276 resultados para Community characteristics


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Objectives. We sought to estimate the risk of death and recurrent myocardial infarction associated with the use of calcium antagonists after myocardial infarction in a population-based cohort study. Background. Calcium antagonists are commonly prescribed after myocardial infarction, but their long-term effects are not well established. Methods. Patients 25 to 69 years old with a suspected myocardial infarction were identified and followed up through a community-based register of myocardial infarction and cardiac death (part of the World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease [MONICA] Project in Newcastle, Australia). Data were collected by review of medical records, in-hospital interview and review of death certificates. Results. From 1989 to 1993, 3,982 patients with a nonfatal suspected myocardial infarction were enrolled in the study. At hospital discharge, 1,001 patients were treated with beta-adrenergic blocking agents, 923 with calcium antagonists, 711 with both beta-blockers and calcium antagonists and 1,346 with neither drug. Compared with patients given beta-blockers, patients given calcium antagonists were more likely to suffer myocardial infarction or cardiac death (adjusted relative risk [RR] 1.4, 95% confidence interval [CI] 1.0 to 1.9), cardiac death (RR 1.6, 95% CI 1.0 to 2.7) and death from all causes (RR 1.7, 95% CI 1.1 to 2.6). Compared with patients given neither beta-blockers nor calcium antagonists, patients given calcium antagonists were not at increased risk of myocardial infarction or cardiac death (RR 1.0, 95% CI 0.8 to 1.3), cardiac death (RR 0.9, 95% CI 0.6 to 1.2) or death from all causes (RR 1.0, 95% CI 0.7 to 1.3). No excess in risk of myocardial infarction or cardiac death was observed among patients taking verapamil (RR 0.9, 95% CI 0.6 to 1.6), diltiazem (RR 1.1, 95% CI 0.8 to 1.4) or nifedipine (RR 1.3, 95% CI 0.7 to 2.2) compared,vith patients taking neither calcium antagonists nor beta-blockers. Conclusions. These results are consistent with randomized trial data showing benefit from beta blockers after myocardial infarction and no effect on the risk of recurrent myocardial infarction and death with the use of calcium antagonists. Comparisons between beta-blockers and calcium antagonists favor beta blockers because of the beneficial effects of beta-blockers and not because of adverse effects of calcium antagonists. (C) 1998 by the American College of Cardiology.

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The writers measured velocity, pressure and energy distributions, wavelengths, and wave amplitudes along undular jumps in a smooth rectangular channel 0.25 m wide. In each case the upstream flow was a fully developed shear flow. Analysis of the data shows that the jump has strong three-dimensional features and that the aspect ratio of the channel is an important parameter. Energy dissipation on the centerline is far from negligible and is largely constrained to the reach between the start of the lateral shock waves and the first wave crest of the jump, in which the boundary layer develops under a strong adverse pressure gradient. A Boussinesq-type solution of the free-surface profile, velocity, and energy and pressure distributions is developed and compared with the data. Limitations of the two-dimensional analysis are discussed.

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The potential of using carbonized slash pine bark as a substitute for activated carbon was examined in this study. The bark was carbonized by slow heating in nitrogen for 6.5 h to 672 degrees C. The BET-N-2 surface area, average micropore and mesopore diameter, and micropore volume were 332 m(2) g(-1) 21.7 Angstrom, and 0.125 cm(3) g(-1), respectively. The adsorption capacities for phenol and pentachlorophenol (PCP) at pH 2 and pH 8 were evaluated. The Langmuir equation provided a slightly better fit than the Freundlich equation to two sets of phenol data. The calculated Freundlich constants, K = 0.41 - 0.58 mmol/g/(mmol dm(-3))(1/n) and 1/n = 0.30 - 0.41, were lower and higher, respectively, than literature values for activated carbons. The adsorption capacity of the carbonized bark was much lower for PCP than for phenol. The protonated and anionic PCP isotherms were Type II or III, respectively, in the Brunauer classification. The BET equation provided the best fit to protonated PCP isotherm data. The anionic PCP data were fitted to both the BET model and an equation used in the literature to represent phosphate adsorption on activated carbons. Nonlinear regression of the data for both phenol and PCP adsorption with the Freundlich, Langmuir and BET equations generally gave more accurate parameters, compared with the use of linearized equations to obtain the parameters. (C) 1998 SCI.

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The study of the mechanisms of mechanical alloying requires knowledge of the impact characteristics between the ball and vial in the presence of milling powders. In this paper, foe falling experiments have br cn used to investigate the characteristics of impact events involved in mechanical milling. The effects of milling conditions, including impact velocity, ball size and powder thickness. on the coefficient of restitution and impact force are studied. It is found that the powder has a significant influence on the impact process due to its porous structure. This effect can be demonstrated using a modified Kelvin model. This study also confirms that the impact force is a relevant parameter for characterising the impact event due to its sensitivity to the milling conditions. (C) 1998 Elsevier Science S.A.

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A study was conducted to examine the relationships among eating pathology, weight dissatisfaction and dieting, and unwanted sexual experiences in childhood. An unselected community sample of 201 young and 268 middle-aged women were administered questionnaires assessing eating behaviors and attitudes, and past and current sexual abuse. Results showed differential relationships among these factors for the two age cohorts: for young women, past sexual abuse predicted weight dissatisfaction, but not dieting or disordered eating behaviors, whereas for middle-aged women, past abuse was predictive of disordered eating, but not dieting or weight dissatisfaction. Current physical or sexual abuse was also found to be predictive of disordered eating for the young women. These findings underscore the complexity of the relationships among unwanted sexual experiences and eating and weight pathology, and suggest that the timing of sexual abuse, and the age of the woman, are important mediating factors. (C) 1998 Elsevier Science Inc.

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Catalytic activities and deactivation characteristics of oxides-supported nickel catalysts for the reaction of methane reforming with carbon dioxide were investigated. The dynamic carbon deposition on various nickel catalysts was also studied by a thermogravimetric method. Among the catalysts prepared, Ni/La2O3, Ni/alpha-Al2O3, Ni/SiO2, and Ni/CeO2 showed very high CH4 and CO2 conversions and moderate deactivation whereas Ni/MgO and Ni/TiO2 had lower conversions when the Ni reduction was conducted at 500 degrees C. When Ni/MgO catalyst was reduced at 800 degrees C, it exhibited not only comparable conversions of CH4 and CO2 with other active catalysts but also much longer period of stability without deactivation. The amount of carbon deposited in Ni-based catalysts varied depending on the nature of support and followed the order of Ni/La2O3 > Ni/alpha-Al2O3 > Ni/SiO2 > Ni/MgO > Ni/CeO2 at 700 degrees C. The carbons formed on the catalyst surface showed different structural and chemical properties, and these in turn affected the catalytic activity of the catalysts.

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The most common types of weirs are the broad-crested weir, the sharp-crested weir, the circular-crested weir, and nowadays, the ogee crest weir, Advantages of the cylindrical weir shape include the stable overflow pattern, the ease to pass floating debris, the simplicity of design compared to ogee crest design, and the associated lower costs. in this study, the writers describe new experiments of circular weir overflows, with eight cylinder sizes, for several weir heights and for five types of inflow conditions: partially developed inflow, fully developed inflow, upstream ramp, upstream undular hydraulic jump, and upstream (breaking) hydraulic jump. Within the range of the experiments, the cylinder size, the weir height DIR and the presence of an upstream ramp had no effect on the discharge coefficient, flow depth at crest, and energy dissipation. But the inflow conditions had substantial effects on the discharge characteristics and flow properties at the crest. Practically, the results indicate that discharge measurements with circular weirs are significantly affected by the upstream flow conditions.

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The purpose of this study was to examine whether methadone maintenance treatment reduces injecting risk behaviour land therefore transmission of blood-borne viral infections) among prisoners in New South Wales (NSW), using comparison of retrospective reports of drug use in prisons for people who received standard drug treatment, time-limited methadone treatment and methadone maintenance treatment, The setting for the study was the NSW prison system. One hundred and eighty-five injecting drug users who had been recently released from NSW prisons were recruited in 1993, Self-reported drug use and injecting risk behaviour were compared in inmates who received standard drug treatment (counselling), time-limited methadone treatment and methadone maintenance treatment. HIV status was determined by serology, Intervention comprised high and low dose methadone treatment and counselling. The groups were similar in terms of most basic demographic characteristics but subjects who had been maintained on methadone reported a significantly lower prevalence of heroin injection, syringe sharing and scored lower on an HIV Risk-taking Behavioural Scale than subjects who received standard drug treatment and time-limited methadone treatment, This study suggests that methadone treatment is associated with reduced injecting risk behaviour in prison with adequate (greater than 60 mg) dose and duration in treatment. These treatment conditions are known to increase effectiveness in community-based methadone programmes. Prospective studies are required to evaluate the effectiveness of methadone programmes in the prevention of HIV and other blood-borne viral infections among IDU prisoners.

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In response to methodological concerns associated with previous research into the educational characteristics of students with high or low self-concept, the topic was re-examined using a significantly more representative sample and a contemporary self-concept measure. From an initial screening of 515 preadolescent, coeducational students in 18 schools, students significantly high or low in self-concept were compared using standardized tests in reading, spelling, and mathematics, and teacher interviews to determine students' academic and nonacademic characteristics. The teachers were not informed of the self-concept status of the students. Compared to students with low self-concept, students with high self-concept were rated by teachers as being more popular, cooperative, and persistent in class, showed greater leadership, were lower in anxiety, had more supportive families, and had higher teacher expectations for their future success. Teachers observed that students with low self-concept were quiet and withdrawn, while peers with high self-concept were talkative and more dominating with peers. Students with lower self-concepts were also lower than their peers in reading, spelling, and mathematical abilities. The findings support the notion that there is an interactive relationship between self-concept and achievement. (C) 1998 John Wiley & Sons, Inc.

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Carbonaceous adsorbents were prepared by heat treatment of coal reject at 600 degrees C, after chemical treatment in HNO3, H2SO4, and NaOH at 25 and 75 degrees C. Pore structure characterization and the phenol adsorption capacities of the adsorbents showed that nitric acid pretreatment significantly enhanced the surface properties, consequently the adsorption capacities of the adsorbents. A number of samples were subsequently prepared by carbonizing coal reject at 600 degrees C, after pretreatment in HNO3 under various conditions. The acid concentration, residence time, and reaction temperature were varied to obtain adsorbents with various pore structures. The adsorption capacities of the derived adsorbents for phenol, p-nitrophenol, and benzene were measured to gain further insights into the pore structure evolution. Adsorption isotherms of phenol, p-nitrophenol, and p-chlorophenol on the best adsorbent prepared were determined and correlated with theoretical isotherm equations, such as the Langmuir, Freundlich, and Redlich-Peterson equations.

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Background and Purpose-Few community-based studies have examined the long-term risk of recurrent stroke after an acute first-ever stroke. This study aimed to determine the absolute and relative risks of a first recurrent stroke over the first 5 years after a first-ever stroke and the predictors of such recurrence in a population-based series of people with first-ever stroke in Perth, Western Australia. Methods-Between February 1989 and August 1990, all people with a suspected acute stroke or transient ischemic attack of the brain who were resident in a geographically defined region of Perth, Western Australia, with a population of 138 708 people, were registered prospectively and assessed according to standardized diagnostic criteria. Patients were followed up prospectively at 4 months, 12 months, and 5 years after the index event. Results-Three hundred seventy patients with a first-ever stroke were registered, of whom 351 survived >2 days. Data were available for 98% of the cohort at 5 years, by which time 199 patients (58%) had died and 52 (15%) had experienced a recurrent stroke, 12 (23%) of which were fatal within 28 days. The 5-year cumulative risk of first recurrent stroke was 22.5% (95% confidence limits [CL], 16.8%, 28.1%). The risk of recurrent stroke was greatest in the first 6 months after stroke, at 8.8% (95% CL, 5.4%, 12.1%). After adjustment for age and sex, the prognostic factors for recurrent stroke were advanced, but not extreme, age (75 to 84 years) (hazard ratio [HR], 2.6; 95% CL, 1.1, 6.2), hemorrhagic index stroke (HR, 2.1; 95% CL, 0.98, 4.4), and diabetes mellitus (HR, 2.1; 95% CL, 0.95, 4.4). Conclusions-Approximately 1 in 6 survivors (15%) of a first-ever stroke experience a recurrent stroke over the next 5 years, of which 25% are fatal within 28 days. The pathological subtype of the recurrent stroke is the same as that of the index stroke in 88% of cases. The predictors of first recurrent stroke in this study were advanced age, hemorrhagic index stroke, and diabetes mellitus, but numbers of recurrent events were modest. Because the risk of recurrent stroke is highest (8.8%) in the first 6 months after stroke, strategies for secondary prevention should be initiated as soon as possible after the index event.