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Older women in Latin America: the health and socioeconomic situation of this important subgroup.

The social and health consequences of aging, for women in Latin America, have been largely unexplored. This research reports the results of a review and secondary analysis of existing published and unpublished data. The analytical framework cross-classifies the data into three categories of age: midlife (40-59), young old (60-74), and old old (75+), and three categories of country type: highly rural, mixed, and highly urban. Findings revealed a group at severe disadvantage educationally, economically and, by virtue of their longevity, likely to end up widowed and suffering the physical effects of premature aging. Older women also bear the major burden for economic survival and emotional vitality of the family. The strategies they develop to respond to these necessities are innovative and often involve creation of new family forms based on cooperation among women. These deserve greater study as potential models for interventions to take advantage of the long-neglected ingenuity represented by this group.

Adult↗
PubMed1977

Influence of the level of nitrate nutrition on ion uptake and assimilation, organic Acid accumulation, and cation-anion balance in whole tomato plants.

Tomato plants (Lycopersicon esculentum L. var. Ailsa Craig) were grown in water culture in nutrient solution in a series of 10 increasing levels of nitrate nutrition. Using whole plant data derived from analytical and yield data of individual plant parts, the fate of anion charge arising from increased NO(3) assimilation was followed in its distribution between organic anion accumulation in the plant and OH(-) efflux into the nutrient solution as calculated by excess anion over cation uptake. With increasing NO(3) nutrition the bulk of the anion charge appeared as organic anion accumulation in the plants. OH(-) efflux at a maximum accounted for only 20% of the anion charge shift. The major organic anion accumulated in response to nitrate assimilation was malate. The increase in organic anion accumulation was paralleled by an increase in cation concentration (K(+), Ca(2+), Mg(2+), Na(+)). Total inorganic anion levels (NO(3) (-), SO(4) (2-), H(2)PO(4) (-), Cl(-)) were relatively constant. The effect of increasing NO(3) nutrition in stimulating organic anion accumulation was much more pronounced in the tops than in the roots.It is suggested that increasing the level of NO(3) nutrition to tomato plants stimulates cation uptake and translocation as counter-ions are required to accompany NO(3) (-) ions to the upper plant parts, the major site of NO(3) reduction. On NO(3) reduction, the resulting stoichiometric accumulation of organic anions is balanced by the cations originally accompanying NO(3) (-) ions. Organic anions and cations are largely retained in the upper plant parts. The results suggest that only a small fraction of the total K absorbed by the roots can be translocated downward from the leaves to the roots in the phloem sap. The possible extent of K recirculation is thus low.

Journal Article↗
PubMed1997

Vicissitudes of remembering in the countertransference. Fervent failure, colonisation and remembering otherwise.

The author argues that certain kinds of transference can have great impact on the analyst's ego functioning. One such effect is impairment of ready recall of the analytic material, such as life historical data, the analytic process itself, and his or her role as analyst. The analyst strives to remember otherwise by analysing the patient's projective identifications and other defensive, manipulative strategies. When successful, these strategies may be said to colonise the analyst's mind. Although other ego functions are often affected by colonisation, remembering is of particular interest owing to its importance in building up and keeping ready at hand the contexts within which balanced and timely interpretations can be formulated with some hope that they will be heard and used effectively and progressively by the threatened, phantasy-ridden patient. Special attention will be paid to themes of failure; other themes, such as omnipotence and erotised transferences will be considered later on. Clinical illustrations are included.

Adult↗
PubMed2006

Scalable implementation of analytic gradients for second-order Z-averaged perturbation theory using the distributed data interface.

The analytic gradient expression for second-order Z-averaged perturbation theory is revised and its parallel implementation is described in detail. The distributed data interface is used to access molecular-orbital integral arrays stored in distributed memory. The algorithm is designed to maximize the use of local data and reduce communication costs. The iterative solution and the preconditioner used to induce the convergence of the coupled-perturbed Hartree-Fock equations are presented. Several illustrative timing examples are discussed.

Journal Article↗
PubMed2001

A review of analytical techniques for gait data. Part 1: Fuzzy, statistical and fractal methods.

In recent years, several new approaches to gait data analysis have been explored, including fuzzy systems, multivariate statistical techniques and fractal dynamics. Through a critical survey of recent gait studies, this paper reviews the potential of these methods to strengthen the gait laboratory's analytical arsenal. It is found that time-honoured multivariate statistical methods are the most widely applied and understood. Although initially promising, fuzzy and fractal analyses of gait data remain largely unknown and their full potential is yet to be realized. The trend towards fusing multiple techniques in a given analysis means that additional research into the application of these two methods will benefit gait data analysis.

Electromyography↗
PubMed2001

Factor analytic models of clustered multivariate data with informative censoring.

This article describes a general class of factor analytic models for the analysis of clustered multivariate data in the presence of informative missingness. We assume that there are distinct sets of cluster-level latent variables related to the primary outcomes and to the censoring process, and we account for dependency between these latent variables through a hierarchical model. A linear model is used to relate covariates and latent variables to the primary outcomes for each subunit. A generalized linear model accounts for covariate and latent variable effects on the probability of censoring for subunits within each cluster. The model accounts for correlation within clusters and within subunits through a flexible factor analytic framework that allows multiple latent variables and covariate effects on the latent variables. The structure of the model facilitates implementation of Markov chain Monte Carlo methods for posterior estimation. Data from a spermatotoxicity study are analyzed to illustrate the proposed approach.

Animals↗
PubMed1988

Protein interaction with immobilized ligands: quantitative analyses of equilibrium partition data and comparison with analytical chromatographic approaches using immobilized metal affinity adsorbents.

Quantitative or analytical affinity chromatography has been successful primarily for the analysis of biologically determined macromolecular affinity relationships. Quantitative approaches are also needed to better characterize simpler, chemically defined immobilized ligands with potential for selective interaction with specific, predetermined protein surface groups. Protein interaction with immobilized metal is a rather selective and versatile, high-affinity adsorption technique for which there is little quantitative information. Using model protein interactions with immobilized Cu2+ ions, we have compared analytical frontal affinity chromatographic methods to a simple, nonchromatographic protocol for the rapid determination of quantitative affinity relationships. Values obtained for the equilibrium dissociation constant (Kd) and binding capacity (Lt) characterizing the interaction of lysozyme with immobilized Cu2+ were quite similar by frontal analysis (Kd = 37-42 X 10(-6) M; Lt = 6.8-7.4 X 10(-6) mol protein/ml gel) and by equilibrium binding analyses (Kd = 33 +/- 4.7 X 10(-6) M; Lt = 5.8-6.1 X 10(-6) mol protein/ml gel; 14 determinations). The interaction of ovalbumin with immobilized Cu2+ was characterized by an affinity (Kd = 4.2-4.8 X 10(-6) M) and capacity (Lt = 1.5-2.1 X 10(-6) mol protein/ml gel) which were also the same regardless of the method for affinity analysis. These values indicate that the total protein bound at saturation corresponds to as much as 17% of the total immobilized Cu2+ ions (approximately 40 X 10(-6) mol/ml gel). Thus, depending on the fraction of total immobilized Cu2+ available for interaction with a given protein (e.g., lysozyme), the number of individual immobilized ligands actively participating as well as those rendered unavailable upon individual protein binding events may be greater than 1. Linear Scatchard plots obtained for both lysozyme and ovalbumin (purified) suggest the presence of only a single type of immobilized Cu2+-protein interaction operative under the experimental conditions employed. However, Scatchard analyses of data obtained by the nonchromatographic equilibrium binding method also demonstrated the ability to simultaneously resolve the contribution of two components whose presence was predicted by frontal chromatography. Our results support the validity and utility of equilibrium binding data analyzed according to the equations outlined by Scatchard and others as an alternative to analytical chromatographic methods.

Chromatography, Affinity↗
PubMed2001

Toward best practice: leveraging the electronic patient record as a clinical data warehouse.

Automating clinical and administrative processes via an electronic patient record (EPR) gives clinicians the point-of-care tools they need to deliver better patient care. However, to improve clinical practice as a whole and then evaluate it, healthcare must go beyond basic automation and convert EPR data into aggregated, multidimensional information. Unfortunately, few EPR systems have the established, powerful analytical clinical data warehouses (CDWs) required for this conversion. This article describes how an organization can support best practice by leveraging a CDW that is fully integrated into its EPR and clinical decision support (CDS) system. The article (1) discusses the requirements for comprehensive CDS, including on-line analytical processing (OLAP) of data at both transactional and aggregate levels, (2) suggests that the transactional data acquired by an OLTP EPR system must be remodeled to support retrospective, population-based, aggregate analysis of those data, and (3) concludes that this aggregate analysis is best provided by a separate CDW system.

Benchmarking↗
PubMed1999

Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes?

CONTEXT: Although physicians report spending a considerable amount of time in continuing medical education (CME) activities, studies have shown a sizable difference between real and ideal performance, suggesting a lack of effect of formal CME. OBJECTIVE: To review, collate, and interpret the effect of formal CME interventions on physician performance and health care outcomes. DATA SOURCES: Sources included searches of the complete Research and Development Resource Base in Continuing Medical Education and the Specialised Register of the Cochrane Effective Practice and Organisation of Care Group, supplemented by searches of MEDLINE from 1993 to January 1999. STUDY SELECTION: Studies were included in the analyses if they were randomized controlled trials of formal didactic and/or interactive CME interventions (conferences, courses, rounds, meetings, symposia, lectures, and other formats) in which at least 50% of the participants were practicing physicians. Fourteen of 64 studies identified met these criteria and were included in the analyses. Articles were reviewed independently by 3 of the authors. DATA EXTRACTION: Determinations were made about the nature of the CME intervention (didactic, interactive, or mixed), its occurrence as a 1-time or sequenced event, and other information about its educational content and format. Two of 3 reviewers independently applied all inclusion/exclusion criteria. Data were then subjected to meta-analytic techniques. DATA SYNTHESIS: The 14 studies generated 17 interventions fitting our criteria. Nine generated positive changes in professional practice, and 3 of 4 interventions altered health care outcomes in 1 or more measures. In 7 studies, sufficient data were available for effect sizes to be calculated; overall, no significant effect of these educational methods was detected (standardized effect size, 0.34; 95% confidence interval [CI], -0.22 to 0.97). However, interactive and mixed educational sessions were associated with a significant effect on practice (standardized effect size, 0.67; 95% CI, 0.01-1.45). CONCLUSIONS: Our data show some evidence that interactive CME sessions that enhance participant activity and provide the opportunity to practice skills can effect change in professional practice and, on occasion, health care outcomes. Based on a small number of well-conducted trials, didactic sessions do not appear to be effective in changing physician performance.

Clinical Competence↗
PubMed1997

Comparison of organochlorine pesticide and polychlorinated biphenyl residues in human breast adipose tissue and serum.

The presence of organochlorine pesticides, such as p,p'-DDT[2,2-bis(p-chlorophenyl)-1,1,1-trichloroethanel, and of polychlorinated biphenyls (PCBs) in human serum and adipose tissue has been reported in many studies over the last four decades. Recently, debate has heightened concerning the link of these compounds to breast cancer. To clarify and resolve this issue, accurate analytical residue data must be obtained. Separation of the organochlorine pesticides from the PCBs in breast tissue is critical to obtaining valid residue data. Based on methods refined in the Analytical Laboratory at Colorado State University, accurate residue levels were established for nine individual PCB congeners and eight organochlorine pesticides. The breast adipose tissue method used was a modification of the Mills et al. and de Faubert Maunder et al. methods. The serum method employed was a modification of the Burse et al. method. Both breast adipose tissue and serum from 36 women were analyzed, and correlations of the residues from the two substrates were evaluated. Serum concentrations of p,p'-DDE, the primary metabolite of p,p'-DDT, were correlated (alpha = .05) with the concentrations of p,p'-DDE in human breast adipose tissue (r = .808). Serum concentrations of the PCB congener BZ 153 were also significantly correlated to the human breast adipose tissue concentrations of BZ 153 (r = .377). No significant relationship was found between serum concentrations and tissue residues for 15 of the 17 compounds analyzed. This lack of correlation between breast adipose tissue and serum, as well as an absence of the compound residues in serum, emphasized that adipose tissue should be analyzed in addition to serum to fully understand the relationship of the organochlorine compounds to breast cancer.

Adipose Tissue↗
PubMed2003

Mathematical models of solute retention in gas chromatography as sources of thermodynamic data. Part III. Alkylbenzenes as the test analytes.

Direct determination of thermodynamic data has always been a complicated and troublesome experimental task. Gas chromatography is among long-established working tools well suited to performing this particular task indirectly. Our own results were first presented in the papers by Ciazynska-Halarewicz and Kowalska (1,2), and this article is Part III in the series. Present experiments are carried out on low- and medium-polarity stationary phases at five different temperatures ranging from 323K to 423K. They enable determination of two thermodynamic properties of the alkylbenzenes, molar enthalpy of vaporization (DeltaH(vap)), and the chemical potential of partitioning of the methylene group between the two phases of the chromatographic system (Delta micro (p(-CH2-))). These properties are obtained from eight nonempirical models and, as is apparent from their derivation (3-7), the terms of the models have clearly defined physical meaning, which enables calculation of thermodynamic properties.

Benzene Derivatives↗
PubMed1998

Effects of the analytical treatment of exposure data on associations of cancer and occupational magnetic field exposure.

Epidemiological studies of cancer among workers exposed to magnetic fields have yielded inconsistent results. This variability may be partly explained by differences in study methods. To assess sensitivity to such methods, data from a previous study of brain cancer and leukemia among electric power company workers were reanalyzed using alternative models, which incorporated uncertainty about the intensity of historical exposures, alternative cut points for categorizing the exposure variable for analysis, and a range of lags for describing cancer latency. Mortality rate ratios for leukemia ranged from 0.8-1.5. For brain cancer, increasing cumulative magnetic field exposure was associated with increasing mortality in virtually all models, with rate ratios between 1.3-3.4 for the most exposed workers. These rate ratios are consistent with previous analyses suggesting a 1.5-3.0-fold increase in the risk of brain cancer but no association with leukemia, and confirm that the previous results are not dependent on arbitrary decisions in applying the exposure data.

Brain Neoplasms↗
PubMed2001

A review of analytical techniques for gait data. Part 2: neural network and wavelet methods.

Multivariate gait data have traditionally been challenging to analyze. Part 1 of this review explored applications of fuzzy, multivariate statistical and fractal methods to gait data analysis. Part 2 extends this critical review to the applications of artificial neural networks and wavelets to gait data analysis. The review concludes with a practical guide to the selection of alternative gait data analysis methods. Neural networks are found to be the most prevalent non-traditional methodology for gait data analysis in the last 10 years. Interpretation of multiple gait signal interactions and quantitative comparisons of gait waveforms are identified as important data analysis topics in need of further research.

Biomechanical Phenomena↗
PubMed1996

Attachment representations in mothers, fathers, adolescents, and clinical groups: a meta-analytic search for normative data.

This meta-analysis on 33 studies, including more than 2,000 Adult Attachment Interview (AAI) classifications, presents distributions of AAI classifications in samples of nonclinical fathers and mothers, in adolescents, in samples from different cultures, and in clinical groups. Fathers, adolescents, and participants from different countries show about the same distribution of AAI classifications as nonclinical mothers do. The distribution of nonclinical mothers is as follows: 24% dismissing, 58% autonomous, and 18% preoccupied mothers. About 19% of the nonclinical mothers are unresolved with respect to loss or trauma of other kinds. Mothers from low socioeconomic status show more often dismissing attachment representations and unresolved loss or trauma. Autonomous women and autonomous men are more often married to each other than can be expected by chance, and the same goes for unresolved men and women. Clinical participants show highly deviating distributions of AAI classifications, with a strong overrepresentation of insecure attachment representations, but systematic relations between clinical diagnosis and type of insecurity are absent.

Adolescent↗
PubMed2002

Analytic approaches to twin data using structural equation models.

The classical twin study is the most popular design in behavioural genetics. It has strong roots in biometrical genetic theory, which allows predictions to be made about the correlations between observed traits of identical and fraternal twins in terms of underlying genetic and environmental components. One can infer the relative importance of these 'latent' factors (model parameters) by structural equation modelling (SEM) of observed covariances of both twin types. SEM programs estimate model parameters by minimising a goodness-of-fit function between observed and predicted covariance matrices, usually by the maximum-likelihood criterion. Likelihood ratio statistics also allow the comparison of fit of different competing models. The program Mx, specifically developed to model genetically sensitive data, is now widely used in twin analyses. The flexibility of Mx allows the modelling of multivariate data to examine the genetic and environmental relations between two or more phenotypes and the modelling to categorical traits under liability-threshold models.

Chi-Square Distribution↗