Use of an Inner-city Well-baby Clinic

This prospective, longitudinal investigation examined factors that influenced the use of well-baby services among a low-income, minority, high-risk group. The health belief model was used as the theoretical framework. Data were collected from 44 primiparous, black mothers attending an urban maternal child health care clinic by interviews at the first and sixth months after the birth of their infants. Analysis focused on the cues component of the model and explored the kinds of cues that influenced the mothers to bring their babies to the well-baby clinic. One important finding was that for mothers influenced by health information from radio or television, FYI commercials on television were most often reported.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72805/1/j.1525-1446.1987.tb00535.x.pd

Fusion energy from the Moon for the twenty-first century

It is shown in this paper that the D-He-3 fusion fuel cycle is not only credible from a physics standpoint, but that its breakeven and ignition characteristics could be developed on roughly the same time schedule as the DT cycle. It was also shown that the extremely low fraction of power in neutrons, the lack of significant radioactivity in the reactants, and the potential for very high conversion efficiencies, can result in definite advantages for the D-He-3 cycle with respect to DT fusion and fission reactors in the twenty-first century. More specifically, the D-He-3 cycle can accomplish the following: (1) eliminate the need for deep geologic waste burial facilities and the wastes can qualify for Class A, near-surface land burial; (2) allow 'inherently safe' reactors to be built that, under the worst conceivable accident, cannot cause a civilian fatality or result in a significant (greater than 100 mrem) exposure to a member of the public; (3) reduce the radiation damage levels to a point where no scheduled replacement of reactor structural components is required, i.e., full reactor lifetimes (approximately 30 FPY) can be credibly claimed; (4) increase the reliability and availability of fusion reactors compared to DT systems because of the greatly reduced radioactivity, the low neutron damage, and the elimination of T breeding; and (5) greatly reduce the capital costs of fusion power plants (compared to DT systems) by as much as 50 percent and present the potential for a significant reduction on the COE. The concepts presented in this paper tie together two of the most ambitious high-technology endeavors of the twentieth century: the development of controlled thermonuclear fusion for civilian power applications and the utilization of outer space for the benefit of mankind on Earth

Perceived health and quality of life: the effect of exposure to atmospheric pollution

International audienc

Screening for childhood anaemia using copper sulphate densitometry

Objective. To evaluate copper sulphate densitometry to screen for childhood anaemia in a primary care setting, with a view to identifying children requiring definitive diagnostic testing and treatment. Design. A cross-sectional screening study. Results of densitometry with a copper sulphate solution of specific gravity (SG) 1.048, corresponding to a haemoglobin (Hb) concentration of 10 g/dl, were compared with laboratory Hb determination. Setting. Outpatient department of Pretoria Academic Hospital (73 children) and a local cr_che (27 children). Subjects. One hundred consecutive children, aged between 6 months and 6 years, with informed written consent by parents. Outcome measure(s). Accuracy of copper sulphate densitometry in screening for Hb concentration below 10 g/dl in terms of sensitivity, specificity, positive and negative predictive values, as well as likelihood ratio. Results. The prevalence of anaemia (Hb < 10 g/dl) was 17% (95% confidence interval (CI) 10.2; 25.8). Copper sulphate densitometry had a sensitivity of 88.2% (95% CI 62.3; 97.9), a specificity of 89.2% (95% CI 79.9; 94.6), a positive predictive value of 62.5% (95% CI 40.8; 80.5) and a negative predictive value of 97.4% (95%CI 90.0; 99.5) in screening for anaemia. The likelihood ratio of a positive screening test was 8.17. Conclusions. Copper sulphate densitometry was accurate in screening for childhood anaemia. (South African Medical Journal: 2002 92(12): 978-981

Towards a New Science of a Clinical Data Intelligence

In this paper we define Clinical Data Intelligence as the analysis of data generated in the clinical routine with the goal of improving patient care. We define a science of a Clinical Data Intelligence as a data analysis that permits the derivation of scientific, i.e., generalizable and reliable results. We argue that a science of a Clinical Data Intelligence is sensible in the context of a Big Data analysis, i.e., with data from many patients and with complete patient information. We discuss that Clinical Data Intelligence requires the joint efforts of knowledge engineering, information extraction (from textual and other unstructured data), and statistics and statistical machine learning. We describe some of our main results as conjectures and relate them to a recently funded research project involving two major German university hospitals.Comment: NIPS 2013 Workshop: Machine Learning for Clinical Data Analysis and Healthcare, 201

Is late-life dependency increasing or not? A comparison of the Cognitive Function and Ageing Studies (CFAS)

Background: Little is known about how dependency levels have changed between generational cohorts of older people. We estimated years lived in different care states at age 65 in 1991 and 2011 and new projections of future demand for care. Methods: Two population-based studies of older people in defined geographical areas conducted two decades apart (the Cognitive Function and Ageing Studies) provided prevalence estimates of dependency in four states: high (24-hour care); medium (daily care); low (less than daily); independent. Years in each dependency state were calculated by Sullivan’s method. To project future demand, the proportions in each dependency state (by age group and sex) were applied to the 2014 England population projections. Findings: Between 1991 and 2011 there were significant increases in years lived from age 65 with low (men:1·7 years, 95%CI 1·0-2·4; women:2·4 years, 95%CI 1·8-3·1) and high dependency (men:0·9 years, 95%CI 0·2-1·7; women:1·3 years, 95%CI 0·5-2·1). The majority of men’s extra years of life were independent (36%) or with low dependency (36%) whilst for women the majority were spent with low dependency (58%), only 5% being independent. There were substantial reductions in the proportions with medium and high dependency who lived in care homes, although, if these dependency and care home proportions remain constant in the future, further population ageing will require an extra 71,000 care home places by 2025. Interpretation: On average older men now spend 2.4 years and women 3.0 years with substantial care needs (medium or high dependency), and most will live in the community. These findings have considerable implications for older people’s families who provide the majority of unpaid care, but the findings also supply valuable new information for governments and care providers planning the resources and funding required for the care of their future ageing populations

The impact of sea surface temperature biases on North American precipitation in a high-resolution climate model

Positive precipitation biases over western North America have remained a pervasive problem in the current generation of coupled global climate models. These biases are substantially reduced, however, in a version of the Geophysical Fluid Dynamics Laboratory Forecast-Oriented Low Ocean Resolution (FLOR) coupled climate model with systematic sea surface temperature (SST) biases artificially corrected through flux adjustment. This study examines how the SST biases in the Atlantic and Pacific Oceans contribute to the North American precipitation biases. Experiments with the FLOR model in which SST biases are removed in the Atlantic and Pacific are carried out to determine the contribution of SST errors in each basin to precipitation statistics over North America. Tropical and North Pacific SST biases have a strong impact on northern North American precipitation, while tropical Atlantic SST biases have a dominant impact on precipitation biases in southern North America, including the western United States. Most notably, negative SST biases in the tropical Atlantic in boreal winter induce an anomalously strong Aleutian low and a southward bias in the North Pacific storm track. In boreal summer, the negative SST biases induce a strengthened North Atlantic subtropical high and Great Plains low-level jet. Each of these impacts contributes to positive annual mean precipitation biases over western North America. Both North Pacific and North Atlantic SST biases induce SST biases in remote basins through dynamical pathways, so a complete attribution of the effects of SST biases on precipitation must account for both the local and remote impacts

Effective interventions for potentially modifiable late-onset dementia risk factors: a costs and cost-effectiveness modelling study

Background The potential economic value of interventions to prevent late-onset dementia is unknown. We modelled this for potentially modifiable dementia risk factors. Methods We searched PubMed and Web of Science from inception to March 2020 and included interventions that (a) successfully targeted any of nine pre-specified potentially modifiable risk factors (hypertension, diabetes, hearing loss, obesity, physical inactivity, social isolation, depression, cigarette smoking and less childhood education), (b) had robust evidence that the intervention improved risk or risk behaviour and (c) are feasible in an adult population. We established when in the life-course each intervention would be delivered. We calculated dementia incidence reduction from: annual incidence of dementia in people with each risk factor; population attributable fraction for each risk, corrected for risk factor clustering, and how effectively the intervention controls the risk factor. We calculated the discounted value of lifetime health gain and impact on cost (including NHS, social care and carer costs) per person eligible for treatment. We estimated annual total expenditure on the fully operational intervention programme in England. Findings We found effective treatments for hypertension, stopping smoking, diabetes prevention and hearing loss. Treatments for stopping smoking and provision of hearing aids reduced cost. Treatment of hypertension was cost-effective by reference to standard UK thresholds. The three interventions when fully implemented would save £1·863 billion annually in England, reduce dementia prevalence by 8·5% and produce QALY gains. The intervention for diabetes was unlikely to be cost-effective in terms of impact on dementia alone. Interpretation There is a strong case for implementing the three effective interventions on grounds of cost-effectiveness and quality of life gains, as well as for improvements in general health. There is considerable room for the interventions to remain cost-saving or cost-effective even with variations in dementia incidence and costs and effectiveness of interventions

Microextensive Chaos of a Spatially Extended System

By analyzing chaotic states of the one-dimensional Kuramoto-Sivashinsky equation for system sizes L in the range 79 <= L <= 93, we show that the Lyapunov fractal dimension D scales microextensively, increasing linearly with L even for increments Delta{L} that are small compared to the average cell size of 9 and to various correlation lengths. This suggests that a spatially homogeneous chaotic system does not have to increase its size by some characteristic amount to increase its dynamical complexity, nor is the increase in dimension related to the increase in the number of linearly unstable modes.Comment: 5 pages including 4 figures. Submitted to PR