%), including those that were revised. This study demonstrates the durability of a cemented matte-finish collared femoral component at twenty years postoperatively

  6. Prospective study of the elder self-neglect and ED use in a community population.

    Science.gov (United States)

    Dong, Xinqi; Simon, Melissa A; Evans, Denis

    2012-05-01

    This study aims to quantify the relation between elder self-neglect and rate of emergency department utilization in a community-dwelling population. A prospective population-based study is conducted in a geographically defined community in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 6864 participants in the Chicago Health and Aging Project, 1165 participants were reported to social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to social services agency. The outcome of interest was the annual rate of emergency department utilization obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. The average annual rate of emergency department visits for those without elder self-neglect was 0.6 (1.3), and for those with reported elder self-neglect, it was 1.9 (3.4). After adjusting for sociodemographics, socioeconomic variables, medical conditions, and cognitive and physical function, older people who self-neglect had significantly higher rates of emergency department utilization (rate ratio, 1.42; 95% confidence interval, 1.29-1.58). Greater self-neglect severity (mild: standardized parameter estimate [PE], 0.27; standard error [SE], 0.04; P self-neglect was associated with increased rates of emergency department utilization in this community population. Greater self-neglect severity was associated with a greater increase in the rate of emergency department utilization. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Prospective Study of the Elder Self-Neglect and Emergency Department Use in a Community Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.; Evans, Denis

    2011-01-01

    Purpose This study aims to quantify the relation between elder self-neglect and rate of emergency department utilization in a community-dwelling population. Methods A prospective population-based study is conducted in a geographically-defined community in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 6,864 participants in the Chicago Health and Aging Project, 1,165 participants were reported to social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to social services agency. The outcome of interest was the annual rate of emergency department utilization obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results The average annual rate of emergency department visits for those without elder self-neglect was 0.6 (1.3) and for those with reported elder self-neglect was 1.9 (3.4). After adjusting for sociodemographics, socioeconomic variables, medical conditions, cognitive and physical function, elders who self-neglect had significantly higher rates of emergency department utilization (RR, 1.42, 95% CI, 1.29–1.58). Greater self-neglect severity (Mild: PE=0.27, SE=0.04, pself-neglect was associated with increased rates of emergency department utilization in this community population. Greater self-neglect severity was associated with a greater increase in the rate of emergency department utilization. PMID:21411263

  8. Cemented rotating-platform total knee replacement: a concise follow-up, at a minimum of twenty years, of a previous report.

    Science.gov (United States)

    Callaghan, John J; Wells, Christopher W; Liu, Steve S; Goetz, Devon D; Johnston, Richard C

    2010-07-07

    We previously evaluated 119 consecutive total knee arthroplasties performed by a single surgeon in eighty-six patients with use of the cemented LCS (low contact stress) mobile-bearing, rotating-platform system and an all-polyethylene patellar component. The average age of the patients at the time of surgery was seventy years. The patients were contacted as part of their routine follow-up and were asked to participate in this study. The purpose of the present study was to report the updated results at a minimum follow-up of twenty years. Twenty patients (twenty-six knees) were living, and one was lost to follow-up. Three knees required a reoperation (two for periprosthetic fractures and one for infection). No component was revised as a part of the reoperations. No knee required revision since the fifteen-year follow-up evaluation. Osteolysis was present in six knees compared with only three knees at the time of the fifteen-year follow-up. One knee had radiographic signs of femoral component loosening, which was associated with osteolysis. It occurred after the fifteen-year follow-up study. The average range of motion was from 1 degrees of extension to 105 degrees of flexion. The average clinical and functional Knee Society scores were 43 and 49 points, respectively, at the preoperative evaluation and 89 and 67 points at the time of the final follow-up. We concluded that the cemented LCS rotating-platform knee performed well, with durable clinical and radiographic results at a minimum follow-up of twenty years. However, the prevalence of osteolysis continues to increase with a longer duration of follow-up in these patients.

  9. Deviant early pregnancy maternal triglyceride levels and increased risk of congenital anomalies : a prospective community-based cohort study

    NARCIS (Netherlands)

    Nederlof, M.; de Walle, H. E. K.; van Poppel, M. N. M.; Vrijkotte, T. G. M.; Gademan, M. G. J.

    ObjectiveThe maternal lipid profile could be of importance in congenital anomaly development. This study therefore investigates whether the maternal lipid profile during early pregnancy is associated with major nonsyndromic congenital anomalies (MNCA). DesignProspective community-based cohort study.

  10. Attitudes and experiences of community pharmacists towards paediatric off-label prescribing: a prospective survey.

    Science.gov (United States)

    Stewart, Derek; Rouf, Abdul; Snaith, Ailsa; Elliott, Kathleen; Helms, Peter J; McLay, James S

    2007-07-01

    To identify community pharmacist experiences of, and attitudes towards paediatric off-label prescribing. A prospective questionnaire-based study, with a 21-item questionnaire issued to 1500 randomly selected community pharmacies throughout the UK during 2005 on three separate occasions. Four hundred and eighty-two (32.1%) completed questionnaires were returned. Over 70% of respondents were familiar with the concept of off-label prescribing, primarily through dispensing experience rather than education, although only 40% were aware of having dispensed a paediatric off-label prescription within the previous month. The reasons given for a prescription being off label were younger age than recommended (84.6%, 297/351), primarily for antihistamines, analgesics and beta(2)-agonists, and higher (73.9%, 229/310) or lower than (41%, 103/258) recommended dose, primarily antibiotics and analgesics. Over 60% of respondents had been asked by the public to sell paediatric over-the-counter medicines, such as antihistamines, analgesics and steroid preparations for off-label use. The majority of respondents used the British National Formulary or the Pack Insert rather than specialist formularies or guidelines as a source of specialist paediatric information. Although 78% of respondents believed they had a responsibility to inform the prescriber that a medicine was off label, only 66% believed that they had a similar responsibility to inform parents. The community pharmacists who responded to this questionnaire appear to be aware of and concerned by the issues which surround paediatric off-label prescribing. Despite this, most gained relevant knowledge through work experience rather than undergraduate or postgraduate training or professional development.

  11. The chemical and biological response of two remote mountain lakes in the Southern Central Alps (Italy to twenty years of changing physical and chemical climate

    Directory of Open Access Journals (Sweden)

    Andrea LAMI

    2004-02-01

    Full Text Available Two small high mountain lakes in the Alps were monitored in 1984-2003 to follow their response to changes in human impact, such as deposition of atmospheric pollutants, fish stocking and climate change. The results were compared to occasional samplings performed in the 1940s, and to the remains found in sediment cores. When monitoring started, the most acid-sensitive of them, Lake Paione Superiore, was acidified, with evident effects in its flora and fauna: benthic diatoms assemblage was shifted towards acidophilous species, and zooplankton lost the dominant species, Arctodiaptomus alpinus. Palaeolimnological studies outlined that lake acidification paralleled the increasing input of long-range transported industrial pollutants, traced by spherical carbonaceous particles. On the contrary, the biota of Lake Paione Inferiore appeared to be mainly affected by fish stocking. In the last twenty years, decrease in acid load from the atmosphere led to an improvement in lake water quality, with an increase in both pH and alkalinity. First signs of biological recovery were identified, such as change in diatom flora and appearance of sensitive species among benthic insects. However, climate change and episodic deposition of Saharan dust were important driving factors controlling lake water chemistry. Further monitoring to assess the effects of climate change and of the increasing load of nitrogen and other pollutants is recommended.

  12. High Angular Resolution Observations of Episodic Dust Emission from Long Period Variable Stars Twenty Years of Observations with the Berkeley Infrared Spatial Interferometer

    Science.gov (United States)

    Danchi, William

    2010-01-01

    Over the past twenty years the U. C. Berkeley Infrared Spatial Interferometer has observed a number of Long Period Variable stars in the mid-infrared, obtaining information on the spatial distribution of dust around these stars with resolutions of the order of a few tens of milliarcseconds. The ISI is a heterodyne interferometer operating mostly at 11.15 microns, initially with two telescopes. In the last decade, it has been taking data regularly with three telescopes, thus obtaining visibility data on three baselines and also a closure phase. Over the course of the years, the ISI has been able to measure the physical properties of the dust shells surrounding these stars, in particular the inner radii of the dust shells, as well as the temperature and density distribution. For some stars, the ISI has also made precision measurements of their diameters in the mid-infrared. Closure phase measurements have revealed asymmetries in the dust distributions around many stars. Most surprisingly the ISI data has shown evidence for substantial changes in the amount of dust on time scales of 5-10 years, rather than being directly correlated with the stellar pulsation periods, which are of the order of one year. We discuss past results and new results from the ISI that highlight the dynamic environment around these stars.

  13. Who gets help for pre-school communication problems? Data from a prospective community study.

    Science.gov (United States)

    Skeat, J; Wake, M; Ukoumunne, O C; Eadie, P; Bretherton, L; Reilly, S

    2014-03-01

    Pre-school communication problems are common, with implications for school readiness and educational achievement. Help is available from a variety of community healthcare providers. This study examined the extent to which help is received, and the predictors of service receipt. Prospective community study, in Melbourne, Victoria. At age 4 years, we assessed the speech, receptive and expressive language and fluency of 1607 children and gave feedback to their parents. At age 5 years, 983 families provided data on service use for communication problems between and 4 and 5 years. We compared service use between participants with and without impairment, and used logistic regression to estimate the strength of association between potential predictors (gender, socio-economic status, maternal education, English-speaking background status, family history of speech and language problems and parent concern) and service use (binary outcome). Data were available for both communication status and service use for 753 children. Only 44.9% of the 196 children with communication impairment received help from a professional. Furthermore, 7% of the 557 that did not meet criteria for communication impairment nevertheless received help from a professional. Parent concern was the strongest predictor of service use (adjusted odds ratio = 9.0; 95% CI: 5.6-14.8). Both over- and under-servicing for communication problems were evident. This study shows that accessing help for communication problems requires more than simply informing parents about the problem and having services available; there is a need for systematic support to get the right children to services. © 2013 John Wiley & Sons Ltd.

  14. Natural history of stuttering to 4 years of age: a prospective community-based study.

    Science.gov (United States)

    Reilly, Sheena; Onslow, Mark; Packman, Ann; Cini, Eileen; Conway, Laura; Ukoumunne, Obioha C; Bavin, Edith L; Prior, Margot; Eadie, Patricia; Block, Susan; Wake, Melissa

    2013-09-01

    To document the natural history of stuttering by age 4 years, including (1) cumulative incidence of onset, (2) 12-month recovery status, (3) predictors of stuttering onset and recovery, and (4) potential comorbidities. The study cohort was a prospective community-ascertained cohort (the Early Language in Victoria Study) from Melbourne, Australia, of 4-year-old children (n = 1619; recruited at age 8 months) and their mothers. Outcome was stuttering onset by age 4 years and recovery within 12 months of onset, defined using concurrent monthly parent and speech pathologist ratings. Potential predictors: child gender, birth weight, birth order, prematurity, and twinning; maternal mental health and education; socioeconomic status; and family history of stuttering. Potential comorbidities: preonset and concurrent temperament, language, nonverbal cognition, and health-related quality of life. By age 4 years, the cumulative incidence of stuttering onset was 11.2% (95% confidence interval [CI]: 9.7% to 12.8%). Higher maternal education (P = .004), male gender (P = .02), and twinning (P = .005) predicted stuttering onset. At outcome, stuttering children had stronger language (mean [SD]: 105.0 [13.0] vs 99.6 [14.6]; mean difference 5.5, 95% CI: 3.1 to 7.8; P stuttering onset is common in preschoolers, adverse affects are not the norm in the first year after onset.

  15. Factors affecting incidence of dry socket: a prospective community-based study.

    Science.gov (United States)

    Parthasarathi, Krishnan; Smith, Andrew; Chandu, Arun

    2011-07-01

    Dry socket, or alveolar osteitis, can occur because of the removal of teeth. No clear etiology has been acknowledged; however, numerous risk factors have been proposed and tested. We report on the results of a prospective, multicenter study of the incidence and factors affecting the occurrence of alveolar osteitis at the Royal Dental Hospital of Melbourne and Community Dental Clinics in Melbourne, Australia. Ethics approval was gained from the University of Melbourne and Dental Health Services Victoria. The data were analyzed in a descriptive fashion, and the factors affecting alveolar osteitis were assessed using logistic regression analysis. The incidence of alveolar osteitis was 2.3% of all teeth extracted, with 4.2% of all patients experiencing alveolar osteitis in a public dental setting. Multivariate analysis revealed operator experience, perioperative crown and root fractures, periodontal disease, posterior teeth, and, interestingly, the use of mental health medications to be significant independent risk factors for the development of alveolar osteitis. No alveolar osteitis was reported in patients taking antibiotics, the oral contraceptive pill, bisphosphonates, or oral steroid drugs. Smoking and extraction technique (either operative or nonoperative) were also not found to significantly affect the development of alveolar osteitis.

  16. Prospective study of the incidence, nature and causes of dispensing errors in community pharmacies.

    Science.gov (United States)

    Ashcroft, Darren M; Quinlan, Paul; Blenkinsopp, Alison

    2005-05-01

    Each year over 600 million prescription items are dispensed in community pharmacies in England and Wales. Despite this, there is little published evidence relating to dispensing errors and near misses occurring in this setting. This study sought to determine their incidence, nature and causes. Prospective study over a 4-week period in 35 community pharmacies (9 independent pharmacies and 26 chain pharmacies) in the UK. Pharmacists recorded details of all incidents that occurred during the dispensing process, including information about: the stage at which the error was detected; who found the error; who made the error; type of error; reported cause of error and circumstances associated with the error. 125,395 prescribed items were dispensed during the study period and 330 incidents were recorded relating to 310 prescriptions. 280 (84.8%) incidents were classified as a near miss (rate per 10,000 items dispensed=22.33, 95%CI 19.79-25.10), while the remaining 50 (15.2%) were classified as dispensing errors (rate per 10,000 items dispensed=3.99, 95%CI 2.96-5.26). Selection errors were the most common types of incidents (199, 60.3%), followed by labeling (109, 33.0%) and bagging errors (22, 6.6%). Most of the incidents were caused either by misreading the prescription (90, 24.5%), similar drug names (62, 16.8%), selecting the previous drug or dose from the patient's medication record on the pharmacy computer (42, 11.4%) or similar packaging (28, 7.6%). This study has demonstrated that a wide range of medication errors occur in community pharmacies. On average, for every 10,000 items dispensed, there are around 22 near misses and four dispensing errors. Given the current plans for reporting adverse events in the NHS, greater insight into the likely incidence and nature of dispensing errors will be helpful in designing effective risk management strategies in primary care. Copyright (c) 2004 John Wiley & Sons, Ltd.

  17. Self-report of healthcare utilization among community-dwelling older persons: a prospective cohort study.

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    Marlies T van Dalen

    Full Text Available BACKGROUND: Self-reported data are often used for estimates on healthcare utilization in cost-effectiveness studies. OBJECTIVE: To analyze older adults' self-report of healthcare utilization compared to data obtained from the general practitioners' (GP electronic medical record (EMR and to study the differences in healthcare utilization between those who completed the study, those who did not respond, and those lost to follow-up. METHODS: A prospective cohort study was conducted among community-dwelling persons aged 70 years and above, without dementia and not living in a nursing home. Self-reporting questionnaires were compared to healthcare utilization data extracted from the EMR at the GP-office. RESULTS: Overall, 790 persons completed questionnaires at baseline, median age 75 years (IQR 72-80, 55.8% had no disabilities in (instrumental activities of daily living. Correlations between self-report data and EMR data on healthcare utilization were substantial for 'hospitalizations' and 'GP home visits' at 12 months intraclass correlation coefficient 0.63 (95% CI; 0.58-0.68. Compared to the EMR, self-reported healthcare utilization was generally slightly over-reported. Non-respondents received more GP home visits (p<0.05. Of the participants who died or were institutionalized 62.2% received 2 or more home visits (p<0.001 and 18.9% had 2 or more hospital admissions (p<0.001 versus respectively 18.6% and 3.9% of the participants who completed the study. Of the participants lost to follow-up for other reasons 33.0% received 2 or more home visits (p<0.01 versus 18.6 of the participants who completed the study. CONCLUSIONS: Self-report of hospitalizations and GP home visits in a broadly 'healthy' community-dwelling older population seems adequate and efficient. However, as people become older and more functionally impaired, collecting healthcare utilization data from the EMR should be considered to avoid measurement bias, particularly if the data will

  18. Pulmonary function and incident bronchitis and asthma in children: a community-based prospective cohort study.

    Science.gov (United States)

    Lee, Yungling Leo; Hwang, Bing-Fang; Chen, Yu-An; Chen, Jer-Min; Wu, Yi-Fan

    2012-01-01

    Previous studies revealed that reduction of airway caliber in infancy might increase the risks for wheezing and asthma. However, the evidence for the predictive effects of pulmonary function on respiratory health in children was still inconsistent. We conducted a population-based prospective cohort study among children in 14 Taiwanese communities. There were 3,160 children completed pulmonary function tests in 2007 and follow-up questionnaire in 2009. Poisson regression models were performed to estimate the effect of pulmonary function on the development of bronchitis and asthma. After adjustment for potential confounders, pulmonary function indices consistently showed protective effects on respiratory diseases in children. The incidence rate ratios of bronchitis and asthma were 0.86 (95% CI 0.79-0.95) and 0.91 (95% CI 0.82-0.99) for forced expiratory volume in 1 second (FEV₁). Similar adverse effects of maximal mid-expiratory flow (MMEF) were also observed on bronchitis (RR = 0.73, 95% CI 0.67-0.81) and asthma (RR = 0.85, 95% CI 0.77-0.93). We found significant decreasing trends in categorized FEV₁ (p for trend = 0.02) and categories of MMEF (p for trend = 0.01) for incident bronchitis. Significant modification effects of traffic-related air pollution were noted for FEV₁ and MMEF on bronchitis and also for MMEF on asthma. Children with high pulmonary function would have lower risks on the development of bronchitis and asthma. The protective effect of high pulmonary function would be modified by traffic-related air pollution exposure.

  19. Laboratory-based prospective surveillance for community outbreaks of Shigella spp. in Argentina.

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    María R Viñas

    Full Text Available BACKGROUND: To implement effective control measures, timely outbreak detection is essential. Shigella is the most common cause of bacterial diarrhea in Argentina. Highly resistant clones of Shigella have emerged, and outbreaks have been recognized in closed settings and in whole communities. We hereby report our experience with an evolving, integrated, laboratory-based, near real-time surveillance system operating in six contiguous provinces of Argentina during April 2009 to March 2012. METHODOLOGY: To detect localized shigellosis outbreaks timely, we used the prospective space-time permutation scan statistic algorithm of SaTScan, embedded in WHONET software. Twenty three laboratories sent updated Shigella data on a weekly basis to the National Reference Laboratory. Cluster detection analysis was performed at several taxonomic levels: for all Shigella spp., for serotypes within species and for antimicrobial resistance phenotypes within species. Shigella isolates associated with statistically significant signals (clusters in time/space with recurrence interval ≥365 days were subtyped by pulsed field gel electrophoresis (PFGE using PulseNet protocols. PRINCIPAL FINDINGS: In three years of active surveillance, our system detected 32 statistically significant events, 26 of them identified before hospital staff was aware of any unexpected increase in the number of Shigella isolates. Twenty-six signals were investigated by PFGE, which confirmed a close relationship among the isolates for 22 events (84.6%. Seven events were investigated epidemiologically, which revealed links among the patients. Seventeen events were found at the resistance profile level. The system detected events of public health importance: infrequent resistance profiles, long-lasting and/or re-emergent clusters and events important for their duration or size, which were reported to local public health authorities. CONCLUSIONS/SIGNIFICANCE: The WHONET-SaTScan system may serve as a

  20. Maternal behaviors promoting language acquisition in slow-to-talk toddlers: prospective community-based study.

    Science.gov (United States)

    Levickis, Penny; Reilly, Sheena; Girolametto, Luigi; Ukoumunne, Obioha C; Wake, Melissa

    2014-05-01

    To determine, in a community-based sample of slow-to-talk toddlers, the extent to which specific maternal responsive behaviors at 24 months predict child language at 24 and 36 months. Mother-child dyads were recruited for this prospective longitudinal study from 3 local government areas spanning low, middle, and high socioeconomic status in Melbourne, Australia. At child age 18 months, 1138 parents completed a 100-word expressive vocabulary checklist; the 251 (22.1%) children scoring ≤20th percentile were then followed up to comprise this study. Six maternal responsive behaviors (imitations, interpretations, labels, expansions, supportive directives and responsive questions) were derived from mother-child free-play videos collected at 24 months of age and coded using the Observer XT system. Expressive and receptive language measured at 24 and 36 months of age (Preschool Language Scale-4), blind to maternal responsiveness ratings. Two hundred and twenty-six of the 251 (90.0%) mother-child dyads were followed up at 36 months. In confounder-adjusted linear regression analyses, expansions, imitations, and responsive questions were strongly associated with better receptive and expressive language at 24 and 36 months. Labels unexpectedly predicted poorer expressive language at 36 months. Expansions were the only maternal behavior that predicted improvement in language between 24 and 36 months. Maternal responsive behaviors, particularly expansions, offer promise in enhancing early language learning in slow-to-talk toddlers. Parent-child interactions characterized by frequent use of maternal labels at 24 months could also be a predictive marker of those slow-to-talk toddlers at greater risk of persistent language problems.

  1. Laboratory-based prospective surveillance for community outbreaks of Shigella spp. in Argentina.

    Science.gov (United States)

    Viñas, María R; Tuduri, Ezequiel; Galar, Alicia; Yih, Katherine; Pichel, Mariana; Stelling, John; Brengi, Silvina P; Della Gaspera, Anabella; van der Ploeg, Claudia; Bruno, Susana; Rogé, Ariel; Caffer, María I; Kulldorff, Martin; Galas, Marcelo

    2013-01-01

    To implement effective control measures, timely outbreak detection is essential. Shigella is the most common cause of bacterial diarrhea in Argentina. Highly resistant clones of Shigella have emerged, and outbreaks have been recognized in closed settings and in whole communities. We hereby report our experience with an evolving, integrated, laboratory-based, near real-time surveillance system operating in six contiguous provinces of Argentina during April 2009 to March 2012. To detect localized shigellosis outbreaks timely, we used the prospective space-time permutation scan statistic algorithm of SaTScan, embedded in WHONET software. Twenty three laboratories sent updated Shigella data on a weekly basis to the National Reference Laboratory. Cluster detection analysis was performed at several taxonomic levels: for all Shigella spp., for serotypes within species and for antimicrobial resistance phenotypes within species. Shigella isolates associated with statistically significant signals (clusters in time/space with recurrence interval ≥365 days) were subtyped by pulsed field gel electrophoresis (PFGE) using PulseNet protocols. In three years of active surveillance, our system detected 32 statistically significant events, 26 of them identified before hospital staff was aware of any unexpected increase in the number of Shigella isolates. Twenty-six signals were investigated by PFGE, which confirmed a close relationship among the isolates for 22 events (84.6%). Seven events were investigated epidemiologically, which revealed links among the patients. Seventeen events were found at the resistance profile level. The system detected events of public health importance: infrequent resistance profiles, long-lasting and/or re-emergent clusters and events important for their duration or size, which were reported to local public health authorities. The WHONET-SaTScan system may serve as a model for surveillance and can be applied to other pathogens, implemented by other

  2. Perinatal mortality in eastern Uganda: a community based prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Victoria Nankabirwa

    Full Text Available BACKGROUND: To achieve a child mortality reduction according to millennium development goal 4, it is necessary to considerably reduce neonatal mortality. We report stillbirth and early neonatal mortality risks as well as determinants of perinatal mortality in Eastern Uganda. METHODS: A community-based prospective cohort study was conducted between 2006 and 2008. A total of 835 pregnant women were followed up for pregnancy outcome and survival of their children until 7 days after delivery. Mother's residence, age, parity, bed net use and whether delivery took place at home were included in multivariable regression analyses to identify risk factors for perinatal death. RESULTS: The stillbirth risk was 19 per 1,000 pregnancies and the early neonatal death risk 22 per 1,000 live births. Overall, the perinatal mortality risk was 41 [95%CI: 27, 54] per 1,000 pregnancies. Of the deaths, 47% followed complicated deliveries and 24% preterm births. Perinatal mortality was 63/1,000 pregnancies among teenage mothers, 76/1,000 pregnancies among nulliparous women and 61/1,000 pregnancies among women delivering at home who, after controlling for potential confounders, had a 3.7 (95%CI: 1.8, 7.4 times higher perinatal mortality than women who gave birth in a health facility. This association was considerably stronger among nulliparous women [RR 8.0 (95%CI: 2.9, 21.6] than among women with a previous live birth [RR 1.8 (95%CI: 0.7, 4.5]. All perinatal deaths occurred among women who did not sleep under a mosquito net. Women living in urban slums had a higher risk of losing their babies than those in rural areas [RR: 2.7 (95%CI: 1.4, 5.3]. CONCLUSION: Our findings strengthen arguments for ensuring that pregnant women have access to and use adequate delivery facilities and bed nets.

  3. Laboratory-Based Prospective Surveillance for Community Outbreaks of Shigella spp. in Argentina

    Science.gov (United States)

    Viñas, María R.; Tuduri, Ezequiel; Galar, Alicia; Yih, Katherine; Pichel, Mariana; Stelling, John; Brengi, Silvina P.; Della Gaspera, Anabella; van der Ploeg, Claudia; Bruno, Susana; Rogé, Ariel; Caffer, María I.; Kulldorff, Martin; Galas, Marcelo

    2013-01-01

    Background To implement effective control measures, timely outbreak detection is essential. Shigella is the most common cause of bacterial diarrhea in Argentina. Highly resistant clones of Shigella have emerged, and outbreaks have been recognized in closed settings and in whole communities. We hereby report our experience with an evolving, integrated, laboratory-based, near real-time surveillance system operating in six contiguous provinces of Argentina during April 2009 to March 2012. Methodology To detect localized shigellosis outbreaks timely, we used the prospective space-time permutation scan statistic algorithm of SaTScan, embedded in WHONET software. Twenty three laboratories sent updated Shigella data on a weekly basis to the National Reference Laboratory. Cluster detection analysis was performed at several taxonomic levels: for all Shigella spp., for serotypes within species and for antimicrobial resistance phenotypes within species. Shigella isolates associated with statistically significant signals (clusters in time/space with recurrence interval ≥365 days) were subtyped by pulsed field gel electrophoresis (PFGE) using PulseNet protocols. Principal Findings In three years of active surveillance, our system detected 32 statistically significant events, 26 of them identified before hospital staff was aware of any unexpected increase in the number of Shigella isolates. Twenty-six signals were investigated by PFGE, which confirmed a close relationship among the isolates for 22 events (84.6%). Seven events were investigated epidemiologically, which revealed links among the patients. Seventeen events were found at the resistance profile level. The system detected events of public health importance: infrequent resistance profiles, long-lasting and/or re-emergent clusters and events important for their duration or size, which were reported to local public health authorities. Conclusions/Significance The WHONET-SaTScan system may serve as a model for

  4. Power-Sharing, Conflict and Transition in Burundi: Twenty Years of Trial and Error Machtteilung, Konflikt und Wandel in Burundi: Zwanzig Jahre Versuch und Irrtum

    Directory of Open Access Journals (Sweden)

    Stef Vandeginste

    2009-01-01

    Full Text Available For the past twenty years, Burundi has experimented with powersharing as an instrument of political liberalisation, democratisation and conflict resolution. This contribution analyses the different meanings the concept of power-sharing has had throughout Burundi’s recent and extremely violent political transition, in particular during the lengthy peace process. It shows how national and international actors have found inspiration in the toolbox of consociationalism to negotiate and design the Arusha Peace and Reconciliation Agreement for Burundi signed in August 2000 and its posttransition Constitution. Power-sharing has been instrumental in achieving the – short-term – objective of war termination. It has also de-ethnicised political competition and reduced the (potentially destabilising effect of elections. Measured against more ambitious state-building objectives (democracy, rule of law, accountable and effective governance, power-sharing has (so far not been able to make a difference. Several factors and developments threaten the “survival” of the power-sharing model in Burundi. In Burundi wird seit zwanzig Jahren mit Power-Sharing als Instrument politischer Liberalisierung, Demokratisierung und Konfliktlösung experimentiert. Der vorliegende Beitrag analysiert, welche unterschiedlichen Bedeutungen das Konzept der Machtteilung in der jüngsten und extrem gewalttätigen Entwicklungsphase Burundis angenommen hat, insbesondere während des langwierigen Friedensprozesses. Er zeigt auf, inwieweit nationale und internationale Akteure sich bei der Aushandlung und Planung des Arusha-Abkommens zu Frieden und Versöhnung in Burundi, das im August 2000 unterzeichnet wurde, sowie der anschließenden Verfassung am Instrumentarium der Konkordanzdemokratie bedient haben. Power-Sharing erwies sich als nützlich, das kurzfristige Ziel einer Beendigung des Krieges zu erreichen, und trug zur De-Ethnisierung des politischen Wettbewerbs und zur

  5. A Twenty-Year Look at “Computational Geology,” an Evolving, In-Discipline Course in Quantitative Literacy at the University of South Florida

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    Victor J. Ricchezza

    2017-01-01

    Full Text Available Since 1996, the Geology (GLY program at the USF has offered “Computational Geology” as part of its commitment to prepare undergraduate majors for the quantitative aspects of their field. The course focuses on geological-mathematical problem solving. Over its twenty years, the course has evolved from a GATC (geometry-algebra-trigonometry-calculus in-discipline capstone to a quantitative literacy (QL course taught within a natural science major. With the formation of the new School of Geosciences in 2013, the merging departments re-examined their various curricular programs. An online survey of the Geology Alumni Society found that “express quantitative evidence in support of an argument” was more favorably viewed as a workplace skill (4th out of 69 than algebra (51st, trig (55th and calculus 1 and 2 (59th and 60th. In that context, we decided to find out from successful alumni, “What did you get out of Computational Geology?” To that end, the first author carried out a formal, qualitative research study (narrative inquiry protocol, whereby he conducted, recorded, and transcribed semi-structured interviews of ten alumni selected from a list of 20 provided by the second author. In response to “Tell me what you remember from the course,” multiple alumni volunteered nine items: Excel (10 out of 10, Excel modules (8, Polya problem solving (5, “important” (4, unit conversions (4, back-of-the-envelope calculations (4, gender equality (3. In response to “Is there anything from the course that you used professionally or personally since graduating?” multiple alumni volunteered seven items: Excel (9 out of 10, QL/thinking (6, unit conversions (5, statistics (5, Excel modules (3, their notes (2. Outcome analysis from the open-ended comments arising from structured questions led to the identification of alumni takeaways in terms of elements of three values: (1 understanding and knowledge (facts such as conversion factors, and concepts

  6. 二十年来国内任璧莲研究述评%A Review of Related Researches of Gish Jen in the Twenty Years in China

    Institute of Scientific and Technical Information of China (English)

    高稳

    2016-01-01

    The introduction and researches of Gish Jen have been made for more than twenty years in China. Thus,a timely review of the research achievements will play a certain role in further carrying out the studies of her works. Overview shows that researches of Gish Jen at home focus on such framework as feminism,post -colonial-ism,post-modern theory and her works are interpreted from such perspectives as cultural attribute,cultural iden-tity,racial discrimination,gender discrimination and mother-daughter relationship. The author thinks that the sys-tematic study of her works should pay attention to the following aspects:strengthening the research of cultural poet-ics,the research of ethics value orientation and the interactive research of any relationship among Gish Jen,other Chinese-American writers and other minority writers.%国内对任璧莲的介绍和研究已有20余年,适时地回头梳理已有的研究成果,对进一步开展任璧莲作品的研究将起到一定的总结和反省作用。总览来国内学界所进行的任璧莲研究,大都是在女性主义、后殖民、后现代等理论的框架下,从文化属性、文化认同、种族歧视、性别歧视、母女关系等视角解读其作品。作者认为,任璧莲作品的系统化研究需要注意以下几个方面:应加强对其作品文化诗学、伦理价值取向、任璧莲与其他华裔作家及其他少数族裔作家(譬如犹太作家、非裔作家等)之间的关联与互动等研究。

  7. Changes in community mobility in older men and women. A 13-year prospective study.

    Directory of Open Access Journals (Sweden)

    Sofi Fristedt

    Full Text Available Community mobility, defined as "moving [ones] self in the community and using public or private transportation", has a unique ability to promote older peoples' wellbeing by enabling independence and access to activity arenas for interaction with others. Early predictors of decreased community mobility among older men and women are useful in developing health promoting strategies. However, long-term prediction is rare, especially when it comes to including both public and private transportation. The present study describes factors associated with community mobility and decreased community mobility over time among older men and women. In total, 119 men and 147 women responded to a questionnaire in 1994 and 2007. Respondents were between 82 and 96 years old at follow-up. After 13 years, 40% of men and 43% of women had decreased community mobility, but 47% of men and 45% of women still experienced some independent community mobility. Cross-sectional independent community mobility among men was associated with higher ratings of subjective health, reporting no depression and more involvement in sport activities. Among women, cross-sectional independent community mobility was associated with better subjective health and doing more instrumental activities of daily living outside the home. Lower subjective health predicted decreased community mobility for both men and women, whereas self-reported health conditions did not. Consequently, general policies and individual interventions aiming to improve community mobility should consider older persons' subjective health.

  8. High mobility group box-1 protein in patients with suspected community-acquired infections and sepsis: a prospective study

    DEFF Research Database (Denmark)

    Gaïni, Shahin; Pedersen, Svend Stenvang; Koldkjaer, Ole Graesbøll

    2008-01-01

    chromosomal protein. Its role as a pro-inflammatory cytokine in sepsis and rheumatoid arthritis has been described recently. The aim of our study was to evaluate HMGB1 as a molecular marker in patients with community-acquired infections. METHODS: Patients suspected of having infections/sepsis and admitted......CD163. CONCLUSION: In a cohort of patients with suspected community-acquired infections and sepsis, HMGB1 levels were statistically significantly higher in patients compared to the healthy controls. There was no statistically significant difference between the infected and the non-infected patients...... to a department of internal medicine were included in the study in a prospective manner. Demographic data, comorbidity, routine biochemistry, microbiological data, infection focus, severity score, and mortality on day 28 were recorded. Plasma and serum were sampled at the time of admission. HMGB1 levels were...

  9. Sarcopenia as a Risk Factor for Cognitive Deterioration in Community-Dwelling Older Adults: A 1-Year Prospective Study.

    Science.gov (United States)

    Nishiguchi, Shu; Yamada, Minoru; Shirooka, Hidehiko; Nozaki, Yuma; Fukutani, Naoto; Tashiro, Yuto; Hirata, Hinako; Yamaguchi, Moe; Tasaka, Seishiro; Matsushita, Tomofumi; Matsubara, Keisuke; Tsuboyama, Tadao; Aoyama, Tomoki

    2016-04-01

    The purpose of this 1-year prospective study was to determine whether sarcopenia is an independent risk factor of cognitive deterioration in community-dwelling older adults. One-year prospective study. Japanese community. A total of 131 community-dwelling older adults aged 65 years and older participated in this study. We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia, and the participants were classified into the sarcopenia and normal groups according to this definition. The participants' cognitive functions were assessed using the Mini-Mental State Examination (MMSE) during pre- and postdata collection (after 1 year). The rate of change in pre- and post-MMSE scores during the follow-up term was significantly different between the 2 groups (normal group, -0.32 ± 8.39%; sarcopenia group, -5.86 ± 5.16%; P = .002). The analysis of covariance, adjusted for demographic data and the pre-MMSE scores, showed a significant change in the MMSE scores between the normal and sarcopenia group (F = 9.30, P = .003). Furthermore, in the multivariate logistic regression analysis, the cognitive function was significantly more likely to deteriorate (defined as a loss of at least 2 points of MMSE) in the sarcopenia group during the follow-up term (odds ratio: 7.86, 95% confidence interval: 1.53-40.5). Sarcopenia was identified as an independent risk factor of cognitive deterioration in community-dwelling older adults during the 1-year study period. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  10. The Many Histories of Community Psychology: Analyses of Current Trends and Future Prospects

    Science.gov (United States)

    Fowler, Patrick J.; Toro, Paul A.

    2008-01-01

    Forty years since the seminal Swampscott Conference, the principles of community psychology transcend multiple areas of action and research, as well as international boundaries. The extensive development of community psychology offers an opportunity to examine from where the field has come and where it is going. Yet, a systematic approach to…

  11. The Many Histories of Community Psychology: Analyses of Current Trends and Future Prospects

    Science.gov (United States)

    Fowler, Patrick J.; Toro, Paul A.

    2008-01-01

    Forty years since the seminal Swampscott Conference, the principles of community psychology transcend multiple areas of action and research, as well as international boundaries. The extensive development of community psychology offers an opportunity to examine from where the field has come and where it is going. Yet, a systematic approach to…

  12. The Availability, Prospects, and Fiscal Potential of On-Campus Housing at Rural Community Colleges

    Science.gov (United States)

    Moeck, Pat G.; Katsinas, Stephen G.; Hardy, David E.; Bush, V. Barbara

    2008-01-01

    Many rural community colleges have long provided on-campus housing. This article profiles the availability of housing at rural community colleges in 2001-2002 and 2005-2006, examines the factors that will continue to make on-campus housing an important service at rural institutions, and draws on 2005-2006 data from the Institutional…

  13. Consultation in university-based and community-based infectious disease practices: a prospective study.

    Science.gov (United States)

    Sexton, D J; Corey, G R; Ingram, C W; Morris, V M; Haywood, H B

    1995-02-01

    Infectious disease physicians in university and community practices completed a standard data form following each of 1,366 inpatient consultations during a 7-month period. The rate of consultation was higher in the university practice than in the community practice (3.4 vs. 1.8 per 100 discharges, respectively). Known or suspected bacterial pathogens accounted for more than half of all consultations in both practice groups. The three organ systems most commonly affected by infection were pulmonary (20% in university practice vs. 19% in community practice), skin and soft tissue (13% in university practice vs. 20% in community practice), and musculoskeletal (12% in university practice vs. 16% in community practice). Bloodstream infection, pneumonia, unexplained fever, osteomyelitis, urinary tract infection, and cellulitis were the six most common disease processes that led to consultation in both practice groups. The percentage of patients with noninfectious diseases and the percentage for whom a change in antimicrobial therapy was advised was nearly identical in both practice settings. Physicians in private practice performed more consultations on weekends (20% vs. 11% in university practices, P consultants in community practices are nearly identical to those of their colleagues in university-based practices.

  14. Community violence exposure, coping, and problematic alcohol and drug use among urban, female caregivers: A prospective study.

    Science.gov (United States)

    Kliewer, Wendy; Zaharakis, Nikola

    2013-08-01

    Victimization is associated with substance use in women, but less is known about linkages between witnessing community violence and substance use, even though more women witness versus directly experience violence. Further, factors that contribute to or protect against women's problematic substance use are less well understood. Urban female caregivers (N = 318; > 92% African American/black) living in low-income communities were interviewed annually for three waves regarding exposure to community violence, coping behaviors, substance use, and protective factors. Path analyses revealed that lifetime witnessing of violence, but not victimization, assessed at baseline, was associated with changes in avoidant coping, but not active coping, one year later; avoidant coping, in turn, was related to changes in and higher levels of problematic drug use the following year. Victimization was directly related to problematic drug use, but not to alcohol use. Regression analyses indicated that high levels of religious commitment and social support at baseline were prospectively associated with lower levels of avoidant coping. Because caregivers are important role models for their children, it is important to attend to the factors that contribute to their substance use and abuse.

  15. The First Twenty Years (1994 2014) of Ozone Soundings from Rapa Nui (27 deg S, 109 deg W, 51 m a.s.l.)

    Science.gov (United States)

    Gallardo, Laura; Henriquez, Adolfo; Thompson, Anne M.; Rondanelli, Roberto; Carrasco, Jorge; Orfanoz-Cheuquelaf, Andrea; Velasquez, Patricio

    2017-01-01

    Ozone (O3) soundings have been performed on Easter Island or Rapa Nui (27 8S, 109 8W, 51 m a.s.l.) since 1994 as part of the Global Atmospheric Watch Programme of the World Meteorological Organization. In this work, we analyze 260 soundings compiled over the period 19942014, and make the data available for the international community. We characterize O3 profiles over this remote area of the Pacific by means of statistical analyses that consider, on the one hand, a traditional climatology that describes the data in terms of seasonal cycles based on monthly averages and, on the other hand, a process-oriented analysis based on self-organizing maps. Our analyses show the influence of both tropical and subtropical/mid-latitude air masses at Rapa Nui. The former occurs in summer and fall when convective conditions prevail, and the latter in late winter and spring when subsiding conditions are recurrent. The occurrence of stratospheric intrusions in late winter and spring in connection with deep troughs and the presence of the subtropical jet stream is also apparent in the data set. The tropospheric ozone column is in good agreement with the corresponding data derived from satellites but with a systematic overestimate of summer and fall values. There is evidence of an upward trend in ozone near the surface, which suggests the impact of local pollution. We look forward to an enhancement of the Rapa Nui observing site, given its location that offers a privileged position to observe climate change over the sparsely sampled and vast South Pacific Ocean.

  16. The first twenty years (1994–2014 of ozone soundings from Rapa Nui (27°S, 109°W, 51 m a.s.l.

    Directory of Open Access Journals (Sweden)

    Laura Gallardo

    2016-11-01

    Full Text Available Ozone (O3 soundings have been performed on Easter Island or Rapa Nui (27 °S, 109 °W, 51 m a.s.l. since 1994 as part of the Global Atmospheric Watch Programme of the World Meteorological Organization. In this work, we analyse 260 soundings compiled over the period 1994–2014, and make the data available for the international community. We characterise O3 profiles over this remote area of the Pacific by means of statistical analyses that consider, on the one hand, a traditional climatology that describes the data in terms of seasonal cycles based on monthly averages and, on the other hand, a process-oriented analysis based on self-organising maps. Our analyses show the influence of both tropical and subtropical/mid-latitude air masses at Rapa Nui. The former occurs in summer and fall when convective conditions prevail, and the latter in late winter and spring when subsiding conditions are recurrent. The occurrence of stratospheric intrusions in late winter and spring in connection with deep troughs and the presence of the subtropical jet stream is also apparent in the data set. The tropospheric ozone column is in good agreement with the corresponding data derived from satellites but with a systematic overestimate of summer and fall values. There is evidence of an upward trend in ozone near the surface, which suggests the impact of local pollution. We look forward to an enhancement of the Rapa Nui observing site, given its location that offers a privileged position to observe climate change over the sparsely sampled and vast South Pacific Ocean.

  17. Architectural Aspects of Grid Computing and its Global Prospects for E-Science Community

    Science.gov (United States)

    Ahmad, Mushtaq

    2008-05-01

    The paper reviews the imminent Architectural Aspects of Grid Computing for e-Science community for scientific research and business/commercial collaboration beyond physical boundaries. Grid Computing provides all the needed facilities; hardware, software, communication interfaces, high speed internet, safe authentication and secure environment for collaboration of research projects around the globe. It provides highly fast compute engine for those scientific and engineering research projects and business/commercial applications which are heavily compute intensive and/or require humongous amounts of data. It also makes possible the use of very advanced methodologies, simulation models, expert systems and treasure of knowledge available around the globe under the umbrella of knowledge sharing. Thus it makes possible one of the dreams of global village for the benefit of e-Science community across the globe.

  18. Solar public engagement: the prospective study on FELDA community in Malaysia

    Science.gov (United States)

    Jamiah Tun Jamil, Siti; Azfahani Ahmad, Nur

    2017-05-01

    Malaysia Energy Outlook 2016 has highlighted that Malaysia's electricity generation mix has always been highly dependent on fossil fuels. There is a concern on energy security for Malaysia recently, since the depletion of fossil fuel occurs and its effect increases the price of electricity tariff. Nevertheless, the energy demand continues to increase, which make the non-fossil renewable energy sources is back on demand. Malaysia's highest potential for renewable energy comes from solar energy and the large roofs of rural houses offer potential to contribute solar electricity for the people. Indeed, the engagement of solar energy to the public is very important in allowing this energy to be accepted by the locals. The paper will review the related literature on public engagement for solar energy project. This paper also tries to prospect the potential of implementing solar electricity for a well-known rural organization in Malaysia, known as FELDA.

  19. Prospects of Waterway Development as a Catalyst to Improve Regional and Community Socio-Economy Level

    OpenAIRE

    Sulaiman M. Yassin; Hayrol A.M. Shaffril; Md. S. Hassan; Mohd S. Othman; Asnarulkhadi A. Samah; Bahaman A. Samah

    2010-01-01

    Problem statement: Malaysia has achieved a number of successes in its transportation development. The success of Kuala Lumpur International Airport and Northern and Southern Highway project for examples have given the community lot of benefits in term of social and economic development, but what if an inland waterway system can be developed in Malaysia especially along Pahang River and Muar River. Can this proposed waterway bring significant impact to local people in term of their social and ...

  20. The Path to Baltimore's "Best Prospect" Jobs without a College Degree: Career Credentialing Programs at Baltimore's Community Colleges. The Abell Report. Volume 28, No. 2

    Science.gov (United States)

    Hopkins, Barbara L.

    2015-01-01

    Only one in five graduates of Baltimore City Public Schools matriculates to a four-year college; the vast majority enroll in community college or look for a full-time job. Baltimore graduates and job-seekers need postsecondary training that works. "The Path to Baltimore's 'Best Prospect' Jobs without a College Degree: Career Credentialing…

  1. Prospective study of a community reintegration programme for patients with acquired chronic brain injury: effects on caregivers' emotional burden and family functioning

    NARCIS (Netherlands)

    Geurtsen, G.J.; Heugten, C.M. van; Meijer, R.; Martina, J.D.; Geurts, A.C.H.

    2011-01-01

    Objective: To examine the effects of a residential community reintegration programme for patients with psychosocial problems due to acquired chronic brain injury on caregivers' emotional burden and family functioning. Design: A prospective cohort study with waiting list control and 1-year follow-up.

  2. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community dwelling seniors age 65 and older

    Science.gov (United States)

    Purpose: To compare the extent to which 7 available definitions of sarcopenia and 2 related definitions predict the prospective rate of falling. Methods: We studied a cohort of 445 seniors (mean age 71 years, 45% men) living in the community who were followed with a detailed fall assessment for 3 ...

  3. Stakeholder Views on the Roles, Challenges, and Future Prospects of Korean and Chinese Heritage Language-Community Language Schools in Phoenix: A Comparative Study

    Science.gov (United States)

    You, Byeong-keun; Liu, Na

    2011-01-01

    This study examines stakeholders' perspectives on Korean and Chinese heritage language and community language (HL-CL) schools and education in the Phoenix Metropolitan Area, Arizona. It investigates and compares the roles, major challenges, and future prospects of Korean and Chinese HL-CL schools as viewed by principals, teachers, and parents. To…

  4. Tool, weapon, or white elephant? A realist analysis of the five phases of a twenty-year programme of occupational health information system implementation in the health sector.

    Science.gov (United States)

    Spiegel, Jerry M; Lockhart, Karen; Dyck, Carmen; Wilson, Andrea; O'Hara, Lyndsay; Yassi, Annalee

    2012-08-06

    Although information systems (IS) have been extensively applied in the health sector worldwide, few initiatives have addressed the health and safety of health workers, a group acknowledged to be at high risk of injury and illness, as well as in great shortage globally, particularly in low and middle-income countries. Adapting a context-mechanism-outcome case study design, we analyze our team's own experience over two decades to address this gap: in two different Canadian provinces; and two distinct South African settings. Applying a realist analysis within an adapted structuration theory framing sensitive to power relations, we explore contextual (socio-political and technological) characteristics and mechanisms affecting outcomes at micro, meso and macro levels. Technological limitations hindered IS usefulness in the initial Canadian locale, while staffing inadequacies amid pronounced power imbalances affecting governance restricted IS usefulness in the subsequent Canadian application. Implementation in South Africa highlighted the special care needed to address power dynamics regarding both worker-employer relations (relevant to all occupational health settings) and North-south imbalances (common to all international interactions). Researchers, managers and front-line workers all view IS implementation differently; relationships amongst the workplace parties and between community and academic partners have been pivotal in determining outcome in all circumstances. Capacity building and applying creative commons and open source solutions are showing promise, as is international collaboration. There is worldwide consensus on the need for IS use to protect the health workforce. However, IS implementation is a resource-intensive undertaking; regardless of how carefully designed the software, contextual factors and the mechanisms adopted to address these are critical to mitigate threats and achieve outcomes of interest to all parties. Issues specific to IS development

  5. Tool, weapon, or white elephant? A realist analysis of the five phases of a twenty-year programme of occupational health information system implementation in the health sector

    Directory of Open Access Journals (Sweden)

    Spiegel Jerry M

    2012-08-01

    Full Text Available Abstract Background Although information systems (IS have been extensively applied in the health sector worldwide, few initiatives have addressed the health and safety of health workers, a group acknowledged to be at high risk of injury and illness, as well as in great shortage globally, particularly in low and middle-income countries. Methods Adapting a context-mechanism-outcome case study design, we analyze our team’s own experience over two decades to address this gap: in two different Canadian provinces; and two distinct South African settings. Applying a realist analysis within an adapted structuration theory framing sensitive to power relations, we explore contextual (socio-political and technological characteristics and mechanisms affecting outcomes at micro, meso and macro levels. Results Technological limitations hindered IS usefulness in the initial Canadian locale, while staffing inadequacies amid pronounced power imbalances affecting governance restricted IS usefulness in the subsequent Canadian application. Implementation in South Africa highlighted the special care needed to address power dynamics regarding both worker-employer relations (relevant to all occupational health settings and North–south imbalances (common to all international interactions. Researchers, managers and front-line workers all view IS implementation differently; relationships amongst the workplace parties and between community and academic partners have been pivotal in determining outcome in all circumstances. Capacity building and applying creative commons and open source solutions are showing promise, as is international collaboration. Conclusions There is worldwide consensus on the need for IS use to protect the health workforce. However, IS implementation is a resource-intensive undertaking; regardless of how carefully designed the software, contextual factors and the mechanisms adopted to address these are critical to mitigate threats and achieve

  6. 中国转基因棉花研发应用二十年%Twenty Years of Research and Application of Transgenic Cotton in China

    Institute of Scientific and Technical Information of China (English)

    郭三堆; 王远; 孙国清; 金石桥; 周焘; 孟志刚; 张锐

    2015-01-01

    , insects and herbicides as well as for the improvement of fiber yield and quality in China and improved methods of genetic transformation like Agrobacterium mediated, tissue culture, gene gun bombardment, pollen tube pathway, shoot tip, floral-dip and nano-carrier pollen mediated transformations. Finally this paper also discussed the biosafety system regarding the transgenic plants development, Bt cotton seed industry and future prospects of transgenic cotton in China.%转基因技术是指利用重组DNA原理,将优良目的基因整合到靶标生物基因组中,并使靶标生物得以表达目的性状的技术.这一技术克服了生物有性杂交的限制,使物种间基因交流的范围无限扩大,既可以从原核生物到真核生物,也可以从单细胞生物到多细胞生物,还可以从低等生物到高等生物,反之亦然.因此,这项技术自发明以来,即广泛应用于农业、林业、医学等领域,为其研究开辟了一个全新的时代.转基因植物是以农杆菌等为媒介,将来源于动物、植物或微生物等其他生物甚至人工合成的外源基因转入基因组中,使之稳定遗传并赋予其靶标性状,如抗病、抗虫、抗逆、高产、优质等的植物.以 1972 年构建第一个重组 DNA 分子为契机,1983年首次获得转基因烟草为起点,植物转基因技术在近30年的时间内发展迅猛,至今已有200多种植物已成功获得转基因株系,40多种数千例转基因植株进入田间试验.根据国际农业生物技术应用咨询服务中心(ISAAA)统计,全球转基因植物的种植面积由1996年的260万hm2已经迅速增到2014年的1.815亿hm2,累计种植面积大约比中国国土总面积还多 80%.在全球转基因植物研发和应用迅猛发展的同时,中国也先后批准了 7 种转基因植物的生产应用,其中,抗虫棉是唯一大规模应用的转基因农作物.从1994年中国研制成功国产单价抗虫棉(GK),以及1995年美国保铃棉进入中国

  7. Twenty years of activity of the radiation protection service of the El Cabril storage center; Veinte anos de actividad del servicio de proteccion radiologica del centro de almacenamiento de El Cabril

    Energy Technology Data Exchange (ETDEWEB)

    Fuentes, L.; Pinilla, J. L.; Ortiz, M. T.

    2013-07-01

    All controls of internal contamination by body radioactivity counter have been lower than the level of logging for internal doses (1 mSv/year). External personal pollution incidents have not occurred. With respect to the dose to the public these remain very low and lower than the limits specified in the authorization. Also the results of the PVRA indicate no influence of the installation in your environment. During the twenty years of operation of the El Cabril Storage Center has not occurred any incidents radiological and doses both to workers and the public in general, are kept very low and lower than the established dose limits. (Author)

  8. Mercury pollution control in industrial area in Rosignano Marittimo (Italy) during last twenty years (1971-1991); Il controllo dell`inquinamento da mercurio nell`area industriale di Rosignano marittimo negli anni 1971-1991

    Energy Technology Data Exchange (ETDEWEB)

    Bertani, R. [Unita Sanitaria Locale 14, Cecina, Livorno (Italy)

    1995-03-01

    Author takes into account some papers dealing with mercury environmental pollution, appeared in different scientific journals over the last twenty years, in the aim of defining a homogeneous frame for the comprehension of the environmental situation development. Data relating to air, marine water, sediments, animal and vegetal organisms, show a consistent decreasing of mercury emissions with the passing of time. Nevertheless, author fearfully points out the environmental fate of the mercury which has been heavily released from the plant in the past years and to whom he wishes to turn attention for the assessment of an adequate control procedure.

  9. The burden and etiology of community-onset pneumonia in the aging Japanese population: a multicenter prospective study.

    Directory of Open Access Journals (Sweden)

    Konosuke Morimoto

    Full Text Available The increasing burden of pneumonia in adults is an emerging health issue in the era of global population aging. This study was conducted to elucidate the burden of community-onset pneumonia (COP and its etiologic fractions in Japan, the world's most aged society.A multicenter prospective surveillance for COP was conducted from September 2011 to January 2013 in Japan. All pneumonia patients aged ≥ 15 years, including those with community-acquired pneumonia (CAP and health care-associated pneumonia (HCAP, were enrolled at four community hospitals on four major islands. The COP burden was estimated based on the surveillance data and national statistics.A total of 1,772 COP episodes out of 932,080 hospital visits were enrolled during the surveillance. The estimated overall incidence rates of adult COP, hospitalization, and in-hospital death were 16.9 (95% confidence interval, 13.6 to 20.9, 5.3 (4.5 to 6.2, and 0.7 (0.6 to 0.8 per 1,000 person-years (PY, respectively. The incidence rates sharply increased with age; the incidence in people aged ≥ 85 years was 10-fold higher than that in people aged 15-64 years. The estimated annual number of adult COP cases in the entire Japanese population was 1,880,000, and 69.4% were aged ≥ 65 years. Aspiration-associated pneumonia (630,000 was the leading etiologic category, followed by Streptococcus pneumoniae-associated pneumonia (530,000, Haemophilus influenzae-associated pneumonia (420,000, and respiratory virus-associated pneumonia (420,000, including influenza-associated pneumonia (30,000.A substantial portion of the COP burden occurs among elderly members of the Japanese adult population. In addition to the introduction of effective vaccines for S. pneumoniae and influenza, multidimensional approaches are needed to reduce the pneumonia burden in an aging society.

  10. C-reactive protein, an early marker of community-acquired sepsis resolution: a multi-center prospective observational study.

    Science.gov (United States)

    Póvoa, Pedro; Teixeira-Pinto, Armando M; Carneiro, António H

    2011-07-15

    C-reactive protein (CRP) has been shown to be a valuable marker in the diagnosis of infection and in monitoring its response to antibiotics. Our objective was to evaluate serial CRP measurements after prescription of antibiotics to describe the clinical course of Community-Acquired Sepsis admitted to intensive care units (ICU). During a 12-month period a multi-center, prospective, observational study was conducted, segregating adults with Community-Acquired Sepsis. Patients were followed-up during the first five ICU days, day of ICU discharge or death and hospital outcome. CRP-ratio was calculated in relation to Day 1 CRP concentration. Patients were classified according to the pattern of CRP-ratio response to antibiotics: fast response if Day 5 CRP-ratio was 0.8. Comparison between survivors and non-survivors was performed. A total of 891 patients (age 60 ± 17 yrs, hospital mortality 38%) were studied. There were no significant differences between the CRP of survivors and non-survivors until Day 2 of antibiotic therapy. On the following three days, CRP of survivors was significantly lower (P patterns was 23%, 30% and 41%, respectively (P = 0.001). No responders had a significant increase on the odds of death (OR = 2.5, CI95% = (1.6, 4.0), P prescription were useful as early as Day 3 in identification of Community-Acquired Sepsis patients with poor outcome. The rate of CRP decline during the first five ICU days was markedly associated with prognosis. The identification of the pattern of CRP-ratio response was useful in the recognition of the individual clinical course.

  11. Universal Indicators for Oil and Gas Prospecting Based on Bacterial Communities Shaped by Light-Hydrocarbon Microseepage in China.

    Science.gov (United States)

    Deng, Chunping; Yu, Xuejian; Yang, Jinshui; Li, Baozhen; Sun, Weilin; Yuan, Hongli

    2016-07-28

    Light hydrocarbons accumulated in subsurface soil by long-term microseepage could favor the anomalous growth of indigenous hydrocarbon-oxidizing microorganisms, which could be crucial indicators of underlying petroleum reservoirs. Here, Illumina MiSeq sequencing of the 16S rRNA gene was conducted to determine the bacterial community structures in soil samples collected from three typical oil and gas fields at different locations in China. Incubation with n-butane at the laboratory scale was performed to confirm the presence of "universal microbes" in light-hydrocarbon microseepage ecosystems. The results indicated significantly higher bacterial diversity in next-to-well samples compared with background samples at two of the three sites, which were notably different to oil-contaminated environments. Variation partitioning analysis showed that the bacterial community structures above the oil and gas fields at the scale of the present study were shaped mainly by environmental parameters, and geographic location was able to explain only 7.05% of the variation independently. The linear discriminant analysis effect size method revealed that the oil and gas fields significantly favored the growth of Mycobacterium, Flavobacterium, and Pseudomonas, as well as other related bacteria. The relative abundance of Mycobacterium and Pseudomonas increased notably after n-butane cultivation, which highlighted their potential as biomarkers of underlying oil deposits. This work contributes to a broader perspective on the bacterial community structures shaped by long-term light-hydrocarbon microseepage and proposes relatively universal indicators, providing an additional resource for the improvement of microbial prospecting of oil and gas.

  12. Predictors of inhospital mortality and re-hospitalization in older adults with community-acquired pneumonia: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Marrie Tom

    2010-05-01

    Full Text Available Abstract Background A better understanding of potentially modifiable predictors of in-hospital mortality and re-admission to the hospital following discharge may help to improve management of community-acquired pneumonia in older adults. We aimed to assess the associations of potentially modifiable factors with mortality and re-hospitalization in older adults hospitalized with community-acquired pneumonia. Methods A prospective cohort study was conducted from July 2003 to April 2005 in two Canadian cities. Patients aged 65 years or older hospitalized for community-acquired pneumonia were followed up for up to 30 days from initial hospitalization for mortality and these patients who were discharged alive within 30 days of initial hospitalization were followed up to 90 days of initial hospitalization for re-hospitalization. Separate logistic regression analyses were performed identify the predictors of mortality and re-hospitalization. Results Of 717 enrolled patients hospitalized for community-acquired pneumonia, 49 (6.8% died within 30 days of hospital admission. Among these patients, 526 were discharged alive within 30 days of hospitalization of whom 58 (11.2% were re-hospitalized within 90 days of initial hospitalization. History of hip fracture (odds ratio (OR = 4.00, 95% confidence interval (CI = (1.46, 10.96, P = .007, chronic obstructive pulmonary disease (OR = 2.31, 95% CI = (1.18, 4.50, P = .014, cerebrovascular disease (OR = 2.11, 95% CI = (1.03, 4.31, P = .040 were associated with mortality. Male sex (OR = 2.35, 95% CI = (1.13, 4.85, P = .022 was associated with re-hospitalization while vitamin E supplementation was protective (OR = 0.37 (0.16, 0.90, P = .028. Lower socioeconomic status, prior influenza and pneumococcal vaccinations, appropriate antibiotic prescription upon admission, and lower nutrition risk were not significantly associated with mortality or re-hospitalization. Conclusion Chronic comorbidities appear to be the most

  13. Parenting and Trajectories of Children’s Maladaptive Behaviors: A 12-year Prospective Community Study

    Science.gov (United States)

    Luyckx, Koen; Tildesley, Elizabeth A.; Soenens, Bart; Andrews, Judy A.; Hampson, Sarah E.; Peterson, Missy; Duriez, Bart

    2011-01-01

    This study investigated how parenting accounted for inter-individual differences in developmental trajectories of different child behaviors across childhood and adolescence. In a cohort sequential community sample of 1,049 children, latent class growth analysis was applied to three parent-reported dimensions (monitoring, positive parenting, inconsistent discipline) across 12 annual assessments (ages 6–18). Four longitudinal parenting styles (authoritative, authoritarian, indulgent, uninvolved) were differentiated on the basis of levels and rates of change in the constituent parenting dimensions. Multi-group analyses demonstrated that these parenting styles were differentially related to changes in parent- and child-reported measures of children’s alcohol and cigarette use, antisocial behavior, and internalizing symptoms, with the authoritative parenting class being related to the most optimal long-term development. Practical implications and future research suggestions are discussed. PMID:21534057

  14. Outcomes of FLEXIBLE Assertive Community Treatment (FACT) Implementation: A Prospective Real Life Study.

    Science.gov (United States)

    Nugter, M Annet; Engelsbel, Fabiana; Bähler, Michiel; Keet, René; van Veldhuizen, Remmers

    2016-11-01

    This study aimed to investigate social and clinical outcomes and use of care during and after implementation of FLEXIBLE Assertive Community Treatment (ACT). Three teams and 372 patients were involved. Model fidelity, clinical and social assessments were performed at baseline and after 1 and 2 years. Use of care was registered continuously. Model fidelity was good at the end of the study. Data showed much variation between patients in number and duration of ACT periods. Statistically significant improvements were found in compliance, unmet needs and quality of life. Improvement of quality of life and functioning was related to duration of ACT. The percentage of remissions increased with 9 %. The number of admissions, admission days and face to face contacts differed between ACT and non-ACT patients, but generally decreased. Findings suggest that implementation of FACT results in a more flexible adaptation of care to the needs of the patients.

  15. Spatiotemporal gait parameters and recurrent falls in community-dwelling elderly women: a prospective study

    Directory of Open Access Journals (Sweden)

    Bruno S. Moreira

    2015-02-01

    Full Text Available BACKGROUND: Falling is a common but devastating and costly problem of aging. There is no consensus in the literature on whether the spatial and temporal gait parameters could identify elderly people at risk of recurrent falls. OBJECTIVE: To determine whether spatiotemporal gait parameters could predict recurrent falls in elderly women. METHOD: One hundred and forty-eight elderly women (65-85 years participated in this study. Seven spatiotemporal gait parameters were collected with the GAITRite(r system. Falls were recorded prospectively during 12 months through biweekly phone contacts. Elderly women who reported two or more falls throughout the follow-up period were considered as recurrent fallers. Principal component analysis (PCA and discriminant analysis followed by biplot graph interpretation were applied to the gait parameters. RESULTS: After 12 months, 23 elderly women fell twice or more and comprised the recurrent fallers group and 110 with one or no falls comprised the non-recurrent fallers group. PCA resulted in three components that explained 88.3% of data variance. Discriminant analysis showed that none of the components could significantly discriminate the groups. However, visual inspection of the biplot showed a trend towards group separation in relation to gait velocity and stance time. PC1 represented gait rhythm and showed that recurrent fallers tend to walk with lower velocity and cadence and increased stance time in relation to non-recurrent fallers. CONCLUSIONS: The analyzed spatiotemporal gait parameters failed to predict recurrent falls in this sample. The PCA-biplot technique highlighted important trends or red flags that should be considered when evaluating recurrent falls in elderly females.

  16. Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study

    Directory of Open Access Journals (Sweden)

    Diallo Abdoulaye

    2010-08-01

    Full Text Available Abstract Background There is a scarcity of reliable data on perinatal mortality (PNM in Sub-Saharan Africa. The PROMISE-EBF trial, during which we promoted exclusive breastfeeding, gave us the opportunity to describe the epidemiology of PNM in Banfora Health District, South-West in Burkina Faso. Study objectives To measure the perinatal mortality rate (PNMR in the PROMISE-EBF cohort in Banfora Health District and to identify potential risk factors for perinatal death. Methods We used data collected prospectively during the PROMISE-EBF-trial to estimate the stillbirth rate (SBR and early neonatal mortality rate (ENMR. We used binomial regression with generalized estimating equations to identify potential risk factors for perinatal death. Results 895 pregnant women were enrolled for data collection in the EBF trial and followed-up to 7 days after birth. The PNMR, the SBR and the ENMR, were 79 per 1000 (95% CI: 59-99, 54 per 1000 (95% CI: 38-69 and 27 per 1000 (95% CI: 9-44, respectively. In a multivariable analysis, nulliparous women (RR = 2.90, 95% CI: 1.6-5.0, primiparae mothers (RR = 2.20, 95% CI: 1.2-3.9, twins (RR = 4.0, 95% CI: 2.3-6.9 and giving birth during the dry season (RR = 2.1 95% CI: 1.3-3.3 were factors associated with increased risk of perinatal death. There was no evidence that risk of perinatal death differed between deliveries at home and at a health centre Conclusion Our study observed the highest PNMR ever reported in Burkina. There is an urgent need for sustainable interventions to improve maternal and newborn health in the country.

  17. Twenty Years' Work Done by SUN ZI'S ART OF WAR Research Association in Retrospect and the Future in Prospect%孙子兵法研究会20年工作的回顾与展望

    Institute of Scientific and Technical Information of China (English)

    寿晓松

    2009-01-01

    中国孙子兵法研究会自1989年5月成立至今的20年间,为推动孙子兵法研究事业的繁荣发展做了大量工作,起到了不可替代的重要作用:与国内外孙子兵法研究团体及学者建立了广泛的联系,成功举办了7届孙子兵法国际学术研讨会,推出了一批重要的科研成果.在新的形势下,研究会应按照新思路开展工作,即坚持以科学发展观为指导,承前启后,开拓进取,进一步健全组织、完善领导工作机制;进一步加强对内对外联系,拓展交流平台;进一步繁荣学术,开创孙子兵法研究的新局面.

  18. The methodology for developing a prospective meta-analysis in the family planning community

    Directory of Open Access Journals (Sweden)

    Jacobson Janet C

    2011-04-01

    Full Text Available Abstract Background Prospective meta-analysis (PMA is a collaborative research design in which individual sites perform randomized controlled trials (RCTs and pool the data for meta-analysis. Members of the PMA collaboration agree upon specific research interventions and outcome measures, ideally before initiation but at least prior to any individual trial publishing results. This allows for uniform reporting of primary and secondary outcomes. With this approach, heterogeneity among trials contributing data for the final meta-analysis is minimized while each site maintains the freedom to design a specific trial. This paper describes the process of creating a PMA collaboration to evaluate the impact of misoprostol on ease of intrauterine device (IUD insertion in nulliparous women. Methods After the principal investigator developed a preliminary PMA protocol, he identified potential collaborating investigators at other sites. One site already had a trial underway and another site was in the planning stages of a trial meeting PMA requirements. Investigators at six sites joined the PMA collaborative. Each site committed to enroll subjects to meet a pre-determined total sample size. A final common research plan and site responsibilities were developed and agreed upon through email and face-to-face meetings. Each site committed to contribute individual patient data to the PMA collaboration, and these data will be analyzed and prepared as a multi-site publication. Individual sites retain the ability to analyze and publish their site's independent findings. Results All six sites have obtained Institutional Review Board approval and each has obtained individual funding to meet the needs of that site's study. Sites have shared resources including study protocols and consents to decrease costs and improve study flow. This PMA protocol is registered with the Cochrane Collaboration and data will be analyzed according to Cochrane standards for meta

  19. Life satisfaction and frailty in community-based older adults: cross-sectional and prospective analyses.

    Science.gov (United States)

    St John, Philip D; Tyas, Suzanne L; Montgomery, Patrick R

    2013-10-01

    Frailty may be associated with reduced life satisfaction (LS). The objectives of this paper are to determine if (1) frailty is associated with LS in community-dwelling older adults in cross-sectional analyses; (2) frailty predicts LS five years later; and (3) specific domains of LS are preferentially associated with frailty. This paper presents analysis of an existing population-based cohort study of 1,751 persons aged 65+ who were assessed in 1991, with follow-up five years later. LS was measured using the terrible-delightful scale, which measures overall LS and LS in specific domains. Frailty was measured using the Brief Frailty Instrument. Analyses were adjusted for age, gender, education, and marital status. Frailty was associated with overall LS at time 1 and predicted overall LS at time 2. This was seen in unadjusted analyses and after adjusting for confounding factors. Frailty was associated with all domains of LS at time 1, and predicted LS at time 2 in all domains except housing and self-esteem. However, the effect was stronger for LS with health than with other domains for both times 1 and 2. Frailty is associated with LS, and the effect is strongest for LS with health.

  20. Twenty years of acanthamoeba diagnostics in Austria.

    Science.gov (United States)

    Walochnik, Julia; Scheikl, Ute; Haller-Schober, Eva-Maria

    2015-01-01

    Acanthamoebae are the causative agents of an often seriously progressing keratitis (AK) occurring predominantly in contact lens wearers and can cause several disseminating infections potentially resulting in granulomatous amoebic encephalitis (GAE) in the immunocompromised host. Our institution is the Austrian reference laboratory for Acanthamoeba diagnostics and the aim of this study was to give an overview of proven cases of Acanthamoeba infections in Austria during the past 20 yr. All samples of patients with suspected AK or GAE were screened for Acanthamoeba spp. by culture and/or PCR and the detected amoebae were genotyped. Altogether, 154 cases of AK and three cases of GAE were diagnosed. Age of the AK patients ranged from 8 to 82 yr (mean 37.8) and 58% of the patients were female. Approximately 89% of the AK patients were contact lens wearers, almost all cases were unilateral and 19% of the patients required a keratoplasty. Age of the GAE patients ranged from 2 to 25 yr (mean 14.7), all were HIV-negative, but two were severely immunosuppressed at the time of diagnosis. The predominant genotype in the AK cases was T4, other genotypes found were T3, T5, T6, T10 and T11. The three GAE cases involved genotypes T2, T4 and T5.

  1. Germany: Twenty Years After The Union

    OpenAIRE

    Pete Mavrokordatos; Stan Stascinsky; Andrew Michael

    2010-01-01

    One of the most important events in the world after World War II was the reunification of Germany, during the late 1980s and early 1990s. The aim of this paper is to discuss the general economic conditions in Germany, before and after the reunification. This paper is divided into four parts. The introductory section provides a summative discussion of the economic conditions in East and West Germany from World War II until the time of reunification. The second section presents an evaluation of...

  2. It was twenty years ago today ...

    CERN Document Server

    Ginsparg, Paul

    2011-01-01

    To mark the 20th anniversary of the (14 Aug 1991) commencement of hep-th@xxx.lanl.gov (now arXiv.org), I've adapted this article from one that first appeared in Physics World (2008), was later reprinted (with permission) in Learned Publishing (2009), but never appeared in arXiv. I trace some historical context and early development of the resource, its later trajectory, and close with some thoughts about the future. This version is closer to my original draft, with some updates for this occasion, plus an astounding $2^5$ added footnotes.

  3. Twenty Years of Diagnosis and the DSM.

    Science.gov (United States)

    Seligman, Linda

    1999-01-01

    The process of diagnosing mental disorders and the use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have been increasingly important for counselors. This article provides information on the hallmarks of this shift. Reviews and discusses the changes form the third and fourth editions of the DSM. Offers predictions as to future…

  4. The New Economic History after Twenty Years

    Science.gov (United States)

    North, Douglass C.

    1977-01-01

    Reviews contributions of economic history to an understanding of the economic past. A discipline which has developed since 1957, economic history deals with causes of economic growth or decline in a society over time, and the well-being of different groups in the society over time. It makes systematic use of theory and quantitative methods.…

  5. Twenty-year survivors of kidney transplantation.

    LENUS (Irish Health Repository)

    Traynor, C

    2012-12-01

    There have been few studies of patients with renal allografts functioning for more than 20 years. We sought to identify clinical factors associated with ultra long-term (>20 year) renal allograft survival and to describe the clinical features of these patients. We performed a retrospective analysis of the Irish Renal Transplant Database and included 1174 transplants in 1002 patients. There were 255 (21.74%) patients with graft function for 20 years or more. Multivariate analysis identified recipient age (HR 1.01, CI 1.01-1.02), gender (male HR 1.25, CI 1.08-1.45), acute rejection (HR 1.26, CI 1.09-1.45) and transplant type (living related donor vs. deceased donor) (HR 0.52, CI 0.40-0.66) as significantly associated with long-term graft loss. Median serum creatinine was 115 μmol\\/L. The 5-year graft survival in 20-year survivors was 74.7%. The mean age at death was 62.7 years (±10.6). The most common causes of death were cardiovascular disease and malignancy. The two major causes of graft loss were death (with function) and interstitial fibrosis\\/tubular atrophy. Comorbidities included skin cancer (36.1%), coronary heart disease (17.3%) and other malignancies (14.5%). This study identifies factors associated with long-term allograft survival and a high rate of morbidity and early mortality in long-term transplant recipients.

  6. [Good use and knowledge of paracetamol (acetaminophen) among self-medicated patients: Prospective study in community pharmacies].

    Science.gov (United States)

    Severin, Anne-Elise; Petitpain, Nadine; Scala-Bertola, Julien; Latarche, Clotilde; Yelehe-Okouma, Melissa; Di Patrizio, Paolo; Gillet, Pierre

    2016-06-01

    Acetaminophen (paracetamol), the highest over-the-counter (OTC) selling drug in France, is also the first cause of acute hepatic failure. We aimed to assess the good use and the knowledge of acetaminophen in a setting of urban self-medicated patients. We conducted a prospective observational study in randomly selected community pharmacies of Metz (France) agglomeration. Patients coming to buy OTC acetaminophen for themselves or their family had to answer to an anonymous autoquestionnaire. Responses were individually and concomitantly analyzed through 3 scores: good use, knowledge and overdosage. Twenty-four community pharmacies participated and 302 patients were interviewed by mean of a dedicated questionnaire. Most of patients (84.4%) could be considered as "good users" and independent factors of good use were (i) a good knowledge of acetaminophen (OR=5.3; P<0.0001) and more surprisingly; (ii) the fact of having no children (parentality: OR=0.1; P=0.006). Responses corresponding to involuntary overdosage were mostly due to a too short interval between drug intakes (3hours). Only 30.8% of patients were aware of liver toxicity of acetaminophen and only 40.7% knew the risk of the association with alcohol. Both good use and knowledge were significantly higher in patients looking for information from their pharmacist, physician and package leaflet. Patients should definitely be better informed about acetaminophen to warrant a better safety of its consumption. Pharmacists and physicians have to remind patients the risk factors of unintentional overdose and liver toxicity. Package leaflets have also to be more informative.

  7. Outcomes of social support programs in brain cancer survivors in an Australian community cohort: a prospective study

    Directory of Open Access Journals (Sweden)

    Khan F

    2013-03-01

    Full Text Available This study evaluated the impact of social support programs on improving cancer related disability, neuro-cognitive dysfunction and enhancing participation (quality of life (QoL, social reintegration in brain tumour (BT survivors. Participants (n=43 were recruited prospectively following definitive treatment in the community. Each BT survivor received an individualised social support program which comprised: face-to-face interview for education/counselling plus peer support program or community education/counselling sessions. The assessments were at baseline (T1, 6-week (T2 and 6-month (T3 post-intervention using validated questionnaires: depression anxiety stress scale (DASS, functional independence measure (FIM, perceived impact problem profile (PIPP, cancer rehabilitation evaluation system–short form (CARES-SF, a cancer survivor unmet needs measure (CaSUN, McGill quality of life questionnaire (MQOL and Brief COPE. Participants’ mean age was 53 years (range 31–72 years, the majority were female (72%; median time since BT diagnosis was 2.3 years and almost half (47% had high grade tumours. At T2, participants reported higher emotional well-being (DASS ‘anxiety’ and ‘stress’ subscales, p<0.05; FIM ‘cognition’ subscale, p<0.01, improved function (FIM ‘motor’ subscale, p<0.01 and higher QoL (CARES-SF ‘global’ score, p<0.05; MQOL ‘physical symptom’ subscale, p<0.05. At the T3 follow-up, most of these effects were maintained. The intervention effect for BT specific coping strategies emerged for the Brief COPE ‘self-distraction’ and ‘behavioural disengagement’ domains, (p<0.05 for both. There were no adverse effects reported. A post-treatment social support program can improve physical and cognitive function and enhancing overall QoL of BT survivors. Social support programs need further evaluation and should be encouraged by clinicians within cancer rehabilitative services.

  8. Epidemiology of episodic adenolymphangitis: a longitudinal prospective surveillance among a rural community endemic for bancroftian filariasis in coastal Orissa, India

    Directory of Open Access Journals (Sweden)

    Dhal Kalpataru

    2005-05-01

    Full Text Available Abstract Background The epidemiological knowledge on acute condition of lymphatic filariasis is essential to understand the burden and issues on management of the disease. Methods A one year long longitudinal prospective surveillance of acute adenolymphangitis (ADL was carried out in rural population of Orissa, India. Results The annual incidence of ADL per 1000 individuals is 85.0, and is slightly higher (P > 0.05 in male (92.0 than in female (77.6. A steady rise in the incidence of ADL episodes along with the age is recorded. The distribution indicates that persons with chronic disease are more prone to ADL attacks. The average number of episodes per year is 1.57 (1.15 SD per affected person, and is gender dependent. Duration of the episode varies from 1 to 11 days with mean duration of 3.93 (1.94 SD days. The chronic disease is the significant predictor for the duration of the episode. The data show that fever and swelling at inguinal regions are most common symptoms. Conclusion The incidence, frequency and duration of ADL episodes in this community are similar to that of other endemic areas. As the loss due to these ADL episodes is substantial, it should be considered while further estimating the burden due to lymphatic filariasis. The disability and loss caused by chronic forms of filariasis is higher, and the additional incapacity caused by the ADL episode, majority of which occur among chronic filariasis patients, further poses the burden on individuals and their families. Hence, morbidity management measures to prevent ADL episodes among endemic communities are to be implemented.

  9. Risk of heart failure after community acquired pneumonia: prospective controlled study with 10 years of follow-up.

    Science.gov (United States)

    Eurich, Dean T; Marrie, Thomas J; Minhas-Sandhu, Jasjeet K; Majumdar, Sumit R

    2017-02-13

    Objective To determine the attributable risk of community acquired pneumonia on incidence of heart failure throughout the age range of affected patients and severity of the infection.Design Cohort study.Setting Six hospitals and seven emergency departments in Edmonton, Alberta, Canada, 2000-02.Participants 4988 adults with community acquired pneumonia and no history of heart failure were prospectively recruited and matched on age, sex, and setting of treatment (inpatient or outpatient) with up to five adults without pneumonia (controls) or prevalent heart failure (n=23 060).Main outcome measures Risk of hospital admission for incident heart failure or a combined endpoint of heart failure or death up to 2012, evaluated using multivariable Cox proportional hazards analyses.Results The average age of participants was 55 years, 2649 (53.1%) were men, and 63.4% were managed as outpatients. Over a median of 9.9 years (interquartile range 5.9-10.6), 11.9% (n=592) of patients with pneumonia had incident heart failure compared with 7.4% (n=1712) of controls (adjusted hazard ratio 1.61, 95% confidence interval 1.44 to 1.81). Patients with pneumonia aged 65 or less had the lowest absolute increase (but greatest relative risk) of heart failure compared with controls (4.8% v 2.2%; adjusted hazard ratio 1.98, 95% confidence interval 1.5 to 2.53), whereas patients with pneumonia aged more than 65 years had the highest absolute increase (but lowest relative risk) of heart failure (24.8% v 18.9%; adjusted hazard ratio 1.55, 1.36 to 1.77). Results were consistent in the short term (90 days) and intermediate term (one year) and whether patients were treated in hospital or as outpatients.Conclusion Our results show that community acquired pneumonia substantially increases the risk of heart failure across the age and severity range of cases. This should be considered when formulating post-discharge care plans and preventive strategies, and assessing downstream episodes of

  10. Screening for developmental delay in the setting of a community pediatric clinic: a prospective assessment of parent-report questionnaires.

    Science.gov (United States)

    Rydz, David; Srour, Myriam; Oskoui, Maryam; Marget, Nancy; Shiller, Mitchell; Birnbaum, Rena; Majnemer, Annette; Shevell, Michael I

    2006-10-01

    Our goal for this study was to prospectively test whether parent-completed questionnaires can be effectively used in the setting of a busy ambulatory pediatric clinic to accurately screen for developmental impairments. Specific objectives included (1) assessing the feasibility of using parent-report instruments in the setting of a community pediatric clinic, (2) evaluating the accuracy of 2 available screening tests (the Ages and Stages Questionnaire and Child Development Inventory), and (3) ascertaining if the pediatrician's clinical judgment could be used as a potential modifier. Subjects were recruited from the patient population of a community clinic providing primary ambulatory pediatric care. Subjects without previous developmental delay or concerns noted were contacted at the time of their routine 18-month-old visit. Those subjects who agreed to participate were randomly assigned to 1 of 2 groups and completed either the Ages and Stages Questionnaire or Child Development Inventory. The child's pediatrician also completed a brief questionnaire regarding his or her opinion of the child's development. Those children for whom concerns were identified by either questionnaire underwent additional detailed testing by the Battelle Development Inventory, the "gold standard" for the purposes of this study. An equal number of children scoring within the norms of the screening measures also underwent testing with the Battelle Development Inventory. Of the 356 parents contacted, 317 parents (90%) agreed to participate. Most parents correctly completed the Ages and Stages Questionnaire (81%) and the Child Development Inventory (75%). Predictive values were calculated for the Ages and Stages Questionnaire and the Child Development Inventory (sensitivity: 0.67 and 0.50; specificity: 0.39 and 0.86; positive predictive value: 34% and 50%; negative predictive value: 71% and 86%, respectively). Incorporating the physician's opinion regarding the developmental status of the

  11. Association of total daily physical activity with disability in community-dwelling older persons: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Shah Raj C

    2012-10-01

    Full Text Available Abstract Background Based on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age. Collecting objective measures of total daily physical activity in community-dwelling older adults is uncommon, but might enhance the understanding of the relationship of physical activity and disability. We examined whether greater total daily physical activity was associated with less report of disability in the elderly. Methods Data were from the Rush Memory and Aging Project, a longitudinal prospective cohort study of common, age-related, chronic conditions. Total daily physical activity was measured in community-dwelling participants with an average age of 82 using actigraphy for approximately 9 days. Disability was measured via self-reported basic activities of daily living (ADL. The odds ratio and 95% Confidence Interval (CI were determined for the baseline association of total daily physical activity and ADL disability using a logistic regression model adjusted for age, education level, gender and self-report physical activity. In participants without initial report of ADL disability, the hazard ratio and 95% CI were determined for the relationship of baseline total daily physical activity and the development of ADL disability using a discrete time Cox proportional hazard model adjusted for demographics and self-report physical activity. Results In 870 participants, the mean total daily physical activity was 2. 9 × 105 counts/day (range in 105 counts/day = 0.16, 13. 6 and the mean hours/week of self-reported physical activity was 3.2 (SD = 3.6. At baseline, 718 (82.5% participants reported being independent in all ADLs. At baseline, total daily physical activity was protective against disability (OR per 105 counts/day difference = 0.55; 95% CI = 0.47, 0.65. Of the participants without baseline disability, 584 were followed for 3.4 years on average. Each 105 counts/day additional total

  12. A prospective comparison of nursing- and healthcare-associated pneumonia (NHCAP) with community-acquired pneumonia (CAP).

    Science.gov (United States)

    Fukuyama, Hajime; Yamashiro, Shin; Tamaki, Hitoshi; Kishaba, Tomoo

    2013-08-01

    Nursing- and healthcare-associated pneumonia (NHCAP) has been proposed by the Japanese Respiratory Society as a new category of pneumonia considering the characteristics of the Japanese medical care environment. It is necessary to ascertain the epidemiology and clinical outcomes of NHCAP. A prospective study was conducted of patients with pneumonia who were hospitalized at our hospital from August 2011 to July 2012. We compared 192 cases of NHCAP with 114 cases of community-acquired pneumonia (CAP). Compared with CAP, NHCAP had a higher disease severity, higher 30-day mortality rate (10.9 vs. 3.5 %, P = 0.022), and longer length of hospital stay (median, 12 vs. 8 days, P pneumoniae was the most frequent causative pathogen in both NHCAP and CAP (33.9 vs. 34.8 %, P = 0.896). The incidence of atypical pathogens in NHCAP was low (1.7 %). Multidrug-resistant (MDR) pathogens were isolated more frequently in NHCAP than in CAP, but there was no significant difference (11.0 vs. 4.5 %, P = 0.135). Among 192 NHCAP patients, 122 (63.5 %) were aspiration pneumonia. Aspiration pneumonia was associated with poor outcomes and was considered a major characteristic of NHCAP. Our study suggested that many patients with NHCAP do not need broad-spectrum antibiotic therapy targeting MDR pathogens. Excess mortality in NHCAP patients is the result of patient backgrounds or disease severity rather than the presence of MDR pathogens.

  13. Prospective evaluation of clinical lung ultrasonography in the diagnosis of community-acquired pneumonia in a pediatric emergency department.

    Science.gov (United States)

    Samson, Frédéric; Gorostiza, Inigo; González, Andrés; Landa, María; Ruiz, Lucía; Grau, Miguel

    2016-08-17

    To evaluate the applicability and utility of point-of-care lung ultrasonography (POCLUS) for the diagnosis of community-acquired pneumonia (CAP) in a pediatric emergency department. A prospective observational study on children with suspected CAP was carried out in a pediatric emergency department from August to December 2014. The evaluation of the chest radiography (CR) by two independent radiologists was considered as a reference standard. POCLUS was performed by pediatricians who were blinded to CR results. Following the WHO criteria, typical CAP was defined as an alveolar consolidation or infiltrate in CR and a visualization of lung consolidation with sonographic air bronchograms in POCLUS. The diagnostic accuracy of POCLUS (sensitivity, specificity, positive, and negative predictive values) was established using CR as a gold standard. We enrolled 200 children with a median age of 29.5 months (interquartile range, 18.5-52.5); 58.1% were males and 42.0% had focal decreased breath sounds and/or crackles. The prevalence of typical CAP according to the radiologist's evaluation was 42.5% (end-point consolidation and/or pleural effusion 56.5%, alveolar infiltrate 43.5%). The sensitivity and specificity of POCLUS were 87.1% [95% confidence interval (CI) 78.0-93.4] and 94.8% (95% CI 89.0-98.1), respectively. The positive and negative predictive values were 92.5% (95% CI 84.4-97.2) and 90.8% (95% CI 84.2-95.3), respectively. POCLUS performed by an emergency pediatrician with a limited experience in ultrasonography enables the diagnosis of pneumonia with high accuracy. POCLUS could become a feasible and promising alternative to CR in the diagnosis of suspected CAP, leading to a relevant decrease in children's exposure to ionizing radiations. Further studies specifically carried out in the pediatric outpatient setting are needed.

  14. Comparison of community-onset Staphylococcus argenteus and Staphylococcus aureus sepsis in Thailand: a prospective multicentre observational study.

    Science.gov (United States)

    Chantratita, N; Wikraiphat, C; Tandhavanant, S; Wongsuvan, G; Ariyaprasert, P; Suntornsut, P; Thaipadungpanit, J; Teerawattanasook, N; Jutrakul, Y; Srisurat, N; Chaimanee, P; Anukunananchai, J; Phiphitaporn, S; Srisamang, P; Chetchotisakd, P; West, T E; Peacock, S J

    2016-05-01

    Staphylococcus argenteus is a globally distributed cause of human infection, but diagnostic laboratories misidentify this as Staphylococcus aureus. We determined whether there is clinical utility in distinguishing between the two. A prospective cohort study of community-onset invasive staphylococcal sepsis was conducted in adults at four hospitals in northeast Thailand between 2010 and 2013. Of 311 patients analysed, 58 (19%) were infected with S. argenteus and 253 (81%) with S. aureus. Most S. argenteus (54/58) were multilocus sequence type 2250. Infection with S. argenteus was more common in males, but rates of bacteraemia and drainage procedures were similar in the two groups. S. argenteus precipitated significantly less respiratory failure than S. aureus (5.2% versus 20.2%, adjusted OR 0.21, 95% CI 0.06-0.74, p 0.015), with a similar but non-significant trend for shock (6.9% versus 12.3%, adjusted OR 0.46, 95% CI 0.15-1.44, p 0.18). This did not translate into a difference in death at 28 days (6.9% versus 8.7%, adjusted OR 0.80, 95% CI 0.24-2.65, p 0.72). S. argenteus was more susceptible to antimicrobial drugs compared with S. aureus, and contained fewer toxin genes although pvl was detected in 16% (9/58). We conclude that clinical differences exist in association with sepsis due to S. argenteus versus S. aureus.

  15. Effectiveness of Powered Mobility Devices in Enabling Community Mobility-Related Participation: A Prospective Study Among People With Mobility Restrictions.

    Science.gov (United States)

    Sund, Terje; Iwarsson, Susanne; Anttila, Heidi; Brandt, Åse

    2015-08-01

    To investigate the effectiveness of powered mobility device (ie, powered wheelchair and scooter) interventions over a 1-year period in Nordic countries. Prospective design. The study involved community-dwelling participants from Denmark, Finland, and Norway. In all, 180 participants with different self-reported impairments participated in the study. The mean age was 68.7 years (95% confidence interval [CI] = 39.9-97.5 years), and 47.8% of the participants were men. Two face-to-face interviews about mobility and mobility-related participation were conducted with participants in their homes. The first interview took place shortly before the participants received their powered mobility device, and the second took place about 1 year later (mean, 386.9 days; standard deviation = 52.78). Changes in frequency, ease/difficulty, and number of mobility-related aspects of participation in daily life were investigated in the total sample and in subgroups by means of the NOMO 1.0 instrument, applying a structured interview format. In the total sample, the frequency of shopping for groceries (P going for a walk/ride (P Going to a restaurant/café/pub, shopping for groceries, doing other shopping, posting letters, going to the bank or the chemist's, going for a walk/ride, and visiting family/friends became easier (P shopping for groceries and going for a walk/ride. The effects varied with regard to the subgroups. The present study further strengthens the current evidence that powered mobility devices increase mobility-related participation in daily life among certain subgroups of adults with mobility restrictions. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  16. FASTCAP study on the management of hospitalized patients with community-acquired pneumonia: pharmacoeconomic analysis of the prospective phase

    Directory of Open Access Journals (Sweden)

    C. Lazzaro

    2013-05-01

    Full Text Available BACKGROUND The economic evaluation of guide-lines based hospital management of Community- Acquired Pneumonia (CAP with antibiotic therapy is rarely reported in literature. AIM OF THE STUDY To compare costs and effectiveness of 5 different antibiotic courses administered to Fine IV and V class patients with CAP, hospitalized in 31 Italian Internal Medicine (IM Departments and enrolled in the prospective phase of the multicentre FASTCAP study after the implementation of the Italian Federation of Internal Medicine (FADOI recommendations on the management of patients with CAP admitted to IM. METHODS 5 main antibiotic courses, administered to 786 patients, were considered (3 monotherapies: levofloxacin, 213 patients; amoxycillin/clavulanate, 134 patients; ceftriaxone, 166 patients; 2 combination therapies: amoxycillin/clavulanate + advanced macrolide, 137 patients; ceftriaxone + advanced macrolide, 136 patients. A cost analysis and two cost/effectiveness analyses (comparing, after the 1st cycle of therapy, cost to outcome for both Fine IV and V classes and cost to avoided mortality during hospitalization for Fine V class only were carried out adopting the hospital viewpoint. Health care cost, reported in euros 2007, included: drugs acquisition; nursing time; devices for ev administration; hospitalization in inpatient setting. RESULTS The least and the most costly therapies are levofloxacin (3,032.19 ± 2,045.34 euros and ceftriaxone (3,666.95 ± 2,389.46 euros in Fine IV class and amoxycillin/clavulanate (2,989.37 ± 2,242.15 euros and ceftriaxone + advanced macrolide (4,633.59 ± 2,491.57 euros in Fine V class. As far as the therapeutic outcome is concerned, levofloxacin dominates comparators in Fine IV class, whereas amoxycillin/clavulanate + advanced macrolide is both the most costly (3,433.16 ± 1,725.63 euros and the most effective option (69.6%; 95% CI: 54.3-82.3% in Fine V class. In Fine V class ceftriaxone + advanced macrolide reports both

  17. Risk factors of functional disability among community-dwelling elderly people by household in Japan: a prospective cohort study.

    Science.gov (United States)

    Saito, Emiko; Ueki, Shouzoh; Yasuda, Nobufumi; Yamazaki, Sachiko; Yasumura, Seiji

    2014-08-26

    Although the number of elderly people needing care is increasing rapidly in the home setting in Japan, family size and ability to provide such support are declining. The purpose of this study was to identify the risk factors of functional disability by household composition among community-dwelling elderly people. A total of 1347 elderly people aged 70 years and over participated in a baseline geriatric health examination for this prospective cohort study. In the health examination, we conducted an interview survey using a questionnaire in July 2004 and July 2005. Questionnaire items covered the following: age, sex, household, medical history, instrumental activities of daily living, intellectual activity, social role, Motor Fitness Scale, falls experienced during the past year, Dietary Variety Score, frequency of going outdoors, cognitive impairment, and depressive status. We defined the occurrence of functional disability as certification for long-term care needs of the subjects. The certification process started with a home visit for an initial assessment to evaluate nursing care needs using a questionnaire on current physical and mental status. The onset of functional disability was followed from July 2004 to March 2011. Cox proportional hazard regression analysis was used to estimate the risk factors related to the onset of functional disability, adjusted for age and sex. Of the 1084 participants, 433 were male (39.9%), and the average age was 77.8 (standard deviation, 5.4). Up to March 2011, functional disabilities occurred in 226 participants (20.9%). Elderly people living only with their children demonstrated a significantly higher risk for functional disability than the three-generation household group (hazard ratio, 1.61; 95% confidence interval, 1.08-2.40). The risk factors for functional disability varied according to household group. In Japan, the number of vulnerable households with elderly people in need of care has increased steadily over the years

  18. Cost of dengue and other febrile illnesses to households in rural Cambodia: a prospective community-based case-control study

    OpenAIRE

    Margolis Harold S; Duong Socheat; Ngan Chantha; Beatty Mark; Wichmann Ole; Huy Rekol; Vong Sirenda

    2009-01-01

    Abstract Background The average annual reported dengue incidence in Cambodia is 3.3/1,000 among children < 15 years of age (2002–2007). To estimate the economic burden of dengue, accurate cost-of-illness data are essential. We conducted a prospective, community-based, matched case-control study to assess the cost and impact of an episode of dengue fever and other febrile illness on households in rural Cambodia. Methods In 2006, active fever surveillance was conducted among a cohort of 6,694 c...

  19. Healthcare-associated, community-acquired and hospital-acquired bacteraemic urinary tract infections in hospitalized patients: a prospective multicentre cohort study in the era of antimicrobial resistance.

    Science.gov (United States)

    Horcajada, J P; Shaw, E; Padilla, B; Pintado, V; Calbo, E; Benito, N; Gamallo, R; Gozalo, M; Rodríguez-Baño, J

    2013-10-01

    The clinical and microbiological characteristics of community-onset healthcare-associated (HCA) bacteraemia of urinary source are not well defined. We conducted a prospective cohort study at eight tertiary-care hospitals in Spain, from October 2010 to June 2011. All consecutive adult patients hospitalized with bacteraemic urinary tract infection (BUTI) were included. HCA-BUTI episodes were compared with community-acquired (CA) and hospital-acquired (HA) BUTI. A logistic regression analysis was performed to identify 30-day mortality risk factors. We included 667 episodes of BUTI (246 HCA, 279 CA and 142 HA). Differences between HCA-BUTI and CA-BUTI were female gender (40% vs 69%, p infection and hospital acquisition. © 2012 The Authors Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

  20. Grassroots community-based inclusive education. Exploring educational prospects for young people with disabilities in the post-conflict Rwandan communities.

    OpenAIRE

    Karangwa, Evariste

    2006-01-01

    Summary The journey through the study on ‘Grassroots community-based inclusive e ducation’ and its outcomes has been considerably shaped by the field. Th e earlier ‘déjà-vu’ attitudes about the Rwandan society and its socio-cu ltural context that the researcher had always been part of, was sensitiv ely changed through the exposure to a number of interventions in the fie ld and experiences within the communities surveyed. It is along this jou rney that new outlooks on the communities of the di...

  1. The Influence of Community Disadvantage and Masculinity Ideology on Number of Sexual Partners: A Prospective Analysis of Young Adult, Rural Black Men.

    Science.gov (United States)

    Kogan, Steven M; Cho, Junhan; Barton, Allen W; Duprey, Erinn B; Hicks, Megan R; Brown, Geoffrey L

    2017-01-01

    Young, rural Black men are disproportionately affected by sexually transmitted infections (STIs), a consequence, in part, of multiple sexual partnerships. We conducted a prospective study that examined the influence of masculinity ideology on changes in numbers of sexual partners in this population. We focused on a set of high-risk attitudes termed reputational masculinity. Community disadvantage during young adulthood was examined as a risk factor for reputational masculinity ideology, and vocational commitment was examined as a potential protective factor. The sample included 505 African American men ages 19 to 22 from high-poverty rural communities. Men reported their numbers of sexual partners during the past three months, masculinity ideology, community disadvantage, and vocational commitment. Follow-up data were collected 18 months after baseline assessment. Negative binomial modeling was used to test study hypotheses. Results indicated that community disadvantage was associated with increases in reputational masculinity during early adulthood, which in turn were linked to increases in numbers of sexual partners. Vocational commitment interacted with reputational masculinity to forecast numbers of sexual partners, attenuating the influence of reputational masculinity. Reputational masculinity and promotion of engagement with the workplace may be important targets for interventions designed to reduce sexual risk behavior.

  2. Concurrent and Prospective Effects of Psychopathic Traits on Affective and Cognitive Empathy in a Community Sample of Late Adolescents

    Science.gov (United States)

    Brouns, Bart H. J.; de Wied, Minet Annette; Keijsers, Loes; Branje, Susan; van Goozen, Stephanie H. M.; Meeus, Wim H. J.

    2013-01-01

    Background: A deficit in affective rather than cognitive empathy is thought to be central to psychopathic traits. However, empirical evidence for empathy deficits in adolescents with psychopathic traits is limited. We investigated the concurrent and prospective effects of psychopathic traits on affective and cognitive trait empathy in late…

  3. Concurrent and Prospective Effects of Psychopathic Traits on Affective and Cognitive Empathy in a Community Sample of Late Adolescents

    Science.gov (United States)

    Brouns, Bart H. J.; de Wied, Minet Annette; Keijsers, Loes; Branje, Susan; van Goozen, Stephanie H. M.; Meeus, Wim H. J.

    2013-01-01

    Background: A deficit in affective rather than cognitive empathy is thought to be central to psychopathic traits. However, empirical evidence for empathy deficits in adolescents with psychopathic traits is limited. We investigated the concurrent and prospective effects of psychopathic traits on affective and cognitive trait empathy in late…

  4. Developing Historical Consciousness and a Community of History Practitioners: A Survey of Prospective History Teachers across Canada

    Science.gov (United States)

    Lévesque, Stéphane G.; Zanazanian, Paul

    2015-01-01

    This paper looks at the historical consciousness of prospective history teachers in Canada. Using a bilingual online survey instrument inspired by the pan-Canadian research "Canadians and their Pasts" with volunteer participants (N = 233), the study investigates their background knowledge, their perceptions of the trustworthiness of…

  5. An Overview and Reflection on Classroom Observation and Evaluation in the Past Twenty Years in China%我国听评课研究二十年:回顾与反思

    Institute of Scientific and Technical Information of China (English)

    方洁

    2014-01-01

    When school-based research goes further , the practice and research of classroom observation and evaluation are heading to prosperity gradually as well . With the ongoing mature of classroom observation techniques nowadays , the contents and forms of research on classroom observation and evaluation has developed and innovated further . In the past twenty years , the researches on classroom observation and evaluation include the nature , meaning and value , types and lens , contents and standards ,models ,strategies .Through reflecting on the researches mentioned above ,we have already achieved fruitful results . However , there are still some problems , such as simplex research method , priority to theory and minor attention to practice . Therefore , multi-dimension research , practice-oriented research , subject-related research multiple research methods are seriously needed .%听评课活动的实践与研究是随着校本教研的深入而逐渐走向繁荣的。在课堂观察技术日趋成熟的今天,听评课研究的内容与形式都得以拓展与创新。近二十年来,听评课活动的研究主要包括:听评课的内涵、意义与价值、类型与视角、内容与标准、模式与路径、策略与方法以及听评课活动中存在的问题等多个方面。反思听评课研究,虽然取得了丰硕的成果,但是不难发现尚存在研究主体与方法单一、重理论轻实践等问题。因此,听评课的研究主体应该多元化、研究取向应该走向实践、研究内容应该深入学科、研究方法应该多样化。

  6. Can We Predict Oral Antibiotic Treatment Failure in Children with Fast-Breathing Pneumonia Managed at the Community Level? A Prospective Cohort Study in Malawi.

    Directory of Open Access Journals (Sweden)

    Carina King

    Full Text Available Pneumonia is the leading cause of infectious death amongst children globally, with the highest burden in Africa. Early identification of children at risk of treatment failure in the community and prompt referral could lower mortality. A number of clinical markers have been independently associated with oral antibiotic failure in childhood pneumonia. This study aimed to develop a prognostic model for fast-breathing pneumonia treatment failure in sub-Saharan Africa.We prospectively followed a cohort of children (2-59 months, diagnosed by community health workers with fast-breathing pneumonia using World Health Organisation (WHO integrated community case management guidelines. Cases were followed at days 5 and 14 by study data collectors, who assessed a range of pre-determined clinical features for treatment outcome. We built the prognostic model using eight pre-defined parameters, using multivariable logistic regression, validated through bootstrapping.We assessed 1,542 cases of which 769 were included (32% ineligible; 19% defaulted. The treatment failure rate was 15% at day 5 and relapse was 4% at day 14. Concurrent malaria diagnosis (OR: 1.62; 95% CI: 1.06, 2.47 and moderate malnutrition (OR: 1.88; 95% CI: 1.09, 3.26 were associated with treatment failure. The model demonstrated poor calibration and discrimination (c-statistic: 0.56.This study suggests that it may be difficult to create a pragmatic community-level prognostic child pneumonia tool based solely on clinical markers and pulse oximetry in an HIV and malaria endemic setting. Further work is needed to identify more accurate and reliable referral algorithms that remain feasible for use by community health workers.

  7. Walking Recovery after a Hip Fracture: A Prospective Follow-Up Study among Community-Dwelling over 60-Year Old Men and Women

    Directory of Open Access Journals (Sweden)

    Anu Salpakoski

    2014-01-01

    Full Text Available Purpose. Recovery of walking outdoors after hip fracture is important for equal participation in the community. The causes of poor recovery are not fully understood. This study investigates recovery of walking outdoors and associated determinants after hip fracture. Methods. A prospective follow-up study, among clinical sample of 81 community-dwelling hip fracture patients over 60 years. Perceived difficulty in walking outdoors and 500 meters was assessed before fracture, at discharge to home (3.2 ± 2.2 weeks after surgery, and on average 6.0 ± 3.3 weeks after discharge. Potential determinants for walking recovery were assessed. Linear latent trajectory model was used to analyse changes during follow-up. Association between walking trajectories and potential determinants was analysed with a logistic regression model. Results. Two trajectories, No-to-minor-difficulty and Catastrophic, were found. Thirty-eight percent of the participants ended up in the Catastrophic trajectory for walking outdoors and 67% for 500 meters. Multivariate logistic regression analysis revealed that use of walking aid and indoor falls before fracture and prolonged pain were independently associated with catastrophic decline in both primary outcomes: difficulty in walking outdoors and 500 meters. Conclusions. A large proportion of community-dwelling older people recovering from hip fracture experienced catastrophic decline in outdoor walking. Acknowledging recovery prognoses at early stage enables individualized rehabilitation.

  8. The variation of psychiatric in -patients' clinical diagnosis and treatment during past twenty years%20年间精神病住院患者的临床诊疗变迁

    Institute of Scientific and Technical Information of China (English)

    仇雅菊; 高静芳; 谭忠林

    2011-01-01

    Objective The aims of this study was to investigate the variations of psychiatric in - patients' clinical diagnosis and treatment in order to explore its discipline and tendency. Method We drew off in - patients' cases in 1991, 2000 and 2009 of the Seventh People's Hospital of Hangzhou, with the method of case data searches. Result ①The study was conducted on 5635 cases of psychosis,the proportion of receiving and curing schizophrenia is relatively stable, it divines more than half( 55.04% ) of all the patients. ②Mood disorders to 16.24% ranked only second to schizophrenia, it consisted 16.24% of all the diseases, the scale of 2000 and 2009 was less than 1991 a little( P = 0.002 ). ③Change of the use of psychotropic drugs was mainly for the following two aspects. First,more and more doctors chose to use second - generation antipsychotic drugs( 29.95% ,50.78% and 75.28% in year of 1991,2000 and 2009 separately ). Second,combination was more and more common( 54.42% ,55.43% and 70. 52% separately ). Conclusion Schizophrenia remains the prime target of specialized hospital of mental disease in late twenty years, and,the trend of dropping of in - patients with mood disorder may concerning with therapeutic change. second - generation antipsychotic drugs'clinical superiority and diversification tendency of medical treatment are accepted by more and more clinicians.%目的 为了探讨近20年来精神病专科医院中住院患者的分布及相关的药物治疗变化趋势.方法 通过病例资料检索方法分别抽取1991年、2000年及2009年在杭州市第七人民医院住院治疗的全部病例资料.结果 共获得病例资料5635例,精神分裂症在各年度中的收治比例无显著差异,占所有精神障碍患者的半数以上(55.04%);心境障碍仅次于精神分裂症,占所有疾病数的16.24%,在2000和2009年度中收治比例略低于1991年(P=0.002);精神药物治疗方面的变化主要表现为新一代的抗精

  9. Twenty-year Sino-Russian Relations:Strategic Cooperation of Stable Development%中俄关系二十年:稳步发展的战略协作

    Institute of Scientific and Technical Information of China (English)

    黄庆; 张萍

    2013-01-01

      1992年,中俄两国友好国家关系正式确立。20多年来,中俄关系经历了跨越式发展的叶利钦时期,也经历了全面、务实推进的普京、梅德韦杰夫时期,中俄战略协作关系稳步发展,在政治、经贸、军事、文化等各个方面都取得了引人瞩目的成就。在当前复杂多变的国际大背景下,中俄关系具有坚实的战略协作基础,但也面临着缺乏深层互信、经贸合作长期滞后等重要问题。2012年,普京第三次入主克里姆林宫,中共十八大选举出新一届中央领导集体。2012—2013年度,中俄新一届领导人实现了互访,为中俄战略协作把脉。未来十年,中俄关系的发展存在巨大潜力与机遇。%In 1992, China and Russia officially established relations of friendly countries. For more than twenty years, the Sino-Russian relations have undergone the time of Yeltsin in which the relations had a leap-over development and the time of Putin and Medvedev in which the relations were pushed on in an all-round and pragmatic way. The Sino-Russian relations of strategic cooperation have won a stable development and made noticeable achievements in politics, economy, military affairs and culture, etc. The Sino-Russian relations have a firm basis of strategic cooperation against a complex and changeable international background, but also meet some problems such as a shortage of deep-level mutual trust and a long-term stagnation of economic and trade cooperation. In 2012, Putin became the master of Kremlin for the third time and the Chinese leaders collective of the central government were elected at the Eighteenth National Congress. In the year of 2012-2013, the new leaders of China and Russia had mutual visits and held the helm of the Sino-Russian strategic cooperation. The development of the Sino-Russian relations has a great potential and opportunity in the ten years to come.

  10. 20年合作“北斗”项目历史回顾%Twenty years of cooperation--A brief history of the“Bei Dou”project

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    . Spurred by the expanding landings of anchovy, analyses were made on the long-term annual yield of anchovy and discussions raised on the need to introduce some fisheries management regulations in order to avoid over-exploitation and possible collapse of the stock.   This and other management issues dominated the Project during the last 5-year period. Norwegian experts, particularly from the Directorate of Fisheries, have participated in a series of seminar organised by the Bureau of Fisheries covering topics in fisheries management such as management objectives, fisheries law, statistics, inspection and coastal zone management. At the same time, workshops have been held at the Yellow Sea Fisheries Research Institute to prepare assessments of fish resources and provide advice to central government authorities on fisheries management.   Project evaluations have demonstrated that the “Bei Dou” Project in its various phases has made important contributions to the development of fisheries in China. It has also brought together scientists, technicians and administrators from China and Norway in fruitful cooperation, thus expanding their professional and cultural knowledge for mutual benefit.   NORAD has offered to support continued cooperation between fisheries institutions in Norway and China and a Project Document for 2001-2005 has been prepared. The Project will during the nearest years provide information on the Norwegian experience related to establishing and managing fisheries in Exclusive Economic Zones.   This will continue the well-established fisheries cooperation beyond the twenty years marked by the present “Bei Dou” Seminar in Qingdao.

  11. Prospective Multicenter Study of Community-Associated Skin and Skin Structure Infections due to Methicillin-Resistant Staphylococcus aureus in Buenos Aires, Argentina

    Science.gov (United States)

    López Furst, María José; de Vedia, Lautaro; Fernández, Silvina; Gardella, Noella; Ganaha, María Cristina; Prieto, Sergio; Carbone, Edith; Lista, Nicolás; Rotryng, Flavio; Morera, Graciana I.; Mollerach, Marta; Stryjewski, Martín E.

    2013-01-01

    Background Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is now the most common cause of skin and skin structure infections (SSSI) in several world regions. In Argentina prospective, multicenter clinical studies have only been conducted in pediatric populations. Objective Primary: describe the prevalence, clinical and demographic characteristics of adult patients with community acquired SSSI due to MRSA; secondary: molecular evaluation of CA-MRSA strains. Patients with MRSA were compared to those without MRSA. Materials and Methods Prospective, observational, multicenter, epidemiologic study, with molecular analysis, conducted at 19 sites in Argentina (18 in Buenos Aires) between March 2010 and October 2011. Patients were included if they were ≥14 years, were diagnosed with SSSI, a culture was obtained, and there had no significant healthcare contact identified. A logistic regression model was used to identify factors associated with CA-MRSA. Pulse field types, SCCmec, and PVL status were also determined. Results A total of 311 patients were included. CA-MRSA was isolated in 70% (218/311) of patients. Clinical variables independently associated with CA-MRSA were: presence of purulent lesion (OR 3.29; 95%CI 1.67, 6.49) and age <50 years (OR 2.39; 95%CI 1.22, 4.70). The vast majority of CA-MRSA strains causing SSSI carried PVL genes (95%) and were SCCmec type IV. The sequence type CA-MRSA ST30 spa t019 was the predominant clone. Conclusions CA-MRSA is now the most common cause of SSSI in our adult patients without healthcare contact. ST30, SCCmec IV, PVL+, spa t019 is the predominant clone in Buenos Aires, Argentina. PMID:24324543

  12. Prospective associations between cardiovascular reactions to acute psychological stress and change in physical disability in a large community sample.

    Science.gov (United States)

    Phillips, Anna C; Der, Geoff; Shipton, Deborah; Benzeval, Michaela

    2011-09-01

    Exaggerated haemodynamic reactions to acute psychological stress have been implicated in cardiovascular disease outcomes, while lower reactions have been considered benign. This study examined, in a large cohort, the prospective associations between stress reactivity and physical disability. Blood pressure and pulse rate were measured at rest and in response to a stress task. Physical disability was assessed using the OPCS survey of disability at baseline and five years later. Heart rate reactivity was negatively associated with change in physical disability over time, such that those with lower heart rate reactivity were more likely to deteriorate over the following five years. These effects remained significant following adjustment for a number of confounding variables. These data give further support to the recent argument that for some health outcomes, lower or blunted cardiovascular stress reactivity is not necessarily protective. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Microbial diversity, community composition and metabolic potential in hydrocarbon contaminated oily sludge: prospects for in situ bioremediation.

    Science.gov (United States)

    Das, Ranjit; Kazy, Sufia K

    2014-06-01

    Microbial community composition and metabolic potential have been explored in petroleum-hydrocarbon-contaminated sludge of an oil storage facility. Culture-independent clone library-based 16S rRNA gene analyses revealed that the bacterial community within the sludge was dominated by the members of β-Proteobacteria (35%), followed by Firmicutes (13%), δ-Proteobacteria (11%), Bacteroidetes (10%), Acidobacteria (6%), α-Proteobacteria (3%), Lentisphaerae (2%), Spirochaetes (2%), and unclassified bacteria (5%), whereas the archaeal community was composed of Thermoprotei (54%), Methanocellales (33%), Methanosarcinales/Methanosaeta (8%) and Methanoculleus (1%) members. Methyl coenzyme M reductase A (mcrA) gene (a functional biomarker) analyses also revealed predominance of hydrogenotrophic, methanogenic Archaea (Methanocellales, Methanobacteriales and Methanoculleus members) over acetoclastic methanogens (Methanosarcinales members). In order to explore the cultivable bacterial population, a total of 28 resident strains were identified and characterized in terms of their physiological and metabolic capabilities. Most of these could be taxonomically affiliated to the members of the genera Bacillus, Paenibacillus, Micrococcus, Brachybacterium, Aerococcus, and Zimmermannella, while two strains were identified as Pseudomonas and Pseudoxanthomonas. Metabolic profiling exhibited that majority of these isolates were capable of growing in presence of a variety of petroleum hydrocarbons as sole source of carbon, tolerating different heavy metals at higher concentrations (≥1 mM) and producing biosurfactant during growth. Many strains could grow under a wide range of pH, temperature, or salinity as well as under anaerobic conditions in the presence of different electron acceptors and donors in the growth medium. Correlation between the isolates and their metabolic properties was estimated by the unweighted pair group method with arithmetic mean (UPGMA) analysis. Overall

  14. Reasons for schizophrenia patients remaining out of treatment: results from a prospective study in a rural south indian community

    Directory of Open Access Journals (Sweden)

    Channaveerachari Naveen Kumar

    2016-01-01

    Full Text Available Background: A few studies have examined the factors associated with schizophrenia patients remaining untreated in India. Materials and Methods: We identified 184 schizophrenia patients in a rural community, offered the treatment with antipsychotics and followed them up in their Primary Health Centers for 1-year. Twenty-nine (15.8% patients remained untreated at both the baseline and 1-year follow-up despite our best attempts to keep them under the treatment umbrella. They were interviewed in detail regarding the reasons for remaining untreated. This group was compared with another group of patients (n = 69 who had stopped the treatment at baseline but were successfully brought under the treatment umbrella throughout the 1-year follow-up period. Results: The reasons for remaining untreated were (n; %: (a Unsatisfactory improvement with previous treatment attempts (19; 65.5%, (b poor bond between the patients and the families (6; 20.7%, (c active symptoms not allowing any treatment efforts from the family members (6; 20.7%, (d magico-religious beliefs about the illness and its treatment (4; 13.8%, (e poor social support (3; 10.3%, (f adverse effects of the medications (2; 6.9%, and (g perception of recovery and cure (1; 3.4%. For many patients, a constellation of these reasons was responsible for them remaining untreated. In contrast, the common reasons for those who restarted medications to have stopped the treatment at some time were the lack of awareness, the need to continue medications (47; 68.1%, and the financial constraints (28; 40.6%. Conclusion: The predominant reason for schizophrenia patients not remaining on the treatment in this rural community was the families′ lack of faith in antipsychotic treatment. Provision of comprehensive treatment package including medical, psychosocial and rehabilitative services, and sensitizing the community about benefits of the treatment may help in ensuring that all patients with psychosis receive

  15. Glomerular filtration rate and proteinuria: association with mortality and renal progression in a prospective cohort of a community-based elderly population.

    Directory of Open Access Journals (Sweden)

    Se Won Oh

    Full Text Available Limited prospective data are available on the importance of estimated glomerular filtration rate (GFR and proteinuria in the prediction of all-cause mortality (ACM in community-based elderly populations. We examined the relationship between GFR or proteinuria and ACM in 949 randomly selected community-dwelling elderly subjects (aged ≥65 years over a 5-year period. A spot urine sample was used to measure proteinuria by the dipstick test, and GFR was estimated using the chronic kidney disease-epidemiology collaboration (CKD-EPI equation. Information about mortality and causes of death was collected by direct enquiry with the subjects and from the national mortality data. Compared to subjects without proteinuria, those with proteinuria of grade ≥1+ had a 1.725-fold (1.134-2.625 higher risk of ACM. Compared to subjects with GFR ≥90 ml/min/1.73 m2, those with GFR<45 ml/min/1.73 m2 had a 2.357 -fold (1.170-4.750 higher risk for ACM. Among the 403 subjects included in the analysis of renal progression, the annual rate of GFR change during follow-up period was -0.52±2.35 ml/min/1.73 m2/year. The renal progression rate was 7.315-fold (1.841-29.071 higher in subjects with GFR<60 ml/min/1.73 m2 than in those with GFR ≥60 ml/min/1.73 m2. Among a community-dwelling elderly Korean population, decreased GFR of <45 ml/min/1.73 m2 and proteinuria were independent risk factors for ACM.

  16. Long-term mortality after community-acquired pneumonia--impacts of diabetes and newly discovered hyperglycaemia: a prospective, observational cohort study.

    Science.gov (United States)

    Koskela, Heikki O; Salonen, Päivi H; Romppanen, Jarkko; Niskanen, Leo

    2014-08-21

    Community-acquired pneumonia is associated with a significant long-term mortality after initial recovery. It has been acknowledged that additional research is urgently needed to examine the contributors to this long-term mortality. The objective of the present study was to assess whether diabetes or newly discovered hyperglycaemia during pneumonia affects long-term mortality. A prospective, observational cohort study. A single secondary centre in eastern Finland. 153 consecutive hospitalised patients who survived at least 30 days after mild-to-moderate community-acquired pneumonia. Plasma glucose levels were recorded seven times during the first day on the ward. Several possible confounders were also recorded. The surveillance status and causes of death were recorded after median of 5 years and 11 months. In multivariate Cox regression analysis, a previous diagnosis of diabetes among the whole population (adjusted HR 2.84 (1.35-5.99)) and new postprandial hyperglycaemia among the non-diabetic population (adjusted HR 2.56 (1.04-6.32)) showed independent associations with late mortality. New fasting hyperglycaemia was not an independent predictor. The mortality rates at the end of follow-up were 54%, 37% and 10% among patients with diabetes, patients without diabetes with new postprandial hyperglycaemia and patients without diabetes without postprandial hyperglycaemia, respectively (pdiabetes and newly discovered postprandial hyperglycaemia increase the risk of death for several years after community-acquired pneumonia. As the knowledge about patient subgroups with an increased late mortality risk is gradually gathering, more studies are needed to evaluate the possible postpneumonia interventions to reduce late mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. 某院急性心肌梗死近20年治疗药物及疗效分析%Drug Therapy and Efficiency Analysis of Acute Myocardial Infarction in Nearly Twenty Years in Some Hospital

    Institute of Scientific and Technical Information of China (English)

    孙红军; 尹成; 梅廷方; 孙超; 李科民

    2012-01-01

    Objective To observe medication changes of acute myocardial infarction nearly twenty years in Bengbu NO1 hospital ,and to explore acute myocardial infarction drug therapy. Methods 402 cases of acute myocardial infarction(group A) were from January 1989 to December 1999, and 414 cases( group B) of acute myocardial infarction were from January 2000 to December 2010,the routine drug therapy proportion and the efficacy were analyzed to explore acute myocardial infarction drug therapy. Statistics was conducted. Results 380 among 402 cases in group A were treated with aspirin in, with the usage rate of 94.5% ;the use of heparin or low molecular weight heparin in 262 patients,with the rate of 65.2% ,the use of β-receptor blocker metoprolol in 132 cases,with the rate of 57.7% ,the use of statin drugs in 240 cases,with the rate of 59.7% .412 cases in group B were treated with aspirin in,with usage rate of 99.5% ,the use of heparin or low molecular weight heparin in 408 patients, with usage rate of 98. 6% , the use of p-receptor blocker metoprolol in 302 cases, with usage rate of 72.9% , the use of statin drugs in 396 cases,with usage rate of 95.7%. Decreased length of stay and reduction of hospital mortality associated with syndrome were observed in group B. Conclusion In recent ten years,aspirin,heparin or low molecular weight heparin,β-receptor blocker metoprolol, and statin usage rate was apparently increased, which indicated that the drug therapy of acute myocardial infarction was markedly improved.%目的 分析蚌埠市第一人民医院急性心肌梗死近20年药物治疗的变化,探讨急性心肌梗死药物治疗进展.方法 分别统计该院1989年1月-1999年12月402例(A组)急性心肌梗死和2000年1月-2010年12月414例(B组)急性心肌梗死的常规药物治疗比例和疗效,探讨急性心肌梗死药物治疗进展.结果 A组402例,应用阿司匹林380例,使用率为94.5%,应用肝素或低分子肝素262例,使用率为65.2%,β-受

  18. Transdiciplinary Research as the Peace Prospective for Community Based Village Tourism: An Example of Machhapuchhre Model Trek in Western Nepal

    Directory of Open Access Journals (Sweden)

    Upadhayaya Pranil Kumar

    2014-01-01

    Full Text Available Tourism is a composite multifaceted product-service with the overlapping roles of interdependent sub-sectors. The dual faces (various problems for causing conflict and potentials for building-peace of tourism have compelled its actors to try for innovative models by crossing the disciplinary boundary. On this conceptual foundation of the structural reality, this paper presents the case study of a Machhapuchhre Model Trek (MMT, a community based tourism model situated in the northern part of Pokhara in Western Nepal. Going beyond disciplinary research, the MMT is developed on the basis of the transdiciplinary approach which has brought scientific researchers [e.g. PhD and senior researchers of Kathmandu University and the Swiss National Centre of Competence in Research (NCCR North-South], tourism industry practitioners (e.g. trekking agencies in Pokhara, local communities (e.g. represented by seven villages in MMT area and local government together for common aim and coordinated partnership actions. The transdisciplinary research process helps grasp lessons on triggering societal learning, appreciating differences, boosting concerted actions, mitigating syndromes of unsustainable development, lessening conflict, and thereby supporting to build peace. This paper adds knowledge on the potential value of transdisciplinary research on tourism.

  19. Triglycerides are a predictive factor for arterial stiffness: a community-based 4.8-year prospective study.

    Science.gov (United States)

    Wang, Xiaona; Ye, Ping; Cao, Ruihua; Yang, Xu; Xiao, Wenkai; Zhang, Yun; Bai, Yongyi; Wu, Hongmei

    2016-05-18

    Epidemiological studies have disclosed an independent effect of triglycerides on coronary heart disease despite achievement of low-density lipoprotein cholesterol goals with statin therapy. Arterial stiffness has been increasingly recognized as a strong predictor of cardiovascular disease and atherosclerotic disease. The association between triglycerides and arterial stiffness is not well characterized. We aimed to determine the relationship between triglycerides and arterial stiffness in a community-based longitudinal sample from Beijing, China. We related levels of plasma TGs to measures of arterial stiffness (carotid-femoral pulse wave velocity [PWV] and carotid-radial PWV) in 1447 subjects (mean age, 61.3 years) from a community-based population in Beijing, China. After a median follow-up interval of 4.8 years, multiple linear regression analysis revealed that TGs were independently associated with carotid-femoral PWV (β = 0.747, P triglyceride levels were significantly associated with decreases in carotid-femoral PWV, indicating that achieving low TG levels may be an additional therapeutic consideration in subjects with atherosclerotic disease.

  20. Using a social marketing framework to evaluate recruitment of a prospective study of genetic counseling and testing for the deaf community.

    Science.gov (United States)

    Kobayashi, Yoko; Boudreault, Patrick; Hill, Karin; Sinsheimer, Janet S; Palmer, Christina G S

    2013-11-25

    Recruiting deaf and hard-of-hearing participants, particularly sign language-users, for genetics health service research is challenging due to communication barriers, mistrust toward genetics, and researchers' unfamiliarity with deaf people. Feelings of social exclusion and lack of social cohesion between researchers and the Deaf community are factors to consider. Social marketing is effective for recruiting hard-to-reach populations because it fosters social inclusion and cohesion by focusing on the targeted audience's needs. For the deaf population this includes recognizing their cultural and linguistic diversity, their geography, and their systems for information exchange. Here we use concepts and language from social marketing to evaluate our effectiveness to engage a U.S. deaf population in a prospective, longitudinal genetic counseling and testing study. The study design was interpreted in terms of a social marketing mix of Product, Price, Place, and Promotion. Price addressed linguistic diversity by including a variety of communication technologies and certified interpreters to facilitate communication; Place addressed geography by including community-based participation locations; Promotion addressed information exchange by using multiple recruitment strategies. Regression analyses examined the study design's effectiveness in recruiting a culturally and linguistically diverse sample. 271 individuals were enrolled, with 66.1% American Sign Language (ASL)-users, 19.9% ASL + English-users, 12.6% English-users. Language was significantly associated with communication technology, participation location, and recruitment. Videophone and interpreters were more likely to be used for communication between ASL-users and researchers while voice telephone and no interpreters were preferred by English-users (Price). ASL-users were more likely to participate in community-based locations while English-users preferred medically-based locations (Place). English-users were

  1. Using a social marketing framework to evaluate recruitment of a prospective study of genetic counseling and testing for the deaf community

    Science.gov (United States)

    2013-01-01

    Background Recruiting deaf and hard-of-hearing participants, particularly sign language-users, for genetics health service research is challenging due to communication barriers, mistrust toward genetics, and researchers’ unfamiliarity with deaf people. Feelings of social exclusion and lack of social cohesion between researchers and the Deaf community are factors to consider. Social marketing is effective for recruiting hard-to-reach populations because it fosters social inclusion and cohesion by focusing on the targeted audience’s needs. For the deaf population this includes recognizing their cultural and linguistic diversity, their geography, and their systems for information exchange. Here we use concepts and language from social marketing to evaluate our effectiveness to engage a U.S. deaf population in a prospective, longitudinal genetic counseling and testing study. Methods The study design was interpreted in terms of a social marketing mix of Product, Price, Place, and Promotion. Price addressed linguistic diversity by including a variety of communication technologies and certified interpreters to facilitate communication; Place addressed geography by including community-based participation locations; Promotion addressed information exchange by using multiple recruitment strategies. Regression analyses examined the study design’s effectiveness in recruiting a culturally and linguistically diverse sample. Results 271 individuals were enrolled, with 66.1% American Sign Language (ASL)-users, 19.9% ASL + English-users, 12.6% English-users. Language was significantly associated with communication technology, participation location, and recruitment. Videophone and interpreters were more likely to be used for communication between ASL-users and researchers while voice telephone and no interpreters were preferred by English-users (Price). ASL-users were more likely to participate in community-based locations while English-users preferred medically

  2. Role of the community pharmacist in emergency contraception counseling and delivery in the United States: current trends and future prospects

    Directory of Open Access Journals (Sweden)

    Rafie S

    2017-03-01

    acetate in seven states. In addition to access with a prescription written by a pharmacist or other health care provider, levonorgestrel EC is available over-the-counter in pharmacies and grocery stores. Pharmacists play a critical role in access to EC in community pharmacies by ensuring product availability in the inventory, up-to-date knowledge, and comprehensive patient counseling. Looking to the future, there are opportunities to expand access to EC in pharmacies further by implementing legislation expanding the pharmacist scope of practice, ensuring third-party reimbursement for clinical services delivered by pharmacists, and including EC in pharmacy education and training. Keywords: pharmacist, community pharmacy, emergency contraception, levonorgestrel, ulipristal acetate, intrauterine device

  3. A prospective study on evaluation of pathogenesis, biofilm formation, antibiotic susceptibility of microbial community in urinary catheter

    Science.gov (United States)

    Younis, Khansa Mohammed; Usup, Gires; Ahmad, Asmat

    2015-09-01

    This study is aimed to isolate, detect biofilm formation ability and antibiotic susceptibility of urinary catheter adherent microorganisms from elderly hospitalized patient at the Universiti Kebangsaan Malaysia Medical Center. Microorganisms were isolated from three samples of urinary catheters (UC) surface; one of the acute vascular rejection patient (UCB) and two from benign prostate hyperplasia patients (UCC and UCD). A total of 100 isolates was isolated with 35 from UCB, 38 (UCC) and 28 (UCD). Ninety six were identified as Gram-negative bacilli, one Gram-positive bacilli and three yeasts. Results of biofilm forming on sterile foley catheter showed that all the isolates can form biofilm at different degrees; strong biofilm forming: 32% from the 35 isolates (UCB), 25% out of 38 isolates (UCC), 26% out of 28 isolates (UCD). As for moderate biofilm forming; 3% from UCB, 10% from UCC and 2% from UCD. Weak biofilm forming in UCC (3%). The antibiotic susceptibility for (UCB) isolates showed highly resistant to ampicillin, novobiocin and penicillin 100 (%), kanamycin (97%), tetracycline (94%), chloramphenicol (91%), streptomycin (77%) and showed low level of resistance to gentamycin (17%), while all the isolates from (UCC-D) showed high resistant towards ampicillin and penicillin, novobiocin (94%), tetracycline (61%), streptomycin (53%), gentamycin (50%) and low level of resistance to kanamycin (48%), chloramphenicol (47%). The findings indicate that these isolates can spread within the community on urinary catheters surface and produce strong biofilm, therefore, monitoring antibiotic susceptibility of bacteria isolated in the aggregation is recommended.

  4. Identifying Temporal Changes and Topics that Promote Growth Within Online Communities: A Prospective Study of Six Online Cancer Forums

    Science.gov (United States)

    Durant, Kathleen T.; McCray, Alexa T.; Safran, Charles

    2011-01-01

    In this paper the authors have extended the methodology for temporal analysis of online forums and applied the methodology to six online cancer forums (melanoma, prostate cancer, testicular cancer, ovarian cancer and breast cancer). The goal was to develop, apply and improve methods that quantify the responsiveness of the interactions in online forums in order to identify the users and topics that promote use and usefulness of these online medical communities. The evolutional stages that gauge when a forum is expanding, contracting, or in a state of equilibrium were considered. The response function was thought to be an approximation of a discussion group’s utility to its members. By applying the evolutionary phase algorithm, it was determined that two out of six of the forums are in contracting phases, while four are in their largest growth phase. By analyzing the topics of the influential threads, the authors conclude that cancer treatment discussions as well as stage IV cancer discussions promote growth in the forums. It is observed that the discussion of treatment rather than diagnosis is important to help a cancer forum thrive. PMID:22022636

  5. Prospective Study on the Impact of Fear of Falling on Functional Decline among Community Dwelling Elderly Women

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    Kyungwon Choi

    2017-04-01

    Full Text Available Fear of falling (FOF is expected to have effects on functional decline in the elderly. In this study, we examined over 2 years the effect of change in FOF on functional decline in community dwelling elderly. We conducted a secondary analysis using data from elderly women, 70 years of age and older, who participated in the Korean Longitudinal Study of Aging (KLoSA. Participants were divided into four categories according to change in FOF between the 2010 and 2012 surveys. Multiple logistic regression analysis was conducted regarding the effects of changes in FOF on functional decline after controlling for variables as known risk factors for functional decline. Rates of functional decline were highest in the “consistently having FOF” group, whereas they were lowest in the “consistently no FOF” group in both 2010 and 2012. Characteristics independently associated with functional decline were change in FOF, depressive symptoms, low frequency of meeting friends, and fear-induced activity avoidance. Longer exposure to FOF was associated with an increased risk of functional decline. FOF is an important health problem that deserves attention in its own right. Public health approaches for elderly persons should address early detection, prevention, and intervention programs for FOF.

  6. No association between dietary vitamin K intake and fracture risk in chinese community-dwelling older men and women: a prospective study.

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    Chan, R; Leung, J; Woo, J

    2012-05-01

    Data on the association between dietary vitamin K intake and fracture risk are limited among Chinese. This study examined such an association in community-dwelling elderly in Hong Kong. We present data from 2,944 subjects (1,605 men, 1,339 women) who participated in a prospective cohort study. Baseline dietary intakes of energy, protein, calcium, vitamin D, and vitamin K were assessed using a food-frequency questionnaire. Data on incident hip fracture and nonvertebral fracture during a median of 6.9 follow-up years were collected from a hospital database. Cox regression analyses were performed with adjustments for age, education attainment, smoking status, alcohol use, body mass index, hip bone mineral density, physical activity, use of calcium supplement, and energy-adjusted nutrient intakes. There were 29 (1.8 %) men and 19 (1.4 %) women with incident hip fractures and 97 (6.0 %) men and 88 (6.6 %) women with nonvertebral fractures. The median (interquartile range) of dietary vitamin K intake was 241.8 (157.5-360.8) and 238.9 (162.4-343.6) μg/day in men and women, respectively. Similar dietary vitamin K intakes were observed between subjects with hip or nonvertebral fractures and subjects without hip or nonvertebral fractures. In both men and women, dietary vitamin K intake was not associated with fracture risks at all measured sites in either crude or adjusted models. In Chinese community-dwelling elderly, hip or nonvertebral fracture risk was not associated with dietary vitamin K intake. The high dietary vitamin K intake of the studied group may have limited the ability to detect the association between vitamin K intake and fracture risk.

  7. Patient Characteristics, Management, and Predictors of Outcome from Severe Community-Onset Staphylococcal Sepsis in Northeast Thailand: A Prospective Multicenter Study.

    Science.gov (United States)

    West, T Eoin; Wikraiphat, Chanthiwa; Tandhavanant, Sarunporn; Ariyaprasert, Pitchayanant; Suntornsut, Pornpan; Okamoto, Shawna; Mahavanakul, Weera; Srisamang, Pramot; Phiphitaporn, Sunchai; Anukunananchai, Jirasak; Chetchotisakd, Ploenchan; Peacock, Sharon J; Chantratita, Narisara

    2017-02-06

    Staphylococcus aureus infection is a persistent threat in resource-restricted settings in southeast Asia but informative data about this disease remain limited. We analyzed characteristics, management, and predictors of outcome in severely septic patients with community-onset S. aureus infection in northeast Thailand. We performed a prospective, multicenter observational cohort study of community-onset S. aureus sepsis in four referral hospitals recruiting patients at least 14 years of age admitted between March 2010 and December 2013. One hundred and nineteen patients with severe staphylococcal sepsis were enrolled. Diabetes was the most common underlying condition. Methicillin-resistant infection was rare. Twenty-eight-day mortality was 20%. Ninety-two percent of patients received appropriate antibiotic therapy and 82% were administered intravenous fluids on the first hospital day, although only 14% were managed in an intensive care unit (ICU). On univariable analysis, clinical variables at enrollment significantly associated with death at 28 days were coagulopathy or respiratory failure. Plasma interleukin (IL) -8 concentration alone accurately predicted mortality (area under the receiver operating curve = 0.82, 95% confidence interval = 0.73-0.90). In multivariable analysis, addition of IL-8 concentration to a mortality prediction model containing clinical variables further improved the predictive ability of the model. We conclude that severe staphylococcal sepsis in northeast Thailand causes significant mortality. Diabetes is a common preexisting condition and most patients are managed outside the ICU even if they receive vasoactive/inotropic agents or mechanical ventilation. While clinical factors apparent on presentation including coagulopathy and respiratory failure predict death, plasma IL-8 improves this prediction.

  8. Transparent meta-analysis of prospective memory and aging.

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    Bob Uttl

    Full Text Available Prospective memory (ProM refers to our ability to become aware of a previously formed plan at the right time and place. After two decades of research on prospective memory and aging, narrative reviews and summaries have arrived at widely different conclusions. One view is that prospective memory shows large age declines, larger than age declines on retrospective memory (RetM. Another view is that prospective memory is an exception to age declines and remains invariant across the adult lifespan. The present meta-analysis of over twenty years of research settles this controversy. It shows that prospective memory declines with aging and that the magnitude of age decline varies by prospective memory subdomain (vigilance, prospective memory proper, habitual prospective memory as well as test setting (laboratory, natural. Moreover, this meta-analysis demonstrates that previous claims of no age declines in prospective memory are artifacts of methodological and conceptual issues afflicting prior research including widespread ceiling effects, low statistical power, age confounds, and failure to distinguish between various subdomains of prospective memory (e.g., vigilance and prospective memory proper.

  9. Dietary Patterns and Risk of Frailty in Chinese Community-Dwelling Older People in Hong Kong: A Prospective Cohort Study

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    Ruth Chan

    2015-08-01

    Full Text Available Dietary pattern analysis is an emerging approach to investigate the association between diet and frailty. This study examined the association of dietary patterns with frailty in 2724 Chinese community-dwelling men and women aged > 65 years. Baseline dietary data were collected using a food frequency questionnaire between 2001 and 2003. Adherence to a priori dietary patterns, including the Diet Quality Index-International (DQI-I and the Mediterranean Diet Score (MDS was assessed. Factor analysis identified three a posteriori dietary patterns, namely “vegetables-fruits”, “snacks-drinks-milk products”, and “meat-fish”. Incident frailty was defined using the FRAIL scale. Binary logistic regression was applied to examine the associations between dietary patterns and four-year incident frailty. There were 31 (1.1% incident frailty cases at four years. Every 10-unit increase in DQI-I was associated with 41% reduced risk of frailty in the sex- and age-adjusted model (odds ratio (OR (95% confidence interval (CI: 0.59 (0.42–0.85, p = 0.004. The association attenuated in the multivariate adjusted model (0.69 (0.47–1.02, p = 0.056. No association between other dietary patterns and incident frailty was observed. Our study showed that a better diet quality as characterized by higher DQI-I was associated with lower odds of developing frailty. The contribution of MDS or a posteriori dietary patterns to the development of frailty in Chinese older people remains to be explored.

  10. Pro-Adrenomedullin predicts 10-year all-cause mortality in community-dwelling patients: a prospective cohort study.

    Science.gov (United States)

    Odermatt, Jonas; Meili, Marc; Hersberger, Lara; Bolliger, Rebekka; Christ-Crain, Mirjam; Briel, Matthias; Bucher, Heiner C; Mueller, Beat; Schuetz, Philipp

    2017-07-04

    Several studies found mid-regional pro-adrenomedullin (ProADM), the prohormone of the cardiovascular protein adrenomedullin, to be strongly associated with short-term mortality, mostly in the inpatient setting. We evaluated associations of ProADM levels with 10-year mortality in community-dwelling primary care patients with respiratory tract infections. This is a post-hoc analysis using clinical and biomarker data of 134 primary care patients with respiratory tract infections. ProADM was measured on admission and after 7 days in batch-analysis. 10-year follow-up data was collected by GP, patient and relative tracing through phone interviews. We calculated Cox regression models and area under the receiver operating characteristics curves to assess associations of ProADM with 10-year all-cause mortality. During the 10-year follow-up 6% of included patients died. Median baseline ProADM blood levels (nmol/l) were significantly higher in non-survivors compared to survivors (0.5, IQR 0.4-1.3; vs. 0.2, IQR 0.1-0.5; p = 0.02) and showed a significant association with 10-year all-cause mortality in an age-adjusted cox regression model (HR: 2.5, 95%-CI: 1.0-6.1, p = 0.04). ProADM levels on day 7 showed similar results. This posthoc analysis found an association of elevated ProADM blood levels and 10-year all-cause mortality in a primary care cohort with respiratory tract infections. Due to the methodological limitations including incomplete data regarding follow-up information and biomarker measurement, this study warrants validation in future larger studies. Current Controlled Trials, SRCTN73182671.

  11. Impact of clinical, psychological, and social factors on decreased Tinetti test score in community-living elderly subjects: a prospective study with two-year follow-up.

    Science.gov (United States)

    Manckoundia, Patrick; Thomas, Frédérique; Buatois, Séverine; Guize, Louis; Jégo, Bertrand; Aquino, Jean-Pierre; Benetos, Athanase

    2008-06-01

    Balance and gait are essential to maintain physical autonomy, particularly in elderly people. Thus the detection of risk factors of balance and gait impairment appears necessary in order to prevent falls and dependency. The objective of this study was to analyze the impact of demographic, social, clinical, psychological, and biological parameters on the decline in balance and gait assessed by the Tinetti test (TT) after a two-year follow-up. This prospective study was conducted among community-living, young elderly volunteers in the centre "Investigations Preventives et Cliniques" and "Observatoire De l'Age" (Paris, France). Three hundred and forty-four participants aged 63.5 on average were enrolled and performed the TT twice, once at inclusion and again two years later. After the two-year follow-up, two groups were constituted according to whether or not there was a decrease in the TT score: the "TT no-deterioration" group comprised subjects with a decrease of less than two points and the "TT deterioration" group comprised those with a decrease of two points or more. Selected demographic, social, clinical, psychological, and biological parameters for the two groups were then compared. Statistical analysis showed that female sex, advanced age, high body mass index, osteoarticular pain, and a high level of anxiety all have a negative impact on TT score. Knowledge of predictive factors of the onset or worsening of balance and gait disorders could allow clinicians to detect young elderly people who should benefit from a specific prevention program.

  12. Does low coping efficacy mediate the association between negative life events and incident psychopathology? A prospective-longitudinal community study among adolescents and young adults.

    Science.gov (United States)

    Asselmann, E; Wittchen, H-U; Lieb, R; Höfler, M; Beesdo-Baum, K

    2016-04-01

    To prospectively examine whether negative life events (NLE) and low perceived coping efficacy (CE) increase the risk for the onset of various forms of psychopathology and low CE mediates the associations between NLE and incident mental disorders. A representative community sample of adolescents and young adults (N = 3017, aged 14-24 at baseline) was prospectively followed up in up to three assessment waves over 10 years. Anxiety, depressive and substance use disorders were assessed at each wave using the DSM-IV/M-CIDI. NLE and CE were assessed at baseline with the Munich Event List and the Scale for Self-Control and Coping Skills. Associations (odds ratios, OR) of NLE and CE at baseline with incident mental disorders at follow-up were estimated using logistic regressions adjusted for sex and age. NLE at baseline predicted the onset of any disorder, any anxiety disorder, panic disorder, agoraphobia, generalised anxiety disorder, any depression, major depressive episodes, dysthymia, any substance use disorder, nicotine dependence and abuse/dependence of illicit drugs at follow-up (OR 1.02-1.09 per one NLE more). When adjusting for any other lifetime disorder prior to baseline, merely the associations of NLE with any anxiety disorder, any depression, major depressive episodes, dysthymia and any substance use disorder remained significant (OR 1.02-1.07). Low CE at baseline predicted the onset of any disorder, any anxiety disorder, agoraphobia, generalised anxiety disorder, any depression, major depressive episodes, dysthymia, any substance use disorder, alcohol abuse/dependence, nicotine dependence and abuse/dependence of illicit drugs at follow-up (OR 1.16-1.72 per standard deviation). When adjusting for any other lifetime disorder prior to baseline, only the associations of low CE with any depression, major depressive episodes, dysthymia, any substance use disorder, alcohol abuse/dependence, nicotine dependence and abuse/dependence of illicit drugs remained

  13. Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial.

    Science.gov (United States)

    Kojima, Gotaro; Masud, Tahir; Kendrick, Denise; Morris, Richard; Gawler, Sheena; Treml, Jonathan; Iliffe, Steve

    2015-04-03

    Falling is common among older people. The Timed-Up-and-Go Test (TUG) is recommended as a screening tool for falls but its predictive value has been challenged. The objectives of this study were to examine the ability of TUG to predict future falls and to estimate the optimal cut-off point to identify those with higher risk for future falls. This is a prospective cohort study nested within a randomised controlled trial including 259 British community-dwelling older people ≥65 years undergoing usual care. TUG was measured at baseline. Prospective diaries captured falls over 24 weeks. A Receiver Operating Characteristic curve analysis determined the optimal cut-off point to classify future falls risk with sensitivity, specificity, and predictive values of TUG times. Logistic regression models examined future falls risk by TUG time. Sixty participants (23%) fell during the 24 weeks. The area under the curve was 0.58 (95% confidence interval (95% CI) = 0.49-0.67, p = 0.06), suggesting limited predictive value. The optimal cut-off point was 12.6 seconds and the corresponding sensitivity, specificity, and positive and negative predictive values were 30.5%, 89.5%, 46.2%, and 81.4%. Logistic regression models showed each second increase in TUG time (adjusted for age, gender, comorbidities, medications and past history of two falls) was significantly associated with future falls (adjusted odds ratio (OR) = 1.09, 95% CI = 1.00-1.19, p = 0.05). A TUG time ≥12.6 seconds (adjusted OR = 3.94, 95% CI = 1.69-9.21, p = 0.002) was significantly associated with future falls, after the same adjustments. TUG times were significantly and independently associated with future falls. The ability of TUG to predict future falls was limited but with high specificity and negative predictive value. TUG may be most useful in ruling in those with a high risk of falling rather than as a primary measure in the ascertainment of risk.

  14. Prospective association of the SHARE-operationalized frailty phenotype with adverse health outcomes: evidence from 60+ community-dwelling Europeans living in 11 countries

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    Macklai Nejma S

    2013-01-01

    Full Text Available Abstract Background Among the many definitions of frailty, the frailty phenotype defined by Fried et al. is one of few constructs that has been repeatedly validated: first in the Cardiovascular Health Study (CHS and subsequently in other large cohorts in the North America. In Europe, the Survey of Health, Aging and Retirement in Europe (SHARE is a gold mine of individual, economic and health information that can provide insight into better understanding of frailty across diverse population settings. A recent adaptation of the original five CHS-frailty criteria was proposed to make use of SHARE data and measure frailty in the European population. To test the validity of the SHARE operationalized frailty phenotype, this study aims to evaluate its prospective association with adverse health outcomes. Methods Data are from 11,015 community-dwelling men and women aged 60+ participating in wave 1 and 2 of the Survey of Health, Aging and Retirement in Europe, a population-based survey. Multivariate logistic regression analyses were used to assess the 2-year follow up effect of SHARE-operationalized frailty phenotype on the incidence of disability (disability-free at baseline and on worsening disability and morbidity, adjusting for age, sex, income and baseline morbidity and disability. Results At 2-year follow up, frail individuals were at increased risk for: developing mobility (OR 3.07, 95% CI, 1.02-9.36, IADL (OR 5.52, 95% CI, 3.76-8.10 and BADL (OR 5.13, 95% CI, 3.53-7.44 disability; worsening mobility (OR 2.94, 95% CI, 2.19- 3.93 IADL (OR 4.43, 95% CI, 3.19-6.15 and BADL disability (OR 4.53, 95% CI, 3.14-6.54; and worsening morbidity (OR 1.77, 95% CI, 1.35-2.32. These associations were significant even among the prefrail, but with a lower magnitude of effect. Conclusions The SHARE-operationalized frailty phenotype is significantly associated with all tested health outcomes independent of baseline morbidity and disability in community-dwelling men

  15. Prospective study of leptospirosis transmission in an urban slum community: role of poor environment in repeated exposures to the Leptospira agent.

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    Ridalva D M Felzemburgh

    Full Text Available BACKGROUND: Leptospirosis has emerged as an urban health problem as slum settlements have rapidly spread worldwide and created conditions for rat-borne transmission. Prospective studies have not been performed to determine the disease burden, identify risk factors for infection and provide information needed to guide interventions in these marginalized communities. METHODOLOGY/PRINCIPAL FINDINGS: We enrolled and followed a cohort of 2,003 residents from a slum community in the city of Salvador, Brazil. Baseline and one-year serosurveys were performed to identify primary and secondary Leptospira infections, defined as respectively, seroconversion and four-fold rise in microscopic agglutination titers. We used multinomial logistic regression models to evaluate risk exposures for acquiring primary and secondary infection. A total of 51 Leptospira infections were identified among 1,585 (79% participants who completed the one-year follow-up protocol. The crude infection rate was 37.8 per 1,000 person-years. The secondary infection rate was 2.3 times higher than that of primary infection rate (71.7 and 31.1 infections per 1,000 person-years, respectively. Male gender (OR 2.88; 95% CI 1.40-5.91 and lower per capita household income (OR 0.54; 95% CI, 0.30-0.98 for an increase of $1 per person per day were independent risk factors for primary infection. In contrast, the 15-34 year age group (OR 10.82, 95% CI 1.38-85.08, and proximity of residence to an open sewer (OR 0.95; 0.91-0.99 for an increase of 1 m distance were significant risk factors for secondary infection. CONCLUSIONS/SIGNIFICANCE: This study found that slum residents had high risk (>3% per year for acquiring a Leptospira infection. Re-infection is a frequent event and occurs in regions of slum settlements that are in proximity to open sewers. Effective prevention of leptospirosis will therefore require interventions that address the infrastructure deficiencies that contribute to repeated

  16. Consumption of fruit and vegetables and risk of frailty: a dose-response analysis of 3 prospective cohorts of community-dwelling older adults.

    Science.gov (United States)

    García-Esquinas, Esther; Rahi, Berna; Peres, Karine; Colpo, Marco; Dartigues, Jean-François; Bandinelli, Stefania; Feart, Catherine; Rodríguez-Artalejo, Fernando

    2016-07-01

    Consuming fruit and vegetables (FVs) may protect against frailty, but to our knowledge no study has yet assessed their prospective dose-response relation. We sought to examine the dose-response association between FV consumption and the risk of frailty in older adults. Data were taken from 3 independent cohorts of community-dwelling older adults: the Seniors-ENRICA (Study on Nutrition and Cardiovascular Risk Factors in Spain) cohort (n = 1872), Three-City (3C) Bordeaux cohort (n = 581), and integrated multidisciplinary approach cohort (n = 473). Baseline food consumption was assessed with a validated computerized diet history (Seniors-ENRICA) or with a food-frequency questionnaire (3C Bordeaux and AMI). In all cohorts, incident frailty was assessed with the use of the Fried criteria. Results across cohorts were pooled with the use of a random-effects model. During a mean 2.5-y follow-up, 300 incident frailty cases occurred. Fully adjusted models showed that the pooled ORs (95% CIs) of incident frailty comparing participants who consumed 1, 2, or ≥3 portions of fruit/d to those with no consumption were, respectively, 0.59 (0.27, 0.90), 0.58 (0.29, 0.86), and 0.48 (0.20, 0.75), with a P-trend of 0.04. The corresponding values for vegetables were 0.69 (0.42, 0.97), 0.56 (0.35, 0.77), and 0.52 (0.13, 0.92), with a P-trend fruit and risk of exhaustion, low physical activity, and slow walking speed, whereas the consumption of vegetables was associated with a decreased risk of exhaustion and unintentional weight loss. Among community-dwelling older adults, FV consumption was associated with a lower short-term risk of frailty in a dose-response manner, and the strongest association was obtained with 3 portions of fruit/d and 2 portions of vegetables/d. © 2016 American Society for Nutrition.

  17. Waist circumference values equivalent to body mass index points for predicting absolute cardiovascular disease risks among adults in an Aboriginal community: a prospective cohort study.

    Science.gov (United States)

    Adegbija, Odewumi; Hoy, Wendy E; Wang, Zhiqiang

    2015-11-13

    There have been suggestions that currently recommended waist circumference (WC) cut-off points for Australians of European origin may not be applicable to Aboriginal people who have different body habitus profiles. We aimed to generate equivalent WC values that correspond to body mass index (BMI) points for identifying absolute cardiovascular disease (CVD) risks. Prospective cohort study. An Aboriginal community in Australia's Northern Territory. From 1992 to 1998, 920 adults without CVD, with age, WC and BMI measurements were followed-up for up to 20 years. Incident CVD, coronary artery disease (CAD) and heart failure (HF) events during the follow-up period ascertained from hospitalisation data. We generated WC values with 10-year absolute risks equivalent for the development of CVD as BMI values (20-34 kg/m(2)) using the Weibull accelerated time-failure model. There were 211 incident cases of CVD over 13,669 person-years of follow-up. At the average age of 35 years, WC values with absolute CVD, CAD and HF risks equivalent to BMI of 25 kg/m(2) were 91.5, 91.8 and 91.7 cm, respectively, for males, and corresponding WC values were 92.5, 92.7 and 93 cm for females. WC values with equal absolute CVD, CAD and HF risks to BMI of 30 kg/m(2) were 101.7, 103.1 and 102.6 cm, respectively, for males, and corresponding values were 99.2, 101.6 and 101.5 cm for females. Association between WC and CVD did not depend on gender (p=0.54). WC ranging from 91 to 93 cm was equivalent to BMI 25 kg/m(2) for overweight, and 99 to 103 cm was equivalent to BMI of 30 kg/m(2) for obesity in terms of predicting 10-year absolute CVD risk. Replicating the absolute risk method in other Aboriginal communities will further validate the WC values generated for future development of WC cut-off points for Aboriginal people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. Interaction of FKBP5 Gene Variants and Adverse Life Events in Predicting Depression Onset: Results From a 10-Year Prospective Community Study

    Science.gov (United States)

    Zimmermann, Petra; Brückl, Tanja; Nocon, Agnes; Pfister, Hildegard; Binder, Elisabeth B.; Uhr, Manfred; Lieb, Roselind; Moffitt, Terrie E.; Caspi, Avshalom; Holsboer, Florian; Ising, Marcus

    2013-01-01

    Objective The binding protein FKBP5 is an important modulator of the function of the glucocorticoid receptor, the main receptor of the stress horm one system. This turns the FKBP5 gene into a key candidate for gene-environment interactions, which are considered critical for pathogenesis of stress-related disorders. The authors explored gene-environment interactions between FKBP5 gene variants and adverse life events in predicting the first occurrence of a major depressive episode. Method The analyses were based on 884 Caucasians in a 10-year prospective community study. At baseline, they were 14–24 years old and did not fulfill criteria for a major depressive episode. The DSM-IV-based Munich Composite International Diagnostic Interview was used to assess adverse life events preceding baseline and major depressive episodes during follow-up. On the basis of previous findings, five single-nucleotide polymorphisms (SNPs) within the FKBP5 gene were selected for genotyping. Results While the authors did not observe genetic main effects, they found interactions between the five SNPs and traumatic (but not separation) events, with the strongest effect for severe trauma. The effect of trauma on incident major depressive episodes was evident among subjects homozygous for the minor alleles but not subjects with other genotypes. The findings were replicated in the U.K. Environmental Risk Longitudinal Twin Study. Conclusions These hypothesis-driven results suggest that an interaction between FKBP5 genotype and trauma is involved in the onset of depression. Subjects homozygous for the minor alleles of the investigated FKBP5 SNPs seem to be particularly sensitive to effects of trauma exposure in terms of triggering depression onset. PMID:21865530

  19. Diagnostic stability of autism spectrum disorder in toddlers prospectively identified in a community-based setting: Behavioural characteristics and predictors of change over time.

    Science.gov (United States)

    Barbaro, Josephine; Dissanayake, Cheryl

    2016-07-28

    Autism spectrum disorder diagnoses in toddlers have been established as accurate and stable across time in high-risk siblings and clinic-referred samples. Few studies have investigated diagnostic stability in children prospective identified in community-based settings. Furthermore, there is a dearth of evidence on the individual behaviours that predict diagnostic change over time. The stability and change of autism spectrum disorder diagnoses were investigated from 24 to 48 months in 77 children drawn from the Social Attention and Communication Study. Diagnostic stability was high, with 88.3% overall stability and 85.5% autism spectrum disorder stability. The behavioural markers at 24 months that contributed to diagnostic shift off the autism spectrum by 48 months included better eye contact, more directed vocalisations, the integration of gaze and directed vocalisations/gestures and higher non-verbal developmental quotient. These four variables correctly predicted 88.7% of children into the autism spectrum disorder-stable and autism spectrum disorder-crossover groups overall, with excellent prediction for the stable group (96.2%) and modest prediction for the crossover group (44.4%). Furthermore, non-verbal developmental quotient at 24 months accounted for the significant improvement across time in 'Social Affect' scores on the Autism Diagnostic Observation Schedule for both groups and was the only unique predictor of diagnostic crossover. These findings contribute to the body of evidence on the feasibility of diagnoses at earlier ages to facilitate children's access to interventions to promote positive developmental outcomes.

  20. Fast-food consumption, diet quality and body weight: cross-sectional and prospective associations in a community sample of working adults.

    Science.gov (United States)

    Barnes, Timothy L; French, Simone A; Mitchell, Nathan R; Wolfson, Julian

    2016-04-01

    To examine the association between fast-food consumption, diet quality and body weight in a community sample of working adults. Cross-sectional and prospective analysis of anthropometric, survey and dietary data from adults recruited to participate in a worksite nutrition intervention. Participants self-reported frequency of fast-food consumption per week. Nutrient intakes and diet quality, using the Healthy Eating Index-2010 (HEI-2010), were computed from dietary recalls collected at baseline and 6 months. Metropolitan medical complex, Minneapolis, MN, USA. Two hundred adults, aged 18-60 years. Cross-sectionally, fast-food consumption was significantly associated with higher daily total energy intake (β=72·5, P=0·005), empty calories (β=0·40, P=0·006) and BMI (β=0·73, P=0·011), and lower HEI-2010 score (β=-1·23, P=0·012), total vegetables (β=-0·14, P=0·004), whole grains (β=-0·39, P=0·005), fibre (β=-0·83, P=0·002), Mg (β=-6·99, P=0·019) and K (β=-57·5, P=0·016). Over 6 months, change in fast-food consumption was not significantly associated with changes in energy intake or BMI, but was significantly inversely associated with total intake of vegetables (β=-0·14, P=0·034). Frequency of fast-food consumption was significantly associated with higher energy intake and poorer diet quality cross-sectionally. Six-month change in fast-food intake was small, and not significantly associated with overall diet quality or BMI.

  1. Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study.

    Directory of Open Access Journals (Sweden)

    Chung-Hsu Lai

    Full Text Available The clinical characteristics of Q fever are poorly identified in the tropics. Fever with pneumonia or hepatitis are the dominant presentations of acute Q fever, which exhibits geographic variability. In southern Taiwan, which is located in a tropical region, the role of Q fever in community-acquired pneumonia (CAP has never been investigated.During the study period, May 2012 to April 2013, 166 cases of adult CAP and 15 cases of acute Q fever were prospectively investigated. Cultures of clinical specimens, urine antigen tests for Streptococcus pneumoniae and Legionella pneumophila, and paired serologic assessments for Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Q fever (Coxiella burnetii were used for identifying pathogens associated with CAP. From April 2004 to April 2013 (the pre-study period, 122 cases of acute Q fever were also included retrospectively for analysis. The geographic distribution of Q fever and CAP cases was similar. Q fever cases were identified in warmer seasons and younger ages than CAP. Based on multivariate analysis, male gender, chills, thrombocytopenia, and elevated liver enzymes were independent characteristics associated with Q fever. In patients with Q fever, 95% and 13.5% of cases presented with hepatitis and pneumonia, respectively. Twelve (7.2% cases of CAP were seropositive for C. burnetii antibodies, but none of them had acute Q fever. Among CAP cases, 22.9% had a CURB-65 score ≧2, and 45.8% had identifiable pathogens. Haemophilus parainfluenzae (14.5%, S. pneumoniae (6.6%, Pseudomonas aeruginosa (4.8%, and Klebsiella pneumoniae (3.0% were the most common pathogens identified by cultures or urine antigen tests. Moreover, M. pneumoniae, C. pneumoniae, and co-infection with 2 pathogens accounted for 9.0%, 7.8%, and 1.8%, respectively.In southern Taiwan, Q fever is an endemic disease with hepatitis as the major presentation and is not a common etiology of CAP.

  2. Effectiveness of artemether-lumefantrine provided by community health workers in under-five children with uncomplicated malaria in rural Tanzania: an open label prospective study

    Directory of Open Access Journals (Sweden)

    Blessborn Daniel

    2011-03-01

    Full Text Available Abstract Background Home-management of malaria (HMM strategy improves early access of anti-malarial medicines to high-risk groups in remote areas of sub-Saharan Africa. However, limited data are available on the effectiveness of using artemisinin-based combination therapy (ACT within the HMM strategy. The aim of this study was to assess the effectiveness of artemether-lumefantrine (AL, presently the most favoured ACT in Africa, in under-five children with uncomplicated Plasmodium falciparum malaria in Tanzania, when provided by community health workers (CHWs and administered unsupervised by parents or guardians at home. Methods An open label, single arm prospective study was conducted in two rural villages with high malaria transmission in Kibaha District, Tanzania. Children presenting to CHWs with uncomplicated fever and a positive rapid malaria diagnostic test (RDT were provisionally enrolled and provided AL for unsupervised treatment at home. Patients with microscopy confirmed P. falciparum parasitaemia were definitely enrolled and reviewed weekly by the CHWs during 42 days. Primary outcome measure was PCR corrected parasitological cure rate by day 42, as estimated by Kaplan-Meier survival analysis. This trial is registered with ClinicalTrials.gov, number NCT00454961. Results A total of 244 febrile children were enrolled between March-August 2007. Two patients were lost to follow up on day 14, and one patient withdrew consent on day 21. Some 141/241 (58.5% patients had recurrent infection during follow-up, of whom 14 had recrudescence. The PCR corrected cure rate by day 42 was 93.0% (95% CI 88.3%-95.9%. The median lumefantrine concentration was statistically significantly lower in patients with recrudescence (97 ng/mL [IQR 0-234]; n = 10 compared with reinfections (205 ng/mL [114-390]; n = 92, or no parasite reappearance (217 [121-374] ng/mL; n = 70; p ≤ 0.046. Conclusions Provision of AL by CHWs for unsupervised malaria treatment at home

  3. IMPACT OF SPECIFIC PHOBIA ON THE RISK OF ONSET OF MENTAL DISORDERS: A 10-YEAR PROSPECTIVE-LONGITUDINAL COMMUNITY STUDY OF ADOLESCENTS AND YOUNG ADULTS.

    Science.gov (United States)

    Lieb, Roselind; Miché, Marcel; Gloster, Andrew T; Beesdo-Baum, Katja; Meyer, Andrea H; Wittchen, Hans-Ulrich

    2016-07-01

    The role of specific phobia as a potentially important psychopathological precursor condition to more severe mental disorders is understudied. We examined the prospective-longitudinal association of early childhood/adolescent phobia with subsequent mental disorders and the proportion of outcome disease incidence attributable to specific phobia simultaneously for a broad range of disorders. N = 2210 14- to 24-year-old community subjects were followed up for 10 years. DSM-IV-specific phobia as exposure and a broad range of DSM-IV mental disorders as outcomes were assessed with the DSM-IV/M-CIDI. Logistic regressions, adjusting for confounders, were used to estimate the associations of specific phobia with the subsequent onset of outcome disorders. Baseline specific phobia predicted the subsequent first onset of anxiety disorders [panic disorder: risk ratio (RR) = 4.38, 95% confidence interval (2.34, 8.21); generalized anxiety disorder: RR = 4.10 (2.19, 7.69); posttraumatic stress disorder: RR = 2.15 (1.13, 4.10); obsessive-compulsive disorder: RR = 3.79 (1.63, 8.82)], affective disorders [major depression: RR = 1.54 (1.16, 2.03); bipolar disorder: RR = 2.20 (1.10, 4.41); dysthymia: RR = 2.75 (1.48, 5.11)], pain disorder: RR = 1.52 (1.14, 2.02), and eating disorders: RR = 2.27 (1.14, 4.51). Population attributable fractions (PAFs; i.e., proportion of outcome disease incidence in the total population attributable to specific phobia) were highest for panic disorder (PAF = 22.9), generalized anxiety disorder (PAF = 32.3), and obsessive-compulsive disorders (PAF = 30.2). This study provides strong evidence that specific phobia is an early onset disorder predicting the subsequent onset of a range of disorders. Future studies should examine the underlying mechanisms and the potential of using specific phobia as a target for prevention of subsequent psychopathology. © 2016 Wiley Periodicals, Inc.

  4. Risk Factors for Long-Term Mortality after Hospitalization for Community-Acquired Pneumonia: A 5-Year Prospective Follow-Up Study.

    Directory of Open Access Journals (Sweden)

    Jan C Holter

    Full Text Available Contributors to long-term mortality in patients with community-acquired pneumonia (CAP remain unclear, with little attention paid to pneumonia etiology. We examined long-term survival, causes of death, and risk factors for long-term mortality in adult patients who had been hospitalized for CAP, with emphasis on demographic, clinical, laboratory, and microbiological characteristics.Two hundred and sixty-seven consecutive patients admitted in 2008-2011 to a general hospital with CAP were prospectively recruited and followed up. Patients who died during hospital stay were excluded. Demographic, clinical, and laboratory data were collected within 48 hours of admission. Extensive microbiological work-up was performed to establish the etiology of CAP in 63% of patients. Mortality data were obtained from the Norwegian Cause of Death Registry. Cox regression models were used to identify independent risk factors for all-cause mortality.Of 259 hospital survivors of CAP (median age 66 years, 79 (30.5% died over a median of 1,804 days (range 1-2,520 days. Cumulative 5-year survival rate was 72.9% (95% CI 67.4-78.4%. Standardized mortality ratio was 2.90 for men and 2.05 for women. The main causes of death were chronic obstructive pulmonary disease (COPD, vascular diseases, and malignancy. Independent risk factors for death were the following (hazard ratio, 95% CI: age (1.83 per decade, 1.47-2.28, cardiovascular disease (2.63, 1.61-4.32, COPD (2.09, 1.27-3.45, immunocompromization (1.98, 1.17-3.37, and low serum albumin level at admission (0.75 per 5 g/L higher, 0.58-0.96, whereas active smoking was protective (0.32, 0.14-0.74; active smokers were younger than non-smokers (P < 0.001. Microbial etiology did not predict mortality.Results largely confirm substantial comorbidity-related 5-year mortality after hospitalization for CAP and the impact of several well-known risk factors for death, and extend previous findings on the prognostic value of serum albumin

  5. Twenty years of child and teenager’s statute

    Directory of Open Access Journals (Sweden)

    Carlos Antonio Bruno da Silva

    2009-12-01

    Full Text Available Em 2010 completaremos 20 anos do Estatuto da Criança e do Adolescente (ECA, instituído pela Lei 8.069, em julho de 1990(1. O seu papel é de fundamental importância, pois até então as políticas relacionadas a crianças e adolescentes surgiam com o objetivo de resolução de problemas sociais. O ECA consiste na forma de regulamentação dos direitos das crianças e dos adolescentes de nosso país.O ECA surgiu a partir das diretrizes da Constituição Federal de 1988(2, explicitadas em seu art 227.Art. 227. É dever da família, da sociedade e do Estado assegurar à criança e ao adolescente, com absoluta prioridade, o direito à vida, à saúde, à alimentação, à educação, ao lazer, à profissionalização, à cultura, à dignidade, ao respeito, à liberdade e à convivência familiar e comunitária, além de colocá-los a salvo de toda forma de negligência, discriminação, exploração, violência, crueldade e opressão.A partir destes dois importantes documentos sociais e em resposta às lutas sociais que vinham sendo travadas desde 1980 em prol da redemocratização e da defesa dos direitos da criança e do adolescetes, estes passaram a ser considerados como “sujeitos de direitos”. Desde então, são considerados em sua “peculiar condição de pessoas em desenvolvimento” e a quem se deve assegurar “prioridade absoluta” na formulação de políticas públicas e destinação privilegiada de recursos nas dotações orçamentárias das diversas instâncias político-administrativas do País(3.Os direitos concernentes à convivência familiar e comunitária e ao lazer como parte fundamental de sua socialização e de seu florescimento enquanto ser humano, também são estabelecidos pelo documento. Entretanto, apesar de serem considerados como direitos básicos de todas as crianças, este aspecto da legislação não recebe ainda a devida atenção. O problema do trabalho infantil, apesar de todos os esforços das organizações governamentais, não governamentais e da sociedade, ainda está longe de ser resolvido (3.O ECA, além de criar mecanismos de proteção nas áreas de educação, saúde, trabalho e assistência social, estabelece o fim da aplicação de punições para adolescentes, tratados com medidas de proteção em caso de desvio de conduta e com medidas socioeducativas em caso de cometimento de atos infracionais. Ponto este que tem sido alvo de debates e de necessidade de maiores estudos acerca da violência. Não só daquela sofrida pelo jovem, mas principalmente aquela que é exercida por ele(4.Com o Estatuto da Criança e do Adolescente surgem os Conselhos e Fundos dos Direitos da Criança e do Adolescente – municipais, estaduais e nacional –, e o Conselho Tutelar – apenas na esfera municipal –, obrigatórios em todo Município. Passa-se assim a responsabilidade para o município.No ano de 2009 foi realizada uma avaliação da Associação Nacional dos Centros de Defesa (ANCED, tendo sido organizado, pela segunda vez, um relatório sobre a situação dos direitos da criança e do adolescente no país. Neste levantamento sobre os principais eixos temáticos que albergam as políticas públicas, destacaram-se aquelas que envolviam: Sistema Geral de Proteção; Medidas Gerais de Implementação da Convenção dos Direitos da Criança (CDC; Homicídios, Atentados à Vida, à Integridade Física, Tortura e Punições Corporais; Convivência Família e Comunitária; Violências Sexuais e Exploração Econômica; Direito à Saúde, Direito à Educação e Justiça Juvenil. Concluindo-se que o estado tem fracassado no seu papel primordial de defesa dos direitos da criança e do adolescente(5.Neste número da Revista Brasileira em Promoção da Saúde publicamos um artigo que aborda o tema Políticas Públicas de Saúde (PPS voltadas para a criança. Esta pesquisa foi realizada nos Centros Municipais de Educação Infantil (CMEI e nas Unidades Básicas de Saúde (UBS na Cidade de Santa Maria no Estado do Rio Grande do Sul(6.Os achados corroboram o que tem sido vis

  6. Baltic cooperation twenty years later / Rokas M. Tracevskis

    Index Scriptorium Estoniae

    Tracevskis, Rokas M.

    2011-01-01

    2. detsembril Tallinnas toimunud Baltimaade ja Poola presidentide kohtumisel arutati Rail Balticu projektiga seonduvat. 2. detsembril Kaunases toimunud Baltimaade kaitseministrite Mart Laari, Rasa Jukneviciene ja Artis Pabriksi kohtumisel arutati Balti riikide kaitsekoostööga seotud küsimusi. Samal ajal Visaginases toimunud Läti ja Leedu peaministrite kohtumisel räägiti Visaginase tuumaelektrijaama projektist. LNG terminaliga seotud vaidlustest

  7. Twenty years of revolutionary democratic Ethiopia, 1991 to 2011

    DEFF Research Database (Denmark)

    Hagmann, Tobias; Abbink, Jon

    2011-01-01

    with a short summary of these 11 papers, but then moves to a substantive review of Ethiopia's political history over the past two decades, featuring consideration of the extent of transformation and continuity under the ruling Ethiopian Peoples' Revolutionary Democratic Front (EPRDF), the importance...

  8. Whooping cough, twenty years from acellular vaccines introduction.

    Science.gov (United States)

    Greco, D; Esposito, S; Tozzi, A; Pandolfi, E; Icardi, G; Giammanco, A

    2015-01-01

    Clinical pertussis resulting from infection with B. pertussis is a significant medical and public health problem, despite the huge success of vaccination that has greatly reduced its incidence. The whole cell vaccine had an undeniable success over the last 50 years, but its acceptance was strongly inhibited by fear, only partially justified, of severe side effects, but also, in the Western world, by the difficulty to enter in combination with other vaccines: today multi-vaccine formulations are essential to maintain a high vaccination coverage. The advent of acellular vaccines was greeted with enthusiasm by the public health world: in the Nineties, several controlled vaccine trials were carried out: they demonstrated a high safety and good efficacy of new vaccines. In fact, in the Western world, the acellular vaccines completely replaced the whole cells ones. In the last years, ample evidence on the variety of protection of these vaccines linked to the presence of different antigens of Bordetella pertussis was collected. It also became clear that the protection provided, on average around 80%, leaves every year a significant cohort of vaccinated susceptible even in countries with a vaccination coverage of 95%, such as Italy. Finally, it was shown that, as for the pertussis disease, protection decreases over time, to leave a proportion of adolescents and adults unprotected. Waiting for improved pertussis vaccines, the disease control today requires a different strategy that includes a booster at 5 years for infants, but also boosters for teenagers and young adults, re-vaccination of health care personnel, and possibly of pregnant women and of those who are in contact with infants (cocooning). Finally, the quest for better vaccines inevitably tends towards pertussis acellular vaccines with at least three components, which have demonstrated superior effectiveness and have been largely in use in Italy for fifteen years.

  9. Hemodynamic characterization of recombinant inbred strains: twenty years later.

    Science.gov (United States)

    Kunes, Jaroslav; Dobesová, Zdenka; Musilová, Alena; Zídek, Václav; Vorlícek, Jaroslav; Pravenec, Michal; Kren, Vladimír; Zicha, Josef

    2008-08-01

    Recombinant inbred (RI) strains (Prague HXB/BXH set) represent a unique model that allows for permanent summation of genetic and physiological information as well as the study of age-dependent changes in phenotypes and/or gene regulation. This study compared blood pressure (BP) measured in adult animals of RI strains by radiotelemetry with BP values obtained in conscious rats of comparable age subjected to short-term carotid catheterization or with those obtained by direct carotid puncture under ether anesthesia (almost 20 years ago). After radiotelemetry recording, the contribution of major vasoactive systems to BP maintenance was studied by consecutive inhibition of the renin-angiotensin system (RAS), sympathetic nervous system (SNS), and nitric oxide synthase. We found highly significant interrelationships among baseline BP values obtained by radiotelemetry, carotid catheterization, or carotid puncture. This indicates considerable stability of RI strains over the course of their long existence, and confirms the reliability of BP values used for genetic studies performed in the past. Subsequent analysis of vasoactive system participation revealed the importance of SNS for the maintenance of BP, as determined by either radiotelemetry or catheterization. The BP of catheterized rats also correlated closely with acute captopril-induced BP changes, but this was not the case for rats measured by radiotelemetry. NO-dependent vasodilatation matched the BP effects of SNS and RAS in both measuring conditions. Residual BP (recorded at sodium nitroprusside-induced dilatation of resistance vessels) was also responsible for a significant portion of the BP variation in RI strains. Our study confirms the validity of RI strains for the further genetic and physiological research of hypertension.

  10. Progress in thermal comfort research over the last twenty years.

    Science.gov (United States)

    de Dear, R J; Akimoto, T; Arens, E A; Brager, G; Candido, C; Cheong, K W D; Li, B; Nishihara, N; Sekhar, S C; Tanabe, S; Toftum, J; Zhang, H; Zhu, Y

    2013-12-01

    Climate change and the urgency of decarbonizing the built environment are driving technological innovation in the way we deliver thermal comfort to occupants. These changes, in turn, seem to be setting the directions for contemporary thermal comfort research. This article presents a literature review of major changes, developments, and trends in the field of thermal comfort research over the last 20 years. One of the main paradigm shift was the fundamental conceptual reorientation that has taken place in thermal comfort thinking over the last 20 years; a shift away from the physically based determinism of Fanger's comfort model toward the mainstream and acceptance of the adaptive comfort model. Another noticeable shift has been from the undesirable toward the desirable qualities of air movement. Additionally, sophisticated models covering the physics and physiology of the human body were developed, driven by the continuous challenge to model thermal comfort at the same anatomical resolution and to combine these localized signals into a coherent, global thermal perception. Finally, the demand for ever increasing building energy efficiency is pushing technological innovation in the way we deliver comfortable indoor environments. These trends, in turn, continue setting the directions for contemporary thermal comfort research for the next decades.

  11. Progress in thermal comfort research over the last twenty years

    DEFF Research Database (Denmark)

    Dear, R. J. de; Akimoto, T.; Arens, E. A.

    2013-01-01

    developed, driven by the continuous challenge to model thermal comfort at the same anatomical resolution and to combine these localized signals into a coherent, global thermal perception. Finally, the demand for ever increasing building energy efficiency is pushing technological innovation in the way we...

  12. Meal-feeding scheme: twenty years of research in Brazil

    Directory of Open Access Journals (Sweden)

    R.B. Bazotte

    2000-09-01

    Full Text Available Naomi Shinomiya Hell was the first researcher to investigate the physiological adaptations to a meal-feeding scheme (MFS in Brazil. Over a period of 20 years, from 1979 to 1999, Naomi's group determined the physiological and metabolic adaptations induced by this feeding scheme in rats. The group showed the persistence of such adaptations even when MFS is associated with moderate exercise training and the performance to a session of intense physical effort. The metabolic changes induced by the feeding training were discriminated from those caused by the effective fasting period. Naomi made an important contribution to the understanding of the MFS but a lot still has to be done. One crucial question still remains to be satisfactorily answered: what is the ideal control for the MFS?

  13. Baltic cooperation twenty years later / Rokas M. Tracevskis

    Index Scriptorium Estoniae

    Tracevskis, Rokas M.

    2011-01-01

    2. detsembril Tallinnas toimunud Baltimaade ja Poola presidentide kohtumisel arutati Rail Balticu projektiga seonduvat. 2. detsembril Kaunases toimunud Baltimaade kaitseministrite Mart Laari, Rasa Jukneviciene ja Artis Pabriksi kohtumisel arutati Balti riikide kaitsekoostööga seotud küsimusi. Samal ajal Visaginases toimunud Läti ja Leedu peaministrite kohtumisel räägiti Visaginase tuumaelektrijaama projektist. LNG terminaliga seotud vaidlustest

  14. Twenty Years' Development of the Postdoc Program at CAS

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Until recently, the concept of a postdoctoral scholar (postdoc) was new in China although it first appeared about 125 years ago, when Johns Hopkins University adopted an ap prenticeship model of high-level training.

  15. Midwifery and obstetrics: twenty years of collaborative academic practice.

    Science.gov (United States)

    Angelini, Diane J; O'Brien, Barbara; Singer, Janet; Coustan, Donald R

    2012-09-01

    This review describes a collaborative educational practice model partnering midwifery and obstetrics within a department of obstetrics and gynecology. For more than 20 years, the authors' model has demonstrated sustainability and influence on medical education. The focus is on resident education in obstetrics, using midwifery faculty as teachers in the obstetric and obstetric triage settings. This noncompetitive and integrated educational practice model has achieved sustainability and success using midwives in a collaborative approach to medical education. The continuing collaboration and innovation within medical and resident education are important elements for the future of collaborative practice.

  16. Twenty years of treatment for Gaucher disease: emerging challenges

    NARCIS (Netherlands)

    van Dussen, L.

    2014-01-01

    Gaucher disease is an autosomal recessively inherited lysosomal storage disorder (LSD). Type I Gaucher disease, the so-called non-neuronopathic variant, is mainly characterised by cytopenia, hepatosplenomegaly and bone complications. Gaucher disease was the first LSD for which enzyme replacement the

  17. A Twenty Year Path: Learning about Assessment; Learning from Assessment

    Directory of Open Access Journals (Sweden)

    Debra L. Gilchrist

    2010-03-01

    Full Text Available This article reviews the development of educational assessment from the 1970’s to the present, including discussions of basic working definitions and models of assessment in information literacy. It reflects on what librarians have learned from assessment and about assessment, and how this information is being used to improve current and future assessment offerings.

  18. Internet Addiction: A Review of the First Twenty Years.

    Science.gov (United States)

    Mihajlov, Martin; Vejmelka, Lucija

    2017-09-01

    Easy access to communication and information technologies has increased our dependence on technology for various aspects of our lives. Nevertheless, this remarkable growth of Internet Usage has been inextricably paired with a rise of excessive and dysfunctional Internet use. Conceptualized around 1996, a few years after the inception of the World Wide Web, Internet addiction has developed into a global issue influencing varying segments of the population at different levels. Despite heated debates on its addictive nature, consensus is emerging regarding the existence of this problematic behavior. In this paper we provide a comprehensive overview of the literature on Internet addiction in last 20 years. Purpose of this paper is to present crucial findings on Internet addiction to health profession. Besides numerous benefits of Internet use, the virtual environment brings various risks in every age group. The Internet is very significant in the everyday activities of children and youth and professional interventions with this age group should be specific considering their developmental characteristics. Exposure to online risks can have long-lasting and intense negative effects. Effective programs in prevention and treatment should include a multi-sectoral and interdisciplinary approach. Detail review of the symptomatology, diagnosis model an possibilities of treatment can be multiple beneficial to the health professionals and other helping professions due to actual needs for interventions in the field of the internet addiction treatment. Internet addiction is slowly becoming a societal concern as it particularly affects adolescents and children, who are more exposed and consequently more vulnerable. Findings presented in the paper can benefit in practice of treatment internet addiction and also as framework for further researches in the field.

  19. Cost in Medical Education: One Hundred and Twenty Years Ago

    Science.gov (United States)

    Walsh, Kieran

    2015-01-01

    The first full paper that is dedicated to cost in medical education appears in the "BMJ" in 1893. This paper "The cost of a medical education" outlines the likely costs associated with undergraduate education at the end of the nineteenth century, and offers guidance to the student on how to make financial planning. Many lessons…

  20. About Chernobyl - Twenty Years Later; Propos sur Tchernobyl

    Energy Technology Data Exchange (ETDEWEB)

    Tubiana, M

    2006-07-01

    The author discusses the reactor accident of Chernobyl, the information on its consequences so contradictory in the former USSR countries, the status of the effects observed, the forecasting concerning the onset of cancers in the coming years among the populations that were exposed to radiations, the public opinion facing the pessimists. He concludes on the lessons which can be drawn from Chernobyl. (A.L.B.)

  1. Twenty years of protein interaction studies for biological function deciphering.

    Science.gov (United States)

    Legrain, Pierre; Rain, Jean-Christophe

    2014-07-31

    Intensive methodological developments and technology innovation have been devoted to protein-protein interaction studies over 20years. Genetic indirect assays and sophisticated large scale biochemical analyses have jointly contributed to the elucidation of protein-protein interactions, still with a lot of drawbacks despite heavy investment in human resources and technologies. With the most recent developments in mass spectrometry and computational tools for studying protein content of complex samples, the initial goal of deciphering molecular bases of biological functions is now within reach. Here, we described the various steps of this process and gave examples of key milestones in this scientific story line. This article is part of a Special Issue entitled: 20years of Proteomics in memory of Viatliano Pallini. Guest Editors: Luca Bini, Juan J. Calvete, Natacha Turck, Denis Hochstrasser and Jean-Charles Sanchez.

  2. Organising services for IMD in Thailand: twenty years experience.

    Science.gov (United States)

    Wasant, Pornswan

    2008-12-01

    The study of inherited metabolic disorders (IMD) in Thailand is in its infancy when compare with developed countries. Prior to 1987, majority of these disorders were clinically diagnosed since there were only a handful of clinicians and scientists with expertise in inborn errors of metabolism, lack of well-equipped laboratory facilities and government support. In developing countries, inherited metabolic disorders are not considered a priority due to the prevalence of infectious diseases such as HIV infection and congenital infections. A multicentre survey conducted in 1994 and 2001 revealed the existence of numerous cases of IMD from all over the country. Case reports and publications on IMD in Thai (and international) medical journals in past 20 years had undoubtedly raised its awareness among Thai paediatricians and scientists. In 2001, the Genetic Metabolic Centre was first established in Siriraj Hospital Faculty of Medicine, Thailand. Numerous new cases of IMD had been identified since then.

  3. Twenty Years of Commercial Lasers--A Capsule History.

    Science.gov (United States)

    Klauminzer, Gary K.

    1986-01-01

    Since the commercial laser industry was born, laser sales and services have grown to billion dollar proportions. This period of growth is reviewed. Discusses types of lasers, expansion of applications and growth in laboratory usage, technical improvements, and current laser development trends. (CT)

  4. More than Twenty Years of Svensén's Handbook

    DEFF Research Database (Denmark)

    Pálfi, Loránd-Levente

    2010-01-01

    The number of real handbooks dealing with lexicography and metalexicography is not, and has never been, impressive. When one looks at comprehensive handbooks and in addition those brought up to date, the number becomes even smaller. Because of this, but also because it has existed for more than 20...... years (i.e. in different editions/versions) and because it is - especially in Scandinavia - a quite well-known work, Svensén's handbook is an important publication. In this review article, I will consider what the critics have written over the years (i.e. on the different editions/versions of Svensén......'s handbook), and I will attempt to determine whether the book is about to become a classic....

  5. Twenty Years on: Reflections on the CEDISYS Project

    DEFF Research Database (Denmark)

    Boudol, Gerard; Castellani, Ilaria; Hennessy, Matthew

    2008-01-01

    We recall some memories of the Esprit Basic Research Action CEDISYS, a small, well-focussed and fruitful project which brought together researchers at the meeting point of true concurrency and process algebra, in the period 1988-1991. The project was initiated and effectively animated by Ugo...

  6. Twenty Years of Prīmary Care

    African Journals Online (AJOL)

    something butcando nothing and psychiatrists as those who ... department of Professor (Mrs) O Olurin and Professor. (Mrs) O .... and the other emergency) died from inadequate fluid therapy. ... Students of laboratory science in our various.

  7. PROGRESS OF CHINESE REGIONAL GEOGRAPHYSTUDIES IN RECENT TWENTY YEARS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Regional geography, embodying the regionality and integration, is the kernel of Geography. Since the 1980s, the Chinese geographers have extensively taken part in the social practical activities and made progress in physicogeographical regionalization, economic regionalization, territorial (regional) development planning, construction of special economic zone, and integrated research in the major areas of China. Through these works, the theories of regional geography have been richened and the capacity participating in the social practice promoted as well. In China, many regional researches had been conducted respectively from the aspects of regional physico-geography and regional economic geography,etc. According to the cases, this paper gives a review on the studies of regional geography during the latest two decades in China. It ought to be indicated that the natural and human components should be combined and the disciplines intersected and permeated, with the support of advanced technology. In order to serve the regional sustainable development, on the background of global change, this is an inevitable tendency for the development of the regional geography.

  8. Weight Loss Emphasis in Popular Magazines: A Twenty Year Analysis.

    Science.gov (United States)

    Shealy, Lucinda; And Others

    Cultural pressure for thinness has been cited as a contributing factor in the apparent increase in the eating disorders of anorexia and bulimia. Previous research has examined popular periodicals as an indicator of cultural pressure for thinness. This study assessed changes over the past 20 years in numbers of popular magazine articles focusing on…

  9. Active control of combustors after twenty years' efforts

    Science.gov (United States)

    Culick, F. E. C.; Palm, S.

    2009-09-01

    Active control of combustion was proposed by Bollay [1]. Following that idea, Tsien [2] worked out an analysis of controlling low-frequency oscillations in a liquid rocket but no successful experimental results followed. More than thirty years passed before the first laboratory demonstrations were performed at Cambridge University. Interest grew rapidly in the 1990s due to potentially wonderful applications to practical combustion systems including liquid and solid rockets, gas turbines, and thrust augmentors. Dreams have not materialized: There are presently no operational control systems, despite considerable efforts, and examples of partially controlled phenomena. Only one practical installation for control of oscillations has been documented, for a large Siemens machine [3]. Its use has been rendered unnecessary by further experimental work leading to development of successful passive control with modifications of hardware [4]. The purpose of this paper is to examine briefly some of the reasons that active control of combustion has failed to become the panacea widely anticipated two decades ago. The authors' view is that the subject is far from exhausted, but rather requires carefully planned research to understand the basis of successful applications.

  10. Twenty years of embryonic stem cell research in farm animals.

    Science.gov (United States)

    Blomberg, L A; Telugu, B P V L

    2012-08-01

    Notable distinctions between an embryonic stem cell (ESC) and somatic cell are that an ESC can maintain an undifferentiated state indefinitely, self-renew, and is pluripotent, meaning that the ESC can potentially generate cells representing all the three primordial germ layers and contribute to the terminally differentiated cells of a conceptus. These attributes make the ESC an ideal source for genome editing for both agricultural and biomedical applications. Although, ESC lines have been successfully established from rodents and primates, authentic ungulate stem cell lines on the contrary are still not available. Outstanding issues including but not limited to differences in pluripotency characteristics among the existing ESC lines, pre-implantation embryo development, pluripotency pathways, and culture conditions plague our efforts to establish authentic ESC lines from farm animals. In this review, we highlight some of these issues and discuss how the recent derivation of induced pluripotent stem cells (iPSCs) might augur the establishment of robust authentic ESC lines from farm animals.

  11. Twenty years of treatment for Gaucher disease: emerging challenges

    NARCIS (Netherlands)

    van Dussen, L.

    2014-01-01

    Gaucher disease is an autosomal recessively inherited lysosomal storage disorder (LSD). Type I Gaucher disease, the so-called non-neuronopathic variant, is mainly characterised by cytopenia, hepatosplenomegaly and bone complications. Gaucher disease was the first LSD for which enzyme replacement

  12. Twenty years of embryonic stem cell research in farm animals

    Science.gov (United States)

    Notable distinctions between an embryonic stem cell (ESC) and somatic cell are that the ESC can maintain an undifferentiated state indefinitely, self renew, and is pluripotent, meaning that the ESC can potentially generate cells representing all the three primordial germ layers and contribute to the...

  13. Twenty years of social capital and health research: a glossary.

    Science.gov (United States)

    Moore, S; Kawachi, I

    2017-05-01

    Research on social capital in public health is approaching its 20th anniversary. Over this period, there have been rich and productive debates on the definition, measurement and importance of social capital for public health research and practice. As a result, the concepts and measures characterising social capital and health research have also evolved, often drawing from research in the social, political and behavioural sciences. The multidisciplinary adaptation of social capital-related concepts to study health has made it challenging for researchers to reach consensus on a common theoretical approach. This glossary thus aims to provide a general overview without recommending any particular approach. Based on our knowledge and research on social capital and health, we have selected key concepts and terms that have gained prominence over the last decade and complement an earlier glossary on social capital and health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Career patterns : A twenty-year panel study

    NARCIS (Netherlands)

    Biemann, Torsten; Zacher, Hannes; Feldman, Daniel C.

    2012-01-01

    Using 20 years of employment and job mobility data from a representative German sample (N=1259), we employ optimal matching analysis (OMA) to identify six career patterns which deviate from the traditional career path of long-term, full-time employment in one organization. Then, in further analyses,

  15. Patented Biologically-inspired Technological Innovations: A Twenty Year View

    Institute of Scientific and Technical Information of China (English)

    Richard H. C. Bonser

    2006-01-01

    Publication rate of patents can be a useful measure of innovation and productivity in fields of science and technology. To assess the growth in industrially-important research, I conducted an appraisal of patents published between 1985 and 2005 on online databases using keywords chosen to select technologies arising as a result of biological inspiration. Whilst the total number of patents increased over the period examined, those with biomimetic content had increased faster as a proportion of total patent publications. Logistic regression analysis reveals that we may be a little over half way through an initial innovation cycle inspired by biological systems.

  16. Twenty years of treatment for Gaucher disease: emerging challenges

    NARCIS (Netherlands)

    van Dussen, L.

    2014-01-01

    Gaucher disease is an autosomal recessively inherited lysosomal storage disorder (LSD). Type I Gaucher disease, the so-called non-neuronopathic variant, is mainly characterised by cytopenia, hepatosplenomegaly and bone complications. Gaucher disease was the first LSD for which enzyme replacement the

  17. Twenty years of punishment (and democracy) in South Africa

    African Journals Online (AJOL)

    Gail Super has a PhD in Law and Society from New York ... combatting has the potential to unleash violent technologies in the quest for 'ethics' and 'morality'. When .... control over a crime situation about which citizens .... empowerment and grassroots localism, have given popular .... Personal communication, 10 April 2014.

  18. Increased Prevalence of Dental Fluorosis after Twenty Years

    DEFF Research Database (Denmark)

    Richards, Alan; Larsen, Mogens Joost; Maare, L.

    2006-01-01

    tooth types in children born and reared in an area with drinking water with (regularly monitored, naturally-occurring) fluoride concentrations of 1 ppm and compare with data recorded for a similar group of children examined in the same way and residing in the same area 20 years ago. Methods: Dental...... children, of similar ages, examined in the same area in 1984. Results: The prevalence and severity of fluorosis varied between tooth types so that the later in childhood the teeth are mineralized the higher the prevalence of dental fluorosis. When the data were compared to those collected 20 years...... in the (later formed) premolars and second molars. Conclusions: A significant increase in fluorosis prevalence has occurred over the last 20 years due to increased fluoride exposure of pre-school children. These findings may be explained by increased use of fluoride toothpaste by this age group from...

  19. Classification in Information Retrieval: The Twenty Years Following Dorking.

    Science.gov (United States)

    Coates, E. J.

    1978-01-01

    Discusses theoretical and practical progress made in the classification of information for retrieval in the last 20 years and suggests alternatives to the Dewey Decimal and Library of Congress classification systems. (JVP)

  20. Building On Builder: The Persistent Icarus Syndrome at Twenty Years

    Science.gov (United States)

    2013-06-01

    branded lessons on the consciousness of the now independent USAF. Further, the employment of atomic weapons had forever changed airpower and...fellow specialists; and their loyalties followed their profession rather than the operational...the book The Icarus Syndrome: The Role of Air Power Theory in the Evolution and Fate of the U.S. Air Force. Clearing Off The Coffee Table Carl

  1. Review. Elimination of viruses in plants: twenty years of progress

    Directory of Open Access Journals (Sweden)

    A. Panattoni

    2013-02-01

    Full Text Available To shed light on trends about elimination of viruses from plants, a bibliographic research was conducted to identify thermotherapy, chemotherapy and tissue culture trials published from 1991 through 2010. Among woody plants, grapevine, apple and peach are the most frequent targets of sanitation protocols because their health status is strictly regulated. Even if thermotherapy represents the preferred method for the host, grapevine viruses can also be eliminated with chemotherapy and tissue culture; apple viruses respond to chemotherapy as well. Although a similar trend was reported among herbaceous plants, chemotherapy was the most frequently used technique in potato. With regard to virus, thermotherapy was successfully applied against viruses belonging to 13 families and an unassigned genus. Instead, chemotherapy and tissue culture techniques eradicated viruses belonging to fewer families (nine. An interpretation of thermotherapy effects considers the new metabolic “pathways” triggered by the natural antiviral response emitted by the infected plant, with particular reference to virus-induced gene silencing. With regard to chemotherapy, several groups of antiviral drugs belong to inosine monophosphate dehydrogenase inhibitors, S-adenosylhomocysteine hydrolase inhibitors, neuraminidase inhibitors. Tissue culture, usually adopted to regenerate plantlets in biotechnological breeding programs, represents the less used tool for eliminate viruses from plants.

  2. Associations between expressive and receptive language and internalizing and externalizing behaviours in a community-based prospective study of slow-to-talk toddlers.

    Science.gov (United States)

    Conway, Laura J; Levickis, Penny A; Mensah, Fiona; McKean, Cristina; Smith, Kylie; Reilly, Sheena

    2017-06-08

    Evidence suggests that language and social, emotional and behavioural (SEB) difficulties are associated in children and adolescents. When these associations emerge and whether they differ by language or SEB difficulty profile is unclear. This knowledge is crucial to guide prevention and intervention programmes for children with language and SEB difficulties. To determine whether receptive and expressive language skills are associated with internalizing and externalizing behaviours in slow-to-talk toddlers. In a community-based prospective study of 200 slow-to-talk children, language was measured at 24 and 36 months using Preschool Language Scale 4th Edition and at 48 months using Clinical Evaluation of Language Fundamentals-Preschool 2nd Edition. Internalizing and externalizing behaviours were measured by parent report at each age. Longitudinal data were analysed using repeated-measures regression, with up to three observations per child. Robust standard errors were used to account for non-independence of measures within participants. The shape of the associations were examined by fitting quadratic and cubic terms. The effects of confounders on the associations were examined. Receptive language had a negative linear association with internalizing behaviours after adjusting for confounders (β = -0.16, 95% [CI = -0.26, -0.07], p = .001); and a negative curved association with externalizing behaviours after adjusting for biological confounders (βquadratic = 0.08 [0.01, 0.15], p = .03, βcubic = -0.04 [-0.07, -0.02], p = .001), attenuating after adjusting for environmental confounders (βquadratic = 0.06 [-0.01, 0.13], p = .09, βcubic = -0.03 [-0.06, -0.003], p = .03). The curvature suggests that the negative association with externalizing behaviours only existed for children with either very low or very high receptive language scores. After controlling for confounders, there was no evidence that expressive language scores were associated with internalizing (β = -0

  3. Trends and developments in community and applied social psychology: JCASP 1991-2010

    NARCIS (Netherlands)

    Schruijer, S.G.L.; Stephenson, G.S.

    2010-01-01

    This paper looks back on the trends and developments in and of the Journal of Community and Applied Social Psychology since its inception twenty years ago. We review to what extent the aims that were originally set for JCASP have been fulfilled. The trends in nationality of authors, themes of public

  4. Everyday suffering outside prison walls: a legacy of community justice in post-genocide Rwanda

    NARCIS (Netherlands)

    Rutayisire, T.; Richters, A.

    2014-01-01

    Twenty years after the 1994 genocide, Rwanda shows all indications of moving quickly towards socio-economic prosperity. Rwanda's community justice system, Gacaca, was to complement this prosperity by establishing peace and stability through justice, reconciliation and healing. Evaluations of the Gac

  5. Association of Panton Valentine Leukocidin (PVL) genes with methicillin resistant Staphylococcus aureus (MRSA) in Western Nepal: a matter of concern for community infections (a hospital based prospective study)

    DEFF Research Database (Denmark)

    Bhatta, Dharm R.; Cavaco, Lina; Nath, Gopal;

    2016-01-01

    Methicillin resistant Staphylococcus aureus (MRSA) is a major human pathogen associated with nosocomial and community infections. Panton Valentine leukocidin (PVL) is considered one of the important virulence factors of S. aureus responsible for destruction of white blood cells, necrosis and apop......Methicillin resistant Staphylococcus aureus (MRSA) is a major human pathogen associated with nosocomial and community infections. Panton Valentine leukocidin (PVL) is considered one of the important virulence factors of S. aureus responsible for destruction of white blood cells, necrosis...

  6. PROSPECTING EXPLORATION

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>20082879 Chen Yaoyu(No.3 Geology and Mineral Exploration Team,Gansu Provincial Bureau of Geology and Mineral Exploration and Development,Lanzhou 730050,China); Gong Quansheng Discussion on the Division of Deposit Scale and the Index of Ore Prospecting(Gansu Geology,ISSN 1004—4116,CN62—1191/P,16(3),2007,p.6—11,4 tables,6 refs.) Key words:prospecting and exploration of mineral

  7. Do community- and individual-level social relationships contribute to the mental health of disaster survivors?: A multilevel prospective study after the Great East Japan Earthquake.

    Science.gov (United States)

    Matsuyama, Yusuke; Aida, Jun; Hase, Akihiro; Sato, Yukihiro; Koyama, Shihoko; Tsuboya, Toru; Osaka, Ken

    2016-02-01

    Disasters greatly threaten the health and lives of people all over the world. Japan experienced severe damage following the Great East Japan Earthquake on March 11, 2011, and some survivors continue to live in prefabricated temporary housing, built collectively in damaged areas. Previous studies have shown that social relationships in such communities have the potential to protect the mental health of disaster survivors. We examined the association between survivors' social support and social participation in 2012 and their psychological distress in 2013 using the K6 scale. Self-reported questionnaires were distributed to all 15,979 households in prefabricated temporary housing in eight municipalities in Miyagi prefecture in 2012, and 19,284 adults from 9366 (58.6%) households responded. One year later, 10,880 adults responded to a follow-up survey. Multivariate multilevel linear regression analyses with multiply imputed datasets showed that survivors' psychological distress at follow-up significantly differed between communities (community-level variance [standard error] = 0.38 [0.13]). The variance was reduced to 0.25 [0.09] after considering individual demographic characteristics and psychological distress at baseline. Individual- and community-level social relationships of 7.1% and 15.8%, respectively, explained the difference. After adjusting for covariates including K6 scale at baseline, individual-level social support, community-level social support, and individual-level social participation were significantly associated with low psychological distress at follow-up (coefficients [95% confidence intervals] were: -0.54 [-0.79, -0.30]; -0.43 [-0.72, -0.14]; and -0.22 [-0.40, -0.04], respectively). Community-level social participation was not significantly associated with psychological distress. The present study showed that: 1) survivors' psychological distress varied between temporary housing communities in 2013; 2) individual- and community-level social

  8. Comparing antiretroviral treatment outcomes between a prospective community-based and hospital-based cohort of HIV patients in rural Uganda

    Directory of Open Access Journals (Sweden)

    Alibhai Arif

    2011-11-01

    Full Text Available Abstract Background Improved availability of antiretroviral therapy in sub-Saharan Africa is intended to benefit all eligible HIV-infected patients; however in reality antiretroviral services are mainly offered in urban hospitals. Poor rural patients have difficulty accessing the drugs, making the provision of antiretroviral therapy inequitable. Initial tests of community-based treatment programs in Uganda suggest that home-based treatment of HIV/AIDS may equal hospital-based treatment; however the literature reveals limited experiences with such programs. The research This intervention study aimed to; 1 assess the effectiveness of a rural community-based ART program in a subcounty (Rwimi of Uganda; and 2 compare treatment outcomes and mortality in a rural community-based antiretroviral therapy program with a well-established hospital-based program. Ethics approvals were obtained in Canada and Uganda. Results and outcomes Successful treatment outcomes after two years in both the community and hospital cohorts were high. All-cause mortality was similar in both cohorts. However, community-based patients were more likely to achieve viral suppression and had good adherence to treatment. The community-based program was slightly more cost-effective. Per capita costs in both settings were unsustainable, representing more than Uganda’s Primary Health Care Services current expenditures per person per year for all health services. The unpaid community volunteers showed high participation and low attrition rates for the two years that this program was evaluated. Challenges and successes Key successes of this study include the demonstration that antiretroviral therapy can be provided in a rural setting, the creation of a research infrastructure and culture within Kabarole’s health system, and the establishment of a research collaboration capable of enriching the global health graduate program at the University of Alberta. Challenging questions about the

  9. Outcomes of Chronic Hepatitis C Therapy in Patients Treated in Community Versus Academic Centres in Canada: Final Results of APPROACH (A Prospective Study of Peginterferon alfa-2a and Ribavirin at Academic and Community Centres in Canada

    Directory of Open Access Journals (Sweden)

    Robert P Myers

    2011-01-01

    Full Text Available BACKGROUND: In patients chronically infected with the hepatitis C virus (HCV, it is not established whether viral outcomes or health-related quality of life (HRQoL differ between individuals treated at academic or community centres.

  10. Vital exhaustion as a risk factor for ischaemic heart disease and all-cause mortality in a community sample. A prospective study of 4084 men and 5479 women in the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Prescott, Eva; Holst, Claus; Grønbaek, Morten

    2003-01-01

    for biological, behavioural, and socioeconomic risk factors did not substantially affect the association for IHD but attenuated the association with all-cause mortality. CONCLUSIONS: Measures of fatigue and depression were common symptoms in this population sample and convey increased risk of IHD and of all-cause......BACKGROUND: Vital exhaustion, a psychological measure characterized by fatigue and depressive symptoms, has been suggested to be an independent risk factor for ischaemic heart disease (IHD) but the generality of the phenomenon remains in question. The aim of this study is to describe prevalence...... of these symptoms in a community sample and determine whether they prospectively predict increased risk of IHD and all-cause mortality in men and women. METHODS: The study base was 4084 men and 5479 women aged 20-98 free of IHD examined in 1991-1993 in the Copenhagen City Heart Study. Events were ascertained...

  11. 法庭科学的真谛——重温林几教授《二十年来法医学之进步》%The True Meaning of Forensic Science — A Retrospective Study of a Dissertation Developments of Forensic Medicine in The Past Twenty Years written by professor Lin Ji(1897-1951)

    Institute of Scientific and Technical Information of China (English)

    黄瑞亭

    2012-01-01

    The Dissertation,,Developments of Forensic Medicine in The Past Twenty Years(Lin,1946),was written based on a combinational research results with regards to forensic history,connotation,definition,education,academic,legislation,humanity and personality.This dissertation is a sample representation of Lin Ji's overall educational methods and academic theories.Moreover,the article revealed the truth of forensic science,which is of historic and practical importance.%《二十年来法医学之进步》一文,是林几对法庭科学史、法庭科学内涵、范围、管理、教育、学术、立法及法庭科学人文、人格等的研究成果,是林几的教育思想及学术思想的集中体现。文章揭示了法庭科学的真谛,对今天仍有十分重要的历史和现实意义。

  12. 近二十年来西方语言、文化、身份三者关系的研究综述%A Review on the Studies of the Relationship between Language, Culture and Identity in the West in the Past Twenty Years

    Institute of Scientific and Technical Information of China (English)

    曹燕萍; 杨燕

    2014-01-01

    Language and culture have the function of constructing identity.This article analyzes the re-search periods and content of the relationship between language,culture and identity.The concept of identity and the theory of identity construction put forward by western scholars in the past twenty years are introduced. The influence of western scholarsresearch on Chinese scholars'research and the implication for the further re-search of Chinese scholars are also discussed.%语言、文化具有身份建构的功能。文章对近二十年来西方语言、文化、身份三者关系的研究阶段和研究内容进行了梳理,在此基础上从语言、文化的视角介绍了身份概念、身份建构理论,并探讨了西方身份问题研究对国内身份研究的影响和启示。

  13. 试论社区护理工作的现状及展望%Present situation and Prospect of Community Nursing Work

    Institute of Scientific and Technical Information of China (English)

    高毅

    2014-01-01

    社区护理是21世纪护理发展的重要方向,是在社区范围内开展以健康为中心,向个人、家庭及人群提供的集预防、保健、医疗、康复、健康教育和计划生育技术指导为一体的系统化整体护理,是社区卫生服务的重要组成部分。本文就我国社区护理的现状和发展进行分析。%Community nursing care is an important direction of development in the 21st century, is to carry out the health center, set of prevention, care, treatment, rehabilitation, health education and family planning technical guidance to individuals, families and groups provided for within the community Holistic integrated care is an important part of community health services. This paper analyzed the present situation and development of community care.

  14. HIV sexual transmission risks in the context of clinical care: a prospective study of behavioural correlates of HIV suppression in a community sample, Atlanta, GA, USA

    Directory of Open Access Journals (Sweden)

    Seth C Kalichman

    2015-08-01

    Full Text Available Introduction: Antiretroviral therapy (ART improves the health of people living with HIV and has the potential to reduce HIV infectiousness, thereby preventing HIV transmission. However, the success of ART for HIV prevention hinges on sustained ART adherence and avoiding sexually transmitted infections (STI. Objectives: To determine the sexual behaviours and HIV transmission risks of individuals with suppressed and unsuppressed HIV replication (i.e., viral load. Methods: Assessed HIV sexual transmission risks among individuals with clinically determined suppressed and unsuppressed HIV. Participants were 760 men and 280 women living with HIV in Atlanta, GA, USA, who completed behavioural assessments, 28-daily prospective sexual behaviour diaries, one-month prospective unannounced pill counts for ART adherence, urine screening for illicit drug use and medical record chart abstraction for HIV viral load. Results: Individuals with unsuppressed HIV demonstrated a constellation of behavioural risks for transmitting HIV to uninfected sex partners that included symptoms of STI and substance use. In addition, 15% of participants with suppressed HIV had recent STI symptoms/diagnoses, indicating significant risks for sexual infectiousness despite their HIV suppression in blood plasma. Overall, 38% of participants were at risk for elevated sexual infectiousness and just as many engaged in unprotected sexual intercourse with non-HIV-infected partners. Conclusions: Implementation strategies for using HIV treatments as HIV prevention requires enhanced behavioural interventions that extend beyond ART to address substance use and sexual health that will otherwise undermine the potential preventive impact of early ART.

  15. Cross-sectional assessment of infants' exposure to toxic metals through breast milk in a prospective cohort study of mining communities in Ghana.

    Science.gov (United States)

    Bansa, David Kwaku; Awua, Adolf Kofi; Boatin, Rose; Adom, Theodosia; Brown-Appiah, Edward Christian; Amewosina, Kennedy Kwame; Diaba, Akusika; Datoghe, Dominic; Okwabi, Wilhelmina

    2017-05-25

    Although breastfeeding of infants is recommended globally, the fact that maternal toxic metal stores are mobilised into breast milk implies infants, whose mothers live and work in mining communities, are at risk of multiple exposure to mining related toxic metals, such as Lead (Pb), Mercury (Hg), Cadmium (Cd) and Arsenic (As), through breast milk intake, in addition to in utero exposure. A total of 114 mother-baby pairs, recruited from two community hospitals servicing mining communities in two different regions in Ghana (57 each), were involved in this study. When the babies were 3 months old, the amount of breast milk intake, concentrations of selected toxic metals in the breast milk and therefore the amount of toxic metals exposure through breast milk were determined. The study also, determined the amount of these toxic metals in the hair and urine of each mother-baby pair at 3 months postpartum. Based on the amounts of milk intake and non-milk oral intakes (geometric mean of 0.701 (95% CL 0.59-0.81) Kg/day and median of 0.22 Kg/day respectively), 90% of the babies were determined to have been exclusively breastfed. The amounts of most of the toxic metals in breast milk were higher than the WHO set limits and for 46.4%, 33.3% and 4.4% of the babies, their intake of As, Hg and Pb respectively were above the WHO provisional tolerable daily intake (PTDI) values. An appreciable proportion of babies living within the communities served by the Mangoasi Community Hospital in the Obuasi Municipality of the Ashanti Region and the Dompime Health Centre in the Tarkwa Municipality of the Western Region were exposed to Hg, As and Pb through breast milk in excess of what they should and these may have health implication for the infants and therefore calls for interventions.

  16. Review and Prospect of Studies on Community Psychology in Canada%加拿大社区心理学研究回顾与展望

    Institute of Scientific and Technical Information of China (English)

    段碧花

    2015-01-01

    Community psychology is an applied sub-discipline in psychology. Before its formal root in America, a nascent commu-nity psychology can be traced further back in Canada. The ne-glect of community psychology by mainstream psychology in Canada apparently has not inhibited the development of the sub-discipline. Its substantial contributions lie in five broad ar-eas: values and ethics, theory, methodology, research and prac-tice. The current community psychology in Canada is facing some challenges, such as social support and identity, organizational development, and education training . In the future, communi-ty psychology will mature through collective reflection and devel-opment of action plan.%社区心理学是心理学的一门应用分支学科。在它于美国正式形成之前,加拿大就出现了社区心理学的雏形,虽一直为主流心理学所忽视,仍不断发展。其实质性贡献主要体现在价值与伦理、理论、方法论、研究和实践五大领域。当前加拿大社区心理学亦面临诸如社会支持与认同、组织发展、教育培训等挑战。未来它将通过加强集体反思和发展行动计划走向成熟。

  17. Rationale, description and baseline findings of a community-based prospective cohort study of kidney function amongst the young rural population of Northwest Nicaragua.

    Science.gov (United States)

    González-Quiroz, Marvin; Camacho, Armando; Faber, Dorien; Aragón, Aurora; Wesseling, Catharina; Glaser, Jason; Le Blond, Jennifer; Smeeth, Liam; Nitsch, Dorothea; Pearce, Neil; Caplin, Ben

    2017-01-13

    An epidemic of Mesoamerican Nephropathy (MeN) is killing thousands of agricultural workers along the Pacific coast of Central America, but the natural history and aetiology of the disease remain poorly understood. We have recently commenced a community-based longitudinal study to investigate Chronic Kidney Disease (CKD) in Nicaragua. Although logistically challenging, study designs of this type have the potential to provide important insights that other study designs cannot. In this paper we discuss the rationale for conducting this study and summarize the findings of the baseline visit. The baseline visit of the community-based cohort study was conducted in 9 communities in the North Western Nicaragua in October and November 2014. All of the young men, and a random sample of young women (aged 18-30) without a pre-existing diagnosis of CKD were invited to participate. Glomerular filtration rate (eGFR) was estimated with CKD-EPI equation, along with clinical measurements, questionnaires, biological and environmental samples to evaluate participants' exposures to proposed risk factors for MeN. We identified 520 young adults (286 males and 234 females) in the 9 different communities. Of these, 16 males with self-reported CKD and 5 females with diagnoses of either diabetes or hypertension were excluded from the study population. All remaining 270 men and 90 women, selected at random, were then invited to participate in the study; 350 (97%) agreed to participate. At baseline, 29 (11%) men and 1 (1%) woman had an eGFR <90 mL/min/1.73 m(2). Conducting a community based study of this type requires active the involvement of communities and commitment from local leaders. Furthermore, a research team with strong links to the area and broad understanding of the context of the problem being studied is essential. The key findings will arise from follow-up, but it is striking that 5% of males under aged 30 had to be excluded because of pre-existing kidney disease, and that

  18. The protective properties of Act-Belong-Commit indicators against incident depression, anxiety, and cognitive impairment among older Irish adults: Findings from a prospective community-based study

    DEFF Research Database (Denmark)

    Santini, Ziggi Ivan; Koyanagi, Ai; Tyrovolas, Stefanos

    2017-01-01

    two consecutive waves of the Irish Longitudinal Study on Ageing (TILDA) were analyzed. The analytical sample consisted of 6098 adults aged ≥ 50 years. Validated scales for depression, anxiety, and cognitive impairment were used. The number of social/recreational activities engaged in was used...... such activities, to increase participation in their activities. Using nationally-representative data from Ireland, the aim of this study was to prospectively assess the association between indicators of the Act-Belong-Commit behavioral domains and incident depression, anxiety, and cognitive impairment. Data from......-Belong-Commit and incident depression, anxiety, and cognitive impairment at two-year follow-up. The adjusted model showed that each increase in the number of social/recreational activities (Act) inversely predicted the onset of depression, anxiety, and cognitive impairment. The same was the case for social network...

  19. Implementation of a pharmacist-led antimicrobial management team in a community teaching hospital: use of pharmacy residents and pharmacy students in a prospective audit and feedback approach.

    Science.gov (United States)

    Laible, Brad R; Nazir, Jawad; Assimacopoulos, Aris P; Schut, Jennifer

    2010-12-01

    Antimicrobial stewardship is an important process proven to combat antimicrobial resistance, improve patient outcomes, and reduce costs. The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) have provided guidelines for the provision of antimicrobial stewardship. According to these recommendations, antimicrobial stewardship teams should be multidisciplinary in nature, with core members consisting of an infectious disease physician and an infectious disease-trained clinical pharmacist. Due to limited resources, our institution chose to implement a pharmacist-led antimicrobial stewardship service on 1 medical/surgical ward, with the existing clinical pharmacist and 3 infectious disease physicians as core members. This clinical pharmacist was not trained in infectious disease specialty, and stewardship activities were only one part of his daily activities. Pharmacy residents and students were extensively utilized to assist in the stewardship process. Approximately two thirds of stewardship recommendations were accepted using primarily a prospective audit and feedback approach.

  20. A comparison of high-mobility group-box 1 protein, lipopolysaccharide-binding protein and procalcitonin in severe community-acquired infections and bacteraemia: a prospective study

    DEFF Research Database (Denmark)

    Gaïni, Shahin; Koldkjaer, Ole G; Møller, Holger J

    2008-01-01

    immune response when the host is challenged by bacterial pathogens. Procalcitonin (PCT) has been suggested as a marker of severe bacterial infections and sepsis. The aim of the present study was to investigate levels of HMGB1, LBP and PCT in a well-characterised sepsis cohort. The study plan included...... analysis of the levels of the inflammatory markers in relation to the severity of infection, to the prognosis and to the ability to identify patients with bacteraemia. METHODS: Patients suspected of having severe infections and admitted to a department of internal medicine were included in a prospective...... manner. Demographic data, comorbidity, routine biochemistry, microbiological data, infection focus, severity score and mortality on day 28 were recorded. Plasma and serum were sampled within 24 hours after admission. Levels of all studied markers (HMGB1, LBP, PCT, IL-6, C-reactive protein, white blood...

  1. Biodiversity Prospecting.

    Science.gov (United States)

    Sittenfeld, Ana; Lovejoy, Annie

    1994-01-01

    Examines the use of biodiversity prospecting as a method for tropical countries to value biodiversity and contribute to conservation upkeep costs. Discusses the first agreement between a public interest organization and pharmaceutical company for the extraction of plant and animal materials in Costa Rica. (LZ)

  2. Factors associated with magnetic resonance imaging defined patellar tendinopathy in community-based middle-aged women: a prospective cohort study.

    Science.gov (United States)

    Toppi, Jason; Fairley, Jessica; Cicuttini, Flavia M; Cook, Jill; Davis, Susan R; Bell, Robin J; Hanna, Fahad; Wang, Yuanyuan

    2015-08-05

    Patellar tendinopathy identified by imaging modalities has been reported in asymptomatic athletes and associated with tendon-related symptoms. However there is little data in community-based populations. The aim of this cohort study was to examine the prevalence of magnetic resonance imaging (MRI) defined patellar tendinopathy, the factors associated with this condition, and whether it was associated with knee pain in community-based middle-aged women. One hundred seventy six women, aged 40-67 years, with no significant knee pain or injury underwent knee MRI. Patellar tendinopathy was defined on both T1- and T2-weighted fat-saturated MRIs. The cross-sectional area of vastus medialis was measured from MRI. Height and weight were measured to calculate body mass index (BMI). Physical activity was assessed using a questionnaire. Knee pain was assessed using the Western Ontario and McMaster University Osteoarthritis Index. The prevalence of MRI defined patellar tendinopathy was 30.1%. Higher levels of physical activity (odds ratio 1.65, 95% CI 1.09-2.51) and greater vastus medialis cross-sectional area (odds ratio 1.22, 95% CI 1.04-1.43) were associated with increased prevalence of patellar tendinopathy, independent of age and BMI. The persistence of patellar tendinopathy was associated with the worsening of knee pain over 2 years (odds ratio 10.65, 95% CI 1.14-99.77). In community-based middle-aged women MRI-diagnosed patellar tendinopathy is common, with higher levels of physical activity and greater vastus medialis size being risk factors suggesting a biomechanical effect. Persistent patellar tendinopathy is associated with worsening of knee pain. These findings suggest that further work is needed to determine the contribution of patellar tendinopathy on knee pain and function in older people.

  3. 社区参与旅游发展研究评述与展望%Research Summary and Prospect of Community Participation in Tourism Development

    Institute of Scientific and Technical Information of China (English)

    孙凤芝; 许峰

    2013-01-01

    旅游发展改变了目的地的区域结构,当地社区作为直接利益相关者反过来又深刻地影响着可持续旅游的实现,成为决定旅游产业化速度与质量的重要力量.社区参与旅游发展是旅游目的地区域实现可持续发展的重要路径,近年来成为国内外学界研究的热点.文章对国内外社区参与旅游发展的不同特征和研究形式进行了较为系统性的梳理与分析,在关注社区角色与定位的演化基础上分辨了各种观点和见解,梳理出国外和国内研究的差异和差距.尤其凸显在同一命题上不同研究者的矛盾观点,还原出社区参与和旅游发展的复杂博弈关系.国外学者主要从社区参与旅游发展的本质和内涵、与可持续发展的关系、不同类型社区参与的比较以及治理结构等领域展开研究,而国内学者则主要关注社区参与旅游发展的概念释义、实践意义、经营模式及其存在问题以及多角度理论透析等方面的命题.今后的研究应该避免概念分歧和理解简化,力求研究起点的一致性,并应结合不同国家和地区实际情况和发展演进对社区及其他利益相关者进行整体考察.%Development of tourism has changed the regional structure of the destination; in turn,the local communities as direct stakeholders profoundly affect the realization of sustainable tourism and has become an important force in determining the speed and quality of the tourist industrialization.Community paaicipation in sustainable development of tourism is an important path for regional sustainable development of tourist destination,and becomes the hot area of academic research in recent years.Based on the comprehensive and systematic summary of research fruits at home and abroad over the past decades in this field,the authors distinguish a variety of perspectives and insights on the basis of concerns about the evolution of the role and position of the community

  4. The diagnostic contribution of the frontal lumbar spine radiograph in community referred low back pain - A prospective study of 1030 patients

    Energy Technology Data Exchange (ETDEWEB)

    Khoo, L.A.L. E-mail: lisanne.khoo@stgeorges.nhs.uk; Heron, C.; Patel, U.; Given-Wilson, R.; Grundy, A.; Khaw, K.T.; Dundas, D

    2003-08-01

    AIM: The diagnostic contribution of the anteroposterior (AP) view was studied to assess whether this view could be omitted safely, thus reducing the radiation burden received by patients undergoing lumbar spine radiography. MATERIALS AND METHODS: Prospective analysis of 1030 consecutive referrals for lumbar spine radiography from general practice. RESULTS: In the majority of cases (90.5%) the AP view was non-contributory. In 4.2% the diagnosis was strengthened and it was altered in 4.6%. However, in the latter group only 1.3% of the total were considered significant alterations. These were cases of possible, but not definite, pars defects and sacroiliitis. Specific important conditions such as infection, malignancy and benign tumours were not missed on the lateral view alone, in our study population. The radiation burden is reduced by 75% by omitting the AP view. CONCLUSION: A single lateral view is an adequate examination, with the proviso that sacroiliac joint disease is not assessed on this view and some pars defects and facet joint degenerative changes may be overlooked. The radiation protection gains are considerable. A single lateral lumbar view is now our routine practice unless sacroiliitis is a specific clinical concern.

  5. Lifestyle factors and site-specific risk of hip fracture in community dwelling older women – a 13-year prospective population-based cohort study

    Directory of Open Access Journals (Sweden)

    Määttä Mikko

    2012-09-01

    Full Text Available Abstract Background Several risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. In this study, we evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period. Methods The study design was a prospective, population-based study consisting of 1681 women (mean age 72 years. Seventy-three percent (n = 1222 participated in the baseline measurements, including medical history, leisure-time physical activity, smoking, and nutrition, along with body anthropometrics and functional mobility. Cox regression was used to identify the independent predictors of cervical and trochanteric hip fractures. Results During the follow-up, 49 cervical and 31 trochanteric fractures were recorded. The women with hip fractures were older, taller, and thinner than the women with no fractures (p  Conclusions Impaired functional mobility, physical inactivity, and low body mass may increase the risk for hip fractures with different effects at the cervical and trochanteric levels.

  6. Integration Processes in the Global Economy: Current State and Prospects. The Cases of the European Union, ASEAN Economic Community, and NAFTA

    Directory of Open Access Journals (Sweden)

    Witkowska Janina

    2016-12-01

    Full Text Available The aim of the paper is to determine the current state of the integration processes in the global economy and prognosticate on the foreseeable changes in this phenomenon in the upcoming. Will they be divergence from or continuity with the past trends in the global economy in this field? The article examines three regional integration groupings, i.e. the European Union, ASEAN Economic Community, and NAFTA. The analysis makes it possible to conclude that all of these groupings/organizations are encountering some problems. In the case of the EU, these are mainly: the two – speed integration process as far as a monetary union is concerned; serious negative consequences of the global financial crisis for the socio-economic cohesion of the EU-28; as well as a worsening position in the world trade in goods and services and in the total global gross capital inflows. The problems of the ASEAN Economic Community seem to be connected with some discrepancies between the political will in favour of deepening integration among member states and the real economic difficulties involved in attaining higher stages of integration among a group of countries extremely differentiated in their economic development. NAFTA’s problems also lie in the asymmetrical development between member states, as well as in the lessening importance of the integration within the organization for the member states, which results from the putting into effect numerous other FTAs. The growing openness of all the analyzed integration groupings, being in line with the globalization process, seems to be a future characteristic of integration processes in the global economy.

  7. Rapid spread of Neisseria gonorrhoeae ciprofloxacin resistance due to a newly introduced resistant strain in Nuuk, Greenland, 2012–2015: a community-based prospective cohort study

    Science.gov (United States)

    Pedersen, Michael Lynge; Poulsen, Peter; Berthelsen, Lene; Nørgaard, Christina; Hoffmann, Steen; Jensen, Jørgen Skov

    2016-01-01

    Objectives To determine the antimicrobial susceptibility and genotype distribution of Neisseria gonorrhoeae strains isolated from a cohort of patients in Nuuk, Greenland in order to assess the risk of rapid spread in the event of introduction of new strains. Methods Gonococcal isolates (n=102) obtained from a prospective cohort study of ciprofloxacin resistance were collected between March 2012 and February 2013. Etest minimal inhibitory concentrations (MICs) were determined for ciprofloxacin, azithromycin, ceftriaxone, penicillin, tetracycline, spectinomycin and gentamicin. All isolates were subjected to molecular typing using N. gonorrhoeae multiantigen sequence typing (NG-MAST). After the introduction of a ciprofloxacin-resistant strain in early 2014, an additional 18 isolates were characterised. Results During the study period, all 102 isolates were fully susceptible to ciprofloxacin (≤0.03 mg/L), azithromycin, spectinomycin, gentamicin and ceftriaxone. 10 different NG-MAST types circulated in Nuuk but 7 were found as single isolates, and 3 of the 7 belonged to 1 of the 3 major genogroups (G210, G9816 and G9817) together comprising 96% of the 102 isolates. ST210 accounted for 55% of the 102 strains. The newly introduced ciprofloxacin resistant strain belonged to ST2400 and dominated the population with 59% resistant strains within 6 months after its introduction. All G2400 strains had MICs≥2 mg/L. Conclusions Introduction of a ciprofloxacin-resistant strain into a very homogeneous N. gonorrhoeae population led to an explosive spread of the resistant clone, probably as a result of large sexual networks suggested by the strain homogeneity. Careful surveillance of antimicrobial susceptibility is essential to avoid widespread treatment failure in closed populations. PMID:27577587

  8. A prospective study of the impact of musculoskeletal pain and radiographic osteoarthritis on health related quality of life in community dwelling older people

    Directory of Open Access Journals (Sweden)

    Laslett Laura L

    2012-09-01

    Full Text Available Abstract Background Pain and radiographic changes are common in persons with osteoarthritis, but their relative contributions to quality of life are unknown. Methods Prospective cohort study of 1098 men and women aged 50–80 years, randomly selected from the electoral roll. Participants were interviewed at baseline and approximately 2.6 and five years later. Participants self-reported prior diagnosis of arthritis and presence of joint pain. Joint space narrowing (JSN and osteophytes at the hip and knee were assessed by X-ray. Quality of life (QoL was assessed using the Assessment of QoL (AQoL instrument. Data was analysed using linear regression and mixed modelling. Results The median AQoL score at baseline was 7.0, indicating very good QoL. Prevalence of pain ranged from 38-62%. Over five years of observation, pain in the neck, shoulders, back, hips, hands, knees and feet were all independently and negatively associated with QoL, in a dose–response relationship. Diagnosed osteoarthritis at all sites was associated with poorer QoL but after adjustment for pain, this only remained significant at the back. Radiographic OA was not associated with QoL. While AQoL scores declined over five years, there was no evidence of an interaction between pain and time. Conclusions Pain is common in older adults, is stable over time, and the strongest musculoskeletal correlate of QoL. It also mediates the association between diagnosed OA and QoL. Since the same factors were associated with quality of life over time as at baseline, this suggests that quality of life tracks over a five year period.

  9. Could a brief assessment of negative emotions and self-esteem identify adolescents at current and future risk of self-harm in the community? A prospective cohort analysis.

    Science.gov (United States)

    Phillips, Rhiannon; Spears, Melissa R; Montgomery, Alan A; Millings, Abigail; Sayal, Kapil; Stallard, Paul

    2013-06-22

    Self-harm is common in adolescents, but it is often unreported and undetected. Available screening tools typically ask directly about self-harm and suicidal ideation. Although in an ideal world, direct enquiry and open discussion around self-harm would be advocated, non-psychiatric professionals in community settings are often reluctant to ask about this directly and disclosure can be met with feeling of intense anxiety. Training non-specialist staff to directly ask about self-harm has limited effects suggesting that alternative approaches are required. This study investigated whether a targeted analysis of negative emotions and self-esteem could identify young adolescents at risk of self-harm in community settings. Data were collected as part of a clinical trial from young people in school years 8-11 (aged 12-16) at eight UK secondary schools (N = 4503 at baseline, N = 3263 in prospective analysis). The Short Mood and Feelings Questionnaire, Revised Child Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, personal failure (Children's Automatic Thoughts Scale), and two items on self-harm were completed at baseline, 6 and 12 months. Following a process of Principal Components Analysis, item reduction, and logistic regression analysis, three internally reliable factors were identified from the original measures that were independently associated with current and future self-harm; personal failure (3 items), physical symptoms of depression/anxiety (6 items), positive self-esteem (5 items). The summed score of these 14 items had good accuracy in identifying current self-harm (AUC 0.87 girls, 0.81 boys) and at six months for girls (0.81), and fair accuracy at six months for boys (AUC 0.74) and 12 months for girls (AUC 0.77). A brief and targeted assessment of negative emotions and self-esteem, focusing on factors that are strongly associated with current and future self-harm, could potentially be used to help identify adolescents who are at risk in

  10. Uptake, Accuracy, Safety, and Linkage into Care over Two Years of Promoting Annual Self-Testing for HIV in Blantyre, Malawi: A Community-Based Prospective Study.

    Directory of Open Access Journals (Sweden)

    Augustine T Choko

    2015-09-01

    Full Text Available Home-based HIV testing and counselling (HTC achieves high uptake, but is difficult and expensive to implement and sustain. We investigated a novel alternative based on HIV self-testing (HIVST. The aim was to evaluate the uptake of testing, accuracy, linkage into care, and health outcomes when highly convenient and flexible but supported access to HIVST kits was provided to a well-defined and closely monitored population.Following enumeration of 14 neighbourhoods in urban Blantyre, Malawi, trained resident volunteer-counsellors offered oral HIVST kits (OraQuick ADVANCE Rapid HIV-1/2 Antibody Test to adult (≥16 y old residents (n = 16,660 and reported community events, with all deaths investigated by verbal autopsy. Written and demonstrated instructions, pre- and post-test counselling, and facilitated HIV care assessment were provided, with a request to return kits and a self-completed questionnaire. Accuracy, residency, and a study-imposed requirement to limit HIVST to one test per year were monitored by home visits in a systematic quality assurance (QA sample. Overall, 14,004 (crude uptake 83.8%, revised to 76.5% to account for population turnover residents self-tested during months 1-12, with adolescents (16-19 y most likely to test. 10,614/14,004 (75.8% participants shared results with volunteer-counsellors. Of 1,257 (11.8% HIV-positive participants, 26.0% were already on antiretroviral therapy, and 524 (linkage 56.3% newly accessed care with a median CD4 count of 250 cells/μl (interquartile range 159-426. HIVST uptake in months 13-24 was more rapid (70.9% uptake by 6 mo, with fewer (7.3%, 95% CI 6.8%-7.8% positive participants. Being "forced to test", usually by a main partner, was reported by 2.9% (95% CI 2.6%-3.2% of 10,017 questionnaire respondents in months 1-12, but satisfaction with HIVST (94.4% remained high. No HIVST-related partner violence or suicides were reported. HIVST and repeat HTC results agreed in 1

  11. Prospective validation of American Diabetes Association risk tool for predicting pre-diabetes and diabetes in Taiwan-Taichung community health study.

    Directory of Open Access Journals (Sweden)

    Chia-Ing Li

    Full Text Available BACKGROUND: A simple diabetes risk tool that does not require laboratory tests would be beneficial in screening individuals at higher risk. Few studies have evaluated the ability of these tools to identify new cases of pre-diabetes. This study aimed to assess the ability of the American Diabetes Association Risk Tool (ADART to predict the 3-year incidence of pre-diabetes and diabetes in Taiwanese. METHODS: This was a 3-year prospective study of 1021 residents with normoglycemia at baseline, gathered from a random sample of residents aged 40-88 years in a metropolitan city in Taiwan. The areas under the curve (AUCs of three models were compared: ADART only, ADART plus lifestyle behaviors at baseline, and ADART plus lifestyle behaviors and biomarkers at baseline. The performance of ADART was compared with that of 16 tools that had been reported in the literature. RESULTS: The AUCs and their 95% confidence intervals (CIs were 0.60 (0.54-0.66 for men and 0.72 (0.66-0.77 for women in model 1; 0.62 (0.56-0.68 for men and 0.74 (0.68-0.80 for women in model 2; and 0.64 (0.58-0.71 for men and 0.75 (0.69-0.80 for women in model 3. The AUCs of these three models were all above 0.7 in women, but not in men. No significant difference in either women or men (p = 0.268 and 0.156, respectively was observed in the AUC of these three models. Compared to 16 tools published in the literature, ADART had the second largest AUC in both men and women. CONCLUSIONS: ADART is a good screening tool for predicting the three-year incidence of pre-diabetes and diabetes in females of a Taiwanese population. The performance of ADART in men was similar to the results with other tools published in the literature. Its performance was one of the best among the tools reported in the literature.

  12. [MIPS: multicenter Italian pneumonia study. Results of an observational, prospective and multicenter study on the clinical approach to community-acquired pneumonia].

    Science.gov (United States)

    Artom, A; Artom, P; Rattenni, S; Castello, C; Lo Pinto, G

    2004-09-01

    In a survey of 25 Divisions of Internal Medicine and Pneumology throughout Italy, our study aimed to ascertain the diagnostic and therapeutic pathway, the gravity in accordance with Fine's score (PSI), the median hospital length of stay and mortality rate among patients consecutively hospitalized for community-acquired pneumonia (CAP), from January 1 to March 31, 2002. Overall 407 patients were evaluated, with a mean age of 69 years; the following Fine's scores: 28% less than 70, 21.4% between 71 and 90, 31.25% between 91 and 130, 19.4% more than130. A single chest radiography was performed in 27.2% of the patients, two chest radiographs in 55.2% of the patients, more than two chest radiographs in 13.2% of the patients. A CT scan of the thorax was performed in 20.1% of the patients; arterial blood gas tensions were measured in 73.4% of the patients. Antibiotics were used as follows: beta-lactams in 46.5% of the patients, fluoroquinolones in 30% of the patients, macrolides in 13.2% of the patients, glycopeptides in 2.2% of the patients, others in 2.9% of the patients. Mean hospital stay was 11 days; the 30-day in-hospital mortality was 9.6%. This study showed that a large number of patients with low-risk CAP were unnecessarily hospitalized.

  13. The prospect of digital living community in the era of big data%大数据时代下数字生活社区的前景

    Institute of Scientific and Technical Information of China (English)

    黄东

    2016-01-01

    随着信息化大数据时代的到来,既给信息科技从业者带来新的机遇和挑战的同时,也给大众百姓的生活带来巨大的品质提升,数字生活社区将引导一场前所未有的技术革命,对影响人们衣、食、住、行、医等方方面面,也使得人们对科技生活的依赖性更加增强,更加的理所当然.%With the arrival of big data era of information technology,brings new opportunities and challenges for information technology practitioners at the same time,but also to improve the quality of people's life has brought huge,digital life community will guide a hitherto unknown technology revolution, to influence people's clothing,food,shelter,medicine, etc.that also makes people dependent on life science and technology more enhanced, more behoove.

  14. Adoption of community-based cardiac rehabilitation programs and physical activity following phase III cardiac rehabilitation in Scotland: a prospective and predictive study.

    Science.gov (United States)

    Sniehotta, Falko F; Gorski, Charlotta; Araujo-Soares, Vera

    2010-09-01

    Little is known about levels of physical activity and attendance at phase IV community-based Cardiac Rehabilitation (CR) programs following completion of exercise-focussed, hospital-based phase III CR. This study aims to test, compare and combine the predictive utility of the Common-Sense Self-Regulation Model (CS-SRM) and the extended Theory of Planned Behaviour (TPB) with action planning for two rehabilitation behaviours: physical activity and phase IV CR attendance. Individuals diagnosed with coronary heart disease (n = 103) completed baseline measures of illness perceptions, intentions, perceived behavioural control (PBC), action planning and past physical activity in the last week of a phase III CR program, and 95 participants completed follow-up measures of physical activity and attended phase IV CR (objectively confirmed) 2 months later. Only one predictor (PBC/cyclical timeline) significantly predicted levels and change of physical activity. While illness perceptions were not predictive of phase IV CR attendance, the extended TPB model showed good predictive power with action planning and intention as the most powerful predictors. Amongst participants who planned when and where to attend phase IV CR at the end of phase III rehabilitation, 65.9% subsequently attended a phase IV CR program compared to only 18.5% of those who had not made a plan. This study adds to our understanding of cardiac rehabilitation behaviour after completion of health service delivered programs. Comparing theoretical models and rehabilitation behaviours contributes to the development of behaviour theory.

  15. A Comparative Study between Mainland China and Taiwan on the “Life and Death Study” in Twenty Years%20年来两岸学界关于“生死问题”的不同进路及其比较

    Institute of Scientific and Technical Information of China (English)

    张永超

    2015-01-01

    生死问题构成人生的起点与终点。学界关于“生死问题”的研究有两条线索:第一条是大陆学者段德智与郑晓江等分别基于西方哲学史和中国儒释道精神所做的关于“西方死亡哲学”和“中国生死智慧”的进路,在生死观探讨中,大陆学者也逐渐由生死智慧走向“生命教育”;第二条线索起源于美国的“死亡学”传统,华人学者傅伟勋教授接续此“死亡学”传统并将其创造性的引向台湾学界,这便是“生死学”学科的确立。尽管大陆与台湾关于“生死学”的研究进路不同,但最终都走向“生命关怀”和“生死教育”。%Born and death are the beginning and end of life,which are both key problems for everyone. In twenty years,there are three main different perspectives for life-and-death studies:philosophy of death,life-and-death studies (thanatology),life-and-death education.With a comparative perspective,there are obvious different ways between mainland China and Taiwan on the study of life and death.In mainland China,take Professor Duan Dezhi and Zheng Xiaojiang as an example,their studyies focus on the philosophy of death and the wisdom of life.However,in Taiwan,take professor Fu Weixun as an example,he developed the thanatology to life-and-death studies.Although there are two different ways on life and death study,we still find that they are chasing for the same aim in mainland China and Taiwan.

  16. Joint impact of physical activity and family history on the development of diabetes among urban adults in Mainland China: a pooled analysis of community-based prospective cohort studies.

    Science.gov (United States)

    Xu, Fei; Wang, Youfa; Ware, Robert S; Tse, Lap Ah; Wang, Zhiyong; Hong, Xin; Dunstan, David W; Owen, Neville

    2015-03-01

    To examine the joint influences of physical activity (PA) and family history (FH) of diabetes on subsequent type 2 diabetes (T2D), the authors pooled and analyzed data from 2 community-based urban adult prospective cohort studies in 2011 in Nanjing, China. Among 4550 urban participants, the 3-year cumulative incidence of T2D was 5.1%. After adjustment for potential confounders, compared with those with FH+ and insufficient PA, the adjusted odds ratio (95% confidence interval) of developing T2D was 0.42 (0.18, 0.98) for participants with sufficient PA and FH+, 0.32 (0.22, 0.46) for participants with insufficient PA and FH-, and 0.15 (0.08, 0.28) for participants with sufficient PA and FH-. Such significant graduated associations between PA/FH and risk of developing T2D were also identified in either men or women, separately. Sufficient PA and FH- may jointly reduce the risk of developing T2D in urban Chinese adults. © 2012 APJPH.

  17. Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study.

    Science.gov (United States)

    Selvin, Elizabeth; Rawlings, Andreea M; Grams, Morgan; Klein, Ronald; Sharrett, A Richey; Steffes, Michael; Coresh, Josef

    2014-04-01

    HbA1c is the standard measure by which to monitor long-term (2-3 months) glucose control in people with diabetes and is now used for diagnosis of diabetes. Fructosamine and glycated albumin are markers of short-term (2-4 weeks) glycaemic control that might add complementary prognostic information to HbA1c. Our aim was to clarify the performance of fructosamine and glycated albumin measurements for identifying people at risk of incident diabetes or diabetic complications. We measured glycated albumin and fructosamine in blood samples from 11 348 adults without diabetes and 958 adults diagnosed with diabetes mellitus (both type 1 and 2) who attended the second examination of the Atherosclerosis Risk in Communities (ARIC) study in 1990-92 (baseline). We assessed the associations of fructosamine and glycated albumin with risk of incident diabetes, retinopathy, and risk of incident chronic kidney disease (CKD), during two decades of follow-up. We compared these associations with those of HbA1c with incident diabetes, retinopathy, and CKD. For analyses of associations with incident diabetes and CKD, adjusted hazard ratios (HRs) and their corresponding 95% CIs were estimated using Cox proportional hazards models. Model discrimination was assessed using Harrell's C statistic. The HRs for incident diabetes were 4·96 (4·36-5·64) for fructosamine above the 95th percentile and 6·17 (5·45-6·99) for glycated albumin above the 95th percentile. Associations were attenuated but persisted after adjustment for HbA1c. Fructosamine and glycated albumin were strongly associated with retinopathy (p<0·0001 for trend). The multivariable-adjusted HRs for CKD for people with fructosamine and glycated albumin above the 95th percentile were 1·50 (95% CI 1·22-1·85) and 1·48 (1·20-1·83), respectively, when compared with people with no diabetes and fructosamine or glycated albumin below the 75th percentile. Prediction of incident CKD by fructosamine (C statistic 0·717) and

  18. The National Early Warning Score (NEWS) for outcome prediction in emergency department patients with community-acquired pneumonia: results from a 6-year prospective cohort study

    Science.gov (United States)

    Sbiti-Rohr, Diana; Kutz, Alexander; Christ-Crain, Mirjam; Thomann, Robert; Zimmerli, Werner; Hoess, Claus; Henzen, Christoph; Mueller, Beat; Schuetz, Philipp

    2016-01-01

    Objective To investigate the accuracy of the National Early Warning Score (NEWS) to predict mortality and adverse clinical outcomes for patients with community-acquired pneumonia (CAP) compared to standard risk scores such as the pneumonia severity index (PSI) and CURB-65. Design Secondary analysis of patients included in a previous randomised-controlled trial with a median follow-up of 6.1 years. Settings Patients with CAP included on admission to the emergency departments (ED) of 6 tertiary care hospitals in Switzerland. Participants A total of 925 patients with confirmed CAP were included. NEWS, PSI and CURB-65 scores were calculated on admission to the ED based on admission data. Main outcome measure Our primary outcome was all-cause mortality within 6 years of follow-up. Secondary outcomes were adverse clinical outcome defined as intensive care unit (ICU) admission, empyema and unplanned hospital readmission all occurring within 30 days after admission. We used regression models to study associations of baseline risk scores and outcomes with the area under the receiver operating curve (AUC) as a measure of discrimination. Results 6-year overall mortality was 45.1% (n=417) with a stepwise increase with higher NEWS categories. For 30 day and 6-year mortality prediction, NEWS showed only low discrimination (AUC 0.65 and 0.60) inferior compared to PSI and CURB-65. For prediction of ICU admission, NEWS showed moderate discrimination (AUC 0.73) and improved the prognostic accuracy of a regression model, including PSI (AUC from 0.66 to 0.74, p=0.001) and CURB-65 (AUC from 0.64 to 0.73, p=0.015). NEWS was also superior to PSI and CURB-65 for prediction of empyema, but did not well predict rehospitalisation. Conclusions NEWS provides additional prognostic information with regard to risk of ICU admission and complications and thereby improves traditional clinical-risk scores in the management of patients with CAP in the ED setting. Trial registration number

  19. Who gets prompt access to artemisinin-based combination therapy? A prospective community-based study in children from rural Kilosa, Tanzania.

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    Daudi O Simba

    Full Text Available BACKGROUND: Effective and timely case management remains one of the fundamental pillars for control of malaria. Tanzania introduced artemisinin-combination therapy [ACT] for uncomplicated malaria; however, the policy change is challenged by limited availability of ACTs due to high cost. This study aimed to determine factors influencing prompt access to ACTs among febrile children in rural Kilosa, Tanzania. METHODS AND FINDINGS: In a community-based study, 1,235 randomly selected children under five were followed up weekly for six months, in 2008. Using a structured questionnaire, children's caretakers were asked about the child's febrile history in the last seven days, and treatment actions including timing, medicines used and source of care. Caretakers' knowledge about malaria and socioeconomic and demographic data were also obtained. About half of followed-up children had at least one episode of fever. Less than half (44.8% of febrile children were taken to government facilities. Almost one-third (37.6%; 95% CI 33.1-42.1 of febrile children had prompt access to ACT. Care-seeking from a government facility was the overriding factor, increasing the likelihood of prompt access to an ACT 18 times (OR 17.7; 95% CI 10.55-29.54; adjusted OR 16.9; 95% CI 10.06-28.28. Caretakers from the better-off household (3rd-5th quintiles were more likely to seek care from government facilities (OR 3.66; 95% CI 2.56-5.24; adjusted OR 1.80; 95% CI 1.18-2.76. The majority of antimalarials accessed by the poor were ineffective [86.0%; 295/343], however, they paid more for them (median Tsh 500 compared to the better-offs (median Tsh 0. CONCLUSIONS: Prompt access to ACT among febrile children was unacceptably low, due mainly to limited availability of subsidised ACT at the location where most caretakers sought care. There is urgent need to accelerate implementation of strategies that will ensure availability of ACT at an affordable price in remote rural areas, where

  20. Prospective study of enteropathogens in two communities of Misiones, Argentina Estudio prospectivo de enteropatógenos en dos comunidades de Misiones, Argentina

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    Marta Vergara

    1996-10-01

    Full Text Available Children under five years of age, from two communities of different socio-economic strata (97 from Zaiman and 55 from Las Dolores were examined epidemiologically during 2 years, by means of quarterly visits of the working team, who carried out the collection of faecal samples. During the study, one or more enteropathogens were identified in 73.9% of samples in children from Zaiman and in 58.3% of the samples from Las Dolores, being associated to diarrhoea in 70.5% and to asymptomatic infections in 65.7%. The number of diarrheic episodes was higher in Zaiman (15.45% than in Las Dolores (12.35%, being more frequent in the spring-summer seasons. In Zaiman, the bacterial enteropathogen proportion was relevantly higher (pNiños menores de cinco años de edad de dos comunidades de diferente condición socio-económica (97 del Barrio Zaimán y 55 del Barrio Las Dolores, fueron vigilados epidemiologicamente durante 2 años, mediante visitas trimestrales del equipo de trabajo, el que realizó la toma de muestras fecales. Durante el estudio, se identificaron uno o más enteropatógenos en el 73,9% de las muestras de niños del Barrio Zaimán y en el 58,3% de Las Dolores, estando asociados a diarrea en un 70,5% y en infecciones asintomáticas en un 65,7%. El número de episodios de diarrea fue superior en Zaimán (15,5% que en Las Dolores (12,4%, presentándose con mayor frecuencia en los meses de primavera-verano. En el Barrio Zaimán la proporción de enteropatógenos bacterianos fue significativamente mayor (p < 0.005 en los niños con diarrea, mientras que los parásitos se presentaron con mayor frecuencia en niños asintomáticos (p < 0.01. Rotavirus tuvo una distribución comparable en niños con diarrea y asintomáticos. En el Barrio Las Dolores, no se encontraron diferencias significativas en la deteccion de enteroparásitos entre asintomáticos y niños con diarrea. Se detectaron infecciones mixtas, siendo ECET-rotavirus y ECET-parásitos, las mas

  1. Vinte anos do MST: a psicologia nesta história Veinte años de lo movimiento de los trabajadores rurales sin tierra: la psicología en esta historia Landless peasants’ movement after twenty years: psychology and the movement’s history

    Directory of Open Access Journals (Sweden)

    Eliane Domingues

    2007-12-01

    resultados y conclusiones de las pesquisas. Se destaca la necesidad de estudios sobre la infancia, desterritorialización y sufrimiento psíquico y salud mental en el campo.The Landless Peasants’ Movement (MST in Brazil commemorated twenty years in 2004. Throughout its lifetime, it has aroused the interest of researchers hailing from different areas, mainly from those involved in Education and Sociology. Few researches on the movement are extant within Psychology. The mapping of general scientific production on the Movement and an analysis of the specific production within Psychology are the objects of current research. An online search was undertaken at the CAPES data bank with regard to the 1987-2004. All abstracts were printed and classified. Whereas the abstracts revealed the theses and dissertations developed in postgraduate programs for Master’s degree in Psychology, the dissertations were read to identify pre-oriented subject matter in the researches, their main results and their conclusions. The need for further studies concerning childhood, de-territorialization, psychic suffering and mental health conditions in the rural area is emphasized.

  2. The Dynamic Change and Trend of Groundwater Level in Jinan Yellow River Irrigation Region More Than Twenty Years%济南引黄灌区近20年地下水位动态变化及趋势分析

    Institute of Scientific and Technical Information of China (English)

    徐淑波; 徐立荣; 梅泽本

    2016-01-01

    利用多年观测资料,对济南引黄灌区地下水位动态变化特征及趋势进行了分析,结果表明:①近二十年济南引黄灌区地下水位年际变化趋势主要受引黄灌溉水量的影响,2002-2013年来地下水位波动下降明显;多年月均地下水位变化出现两个峰值,主峰值主要受汛期降水的影响,次峰值主要受春季引黄灌溉的影响。②对地下水位多年序列和季节序列进行M -K趋势和参数特征分析表明,灌区2000年以后地下水位呈下降趋势,且在2012年以后下降趋势较显著;春季和夏季地下水位总体上无明显趋势,而秋季和冬季分别在2003年和2006年以后呈现较明显的下降趋势。③由于秋季灌区引黄供水远远不能满足实际需水量,为缓解地下水位下降,应适当增加秋季引黄量。%Based on the observational data of many years ,the Mann-Kendall trend test method was adopted to analyze the dynamic change and trend of groundwater level in Jinan Yellow River Irrigation Region .The results indicate that :The trend of annual varia‐tion of groundwater level was mainly affected by irrigation water in irrigation area of Jinan in recent twenty years ,the fluctuation of groundwater level decreased significantly from 2002 to 2013 ;monthly groundwater level has two peaks ,the primary peak mainly af‐fected by the precipitation of flood season and the secondary peak by water supply from the Yellow River in spring .Mann-Kendall trend test of annual and seasonal groundwater level showed that groundwater level declined from 2000 to 2013 ,significantly after 2012 .The rising trend of groundwater level both in spring and summer is not significant ,while significant declining trend of ground‐water level in autumn and in winter can be found after 2003 and 2006 respectively .In autumn drawing groundwater leads to falling of water table as a result of inadequate water supply from the Yellow River for

  3. Affection and Law, Which Is Light or Heavy?-Comparative Study the Connotation of O. Henry's Short Stories After Twenty Years and The Retrieved Reformation%情与法,孰轻孰重?--对比欧·亨利短篇小说《二十年后》与《重新做人》的折射内涵

    Institute of Scientific and Technical Information of China (English)

    任诚刚; 杨丽华; 杨波; 卢静; 李其曙

    2014-01-01

    Based on O. Henry's short stories After Twenty Years and A Retrieved Reformation the comparative study of the differ-ent characteristics and connotation of the refraction in two novels are made. In the first story, O. Henry let us believe that the"law"must overrule the"affection". Law is greater than Mount Tai, one can not pervert the law because of personal affair, Jimmy allows the affection to be overruled by the law, and has Bob arrested. The author, in the second story on the other hand, ex-pounds for us the strong creative side of human nature being more powerful than law can perform. In his stories, in the face of true love the deed of prodigal son is more valuable than gold. Ben Price, the detective with a calm state of mind, and the objec-tive consciousness, has carefully examined Jimmy's past, present, and future. In front of the power of human nature, the law is to get rid of the coldness. At this time, Ben Price finally let go of Jimmy Valentine for the moveness to"affection"and the knowl-edge to "reason". All reflect O. Henry’s connotation of a refraction of "conquering the unyielding with the yielding, and from one’s innermost part".%通过对欧·亨利短篇小说《二十年后》及《重新做人》的解读,对比研究了两篇小说的不同特点及折射内涵。在第一篇中欧·亨利让我们相信,“法”战胜了“情”。法律重于泰山,不可因私枉法,吉米让警察的职责战胜了朋友间的私情,毅然决然逮捕了鲍勃。在第二篇里小说家从另一方面为我们阐释了人性比法律更具强大的改造力量的一面。在他的笔下,在真情真爱面前浪子回头“金不换”。普赖斯侦探用平静的心态、和客观的意识,审视着吉米的过去、现在、和未来。在人性的力量面前,法律也脱去了冰冷的外衣。这时,普赖斯让警察的动之以“情”和晓之以“理”,广开一面,放了吉米·瓦伦汀。这正反映了欧亨利

  4. Caracterization of Aujeszky's disease virus isolated from South Brazil in the last twenty years by restriction enzyme analysis Caracterização de amostras do vírus de Aujeszky isoladas na região Sul do Brasil nos últimos vinte anos através de análise de restrição enzimática

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    Rejane Schaefer

    2006-09-01

    Full Text Available Aujeszky's disease virus (ADV belongs to Herpesviridae family and is an important etiological agent which infects pigs causing economic losses in swine producing countries worldwide and international trade restrictions to products of swine origin. An eradication program for ADV was established in Santa Catarina State since 2001. The last outbreak was reported in July 2004 and since then none has been reported. The disease has been controlled with the use of a genetic modified vaccine and elimination of seropositives. Aiming the characterization of ADV isolated in the South of Brazil in the last twenty years (1983-2003, a retrospective study based on the genomic analysis of the isolates through a digestion of viral genomic DNA with restriction enzyme Bam HI was done. Thirty-seven ADV samples isolated from swine from the States of Santa Catarina, Parana and Rio Grande do Sul were analyzed. These isolates were compared to the reference strains NIA-4, Bartha and Begonia. The most predominant genomic arrangement was type II found in 33 samples isolated in Santa Catarina State and in one isolate from Rio Grande do Sul State. Genomic arrangement type I, characteristic of vaccine strains was identified in 2 isolates from Parana State and in 1 isolate from Rio Grande do Sul State.O vírus da doença de Aujeszky (VDA pertencente à família Herpesviridae é um importante agente etiológico que infecta suínos causando perdas na produção de suínos no mundo inteiro e restrições para o comércio internacional de suínos ou de seus subprodutos. No estado de Santa Catarina, Brasil, foi instituído em 2001 um programa de erradicação da doença de Aujeszky (DA. O último surto da DA foi reportado em julho de 2004 e desde então não foram notificados mais casos. A doença tem sido controlada com o uso de uma vacina geneticamente modificada e eliminação de animais soropositivos para o VDA. Visando caracterizar amostras do VDA isoladas nos últimos vinte

  5. L’esperienza delle Community Forests in Inghilterra

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    Giuseppe Colangelo

    2015-11-01

    Full Text Available Community Forests can be described as multi-purpose forests that are close to people and that deliver environmental, social and economic benefits. Community Forests involve local communities in the planning, design, management and use of trees, woodland and associated green-spaces. In England, Community Forests are a national programme of environmental regeneration reaching half of the England’s population, enhancing the countryside around major towns and cities, creating beautiful landscapes, rich in wildlife with associated opportunities for recreation and education. Overall, Community Forests cover an area of over four hundred and fifty thousand hectares in England: one of the largest environmental initiatives in Europe. After twenty years, the great involvement of people shows the importance of this new strategy for environmental planning and management. 

  6. Defining political community

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    Sladeček Michal M.

    2002-01-01

    Full Text Available This paper considers the concept of political community, its constitution and value. The starting point is that the concept of community is not sufficiently recognized in modern political theories, as well as in contemporary liberal theory. In the last two decades communitarian and republican political theory attempted to revitalize this notion. The first part of the paper elaborates on the polemics between these three theoretical orientations. The concluding part examines the possibilities and prospect for stable political community in conditions of pluralism of particular social communities and ethnocultural heterogeneity.

  7. Understanding real-world adherence in the directly acting antiviral era: A prospective evaluation of adherence among people with a history of drug use at a community-based program in Toronto, Canada.

    Science.gov (United States)

    Mason, Kate; Dodd, Zoë; Guyton, Mary; Tookey, Paula; Lettner, Bernadette; Matelski, John; Sockalingam, Sanjeev; Altenberg, Jason; Powis, Jeff

    2017-09-01

    Direct acting antiviral (DAA) treatments for Hepatitis C (HCV) are now widely available with sustained virologic response (SVR) rates of >90%. A major predictor of response to DAAs is adherence, yet few real-world studies evaluating adherence among marginalized people who use drugs and/or alcohol exist. This study evaluates patterns and factors associated with non-adherence among marginalized people with a history of drug use who were receiving care through a primary care, community-based HCV treatment program where opiate substitution is not offered on-site. Prospective evaluation of chronic HCV patients initiating DAA treatment. Self-report medication adherence questionnaires were completed weekly. Pre/post treatment questionnaires examined socio-demographics, program engagement and substance use. Missing adherence data was counted as a missed dose. Of the 74 participants, who initiated treatment, 76% were male, the average age was 54 years, 69% reported income from disability benefits, 30% did not have stable housing and only 24% received opiate substitution therapy. Substance use was common in the month prior to treatment initiation with, 11% reported injection drug use, 30% reported non-injection drug use and 18% moderate to heavy alcohol use. The majority (85%) were treatment naïve, with 76% receiving sofosbuvir/ledipasvir (8-24 weeks) and 22% Sofosbuvir/Ribarvin (12-24 weeks). The intention to treat proportion with SVR12 was 87% (60/69). In a modified ITT analysis (excluding those with undetectable RNA at end of treatment), 91% (60/66) achieved SVR12. Overall, 89% of treatment weeks had no missed doses. 41% of participants had at least one missed dose. In multivariate analysis the only factor independently associated with weeks with missed doses was moderate to heavy alcohol use (p=0.05). This study demonstrates that strong adherence and SVR with DAAs is achievable, with appropriate supports, even in the context of substance use, and complex health

  8. Design and baseline characteristics of a prospective cohort study for determinants of osteoporotic fracture in community-dwelling elderly Japanese men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN Study

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    Moon Jong-Seong

    2009-12-01

    Full Text Available Abstract Background Osteoporosis and osteoporotic fracture in men are significant public health problems in an aging society. However, information on male osteoporosis remains impressively lacking, especially for Asians. We designed the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN study as an ancillary study of a cohort study, the Fujiwara-kyo study, to determine risk factors for osteoporotic fractures in Japanese men. Methods/Design Design: A community-based single-centre prospective cohort study with at least a 5-year follow-up Subjects: All the male participants of the Fujiwara-kyo study who were living in the four cities studied, aged 65 years and older, and able to walk without aid from others. Primary outcome: Incidence of osteoporotic fractures including vertebral and clinical non-vertebral fractures. Additional outcomes: Change in bone mineral density (BMD, change in hip geometry, onset of receiving benefits from Long-term Care Insurance (LCI, health-related quality of life, and mortality. Baseline measurements: BMD at the lumbar spine (LS and hip (TH, hip geometry, vertebral deformity assessment, bone turnover markers, physical and cognitive performance, various medical and lifestyle factors, and geriatric psychosocial measures confirmed by interviews based on self-administrated questionnaires. Outcome surveillance: Annual mail surveys and a follow-up survey at the fifth year comprising similar items to the baseline study will be used to determine the outcomes. Receipt of benefits from LCI and mortality will be obtained from the city governments. Current status: The baseline study was conducted for 2174 eligible men, and 2012 completed the study and were eligible for follow-up. Prevalence rates of osteoporosis (BMD 2.5 SD or more below the young adult mean (YAM and low BMD (BMD 1 SD or more below YAM in at least one of LS and TH were calculated to be 4.4% and 41.8%, respectively. The proportion of men with low BMD only at TH showed a

  9. Vital exhaustion as a risk factor for ischaemic heart disease and all-cause mortality in a community sample. A prospective study of 4084 men and 5479 women in the Copenhagen City Heart Study.

    Science.gov (United States)

    Prescott, Eva; Holst, Claus; Grønbaek, Morten; Schnohr, Peter; Jensen, Gorm; Barefoot, John

    2003-12-01

    Vital exhaustion, a psychological measure characterized by fatigue and depressive symptoms, has been suggested to be an independent risk factor for ischaemic heart disease (IHD) but the generality of the phenomenon remains in question. The aim of this study is to describe prevalence of these symptoms in a community sample and determine whether they prospectively predict increased risk of IHD and all-cause mortality in men and women. The study base was 4084 men and 5479 women aged 20-98 free of IHD examined in 1991-1993 in the Copenhagen City Heart Study. Events were ascertained through record linkage until 1998 for IHD and September 2000 for all-cause mortality. There were 483 first hospital admissions and deaths caused by IHD and 1559 deaths from all causes during follow-up. The 17 items on the vital exhaustion questionnaire were frequently endorsed with prevalence ranging from 6 to 47 per cent, higher in women. All but 4 of the 17 items were significantly associated with IHD with significant relative risks (RR) ranging between 1.36 (95% CI: 1.08, 1.72) and 2.10 (95% CI: 1.63, 2.71). Associations with all-cause mortality were also observed, but were weaker. RR of both IHD and all-cause mortality increased with increasing item sum score and were similar in men and women. For IHD, RR reached a maximum of 2.57 (95% CI: 1.65, 4.00) for subjects endorsing >9 items. The similar RR for all-cause mortality was 2.50 (95% CI: 2.09, 2.99). Multivariate adjustment for biological, behavioural, and socioeconomic risk factors did not substantially affect the association for IHD but attenuated the association with all-cause mortality. Measures of fatigue and depression were common symptoms in this population sample and convey increased risk of IHD and of all-cause mortality. We propose this knowledge begin to be implemented in risk assessment in clinical practice.

  10. Coral farming – a questionnaire based prospect for coastal ...

    African Journals Online (AJOL)

    Coral farming – a questionnaire based prospect for coastal inhabitants' ... tourism industry; altogether deteriorating the reefs to the verge of destruction. ... already existing aquaculture, available local community and excellent water conditions.

  11. Psychophysiology of prospective memory.

    Science.gov (United States)

    Rothen, Nicolas; Meier, Beat

    2014-01-01

    Prospective memory involves the self-initiated retrieval of an intention upon an appropriate retrieval cue. Cue identification can be considered as an orienting reaction and may thus trigger a psychophysiological response. Here we present two experiments in which skin conductance responses (SCRs) elicited by prospective memory cues were compared to SCRs elicited by aversive stimuli to test whether a single prospective memory cue triggers a similar SCR as an aversive stimulus. In Experiment 2 we also assessed whether cue specificity had a differential influence on prospective memory performance and on SCRs. We found that detecting a single prospective memory cue is as likely to elicit a SCR as an aversive stimulus. Missed prospective memory cues also elicited SCRs. On a behavioural level, specific intentions led to better prospective memory performance. However, on a psychophysiological level specificity had no influence. More generally, the results indicate reliable SCRs for prospective memory cues and point to psychophysiological measures as valuable approach, which offers a new way to study one-off prospective memory tasks. Moreover, the findings are consistent with a theory that posits multiple prospective memory retrieval stages.

  12. Prospects for Detecting Galactic Sources of Cosmic Neutrinos with IceCube: An Update

    CERN Document Server

    Halzen, Francis; Niro, Viviana

    2016-01-01

    Air-Cherenkov telescopes have mapped the Galactic plane at TeV energies. Here we evaluate the prospects for detecting the neutrino emission from sources in the Galactic plane assuming that the highest energy photons originate from the decay of pions, which yields a straightforward prediction for the neutrino flux from the decay of the associated production of charged pions. Four promising sources are identified based on having a large flux and a flat spectrum. We subsequently evaluate the probability of their identification above the atmospheric neutrino background in IceCube data as a function of time. We show that observing them over the twenty-year lifetime of the instrumentation is likely, and that some should be observable at the $3\\,\\sigma$ level with six years of data. In the absence of positive results, we derive constraints on the spectral index and cut-off energy of the sources, assuming a hadronic acceleration mechanism.

  13. Prospects for detecting galactic sources of cosmic neutrinos with IceCube: An update

    Science.gov (United States)

    Halzen, Francis; Kheirandish, Ali; Niro, Viviana

    2017-01-01

    Air-Cherenkov telescopes have mapped the Galactic plane at TeV energies. Here we evaluate the prospects for detecting the neutrino emission from sources in the Galactic plane assuming that the highest energy photons originate from the decay of pions, which yields a straightforward prediction for the neutrino flux from the decay of the associated production of charged pions. Four promising sources are identified based on having a large flux and a flat spectrum. We subsequently evaluate the probability of their identification above the atmospheric neutrino background in IceCube data as a function of time. We show that observing them over the twenty-year lifetime of the instrumentation is likely, and that some should be observable at the 3 σ level with six years of data. In the absence of positive results, we derive constraints on the spectral index and cut-off energy of the sources, assuming a hadronic acceleration mechanism.

  14. Teachers as Community Educators: Training in Teacher Education Colleges

    Science.gov (United States)

    Sandberg, John; Weaver, Donald

    1977-01-01

    Colleges of teacher education should give serious consideration to providing training programs to prepare community educators and inform prospective teachers and school administrators of the potential of the educative community. (JD)

  15. Prospect Theory for Online Financial Trading

    Science.gov (United States)

    Liu, Yang-Yu; Nacher, Jose C.; Ochiai, Tomoshiro; Martino, Mauro; Altshuler, Yaniv

    2014-03-01

    Prospect theory is widely viewed as the best available descriptive model of how people evaluate risk in experimental settings. According to prospect theory, people make decisions based on the potential value of losses and gains rather than the final outcome. People are risk-averse with respect to gains and risk-seeking with respect to losses, a phenomenon called ``loss aversion''. Despite of the fact that prospect theory has been well studied in behavioral economics at the theoretical level, there exist very few empirical research and most of them has been undertaken with micro-panel data. Here we analyze the trading activities of over 1.5 million members of an online financial trading community over 28 months, aiming to explore the large-scale empirical aspect of prospect theory. By analyzing and comparing the behaviour of ``winners'' and ``losers'', i.e., traders with positive or negative final net profit, we find clear evidence of the loss aversion phenomenon, an essence in prospect theory. This work demonstrates an unprecedented large-scale empirical evidence of prospect theory. It has immediate implication in financial trading, e.g., developing new trading strategies by minimizing the effect of loss aversion. It also provides opportunity to augment online social trading, where users are allowed to watch and follow the trading activity of others, by predicting potential winners based on their historical trading behaviour.

  16. Future prospects for the detection and characterization of extrasolar planets

    Directory of Open Access Journals (Sweden)

    Lunine J.I.

    2010-12-01

    Full Text Available Several distinctly different techniques have detected almost 500 planets orbiting around main-sequence stars, 45 multiple planet systems, and a number of extrasolar planets have been the subject of direct study. Hundreds of other “candidate” planets detected by the Kepler spacecraft await confirmation of their existence. Planets are thus common phenomena around stars, and the prospects seem good in the next few years for establishing statistics on the occurrence of Earth-sized planets. Extension of the most successful technique of Doppler spectroscopy in sensitivity to detect Earth-mass planets around Sun-like stars will be limited by the noise generated by the stellar photospheres themselves. The James Webb Space Telescope will have the capability to measure atmospheric abundances of certain gases and of liquid water on extrasolar planets, including “superEarths” within a factor of two of the radius of the Earth. The ultimate goal of measuring the atmospheric composition of an Earth-sized planet orbiting at 1 AU around a star like the Sun remains a daunting challenge that is perhaps twenty years in the future.

  17. Transparent meta-analysis: does aging spare prospective memory with focal vs. non-focal cues?

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    Bob Uttl

    Full Text Available BACKGROUND: Prospective memory (ProM is the ability to become aware of a previously-formed plan at the right time and place. For over twenty years, researchers have been debating whether prospective memory declines with aging or whether it is spared by aging and, most recently, whether aging spares prospective memory with focal vs. non-focal cues. Two recent meta-analyses examining these claims did not include all relevant studies and ignored prevalent ceiling effects, age confounds, and did not distinguish between prospective memory subdomains (e.g., ProM proper, vigilance, habitual ProM (see Uttl, 2008, PLoS ONE. The present meta-analysis focuses on the following questions: Does prospective memory decline with aging? Does prospective memory with focal vs. non-focal cues decline with aging? Does the size of age-related declines with focal vs. non-focal cues vary across ProM subdomains? And are age-related declines in ProM smaller than age-related declines in retrospective memory? METHODS AND FINDINGS: A meta-analysis of event-cued ProM using data visualization and modeling, robust count methods, and conventional meta-analysis techniques revealed that first, the size of age-related declines in ProM with both focal and non-focal cues are large. Second, age-related declines in ProM with focal cues are larger in ProM proper and smaller in vigilance. Third, age-related declines in ProM proper with focal cues are as large as age-related declines in recall measures of retrospective memory. CONCLUSIONS: The results are consistent with Craik's (1983 proposal that age-related declines on ProM tasks are generally large, support the distinction between ProM proper vs. vigilance, and directly contradict widespread claims that ProM, with or without focal cues, is spared by aging.

  18. NOOSPHERE HUMAN COMMUNITY

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    Novozhilova Elena Olegovna

    2013-01-01

    Full Text Available The author dwells upon typical features of noosphere human communities, assessing prospects and hazards of genetic engineering, namely of recombinant DNA technology. Background: Socio-historical ecology ushers in a new approach to studying society in its relation to nature. This interrelation is regarded as a series of socio-ecological transformations ending up in certain types of socio-ecological systems being formed. One of such historical types is represented by a noosphere human community [1]. Results: A number of characteristic features of this kind of community have been outlined, namely: its existence and functioning on global scale, major role of information in making up social wealth, creation of living matter. Conclusion: The noosphere human community is currently the latest stage in the sequence of historical types of socio-ecological systems. Widespread use of information and genetic technology may enable noosphere people to create in future a totally man-made world superseding evolutionary biosphere.

  19. Connectedness to the criminal community and the community at large predicts 1-year post-release outcomes among felony offenders.

    Science.gov (United States)

    Folk, Johanna B; Mashek, Debra; Tangney, June; Stuewig, Jeffrey; Moore, Kelly E

    2016-04-01

    Connectedness to one's community relates to positive psychological and behavioral outcomes. But what implications do connectedness to distinct communities-the criminal community and the community at large-have for inmates about to be released from jail? This study (N = 383) prospectively examined connectedness to the criminal community and community at large prior to release from jail, and functioning at one-year post-release. Connectedness to the community at large positively predicted community adjustment whereas connectedness to the criminal community positively predicted recidivism. Targeting both types of community connectedness may enhance interventions intended to undermine recidivism and increase positive outcomes for inmates.

  20. Kenaf: its prospect in Indonesia

    Directory of Open Access Journals (Sweden)

    Estri Laras Arumingtyas

    2015-09-01

    Full Text Available Kenaf is a plant fibre with high potential as source of material industry. Originally, kenaf usage in Indonesia is still limited only for jute sacks material, which is then displaced by plastic sacks production. While at international scale, kenaf has been started to be developed as pulp material, polypropylene composite, fibreglass replacement, and particle board for automotive industry materials. Indonesia is a tropical country this condition which suitable for kenaf cultivation. However, research reports about kenaf potential usages are still few and limited in domestic level only. Whereas, Indonesian kenaf plant information is needed by international community to understand comprehensively about the potential of tropical plants. This article aims to provide an overview about kenaf cultivation potential and usages in Indonesia as well as the possibility of future development. Key words: kenaf, fibre, prospect, potential.

  1. The PROSPECT Physics Program

    CERN Document Server

    Ashenfelter, J; Band, H R; Barclay, G; Bass, C D; Berish, D; Bowden, N S; Bowes, A; Bryan, C D; Brodsky, J P; Cherwinka, J J; Chu, R; Classen, T; Commeford, K; Davee, D; Dean, D; Deichert, G; Diwan, M V; Dolinski, M J; Dolph, J; Gaison, J K; Galindo-Uribarri, A; Gilje, K; Glenn, A; Goddard, B W; Green, M; Han, K; Hans, S; Heeger, K M; Heffron, B; Jaffe, D E; Jones, D; Langford, T J; Littlejohn, B R; Caicedo, D A Martinez; McKeown, R D; Mendenhall, M P; Mueller, P; Mumm, H P; Napolitano, J; Neilson, R; Norcini, D; Pushin, D; Qian, X; Romero, E; Rosero, R; Seilhan, B S; Sharma, R; Sheets, S; Surukuchi, P T; Varner, R L; Viren, B; Wang, W; White, B; White, C; Wilhelmi, J; Williams, C; Wise, T; Yao, H; Yeh, M; Yen, Y -R; Zangakis, G; Zhang, C; Zhang, X

    2015-01-01

    The Precision Reactor Oscillation and Spectrum Experiment, PROSPECT, is designed to make a precise measurement of the antineutrino spectrum from a highly-enriched uranium reactor and probe eV-scale sterile neutrinos by searching for neutrino oscillations over meter-long distances. PROSPECT is conceived as a 2-phase experiment utilizing segmented $^6$Li-doped liquid scintillator detectors for both efficient detection of reactor antineutrinos through the inverse beta decay reaction and excellent background discrimination. PROSPECT Phase I consists of a movable 3-ton antineutrino detector at distances of 7 - 12 m from the reactor core. It will probe the best-fit point of the $\

  2. Reduced pre-hospital and in-hospital survival rates after out-of-hospital cardiac arrest of patients with type-2 diabetes mellitus : An observational prospective community-based study

    NARCIS (Netherlands)

    Van Hoeijen, Daniel A.; Blom, Marieke T.; Bardai, Abdennasser; Souverein, Patrick C.|info:eu-repo/dai/nl/243074948; De Boer, Anthonius|info:eu-repo/dai/nl/075097346; Tan, Hanno L.

    2015-01-01

    Aims Out-of-hospital cardiac arrest (OHCA) remains a major cause of death. We aimed to determine whether type-2 diabetes mellitus (T2DM) is associated with reduced pre-hospital and in-hospital survival rates after OHCA. Methods and results An observational community-based cohort study was performed

  3. 社区心理咨询师队伍的现状与发展前景探析%Community psychological consultant analysis present situation, problems and development prospects

    Institute of Scientific and Technical Information of China (English)

    焦姬萍

    2014-01-01

    随着社会经济的高速发展,人们的生活水平迅速提升,随之而来的生活压力却与日俱增。社区居民身体的疲惫和心理的负担越来越重,迫切需要一个途径来维护自己身体和心理的健康,社区心理健康服务工作应运而生并迅猛发展。本文通过对社区心理咨询师队伍现状的分析,揭示社区心理咨询师存在问题的原因,力求找到社区咨询师未来发展途径。%With the rapid development of social economy , the living standard of people rapidly im-prove, followed by a life pressure is growing.Community residents of the exhaustion of body and mental burden is getting heavier and heavier, urgently need a way to maintain their physical and mental health, community mental health services work arises at the historic moment and rapid de-velopment.Based on the analysis about the present situation of community psychological consult-ant, revealing the reasons for problems occurred in community psychological cons.

  4. Supervoltage orbital radiotherapy for progressive Graves' ophthalmopathy; Results of a twenty-year experience

    Energy Technology Data Exchange (ETDEWEB)

    Kriss, J.P.; McDougall, I.R. (Division of Nuclear Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Stanford University School of Medicine, Stanford Medical Center, Palo Alto, California (USA)); Petersen, I.A.; Donaldson, S.S. (Department of Radiation Oncology, Stanford University School of Medicine, Stanford Medical Center, Palo Alto, California (USA))

    1989-01-01

    Since 1968 we have employed supervoltage orbital radiation as treatment for severe progressive Graves' ophthalmopathy. A numerical ophthalmic index was used to asess pre- and post-treatment serverity. In the past 20 years we have treated 311 patients of whom 275 have been followed for {le} 1 year or until any eye surgery was performed. An orbital radiation dosage of 2000 rads in 2 weeks was used for the majority of patients (Series I and III). Series II patients received an orbital dose of 3000 rads in 3 weeks. Demographic differences were observed between these series, thus mandating presentation of the results of each separately. Analyses excluded any result achieved by any post-radiation surgical procedure on the eyes. Post-theraphy worsening of ophtalmopathy occurred in only 29 of 1025 observations. Improvement or complete resolution was observed within each category of eye involvement, but lack of favorable response was also recorded in significant numbers. Improvement in proptosis occurred with the lowest frequency and magnitude. About 30% of the patients required eye muscle surgery to correct residual diplopia. Analysis of the data by step-wise linear regression analysis enabled us a. to derive formulae predicting the problable response to radiation therapy according to sign and severity, and b. identify parameters which diminished the likelihood or the extent of a favorable response. The latter included male sex, never thyrotoxic, age greater than 60 years, and requirement for concomitant treatment for hyperthyroidism. No long-term adverse reactions attributable to the radiotherapy have been observed. We conclude that supervoltage orbital radiotherapy, combined with later eye muscle surgery if necessary, is an effective treatment strategy for progressive Graves' ophthalmopathy. (author).

  5. Twenty years of long-term Atrazine monitoring in a shallow aquifer in Western Germany (Invited)

    Science.gov (United States)

    Vereecken, H.; Vonberg, D.; Putz, T.; Vanderborght, J.

    2013-12-01

    Atrazine, one of the most frequent applied pesticides worldwide, was banned in Germany in 1991 due to exceeded threshold values in ground- and drinking waters. Monitoring of atrazine was hence introduced in the Zwischenscholle aquifer, exposed to intensive agricultural land use and susceptible to contaminants due to a shallow water table. In total 60 observation wells were monitored since 1991, of which 11 are sampled monthly today. Descriptive statistics of monitoring data were derived using the 'regression on order statistics' (ROS) data censoring approach, estimating values for nondetects. The monitoring data shows that even 20 years after the ban of atrazine, the concentrations in groundwater are on a constant level without any considerable decrease. The spatial distribution of atrazine concentrations is highly heterogeneous with observation wells exhibiting constantly concentrations above the threshold on the one hand and observation wells where concentrations are frequently below the limit of quantification (LOQ) on the other hand. A deethylatrazine-to-atrazine ratio (DAR) was used to distinguish between diffuse - and point-source contamination, with a global mean value of 0.84 indicating mainly diffuse contamination. Principle Component Analysis (PCA) was applied to the monitoring dataset and relationships of triazine compounds became obvious. Accordingly the metabolite desisopropylatrazine was exclusively associated with the occurrence of the parent compound simazine and not atrazine, whereas deethylatrazine was clearly related to atrazine.

  6. [Infective endocarditis. Systematic review of twenty years of performances in the Sociedad Argentina de Medicina].

    Science.gov (United States)

    Marcelo, Yorio; Milian Andrés, Escudero; Luis, Camera

    2008-01-01

    Infective endocarditis (IE) is still a disease with high morbidity and mortality. Its diagnosis and treatment are still a major challenge in clinical practice. There have been very few studies published about IE in Argentina. We reviewed all the studies about IE published in the Argentine Medicine Society from 1980 to 2003 and we analyzed demographic, clinical and bacteriological data. 27 studies with 628 patients were included. Mean age of patients was 50.7 years old. The most frequent clinical data were fever, murmur and elevated sedimentation rate. Stafilococcus spp was the most common causative organism, followed by streptococcus spp. The echocardiographic demonstration allowed the definitive diagnosis in 2/3 of the patients. The IE data of Argentina are not different from other data published in different countries and this study shows some clinical features of IE in Argentina.

  7. Exposure of growing and adult captive cheetahs (Acinonyx jubatus) to dietary isoflavones: twenty years later.

    Science.gov (United States)

    Bell, K M; Rutherfurd, S M; Hendriks, W H

    2010-12-01

    Dietary isoflavones are associated with oestrogenic and anti-oestrogenic effects, and have been linked to infertility in cheetahs. This study aimed to determine the isoflavone content of commercially prepared diets consumed by captive cheetahs. Sixteen international zoological facilities provided diets, and the isoflavone content of each diet was determined by acid hydrolysis and HPLC quantification. Proximate nutritional composition was also determined. Over half the diets analysed contained detectable concentrations of isoflavones, whereby total isoflavone content ranged from 1.75-183 mg/kg dry matter. The zoo-specific diets were calculated to deliver a median isoflavone dose of 0.07 mg/kg body weight (BW) and a maximum of 1.95 mg/kg BW to captive cheetahs. On a metabolic body weight basis this equates to a maximum of 4.90-5.43 mg/kg(0.75) . Some diets prepared for hand-rearing neonatal cheetahs could expose neonates to doses of up to 4.24 mg/kg BW (or 4.24-6.33 mg/kg(0.75) for cubs under 3 months of age). Only one of six zoo-specific diets was found to deliver isoflavones in doses shown to possess biological activity in other species. Therefore, on average, dietary isoflavones were not found in commercially prepared diets consumed by captive cheetahs in concentrations predicted to cause physiological changes. However, a small proportion of these diets, including hand-rearing formulas, contained elevated isoflavones concentrations which may influence cheetah fertility, behaviour or other physiological parameters. © 2010 Blackwell Verlag GmbH.

  8. exposure of growing and adult captive cheetahs (Acinony Jubatus) to dietary isoflavones: twenty years later

    NARCIS (Netherlands)

    Bell, K.M.; Rutherfurd, S.M.; Hendriks, W.H.

    2010-01-01

    Dietary isoflavones are associated with oestrogenic and anti-oestrogenic effects, and have been linked to infertility in cheetahs. This study aimed to determine the isoflavone content of commercially prepared diets consumed by captive cheetahs. Sixteen international zoological facilities provided

  9. Personal networks and mortality risk in older adults: A twenty-year longitudinal study

    NARCIS (Netherlands)

    Ellwardt, L.; Tilburg, van T.G.; Aartsen, M.J.; Wittek, R.; Steverink, N.

    2015-01-01

    Background: Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investig

  10. Personal Networks and Mortality Risk in Older Adults : A Twenty-Year Longitudinal Study

    NARCIS (Netherlands)

    Ellwardt, Lea; van Tilburg, Theo; Aartsen, Marja; Wittek, Rafael; Steverink, Nardi

    2015-01-01

    Background Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investiga

  11. Personal networks and mortality risk in older adults : A twenty-year longitudinal study

    NARCIS (Netherlands)

    Ellwardt, Lea; Tilburg, Theo G. van; Aartsen, Marja; Wittek, Rafael; Steverink, Nardi

    2015-01-01

    Background: Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investig

  12. Neonatal Listeriosis in Colombia… Is it the Same Since Twenty Years Ago?

    Directory of Open Access Journals (Sweden)

    Juan Luis Vélez Leal

    2015-05-01

    Full Text Available Case: The case is presented including maternal history, clinical and laboratory findings leading to diagnosis, paraclinical monitoring of the infection, the established treatment and outcome of neonatal death. A review of national and international literature on infectious and epidemiology characteristics of L. monocytogenes infection, and its clinical presentation and implications during the gestational and the neonatal period is made. Discussion: neonatal listeriosis is a disease with high fatality whose epidemiology is not clearly described in the national and regional level which hinders the development of prevention strategies in high-risk groups. We suggest this infection becomes a notifiable event to allow the identification of risk factors, lethality, usual presentation and outcome of this infectious disease in Colombia.

  13. Twenty years of vasoplegic syndrome treatment in heart surgery. Methylene blue revised

    Science.gov (United States)

    Evora, Paulo Roberto Barbosa; Alves, Lafaiete; Ferreira, Cesar Augusto; Menardi, Antônio Carlos; Bassetto, Solange; Rodrigues, Alfredo José; Scorzoni, Adilson; Vicente, Walter Vilella de Andrade

    2015-01-01

    Objective This study was conducted to reassess the concepts established over the past 20 years, in particular in the last 5 years, about the use of methylene blue in the treatment of vasoplegic syndrome in cardiac surgery. Methods A wide literature review was carried out using the data extracted from: MEDLINE, SCOPUS and ISI WEB OF SCIENCE. Results The reassessed and reaffirmed concepts were 1) MB is safe in the recommended doses (the lethal dose is 40 mg/kg); 2) MB does not cause endothelial dysfunction; 3) The MB effect appears in cases of NO up-regulation; 4) MB is not a vasoconstrictor, by blocking the cGMP pathway it releases the cAMP pathway, facilitating the norepinephrine vasoconstrictor effect; 5) The most used dosage is 2 mg/kg as IV bolus, followed by the same continuous infusion because plasma concentrations sharply decrease in the first 40 minutes; and 6) There is a possible "window of opportunity" for MB's effectiveness. In the last five years, major challenges were: 1) Observations about side effects; 2) The need for prophylactic and therapeutic guidelines, and; 3) The need for the establishment of the MB therapeutic window in humans. Conclusion MB action to treat vasoplegic syndrome is time-dependent. Therefore, the great challenge is the need, for the establishment the MB therapeutic window in humans. This would be the first step towards a systematic guideline to be followed by possible multicenter studies. PMID:25859872

  14. Twenty years of vasoplegic syndrome treatment in heart surgery. Methylene blue revised

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Barbosa Evora

    2015-02-01

    Full Text Available Objective: This study was conducted to reassess the concepts established over the past 20 years, in particular in the last 5 years, about the use of methylene blue in the treatment of vasoplegic syndrome in cardiac surgery. Methods: A wide literature review was carried out using the data extracted from: MEDLINE, SCOPUS and ISI WEB OF SCIENCE. Results: The reassessed and reaffirmed concepts were 1 MB is safe in the recommended doses (the lethal dose is 40 mg/kg; 2 MB does not cause endothelial dysfunction; 3 The MB effect appears in cases of NO up-regulation; 4 MB is not a vasoconstrictor, by blocking the cGMP pathway it releases the cAMP pathway, facilitating the norepinephrine vasoconstrictor effect; 5 The most used dosage is 2 mg/kg as IV bolus, followed by the same continuous infusion because plasma concentrations sharply decrease in the first 40 minutes; and 6 There is a possible "window of opportunity" for MB's effectiveness. In the last five years, major challenges were: 1 Observations about side effects; 2 The need for prophylactic and therapeutic guidelines, and; 3 The need for the establishment of the MB therapeutic window in humans. Conclusion: MB action to treat vasoplegic syndrome is time-dependent. Therefore, the great challenge is the need, for the establishment the MB therapeutic window in humans. This would be the first step towards a systematic guideline to be followed by possible multicenter studies.

  15. Promoting early literacy in pediatric practice: twenty years of reach out and read.

    Science.gov (United States)

    Zuckerman, Barry

    2009-12-01

    Reach Out and Read (ROR) is the first pediatric, evidence-based strategy to prevent problems of early childhood development and learning. With a start in a single clinic in Boston City Hospital in 1989, doctors working in >4000 clinics and practices gave approximately 5.7 million new books to >3.5 million children in all 50 states in 2008. ROR also has become a model for a different way of thinking about parent education during primary care encounters, based less on telling and more on creating real-time learning experiences. ROR flourished because of (1) the growth of pediatric interest in child development, (2) local leadership of pediatric champions as well as nonmedical supporters, coordinators, and volunteers, (3) evidence of effectiveness, and (4) public financial support attributable to strong bipartisan support in Congress, led by Senator Edward Kennedy. Since ROR started, an increasing amount of research confirms the importance of reading aloud for the development of language and other emergent literacy skills, which in turn helps children get ready for school and leads to later success in reading. Future goals include continued growth until all low-income children are reached with pediatric advice and books, a national campaign led by physicians encouraging all parents to read to their children every day, additional evidence-based, parent information to increase the effectiveness of parents reading to children, quality-improvement efforts to achieve the full potential, and global expansion.

  16. Twenty years of childhood coeliac disease in The Netherlands: a rapidly increasing incidence?

    NARCIS (Netherlands)

    E.K. George (Elvira K.); M.L. Mearin (Maria Luisa); H.C.M. Franken; R.H.J. Houwen (Roderick); R.A. Hirasing (Remy); J.P. Vandenbroucke (Jan)

    1997-01-01

    markdownabstract__Background__ The incidence of coeliac disease varies internationally. __Aims__ To assess the incidence of childhood coeliac disease in The Netherlands and to study the clinical features and the presence of associated disorders. __Subjects__ Identified cases of childhood

  17. Twenty years of childhood coeliac disease in The Netherlands: A rapidly increasing incidence

    NARCIS (Netherlands)

    George, E.K.; Mearin, M.L.; Franken, H.C.M.; Houwen, R.H.J.; Hirasing, R.A.; Vandenbroucke, J.P.

    1997-01-01

    Background - The incidence of coeliac disease varies internationally. Aims - To assess the incidence of childhood coeliac disease in The Netherlands and to study the clinical features and the presence of associated disorders. Subjects - Identified cases of childhood coeliac disease in The

  18. Twenty years since ‘antibody mimics’ by molecular imprinting were first proposed: A critical perspective

    National Research Council Canada - National Science Library

    Jenna L. Bowen; Panagiotis Manesiotis; Chris J. Allender

    2013-01-01

    ... ‘a useful, general alternative to antibodies’. This perspective article examines how far we have come in the 20 years since this publication in terms of realising this hypothesis and poses the question of whether we actually need molecularly...

  19. [Twenty years of bioethics in Mexico: development and perspectives of the National Bioethics Commission].

    Science.gov (United States)

    Ruiz de Chávez-Guerrero, Manuel Hugo

    2014-01-01

    Bioethics in Mexico has a history that reveals the vision and ethical commitment of iconic characters in the fields of health sciences and humanities, leading to the creation of the National Bioethics Commission responsible for promoting a bioethics culture in Mexico. Its development and consolidation from the higher perspective of humanism had the aim to preserve health, life and its environment, while at the same time the bases of ethics and professional practice from different perspectives have been the building blocks of medical practice.

  20. Twenty years of human immunodeficiency virus care at the Mayo Clinic: Past, present and future

    Science.gov (United States)

    Cummins, Nathan W; Badley, Andrew D; Kasten, Mary J; Sampath, Rahul; Temesgen, Zelalem; Whitaker, Jennifer A; Wilson, John W; Yao, Joseph D; Zeuli, John; Rizza, Stacey A

    2016-01-01

    The Mayo human immunodeficiency virus (HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinical outcomes such as retention in care, initiation of antiretroviral therapy and virologic suppression are maximized. In this commentary, we describe the history of the Mayo HIV Clinic and its best practices, providing a “Mayo Model” of HIV care that exceeds national outcomes and may be applicable in other settings. PMID:27175350

  1. Twenty Years of Rad-Hard K14 SPAD in Space Projects

    Directory of Open Access Journals (Sweden)

    Vojtěch Michálek

    2015-07-01

    Full Text Available During last two decades, several photon counting detectors have been developed in our laboratory. One of the most promising detector coming from our group silicon K14 Single Photon Avalanche Diode (SPAD is presented with its valuable features and space applications. Based on the control electronics, it can be operated in both gated and non-gated mode. Although it was designed for photon counting detection, it can be employed for multiphoton detection as well. With respect to control electronics employed, the timing jitter can be as low as 20 ps RMS. Detection efficiency is about 40%in range of 500 nm to 800 nm. The detector including gating and quenching circuitry has outstanding timing stability. Due to its radiation resistivity, the diode withstands 100 krad gamma ray dose without parameters degradation. Single photon detectors based on K14 SPAD were used for planetary altimeter and atmospheric lidar in MARS92/96 and Mars Surveyor ’98 space projects, respectively. Recent space applications of K14 SPAD comprises LIDAR and mainly time transfer between ground stations and artificial satellites. These include Laser Time Transfer, Time Transfer by Laser Link, and European Laser Timing projects.

  2. Trichinellosis in Romania: a short review over the past twenty years

    Directory of Open Access Journals (Sweden)

    Olteanu G.

    2001-06-01

    Full Text Available This paper emphasized the evolution of trichinellosis in man and animals during the last two decades in Romania. Between 1983 and 1993, human cases with Trichinella increased from 217 to 3,649. A similar evolution was observed in pigs. This situation was caused by the large spread of trichinellosis from big "industrial" farms. Complex chemoprophylaxis and treatment-chemoprophylaxis gave some positive results to control trichinellosis in pig.

  3. Twenty Years of Endodontic Success and Failure at West Virginia University.

    Science.gov (United States)

    1982-01-01

    the canals, and when a pronounced overfill was present. Bender and Seltzer called attention to the problem of evaluating success and failure based on...concerning radiographic evaluation of the periapical status of 5 pulpless teeth. He differed with Bender and Seltzer in reporting that the radiograph...radiographic exams showing decided periapical improvement or constant periapical health plus a negative posttreatment history. Bender , Seltzer , and Freedland

  4. Contemporary Curriculum Discourses: Twenty Years of JCT. Counterpoints: Studies in the Postmodern Theory of Education.

    Science.gov (United States)

    Pinar, William F., Ed.

    This collection of essays is taken from a 20-year span of "The Journal of Curriculum Theorizing." The volume contains 31 articles: "Living Metaphors: The Real Curriculum in Environmental Education," F. Krall; "Dialectics and the Development of Curriculum Theory," H. Giroux; "Autobiography and Reconceptualization," M. Grumet; "Women," J. Miller;…

  5. Face-to-Face Interaction with Pedagogical Agents, Twenty Years Later

    Science.gov (United States)

    Johnson, W. Lewis; Lester, James C.

    2016-01-01

    Johnson et al. ("International Journal of Artificial Intelligence in Education," 11, 47-78, 2000) introduced and surveyed a new paradigm for interactive learning environments: animated pedagogical agents. The article argued for combining animated interface agent technologies with intelligent learning environments, yielding intelligent…

  6. Personal networks and mortality risk in older adults : A twenty-year longitudinal study

    NARCIS (Netherlands)

    Ellwardt, Lea; Tilburg, Theo G. van; Aartsen, Marja; Wittek, Rafael; Steverink, Nardi

    2015-01-01

    Background: Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investig

  7. Twenty Years of Stereotype Threat Research: A Review of Psychological Mediators.

    Directory of Open Access Journals (Sweden)

    Charlotte R Pennington

    Full Text Available This systematic literature review appraises critically the mediating variables of stereotype threat. A bibliographic search was conducted across electronic databases between 1995 and 2015. The search identified 45 experiments from 38 articles and 17 unique proposed mediators that were categorized into affective/subjective (n = 6, cognitive (n = 7 and motivational mechanisms (n = 4. Empirical support was accrued for mediators such as anxiety, negative thinking, and mind-wandering, which are suggested to co-opt working memory resources under stereotype threat. Other research points to the assertion that stereotype threatened individuals may be motivated to disconfirm negative stereotypes, which can have a paradoxical effect of hampering performance. However, stereotype threat appears to affect diverse social groups in different ways, with no one mediator providing unequivocal empirical support. Underpinned by the multi-threat framework, the discussion postulates that different forms of stereotype threat may be mediated by distinct mechanisms.

  8. Twenty Years On: Finding a Place for the Rwandan Genocide in Education

    Science.gov (United States)

    Gray, Michael

    2014-01-01

    The Rwandan genocide was perhaps the most paradigmatic human rights catastrophe in the post-Holocaust era, which challenged the mantra of "never again." Yet as we approach the twentieth anniversary, it remains a relatively marginalised entity within mainstream English education. This paper argues that a study of the Rwandan genocide…

  9. Presentation of neuromyelitis optica spectrum disorder after more than twenty years of systemic sclerosis.

    Science.gov (United States)

    Hernández, Zulma M; Cohen, Bruce A; Derwenskus, Joy

    2012-10-01

    Neuromyelitis optica is an autoimmune disorder characterized by optic neuritis, transverse myelitis, and aquaporin-4 autoantibodies. The term "neuromyelitis optica spectrum disorder" refers neuromyelitis optica features occurring in association with other systemic rheumatologic conditions. We present a case of a 51-year-old woman with long-standing systemic sclerosis who developed transverse myelitis in association with the presence aquaporin-4 autoantibodies. This is the first report case of neuromyelitis optica spectrum disorder associated with systemic sclerosis. Given that patients with neuromyelitis optica spectrum disorder with aquaporin-4 autoantibodies have a high risk for clinical relapse, this report underscores the need for recognition of this disorder in patients with systemic sclerosis and neurological dysfunction.

  10. Twenty-year trends in the prevalence of Down syndrome and other trisomies in Europe

    DEFF Research Database (Denmark)

    Loane, Maria; Morris, Joan K; Addor, Marie-Claude

    2013-01-01

    This study examines trends and geographical differences in total and live birth prevalence of trisomies 21, 18 and 13 with regard to increasing maternal age and prenatal diagnosis in Europe. Twenty-one population-based EUROCAT registries covering 6.1 million births between 1990 and 2009 participa...

  11. Twenty years experience with constructed wetland systems in Denmark - what did we learn?

    DEFF Research Database (Denmark)

    Brix, Hans; Schierup, Hans-Henrik; Arias, Carlos Alberto

    2007-01-01

    , the reeds do not increase the hydraulic conductivity of cohesive soils as much as necessary to secure sub-surface flow. Operation needs of soil-based reed beds are low and normally restricted to emptying of the sedimentation tank, cleaning of the distribution system and mowing of the grass around the system...... wetland systems are either compact vertical flow systems which provide good nitrification, willow systems with no discharge or restored wetland systems for nitrate removal. If efficient removal of phosphorus is required, this is achieved by chemical precipitation in the sedimentation tank....

  12. Methods, software and datasets to verify DVH calculations against analytical values: Twenty years late(r)

    Energy Technology Data Exchange (ETDEWEB)

    Nelms, Benjamin [Canis Lupus LLC, Merrimac, Wisconsin 53561 (United States); Stambaugh, Cassandra [Department of Physics, University of South Florida, Tampa, Florida 33612 (United States); Hunt, Dylan; Tonner, Brian; Zhang, Geoffrey; Feygelman, Vladimir, E-mail: vladimir.feygelman@moffitt.org [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida 33612 (United States)

    2015-08-15

    Purpose: The authors designed data, methods, and metrics that can serve as a standard, independent of any software package, to evaluate dose-volume histogram (DVH) calculation accuracy and detect limitations. The authors use simple geometrical objects at different orientations combined with dose grids of varying spatial resolution with linear 1D dose gradients; when combined, ground truth DVH curves can be calculated analytically in closed form to serve as the absolute standards. Methods: DICOM RT structure sets containing a small sphere, cylinder, and cone were created programmatically with axial plane spacing varying from 0.2 to 3 mm. Cylinders and cones were modeled in two different orientations with respect to the IEC 1217 Y axis. The contours were designed to stringently but methodically test voxelation methods required for DVH. Synthetic RT dose files were generated with 1D linear dose gradient and with grid resolution varying from 0.4 to 3 mm. Two commercial DVH algorithms—PINNACLE (Philips Radiation Oncology Systems) and PlanIQ (Sun Nuclear Corp.)—were tested against analytical values using custom, noncommercial analysis software. In Test 1, axial contour spacing was constant at 0.2 mm while dose grid resolution varied. In Tests 2 and 3, the dose grid resolution was matched to varying subsampled axial contours with spacing of 1, 2, and 3 mm, and difference analysis and metrics were employed: (1) histograms of the accuracy of various DVH parameters (total volume, D{sub max}, D{sub min}, and doses to % volume: D99, D95, D5, D1, D0.03 cm{sup 3}) and (2) volume errors extracted along the DVH curves were generated and summarized in tabular and graphical forms. Results: In Test 1, PINNACLE produced 52 deviations (15%) while PlanIQ produced 5 (1.5%). In Test 2, PINNACLE and PlanIQ differed from analytical by >3% in 93 (36%) and 18 (7%) times, respectively. Excluding D{sub min} and D{sub max} as least clinically relevant would result in 32 (15%) vs 5 (2%) scored deviations for PINNACLE vs PlanIQ in Test 1, while Test 2 would yield 53 (25%) vs 17 (8%). In Test 3, statistical analyses of volume errors extracted continuously along the curves show PINNACLE to have more errors and higher variability (relative to PlanIQ), primarily due to PINNACLE’s lack of sufficient 3D grid supersampling. Another major driver for PINNACLE errors is an inconsistency in implementation of the “end-capping”; the additional volume resulting from expanding superior and inferior contours halfway to the next slice is included in the total volume calculation, but dose voxels in this expanded volume are excluded from the DVH. PlanIQ had fewer deviations, and most were associated with a rotated cylinder modeled by rectangular axial contours; for coarser axial spacing, the limited number of cross-sectional rectangles hinders the ability to render the true structure volume. Conclusions: The method is applicable to any DVH-calculating software capable of importing DICOM RT structure set and dose objects (the authors’ examples are available for download). It includes a collection of tests that probe the design of the DVH algorithm, measure its accuracy, and identify failure modes. Merits and applicability of each test are discussed.

  13. Twenty-Year Experience in the Diagnosis and Treatment of Infective Endocarditis.

    Science.gov (United States)

    Abramczuk, Elżbieta; Stępińska, Janina; Hryniewiecki, Tomasz

    2015-01-01

    The aim of this study was to compare the etiology, clinical course, selected diagnostic methods and efficacy of the treatment used in patients with infective endocarditis (IE) in the nineteen eighties and nineties. The study group comprised 300 patients with infective endocarditis hospitalized in the Institute of Cardiology in Warsaw in the following years: from 1982 to 1987 (150 patients: 75 successive patients with IE on the prosthetic valve and 75 successive patients with IE on the native valve), as well as from 1990 to 2003 (150 patients: 75 successive patients with IE on the prosthetic valve and 75 successive patients with IE on the native valve). In the nineties, immunological symptoms, embolism formation and progressive heart failure were diagnosed decidedly more frequently. Early prosthetic valve endocarditis (PVE) (up to 60 days after operation) occurred significantly more frequently in the eighties. The quantity of negative blood cultures in PVE has not decreased, it is still observed in over 20% of cases. For 20 years the etiology of PVE has remained the same, the dominant pathogen remains Staphylococcus. The frequency of PVE caused by Streptococci has markedly reduced. In both the decades analyzed the etiology of native valve endocarditis (NVE) was similar. In the eighties Streptococcus was predominant. In successive years the number of infections caused by Staphylococci was the same as that caused by Streptococci. The incidence of early PVE decreased in the nineties. More patients were treated surgically with lesser peri-operative mortality. A lower incidence of infective endocarditis on prosthetic valves caused by streptococci may signify better prophylaxis against infective endocarditis. Infective endocarditis with sterile blood cultures continues to occur frequently.

  14. Medical dissolution and prevention of canine struvite urolithiasis. Twenty years of experience.

    Science.gov (United States)

    Osborne, C A; Lulich, J P; Polzin, D J; Allen, T A; Kruger, J M; Bartges, J W; Koehler, L A; Ulrich, L K; Bird, K A; Swanson, L L

    1999-01-01

    Two types of canine struvite uroliths have been recognized: infection-induced struvite is the most common type; sterile struvite is uncommonly recognized. Infection-induced struvite is most commonly associated with urease-producing staphylococcal UTI. For dogs that qualify, medical dissolution is an effective method of treatment. Medical dissolution protocols encompass: (1) eradication or control of UTI; (2) use of calculolytic diets; and (3) administration of urease inhibitors to patients with persistent UTI caused by urease-producing microbes.

  15. One hundred twenty years of koala retrovirus evolution determined from museum skins

    DEFF Research Database (Denmark)

    Avila Arcos, Maria del Carmen; Ho, Simon Y W; Ishida, Yasuko

    2013-01-01

    Although endogenous retroviruses are common across vertebrate genomes, the koala retrovirus (KoRV) is the only retrovirus known to be currently invading the germ line of its host. KoRV is believed to have first infected koalas in northern Australia less than two centuries ago. We examined KoRV in...

  16. High Temperature Superconductivity in the Past Twenty Years Part 2-Towards to Practical Applications

    Institute of Scientific and Technical Information of China (English)

    Jian-Xun Jin

    2008-01-01

    After discovering high temperature super- conducting materials 20 years ago, the preparation of applicable HTS materials has been pursued along with HTS mechanism and characteristic study. At present, the focus on the applied HTS technology has been moving to the industrial preparations from the laboratory research stage, and the technology has been well verified for practical applications from small to large scales. The fabrication techniques of engineering HTS materials are being industrialized; and various HTS devices are also on the way towards practical applications. This paper provides a comprehensive summary on the applied high temperature superconductivity with regard to various applicable HTS materials, their preparation techniques and charac- terization, and applications in a wide range.

  17. Eye health in the future: what are the challenges for the next twenty years?

    Directory of Open Access Journals (Sweden)

    Hugh R Taylor

    2008-09-01

    Full Text Available When looking ahead, it is really important to know where we have come from. This allows us to project identified trends and to reflect on the tremendous amount of change that can happen over a relatively short period.Reflect for a moment on the intensity of the debate regarding the use of intraocular lenses (IOLs in low-income settings in the 1990s. As they were still very expensive, some insisted that aphakic correction after surgery was the best approach for these countries. The subsequent availability of low-cost IOLs made the debate irrelevant. It dramatically changed our ability to provide modern IOL cataract surgery and control cataract blindness worldwide, and it laid the basis for VISION 2020. Other dramatic changes occurred with the introduction of ivermectin for onchocerciasis and azithromycin for trachoma, which gave us the ability to eliminate these two devastating and previously intractable causes of blindness. Our medical management of glaucoma or of age-related macular degeneration today is totally different from what it was 20 years ago, although there is still a long way to go. Our approach to refractive error has also altered dramatically, thanks to the recognition of its importance and the availability of high-quality, low-cost spectacles.So, given what we know about the past, what are the challenges we face in the future?

  18. Twenty Years of Basic Vocational Education Provision in Spain: Changes and Trends

    Directory of Open Access Journals (Sweden)

    Fernando Marhuenda

    2015-08-01

    Full Text Available Our contribution attempts to review basic vocational education programmes in Spain over the past 25 years. We intend to compare the evolution of these programmes in terms of conception and conditions of delivery in order to find out how different they are as skill-formation and remedial systems, as well as analysing how different political views have an impact upon such provision. We will focus on the current programmes in two regions in Spain where tourism is the main economic strength and source of employment. The authors have been working on several research projects investigating these issues since the late 1990s and we are currently working on two of them.

  19. Nontuberculous Mycobacteria Isolation from Clinical and Environmental Samples in Iran: Twenty Years of Surveillance

    Directory of Open Access Journals (Sweden)

    Ali Akbar Velayati

    2015-01-01

    Full Text Available Nontuberculous mycobacteria (NTM are opportunistic pathogens that are widely distributed in the environment. There is a lack of data on species distribution of these organisms from Iran. This study consists of a review of NTM articles published in Iran between the years 1992 and 2014. In this review, 20 articles and 14 case reports were identified. Among the 20 articles, 13 (65% studies focused on NTM isolates from clinical specimens, 6 (30% studies examined NTM isolates from environmental samples, and one (5% article included both clinical and environmental isolates. M. fortuitum (229/997; 23% was recorded as the most prevalent and rapid growing mycobacteria (RGM species in both clinical (28% and environmental (19% isolated samples (P < 0.05. Among slow growing mycobacteria (SGM, M. simiae (103/494; 21% demonstrated a higher frequency in clinical samples whereas in environmental samples it was M. flavescens (44/503; 9%. These data represent information from 14 provinces out of 31 provinces of Iran. No information is available in current published data on clinical or environmental NTM from the remaining 17 provinces in Iran. These results emphasize the potential importance of NTM as well as the underestimation of NTM frequency in Iran. NTM is an important clinical problem associated with significant morbidity and mortality in Iran. Continued research is needed from both clinical and environmental sources to help clinicians and researchers better understand and address NTM treatment and prevention.

  20. The summer institute in clinical dental research methods: still going and growing after twenty years.

    Science.gov (United States)

    Derouen, Timothy A; Wiesenbach, Carol

    2012-11-01

    The first Summer Institute in Clinical Dental Research Methods, a faculty development program at the University of Washington, was offered in the summer of 1992 for sixteen participants. The primary objective of the program was to give clinical faculty members in dentistry an introduction to and an understanding of the fundamental principles and methods used in good clinical research. In the twentieth offering of the institute in 2011, there were thirty-five participants, and over the twenty institutes, there has been a cumulative total of 463 participants who have come from thirty U.S. states as well as forty-three countries outside the United States. The curriculum has expanded from the initial offering of biostatistics, clinical epidemiology, behavioral research methods, and ethics in clinical research to now include clinical trials, grantsmanship, data analysis, an elective in molecular biology, and a team project that provides participants with hands-on experience in research proposal development as members of an interdisciplinary team. Enrollment has doubled since the first year, yet exit evaluations of the program content have remained consistently high (rated as very good to excellent). One of the indicators of program quality is that at least 50 percent of recent participants indicated that they attended because the program was recommended by colleagues who had attended. There seems to be an ever-increasing pool of dental faculty members who are eager to learn more about clinical research methodology through the institute despite the intensive demands of full-time participation in a six-week program.

  1. Twenty years of invasion: a review of round goby Neogobius melanostomus biology, spread and ecological implications.

    Science.gov (United States)

    Kornis, M S; Mercado-Silva, N; Vander Zanden, M J

    2012-02-01

    The round goby Neogobius melanostomus is one of the most wide-ranging invasive fish on earth, with substantial introduced populations within the Laurentian Great Lakes watershed, the Baltic Sea and several major European rivers. Rapid expansion and deleterious ecosystem effects have motivated extensive research on this species; here this research is synthesized. Maps of the global distribution are provided and the invasion history of N. melanostomus, which spread more rapidly at first in North America, but has undergone substantial expansion over the past decade in the Baltic Sea, is summarized. Meta-analyses comparing their size at age, diet, competitors and predators in North American and European ecosystems are provided. Size at age is region specific, with saline habitats typically supporting larger and faster growing individuals than fresh water. Neogobius melanostomus prey differs substantially between regions, demonstrating a capacity to adapt to locally abundant food sources. Neogobius melanostomus comprise at least 50% of the diet of eight taxa in at least one site or life stage; in total, 16 predator taxa are documented from the Laurentian Great Lakes v. five from Eurasia. Invasive N. melanostomus are the only common forage fish to heavily exploit mussels in the Laurentian Great Lakes and the Baltic Sea, facilitating the transfer of energy from mussels to higher trophic levels in both systems. Neogobius melanostomus morphology, life history, reproduction, habitat preferences, environmental tolerances, parasites, environmental effects, sampling strategies and management are also discussed. Neogobius melanostomus inhabit a wide range of temperate freshwater and brackish-water ecosystems and will probably continue to spread via ballast water, accidental bait release and natural dispersal worldwide. Climate change will probably enhance N. melanostomus expansion by elevating water temperatures closer to its energetic optimum of 26° C. Future research needs are presented; most pressing are evaluating the economic effects of N. melanostomus invasion, determining long-term population level effects of egg predation on game-fish recruitment and comparing several variables (density, ecological effects morphology and life history) among invaded ecosystems. This review provides a central reference as researchers continue studying N. melanostomus, often as examples for advancing basic ecology and invasion biology.

  2. Practices of Disciplinarity and Interdisciplinarity in Quebec Elementary Schools: Results of Twenty Years of Research

    Directory of Open Access Journals (Sweden)

    Yves Lenoir

    2006-12-01

    Full Text Available This article presents a synthesis of different research projects that have been carried out inthe province of Quebec, Canada over the past 20 years concerning the representations and practices ofelementary teachers regarding the relative importance given to subject matter and the use ofinterdisciplinarity in their teaching practice. The first section will explain the context of the Quebecschool system on a socio-historical and political level and review the emergence of the concept ofinterdisciplinarity in Quebec. The second section will present succinctly the different research projectsthat have been conducted since 1980 and the conceptual framework they were based on. The thirdsection will consider the main results of the various research projects from two angles: first, therepresentations and practices of the teachers regarding interdisciplinarity; secondly, the relativeimportance and role that the teachers give to interdisciplinarity. In the conclusion, we will highlightamong other things the central position teachers give to the role of socialization and their minimalconsideration for the teaching of disciplinary knowledge.

  3. Twenty-Year Evolution of Discourse System of China's Educational Economics

    Institute of Scientific and Technical Information of China (English)

    Li Guirong

    2006-01-01

    Although the discourse system of China's educational economics has a short history of only 20 years,it has gained an important position in the discourse system of pedagogy.This system consists of rich discourse branches including the relations between education and economy,educational investment and educational finance,educational cost and educational benefit.changes and innovation in education system and utilization and efficiency of educational resources.All the above discourse branches show various characteristics in different stages.From theif development and changes.the following features Of diScoursc system of educational economics can be drawn:the specialty of discourse,the trend of time of discourse themes.the positivism of discourse expressions and the applicability of discourse nature and contention of Chinese perspectives.To further improve the quality of the discourse system.the emphasis of educational economic studies should be laid upon the improvement of research attitude,theoretical basis,content and methodology.

  4. Twenty years at the margins: the Herman-Chomsky propaganda model, 1988-2008

    OpenAIRE

    Mullen, Andy

    2008-01-01

    2008 marks the 20th anniversary of the publication of Manufacturing Consent: The Political Economy of the Mass Media by Edward S. Herman and Noam Chomsky. This comment briefly assesses how the Herman-Chomsky Propaganda Model (PM) has been received within the field of media and communication studies in the United Kingdom.

  5. Twenty years of multidisciplinary research and practice: the Journal of Occupational Rehabilitation then and now.

    Science.gov (United States)

    Shaw, William S; Findley, Patricia A; Feuerstein, Michael

    2011-12-01

    Early research of work disability in the 1980s showed a complexity of factors influencing pain and health-related functional limitation at work; hence, multidisciplinary perspectives were necessary to understand the complex interplay between biomechanical, organizational, social, and psychological factors impacting work disability. To address this need, the Journal of Occupational Rehabilitation was founded in 1991 with the goal of providing a scientific, yet practical forum for presenting multidisciplinary research and practice in work disability. Now, the 20-year collection of articles in the Journal reflects important trends and directions in the field of occupational rehabilitation. We conducted a retrospective summary of the past 20 years of the Journal of Occupational Rehabilitation, including its inaugural goals and intent, rates of submission and acceptance, trends in the types of articles published, study topics, global distribution of authors, and future directions. The original goal of providing a multidisciplinary scientific and practical forum has been met, but current trends reflect a maturing scientific evidence base, with less representation of employer-based case studies and practical innovations. There has been a dramatic increase in the international representation of studies, authors, and peer reviewers outside of the US. Also, published studies now address work disability for a larger number of health concerns. Contributions to the Journal continue to reflect a multidisciplinary perspective, but the Journal has seen significant changes with respect to international representation, the expanding study of non-musculoskeletal sources of work disability, and the maturing scientific evidence base in the field of occupational rehabilitation. Future volumes of the Journal will likely reflect continuing changes in the global economy, workforce fitness, and job demands.

  6. Outcomes of oral biotin treatment in patients with biotinidase deficiency — Twenty years follow-up

    Directory of Open Access Journals (Sweden)

    Edyta Szymańska

    2015-12-01

    Conclusion: Since the prognosis for individuals diagnosed with BTD is good, provided they are treated before symptoms occur, it is justified to add this metabolic disorder to the panel of conditions screened under the national newborn screening programme in Poland.

  7. Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital

    OpenAIRE

    Leonardo Augusto Miana; Estela Azeka; Luiz Fernando Canêo; Aída Luisa Turquetto; Carla Tanamati; Juliano Gomes Penha; Alexandre Cauduro; Marcelo Biscegli Jatene

    2014-01-01

    Introduction: Cardiac transplantation remains the gold standard for end-stage cardiomyopathies and congenital heart defects in pediatric patients. Objective: This study aims to report on 20 years of experience since the first case and evaluate our results. Methods: We conducted a retrospective analysis of the database and outpatient follow-up. Between October 1992 and April 2012, 109 patients underwent 114 transplants. 51.8% of them being female. The age of patients ranged from 12 days to...

  8. Twenty years of space radiation physics at the BNL AGS and NASA Space Radiation Laboratory.

    Science.gov (United States)

    Miller, J; Zeitlin, C

    2016-06-01

    Highly ionizing atomic nuclei HZE in the GCR will be a significant source of radiation exposure for humans on extended missions outside low Earth orbit. Accelerators such as the LBNL Bevalac and the BNL AGS, designed decades ago for fundamental nuclear and particle physics research, subsequently found use as sources of GCR-like particles for ground-based physics and biology research relevant to space flight. The NASA Space Radiation Laboratory at BNL was constructed specifically for space radiation research. Here we review some of the space-related physics results obtained over the first 20 years of NASA-sponsored research at Brookhaven.

  9. Twenty-year trends in dietary patterns in French-speaking Switzerland: toward healthier eating.

    Science.gov (United States)

    Marques-Vidal, Pedro; Gaspoz, Jean-Michel; Theler, Jean-Marc; Guessous, Idris

    2017-07-01

    Background: Dietary patterns provide a summary of dietary intake, but to our knowledge, few studies have assessed trends in dietary patterns in the population.Objective: The aim was to assess 20-y trends in dietary patterns in a representative sample of the Geneva, Switzerland, population with the consideration of age, sex, education, and generation.Design: Repeated, independent cross-sectional studies were conducted between 1993 and 2014. Dietary intake was assessed by using a validated food-frequency questionnaire. Dietary patterns were assessed by using principal components analyses.Results: Among 18,763 adults, 1 healthy ("fish and vegetables") and 2 unhealthy ("meat and chips" and "chocolate and sweets") patterns were identified. Scores for the "fish and vegetables" pattern increased, whereas the "meat and chips" and "chocolate and sweets" pattern scores decreased in both sexes and across all age groups. The stronger increase in the "fish and vegetables" pattern score among the less well-educated participants led to a narrowing of educational differences (mean ± SD scores in 1993: -0.56 ± 1.39 compared with -0.05 ± 1.58 in low- compared with highly educated groups, respectively; P chocolate and sweets" was -0.021 (95% CI: -0.027, -0.014; P chocolate and sweets" pattern scores decreased. The stronger increases in the "fish and vegetables" pattern score among the less well-educated participants led to a smaller difference in dietary intake across the different educational levels. © 2017 American Society for Nutrition.

  10. IgA Nephropathy: A Twenty Year Retrospective Single Center Experience

    Directory of Open Access Journals (Sweden)

    Jacob Rube

    2009-01-01

    Full Text Available IgA nephropathy (IgAN is a common glomerular disease whose etiology is unknown. Previous studies have described the clinical and laboratory features but none have specifically compared patients during different time periods. This 20 year retrospective study was performed to assess trends in the severity of IgAN from 1989–2008. We reviewed 57 patient charts that contained a confirmed biopsy diagnosis of IgAN and recorded data at the time of diagnosis and the final follow-up appointment. Clinical data included physical examination, urine, and blood tests. Patients were separated into two cohorts, Cohort 1 1989–1998 and Cohort 2 1999–2008. An increase in severity was noted in Cohort 2 based on a significantly higher Up/c and lower serum albumin level. Other prognostic indicators including GFRe, hematocrit, and glomerular injury score also demonstrated a trend towards more severe disease over the past 20 years. The patients in both Cohorts received similar treatments and had comparable renal function at the last follow-up visit. Based on our findings, we suggest that although a kidney biopsy is required to diagnose IgAN, the procedure may not be necessary in patients clinically suspected of having the disease but who have normal kidney function and minimal urine abnormalities.

  11. Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

    Directory of Open Access Journals (Sweden)

    Amilton dos Santos Jr.

    2013-01-01

    Full Text Available Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02. Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5% reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients.

  12. Intraoperative EBRT and resection for renal cell carcinoma. Twenty-year outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Calvo, F.A. [Hospital Gneral Universitario Gregorio Maranon, Madrid (Spain). Dept. of Oncology; Complutense Univ., Madrid (Spain). School of Medicine; Sole, C.V. [Hospital Gneral Universitario Gregorio Maranon, Madrid (Spain). Dept. of Oncology; Complutense Univ., Madrid (Spain). School of Medicine; Instituto de Radiomedicina, Santiago (Spain). Service of Radiation Oncology; Martinez-Monge, R.; Aristu, J. [Clinica Universitaria de Navarra, Pamplona (Spain). Dept. of Radiation Oncology; Azinovic, I. [Hospital de San Jaime, Torrevieja (Spain). Dept. of Radiation Oncology; Zudaire, J.; Berian, J.M. [Clinica Universitaria de Navarra, Pamplona (Spain). Dept. of Urology; Garcia-Sabrido, J.L. [Hospital General Universitario Gregorio Maranon, Madrid (Spain). Dept. of General Surgery

    2013-02-15

    Purpose: We report the outcomes of a multimodality treatment approach combining maximal surgical resection and intraoperative electron radiotherapy (IOERT) with or without external beam radiation therapy (EBRT) in patients with locoregionally (LR) recurrent renal cell carcinoma (RCC) after radical nephrectomy or LR advanced primary RCC. Patients and methods: From 1983 to 2008, 25 patients with LR recurrent (n = 10) or LR advanced primary (n = 15) RCC were treated with this approach. Median patient age was 60 years (range, 16-79 years). Fifteen patients (60%) received perioperative EBRT (median dose, 44 Gy). Surgical resection was R0 (negative margins) in 6 patients (24%) and R1 (residual microscopic disease) in 19 patients (76%). The median dose of IOERT was 14 Gy (range, 9-15). Overall survival (OS) and relapse patterns were calculated using the Kaplan-Meier method. Results: Median follow-up for surviving patients was 22.2 years (range, 3.6-26 years). OS and DFS at 5 and 10 years were 38% and 18% and 19% and 14%, respectively. LR control (tumor bed or regional lymph nodes) and distant metastases-free survival rates at 5 years were 80% and 22%, respectively. The death rate within 30 days of surgery and IOERT was 4% (n = 1). Six patients (24%) experienced acute or late toxicities of grade 3 or higher according to the National Cancer Institute Common Toxicity Criteria (NCI-CTCAE) v4. Conclusion: In patients with LR recurrent or LR advanced primary RCC, a multimodality approach consisting of maximal surgical resection and IOERT with or without adjuvant EBRT yielded encouraging local control results, justifying further evaluation. (orig.)

  13. Reciprocal Relationships and Lifelong Learning: Twenty Years of Duke in Berlin

    Science.gov (United States)

    Donahue, William Collins; Wohlfeil, Jochen

    2007-01-01

    DepaeThe new conditions of the study abroad "market" have impelled us to rethink the costs and benefits of a small, selective US-based program, such as Duke in Berlin. The principal advantage, we argue, is an environment of "academic intimacy," a generous teacher/student ratio, which in turn fosters additional undergraduate…

  14. Twenty Years On!: Updating the IEA BESTEST Building Thermal Fabric Test Cases for ASHRAE Standard 140

    Energy Technology Data Exchange (ETDEWEB)

    Judkoff, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Neymark, J. [J. Neymark & Associates, Golden, CO (United States)

    2013-07-01

    ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs applies the IEA BESTEST building thermal fabric test cases and example simulation results originally published in 1995. These software accuracy test cases and their example simulation results, which comprise the first test suite adapted for the initial 2001 version of Standard 140, are approaching their 20th anniversary. In response to the evolution of the state of the art in building thermal fabric modeling since the test cases and example simulation results were developed, work is commencing to update the normative test specification and the informative example results.

  15. Twenty-year summary of surveillance for human hantavirus infections, United States.

    Science.gov (United States)

    Knust, Barbara; Rollin, Pierre E

    2013-12-01

    In the past 20 years of surveillance for hantavirus in humans in the United States, 624 cases of hantavirus pulmonary syndrome (HPS) have been reported, 96% of which occurred in states west of the Mississippi River. Most hantavirus infections are caused by Sin Nombre virus, but cases of HPS caused by Bayou, Black Creek Canal, Monongahela, and New York viruses have been reported, and cases of domestically acquired hemorrhagic fever and renal syndrome caused by Seoul virus have also occurred. Rarely, hantavirus infections result in mild illness that does not progress to HPS. Continued testing and surveillance of clinical cases in humans will improve our understanding of the etiologic agents involved and the spectrum of diseases.

  16. Twenty years of universal vaccination against hepatitis B in Italy: achievements and challanges

    Directory of Open Access Journals (Sweden)

    Luisa Romano'

    2012-04-01

    Full Text Available Viral hepatitis B is a vaccine-preventable disease. Vaccination has proved to be safe and highly effective in reducing the incidence, the carrier rate and HBV-related mortality on a global scale. In Italy, universal vaccination against hepatitis B started in 1991 in infants as well as in adolescents, providing an outstanding record of safety and effectiveness. Within a few years, over 95% coverage was consistently reported. Today, some 17 million people are immune against hepatitis B and their immunity has been shown to be long-lasting. At present, no booster is required in healthy vaccinated people to sustain protection. Surveillance data from Italy have shown a clear overall decline in hepatitis B among successfully vaccinated individuals. Furthermore, a generation of children and young people (at present cohorts ranging from 0 to 32 years is emerging with practically no markers of HBV infection. Italy’s vaccination programme has resulted in substantial progress being made towards the prevention and control of hepatitis B. The vaccination programme must continue. Maintaining mandatory vaccination of infants and increasing HBV vaccination coverage in high-risk groups, including households of HBsAg carriers as well as immigrants, remain a priority for the future.

  17. Building Franklin's Truly Democratic, Engaged University: Twenty Years of Practice at the University of Pennsylvania

    Science.gov (United States)

    Hartley, Matthew; Harkavy, Ira; Benson, Lee

    2006-01-01

    Benjamin Franklin founded the University of Pennsylvania as a secular institution with the pragmatic aim of instilling in its students the inclination and ability to serve humankind in both the civic and mercantile realms. On this, the three hundredth anniversary of his birth (1706-2006), Franklin's ideal of a democratic, engaged university has…

  18. Capillary electrophoresis coupled to mass spectrometry (CE-MS): twenty years of development

    OpenAIRE

    Nilson Antonio Assunção; Etelvino José Henriques Bechara; Ana Valéria Colnaghi Simionato; Marina Franco Maggi Tavares; Emanuel Carrilho

    2008-01-01

    CE-MS has been increasingly used for analysis of a vast array of compounds. This article reviews the different electrophoretic modes, interfaces and mass analyzers that are commonly used in the CE-MS coupling, as well as the technique advantages and performance characteristics. A large compilation of CE-MS applications is also presented. Therefore, this review is both a guide for beginners and a collection of key references for people who are familiar to the technique. Furthermore, this is th...

  19. Twenty years of monitoring of persistent organic pollutants in Greenland biota. A review.

    Science.gov (United States)

    Rigét, F; Vorkamp, K; Bossi, R; Sonne, C; Letcher, R J; Dietz, R

    2016-10-01

    The Arctic Monitoring and Assessment Programme (AMAP) is a working group under the Arctic Council with the aim to monitor and assess temporal trends of contaminants in Arctic ecosystems. The Greenland AMAP Core programme was established to contribute to this effort. The Core programme includes three main components; routine monitoring, retrospective studies and new POP screening studies. The programme is based on an adaptive approach, which has led to changes throughout the years. An overview of the temporal trends during the last two to three decades is presently given together with selected examples of different characteristic trends of POPs. The results show how tissue banked samples and retrospective studies has helped in establishing time-series of compounds of emerging concern. Lastly, the statistical power of the Greenlandic time-series is discussed. The lesson learned is that trend monitoring improves with samples over time, and only pays off after decades of data are generated.

  20. Lessons Learned from the Last Twenty Years of Sexual Violence Research

    Science.gov (United States)

    Marx, Brian P.

    2005-01-01

    The present article attempts to answer important questions about the most important thing learned from the past 20 years of research on sexual violence, the most important thing to be learned about sexual violence over the next 10 years, and the most promising methodological innovation in the study of sexual violence from the last 20 years. It is…

  1. Twenty-Year Outcome Following Central Duct Resection for Bloody Nipple Discharge

    Science.gov (United States)

    Nelson, R Scott; Hoehn, James L.

    2006-01-01

    Background: Patients found with pathologic nipple discharge present a diagnostic dilemma to surgeons. No one diagnostic test, including cytology or radiologic imaging, has proved superior to any other in the differentiation of benign versus malignant sources of pathologic nipple discharge. Ductoscopy has been introduced as a way to assist with identification of potential sources of pathologic nipple discharge. Ductoscopy is also useful in the resection of deep or peripheral masses that may be missed with standard blind resection. This report evaluates the risk of missed malignancy following central duct resection (CDR). Methods: Records of 56 patients who underwent CDR for pathologic nipple discharge greater than 15 years previous were reviewed. Data including type of nipple discharge, future biopsy, and pathology reports were all examined. Results: Of the 56 patients, 36 had bloody, 18 serous, and 2 green initial discharges. Fifty-seven percent were found to have intraductal papilloma as the source of discharge, with fibrocystic disease and ductal ectasia providing the next most common causes. One woman was found to have ductal cancer and one lobular carcinoma in situ at time of CDR. Patients were followed for a mean period of 22 years. Fourteen women required future biopsy. Of these, 10 had benign disease and 4 had cancer, 3 on the ipsilateral side. The 3 women with breast cancer were 9, 13, and 17 years from initial resection. Conclusions: CDR for pathologic nipple discharge is an effective way to diagnose and treat pathologic nipple discharge without missing underlying cancers. PMID:16552204

  2. Twenty years of water-quality studies in the Cheney Reservoir Watershed, Kansas, 1996-2016

    Science.gov (United States)

    Graham, Jennifer L.; Foster, Guy M.; Kramer, Ariele R.

    2017-03-31

    Since 1996, the U.S. Geological Survey (USGS), in cooperation with the City of Wichita, has done studies in the Cheney Reservoir watershed to understand environmental effects on water-quality conditions. Early studies (1996–2001) determined subwatershed sources of contaminants, nutrient and sediment loading to Cheney Reservoir, changes in reservoir sediment quality over time, and watershed sources of phosphorus. Later studies (2001–present) focused on nutrient and sediment concentrations and mass transport from the watershed; the presence of cyanobacteria, cyanotoxins, and taste-and-odor compounds in the reservoir; and development of regression models for real-time computations of water-quality constituents of interest that may affect drinking-water treatment. This fact sheet summarizes key results from studies done by the USGS during 1996–2016 in the Cheney Reservoir watershed and Cheney Reservoir.

  3. Twenty years of surveillance of Invasive Meningococcal Diseases in Puglia, Italy

    Directory of Open Access Journals (Sweden)

    Paola Stefanelli

    2015-12-01

    Full Text Available INTRODUCTION: The study aims to investigate the change in the burden of disease and the microbiological characteristics of Invasive Meningococcal Disease (IMD in Puglia in comparison with overall incidence from 1994 through 2014. METHODS: Data are gathered in the frame of the National Surveillance System coordinated by the National Reference Laboratory (NRL of the Istituto Superiore di Sanit`. RESULTS: In Puglia, from 1994 through 2014, the average incidence of IMD was 0.2 per 100 000 inhabitants, below the national average value (0.33. IMD cases tended to be older than the other cases reported in Italy (median age 19 vs 16. The case-fatality rate was 20.4% in Puglia vs 13.3% in Italy. Serogroups B and C were most frequently identified. Serogroups C and Y presented a fairly clonal pattern, whereas serogroup B was genetically rather heterogeneous. CONCLUSION: Surveillance systems are critical in monitoring any change in the epidemiology of IMD.

  4. Twenty years of the Journal of product innovation management : History, participants, and knowledge stock and flows

    NARCIS (Netherlands)

    Biemans, Wim; Griffin, Abbie; Moenaert, Rudy

    2007-01-01

    The Journal of Product Innovation Management (JPIM) serves as a marketplace for science-based, innovative ideas that are produced and consumed by scholars and businesspeople. Now that JPIM has existed for 20 years, two intriguing questions emerge: (1) How has the journal evolved over time in terms o

  5. Twenty years of the journal of product innovation management : History, participants and knowledge stock and flows

    NARCIS (Netherlands)

    Moenaert, R.K.; Griffin, A.; Biemans, W.

    2007-01-01

    The Journal of Product Innovation Management (JPIM) serves as a marketplace for science-based, innovative ideas that are produced and consumed by scholars and businesspeople. Now that JPIM has existed for 20 years, two intriguing questions emerge: (1) How has the journal evolved over time in terms o

  6. Twenty Years of Basic Vocational Education Provision in Spain: Changes and Trends

    Directory of Open Access Journals (Sweden)

    Fernando Marhuenda

    2015-09-01

    Full Text Available Our contribution attempts to review basic vocational education programmes in Spain over the past 25 years. We intend to compare the evolution of these programmes in terms of conception and conditions of delivery in order to find out how different they are as skill-formation and remedial systems, as well as analysing how different political views have an impact upon such provision. We will focus on the current programmes in two regions in Spain where tourism is the main economic strength and source of employment. The authors have been working on several research projects investigating these issues since the late 1990s and we are currently working on two of them.

  7. Twenty years after ACEIs and ARBs: emerging treatment strategies for diabetic nephropathy.

    Science.gov (United States)

    Johnson, Stacy A; Spurney, Robert F

    2015-11-15

    Diabetic nephropathy (DN) is a serious complication of both type 1 and type 2 diabetes mellitus. The disease is now the most common cause of end-stage kidney disease (ESKD) in developed countries, and both the incidence and prevalence of diabetes mellitus is increasing worldwide. Current treatments are directed at controlling hyperglycemia and hypertension, as well as blockade of the renin angiotensin system with angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers. Despite these therapies, DN progresses to ESKD in many patients. As a result, much interest is focused on developing new therapies. It has been over two decades since ACEIs were shown to have beneficial effects in DN independent of their blood pressure-lowering actions. Since that time, our understanding of disease mechanisms in DN has evolved. In this review, we summarize major cell signaling pathways implicated in the pathogenesis of diabetic kidney disease, as well as emerging treatment strategies. The goal is to identify promising targets that might be translated into therapies for the treatment of patients with diabetic kidney disease.

  8. Twenty Years of Stereotype Threat Research: A Review of Psychological Mediators.

    Science.gov (United States)

    Pennington, Charlotte R; Heim, Derek; Levy, Andrew R; Larkin, Derek T

    2016-01-01

    This systematic literature review appraises critically the mediating variables of stereotype threat. A bibliographic search was conducted across electronic databases between 1995 and 2015. The search identified 45 experiments from 38 articles and 17 unique proposed mediators that were categorized into affective/subjective (n = 6), cognitive (n = 7) and motivational mechanisms (n = 4). Empirical support was accrued for mediators such as anxiety, negative thinking, and mind-wandering, which are suggested to co-opt working memory resources under stereotype threat. Other research points to the assertion that stereotype threatened individuals may be motivated to disconfirm negative stereotypes, which can have a paradoxical effect of hampering performance. However, stereotype threat appears to affect diverse social groups in different ways, with no one mediator providing unequivocal empirical support. Underpinned by the multi-threat framework, the discussion postulates that different forms of stereotype threat may be mediated by distinct mechanisms.

  9. Twenty Years After Genocide: The Role of Psychology in the Reconciliation and Reconstruction Process in Rwanda

    Directory of Open Access Journals (Sweden)

    Craig McGarty

    2014-12-01

    Full Text Available This Special Thematic Section brings together eight papers that showcase different aspects of the contribution of psychology to the processes of recovery in Rwanda following the 1994 genocide. The Section is noteworthy in part because a majority of the papers have Rwandan authors. In summarizing the contributions I make six observations about the remarkable context of the genocide and its aftermath: a it was distinctive from previous mass violence in its intensity and character; b it has been characterized by bystander inaction and the problems of positioning outsiders to help; c hundreds of thousands of accused or convicted perpetrators have lived alongside survivors; d electronic media played a profound role not only in promoting violence but also in building peace; e Rwanda has been the site of unprecedented societal interventions with political goals that have the character and content of social psychological experiments; and f the role of memorialization in repairing or sustaining harm needs further examination. I conclude by noting that the study of recovery is clear proof that the genocide in Rwanda, as is the case with genocides of the past, failed to achieve its aims.

  10. Young, Becker, and Pike's "Rogerian" Rhetoric: A Twenty-Year Reassessment.

    Science.gov (United States)

    Brent, Doug

    1991-01-01

    Concludes that the Rogerian rhetoric of Richard Young, Alton Becker, and Kenneth Pike (as presented in their book "Rhetoric: Discovery and Change") shows its age by not being quite the epistemic rhetoric contemporary rhetoricians have come to require. Argues that the Rogerian insights can still provide a focus for a reformed rhetoric of…

  11. Twenty years of barrel-stave flextensional transducer technology in Canada

    Science.gov (United States)

    Jones, Dennis F.

    2005-04-01

    The barrel-stave flextensional transducer, a compact underwater sound source, was conceived at DRDC Atlantic in 1986 [G. W. McMahon and D. F. Jones, U.S. Patent No. 4,922,470 (1 May 1990); Canadian Patent No. 1,285,646 (2 July 1991)]. Over the years, five barrel-stave designs belonging to three flextensional classes were built and tested at DRDC Atlantic. Three Class I transducers with operating frequencies ranging from 800 to 1600 Hz were integrated into submarine communications buoys, low frequency active horizontal projector arrays, and a broadband sonar towbody. A high-power Class II and broadband (1-7 kHz) Class III transducer were deployed under the ice in the Lincoln Sea for research related to rapidly deployable surveillance systems. These barrel-stave flextensional transducers have also supported a variety of marine mammal studies including vocal mimicry in long-finned pilot whales, coda dialects in sperm whales, and the R&D of acoustic detection and tracking systems for endangered northern right whales. In August 2004 a barrel-stave transducer was used to lure a trapped juvenile humpback whale to the sluice gates of a tidal generating station on the Annapolis River in Nova Scotia by transmitting humpback whale calls underwater. The acoustic performance parameters for all 5 transducers will be presented.

  12. Twenty years of the grey partridge population in the LAJTA Project (Western Hungary

    Directory of Open Access Journals (Sweden)

    Faragó, S.

    2012-01-01

    Full Text Available The Lajta Project covers 3,065 ha. Within this area crop cultivation is dominant. Fields are separated from each other by forest belts and tree rows, extending altogether over roughly 120 ha. This habitat structure characterized by cultivation of 12–15 field crops sustained partridge population with densities of 1.75 birds/km2 (1991. The Project started in 1991/1992 and aimed to increase the carrying capacity for grey partridge and other small game species living in the area. A full–time gamekeeper was employed and habitat improvements were initiated. Four years later, the breeding population increased to 10.1 birds/km2. Besides increased numbers of nesting pairs, the number of reared chicks also increased, from 5.1–11.2 individuals/km2 in 1990 to 27.3–38.4 individuals/km2 in 1994. However, field sizes did not change significantly. Although the lengths of field margins increased by approximately 25% (from 82 m/ha to 115 m/ha under the influence of habitat management, they still reached only half those found in the countries of Central Europe where private ownership of land properties is dominant. After the privatisation of fields in 1995 as part of the political change in Hungary —affecting approximately 50% of the project area— the possibilities of habitat improvement decreased, and the technological pressure on large–scale farming area increased. Following these processes the grey partridge population again decreased to 1.43 birds/km2 in 1997. As a result of the new management strategy applied in the project since 1996 we observed a slow increase in the breeding population, which stabilized at around 5 birds/km2, between 2007 and 2009. The August density increased in the same period from 4.5 birds/km2 to 13–17 birds/km2. During the two decades in which this research was conducted, chick mortality and winter mortality were extremely high. The key factors influencing grey partridge population dynamics in our study area seem to be clutch and chick losses and winter mortality. To determine the relationship between environmental factors and the grey partridge population parameters, principal component analysis (PCA was used. August grey partridge density was positively associated with ecotone density and bags of red fox and avian predators (magpie and hooded crow. The density of grey partridge in spring and August also correlated with feral dog bag and feral cat bag. Habitat parameters showed a positive correlation with the density of grey partridge both in spring and in August. The levels of abundance of feral dog and feral cat populations also correlated negatively with winter losses.

  13. Twenty years of ovulation induction with metformin for PCOS; what is the best available evidence?

    Science.gov (United States)

    Abu Hashim, Hatem

    2016-01-01

    The potential reproductive benefits of metformin, a drug endowed with the capacity to ameliorate insulin resistance in polycystic ovary syndrome (PCOS), has garnered much interest over the past 2 decades. In this review, randomized-controlled trials (RCT) and meta-analyses of RCT comparing metformin are critically appraised and summarized. PubMed and CENTRAL databases were consulted. Evidence is insufficient to favour the use of metformin or metformin plus clomiphene citrate instead of clomiphene citrate for ovulation induction in women with newly diagnosed PCOS. Evidence is also insufficient to recommend metformin as a primary treatment for non-obese women with PCOS. Metformin plus clomiphene citrate should be considered as an effective option in clomiphene citrate-resistant PCOS. In women with PCOS undergoing gonadotrophin ovulation induction, metformin significantly increased pregnancy and live birth rates (P PCOS patients undergoing assisted reproduction techniques has been shown. No evidence was found of reduced risk of spontaneous abortion or increased risk of major anomalies in women with PCOS taking metformin during the first trimester.

  14. Twenty Years of Cognitive Dissonance: Case Study of the Evolution of a Theory

    Science.gov (United States)

    Greenwald, Anthony G.; Ronis, David L.

    1978-01-01

    Recent revisions of cognitive dissonance theory no longer encompass some of the important examples, data, and hypotheses that were part of Festinger's (1957) original statement. These changes are so substantial as to prompt the observation that the evolved theory might be identified as a different theory. (Editor/RK)

  15. Quality of Cultural Heritage in EIA; twenty years of experience in Norway

    Energy Technology Data Exchange (ETDEWEB)

    Lindblom, Inge, E-mail: inge.lindblom@niku.no

    2012-04-15

    The aim of this paper is to clarify and discuss how quality, relevance, attitudes, beliefs and transfer value act as underlying driving forces in the development of the Cultural Heritage theme in EIAs. One purpose is to identify and discuss some conditions that can better environmental assessment in order to increase the significance of EIA in decision-making with regard to Cultural Heritage. The main tools used are different research methods designed for analyses of quality and quality changes, primarily based on the relevant opinions of 160 people occupied with Cultural Heritage in EIA in Norway. The study is based on a review of 40 types of EIAs from 1991 to 2000, an online questionnaire to 319 (160 responded) individuals from 14 different backgrounds, and interviews with three institutions in Sweden and Denmark. The study confirms a steadily increasing quality on EIRs over time, parallel with an improvement of the way in which Cultural Heritage is treated in EIA. This is supported by both the interviews and the qualitative comments regarding the survey. Potential for improvements is shown to be a need for more detailed background material as well as more use of adequate methods. The survey shows the existence of a wide variety of negative views, attitudes and beliefs, but the consequences of this are difficult to evaluate. However, most certainly, negative attitudes and beliefs have not been powerful enough to be detrimental to the quality of Cultural Heritage component, as nothing in the study indicates that negative attitudes and myths are undermining the system of EIA. The study shows the importance of having on-going discussions on quality and quality change over time by people involved in EIA, and how this is a necessary condition for successful implementation and acceptance. Beliefs and negative attitudes can also be a catalyst for developing better practice and advancing new methodology. In addition, new EIA countries must be prepared for several years of development and improvements after implementation. This is important in order to gain acceptance from the bureaucracy, especially from the Cultural Heritage authorities and local population.

  16. Water-vapor source shift of Xinjiang region during the recent twenty years

    Institute of Scientific and Technical Information of China (English)

    Dai Xingang; Li Weijing; Ma Zhuguo; Wang Ping

    2007-01-01

    The aim of this paper is to investigate the climate water-vapor sources of Xinjiang region and their shifts during the past 20 years. First, the principle and steps are roughly regulated to seek the water-vapor sources. Second, the climate stationary water-vapor transport in troposphere is calculated to distinguish where the water vapor comes from by ERA-40 reanalysis. In addition, the collocation between the transport and the atmospheric column water vapor content is analyzed. The results show that the major vapor comes from the west side of Xinjiang for mid-month of seasons, apart from July while the water vapor comes from the north or northwest direction. The water vapor sources are different for different seasons, for example, the Caspian Sea and Mediterranean are the sources in January and April, the North Atlantic and the Arctic sea in July, and the Black Sea and Caspian Sea in October, respectively. In recent ten years more water vapor above Xinjiang comes from the high latitudes and the Arctic sea with global warming, and less from Mediterranean in comparison with the case of 1973-1986. In fact, the air over subtropics becomes dry and the anomalous water vapor transport direction turns to west or southwest during 1987-2000. By contrast, the air over middle and high latitudes is warmer and wetter than 14 years ago.

  17. Twenty Years of Cognitive Dissonance: Case Study of the Evolution of a Theory

    Science.gov (United States)

    Greenwald, Anthony G.; Ronis, David L.

    1978-01-01

    Recent revisions of cognitive dissonance theory no longer encompass some of the important examples, data, and hypotheses that were part of Festinger's (1957) original statement. These changes are so substantial as to prompt the observation that the evolved theory might be identified as a different theory. (Editor/RK)

  18. exposure of growing and adult captive cheetahs (Acinony Jubatus) to dietary isoflavones: twenty years later

    NARCIS (Netherlands)

    Bell, K.M.; Rutherfurd, S.M.; Hendriks, W.H.

    2010-01-01

    Dietary isoflavones are associated with oestrogenic and anti-oestrogenic effects, and have been linked to infertility in cheetahs. This study aimed to determine the isoflavone content of commercially prepared diets consumed by captive cheetahs. Sixteen international zoological facilities provided di

  19. Twenty Years of Precise Radial Velocities at Keck and Lick Observatories

    CERN Document Server

    Wright, Jason T

    2016-01-01

    The precise radial velocity survey at Keck Observatory began over 20 years ago. Its survey of thousands of stars now has the time baseline to be sensitive to planets with decade-long orbits, including Jupiter analogs. I present several newly-finished orbital solutions for long-period giant planets. Although hot Jupiters are generally "lonely" (i.e. they are not part of multiplanet systems), those that are not appear to often have giant companions at 5 AU or beyond. I present two of the highest period- ratios among planets in a two-planet system, and some of the longest orbital periods ever measured for exoplanets. In many cases, combining Keck radial velocities from those from other long-term surveys at Lick Observatory, McDonald Observatory, HARPS, and, of course, OHP spectrographs, produces superior orbital fits, constraining both period and eccentricity better than could be possible with any single set alone. Stellar magnetic activity cycles can masquerade as long-period planets. In most cases this effect ...

  20. After twenty years of research on soil carbon and climate change, what's left to learn?

    Science.gov (United States)

    Much effort over the past 230 years has been directed at investigating the roles that soils and specifically soil carbon play in the global carbon cycle and in climate change. As we begin another new decade, we ask whether there is anything left to learn on this topic? Do we kn...

  1. Twenty years' monitoring of Mèze stabilisation ponds: part II--Removal of faecal indicators.

    Science.gov (United States)

    Brissaud, F; Andrianarison, T; Brouillet, J L; Picot, B

    2005-01-01

    The WSP system serving Mèze and Poussan (French Mediterranean coast) was constructed in 1980 and enlarged and upgraded from 1994 to 1998. Water quality along the waste stabilisation pond to (WSP) system has been monitored over the years, thus allowing us to assess the influence of enlargement and upgrading works. A significant enhancement of the average microbiological quality of the effluent was observed, with respective E. coli and streptococci average abatements of 4.1 and 3.4 log. units. Former seasonal variations of microbiological removal have vanished. The contribution of the different ponds to the disinfection performance of the WSP system was analysed. A microbiological quality model was proposed to evaluate the die-off kinetics related to the different ponds and as a tool for the design and management of WSP systems. Though the relationships between die-off coefficients and environmental factors appeared somewhat frail, this modelling is considered a promising approach for the prediction of WSP microbiological performance.

  2. Part I: twenty-year literature overview of veterinary and allopathic medicine.

    Science.gov (United States)

    Turnwald, Grant H; Sponenberg, D Phillip; Meldrum, J Blair

    2008-01-01

    Over the last 20 years, numerous reports, symposia, and workshops have focused on the challenges and changes facing veterinary and allopathic medicine. Many of these have specifically considered the changing economic and demographic profiles of the health professions, the specific roles of health professionals in society, and the importance of professional curricula in meeting changing professional and societal needs. Changing curricula to address future demands is a common thread that runs through all of these reports. Future demands most consistently noted include the fact that modern veterinary curricula must emphasize the acquisition of skills, values, and attitudes in addition to the acquisition of knowledge. Skills relating to business management, strong interpersonal communication, and problem solving have often been noted as lacking in current curricula. Furthermore, future curricula must allow for greater diversification and "specialization" among veterinary students; should promote greater opportunities for an emphasis on public health and population medicine, including food safety, food security, and bio- and agro-terrorism; and should motivate students to be active learners who possess strong lifelong learning skills and attitudes.

  3. The evolution of perforator flap breast reconstruction: twenty years after the first DIEP flap.

    Science.gov (United States)

    Healy, Claragh; Allen, Robert J

    2014-02-01

    It is over 20 years since the inaugural deep inferior epigastric perforator (DIEP) flap breast reconstruction. We review the type of flap utilized and indications in 2,850 microvascular breast reconstruction over the subsequent 20 years in the senior author's practice (Robert J. Allen). Data were extracted from a personal logbook of all microsurgical free flap breast reconstructions performed between August 1992 and August 2012. Indication for surgery; mastectomy pattern in primary reconstruction; flap type, whether unilateral or bilateral; recipient vessels; and adjunctive procedures were recorded. The DIEP was the most commonly performed flap (66%), followed by the superior gluteal artery perforator flap (12%), superficial inferior epigastric artery perforator flap (9%), inferior gluteal artery perforator flap (6%), profunda artery perforator flap (3%), and transverse upper gracilis flap (3%). Primary reconstruction accounted for 1,430 flaps (50%), secondary 992 (35%), and tertiary 425 (15%). As simultaneous bilateral reconstructions, 59% flaps were performed. With each flap, there typically ensues a period of enthusiasm which translated into surge in flap numbers. However, each flap has its own nuances and characteristics that influence patient and physician choice. Of note, each newly introduced flap, either buttock or thigh, results in a sharp decline in its predecessor. In this practice, the DIEP flap has remained the first choice in autologous breast reconstruction. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Twenty-year single-center experience with the medtronic open pivot mechanical heart valve.

    Science.gov (United States)

    Van Nooten, Guido J; Bové, Thierry; Van Belleghem, Yves; François, Katrien; Caes, Frank; Vandenplas, Guy; De Pauw, Michel; Taeymans, Yves

    2014-04-01

    Since May 1992 the Medtronic Open Pivot mechanical heart valve has been implanted routinely at the authors' institution. The study aim was to analyze, retrospectively, the 20-year clinical results of the valve. Between May 1992 and December 2011 a total of 1,520 valves was inserted into 1,382 consecutive patients (1,012 aortic, 473 mitral, 26 tricuspid, 9 pulmonary). The mean age of the patients was 61±13.2 years. Preoperatively, 65% of the patients were in New York Heart Association (NYHA) class III or greater. Frequent comorbidities included atrial fibrillation (n=419), coronary disease (n=357), and diabetes (n=255). The 99% complete follow-up totaled 10,527 patient-years (range 12 to 244 months). Ninety-day mortality was 5.2% (n=73, 8 valve related). Of the 550 total deaths, 240 were cardiac and 56 valve related. Multivariate analysis selected age, NYHA III or greater, concomitant coronary revascularization, and respiratory insufficiency as risk factors for death. Renal failure was considered a risk factor in the aortic and atrial fibrillation in the mitral subgroup. Erratic international normalized ratio (INR), NYHA class III or greater, and non-sinus rhythm were risk factors for thromboembolism; likewise redo operations in the aortic subgroup. Erratic INR and age were risk factors for bleeding as were over-coagulation and coronary revascularization in the aortic subgroup and redo operations and renal failure in mitral patients. This 20-year experience demonstrated excellent clinical outcomes with no structural valve failure. Odds ratio defined aortic patients as the lowest risk for adverse events. By contrast atrial fibrillation and elderly age, in combination with instable anticoagulation, yielded the worst long-term results. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Twenty years of load theory-Where are we now, and where should we go next?

    Science.gov (United States)

    Murphy, Gillian; Groeger, John A; Greene, Ciara M

    2016-10-01

    Selective attention allows us to ignore what is task-irrelevant and focus on what is task-relevant. The cognitive and neural mechanisms that underlie this process are key topics of investigation in cognitive psychology. One of the more prominent theories of attention is perceptual load theory, which suggests that the efficiency of selective attention is dependent on both perceptual and cognitive load. It is now more than 20 years since the proposal of load theory, and it is a good time to evaluate the evidence in support of this influential model. The present article supplements and extends previous reviews (Lavie, Trends in Cognitive Sciences, 9, 75-82. doi: 10.1016/j.tics.2004.12.004 , 2005, Current Directions in Psychological Science, 19, 143-148. doi: 10.1177/0963721410370295 , 2010) by examining more recent research in what appears to be a rapidly expanding area. The article comprises five parts, examining (1) evidence for the effects of perceptual load on attention, (2) cognitive load, (3) individual differences under load, (4) alternative theories and criticisms, and (5) the future of load theory. We argue that the key next step for load theory will be the application of the model to real-world tasks. The potential benefits of applied attention research are numerous, and there is tentative evidence that applied research would provide strong support for the theory itself, as well as real-world benefits related to activities in which attention is crucial, such as driving and education.

  6. Analysis of the Thyroid Carcinoma Incidence in Tianjin Over a Recent Twenty-Year Period

    Institute of Scientific and Technical Information of China (English)

    Biyun Qian; Kexin Chen; Min He; Shufen Dong; Haixin Li; Fengju Song

    2005-01-01

    OBJECTIVE To analyze the incidence rate and trend of thyroid cancer in Tianjin over a recent 20-year period.METHODS A method of descriptive epidemiology was used to study the occurrence of thyroid cancer.RESULTS During 1981~2001, the average incidence rate of thyroid cancer was 1.770 per 100,000 with a male to female incidence ratio of 1:2.74, the occurrence being higher in females than in males. Thyroid cancer incidence increased gradually with time over the 20 years in both males and females, especially the incidence peaked in females of 35~50 years of age.CONCLUSION The rapid increase in the incidence rate of thyroid cancer, especially in females, suggests that further research on the risk factors and preventive efforts related to high-risk women should be conducted.

  7. Vegetation Transformations of Kujawy-Pomerania Region in the Last Twenty Years Period

    OpenAIRE

    Załuski Tomasz

    2012-01-01

    This paper contents dynamic tendencies analysis results of Kujawy-Pomerania region (N Poland) for a 20-year time period. Acreage changes as well as structure and species composition transformations of forest and shrub vegetation (associations) and non-forest vegetation (alliances) were evaluated. Main factors influencing on regressive and progressive changes were set out. Analysis was relied on results of geobotanical research and observations of selected objects. Regressive changes were note...

  8. Drinking Level, Drinking Pattern, and Twenty-Year Total Mortality Among Late-Life Drinkers

    Science.gov (United States)

    Holahan, Charles J.; Schutte, Kathleen K.; Brennan, Penny L.; Holahan, Carole K.; Moos, Rudolf H.

    2015-01-01

    Objective: Research on moderate drinking has focused on the average level of drinking. Recently, however, investigators have begun to consider the role of the pattern of drinking, particularly heavy episodic drinking, in mortality. The present study examined the combined roles of average drinking level (moderate vs. high) and drinking pattern (regular vs. heavy episodic) in 20-year total mortality among late-life drinkers. Method: The sample comprised 1,121 adults ages 55–65 years. Alcohol consumption was assessed at baseline, and total mortality was indexed across 20 years. We used multiple logistic regression analyses controlling for a broad set of sociodemographic, behavioral, and health status covariates. Results: Among individuals whose high level of drinking placed them at risk, a heavy episodic drinking pattern did not increase mortality odds compared with a regular drinking pattern. Conversely, among individuals who engage in a moderate level of drinking, prior findings showed that a heavy episodic drinking pattern did increase mortality risk compared with a regular drinking pattern. Correspondingly, a high compared with a moderate drinking level increased mortality risk among individuals maintaining a regular drinking pattern, but not among individuals engaging in a heavy episodic drinking pattern, whose pattern of consumption had already placed them at risk. Conclusions: Findings highlight that low-risk drinking requires that older adults drink low to moderate average levels of alcohol and avoid heavy episodic drinking. Heavy episodic drinking is frequent among late-middle-aged and older adults and needs to be addressed along with average consumption in understanding the health risks of late-life drinkers. PMID:26098030

  9. Twenty-year survey of the epidemiology of hepatitis B in Denmark: effect of immigration

    DEFF Research Database (Denmark)

    Gjørup, I E; Smith, E; Borgwardt, L

    2003-01-01

    Implementation of hepatitis B virus (HBV) vaccination is being considered in Denmark. Therefore, a 20 y survey on the epidemiology of HBV infection was performed. All notified cases of acute HBV infection in Denmark from 1982 to 2002 were reviewed retrospectively and all available data from 1970...... to 2001 on the prevalence of hepatitis B surface antigen (HBsAg) in different groups of the Danish population were studied. The notified annual incidence of acute HBV infection has declined from more than 200 cases to fewer than 50 cases in 2001. In the indigenous population there has been a similar...

  10. Iowa Gambling Task (IGT: Twenty Years After - Gambling Disorder and IGT

    Directory of Open Access Journals (Sweden)

    Damien eBrevers

    2013-09-01

    Full Text Available The Iowa Gambling Task (IGT involves probabilistic learning via monetary rewards and punishments, where advantageous task performance requires subjects to forego potential large immediate rewards for small longer-term rewards to avoid larger losses. Pathological gamblers perform worse on the IGT compared to controls, relating to their persistent preference toward high, immediate and uncertain rewards despite experiencing larger losses. In this contribution, we review studies that investigated processes associated with poor IGT performance in pathological gamblers. Findings from these studies seem to fit with recent neurocognitive models of addiction, which argue that the diminished ability of addicted individuals to ponder short-term against long-term consequences of a choice may be the product of an hyperactive automatic attentional and memory system for signaling the presence of addiction-related cues (e.g., high uncertain rewards associated with disadvantageous decks selection during the IGT and for attributing to such cues pleasure and excitement. This incentive-salience associated with gambling-related choice in pathological gamblers may be so high that it could literally hijack resources (hot executive functions involved in emotional self-regulation and necessary to allow the enactment of further elaborate decontextualized problem-solving abilities (cool executive functions. A framework for future research is also proposed, which highlights the need for studies examining how these processes contribute specifically to the aberrant choice profile displayed by pathological gamblers on the IGT.

  11. Genetic diversity and evolution of human metapneumovirus fusion protein over twenty years

    Directory of Open Access Journals (Sweden)

    Liem Alexis

    2009-09-01

    Full Text Available Abstract Background Human metapneumovirus (HMPV is an important cause of acute respiratory illness in children. We examined the diversity and molecular evolution of HMPV using 85 full-length F (fusion gene sequences collected over a 20-year period. Results The F gene sequences fell into two major groups, each with two subgroups, which exhibited a mean of 96% identity by predicted amino acid sequences. Amino acid identity within and between subgroups was higher than nucleotide identity, suggesting structural or functional constraints on F protein diversity. There was minimal progressive drift over time, and the genetic lineages were stable over the 20-year period. Several canonical amino acid differences discriminated between major subgroups, and polymorphic variations tended to cluster in discrete regions. The estimated rate of mutation was 7.12 × 10-4 substitutions/site/year and the estimated time to most recent common HMPV ancestor was 97 years (95% likelihood range 66-194 years. Analysis suggested that HMPV diverged from avian metapneumovirus type C (AMPV-C 269 years ago (95% likelihood range 106-382 years. Conclusion HMPV F protein remains conserved over decades. HMPV appears to have diverged from AMPV-C fairly recently.

  12. Twenty years of psychoneuroimmunology and viral infections in Brain, Behavior, and Immunity.

    Science.gov (United States)

    Bonneau, Robert H; Padgett, David A; Sheridan, John F

    2007-03-01

    For 20 years, Brain, Behavior, and Immunity has provided an important venue for the publication of studies in psychoneuroimmunology. During this time period, psychoneuroimmunology has matured into an important multidisciplinary science that has contributed significantly to our knowledge of mind, brain, and body interactions. This review will not only focus on the primary research papers dealing with psychoneuroimmunology, viral infections, and anti-viral vaccine responses in humans and animal models that have appeared on the pages of Brain, Behavior, and Immunity during the past 20 years, but will also outline a variety of strategies that could be used for expanding our understanding of the neuroimmune-viral pathogen relationship.

  13. [Military physician Colonel Robert Yout. Twenty years as a paratrooper medical officer].

    Science.gov (United States)

    Yout, Guillaume

    2014-01-01

    Robert Yout was born on June 15th, 1930. A rugby player and a member of the French Volleyball team, he was already an outstanding sportsman when he began his studies at the Health Services School in Lyons. His career as an army medical officer among the paratroopers was atypical. He spent many years among the most prestigious elite paratroopers of the French army: the 2nd REP, the 1st CHOC and the CINC (The Army Training School for Combat Swimmers) . When he retired, he was Head Doctor of the Paratroopers parent company: The Airborne School of Pau. For the army medical historian, Robert Yout is the perfect example of a man with an outstanding and remarkable career: A crack soldier, a brave army medical officer, a parachuting and diving pioneer and a sportsman of international class.

  14. Dilemmas of the institutionalization of social policies in twenty years of the Brazilian Constitution of 1988.

    Science.gov (United States)

    Lobato, Lenaura de Vasconcelos Costa

    2009-01-01

    The objective is to discuss and analyze some elements of the process of institutionalization of social policies in Brazil after the Constitution of 1988, especially those of social welfare (social security, health and social assistance). It is assumed that this process present hybrids that compromise the results prescribed by the Constitution. From one hand, there are important advances in political and organizational apparatus and in the concept of the social question (treated here through three elements: constitutionalization, scope and expansion). Moreover, obstacles remain, particularly in universalization, financing and quality of services, which are contradictory to the advances achieved. The permanence of these hybrids prevents the fairness and citizenship aimed by the 1988 Constitution.

  15. Epidemiology and risk factors of community-onset urinary tract infection caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in a medical center in Taiwan: a prospective cohort study.

    Science.gov (United States)

    Kung, Che-Hsuan; Ku, Wen-Wei; Lee, Chi-Hung; Fung, Chang-Phone; Kuo, Shu-Chen; Chen, Te-Li; Lee, Yi-Tzu

    2015-04-01

    Extended-spectrum β-lactamase (ESBL)-producing pathogens have been increasingly identified in community-onset urinary tract infection (UTI). This study was conducted to determine the epidemiology and risk factors of community-onset UTI caused by ESBL-producing pathogens, and to determine the correlation of antimicrobial resistance with ESBL detected by phenotypic and genotypic methods. The study was conducted from December 2010 to January 2012. Patients with community-onset UTI caused by Enterobacteriaceae were enrolled from the emergency department. The production of ESBL was determined by the phenotypic method (using the combined disk test) or by the genotypic method (using polymerase chain reaction detection). The patients' medical records were reviewed and risk factors were analyzed by multivariate analysis. A total of 376 patients were enrolled and 393 isolates from urine culture were analyzed. Escherichia coli was the most commonly isolated species (259/393 isolates; 65.9%), followed by Klebsiella pneumoniae (42/393 isolates; 10.7%). Fifty-three (13.5%) isolates were phenotypically positive for ESBL production. Nine (2.3%) isolates were phenotypically positive for both ESBL and AmpC β-lactamase (AmpC) production. Nasogastric tube placement [odds ratio (OR) 2.230; 95% confidence interval (CI) 1.244-3.997; p = 0.007] and hospitalization within the previous 3 months (OR 2.567, 95% CI 1.448-4.551, p = 0.001) were independently associated with the acquisition of ESBL-producing pathogens in community-onset UTI. The ESBL phenotype had a better correlation with resistance to third-generation cephalosporins, compared to the ESBL-positive genotype. In our study, nasogastric tube placement and hospitalization within the previous 3 months were significantly associated with the acquisition of ESBL-producing pathogens in community-onset UTI. Copyright © 2013. Published by Elsevier B.V.

  16. Prospective ergonomics: origin, goal, and prospects.

    Science.gov (United States)

    Robert, Jean-Marc; Brangier, Eric

    2012-01-01

    So far ergonomics has been concerned with two categories of activities: correction and design. We propose to add a third category: prospection, and by so doing, we introduce a new series of activities that opens up the future of ergonomics. Corrective ergonomics relates to the past and comes with a demand and a client. It is turned towards the correction of existing situations and aims to reduce or eliminate problems. Here, after delimiting and defining the problem, the challenge is to find the best solution. Ergonomics for design relates to the present and also comes with a demand and a client. It is turned towards the design of new artefacts that have already been identified by a client, and that will allow users to do some activity and attain their goals. Here, after defining the scope of the project and the functional requirements, the challenge is to do the best design. Finally, prospective ergonomics relates to the future and does not come with a demand and a client. It is turned towards the creation of future things that have not been identified yet. Here the challenge is to detect existing user needs or anticipate future ones, and imagine solutions. These three categories of activities overlap and are not exclusive of each other. In this paper we define prospective ergonomics and compare it with corrective ergonomics and ergonomics for design. We describe its origin, goal, and prospects, we analyze its impacts on education and practice, and we emphasize the need of new collaboration between ergonomics and other disciplines.

  17. Problems, Prospects And Challenges.

    African Journals Online (AJOL)

    Urban Road Transportation in Nigeria From 1960 To 2006: Problems, Prospects And Challenges. ... Ethiopian Journal of Environmental Studies and Management ... The paper suggested the construction of more motor-able roads within cities ...

  18. Prospective Analysis of College Dragon and Lion Dance Sports into Community Sports in Jiangsu%江苏高校龙狮运动进入社区体育的前景探析

    Institute of Scientific and Technical Information of China (English)

    何金

    2014-01-01

    Dragon and lion dance movement has a long history and a broad mass base , with a strong fitness , orna-mental, recreational and athletic.Community Sports is an important part of China ’s sports undertakings, directly related to the accounting for the vast majority of the country ’ s population of adult physical and mental health , physical fitness and well -being of living index .The accelerated college dragon and lion dance sports develop-ment, we must accelerate the process of socialization , dragon and lion dance movement into the community .Sur-vey shows that dragon and lion dance sports community sports in Jiangsu province little figure , from the point of view of universal health situation and existing problems of urban community sports analysis , discusses the universi-ty dragon and lion dance sports and community sports necessary and feasible .That both can learn from each other , complementary advantages , to achieve a “win-win”situation, and the organic integration of new ideas for college dragon and lion dance sports and community sports .%龙狮运动有着悠久的历史渊源和广泛的群众基础,具有较强的健身性、观赏性、娱乐性和竞技性。社区体育是我国体育事业的重要组成部分,直接关系到占全国人口绝大多数成年人的身心健康、体格健美与幸福生活指数。加速高校龙狮运动发展就必须加速其社会化进程,让龙狮运动进入社区。调查显示,江苏省社区体育中鲜有龙狮运动的身影,本文从普及全民健身的角度,对我国城市社区体育的现状及存在的问题进行分析,论述了高校龙狮运动与社区体育互动发展是必要可行的。认为二者能够取长补短、优势互补,实现“双赢”局面,并提出了将高校龙狮运动与社区体育有机结合的新思路。

  19. Vinte anos de avaliação da educação básica no Brasil: aprendizagens e desafios Veinte años de la evaluación de la educación básica en Brasil: aprendizajes y desafíos Twenty years of the evaluation of the basic education in Brazil: learnings and challenges

    Directory of Open Access Journals (Sweden)

    Maria Inês de Matos Coelho

    2008-06-01

    scientific construction of factors like quality, efficiency, equity and productivity. It considers the trajectory along twenty years which has built the Saeb-Evaluation System of the Basic Education established since the late nineties. Using the bibliographical reviews and the state of the art studies in this area, the research analyzes Saeb's focus and improvements. We argued that this evaluation politics has been developed as part of the new regulation and competitive administration politics in the context of the Evaluator State. Finally, we suggest topics as the reflection on conditions and change possibilities.

  20. Prospect theory for online financial trading.

    Directory of Open Access Journals (Sweden)

    Yang-Yu Liu

    Full Text Available Prospect theory is widely viewed as the best available descriptive model of how people evaluate risk in experimental settings. According to prospect theory, people are typically risk-averse with respect to gains and risk-seeking with respect to losses, known as the "reflection effect". People are much more sensitive to losses than to gains of the same magnitude, a phenomenon called "loss aversion". Despite of the fact that prospect theory has been well developed in behavioral economics at the theoretical level, there exist very few large-scale empirical studies and most of the previous studies have been undertaken with micro-panel data. Here we analyze over 28.5 million trades made by 81.3 thousand traders of an online financial trading community over 28 months, aiming to explore the large-scale empirical aspect of prospect theory. By analyzing and comparing the behavior of winning and losing trades and traders, we find clear evidence of the reflection effect and the loss aversion phenomenon, which are essential in prospect theory. This work hence demonstrates an unprecedented large-scale empirical evidence of prospect theory, which has immediate implication in financial trading, e.g., developing new trading strategies by minimizing the impact of the reflection effect and the loss aversion phenomenon. Moreover, we introduce three novel behavioral metrics to differentiate winning and losing traders based on their historical trading behavior. This offers us potential opportunities to augment online social trading where traders are allowed to watch and follow the trading activities of others, by predicting potential winners based on their historical trading behavior.

  1. Prospect theory for online financial trading.

    Science.gov (United States)

    Liu, Yang-Yu; Nacher, Jose C; Ochiai, Tomoshiro; Martino, Mauro; Altshuler, Yaniv

    2014-01-01

    Prospect theory is widely viewed as the best available descriptive model of how people evaluate risk in experimental settings. According to prospect theory, people are typically risk-averse with respect to gains and risk-seeking with respect to losses, known as the "reflection effect". People are much more sensitive to losses than to gains of the same magnitude, a phenomenon called "loss aversion". Despite of the fact that prospect theory has been well developed in behavioral economics at the theoretical level, there exist very few large-scale empirical studies and most of the previous studies have been undertaken with micro-panel data. Here we analyze over 28.5 million trades made by 81.3 thousand traders of an online financial trading community over 28 months, aiming to explore the large-scale empirical aspect of prospect theory. By analyzing and comparing the behavior of winning and losing trades and traders, we find clear evidence of the reflection effect and the loss aversion phenomenon, which are essential in prospect theory. This work hence demonstrates an unprecedented large-scale empirical evidence of prospect theory, which has immediate implication in financial trading, e.g., developing new trading strategies by minimizing the impact of the reflection effect and the loss aversion phenomenon. Moreover, we introduce three novel behavioral metrics to differentiate winning and losing traders based on their historical trading behavior. This offers us potential opportunities to augment online social trading where traders are allowed to watch and follow the trading activities of others, by predicting potential winners based on their historical trading behavior.

  2. Historical Review and Prospect of Development of Community Education in Chongqing%重庆市社区教育发展的历史回顾与展望﹡

    Institute of Scientific and Technical Information of China (English)

    余善云

    2014-01-01

    Community education in Chongqing has experienced a tortuous historical development process. Nowadays, the obvious contradiction appears between supply and demand, the development environment is miserable, the system construction is slow, and the resource integration is not enough. Therefore, we must establish the community education statue, update the concept of education development, strengthen the system construction and promote the teaching team’s capacities, and perfect the construction of course platform. We should facilitate community education rapid and healthy development based on people-oriented principle so as to meet the needs of learning city construction.%重庆市的社区教育经历了一个曲折的历史发展过程,在现阶段面临着供需矛盾突出、发展环境堪忧、体系建设迟缓、资源整合不足等问题。必须确立社区教育地位,更新教育发展观念;加强政策环境建设,完善发展体制机制;加强办学体系建设,提升办学队伍能力;加强平台课程建设,以人为本开展办学。以此促进社区教育快速、健康发展,适应学习型城市建设需要。

  3. Prevalence and correlates of treatment failure among Kenyan children hospitalised with severe community-acquired pneumonia: a prospective study of the clinical effectiveness of WHO pneumonia case management guidelines

    OpenAIRE

    Agweyu, Ambrose; Kibore, Minnie; Digolo, Lina; Kosgei, Caroline; Maina, Virginia; Mugane, Samson; Muma, Sarah; Wachira, John; Waiyego, Mary; Maleche-Obimbo, Elizabeth

    2014-01-01

    Objective To determine the extent and pattern of treatment failure (TF) among children hospitalised with community-acquired pneumonia at a large tertiary hospital in Kenya. Methods We followed up children aged 2–59 months with WHO-defined severe pneumonia (SP) and very severe pneumonia (VSP) for up to 5 days for TF using two definitions: (i) documentation of pre-defined clinical signs resulting in change of treatment (ii) primary clinician's decision to change treatment with or without docume...

  4. The PROSPECT physics program

    Science.gov (United States)

    Ashenfelter, J.; Balantekin, A. B.; Band, H. R.; Barclay, G.; Bass, C. D.; Berish, D.; Bignell, L.; Bowden, N. S.; Bowes, A.; Brodsky, J. P.; Bryan, C. D.; Cherwinka, J. J.; Chu, R.; Classen, T.; Commeford, K.; Conant, A. J.; Davee, D.; Dean, D.; Deichert, G.; Diwan, M. V.; Dolinski, M. J.; Dolph, J.; DuVernois, M.; Erikson, A. S.; Febbraro, M. T.; Gaison, J. K.; Galindo-Uribarri, A.; Gilje, K.; Glenn, A.; Goddard, B. W.; Green, M.; Hackett, B. T.; Han, K.; Hans, S.; Heeger, K. M.; Heffron, B.; Insler, J.; Jaffe, D. E.; Jones, D.; Langford, T. J.; Littlejohn, B. R.; Martinez Caicedo, D. A.; Matta, J. T.; McKeown, R. D.; Mendenhall, M. P.; Mueller, P. E.; Mumm, H. P.; Napolitano, J.; Neilson, R.; Nikkel, J. A.; Norcini, D.; Pushin, D.; Qian, X.; Romero, E.; Rosero, R.; Seilhan, B. S.; Sharma, R.; Sheets, S.; Surukuchi, P. T.; Trinh, C.; Varner, R. L.; Viren, B.; Wang, W.; White, B.; White, C.; Wilhelmi, J.; Williams, C.; Wise, T.; Yao, H.; Yeh, M.; Yen, Y.-R.; Zangakis, G. Z.; Zhang, C.; Zhang, X.; PROSPECT Collaboration

    2016-11-01

    The precision reactor oscillation and spectrum experiment, PROSPECT, is designed to make a precise measurement of the antineutrino spectrum from a highly-enriched uranium reactor and probe eV-scale sterile neutrinos by searching for neutrino oscillations over a distance of several meters. PROSPECT is conceived as a 2-phase experiment utilizing segmented 6Li-doped liquid scintillator detectors for both efficient detection of reactor antineutrinos through the inverse beta decay reaction and excellent background discrimination. PROSPECT Phase I consists of a movable 3 ton antineutrino detector at distances of 7-12 m from the reactor core. It will probe the best-fit point of the {ν }e disappearance experiments at 4σ in 1 year and the favored region of the sterile neutrino parameter space at \\gt 3σ in 3 years. With a second antineutrino detector at 15-19 m from the reactor, Phase II of PROSPECT can probe the entire allowed parameter space below 10 eV2 at 5σ in 3 additional years. The measurement of the reactor antineutrino spectrum and the search for short-baseline oscillations with PROSPECT will test the origin of the spectral deviations observed in recent {θ }13 experiments, search for sterile neutrinos, and conclusively address the hypothesis of sterile neutrinos as an explanation of the reactor anomaly.

  5. Nursing care community health

    Directory of Open Access Journals (Sweden)

    Diana Acosta-Salazar

    2016-07-01

    Full Text Available Process Nursing Care (PAE is a systematic tool that facilitates the scientificity of care in community practice nurse, the application of scientific method in community practice, allows nursing to provide care in logical, systematic and comprehensive reassessing interventions to achieve the proposed results. It began with the valuation of Marjory Gordon Functional Patterns and then at the stage of diagnosis and planning North American Nursing Diagnosis Association (NANDA, Nursing Interventions Classification (NIC and Nursing Outcomes Classification (NOC is interrelate. It is a descriptive and prospective study. Diagnosis was made by applying the instruments measuring scale of the socio-demographic characteristics, symptom questionnaire for early detection of mental disorders in the community and appreciation for functional patterns. The PAE includes more frequent diagnoses, criteria outcomes, indicators, interventions and activities to manage community issues. alteration was evidenced in patterns: Adaptation and Stress Tolerance, Self-perception-Self-concept-, Role-Relationships, sleep and rest and Perception and Health Management. A standardized NANDA-NIC-NOC can provide inter care holistic care from the perspective of community mental health with a degree of scientific nature that frames the professional work projecting the individual, family and community care.

  6. Four Years Prospective Study of Natural History of Atopic Dermatitis Aged 7~8 Years at an Individual Level: A Community-Based Survey by Dermatologists' Skin Examination in Childhood

    Science.gov (United States)

    Kim, Young Jee; Yun, Sook Jung; Lee, Jee-Bum; Kim, Seong Jin; Won, Young Ho

    2016-01-01

    Background The age-dependent change in atopic dermatitis (AD) at an individual level has mostly performed in a hospital-setting. Objective We evaluated the age-dependent change of AD symptoms at an individual level in a community-setting. Methods For the diagnostic accuracy, all participants of schoolchildren were received skin examination by dermatologists (twice a year for the same group), instead of questionnaire-based surveys. For this study, sequential check-ups of 273 elementary school children, aged 7~8 years, were performed for 4 years up to the age of 10~11 years. Results Among the 47 AD children, who had been diagnosed as having AD at the first-year check-up, spontaneous remission was detected in nine children during the follow-up periods (remission rate of 19.1%). As a consequence, the one-year AD prevalence was decreased by 5.9% in the elementary schoolchildren over four years. Unexpectedly, late onset (after 8 years of age) AD was observed in 21.7% of AD children. There was no statistically significant relationship between spontaneous remission and host factors including sex and family history of atopic diseases. Conclusion We observed that 19.1% of AD children in the age group of 7~11 years showed spontaneous remission based on skin examination by dermatologists. There might be an increase in the prevalence of late onset AD in Korea. PMID:27904266

  7. Prospects in MPGDs development for neutron detection

    CERN Document Server

    Croci, Gabriele; Resnati, Filippo

    2016-01-01

    The aim of this document is to summarise the discussion and the contributions from the 2nd Academia-Industry Matching Event on Detecting Neutrons with MPGDs which took place at CERN on the 16th and the 17th of March 2015. These events provide a platform for discussing the prospects of Micro-Pattern Gaseous Detectors (MPGDs) for thermal and fast neutron detection, commercial constraints and possible solutions. The aim is to foster the collaboration between the particle physics community, the neutron detector users, instrument scientists and fabricants.

  8. The Hannibal Community Survey; A Case Study in a Community Development Technique.

    Science.gov (United States)

    Croll, John A.

    Disturbed by the community's negative attitude toward its prospects for progress, the Hannibal (Missouri) Chamber of Commerce initiated a community self-survey to improve the situation. The questionnaire survey concentrated on felt needs relationg to city government, retail facilities and services, recreation, religion, education, industrial…

  9. Adult bacteremic pneumococcal pneumonia acquired in the community: A prospective study on 101 patients Neumonía neumocóccica bacteriémica de la comunidad: Un estudio prospectivo en 101 pacientes

    Directory of Open Access Journals (Sweden)

    J. H. Gentile

    2003-01-01

    Full Text Available Our objective was to describe incidence, clinical, radiographic and microbiological features of bacteremic pneumococcal pneumonia (BPP in our environment. A total of 101 patients (7 were treated as outpatients, older than 18 years of age suffering BPP were prospectively evaluated. The incidence was 2.8 cases per 1000 admissions, 50 were males, mean age was 59.9 years (19-97, mortality was 11.8%. Eighty three percent of fatalities occurred within 3 days of admission. Mortality rate increased with advancing age. Fever, cough and chest pain were the commonest presenting symptoms and 44% of patients had extrapulmonary manifestations. Cigarette smoking, chronic obstructive lung disease, alcoholism and congestive heart failure (CHF were the commonest underlying conditions. CHF was more frequent in non-survivors (p = 0.002. A lobar pattern at chest radiograph predominated in survivors and a diffuse pattern in non-survivors (p = 0.007. Pleural effusion (20.7%, empyema (7.9% and respiratory failure (7.9% were the main complications. Underlying diseases were present in 100% of non-survivors (p = 0.03. Ninety four percent of patients were treated with beta-lactam antibiotics. Streptococcus pneumoniae was isolated from sputum in 6 cases. Three out of 101 S. pneumoniae isolates recovered from blood samples (one from each patient presented organisms resistant to penicillin. We observed an incidence of BPP that is similar to the observed in other countries. There are clinical and radiographic differences between survivors and non-survivors. Penicillin-resistant S. pneumoniae is still an unusual problem in our area.Se evaluaron en forma prospectiva 101 pacientes > 18 años admitidos al hospital con diagnóstico de NNB. El objetivo fue conocer la incidencia y describir las características de la enfermedad, así como la susceptibilidad antibiótica de cepas invasivas de Streptococcus pneumoniae. Se halló una incidencia de 2.8 casos/1000 admisiones; 50 fueron

  10. Prevalence and correlates of treatment failure among Kenyan children hospitalised with severe community-acquired pneumonia: a prospective study of the clinical effectiveness of WHO pneumonia case management guidelines.

    Science.gov (United States)

    Agweyu, Ambrose; Kibore, Minnie; Digolo, Lina; Kosgei, Caroline; Maina, Virginia; Mugane, Samson; Muma, Sarah; Wachira, John; Waiyego, Mary; Maleche-Obimbo, Elizabeth

    2014-11-01

    To determine the extent and pattern of treatment failure (TF) among children hospitalised with community-acquired pneumonia at a large tertiary hospital in Kenya. We followed up children aged 2-59 months with WHO-defined severe pneumonia (SP) and very severe pneumonia (VSP) for up to 5 days for TF using two definitions: (i) documentation of pre-defined clinical signs resulting in change of treatment (ii) primary clinician's decision to change treatment with or without documentation of the same pre-defined clinical signs. We enrolled 385 children. The risk of TF varied between 1.8% (95% CI 0.4-5.1) and 12.4% (95% CI 7.9-18.4) for SP and 21.4% (95% CI 15.9-27) and 39.3% (95% CI 32.5-46.4) for VSP depending on the definition applied. Higher rates were associated with early changes in therapy by clinician in the absence of an obvious clinical rationale. Non-adherence to treatment guidelines was observed for 70/169 (41.4%) and 67/201 (33.3%) of children with SP and VSP, respectively. Among children with SP, adherence to treatment guidelines was associated with the presence of wheeze on initial assessment (P = 0.02), while clinician non-adherence to guideline-recommended treatments for VSP tended to occur in children with altered consciousness (P definitions of TF and appropriate studies of treatment effectiveness of alternative regimens are required. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

  11. Soap production: A green prospective.

    Science.gov (United States)

    Félix, Sandra; Araújo, Joana; Pires, Ana Maria; Sousa, Ana Cláudia

    2017-08-01

    A green prospective based on the reuse of waste materials such as almond shells, orange peel and used cooking oil to manufacture soap is presented. In Portugal, thousands of tons of waste are generated from used cooking oil and production of nut shells' residues is growing every year. In addition, the high consumption of citrus fruits, oranges in particular, generates large amounts of citrus peel. Therefore, it is necessary to diversify reuse mechanisms of these wastes, in order to make them back into raw materials. Complying with this trend, this work was carried out by processing and grinding almond shells, treating used oil, processing orange peels and extracting limonene, formulating and producing soap, and performing an acceptance study of the final product. Results validated a high potential of the idea in the field of environmental education, so it can be replicated in practical classes. It can also be useful for waste management, and it can support the development of community projects on an ecological approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. a prospective study

    OpenAIRE

    Rörster, Elisa geb. Pätel

    2012-01-01

    Bulk fractures only occur on very rare occasions in bilayered all-ceramic crowns, where as veneer fractures, above all chippings, still present a frequent amount of clinical complications. The purpose of the current prospective study was to examine the clinical performance of an anatomically modified framework for a period of two years. All crowns were manufactured following the Cercon process (DeguDent GmbH, Hanau). As is common practice, the frameworks for the control group were made of ...

  13. Bright Economic Prospects

    Institute of Scientific and Technical Information of China (English)

    Zhang Minqiu

    2004-01-01

    @@ India is expected to register an 8.2% growth rate for the 2003-04 fiscal year. The overall economic situation this year has been satisfactory despite the scaled down 6-6.5% growth rate for the new fiscal year due to oil price hikes, reduced monsoon volume and some 7% inflation. Judging from the following factors, bright prospects are in store for the country down the road.

  14. Prospecting for lunar resources

    Science.gov (United States)

    Taylor, G.; Martel, L.

    Large space settlements on the Moon (thousands of people) will require use of indigenous resources to build and maintain the infrastructure and generate products for export. Prospecting for these resources is a crucial step in human migration to space and needs to begin before settlement and the establishment of industrial complexes. We are devising a multi-faceted approach to prospect for resources. A central part of this work is developing the methodology for prospecting the Moon and other planetary bodies. This involves a number of investigations: (1) It is essential to analyze the economics of planetary ore deposits. Ore deposits are planetary materials that we can mine, process, and deliver to customers at a profit. The planetary context tosses in some interesting twists to this definition. (2) We are also making a comprehensive theoretical assessment of potential lunar ore deposits. Our understanding of the compositions, geological histories, and geological processes on the Moon will lead to significant differences in how we assess wh a t types of ores could be present. For example, the bone-dry nature of the Moon (except at the poles) eliminates all ore deposits associated with hydrothermal fluids. (3) We intend to search for resources using existing data for the Moon. Thus, prospecting can begin immediately. We have a wealth of remote sensing data for the Moon. We also have a good sampling of the Moon by the Apollo and Luna missions, and from lunar meteorites. We can target specific types of deposits already identified (e.g. lunar pyroclastic deposits) and look for other geological settings that might have produced ores and other materials of economic value. Another approach we will take is to examine all data available to look for anomalies. Examples are unusual spectral properties, large disagreements between independent techniques that measure the same property, unusual elemental ratios, or simply exceptional properties such as elemental abundances much

  15. Prevalence and correlates of treatment failure among Kenyan children hospitalised with severe community-acquired pneumonia: a prospective study of the clinical effectiveness of WHO pneumonia case management guidelines

    Science.gov (United States)

    Agweyu, Ambrose; Kibore, Minnie; Digolo, Lina; Kosgei, Caroline; Maina, Virginia; Mugane, Samson; Muma, Sarah; Wachira, John; Waiyego, Mary; Maleche-Obimbo, Elizabeth

    2014-01-01

    Objective To determine the extent and pattern of treatment failure (TF) among children hospitalised with community-acquired pneumonia at a large tertiary hospital in Kenya. Methods We followed up children aged 2–59 months with WHO-defined severe pneumonia (SP) and very severe pneumonia (VSP) for up to 5 days for TF using two definitions: (i) documentation of pre-defined clinical signs resulting in change of treatment (ii) primary clinician's decision to change treatment with or without documentation of the same pre-defined clinical signs. Results We enrolled 385 children. The risk of TF varied between 1.8% (95% CI 0.4–5.1) and 12.4% (95% CI 7.9–18.4) for SP and 21.4% (95% CI 15.9–27) and 39.3% (95% CI 32.5–46.4) for VSP depending on the definition applied. Higher rates were associated with early changes in therapy by clinician in the absence of an obvious clinical rationale. Non-adherence to treatment guidelines was observed for 70/169 (41.4%) and 67/201 (33.3%) of children with SP and VSP, respectively. Among children with SP, adherence to treatment guidelines was associated with the presence of wheeze on initial assessment (P = 0.02), while clinician non-adherence to guideline-recommended treatments for VSP tended to occur in children with altered consciousness (P definiciones: (a) documentación de signos clínicos pre-definidos que resultaron en un cambio de tratamiento (b) decisión del clínico principal de cambiar el tratamiento con o sin documentación de los mismos signos clínicos pre-definidos. Resultados Incluimos a 385 niños. El riesgo de FT varió entre un 1.8% (IC 95% 0.4 a 5.1) y 12.4% (IC 95% 7.9 a 18.4) para NS y 21.4% (IC 95% 15.9 a 27) y 39.3% (IC 95% 32.5 a 46.4) para NMS dependiendo de la definición que se aplicase. Unas mayores tasas estaban asociadas con cambios tempranos en la terapia por el clínico y en ausencia de un razonamiento clínico obvio. Se observaba una no adherencia a las guías de tratamiento en 70/169 (41

  16. Community psykologi

    DEFF Research Database (Denmark)

    Berliner, Peter

    2016-01-01

    Kapitlet giver en intriduktion til community psykologien ud fra teori og ud fra forfatterens egen forskning......Kapitlet giver en intriduktion til community psykologien ud fra teori og ud fra forfatterens egen forskning...

  17. Brand Community.

    OpenAIRE

    Muniz, Albert M, Jr; O'Guinn, Thomas C

    2001-01-01

    This article introduces the idea of brand community. A brand community is a specialized, non-geographically bound community, based on a structured set of social relations among admirers of a brand. Grounded in both classic and contemporary sociology and consumer behavior, this article uses ethnographic and computer mediated environment data to explore the characteristics, processes, and particularities of three brand communities (those centered on Ford Bronco, Macintosh, and Saab). These bran...

  18. Population behaviors and language maintenance--a case of the Korean-speaking community in China.

    Science.gov (United States)

    Zhou, Qingsheng

    2004-01-01

    With the regard to language maintenance, one of the most successful in over fifty of ethno-linguistic communities in China is the Korean community with more than two millions of Korean-speakers, in which there have been Regulations Regarding the Ethnic Language Use, and a maintenance-orientated and bilingual education system. However, language attrition comes to be occurring in the Korean community because more than two hundred thousands of Korean-speaking migrants have streamed from the Korean-rural community to the Chinese-urban community for the last twenty years. This paper, in urban-anthropological and sociolinguistic perspectives, is aiming at an analysis of the cause of population moves and the urbanization process of the Korean community as well as their impact on the language maintenance and bilingual education in the Korean community. It is mainly divided into four sections, namely, (1) the situation of Korean-speaking community; (2) the problem of language maintenance; (3) the impact of Korean-speakers moves on language maintenance; (4) the impact of negative growth of population, and (5) the impact of uneven ratio of female population.

  19. 76 FR 74121 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical...

    Science.gov (United States)

    2011-11-30

    ... Community Hospital E/M Evaluation and Management EHR Electronic Health Record ESRD End-Stage Renal Disease... Business Administration SCH Sole Community Hospital SDP Single Drug Pricer SI Status Indicator TEP... Services 42 CFR Parts 410, 411, 416 et al. Medicare and Medicaid Programs: Hospital Outpatient Prospective...

  20. Applied Astronomy: Asteroid Prospecting

    Science.gov (United States)

    Elvis, M.

    2013-09-01

    In the age of asteroid mining the ability to find promising ore-bearing bodies will be valuable. This will give rise to a new discipline- "Applied Astronomy". Just as most geologists work in industry, not in academia, the same will be true of astronomers. Just how rare or common ore-rich asteroids are likely to be, and the skills needed to assay their value, are discussed here, with an emphasis on remote - telescopic - methods. Also considered are the resources needed to conduct extensive surveys of asteroids for prospecting purposes, and the cost and timescale involved. The longer-term need for applied astronomers is also covered.

  1. Astronautics summary and prospects

    CERN Document Server

    Kiselev, Anatoly Ivanovich; Menshikov, Valery Alexandrovich

    2003-01-01

    The monograph by A.I.Kiselev, A.A. Medvedev and Y.A.Menshikov, Astronautics: Summary and Prospects, aroused enthusiasm both among experts and the public at large. This is due to the felicitous choice of presentation that combines a simple description of complex space matters with scientificsubstantiation of the sub­ jectmatter described. The wealth of color photos makes the book still more attractive, and it was nominated for an award at the 14th International Moscow Book Fair, being singled out as the "best publication of the book fair". The book's popularity led to a second edition, substantially revised and enlarged. Since the first edition did not sufficiently cover the issues of space impact on ecology and the prospective development of space systems, the authors revised the entire volume, including in it the chapter "Space activity and ecology" and the section "Multi-function space systems". Using the federal monitoring system, now in the phase of system engi­ neering, as an example, the authors consi...

  2. A prospective, randomized comparison of an in-line heat moisture exchange filter and heated wire humidifiers: rates of ventilator-associated early-onset (community-acquired) or late-onset (hospital-acquired) pneumonia and incidence of endotracheal tube occlusion.

    Science.gov (United States)

    Kirton, O C; DeHaven, B; Morgan, J; Morejon, O; Civetta, J

    1997-10-01

    To compare the performance of an in-line heat moisture exchanging filter (HMEF) (Pall BB-100; Pall Corporation; East Hills, NY) to a conventional heated wire humidifier (H-wH) (Marquest Medical Products Inc., Englewood, Colo) in the mechanical ventilator circuit on the incidence of ventilator-associated pneumonia (VAP) and the rate of endotracheal tube occlusion. This report describes a prospective, randomized trial of 280 consecutive trauma patients in a 20-bed trauma ICU (TICU). All intubated patients not ventilated elsewhere in the medical center prior to their TICU admission were randomized to either an in-line HMEF or a H-wH in the breathing circuit. Ventilator circuits were changed routinely every 7 days, and closed system suction catheters were changed every 3 days. HMEFs were changed every 24 h, or more frequently if necessary. A specific endotracheal tube suction and lavage protocol was not employed. Patients were dropped from the HMEF group if the filter was changed more than three times a day or the patient was placed on a regimen of ultra high-frequency ventilation. The Centers for Disease Control and Prevention (CDC) criteria for diagnosis of pneumonia were used; early-onset, community-acquired pneumonia was defined if CDC criteria were met in 3 days. Laboratory and chest radiograph interpretation were blinded. The patient ages ranged from 15 to 95 years in the HMEF group and 16 to 87 years in the H-wH group (p=not significant), with a mean age of 46 years and 48 years, respectively. The male to female ratio ranged between 78 to 82%/22 to 18%, respectively, and 55% of all admissions were related to blunt trauma, 40% secondary to penetrating trauma, and 5% to major burns. There was no difference in Injury Severity Score (ISS) between the two groups. Moreover, there was no significant difference in mean ISS among those who did not develop pneumonia and those patients who developed either early-onset, community-acquired or late-onset, hospital

  3. Traditions and Management Perspectives of Community and Non-Profit Organizations in Lithuania

    Directory of Open Access Journals (Sweden)

    Andrius Stasiukynas

    2015-02-01

    Full Text Available Purpose – To overview the traditions and management perspectives of community and non-profit organizations in Lithuania.Methodology – For the purpose of this research a literature analysis on community and non-profit organization case studies was conducted. The case studies describing stories of success were singled out and leaders of these organizations were interviewed.Findings – The research has showed the growth of the number of community and nonprofit organizations during the last twenty years and the difficulties of collecting the statistical data. This study presupposes the possibility to identify the tendencies of management in community and non-profit organizations, including the following: increasing use of the social networks for communication; proliferation of strategic planning; greater emphasis on educating and empowering new generation of leaders.Research implications – Prior studies in this area in Lithuania have not exhaustively analyzed the components of human resource management of non-profit organizations. An important follow up on this study would be to analyze the human resource management in community organizations.Practical implications – This study covered the management aspects important for the improvement of how community and non-profit organizations work.Originality/Value – This study expands the knowledge on Lithuanian community and non-profit organization development and management.Research type – literature review, research paper.

  4. The interdisciplinary approach in community interpreting research

    OpenAIRE

    Vargas Urpi, Mireia

    2011-01-01

    Community interpreting is a complex activity that has been studied from many different angles. Based on a review of the literature, this paper aims to highlight the importance of an interdisciplinary approach in community interpreting research, as well as the close relationship between the theoretical and methodological frameworks that have been used to date. As a prospective study and by describing theories applied from five different fields (i.e. anthropology, sociology, applied linguistics...

  5. Claiming Community

    DEFF Research Database (Denmark)

    Jensen, Steffen Bo

    As its point of departure this working paper takes the multitude of different uses and meanings of the concept of community in local politics in Cape Town. Instead of attempting to define it in substantive terms, the paper takes a social constructivist approach to the study of community...... is termed community work. First, the paper explores how community has become a governmental strategy, employed by the apartheid regime as well, although in different ways, as post-apartheid local government. Secondly, the paper explores the ways in which community becomes the means in which local residents...... lay claim on the state, as well as how it enters into local power struggles between different political groups within the township. In the third part, the paper explores how the meanings of community and the struggles to realise it have changed as South Africa, nationally and locally, has become...

  6. Emergence of community-acquired Clostridium difficile infection: the experience of a French hospital and review of the literature

    Directory of Open Access Journals (Sweden)

    Maja Ogielska

    2015-08-01

    Conclusions: CDI can cause community-acquired diarrhoea, and CA-CDI may be more severe than HCA-CDI. Prospective studies of CDI involving people from the general community without risk factors are required to confirm this observation.

  7. Long-term research in Bosque Fray Jorge National Park: Twenty years studying the role of biotic and abiotic factors in a Chilean semiarid scrubland Investigación de largo plazo en el Parque Nacional Bosque Fray Jorge: Veinte años estudiando el rol de los factores bióticos y abióticos en un matorral chileno semiárido

    Directory of Open Access Journals (Sweden)

    JULIO R GUTIÉRREZ

    2010-03-01

    Full Text Available Since 1989, we have conducted a large-scale ecological experiment in semiarid thorn scrub of a national park in north-central Chile. Initially, we focused on the role of biotic interactions including predation, interspecific competition, and herbivory in small mammal and plant components of the community. We utilized a reductionist approach with replicated 0.56 ha fenced grids that selectively excluded vertebrate predators and/or larger small mammal herbivores such as the degu, Octodon degus. Although we detected small transitory effects of predator exclusions on degu survival and numbers, other species failed to show responses. Similarly, interspecific competition (i.e., degus with other small mammals had no detectable numerical effects (although some behavioral responses occurred, and degu-exclusions had relatively small effects on various plant components. Modeling approaches indicate that abiotic factors play a determining role in the dynamics of principal small mammal species such as O. degus and the leaf-eared mouse (Phyllotis darwini. In turn, these are mainly related to aperiodic pulses of higher rainfall (usually during El Niño events which trigger ephemeral plant growth; a food addition experiment in 1997-2000 verified the importance of precipitation as a determinant of food availability. Since 2004, we have expanded long-term monitoring efforts to other important community components including birds and insects in order to understand effects of abiotic factors on them; we report some of the first results of comprehensive surveys on the former in this region. Finally, we recently shifted focus to documenting effects of exotic lagomorphs in the park. We installed additional treatments selectively excluding small mammals, lagomorphs, or both, from replicated grids in order to evaluate putative herbivore impacts. In conjunction with increased annual rainfall since 2000, we predict that introduced lagomorphs will have increasing impacts

  8. Prospective memory on a novel clinical task in older adults with mild cognitive impairment and subjective cognitive decline

    OpenAIRE

    Rabin, Laura A.; Chi, Susan Y.; Wang, Cuiling; Fogel, Joshua; Kann, Sarah J.; Aronov, Avner

    2014-01-01

    Despite the relevance of prospective memory to everyday functioning and the ability to live independently, prospective memory tasks are rarely incorporated into clinical evaluations of older adults. We investigated the validity and clinical utility of a recently developed measure, the Royal Prince Alfred Prospective Memory Test (RPA-ProMem), in a demographically diverse, non-demented, community-dwelling sample of 257 older adults (mean age = 80.78 years, 67.7% female) with amnestic mild cogni...

  9. Biclique communities

    DEFF Research Database (Denmark)

    Jørgensen, Sune Lehmann; Hansen-Schwartz, Martin; Hansen, Lars Kai

    2008-01-01

    We present a method for detecting communities in bipartite networks. Based on an extension of the k-clique community detection algorithm, we demonstrate how modular structure in bipartite networks presents itself as overlapping bicliques. If bipartite information is available, the biclique...... community detection algorithm retains all of the advantages of the k-clique algorithm, but avoids discarding important structural information when performing a one-mode projection of the network. Further, the biclique community detection algorithm provides a level of flexibility by incorporating independent...

  10. Childhood Maltreatment and Prospectively Observed Quality of Early Care as Predictors of Antisocial Personality Disorder Features.

    Science.gov (United States)

    Shi, Zhenyu; Bureau, Jean-Francois; Easterbrooks, M Ann; Zhao, Xudong; Lyons-Ruth, Karlen

    2012-01-01

    Few studies have evaluated the separate contributions of maltreatment and ongoing quality of parent-child interaction to the etiology of antisocial personality features using a prospective longitudinal design. 120 low-income young adults (aged 18-23) were assessed for extent of ASPD features on the Structured Clinical Interview for Diagnosis-Axis II, for presence of maltreatment on the Conflict Tactics Scale, Traumatic Experiences Scale, and Adult Attachment Interview, and for referral in infancy to parent-infant clinical services. Fifty-six of these families had been studied longitudinally since the first year of life. In infancy, attachment disorganization and disrupted mother-infant interaction were assessed; in middle childhood, disorganized-controlling attachment behaviors were reliably rated. In kindergarten and second grade, behavior problems were assessed by teacher report. In cross-sectional analyses, maltreatment was significantly associated with ASPD features but did not account for the independent effect of early referral to parent-infant services on ASPD features. In longitudinal analyses, maternal withdrawal in infancy predicted the extent of ASPD features twenty years later, independently of childhood abuse. In middle childhood, disorganized attachment behavior and maladaptive behavior at school added to prediction of later ASPD features. Antisocial features in young adulthood have precursors in the minute-to-minute process of parent-child interaction beginning in infancy.

  11. Prospect Theory and Coercive Bargaining

    Science.gov (United States)

    Butler, Christopher K.

    2007-01-01

    Despite many applications of prospect theory's concepts to explain political and strategic phenomena, formal analyses of strategic problems using prospect theory are rare. Using Fearon's model of bargaining, Tversky and Kahneman's value function, and an existing probability weighting function, I construct a model that demonstrates the differences…

  12. The Digital Divide and Rural Community Colleges: Problems and Prospects.

    Science.gov (United States)

    Katsinas, Stephen G.; Moeck, Pat

    2002-01-01

    Discusses the seriousness of the digital divide-the discrepancy between technology-literate and -illiterate people-in rural areas in the United States. Reports that rural young, minority, and single-parent households lag behind the national average in both personal computer ownership and Internet access. Offers suggestions for ways rural community…

  13. The Iberian Peninsula in the Atlantic Community: Problems and Prospects.

    Science.gov (United States)

    1983-05-09

    national unity, under Fernando of Aragon and Isabel of Castille -- Los Reyes Catolicos (The Catholic Kings). Also in 1492, Spain launched its overseas...was then established in a political vacuum. From the elections of June 1931 for the Cortes Constituentes (Parliament), a coalition of liberal...initiative by presenting to the other Popular Front parties the following proposed legislation for submission to the Cortes (Parliament): Article 1. All

  14. [Community Nutrition].

    Science.gov (United States)

    Aranceta, Javier

    2004-06-01

    In the last 20 years, Public Health Nutrition focused mainly on the qualitative aspects which may influence the onset of chronic diseases, quality of life, physical and mental performance and life expectancy. This applied knowledge organised as part of preventive and health promotion programs led to the development of Community Nutrition. The aim of Community Nutrition actions is to adequate lifestyles related to food consumption patterns in order to improve the quality of life and contribute to health promotion of the population in the community where programs and services are delivered. Key functions to develop in a Community Nutrition Unit consist in the identification and assessment of nutrition problems in the community as well as the design, implementation and evaluation of intervention programs by means of appropriate strategies. These should aim at different populations groups and settings, such as work places, schools, high risk groups or the general public. Nowadays, Community Nutrition work efforts should focus on three main aspects: nutrition education in schools and in the community; food safety and food security and the development and reinforcement of food preparation skills across all age groups. Social catering services, either in schools, the work place or at the community level, need to ensure adequate nutritional supply, provide foods contributing to healthy eating practices as well as to enhance culinary traditions and social learning. Food safety and food security have become a top priority in Public Health. The concepts referes to the availability of food safe and adequate as well as in sufficient amount in order to satisfy nutrition requirements of all individuals in the community. Social changes along new scientific developments will introduce new demands in Community Nutrition work and individual dietary counselling will become a key strategy. In order to face new challenges, community nutrition pactitioners require a high quality

  15. Cosmic Humanity: Utopia, Realities, Prospects

    Directory of Open Access Journals (Sweden)

    Sergey Krichevsky

    2017-07-01

    Full Text Available The philosophical foundations of the theory and practice of the creation of cosmic humanity as a process of the evolution of human civilization, the emergence into space, with the prospect of resettlement outside the Earth are considered. There is a connection between myths, fantasies, ideas, concepts and projects aimed at the exploration of outer space, the creation of cosmic humanity. A new and voluminous definition of cosmic humanity in the evolutionary paradigm is given. Cosmic humanity is (essence and 4 stages of evolution: 1. Humanity living on Earth, sensing, knowing, understanding its cosmic origin, relationship with the cosmos and cosmic destiny. 2. Humanity living on Earth, leading aerospace activity for the purposes of exploration and use of aerospace space (Heaven, Space for survival and development. 3. Humanity living on Earth and outside the Earth — in the solar system, preserving the Earth and mastering the Cosmos for survival and development. 4. Humanity, settled and living in the Cosmos. Now humanity is in the process of transition from the second to the third stage. In the process of this evolution, a complex transformation of man and society takes place. The problem-semantic field of cosmic humanity is described and its general model is presented. The meta-goal-setting is the justification of cosmic humanity with the application of the anthropic principle and its “active” super (post anthropic supplement: “Cosmic humanity has an evolutionary purpose to actively manage evolution: change man, humanity and the universe.” The evolution of the “cosmic dream”, goals and technologies of space activities is formalized in the form of a conceptual model. Challenges and negative trends are considered in connection with the crisis of space activity, criticism and attempts to limit the flights of people into space. The prototype of cosmic humanity, its basis and acting model is the cosmonauts’ community. The main

  16. HUMAN RIGHTS AND PROSPECTS FOR APPLYING CHEMICAL CASTRATION IN RUSSIA

    Directory of Open Access Journals (Sweden)

    Suzanna Karoevna ABRAMYAN

    2014-01-01

    Full Text Available I The paper examined challenges related to applying chemical castration the Russian community has faced, and assessed the prospect for further implementation as well. The issue has triggered an ample debate in various circles as a new probable way to prevent sexual crime events. The authors inferred that chemical castration should be an option of a complex of measures for pre-venting relapse into pedophilia.

  17. Involving communities in community assessment.

    Science.gov (United States)

    Clark, Mary Jo; Cary, Susan; Diemert, Grover; Ceballos, Rose; Sifuentes, Maria; Atteberry, Irene; Vue, Fu; Trieu, Sandy

    2003-01-01

    Focus groups provide an effective means of incorporating the perspectives of "hidden" populations in assessments of community health needs and assets. A series of focus groups was conducted with specifically targeted segments of a community to develop a comprehensive picture of community health. The authors describe the focus group process, major findings, and the use of focus group results in a highly multicultural community. Despite differences in age, length of residence, and ethnicity, the focus groups were remarkably similar in the issues raised. The majority of participants viewed the multicultural nature of the community as an asset but voiced some of the difficulties of living in a multiethnic and multilanguage environment. Similar areas of concern in the community arose from all of the focus groups, including housing and other environmental issues and problems of access to health care. Focus group findings have been used to initiate activity addressing identified community problems. Focus group participation had the added benefit of increasing community members' participation in other community endeavors.

  18. Community History.

    Science.gov (United States)

    Lewis, Helen M.

    1997-01-01

    Recounts the experience of researching community history in Ivanhoe, Virginia, between 1987 and 1990. The Ivanhoe History Project involved community members in collecting photographs, memorabilia, and oral histories of their town. Subsequent published volumes won the W. D. Weatherford Award and inspired a quilt exhibit and a theatrical production.…

  19. Community Connections

    Science.gov (United States)

    Kemball, Mark

    2009-01-01

    This article discusses the results of a CASE survey, compiled in April 2009, which was sent to almost 2,800 members who had previously indicated that community relations were part of their professional responsibilities or interests. The survey suggests that the role and practice of community relations in a public institution is somewhat different…

  20. Community Ecology

    CERN Document Server

    1988-01-01

    This book presents the proceedings of a workshop on community ecology organized at Davis, in April, 1986, sponsored by the Sloan Foundation. There have been several recent symposia on community ecology (Strong et. al., 1984, Diamond and Case, 1987) which have covered a wide range of topics. The goal of the workshop at Davis was more narrow: to explore the role of scale in developing a theoretical approach to understanding communities. There are a number of aspects of scale that enter into attempts to understand ecological communities. One of the most basic is organizational scale. Should community ecology proceed by building up from population biology? This question and its ramifications are stressed throughout the book and explored in the first chapter by Simon Levin. Notions of scale have long been important in understanding physical systems. Thus, in understanding the interactions of organisms with their physical environment, questions of scale become paramount. These more physical questions illustrate the...

  1. Can Community Colleges Survive the PhD Glut?

    Science.gov (United States)

    Taylor, Anita

    The impact of the current employment situation on hiring faculty for community college teaching is examined. It is concluded that prospects for improving the quality of learning in community colleges are not particularly enhanced by the apparently growing surplus of new PhDs in our field. On the contrary, it is suggested that hiring PhDs for…

  2. Genetics and caries: prospects

    Directory of Open Access Journals (Sweden)

    Alexandre Rezende Vieira

    2012-01-01

    Full Text Available Caries remains the most prevalent non-contagious infectious disease in humans. It is clear that the current approaches to decrease the prevalence of caries in human populations, including water fluoridation and school-based programs, are not enough to protect everyone. The scientific community has suggested the need for innovative work in a number of areas in cariology, encompassing disease etiology, epidemiology, definition, prevention, and treatment. We have pioneered the work on genetic studies to identify genes and genetic markers of diagnostic, prognostic, and therapeutic value. This paper summarizes a presentation that elaborated on these initial findings.

  3. ATLAS Detector Upgrade Prospects

    Science.gov (United States)

    Dobre, M.; ATLAS Collaboration

    2017-01-01

    After the successful operation at the centre-of-mass energies of 7 and 8 TeV in 2010-2012, the LHC was ramped up and successfully took data at the centre-of-mass energies of 13 TeV in 2015 and 2016. Meanwhile, plans are actively advancing for a series of upgrades of the accelerator, culminating roughly ten years from now in the high-luminosity LHC (HL-LHC) project, which will deliver of the order of five times the LHC nominal instantaneous luminosity along with luminosity levelling. The ultimate goal is to extend the dataset from about few hundred fb ‑1 expected for LHC running by the end of 2018 to 3000 fb ‑1 by around 2035 for ATLAS and CMS. The challenge of coping with the HL-LHC instantaneous and integrated luminosity, along with the associated radiation levels, requires further major changes to the ATLAS detector. The designs are developing rapidly for a new all-silicon tracker, significant upgrades of the calorimeter and muon systems, as well as improved triggers and data acquisition. ATLAS is also examining potential benefits of extensions to larger pseudorapidity, particularly in tracking and muon systems. This report summarizes various improvements to the ATLAS detector required to cope with the anticipated evolution of the LHC luminosity during this decade and the next. A brief overview is also given on physics prospects with a pp centre-of-mass energy of 14 TeV.

  4. German energy technology prospects.

    Science.gov (United States)

    Popp, M

    1982-12-24

    After more than 25 years of development of nuclear power and almost 10 years of research and development in numerous areas of nonnuclear energy, there is now a good basis for judging the future prospects of energy technologies in the Federal Republic of Germany. The development of nuclear power has provided an important and economically advantageous new source of energy. Further efforts are needed to establish the nuclear fuel cycle in all stages and to exploit the potential of advanced reactors. In all other areas of energy technology, including energy conservation, new energy sources, and coal, economics has turned out to be the key problem, even at today's energy prices. Opportunities to overcome these economic problems through additional R & D are limited. There is some potential for special applications, and there are many technologies that could contribute to the energy supply of developing countries. In general, however, progress in energy conservation and the use of renewable energy sources will depend on the degree to which energy policy measures can improve their economic basis. For some technologies, such as solar thermal power stations and coal liquefaction, large-scale economic deployment cannot be foreseen today. Instead of establishing costly demonstration projects, emphasis will be put on improving key components of these technologies with the aim of having the most advanced technology available when the economic parameters are more favorable.

  5. ANAIS: Status and prospects

    CERN Document Server

    Amaré, Julio; Cuesta, Clara; García, Eduardo; Ginestra, Carlos; Martínez, María; Oliván, Miguel A; Ortigoza, Ysrael; de Solórzano, Alfonso Ortíz; Pobes, Carlos; Puimedón, Jorge; Sarsa, María Luisa; Villar, José Ángel; Villar, Patricia

    2015-01-01

    ANAIS experiment will look for dark matter annual modulation with large mass of ultra-pure NaI(Tl) scintillators at the Canfranc Underground Laboratory (LSC), aiming to confirm the DAMA/LIBRA positive signal in a model-independent way. Two 12.5 kg each NaI(Tl) crystals provided by Alpha Spectra are currently taking data at the LSC. Present status of ANAIS detectors background and general performance is summarized; in particular, thanks to the high light collection efficiency prospects of lowering the threshold down to 1 keVee are reachable. Crystal radiopurity goals are fulfilled for $^{232}$Th and $^{238}$U chains and $^{40}$K activity, although higher than original goal, could be accepted; however, high $^{210}$Pb contamination out-of-equilibrium has been identified. More radiopure detectors are being built by Alpha Spectra. The ongoing high quantum efficiency PMT tests and muon veto characterization are also presented. Finally, the sensitivity of the experiment for the annual modulation in the WIMP signal,...

  6. IPY Progress and Prospects

    Science.gov (United States)

    Carlson, D.

    2008-12-01

    We can summarize the IPY goals as: (a) make major advances in polar knowledge and understanding; (b) leave a legacy of new or enhanced observational systems, facilities and infrastructure; (c) excite a new generation of polar scientists and engineers, and (d) elicit exceptional interest and participation from polar residents, schoolchildren, the general public, and decision-makers, worldwide. This talk reports on the progress and prospects in each of those areas from an overall international view; separate talks will describe details of future researcher and the IPY outreach efforts. To achieve major advances in knowledge, IPY has entrained the intellectual resources of thousands of scientists, many more than expected, often from 'non- polar' nations, and representing an unprecedented breadth of scientific specialties; integration of those efforts across disciplines to achieve integrated system-level understanding remains a substantial challenge. Many national and international organizations prepare plans to sustain new and improved observational systems, but clear outcomes and the necessary resources remain elusive. International outreach networks gradually build breadth and strength, largely through IPY Polar Science Days and other internationally- coordinated IPY events. A new Association of Polar Early Career Scientists (APECS) devotes talent and energy to shaping the future of polar research. These activities and networks may, with time and with continued international coordination, achieve an exceptional level of interest and participation. In all areas, much work remains.

  7. Natural Communities

    Data.gov (United States)

    Kansas Data Access and Support Center — This dataset shows the locations of known tracts of high quality natural communities in Kansas, generalized to the PLSS section. It is not a compehensive dataset of...

  8. Labour: A Prospective, Descriptive Study

    African Journals Online (AJOL)

    Symphysis Fundus Height Measurements during Labour: A Prospective, Descriptive Study 49. Introduction ... 800g in about 50% of cases,2 and in term preg- nancies to be as .... Discussion. Prematurity and low birthweight are major causes.

  9. Prospect of ultralight airplanes development

    Directory of Open Access Journals (Sweden)

    Adam KONICZEK

    2015-09-01

    Full Text Available The article presents characteristic of ultralight airplanes, rules and current interest of them. The purpose is to determine prospect of ultralight airplanes development on the basis of Civil Aviation Authority statistics analysis and trend of aviation market.

  10. Google Calendar Enhances Prospective Memory in Alzheimer's Disease: A Case Report.

    Science.gov (United States)

    El Haj, Mohamad; Gallouj, Karim; Antoine, Pascal

    2017-01-01

    We investigated whether an external memory aid (i.e., Google Calendar) would alleviate prospective memory compromise in a patient with mild Alzheimer's disease. The patient was asked in the baseline phase to perform three prospective targeted events (e.g., attending her weekly bridge game at the community club) and three prospective control events (e.g., buying her weekly magazine). The same six prospective events were assessed in the intervention phase but the targeted-events were cued by Google Calendar while the control-events were not. Results showed less omission of the targeted events in the training phase than in the baseline phase, suggesting a positive effect of Google Calendar. This case report offers a unique view into how smartphone calendars may alleviate prospective memory compromise in patients with mild Alzheimer's disease.

  11. Relationship between physical activity and risk of type 2 diabetes in urban adults of Nanjing: a pooled study from two 3-year community-based prospective cohorts%南京市城区居民体力活动与2型糖尿病罹患风险关系的随访研究

    Institute of Scientific and Technical Information of China (English)

    李潮; 王志勇; 洪忻; 梁亚琼; 徐斐

    2012-01-01

    OBJECTIVE To investigate the relationship between physical activity and the risk of type 2 diabetes (T2D) in urban adults of Nanjing, China. METHODS Two community-based adult prospective cohort studies were respectively conducted during 2004-2007 and 2007-2010 in urban areas of Nanjing. T2D was defined by World Health Organization criteria based on physicians' diagnosis and fasting blood glucose concentration. Physical activity, parental diabetes history, and covariates were assessed at baseline and in the third-year follow-up survey. The data analyzed in 2011 were pooled from above mentioned two studies. RESULTS In the 4 550 urban adults, the three-year cumulative incidence of T2D was 5.1%. The proportion of sufficient physical activity was 16.5% (753/4 550). Compared to their counterparts with insufficient physical activity, participants with sufficient physical activity were at a significant lower risk of developing T2D (RR = 0.45, 95%C/ = 0.31, 0.77). Such relationship was observed in both men and women. CONCLUSION Sufficient physical activity can reduce the risk of developing T2D. It is of great significance to initiate community-based physical activity promotion in the campaign against T2D in urban adults.%目的 探讨南京市城区居民体力活动与2型糖尿病罹患风险之间的关系.方法 于2004年和2007年分别在南京市抽取5个居委会,以所抽取的居委会中35岁以上常住居民为研究对象.研究内容主要包括慢性疾病罹患情况及相关生活行为因素,使用国际体力活动量表测量体力活动情况.对完成有效基线调查效对象5 659人进行为期3年的随访研究,采用多因素Logistic回归模型分析体力活动与2型糖尿病罹患风险之间的关系.结果 有效随访4 550人,随访率为80.4%.充足体力活动的比例为16.5% (753/4 550),2型糖尿病的3年累计发病率为5.1% (95%CI=4.48,5.80).充足体力活动者其罹患2TD的风险显著低于体力活动不足者的

  12. Community concepts.

    Science.gov (United States)

    Yeung, Thomas; Bates, Tony

    2004-03-01

    Since the publication of "Sustainable Communities--building for the future", Government attention has focused largely on high-density affordable housing in the four "growth areas": Thames Gateway; Ashford; Milton Keynes--South Midlands, and London--Stansted--Cambridge. In this article, Thomas Yeung and Tony Bates suggest that a greater and more sustainable impact would be achieved if architects, planners, and developers considered the potential for community-based water and waste management and on-site energy generation and distribution right from the start of the project. In particular, they consider that the communal nature of hospitals, universities, and public/community housing provides a great opportunity for on-site renewable CHP and/or distributed heating, which could combine global environmental benefits with improved local amenities. They describe a simple model for prioritising energy management in the built environment, and draw on lessons learnt at ETRCL in Dagenham and BedZED in Surrey to offer a few recommendations for Government and developers. Tony Bates is the business development manager for Scott Wilson in the South East and is responsible for the promotion of sustainable communities through relationships with architects, developers, land owners and local authorities. Thomas Yeung leads the Energy Infrastructure Technologies group in Scott Wilson. This team offers an integrated approach to clean community-based energy generation, energy management, waste and water management, sustainable transport, and sustainable buildings/communities.

  13. Community reactions to disaster: An emerging role for the school psychologist

    Directory of Open Access Journals (Sweden)

    Bernie Stein

    2016-02-01

    Full Text Available This article will describe ways in which communities react to severe crises, both on a local and on a national level. Based on experiences in Israel over the past twenty years, including recent traumatic events such as the assassination of prime minister Yitzhak Rabin and the terrorist suicide bombings, and on an intervention in Buenos Aires, Argentina, after the bombing of the Jewish Community Centre in July 1994, a model is presented to describe different stages of reaction. The importance of the creation and development of community prevention and intervention programs is stressed. Emphasis is placed on the role of the schools and the school psychologists in developing and implementing such programs, and on their critical role in dealing immediately with crisis situations and their aftermaths. The prevention program emphasizes the fostering of inner strengths and resources in children and teachers (‘inoculation’, and makes provision for dealing with emotional support for the professionals in charge of helping the community in times of crisis. Finally, a model for the future development of the profession of school psychology into a broader community service is proposed. 

  14. Probiosis: concepts and prospects

    Directory of Open Access Journals (Sweden)

    Lima R Barbosa

    2010-12-01

    Full Text Available The use of probiotics in animal and human feeding has been a subject of increasing interest both for the academia and the industry, mostly due to their potential positive effects on health and profitability. However, the knowledge on the composition of bacterial gastrointestinal communities in humans and animals, as well as its respective nutritional requirements, is far from being elucidated. Due to the ban of the use of antibiotic growth promoters in animal feeds, there has been an increasing interest on the utilization of probiotics to improve animal intestinal health under commercial settings. However, the possibility of horizontal transference of antibiotic-resistant genes between probiotic bacteria and pathogenic species has become a concern of poultry farmers and consumers around the world. Innovative ideas have emerged, such as the addition of essential oils, spices, and other plant extracts to feeds of monogastric animals to promote intestinal health. These natural compounds are considered ecologically adequate and safe for feeding purposes. This new reality will probably change the direction of research and of the use of additives in poultry production.

  15. Twenty-year results of combined meniscal allograft transplantation, anterior cruciate ligament reconstruction and advancement of the medial collateral ligament.

    Science.gov (United States)

    von Lewinski, Gabriela; Milachowski, Klaus A; Weismeier, Karl; Kohn, Dieter; Wirth, Carl Joachim

    2007-09-01

    The purpose of this study was to determine the objective and subjective long-term outcomes of the first free meniscal allograft transplantations in five patients with complete absence or non-repairable lesion of the medial meniscus after 20 years. Between 1984 and 1986 five patients underwent concomitant medial meniscal transplantation with a deep frozen meniscal allograft, ACL reconstruction and femoral advancement or temporary detachment of the MCL. The clinical outcome of the patients was evaluated 20 years postoperatively using clinical assessment, Lysholm-score, KOOS, IKDC-score, radiographs and magnetic resonance imaging. The Lysholm-score ranged between 21 and 97 points of 100 maximal available points. Corresponding to this the total KOOS ranged between 28.4 and 91.1%. The results of the IKDC-score were evaluated as nearly normal (B) (n = 2), abnormal (C) (n = 2) and severely abnormal (D) (n = 1). The radiological evaluation according to the Kellgren-Lawrence classification showed an increase of the degenerative changes between one and four grades. The radiological results revealed clear degenerative changes with long-term follow-up after meniscal allograft transplantation even though some patients did relatively well regarding the subjective and clinical results in the 20-year follow-up examination in comparison with the literature. Despite these relative clear results the question if medial meniscal transplantation can protect against development of arthritis cannot definitely be answered because in this first case series some aspects of meniscus transplantation that have not been considered which turned out to be of importance during the last 20 years. Furthermore, it has to be taken into account that all patients revealed a cartilage damage at the time of surgery and an ACL reconstruction was performed in addition. Nevertheless from biomechanical point of view it might be taken into consideration to combine the medial meniscus transplantation at least with a high tibial osteotomy. Level of evidence was (IV, case series).

  16. Cancer incidence in the population exposed to dioxin after the "Seveso accident": twenty years of follow-up

    Directory of Open Access Journals (Sweden)

    Rubagotti Maurizia

    2009-09-01

    Full Text Available Abstract Background The Seveso, Italy accident in 1976 caused the contamination of a large population by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD. Possible long-term effects have been examined through mortality and cancer incidence studies. We have updated the cancer incidence study which now covers the period 1977-96. Methods The study population includes subjects resident at the time of the accident in three contaminated zones with decreasing TCDD soil levels (zone A, very high; zone B, high; zone R, low and in a surrounding non-contaminated reference territory. Gender-, age-, and period-adjusted rate ratios (RR and 95% confidence intervals (95% CI were calculated by using Poisson regression for subjects aged 0-74 years. Results All cancer incidence did not differ from expectations in any of the contaminated zones. An excess of lymphatic and hematopoietic tissue neoplasms was observed in zones A (four cases; RR, 1.39; 95% CI, 0.52-3.71 and B (29 cases; RR, 1.56; 95% CI, 1.07-2.27 consistent with the findings of the concurrent mortality study. An increased risk of breast cancer was detected in zone A females after 15 years since the accident (five cases, RR, 2.57; 95% CI, 1.07-6.20. No cases of soft tissue sarcomas occurred in the most exposed zones (A and B, 1.17 expected. No cancer cases were observed among subjects diagnosed with chloracne early after the accident. Conclusion The extension of the Seveso cancer incidence study confirmed an excess risk of lymphatic and hematopoietic tissue neoplasms in the most exposed zones. No clear pattern by time since the accident and zones was evident partly because of the low number of cases. The elevated risk of breast cancer in zone A females after 15 years since the accident deserves further and thorough investigation. The follow-up is continuing in order to cover the long time period (even decades usually elapsing from exposure to carcinogenic chemicals and disease occurrence.

  17. Twenty Years On!: Updating the IEA BESTEST Building Thermal Fabric Test Cases for ASHRAE Standard 140: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Judkoff, R.; Neymark, J.

    2013-07-01

    ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs applies the IEA BESTEST building thermal fabric test cases and example simulation results originally published in 1995. These software accuracy test cases and their example simulation results, which comprise the first test suite adapted for the initial 2001 version of Standard 140, are approaching their 20th anniversary. In response to the evolution of the state of the art in building thermal fabric modeling since the test cases and example simulation results were developed, work is commencing to update the normative test specification and the informative example results.

  18. Twenty years of global groundwater research: A Science Citation Index Expanded-based bibliometric survey (1993-2012)

    Science.gov (United States)

    Niu, Beibei; Loáiciga, Hugo A.; Wang, Zhen; Zhan, F. Benjamin; Hong, Song

    2014-11-01

    A bibliometric analysis was conducted to evaluate groundwater research from different perspectives in the period 1993-2012 based on the Science Citation Index-Expanded (SCIE) database. The bibliometric analysis summarizes output, categorical, geographical, and institutional patterns, as well as research hotspots in global groundwater studies. Groundwater research experienced notable growth in the past two decades. “Environmental sciences”, “water resources” and “multidisciplinary geosciences” were the three major subject categories. The Journal of Hydrology published the largest number of groundwater-related publications in the surveyed period. Major author clusters and research regions are located in the United States, Western Europe, Eastern and Southern Asia, and Eastern Australia. The United States was a leading contributor to global groundwater research with the largest number of independent and collaborative papers, its dominance affirmed by housing 12 of the top 20 most active institutions reporting groundwater-related research. The US Geological Survey, the Chinese Academy of Sciences, and the USDA Agricultural Research Service were the three institutions with the largest number of groundwater-related publications. A keywords analysis revealed that groundwater quality and contamination, effective research technologies, and treatment technologies for water-quality improvement were the main research areas in the study period. Several keywords such as “arsenic”, “climate change”, “fluoride”, “groundwater management”, “hydrogeochemistry”, “uncertainty”, “numerical modeling”, “seawater intrusion”, “adsorption”, “remote sensing”, “land use”, “USA”(as study site), and “water supply” received dramatically increased attention during the study period, possibly signaling future research trends.

  19. Almost twenty years' search of transuranium isotopes in effluents discharged to air from nuclear power plants with VVER reactors.

    Science.gov (United States)

    Hölgye, Z; Filgas, R

    2006-04-01

    Airborne effluents of 5 stacks (stacks 1-5) of three nuclear power plants, with 9 pressurized water reactors VVER of 4,520 MWe total power, were searched for transuranium isotopes in different time periods. The search started in 1985. The subject of this work is a presentation of discharge data for the period of 1998-2003 and a final evaluation. It was found that 238Pu, 239,240Pu, 241Am, 242Cm, and 244Cm can be present in airborne effluents. Transuranium isotope contents in most of the quarterly effluent samples from stacks 2, 4 and 5 were not measurable. Transuranium isotopes were present in the effluents from stack l during all 9 years of the study and from stack 3 since the 3rd quarter of 1996 as a result of a defect in the fuel cladding. A relatively high increase of transuranium isotopes in effluents from stack 3 occurred in the 3rd quarter of 1999, and a smaller increase occurred in the 3rd quarter of 2003. In each instance 242Cm prevailed in the transuranium isotope mixtures. 238Pu/239,240Pu, 241Am/239,240Pu, 242Cm/239,240Pu, and 244Cm/239,240Pu ratios in fuel for different burn-up were calculated, and comparison of these ratios in fuel and effluents was performed.

  20. A Review of Twenty Years of Competency-Based Training in the Australian Vocational Education and Training System

    Science.gov (United States)

    Smith, Erica

    2010-01-01

    In this paper, the author reflects, both as an academic researcher and as a senior practitioner, on the experience of competency-based training (CBT) in the Australian vocational education and training system. She seeks to draw conclusions about the Australian experience using a typology drawn from the academic literature which focuses on the…

  1. Social Ecological Approaches to Individuals and Their Contexts: Twenty Years of "Health Education & Behavior" Health Promotion Interventions

    Science.gov (United States)

    Golden, Shelley D.; Earp, Jo Anne L.

    2012-01-01

    Social ecological models that describe the interactive characteristics of individuals and environments that underlie health outcomes have long been recommended to guide public health practice. The extent to which such recommendations have been applied in health promotion interventions, however, is unclear. The authors developed a coding system to…

  2. Cooperation between China and Germany for twenty years as well as development of international welding training and qualification in China

    Institute of Scientific and Technical Information of China (English)

    Xie Yinglong; Dai Wanfu; Piao Dongguang

    2005-01-01

    Chinese Welding Training and Qualification Committee (CANB) was awarded the authorisation of ⅡW in 2000,and has issued nearly 2000 ⅡW diplomas by the end of 2004. Since Harbin Welding Training Institute ( WTI Harbin) was founded based on Sino-German cooperation in 1984, it has trained all kinds of welding personnel 20 000 and it made important contribution to the up-to-date system introduction of international welding training to China. The common questions in Germany foreign aid programs are: when German experts were on site, the project was on the operation; when he/they left,only memory was left. The outstanding achievements of Harbin Welding Training Institute tell us: when German experts were away, the cooperation program is not only run normally, but also gets persistent development, it is the successful model among the cooperation projects between China and Germany.

  3. Family cord blood banking for sickle cell disease: a twenty-year experience in two dedicated public cord blood banks.

    Science.gov (United States)

    Rafii, Hanadi; Bernaudin, Françoise; Rouard, Helene; Vanneaux, Valérie; Ruggeri, Annalisa; Cavazzana, Marina; Gauthereau, Valerie; Stanislas, Aurélie; Benkerrou, Malika; De Montalembert, Mariane; Ferry, Christele; Girot, Robert; Arnaud, Cecile; Kamdem, Annie; Gour, Joelle; Touboul, Claudine; Cras, Audrey; Kuentz, Mathieu; Rieux, Claire; Volt, Fernanda; Cappelli, Barbara; Maio, Karina T; Paviglianiti, Annalisa; Kenzey, Chantal; Larghero, Jerome; Gluckman, Eliane

    2017-06-01

    Efforts to implement family cord blood banking have been developed in the past decades for siblings requiring stem cell transplantation for conditions such as sickle cell disease. However, public banks are faced with challenging decisions about the units to be stored, discarded, or used for other endeavors. We report here 20 years of experience in family cord blood banking for sickle cell disease in two dedicated public banks. Participants were pregnant women who had a previous child diagnosed with homozygous sickle cell disease. Participation was voluntary and free of charge. All mothers underwent mandatory serological screening. Cord blood units were collected in different hospitals, but processed and stored in two public banks. A total of 338 units were stored for 302 families. Median recipient age was six years (11 months-15 years). Median collected volume and total nucleated cell count were 91 mL (range 23-230) and 8.6×10(8) (range 0.7-75×10(8)), respectively. Microbial contamination was observed in 3.5% (n=12), positive hepatitis B serology in 25% (n=84), and homozygous sickle cell disease in 11% (n=37) of the collections. Forty-four units were HLA-identical to the intended recipient, and 28 units were released for transplantation either alone (n=23) or in combination with the bone marrow from the same donor (n=5), reflecting a utilization rate of 8%. Engraftment rate was 96% with 100% survival. Family cord blood banking yields good quality units for sibling transplantation. More comprehensive banking based on close collaboration among banks, clinical and transplant teams is recommended to optimize the use of these units. Copyright© Ferrata Storti Foundation.

  4. Twenty Years of Experience with the Preoperative Diagnosis of Medullary Cancer in a Moderately Iodine-Deficient Region

    Directory of Open Access Journals (Sweden)

    Tamas Solymosi

    2013-01-01

    Full Text Available Background. There is a current debate in the medical literature about plasma calcitonin screening in patients with nodular goiter (NG. We decided on analyzing our 20-year experience with patients in an iodine-deficient region (ID. Patients and Methods. 22,857 consecutive patients with NG underwent ultrasonography and aspiration cytology (FNAC. If FNAC raised suspicion of medullary cancer (MTC, the serum calcitonin was measured. Results. 4,601 patients underwent surgery; there were 23 patients among them who had MTC (0.1% prevalence. Significantly more MTC cases were diagnosed cytologically in the second decade than in the first: 11/12 and 6/11, respectively. The frozen section was of help in 2 cases out of 3. Two patients suffered from a 3-year delay in proper therapy, and reoperation was necessary in 1 case. FNAC raised the suspicion of MTC in 20 cases that were later histologically verified and did not present MTC. The diagnostic accuracy of FNAC in diagnosing MTC was 99.2%. Two false-positive serum calcitonin tests (one of them in a hemodialyzed patient and one false-negative serum calcitonin test occurred in 40 cases. Conclusion. Regarding the low prevalence of MTC in ID regions, calcitonin screening of all NG patients does not only appear superfluously but may have more disadvantages than advantages.

  5. Reducing Phosphorus Runoff and Leaching from Poultry Litter with Alum: Twenty-Year Small Plot and Paired-Watershed Studies.

    Science.gov (United States)

    Huang, Lidong; Moore, Philip A; Kleinman, Peter J A; Elkin, Kyle R; Savin, Mary C; Pote, Daniel H; Edwards, Dwayne R

    2016-07-01

    Treating poultry litter with alum has been shown to lower ammonia (NH) emissions and phosphorus (P) runoff losses. Two long-term studies were conducted to assess the effects of alum-treated poultry litter on P availability, leaching, and runoff under pasture conditions. From 1995 to 2015, litter was applied annually in a paired watershed study comparing alum-treated and untreated litter and in a small plot study comparing 13 treatments (an unfertilized control, four rates of alum-treated litter, four rates of untreated litter, and four rates of NHNO). In the paired watershed study, total P loads in runoff were 231% higher from pasture receiving untreated litter (1.96 kg P ha) than from that receiving alum-treated litter (0.85 kg P ha). In both studies, alum-treated litter resulted in significantly higher Mehlich III P (M3-P) and lower water-extractable P at the soil surface, reflecting greater retention of applied P and lesser availability of that P to runoff or leaching. In soils fertilized with alum-treated litter, M3-P was much higher when analyzed by inductively coupled argon plasma emission spectrometry than by colorimetry, possibly due to the formation of aluminum phytate. Indeed, alum-treated poultry litter leached less P over the 20-yr study: M3-P at 10 to 50 cm was 266% greater in plots fertilized with untreated litter (331 kg M3-P ha) than with alum-treated litter (124 kg M3-P ha). This research provides compelling evidence that treating poultry litter with alum provides short-term and long-term benefits to P conservation and water quality.

  6. The United States twenty-year experience with bombing incidents: implications for terrorism preparedness and medical response.

    Science.gov (United States)

    Kapur, G Bobby; Hutson, H Range; Davis, Mark A; Rice, Phillip L

    2005-12-01

    Terrorist bombings remain a significant threat in the United States. However, minimal longitudinal data exists regarding the medical and public health impact because of bombings. We conducted a retrospective analysis of the number of incidents, injuries, and deaths because of explosive, incendiary, premature, and attempted bombings from January 1983 to December 2002. Morbidity and mortality by motives, target locations, and materials used were evaluated. In the United States, 36,110 bombing incidents, 5,931 injuries, and 699 deaths were reported. There were 21,237 (58.8%) explosive bombings, 6,185 (17.1%) incendiary bombings, 1,107 (3.1%) premature bombings, and 7,581 (21.0%) attempted bombings. For explosive bombings with known motives, 72.9% of injuries and 73.8% of deaths were because of homicide. For incendiary bombings with known motives, 68.2% of injuries were because of extortion and revenge, and 53.5% of deaths were due to homicide. Private residences accounted for 29.0% of incidents, 31.5% of injuries, and 55.5% of deaths. Government installations accounted for 4.4% of incidents but were the site of 12.7% of injuries and 25.5% of deaths. In bombings with known materials, nitrate-based fertilizers accounted for 36.2% of injuries and 30.4% of deaths, and smokeless powder and black powder accounted for 33.2% of injuries and 27.1% of deaths. Illegal bombings and related injuries commonly occur in the United States. Because of the easy availability of bombing materials, government agencies and healthcare providers should prepare for potential mass-casualty bombings.

  7. Family cord blood banking for sickle cell disease: a twenty-year experience in two dedicated public cord blood banks

    Science.gov (United States)

    Rafii, Hanadi; Bernaudin, Françoise; Rouard, Helene; Vanneaux, Valérie; Ruggeri, Annalisa; Cavazzana, Marina; Gauthereau, Valerie; Stanislas, Aurélie; Benkerrou, Malika; De Montalembert, Mariane; Ferry, Christele; Girot, Robert; Arnaud, Cecile; Kamdem, Annie; Gour, Joelle; Touboul, Claudine; Cras, Audrey; Kuentz, Mathieu; Rieux, Claire; Volt, Fernanda; Cappelli, Barbara; Maio, Karina T.; Paviglianiti, Annalisa; Kenzey, Chantal; Larghero, Jerome; Gluckman, Eliane

    2017-01-01

    Efforts to implement family cord blood banking have been developed in the past decades for siblings requiring stem cell transplantation for conditions such as sickle cell disease. However, public banks are faced with challenging decisions about the units to be stored, discarded, or used for other endeavors. We report here 20 years of experience in family cord blood banking for sickle cell disease in two dedicated public banks. Participants were pregnant women who had a previous child diagnosed with homozygous sickle cell disease. Participation was voluntary and free of charge. All mothers underwent mandatory serological screening. Cord blood units were collected in different hospitals, but processed and stored in two public banks. A total of 338 units were stored for 302 families. Median recipient age was six years (11 months-15 years). Median collected volume and total nucleated cell count were 91 mL (range 23–230) and 8.6×108 (range 0.7–75×108), respectively. Microbial contamination was observed in 3.5% (n=12), positive hepatitis B serology in 25% (n=84), and homozygous sickle cell disease in 11% (n=37) of the collections. Forty-four units were HLA-identical to the intended recipient, and 28 units were released for transplantation either alone (n=23) or in combination with the bone marrow from the same donor (n=5), reflecting a utilization rate of 8%. Engraftment rate was 96% with 100% survival. Family cord blood banking yields good quality units for sibling transplantation. More comprehensive banking based on close collaboration among banks, clinical and transplant teams is recommended to optimize the use of these units. PMID:28302713

  8. Twenty Years of Enforcement of Explosives Safety Regulations in France in View of an European Union Directive

    Science.gov (United States)

    1998-08-01

    health) completed by the royal decree 230/1998 dated 16 february 1998 regarding the rules to be applied to explosives " Reglamento de explosivos". The...34Instituto nacional de seguridad e higiene en el trabajo " del Ministerio del Trabajo y Asuntos Sociales has a key role for enforcong this law, as well

  9. Vingt ans après (Twenty years after). Comment on "Disentangling DNA molecules" by Alexander Vologodskii

    Science.gov (United States)

    Grosberg, Alexander Y.

    2016-09-01

    The effect of DNA topology simplification by type II topoisomerase enzymes was discovered experimentally by Rybenkov et al. [1] 20 years ago - which motivates me to borrow the title for this comment from Alexandre Dumas [2]. Ever since the original discovery, the effect keeps entertaining theorists - but the most surprising fact is that the original experiment was never repeated, let alone improved. I do not understand why it is so. In my opinion, there is an acute need of new experiments, not only repeating the original measurements, but also examining numerous other aspects of the phenomenon. In this sense, the review [3] by Vologodskii, one of the original discoverers, is both timely and important. In his review, Vologodskii concentrates on what I would call mechanical aspect of the problem - how bent are T- and G-segments, what kinds of juxtaposition are relevant, etc. The importance of these issues notwithstanding, I want to complement this approach, and to consider in greater detail the thermodynamics of the process. My main points are as follows: action of topo II enzyme violates detailed balance for DNA, leading to circular currents and dissipation (which is indeed quite a common occurrence in many living systems). These currents are potentially observable, and dissipation measurable, which should challenge experimenters. The main goal of this comment is to show how general phenomenological point of view allows to formulate theoretical prediction for the energy dissipation rate.

  10. Twenty years trends and socio-demographic characteristics of HIV prevalence in women giving birth in Catalonia (Spain

    Directory of Open Access Journals (Sweden)

    Dolors Carnicer-Pont

    2015-09-01

    Conclusion: To ensure early identification and treatment of HIV-infected mothers, it is essential to maintain HIV surveillance programs and pre- and post-natal screening programs, both in Barcelona and in cities with 200,000 inhabitants or less, especially in immigrant women.

  11. Priority substances in a SW European coastal lagoon - Ria Formosa, Portugal. Twenty years of temporal evolution of metals and butyltins

    Science.gov (United States)

    Moreira da Silva, Manuela; Carvalho, Pedro; Paquete, Rita; Nuno Duarte, Duarte; Chícharo, Luís

    2013-04-01

    In the last years the European Union has decided to specifically include nickel, cadmium, plumb and TBT in its list of priority substances in water. Trace metals pose a significant threat to organisms because above threshold availability, act as enzyme inhibitors resulting in adverse ecological effects to sediment-associated biota (e.g. macrophytes, benthos, demersal fish) and to higher-biota (e.g. pelagic fish and aquatic birds). Since 2003 International Maritime Organization called for a ban of the application of tributyltin-based paints. Wide distribution, high hydrophobicity, and persistence of organotin compounds have raised concern about their bioaccumulation, their potential biomagnification in the food webs, and their adverse effects to human health and environment, particularly most recent reviews focuses on possible endocrine disrupting effects of OT's (Galloway, 2006; Nakanishi, 2007; Takahashi et al., 1999; Veltman et al., 2006). Saltmarshes are highly heterogeneous environments that have been suffered pressures by the increasing urbanization and industrialization in the adjacent areas. Saltmarsh sediments integrate inputs of contaminants, like metals and organotin compounds and may act as long-term sources of contaminants. At the Ria Formosa saltmarsh several activities were responsible for long-term contaminants, some of them considered priority substances. This work aims to provide information about the present levels and temporal evolution in the last decades of metals (Mn, Zn, Cu, Cr, Ni, Pb, Mo, Cd and Ag, in addition to Fe and Al) and butyltins (TBT, DBT and MBT) in saltmarsh sediments at south of Portugal. Metals were analysed by atomic absorption spectrometry-AAS. Butyltins were determined, after derivatization, by solid phase micro extraction combined with gas chromatography with mass spectrometry (MS/MS). Results showed that legislation was an effective instrument for the decreasing of contamination levels, to sustainable values to ecosystem functioning and human health protection. Keywords: Saltmarshes; Metals; Butyltins; Toxicity; Legislation; Temporal evolution;

  12. The first twenty years of the ASME Committee on nuclear air and gas treatment - a retrospective by a founding member

    Energy Technology Data Exchange (ETDEWEB)

    Jacox, J. [Jacox Associates, Columbus, OH (United States)

    1997-08-01

    Since the 1996 Winter Meeting of CONAGT was the twentieth anniversary of CONAGT a review of the Committee and its members seems in order. This Paper will cover the background and formation of CONAGT as well as the history to date. This history will include not only the basic accomplishments but some of the less successfully met goals and a look at some of the personalities involved in the Committee work. General future plans will be included. The intent of the Paper is less a formal history than a personal recollection of the Committee and those who worked so hard to create the best possible Codes and Standards for the industry to use. 10 refs.

  13. Dietary Intake according to Gender and Education: A Twenty-Year Trend in a Swiss Adult Population.

    Science.gov (United States)

    Marques-Vidal, Pedro; Rousi, Eirini; Paccaud, Fred; Gaspoz, Jean-Michel; Theler, Jean-Marc; Bochud, Murielle; Stringhini, Silvia; Guessous, Idris

    2015-11-18

    We assessed trends in dietary intake according to gender and education using repeated cross-sectional, population-based surveys conducted between 1993 and 2012 in Geneva, Switzerland (17,263 participants, 52.0 ± 10.6 years, 48% male). In 1993-1999, higher educated men had higher monounsaturated fatty acids (MUFA), carotene and vitamin D intakes than lower educated men, and the differences decreased in 2006-2012. In 1993-1999, higher educated women had higher fiber, iron, carotene, vitamin D and alcohol intakes than lower educated women, and the differences decreased in 2006-2012. Total energy, polyunsaturated fatty acids, retinol and alcohol intakes decreased, while mono/disaccharides, MUFA and carotene intake increased in both genders. Lower educated men had stronger decreases in saturated fatty acid (SFA) and calcium intakes than higher educated men: multivariate-adjusted slope and 95% confidence interval -0.11 (-0.15; -0.06) vs. -0.03 (-0.08; 0.02) g/day/year for SFA and -5.2 (-7.8; -2.7) vs. -1.03 (-3.8; 1.8) mg/day/year for calcium, p for interaction day/year, p for interaction = 0.002. We conclude that, in Switzerland, dietary intake evolved similarly between 1993 and 2012 in both educational groups. Educational differences present in 1993 persisted in 2012.

  14. Twenty Years of Elfin Enumeration: Abundance Patterns of Five Species of Callophrys (Lycaenidae) in Central Wisconsin, USA.

    Science.gov (United States)

    Swengel, Ann B; Swengel, Scott R

    2014-04-23

    We recorded five species of elfins (Callophrys) during annual spring surveys targeting frosted elfin C. irus (state-listed as threatened) in 19 pine-oak barrens in central Wisconsin USA during 1994-2013. At the northwest end of its range here, C. irus co-varied with spring temperature, but declined significantly over time (eight sites verified extant of originally 17). Two other specialists increased significantly. The northern specialist, hoary elfin C. polios (nine sites), correlated positively with the previous year's growing season precipitation. The southern specialist, Henry's elfin C. henrici (11 sites), co-varied with winter precipitation and spring temperature and dryness. The two resident generalists had stable trends. For all species, the first observed date per year became earlier over time and varied more than the last observed date. Thus, flight period span increased with earlier first observed dates. Elfin abundance increased significantly with earlier first observed dates in the current and/or prior year. Three species (C. irus, C. henrici, a generalist) had more positive population trends in reserves than non-reserves. This suggests that C. irus declines correspond to habitat conditions. Thus, monitoring programs and habitat management specifically for C. irus appear necessary to obtain a long-term stable trend for this species in Wisconsin.

  15. Twenty Years of Elfin Enumeration: Abundance Patterns of Five Species of Callophrys (Lycaenidae in Central Wisconsin, USA

    Directory of Open Access Journals (Sweden)

    Ann B. Swengel

    2014-04-01

    Full Text Available We recorded five species of elfins (Callophrys during annual spring surveys targeting frosted elfin C. irus (state-listed as threatened in 19 pine-oak barrens in central Wisconsin USA during 1994–2013. At the northwest end of its range here, C. irus co-varied with spring temperature, but declined significantly over time (eight sites verified extant of originally 17. Two other specialists increased significantly. The northern specialist, hoary elfin C. polios (nine sites, correlated positively with the previous year’s growing season precipitation. The southern specialist, Henry’s elfin C. henrici (11 sites, co-varied with winter precipitation and spring temperature and dryness. The two resident generalists had stable trends. For all species, the first observed date per year became earlier over time and varied more than the last observed date. Thus, flight period span increased with earlier first observed dates. Elfin abundance increased significantly with earlier first observed dates in the current and/or prior year. Three species (C. irus, C. henrici, a generalist had more positive population trends in reserves than non-reserves. This suggests that C. irus declines correspond to habitat conditions. Thus, monitoring programs and habitat management specifically for C. irus appear necessary to obtain a long-term stable trend for this species in Wisconsin.

  16. Capturing the angel in "angel dust": twenty years of translational neuroscience studies of NMDA receptor antagonists in animals and humans.

    Science.gov (United States)

    Moghaddam, Bita; Krystal, John H

    2012-09-01

    Here, we describe our collaborative efforts to use N-methyl-d-aspartate (NMDA) receptor antagonists as a translational tool to advance our understanding of the pathophysiology of schizophrenia and identify potential new targets for treatment of schizophrenia. We began these efforts in the late 1980s with a keen sense that, in both human and animal studies, we needed to move beyond the dopamine hypothesis of schizophrenia; if the dopamine hypothesis were correct, the existing dopamine antagonists should have cured the disease but they have not. We used NMDA receptor antagonists, not to produce schizophrenia, but as a tool to provide insights into effects of disturbances in glutamate synaptic function in schizophrenia. Our work has provided insights into potential mechanisms that may contribute to disrupted cortical function in schizophrenia and has helped identify potential treatment targets for the disorder. The translational nature of this study made the clinical testing of the first of these targets feasible. Advances in systems neuroscience approaches in animals and humans make new types of translational research possible; however, our concern is that the current obstacles facing translational research funding and academia-industry collaborations threaten the future progress in this field.

  17. Twenty years of the Journal of Clinical Psychology in Medical Settings: we hope you will enjoy the show.

    Science.gov (United States)

    Rozensky, Ronald H; Tovian, Steven M; Sweet, Jerry J

    2014-03-01

    The 20th anniversary of the Journal of Clinical Psychology in Medical Settings is celebrated by highlighting the scientist-practitioner philosophy on which it was founded. The goal of the Journal-to provide an outlet for evidence-based approaches to healthcare that underscore the important scientific and clinical contributions of psychology in medical settings-is discussed. The contemporary relevance of this approach is related to the current implementation of the Patient Protection and Affordable Care and its focus on accountability and the development of an interprofessional healthcare workforce; both of which have been foci of the Journal throughout its history and will continue to be so into the future. Several recommendations of future topic areas for the Journal to highlight regarding scientific, practice, policy, and education and training in professional health service psychology are offered. Successfully addressing these topics will support the growth of the field of psychology in the ever evolving healthcare system of the future and continue ensure that the Journal is a key source of professional information in health service psychology.

  18. Ecosystem development after mangrove creation: plant-soil change across a twenty-year chronosequence in Tampa Bay, FL

    Science.gov (United States)

    On a global scale, the loss of mangroves has been high (~1-2% loss per year in recent decades). Recognizing the important ecosystem services supported by mangroves, restoration and creation efforts are increasingly proposed as mechanisms to replace those services lost after mangr...

  19. Twenty-year cytogenetic and molecular follow-up of a patient with ring chromosome 15: a case report

    Directory of Open Access Journals (Sweden)

    Guilherme Roberta S

    2012-09-01

    Full Text Available Abstract Introduction Ring chromosome 15 is a rare disorder, with only a few over 40 cases reported in the literature. There are only two previous reports of cases where patients with ring chromosome 15 have been followed-up. Case presentation We report here on the 20-year clinical and cytogenetic follow-up of a patient with a ring chromosome 15. Our patient, a Caucasoid Asian woman, presented with short stature, microcephaly, minor dysmorphic features, hyperextensible knees, generalized hirsutism, café-au-lait and small hypochromic spots spread over her face and the front of her chest and abdomen, dorsolumbar scoliosis and mild intellectual disability. She was followed-up from the age of eight to 28 years. When she was 27 years old, she was reported by her mother to present with compulsive overeating and an aggressive mood when challenged. Karyotyping revealed that the majority of her cells harbored one normal chromosome and one ring chromosome. Silver staining revealed the presence of the nucleolar organizer region in the ring chromosome. Ring loss and/or secondary aberrations exhibited a slight increase over time, from 4.67% in 1989 to 7.67% in 2009, with the presence of two monocentric rings, cells with interlocked rings, a dicentric ring, and broken or open rings. A genome-wide array technique detected a 5.5Mb deletion in 15q26.2. Conclusions We observed that some phenotypic alterations in our patient can be associated with gene loss and haploinsufficiency. Other features may be related to different factors, including ring instability and epigenetic factors.

  20. Twenty-year trends in major cardiovascular risk factors in hospitalized patients with acute myocardial infarction in Beijing

    Institute of Scientific and Technical Information of China (English)

    CAO Cheng-fu; REN Jing-yi; ZHOU Xiang-hai; LI Su-fang; CHEN Hong

    2013-01-01

    Background Hypertension,diabetes mellitus,hypercholesterolaemia and current smoking are the strongest modifiable cardiovascular risk factors for acute myocardial infarction (AMI).We examined their changing trends over the last 20years.Methods The clinical data of 3498 patients hospitalized in Peking University People's Hospital with AMI from 1991 to 2010 were used.Information was collected regarding to patients' demographic data,cardiovascular risk factors (hypertension,diabetes mellitus,hypercholesterolemia and current smoking).To assess trends over time in the prevalence of risk factors,we categorized patients into four groups (1991 to 1995,1996 to 2000,2001 to 2005 and 2006 to 2010).Results Highly significant increases were observed in the prevalence of hypertension from 40.8% to 55.6% for males and from 58.0% to 69.0% for females; and diabetes mellitus from 12.9% to 30.8% for males and from 23.0% to 42.3% for females.Similarly,the prevalence of hypercholesterolaemia decreased from 53.1% to 30.7% for males and from 57.0%to 44.0% for females.The prevalence of current smoking decreased in females from 29.0% to 11.1%,but remained unchanged in males.In addition,the proportion of patients with more than three modifiable risk factors increased from 19.0% to 27.1% and the age at onset of AMI extended to younger as well as older individuals.Conclusions The prevalence of hypertension and diabetes mellitus are still increasing in patients with AMI in Beijing and although the prevalence of hypercholesterolaemia and current smoking decreased,high clustering of risk factors were commonly present.These adverse trends show a compelling need for more effective management of cardiovascular risk factors.