WorldWideScience

Sample records for village treatment center

  1. A village treatment center for malaria: community response in Sri Lanka

    DEFF Research Database (Denmark)

    Konradsen, F; Amerasinghe, P H; Perera, D

    2000-01-01

    . The study reports on the experiences with the establishment of a village health facility and its effect on the treatment-seeking behavior of the population. After the introduction of the village treatment center it quickly took over the role of main provider for diagnosis and treatment of malaria from......Early diagnosis and treatment of malaria cases is one of the basic elements of the current global malaria control strategy. In order to provide this service to people in rural areas there is a need for new cost-effective approaches. To ensure that such new approaches are acceptable to the target...... communities, it is important to know the rationale for people's malaria treatment-seeking behavior. The present study provides insights into the reasons for people's preferences for different types of healthcare facilities and describes variation of these preferences within a rural community in Sri Lanka...

  2. VT Designated Village Centers Boundary

    Data.gov (United States)

    Vermont Center for Geographic Information — This community revitalization program helps maintain or evolve small to medium-sized historic centers with existing civic and commercial buildings. The designation...

  3. Conjunctivitis Bakterial Treatment in Kota Karang Village

    OpenAIRE

    Ramadhanisa, Aqsha

    2014-01-01

    Conjunctivitis is an eye disease that can occur in adults and children. The incident of conjungtivitis in Indonesia currently occupies the second place of 10 major eye disease. In the treatment of disease, the approach in medical care not only focuses on the biological aspect (disease) but also influence by phisicosocial aspect. Because of the interaction between social communities and families with the help of the community environment is helpful not only in solving clinical problem but also...

  4. VT Downtown and Village Center Tax Credit Projects

    Data.gov (United States)

    Vermont Center for Geographic Information — Federal and state rehabilitation tax credits help to stimulate private investment, create jobs, restore historic buildings and jump start the revitalization seen in...

  5. Village of Pender, Nebraska Wastewater Treatment Facility, Pender, Nebraska - Clean Water Act Public Notice

    Science.gov (United States)

    The EPA is providing notice of proposed Administrative Penalty Assessment against the Village of Pender, Nebraska Wastewater Treatment Facility (“Respondent”) for alleged violations of Sections 301 and/or 404 of the Clean Water Act

  6. Community-based wastewater treatment systems and water quality of an Indonesian village.

    Science.gov (United States)

    Lim, H S; Lee, L Y; Bramono, S E

    2014-03-01

    This paper examines the impact of community-based water treatment systems on water quality in a peri-urban village in Yogyakarta, Indonesia. Water samples were taken from the wastewater treatment plants (WWTPs), irrigation canals, paddy fields and wells during the dry and wet seasons. The samples were tested for biological and chemical oxygen demand, nutrients (ammonia, nitrate, total nitrogen and total phosphorus) and Escherichia coli. Water quality in this village is affected by the presence of active septic tanks, WWTP effluent discharge, small-scale tempe industries and external sources. We found that the WWTPs remove oxygen-demanding wastes effectively but discharged nutrients, such as nitrate and ammonia, into irrigation canals. Irrigation canals had high levels of E. coli as well as oxygen-demanding wastes. Well samples had high E. coli, nitrate and total nitrogen levels. Rainfall tended to increase concentrations of biological and chemical oxygen demand and some nutrients. All our samples fell within the drinking water standards for nitrate but failed the international and Indonesian standards for E. coli. Water quality in this village can be improved by improving the WWTP treatment of nutrients, encouraging more villagers to be connected to WWTPs and controlling hotspot contamination areas in the village.

  7. VT Boundaries - village polygons

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) The BNDHASH dataset depicts Vermont villages, towns, counties, Regional Planning Commissions (RPC), and LEPC (Local Emergency Planning Committee)...

  8. The OCHIN community information network: bringing together community health centers, information technology, and data to support a patient-centered medical village.

    Science.gov (United States)

    Devoe, Jennifer E; Sears, Abigail

    2013-01-01

    Creating integrated, comprehensive care practices requires access to data and informatics expertise. Information technology (IT) resources are not readily available to individual practices. One model of shared IT resources and learning is a "patient-centered medical village." We describe the OCHIN Community Health Information Network as an example of this model; community practices have come together collectively to form an organization that leverages shared IT expertise, resources, and data, providing members with the means to fully capitalize on new technologies that support improved care. This collaborative facilitates the identification of "problem sheds" through surveillance of network-wide data, enables shared learning regarding best practices, and provides a "community laboratory" for practice-based research. As an example of a community of solution, OCHIN uses health IT and data-sharing innovations to enhance partnerships between public health leaders, clinicians in community health centers, informatics experts, and policy makers. OCHIN community partners benefit from the shared IT resource (eg, a linked electronic health record, centralized data warehouse, informatics, and improvement expertise). This patient-centered medical village provides (1) the collective mechanism to build community-tailored IT solutions, (2) "neighbors" to share data and improvement strategies, and (3) infrastructure to support innovations based on electronic health records across communities, using experimental approaches.

  9. Rural Christians' view of sickness treatment behavior: a case study from a Shandong village, China.

    Science.gov (United States)

    Zheng, Honge; Wang, Wei; Wang, Libin

    2015-01-01

    There are few studies of Christian views of disease and treatment behavior in rural China. Based on Village G in Shandong Province, this paper describes how, under conditions of rural social and medical deprivation, Christians regard physical (routi) and mental (jingshen) sickness as resulting from disturbances to communal peace. Sickness occurs when everyday sinful words and actions allow the devil to enter or when God uses the devil to test worshippers' beliefs. In either case, it is the devil who directly causes sickness. Christian treatment is through scripture, communal and individual prayer, and expurgation. Diagnosis and treatment thus reflect both theodicy and the emergence of a kind of devil culture in the context of rural social crises.

  10. Village-Randomized Clinical Trial of Home Distribution of Zinc for Treatment of Childhood Diarrhea in Rural Western Kenya

    Science.gov (United States)

    Feikin, Daniel R.; Bigogo, Godfrey; Audi, Allan; Pals, Sherri L.; Aol, George; Mbakaya, Charles; Williamson, John; Breiman, Robert F.; Larson, Charles P.

    2014-01-01

    Background Zinc treatment shortens diarrhea episodes and can prevent future episodes. In rural Africa, most children with diarrhea are not brought to health facilities. In a village-randomized trial in rural Kenya, we assessed if zinc treatment might have a community-level preventive effect on diarrhea incidence if available at home versus only at health facilities. Methods We randomized 16 Kenyan villages (1,903 eligible children) to receive a 10-day course of zinc and two oral rehydration solution (ORS) sachets every two months at home and 17 villages (2,241 eligible children) to receive ORS at home, but zinc at the health–facility only. Children’s caretakers were educated in zinc/ORS use by village workers, both unblinded to intervention arm. We evaluated whether incidence of diarrhea and acute lower respiratory illness (ALRI) reported at biweekly home visits and presenting to clinic were lower in zinc villages, using poisson regression adjusting for baseline disease rates, distance to clinic, and children’s age. Results There were no differences between village groups in diarrhea incidence either reported at the home or presenting to clinic. In zinc villages (1,440 children analyzed), 61.2% of diarrheal episodes were treated with zinc, compared to 5.4% in comparison villages (1,584 children analyzed, p<0.0001). There were no differences in ORS use between zinc (59.6%) and comparison villages (58.8%). Among children with fever or cough without diarrhea, zinc use was low (<0.5%). There was a lower incidence of reported ALRI in zinc villages (adjusted RR 0.68, 95% CI 0.46–0.99), but not presenting at clinic. Conclusions In this study, home zinc use to treat diarrhea did not decrease disease rates in the community. However, with proper training, availability of zinc at home could lead to more episodes of pediatric diarrhea being treated with zinc in parts of rural Africa where healthcare utilization is low. Trial Registration ClinicalTrials.gov NCT00530829

  11. Village-randomized clinical trial of home distribution of zinc for treatment of childhood diarrhea in rural Western kenya.

    Directory of Open Access Journals (Sweden)

    Daniel R Feikin

    Full Text Available BACKGROUND: Zinc treatment shortens diarrhea episodes and can prevent future episodes. In rural Africa, most children with diarrhea are not brought to health facilities. In a village-randomized trial in rural Kenya, we assessed if zinc treatment might have a community-level preventive effect on diarrhea incidence if available at home versus only at health facilities. METHODS: We randomized 16 Kenyan villages (1,903 eligible children to receive a 10-day course of zinc and two oral rehydration solution (ORS sachets every two months at home and 17 villages (2,241 eligible children to receive ORS at home, but zinc at the health-facility only. Children's caretakers were educated in zinc/ORS use by village workers, both unblinded to intervention arm. We evaluated whether incidence of diarrhea and acute lower respiratory illness (ALRI reported at biweekly home visits and presenting to clinic were lower in zinc villages, using poisson regression adjusting for baseline disease rates, distance to clinic, and children's age. RESULTS: There were no differences between village groups in diarrhea incidence either reported at the home or presenting to clinic. In zinc villages (1,440 children analyzed, 61.2% of diarrheal episodes were treated with zinc, compared to 5.4% in comparison villages (1,584 children analyzed, p<0.0001. There were no differences in ORS use between zinc (59.6% and comparison villages (58.8%. Among children with fever or cough without diarrhea, zinc use was low (<0.5%. There was a lower incidence of reported ALRI in zinc villages (adjusted RR 0.68, 95% CI 0.46-0.99, but not presenting at clinic. CONCLUSIONS: In this study, home zinc use to treat diarrhea did not decrease disease rates in the community. However, with proper training, availability of zinc at home could lead to more episodes of pediatric diarrhea being treated with zinc in parts of rural Africa where healthcare utilization is low. TRIAL REGISTRATION: ClinicalTrials.gov NCT

  12. Residential Treatment Centers for Child Abuse

    Directory of Open Access Journals (Sweden)

    Serhat Nasiroglu

    2014-02-01

    Full Text Available Every year millions of reports are being held and cases regarding those reports in courts are carrying on about abusement and omission against children . Abusement against children has been seen throughout of the history. Significant and permanent impacts can occur upon child abusement and neglect on victim children. It is important to know the psychological dynamics which have been lived by the children by the mental health professionalsto protect the children after the abusement report has been written. Cognitive Behaviour Therapy and medications are being used commonly in the treatment of abusement cases. However in some cases it is necessary to send away the victims from environment, enable them to continue their education life, make sure that they are treated by the professional individuals in safe area. For this end there are many Residential Treatment Centers around the world. and ldquo;Oguz Kagan Koksal Social Care and Rehabilitation Center and rdquo; was established in Adana as the first Residential Treatment Center in Turkey. In this report the historical dimensions of the child abusement, the definition of it, its psychological dynamics, the psychological disorders caused by it, treatment approaches and residential treatment centers have been reviewed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(1.000: 67-78

  13. Village Power `97. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Cardinal, J.; Flowers, L.; Taylor, R.; Weingart, J. [eds.

    1997-09-01

    It is estimated that two billion people live without electricity and its services. In addition, there is a sizable number of rural villages that have limited electrical service, with either part-day operation by diesel gen-sets or partial electrification (local school or community center and several nearby houses). For many villages connected to the grid, power is often sporadically available and of poor quality. The U.S. National Renewable Energy Laboratory (NREL) in Golden, Colorado, has initiated a program to address these potential electricity opportunities in rural villages through the application of renewable energy (RE) technologies. The objective of this program is to develop and implement applications that demonstrate the technical performance, economic competitiveness, operational viability, and environmental benefits of renewable rural electric solutions, compared to the conventional options of line extension and isolated diesel mini-grids. These four attributes foster sustainability; therefore, the program is entitled Renewables for Sustainable Village Power (RSVP). The RSVP program is a multi-disciplinary, multi-technology, multi-application program composed of six key activities, including village application development, computer model development, systems analysis, pilot project development, technical assistance, and an Internet-based village power project database. The current program emphasizes wind, photovoltaics (PV), and their hybrids with diesel gen-sets. NREL`s RSVP team is currently involved in rural electricity projects in thirteen countries, with U.S., foreign, and internationally based agencies and institutions. This document contains reports presented at the Proceedings of Village Power, 1997. Individual projects have been processed separately for the United States Department of Energy databases.

  14. Polypharmacy Treatment of Hypertensionin Public Health Centers

    Directory of Open Access Journals (Sweden)

    Vasanthi A/P Nayagam

    2016-12-01

    Full Text Available Background: Hypertension is one of the most prominent global diseases. Despite the availability of effective therapies, hypertension remains poorly controlled in Indonesia. In many cases, patient’s noncompliance may be attributable to the low patients’ knowledge, attitude, and life-style practices such as polypharmacy. Polypharmacy is defined as the administration of many drugs at in one prescription. Polypharmacy increases expenses, possible adverse reaction to a single agent, incidence of drug interactions, and decreases patient’s compliance This study aimed to identify the practice of polypharmacy in hypertension treatment in primary health centers. Methods: A cross-sectional descriptive observational study was carried out on 60 patients from two primary health centers in Jatinangor, West Java, Indonesia in October 2013. Sociodemographic profile, degree of hypertension, types of antihypertensive drugs, concomitant drugs given together with antihypertensive drugs, and treatment compliance data were collected and presented in tables and figures. Results: The incidence of hypertension was more common among male patients compared to female patients. Thirty-three patients (55% have low compliance to their medication. Twenty-nine patients (48% received single drug and 31 patients (52% received more than one drugs. Conclusions: The percentage of polypharmacy practice in treating hypertension in primary health centers is 52%. The most frequently prescribed anti-hypertensive are angiotensin-converting enzyme (ACE inhibitors and calcium-channel blockers (CCB. Most of hypertensive patients have low compliance to therapy.

  15. 42 CFR 412.100 - Special treatment: Renal transplantation centers.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Renal transplantation centers... § 412.100 Special treatment: Renal transplantation centers. (a) Adjustments for renal transplantation... subparts D and E of this part for hospitals approved as renal transplantation centers (described at §§ 405...

  16. Training Centers for Onsite Wastewater Treatment

    Science.gov (United States)

    Onsite wastewater training centers offer classes, demonstration projects and research facilities for onsite industry professionals. Classes include wastewater management, new technologies and pre-licensing.

  17. A conceptual framework for patient-centered fertility treatment

    National Research Council Canada - National Science Library

    Elizabeth A Duthie; Alexandra Cooper; Joseph B Davis; Katherine D Schoyer; Jay Sandlow; Estil Y Strawn; Kathryn E Flynn

    2017-01-01

    .... In this study we used empirical, in-depth data on couples’ experiences of infertility treatment decision making to inform and revise a conceptual framework for patient-centered fertility treatment that was developed based on health care professionals...

  18. Substance Abuse Treatment Centers and Local Crime

    OpenAIRE

    Bondurant, Samuel R.; Lindo, Jason M.; Isaac D. Swensen

    2016-01-01

    In this paper we estimate the effects of expanding access to substance-abuse treatment on local crime. We do so using an identification strategy that leverages variation driven by substance-abuse-treatment facility openings and closings measured at the county level. The results indicate that substance-abuse-treatment facilities reduce both violent and financially motivated crimes in an area, and that the effects are particularly pronounced for relatively serious crimes. The effects on homicid...

  19. Promoting community knowledge and action for malaria control in rural Cambodia: potential contributions of Village Malaria Workers

    Directory of Open Access Journals (Sweden)

    Lim Sachiko

    2012-08-01

    Full Text Available Abstract Background Cambodia has been investing in Village Malaria Workers (VMWs to improve malaria case management in rural areas. This study assessed the quality of the VMWs’ services compared to those by a government-run health center from the perspective of community members. We focused on VMWs’ contribution to promote their action to control malaria. A community-based cross-sectional study was conducted in Kampot province in 2009. Interviews were conducted at every accessible household in a village with VMWs (n = 153 and a village with a health center (n = 159, using interviewer administered questionnaire. Preference of the interview was given to female household head. Multiple regression analyses were run to compare knowledge about malaria, preventive measures taken, and time before first malaria treatment between the two villages. Findings The villagers perceived the VMWs’ services equally as good as those provided by the health center. After controlling for confounding factors, the following indicators did not show any statistical significance between two villages: community members’ knowledge about malaria transmission (AOR = 0.60, 95% CI = 0.30-1.22 and government-recommended antimalarial (AOR = 0.55, 95% CI = 0.25-1.23, preventive measures taken (Beta = −0.191, p = 0.315, and time before the first treatment (Beta = 0.053, p = 0.721. However, knowledge about malaria symptoms was significantly lower in the village with VMWs than the village with a health center (AOR = 0.40, 95% CI = 0.19-0.83. Conclusions VMWs played an equivalent role as the health center in promoting malaria knowledge, action, and effective case management. Although VMWs need to enhance community knowledge about malaria symptoms, the current government policy on VMWs is reasonable and should be expanded to other malaria endemic villages.

  20. Promoting community knowledge and action for malaria control in rural Cambodia: potential contributions of Village Malaria Workers.

    Science.gov (United States)

    Lim, Sachiko; Yasuoka, Junko; Poudel, Krishna C; Ly, Po; Nguon, Chea; Jimba, Masamine

    2012-08-03

    Cambodia has been investing in Village Malaria Workers (VMWs) to improve malaria case management in rural areas. This study assessed the quality of the VMWs' services compared to those by a government-run health center from the perspective of community members. We focused on VMWs' contribution to promote their action to control malaria. A community-based cross-sectional study was conducted in Kampot province in 2009. Interviews were conducted at every accessible household in a village with VMWs (n = 153) and a village with a health center (n = 159), using interviewer administered questionnaire. Preference of the interview was given to female household head. Multiple regression analyses were run to compare knowledge about malaria, preventive measures taken, and time before first malaria treatment between the two villages. The villagers perceived the VMWs' services equally as good as those provided by the health center. After controlling for confounding factors, the following indicators did not show any statistical significance between two villages: community members' knowledge about malaria transmission (AOR = 0.60, 95% CI = 0.30-1.22) and government-recommended antimalarial (AOR = 0.55, 95% CI = 0.25-1.23), preventive measures taken (Beta = -0.191, p = 0.315), and time before the first treatment (Beta = 0.053, p = 0.721). However, knowledge about malaria symptoms was significantly lower in the village with VMWs than the village with a health center (AOR = 0.40, 95% CI = 0.19-0.83). VMWs played an equivalent role as the health center in promoting malaria knowledge, action, and effective case management. Although VMWs need to enhance community knowledge about malaria symptoms, the current government policy on VMWs is reasonable and should be expanded to other malaria endemic villages.

  1. An alternative for urban wastewater from small villages: the symbiotic treatment; Una alternative para el tratamiento de aguas residuales urbanas de pequenos nucleos de poblacion: la depuracion simbiotica

    Energy Technology Data Exchange (ETDEWEB)

    Lorens Pascual del Riquelme, M.; Portero Escribano, S.; Saez Mercader, J.; Aguilar Sanchis, M. I.; Ortuno Sandoval, J. F.; Meseguer Zapata, V. F. [Universidad de Murcia. Murcia (Spain)

    2004-07-01

    The symbiotic treatment is a technology of new development, that combines a natural and subterranean treatment with the generation of green areas over the surface of the plant. It presents low-costs of construction and maintenance due to the simplicity of its constructive elements and the low demand of energy. This technology patented. The treatment of urban wastewaters from small villages is one of its possible applications. In this paper this technology is applied to the treatment of the wastewater produced in the Campus of Espinardo (University of Murcia. Spain). The objective is to prove it the effluent complies with the requirements established the Directive 91/271/EEC. A pilot plant that receives a flow of 13.81/h has been constructed, and a study of its operation has been carried out. The plant effluent satisfies the requirements established by the Directive for the current operation conditions. (Author) 7 refs.

  2. Proton Therapy Research and Treatment Center

    Energy Technology Data Exchange (ETDEWEB)

    Goodnight, J.E. Jr. (University of California Davis Medical Center, Sacramento, CA (United States). Cancer Center); Alonso, J.R. (Lawrence Berkeley Lab., CA (United States))

    1992-05-01

    This Grant proposal outlines the steps that will be undertaken to bring the UC Davis Proton Therapy Research and Treatment, known locally as the Proton Therapy Facility (PTF), through its design and construction phases. This application concentrates on the design phase of the PTF project.

  3. Urban warming in villages

    Science.gov (United States)

    Lindén, J.; Grimmond, C. S. B.; Esper, J.

    2015-07-01

    Long term meteorological records (> 100 years) from stations associated with villages are generally classified as rural and assumed to have no urban influence. Using networks installed in two European villages, the local and microclimatic variations around two of these rural-village sites are examined. An annual average temperature difference (Δ{T}) of 0.6 and 0.4 K was observed between the built-up village area and the current meteorological station in Geisenheim (Germany) and Haparanda (Sweden), respectively. Considerably larger values were recorded for the minimum temperatures and during summer. The spatial variations in temperature within the villages are of the same order as recorded over the past 100+ years in these villages (0.06 to 0.17 K/10 years). This suggests that the potential biases in the long records of rural-villages also warrant careful consideration like those of the more commonly studied large urban areas effects.

  4. Renewables for sustainable village power

    Energy Technology Data Exchange (ETDEWEB)

    Flowers, L

    1997-03-01

    It is estimated that two billion people live without electricity and its services. In addition, there is a sizeable number of rural villages that have limited electrical service, with either part-day operation by diesel gen-sets or partial electrification (local school or community center and several nearby houses). For many villages connected to the grid, power is often sporadically available and of poor quality. The U.S. National Renewable Energy Laboratory (NREL) in Golden, Colorado, has initiated a program to address these potential electricity opportunities in rural villages through the application of renewable energy (RE) technologies. The objective of this program is to develop and implement applications that demonstrate the technical performance, economic competitiveness, operational viability, and environmental benefits of renewable rural electric solutions, compared to the conventional options of line extension and isolated diesel mini-grids. These four attributes foster sustainability; therefore, the program is entitled Renewables for Sustainable Village Power (RSVP). The RSVP program is a multi-technology, multi-application program composed of six activities, including village applications development, computer model development, systems analysis, pilot project development, technical assistance, and Internet-based village power project data base. While the current program emphasizes wind, photovoltaics (PV), and their hybrids with diesel gen-sets, micro-hydro and micro-biomass technologies may be integrated in the future. NREL`s RSVP team is currently involved in rural electricity projects in thirteen countries, with U.S., foreign, and internationally based agencies and institutions. The integration of the technology developments, institutional experiences, and the financial solutions for the implementation of renewables in the main line rural electrification processes in both the developing world and remote regions of the developed world is the goal.

  5. An Evaluation of the Observer Effect on Treatment Integrity in a Day Treatment Center for Children

    Science.gov (United States)

    Howard, Monica R.; Burke, Raymond V.; Allen, Keith D.

    2013-01-01

    Treatment integrity is an important concern in treatment centers but is often overlooked. Performance feedback is a well-established approach to improving treatment integrity, but is underused and undervalued. One way to increase its value to treatment centers may be to expose unrealized benefits on the observer who collects the performance…

  6. Villages in landscapes

    DEFF Research Database (Denmark)

    Møller, Jørgen

    2008-01-01

    , and the physical appearance of many villages and detached farms can at best be characterized as shockingly inferior. It can be argued that the Danish society has grossly omitted to take care of the largest and most important part of its cultural heritage in the Danish landscape; 6-7,000 large and small villages...... dispersed in the Danish cultural landscape.These villages are crucial to the future of rural areas and are normally neglected....

  7. History of malaria treatment as a predictor of subsequent subclinical parasitaemia: a cross-sectional survey and malaria case records from three villages in Pailin, western Cambodia.

    Science.gov (United States)

    Peto, Thomas J; Kloprogge, Sabine E; Tripura, Rupam; Nguon, Chea; Sanann, Nou; Yok, Sovann; Heng, Chhouen; Promnarate, Cholrawee; Chalk, Jeremy; Song, Ngak; Lee, Sue J; Lubell, Yoel; Dhorda, Mehul; Imwong, Mallika; White, Nicholas J; von Seidlein, Lorenz; Dondorp, Arjen

    2016-04-26

    Treatment of the sub-clinical reservoir of malaria, which may maintain transmission, could be an important component of elimination strategies. The reliable detection of asymptomatic infections with low levels of parasitaemia requires high-volume quantitative polymerase chain reaction (uPCR), which is impractical to conduct on a large scale. It is unknown to what extent sub-clinical parasitaemias originate from recent or older clinical episodes. This study explored the association between clinical history of malaria and subsequent sub-clinical parasitaemia. In June 2013 a cross-sectional survey was conducted in three villages in Pailin, western Cambodia. Demographic and epidemiological data and blood samples were collected. Blood was tested for malaria by high-volume qPCR. Positive samples were analysed by nested PCR to determine the Plasmodium species. To identify previous episodes of malaria, case records were collected from village malaria workers and local health facilities and linked to study participants. Among 1343 participants, 40/122 (32.8 %) with a history of clinical malaria were parasitaemic during the cross-sectional survey, compared to 172/1221 (14.1 %) without this history (p history of clinical malaria, compared to 87 out of 1131 (7.7 %) parasite-negative participants; p history of Plasmodium vivax was associated with sub-clinical P. vivax parasitaemia in the survey (p history of P. falciparum. A clinical episode of vivax malaria was associated with subsequent sub-clinical parasitaemia. Treatment of P. vivax with artemisinin-based combination therapy without primaquine often resulted in recurrent episodes. Targeting individuals with a history of clinical malaria will be insufficient to eliminate the sub-clinical reservoir as they constitute a minority of parasitaemias.

  8. A conceptual framework for patient-centered fertility treatment.

    Science.gov (United States)

    Duthie, Elizabeth A; Cooper, Alexandra; Davis, Joseph B; Schoyer, Katherine D; Sandlow, Jay; Strawn, Estil Y; Flynn, Kathryn E

    2017-09-07

    Patient-centered care is a pillar of quality health care and is important to patients experiencing infertility. In this study we used empirical, in-depth data on couples' experiences of infertility treatment decision making to inform and revise a conceptual framework for patient-centered fertility treatment that was developed based on health care professionals' conceptualizations of fertility treatment, covering effectiveness, burden, safety, and costs. In this prospective, longitudinal mixed methods study, we collected data from both members (separately) of 37 couples who scheduled an initial consult with a reproductive specialist. Data collection occurred 1 week before the initial consultation, 1 week after the initial consultation, and then roughly 2, 4, 8, and 12 months later. Data collection included semi-structured qualitative interviews, self-reported questionnaires, and medical record review. Interviews were recorded, transcribed, and content analyzed in NVivo. A single coder analyzed all transcripts, with > 25% of transcripts coded by a second coder to ensure quality control and consistency. Content analysis of the interview transcripts revealed 6 treatment dimensions: effectiveness, physical and emotional burden, time, cost, potential risks, and genetic parentage. Thus, the revised framework for patient-centered fertility treatment retains much from the original framework, with modification to one dimension (from safety to potential risks) and the addition of two dimensions (time and genetic parentage). For patients and their partners making fertility treatment decisions, tradeoffs are explicitly considered across dimensions as opposed to each dimension being considered on its own. Patient-centered fertility treatment should account for the dimensions of treatment that patients and their partners weigh when making decisions about how to add a child to their family. Based on the lived experiences of couples seeking specialist medical care for

  9. Recording Village Life

    DEFF Research Database (Denmark)

    Cromwell, Jennifer Adele

    Recording Village Life presents a close study of over 140 Coptic texts written between 724–756 CE by a single scribe, Aristophanes son of Johannes, of the village Djeme in western Thebes. These texts, which focus primarily on taxation and property concerns, yield a wealth of knowledge about social...... of late antique studies, papyrology, philology, early Islamic history, social and economic history, and Egyptology....

  10. Related factors for defecation behaviour at Bandar Village

    OpenAIRE

    Dwiana, Anna; Herawaty, Lucky

    2017-01-01

    Background: Bandar Batauga village is the village which implements STBM program pillar 1 related stop open defecation but in practice has not been in line with expectations. Besides diarrhea cases recorded in Batauga health center is also very high, as many as 304 cases. The purpose of this study was to identify the factors associated with Community attitudes in defecation in Bandar Batauga village Batauga district South Buton Regency. Method: This study is study with mixed method, with conve...

  11. High reinfection rate and treatment failures in children treated with amodiaquine for falciparum malaria in Muheza villages, Northeastern Tanzania

    DEFF Research Database (Denmark)

    Lemnge, Martha; Alifrangis, Michael; Kafuye, Mwanaidi Y

    2006-01-01

    by polymerase chain reaction (PCR) genotyping of msp1 and msp2 genes. Additionally, Pfcrt codon 72-76 polymorphisms were studied by PCR and sequence-specific oligonucleotide probe (SSOP) ELISA. In 54 cases with complete follow-up, a significant difference in late treatment failure (LTF) rates was seen (60...

  12. Patient-centered communication of community treatment assistants in Tanzania predicts coverage of future mass drug administration for trachoma.

    Science.gov (United States)

    Jenson, Alexander; Roter, Debra L; Mkocha, Harran; Munoz, Beatriz; West, Sheila

    2018-01-06

    Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage. In 2011, CTAs from 23 distribution sites undergoing MDA as part of the Partnership for Rapid Elimination of Trachoma were selected. CTA - villager interactions were audio recorded. Audio was analyzed using an adaptation of the Roter Interaction Analysis System. The outcome of interest was the proportion of adults receiving MDA in 2011 who returned in 2012. 58 CTAs and 3122 interactions were included. Sites with female CTAs had significantly higher patient-centeredness ratio (0.548 vs 0.400) when compared to sites with male CTAs. Sites with more patient-centered interactions had higher proportion of patients return (p = 0.009). Female CTAs had higher proportion of patient-centered communication. Patient centered communication was associated with higher rates of return for MDA. Greater patient-centered connection with health care providers affects participation in public health efforts, even when those providers are lay health workers. Copyright © 2018. Published by Elsevier B.V.

  13. Child advocacy center based group treatment for child sexual abuse.

    Science.gov (United States)

    Hubel, Grace S; Campbell, Christopher; West, Tiffany; Friedenberg, Samantha; Schreier, Alayna; Flood, Mary Fran; Hansen, David J

    2014-01-01

    The present study examines initial symptom presentation among participants, outcomes, and social validity for a group treatment for child sexual abuse delivered at a child advocacy center. Participants were 97 children and their nonoffending caregivers who were referred to Project SAFE (Sexual Abuse Family Education), a standardized, 12-week cognitive-behavioral group treatment for families who have experienced child sexual abuse. Sixty-four percent of children presented with clinically significant symptoms on at least one measure with established clinical cutoffs. Caregivers of children who presented with clinically significant symptoms reported more distress about their competence as caregivers. Children who presented as subclinical were more likely to have experienced intrafamilial sexual abuse. Posttreatment results indicated significant improvements in functioning for all children who participated in treatment, with greater improvements reported for children who initially presented with clinically significant symptoms. Overall, the program was rated favorably on the posttreatment evaluation of social validity.

  14. The Moon Village Concept

    Science.gov (United States)

    Messina, Piero; Foing, Bernard H.; Hufenbach, Bernhard; Haignere, Claudie; Schrogl, Kai-Uwe

    2016-07-01

    The "Moon Village" concept Space exploration is anchored in the International Space Station and in the current and future automatic and planetary automatic and robotic missions that pave the way for future long-term exploration objectives. The Moon represents a prime choice for scientific, operational and programmatic reasons and could be the enterprise that federates all interested Nations. On these considerations ESA is currently elaborating the concept of a Moon Village as an ensemble where multiple users can carry out multiple activities. The Moon Village has the ambition to serve a number of objectives that have proven to be of interest (including astronomy, fundamental research, resources management, moon science, etc. ) to the space community and should be the catalyst of new alliances between public and private entities including non-space industries. Additionally the Moon Village should provide a strong inspirational and education tool for the younger generations . The Moon Village will rely both on automatic, robotic and human-tendered structures to achieve sustainable moon surface operations serving multiple purposes on an open-architecture basis. This Europe-inspired initiative should rally all communities (across scientific disciplines, nations, industries) and make it to the top of the political agendas as a the scientific and technological undertaking but also political and inspirational endeavour of the XXI century. The current reflections are of course based on the current activities and plans on board the ISS and the discussion held in international fora such as the ISECG. The paper will present the status of these reflections, also in view of the ESA Council at Ministerial Level 2016, and will give an overview of the on-going activities being carried out to enable the vision of a Moon Village.

  15. Noise disturbances in daycare centers before and after acoustical treatment.

    Science.gov (United States)

    Gerhardsson, Lars; Nilsson, Erling

    2013-03-01

    The authors' aim was to study noise-related problems in personnel at Swedish daycare centers. The authors' study comprised staff (N = 81) who completed a questionnaire (noise, illumination, indoor climate, hearing problems) at five daycare centers with noise problems. After basic and activity sound measurements, absorbers were attached to the ceilings and to two adjacent walls in the playing and dining rooms. Thereafter, basic and activity sound measures were repeated and the questionnaire was also repeated six months later. The acoustical treatment reduced the sound pressure levels by 2 to 6 dB in the playing rooms and by 0 to 3 dB in the dining rooms. The reverberation time was reduced by 20% to 50%. After the treatment the perceived noise disturbance level decreased slightly but not significantly and the proportion of the staff who often or very often planned the daily activities to reduce the noise level had decreased from about 39% to 25%. Similarly, the percentage that often or very often had a need for silence after work had decreased from 42% to 37%.

  16. "It takes a village" to raise research productivity: impact of a Trauma Interdisciplinary Group for Research at an urban, Level 1 trauma center.

    Science.gov (United States)

    NeSmith, Elizabeth G; Medeiros, Regina S; Ferdinand, Colville H B; Hawkins, Michael L; Holsten, Steven B; Zhu, Haidong; Dong, Yanbin

    2013-07-01

    Few interdisciplinary research groups include basic scientists, pharmacists, therapists, nutritionists, laboratory technicians, as well as trauma patients and families, in addition to clinicians. Increasing interprofessional diversity within scientific teams working to improve trauma care is a goal of national organizations and federal funding agencies such as the National Institutes of Health (NIH). This article describes the design, implementation, and outcomes of a Trauma Interdisciplinary Group for Research (TIGR) at a Level 1 trauma center as it relates to increasing research productivity, with specific examples excerpted from an ongoing NIH-funded study. We used a pretest/posttest design with objectives aimed at measuring increases in research productivity following a targeted intervention. A SWOT (strengths, weaknesses, opportunities, and threats) analysis was used to develop the intervention, which included research skill-building activities, accomplished by adding multidisciplinary investigators to an existing NIH-funded project. The NIH project aimed to test the hypothesis that accelerated biologic aging from chronic stress increases baseline inflammation and reduces inflammatory response to trauma (projected n = 150). Pre-TIGR/post-TIGR data related to participant screening, recruitment, consent, and research processes were compared. Research productivity was measured through abstracts, publications, and investigator-initiated projects. Research products increased from 12 to 42 (approximately 400%). Research proposals for federal funding increased from 0 to 3, with success rate of 66%. Participant screenings for the NIH-funded study increased from 40 to 313. Consents increased from 14 to 70. Laboratory service fees were reduced from $300 per participant to $5 per participant. Adding diversity to our scientific team via TIGR was exponentially successful in (1) improving research productivity, (2) reducing research costs, and (3) increasing research

  17. "It takes a village" to raise research productivity: Impact of a Trauma Interdisciplinary Group for Research (TIGR) at an urban, Level 1 trauma center.

    Science.gov (United States)

    Nesmith, Elizabeth G; Medeiros, Regina S; Ferdinand, Colville H B; Hawkins, Michael L; Holsten, Steven B; Dong, Yanbin; Zhu, Haidong

    2013-07-01

    Few interdisciplinary research groups include basic scientists, pharmacists, therapists, nutritionists, lab technicians, as well as trauma patients and families, in addition to clinicians. Increasing interprofessional diversity within scientific teams working to improve trauma care is a goal of national organizations and federal funding agencies like the National Institutes of Health (NIH). This paper describes the design, implementation, and outcomes of a Trauma Interdisciplinary Group for Research (TIGR) at a Level 1 trauma center as it relates to increasing research productivity, with specific examples excerpted from an on-going NIH-funded study. We utilized a pre-test/post-test design with objectives aimed at measuring increases in research productivity following a targeted intervention. A SWOT (strengths, weaknesses, opportunities, threats) analysis was used to develop the intervention which included research skill-building activities, accomplished by adding multidisciplinary investigators to an existing NIH-funded project. The NIH project aimed to test the hypothesis that accelerated biologic aging from chronic stress increases baseline inflammation and reduces inflammatory response to trauma (projected N=150). Pre/Post-TIGR data related to participant screening, recruitment, consent, and research processes were compared. Research productivity was measured through abstracts, publications, and investigator-initiated projects. Research products increased from N =12 to N=42; (~ 400%). Research proposals for federal funding increased from N=0 to N=3, with success rate of 66%. Participant screenings for the NIH-funded study increased from N=40 to N=313. Consents increased from N=14 to N=70. Lab service fees were reduced from $300/participant to $5/participant. Adding diversity to our scientific team via TIGR was exponentially successful in 1) improving research productivity, 2) reducing research costs, and 3) increasing research products and mentoring activities

  18. Village power options

    Energy Technology Data Exchange (ETDEWEB)

    Lilienthal, P. [National Renewable Energy Laboratory, Golden, CO (United States)

    1997-12-01

    This paper describes three different computer codes which have been written to model village power applications. The reasons which have driven the development of these codes include: the existance of limited field data; diverse applications can be modeled; models allow cost and performance comparisons; simulations generate insights into cost structures. The models which are discussed are: Hybrid2, a public code which provides detailed engineering simulations to analyze the performance of a particular configuration; HOMER - the hybrid optimization model for electric renewables - which provides economic screening for sensitivity analyses; and VIPOR the village power model - which is a network optimization model for comparing mini-grids to individual systems. Examples of the output of these codes are presented for specific applications.

  19. Stricken village. 1948.

    Science.gov (United States)

    Curtis, Marion

    2008-01-01

    An historical reprint, this account of a public health nurse's work with village residents during an outbreak of pneumonia related to tuberculosis was originally published in Public Health Nursing in December 1948. The author, Marion Curtis, was a public health nurse in the Territorial Health Department of Alaska called upon to respond to the rapid death of several victims of an unknown disease affecting a small outpost on Kodiak Island in the Territory of Alaska. Her narrative tells us about the settlement village and what happened from the time of the wire for help to the time she left the community for home. Her original spelling of names has been retained. Curtis's response to the emergency was quick and demonstrated experience. Her application of infection control principles helped quickly control the outbreak. At the end of her story, Curtis reflected on the impact of disease on communities and civilizations, predicting that villages like the one she had described might vanish within 20 years due to tuberculosis. Readers may reflect whether Curtis's view presents an etic or an emic perspective. Old Harbor, however, remains a small but vital community on Kodiak Island's southwestern shore.

  20. Implementing tobacco use treatment guidelines in community health centers in Vietnam.

    Science.gov (United States)

    Shelley, Donna; VanDevanter, Nancy; Cleland, Charles C; Nguyen, Linh; Nguyen, Nam

    2015-10-09

    Vietnam has a smoking prevalence that is the second highest among Southeast Asian countries (SEACs). According to the World Health Organization (WHO), most reductions in mortality from tobacco use in the near future will be achieved through helping current users quit. Yet, largely due to a lack of research on strategies for implementing WHO-endorsed treatment guidelines in primary care settings, services to treat tobacco dependence are not readily available to smokers in low middle-income countries (LMICs) like Vietnam. The objective of this study is to conduct a cluster randomized controlled trial that compares the effectiveness of two system-level strategies for implementing evidence-based guidelines for the treatment of tobacco use in 26 public community health centers (CHCs) in Vietnam. The current study will use a cluster-randomized design and multiple data sources (patient exit interviews, provider and village health worker (VHW) surveys, and semi-structured provider/VHW interviews) to study the process of adapting and implementing clinical practice guidelines in Vietnam and theory-driven mechanisms hypothesized to explain the comparative effectiveness of the two strategies for implementation. CHCs will be randomly assigned to either of the following: (1) training plus clinical reminder system (TC) or (2) TC + referral to a VHW (TCR) for three in person counseling sessions. The primary outcome is provider adherence to tobacco use treatment guidelines. The secondary outcome is 6-month biochemically verified smoking abstinence. The proposed implementation strategies draw on evidence-based approaches and a growing literature that supports the effectiveness of integrating community health workers as members of the health care team to improve access to preventive services. We hypothesize that the value of these implementation strategies is additive and that incorporating a referral resource that allows providers to delegate the task of offering counseling (TCR

  1. Attitude to treatment of patients with psoriasis attending spa center.

    Science.gov (United States)

    Gisondi, P; Farina, S; Giordano, M V; Zanoni, M; Girolomoni, G

    2012-10-01

    The aim of this paper was to investigate beliefs and preferences towards treatment of patients with psoriasis attending Comano SPA (Trentino, Italy) in comparison to patients referring to the University Hospital of Verona. Patient with psoriasis referring to Comano SPA and to the University Hospital of Verona were visited, their clinical data were collected and they were administered a questionnaire investigating their knowledge about psoriasis, as well as their attitude and preferences towards conventional therapies and SPA treatments. [Corrected] A total of 288 patients with chronic plaque psoriasis were recruited, 169 from Comano SPA and 119 from Verona Hospital. There were no differences regarding demographic data, severity of psoriasis, impact on quality of life and prevalence of cardio-metabolic comorbidities between the two groups. SPA patients more rarely believed that pharmacological treatments are safe and effective (6.5% vs. 21.8% P=0.001), had less trust in physician (32.5% vs. 67.2%; P=0.001) and preferred alternative therapies like balneotherapy compared to hospital patients (55.6% vs. 30.3%; P=0.0001), because they assumed they were more safe and effective than systemic drugs (37.3% vs. 1.7%; P=0.001). SPA patients preferred living with psoriasis rather than taking drugs to treat it more commonly than hospital patients (26.6% vs. 5%; P=0.001). Patients attending a SPA centre tend to trust conventional drug treatments less often than those attending a hospital clinic, and prefer balneotherapy as a dedicated alternative therapy. Fear of adverse events is a major concern among patients with psoriasis, especially those attending a SPA center.

  2. Sleeping sickness surveys: game reserve adjacent villages in Malawi

    African Journals Online (AJOL)

    87 in~ividuals traced 2 years after hospital discharge were found well and active in their villages. 4 died in villages after hospital treatment. 3 relapsed and were readmitted to hospital. Sera from 160 game ranger volunteers and from 82 suspected cases_of Rhodesian sleeping sickness were tested by use of ELISA, IF AT ...

  3. Research on the localization method of protecting traditional village landscape: a case study on Tangyin

    Directory of Open Access Journals (Sweden)

    W. Li

    2015-08-01

    Full Text Available China has over 271 million villages and less than the number in ten years ago in which there are 363 million villages. New rural construction indeed do some good for common villages but still destroy hundreds and thousands traditional village which contain great cultural, science, artistic values. In addition, traditional villages can't meet the increasing needs in more convenient and comfortable living conditions. Increasing population also makes traditional villages out of control in construction. With the background of this, we have to set up in traditional village protection. This article put forward an idea in protection which make use of landscape localization to pursue the sustainable development and vernacular landscape protection. Tangyin Town is a famous trade center in history and left many cultural heritage, especially historical buildings. Take Tangyin as a case study to apply the localization method which could guide other similar villages to achieve same goals.

  4. Village Power '98

    Energy Technology Data Exchange (ETDEWEB)

    Cardinal, Julie; Flowers, Larry; Siegel, Judy; Taylor, Roger; Weingart, Jerome

    1999-03-24

    This is the fifth Village Power workshop sponsored by NREL. We have held these meetings every year since 1993, to focus, challenge, and provide a forum for interaction among practitioners working in the field of using renewable energy technologies as an economically viable pathway to electrification of rural populations throughout the world. Starting with a small group of 30 colleagues in 1993, this ''workshop'' has doubled in size every year. When the NREL staff was planning for this meeting, they were hoping for something around 400 participants. We are now looking at over 500, and we apologize for the somewhat cramped accommodations. This overwhelming response, however, shows that the use of renewable energy to solve some of the world's serious problems is coming of age. This meeting, this ''conference'' (it's clearly no longer a workshop) marks a transition. A transition from the viewpoint that renewables are, and forever will be a technology of the future; to the reality that renewables have come of age. We have technologies available today, at today's prices, that can make a substantive contribution to the pressing needs of environmentally sustainable development in the world. This is a collection of all the papers presented at the Village Power '98 conference.

  5. 75 FR 16487 - Center for Substance Abuse Treatment; Notice of Meeting

    Science.gov (United States)

    2010-04-01

    ... Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (CSAT... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse.... Committee Name: Substance Abuse and Mental Health Services Administration's CSAT National Advisory Council...

  6. 75 FR 16488 - Center for Substance Abuse Treatment; Notice of Meeting

    Science.gov (United States)

    2010-04-01

    ... Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (CSAT... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse.... Committee Name: Substance Abuse and Mental Health Services Administration's CSAT National Advisory Council...

  7. 78 FR 37560 - Center for Substance Abuse Treatment; Notice of Meeting

    Science.gov (United States)

    2013-06-21

    ... Treatment; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT... information below). Committee Name: SAMHSA's Center for Substance Abuse Treatment National Advisory Council...

  8. 75 FR 38112 - Center for Substance Abuse Treatment; Notice of Meeting

    Science.gov (United States)

    2010-07-01

    ... Treatment; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT... information below). Committee Name: SAMHSA's Center for Substance Abuse Treatment National Advisory Council...

  9. 75 FR 47819 - Center for Substance Abuse Treatment; Notice of Meeting

    Science.gov (United States)

    2010-08-09

    ... Treatment; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT... information below). Committee Name: SAMHSA's Center for Substance Abuse Treatment National Advisory Council...

  10. Native Nutrition--Northwest Indian Treatment Center Honors Culture to Heal the Mind

    Science.gov (United States)

    Krohn, Elise

    2011-01-01

    The Northwest Indian Treatment Center runs a 45-day inpatient treatment program in Elma, Washington. The Squaxin Island Tribe created the program to address an unmet need for culturally based drug and alcohol treatment centers for Indian people who grew up on reservations. The program specializes in treating people with chronic relapse patterns…

  11. MODEL OF VILLAGE HEAD ELECTION ARRANGEMENT IN VILLAGE GOVERNANCE LAW

    Directory of Open Access Journals (Sweden)

    Sekar Anggun Gading Pinilih

    2017-05-01

    Full Text Available This study aims to examine the right model in the arrangement of village head elections after the stipulation of Law No. 6 year 2014 on Village. This research is a normative law research by laws, historical, and conceptual approach. The result shows that a direct and simultaneous election model shall be the solution for the next Village Head Election. Simultaneous election model is designed since it is philosophically considered to make efficiency of the Village Head Elections, in terms of efficiency of budget, time and effort. The principle of this policy is an attempt to create a more equitable simultaneous democratization to minimize the chances of cheating. Since if the elections were not held simultaneously, it would give chance to the outsider to involve. The simultaneous election requires a coherent policy. This coherence will produce an effective synchronization of all types of elections implementation in Indonesia. Keywords: head of village, model, election, arrangement

  12. IN VOZDVIZHENSKOE VILLAGE

    Directory of Open Access Journals (Sweden)

    Chetyrina Natalya Arkadevna

    2012-10-01

    Full Text Available The paper considers civil engineering in retrospect. The paper presents the records of the two contracts that date back to 1837 and 1838. The contracts cover the two stages of construction of a famous church in Vozdvizhenskoe Village in the Moscow Province. These documents were stored in the Central Historic Archive, namely, in the collection of the town hall of Sergievskij Possad. These records of the two agreements in the collection of the brokers notes (or in other books of the same type are of particular value, as the majority of authentic contracts have been lost. One of the contracts covers the organizational procedure and pre-construction works, while the other one covers the construction of the church. The first document gives the idea of environmental protection, employment of ecological technologies, and safe disposal and recycling of human biowaste in the course of dismantling of an old structure in Vozdvizhenskoe village. The second document that dates back to 1838 covers the sequence of construction works, starting from the foundation and ending with the arches, the types of building materials used, and peculiarities of stone masonry. The information recorded in the contract includes the names of the counterparties, day-to-day mode of life of seasonal workers, remuneration of labour and procedures that assure the quality of construction. This agreement makes it possible to outline the construction process that includes workers, bricklayers, the foreman, the contractor, the architect, and the customer. On the whole, both documents help us outline and assess some of the building practices of the 19th century. This issue is relevant nowadays, as our society has entered the phase of the market economy, while the experience accumulated by the past generations is of undeniable value.

  13. Antibiotic prescribing of village doctors for children under 15 years with upper respiratory tract infections in rural China

    Science.gov (United States)

    Zhang, Zhixia; Zhan, Xingxin; Zhou, Hongjun; Sun, Fang; Zhang, Heng; Zwarenstein, Merrick; Liu, Qian; Li, Yingxue; Yan, Weirong

    2016-01-01

    Abstract The aim of this study was to explore the knowledge, attitudes, and practices of village doctors regarding the prescribing of antibiotics for children under 15 years with upper respiratory tract infections (URTIs) in rural China. Twelve focus group discussions (FGDs) were conducted in Xianning, a prefecture-level city in rural China, during December 2014. We conducted 6 FGDs with 35 village doctors, 3 with 13 primary caregivers (11 parents), and 3 with 17 directors of township hospitals, county-level health bureaus, county-level Centers for Disease Control and Prevention, or county-level Chinese Food and Drug Administration offices. Audio records of the interviews were transcribed verbatim and analyzed using the thematic analysis approach. Participants believed that unnecessary antibiotic prescribing for children under 15 years with The occurrence of URTIs was a problem in village clinics in rural China. The discussions revealed that most of the village doctors had inadequate knowledge and misconceptions about antibiotic use, which was an important factor in the unnecessary prescribing. Village doctors and directors reported that the doctors’ fear of complications, the primary caregivers’ pressure for antibiotic treatment, and the financial considerations of patient retention were the main factors influencing the decision to prescribe antibiotics. Most of the primary caregivers insisted on antibiotics, even when the village doctors were reluctant to prescribe them, and they preferred to go to see those village doctors who prescribed antibiotics. The interviewees also gave their opinions on what would be the most effective measures for optimizing antibiotic prescriptions; these included educational/training campaigns, strict regulations on antibiotic prescription, and improved supervision. Findings emphasized the need to improve the dissemination of information and training/education, and implement legislation on the rational use of antibiotics. And it

  14. 78 FR 45544 - Center for Substance Abuse Treatment (CSAT) National Advisory Council; Notice of Meeting

    Science.gov (United States)

    2013-07-29

    ... Substance Abuse Treatment (CSAT) National Advisory Council will meet August 14, 2013, 9:00 a.m.--4:30 p.m...: Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment National... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse...

  15. Sexually transmitted infections screening at HIV treatment centers for MSM can be cost-effective

    NARCIS (Netherlands)

    Vriend, Henrike J.; Lugnér, Anna K.; Xiridou, Maria; Van Der Loeff, Maarten F. Schim; Prins, Maria; De Vries, Henry J.C.; Geerlings, Suzanne E.; Prins, Jan M.; Rijnders, Bart J.A.; Van Veen, Maaike G.; Fennema, Johannes S.A.; Postma, Maarten J.; Van Der Sande, Marianne A.B.

    2013-01-01

    Objective:To estimate the cost-effectiveness of anorectal chlamydia screening among men who have sex with men (MSM) in care at HIV treatment centers. Design:Transmission model combined with economic analysis over a 20-year period. Setting and participants:MSM in care at HIV treatment centers.

  16. Alaska Village Electric Load Calculator

    Energy Technology Data Exchange (ETDEWEB)

    Devine, M.; Baring-Gould, E. I.

    2004-10-01

    As part of designing a village electric power system, the present and future electric loads must be defined, including both seasonal and daily usage patterns. However, in many cases, detailed electric load information is not readily available. NREL developed the Alaska Village Electric Load Calculator to help estimate the electricity requirements in a village given basic information about the types of facilities located within the community. The purpose of this report is to explain how the load calculator was developed and to provide instructions on its use so that organizations can then use this model to calculate expected electrical energy usage.

  17. Alternative treatments for indoor residual spraying for malaria control in a village with pyrethroid- and DDT-resistant vectors in the Gambia.

    Science.gov (United States)

    Tangena, Julie-Anne A; Adiamoh, Majidah; D'Alessandro, Umberto; Jarju, Lamin; Jawara, Musa; Jeffries, David; Malik, Naiela; Nwakanma, Davis; Kaur, Harparkash; Takken, Willem; Lindsay, Steve W; Pinder, Margaret

    2013-01-01

    Malaria vector control is threatened by resistance to pyrethroids, the only class of insecticides used for treating bed nets. The second major vector control method is indoor residual spraying with pyrethroids or the organochloride DDT. However, resistance to pyrethroids frequently confers resistance to DDT. Therefore, alternative insecticides are urgently needed. Insecticide resistance and the efficacy of indoor residual spraying with different insecticides was determined in a Gambian village. Resistance of local vectors to pyrethroids and DDT was high (31% and 46% mortality, respectively) while resistance to bendiocarb and pirimiphos methyl was low (88% and 100% mortality, respectively). The vectors were predominantly Anopheles gambiae s.s. with 94% of them having the putative resistant genotype kdr 1014F. Four groups of eight residential compounds were each sprayed with either (1) bendiocarb, a carbamate, (2) DDT, an organochlorine, (3) microencapsulated pirimiphos methyl, an organophosphate, or (4) left unsprayed. All insecticides tested showed high residual activity up to five months after application. Mosquito house entry, estimated by light traps, was similar in all houses with metal roofs, but was significantly less in IRS houses with thatched roofs (p=0.02). Residents participating in focus group discussions indicated that IRS was considered a necessary nuisance and also may decrease the use of long-lasting insecticidal nets. Bendiocarb and microencapsulated pirimiphos methyl are viable alternatives for indoor residual spraying where resistance to pyrethroids and DDT is high and may assist in the management of pyrethroid resistance.

  18. Alternative treatments for indoor residual spraying for malaria control in a village with pyrethroid- and DDT-resistant vectors in the Gambia.

    Directory of Open Access Journals (Sweden)

    Julie-Anne A Tangena

    Full Text Available BACKGROUND: Malaria vector control is threatened by resistance to pyrethroids, the only class of insecticides used for treating bed nets. The second major vector control method is indoor residual spraying with pyrethroids or the organochloride DDT. However, resistance to pyrethroids frequently confers resistance to DDT. Therefore, alternative insecticides are urgently needed. METHODOLOGY/PRINCIPAL FINDINGS: Insecticide resistance and the efficacy of indoor residual spraying with different insecticides was determined in a Gambian village. Resistance of local vectors to pyrethroids and DDT was high (31% and 46% mortality, respectively while resistance to bendiocarb and pirimiphos methyl was low (88% and 100% mortality, respectively. The vectors were predominantly Anopheles gambiae s.s. with 94% of them having the putative resistant genotype kdr 1014F. Four groups of eight residential compounds were each sprayed with either (1 bendiocarb, a carbamate, (2 DDT, an organochlorine, (3 microencapsulated pirimiphos methyl, an organophosphate, or (4 left unsprayed. All insecticides tested showed high residual activity up to five months after application. Mosquito house entry, estimated by light traps, was similar in all houses with metal roofs, but was significantly less in IRS houses with thatched roofs (p=0.02. Residents participating in focus group discussions indicated that IRS was considered a necessary nuisance and also may decrease the use of long-lasting insecticidal nets. CONCLUSION/SIGNIFICANCE: Bendiocarb and microencapsulated pirimiphos methyl are viable alternatives for indoor residual spraying where resistance to pyrethroids and DDT is high and may assist in the management of pyrethroid resistance.

  19. Medical treatment for myasthenia gravis at a Myasthenia Center

    Directory of Open Access Journals (Sweden)

    Tatyana Valentinovna Romanova

    2013-01-01

    Full Text Available The paper analyzes the results of treatment in 373 patients included in the Samara Region’s register of myasthenia gravis. The average disease duration was 9.7±7.6 years. Treatment encompassed symptom control with acetylcholinesterase inhibitors and immunosuppressive therapy. To achieve remission and good compensation, most cases needed the combined use of anticholinesterase inhibitors and immunosuppression with glucocorticoids and/or cytostatics. The efficiency of glucocorticoid and cytostatic therapies did not differ essentially. The adverse reactions of the treatment were evaluated. Therapy could achieve stabilization and improvement in 88.2% of cases.

  20. [Benefits of specialized centers for the treatment of addictive disorders].

    Science.gov (United States)

    Soravia, Leila; Allemann, Peter

    2014-10-01

    The attendance of an in-patient therapy program is often an indispensable part in the treatment of addiction disorders. The different stages of treatment, its elements of therapy as well as advantages and disadvantages of a stationary setting are discussed. The importance of an individualized therapy matched with the stage of detoxification and withdrawal is shown on the example of the Klinik Südhang, where patients with alcohol and/or drug addiction disorders seek treatment. Advantages and disadvantages of a stationary setting are discussed. To allow a successful detoxification and/or withdrawal, an interdisciplinary assistance and aftercare is essential.

  1. A Rhetorical Analysis of Village

    DEFF Research Database (Denmark)

    Andersen, Lars Pynt

    2011-01-01

    The award-winning TV spot Village is a creative example of NGO advertising using condensed visual stprytelling. The spot is analysed using rhetorical concepts and communication theory, and potential effects are discused in relation to contexts, strategy and communication ethics.......The award-winning TV spot Village is a creative example of NGO advertising using condensed visual stprytelling. The spot is analysed using rhetorical concepts and communication theory, and potential effects are discused in relation to contexts, strategy and communication ethics....

  2. Surgical treatment of rib fracture nonunion: A single center experience.

    Science.gov (United States)

    de Jong, M B; Houwert, R M; van Heerde, S; de Steenwinkel, M; Hietbrink, F; Leenen, L P H

    2018-02-02

    In contrast to the emerging evidence on the operative treatment of flail chest, there is a paucity of literature on the surgical treatment of rib fracture nonunion. The purpose of this study was to describe our standardized approach and report the outcome (e.g. patient satisfaction, pain and complications) after surgical treatment of a rib fracture nonunion. A single centre retrospective cohort study was performed at a level 1 trauma centre. Symptomatic rib nonunion was defined as a severe persistent localized pain associated with the nonunion of one or more rib fractures on a chest CT scan at least 3 months after the initial trauma. Patients after initial operative treatment of rib fractures were excluded. Nineteen patients (11 men, 8 women), with symptomatic nonunions were included. Fourteen patients were referred from other hospitals and 8 patients received treatment from a pain medicine specialist. The mean follow-up was 36 months. No in-hospital complications were observed. In 2 patients, new fractures adjacent to the implant, without new trauma were observed. Furthermore 3 patients requested implant removal with a persistent nonunion in one patient. There was a mean follow-up of 36 months, the majority of patients (n = 13) were satisfied with the results of their surgical treatment and all patients experienced a reduction in the number of complaints. Persisting pain was a common complaint. Three patients reporting severe pain used opioid analgesics on a daily or weekly basis. Only 1 patient needed ongoing treatment by a pain medicine specialist. Surgical fixation of symptomatic rib nonunion is a safe and feasible procedure, with a low perioperative complication rate, and might be beneficial in selected symptomatic patients in the future. In our study, although the majority of patients were satisfied and the pain level subjectively decreases, complaints of persistent pain were common. Copyright © 2018. Published by Elsevier Ltd.

  3. Generating sustainable towns from Chinese villages: a system modeling approach.

    Science.gov (United States)

    Levine, Richard S; Hughes, Michael T; Ryan Mather, Casey; Yanarella, Ernest J

    2008-04-01

    The great majority of China's developing towns will be extensions of already existing villages. With the prospect of hundreds of millions of Chinese farmers projected to leave their villages to become industrial workers in new and expanded towns within the next few years, new challenges will be faced. As expansion and modernization progress, this development moves from the traditional village model that operates not far from resource sustainability to increasingly unsustainable patterns of commerce, urban development, and modern life. With such an unprecedented mass migration and transformation, how can Chinese culture survive? What is to become of the existing million plus agricultural villages? How can these massively unsustainable new industrial towns survive? In the European Commission sponsored research program SUCCESS, researchers worked from the scale of the Chinese village to find viable answers to these questions. To address these issues, the Center for Sustainable Cities, one of the SUCCESS teams, studied the metabolism of several small villages. In these studies, system dynamics models of a village's metabolism were created and then modified so that inherently unsustainable means were eliminated from the model (fossil fuels, harmful agricultural chemicals, etc.) and replaced by sustainability-oriented means. Small Chinese farming villages are unlikely to survive in anything like their present form or scale, not least because they are too small to provide the range of life opportunities to which the young generation of educated Chinese aspires. As a response to this realization as well as to the many other threats to the Chinese village and its rural way of life, it was proposed that one viable path into the future would be to enlarge the villages to become full service towns with sufficient diversity of opportunity to be able to attract and keep many of the best and brightest young people who are now migrating to the larger cities. Starting with the

  4. Endovascular treatment of cerebral aneurysms at Altai Regional Vascular Center

    Directory of Open Access Journals (Sweden)

    Д. А. Долженко

    2015-10-01

    Full Text Available A retrospective analysis of the results of endovascular treatment of patients with the brain aneurysms was carried out at the Neurosurgical Department of Regional Clinical Hospital in Barnaul over a period from 2009 to 2011. 52 patients with 57 cerebral aneurysms were included in the study and 55 endovascular interventions were performed. Total embolization (type A was used in 77% of patients, embolization type B was performed in 19% of cases, incomplete embolization (type C occurred in 4% of cases. 14 (26,9% patients were operated in the acute period of SAH. Conclusions are made relating to the effectiveness and relative safety of intravascular treatment of aneurysms, the need for differentiated approaches to the tactics of surgical treatment of patients in the acute period of hemorrhagic stroke due to the rupture of a cerebral aneurysm.

  5. Barriers to utilization of postnatal care at village level in Klaten district, central Java Province, Indonesia.

    Science.gov (United States)

    Probandari, Ari; Arcita, Akhda; Kothijah, Kothijah; Pamungkasari, Eti Poncorini

    2017-08-07

    Maternal health remains a persisting public health challenge in Indonesia. Postnatal complications, in particular, are considered as maternal health problems priority that should be addressed. Conducting adequate care for postnatal complications will improve the quality of life of mothers and babies. With the universal health coverage implementation, the Indonesian government provides free maternal and child health services close to clients at the village level, which include postnatal care. Our study aimed to explore barriers to utilization of postnatal care at the village level in Klaten district, Central Java Province, Indonesia. A qualitative study was conducted in March 2015 - June 2016 in Klaten district, Central Java, Indonesia. We selected a total of 19 study participants, including eight mothers with postnatal complications, six family members, and five village midwives for in-depth interviews. We conducted a content analysis technique on verbatim transcripts of the interviews using open code software. This study found three categories of barriers to postnatal care utilization in villages: mother and family members' health literacy on postnatal care, sociocultural beliefs and practices, and health service responses. Most mothers did not have adequate knowledge and skills regarding postnatal care that reflected how they lacked awareness and practice of postnatal care. Inter-generational norms and myths hindered mothers from utilizing postnatal care and from having adequate nutritional intake during the postnatal period. Mothers and family members conducted unsafe self-treatment to address perceived minor postnatal complication. Furthermore, social power from extended family influenced the postnatal care health literacy for mother and family members. Postnatal care in the village lacked patient-centered care practices. Additionally, midwives' workloads and capacities to conduct postnatal information, education and counseling were also issues. Despite the

  6. Addiction treatment centers' progress in preparing for health care reform.

    Science.gov (United States)

    Molfenter, Todd D

    2014-02-01

    The Patient Protection and Affordable Care Act (PPACA) is expected to significantly alter addiction treatment service delivery. Researchers designed the Health Reform Readiness Index (HRRI) for addiction treatment organizations to assess their readiness for the PPACA. Four-hundred twenty-seven organizations completed the HRRI throughout a 3-year period, using a four-point scale to rank their readiness on 13 conditions. HRRI results completed during two different time periods (between 10/1/2010-6/30/2011 and 9/1/2011-9/30/2012) were analyzed and compared. Most respondents self-assessed as being in the early stages of preparation for 9 of the 13 conditions. Survey results showed that organizations with annual budgets $5 million (n=132). The HRRI results suggest that the addiction field, and in particular smaller organizations, is not preparing adequately for health care reform; organizations that are making preparations are making only modest gains. © 2013.

  7. 78 FR 15961 - Center for Substance Abuse Treatment National Advisory Council; Meeting

    Science.gov (United States)

    2013-03-13

    ... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse... meeting of the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment National Advisory Council on April 10, 2013. The meeting is open to the public and will...

  8. Survey of Infection Control Policies within Dental/Educational Patient Treatment Centers.

    Science.gov (United States)

    Dickey, Keith Winfield

    1986-01-01

    The article describes a survey of 36 dental education programs to identify educators' reactive policies and procedures in their patient treatment centers to minimize dental contamination and cross-contamination. (Author/CT)

  9. Violence narratives of Mexican women treated in mutual-aid residential centers for addiction treatment

    OpenAIRE

    Lozano-Verduzco, Ignacio; Romero-Mendoza, Martha; Mar?n-Navarrete, Rodrigo

    2016-01-01

    Background Violence against women is a social and public health issue in Mexico. The aim of this article is to explore violence among an understudied group of women, who attended Mutual-Aid Residential Centers for Addiction Treatment and experienced stigma both as women and addicts. These centers are particular kind of addiction treatment services that stem from 12-step philosophy, but that have been found to manipulate said philosophy and exercise extreme forms of psychological and physical ...

  10. Tackling malaria, village by village: a report on a concerted ...

    African Journals Online (AJOL)

    Abstract. Background: Can an information intervention facilitated by information technology and carried out by an interdisciplinary ... In Mifumi village in Eastern Uganda, MIFUMI Project, Makerere University College of Health Sciences Community Based ... insecticide treated nets (ITNs) using a digital pen application.

  11. EcoVillage: A Net Zero Energy Ready Community

    Energy Technology Data Exchange (ETDEWEB)

    Arena, L. [Consortium for Advanced Residential Buildings, Norwalk, CT (United States); Faakye, O. [Consortium for Advanced Residential Buildings, Norwalk, CT (United States)

    2015-02-01

    CARB is working with the EcoVillage co-housing community in Ithaca, New York, on their third neighborhood called the Third Residential EcoVillage Experience (TREE). This community scale project consists of 40 housing units --15 apartments and 25 single family residences. The community is pursuing certifications for DOE Zero Energy Ready Home, U.S. Green Building Council Leadership in Energy and Environmental Design Gold, and ENERGY STAR for the entire project. Additionally, seven of the 25 homes, along with the four-story apartment building and community center, are being constructed to the Passive House (PH) design standard.

  12. Treatment preference and patient centered prostate cancer care: Design and rationale.

    Science.gov (United States)

    Jayadevappa, Ravishankar; Chhatre, Sumedha; Gallo, Joseph J; Wittink, Marsha; Morales, Knashawn H; Bruce Malkowicz, S; Lee, David; Guzzo, Thomas; Caruso, Adele; Van Arsdalen, Keith; Wein, Alan J; Sanford Schwartz, J

    2015-11-01

    Prostate cancer is a slow progressing cancer that affects millions of men in the US. Due to uncertainties in outcomes and treatment complications, it is important that patients engage in informed decision making to choose the "optimal treatment". Patient centered care that encompasses informed decision-making can improve treatment choice and quality of care. Thus, assessing patient treatment preferences is critical for developing an effective decision support system. The objective of this patient-centered randomized clinical trial was to study the comparative effectiveness of a conjoint analysis intervention compared to usual care in improving subjective and objective outcomes in prostate cancer patients. We identified preferred attributes of alternative prostate cancer treatments that will aid in evaluating attributes of treatment options. In this two-phase study, in Phase 1 we used mixed methods to develop an adaptive conjoint task instrument. The conjoint task required the patients to trade-off attributes associated with treatments by assessing their relative importance. Phase 2 consisted of a randomized controlled trial of men with localized prostate cancer. We analyzed the effect of conjoint task intervention on the association between preferences, treatment and objective and subjective outcomes. Our conjoint task instrument can lead to a values-based patient-centered decision aid tool and help tailor treatment decision making to the values of prostate cancer patients. This will ultimately improve clinical decision making, clinical policy process, enhance patient centered care and improve prostate cancer outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Treatment as usual (TAU) for depression: a comparison of psychotherapy, pharmacotherapy, and combined treatment at a large academic medical center.

    Science.gov (United States)

    Blais, Mark A; Malone, Johanna C; Stein, Michelle B; Slavin-Mulford, Jenelle; O'Keefe, Sheila M; Renna, Megan; Sinclair, Samuel J

    2013-03-01

    Depression is among the most prevalent and burdensome psychiatric disorders in the United States (Kessler et al., Achieves of General Psychiatry 62:617-627, 2005). There is substantial empirical support regarding efficacy of pharmacotherapy, psychotherapy, and combined treatment (both pharmacotherapy and psychotherapy) for treating depression. However, far less is known about the effectiveness of these treatments for real-world patients treated within routine clinical care settings (Cahill et al., The British Journal of Clinical Psychology 49:421-453, 2010). This study seeks to explore the effectiveness of treatment as usual (TAU) for depression in a large cohort of psychiatric outpatients receiving psychotherapy, pharmacotherapy, or combined treatment within an academic medical center. Initial and follow-up self-report assessments were analyzed for 1,322 patients receiving treatment for depression. Using these data, we determined treatment effect sizes, rates of reliable improvement (and deterioration), and rates of clinically significant improvement for psychotherapy, pharmacotherapy, and combined care. On average, all treatments produced significant improvement with effect sizes surpassing our no-treatment benchmark. No significant between-group (treatment) differences in self-report outcomes were found. The rates of reliable change were similar for all treatment groups consistent with past research. The present findings support the effectiveness of psychotherapy, pharmacotherapy, and combined treatment as routinely provided within a large academic medical center for the treatment of real-world patients suffering with depression.

  14. Opportunity for Collaboration Between Radiation Injury Treatment Network Centers and Medical Toxicology Specialists.

    Science.gov (United States)

    Davlantes, Elizabeth; Shartar, Samuel; Venero, Jennifer; Steck, Alaina; Langston, Amelia; Kazzi, Ziad N

    2017-08-01

    The Radiation Injury Treatment Network (RITN) comprises >50 centers across the United States that are poised to care for victims of a radiation emergency. The network is organized around bone marrow transplant centers because these facilities excel in both radiation medicine and the care of patients with severe bone marrow depression. A radiation emergency may cause not only irradiation from an external source but also internal contamination with radioactive material. Because medical toxicologists are trained in radiation injury management and have expertise in the management of internal contamination, RITN centers may benefit from partnerships with medical toxicology resources, which may be located at academic medical centers, hospital inpatient clinical services, outpatient clinics, or poison control centers. We determined the locations of existing RITN centers and assessed their proximity to various medical toxicology resources, including medical toxicology fellowship programs, inpatient toxicology services, outpatient toxicology clinics, and poison control centers. Data were derived from publicly available Internet sources in March 2015. The majority of RITN centers do not have a medical toxicology fellowship, an inpatient toxicology service, or an outpatient toxicology clinic within the same institution. Fifty-seven percent of RITN centers have at least one of these resources located in the same city, however, and 73% of centers have at least one of these resources or a poison control center within the same city. Ninety-five percent of RITN centers have at least one medical toxicology resource within the state. Most RITN centers are located in the same city as at least one medical toxicology resource. Establishing relationships between RITN centers and medical toxicologists needs to be explored further.

  15. Towards a Moon Village : Community Workshops Highlights

    Science.gov (United States)

    Foing, Bernard H.

    2016-07-01

    proposed establishment of the lunar base can be divided into 4 steps. First the primary base infrastructure is laid out through robotic missions, assisted by human tele-operations from Earth, from the lunar orbit, or via a human-tended gateway station in one of the Earth-Moon Lagrange points (EML-1/2). During the second phase, the first manned habitation module will be deployed. This module contains a bare minimum of functionality to support a small crew for a couple of months. During the third phase, additional modules with more dedicated functions will be sent to the Moon, in order to enhance functionality and to provide astronauts with more space and comfort for long-term missions. In the final phase of the lunar village, a new set of modules will be sent to the base in order to accommodate new arriving crew members. To ensure crew safety, the landing site for supply vessels shall be located in safe distance to the base. Extensive utilization of autonomous or tele-operated robots further minimizes the risk for the crew. From the very beginning, quickly accessible emergency escape vehicles, as well as a heavily shielded 'safe haven' module to protect the crew from solar flares, shall be available. Sustainable moon village development would require explorers to fully utilize and process in-situ resources, in order to manufacture necessary equipment and create new infrastructure. Mining activities would be performed by autonomous robotic systems and managed by colonists from the command center. Building upon the heritage of commercial mining activities on Earth the production would be divided into six stages: geological exploration and mapping, mine preparation, extraction of raw resources, processing of raw resources, separation of minerals, storage and utilization. Additional manufacturing techniques, such as forging, would also need to be explored so as not to limit the production capabilities. To facilitate the progress of the Moon Village initiative it is necessary to

  16. Spatial patterns of arrests, police assault and addiction treatment center locations in Tijuana, Mexico.

    Science.gov (United States)

    Werb, Dan; Strathdee, Steffanie A; Vera, Alicia; Arredondo, Jaime; Beletsky, Leo; Gonzalez-Zuniga, Patricia; Gaines, Tommi

    2016-07-01

    In the context of a public health-oriented drug policy reform in Mexico, we assessed the spatial distribution of police encounters among people who inject drugs (PWID) in Tijuana, determined the association between these encounters and the location of addiction treatment centers and explored the association between police encounters and treatment access. Geographically weighted regression (GWR) and logistic regression analysis using prospective spatial data from a community-recruited cohort of PWID in Tijuana and official geographical arrest data from the Tijuana Municipal Police Department. Tijuana, Mexico. A total of 608 participants (median age 37; 28.4% female) in the prospective Proyecto El Cuete cohort study recruited between January and December 2011. We compared the mean distance of police encounters and a randomly distributed set of events to treatment centers. GWR was undertaken to model the spatial relationship between police interactions and treatment centers. Logistic regression analysis was used to investigate factors associated with reporting police interactions. During the study period, 27.5% of police encounters occurred within 500 m of treatment centers. The GWR model suggested spatial correlation between encounters and treatment centers (global R(2)  = 0.53). Reporting a need for addiction treatment was associated with reporting arrest and police assault [adjusted odds ratio = 2.74, 95% confidence interval (CI) = 1.25-6.02, P = 0.012]. A geospatial analysis suggests that, in Mexico, people who inject drugs are at greater risk of being a victim of police violence if they consider themselves in need of addiction treatment, and their interactions with police appear to be more frequent around treatment centers. © 2016 Society for the Study of Addiction.

  17. Welcome to The Green Village

    NARCIS (Netherlands)

    Van Wijk, A.J.M.

    2013-01-01

    A sustainable world can only be achieved by an open collaboration between science, business and the public. That is why we create the Green Village: an innovative, lively, interactive and challenging environment where entrepreneurs, innovators, companies, artists, teachers and visitors can meet,

  18. Renewables for Sustainable Village Power

    Energy Technology Data Exchange (ETDEWEB)

    Flowers, L.; Baring-Gould, I.; Bianchi, J.; Corbus, D.; Drouilhet, S.; Elliott, D.; Gevorgian, V.; Jimenez, A.; Lilienthal, P.; Newcomb, C.; Taylor, R.

    2000-11-06

    This paper describes the efforts of NREL's Renewables for Sustainable Village Power team to match renewable energy technologies with rural energy needs in the international market. The paper describes the team's activities, updates the lessons learned, and proposes an integrated approach as a model for rural electrification with renewables.

  19. Opportunities for renewable energy technologies in water supply in developing country villages

    Energy Technology Data Exchange (ETDEWEB)

    Niewoehner, J.; Larson, R.; Azrag, E.; Hailu, T.; Horner, J.; VanArsdale, P. [Water for People, Denver, CO (United States)

    1997-03-01

    This report provides the National Renewable Energy Laboratory (NREL) with information on village water supply programs in developing countries. The information is intended to help NREL develop renewable energy technologies for water supply and treatment that can be implemented, operated, and maintained by villagers. The report is also useful to manufacturers and suppliers in the renewable energy community in that it describes a methodology for introducing technologies to rural villages in developing countries.

  20. History of malaria treatment as a predictor of subsequent subclinical parasitaemia: A cross-sectional survey and malaria case records from three villages in Pailin, western Cambodia

    NARCIS (Netherlands)

    T.J. Peto (Thomas J.); S.E. Kloprogge (Sabine E.); R. Tripura (Rupam); C. Nguon (Chea); N. Sanann (Nou); S. Yok (Sovann); C. Heng (Chhouen); C. Promnarate (Cholrawee); J. Chalk (Jeremy); N. Song (Ngak); S.J. Lee (Sue J.); Y. Lubell (Yoel); M. Dhorda (Mehul); M. Imwong (Mallika); N.J. White (Nicholas J.); L. Von Seidlein (Lorenz); A.M. Dondorp

    2016-01-01

    textabstractBackground: Treatment of the sub-clinical reservoir of malaria, which may maintain transmission, could be an important component of elimination strategies. The reliable detection of asymptomatic infections with low levels of parasitaemia requires high-volume quantitative polymerase chain

  1. Qualitative analysis of patient-centered decision attributes associated with initiating hepatitis C treatment

    OpenAIRE

    Zuchowski, Jessica L.; Hamilton, Alison B.; Pyne, Jeffrey M; Clark, Jack A.; Naik, Aanand D.; Smith, Donna L.; Kanwal, Fasiha

    2015-01-01

    Background In this era of a constantly changing landscape of antiviral treatment options for chronic viral hepatitis C (CHC), shared clinical decision-making addresses the need to engage patients in complex treatment decisions. However, little is known about the decision attributes that CHC patients consider when making treatment decisions. We identify key patient-centered decision attributes, and explore relationships among these attributes, to help inform the development of a future CHC sha...

  2. Village microgrids: The Chile project

    Energy Technology Data Exchange (ETDEWEB)

    Baring-Gould, E.I.

    1997-12-01

    This paper describes a village application in Chile. The objective was to demonstrate the technical, economic and institutional viability of renewable energy for rural electrification, as well as to allow local partners to gain experience with hybrid/renewable technology, resource assessment, system siting and operation. A micro-grid system is viewed as a small village system, up to 1200 kWh/day load with a 50 kW peak load. It can consist of components of wind, photovoltaic, batteries, and conventional generators. It is usually associated with a single generator source, and uses batteries to cover light day time loads. This paper looks at the experiences learned from this project with regard to all of the facets of planning and installing this project.

  3. Survival of adolescents with cancer treated at pediatric versus adult oncology treatment centers in France.

    Science.gov (United States)

    Desandes, Emmanuel; Brugieres, Laurence; Laurence, Valérie; Berger, Claire; Kanold, Justyna; Tron, Isabelle; Clavel, Jacqueline; Lacour, Brigitte

    2017-05-01

    In France, although children aged less than 15 years with cancer are usually referred to pediatric oncology centers, adolescents may be treated at pediatric or adult oncology centers. The objective was to compare survival according to their site of treatment. Using population-based registration, 15- to 19-year-old patients diagnosed with cancer in 2006 or 2007 and living in six French regions (accounting for 41% of the French population) were included. Of the 594 patients included, 33% of the French adolescents were treated at a pediatric oncology center. Compared with those treated at a pediatric center, adolescents treated at an adult center were older, were more likely to have carcinoma and germ-cell tumor, had a longer time to diagnosis, and were less likely to be enrolled in a clinical trial. In addition, the decisions for their management were less likely to be taken in the context of multidisciplinary team meetings. In multivariate analysis, adolescent patients treated at a pediatric center did not have significantly different overall survival (OS) compared with those treated at an adult center (5-year OS: 84.1% [95% confidence interval: 78.6-90.0] versus 87.7% [95% confidence interval: 84.2-91.3]; P = 0.25). The outcomes of French adolescents with cancer have begun to improve, with 81.2% survival in 2006-2007, with no difference between the types of treatment center. However, for this unique group of diseases, survival is not the unique endpoint. In order to ensure good quality of life after cancer, management of those patients requires specific approaches, designed to reduce the late effects of cancer treatment and improve supportive care. © 2016 Wiley Periodicals, Inc.

  4. Espaces centrés et pouvoirs décentrés : l’exemple des fédérations villageoises dogon au XIXe siècle Centered territorial units and decentered powers: Dogon village federations in the 19th century

    Directory of Open Access Journals (Sweden)

    Éric Jolly

    2011-02-01

    Full Text Available Au xixe siècle, le Sud du pays dogon se caractérisait par un paysage politique singulier avec une mosaïque de petites fédérations villageoises regroupant chacune, sur un même territoire, une douzaine de localités non apparentées. Selon les indices rassemblés, la création de ces formations originales remonterait à la seconde moitié du xviiie siècle et résulterait d’un nouveau rapport à l’espace imposé à la fois par la multiplication des guerres ou des razzias et par un peuplement local de plus en plus dense et diversifié. Face à la pression militaire des États voisins, l’objectif des groupes résidents n’est plus de s’approprier un territoire, mais de le défendre en construisant son unité au centre, à l’endroit présumé de sa fondation. Carrefour politico-religieux, ce centre prenait la forme d’une place publique servant de lieu de rassemblement unitaire, mais aussi d’axe de distribution égalitaire des pouvoirs entre tous les villages installés sur le même territoire.In the 19th century, the southern part of the land of the Dogon stood out owing to its unusual political landscape, a mosaic of small village federations each of which grouped, in a territorial unit, a dozen or so localities unrelated by kinship. These original federations emerged out of a new relation to space during the second half of the 18th century as a result of increasing warfare and raiding in the context of a denser, more diversified local population. Given mounting military pressure from neighboring states, resident groups no longer sought to appropriate a territory but to defend it by establishing its unity in the center, at the presumed place of foundation. As a political and religious crossroads, this center was not only a public meeting place expressing unity but also the axis of an egalitarian distribution of power between all villages located in the same territory.

  5. In-situ Thermal Treatment of Trichloroethene at Marshall Space Flight Center

    Science.gov (United States)

    Cole, Jason; McElroy, William J.; Glasgow, Jason; Heron, Gorm; Galligan, Jim; Parker, Ken; Davis, E. F.

    2008-01-01

    This viewgraph presentation describes the in-situ thermal treatment of trichloroethene at Marshall space Flight Center. The contents include: 1) Background 1 and 2; 2) Source Area-13; 3) In-situ Thermal Treatment; 4) SA-13 Lithology; 5) SA-13 In-Situ Thermal TS; 6) SA-13 ISTD System Components; 7) ISTD Overview; 8) Heaters; 9) SA-13 ISTD Wellfield Layout; 10) SA-13 Well Field; 11) ISTD Process and Instrumentation; 12) Treatment Zone Temperature; 13) SA-13 System Removals; 14) SA-13 DNAPL (typical photos); 15) Treatment Results 1-5; and 16) SA-13 TCE Removal Summary.

  6. [Anxious School Absenteeism: Cognitive-Behavioral Treatment of School Phobia at a Psychological Counseling Center].

    Science.gov (United States)

    Diegel, Klaus

    2015-01-01

    Resulting from a shortage of possibilities in the ambulant treatment of school phobia behavior-therapeutic interventions were established at a psychological counseling center for families twenty years ago, which have been in existence to this day. The criteria of anxiety-based absenteeism as well as problems of terminology and classification will be presented with emphasis on school phobia as a combination of separation anxiety and social anxiety ("Schulphobie"). The multimodal treatment focuses on cognitive interventions, graduated exposition and close cooperation with teachers. The counselor is also in charge of the networking and cooperation of all people concerned. A short case study is used to illustrate the process. Measures such as training and information for teachers and school social workers and a manual for the comprehension and the treatment of school phobia, which was edited in cooperation with a psychological counseling center for schools complement the treatment.

  7. Examining human rights and mental health among women in drug abuse treatment centers in Afghanistan.

    Science.gov (United States)

    Abadi, Melissa Harris; Shamblen, Stephen R; Johnson, Knowlton; Thompson, Kirsten; Young, Linda; Courser, Matthew; Vanderhoff, Jude; Browne, Thom

    2012-01-01

    Denial of human rights, gender disparities, and living in a war zone can be associated with severe depression and poor social functioning, especially for female drug abusers. This study of Afghan women in drug abuse treatment (DAT) centers assesses (a) the extent to which these women have experienced human rights violations and mental health problems prior to entering the DAT centers, and (b) whether there are specific risk factors for human rights violations among this population. A total of 176 in-person interviews were conducted with female patients admitted to three drug abuse treatment centers in Afghanistan in 2010. Nearly all women (91%) reported limitations with social functioning. Further, 41% of the women indicated they had suicide ideation and 27% of the women had attempted suicide at least once 30 days prior to entering the DAT centers due to feelings of sadness or hopelessness. Half of the women (50%) experienced at least one human rights violation in the past year prior to entering the DAT centers. Risk factors for human rights violations among this population include marital status, ethnicity, literacy, employment status, entering treatment based on one's own desire, limited social functioning, and suicide attempts. Conclusions stemming from the results are discussed.

  8. Sleeping sickness surveys: game reserve adjacent villages in Malawi

    African Journals Online (AJOL)

    (Card Agglutination Test for Trypanosomiasis -. CAIT, Indirect ... and treatment; hospital record cards were com- pleted and updated regularly. ... sickness were diag- nosed. The low prevalence of the disease in the villages at this survey time contrasts with the high prevalence of T. brucei species in game animals 5. Yes. No.

  9. Financial Village Standing in Indonesian Financial System

    Directory of Open Access Journals (Sweden)

    Herry Purnomo

    2015-12-01

    Full Text Available Financial resources of the village that are sourced from a country or a Regional Finance Financial based Law Number 6 Year 2014 of The Village is the mandate of the law that must be allocated to the village. The interconnectedness of the financial position of the village in the financial system of the country or Region concerned the Financial administrative and territorial relations, and there is no setting directly regarding the finances of the village as part of the financial system of the country or the financial area. In respect of the elements of the crime of corruption deeds against financial irregularities of the village there are still disagreements on the interpretation of the law in trapping the perpetrators of corruption on the village chief that implies not satisfy the principle of legality and legal certainty in the ruling of the matter of financial irregularities. In fact, many of the village chief or Councilor caught the criminal offence of corruption over the use of financial irregularities. This research analyzes How the financial position of the village in the financial system of the country or region, as well as whether the financial resources of the village is derived from the state budget or region budget managed in village budget belongs to the category of village finances and whether tort against the financial management of the village can be categorized as a criminal act corruption. How To Cite: Purnomo, H. (2015. Financial Village Standing in Indonesian Financial System. Rechtsidee, 2(2, 121-140. doi:http://dx.doi.org/10.21070/jihr.v2i2.81

  10. Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

    Science.gov (United States)

    Klein, Michael C.; Ciotoli, Carlo; Chung, Henry

    2011-01-01

    Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between…

  11. Assessments of Student-Teacher Relationships in Residential Treatment Center Schools

    Science.gov (United States)

    Rudasill, Kathleen Moritz; Gonshak, Amy B.; Pössel, Patrick; Nichols, Andrew; Stipanovic, Natalie

    2013-01-01

    Students in residential treatment center (RTC) schools are likely to have histories of extreme or ongoing relational trauma (e.g., abuse and neglect by primary caregivers), have substantial interpersonal and relationship problems, and exhibit many high-risk behaviors. Accordingly, these students may have particular difficulty forming positive…

  12. Collected World and Single Center Experience With Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms

    NARCIS (Netherlands)

    Veith, Frank J.; Lachat, Mario; Mayer, Dieter; Malina, Martin; Holst, Jan; Mehta, Manish; Verhoeven, Eric L. G.; Larzon, Thomas; Gennai, Stefano; Coppi, Gioacchino; Lipsitz, Evan C.; Gargiulo, Nicholas J.; van der Vliet, J. Adam; Blankensteijn, Jan; Buth, Jacob; Lee, W. Anthony; Biasi, Giorgio; Deleo, Gaetano; Kasirajan, Karthikeshwar; Moore, Randy; Soong, Chee V.; Cayne, Neal S.; Farber, Mark A.; Raithel, Dieter; Greenberg, Roy K.; van Sambeek, Marc R. H. M.; Brunkwall, Jan S.; Rockman, Caron B.; Hinchliffe, Robert J.

    2009-01-01

    Background: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. Objective: To clarify these we examined a

  13. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms.

    NARCIS (Netherlands)

    Veith, F.J.; Lachat, M.; Mayer, D.; Malina, M.; Holst, J.; Mehta, M.; Verhoeven, E.L.; Larzon, T.; Gennai, S.; Coppi, G.; Lipsitz, E.C.; Gargiulo, N.J.; Vliet, J.A. van der; Blankensteijn, J.D.; Buth, J.; Lee, W.A.; Biasiol, G.; Deleo, G.; Kasirajan, K.; Moore, R.; Soong, C.V.; Cayne, N.S.; Farber, M.A.; Raithel, D.; Greenberg, R.K.; Sambeek, M.R. van; Brunkwall, J.S.; Rockman, C.B.; Hinchliffe, R.J.

    2009-01-01

    BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a

  14. Violence narratives of Mexican women treated in mutual-aid residential centers for addiction treatment.

    Science.gov (United States)

    Lozano-Verduzco, Ignacio; Romero-Mendoza, Martha; Marín-Navarrete, Rodrigo

    2016-11-30

    Violence against women is a social and public health issue in Mexico. The aim of this article is to explore violence among an understudied group of women, who attended Mutual-Aid Residential Centers for Addiction Treatment and experienced stigma both as women and addicts. These centers are particular kind of addiction treatment services that stem from 12-step philosophy, but that have been found to manipulate said philosophy and exercise extreme forms of psychological and physical violence. Thirteen semi-structured interviews were carried in 2014 and 2015 out with women who resided in at least one of these centers to understand their experiences of violence prior and during their rehabilitation process. The interview guide covered questions regarding substance use initiations, family violence and dynamics, and rehabilitation experiences. Qualitative data was analyzed using interpretative-phenomenological analysis. Two categories emerged: violence and substance use and abuse, and violence against women in recovery. Results show that all participants experienced violence in their family since childhood, particularly sexual and physical violence. As a result, participants experienced guilt, sadness and shame, which led them to contexts of consumption. Violence continued as they explored alcohol and drug use, even though women felt empowered. Treatment reproduced masculine violence constantly, but women felt that they were in a context that helped them understand their addiction. Even though women felt these centers played a crucial role in their recovery, women's particular needs and experiences are not considered in the treatment program.

  15. Treatment and Rehabilitation of Abused and Neglected Children an Inpatient Center Model

    Directory of Open Access Journals (Sweden)

    Sunay Fırat

    2014-09-01

    Full Text Available Rehabilitation and treatment centers are organizations that provide services for children and adolescents, with the main goal being to implement a “mental health” treatment plan for the individuals under their care. These organizations, which provide a continuous 24-hour service, may differ from one another in terms of the specific programs and treatment methods they apply. The Oğuz Kağan Köksal Children and Youth Center was established in the Adana Province to provide for the treatment and rehabilitation of girls between the ages of 8 and 18 who have been subject to abuse or neglect, who suffer from alcohol/substance abuse, who are in need of treatment for mental problems and/or who live on the streets. A study was made of 72 girls who had been admitted to the institution for treatment and rehabilitation since 2004 with a history abuse and neglect. The girls were assessed with the Beck Depression Inventory (BDI, the State Anxiety Inventory (STAI-I, the Trait Anxiety Inventory (STAI-II and the Maudsley Obsessive Compulsive Inventory (MOCI upon being admitted to the institution and at the end of their stay (i.e. their discharge. The differences between the mean admission and discharge scores of the girls in the BDI, STAI-I, STAI-II and MOCI assessments was determined to be statistically significant (p<0.001. According to the duration of stay groups (0–3 months; 4–6 months; 7–9 months and ≥10 months, a statistically significant difference was identified between the mean admission and discharge scores of children who remained in the institution for 3–7 months, with the post-treatment scores of the inventories being significantly lower in comparison to the baseline values (p≤0.05. These results suggest discharging patients from the center prior to their third month of stay or a stay period of longer than seven months does not affect with any significance the scores of the depression, anxiety and obsession inventories. To ensure a

  16. Examining human rights and mental health among women in drug abuse treatment centers in Afghanistan

    Directory of Open Access Journals (Sweden)

    Abadi MH

    2012-04-01

    Full Text Available Melissa Harris Abadi1, Stephen R Shamblen1, Knowlton Johnson1, Kirsten Thompson1, Linda Young1, Matthew Courser1, Jude Vanderhoff1, Thom Browne21Pacific Institute for Research and Evaluation – Louisville Center, Louisville, KY, USA; 2United States Department of State, Bureau of International Narcotics and Law Enforcement, Washington, DC, USAAbstract: Denial of human rights, gender disparities, and living in a war zone can be associated with severe depression and poor social functioning, especially for female drug abusers. This study of Afghan women in drug abuse treatment (DAT centers assesses (a the extent to which these women have experienced human rights violations and mental health problems prior to entering the DAT centers, and (b whether there are specific risk factors for human rights violations among this population. A total of 176 in-person interviews were conducted with female patients admitted to three drug abuse treatment centers in Afghanistan in 2010. Nearly all women (91% reported limitations with social functioning. Further, 41% of the women indicated they had suicide ideation and 27% of the women had attempted suicide at least once 30 days prior to entering the DAT centers due to feelings of sadness or hopelessness. Half of the women (50% experienced at least one human rights violation in the past year prior to entering the DAT centers. Risk factors for human rights violations among this population include marital status, ethnicity, literacy, employment status, entering treatment based on one’s own desire, limited social functioning, and suicide attempts. Conclusions stemming from the results are discussed.Keywords: Afghanistan, women, human rights, mental health, drug abuse treatment

  17. Characteristics of a treatment-seeking population in outpatient addiction treatment centers in Mexico.

    Science.gov (United States)

    Marín-Navarrete, Rodrigo; Templos-Nuñez, Liliana; Eliosa-Hernández, Angélica; Villalobos-Gallegos, Luis; Fernández-Mondragón, José; Pérez-López, Alejandro; Galván-Sosa, Diana; Verdeja, Rosa E; Alonso, Elizabeth; Feaster, Daniel J; Horigian, Viviana E

    2014-11-01

    Baseline patients' characteristics are critical for treatment planning, as these can be moderators of treatment effects. In Mexico, information on treatment seekers with substance use disorders is scarce and limited to demographic characteristics. This paper presents and analyses demographic characteristics, substance use related problems, clinical features, and addiction severity in a sample of treatment seekers from the first multi-site randomized clinical trial implemented in the Mexican Clinical Trials Network on Addiction and Mental Health. A total of 120 participants were assessed prior randomization. Chi square or F-tests were used to compare sites across variables. Spearman correlation was used to associate negative consequences of substance use and motivation to change. The majority of participants were men, and the most prevalent substances reported were alcohol, marijuana, and cocaine. Participants were predominantly on the contemplation or action stage of change, and this was correlated with the perception of the negative consequences associated with substance use. Participants reported a high prevalence of substance use related problems. Substance use related problems, clinical features, and addiction severity reported by treatment seekers are important characteristics to take into account when planning treatment as they facilitate tailoring treatment to meet patients' needs.

  18. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: a survey in 66 neurotrauma centers participating in the CENTER-TBI study.

    Science.gov (United States)

    Cnossen, Maryse C; Huijben, Jilske A; van der Jagt, Mathieu; Volovici, Victor; van Essen, Thomas; Polinder, Suzanne; Nelson, David; Ercole, Ari; Stocchetti, Nino; Citerio, Giuseppe; Peul, Wilco C; Maas, Andrew I R; Menon, David; Steyerberg, Ewout W; Lingsma, Hester F

    2017-09-06

    No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI. A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n = 60, 91%) and designated level I trauma centers (n = 44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n = 58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n = 32, 48%), whereas the others were considered more conservative (n = 34, 52%). Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research.

  19. Tucson Solar Village: Project management

    Energy Technology Data Exchange (ETDEWEB)

    1991-11-01

    The Tucson Solar Village is a Design/Build Project In Sustainable Community Development which responds to a broad spectrum of energy, environmental, and economic challenges. This project is designed for 820 acres of undeveloped State Trust Land within the Tucson city limits; residential population will be five to six thousand persons with internal employment provided for 1200. This is a 15 year project (for complete buildout and sales) with an estimated cost of $500 million. Details of the project are addressed with emphasis on the process and comments on its transferability.

  20. CULTURAL CAPITAL AS TOURISM DEVELOPMENT BASIS IN TRADITIONAL VILLAGE OF KUTA

    Directory of Open Access Journals (Sweden)

    Ketut Sumadi

    2012-11-01

    Full Text Available Tourism is a favourite sector in improving Bali revenue and kind of tourismdeveloped is cultural one. In cultural tourism, it takes place meaning modification ofcultural practice by krama (member of traditional village in order to cultural capitalcan survive in the middle of tourism dynamic condition. This research entitled“Cultural capital as tourism development basis in traditional village of Kuta”, byproposing three problems, namely how is the process of cultural capital as tourismdevelopment basis, what factors can motivate tourism capital as tourism developmentbasis, and what is the meaning of cultural capital as tourism development basis.The research is conducted using qualitative method and cultural studiesapproach, so data analysis is conducted in descriptive qualitative and interpretativeones. Selection of traditional village of Kuta as research location based onconsideration that traditional village of Kuta having integrated tourism facilities forfacilities addressed to member of traditional village. The review about culturalcapital as the tourism development basis in this traditional village of Kuta, eclecticstheories consisting of Hegemonic theory of Gramsci, co-modification theory of KarlMarx and Adorno, discourse-power/knowledge and truth theory of Foucoult anddeconstruction theory of Derrida.Based on the research output, it can be known: (1 Cultural capital process astourism development basis in traditional village of Kuta is inseparable fromforeigners arrival in traditional village of Kuta, the entrance of Military (TheCooperative Center of Arm Force in managing Kuta beach and the occurrence ofBali bombing tragedy on October 12th, 2002; (2 The factors that motivate culturalcapital as the tourism development basis in traditional village of Kuta, such asmotivation and the necessity of tourists visiting traditional village of Kuta, tourismhegemony, changing of life philosophy of member of traditional village fromidealism into

  1. Patient-centered care and its effect on outcomes in the treatment of asthma

    Directory of Open Access Journals (Sweden)

    Qamar N

    2011-06-01

    Full Text Available Nashmia Qamar1,*, Andrea A Pappalardo2,*, Vineet M Arora3, Valerie G Press41Pediatric Residency Program, University of Chicago Medical Center, Chicago, IL, USA; 2Internal Medicine-Pediatric Residency Program, University of Chicago Medical Center, Chicago, IL, USA; 3Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA; 4Section of Hospital Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA *Drs Qamar and Pappalardo contributed equally to this paperAbstract: Patient-centered care may be pivotal in improving health outcomes for patients with asthma. In addition to increased attention in both research and clinical forums, recent legislation also highlights the importance of patient-centered outcomes research in the Patient Protection and Affordable Care Act. However, whether patient-centered care has been shown to improve outcomes for this population is unclear. To answer this question, we performed a systematic review of the literature that aimed to define current patient-focused management issues, characterize important patient-defined outcomes in asthma control, and identify current and emerging treatments related to patient outcomes and perspectives. We used a parallel search strategy via Medline®, Cochrane Central Register of Controlled Trials, CINAHL® (Cumulative Index to Nursing and Allied Health Literature, and PsycINFO®, complemented with a reference review of key articles that resulted in a total of 133 articles; 58 were interventions that evaluated the effect on patient-centered outcomes, and 75 were descriptive studies. The majority of intervention studies demonstrated improved patient outcomes (44; “positive” results; none showed true harm (0; “negative”; and the remainder were equivocal (14; “neutral”. Key themes emerged relating to patients’ desires for asthma knowledge, preferences for tailored management plans, and

  2. Dosimetry studies in Zaborie village

    Energy Technology Data Exchange (ETDEWEB)

    Takada, J. E-mail: jtakada@ipc.hiroshima-u.ac.jp; Hoshi, M.; Endo, S.; Stepanenko, V.F.; Kondrashov, A.E.; Petin, D.; Skvortsov, V.; Ivannikov, A.; Tikounov, D.; Gavrilin, Y.; Snykov, V.P

    2000-05-15

    Dosimetry studies in Zaborie, a territory in Russia highly contaminated by the Chernobyl accident, were carried out in July, 1997. Studies on dosimetry for people are important not only for epidemiology but also for recovery of local social activity. The local contamination of the soil was measured to be 1.5-6.3 MBq/m{sup 2} of Cs-137 with 0.7-4 {mu}Sv/h of dose rate. A case study for a villager presently 40 years old indicates estimations of 72 and 269 mSv as the expected internal and external doses during 50 years starting in 1997 based on data of a whole-body measurement of Cs-137 and environmental dose rates. Mean values of accumulated external and internal doses for the period from the year 1986 till 1996 are also estimated to be 130 mSv and 16 mSv for Zaborie. The estimation of the 1986-1996 accumulated dose on the basis of large scale ESR teeth enamel dosimetry provides for this village, the value of 180 mSv. For a short term visitor from Japan to this area, external and internal dose are estimated to be 0.13 mSv/9d (during visit in 1997) and 0.024 mSv/50y (during 50 years starting from 1997), respectively.

  3. Emerging Transnational migration from Romanian villages

    Directory of Open Access Journals (Sweden)

    Dumitru Sandu

    2014-11-01

    Full Text Available This article presents the first results of a community census (December 2001 on temporary external migration at the level of all Romanian villages. Local key informants filled in the questionnaire on international temporary migration and its sociodemographic profile. As function of the key destinations, the Romanian villages cluster into six major migration fields: Germany, Hungary, Italy, Turkey, Yugoslavia and Spain. At a more detailed level, considering multiple destinations, those fields break into 15 regions of migration.Village-level analysis of the phenomenon indicates a strong selectivity of migration depending on village characteristics. About 4 percent of the total villages of the country account for more than 60 percent of the total return migration from abroad. These are villages of a high probability of transnationalism. Circular or transnational migration is shown to be connected with the basic characteristics of the migration system of the country: the villages where village to city commuting declined sharply after 1990 and where return migration from cities was high recorded a higher propensity for circular migration abroad. A set of about 2700 villages of high migration prevalence is described as «probable transnational communities».

  4. Are we in crisis? National mental health and treatment trends in college counseling centers.

    Science.gov (United States)

    Xiao, Henry; Carney, Dever M; Youn, Soo Jeong; Janis, Rebecca A; Castonguay, Louis G; Hayes, Jeffrey A; Locke, Benjamin D

    2017-11-01

    The current state of college student mental health is frequently labeled a "crisis," as the demand for services and severity of symptomatology have appeared to increase in recent decades. Nationally representative findings are presented from the Center for Collegiate Mental Health, a practice research network based in the United States, composed of more than 340 university and college counseling centers, in an effort to illuminate trends in symptom severity and patterns in treatment utilization for the campus treatment seeking population. Clinical data collected over 5 academic years (2010-2015) showed small but significantly increasing trends for self-reported distress in generalized anxiety, depression, social anxiety, family distress, and academic distress, with the largest effect sizes observed for generalized anxiety, depression, and social anxiety. On the other hand, a significantly decreasing trend was observed for substance use. No significant changes were observed for eating concerns and hostility. Utilization data over 6 years indicated a gradual yet steady increase in the number of students seeking services (beyond the rate expected with increasing institutional enrollment), as well as increases in the number of appointments scheduled and attended, with great variation between centers. Within the context of changing national trends, we conclude that it is advisable to consider the specific needs of local centers to best accommodate distinct student bodies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. The Tripler Army Medical Center LEAN Program: a healthy lifestyle model for the treatment of obesity.

    Science.gov (United States)

    James, L C; Folen, R A; Garland, F N; Edwards, C; Noce, M; Gohdes, D; Williams, D; Bowles, S; Kellar, M A; Supplee, E

    1997-05-01

    This paper provides an overview of the Tripler Army Medical Center LEAN Program for the treatment of obesity, hypercholesterolemia, and essential hypertension. The LEAN Program, a multi-disciplinary prevention program, emphasizes healthy Lifestyles, Exercise and Emotions, Attitudes, and Nutrition for active duty service members. The treatment model offers a medically healthy, emotionally safe, and reasonable, low-intensity exercise program to facilitate weight loss. We will discuss the philosophy behind the LEAN Program and the major components. Thereafter, we will briefly discuss the preliminary results.

  6. Perceptions of Village Dogs by Villagers and Tourists in the Coastal Region of Rural Oaxaca, Mexico

    NARCIS (Netherlands)

    Ruiz Izaguirre, E.; Eilers, C.H.A.M.

    2012-01-01

    The objective of this study was to gain an understanding of the village dog-keeping system, and of perceptions of dog-related problems by villagers and tourists, in the coastal region of Oaxaca, Mexico. We conducted a survey of the inhabitants of three villages (Mazunte, Puerto Angel, and Río Seco),

  7. Institutional issues in Village Power

    Energy Technology Data Exchange (ETDEWEB)

    Orozco, R.

    1997-12-01

    This paper presents a view on renewable energy resource projects from one much closer to recipient of the services. The author argues that such programs aimed at development of village power situations need to keep certain points clearly in focus. These include the fact that electricity is not the goal, technology is not the problem, site selection involves more than just resource potential, the distinction between demonstration and pilot programs, and that such programs demand local involvement for success. The author recommends coordinating such projects with programs seeking competing funds such as health, education, and transportation. The projects must demonstrate a high economic benefit to justify the high economic cost, and one must use the benefits to leverage the program funding.

  8. Human Trichostrongylus colubriformis Infection in a Rural Village in Laos

    Science.gov (United States)

    Sato, Megumi; Yoonuan, Tippayarat; Sanguankiat, Surapol; Nuamtanong, Supaporn; Pongvongsa, Tiengkham; Phimmayoi, Inthava; Phanhanan, Vilayphone; Boupha, Boungnong; Moji, Kazuhiko; Waikagul, Jitra

    2011-01-01

    In Lahanam Village, Savannakhet Province, Laos, 125 of 253 villagers (49.4%) were found by fecal examination to harbor hookworm eggs. The eggs were heterogeneous in morphology and size, suggesting infections of mixed nematode species. To confirm the hookworm egg species, on a voluntary basis, 46 hookworm egg–positive participants were treated with albendazole, and post-treatment adult worms were collected from purged fecal samples. The common human hookworm was found in only 3 participants; 1 case of Necator americanus, and 2 cases of Ancylostoma duodenale. In contrast, adult Trichostrongylus worms were expelled from most participants (43 of 46, 93.5%). The Trichostrongylus species were confirmed by morphology and internal transcribed spacer 2 sequences; all worms were of the same species (T. colubriformis). In addition, some Trichostrongylus worms were obtained from a goat in the same village and identified as T. colubriformis. The results suggested that T. colubriformis was the main zoonotic species causing hookworm infections in the village. PMID:21212201

  9. Whose Preferences Matter? A Patient-Centered Approach for Eliciting Treatment Goals.

    Science.gov (United States)

    Col, Nananda F; Solomon, Andrew J; Springmann, Vicky; Garbin, Calvin P; Ionete, Carolina; Pbert, Lori; Alvarez, Enrique; Tierman, Brenda; Hopson, Ashli; Kutz, Christen; Berrios Morales, Idanis; Griffin, Carolyn; Phillips, Glenn; Ngo, Long H

    2017-08-01

    Patients facing a high-stakes clinical decision are often confronted with an overwhelming array of options. High-quality decisions about treatment should reflect patients' preferences as well as their clinical characteristics. Preference-assessment instruments typically focus on pre-selected clinical outcomes and attributes chosen by the investigator. We sought to develop a patient-centered approach to elicit and compare the treatment goals of patients with multiple sclerosis (MS) and healthcare providers (HCPs). We conducted five nominal group technique (NGT) meetings to elicit and prioritize treatment goals from patients and HCPs. Five to nine participants in each group responded silently to one question about their treatment goals. Responses were shared, consolidated, and ranked to develop a prioritized list for each group. The ranked lists were combined. Goals were rated and sorted into categories. Multidimensional scaling and hierarchical cluster analysis were used to derive a visual representation, or cognitive map, of the data and to identify conceptual clusters, reflecting how frequently items were sorted into the same category. Five NGT groups yielded 34 unique patient-generated treatment goals and 31 unique HCP-generated goals. There were differences between patients and HCPs in the goals generated and how they were clustered. Patients' goals tended to focus on the impact of specific symptoms on their day-to-day lives, whereas providers' goals focused on slowing down the course of disease progression. Differences between the treatment goals of patients and HCPs underscore the limitations of using HCP- or investigator-identified goals. This new adaptation of cognitive mapping is a patient-centered approach that can be used to generate and organize the outcomes and attributes for values clarification exercises while minimizing investigator bias and maximizing relevance to patients.

  10. Advertising representation, treatment menu and economic circulation of substance misuse treatment centers in Iran: a rapid survey based on newspaper advertisements.

    Science.gov (United States)

    Rezaee, Sobhan; Ekhtiari, Hamed

    2014-05-01

    Daily newspapers are the main platform by which substance misuse treatment (SMT) centers in Iran advertise their services. However, these advertisements provide little information on treatment options or costs. The current research aimed to use advertisements to compile a schema of treatment services and to map the extent and nature of drug treatments offered. During a four-week period (April to May) in 2009, the four most popular Persian newspapers printed in Tehran were reviewed. Across these publications 1704 advertisements were posted by 66 SMT centers. Each center was then contacted by telephone to complete a structured interview about services offered and related costs. The advertisements were also decoded through a quantitative contextual analysis method. On average, each SMT center published 26 advertisements during the review period, costing 421 US$. In addition, advertisements included word signifiers in six main categories including centers' introduction (100%), treatment types (91%), treatment duration (68%), medicines (70%), treatment features (60%) and psychological facilities (52%). The three detoxification programs advertised were the rapid method (57% of clinics, 443.23 US$), buprenorphine (68%, 265 US$) and methadone (71%, 137 US$). More than 90% of the centers in Tehran were offering methadone maintenance (99 US$, per month). SMT services in the Iranian market ranged from abstinence to maintenance programs, with opiates as the main focus. This review of centers' advertisements provides an indirect but rapidly obtained picture of the drug misuse treatment network. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. The experience of implementing a 'TB village' for a pastoralist population in Cherrati, Ethiopia.

    Science.gov (United States)

    Tayler-Smith, K; Khogali, M; Keiluhu, K; Jemmy, J-P; Ayada, L; Weyeyso, T; Issa, A M; De Maio, G; Harries, A D; Zachariah, R

    2011-10-01

    In Cherrati District, Somali Regional State (SRS), Ethiopia, despite a high burden of tuberculosis (TB), TB control activities are virtually absent. The majority of the population is pastoralist with a mobile lifestyle. TB care and treatment were offered using a 'TB village' approach that included traditional style residential care, community empowerment and awareness raising, provision of essential social amenities and essential food and non-food items. To describe 1) key aspects of the implementation of the TB village approach, 2) TB treatment outcomes and 3) the lessons learnt during implementation. Descriptive study. A total of 297 patients entered the TB village between September 2006 and October 2008; 271 (91%) patients were treated successfully, nine (3%) defaulted and 13 (4%) died. For pastoralist populations, a TB village approach may be effective for improving access to TB care, ensuring proper adherence to treatment and achieving good overall TB outcomes. The successes and challenges of this approach are discussed.

  12. Fecal sludge management in developing urban centers: a review on the collection, treatment, and composting.

    Science.gov (United States)

    Odey, Emmanuel Alepu; Li, Zifu; Zhou, Xiaoqin; Kalakodio, Loissi

    2017-10-01

    The problems posed by fecal sludge (FS) are multidimensional because most cities rapidly urbanize, which results in the increase in population, urban settlement, and waste generation. Issues concerning health and waste treatment have continued to create alarming situations. These issues had indeed interfered with the proper steps in managing FS, which contaminates the environment. FS can be used in agriculture as fertilizer because it is an excellent source of nutrients. The recent decline in crop production due to loss of soil organic component, erosion, and nutrient runoff has generated interest in the recycling of FS into soil nutrients through stabilization and composting. However, human feces are considerably liable to spread microorganisms to other persons. Thus, sanitation, stabilization, and composting should be the main objectives of FS treatment to minimize the risk to public and environmental health. This review presents an improved FS management (FSM) and technology option for soil amendment that is grouped into three headings, namely, (1) collection, (2) treatment, and (3) composting. On the basis of the literature review, the main problems associated with the collection and treatment of FS, such as inadequate tools and improper treatment processes, are summarized, and the trends and challenges that concern the applicability of each of the technologies in developing urban centers are critically reviewed. Stabilization during pretreatment before composting is suggested as the best method to reduce pathogens in FS. Results are precisely intended to be used as a support for decisions on policies and strategies for FSM and investments for improved treatment facilities.

  13. INTERNATIONAL COOPERATION OF DRUG TREATMENT CENTER IN MURSKA SOBOTA FOR DEVELOPMENT OF EUROPEAN TREATMENT INDEX EXIT TREATMENT (ETI

    Directory of Open Access Journals (Sweden)

    Dušan Nolimal

    2003-05-01

    Full Text Available Background. Our goal is to introduce the international cooperation of the Drug Treatment Centre in Murska Sobota in European project of the development of the final processing index under patronage of the Pompidou-group. The principal goal of the research was to collect the basic informations for the development of the final processing index and the introduction of unified epidemiological attendance of drug users in different European cities.Methods. The quality research method was used in this research.Difficulties in development of unified attendance of the phenomenon are discribed and informations which should be included in such a system are exposed.15 European cities from 6 different countries cooperated in this project.The project has bin going on for 12 months and includet minimum 20 questionaris.Results. There are introduced basic habbits which were recognized in centre in Murska Sobota. Comparative informationes which we could comprehend with other cities and issuficiences which we recognized at the treatment.Conclusions. It is about the first experiment of collecting such unified information in this area. It is important to compare the information that indicate the initial treatment with the concluded treatment.The continuation of work on developing and indicative and preparation of adequate protocol which will settle the unified convoyment of treatment at the beginning, and on the end is one of the priorities of epidemic work on the area of drugs in Europe and in Slovenia.

  14. Social network analysis of food sharing among households in opisthorchiasis endemic villages of Lawa Lake, Thailand.

    Science.gov (United States)

    Phimpraphai, Waraphon; Tangkawattana, Sirikachorn; Sereerak, Piya; Kasemsuwan, Suwicha; Sripa, Banchob

    2017-05-01

    Consumption of raw fish is a well-documented risk factor for Opisthorchis viverrini infection. Sharing of food, especially raw fish recipes may influence the spread of disease through a community. Using social network analysis of an ego network, we investigated food sharing among households in an Opisthorchis-endemic area. Network centrality properties were used to explain the differences in O. viverrini transmission and control between villages with a low and high prevalence of infection. Information on demography and O. viverrini infection in 2008 from villagers in the Lawa Lake area was extracted from the Tropical Disease Research Center database. The two villages that had the lowest and the highest O. viverrini infection at the household level were recruited. Ten percent of households of each village were randomly sampled. Participatory epidemiology and face-to-face structured interviews guided by a social network questionnaire were used to collect data on livelihood, agricultural patterns, food sources, raw fish eating habits, and other food sharing during daily life and social gatherings. The number of contacts including in-degree and out-degree varied from 0 to 7 in the low-infection village and 0 to 4 in the high-infection village. The mean number of contacts for the food-sharing network among the low- and high-infection villages was 1.64 and 0.73 contacts per household, respectively. Between these villages, the mean number of out-degree (p=0.0125), but not in-degree (p=0.065), was significantly different. Food-sharing differed in numbers of sharing-in and sharing-out between the two villages. Network analysis of food sharing may be of value in designing strategies for opisthorchiasis control at the community level. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Population message from the village.

    Science.gov (United States)

    Hibler, M

    1979-06-01

    According to a number of participants at the population conference in Ontario, sponsored by the School of Journalism of the Univesity of Western Ontario and the Canadian International Development Agency, the villages, in developing countries, have sent a message to population experts, declaring that the most effective way to motivate individuals toward reducing family size is to improve basic educational and health care services. It has been demonstrated that improvements in these areas, by providing women with educational opportunities and by reducing infant mortality, have a direct impact on fertility. Efforts should be directed toward discovering similar direct correlates. The message dismissed as irrelevant the battle raging between those who advocate that population growth must be halted before poverty can be eliminated, between the developmentalists, who believe that fundamental changes in economic and political conditions will automatically solve the population problem, and between those who declare that family planning and development must be dealt with simultaneously for either to be effective. Despite evidence demonstrating the effectiveness of the 'direct correlate' approach, most developing countries continue to accord top priority to family planning programs and neglect educational and health care services.

  16. General level of knowledge about Brief Solution Focused Therapy (BSFT) in Polish addiction treatment centers.

    Science.gov (United States)

    Szczegielniak, Anna; Bracik, Joanna; Mróz, Sylwia; Urbański, Marcin; Cichobłaziński, Leszek; Krysta, Krzysztof; Pyrkosz, Katarzyna; Chudy, Norbert; Krupka-Matuszczyk, Irena

    2013-09-01

    The aim of this study was to estimate the level of knowledge about Brief Solution Focused Therapy (BSFT) among therapists and patients during treatment and identification of existing barriers to the introduction of the method. 64 therapists were examined in total; 37 women (57%) and 27 males (43%). The study involved also 191 patients, 160 men (83.77%) and 31 women (16.23%). All the surveys were anonymous and were collected in health centers within the province of Silesia. More than 2/3 of therapists have heard of the method, but do not know the specifics of it. The most important sources of knowledge are other therapists, literature, and mass media. According to the respondents the most important barriers to alcohol addiction treatment include cultural barriers, such as embarrassment or fear of stigmatization. Younger Patients and those treated for a shorter period, state that they know the name of the current method of treatment to a lesser extent than other subgroups. About 10% of people have not heard about the BSFT method of treatment. The level of knowledge about the BSFT method suggests the need to promote this model among both therapists and patients. An introduction of BSFT can improve the treatment of alcohol addiction.

  17. Sustainability of fisherman village in urban area case study : untia fisherman village, makassar, indonesia

    Science.gov (United States)

    Noegroho, N.; Ardiani, Y. M.

    2017-12-01

    Major cities in Indonesia, many of which have a fisherman village in the city area. One of them is the village of Untia in Makassar which keeps the story about relocation history of fishermen’s settlement in Makassar city. Initially, this village is very ‘friendly’ for the fishermen, especially the existence of canals that can be passed by the fishing boat to the front of the each house. However, the sustainability of this fisherman village is threatened by the development of urban functions that are urging towards it. From day to day, this village is segregated with the surrounding area, not only from its function but also from social point of view. This condition will be more severe related to the local government plan to reclaim sea far to the west side, thus threatening the sustainability of fisherman life in this village. How does a fisherman village in an urban area have to survive? The research begins by highlighting the conditions and problems that exist, data was collected by field survey. This data combined with some literatures then analyzed to propose a direction how fisherman’s village respond to the surrounding development. Become a Tourism village is a one way for fisherman’s village to survive in urban area.

  18. Tele-economics of Village Telco

    OpenAIRE

    Innset, Marte Berg

    2014-01-01

    This master s thesis is written in collaboration with Village Telco. VillageTelco is a grass root solution for establishing communication whereno other can or are willing to do so. The business has developed theMeshPotato, a wireless access point, which uses standard Wi-Fi technologycombined with open-source telephony software and a state of the artmesh protocol, to provide low-cost telephony. Today, Village Telco serveas a hardware provider. The master s thesis provides a background studyof ...

  19. On the treatment of the center of mass motion in nuclear mean field theories

    Science.gov (United States)

    Schmid, K. W.; Grümmer, F.

    1990-03-01

    It is shown how the spurious components due to the center of mass motion can be eliminated from general Hartree-Fock-Bogoliubov quasi-particle configurations with the help of projection techniques. The problem how to restore the additional symmetries being broken by such configurations is discussed. An explicit formulation is given for the spherical Hartree-Fock problem with center of mass momentum projection before the variation. As an example for the application of this method the ground state of4He is studied using two different interactions, a microscopic two-body one as well as a phenomenological one including a Skyrme-type three-body force. The results are compared to those of the usual approximate treatment of the center of mass motion in Hartree-Fock calculations. It turns out that, at least for the chosen example, the latter yields a rather reasonable approximation to the correct total energy, single particle energy and even the mass density provided that it is calculated from a translationally invariant density operator.

  20. The political and scientific challenges in evaluating compulsory drug treatment centers in Southeast Asia.

    Science.gov (United States)

    Vuong, Thu; Nguyen, Nhu; Le, Giang; Shanahan, Marian; Ali, Robert; Ritter, Alison

    2017-01-11

    In Vietnam, like many countries in Southeast Asia, the commonly used approach of center-based compulsory drug treatment (CCT) has been criticized on human rights ground. Meanwhile, community-based voluntary methadone maintenance treatment (MMT) has been implemented for nearly a decade with promising results. Reform-minded leaders have been seeking empirical evidence of the costs and effectiveness associated with these two main treatment modalities. Conducting evaluations of these treatments, especially where randomization is not ethical, presents challenges. The aim of this paper is to discuss political challenges and methodological issues when conducting cost-effectiveness studies within the context of a non-democratic Southeast Asian country. A retrospective analysis of the political and scientific challenges that were experienced in the study design, sample size determination, government approval and ethics approvals, participant recruitment, data collection, and determination of sources, and quantification of cost and effectiveness data was undertaken. As a consequence of the non-randomized design, analysis of patient characteristics for both treatment types was undertaken to identify the magnitude of baseline group differences. Concordance between self-reported heroin use and urine drug testing was undertaken to determine the reliability of self-report data in a politically challenging environment. We demonstrate that conducting research around compulsory treatment in a non-democratic society is feasible, yet it is politically challenging and requires navigation between science and politics. We also demonstrate that engagement with the government decision makers in the research conception, implementation, and dissemination of the results increases the likelihood of research evidence being considered for change in a contentious drug policy area. Local empirical evidence on the comparative cost-effectiveness of CCT and MMT in a Southeast Asian setting is

  1. [Medical treatment of rheumatoid arthritis in 2014 : Current data from the German Collaborative Arthritis Centers].

    Science.gov (United States)

    Albrecht, K; Huscher, D; Eidner, T; Kleinert, S; Späthling-Mestekemper, S; Bischoff, S; Zink, A

    2017-02-01

    Since the introduction of biologic treatment in rheumatoid arthritis (RA), disease activity and treatment modalities have changed substantially. The current provision and developments in recent years are analyzed with annual data from the National Database of the Collaborative Arthritis Centers in Germany. To analyze disease activity, diagnostics and treatment in RA patients in 2014 with regard to seropositivity and disease duration. Time trends from 2007-2014 are reported for disease activity (DAS28) distribution and biologic treatment. In 2014, a total of 8,084 RA patients were analyzed: 72 % were rheumatoid factor and/or ACPA positive, the mean age was 62 years and the mean disease duration 12 years. According to DAS28, 35.9 % were in remission, 19.2 % had low, 37.1 % moderate and 7.8 % high disease activity. An increase since 2007 was only observed in patients with a disease duration >2 years. Synthetic DMARDS were used for treatment in 78 %. Biologic treatment increased from 16 % (2007) to 27 % (2014). Especially those patients with a disease duration >5 years were treated more frequently with biologics. Seronegative patients had slightly less severe mean disease activity parameters. They were treated equally frequent with DMARDS but only half as often with biologics compared to seropositive patients. The use of biologics in RA patients has increased since 2007; however this was not observed in patients with short disease duration. Early intensive treatment adaption seems justified to improve disease activity in the large portion of patients who do not reach low disease activity under conventional DMARDs.

  2. A descriptive survey of types, spread and characteristics of substance abuse treatment centers in Nigeria

    Directory of Open Access Journals (Sweden)

    Akinhanmi Akinwande O

    2011-09-01

    Full Text Available Abstract Background Nigeria, the most populous country in Africa and the 8th most populous in the world with a population of over 154 million, does not have current data on substance abuse treatment demand and treatment facilities; however, the country has the highest one-year prevalence rate of Cannabis use (14.3% in Africa and ranks third in Africa with respect to the one-year prevalence rate of cocaine (0.7% and Opioids (0.7% use. This study aimed to determine the types, spread and characteristics of the substance abuse treatment centers in Nigeria. Methods The study was a cross sectional survey of substance abuse treatment centers in Nigeria. Thirty-one units were invited and participated in filling an online questionnaire, adapted from the European Treatment Unit/Program Form (June 1997 version. Results All the units completed the online questionnaire. A large proportion (48% was located in the South-West geopolitical zone of the country. Most (58% were run by Non-Governmental Organizations. Half of them performed internal or external evaluation of treatment process or outcome. There were a total of 1043 for all categories of paid and volunteer staff, with an average of 33 staff per unit. Most of the funding came from charitable donations (30%. No unit provided drug substitution/maintenance therapy. The units had a total residential capacity of 566 beds. New client admissions in the past one year totalled 765 (mean = 48, median = 26.5, min = 0, max = 147 and 2478 clients received services in the non-residential units in the past year. No unit provided syringe exchange services. Conclusions The study revealed a dearth of substance abuse treatment units (and of funds for the available ones in a country with a large population size and one of the highest prevalence rates of substance abuse in Africa. The available units were not networked and lacked a directory or an evaluation framework. To provide an environment for effective monitoring

  3. Treatment outcomes in stage IIIA non-small-cell lung cancer in a community cancer center.

    Science.gov (United States)

    Hanson, Shaun; Persad, Kamleish; Qiao, Xian; Guarino, Michael; Petrelli, Nicholas

    2015-08-01

    Treatment outcomes for non-small-cell lung cancer (NSCLC) patients diagnosed at stage IIIA have been analyzed in many studies, which generally involve patients younger and healthier than the average patient with this disease. To analyze demographics and treatment outcomes in patients with stage IIIA NSCLC at a community cancer center. We reviewed charts of 226 patients diagnosed with stage IIIA NSCLC from January 2003 to December 2008 treated at our community cancer center. Results Median overall survival for all patients and sequentially and concurrently treated chemoradiation patients were 18 months, and 18 months, and 20 months, respectively. Median overall survival for women and men was 24 months and 16 months, respectively. Median overall survival for all patients and sequentially and concurrently treated chemoradiation patients were 18 months, and 18 months, and 20 months, respectively. Median overall survival for women and men was 24 months and 16 months, respectively. Study design was retrospective and some medical records were not available. However, this population is likely representative of patients treated in similar settings. In our population, advanced age and male gender were associated with lower median survival. Responses to concurrent and sequential chemoradiation seemed to differ based on age group, which may be useful as a prognostic guideline for similar populations. ©2015 Frontline Medical Communications.

  4. The functional status of patients with AIDS attending antiretroviral treatment center

    Directory of Open Access Journals (Sweden)

    T J Thejus

    2009-01-01

    Full Text Available Aims: To assess the functional status of patients with Acquired immunodeficiency syndrome (AIDS registered in the Anti-Retroviral Treatment (ART center. Materials and Methods: Design: Descriptive study. Study setting: ART center in Calicut Medical College, Kerala, India. Subjects: Cohorts of AIDS patients attending the ART center during the year 2007. Data collection: Done prospectively from the secondary data available from the center. Outcome measures: The demographic, morbidity, functional status and laboratory parameters were collected. Data processing was done using Excel datasheet and analysis were done using Epi info 2003. Results: One hundred and ninety-five patients received care during this period; 69% were males. The mean age was 38±9 years; 80% of them were married and in 50% of their spouses also tested positive for HIV. The mean CD4 count was 127 cells/microliter. The majority (90% were categorized as WHO Stage 3 or 4 of HIV. Only 52% of them were able to perform their usual work in or outside their house; the rest were not able to lead an economically productive life. Thirty-six per cent were only able to perform activities of daily living; 12% were bedridden.The functional status of the patients positively correlated with WHO disease stage ( P = < 0-0001, and CD4 count and hemoglobin levels negatively correlated with staging ( P = < 0.001. 62% are having any of the opportunistic infections. Conclusion: Fifty per cent of the AIDS patients are disabled and need support and care. As AIDS is a growing problem, community-based palliative care for AIDS patients should be strengthened in India.

  5. [An evaluation of diagnosis and treatment of acute sinusitis at three health care centers].

    Science.gov (United States)

    Oskarsson, Jón Pálmi; Halldórsson, Sigurdur

    2010-09-01

    The objective of this study was to evaluate the diagnosis and treatment of acute sinusitis at three health care centers in northern and eastern Iceland. Information on all those diagnosed with acute sinusitis (ICD 10 J01.0, J01.9) in the year 2004 at the communal health care centers in Akureyri, Husavik and Egilsstadir was obtained retrospectively from computerized clinical records. Key factors used for diagnosis and treatment were recorded. In order to obtain an equal distribution in population size only about one-third of the diagnoses made in Akureyri were included in the search (the first ten days of every month). The search yielded a total of 468 individuals. The average incidence of acute sinusitis was found to be 3.4 per 100 inhabitants per year. Adherence to clinical guidelines (albeit from other countries) regarding diagnosis of bacterial sinusitis was nearly nonexistent. There were considerable differences found between health care centers as to whether x-rays were used for diagnostic purposes. Blood tests were hardly used at all. The disease was diagnosed over the telephone in 28% of the cases (Husavik 38%, Akureyri 32%, Egilsstadir 10%). Over 90% of all individuals diagnosed with acute sinusitis received antibiotics, regardless of symptom duration. The antibiotics most often prescribed were Doxycyclin and Amoxicillin. The incidence of acute sinusitis in these three communities seems to be similar to other western countries. Acute bacterial sinusitis seems to be overdiagnosed and the use of antibiotics is in no context with clinical guidelines. Our results support the hypothesis that physicians tend to regard acute sinusitis as a bacterial disease, and treat it accordingly.

  6. Experiences of Power and Violence in Mexican Men Attending Mutual-Aid Residential Centers for Addiction Treatment

    National Research Council Canada - National Science Library

    Lozano-Verduzco, Ignacio; Marín-Navarrete, Rodrigo; Romero-Mendoza, Martha; Tena-Suck, Antonio

    2016-01-01

    Fundamental elements of hegemonic masculinity such as power and violence are analyzed through characteristics of 12-step programs and philosophy immersed in Mutual-Aid Residential Centers for Addiction Treatment (CRAMAAs...

  7. Prospective multi-center trial utilizing electronic brachytherapy for the treatment of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Thropay John P

    2010-07-01

    Full Text Available Abstract Background A modified form of high dose rate (HDR brachytherapy has been developed called Axxent Electronic Brachytherapy (EBT. EBT uses a kilovolt X-ray source and does not require treatment in a shielded vault or a HDR afterloader unit. A multi-center clinical study was carried out to evaluate the success of treatment delivery, safety and toxicity of EBT in patients with endometrial cancer. Methods A total of 15 patients with stage I or II endometrial cancer were enrolled at 5 sites. Patients were treated with vaginal EBT alone or in combination with external beam radiation. Results The prescribed doses of EBT were successfully delivered in all 15 patients. From the first fraction through 3 months follow-up, there were 4 CTC Grade 1 adverse events and 2 CTC Grade II adverse events reported that were EBT related. The mild events reported were dysuria, vaginal dryness, mucosal atrophy, and rectal bleeding. The moderate treatment related adverse events included dysuria, and vaginal pain. No Grade III or IV adverse events were reported. The EBT system performed well and was associated with limited acute toxicities. Conclusions EBT shows acute results similar to HDR brachytherapy. Additional research is needed to further assess the clinical efficacy and safety of EBT in the treatment of endometrial cancer.

  8. The constraints of antiretroviral uptake in rural areas: the case of Thamaga and surrounding villages, Botswana.

    Science.gov (United States)

    Bene, Matlhogonolo; Darkoh, Michael B K

    2014-01-01

    This article examines the constraints of antiretroviral (ARV) uptake in the villages of Thamaga, Kumakwane, Mankgodi and Gakgatla which are in the Kweneng District of Botswana. The social interactionist approach and theories of health behaviour provided the theoretical basis of the study. Data were obtained by using interviewer-administered questionnaires which were applied to a sample of 145 respondents and 61 people living with HIV/AIDS in the four villages. The results of the study showed that people aged 30-39 years represented the highest proportion of the persons on ARV treatment in the villages. Some of the people living with HIV believed that ARV therapy could better their lives during the initial stages of introduction, but with time, they lost hope and gave up the treatment. Culturally, parents and children in the villages do not discuss sexual matters at home and it was found in the study that there was little communication between parents and children on AIDS and ARV issues. Some churches in the area discouraged the use of ARV. There were also traditional doctors who made their patients mix traditional herbs treatment with ARV treatment. Distance, travel costs, cultural beliefs, stigma and discrimination among others were found to be important socio-economic factors inhibiting ARV uptake. Even though there were constraints on ARV uptake in the villages, efforts were being made by Government and non-governmental organizations to overcome them. The Ministry of Health provided information and education to the public using its strategy known as Information, Education and Communication. Nurses, doctors and chiefs taught people at kgotlas (traditional courts) in the villages about the dangers of the epidemic. Free HIV testing, ARVs and condoms were provided to the villagers. The outlook for ARV uptake looks generally promising for the future. However, if HIV/AIDS is to be contained, sexual behaviour of people in the villages needs to change.

  9. Development Planning of Tourist Village Using Participatory Mapping (Case study: Mambal Village, Badung Regency, Indonesia)

    Science.gov (United States)

    Arida, I. N. S.; Wiguna, P. P. K.; Narka, I. W.; Febrianti, N. K. O.

    2017-12-01

    Tourism sector is the highest source of income in Badung Regency so it is interesting to see the development of tourist village as one of the alternative tourist destinations in Badung Regency. Most of the village areas in Badung Regency do not have policies, vision and mission as an effort to develop the village into a tourist village. As a result the role of tourist village does not grow in terms of economic and social community. The purpose of this research is to determine and to map the tourism development plan using participatory mapping. The methodology used in this research is field surveys and interviews for data collection and participatory mapping to map the development plan to support tourism. Mambal village is located in Sub-district of Abiansemal, Badung Regency, Indonesia. Mambal village has the potential to become a tourism village because it is supported by the uniqueness of nature and tradition. Mambal village passed by Ayung river, where along the river there are beautiful cliffs which potential to develop as adventure tourism. There is also Senaung Pengibul Cave with a length of more than 15 meters and is wide enough to pass. Mambal village also has a spiritual tour of Pura Demung and Pancoran Pitu, which has a magical story. Currently farmers in Mambal Village are focusing on developing organic farming, of which 38% of the rice fields present in Mambal are pure organic that produces organic rice. Around the rice field area is also created a jogging track for visitors while enjoying the natural beauty of rice fields. Farmers also cultivate oyster mushrooms. In addition, Mambal Village Community also produces handicraft products that are woven in the form of symmetrical Endek (traditional fabrics) and processed products from used goods such as bags, wallets, pencil boxes and others.

  10. Survival advantage associated with treatment of injury at designated trauma centers: a bivariate probit model with instrumental variables.

    Science.gov (United States)

    Pracht, Etienne E; Tepas, Joseph J; Celso, Brian G; Langland-Orban, Barbara; Flint, Lewis

    2007-02-01

    This article analyzes the effectiveness of designated trauma centers in Florida concerning reduction in the mortality risk of severely injured trauma victims. A bivariate probit model is used to compute the differential impact of two alternative acute care treatment sites. The alternative sites are defined as (1) a nontrauma center (NC) or (2) a designated trauma center (DTC). An instrumental-variables method was used to adjust for prehospital selection bias in addition to the influence of age, gender, race, risk of mortality, and type of injury. Treatment at a DTC was associated with a reduction of 0.13 in the probability of mortality.

  11. Village Infrastructure Kit-Alpha. Global Innovation and Strategy Center

    Science.gov (United States)

    2009-05-01

    increases soil quality and reduces erosion, and improves wildlife habitat.‖ 68 Solar and wind energy are the most commonly known and...Africa and Kenya use the Thirst Aid to combat water contamination in their studies and communities. It also exceeds standards and protocols set by...farming, and cultivating tourism . 108 It has been shown that rural communities directly benefit from modern telecommunications services, in job

  12. Actualizing Communities of Practice (COPs and Situated Learning for A Sustainable Eco-Village

    Directory of Open Access Journals (Sweden)

    Maria Victoria Pineda

    2016-05-01

    Full Text Available An eco-village as defined by Robert Gilman is a “human-scale, full-featured settlement where you feel you know the others, and human activities are integrated with natural, biological systems.” Roland Mayerl argued that this maybe ideal, but there are huge challenges. He claims the challenges are at different levels—there is the physical layer that constitutes food production, animals, water and wastewater treatment. Other layers will be the built environment, the economic system and the governance in the village.This paper argues that one of the challenging layers is the human layer that was excluded in the modeling of many eco-village works. While there are many good models of an eco-village, sustainability will primarily be laid on the shoulders of the members of the community or the village for that matter. Sustainability should be espoused by the members of the eco-village. But how can sustainability be attained? What sustainability approach or strategy can be employed?“Communities of practice (COP are formed by people who engage in a process of collective learning in a shared domain of human endeavor.“ (Wenger, 2004 COPs are concepts commonly applied in organizations and virtual communities. Using this approach together with periphery participation and situated learning, this paper presents a human-based model of a sustainable eco-village and some useful examples.The paper also argues that an eco-village necessitates the support of technology in enhancing and preserving the shared practices. Hence, use of social media deployed in the web is one of the recommended ways that also permit collective action among members of the eco-village.

  13. Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center

    Science.gov (United States)

    Detweiler, Mark B.; Pagadala, Bhuvaneshwar; Candelario, Joseph; Boyle, Jennifer S.; Detweiler, Jonna G.; Lutgens, Brian W.

    2016-01-01

    The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis.on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0–6.0 mg), clonidine (63%, 0.1–2.0 mg), quetiapine (50%, 12.5–800.0 mg), mirtazapine (50%; 7.5–30.0 mg), and terazosin (64%, 50.0–300.0 mg). Notably, olanzapine (2.5–10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares. PMID:27999253

  14. Childhood acute lymphoblastic leukemia in Turkey: factors influencing treatment and outcome: a single center experience.

    Science.gov (United States)

    Hazar, Volkan; Karasu, Gulsun Tezcan; Uygun, Vedat; Akcan, Mediha; Küpesiz, Alphan; Yesilipek, Akif

    2010-11-01

    There is limited data about the long-term treatment outcome and prognosis of childhood acute lymphoblastic leukemia (ALL) in developing countries. Our study was designed to assess survival data and identify risk factors. Data of 142 children with ALL who were treated with a modified BFM 95 protocol between 1997 and 2007 were evaluated. The median age was 4.3 years. Complete remission (CR) rate after induction phase was 93.5%; with 2.1% induction-related mortality and 0.7% having resistance disease. Of complete responders, 67.1% are in continuous CR with a median follow-up of 63 months (range: 24 to 153 mo). Treatment-related mortality was 17.7% and the total rate of treatment abandonment was 3.5%. The probability of event-free survival was 67.3% (95% confidence interval 59.3-75.3) at 4 years and 63.2% (95% confidence interval 54.4-72.0) at 8 years. This report examines children with ALL treated with a modified ALL-BFM 95 protocol in a tertiary care center in Turkey with adequate follow up and demonstrates the need for improvements especially for patients with unfavorable risk group and strategies to reduce deaths from infection in CR to keep pace with cure rates in developed countries.

  15. 25 CFR 91.11 - Domestic animals in village reserves.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Domestic animals in village reserves. 91.11 Section 91.11... VILLAGES, OSAGE RESERVATION, OKLAHOMA § 91.11 Domestic animals in village reserves. (a) No livestock shall... owner of the animal, if known, by certified mail or by posting in the village square. The notice shall...

  16. Measuring the Development Patterns of Urban Villages in Shenzhen

    NARCIS (Netherlands)

    Hao, P.; Geertman, S.C.M.; Hooimeijer, P.; Sliuzas, R.

    2011-01-01

    Urban villages are widespread in many Chinese cities, providing affordable and accessible housing for rural migrants. These urban villages are developed by the indigenous village population base on a self-help approach and in an unauthorized style. Consequently, urban villages are characterized by

  17. Designing a concept for an IT-infrastructure for an integrated research and treatment center.

    Science.gov (United States)

    Stäubert, Sebastian; Winter, Alfred; Speer, Ronald; Löffler, Markus

    2010-01-01

    Healthcare and medical research in Germany are heading to more interconnected systems. New initiatives are funded by the German government to encourage the development of Integrated Research and Treatment Centers (IFB). Within an IFB new organizational structures and infrastructures for interdisciplinary, translational and trans-sectoral working relationship between existing rigid separated sectors are intended and needed. This paper describes how an IT-infrastructure of an IFB could look like, what major challenges have to be solved and what methods can be used to plan such a complex IT-infrastructure in the field of healthcare. By means of project management, system analyses, process models, 3LGM2-models and resource plans an appropriate concept with different views is created. This concept supports the information management in its enterprise architecture planning activities and implies a first step of implementing a connected healthcare and medical research platform.

  18. Predictors of disease severity in patients admitted to a cholera treatment center in urban Haiti.

    Science.gov (United States)

    Valcin, Claude-Lyne; Severe, Karine; Riche, Claudia T; Anglade, Benedict S; Moise, Colette Guiteau; Woodworth, Michael; Charles, Macarthur; Li, Zhongze; Joseph, Patrice; Pape, Jean W; Wright, Peter F

    2013-10-01

    Cholera, previously unrecognized in Haiti, spread through the country in the fall of 2010. An analysis was performed to understand the epidemiological characteristics, clinical management, and risk factors for disease severity in a population seen at the GHESKIO Cholera Treatment Center in Port-au-Prince. A comprehensive review of the medical records of patients admitted during the period of October 28, 2010-July 10, 2011 was conducted. Disease severity on admission was directly correlated with older age, more prolonged length of stay, and presentation during the two epidemic waves seen in the observation period. Although there was a high seroprevalence of human immunodeficiency virus (HIV), severity of cholera was not greater with HIV infection. This study documents the correlation of cholera waves with rainfall and its reduction in settings with improved sanitary conditions and potable water when newly introduced cholera affects all ages equally so that interventions must be directed throughout the population.

  19. Availability of Outpatient Clinical Nutrition Services for Patients With Cancer Undergoing Treatment at Comprehensive Cancer Centers.

    Science.gov (United States)

    Platek, Mary E; Johnson, Jordan; Woolf, Kathleen; Makarem, Nour; Ompad, Danielle C

    2015-01-01

    The mission of US Comprehensive Cancer Centers (CCC) is to reduce cancer morbidity and mortality. The type of clinical nutrition services available to outpatients seeking treatment at CCCs is unknown. The purpose of this cross-sectional study was to determine the prevalence and types of outpatient clinical nutrition services available at CCCs. A list of the National Cancer Institute (NCI) -designated CCCs was compiled. A telephone survey that queried clinical nutrition services available to outpatients undergoing treatment was developed. The survey was conducted with clinical nutrition personnel during usual working hours between April and October 2012. Of the 40 CCCs, 32 (80%) completed the survey. Thirty CCCs offered referral- or consult-based services with a clinical nutrition professional such as a registered dietitian (RD). Other services included nutrition classes (56%), nutrition pamphlets (94%), and counseling by non-nutrition health care providers (81%). Twenty-three of the centers monitored patients regularly, but less than half followed a clinical nutrition protocol such as those established by the Academy of Nutrition and Dietetics. Referral-based services were provided for cancers with a high prevalence of malnutrition, such as head and neck and GI, with most monitoring patients regularly but less than half using evidence-based protocols. CCCs rely on referral-based clinical nutrition service, which are not consistently a part of multidisciplinary care. An in-depth comparison of clinical nutrition services among other approaches to cancer care, including a comparison of clinical outcomes among these different approaches, is needed. Copyright © 2015 by American Society of Clinical Oncology.

  20. Gestational Trophoblastic Neoplasia Treatment at the Butaro Cancer Center of Excellence in Rwanda

    Science.gov (United States)

    Nzayisenga, Ignace; Segal, Roanne; Pritchett, Natalie; Xu, Mary J.; Park, Paul H.; Mpanumusingo, Edgie V.; Umuhizi, Denis G.; Goldstein, Donald P.; Berkowitz, Ross S.; Hategekimana, Vedaste; Muhayimana, Clemence; Rubagumya, Fidel; Fadelu, Temidayo; Tapela, Neo; Mpunga, Tharcisse

    2016-01-01

    Purpose Gestational trophoblastic neoplasia (GTN) is a highly treatable disease, most often affecting young women of childbearing age. This study reviewed patients managed for GTN at the Butaro Cancer Center of Excellence (BCCOE) in Rwanda to determine initial program outcomes. Patients and Methods A retrospective medical record review was performed for 35 patients with GTN assessed or treated between May 1, 2012, and November 30, 2014. Stage, risk score, and low or high GTN risk category were based on International Federation of Gynecology and Obstetrics staging and the WHO scoring system and determined by beta human chorionic gonadotropin level, chest x-ray, and ultrasound per protocol guidelines for resource-limited settings. Pathology reports and computed tomography scans were assessed when possible. Treatment was based on a predetermined protocol stratified by risk status. Results Of the 35 patients (mean age, 32 years), 26 (74%) had high-risk and nine (26%) had low-risk disease. Nineteen patients (54%) had undergone dilation and curettage and 11 (31%) had undergone hysterectomy before evaluation at BCCOE. Pathology reports were available in 48% of the molar pregnancy surgical cases. Systemic chemotherapy was initiated in 30 of the initial 35 patients: 13 (43%) received single-agent oral methotrexate, 15 (50%) received EMACO (etoposide, methotrexate, dactinomycin, cyclophosphamide, and vincristine), and two (7%) received alternate regimens. Of the 13 patients initiating methotrexate, three had their treatment intensified to EMACO. Four patients experienced treatment delays because of medication stockouts. At a median follow-up of 7.8 months, the survival probability for low-risk patients was 1.00; for high-risk patients, it was 0.63. Conclusion This experience demonstrates the feasibility of GTN treatment in rural, resource-limited settings. GTN is a curable disease and can be treated following the BCCOE model of cancer care. PMID:28717722

  1. [Cancer plans apply to surgical treatment of prostate cancer: A geographically isolated center balance].

    Science.gov (United States)

    Mondet, F; Alimi, J-C; Boyer, C

    2017-05-01

    Since 2003, fight against cancer was structured by 3 national cancer programs (CP). The objective of this study is to evaluate the application of these measures in the case of surgical prostate cancer (PCa) treatment in a geographically isolated center. Monocentric retrospective study carried in a 100-bed clinic located 2hours away from a Cancer Regional Reference Center. Between August 2009 and December 2014, 251 consecutive patients were treated by total laparoscopic prostatectomy (TLP). Fifty-seven patients (22.7 %) received a secondary treatment after TLP. The study focused on the delay between prostate biopsies and PTL, the traceability of AD elements, the return of active patients, inclusion in clinical trials (GETUG 17, GETUG 20 and GETUG 22). Data were collected in September 2016. The follow-up defined by the time between the date of the last visit and the prostate biopsy allows a median follow-up of 43.1 months (2.4-80.5). All elements of the CAP are totally gathered on 45 % of the patients (113/251). Thirty-four (13.5 %) patients were active at the time of the intervention. Thirty-one (91.2 %) will return to an identical activity after a median work stoppage of 1.7 month (0.25-6). Fourteen percent (35/251) of the patients are eligible to a clinical trial. Seventeen percent (6/35) of them were proposed to one of a trial after multidisciplinary meeting and 5.7 % (2/35) are eventually included in one trial. CP define a course of high quality care. A better transparency of the founding of the enforceable measures and a better consideration for the local specificities should facilitate their application. The TLP treat the PCa with the reasonable objective of a return to an identical professional activity. The multidisciplinary meeting does not guarantee the participation to clinical trial, which depends mainly on distance from the Cancer Regional Reference Center and the vigilance of the Urologist. 4. Copyright © 2017 Elsevier Masson SAS. All rights

  2. Institutional profile: integrated center for research and treatment of vertigo, balance and ocular motor disorders.

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    Brandt, Thomas; Zwergal, Andreas; Jahn, Klaus; Strupp, Michael

    2010-01-01

    In 2009 the German BMBF (German Ministry of Education and Research) established an Integrated Center for Research and Treatment (IFB(LMU)) of Vertigo, Balance and Ocular Motor Disorders in Munich. After the 10-year period of funding by the BMBF, it is envisioned that the (IFB(LMU)) will continue over the long term with the joint support of the University Hospital, the Medical Faculty, and the Bavarian State. Vertigo is one of the most common complaints in medicine. Despite its high prevalence, patients with vertigo generally receive either inappropriate or inadequate treatment. This deplorable situation is internationally well known and its causes are multiple: insufficient interdisciplinary cooperation, no standardized diagnostics and therapy, the failure to translate findings of basic science into clinical applications, and the scarcity of clinical multicenter studies. The (IFB(LMU)) will constitute a suitable tool with which these structural, clinical, and scientific deficits can be overcome. It will also make possible the establishment of an international interdisciplinary referral center. Munich has become the site of a unique concentration of leading experts on vertigo, balance and ocular motor disorders, both in the clinical and basic sciences. Academic structures have paved the way for the creation of an interdisciplinary horizontal network that also allows structured, vertical academic career paths via the Bachelor's and Master's degree programs in Neuroscience, a Graduate School of Systemic Neurosciences, and the Munich Center for Neurosciences - Brain and Mind. The (IFB(LMU)) has the following objectives as regards structure and content: to create an independent patient-oriented clinical research center under the auspices of the Medical Faculty but with autonomous administration and budget; to overcome existing clinical and academic barriers separating the traditional specializations; to establish a standardized interdisciplinary longitudinal and

  3. Are 'Village Doctors' in Bangladesh a curse or a blessing?

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    Wahed Tania

    2010-07-01

    Full Text Available Abstract Background Bangladesh is one of the health workforce crisis countries in the world. In the face of an acute shortage of trained professionals, ensuring healthcare for a population of 150 million remains a major challenge for the nation. To understand the issues related to shortage of health workforce and healthcare provision, this paper investigates the role of various healthcare providers in provision of health services in Chakaria, a remote rural area in Bangladesh. Methods Data were collected through a survey carried out during February 2007 among 1,000 randomly selected households from 8 unions of Chakaria Upazila. Information on health-seeking behaviour was collected from 1 randomly chosen member of a household from those who fell sick during 14 days preceding the survey. Results Around 44% of the villagers suffered from an illness during 14 days preceding the survey and of them 47% sought treatment for their ailment. 65% patients consulted Village Doctors and for 67% patients Village Doctors were the first line of care. Consultation with MBBS doctors was low at 14%. Given the morbidity level observed during the survey it was calculated that 250 physicians would be needed in Chakaria if the patients were to be attended by a qualified physician. Conclusions With the current shortage of physicians and level of production in the country it was asserted that it is very unlikely for Bangladesh to have adequate number of physicians in the near future. Thus, making use of existing healthcare providers, such as Village Doctors, could be considered a realistic option in dealing with the prevailing crisis.

  4. The village as a ‘community of practice’ Constitution of village belonging through leisure sociality

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    Fausto Barlocco

    2010-12-01

    Full Text Available This paper looks at the formation and display of a form of identification alternative to the national one, the belonging to the village, within the leisure practices of Kadazan villagers in Sabah, East Malaysia, both constituted by the regular meetings of peer groups and by festive events. The analysis of the paper applies the concept of ‘community of practice’ to the group of villagers who regularly invest most of their resources of free time, but also money, in interacting between themselves and in organising celebrations for various life-cycle events or for other occasions, and argues that a strong sense of belonging to the village is developed through this engagement. These practices are informed by a powerful and widely spread local ideology, positing the village as the central point of reference for its inhabitants’ sense of belonging and as the locus of a traditionalist ‘way of life’, based on cooperation, sharing and egalitarian principles, and rejecting the modern, multi-ethnic urban world from which the majority of the villagers derive their livelihood. This ideology defines the village as Kadazan and Christian, determining a rootedness in everyday life of ethnic identity as well as a general rejection of government-led nationalist propaganda and of its policies. This ideology is an essential part of the affirmation by the villagers of the primacy of the local and of direct involvement and participation over their sense of belonging to collective categories.

  5. Benzodiazepine use among young attendees of an Irish substance treatment center.

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    Murphy, Kevin Daniel; Byrne, Stephen; McCarthy, Suzanne; Lambert, Sharon; Sahm, Laura Jane

    2014-01-01

    To describe the demographic characteristics of those service users attending Matt Talbot Services, and their current and past substance use, and to explore the use of benzodiazepines among this group. There were 198 service users who attended a substance misuse treatment center in Cork, Ireland, between January 2005 and August 2011. Benzodiazepines had ever been used by 51.0%, and of these, 55.8% were regular benzodiazepine users. The mean age of first use was 14.9 ± 1.4 years. Regular users of benzodiazepines were regular users of significantly more substances (3, interquartile range [IQR] = 2-3) when compared with nonregular benzodiazepine users (1, IQR = 1-2). Regular benzodiazepine users showed more behavioral signs (12, IQR = 10-14) than nonregular users (9, IQR = 7-12). Physical signs were significantly different between regular (8, IQR = 6-11) and nonregular (5, IQR = 3-10) users. The effects of benzodiazepine misuse affect the individual, their family, and society as a whole through hospitalization, substance treatment, and crime. Identifying regular benzodiazepine users can help reduce the burden of benzodiazepines.

  6. Early diagnosis and treatment of breast cancer in Japanese kidney transplant recipients: a single center experience.

    Science.gov (United States)

    Kato, Taigo; Kakuta, Yoichi; Yamanaka, Kazuaki; Okumi, Masayoshi; Abe, Toyofumi; Imamura, Ryoichi; Ichimaru, Naotsugu; Takahara, Shiro; Nonomura, Norio

    2015-01-01

    The incidence of malignancies in kidney transplant recipients is increasing. Breast cancer is a common malignancy after kidney transplantation and can be more aggressive in kidney transplant recipients than in the general population. In this study, we evaluated the incidence and prognosis of breast cancer in kidney transplant recipients. Between 1993 and 2013, 750 kidney transplant patients were followed-up at our center. Since 1999, annual physical examination, mammography, and breast ultrasonography have been performed for such patients. Diagnostic studies, including core needle or mammotome biopsy, were performed for suspected malignancies. Patients with malignant neoplasm were administered the appropriate treatment and followed-up to assess tumor response and symptoms. Nine patients were diagnosed with breast cancer during the follow-up period. The mean age at the initial detection of the breast cancer was 47.7 ± 8.4 years. The mean interval from transplantation to diagnosis was 148.7 ± 37.1 months. Of the 9 patients, 8 were detected through the screening test; 7 were treated with breast conservative surgery and 1 was treated with modified radical mastectomy. The cancer stages were 0 (n = 2), I (n = 6), and II (n = 1). The incidence of breast cancer tended to be unchanged with time between transplantation and diagnosis, inconsistent with the increase in the duration of immunosuppression. Annual screening tests are crucial in the early diagnosis of breast cancer. Early treatment of breast cancer can result in an excellent prognosis in kidney transplant recipients.

  7. Quality of life among breast cancer patients undergoing treatment in national cancer centers in Nepal.

    Science.gov (United States)

    Manandhar, Sajani; Shrestha, Deepak Sundar; Taechaboonsermsk, Pimsurang; Siri, Sukhontha; Suparp, Jarueyporn

    2014-01-01

    To study the quality of life and to identify associated factors among breast cancer patients undergoing treatment in national cancer centers in Nepal. One hundred breast cancer patients were selected and interviewed using a structured questionnaire. European Organization of Research and Treatment of Cancer EORTC-QLQ-C30 and EORTC-QLQ-BR23 were used to assess quality of life and modified Medical Outcome Study -Social Support survey(mMOS-SS) was used to assess social support. Only multi-item scales of EORTC C30 and BR23 were analyzed for relationships. Independent sample T-tests and ANOVA were applied to analyze differences in mean scores. The score of global health status/quality of life (GHS/GQoL) was marginally above average (mean=52.8). The worst performed scales in C-30 were emotional and social function while best performed scales were physical and role function. In BR-23, most of the patients fell into the problematic group regarding sexual function and enjoyment. Almost 90% had financial difficulties. Symptom scales did not demonstrate many problems. Older individuals, patients with stage I breast cancer and thosewith good social support were found to have good GHS/GQoL. Of all the influencing factors, social support was established to have strong statistical associations with most of the functional scales: GHS/GQoL (0.003), emotional function (system.

  8. Aggressive Treatment of Patients with Metastatic Colorectal Cancer Increases Survival: A Scandinavian Single-Center Experience

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    Kristoffer Watten Brudvik

    2013-01-01

    Full Text Available Background. We examined overall and disease-free survivals in a cohort of patients subjected to resection of liver metastasis from colorectal cancer (CRLM in a 10-year period when new treatment strategies were implemented. Methods. Data from 239 consecutive patients selected for liver resection of CRLM during the period from 2002 to 2011 at a single center were used to estimate overall and disease-free survival. The results were assessed against new treatment strategies and established risk factors. Results. The 5-year cumulative overall and disease-free survivals were 46 and 24%. The overall survival was the same after reresection, independently of the number of prior resections and irrespectively of the location of the recurrent disease. The time intervals between each recurrence were similar (11 ± 1 months. Patients with high tumor load given neoadjuvant chemotherapy had comparable survival to those with less extensive disease without neoadjuvant chemotherapy. Positive resection margin or resectable extrahepatic disease did not affect overall survival. Conclusion. Our data support that one still, and perhaps to an even greater extent, should seek an aggressive therapeutic strategy to achieve resectable status for recurrent hepatic and extrahepatic metastases. The data should be viewed in the context of recent advances in the understanding of cancer biology and the metastatic process.

  9. A patient-centered vision of care for ESRD: dialysis as a bridging treatment or as a final destination?

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    Vandecasteele, Stefaan J; Kurella Tamura, Manjula

    2014-08-01

    The ESRD population is heterogeneous, including patients without severe comorbidity for whom dialysis is a bridge to transplantation or a long-term maintenance treatment, as well as patients with a limited life expectancy as a result of advanced age or severe comorbidity for whom dialysis will be the final treatment destination. The complex medical and social context of this latter group fits poorly in the homogeneous, disease-centered, and process-driven approach of many clinical practice guidelines for dialysis. In this commentary, we argue that the standards of treatment allocated to each individual patient should be defined not merely by his or her disease state, but also by his or her preferences and prognosis. In this more patient-centered approach, three attainable treatment goals with a corresponding therapeutic approach could be defined: (1) dialysis as bridging or long-term maintenance treatment, (2) dialysis as final treatment destination, and (3) active medical management without dialysis. For patients with a better overall prognosis, this approach will emphasize complication prevention and long-term survival. For patients with a limited overall prognosis, strictly disease-centered interventions often impose a treatment burden that does not translate into a proportional improvement in quantity or quality of life. For these patients, a patient-centered approach will place more emphasis on palliative management strategies that are less disease specific. Copyright © 2014 by the American Society of Nephrology.

  10. Intravenous ketamine for the treatment of refractory status epilepticus: a retrospective multi-center study

    Science.gov (United States)

    Gaspard, Nicolas; Foreman, Brandon; Judd, Lilith M.; Brenton, James N.; Nathan, Barnett R.; McCoy, Blathnaid M.; Al-Otaibi, Ali; Kilbride, Ronan; Fernández, Ivan Sánchez; Mendoza, Lucy; Samuel, Sophie; Zakaria, Asma; Kalamangalam, Giridhar P.; Legros, Benjamin; Szaflarski, Jerzy P.; Loddenkemper, Tobias; Hahn, Cecil D.; Goodkin, Howard P.; Claassen, Jan; Hirsch, Lawrence J.; LaRoche, Suzette M.

    2013-01-01

    Summary Purpose To examine patterns of use, efficacy and safety of intravenous ketamine for the treatment of refractory status epilepticus (RSE). Methods Multicenter retrospective review of medical records and EEG reports in ten academic medical centers in North America and Europe, including 58 subjects, representing 60 episodes of RSE were identified between 1999 and 2012. Seven episodes occurred after anoxic brain injury. Key findings Permanent control of RSE was achieved in 57% (34/60) of episodes. Ketamine was felt to have contributed to permanent control (“possible” or “likely” responses) in 32% (19/60) including seven (12%) in which ketamine was the last drug added (likely responses). Four of the seven likely responses, but none of the 12 possible ones, occurred in patients with post-anoxic brain injury. No likely responses were observed when infusion rates were lower than 0.9mg/kg/h; when ketamine was introduced at least eight days after SE onset; or after failure of seven or more drugs. Ketamine was discontinued due to possible adverse events in five patients. Complications were mostly attributed to concurrent drugs, especially other anesthetics. Mortality rate was 43% (26/60), but was lower when SE was controlled within 24h of ketamine initiation (16% vs. 56%, p=0.0047). Significance Ketamine appears to be a relatively effective and safe drug for the treatment of RSE. This retrospective series provides preliminary data on effective dose and appropriate time of intervention to aid in the design of a prospective trial to further define the role of ketamine in the treatment of RSE. PMID:23758557

  11. [Implementation of regularly performed resuscitation training at a hyperbaric treatment center].

    Science.gov (United States)

    Dieterich, F; Kanstinger, A; Erdmann, M; Knebel, J; Ott, B; Schöppenthau, H

    2016-03-01

    Medical emergency situations and even cardiac arrest can occur during treatment of patients in therapeutic hyperbaric chambers just as in other clinical departments; therefore, high quality structured management should be implemented for dealing with emergencies in this special working area. To ensure this the emergency medical treatment should not only be performed according to the current state of medical knowledge but needs to take the special features of the hyperbaric environment including safety aspects into account. This article presents a description of the implementation and effects of routine emergency and resuscitation training at a center for hyperbaric medicine. By simulation of emergencies in a hyperbaric chamber it rapidly became clear that the treatment of medical emergencies and cardiac arrest under hyperbaric conditions has some special features and due to safety aspects cannot always be performed according to current medical guidelines. At the time of this simulation in a real life working environment, previously unknown structural and logistic problems became obvious whereby the solutions contributed to a significant improvement of structural and process quality and could potentially also improve the outcome quality. Furthermore, a positive and lasting learning effect in the fields of quality of resuscitation measures, organization of the workplace, communication skills, logistics and safety aspects was detectable by analyzing participant performance over a period of 4 years. On the part of the participating staff a positive feedback and high acceptance of emergency simulator training was confirmed. Through annual compulsory emergency training of the complete staff of the hyperbaric unit at the actual workplace, a structural and confident approach to dealing with emergencies and resuscitation situations was observed. By the use of on-site simulator training even in specialized hospital units, deficits and tentativeness regarding logistics

  12. Towards A Moon Village: Vision and Opportunities

    Science.gov (United States)

    Foing, Bernard

    2016-04-01

    The new DG of ESA, Jan Wörner, has expressed from the very beginning of his duty a clear ambition towards a Moon Village, where Europe could have a lead role. The concept of Moon Village is basically to start with a robotic lunar village and then develop a permanent station on the Moon with different countries and partners that can participate and contribute with different elements, experiments, technologies, and overall support. ESA's DG has communicated about this programme and invited inputs from all the potential stakeholders, especially member states, engineers, industry, scientists, innovators and diverse representatives from the society. In order to fulfill this task, a series of Moon Village workshops have been organized first internally at ESA and then at international community events, and are also planned for the coming months, to gather stakeholders to present their ideas, their developments and their recommendations on how to put Moon Village into the minds of Europeans, international partners and prepare relevant actions for upcoming International Lunar Decade. Moon Village Workshop: The Moon Village Workshop in ESTEC on the 14th December was organized by ILEWG & ESTEC Staff Association in conjunction with the Moon 2020-2030 Symposium. It gathered people coming from all around the world, with many young professionals involved, as well as senior experts and representatives, with a very well gender balanced and multidisciplinary group. Engineers, business experts, managers, scientists, architects, artists, students presented their views and work done in the field of Lunar Exploration. Participants included colleagues from ESA, SGAC Space Generation Advisory Council, NASA, and industries such as OHB SE, TAS, Airbus DS, CGI, etc… and researchers or students from various Universities in Europe, America, and Asia. Working groups include: Moon Habitat Design, Science and Technology potentials on the Moon Village, and Engaging Stakeholders. The Moon

  13. Epilepsy diagnostic and treatment needs identified with a collaborative database involving tertiary centers in France.

    Science.gov (United States)

    Chipaux, Mathilde; Szurhaj, William; Vercueil, Laurent; Milh, Mathieu; Villeneuve, Nathalie; Cances, Claude; Auvin, Stéphane; Chassagnon, Serge; Napuri, Sylvia; Allaire, Catherine; Derambure, Philippe; Marchal, Cécile; Caubel, Isabelle; Ricard-Mousnier, Brigitte; N'Guyen The Tich, Sylvie; Pinard, Jean-Marc; Bahi-Buisson, Nadia; de Baracé, Claire; Kahane, Philippe; Gautier, Agnès; Hamelin, Sophie; Coste-Zeitoun, Delphine; Rosenberg, Sarah-Dominique; Clerson, Pierre; Nabbout, Rima; Kuchenbuch, Mathieu; Picot, Marie-Christine; Kaminska, Anna

    2016-05-01

    To obtain perspective on epilepsy in patients referred to tertiary centers in France, and describe etiology, epilepsy syndromes, and identify factors of drug resistance and comorbidities. We performed a cross-sectional analysis of the characteristics of 5,794 pediatric and adult patients with epilepsy included in a collaborative database in France between 2007 and 2013. Comparisons between groups used Student's t-test or Fisher's exact test for binary or categorical variables. Factors associated with drug resistance and intellectual disability were evaluated in multi-adjusted logistic regression models. Mean age at inclusion was 17.9 years; children accounted for 67%. Epilepsy was unclassified in 20% of patients, and etiology was unknown in 65%, including those with idiopathic epilepsies. Etiologies differed significantly in adult- when compared to pediatric-onset epilepsy; however, among focal structural epilepsies, mesial temporal lobe epilepsy with hippocampal sclerosis began as often in the pediatric as in adult age range. Drug resistance concerned 53% of 4,210 patients evaluable for seizure control and was highest in progressive myoclonic epilepsy (89%), metabolic diseases (84%), focal cortical dysplasia (70%), other cortical malformations (69%), and mesial temporal lobe epilepsy with hippocampal sclerosis (67%). Fifty-nine percent of patients with focal structural epilepsy and 69% with epileptic encephalopathies were drug resistant; however, 40-50% of patients with West syndrome and epileptic encephalopathy with continuous spike-and-waves during sleep were seizure-free. Ages at onset in infancy and in young adults shared the highest risk of drug resistance. Epilepsy onset in infancy comprised the highest risk of intellectual disability, whereas specific cognitive impairment affected 36% of children with idiopathic focal epilepsy. Our study provides a snapshot on epilepsy in patients referred to tertiary centers and discloses needs for diagnosis and treatment

  14. Optimal Time to Enter a Retirement Village

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    Jinhui Zhang

    2017-03-01

    Full Text Available We consider the financial planning problem of a retiree wishing to enter a retirement village at a future uncertain date. The date of entry is determined by the retiree’s utility and bequest maximisation problem within the context of uncertain future health states. In addition, the retiree must choose optimal consumption, investment, bequest and purchase of insurance products prior to their full annuitisation on entry to the retirement village. A hyperbolic absolute risk-aversion (HARA utility function is used to allow necessary consumption for basic living and medical costs. The retirement village will typically require an initial deposit upon entry. This threshold wealth requirement leads to exercising the replication of an American put option at the uncertain stopping time. From our numerical results, active insurance and annuity markets are shown to be a critical aspect in retirement planning.

  15. Treatment of intracranial aneurysms by flow diverter devices: Long-term results from a single center

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    Briganti, Francesco, E-mail: frabriga@unina.it [Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Napoli, Manuela, E-mail: napoli.manuela@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Leone, Giuseppe, E-mail: g.leonemd@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Marseglia, Mariano, E-mail: mariano-marseglia@libero.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Mariniello, Giuseppe, E-mail: giuseppe.mariniello@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Caranci, Ferdinando, E-mail: ferdinando.caranci@unina.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Tortora, Fabio, E-mail: fabiotor@libero.it [Chair of Neuroradiology, “Magrassi Lanzara” Clinical-Surgical Department, Second University of Naples, Viale Colli Aminei 21, 80131 Naples (Italy); Maiuri, Francesco, E-mail: frmaiuri@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy)

    2014-09-15

    Highlights: • We report the long-term results (2–4 years) with Flow Diverter Devices (FDD) from a single-center. • We recommend the use of FDD for large-neck aneurysms of the ICA syphon. • We think that more sophisticate FDD will reduce the incidence of technical adverse events. - Abstract: Objectives: Flow-Diverter Devices (FDD) are a new generation stents designed for the treatment of the intracranial aneurysms. This article reports the long-term results (2–4 years) of this treatment from a single-center. Methods: From November 2008 to January 2012, 35 patients (29 females and 6 males; mean age 53.9 y) with 39 intracranial aneurysms were treated by FDD. Five patients (14.3%) had ruptured aneurysms and 30 (85.7%) had no previous hemorrhage. The procedures were performed in 5 patients (14.3%) with SILK and in 30 (85.7%) with PED. In 3 patients FDDs were used as a second treatment after failure of previous coiling (2 cases) or stenting (one case). The 39 aneurysms were in supraclinoid ICA in 26 (66.7%), cavernous ICA in 2 (5.1%), PCoA in 4 (10.2%), MCA in 5 (12.9%), SCA in 1 (2.6%) and PICA in 1 (2.6%). The aneurysms were small (<10 mm) in 32 cases (82%), large (11–25 mm) in 6 (15.3%) and giant in 1 (2.6%). The occlusion rate according to the aneurysm location, size and neck and the complications were evaluated. Results: Peri-procedural complications included transient dysarthria (2 patients), vasospasm with acute intra-stent aggregation (one), microwire rupture (one) and failure of the stent opening (one). The follow-up was made between 24 and 62 months (mean 41 months); clinical examination and CTA were performed at 1, 3, 6 and 12 months after the procedure. The complete occlusion was confirmed by CTA and DSA. MRI with angiographic-studies was taken every year. Complete occlusion was obtained in 35 aneurysms (92.1%) and subtotal in 3 (7.9%). Complete occlusion occurred at 3 months in 24 cases (68.6%), within 3 and 6 months in 9 (25.7%). The rate and

  16. Organizational-Level Predictors of Adoption Across Time: Naltrexone in Private Substance-Use Disorders Treatment Centers*

    Science.gov (United States)

    Oser, Carrie B.; Roman, Paul M.

    2014-01-01

    Objective Prominent on the nation's research agenda on substance-use disorders treatment is the dissemination of effective pharmacotherapies. Thus, the purpose of this article is to use a “diffusion of innovations” theoretical framework to examine the organizational-level predictors of the adoption of a pharmacotherapy, naltrexone (Revia), in private substance use-disorders treatment centers (N = 165). Method Data for these analyses were derived from the National Treatment Center Study, which contains four waves of data collected between 1994 and 2003. An event history model examined the impact of culture, leadership characteristics, internal structure, and external characteristics on the likelihood of adopting naltrexone between 1994 and 2003. Results The results suggest that organizations embracing a 12-step model and those employing more experienced administrators were significantly less likely to adopt naltrexone. Moreover, treatment centers that used prescription drugs, possessed an employee handbook, were accredited, and operated on a for-profit basis were significantly more likely to adopt naltrexone over time. Conclusions Structural characteristics do affect the innovation adoption behaviors of private substance-use disorders treatment centers. Organizational-level “research to practice” implications to further the adoption of innovative evidence-based treatments are discussed. PMID:17960303

  17. University Counseling Center Use of Prolonged Exposure Therapy: In-Clinic Treatment for Students with PTSD

    Science.gov (United States)

    Bonar, Ted C.

    2015-01-01

    Students utilize university counseling center services to address distress related to post-traumatic stress disorder (PTSD). Since counseling centers services such as group work or general psychotherapy may not address specific PTSD-symptom reduction, centers often give community referrals in such cases. Evidence-based therapies (EBTs), including…

  18. Astronomy Village: Investigating the Solar System

    Science.gov (United States)

    Williams, Jeffrey; Croft, Steven; McGee, Steven

    1998-04-01

    The Astronomy Village: Investigating the Solar System is a new product aimed at astronomy instructional materials for middle school audiences. This multimedia development, funded by the NSF, will be suitable for curriculum supplement, presentations, and public outreach in Earth and planetary science. The presentation will highlight one of the research paths from the Village: Is there life on Mars? Students using this curriculum will solve problems in a rich environment that includes images, hands on labs, simulations, presentations, articles, and web pages. The research questions will be presented using multiple working hypothesis format.

  19. Towards a Moon Village: Young Lunar Explorers Report

    Science.gov (United States)

    Kamps, Oscar; Foing, Bernard; Batenburg, Peter

    2016-04-01

    and creating social places for astronauts to interact and relax. The proposed establishment of the lunar base can be divided into 4 steps. First the primary base infrastructure is laid out through robotic missions, assisted by human tele-operations from Earth, from the lunar orbit, or via a human-tended gateway station in one of the Earth-Moon Lagrange points (EML-1/2). During the second phase, the first manned habitation module will be deployed. This module contains a bare minimum of functionality to support a small crew for a couple of months. During the third phase, additional modules with more dedicated functions will be sent to the Moon, in order to enhance functionality and to provide astronauts with more space and comfort for long-term missions. In the final phase of the lunar village, a new set of modules will be sent to the base in order to accommodate new arriving crew members. To ensure crew safety, the landing site for supply vessels shall be located in safe distance to the base. Extensive utilization of autonomous or tele-operated robots further minimizes the risk for the crew. From the very beginning, quickly accessible emergency escape vehicles, as well as a heavily shielded 'safe haven' module to protect the crew from solar flares, shall be available. Sustainable moon village development would require explorers to fully utilize and process in-situ resources, in order to manufacture necessary equipment and create new infrastructure. Mining activities would be performed by autonomous robotic systems and managed by colonists from the command center. Building upon the heritage of commercial mining activities on Earth the production would be divided into six stages: geological exploration and mapping, mine preparation, extraction of raw resources, processing of raw resources, separation of minerals, storage and utilization. Additional manufacturing techniques, such as forging, would also need to be explored so as not to limit the production capabilities. To

  20. The voluntary work based village activism in contemporary Finland

    Directory of Open Access Journals (Sweden)

    I V Kopoteva

    2016-12-01

    Full Text Available The article considers the voluntary based village activism in contemporary Finland. The author sees the roots of nowadays village activism in the traditional voluntary work: cultivation of common fields called for cooperation, and decision making on common issues required organisation of village meetings to make a collective decision. As a large social movement the village activism started in 1970s in the course of protest actions driven by the diminishing rural population and abandonment of arable lands. A large-scale establishment of village committees was also determined by the reduction of importance of traditional rural productive cooperation and by the changing role of countryside in the era of industrialisation. Nowadays Finland has a well-developed system of village associations, and its structure consists of three levels: village level, regional level and national level. At the local level, there are more than 4200 villages. In 2013, about 3100 villages had a registered village association and about 930 villages had a non-registered village association. Approximately 200 villages in Finland still do not perform any village activities of the considered type. As a rule, village activism generates in response to the specific needs of the village and aims to guarantee its residents’ well-being. At the regional level, there are 19 regional village associations. The most important tasks for the regional rural organisations are to ensure the villages’ interests and to work as a cooperative body for the rural development at the regional level. The top of the system under consideration is the Village Association of Finland. It is an umbrella organisation for the state, regional and local rural actors. The current development of rural movement in Finland could be evaluated in the framework of several theoretical conceptions: social capital and networking, entrepreneurial culture, and institutionalisation.

  1. Impact of Distance to Treatment Center on Care Seeking for Pelvic Floor Disorders.

    Science.gov (United States)

    English, Emily; Rogo-Gupta, Lisa

    The aim of this study was to evaluate the impact of distance from residence to treatment center on access to care for female pelvic floor disorders at an academic institution. A retrospective cross-sectional study was conducted of women seen for pelvic floor disorders at an academic institution from 2008 to 2014. Patient characteristics were extracted from charts. Geographical and US census data was obtained from public records and used to calculate distance from patient residence to physician office. Statistical analysis was performed using R Software (Version 0.98.1102) and Microsoft Excel (Version 14.4.7). Statistical significance was defined as a 2-sided P value of less than 0.05, and the χ test was used to determine associations of categorical variables. A total of 3015 patients were included in the analysis. The mean distance traveled was 93 miles. Thirty percent of patients traveled more than 50 miles. Many patients (43%) reported having the symptoms for more than 2 years. Patients who traveled farther were significantly more likely to be white, English-speaking, and with pelvic organ prolapse as primary complaint. These patients were more likely to plan surgery at the first visit than patients who traveled less far (29% vs 14%). Patients who traveled farther were also more likely to live in counties with a low percentage of persons older than 65 years and low percentage of female inhabitants. Women who travel the farthest for treatment of pelvic floor disorders have experienced the symptoms for longer duration and are more willing to plan surgery at presentation. These women also come from counties with fewer elderly women, suggesting future outreach care should focus on similar geographic areas.

  2. Scorecard - An innovative simplified tool to supplement the existing monitoring mechanism to assess and improve performance of antiretroviral treatment centers

    Directory of Open Access Journals (Sweden)

    Sudhir Chawla

    2017-01-01

    Full Text Available Introduction: All 26 antiretroviral treatment (ART centers of Gujarat were monitored by Gujarat State AIDS Control Society under the National AIDS Control Program. A comprehensive tool is needed to identify gap in service delivery and to prioritize monitoring visits. Objectives: To supplement the existing monitoring system, identify strengths/weakness of ART centers, and give recommendations. Methodology: Scorecard was developed in spreadsheet format with 17 scoring indicators on monthly base from March 2014 onward. The centers were classified in three color zones: green (score ≥80%, yellow (score <80% and ≥50%, and red (score <50%. Visits were prioritized at centers with more indicators in yellow/red zone. The performance of centers was compared for March 2014 and March 2015. Results: The statistically significant improvement was observed in indicator “ART initiation within 2 months of eligibility,” while after removing red zone from analysis, four more indicators named “eligible patients transferred out before ART initiation, general clients started on ART, antenatal women started on ART, and pre-ART follow-up CD4 done” reflect statistically significant improvement. Quadrant analysis was done for some indicators, which provide insight that less number of eligible patients may be a reason for low initiation of ART at one center, and at four other centers, the possible reasons for low retention are high death rate and high lost to follow-up rate. Based on these findings, the recommendations were made to regular mentoring centers, improve coordination between ART center and care and support centers (CSCs, and conduct verbal autopsy. Conclusion: Scorecard is a simple and cost-effective tool for monitoring, and by highlighting low-performing indicators, it helps in improving quality of services provided at ART centers.

  3. Empowering women in villages: all-women village councils in Maharashtra, India.

    Science.gov (United States)

    Gala, C

    1997-01-01

    This study examines the impact of all-women panchayats (village councils) in three small villages in Maharashtra state in India on women's well-being. Field work was conducted during 1991-93 in the villages of Yenora, Metikheda, and Vitner. In 1989 there were nine all-women village councils, which were elected owing to the efforts of a large independent farmers' organization, the Shetkari Sanghatana (SS). Findings indicate that the all-women village councils made a significant difference in women's lives. The mix of male and female leaders varied between the villages and affected the outcomes. The author argues that the strategy for empowerment is more successful than enclave strategies that focus only on a poor minority or radical feminist strategies that insist on women's action and hostility toward male involvement. The legal mandate for the panchayat as a vehicle for development was adopted in Maharashtra in 1965. However, the participation of the community in panchayats was only an assumption. In 1988-89, the 73rd Constitutional Amendment was passed to give power to panchayats and to reserve 30% of the legislative seats for women and backward castes. Prior to 1986, women were appointed, but not elected, to panchayats. During 1986-91, women's interest in local political power increased. As a result of the all-women village councils, women's attitudes toward themselves and their daughters changed in all three villages. Panchayats improved the accessibility of fuel, water, and fodder, which relieved women of their burdens and allowed girls to attend schools. Women's mobility and assets increased. The number of wife-beating incidents declined. Women gained respect in their families and in their maternal homes. Women still had dual labor roles in the labor force and at home. Two of the villages illustrated effective women's leadership. The cases illustrate the effectiveness of a broad-based strategy for women's empowerment.

  4. The impact of permethrin impregnated bednets on the malaria vector Anopheles maculatus (Diptera: Culicidae) in aboriginal villages of Pos Betau Pahang, Malaysia.

    Science.gov (United States)

    Vythilingam, I; Foo, L C; Chiang, G L; Chan, S T; Eng, K L; Mahadevan, S; Mak, J W; Singh, K I

    1995-06-01

    The effect of permethrin impregnated bednets on Anopheles maculatus Theobald was studied in four villages in Pos Betau, Pahang, Malaysia from August 1990 to July 1992. Collections of mosquitos were carried out indoors and outdoors from 1900 to 0700 hours. All mosquitos were dissected for sporozoites and parity. In May 1991 two villages received bednets impregnated with permethrin at 0.5 g/m2 and two villages received placebo bednets. There was a significant difference in the sporozoite and parous rates between the treated and control villages after the distribution of bednets (p < 0.05). There was no significant difference in the bites/man/night of An. maculatus between the pre and post treatment periods in the control villages. However there was a significant difference in bites/man/night between pre and post treatment in the treated villages (p < 0.001).

  5. Neonatal circumcision in severe haemophilia: a survey of paediatric haematologists at United States Hemophilia Treatment Centers.

    Science.gov (United States)

    Kearney, S; Sharathkumar, A; Rodriguez, V; Chitlur, M; Valentino, L; Boggio, L; Gill, J

    2015-01-01

    Neonatal circumcision in patients with severe haemophilia has not been well studied. We performed a survey of paediatric haematologists from Hemophilia Treatment Centers (HTC) across the United States to better understand the attitudes toward and management of neonatal circumcision in haemophilia patients. Response rate to our survey was 40% (n = 64/159). Thirty-eight percent of respondents (n = 24) said that they would allow this procedure in the newborn period but in many cases this was against medical advice. The most reported concern regarding neonatal circumcision in haemophilia patients was the risk of development of an inhibitor (n = 25; 39%) followed by the concern for bleeding (n = 22; 34%) and issues related to vascular access in the neonate (n = 11; 17%). All respondents recommended at least one preprocedure dose of factor replacement. Twenty-two percent (n = 14) of respondents did not use more than one dose of factor replacement but 32% (n = 21) used 1-2 postoperative doses. The remainder of paediatric haematologists surveyed recommended between 3-5 (16%; n = 10) and 6-10 (3%, n = 2) additional days postoperatively. There was wide variation in both techniques of circumcision as well as adjuvant haemostatic agents used. Only 22% of respondents said that they had an established protocol for management of circumcision in the newborn haemophilia patient. These survey results highlight the need for evidence-based guidelines regarding the optimal management of circumcision in neonates with severe haemophilia. © 2014 John Wiley & Sons Ltd.

  6. Topiramate for the treatment of methamphetamine addiction: a multi-center placebo-controlled trial.

    Science.gov (United States)

    Elkashef, Ahmed; Kahn, Roberta; Yu, Elmer; Iturriaga, Erin; Li, Shou-Hua; Anderson, Ann; Chiang, Nora; Ait-Daoud, Nassima; Weiss, David; McSherry, Frances; Serpi, Tracey; Rawson, Richard; Hrymoc, Mark; Weis, Dennis; McCann, Michael; Pham, Tony; Stock, Christopher; Dickinson, Ruth; Campbell, Jan; Gorodetzky, Charles; Haning, William; Carlton, Barry; Mawhinney, Joseph; Li, Ming D; Johnson, Bankole A

    2012-07-01

      Topiramate has shown efficacy at facilitating abstinence from alcohol and cocaine abuse. This double-blind, placebo-controlled out-patient trial tested topiramate for treating methamphetamine addiction.   Participants (n = 140) were randomized to receive topiramate or placebo (13 weeks) in escalating doses from 25 mg/day [DOSAGE ERROR CORRECTED] to the target maintenance of 200 mg/day in weeks 6-12 (tapered in week 13). Medication was combined with weekly brief behavioral compliance enhancement treatment.   The trial was conducted at eight medical centers in the United States.   One hundred and forty methamphetamine-dependent adults took part in the trial.   The primary outcome was abstinence from methamphetamine during weeks 6-12. Secondary outcomes included use reduction versus baseline, as well as psychosocial variables.   In the intent-to-treat analysis, topiramate did not increase abstinence from methamphetamine during weeks 6-12. For secondary outcomes, topiramate reduced weekly median urine methamphetamine levels and observer-rated severity of dependence scores significantly. Subjects with negative urine before randomization (n = 26) had significantly greater abstinence on topiramate versus placebo during study weeks 6-12. Topiramate was safe and well tolerated.   Topiramate does not appear to promote abstinence in methamphetamine users but can reduce the amount taken and reduce relapse rates in those who are already abstinent. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  7. THE PATEMBAYAN CONCEPT TO SPATIAL CHANGES OF CANDIREJO TOURISM VILLAGE

    Directory of Open Access Journals (Sweden)

    SARI Suzanna Ratih

    2014-07-01

    Full Text Available Candirejo village is one of villages that had been neglected in Borobudur the famous Buddhist Temple in Indonesia. Since it began to be visited by tourists, the community responded by conducting tourism village space consolidation based on patembayan concept. The process of space consolidation is involving the whole tourist village community and rural assets. The participation of the community in supporting the space consolidation of tourism village has brought a change in the shape of social value and village spatial. The concept of social organization that experienced a shift from community groups into patembayan groups has changed the way people think.

  8. Analysis of Gap in Service Quality in Drug Addiction Treatment Centers of Kerman, Iran, Using SERVQUAL Model.

    Science.gov (United States)

    Naqavi, Mohammad Reza; Refaiee, Raheleh; Baneshi, Mohammad Reza; Nakhaee, Nouzar

    2014-01-01

    Treatment of drug addicts is one of the main strategies of drug control in Iran. Client satisfaction strongly influences the success of any treatment program. This study aimed to explore the difference between customer expectations and perceptions in drug addiction treatment centers of Kerman, Iran, using SERVQUAL model. Using a cross-sectional design 260 clients referring to drug addiction treatment centers of Kerman, were enrolled in 2012. From among 84 clinics, 20 centers were selected randomly. Based on the number of clients registered in each center, a random sample proportional to the size was selected and 290 subjects were invited for interviews. A well validated 22-item questionnaire, which measured the 5 dimensions of service quality (reliability, assurance, tangibility, empathy, and responsiveness), was completed by participants. Each item measured 2 aspects of service quality; expectations and perceptions. Mean ± SD (Standard deviation) age of the subjects was 37.7 ± 9.4. Most of them were male (87.7%). Less than half of them had an educational level lower than diploma. The total score of clients` expectations was higher than their perceptions (P SERVQUAL model, only 1 dimension (i.e., assurance) showed no difference between perceptions and expectations of the participants (P = 0.134). There was a gap between the clients' expectations and what they actually perceived in the clinics. Thus, more attention should be devoted to the clients' views regarding service quality in addiction treatment clinics.

  9. Characterization of village chicken production performance under ...

    African Journals Online (AJOL)

    Village chicken production was characterized using retrospective and crosssectional methods, where 280 households rearing local chickens in Halaba district of southern Ethiopia were used for data collection. The study revealed that the average flock size was 8.5 chickens (95% CI=7.98 – 9.08). The average number of ...

  10. Homesick vulture moves into retirement village

    African Journals Online (AJOL)

    2007-03-01

    Mar 1, 2007 ... Residents of Pietermaritzburg's. Evergreen Retirement Village had a bit of a turn recently when a rare and homesick vulture took up residence in a pine tree in their garden. Believing it to be a harbinger of bad news, one resident apparently turned to another and said,. “We had better do a head count to see.

  11. Space architecture for MoonVillage

    Science.gov (United States)

    Sherwood, Brent

    2017-10-01

    The concept of a multinational MoonVillage, as proposed by Jan Wörner of ESA, is analyzed with respect to diverse factors affecting its implementation feasibility: potential activities and scale as a function of location, technology, and purpose; potential participants and their roles; business models for growth and sustainability as compared to the ISS; and implications for the field of space architecture. Environmental and operations constraints that govern all types of MoonVillage are detailed. Findings include: 1) while technically feasible, a MoonVillage would be more distributed and complex a project than the ISS; 2) significant and distinctive opportunities exist for willing participants, at all evolutionary scales and degrees of commercialization; 3) the mixed-use space business park model is essential for growth and permanence; 4) growth depends on exporting lunar material products, and the rate and extent of growth depends on export customers including terrestrial industries; 5) industrial-scale operations are a precondition for lunar urbanism, which goal in turn dramatically drives technology requirements; but 6) industrial viability cannot be discerned until significant in situ operations occur; and therefore 7) government investment in lunar surface operations is a strictly enabling step. Because of the resources it could apply, the U.S. government holds the greatest leverage on growth, no matter who founds a MoonVillage. The interplanetary business to be built may because for engagement.

  12. Agroforestry practice in villages surrounding Nyamure former ...

    African Journals Online (AJOL)

    cntaganda

    Abstract. An assessment of fuel wood situation and the contribution of agroforestry and woodlot resources to the supply of household fuel wood requirements were carried out in ten villages surrounding Nyamure former refugee camp, Nyanza District in the Southern. Province. A total of 158 households were surveyed in ...

  13. Shrinking villages – trajectories for local development

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    and services e.g. schools as well as investment. Rural municipalities are challenged due to shrinking villages but by focussing on place bound resources there is a risk of reinforcing disparities between ‘weak’ and ‘strong’ communities as placed bound resources are unevenly distributed. This paper will address...

  14. Agroforestry practice in villages surrounding Nyamure former ...

    African Journals Online (AJOL)

    An assessment of fuel wood situation and the contribution of agroforestry and woodlot resources to the supply of household fuel wood requirements were carried out in ten villages surrounding Nyamure former refugee camp, Nyanza District in the Southern Province. A total of 158 households were surveyed in February ...

  15. Spatial Evolution of Urban Villages in Shenzhen

    NARCIS (Netherlands)

    Hao, P.

    2012-01-01

    Post-reform China has experienced a huge influx of people into cities coupled with massive urban expansion. As a by-product of these processes, urban villages have emerged and evolved rapidly to satisfy the increasing demand for low-cost housing and a variety of social and economic activities. In

  16. Communicative and narrative sound in Village

    DEFF Research Database (Denmark)

    Have, Iben

    2010-01-01

    The soundtrack of the TV spot Village tells a story of its own. Some of the sounds communicate meaning very close to the visuals, for example by creating an African soundscape. But the soundtrack also supplies narrative elements of its own, which is most remarkable when it adds a happy ending...

  17. Evaluation of Livonian Village Landscapes in Latvia

    Directory of Open Access Journals (Sweden)

    Natalija Nitavska

    2013-10-01

    Full Text Available Latvian landscape identity is related to many territories, but as far as the coastal landscapes are concerned, they have some special features. It is important to note that due to storms and coastal erosion living conditions here are frustrating. However the coastal area has some positive magnetism, which is often related to unusual natural conditions, a special aura and unique feelings, because the coastal area is unique on the Latvian scale. One of such places is the Livonian coast. For detailed evaluation of eleven Livonian villages, the method of analysis of the existing situation has been chosen, which also includes the evaluation of the village yard, buildings and infrastructure. The quality and condition evaluation method for rural villages with low level of development by F. G. L. Gremliza (1965 has been also applied as a basis for this evaluation method. Then, according to the results obtained, the villages have been compared and classified. In addition to this, using the evaluation of each rural yard it is possible to mark valuable structures and typical rural yards in the schematic model of the Livonian coast.

  18. Characterization of village chicken production performance under ...

    African Journals Online (AJOL)

    Village chicken production was characterized using retrospective and cross- sectional methods, where 280 households rearing local chickens in Halaba district of southern Ethiopia were used for data collection. The study revealed that the average flock size was 8.5 chickens (95% CI=7.98 – 9.08). The average number of ...

  19. Autour de Montaillou, un village occitan

    OpenAIRE

    Guillot, Florence

    2000-01-01

    International audience; Occupation du sol au Moyen Âge en haute Ariège : naissance d'une forme d'habitat groupé particulière, les villages casaliers, densification des habitats groupés avant l'an Mil.

  20. Scorecard - An Innovative Simplified Tool to Supplement the Existing Monitoring Mechanism to Assess and Improve Performance of Antiretroviral Treatment Centers.

    Science.gov (United States)

    Chawla, Sudhir; Modi, Bhautik; Rewari, Bharat Bhusan; Verma, Pramod B; Chhabra, Sonia Chetandas

    2017-01-01

    All 26 antiretroviral treatment (ART) centers of Gujarat were monitored by Gujarat State AIDS Control Society under the National AIDS Control Program. A comprehensive tool is needed to identify gap in service delivery and to prioritize monitoring visits. To supplement the existing monitoring system, identify strengths/weakness of ART centers, and give recommendations. Scorecard was developed in spreadsheet format with 17 scoring indicators on monthly base from March 2014 onward. The centers were classified in three color zones: green (score ≥80%), yellow (score red (score red zone. The performance of centers was compared for March 2014 and March 2015. The statistically significant improvement was observed in indicator "ART initiation within 2 months of eligibility," while after removing red zone from analysis, four more indicators named "eligible patients transferred out before ART initiation, general clients started on ART, antenatal women started on ART, and pre-ART follow-up CD4 done" reflect statistically significant improvement. Quadrant analysis was done for some indicators, which provide insight that less number of eligible patients may be a reason for low initiation of ART at one center, and at four other centers, the possible reasons for low retention are high death rate and high lost to follow-up rate. Based on these findings, the recommendations were made to regular mentoring centers, improve coordination between ART center and care and support centers (CSCs), and conduct verbal autopsy. Scorecard is a simple and cost-effective tool for monitoring, and by highlighting low-performing indicators, it helps in improving quality of services provided at ART centers.

  1. Village operator feasibility framework: A recommended method for assessing the viability of village operator sites

    CSIR Research Space (South Africa)

    Von Staden, R

    2009-10-01

    Full Text Available guidelines for investigation. To provide a basis for decision-making and comparison, a Feasibility Scorecard is included. The scorecard compares the Village Operator against a standard set of statements that are considered universal characteristics of viable...

  2. Experiences of Power and Violence in Mexican Men Attending Mutual-Aid Residential Centers for Addiction Treatment.

    Science.gov (United States)

    Lozano-Verduzco, Ignacio; Marín-Navarrete, Rodrigo; Romero-Mendoza, Martha; Tena-Suck, Antonio

    2016-05-01

    Fundamental elements of hegemonic masculinity such as power and violence are analyzed through characteristics of 12-step programs and philosophy immersed in Mutual-Aid Residential Centers for Addiction Treatment (CRAMAAs). CRAMAAs are a culturally specific form of substance abuse treatment in Mexico that are characterized by control and violence. Fifteen interviews were carried out with men of varied sociodemographic characteristics, and who resided in at least two of these centers. Results identify that power is expressed through drug abuse and leads them to subsequent biopsychosocial degradation. Residency in CRAMAAs is motivated by women, but men do not seek the residency and are usually admitted unwillingly. Power through violence is carried out inside CRAMAAs where men are victims of abuse. From a 12-step philosophy, this violence is believed to lead them to a path of recovery but instead produces feelings of anger and frustration. The implications of these centers on Mexican public health are discussed. © The Author(s) 2015.

  3. The Contribution of Background Variables, Internal and External Resources to Life Satisfaction among Adolescents in Residential Treatment Centers

    Science.gov (United States)

    Lipschitz-Elhawi, Racheli; Itzhaky, Haya; Michal, Hefetz

    2008-01-01

    The article deals with the contribution of background variables (gender, years of residence in a treatment center, and family status), internal resource (self-esteem), and external resources (peer, family and significant other support, sense of belonging to the community) to life satisfaction among adolescents living in residential treatment…

  4. Sexual Abuse Histories of Youth in Child Welfare Residential Treatment Centers: Analysis of the Odyssey Project Population

    Science.gov (United States)

    Baker, Amy J. L.; Curtis, Patrick A.; Papa-Lentini, Cynthia

    2006-01-01

    This multi-site examination of sexual abuse histories of youth in residential treatment centers asked, for the sample as a whole and by youth's gender: (a) How many perpetrators did each youth have? (b) What was the gender of the perpetrator? (c) What proportion of youth was abused by family members? (d) What proportion of youth was abused in a…

  5. PHYSICAL EDUCATION COURSE AND PHYSICAL ACTIVITIES IN VILLAGE INSTITUTES: A CASE OF CIFTELER VILLAGE INSTITUTE

    OpenAIRE

    Bayrak, Coşkun; Çelik, Veli

    2011-01-01

    Abstract The current study aims at examining the content, objectives and applications of the course titled “Physical Education and National Folklore Dances”, one of the culture courses available in the curriculum of Village Institutes focusing on daily physical activities. For the purposes of the study, a qualitative study was designed, in which a number of interviews were carried out with six teachers who graduated from village institutes in various years and a t...

  6. Day-Case Treatment of Peripheral Arterial Disease: Results from a Multi-Center European Study

    Energy Technology Data Exchange (ETDEWEB)

    Spiliopoulos, Stavros, E-mail: stavspiliop@med.uoa.gr, E-mail: stavspiliop@upatras.gr; Karnabatidis, Dimitrios, E-mail: karnaby@med.upatras.gr [Patras University Hospital, Department of Interventional Radiology (Greece); Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Diamantopoulos, Athanasios, E-mail: adiamantopoulos@gmail.com [Guy’s and St Thomas’ Hospitals, NHS Foundation Trust, King’s Health Partners, Department of Interventional Radiology (United Kingdom); Ali, Tariq, E-mail: tariq.ali@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom); Kitrou, Panagiotis, E-mail: panoskitrou@gmail.com [Patras University Hospital, Department of Interventional Radiology (Greece); Cannavale, Alessandro, E-mail: alessandro.cannavale@hotmail.com; Krokidis, Miltiadis, E-mail: miltiadis.krokidis@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom)

    2016-12-15

    PurposeThe purpose of the study was to investigate safety and feasibility of day-case endovascular procedures for the management of peripheral arterial disease.Materials and MethodsThis was a multi-center, retrospective study including all patients treated over a 30-month period with endovascular angioplasty or stenting for intermittent claudication (IC) or critical limb ischemia (CLI) on a day-case basis, in Interventional Radiology (IR) departments of three European tertiary hospitals. Exclusion criteria were not related to the type of lesion and included unavailability of an adult able to take care of patient overnight; high bleeding risk and ASA score ≥4. Primary efficacy outcome was the rate of procedures performed on an outpatient basis requiring no further hospitalization and primary safety outcome was freedom from 30-day major complications’ rate.ResultsThe study included 652 patients (male 75 %; mean age 68 ± 10 years; range: 27–93), 24.6 % treated for CLI. In 53.3 % of the cases a 6Fr sheath was used. Technical success was 97.1 %. Haemostasis was obtained by manual compression in 52.4 % of the accesses. The primary efficacy outcome occurred in 95.4 % (622/652 patients) and primary safety outcome in 98.6 % (643/652 patients). Major complications included five (0.7 %) retroperitoneal hematomas requiring transfusion; one (0.1 %) common femoral artery pseudoaneurysm successfully treated with US-guided thrombin injection, two cases of intra-procedural distal embolization treated with catheter-directed local thrombolysis and one on-table cardiac arrest necessitating >24 h recovery. No major complication was noted after same-day discharge.ConclusionsDay-case endovascular procedures for the treatment of IC or CLI can be safely and efficiently performed in experienced IR departments of large tertiary hospitals.

  7. Stage I seminoma: treatment outcome at King Hussein Cancer Center in Jordan

    Directory of Open Access Journals (Sweden)

    Khader Jamal

    2012-04-01

    Full Text Available Abstract Background The aim of this report is to address treatment outcomes of patients with early-stage seminoma in a single institution with special reference to patients with history of surgical violation of the scrotum. Methods Seventy four patients with pure seminoma were treated at King Hussein Cancer Center (Amman, Jordan between 2003 and 2010. All patients underwent orchiectomy. All but 3 patients received adjuvant radiotherapy. Patients who underwent surgical violation of the scrotum prior to referral were managed by further excision or irradiation of the scrotal scar. The follow-up ranged from 1 to 200 months (mean, 33 months. Results At the time of follow-up; all but one patient remain alive. The 3-year relapse-free survival for the entire cohort was 95.9%. Three patients developed relapse, all of whom received adjuvant irradiation following inguinal orchiectomy and initially harbored tumors larger than 4 cm upon pathological examination. Median time to relapse was 14 months (range, 8–25 months. None were associated with elevated tumor markers prior to detection of relapse. All but one patient were successfully salvaged by chemotherapy. Conclusions Our results confirm the excellent prognosis of patients with early-stage seminoma treated by orchiectomy and adjuvant radiotherapy in a developing country. Although all patients who developed relapse demonstrated adverse pathological findings upon initial assessment, no consistent predictor of relapse was found. Scrotal scar re-excision or irradiation in patients with prior history of surgical violation of the scrotum are effective measures in preventing local failure.

  8. Neurologic Complications of Methanol Poisoning: A Clinicoepidemiological Report from Poisoning Treatment Centers in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Hakimeh Eghbali

    2015-03-01

    Full Text Available Background: In this study we sought to investigate clinical findings (with a focus on neurologic effects and also to analyze outcomes of a series of patients with methanol poisoning admitted to two poisoning treatment centers in Tehran, Iran. Methods: In this prospective cross-sectional study, methanol-poisoned patients admitted to departments of forensic medicine and toxicology of Loghman Hakim and Baharloo hospitals in Tehran during October 2010 to October 2011 were included; and their data were recorded in predesigned checklists. Results: Twenty-eight methanol poisoned patients (82.1% men with mean age of 29.3±4.6 years were studied. Most patients (67.9% had metabolic acidosis at presentation. On admission, all patients had different degrees of decrease in consciousness, who the majority of them (57.1% were admitted with mildly reduced consciousness (grade I of Grady coma scale. Headache and vertigo were observed in 7.1% and 17.9% of patients, respectively. Most patients (53.6% had no ocular effects, while 46.6% of patients developed impaired vision. All patients received sodium bicarbonate. Ethanol as antidote and folic acid were given to 18 patients (64.2% and 16 patients (57.1%, respectively. Six patients (21.4% underwent hemodialysis. Over half of the patients (53.6% fully recovered and were discharged without complications. Four patients (14.3% developed total blindness. Four patients (14.3% left the hospital against medical advice by self-discharge (they had no significant complication at the time of discharge. Five patients (17.9% died; who compared to survived cases had significantly lower blood pH (P=0.028, higher coma grade (P

  9. Diagnosis and treatment outcome of mycotic keratitis at a tertiary eye care center in eastern india

    Directory of Open Access Journals (Sweden)

    Rautaraya Bibhudutta

    2011-12-01

    Full Text Available Abstract Background Mycotic keratitis is an important cause of corneal blindness world over including India. Geographical location and climate are known to influence the profile of fungal diseases. While there are several reports on mycotic keratitis from southern India, comprehensive clinico-microbiological reports from eastern India are few. The reported prevalence of mycotic keratitis are 36.7%,36.3%,25.6%,7.3% in southern, western, north- eastern and northern India respectively. This study reports the epidemiological characteristics, microbiological diagnosis and treatment outcome of mycotic keratitis at a tertiary eye care center in eastern India. Methods A retrospective review of medical and microbiology records was done for all patients with laboratory proven fungal keratitis. Results Between July 2006 and December 2009, 997 patients were clinically diagnosed as microbial keratitis. While no organisms were found in 25.4% (253/997 corneal samples, 23.4% (233/997 were bacterial, 26.4% (264/997 were fungal (45 cases mixed with bacteria, 1.4% (14/997 were Acanthamoeba with or without bacteria and 23.4% (233/997 were microsporidial with or without bacteria. Two hundred fifteen of 264 (81.4%, 215/264 samples grew fungus in culture while 49 corneal scrapings were positive for fungal elements only in direct microscopy. Clinical diagnosis of fungal keratitis was made in 186 of 264 (70.5% cases. The microscopic detection of fungal elements was achieved by 10% potassium hydroxide with 0.1% calcoflour white stain in 94.8%(238/251 cases. Aspergillus species (27.9%, 60/215 and Fusarium species (23.2%, 50/215 were the major fungal isolates. Concomitant bacterial infection was seen in 45 (17.1%, 45/264 cases of mycotic keratitis. Clinical outcome of healed scar was achieved in 94 (35.6%, 94/264 cases. Fifty two patients (19.7%, 52/264 required therapeutic PK, 9 (3.4%, 9/264 went for evisceration, 18.9% (50/264 received glue application with bandage

  10. [Multi-center study on the treatment of sudden total deafness].

    Science.gov (United States)

    Zheng, Hong; Dai, Qing-qing; Zhou, Lian; Feng, Ning-yu; Qiu, Jian-hua; Chen, Yang; Wen, Li-ting; Han, Yu; Chen, Jun; Lin, Ying

    2013-05-01

    To assess the results of drug therapy in patients with severe idiopathic sudden sensorineural hearing loss (ISSHL) with total frequency hearing loss. A prospective randomized, single blind, multi-center clinical trial was designed. The untreated patients with ISSHL were included, who had severe hearing loss (pure tone audiometry showed patients had total frequency hearing loss, and their mean auditory threshold of 500, 1000, 2000, 4000 Hz was beyond 81 dB HL), age between 18 to 65 years old, and within 14 days of the onset . The patients were divided into one of the four drug groups [batroxobin, batroxobin + ginkgo biloba leaves extract (EGb), batroxobin + EGb + glucocorticoids, EGb + glucocorticoids] according to the random table, and receive treatment. Totally 276 patients with unilateral severe ISSHL were included from 33 hospitals, from August 2007 to October 2011. Among them, male patients accounted for 135 (48.91%), female 141 (51.09%); the average age was (41.7 ± 13.3)years. Forty cases were recovered (14.49%), 78 cases had marked effective (28.26%), 76 cases were effective (27.54%), 82 cases were in-effective (29.71%), and the total effective rate was 70.29%. Among four drug groups, the separate effective rate were 73.33%, 61.43%, 78.31% and 67.95% respectively, no significant difference was found between groups (χ(2) = 9.97,P = 0.62). Among the four groups, the separate cure rate for hearing loss were 11.11%, 12.86%, 16.87% and 15.38%, the glucocorticoid groups were significantly better than those not used. Among severe sudden deafness patients, 92.39% cases accompanied with tinnitus, 44.93% with dizziness (or vertigo), 50.36% with ear stuffy. There had no significant difference between the four groups with accompanied symptoms (all P > 0.05). It is value to give active treatment to sever sudden deafness patients because of an effective rate of 70%. However, the doctors and patients should be mind of a cure rate of only 14%. Steroids are recommended

  11. A Model for Treatment in a Native American Family Service Center.

    Science.gov (United States)

    Metcalf, Ann; And Others

    Contrasting the differences between a non-Indian child abuse/neglect center with an Indian model, this report highlights the qualities of the Urban Indian Child Resource Center (CRC) in Oakland, California. The non-Indian concept of the cause of child abuse/neglect, based on the abused/neglected childhood of the parent, is compared to the Indian…

  12. The Western Danish Center for Prevention, Treatment and Research of Sexual Assault

    DEFF Research Database (Denmark)

    Ingemann-Hansen, Ole

    2006-01-01

    During the 1980’s and 1990’s several Sexual Assault Centers were established in the Nordic countries in order to counteract the health consequences of sexual assault. In Denmark the Western Danish Sexual Assault Center (WDSAC) was established in November 1999 in the town of Aarhus. The victims ar...... as the frequency of posttraumatic stress disorder in relation to sexual assault. Multidisciplinary centers as WDSAC may be the strategy for preventing the serious disability of the posttraumatic stress disorder following sexual assault.......During the 1980’s and 1990’s several Sexual Assault Centers were established in the Nordic countries in order to counteract the health consequences of sexual assault. In Denmark the Western Danish Sexual Assault Center (WDSAC) was established in November 1999 in the town of Aarhus. The victims...

  13. Referring heroin users from compulsory detoxification centers to community methadone maintenance treatment: a comparison of three models.

    Science.gov (United States)

    Yan, Liping; Liu, Enwu; McGoogan, Jennifer M; Duan, Song; Wu, Li-Tzy; Comulada, Scott; Wu, Zunyou

    2013-08-13

    Both compulsory detoxification treatment and community-based methadone maintenance treatment (MMT) exist for heroin addicts in China. We aim to examine the effectiveness of three intervention models for referring heroin addicts released from compulsory detoxification centers to community methadone maintenance treatment (MMT) clinics in Dehong prefecture, Yunnan province, China. Using a quasi-experimental study design, three different referral models were assigned to four detoxification centers. Heroin addicts were enrolled based on their fulfillment to eligibility criteria and provision of informed consent. Two months prior to their release, information on demographic characteristics, history of heroin use, and prior participation in intervention programs was collected via a survey, and blood samples were obtained for HIV testing. All subjects were followed for six months after release from detoxification centers. Multi-level logistic regression analysis was used to examine factors predicting successful referrals to MMT clinics. Of the 226 participants who were released and followed, 9.7% were successfully referred to MMT(16.2% of HIV-positive participants and 7.0% of HIV-negative participants). A higher proportion of successful referrals was observed among participants who received both referral cards and MMT treatment while still in detoxification centers (25.8%) as compared to those who received both referral cards and police-assisted MMT enrollment (5.4%) and those who received referral cards only (0%). Furthermore, those who received referral cards and MMT treatment while still in detoxification had increased odds of successful referral to an MMT clinic (adjusted OR = 1.2, CI = 1.1-1.3). Having participated in an MMT program prior to detention (OR = 1.5, CI = 1.3-1.6) was the only baseline covariate associated with increased odds of successful referral. Findings suggest that providing MMT within detoxification centers promotes successful

  14. Effectiveness of social work intervention with a systematic approach to improve general health in opioid addicts in addiction treatment centers

    Directory of Open Access Journals (Sweden)

    Raheb G

    2016-11-01

    Full Text Available Ghoncheh Raheb,1,2 Esmat Khaleghi,1 Amir Moghanibashi-Mansourieh,1 Ali Farhoudian,2 Robab Teymouri3 1Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 2Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 3Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Purpose: This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. Patients and methods: This is an experimental plan (pretest to posttest with a control group; the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30 and control (30 groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. Results: A covariance analysis test and independent and dependent t-test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Conclusion: Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients’ self-understanding and self-recognition, and enhancing social functioning. Keywords: social work, intervention, systematic approach, general health, opioid addicts

  15. Patient-centered cancer treatment planning: improving the quality of oncology care. Summary of an Institute of Medicine workshop.

    Science.gov (United States)

    Balogh, Erin P; Ganz, Patricia A; Murphy, Sharon B; Nass, Sharyl J; Ferrell, Betty R; Stovall, Ellen

    2011-01-01

    The Institute of Medicine's National Cancer Policy Forum recently convened a workshop on patient-centered cancer treatment planning, with the aim of raising awareness about this important but often overlooked aspect of cancer treatment. A primary goal of patient-centered treatment planning is to engage patients and their families in meaningful, thorough interactions with their health care providers to develop an accurate, well-conceived treatment plan, using all available medical information appropriately while also considering the medical, social, and cultural needs and desires of the patient and family. A cancer treatment plan can be shared among the patient, family, and care team in order to facilitate care coordination and provide a roadmap to help patients navigate the path of cancer treatment. There are numerous obstacles to achieving patient-centered cancer treatment planning in practice. Some of these challenges stem from the patient and include patients' lack of assertiveness, health literacy, and numeracy, and their emotional state and concurrent illnesses. Others are a result of physician limitations, such as a lack of time to explain complex information and a lack of tools to facilitate treatment planning, as well as insensitivity to patients' informational, cultural, and emotional needs. Potential solutions to address these obstacles include better training of health care providers and patients in optimal communication and shared decision making, and greater use of support services and tools such as patient navigation and electronic health records. Other options include greater use of quality metrics and reimbursement for the time it takes to develop, discuss, and document a treatment plan.

  16. What Drives the Spatial Development of Urban Villages in China?

    NARCIS (Netherlands)

    Hao, P.|info:eu-repo/dai/nl/341235814; Hooimeijer, P.|info:eu-repo/dai/nl/073398578; Sliuzas, R.; Geertman, S.C.M.|info:eu-repo/dai/nl/072392924

    2013-01-01

    China’s dramatic urban expansion has encompassed many peri-urban villages and turned them into so-called urban villages that provide a niche housing market for rural migrants for whom the formal housing market is unaffordable. Yet urban villages are very distinct from informal settlements elsewhere,

  17. Spatial diversity of urban village development in Shenzhen

    NARCIS (Netherlands)

    Hao, P.; Geertman, S.C.M.; Hooimeijer, P.; Sliuzas, R.

    2011-01-01

    Dynamic urbanization in China during the reform period has led to the emergence and proliferation of so-called urban villages in many cities. The development of urban villages, based on a self-help approach of indigenous villagers, has been satisfying great demand for migrant housing and space for

  18. High risk pregnancy due to physical traumas in pregnant women referred to forensic medicine center and university treatment centers of Khorramabad

    Directory of Open Access Journals (Sweden)

    mozhgan Masoudi

    2009-01-01

    Full Text Available Masoudi M1, Asti P1, Hadizadegan A2 1. Instructor, Department of Midwifery, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences 2.GP Abstract Background: Trauma during pregnancy can lead to early complications such as abruption placenta, premature contraction and labor and at most, bleeding and fetus-maternal mortality. Trauma is one of the most causes of high risk pregnancy. One out of twelve pregnant women suffers from physical trauma and in 7% of pregnancies involves complications due to trauma. The aim of this study was to determine the high risk pregnancy due to physical trauma in pregnant women referred to forensic medicine center and treatment centers of Lorestan university of medical science in Khorramabad. Materials and method: The present study is a across-sectional survey in which all the pregnant women (71 women that suffered from trauma and referred to forensic medicine center and treatment centers of Lorestan university of medical sciences in Khorramabad city from 23 September, 2005 to 22 September, 2006 (one year were studied. Data were collected using questionnaire and observations chart. Research subjects were studied in their place of hospitalization in the first 24 t0 48 hours after accident. One month after discharging from hospital we referred to their addresses and their complications were followed up and studied.Data was analyzed by SPSS software, and descriptive and inferential statistics. Results: According to the results, the reasons of referral in 60.1% of the cases was accident traumas, 31.6% physical abuse, 8.3% suicide. The most common cause of the traumas was car accident (30.7% and abuse by husband was the most frequent (55.2%. The mean of gestational age was 22.6 weeks and abdomen was the area in which the most amount of trauma has been occurred (39.5% and the most common traumas consisted of multiple traumas. The most common complications due to unintentional traumas was premature labor (13

  19. Assessing village authenticity with satellite images: a method to identify intact cultural landscapes in Europe.

    Science.gov (United States)

    Angelstam, Per; Boresjö-Bronge, Laine; Mikusiński, Grzegorz; Sporrong, Ulf; Wästfelt, Anders

    2003-12-01

    The village with its characteristic zones of different land use from the center to the periphery is a basic unit of Europe's cultural landscapes. However, loss of the authentic pre-industrial village structure characterized by a fine-grained structure of arable land and wooded grasslands is a threat to both cultural heritage and biodiversity in many rural landscapes. Therefore, it is important that the extent and rate of change of such authentic villages in a landscape can be monitored. We studied to what extent loss of authenticity with increasing time after abandonment can be assessed by quantitative analysis and visual interpretation of satellite images. The study was carried out in the Bieszczady Mountains, SE Poland in 1999. Using Landsat Thematic Mapper data from 1998, both the grain size of landscape elements (size of fields) and land-cover composition (encroachment of shrub and forest) were quantitatively described 6 type villages representing different stages of deterioration of the authentic village structure. Historical maps were used to delineate the border of the villages and the former extension of forest and open land was measured. The present land use and the degree of abandonment expressed as grain size and forest encroachment were mapped using satellite data. Deterioration occurred along 2 transformation paths: abandonment and ultimately becoming forest, or intensified agriculture, respectively. To validate these results we classified 22 other villages in a 1000 km2 area by visual interpretation of the original satellite images into 1 of 4 types. We then collected historical data on human population changes over the past six decades. The classification of village authenticity was clearly related to the rate of human population decline. We address the importance of validating and applying this approach for rapid assessment of the authenticity of cultural landscapes in European regions being subject to ongoing as well as expected future change

  20. Perspectives on renewable energy and Village Power

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, A.R.

    1997-12-01

    The author provides a brief overview of the role the Department of Energy has been playing in the area of renewable energy sources and their applications at a village level. Energy demand is rising sharply, and shortages are becoming more acute. Developing countries will present a large demand, and market opportunity over the next 40 years. Environmental concerns are a factor in the choice for what sources to promote and develop. The author touches on the features of renewable sources which makes them attractive to DOE for some applications, and what the goals of the department are in supporting this technology. Examples of applications at the level of village power are presented for both the US and abroad.

  1. Heterogeneity and Risk Sharing in Village Economies*

    Science.gov (United States)

    Chiappori, Pierre-André; Samphantharak, Krislert; Schulhofer-Wohl, Sam; Townsend, Robert M.

    2013-01-01

    We show how to use panel data on household consumption to directly estimate households’ risk preferences. Specifically, we measure heterogeneity in risk aversion among households in Thai villages using a full risk-sharing model, which we then test allowing for this heterogeneity. There is substantial, statistically significant heterogeneity in estimated risk preferences. Full insurance cannot be rejected. As the risk sharing, as-if-complete-markets theory might predict, estimated risk preferences are unrelated to wealth or other characteristics. The heterogeneity matters for policy: Although the average household would benefit from eliminating village-level risk, less-risk-averse households who are paid to absorb that risk would be worse off by several percent of household consumption. PMID:24932226

  2. Heterogeneity and Risk Sharing in Village Economies.

    Science.gov (United States)

    Chiappori, Pierre-André; Samphantharak, Krislert; Schulhofer-Wohl, Sam; Townsend, Robert M

    2014-03-01

    We show how to use panel data on household consumption to directly estimate households' risk preferences. Specifically, we measure heterogeneity in risk aversion among households in Thai villages using a full risk-sharing model, which we then test allowing for this heterogeneity. There is substantial, statistically significant heterogeneity in estimated risk preferences. Full insurance cannot be rejected. As the risk sharing, as-if-complete-markets theory might predict, estimated risk preferences are unrelated to wealth or other characteristics. The heterogeneity matters for policy: Although the average household would benefit from eliminating village-level risk, less-risk-averse households who are paid to absorb that risk would be worse off by several percent of household consumption.

  3. Human–dog interactions and behavioural responses of village dogs in coastal villages in Michoacán, Mexico

    NARCIS (Netherlands)

    Ruiz Izaguirre, E.; Eilers, C.H.A.M.; Bokkers, E.A.M.; Ortolani, A.; Ortega-Pacheco, A.; Boer, de I.J.M.

    2014-01-01

    In Mexican villages, most households keep dogs that roam freely. Therefore, socialisation of village dogs occurs in a different context than that of companion dogs in developed countries. The objectives of this study were: (1) to assess village dogs’ behavioural responses towards familiar and

  4. SERVIR Town Hall - Connecting Space to Village

    Science.gov (United States)

    Limaye, Ashutosh S.; Searby, Nancy D.; Irwin, Daniel; Albers, Cerese

    2013-01-01

    SERVIR, a joint NASA-USAID project, strives to improve environmental decision making through the use of Earth observations, models, and geospatial technology innovations. SERVIR connects these assets with the needs of end users in Mesoamerica, East Africa, and Hindu Kush-Himalaya regions. This Town Hall meeting will engage the AGU community by exploring examples of connecting Space to Village with SERVIR science applications.

  5. Encouraging girl child education in my village

    Directory of Open Access Journals (Sweden)

    Delphine Entongwe

    2015-03-01

    Full Text Available My critical reflection will be drawn from an experience I had just a year after my graduation from the university where I was appointed as one of the X-students to lead a student cultural week in my village with the theme “raising awareness on education”. At the university, I was a member of my association in which students from my tribe generally come together to promote unity and encourage others in education. My role was to present a discourse on girl child education all the entire villagers who were gathered at the village square that evening. A high dropout rate at school and illiteracy are major problems in my region, in which there is still a great deal of gender disparity when it comes to educating children, especially the girl child. This programme is in line with the government’s policy of promoting education in my country, whose priority is for education to reach the grass-roots communities.

  6. The Treatment Effectiveness Assessment (TEA: an efficient, patient-centered instrument for evaluating progress in recovery from addiction

    Directory of Open Access Journals (Sweden)

    Ling W

    2012-12-01

    Full Text Available Walter Ling,1 David Farabee,1 Dagmar Liepa,2 Li-Tzy Wu31Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA; 2Valley Care Medical Center, Panorama City, CA, USA; 3Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USAAbstract: The fields of addiction medicine and addiction research have long sought an efficient yet comprehensive instrument to assess patient progress in treatment and recovery. Traditional tools are expensive, time consuming, complex, and based on topics that clinicians or researchers think are important. Thus, they typically do not provide patient-centered information that is meaningful and relevant to the lives of patients with substance use disorders. To improve our ability to understand patients’ progress in treatment from their perspectives, the authors and colleagues developed a patient-oriented assessment instrument that has considerable advantages over existing instruments: brevity, simplicity, ease of administration, orientation to the patient, and cost (none. The resulting Treatment Effectiveness Assessment (TEA elicits patient responses that help the patient and the clinician quickly gauge patient progress in treatment and in recovery, according to the patients’ sense of what is important within four domains established by prior research. Patients provide both numerical responses and representative details on their substance use, health, lifestyle, and community. No software is required for data entry or scoring, and no formal training is required to administer the TEA. This article describes the development of the TEA and the initial phases of its application in clinical practice and in research.Keywords: substance use disorders, global treatment progress, brief instrument, patient-centered

  7. Understanding abuse of buprenorphine/naloxone film versus tablet products using data from ASI-MV® substance use disorder treatment centers and RADARS® System Poison Centers.

    Science.gov (United States)

    Butler, Stephen F; Black, Ryan A; Severtson, Stevan Geoffrey; Dart, Richard C; Green, Jody L

    2018-01-01

    The objectives were to examine the abuse prevalence and route-of-administration (ROA) profiles of sublingual buprenorphine/naloxone combination (BNX) film in comparison with the BNX tablet and to identify clinically-relevant subgroups of patients or geographic patterns. Between Q1 2015 through Q3 2015, data were collected from two major surveillance systems: (1) assessment of individuals in substance use disorder (SUD) treatment collected from the National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO®) ASI-MV® system and (2) intentional abuse/misuse exposures in the RADARS® System Poison Center Program. Poisson regression models were tailored to each system's data characteristics by population (all SUD treatment patients, US census) and adjusted for prescription volume. Effects of gender, race, age and US region as well as ROA profile were examined. For the ASI-MV study, 45,695 assessments of unique adults evaluated for substance use problems were collected. The abuse rate unadjusted for prescription volume of BNX tablet formulation was 2.64 cases/100 ASI-MV respondents versus 7.01 cases for the film formulation (RR=0.390, pfilm) (RR=1.25, pfilm abuse (0.0364) were greater than for tablet (0.0161), while prescription-adjusted rates were greater for tablet (0.2114) than for film (0.1703) per 100,000 prescriptions. ASI-MV ROA analyses indicated less abuse of the film by any alternate route, insufflation or injection than the tablet. Poison center data found more injection of tablets than film, although insufflation was not significantly different. On a prescription-adjusted basis, overall abuse of the BNX tablet is greater than that of the sublingual film formulation. For those who continue to abuse BNX, use by alternate ROAs was, in general, lower for the film. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Organizational Characteristics Associated With the Predicted Sustainability of Villages.

    Science.gov (United States)

    Scharlach, Andrew E; Lehning, Amanda J; Davitt, Joan K; Greenfield, Emily A; Graham, Carrie L

    2017-02-01

    Guided by resource dependence theory, this mixed-methods study examined organizational characteristics contributing to the perceived sustainability of Villages, a rapidly proliferating grassroots approach for promoting social participation and service access for community-dwelling older adults. Surveys conducted with leaders of 86% of Villages in the United States in 2012 found that higher predicted confidence in their Village's 10-year survival was associated with greater financial reserves, human resources, number of Village members, formal policies and procedures, and formal collaboration agreements. Respondents' explanations of their confidence ratings revealed additional themes of organizational leadership and perceived community need. Member resource inputs were not found to be as salient for Village leaders' perceptions of sustainability as was anticipated given the Village model's emphasis on consumer involvement. Despite the lack of longitudinal prospective data, study findings suggest potential limitations of consumer-driven organizational models such as Villages, including the need for a more stable resource base.

  9. Mental Health Treatment Barriers Among Racial/Ethnic Minority Versus White Young Adults 6 Months After Intake at a College Counseling Center.

    Science.gov (United States)

    Miranda, Regina; Soffer, Ariella; Polanco-Roman, Lillian; Wheeler, Alyssa; Moore, Alyssa

    2015-01-01

    This study examined mental health treatment barriers following intake at a counseling center among racially/ethnically diverse college students. College students (N = 122) seen for intake at a college counseling center in 2012-2013 completed self-reports of depressive symptoms, suicidal ideation, and mental health treatment barriers 6 months later. Racial/ethnic minority students less often reported previous mental health treatment and treatment after being seen at the counseling center, compared with white students. They also endorsed more treatment barriers--most commonly, financial concerns and lack of time--and more often endorsed stigma-related concerns. Treatment barriers were associated with not following through with counseling center recommendations and with greater depressive symptom severity but not with suicidal ideation during follow-up. Improving mental health treatment seeking among racial/ethnic minority college students should involve decreasing treatment barriers, improving access to affordable options, providing flexible scheduling or time-limited options, and decreasing stigma.

  10. The Successful Treatment of Specific Phobia in a College Counseling Center

    Science.gov (United States)

    Adler, Jonathan M.; Cook-Nobles, Robin

    2011-01-01

    Specific phobias are highly prevalent among college students and can be quite debilitating. However, students often do not present for treatment for phobias and, when they do, often do not receive effective treatment. This article will present a case study of the effective treatment of specific phobia using cognitive-behavioral therapy with an…

  11. Longitudinal spirometry among patients in a treatment program for community members with World Trade Center (WTC)-related illness

    Science.gov (United States)

    Liu, Mengling; Qian, Meng; Cheng, Qinyi; Berger, Kenneth I.; Shao, Yongzhao; Turetz, Meredith; Kazeros, Angeliki; Parsia, Sam; Goldring, Roberta M.; Fernandez-Beros, Maria Elena; Marmor, Michael; Reibman, Joan

    2013-01-01

    Objective The course of lung function in community members exposed to World Trade Center (WTC) dust and fumes remains undefined. We studied longitudinal spirometry among patients in the WTC Environmental Health Center (WTCEHC) treatment program. Methods Observational study of 946 WTCEHC patients with repeated spirometry measures analyzed on the population as a whole and stratified by smoking status, initial spirometry pattern and WTC-related exposure category. Results Improvement in forced expiratory volume (FVC; 54.4 ml/year; 95% CI: 45.0-63.8) and forced expiratory volume in one second (FEV1; 36.8 ml/year; 95% CI: 29.3-44.3) was noted for the population as a whole. Heavy smokers did not improve. Spirometry changes differed depending on initial spirometry pattern and exposure category. Conclusions These data demonstrate spirometry improvement in select populations suggesting reversibility in airway injury and reinforcing the importance of continued treatment. PMID:22995806

  12. Research advances in treatment of neurological and psychological diseases by acupuncture at the Acupuncture Meridian Science Research Center

    OpenAIRE

    Lee, Bombi; Kim, Seung-Nam; Park, Hi-Joon; Lee, Hyejung

    2014-01-01

    Acupuncture is an ancient therapeutic intervention that can be traced back at least 2100 years and is emerging worldwide as one of the most widely used therapies in the field of complementary and alternative medicine. Due to limitations associated with Western medicine's focus on the treatment of diseases rather than on their causes, interests are shifting to complementary and alternative medicines. The Acupuncture and Meridian Science Research Center (AMSRC) was established in 2005 to elucid...

  13. SU-E-J-15: A Patient-Centered Scheme to Mitigate Impacts of Treatment Setup Error

    Energy Technology Data Exchange (ETDEWEB)

    Yang, L [UT Southwestern Medical Center, Dallas, TX (United States); Southern Medical University, Guangzhou (China); Tian, Z; Gu, X; Jia, X; Jiang, S [UT Southwestern Medical Center, Dallas, TX (United States)

    2014-06-01

    Purpose: Current Intensity Modulated Radiation Therapy (IMRT) is plan-centered. At each treatment fraction, we position the patient to match the setup in treatment plan. Inaccurate setup can compromise delivered dose distribution, and hence leading to suboptimal treatments. Moreover, current setup approach via couch shift under image guidance can correct translational errors, while rotational and deformation errors are hard to address. To overcome these problems, we propose in this abstract a patient-centered scheme to mitigate impacts of treatment setup errors. Methods: In the patient-centered scheme, we first position the patient on the couch approximately matching the planned-setup. Our Supercomputing Online Replanning Environment (SCORE) is then employed to design an optimal treatment plan based on the daily patient geometry. It hence mitigates the impacts of treatment setup error and reduces the requirements on setup accuracy. We have conducted simulations studies in 10 head-and-neck (HN) patients to investigate the feasibility of this scheme. Rotational and deformation setup errors were simulated. Specifically, 1, 3, 5, 7 degrees of rotations were put on pitch, roll, and yaw directions; deformation errors were simulated by splitting neck movements into four basic types: rotation, lateral bending, flexion and extension. Setup variation ranges are based on observed numbers in previous studies. Dosimetric impacts of our scheme were evaluated on PTVs and OARs in comparison with original plan dose with original geometry and original plan recalculated dose with new setup geometries. Results: With conventional plan-centered approach, setup error could lead to significant PTV D99 decrease (−0.25∼+32.42%) and contralateral-parotid Dmean increase (−35.09∼+42.90%). The patientcentered approach is effective in mitigating such impacts to 0∼+0.20% and −0.03∼+5.01%, respectively. Computation time is <128 s. Conclusion: Patient-centered scheme is proposed to

  14. Composting system for waste treatment coca leaf with the addition of three biological activators in the Experimental Center Kallutaca

    Directory of Open Access Journals (Sweden)

    Apaza-Condori Emma Eva

    2015-11-01

    Full Text Available The objective of this study was to evaluate the composting process waste coca leaf with the addition of three biological activators (yogurt, whey and yeast. This work was carried out Kallutaca Experimental Center, Biofertilizers module Career Agricultural Engineering at the Public University of El Alto, La Paz municipality of Laja. Posed treatments were: T1 (+ Yogurt Coca wastes; T2 (Coca wastes + whey; T3 (Coca wastes + yeast and T4 (Control. The design was completely randomized with 4 treatments and 3 repetitions. The values in N are classified medium and high levels the quantities of P, K are classified as middle levels. The value obtained 7.9 pH, EC 12950 µS/cm and 61% organic matter belong to treatment T1. The decomposition time was a period of 105 days corresponds to treatment T3.

  15. A Qualitative Study of the Treatment Improvement Protocols (TIPs): An Assessment of the Use of TIPs by Individuals Affiliated with the Addiction Technology Transfer Centers (ATTCs).

    Science.gov (United States)

    Hayashi, Susan W.; Suzuki, Marcia; Hubbard, Susan M.; Huang, Judy Y.; Cobb, Anita M.

    2003-01-01

    Evaluated the Addiction Technology Transfer Centers (ATTCs) of the Center for Substance Abuse Treatment (CSAT) as a means of diffusion of innovations, focusing on use of the Treatment Improvement Protocols (TIPs). Qualitative studies at 6 ATTCs that included 57 interviews show that the CSAT is at the forefront of providing resources to the…

  16. Ab initio treatment of ion-water molecule collisions with a three-center pseudo potential

    OpenAIRE

    Martínez, Pablo A.; Errea, L. F.; Méndez, Laura González; Rabadán, Ismanuel

    2012-01-01

    We calculate electron capture cross sections in collisions of protons with water molecules, using two simple ab initio approaches. The formalism involves the calculation of one-electron scattering wave functions and the use of three-center pseudo potential to represent the electron H2O+ interaction. Several methods to obtain many-electron cross sections are considered

  17. Electronic-cigarette use by individuals in treatment for substance abuse: A survey of 24 treatment centers in the United States

    OpenAIRE

    Gubner, Noah R.; Andrews, K. Blakely; Mohammad-Zadeh, Ana; Lisha, Nadra E.; Guydish, Joseph

    2016-01-01

    Prevalence and reasons for using electronic cigarettes (e-cigarettes) was examined among patients enrolled in 24 substance abuse treatment centers in the United States (N=1,113). Prevalence of e-cigarette use was assessed for the full sample. Bivariate analyses and multivariate logistic regression were used to identify characteristics associated with e-cigarette use among current cigarette smokers (the majority of e-cigarette users). Overall 55.5% of the sample reported lifetime use of e-ciga...

  18. Millennium Global Village-Net: bringing together Millennium Villages throughout sub-Saharan Africa.

    Science.gov (United States)

    Kanter, Andrew S; Negin, Joel; Olayo, Bernard; Bukachi, Frederick; Johnson, Edward; Sachs, Sonia Ehrlich

    2009-12-01

    The Millennium Villages Project (MVP), based at The Earth Institute at Columbia University, is a bottom-up, community led approach to show how villages in developing countries can get out of the poverty trap that afflicts more than a billion people worldwide. With well-targeted, practical inputs can help the community invest in a path leading to self-sustaining development. There are 80 Millennium Villages clustered in 10 countries throughout sub-Saharan Africa. MVP is an important development process for empowering communities to invest in a package of integrated interventions aiming to increase food production, improve access to safe water, health care, education and infrastructure. The process benefits from synergies of the integrated approach and relies on community leadership as empowered by proven technological inputs. MVP is committed to a science-based approach to assess and monitor the progress of the communities towards clear objectives; the Millennium Development Goals (MDGs) and to do so with mechanisms that are scalable and sustainable. This approach offers much more than simply collecting and analyzing data since the mechanism used for recording progress would provide a bridge over the divide which separates the haves and the have-nots (by facilitating the sharing of solutions from one community to another bidirectionally). By so doing, it allows people to enhance their own futures in a sustainable manner. Solutions found in one community are transferable to similar communities in other MVP villages. To achieve this goal, the MVP requires an information and communication system which can provide both necessary infrastructure for monitoring and evaluation, and tools for communicating among the villages, cities and countries. This system is called the Millennium Global Village-Net (MGV-Net). It takes advantage of the latest in open source software (OpenMRS), databases (MySQL), interface terminology, a centralized concept dictionary, and uses appropriate

  19. Is directly observed tuberculosis treatment strategy patient-centered? A mixed method study in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Getahun, Belete; Nkosi, Zethu Zerish

    2017-01-01

    The directly observed treatment, short course (DOTS) strategy has been considered as an efficacious approach for better tuberculosis (TB) treatment adherence and outcome. However, its level of patient centerdness has not been studied and documented well. Hence, the study aimed to determine the level of patient centeredness' of the DOTS. The study used explanatory sequential mixed method design in Addis Ababa, Ethiopia. The study employed an interviewer-administered questionnaire with 601 patients with TB, focus group discussions with 23 TB experts, and telephonic-interview with 25 persons lost to follow-up from TB treatment. Descriptive and multivariable analyses carried out for the quantitative data while thematic analysis was used for the qualitative data. Forty percent of patients with TB had not received patient-centered TB care (PC-TB care) with DOTS. Male gender (AOR = 0.45, 95% CI 0.3, 0.7), good communication (AOR = 3.2, 95%CI 1.6, 6.1), and health care providers as a treatment supporter (AOR = 3.4, 95% CI 2.1, 5.48) had significant associations with PC-TB care. All persons lost to follow-up and TB experts perceived that DOTS is merely patient-centered. The identified categories were patient preferences, treatment supporter choice, integration of DOTS with nutritional support, mental health, and transport services, provider's commitment and communication skills. DOTS is limited to provide patient-centered TB care. Hence, DOTS needs a model that enhances effectiveness towards patient centeredness of TB care.

  20. Is directly observed tuberculosis treatment strategy patient-centered? A mixed method study in Addis Ababa, Ethiopia

    Science.gov (United States)

    Getahun, Belete; Nkosi, Zethu Zerish

    2017-01-01

    Introduction The directly observed treatment, short course (DOTS) strategy has been considered as an efficacious approach for better tuberculosis (TB) treatment adherence and outcome. However, its level of patient centerdness has not been studied and documented well. Hence, the study aimed to determine the level of patient centeredness’ of the DOTS. Method The study used explanatory sequential mixed method design in Addis Ababa, Ethiopia. The study employed an interviewer-administered questionnaire with 601 patients with TB, focus group discussions with 23 TB experts, and telephonic-interview with 25 persons lost to follow-up from TB treatment. Descriptive and multivariable analyses carried out for the quantitative data while thematic analysis was used for the qualitative data. Result Forty percent of patients with TB had not received patient-centered TB care (PC-TB care) with DOTS. Male gender (AOR = 0.45, 95% CI 0.3, 0.7), good communication (AOR = 3.2, 95%CI 1.6, 6.1), and health care providers as a treatment supporter (AOR = 3.4, 95% CI 2.1, 5.48) had significant associations with PC-TB care. All persons lost to follow-up and TB experts perceived that DOTS is merely patient-centered. The identified categories were patient preferences, treatment supporter choice, integration of DOTS with nutritional support, mental health, and transport services, provider’s commitment and communication skills. Conclusion DOTS is limited to provide patient-centered TB care. Hence, DOTS needs a model that enhances effectiveness towards patient centeredness of TB care. PMID:28763456

  1. Is directly observed tuberculosis treatment strategy patient-centered? A mixed method study in Addis Ababa, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Belete Getahun

    Full Text Available The directly observed treatment, short course (DOTS strategy has been considered as an efficacious approach for better tuberculosis (TB treatment adherence and outcome. However, its level of patient centerdness has not been studied and documented well. Hence, the study aimed to determine the level of patient centeredness' of the DOTS.The study used explanatory sequential mixed method design in Addis Ababa, Ethiopia. The study employed an interviewer-administered questionnaire with 601 patients with TB, focus group discussions with 23 TB experts, and telephonic-interview with 25 persons lost to follow-up from TB treatment. Descriptive and multivariable analyses carried out for the quantitative data while thematic analysis was used for the qualitative data.Forty percent of patients with TB had not received patient-centered TB care (PC-TB care with DOTS. Male gender (AOR = 0.45, 95% CI 0.3, 0.7, good communication (AOR = 3.2, 95%CI 1.6, 6.1, and health care providers as a treatment supporter (AOR = 3.4, 95% CI 2.1, 5.48 had significant associations with PC-TB care. All persons lost to follow-up and TB experts perceived that DOTS is merely patient-centered. The identified categories were patient preferences, treatment supporter choice, integration of DOTS with nutritional support, mental health, and transport services, provider's commitment and communication skills.DOTS is limited to provide patient-centered TB care. Hence, DOTS needs a model that enhances effectiveness towards patient centeredness of TB care.

  2. Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: A systematic review and meta-analysis (PRISMA Compliant).

    Science.gov (United States)

    Jayadevappa, Ravishankar; Chhatre, Sumedha; Wong, Yu-Ning; Wittink, Marsha N; Cook, Ratna; Morales, Knashawn H; Vapiwala, Neha; Newman, Diane K; Guzzo, Thomas; Wein, Alan J; Malkowicz, Stanley B; Lee, David I; Schwartz, Jerome S; Gallo, Joseph J

    2017-05-01

    In the context of prostate cancer (PCa) characterized by the multiple alternative treatment strategies, comparative effectiveness analysis is essential for informed decision-making. We analyzed the comparative effectiveness of PCa treatments through systematic review and meta-analysis with a focus on outcomes that matter most to newly diagnosed localized PCa patients. We performed a systematic review of literature published in English from 1995 to October 2016. A search strategy was employed using terms "prostate cancer," "localized," "outcomes," "mortality," "health related quality of life," and "complications" to identify relevant randomized controlled trials (RCTs), prospective, and retrospective studies. For observational studies, only those adjusting for selection bias using propensity-score or instrumental-variables approaches were included. Multivariable adjusted hazard ratio was used to assess all-cause and disease-specific mortality. Funnel plots were used to assess the level of bias. Our search strategy yielded 58 articles, of which 29 were RCTs, 6 were prospective studies, and 23 were retrospective studies. The studies provided moderate data for the patient-centered outcome of mortality. Radical prostatectomy demonstrated mortality benefit compared to watchful waiting (all-cause HR = 0.63 CI = 0.45, 0.87; disease-specific HR = 0.48 CI = 0.40, 0.58), and radiation therapy (all-cause HR = 0.65 CI = 0.57, 0.74; disease-specific HR = 0.51 CI = 0.40, 0.65). However, we had minimal comparative information about tradeoffs between and within treatment for other patient-centered outcomes in the short and long-term. Lack of patient-centered outcomes in comparative effectiveness research in localized PCa is a major hurdle to informed and shared decision-making. More rigorous studies that can integrate patient-centered and intermediate outcomes in addition to mortality are needed.

  3. Lessons learned -- NREL Village Power Program

    Energy Technology Data Exchange (ETDEWEB)

    Flowers, L.

    1998-07-01

    In 1993, a workshop was convened at the National Renewable Energy Laboratory (NREL) to discuss the issues of applying renewable energy in a sustainable manner to international rural development. One of the summary recommendations was that NREL could assist in the renewable energy for rural electrification effort by developing and supplying six related activities: resource assessment, comparative analysis and modeling, performance monitoring and analysis, pilot project development, internet-based project data, communications, and training. In response to this recommendation, NREL launched its Village Power Program consisting of these activities that cut across NREL technologies and disciplines. Currently NREL is active in 20 countries, with pilot projects in 12 of those countries. At this time the technologies include photovoltaics, wind, biomass, and hybrids. The rural applications include home lighting and communications, water pumping, schools and health posts, battery charging stations, ecotourism, and village systems. These pilot projects are central to the renewable energy village power development through the demonstration of three aspects critical to replication and implementation of the projects on a significant scale. The three aspects are technical functionality, economic competitiveness, and institutional sustainability. It is important to note that the pilot projects from which NREL's experience has been gained were funded and, in many cases, developed by other organizations and agencies. NREL's role has been one of technical assistance or project management or both. The purpose of this paper is to describe the lessons NREL staff has gleaned from their participation in the various pilot projects. The author hopes that these lessons will help the Renewable Energy-Based Rural Electrification (RERE) community in implementing sustainable projects that lead to replication.

  4. Agricultural production in Kikwawila village, southeastern Tanzania.

    Science.gov (United States)

    Zehnder, A; Jeje, B; Tanner, M; Freyvogel, T A

    1987-06-01

    Food production, land utilisation and agricultural structures were surveyed at Kikwawila village, north of Ifakara (Kilombero District, Morogoro Region) in 1984. This study was part of a more comprehensive, longitudinal programme to investigate the health status of a rural community, aiming in particular at the interrelations between nutrition, parasitic infections, immunity and the environment. Out of 340 households, 100 were interviewed and their subsistence farming activities recorded. The soil was found to be of great variability, being fertile where it was of alluvial origin but of reduced potential where it was non-alluvial. In all, 70 plant species were registered as being cultivated, with rice, maize, cassava and beans providing the main staple food. Apart from a few exceptions, the fields were cultivated without any mechanization. The seasonal distribution of agricultural work is described, but no detailed workload analysis of the villagers with regard to age and sex has been performed. At the foot of the mountains, where artificial irrigation has been introduced, dry season cropping was practised in addition to the prevailing wet season farming, which rendered the cultivation of marketable crops (mainly tomatoes) possible. The farmers were found to be imaginative and capable of adapting to various conditions, irrespective of their tribal origins. Alternatively, the quality of the soil and the unreliable availability of water set limits to the potential of food production in the area. Although land is still available, it is becoming more scarce as the human population increases. The further impoverishment of the land represents an imminent danger. Therefore, top priority ought to be given to soil conservation, followed by intercropping and/or crop rotation, seed production and crop protection against game and pests. Means of implementing such measures are discussed. It is suggested that Community Agricultural Workers be installed, elected by the villagers

  5. Setting the Standard for Autism Treatments: National Autism Center Releases Groundbreaking Report

    Science.gov (United States)

    Wilczynski, Susan M.; Pollack, Eileen G.

    2009-01-01

    In the United States and throughout the world, one's understanding of autism and other related disorders continues to evolve. Parents, educators, and health professionals today benefit from significant advancements in both the diagnosis and treatment of autism. However, the need to evaluate and select from a list of treatment options can be…

  6. Ritual Change in a Turkish Alevi Village

    Directory of Open Access Journals (Sweden)

    Thomas McElwain

    1993-01-01

    Full Text Available This study is a documentation and analysis of change in ritual in the village of Sarilar, on the west bank of the Euphrates River near Yavuseli, Gaziantep. The research problem posed was identification of ritual change within the consultants' memory and some tentative ways of situating such change within the socio-economic context. The mysticism of the dervish lodge remains as a certain life attitude along with the new views of modernization that have been so well inculcated. Although modernization, at least in the Turkish Alevi context, tends to conflict with the mystical experience of the Bektashi dervish in some areas, a democratized inner core remains.

  7. Early diagnosis and treatment of breast cancer in Japanese kidney transplant recipients: a single center experience

    OpenAIRE

    Kato, Taigo; Kakuta, Yoichi; Yamanaka, Kazuaki; Okumi, Masayoshi; Abe, Toyofumi; Imamura, Ryoichi; Ichimaru, Naotsugu; Takahara, Shiro; Nonomura, Norio

    2015-01-01

    Background The incidence of malignancies in kidney transplant recipients is increasing. Breast cancer is a common malignancy after kidney transplantation and can be more aggressive in kidney transplant recipients than in the general population. In this study, we evaluated the incidence and prognosis of breast cancer in kidney transplant recipients. Findings Between 1993 and 2013, 750 kidney transplant patients were followed-up at our center. Since 1999, annual physical examination, mammograph...

  8. Using Discrete-Event Simulation to Promote Quality Improvement and Efficiency in a Radiation Oncology Treatment Center.

    Science.gov (United States)

    Famiglietti, Robin M; Norboge, Emily C; Boving, Valentine; Langabeer, James R; Buchholz, Thomas A; Mikhail, Osama

    To meet demand for radiation oncology services and ensure patient-centered safe care, management in an academic radiation oncology department initiated quality improvement efforts using discrete-event simulation (DES). Although the long-term goal was testing and deploying solutions, the primary aim at the outset was characterizing and validating a computer simulation model of existing operations to identify targets for improvement. The adoption and validation of a DES model of processes and procedures affecting patient flow and satisfaction, employee experience, and efficiency were undertaken in 2012-2013. Multiple sources were tapped for data, including direct observation, equipment logs, timekeeping, and electronic health records. During their treatment visits, patients averaged 50.4 minutes in the treatment center, of which 38% was spent in the treatment room. Patients with appointments between 10 AM and 2 PM experienced the longest delays before entering the treatment room, and those in the clinic in the day's first and last hours, the shortest (<5 minutes). Despite staffed for 14.5 hours daily, the clinic registered only 20% of patients after 2:30 PM. Utilization of equipment averaged 58%, and utilization of staff, 56%. The DES modeling quantified operations, identifying evidence-based targets for next-phase remediation and providing data to justify initiatives.

  9. [The Therapeutic Dilemma in Treatment of Intracranial Infectious Aneurysm in Patients with Infective Endocarditis: Proposal for a Patient-Centered, Interdisciplinary Treatment Concept].

    Science.gov (United States)

    Leuenhagen, S; Burghaus, L; Kukolja, J; Rosenkranz, S; Kabbasch, C; Fink, G R; Onur, O A

    2016-07-01

    Intracranial infectious aneurysms are rare but hazardous complications of an infective endocarditis. To date, there are no evidence-based recommendations for the treatment of patients with this condition. Therefore, it remains an interdisciplinary challenge to decide which treatment steps are required and in which order they should be carried out. To illustrate the interdisciplinary dilemma in the treatment of these patients, we here present a case of a 23-year-old, drug-addicted woman with infectious endocarditis. While antibiotic treatment of the streptococcus-mitis-induced endocarditis stabilized the overall status of the patient, rupture of a basilar artery aneurysm caused her sudden death. We discuss the decision-making processes of the treatment, potential difficulties and dilemmas when dealing with patients suffering from infectious endocarditis and infectious intracranial aneurysm. Based upon case reports, studies and reviews, we present the options and risks of conservative, neurosurgical, endovascular, and cardiosurgical treatment of intracranial infectious aneurysms, and propose a patient-centered, interdisciplinary treatment concept. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Proposals for adaptation to new economic change through the promotion and selection of holiday villages in Romania

    Directory of Open Access Journals (Sweden)

    Florentina MIU

    2011-09-01

    Full Text Available Any settlement that is chosen to promote rural tourism is based on the following fundamental components: the centre of the village where most households are concentrated and which expresses the economic functions of the village; its outskirts (work area is the land beyond the center of the village that supports all agricultural occupations, craft, trade, tourism; the population is represented by demographic indicators: birth rate, mortality, natural growth, morbidity, density. Identification and selection criteria for tourist villages are the potential of rhe natural environment composed of natural elements with great appeal, variety of landscapes (mountain, Alpine hills, lakes, delta, ambient aesthetic beauty (slopes, canyons, gorges, caves, wildlife hunting, forests; accessibility is dependent on geographical location in the territory and the main communication routes that connect with the nearest urban centers. Also, the presence of cultural and ethnographic elements are the most attractive ones for tourists; demographic and economic potential have an important role in the development of rural tourism in a village through: supporting agricultural and non-agricultural occupations, transmission of traditions and customs from generation to generation; preserving environmental quality has become an important milestone for the selection and preservation of rural tourist elements.

  11. Model strategy for village development in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Ladislav ROLÍNEK

    2015-03-01

    Full Text Available The model strategies discussed in this article represent different ways of possible village development in the Czech Republic. We used typologies of strategies from business strategic management for their definition. Twenty municipalities, where structured interviews were carried out with their mayors, were chosen randomly from among 100 villages where a questionnaire survey was conducted in 2012 (Faltová Leitmanová, et al., 2012. Based on the qualitative analysis of the structured interview summaries, eight model strategies were ascertained. These include integration strategy, service differentiation, spending cuts, usage of municipal property, stabilization of village population, business support, fundraising, and identification of the inhabitants with the village (village pride. The most commonly applied model strategy is integration, followed by village population stabilization.

  12. Anti-Mesothelin Monoclonal Antibodies for the Treatment of Cancer | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The National Cancer Institute, Laboratory of Molecular Biology is seeking parties interested in collaborative research to further co-develop monoclonal antibodies for the treatment of mesothelin-expressing cancers.

  13. Ketamine Metabolites for the Treatment of Depression and Pain | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The National Institute on Aging, Laboratory of Clinical Investigation, is seeking parties interested in collaborative research to co-develop ketamine metabolites for the treatment of different forms of depression and for alleviating pain.

  14. [Retinoblastoma: preliminary results of national treatment protocol at Casablanca university medical center].

    Science.gov (United States)

    El Kettani, A; Aderdour, S; Daghouj, G; Knari, S; Zaghloul, K; Zafad, S; Harif, M; Benchekroun, S

    2014-02-01

    Retinoblastoma is the most frequent intraocular cancer, affecting almost exclusively children. We report prospective study results assessing the national protocol for retinoblastoma treatment in Morocco. Treatment included, depending on stage and laterality, primary chemotherapy either to facilitate enucleation or to make conservative treatment possible, postoperative chemotherapy, enucleation and conservative treatments such as transpupillary thermotherapy, thermochemotherapy and cryotherapy. Radiation was used in a few cases. Close supervision was performed until the age of 5. The incidence of retinoblastoma within the study period was 18 new cases per year in our department. Observations of 32 children were included in the study: 18 unilateral retinoblastomas (56%) and 14 bilateral retinoblastomas (44%), for a total of 46 eyes. Leucocoria was the most frequent presenting symptom (69%). Buphthalmia or proptosis were present in 47% of cases. The stage of retinoblastoma was V/D or E (Reese-Elsworth/ABC) in 69.5% of cases. Enucleation was necessary for 28 eyes. Transpupillary thermotherapy or thermochemotherapy were used for 13 eyes (11 children) and cryotherapy for 13 eyes (10 children). After an average follow-up period of 52 months, among 32 children, 4 died and 2 abandoned treatment. Ocular salvage rate was 85.7% (12 eyes out of 14, among which 11 without radiation). Retinoblastoma is a genetic tumor, which occurs in two forms: sporadic, always unilateral, and hereditary, often bilateral. The latter is the most challenging case. Current treatment protocols rely primarily on chemotherapy and local treatments. The future is oriented toward purely local treatments such as intra-arterial chemotherapy and intraocular chemotherapy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  15. The Ohrberg solar village; Solarsiedlung am Ohrberg

    Energy Technology Data Exchange (ETDEWEB)

    Vanoli, K.; Christoffers, D.; Rockendorf, G. [Institut fuer Solarenergieforschung GmbH Hameln/Emmerthal (ISFH), Emmerthal (Germany). Abt. Systemtechnik von Solarenergieanlagen; Kranz, R. [Elektrizitaetswerke Wesertal GmbH, Hameln (Germany). Abt. Energieberatung/Energiekonzepte

    1998-02-01

    As an officially approved regional project of the EXPO 2000, the Ohrberg Solar Village will demonstrate an integrated energy concept - combining customer information and counseling, modern energy technologies and energy services rendered by utilities - which reduces the consumption of conventional energy ressources and the CO{sub 2}-emissions. The local utility Wesertal GmbH will equip the 82 low-energy solar houses of the village with reliable, cost-effective and innovative energy technologies and will provide energy services on the basis of a user-friendly contract. (orig.) [Deutsch] Die Solarsiedlung am Ohrberg demonstriert als registriertes Regionalprojekt der EXPO 2000, wie ein integriertes Energiekonzept - bestehend aus umfassender Energieberatung, Einsatz moderner Energietechnologien und einem Nutz-Energie-Dienstleistungsangebot der Energieversorger - einen substantiellen Beitrag zur Ressourcenschonung und zur Reduzierung der klimarelevanten Umweltbelastung leisten kann. Das regionale Energieversorgungsunternehmen Wesertal GmbH wird innovative, erprobte, kostenguenstige, rationelle und regenerative Energieversorgungstechniken in den 82 solaren Niedrigenergiehaeusern dieser Siedlung installieren und die Waermeversorgung im Rahmen eines Waermedienstleistungskonzeptes uebernehmen. (orig.)

  16. International Lifestyle Migration and Social Marginalization on the Tourism Village

    OpenAIRE

    M. Kolopaking, Lala

    2016-01-01

    By conducting qualitative research that supported with quantitative data analysis, it has founded that International lifestyle migration which committed by Middle East citizens (Saudi Arabian and Qatar) at South Tugu Village, Cisarua in East Java Indonesia as the destination for village tourism - have been raising social unequality. International lifestyle migration process on this village had occured along with International refugee resettlement from Asian country (Pakistan, Afganistan, Moro...

  17. The physical impoverishment and decay of Danish villages

    DEFF Research Database (Denmark)

    Møller, Jørgen

    2005-01-01

    For the latest 30 years the physical environment (buildings, gardens, roads and spaces, etc.) in the Danish villages has undergone drastic changes. Many villages near the large towns are drowned in growth and modern buildings, and other villages in the Danish outskirts are hit by decline and phys......, a regional and local authority level as well as the local level, including a discussion of the Danish rural district policy before and after the re-adjustment of the farm subsidypolicy in the EU....

  18. Patients′ perception of the quality of malaria treatment in primary health care centers of Jos and Environs

    Directory of Open Access Journals (Sweden)

    N S Jimam

    2015-01-01

    Full Text Available Background: Though the fight against malaria continued to be on the increased, the disease still remains a major public health problem in many developing countries, especially in the rural areas. The extent of drug use and its effect is affected among other things by the pattern in which these drugs are prescribed by the health workers. Patients′ assessment of the quality of care depends on their ability to judge whether health care providers are adhering to the defined standard of care, hence it is necessary to assess the views of patients regarding the quality of care they received from the primary health care (PHC centers. Aim: This study aimed at evaluating consumer′s perception of the quality of malaria treatment in PHC centers of Jos and environs. Materials and Methods: Nine PHC centers were selected by multi-stage random sampling, five from Jos North and four from Jos South Local Government Areas of Plateau State. Patients of both sexes within the age range of 18 years and above who visited the PHC centers for malaria treatment were considered eligible to participate in the survey, provided that they were able to understand and respond to the interview questions. A semi-structured interviewer questionnaire which was adapted from previous health survey studies was administered to all the 249 eligible participants. The data collected were analyzed using the Statistical Package for Social Sciences (SPSS version 20.0 software programmer. Results: The result showed that there were no consistently significant differences (P > 0.05 regarding patient satisfaction between male and female patients across selected items in the various domains, that is, irrespective of respondents′ sex, their perception of the quality of health services rendered by PHCs was similar. Conclusion: It was therefore concluded that there was similar satisfaction level between the male and the female, though some key health services were not readily available in the

  19. [Synchronous bilateral breast cancer: experiences in the Mohammed VI Cancer Treatment Center, CHU Ibn Rochd, Casablanca].

    Science.gov (United States)

    Khalil, Ahmadaye Ibrahim; Bendahhou, Karima; Mestaghanmi, Houriya; Saile, Rachid; Benider, Abdellatif

    2016-01-01

    Synchronous bilateral breast cancers (SBBC) are characterized by extensive clinical and morphological heterogeneity, with an frequency between 1.5 and 3.2%. Women treated for unilateral breast cancer are at higher risk of developing contralateral breast cancer. Screening and advances in breast imaging have improved detection rates of SBBC. Our study aims to analyze the epidemiological, clinical, histological and therapeutic features of bilateral breast cancer. We conducted a cross-sectional study of patients with breast cancer treated at the Mohammed VI Center over a two year period. Statistical analysis of the results was performed using R. software. 31 patients had SBBC, representing 2.4% of breast cancer cases in our Center. The average age was 47.8 ± 8.4 years, 22.6% of patients used oral contraceptives. A family history of breast cancer was observed in 22.6% of cases. The most common histological type was invasive ductal carcinoma (58.1%), SBR grade II and III were common (38.7%). Hormone receptors were positive for progesterone (38.7%) and for estrogen (41.9%). HER2 was overexpressed in 20.0% of cases. 29.0% of patients received hormonal therapy and 3.2% targeted therapies. Our study showed that bilateral breast cancer represents a small percentage of all breast cancers but have specific clinical features that help to differentiate it from unilateral breast cancer.

  20. Efficacy of Dapsone in the Treatment of Pemphigus Vulgaris: A Single-Center Case Study.

    Science.gov (United States)

    Baum, Sharon; Debby, Assaf; Gilboa, Sarit; Trau, Henri; Barzilai, Aviv

    2016-01-01

    Pemphigus vulgaris (PV) is a chronic autoimmune blistering disease. Most patients require long-term therapy with systemic steroids, and a steroid-sparing agent is usually also utilized. Dapsone is a chemotherapeutic agent with anti-inflammatory properties that is used as a steroid-sparing agent in PV. The aim of the present study was to evaluate the efficacy of dapsone as an adjuvant therapy in patients with PV. A retrospective analysis of patients' files was performed. All 26 patients included in the study group were treated with dapsone as an adjuvant to systemic steroids for at least 3 consecutive months and were followed up during their dapsone treatment period. After 3 months of treatment with dapsone, 13 patients were in the consolidation phase, 4 patients demonstrated partial remission on minimal therapy, 7 patients demonstrated complete remission on minimal therapy, and 2 patients were defined as treatment failures. The trend of clinical improvement continued after 6 months of treatment and at the study end point. This retrospective case series, one of the largest reported, indicates that dapsone is efficacious and safe for patients with PV in whom it is well tolerated soon after the initiation of treatment. © 2016 S. Karger AG, Basel.

  1. Efficiency of U.S. dialysis centers: an updated examination of facility characteristics that influence production of dialysis treatments.

    Science.gov (United States)

    Shreay, Sanatan; Ma, Martin; McCluskey, Jill; Mittelhammer, Ron C; Gitlin, Matthew; Stephens, J Mark

    2014-06-01

    To explore the relative efficiency of dialysis facilities in the United States and identify factors that are associated with efficiency in the production of dialysis treatments. Medicare cost report data from 4,343 free-standing dialysis facilities in the United States that offered in-center hemodialysis in 2010. A cross-sectional, facility-level retrospective database analysis, utilizing data envelopment analysis (DEA) to estimate facility efficiency. Treatment data and cost and labor inputs of dialysis treatments were obtained from 2010 Medicare Renal Cost Reports. Demographic data were obtained from the 2010 U.S. Census. Only 26.6 percent of facilities were technically efficient. Neither the intensity of market competition nor the profit status of the facility had a significant effect on efficiency. Facilities that were members of large chains were less likely to be efficient. Cost and labor savings due to changes in drug protocols had little effect on overall dialysis center efficiency. The majority of free-standing dialysis facilities in the United States were functioning in a technically inefficient manner. As payment systems increasingly employ capitation and bundling provisions, these institutions will need to evaluate their efficiency to remain competitive. © Health Research and Educational Trust.

  2. Change in clinical indices following laser or scalpel treatment for periodontitis: A split-mouth, randomized, multi-center trial

    Science.gov (United States)

    Harris, David M.; Nicholson, Dawn M.; McCarthy, Delwin; Yukna, Raymond A.; Reynolds, Mark A.; Greenwell, Henry; Finley, James; McCawley, Thomas K.; Xenoudi, Pinelopi; Gregg, Robert H.

    2014-02-01

    Data are presented from a multi-center, prospective, longitudinal, clinical trial comparing four different treatments for periodontitis, (1) the LANAPTM protocol utilizing a FR pulsed-Nd:YAG laser; (2) flap surgery using the Modified Widman technique (MWF); (3) traditional scaling and root planing (SRP); and (4) coronal debridement (CD). Each treatment was randomized to a different quadrant. Fifty-one (54) subjects were recruited at five centers that included both private practice and university-based investigators. At 6-months and 12 months post-treatment the LANAPTM protocol and MWF yielded equivalent results based on changes in probing depths. The major difference observed between the two procedures was that patients reported significantly greater comfort following the LANAP™ procedure than following the MWF (P<0.001). There was greater reduction in bleeding in the LANAPTM quadrant than in the other three at both 6 and 12 months. Improvements following SRP were better than expected at 6 months and continued to improve, providing outcomes that were equivalent to both LANAPTM and MWF at 12 months. The improvement in the SRP quadrants suggests the hypothesis that an aspect of the LANAPTM protocol generated a significant, positive and unanticipated systemic (or trans-oral) effect on sub-gingival wound healing.

  3. Development of village doctors in China: financial compensation and health system support.

    Science.gov (United States)

    Hu, Dan; Zhu, Weiming; Fu, Yaqun; Zhang, Minmin; Zhao, Yang; Hanson, Kara; Martinez-Alvarez, Melisa; Liu, Xiaoyun

    2017-07-01

    Since 1968, China has trained about 1.5 million barefoot doctors in a few years' time to provide basic health services to 0.8 billion rural population. China's Ministry of Health stopped using the term of barefoot doctor in 1985, and changed policy to develop village doctors. Since then, village doctors have kept on playing an irreplaceable role in China's rural health, even though the number of village doctors has fluctuated over the years and they face serious challenges. United Nations declared Sustainable Development Goals in 2015 to achieve universal health coverage by 2030. Under this context, development of Community Health workers (CHWs) has become an emerging policy priority in many resource-poor developing countries. China's experiences and lessons learnt in developing and maintaining village doctors may be useful for these developing countries. This paper aims to synthesis lessons learnt from the Chinese CHW experiences. It summarizes China's experiences in exploring and using strategic partnership between the community and the formal health system to develop CHWs in the two stages, the barefoot doctor stage (1968 -1985) and the village doctor stage (1985-now). Chinese and English literature were searched from PubMed, CNKI and Wanfang. The information extracted from the selected articles were synthesized according to the four partnership strategies for communities and health system to support CHW development, namely 1) joint ownership and design of CHW programmes; 2) collaborative supervision and constructive feedback; 3) a balanced package of incentives, both financial and non-financial; and 4) a practical monitoring system incorporating data from the health system and community. The study found that the townships and villages provided an institutional basis for barefoot doctor policy, while the formal health system, including urban hospitals, county health schools, township health centers, and mobile medical teams provided training to the barefoot

  4. Implementation of village empower program in supporting form of institutions of village business institutions (BUMDes (Study on Dayang Suri Village Bungaraya Sub District Siak Regency Riau Province

    Directory of Open Access Journals (Sweden)

    Wasiah Sufi

    2017-12-01

    Full Text Available The purpose of this research is to investigate the implementation of village empowerment program in support of institutional formation of Village Owned Enterprise (BUMDes. The research carried out at Dayang Suri Village, Bungaraya Subdistrict, Siak Regency at UED-SP Karya Bersama. The data used consist of secondary data in the form of documents relating to the implementation of village empowerment program in support of the formation of BUMDes and primary data in the form of direct observation of research location and interview with key informant. Data analysis employed in descriptively qualitative. Based on the result, it mentioned that into the preparation stage, implementation and principles of management of UED-SP Karya Bersama program has been relatively good. However, there are still less maximal aspects such as lack of socialization conducted by village government, lack of transparency or clarity of information by village fund managers and lack of village facilitators as facilitators in decision making. Keywords: poverty, community empowerment, savings and loans, transparency

  5. The Influence of Environmental Change on Village Safety in Mountain Area: A Case Study of Haucha Village in Taiwan

    Science.gov (United States)

    Wang, Ji-Shang; Huang, Wen-Shun; Jan, Chyan-Deng; Yeh, Nai-Ching

    2015-04-01

    Haucha Village is an indigenous tribe of Rukai people in Pingtung County, Taiwan. Due to the difficulty of providing transportation, education, medical services and jobs, residents were migrated from "Kochapongan" to Haucha village by local authorities in 1980. The site of the relocation is located three km away from Haucha. The new residents in Haucha village lived safely and peacefully before 1996. However, Typhoon Herb brought the first debris flow hazard in 1996, and it caused four deaths. Then, several typhoons caused some damage to the village. Recently, Haucha village was destroyed during typhoon Morakot in 2009 when 128 buildings were buried by sediments. In this study, we used historical map, typhoon records, rainfall data, and the change of river bed elevation to determine the environmental change and the safety of Haucha village. Our results show that Haucha village was located on sand bar of Southern Ailiao stream before 1924, and formed a river terrace between 1925~1960 that was 30m higher than the river bed. Local authorities decided to move Rukai people from Kochapongan to Haucha in 1970. After 30 years, the elevation of Haucha village was equal to the river bed, in other words, the village formed a flood plain of Southern Ailiao stream after typhoon Morakot in 2009. The present landscape of Haucha village looks similar to the one 100 years ago. Morphological changes of mountain area is more rapid than plain changes, hence, we should considered larger temporal and spatial scales to evaluate the village`s safety in the mountain area.

  6. Clinical Presentation, Risk Factors, and Treatment Modalities of Hepatocellular Carcinoma: A Single Tertiary Care Center Experience.

    Science.gov (United States)

    Aljumah, Abdulrahman A; Kuriry, Hadi; AlZunaitan, Mohammed; Al Ghobain, Mohammed; Al Muaikeel, Mohamed; Al Olayan, Ashwaq; Azzumeea, Fahad; Almutairi, Bader; AlAlwan, Abduljaleel; AlGhamdi, Hamdan

    2016-01-01

    Objective. To investigate the risk factors, clinical characteristics, treatment modalities, and outcomes in Saudi patients with HCC and propose points for early detection of the disease. Methods. Patients were stratified according to underlying risk factors for the development of HCC. Barcelona Clinic Liver Cancer (BCLC) was used for cancer staging. Treatment was classified into surgical resection/liver transplantation; locoregional ablation therapy; transarterial embolization; systemic chemotherapy; and best supportive care. Results. A total of 235 patients were included. Males had higher tumor size and incidence of portal vein thrombosis. Viral hepatitis was a risk factor in 75.7%. The most common BCLC stages were B (34.5%) and A (33.6%), and the most common radiological presentation was a single nodule of less than 5 cm. Metastases were present in 13.2%. Overall, 77 patients (32.8%) underwent a potentially curative treatment as the initial therapy. The most commonly utilized treatment modality was chemoembolization with 113 sessions in 71 patients. The overall median survival was 15.97 ± 27.18 months. Conclusion. HCC in Saudi Arabia is associated with high prevalence of HCV. Potentially curative therapies were underutilized in our patients. Cancer stage BCLC-B was the most frequent (34.5%) followed by BCLC-A (33.6%). The overall median survival was shorter than other studies.

  7. Diagnosis and Treatment of Autoimmune Liver Diseases in a Tertiary Referral Center in Cuba

    Directory of Open Access Journals (Sweden)

    Marlen Ivón Castellanos Fernández, MD, PhD, MP

    2017-01-01

    Conclusions: The clinical profile of AILD in a sample of the Cuban population is similar to that reported in South areas (Developing countries. AIH was more frequent than PBC, and usually presented with advanced liver disease that responded poorly to treatment.

  8. Using concept mapping to design an indicator framework for addiction treatment centers.

    NARCIS (Netherlands)

    Nabitz, U.; van den Brink, W.; Jansen, P.G.W.

    2005-01-01

    Objective. The objective of this study is to determine an indicator framework for addiction treatment centres based on the demands of stakeholders and in alignment with the European Foundation for Quality Management (EFQM) Excellence Model. Setting. The setting is the Jellinek Centre based in

  9. Learning From The Socio-Religious Integration In Solor Village Indonesia

    Directory of Open Access Journals (Sweden)

    Irene Ludji

    2015-06-01

    Full Text Available The Indonesian nation with the motto “Bhineka Tunggal Ika” (Unity in Diversity is a nation that believes in the beauty of pluralism as the primary model to build unity. Therefore, in building relationships that produce social integration, it should be characterized by acceptance and respect of pluralism and a willingness to learn from this pluralism. Unfortunately, the increasing number of conflicts results in the inability of society to tolerate differences, as seen in the nation’s self-identity becoming unstable. It is clear that the national identity needs to be reinforced through strategic steps that are systematic, clear-cut, and integrated, so that the national unity can be strongly united again. One of the ways to accomplish this is by learning from social integration that occurs in various locations in Indonesia. One such place is in Solor Village, Kupang.  In the midst of various conflicts that center on ethnic groups, race, religion, and class issues in Indonesia, the relationship between the indigenous people and newcomers in Solor Village offers an alternative for social integration that can occur in this “Unity in Diversity” nation. This is the focus of this research, which uses a descriptive-qualitative format to analyze social integration strategic issues between newcomers with different religious and cultural backgrounds from the native inhabitants of Solor Village. The research shows that Solor Village residents succeed in building a harmonious life because in facing multiculturalism, religious and cultural values play an important role.Harmonious life in Solor Village confirm that social integration that build on respect to pluralism is possible.

  10. Goal Setting and Treatment Adherence Among Patients With Chronic Illness and Depressive Symptoms: Applying a Patient-Centered Approach.

    Science.gov (United States)

    Houston, Eric; Tatum, Alexander K; Guy, Arryn; Mikrut, Cassandra; Yoder, Wren

    2015-10-26

    Poor treatment adherence is a major problem among individuals with chronic illness. Research indicates that adherence is worsened when accompanied by depressive symptoms. In this preliminary study, we aimed to describe how a patient-centered approach could be employed to aid patients with depressive symptoms in following their treatment regimens. The sample consisted of 14 patients undergoing antiretroviral therapy (ART) for HIV who reported clinically-significant depressive symptoms. Participant ratings of 23 treatment-related statements were examined using two assessment and analytic techniques. Interviews were conducted with participants to determine their views of information based on the technique. Results indicate that while participants with optimal adherence focused on views of treatment associated with side effects to a greater extent than participants with poor adherence, they tended to relate these side effects to sources of intrinsic motivation. The study provides examples of how practitioners could employ the assessment techniques outlined to better understand how patients think about treatment and aid them in effectively framing their health-related goals.

  11. Dynamic Compression System: An Effective Nonoperative Treatment for Pectus Carinatum: A Single Center Experience in Basel, Switzerland.

    Science.gov (United States)

    Sesia, Sergio B; Holland-Cunz, Stefan; Häcker, Frank-Martin

    2016-12-01

    Background Several nonoperative treatments are currently available for the correction of pectus carinatum (PC). Objective The objective of this study is to report our single center experience with the dynamic compression system (DCS). Materials and Methods The DCS is a rigid aluminum brace. PC is reshaped into a normal appearance through anterior-posterior pressure and lateral expansion of the chest. Patients with chondrogladiolar PC were considered suitable for the nonoperative treatment with DCS. Results In this study, 53 of 68 children (78%) with chondrogladiolar PC were assessed retrospectively: 2 children were corrected by surgery, 12/53 (23%) treated by a conventional orthesis, 11/53 (21%) remained without therapy because of minor PC, and 36/53 (68%) were treated using the DCS. Of these 36 patients, 17 (47%) are already cured with a good (7/17) to excellent (10/17) cosmetic result after a median treatment period of 9 months (range, 2.5-16 months). The mean daily time of wearing of the device for those 17 patients was 9 hours (range, 5-18). None abandoned the treatment and there were almost no complications. Conclusions Lateral expansion of the chest and the possibility to measure the applied pressure seemed to be the key to DCSs success. We propose the DCS as first choice in the treatment of chondrogladiolar PC in children. Georg Thieme Verlag KG Stuttgart · New York.

  12. Locoregional Prostate Cancer Treatment Pattern Variation in Independent Cancer Centers: Policy Effect, Patient Preference, or Physician Incentive?

    Directory of Open Access Journals (Sweden)

    Andrew S. Camarata

    2015-01-01

    Full Text Available Surveillance, Epidemiologic, and End Results (SEER registry data abstracted from a priority 2 or higher reporting source from 2006 to 2008 were used to compare treatment patterns in 45–64-year old men diagnosed with locoregional prostate cancer (LRPC across states with or without radiation therapy-directed certificate of need (CON laws and across independent cancer centers (ICCs compared to large multi-specialty groups (LMSGs. Adjusted treatment percentages for the five most common LRPC treatments (surgery, external beam radiation therapy (EBRT, combination brachytherapy with EBRT, brachytherapy, and observation were compared using cross-sectional logistic regression between CON-unregulated and -regulated states and between LMSGs and ICCs. LRPC EBRT rates were no different across CON regions, but are increased in ICCs compared to LMSGs (37.00% vs. 13.23%, P < 0.001. Variation in LRPC treatment patterns by reporting source merits further scrutiny under the Affordable Care Act of 2010, considering the intent of incentivized accountable care organizations (ACOs established by the Patient Protection and Affordable Care Act of 2010 (PPACA and the implications of early descriptions of these new healthcare provider organizations on prostate cancer treatment patterns.

  13. Pharmacological treatment strategies in obsessive compulsive disorder: A cross-sectional view in nine international OCD centers.

    Science.gov (United States)

    Van Ameringen, Michael; Simpson, William; Patterson, Beth; Dell'Osso, Bernardo; Fineberg, Naomi; Hollander, Eric; Hranov, Luchezar; Hranov, Georgi; Lochner, Christine; Karamustafalioglu, Oguz; Marazziti, Donatella; Menchon, Jose M; Nicolini, Humberto; Pallanti, Stefano; Stein, Dan J; Zohar, Joseph

    2014-06-01

    It is unknown what next-step strategies are being used in clinical practice for patients with obsessive-compulsive disorder (OCD) who do not respond to first-line treatment. As part of a cross-sectional study of OCD, treatment and symptom information was collected. Consecutive OCD out-patients in nine international centers were evaluated by self-report measures and clinical/structured interviews. OCD symptom severity was evaluated by the Yale Brown Obsessive Compulsive Scale (YBOCS) and Clinical Global Impression-Severity Scale (CGI-S). Clinical response to current treatment was evaluated by the CGI-Improvement Scale (CGI-I ≤ 2). In total, 361 participants reported taking medication; 77.6% were taking a selective serotonin reuptake inhibitor; 50% reported use of at least one augmentation strategy. Antipsychotics were most often prescribed as augmenters (30.3%), followed by benzodiazepines (24.9%) and antidepressants (21.9%). No differences in OCD symptom severity were found between patients taking different classes of augmentation agents. Results from this international cross-sectional study indicate that current OCD treatment is in line with evidence-based treatment guidelines. Although augmentation strategies are widely used, no significant differences in OCD symptom severity were found between monotherapy and augmentation or between different therapeutic agents. © The Author(s) 2014.

  14. Scale-up of community-based malaria control can be achieved without degrading community health workers' service quality: the Village Malaria Worker project in Cambodia

    National Research Council Canada - National Science Library

    Yasuoka, Junko; Poudel, Krishna C; Ly, Po; Nguon, Chea; Socheat, Duong; Jimba, Masamine

    2012-01-01

    .... Cambodia recently scaled up their Village Malaria Worker (VMW) project by substantially increasing the number of VMWs and expanding the project's health services to include treatment of fever, diarrhoea, and Acute Respiratory Infections (ARI...

  15. Toward Implementing Patient Flow in a Cancer Treatment Center to Reduce Patient Waiting Time and Improve Efficiency.

    Science.gov (United States)

    Suss, Samuel; Bhuiyan, Nadia; Demirli, Kudret; Batist, Gerald

    2017-06-01

    Outpatient cancer treatment centers can be considered as complex systems in which several types of medical professionals and administrative staff must coordinate their work to achieve the overall goals of providing quality patient care within budgetary constraints. In this article, we use analytical methods that have been successfully employed for other complex systems to show how a clinic can simultaneously reduce patient waiting times and non-value added staff work in a process that has a series of steps, more than one of which involves a scarce resource. The article describes the system model and the key elements in the operation that lead to staff rework and patient queuing. We propose solutions to the problems and provide a framework to evaluate clinic performance. At the time of this report, the proposals are in the process of implementation at a cancer treatment clinic in a major metropolitan hospital in Montreal, Canada.

  16. β-Elemene treatment of glioblastoma: a single-center retrospective study.

    Science.gov (United States)

    Ma, Chunxiao; Zhou, Wei; Yan, Zhaoyue; Qu, Mingqi; Bu, Xingyao

    2016-01-01

    Glioblastoma (GBM) is the most common primary malignancy in the central nervous system. In this study, we investigated the therapeutic effects of β-elemene (ELE) treatment in patients with newly diagnosed GBM who received concomitant chemoradiotherapy and adjuvant chemotherapy with temozolomide. Our results indicated that compared with control, patients who received ELE showed significantly longer median progression-free survival (PFS) (8 months vs 11 months; PELE treatment could significantly prolong the PFS (P=0.038) and OS (P=0.016). In multivariate analysis, ELE was a significant prognostic factor for PFS (hazard ratio [HR], 0.34; 95% confidence interval [95% CI]: 0.15-0.62; P=0.011) and OS (HR, 0.31; 95% CI: 0.14-0.69; P=0.006). Furthermore, ELE could significantly reduce the hematologic toxicities induced by chemoradiotherapy. In conclusion, ELE might provide a survival benefit in patients with GBM. Further study for verification might be needed.

  17. TREATMENT OF ACUTE MYELOID LEUKEMIA OF ADULTS – 5-YEARSEXPERIENCE AT UNIVERSITY CLINICAL CENTER LJUBLJANA

    Directory of Open Access Journals (Sweden)

    Uroš Mlakar

    2008-04-01

    Results of our analysis for treatment outcome of younger patients with AML are comparable to reports of acknowledged randomized trials. Patients over 59 years who had enteredclinical trials formed a highly selected group which suggests that trial data are non representative of what actually happened in older patients. A high induction death rate in ourgroup of older patients dictates the need for careful selection of older patients for intensivetherapy. Patient’s age, cytogenetics, performance status and comorbidities have to be considered

  18. CD22: A Promising Target for Acute Lymphoblastic Leukemia Treatment | Center for Cancer Research

    Science.gov (United States)

    There are about 4,000 new cases of acute lymphoblastic leukemia (ALL) in the United States each year. Great improvements have been made in the treatment of ALL, but many patients suffer from side effects of standard therapy and continue to die of this disease. One of the most promising therapeutic strategies includes engineering T cells with a chimeric antigen receptor (CAR) that alters T cell specificity and function to recognize tumor antigens.

  19. Fertility in young patients following treatment for Hodgkin's lymphoma: a single center survey.

    Science.gov (United States)

    Boltežar, Lučka; Pintarić, Karlo; Jezeršek Novaković, Barbara

    2016-03-01

    The purpose of this study was to determine the fertility rates following treatment by means of the BEACOPP regimen (regular and escalated) (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) as compared to the ABVD regimen (doxorubicin, vinblastine, dacarbazine, bleomycin) in Hodgkin lymphoma patients under the age of 40 at the time of treatment. A questionnaire was sent to 180 Hodgkin lymphoma (HL) patients. The questionnaire was composed of questions concerning reproduction and also menopausal and aging symptoms in females and males. The analyses were made using data collected from 123 patients (76 females and 47 males) who returned the questionnaire. All of the patients were treated between 1999 and 2012. In comparing the ABVD and BEACOPP groups of female patients, the frequency of the therapy-induced amenorrhea and the restored menses following treatment were found to be significantly different statistically (p = 0.002 and p = 0.012, respectively). The secondary amenorrhea statistically appeared more often in the BEACOPP group (p = 0.003) while the cases of achieving pregnancy and having children after chemotherapy were not significantly different (p = 0.630, p = 0.070, respectively). In comparing the ABVD and BEACOPP treatments in male patients, the only significant difference was in the number of artificially inseminated or in vitro pregnancies achieved in the BEACOPP and escalated BEACOPP group, p = 0.008 and p = 0.002, respectively. In total, 45.2% of patients in the ABVD female group, 34.6% in the BEACOPP female group, 52.6% in the ABVD male group, and 33.3% in the male BEACOPP group, respectively, of patients attempting conception post-therapy, had children after chemotherapy. Based on these high rates of childbirth following BEACOPP chemotherapy, we have concluded that intensified chemotherapy is not a definite predictor of reduced fertility in young HL patients.

  20. The Optimal Treatment Modality for Taiwan Oral Cavity Cancer Patients-Experience of a Medical Center

    OpenAIRE

    Chun-Ta Liao; Chien-Yu Lin; Kang-Hsing Fan; Hung-Ming Wang

    2015-01-01

    Oral cavity cancer ranks sixth in cancer incidence in Taiwan, and it is the most common malignancy diagnosed in Taiwanese men aged between 30 and 50 years. Despite recent declines in high risk habits, the incidence of oral cavity cancer in Taiwan is still increasing with more than 5000 new cases diagnosed in 2011. Currently, the main treatment modality for oral cavity cancer is surgical excision, either with or without adjuvant therapy. The National Comprehensive Cancer Network (NCCN) guideli...

  1. Endoscopic interventional treatment for gastric schwannoma: a single-center experience.

    Science.gov (United States)

    Li, Bin; Liang, Tiejun; Wei, Lili; Ma, Mingze; Huang, Ya; Xu, Hongwei; Shi, Xiuju; Qin, Chengyong

    2014-01-01

    Endoscopic Interventional Treatment is of little trauma and less complications in the treatment of gastric schwannoma and leads to faster recovery and fewer days of hospitalization. This study was aimed to investigate the safety and efficacy of endoscopic interventional therapy for gastric schwannoma, including endoscopic submucosal excavation, non-laparoscopic-assisted endoscopic full-thickness resection, endoscopic tunneling submucosal resection, and so on. Six patients of gastric schwannoma diagnosed by pathology examination were retrospectively analyzed ranging from Oct 2011 to Feb 2014 at Shandong Provincial Hospital affiliated to Shandong University. Five of the six patients accepted endoscopic interventional therapy. Among the five patients, there were four males and one female, aged from 48 to 65 years old (the average age was 58 ± 6.4). The lesions located at the fundus, the fundus-cardia, gastric body or gastric antrum, respectively, with the diameters ranged from 8 to 25 millimeter (the average was 17.1 ± 7.8 mm). All the patients were performed endoscopic interventional therapy successfully. Among five patients, one patient was treated by endoscopic tunneling submucosal resection, two by endoscopic submucosal excavation, and the other two were given endoscopic full-thickness resection. Operation duration was about 43 to 83 minutes (the average was 57.6 ± 16.1 minutes). The mass were completely removed, with limited bleeding. During the operation, perforation and pneumoperitoneum occurred in two patients, who finally recovered by endoscopic and conservative treatment. No bleeding, inflammation or infection occurred in these patients. The average follow-up time was (7.4 ± 4.4) months. Neither recurrence nor metastasis was found during follow-up. Endoscopic interventional therapy is a safe and effective treatment for gastric schwannoma.

  2. Surgical treatment of bronchial carcinoid tumors: a single-center experience.

    Science.gov (United States)

    Machuca, Tiago Noguchi; Cardoso, Paulo Francisco Guerreiro; Camargo, Spencer Marcantonio; Signori, Leonardo; Andrade, Cristiano Feijó; Moreira, Ana Luiza Schneider; Moreira, José da Silva; Felicetti, José Carlos; Camargo, José Jesus

    2010-11-01

    Bronchial carcinoid is an infrequent neoplasm with a neuroendocrine differentiation. Surgical treatment is the gold standard therapy, with procedures varying from sublobar resections to complex lung sparing broncoplastic procedures. This study evaluates the results of surgical treatment of bronchial carcinoids and its prognostic factors. Retrospective review of 126 consecutive patients who underwent surgical treatment for bronchial carcinoid tumors between December 1974 and July 2007. There were 70 females (55%) and the mean age was 46 years, ranging from 17 to 81 years. Upon clinical presentation, 38 patients (30%) have had recurrent respiratory tract infection, 31 (24%) cough, 16 (12%) chest pain and 25 (20%) were asymptomatic. Preoperative bronchoscopic diagnosis was obtained in 74 cases (58.7%). The procedures performed were: 19 sublobar resections (14,9%), 58 lobectomies (46%), 8 bilobectomies (6.3%), 6 pneumonectomies (4.7%), 2 sleeve segmentectomies (1.5%), 26 sleeve lobectomies (20.6%) and 9 bronchoplastic procedures without lung resection (7.1%). Operative mortality was 1.5% (n = 2) and morbidity was 25.8% (n=32), including 12 respiratory tract infections and 4 reinterventions due to bleeding (3) and pleural empyema (1). Among the 112 patients available for follow-up, the overall survival at 3, 5 and 10 years was 89.2%, 85.5% and 79.8%, respectively. Five and 10-year survival for typical and atypical carcinoids were 91, 89% and 56, 47%, respectively. Overall disease-free survival at 5 years was 91.9% Statistical analysis showed that overall disease-free survival correlated with histology--typical vs. atypical--(p = 0.04) and stage (p = 0.02). Surgery provides safe and adequate treatment to bronchial carcinoid tumors. Histology and stage were the main prognostic factors. Copyright © 2010. Published by Elsevier Ireland Ltd.

  3. Anti-Obesity Sodium Tungstate Treatment Triggers Axonal and Glial Plasticity in Hypothalamic Feeding Centers

    OpenAIRE

    Marta Amigó-Correig; Sílvia Barceló-Batllori; Guadalupe Soria; Alice Krezymon; Alexandre Benani; Luc Pénicaud; Raúl Tudela; Anna Maria Planas; Eduardo Fernández; Maria del Carmen Carmona; Ramon Gomis

    2012-01-01

    [Objective]: This study aims at exploring the effects of sodium tungstate treatment on hypothalamic plasticity, which is known to have an important role in the control of energy metabolism. [Methods]: Adult lean and high-fat diet-induced obese mice were orally treated with sodium tungstate. Arcuate and paraventricular nuclei and lateral hypothalamus were separated and subjected to proteomic analysis by DIGE and mass spectrometry. Immunohistochemistry and in vivo magnetic resonance imaging...

  4. Anti-obesity sodium tungstate treatment triggers axonal and glial plasticity in hypothalamic feeding centers.

    Science.gov (United States)

    Amigó-Correig, Marta; Barceló-Batllori, Sílvia; Soria, Guadalupe; Krezymon, Alice; Benani, Alexandre; Pénicaud, Luc; Tudela, Raúl; Planas, Anna Maria; Fernández, Eduardo; Carmona, Maria del Carmen; Gomis, Ramon

    2012-01-01

    This study aims at exploring the effects of sodium tungstate treatment on hypothalamic plasticity, which is known to have an important role in the control of energy metabolism. Adult lean and high-fat diet-induced obese mice were orally treated with sodium tungstate. Arcuate and paraventricular nuclei and lateral hypothalamus were separated and subjected to proteomic analysis by DIGE and mass spectrometry. Immunohistochemistry and in vivo magnetic resonance imaging were also performed. Sodium tungstate treatment reduced body weight gain, food intake, and blood glucose and triglyceride levels. These effects were associated with transcriptional and functional changes in the hypothalamus. Proteomic analysis revealed that sodium tungstate modified the expression levels of proteins involved in cell morphology, axonal growth, and tissue remodeling, such as actin, CRMP2 and neurofilaments, and of proteins related to energy metabolism. Moreover, immunohistochemistry studies confirmed results for some targets and further revealed tungstate-dependent regulation of SNAP25 and HPC-1 proteins, suggesting an effect on synaptogenesis as well. Functional test for cell activity based on c-fos-positive cell counting also suggested that sodium tungstate modified hypothalamic basal activity. Finally, in vivo magnetic resonance imaging showed that tungstate treatment can affect neuronal organization in the hypothalamus. Altogether, these results suggest that sodium tungstate regulates proteins involved in axonal and glial plasticity. The fact that sodium tungstate could modulate hypothalamic plasticity and networks in adulthood makes it a possible and interesting therapeutic strategy not only for obesity management, but also for other neurodegenerative illnesses like Alzheimer's disease.

  5. Lighting: The Killer App of Village Power

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-01

    This paper looks at lighting systems as the major market for village level power generation. To the consumer it is something which is needed, could come from a much friendlier source, and the issues of affordability, convenience, and reliability are important. To the supplier lighting has an enormous range of potential customers, it opens the opportunity for other services, and even small demand can give big returns. Because the efficiency of the light source is critical to the number of lights which a fixed power supply can drive, it is important to pick the proper type of bulb to use in this system. The paper discusses test results from an array of fluorescent and incadescent lamps, compared with a kerosene lamp. Low wattage fluorescents seem to perform the best.

  6. BERCENI VILLAGE - A SOCIAL-ECONOMICAL ANALYSIS

    Directory of Open Access Journals (Sweden)

    Adina IORGA

    2014-06-01

    Full Text Available Rural modernization aims at maintaining rural societies through occupational diversification that will improvequality of life and avoid rural exodus. It aims to acquire some features of the modern world such as those related totechnical, increased productivity, infrastructure, whereby rural community enriches its identity, acquiring newmeanings.This study is a close social-economical analysis of the countryside households of Berceni village. Berceniis in the southern county of Ilfov near Bucharest. It is based on the statistical data provided by National Institute ofStatistics. The data have been processed into the following indicators:age structure and gender, births and deaths,feminization, migration .Considering that human resources is the main factor in developing and moderinization ofrural space, this study is aimed to investigate as well, the posibility of diversifying inhabitants’ occupationsaccording to pshicologycal, social and economical resources.

  7. Jesus the village psychiatrist: A summary

    Directory of Open Access Journals (Sweden)

    Donald Capps

    2010-02-01

    Full Text Available This paper was a response to a panel discussion on the author’s book, Jesus the village psychiatrist, published by Westminster John Knox Press, Louisville, KY, 2008 which formed part of the Society of Biblical Literature’s Psychology and Biblical Studies Section, 21–24 November 2009, New Orleans, LA. The response consisted of an explanation of somatoform disorders, a summary of the book and the following case studies: the case of Fraulein Elisabeth, the case of paralytics, the case of blind persons, the demon-possessed boy, the case of the woman with a haemorrhage, the healings of lepers and the woman who cared for Jesus. The paper concluded with a discussion on words and their power to cure. It illustrated how symptomatology had changed from paralysis in the 19th century to chronic fatigue in the first half of the 20th century to stress today.

  8. Demographic and clinical profile of substance abusing women seeking treatment at a de-addiction center in north India

    Directory of Open Access Journals (Sweden)

    Naresh Nebhinani

    2013-01-01

    Full Text Available Background: In the recent decades increasing number of women have been seeking deaddiction services. Despite that the report data is very limited from India. Objectives: The present research aimed to study the demographic and clinical profile of women seeking deaddiction treatment at a tertiary care center in North India. Materials and Methods: Retrospective structured chart review of 100 women substance abusers seeking treatment at a deaddiction center between September 1978 and December 2011. Results: A typical case was of 36.3 years age, married (65%, urban (61%, nuclear family (59% based housewife (56%, with good to fair social support (69%. The commonest substance of abuse was tobacco (60%, followed by opioids (27%, alcohol (15%, and benzodiazepines (13%. The common reasons for initiation of substance use were to alleviate frustration or stress (49% and curiosity (37%. Family history of drug dependence (43%, comorbidity (25%, and impairments in health (74%, family (57%, and social domains (56% were common. Only a third of the sample paid one or more follow visit, and of those 58% were abstinent at the last follow-up. Significant predictors identified were being non-Hindu and higher educational years for abstinent status at follow-up. Conclusion: The common substances of abuse were tobacco, opioids, and alcohol and benzodiazepines; and family history of drug abuse and comorbidity were common. The follow-up and outcome were generally poor. This profile gives us some clues to address a hidden health problem of the community.

  9. Compliance with pharmacological treatment in outpatients from a Brazilian cardiology referral center

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Chizzola

    Full Text Available To evaluate the degree of compliance with pharmacological therapy, and to identify predictors of non-compliance in outpatients from a cardiology referral center in São Paulo, Brazil, we studied 485 outpatients, 230 (47.4 percent males and 255 (52.6 percent females, through an interview guided by a questionnaire during medical consultation. The ages ranged between 17 and 86 (mean 54, standard deviation 15 years. Heart disease and socioeconomic factors (residence, means of transport, educational level and professional status were studied. In addition, we examined the drugs prescribed including: difficulties in taking them; the source of supply; and the patient's knowledge of the drugs. Assessment of compliance was based on the patients' response. The patients' answers were compared with the prescription and progress notes. Errors were recorded if the patient reported using one or more nonprescribed medicines. Compliance with therapy was recorded if the patient said the prescription was taken correctly without interruption and without error. The variables with significant differences in univariate analysis were further analyzed by multivariate log-linear regression analysis. Noncompliance occurred in 286 (59 percent of the patients, and was predicted by the reported difficulty in taking medication (P<0.001, and by the lack of knowledge of medication names (P<0.001.Thus, noncompliance with medical therapy was common. The main predictors of non-compliance were the reported difficulty in taking medication and inability to identify medicines' names.

  10. Moving Towards Eco Cultural Tourism Village (A Case Study of Pondok Cabe Village

    Directory of Open Access Journals (Sweden)

    Rina Kurniawati

    2015-09-01

    Full Text Available This study identifies some eco-cultural tourism attraction potentials that exist in PondokCabeUdik Village Tangerang Selatan Indonesia. In addition, it investigates local people’s opinion on tourism development. The objective is to provide a preliminary overview of eco-tourism development. This study is a descriptive study that uses three types of instrument in data collection method, including questionnaire, interview and field observation. The data is then analyzed using SWOT analysis. The result indicated that natural potential include farming, lake and fish pond, and chicken hatchery. Cultural potentials include cultural diversity that depicted in praying houses and culinary. 194 respondents involved are the locals. The result showed thatthere is positive view from the local community on the availability of tourism potentials and development in the future. It is proposed that environmental awareness, education, ecotourism development, and consensus buildingare needed to implement eco cultural tourism concept. Keywords: Tourism, Eco-Cultural, Village, Planning and Development

  11. Mental Health Treatment Barriers among Racial/Ethnic Minority versus White Young Adults 6 Months after Intake at a College Counseling Center

    Science.gov (United States)

    Miranda, Regina; Soffer, Ariella; Polanco-Roman, Lillian; Wheeler, Alyssa; Moore, Alyssa

    2015-01-01

    Objective: This study examined mental health treatment barriers following intake at a counseling center among racially/ethnically diverse college students. Methods: College students (N = 122) seen for intake at a college counseling center in 2012-2013 completed self-reports of depressive symptoms, suicidal ideation, and mental health treatment…

  12. AHP 30: A Namuyi Tibetan Woman's Journey from Chinese Village to Indian City to Beijing

    Directory of Open Access Journals (Sweden)

    Li Xiaoqiong 李小琼 (སྒྲོལ་མ། Drolma

    2014-05-01

    Full Text Available Li Xiaoqiong (Drolma, a Namuyi Tibetan from Liangshan Yi Autonomous Prefecture, Sichuan Province describes her childhood; parents; paternal grandmother's early life and death; village life including children's games, tending horses, and herding yaks; her experiences at primary school; a surrogate grandfather; her youngest brother; local lunar New Year festivities; her time at middle school including a special friend and love letters; her schooling at Qinghai Normal University in Xining City; her time in India including college experiences, travels, working in an NGO, and working at a call center in Delhi; and her return to China. Also included are two original poems, three stories by Li Xiaoqiong's grandmother, and photographs of Li Xiaoqiong's village and of her time in India.

  13. CLINICAL PROFILE AND TREATMENT OF PATIENTS WITH IMMUNE THROMBOCYTOPENIA IN TERTIARY CARE CENTER

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    Devasena

    2015-11-01

    Full Text Available BACKGROUND: Idiopathic Thrombocytopenic purpura is relatively uncommon. It is always diagnosis of exclusion. The demographics of Idiopathic Thrombocytopenic purpura can be very varied. Corelation between platelet count and bleeding manifestations and response to therapy have not been clearly established. AIM: The aim of the study was to study the demographics of Idiopathic Thrombocytopenic Purpura in the south Indian population and to analyze the possible relationship between platelet levels, clinical manifestations and response to treatment. MATERIALS AND METHODS: A prospective study was carried out for two years which included all adults with diagnosis of idiopathic thrombocytopenic purpura. Parameters noted were clinical features with emphasis on site of bleeding. Platelet counts on admission were noted. This was monitored regularly till the time of discharge from hospital.Treatment of all patients was with intravenous methyl prednisolone. Some patients also received intravenous immunoglobulin. RESULTS: Sixty patients were included in the study. Patients with average platelet count of more than 60,000 per cubic millimeter did not have bleeding. 63.3 percent of patients presented with bleeding manisfestations. The average platelet count in the group was 26,605 per cubic millimeter. Most common bleeding manifestation was bleeding gums followed by cutaneous bleeding. 61.7 percent had complete response to treatment, 17.3 percent had partial response and 30 percent had poor response. 8.5 percent underwent splenectomy. Mortality rate was five percent. These patients had average platelet count of less than 15000 cells per cubic milliliter. CONCLUSION: Identification of common clinical presentation and their relationship to platelet count helps identify patients who are at increased risk for fatal bleeding diathesis.

  14. Anti-obesity sodium tungstate treatment triggers axonal and glial plasticity in hypothalamic feeding centers.

    Directory of Open Access Journals (Sweden)

    Marta Amigó-Correig

    Full Text Available This study aims at exploring the effects of sodium tungstate treatment on hypothalamic plasticity, which is known to have an important role in the control of energy metabolism.Adult lean and high-fat diet-induced obese mice were orally treated with sodium tungstate. Arcuate and paraventricular nuclei and lateral hypothalamus were separated and subjected to proteomic analysis by DIGE and mass spectrometry. Immunohistochemistry and in vivo magnetic resonance imaging were also performed.Sodium tungstate treatment reduced body weight gain, food intake, and blood glucose and triglyceride levels. These effects were associated with transcriptional and functional changes in the hypothalamus. Proteomic analysis revealed that sodium tungstate modified the expression levels of proteins involved in cell morphology, axonal growth, and tissue remodeling, such as actin, CRMP2 and neurofilaments, and of proteins related to energy metabolism. Moreover, immunohistochemistry studies confirmed results for some targets and further revealed tungstate-dependent regulation of SNAP25 and HPC-1 proteins, suggesting an effect on synaptogenesis as well. Functional test for cell activity based on c-fos-positive cell counting also suggested that sodium tungstate modified hypothalamic basal activity. Finally, in vivo magnetic resonance imaging showed that tungstate treatment can affect neuronal organization in the hypothalamus.Altogether, these results suggest that sodium tungstate regulates proteins involved in axonal and glial plasticity. The fact that sodium tungstate could modulate hypothalamic plasticity and networks in adulthood makes it a possible and interesting therapeutic strategy not only for obesity management, but also for other neurodegenerative illnesses like Alzheimer's disease.

  15. Pediatric Keratoconus in a Tertiary Referral Center: Incidence, Presentation, Risk Factors, and Treatment.

    Science.gov (United States)

    El-Khoury, Sylvain; Abdelmassih, Youssef; Hamade, Adib; Slim, Elise; Cherfan, Carole G; Chelala, Elias; Bleik, Jamal; Jarade, Elias F

    2016-08-01

    To report the incidence, clinical presentation, risk factors, and treatment outcome of pediatric keratoconus in a tertiary referral eye hospital in Beirut, Lebanon. In this retrospective study, the authors evaluated all patients with keratoconus 14 years or younger newly diagnosed at the Beirut Eye Specialist Hospital, Beirut, Lebanon, between January 2010 and December 2014. The incidence of pediatric keratoconus among all pediatric patients and among patients with keratoconus of all ages was assessed. Patients with pediatric keratoconus were evaluated for keratoconus stage, initial presentation, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), corneal topography, and pachymetry. Patients were classified according to different treatment regimen groups and different follow-up visits were evaluated. During 5 years, 16,808 patients were examined, of whom 2,972 were 14 years or younger. A total of 541 patients were diagnosed as having keratoconus; of those, 16 were 14 years or younger at the time of diagnosis. Hence, the incidence of keratoconus was 0.53% among pediatric patients and 3.78% among adult patients (> 14 years). Initial presentation was during routine checkup (1 of 16) for allergic conjunctivitis (3 of 16), reduced vision (10 of 16), and corneal hydrops (mimicking keratitis) (2 of 16). Except for 2 patients lost to follow-up, all eyes received corneal cross-linking treatment and 16 eyes received additional intracorneal ring segment implantation. The incidence of pediatric keratoconus indicates that increased awareness for keratoconus among children is needed, mainly in cases of family history of keratoconus, ocular allergy/pruritus, poor CDVA, corneal hydrops, and/or high astigmatism. [J Refract Surg. 2016;32(8):534-541.]. Copyright 2016, SLACK Incorporated.

  16. Complications of operative treatment of clavicle fractures in a Level I Trauma Center.

    Science.gov (United States)

    Persico, Federico; Lorenz, Eric; Seligson, David

    2014-08-01

    Traditionally, the belief is that the clavicle heals readily and with nonoperative treatment. Since evidence suggests that many clavicles benefit from operative care, the aim of this study was to find the incidence of complications after operative treatment of clavicle fractures. This retrospective study includes 56 patients (41 male and 15 female) who were treated operatively for clavicle fractures between 2010 and 2012. The indications were displacement more than 20 mm, comminution, tenting of the skin, floating shoulder, and open fractures. Seventy-five percent of the fractures occurred in the midshaft and 25 % in the lateral third of the clavicle. There were no fractures of the medial third. The midshaft fractures were either plated with 3.5 mm reconstruction plates or anatomical locking plates. For internal fixation of the lateral fractures, we used acromioclavicular hook plates. The mean follow-up period was 4.6 months (range 1.0-28.0). Three patients did not participate in the follow-up. There were 12 patients with complications (21 %). Five of them required reoperations. Two patients were reoperated due to clavicle nonunions, two patients due to traumatic refracture of the plated clavicle, and one because of pain caused by the plate. Four cases developed superficial infections, and there was one patient with a deep tissue infection. None of the patients showed signs of neurovascular impairment postoperatively. None of the patients complained about decreased range of motion or loss of muscle strength postoperatively. Plating of clavicle fractures is a procedure that results in lower rates of malunion, nonunion, and functional impairment compared with nonoperative treatment. Nonetheless, one case in ten has a complicated course. Attention to technique and careful follow-up may prevent these problems.

  17. The basotho cultural village: Cultural tourism enterprise or custodian ...

    African Journals Online (AJOL)

    The extent to which the Basotho Cultural Village manages to conserve indigenous knowledge systems was investigated. The research was conducted making use of a knowledge audit. Structured interviews were administered to employees as well as to visitors to the Basotho Cultural Village. The investigation was inspired ...

  18. The Village Green Project: Lesson Plans for K-8 Educators ...

    Science.gov (United States)

    This document contains lesson plans spanning kindergarten through 8th grade, that are written to connect next-generation science standards (USA) to the Village Green Project and related air quality topics. This document contains a series of classroom lesson plans to support connections between the Village Green Project and the USA National Science Standards at various education levels.

  19. Fertility Status of Fadama Soils in Gantsare Village, Wamakko Local ...

    African Journals Online (AJOL)

    A study was conducted in Gantsare village, Wamakko local government, Sokoto state to determine the effect of cement dust emitted from Sokoto cement factory on the fertility of fadama soils. Soil samples were collected in June, 2008 from the eastern, northeastern, and southeastern parts of the village and Girabshi; ...

  20. Fertility Status of Fadama Soils in Gantsare Village, Wamakko Local ...

    African Journals Online (AJOL)

    acer

    ABSTRACT: A study was conducted in Gantsare village, Wamakko local government, Sokoto state to determine the effect of cement dust emitted from Sokoto cement factory on the fertility of fadama soils. Soil samples were collected in June, 2008 from the eastern, northeastern, and southeastern parts of the village and ...

  1. Distributions of soil phosphorus in China's densely populated village landscapes

    Science.gov (United States)

    Jiaguo Jiao; Erle C. Ellis; Ian Yesilonis; Junxi Wu; Hongqing Wang; Huixin Li; Linzhang. Yang

    2010-01-01

    Purpose Village landscapes, which integrate small-scale agriculture with housing, forestry and a host of other land use practices, cover more than 2x106 km2 across China. Village lands tend to be managed at very fine spatial scales (≤30 m), with managers altering soil fertility and even terrain by terracing,...

  2. SOCIO-ECONOMIC CHARACTERISTICS OF FOREST VILLAGES IN ARTVIN

    Directory of Open Access Journals (Sweden)

    Devlet Toksoy

    2008-04-01

    Full Text Available Forest villages have been considered apart from the villagers who live on the other rural areas in Turkey since the last quarter of the XIX th century. This type of villagers is supported to the priority for the forest works and to purchase reduced prize for the forest products. On the other hand these villagers are also instructed and exhorted about the subjects like animal husbandry, carpet business etc. However, these villagers are the poorest part of the society at the moment. This study is based on a direct interview survey which was performed to 100 householders from 15 villages to determine the demographic, social, cultural, economic etc. characteristics of villagers and to assist in reaching positive results by using these characteristics in prepared various plans. According the results, the rate of university education is 4% and the active population corresponds to 70%. The 31% of forest villagers are get along with agriculture, only 1 % of the sampled people are get along with forestry. Furthermore, none of the people thinks that forestry is the first level job opportunity for their future.

  3. The land use diversity of urban villages in Shenzhen

    NARCIS (Netherlands)

    Hao, P.; Geertman, S.C.M.; Hooimeijer, P.; Sliuzas, R.

    2012-01-01

    China’s dynamic urbanisation since 1978 has led to the proliferation of so-called ‘urban villages’ in many cities. Their development, via a self-help approach by indigenous villagers, delivers low-cost housing and various other social and economic activities. Consequently, urban villages are

  4. The Concept of Village Autonomy in Indonesia (Indonesian Constitution Perspective

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    Rifqi Ridlo Phahlevy

    2016-06-01

    Full Text Available Indonesia was introduced to the term, “village autonomy” in 1970s; however, throughout the past years of establishing autonomous villages in Indonesia, the legislators have not been able to provide any clarity about this concept. Villages, as a legal entity, do not have enough independence to represent themselves as an autonomous unit of community in the state administration system of Indonesia. Article 18B and 28I of the second amendment of The 1945 Constitution of The State of Republic of Indonesia (UUD 45 state that the villages can have independent governments, by giving the alternative of village autonomy. Implementation the Law No. 6 Year 2014 is a part of the effort to realize the message of constitution and hence conception of autonomous villages is expected to be the catalyst for this concept. The presence of this law had a considerable impact on the 2014 presidential elections. Because of this people are concerned that political interests may try to drive and turning the direction and purpose of the law. This study is a part of the research on the implementation of village autonomy policies in Indonesia, and is compiled by using statute and conceptual approach. How To Cite: Phahlevy, R. (2016. The Concept of Village Autonomy in Indonesia (Indonesian Constitution Perspective. Rechtsidee, 3(1, 27-40. doi:http://dx.doi.org/10.21070/jihr.v3i1.151

  5. Aromatherapy, used as an integrative tool for crisis management by adolescents in a residential treatment center.

    Science.gov (United States)

    Fowler, Nancy A

    2006-05-01

    Little is known about the acceptance and effectiveness of aromatherapy as a complementary support for agitated and aggressive adolescents. Chi-square test was applied to satisfaction surveys, administration records of p.r.n. medication, aromatherapy, and seclusion/ restraint data. Seventy-seven percent of the population accepted and used aromatherapy for crisis management. A trend indicates this population uses less p.r.n. medication for crisis management. This adolescent population was receptive to using less invasive tools for crisis management. A longitudinal study is needed to determine the long-term efficacy of this treatment modality.

  6. Impact of HIV Status on Treatment Outcome of Tuberculosis Patients Registered at Arsi Negele Health Center, Southern Ethiopia: A Six Year Retrospective Study

    National Research Council Canada - National Science Library

    Gebremariam, Gebreslassie; Asmamaw, Getachew; Hussen, Muktar; Hailemariam, Mengistu Z; Asegu, Demissie; Astatkie, Ayalew; Amsalu, Anteneh G

    2016-01-01

    ...)-associated tuberculosis (TB) remains a challenge in Ethiopia. The aim of this study was to assess the impact of HIV status on treatment outcome of tuberculosis patients registered at Arsi Negele Health Center, Southern Ethiopia...

  7. Diagnosis and treatment of intrahepatic biliary cystadenoma: experience with 14 cases in a single center.

    Science.gov (United States)

    Wang, Kewei; Kong, Fanmin; Dong, Ming; Zhou, Jianping; Li, Yuji

    2014-11-01

    Intrahepatic biliary cystadenoma (IHBCA) is a rare type of liver tumor. There are no specific diagnostic methods for IHBCA, so its preoperative diagnostic rate is still fairly low. The aims of this study were to evaluate the clinical manifestations, diagnosis, and treatment of IHBCA. We retrospectively analyzed data from 14 patients treated in our hospital from January 2004 to April 2014. Eleven patients (78.6 %) were female, and the average age was 48.0 years (range 16-77 years). The most common clinical symptoms were abdominal discomfort (i.e., abdominal pain), reported in seven cases (50 %), and fullness after eating, reported in two cases (14.3 %). Jaundice was a less common symptom reported in one case (7.1 %). Four patients (28.6 %) were asymptomatic. Enhanced computed tomography (CT) scan showed multilocular or internal septations in 11 cases (78.6 %) and papillary projections or mural nodules on the cyst wall in one case (7.1 %). After injection of a contrast agent, the cyst walls or septations were slightly enhanced in nine cases (64.3 %). All 14 patients underwent surgical resection. Only one case showed recurrence (2 years postoperatively); the remaining 13 patients were recurrence-free. Intrahepatic biliary cystadenoma often occurs in middle-aged women. The main clinical symptoms are abdominal fullness with a sense of pain and jaundice. Enhanced CT is the main preoperative diagnostic method. Radical resection is the best treatment for IHBCA and can effectively prevent recurrence.

  8. Evaluation and treatment of cardiovascular diseases in patients on hemodialysis – single center experience

    Directory of Open Access Journals (Sweden)

    Halima Resić

    2011-02-01

    Full Text Available Aim To evaluate frequency of CVD in dialysis population, in relationship to patients with and without diabetes, and their mostcommon treatment. Patients and methods This retrospective study included 187 patients, 106 males and 81 females, divided in two groups, diabetics and non-diabetics, treated by chronic hemodialysis. Patients’ analyses included: anamnesis, ECG, chest X rays, echocardiogram, laboratory examinations for calcium (Ca, phosphorus (P, parathormone (PTH, cholesterol (chol, triglicerids (TG, C-reactive protein (CRP, hemoglobin (Hb and uric acid. In addition, we analyzed groups of drugs used by patients as prescribed by cardiologists. Results Average age was 58.0 years, most of them between 51 and 60. Average hemodialysis length was 4 years. Primary kidney diseases were pyelonephritis and glomerulonephritis. 19,78% ofpatients had diabetes. 165 patients (88,23% had one or more cardiovascular diseases. 110 patients (58,2% had hypertension, mostof them used ACE inhibitors. Using test of multiple correlation,statistically signiicant correlations, among others, were shown between BMI and Ca, uric acid and P, albumin and PTH in diabetics, at the statistical signiicance level at p<0,05. Conclusion Cardiovascular diseases are the most common comorbidity and cause of mortality in hemodialysis population. There was no statistical signiicance in age, however there is a statistical difference in the dialysis duration variable, but in some biochemical laboratory parameters there was some difference. ACE inhibitors were most commonly used in the treatment of hypertension and systolic dysfunction, alone or with beta-blockers.

  9. The impact of Vascular Access on the Adequacy of Dialysis and the Outcome of the Dialysis Treatment: One Center Experience.

    Science.gov (United States)

    Mutevelic, Alma; Spanja, Indira; Sultic-Lavic, Indira; Koric, Amila

    2015-04-01

    Chronic kidney disease (CKD) is a gradually reduction in glomerular filtration rate (GFR) caused by destruction of a large number of nephrons. Kidney failure is the final stage of CKD with GFR vascular access, which is also the "life line" and "Achilles heel" of hemodialysis treatment. The purpose of this research is to show the demographic structure of the hemodialysis center in Konjic, and also demonstrate the impact of vascular access to the adequacy and the outcome of dialysis treatment. This cross-sectional study included 36 patients on hemodialysis in Center in Konjic from September 2010 to December 2014. The method of collecting data is performed through medical records and the quality of dialysis is taken to be Kt/V> 1.2. Statistical analysis was performed using SPSS software and Student T-test. The mortality of patients treated by dialysis is 37.8%. The ratio of male and female patients is 55.6% vs. 44.5%, with an average age of 52.91±14.36 years and an average duration of hemodialysis of five years. The highest percentage of patients dialyzed through arterio-venous fistula (AVF) on the forearm (72.2%). In that patients the most common complication is thrombosis with 30.5%, which require recanalization in 11% and replacement in 19.5% of patients. Of the other dialysis patients, 16.7% of patients are dialyzed via a temporary and 11.1% via a permanent catheter (the most common complication in that patients is infection in 83.3% cases) in v.subclavia. Although the AVF is more frequently, experience shows frequent implantation of a permanent catheter in elderly patients due to the less quality of their blood vessels. Although the Kt/V by patients who are dialyzed through temporary catheter is less than 1.2 and by the other two access is greater than 1.2, our results confirm that vascular access does not have an influence on quality of dialysis. Average Kt/V shows that the adequate dialysis dose is delivered in this Center, which means that despite the impact

  10. Astronomy Village: Innovative Uses of Planetary Astronomy Images and Data

    Science.gov (United States)

    Croft, S. K.; Pompea, S. M.

    2008-06-01

    Teaching and learning science is best done by hands-on experience with real scientific data and real scientific problems. Getting such experiences into public and home-schooling classrooms is a challenge. Here we describe two award-winning multimedia products that embody one successful solution to the problem: Astronomy Village: Investigating the Universe, and Astronomy Village: Investigating the Solar System. Each Village provides a virtual environment for inquiry-based scientific exploration of ten planetary and astronomical problems such as ``Mission to Pluto'' and ``Search for a Supernova.'' Both Villages are standards-based and classroom tested. Investigating the Solar System is designed for middle and early high school students, while Investigating the Universe is at the high school and introductory college level. The objective of both Villages is to engage students in scientific inquiry by having them acquire, explore, and analyze real scientific data and images drawn from real scientific problems.

  11. Implementation of a Brief Treatment Counseling Toolkit in Federally Qualified Healthcare Centers: Patient and Clinician Utilization and Satisfaction.

    Science.gov (United States)

    Brooks, Adam C; Chambers, Jaclyn E; Lauby, Jennifer; Byrne, Elizabeth; Carpenedo, Carolyn M; Benishek, Lois A; Medvin, Rachel; Metzger, David S; Kirby, Kimberly C

    2016-01-01

    The need to integrate behavioral health care within medical settings is widely recognized, and integrative care approaches are associated with improved outcomes for a range of disorders. As substance use treatment integration efforts expand within primary care settings, training behavioral health providers in evidence-based brief treatment models that are cost-effective and easily fit within the medical flow is essential. Guided by principles drawn from Diffusion of Innovations theory (Rogers, 2003) and the Consolidated Framework of Implementation Research (Damschroder et al., 2009), we adapted elements of Motivational Enhancement Therapy, cognitive-behavioral therapy, and 12-step facilitation into a brief counseling toolkit. The toolkit is a menu driven assortment of 35 separate structured clinical interventions that each include client takeaway resources to reinforce brief clinical contacts. We then implemented this toolkit in the context of a randomized clinical trial in three Federally Qualified Healthcare Centers. Behavioral Health Consultants (BHCs) used a pre-screening model wherein 10,935 patients received a brief initial screener, and 2011 received more in-depth substance use screening. Six hundred patients were assigned to either a single session brief intervention or an expanded brief treatment encompassing up to five additional sessions. We conducted structured interviews with patients, medical providers, and BHCs to obtain feedback on toolkit implementation. On average, patients assigned to brief treatment attended 3.29 sessions. Fifty eight percent of patients reported using most or all of the educational materials provided to them. Patients assigned to brief treatment reported that the BHC sessions were somewhat more helpful than did patients assigned to a single session brief intervention (p=.072). BHCs generally reported that the addition of the toolkit was helpful to their work in delivering screening and brief treatment. This work is significant

  12. Outpatient Satisfaction With Osteopathic Manipulative Treatment in a Hospital Center: A Survey.

    Science.gov (United States)

    Tramontano, Marco; Martino Cinnera, Alex; Petracca, Marco; Gaeta, Angela; Tamburella, Federica; Audouard, Maurice; Caltagirone, Carlo

    2017-10-28

    Context • Although osteopathy is not yet certified as a health profession in Italy, many people choose osteopathic manipulative treatment (OMT) for pain relief. Nevertheless, no study evaluating patients' degree of satisfaction after OMT and the perceived quality of the treatment has occurred in Italy. Objectives • The study intended to assess outpatients' satisfaction with OMT carried out at a hospital. Design • The research team conducted a survey from January 2015 to January 2016 using 3 questionnaires. Setting • The study took place the Fondazione Santa Lucia Hospital (Rome, Italy), an institute for research and health care. Participants • Participants were 101 patients with musculoskeletal (MSK) disorders undergoing OMT at the hospital. Interventions • The OMT was performed by 3 osteopathic practitioners who had completed the 6-y, part-time training program recognized by the Italian Register of Osteopaths. Outcome Measures • To measure the level of their satisfaction, the research team had patients complete the modified patient satisfaction questionnaire (mPSQ), the patient satisfaction with outpatient physical therapy (PSOPT) instrument, and the visual analog scale for satisfaction (VASS). Parametric and nonparametric analyses were performed to correlate the questionnaires and the demographic variables using the Pearson and Spearman tests. Results • Data were obtained from 97 patients, with mean age of 42.48 ± 16.1 y, 50 of whom were female. The data showed high, average general satisfaction after OMT: (1) VASS-9.36 ± 1.00 and (2) PSOPT-43.27 ± 3.65. A significant negative correlation was found between access to care (D1-TOT) on the mPSQ and at ages older than 65 y-r = -0.24 and P < .05. A significant positive correlation was found between the VASS and female gender-r = 0.23 and P < .05. A significant positive correlation was also found between continuity of care (D3-TOT) and continuity of care-family (D3-1) on the mPSQ and education level

  13. [Multi-center study on the treatment of sudden deafness accompanied with tinnitus].

    Science.gov (United States)

    Zhao, Hui; Dong, Hong; Cheng, Yan; Ma, Yuanxu; Lin, Peng; Zhong, Shixun; Kang, Houyong; Qian, Yi; Hu, Guohua

    2015-06-01

    To investigate the clinical characteristics and the effects of different drug therapies in patients of sudden deafness accompanied with tinnitus. The international standardized clinical research methods, the unified design and program were used in the study. The patients of sudden deafness accompanied with tinnitus, aged between 18 to 65 years old, were recruited, whose duration was less than two weeks with no medication. The patients were divided into four types according to the hearing curve: type A was acute sensorineural hearing loss in low tone frequencies, type B was acute sensorineural hearing loss in high tone frequencies, type C was acute sensorineural hearing loss in all frequencies and type D was total deafness. Each type had four different treatment programs, based on the unified designed randomized table. A total of 1024 cases with single side sudden deafness were recruited in the study by 33 hospitals in China from August 2007 to October 2011. Among the 1024 cases, 922 cases were accompanied with tinnitus (90.04%). By classification of audiogram, among the 922 cases, 169 cases were type A (82.44%), 127 cases were type B (90.07%), 370 cases were type C (92.04%), and 256 cases were type D (92.75%). The tinnitus mostly was persistent and low tone tinnitus. The degree of the tinnitus was mostly 2-3 grade. The curative effects of different types were analyzed, type A had the highest rate of 96.18%, type C was 87.75%, type B was 81.51%, and type D had the lowest rate of 75.32%. Significant difference of curative rate between different types was detected (χ² = 125.33, P = 0.000). There had no significant difference between the four different treatment groups (all P > 0.05). In the cases with single side sudden deafness accompanied with tinnitus, the type in low tone frequencies has the best curative effect, followed by the type in all frequencies. The type in high tone frequencies and the total deafness type have poor curative results. The steroid plays a

  14. Geographic information system (GIS) maps and malaria control monitoring: intervention coverage and health outcome in distal villages of Khammouane province, Laos

    Science.gov (United States)

    Shirayama, Yoshihisa; Phompida, Samlane; Shibuya, Kenji

    2009-01-01

    Background Insecticide-treated nets (ITNs) are a key intervention to control malaria. The intervention coverage varies as a consequence of geographical accessibility to remote villages and limitations of financial and human resources for the intervention. People's adherence to the intervention, i.e., proper use of ITNs, also affects malaria health outcome. The study objective is to explore the impact of the intervention coverage and people's adherence to the intervention on malaria health outcome among targeted villages in various geographic locations. Methods Geographic information system (GIS) maps were developed using the data collected in an active case detection survey in Khammouane province, Laos. The survey was conducted using rapid diagnostic tests (RDTs) and a structured questionnaire at 23 sites in the province from June to July, the rainy season, in 2005. A total of 1,711 villagers from 403 households participated in the survey. Results As indicated on the GIS maps, villages with malaria cases, lower intervention coverage, and lower adherence were identified. Although no malaria case was detected in most villages with the best access to the district center, several cases were detected in the distal villages, where the intervention coverage and adherence to the intervention remained relatively lower. Conclusion Based on the data and maps, it was demonstrated that malaria remained unevenly distributed within districts. Balancing the intervention coverage in the distal villages with the overall coverage and continued promotion of the proper use of ITNs are necessary for a further reduction of malaria cases in the province. PMID:19772628

  15. Geographic information system (GIS maps and malaria control monitoring: intervention coverage and health outcome in distal villages of Khammouane province, Laos

    Directory of Open Access Journals (Sweden)

    Shibuya Kenji

    2009-09-01

    Full Text Available Abstract Background Insecticide-treated nets (ITNs are a key intervention to control malaria. The intervention coverage varies as a consequence of geographical accessibility to remote villages and limitations of financial and human resources for the intervention. People's adherence to the intervention, i.e., proper use of ITNs, also affects malaria health outcome. The study objective is to explore the impact of the intervention coverage and people's adherence to the intervention on malaria health outcome among targeted villages in various geographic locations. Methods Geographic information system (GIS maps were developed using the data collected in an active case detection survey in Khammouane province, Laos. The survey was conducted using rapid diagnostic tests (RDTs and a structured questionnaire at 23 sites in the province from June to July, the rainy season, in 2005. A total of 1,711 villagers from 403 households participated in the survey. Results As indicated on the GIS maps, villages with malaria cases, lower intervention coverage, and lower adherence were identified. Although no malaria case was detected in most villages with the best access to the district center, several cases were detected in the distal villages, where the intervention coverage and adherence to the intervention remained relatively lower. Conclusion Based on the data and maps, it was demonstrated that malaria remained unevenly distributed within districts. Balancing the intervention coverage in the distal villages with the overall coverage and continued promotion of the proper use of ITNs are necessary for a further reduction of malaria cases in the province.

  16. Geographic information system (GIS) maps and malaria control monitoring: intervention coverage and health outcome in distal villages of Khammouane province, Laos.

    Science.gov (United States)

    Shirayama, Yoshihisa; Phompida, Samlane; Shibuya, Kenji

    2009-09-22

    Insecticide-treated nets (ITNs) are a key intervention to control malaria. The intervention coverage varies as a consequence of geographical accessibility to remote villages and limitations of financial and human resources for the intervention. People's adherence to the intervention, i.e., proper use of ITNs, also affects malaria health outcome. The study objective is to explore the impact of the intervention coverage and people's adherence to the intervention on malaria health outcome among targeted villages in various geographic locations. Geographic information system (GIS) maps were developed using the data collected in an active case detection survey in Khammouane province, Laos. The survey was conducted using rapid diagnostic tests (RDTs) and a structured questionnaire at 23 sites in the province from June to July, the rainy season, in 2005. A total of 1,711 villagers from 403 households participated in the survey. As indicated on the GIS maps, villages with malaria cases, lower intervention coverage, and lower adherence were identified. Although no malaria case was detected in most villages with the best access to the district center, several cases were detected in the distal villages, where the intervention coverage and adherence to the intervention remained relatively lower. Based on the data and maps, it was demonstrated that malaria remained unevenly distributed within districts. Balancing the intervention coverage in the distal villages with the overall coverage and continued promotion of the proper use of ITNs are necessary for a further reduction of malaria cases in the province.

  17. [Treatment of acute myeloid leukemia -- a single center experience (2007-2013)].

    Science.gov (United States)

    Selmeczi, Anna; Udvardy, Miklós; Illés, Arpád; Telek, Béla; Kiss, Attila; Batár, Péter; Reményi, Gyula; Szász, Róbert; Ujj, Zsófia; Márton, Adrienn; Ujfalusi, Anikó; Hevessy, Zsuzsanna; Pinczés, László; Bedekovics, Judit; Rejtő, László

    2014-04-27

    Mortality of acute myeloid leukemia is still 60-70% in young (myeloid leukemia. From 2007 to 2013, 173 patients with acute myeloid leukemia were treated. Patients were classified according to the European LeukemiaNet prognostic guideline. Association between mortality and the type of acute myeloid leukemia (secondary or primary), dose of daunoblastin at induction of treatment, and the rate of minimal residual disease were investigated. The 5-year survival probability was 25% in young adults and 2% in the elderly. The survival was significantly influenced by these prognostic factors. The 5-year survival rate was 50% in the young, favorable prognostic group. The 90 mg/m2 daunoblastin dose was found to be beneficial. Addition of bortezomib to the standard induction protocol had an additional beneficial effect. The speed and depth of the response to induction therapy, and the initial white blood cell count had an apparent effect on survival.

  18. Comparison of extramedullary and intramedullary devices for treatment of subtrochanteric femoral fractures at tertiary level center

    Directory of Open Access Journals (Sweden)

    Yadav Sanjay

    2014-06-01

    Full Text Available Objective: The treatment of subtrochanteric fractures is challenging and treatment modalities and implants are constantly evolving. This study attempts to revisit and compare extramedullary vs. intramedullary devices in relatively young population. Methods: Thirty patients with subtrochanteric fractures were enrolled and treated with extramedullary or intramedullary devices and follow-up continued one year for clinico-radiological assessment. Results: The mean age of patients was 37.53 years. Most were males between 21-40 years old. The dominant mode of injury was traffic accidents (66%. Fractures were classifi ed according to Russell-Taylor classifi cation. Forty percent were Russell-Taylor type IA, 37% type IB and 23% type IIA. Average time to surgery was 3.6 days from the time of admission to hospital. Mean duration of surgery was 45 minutes for intramedullary device (group A and 105 minutes for extramedullary device (group B. Average blood loss was 100 ml in group A and 200 ml in group B. Mean duration of radiation exposure was 130 seconds and 140 seconds for groups A and B, while average duration of hospital stay was 12 days and 16 days respectively. Excellent results were seen in 47% of cases in group A and 33% of cases in group B. Conclusion: Intramedullary device is a reliable implant for subtrochanteric fractures. It has high rates of union with minimal soft-tissue damage. Intramedullary fixation has biological and biomechanical advantages, but surgery is technically demanding. Gradual learning and patience is needed to make this method truly rewarding. Key words: Subtrochanteric fractures; Intramedullary; Dynamic hip screw

  19. DIAGNOSTIC AND MEDICAL TREATMENT OF RABIES DISEASE IN HEALTH CENTER OF COMMUNITY

    Directory of Open Access Journals (Sweden)

    Raflizar Raflizar

    2012-11-01

    Full Text Available In Indonesia, Rabies is still considered as the most common zoonotic disease. It is not due to the number of death cases but to the number of human cases of human bitten by rabies virus infected animals or suspected ones. Most of human rabies cases caused by dog bites, besides cat and monkey bites. If rabies can be eliminated from dogs, rabies in cats and monkeys can also be eliminated as spontaneous rabies in these two animals are rare. Rabies is caused by an RNA virus from Rhabdowidae Family and it attacks the central nervous system. It is almost invariably fatal if post-exposure prophylaxis is not administered prior to the onset of severe symptoms in unvaccinated people Diagnose is based on the history of close contacts to infected saliva (via bites or scratches and development of signs and symptoms. The early stage symptoms are fever. malaise, followed by agitation, abnormal behaviours, anxiety, hallucination, progressing to delirium, hypersalivalion, hydrophobia, aerophobia, neurological symptoms such as pharynx spasm. paralysis, seizure, and finally death. Laboratory test to detect rabies virus in saliva can be done by a Reverse transcription followed by Polymerase Cham Reaction (RT/PCR and virus isolation in cultured tissues. Skin biopsies of hair follicles at nape of the neck are exammed for rabies antigen in cutaneous nerves at the base of hair follicles by immunofluoresence staining. The treatment after exposure are cleansing lesion, administering intradermal anti-rabies immunization to accelerate immune response. anti-rabies serum to stop infection process, intravenous and intraventricular ribavirin and alfa interferon, high concentration of ketamine infusion to inhibit rabies virus replication. At last, vaccination is the best prevention. Key words: rabies, RNA-virus, vaccination, diagnosis, treatment

  20. Treatment and Follow Up Outcomes of Patients with Peroneal Nerve Injury: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Yasar Dagistan

    2017-01-01

    Full Text Available Aim: Trap neuropathy is characterized by compression of the peripheral nerve into fibro osseous channels in trespassing areas of body segments. Peroneal nerve is the most frequently injured nerve in traumatic injuries of the lower extremities. In the present study, we investigated functional results of surgical treatment of patients with peroneal nerve injury who delayed visiting our clinics after the damage; we also aimed to observe the effects of this delay on prognosis. We interpreted postoperative results of the patients with EMG and physical examination findings. Material and Method: Subjects with peroneal nerve damage who visited our clinics between 2012 and 2015 were included in the present study. EMG and muscle motor strength tests were conducted pre and postoperatively for clinical assessment. Results: Of the 16 patients in the study population, 7 were men and 9 were women. The median age of the subjects was 49.6 years (14-77 years. Admission time was 9 months after injury. Causes of the peroneal nerve damage were as follows: prosthesis surgery in 4 (25%, ankle damage in 2 (12.5%, excessive squatting by agriculture workers in 4 (25%, aggressive exercise in 2 (12.5%, bone fracture in 2 (12.5%, and unknown origin in 2 (12.5%. Discussion: Peroneal nerve injury usually occurs by compression of the nerve at the head or neck of the fibula. Results of decompression surgery are usually compromising in non-traumatic nerve palsies. Period of duration between injury and diagnosis and muscular atrophy are main factors associated with success of treatment.

  1. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: A survey in 66 neurotrauma centers participating in the CENTER-TBI study

    NARCIS (Netherlands)

    M.C. Cnossen (Maryse); Huijben, J.A. (Jilske A.); van der Jagt, M. (Mathieu); Volovici, V. (Victor); van Essen, T. (Thomas); S. Polinder (Suzanne); D. Nelson (David); Ercole, A. (Ari); Stocchetti, N. (Nino); Citerio, G. (Giuseppe); W.C. Peul (Wilco); A.I.R. Maas (Andrew I.R.); D.K. Menon (David ); E.W. Steyerberg (Ewout W.); Lingsma, H.F. (Hester F.); Adams, H. (Hadie); Alessandro, M. (Masala); J.E. Allanson (Judith); Amrein, K. (Krisztina); Andaluz, N. (Norberto); N. Andelic (Nada); Andrea, N. (Nanni); L. Andreassen (Lasse); Anke, A. (Audny); Antoni, A. (Anna); Ardon, H. (Hilko); Audibert, G. (Gérard); Auslands, K. (Kaspars); Azouvi, P. (Philippe); Baciu, C. (Camelia); Bacon, A. (Andrew); Badenes, R. (Rafael); Baglin, T. (Trevor); R.H.M.A. Bartels (Ronald); P. Barzo (P.); Bauerfeind, U. (Ursula); R. Beer (Ronny); Belda, F.J. (Francisco Javier); B.-M. Bellander (Bo-Michael); A. Belli (Antonio); Bellier, R. (Rémy); H. Benali (Habib); Benard, T. (Thierry); M. Berardino (Maurizio); L. Beretta (Luigi); Beynon, C. (Christopher); Bilotta, F. (Federico); H. Binder (Harald); Biqiri, E. (Erta); Blaabjerg, M. (Morten); Lund, S.B. (Stine Borgen); Bouzat, P. (Pierre); Bragge, P. (Peter); Brazinova, A. (Alexandra); F. Brehar (Felix); Brorsson, C. (Camilla); Buki, A. (Andras); M. Bullinger (Monika); Bucková, V. (Veronika); Calappi, E. (Emiliana); P. Cameron (Peter); Carbayo, L.G. (Lozano Guillermo); Carise, E. (Elsa); K.L.H. Carpenter (Keri L.H.); Castaño-León, A.M. (Ana M.); Causin, F. (Francesco); Chevallard, G. (Giorgio); A. Chieregato (Arturo); G. Citerio (Giuseppe); Cnossen, M. (Maryse); M. Coburn (Mark); J.P. Coles (Jonathan P.); Cooper, J.D. (Jamie D.); Correia, M. (Marta); A. Covic (Amra); N. Curry (Nicola); E. Czeiter (Endre); M. Czosnyka (Marek); Dahyot-Fizelier, C. (Claire); F. Damas (François); P. Damas (Pierre); H. Dawes (Helen); De Keyser, V. (Véronique); F.D. Corte (Francesco); B. Depreitere (Bart); Ding, S. (Shenghao); D.W.J. Dippel (Diederik); K. Dizdarevic (Kemal); Dulière, G.-L. (Guy-Loup); Dzeko, A. (Adelaida); G. Eapen (George); Engemann, H. (Heiko); A. Ercole (Ari); P. Esser (Patrick); Ezer, E. (Erzsébet); M. Fabricius (Martin); V.L. Feigin (V.); Feng, J. (Junfeng); Foks, K. (Kelly); F. Fossi (Francesca); Francony, G. (Gilles); J. Frantzén (Janek); Freo, U. (Ulderico); S.K. Frisvold (Shirin Kordasti); Furmanov, A. (Alex); Gagliardo, P. (Pablo); D. Galanaud (Damien); G. Gao (Guoyi); K. Geleijns (Karin); A. Ghuysen (Alexandre); Giraud, B. (Benoit); Glocker, B. (Ben); Gomez, P.A. (Pedro A.); Grossi, F. (Francesca); R.L. Gruen (Russell); Gupta, D. (Deepak); J.A. Haagsma (Juanita); E. Hadzic (Ermin); I. Haitsma (Iain); J.A. Hartings (Jed); R. Helbok (Raimund); E. Helseth (Eirik); Hertle, D. (Daniel); S. Hill (Sean); Hoedemaekers, A. (Astrid); S. Hoefer (Stefan); P.J. Hutchinson (Peter J.); Håberg, K.A. (Kristine Asta); B.C. Jacobs (Bart); Janciak, I. (Ivan); K. Janssens (Koen); Jiang, J.-Y. (Ji-Yao); Jones, K. (Kelly); Kalala, J.-P. (Jean-Pierre); Kamnitsas, K. (Konstantinos); Karan, M. (Mladen); Karau, J. (Jana); A. Katila (Ari); M. Kaukonen (Maija); Keeling, D. (David); Kerforne, T. (Thomas); N. Ketharanathan (Naomi); Kettunen, J. (Johannes); Kivisaari, R. (Riku); A.G. Kolias (Angelos G.); Kolumbán, B. (Bálint); E.J.O. Kompanje (Erwin); D. Kondziella (Daniel); L.-O. Koskinen (Lars-Owe); Kovács, N. (Noémi); F. Kalovits (Ferenc); A. Lagares (Alfonso); L. Lanyon (Linda); S. Laureys (Steven); Lauritzen, M. (Martin); F.E. Lecky (Fiona); C. Ledig (Christian); R. Lefering; V. Legrand (Valerie); Lei, J. (Jin); L. Levi (Leon); R. Lightfoot (Roger); H.F. Lingsma (Hester); D. Loeckx (Dirk); Lozano, A. (Angels); Luddington, R. (Roger); Luijten-Arts, C. (Chantal); Maas, A.I.R. (Andrew I.R.); MacDonald, S. (Stephen); MacFayden, C. (Charles); M. Maegele; M. Majdan (Marek); Major, S. (Sebastian); A. Manara (Alex); Manhes, P. (Pauline); G. Manley (Geoffrey); Martin, D. (Didier); C. Martino (Costanza); Maruenda, A. (Armando); H. Maréchal (Hugues); Mastelova, D. (Dagmara); Mattern, J. (Julia); McMahon, C. (Catherine); Melegh, B. (Béla); Menon, D. (David); T. Menovsky (Tomas); Morganti-Kossmann, C. (Cristina); Mulazzi, D. (Davide); Mutschler, M. (Manuel); H. Mühlan (Holger); Negru, A. (Ancuta); Nelson, D. (David); E. Neugebauer (Eddy); V.F. Newcombe (Virginia F.); Noirhomme, Q. (Quentin); Nyirádi, J. (József); M. Oddo (Mauro); A.W. Oldenbeuving; M. Oresic (Matej); Ortolano, F. (Fabrizio); A. Palotie (Aarno); P.M. Parizel; Patruno, A. (Adriana); J.-F. Payen (Jean-François); Perera, N. (Natascha); V. Perlbarg (Vincent); Persona, P. (Paolo); Peul, W. (Wilco); N. Pichon (Nicolas); Piilgaard, H. (Henning); A. Piippo (Anna); S.P. Floury (Sébastien Pili); M. Pirinen (Matti); H. Ples (Horia); Polinder, S. (Suzanne); Pomposo, I. (Inigo); M. Psota (Marek); P. Pullens (Pim); L. Puybasset (Louis); A. Ragauskas (Arminas); R. Raj (Rahul); Rambadagalla, M. (Malinka); Rehorcíková, V. (Veronika); J.K.J. Rhodes (Jonathan K.J.); S. Richardson (Sylvia); S. Ripatti (Samuli); S. Rocka (Saulius); Rodier, N. (Nicolas); Roe, C. (Cecilie); Roise, O. (Olav); C.M.A.A. Roks (Gerwin); Romegoux, P. (Pauline); J. Rosand (Jonathan); Rosenfeld, J. (Jeffrey); C. Rosenlund (Christina); G. Rosenthal (Guy); R. Rossaint (Rolf); S. Rossi (Sandra); Rostalski, T. (Tim); D. Rueckert (Daniel); de Ruiz, A.F. (Arcaute Felix); M. Rusnák (Martin); Sacchi, M. (Marco); Sahakian, B. (Barbara); J. Sahuquillo (Juan); O. Sakowitz (Oliver); Sala, F. (Francesca); Sanchez-Pena, P. (Paola); Sanchez-Porras, R. (Renan); Sandor, J. (Janos); Santos, E. (Edgar); N. Sasse (Nadine); Sasu, L. (Luminita); Savo, D. (Davide); I.B. Schipper (Inger); Schlößer, B. (Barbara); S. Schmidt (Silke); Schneider, A. (Annette); H. Schoechl (Herbert); G.G. Schoonman; Rico, F.S. (Frederik Schou); E. Schwendenwein (Elisabeth); Schöll, M. (Michael); Sir, O. (özcan); T. Skandsen (Toril); Smakman, L. (Lidwien); D. Smeets (Dominique); Smielewski, P. (Peter); Sorinola, A. (Abayomi); E. Stamatakis (Emmanuel); S. Stanworth (Simon); Stegemann, K. (Katrin); Steinbüchel, N. (Nicole); R. Stevens (Robert); W. Stewart (William); E.W. Steyerberg (Ewout); N. Stocchetti (Nino); Sundström, N. (Nina); Synnot, A. (Anneliese); J. Szabó (József); J. Söderberg (Jeannette); F.S. Taccone (Fabio); Tamás, V. (Viktória); Tanskanen, P. (Päivi); A. Tascu (Alexandru); Taylor, M.S. (Mark Steven); Te, A.B. (Ao Braden); O. Tenovuo (Olli); Teodorani, G. (Guido); A. Theadom (Alice); Thomas, M. (Matt); D. Tibboel (Dick); C.M. Tolias (Christos M.); Tshibanda, J.-F.L. (Jean-Flory Luaba); Tudora, C.M. (Cristina Maria); P. Vajkoczy (Peter); Valeinis, E. (Egils); Hecke, W.V. (Wim Van); Praag, D.V. (Dominique Van); Dirk, V.R. (Van Roost); Vlierberghe, E.V. (Eline Van); Vyvere, T.V. (Thijs vande); Vanhaudenhuyse, A. (Audrey); A. Vargiolu (Alessia); E. Vega (Emmanuel); J. Verheyden (Jan); Vespa, P.M. (Paul M.); A. Vik (Anne); R. Vilcinis (Rimantas); Vizzino, G. (Giacinta); C.L.A.M. Vleggeert-Lankamp (Carmen); V. Volovici (Victor); P. Vulekovic (Peter); Vámos, Z. (Zoltán); Wade, D. (Derick); Wang, K.K.W. (Kevin K.W.); Wang, L. (Lei); E.D. Wildschut (Enno); G. Williams (Guy); Willumsen, L. (Lisette); Wilson, A. (Adam); Wilson, L. (Lindsay); Winkler, M.K.L. (Maren K.L.); P. Ylén (Peter); Younsi, A. (Alexander); M. Zaaroor (Menashe); Zhang, Z. (Zhiqun); Zheng, Z. (Zelong); Zumbo, F. (Fabrizio); de Lange, S. (Stefanie); G.C.W. De Ruiter (Godard C.W.); den Boogert, H. (Hugo); van Dijck, J. (Jeroen); T.A. van Essen (T.); C.M. van Heugten (Caroline M.); M. van der Jagt (Mathieu); J. van der Naalt (Joukje)

    2017-01-01

    textabstractBackground: No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP)

  2. Relégation au village

    Directory of Open Access Journals (Sweden)

    Nicolas Renahy

    2010-12-01

    Full Text Available Les thèses de l’individualisation des sociétés occidentales, ou de l’exclusion de ceux qui resteraient en marge d’une vaste classe moyenne aux modes de vie homogénéisés, ont sans doute permis de sortir d’une grille de lecture rigide héritée du marxisme. Mais elles résistent aujourd’hui mal aux faits et sont vivement contredites par le renouvellement des études sur les inégalités sociales pensées en termes de stratification. Enquêtant la population ouvrière d’un village industriel de Bourgogne au cours des années 1990, l’auteur a pu mesurer tout autant la force socialisatrice continue du groupe ouvrier sur sa jeunesse que le lent processus de délitement de ses cadres de références, longtemps stabilisés autour d’une mono-industrie métallurgique, provoquant une crise dans la reproduction de ce monde ouvrier. C’est cette crise de reproduction qui est évoquée ici. Dans un premier temps sont explicitées les formes passées de la présence industrielle au village, qui n’a jamais été celle d’un bastion de la grande industrie – la population locale n’est pas structurellement différenciée de celle de son environnement rural immédiat. L’exemple d’une lignée familiale d’artisans montre pour finir l’étroit maillage entre usine et structures sociales plus classiquement rurales, favorisant la constitution d’un capital d’autochtonie, déclinaison populaire du capital social.Relegation to the villageArguments demonstrating the individualisation of western societies, or the exclusion of those who stay on the margins of a vast middle class homogeneous life style, have no doubt allowed the move away from the rigid interpretations inherited from Marxism. However, these arguments resist today in spite of the facts and they are even keenly contradicted by the renewal of stratification studies on social inequalities. Analyzing the working population of an industrial village in Bourgogne during the

  3. A New Method to Directly Observe Tuberculosis Treatment: Skype Observed Therapy, a Patient-Centered Approach.

    Science.gov (United States)

    Buchman, Tavora; Cabello, Celina

    Tuberculosis (TB) treatment completion is in part determined by patient's adherence to long-term drug regimens. To best ensure compliance, directly observed therapy (DOT) is considered the standard of practice. Nassau County Department of Health TB Control is responsible for providing DOT to patients with TB. Tuberculosis Control sought to use and evaluate Skype Observed Therapy (SOT) as an alternative to DOT for eligible patients. The evaluation included analysis of patient's acceptance and adherence to drug regimen using SOT. Tuberculosis Control assessed staff efficiency and cost savings for this program. Percentages of SOT of patients and successful SOT visits, mileage, and travel time savings. Twenty percent of the caseload used SOT and 100% of patients who were eligible opted in. Average SOT success was 79%. Total mileage savings and time saved were $9,929.07 and 614 hours. Because SOT saves cost and time and is a suitable alternative to DOT for patients, it should be considered as part of new policies and practices in TB control programs.

  4. [Endovascular treatment of symptomatic intracranial stenoses: short- and long-term results in a single center].

    Science.gov (United States)

    Aparici Robles, F; Mainar Tello, E; Vázquez-Añón, V; Lago Martín, A; Parkhutik, V; Tembl Ferrairo, J

    2013-09-01

    We present the short- and long-term results of a series of patients with symptomatic intracranial arterial stenoses treated with angioplasty and stenting. We reviewed patients with symptomatic intracranial stenoses greater than 50% who were treated with angioplasty, stenting, or both. We recorded demographic data and risk factors (hypertension, diabetes, dyslipemia, ischemic heart disease). We classified all lesions treated according to their location, degree of stenosis, and length. The degree of stenosis was classified as moderate (50%-70%) or severe (>70%). In the follow-up, we assessed cerebrovascular accidents, episodes of ischemic heart disease, and deaths in the first 30 days and in later follow-up. Between 2006 and 2010, we treated 26 patients (21 men and 5 women; age range, 44-79 years; mean age, 63 years) with 29 intracranial lesions. The endovascular procedure (angioplasty+stenting) was successfully performed in 23 cases (92.0%). In the first 30 days after the procedure, 3 (11.5%) patients had adverse effects of vascular origin: 1 stroke, 1 hemorrhage, and 1 death due to thrombosis of the stent. Long-term follow-up (5-46 months) in the 25 patients who survived more than 30 days detected no recurrence of symptoms. Endovascular treatment of intracranial stenosis is technically feasible. Short-term complications are highly prevalent. No recurrence of symptoms was detected during long-term follow-up. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  5. "Efficacy of interferon and Amantadin for treatment of hepatitis in major thalasemia at Children’s Medical Center, Tehran "

    Directory of Open Access Journals (Sweden)

    Fallahi GHI

    2007-04-01

    Full Text Available Background: Major thalassemia is relatively common in Iran and in looking of their need to recurrent transfusion; their high risk for acquisition of HCV is revealed. These patients also suffer form liver hemosiderosis that accelerate disease excursion to cirrhosis and hepatocellular carcinoma. In this study combined therapy with interferon and amantadin has been evaluated. Methods: This prospective clinical trail has been done on thalasemic patients that had been contaminated by HCV and had laboratory signs of hepatitis. During years of 81-82, 26 patients admitted at Children Mmedical Center with major thalassemia and HCV hepatitis. Inclusion criteria were positive HCV-RNA, high ALT and histologic evidence of hepatitis in liver biopsy and exclusion criteria were history of incomplete treatment any contraindication of IFN or amantadin-emergence of drugs adverse reactions, to intending of these criteria 10 case of them had situation for treatment and follow-up. Results: In 10 cases, treatment with IFN  - 2b in doses 3 mu for every square meter of body surface three times in week subcutaneously and cap. Amantadin in doses 100 mg po B.d for 6 months was done and after it, 8 cases were negative for HCV-RNA (8% and in 6 patients, ALT turned to normal (60% and in 2 other case ALT decrease to lower than 50% of pretreatment value. None of them showed drug adverse reactions and response to therapy was better in lower ages. No relation between response to therapy and liver hemosiderosis, inflammation and sexuality was found. Conclusion: Combined therapy with IFN and Amantadin is effective in HCV treatment and for lower recurrence, treatment period longer than 24 wk, such as 48 wk is recommended

  6. [Accreditation standards concerning patients' rights: a review of the current state of affairs related to drug-addiction treatment centers in Colombia].

    Science.gov (United States)

    Zapata-Vanegas, Mario A

    2014-01-01

    Characterizing and contrasting the current state of affairs concerning patients' rights-associated accreditation standards in a sample of drug-addiction treatment centers in Colombia. This was mixed methodology research (i.e. descriptive and hermeneutic); a pilot sample of 21 drug-addiction treatment centers in Colombia was used for determining the current state of patients' rights accreditation standards. The possible relationship or independence between categorical variables was evaluated by using Fisher's exact test (0.05 significance level). A contrasting documentary review was made at the same time. Drug-addiction treatment centers provided more information for families (95 %) than patients (90 %) or minors (81 %). Possible barriers to gaining access for treatment were being HIV positive (29 %), being part of the LGTB population (14 %) and being female (10 %); religion and ethnicity were not seen as grounds for discrimination or treatment barriers. The patients' rights standards group coincided with Colombia's accreditation system and Joint Commission standards; however, the latter accreditation entity has made significant progress regarding a specific manual for drug-addiction treatment centers. The centers assessed in Colombia had made advances regarding accrediting patients' rights, but such standards require revision for being adapted to international developments and specific matters involved in treating addicts and the specific conditions for institutions dealing with such treatment.

  7. Curative Intent Treatment of Hepatocellular Carcinoma - 844 Cases Treated in a General Surgery and Liver Transplantation Center.

    Science.gov (United States)

    Grigorie, Răzvan; Alexandrescu, Sorin; Smira, Gabriela; Ionescu, Mihnea; Hrehoreţ, Doina; Braşoveanu, Vladislav; Dima, Simona; Ciurea, Silviu; Boeţi, Patricia; Dudus, Ionut; Picu, Nausica; Zamfir, Radu; David, Leonard; Botea, Florin; Gheorghe, Liana; Tomescu, Dana; Lupescu, Ioana; Boroş, Mirela; Grasu, Mugur; Dumitru, Radu; Toma, Mihai; Croitoru, Adina; Herlea, Vlad; Pechianu, Cătălin; Năstase, Anca; Popescu, Irinel

    2017-01-01

    Background: The objective of this study is to assess the outcome of the patients treated for hepatocellular carcinoma (HCC) in a General Surgery and Liver Transplantation Center. Methods: This retrospective study includes 844 patients diagnosed with HCC and surgically treated with curative intent methods. Curative intent treatment is mainly based on surgery, consisting of liver resection (LR), liver transplantation (LT). Tumor ablation could become the choice of treatment in HCC cases not manageable for surgery (LT or LR). 518 patients underwent LR, 162 patients benefited from LT and in 164 patients radiofrequency ablation (RFA) was performed. 615 patients (73%) presented liver cirrhosis. Results: Mordidity rates of patient treated for HCC was 30% and mortality was 4,3% for the entire study population. Five year overall survival rate was 39 % with statistically significant differences between transplanted, resected, or ablated patients (p 0.05) with better results in case of LT followed by LR and RFA. Conclusions: In HCC patients without liver cirrhosis, liver resection is the treatment of choice. For early HCC occurred on cirrhosis, LT offers the best outcome in terms of overall and disease free survival. RFA colud be a curative method for HCC patients not amenable for LT of LR. Celsius.

  8. Challenges of conducting multi-center, multi-disciplinary urinary incontinence clinical trials: experience of the urinary incontinence treatment network.

    Science.gov (United States)

    Steers, William; Richter, Holly; Nyberg, Leroy; Kusek, John; Kraus, Stephen; Dandreo, Kimberly; Chai, Toby; Brubaker, Linda

    2009-01-01

    The Urinary Incontinence Treatment Network (UITN) was established in 2000 as a multi-disciplinary, multi-institutional network by the National Institute for Diabetes, Digestive, and Kidney Diseases (NIDDK) to investigate treatments for urinary incontinence in women. Over 8 years this network composed of urologists, urogynecologists, geriatricians, behavioral psychologists, physical therapists, nurses, epidemiologists, social scientists and statisticians from nine academic sites and a Data Coordinating Center has been effective in designing and completing prospective randomized clinical trials for treatments of urinary incontinence in women. Two major clinical trials have been completed and a third has completed recruitment. The focus of the completed trials was a comparison of surgical methods to treat stress urinary incontinence whereas the third examined the potential benefit of combined behavioral intervention and antimuscarinic drug therapy to eliminate the need for long-term use of drug therapy alone to manage urge urinary incontinence. The scientific output of the network measured by abstracts, original papers and presentations demonstrates the productivity of the network. Many unique challenges are posed by a multi-disciplinary team located at sites across the United States undertaking several clinical trials. This review presents some of the logistics, barriers, tactics, and strategies used to create this successful clinical trials network focused on urinary incontinence.

  9. New Energy Villages in Taiwan and China

    Science.gov (United States)

    Lee, C. S.; Wang, S. C.

    2015-12-01

    Taiwan locates in the active tectonic subdution and collision belts, therefore, the geothermal gradient is very high and have found 128 sites of high geothermal areas; 20% of them have the temperature between 75 - 200 degree C in which they can be directly used for the electricity generation; 50% of them are in 50 - 74 degree C and the rest 30% are below 50 degree C. These areas need the deep drillings to get into higher temperature for power energy. The first 20% high temperature areas are mostly located in the coastal or mountain regions. The government is interesting to develop these areas as the "New Energy Villages" so that they can not only become self-energy sufficient sites, but also to protect themself from being the loss of electricity and water during the typhoon and earthquake hazards. The multiple usages of hot water (such as the first power generation and then the hot spring utilization) have its merits. China, in the other hand, is not within the present-day active tectonic zone. However, the recent Sino Probe Experiments (Deep Exploration in China) have mapped the Cetaceous plate boundaries in the coast of China. The heat is still possibly migrating to near the surface through the existing structures. For example, the Feng Shun Geothermal Power Station in north of Guangzhou, Guangdong Province, used the 96 degree C hot water from a well of 800 m producing a small amount of 300 KW power since 1984. The Guangdong Province is located in the edge of Mesozoic South China Plate. Further in land, the Huang Mountain, one of the world heritage sites, is located at the boundary of another Mesozoic Yangtze River Plate. There is not a geothermal power plant; however, a number of hot springs are in a booming tour business at the foot hill of the mountain. The electricity has to come from a long way of net working. If China develops the local, small, but sufficient power plants by using the modern geothermal exploration and drilling techniques. The "New Energy

  10. Astronomy Village Reaches for New Heights

    Science.gov (United States)

    Croft, S. K.; Pompea, S. M.

    2007-12-01

    We are developing a set of complex, multimedia-based instructional modules emphasizing technical and scientific issues related to Giant Segmented Mirror Telescope project. The modules" pedagogy will be open-ended and problem-based to promote development of problem-solving skills. Problem- based-learning modules that emphasize work on open-ended complex real world problems are particularly valuable in illustrating and promoting a perspective on the process of science and engineering. Research in this area shows that these kinds of learning experiences are superior to more conventional student training in terms of gains in student learning. The format for the modules will be based on the award-winning multi-media educational Astronomy Village products that present students with a simulated environment: a mountaintop community surrounded by a cluster of telescopes, satellite receivers, and telecommunication towers. A number of "buildings" are found in the Village, such as a library, a laboratory, and an auditorium. Each building contains an array of information sources and computer simulations. Students navigate through their research with a mentor via imbedded video. The first module will be "Observatory Site Selection." Students will use astronomical data, basic weather information, and sky brightness data to select the best site for an observatory. Students will investigate the six GSMT sites considered by the professional site selection teams. Students will explore weather and basic site issues (e.g., roads and topography) using remote sensing images, computational fluid dynamics results, turbulence profiles, and scintillation of the different sites. Comparison of student problem solving with expert problem solving will also be done as part of the module. As part of a site selection team they will have to construct a case and present it on why they chose a particular site. The second module will address aspects of system engineering and optimization for a GSMT

  11. Colorectal Cancer Patient Characteristics, Treatment and Survival in Oman--a Single Center Study.

    Science.gov (United States)

    Kumar, Shiyam; Burney, Ikram A; Zahid, Khawaja Farhan; D Souza, Philomena Charlotte; Belushi, Muna A L; Mufti, Taha Dawood; Meki, Waeil A L; Furrukh, Muhammad; Moundhri, Mansour S A L

    2015-01-01

    Colorectal cancer is the most common gastrointestinal cancer in Oman with an increasing incidence. We here report the presenting features, treatment outcomes and survival in a University hospital in Oman and compare our data with regional and international studies. Medical records of patients with colorectal cancer were reviewed retrospectively between June 2000 and December 2013 and were followed until June 2014. A total of 162 patients were diagnosed with colorectal cancer. The majority were males (58.6%), with a median age of 56 years. Rectum was involved in 29.6% of patients, followed by ascending and sigmoid colon. The majority of patients had stage III (42.6%) and stage IV (32.7%) disease at presentation. K-Ras status was checked for 79 patients, and 41 (51.9%) featured the wild type. Median relapse free survival was 22 months. Median overall survival for all patients was 43 months. Observed 5 year overall survival (OS) for stages I, II and III was 100%, 60% and 60% respectively. On Log rank univariate analysis, age, BMI, diabetes, hypertension, metformin use, stage, clinical nodal status for rectal cancer, pathological T and nodal status, site of metastasis, surgical intervention, chemotherapy, radiotherapy, chemotherapy regimen, no of cycles of chemotherapy, response, RFS, site of recurrence and administration of 2nd line chemotherapy were significant factors affecting OS. On Cox regression multivariate analysis none of the factors independently affected the OS. The majority of patients present with advanced disease and at young age. The survival rates are comparable to the published regional and international literature.

  12. Endovascular Modalities for the Treatment of Cavernous Sinus Arteriovenous Fistulas: A Single-Center Experience.

    Science.gov (United States)

    Hassan, Tamer; Rashad, Sherif; Aziz, Waseem; Sultan, Ahmed; Ibrahim, Tamer

    2015-12-01

    Cavernous sinus (CS) fistulas are classified into traumatic and spontaneous. Traumatic carotid-cavernous fistulas (CCFs) are usually direct internal carotid artery (ICA) high-flow fistulas; whereas spontaneous CCFs are usually dural, low-flow fistulas and generally possess less severe symptoms than direct carotid-cavernous fistulas. This study involved 34 patients who were classified into 2 groups: Group A included 26 patients with direct carotid-cavernous fistula; and Group B included 8 patients with indirect dural cavernous fistula. All patients had ocular manifestations. One patient had subarachnoid hemorrhage. Coils were used alone in 19 cases of direct fistula and in 1 case of dural fistulas. Coils and Onyx (Covidien, Mansfield, MA, USA) were used in 7 cases of direct fistula and in 2 cases of dural fistulas. Onyx alone was used to treat 5 cases with dural fistulas but none of the cases with direct fistulas. Covered stents and coils were used in 2 cases of direct fistulas. All patients in both groups showed full recovery of their clinical signs and symptoms. Only 1 procedure-related complication was observed (3%) in which a patient had an embolic event and trigeminal dysesthesia as a result of Onyx reflux through external carotid artery-ICA anastomosis. Coils are superior solid embolic agents used for the treatment of direct high-flow fistulas, while Onyx is more valuable in dural low-flow CCF. Onyx shortens the procedure time and decreases procedure cost. Onyx injection inside the CS proper through the transarterial or transvenous route may be safer than Onyx injected inside dural arteries supplying the CS. However, more cases are needed to determine this. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. Reaching the unreached: Mobile surgical camps in a remote village of Himachal Pradesh

    Directory of Open Access Journals (Sweden)

    Sonal Bathla

    2014-01-01

    Conclusion: Uterovaginal prolapse is not only socially embarrassing and disabling; its surgical treatment is complex and costly too. The free mobile surgical camps under "Project Prolapse" in Shillai, Himachal Pradesh has provided relief to old neglected, disabled women suffering from prolapse in this remote village. Parallel counseling of women and dais for safe hospital delivery and training subordinates in prolapse surgery may help in addressing the problem of POP in this area in the long run.

  14. It takes a village: a community partnership model in caring for the homeless.

    Science.gov (United States)

    Zazworsky, Donna; Johnson, Nancy

    2014-01-01

    Population health management calls for hospitals and health care entities to better align their strategies in order to deliver quality care more efficiently. Although these efforts tend to be addressed with insured populations, the homeless demand a very intentional focus. The issue of homelessness has adverse effects on the health care system, resulting in the inefficient use of resources. Community-wide efforts must be mobilized to address this inefficiency and need for preventative care and self-management education for this population. Carondelet Health Network, in partnership with El Rio Community Health Center, a federally qualified health center, along with other health care and social service providers, has established the Southern Arizona Health Village for the Homeless, providing a health care delivery system to ensure the best functional and clinical outcomes. This system includes a van (the Van of Hope), licensed as a health center, and staffed with an El Rio Community Health Center nurse practitioner and a medical assistant partnering with a Carondelet Health Network behavioral health specialist and a community outreach worker. Clinical patient information is managed via an electronic health record inclusive of clinical data, number of visits, referrals, self-management education, hospitalizations, and follow-up care. A post-hospital program with shelters and an Emergency Room Navigation Program are additional components of the village that provide a comprehensive pre-acute and post-acute effort to support the homeless. Financial impact is measured by reductions in hospitalizations and average length of stay.

  15. Differences between the family-centered "COPCA" program and traditional infant physical therapy based on neurodevelopmental treatment principles.

    Science.gov (United States)

    Dirks, Tineke; Blauw-Hospers, Cornill H; Hulshof, Lily J; Hadders-Algra, Mijna

    2011-09-01

    Evidence for effectiveness of pediatric physical therapy in infants at high risk for developmental motor disorders is limited. Therefore, "Coping With and Caring for Infants With Special Needs" (COPCA), a family-centered, early intervention program, was developed. The COPCA program is based on 2 components: (1) family involvement and educational parenting and (2) the neuromotor principles of the neuronal group selection theory. The COPCA coach uses principles of coaching to encourage the family's own capacities for solving problems of daily care and incorporating variation, along with trial and error in daily activities. The purpose of this study was to evaluate whether the content of sessions of the home-based, early intervention COPCA program differs from that of traditional infant physical therapy (TIP) sessions, which in the Netherlands are largely based on neurodevelopmental treatment. The study was conducted at the University Medical Center Groningen in the Netherlands. A quantitative video analysis of therapy sessions was conducted with infants participating in a 2-arm randomized trial. Forty-six infants at high risk for developmental motor disorders were randomly assigned to receive COPCA (n=21) or TIP (n=25) between 3 and 6 months corrected age. Intervention sessions were videotaped at 4 and 6 months corrected age and analyzed with a standardized observation protocol for the classification of physical therapy actions. Outcome parameters were relative amounts of time spent on specific physical therapy actions. The content of COPCA and TIP differed substantially. For instance, in TIP sessions, more time was spent on facilitation techniques, including handling, than in COPCA sessions (29% versus 3%, respectively). During COPCA, more time was spent on family coaching and education than during TIP (16% versus 4%, respectively). The major limitation of the study was its restriction to the Netherlands, implying that findings cannot be generalized automatically to

  16. Cigarette Smoking Knowledge, Attitudes, and Practices of Patients and Staff at a Perinatal Substance Abuse Treatment Center

    Science.gov (United States)

    Chisolm, Margaret S.; Brigham, Emily P.; Lookatch, Samantha J.; Tuten, Michelle; Strain, Eric C.; Jones, Hendrée E.

    2010-01-01

    This study compares cigarette smoking knowledge, attitudes, and practices (S-KAP) of opioid- and other substance-dependent patients and their multidisciplinary staff at an outpatient perinatal substance abuse treatment center. Consenting patients (n=95) and staff (n=41) concurrently completed a modified form of the S-KAP survey instrument. 95% of patients reported currently smoking, and half endorsed wanting “to quit smoking now.” This patient desire to quit smoking was significantly underrated by staff compared to the patients themselves (p=0.028). Both patients and staff demonstrated sub-optimal knowledge of smoking health risks, but 73% of patients reported trying to quit with past pregnancies to avoid harm to the fetus/baby. Although results show that patients could benefit from smoking cessation strategies centered on smoking’s fetal/neonatal health risks, organizational interventions that focus on changing staff attitudes about patient desire to quit smoking may first need to be implemented. PMID:20667683

  17. [Assessment of Cyto- and Genotoxicity of Underground Waters from the Far Eastern Center on Radioactive Waste Treatment Site].

    Science.gov (United States)

    Oudalova, A A; Pyatkova, S V; Geras'kin, S A; Kiselev, S M; Akhromeev, S V

    2016-01-01

    This study has been completed in the frames of activities on the environment assessment in the vicinity of the Far Eastern center (FEC) on radioactive waste treatment (a branch of Fokino, Sysoev Bay). Underground waters collected at the FEC technical site were surveyed both with instrumental techniques and bioassays. Concentrations of some chemicals (ranged to the third hazard category) in the samples collected are over the permitted limits. Activities of 137Cs and 90Sr in waters amount up to 3.8 and 16.2 Bq/l, correspondingly. The integral pollution index is over 1 in all the samples and could amount up to 165. The Allium-test application allows the detection of the sample points where underground waters have an enhanced mutagenic potential. Dependencies between biological effects and pollution levels are analyzed. The findings obtained could be used for the monitoring optimized and decision making on rehabilitation measures to decrease negative influence of the enterprise on the environment.

  18. [Percutaneous rheolytic thrombectomy in the treatment of high-risk acute pulmonary embolism: Initial experience of a single center].

    Science.gov (United States)

    Faria, Rita; Oliveira, Márcia; Ponte, Marta; Pires-Morais, Gustavo; Sousa, Marta; Fernandes, Paula; Rodrigues, Alberto; Braga, Pedro; Gonçalves, Manuel; Gama, Vasco

    2014-06-01

    For years, the treatment of high-risk pulmonary embolism (PE) was based on two well-defined strategies: thrombolysis, whose benefits have been documented in randomized trials, and surgical embolectomy. However, mechanical reperfusion by percutaneous techniques is used in an increasing number of patients, and is a valid therapeutic option when there is a formal contraindication to thrombolysis, as rescue therapy when thrombolysis fails to improve hemodynamics, and/or when emergency surgical thrombectomy is unavailable or contraindicated. This article discusses the indications for the use of percutaneous techniques in PE, reports the initial experience of our center with the AngioJet® thrombectomy device (Possis Medical Inc, Minneapolis, MN, USA) and reviews the available evidence, the most recent recommendations and the main complications associated with this procedure. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  19. A prospective, multi-center clinical trial of the Taylor intragastric balloon for the treatment of morbid obesity.

    Science.gov (United States)

    Marshall, J B; Schreiber, H; Kolozsi, W; Vasudeva, R; Bacon, B R; McCullough, A J; Holt, S

    1990-07-01

    This report describes the result of a prospective, multicenter clinical trial of the Taylor intragastric balloon for the treatment of morbid obesity. Sixty patients, who had failed sustained weight loss on prior dietary restriction and behavior modification programs, were enrolled in four clinical centers. The Taylor intragastric balloon, a 550-ml, pear-shaped, liquid-filled, silicone device, was inserted in all patients for a period of 16 wk, and patients were maintained on a dietary restriction and behavior modification program. During the study period, patients experienced a 11.6% decrease in mean weight and an 11.4% decrease in body mass index. Seven balloons deflated spontaneously. Examination of these balloons revealed a manufacturing defect that was subsequently corrected. No further deflations occurred. Effects of the balloons on gastric mucosa were minimal with no gastric erosions or ulcerations noted.

  20. Characterizing the therapeutic response to deep brain stimulation for treatment resistant depression: a single center long-term perspective

    Directory of Open Access Journals (Sweden)

    Andrea L Crowell

    2015-06-01

    Full Text Available The number of depressed patients treated with deep brain stimulation is relatively small. However, experience with this intervention now spans more than 10 years at some centers, with study subjects typically monitored closely. Here we describe one center’s evolving impressions regarding optimal patient selection for deep brain stimulation of the subcallosal cingulate as well as observations of short- and long-term patterns in antidepressant response and mood reactivity. A consistent time course of therapeutic response with distinct behavioral phases is observed. Early phases are characterized by changes in mood reactivity and a transient and predictable worsening in self ratings prior to stabilization of response. It is hypothesized that this characteristic recovery curve reflects the timeline of neuroplasticity in response to DBS. Further investigation of these emerging predictable psychiatric, biological, and psychosocial patterns will both improve treatment optimization and enhance understanding and recognition of meaningful DBS antidepressant effects.

  1. Biomass District Heat System for Interior Rural Alaska Villages

    Energy Technology Data Exchange (ETDEWEB)

    Wall, William A.; Parker, Charles R.

    2014-09-01

    Alaska Village Initiatives (AVI) from the outset of the project had a goal of developing an integrated village approach to biomass in Rural Alaskan villages. A successful biomass project had to be ecologically, socially/culturally and economically viable and sustainable. Although many agencies were supportive of biomass programs in villages none had the capacity to deal effectively with developing all of the tools necessary to build a complete integrated program. AVI had a sharp learning curve as well. By the end of the project with all the completed tasks, AVI developed the tools and understanding to connect all of the dots of an integrated village based program. These included initially developing a feasibility model that created the capacity to optimize a biomass system in a village. AVI intent was to develop all aspects or components of a fully integrated biomass program for a village. This meant understand the forest resource and developing a sustainable harvest system that included the “right sized” harvest equipment for the scale of the project. Developing a training program for harvesting and managing the forest for regeneration. Making sure the type, quality, and delivery system matched the needs of the type of boiler or boilers to be installed. AVI intended for each biomass program to be of the scale that would create jobs and a sustainable business.

  2. Physicians’ Critical Thinking and Patients’ Satisfaction Level: a Case Study of Tabriz Sina Treatment and Educational Center

    Directory of Open Access Journals (Sweden)

    Bahram Jalilzadeh Amin

    2014-12-01

    Full Text Available Introduction: Critical thinking is rational and sound thinking that involves investigation and review of opinions followed by actions and decision-making based on reasons with accurate and rational results. In our modern, complex world, we encounter multiple changes and competition in society, especially when it comes to using the latest technology; society must progress in this trend. Medical science is not exempt in this regard, considering that critical thinking is necessary in fulfilling its goals. This research aims to investigate the physicians’ critical thinking and patient satisfaction level in the Tabriz Sina Treatment and Educational Center.Methods: This study is both descriptive and analytical, and the statistical population involves all physicians and the patients of the Tabriz Sina Treatment and Educational Center in 2013. About 30 physicians and 170 patients were selected randomly, and data were collected using the Watson and Glaser critical thinking questionnaire, as well as the Mogimi and Ramazan patient satisfaction questionnaire. The data were then analyzed by Pearson correlation and regression analysis. Results: The results showed that there was a significant and positive relationship between critical thinking and patient satisfaction in all dimensions except identification. Changes in critical thinking dimensions also changed patient satisfaction. The regression test showed that the critical thinking independent variable effect on the dependent variable was 0.558, which indicated a relatively strong correlation between these variables.Conclusion: Although the critical thinking of the physicians and medical staff is important in patient satisfaction, there is no progress towards these goals in the health system. Healthcare authorities should try to empower critical thinking in order to achieve organizational goals.

  3. [The Assesment of Cutaneous Leishmaniasis Patients Admiting to Gaziantep University of Medicine Faculty Leishmaniasis Diagnosis and Treatment Center].

    Science.gov (United States)

    Korkmaz, Selma; Özgöztaşı, Orhan; Kayıran, Nuriye

    2015-03-01

    Cutaneous Leishmaniasis (CL) is a curable clinical condition characterized by atrophic scars caused by the Leishmania species of protozoan parasites. In the period following the beginning of the Syrian Civil War, there has been a dramatic increase in number of CL cases in Gaziantep. The aim of this study was to evaluate the epidemiological characteristics of CL patients admitted to Gaziantep University of Medicine Faculty Leishmaniasis diagnosis and treatment center in Gaziantep. Within the context of this study, a total of 635 CL patients admitted between 01 April 2013 and 01 April 2014 to the Leishmaniasis diagnosis and treatment center of the Gaziantep were evaluated retrospectively. Patient data regarding age, sex, the location of lesions, the number of lesions, the duration of the lesions, and the months in which the lesions appeared were recorded and statistically analyzed. Of these patients, 67 (10.6%) were Turkish citizens, while 568 (89.4%) were Syrian citizens. In addition, 299 (47.1%) of the patients were female, while 336 (52.9%) were male. The large majority of the cases were between 5-9 (n=140, 22%) and 10-19 (n=168, 26.5%) years of age; 66% of all cases were below 20 years of age. An evaluation of the distribution of cases according to the months revealed that the lowest number of cases occurred in the months of July (n=14, 2.2%) and August (n=13, 2.0%), while the highest number of cases occurred in the months of January (n=122, 19.2%) and February (n=106, 16.7%). Cutaneous Leishmaniasis is a condition that affects individuals of all ages and genders. It is thus necessary to conduct regular health screenings for Cutaneous Leishmaniasis, and to inform and educate vulnerable communities and the society in general regarding this condition.

  4. TOURISM WAS BORN IN THE VILLAGE

    Directory of Open Access Journals (Sweden)

    Gabriela-Liliana CIOBAN

    2016-08-01

    Full Text Available Statistical data certifies that tourism is one of the most profitable and dynamic sectors of the economy, occupying the second position in international trade, after oil. By extrapolation results that rural tourism also has major implications for the economic, social and cultural development of the villages. This study presents an analysis of the factors contributing to the practice of rural tourism in Romania during 2000-2015. Using data provided by the National Statistics Institute was possible to analyze the number of employees and number of units specific to rural tourism. In the structure of this study, the methods of improving and developing rural tourism are defined by the concept of volunteer tourism by developing national portals presenting the vacant jobs in tourism and developing human capital by attracting European Funds 2014-2010. The importance of these methods have as a starting point the alignment with the current requirements of tourists and human resources due to the fact that workers in tourism are the main connection point between services and tourist.

  5. The Americleft study: an inter-center study of treatment outcomes for patients with unilateral cleft lip and palate part 4. Nasolabial aesthetics.

    Science.gov (United States)

    Mercado, Ana; Russell, Kathleen; Hathaway, Ronald; Daskalogiannakis, John; Sadek, Hani; Long, Ross E; Cohen, Marilyn; Semb, Gunvor; Shaw, William

    2011-05-01

    To compare the nasolabial aesthetics for individuals with nonsyndromic complete unilateral cleft lip and palate between the ages of 5 and 12 years. Retrospective cross-sectional study. Four cleft centers in North America. A total of 124 subjects with repaired complete unilateral cleft lip and palate who were treated at the four centers. After ethics approval was obtained, 124 preorthodontic frontal and profile patient images were scanned, cropped to show the nose and upper lip, and coded. Using the coded images, four nasolabial features that reflect aesthetics (i.e., nasal symmetry, nasal form, vermilion border, and nasolabial profile) were rated by five examiners using the rating system reported by Asher-McDade et al. (1991) . Intrarater and interrater reliabilities were determined using weighted kappa statistics. Mean ratings, by center, were compared using analysis of variance. Intrarater reliability scores were good to very good and interrater reliability scores were moderate to good. Total nasolabial scores were Center B = 2.98, Center C = 3.02, Center D = 2.80, and Center E = 2.87. No statistically significant differences among centers were detected for both total aesthetic scores and for any of the individual aesthetic components. There were no significant differences in nasolabial aesthetics among the centers evaluated. Overall good to fair nasolabial aesthetic results were achieved using the different treatment protocols in the four North American centers.

  6. Evaluating long-term patient-centered outcomes following prostate cancer treatment: findings from the Michigan Prostate Cancer Survivor study.

    Science.gov (United States)

    Darwish-Yassine, May; Berenji, Manijeh; Wing, Diane; Copeland, Glenn; Demers, Raymond Y; Garlinghouse, Carol; Fagerlin, Angela; Newth, Gail E; Northouse, Laurel; Holmes-Rovner, Margaret; Rovner, David; Sims, Jerry; Wei, John T

    2014-03-01

    Advances in screening and treatment of prostate cancer have dramatically increased the number of survivors in the US population. Yet the effect of screening is controversial, and in some instances may not be beneficial. Previous studies have typically only reported outcomes of treatment and symptoms within a short time frame following treatment. The persistence of such symptoms over time necessitates an improvement of survivor care so that the medical and support needs of these patients are met. This study aims to perform a patient-centered survey of prostate cancer survivors in the Michigan Cancer Registry to identify treatment side effect rates, evaluate survivors' access to preventive care services post-prostate cancer treatment, and assess the informational needs of these survivors regarding their prostate cancer. Linking case files of the Michigan Cancer Registry with records from the National Death Index, we identified prostate cancer patients diagnosed between 1985 and 2004 and alive on 31 December 2005. Participants were selected using a stratified cross-sectional sampling strategy to ensure adequate inclusion of survivors based upon race and ethnicity, urban versus rural location, and number of years since diagnosis of prostate cancer. A total of 2,499 surveys were completed and returned. (1) Physical symptoms--assessing bowel, sexual, urinary, and vitality symptoms by treatment modality. (2) Access to care--identifying whether diagnostic tests for prostate cancer (prostate-specific antigen (PSA) and digital rectal examination) were performed. Determining whether the survivors had knowledge of the "watchful waiting" paradigm for prostate cancer surveillance. (3) Informational needs--assessing whether the informational needs of patients were addressed by providers. Evaluating the significant predictors associated with seeking information about prostate cancer from any other source. Identifying what factors influenced a person to actively seek out

  7. Biomass based energy system for a south Indian village

    Energy Technology Data Exchange (ETDEWEB)

    Ravindranath, N.H.; Chanakya, H.N.

    1986-01-01

    The biomass resources, existing utilization levels and the efficiency of its use have been analyzed for a South Indian village. A biomass based energy efficient strategy has been devised to meet all the energy needs of the village, including substitution of fuels such as electricity and kerosene used in specific activities. Results indicate that the potential as well as the technologies exist for such substitutions. The proposed strategy will lead to an increase in the efficiency of energy use, reduce human drudgery and make villages more self reliant. 19 references.

  8. Traditional and modern use of fuelwood in Indian villages

    Energy Technology Data Exchange (ETDEWEB)

    Ravindranath, N.H.; Chanakya, H.N.

    1994-09-01

    Traditional methods of using fuelwood can be improved to benefit the quality of life of village inhabitants as well as the environment. Modern bioenergy systems offer potential to meet the heating (cooking) and shaft power (and electricity) requirements of villages through a combination of biogas and producer gas systems. These technologies are available indigenously in India and their feasibility in the villages has been demonstrated. Bioenergy options using locally produced feedstocks lead to self reliance, local employment generation, reclamation of degraded and waste lands, enhancing biodiversity, substitution of fossil fuels with concomitant reduction in carbon emissions, etc.

  9. Changing Traditions and Village Development in Kalotaszentkirály

    Directory of Open Access Journals (Sweden)

    Wayne Kraft

    2011-10-01

    Full Text Available The continuity of village traditions depends on the stability and cohesion of village communities. Since the opening of Transylvania after the fall of Nicolae Ceauşescu, there has been a sort of revival of Hungarian village dance and music, on the one hand, but, on the longer term, the communities themselves are threatened by economic challenges and by consequent demographic changes. This essay is based on field research conducted in Kalotaszentkirály (Sincraiu from 1995 to 2010.

  10. Novel ellipsoid spatial analysis for determining malaria risk at the village level.

    Science.gov (United States)

    Lek-Uthai, Usa; Sangsayan, Jare; Kachenchart, Boonlue; Kulpradit, Kasem; Sujirarat, Dusit; Honda, Kiyoshi

    2010-10-01

    The distribution patterns of malaria incidence at a village level in Thailand were demonstrated with the use of a geographical information system (GIS), and provided the study of the malaria situation at a household level. Mosaic imageries from aerial photographs were used to create maps that contained X and Y coordinates. These digitized base maps were kept as computerized files. Standard Distance Ellipse (SDE) was used to measure the prevalence of dispersion around the mean center of malaria cases and points. Households in the SDE were at greater risk of malaria infection than those located outside the SDE. The spatial pattern of malaria incidence was investigated using spatial autocorrelation using Geary's ratio and Moran's index. Five of seven villages had a clustered spatial distribution of malaria incidence, the vector point of which had a 2-3km range from the patient's houses. Only one village had a significant clustered spatial distribution of malaria incidence (p<0.05). Control efforts should be focused on high-risk areas, especially those households with the heaviest caseloads. This approach would probably be more cost effective than the conventional malaria control methods. This SDE analytical technique would be a novel and useful epidemiological control method for use by public health administrators. The ellipsoidal areas required malaria control intervention. Copyright 2010 Elsevier B.V. All rights reserved.

  11. Assessment of Darab County Villagers\\' Satisfaction with Family Doctor Functions from Different Aspects

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    Jalil Azizi

    2012-12-01

    Full Text Available   Background and Objective: Health care systems in different countries are organized to provide services, including prevention, treatment, and rehabilitation of people, and they are influenced by political, economic, and cultural factors. Health and safety are the basic rights of each and every individual in society. This study aimed to assess the satisfaction level of individuals referring to the rural health centers in Darab County in the Fars Province. Materials and Methods: This is a descriptive-analytical study. The collective data tool was a self-made questionnaire with two parts. The first part comprised demographic characteristics, and the second part contained 20 items for the assessment of satisfaction with family doctor functions from different aspects. Multi-stage cluster sampling method was used to determine samples. Data were analyzed using SPSS software, and inferential statistical analysis was performed. Results: In this study, 100 cases were investigated. The majority of the study population were women, married, and aged between 30 and 39 years [mean= 30.42 (5.3 years]. Overall satisfaction averages were 9.47% very high, 20.04% high, 33.09% moderate, 15.12% low, and, 22.28% very low. In all the items, the majority of the participants did not report a high level of satisfaction. Conclusion: Allocating more resources and equipment, providing educational programs to improve physician and staff skills, holding training courses in villages to raise awareness about the goals of the family doctor, and careful monitoring of the quality of services provided by physicians will enhance the satisfaction level of people with this nationally important program.

  12. Patterns of treatment for early stage breast cancers at the M. D. Anderson Cancer Center from 1997 to 2004.

    Science.gov (United States)

    Shen, Yu; Dong, Wenli; Feig, Barry W; Ravdin, Peter; Theriault, Richard L; Giordano, Sharon H

    2009-05-15

    The objectives of this study were to examine the patterns of use for adjuvant therapy and the changes in surgical practice for patients with early stage breast cancer and to describe how recent large clinical trial results impacted the patterns of care at The University of Texas M. D. Anderson Cancer Center (MDACC). The study included 5486 women who were diagnosed with stage I through IIIA breast cancer between 1997 and 2004 and received their treatment at MDACC. A chi-square trend test and multivariate logistic regression model were used to assess changes in treatment patterns over time. Among lymph node-positive patients, the use of anthracycline plus taxane chemotherapy increased from 17% in 1997 to 81% in 2004 (P 1997 and 2000. For postmenopausal patients who received endocrine therapy, the use of tamoxifen was replaced increasingly by the use of aromatase inhibitors (from 100% on tamoxifen in 1997 to 14% in 2004; P 1997 to 2004 (from 1.8% to 69.7%, respectively, among patients who underwent mastectomy; and from 18.1% to 87.1%, respectively, among patients who underwent breast-conserving surgery; P < .001). The results from this study suggested that key findings from adjuvant therapy and surgical procedures from large clinical trials often prompt immediate changes in the patient care practices of research hospitals like MDACC.

  13. Long-term trends in gender, T-stage, subsite and treatment for laryngeal cancer at a single center.

    Science.gov (United States)

    Brandstorp-Boesen, Jesper; Falk, Ragnhild Sørum; Boysen, Morten; Brøndbo, Kjell

    2014-12-01

    To investigate the changes in the epidemiology of laryngeal squamous cell carcinoma (LSCC) regarding gender, T-stage and subsite distribution, and to identify the potential effect of introducing new therapeutic alternatives for early and advanced stage LSCC. A prospective cohort study of LSCC patients diagnosed and treated at a single tertiary referral center in Norway. Retrospective analysis of prospectively recorded data from 1,616 patients treated for LSCC in all subsites of the larynx during 1983-2010. Females represented an increasing proportion of cases throughout the study (p cancer (p laryngeal preservation. The increasing proportion of females with LSCC may be explained by changes in smoking habits. The proportion of T1a glottic LSCC gradually increased over time, while T4 supraglottic LSCC became less frequent. Videostroboscopy should be considered mandatory in the diagnosis and follow-up of LSCC. Transoral laser microsurgery is the standard first-line treatment for T1a glottic tumors. Chemoradiotherapy has reduced the number of total laryngectomies and is now regarded as the primary treatment for advanced stage tumors.

  14. [Characteristics and treatment outcomes in 822 adult patients with acute myeloid leukemia:a single center experience].

    Science.gov (United States)

    Lin, Dong; Zhou, Chunlin; Wei, Hui; Liu, Bingcheng; Wang, Ying; Liu, Kaiqi; Li, Wei; Gong, Benfa; Wang, Jinyu; Wei, Shuning; Zhang, Guangji; Zhao, Xingli; Li, Yan; Liu, Yuntao; Gong, Xiaoyuan; Sun, Mingyuan; Lu, Yuan; Mi, Yingchang; Wang, Jianxiang

    2014-12-01

    To investigate the characteristics and the short- or long-term treatment outcomes of the adult patients with acute myeloid leukemia (AML) in China. From 1999 to 2010, 822 adult cases with AML were enrolled, diagnosed and classified by the FAB and WHO criteria, respectively. The treatment outcomes and prognostic factors were analyzed retrospectively. In all patients with a median age of 38.5(15-83) years, acute monoblastic and monocytic leukemia (M5), AML with t(15;17)/PML-RARα (APL) and AML with t(8;21)/AML1-ETO(M2b) were the most common subtypes, accounting for 29.7%, 20.9% and 14.6% respectively. In APL patients, CR was achieved in 95.2%, with an early death (ED) rate of 4.8%. And the estimated overall survival (OS) and disease-free survival (DFS) at 5 year was 87.5% and 88.8%, respectively. Patients with other AML subtype (Non-APL) revealed a CR rate of 82.0%, ED of 4.3%, and estimated 5-year OS and DFS both of 48.8%. The OS rate of Non-APL patients at 3-year varied significantly (Pleukemia centers. Chemotherapy by risk stratification, after diagnosis and classification according to the WHO criteria, is a key point to improve the outcomes in AML.

  15. Hadiboh: From Peripheral Village to Emerging City

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    Serge D.Elie

    2004-12-01

    Full Text Available Hadiboh is Soqotra Island's main urban formation. It was the capital until 1999, when the island was administratively divided into two districts: the Eastern District (mudîriyya sharqiya with Hadiboh as its capital, and the Western District (mudîriyya gharbiya with Qalansiyah as its capital. The article retraces the evolution of Hadiboh from the 1st century BC, when it was named Panara Tamara, as the main settlement of the island of Panchia, one of the many ancient names of Soqotra. Subsequently, the village of Suq (Shiq in Soqotri became the main settlement as well as anchorage point for all ships until the end of the 15th century. In early 16th century, when the Sultan of Mahra sought to establish a more permanent presence on the island, Hadiboh regained its status as main settlement. Henceforth Hadiboh was commonly known as Tamarida until the end of the British Protectorate in 1967. The constitution of Hadiboh as a mosaic town is discussed through different phases of immigration starting toward the end of the 19th century until the dawn of the 21st century. Its spatial configuration around three formally constituted neighborhoods symbolizing the town's attachment to the major events in Yemen's modern history is discussed. Its social organization into an ascriptive status hierarchy and the subsequent changes are described. The evolution of the economy from autarkic subsistence based on food bartering and minimal external trade to international ecotouristic desti-nation is explained. Finally, the article briefly highlights Hadiboh's pivotal role in the island's political history, and considers the dilemmas confronting its transformation as well as that of the island.

  16. PRIMARY MILK OFFER IN CASTRANOVA VILLAGE, DOLJ COUNTY

    Directory of Open Access Journals (Sweden)

    Radu Lucian PÂNZARU

    2013-10-01

    Full Text Available Castranova village is situated in the south-eastern county of Dolj on county road Leu - Visina (35 km from Craiova, limited in the north by the commune Leu, Apele Vii to the east of village, south and west by the commune Marsani and Bratovoieşti. Commune is composed of villages and wells Castranova. In the village there are 12 agricultural companies and two companies. Specific of the area is agriculture, mainly large crop: wheat and maize farming. Simultaneously develop livestock sector, and milling and bakery activities. Elucidating the communal potential, of milk production is based on use of an appropriate set of indicators: effective in exploitation (by species, total production and average yield per head. The study covers the period 2010-2012, taken as a starting point for developing a strategy of reviving the sector of production.

  17. Villages in Nepal prepare for weather extremes | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2012-03-22

    . Researchers are working with villagers to identify and meet the local challenges in six Nepali communities. Research focus To assess the vulnerability of rural communities in Nepal's diverse ecological regions to help them ...

  18. Notes on village economies and wildlife utilization in arctic Alaska

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Visits were made to 12 Eskimo villages in Arctic Alaska during the spring of 1954. At each settlement information was collected regarding the economy and the...

  19. Mechanisms, Treatment, and Patient Outcome of Iatrogenic Injury to the Brachial Plexus-A Retrospective Single-Center Study.

    Science.gov (United States)

    Dengler, Nora Franziska; Antoniadis, Gregor; Grolik, Brigitta; Wirtz, Christian Rainer; König, Ralph; Pedro, Maria Teresa

    2017-11-01

    Injury to the brachial plexus is a devastating condition, with severe impairment of upper extremity function resulting in distinct disability. There are no systematic reports on epidemiology, causative mechanisms, treatment strategies. or outcomes of iatrogenic brachial plexus injury (iBPI). We screened all cases of iatrogenic nerve injuries recorded between 2007 and 2017 at a single specialized institution. Mechanism of iBPI, type of previous causative intervention, location and type of the lesion as well as the type of revision surgery and functional patient outcome were analyzed. We identified 14 cases of iBPI, which all presented with significant impairment of upper extremity motor function (at least 1 muscle Medical Research Council grade 0). Neuropathic pain was present in most patients (11/14). Orthopedic shoulder procedures such as rotator cuff fixation, arthroplasty, and repositioning of a clavicle fracture accounted for iBPI in 7 of 14 patients. Other reasons for iBPI were resection or biopsy of a peripheral nerve sheath tumor in 3 patients or lymph node situated at the cervicomediastinal area in 2 patients. Mechanisms also included transaxillary rib resection in one and sternotomy in another patient. The treatment of iBPI was conducted according to each individual's needs and included neurolysis in 4, nerve grafting in 9, and nerve transfers in 1 patient. We found improved symptoms after treatment in most patients (11/14). Most common causes for iBPI were shoulder surgery and resection or biopsy of peripheral nerve sheath tumor and lymph nodes. Early referral to specialized peripheral nerve centers may help to improve functional patient outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Everyday burden of musculoskeletal conditions among villagers in rural Botswana

    DEFF Research Database (Denmark)

    Hondras, Maria; Hartvigsen, Jan; Myburgh, Corrie

    2016-01-01

    OBJECTIVE: To examine the perspectives of villagers in rural Botswana about the everyday life burden and impact of their musculoskeletal disorders. METHODS: Ethnographic fieldwork for 8 months included 55 in-depth interviews with 34 villagers. Interviews were typically conducted in Setswana with ...... country settings. Community-engaged partnerships are needed to develop rehabilitation programmes to ease the burden of musculoskeletal disorders in rural Botswana....

  1. Comprehensive Surgical Treatment as the Mainstay of Management in Retroperitoneal Sarcomas: Retrospective Study from Two Non-sarcoma Specialist Centers.

    Science.gov (United States)

    Petrou, Athanasios; Constantinidou, Anastasia; Kontos, Michael; Papalampros, Alexandros; Moris, Demetrios; Bakoyiannis, Chris; Neofytou, Kyriakos; Kourounis, George; Felekouras, Evangelos

    2017-04-01

    Complete resection, surgical expertise and individualization of patient management in comprehensive oncology centres result in better clinical outcomes in patients presenting with retroperitoneal sarcomas. Clinical outcomes of primary and recurrent retroperitoneal sarcoma resections performed between January 2002 and December 2016 in two large surgical oncology, but non-sarcoma specialist centers, were reviewed to determine the efficacy of complete surgical resection as the principle instrument for treatment. The histological type, tumor size and grade, as well as organ resection, were recorded and subsequently reviewed. Our study included 108 cases of sarcoma resection (60 first-time, 38 second-time and 10 third-time laparotomies) in 60 patients (35 males and 25 females). Most patients had complete resection: 57 had a macroscopically complete (R0/R1) resection and three had R2 resection. The 90-day mortality rate was zero and morbidity was minimal. Five- and 10-year overall survival (OS) rates were 88% and 79%, respectively, whereas the corresponding disease-free survival (DFS) rates were 65% and 59%, respectively. High-grade tumors were associated with decreased DFS (hazard ratio(HR)=3.35; 95% confidence interval(CI)=1.23-9.10; p=0.018) and decreased OS (HR=7.18; 95% CI=1.50-34.22; p=0.013). Complete surgical resection of retroperitoneal sarcomas combined with individualized patient management when offered by experienced surgical oncology teams, adhering to international guidelines, can succeed in providing patients with good long-term outcomes, comparable to those achieved at sarcoma-specialist centers. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  2. Passive case detection of malaria in Ratanakiri Province (Cambodia) to detect villages at higher risk for malaria.

    Science.gov (United States)

    Heng, Somony; Durnez, Lies; Mao, Sokny; Siv, Sovannaroth; Tho, Sochantha; Mean, Vanna; Sluydts, Vincent; Coosemans, Marc

    2017-03-06

    Cambodia reduced malaria incidence by more than 75% between 2000 and 2015, a target of the Millennium Development Goal 6. The Cambodian Government aims to eliminate all forms of malaria by 2025. The country's malaria incidence is highly variable at provincial level, but less is known at village level. This study used passive case detection (PCD) data at village level in Ratanakiri Province from 2010 to 2014 to describe incidence trends and identify high-risk areas of malaria to be primarily targeted towards malaria elimination. In 2010, the Cambodian malaria programme created a Malaria Information System (MIS) to capture malaria information at village level through PCD by village malaria workers and health facilities. The MIS data of Ratanakiri Province 2010-2014 were used to calculate annual incidence rates by Plasmodium species at province and commune levels. For estimating the trend at provincial level only villages reporting each year were selected. The communal incidences and the number of cases per village were visualized on a map per Plasmodium species and per year. Analysis of spatial clustering of village malaria cases by Plasmodium species was performed by year. Overall, malaria annual incidence rates per 1000 inhabitants decreased from 86 (2010) to 30 (2014). Falciparum incidence decreased (by 79% in 2014 compared to 2010; CI 95% 76-82%) more rapidly than vivax incidence (by 19% in 2014 compared to 2010; CI 95% 5-32%). There were ten to 16 significant spatial clusters each year. Big clusters tended to extend along the Cambodian-Vietnamese border and along the Sesan River. Three clusters appeared throughout all years (2010-2014): one with 21 villages appeared each year, the second shrunk progressively from 2012 to 2014 and the third was split into two smaller clusters in 2013 and 2014. The decline of malaria burden can be attributed to intensive malaria control activities implemented in the areas: distribution of a long-lasting insecticidal net per person

  3. Survey on treatments for primary headaches in 13 specialized juvenile Headache Centers: The first multicenter Italian study.

    Science.gov (United States)

    Toldo, Irene; Rattin, Martina; Perissinotto, Egle; De Carlo, Debora; Bolzonella, Barbara; Nosadini, Margherita; Rossi, Livia Nicoletta; Vecchio, Angelo; Simonati, Alessandro; Carotenuto, Marco; Scalas, Cinzia; Sciruicchio, Vittorio; Raieli, Vincenzo; Mazzotta, Giovanni; Tozzi, Elisabetta; Valeriani, Massimiliano; Cianchetti, Carlo; Balottin, Umberto; Guidetti, Vincenzo; Sartori, Stefano; Battistella, Pier Antonio

    2017-05-01

    The purpose of this retrospective multicenter study was to evaluate the use and the self-perceived efficacy and tolerability of pharmacological and non-pharmacological treatments in children and adolescents with primary headaches. Study of a cohort of children and adolescents diagnosed with primary headache, consecutively referred to 13 juvenile Italian Headache Centers. An ad hoc questionnaire was used for clinical data collection. Among 706 patients with primary headaches included in the study, 637 cases with a single type of headache (migraine 76% - with and without aura in 10% and 67% respectively; tension-type headache 24%) were selected (mean age at clinical interview: 12 years). Acetaminophen and non-steroidal anti-inflammatory drugs (in particular ibuprofen) were commonly used to treat attacks, by 76% and 46% of cases respectively. Triptans were used overall by 6% of migraineurs and by 13% of adolescents with migraine, with better efficacy than acetaminophen and non-steroidal anti-inflammatory drugs. Preventive drugs were used by 19% of migraineurs and by 3% of subjects with tension-type headache. In migraineurs, flunarizine was the most frequently used drug (18%), followed by antiepileptic drugs (7%) and pizotifen (6%), while cyproheptadine, propanolol and amitriptyline were rarely used. Pizotifen showed the best perceived efficacy and tolerability. Melatonin and nutraceuticals were used by 10% and 32% of subjects, respectively, both for migraine and tension-type headache, with good results in terms of perceived efficacy and tolerability. Non-pharmacological preventive treatments (i.e. relaxation techniques, biofeedback, cognitive-behavioral therapy, acupuncture) were used only by 10% of cases (migraine 9%, tension-type headache 15%). Non-steroidal anti-inflammatory drugs, especially ibuprofen, should be preferred to acetaminophen for acute attacks of migraine or tension-type headache, because they were usually more effective and well tolerated. Triptans

  4. Sarmatian Burials Near the Astanino Village in the Eastern Crimea

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    Kropotov Viktor Valeryevich

    2015-06-01

    Full Text Available The present article contains the materials of two Sarmatian burials that had been studied in 1966-1967 years by the Kerch expedition of Institute of Archeology of Academy of Sciences of Ukraine (the chief of expedition – A.M. Leskov in the Astanino village in the Eastern Crimea. These burials had been made on small depth in embankments of barrows of the bronze epoch, therefore it is not possible to track contours of funeral constructions. The dead were laid on their backs, heads turned to the North and the North-West. The utensils buried in the same tombs included two ceramic gray-clay pelikes, two gray-clay bowls, a red-gloss vessel, a red-clay pottery, a set of glass and cornelian beads, and the Egyptian faience beads. These things allow to exactly date the investigated complexes within the second half of the 1st century BC – the beginnings of the 1st century AD. The main distinctive characteristics of Early-Sarmatian burials of Northern Pontic region consist in the use of already existing barrows for burial places, orientations of the dead in the Northern sector, the insignificant depth of burials. Therefore published monuments should be also referred to them. A small number of such complexes with their distribution on the quite big territory between the Don and Dnepr rivers testify to the low density of the nomadic population at that time. The antique sources of the end of the 2nd – 1st centuries BC mention the presence of Roxolani in the given region. The described complexes supplement our poor knowledge of Sarmatian antiquities of the Eastern Crimea and specify the direct contacts of nomads of Northern Pontic region to the antique centers, in immediate proximity from which they had been located.

  5. Communicating new ideas to traditional villagers (an Indonesian case).

    Science.gov (United States)

    Muis, A

    1984-01-01

    Recent cases derived from a series of communication research projects conducted in remote villages on the island of Sulawesi, Indonesia, are presented. These cases, which indicate the tremendously complex problem of communicating new ideas to traditional villages, also reflect the equally complex problem of social marketing. Indonesian, villagers remain very traditional, but their communication environment has been undergoing marked changes over the past decade or so. Overwhelming media exposure has pushed these people towards a modern environment filled with new knowledge and experiences. In view of the importance of changing attitudes and behavior of traditional villagers -- to realize modernization for the rural society -- the government of Indonesia has been using a host of communication means and channels. These include all the viable traditional or indigenous communication systems, but mainly face-to-face communication. Traditional dances, story-telling, and music are no longer interesting to the rural people themselves, and, apparently, no real developmental message can be transmitted by traditional "mass media." Among the 50 respondents randomly selected from the isolated village of Gelang (Case I), only 17% claimed to have listened to news in addition to music and songs. 67% of the respondents explained that information carrying novel ideas or methods usually attract them, but they are always reluctant to accept the new ideas for real application. Case II is about the effect of movie exposure on traditional villagers. As many as 73% of 50 respondents explained that the knowledge of the peasant-fisherman has increased considerably with regard to the urban way of life, as a result of movie attendance. The informants indicated that many villagers were disgusted by feature films or theatrical ones and that 62% of the villagers had yet to go to a movie. Case III involved the communication of new methods of medication to rural societies, including traditional

  6. Paclitaxel-Coated Balloons for the Treatment of Dysfunctional Dialysis Access. Results from a Single-Center, Retrospective Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kitrou, Panagiotis M., E-mail: panoskitrou@gmail.com; Spiliopoulos, Stavros; Papadimatos, Panagiotis; Christeas, Nicolaos; Petsas, Theodoros; Katsanos, Konstantinos; Karnabatidis, Dimitris [Patras University Hospital, Interventional Radiology Department (Greece)

    2017-01-15

    PurposeTo investigate the safety and effectiveness of lutonix paclitaxel-coated balloon (PCB) for the treatment of dysfunctional dialysis access.Materials and MethodsThis was a single-center, single-arm, retrospective analysis of 39 patients (23 male, 59 %) undergoing 61 interventions using 69 PCBs in a 20-month period. There was a balance between arteriovenous fistulae (AVF) and grafts (AVG) (20 AVFs, 19AVGs), and the majority of lesions were restenotic (25/39, 64.1 %). Mean balloon diameter used was 6.6 mm and length 73.4 mm. Primary outcome measure was target lesion primary patency (TLPP) at 6 months, while secondary outcome measures included factors affecting TLPP and major complications. As there were lesions treated more than once with PCB, authors also compared patency results after first and second PCB angioplasty.ResultsTLPP was 72.2 % at 6 months with a median patency of 260 days according to the Kaplan–Meier survival analysis. No major complications occurred. TLPP between AVFs and AVGs (311 vs. 237 days, respectively; p = 0.29) and de novo and restenotic lesions was similar (270.5 vs. 267.5 days, respectively; p = 0.50). In 14 cases, in which lesions were treated with two PCB angioplasties, a statistically significant difference in TLPP after the second treatment was noted (first intervention 179.5 days vs. second intervention 273.5 days; p = 0.032).ConclusionIn this retrospective analysis, Lutonix PCB proved to be safe and effective in treating restenosis in dysfunctional dialysis access with results comparable to the literature available. Larger studies are needed to prove abovementioned results.

  7. Transpars Microscopic Approach for the Treatment of Purely Foraminal Herniated Lumbar Disc: A Clinical, Radiological, Two-center Study.

    Science.gov (United States)

    De Bonis, Pasquale; Mongardi, Lorenzo; Pompucci, Angelo; Ricciardi, Luca; Cavallo, Michele Alessandro; Farneti, Marco; Lapparelli, Marcello; Capone, Gennaro; Altruda, Carmela; Schivalocchi, Roberta; Campioni, Paolo; Ghisellini, Giulia; Trapella, Giorgio

    2017-03-15

    This is a prospective two-center study. The aim of this study was to assess the safety and efficacy of treating patients with lumbar foraminal disc herniations via a microscopic transpars approach, with a clinical and radiological follow-up evaluation. Purely foraminal lumbar disc herniations comprise about 5% of all lumbar herniated intervertebral discs. Operative management can be technically difficult, and the optimum surgical treatment remains controversial. From January 2012 to January 2015, 47 patients were prospectively recruited. Patients were followed-up as outpatients at 1 week after discharge, then at 1, 6, and 12 months.A clinical multiparametric evaluation of patients including numeric rating scale (NRS), drugs intake, Macnab criteria, and working days lost was used.Postoperative dynamic x-rays (flexion, extension) were performed in all cases 12 months after surgery. No surgery-related complications occurred.Among the 35 patients who were not retired at the time of the study, 29 patients returned to work and to normal daily activities within 60 days after surgery.Pain evaluation at discharge showed a significant improvement of NRS score, from 8.93 to 1.45 at 12 months. Root palsy significantly improved in all cases already at 1-month follow-up. Drugs intake analysis showed that at 6-month follow-up, no patients used steroids, or opioids, 17 patients used non-steroidal anti-inflammatory drugs when needed, and 29 patients (61.7%) used no drugs for pain relief. No significant variations occurred at 12-month-follow-up.At 12-month follow-up, excellent or good outcome (following Macnab criteria) was achieved in 36 (76.6%) and 8 (17%) patients, respectively.There were no cases of spinal instability at 12-month radiological evaluation.No recurrence occurred at follow-up. Transpars microscopic approach is effective and safe for the treatment of FLDH, but larger studies are needed. 3.

  8. The Prevalence and Incidence of Latent Tuberculosis Infection and Its Associated Factors among Village Doctors in China.

    Directory of Open Access Journals (Sweden)

    Guangxue He

    Full Text Available China is a high tuberculosis (TB burden country. More than half of acute TB cases first seek medical care in village doctors' clinics or community health centers. Despite being responsible for patient referral and management, village doctors are not systematically evaluated for TB infection or disease. We assessed prevalence and incidence of latent TB infection (LTBI among village doctors in China.A longitudinal study was conducted in Inner Mongolia Autonomous Region. We administered a questionnaire on demographics and risk factors for TB exposure and disease; Tuberculin skin testing (TST and QuantiFERON-TB Gold in-tube assay (QFT-GIT was conducted at baseline and repeated 12 months later. We used a logistic regression model to calculate adjusted odds ratios (ORs for risk factors for TST and QFT-GIT prevalence and incidence. At the time of follow up, 19.5% of the 880 participating village doctors had a positive TST and 46.0% had a positive QFT-GIT result. Factors associated with TST prevalence included having a BCG scar (OR = 1.45, 95%CI 1.03-2.04 and smoking (OR = 1.69, 95%CI 1.17-2.44. Risk factors associated with QFT-GIT prevalence included being male (OR = 2.17, 95%CI 1.63-2.89, below college education (OR=1.42, 95%CI 1.01-1.97, and working for ≥25 years as a village doctor (OR = 1.64, 95%CI 1.12-2.39. The annual incidence of LTBI was 11.4% by TST and 19.1% by QFT-GIT. QFT-GIT conversion was associated with spending 15 minutes or more per patient on average (OR = 2.62, 95%CI 1.39-4.97 and having BCG scar (OR = 0.53, 95%CI 0.28-1.00.Prevalence and incidence of LTBI among Chinese village doctors is high. TB infection control measures should be strengthened among village doctors and at village healthcare settings.

  9. Treatment of facial fractures at the VU University Medical Center in Amsterdam using 3D virtual planning and printing technology

    Directory of Open Access Journals (Sweden)

    Marteen Veh Meijeer

    2016-06-01

    Full Text Available Traumatic or congenital defects of oneor more of the tissues of the face can lead to major functional and aesthetic impairments. Facialdeformities are commonly caused by violent assaults, falls, traffic accidents or sportinjuries, followed by genetic disorders, cancer, ballistic injuries or infections.To date, numerous materials and methods are used to reconstruct such fractures. In this context medical 3D printing is changing the world of medical treatment. Moreover 3D printing offers unique ways to precisely control the matrix architecture in terms of size, shape, interconnectivity, branching, geometry and orientation. Additive manufacturing in combination with advanced medical imaging techniques such as Computed Tomography (CT and Magnetic Resonance Imaging (MRI is causing a paradigm in the field of surgery from classical serial production to patient specific constructs. When it comes to materials autologous bone grafts are still considered to be the “gold standard”in reconstructive bone surgery due to their low immunogenicity, simultaneous presenceof stem cells and growth factors as well as their osteoinductive and osteconductiveproperties. Moreover, autologous bone possesses the intrinsiccapacity to regenerate without the formation of scare tissue and to continuouslyremodel throughout life. This presentation describes the etiology of facial fractures in the Amsterdam, Netherlands, area and furthermore the planning and reconstruction of facials fractures we currently use at the VU university Medical Center; a simple, precise and cost-effective method of planning and treating facial and orbital fractures using 3D planning and 3D printing technologies in combination with titinium miniplates and autologous bone.

  10. Improvement of Treatment Outcomes after Implementation of a Massive Transfusion Protocol: A Level I Trauma Center Experience.

    Science.gov (United States)

    Nunn, Andrew; Fischer, Peter; Sing, Ronald; Templin, Megan; Avery, Michael; Christmas, A Britton

    2017-04-01

    We assessed the effectiveness of the implementation of an institutional massive transfusion protocol (MTP) for resuscitation with a 1:1:1 transfusion ratio of packed red blood cell (PRBC), fresh frozen plasma, and platelet units. In a Level I trauma center database, all trauma admissions (2004-2012) that received massive transfusions (≥10 units PRBCs in the first 24 hours) were reviewed retrospectively. Demographic data, transfusion ratios, and outcomes were compared before (PRE) and after (POST) MTP implementation in May 2008. Age, sex, and mechanism of injury were similar between 239 PRE and 208 POST trauma patients requiring massive transfusion. Transfusion ratios of fresh frozen plasma:PRBC and platelet:PRBC increased after MTP implementation. Among survivors, MTP implementation shortened hospital length of stay from 31 to 26 days (P = 0.04) and intensive care unit length of stay from 31 to 26 days (P = 0.02). Linear regression identified treatment after (versus before) implementation of MTP as an independent predictor of decreased ventilator days after adjusting for age, Glasgow Coma Scale, and chest Abbreviated Injury Score (P < 0.0001). Modest improvement in ratios likely does not account for all significant improvements in outcomes. Implementing a standardized protocol likely impacts automation, efficiency, and/or timeliness of product delivery.

  11. Research advances in treatment of neurological and psychological diseases by acupuncture at the Acupuncture Meridian Science Research Center

    Directory of Open Access Journals (Sweden)

    Bombi Lee

    2014-06-01

    Full Text Available Acupuncture is an ancient therapeutic intervention that can be traced back at least 2100 years and is emerging worldwide as one of the most widely used therapies in the field of complementary and alternative medicine. Due to limitations associated with Western medicine's focus on the treatment of diseases rather than on their causes, interests are shifting to complementary and alternative medicines. The Acupuncture and Meridian Science Research Center (AMSRC was established in 2005 to elucidate the neurophysiological mechanisms of acupuncture for neurological diseases based on multidisciplinary research supported by the Korean Ministry of Science and Technology. In the AMSRC, resultant research articles have shown that acupuncture can improve neurological and psychological problems, including Parkinson's disease, pain, and depression, in animal models. Basic research studies suggest its effectiveness in treating various problems such as depression, drug addiction, epilepsy, ischemia, dementia, Parkinson's disease, and pain. We strongly believe that these effects, evident from the AMSRC research results, can play leading roles in the use of acupuncture for treating neurological diseases, based on collaboration among various academic fields such as neurophysiology, molecular genetics, and traditional Korean medicine.

  12. Research advances in treatment of neurological and psychological diseases by acupuncture at the Acupuncture Meridian Science Research Center.

    Science.gov (United States)

    Lee, Bombi; Kim, Seung-Nam; Park, Hi-Joon; Lee, Hyejung

    2014-06-01

    Acupuncture is an ancient therapeutic intervention that can be traced back at least 2100 years and is emerging worldwide as one of the most widely used therapies in the field of complementary and alternative medicine. Due to limitations associated with Western medicine's focus on the treatment of diseases rather than on their causes, interests are shifting to complementary and alternative medicines. The Acupuncture and Meridian Science Research Center (AMSRC) was established in 2005 to elucidate the neurophysiological mechanisms of acupuncture for neurological diseases based on multidisciplinary research supported by the Korean Ministry of Science and Technology. In the AMSRC, resultant research articles have shown that acupuncture can improve neurological and psychological problems, including Parkinson's disease, pain, and depression, in animal models. Basic research studies suggest its effectiveness in treating various problems such as depression, drug addiction, epilepsy, ischemia, dementia, Parkinson's disease, and pain. We strongly believe that these effects, evident from the AMSRC research results, can play leading roles in the use of acupuncture for treating neurological diseases, based on collaboration among various academic fields such as neurophysiology, molecular genetics, and traditional Korean medicine.

  13. The Mortality Rate of Nosocomial Infection in Neonatal Intensive Care Unit (NICU of Taleghani Educational and Treatment Center, Tabriz, 2013

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    Parvin Abbasian

    2015-09-01

    Full Text Available Background and Objectives : Information about nosocomial infections (NIs is necessary for both appropriate management and establishment of preventative measures in hospitals. Neonates admitted to the Neonatal Intensive Care Unit (NICU are at high-risk of developing nosocomial infection. The aim of this study was to determine the mortality rate of nosocomial infections and the distribution of pathogens among newborns who were admitted to the neonatal intensive care unit in Taleghani educational and treatment center, Tabriz. Material and Methods : This was a cross-sectional study. The sampling method was census. The inclusion criteria were dead infants who developed signs of infection after 48 hours of hospitalization and those who had symptoms at the admission were excluded. Data were collected through hospital records and were analyzed using Excel software. Results: From 904 infants admitted to NICU, 39 (4.3% acquired hospital infection. Mortality from nosocomial infections in NICU was 20.5% that was 12% of the total deaths. Coagulase-negative staphylococcal Cook (37.5% and Escherichia coli (25% were the most commonly identified agents among dead neonates. Conclusion: For more reduction in nosocomial infection and its mortality rate, mercury hygiene principles and also optimizing bed spaces are recommended. ​

  14. Late effects of treatment in survivors of childhood cancer from a tertiary cancer center in South India

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    Rejiv Rajendranath

    2014-01-01

    Full Text Available Background: Improved survival after childhood cancer is attributed to intensive, aggressive therapy, adverse sequelae of which can manifest months to years after completion of treatment. There is little information about the late adverse effects of both childhood cancer and its therapy in survivors in India. Aim: To determine the long-term sequelae associated with therapy in childhood cancer survivors attending a tertiary cancer center in India. Materials and Methods: We studied 155 consecutive survivors of childhood cancer who were ≤14 years at the time of diagnosis and had completed 3 years of follow-up. The study included a complete history and clinical examination, with specific investigations to detect organ toxicity. Quality of life (QOL was assessed from responses to a standardized questionnaire. Neurocognitive assessment was carried out in 20 survivors with an adaptation of the revised Wechsler adult intelligence scale for adults and the Malins intelligence scale for children. Results: The late effects included impaired fertility in 38 patients (24.5%, impaired growth pattern in 7 (4.5%, endocrine dysfunction in 7 (4.5% and second malignancy in 2 (1.2%. Three of the 20 patients assessed had severe neurocognitive impairment. A high QOL was reported by 60% of survivors and an "average" QOL by 38%. Conclusion: Our study showed that most survivors had a good QOL and our results will help clinicians to better monitor childhood cancer survivors in countries with limited resources.

  15. Treatment of the iatrogenic lesion of the biliary tree secondary to laparoscopic cholecystectomy: a single center experience.

    Science.gov (United States)

    Tropea, Alessandro; Pagano, Duilio; Biondi, Antonio; Spada, Marco; Gruttadauria, Salvatore

    2016-06-01

    Surgical bile duct injury (SBDI), during laparoscopic cholecystectomy, is a worldwide ongoing problem. The purpose of this study is to analyze a single center retrospective experience with this topic. From 1999 to 2012, 30 patients with diagnosis of SBDI after laparoscopic cholecystectomy performed in other institute for gallbladder lithiasis and then transferred to our facility were enrolled in this analysis. We considered in the study the following parameters: classification and site of the bile duct injury, infective complications and therapeutic management according to early or late referral. Twenty four patients (80 %) had a SBDI type E1; a concomitant vascular injury was described in 3/30 (10 %) in right hepatic artery. 11 patients had HJJ as primary surgical treatment in our hospital. Surgical site infection was documented in 9/30 (30 %). The most common micro-organisms documented in SSI were E. coli with an incidence of 55.5 % of SSI. Worse infective complications were detected in the late referral group. Complex SBDI occurred during laparoscopic cholecystectomy should be early referred to advanced hepatobiliary program, for appropriate multidisciplinary management.

  16. The Effect of Near Total Pancreatectomy in Treatment of Hyperinsulinemic Hyperglycemic Infants Children’s Medical Center 2000

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    M Klantary

    2002-09-01

    Full Text Available Background: There are many surgical approaches for hyperinsulinemic hyperglycemic treatment. Subtotal pancreatectomy which has been used for many years, is abounded know due to high recurrence rate, and has been replaced by near total resection. This study focuses on “near total resection”. Materials and Mehods: In this study 15 cases of hyper insulinemic hyperglycemia patients which has been operated since year 1985 till 2000 in the Childrens Medical Center, has brought into consideration and described as a case series study. Results: From the patients, three cases were operated by subtotal pancreatomy and all of them have had recurrence. In the remaining twelve cases, the method used was different and “near subtotal pancreatomy” were used. The recurrence rate in this group was zero and there were not also any case of sepsis. Postoperative complications were rather low and the most common postoperative finding in these patients was transient hypoglycemia. Conclusion: Near total pancreatomy for hyperinsulinemic hypoglycemia which is implemented by an expert surgeon with low complication and high cure rate, can be considered as a safe technique with high cure rate and satisfactory results.

  17. Abolishing Fees at Health Centers in the Context of Community Case Management of Malaria: What Effects on Treatment-Seeking Practices for Febrile Children in Rural Burkina Faso?

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    Thomas Druetz

    Full Text Available Burkina Faso started nationwide community case management of malaria (CCMm in 2010. In 2011, health center user fees for children under five were abolished in some districts.To assess the effects of concurrent implementation of CCMm and user fees abolition on treatment-seeking practices for febrile children.This is a natural experiment conducted in the districts of Kaya (CCMm plus user fees abolition and Zorgho (CCMm only. Registry data from 2005 to 2014 on visits for malaria were collected from all eight rural health centers in the study area. Annual household surveys were administered during malaria transmission season in 2011 and 2012 in 1,035 randomly selected rural households. Interrupted time series models were fitted for registry data and Fine and Gray's competing risks models for survey data.User fees abolition in Kaya significantly increased health center use by eligible children with malaria (incidence rate ratio for intercept change = 2.1, p <0.001. In 2011, in Kaya, likelihood of health center use for febrile children was three times higher and CHW use three times lower when caregivers knew services were free. Among the 421 children with fever in 2012, the delay before visiting a health center was significantly shorter in Kaya than in Zorgho (1.46 versus 1.79 days, p <0.05. Likelihood of visiting a health center on the first day of fever among households <2.5 km or <5 km from a health center was two and three times higher in Kaya than in Zorgho, respectively (p <0.001.User fees abolition reduced visit delay for febrile children living close to health centers. It also increased demand for and use of health center for children with malaria. Concurrently, demand for CHWs' services diminished. User fees abolition and CCMm should be coordinated to maximize prompt access to treatment in rural areas.

  18. Growth performance of free-range village chickens fed dehydrated processed food waste

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    Hossein, S.

    2015-06-01

    Full Text Available The effect of dehydrated processed food waste (DPFW inclusion in the diets on the growth performance (feed intake, body weight gain, body weight change and feed conversion ratio of free-range village chickens was investigated. Food waste collected from 20 different restaurants of Universiti Putra Malaysia Serdang Selangor was processed into DPFW containing 89.3% dry matter, 16% crude protein, 7.1% crude fat, 3.7% crude fiber, 7.4% crude ash, 3.07% NaCl, 1.56% Ca, 0.87% phosphorous and 4053 kcal/kg GE. A total of of 180 village chickens of the Arabian breed were randomly allocated into four dietary treatments of 0 (control, 20, 40 and 60% DPFW for 5-9 week grower and 10-14 week finisher periods with three replicates (15 birds for each replicate. The results showed that the highest feed intake in grower and finisher phases was observed in the control group by 634.0 g and 2,722.1 g, respectively, while the lowest was in 60% DPFW with 586.3 g for grower and 2,542.6 g for finisher phases (P0.05. Body weight gain and body weight change declined linearly with increasing levels of DPFW of more than 20% in the village chicken diets during both grower and finisher rearing phases. FAR increased (P0.05. In conclusion it seems that the dehydrated processed food waste could substitute 20% of formulated feed in grower and finisher phases of free-range village chickens without any adverse effects on growth performance.

  19. The Effect of Matrix Method on Anxiety and Attitude Toward Methamphetamine and Crack Abuse in Males Referring to Addiction Treatment Centers in Tonkabon, Iran

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    Hemmati Sabet

    2015-11-01

    Full Text Available Background Drug abuse is a major problem in the communities and has many harmful effects on human body. Objectives The current study aimed to compare the efficacy of matrix method on anxiety and attitude of male crack abusers referred to addiction treatment centers in Tonkabon, Iran, in 2014. Patients and Methods The current semi -experimental study included 1,000 males referred to addiction treatment centers in Tonkabon with crack abuse history in 2014. Based on Morgan sample volume formula, 278 males with anxiety and higher attitude to drug abuse were randomly selected from 1,000 males referred to addiction treatment centers in Tonkabon. Then, 30 subjects were reselected out of them and equally assigned into two groups of experimental and control, 15 subjects in each group. The experimental group received 24 sessions of 30 - 60 minutes matrix treatment method in group, but the control group received no training. At the end of training period the post-test was carried out. The research findings confirmed the efficacy of matrix method on anxiety and attitude to crack abuse among those referring to the addition treatment center. Results The single covariance analysis of ANCOVA indicated that the value of Eta about 72% of variance of anxiety variable and about 76% of variance of drug abuse variable are taken in to account for variable of group. The intervention was effective in reducing anxiety and attitude to crack in males. Evaluating the adjusted mean showed the effectiveness of matrix method on anxiety and attitude to crack abuse in males. Conclusions The research result showed that matrix method affected the reduction of methamphetamine and attitude to crack abuse in males referred to the addition treatment center.

  20. Socio-Cultural Impacts in the Formation of Urban Village

    Science.gov (United States)

    Marpaung, B. O. Y.

    2017-03-01

    In Indonesia, a group of village people tends to move from one place to another and develops a living space to create a settlement. This research is conducted by taking an example of a particular ethnic group that leaves the forestry area to a new place in the city. After some time, this group of people creates a similar or adapted socio-cultural system adapted from their origin place. The purpose of this research is to examine the socio-cultural aspects that significantly influence the emergence of urban village. This influence is interpreted as social and cultural relations with the establishment of space and significance of urban village. By focusing on this issue, this research will trace the process of how a new and unplanned settlement could emerge. The process and elements are indispensable from social and cultural factors. Essentially, the shape of bulit space is a non-physical manifestation of local people, which is established from time to time. In this case, the research’s challenge lies on the circumstance in Indonesia where society and culture influence the emergence of urban village. Physical appearance can be identified as a tipology of settlement and morphology of urban village.

  1. Pretreatment drug use characteristics and experiences among patients in a voluntary substance abuse treatment center in Malaysia: A mixed-methods approach.

    Science.gov (United States)

    Krishnan, Archana; Brown, Shan-Estelle; Ghani, Mansur A; Khan, Farrah; Kamarulzaman, Adeeba; Altice, Frederick L

    2016-01-01

    Drug use in Malaysia remains a significant public health and social problem despite implementation of harsh punitive drug policies such as forcibly placing suspected drug users into compulsory drug detention centers (CDDCs). Following criticism over human right violations in CDDCs, Malaysia has begun to transition towards voluntary drug treatment centers known as Cure & Care (C&C) centers. To best serve the needs of regional C&C centers, data on drug use are essential among patients accessing treatment. Using a mixed-methods approach, the authors examined pretreatment drug use characteristics and experiences with addiction treatment among C&C patients in Kelantan-a religiously conservative state in northeast Malaysia with high prevalence of drug use but where limited data are available on drug use patterns. A mixed-methods study utilizing surveys (n = 96) and semistructured interviews (n = 20) was conducted among a convenience sample of inpatients and outpatients at the Pengkalan Chepa C&C Center in Kelantan. Survey results showed that 89.6% of participants met screening criteria for moderate to severe addiction severity. Nearly 90% reported lifetime illicit amphetamine (syabu, meth, ice, and pil kuda) use, followed by alcohol (60.4%) and opioids (52.1%). Qualitative results pointed to the powerful influence of peer networks in drug initiation and relapse, and the positive effect of the C&C center on drug rehabilitation. The drug use profile of the Kelantan C&C center enrollees shows extensive pretreatment amphetamine use, polysubstance use, and injection drug use, including high-risk behaviors such as sharing needles, syringes, and containers. Evidence points to the need for integration of social support-oriented practices and behavioral interventions into the rehabilitation of drug users in this region.

  2. Multi-center randomized controlled trial of cognitive treatment, placebo, oxybutynin, bladder training, and pelvic floor training in children with functional urinary incontinence

    NARCIS (Netherlands)

    van Gool, Jan D.; de Jong, Tom P. V. M.; Winkler-Seinstra, Pauline; Tamminen-Moebius, Tytti; Lax, Hildegard; Hirche, Herbert; Nijman, Rien J. M.; Hjalmas, Kelm; Jodal, Ulf; Bachmann, Hannsjoerg; Hoebeke, Piet; Vande Walle, Johan; Misselwitz, Joachim; John, Ulrike; Bael, An

    Objective Functional urinary incontinence causes considerable morbidity in 8.4% of school-age children, mainly girls. To compare oxybutynin, placebo, and bladder training in overactive bladder (OAB), and cognitive treatment and pelvic floor training in dysfunctional voiding (DV), a multi-center

  3. "In their perception we are addicts": social vulnerabilities and sources of support for men released from drug treatment centers in Vietnam.

    Science.gov (United States)

    Tomori, Cecilia; Go, Vivian F; Tuan, Le Nhan; Huong, Nguyen Mai; Binh, Nguyen Thanh; Zelaya, Carla E; Celentano, David D; Dat, Do Tuan; Quan, Vu Minh

    2014-09-01

    Amid the global transition to treat opioid addiction as an illness, many people who inject drugs (PWID) face heterogeneous legal environments that include both punitive and harm reduction measures. In Vietnam, many PWID, who have a high burden of HIV, are sent to drug treatment centers, or "06 centers", for compulsory detoxification, vocational training, and labor for up to four years. This study investigates the challenges and facilitators of reentry into community and family life among men who are released from "06 centers" and provides insights and recommendations for developing policies and interventions that address special needs of this vulnerable population. In-depth interviews were conducted in 2011 by trained interviewers among a sample of 43 male PWID released within the past 2 years from "06 centers" in Hanoi, Vietnam to investigate the above issues and to recommend potential interventions. Participants were recruited from outpatient HIV clinics that serve PWID (n=22) and through peer referral from self-help groups for PWID (n=21). Interviews were audiotaped, transcribed, translated, entered into Atlas.TI qualitative data analysis software and analyzed for key themes. The interviews revealed persistent drug-related stigmatization, frequently paired with HIV-related stigmatization and discrimination, which hindered employment, increased participants' social isolation and exacerbated their struggles with addiction. Families were participants' primary source of financial, employment, and emotional support, but addiction-related family tensions also had negative psychological effects. Participants identified methadone maintenance treatment as an effective means of overcoming addiction, yet few could fully benefit from this treatment due to its limited availability. Our study suggests that PWID released from "06 centers" would greatly benefit from the scale-up of community-based harm reduction measures that include addiction and HIV treatment, coupled with

  4. Treatment of Household Waste in Small Towns of China: Status, Basic Conditions and Appropriate Modes

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    HE Pin-jing

    2015-04-01

    Full Text Available Small town is the gateway of population migrating from rural areas to urban areas in the process of urbanization. The level of its household solid waste treatment is pivotal to the environmental and sanitary quality of surrounding rural areas. Furthermore, small town is the primary administrative center for rural districts, and will impose important influences on the solid waste management in villages. Therefore, it is necessary to investigate the effects of treatment modes on the household solid waste treatment in towns and surrounding villages. Based on the waste generation in small towns, this study analyzed the current status and existing problems for solid waste treatment, and discussed the related administrative management and financial supporting conditions in small towns. By summarizing the characteristics of the existing modes and comparing the costs for different treatment modes, the present study proposed that the most appropriate mode was“diversion in villages-diversion, transportation or treatment in towns-treatment and disposal in counties”, in which the town was the core node for the treatment of rural solid waste, so that the administrative and financial advantages of small towns could be highlighted and consequentially promoted the management of rural solid waste.

  5. Randomised primary health center based interventions to improve the diagnosis and treatment of undifferentiated fever and dengue in Vietnam

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    Binh Tran Q

    2010-09-01

    Full Text Available Abstract Background Fever is a common reason for attending primary health facilities in Vietnam. Response of health care providers to patients with fever commonly consists of making a presumptive diagnosis and proposing corresponding treatment. In Vietnam, where malaria was brought under control, viral infections, notably dengue, are the main causes of undifferentiated fever but they are often misdiagnosed and inappropriately treated with antibiotics. This study investigate if educating primary health center (PHC staff or introducing rapid diagnostic tests (RDTs improve diagnostic resolution and accuracy for acute undifferentiated fever (AUF and reduce prescription of antibiotics and costs for patients. Methods In a PHC randomized intervention study in southern Vietnam, the presumptive diagnoses for AUF patients were recorded and confirmed by serology on paired (acute and convalescence sera. After one year, PHCs were randomized to four intervention arms: training on infectious diseases (A, the provision of RDTs (B, the combination (AB and control (C. The intervention lasted from 2002 until 2006. Results The frequency of the non-etiologic diagnosis "undifferentiated fever" decreased in group AB, and - with some delay- also in group B. The diagnosis "dengue" increased in group AB, but only temporarily, although dengue was the most common cause of fever. A correct diagnosis for dengue initially increased in groups AB and B but only for AB this was sustained. Antibiotics prescriptions increased in group C. During intervention it initially declined in AB with a tendency to increase afterwards; in B it gradually declined. There was a substantial increase of patients' costs in B. Conclusions The introduction of RDTs for infectious diseases such as dengue, through free market principles, does improve the quality of the diagnosis and decreases the prescription of antibiotics at the PHC level. However, the effect is more sustainable in combination with

  6. Randomised primary health center based interventions to improve the diagnosis and treatment of undifferentiated fever and dengue in Vietnam.

    Science.gov (United States)

    Phuong, Hoang L; Nga, Tran T T; Giao, Phan T; Hung, Le Q; Binh, Tran Q; Nam, Nguyen V; Nagelkerke, Nico; de Vries, Peter J

    2010-09-21

    Fever is a common reason for attending primary health facilities in Vietnam. Response of health care providers to patients with fever commonly consists of making a presumptive diagnosis and proposing corresponding treatment. In Vietnam, where malaria was brought under control, viral infections, notably dengue, are the main causes of undifferentiated fever but they are often misdiagnosed and inappropriately treated with antibiotics.This study investigate if educating primary health center (PHC) staff or introducing rapid diagnostic tests (RDTs) improve diagnostic resolution and accuracy for acute undifferentiated fever (AUF) and reduce prescription of antibiotics and costs for patients. In a PHC randomized intervention study in southern Vietnam, the presumptive diagnoses for AUF patients were recorded and confirmed by serology on paired (acute and convalescence) sera. After one year, PHCs were randomized to four intervention arms: training on infectious diseases (A), the provision of RDTs (B), the combination (AB) and control (C). The intervention lasted from 2002 until 2006. The frequency of the non-etiologic diagnosis "undifferentiated fever" decreased in group AB, and - with some delay- also in group B. The diagnosis "dengue" increased in group AB, but only temporarily, although dengue was the most common cause of fever. A correct diagnosis for dengue initially increased in groups AB and B but only for AB this was sustained. Antibiotics prescriptions increased in group C. During intervention it initially declined in AB with a tendency to increase afterwards; in B it gradually declined. There was a substantial increase of patients' costs in B. The introduction of RDTs for infectious diseases such as dengue, through free market principles, does improve the quality of the diagnosis and decreases the prescription of antibiotics at the PHC level. However, the effect is more sustainable in combination with training; without it RDTs lead to an excess of costs.

  7. Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Prologo, J.D. [Emory University Hospital, Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Atlanta, GA (United States); Passalacqua, Matthew; Patel, Indravadan; Bohnert, Nathan [University Hospitals Case Medical Center, Department of Radiology, Cleveland, OH (United States); Corn, David J. [University Hospitals Case Medical Center, Departments of Radiology and Biomedical Engineering, Cleveland, OH (United States)

    2014-11-15

    The role of image-guided thermal ablation techniques for the nonoperative local management of painful osseous metastatic disease has expanded during recent years, and several advantages of cryoablation in this setting have emerged. The purpose of this study is to retrospectively evaluate and report a single-center experience of CT-guided percutaneous cryoablation in the setting of painful musculoskeletal metastatic disease. This study was approved by the institutional review board and is compliant with the Health Insurance Portability and Accountability Act. Electronic medical records of all patients who underwent percutaneous image-guided palliative cryoablation at our institution were reviewed (n = 61). An intent-to-treat analysis was performed. Records were reviewed for demographic data and anatomical data, primary tumor type, procedure details, and outcome - including change in analgesic requirements (expressed as morphine equivalent dosages), pain scores (utilizing the clinically implemented visual analog scale), subsequent therapies (including radiation and/or surgery), and complications during the 24 h following the procedure and at 3 months. Patients were excluded (n = 7) if data were not retrospectively identifiable at the defined time points. Fifty-four tumors were ablated in 50 patients. There were statistically significant decreases in the median VAS score and narcotic usage at both 24 h and 3 months (p < 0.000). Six patients (11 %) incurred complications related to their therapy. Two patients had no relief at 24 h, of which both reported worsened pain at 3 months. One patient had initial relief but symptom recurrence at 3 months. Four patients went on to have radiation therapy of the ablation site at some point following the procedure. CT-guided cryoablation is a safe, effective, reproducible procedural option for the nonoperative local treatment of painful musculoskeletal metastatic disease. (orig.)

  8. YMDD motif mutations in chronic hepatitis B antiviral treatment naïve patients: a multi-center study

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    You-Wen Tan

    Full Text Available OBJECTIVE: This study aimed to determine the natural prevalence of variants of tyrosine-methionine-aspartic acid-aspartic acid (YMDD motif in patients with chronic hepatitis B (CHB, and to explore its relation with demographic and clinical features, hepatitis B virus (HBV genotypes, and HBV DNA levels. METHODS: A total of 1,042 antiviral treatment naïve CHB patients (including with lamivudine [LAM] in the past year were recruited from outpatient and inpatient departments of six centers from December 2008 to June 2010. YMDD variants were analyzed using the HBV drug resistance line probe assay (Inno-Lipa HBV-DR. HBV genotypes were detected with polymerase chain reaction (PCR microcosmic nucleic acid cross-ELISA, and HBV deoxyribonucleic acid (DNA was quantitated with real-time PCR. All serum samples underwent tests for HBV, HCV, and HDV with ELISA. RESULTS: YMDD variants were detected in 23.3% (243/1042 of CHB patients. YMDD mutation was accompanied by L180M mutation in 154 (76.9% patients. Both wild-type HBV and YMDD variant HBV were present in 231 of 243 patients. Interestingly, 12 patients had only YIDD and/or YVDD variants without wild YMDD motif. In addition, 27.2% (98/359 of HbeAg-positive patients had YMDD mutations, which was higher than that in HbeAg-negative patients (21.2%, 145/683. The incidence of YMDD varied among patients with different HBV genotypes, but the difference was not significant. Moreover, the incidence of YMDD in patients with high HBV DNA level was significantly higher than that in those with low HBV DNA level. CONCLUSION: Mutation of YMDD motif was detectable at a high rate in CHB patients in this study. The incidence of YMDD may be correlated with HBeAg and HBV DNA level.

  9. Probing the Spinning of the Massive Black Hole in the Galactic Center via Pulsar Timing: A Full Relativistic Treatment

    Science.gov (United States)

    Zhang, Fupeng; Saha, Prasenjit

    2017-11-01

    Pulsars around the massive black hole (MBH) in the Galactic center (GC) are expected to be revealed by upcoming facilities (e.g., the Square Kilometer Array). Under a full relativistic framework with the pulsar approximated as a test particle, we investigate the constraints on the spinning of the MBH by monitoring the timing of surrounding pulsars. For GC pulsars orbiting closely around the MBH (e.g., ≲1000 au), we find that full relativistic treatment in modeling accurately their timing signals can be necessary, as the relativistic signals are orders of magnitude larger than the time-of-arrival measurement accuracies. Although usually there are near degeneracies among MBH spin parameters, the constraints on the spinning of the MBH are still very tight. By continuously monitoring a normal pulsar in orbits with a period of ∼2.6 yr and an eccentricity of 0.3–0.9 under a timing precision of 1–5 ms, within ∼8 yr the spin magnitude and the orientations of the GC MBH can be constrained with 2σ error of {10}-3{--}{10}-2 and {10}-1{--}{10}0, respectively. Even for pulsars in orbits similar to the detected star S2/S0-2 or S0-102, we find that the spinning of the MBH can still be constrained within 4–8 yr, with the most significant constraints provided near the pericenter passage. If the proper motion of the pulsars with astrometric accuracy of 10 μas can also be collected along with the timing measurement, then the position, velocity, mass, and distance to the solar system of the MBH can be constrained to ∼10 μas, ∼1 μas yr‑1, ∼ 10 {M}ȯ , and ∼1 pc, respectively.

  10. Treatment of Chlorinated Solvents in Groundwater Beneath an Occupied Building at the Young-Rainey STAR Center, Pinellas, FL

    Energy Technology Data Exchange (ETDEWEB)

    Daniel, Joe [Navarro Research and Engineering; Surovchak, Scott [Dept. of Energy (DOE), Legacy Management; Tabor, Charles [Navarro Research and Engineering

    2016-03-01

    Groundwater contamination, consisting of two dissolved-phase plumes originating from chlorinated solvent source areas, in the southeastern portion of the Young- Rainey Star Center (also known as the Pinellas County, Florida, Site) in Largo, Florida, has migrated beyond the property boundary, beneath the roadways, and beneath adjacent properties to the south and east. Groundwater contamination will persist as long as the onsite contaminant source remains. The origin of the contamination appears to be multiple long-term point sources beneath Building 100, a 4.5 ha (11 acre) building that housed manufacturing facilities during US DOE operations at the site. The site is now owned by Pinellas County, and most of the space inside the building is leased to private companies, so DOE chose not to conduct characterization or remediation through the floor of the building, instead choosing to conduct all work from outside the building. Injection of emulsified soybean oil and a microbial culture has been used at other areas of the site to accelerate naturally occurring bacterial processes that degrade groundwater contaminants to harmless compounds, and that same approach was chosen for this task. The technical approach consisted of installing horizontal wells from outside the building footprint, extending through and around the identified subsurface treatment areas, and terminating beneath the building. Two 107 m (350 ft) long wells, two 122 m (400 ft) long wells, and four 137 m (450 ft) long wells have been installed to intersect the inferred source areas and confirmed contaminant plumes beneath the building. DOE then injected emulsified vegetable oil and a microbial culture into the horizontal wells at each of several target areas beneath the building where the highest groundwater contaminant concentrations have been detected. The target areas are the northwest corner of the building between the old drum storage pad locations and monitoring well PIN12-S35B, the vicinity of

  11. Village demonstration of biogas technology: an Egyptian case study

    Energy Technology Data Exchange (ETDEWEB)

    El Halwagi, M.M.; Abdel Dayem, A.M.; Hamad, M.A.

    1982-10-01

    Biomass is among the principal renewable energy resources available to Egyptian villages; in addition to converting wastes into useful energy (biogas), the anaerobic digestion of biomass wastes produces a slurry that can be used as a fertilizer, improves sanitation, and can be easily adapted using locally available materials and labor. After a preliminary sociological survey, the NRC selected Al Manawat, a traditional Egyptian village, for the first demonstration site. Concomitant with the family energy requirements, availability of digester feed materials, and site characteristics, a modified Indian-type family size unit was designed and erected. The digester, with an effective volume of 320 ft/sub 3/, is connected to both a latrine and an animal shed. A preliminary technoeconomic appraisal and an assessment of the social impact indicate that under village conditions and particularly with the heavily subsidized fuel prices, the digester's main benefit to the farmer is the considerable saving in manure transport.

  12. Quality of life of adolescents and young people arrive at an addiction treatment centers upon their admission, and 1, 4 and 8 months after methadone maintenance therapy.

    Science.gov (United States)

    Sadeghi, Narges; Davaridolatabadi, Elham; Rahmani, Azam; Ghodousi, Arash; Ziaeirad, Marzieh

    2017-01-01

    Drug abuse influences the quality of life significantly. Thus, the present study is designed to compare the quality of life of adolescents and young adults who have voluntarily referred to addiction treatment centers at different time slots of upon admission, and 1, 4, and 8 months after maintenance therapy. The present paper is a longitudinal study on 141 of adolescents and young adults who had referred to various addiction treatment centers throughout Isfahan voluntarily. The population was selected through convenience sampling method and 137 of adolescents and young adults continued the research until the end. The results were analyzed using descriptive and analytic statistics (frequency, mean, standard deviation, repeated measure test, and post-hoc test) in SPSS 17. Results showed that the average of quality of life total score was sequential and not the same in the 4 times slots under study. The total quality of life score upon admission was significantly different from 1, 4, and 8 months after maintenance treatment. However, quality of life at 1-month was not significantly different to that at 4 and 8 months after the treatment; quality of life at 4 months after the treatment was not significantly different to that at 8 months after. According to the present study, it can be concluded that the quality of life of adolescents and young adults referring to addiction treatment centers increases 1-month after the treatment; nevertheless, it is worth to note that the degree of quality of life increase in 4 and 8 months after the treatment is not as much as that in 1-month after the treatment.

  13. World Heritage Site Designation Impacts on a Historic Village: A Case Study on Residents’ Perceptions of Hahoe Village (Korea

    Directory of Open Access Journals (Sweden)

    Soonki Kim

    2016-03-01

    Full Text Available This study examines the relationship between World Heritage Site (WHS designation and the community sustainability of a historic village, focusing on Hahoe Village, Korea, which was inscribed in 2010. It examines residents’ perceptions of increasing tourism at Hahoe Village by adopting a questionnaire and using an interview as research methods. This study examined both the positive and negative impacts that Hahoe Village’s WHS designation has had on its sustainability. Of all of the impacts examined in this research, the three most noteworthy issues are identified: (1 the acceleration of the change of the village’s industrial base and the influx of strangers; (2 the degradation of quality of life (in the physical aspects caused by increasing tourism; and (3 the collision predicated by the tension between conserving the village’s historic environments and developing tourism. In conclusion, the WHS designation impacts on Hahoe Village, which local residents perceived, have both positive and negative aspects. WHS designation needs to be accompanied by a management plan that is more concerned about the impact from tourism after the designation. In this context, Hahoe Village must not only have a comprehensive preservation plan that balances with the demand for tourism development, but also secure the village’s community sustainability as a living place other than a tourist destination.

  14. Psychological evaluation and medical treatment of transgender youth in an interdisciplinary "Gender Management Service" (GeMS) in a major pediatric center.

    Science.gov (United States)

    Edwards-Leeper, Laura; Spack, Norman P

    2012-01-01

    In 2007, an interdisciplinary clinic for children and adolescents with disorders of sex development (DSD) or gender identity disorder (GID) opened in a major pediatric center. Psychometric evaluation and endocrine treatment via pubertal suppressive therapy and administration of cross-sex steroid hormones was offered to carefully selected patients according to effective protocols used in Holland. Hembree et al.'s (2009) Guidelines for Endocrine Treatment of Transsexual Persons published by the Endocrine Society endorsed these methods. A description of the clinic's protocol and general patient demographics are provided, along with treatment philosophy and goals.

  15. Rural architectural state in Sfântu Gheorghe village

    Directory of Open Access Journals (Sweden)

    PORUNCIA Alina

    2007-10-01

    Full Text Available The study of cultural patrimony regarding the rural landscape in Danube Delta's localities focus on cultural landscape that reflects traditional lifestyle of local people, activities that confer sustainable use of natural resources, all these aspects creating visual elements for rural landscape. For this research, traditionalarchitecture represents the main assumption in order to identify and preserve traditional architecture line, generally in Danube Delta localities and especially in Sfântu Gheorghe village. Field research enabled us to distinguish favourable and restrictive factors that leaded to the architectural transformation in Sfântu Gheorghe village, and also to know in what measures the traditional architecture is preserved.

  16. Village Fund in the Light of New Regulations

    Directory of Open Access Journals (Sweden)

    Michał Wójcik

    2014-12-01

    Full Text Available The article analyses legal conditionality particular form of participatory budgeting which is village fund. His five-year term of office gave rise to a positive evaluation of the project and to make specific legislative changes in this area. This was done in the new law of the village fund of 21 February 2014, which regulates the formation of the fund and reimbursement of expenses. This work research to both the old and the new provisions of the act and the exegesis of the regulations of the year.

  17. Lessons learned from the NREL village power program

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, R.W. [National Renewable Energy Lab., Golden, CO (United States)

    1998-09-01

    Renewable energy solutions for village power applications can be economical, functional, and sustainable. Pilot projects are an appropriate step in the development of a commercially viable market for rural renewable energy solutions. Moreover, there are a significant number of rural electrification projects under way that employ various technologies, delivery mechanisms, and financing arrangements. These projects, if properly evaluated, communicated, and their lessons incorporated in future projects and programs, can lead the way to a future that includes a robust opportunity for cost-effective, renewable-based village power systems. This paper summarizes some of NREL`s recent experiences and lessons learned.

  18. Tempe as Language: An Indonesian Village Revitalisation Mini-project

    Directory of Open Access Journals (Sweden)

    Kirsten Bradley

    2016-08-01

    Full Text Available In Kandangan, a village in the Temmanggung Regency (Kabupaten Temanggung in the Province of Central Java, tempe bunguk used to be a daily food—using locally grown bunguk beans—and made in many households. But imported blocks of tempe from China made with industrially grown soy beans have slowly crept in and replaced it. As part of her food skills mapping (a part of the Spedagi Project, Francisca Callista (Siska went searching for what used to be eaten in her village, and for those who could remember how to make it.

  19. Lessons Learned from the NREL Village Power Program

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, R.

    1998-07-01

    Renewable energy solutions for village power applications can be economical, functional, and sustainable. Pilot projects are an appropriate step in the development of a commercially viable market for rural renewable energy solutions. Moreover, there are a significant number of rural electrification projects under way that employ various technologies, delivery mechanisms, and financing arrangements. These projects, if properly evaluated, communicated, and their lessons incorporated in future projects and programs, can lead the way to a future that includes a robust opportunity for cost-effective, renewable-based village power systems. This paper summarizes some of NRELs recent experiences and lessons learned.

  20. [Internet addiction: a descriptive clinical study of people asking for help in rehabilitation treatment center in Quebec: exploratory study].

    Science.gov (United States)

    Dufour, Magali; Nadeau, Louise; Gagnon, Sylvie R

    2014-01-01

    To date, there is no consensus on the diagnostic criteria for Internet addiction (Hinic, 2011; Tonioni & coll., 2012; Weinstein & Lejoyeux, 2010). Nonetheless, some people consider themselves cyberdependent and request treatment services in the addiction rehabilitation centers (ARC) of the province of Quebec. These admissions have led the Health and Social Services Agency of Montreal to ask for the realization of a descriptive study on Internet addiction. 1) Describe the socio-demographical characteristics of cyberdependent individuals receiving treatment in the ARC; 2) Document their associated problems, such as problems related to alcohol and drug abuse, gambling, self-esteem, and symptoms of depression and anxiety. The study was conducted in eight ARC's of the province of Quebec. A convenience sample of 57 people was recruited over a period of 24 months, from 2010 to 2012. To participate in this study, individuals had to be 18 years or older, identify themselves as cyberdependent, and request help for an Internet addiction problem in a public ARC. The Internet Addiction Test (Young, 1998), in its validated French version (Khazaal & coll., 2008), was used to assess the severity of Internet use habits. The associated problems were assessed using the following questionnaires: the Beck Anxiety Inventory (Beck, Epstein, Brown & Steer, 1988); the Beck Depression Inventory, in its validated French version (Bourque & Beaudette, 1982); the DÉBA-Alcool/Drogues/Jeu (Dépistage-évaluation du besoin d'aide), an instrument used to screen and assess the need for help in problems related to alcohol, drugs, and gambling (Tremblay & Blanchette-Martin, 2009), and the Rosenberg's Self-Esteem Scale (Rosenberg, 1965). Fifty-seven people agreed to participate in the study. A large majority of these cyberdependent individuals were male (88%), the mean age was 30 years old, had low incomes and were living with their parents. They consulted following the pressure of their entourage and

  1. Enviromental Assessment: Security Forces Regional Training Center at Little Rock Air Force Base Arkansas

    Science.gov (United States)

    2004-07-14

    long-distance trade of raw materials and artifacts increased, as did population. With the introduction of maize cultivation, larger villages, with...West Wastewater Treatment Plant. Treatment processes include activated sludge treatment with anaerobic digestion of sludge (personal communication

  2. A Resilience Pattern in Village level: The Case Babalan Village, Pati, Central Java Indonesia

    Directory of Open Access Journals (Sweden)

    Nurwahyudi Ragil

    2018-01-01

    Full Text Available Based on the Indonesia Disaster Prone Index 2013, Pati Regency is a high risk area of disaster and is ranked 11th level Central Java province while nationally ranked 156. Babalan Village located on the edge of Juwana River has disaster history from 2006-2014 shows flood disaster Giving the greatest probability and impact followed by rat pest, tornado, drought, fire. The public recognizes the signs of a continuous flooding of heavy rains accompanied by clouds all over the edge, the continuous rise of the Juwana River surface to overflow, ants, isoptera, and animals out of its nest, “Yuyu Bule”, earthworms out, clear water for “Rowo floods ”, Brownish water for the flash floods. Most residents have boats and can make rafts from makeshift materials (jerry cans, bamboo, banana stems. Make “Ranggon” at home for those who do not evacuate for a place to stay during the flood. Citizens elevate the kitchen (to evacuate people and goods / household furniture. Breeding Tyto Alba owl for rats pest control post-flood and controllers in the fields. Develop vegetable crops in the yard with viticulture pattern (upstairs if flood can be moved and can eat vegetables during flood. Have food reserves for stock before outside help comes. Citizens initiate “Water Bath honesty” to meet the water needs during the dry season.

  3. A Resilience Pattern in Village level: The Case Babalan Village, Pati, Central Java Indonesia

    Science.gov (United States)

    Nurwahyudi, Ragil; Maryono

    2018-02-01

    Based on the Indonesia Disaster Prone Index 2013, Pati Regency is a high risk area of disaster and is ranked 11th level Central Java province while nationally ranked 156. Babalan Village located on the edge of Juwana River has disaster history from 2006-2014 shows flood disaster Giving the greatest probability and impact followed by rat pest, tornado, drought, fire. The public recognizes the signs of a continuous flooding of heavy rains accompanied by clouds all over the edge, the continuous rise of the Juwana River surface to overflow, ants, isoptera, and animals out of its nest, "Yuyu Bule", earthworms out, clear water for "Rowo floods ", Brownish water for the flash floods. Most residents have boats and can make rafts from makeshift materials (jerry cans, bamboo, banana stems). Make "Ranggon" at home for those who do not evacuate for a place to stay during the flood. Citizens elevate the kitchen (to evacuate people and goods / household furniture). Breeding Tyto Alba owl for rats pest control post-flood and controllers in the fields. Develop vegetable crops in the yard with viticulture pattern (upstairs) if flood can be moved and can eat vegetables during flood. Have food reserves for stock before outside help comes. Citizens initiate "Water Bath honesty" to meet the water needs during the dry season.

  4. Buprenorphine maintenance treatment retention improves nationally recommended preventive primary care screenings when integrated into urban federally qualified health centers.

    Science.gov (United States)

    Haddad, Marwan S; Zelenev, Alexei; Altice, Frederick L

    2015-02-01

    Buprenorphine maintenance therapy (BMT) expands treatment access for opioid dependence and can be integrated into primary health-care settings. Treating opioid dependence, however, should ideally improve other aspects of overall health, including preventive services. Therefore, we examined how BMT affects preventive health-care outcomes, specifically nine nationally recommended primary care quality health-care indicators (QHIs), within federally qualified health centers (FQHCs) from an observational cohort study of 266 opioid-dependent patients initiating BMT between 07/01/07 and 11/30/08 within Connecticut's largest FQHC network. Nine nationally recommended preventive QHIs were collected longitudinally from electronic health records, including screening for chronic infections, metabolic conditions, and cancer. A composite QHI score (QHI-S), based on the percentage of eligible QHIs achieved, was categorized as QHI-S ≥80% (recommended) and ≥90% (optimal). The proportion of subjects achieving a composite QHI-S ≥80 and ≥90 % was 57.1 and 28.6%, respectively. Screening was highest for hypertension (91.0%), hepatitis C (80.1%), hepatitis B (76.3%), human immunodeficiency virus (71.4%), and hyperlipidemia (72.9%) and lower for syphilis (49.3%) and cervical (58.5%), breast (44.4%), and colorectal (48.7%) cancer. Achieving QHI-S ≥80% was positively and independently associated with ≥3-month BMT retention (adjusted odds ratio (AOR) = 2.19; 95% confidence interval (CI) = 1.18-4.04) and BMT prescription by primary care providers (PCPs) rather than addiction psychiatric specialists (AOR = 3.38; 95% CI = 1.78-6.37), and negatively with being female (AOR = 0.30; 95% CI = 0.16-0.55). Within primary health-care settings, achieving greater nationally recommended health-care screenings or QHIs was associated with being able to successfully retain patients on buprenorphine longer (3 months or more) and when buprenorphine was prescribed

  5. RELATIONSHIP OF ASSESS SELF-ESTEEM AND LOCUS OF CONTROL WITH QUALITY OF LIFE DURING TREATMENT STAGES IN PATIENTS REFERRING TO DRUG ADDICTION REHABILITATION CENTERS.

    Science.gov (United States)

    Heidari, Mohammad; Ghodusi, Mansureh

    2016-07-24

    Thus, the present research was carried out aimed at determining the relationship between self-esteem and locus of control and quality of life during treatment stages in the patients referring to drug addiction rehabilitation centers of Borujen city, Iran. The current study was a sectional research of descriptive correlation type. The research sample was 150 individuals of patients referring to addiction rehabilitation centers of Borujen city. For data gathering, Rosenberg Self-esteem Scale, Rotter's Locus of Control Scale, and SF36 Quality of Life Questionnaire were used. Following collection of questionnaires, the data were analyzed using SPSS/16 software. According to the results, in the 12(th) day of treatment, 96 patients exhibited moderate self-esteem, 102 patients had internal locus of control, and the score of their overall quality of life was 40.43±12.71. Furthermore, Pearson's correlation coefficient indicated that a significant and positive relationship was observed between locus of control and quality of life during different treatment stages. It seems that quality of life improves during addiction treatment stages due to improvement of personality traits including locus of control and self-esteem. Therefore, consultation methods as a very crucial priority in addiction rehabilitation centers shall be taken into account by the health sector authorities and managers and can play an essential role in enhancing quality of life.

  6. Process and Product in Cross-Cultural Treatment Research: Development of a Culturally Sensitive Women-Centered Substance Use Intervention in Georgia

    Directory of Open Access Journals (Sweden)

    Hendrée E. Jones

    2014-01-01

    Full Text Available Women who inject drugs (WID are highly marginalized and stigmatized and experience ongoing discrimination in Georgia. Few opportunities exist for WID to receive publicly funded treatment for substance use disorders. The IMEDI (Investigating Methods for Enhancing Development in Individuals project was developed in response to the need for women-specific and women-centered treatment services. This paper described our approach to understanding the Georgian culture—and WID within that culture—so that we could integrate two interventions for substance use found effective in other Western and non-Western cultures and to outline how we refined and adapted our integrated intervention to yield a comprehensive women-centered intervention for substance use. Reinforcement Based Treatment (RBT and the Women’s CoOp (WC were adapted and refined based on in-depth interviews with WID (N=55 and providers of health services (N=34 to such women and focus groups [2 with WID (N=15 and 2 with health service providers (N=12]. The resulting comprehensive women-centered intervention, RBT+WC, was then pretested and further refined in a sample of 20 WID. Results indicated positive pre-post changes in urine screening results and perceived needs for both RBT+WC and a case management control condition. The approach to treatment adaptation and the revised elements of RBT+WC are presented and discussed.

  7. A Wiki-based Key to Garden and Village Birds

    OpenAIRE

    Trilar, Tomi

    2010-01-01

    A Wiki-based Key to Garden and Village Birds is available in two versions: a dichotomous, hyperlinked and printable version, and as step-bystep identification version. It is supported by jKey Player in English, Slovenian, Spanish, Romanian and German.

  8. Appraisal of Village Chickens Potential in Egg Production | Bebora ...

    African Journals Online (AJOL)

    The parameter of egg-production capacity was estimated by the pliability of bones, especially the pubic bone spread and the space between the pubic bone and ... This observation indicates that, with a little extra effort in management and genetic selection, these village birds have a potential of increasing their egg yields.

  9. STUDY ON INTESTINAL PROTOZOA IN SEVEN VILLAGES OF BANDARABASS

    OpenAIRE

    J.Sheiban; M.Rezaian

    1981-01-01

    A survey was carried out in seven villages around Bandarabass, on Persion Gulf, to determine the prevalence of the intestinal protozoa infections. Out of the 835 stool specimens examined, 676 samples were positive with single and multiple infections. The most prevalent of intestinal protozoa in Bandarabass were Entamoeba histolytica, Entamoeba coli, Giardia lambia and Iodamoeba butschlii.

  10. Review and assessment of mechanic village potentials for small ...

    African Journals Online (AJOL)

    user

    importation of used motor vehicles to Nigeria from less than 500 in 1988 to about 30,000 in 2000. The degree of ... on the total vehicle registrations in the country. Data from the Federal Road Safety Commission ... in oil change such as motorcycle and electrical generator mechanics to mechanic villages. It is time also for ...

  11. The Role of Libraries in the Global Village.

    Science.gov (United States)

    Ballard, Donna Weiss

    1995-01-01

    Discusses the introduction and evolution of the term "global village" by author Marshall McLuhan, and presents findings from literature that associate libraries and education with society's technological advancements such as telecommunication and computerized services. Examines the role of libraries, librarians, commerce, and global…

  12. Ekspansif soil solution in the villages at Trenggalek

    Science.gov (United States)

    Triastuti, Nusa Setiani

    2017-11-01

    District 2/3 hills with easy sliding and land survey results showed the soil because it consists of expansive soil Survey some villages who experience insatiability or failure, a secondary analysis of the data gathered from the expert on geology, Trenggalek geological map, Trenggalek geography. Ground location researched several villages, the Terbis village of focus discussion of the landslides and plan of relocation. In the watching a black. Colored soil and easily slide, showed very expansive soil due to montmorrelite. While soil relocation contour relative is more stable because the land of kaolin and invisible water sources that could push the land. Expansive soil in the village of solution should be cheap, easily obtainable, not damaging the fertility of the soil, groundwater should be awake to the source of life, ease of implementation, utilizing local materials and use modest tools and equipment. Under the soil surface do not get there water stored in the soil until deep the water because it will slide the ground. The analysis must meet the 7 items above and steady the contour. Design of building installed sub drain, the shallow bore foundations tied tie beam, floor plate into the unity of the structure.

  13. MoonVillage: Frame & Opportunity for Space Economy

    Science.gov (United States)

    Foing, B. H.

    2017-09-01

    We shall discuss the frame and opportunity for space economy in the context of elaborating the concept of a Moon Village with the goal of a sustainable human presence and activity on the lunar surface as an ensemble where multiple users can carry out multiple activities. This enterprise can federate all interested Nations and partners, in particular from terrestrial and non space commercial sectors .

  14. Morphological diversity in fourteen cultivars Tiron village, Kediri, Indonesia

    Directory of Open Access Journals (Sweden)

    Nur Azis Fuad

    2016-01-01

    Full Text Available Tiron village, Kediri is one of central mangoes in Indonesia. Many cultivar of mangoes encountered at this location. This study aims to look at the diversity of mango cultivars in the Tiron Village, Kediri, Indonesia. Mangoes diversity is based on qualitative and quantitative character of each cultivar. The diversity among cultivar indicated by the standard deviation and variance in the eleven quantitative characters of mango. Mango cultivars categorized by phylogeny morphological characters. The method used for phylogeny analysis is an UPGMA method (unweighted pair group method with arithmetic mean. Phylogenic analysis is based by the qualitative character of the plant. The results showed there were fourteen cultivars of mango in the village of Tiron Kediri have high diversity. Fourteen mango cultivars were categorized four groups. Based on a qualitative character, there are four classes of mango. The first group is the Katul, Podang Urang, and Podang Lumut. The second group is the Gadung, Jaran, Madu, Endog, Pakel, Dodonilo, Ireng, Lanang and Cantek. Santok Kapur into groups to form groups of three and Kopyor fourth. The high diversity in the village mango Tiron Kediri potential for resource in situ germplasm.

  15. An information needs assessment in Oribi Village, Pietermaritzburg ...

    African Journals Online (AJOL)

    ... also examined. The results of the study indicated a significant need for information concerning fundamental issues such as housing, health and education. Finally, a few suggestions are made as to ways to improve the information availability and general information literacy of Oribi Village. Innovation No.29 2004: 13-23 ...

  16. Entrepreneurial Management Coastal Muslim In The Village Bongo Gorontalo

    Directory of Open Access Journals (Sweden)

    Abdul Rahmat

    2017-05-01

    Full Text Available The aim of this research activities to proving the entrepreneurial management of the coastal Muslim community in the village of Bongo. Experimental design used in this research is quasi experiment with the design of "The One-group pre-test - Post-test Design". The results showed that the model of functional skills for women of fishermen in the village of Bongo district of Gorontalo, can be seen from several aspects, namely: (1 The control / understanding of learners (female fisherman in the village of Bongo of the learning materials functional skills wives of the fishermen in the form of entrepreneurship, practice makes kolombengi taste of fish, practice makes fish nuggets and practice makes sticks corn fish. (2 understanding wives of the fishermen village of Bongo towards community empowerment programs and Improved skills of students in the field of entrepreneurship, especially in terms of business development and business administration, and (3 the ability of learners work together in a business group that can produce a product with the criteria and processes in place.

  17. Understanding local attitudes towards dogs in villages surrounding ...

    African Journals Online (AJOL)

    ABSTRACT. Exotic carnivores, particularly feral and domestic dogs, represent a serious threat to Madagascar's endemic fauna. We obtained information from the local community about dogs in villages in and around Ranomafana National Park (RNP), Madagascar. Sur- veys were conducted (N=359) to assess local ...

  18. Burkina Faso: Managing conflict at the village handpump and beyond

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-02-09

    Feb 9, 2011 ... These conflicts become visible when clay water jugs are smashed or women get into shoving matches. At other times, the conflict remains invisible, but is felt nonetheless, says Karidia Sanon, an economist on the project team. She cites the case of a village chief's wife who went to the head of the line while ...

  19. Votian Village Feasts in the Context of Russian Orthodoxy

    Directory of Open Access Journals (Sweden)

    Ergo-Hart Västrik

    2008-09-01

    Full Text Available This article considers Votian village feasts that evidently belong to the sphere of Christian folk religion. Village feasts are analysed as expressions of collective activity in pre-industrial rural society that enclosed certain religious, social and economic functions. This phenomenon of celebrating collectively certain days of church calendar, which included ritual activities in village chapels or other local sanctuaries, common meals and heavy drinking as well singing and dancing in the course of 3–4 days, was a part of common Russian Orthodox tradition shared by several ethnic groups throughout North-West Russia in the second half of the 19th century and the beginning of the 20th century. Despite the fact that this phenomenon was familiar to the wider community of Russian Orthodox believers, there were obviously certain local characteristics and variation typical to Votian tradition. However, Votain village feasts are studied in the article in the context of Russian Orthodoxy, without favouring assumed pre-Christian elements of the Finno-Ugric religions.

  20. Votian Village Feasts in the Context of Russian Orthodoxy

    Directory of Open Access Journals (Sweden)

    Ergo-Hart Västrik

    2011-03-01

    Full Text Available This article considers Votian village feasts that evidently belong to the sphere of Christian folk religion. Village feasts are analysed as expressions of collective activity in pre-industrial rural society that enclosed certain religious, social and economic functions. This phenomenon of celebrating collectively certain days of church calendar, which included ritual activities in village chapels or other local sanctuaries, common meals and heavy drinking as well singing and dancing in the course of 3–4 days, was a part of common Russian Orthodox tradition shared by several ethnic groups throughout North-West Russia in the second half of the 19th century and the beginning of the 20th century. Despite the fact that this phenomenon was familiar to the wider community of Russian Orthodox believers, there were obviously certain local characteristics and variation typical to Votian tradition. However, Votain village feasts are studied in the article in the context of Russian Orthodoxy, without favouring assumed pre-Christian elements of the Finno-Ugric religions.

  1. Medicinal plant use of villagers in the Mopani district, Limpopo ...

    African Journals Online (AJOL)

    Conclusion: The results of the survey indicate that plants play a significant role in primary healthcare of the community of Mashishimale Village. It would seem that a number of major diseases/ailments are treated by traditional methods. Scientific investigation is therefore needed to isolate active compounds and to determine ...

  2. Assessment of Services Provided By Village Alive Women ...

    African Journals Online (AJOL)

    Assessment of Services Provided By Village Alive Women Association to Rural Women in Ifelodun Local Government Area of Kwara State, Nigeria. ... hardworking Rural women of Nigeria by different NGOs and Voluntary organizations so that they can increase their productivity those government organs or agencies (ADP, ...

  3. Village Health Volunteers: Key Issues Facing Agencies in Malawi

    African Journals Online (AJOL)

    cruitment, support and supervision, working conditions, and hours for village health volunteers. There is a sound public health policy established in Malawi although there are not enough trained people (or other resources) to teach, counsel, treat, and motivate the community to good health. It has been shown elsewhere that ...

  4. Assessment of Population Density and Disparity of Village ...

    African Journals Online (AJOL)

    Study of Village weaverbirds Ploceus cucullatus along the roads was necessary in order to provide prospect of their population, density and platform for monitoring their distribution. Data were collected through on-site observations and pointcount method at thirty-four (34) point-count stations. Collected data were subjected ...

  5. An ethnobotanical study of medicinal plants used in villages under ...

    African Journals Online (AJOL)

    Background: Medicinal plants remain an integral part of the lives of people in rural areas. The aim of this study was to document information about the medicinal plants used by Shangaan people in villages under Jongilanga tribal council, Bushbuckridge municipality, Mpumalanga Province, South Africa. Materials and ...

  6. Conceptualizing responsible innovation in craft villages in Vietnam

    NARCIS (Netherlands)

    Voeten, J.; de Haan, J.A.C.; Roome, N.; de Groot, G.A.; Nguyen Thi, Huong; van den Hoven, J.; Doorn, N.; Swierstra, T.; Koops, B.-J.; Romijn, H.

    2014-01-01

    Previous research by the authors has explored small-scale innovations in poor craft producers’ clusters in villages in the Red River Delta in northern Vietnam. Although these innovations resulted in value creation and increased incomes, they also often gave rise to negative environmental or social

  7. Comparison of photovoltaic energy systems for the solar village

    Science.gov (United States)

    Piercefrench, Eric C.

    1988-08-01

    Three different solar photovoltaic (PV) energy systems are compared to determine if the electrical needs of a solar village could be supplied more economically by electricity generated by the sun than by existing utility companies. The solar village, a one square mile community of 900 homes and 50 businesses, would be located in a semi-remote area of the Arizona desert. A load survey is conducted and information on the solar PV industry is reviewed for equipment specifications, availability, and cost. Three specific PV designs, designated as Stand-Alone, Stand-Alone with interconnection, and Central Solar Plant, were created and then economically compared through present worth analysis against utility supplied electrical costs. A variety of technical issues, such as array protection, system configuration and operation, and practicability, are discussed for each design. The present worth analysis conclusively shows none of the solar PV designs could supply electricity to the solar village for less cost than utility supplied electricity, all other factors being equal. No construction on a solar village should begin until the cost of solar generated electricity is more competitive with electricity generated by coal, oil, and nuclear energy. However, research on ways to reduce solar PV equipment costs and on ways to complement solar PV energy, such as the use of solar thermal ponds for heating and cooling, should continue.

  8. Expanding Global Mindedness through a 4-H International Village

    Science.gov (United States)

    Seal, Susan D.; Peterson, Donna J.; Iwata, Chieko; Kobia, Caroline; Reddy, Raja

    2017-01-01

    With expanding global interdependence, it is vital that 4-H youths learn more about the ever-increasing diverse cultures in their own communities as well as expand their global mindedness and understanding of globalization. The 4-H International Village (a) offers a comfortable yet engaging avenue for youths to expand their knowledge of and…

  9. Analysis of Edible Mushroom Marketing in Three Villages in Central ...

    African Journals Online (AJOL)

    This study examined the marketing of edible mushroom in three villages (Alesi, Ekukunela and Ohon) in Central Cross River State, Nigeria. The marketing of edible mushroom in the state offers job opportunities for both skilled and unskilled rural population at farm gate and offers market employment opportunities for ...

  10. Overview of village scale, renewable energy powered desalination

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, K.E.

    1997-04-01

    An overview of desalination technologies is presented, focusing on those technologies appropriate for use in remote villages, and how they can be powered using renewable energy. Technologies are compared on the basis of capital cost, lifecycle cost, operations and maintenance complexity, and energy requirements. Conclusions on the appropriateness of different technologies are drawn, and recommendations for future research are given.

  11. Forest product use at an upper elevation village in Nepal

    Science.gov (United States)

    Metz, John J.

    1994-05-01

    This paper describes forest product use at Chimkhola, an upper elevation village of west central Nepal. Villagers have large herds of livestock that they use to fertilize agricultural fields by holding the animals on cropland for one to several weeks prior to planting. Herds are moved sequentially from one group of fields to another until all are planted, and then families take animals into the forests. Herders, therefore, live in temporary shelters away from the homestead throughout the year, and for much of the year feed their livestock fodder cut from forest trees. By combining repeated interviews of sample households, one-time interviews with a large sample of village families, and direct measurements of forest products being used, I found that livestock maintenance consumes 74% of the hand-harvested wild biomass: 26.4% for green fodder, 32.3% for fuelwood at the herder's hut, and 13.8% for construction of the herder's hut. Fuelwood burned at the homestead is the next largest consumer, 17.6%. Villagers also use small amounts of forest materials for house construction, charcoal, agricultural implements, and bamboo for baskets and mats. The large amounts used by herders and livestock at Chimkhola mean that wild vegetation use there far exceeds the measurements made by previous reliable studies at other communities. This system of forest use is, however, degrading Chimkhola's forests and gradually converting them to shrublands.

  12. Slavic Village: incorporating active living into community development through partnerships.

    Science.gov (United States)

    Miller, Emily K; Scofield, Jennifer L

    2009-12-01

    The Slavic Village neighborhood in Cleveland, Ohio, is a diverse community of 30,524 residents that is struggling economically yet strong in tradition. The neighborhood is located just south of downtown and adjacent to the city's industrial valley. Slavic Village Development (SVD) works with local and state partners to improve the quality of life for its residents, including low-income and market-rate housing developments, economic development, community organizing, and greenspace planning. Using the Active Living by Design framework (ALbD), SVD developed strong partnerships to address preparation, promotions, programs, policy, and physical projects. Efforts were focused on Safe Routes to School, neighborhood activities, asset mapping, worksite wellness, and social marketing. The ALbD project changed both the physical environment of Slavic Village and its marketed image. The initiative built cross-disciplinary partnerships that leveraged individual strengths to implement strategies to make Slavic Village a vibrant, healthy, family-friendly neighborhood that promotes active living. There is a strong connection between health and community development. When partners from multiple disciplines work together on a common goal, it is easier to leverage resources and create change. Resource development will always be a challenge. Through the leadership of SVD and its strong ties in the community, the ALbD initiative has re-engaged residents and businesses in efforts to restore the vitality of the community. The partnership in Cleveland has successfully incorporated health into community development, a model of collaboration that can be replicated in other communities.

  13. 427 knowledge, attitude and perceptions of village residents on the ...

    African Journals Online (AJOL)

    Osondu

    2013-07-04

    Jul 4, 2013 ... education programmes for the general population on the dangers of uncontrolled waste disposal sites. ... improperly managed waste sites are affected the .... Separated. 15. 4.6. Windowed. 7. 2.2. Total. 323. 100. Number of years lived in the village.  ...

  14. Evaluation of oral vaccination of village chickens against newcastle ...

    African Journals Online (AJOL)

    The study was conducted to assess the suitability of soaked parboiled cracked maize as a carrier of I-2 vaccine for oral immunization of village chickens. Chickens were vaccinated once via ocular route and orally with cracked maize at the second and fifth weeks of the experiment. Post vaccination serum was collected 4, 7, ...

  15. Ethnomedicinal plants and their utilization by villagers in Kumaragiri ...

    African Journals Online (AJOL)

    The present investigation deals with the ethnomedicinal plants of Kumaragiri Hills of Salem district, Tamilnadu. The indigenous knowledge of the village dwellers, the herbal medicine practitioners and other traditional healers and the native plants used for medicinal value were collected through questionnaire and personal ...

  16. Control of morbidity in lymphatic filariasis patients in Indian villages

    African Journals Online (AJOL)

    flyers, a BEP information sheet and checklist, yoga checklist, yoga information sheet/ book, patients' feedback form, video CDs demonstrating pre-Indian manual lymph drainage (IMLD) yoga ... as NGO/CBO office bearers. Establishing village units. We hired an old house for implementing the project in AK. District health ...

  17. Review and assessment of mechanic village potentials for small ...

    African Journals Online (AJOL)

    This is suggested because developing countries are yet to enforce environmentally friendly automobile workshops and mechanic practice. If all automobile repair works in different cities are confined to mechanic villages, collection, preservation, recycling and reuse of spent oil will become effective. The goal is to stop the ...

  18. Sustainability Literacy of Older People in Retirement Villages

    Directory of Open Access Journals (Sweden)

    Bo Xia

    2014-01-01

    Full Text Available With many developed countries experiencing the aging of the population, older people play a large role in contributing to environmental problems but also to environmental solutions. The purpose of this research is to understand the awareness and behavior of current older people living in retirement villages towards sustainability development. To achieve this, a sustainability literacy survey was conducted with 65 older residents of a private retirement village located 10 Km outside the Brisbane, Australia’s central business district (CBD. Most of residents recognized the importance of environment protection and would like to lead a more environmentally friendly lifestyle. In addition, the majority were willing to pay higher prices for a living environment with sustainable features. The importance of positive social communications was emphasized with most residents having established good relationships with others in the village. The findings provide an important insight into consumer perspectives regarding the sustainable features that should and can be incorporated into the village planning and development.

  19. Studies on Urinary Schistosomiasis in Selected Villages around ...

    African Journals Online (AJOL)

    Available online at http://www.ajol.info/index.php/njbas/index. Nigerian Journal of Basic and Applied Science (September, 2012), 20(3): 189-194. ISSN 0794-5698. Studies on Urinary Schistosomiasis in Selected Villages around Gusau Dam Site, Zamfara State,. Nigeria. *1M.U Ladan, 1U. Abubakar, 1K. Abdullahi, 1M.

  20. Pennsylvania Village to Get Safe, Reliable Water Supply

    Science.gov (United States)

    A Pennsylvania village whose unfiltered, contaminated water source made it the top violator of federal and state drinking water laws will be connected to a public water system in 2015 with $2.2 million from EPA’s Drinking Water State Revolving Fund

  1. Marin Solar Village: feasibility study and technical analysis. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1980-08-31

    The energy needs of Hamilton Air Force Base's Solar Village for electricity and heating and cooling of buildings are considered and alternative ways of meeting the Village's requirements for these forms of energy are evaluated. First, Solar Village's energy demand is calculated and compared to a base case representing calculations for typical energy usage for a development of similar size and density that is in conformance with current state and local ordinances. The potential of selected alternative technologies to meet the Solar Village projected demand for electrical power and natural gas is evaluated. Scenarios were developed to reduce demand, particularly in the building sector. Four alternative on-site energy technologies have been evaluated: wind, solar thermal electric, biomass conversion, photovoltaics. Each alternative is analyzed in detail. Of the four alternatives considered, the one with the greatest present potential is biomass conversion. Two technologies have been incorporated into the design. A 3-acre land fill is covered with a mantle of soil. A network of pipes carries off the methane gas which is a natural product of anaerobic decomposition of the materials in the land fill. The second technology involves the planting of rapidly-growing trees on denuded and unused portions of the site; 50 acres devoted to tree production could yield 12% of the back-up energy required for home heating on a sustainable basis.

  2. Environmental status at Samunge Village (Tanzania) following a ...

    African Journals Online (AJOL)

    The present study made some quantification on environmental status in the village during the peak visitor days in March 2011. ... green hills and lowlands became bisected by a long chain of different types of vehicles including large and small lorries, large and small buses, Land Cruisers, Land Rovers and saloon cars.

  3. Self-reliance in health among village women.

    Science.gov (United States)

    Wong, M L; Chen, P C

    1991-01-01

    A project in a remote region in Sarawak, Malaysia, in which village women were mobilized to plan and implement a kindergarten and child feeding program, illustrates the potential of carefully conceptualized community participation. Permission was obtained from village elders to train 18 mothers (all of whom has at least 4 years of education) to conduct a community needs survey. III health among children emerged as the problem of greatest concern to villagers and a health committee was formed to plan an intervention. Although a team of outside professionals was available for technical support, the emphasis from he onset was on developing self-reliance and community involvement in all decisions. To build confidence and develop leadership, a month-long participatory training course in promotive health care was organized by village health volunteers. Preparation for the project included conversion of an unused hut into a kindergarten and construction of furniture by village men, registration of preschool children, preparation of educational materials, and organization of a kitchen and duty roster for the feeding program. Project funding came from local bake sales and kindergarten subscriptions. Monitoring during the initial phase identified several problems, such as food shortages brought about by drought, some parents' inability to pay for kindergarten services, and a lack of trust in the teacher's abilities. These problems were corrected by the field team, but subsequent supervisory visits focused on teaching problem-solving skills to the local women. An evaluation conducted 1 year after program implementation revealed dramatic increases in the proportion of households producing fruits and vegetables, a higher percentage of breastfeeding mothers, and improvements in weight-for-age among kindergartners.

  4. Implementation of a "County-Township-Village" Allied HIV Prevention and Control Intervention in Rural China.

    Science.gov (United States)

    Yu, Jun; Zhang, Yi; Jiang, Junjun; Lu, Qinglin; Liang, Bingyu; Liu, Deping; Fang, Keyong; Huang, Jiegang; He, Yang; Ning, Chuanyi; Liao, Yanyan; Lai, Jingzhen; Wei, Wudi; Qin, Fengxiang; Ye, Li; Geng, Wenkui; Liang, Hao

    2017-09-01

    In China, rural areas are a weak link of HIV/AIDS prevention and control. From September 2011, an innovative "county-township-village" allied intervention was implemented in Longzhou County, Guangxi, which assigned the tasks of HIV/AIDS prevention and control to the county Centers for Disease Control and Prevention (CDC), township hospitals, and village clinics, respectively, instead of traditional intervention in which the county CDC undertook the entire work. A 6-year consecutive cross-sectional survey, including 3-year traditional intervention (2009-2011) and 3-year innovative intervention (2012-2014), was conducted to evaluate the effects of the new intervention. Compared to traditional intervention, the innovative intervention achieved positive effects in decreasing risky behaviors. Among female sex workers, condom use rate in the last month increased from 72.06% to 96.82% (p traditional one. Cost-effectiveness analysis indicates that innovative intervention restores each disability-adjusted life year costing an average of $124.26. Taken together, Longzhou's innovative intervention has achieved good effects on HIV/AIDS prevention and control and provides a good reference for rural China.

  5. The Lake Clinic - providing primary care to isolated floating villages on the Tonle Sap Lake, Cambodia.

    Science.gov (United States)

    Merali, H S; Morgan, J F; Uk, S; Phlan, S; Wang, L T; Korng, S

    2014-01-01

    One of the most isolated areas in South-East Asia is the Tonle Sap Lake region in Cambodia. Scattered throughout the lake are remote fishing villages that are geographically isolated from the rest of the country. Receiving health care at a clinic or hospital often involves a full day of travel from the Tonle Sap Lake region, which is unaffordable for the vast majority of residents. The Lake Clinic (TLC) is a non-government organization established in 2007. In 2008, a ship was built that was designed for transport of a medical team and supplies to provide primary care to the fishing villages. Initially the project started with one team serving seven villages. TLC has since expanded to two full teams serving 19 villages. TLC provides adult and pediatric primary care, vaccinations, dental services, eyecare services, antenatal care and health education free of charge. From 2008 to 2012, there were a total of 13 160 pediatric visits and 17 722 adult visits. In addition to these services, 739 patients received dental care, 346 patients received eye care, there were 1239 antenatal visits, 116 family planning visits, and 1600 patients received health education. In total, 130 patients were referred to hospitals or health centers for a higher level of care. A total of 6627 immunizations were provided. The most common pediatric illness was upper respiratory infection (44.4%), and the most common adult illness observed was gastritis (20.6%). Despite the challenges, TLC has been able to achieve a significant goal: to provide primary care medical services to a remote area of Cambodia where no medical services were previously available. TLC strives to strengthen healthcare delivery with the goal to provide the best possible care in the region. New partnerships have allowed laboratory capacity and a formalized hospital referral system for pediatric patients beginning in 2014. A new boat, which completed construction in December 2013 and is now fully operational, has allowed the

  6. Impact of HIV Status on Treatment Outcome of Tuberculosis Patients Registered at Arsi Negele Health Center, Southern Ethiopia: A Six Year Retrospective Study

    OpenAIRE

    Gebreslassie Gebremariam; Getachew Asmamaw; Muktar Hussen; Hailemariam, Mengistu Z.; Demissie Asegu; Ayalew Astatkie; Amsalu, Anteneh G.

    2016-01-01

    Background Despite implementation of different strategies, the burden and mortality of human immunodeficiency virus (HIV)-associated tuberculosis (TB) remains a challenge in Ethiopia. The aim of this study was to assess the impact of HIV status on treatment outcome of tuberculosis patients registered at Arsi Negele Health Center, Southern Ethiopia. Methods A six-year retrospective data (from September 2008 to August 2014) of tuberculosis patients (n = 1649) registered at the directly observed...

  7. Toxorhynchites amboinensis larvae released in domestic containers fail to control dengue vectors in a rural village in central Java.

    Science.gov (United States)

    Annis, B; Nalim, S; Hadisuwasono; Widiarti; Boewono, D T

    1990-03-01

    The efficacy of Toxorhynchites amboinensis larvae for control of dengue vectors in household water storage containers was tested in a rural village in Central Java, Indonesia. Concrete cisterns and clay jars were the most common types of containers used for long-term water storage, although smaller numbers of metal drums were also used. All containers in use in the village received 5-10 second- or third-instar Tx. amboinensis larvae biweekly for 7 months. Vector surveillance (adult and larval) was conducted biweekly between treatments. No differences in man-biting rates or larval population indices were noted between the treatment and control areas. It is hypothesized that the multiplicity of larval habitats in this rural area accounted for the lack of impact of predator releases, which were directed solely toward artificial containers.

  8. LONG TERM MUCOLYTIC THERAPY WITH DORNASE ALFA AT NOVOSIBIRSK CENTER FOR DIAGNOSTICS, TREATMENT, RHEABILITATION AND ADAPTATION OF CHILDREN WITH CYSTIC FIBROSIS

    Directory of Open Access Journals (Sweden)

    N.I. Romanenko

    2006-01-01

    Full Text Available The center for diagnostic, treatment, rehabilitation and social adaptation of patients with cystic fibrosis was established in pulmonology department of the children's clinical hospital № 3 of Novosibirsk in 1994. Since 1995 the database of the center has registered 23 patients. the center has carried out an open prospective study of clinical efficacy and safety of dornase alfa (pulmozyme, «F. hoffmannala roche ltd.», basel in 10 patients with cystic fibrosis. The patients have received mucolytic therapy with dornase alfa for 2 years (2003–2005. They have been administered a daily inhalation of 2.5 ml of the solution (pulmozyme inhalation solution containing 2.5 of dornaza alfa. The study has shown an improvement of pulmonary function and elevation of oxygen saturation. The number of respiratory infections have dropped by 33%, the administration of intravenous antibiotics has shortened by 25%, the nutrition status has trended towards improvement. regardless of it's high price, dornasa alfa has proven its' benefits in the treatment of cystic fibrosis in patients of any age and disease severity.Key words: dornase alfa, children, cystic fibrosis, treatment.

  9. Differences Between the Family-Centered "COPCA" Program and Traditional Infant Physical Therapy Based on Neurodevelopmental Treatment Principles

    NARCIS (Netherlands)

    Dirks, Tineke; Blauw-Hospers, Cornill H.; Hulshof, Lily J.; Hadders-Algra, Mijna

    Background. Evidence for effectiveness of pediatric physical therapy in infants at high risk for developmental motor disorders is limited. Therefore, "Coping With and Caring for Infants With Special Needs" (COPCA), a family-centered, early intervention program, was developed. The COPCA program is

  10. Village context and health-seeking behaviour in the Fatick region of Senegal

    OpenAIRE

    Aurélien Franckel; Frédéric Arcens; Richard Lalou

    2008-01-01

    In the dense literature on health-seeking behaviour in the African rural environment, contextual aspects, and, more especially, differences between villages, are rarely studied. This article therefore considers the village or group of villages as an aggregate level of analysis, based on a study conducted in the Fatick region in Senegal. The descriptive results show significant variations in therapeutic practices, disease management and health care planning strategies from one village to the n...

  11. Wastewater retreatment and reuse system for agricultural irrigation in rural villages.

    Science.gov (United States)

    Kim, Minyoung; Lee, Hyejin; Kim, Minkyeong; Kang, Donghyeon; Kim, Dongeok; Kim, YoungJin; Lee, Sangbong

    2014-01-01

    Climate changes and continuous population growth increase water demands that will not be met by traditional water resources, like surface and ground water. To handle increased water demand, treated municipal wastewater is offered to farmers for agricultural irrigation. This study aimed to enhance the effluent quality from worn-out sewage treatment facilities in rural villages, retreat effluent to meet water quality criteria for irrigation, and assess any health-related and environmental impacts from using retreated wastewater irrigation on crops and in soil. We developed the compact wastewater retreatment and reuse system (WRRS), equipped with filters, ultraviolet light, and bubble elements. A pilot greenhouse experiment was conducted to evaluate lettuce growth patterns and quantify the heavy metal concentration and pathogenic microorganisms on lettuce and in soil after irrigating with tap water, treated wastewater, and WRRS retreated wastewater. The purification performance of each WRRS component was also assessed. The study findings revealed that existing worn-out sewage treatment facilities in rural villages could meet the water quality criteria for treated effluent and also reuse retreated wastewater for crop growth and other miscellaneous agricultural purposes.

  12. SOCIO-POLITICAL DYNAMICS TAKING PLACE AT KUTA TRADITIONAL VILLAGE, BALI: FROM DESA ADAT (TRADITIONAL VILLAGE TO DESA PEKRAMAN (ANOTHER TYPE OF TRADITIONAL VILLAGE IN THE PERSPECTIVE OF CULTURAL STUDIES

    Directory of Open Access Journals (Sweden)

    I Wayan Wesna Astara

    2012-11-01

    Full Text Available This research explores the socio-political dynamics taking place at KutaTraditional Village, Bali: from desa adat (traditional village to desa pekraman (anothertype of traditional village in the perspective of cultural studies. There are three problemsformulated in this research. The first problem is how the socio-political dynamics fromdesa adat (traditional village to desa pekraman (another type of traditional village tookplace at Kuta? The next problem is how the traditional village interacted with theadministrative village at Kuta? And the last problem, which is the third, is what were theimpacts and meanings of the change from desa adat to desa pekraman? In this studyqualitative method was employed. And the data needed was obtained by employing thetechnique of in-depth interview, the technique of participatory observation, anddocumentation study. To give responses to the problems mentioned above, the theory ofhegemony, the theory of deconstruction, the theory of conflict, the theory of power andknowledge and the theory of eclectically symbolic interaction were applied.The findings show that the socio-political dynamics taking place Kuta TraditionalVillage resulted in turbulence among the villagers. This is indicated by the Local Rulesand Regulations (Perda issued by Desa Pekraman of Number 3 of Year 2001. Thiscould be responsible for the factors of pro’s and con’s in various aspects. Clause (6 ofArticle 3 of the Perda of Number 3 of Year 2001 was reversed by the leaders of KutaTraditional Village. They did not agree that non-Hindu people were included as thetraditional village members.As far as the interaction between the traditional village and the administrativevillage is concerned, the governmental hegemony took place. The government appliedhegemony to the traditional village through the administrative village in the form of rulesand regulations. The local rules and regulations issued by the desa pekraman, as a legalproduct in Bali

  13. Poverty and Basic Education in Rural China: Villages, Households, and Girls' and Boys' Enrollment.

    Science.gov (United States)

    Hannum, Emily

    2003-01-01

    Against a backdrop of educational decentralization and market transition, China demonstrates how local community resources condition educational inequality. Analysis of 1992 national survey data on 7,550 villages and nearly 78,000 rural children aged 12-14 revealed that household income, village income, and village provision of junior high schools…

  14. Gezin tussen verleden en toekomst, 1960-1972 [Family in the changing village, 1960-1972

    NARCIS (Netherlands)

    Douma, W.H.

    2007-01-01

    Contacts with inhabitants of second houses / opinion on different aspects of village / necessary facilities in village / preference of living near the town / use of car / opinion on future of village / attitude towards renovated old houses and their owners. Background variables: basic

  15. Building an image of Villages-in-the-City: a clarification of China's distinct urban spaces.

    Science.gov (United States)

    Chung, Him

    2010-01-01

    Villages-in-the-city (chengzhongcun) as distinct urban spaces in Chinese cities have attracted a lot of scholarly attention, and the term has been variously interpreted. The term "urban village" was initially borrowed and applied to describe this urban phenomenon. While the term in a Western context refers to a planned neighbourhood that features good urban planning and design, the question posed in this essay is: are villages-in-the-city the Chinese equivalent of urban villages? Furthermore, within China, villages-in-the-city are always regarded as migrant enclaves, no different from Zhejiang village or Xinjiang village in Beijing. Are they the same kind of settlement? A primary aim of this essay is to reassert the differences between villages-in-the-city and urban villages that have developed in the United Kingdom. A secondary objective is to explore the variations between villages-in-the-city and Zhejiang village. Through investigating the variations between these urban morphologies, this study attempts to fill gaps in the current literature and hence clarify the misconceptions and confusion about Chinese villages-in-the-city.

  16. REDD+ piloting in Tanzania: The village as an arena for defining ...

    African Journals Online (AJOL)

    brokers between state agencies and local communities. The governance structures at village level play a key role in regulating forest use and implementation of any project. Since communities have a higher trust on their village governments, the villages remain core area for protecting interests of REDD+ and conservation

  17. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... Resources ADHD Resource Center Resource Centers Obsessive Compulsive Disorder Resource Center Youth Resources Child and Adolescent Psychiatrist Finder Getting Treatment Without treatment, ...

  18. Environmental Factors in the Growth of Jatropha at Potorono Village, Yogyakarta

    Directory of Open Access Journals (Sweden)

    Mohammad Nurcholis

    2015-01-01

    Full Text Available Jatropha curcas is a perennial crop that has been known by Indonesian people for more than seven decades as a plant that produces renewable biofuel. In the present decade, plants producing biofuel are expected to be developed to overcome the lowering nonrenewable fuel reserves. There is a myth that jatropha can grow well on marginal lands and draught condition, perform well on non-fertile soils, no need for agronomic management and is resistant to plant pests and diseases. This study was conducted to identify the environmental factors that influenced the growth of jatropha on the marginal land at Potorono village, Yogyakarta Province, Indonesia. Jatropha has been planted by local people at the village road sides and on the marginal land field at the local governmental land in this village. They grew jatropha on these areas with the purpose of preventing competition of area utilization with food crops. The results showed that the growth of jatropha was restricted by low content of organic matter, plant nutrition and poor soil drainage. Applications of manure and macro nutrients (N, P and K to this crop were able to increase crop performance. The number of shoots, flowers and fruit bunches increased by manure and nutrients treatments. Field observation showed that there were several plant pests, such as Aspidiotus sp., Paracoccus marginatus, Poliphagotarsonemus latus, Selenothrips rubrocinctus, Chrysochoris javanus, Valanga nigricornis, Chloracris prasina, and Helicoverpa armigera that attacked plant leaves and fruits. There were plant leaf necrotic symptoms that caused by plant pathogens were also observed. The diseases are bacterial leaf spot (Xanthomonas ricinicola, cercospora leaf spot (Cercospora ricinella and rust (Phakopsora jatrophicola. Thus, jatropha is like any other plants that need a good agro-ecological condition to grow well and produce high yield.

  19. Evaluation of 5536 patients treated in an integrative outpatient tinnitus treatment center-immediate effects and a modeling approach for sustainability.

    Science.gov (United States)

    Ostermann, Thomas; Boehm, Katja; Kusatz, Martin

    2016-08-11

    Tinnitus is an increasingly serious problem for health care systems. According to epidemiological data, 7-14 % of outpatients have asked their physician about tinnitus and management strategies. Integrative outpatient treatments are currently regarded as promising therapeutic approaches for managing tinnitus. In this article we report on the treatment success of an outpatient tinnitus treatment center in Germany. This cohort study included pre-post data of 5536 outpatients which were treated between 2003 and 2010 in the tinnitus-therapy center, Krefeld-Düsseldorf (TTZ). The intervention consisted of psychological immunization training as well as an auditory stimulation therapy component. The main outcome parameter was the score of the Tinnitus Questionnaire (TQ) which was assessed before and after a 9 days treatment and (in a small subsample) at a 6 months follow-up. Missing data were multiply imputed. Pre-post effect sizes were calculated and adjusted for regression to the mean (RTM). RTM-adjusted treatment effects at the end of treatment were estimated as -18.6 (CI: -18.9 to 18.2, p < 0.001) score points which corresponds to a standardized effect of d = -1.03 (CI: -1.05 to -1.01). These effects can be corroborated in various subgroups and all subscales of the TQ (d ranging from -0.31 to -0.97). The study suggests the effectiveness of this outpatient tinnitus therapy concept. Multiple imputations techniques and RTM analysis were helpful in carving out true treatment effects.

  20. Bergamot (Citrus bergamia) Essential Oil Inhalation Improves Positive Feelings in the Waiting Room of a Mental Health Treatment Center: A Pilot Study.

    Science.gov (United States)

    Han, Xuesheng; Gibson, Jacob; Eggett, Dennis L; Parker, Tory L

    2017-05-01

    Mental health issues have been increasingly recognized as public health problems globally. Their burden is projected to increase over the next several decades. Additional therapies for mental problems are in urgent need worldwide due to the limitations and costs of existing healthcare approaches. Essential oil aromatherapy can provide a cost-effective and safe treatment for many mental problems. This pilot study observed the effects of bergamot essential oil inhalation on mental health and well-being, as measured by the Positive and Negative Affect Scale, in a mental-health treatment center located in Utah, USA. Fifty-seven eligible participants (50 women, age range: 23-70 years) were included for analysis. Fifteen minutes of bergamot essential oil exposure improved participants' positive feelings compared with the control group (17% higher). Unexpectedly, more participants participated in experimental periods rather than control periods, suggesting even brief exposure to essential oil aroma may make people more willing to enroll in clinical trials. This study provides preliminary evidence of the efficacy and safety of bergamot essential oil inhalation on mental well-being in a mental health treatment center, suggesting that bergamot essential oil aromatherapy can be an effective adjunct treatment to improve individuals' mental health and well-being. © 2017 The Authors. Phytotherapy Research published by John Wiley & Sons Ltd. © 2017 The Authors. Phytotherapy Research published by John Wiley & Sons Ltd.

  1. "The Moon Village and Journey to Mars enable each other"

    Science.gov (United States)

    Beldavs, Vidvuds

    2016-07-01

    NASA has proposed the Journey to Mars, a multi-decade collaborative international effort to establish permanent manned operations on the Martian surface as well as in orbit, most likely on the Martian moons. NASA's proposed the Journey to Mars has come under politically motivated attack as illusory, as beyond NASA's capabilities and anticipated NASA budgets in the foreseeable future. [1]. Other concerns come from various communities of researchers concerned about securing sustaining funding for their largely robotic research missions. ESA's Director General Dietrich Woerner's proposed Moon Village faces challenges ESA member states concerned about sustaining funding for projects already underway or in planning. Both the Journey to Mars and Moon Village raise the question - who will or who can pay for it? The 2013 US Research Council study suggested potential benefits to a mission to Mars from activities on the Moon [2]. The NASA funded Flexible Lunar Architecture study came to similar conclusions using a different methodology [3]. A logistics analysis by an MIT team suggested the possibility of cost savings through use of lunar water for propellant to reach Mars [4]. The highly promising private-public financing approach has been examined for potential application to funding the costs of reaching Mars [5]. Insofar as the feasibility of utilization of lunar water has not been determined these conclusions are speculative. This study will examine the following alternative scenarios for establishing sustainable, manned operations on Mars and permanent manned operations on the Moon: A. NASA-led Journey to Mars without an ESA-led Moon Village B. ESA-led Moon Village without NASA-led Journey to Mars C. NASA-led Journey to Mars with an ESA-led Moon Village D. Shared Infrastructure scenario - NASA-led Journey to Mars with ESA-led Moon Village and with a potential JAXA-led space-based-solar power initiative E. Space Industrialization scenario - Shared Infrastructure scenario

  2. The impact of circular migration on a village economy.

    Science.gov (United States)

    Hetler, C B

    1989-04-01

    The author examines the economy of a rural village in Indonesia in which a high proportion of households rely on remittances from urban informal sector earnings. Household income and per capita income are analyzed according to whether or not households have at least one temporary migrant, and by the sex and age of the household head. Findings indicate that "remittances from short-term circular migration push many households into the middle and upper income ranges. However, the wealthiest households continue to rely on traditional high earning activities and do not depend on remittances. The poorest households are scattered among those who rely on remittances and those still totally dependent upon traditional low earning village activities, regardless of the sex and age of the household head." excerpt

  3. Preparing nursing students for education in the global village.

    Science.gov (United States)

    Nicholas, Patrice K; Corless, Inge B; Fulmer, Holly; Meedzan, Nancy

    2012-01-01

    Educating nurses for the 21st century requires a broad understanding of the health needs of local and global communities. With an increasingly diverse population, nursing students in the United States can gain a unique perspective on health disparities and challenges in providing healthcare for diverse populations. Nursing education has the opportunity to engage students in our global village by providing clinical and theory-based educational opportunities for undergraduate and graduate nursing students. Some nursing educational settings in schools of nursing provide global nursing opportunities to explore the social responsibility of nursing. This paper details a specific framework and opportunities for engaging undergraduate and graduate nursing students in caring for the underserved in our global village. Opportunities in the Fulbright Student Exchange Program and Fulbright Senior Scholar Award mechanisms are discussed, and partnerships with international nursing programs are explored.

  4. CERN’s role in the scientific global village

    CERN Multimedia

    2009-01-01

    We’re proud of saying that there are over 100 nationalities at CERN, proof that people can overcome cultural boundaries in pursuit of common goals. We’re also proud of saying that our goals are noble ones: the understanding of the Universe, training of the highest quality, pushing the frontiers of technology and bringing nations together. For over 50 years, CERN has pursued these goals as part of the global scientific village. We have enjoyed healthy collaboration, and competition, with other laboratories in other regions of the world. The flow of scientists around the world has been balanced, enriching all regions. Today, however, the landscape is changing for particle physics, and as responsible citizens of our global village, we also have to evolve. The research facilities for CERN’s melting pot of nationalities are supported financially largely by the Organization’s 20 Member States. Other countries that make significant c...

  5. Targeting Villages for Rural Development Using Satellite Image Analysis.

    Science.gov (United States)

    Varshney, Kush R; Chen, George H; Abelson, Brian; Nowocin, Kendall; Sakhrani, Vivek; Xu, Ling; Spatocco, Brian L

    2015-03-01

    Satellite imagery is a form of big data that can be harnessed for many social good applications, especially those focusing on rural areas. In this article, we describe the common problem of selecting sites for and planning rural development activities as informed by remote sensing and satellite image analysis. Effective planning in poor rural areas benefits from information that is not available and is difficult to obtain at any appreciable scale by any means other than algorithms for estimation and inference from remotely sensed images. We discuss two cases in depth: the targeting of unconditional cash transfers to extremely poor villages in sub-Saharan Africa and the siting and planning of solar-powered microgrids in remote villages in India. From these cases, we draw out some common lessons broadly applicable to informed rural development.

  6. Everyday burden of musculoskeletal conditions among villagers in rural Botswana

    DEFF Research Database (Denmark)

    Hondras, Maria; Hartvigsen, Jan; Myburgh, Corrie

    2016-01-01

    of independence and social identity to fulfil traditional roles held meaning as significance. Outmigration for wage labour and other shifts in family structure compounded everyday musculoskeletal burden. CONCLUSION: Uncovering burden is an important first step to address musculoskeletal care needs in developing......OBJECTIVE: To examine the perspectives of villagers in rural Botswana about the everyday life burden and impact of their musculoskeletal disorders. METHODS: Ethnographic fieldwork for 8 months included 55 in-depth interviews with 34 villagers. Interviews were typically conducted in Setswana...... for the consequences and significance of musculoskeletal burden related to 3 themes: (i) hard work for traditional lives; (ii) bearing the load of a rugged landscape; and, (iii) caring for others with disrupted lives. Physical labour with musculoskeletal symptoms had economic and subsistence consequences. The loss...

  7. A measure for the promotion of mountain ecological villages in South Korea: focus on the national mountain ecological village investigation of 2014.

    Science.gov (United States)

    Choi, Soo Im; Kang, Hag Mo; Kim, Hyun; Lee, Chang Heon; Lee, Chong Kyu

    2016-01-01

    Although South Korean mountain villages occupy 44 and 55 % of land and forest areas, respectively, these villages account for only 3 % of the national population and they suffer from a declining workforce owing to aging, wage inflation, and low forestry productivity. As a result, the South Korean government implemented a mountain ecological village development project from 1995 to 2013 in 312 of the 4972 mountain villages and investigated project performance in 2014. The present study establishes a measure for the promotion of mountain ecological villages by comparing the situation before and after the project. The analysis found a threefold increase in the inflow of farm/rural-returning and multicultural households compared with before the project, while the average income per farm, local product sales, and experience tourism revenue also grew remarkably every year. In addition, households utilizing forest resources increased by about 30 %, but 45.8 % of the 312 villages had no long-term plan for village development and villagers experienced low satisfaction with job creation and village income. A systematic revision of agroforestry production and forest administration is needed to define the characteristics of farm/rural-returning populations clearly, reorganize urban-rural exchange and experience programs, and reinforce tangible/intangible cultural assets and religious traditions.

  8. Directly Improving the Quality of Radiation Treatment Through Peer Review: A Cross-sectional Analysis of Cancer Centers Across a Provincial Cancer Program.

    Science.gov (United States)

    Rouette, Julie; Gutierrez, Eric; O'Donnell, Jennifer; Reddeman, Lindsay; Hart, Margaret; Foxcroft, Sophie; Mitera, Gunita; Warde, Padraig; Brundage, Michael D

    2017-07-01

    To describe the outcomes of peer review across all 14 cancer centers in Ontario. We identified all peer-reviewed, curative treatment plans delivered in Ontario within a 3-month study period from 2013 to 2014 using a provincial cancer treatment database and collected additional data on the peer-review outcomes. Considerable variation was found in the proportion of peer-reviewed plans across the centers (average 70.2%, range 40.8%-99.2%). During the study period, 5561 curative plans underwent peer review. Of those, 184 plans (3.3%) had changes recommended. Of the 184 plans, the changes were major (defined as requiring repeat planning or having a major effect on planning or clinical outcomes, or both) in 40.2% and minor in 47.8%. For the remaining 12.0%, data were missing. The proportions of recommended changes varied among disease sites (0.0%-7.0%). The disease sites with the most recommended changes to treatment plans after peer review and with the greatest potential for benefit were the esophagus (7.0%), uterus (6.7%), upper limb (6.3%), cervix and lower limb (both 6.0%), head and neck and bilateral lung (both 5.9%), right supraclavicular lymph nodes (5.7%), rectum (5.3%), and spine (5.0%). Although the heart is an organ at risk in left-sided breast treatment plans, the proportions of recommended changes did not significantly differ between the left breast treatment plans (3.0%, 95% confidence interval 2.0%-4.5%) and right breast treatment plans (2.4%, 95% confidence interval 1.5%-3.8%). The recommended changes were more frequently made when peer review occurred before radiation therapy (3.8%) than during treatment (1.4%-2.8%; P=.0048). The proportion of plans with recommended changes was not significantly associated with patient volume (P=.23), peer-review performance (P=.36), or center academic status (P=.75). Peer review of treatment plans directly affects the quality of care by identifying important clinical and planning changes. Provincial strategies are

  9. Evaluating Patient-Centered Outcomes in Clinical Trials of Procedural Sedation, Part 1 Efficacy: Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research Recommendations.

    Science.gov (United States)

    Williams, Mark R; Ward, Denham S; Carlson, Douglas; Cravero, Joseph; Dexter, Franklin; Lightdale, Jenifer R; Mason, Keira P; Miner, James; Vargo, John J; Berkenbosch, John W; Clark, Randall M; Constant, Isabelle; Dionne, Raymond; Dworkin, Robert H; Gozal, David; Grayzel, David; Irwin, Michael G; Lerman, Jerrold; O'Connor, Robert E; Pandharipande, Pratik; Rappaport, Bob A; Riker, Richard R; Tobin, Joseph R; Turk, Dennis C; Twersky, Rebecca S; Sessler, Daniel I

    2017-03-01

    The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research, established by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks public-private partnership with the US Food and Drug Administration, convened a meeting of sedation experts from a variety of clinical specialties and research backgrounds with the objective of developing recommendations for procedural sedation research. Four core outcome domains were recommended for consideration in sedation clinical trials: (1) safety, (2) efficacy, (3) patient-centered and/or family-centered outcomes, and (4) efficiency. This meeting identified core outcome measures within the efficacy and patient-centered and/or family-centered domains. Safety will be addressed in a subsequent meeting, and efficiency will not be addressed at this time. These measures encompass depth and levels of sedation, proceduralist and patient satisfaction, patient recall, and degree of pain experienced. Consistent use of the recommended outcome measures will facilitate the comprehensive reporting across sedation trials, along with meaningful comparisons among studies and interventions in systematic reviews and meta-analyses.

  10. Advantageous and disadvantageous impacts of tourism development on the living of Li ethnic minority villagers in Hainan Island, China.

    Science.gov (United States)

    Liang, Jing-yu; Umezaki, Masahiro; Ohtsuka, Ryutaro

    2003-06-01

    Around the Mt. Wuzhishan in Hainan Island, China, tourism development has been rapidly progressed by the government and private companies since the 1980s, especially since the late 1990s, and consequently the living conditions of the Li ethnic minority people in Shuiman village, located in its center, have been drastically changing. As expected by the government, the villagers' income has increased by means of wage labors, selling the local products to the tourists, and compensatory payments for crops grown in the customary land when its use right was transferred to the company. Various changes in their lifestyle have contributed to the release from poverty and the overall improvement in basic human needs and primary health care. The villagers' flexible decision-makings on their living and environment use, with application of their traditional knowledge for resource uses, have been effective for sustainable human-environment relations, though further changes due to orders and requests of the government and companies may lead to environmental deterioration. Furthermore, inter-household differentiation in income and the perception on tourism development and agricultural development has been enlarged. These situations are discussed from the viewpoint of community-based sustainable development.

  11. Dialysis centers - what to expect

    Science.gov (United States)

    ... in a treatment center. This article focuses on hemodialysis at a treatment center. ... JT, Blake PG, Ing TS, eds. Handbook of Dialysis . 5th ed. ... TA. Hemodialysis. In: Skorecki K, Chertow GM, Marsden PA, Taal ...

  12. Comparison of continuing medical education (CME priorities of midwives employed at health facilities and treatment centers of Kashan and Aran & Bidgol - 2010

    Directory of Open Access Journals (Sweden)

    S Behrouzifar

    2012-06-01

    Full Text Available Introduction: In Continuing Medical Education (CME, paying attention to professional empowerment on the basis of community needs and learners’ institutional requirements is necessary. This study was conducted to determine continuing CME priorities of midwifery graduates employed in health and treatment centers of Kashan and Aran & Bidgol cities located in central Iran (2010. Methods: This cross-sectional study was conducted on 71 midwives. A questionnaire including 87 educational items in 6 subjects was designed. Every item was scored on a Likert scale ranging from zero to ten. Data were extracted, classified and analyzed by SPSS software using descriptive and inferential statistics. Results: Of the six subjects raised, gynecology (7.89±1.54 had the highest score and fundamentals of nursing (6.05±2.35 had the lowest score. Among different disease the topics of abnormal genital tract bleeding (9.32±1.3, diabetes mellitus during pregnancy (9.26±1.27, breast cancer (9±1.97, anemia (8.87±1.71, preventing the birth of premature infants (8.44±2.34 and infection control in special units (7.36±3.06, had the highest means, respectively. There was a statistically significant difference between two groups of midwives employed in health centers and treatment centers regarding the need for learning some subjects. Conclusion: The need for CME priorities varied according to functional domains. This is essential to be considered by decision makers.

  13. Results of Integrated Investigation of Collapse Sinkhole in Sarkayevo Village

    OpenAIRE

    O. N. Kovin; S. M. Blinov; P. A. Belkin; S. S. Vaganov; Bhavik Lodhia; Ruth Amey; Gan Yuqian

    2014-01-01

    The integrated investigations of karstic collapse sinkhole were conducted at the area of Sarkayevo village. The obtained hydrogeologic data show the local concentration of underground water flow at the investigated site, and high sulfate ion content in the water samples that suggests that a sinkhole is karstic in nature. Geophysical investigations allowed determining basic parameters of the site geological structure, to reveal the depth distribution of the disturbed ground in vicinity of the ...

  14. Benefits from a renewable energy village electrification system

    Energy Technology Data Exchange (ETDEWEB)

    Zahnd, Alex [Kathmandu University, School of Mechanical Engineering, and RIDS-Nepal - ISIS Humla Project Director (Nepal); Kimber, Haddix McKay [University of Montana and The ISIS Foundation, Missoula, Montana (United States)

    2009-02-15

    More than 100 years after Edison's life changing discovery, 1.6-2 billion people around the globe still live without light, in dark and smoke filled homes. The remote and impoverished Himalayan villages of upper Humla, in north-west Nepal, belong to some of the 2.4 billion people who still depend on the use of traditional biomass for their daily energy services such as cooking, heating and light. These activities on open fireplaces have a direct chronic impact on the health and extremely low life expectancy of the women and children along with devastating deforestation. There is a strong relationship between prosperity and access to electricity. The more remote and isolated communities in Nepal generally live in great poverty. Eighty percent of Nepal's 28.5 million people live in rural areas, with around half of these so remote, that neither a road, nor the national grid is ever likely to reach them. While Nepal has no fossil fuel resources, it is a country that is rich in renewable energy resources such as hydropower and solar energy. These abundant and locally available renewable energy resources can be tapped into with appropriate locally developed technologies. Generating and storing electrical energy derived from these rich local energy resources can provide for appropriate and sustainable lighting, which brings potential health, education, social and economic benefits to the people who have previously lived in homes with excessive indoor air pollution. This paper describes the living conditions of some villages in upper Humla, and the possible benefits of a simple village electrification system that provides basic lighting for the homes and the consequent improvements in the living conditions of the villagers. (author)

  15. CAN WE TREAT THEMATIC VILLAGES AS SOCIAL INNOVATIONS?

    OpenAIRE

    Kloczko-Gajewska, Anna

    2014-01-01

    The term “social innovation” gained popularity within scholars, however its definitions differ to a large extent; the most promising one says about a change in attitudes and behaviour of a group of people that in relation to the group’s horizon leads to new and improved ways of collaborative action. This paper tries to answer the question whether thematic villages, where the inhabitants jointly decide on a topic and prepare unique tourist attractions based mainly on local cultural, natural, a...

  16. Multicultourism in Mexico’s Magical Village Cuetzalan

    DEFF Research Database (Denmark)

    Jacobsen, Casper

    into the identity and power configurations that are produced by and in relation to the program.Combining recent readings on the Foucauldian concept of governmentality and sociologist Erving Goffman's ideas on conceptual frames, the thesis shows how the MagicalVillages program conducts and organizes political...... capital Cuetzalan (Puebla) and surrounding indigenous Nahua communities and through analysis of government and program documents, press releases, newspaper articles, institutional interaction, public space and ritual, tourism magazine texts, field notes, and interviews, the analysis tunes...

  17. Village Stability Operations and the Afghan Local Police

    Science.gov (United States)

    2014-10-01

    total, were removed as a consequence of the revetting process.69 These precautions most likely prevented some insider attacks. But experience was...paperwork 69 Moyar: Village Stability Operations and the Afghan Local Police to the Ministry of Interior, which was demanding the paperwork as a safe ...US-Trained ‘ Neighborhood Militia’ A Force for Safety and Controversy,” McClatchy Newspapers, March 6, 2011. 27. Noor had asked the central government

  18. The eastern limit of the freeholder's villages in Bessarabia

    Directory of Open Access Journals (Sweden)

    Maria CIGOLEA

    2010-10-01

    Full Text Available The freeholder's villages are spread in large part, to their old location in geographic space. This location is significant because it reflects the spread of the eastern part of Bessarabia in freeholders settlements. In other words, it tells us that were populated parts of the territory betweenthe Prut and Dniester, which was the "empty" during the nineteenth century.

  19. Quality Management of Lontar Village Coastal Waters, Banten

    Directory of Open Access Journals (Sweden)

    Ani Rahmawati

    2017-11-01

    Full Text Available The coastal waters of Lontar Village is located in Tirtayasa District, Banten. The coastal waters of Lontar Village is also used for fishing activities that become the livelihood of the surrounding community. Communities around the coast of Lontar village dispose of household waste directly into the waters so that the waters become dirty. The existence of these activities can cause the condition of the waters to decrease even can lead to contamination. Decrease in water conditions will affect the living biota inside. Waters quality can be determined by measuring physical, chemical, biological and heavy metal parameters. Physical parameters include brightness, turbidity, and temperature. Chemical parameters are salinity, pH, dissolved oxygen, nitrate, phosphate, BOD, TSS. The biological parameter is total coliform. The parameters of heavy metals are lead and copper. The purpose of this study is to analyze the quality of coastal waters of Lontar Village based on physical, chemical, biological and heavy metal parameters. The results showed that most of the parameters of water quality (physics, chemistry, biology and heavy metals are still in accordance with the value of water quality standards (Decree of the Minister of Environment No. 51 of 2004 only the value of lead metals exceeding the standard quality. It must be overcome so as not to disrupt the life of biota in the waters. Management that can be done is utilize aquatic biota that can absorb heavy metal content such as green shell (shell should not be consumed, reducing oil spilled from the activity of motor boats (giving box shelter under motor boat engines so that oil does not directly spill into the waters.

  20. Village Building Identification Based on Ensemble Convolutional Neural Networks

    Directory of Open Access Journals (Sweden)

    Zhiling Guo

    2017-10-01

    Full Text Available In this study, we present the Ensemble Convolutional Neural Network (ECNN, an elaborate CNN frame formulated based on ensembling state-of-the-art CNN models, to identify village buildings from open high-resolution remote sensing (HRRS images. First, to optimize and mine the capability of CNN for village mapping and to ensure compatibility with our classification targets, a few state-of-the-art models were carefully optimized and enhanced based on a series of rigorous analyses and evaluations. Second, rather than directly implementing building identification by using these models, we exploited most of their advantages by ensembling their feature extractor parts into a stronger model called ECNN based on the multiscale feature learning method. Finally, the generated ECNN was applied to a pixel-level classification frame to implement object identification. The proposed method can serve as a viable tool for village building identification with high accuracy and efficiency. The experimental results obtained from the test area in Savannakhet province, Laos, prove that the proposed ECNN model significantly outperforms existing methods, improving overall accuracy from 96.64% to 99.26%, and kappa from 0.57 to 0.86.

  1. West Village Student Housing Phase I: Apartment Monitoring and Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    German, A. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Bell, C. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Hoeschele, M. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)

    2014-06-01

    Building America team Alliance for Residential Building Innovation (ARBI) worked with the University of California, Davis and the developer partner West Village Community Partnership (WVCP) to evaluate performance on 192 student apartments completed in September, 2011 as part of Phase I of the multi-purpose West Village project. West Village is the largest planned zero net energy community in the United States. The campus neighborhood is designed to enable faculty, staff, and students to affordably live near campus, take advantage of environmentally friendly transportation options, and participate fully in campus life. The aggressive energy efficiency measures that are incorporated in the design contribute to source energy reductions of 37% over the B10 Benchmark. These measures include increased wall and attic insulation, high performance windows, high efficiency heat pumps for heating and cooling, central heat pump water heaters (HPWHs), 100% high efficacy lighting, and ENERGY STAR major appliances. The report discusses how measured energy use compares to modeling estimates over a 10-month monitoring period and includes a cost effective evaluation.

  2. West Village Student Housing Phase I: Apartment Monitoring and Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    German, A.; Bell, C.; Dakin, B.; Hoeschele, M.

    2014-06-01

    Building America team Alliance for Residential Building Innovation (ARBI) worked with the University of California, Davis (UC Davis) and the developer partner West Village Community Partnership (WVCP) to evaluate performance on 192 student apartments completed in September, 2011 as part of Phase I of the multi-purpose West Village project. West Village, the largest planned zero net energy community in the United States. The campus neighborhood is designed to enable faculty, staff and students to affordably live near campus, take advantage of environmentally friendly transportation options, and participate fully in campus life. The aggressive energy efficiency measures that are incorporated in the design contribute to source energy reductions of 37% over the B10 Benchmark. The energy efficiency measures that are incorporated into these apartments include increased wall & attic insulation, high performance windows, high efficiency heat pumps for heating and cooling, central heat pump water heaters (HPWHs), 100% high efficacy lighting, and ENERGY STAR major appliances. Results discuss how measured energy use compares to modeling estimates over a 10 month monitoring period and includes a cost effective evaluation.

  3. Animal-Assisted Therapy for Patients Undergoing Treatment at NIH Clinical Center | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Therapy Dogs Animal-Assisted Therapy for Patients Undergoing Treatment at NIH ... is unlike any other." A self-described "huge animal lover," she coordinates 14 teams of trained and ...

  4. Improving village poultry's survival rate through community-based poultry health management

    DEFF Research Database (Denmark)

    Sodjinou, Epiphane; Henningsen, Arne; Koudande, Olorounto Delphin

    2012-01-01

    Community-based poultry health management (CBM) is a strategy for village poultry improvement based on the installment of “poultry interest groups” in experimental villages. These groups serve as a channel for the dissemination of village poultry improvement technologies. The use of CBM is due...... that governments and development agencies can improve village poultry survival rates by investing in the dissemination of information regarding best husbandry management practices through approaches that rely on the community such as CBM because CBM groups serve as channels for the dissemination of village poultry...

  5. Improving village poultry’s survival rate through community-based poultry health management

    DEFF Research Database (Denmark)

    Sodjinou, Epiphane; Henningsen, Arne; Koudande, Olorounto D.

    Community-based poultry health management (CBM) is a strategy for village poultry improvement based on the installment of “poultry interest groups” in experimental villages. These groups serve as a channel for the dissemination of village poultry improvement technologies. The use of CBM is due...... that governments and development agencies can improve village poultry survival rates by investing in the dissemination of information regarding best husbandry management practices through approaches that rely on the community such as CBM because CBM groups serve as channels for the dissemination of village poultry...

  6. Flexible endoscopic treatment for Zenker's diverticulum with the SB Knife. Preliminary results from a single-center experience.

    Science.gov (United States)

    Battaglia, Giorgio; Antonello, Alessandro; Realdon, Stefano; Cesarotto, Martina; Zanatta, Lisa; Ishaq, Sauid

    2015-11-01

    Flexible endoscopic septum division is becoming a prominent treatment option for Zenker's diverticulum (ZD). Over the years, various techniques have been developed and many cutting tools have been tested with varying results. We report our experience with a recently designed, monopolar, rotating, scissor-shaped device (SB Knife). Data on 31 consecutive patients that underwent flexible endoscopic treatment for ZD with the use of the SB Knife were retrieved. Dysphagia, regurgitation, and respiratory symptom severity before the procedure were graded. Procedure duration, rate of complications, symptom changes after the procedure and rate of relapsing patients during follow up were recorded. The procedure was carried out successfully in all patients. Median procedure time was 14 min. One case of late-onset bleeding developed 1 week after the procedure, and was managed endoscopically. A significant symptom improvement was achieved (dysphagia: median score 0, P 0, P 0, P = 0.009). Two patients had mild relapsing symptoms, respectively, after 4 and 9 months from the procedure but refused further treatment. Endoscopic treatment of ZD using this new device is safe and efficient at short term follow up. No perforations were observed and there was a substantial reduction of symptoms after the treatment. Larger studies are needed to fully assess advantages of this new device for endoscopic treatment of ZD. © 2015 The Authors. Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

  7. Development of antibiotic resistance in Pseudomonas aeruginosa during two decades of antipseudomonal treatment at the Danish CF Center

    DEFF Research Database (Denmark)

    Ciofu, O; Giwercman, B; Pedersen, S S

    1994-01-01

    At the Danish CF Center patients with chronic Pseudomonas aeruginosa lung infection were treated 3-4 times a year (from 1976) with a 2-week intravenous antipseudomonal course which included preferentially an aminoglycoside and a beta-lactam antibiotic. We investigated the development of antibiotic...... resistance in P. aeruginosa strains isolated from Danish CF patients over a period of 18 years by testing the in vitro efficacy of carbenicillin, piperacillin, ceftazidime, tobramycin and ciprofloxacin against P. aeruginosa strains collected in 1973 (51 strains), 1980 (80 strains), 1985 (58 strains...

  8. High-dose 8% capsaicin patch in treatment of chemotherapy-induced peripheral neuropathy: single-center experience.

    Science.gov (United States)

    Filipczak-Bryniarska, Iwona; Krzyzewski, Roger M; Kucharz, Jakub; Michalowska-Kaczmarczyk, Anna; Kleja, Justyna; Woron, Jarosław; Strzepek, Katarzyna; Kazior, Lucyna; Wordliczek, Jerzy; Grodzicki, Tomasz; Krzemieniecki, Krzysztof

    2017-08-17

    High-dose capsaicin patch is effective in treatment of neuropathic pain in HIV-associated neuropathy and diabetic neuropathy. There are no studies assessing effectiveness of high-dose capsaicin patch in treatment of chemotherapy-induced peripheral neuropathy. We sought to determine the effectiveness of treatment of pain associated with chemotherapy-induced peripheral neuropathy with high-dose capsaicin patch. Our study group consisted of 18 patients with clinically confirmed oxaliplatin-induced neuropathy. Baseline characteristic including underling disease, received cumulative dose of neurotoxic agent, neuropathic symptoms, prior treatment and initial pain level were recorded. Pain was evaluated with Numeric Rating Scale prior to treatment with high-dose capsaicin and after 1.8 day and after 8 and 12 weeks after introducing treatment. Patients were divided into two groups accordingly to the amount of neurotoxic agent that caused neuropathy (high sensitivity and low sensitivity group). Most frequent symptoms of chemotherapy-induced neuropathy were: pain (88.89%), paresthesis (100%), sock and gloves sensation (100%) and hypoesthesis (100%). Initial pain level was 7.45 ± 1.14. Mean cumulative dose of oxaliplatin after which patients developed symptoms was 648.07 mg/m2. Mean pain level after 12 weeks of treatment was 0.20 ± 0.41. When examined according to high and low sensitivity to neurotoxic agent patients with low sensitivity had higher pain reduction, especially after 8 days after introducing treatment (69.55 ± 12.09 vs. 49.40 ± 20.34%; p = 0.02) and after 12 weeks (96.96 ± 5.56 vs. 83.93 ± 18.59%; p = 0.04). High-dose capsaicin patch is an effective treatment for pain associated with chemotherapy-induced neuropathy in patients treated with oxaliplatin. Patients with lower sensitivity to neurotoxic agents have better response to treatment and pain reduction.

  9. Data mining for clustering naming of the village at Java Island

    Science.gov (United States)

    Setiawan Abdullah, Atje; Nurani Ruchjana, Budi; Hidayat, Akik; Akmal; Setiana, Deni

    2017-10-01

    Clustering of query based data mining to identify the meaning of the naming of the village in Java island, done by exploring the database village with three categories namely: prefix in the naming of the village, syllables contained in the naming of the village, and full word naming of the village which is actually used. While syllables contained in the naming of the village are classified by the behaviour of the culture and character of each province that describes the business, feelings, circumstances, places, nature, respect, plants, fruits, and animals. Sources of data used for the clustering of the naming of the village on the island of Java was obtained from Geospatial Information Agency (BIG) in the form of a complete village name data with the coordinates in six provinces in Java, which is arranged in a hierarchy of provinces, districts / cities, districts and villages. The research method using KDD (Knowledge Discovery in Database) through the process of preprocessing, data mining and postprocessing to obtain knowledge. In this study, data mining applications to facilitate the search query based on the name of the village, using Java software. While the contours of a map is processed using ArcGIS software. The results of the research can give recommendations to stakeholders such as the Department of Tourism to describe the meaning of the classification of naming the village according to the character in each province at Java island.

  10. The concept of cluster- villages as planning tool in the rural districts of Denmark

    DEFF Research Database (Denmark)

    Laursen, Lea Louise Holst; Møller, Jørgen

    villages in order to secure their future. This paper will address the concept of cluster-villages as a possible approach to strengthen the conditions of contemporary Danish villages. Cluster-villages is a concept that gather a number of villages in a network-structure where the villages both work together...... on economies of scale, or the decentralised model based on proximity. In the developments and debate relating to these matters, strategic and visionary planning is back in the municipal arena as the only tool capable of handling the many different challenges facing the municipalities. Mellem disse...... to forskellige positioner ser vi en ny mulighed for landsbyudvikling, som vi kalder Clustervillages. In order to investigate the potentials and possibilities of the cluster-village concept the paper will seek to unfold the concept strategically; looking into the benefits of such concept. Further, the paper seeks...

  11. Multi-center experience of 164 consecutive Hemodialysis Reliable Outflow [HeRO] graft implants for hemodialysis treatment.

    Science.gov (United States)

    Gage, S M; Katzman, H E; Ross, J R; Hohmann, S E; Sharpe, C A; Butterly, D W; Lawson, J H

    2012-07-01

    To report a multi-center experience with the novel Hemodialysis Reliable Outflow (HeRO) vascular access graft. Four centers conducted a retrospective review of end stage renal disease patients who received the HeRO device from implant to last available follow-up. Data is available on 164 patients with an accumulated 2092.1 HeRO implant months. At 6 months, HeRO primary and secondary patency is 60% and 90.8%, respectively and at 12 months, 48.8% and 90.8%, respectively. At 24 months, HeRO had a primary patency of 42.9% and secondary patency was 86.7%. Interventions to maintain or re-establish patency have been required in 71.3% of patients (117/164) resulting in an intervention rate of 1.5/year. Access related infections have been reported in 4.3% patients resulting in a rate of 0.14/1000 implant days. In our experience the HeRO device has performed comparably to standard AVGs and has proven superior to TDCs in terms of patency, intervention, and infection rates when compared to the peer-reviewed literature. As an alternative to catheter dependence as a means for hemodialysis access, this graft could reduce the morbidity and mortality associated with TDCs and have a profound impact on the costs associated with catheter related infections and interventions. Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  12. A Study On Outbreak Of Malarial Fever Among The Residents Of Village Mandal Of Taluka Viramgam, Distt. Ahmedabad, Gujarat

    Directory of Open Access Journals (Sweden)

    Lala M.K

    1989-01-01

    Full Text Available Outbreak of malaria had occurred in the months of September to November 1988 amongst the residents of village mandal, taluka viramgam, district ahmedabad. As compared to September-November 1987, significant increase in annual blood examination rate (ABER and slide positivity rate (SPR was observed in 1988 (September-November. 88 deaths occurred due to malaria from August to December 1988. Mortality rate was more amongst children and people of the lower class. Case fatality rate (CFR was maximum (11.45% in October 1988. But due to intensive measures it decreased to 1.47% in December 1988. Appearance of breeding places of mosquitoes due to heavy rains after three consecutive droughts, inadequate surveillance, mosquito resistance to insecticides, plasmodium resistance to drug treatment may have led to this outbreak amongst the residents of village mandal.

  13. Arsenic Removal from Drinking Water by Adsorptive Media - U.S. EPA Demonstration Project at Seely-Brown Village in Pomfret, CT - Final Performance Evaluation Report

    Science.gov (United States)

    This report documents the activities performed for and the results obtained from the arsenic removal treatment technology demonstration project at Seely-Brown Village in Pomfret, CT. The objectives of the project were to evaluate the effectiveness of ArsenXnp adsorption media in...

  14. Arsenic Removal from Drinking Water by Coagulation/Filtration - U.S. EPA Demonstration Project at Village of Waynesville, IL - Final Performance Evaluation Report

    Science.gov (United States)

    This report documents the activities performed and the results obtained from the arsenic removal drinking water treatment technology demonstration project at the Village of Waynesville, IL. The main objective of the project was to evaluate the effectiveness of the Peerless coagu...

  15. Developing and Initiating Validation of a Model Opioid Patient-Prescriber Agreement as a Tool for Patient-Centered Pain Treatment.

    Science.gov (United States)

    Ghods, Mary P; Schmid, Ian T; Pamer, Carol A; Lappin, Brian M; Slavin, Dale C

    2015-08-01

    Opioid treatment agreements generally are used in pain treatment to delineate the terms and consequences of opioid use and abuse. The US Food and Drug Administration (FDA) Safe Use Initiative convened a multi-disciplinary working group with outside experts to draft a patient-centered, model opioid treatment agreement named the Model Patient-Prescriber Agreement (model PPA). The model PPA was evaluated for readability and usability in two tests that sampled both healthcare professional and non-healthcare professional FDA employees. In a survey sent to FDA employees in the Center for Drug Evaluation and Research (CDER), 209 respondents assessed the quality of the content and the level of difficulty in reading and understanding the model PPA. Ten other FDA employees participated in usability testing to assess the effectiveness of the model PPA as an educational and decision-making tool. The majority of the 209 CDER employee survey respondents indicated the model PPA was neutral in tone (67.5%) and easy or somewhat easy to understand (90.4%). Usability study participants generally thought the model PPA would facilitate discussion between patient and prescriber and that the content was informative, thorough, and clear. These studies suggest that the working group was able to develop an opioid PPA that may be acceptable and usable among a diverse population of stakeholders. A follow-up pilot study using the model PPA in medical facilities in the USA with patients is underway and will facilitate this determination.

  16. Testing a maintenance model for eating disorders in a sample seeking treatment at a tertiary care center: a structural equation modeling approach.

    Science.gov (United States)

    Tasca, Giorgio A; Presniak, Michelle D; Demidenko, Natasha; Balfour, Louise; Krysanski, Valerie; Trinneer, Anne; Bissada, Hany

    2011-01-01

    Fairburn et al (Fairburn, CG, Cooper, Z, Shafran, R. Behav Res Ther 2003;41:509-528) proposed additional maintenance mechanisms (ie, interpersonal difficulties, mood intolerance, low self-esteem, and perfectionism) for some individuals with eating disorders in addition to core eating disorder psychopathology (ie, overevaluation of eating, weight, and shape and their control). This is the first study to both elaborate and test this maintenance model as a structural model. Adults seeking treatment of an eating disorder (N = 1451) at a specialized tertiary care center were included in this cross-sectional study. In the first part of the study, diagnostically heterogeneous participants (n = 406) were randomly selected to test a structural model based on the maintenance model. In the second part of the study, remaining participants (n = 1045) were grouped according to eating disorder diagnosis to test for invariance of the structural paths of the final model across diagnoses. Overall, the structural model with core and additional mechanisms fit the data well and, with 1 exception, represented maintenance processes for each of the diagnostic groups. Treatment models based on both core and additional maintenance factors for those seeking therapy at a specialized tertiary care center may result in improved treatment outcomes for these patients with eating disorders. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. AN ETHNOBOTANICAL STUDY OF MEDICINAL PLANTS USED IN VILLAGES UNDER JONGILANGA TRIBAL COUNCIL, MPUMALANGA, SOUTH AFRICA.

    Science.gov (United States)

    Tshikalange, Thilivhali Emmanuel; Mophuting, Boikanyo Calvin; Mahore, James; Winterboer, Stefan; Lall, Namrita

    2016-01-01

    Medicinal plants remain an integral part of the lives of people in rural areas. The aim of this study was to document information about the medicinal plants used by Shangaan people in villages under Jongilanga tribal council, Bushbuckridge municipality, Mpumalanga Province, South Africa. An ethnobotanical survey of medicinal plants was conducted using a semi-structured questionnaire with 15 traditional healers as informants; one of them also served as a field guide during data collection. Results were analysed by using various quantitative indices of information consensus factor (ICF), use report (UR), frequency citation (FC) and relative frequency citation (RFC). The study reported 86 medicinal plants used in villages for the treatment of various ailments, the majority (25 species) of which were used for urino-genital disorders. The Fabaceae family was the most represented family (17 species) of all the medicinal plants recorded in this study. The roots were the most frequently used plant part, accounting for 56% of the plants reported, and decoctions were often used in the preparation of herbal remedies. Respiratory diseases had the highest ICF value recorded among the 8 categories of ailments. The highest use report was reported for Combretum collinum (4), while the FC and RFC values (15) were highest in 12 plant species. The study revealed that medicinal plants are still widely used in rural areas and this documentation can serve as an ethno pharmacological basis for selecting plants with potential pharmaceutical properties.

  18. Ethnomedicinal study of plants used in villages around Kimboza forest reserve in Morogoro, Tanzania

    Directory of Open Access Journals (Sweden)

    Amri Ezekiel

    2012-01-01

    Full Text Available Abstract Background An ethnomedicinal study was conducted to document medicinal plants used in the treatment of ailments in villages surrounding Kimboza forest reserve, a low land catchment forest with high number of endemic plant species. Methods Ethnobotanical interviews on medicinal plants used to treat common illnesses were conducted with the traditional medical practitioners using open-ended semi -structured questionnaires. Diseases treated, methods of preparation, use and habitat of medicinal plants were recorded. Results A total of 82 medicinal plant species belonging to 29 families were recorded during the study. The most commonly used plant families recorded were Fabaceae (29%, Euphorbiaceae (20%, Asteraceae and Moraceae (17% each and Rubiaceae (15% in that order. The most frequently utilized medicinal plant parts were leaves (41.3%, followed by roots (29.0%, bark (21.7%, seeds (5.31%, and fruits (2.6%. The study revealed that stomach ache was the condition treated with the highest percentage of medicinal plant species (15%, followed by hernia (13%, diarrhea (12, fever and wound (11% each, and coughs (10%. Majority of medicinal plant species (65.9% were collected from the wild compared to only 26.7% from cultivated land. Conclusions A rich diversity of medicinal plant species are used for treating different diseases in villages around Kimboza forest reserve, with the wild habitat being the most important reservoir for the majority of the plants. Awareness programmes on sustainable utilization and active involvement of community in conservation programmes are needed.

  19. Village renewal in spatial plans of the community: Example of the SP of Subotica community

    Directory of Open Access Journals (Sweden)

    Šećerov Velimir

    2007-01-01

    Full Text Available Spatial plans of communities, returned to legal framework in 2003 and imposed as obligation for all local communities in Serbia, present a strategic document for development, organization and protection of the whole territory of the community. The base for integral observation and treatment of the urban and rural settlements, within the local administrative area, has been set thereby. The current function of villages has been significantly changed regarding traditional organization and the essential role, that they used to have in the past. First of all, it is a consequence of an intensive deagrarization and industrialization/ urbanization, as a result of official (state strategy in the middle of the 20. century. As a rule, these processes were painful for villages, leaving them depopulized, with varied age structure of the population and with new relation to agriculture, which led to economic stagnation, social fallow and unclear development perspectives as a consequence. The reconstruction of these areas is, therefore, of enormous interest for development of the whole territory of a community, as well as even intra-communal and broader, intra-regional and intra-national development.

  20. Wioski tematyczne w powiecie tucholskim = Theme villages in powiat tucholski

    Directory of Open Access Journals (Sweden)

    Kawska Paulina

    2016-11-01

    Full Text Available Kawska Paulina, Gotowski Rafał. Wioski tematyczne w powiecie tucholskim = Theme villages in powiat tucholski. Journal of Education, Health and Sport. 2016;6(11:46-53. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.163526 http://ojs.ukw.edu.pl/index.php/johs/article/view/3960 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015. 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.10.2016. Revised 12.10.2016. Accepted: 27.10.2016. Wioski tematyczne w powiecie tucholskim Theme villages in powiat tucholski Paulina Kawska, Rafał Gotowski Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Polska Słowa kluczowe: wioska tematyczna, odnowa wsi, specjalizacja. Key words: theme village, village renewal, specialization. Streszczenie Artykuł koncentruje się na zagadnieniu wiosek

  1. Impact of tropical forage seed development in villages in Thailand and Laos: Research to village farmer production to seed export

    Directory of Open Access Journals (Sweden)

    Michael D. Hare

    2013-12-01

    Full Text Available Seed of 6 forage varieties, Mulato II hybrid brachiaria, Cayman hybrid brachiaria, Mombasa guinea, Tanzania guinea, Ubon stylo and Ubon paspalum, are currently being produced by more than 1000 smallholder farmers in villages in northeast Thailand and northern Laos, under contract to Ubon Forage Seeds, Faculty of Agriculture, Ubon Ratchathani University, Thailand. The seed is mainly exported overseas (95% and the remainder is sold within Thailand. Tropical Seeds LLC, a subsidiary of the Mexican seed company, Grupo Papalotla, employs the seed producing and seed research group, Ubon Forage Seeds, to manage seed production, seed sales and export, and to conduct research on new forage species. This paper discusses in detail how the development in villages of a smallholder farmer seed production program has had positive social and economic outcomes for the village seed growers and enabled farmers in other countries to receive high quality forage seeds. The strong emphasis on seed quality, high purity, high vigor and high germination, has had a large impact on tropical pastures in more than 20 tropical countries in Asia, Africa, the Pacific and Central and South America.

  2. Surgical Treatment of Spinal Dural Arteriovenous Fistula: Management and Long-Term Outcome in a Single-Center Series.

    Science.gov (United States)

    Schuss, Patrick; Daher, Frederick H; Greschus, Susanne; Vatter, Hartmut; Güresir, Erdem

    2015-06-01

    To perform a retrospective chart review of surgically treated patients with spinal dural arteriovenous fistula (SDAVF), a rare disease but the most common vascular malformation of the spine, focusing on clinical characteristics and functional outcome during long-term follow-up. Between June 1990 and April 2012, 29 patients with SDAVFs were treated surgically in a single institution. Patient characteristics, time from onset of symptoms to treatment, radiologic features, treatment-related complications, and functional outcome were analyzed. Outcome was assessed according to the Aminoff-Logue scale during follow-up. Results of magnetic resonance imaging scans performed during long-term follow-up were correlated with functional outcome. There were 3 female (10%) and 26 male (90%) patients with SDAVFs treated surgically. Mean age was 61 years ± 11. Location of the fistula was at the thoracic level in 20 patients (69%), at the lumbar level in 8 patients (28%), and at the sacral level in 1 patient (3%). Mean postoperative Aminoff-Logue scale scores regarding gait and micturition improved after treatment compared with preoperatively (P = 0.02; P = 0.03). After surgical treatment, 22 patients (76%) achieved improvement in neurologic symptoms. In 6 patients (21%), neurologic status was the same as preoperatively. In 1 patient (3%), neurologic status worsened. Medullary signal alteration of diagnostic magnetic resonance imaging scans did not correlate with functional outcome (P = 0.2). Mean follow-up time was 63 months ± 55. All SDAVFs were treated in a single session without recurrence during the long-term follow-up period. Surgical treatment of SDAVFs is safe and effective and leads to an improvement of neurologic symptoms in most patients. Surgical treatment of SDAVFs also provides long-term stability. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Is the adjustable transobturator system ATOMS® useful for the treatment of male urinary incontinence in low to medium volume urological centers?

    Science.gov (United States)

    Manso, M; Alexandre, B; Antunes-Lopes, T; Martins-da-Silva, C; Cruz, F

    2017-11-21

    Urinary incontinence (UI) is a complication of radical prostatectomy (RP) and transurethral resection of the prostate (TURP). The gold-standard treatment is the artificial urinary sphincter, however, new treatments have been investigated. To examine the outcome of an adjustable transobturator male system (ATOMS ® ) in men with UI after prostatic surgery in a low to medium volume continence center. Twenty-five men with UI were implanted with ATOMS ® system between 2012 and 2014. The most common indication was UI after RP (92%), followed by UI after TURP (8%). Eleven patients (44%) had received adjuvant external beam radiotherapy (RT). Patients were considered to be 'dry' if they stopped wearing pads or needed just one protective pad per day; and improved if the daily number of pads used decreased by at least half. The Incontinence Quality of Life questionnaire (ICIQ-SF) was used, adding a verbal question about the satisfaction of the patient considering the outcome. After a mean follow-up of 21.56 months, 64% were dry and 8% revealed a significant improvement. The success of the procedure was negatively correlated with the severity of the previous UI and with previous treatment with RT. Concerning patients satisfaction, 84% of the patients would repeat the procedure. ATOMS ® offers good rates of cure and improvement of UI after prostatic surgery with a reasonable rate of minor complications. The results of this study, performed in a low to medium volume continence center, are comparable to the results achieved in high volume continence centers. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Effect of Educational Program to Encourage Safe Sexual Behaviors Among Addicted Men Refered to Substance Abuse Treatment Centers in Hamadan, Western Iran: Applying the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Babak Moeini

    2014-06-01

    Full Text Available Introduction: Unsafe sexual behaviors as important risky behaviors can expose individuals and society to dangerous infectious disease such as AIDS and viral hepatitis. Considering the high prevalence of unsafe sexual behaviors, this study aimed to determine the effect of educational programs to encourage safe sexual behaviors among substance abusers referred to substance abuse treatment centers in Hamadan, Western Iran by applying the theory of planned behavior. Materials & Methods: This quasi-experimental study was performed on 104 men substance abusers (52 participants in each of the control and intervention groups referred to substance abuse treatment centers in Hamadan. Data collection tool was a questionnaire containing demographic information and the theory of planned behavior constructs. Before the educational program, questionnaires were completed by both groups. After the pretest in both groups, participants in the intervention group participated in four educational sessions designed based on the theory of planned behavior. Two months after the end of program, posttest was performed. Data was analyzed using independent T-test, chi-square, fisher exact test, McNemar’s test and multiple linear regressions using SPSS-16. Results: After educational intervention, the mean scores of the theory constructs (attitude toward behavior, subjective norms, behavioral control, behavioral intention and behaviors, in the intervention group increased significantly (P<0.05, despite the fact, changes were not significant in the control group. Conclusion: Implementation of educational courses to encourage safe sexual behaviors based on the theory of planned behavior can be beneficial for substance abusers referred to substance abuse treatment centers.

  5. Prostate-specific antigen screening and prostate cancer treatment in renal transplantation candidates: A survey of U.S. transplantation centers.

    Science.gov (United States)

    Gin, Greg E; Pereira, Jorge F; Weinberg, Alan D; Mehrazin, Reza; Lerner, Susan M; Sfakianos, John P; Phillips, Courtney K

    2016-02-01

    Renal transplantation candidates are a highly screened population. There are currently no guidelines or consensus on prostate cancer (CaP) screening in these patients. In light of the recent United States Preventive Services Task Force recommendations against prostate-specific antigen (PSA) screening, we conducted a survey of transplantation surgeons to gain a better understanding of practice patterns among U.S. centers. A 14-question multiple-choice online survey was e-mailed to 195 U.S. renal transplantation centers. The questionnaire assessed CaP screening and treatment practices. The survey also evaluated characteristics of the respondent's institution. Descriptive statistics were used for each of the responses, and associations were made with program characterization using logistic or linear regression models. A total of 90 surgeons responded, representing 65 of 195 programs (33% response rate). Overall, 89% of respondents reported routinely screening for CaP in renal transplantation candidates and 71% had set guidelines for PSA screening. The most common age to start PSA screening was 50 years (51%) and 79% of respondents reported no age limit to stop PSA screening. Definitive treatment of CaP was required before proceeding to transplantation in 45% of respondents. Active surveillance was a viable option in 67% of responders. Most respondents (73%) replied that the waiting time for eligibility after treatment depended on the CaP stage and risk. Although most programs have guidelines on PSA screening in renal transplantation candidates, there is still variation nationwide in screening and treatment practices. AS is a viable treatment option in most of the programs. Our results suggest a benefit of a consensus panel to recommend guidelines in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Noninvasive prenatal testing (NIPT) in twin pregnancies with treatment of assisted reproductive techniques (ART) in a single center

    DEFF Research Database (Denmark)

    Tan, YueQiu; Gao, Ya; Lin, Ge

    2016-01-01

    Objective: The objective of the study is to report the performance of noninvasive prenatal testing (NIPT) in twin pregnancies after the treatment of assisted reproductive technology (ART). Method: In two years period, 565 pregnant women with ART twin pregnancies were prospectively tested by NIPT...

  7. Iron chelation with deferasirox for the treatment of secondary hemosiderosis in pediatric oncology patients: a single-center experience.

    Science.gov (United States)

    Ktena, Yiouli P; Athanasiadou, Anastasia; Lambrou, George; Adamaki, Maria; Moschovi, Maria

    2013-08-01

    Pediatric oncology patients are often iron overloaded, due to the multiple blood transfusions necessary during the course of chemotherapy. Our aim is to report the efficacy and safety of deferasirox, an oral iron chelator, in this patient group. Deferasirox was administered to 13 children with malignancies in remission and iron overload. Ferritin, blood urea nitrogen, creatinine, transaminases, and bilirubin were recorded at 4- to 8-week intervals, and hepatic and cardiac iron overload were assessed with magnetic resonance imaging before initiation of treatment. Deferasirox was administered for an average of 6 months (SD=4.5; range, 0.3 to 18.2). Two children presented with skin rash, 1 with gastrointestinal disturbances, and 1 with fully reversible acute renal failure. The mean monthly rate of change in ferritin levels was -10.8 μg/L before initiation of treatment (95% confidence interval [CI], -19.8 to -1.8; P=0.02) and -93.6 μg/L during deferasirox treatment (95% CI, -118.1 to -69.1; P<0.001). The difference in the monthly rate of change in ferritin levels before and after treatment initiation was -82.8 μg/L (95% CI, -111.6 to -53.9; P<0.001). Deferasirox was effective in reducing the iron burden. The adverse effects were easily monitored and managed. Further studies are warranted to investigate the effect of deferasirox on mortality and morbidity in this population.

  8. Randomised primary health center based interventions to improve the diagnosis and treatment of undifferentiated fever and dengue in Vietnam

    NARCIS (Netherlands)

    Phuong, H.L.; Nga, T.T.T.; Giao, P.T.; Hung, L.Q.; Binh, T.Q.; Nam, N.V.; Nagelkerke, N.; de Vries, P.J.

    2010-01-01

    ABSTRACT: BACKGROUND: Fever is a common reason for attending primary health facilities in Vietnam. Response of health care providers to patients with fever commonly consists of making a presumptive diagnosis and proposing corresponding treatment. In Vietnam, where malaria was brought under control,

  9. Tetracycline- and furazolidone-containing quadruple regimen as rescue treatment for Helicobacter pylori infection: a single center retrospective study.

    Science.gov (United States)

    Zhang, Yuemiao; Gao, Wen; Cheng, Hong; Zhang, Xuezhi; Hu, Fulian

    2014-10-01

    Eradication rate of Helicobacter pylori decreases worldwide, while antibiotics resistance rates of H. pylori increase rapidly in recent years. In most cases, H. pylori would be resistant to clarithromycin, metronidazole, and quinolone if these antibiotics had been used as component of eradication regimen. H. pylori strains resistant to both tetracycline and furazolidone are rare. The aim of our study was to evaluate efficacy and side effects of tetracycline- and furazolidone-containing quadruple regimen as rescue treatment. Patients with H. pylori infection given RTFB (rabeprazole 20 mg b.i.d. + tetracycline 750 mg b.i.d. +furazolidone 100 mg b.i.d. + colloidal bismuth subcitrate 200 mg b.i.d.) regimen for 14 days as rescue treatment were enrolled in this retrospective study. Eradication status was evaluated by (13) C-urea breath test, and side effects were collected. One hundred and nine patients were enrolled. The intention-to-treat eradication rate was 91.74% (100 of 109) and 95.24% (100 of 105) per protocol analysis. Side effects including fever, palpitation, and skin rash occurred in 35 patients. The 14-day tetracycline- and furazolidone-containing quadruple regimen can achieve a relatively high eradication rate as rescue treatment. Some side effects including fever may occur during the treatment. © 2014 John Wiley & Sons Ltd.

  10. New and Safe Treatment of Food Impacted in the Esophagus: A Single Center Experience of 100 Consecutive Cases

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    Muhammad Shafique

    2013-01-01

    Full Text Available Aim. Large food bits can get stuck in the esophagus and must be removed by endoscopy. In some cases, this can be difficult or unsafe. We describe a new and safe treatment for such patients. Materials and Methods. 100 consecutive patients were referred to Akershus University Hospital with impacted food in the esophagus. In 36 patients (36%, the food passed spontaneously. In 59 (92% of the remaining 64 patients, the food was removed by endoscopic intervention. In the last five patients, endoscopic removal was judged difficult or unsafe. These patients received the new treatment: one capsule Creon 10000 IU dissolved in 30 mL of Coca-Cola administered by a nasooesophageal tube four times daily for 2-3 days. Results. Of the 59 patients treated with endoscopic procedure, complications occurred in four (7%: three bleedings and one perforation of the esophagus. In five patients treated with Coca-Cola and Creon, the food had either passed or was soft after 2-3 days and could easily be removed. Conclusion. The treatment of choice of impacted food in the esophagus is endoscopic removal. In cases where this is difficult, we recommend treatment with Coca-Cola and Creon for 2-3 days before complications occur.

  11. The implementation and the cultural adjustment of functional family therapy in a Dutch psychiatric day-treatment center

    NARCIS (Netherlands)

    Breuk, R.E.; Sexton, T.L.; Dam, A.; Disse, C.; Doreleijers, T.A.H.; Slot, N.W.

    2006-01-01

    Because of the increasing severity of adolescent problem behavior, evidence-based practices are becoming of interest as an alternative to traditional treatment with the behavior problems of adolescents in juvenile justice settings. Despite interest in evidence-based practices, questions exist

  12. Comparison of tolvaptan treatment between patients with the SIADH and congestive heart failure: a single-center experience.

    Science.gov (United States)

    Park, Gun Ha; Lee, Chang Min; Song, Jae Won; Jung, Moon Chan; Kim, Jwa Kyung; Song, Young Rim; Kim, Hyung Jik; Kim, Sung Gyun

    2017-03-13

    Tolvaptan is a very effective treatment for hypervolemic or euvolemic hyponatremia. We compared the clinical efficacy of and response to tolvaptan in patients with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and congestive heart failure (CHF). We retrospectively reviewed the medical records of 50 patients (SIADH, n = 30; CHF, n = 20) who were prescribed tolvaptan between July 2013 and October 2015. Tolvaptan was prescribed when the serum sodium level was 135 mmol/L. After the initiation of tolvaptan therapy, there was an immediate response in the urine volume and serum sodium level in all patients. The improvements in the urine volume and serum sodium concentration were highest within the first 24 hours of treatment. In addition, the mean change in the serum sodium level during the first 24 hours was significantly higher in patients with SIADH than in those with CHF (∆Na, 9.9 ± 4.5 mmol/L vs. 6.9 ± 4.4 mmol/L, respectively; p = 0.025). Also, the mean maintenance dose was lower, and the total duration of tolvaptan use was slightly shorter in the SIADH group than CHF group (21.5 ± 14.9 days vs. 28.0 ± 20.1 days, p = 0.070). The early response to tolvaptan treatment was better in patients with SIADH than in those with CHF. Thus, the tolvaptan treatment strategy should be differed between patients with SIADH and those with CHF.

  13. Multi-center randomized controlled trial of cognitive treatment, placebo, oxybutynin, bladder training, and pelvic floor training in children with functional urinary incontinence.

    Science.gov (United States)

    van Gool, Jan D; de Jong, Tom P V M; Winkler-Seinstra, Pauline; Tamminen-Möbius, Tytti; Lax, Hildegard; Hirche, Herbert; Nijman, Rien J M; Hjälmås, Kelm; Jodal, Ulf; Bachmann, Hannsjörg; Hoebeke, Piet; Walle, Johan Vande; Misselwitz, Joachim; John, Ulrike; Bael, An

    2014-06-01

    Functional urinary incontinence causes considerable morbidity in 8.4% of school-age children, mainly girls. To compare oxybutynin, placebo, and bladder training in overactive bladder (OAB), and cognitive treatment and pelvic floor training in dysfunctional voiding (DV), a multi-center controlled trial was designed, the European Bladder Dysfunction Study. Seventy girls and 27 boys with clinically diagnosed OAB and urge incontinence were randomly allocated to placebo, oxybutynin, or bladder training (branch I), and 89 girls and 16 boys with clinically diagnosed DV to either cognitive treatment or pelvic floor training (branch II). All children received standardized cognitive treatment, to which these interventions were added. The main outcome variable was daytime incontinence with/without urinary tract infections. Urodynamic studies were performed before and after treatment. In branch I, the 15% full response evolved to cure rates of 39% for placebo, 43% for oxybutynin, and 44% for bladder training. In branch II, the 25% full response evolved to cure rates of 52% for controls and 49% for pelvic floor training. Before treatment, detrusor overactivity (OAB) or pelvic floor overactivity (DV) did not correlate with the clinical diagnosis. After treatment these urodynamic patterns occurred de novo in at least 20%. The mismatch between urodynamic patterns and clinical symptoms explains why cognitive treatment was the key to success, not the added interventions. Unpredictable changes in urodynamic patterns over time, the response to cognitive treatment, and the gender-specific prevalence suggest social stress might be a cause for the symptoms, mediated by corticotropin-releasing factor signaling pathways. © 2013 Wiley Periodicals, Inc.

  14. [Tuberculosis in a primary care center in a socioeconomically depressed area: variables associated with giving up treatment].

    Science.gov (United States)

    Solá, M; Gardella, A; Llauger, M A; Muñoz, J; Birulés, M; Foz, G

    1990-06-01

    We report the features of 72 patients with tuberculosis of a low socioeconomical level, seen at the primary care center of Perecamps (Barcelona). We identify the factors associated with giving up therapy. We found a predominance of males and of the 40-59 years age group. In 1988 we found an increased rate of young patients (20-39 years) and PDA/HIV+. Twenty-five patients (35%) had had previous episodes of tuberculosis. 19 had had inadequate chemotherapy because of abandonment. The rate of follow-up losses was high (36%). A history of previous PDA/HIV+ were associated with giving up therapy. We indicate the several measures to be applied in our area to improve compliance with chemotherapy in patients with tuberculosis.

  15. The utility of MMPI-2-RF substantive scales in prediction of negative treatment outcomes in a community mental health center.

    Science.gov (United States)

    Anestis, Joye C; Gottfried, Emily D; Joiner, Thomas E

    2015-02-01

    This study examined the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) substantive scales in the prediction of premature termination and therapy no-shows while controlling for other relevant predictors in a university-based community mental health center, a sample at high risk of both premature termination and no-show appointments. Participants included 457 individuals seeking services from a university-based psychology clinic. Results indicated that Juvenile Conduct Problems (JCP) predicted premature termination and Behavioral/Externalizing Dysfunction and JCP predicted number of no-shows, when accounting for initial severity of illness, personality disorder diagnosis, therapist experience, and other related MMPI-2-RF scales. The MMPI-2-RF Aesthetic-Literary Interests scale also predicted number of no-shows. Recommendations for applying these findings in clinical practice are discussed. © The Author(s) 2014.

  16. Studies on retrospective analysis of leading primary cancers and improvement of cancer treatment method in Korea cancer center hospital

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong In; Lee, Kang Hyun; Choi, Soo Yong; Kim, Ki Wha; Kang, Sung Mok

    2000-12-01

    a. Retrospective studies included cancers of the stomach, breast, bladder, salivary gland, thyroid, esophagus, endometrium and ovary. (1) Study cancers were analyzed about clinical characteristics, prognostic factors influenced on survival time, survival rate, etc. (2) Among 5,305 study patients, 1,405(26.5%) were identified with death, 3,485(65.7%) were alive and 415(7.8%) were not identified. b. Prospective studies included 10 subjects such as bladder cancer, retinoblastoma, malignant patients, gastric cancer, uterine cervix cancer and ovary cancer. We are continuing registering eligible study patients. c. Results for 11 papers were published at the journal. d. We established follow-up system in order to identify the survival for study subjects through National Statistical Office, Government Provincial Office and Cancer Registration System at Korea Cancer Center Hospital. e. At present, we are establishing computerized registration system about case report form for study cancers.

  17. Aspiration Thrombectomy for Treatment of Acute Massive and Submassive Pulmonary Embolism: Initial Single-Center Prospective Experience.

    Science.gov (United States)

    Ciampi-Dopazo, Juan José; Romeu-Prieto, Juan María; Sánchez-Casado, Marcelino; Romerosa, Beatriz; Canabal, Alfonso; Rodríguez-Blanco, María Luisa; Lanciego, Carlos

    2018-01-01

    To evaluate the feasibility of aspiration thrombectomy in patients with acute massive or submassive pulmonary embolism (PE). This prospective study analyzed patient demographic data, procedural details, and outcomes in 18 consecutive patients (8 men and 10 women; mean age, 60.1 y; range, 36-80 y), 10 with acute submassive PE and 8 with massive PE, treated with an Indigo Continuous Aspiration Mechanical Thrombectomy Catheter between January 2016 and February 2017. Three patients underwent concomitant systemic fibrinolytic treatment with 100 mg tissue plasminogen activator. Technical success was defined as successful placement of devices and initiation of aspiration thrombectomy. Clinical success was defined as stabilization of hemodynamic parameters; improvement in pulmonary hypertension, right heart strain, or both; and survival to hospital discharge. Complications were also analyzed. The procedure was considered a technical success in 17 patients (94.4%) and a clinical success in 15 (83.3%). Echocardiography showed significant improvements in right ventricle size (46.36 mm ± 2.2 before treatment vs 41.79 mm ± 7.4 after; P = .041), tricuspid annular plane systolic excursion (16 ± 3 before treatment vs 18.57 ± 3.9 after; P = .011), and systolic wave (10 ± 2.1 before treatment vs 13.1 ± 3.8 after; P = .020). Two patients died of massive PE, and 1 died of submassive PE. Two patients who received systemic fibrinolytic agents experienced intracranial bleeding, and abdominal bleeding developed in 1. Aspiration thrombectomy is a feasible option for the treatment of acute massive or submassive PE in patients with hemodynamic compromise or right ventricular dysfunction. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  18. Treatment outcomes and morbidity following definitive brachytherapy with or without external beam radiation for the treatment of localized prostate cancer: 20-year experience at Mount Sinai Medical Center.

    Science.gov (United States)

    Marshall, Richard A; Buckstein, Michael; Stone, Nelson N; Stock, Richard

    2014-01-01

    To present our treatment algorithm and 20-year experience in treating prostate cancer with brachytherapy since 1990, with focus on cancer-control outcomes and treatment-related morbidity. We selected patients treated for localized prostate cancer with brachytherapy, combination therapy with external beam radiotherapy, and adjuvant androgen deprivation therapy as prescribed by our Mount Sinai risk stratification and treatment algorithm. Outcomes were analyzed with respect to biochemical failure, distant metastases, prostate cancer-specific survival, and overall survival. Morbidity was assessed with respect to urinary, sexual, and rectal outcomes. In total, 2,495 patients met inclusion criteria. The 12-year actuarial freedom from biochemical failure was 83% (low risk: 90%, intermediate risk: 84%, and high risk: 64%); freedom from distant metastasis was 95%; prostate cancer-specific survival was 95%; and overall survival was 70%. On multivariate analysis, significant associations were found between cancer control and risk group, total biologically effective dose, and androgen deprivation therapy. With regard to morbidity, potency was preserved in 61%, and urinary symptoms improved in 35%. The 12-year actuarial freedom from urinary retention events was 90% and from severe rectal bleed was 93%. Brachytherapy, as administered via the Mount Sinai algorithm, remains an efficacious and benign treatment option for patients with localized prostate cancer of all risk groups. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. A Retrospective, Single-Center Comparative Cost Analysis of OnabotulinumtoxinA and AbobotulinumtoxinA for Cervical Dystonia Treatment.

    Science.gov (United States)

    Trosch, Richard M; Shillington, Alicia C; English, Marci L; Marchese, Dominic

    2015-10-01

    Chemodenervation with botulinum neurotoxin (BoNT) is recommended as first-line treatment for the management of cervical dystonia. The choice of BoNT for treatment is subject to the consideration of several factors, including cost. To compare the costs incurred by patients and payers for onabotulinumtoxinA (ONA) or abobotulinumtoxinA (ABO) for the treatment of cervical dystonia. We conducted a retrospective, noninterventional closed cohort study of cervical dystonia patients within a single U.S. private neurological practice. Patient and payer incurred costs from medical billing records for patients satisfying inclusion and exclusion criteria treated from November 1, 2009, through January 1, 2013, were de-identified and included in the analysis. Forty-seven patients initially treated with at least 3 consecutive cycles of ONA, followed by at least 3 consecutive cycles of ABO were included, representing 282 injection cycles available for analysis. Patients were required to have had a positive response to treatment with both agents and no concomitant treatment with BoNT for any other condition during the analysis period. The analysis compared the primary endpoint of median overall payer and patient incurred costs reimbursed to the clinic under each treatment regimen. For the purposes of this cost analysis, comparable clinical outcomes on both therapies was assumed.   Switching from ONA to ABO resulted in an overall incurred reimbursement cost savings for payers and patients. Median costs per injection cycle for ONA were $1,925 ($0-$2,814) compared with $1,214 ($229-$2,899; P  less than  0.0001) for ABO, representing an approximate 37% reduction in incurred reimbursement costs inclusive of toxin and procedure. Overall toxin reimbursement costs, patient out-of-pocket toxin costs, and the cost of unavoidable waste were also lower when patients were treated with ABO.  For patients treated for cervical dystonia, switching from ONA to ABO resulted in payer and patient

  20. Treatment of Depression and Anxiety by Naturopathic Physicians: An Observational Study of Naturopathic Medicine Within an Integrated Multidisciplinary Community Health Center.

    Science.gov (United States)

    Breed, Cindy; Bereznay, Catherine

    2017-05-01

    This project was designed to assess the quality of care received by patients with depression and anxiety who were seen by naturopathic physicians in a community health center. The Natural Medicine Quality Improvement Project for the Treatment of Depression and Anxiety (NMQP-DA) was conducted over a 26-month period from December 2009 through February 2012 at HealthPoint, a non-profit, consumer-governed, community health center network located in suburban King County, Washington. A total of 112 patients enrolled in the NMQP-DA, and 60 were seen for two or more visits, thus meeting eligibility criteria for inclusion in the study. The mean number of visits was 3.3. The Patient Health Questionnaire (PHQ-9) depression screener and the Generalized Anxiety Disorder 7-item scale (GAD-7) anxiety screener were the outcome measures. The overall improvement in symptoms of depression and anxiety was highly significant (p anxiety (12.4 vs. 7.2). The response rate, as measured by a 50% decrease in scores, for those with initial scores ≥10 was 58.6% for depression (PHQ-9) and 50% for anxiety (GAD-7). This study adds new data to the limited literature on the nature and effectiveness of naturopathic medicine to treat anxiety and depression in the context of an integrative community health center.