Abstract Objective Health-related quality of life (HRQOL) is an important outcome for patients living with chronic kidney disease (CKD), and it is necessary to better understand potential gender and ...racial differences as well as predictors associated with reduced HRQOL so effective interventions can be developed. Methods Participants included 182 patients with CKD who were administered a battery of questions that included the Medical Outcomes Study- Short Form 36; Perceived Stress Scale, and the Brief COPE. Demographic and disease specific information was abstracted from the patients’ medical record. Results No differences by race were observed with regard to stress, quality of life or coping with the exception that minority patients reported use of religious coping more often (p=0.001) and had higher levels of energy when compared to non-minority CKD patients (p=0.27). Women with CKD tended to use self-distraction (p=0.002), positive reframing (p=0.035), venting (p=0.024), and religious coping (p=0<0.001) more often than men. No significant differences in perceived stress or domains of quality of life were observed between men and women with CKD. A link between coping strategies and HRQOL was observed in women (p=0.001-0.02) but not men. Perceived stress was associated with poorer quality of life for men (p=0.017-<0.001) and women (p=0.001-<0.001), but more domains of men’s quality of life were affected by perceived stress when compared to women. Conclusions The findings of the study suggest that the wider range of coping strategies used by women may be associated with buffering the link between perceived stress and quality of life. Men with CKD may benefit from interventions that not only reduce stress but also facilitate the use of a broader range of coping strategies to reduce stress and improve quality of life.
We describe ncWMS, an implementation of the Open Geospatial Consortium's Web Map Service (WMS) specification for multidimensional gridded environmental data. ncWMS can read data in a large number of ...common scientific data formats – notably the NetCDF format with the Climate and Forecast conventions – then efficiently generate map imagery in thousands of different coordinate reference systems. It is designed to require minimal configuration from the system administrator and, when used in conjunction with a suitable client tool, provides end users with an interactive means for visualizing data without the need to download large files or interpret complex metadata. It is also used as a “bridging” tool providing interoperability between the environmental science community and users of geographic information systems. ncWMS implements a number of extensions to the WMS standard in order to fulfil some common scientific requirements, including the ability to generate plots representing timeseries and vertical sections. We discuss these extensions and their impact upon present and future interoperability. We discuss the conceptual mapping between the WMS data model and the data models used by gridded data formats, highlighting areas in which the mapping is incomplete or ambiguous. We discuss the architecture of the system and particular technical innovations of note, including the algorithms used for fast data reading and image generation. ncWMS has been widely adopted within the environmental data community and we discuss some of the ways in which the software is integrated within data infrastructures and portals.
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Different proteins such as antibodies, antigens, and enzymes were immobilized within the 100 × 100 × 20-μm gel pads of protein microchips. A modified polyacrylamide gel has been developed to ...accommodate proteins of a size up to 400,000 daltons. Electrophoresis in the microchip reaction chamber speeded up antigen–antibody interactions within the gel. Protein microchips were used in immunoassays for detection of antigens or antibodies, as well as to carry out enzymatic reactions and to measure their kinetics in the absence or presence of an inhibitor. A protein microchip can be used several times in different immunoassays and enzymatic kinetic measurements.
Here we present geomorphologic, palaeoenvironmental and archaeo-botanical data which elucidate the Late Pleistocene and Holocene glacial history of the high, mountain-locked Himalayan valleys in ...northwest Bhutan and provide one of the earliest proofs of human activity yet known for the High Himalaya range. In this area, difficult to access, close linkage between climatic change, glacier fluctuations and human migration patterns has been discovered. Glacier systems in the studied area are characterized by avalanching and debris mantled glacier snouts, with the significant local influence of the Indian summer monsoon causing decoupling of glacier responses from temperature changes but supporting the idea of monsoonal forcing. Geomorphologic mapping, together with Optically Stimulated Luminescence (OSL) and radiocarbon dating of ice-proximal sediments, has been used to construct a local glacial chronology. Local ice-stream networks developed during the Early Holocene (ca 10,000–9000
a ago) and during the early part of the Mid Holocene (6710
±
90–4680
±
155
cal
a
BP) at which times there were ice advances of about 5
km from the modern glacier termini. At such times, the intensity of pro- and periglacial processes would have intensified and ice-dammed lakes were probably common as well, rendering human colonization of the high valleys in northwest Bhutan impossible. An abrupt shift to dry climatic conditions on the Tibetan Plateau between 5000 and 4500
a
BP coincided with glacial decay and the onset of morphodynamically stable conditions on the broad valley floors of the high valleys in this part of the Himalaya. Palynological data suggest that the sudden disappearance of juniper and rhododendron pollen, the immediate onset of pollen input from cereals (confirmed by detailed SEM analysis) and a clear pattern of over-grazing, trampling and peat deterioration can be linked to human arrival in the valleys at ca 4280
±
130
cal
a
BP. Extensive charcoal horizons dating to 4745
±
250 and 4680
±
155
cal
a
BP are interpreted as evidence for human use of fire and forest clearances and agree spatially and temporally with the pollen-based picture. Charcoal occurrences as old as 6710
±
90
cal
a
BP might be linked to yet earlier exploration of these Himalayan valleys during phases of low glacial activity. We provide an account of the colonization of these high valleys in response to glacial and monsoonal change and argue that the most likely founder societies come from the Tibetan Plateau, where yak and barley based pastoralism and Neolithic settlements are known to have existed since the Mid Holocene.
This study sought to assess change in knowledge and preference for epidural use associated with use of an information pamphlet and to explore women's decision-making and information needs regarding ...pain relief in labour.
Six focus groups with women who were pregnant or had given birth during the past 12 months were conducted in three northern communities in British Columbia. Following completion of a 10-item knowledge pretest, women were randomly assigned to read either a short version or a detailed version of the pamphlet and then complete a post-test. After reading the alternate pamphlet they participated in a moderated discussion. Pretest and post-test knowledge scores were compared, and a thematic analysis of focus group data was conducted.
Knowledge scores increased (2.12 points out of a possible total of 10; standard deviation 2.38; 95% CI 1.38 to 2.87). There was no difference in knowledge change or epidural preferences according to which version participants read first. Women preferred the detailed version and indicated that its information was more balanced. Four themes related to decision-making and information needs arose from the focus groups: making an informed choice, being open-minded, wanting comprehensive information, and experiencing pressure to have/not have an epidural.
An illustrated information pamphlet can significantly increase women's knowledge of benefits and risks of epidural analgesia, but it is not associated with change of preference. Women prefer to receive comprehensive information prenatally to support informed choices in labour.
La présente étude avait pour but d'évaluer le changement dans le niveau de connaissance sur la péridurale et le choix d'y recourir à la suite de la lecture d'un dépliant d'information, et d'étudier le processus décisionnel sous-jacent et les besoins en information concernant l'analgésie pendant le travail.
Six séances de discussion entre des femmes qui étaient enceintes ou avaient accouché dans les 12 mois précédents ont eu lieu dans trois localités du Nord de la Colombie-Britannique. Après avoir répondu à un test de connaissances de dix questions, les participantes ont lu la version courte ou la version détaillée d'un dépliant, selon une répartition aléatoire. Elles ont ensuite répondu une nouvelle fois au test, puis ont pris part à une discussion animée. Les résultats du pré-test et du post-test ont été comparés, et les données issues des séances de discussion ont fait l'objet d'une analyse thématique.
Les résultats au test de connaissances ont augmenté (de 2,12 points sur un maximum de 10; écart-type : 2,38; IC à 95 % : 1,38 à 2,87) après la lecture. Le changement dans le niveau de connaissance et le choix de recourir à la péridurale était le même, peu importe la version du dépliant lue en premier. Les participantes ont préféré la version détaillée, précisant que son contenu était mieux équilibré. Enfin, les séances de discussion ont permis de dégager quatre thèmes en lien avec le processus décisionnel et les besoins en information : la prise de décision éclairée, l'ouverture d'esprit, le désir d'obtenir de l'information complète et la pression de recourir ou non à la péridurale.
La lecture d'un dépliant d'information illustré peut entraîner une hausse significative de la connaissance des avantages et des risques de la péridurale, mais n'est pas associée à un changement dans la décision d'y recourir ou non. Les femmes préfèrent obtenir de l'information complète sur le sujet pendant la grossesse afin d'être en mesure de faire un choix éclairé pendant le travail.
Sonographic evidence of asymptomatic Echinococcus granulosus lesions in the liver was found in 156 of 9,515 persons in the Department of Florida, Uruguay. The sensitivity of ELISA and latex ...agglutination serology compared with ultrasound was 47.6% and 28.1%, respectively, and specificity was > 85%. There was a significant positive association between positive sonography and a personal history of previous but treated Echinococcus infection while those that were seropositive but ultrasound-negative were significantly more likely to have a personal history of infection or a history of infection in their family. Prevalence of infection increased significantly with age. There was no correlation between echinococcosis and dog ownership or home slaughter of sheep but offal disposal was important, with an increased prevalence of infection of 3.2%, 2.8%, and 3.1%, respectively, in persons feeding offal to dogs or burying or burning it compared with a prevalence of 0.8-1.5% in those using other methods of disposal. Almost half the population, when questioned, seemed to have sound knowledge about E. granulosus and described correct treatment of E. granulosus in dogs but this did not affect prevalence. There was a significant positive association between infection and the presence of a fenced fruit/vegetable garden and use of rural waters, particularly the cachimba (a small dam) and the aljibe (a cistern or tank) that collect rainwater from the ground surface and roofs, respectively.
Results are presented from a new web application called OceanDIVA - Ocean Data Intercomparison and Visualization Application. This tool reads hydrographic profiles and ocean model output and presents ...the data on either depth levels or isotherms for viewing in Google Earth, or as probability density functions (PDFs) of regional model-data misfits. As part of the CLIVAR Global Synthesis and Observations Panel, an intercomparison of water mass properties of various ocean syntheses has been undertaken using OceanDIVA. Analysis of model-data misfits reveals significant differences between the water mass properties of the syntheses, such as the ability to capture mode water properties.
For several years after Echinococcus granulosus was introduced into Australasia from Europe, its life cycle was unknown. Before the end of the 19th century, however, Cystic Hydatid Disease (CHD) was ...recognized in humans as an important cause of death, although its magnitude was not quantified. During the first 50 years of the 20th century, the urban component declined, but CHD remained a serious source of ill-health. During the second half of the 20th century major research contributions have included: (i) differentiation of pastoral from wildlife Echinococcus and (ii) breaking the 'epidemiological code' of the family Taeniidae, thereby defining the conditions under which transmission occurs. Based on this research and concurrent surveys, it is concluded that the present geographical distribution of E. granulosus in domestic animals and CHD in the rural population is determined by climate; being uncommon where hot dry seasons continue beyond a few months. The parasite's range may be extended in its wildlife cycle through a highly susceptible definitive host--the dingo. The ease with which blowflies transfer taeniid eggs from dog faeces to animal and human foodstuffs implies that in Australasia, CHD can sometimes be regarded as foodborne. A perceived decline in autochthonus cases in the rural community during the second half of the 20th century may be accounted for by increased standards of living generated by economic advancement. Where a decline has not occurred or incidence is unusually high, CHD may be acting as an indicator of social disadvantage. Field trials and control programmes demonstrated that pastoral echinococcosis readily responded to intervention. Indeed, in both New Zealand and Tasmania, using different administrative structures and methods of funding, E. granulosus was driven from endemic towards extinction status. The really convincing result was the rapid decline in CHD in all age groups. The problem still to be solved is to identify methods for eliminating foci where high levels of CHD still exist but, continent- or even state-wide intervention may not be considered to be cost-effective using current tools. Here, mathematical modelling and cost-benefit analysis can be regarded as powerful methods to assist the decision-making process.
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