655 research outputs found

    Сучасний стан і шляхи подальшого розвитку вітчизняної вугільної промисловості

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    Викладено загальну характеристику вугільної промисловості України (порівняно з деякими іншими країнами), наведено динаміку основних показників вітчизняної вугільної галузі за останнє десятиріччя. Визначено найбільш актуальні проблеми розвитку галузі та заходи щодо їх вирішення.Изложена общая характеристика угольной промышленности Украины (в сравнении с некоторыми другими странами), приведена динамика основных показателей отечественной угольной отрасли за последнее десятилетие. Определены наиболее актуальные проблемы развития отрасли и меры по их решению.Coal mining of Ukraine is characterized (as compared with some other countries), dynamics of main native mining indices for the last ten years is demonstrated. The urgent problems of mining development have been identified and the ways to solve them as well

    Reluctance of general practice staff to register patients without documentation: a qualitative study in North East London.

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    BACKGROUND: Lack of access to documentation is a key barrier to GP registration, despite NHS England guidance stating that documents are not required. Staff attitudes and practice regarding registration of those without documentation are under- researched. AIM: To understand the processes through which registration might be refused for those without documents, and the factors operating to influence this. DESIGN AND SETTING: Qualitative study conducted in general practice across three clinical commissioning groups in North East London. METHOD: In total, 33 participants (GP staff involved in registering new patients) were recruited through email invitation. Semi-structured interviews and focus groups were conducted. Data were analysed using Braun and Clarke's reflexive thematic analysis. Two social theories informed this analysis: Lipsky's street-level bureaucracy and Bourdieu's theory of practice. RESULTS: Despite good knowledge of guidance, most participants expressed reluctance to register those without documentation, often introducing additional hurdles or requirements in their everyday practice. Two explanatory themes were generated: that those without documents were perceived as burdensome, and/or that moral judgements were made about their deservedness to finite resources. Participants described a context of high workload and insufficient funding. Some felt that GP services should be restricted by immigration status, as is widespread in secondary care. CONCLUSION: Improving inclusive registration practice requires addressing staff concerns, supporting navigation of high workloads, tackling financial disincentives to registering transient groups, and challenging narratives that undocumented migrants represent a 'threat' to NHS resources. Furthermore, it is imperative to acknowledge and address upstream drivers, in this instance the Hostile Environment

    The effect of a probiotic blend on gastrointestinal symptoms in constipated patients: A double blind, randomised, placebo controlled 2-week trial

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    Selected strains of lactobacilli and bifidobacteria are known to ameliorate constipation-related symptoms and have previously shown efficacy on digestive health. In this clinical trial, the safety and effectiveness of a probiotic blend containing lactobacilli and bifidobacteria were evaluated in adults with self-reported bloating and functional constipation. Constipation was diagnosed by the Rome III criteria. A total of 156 adults were randomised into this double-blind and placebo-controlled trial. Participants consumed the combination of Lactobacillus acidophilus NCFM (1010 cfu), Lactobacillus paracasei Lpc-37 (2.5×109 cfu), Bifidobacterium animalis subsp. lactis strains Bl-04 (2.5×109 cfu), Bi-07 (2.5×109 cfu) and HN019 (1010 cfu) (n=78), or placebo (microcrystalline cellulose) (n=78) for two weeks. After treatment the following were measured: primary outcome of bloating and secondary outcomes of colonic transit time, bowel movement frequency, stool consistency, other gastrointestinal symptoms (flatulence, abdominal pain, and burbling), constipation-related questionnaires (PAC-SYM and PAC-QoL) and product satisfaction. Faecal recovery of consumed strains was determined. The enrolled population was defined as constipated, however, the initial bloating severity was lower than in previous similar studies. No clinically significant observations related to the safety of the product were reported. Product efficacy was not shown in the primary analysis for bloating nor for the secondary efficacy analyses. The placebo functioned similarly as the probiotic product. In post-hoc analysis, a statistically significant decrease in flatulence in favour of the probiotic group was observed; day 7 (intention-to-treat (ITT): P=0.0313; per-protocol (PP): 0.0253) and on day 14 (ITT: P=0.0116; PP: P=0.0102) as measured by area under the curve (AUC) analysis. The mean AUC of all symptoms decreased in favour of the probiotic group, indicating less digestive discomfort. The study was registered at the ISRCTN registry (ISRCTN41607808)

    Holy Apparition or Hyper-Religiosity:Prevalence of Explanatory Models for Religious and Spiritual Experiences in Patients with Bipolar Disorder and Their Associations with Religiousness

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    One point that emerges from qualitative research on religion and bipolar disorder (BD) is the problem patients with BD experience in distinguishing between genuine religious experiences and hyper-religiosity. However, clinical practice does not obviously address communication about differences in explanatory models for illness experiences. The aim of the current study is first to estimate the frequencies of different types of explanations (medical versus religious) for experiences perceived as religious and related to BD, second to explore how these types relate to diagnosis and religiousness, and third to explore the frequency of expectation of treatment for religiosity. In total, 196 adult patients at a specialist outpatient center for BD in the Netherlands completed a questionnaire consisting of seven types of explanations for religious experiences and several items on religiousness. Of the participants who had had religious experiences (66%), 46% viewed the experiences as 'part of spiritual development' and 42% as 'both spiritual and pathological,' 31% reported 'keeping distance from such experiences,' and 15% viewed them as 'only pathological.' Measures of religiousness were positively associated with 'part of spiritual development' and negatively associated with 'keeping distance from the experiences' and 'only pathological.' Half of the sample viewed religiosity as an important topic in treatment. It can be hypothesized that strength of religiousness may help people to integrate destabilizing experiences related to BD into their spiritual development. However, the ambiguity of strong religious involvement in BD necessitates careful exploration of the subject in clinical practice

    Influence of 2 '-fucosyllactose and galacto-oligosaccharides on the growth and adhesion of Streptococcus mutans

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    Human milk oligosaccharides, such as 2 '-fucosyllactose (2 '-FL), and galacto-oligosaccharides (GOS), a prebiotic carbohydrate mixture, are being increasingly added to infant formulas, necessitating the understanding of their impact on the oral microbiota. Here, for the first time, the effects of 2 '-FL and GOS on the planktonic growth and adhesion characteristics of the caries-associated oral pathogenStreptococcus mutanswere assessed, and the results were compared against the effects of xylitol, lactose and glucose. There were differences inS. mutansgrowth between 2 '-FL and GOS. None of the threeS. mutansstrains grew with 2 '-FL, while they all grew with GOS as well as lactose and glucose. Xylitol inhibitedS. mutansgrowth. The adhesion ofS. mutansCI 2366 to saliva-coated hydroxyapatite was reduced by 2 '-FL and GOS. Exopolysaccharide-mediated adhesion ofS. mutansDSM 20523 to a glass surface was decreased with 2 '-FL, GOS and lactose, and the adhesion of strain CI 2366 strain was reduced only by GOS. Unlike GOS, 2 '-FL did not support the growth of anyS. mutansstrain. Neither 2 '-FL nor GOS enhanced the adhesive properties of theS. mutansstrains, but they inhibited some of the tested strains. Thus, the cariogenic tendency may vary between infant formulas containing different types of oligosaccharides

    Composition and teaching quality characteristics in schools for secondary education:Results from secondary analyses on the Dutch OECD-TALIS 2013 data

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    The current study presents the results of secondary analyses on the Dutch data in the Teaching and Learning International Survey (TALIS) from the OECD. Using multi-level regression analyses, job satisfaction, teaching quality characteristics as well as need for professional development are investigated in schools that vary according to composition. The results show that teachers in schools with relatively large percentages of students from low socio-economic backgrounds are less satisfied with their profession, they show lower levels of self-efficacy and less positive student-teacher relationships. In schools with relatively large percentages of students who have a different home language than the language of instruction, the results show no relationships with job satisfaction and the educational quality characteristics. The results also show that teachers in schools with low SES pupils and pupils with different home languages have more need for professional development in the area of diversity and this is especially true for beginning teachers. The study ends with recommendations for future research and educational practice.</p

    Effects of an acute physical activity break on test anxiety and math test performance

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    (1) Background: Test anxiety has been found to negatively affect students’ mental health and academic performance. A primary explanation for this is that anxiety-related thoughts occupy working memory resources during testing that cannot be used for test-related processes (such as information retrieval and problem-solving). The present intervention study investigated whether physical activity could decrease anxiety levels and improve math test performance in sixth-grade children. (2) Methods: Sixty-eight children of 11–12 years from two primary schools in New South Wales, Australia were categorised as low or high anxious from their scores on a trait-anxiety questionnaire. After this assessment, they were randomly assigned to the activity break condition, in which they had to do several physical activities of moderate intensity (e.g., star jumps) for 10 min, or the control condition, in which they played a vocabulary game for 10 min. The outcome measures were children’s anxiety levels at the beginning, during, and at the end of the test, invested mental effort, perceived task difficulty and math test perfo

    Mutational and phenotypic characterisation of hereditary hemorrhagic telangiectasia

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    Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular dysplasia. Care delivery for HHT patients is impeded by the need for laborious, repeated phenotyping and gaps in knowledge regarding the relationships between causal DNA variants in ENG, ACVRL1, SMAD4 and GDF2, and clinical manifestations. To address this, we analyzed DNA samples from 183 previously uncharacterized, unrelated HHT and suspected HHT cases using the ThromboGenomics high-throughput sequencing platform. We identified 127 rare variants across 168 heterozygous genotypes. Applying modified American College of Medical Genetics and Genomics Guidelines, 106 variants were classified as pathogenic/likely pathogenic and 21 as nonpathogenic (variant of uncertain significance/benign). Unlike the protein products of ACVRL1 and SMAD4, the extracellular ENG amino acids are not strongly conserved. Our inferences of the functional consequences of causal variants in ENG were therefore informed by the crystal structure of endoglin. We then compared the accuracy of predictions of the causal gene blinded to the genetic data using 2 approaches: subjective clinical predictions and statistical predictions based on 8 Human Phenotype Ontology terms. Both approaches had some predictive power, but they were insufficiently accurate to be used clinically, without genetic testing. The distributions of red cell indices differed by causal gene but not sufficiently for clinical use in isolation from genetic data. We conclude that parallel sequencing of the 4 known HHT genes, multidisciplinary team review of variant calls in the context of detailed clinical information, and statistical and structural modeling improve the prognostication and treatment of HHT
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