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PubMed1983

An analysis of problem areas and counseling experiences of gay white males.

An analysis of problem areas and counseling experiences of gay white males was performed in preparation for a larger study. Subjects were members of several gay organizations. A number of relationships among demographic variables and problem areas were found. Two factors, a general social functioning factor and a factor relating to acknowledging one's gayness to others (coming-out), accounted for almost 70% of the variance in a structure of problem areas. Approximately half of the respondents reported having had counseling experience. Of those reporting their satisfaction with the experience, the majority were satisfied. Results suggested that white, educated, middle-class gay males may not be underserved with respect to psychological service delivery.

Adolescent↗
PubMed2005

Molecular phylogenetics and biogeography of Lepus in Eastern Asia based on mitochondrial DNA sequences.

In spite of several classification attempts among taxa of the genus Lepus, phylogenetic relationships still remain poorly understood. Here, we present molecular genetic evidence that may resolve some of the current incongruities in the phylogeny of the leporids. The complete mitochondrial cytb, 12S genes, and parts of ND4 and control region fragments were sequenced to examine phylogenetic relationships among Chinese hare taxa and other leporids throughout the World using maximum parsimony, maximum likelihood, and Bayesian phylogenetic reconstruction approaches. Using reconstructed phylogenies, we observed that the Chinese hare is not a single monophyletic group as originally thought. Instead, the data infers that the genus Lepus is monophyletic with three unique species groups: North American, Eurasian, and African. Ancestral area analysis indicated that ancestral Lepus arose in North America and then dispersed into Eurasia via the Bering Land Bridge eventually extending to Africa. Brooks Parsimony analysis showed that dispersal events followed by subsequent speciation have occurred in other geographic areas as well and resulted in the rapid radiation and speciation of Lepus. A Bayesian relaxed molecular clock approach based on the continuous autocorrelation of evolutionary rates along branches estimated the divergence time between the three major groups within Lepus. The genus appears to have arisen approximately 10.76 MYA (+/-0.86 MYA), with most speciation events occurring during the Pliocene epoch (5.65+/-1.15 MYA approximately 1.12 +/- 0.47 MYA).

Animals↗
PubMed1995

Bond strength, interfacial characterization, and fracture surface analysis for a new stress-breaking bonding agent.

Three commercial dentin bonding systems were analyzed by tensile bond testing, area analysis of fractured surfaces, and SEM analysis of the tooth-resin interfaces. Tensile bond strengths in megapascals(SD) were Tenure-Marathon V ([T-M]; 8.86[3.02]), new system with low-viscosity resin ([K-LVR-P]; 6.50[2.01]), and new system without low-viscosity resin ([K-P] = 7.28[1.75]), which were significantly greater than Scotch-bond 2-P50 ([SB-P50]; 3.96[1.02]). Gaps that ranged up to 5.6 microns (mean for the group) were observed around most of the restorations at dentin surfaces and less so at enamel surfaces, where some of the restorations remained free of gaps. The gaps near the dentin margin were significantly smaller for K-LVR-P than for SB-P50. The tensile test revealed mixed failure modes in all systems, and in the cross sections of class V restorations, the gaps were confined to the dentin-resin junction.

Analysis of Variance↗
PubMed2002

Treatment decisions about lumbar herniated disk in a shared decision-making program.

BACKGROUND: An explicit process of collaborative (shared) decision making involving the patient and physician has been recommended for discretionary surgical procedures in which small-area analysis demonstrates high variation not attributable to differences in the patient population in the area. One such example is laminectomy for lumbar herniated disk (HD). An observational study was undertaken to evaluate the impact of an HD videodisk program on patient satisfaction, decision making, and treatment preferences. METHODS: Enrollment occurred in the outpatient offices of surgeons treating Kaiser Permanente (Colorado Region) patients with HD who had indications for surgery. Enrollment took place from May 1993 to December 1995, and follow-up surveys of patients were completed by January 1997. RESULTS: A 6.0% decrease in the undecided group and a 1.3% decrease in the group preferring nonsurgical treatment drove a shift of patients toward laminectomy, from 26.7% to 35.8% (Wilcoxon signed rank test = 349.5, p = .017). Postviewing preference (74.0%) was a better aggregate predictor of the ultimate treatment than previewing preference (70.0%) for laminectomy. DISCUSSION: Viewing the videodisk increased the preference for laminectomy. However, limitations in the data prevented us from determining whether this change in preference was actually reflected in patients' ultimate decisions. The fact that the strongest predictor of choosing surgery was the patient's valuation of his or her condition supports shared decision making, with its emphasis on patient's values. Participation in other videodisk programs has been low; perhaps physicians should ask patients to view these videodisks before their visits.

Adult↗
PubMed1990

[Analysis of morbidity among adolescents in rural areas].

The analysis of the level and pattern of morbidity among rural adolescents indicates that the leading causes of visits both to out-patient and in-patient facilities are diseases of respiratory and digestive tract, diseases of the central nervous system and sense organs. To promote better health of rural adolescents it is recommended to establish in summer months preventive facilities at industrial training classes which will enable the adolescents to undergo a course of physiotherapy and drug treatment, medical physical exercises and phytotherapy.

Adolescent↗
PubMed2001

Testing abnormality in the spatial arrangement of cells in the corneal endothelium using spatial point processes.

The study of central corneal endothelium morphology is important in Ophthalmology. Some of the pathologies that could compromise endothelial cell morphology are trauma, cataract, surgery, use of contact lenses, corneal dystrophies or degenerations. The quantitative analysis of cell shape and cellular pattern is more sensitive in detecting subtle changes in endothelial morphology than cell density measurement or cell area analysis. In this paper, the morphology of the central cornea, the most important area from the point of view of vision, is studied through an associated bivariate spatial point pattern: the centroids of the cells and the triple points, that is, the points where three different cells converge. Nine different summary descriptors (widely used in the statistical analysis of spatial point patterns) have been used: the empty space distribution function; the nearest neighbour distribution function and Ripley's K-function for each type of point separately (centroids and triple points), plus the corresponding three versions of these functions in the bivariate case. A control sample with similar age and cell density and no known abnormality is associated to each patient. The above descriptors are calculated for the patient and the controls. Each descriptive of the patient is compared with the corresponding descriptors from the controls by means of a graphical analysis and a formal test. Some patients presenting different pathologies are analysed in detail. Endothelia considered morphologically abnormal by visual inspection, which were not detected by hexagonality or density analysis, could be distinguished from control endothelia by these new descriptors.

Adult↗
PubMed1995

A population-based approach to monitoring adverse outcomes of medical care.

A population-based approach to monitoring quality of care combining small-area analysis and outcomes assessment is proposed. While adverse outcomes due to poor surgical technique have long been targeted for quality-of-care review, in this study, giving similar attention to adverse outcomes produced by high rates of interventions is proposed. A population-based approach will strengthen traditional review efforts that currently begin and end at the hospital door. Excluded from these reviews have been questions such as the following: Should the procedure have been performed in the first place? Did the benefits outweigh the risks? Were there other patients not operated on who might have benefited more? Traditional approaches can identify less competent hospitals or practitioners: population-based approaches can identify the surgical enthusiasts who may pose equal risks to the populations of the areas they serve. Applying a population-based approach to review of coronary artery bypass graft surgery for Medicare patients in five cities in the United States demonstrates that at least as many deaths could have been prevented by decreasing surgical rates to the U.S. average as by improving the technical quality of care with which the procedure was performed. A similar population-based analysis of complications (as judged by re-admissions within 30 days of surgery) associated with hysterectomy across regions of Manitoba, Canada, is presented. In summary, negligent acts in the delivery of health care in institutions are rare and are difficult to detect because medicine is an inexact science and because adverse outcomes are more likely in high-risk patients, regardless of the quality of care. However, from a population perspective, adverse events are predictable, occur relatively frequently, and are directly related to the frequency of a population's exposure to surgical intervention. Efforts to improve quality of care could be made more effective by including the rates at which populations are exposed to treatments and the technical quality of care delivered.

Adult↗
PubMed2004

Spray freezing into liquid nitrogen for highly stable protein nanostructured microparticles.

The objectives of this study were to produce nanostructured protein microparticles with the spray freezing into liquid (SFL) cryogenic process and to demonstrate a smaller degree of protein denaturation and aggregation than observed in spray freeze drying (SFD). Nanostructured microparticles were formed by atomization of an aqueous buffer solution containing bovine serum albumin (BSA) with and without excipients beneath the surface of a cryogenic liquid. Lyophilization was used to sublime the water in the frozen particles. The resulting BSA dry powder was characterized by size exclusion chromatography, Fourier-transform infrared spectroscopy, scanning electron microscopy (SEM), light scattering, and specific surface area analysis. SEM revealed highly porous microparticle with features smaller than 500 nm. The specific surface area of the BSA microparticles ranged from 19.2 to 97.7 m(2)/g as a function of the total protein and excipient content in the aqueous feed solution. SFL produced less denaturation and aggregation of protein monomer than SFD, despite the extremely high surface areas in both processes. The intense atomization and ultra-rapid freezing in the SFL process lead to nanostructured BSA microparticles with high surface areas. Protein denaturation and aggregation are reduced in SFL relative to SFD. The more rapid freezing in SFL lowers the time for proteins to aggregate or diffuse to water-air and water-ice interfaces where they may be denatured.

Animals↗
PubMed1994

Understanding differences between high and low childhood accident rate areas: the importance of qualitative data.

BACKGROUND: The research discussed in the paper was undertaken for a District Health Authority to aid the development of appropriate policies to achieve the Health of the nation strategic target for reducing the death rate from accidents amongst children under 15. There has been a great deal of quantitative and epidemiological research into childhood accidents which has demonstrated a clear social class gradient in childhood accidents, fatalities and injuries. Less research has been undertaken into the possible reasons for the 'social patterning' of accidents and other aspects of health. Recent sociological research on childhood accidents has adopted a more qualitative approach and studied childhood safety within a family and community context. This approach has been used in the Huddersfield study on parental perspectives on childhood safety. METHODS: In-depth interviews were held with a sample of parents from a high and a low childhood accident rate area. RESULTS: The two focus areas reveal contrasting social profiles. There were significant differences on a number of aspects of parental perceptions on safety and beliefs about accidents, in the two areas. Analysis of accident events revealed that all the families in the high childhood accident rate area sample had children who had had an accident in the past which required hospital treatment. A high proportion of their children had experienced 'near misses'. In contrast, half the families in the low childhood accident rate area had children who had experienced an accident in the past and a much smaller proportion had experienced 'near misses'. All the parents in the sample from both areas developed rules, routines and practices to keep their children safe. The study suggests that there are social class differences in the effective use of these safety rules. CONCLUSION: Qualitatively orientated sociological research into parental perspectives on childhood safety contributes to an understanding of the reasons for the social patterning of childhood accidents. Such information should be of help to professionals in their prevention and safety promotion work.

Accident Prevention↗
PubMed2000

Area income as a predictor of preventable hospitalizations in the Harris County Hospital District, Houston.

This study assesses whether geographical area income based on census data is a good predictor of preventable (or ambulatory care-sensitive) hospitalizations in a large public hospital system in Texas, and how area income correlates with the socioeconomic status reported by patients. Documenting a correspondence between area and individual-level income, as well as meaningful variation in rates of avoidable hospitalizations across subgroups and areas with varying concentrations of low-income persons, points to the validity and utility of this approach for monitoring how well public hospital systems in Texas address the needs of those they most directly serve. Area income may not fully reflect the disproportionately lower socioeconomic status of patients seen in the public hospital system. Nonetheless, living in lower-income zip codes was associated with higher preventable hospitalization rates for the predominantly low-income population served by the public hospital system. A tenfold difference found in the adjusted rates of hospitalizations for preventable conditions compared with control (or marker) conditions among persons living in low-income areas signals the likelihood of substantial unmet needs in this population. Small-area analysis and related comparisons of rates of preventable hospitalizations in high- and low-income areas provide useful indicators for monitoring and assessing the performance of public hospital systems in Texas.

Ambulatory Care↗
PubMed1991

Composition of atherosclerotic plaques in the four major epicardial coronary arteries in patients greater than or equal to 90 years of age.

The composition of atherosclerotic plaques in 733 five-mm segments of the 4 major (left main, left anterior descending, left circumflex and right) epicardial coronary arteries of 18 patients greater than or equal to 90 years of age was determined by computerized planimetric analysis. By analysis of all coronary segments of all patients greater than 90, the plaques consisted primarily of fibrous tissue (87 +/- 8%) with calcific deposits (7 +/- 6%), pultaceous debris (5 +/- 4%) and foam cells (1 +/- 1%) occupying a much smaller percentage of plaque area. Analysis of composition according to the 4 degrees of luminal cross-sectional area narrowing revealed marked step-wise increases in pultaceous debris (from 0 +/- 0% at 0 to 25% narrowing to 18 +/- 22% at 76 to 100% narrowing, p = 0.0001) and calcific deposits (from 0 +/- 0 to 10 +/- 15%, p = 0.002), and decreases in fibrous tissue (from 99 +/- 3 to 71 +/- 23%, p = 0.0001) and area occupied by the media (from 35 +/- 8 to 16 +/- 8%, p = 0.0001). When the analysis was restricted to sections narrowed greater than 75%, no significant differences were found in plaque components or medial area between patients with (11 patients) and without (7 patients) myocardial infarcts at necropsy.

Aged↗
PubMed2002

Anisometropia and degree of optic nerve damage in chronic open-angle glaucoma.

PURPOSE: To address the question of whether the refractive error plays a role in the amount of optic nerve damage in glaucoma, we intraindividually compared inter-eye differences in refractive error with inter-eye differences in parameters indicating the degree of glaucomatous optic nerve damage, and we interindividually correlated refractive error with neuroretinal rim area and visual field loss. DESIGN: Comparative clinical observational study. METHODS: This comparative clinical observational study was conducted in a university eye hospital. The study included 1,444 eyes of 876 patients with primary or secondary chronic open-angle glaucoma. Patients with a highly myopic refractive error (> or = -8 diopters) were excluded, owing to differences in the anatomy of the optic nerve head. Color stereo optic disk photographs were taken and morphometrically evaluated. The main outcome measures were refractive error, neuroretinal rim area, horizontal and vertical cup/disk diameter ratios, and visual field loss. RESULTS: In an interindividual statistical analysis, area of neuroretinal rim, horizontal and vertical cup/disk diameter ratios, and mean visual field loss were not significantly (P >.10) correlated with refractive error. In an intraindividual comparison, inter-eye differences in refractive error were not significantly (P >.05) correlated with inter-eye differences in neuroretinal rim area and mean visual field defect. The eye with the more myopic refractive error and the contralateral eye with the less myopic refractive error did not vary significantly in neuroretinal rim area and mean visual field defect. CONCLUSIONS: For nonhighly myopic (< -8 diopters) patients with primary or secondary chronic open-angle glaucoma, the refractive error may not play a major role for the amount of glaucomatous optic neuropathy. For nonhighly myopic (< -8 diopters) patients with primary or secondary chronic open-angle glaucoma, myopia may not be an important risk factor for glaucoma.

Adolescent↗
PubMed1995

Lead and cadmium levels in human milk and blood.

Lead and cadmium levels were determined (with AAS) in blood and milk obtained at 6 weeks after delivery from women living in the vicinity of a copper and lead metal smelter and in a control area. Analysis of lead and cadmium were also performed in blood samples obtained at delivery. Accuracy of the analysis was confirmed by the analysis of quality control samples. In general, blood and milk levels of lead and cadmium were low in both areas. At 6 weeks after delivery the lead levels in blood and milk were 32 +/- 8 and 0.7 +/- 0.4 micrograms Pb/l, respectively (total mean +/- S.D., n = 75). Cadmium levels in blood and milk were 0.9 +/- 0.3 and 0.06 +/- 0.04 microgram Cd/l, respectively (n = 75). At delivery the lead levels in blood of women in the smelter area were higher, 38.7 micrograms Pb/l, than the blood lead levels in women from the control area, 32.3 micrograms Pb/l, (P < 0.001). At 6 weeks after delivery there was no difference in blood lead levels between the two groups. In contrast, the lead levels in milk were higher in women from the smelter area, 0.9 microgram Pb/l, than in women from the control area, 0.5 microgram Pb/l, (P < 0.001). No differences in blood cadmium levels were found between the two groups. Milk cadmium levels in women from the control area, 0.07 microgram Cd/l, were somewhat higher (P < 0.01) than in women from the smelter area, 0.05 microgram Cd/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed2003

Place of death: analysis of cancer deaths in part of North West England.

BACKGROUND: Relatively little work of a detailed geographical nature has been undertaken on the distribution of place of death. In particular, given evidence that most cancer patients would prefer to die at home there is a need to examine the extent to which this preference is met differentially from place to place. METHODS: Using data on cancer deaths for a single Health Authority in North West England we conducted both small area and individual analyses of place of death, using binomial and binary logistic regression models, respectively. RESULTS: Results from the small area analysis show that in more deprived areas cancer patients are more likely to die in hospital or hospice, and less likely to die at home, but that the effect disappears for home and hospice deaths once other factors are controlled for. At the individual level, the probability of death at home decreases among those living in deprived areas, whereas the probability of death in hospital increases as area deprivation increases. Age, gender, type of cancer, and proximity to hospital or hospice all have some effect on the probability of dying in a particular setting. CONCLUSION: There is significant place-to-place variation in place of death among cancer patients in part of North West England. However, studies of place of death among cancer patients need to consider the full range of settings and, if examining the impact of deprivation or social class, need to adjust for other factors, including proximity to different settings.

Death↗
PubMedDate not supplied

Area estimation in pharmacokinetic studies using a hand-held programmable calculator.

A short program for area analysis in pharmacokinetic studies using the Hewlett-Packard HP41C hand-held programmable calculator is described. Area under the concentration-time curve is calculated firstly within defined time limits and then with extrapolation to infinite time using the slope constant of the terminal phase. Input of concentration-time data is simple and there is no limit on the number of time-concentration co-ordinates which can be entered for area calculation.

Computers↗
PubMed1993

Child morbidity patterns in two tropical seasons and associated mortality rates.

Cross-sectional morbidity recorded during two successive quarterly survey rounds and subsequent 27-months mortality were studied in a random sample of 4238 preschool children in a rural Zairian area. Analysis focuses on morbid patterns, i.e. any combination of the principal signs and symptoms encountered in tropical areas (oedema, marasmus, cough, fever, diarrhoea and tachypnoea). Almost half the children (45-48%) had signs of morbidity, a very high rate. The 3-6 month age group emerged as particularly vulnerable with the highest prevalences of all morbid patterns except for isolated fever. Isolated cough was more prevalent in the dry season probably as an effect of nightly indoor woodburning. All other morbid patterns were significantly more prevalent in the rainy season. Diarrhoea with cough was found to constitute half of all cases of diarrhoea. The results show that with a few simple questions on major symptoms and a brief examination by paramedical health workers, children with an increased risk of death can be identified. The method can be applied at under-5 clinics. Prognosis is particularly bad in severe malnutrition, especially when associated with diarrhoea, in diarrhoea with cough, cough with fever/tachypnoea and for children who are found sick both in the rainy and the subsequent dry season.

Child, Preschool↗
PubMed1976

[Tooth supporting structure and its importance for the regular development of the dentition and resulting therapeutic recommendations for practice].

The authors emphasize the importance of the supporting area to the regular development of the dentition and describe possibilities for preserving the deciduous teeth until the physiological change to the permanent dentition occurs. The change to the permanent dentition should be guided by a competent evaluation of space supply and space need to avoid expensive orthodontic measures. The supporting area analysis according to Moyers has been used with success to estimate whether the space in the supporting area will be sufficient for the permanent teeth.

Child↗
PubMed2006

Thermal decomposition of commercial silicone oil to produce high yield high surface area SiC nanorods.

This article reports on the synthesis of high surface area (563m2/g) beta-SiC nanorods by thermal decomposition of commercial silicone oil at a relatively low reaction temperature (800 degrees C) in a closed Swagelok cell. High yield (75%) of SiC nanorods are obtained in this one-stage, solvent-, catalyst-, and template-free synthesis technique that runs at a relative low temperature and employs cheap single-precursor. The morphological (TEM, HR-SEM), compositional (CHNS, EDX, SAEDX]), structural (XRD, HR-TEM, and ED), thermal (TGA) characterizations and surface area analysis are carried out for the obtained SiC nanorods. The possibility of hydrogen storage in this high surface area nano-SiC rods are also tested and reported for the first time.

Carbon Compounds, Inorganic↗