Mammography Social Support for Women Living in a Midwestern City: Toward Screening Promotion via Social Interactions

Notwithstanding recommendations and interventions, the percentage of 50 – 74-year-old U.S. women who reported having had a mammography in the past two years remained below target coverage. Social interactions may influence mammography rates. To measure characteristics of social interactions in a Midwestern city as they relate to social support for mammography received by women older than 40 years of age. A cross-sectional study was conducted in Bloomington, Indiana, sending mail surveys to 3,000 telephone directory addresses selected by simple random sampling. An anonymous, self-administered, closed-ended, questionnaire with eight checklist items (for demographics) and six multipart semantic differential scale items (for social support), derived from validated instruments, was used. Social support for mammography in women who had undergone regular screening was analyzed using chi-square test and logistic regression. Of 450 respondents with valid responses, 91% were white; 47% were older than 80; 92% had good health insurance coverage; and 82% had undergone regular mammography. Healthcare workers provided the highest support, followed by children, siblings, and relatives. Friends, neighbors, and co-workers were least supportive. In social interactions, emotional support was the most prominent, followed by informational, appraisal, and instrumental supports. Having higher income and being married were associated with receiving greater support. Although mammography provides limited benefits after age 74, women older than 80 years of age received the highest support. Identifying the structural and functional characteristics of social interactions is important for: 1) designing interventions that enhance social support, and 2) expanding breast cancer screening via personalized approaches using existing social interactions

Caves and karst-like features in Proterozoic gneiss and Cambrian granite, southern and central Sri Lanka: An introduction

There has been little study of the geology and geomorphologyof the caves and karst-like features developed in the Proterozoicgneiss and Cambrian granite of Sri Lanka. This lack of studyis surprising given that caves and rockshelters in these rockscontain significant archaeological and cultural sites. Caves andkarren, both mimicking those developed in carbonate rocks,have formed both in gneiss, which is the dominant rock type ofthe Proterozoic crust of the island and in granite. In addition tooverhangs, boulder caves, soil pipes and tectonic caves, tunnelcaves, arch caves and block breakdown caves of significant sizeare developed in siliceous rocks in Sri Lanka. While metamorphoseddolomites are interfoliated within the gneissic suite,simple removal of carbonate by solution from within the surroundingrock cannot account for all or most of the speleogenesisobserved. While spalling and breakdown are responsiblefor cave enlargement cave initiation is probably due to eitherphreatic solution of silicates and/or phantom rock processes.Speleothems and cave minerals including silicates, phosphates,gypsum, carbonates and niter are found in the caves. Activesilicate speleothems are not restricted to joints and fissures andsuggest that solution of silicates is currently occurring withinthe body of the rock in the vadose zone. While guano is thelikely source of the phosphate, sulfate and nitrate, the sourceof the calcium in the carbonates remains unclear. Caves in theintrusive and metamorphic rocks of Sri Lanka are enigmatic.They are unexpectedly similar in appearance to their carbonatekarst counterparts. Continuing research will allow them tohold a mirror to our understanding of speleogenesis, mineralizationand sedimentation in carbonate karst caves

Rating Valuation Model for Residential Properties in Sri Lanka: Case Study in Homagama

Similar to the most countries, the property tax is the main source of income in local government authorities in Sri Lanka.  Property taxes include a variety of taxes on land, building & other immovable property. Rating is one form of property taxes and it is the major property tax in Sri Lanka.  The current practice of rating levying in the country is on the basis of Annual Value of the property. However, in some developed countries such as United Kingdom, it is calculated on the basis of the capital value. Hence, the aim of this research is searching for an alternative approach for rating valuation based on the capital value of the property. Data collection was mainly done with the help of Rating Cards maintained by the Government Valuation Department of Sri Lanka. Results indicate that six main factors significantly influence in calculating the capital value. Hence, the final model, which is based on both land and building values was calculated according to the six factors that were significant in the analysis. Key Words: Rating Valuation, Capital Value, Annual Value, Mass Appraisal, Valuation Mode

Influence of the geometry of partially-spanning joints on mechanical properties of rock in uniaxial compression

As jointed rocks consist of joints embedded within intact rock blocks, their behavior depends on the behaviors of the joints and the intact rock blocks. In a jointed rock, there are two levels of heterogeneity within the jointed rocks due to the differences in properties between the rock blocks and the joints at a macro-scale, and within the intact rock blocks due to difference in the randomly-distributed flaws at a meso-scale. In this paper, numerical tests on plane stress numerical specimens with an embedded, partially-spanning joint are reported. The individual influence of three parameters relating to the geometry of partially-spanning joints: joint location, joint orientation and trace length was studied. In the simulations, the joints were modeled by elements with low moduli and strengths, whereas the heterogeneity of the rock properties of the intact rock block was taken into account by assuming that they obey the Weibull distribution. The numerical simulations not only agreed well with the experimental results, but also duplicated the complete rupture process of samples with the stress evolution and tempo-spatial distribution of damage events. The numerical results show that there is an approximately linear relationship between the location of the terminus of the partially-spanning joint with respect to the end of the sample (joint location) and the compressive strength of the partially-cut sample, whereby failure stress increases with increasing joint location value. With respect to joint orientation, the simulations show that the minimum compressive strength occurs for a joint angle of 45°, and that compressive strength increases with both increasing joint angle and decreasing joint angle from this critical value of 45°. In relation to the joint trace length, the numerical results reveal that the compressive strength of partially-cut specimens is correlated with the joint trace length using an approximately linear relationship. © 2013 Elsevier B.V

A Polypill for primary prevention of cardiovascular disease: A feasibility study of the World Health Organization

<p>Abstract</p> <p>Background</p> <p>The feasibility of conducting a large-scale Polypill clinical trial in developing countries remains unclear. More information is needed regarding the efficacy in reducing the risk factors of cardiovascular disease (CVD), side effects, improvement in adherence and physician/patient "acceptability" of the Polypill.</p> <p>Methods</p> <p>We conducted an open-label, parallel-group, randomized clinical trial involving three sites in Sri Lanka that enrolled a total of 216 patients without established CVD. The trial compared a Polypill (75 mg aspirin, 20 mg simvastatin, 10 mg lisinopril and 12.5 mg hydrochlorothiazide) to Standard Practice. After randomization, patients were followed monthly for three months. Pre-specified primary outcomes included reduction in systolic blood pressure, total cholesterol and estimated 10-year CVD risk. We also evaluated the recruitment process and acceptability of the Polypill by both physicians and patients.</p> <p>Results</p> <p>Patients were recruited in a six-month period as planned. Two hundred three patients (94.0%) completed the treatment program and returned for their three-month follow-up visits. No safety concerns were reported. These findings suggest a high rate of patient acceptability, a finding that is bolstered by the majority of patients completing the trial (90%) indicating that they would take the Polypill "for life" if proven to be effective in reducing CVD risk. Approximately 86% of the physicians surveyed agreed with and supported use of the Polypill for primary prevention and 93% for secondary prevention of CVD. Both the Polypill and Standard Practice resulted in marked reductions in systolic blood pressure, total cholesterol and 10-year risk of CVD. However, the differences between the treatment groups were not statistically significant.</p> <p>Conclusions</p> <p>We successfully completed a Polypill feasibility trial in Sri Lanka. We were able to document high acceptability of the Polypill to patients and physicians. We were unable to estimate the risk factor reductions on the Polypill because the control group received similar treatment with individual drugs. The Polypill was however simpler and achieved comparable risk factor reductions, highlighting its potential usefulness in the prevention of CVD.</p> <p>Trial registration number</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/NCT00567307">NCT00567307</a></p

IMPORTANCE OF IMPROVING BIOLOGICAL ACTIVITY OF TEA SOILS IN SOUTHERN PROVINCE OF SRI LANKA.

The detrimental effects of soil pesticides on soil micro biota and biodiversity of the teaecosystem are poorly understood. In the current study, microbial activity in southern teasoils of Sri Lanka as affected by application of commonly used soil pesticides and certaincultural practices was evaluated by m-:asuring the soil respiration in vitro and in vivo.CO2 evolution rates in Southern tea soils were generally low as compared to soils in otherareas. Herbicide and formalin applications significantly (p=O.005) suppressed thebiological activity of Southern tea soils; the nematicide tested was less effective.Incorporation of compost and tea waste significantly (p=O.005) elevated CO2 evolution ratein tea soils than that of in undisturbed, virgin forest soils. Forking strengthened microbialbiomass through improved soil physical conditions. Soil biomass was positively correlatedwith growth of the test plants viz tea and tomatoSouthern tea soils with low organic matter contents arc exposed to repeated application ofherbicides and negligence of important agronomic practices due to labour shortage. Suchmalpractices could aggravate potential build up of pesticide residues in the soil. Thus,improvement of soil organic matter status by incorporation of various organic amendments,establishment of green manure crops, rehabilitation of old tea soils and more importantly,restricted usage of agro-chemicals etc. is essential. These practices will assure long-termsustainable productivity and quality of soils as well as help degrade accumulated chemicalresidues and elevate densities of soil microbial communities. As a consequence, increasedefficacy of bio control of nematodes and soil borne pathogens and proper administration ofnatural nutrient cycles could be envisaged.

Chikungunya as a cause of acute febrile illness in southern Sri Lanka

10.1371/journal.pone.0082259PLoS ONE812-POLN

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries