Understanding the Extent, Composition, and Characteristics of the Poor

Probing deeper into the poverty picture, this Policy Note examines the extent, composition, and characteristics of the poor, using various rounds of the Family Income and Expenditure Survey (FIES) and Annual Poverty Indicator Survey (APIS) as panel data sets. Understanding these aspects could provide insights that may guide the government in formulating specific types of interventions for different groups of households, especially the chronic and transient poor.Philippines, chronic poor, transient poor, panel data

Comparing external ventricular drains-related ventriculitis surveillance definitions

OBJECTIVETo evaluate the agreement between the current National Healthcare Safety Network (NHSN) definition for ventriculitis and others found in the literature among patients with an external ventricular drain (EVD)DESIGNRetrospective cohort study from January 2009 to December 2014SETTINGNeurology and neurosurgery intensive care unit of a large tertiary-care centerPATIENTSPatients with an EVD were included. Patients with an infection prior to EVD placement or a permanent ventricular shunt were excluded.METHODSWe reviewed the charts of patients with positive cerebrospinal fluid (CSF) cultures and/or abnormal CSF results while they had an EVD in place and applied various ventriculitis definitions.RESULTSWe identified 48 patients with a total of 52 cases of ventriculitis (41 CSF culture-positive cases and 11 cases based on abnormal CSF test results) using the NHSN definition. The most common organisms causing ventriculitis were gram-positive commensals (79.2%); however, 45% showed growth of only 1 colony on 1 piece of media. Approximately 60% of the ventriculitis cases by the NHSN definition met the Honda criteria, approximately 56% met the Gozal criteria, and 23% met Citerio’s definition. Cases defined using Honda versus Gozal definitions had a moderate agreement (κ=0.528; P&lt;.05) whereas comparisons of Honda versus Citerio definitions (κ=0.338; P&lt;.05) and Citerio versus Gozal definitions (κ=0.384; P&lt;.05) had only fair agreements.CONCLUSIONSThe agreement between published ventriculostomy-associated infection (VAI) definitions in this cohort was moderate to fair. A VAI surveillance definition that better defines contaminants is needed for more homogenous application of surveillance definitions between institutions and better comparison of rates.Infect Control Hosp Epidemiol 2017;38:574–579</jats:sec

Resilience amongst Older Colombians Living in Poverty: an Ecological Approach.

Older Colombians face significant adversities: poverty, violence and displacement. However, there is evidence that Latinos are often resilient. We examine resilience in older Colombians living in poverty using an ecological framework that identifies three levels: individual; community; and societal. In this paper we examine data from 16 semi-structured interviews with older Colombians that explore resilience within the context of poverty. We analyze our data using three stages: (1) modified grounded theory; (2) assignment of resilience status; (3) identification of components of the ecological framework which contribute to resilience in these participants. The most striking feature is that some participants are able to adapt to their situation, demonstrating resilience, whilst others are not. Individual characteristics such as psychological and material resources contribute to resilience. At the community level, family, social support, participation and cohesion promote resilience. Finally, at the societal level, social and welfare services, finance, religion and social policy, are important factors. These different levels of resilience are co-dependent, and we illustrate how this is so. We suggest that older Colombians living in poverty often demonstrate resilience, but that more can be done to enhance their lives. This includes interventions at the individual and community levels alongside changes in social policy

Achilles Tendon and Athletes

Achilles tendon (AT) is the strongest human tendon. AT disorders are common among athletes. AT pathologies vary from tendinopathy to frank rupture. Diagnosis is made clinically. Imaging modalities are used adjunctively. Management of AT rupture in athletes is challenging to surgeons due to worldwide growing popularity of sports and potential social and financial impact of AT injury to an athlete. Hence, new surgical techniques aim at attaining quick recovery with good outcome, finding similar results with both open and percutaneous techniques when accompanying these with functional rehabilitation protocols. Non-operative strategies include shoe wear modification, physiotherapy and extracorporeal shock wave therapy. Surgical interventions vary based on the AT pathology nature and extent. Direct repair can work for small-sized defects. V-Y gastrocnemius advancement could approximate the tendon edges for repair within 2–8 cm original gap. Gastrocnemius turndown can bridge tendon loss > 8 cm. Autogenous, allogeneous or synthetic tendon grafts were used for AT reconstruction purposes. In AT tendinopathies with no tendon tissue loss, surgical procedures revolve around induction of tissue repair through lesion incision or debridement to full detachment followed by reattachment. Extra-precautions are exercised for prevention of AT disorders especially among susceptible athletes participating in sports involving excessive AT strain

Psychometric properties of the perceived stress scale (pss-10) with breast cancer patients

Breast cancer diagnosisis one of the most difficult events that a woman canexperienceduring her life and it usually produceshigh levels of stress. Globalmeasuresof perceivedstress are useful for screeningand for comparingstresslevels between cancer patients and other clinical and nonclinicalpopulations.Onesuch instrumentthat is widely used is the PerceivedStress Scale (pss‐10), but itspsychometricpropertieshave scarcely been analysed with breast cancer patients.Theaimofthisstudywastoprovidevalidityevidenceregardingtheuseofthe10‐itemversionofthepss‐10 asatoolformeasuringperceivedstressinthiscontext.Participantswere 215 Spanish breast cancer patients who completedthe PSS‐10andthe DASS‐21,a measureofaffective distress(depression,anxiety,andstress).The internal structureof the PSS‐10 was examinedthrough confirmatoryfactoranalysis (CFA), and the reliabilityof test scores was estimatedusing McDonald'somegacoefficient.Validityevidencebasedonrelationshipswithothervariableswasalsoobtainedusingcorrelationanalysis.TheCFAsupportedacorrelatedtwo‐factorstructure:perceivedhelplessness(sixnegativelywordeditems)andperceivedself‐efficacy (four positivelyworded items). Reliabilitycoefficientsfor scores on thesetwofactorswere0.87and0.73,respectively.Scoresonaffectivedistress(DASS‐21)werestronglyandpositivelycorrelatedwithperceivedhelplessnessandmoderatelyand negativelycorrelatedwith perceivedself‐efficacy.The PSS‐10 is an adequatetool for measuringperceivedstress in the breast cancer context and it may beusefulfor identifyingwomenat riskofpsychologicalmaladjustment.Fundingfor open access charge: Universidad de Málaga/CBU

Cost-utility of a walking programme for moderately depressed, obese, or overweight elderly women in primary care: a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>There is a considerable public health burden due to physical inactivity, because it is a major independent risk factor for several diseases (e.g., type 2 diabetes, cardiovascular disease, moderate mood disorders neurotic diseases such as depression, etc.). This study assesses the cost utility of the adding a supervised walking programme to the standard "best primary care" for overweight, moderately obese, or moderately depressed elderly women.</p> <p>Methods</p> <p>One-hundred six participants were randomly assigned to an interventional group (n = 55) or a control group (n = 51). The intervention consisted of an invitation, from a general practitioner, to participate in a 6-month walking-based, supervised exercise program with three 50-minute sessions per week. The main outcome measures were the healthcare costs from the Health System perspective and quality adjusted life years (QALYs) using EuroQol (EQ-5D.)</p> <p>Results</p> <p>Of the patients invited to participate in the program, 79% were successfully recruited, and 86% of the participants in the exercise group completed the programme. Over 6 months, the mean treatment cost per patient in the exercise group was €41 more than "best care". The mean incremental QALY of intervention was 0.132 (95% CI: 0.104–0.286). Each extra QALY gained by the exercise programme relative to best care cost €311 (95% CI, €143–€394). The cost effectiveness acceptability curves showed a 90% probability that the addition of the walking programme is the best strategy if the ceiling of inversion is €350/QALY.</p> <p>Conclusion</p> <p>The invitation strategy and exercise programme resulted in a high rate of participation and is a feasible and cost-effective addition to best care. The programme is a cost-effective resource for helping patients to increase their physical activity, according to the recommendations of general practitioners. Moreover, the present study could help decision makers enhance the preventive role of primary care and optimize health care resources.</p> <p>Trial Registration</p> <p>[ISRCTN98931797]</p

An Inquiry into the Competitiveness of Emerging Philippine Cities

This paper attempts to approximate the competitiveness of the country’s ten leading emerging urban centers: Angeles, Baguio, Cagayan de Oro, Davao City, General Santos, Iligan, Iloilo, San Fernando La Union, Tacloban and Zamboanga. The study uses both ranking and scoring methods to rate the cities in eight major drivers: cost competitiveness, human resources endowment, infrastructure, linkages with major urban centers and growth areas, quality of life, responsive of local government units and dynamism of local economy. It best serves as a policy and urban management tool for concerned local officials and leaders of various private sector groups in identifying the cities’ strength and areas of improvement. Insights on overall scores and rankings point to the importance of local leadership, emphasis on improving quality of lives in urban centers and the role of surrounding local and/or international growth formations in enhancing urban competitiveness. Any combination of these factors actually explains the high rankings garnered by General Santos City, Angeles City and Baguio.urban management, urbanization, competitiveness, urban development

Autologous and Allogeneic Stem Cell Transplantation for Treatment of Crohn’s Fistulae

Up to 20% of patients with Crohn’s disease (CD) may have perianal fistula disease. Classically, surgery has played an important role; in recent years, medical treatment has taken a leading role. Immunosuppressants and biological trea tments have proven beneficial in many patients, but still, the percentage of patients who do not respond remains significant. In this scenario, cell therapy is envisaged as an effective alternative to surgery. The promising preclinical and clinical data that we review below suggest that cell therapy could represent a major advance in the clinical management of this difficult problem

Dynamic bonding of metallic nanocontacts: Insights from experiments and atomistic simulations

The conductance across an atomically narrow metallic contact can be measured by using scanning tunneling microscopy. In certain situations, a jump in the conductance is observed right at the point of contact between the tip and the surface, which is known as “jump to contact” (JC). Such behavior provides a way to explore, at a fundamental level, how bonding between metallic atoms occurs dynamically. This phenomenon depends not only on the type of metal but also on the geometry of the two electrodes. For example, while some authors always find JC when approaching two atomically sharp tips of Cu, others find that a smooth transition occurs when approaching a Cu tip to an adatom on a flat surface of Cu. In an attempt to show that all these results are consistent, we make use of atomistic simulations; in particular, classical molecular dynamics together with density functional theory transport calculations to explore a number of possible scenarios. Simulations are performed for two different materials: Cu and Au in a [100] crystal orientation and at a temperature of 4.2 K. These simulations allow us to study the contribution of short- and long-range interactions to the process of bonding between metallic atoms, as well as to compare directly with experimental measurements of conductance, giving a plausible explanation for the different experimental observations. Moreover, we show a correlation between the cohesive energy of the metal, its Young's modulus, and the frequency of occurrence of a jump to contact.W. Dednam acknowledges support from the National Research Foundation of South Africa through the Scarce Skills Masters scholarship funding programme (Grant Unique Number 92138). This work is supported by the Generalitat Valenciana through Grant Reference PROMETEO2012/011 and MINECO under Grant No. FIS2013-47328, by European Union structural funds and the Comunidad de Madrid Programs S2013/MIT-3007 and P2013/MIT-2850. This work is also part of the research programme of the Foundation for Fundamental Research on Matter (FOM), which is financially supported by the Netherlands Organisation for Scientific Research (NWO)