OUT-OF-HOSPITAL CHILDBEARING CENTERS IN THE UNITED STATES: A DESCRIPTIVE STUDY OF THE DEMOGRAPHIC AND MEDICAL-OBSTETRIC CHARACTERISTICS OF WOMEN BEGINNING LABOR THEREIN 1972-1979

There is currently much interest in the appropriate use of obstetrical technology, cost containment and meeting consumers' needs for safe and satisfying maternity care. At the same time, there has been an increase in professionally unattended home births. In response, a new type of service, the out-of-hospital childbearing center (CBC) has been developed which is administratively and structurally separate from the hospital. In the CBC, maternity care is provided by certified nurse-midwives to carefully screened low risk childbearing families in conjunction with physician and hospital back-up.^ It was the purpose of this study to accomplish the following objectives: (1) To describe in a historical prospective study the demographic and medical-obstetric characteristics of patients laboring in eleven selected out-of-hospital childbearing centers in the United States from May 1, 1972, to December 15, 1979. Labor is defined as the onset of regular contractions as determined by the patient. (2) To describe any differences between those patients who require transfer to a back-up hospital and those who do not. (3) To describe administrative and service characteristics of eleven selected out-of-hospital childbearing centers in the United States. (4) To compare the demographic and medical-obstetric characteristics of women laboring in eleven selected out-of-hospital childbearing centers with a national sample of women of similar obstetric risk who according to birth certificates delivered legitimate infants in a hospital setting in the United States in 1972.^ Research concerning CBCs and supportive to the development of CBCs including studies which identified factors associated with fetal and perinatal morbidity and mortality, obstetrical risk screening, and the progress of technological development in obstetrics were reviewed. Information concerning the organization and delivery of care at each selected CBC was also collected and analyzed.^ A stratified, systematic sample of 1938 low risk women who began labor in a selected CBC were included in the study. These women were not unlike those described previously in small single center studies reported in the literature. The mean age was 25 years. Sixty-three per cent were white, 34 per cent Hispanic, 88 per cent married, 45 per cent had completed at least two years of college, nearly one-third were professionals and over a third were housewives. . . . (Author's abstract exceeds stipulated maximum length. Discontinued here with permission of school.) UMI ^

BLOOD PRESSURE CHANGES IN RELATION TO DEMOGRAPHIC, ANTHROPOMETRIC, AND SEXUAL MATURATION VARIABLES IN U.S. HEALTH EXAMINATION SURVEY OF CHILDREN AND YOUTHS (UNITED STATES)

The determinants of change in blood pressure during childhood and adolescence were studied in a cohort of U.S. national probability sample of 2146 children examined on two occasions during the Health Examination Survey. Significant negative correlations between the initial level and the subsequent changes in blood pressure were observed. The multiple regression analyses showed that the major determinants of systolic blood pressure (SBP) change were change in weight, baseline SBP, and baseline upper arm girth. Race, time interval between examinations, baseline age, and height change were also significant determinants in SBP change. For the change in diastolic blood pressure (DBP), baseline DBP, baseline weight, and weight change were the major determinants. Baseline SBP, time interval and race were also significant determinants. Sexual maturation variables were also considered in the subgroup analysis for girls. Weight change was the most important predictor of the change in SBP for the group of girls who were still in the pre-menarchal or pre-breast maturation status at the time of the follow-up examination, and who had started to menstruate or to develop breast maturation at sometime between the two examinations. Baseline triceps skinfold thickness or initial SBP were more important variables than weight change for the group of girls who had already experienced menarche or breast maturation at the time of the initial survey. For the total group, pubic hair maturation was found to be a significant predictor of SBP change at the 5% significance level. The importance of weight change and baseline weight for the changes in blood pressure warrants further study. ^

Volunteering: Demographic characteristics, motives and potential benefits from service

Volunteering is intricately woven into the fabric of our society. In 2009 alone, approximately 63.4 million Americans participated in volunteer activities, collectively donating over 8.1 billion service-hours (Corporation for National and Community Service [CNCS], 2010). Each service-hour is determined by the U.S. Bureau of Labor Statistics (2010) to be valued at $20.85/hr which translates to a national savings of $169 billion. Thus, we can clearly observe the significance of volunteer contribution to the overall benefit of society. In addition, there is now evidence that voluntary service may also benefit the actual volunteer, especially individuals who are 65+ years. As we reach 2020 this elderly class, composed of nearly 13 million (CNCS, 2010) Americans, will be of much consequence. Their potential to contribute in community-related efforts may save the U.S. billions in labor costs, and may also help reduce healthcare-related expenditures if volunteering proves to be a protective factor. In this literature review, we set out to explore the potential relationship between volunteer participation and increased mental and physical wellness. We also examined volunteer demographic characteristics and common motives for engaging in service-related activities. Analysis showed that volunteer work often combined low-impact physical activity and mental satisfaction from serving others, resulting in overall health benefit. Demographic characteristics displayed were consistent with previous studies and found that a majority of volunteers were female, White, married status, having received college degree or higher, employed, middle-high SES. In addition, age was seen to be a key characteristic in forecasting volunteer motivation and self-reported perceived health benefits.^

Análisis de envejecimiento en paneles sándwich de madera/ Ageing tests study on wood-based sandwich panels

Los paneles sándwich de madera son un producto de creciente aplicación en la edificación de nuestro país. Este ascendente uso del material debe estar acompañado de las garantías necesarias avaladas por un estudio previo de sus prestaciones. Como es preceptivo y entre otros, se evalúa su durabilidad frente a las condiciones climatológicas, clave en los productos derivados de la madera, acorde a la normativa actual definida con tal fin, la Guía ETAG 016. Sin embargo, debido a la clase de uso del material, se ha detectado que dicha normativa tal y como está concebida no es capaz de valorar su envejecimiento adecuadamente. En este trabajo se proponen ensayos alternativos al establecido tras exhaustivos aná- lisis que recrean las condiciones reales de uso y más acordes a los productos de madera. Se concluye que la incorporación de una lámina impermeable, pero permeable al vapor de agua hacia el exterior, como las utilizadas en el montaje, aportan el mejor procedimiento de ensayo. Composite lightweight wood panels are being increasingly used in construction in Spain. Their growing use should be accompanied by necessary guarantees based on studies of their properties. As it is prescriptive and in addition to others tests, in the present work is examinated the durability of these panels when exposed to the climatic conditions, a characteristic of great importance for wood products, according to Guide ETAG 016, the current standard defining the ageing tests to be used. However, due to the use class of this material, there are indications that the testing outlined in this Guide is inappropriate for assessing the ageing of wood-based sandwich panels. Alternative tests are here proposed that recreate rather better the real conditions under which these products are used. Covering the samples in a waterproof sheeting permeable to the outward movement of water vapour, which is in fact used in the installation, provided the best procedure for testing these panels.

Cup Anemometer's loss of performance due to ageing process, and its effect on Annual energy Production (AEP) estimates

The deviation of calibration coefficients from five cup anemometer models over time was analyzed. The analysis was based on a series of laboratory calibrations between January 2001 and August 2010. The analysis was performed on two different groups of anemometers: (1) anemometers not used for any industrial purpose (that is, just stored); and (2) anemometers used in different industrial applications (mainly in the field—or outside—applications like wind farms). Results indicate a loss of performance of the studied anemometers over time. In the case of the unused anemometers the degradation shows a clear pattern. In the case of the anemometers used in the field, the data analyzed also suggest a loss of performance, yet the degradation does not show a clear trend. A recalibration schedule is proposed based on the observed performances variations

Population dynamics, demographic stochasticity, and the evolution of cooperation

A basic evolutionary problem posed by the Iterated Prisoner’s Dilemma game is to understand when the paradigmatic cooperative strategy Tit-for-Tat can invade a population of pure defectors. Deterministically, this is impossible. We consider the role of demographic stochasticity by embedding the Iterated Prisoner’s Dilemma into a population dynamic framework. Tit-for-Tat can invade a population of defectors when their dynamics exhibit short episodes of high population densities with subsequent crashes and long low density periods with strong genetic drift. Such dynamics tend to have reddened power spectra and temporal distributions of population size that are asymmetric and skewed toward low densities. The results indicate that ecological dynamics are important for evolutionary shifts between adaptive peaks.

Demographic and epidemiological determinants of healthcare costs in Netherlands: cost of illness study

Objectives: To determine the demands on healthcare resources caused by different types of illnesses and variation with age and sex.

A demographic approach to selection

The concepts of demography provide a means of combining the ecological approach to population growth with the genetical approach to natural selection. We have utilized the demographic theory of natural selection developed by Norton and Charlesworth to analyze life history schedules of births and deaths for populations of genotypes in Drosophila pseudoobscura. Our populations illustrate a stable genetic equilibrium, an unstable genetic equilibrium, and a case of no equilibrium. We have estimated population growth rates and Darwinian fitnesses of the genotypes and have explored the role of population growth in determining natural selection. The age-specific rates of births and deaths provide insights into components of selection. Both viability and fertility are important components in our populations.

Characterization and ageing study of poly(lactic acid) films plasticized with oligomeric lactic acid

Poly(lactic acid) (PLA) was melt-blended with a bio-based oligomeric lactic acid (OLA) plasticizer at different concentrations between 15 wt% and 25 wt% in order to enhance PLA ductility and to get a fully biodegradable material with potential application in films manufacturing. OLA was an efficient plasticizer for PLA, as it caused a significant decrease on glass transition temperature (Tg) while improving considerably ductile properties. Only one Tg value was observed in all cases and no apparent phase separation was detected. Films obtained by compression moulding were stored during 3 months under ambient controlled conditions and thermal, mechanical, structural and oxygen barrier properties were studied in order to evaluate the stability of the PLA–OLA films over time. Blends with 20 and 25 wt% OLA remained stable and compatible with PLA within the ageing period. Besides, PLA–20 wt% OLA formulation was the only one which maintained its amorphous state with adequate thermal, mechanical and oxygen barrier properties for flexible films manufacturing.

Optimization of test and maintenance of ageing components consisting of multiple items and addressing effectiveness

There are many models in the literature that have been proposed in the last decades aimed at assessing the reliability, availability and maintainability (RAM) of safety equipment, many of them with a focus on their use to assess the risk level of a technological system or to search for appropriate design and/or surveillance and maintenance policies in order to assure that an optimum level of RAM of safety systems is kept during all the plant operational life. This paper proposes a new approach for RAM modelling that accounts for equipment ageing and maintenance and testing effectiveness of equipment consisting of multiple items in an integrated manner. This model is then used to perform the simultaneous optimization of testing and maintenance for ageing equipment consisting of multiple items. An example of application is provided, which considers a simplified High Pressure Injection System (HPIS) of a typical Power Water Reactor (PWR). Basically, this system consists of motor driven pumps (MDP) and motor operated valves (MOV), where both types of components consists of two items each. These components present different failure and cause modes and behaviours, and they also undertake complex test and maintenance activities depending on the item involved. The results of the example of application demonstrate that the optimization algorithm provide the best solutions when the optimization problem is formulated and solved considering full flexibility in the implementation of testing and maintenance activities taking part of such an integrated RAM model.