838 resultados para Dental Health Services, organization and administration


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House file 2782 (2007 Infrastructure Appropriations Act) requires state agencies that receive appropriations from specific funds to report that information. The Iowa Department of Transportation received funds from the Rebuild Iowa Infrastructure Fund, the State Recreational Trails Fund, the Health Restricted Capitals, and the Rail Revolving Loan and Grant Program in FY 2007. These are the status reports for those funds and the status of the FY2006 funds received from the State Recreational Trails Fund, the Rebuild Iowa Infrastructure Fund and the Tobacco Settlement Trust Fund.

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This article reviews the methodology of the studies on drug utilization with particular emphasis on primary care. Population based studies of drug inappropriateness can be done with microdata from Health Electronic Records and e-prescriptions. Multilevel models estimate the influence of factors affecting the appropriateness of drug prescription at different hierarchical levels: patient, doctor, health care organization and regulatory environment.Work by the GIUMAP suggest that patient characteristics are the most important factor in the appropriateness of prescriptions with significant effects at the general practicioner level.

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The very diverse social systems of sweat bees make them interesting models to study social evolution. Here we focus on the dispersal behaviour and social organization of Halictus scabiosae, a common yet poorly known species of Europe. By combining field observations and genetic data, we show that females have multiple reproductive strategies, which generates a large diversity in the social structure of nests. A detailed microsatellite analysis of 60 nests revealed that 55% of the nests contained the offspring of a single female, whereas the rest had more complex social structures, with three clear cases of multiple females reproducing in the same nest and frequent occurrence of unrelated individuals. Drifting among nests was surprisingly common, as 16% of the 122 nests in the overall sample and 44% of the nests with complex social structure contained females that had genotypes consistent with being full-sisters of females sampled in other nests of the population. Drifters originated from nests with an above-average productivity and were unrelated to their nestmates, suggesting that drifting might be a strategy to avoid competition among related females. The sex-specific comparison of genetic differentiation indicated that dispersal was male-biased, which would reinforce local resource competition among females. The pattern of genetic differentiation among populations was consistent with a dynamic process of patch colonization and extinction, as expected from the unstable, anthropogenic habitat of this species. Overall, our data show that H. scabiosae varies greatly in dispersal behaviour and social organization. The surprisingly high frequency of drifters echoes recent findings in wasps and bees, calling for further investigation of the adaptive basis of drifting in the social insects.

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Pollinator guild organization and its consequences for reproduction in three synchronopatric species of Tibouchina (Melastomataceae). In co-flowering plant species, pollinator sharing can result in interspecific pollen transfer and fecundity reduction. Competition will be relaxed whenever there is a large amount of initial pollen supply or if each plant species occupies different habitat patches. Reproduction in Tibouchina cerastifolia (Naudin) Cogn., T. clinopodifolia (DC.) Cogn. and T. gracilis (Bonpl.) Cogn. was studied in an area of Atlantic rainforest to examine whether synchronopatry induces time partitioning among pollinator species. Eleven bee species comprised the pollinator guild. Among pollinators, there were overlaps in bee species composition and in flower visitation time. Direct competition for pollen in Tibouchina Aubl. at the study site seems to lead to different activity periods among the bee species, in which Bombus pauloensis Friese,1913 was most active earlier, while the other species were active later in the day. Bombus pauloensis, the largest bee species recorded on Tibouchina flowers, was the most important and efficient pollinator. This species harvested pollen before the other species and had the shortest handling time. The plants reproduced sexually by selfing or outcrossing, and hybridization was not avoided by incompatibility reactions at the style. The avoidance of direct competition for pollen and no pollinator partitioning among the synchronopatric species of Tibouchina may reflect a facilitative interaction among these pioneer plants.

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OBJECTIVES: To conduct a national survey on adolescent health and lifestyles in Georgia and to thus set up a database on adolescent. METHODS: A two-stage cluster sample of around 8000-10000 in-school 15-18 years adolescents are being reached through a random selection of classes in Georgia. The sample has been stratified by age, region, type of school and language. A self-administered questionnaire of 87 questions has been developed and translated into the four main languages used in Georgia. RESULTS: Up to June 2004, the researchers have reached 511 classes (9306 pupils). In total, 8039 questionnaires have been considered valid. The main concerns encountered for this survey are linked with acceptance of the survey, cross-cultural issues, political and strategic problems as well as inadequate physical environmental support. CONCLUSION: Despite Georgia's unfavourable economical and political situation, it has been possible to run a national survey on the health of adolescents, according to the usual standards used in the field. This survey should allow for 1) the identification of priorities in the field of health care and health promotion 2) the monitoring of adolescent health in the future.

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We analyzed a one-year case series and performed a longitudinal (4 month) cohort analysis of urgent requests made to home care agencies by and for their > or = 65 years old clients in order to estimate the frequency of unscheduled services delivered by home care agencies and to identify risk factors. All 40 home care agencies located in a Swiss region were included in the study and we registered 3,816 urgent requests (75/1,000 > or = 65 years residents per year). Among home care users, the presence of a urinary catheter, incontinence and the need for assistance in bathing were predictors of unscheduled services. Resources should be planned in order to help home care teams to handle unexpected, disruptive clusters of urgent requests that may compromise their scheduled activities.

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Overall introduction.- Longitudinal studies have been designed to investigate prospectively, from their beginning, the pathway leading from health to frailty and to disability. Knowledge about determinants of healthy ageing and health behaviour (resources) as well as risks of functional decline is required to propose appropriate preventative interventions. The functional status in older people is important considering clinical outcome in general, healthcare need and mortality. Part I.- Results and interventions from lucas (longitudinal urban cohort ageing study). Authors.- J. Anders, U. Dapp, L. Neumann, F. Pröfener, C. Minder, S. Golgert, A. Daubmann, K. Wegscheider,. W. von Renteln-Kruse Methods.- The LUCAS core project is a longitudinal cohort of urban community-dwelling people 60 years and older, recruited in 2000/2001. Further LUCAS projects are cross-sectional comparative and interventional studies (RCT). Results.- The emphasis will be on geriatric medical care in a population-based approach, discussing different forms of access, too. (Dapp et al. BMC Geriatrics 2012, 12:35; http://www.biomedcentral.com/1471-2318/12/35): - longitudinal data from the LUCAS urban cohort (n = 3.326) will be presented covering 10 years of observation, including the prediction of functional decline, need of nursing care, and mortality by using a self-filling screening tool; - interventions to prevent functional decline do focus on first (pre-clinical) signs of pre-frailty before entering the frailty-cascade ("Active Health Promotion in Old Age", "geriatric mobility centre") or disability ("home visits"). Conclusions.- The LUCAS research consortium was established to study particular aspects of functional competence, its changes with ageing, to detect pre-clinical signs of functional decline, and to address questions on how to maintain functional competence and to prevent adverse outcome in different settings. The multidimensional data base allows the exploration of several further questions. Gait performance was exmined by GAITRite®-System. Supported by the Federal Ministry for Education and Research (BMBF Funding No. 01ET1002A). Part II.- Selected results from the lausanne cohort 65+ (Lc65 + ) Study (Switzerland). Authors.- Prof Santos-Eggimann Brigitte, Dr Seematter-Bagnoud Laurence, Prof Büla Christophe, Dr Rochat Stéphane. Methods.- The Lc65+ cohort was launched in 2004 with the random selection of 3054 eligible individuals aged 65 to 70 (birth year 1934-1938) in the non-institutionalized population of Lausanne (Switzerland). Results.- Information is collected about life course social and health-related events, socio-economics, medical and psychosocial dimensions, lifestyle habits, limitations in activities of daily living, mobility impairments, and falls. Gait performance are objectively measured using body-fixed sensors. Frailty is assessed using Fried's frailty phenotype. Follow-up consists in annual self-completed questionnaires, as well as physical examination and physical and mental performance tests every three years. - Lausanne cohort 65+ (Lc65 + ): design and longitudinal outcomes. The baseline data collection was completed among 1422 participants in 2004-2005 through self-completed questionnaires, face-to-face interviews, physical examination and tests of mental and physical performances. Information about institutionalization, self-reported health services utilization, and death is also assessed. An additional random sample (n = 1525) of 65-70 years old subjects was recruited in 2009 (birth year 1939-1943). - lecture no 4: alcohol intake and gait parameters: prevalent and longitudinal association in the Lc65+ study. The association between alcohol intake and gait performance was investigated.

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OBJECTIVE: We investigated whether the INTERMED, a generic instrument for assessing biopsychosocial case complexity and direct care, identifies organ transplant patients at risk of unfavourable post-transplant development by comparing it to the Transplant Evaluation Rating Scale (TERS), the established measure for pretransplant psychosocial evaluation. METHOD: One hundred nineteen kidney, liver, and heart transplant candidates were evaluated using the INTERMED, TERS, SF-36, EuroQol, Montgomery-Åsberg Depression Rating Scale (MADRS), and Hospital Anxiety & Depression Scale (HADS). RESULTS: We found significant relationships between the INTERMED and the TERS scores. The INTERMED highly correlated with the HADS,MADRS, and mental and physical health scores of the SF-36 Health Survey. CONCLUSIONS: The results demonstrate the validity and usefulness of the INTERMED instrument for pretransplant evaluation. Furthermore, our findings demonstrate the different qualities of INTERMED and TERS in clinical practice. The advantages of the psychiatric focus of the TERS and the biopsychosocial perspective of the INTERMED are discussed in the context of current literature on integrated care.

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The goal of the study is to locate a site appropriate for a 170 offender unit, based on an understanding of current needs, existing and proposed procedure and the longevity of existing facility use. The study is based on master-plan process. A framework on which multiple stages of infrastructure development can be based is initiated through the systemic study of infrastructure condition, infrastructure needs and treatment objectives.

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BACKGROUND: The escalating prevalence of obesity might prompt obese subjects to consider themselves as normal, as this condition is gradually becoming as frequent as normal weight. In this study, we aimed to assess the trends in the associations between obesity and self-rated health in two countries. METHODS: Data from the Portuguese (years 1995-6, 1998-6 and 2005-6) and Swiss (1992-3, 1997, 2002 and 2007) National Health Surveys were used, corresponding to more than 130,000 adults (64,793 for Portugal and 65,829 for Switzerland). Body mass index and self-rated health were derived from self-reported data. RESULTS: Obesity levels were higher in Portugal (17.5% in 2005-6 vs. 8.9% in 2007 in Switzerland, p < 0.001) and increased in both countries. The prevalence of participants rating their health as "bad" or "very bad" was higher in Portugal than in Switzerland (21.8% in 2005-6 vs 3.9% in 2007, p < 0.001). In both countries, obese participants rated more frequently their health as "bad" or "very bad" than participants with regular weight. In Switzerland, the prevalence of "bad" or "very bad" rates among obese participants, increased from 6.5% in 1992-3 to 9.8% in 2007, while in Portugal it decreased from 41.3% to 32.3%. After multivariate adjustment, the odds ratio (OR) of stating one self's health as "bad" or "very bad" among obese relative to normal weight participants, almost doubled in Switzerland: from 1.38 (95% confidence interval, CI: 1.01-1.87) in 1992-3 to 2.64 (95% CI: 2.14-3.26) in 2007, and similar findings were obtained after sample weighting. Conversely, no such trend was found in Portugal: 1.35 (95% CI: 1.23-1.48) in 1995-6 and 1.52 (95% CI: 1.37-1.70) in 2005-6. CONCLUSION: Obesity is increasing in Switzerland and Portugal. Obesity is increasingly associated with poorer self-health ratings in Switzerland but not in Portugal.

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Cette étude a été menée par l'Unité d'évaluation de programmes de prévention de l'Institut de médecine sociale et préventive (IUMSP) de Lausanne. Elle s'inscrit dans le cadre de l'évaluation globale de la stratégie de prévention du VIH/sida pour laquelle l'IUMSP a reçu mandat de l'Office fédéral de la santé publique. Le programme national "VIH et sida : Programme national de 1999 à 2003" a été préparé en 1998 par l'OFSP en collaboration avec des experts et publié en février 1999. Il fait suite au manuel "Prévention du VIH en Suisse : buts, stratégies, mesures" publié en 1993 et couvre la période de 1999 à 2003. Les 14 objectifs qu'il définit, avec leurs jalons, sont répartis dans cinq grands domaines à savoir: promotion de la santé, prévention, thérapie et diagnostic, conseil et soutien, savoir et transfert des compétences. Afin d'en planifier la mise en oeuvre, l'OFSP a organisé 14 plates-formes régionales en août et septembre 1999 qui ont fait l'objet d'un rapport publié en janvier 2000. Les plates-formes ont été suivies d'une "Conférence intercantonale VIH/sida" le 8 septembre 2000 à Berne, organisée conjointement par l'Office fédéral de la santé publique (OFSP)/Section Sida et l'Aide Suisse contre le Sida (ASS), dont le thème général était "Transfert dans la lutte contre le VIH/sida". Faisant suite à la première phase d'évaluation qui, elle, a porté sur l'état des activités de lutte contre le VIH/sida dans les cantons, la deuxième phase de l'évaluation fait le point sur la mise en oeuvre du programme national 1999-2003 au niveau national et dans les cinq cantons pour la période 2000-2001 et porte sur l'implantation du programme national. Y sont analysés le développement des activités dans tous les domaines, la pertinence des objectifs et jalons, les éléments garantissant la pérennité et la qualité des interventions, et le développement des collaborations à différents niveaux.

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Spatial hearing refers to a set of abilities enabling us to determine the location of sound sources, redirect our attention toward relevant acoustic events, and recognize separate sound sources in noisy environments. Determining the location of sound sources plays a key role in the way in which humans perceive and interact with their environment. Deficits in sound localization abilities are observed after lesions to the neural tissues supporting these functions and can result in serious handicaps in everyday life. These deficits can, however, be remediated (at least to a certain degree) by the surprising capacity of reorganization that the human brain possesses following damage and/or learning, namely, the brain plasticity. In this thesis, our aim was to investigate the functional organization of auditory spatial functions and the learning-induced plasticity of these functions. Overall, we describe the results of three studies. The first study entitled "The role of the right parietal cortex in sound localization: A chronometric single pulse transcranial magnetic stimulation study" (At et al., 2011), study A, investigated the role of the right parietal cortex in spatial functions and its chronometry (i.e. the critical time window of its contribution to sound localizations). We concentrated on the behavioral changes produced by the temporarily inactivation of the parietal cortex with transcranial magnetic stimulation (TMS). We found that the integrity of the right parietal cortex is crucial for localizing sounds in the space and determined a critical time window of its involvement, suggesting a right parietal dominance for auditory spatial discrimination in both hemispaces. In "Distributed coding of the auditory space in man: evidence from training-induced plasticity" (At et al., 2013a), study B, we investigated the neurophysiological correlates and changes of the different sub-parties of the right auditory hemispace induced by a multi-day auditory spatial training in healthy subjects with electroencephalography (EEG). We report a distributed coding for sound locations over numerous auditory regions, particular auditory areas code specifically for precise parts of the auditory space, and this specificity for a distinct region is enhanced with training. In the third study "Training-induced changes in auditory spatial mismatch negativity" (At et al., 2013b), study C, we investigated the pre-attentive neurophysiological changes induced with a training over 4 days in healthy subjects with a passive mismatch negativity (MMN) paradigm. We showed that training changed the mechanisms for the relative representation of sound positions and not the specific lateralization themselves and that it changed the coding in right parahippocampal regions. - L'audition spatiale désigne notre capacité à localiser des sources sonores dans l'espace, de diriger notre attention vers les événements acoustiques pertinents et de reconnaître des sources sonores appartenant à des objets distincts dans un environnement bruyant. La localisation des sources sonores joue un rôle important dans la façon dont les humains perçoivent et interagissent avec leur environnement. Des déficits dans la localisation de sons sont souvent observés quand les réseaux neuronaux impliqués dans cette fonction sont endommagés. Ces déficits peuvent handicaper sévèrement les patients dans leur vie de tous les jours. Cependant, ces déficits peuvent (au moins à un certain degré) être réhabilités grâce à la plasticité cérébrale, la capacité du cerveau humain à se réorganiser après des lésions ou un apprentissage. L'objectif de cette thèse était d'étudier l'organisation fonctionnelle de l'audition spatiale et la plasticité induite par l'apprentissage de ces fonctions. Dans la première étude intitulé « The role of the right parietal cortex in sound localization : A chronometric single pulse study » (At et al., 2011), étude A, nous avons examiné le rôle du cortex pariétal droit dans l'audition spatiale et sa chronométrie, c'est-à- dire le moment critique de son intervention dans la localisation de sons. Nous nous sommes concentrés sur les changements comportementaux induits par l'inactivation temporaire du cortex pariétal droit par le biais de la Stimulation Transcrânienne Magnétique (TMS). Nous avons démontré que l'intégrité du cortex pariétal droit est cruciale pour localiser des sons dans l'espace. Nous avons aussi défini le moment critique de l'intervention de cette structure. Dans « Distributed coding of the auditory space : evidence from training-induced plasticity » (At et al., 2013a), étude B, nous avons examiné la plasticité cérébrale induite par un entraînement des capacités de discrimination auditive spatiale de plusieurs jours. Nous avons montré que le codage des positions spatiales est distribué dans de nombreuses régions auditives, que des aires auditives spécifiques codent pour des parties données de l'espace et que cette spécificité pour des régions distinctes est augmentée par l'entraînement. Dans « Training-induced changes in auditory spatial mismatch negativity » (At et al., 2013b), étude C, nous avons examiné les changements neurophysiologiques pré- attentionnels induits par un entraînement de quatre jours. Nous avons montré que l'entraînement modifie la représentation des positions spatiales entraînées et non-entrainées, et que le codage de ces positions est modifié dans des régions parahippocampales.

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The Engineering Research Institute at Iowa State University studied the organization and procedures for highway planning by all levels of government and the coordination among various state agencies and local governments in Iowa. Study information was derived from interviews, questionnaires, and a review of the literature. Representatives from state transportation or highway organizations in all states responded to questionnaires. Additionally, selected upper and intermediate level personnel from highway organizations in seven other states were interviewed and a visit was made to one state transportation department. Within Iowa, employees were interviewed in the Highway Commission, Office for Planning and Programming, Development Commission, Commerce Commission, Conservation Commission, and Highway Patrol. Nearly 600 officials of local governments in Iowa contributed factual data and opinions through questionnaires and interviews. Private citizens and consultants also provided input to the investigation through their responses to questionnaires. Twelve recommendations to improve highway planning in Iowa were formulated as a result of this study.

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The structural organization and the coding nucleotide sequence of the Xenopus laevis A2 and the chicken major vitellogenin genes have been compared. Both genes show the same exon-intron organization. However, the degree of homology between the nucleotide and derived amino acid sequences varies extensively along the genes. Several of the 35 exons are quite similar, and a unique cysteine motif in the lipovitellin II domain is conserved between the two genes. In contrast, one internal region is quite divergent. Part of this region encodes phosvitin, which appears to have evolved rapidly by both point mutations and duplications of serines or short other amino acid stretches. On the basis of these observations, we discuss the possible mechanism of evolution of phosvitin in vertebrates.