WorldWideScience

Sample records for twenty-year prospective community

  1. Is it resources, habit or both: interpreting twenty years of hospital strategic response to prospective payment.

    Science.gov (United States)

    Balotsky, Edward R

    2005-01-01

    The 1983 Tax Equity and Fiscal Responsibility Act (TEFRA) transformed acute care from a benevolent to malevolent environment. A dual-paradigm of resource dependency and institutional theories that balances isomorphic with economic variables has emerged to better explain hospital strategic response to the resultant constraint on resources than a traditional single paradigm approach. Using the population of non-rural, non-federal acute-care hospitals, strategic response from 1982 to 2001 is studied; distinct cost and service changes occur. Cost strategy is linked primarily to Medicare utilization, a resource dependence response. Service strategy favors high technology regardless of prospective payment diffusion, an institutional theory perspective. Strategic implications are discussed.

  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. Twenty years of JHEP

    International Nuclear Information System (INIS)

    Amati, Daniele; Bonora, Loriano

    2017-01-01

    On July 1st of twenty years ago we launched the first issue of JHEP. It was a real challenge to try the adventure of a scientific journal thought and managed by scientists, independent of private or institutional publishers. The idea was that physicists who were performing the work, writing the papers, and refereeing those of their peers, could also edit them in an electronic format. Thus, at a limited cost which could be handled by academic or scientific institutions, giving open access to the published information, and avoiding the heavy burden at that time placed on our libraries. In order to avoid the failure that - as we well remember was predicted to us by publishing companies and institutions, we needed the active support of the scientific community. A support in collaborating to the scrutiny of papers and scientific policies but, mainly, in sending to us their good papers. We contacted in that sense several of our most active and renowned colleagues, restricting of course to our high energy physics field. We received many enthusiastic responses as can be specifically seen from the papers that appear in the first issues of the journal, as well as the respected names listed in the advisory and in the editorial boards featuring in the opening page of the first issue of JHEP attached to this letter. We were optimists, but perhaps not as much as to foresee the success of the journal, which, in his first 20 years, turned out to be one of the most (if not the most) prestigious one in our field. Success for which --- as first project chairman and executive editor - we must essentially thank the scientific community who supported JHEP by considering it ''their journal'', as was our intention from the start. In this occasion we would like to recall the important contribution of Marco Fabbrichesi who designed the software on which the journal is based, and the technical personnel who implemented it and made it work. It is our pleasure to mention

  4. 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.

  5. The fine sand Abra alba community of the Bay of Morlaix twenty years after the Amoco Cadiz oil spill

    Energy Technology Data Exchange (ETDEWEB)

    Dauvin, J.-C. [CNRS-UPRES-A Elico, Wimereux (France). Station Marine de Wimereux

    1998-09-01

    The fine sand Abra alba community from the Bay of Morlaix (western English Channel) was strongly affected by the Amoco Cadiz oil spill of April 1978. The long term changes in the community (1977-1996) show that reconstitution of this community is slow (over 10 yr). A progressive recolonization by amphipod Ampelisca populations constituting the dominant species is observed. The results show that it is necessary to survey the affected communities for a long period of time (> 10 yr) after an event to identify the real ecological impact of an oil spill. The abiotic and biotic factor existing in the Bay of Morlaix are favorable to the establishment and the persistence of stable dominant Ampelisca populations in time. The `climax` concept seems to be applicable to this type of stable environment. The soft-bottom Abra alba community of the Bay of Morlaix may only support a maximal carrying capacity of approximately 10-11 g m{sup -2} (mean annual biomass in decalcified dry weight). The deficit of production during 11 annual cycles may have affected the fish biomass feeding on this community. (author)

  6. The fine sand Abra alba community of the Bay of Morlaix twenty years after the Amoco Cadiz oil spill

    Energy Technology Data Exchange (ETDEWEB)

    Dauvin, J.-C. [CNRS-UPRES-A Elico, Wimereux (France). Station Marine de Wimereux

    1998-09-01

    The fine sand Abra alba community from the Bay of Morlaix (western English Channel) was strongly affected by the Amoco Cadiz oil spill of April 1978. The long term changes in the community (1977-1996) show that reconstitution of this community is slow (over 10 yr). A progressive recolonization by amphipod Ampelisca populations constituting the dominant species is observed. The results show that it is necessary to survey the affected communities for a long period of time (> 10 yr) after an event to identify the real ecological impact of an oil spill. The abiotic and biotic factor existing in the Bay of Morlaix are favorable to the establishment and the persistence of stable dominant Ampelisca populations in time. The 'climax' concept seems to be applicable to this type of stable environment. The soft-bottom Abra alba community of the Bay of Morlaix may only support a maximal carrying capacity ofapproximately 10-11 g m{sup -2} (mean annual biomass in decalcified dry weight). The deficit of production during 11 annual cycles may have affected the fish biomass feeding on this community. (author)

  7. The fine sand Abra alba community of the Bay of Morlaix twenty years after the Amoco Cadiz oil spill

    International Nuclear Information System (INIS)

    Dauvin, J.-C.

    1998-01-01

    The fine sand Abra alba community from the Bay of Morlaix (western English Channel) was strongly affected by the Amoco Cadiz oil spill of April 1978. The long term changes in the community (1977-1996) show that reconstitution of this community is slow (over 10 yr). A progressive recolonization by amphipod Ampelisca populations constituting the dominant species is observed. The results show that it is necessary to survey the affected communities for a long period of time (> 10 yr) after an event to identify the real ecological impact of an oil spill. The abiotic and biotic factor existing in the Bay of Morlaix are favorable to the establishment and the persistence of stable dominant Ampelisca populations in time. The 'climax' concept seems to be applicable to this type of stable environment. The soft-bottom Abra alba community of the Bay of Morlaix may only support a maximal carrying capacity of approximately 10-11 g m -2 (mean annual biomass in decalcified dry weight). The deficit of production during 11 annual cycles may have affected the fish biomass feeding on this community. (author)

  8. 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...

  9. 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.

  10. Deformation quantization: Twenty years after

    International Nuclear Information System (INIS)

    Sternheimer, Daniel

    1998-01-01

    We first review the historical developments, both in physics and in mathematics, that preceded (and in some sense provided the background of) deformation quantization. Then we describe the birth of the latter theory and its evolution in the past twenty years, insisting on the main conceptual developments and keeping here as much as possible on the physical side. For the physical part the accent is put on its relations to, and relevance for, 'conventional' physics. For the mathematical part we concentrate on the questions of existence and equivalence, including most recent developments for general Poisson manifolds; we touch also noncommutative geometry and index theorems, and relations with group theory, including quantum groups. An extensive (though very incomplete) bibliography is appended and includes background mathematical literature

  11. Twenty years of diffraction at the Tevatron

    International Nuclear Information System (INIS)

    Goulianos, K.; Rockefeller U.

    2005-01-01

    Results on diffractive particle interactions from the Fermilab Tevatron (bar p)p collider are placed in perspective through a QCD inspired phenomenological approach, which exploits scaling and factorization properties observed in data. The results discussed are those obtained by the CDF Collaboration from a comprehensive set of single, double, and multigap soft and hard diffraction processes studied during the twenty year period since 1985, when the CDF diffractive program was proposed and the first Blois Workshop was held

  12. Safety regulation - twenty years after Chernobyl accident

    International Nuclear Information System (INIS)

    Aleksashin, P.P.; Bukrinskij, A.M.; Gordon, B.G.

    2006-01-01

    Main stages of development, successes, achievements and shortcomings of activity of supervision body after the Chernobyl NPP accident are analysed. The estimation of the realized variations of the functions of the state supervision department is carried out. Results of the twenty year period of improvement of the supervision body are summed up. The measures for increasing the efficiency of the supervision body operation are outlined [ru

  13. Twenty years after the Chernobyl accident

    International Nuclear Information System (INIS)

    2006-01-01

    Full text: The April 1986 accident at the Chernobyl nuclear power plant remains a painful memory in the lives of the hundreds of thousands of people who were most affected by the accident. In addition to the emergency rescue workers who died, thousands of children contracted thyroid cancer, and thousands of other individuals will eventually die of other cancers caused by the release of radiation. Vast areas of cropland, forests, rivers and urban centres were contaminated by environmental fallout. Hundreds of thousands of people were evacuated from these affected areas - forced to leave behind their homes, possessions, and livelihoods - and resettled elsewhere, in a traumatic outcome that has had long-lasting psychological and social impacts. The commemoration of the Chernobyl tragedy is taking place in many forums this month - in Minsk, in Kiev and in other locations. At the IAEA, it might be said that we have been responding to the accident and its consequences for twenty years, in a number of ways: first, through a variety of programmes designed to help mitigate the environmental and health consequences of the accident; second, by analyzing the lessons of what went wrong to allow such an accident to occur at all; and third, by working to prevent any such accident from occurring in the future. Building a strong and effective global nuclear safety regime is a central objective of our work. This requires effective international cooperation. The explosions that destroyed the Unit 4 reactor core, and discharged its contents in a cloud of radionuclides, made painfully clear that the safety risks associated with nuclear and radiological activities extend beyond national borders. International cooperation on nuclear safety matters - sharing information, setting clear safety standards, assisting with safety upgrades, and reviewing operational performance - has therefore become a hallmark of IAEA activity, particularly at a time when we are witnessing an expansion of

  14. The next twenty years - IAEA's role

    International Nuclear Information System (INIS)

    Tape, G.F.

    1977-01-01

    The twentieth anniversary of an institution is an appropriate time to look back and to ask what has been achieved. It is also an appropriate time to look ahead and to ask what should be the mission for the future. How can the strengths of the International Atomic Energy Agency (IAEA) be best utilized, what new opportunities should be seized upon, and what challenges should the IAEA be prepared to meet in the next twenty years? Forward planning is a very necessary activity in today's world. There are so many demands on national or institutional resources that careful analysis of options is necessary to establish priorities and ultimately to provide for implementation. But such planning must be done carefully with full appreciation for the validity and sensitivity of the input assumptions and data. Furthermore, today's plan, while setting goals and directions, cannot be so inflexible that it cannot be responsive to ever-changing political, economic and technical constraints or opportunities. Thus in looking ahead, the plan must contain provisions for flexibility to provide for further modifications in the light of ever-changing knowledge, attitudes, and world conditions. The experience of the past five years in the energy field, and especially in nuclear energy, underscores this need. In looking ahead for the next twenty years, we are attempting to describe the International Atomic Energy Agency and its role through the twentieth century. In doing so, we are automatically laying the base for the Agency's work going into the twenty-first century. In short, we are trying to visualize a programme that can serve the coming generation and, in doing so, creating a base from which the needs of the succeeding generation can be met. This is a large order and the crystal ball is less than clear. (author)

  15. Twenty years of Korea radioisotope association history

    International Nuclear Information System (INIS)

    2005-09-01

    This contents has two parts. The first part describes the present and post of Korea radioisotope association which are about the foundation of the association, organization, main projects and vision of the association. The second part is about the use and the prospect of radiation and radioisotope in Korea, which shows the plan of expansion of use of radiation and radioisotope, the prospect and present condition in fields such as medical, industry and farming, product and distribution, research and development of human resources, system and management of safety of radiation.

  16. The Next Twenty Years in Management Education

    Science.gov (United States)

    Ansoff, H. Igor

    1973-01-01

    The concern in this article is with the manner in which education serves the managerial needs of organizations. It is the managerial needs of organizations that provide the demand function to educational institutions. Presently, the state of management education lags behind managerial needs, and prospects of closing the gap are doubtful. (41…

  17. Twenty years of improvements in LWR safety

    International Nuclear Information System (INIS)

    Franks, S. III; Mulkey, J.P.; Moonka, A.

    1996-01-01

    Substantial improvements have been made in the safety of light-water reactors in the US during the past two decades, making currently operating reactors safer than ever before. Safety improvements have resulted both from regulatory and operational changes and from new knowledge and technology. The US Nuclear Regulatory Commission, the US Department of Energy, and the American nuclear power industry have worked together and with the international community to enhance the safety of existing plants and to incorporate lessons learned from prior operation into designs for a new generation of advanced, inherently safer reactors

  18. [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

  19. Twenty years of RERTR in Russia: Past, present and future

    International Nuclear Information System (INIS)

    Arkhangelsky, N.

    2000-01-01

    The Russian RERTR Program started approximately 20 years ago. The USSR always supported principles and goals of the policy of nonproliferation and at the end of 70's the Soviet Government decided to create such national program. Twenty years is the sufficient time to estimate preliminary results of the realization of the program and its prospects on the future. After the first successes of the program, when the enrichment of uranium in fuel elements for foreign supplies was reduced from 80 % to 36 %, the realization of the program was suspended in connection with financial difficulties. But in the beginning of the 90's the Program has received a new pulse connected to the inclusion of Russian scientists and engineers in the international Program. Now basic directions in development of new kinds of fuel are development of works on fuel on a basis dioxide of uranium and development of fuel on a basis of U-Mo alloy. In the future to basic goals of the program the problem of the management of the spent nuclear fuel should be added. The management of HEU at the final stage of a fuel cycle becomes an important objective of the program, since the basic amount of HEU is concentrated in storage of SNF. (author)

  20. Twenty Years of French "Didactique" Viewed from the United States

    Science.gov (United States)

    Kilpatrick, Jeremy

    2003-01-01

    One cannot begin considering the topic of this colloquium without asking, why twenty years? Why not two hundred? Two hundred years ago, Silvestre Franois Lacroix was about to be named chief officer of the Commission Executive de L'Instruction Publique. Out of that experience, together with his long career in instruction, especially as professor of…

  1. Investigating the Twenty Year Lag in the Vocational Rehabilitation Process.

    Science.gov (United States)

    Lowitt, Julian

    In the rehabilitation workshop there is insufficient attention to job development oriented to the current and future needs of industry. Many types of work which were done in vocational workshops in contract from industrial firms are now done by automation. Semiskilled labor is thus in diminished demand. There is a twenty year lag in the industrial…

  2. Twenty years of analysis of light elements at the LARN

    International Nuclear Information System (INIS)

    Demortier, G.

    1992-01-01

    We review the applications of ion beam analysis of light elements performed in the LARN during the last twenty years. The works mainly concern: helium bubbles in aluminum foils, Li in aluminum alloys, carbon in high purity MgO crystals and in olivines, nitrogen bubbles in glass and implanted nitrogen in iron and aluminum, oxygen in YBaCuO superconductors, fluorine in tooth enamel and implanted fluorine in metals. (orig.)

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

    International Nuclear Information System (INIS)

    Greene, D.L.

    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

  4. 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.

  5. 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.

  6. Twenty years of environmental opposition in the electric sector

    International Nuclear Information System (INIS)

    Molocchi, Andrea

    1997-01-01

    This article aims to provide a framework for analysing social opposition In Italy against the construction and management of electric power plants (nuclear and thermoelectric) and big electricity power lines in the past twenty years. First The author provide a history of social environmental opposition in the electric sector. This is followed by a typology of reason for opposition in terms of risk perception, which has been applied to about forty cases of social opposition against electric plants. This study an original experimental methodology which could also yield useful results when applied to other complex social phenomena. In the third phase of the study the author analyse the various roles of the social and institutional actors involved in the opposition, and the obstacles to future consensus building. The most interesting result of the study is the not only social but political nature opposition. This factor necessitates integration of the traditional individual risk perception approach with an approach which analyses political and social action of NGO's

  7. Twenty years of operation of Ljubljana's TRIGA Mark II reactor

    International Nuclear Information System (INIS)

    Dimic, V.

    1986-01-01

    Twenty years have now passed since the start of the TRIGA Mark II reactor in Ljubljana. The reactor was critical on May 31, 1966. The total energy produced until the end of May 1986 was 14.048 MWh or 585 MWd. For the first 14 years (until 1981) the yearly energy produced was about 600 MWh, since 1981 the yearly energy produced was 1000 MWh when a routine radioactive isotopes production started for medical use as well as other industrial applications, such as doping and irradiation with fast neutrons of silicon monocrystals, production of level indicators (irradiated cobalt wire), production of radioactive iridium for gamma-radiography, leak detection in pipes by sodium, etc. Besides these, applied research around the reactor is being conducted in the following main fields, where- many unique methods have been developed or have found their way into the local industry or hospitals: neutron radiography, neutron induced auto-radiography using solid state nuclear track detectors, nondestructive methods for assessment of nuclear burn-up, neutron dosimetry, calculation of core burn-up for the optimal in-core fuel management strategy. The solvent extraction method was developed for the everyday production of 99m Tc, which is the most widely used radionuclide in diagnostic nuclear medicine. The methods were developed for the production of the following isotopes: 18 F, 85m Kr, 24 Na, 82 Br, 64 Zn, 125 I. Neutron activation analysis represents one of the major usages for the TRIGA reactor. Basic research is being conducted in the following main fields: solid state physics (elastic and inelastic scattering of the neutrons), neutron dosimetry, neutron radiography, reactor physics and neutron activation analysis. The reactor is used very extensively as a main instrument in the Reactor Training Centre in Ljubljana where manpower training for our nuclear power plant and other organisations has been performed. Although the reactor was designed very carefully in order to be used for

  8. 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

  9. EBR-II: twenty years of operating experience

    International Nuclear Information System (INIS)

    Lentz, G.L.; Buschman, H.W.; Smith, R.N.

    1985-01-01

    Experimental Breeder Reactor No. 2 (EBR-II) is an unmoderated, sodium-cooled reactor with a design power of 62.5 MWt. For the last 20 years EBR-II has operated safely, has demonstrated stable operating characteristics, has shown excellent performance of its sodium components, and has had an excellent plant factor. These years of operating experience provide a valuable resource to the nuclear community for the development and design of future liquid metal fast reactors. This report provides a brief description of the EBR-II plant and its early operating experience, describes some recent problems of interest to the nuclear community, and also mentions some of the significant operating achievements of EBR-II. Finally, a few words and speculations on EBR-II's future are offered. 4 figs., 1 tab

  10. Twenty Years of National Minority Protection in the Republic of Croatia

    Directory of Open Access Journals (Sweden)

    Siniša Tatalović

    2011-12-01

    Full Text Available The paper contains a review of policies towards national minorities in the Republic of Croatia in the past twenty years, with reference to the perspective of minority rights implementation. The topic has been analysed in relation to two independent variables – the influence of external factors, i.e. the international community, and internal political processes that have had influence on the realisation of national minority rights. Today, as a country and society on the eve of accession to the European Union, along with a legislatively developed and institutionally branched model of the implementation of national minority rights, we can not claim to have established permanent protection of their rights. The degree of national minority integration in society is the only true indicator of policy success in relation to national minorities. The goal of this policy ought to be complete integration of national minorities into public, cultural, economic and political life, but accompanied by the preservation of their cultural and national identity. The Croatian model has been set up in such a way, but the manner in which it functions will depend on the political will to implement it, the willingness of national minority members to be active subjects of social and political life, as well as on civil society and Croatian society as a whole.

  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. 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…

  13. Trends in CPAP adherence over twenty years of data collection: a flattened curve.

    Science.gov (United States)

    Rotenberg, Brian W; Murariu, Dorian; Pang, Kenny P

    2016-08-19

    Obstructive sleep apnea (OSA) is a common disorder, and continuous airway positive pressure (CPAP) is considered to be the gold standard of therapy. CPAP however is known to have problems with adherence, with many patients eventually abandoning the device. The purpose of this paper is to assess secular trends in CPAP adherence over the long term to see if there have been meaningful improvements in adherence in light of the multiple interventions proposed to do so. A comprehensive systematic literature review was conducted using the Medline-Ovid, Embase, and Pubmed databases, searching for data regarding CPAP adherence over a twenty year timeframe (1994-2015). Data was assessed for quality and then extracted. The main outcome measure was reported CPAP non-adherence. Secondary outcomes included changes in CPAP non-adherence when comparing short versus long-term, and changes in terms of behavioral counseling. Eighty-two papers met study inclusion/exclusion criteria. The overall CPAP non-adherence rate based on a 7-h/night sleep time that was reported in studies conducted over the twenty year time frame was 34.1 %. There was no significant improvement over the time frame. Behavioral intervention improved adherence rates by ~1 h per night on average. The rate of CPAP adherence remains persistently low over twenty years worth of reported data. No clinically significant improvement in CPAP adherence was seen even in recent years despite efforts toward behavioral intervention and patient coaching. This low rate of adherence is problematic, and calls into question the concept of CPAP as gold-standard of therapy for OSA.

  14. 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.

  15. 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......-power) and reliable systems (redundant RNS). Advances in microelectronics and CAD tools play an important role in favoring one technology over another, and a winning choice of the past may become at disadvantage today. In this paper, we address a number of factors influencing the choice of RNS as the winning solution...

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

    International Nuclear Information System (INIS)

    1992-01-01

    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

  17. 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)

  18. 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.

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

    International Nuclear Information System (INIS)

    Fesenko, S V; Alexakhin, R M; Balonov, M I; Bogdevich, I M; Howard, B J; Kashparov, V A; Sanzharova, N I; Panov, A V; Voigt, G; Zhuchenka, Yu M

    2006-01-01

    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)

  20. 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.

  1. Achievements in the past twenty years and perspective outlook of crop space breeding in China

    International Nuclear Information System (INIS)

    Liu Luxiang; Guo Huijun; Zhao Linshu; Gu Jiayu; Zhao Shirong

    2007-01-01

    Space breeding is a novel effective approach to crop mutational improvement, which was firstly founded by the chinese scientists in 1987. A national collaborative research network has been established and significant achievements have been made during the past twenty years. More than forty new mutant varieties derived from space mutagenesis in rice, wheat, cotton, sweet pepper, tomato, sesame and alfalfa have been developed, officially released and put into production. A series of useful rare mutant germplasms which might make a great breakthrough in crop grain yield and/or quality improvement have been obtained. Technique innovations in space breeding and ground simulation of space environmental factors have been made good progresses. Intellective property right protection and industrialization of space mutation techniques and mutant varieties, exploration of the mechanism of space mutation induction have also been stably advanced. In this paper, the main achievements of crop space breeding in the past twenty years had been reviewed. The perspective development strategies of space breeding were also discussed. (authors)

  2. Over Twenty Years Of Experience In ITU TRIGA MARK-II Reactor

    International Nuclear Information System (INIS)

    Yavuz, Hasbi

    2008-01-01

    I.T.U. TRIGA MARK-II Training and Research Reactor, rated at 250 kW steady-state and 1200 MW pulsing power is the only research and training reactor owned and operated by a university in Turkey. Reactor has been operating since March 11, 1979; therefore the reactor has been operating successfully for more than twenty years. Over the twenty years of operation: - The tangential beam tube was equipped with a neutron radiography facility, which consists of a divergent collimator and exposure room; - A computerized data acquisition system was designed and installed such that all parameters of the reactor, which are observed from the console, could be monitored both in normal and pulse operations; - An electrical power calibration system was built for the thermal power calibration of the reactor; - Publications related with I.T.U. TRIGA MARK-II Training and Research Reactor are listed in Appendix; - Two majors undesired shutdown occurred; - The I.T.U. TRIGA MARK-II Training and Research Reactor is still in operation at the moment. (authors)

  3. Twenty years of operation of WWER 440/230 units in Jaslovske Bohunice

    International Nuclear Information System (INIS)

    Tomek, J.

    1998-01-01

    It is twenty years this year since the first unit WWER 440 of Slovak Nuclear Power Plant Jaslovske Bohunice was commissioned. There are four units WWER 440 in operation Jaslovske Bohunice site. First two units of older soviet PWR design V-230 (also known as V-1) and other two units of newer V-213 type (also known as V-2). The goal of this presentation is to summarize and evaluate the operation of Unit 1 and 2 for this period of time and mainly to describe what has been done and what is planned to be done to increase the nuclear safety and operational reliability of both units. The operating organization and regulatory authority assume that an internationally acceptable level of safety will be reached by accomplishing of the upgrading program.(author)

  4. Prospects for local community wind energy projects in the UK

    International Nuclear Information System (INIS)

    Taylor, Derek; Open Univ., Milton Keynes

    1993-01-01

    This paper examines the prospects for local community wind energy projects in the UK. After explaining the advantages of such projects compared to purely commercial developments, the scale and funding for the projects are discussed. It is argued that such projects are beneficial both financially to individual members and also to the local rural economies particularly in deprived regions. (UK)

  5. 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.

  6. 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).

  7. Twenty years research of chronic gamma-ray irradiation on seed crops

    International Nuclear Information System (INIS)

    Yamashita, Atsushi

    1983-01-01

    Twenty years of the works on the chronic gamma-ray irradiation of seed crops are summarized. Radiosensitivity and the mutation rate per unit exposure varies not only with the genetic factor but also depend on whether treatment is given to seeds or growing plants. The relation between the radiosensitivity of seeds and growing plants also varies with plant species. In Hordeum, Avena and Nicotiana, the highest mutation rate obtained by the chronic irradiation of growing plants is similar to that in seed irradiation, but in Oryza and Setalia, chronic irradiation was two to three times more effective for attaining a higher mutation rate. The mutation spectrum also varies with the mutagen, the factors modifying the effects of mutagen, and the dose of mutagen. The suitability of a particular mutagenic treatment to a species should be taken into consideration in the evaluation of mutagenic treatment. For instance, NaN 3 is highly mutagenic to barley, but less mutagenic to rice. The gene ea7 controlling the maturing earliness of barley seems to be mutable in chronic irradiation, and the mutants obtained by chronic irradiation are healthy. The author emphasized that the chronic irradiation at the gamma-field is a useful mutagenic treatment, even though some negative results have been reported in European countries. (Kaihara, S.)

  8. Hypopigmented mycosis fungoides in a twenty-year-old Saudi woman with fair skin

    Directory of Open Access Journals (Sweden)

    Al-Ratrout J

    2006-01-01

    Full Text Available The hypopigmented variant of mycosis fungoides (MF is charactrized by the presence of hypopigmented patches as the sole manifestation of the disease. This variant is usually observed in the dark skin of African or Asian individuals particularly children, but nevertheless is an uncommonly reported presentation of the disease. The incidence of hypopigmented MF in Caucasian patients and others of fair skin color is rare. We describe hypopigmented lesions arising in a twenty-year-old Saudi woman with type IV skin color. The diagnosis of mycosis fungoides stage IA was made based on the clinico-radiological and histological features. The patient responded well to PUVA therapy and is currently clear of lesions. MF should be considered in the differential diagnosis of hypopigmented macular lesions in patients of any skin color and age. Multiple skin biopsies must be performed on different occasions so as not to miss the diagnosis; and long term follow up is recommended since recurrence is common and occasional cases behave aggressively.

  9. Reactions to combat stress in Israeli veterans twenty years after the 1982 Lebanon war.

    Science.gov (United States)

    Solomon, Zahava; Shklar, Rami; Singer, Yaffa; Mikulincer, Mario

    2006-12-01

    During the war or shortly thereafter, the most common manifestation of combat induced psychopathology is combat stress reaction (CSR). The long-term consequences of CSR have so far received little scientific attention. The aim of this study was to examine whether CSR is a marker for long-term PTSD and other psychiatric comorbidities. Two groups of veterans from the 1982 Lebanon war were assessed 20 years after the war: one comprised 286 CSR casualties and the other comprised 218 matched non-CSR soldiers. Participants were assessed for PTSD, psychiatric symptomatology, social functioning, physical health, and postwar life events. Twenty years after the war, veterans with antecedent CSR reported more PTSD, psychiatric symptomatology and distress, social dysfunction, and health problems than did non-CSR veterans. We conclude that CSR should be seen as a marker for long-term psychiatric distress and impairment. In addition, the implications of combat-related trauma are broad and varied, and go beyond the narrow scope of PTSD.

  10. 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.

  11. Industries processing naturally occurring radioactive materials: twenty years of emission data in the Netherlands

    International Nuclear Information System (INIS)

    Tanzi, C.P.

    2008-01-01

    This paper provides a review of the dose assessment of discharges to air of two industries processing NORM (Naturally Occurring Radioactive Materials) in the Netherlands. An industrial plant producing elemental phosphorus (thermal process, unique within Europe) reports since 1987 its emission data to the Dutch Ministry of the Environment (VROM: Ministry of Housing, Spatial Planning and the Environment). This plant accounts for the highest release of Po-210 to air in the Netherlands, with a yearly average of approximately 500 GBq. Other significant NORM discharges to air arise from an industrial plant with blast-furnaces for steel production. Yearly discharges fall under permit, and are reported, since 1993. RIVM, the National Institute for Public Health and the Environment, is tasked by the Ministry to assess the dose to the general public arising from these discharges to air. Air transport modelling is used to determine both air concentration (for inhalation exposure) and deposition rate of the radionuclides. A (conservative) committed ingestion dose is determined by modelling the uptake of radionuclides from contaminated farmland, and assuming a food basket to be fairly representative for the population of the Netherlands. Discharges to water in the Netherlands have decreased in the past twenty years, due both to the closure of two phosphoric acid plants a decade ago and the improved treatment of waste fluids by other NORM industries. The collective dose assessed from discharges to air since 1987 is presented here. (author)

  12. Twenty years of student sexual behavior: subcultural adaptations to a changing health environment.

    Science.gov (United States)

    Netting, Nancy S; Burnett, Matthew L

    2004-01-01

    This twenty-year study analyzes changes in sexual behavior among students at Okanagan University College in British Columbia, Canada. Surveys conducted in 1980, 1990, and 2000 reveal a steady increase in safer sexual practices. Most students now question potential partners about their past, use condoms with a new sexual partner, and maintain fairly long-term monogamous relationships. Three sexual subcultures continue to coexist in fairly stable proportions: celibacy (about 30%), monogamy (about 60%), and free experimentation (about 10%). Each subculture has created its own response to the danger of HIV/AIDS: celibates exaggerate the danger they face, monogamists rely on love and fidelity for protection, and free experimenters have increased their use of condoms. While romantic feelings lead many monogamous couples to abandon condoms without objective HIV/AIDS knowledge, free experimenters still face the highest risk. Although they now use condoms more than half the time, their lifestyle, which involves multiple partners, risky sexual acts, and frequent drug and/or alcohol use, clearly remains dangerous. The persistence of distinct subcultures has implications for health education programs, which would be most effective if based on key values held by specific target groups.

  13. 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.

  14. 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.

  15. Twenty Years of Regional Safeguards: the ABACC System and the Synergy with the National Nuclear Material Control Systems

    International Nuclear Information System (INIS)

    Dias, Fabio C.; Palhares, Lilia C.; De Mello, Luiz A.; Vicens, Hugo E.; Maceiras, Elena; Terigi, Gabriel

    2011-01-01

    As result of the nuclear integration between Brazil and Argentina, in July 1991 the Agreement for Peaceful Uses of the Nuclear Energy (Bilateral Agreement) was signed and the Brazilian Argentine Agency for Accountancy and Control of Nuclear Material (ABACC) was created [1]. The main role assigned to ABACC was the implementation and administration of the regional control system and the coordination with the International Atomic Energy Agency (IAEA) in order to apply safeguards to all nuclear material in all nuclear activities of Argentina and Brazil. In December 1991 the IAEA, ABACC, Argentina and Brazil signed the Quadripartite Agreement (INFCIRC/435) [2]. The agreement establishes obligations similar to those established by model INFCIRC/153 comprehensive agreements. The Bilateral Agreement establishes that the Parties should make available financial and technical capabilities to support ABACC activities. In order to accomplish this challenge, the National Systems had to improve their structure and capabilities. Through the close interaction with the IAEA and ABACC, the national systems have been enriched by adopting new methodologies, implementing innovative safeguards approaches and providing specialized training to the regional inspectors. All of this also resulted in relevant technical improvements to the regional system as a whole. The approach of both neighborhoods controlling each other increased the confidence between the partners and permitted a better knowledge of their potentialities. The recognized performance of the regional system in the implementation of innovative, efficient and credible safeguards measures increased the confidence of the international community on the implementation of nuclear safeguards in Argentina and Brazil. In this paper, after twenty years of the creation of the ABACC System, the view of the Brazilian and Argentine National Authorities is presented. (authors)

  16. Commercial NAA — Is It a Success? Evaluation of a Twenty Year Experiment

    International Nuclear Information System (INIS)

    Parry, S.

    2013-01-01

    The commercial service at Imperial College was maintained for twenty years by juggling staff, equipment and irradiation facilities, building when required and downsizing when necessary. At no point was the service entirely self-sufficient since staff had more than one role and participated in teaching and research as well as the analytical service. The balance was of benefit everyone concerned, including students who have studied with us and gained experience of working within a well maintained and quality assured laboratory. The benefits of collaborating with industry cannot be overestimated, with the secondary effects for research and teaching identified previously. A key change took place in the early 2000s, which can be seen in Figure 5 by the fall in income from 2002. The author’s academic department became a separate cost centre to the Reactor Centre, and irradiations were charged at a more realistic price. Once the true costs were built in, including space, overheads and irradiation charges, it was not possible to maintain a viable business plan without reducing staff to a non-viable number. As a result, in 2003 the analytical service was handed to the Reactor Centre, in which the business could remain viable because the irradiation charge became income not expenditure. Without the continued interactions that academic research generated, the NAA service has diminished with very few customers in the past few years. Staff are occupied with internal work for the reactor such as routine monitoring using gamma spectrometry. In summary the introduction and operation of a commercial service is to be recommended, particularly in those situations where it can complement other parts of the organisation such other analytical or academic activities. It is not practical to fund reactor operations entirely on commercial activities, but it can result in a number of spin-offs that can increase other income streams such as teaching and research projects. Over the past 28

  17. Twenty years of meta-analyses in orthopaedic surgery: has quality kept up with quantity?

    Science.gov (United States)

    Dijkman, Bernadette G; Abouali, Jihad A K; Kooistra, Bauke W; Conter, Henry J; Poolman, Rudolf W; Kulkarni, Abhaya V; Tornetta, Paul; Bhandari, Mohit

    2010-01-01

    As the number of studies in the literature is increasing, orthopaedic surgeons highly depend on meta-analyses as their primary source of scientific evidence. The objectives of this review were to assess the scientific quality and number of published meta-analyses on orthopaedics-related topics over time. We conducted, in duplicate and independently, a systematic review of published meta-analyses in orthopaedics in the years 2005 and 2008 and compared them with a previous systematic review of meta-analyses from 1969 to 1999. A search of electronic databases (MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews) was performed to identify meta-analyses published in 2005 and 2008. We searched bibliographies and contacted content experts to identify additional relevant studies. Two investigators independently assessed the quality of the studies, using the Oxman and Guyatt index, and abstracted relevant data. We included forty-five and forty-four meta-analyses from 2005 and 2008, respectively. While the number of meta-analyses increased fivefold from 1999 to 2008, the mean quality score did not change significantly over time (p = 0.067). In the later years, a significantly lower proportion of meta-analyses had methodological flaws (56% in 2005 and 68% in 2008) compared with meta-analyses published prior to 2000 (88%) (p = 0.006). In 2005 and 2008, respectively, 18% and 30% of the meta-analyses had major to extensive flaws in their methodology. Studies from 2008 with positive conclusions used and described appropriate criteria for the validity assessment less often than did those with negative results. The use of random-effects and fixed-effects models as pooling methods became more popular toward 2008. Although the methodological quality of orthopaedic meta-analyses has increased in the past twenty years, a substantial proportion continues to show major to extensive flaws. As the number of published meta-analyses is increasing, a routine checklist for

  18. 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)

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

    International Nuclear Information System (INIS)

    Goffin, C.; Duvivier, L.; Girasa, E.; Brognez, J.

    2002-01-01

    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)

  20. 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.

  1. Twenty years of experience with central softening in The Netherlands : Water quality – Environmental benefits – Costs

    NARCIS (Netherlands)

    Hofman, J.A.M.H.; Kramer, O.J.I.; van der Hoek, J.P.; Nederlof, M; Groenendijk, M

    2006-01-01

    Central softening has been utilized by the Dutch water utilities since the late 1970s. It was introduced in the water treatment process as a method to supply water with an optimum water composition to prevent lead and copper release and to prevent excessive scaling. Twenty years of experience show

  2. 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.

  3. The last twenty years of the IAEA technical cooperation on the uranium production cycle in Argentina

    International Nuclear Information System (INIS)

    Lopez, L.

    2014-01-01

    Since 1993, the National Atomic Energy Commission (Argentina) has been involved in several IAEA Technical Cooperation Projects at interregional, regional and national levels, covering different aspects of the uranium production cycle. The TC referred projects can be listed as follows: - INT 2/015 “Supporting Uranium Exploration Resource Augmentation and Production Using Advanced Techniques” (2012 – Present). - RLA 3/006 - 010 “Upgrading of Uranium Exploration, Exploitation and Yellowcake Production Techniques taking Environmental Problems into Account” (2007 - Present). - ARG 2/014 “Development and Strengthening of the Uranium Mining Cycle Human Resources” (2012 – Present). - ARG 3/012 - 014 "Geology favourability, production feasibility and environmental impact assessment of uranium deposits exploitable by the in situ leaching technology (ISL)'' (2007 - Present). - ARG 3/009 “Development and use of biological techniques for uranium production (ARG 3/009)” (2003 - 2006). - ARG 3/008 “Prospection of uranium and other elements using gamma-ray spectrometry surveys” (2001 – 2005). - ARG 3/007 “Uranium Favorability and Exploration in Argentina” (1993 - 1997). It can be considered that the role of the technological transfer by the IAEA has been highly relevant for increasing the capability of strategically plan and more efficiently carry out the uranium production cycle projects in Argentina. (author)

  4. Twenty Years after Philippine Trade Liberalization and Industrialization: What Has Happened and Where Do We Go from Here

    OpenAIRE

    Aldaba, Rafaelita M.

    2013-01-01

    The paper aims to review our trade liberalization policy and its contribution to the country`s industrial growth and performance. After more than twenty years of liberalization, the overall performance of the manufacturing industry has been weak, growth has been slow, and contribution to value added and employment has been limited. Total factor productivity growth declined from 1996 to 2006. The industrial structure has remained "hollow" or "missing" in the middle and medium enterprises have ...

  5. 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.

  6. Twenty Years of Creativity Research in Human-Computer Interaction: Current State and Future Directions

    DEFF Research Database (Denmark)

    Frich Pedersen, Jonas; Biskjaer, Michael Mose; Dalsgaard, Peter

    2018-01-01

    Creativity has been a growing topic within the ACM community since the 1990s. However, no clear overview of this trend has been offered. We present a thorough survey of 998 creativity-related publications in the ACM Digital Library collected using keyword search to determine prevailing approaches......, topics, and characteristics of creativity-oriented Human-Computer Interaction (HCI) research. . A selected sample based on yearly citations yielded 221 publications, which were analyzed using constant comparison analysis. We found that HCI is almost exclusively responsible for creativity......-oriented publications; they focus on collaborative creativity rather than individual creativity; there is a general lack of definition of the term ‘creativity’; empirically based contributions are prevalent; and many publications focus on new tools, often developed by researchers. On this basis, we present three...

  7. Changes in Reef Fish Abundances Associated with the Introduction of Indo-Pacific Lionfish to the Florida Keys National Marine Sanctuary: a Twenty Year Time Series.

    Science.gov (United States)

    Hepner, M.; Muller-Karger, F. E.; Gittings, S.; Stallings, C.

    2016-02-01

    The Marine Biodiversity Observation Network (MBON) is a partnership between academic, private, and government researchers seeking to understand how marine biodiversity changes over long periods of time. In this context, a study of the multi-agency Reef Visual Census (RVC) data, collected over twenty years in the Florida Keys National Marine Sanctuary (FKNMS), was analyzed to measure possible changes in reef fish abundances as a result of possible predation by lionfish predation or due to related trophic cascading. Lionfish were first sighted in the FKNMS in January 2009, with abundances and frequency of occurrence increasing three to six fold throughout the sanctuary by 2011. Their high consumption rates of smaller fish, coupled with their rapidly increasing densities may be having a significant effect on coral reef fish communities. The study compares the natural variability in reef fish abundances from 1994-2009 in the FKNMS, 15 years prior to the first lionfish detected in the sanctuary, to changes in reef fish abundances 5 years after the invasion. The MBON project also aims to develop environmental DNA (eDNA) technology for conducting biodiversity assessments. eDNA is an emerging technique that seeks to quantify biodiversity in an area by obtaining genetic material directly from environmental samples (soil, sediment, water, etc.) without any obvious signs of biological source material. All marine organisms shed DNA into their surrounding habitat, leaving a "fingerprint." Similar to forensic science, the DNA can be collected from seawater and analyzed to determine what species were recently present. The MBON team is evaluating whether eDNA can be used to adequately monitor reef fish biodiversity in coral reef ecosystems. We will compare species detected in our samples to the taxonomic composition of reef fish communities at the sample site as recorded over the past twenty years in the Reef Visual Census data.

  8. Science underlying radioactive waste management: Status and needs -- twenty years later

    International Nuclear Information System (INIS)

    Roy, R.

    1997-01-01

    The setting of the technical subsystem within the overall socio-political-economic-technical radwaste system will be described and the highly interactive nature of the larger setting emphasized. It will be shown that because of the dominance of the socio-political subsystem, the importance of the technical subsystem is overshadowed. Moreover the key issue in the technical subsystem, whether to put more reliance on the immobilization (via the waste package or engineered barriers) or the isolation (via the geology) has stayed tilted toward the latter since 1978, when the author organized the first symposium on radwaste science (at the Materials Research Society Meeting). Now that the isolation strategy is stymied, the opportunity arises again for the materials community to make a compelling case for the waste package''s true significance. This review is made mainly from the perspective of one laboratory in one country, the US. What is remarkable about the state of research in the technical subsystem is how little the big picture of the science or the technology has changed after some billions spent on R/D. The borosilicate glass (almost unchanged) is still the establishment''s choice of reference waste form for HLW. Cost, however, is finally forcing cement encapsulated forms to be given a second look. Mineral-modeled ceramics have received a great deal of scientific attention but remain esoteric to managers. It will be shown that in the author''s opinion an enormous amount of detailed science has been done but most of it is unlikely to prove to be of any relevance or use. The policy implications for future R/D are discussed

  9. Twenty Years of Progress on Global Ocean Tides: The Impact of Satellite Altimetry

    Science.gov (United States)

    Egbert, Gary; Ray, Richard

    2012-01-01

    At the dawn of the era of high-precision altimetry, before the launch of TOPEX/Poseidon, ocean tides were properly viewed as a source of noise--tidal variations in ocean height would represent a very substantial fraction of what the altimeter measures, and would have to be accurately predicted and subtracted if altimetry were to achieve its potential for ocean and climate studies. But to the extent that the altimetry could be severely contaminated by tides, it also represented an unprecedented global-scale tidal data set. These new data, together with research stimulated by the need for accurate tidal corrections, led to a renaissance in tidal studies in the oceanographic community. In this paper we review contributions of altimetry to tidal science over the past 20 years, emphasizing recent progress. Mapping of tides has now been extended from the early focus on major constituents in the open ocean to include minor constituents, (e.g., long-period tides; non-linear tides in shelf waters, and in the open ocean), and into shallow and coastal waters. Global and spatially local estimates of tidal energy balance have been refined, and the role of internal tide conversion in dissipating barotropic tidal energy is now well established through modeling, altimetry, and in situ observations. However, energy budgets for internal tides, and the role of tidal dissipation in vertical ocean mixing remain controversial topics. Altimetry may contribute to resolving some of these important questions through improved mapping of low-mode internal tides. This area has advanced significantly in recent years, with several global maps now available, and progress on constraining temporally incoherent components. For the future, new applications of altimetry (e.g., in the coastal ocean, where barotropic tidal models remain inadequate), and new mission concepts (studies of the submesoscale with SWOT, which will require correction for internal tides) may bring us full circle, again pushing

  10. Environmental consequences of the Chernobyl accident and their remediation: Twenty years of experience

    International Nuclear Information System (INIS)

    Anspaugh, L.R.

    2005-01-01

    health effects attributable to radiation exposure arising from the accident as well as to provide advice on environmental remediation and special health care programmes, and to suggest areas where further research is required. The Forum was created as a contribution to the United Nations' ten years strategy for Chernobyl, launched in 2002 with the publication of Human Consequences of the Chernobyl Nuclear Accident - A Strategy for Recovery. In 2003-2004, two groups of experts from twelve countries, including Belarus, Russia and Ukraine, and from relevant international organizations have assessed the accident's environmental and health consequences. In early 2005, the group Environment, Coordinated by the IAEA, and the group Health, coordinated by the WHO, have presented their reports for Forum consideration. Both reports were considered and approved by the Forum at its meeting on 18-20 April 2005. This meeting also decided, inter alia, 'to consider he approved reports - as a common position of the Forum members, i.e., of the eight United Nations organizations and the three more affected countries, regarding environmental and health consequences of the Chernobyl accident, as well as recommended future actions, i.e., as a consensus within the United Nations system. Tis report presents the findings and recommendations of the Chernobyl Forum concerning Environmental effects of the Chernobyl accident. The Forum's report considering health effects is in process of publication under WHO responsibility. The environmental group of experts was chaired by Dr. Lynn Anspaugh from the University of Utah, USA; the scientific secretary of this group and of the whole Chernobyl Forum activity was Dr. Mikhail Balonov of the Division of Radiation, Transport and Waste Safety, IAEA. In all cases the scientists from the UN organisations, the international community, and the three more affected countries have been able to reach consensus in the preparation of their respective documents. After

  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. Mercury pollution control in industrial area in Rosignano Marittimo (Italy) during last twenty years (1971-1991)

    International Nuclear Information System (INIS)

    Bertani, R.

    1995-01-01

    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

  13. 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.

  14. CND twenty years on

    International Nuclear Information System (INIS)

    Taylor, R.; Pritchard, C.

    1980-01-01

    A study is presented of people who were supporters or leaders in the Campaign for Nuclear Disarmament (CND) in the 1950s and 1960s. Information is given from questionnaires completed by 403 respondents, about their social and political development during the past 20 years. (author)

  15. 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.

  16. 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.

  17. Muiris O’Sullivan’s “New Storytelling”: The Art of Twenty Years A-Growing

    Directory of Open Access Journals (Sweden)

    Thomas F. Shea

    2018-03-01

    Full Text Available Since its publication in 1933, Muiris O’Sullivan’s Fiche Blian ag Fás (Twenty Years A-Growing has been limited and distorted by critics who view the memoir through a lens shaped by prior assessments of Tomás Ó Criomhthain’s earlier Blasket autobiography, An tOileánach (The Islandman. Muiris Mac Conghail voices the standard perspective when he states, “It was the publication of Tomás Ó Criomhthain’s An tOileánach, in 1929, which both acted as an incentive and provided an exemplar to Muiris” (150. O’Crohan’s autobiography certainly inspired O’Sullivan; however, Muiris’s more literary sensibility set him on his own inscriptive journey during which he creates a new type of narrative, one which creatively interweaves oral traditions with the contours of the novel. As we investigate what Pádraig Ó Fiannachta terms the author’s nua scéalaíocht, or “new storytelling” techniques, we can more fully appreciate O’Sullivan’s subtle dexterities as both traditional storyteller and novelistic craftsman.

  18. Health effects following long-term exposure to thorium dusts: a twenty-year follow-up study in China

    International Nuclear Information System (INIS)

    Chen, X.A.; Cheng, Y.E.; Xiao, H.; Chen, L.; Yang, Y.J.; Dong, Z.H.; Zheng, R.; Feng, G.; Deng, Y.H.; Feng, Z.L.; Han, X.M.

    2004-01-01

    A twenty-year follow-up study was carried out at Baiyun Obo Rare-earth Iron Mine in China, This mine has been mined since 1958. Its ore contains 0.04% of ThO 2 and 10% of SiO 2 . The purpose of this study is to investigate possible health effects in dust-exposed miners following long-term exposure to thorium-containing dusts and thoron progeny. By using the negative high voltage exhaled thoron progeny measurement system to estimate the miner's thorium lung burden. The highest thorium lung burden among 1 158 measurements of 638 miners was 11.11 Bq. The incidence of stage 0 + pneumoconiosis was increased among dust-exposed miners. An epidemiological study showed that the lung cancer mortality of the dust-exposed miners was significantly (p 2 and SiO 2 ) and thoron progeny. This is the first evidence in humans of the carcinogenicity after long-term inhalation of thorium-containing dusts and thoron progeny. The total person-years of observation for the dust-exposed miners and the controls were 62 712 and 34 672 respectively. (author)

  19. 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.

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

    Science.gov (United States)

    Silva, Luci Meire Pereira da; Muccioli, Cristina; Oliveira, Filipe de; Arantes, Tiago Eugênio; Gonzaga, Lucas Renó; Nakanami, Célia Regina

    2013-01-01

    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. 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. 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%). 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. Decoding the Digital Campus Climate for Prospective LGBTQ+ Community Colleges Students

    Science.gov (United States)

    Taylor, Jason L.; Dockendorff, Kari J.; Inselman, Kyle

    2018-01-01

    LGBTQ+ students are increasingly visible on community college campuses, and a safe and welcoming campus climate is critical to LGBTQ+ students' academic success and well-being. Campus climate is difficult to assess for prospective LGBTQ+ community college students, and institutional websites may be a source of information about campus climate.…

  2. 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…

  3. The Italian National Register of infants with congenital hypothyroidism: twenty years of surveillance and study of congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    Olivieri Antonella

    2009-02-01

    Full Text Available Abstract All the Italian Centres in charge of screening, diagnosis, and follow-up of infants with congenital hypothyroidism participate in the Italian National Registry of affected infants, which performs the nationwide surveillance of the disease. It was established in 1987 as a program of the Health Ministry and is coordinated by the Istituto Superiore di Sanità. The early diagnosis performed by the nationwide newborn screening programme, the prompt treatment and the appropriate clinical management of the patients carried out by the Follow-up Centres, and the surveillance of the disease performed by the National Register of infants with congenital hypothyroidism are the components of an integrated approach to the disease which has been successfully established in our country. The aim of the Register is to monitor efficiency and effectiveness of neonatal screening, to provide disease surveillance and to allow identification of possible aetiological risk factors for the disease. During the past twenty years the active and continuous collaboration between the Register and the Italian Screening and Follow up Centres for Congenital Hypothyroidism allowed to perform a standardization of screening procedures and considerable improvements in the time at starting treatment and in the dose of therapy. Furthermore, the large amount and the high quality of information collected in the Register provided a unique opportunity for research into the disease. This because data collected in the Register are highly representative as referred to the entire Italian population with congenital hypothyroidism. The results derived from the epidemiological studies performed in these years, by using the Register database, contributed to deepen the knowledge of congenital hypothyroidism, to start identifying the most important risk factors for the disease, and to orient molecular studies aimed at identifying new genes involved in the aetiology of this condition.

  4. LNG (liquefied natural gas) in the Asia-Pacific region: Twenty years of trade and outlook for the future

    Energy Technology Data Exchange (ETDEWEB)

    Kiani, B.

    1990-01-01

    This report discusses the following topics: the current status of LNG trade in the Asia-Pacific region; present structure and projected demand in the Asia-Pacific region; prospective and tentative projects; and LNG contracts: stability versus flexibility.

  5. 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.

  6. Epidemiological characteristics of children born with Down syndrome in western Herzegovina in the period of the last twenty years (1994-2013).

    Science.gov (United States)

    Sumanović-Glamuzina, Darinka; Zovko, Ana; Letica, Ivona; Jerković-Raguž, Marjana; Mustapić, Antonija; Božić, Tomica; Vukojević, Mladenka

    2014-12-01

    Children with Down syndrome (DS) are an everyday casuistry of pediatric clinical medicine. The prevalence of DS is dependent on socio-demographic and cultural conditions of a community. Antenatal screening is not carried out mainly due to religious views, and the prevalence of DS in our region is really considered a "natural phenomenon". The aim of the study was to analyze some epidemiological characteristics of infants with Down syndrome in the western region of Herzegovina in the period between year 1994-2013. We performed a retrospective analysis of hospital records of children who were supervised and treated at Children's Hospital through the twenty-year period. In this period there were 44,100 liveborn infants. Down syndrome was detected in 78 children (54 male and 24 female). The prevalence is estimated at 1.8/1,000 of live births. Aborted fetuses and stillbirths were not analyzed. 37 (47%) of the parent couples were over 35 years of age. Out of that 65 cytogenetic analysis, a regular type of trisomy 21 was found in 94% of cases, and the translocation in 6%. From major malformations (MM) heart failure was more often present (47%), then the anomaly of the gastrointestinal and genitourinary systems. Ten children (12%) died, most often in the early period of infancy due to complications of the cardiovascular system. The prevalence of DS throughout these two decades has been uniform in the region of western Herzegovina. Improvement in perinatal care in recent years caused higher survival and a better quality of life for the children with DS and thus their families. DS is less a desirable family tragedy, and increasingly a tolerable family fate.

  7. "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…

  8. Review: Devan Pillay, Gilbert M. Khadiagala, Prishani Naidoo and Roger Southall (eds, New South African Review 4: A Fragile Democracy – Twenty Years On (2014

    Directory of Open Access Journals (Sweden)

    Ian Taylor

    2015-01-01

    Full Text Available Review of the edited volume:Devan Pillay, Gilbert M. Khadiagala, Prishani Naidoo and Roger Southall (eds, New South African Review 4: A Fragile Democracy – Twenty Years On, Johannesburg: Wits University Press, 2014, ISBN 9781868147632, 380 pp.

  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. Twenty years of research on fungal-plant interactions on Lyman Glacier forefront—lessons learned and questions yet unanswered

    Science.gov (United States)

    Ari Jumpponen; Shawn P. Brown; James M. Trappe; Efrén Cázares; Rauni. Strömmer

    2012-01-01

    Retreating glaciers and the periglacial areas that they vacate produce a harsh environment of extreme radiation, nutrient limitations and temperature oscillations. They provide a model system for studying mechanisms that drive the establishment and early assembly of communities. Here, we synthesize more than 20 years of research at the Lyman Glacier forefront in the...

  11. Training medical students in health promotion: twenty years of experience at the Faculty of Medicine of the University of Geneva

    Directory of Open Access Journals (Sweden)

    Thomas Mattig

    2017-09-01

    Full Text Available Background: In most cases, the work of medical doctors, be they general practitioners or specialists, involves some dimension of health promotion (HP. There is thus ample justification for increasing the awareness of medical students vis-à-vis HP and its relevance for their future practice.Methods: In the context of a major curriculum reform (problem-based learning [PBL] at the Faculty of Medicine of the University of Geneva in the mid-1990s, several steps were taken to strengthen HP throughout the curriculum and include HP in its key domains as defined by the Ottawa Charter (OC.Results: First, the political dimension of HP was developed in a series of first- and fifth-year lectures and third-year workshops; second, community action was strengthened through a third year one-month community immersion program; third, the development of personal skills was integrated into second- and third-year PBL cases and into fourth-and fifth-year learning activities in clinical settings as well as second- and third-year HP electives; in terms of reorienting health services, the chosen approach included the development of a HP-specific track in the context of a Certificate of Advanced Studies (CAS in Community Health and a Master of Advanced Studies(MAS in Public Health. Furthermore, a supportive intra-university environment was created through a collaborative convention with Health Promotion Switzerland, which is in charge of coordinating HP in Switzerland.Conclusion: In our view, HP teaching for medical students seems all the more relevant given that future medical doctors will have to take care of an increasing number of patients likely to develop chronic non-communicable diseases.

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    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.

  14. Twenty years of chemistry associated with the needs and utilization of nuclear reactors at the 'Boris Kidric' Institute of nuclear sciences, Vinca, Yugoslavia

    International Nuclear Information System (INIS)

    1969-01-01

    This publication covers nine review papers on the following topics related to the needs and utilization of nuclear reactors in the Boris Kidric Institute of nuclear sciences during previous twenty years: radiochemistry, hot atom chemistry, isotope production, spent nuclear fuel reprocessing, chemistry of transuranium elements; liquid radioactive waste processing, purification of reactor coolant water by inorganic ion exchangers, research related to deuterium concentration processes, and chemical dosimetry at the RA reactor [sr

  15. Twenty years of the Italian Fanconi Anemia Registry: where we stand and what remains to be learned.

    Science.gov (United States)

    Risitano, Antonio M; Marotta, Serena; Calzone, Rita; Grimaldi, Francesco; Zatterale, Adriana

    2016-03-01

    The natural history of Fanconi anemia remains hard to establish because of its rarity and its heterogeneous clinical presentation; since 1994, the Italian Fanconi Anemia Registry has collected clinical, epidemiological and genetic data of Italian Fanconi Anemia patients. This registry includes 180 patients with a confirmed diagnosis of Fanconi anemia who have either been enrolled prospectively, at diagnosis, or later on. After enrollment, follow-up data were periodically collected to assess the clinical course, possible complications and long-term survival; the median follow up was 15.6 years. The main goal of the study was to describe the natural history of Fanconi anemia, focusing on the following variables: family history, disease presentation, development of hematological manifestations, development of malignancies, occurrence of hematopoietic stem cell transplantation and survival. Typical morphological and/or hematological abnormalities and/or growth retardation were the most common manifestations at diagnosis; the majority of patients (77%) exhibited hematological abnormalities at the initial presentation, and almost all (96%) eventually developed hematological manifestations. More than half of the patients (57%) underwent a bone-marrow transplant. The occurrence of cancer was quite rare at diagnosis, whereas the cumulative incidence of malignancies at 10, 20 and 30 years was 5%, 8% and 22%, respectively, for hematological cancers and 1%, 15% and 32%, respectively, for solid tumors. Overall survival at 10, 20 and 30 years were 88%, 56% and 37%, respectively; the main causes of death were cancer, complications of the hematological presentation and complications of transplantation. These data clearly confirm the detrimental outcome of Fanconi anemia, with no major improvement in the past decades. Copyright© Ferrata Storti Foundation.

  16. Quality control processes in allografting: A twenty-year retrospective review of a hospital-based bone bank in Taiwan.

    Science.gov (United States)

    Fu, Shau-Huai; Liu, Jyh-You; Huang, Chuan-Ching; Lin, Feng-Ling; Yang, Rong-Sen; Hou, Chun-Han

    2017-01-01

    Musculoskeletal allografts are now commonly used. To decrease the potential risks of transmission of pathogenic bacteria, fungi, or viruses to the transplant recipients, certain issues regarding the management of patients who receive contaminated allografts need to be addressed. We aimed to clarify the incidence and extent of disease transmission from allografts by analyzing the allografting procedures performed in the bone bank of our hospital over the past 20 years. We retrospectively reviewed the data from our allograft registry center on 3979 allografts that were implanted in 3193 recipients throughout a period of two decades, from July 1991 to June 2011. The source of the allografts, results of all screening tests, dates of harvesting and implantation, and recipients of all allografts were checked. With the help of the Center for Infection Control of our hospital, a strict prospective, hospital-wide, on-site surveillance was conducted, and every patient with healthcare-associated infection was identified. Fisher's exact test was used to compare the infection rate between recipients with sterile allografts and those with contaminated allografts. The overall discard and infection rates were, respectively, 23% and 1.3% in the first decade (1991-2001); and 18.4% and 1.25% in the second decade (2001-2011). The infection rate of contaminated allograft recipients was significantly higher than that of sterile allograft recipients (10% vs. 1.15%, P bank are comparable with those of international bone banks. Strict allograft processing and adequate prophylactic use of antibiotics are critical to prevent infection and disease transmission in such cases.

  17. Quality control processes in allografting: A twenty-year retrospective review of a hospital-based bone bank in Taiwan.

    Directory of Open Access Journals (Sweden)

    Shau-Huai Fu

    Full Text Available Musculoskeletal allografts are now commonly used. To decrease the potential risks of transmission of pathogenic bacteria, fungi, or viruses to the transplant recipients, certain issues regarding the management of patients who receive contaminated allografts need to be addressed. We aimed to clarify the incidence and extent of disease transmission from allografts by analyzing the allografting procedures performed in the bone bank of our hospital over the past 20 years. We retrospectively reviewed the data from our allograft registry center on 3979 allografts that were implanted in 3193 recipients throughout a period of two decades, from July 1991 to June 2011. The source of the allografts, results of all screening tests, dates of harvesting and implantation, and recipients of all allografts were checked. With the help of the Center for Infection Control of our hospital, a strict prospective, hospital-wide, on-site surveillance was conducted, and every patient with healthcare-associated infection was identified. Fisher's exact test was used to compare the infection rate between recipients with sterile allografts and those with contaminated allografts. The overall discard and infection rates were, respectively, 23% and 1.3% in the first decade (1991-2001; and 18.4% and 1.25% in the second decade (2001-2011. The infection rate of contaminated allograft recipients was significantly higher than that of sterile allograft recipients (10% vs. 1.15%, P < 0.01 in the second decade. Both infection and discard rates of our bone bank are comparable with those of international bone banks. Strict allograft processing and adequate prophylactic use of antibiotics are critical to prevent infection and disease transmission in such cases.

  18. Twenty year multi-follow-up of different types of hallucinations in schizophrenia, schizoaffective disorder, bipolar disorder, and depression.

    Science.gov (United States)

    Goghari, Vina M; Harrow, Martin

    2016-10-01

    Hallucinations are a salient feature of both psychotic and mood disorders. Currently there is a call for more research on the phenomenology of different forms of hallucinations, in a broader array of disorders, to further both theoretical knowledge and clinical utility. We investigated auditory, visual, and olfactory hallucinations at index hospitalization and auditory and visual hallucinations prospectively for 20years in 150 young patients, namely 51 schizophrenia, 25 schizoaffective, 28 bipolar, and 79 unipolar depression. For the index hospitalization, the data showed schizophrenia and schizoaffective patients had a greater rate of auditory and visual hallucinations than bipolar and depression patients. However, over the longitudinal trajectory of their illness, a greater percentage of schizophrenia patients had auditory and visual hallucinations than schizoaffective patients, as well as bipolar and depression patients. Also, in contrast to the initial period, schizoaffective patients did not differentiate themselves over the follow-up period from bipolar patients. Bipolar and depression patients did not significantly differ at index hospitalization or at follow-up. We found visual hallucinations differentiated the groups to a greater degree over the 20year course than did auditory hallucinations. These findings suggest the longitudinal course is more important for differentiating schizophrenia and schizoaffective disorder, whereas the initial years may be more useful to differentiate schizoaffective disorder from bipolar disorder. Furthermore, we found that the early presence of auditory hallucinations was associated with a reduced likelihood for a future period of recovery. No olfactory hallucinations were present at the index hospitalization in any patients. Over the course of 20years, a minority of schizophrenia patients presented with olfactory hallucinations, and very few schizoaffective and bipolar patients presented with olfactory hallucinations. This

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

    Science.gov (United States)

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

    2006-01-01

    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 and survival (relative hazard of dying=RH .70; 95% CI .58-.85) and church attendance and survival (RH .73; 95% CI .64-.87). Results decreased and only stayed significant regarding church attendance when controlled for covariates. Nearly all significant effects were seen in women, but not in men. The effect size of the full sample is less than in more religious environments in United States samples. Although the positive overall RHs are comparable to those of other studies, the mediating variables and pathways of effects seem dissimilar in this sample from a secular environment. Receiving and especially giving help to others are suggested as variables of explanatory value.

  20. Acquired pneumonias in the community in adults: An etiologic prospective study with emphasis in the diagnosis

    International Nuclear Information System (INIS)

    Robledo, J; Sierra, P; Bedoya, F; Londono, A; Porras, A; Lujan, M; Correa, N; Mejia, GI; Realpe, T; Trujillo, H

    2003-01-01

    Is defined prospectively in adults the etiology of acquired pneumonia in the community (NAC) in three hospitals of the city of Medellin. The etiology of NAC in the studied group does not vary of the one reported in other countries, the pneumococo frequency and M. pneumoniae, suggests that the empiric therapies should contemplate these two pathologies, the resource toasted by the microbiology laboratory allows to define the etiology and the specific treatment

  1. MUSYARAKAH FINANCE PROSPECT IN ISLAMIC BANK IN THE FACE OF ASEAN ECONOMIC COMMUNITY (MEA

    Directory of Open Access Journals (Sweden)

    Ahmad Supriyadi

    2016-11-01

    Full Text Available In the era of Dutch colonial, the majority of entrepreneurs in Central Java and Yogyakarta come from the students. But after Indonesian independence, the students did not show up in the business world because of political policy. Nowadays the entrepreneur students bounced back with Islamic banks that one of its products is a Musharakah finance. Musharakah finance deal with the birth of the free market, namely the ASEAN Economic Community so that the question arises how the prospect Musharakah finance in Indonesian Islamic banks of facing the ASEAN Economic Community (AEC. This paper aims to describe the prospect of Musharakah finance to face AEC. The results showed that the Musharakah finance has a lot of prospects such as financing products that can be performed well and have a competitive value because it has a solid legal basis. From the network side, Islamic banks have been supported by a network offices that much better at home and abroad with excellent quality customer service. In addition, the presence Bank Indonesia blueprint of the Islamic banking institution can strengthen the Musharakah finance products so that can be applied in the ASEAN Economic Community (AEC.

  2. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Responsiveness to a Prospective Student E-Mail Inquiry by Community Colleges in the Nine Mega-States

    Science.gov (United States)

    Shadinger, David A.

    2014-01-01

    This quantitative study investigated e-mail responsiveness by community colleges in the nine mega-states to an inquiry from a prospective student. Noel-Levitz (2006b) reported that prospective students want to receive an e-mail with information about an institution prior to applying for admission. Specifically, high school juniors and seniors want…

  5. Which Russia, twenty years later?

    Directory of Open Access Journals (Sweden)

    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.

  6. Twenty Years of Cultural Journalism.

    Science.gov (United States)

    Olmstead, Kathryn J.

    1986-01-01

    Traces history and contributions of cultural journalism since the inception of the first Foxfire Book in 1966. Reviews successful student projects across the country. Discusses significance of cultural journalism as source of cultural identity with potential to increase understanding among different groups of people. (NEC)

  7. Twenty years after the embargo

    International Nuclear Information System (INIS)

    Geller, H.; DeCicco, J.; Laitner, S.; Dyson, C.

    1994-01-01

    This paper reviews the direct and indirect oil import costs and examines actions that can be taken to reduce future imports. We find that the USA could greatly reduce its oil imports during the next 20 years by increasing energy efficiency and accelerating the introduction of fuels derived from renewable energy sources, particularly in the transport sector. (author)

  8. About Chernobyl - Twenty Years Later

    International Nuclear Information System (INIS)

    Tubiana, M.

    2006-01-01

    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.)

  9. Twenty years of operation of the Radioisotope Department of the 3rd Medical Clinic, Faculty of General Medicine, Charles University in Prague

    International Nuclear Information System (INIS)

    Kapitola, J.

    1983-01-01

    Twenty years ago a radioisotope department was established in the old building of the 3rd Medical Clinic in Prague 2. The department is suitably placed and meets present requirements. It was set up as part of the 3rd Medical Clinic and of the Laboratory for endocrinology and Metabolism which gave it its main orientation and scope. Its present scope is much broader. In the twenty years since it was established 115,800 examinations were carried out, some 40 examination methods were introduced, 103 publications published, members of the department were co-authors of another 113 publications, they completed 11 research projects. The production of the department represents a substantial part of laboratory material especially in the diagnosis of endocrinopathy and metabolic disorders at the Clinic and is a significant part of the material of a number of research projects. The department has significantly contributed to the development of nuclear medicine in the Czechoslovak Socialist Republic in thyroid diagnosis, by the first introduction of radioimmunoassay methods, by the introduction of certain other special examination and laboratory methods and is currently taking part in the fulfilment of tasks given by the zoning of nuclear medicine in health care in Czechoslovakia in general and in Prague in particular. (author)

  10. One-year prospective replication study of an untreated sample of community dysthymia subjects.

    Science.gov (United States)

    McCullough, J P; McCune, K J; Kaye, A L; Braith, J A; Friend, R; Roberts, W C; Belyea-Caldwell, S; Norris, S L; Hampton, C

    1994-07-01

    This study replicates an earlier naturalistic-prospective investigation of nontreatment, community DSM-III-R dysthymia subjects. Major goals were to determine spontaneous remission rates and monitor the stability of psychosocial functioning levels over time. Twenty-four dysthymia subjects were followed for 1 year. Three remissions (13%) were diagnosed at the final interview. At a 4-year diagnostic follow-up contact with the remitters only, one remitter had relapsed and two remained in remission. Subjects were monitored for depressive symptom intensity, personality functioning, general medical distress, cognitive functioning, coping stylistics, interpersonal functioning, quality of their social support resources, and general family functioning. Stable levels of psychosocial functioning were maintained across all measures over the 1-year period. Current psychometric findings confirm the conclusions of the earlier nontreatment prospective study that dysthymia is a chronic mood disorder with stable psychosocial features and is unlikely to remit spontaneously over time.

  11. Pharmacists' interventions on prescription problems in one French community pharmacy: A prospective pilot study.

    Science.gov (United States)

    Castronovo, A; Gervais, F; Mongaret, C; Slimano, F

    2018-03-16

    While many international studies widely describe pharmacists' interventions (PIs) on drug-related problems (DRP) in community pharmacies, in France, these activities are underreported. The aim of this study is to describe the PI rate, given as the number of interventions in among all prescriptions reviewed during the study period. This study was conducted in one French rural community pharmacy during a 7-month period. Age, sex, type of prescriber, type of problems, intervention and the outcome were prospectively recorded. PIs were prospectively formalized and classified using the validated tool from the French Society of Clinical Pharmacy. In addition, all interventions were reviewed by an independent pharmacist. Among the 20,238 prescriptions, n=211 pharmacists' interventions on 159 prescriptions (0.79%) were performed. Prescriptions were ordered by general practitioners in 78.6%. The most common DRP were the improper prescription (30.8%), a drug or medical device not received by the patient (21.8%, all linked to drug shortages) or a dosage problem (18.9%). Antibiotics were the most common drugs involved in DRP (13.3%). The main PI were the drug switch/establishment of a therapeutic alternative (38.4%), dose adjustment (25.6%) and optimization of the dispensing/administration modalities (25.1%). The overall acceptance rate of PIs was 93.4%. We found a PI rate, as well as acceptance rate by prescribers, in the same range than as reported in studies performed in other countries. A consequent large part percentage of PIs can be classified as "administrative". This first prospective French study needs to be further supported by multi-site studies. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  12. 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.

  13. Prospective identification of adolescent suicide ideation using classification tree analysis: Models for community-based screening.

    Science.gov (United States)

    Hill, Ryan M; Oosterhoff, Benjamin; Kaplow, Julie B

    2017-07-01

    Although a large number of risk markers for suicide ideation have been identified, little guidance has been provided to prospectively identify adolescents at risk for suicide ideation within community settings. The current study addressed this gap in the literature by utilizing classification tree analysis (CTA) to provide a decision-making model for screening adolescents at risk for suicide ideation. Participants were N = 4,799 youth (Mage = 16.15 years, SD = 1.63) who completed both Waves 1 and 2 of the National Longitudinal Study of Adolescent to Adult Health. CTA was used to generate a series of decision rules for identifying adolescents at risk for reporting suicide ideation at Wave 2. Findings revealed 3 distinct solutions with varying sensitivity and specificity for identifying adolescents who reported suicide ideation. Sensitivity of the classification trees ranged from 44.6% to 77.6%. The tree with greatest specificity and lowest sensitivity was based on a history of suicide ideation. The tree with moderate sensitivity and high specificity was based on depressive symptoms, suicide attempts or suicide among family and friends, and social support. The most sensitive but least specific tree utilized these factors and gender, ethnicity, hours of sleep, school-related factors, and future orientation. These classification trees offer community organizations options for instituting large-scale screenings for suicide ideation risk depending on the available resources and modality of services to be provided. This study provides a theoretically and empirically driven model for prospectively identifying adolescents at risk for suicide ideation and has implications for preventive interventions among at-risk youth. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. 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.

  15. Supporting and improving community health services-a prospective evaluation of ECHO technology in community palliative care nursing teams.

    Science.gov (United States)

    White, Clare; McIlfatrick, Sonja; Dunwoody, Lynn; Watson, Max

    2015-12-01

    Project ECHO (Extension for Community Healthcare Outcomes) uses teleconferencing technology to support and train healthcare providers (HCPs) remotely, and has improved care across the USA. A 6-month pilot was trialled in a community palliative care nursing setting to determine if ECHO would be effective in the UK in providing education and support to community hospice nurses (CHN). The pilot involved weekly 2 hour sessions of teaching and case-based discussions facilitated by hospice staff linking with nine teams of CHN using video conferencing technology. A mixed-methods prospective longitudinal cohort study was used to evaluate the pilot. Each CHN provided demographic data, and completed a written knowledge assessment and a self-efficacy tool before and after the pilot. Two focus groups were also performed after the pilot. 28 CHNs completed the evaluation. Mean knowledge score improved significantly from 71.3% to 82.7% (p=0.0005) as did overall self-efficacy scores following the ECHO pilot. Pre-ECHO (p=0.036) and Retro-Pretest ECHO (p=0.0005) self-efficacy were significantly lower than post-ECHO. There was no significant difference between Pretest and Retro-Pretest ECHO self-efficacy (p=0.063). 96% recorded gains in learning, and 90% felt that ECHO had improved the care they provided for patients. 83% would recommend ECHO to other HCPs. 70% stated the technology used in ECHO had given them access to education that would have been hard to access due to geography. This study supports the use of Project ECHO for CHNs in the UK by demonstrating how a 6-month pilot improved knowledge and self-efficacy. As a low-cost high-impact model, ECHO provides an affordable solution to addressing growing need. 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/

  16. (Re)Educating the Senses to Multicultural Communities: Prospective Teachers Using Digital Media and Sonic Cartography to Listen for Culture

    Science.gov (United States)

    Brownell, Cassie J.; Wargo, Jon M.

    2017-01-01

    Attuning to the acoustic ecologies of multicultural education, this critical qualitative project interrogated how elementary prospective teachers (PST) used digital media to write community through and with sound. Examining PST produced soundscapes and the practice of sonic cartography, this study inquired how "hearing" difference and…

  17. Long-Term Cognitive Impairment after Hospitalization for Community-Acquired Pneumonia: a Prospective Cohort Study.

    Science.gov (United States)

    Girard, Timothy D; Self, Wesley H; Edwards, Kathryn M; Grijalva, Carlos G; Zhu, Yuwei; Williams, Derek J; Jain, Seema; Jackson, James C

    2018-06-01

    Recent studies suggest older patients hospitalized for community-acquired pneumonia are at risk for new-onset cognitive impairment. The characteristics of long-term cognitive impairment after pneumonia, however, have not been elucidated. To characterize long-term cognitive impairment among adults of all ages hospitalized for community-acquired pneumonia. Prospective cohort study. Adults without severe preexisting cognitive impairment who were hospitalized with community-acquired pneumonia. At enrollment, we estimated baseline cognitive function with the Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). At 2- and 12-month follow-up, we assessed cognition using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and tests of executive function, diagnosing cognitive impairment when results were ≥ 1.5 standard deviations below published age-adjusted means for the general population. We also identified subtypes of mild cognitive impairment using standard definitions. We assessed 58 (73%) of 80 patients who survived to 2-month follow-up and 57 (77%) of 74 who survived to 12-month follow-up. The median [range] age of survivors tested was 57 [19-97] years. Only 8 (12%) had evidence of mild cognitive impairment at baseline according to the Short IQCODE, but 21 (38%) at 2 months and 17 (30%) at 12 months had mild cognitive impairment per the RBANS. Moderate-to-severe cognitive impairment was common among adults ≥ 65 years [4/13 (31%) and 5/13 (38%) at 2 and 12 months, respectively] but also affected many of those cognitive domains affected one-third of patients ≥ 65 years old and 20% of younger patients, and another third of survivors had mild cognitive impairment.

  18. Risk factors of indoor fall injuries in community-dwelling older women: a prospective cohort study.

    Science.gov (United States)

    Hu, Jia; Xia, Qinghua; Jiang, Yu; Zhou, Peng; Li, Yuhua

    2015-01-01

    The aims of the study were to explore the characteristics and the potential risk factors of indoor fall injuries in community-dwelling older women, and to provide evidence for the future intervention strategy. A prospective cohort of 3043 women aged 60 years old and above from 3 selected counties in Shanghai was followed up on the outcomes of indoor fall injuries for up to 1 year. Demographic and health data were collected during admission; the physical function, balance ability and home-living environment were examined by a structured questionnaire when admitted. The outcome of indoor fall injury was investigated by a visit in month 3, month 6 and month 12 after baseline survey. Univariate analysis and Multiple Logistic Regression Model were used to examine the associations between potential risk factors and outcomes of indoor fall injuries. Two hundred and thirty-one of the 3043 women (7.6%) eventually suffered indoor fall injuries at least once during the 1-year follow-up. The injurious falls of women were significantly associated with age, educational level, marital status, health status, balance ability, physical activity and home-living environment in the univariate analyses. Women who worried about falls and restrained activities for it were more likely to suffer fall injury. Younger women, with less chronic disease, with good balance ability and living in good corridor environment, were less likely to receive fall injury in multiple logistic regression analyses. Multidimensional factors were associated with indoor fall injuries for community-dwelling older women. Proper clinical treatment of chronic disease and improvement of women's balance ability, as well as reducing the risk factor of indoor environment, which will play vital roles in preventing indoor fall injuries, should be prioritized for the intervention strategy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. 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.

  20. A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Women.

    Science.gov (United States)

    Marshall, Lynn M; Litwack-Harrison, Stephanie; Cawthon, Peggy M; Kado, Deborah M; Deyo, Richard A; Makris, Una E; Carlson, Hans L; Nevitt, Michael C

    2016-09-01

    Back pain and falls are common health conditions among older U.S. women. The extent to which back pain is an independent risk factor for falls has not been established. We conducted a prospective study among 6,841 community-dwelling U.S. women at least 65 years of age from the Study of Osteoporotic Fractures (SOF). Baseline questionnaires inquired about any back pain, pain severity, and frequency in the past year. During 1 year of follow-up, falls were summed from self-reports obtained every 4 months. Two outcomes were studied: recurrent falls (≥2 falls) and any fall (≥1 fall). Associations of back pain and each fall outcome were estimated with risk ratios (RRs) and 95% confidence intervals (CIs) from multivariable log-binomial regression. Adjustments were made for age, education, smoking status, fainting history, hip pain, stroke history, vertebral fracture, and Geriatric Depression Scale. Most (61%) women reported any back pain. During follow-up, 10% had recurrent falls and 26% fell at least once. Any back pain relative to no back pain was associated with a 50% increased risk of recurrent falls (multivariable RR = 1.5, 95% CI: 1.3, 1.8). Multivariable RRs for recurrent falls were significantly elevated for all back pain symptoms, ranging from 1.4 (95% CI: 1.1, 1.8) for mild back pain to 1.8 (95% CI: 1.4, 2.3) for activity-limiting back pain. RRs of any fall were also significantly increased albeit smaller than those for recurrent falls. Older community-dwelling women with a recent history of back pain are at increased risk for falls. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    Directory of Open Access Journals (Sweden)

    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

  2. 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. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. A prospective study of monitoring practices for metabolic disease in antipsychotic-treated community psychiatric patients

    Directory of Open Access Journals (Sweden)

    Watkinson Helen MO

    2007-06-01

    Full Text Available Abstract Background Patients with severe mental illness are at increased risk for metabolic and cardiovascular disease. A number of recent guidelines and consensus statements recommend stringent monitoring of metabolic function in individuals receiving antipsychotic drugs. Methods We conducted a prospective cohort study of 106 community-treated psychiatric patients from across the diagnostic spectrum from the Northeast of England to investigate changes in metabolic status and monitoring practices for metabolic and cardiovascular disease. We undertook detailed anthropometric and metabolic assessment at baseline and follow-up, and examined clinical notes and hospital laboratory records to ascertain monitoring practices. Results A high prevalence of undiagnosed and untreated metabolic disease was present at baseline assessment. Mean follow-up time was 599.3 (SD ± 235.4 days. Body mass index (p 50% of subjects had neither blood glucose nor lipids monitored during the follow-up period. Conclusion This cohort has a high prevalence of metabolic disease and heightened cardiovascular risk. Despite the publication of a number of recommendations regarding physical health screening in this population, monitoring rates are poor, and physical health worsened during the follow-up period.

  4. Twintig jaar coeliakie bij kinderen in Nederland: Meer diagnosen en een veranderde verschijningsvorm [Twenty years of childhood coeliac disease in the Netherlands: More diagnoses and changed clinical picture

    NARCIS (Netherlands)

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

    1998-01-01

    Objective. To assess the incidence of childhood coeliac disease in the Netherlands and to study the clinical features. Design. Prospective. Setting. Leiden University Medical Centre, Leiden, the Netherlands. Method. Cases of childhood coeliac disease in the Netherlands in 1993-1995 were identified

  5. A Clinical Risk Score for Atrial Fibrillation in a Biracial Prospective Cohort (From the Atherosclerosis Risk in Communities (ARIC) Study)

    OpenAIRE

    Chamberlain, Alanna M.; Agarwal, Sunil K.; Folsom, Aaron R.; Soliman, Elsayed Z.; Chambless, Lloyd E.; Crow, Richard; Ambrose, Marietta; Alonso, Alvaro

    2011-01-01

    A risk score for AF has been developed by the Framingham Heart Study; however the applicability of this risk score, derived from whites, to predict new-onset AF in non-whites is uncertain. Therefore, we developed a 10-year risk score for new-onset AF using risk factors commonly measured in clinical practice using 14,546 individuals from the Atherosclerosis Risk in Communities study, a prospective community-based cohort of blacks and whites in the United States. During 10 years of follow-up, 5...

  6. Twenty years of the Chernobyl accident: Results and problems in eliminating its consequences in Russia 1986-2006. Russian national report

    International Nuclear Information System (INIS)

    Gerasimova, N.V.; Marchenko, T.A.; Shoigu, S.K.; Bolshov, L.A.

    2006-01-01

    Twenty years after the Chernobyl accident, above 1.5 million people in 14 subjects of the Russian Federation continue to live in the area of radioactive contamination. More than 180,000 of the Russians were affected by radiation, when participating in elimination of the accident and its consequences. Since the first days of the accident, the public health service faced a task to develop and implement the measures on minimization of medical effects of the accident and public provision with medical assistance, including the employees of the nuclear power plant and the participants in mitigation of the accident. The health of the liquidators and the public living in the contaminated areas is the most socially significant issue being solved in the process of elimination of the Chernobyl consequences. Radiological effects have been the focus of attention for the overall 20-year period. The radiation protection system was based on performance of the two conditions, namely: absolute prevention of acute (deterministic) effects and reduction in the risk of remote (stochastic) effects to acceptable (justified) levels. As early as in 1986, a decision was made to create the unified system of medical observation for the individuals affected by radiation as a result of the Chernobyl accident. The Russian State Medical and Dosimetry Register (RSMDR) was established on the basis of the Medical Radiological Research Center of the Russian Academy of Medical Sciences. The two most suffered public groups were defined as a result of research activity of the Register. These are the children (at the moment of the accident) living in the highly contaminated areas and the liquidators who have obtained the exposure dose above 150 mGy. According to the Register's data, 122 cases (54%) out of 226 thyroid cancers revealed during the years 1991-2003 among the children (at the moment of the Chernobyl catastrophe) from the Bryansk region can be considered as radiation-stipulated. Hygienic

  7. Potential Economic and Development Prospects of Non Timber Forest Products in Community Agroforestry Land around Sibolangit Tourism Park

    Directory of Open Access Journals (Sweden)

    Oding Affandi

    2018-02-01

    Full Text Available The communities who live around Sibolangit Tourism Park have developed nontimber forest products (NTFP in their own agroforestry lands. This research evaluates the potential economic and development prospects from NTFP development in the Park by examining: (1 type of NTFP and economic value from community agrofrestry land, (2 contribution of NTFPs on household income, (3 development prospects of NTFP-based agroforestry around Sibolangit Tourism Park. The research was conducted in two selected villages around Sibolangit Tourism Park: Sembahe Village and Batu Mbelin Village. The research took place over a period between June and August 2016. Research data was obtained from in-depth interviews and observations. A descriptive method was used to analyze and describe facts related to the research aims. The type of NTFPs cultivated by communities at the research sites include mangosteen, durian, garcinia, candlenut, lanzones, lansium, bitter bean, and areca nut (as their forestry component and ginger, turmeric, chili, papaya, etlingera, and banana (as the agriculture component. Most NTFPs are cultivated as a comercial product. The economic value of NTFPs in Batu Mbelin Village has reached Rp. 547,275,000/year or contribute 80.07% of total family income. Meanwhile, the economic value of NTFPs in Sembahe Village has reached Rp 682,100,000/year, contributing to 78.75% of total household income. Therefore, the prospects for supporting and expanding NTFP in agroforestry plots in and around Sibolangit Tourism Park has high potential for supporting household income

  8. A community-based prospective cohort study of dengue viral infection in Malaysia: the study protocol.

    Science.gov (United States)

    Jahan, Nowrozy Kamar; Ahmad, Mohtar Pungut; Dhanoa, Amreeta; Meng, Cheong Yuet; Ming, Lau Wee; Reidpath, Daniel D; Allotey, Pascale; Zaini, Anuar; Phipps, Maude Elvira; Fatt, Quek Kia; Rabu, Aman Bin; Sirajudeen, Rowther; Fatan, Ahmad AbdulBasitz Ahmad; Ghafar, Faidzal Adlee; Ahmad, Hamdan Bin; Othman, Iekhsan; SyedHassan, Sharifah

    2016-08-11

    Globally, dengue infections constitute a significant public health burden. In recent decades, Malaysia has become a dengue hyper-endemic country with the co-circulation of the four dengue virus serotypes. The cyclical dominance of sub-types contributes to a pattern of major outbreaks. The consequences can be observed in the rising incidence of reported dengue cases and dengue related deaths. Understanding the complex interaction of the dengue virus, its human hosts and the mosquito vectors at the community level may help develop strategies for addressing the problem. A prospective cohort study will be conducted in Segamat district of Johor State in Peninsular Malaysia. Researchers received approval from the Malaysian Medical Research Ethics Committee and Monash University Human Research Ethics Committee. The study will be conducted at a Malaysian based health and demographic surveillance site over a 1 year period in three different settings (urban, semi-urban and rural). The study will recruit healthy adults (male and female) aged 18 years and over, from three ethnic groups (Malay, Chinese and Indian). The sample size calculated using the Fleiss method with continuity correction is 333. Sero-surveillance of participants will be undertaken to identify asymptomatic, otherwise healthy cases; cases with dengue fever who are managed as out-patients; and cases with dengue fever admitted to a hospital. A genetic analysis of the participants will be undertaken to determine whether there is a relationship between genetic predisposition and disease severity. A detailed medical history, past history of dengue infection, vaccination history against other flaviviruses such as Japanese encephalitis and Yellow fever, and the family history of dengue infection will also be collected. In addition, a mosquito surveillance will be carried out simultaneously in recruitment areas to determine the molecular taxonomy of circulating vectors. The research findings will estimate the burden

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

    Science.gov (United States)

    Nankabirwa, Victoria; Tumwine, James K; Tylleskär, Thorkild; Nankunda, Jolly; Sommerfelt, Halvor

    2011-05-09

    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. 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. 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)]. Our findings strengthen arguments for ensuring that pregnant women have access to and use adequate delivery facilities and bed nets.

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

    Directory of Open Access Journals (Sweden)

    Victoria Nankabirwa

    2011-05-01

    Full Text Available 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.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.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].Our findings strengthen arguments for ensuring that pregnant women have access to and use adequate delivery facilities and bed nets.

  11. Novel use of the Wii Balance Board to prospectively predict falls in community-dwelling older adults.

    Science.gov (United States)

    Kwok, Boon-Chong; Clark, Ross A; Pua, Yong-Hao

    2015-06-01

    The Wii Balance Board has received increasing attention as a balance measurement tool; however its ability to prospectively predict falls is unknown. This exploratory study investigated the use of the Wii Balance Board and other clinical-based measures for prospectively predicting falls among community-dwelling older adults. Seventy-three community-dwelling men and women, aged 60-85years were followed-up over a year for falls. Standing balance was indexed by sway velocities measured using the Wii Balance Board interfaced with a laptop. Clinical-based measures included Short Physical Performance Battery, gait speed and Timed-Up-and-Go test. Multivariable regression analyses were used to assess the ability of the Wii Balance Board measure to complement the TUG test in fall screening. Individually, the study found Wii Balance Board anteroposterior (odds ratio 1.98, 95% CI 1.16 to 3.40, P=0.01) and mediolateral (odds ratio 2.80, 95% CI 1.10 to 7.13, p=0.03) sway velocity measures predictive of prospective falls. However, when each velocity measure was adjusted with body mass index and Timed-Up-and-Go, only anteroposterior sway velocity was predictive of prospective falls (odds ratio 2.21, 95% CI 1.18 to 4.14). A faster anteroposterior velocity was associated with increased odds of falling. Area-under-the-curves for Wii Balance Board sway velocities were 0.67 and 0.71 for anteroposterior and mediolateral respectively. The Wii Balance Board-derived anteroposterior sway velocity measure could complement existing clinical-based measures in predicting future falls among community-dwelling older adults. Australian New Zealand Clinical Trials Registry number: ACTRN12610001099011. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study

    NARCIS (Netherlands)

    van der Eerden, M. M.; Vlaspolder, F.; de Graaff, C. S.; Groot, T.; Bronsveld, W.; Jansen, H. M.; Boersma, W. G.

    2005-01-01

    Background: There is much controversy about the ideal approach to the management of community acquired pneumonia ( CAP). Recommendations differ from a pathogen directed approach to an empirical strategy with broad spectrum antibiotics. Methods: In a prospective randomised open study performed

  13. A risk profile for identifying community-dwelling elderly with a highrisk of recurrent falling: results of a 3-year prospective study

    NARCIS (Netherlands)

    Pluym, S.M.F.; Smit, J.H.; Tromp, A.M.; Stel, V.S.; Deeg, D.J.H.; Bouter, L.M.; Lips, P.T.A.M.

    2007-01-01

    Introduction: The aim of the prospective study reported here was to develop a risk profile that can be used to identify community-dwelling elderly at a high risk of recurrent falling. Materials and methods: The study was designed as a 3-year prospective cohort study. A total of 1365

  14. Respiratory viruses among children with non-severe community-acquired pneumonia: A prospective cohort study.

    Science.gov (United States)

    Nascimento-Carvalho, Amanda C; Vilas-Boas, Ana-Luisa; Fontoura, Maria-Socorro H; Vuorinen, Tytti; Nascimento-Carvalho, Cristiana M

    2018-06-06

    Community-acquired pneumonia (CAP) causes a major burden to the health care system among children under-5 years worldwide. Information on respiratory viruses in non-severe CAP cases is scarce. To estimate the frequency of respiratory viruses among non-severe CAP cases. Prospective study conducted in Salvador, Brazil. Out of 820 children aged 2-59 months with non-severe CAP diagnosed by pediatricians (respiratory complaints and radiographic pulmonary infiltrate/consolidation), recruited in a clinical trial (ClinicalTrials.gov Identifier NCT01200706), nasopharyngeal aspirate samples were obtained from 774 (94.4%) patients and tested for 16 respiratory viruses by PCRs. Viruses were detected in 708 (91.5%; 95%CI: 89.3-93.3) cases, out of which 491 (69.4%; 95%CI: 65.9-72.7) harbored multiple viruses. Rhinovirus (46.1%; 95%CI: 42.6-49.6), adenovirus (38.4%; 95%CI: 35.0-41.8), and enterovirus (26.5%; 95%CI: 23.5-29.7) were the most commonly found viruses. The most frequent combination comprised rhinovirus plus adenovirus. No difference was found in the frequency of RSVA (16.1% vs. 14.6%; P = 0.6), RSVB (10.9% vs. 13.2%; P = 0.4) influenza (Flu) A (6.3% vs. 5.1%; P = 0.5), FluB (4.5% vs. 1.8%; P = 0.09), parainfluenza virus (PIV) 1 (5.1% vs. 2.8%; P = 0.2), or PIV4 (7.7% vs. 4.1%; P = 0.08), when children with multiple or sole virus detection were compared. Conversely, rhinovirus, adenovirus, enterovirus, bocavirus, PIV2, PIV3, metapneumovirus, coronavirus OC43, NL63, 229E were significantly more frequent among cases with multiple virus detection. Respiratory viruses were detected in over 90% of the cases, out of which 70% had multiple viruses. Several viruses are more commonly found in multiple virus detection whereas other viruses are similarly found in sole and in multiple virus detection. Copyright © 2018 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2008-07-01

    To assess the effectiveness of a residential community reintegration programme for participants with chronic sequelae of severe acquired brain injury that hamper community functioning. Prospective cohort study. Twenty-four participants with acquired brain injury (traumatic n = 18; stroke n = 3, tumour n = 2, encephalitis n = 1). Participants had impaired illness awareness, alcohol and drug problems and/or behavioural problems. A skills-oriented programme with modules related to independent living, work, social and emotional well-being. The Community Integration Questionnaire, CES-Depression, EuroQOL, Employability Rating Scale, living situation and work status were scored at the start (T0), end of treatment (T1) and 1-year follow-up (T2). Significant effects on the majority of outcome measures were present at T1. Employability significantly improved at T2 and living independently rose from 42% to over 70%. Participants working increased from 38% to 58% and the hours of work per week increased from 8 to 15. The Brain Integration Programme led to a sustained reduction in experienced problems and improved community integration. It is concluded that even participants with complex problems due to severe brain injury who got stuck in life could improve their social participation and emotional well-being through a residential community reintegration programme.

  16. Prospective effect of community distress and subcultural orientation on mortality following life-threatening diseases in later life.

    Science.gov (United States)

    Wen, Ming; Christakis, Nicholas A

    2006-07-01

    We conducted a prospective and contextual study to examine the effects of community social-economic-physical distress and subcultural orientation on mortality following onset of 13 life-threatening diseases in later life. We also examined the inter-relationship between the effects of community social, economic and physical distress (i.e. poverty, physical disorder and low collective efficacy) and subcultural orientation (i.e. anomie and tolerance of risk behaviour) on the survival chances of seriously ill older patients. Three data sources were combined to construct the working sample: 1990 Census data, the 1994-95 PHDCN-CS, and the COSI data. Fifty-one ZIP code areas in Chicago and 12,672 elderly patients were studied. Community distress (HR = 1.04; 95% CI = (1.01, 1.07)) and anomie (HR = 1.26; 95% CI = (1.02, 1.54)) are found to be significantly and positively associated with a higher hazard of death. Moreover, community anomie contributes to the effect of community distress on post-hospitalisation mortality. The social, economic, physical and cultural environment in which people live appears to exert a significant impact on whether older people facing life-threatening illness live or die.

  17. Twenty-Year Systematic Review of the Hip Pathology, Risk Factors, Treatment, and Clinical Outcomes in Artistic Athletes-Dancers, Figure Skaters, and Gymnasts.

    Science.gov (United States)

    Bolia, Ioanna; Utsunomiya, Hajime; Locks, Renato; Briggs, Karen; Philippon, Marc J

    2018-01-01

    To identify (1) the predominant level of evidence of the clinical studies regarding the hip pathology, risk factors, treatment, and clinical outcomes in artistic athletes (dancers, figure skaters, and gymnasts) (2) the most commonly reported hip pathology, risk factors, treatments, and clinical outcomes in dancers, figure skaters, and gymnasts. To conduct this systematic review PubMed, EMBASE, and Scopus databases were searched for relevant studies and pertinent data were collected from the eligible articles. Included were studies which reported hip injuries in artistic athletes, the risk factors, treatment, and/or the clinical outcomes. We excluded case reports or irrelevant studies. No meta-analysis was performed because of study heterogeneity. The methodical index for nonrandomized studies (MINORS) criteria were used for quality control. Thirty-eight studies were included in the analysis. The mean MINORS score was 13.6 ± 4.6 points indicating fair quality of evidence of the included articles. The predominant level of evidence was level IV. Chondrolabral pathology and muscle injuries were the most commonly reported pathologies. We found only 2 risk factor analysis studies; however, many studies reported risk correlation between artistic sports or imaging findings and hip pathology. Treatment strategies were reported in only 7 studies, clinical outcomes are significantly underreported. Chondrolabral pathology was the most commonly reported hip pathology in artistic athletes, however, prospective cohort studies are necessary to really understand these injuries and their associated risk factors. The lack of clinical outcomes is significant and future data collection is required to assess the effectiveness of the various treatments.

  18. The National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System: Twenty Years of Contributions to Clinical Service and Research.

    Science.gov (United States)

    Goverman, Jeremy; Mathews, Katie; Holavanahalli, Radha K; Vardanian, Andrew; Herndon, David N; Meyer, Walter J; Kowalske, Karen; Fauerbach, Jim; Gibran, Nicole S; Carrougher, Gretchen J; Amtmann, Dagmar; Schneider, Jeffrey C; Ryan, Colleen M

    The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) established the Burn Model System (BMS) in 1993 to improve the lives of burn survivors. The BMS program includes 1) a multicenter longitudinal database describing the functional and psychosocial recovery of burn survivors; 2) site-specific burn-related research; and 3) a knowledge dissemination component directed toward patients and providers. Output from each BMS component was analyzed. Database structure, content, and access procedures are described. Publications using the database were identified and categorized to illustrate the content area of the work. Unused areas of the database were identified for future study. Publications related to site-specific projects were cataloged. The most frequently cited articles are summarized to illustrate the scope of these projects. The effectiveness of dissemination activities was measured by quantifying website hits and information downloads. There were 25 NIDILRR-supported publications that utilized the database. These articles covered topics related to psychological outcomes, functional outcomes, community reintegration, and burn demographics. There were 172 site-specific publications; highly cited articles demonstrate a wide scope of study. For information dissemination, visits to the BMS website quadrupled between 2013 and 2014, with 124,063 downloads of educational material in 2014. The NIDILRR BMS program has played a major role in defining the course of burn recovery, and making that information accessible to the general public. The accumulating information in the database serves as a rich resource to the burn community for future study. The BMS is a model for collaborative research that is multidisciplinary and outcome focused.

  19. 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.

  20. Twenty years of home-based palliative care in Malappuram, Kerala, India: a descriptive study of patients and their care-givers.

    Science.gov (United States)

    Philip, Rekha Rachel; Philip, Sairu; Tripathy, Jaya Prasad; Manima, Abdulla; Venables, Emilie

    2018-02-14

    The well lauded community-based palliative care programme of Kerala, India provides medical and social support, through home-based care, for patients with terminal illness and diseases requiring long-term support. There is, however, limited information on patient characteristics, caregivers and programme performance. This study was carried out to describe: i) the patients enrolled in the programme from 1996 to 2016 and their diagnosis, and ii) the care-giver characteristics and palliative care support from nurses and doctors in a cohort of patients registered during 2013-2015. A descriptive study was conducted in the oldest community-based palliative clinic in Kerala. Data were collected from annual patient registers from 1996 to 2016 and patient case records during the period 2013-2015. While 91% of the patients registered in the clinic in 1996 had cancer, its relative proportion came down to 32% in 2016 with the inclusion of dementia-related illness (19%) cardiovascular accidents (17%) and severe mental illness (5%).Among patients registered during 2013-15, the median number of home visits from nurses and doctors in 12 months were five and one respectively. In the same cohort, twelve months' post-enrolment, 56% of patients died, 30% were in continuing in active care and 7% opted out. Those who opted out of care were likely to be aged care-giver at home, 85% of these care-givers being female. The changing dynamics over a 20-year period of this palliative care programme in Kerala, India, highlights the need for similar programmes to remain flexible and adapt their services in response to a growing global burden of Non Communicable Diseases. While a high death rate is expected in this population, the high proportion of patients choosing to stay in the programme suggests that home-based care is valued within this particular group. A diverse range of clinical and psycho-social support skills are required to assist families and their caregivers when caring for a

  1. Incidence and sources of native and prosthetic joint infection: a community based prospective survey

    NARCIS (Netherlands)

    Kaandorp, C. J.; Dinant, H. J.; van de Laar, M. A.; Moens, H. J.; Prins, A. P.; Dijkmans, B. A.

    1997-01-01

    To determine the incidence and sources of bacterial arthritis in the Amsterdam health district and the maximum percentage of cases that theoretically would be preventable. Patients with bacterial arthritis diagnosed between 1 October 1990 and 1 October 1993 were prospectively reported to the study

  2. Anxiety in 11-Year-Old Children Who Stutter: Findings from a Prospective Longitudinal Community Sample

    Science.gov (United States)

    Smith, Kylie A.; Iverach, Lisa; O'Brian, Susan; Mensah, Fiona; Kefalianos, Elaina; Hearne, Anna; Reilly, Sheena

    2017-01-01

    Purpose: To examine if a community sample of 11-year-old children with persistent stuttering have higher anxiety than children who have recovered from stuttering and nonstuttering controls. Method: Participants in a community cohort study were categorized into 3 groups: (a) those with persistent stuttering, (b) those with recovered stuttering, and…

  3. 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…

  4. Twenty years of struggle against global warming in France: assessment and perspectives for public policies. Opinion of the Economic, Social and Environmental Council

    International Nuclear Information System (INIS)

    Virlouvet, Gael

    2015-04-01

    This huge report proposes a rather detailed overview of the evolution of the French policy to reduce greenhouse gas emissions in order to struggle against climate change and global warming. The introduction proposes a large synthesis by addressing the challenges of this struggle, the French attenuation trajectory within the European framework, the relationship between energy and climate policies, the progressive development of a method, the increasing number of involved actors, the commitment of the various economic sectors and local communities. Some recommendations are made within the perspective of the next Conference on Climate (COP21) and beyond. Then, the report first part addresses the 1992-2014 period, describes the international context (evolutions of greenhouse gas emissions in the world and per sector), presents the different international agreements (Kyoto protocol, Doha amendment, European commitments, the role of France in the world and European dynamics), gives an overview of the progressive emergence of a climate policy in France and of its results (global decrease of emissions, but with variations among sectors), proposes a comparison of climate policies debated and implemented in different countries (China, USA, Swede, United Kingdom, Italy, Germany). An analysis discusses the obtained results, the difficult implementation of Climate plans in France, the coherence of public policies, the territorialisation of the climate challenge, and the influence of the economic context on the evolution of emissions. The next part outlines and comments how the French population becomes always more aware of the climate challenge, how intermediate bodies tend to take charge of this issue, how economic activities progressively integrate the reduction of greenhouse gas emissions, and how local policies can also tackle the problem. Perspectives are then discussed: on the long term (factor 4 objective for the various sectors), on the medium term (by 2020-2030), and

  5. Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals.

    Science.gov (United States)

    Johansson, Jonas; Nordström, Anna; Gustafson, Yngve; Westling, Göran; Nordström, Peter

    2017-11-01

    fall-related injuries constitute major health risks in older individuals, and these risks are projected to increase in parallel with increasing human longevity. Impaired postural stability is a potential risk factor related to falls, although the evidence is inconclusive, partly due to the lack of prospective studies. This study aimed to investigate how objective measures of postural sway predict incident falls. this prospectively observational study included 1,877 community-dwelling individuals aged 70 years who participated in the Healthy Ageing Initiative between June 2012 and December 2015. postural sway was measured during eyes-open (EO) and eyes-closed (EC) trials using the Wii Balance Board. Functional mobility, muscle strength, objective physical activity and cognitive performance were also measured. Participants reported incident falls 6 and 12 months after the examination. during follow-up, 255 (14%) prospective fallers were identified. Division of centre of pressure (COP) sway lengths into quintiles revealed a nonlinear distribution of falls for EO trial data, but not EC trial data. After adjustment for multiple confounders, fall risk was increased by 75% for participants with COP sway lengths ≥400 mm during the EO trial (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.09-2.79), and approximately doubled for sway lengths ≥920 mm during the EC trial (OR 1.90, 95% CI 1.12-3.22). objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  6. The prospects of nuclear energy in the economy of the European Economic Community by 2000

    International Nuclear Information System (INIS)

    Swadzba, S.

    1987-01-01

    The forecast for nuclear energy in the EEC countries by 2000 on the base of the growth of national income and energy demand is presented. There are discussed the prospects of electric energy production and the part of nuclear energy in it asa well as the expected share of nuclear energy in the consumption and in the production of primary energy. A short appraisal of these forecasts is presented. 5 tabs. (author)

  7. 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

  8. 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

  9. Ecological assembly rules in plant communities--approaches, patterns and prospects.

    Science.gov (United States)

    Götzenberger, Lars; de Bello, Francesco; Bråthen, Kari Anne; Davison, John; Dubuis, Anne; Guisan, Antoine; Lepš, Jan; Lindborg, Regina; Moora, Mari; Pärtel, Meelis; Pellissier, Loic; Pottier, Julien; Vittoz, Pascal; Zobel, Kristjan; Zobel, Martin

    2012-02-01

    Understanding how communities of living organisms assemble has been a central question in ecology since the early days of the discipline. Disentangling the different processes involved in community assembly is not only interesting in itself but also crucial for an understanding of how communities will behave under future environmental scenarios. The traditional concept of assembly rules reflects the notion that species do not co-occur randomly but are restricted in their co-occurrence by interspecific competition. This concept can be redefined in a more general framework where the co-occurrence of species is a product of chance, historical patterns of speciation and migration, dispersal, abiotic environmental factors, and biotic interactions, with none of these processes being mutually exclusive. Here we present a survey and meta-analyses of 59 papers that compare observed patterns in plant communities with null models simulating random patterns of species assembly. According to the type of data under study and the different methods that are applied to detect community assembly, we distinguish four main types of approach in the published literature: species co-occurrence, niche limitation, guild proportionality and limiting similarity. Results from our meta-analyses suggest that non-random co-occurrence of plant species is not a widespread phenomenon. However, whether this finding reflects the individualistic nature of plant communities or is caused by methodological shortcomings associated with the studies considered cannot be discerned from the available metadata. We advocate that more thorough surveys be conducted using a set of standardized methods to test for the existence of assembly rules in data sets spanning larger biological and geographical scales than have been considered until now. We underpin this general advice with guidelines that should be considered in future assembly rules research. This will enable us to draw more accurate and general

  10. Environmental consequences of the Chernobyl accident and their remediation: Twenty years of experience. Report of the UN Chernobyl Forum Expert Group 'Environment' (EGE). Working material

    International Nuclear Information System (INIS)

    2005-08-01

    recognised international scientists, including those from the three more affected countries. Within these two groups and their subworking groups the draft documents to support this report were prepared for consideration by the members of the Forum. The EGE was coordinated by the IAEA and the EGH was coordinated by the WHO. In all cases the scientists from the UN organisations, the international community, and the three affected countries have been able to reach consensus in the preparation of their respective draft documents. After approval by the members of the Forum itself and final editing of the draft documents, this report is the result of that process regarding the environmental consequences of the Chernobyl accident. A similar report on the health effects attributable to radiation exposure arising from the accident has been prepared for Forum consideration and approval by the Expert Group 'Health'

  11. Environmental consequences of the Chernobyl accident and their remediation: Twenty years of experience. Report of the UN Chernobyl Forum Expert Group 'Environment' (EGE). Working material

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-08-01

    recognised international scientists, including those from the three more affected countries. Within these two groups and their subworking groups the draft documents to support this report were prepared for consideration by the members of the Forum. The EGE was coordinated by the IAEA and the EGH was coordinated by the WHO. In all cases the scientists from the UN organisations, the international community, and the three affected countries have been able to reach consensus in the preparation of their respective draft documents. After approval by the members of the Forum itself and final editing of the draft documents, this report is the result of that process regarding the environmental consequences of the Chernobyl accident. A similar report on the health effects attributable to radiation exposure arising from the accident has been prepared for Forum consideration and approval by the Expert Group 'Health'.

  12. A long and winding road: federally qualified health centers, community variation and prospects under reform.

    Science.gov (United States)

    Katz, Aaron B; Felland, Laurie E; Hill, Ian; Stark, Lucy B

    2011-11-01

    Community health centers have evolved from fringe providers to mainstays of many local health care systems. Those designated as federally qualified health centers (FQHCs), in particular, have largely established themselves as key providers of comprehensive, efficient, high-quality primary care services to low-income people, especially Medicaid and uninsured patients. The Center for Studying Health System Change's (HSC's) site visits to 12 nationally representative metropolitan communities since 1996 document substantial growth in FQHC capacity, based on growing numbers of Medicaid enrollees and uninsured people, increased federal support, and improved managerial acumen. At the same time, FQHC development has varied considerably across communities because of several important factors, including local health system characteristics and financial and political support at federal, state and local levels. Some communities--Boston; Syracuse, N.Y.; Miami; and Seattle--have relatively extensive FQHC capacity for their Medicaid and uninsured populations, while other communities--Lansing, Mich.; northern New Jersey; Indianapolis; and Greenville, S.C.--fall in the middle. FQHC growth in Phoenix; Little Rock, Ark.; Cleveland; and Orange County, Calif.; has lagged in comparison. Today, FQHCs seem poised to play a key role in federal health care reform, including coverage expansions and the emphasis on primary care and medical homes.

  13. Situation and prospects of radioactive waste disposal in the member states of the European Community

    International Nuclear Information System (INIS)

    Schaller, K.H.; Orlowski, S.

    1990-01-01

    All Member States of the European Community with a nuclear power production programme are preparing for the disposal of radioactive waste produced in the nuclear fuel cycle and through the use of radionuclides in health care, research and industry. The situation of storage and planned, on-going - and already performed - disposal of radioactive waste in these States is first summarised. Suitable sites for disposal of radioactive waste of all categories exist in all Member States concerned. The general principles and international recommendations, and common principles, standards and requirements applicable to disposal in the European Community are then presented, followed by a description of existing disposal facilities and of those which are in an advanced planning stage, and the implementation of basic criteria by national authorities. Finally, policies and strategies for long-term storage and disposal for definitively shut-down nuclear installations, and contributions to research in this field in the ''Communities' Radioactive Waste Management Programme'' are discussed. (author)

  14. 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)

  15. 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 interindividual 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,…

  16. Cryogenic air separation: the last twenty years

    International Nuclear Information System (INIS)

    Grenier, M.; Petit, P.

    1986-01-01

    In the last 20 years cryogenic air separation plant sizes have increased from 150 tons per day to 2800 tons per day. Progressively reversing heat exchangers have replaced regenerators. However, with this arrangement, the quantity of pure product output is limited to about 50% of the air input. With the appearance on the market of molecular sieve, another arrangement was developed, which allows one to produce a combined pure product flow equivalent to 85% of the air input. Recently, there has been a strong tendency for the reversing exchangers to be superseded by this arrangement. Due to the ever increasing cost of energy, optimization studies are today pushed much further than they used to be; as a consequence there have been major changes in the size of equipment, improvements in the machinery, and simultaneous developments in instrumentation

  17. 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.

  18. Twenty years of radiation sterilization in Croatia

    Science.gov (United States)

    Ražem, Dus̆an

    2004-09-01

    The development of radiation processing in Croatia is described from its inception 20 years ago up to the present time. Annual throughputs of treated materials are given by the categories of materials and pertaining volumes. The pasteurization of hard gelatine capsules occured during the early stages, while sterilization of disposable medical supplies has been dominant in the later stages. Irradiation of foods and of cosmetics and toiletries has been a minor fraction of the total throughput. Since the recovery of everyday life and economy of the country after the war, the total throughput has increased steadily to reach 13,000 m 3 kGy in 2002, 90% of which are medical supplies. Estimates of the present maximum capacity of 30,000 m 3 kGy and of future needs indicate that the present rate of growth could be sustained for the next several years only, unless a major upgrading is undertaken. An estimate of potential future needs is made.

  19. 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…

  20. Twenty years of immunocontraceptive research: lessons learned.

    Science.gov (United States)

    Miller, Lowell A; Fagerstone, Kathleen A; Eckery, Douglas C

    2013-12-01

    The National Wildlife Research Center (NWRC) began immunocontraception vaccine research by testing porcine zona pellucida (PZP) on white-tailed deer (Odocoileus virginianus). Early PZP research demonstrated that PZP induced infertility; however, increased length of the rut was observed in PZP-treated deer. An alternative vaccine using a keyhole limpet hemocyanin-gonadotropin-releasing hormone (KLH-GnRH) conjugate formulated with modified Freund's adjuvant was developed at NWRC. Suppression of GnRH has reduced reproduction in both sexes but is most effective in females. This vaccine was effective in preventing contraception in female deer for several years after a prime and boost. Due to adverse side effects of Freund's adjuvant, NWRC developed a new adjuvant called AdjuVac, a mineral oil/surfactant adjuvant with the addition of Mycobacterium avium as an immunostimulant. The price of KLH prompted a search for a more economical hemocyanin carrier protein for the GnRH peptide. Blue protein, derived from the mollusk Concholepas concholepas, proved to be a successful option. Formulation improvements resulted in a vaccine that can be effective as a single injection for multiple years, now called GonaCon. GonaCon is registered with the Environmental Protection Agency (EPA) for use in white-tailed deer in urban/suburban areas and for wild horses (Equus caballus) and burros (Equus asinus). Future GonaCon applications may include reducing reproduction to manage populations of other wildlife species, such as prairie dogs (Cynomys ludovicianus) in urban areas and suppressing reproduction to reduce the spread of venereal diseases such as brucellosis. Research is being conducted to develop a GnRH vaccine used in combination with the rabies vaccine to control population growth in free-roaming dogs, with the secondary effect of managing the spread of rabies. The EPA would regulate all these uses. Research is also ongoing on a GnRH vaccine to delay the onset of adrenocortical disease in pet ferrets (Mustela putorius), a use regulated by the United States Department of Agriculture.

  1. UNESCO's twenty years of work for peace

    International Nuclear Information System (INIS)

    1967-01-01

    When UNESCO, the United Nations Educational, Scientific and Cultural Organization, celebrated its twentieth anniversary in November, the Agency was happy to join in the congratulations sent from all parts of the world. In this case there were special reasons, since UNESCO was interested in the peaceful development of atomic energy before IAEA was set up, and there have been a number of areas of common interest

  2. Twenty years of ''Nuclear Fusion''. Inertial confinement

    International Nuclear Information System (INIS)

    Yamanaka, C.

    1980-01-01

    Inertial confinement (ICF) fusion research is directed towards demonstrating the feasibility of very rapidly heating and compressing small pellets of suitable fuel until conditions exist where thermonuclear fusion can occur and useful amounts of power can be produced. Major problems which have to be solved are the following: 1) pellet design based on driver-plasma coupling; 2) the technology of energy drivers; 3) feasibility of ICF reactor systems

  3. Twenty years of an international nuclear laboratory

    International Nuclear Information System (INIS)

    Suschny, O.

    1982-01-01

    The laboratories of the International Atomic Energy Agency were started in 1959 with a physics laboratory, a chemistry laboratory and an electronics workshop. Early work centred on absolute radionuclide calibrations and on assessments of the consequences of radioactive fallout from atomic weapons testing on the health of the people in Member States. Subsequently, work was started on the use of radioactive and stable isotopes in agriculture, in hydrology, in medical applications, in pest and insect control and with the entry into force of the Nuclear Non-Proliferation Treaty a Safeguard Analytical Laboratory was established to provide support for the Agency's safeguards inspection responsibilities. Together with WHO a network of 43 Secondary Standard Dosimetry Laboratories were set up in Member States to improve dosimetric accuracy in medicine and radiation protection worldwide. Throughout their history, the laboratories of the IAEA have lent great importance on their training programmes that have enabled many workers in nuclear or nuclear related research to gain experience. This emphasis on training has been stressed particularly to benefit research workers from developing countries

  4. Twenty years of molecular beam epitaxy

    Science.gov (United States)

    Cho, A. Y.

    1995-05-01

    The term "molecular beam epitaxy" (MBE) was first used in one of our crystal growth papers in 1970, after having conducted extensive surface physics studies in the late 1960's of the interaction of atomic and molecular beams with solid surfaces. The unique feature of MBE is the ability to prepare single crystal layers with atomic dimensional precision. MBE sets the standard for epitaxial growth and has made possible semiconductor structures that could not be fabricated with either naturally existing materials or by other crystal growth techniques. MBE led the crystal growth technologies when it prepared the first semiconductor quantum well and superlattice structures that gave unexpected and exciting electrical and optical properties. For example, the discovery of the fractional quantized Hall effect. It brought experimental quantum physics to the classroom, and practically all major universities throughout the world are now equipped with MBE systems. The fundamental principles demonstrated by the MBE growth of III-V compound semiconductors have also been applied to the growth of group IV, II-VI, metal, and insulating materials. For manufacturing, the most important criteria are uniformity, precise control of the device structure, and reproducibility. MBE has produced more lasers (3 to 5 million per month for compact disc application) than any other crystal growth technique in the world. New directions for MBE are to incorporate in-situ, real-time monitoring capabilities so that complex structures can be precisely "engineered". In the future, as environmental concerns increase, the use of toxic arsine and phosphine may be limited. Successful use of valved cracker cells for solid arsenic and phosphorus has already produced InP based injection lasers.

  5. Twenty years of radiation sterilization in Croatia

    International Nuclear Information System (INIS)

    Razem, Dusan

    2004-01-01

    The development of radiation processing in Croatia is described from its inception 20 years ago up to the present time. Annual throughputs of treated materials are given by the categories of materials and pertaining volumes. The pasteurization of hard gelatine capsules occured during the early stages, while sterilization of disposable medical supplies has been dominant in the later stages. Irradiation of foods and of cosmetics and toiletries has been a minor fraction of the total throughput. Since the recovery of everyday life and economy of the country after the war, the total throughput has increased steadily to reach 13,000 m 3 kGy in 2002, 90% of which are medical supplies. Estimates of the present maximum capacity of 30,000 m 3 kGy and of future needs indicate that the present rate of growth could be sustained for the next several years only, unless a major upgrading is undertaken. An estimate of potential future needs is made

  6. Twenty years of radiation sterilization in Croatia

    Energy Technology Data Exchange (ETDEWEB)

    Razem, Dusan E-mail: razem@irb.hr

    2004-10-01

    The development of radiation processing in Croatia is described from its inception 20 years ago up to the present time. Annual throughputs of treated materials are given by the categories of materials and pertaining volumes. The pasteurization of hard gelatine capsules occured during the early stages, while sterilization of disposable medical supplies has been dominant in the later stages. Irradiation of foods and of cosmetics and toiletries has been a minor fraction of the total throughput. Since the recovery of everyday life and economy of the country after the war, the total throughput has increased steadily to reach 13,000 m{sup 3} kGy in 2002, 90% of which are medical supplies. Estimates of the present maximum capacity of 30,000 m{sup 3} kGy and of future needs indicate that the present rate of growth could be sustained for the next several years only, unless a major upgrading is undertaken. An estimate of potential future needs is made.

  7. 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.

  8. Ecological assembly rules in plant communities-approaches, patterns and prospects

    Czech Academy of Sciences Publication Activity Database

    Götzenberger, L.; de Bello, Francesco; Brathen, K. A.; Davison, J.; Dubuis, A.; Guisan, A.; Lepš, Jan; Lindborg, R.; Moora, M.; Partel, M.; Pellissier, L.; Pottier, J.; Vittoz, P.; Zobel, K.; Zobel, M.

    2012-01-01

    Roč. 87, č. 1 (2012), s. 111-127 ISSN 1464-7931 R&D Projects: GA ČR GA206/09/1471 Institutional research plan: CEZ:AV0Z60050516; CEZ:AV0Z50070508 Institutional support: RVO:67985939 ; RVO:60077344 Keywords : community assembly * competition * meta - analysis Subject RIV: EH - Ecology, Behaviour Impact factor: 10.256, year: 2012

  9. Prospects for plutonium recycling in light-water reactors in the European Communities

    International Nuclear Information System (INIS)

    Haijtink, B.

    1977-01-01

    On the basis of a forecast on nuclear power installation programmes and spent nuclear fuel reprocessing capacities in the European Community, an assessment has been made of the developmnt of the plutonium handling industry up to the year 1990. Data on plutonium recovered in the reprocessing plants, requirements for fuelling the fast-breeder reactors and the remaining stockpile have been evaluated. A possible strategy for recycling the plutonium surplus in light-water reactors has been developed and its effects as regards saving on requirements for natural uranium and enrichment services have been estimated

  10. 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 ...

  11. 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, Gert J.; van Heugten, Caroline M.; Meijer, Ron; Martina, Juan D.; Geurts, Alexander 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.

  12. 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…

  13. Body composition impacts appetite regulation in middle childhood. A prospective study of Norwegian community children.

    Science.gov (United States)

    Steinsbekk, Silje; Llewellyn, Clare H; Fildes, Alison; Wichstrøm, Lars

    2017-05-30

    Research suggests a role for both fat mass and muscle mass in appetite regulation, but the longitudinal relationships between them have not yet been examined in children. The present study therefore aimed to explore the prospective relationships between fat mass, muscle mass and the appetitive traits food responsiveness and satiety responsiveness in middle childhood. Food responsiveness and satiety responsiveness were measured using the parent-reported Children's Eating Behavior Questionnaire in a representative sample of Norwegian 6 year olds, followed up at 8 and 10 years of age (n = 807). Body composition was measured by bioelectrical impedance. Applying a structural equation modeling framework we found that higher fat mass predicted greater increases in food responsiveness over time, whereas greater muscle mass predicted decreases in satiety responsiveness. This pattern was consistent both from ages 6 to 8 and from ages 8 to 10 years. Our study is the first to reveal that fat mass and muscle mass predict distinct changes in different appetitive traits over time. Replication of findings in non-European populations are needed, as are studies of children in other age groups. Future studies should also aim to reveal the underlying mechanisms.

  14. 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.

  15. The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study

    Directory of Open Access Journals (Sweden)

    Diallo Abdoulaye

    2012-09-01

    Full Text Available Abstract Background Infant mortality rates (IMR remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. Methods A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150 in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Results Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89–143. Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51–88. Infections (35% and preterm births complications (23% were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. Conclusions We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

  16. The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study.

    Science.gov (United States)

    Hama Diallo, Abdoulaye; Meda, Nicolas; Sommerfelt, Halvor; Traore, Germain S; Cousens, Simon; Tylleskar, Thorkild

    2012-09-05

    Infant mortality rates (IMR) remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150) in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89-143). Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51-88). Infections (35%) and preterm births complications (23%) were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

  17. 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

  18. 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 interindividual 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. Multigroup 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.

  19. 25 Years of Community Activities towards Harmonization of Nuclear Safety Criteria and Requirements - Achievements and Prospects

    International Nuclear Information System (INIS)

    Lillington, J.N.; Turland, B.D.; Haste, T.J.; Seiler, J.M.; Carretero, A.; Perez, T.; Geutges, A.; Van Hienen, J.F.A.; Jehee, J.N.T.; Sehgal, B.R.; Mattila, L.; Holmstrom, H.; Karwat, H.; Maroti, L.; Toth, I.; Husarcek, J.

    2001-10-01

    The main objective was to advise the EC on future challenges and opportunities in terms of enhanced co-operation in the area of nuclear safety and harmonization of safety requirements and practices in an enlarged European Union. The activities were divided into 3 sub-tasks as follows: part A, to prepare an analysis, synthesis and assessment of the main achievements from Community activities related to the Resolutions on the technological problems of nuclear safety of 1975 and 1992, with due consideration for related research activities; part B, to prepare an overview of safety philosophies and practices in EU Member States, taking account of their specific national practices in terms of legal framework, type and age of operating nuclear reactors; part C, to provide elements of a strategy for future activities in the frame of the Council Resolutions, with particular attention to the context of enlargement of the EU. (author)

  20. Stride dynamics, gait variability and prospective falls risk in active community dwelling older women.

    Science.gov (United States)

    Paterson, Kade; Hill, Keith; Lythgo, Noel

    2011-02-01

    Measures of walking instability such as stride dynamics and gait variability have been shown to identify future fallers in older adult populations with gait limitations or mobility disorders. This study investigated whether measures of walking instability can predict future fallers (over a prospective 12 month period) in a group of healthy and active older women. Ninety-seven healthy active women aged between 55 and 90 years walked for 7 min around a continuous walking circuit. Gait data recorded by a GAITRite(®) walkway and foot-mounted accelerometers were used to calculate measures of stride dynamics and gait variability. The participant's physical function and balance were assessed. Fall incidence was monitored over the following 12 months. Inter-limb differences (p≤0.04) in stride dynamics were found for fallers (one or more falls) aged over 70 years, and multiple fallers (two or more falls) aged over 55 years, but not in non-fallers or a combined group of single and non-fallers. No group differences were found in the measures of physical function, balance or gait, including variability. Additionally, no gait variable predicted falls. Reduced coordination of inter-limb dynamics was found in active healthy older fallers and multiple fallers despite no difference in other measures of intrinsic falls risk. Evaluating inter-limb dynamics may be a clinically sensitive technique to detect early gait instability and falls risk in high functioning older adults, prior to change in other measures of physical function, balance and gait. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. 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.

  2. [Prognostic factors in community acquired pneumonia. Prospective multicenter study in internal medical departments].

    Science.gov (United States)

    Apolinario Hidalgo, R; Suárez Cabrera, M; Geijo Martínez, M P; Bernabéu-Wittel, M; Falguera Sacrest, M; Limiñana Cañal, J M

    2007-10-01

    the aims of the present study were to evaluate the clinical and microbiological characteristics of patients suffering from community-acquired pneumonia attended in the Internal Medical Departments of several Spanish institutions and to analyze those prognostic factors predicting thirty-day mortality in such patients. Past medical history, symptoms and signs, radiological pattern and blood parameters including albumin and C Reactive Protein, were recorded for each patient. Time from admission to starting antibiotics (in hours) and follow-up (in days) were also recorded. Patients were stratified by the Pneumonia Severity Index in five risk classes. 389 patients were included in the study, most of them in Fine categories III to V. Mortality rate for all patients was 12.1% (48 patients), increasing up to 40% in Fine Class V. Neither age, sex nor time from admission to the start of antibiotic treatment predicted survival rates. Plasmatic levels of PCR or microbiologic diagnosis were not related to clinical outcome. In the Cox regression analysis, oriented patients (OR 0.138, IC95% 0.055-0.324), and those with normal albuminemia (OR 0.207, IC95% 0.103-0.417) showed better survival rates. On the contrary, those with active carcinoma (OR 3.2, IC95% 1.181-8.947) significantly showed a reduced life expectancy. Besides the fully accepted Fine scale criteria, albumin measurements should be included in routine evaluation in order to improve patient s prognostic classification.

  3. Depressive Symptoms and Deliberate Self-Harm in a Community Sample of Adolescents: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Lars-Gunnar Lundh

    2011-01-01

    Full Text Available The associations between depressive symptoms and deliberate self-harm were studied by means of a 2-wave longitudinal design in a community sample of 1052 young adolescents, with longitudinal data for 83.6% of the sample. Evidence was found for a bidirectional relationship in girls, with depressive symptoms being a risk factor for increased self-harm one year later and self-harm a risk factor for increased depressive symptoms. Cluster analysis of profiles of depressive symptoms led to the identification of two clusters with clear depressive profiles (one severe, the other mild/moderate which were both characterized by an overrepresentation of girls and elevated levels of self-harm. Clusters with more circumscribed problems were also identified; of these, significantly increased levels of self-harm were found in a cluster characterized by negative self-image and in a cluster characterized by dysphoric relations to parents. It is suggested that self-harm serves more to regulate negative self-related feelings than sadness.

  4. Fall predictors in the community dwelling elderly: a cross sectional and prospective cohort study.

    Science.gov (United States)

    Sai, A J; Gallagher, J C; Smith, L M; Logsdon, S

    2010-06-01

    To ascertain the risk factors for falls, stumbles and recurrent falls in a cohort of elderly people with mean age of 76.7-/+6.1 years. 137 community dwelling elderly living independently or in assisted living institutions participated in the study. Each subject was assessed by history, physical examination and physical performance tests at the beginning and end of study. Falls and stumbles were recorded in a falls dairy for 1 year. Significant predictors of being a faller were a history of falls at baseline (Odds Ratio (OR) = 3.85, 95% Confidence Interval (CI) = 1.56 - 9.50), depression (OR = 1.19, 95% CI = 1.02 - 1.38) and timed rise (Incident Rate Ratio (IRR) = 1.24, 95% CI = 1.03 - 1.50). For predicting recurrent fallers Receiver Operator Characteristic (ROC) curves were as follows: 0.71 (95%CI 0.61-0.81) for timed up and go, 0.67 (95%CI 0.56-0.78) for timed rise and 0.70 (95%CI 0.60-0.80) for timed walk fast pace. Timed rise was the single most important test that was able to predict both a first time faller and recurrent faller. Timed up and go was the most significant test to predict recurrent fallers.

  5. General life satisfaction predicts dementia in community living older adults: a prospective cohort study.

    Science.gov (United States)

    Peitsch, Lorraine; Tyas, Suzanne L; Menec, Verena H; St John, Philip D

    2016-07-01

    Low life satisfaction predicts adverse outcomes, and may predict dementia. The objectives were: (1) to determine if life satisfaction predicts dementia over a five year period in those with normal cognition at baseline; and (2) to determine if different aspects of life satisfaction differentially predict dementia. Secondary analysis of an existing population-based cohort study with initial assessment in 1991 and follow-up five years later. Initially, 1,751 adults age 65+ living in the community were sampled from a representative sampling frame. Of these, 1,024 were alive and had complete data at time 2, of whom 96 were diagnosed with dementia. Life satisfaction was measured using the Terrible-Delightful scale, which measures overall life satisfaction on a 7-point scale, as well as various aspects of life satisfaction (e.g. friendships, finances, etc.) Dementia was diagnosed by clinical examination using DSM-IIIR criteria. Logistic regression models were constructed for the outcome of dementia at time 2, and adjusted for age, gender, education, and comorbidities. Overall life satisfaction predicted dementia five years later, at time 2. The unadjusted Odds Ratio (OR; 95% confidence interval) for dementia at time 2 was 0.72 (0.55, 0.95) per point. The adjusted OR for dementia was 0.70 (0.51, 0.96). No individual item on the life satisfaction scale predicted dementia. However, the competing risk of mortality was very high for some items. A global single-item measure of life satisfaction predicts dementia over a five year period in older adults without cognitive impairment.

  6. Prospective evaluation of biomarkers for prediction of quality of life in community-acquired pneumonia.

    Science.gov (United States)

    Nickler, Manuela; Schaffner, Daniela; Christ-Crain, Mirjam; Ottiger, Manuel; Thomann, Robert; Hoess, Claus; Henzen, Christoph; Mueller, Beat; Schuetz, Philipp

    2016-11-01

    Most clinical research investigated prognostic biomarkers for their ability to predict cardiovascular events or mortality. It is unknown whether biomarkers allow prediction of quality of life (QoL) after survival of the acute event. Herein, we investigated the prognostic potential of well-established inflammatory/cardiovascular blood biomarkers including white blood cells (WBC), C-reactive protein (CRP), procalcitonin (PCT), pro-adrenomedullin (proADM) and pro-atrial natriuretic peptide (proANP) in regard to a decline in QoL in a well-defined cohort of patients with community-acquired pneumonia (CAP). Within this secondary analysis including 753 patients with a final inpatient diagnosis of CAP from a multicenter trial, we investigated associations between admission biomarker levels and decline in QoL assessed by the EQ-5D health questionnaire from admission to day 30 and after 6 years. Admission proADM and proANP levels significantly predicted decline of the weighted EQ-5D index after 30 days (n=753) with adjusted odds ratios (ORs) of 2.0 ([95% CI 1.1-3.8]; p=0.027) and 3.7 ([95% CI 2.2-6.0]; pscale (VAS). Initial WBC, PCT and CRP values did not well predict QoL at any time point. ProADM and proANP accurately predict short- and long-term decline in QoL across most dimensions in CAP patients. It will be interesting to reveal underlying physiopathology in future studies.

  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. Prospective comparative effectiveness cohort study comparing two models of advance care planning provision for Australian community aged care clients.

    Science.gov (United States)

    Detering, Karen Margaret; Carter, Rachel Zoe; Sellars, Marcus William; Lewis, Virginia; Sutton, Elizabeth Anne

    2017-12-01

    Conduct a prospective comparative effectiveness cohort study comparing two models of advance care planning (ACP) provision in community aged care: ACP conducted by the client's case manager (CM) ('Facilitator') and ACP conducted by an external ACP service ('Referral') over a 6-month period. This Australian study involved CMs and their clients. Eligible CM were English speaking, ≥18 years, had expected availability for the trial and worked ≥3 days per week. CMs were recruited via their organisations, sequentially allocated to a group and received education based on the group allocation. They were expected to initiate ACP with all clients and to facilitate ACP or refer for ACP. Outcomes were quantity of new ACP conversations and quantity and quality of new advance care directives (ACDs). 30 CMs (16 Facilitator, 14 Referral) completed the study; all 784 client's files (427 Facilitator, 357 Referral) were audited. ACP was initiated with 508 (65%) clients (293 Facilitator, 215 Referral; p<0.05); 89 (18%) of these (53 Facilitator, 36 Referral) and 41 (46%) (13 Facilitator, 28 Referral; p<0.005) completed ACDs. Most ACDs (71%) were of poor quality/not valid. A further 167 clients (facilitator 124; referral 43; p<0.005) reported ACP was in progress at study completion. While there were some differences, overall, models achieved similar outcomes. ACP was initiated with 65% of clients. However, fewer clients completed ACP, there was low numbers of ACDs and document quality was generally poor. The findings raise questions for future implementation and research into community ACP provision. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. [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. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  10. Social relationships, loneliness, and mental health among older men and women in Ireland: A prospective community-based study.

    Science.gov (United States)

    Santini, Ziggi Ivan; Fiori, Katherine Leigh; Feeney, Joanne; Tyrovolas, Stefanos; Haro, Josep Maria; Koyanagi, Ai

    2016-11-01

    Data is lacking on the association of interpersonal stressors and social isolation with mental disorders and the mediating role of loneliness. Thus, we examined this association prospectively using community-based data. Data on 6105 adults aged ≥50 years from the Irish Longitudinal Study on Ageing (TILDA) was analyzed. Mental health outcomes were assessed 2 years after baseline. Depressive and anxiety symptoms were evaluated with validated scales. Multivariable linear regression and mediation analyses were conducted. Higher levels of spousal support, less strain from spouse and better social network integration were protective against depressive symptoms in men. Social support from friends and children was protective against depressive symptoms in both genders. Higher levels of social strain from children were positively associated with depressive symptoms in women. Loneliness was a significant mediator in the majority of these associations. Interventions aimed at increasing relationship quality and strengthening existing social network structures, with a specific focus on reducing feelings of loneliness, may be beneficial in the prevention of depressive symptoms among older adults. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. First-episode psychosis at the West Bologna Community Mental Health Centre: results of an 8-year prospective study.

    Science.gov (United States)

    Tarricone, I; Mimmi, S; Paparelli, A; Rossi, E; Mori, E; Panigada, S; Carchia, G; Bandieri, V; Michetti, R; Minenna, G; Boydell, J; Morgan, C; Berardi, D

    2012-11-01

    Research mostly conducted in the UK and northern Europe has established that there are high rates of first-episode psychosis (FEP) in large cities and immigrant populations; moreover, psychosis has been found to be associated with cannabis use and early trauma. The present study aimed to evaluate the incidence rate of FEP and the distribution of several risk factors (e.g. age, ethnicity, substance abuse) in Bologna, Italy. The Bologna FEP (BoFEP) study is an 8-year prospective study. All FEP patients, 18-64 years old, consecutively referred to the West Bologna Community Mental Health Centre (CMHC) from 2002 to 2009 were evaluated. Sociodemographic information, migration history and clinical data were collected through an ad-hoc schedule. Psychiatric diagnoses were recorded using the Schedule for Clinical Assessment of Neuropsychiatry (SCAN). The overall incidence rate (IR) in the BoFEP study was 16.4 per 100 000 person-years [95% confidence interval (CI) 13.9-18.9]. The incidence was higher in young people, men and migrants (MI). The IR of FEP found by the Bologna study is lower than that found by other European studies. However, as in other studies, the incidence was higher in certain groups. This heterogeneity has implications for policy and mental health service development, and for understanding the aetiology of psychosis.

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

    Science.gov (United States)

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

    2017-01-01

    Abstract 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

  13. 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

  14. Interprofessional Communities of Practice in Continuing Medical Education for Promoting and Sustaining Practice Change: A Prospective Cohort Study.

    Science.gov (United States)

    Barker, Megan; Lecce, Julia; Ivanova, Anna; Zawertailo, Laurie; Dragonetti, Rosa; Selby, Peter

    2018-01-01

    Standard knowledge delivery formats for CME may have limited impact on long-term practice change. A community of practice (CoP) is one tool that may enhance competencies and support practice change. This study explores the utility of an interprofessional CoP as an adjunct to a CME program in tobacco addiction treatment (Training Enhancement in Applied Counselling and Health [TEACH] Project) to promote and sustain practice change. A prospective cohort design was utilized to examine the long-term impact of the TEACH CoP on practice change. An online survey was administered to TEACH-trained practitioners to assess perceived feasibility, importance, and confidence related to course competencies, involvement in TEACH CoP activities, engagement in knowledge transfer (KT), and implementation of new programming. Chi-square tests were used to detect differences in KT and program development associated with CoP participation. Course competency scores from immediate postcourse surveys and long-term follow-up surveys were compared. No significant differences in participant characteristics were found between those who did (n = 300) and did not (n = 122) participate in the TEACH CoP. Mean self-perceived competency scores were greater immediately after course than at long-term follow-up; however, self-ratings of competency in pharmacological interventions and motivational interviewing were higher at follow-up. TEACH CoP participation was associated with significantly greater engagement in KT and implementation of new programming after training. The findings from this evaluation suggest the value of interprofessional CoPs offered posttraining as a mechanism to enhance practice. CME providers should consider offering CoPs as a component of training programs to promote and sustain practice change.

  15. Effectiveness of Liposomal Bupivacaine in Colorectal Surgery: A Pragmatic Nonsponsored Prospective Randomized Double Blinded Trial in a Community Hospital.

    Science.gov (United States)

    Knudson, Rachel A; Dunlavy, Paul W; Franko, Jan; Raman, Shankar R; Kraemer, Soren R

    2016-09-01

    Prior industry conducted studies have shown that long acting liposomal bupivacaine injection improves pain control postoperatively. To evaluate whether liposomal bupivacaine reduced the use of postoperative opioid (http://links.lww.com/DCR/A253) pain medication as compared to standard bupivacaine following colorectal surgery. A double blinded, prospective, randomized controlled trial comparing liposomal bupivacaine versus standard bupivacaine in patients undergoing elective colon resection. Community hospital with general surgery residency program with all cases performed by colorectal surgeons. Fifty-seven patients were randomized and reported as intention-to-treat analysis with 6 protocol violations. Sensitivity analysis excluding these 6 patients demonstrated no change in study results or conclusion. Mean age was 67 ± 2 years and 56% were male. There were 36 patients who underwent minimally invasive surgery, and 21 patients had an open colon resection. Experimental arm received liposomal bupivacaine while control arm received standard bupivacaine. Primary outcome measure was intravenous hydromorphone equivalent used via PCA during first 48 hours after operation. There was no significant difference between the two groups in the amount of opioid used orally or intravenously in the postoperative period. The primary outcome measure was PCA hydromorphone consumption during first two postoperative days after operation (hydromorphone equivalent use in standard bupivacaine group 11.3 ± 8.9 mg versus 13.3 ± 11.9 mg in liposomal bupivacaine group, p = 0.58 Mann-Whitney test). Small pragmatic trials typically remain underpowered for secondary analyses. A larger study could help to further delineate other outcomes that are impacted by postoperative pain. Liposomal bupivacaine did not change the amount of opioid used postoperatively. Based on our study, liposomal bupivacaine does not provide any added benefit over conventional bupivacaine after colon

  16. Comparative prognostic performance of definitions of prediabetes: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study.

    Science.gov (United States)

    Warren, Bethany; Pankow, James S; Matsushita, Kunihiro; Punjabi, Naresh M; Daya, Natalie R; Grams, Morgan; Woodward, Mark; Selvin, Elizabeth

    2017-01-01

    No consensus on definitions of prediabetes exists among international organisations. Analysis of associations with different definitions and clinical complications can inform the comparative value of different prediabetes definitions. We compared the risk of future outcomes across different prediabetes definitions based on fasting glucose concentration, HbA 1c , and 2 h glucose concentration during over two decades of follow-up in the community-based Atherosclerosis Risk in Communities (ARIC) study. We aimed to analyse the associations of definitions with outcomes to provide a comparison of different definitions. We did a prospective cohort study of participants in the ARIC study who did not have diagnosed diabetes and who attended visit 2 (1990-92; n=10 844) and who attended visit 4 (1996-98; n=7194). ARIC participants were enrolled from four communities across the USA. Fasting glucose concentration and HbA 1c were measured at visit 2 and fasting glucose concentration and 2 h glucose concentration were measured at visit 4. We compared prediabetes definitions based on fasting glucose concentration (American Diabetes Association [ADA] fasting glucose concentration cutoff 5·6-6·9 mmol/L and WHO fasting glucose concentration cutoff 6·1-6·9 mmol/L), HbA 1c (ADA HbA 1c cutoff 5·7-6·4% [39-46 mmol/mol] and International Expert Committee [IEC] HbA 1c cutoff 6·0-6·4% [42-46 mmol/mol]), and 2 h glucose concentration (ADA and WHO 2 h glucose concentration cutoff 7·8-11·0 mmol/L). Prediabetes defined using the ADA fasting glucose concentration cutoff (prevalence 4112 [38%] of 10 844 people; 95% CI 37·0-38·8) was the most sensitive for major clinical outcomes, whereas using the ADA HbA 1c cutoff (2027 [19%] of 10 884 people; 18·0-19·4) and IEC HbA 1c cutoff (970 [9%] of 10 844 people; 8·4-9·5), and the WHO fasting glucose concentration cutoff (1213 [11%] of 10 844 people; 10·6-11·8) were more specific. After demographic adjustment, HbA 1c -based

  17. Revisiting the association of blood pressure with mortality in oldest old people in China: community based, longitudinal prospective study

    Science.gov (United States)

    Lv, Yue-Bin; Gao, Xiang; Yin, Zhao-Xue; Chen, Hua-Shuai; Luo, Jie-Si; Brasher, Melanie Sereny; Kraus, Virginia Byers; Li, Tian-Tian; Zeng, Yi

    2018-01-01

    Abstract Objective To examine the associations of blood pressure with all cause mortality and cause specific mortality at three years among oldest old people in China. Design Community based, longitudinal prospective study. Setting 2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey, conducted in 22 Chinese provinces. Participants 4658 oldest old individuals (mean age 92.1 years). Main outcome measures All cause mortality and cause specific mortality assessed at three year follow-up. Results 1997 deaths were recorded at three year follow-up. U shaped associations of mortality with systolic blood pressure, mean arterial pressure, and pulse pressure were identified; values of 143.5 mm Hg, 101 mm Hg, and 66 mm Hg conferred the minimum mortality risk, respectively. After adjustment for covariates, the U shaped association remained only for systolic blood pressure (minimum mortality risk at 129 mm Hg). Compared with a systolic blood pressure value of 129 mm Hg, risk of all cause mortality decreased for values lower than 107 mm Hg (from 1.47 (95% confidence interval 1.01 to 2.17) to 1.08 (1.01 to 1.17)), and increased for values greater than 154 mm Hg (from 1.08 (1.01 to 1.17) to 1.27 (1.02 to 1.58)). In the cause specific analysis, compared with a middle range of systolic blood pressure (107-154 mm Hg), higher values (>154 mm Hg) were associated with a higher risk of cardiovascular mortality (adjusted hazard ratio 1.51 (95% confidence interval 1.12 to 2.02)); lower values (blood pressure and all cause mortality at three years among oldest old people in China. This association could be explained by the finding that higher systolic blood pressure predicted a higher risk of death from cardiovascular disease, and that lower systolic blood pressure predicted a higher risk of death from non-cardiovascular causes. These results emphasise the importance of revisiting blood pressure management or establishing specific guidelines for management among oldest

  18. The Subclonal Architecture of Metastatic Breast Cancer: Results from a Prospective Community-Based Rapid Autopsy Program “CASCADE”

    Science.gov (United States)

    Flensburg, Christoffer; Alsop, Kathryn; Mansour, Mariam; Francis, Prudence A.; Thorne, Heather A.; Silva, Maria Joao; Kanu, Nnennaya; Dietzen, Michelle; Bowtell, David D.; Speed, Terence P.; Swanton, Charles; Loi, Sherene

    2016-01-01

    Background Understanding the cancer genome is seen as a key step in improving outcomes for cancer patients. Genomic assays are emerging as a possible avenue to personalised medicine in breast cancer. However, evolution of the cancer genome during the natural history of breast cancer is largely unknown, as is the profile of disease at death. We sought to study in detail these aspects of advanced breast cancers that have resulted in lethal disease. Methods and Findings Three patients with oestrogen-receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer and one patient with triple negative breast cancer underwent rapid autopsy as part of an institutional prospective community-based rapid autopsy program (CASCADE). Cases represented a range of management problems in breast cancer, including late relapse after early stage disease, de novo metastatic disease, discordant disease response, and disease refractory to treatment. Between 5 and 12 metastatic sites were collected at autopsy together with available primary tumours and longitudinal metastatic biopsies taken during life. Samples underwent paired tumour-normal whole exome sequencing and single nucleotide polymorphism (SNP) arrays. Subclonal architectures were inferred by jointly analysing all samples from each patient. Mutations were validated using high depth amplicon sequencing. Between cases, there were significant differences in mutational burden, driver mutations, mutational processes, and copy number variation. Within each case, we found dramatic heterogeneity in subclonal structure from primary to metastatic disease and between metastatic sites, such that no single lesion captured the breadth of disease. Metastatic cross-seeding was found in each case, and treatment drove subclonal diversification. Subclones displayed parallel evolution of treatment resistance in some cases and apparent augmentation of key oncogenic drivers as an alternative resistance mechanism. We

  19. Community

    Science.gov (United States)

    stability Science & Innovation Collaboration Careers Community Environment Science & Innovation Recruitment Events Community Commitment Giving Campaigns, Drives Economic Development Employee Funded neighbor pledge: contribute to quality of life in Northern New Mexico through economic development

  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. 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…

  2. Use of stance time variability for predicting mobility disability in community-dwelling older persons: a prospective study.

    NARCIS (Netherlands)

    Brach, J.S.; Wert, D.; Swearingen, J.M. van; Newman, A.B.; Studenski, S.A.

    2012-01-01

    BACKGROUND AND PURPOSE: Mobility disability is a serious and frequent adverse health outcome associated with aging. Early identification of individuals at risk for mobility disability is important if interventions to prevent disability are to be instituted. The objectives of this prospective study

  3. Economic development prospects of forest-dependent communities: analyzing trade-offs using a compromise-fuzzy programming framework

    NARCIS (Netherlands)

    Krcmar, E.; Kooten, van G.C.

    2008-01-01

    Many aboriginal communities look to forest resources for short- and long-term employment, adequate timber for mills, an even flow of wood fiber for community stability, and financial returns for economic diversification. We address these conflicting objectives using multiple-objective programming.

  4. 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.

  5. Community.

    Science.gov (United States)

    Grauer, Kit, Ed.

    1995-01-01

    Art in context of community is the theme of this newsletter. The theme is introduced in an editorial "Community-Enlarging the Definition" (Kit Grauer). Related articles include: (1) "The Children's Bridge is not Destroyed: Heart in the Middle of the World" (Emil Robert Tanay); (2) "Making Bridges: The Sock Doll…

  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. Clinical and epidemiological factors associated with methicillin resistance in community-onset invasive Staphylococcus aureus infections: prospective multicenter cross-sectional study in Korea.

    Directory of Open Access Journals (Sweden)

    Eu Suk Kim

    Full Text Available Successful empirical therapy of Staphylococcus aureus infections requires the ability to predict methicillin resistance. Our aim was to identify predictors of methicillin resistance in community-onset (CO invasive S. aureus infections. Sixteen hospitals across Korea participated in this study from May to December 2012. We prospectively included cases of S. aureus infection in which S. aureus was isolated from sterile clinical specimens ≤ 72 hours after hospitalization. Clinical and epidemiological data were gathered and compared in methicillin-resistant S. aureus (MRSA and methicillin-susceptible S. aureus (MSSA cases. Community-associated (CA infections were defined as in previous studies. In total, there were 786 cases of community-onset S. aureus infection, 102 (13.0% of which were CA-MRSA. In addition to known risk factors, exposure to 3rd generation cephalosporins in the past 6 months [odds ratio (OR, 1.922; 95% confidence interval (CI, 1.176-3.142] and close contact with chronically ill patients in the past month (OR, 2.647; 95% CI, 1.189-5.891 were independent risk factors for MRSA infection. However, no clinical predictors of CA-MRSA were identified. Methicillin resistance, CO infection, and appropriateness of empirical antibiotics were not significantly related to 30-day mortality. MRSA infection should be suspected in patients recently exposed to 3rd generation cephalosporins or chronically-ill patients. There were no reliable predictors of CA-MRSA infection, and mortality was not affected by methicillin resistance.

  8. 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.

  9. Efeito de sistemas de manejo de solo e de rotação de culturas na fertilidade do solo, após vinte anos Soil tillage and crop rotation systems on soil fertility attributes after twenty years

    Directory of Open Access Journals (Sweden)

    Henrique Pereira dos Santos

    2008-01-01

    Full Text Available No Brasil, ainda são escassos os estudos disponíveis com experimentos de longa duração em sistemas de manejo de solo e de rotação de culturas. Após vinte anos (1985 a 2005, a fertilidade de solo foi avaliada, em Latossolo Vermelho distrófico típico, em Passo Fundo (RS, em quatro sistemas de manejo de solo (SMSs - 1 plantio direto (PD, 2 cultivo mínimo (CM, 3 preparo convencional de solo com arado de discos e com grade de discos (PCD e 4 preparo convencional de solo com arado de aivecas e com grade de discos (PCA - e em três sistemas de rotação de culturas (SRCs: I (trigo/soja, II (trigo/soja e ervilhaca/milho e III (trigo/soja, ervilhaca/milho e aveia branca/soja, incluindo como testemunha um fragmento adjacente de floresta subtropical (FST. O delineamento experimental foi em blocos completos ao acaso, com parcelas subdivididas e três repetições. As parcelas (4 x 90 m no total de 12, foram constituídas pelos SMSs, e as subparcelas, pelos SRCs (4 x 10 m, no total de 72. Os valores de pH, carbono, P extraível e K disponível diferiram entre os SMSs. No PD, houve acúmulo de carbono orgânico, P e K, na camada superficial. Não houve diferença do nível de matéria orgânica (MOS entre PD e FST, em todas as camadas estudadas. O nível de MOS e os teores de P e K foram mais elevados na camada 0-0,05 m, quando comparados com os observados de 0,15-0,20 m de profundidade, sob PD e nas rotações II e III. Observou-se que em FST os valores de pH, Ca, P e de K foram menores do que os dos SMSs e SRCs.Long term field studies on crop rotation and soil tillage systems under Brazilian conditions are scarce. Soil fertility characteristics were assessed after twenty years (1985 to 2005 on a typical dystrophic Red Latosol located in Passo Fundo, in Rio Grande do Sul, the southernmost state of Brazil. Four soil tillage systems (STS - 1 no-tillage, 2 minimum tillage, 3 conventional tillage using disk plow followed by disk harrow, and 4

  10. The contribution of community and family contexts to African American young adults' romantic relationship health: a prospective analysis.

    Science.gov (United States)

    Kogan, Steven M; Lei, Man-Kit; Grange, Christina R; Simons, Ronald L; Brody, Gene H; Gibbons, Frederick X; Chen, Yi-Fu

    2013-06-01

    Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10-22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths' exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults' romantic relationships.

  11. The Contribution of Community and Family Contexts to African American Young Adults’ Romantic Relationship Health: A Prospective Analysis

    Science.gov (United States)

    Kogan, Steven M.; Lei, Man-Kit; Grange, Christina R.; Simons, Ronald L.; Brody, Gene H.; Gibbons, Frederick X.; Chen, Yifu

    2013-01-01

    Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10–22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths’ exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults’ romantic relationships. PMID:23494451

  12. The History of Stuttering by 7 Years of Age: Follow-Up of a Prospective Community Cohort

    Science.gov (United States)

    Kefalianos, Elaina; Onslow, Mark; Packman, Ann; Vogel, Adam; Pezic, Angela; Mensah, Fiona; Conway, Laura; Bavin, Edith; Block, Susan; Reilly, Sheena

    2017-01-01

    Purpose: For a community cohort of children confirmed to have stuttered by the age of 4 years, we report (a) the recovery rate from stuttering, (b) predictors of recovery, and (c) comorbidities at the age of 7 years. Method: This study was nested in the Early Language in Victoria Study. Predictors of stuttering recovery included child, family, and…

  13. The communities first (ComFi) study: protocol for a prospective controlled quasi-experimental study to evaluate the impact of area-wide regeneration on mental health and social cohesion in deprived communities.

    Science.gov (United States)

    White, James; Greene, Giles; Dunstan, Frank; Rodgers, Sarah; Lyons, Ronan A; Humphreys, Ioan; John, Ann; Webster, Chris; Palmer, Stephen; Elliott, Eva; Phillips, Ceri J; Fone, David

    2014-10-14

    Recent systematic reviews have highlighted the dearth of evidence on the effectiveness of regeneration on health and health inequalities. 'Communities First' is an area-wide regeneration scheme to improve the lives of people living in the most deprived areas in Wales (UK). This study will evaluate the impact of Communities First on residents' mental health and social cohesion. A prospective controlled quasi-experimental study of the association between residence in Communities First regeneration areas in Caerphilly county borough and change in mental health and social cohesion. The study population is the 4226 residents aged 18-74 years who responded to the Caerphilly Health and Social Needs Study in 2001 (before delivery) and 2008 (after delivery of Communities First). Data on the location, type and cost of Communities First interventions will be extracted from records collected by Caerphilly county borough council. The primary outcome is the change in mental health between 2001 and 2008. Secondary outcomes are changes: in common mental disorder case status (using survey and general practice data), social cohesion and mental health inequalities. Multilevel models will examine change in mental health and social cohesion between Communities First and control areas, adjusting for individual and household level confounding factors. Further models will examine the effects of (1) different types of intervention, (2) contamination across areas, (3) length of residence in a Communities First area, and (4) population migration. We will carry out a cost-consequences analysis to summarise the outcomes generated for participants, as well as service utilisation and utility gains. This study has had approval from the Information Governance Review Panel at Swansea University (Ref: 0266 CF). Findings will be disseminated through peer-review publications, international conferences, policy and practice partners in local and national government, and updates on our study website

  14. Reasons for Schizophrenia Patients Remaining out of Treatment: Results from a Prospective Study in a Rural South Indian Community.

    Science.gov (United States)

    Kumar, Channaveerachari Naveen; Thirthalli, Jagadisha; Suresha, Kudumallige Krishnappa; Venkatesh, Basappa K; Kishorekumar, Kengeri V; Arunachala, Udupi; Gangadhar, Bangalore N

    2016-01-01

    A few studies have examined the factors associated with schizophrenia patients remaining untreated in India. 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. 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%). 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 the best care.

  15. Community child psychiatric medication experiences measured by an internet-based, prospective parent survey of retail pharmacy customers.

    Science.gov (United States)

    Hilt, Robert; Wolf, Christine; Koprowicz, Kent; Thomas, Elizabeth; Chandler, Mary; Hao, Xiao Lei; Russell, Matthew; Le, Tung; Hooks, Lee; King, Bryan

    2014-02-01

    One thousand five hundred parents filling a psychiatric prescription for their 6-18 year old child with a multi-state retail pharmacy chain received a single mailed invitation to complete a detailed online survey. 276 parents responded (18.4%). 60% of children on medications had a parent rated CBCL scale score in the clinically significant range at enrollment (T score ≥65), with a similar frequency of clinically significant CBCL scores through 15 months of survey followup. 47% of medication regimens were noted to be causing persistent side effects. This simple community based data collection method can offer a unique way to investigate naturalistic treatment outcomes.

  16. Congenital Critical Heart Defect Screening in a Health Area of the Community of Valencia (Spain: A Prospective Observational Study

    Directory of Open Access Journals (Sweden)

    Elena Cubells

    2018-01-01

    Full Text Available Despite the progress in the fetal echocardiographic detection of congenital critical heart defects and neonatal physical examination, a significant number of newborn infants are discharged and readmitted to the hospital in severe condition due to cardiac failure or collapse. The aim of this study was to assess the incidence of undetected critical congenital heart disease (CCHD by a pulse oximetry-screening program in the maternity wards of hospitals with Perinatal Services in a specific geographic area. This is a prospective observational study performed in in the health area corresponding to the city of Valencia. Eligible infants were consecutively admitted newborn infants in the maternities of the participating hospitals with negative fetal echocardiography after normal physical examination in the delivery room. All patients were screened following a specific pulse oximetry protocol before discharge. A total of 8856 newborn infants were screened. A total of three babies presented with severe congenital cardiac malformation and two babies presented with early onset sepsis. Sensitivity was 100% and specificity was 99.97%, with a positive predictive value of 60% and negative predictive value of 100%. Pulse oximetry screening programs in the early neonatal period constitute a valuable tool to avoid inadvertent hospital discharge of severe cardiac malformations and the subsequent life-threatening complications derived.

  17. The effect of vacuum assisted socket suspension on prospective, community-based falls by users of lower limb prostheses.

    Science.gov (United States)

    Rosenblatt, Noah J; Ehrhardt, Tess

    2017-06-01

    Individuals with lower limb amputation are at increased risk of falling compared to age-matched peers. The purpose of this study was to quantify the effect of socket suspension on the risk of falling, by comparing prospectively tracked falls between a group of participants that used vacuum assisted socket suspension (VASS) and a group that did not use this system. Fifteen current users of VASS and 12 non-VASS users received an email every two weeks for one year, with a link to an online survey that asked whether they fell (i.e., "unintentionally came to rest on a lower surface") or stumbled (i.e., lost balance but did not fall) in the prior two weeks. A Chi-squared test was used to compare fall and stumble risk between groups, after stratifying by level of amputation, and the phi coefficient (φ) was used to quantify effect size. While the use of VASS did not affect the rate of falling (i.e., falls per person year) for either persons with transtibial amputation (TTA) or those with transfemoral amputation (TFA), the absolute risk of having multiple falls was reduced by nearly 75% in the former (φ=0.83), which is particularly important given that recurrent falls are associated with more severe injuries. There was no effect of VASS on the risk of falls in TFA. Further work is warranted to demonstrate the persistence of these effects in larger, more controlled samples. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Protective Factors, Coping Appraisals, and Social Barriers Predict Mental Health Following Community Violence: A Prospective Test of Social Cognitive Theory.

    Science.gov (United States)

    Smith, Andrew J; Felix, Erika D; Benight, Charles C; Jones, Russell T

    2017-06-01

    This study tested social cognitive theory of posttraumatic adaptation in the context of mass violence, hypothesizing that pre-event protective factors (general self-efficacy and perceived social support) would reduce posttraumatic stress symptoms (PTSS) and depression severity through boosting post-event coping self-efficacy appraisals (mediator). We qualified hypotheses by predicting that post-event social support barriers would disrupt (moderate) the health-promoting indirect effects of pre-event protective factors. With a prospective longitudinal sample, we employed path models with bootstrapping resampling to test hypotheses. Participants included 70 university students (71.4% female; 40.0% White; 34.3% Asian; 14.3% Hispanic) enrolled during a mass violence event who completed surveys one year pre-event and 5-6 months post-event. Results revealed significant large effects in predicting coping self-efficacy (mastery model, R 2 = .34; enabling model, R 2 = .36), PTSS (mastery model, R 2 = .35; enabling model, R 2 = .41), and depression severity (mastery model, R 2 = .43; enabling model, R 2 = .46). Overall findings supported study hypotheses, showing that at low levels of post-event social support barriers, pre-event protective factors reduced distress severity through boosting coping self-efficacy. However, as post-event social support barriers increased, the indirect, distress-reducing effects of pre-event protective factors were reduced to nonsignificance. Study implications focus on preventative and responsive intervention. Copyright © 2017 International Society for Traumatic Stress Studies.

  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. A Prospective Pilot Study to Validate the Management Protocol for Patients Presenting with Acute Urinary Retention: A Community-Based, Nonhospitalised Protocol

    Directory of Open Access Journals (Sweden)

    Shyamala S. Gopi

    2006-01-01

    Full Text Available Acute urinary retention (AUR in males is managed conventionally by hospital admission, alpha-adrenergic therapy, and trial without catheter. To reduce inpatient bed pressures, we set up a protocol to manage such patients in the community. We review our results in this paper. We performed a prospective study of male patients presenting to our acute admissions ward and Accident and Emergency department over 6 months. Patients with chronic urinary retention, macroscopic haematuria, sepsis, urinary tract infection, and/or serum creatinine >130 mmol/l were excluded from the study. Those enrolled were catheterised, commenced on alfuzosin (10 mg nocte, and discharged to the community. A trial without catheter (TWOC was performed 5—7 days later. QoL/IPSS, peak flow rate, and residual volume assessment were performed following successful TWOC 3 months later.Thirty-one male patients with a median age of 69 years were studied and the median residual volume following catheterisation was 900 ml. The aetiology of AUR was benign prostatic hyperplasia (BPH in 29 patients and constipation in the remaining 2 patients. TWOC was successful in 19 patients (61.3% following first TWOC, 26 (83.9% following second trial of voiding. The mean peak flow rate was 6.5 ml/sec and postvoid scan 165 ml, following an immediate TWOC. At 3 months follow-up, mean peak flow rate was 13.2 ml/sec, postvoid scan 26.5 ml, IPSS 4.5, and QoL score was 2. This study has shown that AUR can be managed safely and effectively in the community. Effective communication with the nurse urology specialist, general practitioner, and emergency department are crucial for the successful implementation of the protocol.

  1. Gender Differences During Toddlerhood in Autism Spectrum Disorder: A Prospective Community-Based Longitudinal Follow-Up Study.

    Science.gov (United States)

    Lawson, Lauren P; Joshi, Rucha; Barbaro, Josephine; Dissanayake, Cheryl

    2018-03-01

    Relatively few studies have examined gender differences in infants and toddlers, and most focus on clinically referred samples or high-risk infant cohorts. The current study aimed to examine gender differences in early autism manifestations and cognitive development in a community-ascertained sample. In total, 46 males and 21 females with ASD were seen at approximately 24 and 48 months of age. No significant gender differences were observed on overall cognitive ability, verbal skills, non-verbal skills, overall autism severity, or restricted repetitive behaviours. However, females were found to exhibit more social communication impairments than males. These findings may indicate that female toddlers with less severe or different, social communication impairments may be more likely to be missed during routine surveillance during toddlerhood.

  2. Cohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community.

    Science.gov (United States)

    Ward, Alison; Tompson, Alice; Fitzmaurice, David; Sutton, Stephen; Perera, Rafael; Heneghan, Carl

    2015-07-01

    Trials show that oral anticoagulation therapy (OAT) substantially reduces thromboembolic events without an increase in major haemorrhagic events, but it is not known whether these results translate into routine practice. To estimate the current levels of control and adverse events in patients self-monitoring OAT, explore the factors that predict success, and determine whether the level of side effects reported from randomised controlled trials are translated to a non-selected population. Prospective cohort study in the UK. Participants were aged ≥18 years and registered with a GP. Main outcomes were the proportion of participants, over 12 months, who were still self-monitoring, had not experienced adverse events, and had achieved >80% of time in therapeutic range (TTR). In total, 296 participants were recruited; their median age was 61 years and 55.1% were male. Participants were predominately professional or held a university qualification (82.7%). At 12 months, 267 (90.2%) were still self-monitoring. Mean TTR was 75.3% (standard deviation 16.9).Six serious and two minor adverse events were reported by GPs. Only 45.9% of participants received any in-person training at the outset. Increased age (P = 0.027), general wellbeing (EQ-5D visual score, P = 0.020), and lower target international normalised range (INR, P = 0.032) were all associated with high (>80% TTR) levels of control. The findings show that, even with little training, people on OAT can successfully self-monitor, and even self-manage, their INR. TTR was shown to improve with age. However, widespread use of self-monitoring of INR may be limited by the initial costs, as well as a lack of training and support at the outset. © British Journal of General Practice 2015.

  3. Performance of a brief asthma control screening tool in community pharmacy: a cross-sectional and prospective longitudinal analysis.

    Science.gov (United States)

    LeMay, Kate S; Armour, Carol L; Reddel, Helen K

    2014-03-01

    Guidelines recommend basing asthma management on assessment of asthma control. Validated control tools, while suitable for clinical research, may not be feasible for routine use in primary care. To describe the performance of the Pharmacy Asthma Control Screening tool (PACS) compared with the Asthma Control Questionnaire (ACQ-6). Data were obtained from a multicentre study of a community pharmacy asthma management programme in Australia, with three or four visits over six months. Eligible participants had suboptimal asthma control or no recent visit to their doctor for asthma. Asthma control was assessed at baseline and at six months with the PACS tool and ACQ-6. A total of 570 patients were enrolled and 398 (70%) completed the programme. The average ACQ-6 score was 1.58±1.05 at baseline and 0.96±0.88 (n=392) after six months. Sensitivity and specificity of PACS 'poor control' for not well-controlled asthma (ACQ- 6 >1.0) were 0.92 and 0.66, respectively, at baseline and 0.76 and 0.83 at six months. Agreement between the two tools at six months was moderate (κ=0.54). Both tools showed highly significant change during the study (p<0.0001 for each), but agreement between the change in the two tools was only fair (κ=0.31). This study shows that a simple asthma control screening tool is feasible for use in community pharmacies and has good sensitivity for identifying patients with not well-controlled asthma. Screening tools are useful in primary care to identify patients who require more detailed assessment of their asthma status, whereas for monitoring asthma control over time, a continuous control measure is more appropriate.

  4. A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service.

    Science.gov (United States)

    Ryan, Alexandra; Uppal, Meenakshi; Cunning, Imelda; Buckley, Claire M

    2015-01-01

    The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the 'Guidelines on prevention & management of foot problems in Type 2 Diabetes' by the National Institute of Clinical Excellence (NICE). Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot). Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines.

  5. A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service

    Directory of Open Access Journals (Sweden)

    Alexandra Ryan

    2015-06-01

    Full Text Available Objective: The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. Methods: An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the ‘Guidelines on prevention & management of foot problems in Type 2 Diabetes’ by the National Institute of Clinical Excellence (NICE. Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. Results: An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot. Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. Discussion: During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines.

  6. Inappropriate medication use and risk of falls – A prospective study in a large community-dwelling elderly cohort

    Directory of Open Access Journals (Sweden)

    Fourrier Annie

    2009-07-01

    Full Text Available Abstract Background Explicit criteria for determining potentially inappropriate medication consumption in elderly were elaborated by Beers et al. These lists have been used worldwide to evaluate medical prescriptions but there is little epidemiologic evidence demonstrating negative consequences of inappropriate medication use. It has been reported that some drugs could increase the risk of falls, which are a frequent and serious problem in elderly population. We aimed to evaluate the association between the use of potentially inappropriate medications and the risk of falls. Methods The 3C Study is a multicentre prospective cohort study conducted in France with 4 years of follow-up. Non-institutionalized men and women aged 65 years or over (N = 6343 were randomly selected from electoral rolls. Data on socio-demographic, medical characteristics and medication use (based on self-reports and data from the national healthcare insurance were collected. Use of inappropriate medication for elderly was defined from established criteria. Data about falls were collected at the two follow-up examinations (2 years and 4 years after baseline. The association between the exposure to inappropriate medications and the risk of falls was evaluated using multivariate models (Cox model and logistic regression. Results 32% of subjects reported inappropriate medication use at baseline and 29% at least two of the three examinations; 22% had fallen 2 times or more during follow-up. Overall, inappropriate medication users had an increased risk of falling. This increase was mainly due to the use of long-acting benzodiazepines (adjusted odds ratio (OR = 1.4, 95% confidence interval: [1.1–1.8], in both occasional and regular users, other inappropriate psychotropics (adjusted OR = 1.7 [1.7–2.7] in regular users, or medication with anticholinergic properties (adjusted OR = 1.6 [1.2–2.1] in regular users. Neither occasional, nor regular use of short- or intermediate

  7. 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

  8. 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

  9. 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

  10. Incidence and 30-day case fatality rate of first-ever stroke in urban Nigeria: the prospective community based Epidemiology of Stroke in Lagos (EPISIL) phase II results.

    Science.gov (United States)

    Danesi, Mustapha A; Okubadejo, Njideka U; Ojini, Frank I; Ojo, Oluwadamilola O

    2013-08-15

    Stroke is a leading cause of death worldwide and a major contributor to global disease burden. Although epidemiologic information from a community perspective is important in determining the magnitude of the burden in specific regions, and directing equitable distribution of health resources, data on the incidence of stroke in developing countries in Africa are scarce. To determine the current incidence rate and short-term (30-day) case fatality rate (CFR) of stroke in urban Nigeria, and provide age-adjusted and gender-specific incidence rates to enable comparison with global populations. The study was a prospective community-based stroke registry enrolling hospitalized and non-hospitalized first-ever in a lifetime stroke cases presenting at all health facilities (hospitals, homeopathic caregivers, physiotherapy clinics) located in the designated community. Pre-hospitalization deaths due to stroke were not included in our study. The study was conducted between January 1st and December 31st 2007 in Surulere Local Government Area of Lagos State, south western Nigeria, a mixed-income urban locality with a population of approximately 750,000 based on data from the National Population Commission. Stroke was defined using the World Health Organization (WHO) clinical criteria. Case fatality at 30-days post stroke was determined at follow-up on 160 hospitalized stroke cases. 189 first-ever strokes, comprised of 112 men and 77 women (mean±SD age 58.5±13.5 years) were documented, giving a crude incidence rate of 25.2 per 100,000 per year (95% confidence interval 21.6- 28.8). The gender-specific rates were 28.3/100,000 and 21.3/100,000 for males and females respectively. The age-adjusted incidence rate was 54.08 per 100,000 per year (adjusted to the WHO New World Population). Hospitalization rate was 84.6%, while the CFR (hospitalized) was 16.2%. The stroke incidence in this urban sub-Saharan African community remains lower than that in emerging and developed economies

  11. A prospective study of hormonal treatment and anxiety disorders in community-dwelling elderly women (the Esprit Study).

    Science.gov (United States)

    Scali, Jacqueline; Ryan, Joanne; Carrière, Isabelle; Ritchie, Karen; Ancelin, Marie-Laure

    2009-05-01

    The impact of hormone therapy use on late-life anxiety disorder in elderly women has not been evaluated. Anxiety disorders were evaluated in 838 community-dwelling postmenopausal women aged 65 years and over, randomly recruited from electoral rolls. Anxiety disorders were assessed using a standardized psychiatric examination based on DSM-IV criteria, at baseline and as part of the 2- and 4-year follow-up. Multivariate logistic regression analyses adjusted for socio-demographic variables, measures of physical health and cognitive impairment, as well as current depressive symptomatology indicated no significant association between hormone therapy and anxiety disorders at baseline or after the 4-year follow-up period, regardless of type of treatment. Compared to women who have never taken hormonal therapy, no significant difference was observed for women taking continuously hormone therapy over the follow-up or those who stopped their treatment. The use of hormone therapy was not associated with improved anxiety symptomatology in elderly postmenopausal women.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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.

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

    Science.gov (United States)

    Geurtsen, Gert J; van Heugten, Caroline M; Meijer, Ron; Martina, Juan D; Geurts, Alexander C H

    2011-01-01

    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. A prospective cohort study with waiting list control and 1-year follow-up. Forty-one caregivers of which 28 female. Mean age was 48 ± 8.3 years and 33 caregivers were parents. A structured residential treatment programme was offered to the patients directed at domestic life, work, leisure time and social interactions. The Involvement Evaluation Questionnaire for Brain Injury (IEQ-BI) for emotional burden, the General Health Questionnaire (GHQ) for psychological health and the Family Assessment Device (FAD) for family functioning were used. There was an overall significant effect of Time for all outcome measures (MANOVA T(2 )= 9.1, F(15,317) = 64.1, p = 0.000). The effect sizes were moderate for three IEQ-BI sub-scales (partial η(2 )= 0.12-0.17) and small for two sub-scales (partial η(2 )= 0.05-0.09). The effect size for GHQ was moderate (partial η(2 )= 0.11). As for FAD no significant time effects were present (partial η(2 )= 0.00-0.04). Emotional burden and psychological health of the caregivers improved significantly when patients with acquired brain injury and psychosocial problems followed a residential community reintegration programme. Family dynamics remained stable.

  15. Effect of fall-related concerns on physical, mental, and social function in community-dwelling older adults: a prospective cohort study.

    Science.gov (United States)

    van der Meulen, Erik; Zijlstra, G A Rixt; Ambergen, Ton; Kempen, Gertrudis I J M

    2014-12-01

    To determine the effect of fall-related concerns on physical, mental, and social function. Community-based prospective cohort study (secondary analysis using control group data from a randomized controlled trial). Two municipalities in the south of the Netherlands. Community-dwelling older adults (N = 260). Two groups were created using Modified Falls Efficacy Scale scores (high and low levels of fall-related concerns). Five outcome measures representing physical, mental, and social function were included: activities of daily living (ADLs), symptoms of depression, feelings of anxiety, social participation, and social support interactions. Outcomes were measured at baseline and at 2, 8, and 14 months. Data were analyzed using analysis of covariance and mixed-effect regression models for longitudinal data, adjusting for age, sex, living status (alone or with another person), educational level, cognitive status, self-perceived health, and falls history at baseline. At baseline, significantly more limitations in ADLs and social participation were found for older persons with high levels of fall-related concerns than for those with low levels of concern. These differences persisted over 14 months of follow-up and were consistent over time. No significant differences were found for symptoms of depression, feelings of anxiety, or social support interactions, except for feelings of anxiety at 14 months. Older persons with higher levels of fall-related concerns reported up to 14 months poorer ADL and social participation for up to 14 months than those with lower levels of fall-related concerns. From a clinical point of view, the clear relationship between fall-related concerns and ADL dysfunction and social participation may help to target groups who are at risk of developing adverse consequences of concerns about falls. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

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

    Science.gov (United States)

    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.

  17. Is bilingualism associated with a lower risk of dementia in community-living older adults? Cross-sectional and prospective analyses.

    Science.gov (United States)

    Yeung, Caleb M; St John, Philip D; Menec, Verena; Tyas, Suzanne L

    2014-01-01

    The aim of this study was to determine whether bilingualism is associated with dementia in cross-sectional or prospective analyses of older adults. In 1991, 1616 community-living older adults were assessed and were followed 5 years later. Measures included age, sex, education, subjective memory loss (SML), and the modified Mini-mental State Examination (3MS). Dementia was determined by clinical examination in those who scored below the cut point on the 3MS. Language status was categorized based upon self-report into 3 groups: English as a first language (monolingual English, bilingual English) and English as a Second Language (ESL). The ESL category had lower education, lower 3MS scores, more SML, and were more likely to be diagnosed with cognitive impairment, no dementia at both time 1 and time 2 compared with those speaking English as a first language. There was no association between being bilingual (ESL and bilingual English vs. monolingual) and having dementia at time 1 in bivariate or multivariate analyses. In those who were cognitively intact at time 1, there was no association between being bilingual and having dementia at time 2 in bivariate or multivariate analyses. We did not find any association between speaking >1 language and dementia.

  18. Incidence of childhood and adolescence epilepsy: a community-based prospective study in the province of Ferrara and in Copparo, Italy, 1996-2005.

    Science.gov (United States)

    Casetta, I; Pugliatti, M; Faggioli, R; Cesnik, E; Simioni, V; Bencivelli, D; De Carlo, L; Granieri, E

    2012-02-01

    The annual incidence of childhood and adolescence epilepsy ranges from 41 to 97 diagnoses per 100,000 people in western Countries, with a reported decline over time. We aimed at studying the incidence of epilepsy in children and adolescents (1 month to 14 years) and its temporal trend in the province of Ferrara, northern Italy. We implemented a community-based prospective multi-source registry. All children with newly diagnosed epilepsy in the period 1996-2005 were recorded. The incidence rate of newly diagnosed epilepsy in the considered age range was 57 per 100,000 person-years, (95% CI: 49.3-65.9), with a peak in the first year of life (109.4; 95% CI: 69.4-164.1), without differences between the two gender. The estimates were significantly lower than those observed previously (97.3; 95% CI: 81.9-115.7). Incidence rates for epilepsy in the Italian population aged 1 month to 14 years are in line with those of other European and Northern American Countries. The incidence of childhood epilepsy has declined over time in our area. A reduced impact of serious perinatal adverse events could partly explain the decline. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Felzemburgh, Ridalva D M; Ribeiro, Guilherme S; Costa, Federico; Reis, Renato B; Hagan, José E; Melendez, Astrid X T O; Fraga, Deborah; Santana, Francisco S; Mohr, Sharif; dos Santos, Balbino L; Silva, Adriano Q; Santos, Andréia C; Ravines, Romy R; Tassinari, Wagner S; Carvalho, Marília S; Reis, Mitermayer G; Ko, Albert I

    2014-01-01

    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. 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. 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 exposures among slum inhabitants.

  1. Effects of different amounts of exercise on preventing depressive symptoms in community-dwelling older adults: a prospective cohort study in Taiwan.

    Science.gov (United States)

    Chang, Yu-Chen; Lu, Mei-Chun; Hu, I-Han; Wu, Wan-Chi Ida; Hu, Susan C

    2017-05-02

    To compare the effects of four different amounts of exercise for preventing depressive symptoms in community-dwelling older adults. Prospective cohort study. A nationally representative sample in Taiwan. Four waves of the survey 'Taiwan Longitudinal Study on Aging (TLSA)' from 1996 to 2007 were analysed. A total of 2673 older adults aged 65 years and over were recruited. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CESD). Four different types/amounts of exercise were examined including: (1) 3 times/week, 15 min/time; (2) 3 times/week, 30 min/time; (3) 6 times/week, 15 min/time; and (4) 6 times/week, 30 min/time. All exercise types were required to have at least moderate intensity. The impacts of different amounts of exercise on depressive symptoms were analysed using generalised linear mixed models. More than one-fifth of the elder individuals under consideration had depressive symptoms (CESD ≥10). About 38.6% of older adults met the lowest criteria for exercise type 1, and fewer (28.0%) met the highest criteria for type 4. Only exercise type 4 in the current survey was initially related to lower depressive symptoms (OR=0.8, 95% CI 0.66 to 0.95). However, after considering the interaction between time and changes in exercise patterns, the results showed that all persistent exercise models, even if a very low amount (3 times/week, 15 min/time), had significantly preventive effects on depressive symptoms (OR=0.56~0.67). Consistent exercise with at least 15 min per time, three times a week of moderate intensity is significantly associated with lower risk of depressive symptoms. This low amount of exercise may be easier to promote at the community and population level than other alternatives. Registry number 104040 of the Institutional Ethics Committee of Chia-Yi Christian Hospital. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

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

    Science.gov (United States)

    Macklai, Nejma S; Spagnoli, Jacques; Junod, Julien; Santos-Eggimann, Brigitte

    2013-01-03

    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. 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. 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. The SHARE-operationalized frailty phenotype is significantly associated with all tested health outcomes independent of baseline morbidity and disability in community-dwelling men and women aged 60 and older living in Europe. The

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

    Directory of Open Access Journals (Sweden)

    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

  4. 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 consumption of 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.

  5. 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.

  6. Philosophy of veterinary radiobiology twenty years after the Chernobyl disaster

    International Nuclear Information System (INIS)

    Dvorak, P.; Toropila, M.

    2006-01-01

    The basic objective is to provide safe foodstuffs. This approach has connection with the food chain protection including the diagnostics and the acute radiation disease therapy at the farm animals. The extra significance is given to the research of technologies which can reduce the activity of the contaminated foodstuffs. In the field of the ionizing radiation effect research in live organisms attention should be devoted to the new alternative bio-tests. The low-dose effect or the interaction with other negative physical and chemical aspects of the environment is mainly considered. In cooperation with human medicine, it is necessary to develop radiotherapy and to study the effects of therapy and radiotherapy. From the standpoint of perspective technologies, it is advisable to focus on irradiation of the foodstuffs in veterinary radiobiology. (authors)

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

    Science.gov (United States)

    2013-06-01

    mission of the United States Air Force is to "fly, fight, and win…in air, space and cyberspace"--as an intergral member of the Joint team that...Scenarios: A Military Futurist Explores War in the Twenty-First Century (New York: Bantam Books Trade Paperbacksl, 2009), 17. 33 Carl H. Builder

  8. 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...

  9. 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

  10. Twenty years of audiology in a patient with Norrie disease.

    Science.gov (United States)

    Halpin, Chris; Sims, Katherine

    2008-11-01

    To describe disease progression and treatment outcomes over a 20-year period (ages 5-25) in a young man with Norrie disease (occuloacousticocerebral dysplasia), ND; OMIM #310600. Affected individuals are born blind and develop progressive sensory loss with onset in adolescence. This disease is X-linked and has been associated with mutations of the NDP gene (Xp11.4). The patient was followed using repeated audiograms, as well as reports of educational progress and hearing aid use. The specific mutation was found by molecular analysis. The patient demonstrated progressive sensory loss with good preservation of word recognition. The loss was initially high frequency and asymmetric in adolescence and became more severe, more symmetric and affected practically all frequencies by the end of childhood. Educational progress was affected by the cognitive effects of the syndrome, and hearing aid use was very effective. A bilateral progressive sensory loss with good preservation of word recognition was documented in detail. The residual word recognition supported good use of hearing aids in this case.

  11. Disarmament processes for a world at peace in twenty years

    International Nuclear Information System (INIS)

    Toernudd, K.

    1998-01-01

    Disarmament is not an end in itself. Security - or more accurately peace and security - is usually regarded as the real objective of both disarmament and the possession of arms. The most desirable road to international peace and security, however goes through disarmament. Disarmament programmes and strategies may include a wide range of partial or collateral measures, such as control, conversion, destruction, detection, dismantlement, inspection, limitation, non-proliferation, redeployment, reduction, removal, restriction, storage, verification. The more comprehensive concept to cover the whole range would probably be arms regulation. (The United Nations Charter mentions ''regulation of armaments'' in Articles 11 and 47). Whatever terms are used, the overall objective of strengthening international peace and security must be kept in sight. (author)

  12. Career Patterns: A Twenty-Year Panel Study

    Science.gov (United States)

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

    2012-01-01

    Using 20years 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, we examine which socio-demographic predictors…

  13. Twenty years of health physics research reactor operation

    International Nuclear Information System (INIS)

    Sims, C.S.; Gilley, L.W.

    1983-01-01

    The Health Physics Research Reactor at the Oak Ridge National Laboratory has been in regular use for more than two decades. Safe operation of this fast reactor over this extended period indicates that (1) fundamental design, (2) operational procedures, (3) operator training and performance, (4) maintenance activites, and (5) management have all been eminently satisfactory. The reactor and its uses are described, the operational history and significant events are reviewed, and operational improvements and maintenance are discussed

  14. Sea Grant in California: Twenty Years of Achievement.

    Science.gov (United States)

    Amidei, Rosemary

    Since 1968, the California Sea Grant program has operated to produce scientific research oriented to solving problems in marine resource development, management, and conservation. This document decribes the facets of this program, their accomplishments and goals. Discussions include: (1) historical notes; (2) coastal governance; (3) coastal…

  15. Twenty years' experience with shallow ground repositories in India

    International Nuclear Information System (INIS)

    Balu, K.; Mohan, A.L.; Narayan, P.K.; Godse, V.B.; Sunder Rajan, N.S.

    1984-01-01

    With the setting up of the Bhabha Atomic Research Centre at Trombay, the first nuclear research centre in India, more than two decades ago, the need arose for disposal of the country's low-level radioactive solid wastes. Since then, nuclear power stations and other nuclear installations have been set up in different locations and the major mode of disposal for low-level solid wastes has been in engineered facilities in shallow land. The paper presents an overview of the Indian experience, with shallow land repositories for low-active solid wastes, from the point of view of design, operation and surveillance, at a number of sites. The influence of site characteristics on the design of the repository and the underground disposal modules is discussed. Details of the pre-operational investigations performed at different sites and the scheme for monitoring and surveillance of operating repositories are also included. The paper also presents briefly the type of safety analysis being carried out to evaluate possible environmental impact due to the operation of the shallow land repositories. (author)

  16. Twenty years of experience in applying gamma spectrometry for NDT

    International Nuclear Information System (INIS)

    Meenakshisundaram, V.; Raghunath, V.M.

    1996-01-01

    A NDT technique using NaI(Tl) detector and Single Channel Analyser (SCA) based gamma ray spectrometer was developed to check the shielding integrity of lead poured vessels, for as low a specification as 2% tolerance. The method in detail, its advantages, and some of the interesting findings are described. This paper also highlights other possible in-situ applications like i) identifying cracks propagating in end shield of a Pressurised Heavy Water Reactor (PHWR) in the presence of high radiation field and ii) level estimation for liquids such as Na and NaK used in fast reactor storage tanks. (author)

  17. 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...

  18. Validity aspects in Chernobyl at twenty years of the accident

    International Nuclear Information System (INIS)

    Arredondo, C.

    2006-01-01

    For April 25, 1986 the annual stop of the unit 4 of the nuclear power plant of Chernobyl was programmed, in order to carry out maintenance tasks. This unit was equipped with a reactor of 1000 MW, type RBMK, developed in the former Soviet Union, this type of reactors uses graphite like moderator, the core is refrigerated with common water in boil, and the fuel is uranium enriched to 2%. Also it had been programmed to carry out, before stopping the operation of the power station, a test with one of the two turbogenerators, which would not affect to the reactor. However, the intrinsic characteristics of the design of the reactor and the fact that the operators disconnected intentionally several systems of security that had stopped the reactor automatically, caused a decontrolled increase of the power (a factor 1000 in 4 seconds), with the consequent fusion of the fuel and the generation of a shock wave, produced by the fast evaporation of the refrigeration water and caused by the interaction of the fuel fused with the same one. It broke the core in pieces and destroy the structure of the reactor building that was not resistant to the pressure. When being exposed to the air, the graphite of the moderator entered in combustion, while the radioactive material was dispersed in the environment. The radionuclides liberation was prolong during 10 days, and only it was stopped by means of the one poured from helicopters, of some 5000 tons of absorbent materials on the destroyed reactor, as long as tunnels were dug to carry out the cooling of the core with liquid nitrogen. Later on, the whole building of the damaged reactor was contained inside a concrete building. The immediate consequence of the accident was the death of 31 people, between operators of the nuclear power station and firemen. One of people died as consequence of the explosion and 30 died by cause of the irradiation, with dose of the order of 16 Gy. The liberated radioactive material was the entirety of the inventory of rare gases of the core. The consequences of the accident have been studied during the twenty lapsed years since it happened. In this work the more recent discoveries on the effects in the health, the environment and economic that have been reported, as well as the current advances regarding the solution of the problems with the sarcophagus are commented. Other aspects little mentioned that consequences of the accident can be considered are discussed also, like they are the increment in the nuclear safety in the reactors in operation in the entire world and the termination of the cold war with the consequent dismantlement of a great one numbers of nuclear weapons. Finally it is remembered that the lessons learned in Chernobyl should never be forgotten. (Author)

  19. Twenty year of the State Office for Nuclear Safety

    International Nuclear Information System (INIS)

    Drabova, Dana

    2013-01-01

    This overview of the history of the Office presents information regarding the Czech legal framework for nuclear safety, radiation safety, and scope and authority of the Office, main Office's activities in nuclear safety and radiation safety supervision in the Czech Republic, international cooperation, and the Office's human resources. (P.A.)

  20. 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 visto em todo o Brasil: as políticas públicas direcionadas para as crianças e adolescentes necessitam de maior empenho para que sejam plenamente executadas.REFERÊNCIAS1. BRASIL. Estatuto da Criança e do Adolescente: Lei8.069/90, de 13 de Julho de 1990. Brasília: SenadoFederal;19902. BRASIL. Constituição da República Federativa doBrasil. Brasília: Senado Federal;19883. Sposito MP, Carrano PCR. Juventude e políticaspúblicas no Brasil. Rev Bras Educ 2003; 24:16-39.4. Oliveira APG, Milnitsky-Sapiro C. Políticas públicaspara adolescentes em vulnerabilidade social: abrigo eprovisoriedade. Psicol Cienc Prof 2007;27(4:623-35.5. Anced – Associação Nacional dos Centros de Defesa daCriança e do Adolescente. Análise sobre os direitos dacriança e do adolescente no Brasil: relatório preliminarda ANCED. [acesso em dez 2009]. Disponível em:http://www.anced.org.br/sitio/anced_2009/cyberteca/publicacoes/relatorio-alternativo-cdc.6. Rizzetti DA, Fabbrin APA, Trevisan CM. Políticaspúblicas de saúde voltadas para a criança no municípiode Santa Maria-RS. Rev Bras Promoção Saúde.

  1. 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/.

  2. Cost in medical education: one hundred and twenty years ago.

    Science.gov (United States)

    Walsh, Kieran

    2015-10-01

    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 can be gleaned from the paper about the cost and other aspects of nineteenth century medical education. Cost is viewed almost exclusively from the domain of the male gender. Cost is viewed not just from the perspective of a young man but of a young gentleman. There is a strong implication that medicine is a club and that you have to have money to join the club and then to take part in the club's activities. Cost affects choice of medical school and selection into schools. The paper places great emphasis on the importance of passing exams at their first sitting and progressing through each year in a timely manner-mainly to save costs. The subject of cost is viewed from the perspective of the payer-at this time students and their families. The paper encourages the reader to reflect on what has and has not changed in this field since 1893. Modern medical education is still expensive; its expense deters students; and we have only started to think about how to control costs or how to ensure value. Too much of the cost of medical education continues to burden students and their families.

  3. The technical support organization at BNL is twenty years old

    International Nuclear Information System (INIS)

    Indusi, J.P.

    1988-01-01

    The Technical Support Organization was established by the Atomic Energy Commission in January 1968 at Brookhaven National Laboratory (BNL). The original idea came from a small group of scientists at BNL. The group included Willy Higinbotham, Herb Kouts, Frank Miles, Richard Dodson, and Gerhardt Friedlander. The AEC endorsed the idea of a technical support group to provide technical assistance to AEC's Office of Safeguards and Materials Management and they sent requests for expressions of interest throughout the complex. For a number of reasons, to be discussed in the paper, the Technical Support Organization was established at BNL. An early project was the Conceptual Design for Safeguarding Nuclear Material which formed the first logical and systematic description of the integration of several elements into a safeguards system for protecting nuclear materials. Many other projects were undertaken over the years. TSO today provides technical assistance to the DOE Office of Safeguards and Secuirty, the Office of Classification and Technology Policy, and the Office of Security Evaluations. Technical support to the IAEA is provided under the Program of Technical Assistance to Agency Safeguards (POTAS). Recently, TSO began a program of technical assistance to the Air Force Weapons Laboratory in the area of nuclear systems security

  4. Mapping Pluto's Temperature Distribution Through Twenty Years of Stellar Occultations

    Science.gov (United States)

    Zangari, Amanda; Binzel, R. P.; Person, M. J.

    2012-10-01

    Multi-chord, high signal-to-noise Pluto occultations have been observed several times over the past two decades, including events in 1988, 2002, 2006, 2007, 2010 and 2011 (Elliot et al. 1989, 2003, 2007; Person et al. 2008, 2010, 2011). We fit separate immersion and emersion occultation light-curve models to each of the individual light curves obtained from these efforts. Asymmetries in the light curves result in the half-light temperatures for opposite sides of a single chord to differ by up to 20 Kelvin in the largest case. The temperature difference for each chord is consistent using both isothermal (b=0) and non-isothermal (e.g. b=-2.2) models based on the methodology described by Elliot & Young (1992). We examine the relationship between the location of immersion and emersion points on Pluto and these temperatures at the half-light radius and will present results for correlations between these location/temperature data and surface composition maps, Pluto geometry, and accumulated insolation patterns. This work was supported by NASA Planetary Astronomy Grant to MIT (NNX10AB27G), and NSF Astronomy and Astrophysics Grant to MIT (0707609). The authors would like to acknowledge the late Professor James L. Elliot for his efforts in beginning this work. References: Elliot, J. L., Dunham, E. W., Bosh, A. S., et al. 1989, Icarus, 77,148 Elliot, J. L., Ates, A., Babcock, B. A., et al. 2003, Nature, 424,165 Elliot, J. L., Person, M. J., Gulbis, A. A. S., et al. 2007, AJ, 134, 1 Elliot, J. L., & Young, L. A. 1992, AJ, 103, 991. Person, M. J., Elliot, J. L., Gulbis, A. A. S., et al. 2008, AJ, 136, 1510 Person, M. J., Elliot, J. L., Bosh, A. S., et al. 2010, Bulletin of the American Astronomical Society, 42, 983 Person, M. J., Dunham, E. W., Bida, T., et al. 2011, EPSC-DPS Joint Meeting 2011, 1374.

  5. Twenty years of Radiology in RP-10 nuclear reactor protection

    International Nuclear Information System (INIS)

    Zapata, Alejandro L.; Ramos, Fernando T.; Arrieta, Rolando W.B.; Vela Mora, Mariano

    2013-01-01

    In this report we present the results about radiation controls during 1990 - 2010, carried out in the Nuclear Reactor RP-10 of the Nuclear Center of Huarangal. These controls and radiological evaluation are of much utility for the radio personnel protection of this one and other reactors, since it allows to compares these variables with respect to the time. From the results obtained in monitoring and radiation controls, we conclude that in no case it has been reached the limits allowed by the Peruvian Regulating Authority. (author)

  6. Twenty years bone banking in Macedonia application and legislation

    International Nuclear Information System (INIS)

    Karevski, L.; Videovski, G.; Nospal, T.

    1999-01-01

    After establishing the Department for Bone Transplantation and Bone Bank as a part of the University Clinic for Orthopaedic Surgery in Skopje in 1978, we started our activities in bone banking. In the beginning we stored the transplants at -20 degree C in a deep-freezer using standard storage procedures. Since 1986 we stored the transplants at-70 degree C in a special deep-freezer. 1012 transplants were preserved in the Bone Bank. 657 of them (65%) were used in different procedures, mainly in tumor surgery (407), revision total hip replacement (I 70), elongation of long bones (66), pseudoarthroses (I 5) etc. The most common transplants used in our bone bank are femoral heads taken from live donors during THR procedures, or small parts of cortical and cancellous bones taken during TKR and different types of osteotomies. 187 transplants were rejected due to infection after a defect in the storage system. We had good incorporation of the grafts in most of the patients, although we had delayed incorporation in 26 patients (4%), total resorption of the graft in 9 patients (1.4%), and infection in 4 patients (0.6%). Fracture of the graft occurred in 3 cases (0.5%). After the recognition and becoming a regular member of the United Nations as a former Yugoslav Republic in 1992, Republic of Macedonia started with the so-called 'transitional' period in all parts of life, especially in legislation. After bringing the systemic Health Law in 199 1, the Parliament brought 'The Law for taking, exchange, transportation and transplantation of parts of the human body by reason of curing' in June 1995. This Law defines the conditions under which it is possible to take, store, process, exchange, transport and transplant parts of the human body by reason of curing and the rights, obligations and conditions that have to be fulfilled by the Health Organizations and other organizations engaged in these activities. This Law accepts 'brain death' item, as biological death concept. The cell and tissue banks function as non-profitable, non-commercial / trade organizations. The principle of donation is voluntarily. The article 6 of the Law regulates which parts of the deceased (cadaver) can be taken for transplantation, that is, if the deceased person during his life has not declared in written form, that parts of his body can not be used for transplantation. This is probably a solution and compromise between 'opting in' and 'opting out', close to the proposed concept of 'informed consent' from Von Versen. We called this regulation as 'voluntary negative selection'. We think that this regulation stimulates the transplantation by reason of curing, respecting the ethical and moral problems. Despite all difficulties encountered, we try to work in accordance to the EATB standards and aim to accomplish similar results as other Bone Banks around the World by using the latest methods for bone procurement

  7. Twenty years of ABACC: Accomplishments, lessons learnt and future perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Peixoto, Orpet J.M. [ABACC- Brazilian Argentine Agency for Accounting and Control of Nuclear Materials, Rio de Janeiro (Brazil)

    2012-06-15

    From the inception of the implementation of the Quadripartite Agreement (INFCIRC/435), in 1991, ABACC has had an important role at the non-proliferation agenda and has also been an active player in the international safeguards. It was necessary for ABACC to develop a technical capacity to face the challenges to be a safeguards agency and to gain credibility in the nuclear safeguards world. This capacity means to develop and implement safeguards systems in the technical area, in the inspection framework, in the conceptual analysis of processes and approaches and in the political scenario. These tasks conducted the strategic plan of ABACC on the last 20 years. Among the accomplishments, ABACC has been involved in the application of safeguards to sensitive and complex installations, in developing safeguards instrumentation, in establishing a technical and trained inspectorate, in constructing a cooperative and coordinate environment with IAEA for safeguards application. Other challenges as R and D of equipment and quality assurance systems were also managed during all these years. ESARDA is one forum that ABACC is involved and always shares experience and ideas. On July 18th, 2011 ABACC will formally complete 20 years. This paper summarizes the accomplishments, lessons learnt and future actions for strengthen the ABACC safeguards role. It also addresses the collaboration of ABACC with other organizations in the non-proliferation and international safeguards arena.

  8. Hemodynamic Characterization of Recombinant Inbred Strains: Twenty Years Later

    Czech Academy of Sciences Publication Activity Database

    Kuneš, Jaroslav; Dobešová, Zdenka; Musilová, Alena; Zídek, Václav; Vorlíček, Jaroslav; Pravenec, Michal; Křen, Vladimír; Zicha, Josef

    2008-01-01

    Roč. 31, č. 8 (2008), s. 1659-1668 ISSN 0916-9636 R&D Projects: GA MŠk(CZ) 1M0510; GA ČR(CZ) GA305/08/0139; GA AV ČR(CZ) IAA500110604 Institutional research plan: CEZ:AV0Z50110509 Keywords : recombinant inbred strains * blood pressure * telemetry Subject RIV: ED - Physiology Impact factor: 3.146, year: 2008

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

    OpenAIRE

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

    2013-01-01

    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 ta...

  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. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  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

    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...... 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. Faculty Time Allocation: A Study of Change over Twenty Years.

    Science.gov (United States)

    Milem, Jeffrey F.; Berger, Joseph B.; Dey, Eric L.

    2000-01-01

    Examined changes in amounts of time faculty spent in teaching, advising, and research activities over the past 20 years. Found institutions are becoming more similar in their patterns of faculty time allocation, particularly regarding time spend on research. However, time spent advising and interacting informally with students appears to be…

  13. Twenty Years of Constitutional Court Judgments: What Lessons are ...

    African Journals Online (AJOL)

    MJM Venter

    2017-12-05

    Dec 5, 2017 ... about sentencing from its judgments during this time?2. 2 Overview of ... In short succession the Court declared unconstitutional the death penalty, in S v. Makwanyane,3 and corporal punishment for juvenile offenders, in S v.

  14. Twenty years of the Non-proliferation Treaty

    International Nuclear Information System (INIS)

    Goldblat, Jozef.

    1990-01-01

    The report assesses the achievements of the Non-proliferation Treaty (NPT) and discusses ways in which the non-proliferation regime could be strenghtened. It recommends a series of measures to be taken by the parties of the Treaty, both nuclear and non-nuclear weapons states, with a view to reinforcing the Treaty and achieving its universality. 198 refs

  15. Reflections on "Twenty Years of Feminist Counseling and Therapy."

    Science.gov (United States)

    Rawlings, Edna I.

    1993-01-01

    Responds to previous article by Carolyn Zerbe Enns on feminist counseling and psychotherapy. Sees Enns's article as a valuable resource and reacts to Enns's article from the perspective of a radical feminist therapist. Discusses the difficulty involved in trying to effectively integrate radical feminism with psychotherapy. (NB)

  16. Packaged solar water heating technology: twenty years of progress

    International Nuclear Information System (INIS)

    Morrison, Graham; Wood, Byard

    2000-01-01

    The world market for packaged solar water heaters is reviewed, and descriptions are given of the different types of solar domestic water heaters (SDWH), design concepts for packaged SDWH, thermosyphon SDWH, evacuated insulation and excavated tube collectors, seasonally biased solar collectors, heat pump water heaters, and photovoltaic water heaters. The consumer market value for SDWHs is explained, and the results of a survey of solar water heating are summarised covering advantages, perceived disadvantages, the relative importance of purchase decision factors, experience with system components, and the most frequent maintenance problems. The durability, reliability, and performance of SDWHs are discussed

  17. More than Twenty Years of Svensén's Handbook

    African Journals Online (AJOL)

    rbr

    an international audience, dominated by English texts with a supplement of. German and .... digital world must — and will probably soon — appear. Svensén's ... The next critical point from Varantola (2006: 107) regards the targeted readership .... impression that the former is mainly conceived by administrators, marketers,.

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

    DEFF Research Database (Denmark)

    Hagmann, Tobias; Abbink, Jon

    2011-01-01

    This paper introduces a special issue of the Journal of Eastern African Studies devoted to a review of Ethiopia's 20 years of “revolutionary democracy”. The collection brings together 11 articles exploring differing aspects of Ethiopia's political experience since 1991. This introduction begins...... 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...

  19. 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.)

  20. 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...

  1. Twenty years on: the impact of fragments on drug discovery.

    Science.gov (United States)

    Erlanson, Daniel A; Fesik, Stephen W; Hubbard, Roderick E; Jahnke, Wolfgang; Jhoti, Harren

    2016-09-01

    After 20 years of sometimes quiet growth, fragment-based drug discovery (FBDD) has become mainstream. More than 30 drug candidates derived from fragments have entered the clinic, with two approved and several more in advanced trials. FBDD has been widely applied in both academia and industry, as evidenced by the large number of papers from universities, non-profit research institutions, biotechnology companies and pharmaceutical companies. Moreover, FBDD draws on a diverse range of disciplines, from biochemistry and biophysics to computational and medicinal chemistry. As the promise of FBDD strategies becomes increasingly realized, now is an opportune time to draw lessons and point the way to the future. This Review briefly discusses how to design fragment libraries, how to select screening techniques and how to make the most of information gleaned from them. It also shows how concepts from FBDD have permeated and enhanced drug discovery efforts.

  2. Title IX: The Realization of a Dream Deferred Twenty Years.

    Science.gov (United States)

    Fields, Cheryl D.

    1997-01-01

    For one woman, federal legislation forbidding sex discrimination in educational institutions receiving federal funds has made it possible to return to college on an athletic scholarship after almost two decades of waiting. Since passage of the law, the average number of sports available to women at colleges and universities and the number of women…

  3. Dynamics of blood flow: twenty years of achievement

    International Nuclear Information System (INIS)

    Rosendorff, C.

    1988-01-01

    The physiology of blood circulation has evolved from the descriptive phenomenology of William Harvey's time to an interdisciplinary science, involving elements of fluid dynamics, vessel wall mechanics, electrophysiology, cell biology, biochemistry and molecular biology. Most of these new developments have occured during the lifetime of the South African Medical Research Council. Highlights of the research undertaken by the Council regarding circulatory physiology are given. In the 1960s the use of xenon-133 to study the flow of blood to the brain resulted in the first systematic description of cerebral blood flow and its control by sympathetic nerves. During the 1970s this technique was refined and the use of radioactive microspheres for the measurement of tissue blood flow was developed. Research concerning the control of blood vessels in the kidney was also carried out, and this showed that the sympathetic nerves control renal blood flow by releasing a local hormone called renin. The renal release of renin was later recognised as being important in the control of blood pressure. Another development was the discovery that vascular sensitivity to noradrenaline was increased in certain types of liver diseases. An analysis of the blood of patients with obstructive jaundice showed that the substance responsible for this noradrenaline effect was a combination of cholesterol and lipo-protein. This led to the theory that excessive cholesterol in the blood may be dangerous. In the late 1970s a shift in research emphasis to coronary artery physiology occurred and the 1980s saw research move into the area of cell biology

  4. Does lead have a future? A twenty-year vision

    International Nuclear Information System (INIS)

    Stewart, D.M.

    1994-01-01

    There is a clear interdependence between the lead-producing industry and battery producers. An ever-increasing percentage of total lead production is consumed in batteries. Trends in lead production, consumption and uses, as well as lead prices are reviewed. A discussion is given of the impact of environmental pressures from government authorities and public opinion. A number of significant future opportunities are identified for the battery industry (and, hence, the lead industry) that together with the convenience and the cost competitiveness of the lead/acid battery ensures a strong future for the industry into the 21st century. (orig.)

  5. Radiation protection training: twenty year experience in Hungary

    International Nuclear Information System (INIS)

    Pellet, Sandor; Kanyar, Bela; Zagyvay, Peter; Solymosi, Jozsef; Bujtas, Tibor; Feher, Istvan; Giczi, Ferenc; Deme, Sandor; Uray, Istvan

    2008-01-01

    In Hungary, radiation protection training for radiation workers has been introduced in very early, just following the publication of the ICRP recommendation No. 26. Before that, in some of the institutions, radiation protection training was recommended for technicians and medical doctors working in nuclear medicine, X-ray diagnostic radiology and radiation therapy, as well as in some of industrial applications, but not on regular way. Since 1988, radiation protection training regulated by the Ministry of Health and required for all of the workers in radiation workplaces licensed by the authority the State Public Health and Medical Officers Service (SPHAMOS). Decree No. 16/2000. (VI. 8.) EuM of the Minister of Health on the enforcement of Clauses of the Nuclear Law 116/1996 regulates the radiation protection training of Radiation Workers (RW). Annex 4 of Decree sees radiation protection training and in-service training: Persons performing conducted work in the field of the use of the nuclear energy and any other work within legal relationship shall be educated in training and in-service training at an interval of 5 years. Three levels of the training introduced; basic, extended and comprehensive, based on radiation risk related to the given job. Several institutions are involved in performing radiation protection training, such universities, scientific institutions, Regional Radiological Health Centers (RRHC) of SPHAMOS, private enterprises etc. All training course material is subject to accreditation. Most of the faculties of the universities involved in training of natural sciences and engineering provide subjects on the fundamentals of dosimetry, radiobiology and radiation protection within the courses of physics, biophysics, chemistry, biology, ecology etc. These courses take 5-10 contact hours per week on average. The members of the Hungarian Committee of EUTERP Platform summarize their broad experience collected in the past 20 year. (author)

  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 Triga Mark I reactor use

    International Nuclear Information System (INIS)

    Stasiulevicius, R.; Maretti Junior, F.

    1981-01-01

    This work is a report on the 20 years of activities of the Triga Mark I, research reactor located in Belo Horizonte, Brazil. It contains also a list of publications, details of operation and improvements introduced in the reactor as well as some perspectives for its future. (A.C.A.S.)

  8. 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.

  9. 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,

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

    African Journals Online (AJOL)

    in 2004, South Africa has the highest incarceration rate in Africa and one of the highest in the world.2 In. 2013, the number of people serving life imprisonment stood at 11 000, as opposed to 400 in 1994.3. Democratisation has thus brought with it a dramatic increase in long-term prison sentences, ranging from seven years ...

  11. Twenty Years of Research on Cytokine-Induced Sickness Behavior*

    Science.gov (United States)

    Dantzer, Robert; Kelley, Keith W.

    2007-01-01

    Cytokine-induced sickness behavior was recognized within a few years of the cloning and expression of interferon-α, IL-1 and IL-2, which occurred around the time that the first issue of Brain, Behavior, and Immunity was published in 1987. Phase I clinical trials established that injection of recombinant cytokines into cancer patients led to a variety of psychological disturbances. It was subsequently shown that physiological concentrations of proinflammatory cytokines that occur after infection act in the brain to induce common symptoms of sickness, such as loss of appetite, sleepiness, withdrawal from normal social activities, fever, aching joints and fatigue. This syndrome was defined as sickness behavior and is now recognized to be part of a motivational system that reorganizes the organism's priorities to facilitate recovery from the infection. Cytokines convey to the brain that an infection has occurred in the periphery, and this action of cytokines can occur via the traditional endocrine route via the blood or by direct neural transmission via the afferent vagus nerve. The finding that sickness behavior occurs in all mammals and birds indicates that communication between the immune system and brain has been evolutionarily conserved and forms an important physiological adaptive response that favors survival of the organism during infections. The fact that cytokines act in the brain to induce physiological adaptations that promote survival has led to the hypothesis that inappropriate, prolonged activation of the innate immune system may be involved in a number of pathological disturbances in the brain, ranging from Alzheimers' disease to stroke. Conversely, the newly-defined role of cytokines in a wide variety of systemic co-morbid conditions, ranging from chronic heart failure to obesity, may begin to explain changes in the mental state of these subjects. Indeed, the newest findings of cytokine actions in the brain offer some of the first clues about the pathophysiology of certain mental health disorders, including depression. The time is ripe to begin to move these fundamental discoveries in mice to man, and some of the pharmacological tools are already available to antagonize the detrimental actions of cytokines. PMID:17088043

  12. 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

    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...... key characteristics of the developing European IS research profile: (1) continuation of the traditional European IS research profile as developed in the first decade; (2) convergence with aspects of the North American tradition and (3) development of a distinct approach to design science. We place...... 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...

  13. The Danish eID Case: Twenty years of Delay

    DEFF Research Database (Denmark)

    Hoff, Jens Villiam; Hoff, Frederik Villiam

    2010-01-01

    the technological, organizational and legal dimensions of eID in Denmark, and comparing these with a number of other European countries made it possible to explain this paradox. Thus, the three main reasons for the special route development has taken in Denmark seems to be concerns over privacy, lack...

  14. Twenty Years of Evidence on the Outcomes of Malpractice Claims

    Science.gov (United States)

    2008-01-01

    Two decades of social science research on the outcomes of medical malpractice claims show malpractice outcomes bear a surprisingly good correlation with the quality of care provided to the patient as judged by other physicians. Physicians win 80% to 90% of the jury trials with weak evidence of medical negligence, approximately 70% of the borderline cases, and even 50% of the trials in cases with strong evidence of medical negligence. With only one exception, all of the studies of malpractice settlements also find a correlation between the odds of a settlement payment and the quality of care provided to the plaintiff. Between 80% and 90% of the claims rated as defensible are dropped or dismissed without payment. In addition, the amount paid in settlement drops as the strength of the patient’s evidence weakens. PMID:19048355

  15. Twenty years of isotope applications in the Hungarian aluminium industry

    International Nuclear Information System (INIS)

    Bujdoso, E.

    1982-01-01

    After a short review of the isotope techniques applied in the Hungarian aluminium industry some special applications and their results are briefly outlined. Industrial and laboratory scale trace constituent determinations, isotope and activation analytical methods and the application of sealed radiation sources are discussed. It has been shown that the related R+D activity followed closely the development trends of the aluminium industry. The references given is a comprehensive bibliography of Hungarian publications in this field. (author)

  16. Women in neuroscience (WIN): the first twenty years.

    Science.gov (United States)

    Haak, Laurel L

    2002-03-01

    Women in Neuroscience (WIN) is an international organization whose major goal is to promote the professional advancement of women neuroscientists. To this end, WIN facilitates contacts and communication among women working in neuroscience, and organizes appropriate activities at the annual Society for Neuroscience (SfN) meeting. WIN was created in 1980, when despite major changes and advances in 'equal opportunities', women were still not achieving a proportionate level of success in the subdiscipline of neurosciences. In 1980, women made up 40 to 50% of entering classes in medical schools or graduate programs, but often comprised only 5 to 15% of leadership in respective organizations. Although there had been women elected to serve as SfN presidents, council, and committee members, women were under-represented in other positions of the Society, such as symposium and session chairs. There was an even lesser degree of representation in leadership positions at universities and medical schools in terms of full professorships, chairs, and program directors, as well as on editorial boards, advisory boards, and councils. Over the years, WIN has worked with success toward increasing the participation of women in neuroscience.

  17. 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...

  18. INTERNET ADDICTION: A REVIEW OF THE FIRST TWENTY YEARS

    OpenAIRE

    Mihajlov, Martin; Vejmelka, Lucija

    2017-01-01

    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 ...

  19. Validation of sputum Gram stain for treatment of community-acquired pneumonia and healthcare-associated pneumonia: a prospective observational study.

    Science.gov (United States)

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

    2014-10-18

    The usefulness of sputum Gram stain in patients with community-acquired pneumonia (CAP) is controversial. There has been no study to evaluate the diagnostic value of this method in patients with healthcare-associated pneumonia (HCAP). The purpose of this study was to evaluate the usefulness of sputum Gram stain in etiological diagnosis and pathogen-targeted antibiotic treatment of CAP and HCAP. We conducted a prospective observational study on hospitalized patients with pneumonia admitted to our hospital from August 2010 to July 2012. Before administering antibiotics on admission, Gram stain was performed and examined by trained physicians immediately after sputum samples were obtained. We analyzed the quality of sputum samples and the diagnostic performance of Gram stain. We also compared pathogen-targeted antibiotic treatment guided by sputum Gram stain with empirical treatment. Of 670 patients with pneumonia, 328 were CAP and 342 were HCAP. Sputum samples were obtained from 591 patients, of these 478 samples were good quality. The sensitivity and specificity of sputum Gram stain were 62.5% and 91.5% for Streptococcus pneumoniae, 60.9% and 95.1% for Haemophilus influenzae, 68.2% and 96.1% for Moraxella catarrhalis, 39.5% and 98.2% for Klebsiella pneumoniae, 22.2% and 99.8% for Pseudomonas aeruginosa, 9.1% and 100% for Staphylococcus aureus. The diagnostic yield decreased in patients who had received antibiotics or patients with suspected aspiration pneumonia. Pathogen-targeted treatment provided similar efficacy with a decrease in adverse events compared to empirical treatment. Sputum Gram stain is highly specific for the etiologic diagnosis and useful in guiding pathogen-targeted antibiotic treatment of CAP and HCAP.

  20. 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.

  1. Alzheimer's Disease Sequencing Project discovery and replication criteria for cases and controls: Data from a community-based prospective cohort study with autopsy follow-up.

    Science.gov (United States)

    Crane, Paul K; Foroud, Tatiana; Montine, Thomas J; Larson, Eric B

    2017-12-01

    The Alzheimer's Disease Sequencing Project (ADSP) used different criteria for assigning case and control status from the discovery and replication phases of the project. We considered data from a community-based prospective cohort study with autopsy follow-up where participants could be categorized as case, control, or neither by both definitions and compared the two sets of criteria. We used data from the Adult Changes in Thought (ACT) study including Diagnostic and Statistical Manual-IV criteria for dementia status, McKhann et al. criteria for clinical Alzheimer's disease, and Braak and Consortium to Establish a Registry for AD findings on neurofibrillary tangles and neuritic plaques to categorize the 621 ACT participants of European ancestry who died and came to autopsy. We applied ADSP discovery and replication definitions to identify controls, cases, and people who were neither controls nor cases. There was some agreement between the discovery and replication definitions. Major areas of discrepancy included the finding that only 40% of the discovery sample controls had sufficiently low levels of neurofibrillary tangles and neuritic plaques to be considered controls by the replication criteria and the finding that 16% of the replication phase cases were diagnosed with non-AD dementia during life and thus were excluded as cases for the discovery phase. These findings should inform interpretation of genetic association findings from the ADSP. Differences in genetic association findings between the two phases of the study may reflect these different phenotype definitions from the discovery and replication phase of the ADSP. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  2. 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.

  3. 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

    2017-10-01

    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.

  4. A prospective study on the variation in falling and fall risk among community-dwelling older citizens in 12 European countries.

    Science.gov (United States)

    Franse, Carmen B; Rietjens, Judith Ac; Burdorf, Alex; van Grieken, Amy; Korfage, Ida J; van der Heide, Agnes; Mattace Raso, Francesco; van Beeck, Ed; Raat, Hein

    2017-06-30

    The rate of falling among older citizens appears to vary across different countries, but the underlying aspects causing this variation are unexplained. We aim to describe between-country variation in falling and explore whether intrinsic fall risk factors can explain possible variation. Prospective study on data from the cross-national Survey of Health, Ageing and Retirement in Europe (SHARE). Twelve European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, The Netherlands, Spain, Sweden, Switzerland). Community-dwelling persons aged ≥65 years (n=18 596). Socio-demographic factors (age, gender, education level and living situation) and intrinsic fall risk factors (less than good self-rated health (SRH), mobility limitations, limitations with activities of daily living (ADL), dizziness, impaired vision, depression and impaired cognition) were assessed in a baseline interview. Falling was assessed 2 years later by asking whether the participant had fallen within the 6 months prior to the follow-up interview. There was significant between-country variation in the rate of falling (varying from 7.9% in Switzerland to 16.2% in the Czech Republic). The prevalence of intrinsic fall risk factors varied twofold to fourfold between countries. Associations between factors age ≥80 years, less than good SRH, mobility limitations, ADL limitations, dizziness and depression, and falling were different between countries (pfalling largely persisted after adjusting for socio-demographic differences but strongly attenuated after adjusting for differences in intrinsic fall risk factors. There is considerable variation in the rate of falling between European countries, which can largely be explained by between-country variation in the prevalence of intrinsic fall risk factors. There are also country-specific variations in the association between these intrinsic risk factors and falling. These findings emphasise the importance of addressing

  5. Association of hypercapnia on admission with increased length of hospital stay and severity in patients admitted with community-acquired pneumonia: a prospective observational study from Pakistan.

    Science.gov (United States)

    Iqbal, Nousheen; Irfan, Muhammad; Zubairi, Ali Bin Sarwar; Awan, Safia; Khan, Javaid A

    2017-06-15

    To determine whether the presence of hypercapnia on admission in adult patients admitted to a university-based hospital in Karachi, Pakistan with community-acquired pneumonia (CAP) correlates with an increased length of hospital stay and severity compared with no hypercapnia on admission. A prospective observational study. Tertiary care hospital in Karachi, Pakistan. Patients who met the inclusion criteria were enrolled in the study. The severity of pneumonia was assessed by CURB-65 and PSI scores. An arterial blood gas analysis was obtained within 24 hours of admission. Based on arterial PaCO 2 levels, patients were divided into three groups: hypocapnic (PaCO 2 45 mm Hg) and normocapnic (PaCO 2 <35-45 mm Hg). The primary outcome was the association of hypercapnia on admission with mean length of hospital stay. Secondary outcomes were the need for mechanical ventilation, ICU admission and in-hospital mortality. A total of 295 patients of mean age 60.20±17.0 years (157 (53.22%) men) were enrolled over a 1-year period. Hypocapnia was found in 181 (61.35%) and hypercapnia in 57 (19.32%) patients. Hypercapnic patients had a longer hospital stay (mean 9.27±7.57 days), increased requirement for non-invasive mechanical ventilation (NIMV) on admission (n=45 (78.94%)) and longer mean time to clinical stability (4.39±2.0 days) compared with the other groups. Overall mortality was 41 (13.89%), but there was no statistically significant difference in mortality (p=0.35) and ICU admission (p=0.37) between the three groups. On multivariable analysis, increased length of hospital stay was associated with NIMV use, ICU admission, hypercapnia and normocapnia. Hypercapnia on admission is associated with severity of CAP, longer time to clinical stability, increased length of hospital stay and need for NIMV. It should be considered as an important criterion to label the severity of the illness and also a determinant of patients who will require a higher level of hospital

  6. Twenty years of chemistry associated with the needs and utilization of nuclear reactors at the 'Boris Kidric' Institute of nuclear sciences, Vinca, Yugoslavia; Dvadeset godina hemije vezane za potrebe i koriscenje nuklearnih reaktora u Institutu za nuklearne nauke 'Boris kidric' i Vinci

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1969-07-01

    This publication covers nine review papers on the following topics related to the needs and utilization of nuclear reactors in the Boris Kidric Institute of nuclear sciences during previous twenty years: radiochemistry, hot atom chemistry, isotope production, spent nuclear fuel reprocessing, chemistry of transuranium elements; liquid radioactive waste processing, purification of reactor coolant water by inorganic ion exchangers, research related to deuterium concentration processes, and chemical dosimetry at the RA reactor. [Serbo-Croat] Ova publikacija obuhvata devet radova, po sledecim naslovima, a odnose se na potrebe i uslove nuklearnih reaktora u Institutu za nuklearne nauke 'Boris Kidric' tokom prethodnih dvadeset godina: radiohemija, hemija vruceg atoma, proizvodnja radioaktivnih izotopa, prerada isluzenog nuklearnog goriva, hemija transuranskih elemenata, obrada radioaktivnih otpadnih voda, preciscavanje vode za hladjenje nuklearnih reaktora pomocu neorganskih jonoizmenjivaca, istrazivanje procesa za koncentrovanje deuterijuma i hemijska dozimetrija reaktora RA.

  7. The Incidence and Short-term Outcomes of Acute Respiratory Illness with Cough in Children from a Socioeconomically Disadvantaged Urban Community in Australia: A Community-Based Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Kerry K. Hall

    2017-10-01

    Full Text Available BackgroundAcute respiratory illnesses with cough (ARIwC are predominant causes of morbidity in Australian Indigenous children; however, data on disease burden in urban communities are scarce. This study aimed to determine the incidence of ARIwC, the predictors of recurrent (≥4 episodes ARIwC, and development of chronic cough following an ARIwC in urban, predominantly Indigenous, children aged <5 years from northern Brisbane, Australia.MethodsProspective cohort study of children aged <5 years registered with a primary healthcare center. ARIwC episodes and outcomes were collected for 12 months. Recurrent ARIwC was defined as ≥4 episodes in 12 months. Chronic cough was defined as cough lasting >4 weeks. Children who developed chronic cough were reviewed by a pediatric pulmonologist. Incidence densities per child-month of observation were calculated and predictors of recurrent ARIwC and chronic cough were evaluated in logistic regression models.ResultsBetween February 2013 and November 2015, 200 children were enrolled; median age of 18.1 months, range (0.7–59.7 months and 90% identified as Indigenous. A total of 1,722 child-months of observation were analyzed (mean/child = 8.58, 95% CI 8.18–9.0. The incidence of ARIwC was 24.8/100 child-months at risk (95% CI 22.3–27.5. Twenty-one children (10.5% experienced recurrent ARIwC. Chronic cough was identified in 70/272 (25.7% episodes of ARIwC. Predictors of recurrent ARIwC were presence of eczema, mold in the house, parent/carer employment status, and having an Aboriginal and Torres Strait Islander mother/non-Aboriginal and Torres Strait Islander father (compared to both parents being Aboriginal and Torres Strait Islander. Predictors of chronic cough included being aged <12 months, eczema, childcare attendance, previous history of cough of >4 weeks duration, having an Aboriginal and Torres Strait Islander mother/non-Aboriginal and Torres Strait Islander father (compared to

  8. World Community: Middlesex CC Infuses Global Initiatives into Core Curriculum and beyond

    Science.gov (United States)

    Cowan, Carole A.

    2006-01-01

    Twenty years ago, Middlesex Community College (MCC) in Massachusetts decided to add a global focus to its programs. Since then, the college has garnered worldwide recognition for the range of international initiatives it has integrated into its curriculum across academic disciplines. Today, Middlesex offers unique opportunities for international…

  9. 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

  10. 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

  11. Raising the Bar: Love, the Community of Inquiry, and the Flourishing Life

    Science.gov (United States)

    Yos, Thomas B.

    2012-01-01

    The author has been working at the same elementary school in Hawai'i for nearly twenty years. Nearly ten years ago, he argued in his doctoral dissertation that philosophy for children and its pedagogy of the community of inquiry is good for kids. His thesis is this: In today's American educational climate, with its laser-sharp focus on…

  12. 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

  13. Antiretroviral treatment for HIV in rural Uganda: two-year treatment outcomes of a prospective health centre/community-based and hospital-based cohort.

    Directory of Open Access Journals (Sweden)

    Walter Kipp

    Full Text Available In sub-Saharan Africa, a shortage of trained health professionals and limited geographical access to health facilities present major barriers to the expansion of antiretroviral therapy (ART. We tested the utility of a health centre (HC/community-based approach in the provision of ART to persons living with HIV in a rural area in western Uganda.The HIV treatment outcomes of the HC/community-based ART program were evaluated and compared with those of an ART program at a best-practice regional hospital. The HC/community-based cohort comprised 185 treatment-naïve patients enrolled in 2006. The hospital cohort comprised of 200 patients enrolled in the same time period. The HC/community-based program involved weekly home visits to patients by community volunteers who were trained to deliver antiretroviral drugs to monitor and support adherence to treatment, and to identify and report adverse reactions and other clinical symptoms. Treatment supporters in the homes also had the responsibility to remind patients to take their drugs regularly. ART treatment outcomes were measured by HIV-1 RNA viral load (VL after two years of treatment. Adherence was determined through weekly pill counts.Successful ART treatment outcomes in the HC/community-based cohort were equivalent to those in the hospital-based cohort after two years of treatment in on-treatment analysis (VL≤400 copies/mL, 93.0% vs. 87.3%, p = 0.12, and in intention-to-treat analysis (VL≤400 copies/mL, 64.9% and 62.0%, p = 0.560. In multivariate analysis patients in the HC/community-based cohort were more likely to have virologic suppression compared to hospital-based patients (adjusted OR = 2.47, 95% CI 1.01-6.04.Acceptable rates of virologic suppression were achieved using existing rural clinic and community resources in a HC/community-based ART program run by clinical officers and supported by lay volunteers and treatment supporters. The results were equivalent to those of a

  14. 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 apoptosis and as a marker of community acquired MRSA. This study was aimed to determine the prevalence of PVL genes among MRSA isolates and to check the reliability of PVL as marker of community acquired MRSA isolates from Western Nepal. A total of 400 strains of S. aureus were collected from clinical...... specimens and various units (Operation Theater, Intensive Care Units) of the hospital and 139 of these had been confirmed as MRSA by previous study. Multiplex PCR was used to detect mecA and PVL genes. Clinical data as well as antimicrobial susceptibility data was analyzed and compared among PVL positive...

  15. 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

  16. 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.

    Science.gov (United States)

    Kalichman, Seth C; Cherry, Chauncey; Kalichman, Moira O; Washington, Christopher; Grebler, Tamar; Merely, Cindy; Welles, Brandi; Pellowski, Jennifer; Kegler, Christopher

    2015-01-01

    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). To determine the sexual behaviours and HIV transmission risks of individuals with suppressed and unsuppressed HIV replication (i.e., viral load). 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. 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. 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.

  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. Neonatal sepsis in rural India: timing, microbiology and antibiotic resistance in a population-based prospective study in the community setting.

    Science.gov (United States)

    Panigrahi, P; Chandel, D S; Hansen, N I; Sharma, N; Kandefer, S; Parida, S; Satpathy, R; Pradhan, L; Mohapatra, A; Mohapatra, S S; Misra, P R; Banaji, N; Johnson, J A; Morris, J G; Gewolb, I H; Chaudhry, R

    2017-08-01

    To examine the timing and microbiology of neonatal sepsis in a population-based surveillance in the Indian community setting. All live born infants in 223 villages of Odisha state were followed at home for 60 days. Suspect sepsis cases were referred to study hospitals for further evaluation including blood culture. Of 12 622 births, 842 were admitted with suspected sepsis of whom 95% were 4 to 60 days old. Culture-confirmed incidence of sepsis was 6.7/1000 births with 51% Gram negatives (Klebsiella predominating) and 26% Gram positives (mostly Staphylococcus aureus). A very high level of resistance to penicillin and ampicillin, moderate resistance to cephalosporins and extremely low resistance to Gentamicin and Amikacin was observed. The bacterial burden of sepsis in the Indian community is not high. Judicious choice of empiric antibiotics, antibiotic stewardship and alternate modalities should be considered for the management or prevention of neonatal sepsis in India.

  19. Twenty-one days of isolation: A prospective observational cohort study of an Ebola-exposed hot zone community in Liberia.

    Science.gov (United States)

    Williams, George Sie; Naiene, Jeremias; Gayflor, Joseph; Malibiche, Theophil; Zoogley, Bentoe; Frank, Wimot G; Nayeri, Fariba

    2015-08-01

    As West Africa continues to suffer from a deadly Ebola epidemic, the national health sectors struggle to minimize the damages and stop the spread of disease. A cohort of inhabitants of a small village and an Ebola hot zone in Sinoe County of Liberia was followed on a day-by-day basis to search for new cases and to minimize the spread of Ebola to the other community members or to other regions. Technical, clinical, and humanistic aspects of the response are discussed in this report. Of the 22 confirmed Ebola cases in Sinoe County since the beginning of outbreak (June 16, 2014), 7 cases were inhabitants of Polay Town, a small village 5.5 miles east of Greenville, the Sinoe County capital. After the last wave of outbreak at the beginning of December, enhanced response activity provided essential coordination and mobilized the resources to stop the epidemic. Despite unprotected contacts in crowded houses, no new cases were detected among the contact families, or in the surrounding houses or communities. Strong national mobilization in a decentralized but harmonized system at the community level has been of great value in controlling the epidemic in Liberia. The major interventions include epidemiological surveillance, public information dissemination, effective communication, case management, and infection control. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Twenty-one days of isolation: A prospective observational cohort study of an Ebola-exposed hot zone community in Liberia

    OpenAIRE

    Williams, George Sie; Naiene, Jeremias; Gayflor, Joseph; Malibiche, Theophil; Zoogley, Bentoe; Frank Jr., Wimot G.; Nayeri, Fariba

    2015-01-01

    BACKGROUND: As West Africa continues to suffer from a deadly Ebola epidemic, the national health sectors struggle to minimize the damages and stop the spread of disease. METHODS: A cohort of inhabitants of a small village and an Ebola hot zone in Sinoe County of Liberia was followed on a day-by-day basis to search for new cases and to minimize the spread of Ebola to the other community members or to other regions. Technical, clinical, and humanistic aspects of the response are discussed in th...

  1. 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.

  2. 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.

  3. Human resource constraints and the prospect of task-sharing among community health workers for the detection of early signs of pre-eclampsia in Ogun State, Nigeria.

    Science.gov (United States)

    Akeju, David O; Vidler, Marianne; Sotunsa, J O; Osiberu, M O; Orenuga, E O; Oladapo, Olufemi T; Adepoju, A A; Qureshi, Rahat; Sawchuck, Diane; Adetoro, Olalekan O; von Dadelszen, Peter; Dada, Olukayode A

    2016-09-30

    The dearth of health personnel in low income countries has attracted global attention. Ways as to how health care services can be delivered in a more efficient and effective way using available health personnel are being explored. Task-sharing expands the responsibilities of low-cadre health workers and allows them to share these responsibilities with highly qualified health care providers in an effort to best utilize available human resources. This is appropriate in a country like Nigeria where there is a shortage of qualified health professionals and a huge burden of maternal mortality resulting from obstetric complications like pre-eclampsia. This study examines the prospect for task-sharing among Community Health Extension Workers (CHEW) for the detection of early signs of pre-eclampsia, in Ogun State, Nigeria. This study is part of a larger community-based trial evaluating the acceptability of community treatment for severe pre-eclampsia in Ogun State, Nigeria. Data was collected between 2011 and 2012 using focus group discussions; seven with CHEWs (n = 71), three with male decision-makers (n = 35), six with community leaders (n = 68), and one with member of the Society of Obstetricians and Gynaecologists of Nigeria (n = 9). In addition, interviews were conducted with the heads of the local government administration (n = 4), directors of planning (n = 4), medical officers (n = 4), and Chief Nursing Officers (n = 4). Qualitative data were analysed using NVivo version 10.0 3 computer software. The non-availability of health personnel is a major challenge, and has resulted in a high proportion of facility-based care performed by CHEWs. As a result, CHEWs often take on roles that are designated for senior health workers. This role expansion has exposed CHEWs to the basics of obstetric care, and has resulted in informal task-sharing among the health workers. The knowledge and ability of CHEWs to perform basic clinical assessments

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

    Science.gov (United States)

    2012-01-01

    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 trochanteric fractures (HR = 3.4, 95% CI 1.8-6.6, and HR = 5.3, 95% CI 2.5-11.4, respectively). Low baseline physical activity was associated with an increased risk of hip fracture, especially in the cervical region (HR = 2.5, 95% CI 1.3-4.9). A decrease in cervical fracture risk (p = 0.002) was observed with physically active individuals compared to their less active peers (categories: very low or low, moderate, and high). Moderate coffee consumption and hypertension decreased the risk of cervical fractures (HR = 0.4, 95% CI 0.2-0.8, for both), while smoking was a predisposing factor for trochanteric fractures (HR = 3.2, 95% CI 1.1-9.3). 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. PMID:22978821

  5. Big Five personality traits may inform public health policy and preventive medicine: Evidence from a cross-sectional and a prospective longitudinal epidemiologic study in a Swiss community.

    Science.gov (United States)

    Hengartner, Michael P; Kawohl, Wolfram; Haker, Helene; Rössler, Wulf; Ajdacic-Gross, Vladeta

    2016-05-01

    Some evidence documents the importance of personality assessments for health research and practise. However, no study has opted to test whether a short self-report personality inventory may comprehensively inform health policy. Data were taken from a population-based epidemiologic survey in Zurich, Switzerland, conducted from 2010-2012. A short form of the Big Five Inventory was completed by n=1155 participants (54.4% women; mean age=29.6 years), while health-related outcomes were taken from a comprehensive semi-structured clinical interview. A convenience subsample averaging n=171 participants additionally provided laboratory measures and n=133 were subsequently followed-up at least once over a maximal period of 6 months. Personality traits, in particular high neuroticism and low conscientiousness, related significantly to poor environmental resources such as low social support (R(2)=0.071), health-impairing behaviours such as cannabis use (R(2)=0.071), and psychopathology, including negative affect (R(2)=0.269) and various mental disorders (R(2)=0.060-0.195). The proportion of total variance explained was R(2)=0.339 in persons with three or more mental disorders. Personality significantly related to some laboratory measures including total cholesterol (R(2)=0.095) and C-Reactive Protein (R(2)=0.062). Finally, personality prospectively predicted global psychopathological distress and vegetative symptoms over a 6-month observation period. Personality relates consistently to poor socio-environmental resources, health-impairing behaviours and psychopathology. We also found some evidence for an association with metabolic and immune functions that are assumed to influence health. A short personality inventory could provide valuable information for preventive medicine when used as a means to screen entire populations for distinct risk exposure, in particular with respect to psychopathology. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. The association between C-reactive protein levels and the risk for chronic kidney disease hospitalizations in adults of a remote Indigenous Australian community - A prospective cohort study.

    Science.gov (United States)

    Arnold, Luke W; Hoy, Wendy E; Wang, Zhiqiang

    2017-09-01

    Indigenous Australians are significantly burdened by chronic kidney disease (CKD). Elevated levels of C-reactive protein (CRP) have been associated with diabetes and cardiovascular incidence in previous studies. Elevated CRP has been associated with albuminuria and reduced eGFR in cross-sectional studies. This study investigated the long-term predictive association between CRP measured at a baseline exam and the incidence of a CKD-related hospitalization. Health screening examinations were conducted in individuals of a remote indigenous Australian community between 1992 and 1998. The risk of subsequent CKD hospitalisations, documented through Northern Territory hospital records up to 2010, was estimated with Cox proportional hazard models in people aged over 18 years at the baseline screen and who had albumin-creatinine ratios (ACRs) less than 34g/mol. 546 participants were eligible for our study. Individuals in the highest CRP tertile at baseline had increased levels of traditional cardiovascular risk factors. They also had almost 4 times the risk of a CKD-related hospitalisation compared with participants in the lowest CRP tertile (HR=3.91, 95%CI 1.01-15.20, P=0.049) after adjustment for potential confounding factors. Participants with CRP concentrations greater than 3mg/L had almost 3 times the risk of CKD hospitalisations than those ≤3mg/L (HR=2.84, 95%CI 1.00-8.00, P=0.049). Furthermore, risk of CKD hospitalisations increased 34% per doubling of baseline CRP (HR=1.34, 95%CI 1.04-1.74, P=0.024). In individuals in this remote indigenous community without overt albuminuria at baseline the risk for incident CKD related hospitalisations was predicted by elevated C-reactive protein levels almost a decade earlier. Further research is needed to understand the roles that CRP and systemic inflammation play in CKD risk. © 2016 Asian Pacific Society of Nephrology.

  7. A prospective association between dietary folate intake and type 2 diabetes risk among Korean adults aged 40 years or older: the Korean Multi-Rural Communities Cohort (MRCohort) Study.

    Science.gov (United States)

    Hong, Sang M; Woo, Hey W; Kim, Mi K; Kim, Se Y; Lee, Young-Hoon; Shin, Dong H; Shin, Min-Ho; Chun, Byung-Yeol; Choi, Bo Y

    2017-12-01

    It has not been well established whether dietary folate intake reduces the risk of diabetes development. We aimed to clarify the prospective association between dietary folate intake and type 2 diabetes (T2D) risk among 7333 Korean adults aged 40 years or older who were included in the Multi-Rural Communities Cohort. Dietary folate intake was estimated from all 106 food items listed on a FFQ, not including folate intake from supplements. Two different measurements of dietary folate intake were used: the baseline consumption and the average consumption from baseline until just before the end of follow-up. The association between folate intake and T2D risk was determined through a modified Poisson regression model with a robust error estimator controlling for potential confounders. For 29 745 person years, 319 cases of diabetes were ascertained. In multivariable analyses, dietary folate intake was inversely associated with risk of T2D for women, not for men. For women, the incidence rate ratio of diabetes in the third tertile compared with the first tertile was 0·57 (95 % CI 0·38-0·87, P for trend=0·0085) in the baseline consumption model and 0·64 (95 % CI 0·43-0·95, P for trend=0·0244) in the average consumption model. These inverse associations was found in both normal fasting blood glucose group and impaired fasting glucose group among women. Among non-users of multinutrients and vitamin supplements, the significant inverse association remained. Thus, higher dietary intake of folate is prospectively associated with lower risk of diabetes for women.

  8. Early results of a prospective quality of life analysis using the lung cancer symptom scale (LCSS) in patients receiving radiation therapy (XRT) for lung cancer in the community hospital setting

    International Nuclear Information System (INIS)

    Lutz, Stephen T.; Norrell, Ruth; Johnson, Christopher R.; Kachnic, Lisa A.; Arthur, Douglas W.; Huang, David T.

    1997-01-01

    Purpose/Objective: To prospectively determine symptom response in patients receiving radiation therapy for primary lung cancer. Materials and Methods: Thirty-three consecutive lung cancer patients were evaluated between March 1996 and February 1997 at the Medical College of Virginia satellite facility which serves a local community hospital. The LCSS, a validated quality of life scale, was used prospectively during the consultation and upon subsequent follow-up. The scale allowed scoring of symptom improvement, worsening, or stability following therapy. One patient declined therapy, while another was not offered XRT. The 31 remaining patients received a median dose of 54 Gy. Eleven patients received radiotherapy with curative intent to doses between 60 and 70 Gy, 5 small cell lung carcinoma (SmCCa) patients received 54 Gy consolidative therapy, and 13 patients received 15 to 30 Gy with palliative intent. Eight patients received chemotherapy as part of their initial treatment course, including all of those diagnosed with SmCCa. Twenty-one patients completed the LCSS at least once in the three month interval after therapy, while 6 died prior to follow-up, 2 were under treatment at the time of this analysis, and 2 were lost to follow-up. Survival analysis was completed using the Kaplan-Meier method. Results: Median follow-up was 4 months (range = 1 to 14), with an estimated median survival of 5 months. Fourteen patients died of lung cancer, 12 are alive with disease, 6 are alive without disease, and 1 died without disease. Patient characteristics were median age of 69 years (range = 43 to 91), male to female ratio of 4.5 to 1, mean weight loss of 12 pounds (range = 0 to 27), and mean duration of symptoms of 3 months (range = 0 to 12). Stage was: I 9%, II = 0%, IIIA = 6%, IIIB = 43%, IV = 27%, and limited stage SmCCa = 15%. Histology was: squamous cell carcinoma = 21%, adenocarcinoma = 23%, large cell carcinoma = 23%, poorly differentiated carcinoma = 15%, mesothelioma

  9. 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

  10. 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.

  11. Impaired baroreflex sensitivity, carotid stiffness, and exaggerated exercise blood pressure: a community-based analysis from the Paris Prospective Study III.

    Science.gov (United States)

    Sharman, James E; Boutouyrie, Pierre; Perier, Marie-Cécile; Thomas, Frédérique; Guibout, Catherine; Khettab, Hakim; Pannier, Bruno; Laurent, Stéphane; Jouven, Xavier; Empana, Jean-Philippe

    2018-02-14

    People with exaggerated exercise blood pressure (BP) have adverse cardiovascular outcomes. Mechanisms are unknown but could be explained through impaired neural baroreflex sensitivity (BRS) and/or large artery stiffness. This study aimed to determine the associations of carotid BRS and carotid stiffness with exaggerated exercise BP. Blood pressure was recorded at rest and following an exercise step-test among 8976 adults aged 50 to 75 years from the Paris Prospective Study III. Resting carotid BRS (low frequency gain, from carotid distension rate, and heart rate) and stiffness were measured by high-precision echotracking. A systolic BP threshold of ≥ 150 mmHg defined exaggerated exercise BP and ≥140/90 mmHg defined resting hypertension (±antihypertensive treatment). Participants with exaggerated exercise BP had significantly lower BRS [median (Q1; Q3) 0.10 (0.06; 0.16) vs. 0.12 (0.08; 0.19) (ms2/mm) 2×108; P < 0.001] but higher stiffness [mean ± standard deviation (SD); 7.34 ± 1.37 vs. 6.76 ± 1.25 m/s; P < 0.001) compared to those with non-exaggerated exercise BP. However, only lower BRS (per 1SD decrement) was associated with exaggerated exercise BP among people without hypertension at rest {specifically among those with optimal BP; odds ratio (OR) 1.16 [95% confidence intervals (95% CI) 1.01; 1.33], P = 0.04 and high-normal BP; OR, 1.19 (95% CI 1.07; 1.32), P = 0.001} after adjustment for age, sex, body mass index, smoking, alcohol, total cholesterol, high-density lipoprotein cholesterol, resting heart rate, and antihypertensive medications. Impaired BRS, but not carotid stiffness, is independently associated with exaggerated exercise BP even among those with well controlled resting BP. This indicates a potential pathway from depressed neural baroreflex function to abnormal exercise BP and clinical outcomes. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For

  12. 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

  13. The Effects of Combinations of Cognitive Impairment and Pre-frailty on Adverse Outcomes from a Prospective Community-Based Cohort Study of Older Chinese People.

    Science.gov (United States)

    Yu, Ruby; Morley, John E; Kwok, Timothy; Leung, Jason; Cheung, Osbert; Woo, Jean

    2018-01-01

    To examine how various combinations of cognitive impairment (overall performance and specific domains) and pre-frailty predict risks of adverse outcomes; and to determine whether cognitive frailty may be defined as the combination of cognitive impairment and the presence of pre-frailty. Community-based cohort study. Chinese men and women ( n  = 3,491) aged 65+ without dementia, Parkinson's disease and/or frailty at baseline. Frailty was characterized using the Cardiovascular Health Study criteria. Overall cognitive impairment was defined by a Cantonese Mini-Mental Status Examination (CMMSE) total score (impairment by a CMMSE delayed recall score (impairment by a CMMSE language and praxis score (impaired were more likely to develop pre-frailty/frailty after 4 years ( P  impairment had lower grip strength ( P  without cognitive impairment at baseline. Similar results were obtained with delayed recall and language and praxis impairments. Robust and cognitively impaired participants had higher risks of becoming pre-frail/frail over 4 years compared with those with normal cognition. Cognitive impairment characterized by the CMMSE overall score or its individual domain score improved the predictive power of pre-frailty for poor quality of life, incident physical limitation, increased cumulative hospital stay, and mortality. Our findings support to the concept that cognitive frailty may be defined as the occurrence of both cognitive impairment and pre-frailty, not necessarily progressing to dementia.

  14. 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.

  15. 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

    Directory of Open Access Journals (Sweden)

    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

  16. Type 2 diabetes, depressive symptoms and trajectories of cognitive decline in a national sample of community-dwellers: A prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Panayotes Demakakos

    Full Text Available We examined the individual and synergistic effects of type 2 diabetes and elevated depressive symptoms on memory and executive function trajectories over 10 and eight years of follow-up, respectively. Our sample comprised 10,524 community-dwellers aged ≥50 years in 2002-03 from the English Longitudinal Study of Ageing. With respect to memory (word recall, participants with either diabetes or elevated depressive symptoms recalled significantly fewer words compared with those free of these conditions (reference category, but more words compared with those with both conditions. There was a significant acceleration in the rate of memory decline in participants aged 50-64 years with both conditions (-0.27, 95% CI, -0.45 to -0.08, per study wave, which was not observed in those with either condition or aged ≥65 years. With respect to executive function (animal naming, participants aged ≥65 years with diabetes or those with elevated depressive symptoms named significantly fewer animals compared with the reference category, while those with both conditions named fewer animals compared with any other category. The rate of executive function decline was significantly greater in participants with both conditions (-0.54, 95% CI, -0.99 to -0.10; and -0.71, 95% CI, -1.16 to -0.27, per study wave, for those aged 50-64 and ≥65 years, respectively, but not in participants with either condition. Diabetes and elevated depressive symptoms are inversely associated with memory and executive function, but, individually, do not accelerate cognitive decline. The co-occurrence of diabetes and elevated depressive symptoms significantly accelerates cognitive decline over time, especially among those aged 50-64 years.

  17. A prospective interrupted time series study of interventions to improve the quality, rating, framing and structure of goal-setting in community-based brain injury rehabilitation.

    Science.gov (United States)

    Hassett, Leanne; Simpson, Grahame; Cotter, Rachel; Whiting, Diane; Hodgkinson, Adeline; Martin, Diane

    2015-04-01

    To investigate whether the introduction of an electronic goals system followed by staff training improved the quality, rating, framing and structure of goals written by a community-based brain injury rehabilitation team. Interrupted time series design. Two interventions were introduced six months apart. The first intervention comprised the introduction of an electronic goals system. The second intervention comprised a staff goal training workshop. An audit protocol was devised to evaluate the goals. A random selection of goal statements from the 12 months prior to the interventions (Time 1 baseline) were compared with all goal statements written after the introduction of the electronic goals system (Time 2) and staff training (Time 3). All goals were de-identified for client and time-period, and randomly ordered. A total of 745 goals (Time 1 n = 242; Time 2 n = 283; Time 3 n = 220) were evaluated. Compared with baseline, the introduction of the electronic goals system alone significantly increased goal rating, framing and structure (χ(2) tests 144.7, 18.9, 48.1, respectively, p goal quality, which was only a trend at Time 2, was statistically significant at Time 3 (χ(2) 15.0, p ≤ 001). The training also led to a further significant increase in the framing and structuring of goals over the electronic goals system (χ(2) 11.5, 12.5, respectively, p ≤ 0.001). An electronic goals system combined with staff training improved the quality, rating, framing and structure of goal statements. © The Author(s) 2014.

  18. Korea prospects

    International Nuclear Information System (INIS)

    Wyman, V.

    1990-01-01

    Contacts between the South Korean nuclear industry and a combined United Kingdom mission representing AEA Technology and British Nuclear Fuels Limited (BNFL) are reported. Prospects for entering the Korean market in two areas are perceived. The first is waste management and the second is the Safe Integral Reactor (SIR), an advanced pressurized water reactor design. AEA Technology and three collaborators have been promoting SIR as an inherently safe reactor design. Korean interest could be expressed in financial backing for the building of SIR stations in Korea and the opportunity could arise for BNFL to win fuel supply contracts. (UK)

  19. 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

    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...... 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...

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

    Directory of Open Access Journals (Sweden)

    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. The Effects of Combinations of Cognitive Impairment and Pre-frailty on Adverse Outcomes from a Prospective Community-Based Cohort Study of Older Chinese People

    Directory of Open Access Journals (Sweden)

    Ruby Yu

    2018-03-01

    Full Text Available ObjectivesTo examine how various combinations of cognitive impairment (overall performance and specific domains and pre-frailty predict risks of adverse outcomes; and to determine whether cognitive frailty may be defined as the combination of cognitive impairment and the presence of pre-frailty.DesignCommunity-based cohort study.ParticipantsChinese men and women (n = 3,491 aged 65+ without dementia, Parkinson’s disease and/or frailty at baseline.MeasurementsFrailty was characterized using the Cardiovascular Health Study criteria. Overall cognitive impairment was defined by a Cantonese Mini-Mental Status Examination (CMMSE total score (<21/24/27, depending on participants’ educational levels; delayed recall impairment by a CMMSE delayed recall score (<3; and language and praxis impairment by a CMMSE language and praxis score (<9. Adverse outcomes included poor quality of life, physical limitation, increased cumulative hospital stay, and mortality.ResultsCompared to those who were robust and cognitively intact at baseline, those who were robust but cognitively impaired were more likely to develop pre-frailty/frailty after 4 years (P < 0.01. Compared to participants who were robust and cognitively intact at baseline, those who were pre-frail and with overall cognitive impairment had lower grip strength (P < 0.05, lower gait speed (P < 0.01, poorer lower limb strength (P < 0.01, and poorer delayed recall at year 4 [OR, 1.6; 95% confidence interval (CI, 1.2–2.3]. They were also associated with increased risks of poor quality of life (OR, 1.5; 95% CI, 1.1–2.2 and incident physical limitation at year 4 (OR, 1.8; 95% CI, 1.3–2.5, increased cumulative hospital stay at year 7 (OR, 1.5; 95% CI, 1.1–2.1, and mortality over an average of 12 years (OR, 1.5; 95% CI, 1.0–2.1 after adjustment for covariates. There was no significant difference in risks of adverse outcomes between participants who were pre-frail, with

  2. Energy prospects

    International Nuclear Information System (INIS)

    Lyall, K.

    1991-01-01

    The Business Council of Australia's study on Prospects for Improved Energy Efficiency and the Application of Renewable Energy Resources is summarised. The study estimates that replacement of all off-peak electric units in Australia with solar gas boosted systems would reduce electricity consumption for residential water heating by approximately 25% and almost halve carbon dioxide emissions resulting from residential water heating. Furthermore, substitution of all water heating units in Australia with solar gas systems would reduce total emissions by about 80%. The study concludes that while substitution on such a scale could not readily be achieved even within several decades, the estimates do indicate the significant benefits that might be realised by a long term program. 2 refs., 3 tabs

  3. Competing preferent community prospecting rights: A nonchalant ...

    African Journals Online (AJOL)

    Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 1 (2017) >. Log in or Register to get access to full text downloads.

  4. L’esperienza delle Community Forests in Inghilterra

    Directory of Open Access Journals (Sweden)

    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. 

  5. Health values and prospect theory: a comment.

    Science.gov (United States)

    Stratmann-Schoene, D; Klose, T

    2001-01-01

    In a recent volume of Medical Decision Making, Treadwell and Lenert stated that under prospect theory, community members compared with patients underestimate the utility of health improvements. In this comment, the authors show that this statement holds only for a subset of possible preference functions. Furthermore, the authors provide arguments that, in general, the rater's current health state is not the appropriate reference level if applying prospect theory to health valuations.

  6. Defining political community

    Directory of Open Access Journals (Sweden)

    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. Uranium project. Geochemistry prospection

    International Nuclear Information System (INIS)

    Lambert, J.

    1983-01-01

    Geochemistry studies the distribution of the chemicals elements in the terrestrial crust and its ways to migrate. The terminology used in this report is the following one: 1) Principles of the prospection geochemistry 2) Stages of the prospection geochemistry 3)utility of the prospection geochemistry 4) geochemistry of uranium 5) procedures used within the framework of uranium project 6) Average available 7) Selection of the zones of prospection geochemistry 8) Stages of the prospection, Sample preparation and analisis 9) Presentation of the results

  8. Clinical patterns, epidemiology and risk factors of community-acquired urinary tract infection caused by extended-spectrum beta-lactamase producers: a prospective hospital case-control study.

    Science.gov (United States)

    Almomani, Basima A; Hayajneh, Wail A; Ayoub, Abeer M; Ababneh, Mera A; Al Momani, Miral A

    2018-05-10

    To assess incidence rate, risk factors and susceptibility patterns associated with extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli or Klebsiella pneumoniae in community-acquired urinary tract infections (CA-UTIs). A prospective, case-control study was conducted at a tertiary teaching hospital from Jan 2015 to Dec 2016. The results of microbiology cultures were initially screened to include only patients with positive E. coli or K. pneumoniae urine cultures. Afterwards, clinical symptoms were assessed to confirm the UTI. To investigate the risk factors, patients with a positive urine culture for ESBL-producing isolates were assigned as cases, while patients with non-ESBL were assigned as controls. Out of 591 patients included in this study, 57.5% (n = 340) were included in the control group and 42.5% (n = 251) were in the case group. The incidence rate of ESBL-producing isolates was 3.465 cases per 1000-patient hospital admissions. Male gender (OR = 1.856, 95% CI = 1.192-2.889, p = 0.006), pediatrics (OR = 1.676, 95% CI = 1.117-2.517, p = 0.013), patients with comorbidity (OR = 1.542, 95% CI = 1.029-2.312, p = 0.036) and UTI in the previous 12 months (OR = 1.705, 95% CI = 1.106-2.628, p = 0.016) were independently associated with a higher risk of infection. The resistance rate for most commonly prescribed antibiotics was high. Our results suggest that the incidence of ESBL producers among CA-UTIs is high. Male gender, pediatrics, comorbidity and UTI in the previous 12 months were associated with a higher risk for infection. Continuous surveillance and prudent antibiotic use by healthcare professionals are important factors for effective control of ESBL associated infections.

  9. Impact of exposure to cooking fuels on stillbirths, perinatal, very early and late neonatal mortality - a multicenter prospective cohort study in rural communities in India, Pakistan, Kenya, Zambia and Guatemala.

    Science.gov (United States)

    Patel, Archana B; Meleth, Sreelatha; Pasha, Omrana; Goudar, Shivaprasad S; Esamai, Fabian; Garces, Ana L; Chomba, Elwyn; McClure, Elizabeth M; Wright, Linda L; Koso-Thomas, Marion; Moore, Janet L; Saleem, Sarah; Liechty, Edward A; Goldenberg, Robert L; Derman, Richard J; Hambidge, K Michael; Carlo, Waldemar A; Hibberd, Patricia L

    2015-01-01

    Consequences of exposure to household air pollution (HAP) from biomass fuels used for cooking on neonatal deaths and stillbirths is poorly understood. In a large multi-country observational study, we examined whether exposure to HAP was associated with perinatal mortality (stillbirths from gestation week 20 and deaths through day 7 of life) as well as when the deaths occurred (macerated, non-macerated stillbirths, very early neonatal mortality (day 0-2) and later neonatal mortality (day 3-28). Questions addressing household fuel use were asked at pregnancy, delivery, and neonatal follow-up visits in a prospective cohort study of pregnant women in rural communities in five low and lower middle income countries participating in the Global Network for Women and Children's Health's Maternal and Newborn Health Registry. The study was conducted between May 2011 and October 2012. Polluting fuels included kerosene, charcoal, coal, wood, straw, crop waste and dung. Clean fuels included electricity, liquefied petroleum gas (LPG), natural gas and biogas. We studied the outcomes of 65,912 singleton pregnancies, 18 % from households using clean fuels (59 % LPG) and 82 % from households using polluting fuels (86 % wood). Compared to households cooking with clean fuels, there was an increased risk of perinatal mortality among households using polluting fuels (adjusted relative risk (aRR) 1.44, 95 % confidence interval (CI) 1.30-1.61). Exposure to HAP increased the risk of having a macerated stillbirth (adjusted odds ratio (aOR) 1.66, 95%CI 1.23-2.25), non-macerated stillbirth (aOR 1.43, 95 % CI 1.15-1.85) and very early neonatal mortality (aOR 1.82, 95 % CI 1.47-2.22). Perinatal mortality was associated with exposure to HAP from week 20 of pregnancy through at least day 2 of life. Since pregnancy losses before labor and delivery are difficult to track, the effect of exposure to polluting fuels on global perinatal mortality may have previously been underestimated. Clinical

  10. Priorities and prospect theory.

    Science.gov (United States)

    Happich, M; Mazurek, B

    2002-01-01

    Whose preferences are to be used for cost-effectiveness analysis? It has been recommended that community preferences for health states are the most appropriate ones for use in a reference case analysis. However, critics maintain that persons are not able properly to judge a health state if they have not experienced the condition themselves. This problem is analyzed here in the framework of Prospect Theory. It can be argued that the differing reference points of patients and the general public are responsible for deviating results. In addition, we argue that risk attitudes with respect to health-related quality of life are an indicator of reference points. If patients and the general public refer to the same reference point, i.e., they have the same risk attitude, the hypothesis is that deviations no longer significantly differ. Evaluations of the health condition of tinnitus by 210 patients and 210 unaffected persons were compared. The Time Tradeoff and Standard Gamble methods were applied to elicit preferences. Risk attitude was measured with the question of whether participants would undergo a treatment that could either improve or worsen their health condition, both with an equal chance (five possible answers between "in no case" and "in any case"). Affected persons indicated significantly higher values for tinnitus-related quality of life according to the Standard Gamble method. The difference between Time Tradeoff values was less dramatic but still significant. In addition, nonaffected persons are more risk-averse than affected persons. However, differences in evaluations are not significant considering single risk groups (e.g., those who answered "in no case"). Prospect Theory is a reasonable framework for considering the question of whose preferences count. If this result can be generalized for other diseases as well, it allows the mathematical combination of "objective" evaluations by the general public with the illness experience of patients. These

  11. From public open access to common property: the prospects and ...

    African Journals Online (AJOL)

    From public open access to common property: the prospects and challenges of institutionalizing boundaries for self-governance and management of community irrigation dams in the Upper East Region, Ghana.

  12. Prospects for inherently safe reactors

    International Nuclear Information System (INIS)

    Barkenbus, J.N.

    1988-01-01

    Public fears over nuclear safety have led some within the nuclear community to investigate the possibility of producing inherently safe nuclear reactors; that is, reactors that are transparently incapable of producing a core melt. While several promising designs of such reactors have been produced, support for large-scale research and development efforts has not been forthcoming. The prospects for commercialization of inherently safe reactors, therefore, are problematic; possible events such as further nuclear reactor accidents and superpower summits, could alter the present situation significantly. (author)

  13. Geochemical prospecting in Guiana

    International Nuclear Information System (INIS)

    Coulomb, R.

    1957-01-01

    During the last few years geochemical prospecting techniques have become common usage in the field of mineral deposit prospecting. The real scope of these methods lies in their use in the prospecting of large areas. The most promising use of the geochemistry and hydro-geochemistry of uranium is in heavily forested tropical territories, with few outcrops, where radiometry is strongly handicapped. (author) [fr

  14. Endogenous Prospect Theory

    OpenAIRE

    Schmidt, Ulrich; Zank, Horst

    2010-01-01

    In previous models of (cumulative) prospect theory reference-dependence of preferences is imposed beforehand and the location of the reference point is exogenously determined. This paper provides an axiomatization of a new specification of cumulative prospect theory, termed endogenous prospect theory, where reference-dependence is derived from preference conditions and a unique reference point arises endogenously.

  15. 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.

  16. 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.

  17. Twenty years nuclear power sector in Bulgaria - an attempt at striking a balance

    Energy Technology Data Exchange (ETDEWEB)

    Shervashidze, N

    1994-12-31

    The advantages of nuclear power and the mistakes that cause the opposition against it on the example of the history of the Bulgarian nuclear power sector are considered in a polemical manner. Four WWER 440/230 and two WWER 1000 units have been put into operation in Kozloduj NPP in the period 1974 - 1993. Before 1991, however, safety operation criteria were compromised numerous times and the atmosphere of secrecy, self-complacency and the series of absurdities about the Chernobyl accident were clearly used by the opponents of nuclear energy. Now the attitude towards nuclear power is changing for the better. Much progress has been made in recovering the nuclear power sector under complicated economic and political conditions. The role of NPP as an anti-inflation factor, an element providing the national security, a stimulator of industry and infrastructure, and an ecological salvation factor, is stressed. (I.M.).

  18. The fate of stranded oil at the BIOS site twenty years after the experiment

    International Nuclear Information System (INIS)

    Owens, E.H.; Sergy, G.A.; Prince, R.C.

    2002-01-01

    As part of the 1981 Baffin Island Oil Spill (BIOS) Project, 15 cubic metres of aged crude oil was released onto the shores of an experimental beach at Cape Hatt, northern Baffin Island, Canada. The oil was left to weather naturally and the distribution, quantity and character of the oil was monitored over time. The experiment provided a unique opportunity to study and sample oil as it weathers over a 20 year period in a low-energy, arctic environment. Over the 20 years of the study, the oil was exposed to weathering processes for about 40 months during ice-free periods. While most of the stranded oil was removed in the first few months of open water immediately following the experiment, some small surface patches still persist. It was noted that there has been very little change in the distribution or in the physical condition of the oil patches between 1993 and 2001. Geochemical analysis reveals that some samples are unaltered despite more than 20 years of exposure to elements. Other samples indicate that biodegradation and photo-oxidation play a major role in removing most of the components of the oil in this low-energy arctic environment. Some highly biodegraded samples had less than 87 per cent of the original hydrocarbons. The study revealed that there are 4 stages in the evolution of the stranded oil: (1) initial rapid refloating of oil during the first 24 to 48 hours in 1981, (2) period of relative stability up to the formation of an asphalt pavement within 4 open-water months, (3) degradation of an asphalt pavement in the upper intertidal zone over a 10-month open-water period from August 1983 to August 1989, and (4) disintegration of the pavement after 1989 and before August 1991, with soft interstitial surface oil still present in 2001. 21 refs., 1 tab., 1 fig

  19. Twenty-year mortality of adult patients with primary immune thrombocytopenia

    DEFF Research Database (Denmark)

    Frederiksen, Henrik; dybdal, Merete Lund; Nørgaard, Mette

    2014-01-01

    Studies have reported a 1·3- to 2·2-fold higher mortality rate among patients with primary immune thrombocytopenia (ITP) compared to the general population. However, long-term mortality estimates as well as cause-specific mortality data are sparse. In our population-based cohort of adult patients...

  20. The discovery of mesoporous molecular sieves from the twenty year perspective

    Czech Academy of Sciences Publication Activity Database

    Kresge, Ch. T.; Roth, Wieslaw Jerzy

    2013-01-01

    Roč. 42, č. 9 (2013), s. 3663-3670 ISSN 0306-0012 R&D Projects: GA ČR GBP106/12/G015 Institutional support: RVO:61388955 Keywords : liquid crystal phases * surfactant * silica Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 30.425, year: 2013

  1. 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.

  2. 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.

  3. Maxillofacial fractures: twenty years of study in the department of maxillofacial surgery in kosovo.

    Science.gov (United States)

    Loxha, Mergime Prekazi; Sejfija, Osman; Salihu, Sami; Gjinolli, Fellanza; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida Namani; Gecaj-Gashi, Agreta

    2013-01-01

    The aim of this study was to analyze maxillofacial region fractures during the past 20 years in the Department of Maxillofacial Surgery in Prishtina. We have analyzed the histories of all patients with trauma who were hospitalized in the Department of Maxillofacial Surgery in Prishtina since the opening of the clinic in 1983 through 2005. Narrowing the subject of our research, we concentrated on fractures of the maxillofacial region treated at the Clinic of Maxillofacial Surgery for the period 2001-2005. We have analyzed those fractures and compared them with the period from 1983 to 2005 only when it was reasonable. During this period, 1,945 patients were treated for trauma in the maxillofacial region by the Department of Maxillofacial Surgery. This group included 19.8% females and 80.2% males. The largest age group were those between 20 and 20 years of age. Causes of trauma for both periods were predominantly traffic accidents; however, during the period 2001-2005, interpersonal conflicts were increasingly the cause of fractures. Interpersonal conflict as a cause of maxillofacial trauma has risen in recent years. With this increase the methods of treating fractures in this region are also changing.

  4. 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 treatment in increasing clinical pregnancy rates and reducing the risk of OHSS in 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. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  5. [Diagnosis and treatment of congenital biliary duct cyst: twenty-year experience].

    Science.gov (United States)

    Peng, S; Shi, L; Peng, C; Yang, D; Ji, Z; Wu, Y; Liu, Y; Gao, N; Chen, H

    2001-12-01

    To summarize the experience in diagnosis and treatment of congenital biliary duct cyst. Clinical data from 108 patients treated from 1980 to 2000 were analyzed retrospectively. Abdominal pain, jaundice and abdominal mass were presented in most pediatric patients. Clinical symptoms in adult patients were non-specific, resulting in delayed diagnosis frequently. Fifty-seven patients (52.7%) had coexistent pancreatic biliary disease. Carcinoma of the biliary duct occurred in 18 patients (16.6%). Ultrasonic examination was performed in 94 patients, ERCP in 46, and CT in 71. All of the patients were correctly diagnosed before operation. Abnormal pancreatobiliary duct junction was found in 39 patients. Before 1985, the diagnosis and classification of congenital biliary duct cyst were established by ultrasonography preoperatively and confirmed during operation. The main procedure was internal drainage by cyst-enterostomy. After 1985, the diagnosis was decided with ERCP and CT, the procedure was cyst excision with Roux-en-Y hepaticojejunostomy. In 1994, we used a new and simplified operative procedure to reduce the risk of malignancy of choledochal cyst. Retrograde infection of the biliary tract the major postoperative complication, could be controlled by the administration of antibiotics. The concept in diagnosis and treatment of congenital choledochal cyst has been changed greatly. CT and ERCP are of great help in the classification of the disease. Currently, cyst excision with Roux-en-Y hepaticojejunostomy is strongly recommended as the treatment of choice for patients with type I and IV cysts. Piggyback orthotopic liver transplantation is indicated for type V cysts (Caroli's disease) with frequently recurrent cholangitis, resulting in biliary cirrhosis.

  6. Twenty-years of splenic preservation at a level 1 pediatric trauma center.

    Science.gov (United States)

    Bairdain, Sigrid; Litman, Heather J; Troy, Michael; McMahon, Maria; Almodovar, Heidi; Zurakowski, David; Mooney, David P

    2015-05-01

    Splenic preservation is the standard of care for hemodynamically stable children with splenic injuries. We report a 20-year single-institutional series of children with splenic injuries managed without a splenectomy. Children evaluated and treated for blunt splenic injury at Boston Children's Hospital from 1994 to 2014 were extracted from the trauma registry. Demographics, clinical characteristics, complications, and outcomes were reviewed. Three time-periods were evaluated based upon the development and modification of splenic injury clinical pathway guidelines (CPGs). Survival was defined as being discharged from the hospital alive. 502 suffered isolated splenic injuries. The median AAST grade of splenic injury increased across the three CPG time periods (psplenic-injury related mortalities occurred. Hospital length of stay decreased significantly secondary to splenic injury CPGs (psplenic injury, no patient died or underwent splenectomy. Hospital length of stay decreased across time, despite an increase in the severity of splenic injuries encountered. Splenectomy has become so unusual in the management of hemodynamically stable children with a splenic injury that it may no longer be a legitimate outcome marker. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Overview of Twenty Years of Radiation and Tissue Banking Activity in Argentina

    International Nuclear Information System (INIS)

    Kairiyama, E.

    2015-01-01

    Radiation sterilization of human tissues in Argentina was a consequence of health care products sterilization by gamma radiation. Radiation technology was implemented in 1970 when the first multipurpose gamma facility was built at the Ezeiza Atomic Centre of CNEA. Organ and tissue transplantation is a well established effective therapy that saves lives and significantly improves the quality of life. Ionizing radiation is used for sterilization in order to provide clinically safe tissue for therapeutic purposes of implantation in every patient in need. Argentina radiation and tissue banking activity started in 1993 with the establishment of two tissue banks using radiation under the IAEA programme of technical cooperation, a skin bank and a bone one. Additionally to this start, other tissue banks have adopted tissue sterilization by irradiation. The compatible tissues sterilized with this methodology are mainly skin (frozen, glycerolized), bone (lyophilized, frozen), and amniotic membrane (glycerolized, frozen, dehydrated). The donation and transplant of human organ, tissue and cells is regulated and coordinated by the National Institute Unique Central Coordinator of Ablation and Implant (INCUCAI). In regards to radiation and nuclear safety, physical protection and nuclear non-proliferation issues are regulated and contorted by the Nuclear Regulatory Authority (ARN). Eight tissue banks use gamma radiation for sterilization of human tissues (6 musculoskeletal, 1 skin and 1 amniotic membrane). Argentina has participated actively in several IAEA projects regarding radiation and tissue banking program, and it has been selected by the IAEA to host the Regional Training Centre for the Latin American region. The following activities were implemented: regional training courses in Buenos Aires, face to face (five) and virtual (four) modalities; collaboration on several materials related to tissue banking and radiation sterilization of tissue allograft, codes of practice for radiation sterilization of human tissues and recommendations for the operation of tissue banks. (author)

  8. Twenty years of post-apartheid archiving: have we reckoned with the ...

    African Journals Online (AJOL)

    Verne

    Ministry for Economic Cooperation and. Development (BMZ) ... Kenya, Serbia, South Africa and Uruguay. 3 For a full account see .... The fragile moral underpinning of the TRC has been unravelled. And, crucially, the. RDP was replaced by a neo-liberal macro- economic policy. Inequality in South Africa today is greater than ...

  9. 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

  10. Open abdomen management of intra-abdominal infections: analysis of a twenty-year experience.

    Science.gov (United States)

    Rausei, Stefano; Dionigi, Gianlorenzo; Boni, Luigi; Rovera, Francesca; Minoja, Giulio; Cuffari, Salvatore; Dionigi, Renzo

    2014-06-01

    No conclusive results on the efficacy and timing of open abdomen (OA) are available, particularly in the setting of intra-abdominal infections. We analyzed outcomes and risk factors retrospectively in a large series of patients managed with an OA during the past 20 y in an effort to clarify this issue. We reviewed the records of 133 patients who underwent treatment with an OA, considering factors related to patient, disease, medical management, and surgical treatment. The end points of the bi-variable analysis were 1-y mortality, calculated from the time of an initial OA procedure, and definitive fascial closure. Most patients (112/133) managed with an OA had one of several types of peritonitis. Many patients had severe clinical conditions (mean Acute Physiology and Chronic Health Evaluation [APACHE] II score was almost 9 points for the study population). With regard to surgical management, the mean (+SD) number of abdominal revisions was 5.9+9.3 during a mean duration of treatment with an OA of 14.3+11.6 d. The overall mortality in the study was 26% (35/133). Bi-variable analysis revealed factors associated with overall mortality to be age, renal and respiratory co-morbidities, edema on an initial chest radiograph, blood pressure, blood glucose and creatinine concentrations; and APACHE II score. The rate of definitive fascial closure was 75% (100/133). Factors associated negatively with fascial closure were respiratory co-morbidity, edema on a first chest radiograph, post-operative mesenteric ischemia as an indication for OA, blood glucose and creatinine concentrations, and duration of an OA. Patients' pre-operative clinical status influences strongly their response to surgical treatment. The management of OA does not affect adversely the survival of patients with intra-abdominal infections, but factors related to the management of OA (duration of OA) seem to affect the possibility of definitive fascial closure.

  11. Twenty Years Lasting Interventional Study of Cardiovascular Risk Factors in Middle Aged Men

    Czech Academy of Sciences Publication Activity Database

    Tomečková, M.; Boudík, F.; Zvárová, Jana; Zvára, Karel; Štefek, Martin; Bultas, J.

    1997-01-01

    Roč. 13, Suppl.B (1997), s. 127B ISSN 0828-282X. [International Conference on Preventive Cardiology /4./ jointly with Annual Meeting of The Council on Epidemiology and Prevention /37./. 29.06.1997-03.07.1997, Montréal] Grant - others:COPERNICUS(XE) 10013; IGA MZ CR(CZ) IZ4038

  12. 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.

  13. 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...... decline in prevalence of HBsAg carriers, from 0.15 to 0.03%, but owing to immigration of new HBsAg carriers from developing countries the overall number of carriers has not changed. The small effect of immigration on the incidence of acute HBV infections as well as the decreasing prevalence of HBs...

  14. 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.

  15. [Changes in processed food expenditure in the population of Metropolitan Santiago in the last twenty years].

    Science.gov (United States)

    Crovetto, Mirta; Uauy, Ricardo

    2012-03-01

    During recent decades household incomes have increased steadily, leading to changes in dietary habits and food expenditure. To report changes in household food expenditure focusing on trends in processed food across income quintiles in Metropolitan Santiago. Information obtained from the Fourth (1986-1987), Fifth (1996-1997) and Sixth National Institute of Statistics (INE) Surveys (2006-2007) were used. Food expenditure data over the study periods was extracted from household expenditure surveys (HES) after verifying and adjusting food prices registered by the INE to current 2007 prices. Absolute food expenditure over the study period increased for all groups; the largest increase was found in lowest income quintiles; however, the proportion of total family budget spent on food decreased in all groups. The largest increases in food expenditure corresponded to sweetened beverages, processed fruit juices, alcoholic drinks, ready meals and "eating out". Expenditure on fish rose slightly whereas the absolute spending on legumes, eggs and oils decreased. Expenditure in processed food as percentage of total food expenditure increased from 42% to 57% of total for mean household. For the 2nd quintile it rose from 31% to 48% and for the lowest quintile increased from 53% to 68% over the three decades (1987-2007). Changes were greatest in energy rich processed foods such as bread, pastries, confectioneries and granulated sugar. These particular foods are of high energy density and contain high amounts of saturated fat, sodium and added sugars. These results confirm that food consumption patterns over the past decades have progressively departed from the recommended dietary guidelines given by national and international health organizations.

  16. [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.

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

    Science.gov (United States)

    2013-05-23

    Joint Task Force – National Capitol Region MACA Military Assistance to Civil Authorities MSCA Military Support to Civil Authorities NCR National...Assistance to Civil Authorities ( MACA ). MSCA was defined as civil support consisting of support for natural or manmade disasters, chemical, biological...consequence management, and other support as required.16 MACA was defined as

  18. [Primary intestinal lymphangiectasia: twenty years of experience at a Mexican tertiary care hospital].

    Science.gov (United States)

    Valdovinos-Oregón, D; Ramírez-Mayans, J; Cervantes-Bustamante, R; Toro-Monjaraz, E; Cázares-Méndez, M; Cadena-León, J; Zárate-Mondragón, F; Montijo-Barrios, E

    2014-01-01

    Primary intestinal lymphangiectasia is a rare congenital disease described by Waldmann in 1961 that is a consequence of obstruction of the lymphatic drainage of the small bowel with secondary lymph vessel dilation. This distorts the architecture of the villi and causes a leakage of lymph into the intestinal lumen, resulting in protein-losing enteropathy and malabsorption. To describe the clinical, biochemical, radiologic, endoscopic, and histologic characteristics in children with primary intestinal lymphangiectasia. A retrospective observational, descriptive, cross-sectional study was conducted that reviewed the case records of children diagnosed with primary intestinal lymphangiectasia that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 1, 1992 to September 30, 2012. Four patients were found that presented with primary intestinal lymphangiectasia. Three of them had been diagnosed before 3 years of age. All the patients presented with chronic diarrhea, edema, lymphopenia, hypocalcemia, and hypogammaglobulinemia, and 3 patients presented with hypocholesterolemia. Bowel transit time, endoscopy, and intestinal biopsies were characteristic of this pathology. Intestinal lymphangiectasia should be suspected when there is a clinical picture of chronic diarrhea and protein-losing enteropathy accompanied with edema at any level, as well as hypoalbuminemia, hypocalcemia, lymphopenia, hypogammaglobulinemia, and hypocholesterolemia, which are the main biochemical findings of this pathology. All children presenting with intestinal lymphangiectasia should undergo an upper gastrointestinal series with bowel transit time and endoscopy with biopsies taken at the level of the duodenum. Treatment includes diet and the periodic administration of albumin and gamma globulin. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  19. Primary intestinal lymphangiectasia: twenty years of experience at a Mexican tertiary care hospital

    Directory of Open Access Journals (Sweden)

    D. Valdovinos-Oregón

    2014-01-01

    Conclusions: Intestinal lymphangiectasia should be suspected when there is a clinical picture of chronic diarrhea and protein-losing enteropathy accompanied with edema at any level, as well as hypoalbuminemia, hypocalcemia, lymphopenia, hypogammaglobulinemia, and hypocholesterolemia, which are the main biochemical findings of this pathology. All children presenting with intestinal lymphangiectasia should undergo an upper gastrointestinal series with bowel transit time and endoscopy with biopsies taken at the level of the duodenum. Treatment includes diet and the periodic administration of albumin and gamma globulin.

  20. Twenty Years of European Union Support to Gene Therapy and Gene Transfer.

    Science.gov (United States)

    Gancberg, David

    2017-11-01

    For 20 years and throughout its research programmes, the European Union has supported the entire innovation chain for gene transfer and gene therapy. The fruits of this investment are ripening as gene therapy products are reaching the European market and as clinical trials are demonstrating the safety of this approach to treat previously untreatable diseases.

  1. The USAF Scientific Advisory Board: Its First Twenty Years. 1944-1964

    Science.gov (United States)

    1967-02-01

    Academy advisory committee gainfully employed ."’ However, he subsequently dropped the project, informing Putt in October 1960 that "the establish...factories in rr-y-S-’’.^’- Switzerland and Bavaria.*12 Many significant developments in American aviation had their genesis in SAG proposals submitted...Johnson put the matter even more strongly to General LeMay, noting that the AAF had to decide soon how it was going to handle and employ the SAB or

  2. Twenty years of principal-agent research in EU politics: how to cope with complexity?

    NARCIS (Netherlands)

    Delreux, Tom; Adriaensen, J.

    2017-01-01

    In the 20 years after its introduction, the principal-agent model has seen increasing use to study political processes in virtually all policy domains in which the EU is active. Relaxing the strict assumptions that guided the original economic applications has greatly widened the scope for potential

  3. ILK statement on the consequences of the Chernobyl accident. Taking stock after twenty years

    International Nuclear Information System (INIS)

    2006-01-01

    The Chernobyl reactor accident was the consequence of a reactor design which was not inherently safe, and of a lack of 'safety culture'. The RBMK-type reactor (a Russian graphite-moderated light water reactor design: reaktor bolshoi moshnosty kanalny=high-power channel reactor) had not been designed to a satisfactory safety level, and the operating staff were not informed on the weak spots in plant design. The combination of these factors caused the worst nuclear accident, completely destroying the reactor. The consequences may be seen as the product of two severe accidents superimposed upon each other: the explosion of the reactor, and core melt-down associated with an intense, persistent fire of the graphite moderator. The Statement contains analyses of these points: Release, Propagation and Deposition of Radioactive Materials; Protective Measures; Impact on the Environment and Agriculture; Assessment of Radiation Exposure; Health Impact; Psychological and Societal Impacts; Potential Residual Risks. (orig.)

  4. Twenty Years of Global Climatic Governance Impasse: For Another Order of Governmentality

    International Nuclear Information System (INIS)

    Dahan, Amy

    2014-01-01

    At once a scientific question and political problem, climate change has given rise to a complex system of arenas, institutions, experts and varied actors. They are all engaged in a process of world governance in the aim of finding solutions. That being the case, how is one to explain the fact that this process has achieved so little in the way of reducing greenhouse gas emissions? In order to answer this question, I focus on the manner in which the framing of the climate problem has been conceived, understood and embodied in negotiations. I review several of its characteristic elements: the pollution paradigm, globalization, the top-down strategy of 'burden sharing', market and compensation mechanisms, the specific interactions between science and politics, which entail various models of expertise and give rise to contradictory expectations, and, finally, the theme of adaptation, which has come to occupy an increasingly important place on the UN's governance agenda for reasons relating to reconfigurations of the geopolitics of climate. The failure of the Copenhagen Conference (2009), which was presented as a decisive moment for dealing with climate issues at a planetary level, challenges this framing, and calls for a rethinking of the order of governmentality of the climate problem. To that end, I put forward a few proposals and suggestions for future study

  5. Twenty years of functional near-infrared spectroscopy: introduction for the special issue.

    Science.gov (United States)

    Boas, David A; Elwell, Clare E; Ferrari, Marco; Taga, Gentaro

    2014-01-15

    Papers from four different groups were published in 1993 demonstrating the ability of functional near infrared spectroscopy (fNIRS) to non-invasively measure hemoglobin concentration responses to brain function in humans. This special issue commemorates the first 20years of fNIRS research. The 9 reviews and 49 contributed papers provide a comprehensive survey of the exciting advances driving the field forward and of the myriad of applications that will benefit from fNIRS. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. 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…

  7. TRACG: Twenty years of collaboration between ENUSA and GE-HITACHI

    International Nuclear Information System (INIS)

    Haces, J.; Trueba, M.; Garcia, J.; Barrera, J.

    2011-01-01

    TRACG is the GE Hitachi Nuclear Energy (GEH) proprietary version of the Transient Reactor Analysis Code. It is a best-estimate code for analysis of boiling eater reactors (BWR). Enusa has extensively contributed to the development of TRACG, applying this code to different scenarios and BWR plants: loss-of-coolant accident (LOCA), anticipated operational occurrences (AOO), instability events licensing of GNF fuel for Nordic plants, anticipated transients without scram (ATWS) reactivity insertion accidents (RIA), validation of the simulator for the Advanced BWR (ABWR) plant, the licensing of the TRACG based U. s. Nuclear Regulatory commission (NRC)-approved AOO and LOCA licensing methodologies, and in the licensing of the passively safe generation III+ Economic Simplified Boiling Water Reactor (ESBWR).

  8. Twenty-year-old results from a bottomland oak species comparison trial in western Kentucky

    Science.gov (United States)

    Randall J. Rousseau

    2008-01-01

    A 20-year-old trial of five bottomland oak species (cherrybark, Nuttall, pin, water, and willow oaks) located in western Kentucky showed little difference in survival and growth but considerable difference in form characteristics. Mortality was highest between ages 1 and 3 years during plantation establishment until tree-to-tree competition began increasing between the...

  9. 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

  10. Twenty years of the Journal of product innovation management : History, participants, and knowledge stock and flows

    NARCIS (Netherlands)

    Biemans, Wim; Griffin, Abbie; Moenaert, Rudy

    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

  11. Twenty Years of Brassinosteroids : Steroidal Plant Hormones Warrant Better Crops for the XXI Century

    NARCIS (Netherlands)

    Khripach, V.; Zhabinskii, V.; Groot, de C.P.G.M.

    2000-01-01

    The discovery of brassinosteroids (BS) just over 20 years ago opened a new era in studies of bio-regulation in living organisms. Previously, the only known role of steroids as hormones was in animals and fungi; now a steroidal hormone in plants had been added. Progress in brassinosteroid research

  12. Physical Activity and Personality Development over Twenty Years: Evidence from Three Longitudinal Samples.

    Science.gov (United States)

    Stephan, Yannick; Sutin, Angelina R; Luchetti, Martina; Bosselut, Grégoire; Terracciano, Antonio

    2018-04-01

    A physically inactive lifestyle is associated with maladaptive patterns of personality development over relatively short follow-up periods. The present study extends existing research by examining whether this association persists over 20 years. Participants (total N = 8,723) were drawn from the Wisconsin Longitudinal Study Graduates and Siblings samples and the Midlife in the United States Study. Controlling for demographic factors and disease burden, baseline physical inactivity was related to steeper declines in conscientiousness in all three samples and a meta-analysis (β=-.06). The meta-analysis further showed that lower physical activity was associated with declines in openness (β=-.05), extraversion (β=-.03), and agreeableness (β=-.03). These findings provide evidence that a physically inactive lifestyle is associated with long-term detrimental personality trajectories.

  13. The impact of twenty years of noise research on nuclear power plant design, instrumentation and control

    International Nuclear Information System (INIS)

    Kemeny, L.G.

    1975-01-01

    Early investigations demonstrated that time constants and the dynamic characteristics of low energy nuclear systems could be elegantly determined by correlation of spectral analysis of fluctuating signals from ion chambers and proportional counters. Analyses of the time series information and the multi-filtering operations in the frequency domain were time consuming and tedious projects due to the lack of suitable data processing equipment. During the last decade, the significant advances were the recognition of the advantages of the two-channel cross-correlation technique and the realisation that the dynamic behaviour of nuclear power plant at power could be monitored and studied in depth by the cross-correlation of mechanical, thermal and hydrodynamic signals with neutronic information. The former concept led to the development of theoretical models for spatial and energy-dependent noise fields within a nuclear system. The latter opened a floodgate of potential advances in nuclear power plant design optimization, control and safety instrumentation, and control and safety diagnostic systems. (U.K.)

  14. Twenty years of cable-in-conduit conductors: 1975-1995

    International Nuclear Information System (INIS)

    Dresner, L.

    1995-01-01

    This paper reviews our progress during the last two decades in understanding cable-in-conduit conductors. The emphasis is on the physical principles governing the behavior of cable-in-conduit conductors, and no detailed mathematics is presented. The paper is constructed as a historical narrative

  15. Methods, software and datasets to verify DVH calculations against analytical values: Twenty years late(r).

    Science.gov (United States)

    Nelms, Benjamin; Stambaugh, Cassandra; Hunt, Dylan; Tonner, Brian; Zhang, Geoffrey; Feygelman, Vladimir

    2015-08-01

    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. 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, Dmax, Dmin, and doses to % volume: D99, D95, D5, D1, D0.03 cm(3)) and (2) volume errors extracted along the DVH curves were generated and summarized in tabular and graphical forms. 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 Dmin and Dmax 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. 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.

  16. Twenty-year trends in the utilization of Heller myotomy for achalasia in the United States.

    Science.gov (United States)

    Haisley, Kelly R; Preston, Jennifer F; Dolan, James P; Diggs, Brian S; Hunter, John G

    2017-08-01

    Trends in the utilization of Heller myotomy for achalasia in the U.S. over time have not been previously described. Using the Nationwide Inpatient Sample (NIS) database, we analyzed patients undergoing Heller myotomy for achalasia over a 20-year period (1992-2011) to estimate rates of Heller myotomy, locations where the procedures were performed (rural, urban or teaching) and changes in technique (laparoscopic vs open) as well as outcomes of length of stay and in-hospital mortality. Over the last 20 years, the total number of Heller myotomies performed in the U.S. has increased (1576 cases in 1992 to 5046 cases in 2011, p = 0.001). These procedures are now being performed laparoscopically (0.9%-67.0%, p Heller myotomy at teaching institutions with decreased in-hospital mortality and shorter LOS. Copyright © 2017. Published by Elsevier Inc.

  17. Job Insecurity Research is Still Alive and Kicking Twenty Years Later : A Commentary

    NARCIS (Netherlands)

    Schaufeli, Wilmar B.

    2016-01-01

    This paper comments on the review of longitudinal job insecurity studies in this special issue. The main conclusion of that review, namely that job insecurity leads to poor health and well-being, remains undisputed. It is argued, however, that future job insecurity research should focus more on: (a)

  18. Reflecting on twenty years of Masculinities: an interview with Raewyn Connell

    Directory of Open Access Journals (Sweden)

    Marcos Nascimento

    Full Text Available Abstract Raewyn Connell is very well known for her work on social theory and gender studies, and more specifically on masculinities. She was one of the founders of masculinities research and her 1995 book Masculinities is considered one of the most important references on the topic. Connell's concept of hegemonic masculinity has been particularly influential and has attracted much debate. She has written extensively about its applications to education, health, and violence prevention. Our conversation was about her trajectory as an intellectual, her commitment to gender justice, and the development of her work from Australia to the global scale.

  19. Twenty years of post-apartheid archiving: have we reckoned with the ...

    African Journals Online (AJOL)

    Verne

    flood of post-1990 memory work, the transformed national ... 1 Nelson Mandela, Long Walk to Freedom (Abacus,. 1994), p.617. ... term to describe: the processes whereby those who are traumatised .... no short-cut to the liberatory future our.

  20. Twenty years of research at the Mont Terri rock laboratory: what we have learnt

    Energy Technology Data Exchange (ETDEWEB)

    Bossart, P. [Federal Office of Topography swisstopo, Wabern (Switzerland)

    2017-04-15

    The 20 papers in this Special Issue address questions related to the safe deep geological disposal of radioactive waste. Here we summarize the main results of these papers related to issues such as: formation of the excavation damaged zone, self-sealing processes, thermo-hydro-mechanical processes, anaerobic corrosion, hydrogen production and effects of microbial activity, and transport and retention processes of radionuclides. In addition, we clarify the question of transferability of results to other sites and programs and the role of rock laboratories for cooperation and training. Finally, we address the important role of the Mont Terri rock laboratory for the public acceptance of radioactive waste disposal. (author)

  1. Twenty years of providing information on nuclear power. The experience of EDF

    International Nuclear Information System (INIS)

    Durr, M.; Ansel, P.; Chaussade, J.P.; Haller, P.; Hezard, L.; Hue, L.

    1995-01-01

    In France, the anti-nuclear protest movement became a real problem after 1968, as new sites were sought. Initially, information on nuclear power involved communication by the entities responsible for building the plants. Once Government officials and politicians overcame their initial hesitation, their support, which underscores the continuity of France's energy policy, came to play a major role in the public acceptance of nuclear power. Electricite de France (EDF) then had to master the art of informing and communicating with the public. The change in the parliamentary majority in 1981 did not call into question the nuclear programme, and new plants were commissioned with relative ease. The situation changed dramatically with the Chernobyl disaster. It therefore became vital to establish an efficient structure for crisis communications, and transparency became crucial. The focus shifted from launching new plants to operating existing facilities and restoring public confidence. While not neglecting the general public, the emphasis was on certain strategic segments of the population, notably teachers and health care professionals. Advertising campaigns are today aimed at certain segments of the public, whose opinion could well shift in favour of nuclear power. Lastly, EDF, as power plant operator, has to realize the importance of providing information on nuclear waste. Starting from a strategic policy of informing politicians and senior decision makers, in 1974 EDF began to focus on providing information that would 'educate' the public. This information was issued via technicians who had no specific training in communications techniques. In addition to the need to explain and justify its projects, EDF had to adopt a policy of transparency, and to dispense with the esoteric language of specialists and their preference for secrecy. After Chernobyl, EDF's managers made communications with the 'outside world' an integral part of their jobs. Nuclear information became a matter for communications professionals. (author)

  2. Cardiac myxoma: diagnostic approach, surgical treatment and follow-up. A twenty years experience.

    Science.gov (United States)

    Jelic, J; Milicić, D; Alfirević, I; Anić, D; Baudoin, Z; Bulat, C; Corić, V; Dadić, D; Husar, J; Ivanćan, V; Korda, Z; Letica, D; Predrijevac, M; Ugljen, R; Vućemilo, I

    1996-12-01

    At the University Department of Cardiovascular Surgery in Zagreb, Croatia, we treated 81 patients with primary intracardiac myxoma, in a period from January 1975 to December 1994. There were 55 female and 26 male pts, in age from 1 month to 80 years, mean 46+/-15 years. Clinical manifestations varied from no symptoms and very poor or no clinical signs to various manifestations of chronic or acute congestive heart failure, syncope and arrhythmias with or without systemic findings such as high erythrocyte sedimentation rate, anaemia, leucocytosis, elevated gamma globulin, thrombocytopenia or low grade fever, as well as cerebrovascular accidents due to tumour embolization. Cardiac symptoms were predominant in 54 pts (66.6%) and cerebrovascular in 20 pts (24.7%). Seven pts (8.6%) were symptomless and discovered accidentally, mostly regarding on an unexplained heart murmur. In almost all the patients preoperative diagnosis of intracardiac myxoma was sufficiently established by echocardiography. The tumour was located in the left atrium in 62 pts (76.5%) and in the right atrium in 19 pts (23.5%). Delay from the onset of symptoms to the diagnosis was 6 months in average (range 10 days to 25 months). The average waiting for the operation was 9 days (range from 1 to 60 days). The echocardiographic diagnosis was confirmed during intraoperative examination followed by histological analysis. All pts underwent excision of myxoma using cardiopulmonary bypass with core and topical hypothermia and cold crystaloid cardioplegia. According to the additional preoperative and intraoperative findings, in 6 pts sinchronous mitral valve reconstruction, in 3 pts artificial mitral valve implantation and in 2 pts atrial wall reconstruction was performed. There was no perioperative mortality. After the operation, we could not evaluate all the patients long enough, mostly because of some paramedical circumstancies, such as war, migrations, etc. Twenty two pts undevent evaluation for at least 5 years after the operation. Among them there was no evidence of the tumour recurrence, 15 pts were asymptomatic and 7 had NYHA II class symptoms. For 17 pts with a left atrial myxoma preoperative and postoperative echocardiographic data were available for comparison, showing a significant reduction of the left atrial diameter (p<0.001) during the postoperative follow-up. Our data, presenting one of the biggest reports concerning cardiac myxomas, showed a broad spectrum of their clinical presentation, importance of echocardiography in diagnosing and postoperative follow-up and efficacy of a proper surgical intervention as a definite, curative therapy since there were no deaths and no significant cardiac dysfunction neither tumour reccurrence as well.

  3. [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.

  4. 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.

  5. Combined immunodeficiencies: twenty years experience from a single center in Turkey

    OpenAIRE

    Akar, H. Haluk; Patiroglu, Turkan; Hershfield, Michael; van der Burg, Mirjam

    2016-01-01

    Combined immunodeficiencies (CIDs) include a group of inherited monogenic disorders. CIDs are characterized by defective cellular and humoral immunities that lead to severe infections. CIDs can be classified according to immunologic phenotypes as T?B?NK? CID, T?B?NK+ CID, T?B+NK? CID and T?B+NK+ CID. In a 20-year period, from 1994 to 2014, a total of 40 CID patients were diagnosed at the Pediatric Immunology of Erciyes University Medical Faculty in Kayseri, Turkey. The gender ratio (F/M) was ...

  6. 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.

  7. 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.

  8. Nontuberculous Mycobacteria Isolation from Clinical and Environmental Samples in Iran: Twenty Years of Surveillance.

    Science.gov (United States)

    Velayati, Ali Akbar; Farnia, Parissa; Mozafari, Mohadese; Mirsaeidi, Mehdi

    2015-01-01

    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.

  9. [Quality assurance systems and occupational medicine system: an history twenty years along].

    Science.gov (United States)

    Apostoli, Pietro

    2014-01-01

    Along the last tventy years, in our country the quality assurance systems and the occupational medicine deeply interacted both in theoretical and practical fields of interest at three levels: (i) the need of preventive and therefore of occupational medicine in quality assurance systems; (ii) the need on reverse of quality in prevention and occupational mnedicine mainly in qualification and updating process; (iii) the evidence, proofs of efficacy or appropriateness of different preventive procedures and occupational physician activities; (iv) the connection with European and national legal directives and with technical or good practice norms. Finally we discuss about the role of occupational physician as the global consultant for enterprise, as a mandatory strategic technical figure in a typical multidisciplinary processes as the implementation of the quality systems.

  10. Incidence of hypothyroidism more than twenty years after therapy in hyperthyroid patients treated with radioactive iodine

    International Nuclear Information System (INIS)

    Ronga, G.; Esposito, M.; Bschieri, I.; Fenzi, G.F.; Martino, E.; Pinchera, A.

    1988-01-01

    It is confirmed that delayed hypothyroidism is the major complication of I 131 therapy of the hyperthyroid syndromes of toxic diffuse or toxic multinodular goiter. In a homogeneous group of 94 patients taken from case histories of 454 subjects treated between 1957 and 1967, the annual increment of complications over the years appears significantly less than that found by other Authors and by us in prior review afeter a shorter interval of time

  11. Control of Hypertension in STULONG - Twenty Years Lasting Primary Preventive Study

    Czech Academy of Sciences Publication Activity Database

    Tomečková, Marie; Stanovská, Zuzana; Boudík, F.; Zvárová, Jana

    22 Suppl. 2, - (2004), s. 271 ISSN 0263-6352. [European Meeting on Hypertension /14./. 13.06.2004-17.06.2004, Paris] R&D Projects: GA MŠk LN00B107 Keywords : hypertension * primary preventive study Subject RIV: BB - Applied Statistics, Operational Research

  12. Twenty years nuclear power sector in Bulgaria - an attempt at striking a balance

    International Nuclear Information System (INIS)

    Shervashidze, N.

    1994-01-01

    The advantages of nuclear power and the mistakes that cause the opposition against it on the example of the history of the Bulgarian nuclear power sector are considered in a polemical manner. Four WWER 440/230 and two WWER 1000 units have been put into operation in Kozloduj NPP in the period 1974 - 1993. Before 1991, however, safety operation criteria were compromised numerous times and the atmosphere of secrecy, self-complacency and the series of absurdities about the Chernobyl accident were clearly used by the opponents of nuclear energy. Now the attitude towards nuclear power is changing for the better. Much progress has been made in recovering the nuclear power sector under complicated economic and political conditions. The role of NPP as an anti-inflation factor, an element providing the national security, a stimulator of industry and infrastructure, and an ecological salvation factor, is stressed. (I.M.)

  13. 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.

  14. Twenty Years of Basic Vocational Education Provision in Spain: Changes and Trends

    Science.gov (United States)

    Marhuenda-Fluixá, Fernando; Salvà, Francesca; Saurin, Almudena A. Navas; López, Miriam Abiétar

    2015-01-01

    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…

  15. Twenty years of application of Ivor Lewis' technique in esophageal cancer surgery

    International Nuclear Information System (INIS)

    Leal Mursuli, Armando; Adefna Perez, Radames Isaac; Ramos Diaz, Nelida

    2012-01-01

    A case series-type descriptive and observational study was carried out in the 1987-2010 period, in which the patients operated on from this disease were included. Some variables of interest such as location of lesion, staging, type of surgery, complications and survival rate were researched on

  16. Twenty Years of Successful Private Management. The Debate over Private vs. Public Management of Food Service.

    Science.gov (United States)

    Riegel, Ronald B.

    1994-01-01

    Companies such as ARA Services provide lunch every day to more than 1 million students in over 280 school districts nationwide. An Illinois superintendent lists several reasons for school districts to consider "outsourcing" their food-service operations, including cost-saving opportunities, capacity for offering comprehensive services…

  17. Twenty years with monoclonal antibodies. State of the art - where do we go?

    International Nuclear Information System (INIS)

    Stigbrand, T.; Ullen, A.; Sandstroem, P.; Mirzaie-Joniani, H.; Sundstroem, B.; Nilsson, B.; Aerlestig, L.; Rossi Norrlund, R.; Riklund Aahlstroem, K.; Hietala, S.O.

    1996-01-01

    In this review, we have selected some parameters with the potential to improve the efficacy of RIL and RIT. Focus has partially been on the behaviour of radiolabelled antibodies in vivo in relation to properties and amounts of both target antigen and the antibodies used. If, out of the 28 factors listed in Table 1, some should be given preference in future work, it is our opinion that after the initial saturation of the tumour site a rapid decrease in redundant antibody is of significant importance. Furthermore, quantitative aspects of both antigens and antibodies should be more carefully evaluated when possible. By combining several of the listed approaches toward incresing efficiency, a more extensive use of RIL and RIT could be expected in the future. (orig.)

  18. Twenty Years of General Education in China: Progress, Problems, and Solutions

    Science.gov (United States)

    Wang, Hongcai; Xie, Debo

    2018-01-01

    General education is a subject with rich contents and that is highly contested in the field of higher education studies. It has been highly praised for its core concepts such as broad educational targets, liberating educational objectives, and balanced educational content. Looking back at the course of general education in China over the past 20…

  19. Twenty years after Erich Muhe: Persisting controversies with the gold standard of laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Jani Kalpesh

    2006-01-01

    Full Text Available This review article is a tribute to the genius of Professor Erich Muhe, a man ahead of his times. We trace the development of laparoscopic cholecystectomy and detail the tribulations faced by Muhe. On the occasion of the twentieth anniversary of the first laparoscopic cholecystectomy, we take another look at some of the controversies surrounding this gold standard in the management of gallbladder disease

  20. Twenty years after Erich Muhe: Persisting controversies with the gold standard of laparoscopic cholecystectomy.

    Science.gov (United States)

    Jani, Kalpesh; Rajan, P S; Sendhilkumar, K; Palanivelu, C

    2006-06-01

    This review article is a tribute to the genius of Professor Erich Muhe, a man ahead of his times. We trace the development of laparoscopic cholecystectomy and detail the tribulations faced by Muhe. On the occasion of the twentieth anniversary of the first laparoscopic cholecystectomy, we take another look at some of the controversies surrounding this gold standard in the management of gallbladder disease.

  1. Twenty years after Erich Muhe: Persisting controversies with the gold standard of laparoscopic cholecystectomy

    OpenAIRE

    Jani, Kalpesh; Rajan, P S; Sendhilkumar, K; Palanivelu, C

    2006-01-01

    This review article is a tribute to the genius of Professor Erich Muhe, a man ahead of his times. We trace the development of laparoscopic cholecystectomy and detail the tribulations faced by Muhe. On the occasion of the twentieth anniversary of the first laparoscopic cholecystectomy, we take another look at some of the controversies surrounding this gold standard in the management of gallbladder disease

  2. Actinomycosis of Distal Phalanx Twenty Years after Flap Reconstruction of Index Finger: A Case Report

    Directory of Open Access Journals (Sweden)

    Prashant N

    2018-03-01

    Full Text Available Actinomycosis is a chronic granulomatous suppurative infection caused by anaerobic bacteria from genus Actinomyces which are normal flora of mouth, colon and vagina. Actinomycosis of upper extremity is rare. We report a case of actinomycosis of the distal phalanx of finger many years after flap reconstruction. The patient presented with two months’ history of chronic discharging sinus from the tip of his right index finger, which had sustained a degloving injury 20 years previously. It had been treated with an anterior chest wall flap which had healed uneventfully but was bulky due to excess tissue from the donor site. Radiograph revealed osetomyelitis changes of distal phalanx. Debulking surgery with curettage of the distal phalanx was done. Wound healing was uneventful. He was treated with six weeks of metronidazole and ciprofloxacin. The discharge from the distal phalanx cultured actinomycosis odontolyticus. Histopathology of the debrided tissue showed chronic inflammation. As far as we are aware, there are no reports of actinomycosis in a flap involving the finger treated previously with a chest wall skin flap. The infection was probably dormant for many years before manifesting as a discharging sinus. Although the finger flap was bulky, it was not problematic until it started to have serous discharge. With a thorough debridement of all infected tissue, six weeks of antibiotic was adequate. Ciprofloxacin was prescribed based on discharge culture sensitivity. Metronidazole was added as actinomycosis is anaerobic. Response was prompt as patient was not immunocompromised. At follow-up six months post-surgery the finger had recovered with good function. If not for the discharging sinus, patient would probably have tolerated his bulky finger for the rest of his life.

  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 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.

  5. Twenty Years of One Astronomy Teacher Professional Development - The EXES Teacher Associate Program at UT Austin

    Science.gov (United States)

    Finkelstein, Keely; Hemenway, Mary Kay; Sneden, Chris; Lacy, John; Richter, Matthew J.; EXES Teacher Associates

    2018-01-01

    The Astronomy Department and McDonald Observatory at the University of Texas at Austin has and continues to offer a suite of different astronomy based K-12 teacher professional development programs. One of our longest running, and most successful programs, is reaching its 20th anniversary, the EXES Teacher Associate Program, which was started in 1998. The EXES Teacher Associate program features sustained and continued professional development opportunities for K-12 science and math educators. It consists of 6 times per year day-long meetings, coupled with other professional development opportunities provided at various times. In total, there are approximately 30 active members of the group currently, but more than 90 teachers have participated in this group over its 20 year history. The program has had astronomy education as its focus throughout its history, but different partnerships and collaborations with other programs have supported the group and have allowed for a variety of professional development opportunities and themes for educators to engage in. We will give an overview of this program, present evaluation data and teacher feedback related to program success and student impact, and highlight a few specific program opportunities that are unique and have been shown to be most impactful for participants.

  6. Twenty Years On: Reflections on "Supporting the Use of External Representations in Problem Solving"…

    Science.gov (United States)

    Cox, Richard; Brna, Paul

    2016-01-01

    We reflect upon a paper we wrote that was published in 1995 (20 years ago). We outline the motivation for the work and situate it in the state of the art at that time. We suggest that a key contribution was to highlight the need to provide support for learners who reason with external representations. The support must be flexible enough to…

  7. Twenty Years of Feminist Counseling and Therapy: From Naming Biases to Implementing Multifaceted Practice.

    Science.gov (United States)

    Enns, Carolyn Zerbe

    1993-01-01

    Summarizes history and current status of feminist counseling and psychotherapy. Describes formation and development of feminist therapy during the 1970s, compares early commitments with aspects of change and maturation, and reviews areas of agreement and disagreement during 1980s and early 1990s. Draws on literatures of social work and psychology…

  8. 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 Generational analysis showed that older age groups tended to show smaller changes than younger age groups: the yearly score change in "chocolate and sweets" was -0.021 (95% CI: -0.027, -0.014; P y cohort compared with -0.002 (95% CI: -0.009, 0.005; P = 0.546) for the 45- to 54-y cohort. Conclusions: Three dietary patterns were identified; scores for the "fish and vegetables" pattern increased, whereas the "meat and chips" and the "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.

  9. International Conference 'Twenty Years after Chernobyl Accident. Future Outlook'. Abstracts proceeding

    International Nuclear Information System (INIS)

    Anon

    2006-01-01

    This conference concludes a series of events dedicated to the 20 anniversary of the Chernobyl accident and promote an effective implementation of the accumulated international experience in the following areas: Radiation protection of the population and emergency workers, and the environmental consequences of Chernobyl accident; Medical and public health response to radiation emergencies; Strengthening radiological emergency management of radiation accidents; Economic and legal aspects of radioactive waste management and nuclear power plants decommissioning; Radioactive waste management: Chernobyl experience; Nuclear power plant decommissioning: Chernobyl NPP; Transformation of the Chernobyl Sarcophagus into an ecologically safe system

  10. 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.

  11. Twenty Years of Research on the Alcator C-Mod Tokamak

    Science.gov (United States)

    Greenwald, Martin

    2013-10-01

    Alcator C-Mod is a compact, high-field tokamak, whose unique design and operating parameters have produced a wealth of new and important results since its start in 1993, contributing data that extended tests of critical physical models into new parameter ranges and into new regimes. Using only RF for heating and current drive with innovative launching structures, C-Mod operates routinely at very high power densities. Research highlights include direct experimental observation of ICRF mode-conversion, ICRF flow drive, demonstration of Lower-Hybrid current drive at ITER-like densities and fields and, using a set of powerful new diagnostics, extensive validation of advanced RF codes. C-Mod spearheaded the development of the vertical-target divertor and has always operated with high-Z metal plasma facing components--an approach adopted for ITER. C-Mod has made ground-breaking discoveries in divertor physics and plasma-material interactions at reactor-like power and particle fluxes and elucidated the critical role of cross-field transport in divertor operation, edge flows and the tokamak density limit. C-Mod developed the I-mode and EDA H-mode regimes which have high performance without large ELMs and with pedestal transport self-regulated by short-wavelength electromagnetic waves. C-Mod has carried out pioneering studies of intrinsic rotation and found that self-generated flow shear can be strong enough to significantly modify transport. C-Mod made the first quantitative link between pedestal temperature and H-mode performance, showing that the observed self-similar temperature profiles were consistent with critical-gradient-length theories and followed up with quantitative tests of nonlinear gyrokinetic models. Disruption studies on C-Mod provided the first observation of non-axisymmetric halo currents and non-axisymmetric radiation in mitigated disruptions. Work supported by U.S. DoE

  12. 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....

  13. Twenty Years of Australian Educational Computing: A Call for Modern Traditionalism

    Science.gov (United States)

    McDougall, Anne

    2005-01-01

    This article reflects on twenty or more years of development and research in educational computing. It argues that the emphasis on exploiting the technology in the service of contemporary ideas about learning held by many of the early workers has been lost to a focus on the technology itself and its capabilities. In schools this has led to an…

  14. Gender Equity in College Athletics: How Far Have We Really Come in Twenty Years?

    Science.gov (United States)

    Crawford, Julie Dunn; Strope, John L.

    1996-01-01

    Title IX prohibits sex discrimination in educational institutions receiving any federal funds. Until 1988, college athletics were exempt from compliance. Examines the results of some recent court cases to see how the law was interpreted and concludes what schools should do to be proactive in the struggle for gender equity in collegiate sports. (72…

  15. Twenty years of experience in the control of low radiation doses

    International Nuclear Information System (INIS)

    Caspani, C.E.; Lescano, R.

    1997-01-01

    The steps taken in the health care institutions of the Province of Santa Fe, Argentina, are described which aim to optimize radiation protection in accordance with the 'as low as reasonably achievable' (ALARA) concept

  16. [Therapeutic drug monitoring of three antiepileptic drugs - Back on twenty years of experience].

    Science.gov (United States)

    Serragui, Samira; Zalagh, Fatima; Tanani, Driss Soussi; Ouammi, Lahcen; Moussa, Latifa Ait; Badrane, Narjis; Bencheikh, Rachida Soulaymani

    2016-01-01

    The therapeutic drug monitoring (TDM) of antiepileptic drugs is a tool widely used in the management of epilepsy. In Morocco, this monitoring is carried out by the Centre Anti Poison et Pharmacovigilance (CAPM) since April 1995. This is a retrospective study spanning 20 years. It concerns the therapeutic drug monitoring of Phenobarbital (PB) of carbamazepine (CBZ) and valproic acid (VPA). Therapeutic drug monitoring of the 3 antiepileptic drugs represent 58.85% of all applications received by the CAPM. The dosage of PB was ranked first followed by that of CBZ and finally by the VPA. Weak demand for therapeutic drug monitoring in Morocco could be explained by the low number of neurologists in addition to social factors. With its affordable price by patients, PB is the most prescribed antiepileptic drug in our country, which explains the high demand for its dosage. As for the therapeutic drug monitoring of the antiepileptic drug, they were mainly related to age, the occurrence of adverse effects, the association antiepileptic drugs or in the case of verification of patient compliance. Efforts are required for promoting the interests of therapeutic drug monitoring of antiepileptic drug in the management of epilepsy in Morocco.

  17. Twenty years of environmental education in Germany - a stocktaking; 20 Jahre Umweltbildung in Deutschland. Eine Bilanz

    Energy Technology Data Exchange (ETDEWEB)

    Lob, R.E. [Essen Univ. (Gesamthochschule) (Germany). Zentralstelle fuer Umwelterziehung

    1997-12-31

    The book is a precise documentation of the development of environmental edcuation as an educational task in the Federal Republic of Germany. It covers a large range: from Stockholm over Tiflis and Moscow to Rio and Toronto under the catchword ``national and international conferences``, and from eco-pedagogy over environmental consciousness to environmental activities in the chapter ``fundamentals and concepts``. Inventories and analyses of activities at schools are given, curricula and textbooks are examined, and developments in the subjects biology and geography are assessed. The book deals with nature and forest pedagogy, environmental games and projects, LUCAS - the environmental education learning programme at schools of commerce, and the European environmental academy at Borken, Westphalia. After an overview on central research and sponsoring institutions, conclusions are drawn and an outlook is given. (orig.) [Deutsch] Das Buch ist eine praezise Dokumentation der Entwicklung der `Bildungsaufgabe Umwelterziehung` in der Bundesrepublik Deutschland. Der Bogen wird weit gespannt: Von Stockholm ueber Tiflis und Moskau nach Rio und Toronto beim Stichwort `nationale und internationale Konferenzen`, von der Oekopaedagogik ueber das Umweltbewusstsein bis hin zum Umwelthandeln im Kapitel `Grundlagen und Begriffe`. Es folgen Bestandsaufnahmen und Analysen der Schulpraxis, Untersuchungen von Lehrplaenen und Schulbuechern sowie eine Begutachtung der Entwicklungen in den Faechern Biologie und Geographie. Der Autor thematisiert Natur- und Waldpaedagogik, Umweltspiele oder Projekte, LUKAS - das Lernprogramm Umweltbildung an kaufmaennischen Schulen und die `Europaeische Umweltakademie` im westfaelischen Borken. Der Bestandsaufnahme ueber zentrale Forschungs- und Foerdereinrichtungen folgen abschliessend Bilanz und Ausblick. (orig.)

  18. Reflecting on twenty years of Masculinities: an interview with Raewyn Connell

    OpenAIRE

    Nascimento, Marcos; Connell, Raewyn

    2017-01-01

    Abstract Raewyn Connell is very well known for her work on social theory and gender studies, and more specifically on masculinities. She was one of the founders of masculinities research and her 1995 book Masculinities is considered one of the most important references on the topic. Connell's concept of hegemonic masculinity has been particularly influential and has attracted much debate. She has written extensively about its applications to education, health, and violence prevention. Our con...

  19. 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

    2015-07-01

    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. 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. 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. 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.

  20. 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.

  1. Twenty Years After Genocide: The Role of Psychology in the Reconciliation and Reconstruction Process in Rwanda

    OpenAIRE

    Craig McGarty

    2014-01-01

    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 be...

  2. 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.

  3. 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.

  4. Twenty years of radioisotope production from Institute of Atomic Energy reactors

    International Nuclear Information System (INIS)

    Lun, Xiao

    1980-01-01

    The heavy water reactor in People's Republic of China went critical in November, 1958, and the radioisotope development work began since then. The thermal power of the reactor was 7 MW, and the maximum thermal neutron flux was 1.2 x 10 14 n/cm 2 /sec. Since 1967, it was operated at 10 MW. The first radioisotope product was 24 Na, using Na 2 CO 3 as a target, while the first chemically processed product was an electroplated reference source of 60 Co. The first processed radiochemical was the carrier-free H 2 SO 4 of 35 S. Since then, 131 I and 32 P for medical uses, colloidal 198 Au, colloidal Cr 32 PO 4 , chemicals containing 203 Hg, organic compounds labelled with 125 I, 131 I, 3 H and 14 C and smoke detectors have been produced to date. In addition, 22 Na, 54 Mn, 57 Co, 88 Y, 109 Cd have been prepared from a cyclotron. Now about 140 kinds of products can be supplied, and 60% of the users are the hospitals with nuclear medicine department. The present status of the kinds and production figures of nuclear medicines, radiopharmaceuticals, labelled compounds, radiation sources, and some works in progress are reported. General aspects of the application of radioisotopes in China are also described. Radioisotopes have been applied to agriculture, industry, medicine, and sciences such as physics, chemistry, biology and geography. (Wakatsuki, Y.)

  5. Plutonium contamination twenty years after the nuclear weapons accident in Spain

    International Nuclear Information System (INIS)

    Iranzo, E.; Richmond, C.R.

    1987-01-01

    An accident involving two US Air Force planes engaged in a refueling operation occurred at 0922 GMT on January 17, 1966 over the town of Palomares in southeastern Spain. Three of the bombs, one intact, were found on land, in or near Palomares while the fourth was removed from the Mediterranean Sea. The parachutes of two of the bombs did not deploy resulting in the detonation of their conventional explosives and release of fissile material upon impact. Partial burning of the fissile material formed an aerosol that contaminated approximately 226 hectares of uncultivated, farmed, and urban land. The objective of this study was to determine the magnitude of the risk from internal contamination of the area inhabitants immediately after the accident and during the emergency phase and to determine the short, medium and long-term risk of internal contamination for the inhabitants of Palomares and its environs and to those who consume planet products cultivated in that area

  6. Twenty-year review of medical findings in a Marshallese population accidentally exposed to radioactive fallout

    International Nuclear Information System (INIS)

    Conard, R.A.

    1975-01-01

    A summary is presented of results of medical examinations of inhabitants of the Marshall Islands during the 20-year period following the exposure of Rongelap people to radioactive fallout in 1954. The initial effect observed was β burns of the skin of some individuals. Few significant findings were observed during the subsequent 9-year period, although an increase in miscarriages and stillbirths among the exposed women was noted. In 1963 some thyroid abnormalities and growth retardation of some children were noted. (177 references)

  7. Twenty-year trends of authorship and sampling in applied biomechanics research.

    Science.gov (United States)

    Knudson, Duane

    2012-02-01

    This study documented the trends in authorship and sampling in applied biomechanics research published in the Journal of Applied Biomechanics and ISBS Proceedings. Original research articles of the 1989, 1994, 1999, 2004, and 2009 volumes of these serials were reviewed, excluding reviews, modeling papers, technical notes, and editorials. Compared to 1989 volumes, the mean number of authors per paper significantly increased (35 and 100%, respectively) in the 2009 volumes, along with increased rates of hyperauthorship, and a decline in rates of single authorship. Sample sizes varied widely across papers and did not appear to change since 1989.

  8. 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.

  9. 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.

  10. Physical Activity and Personality Development over Twenty Years: Evidence from Three Longitudinal Samples

    Science.gov (United States)

    Stephan, Yannick; Sutin, Angelina R.; Luchetti, Martina; Bosselut, Grégoire; Terracciano, Antonio

    2018-01-01

    A physically inactive lifestyle is associated with maladaptive patterns of personality development over relatively short follow-up periods. The present study extends existing research by examining whether this association persists over 20 years. Participants (total N = 8,723) were drawn from the Wisconsin Longitudinal Study Graduates and Siblings samples and the Midlife in the United States Study. Controlling for demographic factors and disease burden, baseline physical inactivity was related to steeper declines in conscientiousness in all three samples and a meta-analysis (β=−.06). The meta-analysis further showed that lower physical activity was associated with declines in openness (β=−.05), extraversion (β=−.03), and agreeableness (β=−.03). These findings provide evidence that a physically inactive lifestyle is associated with long-term detrimental personality trajectories. PMID:29651189

  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. The century experiment: the first twenty years of UC Davis' Mediterranean agroecological experiment.

    Science.gov (United States)

    Wolf, Kristina M; Torbert, Emma E; Bryant, Dennis; Burger, Martin; Denison, R Ford; Herrera, Israel; Hopmans, Jan; Horwath, Will; Kaffka, Stephen; Kong, Angela Y Y; Norris, R F; Six, Johan; Tomich, Thomas P; Scow, Kate M

    2018-02-01

    The Century Experiment at the Russell Ranch Sustainable Agriculture Facility at the University of California, Davis provides long-term agroecological data from row crop systems in California's Central Valley starting in 1993. The Century Experiment was initially designed to study the effects of a gradient of water and nitrogen availability on soil properties and crop performance in ten different cropping systems to measure tradeoffs and synergies between agricultural productivity and sustainability. Currently systems include 11 different cropping systems-consisting of four different crops and a cover crop mixture-and one native grass system. This paper describes the long-term core data from the Century Experiment from 1993-2014, including crop yields and biomass, crop elemental contents, aerial-photo-based Normalized Difference Vegetation Index data, soil properties, weather, chemical constituents in irrigation water, winter weed populations, and operational data including fertilizer and pesticide application amounts and dates, planting dates, planting quantity and crop variety, and harvest dates. This data set represents the only known long-term set of data characterizing food production and sustainability in irrigated and rainfed Mediterranean annual cropping systems. There are no copyright restrictions associated with the use of this dataset. © 2018 by the Ecological Society of America.

  13. Twenty years of high-speed lines in Spain; Zwanzig Jahre Hochgeschwindigkeitsstrecken in Spanien

    Energy Technology Data Exchange (ETDEWEB)

    Vega Vega, Tomas [ADIF, Madrid (Spain); Gil Ortiz, Jose Miguel [Balfour Beatty Rail Iberica, Alcobendas (Spain)

    2012-07-15

    In April 1992, i.e. 20 years ago, fast train services started in Spain when high-speed trains were put into operation on the almost 500 km long Madrid-Cordoba-Sevilla railway line. Both the 1,435 mm UIC standard gauge and the 1 AC 25 kV 50 Hz overhead line voltage level meant a big step in the development. Today the Spanish high-speed network covers some 2,200 km of railway line, and more lines are planned or already under construction. (orig.)

  14. 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

  15. Longitudinal extensive transverse myelitis (LETM) in children: A twenty-year study from Oman.

    Science.gov (United States)

    Koul, Roshan; Alfutaisi, Amna M; Mani, Renjith; Abdel Rahim, Rana A; Sankhla, Dilip K; Al Azri, Faisal M

    2017-04-01

    The data on children with diagnosis of idiopathic transverse myelitis (ITM) was searched to find the pattern of myelitis in Oman. A retrospective study was carried out from January1995 to December 2014. Electronic medical records and patient medical files were seen to get the complete data of the children with ITM. This work was carried out at Sultan Qaboos University hospital, Muscat, Oman. The ethical committee of the hospital had approved the study. The diagnosis was based on the established criteria. Other causes of myelopathy were excluded. 19 children with idiopathic transverse myelitis were found. There were 18 out of 19 (94.6%) children with longitudinal extensive transverse myelitis (LETM). Longitudinal transverse extensive myelitis is the most common form of ITM in Oman.

  16. 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...

  17. Twenty-years of lung transplantation in Taiwan: Effects of cumulative institutional experience on early outcomes

    Directory of Open Access Journals (Sweden)

    Shun-Mao Yang

    2017-11-01

    Conclusion: Although the results were undesirable in the first decade of the transplant program, the cumulative institutional experience led to significantly improved outcomes in the second decade of the transplant program.

  18. 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).

  19. Where do we stand after twenty years of dynamic triggering studies? (Invited)

    Science.gov (United States)

    Prejean, S. G.; Hill, D. P.

    2013-12-01

    In the past two decades, remote dynamic triggering of earthquakes by other earthquakes has been explored in a variety of physical environments with a wide array of observation and modeling techniques. These studies have significantly refined our understanding of the state of the crust and the physical conditions controlling earthquake nucleation. Despite an ever growing database of dynamic triggering observations, significant uncertainties remain and vigorous debate in almost all aspects of the science continues. For example, although dynamic earthquake triggering can occur with peak dynamic stresses as small as 1 kPa, triggering thresholds and their dependence on local stress state, hydrological environment, and frictional properties of faults are not well understood. Some studies find a simple threshold based on the peak amplitude of shaking while others find dependencies on frequency, recharge time, and other parameters. Considerable debate remains over the range of physical processes responsible for dynamic triggering, and the wide variation in dynamic triggering responses and time scales suggests triggering by multiple physical processes. Although Coulomb shear failure with various friction laws can often explain dynamic triggering, particularly instantaneous triggering, delayed dynamic triggering may be dependent on fluid transport and other slowly evolving aseismic processes. Although our understanding of the global distribution of dynamic triggering has improved, it is far from complete due to spatially uneven monitoring. A major challenge involves establishing statistical significance of potentially triggered earthquakes, particularly if they are isolated events or time-delayed with respect to triggering stresses. Here we highlight these challenges and opportunities with existing data. We focus on environmental dependence of dynamic triggering by large remote earthquakes particularly in volcanic and geothermal systems, as these systems often have high rates of background seismicity. In many volcanic and geothermal systems, such as the Geysers in Northern California, dynamic triggering of micro-earthquakes is frequent and predictable. In contrast, most active and even erupting volcanoes in Alaska (with the exception of the Katmai Volcanic Cluster) do not experience dynamic triggering. We explore why.

  20. Twenty-Year Experience in the Diagnosis and Treatment of Infective Endocarditis

    Science.gov (United States)

    2015-01-01

    Aims 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. Material and Methods 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). Results 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. Conclusions 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. PMID:26230402

  1. Twenty year development of occupational diseases in the Czech Republic: medical and geographical aspects.

    Science.gov (United States)

    Jarolímek, Jan; Urban, Pavel

    2014-12-01

    The study analysed occupational diseases in the Czech Republic from the viewpoint of occupational medicine and medical geography. It used a dataset consisting of 32,646 cases of occupational diseases reported during the period of 1994-2013. The descriptive part of the study analysed occupational diseases according to their spatial distribution, occurrence in different branches of economic activities, employees' gender, and according to chapters of the List of occupational diseases. The incidence of occupational diseases showed an overall decreasing trend, which can be related to several factors--transformation of the national economy (shift from heavy industry to manufacturing industry and services), an improvement in access to occupational healthcare services, increased responsibility of employers for safe working conditions, but also a concealment of health problems by employees for fear of losing job. An exception to the decreasing trend is the automotive industry, in which the upward trend in occupational diseases occurrence was noted. The analytical part of the study focused on the relation between unemployment and occupational diseases incidence rates in different regions of the Czech Republic. In most regions, a statistically significant inverse association was shown between the rate of unemployment and occupational disease incidence. The situation is described in more detail for the Moravia-Silesia and Ustí nad Labem Regions and the Capital City of Prague, wherein a statistically significant inverse association was shown between the rate of unemployment and occupational disease incidence. The theory of marginal utility can explain the phenomenon. To certain degree of health problems, employees tend to prefer employment stability, especially if the unemployment is on rise in their region. On the other hand, if losing their job, they often try to claim benefits connected with occupational diseases.

  2. Twenty Years of Growth and Innovation: A Reflection on PACKRAT's Impact on Physician Assistant Education.

    Science.gov (United States)

    Cavanagh, Kim; Lessard, Donovan; Britt, Zach

    2015-12-01

    In its 20th year, the Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT) is a student self-assessment that can assist physician assistant (PA) students and PA program faculty in identifying strengths and areas in need of improvement in the didactic and clinical phases of PA education. In this reflection, we provide an overview of the history of PACKRAT and outline some of its benefits for students and PA programs, as well as its generative role in assessment within PA studies. Taking a broader view of PACKRAT's impact on assessment for the PA profession, we outline the research on its benefits and its use to maximize student performance, as well as how it has promoted the development of additional assessment tools.

  3. Twenty years of telemedicine in chronic disease management – an evidence synthesis

    Science.gov (United States)

    Wootton, Richard

    2012-01-01

    A literature review was conducted to obtain a high-level view of the value of telemedicine in the management of five common chronic diseases (asthma, COPD, diabetes, heart failure, hypertension). A total of 141 randomised controlled trials (RCTs) was identified, in which 148 telemedicine interventions of various kinds had been tested in a total of 37,695 patients. The value of each intervention was categorised in terms of the outcomes specified by the investigators in that trial, i.e. no attempt was made to extract a common outcome from all studies, as would be required for a conventional meta-analysis. Summarizing the value of these interventions shows, first, that most studies have reported positive effects (n = 108), and almost none have reported negative effects (n = 2). This suggests publication bias. Second, there were no significant differences between the chronic diseases, i.e. telemedicine seems equally effective (or ineffective) in the diseases studied. Third, most studies have been relatively short-term (median duration 6 months). It seems unlikely that in a chronic disease, any intervention can have much effect unless applied for a long period. Finally, there have been very few studies of cost-effectiveness. Thus the evidence base for the value of telemedicine in managing chronic diseases is on the whole weak and contradictory. PMID:22674020

  4. Collembola at three alpine subarctic sites resistant to twenty years of experimental warming

    Czech Academy of Sciences Publication Activity Database

    Alatalo, J.M.; Jägerbrand, A.K.; Čuchta, Peter

    2015-01-01

    Roč. 5, December (2015), s. 18161 ISSN 2045-2322 Institutional support: RVO:60077344 Keywords : Collembola * alpine subarctic sites * experimental warming Subject RIV: EH - Ecology, Behaviour Impact factor: 5.228, year: 2015

  5. Twenty Years of Precise Radial Velocities at Keck and Lick Observatories

    Science.gov (United States)

    Wright, J. T.

    2015-10-01

    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 is very small, but a loud minority of stars, including, apparently, HD 154345, show very strong RV-activity correlations.

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

    Science.gov (United States)

    1982-01-01

    demonstrates that conventional root canal therapy can lead to resolution of periapical cysts . The apical termination of the filling material is quite important...The Frequency and Distribution of Periapical Cysts and Granulomas. Oral Surg 25(6):861-868, 1968. 37 APPENDIX I 38 ABS TRACT various investigators have...system with healthy periapical and periodontal tissues. The dentist must reduce or eliminate toxic or irritating substances from within the root canals to

  7. Twenty-year trends in benzodiazepine dispensing in the Australian population.

    Science.gov (United States)

    Islam, M M; Conigrave, K M; Day, C A; Nguyen, Y; Haber, P S

    2014-01-01

    Considerable concern has been expressed about overprescribing of benzodiazepines and related harms. Past analyses have relied on World Health Organization-defined daily doses (DDD) which are sometimes out of keeping with clinical usage. This study examines 20-year (1992-2011) trends of benzodiazepine dispensing in Australia using both DDD and Ashton equivalent dose. Data from the Drug Utilisation Sub-Committee and the Pharmaceutical Benefits Scheme (PBS) website were analysed. Trends in number of prescriptions, DDD/1000 people/day and DDD/prescription were examined over time, and between states/territories. In the 20-year period, 174 080 904 scripts were recorded, with temazepam the most dispensed benzodiazepine (35% of scripts), followed by diazepam (23%). Overall recorded utilisation fell from 27.7 DDD/1000 people/day in 1992 to 20.8 in 2011 (24.9% decrease). There were striking changes in use of individual benzodiazepines over time, with reductions in oxazepam and flunitrazepam and dramatic increases in alprazolam. Since 1998, there has been a steady increase, albeit modest, in per script DDD. The DDD/1000 people/day for items dispensed through PBS/Repatriaton-PBS was highest in Tasmania and lowest in Northern Territory. Despite a modest overall decline in the amount of benzodiazepine dispensed, the level of use is still likely to reflect relative over-prescribing given the paucity of accepted indications for long-term use. Since 1998, there was a polynomial increase in quantity dispensed per script. The WHO-defined DDD for clonazepam seems inappropriate and could impede monitoring of its abuse. Other problems include lack of national data for medications not subsidised on PBS/Repatriation PBS. A broad policy approach is required, not one which targets only one particular benzodiazepine. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  8. Twenty years of fracture mechanics and flaw evaluation applications in the ASME Nuclear Code

    International Nuclear Information System (INIS)

    Riccardella, P.C.

    1991-01-01

    The paper presents a retrospective on the development and applications of fracture mechanics-based toughness requirements and flaw evaluation methodology in Sections III and XI of the ASME Code. Section III developments range from the rules and requirements for thick section Class 1 pressure vessels to thinner section components in other Classes. Section XI applications include flaw acceptance standards and evaluation methodology for various components ranging from pressure vessels to thins section piping of carbon and austenitic steels. The experience gained in operating plant applications of these rules and procedures are also discussed

  9. Twenty years of development and transformation in exploiting nuclear energy in the world

    International Nuclear Information System (INIS)

    Khazaneh, R.

    1992-01-01

    Problems concern to exploiting nuclear energy in the world in two decades from 1970-1990 is briefly investigated. Historical prelude of technical evolution of nuclear energy is included to be recognized the relevant events occurred in the seventies. The intention is to give general information to those who have not sufficient time to study deeply in the field

  10. 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 Ko......RV in 28 koala museum skins collected in the late 19th and 20th centuries and deep sequenced the complete proviral envelope region from five northern Australian specimens. Strikingly, KoRV env sequences were conserved among koalas collected over the span of a century, and two functional motifs that affect...... viral infectivity were fixed across the museum koala specimens. We detected only 20 env polymorphisms among the koalas, likely representing derived mutations subject to purifying selection. Among northern Australian koalas, KoRV was already ubiquitous by the late 19th century, suggesting that Ko...

  11. One Hundred Twenty Years of Koala Retrovirus Evolution Determined from Museum Skins

    OpenAIRE

    ?vila-Arcos, Mar?a C.; Ho, Simon Y.W.; Ishida, Yasuko; Nikolaidis, Nikolas; Tsangaras, Kyriakos; H?nig, Karin; Medina, Rebeca; Rasmussen, Morten; Fordyce, Sarah L.; Calvignac-Spencer, S?bastien; Willerslev, Eske; Gilbert, M. Thomas P.; Helgen, Kristofer M.; Roca, Alfred L.; Greenwood, Alex D.

    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 28 koala museum skins collected in the late 19th and 20th centuries and deep sequenced the complete proviral envelope region from five northern Australian specimens. Strikingly, KoRV env sequences we...

  12. The ASTRONET Infrastructure Roadmap: A Twenty Year Strategy for European Astronomy

    Science.gov (United States)

    Bode, M.; Monnet, G.

    2008-12-01

    The process followed by ASTRONET to build a long-term strategy for European astronomy is presented. The main conclusions and priorities given in the recently unveiled report on the Infrastructure Roadmap for the next 20 years, following the establishment of a Science Vision last year, are summarised. These reports together hopefully represent a blueprint for a bright future for European astronomy.

  13. Twenty Years of Women's Leadership: Have We Come "A Long Way, Baby?"

    Science.gov (United States)

    Boatman, Sara A.

    2007-01-01

    I'd like to share with you some thoughts from my last 20 years of leadership study and what I've come to understand during this time about women in relationship to leadership. Consider these remarks personal reflections on some of what has been written and discussed about leadership and especially about how women relate to leadership. Let's wonder…

  14. Twenty years later: Why I still believe in SU(4)-color

    International Nuclear Information System (INIS)

    Pati, J.C.

    1994-01-01

    Following some preliminary remarks of a historical nature, the recent success of the conventional approach to grand unification as regards the meeting of the coupling constants is summarized. Its shortcomings as regards the arbitrariness in the Higgs sector are noted and a case is made for an alternative approach to unification based on a purely gauge origin of the fundamental forces. This seems to call for the ideas of local supersymmetry and preons. Preonic ideas in turn seem to require SU(4)-color symmetry. The advantages of the marriage of these ideas as regards an understanding of the origins of (a) diverse mass-scales, (b) family-replication and (c) inter-family mass-hierarchy are discussed. (author). 31 refs, 2 figs

  15. Twenty Years After the 1988 Yellowstone Fires: Lessons About Disturbance and Ecosystems

    Science.gov (United States)

    Romme, W.H.; Boyce, M.S.; Gresswell, R.; Merrill, E.H.; Minshall, G.W.; Whitlock, C.; Turner, M.G.

    2011-01-01

    The 1988 Yellowstone fires were among the first in what has proven to be an upsurge in large severe fires in the western USA during the past 20 years. At the time of the fires, little was known about the impacts of such a large severe disturbance because scientists had had few previous opportunities to study such an event. Ecologists predicted short- and long-term effects of the 1988 fires on vegetation, biogeochemistry, primary productivity, wildlife, and aquatic ecosystems based on scientific understanding of the time. Twenty-plus years of subsequent study allow these early predictions to be evaluated. Most of the original predictions were at least partially supported, but some predictions were refuted, others nuanced, and a few postfire phenomena were entirely unexpected. Post-1988 Yellowstone studies catalyzed advances in ecology focused on the importance of spatial and temporal heterogeneity, contingent influences, and multiple interacting drivers. Post-1988 research in Yellowstone also has changed public perceptions of fire as an ecological process and attitudes towards fire management. Looking ahead to projected climate change and more frequent large fires, the well-documented ecological responses to the 1988 Yellowstone fires provide a foundation for detecting and evaluating potential changes in fire regimes of temperate mountainous regions. ?? 2011 Springer Science+Business Media, LLC.

  16. 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.

  17. Genetic diversity and evolution of human metapneumovirus fusion protein over twenty years

    Science.gov (United States)

    Yang, Chin-Fen; Wang, Chiaoyin K; Tollefson, Sharon J; Piyaratna, Rohith; Lintao, Linda D; Chu, Marla; Liem, Alexis; Mark, Mary; Spaete, Richard R; Crowe, James E; Williams, John V

    2009-01-01

    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. PMID:19740442

  18. Twenty years of the G protein-coupled estrogen receptor GPER: Historical and personal perspectives.

    Science.gov (United States)

    Barton, Matthias; Filardo, Edward J; Lolait, Stephen J; Thomas, Peter; Maggiolini, Marcello; Prossnitz, Eric R

    2018-02-01

    Estrogens play a critical role in many aspects of physiology, particularly female reproductive function, but also in pathophysiology, and are associated with protection from numerous diseases in premenopausal women. Steroids and the effects of estrogen have been known for ∼90 years, with the first evidence for a receptor for estrogen presented ∼50 years ago. The original ancestral steroid receptor, extending back into evolution more than 500 million years, was likely an estrogen receptor, whereas G protein-coupled receptors (GPCRs) trace their origins back into history more than one billion years. The classical estrogen receptors (ERα and ERβ) are ligand-activated transcription factors that confer estrogen sensitivity upon many genes. It was soon apparent that these, or novel receptors may also be responsible for the "rapid"/"non-genomic" membrane-associated effects of estrogen. The identification of an orphan GPCR (GPR30, published in 1996) opened a new field of research with the description in 2000 that GPR30 expression is required for rapid estrogen signaling. In 2005-2006, the field was greatly stimulated by two studies that described the binding of estrogen to GPR30-expressing cell membranes, followed by the identification of a GPR30-selective agonist (that lacked binding and activity towards ERα and ERβ). Renamed GPER (G protein-coupled estrogen receptor) by IUPHAR in 2007, the total number of articles in PubMed related to this receptor recently surpassed 1000. In this article, the authors present personal perspectives on how they became involved in the discovery and/or advancement of GPER research. These areas include non-genomic effects on vascular tone, receptor cloning, molecular and cellular biology, signal transduction mechanisms and pharmacology of GPER, highlighting the roles of GPER and GPER-selective compounds in diseases such as obesity, diabetes, and cancer and the obligatory role of GPER in propagating cardiovascular aging, arterial hypertension and heart failure through the stimulation of Nox expression. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Twenty years of staffing, practice environment, and outcomes research in military nursing.

    Science.gov (United States)

    Patrician, Patricia A; Loan, Lori A; McCarthy, Mary S; Swiger, Pauline; Breckenridge-Sproat, Sara; Brosch, Laura Ruse; Jennings, Bonnie Mowinski

    Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research. The MilNOD, in combination with evidence from other health care studies, provides nurses and leaders with information about the associations between staffing, patient outcomes, and the professional practice environment of nursing in the military. Leaders, therefore, have useful empirical evidence to make data-driven decisions. The MilNOD studies are the basis for the current Army nursing dashboard, and care delivery framework, called the Patent CaringTouch System. Future research is needed to identify ideal staffing based on workload demands, and provide leaders with factors to consider when operationalizing staffing recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. 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?

  1. Twenty Years of Cultural Imperialism Research: Some Conceptual and Methodological Problems.

    Science.gov (United States)

    Burrowes, Carl Patrick

    While the notion of "cultural imperialism" has received significant attention in communication studies since the early 1970s, researchers have ignored analyses of message systems and audience cultivation in favor of institutional analysis. Likewise, researchers have concentrated on the technologies, media products and processes of…

  2. A Short Twenty Years: Meeting the Challenges Facing Teachers Who Bring Rwanda into the Classroom

    Science.gov (United States)

    Gudgel, Mark

    2013-01-01

    As the twentieth anniversary of the 1994 genocide in Rwanda approaches, Mark Gudgel argues that we should face the challenges posed by teaching about Rwanda. Drawing on his experience as a history teacher in the US, his experience researching and supporting others' classrooms in the US and UK, his training in Holocaust education and his knowledge…

  3. Leibstadt nuclear power station (KKL): The Future after twenty years of operation

    International Nuclear Information System (INIS)

    Schoenenberger, M.

    2005-01-01

    Switzerland's largest power plant, KKL (1 165 MW BWR), is situated on the Swiss side of the Rhine River, not far from the entry of the Aare River. In 2003, the plant generated some 17% of the electricity consumed in the country. In line with the importance of the plant, it shareholders are all major Swiss power utilities. KKL was connected to the power grid in December 1984. Its construction cost amounted to approx. euro 3 200 million. After some backfitting measures at an expense of approx. euro 200 million, the plant is now in excellent technical shape. Generating costs, which were very high in the beginning, have been greatly reduced in the meantime. This was helped by a decrease of borrowed capital, the favorable development of interest rates and, above all, the rise in annual production. This, in turn, was achieved in various programs increasing plant power, and by shortening the annual revision outages. From the coming year onward, costs could be below Eurocent 3.3/kWh. Also the organization and the staff of te plant are prepared for the future. They have demonstrated their fitness in various national and international reviews. Also the political environment is favorable, by and large. In 2003, the Swiss voting population so clearly rejected the two opt-out initiatives that there has been a lasting positive change in the policy of continuing the operation of existing plants. Also for KKL, the waste management problem is still unsolved. This is due primarily to political reasons. The envisaged repository for low-level waste was rejected in a referendum in 2003. Technically and in its organization, the Leibstadt Nuclear Power Station is ready for the future. The electricity generated at Leibstadt is desired and accepted politically. (orig.)

  4. Twenty years from the start-up of A-1, the first Czechoslovak nuclear power plant

    International Nuclear Information System (INIS)

    Komarek, A.

    1992-01-01

    On the occasion of the 20th anniversary of the start-up of A-1, the first Czechoslovak nuclear power plant, some less widely known data concerning the background of its development and construction, its importance for Czechoslovak engineering, and some conclusions for the future development of the Czechoslovak power industry are presented. (author) 3 figs

  5. Twenty Years after the Velvet Revolution: Shifts in Czech Adolescents' Perceptions of Family, School, and Society

    Science.gov (United States)

    Šerek, Jan; Macek, Petr; Ježek, Stanislav; Lacinová, Lenka

    2014-01-01

    Families and schools are traditionally seen as substantial socialization agents forming adolescents' social values and their views of society. Special attention is paid to the question whether the relative importance of these influences remains stable in times of major social changes. In this study, two different generations of Czech middle…

  6. Quality of Cultural Heritage in EIA; twenty years of experience in Norway

    International Nuclear Information System (INIS)

    Lindblom, Inge

    2012-01-01

    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.

  7. 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.

  8. 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.

  9. Community integration after deployment to Afghanistan

    DEFF Research Database (Denmark)

    Karstoft, Karen-Inge; Armour, Cherie; Andersen, Søren B.

    2015-01-01

    OBJECTIVE: In the years following military deployment, soldiers may experience problems integrating into the community. However, little is known about the nature and prevalence of these problems and if they relate to posttraumatic symptomatology. METHODS: In a prospective, longitudinal study...

  10. CANDU market prospects

    International Nuclear Information System (INIS)

    Kakaria, B.K.

    1994-01-01

    This 1994 survey of prospective markets for CANDU reactors discusses prospects in Turkey, Thailand, the Philippines, Korea, Indonesia, China and Egypt, and other opportunities, such as in fuel cycles and nuclear safety. It was concluded that foreign partners would be needed to help with financing

  11. Sharpening Intertemporal Prospect Theory

    OpenAIRE

    Pushpa, Rathie; Carlos, Radavelli; Sergio, Da Silva

    2006-01-01

    Prospect theory [4] of risky choices has been extended to encompass intertemporal choices [6]. Presentation of intertemporal prospect theory suffers from minor mistakes, however [2]. To clarify the theory we restate it and show further mistakes in current presentations ([6], [2]) of value and discount functions.

  12. Energy efficiency and human activity: Past trends, future prospects

    International Nuclear Information System (INIS)

    Schipper, L.; Meyers, S.; Howarth, R.B.; Steiner, R.

    1992-01-01

    This book, sponsored by the Stockholm Environmental Institute (SEI), presents a detailed analysis of changes in world energy use over the past twenty years. It considers the future prospects of energy demand, and discusses ways of restraining growth in consumption in order to meet environmental and economic development goals. Based on a decade of research by the authors and their colleagues at Lawrence Berkeley Laboratory in collaboration with the SEI, it presents information on energy use and the forces shaping it in the industrial, developing, and formerly planned economies. Looking separately at industry, passenger travel, freight transport, and the residential and service sectors, the authors describe the impact on energy use of growth in activity, structural change, and change in energy intensities, and discuss the role of energy prices and energy conservation policies in the industrial countries and the former Soviet Union. The book presents an overview of the potential for improving energy efficiency, and discusses the policies that could help realize the potential. While calling for strong action by governments and the private sector, the authors stress the importance of considering the full range of factors that will shape realization of the energy efficiency potential around the world

  13. Is immunising all patients with chronic lung disease in the community against influenza cost effective? : Evidence from a general practice based clinical prospective cohort study in Utrecht, The Netherlands

    NARCIS (Netherlands)

    Hak, E; van Essen, G A; Buskens, E; Stalman, W; de Melker, R A

    STUDY OBJECTIVE: There is little information on the potential benefit of immunising all patients with chronic lung disease in the community against influenza. The clinical effectiveness and economic benefit was established of the influenza vaccination programme in a general practice based cohort of

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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.

  16. Evolution of the legal system of nuclear research in the European Communities

    International Nuclear Information System (INIS)

    Prelle, M.

    1977-01-01

    Twenty years after the creation of Euratom, the Treaty establishing it is analysed together with the procedures for setting up joint projects and research programmes. The projects and programmes and their results are described as are the changes in the outlook and objectives of Euratom as compared with its original concept. In view of developments in the nuclear field, from the economic, political and social angles, its legal basis has developed greater flexibility from the institutional point of view, thus enabling closer co-operation between the Member States and the Commission in the setting up of efficient and useful programmes for the Communities. (NEA) [fr

  17. The European Innovation Partnership on Active and Healthy Ageing synergies: protocol for a prospective observational study to measure the Impact of a community-based program on prevention and mitigation of frailty (ICP – PMF) in community-dwelling older adults

    NARCIS (Netherlands)

    Liotta, G.; Orfila, F.; Vollenbroek-Hutten, Miriam Marie Rosé; Roller-Winsberger, R.; Illaria, M.; Musian, D.; Alvino, S.; O'Caoimh, R.; Cano, A.; Molloy, W.; Iaccarino, G.; Marazzi, M.C.; Inzerilli, M.C.; Madaro, O.; Paul, C.; Csonka, P.; Vince, A.C.; Menditto, E.; Maggio, M.; Scarcella, P.; Gilardi, F.; Lucaroni, F.; Abete, P.; Girardi, V.; Barra, R.; Palombi, L.

    2016-01-01

    Aim of this paper is to describe the protocol of the study “Impact of a Community-based Program on Prevention and Mitigation of Frailty in community-dwelling older adults‿ developed in the framework of the European Innovation Partnership on Active and Healthy Ageing. This proposal has been developed

  18. Perceiving prospects properly

    Czech Academy of Sciences Publication Activity Database

    Steiner, Jakub; Stewart, C.

    2016-01-01

    Roč. 106, č. 7 (2016), s. 1601-1631 ISSN 0002-8282 Institutional support: RVO:67985998 Keywords : evolution * perception bias * prospect theory Subject RIV: AH - Economics Impact factor: 4.026, year: 2016

  19. 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.

  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.