Cost-effectiveness of counselling, graded-exercise and usual care for chronic fatigue: evidence from a randomised trial in primary care

Fatigue is common and has been shown to result in high economic costs to society. The aim of this study is to compare the cost-effectiveness of two active therapies, graded-exercise (GET) and counselling (COUN) with usual care plus a self-help booklet (BUC) for people presenting with chronic fatigue

Some Curvature Problems in Semi-Riemannian Geometry

In this survey article we review several results on the curvature of semi-Riemannian metrics which are motivated by the positive mass theorem. The main themes are estimates of the Riemann tensor of an asymptotically flat manifold and the construction of Lorentzian metrics which satisfy the dominant energy condition.Comment: 25 pages, LaTeX, 4 figure

Socio-demographic and behavioural correlates of oral hygiene status and oral health related quality of life, the Limpopo - Arusha school health project (LASH): A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Promoting oral health of adolescents is important for improvement of oral health globally. This study used baseline-data from LASH-project targeting secondary students to; 1) assess frequency of poor oral hygiene status and oral impacts on daily performances, OIDP, by socio-demographic and behavioural characteristics, 2) examine whether socio-economic and behavioural correlates of oral hygiene status and OIDP differed by gender and 3) examine whether socio-demographic disparity in oral health was explained by oral health-related behaviours.</p> <p>Methods</p> <p>Cross-sectional study was conducted in 2009 using one-stage cluster sampling design. Total of 2412 students (mean age 15.2 yr) completed self-administered questionnaires, whereas 1077 (mean age 14.9 yr) underwent dental-examination. Bivariate analyses were conducted using cross-tabulations and chi-square statistics. Multiple variable analyses were conducted using stepwise standardized logistic regression (SLR) with odds ratios and 95% Confidence intervals (CI).</p> <p>Results</p> <p>44.8% presented with fair to poor OHIS and 48.2% reported any OIDP. Older students, those from low socio-economic status families, had parents who couldn't afford dental care and had low educational-level reported oral impacts, poor oral hygiene, irregular toothbrushing, less dental attendance and fewer intakes of sugar-sweetened drinks more frequently than their counterparts. Stepwise logistic regression revealed that reporting any OIDP was independently associated with; older age-groups, parents do not afford dental care, smoking experience, no dental visits and fewer intakes of sugar-sweetened soft drinks. Behavioural factors accounted partly for association between low family SES and OIDP. Low family SES, no dental attendance and smoking experience were most important in males. Low family SES and fewer intakes of sugar-sweetened soft drinks were the most important correlates in females.</p> <p>Socio-behavioural factors associated with higher odds ratios for poor OHIS were; older age, belonging to the poorest household category and having parents who did not afford dental care across both genders.</p> <p>Conclusion</p> <p>Disparities in oral hygiene status and OIDP existed in relation to age, affording dental care, smoking and intake of sugar sweetened soft drinks. Gender differences should be considered in intervention studies, and modifiable behaviours have some relevance in reducing social disparity in oral health.</p

Conceptualizing Social Responsibility in Operations via Stakeholder Resource-Based View

We seek to conceptualize social responsibility for operations management (OM) research to develop a social responsibility lens through which to view operations. To do so, we first consider the corporate social responsibility, sustainability, as well as the bottom-ofthe-pyramid and shared value approaches and identify three challenges to developing such a lens: selecting the level of analysis, tackling the huge multitude of objectives, and developing theoretical underpinnings. We then propose a ‘stakeholder resource-based view’ (SRBV) building on resource-based view, stakeholder theory, and utility theory to address these challenges. Under SRBV, all stakeholders are treated on a par with each other. These different stakeholders are all presumed to seek maximizing their respective (expected) utility, with different drivers shaping their preferences and do so they use their respective resources, routines and dynamic capabilities. SRBV provides (a) a descriptive framework for qualitative research, (b) an instrumental framework for empirical research, and (c) a normative framework for analytical research. It enables tackling many opportunities for OM research to do with social responsibility and we outline some of these in each of the three types of research methodologies

Interleukin-13 and Its Receptors in Idiopathic Interstitial Pneumonia: Clinical Implications for Lung Function

Idiopathic interstitial pneumonia (IIP) is characterized by varying degrees of interstitial fibrosis. IL-13 and IL-4 are strong inducers of tissue fibrosis, whereas IFN-γ has antifibrotic potential. However, the roles of these substances in IIP remain unknown. IL-13, IL-4, and IFN-γ were measured in the BAL fluid of 16 idiopathic pulmonary fibrosis (IPF) patients, 10 nonspecific interstitial pneumonia (NSIP) patients, and 8 normal controls. The expression of IL-13 and IL-13Rα1/α2 in lung tissues was analyzed using ELISA and immunohistochemistry. IL-13 levels were significantly higher in IPF patients than the others (P<0.05). IL-4 levels were higher in both IPF and NSIP patients than in normal controls (P<0.05), and IFN-γ levels were lower in NSIP patients than in normal controls (P=0.047). IL-13 levels correlated inversely with FVC% (r=-0.47, P=0.043) and DLCO% (r=-0.58, P=0.014) in IPF and NSIP patients. IL-13 was strongly expressed in the smooth muscle, bronchial epithelium, alveolar macrophages and endothelium of IPF patients. IL-13Rα1, rather than IL-13Rα2, was strongly expressed in the smooth muscle, bronchial epithelium, and endothelium of IPF patients. IL-13 and its receptors may contribute to the pathogenesis of fibrosis in IIP and appear to be related to the severity of the disease

Updated fracture incidence rates for the US version of FRAX®

# The Author(s) 2009. This article is published with open access at Springerlink.com Summary On the basis of updated fracture and mortality data, we recommend that the base population values used in the US version of FRAX ® be revised. The impact of suggested changes is likely to be a lowering of 10-year fracture probabilities. Introduction Evaluation of results produced by the US version of FRAX ® indicates that this tool overestimates the likelihood of major osteoporotic fracture. In an attempt to correct this, we updated underlying fracture and mortality rates for the model. Methods We used US hospital discharge data from 2006 t

Dental anxiety and dental attendance among 25-year-olds in Norway: time trends from 1997 to 2007

<p>Abstract</p> <p>Background</p> <p>So far, there are few studies considering the development of dental anxiety and dental attendance patterns across time in the general population of Norwegian adults. This study aimed to 1) determine the frequency of dental anxiety and regular dental attendance among 25-year-olds in Norway in 1997 and 2007, 2) to study the development (time trend) of dental anxiety and the socio-behavioral distribution of dental anxiety from 1997 to 2007.</p> <p>Method</p> <p>Random samples of 1,190 and 8,000 25-yr-olds were drawn from the populations of three counties in Western Norway in 1997 and 2007, respectively. The eligible participants received questionnaires by mail including questions on socio-demographics, dental anxiety (DAS) and dental attendance.</p> <p>Results</p> <p>In 1997, 11.5% males versus 23% females reported high dental anxiety (DAS ≥ 13). Corresponding figures in 2007 were 11.3% and 19.8%. The proportions who had attended yearly for a dental check-up during the past 5 years fell from 62% in 1997 (men 56.9% and women 66.4%) to 44.6% (men 38.1% and women 48.6%) in 2007. After controlling for potential confounding factors, the 25-year-olds were 1.4 times more likely to report dental anxiety in 1997 compared to 2007. The decrease was largely attributable to a lower mean DAS score among higher educated females in 2007 than in 1997. The discrepancy in dental anxiety between regular and non-regular dental attendees had decreased, largely attributable to a decline in dental anxiety among irregular dental attendees.</p> <p>Conclusion</p> <p>The study showed reduced dental anxiety and dental attendance among 25 year-olds in Norway from 1997 to 2007. This study points to the importance of controlling for possible changes in socio-demographic distributions when different cohorts are compared.</p