de la Piedra, Maria Teresa
This article presents partial results of an ethnographic study about literacy practices among adolescents living near the United States-Mexico border. The students became involved in literacy practices with their friends and family at home. These practices were related to the adolescents' interests in popular culture such as reading magazines or…
Hamann, Edmund T.; Zuniga, Victor; Garcia, Juan Sanchez
We use 3 brief educational biographies of students in Mexico who have previously attended public school in the United States to introduce this literature review on United States-Mexico transnational students. This article is also the first of several planned articles stemming from a currently ongoing, Consejo Nacional de Ciencia y…
As a result of the agreement between the respective presidents, a joint study was undertaken to analyze the possibilities of increasing the international electricity exchange between the two countries. Responsibility for this undertaking was assigned to the United States Department of Energy (DOE) and to the Direccion de Energia de Mexico (DEM) through the Comision Federal de Electricidad (CFE). Representatives from Mexico and the US were chosen from the regional utilities along the border between the two countries and made up working groups that particiated in the study. With the support of both governments, and a high degree of cooperation between the two countries, work on the study was completed within fourteen months The completion of the study has been a major step in broadening the base of bilateral energy relations. the study highlights the opportunities for increased electricity exchanges, which could increase cooperation along the common border. Expansion of electricity interchange could offer substantial economic benefit to both countries, both directly and indirectly. Direct benefits include increased reliability of electric power and cost savings through economies of scale and diversity of peak demand patterns. Indirect benefits include improved economic and employment opportunities, especially in the border areas of both countries. This report provides background on the history of past exchanges and the characteristics of the US and Mexico electric systems, a summary of opportunities and incentives, and suggestions for procedures to remove obstacles and constraints.
Parcher, Jean W.; Humberson, Delbert G.
Colonias, which are unincorporated border settlements in the United States, have emerged in rural areas without the governance and services normally provided by local government. Colonia residents live in poverty and lack adequate health care, potable water, and sanitation systems. These conditions create substantial health risks for colonias and surrounding communities. By 2001, more than 1,400 colonias were identified in Texas. Cooperation with the U.S. Department of Housing and Urban Development, Offices of the Texas Attorney General, Secretary of State, and the Texas Water Development Board has allowed the U.S. Geological Survey (USGS) to improve colonia Geographic Information System (GIS) boundaries and develop the Colonia Health, Infrastructure, and Platting Status tool (CHIPS). Together, the GIS boundaries and CHIPS aid the Texas government in prioritizing the limited funds that are available for infrastructure improvement. CHIPS's report generator can be tailored to the needs of the user, providing either broad or specific output. For example, a congressman could use CHIPS to list colonias with wastewater issues in a specific county, whereas a health researcher could list all colonias without clinical access. To help cities along the United States-Mexico border manage issues related to colonias growth, CHIPS will become publicly available in an Internet-enabled GIS as part of a cooperative study between the USGS, the U.S. Department of Housing and Urban Development, and the Mexican Instituto Nacional de Estadistica Geografia e Informatica.
McLean, Susan F; Tyroch, Alan H
To compare demographics and motivations for falls from bridges at the United States-Mexico border and in El Paso County, Texas, and to analyze injuries and injury patterns to support intentionality and to provide treatment recommendations. A retrospective observational review was conducted of hospital admissions to a trauma center after falls from bridges from 1995 to 2009. Statistical methods used were chi-square testing, T-test for means comparison, univariate correlations, and regression analysis. Of the 97 evaluated patients, 81.4% fell from U.S.-Mexico border bridges, including one patient who fell from a railway bridge; 74.7% of those falling from border bridges had a non-U.S. address, contrasting with 22.2% of those who fell within the United States. Falls over the border were associated with more immigration-related motivations and fewer suicide attempts. Injuries included lower extremities in 76 (78.4%) and thoracolumbar spine in 27 (27.8%) patients; 16 patients with a thoracolumbar spine fracture (59.3%) also had a lower extremity injury. Mean hospital length of stay was 7.2 days. Mean injury severity score was 8.45 (range 1-43). Age, injury severity score, and pelvic fracture increased the hospital length of stay. Patients fell while emigrating-immigrating based on residence and motivating factors. A dyad of lower extremity and thoracolumbar spine injuries coincided in 59.3% of those with a thoracolumbar spine injury; thoracolumbar spine imaging of patients evaluated after falls from bridges is recommended. Proposed prevention strategies include posting signs on bridges and installing catch-net safety barriers.
Woodruff, Rachel S Yelk; Miner, Mark C; Miramontes, Roque
Consistently collected binational surveillance data are important in advocating for resources to manage and treat binational cases of tuberculosis (TB). The objective of this study was to develop a surveillance definition for binational (United States-Mexico) cases of TB to assess the burden on US TB program resources. We collaborated with state and local TB program staff members in the United States to identify characteristics associated with binational cases of TB. We collected data on all cases of TB from 9 pilot sites in 5 states (Arizona, California, Colorado, New Mexico, and Texas) during January 1-June 30, 2014, that had at least 1 binational characteristic (eg, "crossed border while on TB treatment" and "received treatment in another country, coordinated by an established, US-funded, binational TB program"). A workgroup of US state, local, and federal partners reviewed results and used them to develop a practical surveillance definition. The pilot sites reported 87 cases of TB with at least 1 binational characteristic during the project period. The workgroup drafted a proposed surveillance definition to include 2 binational characteristics: "crossed border while on TB treatment" (34 of 87 cases, 39%) and "received treatment in another country, coordinated by an established, US-funded, binational TB program" (26 of 87 cases, 30%). Applying the new proposed definition, 39 of 87 pilot cases of TB (45%) met the definition of binational. Input from partners who were responsible for the care and treatment of patients who cross the United States-Mexico border was crucial in defining a binational case of TB.
Guy R. McPherson; Jake F. Weltzin
This review evaluates the effects and importance of disturbance and climate change on plant community dynamics in the United States/Mexico borderlands region. Our primary focus is on knowledge of physiognomic-level change in grasslands and woodlands of southeastern Arizona and southwestern New Mexico. Changes in vegetation physiognomy have broad implications for...
Leiner, Marie; Puertas, Hector; Caratachea, Raúl; Avila, Carmen; Atluru, Aparna; Briones, David; Vargas, Cecilia de
To investigate the risk effects of poverty and exposure to collective violence attributed to organized crime on the mental health of children living on the United States-Mexico border. A repeated, cross-sectional study measured risk effects by comparing scores of psychosocial and behavioral problems among children and adolescents living on the border in the United States or Mexico in 2007 and 2010. Patients living in poverty who responded once to the Pictorial Child Behavior Checklist (P+CBCL) in Spanish were randomly selected from clinics in El Paso, Texas, United States (poverty alone group), and Ciudad Juarez, Chihuahua, Mexico (poverty plus violence group). Only children of Hispanic origin (Mexican-American or Mexican) living below the poverty level and presenting at the clinic for nonemergency visits with no history of diagnosed mental, neurological, or life-threatening disease or disability were included. Exposure to collective violence and poverty seemed to have an additive effect on children's mental health. Children exposed to both poverty and collective violence had higher problem scores, as measured by the P+CBCL, than those exposed to poverty alone. It is important to consider that children and adolescents exposed to collective violence and poverty also have fewer chances to receive treatment. Untreated mental health problems predict violence, antisocial behaviors, and delinquency and affect families, communities, and individuals. It is crucial to address the mental health of children on the border to counteract the devastating effects this setting will have in the short term and the near future.
Weinberg, Michelle; Hopkins, Jackie; Farrington, Leigh; Gresham, Louise; Ginsberg, Michele; Bell, Beth P
Hispanic children who live along the United States-Mexico border historically have had among the highest hepatitis A rates in the United States, but risk factors have not been well characterized. The objective of this study was to examine risk factors associated with acute hepatitis A virus (HAV) infection in Hispanic children who live along the United States-Mexico border in San Diego County, California. In this case-control study, hepatitis A cases among Hispanic children who were younger than 18 years reported from June 1998 through August 2000 were matched by age group and exposure period to Hispanic children who were susceptible to HAV infection. Participants and their families were interviewed about demographic information and potential sources of HAV infection, including attending child care, food and waterborne exposures, cross-border and other international travel, and travel-related activities. Participants included 132 children with hepatitis A and 354 control subjects. The median age of study participants was 7 years (range: 1-17). Sixty-seven percent of case-patients traveled outside the United States during the incubation period, compared with 25% of the children without hepatitis A (odds ratio [OR]: 6.3; 95% confidence interval [CI]: 4.0-9.7); all children, except 1, had traveled to Mexico. In multivariate analysis, hepatitis A was associated with having eaten food from a taco stand or street food vendor (adjusted OR: 17.0; 95% CI: 4.1-71.1) and having eaten salad/lettuce (adjusted OR: 5.2; 95% CI: 1.3-20.1) during travel. Hepatitis A among Hispanic children who live in an urban area of the United States-Mexico border is associated with cross-border travel to Mexico and food-borne exposures during travel. Travelers to areas where hepatitis A is endemic should receive hepatitis A vaccine before travel.
David F. Briones
Full Text Available We investigated the prevalence of “high” levels of depressive symptomatology and 13 health-related medical conditions in elderly Mexican American (MA and non-Hispanic white (NHW residents of El Paso County, Texas. We analyzed the extent to which depressive symptoms in this population are associated with these conditions. Elderly MA residents possessed a higher prevalence of current depression, a relatively unique health-related condition profile, and were more likely to experience a set of conditions that impede participation in daily life—conditions that we found to be strongly associated with high depressive symptomatology in the elderly. After adjusting for educational attainment, using multiple regression analyses, depression was not associated with ethnicity and only six of the health related conditions showed significant differences between MA and NHW subjects. We believe these results provide an important insight into the mechanism of health-related conditions and depressive symptomatology in a large sample of elderly MAs; and how conditions typically attributed to MA ethnicity may in actuality be an artifact of socioeconomic status variables such as educational-attainment.
de Cosío, Federico G; Díaz-Apodaca, Beatriz A; Ruiz-Holguín, Rosalba; Lara, Agustín; Castillo-Salgado, Carlos
This paper reviews and discusses the main procedures and policies that need to be followed when designing and implementing a binational survey such as the United States of America (U.S.)-Mexico Border Diabetes Prevalence Study that took place between 2001 and 2002. The main objective of the survey was to determine the prevalence of diabetes in the population 18 years of age or older along U.S.-Mexico border counties and municipalities. Several political, administrative, financial, legal, and cultural issues were identified as critical factors that need to be considered when developing and implementing similar binational projects. The lack of understanding of public health practices, implementation of existing policies, legislation, and management procedures in Mexico and the United States may delay or cancel binational research, affecting the working relation of both countries. Many challenges were identified: multiagency/multifunding, ethical/budget clearances, project management, administrative procedures, laboratory procedures, cultural issues, and project communications. Binational projects are complex; they require coordination between agencies and institutions at federal, state, and local levels and between countries and need a political, administrative, bureaucratic, cultural, and language balance. Binational agencies and staff should coordinate these projects for successful implementation.
Schneider, Eileen; Laserson, Kayla F; Wells, Charles D; Moore, Marisa
Tuberculosis (TB) is a leading public health problem and a recognized priority for the federal Governments of both Mexico and the United States of America. The objectives of this research, primarily for the four states in the United States that are along the border with Mexico, were to: (1) describe the epidemiological situation of TB, (2) identify TB risk factors, and (3) discuss tuberculosis program strategies. We analyzed tuberculosis case reports collected from 1993 through 2001 by the tuberculosis surveillance system of the United States. We used those data to compare TB cases mainly among three groups: (1) Mexican-born persons in the four United States border states (Arizona, California, New Mexico, and Texas), (2) persons in those four border states who had been born in the United States, and (3) Mexican-born persons in the 46 other states of the United States, which do not border Mexico. For the period from 1993 through 2001, of the 16 223 TB cases reported for Mexican-born persons in the United States, 12 450 of them (76.7%) were reported by Arizona, California, New Mexico, and Texas. In those four border states overall in 2001, tuberculosis case rates for Mexican-born persons were 5.0 times as high as the rates for persons born in the United States; those four states have 23 counties that directly border on Mexico, and the ratio in those counties was 5.8. HIV seropositivity, drug and alcohol use, unemployment, and incarceration were significantly less likely to be reported in Mexican-born TB patients from the four border states and the nonborder states than in patients born in the United States from the four border states (P pulmonary tuberculosis patients who were 18-64 years of age and residing in the four border states, the Mexican-born patients were 3.6 times as likely as the United States-born patients were to have resistance to at least isoniazid and rifampin (i. e., to have multidrug-resistant TB) and twice as likely to have isoniazid resistance
Kelly, Kerry; Wagner, David; Lighty, JoAnn; Quintero Núñez, Margarito; Vazquez, F Adrian; Collins, Kimberly; Barud-Zubillaga, Alberto
The investigators developed a system to measure black carbon (BC) and particle-bound polycyclic aromatic hydrocarbon (PAH) emission factors during roadside sampling in four cities along the United States-Mexico border, Calexico/Mexicali and El Paso/Juarez. The measurement system included a photoacoustic analyzer for BC, a photoelectric aerosol sensor for particle-bound PAHs, and a carbon dioxide (CO2) analyzer. When a vehicle with measurable emissions passed the system probe, corresponding BC, PAH, and CO2 peaks were evident, and a fuel-based emission factor was estimated. A picture of each vehicle was also recorded with a digital camera. The advantage of this system, compared with other roadside methods, is the direct measurement of particulate matter components and limited interference from roadside dust. The study revealed some interesting trends: Mexican buses and all medium-duty trucks were more frequently identified as high emitters of BC and PAH than heavy-duty trucks or passenger vehicles. In addition, because of the high daily mileage of buses, they are good candidates for additional study. Mexican trucks and buses had higher average emission factors compared with U.S. trucks and buses, but the differences were not statistically significant. Few passenger vehicles had measurable BC and PAH emissions, although the highest emission factor came from an older model passenger vehicle licensed in Baja California.
William R. Radke
Many conservation strategies have been developed by the U.S. Fish and Wildlife Service in cooperation with others to protect habitat and enhance the recovery of fish and wildlife populations in the San Bernardino Valley, which straddles Arizona, United States, and Sonora, Mexico. Habitats along this international border have been impacted by illegal activities,...
Brady, Laura Margaret; Gray, Floyd; Castaneda, Mario; Bultman, Mark; Bolm, Karen Sue
The United States - Mexico border area faces the challenge of integrating aspects of its binational physical boundaries to form a unified or, at least, compatible natural resource management plan. Specified geospatial components such as stream drainages, mineral occurrences, vegetation, wildlife, and land-use can be analyzed in terms of their overlapping impacts upon one another. Watersheds have been utilized as a basic unit in resource analysis because they contain components that are interrelated and can be viewed as a single interactive ecological system. In developing and analyzing critical regional natural resource databases, the Environmental Protection Agency (EPA) and other federal and non-governmental agencies have adopted a ?watershed by watershed? approach to dealing with such complicated issues as ecosystem health, natural resource use, urban growth, and pollutant transport within hydrologic systems. These watersheds can facilitate the delineation of both large scale and locally important hydrologic systems and urban management parameters necessary for sustainable, diversified land-use. The twin border cities area of Nogales, Sonora and Nogales, Arizona, provide the ideal setting to demonstrate the utility and application of a complete, cross-border, geographic information systems (GIS) based, watershed analysis in the characterization of a wide range of natural resource as well as urban features and their interactions. In addition to the delineation of a unified, cross-border watershed, the database contains sewer/water line locations and status, well locations, geology, hydrology, topography, soils, geomorphology, and vegetation data, as well as remotely sensed imagery. This report is preliminary and part of an ongoing project to develop a GIS database that will be widely accessible to the general public, researchers, and the local land management community with a broad range of application and utility.
Full Text Available ABSTRACT Childhood obesity is an important public health problem that affects countries in the Americas. In 2014, Pan American Health Organization (PAHO Member States agreed on a Plan of Action for the Prevention of Obesity in Children and Adolescents in an effort to address the impact of this disorder in the Americas region. The interventions laid out in this regional plan are multi-faceted and require multi-sectoral partnerships. Building on a strong history of successful trilateral collaboration, Canada, Mexico, and the United States formed a partnership to address the growing epidemic of childhood obesity in the North American region. This collaborative effort, known as the Trilateral Cooperation on Childhood Obesity Initiative, is the first initiative in the region to address chronic noncommunicable diseases by bringing together technical and policy experts, with strong leadership and support from the secretaries and ministers of health. The Initiative’s goals include increasing levels of physical activity and reducing sedentary behavior through 1 increased social mobilization and citizen engagement, 2 community- based outreach, and 3 changes to the built (man-made environment. This article describes the background and development process of the Initiative; specific goals, activities, and actions achieved to date; and opportunities and next steps. This information may be useful for those forming other partnerships designed to address childhood obesity or other complex public health challenges in the region.
Barton Behravesh, C; Mayberry, L F; Bristol, J R; Cardenas, V M; Mena, K D; Martínez-Ocaña, J; Flisser, A; Snowden, K F
Taenia solium and T. saginata are zoonotic tapeworms of substantial medical and economic importance. Although human taeniasis is widely recognised as an endemic problem in Mexico, its presence in the United States is poorly understood. The first population-based study to estimate the prevalence of human infection with Taenia tapeworms along the Texas-Mexico border has recently been conducted. Households were interviewed in the Texan city of El Paso and in the neighbouring Ciudad Juárez, in Mexico. Faecal samples from household members were then checked for Taenia eggs by flotation and/or for Taenia copro-antigens in an ELISA. The overall prevalence of taeniasis in this border region was found to be 3% but, compared with the residents of Juárez, El Paso residents were 8.6-fold more likely to be tapeworm carriers. The interviews revealed some important differences between the two study sites, particularly the more frequent use of anthelminthic drugs on the Mexican side of the border. These findings have implications in terms of the planning of effective health-education campaigns to decrease the prevalence of taeniasis in the human populations along the Texas-Mexico border.
Ghaddar, Suad; Brown, Cynthia J; Pagán, José A; Díaz, Violeta
To explore the relationship between acculturation and healthy lifestyle habits in the largely Hispanic populations living in underserved communities in the United States of America along the U.S.-Mexico border. A cross-sectional study was conducted from April 2006 to June 2008 using survey data from the Alliance for a Healthy Border, a program designed to reduce health disparities in the U.S.-Mexico border region by funding nutrition and physical activity education programs at 12 federally qualified community health centers in Arizona, California, New Mexico, and Texas. The survey included questions on acculturation, diet, exercise, and demographic factors and was completed by 2,381 Alliance program participants, of whom 95.3% were Hispanic and 45.4% were under the U.S. poverty level for 2007. Chi-square (χ2) and Student's t tests were used for bivariate comparisons between acculturation and dietary and physical activity measures. Linear regression and binary logistic regression were used to control for factors associated with nutrition and exercise. Based on univariate tests and confirmed by regression analysis controlling for sociodemographic and health variables, less acculturated survey respondents reported a significantly higher frequency of fruit and vegetable consumption and healthier dietary habits than those who were more acculturated. Adjusted binary logistic regression confirmed that individuals with low language acculturation were less likely to engage in physical activity than those with moderate to high acculturation (odds ratio 0.75, 95% confidence interval 0.59-0.95). Findings confirmed an association between acculturation and healthy lifestyle habits and supported the hypothesis that acculturation in border community populations tends to decrease the practice of some healthy dietary habits while increasing exposure to and awareness of the importance of other healthy behaviors.
Vargas Bustamante, Arturo; Laugesen, Miriam; Caban, Mabel; Rosenau, Pauline
While U.S. health care reform will most likely reduce the overall number of uninsured Mexican-Americans, it does not address challenges related to health care coverage for undocumented Mexican immigrants, who will remain uninsured under the measures of the reform; documented low-income Mexican immigrants who have not met the five-year waiting period required for Medicaid benefits; or the growing number of retired U.S. citizens living in Mexico, who lack easy access to Medicare-supported services. This article reviews two promising binational initiatives that could help address these challenges-Salud Migrante and Medicare in Mexico; discusses their prospective applications within the context of U.S. health care reform; and identifies potential challenges to their implementation (legal, political, and regulatory), as well as the possible benefits, including coverage of uninsured Mexican immigrants, and their integration into the U.S. health care system (through Salud Migrante), and access to lower-cost Medicare-supported health care for U.S. retirees in Mexico (Medicare in Mexico).
Rabadán-Diehl, Cristina; Safdie, Margarita; Rodin, Rachel
Childhood obesity is an important public health problem that affects countries in the Americas. In 2014, Pan American Health Organization (PAHO) Member States agreed on a Plan of Action for the Prevention of Obesity in Children and Adolescents in an effort to address the impact of this disorder in the Americas region. The interventions laid out in this regional plan are multi-faceted and require multi-sectoral partnerships. Building on a strong history of successful trilateral collaboration, Canada, Mexico, and the United States formed a partnership to address the growing epidemic of childhood obesity in the North American region. This collaborative effort, known as the Trilateral Cooperation on Childhood Obesity Initiative, is the first initiative in the region to address chronic noncommunicable diseases by bringing together technical and policy experts, with strong leadership and support from the secretaries and ministers of health. The Initiative's goals include increasing levels of physical activity and reducing sedentary behavior through 1) increased social mobilization and citizen engagement, 2) community- based outreach, and 3) changes to the built (man-made) environment. This article describes the background and development process of the Initiative; specific goals, activities, and actions achieved to date; and opportunities and next steps. This information may be useful for those forming other partnerships designed to address childhood obesity or other complex public health challenges in the region. RESUMEN La obesidad infantil es un problema de salud pública importante que afecta a los países de las Américas. En el 2014, los Estados Miembros de la Organización Panamericana de la Salud (OPS) acordaron un Plan de acción para la prevención de la obesidad en la niñez y la adolescencia con el fin de hacer frente a las repercusiones de este trastorno en la Región de las Américas. Las intervenciones que componen este plan regional son multifacéticas y
Norman, Laura M.; Donelson, Angela J.; Pfeifer, Edwin L.; Lam, Alven H.; Osborn, Kenneth J.
The U.S. Department of Housing and Urban Development (HUD) and the U.S. Geological Survey (USGS) have developed a joint project to create Internet-enabled geographic information systems (GIS) that will help cities along the United States-Mexico border deal with issues related to colonias. HUD defines colonias as rural neighborhoods in the United States-Mexico border region that lack adequate infrastructure or housing and other basic services. They typically have high poverty rates that make it difficult for residents to pay for roads, sanitary water and sewer systems, decent housing, street lighting, and other services through assessment. Many Federal agencies recognize colonias designations and provide funding assistance. It is the intention of this project to empower Arizona-Sonora borderland neighborhoods and community members by recognizing them as colonias. This recognition will result in eligibility for available economic subsidies and accessibility to geospatial tools and information for urban planning. The steps to achieve this goal include delineation of colonia-like neighborhoods, identification of their urbanization over time, development of geospatial databases describing their infrastructure, and establishment of a framework for distributing Web-based GIS decision support systems. A combination of imagery and infrastructure information was used to help delineate colonia boundaries. A land-use change analysis, focused on urbanization in the cities over a 30-year timeframe, was implemented. The results of this project are being served over the Internet, providing data to the public as well as to participating agencies. One of the initial study areas for this project was the City of Douglas, Ariz., and its Mexican sister-city Agua Prieta, Sonora, which are described herein. Because of its location on the border, this twin-cities area is especially well suited to international manufacturing and commerce, which has, in turn, led to an uncontrolled spread of
Aristizabal, Paula; Fuller, Spencer; Rivera, Rebeca; Beyda, David; Ribeiro, Raul C; Roberts, William
In 2007, the 5-year survival rate for children with acute leukemia in Baja California, Mexico was estimated at 10% (vs. 88% in the United States). In response, stakeholders at St. Jude Children's Research Hospital, Rady Children's Hospital San Diego, and the Hospital General de Tijuana (HGT) implemented a transcultural partnership to establish a pediatric oncology program. The aim was to improve clinical outcomes and overall survival for children in Baja California. An initial needs assessment evaluation was performed and a culturally sensitive, comprehensive, 5-year plan was designed and implemented. After six years, healthcare system accomplishments include the establishment of a fully functional pediatric oncology unit with 60 new healthcare providers (vs. five in 2007). Patient outcome improvements include a rise in 5-year survival for leukemia from 10 to 43%, a rise in new cases diagnosed per year from 21 to 70, a reduction in the treatment abandonment rate from 10% to 2%, and a 45% decrease in the infection rate. More than 600 patients have benefited from this program. Knowledge sharing has taken place between teams at the HGT and Rady Children's Hospital San Diego. Further, one of the most significant outcomes is that the HGT has transitioned into a regional referral center and now mentors other hospitals in Mexico. Our results show that collaborative initiatives that implement long-term partnerships along the United States-Mexico border can effectively build local capacity and reduce the survival gap between children with cancer in the two nations. Long-term collaborative partnerships should be encouraged across other disciplines in medicine to further reduce health disparities across the United States-Mexico border.
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Full Text Available OBJECTIVES: Tuberculosis (TB is a leading public health problem and a recognized priority for the federal Governments of both Mexico and the United States of America. The objectives of this research, primarily for the four states in the United States that are along the border with Mexico, were to: (1 describe the epidemiological situation of TB, (2 identify TB risk factors, and (3 discuss tuberculosis program strategies. METHODS: We analyzed tuberculosis case reports collected from 1993 through 2001 by the tuberculosis surveillance system of the United States. We used those data to compare TB cases mainly among three groups: (1 Mexican-born persons in the four United States border states (Arizona, California, New Mexico, and Texas, (2 persons in those four border states who had been born in the United States, and (3 Mexican-born persons in the 46 other states of the United States, which do not border Mexico. RESULTS: For the period from 1993 through 2001, of the 16 223 TB cases reported for Mexican-born persons in the United States, 12 450 of them (76.7% were reported by Arizona, California, New Mexico, and Texas. In those four border states overall in 2001, tuberculosis case rates for Mexican-born persons were 5.0 times as high as the rates for persons born in the United States; those four states have 23 counties that directly border on Mexico, and the ratio in those counties was 5.8. HIV seropositivity, drug and alcohol use, unemployment, and incarceration were significantly less likely to be reported in Mexican-born TB patients from the four border states and the nonborder states than in patients born in the United States from the four border states (P OBJETIVOS: La tuberculosis es un problema de salud pública importante y es una prioridad reconocida por los gobiernos federales de México y Estados Unidos de América. Los objetivos de la presente investigación fueron los siguientes, atendiendo específicamente a los cuatro estados de los
Alley, William M.
Transboundary aquifers are an essential, and in many cases, singular source of water for United States – Mexico border communities, particularly in arid regions. Declining water levels, deteriorating water quality, and increasing use of groundwater resources by municipal, industrial, and agricultural water users on both sides of the international border have raised concerns about the long-term availability of this supply. Water quantity and quality are determining and limiting factors that ultimately control agriculture, future economic development, population growth, human health, and ecological conditions along the border. Knowledge about the extent, depletion rates, and quality of transboundary aquifers, however, is limited and, in some areas, completely absent. The U.S. – Mexico Transboundary Aquifer Assessment Act (Public Law 109-448), referred to in this report as “the Act,” was signed into law by the President of the United States on December 22, 2006, to conduct binational scientific research to systematically assess priority transboundary aquifers and to address water information needs of border communities. The Act authorizes the Secretary of the Interior, through the U.S. Geological Survey (USGS), to collaborate with the States of Arizona, New Mexico, and Texas through their Water Resources Research Institutes (WRRIs) and with the International Boundary and Water Commission (IBWC), stakeholders, and Mexican counterparts to provide new information and a scientific foundation for State and local officials to address pressing water-resource challenges along the U.S. – Mexico border.
Parcher, J.W.; Humberson, D.G.
Colonias, which are unincorporated border setdements in the United. States, have emerged in rural areas without the governance and services normally provided by local government. Colonia residents live in poverty and lack adequate health care, potable water, and sanitation systems. These conditions create substantial health risks for themselves and surrounding communities. By 2001, more than 1,400 colonias were identified in Texas. Cooperation with several Federal and Texas state agencies has allowed the U.S. Geological Survey (USGS) to improve colonia Geographic Information System (GIS) boundaries and develop the Colonia Health, Infrastructure, and Platting Status tool (CHIPS). Together, the GIS boundaries and CHIPS aid the Texas government in prioritizing the limited funds that are available for infrastructure improvement. CHIPS's report: generator can be tailored, to the needs of the user, providing either broad or specific output. CHIPS is publicly available on the U.S. Geological Survey Border Environmental Health Initiative website at http://borderhealth.cr. usgs.gov.
Kuhns, Hampden; Knipping, Eladio M; Vukovich, Jeffrey M
The Big Bend Regional Aerosol and Visibility Observational (BRAVO) Study was commissioned to investigate the sources of haze at Big Bend National Park in southwest Texas. The modeling domain of the BRAVO Study includes most of the continental United States and Mexico. The BRAVO emissions inventory was constructed from the 1999 National Emission Inventory for the United States, modified to include finer-resolution data for Texas and 13 U.S. states in close proximity. The first regional-scale Mexican emissions inventory designed for air-quality modeling applications was developed for 10 northern Mexican states, the Tula Industrial Park in the state of Hidalgo, and the Popocatépetl volcano in the state of Puebla. Emissions data were compiled from numerous sources, including the U.S. Environmental Protection Agency (EPA), the Texas Natural Resources Conservation Commission (now Texas Commission on Environmental Quality), the Eastern Research Group, the Minerals Management Service, the Instituto Nacional de Ecología, and the Instituto Nacional de Estadistica Geografía y Informática. The inventory includes emissions for CO, nitrogen oxides, sulfur dioxide, volatile organic compounds (VOCs), ammonia, particulate matter (PM) < 10 microm in aerodynamic diameter, and PM < 2.5 microm in aerodynamic diameter. Wind-blown dust and biomass burning were not included in the inventory, although high concentrations of dust and organic PM attributed to biomass burning have been observed at Big Bend National Park. The SMOKE modeling system was used to generate gridded emissions fields for use with the Regional Modeling System for Aerosols and Deposition (REMSAD) and the Community Multiscale Air Quality model modified with the Model of Aerosol Dynamics, Reaction, Ionization and Dissolution (CMAQ-MADRID). The compilation of the inventory, supporting model input data, and issues encountered during the development of the inventory are documented. A comparison of the BRAVO emissions
Joseph Robert Fitchett
Full Text Available In this era of increasing drug resistance among infectious diseases such as tuberculosis (TB, the complex population dynamics of border areas must be monitored more extensively. TB remains a major public health threat; its antimicrobial treatment is long; and the only vaccine licensed in the world, live-attenuated Mycobacterium bovis Bacille Calmette-Guérin (BCG, exhibits varying efficacy. In addition to epidemiological surveillance, the underlying determinants contributing to the health and wellbeing of populations are of key importance. Although it received heightened attention in the past, tuberculosis transmission in the United States-Mexico border area demands renewed interest. Lessons learned should be applied to similar areas around the globe.En esta época en la que cada vez es mayor la farmacorresistencia de enfermedades infecciosas como la tuberculosis, es preciso vigilar más ampliamente la compleja dinámica de la población de las zonas fronterizas. La tuberculosis sigue siendo un problema muy importante de salud pública, el tratamiento antimicrobiano es prolongado y la vacuna BCG (Bacilo de Calmette-Guérin -la única autorizada en el mundo, elaborada con bacilos atenuados de Mycobacterium bovis- tiene eficacia variable. Además de la vigilancia epidemiológica, revisten suma importancia los determinantes fundamentales que inciden en la salud y el bienestar de las poblaciones. Si bien la transmisión transfronteriza de la tuberculosis entre México y los Estados Unidos recibió gran atención en el pasado, la situación actual exige renovar el interés por este tema. Es necesario aplicar las lecciones aprendidas en zonas similares del resto del mundo.
Michele T Jay-Russell
Full Text Available In 2010, Romaine lettuce grown in southern Arizona was implicated in a multi-state outbreak of Escherichia coli O145:H28 infections. This was the first known Shiga toxin-producing E. coli (STEC outbreak traced to the southwest desert leafy green vegetable production region along the United States-Mexico border. Limited information exists on sources of STEC and other enteric zoonotic pathogens in domestic and wild animals in this region. According to local vegetable growers, unleashed or stray domestic dogs and free-roaming coyotes are a significant problem due to intrusions into their crop fields. During the 2010-2011 leafy greens growing season, we conducted a prevalence survey of STEC and Salmonella presence in stray dog and coyote feces. Fresh fecal samples from impounded dogs and coyotes from lands near produce fields were collected and cultured using extended enrichment and serogroup-specific immunomagnetic separation (IMS followed by serotyping, pulsed-field gel electrophoresis (PFGE, and antimicrobial susceptibility testing. A total of 461 fecal samples were analyzed including 358 domestic dog and 103 coyote fecals. STEC was not detected, but atypical enteropathogenic E. coli (aEPEC strains comprising 14 different serotypes were isolated from 13 (3.6% dog and 5 (4.9% coyote samples. Salmonella was cultured from 33 (9.2% dog and 33 (32% coyote samples comprising 29 serovars with 58% from dogs belonging to Senftenberg or Typhimurium. PFGE analysis revealed 17 aEPEC and 27 Salmonella distinct pulsotypes. Four (22.2% of 18 aEPEC and 4 (6.1% of 66 Salmonella isolates were resistant to two or more antibiotic classes. Our findings suggest that stray dogs and coyotes in the desert southwest may not be significant sources of STEC, but are potential reservoirs of other pathogenic E. coli and Salmonella. These results underscore the importance of good agriculture practices relating to mitigation of microbial risks from animal fecal deposits in the
Full Text Available Abstract Background Epidemiological studies show wide variability in the occurrence of cannabis smoking and related disorders across countries. This study aims to estimate cross-national variation in cannabis users' experience of clinically significant cannabis-related problems in three countries of the Americas, with a focus on cannabis users who may have tried alcohol or tobacco, but who have not used cocaine, heroin, LSD, or other internationally regulated drugs. Methods Data are from the World Mental Health Surveys Initiative and the National Latino and Asian American Study, with probability samples in Mexico (n = 4426, Colombia (n = 5,782 and the United States (USA; n = 8,228. The samples included 212 'cannabis only' users in Mexico, 260 in Colombia and 1,724 in the USA. Conditional GLM with GEE and 'exact' methods were used to estimate variation in the occurrence of clinically significant problems in cannabis only (CO users across these surveyed populations. Results The experience of cannabis-related problems was quite infrequent among CO users in these countries, with weighted frequencies ranging from 1% to 5% across survey populations, and with no appreciable cross-national variation in general. CO users in Colombia proved to be an exception. As compared to CO users in the USA, the Colombia smokers were more likely to have experienced cannabis-associated 'social problems' (odds ratio, OR = 3.0; 95% CI = 1.4, 6.3; p = 0.004 and 'legal problems' (OR = 9.7; 95% CI = 2.7, 35.2; p = 0.001. Conclusions This study's most remarkable finding may be the similarity in occurrence of cannabis-related problems in this cross-national comparison within the Americas. Wide cross-national variations in estimated population-level cumulative incidence of cannabis use disorders may be traced to large differences in cannabis smoking prevalence, rather than qualitative differences in cannabis experiences. More research is needed to identify conditions that
Blitvich, Bradley J; Fernández-Salas, Ildefonso; Contreras-Cordero, Juan F; Loroño-Pino, María A; Marlenee, Nicole L; Díaz, Francisco J; González-Rojas, José I; Obregón-Martínez, Nelson; Chiu-García, Jorge A; Black, William C; Beaty, Barry J
West Nile virus RNA was detected in brain tissue from a horse that died in June 2003 in Nuevo Leon State, Mexico. Nucleotide sequencing and phylogenetic analysis of the premembrane and envelope genes showed that the virus was most closely related to West Nile virus isolates collected in Texas in 2002.
De La Torre-Roche, Roberto J.; Lee, Wen-Yee; Campos-Díaz, Sandra I.
Ultrasonic extraction followed by Stir Bar Sorptive Extraction (SBSE) and thermal desorption inline coupled with Gas Chromatography and Mass Spectrometry (TD/GC/MS)was used to perform a comprehensive determination of soil-borne polycyclic aromatic hydrocarbons (PAHs) in El Paso, Texas. The method provided good sensitivity and faster processing time for the analysis. The total PAHs in El Paso soil ranged from 0.1 to 2225.5 µg kg−1. Although the majority of PAH concentrations did not exceed the soil screening levels regulated by the United States Environmental Protection Agency, the existence of PAHs in this ecosystem is ubiquitous. Naphthalene were found in 100% of the soil samples; while the heavy PAHs (five- and six-ring) were not often detected and mostly remained in closer proximity to industrial areas and major traffic points. The results ruled out the possibility of petroleum refining as the significant source of local soil-borne PAH contamination, but they suggested that the PAHs found in El Paso soil were closely linked to human activities and possible other industrial processes. PMID:18768257
Injuries sustained after falls from bridges across the United States-Mexico border at El Paso Traumatismos por caídas desde puentes que atraviesan la frontera entre México y los Estados Unidos en El Paso
Susan F. McLean
Full Text Available OBJECTIVE: To compare demographics and motivations for falls from bridges at the United States-Mexico border and in El Paso County, Texas, and to analyze injuries and injury patterns to support intentionality and to provide treatment recommendations. METHODS: A retrospective observational review was conducted of hospital admissions to a trauma center after falls from bridges from 1995 to 2009. Statistical methods used were chi-square testing, T-test for means comparison, univariate correlations, and regression analysis. RESULTS: Of the 97 evaluated patients, 81.4% fell from U.S.-Mexico border bridges, including one patient who fell from a railway bridge; 74.7% of those falling from border bridges had a non-U.S. address, contrasting with 22.2% of those who fell within the United States. Falls over the border were associated with more immigration-related motivations and fewer suicide attempts. Injuries included lower extremities in 76 (78.4% and thoracolumbar spine in 27 (27.8% patients; 16 patients with a thoracolumbar spine fracture (59.3% also had a lower extremity injury. Mean hospital length of stay was 7.2 days. Mean injury severity score was 8.45 (range 1-43. Age, injury severity score, and pelvic fracture increased the hospital length of stay. CONCLUSIONS: Patients fell while emigrating-immigrating based on residence and motivating factors. A dyad of lower extremity and thoracolumbar spine injuries coincided in 59.3% of those with a thoracolumbar spine injury; thoracolumbar spine imaging of patients evaluated after falls from bridges is recommended. Proposed prevention strategies include posting signs on bridges and installing catch-net safety barriers.OBJETIVO: Comparar la información demográfica y las motivaciones relacionadas con las caídas desde puentes que atraviesan la frontera entre México y los Estados Unidos en el condado de El Paso, Texas; analizar las lesiones y los patrones de lesiones que avalan la intencionalidad; y
International Boundary & Water Commission — This dataset was created to provide resource managers, public officials, researchers, and the general public with ready access to the location of the international...
Childhood asthma along the United States/ Mexico border: hospitalizations and air quality in two California counties El asma infantil en la frontera mexicana-estadounidense: hospitalizaciones y calidad del aire ambiental en dos condados de California
Paul B English
Full Text Available Since the passage of the North American Free Trade Agreement in 1993, there has been an increasing need to monitor environmental health trends that may be related to the rapid industrialization of the United States/Mexico border. We studied two counties on the California/Baja California border to obtain baseline data on trends in childhood asthma hospitalizations and two pollutants that aggravate asthma, ozone and particulate matter (less than 10 microns in diameter, from 1983 to 1994. Hospital discharge records of children 14 years and younger were analyzed, and rates by county, race, and sex were age-adjusted to the 1990 California population. Data on five ozone and particulate matter indices obtained from the California Environmental Protection Agency were used. Imperial County had the highest childhood asthma hospitalization rates in California for non-Hispanic whites and African-Americans, and the second highest for Hispanics. San Diego County had rates below the state average. Over the time period examined, rates in Imperial County increased 59%, while those in San Diego County decreased 9%. Maximum ozone levels increased 64% in Imperial County but decreased 46% in San Diego County. Particulate matter levels were four times higher in Imperial than in San Diego County. High rates of childhood asthma hospitalizations in Imperial County may be partially related to high levels of poverty and worsening air quality conditions produced by increased burdens on the local airshed. Asthma prevalence surveys and binational time-series analyses examining asthma-pollutant relationships are needed.Desde que se firmó el Tratado de Libre Comercio en 1993, ha aumentado la necesidad de monitorear problemas de salud que podrían relacionarse con la rápida industrialización de la frontera mexicana-estadounidense. Estudiamos dos condados de la fontera entre California y Baja California con objeto de obtener datos de base sobre las tendencias observadas de
Children's mental health and collective violence: a binational study on the United States-Mexico border Salud mental infantil y violencia colectiva: un estudio binacional en la frontera entre México y los Estados Unidos
Full Text Available OBJECTIVE: To investigate the risk effects of poverty and exposure to collective violence attributed to organized crime on the mental health of children living on the United States-Mexico border. METHODS: A repeated, cross-sectional study measured risk effects by comparing scores of psychosocial and behavioral problems among children and adolescents living on the border in the United States or Mexico in 2007 and 2010. Patients living in poverty who responded once to the Pictorial Child Behavior Checklist (P+CBCL in Spanish were randomly selected from clinics in El Paso, Texas, United States (poverty alone group, and Ciudad Juarez, Chihuahua, Mexico (poverty plus violence group. Only children of Hispanic origin (Mexican-American or Mexican living below the poverty level and presenting at the clinic for nonemergency visits with no history of diagnosed mental, neurological, or life-threatening disease or disability were included. RESULTS: Exposure to collective violence and poverty seemed to have an additive effect on children's mental health. Children exposed to both poverty and collective violence had higher problem scores, as measured by the P+CBCL, than those exposed to poverty alone. CONCLUSIONS: It is important to consider that children and adolescents exposed to collective violence and poverty also have fewer chances to receive treatment. Untreated mental health problems predict violence, antisocial behaviors, and delinquency and affect families, communities, and individuals. It is crucial to address the mental health of children on the border to counteract the devastating effects this setting will have in the short term and the near future.OBJETIVO: Investigar los efectos del riesgo de pobreza y la exposición a la violencia colectiva atribuida al crimen organizado sobre la salud mental de los niños que viven en la frontera entre México y los Estados Unidos. MÉTODOS: En este estudio transversal seriado se midieron los efectos del riesgo
Karen J. Coleman
Full Text Available OBJECTIVE: To study overweight and aerobic fitness among children in the third and fourth grades of elementary schools in a city in the United States of America (El Paso, Texas and a city in Mexico (Chihuahua, Chihuahua that are on or near the border between those two countries, and to compare the results from those two cities with earlier findings for other children in the United States. METHODS: We followed the El Paso children (427 boys and 385 girls, 93% of them of Mexican descent from third to fourth grade and assessed the change in their body mass index (BMI. In the city of Chihuahua we cross-sectionally measured the BMI of a sample of third grade children (221 boys and 237 girls and a sample of fourth grade children (268 boys and 215 girls. BMI and triceps skinfolds were measured for all the children studied in the two cities. BMI was used to assess risk for overweight (at least the 85th percentile BMI for age and gender and overweight (at least the 95th percentile BMI for age and gender in all the children. The distance that El Paso children ran in nine minutes was used to assess their aerobic fitness (aerobic fitness was not measured in the Chihuahua children. The data from El Paso were collected in 1999, 2000, and 2001, and the Chihuahua data were collected in 2000 and 2001. RESULTS: In the El Paso boys, overweight significantly increased in the one year from third grade to fourth grade, from 22% to 28%, while risk for overweight significantly increased, from 37% to 44%. In the El Paso girls, risk for overweight significantly increased over the same one-year period, from 29% to 37%. The El Paso boys and girls were significantly less fit when compared to samples of children from throughout the United States. Third and fourth grade children from Chihuahua had similar rates of risk for overweight and of overweight when compared to the children from the same grades in El Paso. CONCLUSIONS: Children in both El Paso and Chihuahua were more
Disparities in undiagnosed diabetes among United States-Mexico border populations Disparidades en la prevalencia de diabetes no diagnosticada en las poblaciones residentes en la frontera México-Estados Unidos
Full Text Available OBJECTIVE: To compare the prevalence of undiagnosed diabetes among populations with diabetes living on the United States (U.S.-Mexico border, examine explanations for differences between groups, and investigate differences in metabolic outcomes by diagnosis status. METHODS: Data come from the U.S.-Mexico Border Diabetes Prevention and Control Project survey (2001-2002, which used a stratified, multistage design. The sample included 603 adults (18 years or older with diabetes. Undiagnosed diabetes was defined as a fasting plasma glucose (FPG value of > 126 mg/dL and no report of diagnosis. Logistic regression was used to compare the odds of being undiagnosed among border populations with diabetes. Metabolic outcomes included FPG, glycosylated hemoglobin, and mean arterial blood pressure. RESULTS: One in four adults with diabetes (25.9% living on the U.S.-Mexico border was undiagnosed. Mexicans (43.8% and Mexican immigrants (39.0% with diabetes were significantly more likely to be undiagnosed than were U.S.-born Hispanics (15.0%; P OBJETIVO: Comparar la prevalencia de diabetes no diagnosticada en la población con diabetes residente en la zona fronteriza entre México y los Estados Unidos; intentar explicar las diferencias entre grupos, e investigar las diferencias de los resultados metabólicos según la situación diagnóstica. MÉTODOS: Los datos proceden de la encuesta del Proyecto de Prevención y Control de la Diabetes en la Frontera México-Estados Unidos (2001-2002, que utilizó un diseño estratificado polietápico. La muestra incluyó a 603 adultos (> 18 años con diabetes. Se definió como diabetes no diagnosticada una glucemia plasmática en ayunas > 126 mg/dl sin diagnóstico previo. Se utilizó un modelo de regresión logística para comparar la probabilidad de que la diabetes no fuera diagnosticada en las poblaciones fronterizas. Los resultados metabólicos incluyeron la glucemia plasmática en ayunas, la hemoglobina glicosilada (Hb
Full Text Available OBJETIVE: To examine the relationship between access to health care and undiagnosed diabetes among the high-risk, vulnerable population in the border region between the United States of America and Mexico. METHODS: Using survey and fasting plasma glucose data from Phase I of the U.S.-Mexico Border Diabetes Prevention and Control Project (February 2001 to October 2002, this epidemiological study identified 178 adults 18-64 years old with undiagnosed diabetes, 326 with diagnosed diabetes, and 2 966 without diabetes. Access to health care among that sample (n = 3 470, was assessed by type of health insurance coverage (including "none", number of health care visits over the past year, routine pattern of health care utilization, and country of residence. RESULTS: People with diabetes who had no insurance and no place to go for routine health care were more likely to be undiagnosed than those with insurance and a place for routine health care (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.0-6.6, and OR 4.5, 95% CI 1.4-14.1, respectively. When stratified by country, the survey data showed that on the U.S. side of the border there were more people with undiagnosed diabetes if they were 1 uninsured versus the insured (28.9%, 95% CI 11.5%-46.3%, versus 9.1%, 95% CI 1.5%-16.7%, respectively and if they 2 had made no visits or 1-3 visits to a health care facility in the past year versus had made > 4 visits (40.8%, 95% CI 19.6%-62.0%, and 23.4%, 95% CI 9.9%-36.9%, respectively, versus 2.4%, 95% CI -0.9%-5.7% (all, P OBJETIVO: Examinar la relación entre el acceso a la atención de salud y la diabetes no diagnosticada en la población de alto riesgo y vulnerable de la zona fronteriza entre México y los Estados Unidos. MÉTODOS: Mediante el uso de los datos de la encuesta y de la glucosa plasmática en ayunas de la fase I del Proyecto de Prevención y Control de la Diabetes en la Frontera México-Estados Unidos (de febrero del 2001 a octubre del 2002
Norman, L.M.; Feller, M.; Phillip, Guertin D.
The sister-city area of Nogales, Arizona, and Nogales, Sonora, Mexico, is known collectively as Ambos (both) Nogales. This area was historically one city and was administratively divided by the Gadsden Purchase in 1853. These arid-lands have limited and sensitive natural resources. Environmental planning can support sustainable development to accommodate the predicted influx of population. The objective of this research is to quantify the amount of predicted urban growth for the Ambos Nogales watershed to support future planning for sustainable development. Two modeling regimes are explored. Our goal is to identify possible growth patterns associated with the twin-city area as a whole and with the two cities modeled as separate entities. We analyzed the cross-border watershed using regression analysis from satellite images from 1975, 1983, 1996, and 2002 and created urban area classifications. We used these classifications as input to the urban growth model, SLEUTH, to simulate likely patterns of development and define projected conversion probabilities. Model results indicate that the two cities are undergoing very different patterns of change and identify locations of expected growth based on historical development. Growth in Nogales, Arizona is stagnant while the urban area in Nogales, Sonora is exploding. This paper demonstrates an application that portrays how future binational urban growth could develop and affect the environment. This research also provides locations of potential growth for use in city planning.
Smoking behavior among Hispanic adults with diabetes on the United States-Mexico border: a public health opportunity Hábito tabáquico en adultos hispanos con diabetes residentes en la frontera México-Estados Unidos: una oportunidad de salud pública
Full Text Available OBJECTIVE: To examine the prevalence of smoking behaviors among adults with diabetes on the United States-Mexico border, to compare these behaviors in U.S. Hispanics and Mexicans with diabetes, and to identify explanations for group differences. METHODS: Data came from the U.S.-Mexico Border Diabetes Prevention and Control Project survey (2001-2002, a stratified, multistage sample representative of the border population. The analytic sample included adults from all racial and ethnic backgrounds with diabetes (n = 665, including 333 Mexicans and 268 U.S. Hispanics. Smoking behaviors were based on self-reports. Age- and gender-specific prevalence of smoking behavior was estimated and logistic regression was used for mediation analysis of group differences. RESULTS: One in five adults with diabetes (20.1% in the region was a current smoker. Prevalence was higher among Mexicans (26.2% than U.S. Hispanics (10.1%, P = 0.003; differences were not explained by sociodemographic or healthcare-related characteristics (odds ratio [OR] 3.86, 95% confidence interval [CI] 1.50-9.91, P = 0.004. Younger Mexicans with diabetes (OBJETIVO: Analizar la prevalencia de tabaquismo en adultos con diabetes residentes en la zona fronteriza entre los Estados Unidos y México, comparar este hábito entre los hispanos estadounidenses y los mexicanos con diabetes, y tratar de explicar las diferencias observadas entre ambos grupos. MÉTODOS: Los datos procedieron de la encuesta del Proyecto de Prevención y Control de la Diabetes en la Frontera México-Estados Unidos (2001-2002, llevada a cabo en una muestra estratificada polietápica, representativa de la población fronteriza. La muestra analítica incluyó a adultos con diabetes de todos los orígenes raciales y étnicos (n = 665, incluidos 333 mexicanos y 268 hispanos estadounidenses. La información en cuanto al hábito de fumar fue facilitada por los entrevistados. Se calculó la prevalencia específica de tabaquismo seg
Dengue occurrence relations and serology: cross-sectional analysis of results from the Guerrero State, Mexico, baseline for a cluster-randomised controlled trial of community mobilisation for dengue prevention.
Nava-Aguilera, Elizabeth; Morales-Pérez, Arcadio; Balanzar-Martínez, Alejandro; Rodríguez-Ramírez, Ofelia; Jiménez-Alejo, Abel; Flores-Moreno, Miguel; Gasga-Salinas, David; Legorreta-Soberanis, José; Paredes-Solís, Sergio; Morales-Nava, Pedro Antonio; de Lourdes Soto-Ríos, María; Ledogar, Robert J; Coloma, Joséfina; Harris, Eva; Andersson, Neil
community leadership and the relatively low rates of self-reported dengue illness were challenges that the Mexican intervention team had to overcome. The higher dengue illness occurrence among women in Costa Grande and Costa Chica may help explain why women participated more than men in activities during the Camino Verde trial.
Aldape, F.; Hernandez-Mendez, B.; Flores M, J.
A manganese (Mn) survey in airborne particulate matter from a mining area located in Hidalgo State (Mexico) was performed using PIXE. Deposits of Mn ore, first discovered in 1959 and under continuous exploitation since 1962, are nowadays considered as one of the most important of their kind in the American Continent. Afterwards, local inhabitants have been under continuous overexposure to dusts and water highly enriched with Mn. Since no information was available about Mn content in airborne particulate matter in that area, especially in the respirable fraction PM 2.5 , airborne particles were collected simultaneously at two sites located on opposite sides of the rim of the mining valley, and along the line of prevailing local winds. The sample collection was performed on eight alternate days, taking two samples per day (day-time and night-time) at each sampling site, using Stacked Filter Units (SFUs) of the Davis design to separate particles into fine (PM 2.5 ) and coarse (PM 15 ) sizes. The samples were PIXE analyzed and the results of this study revealed that Mn content, in both fine and coarse fractions, were in excess of the general urban background level of 40 ng/m 3 (US Environmental Protection Agency, 1990) in more than 50% of the samples, which indicate severe environmental deterioration in the place under study
Garcia-Rejon, Julian E.; Blitvich, Bradley J.; Farfan-Ale, Jose A.; Loroño-Pino, Maria A.; Chi Chim, Wilberth A.; Flores-Flores, Luis F.; Rosado-Paredes, Elsy; Baak-Baak, Carlos; Perez-Mutul, Jose; Suarez-Solis, Victor; Fernandez-Salas, Ildefonso; Beaty, Barry J.
Studies were conducted to determine the host-feeding preference of Culex quinquefasciatus Say (Diptera: Culicidae) in relation to the availability of human and domestic animals in the city of Merida, Yucatan State, Mexico. Mosquitoes were collected in the backyards of houses using resting wooden boxes. Collections were made five times per week from January to December 2005. DNA was extracted from engorged females and tested by PCR using universal avian- and mammalian-specific primers. DNA extracted from avian-derived blood was further analyzed by PCR using primers that differentiate among the birds of three avian orders: Passeriformes, Columbiformes and Galliformes. PCR products obtained from mammalian-derived blood were subjected to restriction enzyme digestion to differentiate between human-, dog-, cat-, pig-, and horse-derived blood meals. Overall, 82% of engorged mosquitoes had fed on birds, and 18% had fed on mammals. The most frequent vertebrate hosts were Galliformes (47.1%), Passeriformes (23.8%), Columbiformes (11.2%) birds, and dogs (8.8%). The overall human blood index was 6.7%. The overall forage ratio for humans was 0.1, indicating that humans were not a preferred host for Cx. quinquefasciatus in Merida. PMID:20578953
United States-Mexico border diabetes prevalence survey: lessons learned from implementation of the project Encuesta de prevalencia de diabetes en la zona fronteriza entre México y los Estados Unidos: lecciones aprendidas de la ejecución del proyecto
Federico G. de Cosío
Full Text Available This paper reviews and discusses the main procedures and policies that need to be followed when designing and implementing a binational survey such as the United States of America (U.S.-Mexico Border Diabetes Prevalence Study that took place between 2001 and 2002. The main objective of the survey was to determine the prevalence of diabetes in the population 18 years of age or older along U.S.-Mexico border counties and municipalities. Several political, administrative, financial, legal, and cultural issues were identified as critical factors that need to be considered when developing and implementing similar binational projects. The lack of understanding of public health practices, implementation of existing policies, legislation, and management procedures in Mexico and the United States may delay or cancel binational research, affecting the working relation of both countries. Many challenges were identified: multiagency/multifunding, ethical/budget clearances, project management, administrative procedures, laboratory procedures, cultural issues, and project communications. Binational projects are complex; they require coordination between agencies and institutions at federal, state, and local levels and between countries and need a political, administrative, bureaucratic, cultural, and language balance. Binational agencies and staff should coordinate these projects for successful implementation.En este artículo se analizan los principales procedimientos y normas que se deberían seguir al diseñar y ejecutar una encuesta binacional, como el estudio de prevalencia de la diabetes en la zona fronteriza entre México y los Estados Unidos que se llevó a cabo entre el 2001 y el 2002. El objetivo principal de la encuesta fue determinar la prevalencia de diabetes en las personas de 18 años o mayores en los condados y municipios fronterizos entre México y los Estados Unidos. Se definieron diversos aspectos políticos, administrativos, financieros
Dec 25, 2009 ... response from the Nigerian government. ... domestic crises that negatively impacts state stability, the US government ... Harrison C. Ajebon, Department of Political Science, University of Calabar, ..... Sweden. United Kingdom. Switzerland. Asia & far East. Japan ..... case Study of Nigeria, in Ikonnechidi and.
Dec 25, 2009 ... Peru. Venezuela. Mexico. New Zealand. Virgin Island. Europe. Germany. France. Italy. Netherlands. Portugal. Spain. Sweden. United Kingdom. Switzerland. Asia & far East. Japan. Singapore. India. Indonesia. Korea. Taiwan. China. Thailand. 321,797.8. 12,782.7. 309,015.1. 56,421.7. 2,413.7. 44,448.1.
Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region Control de la presión arterial, hipertensión, concientización y tratamiento en adultos con diabetes de la zona fronteriza entre México y los Estados Unidos
Full Text Available OBJETIVE: To determine prevalence of blood pressure control, hypertension, hypertension awareness, and antihypertensive treatment among adults (> 18 years old with diabetes living in the border region between the United States of America and Mexico, and to explore variation in those variables between all adults on the Mexican side of the border ("Mexicans" and three groups on the U.S. side of the border ("all U.S. adults," "U.S.-born Hispanics," and "Mexican immigrants". METHODS: Using data from Phase I (February 2001-October 2002 of the U.S.-Mexico Border Diabetes Prevention and Control Project, a prevalence study of type 2 diabetes and its risk factors, age-adjusted prevalence of hypertension-related variables was calculated for the sample (n = 682 and differences between the border groups were examined through logistic regression. RESULTS: Less than one-third of the sample had controlled blood pressure (140/90 mm Hg, and hypertension awareness and treatment were inadequate. After adjusting for demographics, body mass index, and access to health care, there were no differences in blood pressure control, hypertension, hypertension awareness, or treatment between Mexicans and both U.S. adults and Mexican immigrants. However, compared to Mexicans and Mexican immigrants, U.S.-born Hispanics, particularly younger individuals, had the lowest rates of blood pressure control (17.3% and the highest rates of coexisting hypertension (54.8%. Compared to Mexicans, U.S.-born Hispanics had lower odds of controlled blood pressure (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.09-0.95 and greater odds of hypertension (OR 3.75, 95% CI 1.51-9.29 and hypertension awareness (OR 6.19, 95% CI 1.46-26.15. CONCLUSION: Co-occurrence of diabetes and hypertension is a major public health problem among U.S.-Mexico border residents. The low rate of blood pressure control among various border groups, especially younger U.S.-born Hispanics, suggests that initiatives
Full Text Available Relief influences on climate, lead to a wide environmental conditions, even more than latitude. The Köppen Method, one of the most used, is of physical type, and leads to excellent approaches to real climate conditions, but it doesn't consider in a full dimension the water-soil-cultivated-plant-atmosphere interaction, being that these factors decide so much the natural vegetation as crops. The periods with freezing temperatures or with high frost risk, and the duration of dry months, all of them are decisive for agriculture. These risk factors are considered in the Papadakis Method, which allows evaluating the potentiality and limitations of the climatic areas, related to crops. In this work an application is made of this method on a wide region in Northwest Mexico, where agriculture is very important, and the obtained results converge to define that existent climatic groups are the following, according to Papadakis Method: 1.4: continental savanna 1.5: tropical semi-arid 1.9: tropical with fresh winter 2.3: medium-cold highland 4.2: continental subtropical 4.3: continental semitropical
Acculturation and healthy lifestyle habits among Hispanics in United States-Mexico border communities Aculturación y hábitos de vida saludables en los hispanos de las comunidades de la zona fronteriza entre México y los Estados Unidos
Full Text Available OBJECTIVE: To explore the relationship between acculturation and healthy lifestyle habits in the largely Hispanic populations living in underserved communities in the United States of America along the U.S.-Mexico border. METHODS: A cross-sectional study was conducted from April 2006 to June 2008 using survey data from the Alliance for a Healthy Border, a program designed to reduce health disparities in the U.S.-Mexico border region by funding nutrition and physical activity education programs at 12 federally qualified community health centers in Arizona, California, New Mexico, and Texas. The survey included questions on acculturation, diet, exercise, and demographic factors and was completed by 2 381 Alliance program participants, of whom 95.3% were Hispanic and 45.4% were under the U.S. poverty level for 2007. Chi-square (χ2 and Student's t tests were used for bivariate comparisons between acculturation and dietary and physical activity measures. Linear regression and binary logistic regression were used to control for factors associated with nutrition and exercise. RESULTS: Based on univariate tests and confirmed by regression analysis controlling for sociodemographic and health variables, less acculturated survey respondents reported a significantly higher frequency of fruit and vegetable consumption and healthier dietary habits than those who were more acculturated. Adjusted binary logistic regression confirmed that individuals with low language acculturation were less likely to engage in physical activity than those with moderate to high acculturation (odds ratio 0.75, 95% confidence interval 0.59-0.95. CONCLUSIONS: Findings confirmed an association between acculturation and healthy lifestyle habits and supported the hypothesis that acculturation in border community populations tends to decrease the practice of some healthy dietary habits while increasing exposure to and awareness of the importance of other healthy behaviors
Quality of diabetes care: a cross-sectional study of adults of Hispanic origin across and along the United States-Mexico border Calidad de la atención de la diabetes: un estudio transversal de adultos hispanos residentes en ambos lados de la zona fronteriza entre México y los Estados Unidos
Beatriz A. Díaz-Apodaca
Full Text Available OBJECTIVE: To assess and monitor the quality of care provided to Hispanics diagnosed with diabetes living in the border region between the United States of America and Mexico. METHODS: From April 2001 to November 2002, Phase I of the U.S.-Mexico Border Diabetes Prevention and Control Project, a prevalence study of type 2 diabetes and its risk factors, was conducted along the U.S.-Mexico border using two-stage cluster sampling of towns and households within towns. A questionnaire was administered on diabetes (self-reported and lifestyle and a physical examination and blood sample were obtained. Of the 4 027 study participants, 521 (13.0% reported receiving a pre-study diagnosis of diabetes. Of those, 466 were of Hispanic origin (226 on the Mexican side of the border and 240 on the U.S. side. RESULTS: Results indicated 42.1% of Hispanics on the U.S. side of the border (95% confidence interval [CI] 35.8%-48.6% and 37.6% of Hispanics on the Mexican side (95% CI 31.3%-44.3% had controlled diabetes (defined as glycosylated hemoglobin A1c OBJETIVO: Evaluar y vigilar la calidad de la atención prestada a los hispanos diagnosticados de diabetes residentes en la zona fronteriza entre los Estados Unidos y México. MÉTODOS: De abril del 2001 a noviembre del 2002, se llevó a cabo la primera fase del Proyecto de Prevención y Control de la Diabetes en la Frontera México-Estados Unidos, un estudio sobre la prevalencia de la diabetes tipo 2 y sus factores de riesgo; el proyecto se realizó a lo largo de la zona fronteriza entre los Estados Unidos y México, mediante muestreo por conglomerados, en dos etapas, de poblaciones y hogares de esas poblaciones. Mediante un cuestionario (se recogió la información facilitada por los entrevistados sobre la diabetes y su modo de vida; también se realizó una exploración física y se obtuvo una muestra de sangre. De los 4 027 participantes, 521 (13,0% informaron que previamente al estudio ya se les hab
Prevalence of type 2 diabetes and impaired fasting glucose: cross-sectional study of multiethnic adult population at the United States-Mexico border Prevalencia de diabetes tipo 2 y de alteración de la glucosa en ayunas: estudio transversal de una población adulta multiétnica en la frontera México-Estados Unidos
Beatriz A. Díaz-Apodaca
Full Text Available OBJETIVE: To estimate prevalence of type 2 diabetes (diabetes and impaired fasting glucose (IFG in the border region between the United States of America and Mexico, by ethnic origin and country of residence; identify risk factors associated with both conditions; and explore the extent to which these factors account for cross-border or ethnic disparities in prevalence. METHODS: From April 2001 to November 2002, Phase I of the U.S.-Mexico Border Diabetes Prevention and Control Project, a prevalence study of diabetes and its risk factors, was conducted at the U.S.-Mexico border using multistage cluster sampling. A questionnaire was administered on diabetes (self-reported and lifestyle and a physical examination and blood sample were obtained. A total of 4 027 adults participated in the study: 2 120 Hispanics from the Mexican side of the border and 1 437 Hispanics and 470 non-Hispanics (of whom 385 were classified as "white" from the U.S. side of the border. RESULTS: The age-adjusted prevalence of self-reported and unrecognized diabetes in Hispanics was 15.4% (16.6% on the Mexican side of the border and 14.7% on the U.S. side. The age-adjusted prevalence of IFG was similar on both sides of the border (14.1% on the Mexican side and 13.6% on the U.S. side. CONCLUSIONS: Established risk factors for diabetes (e.g., age, obesity, and family history were relevant and there was an inverse relationship between diabetes and education and socioeconomic level. While diabetes prevalence is high on both sides of the U.S.-Mexico border, one-fourth of the cases remain undiagnosed, suggesting a need for development and implementation of a public health program for prevention, diagnosis, and control of diabetes in the region.OBJETIVO: Calcular la prevalencia de la diabetes de tipo 2 (diabetes y de la alteración de la glucosa en ayunas en la zona fronteriza entre México y los Estados Unidos, por origen étnico y país de residencia; identificar los factores de
Herrera, Hugo Francisco Lopez
As world population grows, and its technology evolves, the demand for electricity inexorably increases. Until now most of this electricity has been produced via fossil fuels, non-renewable energy resources that are irreversibly deteriorating our environment. On the economical aspect it does not get any better. Let's not forget market rules, the higher the demand and lower the offer, the higher the price we will have to pay. Oil is an excellent example. Some countries try to solve this situation with Pharaohnic projects, i.e. investing absurd amounts of money in 'green electricity' building monstrous dams to power equally monstrous hydroelectric power plants. The only problem with this is that it is not green at all---it does have an enormous environmental impact---it is extremely complicated and expensive to implement. It is important to point out, that this research project does not try to solve world's thirst for electricity. It is rather aimed to help solve this problematic at a much lower scale---it should be considered as an extremely small step in the right direction. It focuses on satisfying the local electricity needs with renewable, non-contaminating and locally available resources. More concisely, this project focuses on the attainment and use of hydrogen as an alternate energy source in El Paso/Juarez region. Clean technology is nowadays available to produce hydrogen and oxygen, i.e. the photoelectrolysis process. Photovoltaic cells coupled with electrolytic devices can be used to produce hydrogen and oxygen in a sustainable manner. In this research, simulation models of hybrid systems were designed and developed. They were capable to compare, predict and evaluate different options for hydrogen generation. On the other hand, with the produced hydrogen from the electrolysis process it was possible to generate electricity through fuel cells. The main objectives of the proposed research were to define how to use the resources for the attainment of hydrogen and distribution of it in El Paso/Juarez region. More precisely, the goals were the conversion of brines and waste-waters to hydrogen via electrolysis, and the generation of electricity through fuel cells. Thereafter, the specific objectives were to (1) design a simulation model for hydrogen generation, (2) design and simulate a model of photovoltaic (PV) array capable to generate the required energy for the process, (3) simulate fuel cells in order to be used as electricity power supply in remote houses, and (4) simulate a complete remote house hybrid system. The results of this research gave us information about the feasibility of high-volume hydrogen generation with the diverse resources of the region. On the other hand, this research has shown the alternatives of local energy generation, and efficiency of a remote house hybrid system located in El Paso/Juarez area. Experiences obtained from this research will also provide information for future investigations in the field of alternate energy sources, in order to get a clean environment through sustainable development.
Drexler, Naomi A; Yaglom, Hayley; Casal, Mariana; Fierro, Maria; Kriner, Paula; Murphy, Brian; Kjemtrup, Anne; Paddock, Christopher D
Rocky Mountain spotted fever (RMSF) is an emerging public health concern near the US-Mexico border, where it has resulted in thousands of cases and hundreds of deaths in the past decade. We identified 4 patients who had acquired RMSF in northern Mexico and subsequently died at US healthcare facilities. Two patients sought care in Mexico before being admitted to US-based hospitals. All patients initially had several nonspecific signs and symptoms, including fever, headache, nausea, vomiting, or myalgia, but deteriorated rapidly without receipt of a tetracycline-class antimicrobial drug. Each patient experienced respiratory failure late in illness. Although transborder cases are not common, early recognition and prompt initiation of appropriate treatment are vital for averting severe illness and death. Clinicians on both sides of the US-Mexico border should consider a diagnosis of RMSF for patients with rapidly progressing febrile illness and recent exposure in northern Mexico.
Celina I. Valencia
Full Text Available BackgroundTuberculosis (TB remains a salient public health issue along the U.S./Mexico border. This study seeks to identify the social and structural factors, which are associated with TB disease burden in the binational geographic region. Identification of barriers of treatment completion provides the necessary framework for developing evidence-based interventions that are culturally relevant and context specific for the U.S./Mexico border region.MethodsRetrospective study of data extracted from medical charts (n = 439 from Yuma County Health Department (YCHD (n = 160 and Centro de Salud San Luis Río Colorado (n = 279. Patients currently accessing TB treatment at either facility were excluded from the study. Chi-square, unadjusted odds ratios, and logistic regression were utilized to identify characteristics associated with successful TB treatment in this population.FindingsThe study population was predominantly male (n = 327. Females were more likely to complete TB treatment (OR = 3.71. The absence of drug use and/or the absence of an HIV positive diagnosis were found to be predictors of TB treatment completion across both clinical sites. Forty-four percent (43.59% (n = 85 TB patients treated at CDS San Luis did not complete treatment versus 40.35% (n = 49 of TB patients who did not complete treatment at YCHD. Moving from the area or being deported was the highest category (20.78% for incomplete TB treatment in the population (n = 64 across both clinical sites.
... Growth, Productivity, Entrepreneurship, and Innovation (1) Workforce Development; (2) Joint Investment Promotion; (3) Travel and Tourism; (4) Economic Development along the Border as well as a Comprehensive...
The initiation of a new approach to non-proliferation policy by the United States in 1977 was the most upsetting development in the history of US-Japanese nuclear relations. The policy has seemingly altered Japanese views of its own nuclear future very little, yet it has altered the tone of the nuclear relationship with the United States. Recent Japanese nuclear power developments, both technical and administrative, are outlined and the prospects for the future of the United States-Japanese nuclear relationship and for Pacific regional cooperation assessed. Issues of importance in the relationship include reprocessing - enrichment, plutonium management, spent fuel and waste management and uranium supplies
Full Text Available Se analizó la influencia de las variables climáticas en la distribución de 15 especies del género Bursera en Morelos, México. Se obtuvieron datos de presencia de especies y de variables climáticas de 47 estaciones meteorológicas, y se elaboraron mapas de distribución real y potencial de cada especie, por medio de un SIG; la influencia de las variables climáticas en la distribución se evaluó mediante análisis de componentes principales y de conglomerados. Las especies se distribuyen en un intervalo altitudinal de 800 a 2 800 m; la riqueza es mayor en las áreas más cálidas y relativamente más secas del sur del estado. Se identificaron 2 grandes grupos de especies: a, las de distribución restringida a sitos relativamente cálidos y b, las de distribución más amplia, incluyendo sitios menos cálidos. La precipitación, las temperaturas máxima y mínima, la evapotranspiración y su estacionalidad influyeron en la distribución de las especies. Bursera bicolor, B. bipinnata, B. cuneata, B. copallifera, B. fagaroides, B. grandifolia y B. glabrifolia se presentan en sitios con temperatura mínima relativamente baja (5-10° C y más húmedos, mientras que B. aptera, B. ariensis, B. lancifolia, B. linanoe, B. longipes, B. morelensis, B. schlechtendalii y B. submoniliformis se encuentran en zonas con temperaturas mínimas más altas (≥ 14° C y condiciones más secas.The influence of climatic variables on the distribution of 15 species of Bursera in Morelos Mexico, was analyzed. Data on the presence of species and climatic variables from 47 meteorological stations were obtained, and maps of actual and potential distribution were made using a GIS; the influence of the main climatic variables on the distribution was analyzed by principal component and cluster analyses. The species of Bursera are found in an altitudinal range of 800-2 800 m; species richness is higher in the warm, relatively dry areas south of the state. Two main groups
Tourtelot, H A
Geochemical surveys in relation to health may be classified as having one, two or three dimensions. One-dimensional surveys examine relations between concentrations of elements such as Pb in soils and other media and burdens of the same elements in humans, at a given time. The spatial distributions of element concentrations are not investigated. The primary objective of two-dimensional surveys is to map the distributions of element concentrations, commonly according to stratified random sampling designs based on either conceptual landscape units or artificial sampling strata, but systematic sampling intervals have also been used. Political units have defined sample areas that coincide with the units used to accumulate epidemiological data. Element concentrations affected by point sources have also been mapped. Background values, location of natural or technological anomalies and the geographic scale of variation for several elements often are determined. Three-dimensional surveys result when two-dimensional surveys are repeated to detect environmental changes.
Pérez Quezadas, Juan; Heilweil, Victor M.; Cortés Silva, Alejandra; Araguas, Luis; Salas Ortega, María del Rocío
Geochemistry and environmental tracers were used to understand groundwater resources, recharge processes, and potential sources of contamination in the Rio Actopan Basin, Veracruz State, Mexico. Total dissolved solids are lower in wells and springs located in the basin uplands compared with those closer to the coast, likely associated with rock/water interaction. Geochemical results also indicate some saltwater intrusion near the coast and increased nitrate near urban centers. Stable isotopes show that precipitation is the source of recharge to the groundwater system. Interestingly, some high-elevation springs are more isotopically enriched than average annual precipitation at higher elevations, indicating preferential recharge during the drier but cooler winter months when evapotranspiration is reduced. In contrast, groundwater below 1,200 m elevation is more isotopically depleted than average precipitation, indicating recharge occurring at much higher elevation than the sampling site. Relatively cool recharge temperatures, derived from noble gas measurements at four sites (11-20 °C), also suggest higher elevation recharge. Environmental tracers indicate that groundwater residence time in the basin ranges from 12,000 years to modern. While this large range shows varying groundwater flowpaths and travel times, ages using different tracer methods (14C, 3H/3He, CFCs) were generally consistent. Comparing multiple tracers such as CFC-12 with CFC-113 indicates piston-flow to some discharge points, yet binary mixing of young and older groundwater at other points. In summary, groundwater within the Rio Actopan Basin watershed is relatively young (Holocene) and the majority of recharge occurs in the basin uplands and moves towards the coast.
Fereshteh, M. Hussein
This review examined the views of 35 higher education professionals in order to explore the history of higher education relations between Iran and the United States particularly before and after the revolution in Iran. The study used interviews with participants, correspondence, and published material from journals, monographs, and newspapers. All…
Cox, K B
Health care organizations face major changes, and these changes are likely to increase conflict in organizations. Although numerous studies have focused on conflict management, few have considered causes and effect of conflict in nursing units. The investigation tested a structural equation that examined the relationships among individual and contextual variables and intragroup conflict, job satisfaction, team performance effectiveness, and anticipated turnover. The nonrandom sample consisted of 141 nurses employed on 13 inpatient units at a state-supported, 597-bed academic medical centre in a southeastern city. Intragroup conflict was higher on smaller units with a higher ratio of RNs to total staff. Intragroup conflict was not associated with satisfaction with pay or anticipated turnover. In the final model, the unit morale and interpersonal relations dimension of team performance effectiveness was negatively associated with intragroup conflict and anticipated turnover, and positively associated with satisfaction with pay. High perceptions of unit morale and interpersonal relations buffered the effect of unit size and skill mix on intragroup conflict. Goodness of fit statistics indicated a good fit of the model to data. The findings have implications for nursing educators and administrators, and provide direction for future research.
Siddiqi, Ariba; Kumar, Dinesh; Arjunan, Sridhar
Limited studies exist on the use of surface electromyogram (EMG) signal features to detect age-related motor unit remodeling in the Tibialis Anterior. Motor unit remodeling leads to declined muscle strength and force steadiness during submaximal contractions which are factors for risk of falls in the elderly. This study investigated the remodeling phenomena in the Tibialis Anterior using sample entropy and higher order statistics. Eighteen young (26.1 ± 2.9 years) and twelve elderly (68.7 ± 9.0 years) participants performed isometric dorsiflexion of the ankle at 20% maximal voluntary contraction (MVC) and their Tibialis Anterior (TA) EMG was recorded. Sample entropy, Gaussianity and Linearity Test statistics were calculated from the recorded EMG for each MVC. Shapiro-Wilk test was used to determine normality, and either a two-tail student t-test or Wilcoxon rank sum test was performed to determine significant difference in the EMG features between the young and old cohorts. Results show age-related motor unit remodeling to be depicted by decreased sample entropy (p <; 0.1), increased non-Gaussianity (p <; 0.05) and lesser degree of linearity in the elderly. This is due to the increased sparsity of the MUAPs as a result of the denervation-reinnervation process, and the decrease in total number of motor units.
Bashilov, A. V.; Borisevich, N.Ya.; Sobolev, O.V.
The United Fund of materials about Chernobyl-related issues was created in Russian-Belarusian Information Center on the Problems of the Consequences of the Catastrophe at Chernobyl NPP branch RSRUE 'Institute of Radiology' Ministry for Emergency Situations of the Republic of Belarus. It contains accumulated during the post-Chernobyl period systematized maps, scientific and practical, educational, documentary, journalistic, artistic, photographic and other information. (authors)
Saavedra-Rodriguez, Karla; Beaty, Meaghan; Lozano-Fuentes, Saul; Denham, Steven; Garcia-Rejon, Julian; Reyes-Solis, Guadalupe; Machain-Williams, Carlos; Loroño-Pino, Maria Alba; Flores-Suarez, Adriana; Ponce-Garcia, Gustavo; Beaty, Barry; Eisen, Lars; Black, William C
The mosquito Aedes aegypti is the major vector of the four serotypes of dengue virus (DENV1-4). Previous studies have shown that Ae. aegypti in Mexico have a high effective migration rate and that gene flow occurs among populations that are up to 150 km apart. Since 2000, pyrethroids have been widely used for suppression of Ae. aegypti in cities in Mexico. In Yucatan State in particular, pyrethroids have been applied in and around dengue case households creating an opportunity for local selection and evolution of resistance. Herein, we test for evidence of local adaptation by comparing patterns of variation among 27 Ae. aegypti collections at 13 single nucleotide polymorphisms (SNPs): two in the voltage-gated sodium channel gene para known to confer knockdown resistance, three in detoxification genes previously associated with pyrethroid resistance, and eight in putatively neutral loci. The SNPs in para varied greatly in frequency among collections, whereas SNPs at the remaining 11 loci showed little variation supporting previous evidence for extensive local gene flow. Among Ae. aegypti in Yucatan State, Mexico, local adaptation to pyrethroids appears to offset the homogenizing effects of gene flow. © The American Society of Tropical Medicine and Hygiene.
Full Text Available The present prospective study was carried out in the Paediatric Intensive Care Unit (PICU of a tertiary care teaching hospital in Mumbai. The objective was to determine the incidence, risk factors, mortality and organisms responsible for urinary catheter related infections (UCRI. Colonization and/or bacteriuria was labelled as urinary catheter related infection (UCRI. Forty-four patients with 51 urinary catheters were studied. Incidence of UCRI was 47.06%. Age, female sex and immunocompromised status did not increase the risk of UCRI. Duration of catheter in-situ and duration of stay in the PICU were associated with higher risk of UCRI. The mortality was not increased by UCRI. Commonest organism isolated in UCRI was E. coli, which had maximum susceptibility to nitrofurantoin and amikacin.
Full Text Available Teaching units are very important when you want to integrate university and society, to pre- degree and post- degree teaching process, and during research, becoming a huge educative place to develop these activities. This research is related to a diagnose the author made to particular workers and Tributary Administrations National Office functionaries from Santiago of Cuba related to the information level contributors have about tributary subjects, to be sure there are insufficiencies in the local and national media when it comes to tributary information. Based on the results, the author contributes with some actions to improve teachers, communication, integrating university and tributary offices. This actions are also directed to students, functionaries and leaders from both institutions, in order to be more efficients in the contributors, knowledge so they can understand the importance of tributes and therefore, to improve the low collection indicator the Tributary Administrations are facing right now.
International aviation trade bargaining is distinguished by its use of a formal process of bilateral bargaining based on the reciprocal exchange of rights by states. Australia-United States aviation trade relations are currently without rancour, but this has not always been the case and in the late 1980s and early 1990s, their formal bilateral aviation negotiations were a forum for a bitter conflict between two competing international aviation policies. In seeking to explain the bilateral aviation outcomes between Australia and the United States and how Australia has sought to improve upon these, analytical frameworks derived from international political economy were considered, along with the bilateral bargaining process itself. The paper adopts a modified neorealist model and concludes that to understand how Australia has sought to improve upon these aviation outcomes, neorealist assumptions that relative power capabilities determine outcomes must be qualified by reference to the formal bilateral bargaining process. In particular, Australia's use of this process and its application of certain bargaining tactics within that process remain critical to understanding bilateral outcomes.
Chung, Wonjun; Choi, Jinbong
Based on a concept of professionalism, this study analyzed and compared current public relations curricula of higher education among the United States, the United Kingdom, and South Korea. In terms of three educational orientations, results indicated that public relations education in the United States is the most balanced among theoretical,…
Procurement of nuclear facilities in the United Kingdom is subject to nuclear site licence conditions issued by the Government through the Office for Nuclear Regulation (ONR). Each nuclear facility in the United Kingdom must have a nuclear site licence and must comply with the 36 general conditions that are set out in the Licence Condition Handbook (October 2014). In addition, the ONR has published a technical assessment guide for the procurement of nuclear safety related items or services; a guide on intelligent customers and a guide on records management also apply to the procurement phase, and ONR interventions look across all three of these documents. Procurement governance arrangements need to be developed (including a policy, manual, procedures and template documents) and approved within the utility company. The ONR monitors the arrangements via interventions and deems the arrangements to be ‘adequate’. Some procurement contracts become lifetime records for nuclear safety related systems and need to be retained while the plant is in place. A formal record retention schedule needs to be created and managed by the procurement organization. The utility company may elect to set hold points during the various procurement stages and, importantly, obtain approval for the contract and its content from all technical stakeholders (with particular emphasis on the engineering, project management and design authority quality functions before contract award). For contracts with high nuclear safety significance, the ONR may enforce additional hold points before and/or after contract award. There is a general requirement that the utility puts in place adequate arrangements to ensure that suitably qualified and experienced personnel are employed to implement adequate management arrangements and to act as an intelligent customer. This includes being able to demonstrate that any contractor or supplier is suitable, capable and experienced, and has the necessary processes and
Petrie, W.L.; Cannon, H.L.
Increasing concern regarding the effects of the geochemical environment on health in the United States has fostered research studies in a number of universities and government agencies. The necessity to evaluate the effects of natural and man-made elemental excesses in the environment on health requires the establishment of requirements and tolerance limits for the various elements in water and crops. Maps of the geographic distribution of these elements in rocks, surficial materials and ground and surface waters are also essential for comparison with the occurrence of disease. Funding support for research projects that relate to various parameters of these problems emanates largely from a few federal agencies, and much of the work is conducted at government, university and private facilities. An example of the latter is the National Academy of Sciences-National Research Council, which has several components that are addressing a variety of comparative studies of the geochemical environment related to health; studies involve specific trace elements (like selenium and magnesium), diseases (like cancer, urolithiasis and cardiovascular disease), other health factors (like aging and nutrition) and links with timely major problems (like the health effects of greatly increasing the use of coal). ?? 1979.
Thompson, Debra N; Hoffman, Leslie A; Sereika, Susan M; Lorenz, Holly L; Wolf, Gail A; Burns, Helen K; Minnier, Tamra E; Ramanujam, Rangaraj
This study compared nursing staff perceptions of safety climate in clinical units characterized by high and low ratings of leader-member exchange (LMX) and explored characteristics that might account for differences. Frontline nursing leaders' actions are critical to ensure patient safety. Specific leadership behaviors to achieve this goal are underexamined. The LMX perspective has shown promise in nonhealthcare settings as a means to explain safety climate perceptions. Cross-sectional survey of staff (n = 711) and unit directors from 34 inpatient units in an academic medical center was conducted. Significant differences were found between high and low LMX scoring units on supervisor safety expectations, organizational learning-continuous improvement, total communication, feedback and communication about errors, and nonpunitive response to errors. The LMX perspective can be used to identify differences in perceptions of safety climate among nursing staff. Future studies are needed to identify strategies to improve staff safety attitudes and behaviors. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
This article presents an analysis of the Great Wall of China and the Berlin Wall which reveals that both grew from unique political, historical, geographical, cultural, and economic circumstances. The purpose of this article is to provide new arguments for a debate that all too often has been waged with emotions, polemics, and misinformation. The…
Jones, Jefferson M; Lopez, Benito; Adams, Laura; Gálvez, Francisco Javier Navarro; Núñez, Alfredo Sánchez; Santillán, Nubia Astrid Hernández; Plante, Lydia; Hemme, Ryan R; Casal, Mariana; Hunsperger, Elizabeth A; Muñoz-Jordan, Jorge; Acevedo, Veronica; Ernst, Kacey; Hayden, Mary; Waterman, Steve; Gomez, Diana; Sharp, Tyler M; Komatsu, Kenneth K
Dengue is an acute febrile illness caused by any of four dengue virus types (DENV-1-4). DENVs are transmitted by mosquitos of the genus Aedes (1) and are endemic throughout the tropics (2). In 2010, an estimated 390 million DENV infections occurred worldwide (2). During 2007-2013, a total of three to 10 dengue cases were reported annually in Arizona and all were travel-associated. During September-December 2014, coincident with a dengue outbreak in Sonora, Mexico, 93 travel-associated dengue cases were reported in Arizona residents; 70 (75%) cases were among residents of Yuma County, which borders San Luis Río Colorado, Sonora, Mexico. San Luis Río Colorado reported its first case of locally acquired dengue in September 2014. To investigate the temporal relationship of the dengue outbreaks in Yuma County and San Luis Río Colorado and compare patient characteristics and signs and symptoms, passive surveillance data from both locations were analyzed. In addition, household-based cluster investigations were conducted near the residences of reported dengue cases in Yuma County to identify unreported cases and assess risk for local transmission. Surveillance data identified 52 locally acquired cases (21% hospitalized) in San Luis Río Colorado and 70 travel-associated cases (66% hospitalized) in Yuma County with illness onset during September-December 2014. Among 194 persons who participated in the cluster investigations in Yuma County, 152 (78%) traveled to Mexico at least monthly during the preceding 3 months. Four (2%) of 161 Yuma County residents who provided serum samples for diagnostic testing during cluster investigations had detectable DENV immunoglobulin M (IgM); one reported a recent febrile illness, and all four had traveled to Mexico during the preceding 3 months. Entomologic assessments among 105 households revealed 24 water containers per 100 houses colonized by Ae. aegypti. Frequent travel to Mexico and Ae. aegypti colonization indicate risk for local transmission of DENV in Yuma County. Public health officials in Sonora and Arizona should continue to collaborate on dengue surveillance and educate the public regarding mosquito abatement and avoidance practices. Clinicians evaluating patients from the U.S.-Mexico border region should consider dengue in patients with acute febrile illness and report suspected cases to public health authorities.
D. H. Zetina
Full Text Available Eighteen species of edible insects belonging to 15 families of six orders of Insecta were recorded in the county of La Purísima Palmar de Bravo in Puebla State, Mexico. They had the following taxonomic distribution among the different families: Lygaeidae, Pentatomidae, Membracidae, Cercopidae, Psocidae, Melolonthidae, Curculionidae, Cossidae, Megathymidae, Pyralidae, Geometridae and Apidae, all with a single recorded species; the families Acrididae, Formicidae and Vespidae with two species in each family. The latter were the most abundant families, and Hymenoptera was the most salient order with five species. Three species were reported as new registers of edible insects for Mexico and also for the world. The nutritive value of insects in terms of macro and micronutrients is discussed.
Julio C. Carbajal Monroy
Full Text Available This work deals with the delimitation of physical-geographical landscapes of the territory of the Tourist Circuit Chilpancingo Azul, at Guerrero's State central region, from geo-ecological conception for the physical-geographical synthetic classification of territorial units. This approach obtained territorial units and its hierarchical classification using a taxonomic system of localities, neighborhoods and boroughs (smallest categories. Taking into account the 1:100 000 scale different geographical units were determined: 3 localities, 31 neighborhoods and 177 boroughs. The characterization of these territorial units include lithologic constitution, geomorphological conditions (morphogenesis and morphometrics and spatial distribution of major types of soils and vegetation and land uses in the territory.
Bolivariana para las Americas (Spanish for Bolivarian Alternative for the Americas) ALC Acuerdo de Libre Comercio (Spanish for Free Trade Agreement) ATPA...Challenge Account) DEA Drug Enforcement Agency FELCN Fuerza Especial de Lucha Contra el Narcotráfico (Spanish for Special Force to Combat Drug...Organizacion de Estados Americanos (Spanish for Organization of American States) PNUD United Nations Program for Development) TCP Tratado de Comercio de
The article departs from the finding that religious texts and actors relate to other religions as for instance The Old Testament relates to Canaanites, the New Testament to Jews, Pagans etc. A consequence of this inter-relatedness of religion is that religion can be studied as a relational......, a religion can be defined and studied as the result of complex set of dynamic relations, where a central tenet of a religion is that it relates to the significant religious other. As such religion is not a stable phenomenon but embedded in a dynamic historical process, which can explain the difficulties...
We aimed to determine the seroprevalence of infection with N. caninum, Leptospira, and bovine herpesvirus type 1 and risk factors associated with these infections in water buffaloes in Veracruz State, Mexico. Through a cross-sectional study, 144 water buffaloes (Bubalus bubalis) raised in 5 ranches ...
Almazan-Torres, M.G.; Aguirre-Martinez, P.I.
Obsidian samples from San Miguel Ixtapan Mexico State, Mexico were analyzed by means of neutron activation. Statistical treatments such as bivariate, cluster and principal-components analyses were applied to the data set. Obsidians were identified as coming from three important sources: Sierra of Pachuca in the state of Hidalgo, Zinap uaro and Zin aro-Varal in the state of Michoacan. (author)
Tenorio, D.; Monroy-Guzman, F.; Longoria, L.C.; Almazan-Torres, M.G.; Universidad Autonoma del Estado de Mexico, Toluca; Rodriguez-Garcia, N.L.
Ceramic samples found in San Miguel Ixtapan, Mexico State, Mexico, were analyzed by means of NAA, PIXE, SEM and XRD. Statistical treatments such as bivariate cluster and principal-components analysis were applied to the data set. The origins of these ceramic samples were classified as local, regional and foreign. (author)
Anglo - Saxon ally over Nasser and the canal.55 In 2010, in a speech at Chatham House, Liberal Democrat Nick Clegg suggested that “what...strategic culture, and as an expression of shared values and institutions the character of which is vital for those charged with service in an Anglo ...American context as well as NATO. 14. SUBJECT TERMS United Kingdom, United States, Special Relationship, Anglo - American Relations, Iraq, Afghanistan
Wintermark, M; Zeineh, M; Zaharchuk, G; Srivastava, A; Fischbein, N
A neuroradiologist's activity includes many tasks beyond interpreting relative value unit-generating imaging studies. Our aim was to test a simple method to record and quantify the non-relative value unit-generating clinical activity represented by consults and clinical conferences, including tumor boards. Four full-time neuroradiologists, working an average of 50% clinical and 50% academic activity, systematically recorded all the non-relative value unit-generating consults and conferences in which they were involved during 3 months by using a simple, Web-based, computer-based application accessible from smartphones, tablets, or computers. The number and type of imaging studies they interpreted during the same period and the associated relative value units were extracted from our billing system. During 3 months, the 4 neuroradiologists working an average of 50% clinical activity interpreted 4241 relative value unit-generating imaging studies, representing 8152 work relative value units. During the same period, they recorded 792 non-relative value unit-generating study reviews as part of consults and conferences (not including reading room consults), representing 19% of the interpreted relative value unit-generating imaging studies. We propose a simple Web-based smartphone app to record and quantify non-relative value unit-generating activities including consults, clinical conferences, and tumor boards. The quantification of non-relative value unit-generating activities is paramount in this time of a paradigm shift from volume to value. It also represents an important tool for determining staffing levels, which cannot be performed on the basis of relative value unit only, considering the importance of time spent by radiologists on non-relative value unit-generating activities. It may also influence payment models from medical centers to radiology departments or practices. © 2016 by American Journal of Neuroradiology.
... its neighbors. Armed conflict has marked every decade of Israel's existence. Despite its unstable regional environment, Israel has developed a vibrant parliamentary democracy, albeit with relatively fragile governments...
... its neighbors. Armed conflict has marked every decade of Israel's existence. Despite its unstable regional environment, Israel has developed a vibrant parliamentary democracy, albeit with relatively fragile governments...
... its neighbors. Armed conflict has marked every decade of Israel's existence. Despite its unstable regional environment, Israel has developed a vibrant parliamentary democracy, albeit with relatively fragile governments...
Stoller, Roger E.
The observable effects of irradiation on material properties are complex and each such property changed depends sensitively on a range of irradiation and material parameters. This works against development of a universal exposure parameter. The irradiation dose to the material (both ionizing and displacement dose) can be calculated with good accuracy as long as the relevant reaction cross sections are known and implemented in the codes used. This suggests that a focus on dose calculations is warranted. When assessing damage correlation parameters, it is important to determine the appropriate dose parameter first. Then a clear distinction between damage formation and damage accumulation needs to be kept in mind. The dose unit is most helpful for estimating the primary damage generation, e.g. how damage energy is used to estimate atomic displacements. However, damage accumulation requires longer times and involves kinetic and thermodynamic processes that cannot be accounted for in a dose or primary damage unit. The adequacy of the primary damage formulations can be assessed through their use in mean field reaction rate theory or kinetic Monte Carlo microstructural evolution models to predict damage accumulation. The results of these models can be directly compared with experimental observations. (author)
Bichenkov, E.I.; Klypin, V.V.; Palchikov, E.I.
A pulsed X-ray unit comprises a pulsed X-ray tube connected to a discharge capacitor. The discharge capacitor comprises two coaxially arranged cylinders. One cylinder of the discharge capacitor is connected to the X-ray tube and to the high-voltage end of the secondary winding of the pulsed transformer which is shaped as a truncated cone, and is arranged internally of this winding coaxially therewith. The other cylinder of the discharge capacitor is also connected to the X-ray tube and to the low-voltage end of the secondary winding of the pulsed transformer, and is arranged intermediate this winding and the primary winding of the pulsed transformer which is shaped as a hollow cylinder, and connected to the charging device. The cylinders of the discharge capacitor have ports made therein for the passage therethrough of the magnetic flux produced by the windings of the pulsed transformer. (author)
Khoury, C.K.; Greene, S.; Wiersema, J.; Maxted, N.; Jarvis, A.; Struik, P.C.
The use of crop wild relatives (CWRs) in breeding is likely to continue to intensify as utilization techniques improve and crop adaptation to climate change becomes more pressing. Signifi cant gaps remain in the conservation of these genetic resources. As a fi rst step toward a national strategy for
Koyi, Hemin; Schmeling, Harro; Burchardt, Steffi
Shear zones are normally viewed as relatively narrow deformation zones that accommodate relative displacement between two "blocks" that have moved past each other in opposite directions. This study reports localized zones of shear between adjacent blocks that have not moved past each other. Such ...... given credit for and may be responsible for some reverse kinematics reported in shear zones....... or wakes, elongated bodies (vertical plates or horizontal rod-like bodies) produce tabular shear zones or wakes. Unlike conventional shear zones across which shear indicators usually display consistent symmetries, shear indicators on either side of the shear zone or wake reported here show reverse...... kinematics. Thus profiles exhibit shear zones with opposed senses of movement across their center-lines or -planes.We have used field observations and results from analytical and numerical models to suggest that examples of wakes are the transit paths that develop where denser blocks sink within salt...
Walsh, Brittany A; Chounthirath, Thiphalak; Friedenberg, Laura; Smith, Gary A
This study investigates unintentional non-fatal golf-related injuries in the US using a nationally representative database. This study analyzed golf-related injuries treated in US hospital emergency departments from 1990 through 2011 using the National Electronic Injury Surveillance System database. Injury rates were calculated using golf participation data. During 1990 through 2011, an estimated 663,471 (95% CI: 496,370-830,573) individuals ≥7years old were treated in US emergency departments for golf-related injuries, averaging 30,158 annually or 12.3 individuals per 10,000 golf participants. Patients 18-54years old accounted for 42.2% of injuries, but injury rates per 10,000 golf participants were highest among individuals 7-17years old (22.1) and ≥55years old (21.8) compared with 18-54years old (7.6). Patients ≥55years old had a hospital admission rate that was 5.01 (95% CI: 4.12-6.09) times higher than that of younger patients. Injured by a golf club (23.4%) or struck by a golf ball (16.0%) were the most common specified mechanisms of injury. The head/neck was the most frequently injured body region (36.2%), and sprain/strain (30.6%) was the most common type of injury. Most patients were treated and released (93.7%) and 5.9% required hospitalization. Although golf is a source of injury among all age groups, the frequency and rate of injury were higher at the two ends of the age spectrum. Given the higher injury and hospital admission rates of patients ≥55years, this age group merits the special attention of additional research and injury prevention efforts. Copyright © 2017 Elsevier Inc. All rights reserved.
Following a recent review, the UK Government has confirmed that it continues to favour a policy of deep disposal of intermediate low-level waste. The Government's continuing policy stems from the recommendations of the 1976 Royal Commission on Environmental Pollution (the 'Flowers'Report) and White Papers issued in 1977 and 1982 and 1982. The paper outlines the search for a disposal site in the UK. Nirex (Nuclear Industry Radioactive Waste Executive) was set up in 1982 to research and develop disposal facilities for intermediate low-level waste and low-level waste. At that time disposal facilities were envisaged as an engineered near-surface facility for LLW and short-lived ILW, and a modified mine or purpose built cavity at greater depth for long-lived ILW. Investigation of various sites followed and is discussed in the paper. The paper reviews the lessons learned in the field of public relations and public consultation, notably that public acceptance is a key factor in site selection and development, and that transparency is essential. For example, when it was announced that Sellafield was the preferred site for the repository, local councils became involved in discussions and planning, and Nirex is becoming more and more integrated into the local community. (author)
Hinojosa de la Garza, Octavio R.; Montero Cabrera, María Elena; Sanín, Luz H.; Reyes Cortés, Manuel; Martínez Meyer, Enrique
To estimate the distribution of uranium minerals in Chihuahua, the advanced statistical model "Maximun Entropy Method" (MaxEnt) was applied. A distinguishing feature of this method is that it can fit more complex models in case of small datasets (x and y data), as is the location of uranium ores in the State of Chihuahua. For georeferencing uranium ores, a database from the United States Geological Survey and workgroup of experts in Mexico was used. The main contribution of this paper is the proposal of maximum entropy techniques to obtain the mineral's potential distribution. For this model were used 24 environmental layers like topography, gravimetry, climate (worldclim), soil properties and others that were useful to project the uranium's distribution across the study area. For the validation of the places predicted by the model, comparisons were done with other research of the Mexican Service of Geological Survey, with direct exploration of specific areas and by talks with former exploration workers of the enterprise "Uranio de Mexico". Results. New uranium areas predicted by the model were validated, finding some relationship between the model predictions and geological faults. Conclusions. Modeling by spatial analysis provides additional information to the energy and mineral resources sectors.
Cleary, T. Anne; And Others
Evaluated special unit for care of patients with Alzheimer's disease or related disorders. Results showed in the unit, in which reduced stimulation was emphasized, patient weight loss was curtailed, patient agitation was diminished, restraint use was reduced, and wandering was no longer a concern. Found family members to be satisfied with care.…
Wallinga, W.; Bouwens, Jeroen S.; Baten, Christian T.M.
During fatigue the shape of motor unit action potentials (MUAPs) change. Characteristics of the MUAPs described before concern several time related aspects. No attention has been given to the frequency spectrum changes of MUAPS. The median frequency of MUAPS has now been determined for motor units
Torrecillas Nunez, C.; Miguel-Rodriguez, A.
education unit; developing and distributing educational materials; creation of a State Government webpage and establishing a network of trainers and promoters. The following items were agreed at the workshop: Mission - To be promoters of good water management, through interdisciplinary programs and innovation to provide knowledge about the proper use and care of water, ensuring a sustainable future for Sinaloa; Vision- To be the most committed and recognized state for the actions taken in water conservation and efficient use through the use of technology, knowledge and participatory processes; Objective- in three years reach at least 20% of the population, generating positive changes in customs, habits and behaviors in consumption and water management; and Specific objectives - helping to reduce total water consumption by 15% over three years and minimize the actual cost of providing water; report timely and effectively to the public about water scarcity, the cost of providing it, the need for payment, responsible use and its economic, health, social and environmental; education and communication programs to promote water culture; foster teamwork of the agencies involved in water management; and optimize the resources available to deliver the PCA.
Carpenter, Thomas P.
The major purpose of this study was 1) to investigate the development of the concept of a unit of measure and the coordination of unit size and the number of units 2) to relate this development to the development of conservation and 3) to determine the role of equivalence and nonequivalence relations in certain conservation and measurement…
Deaths related to Clostridium difficile are on the rise in the United States. Matthew Redelings from the Los Angeles County Department of Health discusses the increase and what can be done to prevent this infection.
Full Text Available Wetlands are one of the most important ecosystems worldwide due to the great biologic diversity that they harbor and the resources and ecosystem services that they provide; however, their conservation is seriously threatened. Waterfowl are one of the most representative components of wetland biodiversity and the study of their communities is necessary to establish protection priorities appropriately. In this study, we describe the species richness and relative abundance of the waterfowl community of an artificial wetland in Mexico State which we visited from August 2010 to August 2011. We found 23 species, most of which belong to the Anatidae (ducks and Ardeidae (herons families and we recorded an accumulated abundance of 25,220 individuals. We performed an accumulation curve and we used Clench’s model which estimated 24 species; thus, we observed 95% of the predicted species. The arrival of migratory species contributed substantially to the increase of the species richness and the abundance of individuals, especially from October to March. We consider that the species richness and the abundance that we recorded, including observations of rare species, species reproducing, and species under a conservation category, are indicative of the great ecological value of this wetland despite its limited size. Therefore, it is relevant to assess ecological features of natural and artificial wetlands, including waterfowl communities, in order to improve the conservation actions in this region.
Zumaquero-Ríos, José Lino; Sarracent-Pérez, Jorge; Rojas-García, Raúl; Rojas-Rivero, Lázara; Martínez-Tovilla, Yaneth; Valero, María Adela; Mas-Coma, Santiago
Background The Atlixco municipality, Puebla State, at a mean altitude of 1840 m, was selected for a study of Fasciola hepatica infection in schoolchildren in Mexico. This area presents permanent water collections continuously receiving thaw water from Popocatepetl volcano (5426 m altitude) through the community supply channels, conforming an epidemiological scenario similar to those known in hyperendemic areas of Andean countries. Methodology and Findings A total of 865 6–14 year-old schoolchildren were analyzed with FasciDIG coproantigen test and Lumbreras rapid sedimentation technique, and quantitatively assessed with Kato-Katz. Fascioliasis prevalences ranged 2.94–13.33% according to localities (mean 5.78%). Intensities were however low (24–384 epg). The association between fascioliasis and the habit of eating raw vegetables was identified, including watercress and radish with pronouncedly higher relative risk than lettuce, corncob, spinach, alfalfa juice, and broccoli. Many F. hepatica-infected children were coinfected by other parasites. Entamoeba histolytica/dispar, Giardia intestinalis, Blastocystis hominis, Hymenolepis nana and Ascaris lumbricoides infection resulted in risk factors for F. hepatica infection. Nitazoxanide efficacy against fascioliasis was 94.0% and 100% after first and second treatment courses, respectively. The few children, for whom a second treatment course was needed, were concomitantly infected by moderate ascariasis burdens. Its efficacy was also very high in the treatment of E. histolytica/E. dispar, G. intestinalis, B. hominis, H. nana, A. lumbricoides, Trichuris trichiura, and Enterobius vermicularis. A second treatment course was needed for all children affected by ancylostomatids. Conclusions Fascioliasis prevalences indicate this area to be mesoendemic, with isolated hyperendemic foci. This is the first time that a human fascioliasis endemic area is described in North America. Nitazoxanide appears as an appropriate
Zumaquero-Ríos, José Lino; Sarracent-Pérez, Jorge; Rojas-García, Raúl; Rojas-Rivero, Lázara; Martínez-Tovilla, Yaneth; Valero, María Adela; Mas-Coma, Santiago
The Atlixco municipality, Puebla State, at a mean altitude of 1840 m, was selected for a study of Fasciola hepatica infection in schoolchildren in Mexico. This area presents permanent water collections continuously receiving thaw water from Popocatepetl volcano (5426 m altitude) through the community supply channels, conforming an epidemiological scenario similar to those known in hyperendemic areas of Andean countries. A total of 865 6-14 year-old schoolchildren were analyzed with FasciDIG coproantigen test and Lumbreras rapid sedimentation technique, and quantitatively assessed with Kato-Katz. Fascioliasis prevalences ranged 2.94-13.33% according to localities (mean 5.78%). Intensities were however low (24-384 epg). The association between fascioliasis and the habit of eating raw vegetables was identified, including watercress and radish with pronouncedly higher relative risk than lettuce, corncob, spinach, alfalfa juice, and broccoli. Many F. hepatica-infected children were coinfected by other parasites. Entamoeba histolytica/dispar, Giardia intestinalis, Blastocystis hominis, Hymenolepis nana and Ascaris lumbricoides infection resulted in risk factors for F. hepatica infection. Nitazoxanide efficacy against fascioliasis was 94.0% and 100% after first and second treatment courses, respectively. The few children, for whom a second treatment course was needed, were concomitantly infected by moderate ascariasis burdens. Its efficacy was also very high in the treatment of E. histolytica/E. dispar, G. intestinalis, B. hominis, H. nana, A. lumbricoides, Trichuris trichiura, and Enterobius vermicularis. A second treatment course was needed for all children affected by ancylostomatids. Fascioliasis prevalences indicate this area to be mesoendemic, with isolated hyperendemic foci. This is the first time that a human fascioliasis endemic area is described in North America. Nitazoxanide appears as an appropriate alternative to triclabendazole, the present drug of choice
Falcón-Lezama, Jorge Abelardo; Santos-Luna, René; Román-Pérez, Susana; Martínez-Vega, Ruth Aralí; Herrera-Valdez, Marco Arieli; Kuri-Morales, Ángel Fernando; Adams, Ben; Kuri-Morales, Pablo Antonio; López-Cervantes, Malaquías; Ramos-Castañeda, José
Mathematical models and field data suggest that human mobility is an important driver for Dengue virus transmission. Nonetheless little is known on this matter due the lack of instruments for precise mobility quantification and study design difficulties. We carried out a cohort-nested, case-control study with 126 individuals (42 cases, 42 intradomestic controls and 42 population controls) with the goal of describing human mobility patterns of recently Dengue virus-infected subjects, and comparing them with those of non-infected subjects living in an urban endemic locality. Mobility was quantified using a GPS-data logger registering waypoints at 60-second intervals for a minimum of 15 natural days. Although absolute displacement was highly biased towards the intradomestic and peridomestic areas, occasional displacements exceeding a 100-Km radius from the center of the studied locality were recorded for all three study groups and individual displacements were recorded traveling across six states from central Mexico. Additionally, cases had a larger number of visits out of the municipality´s administrative limits when compared to intradomestic controls (cases: 10.4 versus intradomestic controls: 2.9, p = 0.0282). We were able to identify extradomestic places within and out of the locality that were independently visited by apparently non-related infected subjects, consistent with houses, working and leisure places. Results of this study show that human mobility in a small urban setting exceeded that considered by local health authority's administrative limits, and was different between recently infected and non-infected subjects living in the same household. These observations provide important insights about the role that human mobility may have in Dengue virus transmission and persistence across endemic geographic areas that need to be taken into account when planning preventive and control measures. Finally, these results are a valuable reference when setting the
José Lino Zumaquero-Ríos
Full Text Available The Atlixco municipality, Puebla State, at a mean altitude of 1840 m, was selected for a study of Fasciola hepatica infection in schoolchildren in Mexico. This area presents permanent water collections continuously receiving thaw water from Popocatepetl volcano (5426 m altitude through the community supply channels, conforming an epidemiological scenario similar to those known in hyperendemic areas of Andean countries.A total of 865 6-14 year-old schoolchildren were analyzed with FasciDIG coproantigen test and Lumbreras rapid sedimentation technique, and quantitatively assessed with Kato-Katz. Fascioliasis prevalences ranged 2.94-13.33% according to localities (mean 5.78%. Intensities were however low (24-384 epg. The association between fascioliasis and the habit of eating raw vegetables was identified, including watercress and radish with pronouncedly higher relative risk than lettuce, corncob, spinach, alfalfa juice, and broccoli. Many F. hepatica-infected children were coinfected by other parasites. Entamoeba histolytica/dispar, Giardia intestinalis, Blastocystis hominis, Hymenolepis nana and Ascaris lumbricoides infection resulted in risk factors for F. hepatica infection. Nitazoxanide efficacy against fascioliasis was 94.0% and 100% after first and second treatment courses, respectively. The few children, for whom a second treatment course was needed, were concomitantly infected by moderate ascariasis burdens. Its efficacy was also very high in the treatment of E. histolytica/E. dispar, G. intestinalis, B. hominis, H. nana, A. lumbricoides, Trichuris trichiura, and Enterobius vermicularis. A second treatment course was needed for all children affected by ancylostomatids.Fascioliasis prevalences indicate this area to be mesoendemic, with isolated hyperendemic foci. This is the first time that a human fascioliasis endemic area is described in North America. Nitazoxanide appears as an appropriate alternative to triclabendazole, the present
Kang, D. I.; Kim, K. Y.
We performed a categorization of safety related Motor Operated Valve (MOV) safety significance for Ulchin Unit 3. The safety evaluation of MOV of domestic nuclear power plants affects the generic data used for the quantification of MOV common cause failure ( CCF) events in Ulchin Units 3 PSA. Therefore, in this study, we re-estimated the MGL(Multiple Greek Letter) parameter used for the evaluation of MOV CCF probabilities in Ulchin Units 3 Probabilistic Safety Assessment (PSA) and performed a classification of the MOV safety significance. The re-estimation results of the MGL parameter show that its value is decreased by 30% compared with the current value in Ulchin Unit 3 PSA. The categorization results of MOV safety significance using the changed value of MGL parameter shows that the number of HSSCs(High Safety Significant Components) is decreased by 54.5% compared with those using the current value of it in Ulchin Units 3 PSA
Padrón-Rivera, Gustavo; Rebolledo-Mendez, Genaro; Parra, Pilar Pozos; Huerta-Pacheco, N. Sofia
Affect is an important element of the learning process both in the classroom and with educational technology. This paper presents analyses in relation to the identification of Action Units (AUs) related to affective states and their impact on learning with a tutoring system. To assess affect, a tool was devised to identify AUs on pictures of human…
Schoch, Kathleen S.
A chronological history of major public relations organizations in the United States is presented in this paper. Following an overview of the public relations profession, the paper traces the development of several sporatically formed organizations, starting with the Financial Advertising Association in 1915, and leading to the largest…
Barth, Angélica Adam; Weigel, Bruna Dorfey; Dummer, Claus Dieter; Machado, Kelly Campara; Tisott, Taís Montagner
To identify and stratify the main stressors for the relatives of patients admitted to the adult intensive care unit of a teaching hospital. Cross-sectional descriptive study conducted with relatives of patients admitted to an intensive care unit from April to October 2014. The following materials were used: a questionnaire containing identification information and demographic data of the relatives, clinical data of the patients, and 25 stressors adapted from the Intensive Care Unit Environmental Stressor Scale. The degree of stress caused by each factor was determined on a scale of values from 1 to 4. The stressors were ranked based on the average score obtained. The main cause of admission to the intensive care unit was clinical in 36 (52.2%) cases. The main stressors were the patient being in a state of coma (3.15 ± 1.23), the patient being unable to speak (3.15 ± 1.20), and the reason for admission (3.00 ± 1.27). After removing the 27 (39.1%) coma patients from the analysis, the main stressors for the relatives were the reason for admission (2.75 ± 1.354), seeing the patient in the intensive care unit (2.51 ± 1.227), and the patient being unable to speak (2.50 ± 1.269). Difficulties in communication and in the relationship with the patient admitted to the intensive care unit were identified as the main stressors by their relatives, with the state of coma being predominant. By contrast, the environment, work routines, and relationship between the relatives and intensive care unit team had the least impact as stressors.
Full Text Available The modern metric system defines units of volume based on the cube. We propose that the ancient Egyptian system of measuring capacity employed a similar concept, but used the sphere instead. When considered in ancient Egyptian units, the volume of a sphere, whose circumference is one royal cubit, equals half a hekat. Using the measurements of large sets of ancient containers as a database, the article demonstrates that this formula was characteristic of Egyptian and Egyptian-related pottery vessels but not of the ceramics of Mesopotamia, which had a different system of measuring length and volume units.
Seidman, Carly J; Linakis, James G; Mello, Michael J; Greenberg, Paul B
To quantify and characterize eye injuries related to aerosol container consumer products treated in United States hospital emergency departments (EDs) from 1997 through 2009. Retrospective study. Descriptive analysis of aerosol container-related eye injury data derived from the National Electronic Injury Surveillance System, a stratified probability sample of hospital-affiliated United States EDs. Data collected included demographic variables (gender and age), locale, diagnoses, and hospital disposition associated with aerosol container-related eye injuries treated in United States EDs from 1997 through 2009. Products associated with injury and mechanisms of injury also were extracted and analyzed. There were an estimated 10 765 (95% confidence interval [CI], 9842 to 11 688) visits to United States EDs for aerosol container-related eye injuries during the study period; 6756 (95% CI, 5771 to 7742; 63%) patients were male; 5927 (95% CI, 4956 to 6897; 55%) injuries occurred in children (age container-related eye injuries in the United States occur in men and children and that self-inflicted spray to the eye is the most common mechanism of injury. Further research is needed to devise effective prevention strategies for these types of injuries. Published by Elsevier Inc.
Moyer, T.C.; Geslin, J.K.; Flint, L.E.
Yucca Mountain is being investigated as a potential site for a high- level nuclear waste repository. The intent of this study was to clarify stratigraphic relations within the Paintbrush Tuff (PTn) unit at Yucca Mountain in order to better understand vertical and lateral variations in hydrologic properties as they relate to the lithologic character of these rocks. This report defines informal stratigraphic units within the PTn interval, demonstrates their lateral continuity in the Yucca Mountain region, describes later and vertical variations within them, and characterizes their hydrologic properties and importance to numerical flow and transport models. We present tables summarizing the depth to stratigraphic contacts in cored borehole studies, and unit descriptions and correlations in 10 measured sections
Moyer, T.C.; Geslin, J.K. [Science Applications International Corp., Golden, CO (United States); Flint, L.E. [U.S. Geological Survey, Yucca Mountain Project, Mercury, NV (United States)
Yucca Mountain is being investigated as a potential site for a high- level nuclear waste repository. The intent of this study was to clarify stratigraphic relations within the Paintbrush Tuff (PTn) unit at Yucca Mountain in order to better understand vertical and lateral variations in hydrologic properties as they relate to the lithologic character of these rocks. This report defines informal stratigraphic units within the PTn interval, demonstrates their lateral continuity in the Yucca Mountain region, describes later and vertical variations within them, and characterizes their hydrologic properties and importance to numerical flow and transport models. We present tables summarizing the depth to stratigraphic contacts in cored borehole studies, and unit descriptions and correlations in 10 measured sections.
Colin K. Khoury; Stephanie L. Greene; Karen A. Williams; Chrystian C. Sosa; Chris. Richards
Crop wild relatives native to the United States have proved useful as genetic resources in breeding more productive, nutritious, and resilient crops. Their utilization is expected to increase with better information about the species and improving breeding tools. But this utilization may be constrained by their limited representation in genebanks and the ongoing loss...
Fereshteh, M. Hussein
This review evaluates the writings and opinions of Americans and Iranians on relations and influences between institutions of higher education in Iran and the United States before and after the 1979 revolution. The review explores the arrival of modern western education in Iran, Egypt, and Turkey where a traditional education system had prevailed…
In the views of Palmer and Perkins, (2007) “these are times that try men's souls”. The statement corroborates the America relations with Iran since the mid-1980s, when the United States, Israel and other Western Powers started accusing Iran of Uranium enrichment toward pursuing a nuclear weapons capability, a situation ...
Deaths related to Clostridium difficile are on the rise in the United States. Matthew Redelings from the Los Angeles County Department of Health discusses the increase and what can be done to prevent this infection. Created: 1/8/2008 by Emerging Infectious Diseases. Date Released: 1/8/2008.
Fitch, Kate; Surma, Anne
Murdoch University's public relations program attracts a significant number of international students. Up to 60% of students in some units come from Singapore and Malaysia. While many spend at least one year in Australia as part of the three year degree, students in both countries may complete the entire degree offshore from 2007. The authors…
Richard C. Johnson; Matthew E. Horning; Erin Espeland; Ken Vance-Borland
Genetic variation for potentially adaptive traits of the key restoration species Sandberg bluegrass (Poa secunda J. Presl) was assessed over the intermountain western United States in relation to source population climate. Common gardens were established at two intermountain west sites with progeny from two maternal parents from each of 130 wild populations. Data were...
Quinn, Brian J.
In the past decade researchers began to remedy a literature deficit in the study of broadcasting institutions – addressing in particular the issues of labour process, restructuring and industrial relations. This thesis which considers management change, industrial relations and restructuring within the United Kingdom (‘UK’) broadcasting industry employs a case study format with a view to highlighting the variations of industry (macro) and firm (micro) based restructuring. Organizational chang...
Shantakumari, N; Eldeeb, R; Sreedharan, J; Gopal, K
Background: The extensive use of computers as medium of teaching and learning in universities necessitates introspection into the extent of computer related health disorders among student population. Aim: This study was undertaken to assess the pattern of computer usage and related visual problems, among University students in Ajman, United Arab Emirates. Materials and Methods: A total of 500 Students studying in Gulf Medical University, Ajman and Ajman University of Science and Technology we...
Full Text Available The article presents some problems related to securing the Bulgarian system for disaster management with the necessary resources for its proper functioning. The main challenges for the united rescue system in the country are analyzed, including those related to ensuring the system with the necessary material, financial and human resources. Some possibilities for solving these problems with the use of funds from the European Union are presented.
Capelastegui, A.; Villanua, J.
To analyze the merit and repercussions of measuring magnetic resonance (MR) activity in units of radiological activity, and of using complexity index (CI) as an activity indicator. We studied the MR activity of Osatek, Inc. during an 8-year period (1994-2001). We measured this activity both in number of MR procedures performed and in units of radiological activity, such units being based on the scale of relative units published in the Radiological Services Administration Guidelines published by the Spanish Society or Medical Radiology. We calculated the annual complexity index, this being a quotient between the number of MR procedures performed and corresponding value in units of radiological activity. We also analyzed factors that can have an impact on the CI: type of exploration and power of the equipment's magnetic field. The CL stayed practically stable during the first 4 years of the study, while it increased during the second 4 years. There exists a direct relationship between this increase and the percentage of explorations that we term complex (basically, body-and angio-MR). The increasing complexity of MR studies in the last years is evident from a consideration of CI. MR productivity is more realistically expressed in units of radiological activity than in number of procedures performed by any one center. It also allows for making external comparisons. CI is a useful indicator that can be utilized as an administrative tool. (Author) 13 refs
Full Text Available Introduction: Clinical competence of nurses working in the neonatal intensive care units together with advancements in medical science and technology increased the survival rate of newborns that need specialized care. To ensure the quality of care and provide the safety of patients, evaluating the clinical competence of nurses seems necessary. This study aimed to evaluate the clinical competence of nurses in the neonatal intensive care units. Methods: In this cross-sectional study, 117 nurses working in the neonatal intensive care units of the hospitals affiliated to Tehran University of Medical Sciences were selected by census method. The research tool was Development of Competency Inventory for Registered Nurses questionnaire which completed by self-assessment. The mean clinical competence scores of participants categorized into 3 levels: weak: 273. Data were analyzed by SPSS version 13 using the Pearson correlation coefficient, t-test and Chi-square test. Results: The highest levels of competence were related to critical thinking and research attitude and interpersonal relationships, and the lowest level was related to training and mentoring. There was a direct statistically significant relationship between marital status, employment status, level of interest in working in the neonatal intensive-care units and the clinical competence of nurses. Conclusion: Since the clinical competence of nurses in the Neonatal Intensive Care Units is vital, some variables such as interest in the nursing profession, employment status, the neonatal intensive theoretical and practical training courses and the amount of overtime working hours should be taken into consideration.
Kallio, J; Søgaard, Karen; Avela, J
Aging is related to multiple changes in muscle physiology and function. Previous findings concerning the effects of aging on motor unit discharge rate (DR) and fluctuations in DR and force are somewhat contradictory. Eight YOUNG and nine OLD physically active males performed isometric ramp (RECR......) and isotonic (ISO) plantar flexions at 10 and 20% of surface EMG at MVC. Motor unit (MU) action potentials were recorded with intramuscular fine-wire electrodes and decomposed with custom build software "Daisy". DR was lower in OLD in RECR-10% (17.9%, p...
Ana Carolina Coimbra de Castro
Full Text Available Objective: To identify the prevalence of bloodstream infection associated with the Catheter related Blood stream infections in patients of the Intensive Care Unit, and the characteristics of its use and handling. Methods: Descriptive and transversal study with a sample of 88 participants. Data were collected through the observational method and the records in the medical records. The absolute and relative frequencies were used for data analysis. Results: 73.86% of the patients had central venous access in the subclavian vein, 100% used double lumen Catheter related Blood stream infections, 0.5% chlorhexidine solution for skin antisepsis, dressing coverage is performed mostly with Sterile gauze and tape, with a daily exchange. The rate of infection related to the use of the Catheter related Blood stream infections was (6.81%. The most infused pharmacological drugs were antimicrobials (69.32%. Conclusion: The study showed that care with central venous accesses is performed according to recommendations for prevention of bloodstream infection related to the use of these devices. The infection rate is close to the standards found in the literature. Key words: Central Venous Catheterization. Hospital Infection. Intensive care unit. Risk factors. Catheter-Related Infection..
... Friendship and General Relations Between the United States and Spain. 0.109 Section 0.109 Judicial... Service § 0.109 Implementation of the Treaty of Friendship and General Relations Between the United States... States within the meaning of Article XXIV of the Treaty of Friendship and General Relations Between the...
Burcharth, H. F.; Howell, G.L.; Liu, Z.
Failures of rubble mound breakwaters armoured with complex types of unreinforced concrete armour units are often due to breakage. This happens when the stresses exceed the material strength. Sufficient parametric studies of the stresses are not yet available to produce design diagrams for structural integrity. The paper presents a general discussion of the problems related to stress etermination and describes the results and the analyses of model tests with 200 kg and 200 g load-cell instrume...
Smith, G A
To describe the epidemiology of trampoline-related injuries among children in the United States. A retrospective analysis of data for children 18 years old and younger from the National Electronic Injury Surveillance System of the United States Consumer Product Safety Commission for 1990 through 1995. There were an estimated 249 400 trampoline-related injuries [95% confidence interval (CI), 166 300-332 500] to children 18 years old and younger treated in hospital emergency departments in the United States during the 6-year study period. The number of injuries increased by 98% from 29 600 in 1990 to 58 400 in 1995, with an average of 41 600 (95% CI, 27 700-55 500) injuries per year, or 59.4 injuries per 100 000 United States children per year (95% CI, 39.6-79.3). The median age of injured children was 10 years, and 50% were males. Ninety-three percent of injuries occurred at home. Injuries to the extremities predominated among children of all ages and accounted for more than 70% of all injuries. This study identified several age-specific injury patterns. There was an inverse relationship between age versus the relative frequency of upper extremity injuries, and fractures and dislocations; and there was a direct relationship between age versus lower extremity injuries and soft tissue injury. There was also an inverse relationship between age versus facial injuries, head and neck injuries, and lacerations. Annually, an estimated 1400 children (95% CI, 800-2000), or 2.0 per 100 000 United States children (95% CI, 1. 1-2.9), required hospital admission or interhospital transfer because of a trampoline-related injury. This represented 3.3% of all children with a trampoline-associated injury. Fractures or dislocations accounted for 83% of injuries among admitted or transferred children, and children with a fracture or dislocation were more likely to be admitted or transferred to another hospital (8.4%) than children with other types of injury (relative risk, 10.80; 95% CI
Muroi, Maki; Shen, Jay J; Angosta, Alona
Registered nurses (RNs) play an important role in safe medication administration and patient safety. This study examined a total of 1276 medication error (ME) incident reports made by RNs in hospital inpatient settings in the southwestern region of the United States. The most common drug class associated with MEs was cardiovascular drugs (24.7%). Among this class, anticoagulants had the most errors (11.3%). The antimicrobials was the second most common drug class associated with errors (19.1%) and vancomycin was the most common antimicrobial that caused errors in this category (6.1%). MEs occurred more frequently in the medical-surgical and intensive care units than any other hospital units. Ten percent of MEs reached the patients with harm and 11% reached the patients with increased monitoring. Understanding the contributing factors related to MEs, addressing and eliminating risk of errors across hospital units, and providing education and resources for nurses may help reduce MEs. Copyright © 2016 Elsevier Inc. All rights reserved.
Guerriero, Réjean M; Proctor, Mark R; Mannix, Rebekah; Meehan, William P
Sport-related concussion affects athletes at every level of participation. The short and long-term effects of concussions that occur during childhood and adolescence are not fully understood. The purpose of this review is to describe the current burden of disease, current practice patterns and current recommendations for the assessment and management of sport-related concussions sustained by United States high school athletes. Millions of high school students participate in organized sports in the United States. Current estimates suggest that, across all sports, approximately 2.5 concussions occur for every 10 000 athletic exposures, in which an athletic exposure is defined as one athlete participating in one game or practice. At schools that employ at least one athletic trainer, most high school athletes who sustain sport-related concussions will be cared for by athletic trainers and primary care physicians. Approximately 40% will undergo computerized neurocognitive assessment. The number of high school athletes being diagnosed with sport-related concussions is rising. American football has the highest number of concussions in high school with girls' soccer having the second highest total number. Fortunately, coaches are becoming increasingly aware of these injuries and return-to-play guidelines are being implemented.
Burcharth, H. F.; Howell, G.L.; Liu, Z.
Failures of rubble mound breakwaters armoured with complex types of unreinforced concrete armour units are often due to breakage. This happens when the stresses exceed the material strength. Sufficient parametric studies of the stresses are not yet available to produce design diagrams for structu......Failures of rubble mound breakwaters armoured with complex types of unreinforced concrete armour units are often due to breakage. This happens when the stresses exceed the material strength. Sufficient parametric studies of the stresses are not yet available to produce design diagrams...... and scale effects. Moreover, some results from the Crescent City Prototype Dolosse study are presented and related to results from small-de model tests. A preliminary design diagram for Dolosse ir presented as well....
Full Text Available Public health protection from air pollution can be achieved more effectively by shifting from a single-pollutant approach to a multi-pollutant approach. To develop such multi-pollutant approaches, identifying which air pollutants are present most frequently is essential. This study aims to determine the frequently found carcinogenic air toxics or hazardous air pollutants (HAPs combinations across the United States as well as to analyze the health impacts of developing cancer due to exposure to these HAPs. To identify the most commonly found carcinogenic air toxics combinations, we first identified HAPs with cancer risk greater than one in a million in more than 5% of the census tracts across the United States, based on the National-Scale Air Toxics Assessment (NATA by the U.S. EPA for year 2005. We then calculated the frequencies of their two-component (binary, and three-component (ternary combinations. To quantify the cancer-related health impacts, we focused on the 10 most frequently found HAPs with national average cancer risk greater than one in a million. Their cancer-related health impacts were calculated by converting lifetime cancer risk reported in NATA 2005 to years of healthy life lost or Disability-Adjusted Life Years (DALYs. We found that the most frequently found air toxics with cancer risk greater than one in a million are formaldehyde, carbon tetrachloride, acetaldehyde, and benzene. The most frequently occurring binary pairs and ternary mixtures are the various combinations of these four air toxics. Analysis of urban and rural HAPs did not reveal significant differences in the top combinations of these chemicals. The cumulative annual cancer-related health impacts of inhaling the top 10 carcinogenic air toxics included was about 1,600 DALYs in the United States or 0.6 DALYs per 100,000 people. Formaldehyde and benzene together contribute nearly 60 percent of the total cancer-related health impacts. Our study shows that although
Zhou, Ying; Li, Chaoyang; Huijbregts, Mark A J; Mumtaz, M Moiz
Public health protection from air pollution can be achieved more effectively by shifting from a single-pollutant approach to a multi-pollutant approach. To develop such multi-pollutant approaches, identifying which air pollutants are present most frequently is essential. This study aims to determine the frequently found carcinogenic air toxics or hazardous air pollutants (HAPs) combinations across the United States as well as to analyze the health impacts of developing cancer due to exposure to these HAPs. To identify the most commonly found carcinogenic air toxics combinations, we first identified HAPs with cancer risk greater than one in a million in more than 5% of the census tracts across the United States, based on the National-Scale Air Toxics Assessment (NATA) by the U.S. EPA for year 2005. We then calculated the frequencies of their two-component (binary), and three-component (ternary) combinations. To quantify the cancer-related health impacts, we focused on the 10 most frequently found HAPs with national average cancer risk greater than one in a million. Their cancer-related health impacts were calculated by converting lifetime cancer risk reported in NATA 2005 to years of healthy life lost or Disability-Adjusted Life Years (DALYs). We found that the most frequently found air toxics with cancer risk greater than one in a million are formaldehyde, carbon tetrachloride, acetaldehyde, and benzene. The most frequently occurring binary pairs and ternary mixtures are the various combinations of these four air toxics. Analysis of urban and rural HAPs did not reveal significant differences in the top combinations of these chemicals. The cumulative annual cancer-related health impacts of inhaling the top 10 carcinogenic air toxics included was about 1,600 DALYs in the United States or 0.6 DALYs per 100,000 people. Formaldehyde and benzene together contribute nearly 60 percent of the total cancer-related health impacts. Our study shows that although there are many
Grøthe, Å; Biong, Stian; Grov, E K
Admission of a cancer patient to a palliative unit when near the final stage of their disease trajectory undoubtedly impacts their relatives. The aim of our study was to illuminate and interpret relatives' lived experiences of health personnel's provision of care in a palliative ward. A phenomenological/hermeneutic approach was employed that was inspired by the philosophical tradition of Heidegger and Ricoeur and further developed by Lindseth and Nordberg. The perspectives of the narrator and the text were interpreted by highlighting relatives' views on a situation in which they have to face existential challenges. The analysis was undertaken in three steps: naïve reading, structural analysis, and comprehensive understanding, including the authors' professional experiences and theoretical background. Six subthemes appeared: the dying person, the bubble, the sight, the cover, the provision for children's needs, and the availability of immediate help. These components were further constructed into three themes: the meaning of relating, the meaning of action, and the meaning of resources. Our comprehensive understanding of the results suggests that the most important theme is "acting with dedication and expertise." The following aspects are crucial for relatives of cancer patients hospitalized in a palliative ward: time and existence, family dynamics, and care adjusted to the situation. Our study results led to reflections on the impact of how nurses behave when providing care to patients during the palliative phase, and how they interact with relatives in this situation. We found that cancer patients in a palliative unit most appreciate nurses who act with dedication and expertise.
Cicekci, Faruk; Duran, Numan; Ayhan, Bunyamin; Arican, Sule; Ilban, Omur; Kara, Iskender; Turkoglu, Melda; Yildirim, Fatma; Hasirci, Ismail; Karaibrahimoglu, Adnan; Kara, Inci
Patients in intensive care units (ICUs) are often physically unable to communicate with their physicians. Thus, the sharing of information about the on-going treatment of the patients in ICUs is directly related to the communication attitudes governing a patient's relatives and the physician. This study aims to analyze the attitudes displayed by the relatives of patients and the physician with the purpose of determining the communication between the two parties. For data collection, two similar survey forms were created in context of the study; one for the relatives of the patients and one for the ICU physicians. The questionnaire included three sub-dimensions: informing, empathy and trust. The study included 181 patient relatives and 103 ICU physicians from three different cities and six hospitals. Based on the results of the questionnaire, identification of the mutual expectations and substance of the messages involved in the communication process between the ICU patients' relatives and physicians was made. The gender and various disciplines of the physicians and the time of the conversation with the patients' relatives were found to affect the communication attitude towards the patient. Moreover, the age of the patient's relatives, the level of education, the physician's perception, and the contact frequency with the patient when he/she was healthy were also proven to have an impact on the communication attitude of the physician. This study demonstrates the mutual expectations and substance of messages in the informing, empathy and trust sub-dimensions of the communication process between patient relatives and physicians in the ICU. The communication between patient relatives and physicians can be strengthened through a variety of training programs to improve communication skills.
Gregory, Kent J.; Pattison, John E.; Bibbo, Giovanni
Breast screening programs operate in many countries with mammographic x-ray units subject to stringent quality control tests. These tests include the evaluation of quantities based on exposure measurements, such as half value layer, automatic exposure control reproducibility, average glandular dose, and radiation output rate. There are numerous error sources that contribute to the uncertainty of these exposure-related quantities, some of which are unique to the low energy x-ray spectrum produced by mammographic x-ray units. For each of these exposure-related quantities, the applicable error sources and their magnitudes vary, depending on the test equipment used to make the measurement, and whether or not relevant corrections have been applied. This study has identified and quantified a range of error sources that may be used to estimate the combined uncertainty of these exposure-related quantities, given the test equipment used and corrections applied. The uncertainty analysis uses methods described by the International Standards Organization's Guide to the Expression of Uncertainty in Measurement. Examples of how these error sources combine to give the uncertainty of the exposure-related quantities are presented. Using the best test equipment evaluated in this study, uncertainties of the four exposure-related quantities at the 95% confidence interval were found to be ±1.6% (half value layer), ±0.0008 (automatic exposure control reproducibility), ±2.3% (average glandular dose), and ±2.1% (radiation output rate). In some cases, using less precise test equipment or failing to apply corrections, resulted in uncertainties more than double in magnitude
Zane, Suzanne; Creanga, Andreea A.; Berg, Cynthia J.; Pazol, Karen; Suchdev, Danielle B.; Jamieson, Denise J.; Callaghan, William M.
OBJECTIVE To examine characteristics and causes of legal induced abortion–related deaths in the United States between 1998 and 2010. METHODS Abortion-related deaths were identified through the national Pregnancy Mortality Surveillance System with enhanced case-finding. We calculated the abortion mortality rate by race, maternal age, and gestational age and the distribution of causes of death by gestational age and procedure. RESULTS During the period from 1998–2010, of approximately 16.1 million abortion procedures, 108 women died, for a mortality rate of 0.7 deaths per 100,000 procedures overall, 0.4 deaths for non-Hispanic white women, 0.5 deaths for Hispanic women, and 1.1 deaths for black women. The mortality rate increased with gestational age, from 0.3 to 6.7 deaths for procedures performed at 8 weeks or less and at 18 weeks or greater, respectively. A majority of abortion-related deaths at 13 weeks of gestation or less were associated with anesthesia complications and infection, whereas a majority of abortion-related deaths at more than 13 weeks of gestation were associated with infection and hemorrhage. In 20 of the 108 cases, the abortion was performed as a result of a severe medical condition where continuation of the pregnancy threatened the woman’s life. CONCLUSION Deaths associated with legal induced abortion continue to be rare events—less than 1 per 100,000 procedures. Primary prevention of unintended pregnancy, including those in women with serious pre-existing medical conditions, and increased access to abortion services at early gestational ages may help to further decrease abortion-related mortality in the United States. PMID:26241413
Plakas, Sotirios; Taket, Ann; Cant, Bob; Fouka, Georgia; Vardaki, Zambia
To explore the meaning of vigilant attendance for relatives of critically ill patients in Greece. A plethora of international research has identified proximity to the patient to be a major concern for relatives of critically ill patients. Greece however follows a strict visiting policy in intensive care units (ICUs) so Greek relatives spend great amounts of time just outside the ICUs. This qualitative study adopted the social constructionist version of grounded theory. Data were collected from three ICUs in Athens through in depth interviews with 25 informants and approximately 10 h of observations outside the ICUs on 159 relatives. Vigilant attendance was one of the main coping mechanisms identified for relatives. Four subcategories were found to comprise vigilant attendance: (1) being as close as possible to feel relief, (2) being there to find out what is going on, (3) monitoring changes in the loved one and making own diagnosis and (4) interacting with the ICU professionals. Vigilant attendance describes the way in which relatives in Greece stayed outside the ICUs. Relatives felt satisfaction from being close as the best alternative for not actually being inside the ICU and they tried to learn what was going on by alternative methods. By seeing the patients, relatives were also able to make their own diagnoses and could therefore avoid relying solely on information given to them. However, a prerequisite for successful vigilant attendance was to get on well with doctors and nurses. Changes in visiting policies in Greece are needed to meet the needs of relatives adequately. Recommendations for changes with minimal investment of time and funding are made. © 2013 British Association of Critical Care Nurses.
Full Text Available This paper provides a framework for segmenting Cyprus as a tourism destination and discusses ways for reaching various target markets in the United States. Prior research using multi-dimensional scaling demonstrates (Yiannakis & Gibson, 1988, 1992, 2002; Gibson 1994; Foo, McGuiggan & Yiannakis, 2004 that when tourists go on vacation they seek a balance among three fundamental or core push factors: familiarity-strangeness, structure-independence and stimulation tranquility. When the above are matched with various product categories (pull factors that represent what Cyprus has to offer (e.g., heritage/cultural tourism, escapist tourism, sport tourism, eco-tourism and the like, we are able to develop a targeted framework that can help us market Cyprus as a tourism destination to various markets in the United States. The authors also discuss some of the major selling points that make Cyprus attractive as a tourism destination and suggest how these may be employed in an overall strategy for reaching the relatively untapped markets of the United States. The authors make a number of recommendations involving new market exploration and discuss strategies for increasing the island's exposure through both marketing, as well as public relations activities. In closing, the authors recommend that in addition to economic impact studies Cyprus needs to assess the socio-cultural and environmental impacts of tourism on the island and its people. Such findings may help the tourism industry and the people of Cyprus determine the kind of tourism product they want, and the type of tourist they would prefer to attract to the island.
Yang, Haiou; Hitchcock, Edward; Haldeman, Scott; Swanson, Naomi; Lu, Ming-Lun; Choi, BongKyoo; Nakata, Akinori; Baker, Dean
Background Neck pain is a prevalent musculoskeletal condition among workers in the United States. This study explores a set of workplace psychosocial and organization-related factors for neck pain. Methods Data used for this study comes from the 2010 National Health interview Survey which provides a representative sample of the US population. To account for the complex sampling design, the Taylor linearized variance estimation method was used. Logistic regression models were constructed to measure the associations. Results This study demonstrated significant associations between neck pain and a set of workplace risk factors including work-family imbalance, exposure to a hostile work environment and job insecurity, non-standard work arrangements, multiple jobs and long work hours. Conclusion Workers with neck pain may benefit from intervention programs that address issues related to these workplace risk factors. Future studies exploring both psychosocial risk factors and physical risk factors with a longitudinal design will be important. PMID:27184340
O'Neil, Joseph; Steele, Gregory K; Huisingh, Carrie; Smith, Gary A
This study describes the epidemiology of elevator-related injuries among children in the United States from 1990 to 2004. A retrospective cohort analysis was performed using data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission. Reported cases were used to project national estimates. An estimated 29 030 elevator-related injuries occurred among children in the United States during 1990 to 2004. The mean age was 8.1 years (SD, 6.1 years), with 53.3% of injuries among boys. The overall injury rate was 2.5 injuries per 100,000 population. The injury rate for children aged 0-4 years was 4.2 per 100,000 population, and for children aged 5-19 years the injury rate was 1.9 per 100,000 population. The most frequent cause of injury was the elevator door closing on a body part, the most frequently injured body region was the upper extremity, and soft-tissue injuries were the most frequent type of injury. Children should be closely supervised on or near elevators to reduce the risk of injury.
Woodward, R.; Rautenstrauch, K.R.; Hall, D.B.; Ostler, W.K.
Sign-survey transects were sampled in 1996 to better determine the relative abundance of desert tortoises on the Nevada Test Site (NTS). These transects were sampled within ecological land-form units (ELUs), which are small, ecologically homogeneous units of land. Two-hundred and six ELUs were sampled by walking 332 transects totaling 889 kilometers (km). These ELUs covered 528 km 2 . Two-hundred and eight-one sign were counted. An average of 0.32 sign was found per km walked. Seventy percent of the area sampled had a very low abundance of tortoises, 29% had a low abundance, and 1% had a moderate abundance. A revised map of the relative abundance of desert tortoise on the NTS is presented. Within the 1,330 km 2 of desert tortoise habitat on the NTS, 49% is classified as having no tortoises or a very low abundance, 18% has a low or moderate abundance, 12% is unclassified land being used by the Yucca Mountain Site Characterization Project, and the remaining 21% still has an unknown abundance of desert tortoises. Based on the results of this work, the amount of tortoise habitat previously classified as having an unknown or low-moderate abundance, and on which clearance surveys and on-site monitoring was required, has been reduced by 20%
Brewer, Devon D; Dudek, Jonathan A; Potterat, John J; Muth, Stephen Q; Roberts, John M; Woodhouse, Donald E
Prostitute women have the highest homicide victimization rate of any set of women ever studied. We analyzed nine diverse homicide data sets to examine the extent, trends, and perpetrators of prostitution-related homicide in the United States. Most data sources substantially under-ascertained prostitute homicides. As estimated from a conservative capture-recapture analysis, 2.7% of female homicide victims in the United States between 1982 and 2000 were prostitutes. Frequencies of recorded prostitute and client homicides increased substantially in the late 1980s and early 1990s; nearly all of the few observed pimp homicides occurred before the late 1980s. These trends may be linked to the rise of crack cocaine use. Prostitutes were killed primarily by clients, clients were killed mainly by prostitutes, and pimps were killed predominantly by pimps. Another conservative estimate suggests that serial killers accounted for 35% of prostitute homicides. Proactive surveillance of, and evidence collection from, clients and prostitutes might enhance the investigation of prostitution-related homicide.
Christensen, Martin; Probst, Barbara
The aim of this reflective account is to provide a view of the intensive care unit (ICU) relative's experiences of supporting and being supported in the ICU. Understanding the relatives' experiences of ICU is important especially because a recent work has identified the potential for this group to develop post-traumatic stress disorder, a condition that is normally equated with the ICU survivor. A thematic analysis was used in identifying emerging themes that would be significant in an ICU nursing context. The incident took place in two 8-bedded ICUs (Private and National Health Service) in October. Two emergent themes were identified from the reflective story - fear of the technological environment and feeling hopeless and helpless. The use of relative stories as an insight into the live experiences of ICU relatives may give a deeper understanding of their life-world. The loneliness, anguish and pain of the ICU relative extends beyond the walls of the ICU, and this is often negated as the focus of the ICU team is the patient. Developing strategies to support relatives might include the use of relative diaries used concurrently with patient diaries to support this groups recovery or at the very least a gaining a sense of understanding for their ICU experience. Relative follow-up clinics designed specifically to meet their needs where support and advice can be given by the ICU team, in addition to making timely and appropriate referrals to counselling services and perhaps involving spiritual leaders where appropriate. © 2014 British Association of Critical Care Nurses.
Rasberry, Catherine N; Tiu, Georgianne F; Kann, Laura; McManus, Tim; Michael, Shannon L; Merlo, Caitlin L; Lee, Sarah M; Bohm, Michele K; Annor, Francis; Ethier, Kathleen A
Studies have shown links between educational outcomes such as letter grades, test scores, or other measures of academic achievement, and health-related behaviors (1-4). However, as reported in a 2013 systematic review, many of these studies have used samples that are not nationally representative, and quite a few studies are now at least 2 decades old (1). To update the relevant data, CDC analyzed results from the 2015 national Youth Risk Behavior Survey (YRBS), a biennial, cross-sectional, school-based survey measuring health-related behaviors among U.S. students in grades 9-12. Analyses assessed relationships between academic achievement (i.e., self-reported letter grades in school) and 30 health-related behaviors (categorized as dietary behaviors, physical activity, sedentary behaviors, substance use, sexual risk behaviors, violence-related behaviors, and suicide-related behaviors) that contribute to leading causes of morbidity and mortality among adolescents in the United States (5). Logistic regression models controlling for sex, race/ethnicity, and grade in school found that students who earned mostly A's, mostly B's, or mostly C's had statistically significantly higher prevalence estimates for most protective health-related behaviors and significantly lower prevalence estimates for most health-related risk behaviors than did students with mostly D's/F's. These findings highlight the link between health-related behaviors and education outcomes, suggesting that education and public health professionals can find their respective education and health improvement goals to be mutually beneficial. Education and public health professionals might benefit from collaborating to achieve both improved education and health outcomes for youths.
First page Back Continue Last page Graphics. Influenza-like illness in Mexico and the United States. Mexico. First case April 13, 2009 in Mexico. By May 3, 2,498 suspected cases,165 deaths in 31 of 32 States in Mexico. The USA. 24 April 2009. The US reported 7 confirmed human cases of Influenza A/H1N1. Five cases in ...
Ross, S A; Topp, C F E; Ennos, R A; Chagunda, M G G
This study aimed to assess the merit and suitability of individual functional units (FU) in expressing greenhouse gas emissions intensity in different dairy production systems. An FU provides a clearly defined and measurable reference to which input and output data are normalised. This enables the results from life-cycle assessment (LCA) of different systems to be treated as functionally equivalent. Although the methodological framework of LCA has been standardised, selection of an appropriate FU remains ultimately at the discretion of the individual study. The aim of the present analysis was to examine the effect of different FU on the emissions intensities of different dairy production systems. Analysis was based on 7 years of data (2004 to 2010) from four Holstein-Friesian dairy systems at Scotland's Rural College's long-term genetic and management systems project, the Langhill herd. Implementation of LCA accounted for the environmental impacts of the whole-farm systems and their production of milk from 'cradle to farm gate'. Emissions intensity was determined as kilograms of carbon dioxide equivalents referenced to six FU: UK livestock units, energy-corrected milk yield, total combined milk solids yield, on-farm land used for production, total combined on- and off-farm land used for production, and the proposed new FU-energy-corrected milk yield per hectare of total land used. Energy-corrected milk was the FU most effective for reflecting differences between the systems. Functional unit that incorporated a land-related aspect did not find difference between systems which were managed under the same forage regime, despite their comprising different genetic lines. Employing on-farm land as the FU favoured grazing systems. The proposed dual FU combining both productivity and land use did not differentiate between emissions intensity of systems as effectively as the productivity-based units. However, this dual unit displayed potential to quantify in a simple way
Woo, Jessica G; Guerrero, M Lourdes; Ruiz-Palacios, Guillermo M; Peng, Yong-mei; Herbers, Patricia M; Yao, Wen; Ortega, Hilda; Davidson, Barbara S; McMahon, Robert J; Morrow, Ardythe L
Infant feeding practices generally influence infant growth, but it is unclear how introduction of specific foods affects growth across global populations. We studied 3 urban populations in the Global Exploration of Human Milk study to determine the association between infant feeding and anthropometry at 1 y of age. Three hundred sixty-five breastfeeding mother-infant pairs (120 US, 120 China, and 125 Mexico) were recruited soon after the infant's birth. Enrollment required agreement to breastfeed ≥75% for at least 3 mo. Weekly, 24-h, food frequency data were conducted on infants for 1 y and exclusive breastfeeding (EBF) duration and timing of specific complementary food introduction were calculated. Weight and length were measured at age 1 y and anthropometry Z-scores calculated using WHO standards. Cohorts in the 3 urban populations (Shanghai, China; Cincinnati, USA; and Mexico City, Mexico) differed by median EBF duration (5, 14, and 7 wk, respectively; P Mexico City infants (P < 0.001). Adjusting for nonfeeding covariates, the only feeding variable associated with anthropometry was EBF duration, which was modestly inversely associated with weight-for-age but not length-for-age or BMI Z-scores at 1 y. Although feeding variables differed by cohort, their impact on anthropometry differences was not consistent among cohorts. Overall, across these urban, international, breast-fed cohorts, differences in specific feeding practices did not explain the significant variation in anthropometry.
Woo, Jessica G.; Guerrero, M. Lourdes; Ruiz-Palacios, Guillermo M.; Peng, Yong-mei; Herbers, Patricia M.; Yao, Wen; Ortega, Hilda; Davidson, Barbara S.; McMahon, Robert J.; Morrow, Ardythe L.
Infant feeding practices generally influence infant growth, but it is unclear how introduction of specific foods affects growth across global populations. We studied 3 urban populations in the Global Exploration of Human Milk study to determine the association between infant feeding and anthropometry at 1 y of age. Three hundred sixty-five breastfeeding mother-infant pairs (120 US, 120 China, and 125 Mexico) were recruited soon after the infant’s birth. Enrollment required agreement to breastfeed ≥75% for at least 3 mo. Weekly, 24-h, food frequency data were conducted on infants for 1 y and exclusive breastfeeding (EBF) duration and timing of specific complementary food introduction were calculated. Weight and length were measured at age 1 y and anthropometry Z-scores calculated using WHO standards. Cohorts in the 3 urban populations (Shanghai, China; Cincinnati, USA; and Mexico City, Mexico) differed by median EBF duration (5, 14, and 7 wk, respectively; P Mexico City infants (P < 0.001). Adjusting for nonfeeding covariates, the only feeding variable associated with anthropometry was EBF duration, which was modestly inversely associated with weight-for-age but not length-for-age or BMI Z-scores at 1 y. Although feeding variables differed by cohort, their impact on anthropometry differences was not consistent among cohorts. Overall, across these urban, international, breast-fed cohorts, differences in specific feeding practices did not explain the significant variation in anthropometry. PMID:23236024
Holmes, Ryan Clevis
Campus safety has been a source of concern since the 1990s. However, in 2007, the tragedy at the Virginia Polytechnic and State University sent a sense of alarm through many institutions of higher education. Immediately following this tragedy, institutions across the country began to evaluate and question their safety and security practices. While…
Winkler, Ethan A; Yue, John K; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E
OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories-fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic brain injury during aquatic sports was similarly associated with prolonged ICU and hospital LOSs, medical complications, and failure to be discharged to
Navne, Laura E; Svendsen, Mette N; Gammeltoft, Tine M
In this article, we explore how parents establish relations with extremely premature infants whose lives and futures are uncertain. Drawing on ethnographic fieldwork in a Danish Neonatal Intensive Care Unit (NICU), we engage recent discussions of the limits of conventional anthropological thinking on social relations and point to the productive aspects of practices of distance and detachment. We show that while the NICU upholds an imperative of attachment independently of the infant's chances of survival, for parents, attachment is contingent on certain hesitations in relation to their infant. We argue that there are nuances in practices of relationmaking in need of more attention (i.e., the nexus of attachment and detachment). Refraining from touching, holding, and feeding their infants during critical periods, the parents enact detachment as integral to their practices of attachment. Such "cuts" in parent-infant relations become steps on the way to securing the infant's survival and making kin(ship). We conclude that although infants may be articulated as "maybe-lives" by staff, in the NICU as well as in Danish society, the ideal of attachment appears to leave little room for "maybe-parents." © 2017 by the American Anthropological Association.
Drago, Dorothy A
This descriptive study examines twenty years of gasoline-related fatalities and emergency department treated injuries in the United States, based on data from the US Consumer Product Safety Commission. Thermal burns consistently accounted for the majority (56%) of gasoline-related injuries and for most (82%) gasoline-related deaths, and were commonly (57-71%) associated with the use of gasoline as an accelerant. Poisoning accounted for 13% of injuries and 17% of deaths. The primary poisoning injury pattern was ingestion; the primary fatality pattern was inhalation, with about half of those associated with deliberate abuse. The estimated number of ingestions decreased from 60 to 23% of poisoning-related injuries, while injuries associated with inhalation abuse increased from 6 to 23%. Chemical burns and dermatitis were less represented in the injury data and were primarily associated with gasoline spills or splashes. Gasoline cans reportedly ignited or exploded in about 5% of thermal burn injuries and fatalities. While mandatory requirements for child resistant closures on gasoline cans (a primary intervention) have potentially impacted poisonings, the use of flame mitigation devices to address thermal injuries, if successful, would be a secondary intervention, and could address only a small percentage (about 5%) of injuries and deaths.
Nelson, Nicolas G; McKenzie, Lara B
Injury research on mountain biking has been mostly limited to examining professional riders and off-road biking. Mountain bikes represent the largest segment of bike sales in the United States. Recreational mountain bike use is popular and understudied. To describe the scope, distribution, and trends of mountain bike-related injuries treated in US emergency departments. Descriptive epidemiologic study. A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for patients aged ≥ 8 years from 1994 through 2007. Sample weights provided by the system were used to calculate national estimates of mountain bike-related injuries based on 4624 cases. Bivariate comparisons between categorical variables were assessed with injury proportion ratios and 95% confidence intervals. Nationwide, an estimated 217 433 patients were treated for mountain bike-related injuries in US emergency departments from 1994 to 2007, an average of 15 531 injuries per year. The annual number of injuries decreased 56%, from a high of 23 177 in 1995 to 10 267 in 2007 (P bike-related injuries decreased from 1994 to 2007. Upper extremity fractures were the most common injury. Girls and women may be more likely than boys and men to sustain more severe injuries requiring hospitalization. Despite the decline over the past decade, more can be done to improve safety and reduce injuries in this popular recreational activity.
Yue, John K; Winkler, Ethan A; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E
OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the authors characterize the demographics of sports-related TBI in the pediatric population and identify predictors of prolonged hospitalization and of increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from children (age 0-17 years) across 5 sports categories: fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged length of stay (LOS) in the hospital or intensive care unit (ICU), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α sports-related TBIs were recorded in the NTDB, and these injuries represented 11,614 incidents nationally after sample weighting. Fall or interpersonal contact events were the greatest contributors to sports-related TBI (47.4%). Mild TBI represented 87.1% of the injuries overall. Mean (± SEM) LOSs in the hospital and ICU were 2.68 ± 0.07 days and 2.73 ± 0.12 days, respectively. The overall mortality rate was 0.8%, and the prevalence of medical complications was 2.1% across all patients. Severities of head and extracranial injuries were significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Hypotension on admission to the ED was a significant predictor of failure to discharge to home (OR 0.05, 95% CI 0.03-0.07, p sports was independently associated with prolonged hospital LOS compared with FIC events (mean increase
Mori, Satomi; Takeda, Juliana Rumy Tsuchihashi; Carrara, Fernanda Souza Angotti; Cohrs, Cibelli Rizzo; Zanei, Suely Sueko Viski; Whitaker, Iveth Yamaguchi
To identify the incidence of delirium, compare the demographic and clinical characteristics of patients with and without delirium, and verify factors related to delirium in critical care patients. Prospective cohort with a sample made up of patients hospitalized in the Intensive Care Unit (ICU) of a university hospital. Demographic, clinical variables and evaluation with the Confusion Assessment Method for Intensive Care Unit to identify delirium were processed to the univariate analysis and logistic regression to identify factors related to the occurrence of delirium. Of the total 149 patients in the sample, 69 (46.3%) presented delirium during ICU stay, whose mean age, severity of illness and length of ICU stay were statistically higher. The factors related to delirium were: age, midazolam, morphine and propofol. Results showed high incidence of ICU delirium associated with older age, use of sedatives and analgesics, emphasizing the need for relevant nursing care to prevent and identify early, patients presenting these characteristics. Identificar a incidência de delirium, comparar as características demográficas e clínicas dos pacientes com e sem delirium e verificar os fatores relacionados ao delirium em pacientes internados em Unidade de Terapia Intensiva (UTI). Coorte prospectiva, cuja amostra foi constituída de pacientes internados em UTI de um hospital universitário. Variáveis demográficas, clínicas e da avaliação com o Confusion Assessment Method for Intensive Care Unit para identificação de delirium foram processadas para análise univariada, e regressão logística para identificar fatores relacionados à ocorrência do delirium. Do total de 149 pacientes da amostra, 69 (46,3%) apresentaram delirium durante a internação na UTI, observando-se que a média da idade, o índice de gravidade e o tempo de permanência nas UTI foram estatisticamente maiores. Os fatores relacionados ao delirium foram: idade, midazolam, morfina e propofol. Os
... Government of Iran of any goods, technology, or services, except to the extent that such exportation or... States Government and the granting of such a license by that agency would be prohibited by law; (3) Financial transactions related to the resolution of disputes at tribunals, including transactions related to...
Burcharth, H. F.; Liu, Zhou
Recent breakwater failures revealed the shortcomings of the traditional design procedures for concrete armour units. This paper deals with one of them, which can be expressed as the "lack of balance between the hydraulic stability of the armour layer and the mechanical strength or integrity...... of the units". This problem is related mainly to the slender types of armour units. The paper discusses the various types of loads, and the practical determination of the wave and gravity induced loads and stresses, especially the model test technique and its restrictions. Examples related to Dolosse...
Barbour, Kamil E; Moss, Susan; Croft, Janet B; Helmick, Charles G; Theis, Kristina A; Brady, Teresa J; Murphy, Louise B; Hootman, Jennifer M; Greenlund, Kurt J; Lu, Hua; Wang, Yan
Doctor-diagnosed arthritis is a common chronic condition affecting an estimated 23% (54 million) of adults in the United States, greatly influencing quality of life and costing approximately $300 billion annually. The geographic variations in arthritis prevalence, health-related characteristics, and management among states and territories are unknown. Therefore, public health professionals need to understand arthritis in their areas to target dissemination of evidence-based interventions that reduce arthritis morbidity. 2015. The Behavioral Risk Factor Surveillance System is an annual, random-digit-dialed landline and cellular telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Self-reported data are collected from the 50 states, the District of Columbia, Guam, and Puerto Rico. Unadjusted and age-standardized prevalences of arthritis, arthritis health-related characteristics, and arthritis management were calculated. County-level estimates were calculated using a validated statistical modeling method. In 2015, in the 50 states and the District of Columbia, median age-standardized prevalence of arthritis was 23.0% (range: 17.2%-33.6%). Modeled prevalence of arthritis varied considerably by county (range: 11.2%-42.7%). In 13 states that administered the arthritis management module, among adults with arthritis, the age-standardized median percentage of participation in a self-management education course was 14.5% (range: 9.1%-19.0%), being told by a health care provider to engage in physical activity or exercise was 58.5% (range: 52.3%-61.9%), and being told to lose weight to manage arthritis symptoms (if overweight or obese) was 44.5% (range: 35.1%-53.2%). Respondents with arthritis who lived in the quartile of states with the highest prevalences of arthritis had the highest percentages of negative health-related characteristics (i.e., arthritis-attributable activity limitations, arthritis-attributable severe joint pain
Darlington, Caroline K; Hutson, Sadie P
Societal stigmatization of HIV/AIDS due to assumptions about transmission and associated behaviors plays a substantial role in the psychosocial well-being of people living with this chronic illness, particularly for women in traditionally conservative geographic regions. Known for social conservatism, the Southern United States (US) holds the highest incidence rate of HIV infection in the US. A systematic search of four databases was used to identify 27 relevant scientific articles pertaining to HIV-related stigma among women living with HIV/AIDS in the Southern US. These studies revealed a rudimentary understanding of stigma sources, effects, and stigma-reduction interventions in this population. Due to the cultural specificity of stigma, further differentiation of stigma in discrete sectors of the South as well as a dialogue about the moral implications of stigma is necessary to lay the groundwork for patient-centered interventions to mitigate the destructive effects of stigma experienced by women in this region.
Veronica R GROSU
Full Text Available In light of the difficulties encountered in assessing the value of the CGU (Cash Generating Unit and of the cash flows associated with goodwill or other intangible assets of a company and after performing the impairment test as provided by the IAS 36-Intangibile Asset and the forecasts related to it, the aim of this paper is to identify and suggest software instruments that would assist in the measurement and forecasting of these elements. The employment of the SPSS and the NeuroShell programmes in analyzing and forecasting the changes in CGU and CGU flows has helped compare the results and the ensuing error margins, thus giving the business entity the possibility to select the best software option, depending on certain variables identified on a micro or a macroeconomic level that may affect the depreciation or the increases in value of the underlying assets for CGU or CGU flows.
Laura S. Gold PhD
Full Text Available Objective: To describe associations between health care utilization measures and patient-reported outcomes (PROs. Method: Primary data were collected from patients ≥65 years with low back pain visits from 2011 to 2013. Six PROs of pain and functionality were collected 12 and 24 months after the index visits and total and spine-specific relative value units (RVUs from electronic health records were tabulated over 1 year. We calculated correlation coefficients between RVUs and 12- and 24-month PROs and conducted linear regressions with each 12- and 24-month PRO as the outcome variables and RVUs as predictors of interest. Results: We observed very weak correlations between worse PROs at 12 and 24 months and greater 12-month utilization. In regression analyses, we observed slight associations between greater utilization and worse 12- and 24-month PROs. Discussion: We found that 12-month health care utilization is not strongly associated with PROs at 12 or 24 months.
Terebesi, S; Giannakopoulos, N N; Brüstle, F; Hellmann, D; Türp, J C; Schindler, H J
Strategies for recruitment of masseter muscle motor units (MUs), provoked by constant bite force, for different vertical jaw relations have not previously been investigated. The objective of this study was to analyse the effect of small changes in vertical jaw relation on MU recruitment behaviour in different regions of the masseter during feedback-controlled submaximum biting tasks. Twenty healthy subjects (mean age: 24·6 ± 2·4 years) were involved in the investigation. Intra-muscular electromyographic (EMG) activity of the right masseter was recorded in different regions of the muscle. MUs were identified by the use of decomposition software, and root-mean-square (RMS) values were calculated for each experimental condition. Six hundred and eleven decomposed MUs with significantly (P recruitment behaviour were organised into localised MU task groups. MUs with different task specificity in seven examined tasks were observed. The RMS EMG values obtained from the different recording sites were also significantly (P recruitment was significantly (P recruited MUs and the RMS EMG values decreased significantly (P recruitment behaviour in discrete subvolumes of the masseter in response to small changes in vertical jaw relations. These fine-motor skills might be responsible for its excellent functional adaptability and might also explain the successful management of temporomandibular disorder patients by somatic intervention, in particular by the use of oral splints. © 2015 John Wiley & Sons Ltd.
Carbon monoxide (CO) is a colorless, odorless, nonirritating gas that is produced through the incomplete combustion of hydrocarbons. Sources of CO include combustion devices (e.g., boilers and furnaces), motor-vehicle exhaust, generators and other gasoline or diesel-powered engines, gas space heaters, woodstoves, gas stoves, fireplaces, tobacco smoke, and various occupational sources. CO poisoning is a leading cause of unintentional poisoning deaths in the United States; it was responsible for approximately 450 deaths each year during 1999-2004 and an estimated 15,200 emergency department (ED) visits each year during 2001-2003. Health effects of CO exposure can range from viral-like symptoms (e.g., fatigue, dizziness, headache, confusion, and nausea) to more severe conditions (e.g., disorientation, unconsciousness, long-term neurologic disabilities, coma, cardiorespiratory failure, and death). CO poisoning often is misdiagnosed and underdetected because of the nonspecific nature of symptoms. To update a previously published report and provide national estimates of CO-related ED visits during 2004-2006, CDC analyzed data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) database. During 2004-2006, an estimated average of 20,636 ED visits for nonfatal, unintentional, non-fire-related CO exposures occurred each year. Approximately 73% of these exposures occurred in homes, and 41% occurred during winter months (December-February). Prevention efforts targeting residential and seasonal CO exposures can substantially reduce CO-related morbidity.
Cappellini, Elena; Bambi, Stefano; Lucchini, Alberto; Milanesio, Erika
The aims of this study were to describe the current status of intensive care unit (ICU) visiting hours policies internationally and to explore the influence of ICUs' open visiting policies on patients', visitors', and staff perceptions, as well as on patients' outcomes. A review of the literature was done through MEDLINE, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. The following keywords were searched: "visiting," "hours," "ICU," "policy," and "intensive care unit." Inclusion criteria for the review were original research paper, adult ICU, articles published in the last 10 years, English or Italian language, and available abstract. Twenty-nine original articles, mainly descriptive studies, were selected and retrieved. In international literature, there is a wide variability about open visiting policies in ICUs. The highest percentage of open ICUs is reported in Sweden (70%), whereas in Italy there is the lowest rate (1%). Visiting hours policies and number of allowed relatives are variable, from limits of short precise segments to 24 hours and usually 2 visitors. Open ICUs policy/guidelines acknowledge concerns with visitor hand washing to prevent the risk of infection transmission to patients. Patients, visitors, and staff seem to be inclined to support open ICU programs, although physicians are more inclined to the enhancement of visiting hours than nurses. The percentages of open ICUs are very different among countries. It can be due to local factors, cultural differences, and lack of legislation or hospital policy. There is a need for more studies about the impact of open ICUs programs on patients' mortality, length of stay, infections' risk, and the mental health of patients and their relatives.
Bolm, Karen S.; Wallace, Alan R.; Moyle, Phillip R.; Bliss, James D.; Orris, Greta J.
Introduction As part of the assessment of lacustrine diatomite resources in the Western United States (fig. 1), U.S. Geological Survey (USGS) project members conducted a review of literature relating to the formation, location, and nature of deposits in the study area. This preliminary bibliography consists of selected publications to identify, locate, and describe the deposits to be studied, to characterize common geologic factors about the deposits, and to better understand the factors that control their formation, preservation, or destruction. The bibliography also serves as a resource for other workers to research the topic. References included in the preliminary bibliography were gathered by searching existing bibliographic data bases and library collections. Project researchers also contributed references that they found during the course of their work. This bibliography should be considered a working document that will grow as research and literature searches continue. Clearly, many significant publications may be missing from this preliminary list; therefore, USGS staff members intend to issue a revised bibliography as project work progresses. To assure completeness, input from other researchers and industry is welcome. Although the focus of this bibliography is lacustrine diatomite deposits of the Western United States, additional references that provide a foundation of knowledge for the study of diatomites, diatoms, and diatom-related processes (ecology, geology, geochemistry) and for the uses and behavior of diatomite have also been included. An index of keywords has been added to this bibliography, designed to help the user locate reports by topic or by geographic location. The letter 'A' following a number indicates that the report referenced is an abstract.
Catheter-related infection (CRI) surveillance is advocated as a healthcare quality indicator. However, there is no national CRI surveillance programme or standardized CRI definitions in Irish intensive care units (ICUs).
Moore, Justin Xavier; McGwin, Gerald; Griffin, Russell L
The purpose of this study is to examine the epidemiology of firework-related injuries among an emergency department (ED) nationally representative population of the United States for the years 2000-2010, including whether the type of firework causing the injury is differential by patient demographics and whether the severity of injury is associated with the firework type. The data analysed in this study was collected from the Consumer Product Safety Commission's (CPSC's) National Electronic Injury Surveillance System (NEISS). A total of 2812 injuries represented an estimated 97,562 firework-related injuries treated in emergency departments within the United States from 2000 to 2010. The incidence generally decreased over time. With respect to age, the rate was higher for children, with the highest rates being observed for 10-19 year olds (7.28 per 100,000 persons) and 0-9 year olds (5.45 per 100,000 persons). The injury rate was nearly three times higher for males compared to the female counterparts (4.48 vs. 1.57 per 100,000 persons). Females were less likely than males to severely injure themselves with all types of fireworks besides sparklers/novelty devices (OR 1.08, CI 0.26-4.38). The results from this suggest that firework-related injuries have decreased by nearly 30% over the 11-year period between 2000 and 2010. Moreover, there has been a decreasing trend in the type of firework causing injury for every firework type excluding the unspecified firework type. However, adolescents of 10-19 years old had the highest rate of injury for fireworks over the 11-year period. In addition odds of injury are differential by firework type. Understanding the specific types of fireworks may lead to better preventative methods and regulations. Moreover, preventative methods should be taken to reduce the rate of firework-related injuries among U.S. youths , and possibly more regulations and enforcement of laws geared towards prohibiting novice use of fireworks. Published
.... The United States is working with President Saca to combat narco-trafficking, to resolve immigration issues, and to promote free trade, possibly through the proposed United States- Dominican Republic...
Willis, Jeffrey R; Doan, Quan V; Gleeson, Michelle; Haskova, Zdenka; Ramulu, Pradeep; Morse, Lawrence; Cantrell, Ronald A
Among adults with diabetes in the United States, severe forms of diabetic retinopathy (DR) are significantly associated with a greater vision-related functional burden. To assess the functional burden of DR across severity levels in the United States. This cross-sectional study was based on 1004 participants 40 years or older with diabetes and valid ocular and sociodemographic outcomes in the National Health and Nutrition Examination Surveys (NHANES) (2005-2006 and 2007-2008). Diabetic retinopathy was based on fundus photograph grading, using the Early Treatment Diabetic Retinopathy Study severity scale. The analysis was performed from October 15, 2016, to June 15, 2017. Functional difficulties secondary to vision were assessed during a household questionnaire in which participants self-reported difficulty with reading, visuospatial tasks (ie, close-up work or finding things on a crowded shelf), mobility (ie, walking down steps, stairs, or curbs), and driving. The main outcome measure was vision-related functional burden, which was defined as present for individuals reporting moderate or greater difficulty in any of the aforementioned tasks. Of the 1004 persons with diabetes analyzed for this study (mean age, 65.7 years [95% CI, 64.0-67.3 years]; 51.1% male [95% CI, 47.1-55.2] and 48.9% female [95% CI, 44.8-52.9]), the prevalence was 72.3% for no retinopathy, 25.4% for mild and moderate nonproliferative diabetic retinopathy (NPDR), and 2.3% for severe NPDR or proliferative diabetic retinopathy (PDR). The prevalence of vision-related functional burden was 20.2% (95% CI, 16.3%-24.1%) for those with no retinopathy, 20.4% (95% CI, 15.3%-27.8%) for those with mild and moderate NPDR, and 48.5% (95% CI, 25.6%-71.5%) for those with severe NPDR or PDR (P = .02). In multivariable analysis, the odds of vision-related functional burden were significantly greater among those with severe NPDR or PDR relative to those with no retinopathy (adjusted odds ratio [aOR], 3.59; 95
James Michael Olivero
Full Text Available This paper reviews death penalty perspectives from the United States, Mexico and international law. The United States practices the death penalty on not only its citizens, but those of other nations who commit capital crimes. Mexico is a death penalty abolitionist state that takes significant issue with the United States over executing Mexican nationals. The paper analyzes the cultural, legal and political conflict between the two countries surrounding the application of the death penalty on Mexican nationals.
Shantakumari, N; Eldeeb, R; Sreedharan, J; Gopal, K
The extensive use of computers as medium of teaching and learning in universities necessitates introspection into the extent of computer related health disorders among student population. This study was undertaken to assess the pattern of computer usage and related visual problems, among University students in Ajman, United Arab Emirates. A total of 500 Students studying in Gulf Medical University, Ajman and Ajman University of Science and Technology were recruited into this study. Demographic characteristics, pattern of usage of computers and associated visual symptoms were recorded in a validated self-administered questionnaire. Chi-square test was used to determine the significance of the observed differences between the variables. The level of statistical significance was at P computer users were headache - 53.3% (251/471), burning sensation in the eyes - 54.8% (258/471) and tired eyes - 48% (226/471). Female students were found to be at a higher risk. Nearly 72% of students reported frequent interruption of computer work. Headache caused interruption of work in 43.85% (110/168) of the students while tired eyes caused interruption of work in 43.5% (98/168) of the students. When the screen was viewed at distance more than 50 cm, the prevalence of headaches decreased by 38% (50-100 cm - OR: 0.62, 95% of the confidence interval [CI]: 0.42-0.92). Prevalence of tired eyes increased by 89% when screen filters were not used (OR: 1.894, 95% CI: 1.065-3.368). High prevalence of vision related problems was noted among university students. Sustained periods of close screen work without screen filters were found to be associated with occurrence of the symptoms and increased interruptions of work of the students. There is a need to increase the ergonomic awareness among students and corrective measures need to be implemented to reduce the impact of computer related vision problems.
Wu, Li-Tzy; Woody, George E; Yang, Chongming; Pan, Jeng-Jong; Blazer, Dan G
While young racial/ethnic groups are the fastest growing population in the United States, data about substance-related disorders among adolescents of various racial/ethnic backgrounds are lacking. To examine the magnitude of past-year DSM-IV substance-related disorders (alcohol, marijuana, cocaine, inhalants, hallucinogens, heroin, analgesic opioids, stimulants, sedatives, and tranquilizers) among adolescents of white, Hispanic, African American, Native American, Asian or Pacific Islander, and multiple race/ethnicity. The 2005 to 2008 National Survey on Drug Use and Health. Academic research. Noninstitutionalized household adolescents aged 12 to 17 years. Substance-related disorders were assessed by standardized survey questions administered using the audio computer-assisted self-interviewing method. Of 72 561 adolescents aged 12 to 17 years, 37.0% used alcohol or drugs in the past year; 7.9% met criteria for a substance-related disorder, with Native Americans having the highest prevalence of use (47.5%) and disorder (15.0%). Analgesic opioids were the second most commonly used illegal drugs, following marijuana, in all racial/ethnic groups; analgesic opioid use was comparatively prevalent among adolescents of Native American (9.7%) and multiple race/ethnicity (8.8%). Among 27 705 past-year alcohol or drug users, Native Americans (31.5%), adolescents of multiple race/ethnicity (25.2%), adolescents of white race/ethnicity (22.9%), and Hispanics (21.0%) had the highest rates of substance-related disorders. Adolescents used marijuana more frequently than alcohol or other drugs, and 25.9% of marijuana users met criteria for marijuana abuse or dependence. After controlling for adolescents' age, socioeconomic variables, population density of residence, self-rated health, and survey year, adjusted analyses of adolescent substance users indicated elevated odds of substance-related disorders among Native Americans, adolescents of multiple race/ethnicity, adolescents of
Full Text Available China’s trade relations with the United States over the past four decades is a topic that has not been fully dealt with in scholarly works. This paper charts the course of US-China economic relations since 1971, explains the principal forces stimulating growth and encouraging change and, finally, discusses how these two economic giants fit into an interlocking Asian and world economy. In reaction to the post-2008 financial downturn, advocates for a new world economic order have suggested a rebalancing of global demand, which will arguably become a major, politically charged issue in the US and in China in the years to come. Growing economic interdependence has quickly presented new challenges and opportunities, with issues such as human rights, Most-Favoured-Nation status, the Taiwan and Tibet question, and the huge American trade deficit threatening to cloud the relationship at times. With China’s emergence as a major power and America’s hegemonic ambitions tested in successive wars, the contradiction between a booming commercial relationship and conflict associated with geopolitical and ideological differences will continue to constitute a serious challenge. The long-term goal for each side will be to forge economic ties strong enough to create a stable political relationship, rather than to be held hostage by geopolitical constraints.
Barragan, Noel C; Moschetti, Kristin; Smith, Lisa V; Sorvillo, Frank; Kuo, Tony
After reaching an all time low in 2000, the rate of syphilis in the United States has been steadily increasing. Parallel benchmarking of the disease's mortality burden has not been undertaken. Using ICD-10 classification, all syphilis-related deaths in the national Multiple Cause of Death dataset were examined for the period 2000-2014. Descriptive statistics and age-adjusted mortality rates were generated. Poisson regression was performed to analyze trends over time. A matched case-control analysis was conducted to assess the associations between syphilis-related deaths and comorbid conditions listed in the death records. A total of 1,829 deaths were attributed to syphilis; 32% (n = 593) identified syphilis as the underlying cause of death. Most decedents were men (60%) and either black (48%) or white (39%). Decedents aged ≥85 years had the highest average mortality rate (0.47 per 100,000 population; 95% confidence interval [CI], 0.42-0.52). For the sampled period, the average annual decline in mortality was -2.90% (95% CI, -3.93% to -1.87%). However, the average annual percent change varied across subgroups of interest. Declines in U.S. syphilis mortality suggest early detection and improved treatment access likely helped attenuate disease progression; however, increases in the disease rate since 2000 may be offsetting the impact of these advancements. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Full Text Available The psychiatric patient’s attitudes towards hospitalization have found an association between patient perceptions of the ward atmosphere and dissatisfaction. The aim of the study was to determine the aspects of stress related to hospitalization in inpatients admitted to a psychiatric facility. Fifty in-patients of both sexes admitted consecutively to a psychiatric unit in a General Hospital were asked to rate the importance of, and their satisfaction with, 38 different aspects of in-patient care and treatment. Results showed that the major sources of stress were related to having a violent patient near to his/her bed; being away from family; having to stay in closed wards; having to eat cold and tasteless food; losing income or job due to illness, being hospitalized away from home; not able to understand the jargons used by the clinical staff and not getting medication for sleep. A well-differentiated assessment of stress and satisfaction has implications for the evaluation of the quality of psychiatric care and for the improvement of in-patient psychiatric care.
Billock, Rachael M; Chounthirath, Thiphalak; Smith, Gary A
This study characterizes the epidemiology of nonfatal pediatric firework-related injuries in the United States among children and adolescents by analyzing data from the National Electronic Injury Surveillance System from 1990 through 2014. During this 25-year period, an estimated 136 991 (95% CI = 113 574-160 408) children firework-related injuries. The annual injury rate decreased significantly by 30.4% during this period. Most of those injured were male (75.7%), mean patient age was 10.6 years, and 7.6% required hospital admission. The hands (30.0%) were the most commonly injured body region, followed by head and neck (22.2%), and eyes (21.5%). Sixty percent of injuries were burns. Injuries were most commonly associated with firecrackers (26.2%), aerial devices (16.3%), and sparklers (14.3%). Consumer fireworks pose a serious injury risk to pediatric users and bystanders, and families should be encouraged to attend public firework displays rather than use consumer fireworks.
Brown, Joshua B; Rosengart, Matthew R; Billiar, Timothy R; Peitzman, Andrew B; Sperry, Jason L
Regionalized trauma care improves outcomes; however, access to care is not uniform across the United States. The objective was to evaluate whether geographic distribution of trauma centers correlates with injury mortality across state trauma systems. Level I or II trauma centers in the contiguous United States were mapped. State-level age-adjusted injury fatality rates per 100,000 people were obtained and evaluated for spatial autocorrelation. Nearest neighbor ratios (NNRs) were generated for each state. A NNR less than 1 indicates clustering, while a NNR greater than 1 indicates dispersion. NNRs were tested for difference from random geographic distribution. Fatality rates and NNRs were examined for correlation. Fatality rates were compared between states with trauma center clustering versus dispersion. Trauma center distribution and population density were evaluated. Spatial-lag regression determined the association between fatality rate and NNR, controlling for state-level demographics, population density, injury severity, trauma system resources, and socioeconomic factors. Fatality rates were spatially autocorrelated (Moran's I = 0.35, p center distribution. Fatality rate and NNR were correlated (ρ = 0.34, p = 0.03). Clustered states had a lower median injury fatality rate compared with dispersed states (56.9 [IQR, 46.5-58.9] vs. 64.9 [IQR, 52.5-77.1]; p = 0.04). Dispersed compared with clustered states had more counties without a trauma center that had higher population density than counties with a trauma center (5.7% vs. 1.2%, p distribution of trauma centers correlates with injury mortality, with more clustered state trauma centers associated with lower fatality rates. This may be a result of access relative to population density. These results may have implications for trauma system planning and require further study to investigate underlying mechanisms. Therapeutic/care management study, level IV.
Harvey, Kira; Esposito, Douglas H; Han, Pauline; Kozarsky, Phyllis; Freedman, David O; Plier, D Adam; Sotir, Mark J
probable travel-related diagnoses. Of these, 23,006 (16%) patients were evaluated in the United States, 10,032 (44%) of whom were evaluated after returning from travel outside of the United States (i.e., after-travel patients). Of the 10,032 after-travel patients, 4,977 (50%) were female, 4,856 (48%) were male, and 199 (2%) did not report sex; the median age was 34 years. Most were evaluated in outpatient settings (84%), were born in the United States (76%), and reported current U.S. residence (99%). The most common reasons for travel were tourism (38%), missionary/volunteer/research/aid work (24%), visiting friends and relatives (17%), and business (15%). The most common regions of exposure were Sub-Saharan Africa (23%), Central America (15%), and South America (12%). Fewer than half (44%) reported having had a pretravel visit with a health-care provider. Of the 13,059 diagnoses among the 10,032 after-travel patients, the most common diagnoses were acute unspecified diarrhea (8%), acute bacterial diarrhea (5%), postinfectious irritable bowel syndrome (5%), giardiasis (3%), and chronic unknown diarrhea (3%). The most common diagnostic groupings were acute diarrhea (22%), nondiarrheal gastrointestinal (15%), febrile/systemic illness (14%), and dermatologic (12%). Among 1,802 patients with febrile/systemic illness diagnoses, the most common diagnosis was Plasmodium falciparum malaria (19%). The rapid communication component of the GeoSentinel network has allowed prompt responses to important health events affecting travelers; during 2010 and 2011, the notification capability of the GeoSentinel network was used in the identification and public health response to East African trypanosomiasis in Eastern Zambia and North Central Zimbabwe, P. vivax malaria in Greece, and muscular sarcocystosis on Tioman Island, Malaysia. The GeoSentinel Global Surveillance System is the largest repository of provider-based data on travel-related illness. Among ill travelers evaluated in U.S. Geo
Simon, Tamara D; Bublitz, Caroline; Hambidge, Simon J
To characterize the types and external causes of pediatric injury-related visits (IRVs) to emergency departments (EDs), in particular, sports-related injuries. To compare the characteristics of children with IRVs with those with non-IRVs, specifically, differences in IRV rates by race and ethnicity and by health insurance. This was a stratified random-sample survey of EDs in the National Hospital Ambulatory Medical Care Survey (NHAMCS), including all IRVs for patients less than 19 years of age in 1998 (n = 2,656). National estimates of pediatric IRVs were obtained using the assigned patient visit weights in the NHAMCS databases and SUDAAN analyses. Measures of association between predictor variables (patient and health insurance characteristics) and whether a child had an IRV were calculated using multivariate logistic regression analyses to determine adjusted odds ratios with 95% confidence intervals. Pediatric IRVs accounted for more than 11 million ED visits annually. The most common diagnoses for IRVs were open wounds, contusions, sprains and strains, and fractures and dislocations. The leading external causes of IRVs were sports-related injuries, accidental falls, being struck by objects, and motor vehicle collisions. Children with IRVs differed from those who presented for non-IRVs in many characteristics: they were more likely to be male, to be older, to be of white race, and to have private insurance, and less likely to be of Asian or Hispanic ethnicity. Sports and recreation are the leading external causes of pediatric IRVs to EDs in the United States. There are different patterns of IRVs according to gender, age, race, ethnicity, and insurance. Identification of specific patterns of injury is necessary for the design of effective prevention strategies.
Wichmann, D; Heinemann, A; Zähler, S; Vogel, H; Höpker, W; Püschel, K; Kluge, S
There has been increasing use of invasive techniques, such as extracorporeal organ support, in intensive care units (ICU), and declining autopsy rates. Thus, new measures are needed to maintain high-quality standards. We investigated the potential of computed tomography (CT)-based virtual autopsy to substitute for medical autopsy in this setting. We investigated the potential of virtual autopsy by post-mortem CT to identify complications associated with medical devices in a prospective study of patients who had died in the ICU. Clinical records were reviewed to determine the number and types of medical devices used, and findings from medical and virtual autopsies, related and unrelated to the medical devices, were compared. Medical and virtual autopsies could be performed in 61 patients (Group M/V), and virtual autopsy only in 101 patients (Group V). In Group M/V, 41 device-related complications and 30 device malpositions were identified, but only with a low inter-method agreement. Major findings unrelated to a device were identified in about 25% of patients with a high level of agreement between methods. In Group V, 8 device complications and 36 device malpositions were identified. Device-related complications are frequent in ICU patients. Virtual and medical autopsies showed clear differences in the detection of complications and device malpositions. Both methods should supplement each other rather than one alone for quality control of medical devices in the ICU. Further studies should focus on the identification of special patient populations in which virtual autopsy might be of particular benefit. NCT01541982. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.
Héctor Daniel García Díaz
Full Text Available The planning policies of the Mexican urban development oriented to the industrial activities implemented regionally and locally, have responded in different ways. The commitment to the sector led to the need to regulate urban growth and development as a substantial factor in achieving government strategies in the search for equitable sharing of national wealth and potential. The publication in 1976 of the General Law of Human Settlements born with this fundamental purpose. Excessive administrative burden of the Mexican social property and the need to insert in an increasingly globalizing economic activities led, in 1992 and 1994, respectively, the amendments to the Land Act and the signing of the Free Trade Agreement between North America, Canada, United States and Mexico. In the West Central Region, consisting of the metropolitan areas of Guadalajara, Zacatecas, San Luis Potosi, Queretaro, Guanajuato and Aguascalientes, spatial area in which a third of the country's inhabitants is based, and hosts the 100% extension territorial state of Aguascalientes, have been exploited discontinuously the natural and man-made resources available in the area. In the Valley of Aguascalientes, north-south strip of the state territory, have been authorized industrial subdivisions under plans and urban development programs that have accelerated or inhibited impulses, according to the vision and expectations of government power in turn; the different rhythms and changes of strategy applied to organize the disorder potential of the rural and urban environment express divergences in the reaches of consolidation and longed purposes. Research indicates and identifies the dynamics with which the last eight administrations of the Mexican State have acted in shaping the industrial potential of the Valley, which the south side hosts industrial city, Nissan I, Nissan II and Automotive Logistics Industrial Park, industrial settlements seeking to consolidate the region
Rayner, M; Boaz, A; Higginson, C
The objective of this research was to examine how consumers use health-related food endorsements on food labels. Three endorsement programs were examined: those of the two major retailers in the United Kingdom, Tesco and Sainsbury's, and the "Pick the Tick" program of the National Heart Foundation of Australia. The main methodology used was protocol analysis. This involves the subject "thinking aloud" while performing a task--in this case, (a) shopping normally and (b) shopping "healthily" for foods on a predetermined list--to generate a protocol. Each subject was also interviewed to investigate reported use of endorsements. Subjects were a quota sample (N = 44) of shoppers representative of the U.K. and Australian populations. Information about the subjects, the protocols, and interview data were analyzed quantitatively; the protocols were also analyzed qualitatively. Sainsbury's and Australian shoppers never used the endorsements when shopping but Tesco shoppers did, albeit rarely. Tesco shoppers used the endorsement in complex ways and not just as a trigger to food selection. They sometimes used the endorsement to reject endorsed foods. Subjects claimed to use the endorsements even though the protocol analysis revealed no actual use. There are features of the Tesco endorsement program that make it more helpful to consumers than the other programs.
Conlon, Niamh P
OBJECTIVE: To investigate the long-term health-related quality of life (HRQOL) outcomes for patients requiring at least 28 days of pediatric intensive care. DESIGN: Retrospective cohort and prospective follow-up study. SETTING: A 21-bed pediatric intensive care unit (PICU) in a university-affiliated, tertiary referral pediatric hospital. PATIENTS: One hundred ninety-three patients who spent 28 days or longer in the PICU between January 1, 1997 and December 31, 2004. INTERVENTIONS: Quality of life was measured using the Pediatric Quality of Life Inventory (Peds QL 4.0) parent-proxy version at 2 to 10 yrs after discharge. The PedsQL 4.0 is a modular measure of HRQOL, which is reliable in children aged 2 to 18 yrs. It generates a total score and physical, emotional, social, school, and psychosocial subscores. MEASUREMENTS AND MAIN RESULTS: Of the 193 patients, 41 died during their PICU admission and 27 died between PICU discharge and follow-up. Quality of life questionnaires were posted to parents of 108 of the 125 survivors and 70 were returned completed. Forty children (57.1%) had scores indicating a normal quality of life, whereas 30 (42.9%) had scores indicating impaired HRQOL. Of these, 14 (20%) had scores indicating poor quality of life with ongoing disabling health problems requiring hospitalization or the equivalent. CONCLUSIONS: Our results indicate that, while long PICU stay is associated with significant mortality, the long-term HRQOL is normal for the majority of surviving children.
Witter, D J; Gerritsen, A E; van Spijker, A; Creugers, N H J
Occlusion concepts based on functional aspects offer more solid ground in the diagnostic process and in the treatment of (reduced) dentitions than morphologically and mechanically oriented occlusion concepts. Nevertheless, for occlusal reconstruction morphologically oriented guidelines are necessary. These guidelines are based on the border movements and positions of the mandible in the orofacial system, and on the location and modelling of the occlusal contacts in the occlusal system. The modelling of single- and multi-unit fixed dental prostheses must harmonize with the occlusal system. Moreover, an important feature is the relation of the anterior teeth which enables mutually protected occlusion. Characteristics of a healthy orofacial and occlusal system are: absence of pathology, perceived sufficient oral functions, variability inform and function, and adaptive capacity. When designing single- or multiunit fixed dental prostheses, a pragmatic starting point is to maintain the existing occlusion and the existing speech pattern unless arguments can be provided for alterations. The occlusal design should aim at optimizing oral functions, such as mandibular and occlusal stability.
Tawfik, D S; Sexton, J B; Kan, P; Sharek, P J; Nisbet, C C; Rigdon, J; Lee, H C; Profit, J
To examine burnout prevalence among California neonatal intensive care units (NICUs) and to test the relation between burnout and healthcare-associated infection (HAI) rates in very low birth weight (VLBW) neonates. Retrospective observational study of provider perceptions of burnout from 2073 nurse practitioners, physicians, registered nurses and respiratory therapists, using a validated four-item questionnaire based on the Maslach Burnout Inventory. The relation between burnout and HAI rates among VLBW (<1500 g) neonates from each NICU was evaluated using multi-level logistic regression analysis with patient-level factors as fixed effects. We found variable prevalence of burnout across the NICUs surveyed (mean 25.2±10.1%). Healthcare-associated infection rates were 8.3±5.1% during the study period. Highest burnout prevalence was found among nurses, nurse practitioners and respiratory therapists (non-physicians, 28±11% vs 17±19% physicians), day shift workers (30±3% vs 25±4% night shift) and workers with 5 or more years of service (29±2% vs 16±6% in fewer than 3 years group). Overall burnout rates showed no correlation with risk-adjusted rates of HAIs (r=-0.133). Item-level analysis showed positive association between HAIs and perceptions of working too hard (odds ratio 1.15, 95% confidence interval 1.04-1.28). Sensitivity analysis of high-volume NICUs suggested a moderate correlation between burnout prevalence and HAIs (r=0.34). Burnout is most prevalent among non-physicians, daytime workers and experienced workers. Perceptions of working too hard associate with increased HAIs in this cohort of VLBW infants, but overall burnout prevalence is not predictive.
Steele, Gregory K; O'Neil, Joseph; Huisingh, Carrie; Smith, Gary A
Elevators remain one of the safest forms of transportation; however, they are still associated with deaths and injuries. This study describes the epidemiology of elevator-related injuries among adults aged 65 years and older in the United States between 1990 and 2006, through a retrospective analysis of data from the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission. Proportions with 95% confidence intervals were calculated by age group for cause of injury, injured body region, injury type, and locale. Rate ratios with 95% confidence interval were calculated to determine any association between the body region injured, type of injury, and cause of injury categories. There were an estimated 44,870 elevator-related injuries in older adults. The mean age was 79.5 years, and approximately 75% were women. More than half of the injuries (51.4%) were caused from a slip, trip, or fall. Soft-tissue injuries were the most common injury type (48.0%). The upper extremities were the most commonly injured body region (26.2%). Almost 15% (14.5%) of those injured required hospital admission. Of those admitted, more than 40% were for a fractured hip. Injuries associated with passenger elevators occur fairly frequently among older adults, are often associated with slip, trip or falls, and can be severe enough to require hospital admission. Older adults should use caution when stepping on or off an elevator. Awareness of the risk and the circumstances leading to falls allows for better direction of intervention strategies.
Low, Garren M I; Attiga, Yasser S; Garg, Gaurav; Schlegal, Richard; Gallicano, G Ian
Human papillomavirus (HPV) can cause cervical cancer, as well as a number of other diseases in both men and women. Both sexes play a role in transmission of the disease, but the cost-effectiveness of HPV vaccination differs between them. It is necessary to determine the best allocation of limited resources between these two populations to produce the most effective strategy for reducing the burden from HPV-related disease. This literature review intends to elucidate the economic and social considerations that will lead to maximum utilization of vaccination programs, which in turn will reduce the burden of HPV-related disease. Current outreach in the United States is based on vaccination against HPV as a means for combating cervical cancer in women. If we are to include males, however, new marketing strategies must focus on educating patients about the full range of the vaccine's benefits. Men who have sex with men (MSM) are also unprotected against HPV in the current system. Social considerations alone may not be enough, however, as economic prediction models suggest that the associated costs outweigh the benefits in most circumstances. Taking this into account, our review also considers alternate methods of maximizing prevention of HPV-associated disease. The most prudent programs will include physician involvement in patient education and the implementation of structured vaccination and screening programs. Unfortunately, many countries do not have the necessary resources to undertake national vaccination programs. HPV testing and cytology screening for women and MSM may be the most financially reasonable option for many countries.
Background Unintentional falls are a major cause of morbidity and mortality with a significant burden on victims, families, and societies. We aimed to study the mechanism, risk factors, and outcome of hospitalized patients with fall-related injuries in order to propose preventive measures. Methods Fall-related injured patients who were admitted to Al Ain Hospital, United Arab Emirates (UAE) for more than 24 hours or who died after arrival to the hospital, were studied over 3 years. Demography, location and time of injury, affected body regions, hospital and ICU stay, and outcome were analyzed. Results 882 patients were studied, 82% were males, and 22% were less than 19 years old. Majority were from the Indian subcontinent. The most common location for fall injuries was work. Patients injured at work were older and mainly non-UAE nationals (p < 0.0001) when compared with those injured at home. Patients falling from height, when compared with those falling from same level, were older (p = 0.017), had more males (p < 0.001), were mainly from the Indian subcontinent (p < 0.001), had higher ISS (p = 0.011) and longer total hospital stay (p < 0.001). Conclusions Falls are a major health problem in the UAE. Falls at work can be prevented by safety education tailored to different ethnic groups, and proper legislation and regulation. Environmental modification using evidence-based architectural design may prevent falls among vulnerable risk groups. PMID:25178823
New York State Education Dept., Albany. Bureau of Occupational and Career Curriculum Development.
The safety education unit is presented to assist apprentices to acquire a general knowledge of procedures for insuring safety on the job. The unit consists of 10 modules: (1) the Occupational Safety and Health Act: safety and health bill of rights for workers; (2) accident prevention; (3) first aid; (4) accident reports; importance, use, and how…
A.E. Lugo; S. L. Brown; R. Dodson; T. S Smith; H. H. Shugart
Aim Our main goals were to develop a map of the life zones for the conterminous United States, based on the Holdridge Life Zone system, as a tool for ecosystem mapping, and to compare the map of Holdridge life zones with other global vegetation classification and mapping efforts. Location The area of interest is the forty-eight contiguous states of the United States....
New York State Education Dept., Albany. Bureau of Occupational and Career Curriculum Development.
The tool handling unit is presented to assist apprentices to acquire a general knowledge on the use of various basic tools. The unit consists of seven modules: (1) introduction to hand tools and small power tools; (2) measuring tools: layout and measuring tools for woodworking; (3) measuring tools: feeler gauge, micrometer, and torque wrench; (4)…
Boonstra, T.W.; Daffertshofer, A.; van Ditshuizen, J.C.; van den Heuvel, M.R.C.; Hofman, C.; Willigenburg, N.W.; Beek, P.J.
Two experiments were conducted to examine effects of muscle fatigue on motor-unit synchronization of quadriceps muscles (rectus femoris, vastus medialis, vastus lateralis) within and between legs. We expected muscle fatigue to result in an increased common drive to different motor units of
Milland, Maria; Mikkelsen, Kim L; Christoffersen, Jens K
with decreasing annual delivery volume. Face value incidence rate ratios of approved severe injuries increased with decreasing labor unit volume, but the association did not reach statistical significance. CONCLUSION: High volume labor units appear associated with fewer approved and fewer fatal injury claims...... in labor units in 1995-2012. METHODS: Exposure information regarding the annual number of deliveries per labor unit was retrieved from the Danish National Birth Register. Outcome information was retrieved from the Danish Patient Compensation Association. Exposure was categorized in delivery volume...... quintiles as annual volume per labor unit: (10-1377), (1378-2016), (2017-2801), (2802-3861), (3862-6659). MAIN OUTCOME MEASURES: Five primary measures of outcome were used. Incidence rate ratios of (A) Submitted claims, (B) Approved claims, (C) Approved severe injury claims (120% degree of disability), (D...
Shin, Henry; Suresh, Nina L.; Zev Rymer, William; Hu, Xiaogang
Objective. Chronic muscle weakness impacts the majority of individuals after a stroke. The origins of this hemiparesis is multifaceted, and an altered spinal control of the motor unit (MU) pool can lead to muscle weakness. However, the relative contribution of different MU recruitment and discharge organization is not well understood. In this study, we sought to examine these different effects by utilizing a MU simulation with variations set to mimic the changes of MU control in stroke. Approach. Using a well-established model of the MU pool, this study quantified the changes in force output caused by changes in MU recruitment range and recruitment order, as well as MU firing rate organization at the population level. We additionally expanded the original model to include a fatigue component, which variably decreased the output force with increasing length of contraction. Differences in the force output at both the peak and fatigued time points across different excitation levels were quantified and compared across different sets of MU parameters. Main results. Across the different simulation parameters, we found that the main driving factor of the reduced force output was due to the compressed range of MU recruitment. Recruitment compression caused a decrease in total force across all excitation levels. Additionally, a compression of the range of MU firing rates also demonstrated a decrease in the force output mainly at the higher excitation levels. Lastly, changes to the recruitment order of MUs appeared to minimally impact the force output. Significance. We found that altered control of MUs alone, as simulated in this study, can lead to a substantial reduction in muscle force generation in stroke survivors. These findings may provide valuable insight for both clinicians and researchers in prescribing and developing different types of therapies for the rehabilitation and restoration of lost strength after stroke.
During April 25-28, 2011, a massive storm system generated 351 tornadoes (including 15 registering 4 or 5 on the Enhanced Fujita [EF] scale*), killing 338 persons in Alabama, Arkansas, Georgia, Mississippi, and Tennessee. This was the third-deadliest tornado event in the United States, surpassing an April 1974 event that resulted in 315 fatalities. This event also was historic because of the record number of fatalities that occurred despite modern advances in tornado forecasting, advanced warning times, and media coverage. Risk factors for death and injury from tornadoes are sheltering in mobile homes, proximity to an EF-4 or EF-5 tornado, being an older adult (aged ≥65 years), lack of accessibility to safe rooms (e.g., basements or reinforced shelters), and a night-time tornado impact. To describe the fatalities by demographic characteristics, type of shelter used, cause of death, and tornado severity and location, CDC reviewed data from the American Red Cross (Red Cross), death certificates, and the National Weather Service (NWS). This report summarizes the results of that review. Among the 338 decedents, median age was 55.0 years (range: 4 days-97 years); approximately one third were older adults. On tornado impact, 46.7% of decedents were in single-family homes, and 26.6% were in mobile homes. The leading cause of death was traumatic injury, including 21.9% with head injuries. Half of the deadly tornadoes were rated EF-4 or EF-5 and were responsible for 89.5% of the deaths. To prevent tornado-related deaths, health messaging should encourage the public (especially older adults and residents of mobile/manufactured homes) to pre-identify an accessible safe room, prepare the room with personal protection items (e.g., blankets and helmets), and monitor local weather.
Alhomoud, Faten; Dhillon, Soraya; Aslanpour, Zoe; Smith, Felicity
There has been little research which specifically examines medicine use among South Asian (SA) and Middle Eastern (ME) groups, although evidence suggests that medicine-related needs may be poorly met for these groups. To describe medicine-related problems (MRPs) experienced by SA and ME patients from their perspectives and identify possible contributory factors that may be specific to their cultures. The data were collected in seven pharmacies in London, United Kingdom (UK). The study was a qualitative study. Patients were from SA and ME origins, aged over 18 and prescribed three or more regular medicines. Patients were identified when presenting with a prescription. The data were collected in 80 face-to-face semi-structured interviews using Gordon's MRPs tool. Interviews were audiotaped, transcribed verbatim and analysed thematically using Gordon's coding frame and Nvivo 10 software. Describing MRPs experienced by SA and ME patients from their perspectives and identifying possible contributory factors that may be specific to their cultures. Results Eighty participants (61 % male) had mean (SD) age 58 (13.4) years and a mean (SD) of 8 (4) medicines. Interviews revealed that several factors contributed to the development of MRPs; some appeared to be specific to SA and ME cultures and others were similar to the general population. The factors that were reported to be specific to SA and ME groups comprised religious practices and beliefs, use of non-prescription medicines, extent of family support, and travelling abroad--to patient's homeland or to take religious journeys. Illiteracy, language and communication barriers, lack of translated resources, perceptions of healthcare providers, and difficulty consulting a doctor of the same gender may also contribute to the problems. Many of these factors could be expected to influence patient's safety, adherence, and informed decision-making. This study demonstrated that SA and ME patients have their own problems and needs
Herrmann, Robert O.
Describes a suggested unit in consumer education designed to give students insight into the controversy about consumer protection policy and proposals, and compares the basic views of three economic belief systems: neoclassical, managerial, and liberal-Galbraithian. (MF)
Quattrochi, Dale A.; Crosson, William L.; Al-Hamdan, Mohammad Z.; Estes, Maurice G., Jr.
In the United States, extreme heat is the most deadly weather-related hazard. In the face of a warming climate and urbanization, which contributes to local-scale urban heat islands, it is very likely that extreme heat events (EHEs) will become more common and more severe in the U.S. This research seeks to provide historical and future measures of climate-driven extreme heat events to enable assessments of the impacts of heat on public health over the coterminous U.S. We use atmospheric temperature and humidity information from meteorological reanalysis and from Global Climate Models (GCMs) to provide data on past and future heat events. The focus of research is on providing assessments of the magnitude, frequency and geographic distribution of extreme heat in the U.S. to facilitate public health studies. In our approach, long-term climate change is captured with GCM outputs, and the temporal and spatial characteristics of short-term extremes are represented by the reanalysis data. Two future time horizons for 2040 and 2090 are compared to the recent past period of 1981- 2000. We characterize regional-scale temperature and humidity conditions using GCM outputs for two climate change scenarios (A2 and A1B) defined in the Special Report on Emissions Scenarios (SRES). For each future period, 20 years of multi-model GCM outputs are analyzed to develop a 'heat stress climatology' based on statistics of extreme heat indicators. Differences between the two future and the past period are used to define temperature and humidity changes on a monthly time scale and regional spatial scale. These changes are combined with the historical meteorological data, which is hourly and at a spatial scale (12 km) much finer than that of GCMs, to create future climate realizations. From these realizations, we compute the daily heat stress measures and related spatially-specific climatological fields, such as the mean annual number of days above certain thresholds of maximum and minimum air
Supplement 26 to the Safety Evaluation Report related to the operation of the Comanche Peak Steam Electric Station (CPSES), Unit 2, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission (NRC). The facility is located in Somervell County, Texas, approximately 40 miles southwest of Fort Worth, Texas. This supplement reports the status of certain issues that had not been resolved when the Safety Evaluation Report and Supplements 1, 2, 3, 4, 6, 12, 21, 22, 23, 24, and 25 to that report were published. This supplement deals primarily with Unit 2 issues; however, it also references evaluations for several licensing issues that relate to Unit 1, which have been resolved since Supplement 25 was issued
Powell, Gregory L; Rice, Amber; Bennett-Cross, Seres J; Fregosi, Ralph F
Although respiratory muscle motor units have been studied during natural breathing, simultaneous measures of muscle force have never been obtained. Tongue retractor muscles, such as the hyoglossus (HG), play an important role in swallowing, licking, chewing, breathing, and, in humans, speech. The HG is phasically recruited during the inspiratory phase of the respiratory cycle. Moreover, in urethane anesthetized rats the drive to the HG waxes and wanes spontaneously, providing a unique opportunity to study motor unit firing patterns as the muscle is driven naturally by the central pattern generator for breathing. We recorded tongue retraction force, the whole HG muscle EMG and the activity of 38 HG motor units in spontaneously breathing anesthetized rats under low-force and high-force conditions. Activity in all cases was confined to the inspiratory phase of the respiratory cycle. Changes in the EMG were correlated significantly with corresponding changes in force, with the change in EMG able to predict 53-68% of the force variation. Mean and peak motor unit firing rates were greater under high-force conditions, although the magnitude of discharge rate modulation varied widely across the population. Changes in mean and peak firing rates were significantly correlated with the corresponding changes in force, but the correlations were weak (r(2) = 0.27 and 0.25, respectively). These data indicate that, during spontaneous breathing, recruitment of HG motor units plays a critical role in the control of muscle force, with firing rate modulation playing an important but lesser role.
The text of the Safeguards Transfer Agreement between the Agency. Thailand and the United States of America relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members.
The text of the Safeguards Transfer Agreement between the Agency. Switzerland and the United States of America relating to the agreement of 30 December 1965 between the two Governments for co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for 'the information of all Members.
The text of a Safeguards Transfer Agreement between the Agency, Sweden and the United States of America relating to the agreement of 28 July 1966, as amended, between the two Governments for co-operation in the civil uses of atomic energy is reproduced in this document for the information of all Members
The text of the Safeguards Transfer Agreement between the Agency, Colombia and the United States of America relating to the agreement between the two Governments for co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members. The Safeguards Transfer Agreement entered into force on 9 December 1970.
The text of the Safeguards Transfer Agreement between the Agency, Spain and the United States of America relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members.
The text of the Safeguards Transfer Agreement between the Agency, Colombia and the United States of America relating to the agreement between the two Governments for co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members. The Safeguards Transfer Agreement entered into force on 9 December 1970.
The text of the Safeguards Transfer Agreement between the Agency, Israel and the United States of America relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members.
The text of the Safeguards Transfer Agreement between the Agency, Iran and the United States of America relating to the agreement berween the two Governments concerning co-operation in the promotion and development or the peaceful uses of atomic energy is reproduced in this document for the information of all Members.
The text of the Safeguards Transfer Agreement between the Agency. Thailand and the United States of America relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members
The text of the Safeguards Transfer Agreement between the Agency, Spain and the United States of America relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members
The text of the Safeguards Transfer Agreement between the Agency, Israel and the United States of America relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members
The text of the Safeguards Transfer Agreement between the Agency, Iran and the United States of America relating to the agreement berween the two Governments concerning co-operation in the promotion and development or the peaceful uses of atomic energy is reproduced in this document for the information of all Members
Kai Duan; Ge Sun; Steven G. McNulty; Peter V. Caldwell; Erika C. Cohen; Shanlei Sun; Heather D. Aldridge; Decheng Zhou; Liangxia Zhang; Yang Zhang
This study examines the relative roles of cli- matic variables in altering annual runoff in the contermi- nous United States (CONUS) in the 21st century, using a monthly ecohydrological model (the Water Supply Stress In- dex model, WaSSI) driven with historical records and future scenarios constructed from 20 Coupled Model Intercompar- ison Project Phase 5 (CMIP5)...
Almaden, Abdullah; Ku, Heng-Yu
The purpose of this study was to analyze on-campus and online PhD programs in educational technology-related fields in the United States. In particular, it sought to evaluate the most common program titles; core, elective, and research courses based on program curricula. The research design was quantitative content analysis and data were collected…
Johnson, Eric Norman (Inventor); Calise, Anthony J. (Inventor)
The invention includes an adaptive control system used to control a plant. The adaptive control system includes a hedge unit that receives at least one control signal and a plant state signal. The hedge unit generates a hedge signal based on the control signal, the plant state signal, and a hedge model including a first model having one or more characteristics to which the adaptive control system is not to adapt, and a second model not having the characteristic(s) to which the adaptive control system is not to adapt. The hedge signal is used in the adaptive control system to remove the effect of the characteristic from a signal supplied to an adaptation law unit of the adaptive control system so that the adaptive control system does not adapt to the characteristic in controlling the plant.
Chapman, Stephanie; Ashack, Kurt; Bell, Eric; Sendelweck, Myra Ann; Dellavalle, Robert
Understanding of the associations between indoor tanning and risky health related behaviors such as sexual activity and substance abuse among adolescents across the United States is incomplete. The purpose of this study is to identify risky health related behaviors among high school students utilizing indoor tanning according to region. We analyzed the results from surveys of adolescents in 14 different states administered as part of the Youth Risk Behavior Surveillance System (YRBSS) 2013. D...
Penn, Stefani L; Arunachalam, Saravanan; Woody, Matthew; Heiger-Bernays, Wendy; Tripodis, Yorghos; Levy, Jonathan I
Residential combustion (RC) and electricity generating unit (EGU) emissions adversely impact air quality and human health by increasing ambient concentrations of fine particulate matter (PM 2.5 ) and ozone (O 3 ). Studies to date have not isolated contributing emissions by state of origin (source-state), which is necessary for policy makers to determine efficient strategies to decrease health impacts. In this study, we aimed to estimate health impacts (premature mortalities) attributable to PM 2.5 and O 3 from RC and EGU emissions by precursor species, source sector, and source-state in the continental United States for 2005. We used the Community Multiscale Air Quality model employing the decoupled direct method to quantify changes in air quality and epidemiological evidence to determine concentration-response functions to calculate associated health impacts. We estimated 21,000 premature mortalities per year from EGU emissions, driven by sulfur dioxide emissions forming PM 2.5 . More than half of EGU health impacts are attributable to emissions from eight states with significant coal combustion and large downwind populations. We estimate 10,000 premature mortalities per year from RC emissions, driven by primary PM 2.5 emissions. States with large populations and significant residential wood combustion dominate RC health impacts. Annual mortality risk per thousand tons of precursor emissions (health damage functions) varied significantly across source-states for both source sectors and all precursor pollutants. Our findings reinforce the importance of pollutant-specific, location-specific, and source-specific models of health impacts in design of health-risk minimizing emissions control policies. Citation: Penn SL, Arunachalam S, Woody M, Heiger-Bernays W, Tripodis Y, Levy JI. 2017. Estimating state-specific contributions to PM 2.5 - and O 3 -related health burden from residential combustion and electricity generating unit emissions in the United States. Environ
Data and metadata exchange between organizations requires a common language for describing structure and content of statistical data and metadata. The SDMX consortium develops content oriented guidelines (COG) recommending harmonized cross-domain concepts and terminology to increase the efficiency of (meta-) data exchange. A recent challenge is a recommended code list for the unit of measure. Based on examples from SDMX sponsor organizations this paper analyses the diversity of ""unit of measure"" as used in practice, including potential breakdowns and interdependencies of the respective meta-
MacDorman, M.F.; Mathews, T.J.; Mohangoo, A.D.; Zeitlin, J.
OBJECTIVES: This report investigates the reasons for the United States' high infant mortality rate when compared with European countries. Specifically, the report measures the impact on infant mortality differences of two major factors: the percentage of preterm births and gestational age-specific
territories t- ken from the enemy in this war, as Might be agreed upon at a later date, end also such other territories as mi~r.it voluntarily...lag controls* In consequence tho process of Giving definition 211 . the ontot’prise * A dispassionate cvpprsisSl loach ) tho United States
FELLENDORF, GEORGE W.
REPRESENTATIVE OF THE VIEWS OF THE ALEXANDER GRAHAM BELL ASSOCIATION FOR THE DEAF, THIS STATEMENT SETS FORTH THE PURPOSES OF THE BELL ASSOCIATION AND DISCUSSES THE FOLLOWING TOPICS ABOUT DEAF EDUCATION--(1) THEIR AMBITIONS FOR ALL DEAF CHILDREN, (2) A CRITIQUE ON THE EDUCATION OF THE DEAF IN THE UNITED STATES, (3) CONCERN FOR DEAF CHILDREN WHO ARE…
Scott L. Goodrick; John A. Stanturf
In the Southeastern United States, forests are subject to a variety of damage-causing wind phenomena that range in scale from very localized (downbursts and tornadoes) to broad spatial scales (hurricanes). Incorporating the threat of wind damage into forest management plans requires tools capable of assessing risk across this range of scales. Our conceptual approach...
President Toomas Hendrik Ilves pälvis Balti riikide ja Ameerika Ühendriikide suhete edendamise eest Ameerika-Balti Fondi (USBF - The United States-Baltic Foundation) autasu - Baltic Statesmanship Award'i. Vabariigi President töövisiidil Ameerika Ühendriikides 17.-23.04.2008
We analyzed the potential physical and economic impacts of climate change on freshwater fisheries and coral reefs in the United States, examining a reference scenario and two policy scenarios that limit global greenhouse gas (GHG) emissions. We modeled shifts in suitable habitat ...
Shakya, Samasty; Singh, Sadin Kumar
Sadin Kumar Singh & Samasty Shakya. Diversity in Diak Järvenpää Campus Unit: Diversity and Relation among Different Institution Located within the campus premises. Järvenpää, Spring 2012. 48p. Diaconia University of Applied Sciences, Diak South, Järvenpää Unit, Degree program in Social Services (UAS) Focus on Community Development Work The primary purpose of this research was to find the biggest issue of diversity in the campus area. All three educational institutions operating from t...
The document reproduces the text of a safeguards transfer agreement of 28 August 1996 relating to a bilateral agreement between Argentina and the United States of America to suspend the application of safeguards pursuant to the agreement of 25 July 1969 between the Agency, Argentina and the United States of America in light of the provisions for the application of safeguards pursuant to the quadripartite safeguards agreement between Argentina, Brazil, the Brazilian-Argentine Agency for the Accounting and Control of Nuclear Materials and the IAEA. The Protocol entered into force on 13 January 1997
Ganz, Freda DeKeyser; Endacott, Ruth; Chaboyer, Wendy; Benbinishty, Julie; Ben Nun, Maureen; Ryan, Helen; Schoter, Amanda; Boulanger, Carole; Chamberlain, Wendy; Spooner, Amy
Quality ICU end-of-life-care has been found to be related to good communication. Handover is one form of communication that can be problematic due to lost or omitted information. A first step in improving care is to measure and describe it. The objective of this study was to describe the quality of ICU nurse handover related to end-of-life care and to compare the practices of different ICUs in three different countries. This was a descriptive comparative study. The study was conducted in seven ICUs in three countries: Australia (1 unit), Israel (3 units) and the UK (3 units). A convenience sample of 157 handovers was studied. Handover quality was rated based on the ICU End-of-Life Handover tool, developed by the authors. The highest levels of handover quality were in the areas of goals of care and pain management while lowest levels were for legal issues (proxy and advanced directives) related to end of life. Significant differences were found between countries and units in the total handover score (country: F(2,154)=25.97, p=studied. The total score was higher when quality of care might be deemed at greater risk (if the nurses did not know the patient or the patient was expected to die), indicating that nurses were exercising some form of discretionary decision making around handover communication; thus validating the measurement tool. Copyright © 2014. Published by Elsevier Ltd.
Lindsey, Bruce D.; Katz, Brian G.; Berndt, Marian P.; Ardis, Ann F.; Skach, Kenneth A.
The relation between sinkhole density and water quality was investigated in seven selected carbonate aquifers in the eastern United States. Sinkhole density for these aquifers was grouped into high (>25 sinkholes/100 km2), medium (1–25 sinkholes/100 km2), or low (2) categories using a geographical information system that included four independent databases covering parts of Alabama, Florida, Missouri, Pennsylvania, and Tennessee. Field measurements and concentrations of major ions, nitrate, and selected pesticides in samples from 451 wells and 70 springs were included in the water-quality database. Data were collected as a part of the US Geological Survey (USGS) National Water-Quality Assessment (NAWQA) Program. Areas with high and medium sinkhole density had the greatest well depths and depths to water, the lowest concentrations of total dissolved solids and bicarbonate, the highest concentrations of dissolved oxygen, and the lowest partial pressure of CO2 compared to areas with low sinkhole density. These chemical indicators are consistent conceptually with a conduit-flow-dominated system in areas with a high density of sinkholes and a diffuse-flow-dominated system in areas with a low density of sinkholes. Higher cave density and spring discharge in Pennsylvania also support the concept that the high sinkhole density areas are dominated by conduit-flow systems. Concentrations of nitrate-N were significantly higher (p sinkhole density than in low sinkhole-density areas; when accounting for the variations in land use near the sampling sites, the high sinkhole-density area still had higher concentrations of nitrate-N than the low sinkhole-density area. Detection frequencies of atrazine, simazine, metolachlor, prometon, and the atrazine degradate deethylatrazine indicated a pattern similar to nitrate; highest pesticide detections were associated with high sinkhole-density areas. These patterns generally persisted when analyzing the detection frequency by land
Van Bogaert, Peter; Adriaenssens, Jef; Dilles, Tinne; Martens, Daisy; Van Rompaey, Bart; Timmermans, Olaf
To study the impact of role, job- and organizational characteristics on nurse managers' work related stress and well-being such as feelings of emotional exhaustion, work engagement, job satisfaction and turnover intention. Various studies investigated role-, job- and organizational characteristics influencing nurse-related work environments. Research on nurse managers' related work environments define influencing factors, but, a clear understanding of the impact of nurse-managers' work-environment characteristics on their work related stress and well-being is limited. A cross-sectional design with a survey. A cross-sectional survey (N = 365) was carried out between December 2011-March 2012. The questionnaire was based on various validated measurement instruments identified by expert meetings (e.g. staff nurses, nurse managers and executives and physicians). Hierarchical regression analyses were performed using emotional exhaustion, work engagement, job satisfaction and turnover intentions as outcome variables. Study results showed one out of six nursing unit managers have high to very high feelings of emotional exhaustion and two out of three respondents have high to very high work engagement. Hierarchical regression models showed that role conflict and role meaningfulness were strong predictors of nursing unit managers' work related stress and well-being, alongside with job- and organizational characteristics. Several risk factors and stimulating factors influencing nurse unit managers' work related stress and well-being were identified. Further challenges will be to develop proper interventions and strategies to support nursing unit managers and their team in daily practice to deliver the best and safest patient care. © 2014 John Wiley & Sons Ltd.
This document supplement 25 to the Safety Evaluation Report related to the operation of the Comanche Peak Steam Electric Station (CPSES), Unit 2 (NUREG-0797), has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission (NRC). The facility is located in Somervell County, Texas, approximately 40 miles southwest of Fort Worth, Texas. This supplement reports the status of certain issues that had not been resolved when the Safety Evaluation Report and Supplements 1, 2, 3, 4, 6, 12, 21, 22, 23, and 24 to that report were published. This supplement deals primarily with Unit 2 issues; however, it also references evaluations for several Unit 1 licensing items resolved since Supplement 24 was issued
Font Gomez, J. A.; Gandia Martinez, A.; Jimenez Albericio, F. J.; Andres Redondon, M. M.; Mengual Gil, M. A.
A single - although laborious - start in the economic and clinical management of our units can be come to the knowledge of the time invested in the tasks functional, having to differentiate them, name them and even encrypt them. The time spent in performing the tasks multiplied by the annual number of these will indicate the resources necessary to achieve our objectives. In addition, pooling the values of times that members of the Unit provide analysed inter-workers dispersal, their causes and possible solutions. The establishment of relative units of value in any process benefits all workers involved in the process since it allows to know the dispersion of the times that each person employed in the development of the tasks. (Author)
Inskip, Peter D.; Hoover, Robert N.; Devesa, Susan S.
The use of cellular telephones has grown explosively during the past two decades, and there are now more than 279 million wireless subscribers in the United States. If cellular phone use causes brain cancer, as some suggest, the potential public health implications could be considerable. One might expect the effects of such a prevalent exposure to be reflected in general population incidence rates, unless the induction period is very long or confined to very long-term users. To address this i...
provisions of this chap- (4) is a fugitive from justice; ter; and (5) is an unlawful user of marihuana (as (3) other than a licensee or permittee defined...1) the applicant (including in the case of ed to marihuana (as defined in Section 4761 a corporation, partnership, or association, of the Internal...materials in ing the commission of any felony which may medicines and medicinal agents in the forms be prosecuted in a court of the United prescribed by the
Lewis, Shannon FitzPatrick.
This study employed quantitative and qualitative methods to examine gender trends and the quality of gender interactions at the United States Naval Academy (USNA). In addition to gender, midshipmen demographics, experiences, personality types, interests, and graduation outcomes were compared within and across gender for graduation years, 1980, 1985, 1990, 1995, 2000, and 2004. Representation of women has increased to the current high of around 16%. Further, the data revealed similarities and ...
Greg A. Breed
Full Text Available Consumer-grade GPS units are a staple of modern field ecology, but the relatively large error radii reported by manufacturers (up to 10 m ostensibly precludes their utility in measuring fine-scale movement of small animals such as insects. Here we demonstrate that for data collected at fine spatio-temporal scales, these devices can produce exceptionally accurate data on step-length and movement patterns of small animals. With an understanding of the properties of GPS error and how it arises, it is possible, using a simple field protocol, to use consumer grade GPS units to collect step-length data for the movement of small animals that introduces a median error as small as 11 cm. These small error rates were measured in controlled observations of real butterfly movement. Similar conclusions were reached using a ground-truth test track prepared with a field tape and compass and subsequently measured 20 times using the same methodology as the butterfly tracking. Median error in the ground-truth track was slightly higher than the field data, mostly between 20 and 30 cm, but even for the smallest ground-truth step (70 cm, this is still a signal-to-noise ratio of 3:1, and for steps of 3 m or more, the ratio is greater than 10:1. Such small errors relative to the movements being measured make these inexpensive units useful for measuring insect and other small animal movements on small to intermediate scales with budgets orders of magnitude lower than survey-grade units used in past studies. As an additional advantage, these units are simpler to operate, and insect or other small animal trackways can be collected more quickly than either survey-grade units or more traditional ruler/gird approaches.
U.S. Department of Health & Human Services — Changes in the rates of TBI-related deaths vary depending on age. For persons 44 years of age and younger, TBI-related deaths decreased between the periods of...
Perko, T; Tomkiv, Y; Oughton, D H; Cantone, M C; Gallego, E; Prezelj, I; Byrkina, E
Using an analysis of the way European newspapers covered the Fukushima nuclear accident, this article explores how the mass media transmit information about radiation risks from experts to the general public. The study applied a media content analysis method on a total of 1340 articles from 12 leading newspapers in 6 countries: Belgium (N = 260), Italy (N = 270), Norway (N = 133), Russia (N = 172), Slovenia (N = 190) and Spain (N = 315). All articles analysed were selected as being directly or indirectly related to the Fukushima accident by containing the word 'nuclear' and/or 'Fukushima' and were published between the 11th March and the 11th May 2011. The data presented here focus specifically on a cross-cultural comparison of the way the media use quantitative units. Results suggest that although experts are accustomed to communicating about radiological risks in technical language, often using quantitative units to describe the risks, mass media do not tend to use these units in their reporting. Although the study found a large variation in the measurement units used in different countries, it appeared that journalists in all the analysed countries preferred to describe radioactivity by comparing different radiation exposures, rather than reporting the actual measured units. The paper concludes with some practical guidelines for sound public communication about radiation risks. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Perko, T.; Tomkiv, Y.; Oughton, D.H.; Cantone, M.C.; Gallego, E.; Prezelj, I.; Byrkina, E.
Using an analysis of the way European newspapers covered the Fukushima nuclear accident, this article explores how the mass media transmit information about radiation risks from experts to the general public. The study applied a media content analysis method on a total of 1340 articles from 12 leading newspapers in 6 countries: Belgium (N = 260), Italy (N = 270), Norway (N = 133), Russia (N = 172), Slovenia (N = 190) and Spain (N = 315). All articles analysed were selected as being directly or indirectly related to the Fukushima accident by containing the word 'nuclear' and/or 'Fukushima' and were published between the 11 March and the 11 May 2011. The data presented here focus specifically on a cross-cultural comparison of the way the media use quantitative units. Results suggest that although experts are accustomed to communicating about radiological risks in technical language, often using quantitative units to describe the risks, mass media do not tend to use these units in their reporting. Although the study found a large variation in the measurement units used in different countries, it appeared that journalists in all the analysed countries preferred to describe radioactivity by comparing different radiation exposures, rather than reporting the actual measured units. The paper concludes with some practical guidelines for sound public communication about radiation risks. (authors)
Kaspersen, Lars Bo; Gabriel, Norman
Relational social theory can be found in the works of Hegel, Marx, Simmel, Mannheim, Mead, Saussure, Lévi-Strauss, Althusser, Foucault and Bourdieu. However, one of the most consistent relational thinkers is Norbert Elias. In order to develop his figurational and relational social theory Elias...
Full Text Available University of applied science and technology has been designed to create a platform for multilateral activities such as industrial, military and academic in developing countries to promote science and scientific research applications. These universities are responsible to promote practical training in quantitative and qualitative indicators and they provide appropriate infrastructure to implement theoretical graduates to solve practical problems to build necessary infrastructure to transfer modern technology into developing countries. During the past few years, there have been tremendous development on these units but some of them have not been efficient. In this paper, we present an empirical study to measure the relative efficiencies of various units of applied science and technology universities using data envelopment analysis. The proposed model of this paper uses two inputs including human resources as well as total assets and two outputs including the number of graduate students as well as operating profit. The results of the study have indicated that some of the units are inefficient and need to be merged with other units to increase the relative efficiency of these universities.
Full Text Available The main purpose of this study was to investigate the impact of perceived HR practices on affective commitment and turnover intention. This study explored which HR practices were relatively more important in predicting affective commitment and turnover intention. A total of 302 employees from the United States and 317 from South Korea completed the same questionnaires for assessing the aforementioned relationships. The results illustrated that among perceived HR practices, internal mobility had the most significant association with turnover intention in both the United States and South Korea. While internal mobility was a stronger predictor of affective commitment for the United States sample, training was the most important variable for predicting affective commitment in South Korea. The second purpose of the study was to examine whether individuals’ positive affect influences the relationship between perceived HR practices and affective commitment and turnover intention. In the United States, positive affect moderated the relationship between perceived HR practices and affective commitment and turnover intention such that the relationships were stronger for individuals reporting high positive affect relative to those reporting low positive affect. However, these relationships were not significant in South Korea. We discuss the implications of these results, study limitations, and practical suggestions for future research.
The systematic evaluation of the deficiencies of the original design of the WWER reactors brought to the development of a Short Term Programme for Safety Upgrading and Modernisation of Kozloduy WWER-440 units. The implementation of this Programme was completed in 1997. The strive for continuos improvement of Kozloduy Nuclear Power Plant (NPP) safety level, the new requirements of the Bulgarian Nuclear Safety Authority and the public concern initiated the development of new Complex Programme for Safety Improvement (PRG'97), now in a process of implementation. (author)
Fisher, James C.; Martin, Larry G.
This paper summarizes the legislation upon which the current welfare-to-work transition in the United States is based and describes characteristics of the former welfare population from which various tiers of employment options have emerged: unsubsidized-employed workers, subsidized-employed workers, subsidized-unemployed recipients, and unsubsidized-unemployed individuals. It also discusses current program emphases, and presents a format for directions for future program development which includes academic programs, situated cognition programs, integrated literacy/occupational skills programs, and integrated literacy/soft skills training.
The text of the Safeguards Transfer Agreement between the Agency, Argentina and the United States of America relating to the agreement of 25 June 1969 between the two Governments for co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members. The Safeguards Transfer Agreement entered into force on 25 July 1969.
The text of the Safeguards Transfer Agreement between the Agency, Denmark and the United Kingdom of Great Britain and Northern Ireland relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members. This Safeguards Transfer Agreement was signed and entered into force on 23 June 1965.
The text of the Safeguards Transfer Agreement between the Agency, Denmark and the United Kingdom of Great Britain and Northern Ireland relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members. This Safeguards Transfer Agreement was signed and entered into force on 23 June 1965
Objectives: To test the “Trump Hypothesis”: whether immigrants are responsible for higher levels of violent and drug-related crime in the United States, as asserted by Donald Trump in his 2015 presidential campaign announcement. This is achieved using recent crime and immigration data, thus testing the common public perception linking immigrants to crime, and providing an updated assessment of the immigrant-crime nexus. Methods: Rates of violent crime and drug arrests by state are pooled for ...
The text of the Safeguards Transfer Agreement between the Agency, Austria and the United States of America relating to the agreement of 11 July 1969 between the two Governments for cooperation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members. The Safeguards Transfer Agreement entered into force on 24 January 1970.
The text of the Safeguards Transfer Agreement between the Agency, Iran and the United States of America relating to the agreement between the two Governments for co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members. Members will be informed of the entry into force of the Safeguards Transfer Agreement.
Gateau, C.; Chatterton, N.; Nonat, A.; Mazzanti, M.; Pecaut, J.; Borel, A.; Merbach, A.; Heim, L.
In order to study the influence of the coordination sphere on the properties which govern the relaxivity, ligands containing pyridine carboxylates units have been particularly studied. It has been shown that the tripodal ligand tpaa forms with gadolinium (III) a neutral complex having a relaxivity (r1p=13.3 mM -1 at 298 K and 60 MHz) which is three times superior to the contrast agents currently used in NMR Imaging. To explain this remarkably relaxivity, two new ligands analogous to the tpaa: the tpatcn and the bpeda containing pyridine carboxylate units bound to one or several aliphatic nitrogen have been studied in modulating the number of coordination sites and the symmetry degree. The study of the relaxivity of the corresponding gadolinium (III) complexes gives precious data on the understanding of the results in the case of the complex [Gd(tpaa)]. The synthesis and the properties of these gadolinium (III) complexes will be presented during this conference. (O.M.)
Full Text Available Bell (2012 catalogued unit root factors contained in linear filters used in seasonal adjustment (model-based or from the X-11 method but noted that, for model-based seasonal adjustment, special cases could arise where filters could contain more unit root factors than was indicated by the general results. This article reviews some special cases that occur with canonical ARIMA model based adjustment in which, with some commonly used ARIMA models, the symmetric seasonal filters contain two extra nonseasonal differences (i.e., they include an extra (1 - B(1 - F. This increases by two the degree of polynomials in time that are annihilated by the seasonal filter and reproduced by the seasonal adjustment filter. Other results for canonical ARIMA adjustment that are reported in Bell (2012, including properties of the trend and irregular filters, and properties of the asymmetric and finite filters, are unaltered in these special cases. Special cases for seasonal adjustment with structural ARIMA component models are also briefly discussed.
The purpose of this lesson plan is to introduce the importance of social media and the Internet on public relations and marketing. The lesson describes the new rules for public relations versus the old rules. It is a more in depth look at how, and why, to use blogging, social media, and the Internet for promoting a company and appealing to buyers.…
Hawkins, Joy L.; Chang, Jeani; Palmer, Susan K.; Gibbs, Charles P.; Callaghan, William M.
OBJECTIVE: To examine 12 years of anesthesia-related maternal deaths from 1991 to 2002 and compare them with data from 1979 to 1990, to estimate trends in anesthesia-related maternal mortality over time, and to compare the risks of general and regional anesthesia during cesarean delivery. METHODS:
Cláudio Penido Campos Júnior
Full Text Available Despite improvements in care and rehabilitation of burned patients, infections still remain the main complication and death cause. Catheter-related infections are among the four most common infections and are associated with skin damage and insertion site colonization. There are few studies evaluating this kind of infection worldwide in this special group of patients. Padre Albino Hospital Burn Care Unit (PAHBCU is the only reference center in the Northwestern São Paulo for treatment of burned patients. This paper presents the results of a retrospective study aiming at describing the epidemiological and clinical features of catheter-related infections at PAHBCU.
Santosh K Verma
Full Text Available Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span.Nationally representative data from the National Health Interview Survey (NHIS 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004-2013. Costs of unintentional fall-related injuries were extracted from the CDC's Web-based Injury Statistics Query and Reporting System.Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+, 1.1% of middle-aged adults (45-64 and 0.7% of young adults (18-44 reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%-7% from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010.Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a greater public health benefit.
Verma, Santosh K.; Willetts, Joanna L.; Corns, Helen L.; Marucci-Wellman, Helen R.; Lombardi, David A.; Courtney, Theodore K.
Introduction Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span. Methods Nationally representative data from the National Health Interview Survey (NHIS) 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004–2013. Costs of unintentional fall-related injuries were extracted from the CDC’s Web-based Injury Statistics Query and Reporting System. Results Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+), 1.1% of middle-aged adults (45–64) and 0.7% of young adults (18–44) reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%–7%) from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010. Conclusions Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a
Fuller, D C; Suruda, A J
Alice Hamilton described fatal work injuries from acute hydrogen sulfide poisonings in 1925 in her book Industrial Poisons in the United States. There is no unique code for H2S poisoning in the International Classification of Diseases, 9th Revision; therefore, these deaths cannot be identified easily from vital records. We reviewed US Occupational Safety and Health Administration (OSHA) investigation records for the period 1984 to 1994 for mention of hazardous substance 1480 (hydrogen sulfide). There were 80 fatalities from hydrogen sulfide in 57 incidents, with 19 fatalities and 36 injuries among coworkers attempting to rescue fallen workers. Only 17% of the deaths were at workplaces covered by collective bargaining agreements. OSHA issued citations for violation of respiratory protection and confined space standards in 60% of the fatalities. The use of hydrogen sulfide detection equipment, air-supplied respirators, and confined space safety training would have prevented most of the fatalities.
Inskip, Peter D; Hoover, Robert N; Devesa, Susan S
The use of cellular telephones has grown explosively during the past two decades, and there are now more than 279 million wireless subscribers in the United States. If cellular phone use causes brain cancer, as some suggest, the potential public health implications could be considerable. One might expect the effects of such a prevalent exposure to be reflected in general population incidence rates, unless the induction period is very long or confined to very long-term users. To address this issue, we examined temporal trends in brain cancer incidence rates in the United States, using data collected by the Surveillance, Epidemiology, and End Results (SEER) Program. Log-linear models were used to estimate the annual percent change in rates among whites. With the exception of the 20-29-year age group, the trends for 1992-2006 were downward or flat. Among those aged 20-29 years, there was a statistically significant increasing trend between 1992 and 2006 among females but not among males. The recent trend in 20-29-year-old women was driven by a rising incidence of frontal lobe cancers. No increases were apparent for temporal or parietal lobe cancers, or cancers of the cerebellum, which involve the parts of the brain that would be more highly exposed to radiofrequency radiation from cellular phones. Frontal lobe cancer rates also rose among 20-29-year-old males, but the increase began earlier than among females and before cell phone use was highly prevalent. Overall, these incidence data do not provide support to the view that cellular phone use causes brain cancer.
Garrett, Robert G.
To support the development of protocols for the proposed North American Soil Geochemical Landscapes project, whose objective is to establish baselines for the geochemistry of North American soils, two continental-scale transects across the United States and Canada were sampled in 2004. The sampling employed a spatially stratified random sampling design in order to estimate the variability between 40-km linear sampling units, within them, at sample sites, and due to sample preparation and analytical chemical procedures. The 40-km scale was chosen to be consistent with the density proposed for the continental-scale project. The two transects, north–south (N–S) from northern Manitoba to the USA–Mexico border near El Paso, Texas, and east–west (E–W) from the Virginia shore north of Washington, DC, to north of San Francisco, California, closely following the 38th parallel, have been studied individually. The purpose of this study was to determine if statistically significant systematic spatial variation occurred along the transects. Data for 38 major, minor and trace elements in A- and C-horizon soils where less than 5% of the data were below the detection limit were investigated by Analysis of Variance (ANOVA). A total of 15 elements (K, Na, As, Ba, Be, Ce, La, Mn, Nb, P, Rb, Sb, Th, Tl and W) demonstrated statistically significant (p<0.05) variability at the between-40-km scale for both horizons along both transects. Only Cu failed to demonstrate significant variability at the between-40-km scale for both soil horizons along both transects.
Bradbury, P.; Dam, S.; Starke, W.
Radioactively contaminated metallic materials comprise a large part of the potential waste products which result from nuclear facility repair, refurbishment, and decommissioning. United States Government (Departments of Energy and Defense) facilities, U.S. nuclear power plants, and other commercial nuclear fuel cycle facilities have large inventories of radioactive scrap metal which could be decontaminated and recycled into useful radioactive and non-radioactive products. Residual radioactivity and recycling criteria is needed to avoid the high cost of disposal and the waste of natural resources. In the United Kingdom, BNFL has decommissioned the gaseous diffusion plant at Capenhurst and has recycled a large fraction of the metallic scrap into the metals market. Other structural materials have also been released as uncontaminated scrap. U.K. release criteria for residual radionuclide contamination have been applied to these operations. A variety of techniques were utilized to size reduce large components, to remove radioactivity, and to survey and release these materials. These methods and the application of release criteria has a direct relationship to methods which would be applicable in the U.S. and in other countries. This paper will describe the specific U.K. technology and experience in the decontamination, recycle, and release of scrap metal. It will also describe the U.S. environment for metal recycle, including the volumes and levels of contamination, and the current and proposed release criteria. Comparisons will be presented between the U.S. and U.K., both in technology and methodology for recycle and in regulatory criteria for residual radioactivity and material release and for ultimate decommissioning. The paper will then provide suggested approaches and criteria for U.S. recycling and decommissioning. (author)
Choi, I.; Song, M.S.; Kim, K.M.; Lee, Y-H.
Despite surging interests in analyzing business processes, there are few scientific approaches to analysis and redesign of organizational structures which can greatly affect the performance of business processes. This paper presents a method for deriving and analyzing organizational relations from
While the link between geographic and social mobility has long been a cornerstone of sociological approaches to migration, recent research has cast doubt on the economic returns to internal U.S. migration. Moreover, important racial disparities in migration patterns remain poorly understood. Drawing on data from the 2000 census, I reappraise the link between migration and social mobility by taking relative deprivation into consideration. I examine the association between migration, disaggregated by region of origin and destination, and absolute and relative earnings and occupational prestige, separately by race. Findings lend new insight into the theoretical and stratification implications of growing racial disparities in migration patterns; while both blacks and whites who move north-south generally average lower absolute incomes than their stationary northern peers, they enjoy significantly higher relative social position. Moreover, the relative “gains” to migration are substantially larger for blacks than whites. The opposite patterns obtain for south-north migration. PMID:24391221
U.S. Department of Health & Human Services — In general, total combined rates for traumatic brain injury (TBI)-related emergency department (ED) visits, hospitalizations and deaths have increased over the past...
Vande Griek, Olivia H.; Clark, Malissa A.; Witte, Tracy K.; Nett, Randall J.; Moeller, Amanda N.; Stabler, Margaret E.
OBJECTIVE To develop a comprehensive taxonomy of practice-related stressors experienced by US veterinarians. DESIGN Cross-sectional survey. SAMPLE A subset of 1,422 US veterinarians who provided written (vs selected) responses to a question in a previous survey regarding practice-related stressors. PROCEDURES Using grounded theory analysis, 3 researchers inductively analyzed written survey responses concerning respondents’ main practice-related stressors. In 5 iterations, responses were individually coded and categorized, and a final list of practice-related stressor categories and subcategories was iteratively and collaboratively developed until theoretical and analytic saturation of the data was achieved. RESULTS A taxonomy of 15 categories of broad practice-related stressors and 40 subcategories of more specific practice-related stressors was developed. The most common practice-related stressor categories included financial insecurity (n = 289 [20.3%]), client issues (254 [17.9%]), coworker or interpersonal issues (181 [12.7%]), and work-life balance (166 [11.7%]). The most common subcategories were clients unwilling to pay (118 [8.3%]), low income (98 [6.9%]), cost of maintaining practice (56 [3.9%]), and government or state board policies (48 [3.4%]). CONCLUSIONS AND CLINICAL RELEVANCE This study provided a comprehensive list of the types of practice-related stressors experienced by US veterinarians, building a foundation for future research into relationships between job stress and mental health in this population. Frequency data on the various stressors provided an initial understanding of factors that might be contributing to high stress rates among US veterinarians. PMID:29319445
Vande Griek, Olivia H; Clark, Malissa A; Witte, Tracy K; Nett, Randall J; Moeller, Amanda N; Stabler, Margaret E
OBJECTIVE To develop a comprehensive taxonomy of practice-related stressors experienced by US veterinarians. DESIGN Cross-sectional survey. SAMPLE A subset of 1,422 US veterinarians who provided written (vs selected) responses to a question in a previous survey regarding practice-related stressors. PROCEDURES Using grounded theory analysis, 3 researchers inductively analyzed written survey responses concerning respondents' main practice-related stressors. In 5 iterations, responses were individually coded and categorized, and a final list of practice-related stressor categories and subcategories was iteratively and collaboratively developed until theoretical and analytic saturation of the data was achieved. RESULTS A taxonomy of 15 categories of broad practice-related stressors and 40 subcategories of more specific practice-related stressors was developed. The most common practice-related stressor categories included financial insecurity (n = 289 [20.3%]), client issues (254 [17.9%]), coworker or interpersonal issues (181 [12.7%]), and work-life balance (166 [11.7%]). The most common subcategories were clients unwilling to pay (118 [8.3%]), low income (98 [6.9%]), cost of maintaining practice (56 [3.9%]), and government or state board policies (48 [3.4%]). CONCLUSIONS AND CLINICAL RELEVANCE This study provided a comprehensive list of the types of practice-related stressors experienced by US veterinarians, building a foundation for future research into relationships between job stress and mental health in this population. Frequency data on the various stressors provided an initial understanding of factors that might be contributing to high stress rates among US veterinarians.
Keyson, D.V.; Freudenthal, A.; De Hoogh, M.P.A.; Dekoven, E.A.M.
The invention relates to an interface unit comprising at least a display unit for communication with a user, which is designed for being coupled with a control unit for at least one or more parameters in a living or working environment, such as the temperature setting in a house, which control unit
Taylor, Ethel V; Vaidyanathan, Ambarish; Flanders, W Dana; Murphy, Matthew; Spencer, Merianne; Noe, Rebecca S
To determine whether non-US citizens have a higher mortality risk of heat-related deaths than do US citizens. We used place of residence reported in mortality data from the National Vital Statistics System from 2005 to 2014 as a proxy for citizenship to examine differences in heat-related deaths between non-US and US citizens. Estimates from the US Census Bureau American Community Survey of self-reported citizenship status and place of birth provided the numbers for the study population. We calculated the standardized mortality ratio and relative risk for heat-related deaths between non-US and US citizens nationally. Heat-related deaths accounted for 2.23% (n = 999) of deaths among non-US citizens and 0.02% (n = 4196) of deaths among US citizens. The age-adjusted standardized mortality ratio for non-US citizens compared with US citizens was 3.4 (95% confidence ratio [CI] = 3.2, 3.6). This risk was higher for Hispanic non-US citizens (risk ratio [RR] = 3.6; 95% CI = 3.2, 3.9) and non-US citizens aged 18 to 24 years (RR = 20.6; 95% CI = 16.5, 25.7). We found an increased mortality risk among non-US citizens compared with US citizens for heat-related deaths, especially those younger and of Hispanic ethnicity.
Brian C. Houle
Full Text Available Few studies consider obesity inequalities as a distributional property. This study uses relative distribution methods to explore inequalities in body mass index (BMI; kg/m2. Data from 1999–2006 from the National Health and Nutrition Examination Survey were used to compare BMI distributions by gender, Black/White race, and education subgroups in the United States. For men, comparisons between Whites and Blacks show a polarized relative distribution, with more Black men at increased risk of over or underweight. Comparisons by education (overall and within race/ethnic groups effects also show a polarized relative distribution, with more cases of the least educated men at the upper and lower tails of the BMI distribution. For women, Blacks have a greater probability of high BMI values largely due to a right-shifted BMI distribution relative to White women. Women with less education also have a BMI distribution shifted to the right compared to the most educated women.
Chang, Ann; Kicis, Jennifer; Sangha, Gurjit
High patient acuity, heavy workload, and patient deaths can all contribute to work-related stress for pediatric oncology nurses. A new leadership role, the clinical support nurse (CSN), was recently initiated on the oncology unit of a large Canadian pediatric hospital to support frontline staff and reduce some of the stresses related to clinical activity. The CSN assists nurses with complex patient care procedures, provides hands-on education at the bedside, and supports staff in managing challenging family situations. This study explores the effect of the CSN role on the nurses' work-related stress using the Stressor Scale for Pediatric Oncology Nurses. A total of 58 nurses participated in this study for a response rate of 86%. The results show that the intensity of work-related stress experienced by nurses in this study is significantly less (P < .001) on shifts staffed with a CSN compared with shifts without a CSN.
Kaufmann, R.B.; Staes, Catherine J.; Matte, Thomas D.
This study was conducted to describe trends in US lead poisoning-relate deaths between 1979 and 1998. The predictive value of relevant ICD-9 codes was also evaluated. Multiple cause-of-death files were searched for record containing relevant ICD-9 codes, and underlying causes and demographic characteristics were assessed. For 1979-1988, death certificates were reviewed; lead source information was abstracted and accuracy of coding was determined. An estimated 200 lead poisoning-related deaths occurred from 1979 to 1998. Most were among males (74%), Blacks (67%), adults of age ≥45 years (76%), and Southerners (70%). The death rate was significantly lower in more recent years. An alcohol-related code was a contributing cause for 28% of adults. Only three of nine ICD-9 codes for lead poisoning were highl predictive of lead poisoning-related deaths. In conclusion, lead poisoning-related death rates have dropped dramatically since earlier decades and are continuing to decline. However, the findings imply that moonshine ingestion remains a source of high-dose lead exposure in adults
Rhodes, Corinne M; Chang, Yuchiao; Percac-Lima, Sanja
Despite increases in obesity and related diseases in developing nations, initial refugee clinical visits do not address these issues. We explored the development of obesity and related diseases in a longitudinal prospective cohort of African refugees resettling in northeastern US. Using state Department of Health data, refugees were linked to a health system. Body mass index, diabetes, hypertension, and hyperlipidemia status were extracted from charts. US regional controls from NAMCS/NHAMCS data were matched by age, sex, race, and visit year. African refugee BMI increased after resettlement at 1 (1.7 ± 2.9, p resettlement to prevent development of obesity and related disease in this vulnerable population.
Walker, Mary Ellen; Anonson, June; Szafron, Michael
The relationship between political environment and health services accessibility (HSA) has not been the focus of any specific studies. The purpose of this study was to address this gap in the literature by examining the relationship between political environment and HSA. This relationship that HSA indicators (physicians, nurses and hospital beds per 10 000 people) has with political environment was analyzed with multiple least-squares regression using the components of democracy (electoral processes and pluralism, functioning of government, political participation, political culture, and civil liberties). The components of democracy were represented by the 2011 Economist Intelligence Unit Democracy Index (EIUDI) sub-scores. The EIUDI sub-scores and the HSA indicators were evaluated for significant relationships with multiple least-squares regression. While controlling for a country's geographic location and level of democracy, we found that two components of a nation's political environment: functioning of government and political participation, and their interaction had significant relationships with the three HSA indicators. These study findings are of significance to health professionals because they examine the political contexts in which citizens access health services, they come from research that is the first of its kind, and they help explain the effect political environment has on health. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Cramer, Ryan; Hexem, Sarah; LaPollo, Archana; Cuffe, Kendra M; Chesson, Harrell W; Leichliter, Jami S
Poorer health suffered by lesbian, gay, and bisexual (LGB) populations may be associated with public policies. We collected the laws that in 2013 prohibited discrimination based on sexual orientation from 50 United States (US) states, the District of Columbia (Washington, DC or DC), and the 30 most populous US metropolitan areas. To facilitate future research, we coded certain aspects of these laws to create a dataset. We generated descriptive statistics by jurisdiction type and tested for regional differences in state law using Chi-square tests. Sixteen (31.4 per cent) states prohibited discrimination by all employers based on sexual orientation, 25 states (49.0 per cent) in public employment, 18 states (35.3 per cent) in government contracting, and 21 states (41.2 per cent) in private employment. Twenty-one states prohibited discrimination (41.2 per cent) in housing practices (selling and renting), and 17 (33.3 per cent) in public accommodations. Local (county/city) laws prohibiting discrimination were less common. State laws differed significantly by US census region - West, Midwest, Northeast, and South. Future analyses of these data could examine the impact of these laws on various outcomes, including health among LGB populations.
This report supplements the Safety Evaluation Report (SER), NUREG-0847 (June 1982), Supplement No. 1 (September 1982), Supplement No. 2 (January 1984), Supplement No. 3 (January 1985). Supplement No. 4 (March 1985), Supplement No. 5 (November 1990), Supplement No. 6 (April 1991), Supplement No. 7 (September 1991), Supplement No. 8 (January 1992). Supplement No. 9 (June 1992), Supplement No. 10 (October 1992), Supplement No. 11 (April 1993), Supplement No. 12 (October 1993). Supplement No. 13 (April 1994), Supplement No. 14 (December 1994), and Supplement No. 15 (June 1995) issued by the Office of Nuclear Reactor Regulation of the U.S. Nuclear Regulatory Commission with respect to the application filed by the Tennessee Valley Authority, as applicant and owner, for licenses to operate the Watts Bar Nuclear Plant, Units 1 and 2 (Docket Nos, 50-390 and 50-391). The facility is located in Rhea County, Tennessee, near the Watts Bar Dam on the Tennessee River. This supplement provides recent information regarding resolution of some of the outstanding and confirmatory items, and proposed license conditions identified in the SER
Mauro H. Chagas
Full Text Available ABSTRACT Background Stretching exercises are able to promote adaptations in the muscle-tendon unit (MTU, which can be tested through physiological and biomechanical variables. Identifying the key variables in MTU adaptations is crucial to improvements in training. Objective To perform an exploratory factor analysis (EFA involving the variables often used to evaluate the response of the MTU to stretching exercises. Method Maximum joint range of motion (ROMMAX, ROM at first sensation of stretching (FSTROM, peak torque (torqueMAX, passive stiffness, normalized stiffness, passive energy, and normalized energy were investigated in 36 participants during passive knee extension on an isokinetic dynamometer. Stiffness and energy values were normalized by the muscle cross-sectional area and their passive mode assured by monitoring the EMG activity. Results EFA revealed two major factors that explained 89.68% of the total variance: 53.13% was explained by the variables torqueMAX, passive stiffness, normalized stiffness, passive energy, and normalized energy, whereas the remaining 36.55% was explained by the variables ROMMAX and FSTROM. Conclusion This result supports the literature wherein two main hypotheses (mechanical and sensory theories have been suggested to describe the adaptations of the MTU to stretching exercises. Contrary to some studies, in the present investigation torqueMAX was significantly correlated with the variables of the mechanical theory rather than those of the sensory theory. Therefore, a new approach was proposed to explain the behavior of the torqueMAX during stretching exercises.
In 1955, growing global concerns about ionizing radiation led the General Assembly of the United Nations to establish the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). The mandate of this committee, which presently includes 21 Member States, is to assess and report on the levels and effects of exposure to ionizing radiation. Accordingly, UNSCEAR applies scientific judgement in undertaking comprehensive reviews and evaluations concerning radiation and maintains an independent and neutral position in drawing its conclusions. These are published in authoritative reports to the UN General Assembly, with there having been 14 such substantive reports, with technical annexes, since 1958. The information provided by UNSCEAR assists the General Assembly in making recommendations in relation, for example, to international collaboration in the field of health. Governments and organizations all over the world rely on the committee's evaluations as the scientific basis for estimating radiation risk, establishing radiation protection and safety standards, and regulating radiation sources
Butler, Corey R; O'Connor, Mary B; Lincoln, Jennifer M
Airplanes and helicopters are integral to the management and suppression of wildfires, often operating in high-risk, low-altitude environments. To update data on aviation-related wildland firefighting fatalities, identify risk factors, and make recommendations for improved safety, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed reports from multiple data sources for the period 2000-2013. Among 298 wildland firefighter fatalities identified during 2000-2013, 78 (26.2%) were aviation-related occupational fatalities that occurred during 41 separate events involving 42 aircraft. Aircraft crashes accounted for 38 events. Pilots, copilots, and flight engineers represented 53 (68%) of the aviation-related fatalities. The leading causes of fatal aircraft crashes were engine, structure, or component failure (24%); pilot loss of control (24%); failure to maintain clearance from terrain, water, or objects (20%); and hazardous weather (15%). To reduce fatalities from aviation-related wildland firefighting activities, stringent safety guidelines need to be followed during all phases of firefighting, including training exercises. Crew resource management techniques, which use all available resources, information, equipment, and personnel to achieve safe and efficient flight operations, can be applied to firefighting operations.
Keith B. Aubry; McKelvey Kevin S.; Copeland Jeffrey P.
Conservation of the wolverine (Gulo gulo) at the southern extent of its North American range requires reliable understandings of past and present distribution patterns and broad-scale habitat relations. We compiled 820 verifiable and documented records of wolverine occurrence (specimens, DNA detections, photos, and accounts of wolverines being killed...
Cynthia G. Ayres, PhD, RN
Conclusions: Study findings extend existing knowledge and contribute to a more comprehensive knowledge base regarding health practices among Asian adolescents. Having this knowledge base provides practitioners with a better understanding of the factors related to health practices in Asian adolescents and assists them in developing culturally sensitive interventions aimed at promoting PHP in this population.
Introduction: Non‑communicable diseases are emerging as an important component of the burden of diseases in developing countries. Knowledge on admission and mortality patterns of endocrine‑related diseases will give insight into the magnitude of these conditions and provide effective tools for planning, delivery, and ...
Mariana de Almeida Moraes Gibaut
Full Text Available This study aimed to identify the level of comfort of families of patients in a critical health condition related to the welcoming practices performed by the hospital staff. Interviews were conducted with 250 relatives in hospitals of the state Bahia, using a Likert scale. Data were analyzed as percentages and quartiles. For nine of the 12 statements of the scale, most relatives scored their comfort level between very and totally comfortable, median of 4,revealing kindness, tranquility and friendly communication with family members. More than half of the sample scored its level as not at all to more or less comfortable, median of 3, for statements about demonstration of interest towards the relative by the staff and flexible visiting of the patient. The necessity of greater interest of the team in the condition and needs of the family was observed. Promoting comfort from the dimension of welcoming demands interdisciplinary actions grounded in humanistic philosophy, in which the nurse has an important role to play.
Meehan, William P; d'Hemecourt, Pierre; Collins, Christy L; Comstock, R Dawn
Little existing data describe which medical professionals and which medical studies are used to assess sport-related concussions in high school athletes. To describe the medical providers and medical studies used when assessing sport-related concussions. To determine the effects of medical provider type on timing of return to play, frequency of imaging, and frequency of neuropsychological testing. Descriptive epidemiology study. All concussions recorded by the High School Reporting Information Online (HS RIO) injury surveillance system during the 2009 to 2010 academic year were included. χ(2) analyses were conducted for categorical variables. Fisher exact test was used for nonparametric data. Logistic regression analyses were used when adjusting for potential confounders. Statistical significance was considered for P sport-related concussions, representing 14.6% of all injuries. Most (94.4%) concussions were assessed by athletic trainers (ATs), 58.8% by a primary care physician. Few concussions were managed by specialists. The assessment of 21.2% included computed tomography. Computerized neuropsychological testing was used for 41.2%. For 50.1%, a physician decided when to return the athlete to play; for 46.2%, the decision was made by an AT. After adjusting for potential confounders, no associations between timing of return to play and the type of provider (physician vs AT) deciding to return the athlete to play were found. Concussions account for nearly 15% of all sport-related injuries in high school athletes. The timing of return to play after a sport-related concussion is similar regardless of whether the decision to return the athlete to play is made by a physician or an AT. When a medical doctor is involved, most concussions are assessed by primary care physicians as opposed to subspecialists. Computed tomography is obtained during the assessment of 1 of every 5 concussions occurring in high school athletes.
Moaddab, Amirhossein; Dildy, Gary A; Brown, Haywood L; Bateni, Zhoobin H; Belfort, Michael A; Sangi-Haghpeykar, Haleh; Clark, Steven L
To quantitate the contribution of various demographic factors to the U.S. maternal mortality ratio. This was a retrospective observational study. We analyzed data from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics database and the Detailed Mortality Underlying Cause of Death database (CDC WONDER) from 2005 to 2014 that contains mortality and population counts for all U.S. counties. Bivariate correlations between the maternal mortality ratio and all maternal demographic, lifestyle, health, and medical service utilization characteristics were calculated. We performed a maximum likelihood factor analysis with varimax rotation retaining variables that were significant (Pmulticollinearity among the existing variables. The United States has experienced an increase in maternal mortality ratio since 2005 with rates increasing from 15 per 100,00 live births in 2005 to 21-22 per 100,000 live births in 2013 and 2014. (P<.001) This increase in mortality was most pronounced in non-Hispanic black women, with ratios rising from 39 to 49 per 100,000 live births. A significant correlation between state mortality ranking and the percentage of non-Hispanic black women in the delivery population was demonstrated. Cesarean deliveries, unintended births, unmarried status, percentage of deliveries to non-Hispanic black women, and four or fewer prenatal visits were significantly (P<.05) associated with the increased maternal mortality ratio. The current U.S. maternal mortality ratio is heavily influenced by a higher rate of death among non-Hispanic black or unmarried patients with unplanned pregnancies. Racial disparities in health care availability and access or utilization by underserved populations are important issues faced by states seeking to decrease maternal mortality.
The pursuit of a vigorous research and development program to provide renewable and other resources to meet U. S. energy needs in the next century is an important objective of President Carter's National Energy Plan. A highly educated and motivated pool of engineers and scientists must be available for energy research and development if this objective is to be achieved. This report provides, for the first time, information about the number and characteristics of doctoral-level engineers and scientists in primarily energy-related activities. These data for the year 1975 will become part of the data base for a program of continuing studies on the employment and utilization of all scientists and engineers involved in energy-related activities. Information is provided for employment in the following fields: mathematics; physics/astronomy; chemistry; Earth, Environment, and Marine Sciences; Engineering; Life Sciences; Psychology; Social Sciences; Arts and Humanities; and Education and Business.
Irina A. Svistunova
Full Text Available Security cooperation has always been an important aspect of the relations between Turkey and the USA. In Cold War era Turkish-American interaction within NATO played a crucial role in this cooperation. After that period the two countries began to search for a new model of their relations. Both Turkey and the USA started to use cooperation within NATO for the purpose of strengthening their global positions. At the same time the USA aspiration to use military bases in Turkey beyond NATO obligations frequently becomes a source of disagreement and crises in the relations of the two countries as it happened during the American intervention to Iraq in 2003. At present new challenges for regional security, especially in the Middle East, demands new forms of interaction between Turkey and the USA. The beginning of "the Arab spring" was met in Ankara and Washington with overlapping interest in changing conservative regimes and promoting "Turkish model". At the same time such questions as participation of Turkey in the fight against ISIL and the USA military cooperation with the Syrian Kurds, whom Ankara considers to be connected with the PKK terrorist organization, has brought serious contradictions between the two countries. The cause of these contradiction is the difference in the perception of threats in Turkey and in the Western countries. While the search for new forms of security cooperation meets with difficulties, NATO remains important for the relations between Turkey and the USA, despite traditionally high level of anti-NATO moods in the Turkish society.
Wang, Jing; Iannotti, Ronald J; Nansel, Tonja R
Four forms of school bullying behaviors among US adolescents and their association with sociodemographic characteristics, parental support, and friends were examined. Data were obtained from the Health Behavior in School-Aged Children (HBSC) 2005 Survey, a nationally representative sample of grades 6-10 (N = 7,182). The revised Olweus Bully/Victim Questionnaire was used to measure physical, verbal, and relational forms of bullying. Two items were added using the same format to measure cyber bullying. For each form, four categories were created: bully, victim, bully-victim, and not involved. Multinomial logistic regressions were applied, with sociodemographic variables, parental support, and number of friends as predictors. Prevalence rates of having bullied others or having been bullied at school for at least once in the last 2 months were 20.8% physically, 53.6% verbally, 51.4% socially, or 13.6% electronically. Boys were more involved in physical or verbal bullying, whereas girls were more involved in relational bullying. Boys were more likely to be cyber bullies, whereas girls were more likely to be cyber victims. African-American adolescents were involved in more bullying (physical, verbal, or cyber) but less victimization (verbal or relational). Higher parental support was associated with less involvement across all forms and classifications of bullying. Having more friends was associated with more bullying and less victimization for physical, verbal, and relational forms but was not associated with cyber bullying. Parental support may protect adolescents from all four forms of bullying. Friends associate differentially with traditional and cyber bullying. Results indicate that cyber bullying is a distinct nature from that of traditional bullying.
The monograph provides knowledge on the complex nature of both external and internal determinants influencing foreign policies of East Asian countries. Through a range of case studies on Japan, China, Taiwan and North Korea, the authors analyze international relations in East Asia as a mosaic of intertwining processes of globalization and regionalization, interests of global and regional powers, local social and economic conditions, national institutional arrangements, and even personal facto...
Bagga, Herman S; Fisher, Patrick B; Tasian, Gregory E; Blaschko, Sarah D; McCulloch, Charles E; McAninch, Jack W; Breyer, Benjamin N
To describe epidemiologic features of sports-related genitourinary (GU) injuries and determine patient cohorts and particular sporting activities associated with increased GU injury risk. The National Electronic Injury Surveillance System, a data set validated to provide a probability sample of injury-related US emergency department (ED) presentations, was analyzed to characterize GU injuries between 2002 and 2010. A total of 13,851 observations were analyzed to derive national estimates. Between 2002 and 2010, an estimated 137,525 individuals (95% confidence interval, 104,490-170,620) presented to US EDs with GU injuries sustained during sporting activities. Nearly three-quarters of injuries occurred in the pediatric population. The most common product involved was a bicycle, representing approximately one-third of injuries in both adult and pediatric populations. Injuries related to team sports such as football, baseball or softball, basketball, and soccer were also common, particularly among boys where they represented a combined third of all injuries. Eighty-nine percent of all patients were evaluated and treated in the ED without inpatient admission. The large majority of injuries involved the external genitalia (60%), and significant injuries of paired GU organs (kidneys and testicles) requiring inpatient admission were rare (8.5%). Sports-related GU injuries are most commonly sustained during the use of a bicycle. However, there are other associated activities with identifiable high-risk cohorts, products, and situations. Consumers, practitioners, and injury-prevention experts can use our epidemiologic data to prioritize and develop strategies aimed at the prevention and limitation of such injuries, particularly when counseling at-risk cohorts, such as those with solitary kidneys or testicles. Copyright © 2015. Published by Elsevier Inc.
Meehan, William P.; d’Hemecourt, Pierre; Collins, Christy L.; Comstock, R. Dawn
Background Little existing data describe which medical professionals and which medical studies are used to assess sport-related concussions in high school athletes. Purpose To describe the medical providers and medical studies used when assessing sport-related concussions. To determine the effects of medical provider type on timing of return to play, frequency of imaging, and frequency of neuropsychological testing. Study Design Descriptive epidemiology study. Methods All concussions recorded by the High School Reporting Information Online (HS RIO) injury surveillance system during the 2009 to 2010 academic year were included. χ2 analyses were conducted for categorical variables. Fisher exact test was used for nonparametric data. Logistic regression analyses were used when adjusting for potential confounders. Statistical significance was considered for P concussions, representing 14.6% of all injuries. Most (94.4%) concussions were assessed by athletic trainers (ATs), 58.8% by a primary care physician. Few concussions were managed by specialists. The assessment of 21.2% included computed tomography. Computerized neuropsychological testing was used for 41.2%. For 50.1%, a physician decided when to return the athlete to play; for 46.2%, the decision was made by an AT. After adjusting for potential confounders, no associations between timing of return to play and the type of provider (physician vs AT) deciding to return the athlete to play were found. Conclusion Concussions account for nearly 15% of all sport-related injuries in high school athletes. The timing of return to play after a sport-related concussion is similar regardless of whether the decision to return the athlete to play is made by a physician or an AT. When a medical doctor is involved, most concussions are assessed by primary care physicians as opposed to subspecialists. Computed tomography is obtained during the assessment of 1 of every 5 concussions occurring in high school athletes. PMID:21969181
Gaw, Christopher E; Chounthirath, Thiphalak; Smith, Gary A
The goal of this study was to determine the epidemiology of injuries associated with nursery products among young children treated in US emergency departments. Data from the National Electronic Injury Surveillance System were retrospectively analyzed for patients aged nursery product from 1991 through 2011. An estimated 1 391 844 (95% confidence interval, 1 169 489-1 614 199) nursery product-related injuries among children aged Nursery product-related injuries were most commonly associated with baby carriers (19.5%), cribs/mattresses (18.6%), strollers/carriages (16.5%), or baby walkers/jumpers/exercisers (16.2%). The most common mechanism of injury was a self-precipitated fall (80.0%), and the most frequently injured body region was the head or neck (47.1%). Although successful injury prevention efforts with baby walkers led to a decline in nursery product-related injuries from 1991 to 2003, the number and rate of these injuries have been increasing since 2003. Greater efforts are warranted to prevent injuries associated with other nursery products, especially baby carriers, cribs, and strollers. Prevention of falls and concussions/closed head injuries associated with nursery products also deserves special attention. Copyright © 2017 by the American Academy of Pediatrics.
Osman, Ibrahim H; Berbary, Lynn N; Sidani, Yusuf; Al-Ayoubi, Baydaa; Emrouznejad, Ali
The appraisal and relative performance evaluation of nurses are very important and beneficial for both nurses and employers in an era of clinical governance, increased accountability and high standards of health care services. They enhance and consolidate the knowledge and practical skills of nurses by identification of training and career development plans as well as improvement in health care quality services, increase in job satisfaction and use of cost-effective resources. In this paper, a data envelopment analysis (DEA) model is proposed for the appraisal and relative performance evaluation of nurses. The model is validated on thirty-two nurses working at an Intensive Care Unit (ICU) at one of the most recognized hospitals in Lebanon. The DEA was able to classify nurses into efficient and inefficient ones. The set of efficient nurses was used to establish an internal best practice benchmark to project career development plans for improving the performance of other inefficient nurses. The DEA result confirmed the ranking of some nurses and highlighted injustice in other cases that were produced by the currently practiced appraisal system. Further, the DEA model is shown to be an effective talent management and motivational tool as it can provide clear managerial plans related to promoting, training and development activities from the perspective of nurses, hence increasing their satisfaction, motivation and acceptance of appraisal results. Due to such features, the model is currently being considered for implementation at ICU. Finally, the ratio of the number DEA units to the number of input/output measures is revisited with new suggested values on its upper and lower limits depending on the type of DEA models and the desired number of efficient units from a managerial perspective.
Nemeth, Tammy Lynn
While there were overtures from each country to develop a more formal accord to govern the trade of oil and natural gas at different times since 1958, Canada rejected that option in 1974 when it decided to phase out oil exports to the U.S. The main purpose of this research is to trace the development and evolution of Canada-U.S. oil and gas relations from the beginning of the informal continental relationship in 1959, through attempts to formalize a continental oil and gas agreement in the late 1960s, to the initial reversal of continentalism by Canada in 1974. This study examines and compares the changing influence of the explanatory variables of interest groups, international forces, national security, economics, ideas, and personalities on the energy decision- and policy-making processes of Canada and the U.S. between 1958 and 1974. Four key decisions or events that can be considered turning points in the Canada-U.S. oil and gas relationship are analysed and include: Canada's exemption to the American Mandatory Oil Import Program (MOIP); Canada's National Oil Policy (NOP); the near revocation of Canada's MOIP exemption; and Canada's decision to phase out oil exports. These events and relationships are situated in the larger context of interdependence, intergovernmental and transgovernmental relations, and the altered bureaucratic structures of governments in both countries over this period of time. Although decisions concerning Canada-U.S. oil and gas relations, and the pursuit and reversal of continentalist policies, were influenced by concerns regarding the pressure of various interest groups, international forces, national security, and changing economic and ideological circumstances; in the period examined here, the personalities of and personal relationships between Presidents and Prime Ministers, and the actions of key officials, as well as their transgovernmental networks across the border, often made the difference in determining what policy or approach
experienced a golden era during the Ataturk and Riza Shah Pahlavi period. Both states’ fates were similar against the imperial powers. The Soviet...February 21, 2009). 107 Arif Keskin, “Bütün Boyutları ile İran ve Türkiye İlişkileri”, http://www.oyrenci.com/SpecialPart/b5775632-5417-4cf3-a4fa...cetinsaya.pdf (accessed February 21, 2009). 109 Arif Keskin, “Iran-Turkey Relations: Balance, Rivalry and Mutual Dependence”, Avrasya Stratejik
A compilation of data relating to geothermal energy in each of the 50 states is presented. The data are summarized on one page for each state. All summary data sheets use a common format. Following the summary data sheet there are additional data on the geology of each state pertaining to possible hydrothermal/geothermal resources. Also there is a list of some of the reports available pertaining to the state and state energy contacts. The intent of these documents is to present in a concise form reference data for planning by the Department of Energy.
Taft, E.P.; Winchell, F.C.; Cook, T.C.
Procedure for meeting re-licensing requirements related to environmental protection and an overview of several new and emerging technologies regarding the development of ways to prevent fish passage through hydraulic turbines at hydroelectric power dams is described. Fish mortality and injury has long been a concern in the hydroelectric industry and research and development efforts have been ongoing since the 1970s to prevent fish passage through turbines. Several new and emerging technologies are examined that have the potential for wide-spread cost-effective applications
Karlsson, Leif; Nilsson, Ove; Lidh, B.
This report is intended for use by the Swedish Nuclear Power Inspectorate. It has been published to enable comparison of modification and backfitting implemented at Oskarshamn-2, with those implemented at other plants, both domestic and abroad. The report summarizes the more notable modifications and backfitting carried out on any safety-related equipment, or software, at Barsebaeck, and covers the decade 1984 to 1994. Modifications to hardware, and to some extent to software, are catalogued, but not described in any detail. No general procedures (operational or maintenance) are dealt with. 3 refs
The text of the Safeguards Agreement between the Agency, the Government of India and the Government of the United States of America providing for the Agency to apply safeguards in relation to the agreement between those Governments concerning co-operation in the civil uses of atomic energy, is reproduced in part I of this document for the information of all Members. The text of the co-operation agreement is reproduced in part II. The Safeguards Agreement entered into force on 27 January 1971
This article appeared in Strategic Insights, v.4, issue 9 (2005) Strategic Insights, is a quarterly electronic journal produced by the Center for Contemporary Conflict at the Naval Postgraduate School in Monterey, California. ChinaÃ¢â‚¬â„¢s new leadership has been in office for more than three yearsÃ¢â‚¬â€and during this time, ChinaÃ¢â‚¬â„¢s relations with the United States have received unprecedented international attention. While all share the view that this relationship is of unp...
The text of the Safeguards Agreement between the Agency, the Government of India and the Government of the United States of America providing for the Agency to apply safeguards in relation to the agreement between those Governments concerning co-operation in the civil uses of atomic energy, is reproduced in part I of this document for the information of all Members. The text of the co-operation agreement is reproduced in part II. The Safeguards Agreement entered into force on 27 January 1971.
Kaushal, Neeraj; Lu, Yao
Using large-scale census data and adjusting for sending-country fixed effect to account for changing composition of immigrants, we study relative immigrant selection to Canada and the U.S. during 1990–2006, a period characterized by diverging immigration policies in the two countries. Results show a gradual change in selection patterns in educational attainment and host country language proficiency in favor of Canada as its post-1990 immigration policy allocated more points to the human capital of new entrants. Specifically, in 1990, new immigrants in Canada were less likely to have a B.A. degree than those in the U.S.; they were also less likely to have a high-school or lower education. By 2006, Canada surpassed the U.S. in drawing highly-educated immigrants, while continuing to attract fewer low-educated immigrants. Canada also improved its edge over the U.S. in terms of host-country language proficiency of new immigrants. Entry-level earnings, however, do not reflect the same trend: recent immigrants to Canada have experienced a wage disadvantage compared to recent immigrants to the U.S., as well as Canadian natives. One plausible explanation is that, while the Canadian points system has successfully attracted more educated immigrants, it may not be effective in capturing productivity-related traits that are not easily measurable. PMID:27642205
This study examined and compared the changing influence of interest groups, international forces, national security, changing economics and ideology on the energy decision- and policy-making processes of Canada and the US between 1958 and 1974. The 4 key events that marked the turning points in the Canada-US oil and gas relationship were Canada's exemption to the American Mandatory Oil Import Program (MOIP); Canada's National Oil Policy (NOP); the near revocation of Canada's MOIP exemption; and Canada's decision to phase out oil exports. In the larger context, these events signaled interdependence, intergovernmental and transgovernmental relations, and the altered bureaucratic structures of governments in both countries over this period of time. The study showed that the policy decisions concerning Canada-US oil and gas relations often depended on the personalities of, and personal relationships between Presidents and Prime Ministers, as well as the actions of key officials and their transgovernmental networks across the border.
Suhonen, Marjo; Paasivaara, Leena
To explore factors of human capital related to project success that employees expect from nurse managers. Human capital refers to those resources that managers working with projects possess, such as abilities, knowledge and qualities of character. The data were collected by open interviews (n=14) with nurses, public health nurses and nurse managers working in primary health care and a hospital. Data analysis was carried out using qualitative content analysis. The main factors of human capital related to project success proved to be as follows: (1) management of enthusiastic project culture, (2) management of regeneration and (3) management of emotional intelligence. Future research is needed on the kind of means nurse managers use in human capital management in projects and how they see their possibilities in managing human capital. Human capital management skills should be underlined as an important competence area when recruiting a nurse manager. The success of health care projects cannot be improved only through education or by training of nurse managers; in addition, projects need nurse managers who understand workplace spirituality and have high emotional intelligence. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
Bronder, Kayla L; Dooyema, Carrie A; Onufrak, Stephen J; Foltz, Jennifer L
Obesity-related electronic health record functions increase the rates of measuring Body Mass Index, diagnosing obesity, and providing obesity services. This study describes the prevalence of obesity-related electronic health record functions in clinical practice and analyzes characteristics associated with increased obesity-related electronic health record sophistication. Data were analyzed from DocStyles, a web-based panel survey administered to 1507 primary care providers practicing in the United States in June, 2013. Physicians were asked if their electronic health record has specific obesity-related functions. Logistical regression analyses identified characteristics associated with improved obesity-related electronic health record sophistication. Of the 88% of providers with an electronic health record, 83% of electronic health records calculate Body Mass Index, 52% calculate pediatric Body Mass Index percentile, and 32% flag patients with abnormal Body Mass Index values. Only 36% provide obesity-related decision support and 17% suggest additional resources for obesity-related care. Characteristics associated with having a more sophisticated electronic health record include age ≤45years old, being a pediatrician or family practitioner, and practicing in a larger, outpatient practice. Few electronic health records optimally supported physician's obesity-related clinical care. The low rates of obesity-related electronic health record functions currently in practice highlight areas to improve the clinical health information technology in primary care practice. More work can be done to develop, implement, and promote the effective utilization of obesity-related electronic health record functions to improve obesity treatment and prevention efforts. Published by Elsevier Inc.
Stenehjem, E.J.; Santini, D.J.
This report contains a description of the Social and Economic Assessment Model, which is used to analyze the social and economic effects of energy development at the regional and county levels. Using the SEAM, the effects of coal mines and coal-fired utilities projected for over 340 US counties are examined. The study utilizes a clustering algorithm to determine the assimilative capacity of a county, that is, the county's ability to sustain the effects of an influx of population and thus an increased demand on its resources. The results of the clustering algorithm are used, together with county demographic data, as well as data on projected facility location, size, timing, and type, to estimate socioeconomic effects in terms of public costs that will be imposed on the affected populations. These results are aggregated to the regional level to give a rough estimate of the relative regional effects of coal development. The results indicate that 93% of the entire long-term, adverse impact from coal will be borne by states and counties of the Rocky Mountain area, whereas only 14% of the short-term impacts will be borne by this region. About 42% of the short-term costs will occur in the Southern region and 33% in the North Central region, but only 5% of the long-term costs are estimated for these two regions. Of the four major Census regions (Northeast, South, North Central, and West) only the Northeast is expected to be relatively free of community growth problems caused by coal development.
Garbarino, Sergio; Cuomo, Giovanni; Chiorri, Carlo; Magnavita, Nicola
Law and order enforcement tasks may expose special force police officers to significant psychosocial risk factors. The aim of this work is to investigate the relationship between job stress and the presence of mental health symptoms while controlling sociodemographical, occupational and personality variables in special force police officers. At different time points, 292 of 294 members of the 'VI Reparto Mobile', a special police force engaged exclusively in the enforcement of law and order, responded to our invitation to complete questionnaires for the assessment of personality traits, work-related stress (using the Demand-Control-Support (DCS) and the Effort-Reward-Imbalance (ERI) models) and mental health problems such as depression, anxiety and burnout. Regression analyses showed that lower levels of support and reward and higher levels of effort and overcommitment were associated with higher levels of mental health symptoms. Psychological screening revealed 21 (7.3%) likely cases of mild depression (Beck Depression Inventory, BDI≥10). Officers who had experienced a discrepancy between work effort and rewards showed a marked increase in the risk of depression (OR 7.89, 95% CI 2.32 to 26.82) when compared with their counterparts who did not perceive themselves to be in a condition of distress. The findings of this study suggest that work-related stress may play a role in the development of mental health problems in police officers. The prevalence of mental health symptoms in the cohort investigated here was low, but not negligible in the case of depression. Since special forces police officers have to perform sensitive tasks for which a healthy psychological functioning is needed, the results of this study suggest that steps should be taken to prevent distress and improve the mental well-being of these workers.
Ross, Mindy K; Romero, Tahmineh; Sim, Myung S; Szilagyi, Peter G
Pediatric asthma is heterogeneous with phenotypes that reflect differing underlying inflammation and pathophysiology. Little is known about the national prevalence of certain obesity and allergy related asthma phenotypes or associated characteristics. We therefore assessed the national prevalence, risk factors, and parent-reported severity of four asthma phenotypes: not-allergic-not-obese, allergic-not-obese, obese-not-allergic, and allergic-and-obese. We analyzed data from the 2007-2008 National Survey of Children's Health (NSCH) of 10-17 year-olds with parent-reported asthma. We described sociodemographic and health risk factors of each phenotype and then applied logistic and ordinal regression models to identify associated risk factors and level of severity of the phenotypes. Among 4,427 children with asthma in this NSCH cohort, the association between race and phenotype is statistically significant (p<0.0001); white children with asthma were most likely to have allergic-not-obese asthma while black and Hispanic children with asthma were most likely to have the obese-non-allergic phenotype (p<0.001). ADD/ADHD was more likely to be present in allergic-not-obese children (OR 1.50, CI 1.14-1.98, p = 0.004). The phenotype with the highest risk for more severe compared to mild asthma was the obese-and-allergic asthma phenotype (OR 3.34, CI 2.23-5.01, p<0.001). Allergic-not-obese asthma comprised half of our studied asthma phenotypes, while obesity-related asthma (with or without allergic components) comprised one-fifth of asthma phenotypes in this cohort representative of the U.S. Children with both obese and allergic asthma are most likely to have severe asthma. Future management of childhood asthma might consider more tailoring of treatment and management plans based upon different childhood asthma phenotypes.
Participation in high school sports helps promote a physically active lifestyle. High school sports participation has grown from an estimated 4 million participants during the 1971-72 school year to an estimated 7.2 million in 2005-06. However, despite the documented health benefits of increased physical activity (e.g., weight management, improved self-esteem, and increased strength, endurance, and flexibility), those who participate in athletics are at risk for sports-related injuries. High school athletes account for an estimated 2 million injuries, 500,000 doctor visits, and 30,000 hospitalizations annually. To date, the study of these injuries has been limited by inabilities to calculate injury rates, compare results among groups, and generalize findings from small, nonrepresentative samples. During the 2005-06 school year, researchers at a children's hospital in Ohio used an Internet-based data-collection tool to pilot an injury surveillance system among athletes from a representative national sample of U.S. high schools. This report summarizes the findings of that study, which indicated that participation in high school sports resulted in an estimated 1.4 million injuries at a rate of 2.4 injuries per 1,000 athlete exposures (i.e., practices or competitions). Surveillance of exposure-based injury rates in a nationally representative sample of high school athletes and analysis of injury patterns can help guide activities aimed at reducing these injuries.
Scott, R M; Schneider, R J; Snitbhan, R; Karwacki, J J
To determine the incidence of clinical and inapparent hepatitis in a US military population stationed in Thailand, the authors prospectively studied a cohort of 326 men during one year. Clinical hepatitis A occurred in one man (clinical attack rate = 3.1/1000 men/year), and clinical hepatitis B was found in four men (clinical attack rate = 12.3/1000 men/year). No non-A, non-B hepatitis was identified. There was no serologically identified inapparent hepatitis A but inapparent hepatitis B occurred in 17 men. The apparent/inapparent ratio for hepatitis B was 1:4.25. Serotype analysis suggested that hepatitis B virus largely originated from Thai contacts, although 23% of cases were derived from western sources. To determine the relative contribution of 16 statistically significant (out of 67 studied) behavioral variables to the transmission of HBV, a factor analysis and a multivariate correlation analysis were employed. Factor analysis indicated that social and sexual contact with the indigenous population, including prostitutes, residence within the Thai community and marijuana use were behavioral areas that were associated with the acquisition of hepatitis B. Residence in the Thai community during the first four-month period in Thailand, sexual contact with a prostitute during the third four-month period, and ever having maintained a Thai mistress were found to be significant and independent risk factors by multiple regression analysis.
Brown, Joshua B.; Rosengart, Matthew R.; Billiar, Timothy R.; Peitzman, Andrew B.; Sperry, Jason L.
Background Regionalized trauma care improves outcomes; however access to care is not uniform across the US. The objective was to evaluate whether geographic distribution of trauma centers correlates with injury mortality across state trauma systems. Methods Level I/II trauma centers in the contiguous US were mapped. State-level age-adjusted injury fatality rates/100,000people were obtained and evaluated for spatial autocorrelation. Nearest neighbor ratios (NNR) were generated for each state. A NNR1 indicates dispersion. NNR were tested for difference from random geographic distribution. Fatality rates and NNR were examined for correlation. Fatality rates were compared between states with trauma center clustering versus dispersion. Trauma center distribution and population density were evaluated. Spatial-lag regression determined the association between fatality rate and NNR, controlling for state-level demographics, population density, injury severity, trauma system resources, and socioeconomic factors. Results Fatality rates were spatially autocorrelated (Moran's I=0.35, pcenter distribution. Fatality rate and NNR were correlated (ρ=0.34, p=0.03). Clustered states had a lower median injury fatality rate compared to dispersed states (56.9 [IQR 46.5–58.9] versus 64.9 [IQR 52.5–77.1], p=0.04). Dispersed compared to clustered states had more counties without a trauma center that had higher population density than counties with a trauma center (5.7% versus 1.2%, pdistribution of trauma centers correlates with injury mortality, with more clustered state trauma centers associated with lower fatality rates. This may be a result of access relative to population density. These results may have implications for trauma system planning and requires further study to investigate underlying mechanisms PMID:26517780
Diekmann, Nina; Burghartz, Melanie; Remus, Lars; Kaufholz, Anna-Lena; Nawrath, Thorben; Rohde, Manfred; Schulz, Stefan; Roselius, Louisa; Schaper, Jörg; Mamber, Oliver; Jahn, Dieter; Jahn, Martina
During operation of mobile air conditioning (MAC) systems in automobiles, malodours can occur. We studied the microbial communities found on contaminated heat exchanger fins of 45 evaporators from car MAC systems which were operated in seven different regions of the world and identified corresponding volatile organic compounds. Collected biofilms were examined by scanning electron microscopy and fluorescent in situ hybridization. The detected bacteria were loosely attached to the metal surface. Further analyses of the bacteria using PCR-based single-strand conformation polymorphism and sequencing of isolated 16S rRNA gene fragments identified highly divergent microbial communities with multiple members of the Alphaproteobacteriales, Methylobacteria were the prevalent bacteria. In addition, Sphingomonadales, Burkholderiales, Bacillales, Alcanivorax spp. and Stenotrophomonas spp. were found among many others depending on the location the evaporators were operated. Interestingly, typical pathogenic bacteria related to air conditioning systems including Legionella spp. were not found. In order to determine the nature of the chemical compounds produced by the bacteria, the volatile organic compounds were examined by closed loop stripping analysis and identified by combined gas chromatography/mass spectrometry. Sulphur compounds, i.e. di-, tri- and multiple sulphides, acetylthiazole, aromatic compounds and diverse substituted pyrazines were detected. Mathematical clustering of the determined microbial community structures against their origin identified a European/American/Arabic cluster versus two mainly tropical Asian clusters. Interestingly, clustering of the determined volatiles against the origin of the corresponding MAC revealed a highly similar pattern. A close relationship of microbial community structure and resulting malodours to the climate and air quality at the location of MAC operation was concluded.
Lacroix, Christophe; Alves-Vieira, Maria; Jutel, Laurent
A significant number of improvements, including for chemistry, have been made for the design of the EPR turbine hall as a result of the considerable wealth of experience and feedback drawn from the EDF fleet. To reduce issues associated with flow accelerated corrosion, as well as Steam Generator (SG) fouling or clogging, appropriate materials for the piping and the exchangers, and an adequate chemical conditioning, were chosen to ensure a 60 year lifespan of the main components of the circuit. The condenser technology was also improved to mitigate the risks of raw water ingress. A dedicated local sampling line was added at feedwater (FW) to monitor the iron concentration. EPR includes a polishing system at start-up to ensure the purification of feedwater in a short time (less than 16 hours) along with reduced discharged effluents. Comprehensive studies were carried out, taking into account costs (investment, operation, and maintenance), consumption and discharge of chemical reagents, or risks of pollutions during the process. This lead to the choice of system dedicated to start-up only, similar to the mobile system used in some French Nuclear Power Plants (NPPs), instead of a condensate polishing plant. Emphasis was also placed on providing a flexible and secure injection system for the chemical reagents (SIR). Indeed, it will be possible to inject two amines and hydrazine, and to perform tailored injection in many parts of the circuit. Furthermore, the room was design to facilitate future design changes, such as if dispersant injection is required as a preventative solution for SG fouling. In addition to that, close attention was applied to mitigate chemical hazards, especially regarding the hydrazine CMR effect or explosive atmosphere. This paper describes the technical and the economical choices that lead to these improvements related to chemistry in the turbine hall design, along with a comprehensive overview of the chosen designs. (authors)
Full Text Available Objective. This article describes the demographic characteristics and psychological differences in a sample of female heavy and non-heavy drinkers who attended three emergency services of the Mexican city of Pachuca, Hidalgo. Material and Methods. A sample of patients seen at emergency services (ES patients over the age of 18 was selected using ES admission forms. Twenty-five-minute, face-to-face interviews were conducted by a group of trained interviewers. Patients answered various questionnaires and scales to measure alcohol consumption and to provide information on variables that have proved to be related to female drinking. Results. Thirty-six women (5.2% out of 717 of the total number of women were found to be heavy drinkers according to the TWEAK scale. This group of women had 2.3 times the risk of becoming depressed, 2.87 times the risk of taking other drugs, 1.95 times the likelihood of having been sexually abused and 1.57 times the risk of displaying suicidal ideation. Conclusions. Data from this small analysis confirm international findings that problem drinking among females throughout the life cycle is linked to depression. As regards the screening instruments employed, it is necessary to conduct more in-depth research to enrich their contents and increase their reliability and validity when used among female populations. In this study, the TWEAK proved to be extremely useful for studies in emergency services. The English version of this paper is available too at: http://www.insp.mx/salud/index.html
Rogers, S N; Palmer, N O A; Lowe, D; Randall, C
We aimed to record all new patients who presented to departments of oral surgery, oral medicine, and oral and maxillofacial surgery, and to dental hospitals in the UK, with avascular necrosis of the jaws including bisphosphonate-related necrosis (BRONJ) over a 2-year period (1 June 2009-31 May 2011). They were eligible irrespective of age, cause, or coexisting conditions. Data on incidence, clinical characteristics, risk factors, and coexisting conditions were collected. A total of 383 cases were registered: 369 were described as BRONJ, 5 as avascular necrosis, and 9 were unknown. Bisphosphonates had been given orally in 207 (56%), intravenously in 125 (34%), both orally and intravenously in 27 (7%), and was unknown in 9 (2%); one had been given denosumab. The main risk factor was dental extraction, and the mandible was commonly affected. The median duration of administration until onset of BRONJ was 3 years in those treated intravenously and 4 years in those treated orally. Levels of engagement with the study varied between regions, and extrapolation from the 2 most involved (Merseyside and Northern Ireland) found around 8.2-12.8 cases/million/year, which is 508-793 patients/year across the UK. To our knowledge this is one of the first studies to estimate national rates of BRONJ. It confirms that the risk and incidence are low. With changes in trends for antiresorptive bone medication, and increasing numbers of elderly people, it would be useful to repeat the registration in the future. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Nowell, Lisa H.; Moran, Patrick W.; Gilliom, Robert J.; Calhoun, Daniel L.; Ingersoll, Christopher G.; Kemble, Nile E.; Kuivila, Kathryn; Phillips, Patrick J.
Organic contaminants and trace elements were measured in bed sediments collected from streams in seven metropolitan study areas across the United States to assess concentrations in relation to urbanization. Polycyclic aromatic hydrocarbons, polychlorinated biphenyls, organochlorine pesticides, the pyrethroid insecticide bifenthrin, and several trace elements were significantly related to urbanization across study areas. Most contaminants (except bifenthrin, chromium, nickel) were significantly related to the total organic carbon (TOC) content of the sediments. Regression models explained 45–80 % of the variability in individual contaminant concentrations using degree of urbanization, sediment-TOC, and study-area indicator variables (which represent the combined influence of unknown factors, such as chemical use or release, that are not captured by available explanatory variables). The significance of one or more study-area indicator variables in all models indicates marked differences in contaminant levels among some study areas, even after accounting for the nationally modeled effects of urbanization and sediment-TOC. Mean probable effect concentration quotients (PECQs) were significantly related to urbanization. Trace elements were the major contributors to mean PECQs at undeveloped sites, whereas organic contaminants, especially bifenthrin, were the major contributors at highly urban sites. Pyrethroids, where detected, accounted for the largest share of the mean PECQ. Part 2 of this series (Kemble et al. 2012) evaluates sediment toxicity to amphipods and midge in relation to sediment chemistry.
Kerr, Zachary Y; Marshall, Stephen W; Dompier, Thomas P; Corlette, Jill; Klossner, David A; Gilchrist, Julie
Sports-related injuries can have a substantial impact on the long-term health of student-athletes. The National Collegiate Athletic Association (NCAA) monitors injuries among college student-athletes at member schools. In academic year 2013-14, a total of 1,113 member schools fielded 19,334 teams with 478,869 participating student-athletes in NCAA championship sports (i.e., sports with NCAA championship competition) (1). External researchers and CDC used information reported to the NCAA Injury Surveillance Program (NCAA-ISP) by a sample of championship sports programs to summarize the estimated national cumulative and annual average numbers of injuries during the 5 academic years from 2009-10 through 2013-14. Analyses were restricted to injuries reported among student-athletes in 25 NCAA championship sports. During this period, 1,053,370 injuries were estimated to have occurred during an estimated 176.7 million athlete-exposures to potential injury (i.e., one athlete's participation in one competition or one practice). Injury incidence varied widely by sport. Among all sports, men's football accounted for the largest average annual estimated number of injuries (47,199) and the highest competition injury rate (39.9 per 1,000 athlete-exposures). Men's wrestling experienced the highest overall injury rate (13.1 per 1,000) and practice injury rate (10.2 per 1,000). Among women's sports, gymnastics had the highest overall injury rate (10.4 per 1,000) and practice injury rate (10.0 per 1,000), although soccer had the highest competition injury rate (17.2 per 1,000). More injuries were estimated to have occurred from practice than from competition for all sports, with the exception of men's ice hockey and baseball. However, injuries incurred during competition were somewhat more severe (e.g., requiring ≥7 days to return to full participation) than those acquired during practice. Multiple strategies are employed by NCAA and others to reduce the number of injuries in
Long, Robert P; Horsley, Stephen B; Hallett, Richard A; Bailey, Scott W
Sugar maple, Acer saccharum, decline disease is incited by multiple disturbance factors when imbalanced calcium (Ca), magnesium (Mg), and manganese (Mn) act as predisposing stressors. Our objective in this study was to determine whether factors affecting sugar maple health also affect growth as estimated by basal area increment (BAI). We used 76 northern hardwood stands in northern Pennsylvania, New York, Vermont, and New Hampshire, USA, and found that sugar maple growth was positively related to foliar concentrations of Ca and Mg and stand level estimates of sugar maple crown health during a high stress period from 1987 to 1996. Foliar nutrient threshold values for Ca, Mg, and Mn were used to analyze long-term BAI trends from 1937 to 1996. Significant (P maples sampled in the 1990s had decreased growth in the 1970s, 10-20 years in advance of the 1980s and 1990s decline episode in Pennsylvania. Even apparently healthy stands that had no defoliation, but had below-threshold amounts of Ca or Mg and above-threshold Mn (from foliage samples taken in the mid 1990s), had decreasing growth by the 1970s. Co-occurring black cherry, Prunus serotina, in a subset of the Pennsylvania and New York stands, showed opposite growth responses with greater growth in stands with below-threshold Ca and Mg compared with above-threshold stands. Sugar maple growing on sites with the highest concentrations of foliar Ca and Mg show a general increase in growth from 1937 to 1996 while other stands with lower Ca and Mg concentrations show a stable or decreasing growth trend. We conclude that acid deposition induced changes in soil nutrient status that crossed a threshold necessary to sustain sugar maple growth during the 1970s on some sites. While nutrition of these elements has not been considered in forest management decisions, our research shows species specific responses to Ca and Mg that may reduce health and growth of sugar maple or change species composition, if not addressed.
Zahran, Hatice S; Kobau, Rosemarie; Moriarty, David G; Zack, Matthew M; Holt, James; Donehoo, Ralph
Population-based surveillance of health-related quality of life (HRQOL) is needed to promote the health and quality of life of U.S. residents and to monitor progress in achieving the two overall Healthy People 2010 goals: 1) increase the quality and years of healthy life and 2) eliminate health disparities. This report examines surveillance-based HRQOL data from 1993 through 2002. Survey data from a validated set of HRQOL measures (CDC HRQOL-4) were analyzed for 1993-2001 from the Behavioral Risk Factor Surveillance System (BRFSS) surveys for the 50 states and the District of Columbia (DC) and for 2001-2002 from the National Health and Nutrition Examination Survey (NHANES). These measures assessed self-rated health; physically unhealthy days (i.e., the number of days during the preceding 30 days for which physical health, including physical illness and injury, was not good); mentally unhealthy days (i.e., the number of days during the preceding 30 days for which mental health, including stress, depression, and problems with emotions, was not good); and days with activity limitation (i.e., number of days during the preceding 30 days that poor physical or mental health prevented normal daily activities). A summary measure of overall unhealthy days also was computed from the sum of a respondent's physically unhealthy and mentally unhealthy days, with a maximum of 30 days. During 1993-2001, the mean number of physically unhealthy days, mentally unhealthy days, overall unhealthy days, and activity limitation days was higher after 1997 than before 1997. During 1993-1997, the percentage of respondents with zero overall unhealthy days was stable (51%-53%) but declined to 48% by 2001. The percentage of respondents with >/=14 overall unhealthy days increased from 15%-16% during 1993-1997 to 18% by 2001. Adults increasingly rated their health as fair or poor and decreasingly rated it as excellent or very good. Women, American Indians/Alaska Natives, persons of "other races
Full Text Available Apart from relations with its neighbours, Croatia’s relations with the United Kingdom (UK were undoubtedly its greatest international challenge since it won its independence in the early 1990s. Relations between the two countries during this period were frequently strained partly due to Zagreb’s democratic shortcomings, but partly also due to competing visions of post-Cold War Southeast Europe and due to long-lasting biases rooted in Croatia’s and Britain’s conflicting policies during Yugoslavia’s breakup and wars. Croatia’s accession to the EU in 2013 offered an opportunity for the two countries to leave the burdens of their past behind, since Zagreb and London had similar preferences on a number of crucial EU policy fronts. However, Brexit changed everything. Croatia’s future relations with the UK are likely to be determined by the nature of Brexit negotiations and the evolution of British policy toward the pace and direction of EU integration.
Kiu, Andrew; Horowitz, John D; Stewart, Simon
Seasonal variations in atrial fibrillation (AF)-related morbidity and mortality have been demonstrated in "cold" northern European climates, but there are few data describing such a phenomenon in a "hot" climate. To examine the pattern of AF-related admissions to a coronary care unit (CCU) in South Australia operating within a Mediterranean climate, and to determine potential differences according to mean daily temperatures. PATIENT COHORT AND METHODS: A total of 144 admissions to the CCU during the 30 hottest and coldest days (60 days in total) during the calendar year 2001 were analyzed in respect to the absolute number of admissions and the profile of those admitted during "hot" and "cold" days. Overall, there were significantly more admissions to the CCU on "cold" as opposed to "hot" days (90 vs 54 patients in 30 days, P < or = .001). Of the 24 patients found to be in AF on presentation to hospital, 18 (75%) were admitted on cold days (P < .05). Alternatively, during "hot" days, patients were more likely to be diagnosed with unstable angina rather than acute myocardial infarction (46% vs 30%, P = .07) with proportionately fewer patients in AF at the time (11% vs 20%, P = NS). These preliminary data suggest that the phenomenon of seasonal variations in AF-related morbidity extend beyond colder climates to hotter climates with sufficiently large relative (as opposed to absolute) changes in ambient temperatures during the year.
Chow, Angela; Eccles, Jacquelynne S; Salmela-Aro, Katariina
Two independent studies were conducted to extend previous research by examining the associations between task value priority patterns across school subjects and aspirations toward the physical and information technology- (IT-) related sciences. Study 1 measured task values of a sample of 10th graders in the United States (N = 249) across (a) physics and chemistry, (b) math, and (c) English. Study 2 measured task values of a sample of students in the second year of high school in Finland (N = 351) across (a) math and science, (b) Finnish, and (c) the arts and physical education. In both studies, students were classified into groups according to how they ranked math and science in relation to the other subjects. Regression analyses indicated that task value group membership significantly predicted subsequent aspirations toward physical and IT-related sciences measured 1-2 years later. The task value groups who placed the highest priority on math and science were significantly more likely to aspire to physical and IT-related sciences than were the other groups. These findings provide support for the theoretical assumption regarding the predictive role of intraindividual hierarchical patterns of task values for subsequent preferences and choices suggested by the Eccles [Parsons] (1983) expectancy-value model.
Ohio State Univ., Columbus. National Center for Research in Vocational Education.
This three-part curriculum for entrepreneurship education is primarily for postsecondary level, including four-year colleges and adult education, but it can be adapted for special groups of vocational teacher education. The emphasis of the eight instructional units in Part III is operating a business. Unit G focuses on community relations. It…
Del Razo, Parvati Heliana
The purpose of this study was to find out if the demographic variables of country of origin, generation in the United States (immigration status), income and parental education had an impact on the financial aid packages of Hispanic undergraduate students. This dissertation asked: What is the relation between generation in the United States,…
Jasso-Aguilar, Rebeca; Waitzkin, Howard; Landwehr, Angela
In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector. Multinational managed care organizations have entered managed care markets in several Latin American countries at the same time as they were withdrawing from managed care activities in Medicaid and Medicare within the United States. Corporate strategies have culminated in a marked expansion of corporations' access to social security and related public sector funds for the support of privatized health services. International financial institutions and multinational corporations have influenced reforms that, while favorable to corporate interests, have worsened access to needed services and have strained the remaining public sector institutions. A theoretical approach to these problems emphasizes the falling rate of profit as an economic motivation of corporate actions, silent reform, and the subordination of polity to economy. Praxis to address these problems involves opposition to policies that enhance corporate interests while reducing public sector services, as well as alternative models that emphasize a strengthened public sector
This interim report summarizes the scope and results of the radiological safety review performed to date by the NRC staff with respect to the operating license phase for the Enrico Fermi Atomic Power Plant, Unit 2. The major effort was the review of the facility design and proposed operating procedures described in applicant's Final Safety Analysis Report. In the course of the review, several meetings were held with representatives of the applicant to discuss plant design, construction and proposed operation. Additional information was requested, which the applicant provided through Amendment 7 to the Final Safety Analysis Report. A chronology of the principal actions relating to the review of the application is attached as Appendix A to the report. The Final Safety Analysis Report and amendments thereto are available for public inspection at the Nuclear Regulatory Commission Public Document Room, 1717 H Street, N. W., Washington, D.C. and at Monroe County Library System, 3700 South Custer Road, Monroe, Michigan 48161
Wilensky, H L
It is tempting to oversell the practical value of applied research. A hard look at the effects of U.S. social science on public policy in areas such as active labor market policies (training, job creation, placement, etc.), crime prevention, fiscal policy, poverty reduction, and health care reform suggests an inverse relationship between social science consensus and policy and budgetary decisions. Fragmented and decentralized political economies (e.g., the United States) foster policy segmentation and isolated, short-run single-issue research--often politicized and misleading. More corporatist democracies (such as Sweden, Norway, Austria, and Germany) evidence a tighter relation between knowledge and power in which a wider range of issues is connected, longer-range effects are sometimes considered, and research is more often actually used for planning and implementation. Even in less hospitable societies, however, social science does make its way in the long run. Favorable conditions and examples are discussed.
Cocaine misuse is increasing and it is evidently considered a relatively safe drug of abuse in Ireland. To address this perception, we reviewed the database of an 18-bed Dublin intensive care unit, covering all admissions from 2003 to 2007. We identified cocaine-related cases, measuring hospital mortality and long-term survival in early 2009. Cocaine-related admissions increased from around one annually in 2003-05 to 10 in 2007. Their median (IQR [range]) age was 25 (21-35 [17-47]) years and 78% were male. The median (IQR [range]) APACHE II score was 16 (11-27 [5-36]) and length of intensive care stay was 5 (3-9 [1-16]) days. Ten patients died during their hospital stay. A further five had died by the time of follow-up, a median of 24 months later. One was untraceable. Cocaine toxicity necessitating intensive care is increasingly common in Dublin. Hospital mortality in this series was 52%. These findings may help to inform public attitudes to cocaine.
Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit; Chervenak, Frank A
We examined neonatal mortality in relation to birth settings and birth attendants in the United States from 2006 through 2009. Data from the Centers for Disease Control and Prevention-linked birth and infant death dataset in the United States from 2006 through 2009 were used to assess early and total neonatal mortality for singleton, vertex, and term births without congenital malformations delivered by midwives and physicians in the hospital and midwives and others out of the hospital. Deliveries by hospital midwives served as the reference. Midwife home births had a significantly higher total neonatal mortality risk than deliveries by hospital midwives (1.26 per 1000 births; relative risk [RR], 3.87 vs 0.32 per 1000; P home births of 41 weeks or longer (1.84 per 1000; RR, 6.76 vs 0.27 per 1000; P home births of women with a first birth (2.19 per 1000; RR, 6.74 vs 0.33 per 1000; P home births, neonatal mortality for first births was twice that of subsequent births (2.19 vs 0.96 per 1000; P home births compared with midwife hospital births was 9.32 per 10,000 births, and the excess early neonatal mortality was 7.89 per 10,000 births. Our study shows a significantly increased total and early neonatal mortality for home births and even higher risks for women of 41 weeks or longer and women having a first birth. These significantly increased risks of neonatal mortality in home births must be disclosed by all obstetric practitioners to all pregnant women who express an interest in such births. Copyright © 2014 Elsevier Inc. All rights reserved.
Zappettini, Eduardo O.; Chernicoff, Carlos J.; Santos, Joao O. S.; Dalponte, Marcelo; Belousova, Elena; McNaughton, Neal
to represent passive margin deposits of mostly Lower Carboniferous age (younger than 374 Ma and older than 326 Ma) that precede the onset of the accretionary prism in Chile and extend into the earliest stage of the accretion, in a retrowedge position. The Arroyo del Torreón and Huaraco formations are considered to be retrowedge basin deposits to the early frontal accretionary prism (Eastern Series) of Chile. The presence of volcanism with arc signature in the units provides evidence of a Mississippian magmatic arc that can be correlated with limited exposures of the same age in the Frontal Cordillera (Argentina). The arc would have migrated to the West (Coastal Batholith) during Pennsylvanian-Permian times (coevally with the later basal accretionary prism/Western Series). The source of a conspicuous population of Devonian detrital zircon interpreted to be of magmatic origin in the studied units is discussed in various possible geotectonic scenarios, the preferred model being a magmatic arc developed in the Chilenia block, related to a west-dipping subduction beneath Chilenia before and shortly after its collision against Cuyania/Gondwana, at around 390 Ma and not linked to the independent, Devonian-Mississippian arc, developed to the south, in Patagonia.
Daniulaityte, Raminta; Lamy, Francois R; Smith, G Alan; Nahhas, Ramzi W; Carlson, Robert G; Thirunarayan, Krishnaprasad; Martins, Silvia S; Boyer, Edward W; Sheth, Amit
Twitter data offer new possibilities for tracking health-related communications. This study is among the first to apply advanced information processing to identify geographic and content features of cannabis-related tweeting in the United States. Tweets were collected using streaming Application Programming Interface (March-May 2016) and were processed by eDrugTrends to identify geolocation and classify content by source (personal communication, media, retail) and sentiment (positive, negative, neutral). States were grouped by cannabis legalization policies into "recreational," "medical, less restrictive," "medical, more restrictive," and "illegal." Permutation tests were performed to analyze differences among four groups in adjusted percentages of all tweets, unique users, personal communications only, and positive-to-negative sentiment ratios. About 30% of all 13,233,837 cannabis-related tweets had identifiable state-level geo-information. Among geolocated tweets, 76.2% were personal communications, 21.1% media, and 2.7% retail. About 71% of personal communication tweets expressed positive sentiment toward cannabis; 16% expressed negative sentiment. States in the recreational group had significantly greater average adjusted percentage of cannabis tweets (3.01%) compared with other groups. For personal communication tweets only, the recreational group (2.47%) was significantly greater than the medical, more restrictive (1.84%) and illegal (1.85%) groups. Similarly, the recreational group had significantly greater average positive-to-negative sentiment ratio (4.64) compared with the medical, more restrictive (4.15) and illegal (4.19) groups. Average adjusted percentages of unique users showed similar differences between recreational and other groups. States with less restrictive policies displayed greater cannabis-related tweeting and conveyed more positive sentiment. The study demonstrates the potential of Twitter data to become a valuable indicator of drug-related
Temperature is known to be correlated with crop yields, causing reduction of crop yield with climate warming without adaptations or CO2 fertilization effects. The historical temperature-crop yield relation has often been used for informing future changes. This relationship, however, may change over time following alternations in other environmental factors. Results show that the strength of the relationship between the interannual variability of growing season temperature and corn yield (RGST_CY) has declined in the United States between 1980 and 2010 with a loss in the statistical significance. The regression slope which represents the anomalies in corn yield that occur in association with 1 degree temperature anomaly has decreased significantly from -6.9%/K of the first half period to -2.4%/K~-3.5%/K of the second half period. This implies that projected corn yield reduction will be overestimated by a fact of 2 in a given warming scenario, if the corn-temperature relation is derived from the earlier historical period. Changes in RGST_CY are mainly observed in Midwest Corn Belt and central High Plains, and are well reproduced by 11 process-based crop models. In Midwest rain-fed systems, the decrease of negative temperature effects coincides with an increase in water availability by precipitation. In irrigated areas where water stress is minimized, the decline of beneficial temperature effects is significantly related to the increase in extreme hot days. The results indicate that an extrapolation of historical yield response to temperature may bias the assessment of agriculture vulnerability to climate change. Efforts to reduce climate impacts on agriculture should pay attention not only to climate change, but also to changes in climate-crop yield relations. There are some caveats that should be acknowledged as the analysis is restricted to the changes in the linear relation between growing season mean temperature and corn yield for the specific study period.
The problem of nonrelativistic dependence of unit length and unit time on the position in the space is considered on the basis of centre-containing spiral-geometric structure of the space-time. The experimental results of variation of the unit time are analyzed which well agree with the requirements of the model proposed. 13 refs.; 12 figs
Yoshinaga, S.; Hauptmann, M.; Sigurdson, A.J.; Doody, M.M.; Freedman, D.M.; Linet, M.S.; Ron, E.; Mabuchi, K.
Ionizing and ultraviolet (UV) radiations are known to increase the risk of non-melanoma skin cancer. However, the effect of chronic or protracted exposure to ionizing radiation and the modifying effect of UV exposure on skin cancer risk are not well defined. We evaluated risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin among radiologic technologists in the United States. A total of 1,355 incident cases with BCC and 270 with SCC were ascertained in 65,304 white technologists between the baseline questionnaire survey in 1983-1989 and the follow-up survey in 1994-1998. Analysis by Cox's proportional hazard model, stratified by birth cohort and adjusted for potential confounders including pigmentation characteristics (skin complexion, eye and hair color) and estimated index of residential UV exposure, indicated significantly increased relative risks for BCC, but not for SCC, among early technologists who likely had high radiation exposure. Relative risks of BCC were 1.42 (95% CI: 1.12-1.79), 2.04 (95% CI: 1.44-2.88), and 2.17 (95% CI: 1.14-4.10) among those who first worked in the 1950s, 1940s, and before 1940, respectively (p for trend: <0.01), compared with technologists who first worked after 1960. The effects of ionizing radiation on BCC were not significantly modified by UV exposure (p for effect modification: 0.31), but they were modified by eye and hair color (p=0.01 and 0.03), with light eye or hair color conferring a higher radiation-related risk. In contrast, relative risks of both BCC and SCC significantly increased with increasing residential UV exposure index, and no modifying effects of pigmentation characteristics were observed. This study provides evidence of increased BCC risk associated with chronic, occupational exposure to a low-to-moderate level of ionizing radiation, which may be modified by pigmentation characteristics
Rosie D Salazar
Full Text Available The common toad (Bufo bufo is of increasing conservation concern in the United Kingdom (UK due to dramatic population declines occurring in the past century. Many of these population declines coincided with reductions in both terrestrial and aquatic habitat availability and quality and have been primarily attributed to the effect of agricultural land conversion (of natural and semi-natural habitats to arable and pasture fields and pond drainage. However, there is little evidence available to link habitat availability with common toad population declines, especially when examined at a broad landscape scale. Assessing such patterns of population declines at the landscape scale, for instance, require an understanding of how this species uses terrestrial habitat.We intensively studied the terrestrial resource selection of a large population of common toads in Oxfordshire, England, UK. Adult common toads were fitted with passive integrated transponder (PIT tags to allow detection in the terrestrial environment using a portable PIT antenna once toads left the pond and before going into hibernation (April/May-October 2012 and 2013. We developed a population-level resource selection function (RSF to assess the relative probability of toad occurrence in the terrestrial environment by collecting location data for 90 recaptured toads.The predicted relative probability of toad occurrence for this population was greatest in wooded habitat near to water bodies; relative probability of occurrence declined dramatically > 50 m from these habitats. Toads also tended to select habitat near to their breeding pond and toad occurrence was negatively related to urban environments.
Mars, Sarah G.; Fessel, Jason N.; Bourgois, Philippe; Montero, Fernando; Karandinos, George; Ciccarone, Daniel
Heroin overdose, more accurately termed ‘heroin-related overdose’ due to the frequent involvement of other drugs, is the leading cause of mortality among regular heroin users. (Degenhardt et al., 2010) Heroin injectors are at greater risk of hospital admission for heroin-related overdose (HOD) in the eastern United States where Colombian-sourced powder heroin is sold than in the western US where black ‘tar’ heroin predominates. (Unick et al., 2014) This paper examines under-researched influences on HOD, both fatal and non-fatal, using data from a qualitative study of injecting drug users of black tar heroin in San Francisco and powder heroin in Philadelphia Data were collected through in-depth, semi-structured interviews carried out in 2012 that were conducted against a background of longer-term participant-observation, ethnographic studies of drug users and dealers in Philadelphia (2007–12) and of users in San Francisco (1994–2007, 2012). Our findings suggest three types of previously unconsidered influences on overdose risk that arise both from structural socio-economic factors and from the physical properties of the heroin source-types: 1) retail market structure including information flow between users; 2) marketing techniques such as branding, free samples and pricing and 3) differences in the physical characteristics of the two major heroin source forms and how they affect injecting techniques and vascular health. Although chosen for their contrasting source-forms, we found that the two cities have contrasting dominant models of drug retailing: San Francisco respondents tended to buy through private dealers and Philadelphia respondents frequented an open-air street market where heroin is branded and free samples are distributed, although each city included both types of drug sales. These market structures and marketing techniques shape the availability of information regarding heroin potency and its dissemination among users who tend to seek out
Mars, Sarah G; Fessel, Jason N; Bourgois, Philippe; Montero, Fernando; Karandinos, George; Ciccarone, Daniel
Heroin overdose, more accurately termed 'heroin-related overdose' due to the frequent involvement of other drugs, is the leading cause of mortality among regular heroin users. (Degenhardt et al., 2010) Heroin injectors are at greater risk of hospital admission for heroin-related overdose (HOD) in the eastern United States where Colombian-sourced powder heroin is sold than in the western US where black 'tar' heroin predominates. (Unick et al., 2014) This paper examines under-researched influences on HOD, both fatal and non-fatal, using data from a qualitative study of injecting drug users of black tar heroin in San Francisco and powder heroin in Philadelphia Data were collected through in-depth, semi-structured interviews carried out in 2012 that were conducted against a background of longer-term participant-observation, ethnographic studies of drug users and dealers in Philadelphia (2007-12) and of users in San Francisco (1994-2007, 2012). Our findings suggest three types of previously unconsidered influences on overdose risk that arise both from structural socio-economic factors and from the physical properties of the heroin source-types: 1) retail market structure including information flow between users; 2) marketing techniques such as branding, free samples and pricing and 3) differences in the physical characteristics of the two major heroin source forms and how they affect injecting techniques and vascular health. Although chosen for their contrasting source-forms, we found that the two cities have contrasting dominant models of drug retailing: San Francisco respondents tended to buy through private dealers and Philadelphia respondents frequented an open-air street market where heroin is branded and free samples are distributed, although each city included both types of drug sales. These market structures and marketing techniques shape the availability of information regarding heroin potency and its dissemination among users who tend to seek out the
Barbieri, Magali; Désesquelles, Aline; Egidi, Viviana; Demuru, Elena; Frova, Luisa; Meslé, France; Pappagallo, Marilena
We investigate the reporting of obesity on death certificates in three countries (France, Italy, and the United States) with different levels of prevalence, and we examine which causes are frequently associated with obesity. We use cause-of-death data for all deaths at ages 50-89 in 2010-2011. Since obesity may not be the underlying cause (UC) of death, we compute age- and sex-standardized death rates considering all mentions of obesity (multiple causes or MC). We use cluster analyses to identify patterns of cause-of-death combinations. Obesity is selected as UC in no more than 20% of the deaths with a mention of obesity. Mortality levels, whether measured from the UC or the MC, are weakly related to levels of prevalence. Patterns of cause-of-death combinations are similar across the countries. In addition to strong links with cardiovascular diseases and diabetes, we identify several less familiar associations. Considering all mentions on the deaths certificates reduces the underestimation of obesity-related mortality based on the UC only. It also enables us to describe the various mortality patterns involving obesity.
Gartner, Joseph E.; Cannon, Susan H.; Bigio, Erica R.; Davis, Nicole K.; Parrett, Charles; Pierce, Kenneth L.; Rupert, Michael G.; Thurston, Brandon L.; Trebesch, Matthew J.; Garcia, Steve P.; Rea, Alan H.
This report presents a compilation of data on the erosive response, debris-flow initiation processes, basin morphology, burn severity, event-triggering rainfall, rock type, and soils for 608 basins recently burned by 53 fires located throughout the Western United States. The data presented here are a combination of those collected during our own field research and those reported in the literature. In some cases, data from a Geographic Information System (GIS) and Digital Elevation Models (DEMs) were used to supplement the data from the primary source. Due to gaps in the information available, not all parameters are characterized for all basins. This database provides a resource for researchers and land managers interested in examining relations between the runoff response of recently burned basins and their morphology, burn severity, soils and rock type, and triggering rainfall. The purpose of this compilation is to provide a single resource for future studies addressing problems associated with wildfire-related erosion. For example, data in this compilation have been used to develop a model for debris flow probability from recently burned basins using logistic multiple regression analysis (Cannon and others, 2004). This database provides a convenient starting point for other studies. For additional information on estimated post-fire runoff peak discharges and debris-flow volumes, see Gartner and others (2004).
Kipfmueller, K.F. [Minnesota Univ., Minneapolis, MN (United States). Dept. of Geography; Salzer, M.W. [Arizona Univ., Tucson, AZ (United States). Laboratory of Tree-Ring Research
This study investigated sixty-six 5-needle pine growth chronologies from 1896 to their end years in order to identify potential patterns related to linear trends in ring width. Individual chronology responses to climate were also evaluated by comparing the chronologies with seasonal temperature and precipitation data from 1896 to the present date. Chronologies exhibiting similar patterns of climate response were grouped in order to examine the role of treeline proximity on climate-growth relationships. Ring width measurements for pine sites located in the western United States were obtained from the International Tree Ring Data Bank. Growth indices were compared among all sites in order to assess the relative strength of common signals with increasing distance. Pearson correlations were used to calculate linear trends for each chronology. A cluster analysis of climate response patterns indicated that most chronologies positively associated with temperatures were located near upper treeline and contained significant positive linear trends. The study suggested that 5-needle pine treeline chronologies may be used as predictors in temperature reconstructions. However, care must be taken to determine that collection sites have not been impacted by disturbances such as fire or insect outbreaks. 35 refs., 2 tabs., 5 figs.
Lee, Keunsung [KHNP-CRI, Daejeon (Korea, Republic of); Kim, Sukhoon [FNC Technology Co., Ltd., Yongin (Korea, Republic of); Lee, Chonghui [KEPCO E and C, Yongin (Korea, Republic of)
As part of the project for acquiring the certification from EUR organization, in accordance with Articles 4.8 and 5.5 specified in Section 2.20 of EUR Volume 2, the effects of ionizing radiation from the standard design of EU-APR on biota and ecosystems during operation and decommissioning phases shall be assessed. This assessment must be carried out according to the ERICA (i.e. Environmental Risk from Ionizing Contaminants: Assessment and management) integrated approach. This paper describes the evaluation results for unit risk quotient and relative significance by radionuclide derived from performing Tier 1 assessment on flora and fauna for the EU-APR design using ERICA Tool. As specified previously, Pa-231 and Th-228 are the most significant for the terrestrial and for the marine/freshwater ecosystems, respectively. And, in terms of environmental risk, those radionuclides having the most impact on flora and fauna are relatively more significant than isotope having the least impact by about 7 to 10 orders of magnitude.
Lee, Keunsung; Kim, Sukhoon; Lee, Chonghui
As part of the project for acquiring the certification from EUR organization, in accordance with Articles 4.8 and 5.5 specified in Section 2.20 of EUR Volume 2, the effects of ionizing radiation from the standard design of EU-APR on biota and ecosystems during operation and decommissioning phases shall be assessed. This assessment must be carried out according to the ERICA (i.e. Environmental Risk from Ionizing Contaminants: Assessment and management) integrated approach. This paper describes the evaluation results for unit risk quotient and relative significance by radionuclide derived from performing Tier 1 assessment on flora and fauna for the EU-APR design using ERICA Tool. As specified previously, Pa-231 and Th-228 are the most significant for the terrestrial and for the marine/freshwater ecosystems, respectively. And, in terms of environmental risk, those radionuclides having the most impact on flora and fauna are relatively more significant than isotope having the least impact by about 7 to 10 orders of magnitude
This final environmental statement contains the second assessment of the environmental impact associated with operation of Clinton Power Station Unit 1 pursuant to the National Environmental Policy Act of 1969 (NEPA) and 10 CFR Part 51, as amended, of the NRC's regulations. This statement examines: the affected environment, environmental consequences and mitigating actions, and environmental and economic benefits and costs. Land-use and terrestrial- and aquatic-ecological impacts will be small. Air-quality impacts will also be small. However, steam fog from the station's cooling lake has the potential for reducing visibility over nearby roads and bridges. A fog-monitoring program for roads and ridges near the lake has been recommended. Impacts to historic and prehistoric sites will be negligible. Chemical discharges to Lake Clinton and Salt Creek are expected to have no appreciable impacts on water quality under normal conditions and will be required to meet conditions of the station's NPDES permit. The hydrothermal analyses indicate that under certain meteorological conditions (1-in-50-year drought), the plant would have to be operated at reduced power levels in order to meet the thermal standards established by the Illinois Pollution Control Board Order PCB 81-82. The effects of routine operations, energy transmission, and periodic maintenance of rights-of-way and transmission line facilties should not jeopardize any populations of endangered or threatened species. No significant impacts are anticipated from normal operational releases of radioactivity. Contentions associated with environmental issues accepted during the operating-license hearing are related to assessment of effects of low-level radiation. The net socioeconomic effects of the project will be beneficial. The action called for is the issuance of an operating license for Unit 1 of Clinton
Bansagi, Boglarka; Antoniadi, Thalia; Burton-Jones, Sarah; Murphy, Sinead M; McHugh, John; Alexander, Michael; Wells, Richard; Davies, Joanna; Hilton-Jones, David; Lochmüller, Hanns; Chinnery, Patrick; Horvath, Rita
Charcot-Marie-Tooth disease (CMT) is the most common inherited neuropathy with heterogeneous clinical presentation and genetic background. The axonal form (CMT2) is characterised by decreased action potentials indicating primary axonal damage. The underlying pathology involves axonal degeneration which is supposed to be related to axonal protein dysfunction caused by various gene mutations. The overlapping clinical manifestation of CMT2 with distal hereditary motor neuropathy (dHMN) and intermediate CMT causes further diagnostic difficulties. Aminoacyl-tRNA synthetases have been implicated in the pathomechanism of CMT2. They have an essential role in protein translation by attaching amino acids to their cognate tRNAs. To date six families have been reported worldwide with dominant missense alanyl-tRNA synthetase (AARS) mutations leading to clinically heterogeneous axonal neuropathies. The pathomechanism of some variants could be explained by impaired amino acylation activity while other variants implicating an editing defect need to be further investigated. Here, we report a cohort of six additional families originating from the United Kingdom and Ireland with dominant AARS-related neuropathies. The phenotypic manifestation was distal lower limb predominant sensorimotor neuropathy but upper limb impairment with split hand deformity occasionally associated. Nerve conduction studies revealed significant demyelination accompanying the axonal lesion in motor and sensory nerves. Five families have the c.986G>A, p.(Arg329His) variant, further supporting that this is a recurrent loss of function variant. The sixth family, of Irish origin, had a novel missense variant, c.2063A>G, p.(Glu688Gly). We discuss our findings and the associated phenotypic heterogeneity in these families, which expands the clinical spectrum of AARS-related neuropathies.
Bagga, Herman S; Tasian, Gregory E; Fisher, Patrick B; McCulloch, Charles E; McAninch, Jack W; Breyer, Benjamin N
We describe the epidemiological features of adult genitourinary injuries related to consumer products and determined the patient cohorts, products and situations associated with increased genitourinary injury risk. The National Electronic Injury Surveillance System, a data set validated to provide a probability sample of injury related emergency department presentations in the United States, was analyzed to characterize genitourinary injuries from 2002 to 2010. We analyzed 3,545 observations to derive national estimates. An estimated 142,144 adults (95% CI 115,324-168,964) presented to American emergency departments with genitourinary injuries from 2002 to 2010. Of the injuries 69% occurred in men. A large majority of injuries involved the external genitalia. The most common categories of products involved were sporting items in 30.2% of cases, clothing articles in 9.4% and furniture in 9.2%. The highest prevalence of injury was at ages 18 to 28 years (37.5%), which was most often related to sports equipment, such as bicycles. Older cohorts (age greater than 65 years) more commonly sustained injuries during falls and often in the bathroom during use of a shower or tub. Of all patients 88% were evaluated and treated in the emergency department without inpatient admission, although the admission rate increased with increasing patient age. Acute genitourinary injury is often associated with common consumer items and with identifiable high risk cohorts, products and situations. Consumers, practitioners and safety champions can use our epidemiological data to prioritize and develop strategies aimed at the prevention, limitation and informed treatment of such injuries. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Mollon, Lea; Bhattacharjee, Sandipan
Little is known regarding the health-related quality of life among myocardial infarction (MI) survivors in the United States. The purpose of this population-based study was to identify differences in health-related quality of life domains between MI survivors and propensity score matched controls. This retrospective, cross-sectional matched case-control study examined differences in health-related quality of life (HRQoL) among MI survivors of myocardial infarction compared to propensity score matched controls using data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) survey. Propensity scores were generated via logistic regression for MI survivors and controls based on gender, race/ethnicity, age, body mass index (BMI), smoking status, and comorbidities. Chi-square tests were used to compare differences between MI survivors to controls for demographic variables. A multivariate analysis of HRQoL domains estimated odds ratios. Life satisfaction, sleep quality, and activity limitations were estimated using binary logistic regression. Social support, perceived general health, perceived physical health, and perceived mental health were estimated using multinomial logistic regression. Significance was set at p 15 days in the month (AOR = 1.63, 95% CI: 1.46-1.83) and poor mental health >15 days in the month (AOR = 1.25, 95% CI: 1.07-1.46) compared to matched controls. There was no difference in survivors compared to controls in level of emotional support (rarely/never: AOR = 0.75, 95% CI: 0.48-1.18; sometimes: AOR = 0.73, 95% CI: 0.41-1.28), hours of recommended sleep (AOR = 1.14, 95% CI: 0.94-1.38), or life satisfaction (AOR = 1.62, 95% CI: 0.99-2.63). MI survivors experienced lower HRQoL on domains of general health, physical health, daily activity, and mental health compared to the general population.
Azofeifa, Alejandro; Mattson, Margaret E; Schauer, Gillian; McAfee, Tim; Grant, Althea; Lyerla, Rob
In the United States, marijuana is the most commonly used illicit drug. In 2013, 7.5% (19.8 million) of the U.S. population aged ≥12 years reported using marijuana during the preceding month. Because of certain state-level policies that have legalized marijuana for medical or recreational use, population-based data on marijuana use and other related indicators are needed to help monitor behavioral health changes in the United States. 2002-2014. The National Survey on Drug Use and Health (NSDUH) is a national- and state-level survey of a representative sample of the civilian, noninstitutionalized U.S. population aged ≥12 years. NSDUH collects information about the use of illicit drugs, alcohol, and tobacco; initiation of substance use; frequency of substance use; substance dependence and abuse; perception of substance harm risk or no risk; and other related behavioral health indicators. This report describes national trends for selected marijuana use and related indicators, including prevalence of marijuana use; initiation; perception of harm risk, approval, and attitudes; perception of availability and mode of acquisition; dependence and abuse; and perception of legal penalty for marijuana possession. In 2014, a total of 2.5 million persons aged ≥12 years had used marijuana for the first time during the preceding 12 months, an average of approximately 7,000 new users each day. During 2002-2014, the prevalence of marijuana use during the past month, past year, and daily or almost daily increased among persons aged ≥18 years, but not among those aged 12-17 years. Among persons aged ≥12 years, the prevalence of perceived great risk from smoking marijuana once or twice a week and once a month decreased and the prevalence of perceived no risk increased. The prevalence of past year marijuana dependence and abuse decreased, except among persons aged ≥26 years. Among persons aged ≥12 years, the percentage reporting that marijuana was fairly easy or very easy
Fitzpatrick, Faith A.; Peppler, Marie C.
The relation of urbanization to stream habitat and geomorphic characteristics was examined collectively and individually for nine metropolitan areas of the United States?Portland, Oregon; Salt Lake City, Utah; Denver, Colorado; Dallas?Forth Worth, Texas; Milwaukee?Green Bay, Wisconsin; Birmingham, Alabama; Atlanta, Georgia; Raleigh, North Carolina; and Boston, Massachusetts. The study was part of a larger study conducted by the U.S. Geological Survey from 1999 to 2004 to examine the effects of urbanization on the physical, chemical, and biological components of stream ecosystems. The objectives of the current study were to determine how stream habitat and geomorphic characteristics relate to different aspects of urbanization across a variety of diverse environmental settings and spatial scales. A space-for-time rural-to-urban land-cover gradient approach was used. Reach-scale habitat data and geomorphic characteristic data were collected once during low flow and included indicators of potential habitat degradation such as measures of channel geometry and hydraulics, streambed substrate, low-flow reach volume (an estimate of base-flow conditions), habitat complexity, and riparian/bank conditions. Hydrologic metrics included in the analyses were those expected to be altered by increases in impervious surfaces, such as high-flow frequency and duration, flashiness, and low-flow duration. Other natural and human features, such as reach-scale channel engineering, geologic setting, and slope, were quantified to identify their possible confounding influences on habitat relations with watershed-scale urbanization indicators. Habitat and geomorphic characteristics were compared to several watershed-scale indicators of urbanization, natural landscape characteristics, and hydrologic metrics by use of correlation analyses and stepwise linear regression. Habitat and geomorphic characteristics were related to percentages of impervious surfaces only in some metropolitan areas and
SANTOS, NORMA BREDA DOS; UZIEL, EDUARDO
Abstract In 1975, Brazil voted in favor of the United Nations General Assembly resolution 3379 (XXX), equating Zionism with a form of racism. Focusing on the decision-making process of president Ernesto Geisel's (1974-1979) foreign policy, "responsible pragmatism", this article discusses how the ultimate decision to vote in favor of resolution was taken taking into account mainly US-Brazil relationship. Resumo Em 1975, o Brasil votou a favor da resolução da Assembleia Geral das Nações Unid...
Lee, Joyce M; Davis, Matthew M; Menon, Ram K; Freed, Gary L
To determine the geographic distribution of childhood diabetes and obesity relative to the supply of US pediatric endocrinologists. Estimation of observed and "index" ratios of children with diabetes (by region and division) and obesity (body mass index >/=95th % for age and sex) (by region and state) to board-certified pediatric endocrinologists. At the national level, the ratio of children with diabetes to pediatric endocrinologists is 290:1, and the ratio of obese children to pediatric endocrinologists is 17,741:1. Ratios of children with diabetes to pediatric endocrinologists in the Midwest (370:1), South (335:1), and West (367:1) are twice as high as in the Northeast (144:1). Across states, there is up to a 19-fold difference in the observed ratios of obese children to pediatric endocrinologists. Under conditions of equitably distributed endocrinologist supply, variation across states would be mitigated considerably. The distribution of children with diabetes and obesity does not parallel the distribution of pediatric endocrinologists in the United States, due largely to geographic disparities in endocrinologist supply. Given the large burden of obese children to endocrinologists, multidisciplinary models of care delivery are essential for the US health care system to address the needs of children with diabetes and obesity.
The International Atomic Energy Agency (IAEA) has conducted consultant and advisory meetings to prepare a Technical Document which is intended to provide guidance to all IAEA Member States (otherwise known as countries) that are currently planning, designing, constructing or operating a deep or near surface geological repository for the storage and protection of vitrified high-level radioactive waste, spent fuel waste and TRU-waste (transuranic). Eleven countries of the international community are presently in various stages of siting, designing, or constructing deep geologic repositories. Member States of the IAEA have determined that the principle safety of such completed and operation sites must not rely solely on long term institutional arrangements for the retention of information. It is believed that repository siting, design, operation and postoperation information should be gathered, managed and retained in a manner that will provide information to future societies over a very long period of time. The radionuclide life is 10,000 years thus the retention of information must outlive current societies, languages, and be continually migrated to new technology to assure retrieval. This presentation will provide an overview of the status of consideration and implementation of these issues within the United States efforts relative to deep geologic repository projects.
Sellers, Sherrill; Cherepanav, Dasha; Hanmer, Janel; Fryback, Dennis G; Palta, Mari
We assessed associations between discrimination and health-related quality of life among black and white men and women in the United States. We examined data from the National Health Measurement Study, a nationally representative sample of 3,648 adults aged 35-89 in the non-institutionalized US population. These data include self-reported lifetime and everyday discrimination as well as several health utility indexes (EQ-5D, HUI3, and SF-6D). Multiple regression was used to compute mean health utility scores adjusted for age, income, education, and chronic diseases for each race-by-gender subgroup. Black men and women reported more discrimination compared to white men and women. Health utility tended to be worse as reported discrimination increased. With a few exceptions, differences between mean health utility scores in the lowest and highest discrimination groups exceeded the 0.03 difference generally considered to be a clinically significant difference. Persons who experienced discrimination tended to score lower on health utility measures. The study also revealed a complex relationship between experiences of discrimination and race and gender. Because of these differential social and demographic relationships caution is urged when interpreting self-rated health measures in research, clinical, and policy settings.
Duan, Kai; Sun, Ge; McNulty, Steven G.; Caldwell, Peter V.; Cohen, Erika C.; Sun, Shanlei; Aldridge, Heather D.; Zhou, Decheng; Zhang, Liangxia; Zhang, Yang
This study examines the relative roles of climatic variables in altering annual runoff in the conterminous United States (CONUS) in the 21st century, using a monthly ecohydrological model (the Water Supply Stress Index model, WaSSI) driven with historical records and future scenarios constructed from 20 Coupled Model Intercomparison Project Phase 5 (CMIP5) climate models. The results suggest that precipitation has been the primary control of runoff variation during the latest decades, but the role of temperature will outweigh that of precipitation in most regions if future climate change follows the projections of climate models instead of the historical tendencies. Besides these two key factors, increasing air humidity is projected to partially offset the additional evaporative demand caused by warming and consequently enhance runoff. Overall, the projections from 20 climate models suggest a high degree of consistency on the increasing trends in temperature, precipitation, and humidity, which will be the major climatic driving factors accounting for 43-50, 20-24, and 16-23 % of the runoff change, respectively. Spatially, while temperature rise is recognized as the largest contributor that suppresses runoff in most areas, precipitation is expected to be the dominant factor driving runoff to increase across the Pacific coast and the southwest. The combined effects of increasing humidity and precipitation may also surpass the detrimental effects of warming and result in a hydrologically wetter future in the east. However, severe runoff depletion is more likely to occur in the central CONUS as temperature effect prevails.
Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B
Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.
Guillaume, Fabrice; Etienne, Yann
Using two exclusion tasks, the present study examined how the ERP correlates of face recognition are affected by the nature of the information to be retrieved. Intrinsic (facial expression) and extrinsic (background scene) visual information were paired with face identity and constituted the exclusion criterion at test time. Although perceptual information had to be taken into account in both situations, the FN400 old-new effect was observed only for old target faces on the expression-exclusion task, whereas it was found for both old target and old non-target faces in the background-exclusion situation. These results reveal that the FN400, which is generally interpreted as a correlate of familiarity, was modulated by the retrieval of intra-item and intrinsic face information, but not by the retrieval of extrinsic information. The observed effects on the FN400 depended on the nature of the information to be retrieved and its relationship (unitization) to the recognition target. On the other hand, the parietal old-new effect (generally described as an ERP correlate of recollection) reflected the retrieval of both types of contextual features equivalently. The current findings are discussed in relation to recent controversies about the nature of the recognition processes reflected by the ERP correlates of face recognition. Copyright © 2015 Elsevier B.V. All rights reserved.
The International Atomic Energy Agency (IAEA) has conducted consultant and advisory meetings to prepare a Technical Document which is intended to provide guidance to all IAEA Member States (otherwise known as countries) that are currently planning, designing, constructing or operating a deep or near surface geological repository for the storage and protection of vitrified high-level radioactive waste, spent fuel waste and TRU-waste (transuranic). Eleven countries of the international community are presently in various stages of siting, designing, or constructing deep geologic repositories. Member States of the IAEA have determined that the principle safety of such completed and operation sites must not rely solely on long term institutional arrangements for the retention of information. It is believed that repository siting, design, operation and postoperation information should be gathered, managed and retained in a manner that will provide information to future societies over a very long period of time. The radionuclide life is 10,000 years thus the retention of information must outlive current societies, languages, and be continually migrated to new technology to assure retrieval. This presentation will provide an overview of the status of consideration and implementation of these issues within the United States efforts relative to deep geologic repository projects
Shields, Brenda J; Fernandez, Soledad A; Smith, Gary A
To compare mini- and full-sized trampoline-related injuries in the United States. A retrospective analysis of data was conducted for all ages from the National Electronic Injury Surveillance System (NEISS) of the US Consumer Product Safety Commission from 1990 to 2002. We compared 137 minitrampoline-related injuries with 143 full-sized trampoline-related injuries, randomly selected from all full-sized trampoline-related injuries reported to the NEISS during the study period. Patients ranged in age from 1 to 80 years (mean [SD]: 13.9 [17.7]) and 2 to 52 years (mean [SD]: 11.0 [8.0]) for mini- and full-sized trampoline-related injuries, respectively. Most patients were younger than 18 years (82% mini, 91% full-sized). Thirty-two percent of minitrampoline- and 19% of full-sized trampoline-related injuries were to children who were younger than 6 years; girls predominated (63% mini, 51% full-sized). Children who were younger than 6 years were more likely to be injured on a minitrampoline than on a full-sized trampoline, when compared with 6- to 17-year-olds (odds ratio [OR]: 2.43; 95% confidence interval [CI]: 1.33-4.47). The majority of injuries occurred at home (87% mini, 89% full-sized). All patients who were injured on a minitrampoline were treated and released, whereas 5% of patients who were injured on a full-sized trampoline were admitted to the hospital. On minitrampolines, children who were younger than 6 years were at risk for head lacerations (OR: 4.98; 95% CI: 1.71-16.03), and children who were 6 to 17 years were at risk for lower extremity strains or sprains (OR: 6.26; 95% CI: 1.35-59.14). Children who were 6 to 17 years and injured on a full-sized trampoline were at risk for lower extremity strains or sprains (OR: 4.85; 95% CI: 1.09-44.93). Lower extremity strains or sprains were the most common injury sustained by adults (18 years and older; 33% mini, 15% full-sized). Injury patterns were similar for mini- and full-sized trampolines, although
Elhoseeny, Taghareed A; Mourad, Juidan K
The Safe Injection Global Network (SIGN) developed an intervention strategy for reducing overuse of injections and promoting the administration of safe injections. Tool C--Revised is designed to assess the safety of the most common procedures that puncture the skin within health services. The aim of the study was to assess injection safety within the primary healthcare facilities in Alexandria using Tool C--Revised. A total of 45 family health units and centers in Alexandria were selected by proportional allocation from the eight regions of Alexandria. The Tool C--Revised of the WHO was used for observation of the entire facility, injection practices and injection-related procedures, and sterilization practices. Interview of different health providers and immediate supervisor of injections was carried out. Indicators that reflect risk included: deficiency of alcohol-based hand rub for cleansing hands (13.3%), compliance with hand wash before preparing a procedure (56.9% before injection practices, 61.3% before phlebotomy, and 67.6% before lancet puncture), and wearing a new pair of gloves before new procedures (48.6% before injection practices, 9.7% for phlebotomy, 11.8% for lancet puncture, and 80% for both intravenous injections and infusions). Enough disposable equipment in all facilities for at least 2 weeks dependent on the statement of the average numbers of procedures per week was shown. Only 38% of the providers had received training regarding injection safety in the last 2 years and 62.5% had completed their three doses of hepatitis B vaccine. Only 42.2% of staffs who handled healthcare waste had access to heavy gloves. Indicators related to injection and injection-related practices that reflect risk to patients include deficiency of alcohol-based hand rub tools, nonadherence to hand hygiene before preparing an injection, and inadequate adherence to using a clean barrier when opening a glass ampule and use of gloves. Indicators that may reflect risk to
Reignier, Jean; Dumont, Romain; Katsahian, Sandrine; Martin-Lefevre, Laurent; Renard, Benoit; Fiancette, Maud; Lebert, Christine; Clementi, Eva; Bontemps, Frederic
To assess decisions to forego life-sustaining treatment (LST) in patients too sick for intensive care unit (ICU) admission, comparatively to patients admitted to the ICU. Prospective observational cohort study. A medical-surgical ICU. Consecutive patients referred to the ICU during a one-yr period. None. Of 898 triaged patients, 147 were deemed too well to benefit from ICU admission. Decisions to forego LST were made in 148 of 666 (22.2%) admitted patients and in all 85 patients deemed too sick for ICU admission. Independent predictors of decisions to forego LST at ICU refusal rather than after ICU admission were: age; underlying disease; living in an institution; preexisting cognitive impairment; admission for medical reasons; and acute cardiac failure, acute central neurologic illness, or sepsis. Hospital mortality after decisions to forego LST was not significantly different in refused and admitted patients (77.5% vs. 86.5%; p = .1). Decisions to forego LST were made via telephone in 58.8% of refused patients and none of the admitted patients. Nurses caring for the patient had no direct contact with the ICU physicians for 62.3% of the decisions in refused patients, whereas meetings between nurses and physicians occurred in 70.3% of decisions to forego LST in the ICU. Patients or relatives were involved in 28.2% of decisions to forego LST at ICU refusal compared with 78.4% of decisions to forego LST in ICU patients (p refused patients (vs. none of admitted patients) and were associated with less involvement of nurses and relatives compared with decisions in admitted patients. Further work is needed to improve decisions to forego LST made under the distinctive circumstances of triage.
Supplement No. 7 to the Safety Evaluation Report related to Commonwealth Edison Company's application for licenses to operate the Byron Station, Units 1 and 2, located in Rockvale Township, Ogle County, Illinois, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement provides additional information supporting the license for initial criticality and power ascension to full-power operation for Unit 2
Supplement 27 to the Safety Evaluation Report for Pacific Gas and Electric Company's application for a license to operate Diablo Canyon Nuclear Power Plant, Unit 1 (Docket No. 50-275), has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement addresses the revisions to the license conditions and to the Technical Specifications as they relate to Amendment 10 to Diablo Canyon, Unit 1 Facility Operating License, DPR-76
Moustafa, H.; Amin, A.; El-Haddad, Sh.; Moustafa, B.; Wageeh, Sh.; Soliman, N.
Seventy nine patients with repeated urinary tract infection were evaluated for detection of vesico-ureteric reflux (VUR) by direct (DRC) and indirect (IRC) radionuclide cystography as well as assessment of renal scarring using 99 mTc-DMSA. Positive VUR was evident in 38 patients (59 renal units), 50%, patients had history of recurrent urinary tract infection. Patients kidneys were divided into 2 groups: group A with normal if kidneys (74 renal units), but still they have high grade VUR in 20 renal units (20.6%.Group B with scarred kidneys (84 renal Units) with high grade VUR in 36 renal units (42.9%) with significant difference between both groups (P 99 mTc-DMSA with VUR assessment are essential in pediatric patients with urinary tract infection for detection of high grade VUR which may contribute to renal scarring and damage
Payne Karl Frederick
Full Text Available Abstract Background Smartphone usage has spread to many settings including that of healthcare with numerous potential and realised benefits. The ability to download custom-built software applications (apps has created a new wealth of clinical resources available to healthcare staff, providing evidence-based decisional tools to reduce medical errors. Previous literature has examined how smartphones can be utilised by both medical student and doctor populations, to enhance educational and workplace activities, with the potential to improve overall patient care. However, this literature has not examined smartphone acceptance and patterns of medical app usage within the student and junior doctor populations. Methods An online survey of medical student and foundation level junior doctor cohorts was undertaken within one United Kingdom healthcare region. Participants were asked whether they owned a Smartphone and if they used apps on their Smartphones to support their education and practice activities. Frequency of use and type of app used was also investigated. Open response questions explored participants’ views on apps that were desired or recommended and the characteristics of apps that were useful. Results 257 medical students and 131 junior doctors responded, equating to a response rate of 15.0% and 21.8% respectively. 79.0% (n=203/257 of medical students and 74.8% (n=98/131 of junior doctors owned a smartphone, with 56.6% (n=115/203 of students and 68.4% (n=67/98 of doctors owning an iPhone. The majority of students and doctors owned 1–5 medical related applications, with very few owning more than 10, and iPhone owners significantly more likely to own apps (Chi sq, p Conclusions This study found a high level of smartphone ownership and usage among medical students and junior doctors. Both groups endorse the development of more apps to support their education and clinical practice.
Li, Xixi; He, Mei; Wang, Haiyan
In this study, failure mode and effect analysis (FMEA), a proactive tool, was applied to reduce errors associated with the process which begins with assessment of patient and ends with treatment of complications. The aim of this study is to assess whether FMEA implementation will significantly reduce the incidence of catheter-related bloodstream infections (CRBSIs) in intensive care unit.The FMEA team was constructed. A team of 15 medical staff from different departments were recruited and trained. Their main responsibility was to analyze and score all possible processes of central venous catheterization failures. Failure modes with risk priority number (RPN) ≥100 (top 10 RPN scores) were deemed as high-priority-risks, meaning that they needed immediate corrective action. After modifications were put, the resulting RPN was compared with the previous one. A centralized nursing care system was designed.A total of 25 failure modes were identified. High-priority risks were "Unqualified medical device sterilization" (RPN, 337), "leukopenia, very low immunity" (RPN, 222), and "Poor hand hygiene Basic diseases" (RPN, 160). The corrective measures that we took allowed a decrease in the RPNs, especially for the high-priority risks. The maximum reduction was approximately 80%, as observed for the failure mode "Not creating the maximal barrier for patient." The averaged incidence of CRBSIs was reduced from 5.19% to 1.45%, with 3 months of 0 infection rate.The FMEA can effectively reduce incidence of CRBSIs, improve the security of central venous catheterization technology, decrease overall medical expenses, and improve nursing quality. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
Full Text Available This study examines the relative roles of climatic variables in altering annual runoff in the conterminous United States (CONUS in the 21st century, using a monthly ecohydrological model (the Water Supply Stress Index model, WaSSI driven with historical records and future scenarios constructed from 20 Coupled Model Intercomparison Project Phase 5 (CMIP5 climate models. The results suggest that precipitation has been the primary control of runoff variation during the latest decades, but the role of temperature will outweigh that of precipitation in most regions if future climate change follows the projections of climate models instead of the historical tendencies. Besides these two key factors, increasing air humidity is projected to partially offset the additional evaporative demand caused by warming and consequently enhance runoff. Overall, the projections from 20 climate models suggest a high degree of consistency on the increasing trends in temperature, precipitation, and humidity, which will be the major climatic driving factors accounting for 43–50, 20–24, and 16–23 % of the runoff change, respectively. Spatially, while temperature rise is recognized as the largest contributor that suppresses runoff in most areas, precipitation is expected to be the dominant factor driving runoff to increase across the Pacific coast and the southwest. The combined effects of increasing humidity and precipitation may also surpass the detrimental effects of warming and result in a hydrologically wetter future in the east. However, severe runoff depletion is more likely to occur in the central CONUS as temperature effect prevails.
de Saint Blanquat, L; Cremer, R; Elie, C; Lesage, F; Dupic, L; Hubert, P
To identify the knowledge of caregivers of pediatric intensive care units (PICUs) on the French law related to patients' rights and end of life, their views on withholding/withdrawing life-sustaining treatment (WWLST) decisions, and their feelings about how these decisions were made and implemented. A multicenter survey in 24 French PICUs during the fourth trimester 2010. One thousand three hundred and thirty-nine professional healthcare workers (1005 paramedics and 334 physicians) responded. Over 85% of caregivers had good knowledge of the WWLST decision-making processes required by law. More than 80% of caregivers accepted mechanical ventilation, hemodiafiltration, or hemodynamic support withdrawal or withholding. Nevertheless, the withdrawal of artificial nutrition and hydration generated reluctance or opposition for the majority of respondents. While paramedics' participation in the decision-making process was deemed necessary by all caregivers, paramedics found more often than physicians that they were insufficiently involved. The quality of end-of-life care was judged very positively by caregivers. The answers on how WWLST was applied suggest very different interpretations of the law. Some caregivers respect the principles of palliative care as stated in the public health code and 40% of doctors and 64% of caregivers consider it "acceptable" to hasten death if resulting from a collaborative decision-making process. This study is the first to show that caregivers of French PICUs have good knowledge of the French law concerning the end of life. Yet, there is still confusion about the limits of practice during the end-of-life period. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Shehnaz, Syed Ilyas; Khan, Nelofer; Sreedharan, Jayadevan; Issa, Khaled Jamal; Arifulla, Mohamed
Background Self-medication, often without adult guidance, has been reported to be a common practice during adolescence. Similar to other preventable health-risk behaviors initiated in early adolescence, it has become a cause for concern universally. Objective This study examines the prevalence of self-medication with both prescribed and non-prescribed (OTC) medications, related health complaints, sources of drugs, and sources of drug recommendation, and gender differences related to self-medication among expatriate high school students in the United Arab Emirates (UAE). Methods A cross-sectional survey was conducted among 324 expatriate students through a validated, self-administered questionnaire and data was analyzed using SPSS 19 version. Means and proportions were calculated and Pearson Chi-square test of significance was used to analyze association among variables. Results Majority of the participating students, almost equally distributed by gender, was aged 16 to 17 years. The period prevalence rate of self-medication with prescribed and OTC medications were 89.2%, which did not vary with age, gender, ethnicity or parents’ educational level. The most common sources of drug and drug recommendation were community pharmacies and parents respectively. Headache and fever were the common self-medicated conditions and consequently, analgesics and antipyretics were most commonly used both in the previous two weeks and the previous year prior to the survey. A high prevalence of self-medication with antibiotics (53%) and sedative/hypnotics (27%) was also observed. A female excess emerged for certain health complaints and use of medicines except for the use of anti-allergic and herbal/homeopathic drugs. Conclusions This is the first study to explore self-medication practices among high school students in UAE and provides baseline data critical in creating awareness about the risks and benefits of self-medication. Health care providers, educators and parents should be
This article focuses on the nature of the writing in 73 articles published in six U.S. and U.K. political science and international relations journals that focus on teaching and learning. A comparative analysis is made of the articles through a review of the characteristics of the authors, the themes researched, the analytical focus, the research…
This Final Environmental Statement contains the second assessment of the environmental impact associated with Beaver Valley Power Station Unit 2 pursuant to the National Environmental Policy Act of 1969 (NEPA) and Title 10 of the Code of Federal Regulations, Part 51, as amended, of the Nuclear Regulatory Commission regulations. This statement examines the environment, environmental consequences and mitigating actions, and environmental benefits and costs, and concludes that the action called for is the issuance of an operating license for Beaver Valley Unit 2
This report supplements the Safety Evaluation Report Related to the Operation of McGuire Nuclear Station, Units 1 and 2 (SER (NUREG-0422)) issued in March 1978 by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission with respect to the application filed by Duke Power Company, as applicant and owner, for licenses to operate the McGuire Nuclear Station, Units 1 and 2 (Docket Nos. 50-369 and 50-370). The facility is located in Mecklenburg County, North Carolina, about 17 mi north-northwest of Charlotte, North Carolina. This supplement provides information related to issuance of a full-power authorization for Unit 2. The staff concludes that the McGuire Nuclear Station can be operated by the licensee without endangering the health and safety of the public
Hutchings Hayley A
Full Text Available Abstract Background The availability of routinely collected service-related endoscopy data from NHS endoscopy units has never been quantified. Methods This retrospective observational study asked 19 endoscopy units to submit copies of all in-house, service-related endoscopy data that had been routinely collected by the unit – Referral numbers, Activity, Number of patients waiting and Number of lost slots. Nine of the endoscopy units had previously participated in the Modernising Endoscopy Services (MES project during 2003 to redesign their endoscopy services. These MES sites had access to additional funding and data collection software. The other ten (Control sites had modernised independently. All data was requested in two phases and corresponded to eight specific time points between January 2003 and April 2006. Results Only eight of 19 endoscopy units submitted routinely collected, service-related data. Another site's data was collected specifically for the study. A further two units claimed to routinely collect service-related data but did not submit any to the study. The remaining eight did not collect any service-related endoscopy data routinely and liaised with their Trust for data. Of the eight sites submitting service-related data, only three were MES project sites. Of these three, the data variables collected were limited and none collected the complete set of endoscopy data variables requested. Of the other five sites, two collected all four endoscopy data types. Data for the three MES project sites went back as far as January 2003, whilst the five Control sites were only able to submit data from December 2003 onwards. Conclusion There was a lack of service-related endoscopy data routinely collected by the study sites, especially those who had participated in the MES project. Without this data, NHS endoscopy services cannot have a true understanding of their services, cannot identify problems and cannot measure the impact of any
Jiwani, Aliya; Himmelstein, David; Woolhandler, Steffie; Kahn, James G
The United States' multiple-payer health care system requires substantial effort and costs for administration, with billing and insurance-related (BIR) activities comprising a large but incompletely characterized proportion. A number of studies have quantified BIR costs for specific health care sectors, using micro-costing techniques. However, variation in the types of payers, providers, and BIR activities across studies complicates estimation of system-wide costs. Using a consistent and comprehensive definition of BIR (including both public and private payers, all providers, and all types of BIR activities), we synthesized and updated available micro-costing evidence in order to estimate total and added BIR costs for the U.S. health care system in 2012. We reviewed BIR micro-costing studies across healthcare sectors. For physician practices, hospitals, and insurers, we estimated the % BIR using existing research and publicly reported data, re-calculated to a standard and comprehensive definition of BIR where necessary. We found no data on % BIR in other health services or supplies settings, so extrapolated from known sectors. We calculated total BIR costs in each sector as the product of 2012 U.S. national health expenditures and the percentage of revenue used for BIR. We estimated "added" BIR costs by comparing total BIR costs in each sector to those observed in existing, simplified financing systems (Canada's single payer system for providers, and U.S. Medicare for insurers). Due to uncertainty in inputs, we performed sensitivity analyses. BIR costs in the U.S. health care system totaled approximately $471 ($330 - $597) billion in 2012. This includes $70 ($54 - $76) billion in physician practices, $74 ($58 - $94) billion in hospitals, an estimated $94 ($47 - $141) billion in settings providing other health services and supplies, $198 ($154 - $233) billion in private insurers, and $35 ($17 - $52) billion in public insurers. Compared to simplified financing, $375
Supplement No. 4 to the Safety Evaluation Report related to the operation of the Enrico Fermi Atomic Power Plant, Unit 2, provides the staff's evaluation of additional information submitted by the applicant regarding outstanding review issues identified in Supplement No. 3 to the Safety Evaluation Report, dated January 1983
North Dakota Univ., Fargo. Dept. of Agriculture and Applied Science.
Situational issues related to families and influences upon families in North Dakota and the United States are briefly outlined in these fact sheets. Contents specifically concern (1) outbound migration from North Dakota and transition of rural families from farming; (2) suicide in North Dakota and the nation; (3) child care issues, such as child…
Supplement No. 3 to the Safety Evaluation Report related to the operation of the Enrico Fermi Atomic Power Plant, Unit 2, provides the staff's evaluation of additional information submitted by the applicant regarding outstanding review issues identified in Supplement No. 2 to the Safety Evaluation Report, dated January 1982
The text of the Safeguards Transfer Agreement between the Agency, the Commonwealth of Australia and the United States of America relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members.
The text of the Safeguards Transfer Agreement between the Agency, the Philippines and the United States of America relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members.
The text of the Safeguards Transfer Agreement between the Agency, the Commonwealth of Australia and the United States of America relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members
The text of the Safeguards Transfer Agreement between the Agency, the Philippines and the United States of America relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members
Westerhof, Gerben Johan; Whitbourne, S.K.; Freeman, G.P.
Objectives. To study the aging self, that is, conceptions of one’s own aging process, in relation to identity processes and self-esteem in the United States and the Netherlands. As the liberal American system has a stronger emphasis on individual responsibility and youthfulness than the
Klopotowska, J.E.; Kuiper, R.; van Kan, H.J.; de Pont, A.C.; Dijkgraaf, M.G.; Lie-A-Huen, L.; Vroom, M.B.; Smorenburg, S.M.
Introduction: Patients admitted to an intensive care unit (ICU) are at high risk for prescribing errors and related adverse drug events (ADEs). An effective intervention to decrease this risk, based on studies conducted mainly in North America, is on-ward participation of a clinical pharmacist in an
Klopotowska, Joanna E.; Kuiper, Rob; van Kan, Hendrikus J.; de Pont, Anne-Cornelie; Dijkgraaf, Marcel G.; Lie-A-Huen, Loraine; Vroom, Margreeth B.; Smorenburg, Susanne M.
Patients admitted to an intensive care unit (ICU) are at high risk for prescribing errors and related adverse drug events (ADEs). An effective intervention to decrease this risk, based on studies conducted mainly in North America, is on-ward participation of a clinical pharmacist in an ICU team. As
The text of a Safeguards Transfer Agreement between the Agency, the Republic of China and the United States of America relating to the agreement of 18 July 1955 between the two Governments for co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members.
The text of a Safeguards Transfer Agreement between the Agency, the Republic of China and the United States of America relating to the agreement of 18 July 1955 between the two Governments for co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members
Noome, M.; Beneken genaamd Kolmer, D.M.; Leeuwen, E. van; Dijkstra, B.M.; Vloet, L.C.M.
AIM: The aim of this study was to explore how intensive care unit (ICU) nurses describe their role during End-of-Life Care (EOLC) in the ICU, related to the interaction between patient, family and professionals (care triad). METHOD: Three electronic databases, PubMed, CINAHL and EMBASE, and
Noome, M.; Beneken genaamd Kolmer, D.M.; van Leeuwen, E.; Dijkstra, B.M.; Vloet, L.
Aim The aim of this study was to explore how intensive care unit (ICU) nurses describe their role during End-of-Life Care (EOLC) in the ICU, related to the interaction between patient, family and professionals (care triad). Method Three electronic databases, PubMed, CINAHL and EMBASE, and reference
Because of the jaguar’s (Panthera onca) endangered status under the Endangered Species Act (ESA) of 1973 throughout its range (from Arizona in the north to Argentina in the south), jaguar individuals and populations are monitored to varying degrees throughout their range. Knowledge gained from monitoring jaguars is helpful for wildlife managers who are responsible for conserving this species. The University of Arizona (UA) has conducted a multiyear surveying and monitoring effort for jaguars and ocelots in southern Arizona and New Mexico. The purpose of this work was to establish an effective surveying and monitoring system for jaguars along the United States-Mexico border. Surveying and monitoring in this study focused on the United States side of the border, but the methods could also be used in Mexico. The intent was to develop and implement a surveying and monitoring system that would provide the greatest probability of recording jaguar presence in, and passage through, the border area.
Supplement No. 6 to the Safety Evaluation Report (SER) related to the operation of the Tennessee Valley Authority's Sequoyah Nuclear Plant, Units 1 and 2, located in Hamilton County, Tennessee, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The purpose of this supplement is to update the staff's evaluations of the issues related to the hydrogen mitigation system identified in the SER and previous supplements as needing resolution
Omernik, James M.; Griffith, Glenn E.
A map of ecological regions of the conterminous United States, first published in 1987, has been greatly refined and expanded into a hierarchical spatial framework in response to user needs, particularly by state resource management agencies. In collaboration with scientists and resource managers from numerous agencies and institutions in the United States, Mexico, and Canada, the framework has been expanded to cover North America, and the original ecoregions (now termed Level III) have been refined, subdivided, and aggregated to identify coarser as well as more detailed spatial units. The most generalized units (Level I) define 10 ecoregions in the conterminous U.S., while the finest-scale units (Level IV) identify 967 ecoregions. In this paper, we explain the logic underpinning the approach, discuss the evolution of the regional mapping process, and provide examples of how the ecoregions were distinguished at each hierarchical level. The variety of applications of the ecoregion framework illustrates its utility in resource assessment and management.
Gielen, C.C.A.M.; Haar Romeny, B.M. ter; Gon, J.J.D. van der
Critical firing levels (CFLs) of single motor units (MUs) in the long head of the human biceps brachii muscle were determined in combinations of two isometric tasks: flexion of the elbow, supination of the lower arm, and exorotation of the humerus, as well as the corresponding antagonistic tasks.
This study intends to compare and contrast student and school factors that are associated with students' mathematics self-efficacy in the United States and China. Using hierarchical linear regressions to analyze the Programme for International Student Assessment (PISA) 2012 data, this study compares math self-efficacy, achievement, and variables…
Supplement No. 3 to the Safety Evaluation Report of Long Island Lighting Company's application for a license to operate the Shoreham Nuclear Power Station, Unit 1, located in Suffolk County, New York, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement addresses several items that have come to light since the previous supplement was issued
Curtis, David F.; Hamilton, Richard J.; Moore, Dennis W.; Pisecco, Stewart
This investigation examined the relationship between teachers' beliefs and their preferences for classroom interventions for behaviours consistent with attention-deficit/hyperactivity disorder (ADHD). Teacher ratings of intervention acceptability, effectiveness, and rate of change were compared across United States and New Zealand samples. Beliefs…
This Draft Environmental Statement contains the second assessment of the environmental impact associated with Beaver Valley Power Station Unit 2 pursuant to the National Environmental Policy Act of 1969 (NEPA) and Title 10 of the Code of Federal Regulations, Part 51, as amended, of the Nuclear Regulatory Commission regulations. This statement examines the environment, environmental consequences and mitigating actions, and environmental benefits and costs
post traumatic stress disorder ( PTSD ) and depression (MDD) than...United States Several epidemiological studies have been conducted on the prevalence of post traumatic stress disorder ( PTSD ) and major depression in...forms contain the same 4-item screener for post - traumatic stress disorder ( PTSD ). This screener was developed by the National Center for PTSD and
Supplement No. 4 to the Safety Evaluation Report related to the operation of the Wolf Creek Generating Station, Unit No. 1 updates the information contained in the Safety Evaluation Report, dated April 1982 and Supplements 1, 2, and 3, dated August 1982, June 1983 and August, 1983, respectively. Supplement No. 4 addresses open issues, confirmatory items and addresses Board Notifications. The Safety Evaluation and its supplements pertain to the application for a license to operate the Wolf Creek Generating Station, Unit No. 1 filed by Kansas Gas and Electric Company on February 19, 1980. The Construction Permit No. CPPR-147 was issued on May 17, 1977
Supplement No. 8 to the Safety Evaluation Report related to Commonwealth Edison Company's application for licenses to operate the Byron Station, Units 1 and 2, located in Rockvale Township, Ogle County, Illinois, has been prepared by th Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement provides recent information regarding resolution of the license conditions identified in the SER. Because of the favorable resolution of the items discussed in this report, the staff concludes that the Byron Station, Unit 2 can be operated by the licensee at power levels greater than 5% without endangering the health and safety of the public
Acosta-Maldonado, Brenda; Sánchez-Ramírez, Blanca; Reza-López, Sandra; Levario-Carrillo, Margarita
It is known that pesticides cross the placental barrier and can cause alterations in the development of placental structures resulting in adverse effects in reproduction. The objectives of this study were to investigate the effects of pesticide exposure during pregnancy on placental maturity and to evaluate the relationship between placental maturity, gestational age and birth weight. We collected the placentas from singleton pregnancies from women exposed (n = 9) and non-exposed (n = 45 full-term and n = 31 preterm) to pesticides as evaluated geographically, by questionnaire and by acetylcholinesterase levels. Placental morphometry from the central and peripheral regions was examined by microscopy and staining with hematoxylin and eosin. The placental maturity index (PMI) was estimated by dividing the number of epithelial plates in terminal villi to their thickness in 1 mm(2) of the placental parenchyma. Gestational age, birth weight and the following characteristics of the mother were also recorded: pre-pregnancy body mass index, weight gain during pregnancy and hemoglobin concentrations. Birth weight and the gestational age were correlated with PMI (r = .54 and r = .44, respectively; p Pesticide exposure was associated with a higher PMI (beta = 7.38, p = .01) after adjusting by variables related to placental maturity. In conclusion, the results suggest a relationship between prenatal exposure to pesticides and placental maturity and may potentially affect the nutrient transport from the mother to the fetus.
Full Text Available El escorpión mexicano Heloderma horridum es una de las 2 especies de lagartijas venenosas que se conocen en el mundo; hay 3 subespecies, todas en una distribución muy localizada, a lo largo de la costa del Pacífico. En la parte suroeste de Durango, en el río Presidio, un grupo de técnicos topógrafos observaron un ejemplar de Heloderma horridum y tomaron fotografías, las cuales aportaron al autor de esta nota, quien por medio de claves determinó la especie. Se trata de una especie que se considera amenazada dentro de la NOM-ECOL-059-2001, razón por la cual no se recolectó. Este registro amplía la distribución de la especie hacia el suroeste de la sierra Madre Occidental y confirma su presencia en el estado de Durango, México.The Beaded Mexican Reptile is one of the 2 species recognized as venomous reptiles in the world. There are known 3 subspecies of Heloderma horridum, all show a very localized distribution, along the Pacific Coast. At the Southwestern part of Durango, this species was seen at the river Presidio. One specimen of Heloderma horridum, was observed and photographed, by a group of topography technical, who donated the pictures. By using taxonomic keys, the specimen was determined as Heloderma horridum. This species is registered in NOM-ECOL-059-2001, and is considered Amazing species, so the specimen was not collected. This is new registration, broads the geographical distribution of this taxon towards the southwestern of the Sierra Madre Occidental and its presence in Durango state, Mexico.
Despins, Laurel A
This study examines what prompts the intensive care unit (ICU) nurse to go to the patient's bedside to investigate an alarm and the influences on the nurse's determination regarding how quickly this needs to occur. A qualitative descriptive design guided data collection and analysis. Individual semi-structured interviews were conducted. Thematic analysis guided by the Patient Risk Detection Theoretical Framework was applied to the data. Four specialty intensive care units in an academic medical center. ICU nurses go the patient's bedside in response to an alarm to catch patient deterioration and avert harm. Their determination of the immediacy of patient risk and their desire to prioritize their bedside investigations to true alarms influences how quickly they proceed to the bedside. Ready visual access to physiological data and waveform configurations, experience, teamwork, and false alarms are important determinants in the timing of ICU nurses' bedside alarm investigations. Copyright © 2017 Elsevier Ltd. All rights reserved.
During the late 1950s and the 1960s America faced a high level of racial tension. At the same time Britain imposed racially discriminatory immigration controls and passed legislation to outlaw racial discrimination. This thesis asks to what extent the events in the United States had an impact on the response of British institutions to the development of a multi-racial society and increased rate of non-white immigration during these crucial years between the 1958 race riots to t...
Gr?nebaum, Amos; McCullough, Laurence B.; Arabin, Birgit; Brent, Robert L.; Levene, Malcolm I.; Chervenak, Frank A.
Introduction Over the last decade, planned home births in the United States (US) have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status. Purpose The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of...
This report, Supplement No. 4 to the Safety Evaluation Report for the application filed by the Duquesne Light Company et al. (the applicant) for a license to operate the Beaver Valley Power Station, Unit 2 (Docket No. 50-412), has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports the status of certain items that had not been resolved when the Safety Evaluation Report and its Supplements 1, 2, and 3 were published
examines the extent to which the Army has (1) assessed the costs and benefits of Pacific Pathways; and (2) synchronized plans and incorporated ... costs . Such an analysis could both: • incorporate financial and non-financial costs and benefits of the initiative, to include readiness benefits for... logistics and sustainment units, any training efficiencies or cost avoidance resulting from Pacific Pathways, and non-financial costs , such as
This report, Supplement No. 1 to the Safety Evaluation Report for the application filed by the Duquesne Light Company et al. (the applicant) for a license to operate the Beaver valley Power Station, Unit 2 (Docket No. 50-412), has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports the status of certain items that had not been resolved at the time the Safety Evaluation Report was published
This Draft Environmental Statement contains the second assessment of the environmental impact associated with the operation of Millstone Nuclear Power Station, Unit 3, pursuant to the National Environmental Policy Act of 1969 (NEPA) and Title 10 of the Code of Federal Regulations, Part 51, as amended, of the Nuclear Regulatory Commission regulations. This statement examines the environment, environmental consequences and mitigating actions, and environmental and economic benefits and costs
Supplement 10 (SSER 10) to the Safety Evaluation Report on Long Island Lighting Company's application for a license to operate the Shoreham Nuclear Power Station, Unit 1, located in Suffolk County, New York, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement addresses several items that have been reviewed by the staff since the previous supplement was issued
In April 1986 the staff of the US Nuclear Regulatory Commission issued its Safety Evaluation Report (NUREG-0781) regarding the application of Houston Lighting and Power Company (applicant and agent for the owners) for a license to operate South Texas Project, Units 1 and 2 (Docket Nos. 50-498 and 50-499). The facility is located in Matagorda County, Texas, west of the Colorado River, 8 miles north-northwest of the town of Matagorda and about 89 miles southwest of Houston. The first supplement to NUREG-0781 was issued in September 1986, the second supplement in January 1987, the third supplement in May 1987, the fourth supplement in July 1987, the fifth supplement in March 1988, and the sixth supplement in January 1989. This seventh supplement, which supports the issuance of a full-power license for Unit 2, provides updated information on the issues that had been considered previously as well as the evaluation of issues that have arisen since the sixth supplement was issued. The evaluation resolves all the issues necessary to support the issuance of a full-power license for Unit 2. 2 refs., 2 figs., 1 tab
Kim, J. O.; Kim, J. K.
Relative power density distributions of the Kori unit 1 pressurized water reactor calculated by Monte Carlo modeling with the MCNP code. The Kori unit 1 core is modeled on a three-dimensional representation of the one-eighth of the reactor in-vessel component with reflective boundaries at 0 and 45 degrees. The axial core model is based on half core symmetry and is divided into four axial segments. Fission reaction density in each rod is calculated by following 100 cycles with 5,000 test neutrons in each cycle after starting with a localized neutron source and ten noncontributing settle cycles. Relative assembly power distributions are calculated from fission reaction densities of rods in assembly. After 100 cycle calculations, the system coverages to a κ value of 1.00039 ≥ 0.00084. Relative assembly power distribution is nearly the same with that of the Kori unit 1 FSAR. Applicability of the full-scope Monte Carlo simulation in the power distribution calculation is examined by the relative root mean square error of 2.159%. (author)
Baker, John I; Griffin, Russell; Brauneis, Paul F; Rue, Loring W; McGwin, Gerald
The purpose of the study was to compare tubing-related injuries to wakeboarding- and water skiing-related injuries. Data was collected from the 2000-2007 National Electronic Injury Surveillance Survey for 1,761 individuals seeking care at an emergency department due to a tubing-, wakeboarding, or water skiing-related injury. Data included patient age and sex, as well as injury characteristics including body region injured (i.e., head and neck, trunk, shoulder and upper extremity, and hip and lower extremity) and diagnosis of injury (e.g., contusion, laceration, or fracture). Case narratives were reviewed to ensure that a tubing-, wakeboarding-, or water skiing-related injury occurred while the individual was being towed behind a boat. Severe injury (defined as an injury resulting in the individual being hospitalized, transferred, held for observation) was compared among the groups using logistic regression. Wakeboard- and tubing-related injuries more commonly involved the head and neck, while water skiing- related injuries were likely to involve the hip and lower extremity. Tubing-related injuries, compared to water skiing-related injuries, were more likely to be severe (OR 2.31, 95% CI 1.23-4. 33). Like wakeboarding and water skiing, tubing has inherent risks that must be understood by the participant. While tubing is generally considered a safer alternative to wakeboarding and water skiing, the results of the current study suggest otherwise. Both the number and severity of tubing- related injuries could be prevented through means such as advocating the use of protective wear such as helmets while riding a tube or having recommended safe towing speeds prominently placed on inner tubes. Key pointsIncrease annual injury rate trend in wakeboard injuries.Wakeboard- and tubing-related injuries more often to head and neck, waterskiing-related injuries more often to hip and lower extremity.Tubing-related injuries over 2-times as likely to be severe compared to
This report, Supplement No. 5 to the Safety Evaluation Report for the application filed by the Duquesne Light Company et al. (the applicant) for a license to operate the Beaver Valley Power Station, Unit 2 (Docket No. 50-412), has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports the status of certain items that had not been resolved when the Safety Evaluation Report and its Supplements 1, 2, 3, and 4 were published
Supplement No. 2 to the Safety Evaluation Report on the application filed by Illinois Power Company, Soyland Power Cooperative, Inc., and Western Illinois Power Cooperative, Inc., as applicants and owners, for a license to operate the Clinton Power Station, Unit No. 1, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located in Harp Township, DeWitt County, Illinois. This supplement reports the status of certain items that had not been resolved at the time of publication of the Safety Evaluation Report and Supplement No. 1
Supplement No. 8 to the Safety Evaluation Report on the application filed by Illinois Power Company, Soyland Power Cooperative, Inc., and Western Illinois Power Cooperative, Inc., as applicants and owners, for a license to operate the Clinton Power Station, Unit No. 1, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located in Harp Township, DeWitt County, Illinois. This supplement reports the status of items that have been resolved by the staff since Supplement No. 7 was issued
The Safety Evaluation Report for the application filed by Northeast Nuclear Energy Company, as applicant and agent for the owners, for a license to operate the Millstone Nuclear Power Station Unit 3 (Docket No. 50-423), has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located in the town of Waterford, New London County, Connecticut, on the north shore of Long Island Sound. Subject to favorable resolution of the items discussed in this report, the NRC staff concludes that the facility can be operated by the applicant without endangering the health and safety of the public
This Safety Evaluation Report on the application filed by Duquesne Light Company, as applicant and agent for the owners, for a license to operate the Beaver Valley Power Station Unit 2 (Docket No. 50-412) has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located in Shippingport Borough, Beaver County, Pennsylvania, on the south bank of the Ohio River. Subject to the favorable resolution of the items discussed in this report, the staff concludes that the facility can be operated by the applicant without endangering the health and safety of the public
Supplement 10 to the Safety Evaluation Report for the application filed by Louisiana Power and Light Company for a license to operate the Waterford Steam Electric Station, Unit 3 (Docket No. 50-382), located in St. Charles Parish, Louisiana, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The purpose of this supplement is to update the Safety Evaluation Report by providing the staff's evaluation of information submitted by the licensee since the Safety Evaluation Report and its nine previous supplements were issued
The Safety Evaluation Report issued in August 1984 provided the results of the NRC staff review of Northeast Nuclear Energy Company's application for a license to operate the Millstone Nuclear Power Station, Unit No. 3. Supplement No. 1 to that report, issued in March 1985 updated the information contained in the Safety Evaluation Report and addressed the ACRS Report issued on September 10, 1984. The Report, Supplement No. 2 updates the information contained in the Safety Evaluation Report and Supplement No. 1 and addresses prior unresolved items. The facility is located in Waterford Township, New London, Connecticut. 11 refs., 9 tabs
This report, Supplement No. 6 to the Safety Evaluation Report for the application filed by the Duquesne Light Company et al. (the licensee) for a license to operate the Beaver Valley Power Station, Unit 2 (Docket No. 50-412), has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports the status of certain items that had not been resolved when the Safety Evaluation Report and its Supplements 1, 2, 3, 4, and 5 were published
The following thesis applies Icek Ajzen's Theory of Planned Behavior to explain consumer and government response to safety of Chinese-made products sold in China and the United States. The thesis relies on secondary data as it considers the responses and actions relative to product safety by four different groups: Chinese government, U.S. government, Chinese consumers and U.S. consumers. Increased globalization has heightened the need for a better understanding and agreement...
Supplement No. 3 to the Safety Evaluation Report related to Commonwealth Edison Company's application for licenses to operate the Byron Station, Units 1 and 2, located in Rockvale Township, Ogle County, Illinois, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports the status of certain items that had not been resolved at the time of publication of the Safety Evaluation Report
Supplement No. 2 to the Safety Evaluation Report related to Commonwealth Edison Company's application for licenses to operate the Byron Station, Units 1 and 2, located in Rockvale Township, Ogle County, Illinois, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports the status of certain items that had not been resolved at the time of publication of the Safety Evaluation Report
Supplement No. 4 to the Safety Evaluation Report related to Commonwealth Edison Company's application for licenses to operate the Byron Station, Units 1 and 2, located in Rockvale Township, Ogle County, Illinois, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports the status of certain items that had not been resolved at the time of publication of the Safety Evaluation Report
The final environmental statement contains the second assessment of the environmental impact associated with operation of Callaway Plant Unit 1, pursuant to the National Environmental Policy Act of 1969 (NEPA) and 10 CFR Par 51, as amended, of the NRC's regulations. This statement examines: the purpose and need for the Callaway project, alternatives to the project, the affected environment, environmental consequences and mitigating actions, and environmental and economic benefits and costs. No water-use impacts are expected from cooling-tower markup withdrawn from, or blowdown discharged into, the Missouri River. Land-use and terrestrial- and aquatic-ecological impacts will be small. Air-quality impacts from cooling-tower drift and other emissions and dust will also be small. Impacts to historic and prehistoric sites will be negligible with the development and implementation of the applicant's cultural-resources management plan. No significant impacts are anticipated from normal operational releases of radioactivity. The risk associated with accidental radiation exposure is very low. The net socioeconomic effects of the project will be beneficial. The action called for is the issuance of an operating license for Unit 1 of the Callaway Plant. 18 figs., 16 tabs
In April 1986 the staff of the US Nuclear Regulatory Commission issued its Safety Evaluation Report (NUREG-0781) regarding the application of Houston Lighting and Power Company (applicant and agent for the owners) for a license to operate South Texas Project, Units 1 and 2 (Docket Nos. 50-498 and 50-499). The facility is located in Matagorda County, Texas, west of the Colorado River, 8 miles north-northwest of the town of Matagorda and about 89 miles southwest of Houston. The first supplement to NUREG-0781 was issued in September 1986, the second supplement in January 1987, the third supplement in May 1987, the fourth supplement in July 1987 and the fifth supplement in March 1988. This sixth supplement provides updated information on the issues that had been considered previously as well as the evaluation of issues that have arisen since the fifth supplement was issued. The evaluation resolves all the issues necessary to support the issuance of a low-power license for Unit 2
This Final Environmental Statement contains the second assessment of the environmental impact associated with the operation of Millstone Nuclear Power Station, Unit 3, pursuant to the National Environmental Policy Act of 1969 (NEPA) and Title 10 of the Code of Federal Regulations, Part 51, as amended, of the Nuclear Regulatory Commission regulations. This statement examines the environment, environmental consequences and mitigating actions, and environmental and economic benefits and costs. Land use and terrestrial and aquatic ecological impacts will be small. Operational impacts to historic and archeologic sites will be small. The effects of routine operations, energy transmission, and periodic maintenance of rights-of-way and transmission facilities should not jeopardize any populations of endangered or threatened species. No significant impacts are anticipated from normal operational releases of radioactivity. The risk of radiation exposure associated with accidental release of radioactivity is very low. The net socioeconomic effects of the project will be beneficial. On the basis of the analysis and evaluation set forth in this environmental statement, it is concluded that the action called for under NEPA and 10 CFR 51 is the issuance of an operating license for Millstone Nuclear Power Station, Unit 3. 101 references, 33 figures, 30 tables
Westerhof, Gerben J; Whitbourne, Susan Krauss; Freeman, Gillian P
To study the aging self, that is, conceptions of one's own aging process, in relation to identity processes and self-esteem in the United States and the Netherlands. As the liberal American system has a stronger emphasis on individual responsibility and youthfulness than the social-democratic Dutch system, we expect that youthful and positive perceptions of one's own aging process are more important in the United States than in the Netherlands. Three hundred and nineteen American and 235 Dutch persons between 40 and 85 years participated in the study. A single question on age identity and the Personal Experience of Aging Scale measured aspects of the aging self. The Identity and Experiences Scale measured identity processes and Rosenberg's scale measured self-esteem. A youthful age identity and more positive personal experiences of aging were related to identity processes and self-esteem. These conceptions of one's own aging process also mediate the relation between identity processes and self-esteem. This mediating effect is stronger in the United States than in the Netherlands. As expected, the self-enhancing function of youthful and positive aging perceptions is stronger in the liberal American system than in the social-democratic Dutch welfare system. The aging self should therefore be studied in its cultural context.
John I. Baker
Full Text Available The purpose of the study was to compare tubing-related injuries to wakeboarding- and water skiing-related injuries. Data was collected from the 2000-2007 National Electronic Injury Surveillance Survey for 1,761 individuals seeking care at an emergency department due to a tubing-, wakeboarding, or water skiing-related injury. Data included patient age and sex, as well as injury characteristics including body region injured (i.e., head and neck, trunk, shoulder and upper extremity, and hip and lower extremity and diagnosis of injury (e.g., contusion, laceration, or fracture. Case narratives were reviewed to ensure that a tubing-, wakeboarding-, or water skiing-related injury occurred while the individual was being towed behind a boat. Severe injury (defined as an injury resulting in the individual being hospitalized, transferred, held for observation was compared among the groups using logistic regression. Wakeboard- and tubing-related injuries more commonly involved the head and neck, while water skiing- related injuries were likely to involve the hip and lower extremity. Tubing-related injuries, compared to water skiing-related injuries, were more likely to be severe (OR 2.31, 95% CI 1.23-4. 33. Like wakeboarding and water skiing, tubing has inherent risks that must be understood by the participant. While tubing is generally considered a safer alternative to wakeboarding and water skiing, the results of the current study suggest otherwise. Both the number and severity of tubing- related injuries could be prevented through means such as advocating the use of protective wear such as helmets while riding a tube or having recommended safe towing speeds prominently placed on inner tubes
McLeod, Carmen; Hobson-West, Pru
The use of animals in scientific research represents an interesting case to consider in the context of the contemporary preoccupation with transparency and openness in science and governance. In the United Kingdom, organisations critical of animal research have long called for more openness. More recently, organisations involved in animal research also seem to be embracing transparency discourses. This article provides a detailed analysis of publically available documents from animal protection groups, the animal research community and government/research funders. Our aim is to explore the similarities and differences in the way transparency is constructed and to identify what more openness is expected to achieve. In contrast to the existing literature, we conclude that the slipperiness of transparency discourses may ultimately have transformative implications for the relationship between science and society and that contemporary openness initiatives might be sowing the seeds for change to the status quo. © The Author(s) 2015.
McLeod, Carmen; Hobson-West, Pru
The use of animals in scientific research represents an interesting case to consider in the context of the contemporary preoccupation with transparency and openness in science and governance. In the United Kingdom, organisations critical of animal research have long called for more openness. More recently, organisations involved in animal research also seem to be embracing transparency discourses. This article provides a detailed analysis of publically available documents from animal protection groups, the animal research community and government/research funders. Our aim is to explore the similarities and differences in the way transparency is constructed and to identify what more openness is expected to achieve. In contrast to the existing literature, we conclude that the slipperiness of transparency discourses may ultimately have transformative implications for the relationship between science and society and that contemporary openness initiatives might be sowing the seeds for change to the status quo. PMID:26009149
Mondillon, Laurie; Niedenthal, Paula M; Brauer, Markus; Rohmann, Anette; Dalle, Nathalie; Uchida, Yukiko
This research examined the concept of power in Japan, France, Germany, and the United States, as well as beliefs about the emotions persons in power tend to elicit in others and about powerful people's regulation (specifically, inhibition) of certain emotions. Definitions of power were assessed by examining the importance of two main components: control over self versus other and freedom of action vis-à-vis social norms. Beliefs about both positive (pride, admiration) and negative (jealousy, contempt) emotions were measured. Analyses revealed that the concept of power differed across countries and that the definitions of power as well as country of origin significantly predicted beliefs about the emotions that are elicited in others by powerful people and also the regulation of expression of emotion by powerful people.
Twedt, Robert M.; Spaulding, Procter L.; Hall, Herbert E.
Morphological, cultural, biochemical, and serological characteristics of 79 strains of Vibrio parahemolyticus isolated from patients suffering from gastroenteric disease in Japan were compared with 17 suspected V. parahemolyticus cultures isolated from wound infections and 14 nonpathogenic vibrios isolated from an estuarine environment in the United States. These groups were differentiated on the basis of several key reactions which included: the range of growth temperature and salt tolerance; the production of catalase and acetoin; the hydrolysis of starch; the fermentation and utilization as single carbon source of sucrose, cellobiose, and arabinose; and the ability to swarm on 1% agar. The separation of the groups on the basis of cultural and biochemical analyses was confirmed by means of slide agglutinations with specific anti-K antisera. The results of this study strongly suggest that the wound infection isolates are V. parahemolyticus species which are easily distinguished from the nonpathogenic estuarine vibrios. PMID:5784207
Twedt, R M; Spaulding, P L; Hall, H E
Morphological, cultural, biochemical, and serological characteristics of 79 strains of Vibrio parahemolyticus isolated from patients suffering from gastroenteric disease in Japan were compared with 17 suspected V. parahemolyticus cultures isolated from wound infections and 14 nonpathogenic vibrios isolated from an estuarine environment in the United States. These groups were differentiated on the basis of several key reactions which included: the range of growth temperature and salt tolerance; the production of catalase and acetoin; the hydrolysis of starch; the fermentation and utilization as single carbon source of sucrose, cellobiose, and arabinose; and the ability to swarm on 1% agar. The separation of the groups on the basis of cultural and biochemical analyses was confirmed by means of slide agglutinations with specific anti-K antisera. The results of this study strongly suggest that the wound infection isolates are V. parahemolyticus species which are easily distinguished from the nonpathogenic estuarine vibrios.
Full Text Available Contemporary authors often overstate the differences within the human rights regimes in the Russian Federation and the United States. This article is meant to provide insight into why the two systems, although taking markedly different developmental paths, have come to be far more similar than is often realized. The first question raised is, how did the two human rights systems develop historically? The next question is, how did the Universal Declaration of Human Rights and its subsequent split into two separate Covenants affect the rights within each system? The third question raised is, what modern advancements have taken place within each system? And finally, what failures within each system are also demonstrative of similarities within the two systems? Thus, the article begins by tracing historical developments within the two systems in order to elucidate regional variances that exist, and to explain how such variance materialized. Next, the article will provide concrete examples by comparing specific rights – such as the right to a public education, the right to social security, the right to participate in political life, and the right to privately own land – in order to provide some insight into why the author believes the differences in the two systems are often overstated by commentators. Finally, the article will explore some shortcomings that also share marked similarities within both systems. The article concludes that while the human rights regimes within Russia and the United States took markedly different paths during their development, and have relied on vastly different political and social situations during their evolution, they have ultimately reached a much greater level of maturity and protection under the law than is often given credit.
Full Text Available Background and Aim: Possible associations between depressive symptoms and work-related parameters have frequently been discussed in the literature. The present study was aimed to evaluate the work-related depressive symptoms and their possible-related parameters among male employees of Esfahan Steel Company (ESCO as one of the most important industrial sites in Iran. Materials and Methods: With a cross-sectional design and a stratified random sampling method in 2010, a total of 400 male employees were enrolled from the operational parts of the ESCO. Results: Among 400 participated employees, 245 (61.3% were rotational duty employees and 358 (89.5% were reported making <$500. After applying the linear regression model, some variables including: economic difficulties (P = 0.022, odds ratio [OR] = 0.558, 95% confidence interval [CI] =0.339–0.919, family-related problems (P = 0.003, OR = 0.303, 95% CI = 0.138–0.669, and work environment (P < 0.001, OR = 0.244, 95% CI = 0.140–0.426 were found to be significantly associated with higher depressive symptoms among the participants. Conclusion: The present study brought to light the predictors of occupational depressive symptoms among blue-collar employees of ESCO. More research is needed to find the causal relations between mental health and work-related parameters among Iranian employees.
Full Text Available Over the last decade, planned home births in the United States (US have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status.The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States.This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM, nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board.Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53 than home births attended by certified midwives (NNM: 10.0/10,000; RR 1 and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]. The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2.This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal
Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Brent, Robert L; Levene, Malcolm I; Chervenak, Frank A
Over the last decade, planned home births in the United States (US) have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status. The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States. This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life) in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams) without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM), nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board. Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53) than home births attended by certified midwives (NNM: 10.0/10,000; RR 1) and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]). The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2). This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal mortality rates
Han, Kihye; Trinkoff, Alison M; Gurses, Ayse P
To examine the relationships of work-related factors (e.g., autonomy, work schedule, supervisory and peer support) to nurses' job satisfaction and intent to leave their current position. Low job satisfaction and high turnover of nurses are major problems for health care. To improve nurse retention, work-related factors associated with job satisfaction and intent to leave should be investigated. A cross-sectional secondary data analysis. Data were obtained in 2004 from Wave 3 of the Nurses' Worklife and Health Study. A random sample of 5000 actively licenced nurses in Illinois and North Carolina (two U.S. states) were sent the survey in wave 1, of which 1641 actively working bedside nurses participated in wave 3. We examined associations of various work-related factors with job satisfaction and intent to leave the current position. Nurses who were dissatisfied with their job reported significantly higher psychological demands and lower autonomy than nurses who were satisfied. Nurses were significantly less satisfied with their jobs when they worked longer hours with inadequate breaks or sick days. Lack of support from peers and supervisors was also related to significantly lower odds of job satisfaction. For intention to leave, nurses who said they planned to leave their current job reported significantly lower autonomy and less support from their peers than nurses who intended to stay. A variety of modifiable work-related factors were significantly related to job satisfaction and intention to leave the current job among nurses. Future research should focus on developing interventions that could mitigate these factors (e.g., by improving work schedules, increasing autonomy and/or nurse support). The impact of such interventions on job satisfaction and intention to leave the current position could then be evaluated. To increase nurse retention, improved schedules, autonomy and supportive work environments should be promoted. © 2015 John Wiley & Sons Ltd.
Rees, A M; Rothenberg, L; Denison, B
THE PRESENT SYSTEM OF EDUCATION FOR MEDICAL LIBRARY PRACTICE IN THE UNITED STATES CONSISTS OF FOUR MAJOR COMPONENTS: graduate degree programs in library science with specialization in medical librarianship; graduate degree programs in library science with no such specialization; postgraduate internships in medical libraries; continuing education programs. Data are presented illustrating the flow of graduates along these several educational pathways into medical library practice.The relevance of these educational components to the current medical library work force is discussed with reference to manpower data compiled for Ohio. The total number of medical library personnel in Ohio in 1968 is 316. Of this total, only forty-two (approximately 14 percent) have received any formal library training. Seventy persons have only a high school education. From these figures, it is concluded that there is no standard or essential qualification which is universally accepted as educational preparation for work in medical libraries; that the comparative sophistication of the educational programs in medical librarianship has yet to be reflected widely in general medical library practice; that an increasingly large number of non-professional or ancillary personnel are being, and will continue to be, utilized in medical libraries; that large numbers of untrained persons have sole responsibility for medical libraries; and that appropriate educational programs will have to be designed specifically for this type of personnel.
Patel, Minal R; Caldwell, Cleopatra H; Song, Peter X K; Wheeler, John R C
Given the complexity of the health insurance market in the United States and the confusion that often stems from these complexities, patient perception about the value of health insurance in managing chronic disease is important to understand. To examine differences between public and private health insurance in perceptions of financial burden with managing asthma, outcomes, and factors that explain these perceptions. Secondary analysis was performed using baseline data from a randomized clinical trial that were collected through telephone interviews with 219 African American women seeking services for asthma and reporting perceptions of financial burden with asthma management. Path analysis with multigroup models and multiple variable regression analyses were used to examine associations. For public (P financial burden through different explanatory pathways. When adjusted for multiple morbidities, asthma control, income, and out-of-pocket expenses, those with private insurance used fewer inpatient (P financial burden was associated with more urgent office visits (P financial burden regardless of health insurance report more urgent health care visits and lower quality of life. Burden may be present despite having and being able to generate economic resources and health insurance. Further policy efforts are indicated and special attention should focus on type of coverage. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Uresk, D.W.; Rickard, W.H.
The study area is the Arid Lands Ecology (ALE) Reserve, a portion of the United States Energy Research and Development Administration's Hanford Reservation located in the semi-arid region of south-central Washington. Small experimental pastures were subjected to four consecutive years of moderate spring grazing by yearling steers. These pastures are unique in that they represent grazing stresses imposed upon previously ungrazed (by livestock) plant communities. These communities had been protected from grazing by livestock for more than 30 years under ERDA management. Bluebunch wheatgrass (Agropyron spicatum), the dominant species, was the major forage plant in the diet of the steers during the 1974 grazing season, followed by Cusick's bluegrass (Poa cusickii), Thurber's needlegrass (Stipa thurberiania) and hawksbeard (Crepis atrabarba). These four species made up approximately 93% of the total diet. The forage intake ranged from 9.9 kg/head daily to 10.9 kg/head daily during the grazing season. During this period, these steers gained a total of 21.6 kg/ha live weight. Fifteen kg of forage consumed produces 1 kg of live steer for a 6.7% conversion. The conversion rate for crude protein was 12.7%, 83.3% for phosphorus and 25.6% for calcium. (author)
Shaun M. Tanger
Full Text Available In recent years, specialty license plates have become an increasingly popular way to raise awareness and show support for a myriad of issues with which the plate is linked. Several states and various organizations that provide forestry education have developed forestry license plates. Vehicle owners can purchase the plates to show their support towards forestry by buying the forestry license plates, which generates revenue for the provider organization. Using county-level data from five states in the Southeastern United States, a statistical model was developed to examine explanatory factors of forestry-based specialty license plate sales in 2014. Using linear count regression modeling, we observed that the significant predictor variables of plate sales were income per capita, population density, the percentage of acres that are forested in the county, acres of forest in the county that are privately owned, percentage of people who are 65 or older, and presence of the forest industry in the county. Plate sales were positively correlated with the presence of the forest industry in the county.
Schrödter, Erik; Brüggemann, Gert-Peter; Willwacher, Steffen
To describe the stretch-shortening behavior of ankle plantar-flexing muscle-tendon units (MTUs) during the push-off in a sprint start. Fifty-four male (100-m personal best: 9.58-12.07 s) and 34 female (100-m personal best: 11.05-14.00 s) sprinters were analyzed using an instrumented starting block and 2-dimensional high-speed video imaging. Analysis was performed separately for front and rear legs, while accounting for block obliquities and performance levels. The results showed clear signs of a dorsiflexion in the upper ankle joint (front block 15.8° ± 7.4°, 95% CI 13.2-18.2°; rear block 8.0° ± 5.7°, 95% CI 6.4-9.7°) preceding plantar flexion. When observed in their natural block settings, the athletes' block obliquity did not significantly affect push-off characteristics. It seems that the stretch-shortening-cycle-like motion of the soleus MTU has an enhancing influence on push-off force generation. This study provides the first systematic observation of ankle-joint stretch-shortening behavior for sprinters of a wide range of performance levels. The findings highlight the importance of reactive-type training for the improvement of starting performance. Nonetheless, future studies need to resolve the independent contributions of tendinous and muscle-fascicle structures to overall MTU performance.
Dillon, William P.; Danforth, W.W.; Hutchinson, D.R.; Drury, R.M.; Taylor, M.H.; Booth, J.S.
This paper is part of the special publication Gas hydrates: relevance to world margin stability and climatic change (eds J.P. Henriet and J. Mienert). An irregular, faulted, collapse depression about 38 x 18 km in extent is located on the crest of the Blake Ridge offshore from the south- eastern United States. Faults disrupt the sea floor and terminate or sole out about 40-500 m below the sea floor at the base of the gas hydrate stable zone, which is identified from the location of the bottom simulating reflection (BSR). Normal faults are common but reverse faults and folds also are widespread. Folds commonly convert upward into faults. Sediment diapirs and deposits of sediments that were erupted onto the sea floor are also present. Sea-floor depressions at faults may represent locations of liquid/gas vents. The collapse was probably caused by overpressures and by the decoupling of the overlying sediments by gassy muds that existed just beneath the zone of gas hydrate stability.
Orlandi, F.; Fornaciari, M.; Romano, B.
The aim of this study was to develop a practical method to evaluate the effective relationship between the amount of winter chilling and the response expressed as the spring reproductive re-starting dates in the olive ( Olea europaea L.). Two olive cultivars growing in a special olive orchard in Umbria (central Italy) were studied over a 3-year period (1998-2000): the cultivar Ascolana, typical of central Italy, and the cultivar Giarraffa, typical of southern Italy. The spring reproductive re-starts were assessed using data from detailed phenological observations made on 60 trees of each cultivar in an effort to establish the exact date of reproductive bud swelling. The chilling phenomenon was evaluated by using 341 functions derived from a formula developed by researchers at Utah State University to calculate chilling units. The mathematical functions are defined, and show the very close relationship between the amount of winter chilling and the spring reproductive response in the two cultivars in the orchard studied. The results can be used to define the relationship between local climate and plant development, and the mathematical approach can be used to draw maps that can show the suitability of different cultivars on the basis of local climatic conditions.
Loft, Mia I; Poulsen, Ingrid; Esbensen, Bente A
AIMS AND OBJECTIVES: To explore nurses' and nurse assistants' beliefs, attitudes and actions related to their function in an inpatient stroke rehabilitation unit. BACKGROUND: Several attempts have been made to describe nurses' roles and functions in inpatient neurorehabilitation. However, current...... understandings of the contributions that nurses and nurse assistants make to neurorehabilitation remain sparse. DESIGN: Descriptive, interpretive qualitative study. METHODS: Participant observations were conducted during 1 month in a stroke rehabilitation unit at a university hospital in the Capital Region...... stroke rehabilitation. We obtained insights into nursing staff's beliefs and attitudes about rehabilitation-as well as their own role and function-and furthermore how the latter affects their actions in daily practice. RELEVANCE TO CLINICAL PRACTICE: The nursing role and function are still not clearly...
Ticehurst, R L; Henry, R L
Behavioural problems in preschool (1-4 years) children are a common cause of referral to health services. Parents of children presenting to the child development unit with behavioural problems (n = 18) were compared with a control group (n = 45). A questionnaire was utilized to examine the parents' expectations of the children's behaviours. As might be expected, the parents of children presenting to the Unit rated their children as having more difficult behaviours. These parents had unrealistic expectations, particularly for the 'negative' behaviours (disobedience, temper tantrums, defiance and whinging). However, they were able to anticipate normal age-related difficulties in some problem areas (dawdling during mealtimes, masturbating, not sharing toys and being jealous of one's siblings). Counselling should address the issue of matching the expectations of parents with the individual rates of development of their children.
In April 1984 the staff of the Nuclear Regulatory Commission issued its Final Environmental Statement (NUREG-0974) related to the operation of Limerick Generating Station, Units 1 and 2, (Docket Nos. 50-352 and 50-353), located on the Schuylkill River, near Pottstown, in Limerick Township, Montgomery and Chester Counties, Pennsylvania. The NRC has prepared this supplement to NUREG-0974 to present its evaluation of the alternative of facility operation with the installation of further severe accident mitigation design features. The NRC staff has discovered no substantial changes in the proposed action as previously evaluated in the Final Environmental Statement that are relevant to environmental concerns nor significant new circumstances or information relevant to environmental concerns and bearing on the licensing of Limerick Generating Station, Units 1 and 2. 15 refs., 10 tabs
In September 1981, the staff of the Nuclear Regulatory Commission (NRC) issued its Final Environmental Statement (NUREG-0775) related to the operation of Comanche Peak Steam Electric Station, Units 1 and 2 (Docket Nos. 50-445 and 50-446), located in Somervell County, Texas, approximately 40 miles southwest of Fort Worth, Texas. The NRC has prepared this supplement to NUREG-0775 to present its evaluation of the alternative of operating Comanche Peak with the installation of further severe-accident-mitigation design features. The NRC has discovered no substantial changes in the proposed action as previously evaluated in the Final Environmental Statement that are relevant to environmental concerns and bearing on the licensing of Comanche Peak Steam Electric Station, Units 1 and 2. 6 refs., 3 tabs
This report supplements the Safety Evaluation Report related to the Operation of Midland Plant, Units 1 and 2 (SER) (NUREG-0793) issued in May 1982 by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission with respect to the application filed by Consumers Power Company, as applicant and owner, for licenses to operate the Midland Plant, Units 1 and 2 (Docket Nos. 50-329 and 50-330). The facility is located in the city of Midland in Midland County, Michigan. This supplement provides recent information regarding resolution of the soils settlement issue, one of the open items identified in the SER. Certain confirmatory issues identified in the SER also are addressed
Monuteaux, Michael C; Fleegler, Eric W; Lee, Lois K
Violent-related (assault) injuries are a leading cause of death and disability in the United States. Many violent injury victims seek treatment in the emergency department (ED). Our objectives were to (1) estimate rates of violent-related injuries evaluated in United States EDs, (2) estimate linear trends in ED visits for violent-related injuries from 2000 to 2010, and (3) to determine the associated health care and work-loss costs. We examined adults 18 years and older from a nationally representative survey (the National Hospital Ambulatory Medical Care Survey) of ED visits, from 2000 to 2010. Violent injury was defined using International Classification of Diseases-9th Rev.-Clinical Modification, diagnosis and mechanism of injury codes. We calculated rates of ED visits for violent injuries. Medical and work-loss costs accrued by these injuries were calculated for 2005, inflation-adjusted to 2011 dollars using the WISQARS Cost of Injury Reports. An annual average of 1.4 million adults were treated for violent injuries in EDs from 2000 to 2010, comprising 1.6% (95% confidence interval, 1.5%-1.6%) of all US adult ED visits. Young adults (18-25 years), men, nonwhites, uninsured or publically insured patients, and those residing in high poverty urban areas were at increased risk for ED visits for violent injury. The 1-year, inflation-adjusted medical and work-loss cost of violent-inflicted injuries in adults in the United States was US $49.5 billion. Violent injuries account for over one million ED visits annually among adults, with no change in rates over the past decade. Young black men are at especially increased risk for ED visits for violent injuries. Overall, violent-related injuries resulted in substantial financial and societal costs. Epidemiological study, level III.
Kiss Gabriella B.
Full Text Available The geology of the NE Hungarian Darnó Unit is rather complicated, as it is composed mostly of a Jurassic accretionary mélange complex, according to the most recent investigations. The magmatic and sedimentary rock blocks of the mélange represent products of different evolutionary stages of the Neotethys; including Permian and Triassic sedimentary rocks of marine rifting related origin, Triassic pillow basalt of advanced rifting related origin and Jurassic pillow basalt originated in back-arc-basin environment. This small unit contains a copper-gold occurrence in the Permian marly-clayey limestone, an iron enrichment in the Triassic sedimentary succession, a copper-silver ore occurrence in Triassic pillow basalts and a copper ore indication, occurring both in the Triassic and Jurassic pillow basalts. The present study deals with the Cu(-Ag occurrence in the Triassic basalt and the Fe occurrence in the Triassic sedimentary succession. The former shows significant similarities with the Michigan-type mineralizations, while the latter has typical characteristics of the Fe-SEDEX deposits. All the above localities fit well into the new geological model of the investigated area. The mineralizations represent the different evolutionary stages of the Neotethyan rifting and an epigenetic, Alpine metamorphism-related process and their recent, spatially close position is the result of the accretionary mélange formation. Thus, the Darnó Unit represents a perfect natural laboratory for studying and understanding the characteristic features of several different rifting related ore forming processes.
Siegelaar, Sarah E.; Barwari, Temo; Hermanides, Jeroen; van der Voort, Peter H. J.; Hoekstra, Joost B. L.; DeVries, J. Hans
Continuous glucose monitoring could be helpful for glucose regulation in critically ill patients; however, its accuracy is uncertain and might be influenced by microcirculation. We investigated the microcirculation and its relation to the accuracy of 2 continuous glucose monitoring devices in
Demissie, Zewditu; Brener, Nancy
Background: Mental health conditions among youth are a major concern. Schools can play an important role in supporting students affected by these conditions. This study examined district-level school health policies related to mental health and social services to determine if they varied by district demographic characteristics. Methods: The School…
Changes in policies and practices related to repeat cesareans and home birth in the U.S. have been influenced by different interpretations of the risk of poor outcomes. This article examines two cases-vaginal birth after cesarean (VBAC) and home birth to illustrate how an emphasis on relative over absolute risk has been used to characterize outcomes associated with these practices. The case studies will rely on reviews of the research literature and examination of data on birth trends and outcomes. Childbirth involves some unique challenges in assessing health risks, specifically the issues of: (1) timing of risks (lowering health risk in a current birth can increase it in subsequent births); (2) the potential weighing of risks to the mother's versus the infant's health; (3) the fact that birth is a condition of health and many of the feared outcomes (for example, symptomatic uterine rupture) involve very low absolute risk of occurrence; and (4) a malpractice environment that seizes upon those rare poor outcomes in highly publicized lawsuits that receive widespread attention in the clinical community. In the cases of VBAC and home birth, the result has been considerable emphasis on relative risks, typically an adjusted odds ratio, with little consideration of absolute risks. Assessments of the safety of interventions in childbirth should involve careful consideration and communication of the multiple dimensions of risk, particularly a balancing of relative and absolute risks of poor health outcomes.
Wing, Steve; Richardson, David; Wolf, Susanne; Mihlan, Gary
Health effects of working with plutonium remain unclear. Plutonium workers at the United States Department of Energy (US-DOE) Hanford Site in Washington State, USA were evaluated for increased risks of cancer and non-cancer mortality. Periods of employment in jobs with routine or non-routine potential for plutonium exposure were identified for 26,389 workers hired between 1944 and 1978. Life table regression was used to examine associations of length of employment in plutonium jobs with confirmed plutonium deposition and with cause specific mortality through 1994. Incidence of confirmed internal plutonium deposition in all plutonium workers was 15.4 times greater than in other Hanford jobs. Plutonium workers had low death rates compared to other workers, particularly for cancer causes. Mortality for several causes was positively associated with length of employment in routine plutonium jobs, especially for employment at older ages. At ages 50 and above, death rates for non-external causes of death, all cancers, cancers of tissues where plutonium deposits, and lung cancer, increased 2.0 +/- 1.1%, 2.6 +/- 2.0%, 4.9 +/- 3.3%, and 7.1 +/- 3.4% (+/-SE) per year of employment in routine plutonium jobs, respectively. Workers employed in jobs with routine potential for plutonium exposure have low mortality rates compared to other Hanford workers even with adjustment for demographic, socioeconomic, and employment factors. This may be due, in part, to medical screening. Associations between duration of employment in jobs with routine potential for plutonium exposure and mortality may indicate occupational exposure effects. Copyright 2004 Wiley-Liss, Inc.
Warren, R B; Halliday, A; Graham, C N; Gilloteau, I; Miles, L; McBride, D
Psoriasis causes work productivity impairment that increases with disease severity. Whether differential treatment efficacy translates into differential indirect cost savings is unknown. To assess work hours lost and indirect costs associated with secukinumab versus ustekinumab and etanercept in the United Kingdom (UK). This was a post hoc analysis of work impairment data collected in the CLEAR study (secukinumab vs. ustekinumab) and applied to the FIXTURE study (secukinumab vs. etanercept). Weighted weekly and annual average indirect costs per patient per treatment were calculated from (1) overall work impairment derived from Work Productivity and Activity Impairment data collected in CLEAR at 16 and 52 weeks by Psoriasis Area and Severity Index (PASI) response level; (2) weekly/annual work productivity loss by PASI response level; (3) weekly and annual indirect costs by PASI response level, based on hours of work productivity loss; and (4) weighted average indirect costs for each treatment. In the primary analysis, work impairment data for employed patients in CLEAR at Week 16 were used to compare secukinumab and ustekinumab. Secondary analyses were conducted at different timepoints and with patient cohorts, including FIXTURE. In CLEAR, 452 patients (67%) were employed at baseline. At Week 16, percentages of weekly work impairment/mean hours lost decreased with higher PASI: PASI hours; PASI 50-74: 13.3%/4.45 hours; PASI 75-89: 6.4%/2.14 hours; PASI ≥90: 4.9%/1.65 hours. Weighted mean weekly/annual work hours lost were significantly lower for secukinumab than ustekinumab (1.96/102.51 vs. 2.40/125.12; P=0.0006). Results were consistent for secukinumab versus etanercept (2.29/119.67 vs. 3.59/187.17; Ρreduced work impairment and associated indirect costs of psoriasis compared with ustekinumab and etanercept at Week 16 through 52 in the UK. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Kim, Sung Young; Kim, Young Bum; Lee, Won Sang
Protective coating inside nuclear power plants could find its origin from NRC Reg. Guide 1.82(Rev. 3) regarding current issue for the regulation of foreign materials inside containment building. The current issue for the regulation of foreign materials inside containment considered/determined the current issues only regarding the blockage of sump screen by foreign materials such as coating material, insulator, and other materials, while safety-related coating is separately managed by NRC Reg. Guide 1.54(Rev. 1). In this study, we performed field walk-down to evaluate the as-is condition of protective coating inside containment building which was classified as for structure and for equipment with applying the requirement for safety-related coating
Bhangal, K K; Neen, D; Dodds, R
To test the observation that the incidence of trampoline related pediatric fractures is increasing-both nationally and in a large district general hospital. A retrospective analysis was undertaken of patient records establishing mechanism of injury of pediatric fractures over three consecutive summers from 2000-03. Theatre records of fractures treated operatively were used as the initial data source. A statistically significant increase in trampoline related injuries was discovered. This reflects the rising incidence of injuries from national data and furthermore corresponds to the growing popularity of domestic use trampolines in the UK. The incidence of injuries is increasing. There are lessons to be learnt from existing work from countries where trampoline prevalence has been greater for longer. The authors recommend various safety measures that may reduce children's injuries.
The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related...
The geological sequences beneath ten British nuclear sites are extrapolated from the available data. Formations that are potentially suitable hosts for low and medium level radioactive waste are identified and their relative merits assessed. Of the sites investigated, formations beneath five afford little or no potential, formations beneath a further three offer only moderate potential and sites underlain by the most favourable formations are at Dounreay and Harwell. (author)
The geological sequences beneath a further twelve nuclear sites in Britain are predicted from available data. Formations that are potentially suitable hosts for low and medium-level radioactive waste are identified and their relative merits assessed. Of the sites investigated, formations beneath six afford little or no potential, formations beneath a further 4 offer only moderate potential and sites underlain by the most favourable formations are Dungeness and Hinkley Point. (author)
Padula, Cynthia A; Paradis, Heidi; Goodwin, Robert; Lynch, Judith; Hegerich-Bartula, Deborah
Medical devices have been identified as an extrinsic risk factor for development of pressure injuries, with as many as 30% to 70% of medical device-related pressure injuries resulting from respiratory equipment. This article describes a quality improvement project undertaken to reduce the occurrence of respiratory device-related pressure injuries in a critically care unit. Multiple actions were implemented to achieve this goal. Respiratory therapists were trained to document occurrences on a daily basis, and apparent cause analyses were conducted on each occurrence. An interdisciplinary team conducted biweekly rounds on patients with respiratory devices and consulted other professionals as indicated. Nurses and respiratory therapists attended an evidence-based, collaborative, educational offering and completed a measure of team functioning before the program and at the end of the study period. The occurrence rates of respiratory device-related pressure injuries were reduced over the project period, and these changes were sustained over the subsequent 12 months.
Baugher, Amy R; Beer, Linda; Fagan, Jennifer L; Mattson, Christine L; Freedman, Mark; Skarbinski, Jacek; Shouse, R Luke
HIV-infected U.S. adults have reported internalized HIV-related stigma; however, the national prevalence of stigma is unknown. We sought to determine HIV-related stigma prevalence among adults in care, describe which socio-demographic groups bear the greatest stigma burden, and assess the association between stigma and sustained HIV viral suppression. The Medical Monitoring Project measures characteristics of U.S. HIV-infected adults receiving care using a national probability sample. We used weighted data collected from June 2011 to May 2014 and assessed self-reported internalized stigma based on agreement with six statements. Overall, 79.1% endorsed ≥1 HIV-related stigma statements (n = 13,841). The average stigma score was 2.4 (out of a possible high score of six). White males had the lowest stigma scores while Hispanic/Latina females and transgender persons who were multiracial or other race had the highest. Although stigma was associated with viral suppression, it was no longer associated after adjusting for age. Stigma was common among HIV-infected adults in care. Results suggest individual and community stigma interventions may be needed, particularly among those who are Stigma was not independently associated with viral suppression; however, this sample was limited to adults in care. Examining HIV-infected persons not in care may elucidate stigma's association with viral suppression.
McGeehin, M A; Mirabelli, M
Heat and heat waves are projected to increase in severity and frequency with increasing global mean temperatures. Studies in urban areas show an association between increases in mortality and increases in heat, measured by maximum or minimum temperature, heat index, and sometimes, other weather conditions. Health effects associated with exposure to extreme and prolonged heat appear to be related to environmental temperatures above those to which the population is accustomed. Models of weather-mortality relationships indicate that populations in northeastern and midwestern U.S. cities are likely to experience the greatest number of illnesses and deaths in response to changes in summer temperature. Physiologic and behavioral adaptations may reduce morbidity and mortality. Within heat-sensitive regions, urban populations are the most vulnerable to adverse heat-related health outcomes. The elderly, young children, the poor, and people who are bedridden or are on certain medications are at particular risk. Heat-related illnesses and deaths are largely preventable through behavioral adaptations, including the use of air conditioning and increased fluid intake. Overall death rates are higher in winter than in summer, and it is possible that milder winters could reduce deaths in winter months. However, the relationship between winter weather and mortality is difficult to interpret. Other adaptation measures include heat emergency plans, warning systems, and illness management plans. Research is needed to identify critical weather parameters, the associations between heat and nonfatal illnesses, the evaluation of implemented heat response plans, and the effectiveness of urban design in reducing heat retention.
Terry-McElrath, Yvonne M.; Emery, Sherry; Wakefield, Melanie A.; O’Malley, Patrick M.; Szczypka, Glen; Johnston, Lloyd D.
Objective Young adults in the U.S. have one of the highest smoking prevalence rates of any age group, and young adulthood is a critical time period of targeting by the tobacco industry. We examined relationships between potential exposure to tobacco-related media campaigns from a variety of sponsors and 2-year smoking change measures among a longitudinal sample of U.S. adults aged 20-30 from 2001-2008. Methods Self-report data were collected from a longitudinal sample of 13,076 U.S. young adults from age 20-30. These data were merged with tobacco-related advertising exposure data from Nielsen Media Research. Two-year measures of change in smoking were regressed on advertising exposures. Results Two-year smoking uptake was unrelated to advertising exposure. The odds of quitting among all smokers and reduction among daily smokers in the two years between the prior and current survey were positively related to anti-tobacco advertising, especially potential exposure levels of 104-155 ads over the past 24 months. Tobacco company advertising (including corporate image and anti-smoking) and pharmaceutical industry advertising were unrelated to quitting or reduction. Conclusions Continued support for sustained, public health-based, well-funded anti-tobacco media campaigns may help reduce tobacco use among young adults. PMID:21972061
Time magazine's ""Man of the Century"", Albert Einstein is the founder of modern physics and his theory of relativity is the most important scientific idea of the modern era. In this short book, Einstein explains, using the minimum of mathematical terms, the basic ideas and principles of the theory that has shaped the world we live in today. Unsurpassed by any subsequent books on relativity, this remains the most popular and useful exposition of Einstein's immense contribution to human knowledge.With a new foreword by Derek Raine.
Grabow, Maggie L; Spak, Scott N; Holloway, Tracey; Stone, Brian; Mednick, Adam C; Patz, Jonathan A
Automobile exhaust contains precursors to ozone and fine particulate matter (PM ≤ 2.5 µm in aerodynamic diameter; PM2.5), posing health risks. Dependency on car commuting also reduces physical fitness opportunities. In this study we sought to quantify benefits from reducing automobile usage for short urban and suburban trips. We simulated census-tract level changes in hourly pollutant concentrations from the elimination of automobile round trips ≤ 8 km in 11 metropolitan areas in the upper midwestern United States using the Community Multiscale Air Quality (CMAQ) model. Next, we estimated annual changes in health outcomes and monetary costs expected from pollution changes using the U.S. Environmental Protection Agency Benefits Mapping Analysis Program (BenMAP). In addition, we used the World Health Organization Health Economic Assessment Tool (HEAT) to calculate benefits of increased physical activity if 50% of short trips were made by bicycle. We estimate that, by eliminating these short automobile trips, annual average urban PM2.5 would decline by 0.1 µg/m3 and that summer ozone (O3) would increase slightly in cities but decline regionally, resulting in net health benefits of $4.94 billion/year [95% confidence interval (CI): $0.2 billion, $13.5 billion), with 25% of PM2.5 and most O3 benefits to populations outside metropolitan areas. Across the study region of approximately 31.3 million people and 37,000 total square miles, mortality would decline by approximately 1,295 deaths/year (95% CI: 912, 1,636) because of improved air quality and increased exercise. Making 50% of short trips by bicycle would yield savings of approximately $3.8 billion/year from avoided mortality and reduced health care costs (95% CI: $2.7 billion, $5.0 billion]. We estimate that the combined benefits of improved air quality and physical fitness would exceed $8 billion/year. Our findings suggest that significant health and economic benefits are possible if bicycling replaces short
Murphy, Patrick J; Garrido-Hernansaiz, Helena; Mulcahy, Fiona; Hevey, David
This study investigated the associations between forms of HIV-related optimism, HIV-related stigma, and anxiety and depression among HIV-positive men who have sex with men (MSM) in the United Kingdom and Ireland. HIV health optimism (HHO) and HIV transmission optimism (HTO) were hypothesised to be protective factors for anxiety and depression, while the components of HIV-related stigma (enacted stigma, disclosure concerns, concern with public attitudes, and internalised stigma) were hypothesised to be risk factors. Data were collected from 278 HIV-positive MSM using an online questionnaire. The prevalence of psychological distress was high, with close to half (48.9%) of all participants reporting symptoms of anxiety, and more than half (57.9%) reporting symptoms of depression. Multiple linear regressions revealed that both anxiety and depression were positively predicted by internalised stigma and enacted stigma, and negatively predicted by HHO. For both anxiety and depression, internalised stigma was the strongest and most significant predictor. The results highlight the continued psychological burden associated with HIV infection among MSM, even as community support services are being defunded across the United Kingdom and Ireland. The results point to the need for clinicians and policy makers to implement stigma reduction interventions among this population.
Supplement 19 to the Safety Evaluation Report related to the operation of the Comanche Peak Steam Electric Station (CPSES), Units 1 and 2 (NUREG-0797), has been prepared by the Office of Special Projects of the US Nuclear Regulatory Commission (NRC). The facility is located in Somervell County, Texas, approximately 40 miles southwest of Fort Worth, Texas. This supplement presents the staff's evaluation of the Texas Utilities Electric Company's (lead applicant's) corrective action program (CAP) related to equipment qualification. The scope and methodology for the CAP workscope, as summarized in Revision 0 to the Equipment Qualification Project Status Report and as detailed in related documents, were developed to resolve various issues raised by the Comanche Peak Response Team (CPRT) and the NRC staff to ensure that plant equipment is appropriately environmentally and/or seismically and dynamically qualified and documented in accordance with the validated plant design resulting from other CAP scopes of work for Unit 1 and areas common to Units 1 and 2. The staff concludes that the CAP workscope for equipment qualification provides a comprehensive program for resolving the concerns identified by the CPRT and the NRC staff, including issues raised in the Comanche Peak Safety Evaluation Report and its supplements, and its implementation will ensure that the environmental and/or seismic and dynamic qualification of equipment at CPSES satisfies the validated plant design and the applicable requirements of 10 CFR Part 50. As is routine staff practice, the NRC staff will verify the adequacy of implementation of the environmental and seismic and dynamic equipment qualification program at CPSES during inspections that will take place before fuel loading. 97 refs
Cherry, Donald; Albert, Michael; McCaig, Linda F
In 2016, mental illness affected about 45 million U.S. adults (1). Although mental health-related office visits are often made to psychiatrists (2), primary care physicians can serve as the main source of treatment for patients with mental health issues (3); however, availability of provider type may vary by geographic region (3,4). This report uses data from the 2012-2014 National Ambulatory Medical Care Survey (NAMCS) to examine adult mental healthrelated physician office visits by specialty and selected patient characteristics. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Karlsson, Leif; Nilsson, Ove; Lidh, B.
This report is intended for use by the Swedish Nuclear Power Inspectorate. It has been published to enable comparison of modification and backfitting implemented at Barsebaeck, with those implemented at other plants, both domestic and abroad. The report summarizes the more notable modifications and backfitting carried out on any safety-related equipment, or software, at Barsebaeck, and covers the decade 1984 to 1994. Modifications to hardware, and to some extent to software, are catalogued, but not described in any detail. No general procedures (operational or maintenance) are dealt with. 3 refs
Full Text Available The decentralization of public administration refers to the process of increasing the autonomy of local communities by transferring new decision-making responsibilities, as well as financial and patrimonial resources, respecting the principle of subsidiarity, reducing current spending and increasing transparency in relation to citizens and increasing the quality and access to public services, or in other words, is a process of transferring authority and administrative responsibilities from central to local government in the areas of planning, decision-making, legal accountability and public service management.
Supplement No. 5 to the Safety Evaluation Report related to Commonwealth Edison Company's application for licenses to operate the Byron Station, Units 1 and 2, located in Rockvale Township, Ogle County, Illinois, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports the status of certain items that had not been resolved at the time of publication of the Safety Evaluation Report. Because of the favorable resolution of the items discussed in this report, the staff concludes that there is reasonable assurance that the facility can be operated by the applicant without endangering the health and safety of the public
Zhou, Qing; Lengua, Liliana J.; Wang, Yun
The relations of parents’ and teachers’ reports of temperament anger-irritability, positive emotionality, and effortful control (attention focusing and inhibitory control) to children’s externalizing and internalizing problems were examined in Chinese (N = 382) and U.S. (N = 322) samples of school-age children. Results suggested that in both cultures, low effortful control and high anger–irritability were associated with high externalizing problems, although the relations were stronger in the Chinese sample than in the U.S. sample. Low positive emotionality was associated with high internalizing problems in both cultures. However, high positive emotionality was associated with noncomorbid externalizing problems (teachers’ reports) in the Chinese sample but not in the U.S. sample. These findings suggest that there are considerable cross-cultural similarities in the temperament-adjustment associations, although some cross-cultural differences might exist. Implications of the findings for the detection and intervention of adjustment problems in Chinese children are discussed. PMID:19413428
Wheaton, Anne G; Olsen, Emily O'Malley; Miller, Gabrielle F; Croft, Janet B
Insufficient sleep is common among high school students and has been associated with an increased risk for motor vehicle crashes (1), sports injuries (2), and occupational injuries (3). To evaluate the association between self-reported sleep duration on an average school night and several injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) among U.S. high school students, CDC analyzed data from 50,370 high school students (grades 9-12) who participated in the national Youth Risk Behavior Surveys (YRBSs) in 2007, 2009, 2011, or 2013. The likelihood of each of the five risk behaviors was significantly higher for students who reported sleeping ≤7 hours on an average school night; infrequent seatbelt use, riding with a drinking driver, and drinking and driving were also more likely for students who reported sleeping ≥10 hours compared with 9 hours on an average school night. Although insufficient sleep directly contributes to injury risk, some of the increased risk associated with insufficient sleep might be caused by engaging in injury-related risk behaviors. Intervention efforts aimed at these behaviors might help reduce injuries resulting from sleepiness, as well as provide opportunities for increasing awareness of the importance of sleep.
Kim, Young Mee; Kang, Seung Wan; Kim, Se Young
This research was an empirical study designed to identify precursors and interaction effects related to nurses' patient identification behavior. A multilevel analysis methodology was used. A self-report survey was administered to registered nurses (RNs) of a university hospital in South Korea. Of the questionnaires, 1114 were analyzed. The individual-level factors that had a significantly positive association with patient identification behavior were person-organization value congruence, organizational commitment, occupational commitment, tenure at the hospital, and tenure at the unit. Significantly negative group-level precursors of patient identification behavior were burnout climate and the number of RNs. Two interaction effects of the person-organization value congruence climate were identified. The first was a group-level moderating effect in which the negative relationship between the number of RNs and patient identification behavior was weaker when the nursing unit's value congruence climate was high. The second was a cross-level moderating effect in which the positive relationship between tenure at the unit and patient identification behavior was weaker when value congruence climate was high. This study simultaneously tested both individual-level and group-level factors that potentially influence patient identification behavior and identified the moderating role of person-organization value congruence climate. Implications of these results are discussed.
Li, Wan; Chen, Lina; Li, Xia; Jia, Xu; Feng, Chenchen; Zhang, Liangcai; He, Weiming; Lv, Junjie; He, Yuehan; Li, Weiguo; Qu, Xiaoli; Zhou, Yanyan; Shi, Yuchen
Network motifs in central positions are considered to not only have more in-coming and out-going connections but are also localized in an area where more paths reach the networks. These central motifs have been extensively investigated to determine their consistent functions or associations with specific function categories. However, their functional potentials in the maintenance of cross-talk between different functional communities are unclear. In this paper, we constructed an integrated human signaling network from the Pathway Interaction Database. We identified 39 essential cancer-related motifs in central roles, which we called cancer-related marketing centrality motifs, using combined centrality indices on the system level. Our results demonstrated that these cancer-related marketing centrality motifs were pivotal units in the signaling network, and could mediate cross-talk between 61 biological pathways (25 could be mediated by one motif on average), most of which were cancer-related pathways. Further analysis showed that molecules of most marketing centrality motifs were in the same or adjacent subcellular localizations, such as the motif containing PI3K, PDK1 and AKT1 in the plasma membrane, to mediate signal transduction between 32 cancer-related pathways. Finally, we analyzed the pivotal roles of cancer genes in these marketing centrality motifs in the pathogenesis of cancers, and found that non-cancer genes were potential cancer-related genes.
Virginia T. McLemore
Full Text Available W.G. Lindgren in 1933 first noted that a belt of alkaline-igneous rocks extends along the eastern edge of the Rocky Mountains and Basin and Range provinces from Alaska and British Columbia southward into New Mexico, Trans-Pecos Texas, and eastern Mexico and that these rocks contain relatively large quantities of important commodities such as, gold, fluorine, zirconium, rare earth elements (REE, tellurium, gallium, and other critical elements. In New Mexico, these deposits were called Great Plain Margin (GPM deposits, because this north-south belt of alkaline-igneous rocks roughly coincides with crustal thickening along the margin between the Great Plains physiographic province with the Basin and Range (including the Rio Grande rift and Rocky Mountains physiographic provinces, which extends into Trans-Pecos Texas and eastern Mexico. Since 1996, only minor exploration and development of these deposits in New Mexico, Texas, and eastern Mexico has occurred because of low commodity prices, permitting issues, and environmental concerns. However, as the current demand for gold and critical elements, such as REE and tellurium has increased, new exploration programs have encouraged additional research on the geology of these deposits. The lack of abundant quartz in these systems results in these deposits being less resistant to erosion, being covered, and not as well exposed as other types of quartz-rich deposits, therefore additional undiscovered alkaline-related gold and REE deposits are likely in these areas. Deposits of Th-REE-fluorite (±U, Nb epithermal veins and breccias are found in the several GPM districts, but typically do not contain significant gold, although trace amounts of gold are found in most GPM districts. Gold-rich deposits in these districts tend to have moderate to low REE and anomalously high tungsten and sporadic amounts of tellurium. Carbonatites are only found in New Mexico and Mexico. The diversity of igneous rocks, including
Collignon, Julien; Rouch, Isabelle; Gonthier, Régis; Corbin-Seguin, Aude; Combe, Lorraine; Trombert-Paviot, Béatrice; Laurent, Bernard; Girtanner, Chantal
Refusal of care and support in these patients with Alzheimer's disease and related illnesses at home is a cause of accelerated loss of autonomy and increases the risk of a crisis with early institutionalization. Factors contributing to the denial of care are poorly understood and very few epidemiological data exist. we compared age, diagnosis, level of severity of the disease, the type of behavioral, family status of 101 patients living in denial of care and support as seen by a mobile home (group UPEPc) to 136 control patients seen at the memory clinic (group CM). Patients living in denial of care appear to significantly low age [82/80.5, prefusing home care is specific and it is important to educate GPs conditions that favor an obstacle to medicalization. The advantage of a mobile extramural to analyze risk factors for refusal of care and propose alternatives should be further investigated.
The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related injuries that were in the National Electronic Injury Surveillance System database and resulted in Emergency Department visits between 2002 and 2005. Pearson’s chi-square statistics were calculated to compare injury rates for each activity accounting for complex sample design. Martial arts had lower injury rates compared to boxing and wrestling for all diagnoses (pMartial arts have lower emergency department injury rates compared to boxing and wrestling. Wrestling has higher strains/sprains and dislocation injury rates compared to boxing. Combat sports do not appear to have higher injury rates compared to non-combat sports. PMID:24198705
Full Text Available The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related injuries that were in the National Electronic Injury Surveillance System database and resulted in Emergency Department visits between 2002 and 2005. Pearson's chi-square statistics were calculated to compare injury rates for each activity accounting for complex sample design. Martial arts had lower injury rates compared to boxing and wrestling for all diagnoses (p<0.001. Boxing had lower injury rates compared to wrestling for strains/sprains and dislocations. Boxing and wrestling had similar injury rates for concussions. Injury prevention efforts should consider the distribution of injuries and concentrate on preventing strains/sprains in wrestling, concussions in boxing and wrestling, and fractures for all three activities. The findings of the present study do not provide evidence that combat sports have alarmingly high rates of injuries resulting in emergency department visits
Fatih Doğu Geyik
Full Text Available Aim: We aimed to evaluate patients who were hospitalized in our intensive care unit due to drug-related suicide attempt (medical or insecticides and their access to these drugs. Methods: We prospectively recorded the demographic characteristics and medical data of 50 patients (32 females and 18 males who were hospitalized in our intensive care unit due to drug-related suicide attempt. Results: 66% of subjects were between the ages of 15 and 24 years with a mean age of 25.4±8.8 years. Multiple drug overdose was observed in 28% of patients. The unemployment rate was higher for women than men (p<0.001. Men obtained drugs from pharmacy more often than women (27.8% vs 6.2%, p=0,03. Of the patients, 86% got the drugs from home medicine cabinet while this rate was 93% among women (n=30. The level of toxicity was higher among patients who got the drugs from pharmacy than in those who used drugs at home (p=0.06. The length of stay in the intensive care unit was longer among patients with toxic level of medication (p=0.001. Conclusion: Patients usually use drugs or insecticides available at home to commit suicide. We believe that in patients with risk of suicide attempt, access to drugs should be limited and state regulations should be applied. (The Medical Bulletin of Haseki 2014; 52:111-5
Gil, Joseph A; DeFroda, Steven F; Kriz, Peter; Owens, Brett D
To examine the trend of concussions in skiers and snowboarders from 2010 to 2014; and to quantify and compare the incidence of concussions injuries in skiers and snowboarders who presented to emergency departments in the United States in 2014. Cross-sectional study of concussions in skiers and snowboarders who were evaluated in emergency departments in the United States. Incidence of concussions. The trend of the annual incidence of concussions for skiers and snowboarders remained stable from 2010 to 2014. An estimated total of 5388 skiing-related concussions and 5558 snowboarding-related concussions presented to emergency departments in the United States between January 1st, 2014, and December 31st, 2014. This represented an incidence of 16.9 concussions per 1 000 000 person-years for skiers and 17.4 concussions per 1 000 000 person-years for snowboarders. The incidence of concussions in the pediatric and young adult population of skiers was significantly higher than the incidence in the adult population. Similarly, the incidence of concussions in the pediatric and young adult population of snowboarders was significantly higher than the incidence in the adult population. The incidence of concussions was significantly higher in males compared with females in both skiing and snowboarding. The incidence of concussions from 2010 to 2014 plateaued in both skiers and snowboarders. Pediatric and young adult skiers and snowboarders had significantly higher incidences of concussion than the adult population. In contrast to the higher incidence of concussions in females in several sports including ice hockey, soccer, and basketball, the incidence of concussions was higher in males compared with females in both skiing and snowboarding.
Ulrich, Connie M; Zhou, Qiuping Pearl; Hanlon, Alexandra; Danis, Marion; Grady, Christine
Nurse practitioners (NPs) and physician assistants (PAs) provide primary care services for many American patients. Ethical knowledge is foundational to resolving challenging practice issues, yet little is known about the importance of ethics and work-related factors in the delivery of quality care. The aim of this study was to quantitatively assess whether the quality of the care that practitioners deliver is influenced by ethics and work-related factors. This paper is a secondary data analysis of a cross-sectional self-administered mailed survey of 1,371 primary care NPs and PAs randomly selected from primary care and primary care subspecialties in the United States. Ethics preparedness and confidence were significantly associated with perceived quality of care (pfactors. Investing in ethics education and addressing restrictive practice environments may improve collaborative practice, teamwork, and quality of care. Copyright © 2014 Elsevier Inc. All rights reserved.
Li, Qian; Blume, Steven W; Huang, Joanna C; Hammer, Mette; Ganz, Michael L
This study estimated the economic burden of obesity-related comorbidities (ORCs) in the US, at both the person and population levels. The Geisinger Health System provided electronic medical records and claims between January 2004 and May 2013 for a sample of 153,561 adults (50% males and 97% white). Adults with A total of 21 chronic conditions, with established association with obesity in the literature, were identified by diagnosis codes and/or lab test results. The total healthcare costs were measured in each year. The association between annual costs and ORCs was assessed by a regression, which jointly considered all the ORCs. The per-person incremental costs of a single comorbidity, without any of the other ORCs, were calculated. The population-level economic burden was the product of each ORC's incremental costs and the annual prevalence of the ORC among 100,000 individuals. The prevalence of ORCs was stratified by obesity status to estimate the economic burden among 100,000 individuals with obesity and among those without. This study identified 56,895 adults (mean age = 47 years; mean BMI = 29.6 kg/m(2)). The annual prevalence of ORCs ranged from 0.5% for pulmonary embolism (PE) to 41.8% for dyslipidemia. The per-person annual incremental costs of a single ORC ranged from $120 for angina to $1665 for PE. Hypertensive diseases (HTND), dyslipidemia, and osteoarthritis were the three most expensive ORCs at the population level; each responsible for ≥$18 million annually among 100,000 individuals. HTND and osteoarthritis were much more costly among individuals with obesity than those without obesity. Data were from a small geographic region. ORCs are associated with substantial economic burden, especially for those requiring continuous treatments.
Dupéy, Lauren Nicole; Smith, Jordan W.
Social science research from a variety of disciplines has generated a collective understanding of how individuals prepare for, and respond to, the risks associated with prescribed burning and wildfire. We provide a systematic compilation, review, and quantification of dominant trends in this literature by collecting all empirical research conducted within the U.S. that has addressed perceptions and behaviors surrounding various aspects of prescribed burning and wildfire. We reviewed and quantified this literature using four thematic categories covering: (1) the theory and methods that have been used in previous research; (2) the psychosocial aspects of prescribed burning and wildfire that have been studied; (3) the biophysical characteristics of the fires which have been studied; and (4) the types of fire and management approaches that have been examined. Our integrative review builds on previous literature reviews on the subject by offering new insight on the dominant trends, underutilized approaches, and under-studied topics within each thematic category. For example, we found that a select set of theories (e.g., Protection Motivation Theory, Attribution Theory, etc.) and approaches (e.g., mixed-methods) have only been used sparingly in previous research, even though these theories and approaches can produce insightful results that can readily be implemented by fire-management professionals and decision makers. By identifying trends and gaps in the literature across the thematic categories, we were able to answer four questions that address how future research can make the greatest contribution to our understanding of perceptions and behaviors related to prescribed burning and wildfire.
Sridhar, K.; Jackson, M.L.; Clayton, R.N.; Gillette, D.A.; Hawley, J.W.
The oxygen isotopic ratios (expressed as parts per thousand relative to mean ocean water, SMOW, delta/sup 18/O) of the quartz from 13 soils undergoing much wind erosion during the study period of 1972-1975 in four southwestern states and from comparison areas were determined. The delta/sup 18/O for quartz from eight Texas (TX) and Arizona (AZ) soils range from 13.0 to 15.9 /sup 0///sub 00/. The quartz of the sands and silts coarser than 20 ..mu..m from three of the soils had delta/sup 18/O values ranging from 13.1 to 15.1 /sup 0///sub 00/, characteristic of an ultimate igneous-metamorphic origin. The delta/sup 18/O values increase greatly with decreasing particle size of quartz from three soils ranging from loamy fine sand to loam to clay in texture. The delta/sup 18/O of the 1-10 ..mu..m quartz fraction (aerosol size) ranged from 19.2 to 20.2 /sup 0///sub 00/ (19.55 +- 0.28 /sup 0///sub 00/; +- sigma) for the thirteen soils most affected by dust storms. The oxygen isotopic ratios of 1-10 ..mu..m quartz from three Hawaiian soils and two sediments from Lake Waiau occurring at 3,970 m altitude on the Mauna Kea summit on the Island of Hawaii give a delta/sup 18/O mean of 18.3 +- 0.2 /sup 0///sub 00/.
Dupéy, Lauren Nicole; Smith, Jordan W
Social science research from a variety of disciplines has generated a collective understanding of how individuals prepare for, and respond to, the risks associated with prescribed burning and wildfire. We provide a systematic compilation, review, and quantification of dominant trends in this literature by collecting all empirical research conducted within the U.S. that has addressed perceptions and behaviors surrounding various aspects of prescribed burning and wildfire. We reviewed and quantified this literature using four thematic categories covering: (1) the theory and methods that have been used in previous research; (2) the psychosocial aspects of prescribed burning and wildfire that have been studied; (3) the biophysical characteristics of the fires which have been studied; and (4) the types of fire and management approaches that have been examined. Our integrative review builds on previous literature reviews on the subject by offering new insight on the dominant trends, underutilized approaches, and under-studied topics within each thematic category. For example, we found that a select set of theories (e.g., Protection Motivation Theory, Attribution Theory, etc.) and approaches (e.g., mixed-methods) have only been used sparingly in previous research, even though these theories and approaches can produce insightful results that can readily be implemented by fire-management professionals and decision makers. By identifying trends and gaps in the literature across the thematic categories, we were able to answer four questions that address how future research can make the greatest contribution to our understanding of perceptions and behaviors related to prescribed burning and wildfire.
Capurro, Diego Alberto; Iafolla, Timothy; Kingman, Albert; Chattopadhyay, Amit; Garcia, Isabel
The goal of this analysis was to describe income-related inequality in untreated caries among children in the United States over time. The analysis focuses on children ages 2-12 years in three nationally representative U.S. surveys: the National Health and Nutrition Examination Survey (NHANES) 1971-1974, NHANES 1988-1994, and NHANES 1999-2004. The outcome of interest is untreated dental caries. Various methods are employed to measure absolute and relative inequality within each survey such as pair-wise comparisons, measures of association (odds ratios), and three summary measures of overall inequality: the slope index of inequality, the relative index of inequality, and the concentration index. Inequality trends are then assessed by comparing these estimates across the three surveys. Inequality was present in each of the three surveys analyzed. Whether measured on an absolute or relative scale, untreated caries disproportionately affected those with lower income. Trend analysis shows that, despite population-wide reductions in untreated caries between NHANES I and NHANES III, overall absolute inequality slightly increased, while overall relative inequality significantly increased. Between NHANES III and NHANES 1999-2004, both absolute and relative inequality tended to decrease; however, these changes were not statistically significant. Socioeconomic inequality in oral health is an important measure of progress in overall population health and a key input to inform health policies. This analysis shows the presence of socioeconomic inequality in oral health in the American child population, as well as changes in its magnitude over time. Further research is needed to determine the factors related to these changes and their relative contribution to inequality trends. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Terry-McElrath, Yvonne M.; Emery, Sherry; Szczypka, Glen; Johnston, Lloyd D.
Using nationally representative data from the Monitoring the Future Study on United States middle and high school students, we related exposure to anti-drug television advertising as measured by Nielsen Media Research ratings points to student self-reported drug-related outcomes from 1995-2006. Multivariate analyses controlling for key socio-demographics and accounting for the complex survey design included 337,918 cases. Results indicated that attitudes, beliefs, and behaviors regarding substance use were significantly related to such advertising exposure over the six months prior to the date youth were surveyed. However, the observed relationships varied by grade level, over time and by advertising tagline and marijuana focus. Findings differed markedly between middle and high school students across the study interval. One factor that may partially explain observed differences may be variation in the degree to which the ads focused on marijuana. Putting a concerted effort into increasing anti-drug advertising will likely increase the exposure to and recall of such ads among youth. However, the likelihood that such advertising will result in youth being less likely to use drugs seems to depend heavily on the type of advertising utilized and how it relates to different ages and characteristics of targeted youth. PMID:20961691
Iyer, P S [Bhabha Atomic Research Centre, Bombay (India). Div. of Radiation Protection
The proposal of the International Commission on Radiation Units and Measurements that the special units of radiation and radioactivity-roentgen, rad, rem and curie-be replaced by the International System (SI) of Units has been accepted by international bodies. This paper reviews the resons for introducing the new units and their features. The relation between the special units and the corresponding SI units is discussed with examples. In spite of anticipated difficulties, the commission recommends a smooth and efficient changeover to the SI units in ten years.
Clark, Lara P; Millet, Dylan B; Marshall, Julian D
Disparities in exposure to air pollution by race-ethnicity and by socioeconomic status have been documented in the United States, but the impacts of declining transportation-related air pollutant emissions on disparities in exposure have not been studied in detail. This study was designed to estimate changes over time (2000 to 2010) in disparities in exposure to outdoor concentrations of a transportation-related air pollutant, nitrogen dioxide (NO2), in the United States. We combined annual average NO2 concentration estimates from a temporal land use regression model with Census demographic data to estimate outdoor exposures by race-ethnicity, socioeconomic characteristics (income, age, education), and by location (region, state, county, urban area) for the contiguous United States in 2000 and 2010. Estimated annual average NO2 concentrations decreased from 2000 to 2010 for all of the race-ethnicity and socioeconomic status groups, including a decrease from 17.6 ppb to 10.7 ppb (-6.9 ppb) in nonwhite [non-(white alone, non-Hispanic)] populations, and 12.6 ppb to 7.8 ppb (-4.7 ppb) in white (white alone, non-Hispanic) populations. In 2000 and 2010, disparities in NO2 concentrations were larger by race-ethnicity than by income. Although the national nonwhite-white mean NO2 concentration disparity decreased from a difference of 5.0 ppb in 2000 to 2.9 ppb in 2010, estimated mean NO2 concentrations remained 37% higher for nonwhites than whites in 2010 (40% higher in 2000), and nonwhites were 2.5 times more likely than whites to live in a block group with an average NO2 concentration above the WHO annual guideline in 2010 (3.0 times more likely in 2000). Findings suggest that absolute NO2 exposure disparities by race-ethnicity decreased from 2000 to 2010, but relative NO2 exposure disparities persisted, with higher NO2 concentrations for nonwhites than whites in 2010. https://doi.org/10.1289/EHP959.
Cherry, Nicola M; Chen, Yiqun; McDonald, J Corbett
Work-related mental ill-health appears to be increasing. Population-based data on incidence are scarce but in the United Kingdom occupational physicians and psychiatrists report these conditions to voluntary surveillance schemes. To estimate the incidence of work-related stress and mental illness reported 1996-2001 by occupational physicians and 1999-2001 by psychiatrists. Estimated annual average incidence rates were calculated by sex, occupation and industry against appropriate populations at risk. An in-house coding scheme was used to classify and analyse data on precipitating events. An estimated annual average of 3,624 new cases were reported by psychiatrists, and 2,718 by occupational physicians; the rates were higher for men in reports based on the former and for women on the latter. Most diagnoses were of anxiety/depression or work-related stress, with post-traumatic stress accounting for approximately 10% of cases reported by psychiatrists. High rates of ill-health were seen among professional and associated workers and in those in personal and protective services. Factors (such as work overload) intrinsic to the job and issues with interpersonal relations were the most common causes overall. The steep increase in new cases of work-related mental ill-health reported by occupational physicians since 1996 may reflect a greater willingness by workers to seek help but may also signify an increasing dissonance between workers' expectations and the work environment. Greater expertise is needed to improve the workplace by adjustment of job demands, improvement of working relations, increasing workers' capacities and management of organizational change.
Binswanger, Ingrid A; Blatchford, Patrick J; Forsyth, Simon J; Stern, Marc F; Kinner, Stuart A
People in prison may be at high risk for infectious diseases and have an elevated risk of death immediately after release compared with later; their risk of death is elevated for at least a decade after release. We compared rates, characteristics, and prison-related risk factors for infectious disease-related mortality among people released from prisons in Queensland, Australia, and Washington State, United States, regions with analogous available data. We analyzed data from retrospective cohort studies of people released from prison in Queensland (1997-2007, n=37,180) and Washington State (1999-2009, n=76,208) and linked identifiers from each cohort to its respective national death index. We estimated infectious disease-related mortality rates (deaths per person-years in community) and examined associations using Cox proportional hazard models. The most frequent infectious disease-related underlying cause of death after release from prison was pneumonia (43%, 23/54 deaths) in the Australian cohort and viral hepatitis (40%, 69/171 deaths) in the U.S. cohort. The infectious disease-related mortality rate was significantly higher in the U.S. cohort than in the Australian cohort (51.2 vs. 26.5 deaths per 100,000 person-years; incidence rate ratio = 1.93, 95% confidence interval 1.42, 2.62). In both cohorts, increasing age was strongly associated with mortality from infectious diseases. Differences in the epidemiology of infectious disease-related mortality among people released from prison may reflect differences in patterns of community health service delivery in each region. These findings highlight the importance of preventing and treating hepatitis C and other infectious diseases during the transition from prison to the community.
Claudia Cristina de Aguiar Pereira
Full Text Available Race differences in health have been extensively analyzed and documented in the literature, especially between African Americans or blacks and whites in the United States. Despite the vast literature in the area, the majority of studies that explore the relationship between race and health use outcomes such as self-rated health, mortality or morbidity, and disability, but very few use Health-Related Quality of Life (HRQoL measures and their domains or dimensions. This narrative review aims to provide a better understanding of the relationship between race and health domains that are commonly used in preference-based HRQoL measures. We investigated the literature on race, physical health, mental health, pain and discomfort, cognition, neurologic spectrum domains, dexterity, ambulation, vitality and social functioning domains. We conducted a literature search and review using the key words race and the health domain of interest, using medical and social sciences databases, such as MEDLINE/Pubmed, Web of Science, and the Google Scholar portal.The majority of the studies identified in the literature show that African Americans or blacks in the United States tend to have lower scores than whites throughout a variety of health domains found in preference-based HRQoL measures. This review also emphasizes the scarcity of studies that investigate some health domains, such as social functioning, dexterity, vitality and neurologic spectrum domains, and therefore we identify the need for more studies focusing on race and measures that address such domains.
Rensen, Ans; van Mol, Margo M; Menheere, Ilse; Nijkamp, Marjan D; Verhoogt, Ellen; Maris, Bea; Manders, Willeke; Vloet, Lilian; Verharen, Lisbeth
The quality standards of the Dutch Society of Intensive Care require monitoring of the satisfaction of patient's relatives with respect to care. Currently, no suitable instrument is available in the Netherlands to measure this. This study describes the development and psychometric evaluation of the questionnaire-based Consumer Quality Index 'Relatives in Intensive Care Unit' (CQI 'R-ICU'). The CQI 'R-ICU' measures the perceived quality of care from the perspective of patients' relatives, and identifies aspects of care that need improvement. The CQI 'R-ICU' was developed using a mixed method design. Items were based on quality of care aspects from earlier studies and from focus group interviews with patients' relatives. The time period for the data collection of the psychometric evaluation was from October 2011 until July 2012. Relatives of adult intensive care patients in one university hospital and five general hospitals in the Netherlands were approached to participate. Psychometric evaluation included item analysis, inter-item analysis, and factor analysis. Twelve aspects were noted as being indicators of quality of care, and were subsequently selected for the questionnaire's vocabulary. The response rate of patients' relatives was 81% (n = 455). Quality of care was represented by two clusters, each showing a high reliability: 'Communication' (α = .80) and 'Participation' (α = .84). Relatives ranked the following aspects for quality of care as most important: no conflicting information, information from doctors and nurses is comprehensive, and health professionals take patients' relatives seriously. The least important care aspects were: need for contact with peers, nuisance, and contact with a spiritual counsellor. Aspects that needed the most urgent improvement (highest quality improvement scores) were: information about how relatives can contribute to the care of the patient, information about the use of meal-facilities in the hospital, and
Mark, Clyde R
.... Experience gained from Egyptian-U.S. joint military exercises proved valuable in easing coordination during the February 1991 Desert Storm operation to reverse Iraqi aggression against Kuwait. Egypt is seen by U.S...
Mark, Clyde R
.... Experience gained from Egyptian-U.S. joint military exercises proved valuable in easing coordination during the February 1991 Desert Storm operation to reverse Iraqi aggression against Kuwait. Egypt is seen by U.S...
Gao, J X; Liu, L
In urethane-anesthetized, vagotomized and paralyzed rabbits, effects of electrical stimulation of the dorso-medial area of the nucleus facialis (DMNF) on the respiration-related units (RRUs) in ventro-lateral region of nucleus tractus solitaris (VLNTS) were observed. The experimental results showed that during electrical stimulation of DMNF the majority of the inspiratory (I) neurons (64.4%) were increased in frequency and duration of discharge, some to a marked extent. During electrical stimulation of DMNF the expiratory neurons (35%) were decreased in their frequency and duration of discharge, some to a marked extent too. The responses of RRUs in ipsilateral and contralateral VLNTS to stimulation of DMNF was not statistically significant (P greater than 0.05). It is suggested that DMNF may have a facilitating effect on the inspiratory neurons and an inhibiting effect on the expiratory neurons in VLNTS.
[Clinical epidemiological assessments on 3521 patients suffering from road traffic injuries, in relation with trauma localisation and severity, assisted in "Sf. Ioan" Emergency Unit, during 2002-2009].
Manole, M; Ciuhodaru, T; Zanoschi, Georgeta; Manole, Alina; Ivan, A
The aim of study was to assess road traffic injuries in relation with their localisation and severity. A sample of 3521 patients suffering from road traffic injuries and assisted in "Sf. Ioan" Emergency Unit, Iaşi, Romania was assess regarding age group, sex and residence area, type of lesions and ther localisation and severity, between 2002-2009. Data were collected using a special epidemiological inquiry and processed using SPSS and MS Excel statistical softs. The incidence of road traffic injuries increased during the last decade, with a report men/women of 1.5, urban and 21-30 age group predominance. The most frequent were leg fractures (16.7%) and thoracal contusions (19.1%), cranial and facial trauma (32.4%), with open injuries (10.5%). Prevention programmes with a high efficiency at the national level, as well as a concret identification of risk factors with a multidisciplinar approach of road traffic accidents, are needed.
Supplement No. 3 to the Safety Evaluation Report (SER) related to the operation of the Comanche Peak Steam electric Station, Units 1 and 2, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. the facility is located in Somervell County, Texas. Subject to favorable resolution of the items identified in this supplement, the staff concludes that the facility can be operated by the applicatn without endangering the health and safety of the public. This document provides the NRC staff's evaluation of the outstanding and confirmatory issues that have been resolved since Supplement No. 2 was issued in January 1982, and addresses changes to the SER and its earlier supplements which have resulted from the receipt of additonal information from the applicant during the period of January throught October 1982
Supplement 15 to the Safety Evaluation Report related to the operation of the Comanche Peak Steam Electric Station (CPSES), Units 1 and 2 (NUREG-0797), has been prepared by the Office of Special Projects of the US Nuclear Regulatory Commission (NRC). The facility is located in Somervell County, Texas, approximately 40 miles southwest of Fort Worth, Texas. This supplement presents the staff's evaluation of the applicant's Corrective Action Program (CAP) related to the design of cable trays and cable tray hangers. The scope and methodologies for the CAP workscope as summarized in Revision O to the cable tray and cable tray hanger project status report and as detailed in related documents referenced in this evaluation were developed to resolve various design issues raised by the Atomic Safety and Licensing Board (ASLB) the intervenor, Citizens Association for Sound Energy (CASE); the Comanche Peak Response Team (CPRT); CYGNA Energy Services (CYGNA); and the NRC staff. The NRC staff concludes that the CAP workscope for cable trays and cable tray hangers provides a comprehensive program for resolving the associated technical concerns identified by the ASLB, CASE, CPRT, CYGNA, and the NRC staff and its implementation ensures that the design of cable trays and cable tray hangers at CPSES satisfies the applicable requirements of 10 CFR Part 50