712 research outputs found

    The Ecosystem Services for a sustainable multi-level planning. The Project Life SAM4CP. 8th Conference of Ecosystem Services Partnership, 9-13 November 2015, South Africa.

    Get PDF
    The poster highlights the ways by which Ecosystem Services (ES) mapping tools and techniques can be used effectively in decision-making problems when programming and planning the city and the territory. The supported thesis is that the analysis of ES finds the benefits of each planning option and thus help in deciding the optimum trough a multilevel governance model

    Systemic lupus erythematosus and implications for the oral cavity

    Get PDF
    Systemic Lupus Erythematosus affects several people around the world and because it is characterized as a chronic inflammatory disease of multifactorial origin, and with systemic impairment, great attention must be paid from diagnosis to treatment in order to optimize the entire follow-up of the patient. The dental doctor plays an important role in the diagnosis of the condition and must be attentive to the early signs that can appear in the oral cavity with a frequency of up to 21%. In this way, through this bibliographic review, which has as main goal to correlate Systemic Lupus Erythematosus with its direct consequences in the oral cavity, it will be possible to help dentists in the diagnosis, to understand in detail the development of the disease and what attitude should be taken in its presence.info:eu-repo/semantics/publishedVersio

    The Validity of Patient-Reported Short-Term Complications following Total Hip and Knee Arthroplasty

    Get PDF
    Introduction: Given the lack of national data on outcomes of on patients who undergo total joint arthroplasty (TJA) and the limitations of hospital databases to capture information on patients who seek post-TJA care elsewhere, there is growing interest in using patient self-report to identify possible complications following surgery. We examined the concordance between patients self-report of potential short-term complications with review of available medical records as well as the location of the reported post-operative care. Material & Methods: Patients undergoing primary hip or knee arthroplasty from 7/1/11 through 12/3/12 participating in a tertiary care center were identified. Patients completed a 6-month post-operative survey regarding needing evaluation at an emergency department, day surgery or hospitalization for possible medical or mechanical complications and the location of care. We reviewed available inpatient and outpatient medical records to identify the location of postoperative care as well as the validity of patient self-report (sensitivity, specificity, positive predictive values and negative predictive values). Results: There were 413 patients who had 431 surgeries and completed the 6-month questionnaire. Patients reported 40 medical encounters including emergency department, day surgery or inpatient care resulting in a 9% reported complication rate, of which 20% occurred at outside hospitals Overall patient self-report of emergency department, day surgery and inpatient care for possible complications was both sensitive (82%) and specific (100%). The positive predictive value was 100% and negative predictive value 98%. Conclusion: Given the prevalence of events requiring care at outlying hospitals and the accuracy of self-report, methods that directly engage patients can augment current surveillance procedures

    efficacy of botulinum toxin type a treatment of functional impairment of degenerative hip joint preliminary results

    Get PDF
    Objective: the aim of this study was to investigate the effect of botulinum toxin type a injection into the adductor muscles in reducing pain and improving joint mobility and quality of life in patients affected by hip osteoarthritis. Methods: a total of 39 outpatients, mean age 68 years (age range 41–82 years), were evaluated using the harris hip Score to test hip function, a visual analogue scale to measure pain intensity and the Short Form 36 (SF-36) questionnaire to assess patient well-being and quality of life at baseline, 2, 4 and 12 weeks after treatment with botulinum toxin type a. a total of 400 u of botulinum toxin type a (Dysport) was injected into the adductor longus muscle and the adductor magnus muscle. Results: The Harris Hip Score increased significantly after 2, 4 and 12 weeks (df 3, χ 2 = 45.1; p < 0.0001). A significant decrease in pain intensity was detected at all the follow-up visits, after 2, 4 and 12 weeks (df 3; χ 2 = 27.8; p < 0.001). the SF-36 score was significantly higher 4 and 12 weeks after treatment. At each evaluation visit a significant correlation was detected between decreased pain and improved hip mobility. Conclusion: Botulinum toxin type a induced a reduction in pain, indicating that this might be an innovative, less invasive treatment in patients affected by severe hip osteoarthritis, with remarkable effects on the clinical management of this disease

    Efficacy of botulinum toxin type A treatment of functional impairment of degenerative hip joint: Preliminary results

    Get PDF
    Objective: the aim of this study was to investigate the effect of botulinum toxin type a injection into the adductor muscles in reducing pain and improving joint mobility and quality of life in patients affected by hip osteoarthritis. Methods: a total of 39 outpatients, mean age 68 years (age range 41–82 years), were evaluated using the harris hip Score to test hip function, a visual analogue scale to measure pain intensity and the Short Form 36 (SF-36) questionnaire to assess patient well-being and quality of life at baseline, 2, 4 and 12 weeks after treatment with botulinum toxin type a. a total of 400 u of botulinum toxin type a (Dysport) was injected into the adductor longus muscle and the adductor magnus muscle. Results: The Harris Hip Score increased significantly after 2, 4 and 12 weeks (df 3, χ 2 = 45.1; p < 0.0001). A significant decrease in pain intensity was detected at all the follow-up visits, after 2, 4 and 12 weeks (df 3; χ 2 = 27.8; p < 0.001). the SF-36 score was significantly higher 4 and 12 weeks after treatment. At each evaluation visit a significant correlation was detected between decreased pain and improved hip mobility. Conclusion: Botulinum toxin type a induced a reduction in pain, indicating that this might be an innovative, less invasive treatment in patients affected by severe hip osteoarthritis, with remarkable effects on the clinical management of this disease

    Trend analysis of tuberculosis case notifications with scale-up of antiretroviral therapy and roll-out of isoniazid preventive therapy in Zimbabwe, 2000-2018.

    Get PDF
    OBJECTIVES: Antiretroviral therapy (ART) and isoniazid preventive therapy (IPT) are known to have a tuberculosis (TB) protective effect at the individual level among people living with HIV (PLHIV). In Zimbabwe where TB is driven by HIV infection, we have assessed whether there is a population-level association between IPT and ART scale-up and annual TB case notification rates (CNRs) from 2000 to 2018. DESIGN: Ecological study using aggregate national data. SETTING: Annual aggregate national data on TB case notification rates (stratified by TB category and type of disease), numbers (and proportions) of PLHIV in ART care and of these, numbers (and proportions) ever commenced on IPT. RESULTS: ART coverage in the public sector increased from 1.1 million PLHIV patients) by December 2018, while IPT coverage among PLHIV in ART care increased from <1% (98 PLHIV) in 2012 to ~33% (373 917 PLHIV) by December 2018. These HIV-related interventions were associated with significant declines in TB CNRs: between the highest CNR prior to national roll-out of ART (in 2004) to the lowest recorded CNR after national IPT roll-out from 2012, these were (1) for all TB case (510 to 173 cases/100 000 population; 66% decline, p<0.001); (2) for those with new TB (501 to 159 cases/100 000 population; 68% decline, p<0.001) and (3) for those with new clinically diagnosed PTB (284 to 63 cases/100 000 population; 77.8% decline, p<0.001). CONCLUSIONS: This study shows the population-level impact of the continued scale-up of ART among PLHIV and the national roll-out of IPT among those in ART care in reducing TB, particularly clinically diagnosed TB which is largely associated with HIV. There are further opportunities for continued mitigation of TB with increasing coverage of ART and in particular IPT which still has a low coverage

    Location of All-cause 30-day Readmission Following Total Joint Replacement: Surgical Hospital Versus Outside Hospital

    Get PDF
    Background: Evaluating posthospital complications and hospital readmissions in the United States is limited under the current system. This is due to an inability to quantify posthospital care delivered to patients at locations other than the surgical hospital. In order to circumvent this issue, information can be sought directly from patients about posthospital health care utilization. This approach provides a more complete record in comparison with methods that evaluate complications treated only at the surgical hospital. Methods: Participants undergoing total joint replacement (TJR) between 5/10/11 and 5/17/11 were identified from the Function and Outcomes Research in Comparative Effectiveness Registry (FORCE-TJR) cohort. The cohort is a nationally representative sample of TJR patients undergoing total knee replacement and total hip replacement. Patients are asked to self-report complications on the six-month follow-up questionnaire. The questionnaire specifically inquires about any emergency department visit, outpatient surgery, or hospital admission that occurred within six months of the total joint replacement surgery. For each positive report of postoperative complication, the pertinent medical records are retrieved and reviewed and discharge diagnoses are used to identify whether the complication is a surgical site symptom or a medical complication. The location of the care is identified as the surgical hospital or an outside hospital. We report on the location of all readmissions within 30 days of discharge from the initial TJR surgery. Results: In total, our sample yielded 112 validated patient-reported readmissions following TJR. Of these readmissions, 75% were treated at the surgical hospital and 25% were treated at an outside hospital. Patients receiving care at the surgical hospital were similar in terms of demographics compared with those seeking care at an outside hospital in terms of mean age (66.7 years vs. 66.9 years, p=0.92), and gender (67.9% male vs. 63.1% male, p=0.65). Additionally, the mean number of days since discharge was similar (16.7 days vs. 15.1 days, p = 0.45) among patients treated at the surgical hospital compared with those treated at an outside hospital. Discharge diagnoses varied by the location of care. At the surgical hospital, discharge diagnoses identified surgical site symptoms as the cause of 36.9% of admissions and medical conditions as the cause of 63.1% of admissions. When compared with discharge diagnoses at outside hospitals, surgical site symptoms accounted for 17.9% of admissions and medical conditions for 82.1% (p=0.067). Conclusion: Public reporting of all post-TJR discharge complications is currently used to compare quality of care between hospitals. However, our study demonstrates that hospitals and surgeons may underestimate their complication rates by 25%. This suggests that novel approaches, such as direct to patient contact, are needed to minimize missing post-hospital event data

    In-beam fast-timing measurements in 103,105,107Cd

    Full text link
    Fast-timing measurements were performed recently in the region of the medium-mass 103,105,107Cd isotopes, produced in fusion evaporation reactions. Emitted gamma-rays were detected by eight HPGe and five LaBr3:Ce detectors working in coincidence. Results on new and re-evaluated half-lives are discussed within a systematic of transition rates. The 7/21+7/2_1^+ states in 103,105,107Cd are interpreted as arising from a single-particle excitation. The half-life analysis of the 11/2111/2_1^- states in 103,105,107Cd shows no change in the single-particle transition strength as a function of the neutron number

    The Cosmic Microwave Background in an Inhomogeneous Universe - why void models of dark energy are only weakly constrained by the CMB

    Full text link
    The dimming of Type Ia supernovae could be the result of Hubble-scale inhomogeneity in the matter and spatial curvature, rather than signaling the presence of a dark energy component. A key challenge for such models is to fit the detailed spectrum of the cosmic microwave background (CMB). We present a detailed discussion of the small-scale CMB in an inhomogeneous universe, focusing on spherically symmetric `void' models. We allow for the dynamical effects of radiation while analyzing the problem, in contrast to other work which inadvertently fine tunes its spatial profile. This is a surprisingly important effect and we reach substantially different conclusions. Models which are open at CMB distances fit the CMB power spectrum without fine tuning; these models also fit the supernovae and local Hubble rate data which favours a high expansion rate. Asymptotically flat models may fit the CMB, but require some extra assumptions. We argue that a full treatment of the radiation in these models is necessary if we are to understand the correct constraints from the CMB, as well as other observations which rely on it, such as spectral distortions of the black body spectrum, the kinematic Sunyaev-Zeldovich effect or the Baryon Acoustic Oscillations.Comment: 23 pages with 14 figures. v2 has considerably extended discussion and analysis, but the basic results are unchanged. v3 is the final versio
    corecore