Maternal health care utilization in rural Jordanian villages: Patterns and predictors

Background. Different individual (demographic) characteristic and health system related characteristics have been identified in the literature to contribute to different rates of maternal health care utilization in developing countries. This study is going to evaluate the individual and quality of health predictors of maternal health care utilization in rural Jordanian villages. ^ Methods. Data from a 2004 survey was used. Individual (predisposing and enabling) variables, quality of health care variables, and maternal care utilization variables were selected for 477 women who had a live birth during the last 5 years. The conceptual framework used in this study will be the Aday-Andersen model for health services utilization. ^ Results. 82.4% of women received at least one antenatal care visit. Individually, village of residence (p=0.036), parity (p=0.048), education (p=0.006), and health insurance (p=0.029) were found to be significant; in addition to respectful treatment (p=0.045) and clean facilities (p=0.001) were the only quality of health care factors found to be significant in predicting antenatal care use. Using logistic regression, living in southern villages (OR=4.7, p=0.01) and availability of transportation (sometimes OR=3.2, p=0.01 and never OR=2.4, p<0.05) were the only two factors to influence maternal care use. ^ Conclusions. Living in the South and transportation are major barriers to maternal care utilization in rural Jordan. Other important cultural factors of interest in some villages should be addressed in future research. Perceptions of women regarding quality of health services should be seriously taken into account. ^

Statins and myasthenia gravis

Introduction. 3-hydroxy-3-methylglutaryl CoA reductase inhibitor ("statin") have been widely used for hypercholesteroremia and Statin induced myopathy is well known. Whether Statins contribute to exacerbation of Myasthenia Gravis (MG) requiring hospitalization is not well known. ^ Objectives. To determine the frequency of statin use in patients with MG seen at the neuromuscular division at University of Alabama in Birmingham (UAB) and to evaluate any association between use of statins and MG exacerbations requiring hospitalization in patients with an established diagnosis of Myasthenia Gravis. ^ Methods. We reviewed records of all current MG patients at the UAB neuromuscular department to obtain details on use of statins and any hospitalizations due to exacerbation of MG over the period from January 1, 2003 to December 31, 2006. ^ Results. Of the 113 MG patients on whom information was available for this period, 40 were on statins during at least one clinic visit. Statin users were more likely to be older (mean age 60.2 vs 53.8, p = 0.029), male (70.0% vs 43.8%, p = 0.008), and had a later onset of myasthenia gravis (mean age in years at onset 49.8 versus 42.9, p = 0.051). The total number of hospitalizations or the proportion of subjects who had at least one hospitalization during the study period did not differ in the statin versus no-statin group. However, when hospitalizations which occurred from a suspected precipitant were excluded ("event"), the proportion of subjects who had at least one such event during the study period was higher in the group using statins. In the final Cox proportional hazard model for cumulative time to event, statin use (OR = 6.44, p <0.01) and baseline immunosuppression (OR = 3.03, p = 0.07) were found to increase the odds of event. ^ Conclusions. Statin use may increase the rate of hospitalizations due to MG exacerbation, when excluding exacerbations precipitated by other suspected factors.^

Association of self-reported physical activity and performance in the physical fitness assessment among Airmen

The U.S. Air Force, as with the other branches of military services, has physical fitness standards imposed on their personnel. These standards ensure a healthy and fit combat force. To meet these standards, Airmen have to maintain a certain level of physical activity in their lifestyle. Objective. This was a cross sectional (prevalence) study to evaluate the association of Airmen's self-reported physical activity and their performance in the Air Force Physical Fitness Assessment in 2007. Methods. The self-reported physical activity data were obtained from the Air Force Web Health Assessment (AF WEB HA), a web-based health questionnaire completed by the Airmen during their annual Preventive Health Assessment. The physical activity levels were categorized as having met or not having met the Centers for Disease Control and Prevention (CDC) and the American College of Sports Medicine (ACSM) physical activity recommendations. Physical Fitness scores were collected from the Air Force Fitness Management System (AFFMS), a repository of physical fitness test data. Results. There were 49,029 Airmen who answered the AF WEB HA in 2007 and also took their physical fitness test. 94.4% (n = 46,304) of Airmen met the recommended physical activity guidelines and 79.9% (n = 39,178) passed the fitness test. Total Airmen who both met the physical activity recommendations and passed the fitness test was 75.6% (n = 37,088). Airmen who did not meet the activity recommendations and also failed the fitness test totaled 635 or 1.3% of the study group. The Mantel-Haenszel Chi-Square analysis of the data on the activity levels and the physical fitness test relationship was the following χ2 = 18.52, df 1, and p = <0.0001. The Odds Ratio (OR) was 1.22 (95% CI 1.12, 1.34). Conclusion. The study determined that there was a positive association between Airmen's self-reported physical activity and their performance in the physical fitness assessment.^

Statistical and methodological challenges for disaster preparedness and medical needs assessment in Rio Grande Valley of Texas

In recent years, disaster preparedness through assessment of medical and special needs persons (MSNP) has taken a center place in public eye in effect of frequent natural disasters such as hurricanes, storm surge or tsunami due to climate change and increased human activity on our planet. Statistical methods complex survey design and analysis have equally gained significance as a consequence. However, there exist many challenges still, to infer such assessments over the target population for policy level advocacy and implementation. ^ Objective. This study discusses the use of some of the statistical methods for disaster preparedness and medical needs assessment to facilitate local and state governments for its policy level decision making and logistic support to avoid any loss of life and property in future calamities. ^ Methods. In order to obtain precise and unbiased estimates for Medical Special Needs Persons (MSNP) and disaster preparedness for evacuation in Rio Grande Valley (RGV) of Texas, a stratified and cluster-randomized multi-stage sampling design was implemented. US School of Public Health, Brownsville surveyed 3088 households in three counties namely Cameron, Hidalgo, and Willacy. Multiple statistical methods were implemented and estimates were obtained taking into count probability of selection and clustering effects. Statistical methods for data analysis discussed were Multivariate Linear Regression (MLR), Survey Linear Regression (Svy-Reg), Generalized Estimation Equation (GEE) and Multilevel Mixed Models (MLM) all with and without sampling weights. ^ Results. Estimated population for RGV was 1,146,796. There were 51.5% female, 90% Hispanic, 73% married, 56% unemployed and 37% with their personal transport. 40% people attained education up to elementary school, another 42% reaching high school and only 18% went to college. Median household income is less than $15,000/year. MSNP estimated to be 44,196 (3.98%) [95% CI: 39,029; 51,123]. All statistical models are in concordance with MSNP estimates ranging from 44,000 to 48,000. MSNP estimates for statistical methods are: MLR (47,707; 95% CI: 42,462; 52,999), MLR with weights (45,882; 95% CI: 39,792; 51,972), Bootstrap Regression (47,730; 95% CI: 41,629; 53,785), GEE (47,649; 95% CI: 41,629; 53,670), GEE with weights (45,076; 95% CI: 39,029; 51,123), Svy-Reg (44,196; 95% CI: 40,004; 48,390) and MLM (46,513; 95% CI: 39,869; 53,157). ^ Conclusion. RGV is a flood zone, most susceptible to hurricanes and other natural disasters. People in the region are mostly Hispanic, under-educated with least income levels in the U.S. In case of any disaster people in large are incapacitated with only 37% have their personal transport to take care of MSNP. Local and state government’s intervention in terms of planning, preparation and support for evacuation is necessary in any such disaster to avoid loss of precious human life. ^ Key words: Complex Surveys, statistical methods, multilevel models, cluster randomized, sampling weights, raking, survey regression, generalized estimation equations (GEE), random effects, Intracluster correlation coefficient (ICC).^

Fasting blood glucose and 8-year mortality in the hypertension detection follow-up program population

This study analyzed the relationship between fasting blood glucose (FBG) and 8-year mortality in the Hypertension Detection Follow-up Program (HDFP) population. Fasting blood glucose (FBG) was examined both as a continuous variable and by specified FBG strata: Normal (FBG 60–100 mg/dL), Impaired (FBG ≥100 and ≤125 mg/dL), and Diabetic (FBG>125 mg/dL or pre-existing diabetes) subgroups. The relationship between type 2 diabetes was examined with all-cause mortality. This thesis described and compared the characteristics of fasting blood glucose strata by recognized glucose cut-points; described the mortality rates in the various fasting blood glucose strata using Kaplan-Meier mortality curves, and compared the mortality risk of various strata using Cox Regression analysis. Overall, mortality was significantly greater among Referred Care (RC) participants compared to Stepped Care (SC) {HR = 1.17; 95% CI (1.052,1.309); p-value = 0.004}, as reported by the HDFP investigators in 1979. Compared with SC participants, the RC mortality rate was significantly higher for the Normal FBG group {HR = 1.18; 95% CI (1.029,1.363); p-value = 0.019} and the Impaired FBG group, {HR = 1.34; 95% CI (1.036,1.734); p-value = 0.026,}. However, for the diabetic group, 8-year mortality did not differ significantly between the RC and SC groups after adjusting for race, gender, age, smoking status among Diabetic individuals {HR = 1.03; 95% CI (0.816,1.303); p-value = 0.798}. This latter finding is possibly due to a lack of a treatment difference of hypertension among Diabetic participants in both RC and SC groups. The largest difference in mortality between RC and SC was in the Impaired subgroup, suggesting that hypertensive patients with FBG between 100 and 125 mg/dL would benefit from aggressive antihypertensive therapy.^

Epiphytic orchid diversity and community composition in managed and natural moist evergreen Afromontane forest in SW Ethiopia

In SW Ethiopia, the moist evergreen Afromontane forest has become extremely fragmented and most of the remnants are intensively managed for coffee cultivation (Coffea arabica), with considerable impacts on biodiversity and ecosystem functioning. Because epiphytic orchids are potential indicators for forest quality and a proxy for overall forest biodiversity, we assessed the effect of forest management and forest fragmentation on epiphytic orchid diversity. We selected managed forest sites from both large and small forest remnants and compared their epiphytic orchid diversity with the diversity of natural unfragmented forest. We surveyed 339 canopy trees using rope climbing techniques. Orchid richness decreased and community composition changed, from the natural unfragmented forest, over the large managed forest fragments to the small managed forest fragments. This indicates that both forest management and fragmentation contribute to the loss of epiphytic orchids. Both the removal of large canopy trees typical for coffee management, and the occurrence of edge effects accompanying forest fragmentation are likely responsible for species loss and community composition changes. Even though some endangered orchid species persist even in the smallest fragments, large managed forest fragments are better options for the conservation of epiphytic orchids than small managed forests. Our results ultimately show that even though shade coffee cultivation is considered as a close-to-nature practice and is promoted as biodiversity conservation friendly, it cannot compete with the epiphytic orchid conservation benefit generated by unmanaged moist evergreen Afromontane forests.

Producción de materiales didácticos en portugués: enfoque interdisciplinario. 16H368

El presente proyecto es una continuación del proyecto de investigación: Producción de materiales teóricodidácticos en portugués: enfoque interdisciplinario (Cód. 16h286). El contexto de investigación es la Carrera de Profesorado en Portugués de la Facultad de humanidades y Ciencias Sociales – UNaM. El equipo de investigadores y auxiliares involucrados son docentes de las cátedras y graduados adscriptos, que planificarán y llevarán a cabo el trabajo de campo en disciplinas del Profesorado. Como lo indica el título uno de los propósito de la investigación es el de desarrollar materiales didácticos adecuados a las necesidades de las cátedras y estratégicos en la resolución de problemas de aprendizaje. Desde el paradigma interpretativo, se realizará una investigación aplicada e interdisciplinaria, en la que se utilizará el método etnográfico a fin de estudiar el contexto socio-cultural del estudiante y el análisis del discurso para analizar sus producciones, en procura de plantear resoluciones.

Las representaciones sociales de los docentes, en relación con la incidencia de la enseñanza de idiomas extranjeros en la formación de grado universitario en el ámbito de la Facultad de Humanidades y Ciencias Sociales (FHyCS-UNaM). EIERS 2. 16H314

Es continuidad del Proyecto EIERS (16H-254); continuando con el diseño de investigación exploratoria, cuali-cuantitativo, que tiene por objeto relevar las representaciones sociales de los docentes de la FHyCS-UNaM sobre el valor otorgado a la inclusión del aprendizaje de idiomas extranjeros en la formación académica de grado y contrastarlos con las prácticas académicas (programas de cátedras, producciones didácticas e Informes de Investigación, de Avance y Finales, producidos por los docentes de las carreras de grado en estudio y con el Informe Final del proyecto EIERS). La finalidad será construir un corpus crítico entre lo relevado en los discursos y lo que se hace en la praxis en cuanto a la incorporación de la lengua extranjera en los procesos de enseñanzaaprendizaje en la formación de estudiantes universitarios de las carreras de grado de la FHyCSUNaM. Con este proceso de indagación se busca disponer de conocimiento, analizado a partir de datos primarios y fuentes secundarias, para construir criterios de análisis que posibiliten desarrollar acciones críticas sobre el quehacer en la formación universitaria de grado en relación a la adquisición de competencias lingüísticas que posibiliten el acceso a la producción científico académica que se realiza en otros idiomas. En esta segunda etapa el equipo de investigadores se propone explorar la percepción que tienen los docentes sobre los aprendizajes instrumentales de lenguas extranjeras y la valoración que realizan acerca del impacto de estos conocimientos en la habilitación académica de los estudiantes en su formación de grado universitario; como así también en la continuidad de las carreras de postgrado y / en su desarrollo profesional. El análisis de las RSd sobre la importancia de los IE en su formación de grado, brindará información acerca de los modos en que el docente construye el espacio disciplinar en que está inmerso a fin de trazar nuevas y más complejas redes conceptuales, redimensionando sus prácticas áulicas Resumen técnico: Es continuidad del Proyecto EIERS (16H-254); continuando con el diseño de investigación exploratoria, cuali-cuantitativo, que tiene por objeto relevar las representaciones sociales de los docentes de la FHyCS-UNaM sobre el valor otorgado a la inclusión del aprendizaje de idiomas extranjeros en la formación académica de grado y contrastarlos con las prácticas académicas (programas de cátedras, producciones didácticas e Informes de Investigación, de Avance y Finales, producidos por los docentes de las carreras de grado en estudio y con el Informe Final del proyecto EIERS). La finalidad será construir un corpus crítico entre lo relevado en los discursos y lo que se hace en la praxis en cuanto a la incorporación de la lengua extranjera en los procesos de enseñanzaaprendizaje en la formación de estudiantes universitarios de las carreras de grado de la FHyCSUNaM. Con este proceso de indagación se busca disponer de conocimiento, analizado a partir de datos primarios y fuentes secundarias, para construir criterios de análisis que posibiliten desarrollar acciones críticas sobre el quehacer en la formación universitaria de grado en relación a la UNaM – FHCS – SinvyP Gsinvyp03 adquisición de competencias lingüísticas que posibiliten el acceso a la producción científico académica que se realiza en otros idiomas.

Les Tribus Dans l´histoire et face aux états. En: Avá, nº 17

Este brevísimo libro de Maurice Godelier, cuyo texto procede de la conferencia inaugural del coloquio internacional The Political Role of Tribes in the Middle East (Ammán, Jordania, Octubre de 2009), ofrece en apenas unas 80 páginas un panorama general de cuestiones de antropología política, con una vertiente de comparación histórica en diversos períodos y lugares, sobre la naturaleza de las sociedades tribales y su relación con las organizaciones estatales.

Del libro didáctico a la secuencia de formación: propuestas de intervención pedagógica. 16H/342

Este proyecto se desprende de El LD como material para la enseñanza de PLE -Perspectivas políticas: industria editorial y trabajo simbólico culminado en 2011. El análisis de los LDs (libros didácticos) de PLE (Portugués Lengua Extranjera) nos proporcionó bases teórico-metodológicas para la reflexión sobre las configuraciones textuales, discursivas y semióticas acerca de la enseñanza del PLE en la Argentina y en nuestra región. Sin embargo, consideramos que nuestra tarea investigativa debe avanzar en una propuesta de intervención pedagógica que ayude a explorar nuevas estrategias y prácticas de comprensión y producción, a partir de materiales que favorezcan aprendizajes significativos. Para ello revisamos las conclusiones elaboradas en la etapa anterior en relación con las matrices discursivas predominantes de los LDs focalizadas en las dimensiones históricopolíticas y de gramaticalización de la lengua, en las matrices ético-culturales de la identidad brasileña y en las configuraciones editoriales del mundo de los negocios. Nuestro objetivo es elaborar propuestas de intervención para la enseñanza del PLE que ponderen críticamente los posicionamientos ideológicos respecto de la lengua y las textualidades que propicien la condición dialógica del quehacer educativo. Dichas propuestas serán consideradas como secuencias de formación, entendidas como focos del proceso polisémico de los saberes implicados en el aprendizaje de una lengua extranjera.

Representaciones de las actividades económicas en el Territorio Nacional de Misiones (1930-1950). En: LaRivada, V. 2, n° 3

La representación de una región excede la delimitación de un espacio geográfico, ya que de ella devienen prácticas y fundamentaciones discursivas y simbólicas, configurando tanto un sentido político como identitario en relación a la vivencia, la percepción y el ejercicio de poder. El relevamiento de información de los representantes estatales constituyó una “excusa” para evaluar los intereses, los saberes y las perspectivas que derivaron en argumentos de consenso respecto de la construcción de la opinión pública, en torno a la región desde el poder central. Nuestro análisis está centrado, fundamentalmente, en la perspectiva de Jorge Newton (1950) y Alberto Carlos Muello (1930). La puesta en diálogo de las perspectivas de dos exploradores en torno al desarrollo de Misiones posibilita un entendimiento aproximativo a las definiciones en las que se sustentan las actividades económicas, las relaciones con las múltiples formas de colonización implementadas y los criterios políticos para la orientación económica de la región y el país.

Water temperature reconstruction for Terminations I and II of sediment core MD01-2378

We present centennial records of sea surface and upper thermocline temperatures in Core MD01-2378 from the Timor Sea, which provide new insights into the variability of the Indonesian outflow across the last two glacial terminations. Mg/Ca in Globigerinoides ruber (white s. s.) indicates an overall increase of 3.2 °C in sea surface temperature (SST) over Termination I. Following an early Holocene plateau at 11.3-6.4 ka, SSTs cooled by 0.6 °C during the middle to late Holocene (6.4-0.7 ka). The early Holocene warming occurred in phase with increasing northern hemisphere summer insolation, coinciding with northward displacement of the Intertropical Convergence Zone, enhanced boreal summer monsoon and expansion of the Indo-Pacific Warm Pool. Thermocline temperatures (Pulleniatina obliquiloculata Mg/Ca) gradually decreased from 24.5 to 21.5 °C since 10.3 ka, reflecting intensification of a cool thermocline throughflow. The vertical structure of the upper ocean in the Timor Sea evolved in similar fashion during the Holocene and MIS5e, although the duration of SST plateaux differed (11.3 to 6.4 ka in Termination I and from 129 to 119 ka in Termination II), which was probably due to the more intense northern hemisphere summer insolation during MIS 5e. During both terminations, SST increased simultaneously in the southern high latitudes and the tropical eastern Indian Ocean, suggesting virtually instantaneous atmospheric climate feedbacks between the high and low latitudes.