A profile of middle-aged women who consult a chiropractor or osteopath: Findings from a survey of 11,143 Australian women

Purpose: The aim of this study is to examine the prevalence of chiropractic and osteopathy use and the profile of chiropractor/osteopath users among middle-aged Australian women. Methods: This article reports on research conducted as part of the Australian Longitudinal Study on Women's Health. The focus of this article is the middle-aged women who responded to Survey 3 in 2001 when they were between the ages of 50 and 55 years. The demographic characteristics, health status, and health service use of chiropractic/osteopathy users and nonusers were compared using chi(2) tests for categorical variables and t tests for continuous variables. Results: We estimate that 16% of middle-aged women consult with a chiropractor or osteopath (after adjustment for the oversampling of rural women). Area of residence, education, and employment status were all statistically significantly associated with chiropractic and osteopath use. Specifically, women who live in nonurban areas were more likely to consult a chiropractor or osteopath, compared with women who live in urban areas. Women are significantly more likely to consult with a chiropractor/osteopath if they have had a major personal injury in the previous year, and women who use chiropractic/osteopathy are also high users of 'conventional' health services. Conclusions: Chiropractic/osteopathy use among women in Australia is substantial and cannot be ignored by those providing or managing primary health care services for women. It is essential that the interface and communication between chiropractors/osteopaths and other health care providers be highlighted and maximized to establish and maintain effective overall patient coordination and management.

Cost-effectiveness of cholesterol-lowering therapy with pravastatin in patients with previous acute coronary syndromes aged 65 to 74 years compared with younger patients: Results from the LIPID study

Background We compared cost-effectiveness of pravastatin in a placebo-controlled trial in 5500 younger (31-64 years) and 3514 older patients (65-74 years) with previous acute coronary syndromes. Methods Hospitalizations and long-term medication within the 6 years of the trial were estimated in all patients. Drug dosage, nursing home, and ambulatory care costs were estimated from substudies. Incremental costs per life saved of pravastatin relative to placebo were estimated from treatment effects and resource use. Results Over 6 years, pravastatin reduced all-cause mortality by 4.3% in the older patients and by 2.3% in the younger patients. Older patients assigned pravastatin had marginally lower cost of pravastatin and other medication over 6 years (A$4442 vs A$4637), but greater cost offsets (A$2061 vs. A$897) from lower rates of hospitalizations. The incremental cost per life saved with pravastatin was A$55500 in the old and A$167200 in the young. Assuming no treatment effect beyond the study period, the life expectancy to age 82 years of additional survivors was 9.1 years in the older and. 17.3 years in the younger. Estimated additional life-years saved from pravastatin therapy were 0.39 years for older and 0.40 years for younger patients. Incremental costs per life-year saved were A$7581 in the older and A$1.4944 in the younger, if discounted at 5% per annum. Conclusions Pravastatin therapy was more cost-effective among older than younger patients, because of their higher baseline risk and greater cost offsets, despite their shorter life expectancy.

The effect of residence time and aeration on coal recovery within the high density zone of a flotation machine

The high intensity zone within the Jameson Cell is the downcomer. It is largely external and separated from the flotation tank. This, together with operation of the downcomer under vacuum, rather than at elevated pressure and the absence of moving parts, allows ready access to the high intensity zone for measurement and analysis. Experimentation was conducted allowing measurements of recovery for residence times of between 20 milliseconds and ten seconds within the downcomer of a Jameson Cell. The affect of aeration rate on the recovery of different particle sizes was also studied.

Technical entrepreneurship in the UK:an examination of the relationship between the previous occupational background of the technical entrepreneur and the management of the small technology-based venture

With the growing appreciation of the contribution of small technology-based ventures to a healthy economy, an analysis of the individual who initiates and manages such ventures - the technical entrepreneur - is highly desirable, predominantly because of the influence of such an individual on the management and future strategy of the venture. An examination of recent research has indicated that a study of the previous experience and expertise of the entrepreneur, gained in previous occupations, may be highly relevant in determining the possible success of a new venture. This is particularly true where the specific expertise of the entrepreneur forms the main strategic advantage of the business, as in the case of small technology-based firms. Despite this, there has been very little research which has attempted to examine the relationship between the previous occupational background of the technical entrepreneur, and the management of the small technology-based firm. This thesis will examine this relationship, as well as providing an original contribution to the study of technical entrepreneurship in the UK. Consequently, the exploratory nature of the research prompted an inductive qualitative approach being adopted for the thesis. Through a two stage, multiple-site research approach, an examination was made of technical entrepreneurs heading award-winning technology-based small firms in the UK. The main research questions focused on management within the firm, the novelty and origin of the technology adopted, and the personal characteristics of the entrepreneur under study. The results of this study led to the creation of a specific typology for technical entrepreneurs, based on the individual's role in the development of technology within his previous occupation.

Influence of reaction atmosphere (H2O, N2, H2, CO2, CO) on fluidized-bed fast pyrolysis of biomass using detailed tar vapor chemistry in computational fluid dynamics

Secondary pyrolysis in fluidized bed fast pyrolysis of biomass is the focus of this work. A novel computational fluid dynamics (CFD) model coupled with a comprehensive chemistry scheme (134 species and 4169 reactions, in CHEMKIN format) has been developed to investigate this complex phenomenon. Previous results from a transient three-dimensional model of primary pyrolysis were used for the source terms of primary products in this model. A parametric study of reaction atmospheres (H2O, N2, H2, CO2, CO) has been performed. For the N2 and H2O atmosphere, results of the model compared favorably to experimentally obtained yields after the temperature was adjusted to a value higher than that used in experiments. One notable deviation versus experiments is pyrolytic water yield and yield of higher hydrocarbons. The model suggests a not overly strong impact of the reaction atmosphere. However, both chemical and physical effects were observed. Most notably, effects could be seen on the yield of various compounds, temperature profile throughout the reactor system, residence time, radical concentration, and turbulent intensity. At the investigated temperature (873 K), turbulent intensity appeared to have the strongest influence on liquid yield. With the aid of acceleration techniques, most importantly dimension reduction, chemistry agglomeration, and in-situ tabulation, a converged solution could be obtained within a reasonable time (∼30 h). As such, a new potentially useful method has been suggested for numerical analysis of fast pyrolysis.

Previous Holocaust Experiences Continue to Affect Food Attitudes in Survivors

A qualitative study was conducted to determine if Holocaust survivors’ food attitudes are influenced by their earlier experiences. The 25 survivor interviewees (14 males, 11 females) ranged in age from 71 to 85 years and resided in Miami-Dade and Broward, Florida counties. Most (56%) were interned in concentration camps during the Holocaust. Interviews were tape-recorded and later transcribed. Results showed earlier experiences influenced food attitudes. The most common themes were: 1) Difficulty throwing food away - even when spoiled; 2) Storing excess food; 3) Craving a certain food; 4) Difficulty standing in line for food; and 5) Anxiety when food is not readily available. Sub-themes included healthy eating and empathy for those currently suffering from hunger. Fourteen (56%) fast for religious holidays, but 7 (28%) said they already had “fasted enough.” Dietitians and others are encouraged to evaluate food service programs to minimize uncomfortable food-related situations for Holocaust survivors.

(Table 1) Sample locations, Hf and Nd isotopic compositions and concentrations of Atlantic seawater samples with hydrographic details

The first full water column hafnium isotopic compositions of Atlantic seawater have been obtained at seven locations from the Labrador Sea to the Drake Passage. Despite subpicomolar concentrations in seawater, a precision of the Hf isotopic measurements of <0.7 epsilon-Hf units was achieved. An overall epsilon-Hf range between -3.1 in the Labrador Sea and +4.4 in Antarctic bottom water was determined, the distribution of which broadly reflects continental weathering inputs. Within particular water column profiles, significant differences of up to 4 epsilon-Hf units occur. Combined with Nd isotope data of the same samples, it is evident that the Hf isotopic composition of seawater is too radiogenic for a given Nd isotopic composition and that the largest difference between expected and measured Hf isotopic compositions in seawater occurs near the oldest continental crust in the Labrador Sea. This corroborates the previous proposition, which was mainly based on ferromanganese crust data, that the Hf isotopic composition of seawater is controlled by incongruent weathering of continental crust and possibly, to some extent, by hydrothermal contributions. Hafnium concentrations in the ocean do not increase along the deep ocean conveyer indicating an oceanic residence time of only a few hundred years, which is significantly shorter than previously assumed. The Hf isotopic composition of past seawater can therefore serve as a proxy for short distance, basin scale mixing processes and the regime and intensity of nearby continental weathering processes.

Tomada de decisão individual e aprendizado em Dinoponera quadríceps (Ponerinae, Hymenoptera) forrageando em ambientes dinâmicos

When searching for food, animals often make decisions of where to go, how long to stay in a foraging area and whether or not to return to the last visited spot. These decisions can be enhanced by cognitive traits and adjusted based on previous experience. In social insects such as ants, foraging efficiency have an impact on both individual and colony level. The present study investigated, in the laboratory, the effect of distance from food, capture success and food size, and reward rate on decisions of where to forage in Dinoponera quadriceps, a ponerine ant that forage solitarily and individually make their foraging decisions. We also investigated the influence of learning on the performance of workers over successive trips searching for food by measuring the patch residence time in each foraging trip. Four scenarios were created differing in food reward rates, food size offered and distances colony-food site. Our work has shown that as a rule-of-thumb, workers of D. quadriceps return to the place where a prey item was found on the previous trip, regardless of distance, food size and reward rate. When ants did not capture preys, they were more likely to change path to search for food. However, in one of the scenarios, this decision to switch paths when unsuccessful was less evident, possibly due to the greater variation of possible outcomes ants could experience in this scenario and cognitive constraints of D. quadriceps to predict variations of food distribution. Our results also indicated a learning process of routes of exploration as well as the food site conditions for exploration. After repeated trips, foragers reduced the patch residence time in areas that they did not capture food and quickly changed of foraging area, increasing their foraging efficiency.

Attachment, psychological functioning, and resilience within the street involved youth populations: describing youth who access community agency support

Youth homelessness is defined within the literature as youth who have left their homes and are living independent of parental figures and/or caregivers, have no stable residence or source of income, and lack access to the supports needed to make the challenging transition into adulthood (Canadian Observatory on Homelessness, 2015). Previous research studying homeless (or street-involved) youth has primarily focused on risk factors hindering the development of this population, and has largely ignored resilience, coping, and help-seeking behaviours. The current study examined the attachment styles (both categorically and dimensionally), psychological functioning, resilience, and help-seeking behaviours in street-involved youth of St. John’s, Newfoundland. Face-to face interviews were completed over a four-month period with 63 youth (42 males, 21 females) aged 15-29 (Mage = 20.00), recruited from a local community organization providing outreach services to street-involved youth. Results revealed the disproportionate struggles of the street-involved youth population, and highlighted higher levels of attachment insecurity, psychological distress and lower resilience compared to normative peers. Findings also showed a significant difference in psychological functioning, overall resilience, and emotional reactivity based on individual attachment style. In an exploratory model of help-seeking, a positive relationship was found between overall resilience (defined as a sense of mastery and sense of relatedness) and frequency of community service access. However, contrary to predictions, no relationships were found between frequency of community service access and attachment, psychological functioning, or emotional reactivity. Implications of the present findings in development of interventions for street-involved youth are discussed, in addition to strengths and limitations of the present research, and suggested areas of future inquiry.

Morbidity and mortality following pelvic rami fractures in an elderly Newfoundland population

Introduction: Pelvic rami fractures in the elderly are associated with significant morbidity and mortality. Despite our rapidly aging population there is a paucity of literature dealing with fractures of the pelvic rami in this age group. The purpose of this study is report mortality rates following these injuries in the Eastern region of Newfoundland. Additionally, we aim to describe and quantify the important resultant morbidity in this vulnerable elderly population . Methods: A retrospective chart review was performed of all the pelvic fractures in individuals over the age of 60 between 2000 and 2005 in the Eastern Health region of Newfoundland and Labrador. From these patients, only those with the radiographic parameters consistent with low energy pattern pelvic ring injuries were included. Excluded from the study were those with concurrent fractures of the femur. Survival data, comorbidities, injury characteristics, hospital stay, ambulatory status, and place of residence were recorded from the chart. A surrogate control group was formulated from Statistics Canada survival data for use as a survival comparison group. Results: There were 80 fractures of the pelvis identified in patients over 60 years old from 2000-2005. Of these, 43 met our inclusion/exclusion criteria and were used in our analysis. The one and five year mortalities of these patients were 16.3% (95% CI; 7.80% to 30.3%) and 58.1% (95% CI; 43.3% to 71.6%), respectively. These were both significantly different from the point estimates from our constructed age and gender matched control group from the Statistics Canada data of 6.58% (one year mortality) and 31.3% (five year mortality). Morbidity was quantified by change in ambulatory status (independent, walker/cane assisted, wheelchair) and change in residential independence (independent, assisted living, nursing home). Post fracture, 36% of patients permanently required increased ambulatory aids and 21% of patients required a permanent increase in everyday level of care. Conclusion: This study suggests that there may be significantly increased mortality and morbidity following low energy pattern pelvic rami fractures in an elderly population compared to age and gender matched controls. In contrast to previous studies describing these injuries, there is greater homogeneity in this population with respect to age and mechanism of injury. This study generates several important hypotheses for future research and in particular highlights the need for larger prospective studies to identify factors predicting the highest risk for poor outcomes in this population.

Aglomeração urbana descontínua: o exemplo de Araguari e Uberlândia/MG

The analysis of urban conurbations demands the understanding regarding the difference between urban territorial continuity and spatial continuity. While the spatial continuity is understood due to its interrelations and established fluxes, in other words, through the spatial integration, the territorial continuity is related to the urban tissue. Therefore, the spatial continuity can manifest in a simultaneous way or associated to the territorial discontinuity. From this perspective, the main objective of this research consists on identifying and dimensioning the spatial interactions that are driven to a urban conurbation process between the municipalities of Araguari and Uberlândia/MG, besides the not continuity of the territorial urban area. The intensity of these interactions was identified from the displacements by the dwellers from both municipalities in search of job occupations, education and health assistance. So it would be able to reach the proposed objectives we used several methodological procedures, such as a bibliographic and documental researches. In order to identify the education and work fluxes we analyzed the micro data from the Demographic Census 2010. For the educational sector it was also accomplished a research, in Araguari, the place of residence of students enrolled at Instituto Master de Ensino Presidente Antônio Carlos (IMEPAC) and, in Uberlândia, the place of residence of students enrolled at Universidade Federal de Uberlândia (UFU). The identification of health fluxes was done through a research, in Uberlândia, of the inpatients' origin at Hospital de Clínicas de Uberlândia of the Universidade Federal de Uberlândia (HCU/UFU) and, in Araguari, of the origin of patients that are attended at the Pronto-Socorro Municipal. Semi structured interviews were also accomplished with different social actors. Another important step was the use of questionnaires with the inter-municipal public transportation users at their boarding place in Araguari and Uberlândia. This paper was organized in five chapters, while in the first one we accomplished a theoretical discussion over the concept of urban conurbation, in order to presenting the identification and classification criteria and the urban conurbation of non metropolitan criteria. The second chapter analyses the differentiation process between Araguari and Uberlândia, which is a result of the distinct territorial formation of the municipalities. The third chapter analyses the intensity and degree of the spatial interactions between the two municipalities, having as a focus the established fluxes in the work sector. The fourth chapter, on the other hand, focuses on the education and health sectors, while the last chapter accomplishes a discussion to investigate if the analyzed fluxes in the previous chapters make it able to identify if the spatial interactions established between Araguari and Uberlândia are measured through complementarities or dependence. As a result it was possible to identify that, due to the expressiveness of the established fluxes between the two municipalities, beyond the further ones of Triângulo Mineiro and Alto Paranaíba in the three selected sectors, there is a configuration of a discontinuous urban conurbation process. It was also possible to conclude that, despite the fluxes between Araguari and Uberlândia being more representative than the other way around there's a coexistence dependence relationship and complementarity between the two municipalities.