Floyd County, Texas : records of wells and springs, drillers' logs, and water analyses, and map showing location of wells and springs (1938)

Map of Floyd County, Texas, showing locations of water wells listed. "Prepared in cooperation with the Geological Survey, United States Department of the Interior, the Bureau of Industrial Chemistry of The University of Texas, the Resettlement Administration, and the Works Progress Administration ground-water survey project number 5072."UT Librarie

Tata Kelola Pemerintahan Daerah Yang Inovatif dan Kolaboratif Dimasa Pandemi Covid 19 di Kota Cimahi

Dampak wabah Pandemi covid 19 di Indonesia secara umum telah berdampak kepada semua sector kehidupan masyarakat salah satu sektornya adalah pelayanan Masyarakat dibatasi untuk melakukan kegiatan-kegiatan diruang-ruang publik, dan membatasi ijin operasional perkantoran, serta membatasi pegawai-pegawai yang masuk kantor, hanya diijinkan 50 % dari jumlah pegawai, membuat pelayanan publik, mengalami hambatan, namun Kota Cimahi tidak berhenti dengan melakukan inovasi dan kolaborasi dalam tata kelola pemerintahannya. Tujuan penelitian untuk mengetahui tata kelola pemerintahan daerah yang inovatif dan kolaboratif dimasa pandemi covid 19 dikota Cimahi, hambatan serta upaya untuk mengatasi hambatan tersebut. Metode ysng digunakan adalah kualitatif deskriptif dengan pendekatan induktif. Data didapat dari data sekunder dan data primer. Hasil dan simpulan. Sebelum adanya wabah Pandemi Covid 19, pelayanan dilakukan secara tata muka langsung, namun adanya wabah pandemi Covid 19, pelayanan dirubah dengan menggunakan aplikasi secara on-line terkoneksi jaringan internet, pelayanan dalam bentuk on-line dapat dikatakan berhasil, karena adaya kepuasan masyarakat atas pelayanan tersebut . sehingga dapat dijadikan contoh, oleh daerah-daerah lain diprovinsi Jawa Barat, adapun hambatan yang terjadi adalah berupa jaringan, sarana belum memadai dan keterbatasan Sumber Daya Manusia.Kata Kunci : Tata Kelola, Inovatif dan Kolaboratif, Pandemi Covid 19

Pain assessment and management in different wards of a tertiary care hospital

OBJECTIVE: To assess the pain management by medical team, emergency room (ER) team and Acute Pain team in a tertiary care hospital. METHODS: The cross-sectional study was done in Medical Ward, Surgical Ward and Emergency Room of Aga Khan University, Karachi, in March-April 2010. The assigned research medical officer visited the three locations every day and selected patients by way of convenient sampling. The study comprised 75 patients; 25 each in three groups. Information was collected on patient\u27s demographics, general characteristics, type of drugs and modalities used. Specific queries about pain were sorted out like adequacy of pain assessment done by primary physician, pain intensity, any intervention done and pain relief post-intervention. SPSS version 17, analysis of variance and Chi square test were used for statistical purpose. RESULTS: The mean current pain score on the visual analogue score (VAS) was lowest in the Surgical Ward which was being managed by the Acute Pain Management Service (APMS) team followed by the Medical Ward and then Emergency Rooms. The difference was found to be statistically significant. The mean of worst pain score was also the lowest in the Surgical Ward. There was significant difference between wards in terms of the use of pain medications. Proper documentation for pain was done for all patients in the Surgical Ward, followed by the Emergency Room and then the Medical Ward. CONCLUSION: Better pain assessment, re-assessment, documentation and patient satisfaction were observed in the Surgical Ward compared to the other two locations of the study

Eye care services evaluation in a low-income urban population of São Paulo City - Brazil

PURPOSE: To evaluate eye care services from the user's perspective in a low income population from the east zone of the city of São Paulo - Brazil. METHODS: A household survey was performed using cluster sampling in three low income districts of the city of São Paulo - Brazil. From July/2004 to January/2005, 1055 interviews with an adult household representative were carried and an eye care system responsiveness questionnaire was administered through individual interview. RESULTS: 71.56% of the participants were women. Respondents' age ranged from 18 to 92 years (41.42 ± 15.67 years). Regarding schooling, 525 (49.77%) had four years or less; 489 (46.35%) between five and eleven years, 40 (3.79%) had eleven or more years of study. Eye care services need was reported as 712 (67.49%) declaring themselves or someone else of the household needing and obtaining services and 135 (12.80%) had never needed eye care. The most frequently cited barriers to obtain the eye care service by respondents was cost (77.29%), followed by unsuccessful attempt to obtain eye care (42.21%). General satisfaction for the criteria contained in the questionnaire was 63.37%. In the 36.63% dissatisfied respondents, the most frequently cited claim was the amount of time waited before consultation. CONCLUSION: The main barriers to obtain eye care services were cost of medical appointment and lack of access to the services. 63.37% of the individuals in need who had received eye care in last 12 months were satisfied with the service provided.OBJETIVO: Avaliar os serviços de assistência ocular do ponto de vista do usuário em população de baixa renda, na zona leste da cidade de São Paulo - Brasil. MÉTODOS: Estudo realizado por meio de inquérito domiciliar em uma amostra por conglomerados em três distritos de baixa renda da cidade de São Paulo - Brasil. No período de julho/2004 a janeiro/2005 foram realizadas 1.055 entrevistas com um representante do domicílio, sendo aplicado o questionário de responsividade aos serviços de assistência ocular em entrevista individual. RESULTADOS: Dos participantes, 71,56% eram mulheres. A idade dos respondentes variou de 18 a 92 anos (41,42 ± 15,67 anos). Quanto à escolaridade, 525 (49,77%) tinham 4 anos ou menos; 489 (46,35%) entre 5 e 11 anos; 40 (3,79%) 11 ou mais anos de estudo. Quanto à necessidade de utilização dos serviços de assistência ocular: 712 (67,49%) relataram que algum morador do seu domicílio necessitou e obteve assistência ocular e 135 (12,80%) nunca precisaram de assistência ocular. A barreira mais frequentemente citada para obtenção dos serviços de assistência ocular pelos respondentes foi o custo da consulta (77,29%) seguida de tentativa frustrada de obtenção da assistência ocular (42,21%). A frequência de avaliações positivas para os critérios contidos no questionário foi de 63,37%. Dos 36,63% respondentes insatisfeitos, o tempo de espera na sala de recepção dos serviços de assistência ocular foi o fator mais frequentemente apontado. CONCLUSÃO: As principais barreiras para obter assistência ocular foram o custo da consulta e a falta de acesso aos serviços, 63,37% dos indivíduos que necessitaram e obtiveram assistência ocular nos últimos 12 meses mostraram-se satisfeitos.Universidade Federal de São Paulo (UNIFESP) Departamento de Oftalmologia Setor de Eletrofisiologia Visual ClínicaUNIFESP Departamento de OftalmologiaUNIFESPUNIFESP Departamento de Oftalmologia Setor de Eletrofisiologia Visual ClínicaUNIFESP, Depto. de Oftalmologia Setor de Eletrofisiologia Visual ClínicaUNIFESP, Depto. de OftalmologiaUNIFESP, Depto. de Oftalmologia Setor de Eletrofisiologia Visual ClínicaSciEL

Cardiovascular Risk Factors as Differential Predictors of Incident Atypical and Typical Major Depressive Disorder in U.S. Adults

Objectives While the association between major depressive disorder (MDD) and future cardiovascular disease (CVD) is established, less is known about the relationship between CVD risk factors and future depression, and no studies have examined MDD subtypes. Our objective was to determine whether hypertension, tobacco use, and body mass index (BMI) differentially predict atypical and typical MDD in a national sample of U.S. adults. Methods We examined prospective data from 22,915 adults with no depressive disorder history at baseline who participated in Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). CVD risk factors (Wave 1) and incident MDD subtypes (Wave 2) were determined by structured interviews. Results There were 252 atypical and 991 typical MDD cases. In fully-adjusted models, baseline hypertension (OR=0.58, 95% CI: 0.43-0.76), former tobacco use (OR=1.46, 95% CI: 1.20-1.78), and BMI (OR=1.32, 95% CI: 1.25-1.40; all p’s<0.001) predicted incident atypical MDD versus no MDD, whereas no CVD risk factor predicted incident typical MDD. Baseline hypertension (OR=0.52, 95% CI: 0.39-0.70), former tobacco use (OR=1.53, 95% CI: 1.22-1.93), and BMI (OR=1.26, 95% CI: 1.18-1.36; all p’s<0.001) also predicted incident atypical MDD versus typical MDD. Conclusions Our study is the first to report that CVD risk factors differentially predict MDD subtypes, with hypertension (protective factor), former tobacco use (risk factor), and BMI (risk factor) being stronger predictors of incident atypical versus typical MDD. Such evidence could provide insights into the etiologies of MDD subtypes and inform interventions tailored to MDD subtype

Joint Models for Multiple Longitudinal Processes and Time-to-event Outcome

Joint models are statistical tools for estimating the association between time-to-event and longitudinal outcomes. One challenge to the application of joint models is its computational complexity. Common estimation methods for joint models include a two-stage method, Bayesian and maximum-likelihood methods. In this work, we consider joint models of a time-to-event outcome and multiple longitudinal processes and develop a maximum-likelihood estimation method using the expectation–maximization algorithm. We assess the performance of the proposed method via simulations and apply the methodology to a data set to determine the association between longitudinal systolic and diastolic blood pressure measures and time to coronary artery disease