92 research outputs found

    An orbital analysis technique for sharply varying geophysical phenomena

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    Orbital analysis technique for sharply varying geophysical phenomen

    European Migration in the Late Twentieth Century

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    Migration in Europe is a pressing social and political issue for the policy makers of the 1990s. Drawing upon a wide body of language, expertise and analysis, the book combines an important survey with a series of detailed country studies on migration in Europe. The authoritative overview essay by the editors examines migration to and within Europe. They compare the flow during the last forty years with the present situation, detailing both the magnitude and geography of migration over this period. This is followed by thirteen individual country studies each of which features an historical introduction to emigration and immigration in the featured country, quantitative data sets and a detailed assessment of the social and political implications. These studies- specially prepared by leading scholars- cover the United Kingdom, France, Germany, The Netherlands, Switzerland, Italy, Israel, Austria, Hungary, Poland, Bulgaria, the former Yugoslavia, and the former USSR. This comprehensive and scholarly book will be welcomed by teachers and researchers of social sciences and history for presenting new insights into one of the key political, social and economic issues facing modern Europe

    Conditional Survival in Patients with Thyroid Cancer

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    Background: Thyroid cancer is an increasingly common malignancy. Although likelihood of survival from well-differentiated thyroid cancer can vary by disease severity, it is not known how patients' life expectancies change the farther they are from time of diagnosis. Methods: Using data from the Surveillance, Epidemiology, End Results (SEER) registry, we selected patients diagnosed with well-differentiated thyroid cancer (N=43,392) between 1998 and 2005. Patients were followed for up to 12 years. Conditional survival estimates by SEER stage and age were obtained based on Cox proportional hazards regression model of disease-specific survival. Results: Patients with localized thyroid cancer have excellent conditional 5-year survival, irrespective of where they are in their survivorship phase. Patients with regional thyroid cancer have relatively stable conditional 5-year survival, whereas for patients with distant thyroid cancer there is gradual improvement the farther from time of diagnosis. Age and gender influence conditional survival. Similarly, age has a strong effect on disease-specific survival for patients with thyroid cancer with localized (hazard ratio [HR] 88.7 [95% confidence interval {CI} 26.3?552), comparing age ≥80 with <30 years), regional (HR 105 [95% CI 52.6?250]), and distant disease [HR 86.8 (95% CI 32.5?354)]. Male gender is also associated with a significantly worse disease-specific survival among patients with regional disease (HR 1.56 [95% CI 1.31?1.85]) but not among patients with localized or distant disease. Conclusion: Cancer stage, gender, age at diagnosis, and length of time already survived can influence conditional survival for patients with thyroid cancer. Understanding the conditional 5-year disease-specific survival of well-differentiated thyroid cancer is key to creating treatment plans and tailoring surveillance.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140260/1/thy.2014.0264.pd

    Treatment of hyperphosphatemia in hemodialysis patients: The Calcium Acetate Renagel Evaluation (CARE Study)

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    Treatment of hyperphosphatemia in hemodialysis patients: The Calcium Acetate Renagel Evaluation (CARE Study).BackgroundHyperphosphatemia underlies development of hyperparathyroidism, osteodystrophy, extraosseous calcification, and is associated with increased mortality in hemodialysis patients.MethodsTo determine whether calcium acetate or sevelamer hydrochloride best achieves recently recommended treatment goals of phosphorus ≤5.5mg/dL and Ca × P product ≤55mg2/dL2, we conducted an 8-week randomized, double-blind study in 100 hemodialysis patients.ResultsComparisons of time-averaged concentrations (weeks 1 to 8) demonstrated that calcium acetate recipients had lower serum phosphorus (1.08mg/dL difference, P = 0.0006), higher serum calcium (0.63mg/dL difference, P < 0.0001), and lower Ca × P (6.1mg2/dL2 difference, P = 0.022) than sevelamer recipients. At each week, calcium acetate recipients were 20% to 24% more likely to attain goal phosphorus [odds ratio (OR) 2.37, 95% CI 1.28–4.37, P = 0.0058], and 15% to 20% more likely to attain goal Ca × P (OR 2.16, 95% CI 1.20–3.86, P = 0.0097). Transient hypercalcemia occurred in 8 of 48 (16.7%) calcium acetate recipients, all of whom received concomitant intravenous vitamin D. By regression analysis hypercalcemia was more likely with calcium acetate (OR 6.1, 95% CI 2.8–13.3, P < 0.0001). Week 8 intact PTH levels were not significantly different. Serum bicarbonate levels were significantly lower with sevelamer hydrochloride treatment (P < 0.0001).ConclusionCalcium acetate controls serum phosphorus and calcium-phosphate product more effectively than sevelamer hydrochloride. Cost-benefit analysis indicates that in the absence of hypercalcemia, calcium acetate should remain the treatment of choice for hyperphosphatemia in hemodialysis patients

    The relationship between blood–brain barrier dysfunction and neurocognitive impairments in first-episode psychosis: findings from a retrospective chart analysis

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    Background Even before the onset of psychotic symptoms, individuals with schizophrenia display cognitive impairments. Simultaneously, increasing amounts of individuals exhibit dysfunction of the blood–brain barrier (BBB). However, the impact of BBB dysfunction on neurocognitive impairment in people with first-episode psychosis has not yet been investigated. Aims To advance understanding of said relationship, we considered one of the largest first-episode psychosis cohorts with cerebrospinal fluid parameters available, and investigated whether BBB dysfunction is related to working memory, working speed and attention. Method We conducted a retrospective chart review of 121 in-patients diagnosed with a first episode of a schizophrenia spectrum disorder. Patients underwent neurocognitive testing and a lumbar puncture within routine clinical care. To define BBB dysfunction, albumin cerebrospinal fluid/serum quotients, immunoglobulin G ratios and oligoclonal band types were evaluated, and gender-specific differences investigated. Neurocognitive functioning was assessed by the Wechsler Adult Intelligence Scale, Test of Attentional Performance and Repeatable Battery for the Assessment of Neuropsychological Status. We performed simple and multiple linear regression analyses to interpret associations of interest. Results Of those tested, 16% showed an alteration in albumin quotients and 12% had an oligoclonal band type indicating BBB dysfunction. Notably, male patients were more likely to have an increased albumin quotient and a higher immunoglobulin G ratio than female patients. We found no significant association between BBB dysfunction and neurocognitive assessments. Conclusions The hypothesised relationship between BBB and neurocognitive impairments was not detectable in our retrospective cohort. Further cerebrospinal fluid-based studies with a longitudinal assessment of cognitive functioning and disease trajectory are urgently needed

    Development and preliminary validation of a questionnaire to measure satisfaction with home care in Greece: an exploratory factor analysis of polychoric correlations

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    <p>Abstract</p> <p>Background</p> <p>The primary aim of this study was to develop and psychometrically test a Greek-language instrument for measuring satisfaction with home care. The first empirical evidence about the level of satisfaction with these services in Greece is also provided.</p> <p>Methods</p> <p>The questionnaire resulted from literature search, on-site observation and cognitive interviews. It was applied in 2006 to a sample of 201 enrollees of five home care programs in the city of Thessaloniki and contains 31 items that measure satisfaction with individual service attributes and are expressed on a 5-point Likert scale. The latter has been usually considered in practice as an interval scale, although it is in principle ordinal. We thus treated the variable as an ordinal one, but also employed the traditional approach in order to compare the findings. Our analysis was therefore based on ordinal measures such as the polychoric correlation, Kendall's Tau b coefficient and ordinal Cronbach's alpha. Exploratory factor analysis was followed by an assessment of internal consistency reliability, test-retest reliability, construct validity and sensitivity.</p> <p>Results</p> <p>Analyses with ordinal and interval scale measures produced in essence very similar results and identified four multi-item scales. Three of these were found to be reliable and valid: socioeconomic change, staff skills and attitudes and service appropriateness. A fourth dimension -service planning- had lower internal consistency reliability and yet very satisfactory test-retest reliability, construct validity and floor and ceiling effects. The global satisfaction scale created was also quite reliable. Overall, participants were satisfied -yet not very satisfied- with home care services. More room for improvement seems to exist for the socio-economic and planning aspects of care and less for staff skills and attitudes and appropriateness of provided services.</p> <p>Conclusions</p> <p>The methods developed seem to be a promising tool for the measurement of home care satisfaction in Greece.</p
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