970 resultados para EPIDEMIOLOGICAL SURVEY


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CONTEXT: Media and scientific reports have indicated an increase in recreational use of Salvia divinorum. Epidemiological data are lacking on the trends, prevalence, and correlates of S. divinorum use in large representative samples, as well as the extent of substance use and mental health problems among S. divinorum users. OBJECTIVE: To examine the national trend in prevalence of S. divinorum use and to identify sociodemographic, behavioral, mental health, and substance-use profiles of recent (past-year) and former users of S. divinorum. DESIGN: Analyses of public-use data files from the 2006-2008 United States National Surveys on Drug Use and Health (N = 166,453). SETTING: Noninstitutionalized individuals aged 12 years or older were interviewed in their places of residence. MAIN MEASURES: Substance use, S. divinorum, self-reported substance use disorders, criminality, depression, and mental health treatment were assessed by standardized survey questions administered by the audio computer-assisted self-interviewing method. RESULTS: Among survey respondents, lifetime prevalence of S. divinorum use had increased from 0.7% in 2006 to 1.3% in 2008 (an 83% increase). S. divinorum use was associated with ages 18-25 years, male gender, white or multiple race, residence of large metropolitan areas, arrests for criminal activities, and depression. S. divinorum use was particularly common among recent drug users, including users of lysergic acid diethylamide (53.7%), ecstasy (30.1%), heroin (24.2%), phencyclidine (22.4%), and cocaine (17.5%). Adjusted multinomial logistic analyses indicated polydrug use as the strongest determinant for recent and former S. divinorum use. An estimated 43.0% of past-year S. divinorum users and 28.9% of former S. divinorum users had an illicit or nonmedical drug-use disorder compared with 2.5% of nonusers. Adjusted logistic regression analyses showed that recent and former S. divinorum users had greater odds of having past-year depression and a substance-use disorder (alcohol or drugs) than past-year alcohol or drug users who did not use S. divinorum. CONCLUSION: S. divinorum use is prevalent among recent or active drug users who have used other hallucinogens or stimulants. The high prevalence of substance use disorders among recent S. divinorum users emphasizes the need to study health risks of drug interactions.

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French music flourished from the last quarter of the nineteenth century into the early twentieth century, especially in the genres of opera and orchestral music. Although French keyboard music enjoyed less popularity, being overshadowed by these predominant genres, prominent impressionist figures Claude Debussy (1862-1918) and Maurice Ravel (1875-1937) . . brought its revival to the French music. Scholars consider Debussy to be a frontrunner of Impressionism, and his influence had a major impact on subsequent composers. As a result of his popularity, other significant works by French composers seem to be overlooked by pianists and audiences and are not as often performed. Because keyboard works by Debussy and Ravel are a popular performance choice among pianists, I was eager to examine music by other French composers. Through my resea,rch, I found many great works that warranted further study and deserve a place in the keyboard repertoire. This recording project contains works by lesser-known French composers written between the years of 1880 and 1950, namely Emmanuel Chabrier (1841-1894), Gabriel-Urbain Faure (1845-1924), Charles Koechlin (1867-1950), Albert Roussel (1869-1937), Erik Satie (1866-1925), Francis Poulenc (1899-1963), Darius Milhaud (1892-1974), Robert Casadesus (1899-1972) and Henri Dutilleux (b.1916). Since piano repertoire is abundant, it is sometimes difficult to create a performance program. Therefore, it frequently becomes the default to choosing familiar repertoire rather than using the opportunity to expand the repertoire. As a pianist, I feel responsible to search for hidden musical treasures with which pianists and audiences alike are not so well acquainted. This recording project explores nine lesser-known French compositions written between 1880 and 1950. I expect this to be an opportunity to introduce both pianists and audiences to outstanding but unfamiliar works by French composers. This dissertation was recorded on two compact discs in Dekelboum Concert Hall at Clarice Smith Performing Arts Center of the University of Maryland. The recordings are archived in the University of Maryland Library.

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OBJECTIVE: To assess potential diagnostic and practice barriers to successful management of massive postpartum hemorrhage (PPH), emphasizing recognition and management of contributing coagulation disorders. STUDY DESIGN: A quantitative survey was conducted to assess practice patterns of US obstetrician-gynecologists in managing massive PPH, including assessment of coagulation. RESULTS: Nearly all (98%) of the 50 obstetrician-gynecologists participating in the survey reported having encountered at least one patient with "massive" PPH in the past 5 years. Approximately half (52%) reported having previously discovered an underlying bleeding disorder in a patient with PPH, with disseminated intravascular coagulation (88%, n=23/26) being identified more often than von Willebrand disease (73%, n=19/26). All reported having used methylergonovine and packed red blood cells in managing massive PPH, while 90% reported performing a hysterectomy. A drop in blood pressure and ongoing visible bleeding were the most commonly accepted indications for rechecking a "stat" complete blood count and coagulation studies, respectively, in patients with PPH; however, 4% of respondents reported that they would not routinely order coagulation studies. Forty-two percent reported having never consulted a hematologist for massive PPH. CONCLUSION: The survey findings highlight potential areas for improved practice in managing massive PPH, including earlier and more consistent assessment, monitoring of coagulation studies, and consultation with a hematologist.

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The process of determining the level of care and specific postacute care facility for stroke patients has not been adequately studied. The objective of this study was to better understand the factors that influence postacute care decisions by surveying stroke discharge planners. Requests were sent to discharge planners at 471 hospitals in the Northeast United States to complete an online survey regarding the factors impacting the selection of postacute care. Seventy-seven (16%) discharge planners completed the online survey. Respondents were mainly nurses and social workers and 73% reported ≥20 years healthcare experience. Patients and families were found to be significantly more influential than physicians (P < 0.001) and other clinicians (P = 0.04) in influencing postdischarge care. Other clinicians were significantly more influential than physicians (P < 0.001). Insurance and quality of postacute care were the factors likely to most affect the selection of postacute care facility. Insurance was also identified as the greatest barrier in the selection of level of postacute care (70%; P < 0.001) and specific postacute care facility (46%; P = 0.02). More than half reported that pressure to discharge patients quickly impacts a patients' final destination. Nonclinical factors are perceived by discharge planners to have a major influence on postacute stroke care decision making.

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The survey was made available online to library faculty, staff, and student workers. Participation in the survey was completely voluntary, and each individual question was entirely optional. In accordance with UMD policy, responses were treated as confidential. Fewer than five responses in a particular category were considered identifiable by the U.S. Department of Education and were not included in this report. Those who participated in the survey represent a significant portion of the Libraries’ community.

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Interleukin-12 receptor β1 (IL-12Rβ1) deficiency is the most common form of Mendelian susceptibility to mycobacterial disease (MSMD). We undertook an international survey of 141 patients from 102 kindreds in 30 countries. Among 102 probands, the first infection occurred at a mean age of 2.4 years. In 78 patients, this infection was caused by Bacille Calmette-Guérin (BCG; n = 65), environmental mycobacteria (EM; also known as atypical or nontuberculous mycobacteria) (n = 9) or Mycobacterium tuberculosis (n = 4). Twenty-two of the remaining 24 probands initially presented with nontyphoidal, extraintestinal salmonellosis. Twenty of the 29 genetically affected sibs displayed clinical signs (69%); however 8 remained asymptomatic (27%). Nine nongenotyped sibs with symptoms died. Recurrent BCG infection was diagnosed in 15 cases, recurrent EM in 3 cases, recurrent salmonellosis in 22 patients. Ninety of the 132 symptomatic patients had infections with a single microorganism. Multiple infections were diagnosed in 40 cases, with combined mycobacteriosis and salmonellosis in 36 individuals. BCG disease strongly protected against subsequent EM disease (p = 0.00008). Various other infectious diseases occurred, albeit each rarely, yet candidiasis was reported in 33 of the patients (23%). Ninety-nine patients (70%) survived, with a mean age at last follow-up visit of 12.7 years ± 9.8 years (range, 0.5-46.4 yr). IL-12Rβ1 deficiency is characterized by childhood-onset mycobacteriosis and salmonellosis, rare recurrences of mycobacterial disease, and more frequent recurrence of salmonellosis. The condition has higher clinical penetrance, broader susceptibility to infections, and less favorable outcome than previously thought. © 2010 Lippincott Williams & Wilkins.

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Background: This epidemiological study was carried out to establish the magnitude of the changing incidence of gastric and oesophageal cancer. Methods: Time-trend analyses of subsite-specific cancers of the oesophagus and stomach were performed using data from the Thames Cancer Registry database (1960-1996) for the South Thames Region. The changes in sex ratio and peak age of incidence are reported. Results: In the upper two-thirds of the oesophagus there was no significant change in the incidence rate, but the lower third of the oesophagus showed a marked rise for both sexes (average annual change + 0.05 for men, + 0.009 for women). For the gastric cardia, the incidence in males increased (average annual change + 0.025), while in females it remained unchanged. Cancers of the oesophagogastric junction showed a clear increase for both sexes (average annual change + 0.07 for men, + 0.009 for women). There were changes in the sex ratio and peak age of incidence for all subsite cancers for both sexes. Conclusion: Over a 37-year period the incidence of cancer of the oesophagogastric junction increased threefold, while the incidence of cancers of the other subsites of the stomach decreased. Further studies are needed to investigate the aetiology of these changes.

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We survey recent results on the computational complexity of mixed shop scheduling problems. In a mixed shop, some jobs have fixed machine orders (as in the job shop), while the operations of the other jobs may be processed in arbitrary order (as in the open shop). The main attention is devoted to establishing the boundary between polynomially solvable and NP-hard problems. When the number of operations per job is unlimited, we focus on problems with a fixed number of jobs.

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As announced in the November 2000 issue of MathStats&OR [1], one of the projects supported by the Maths, Stats & OR Network funds is an international survey of research into pedagogic issues in statistics and OR. I am taking the lead on this and report here on the progress that has been made during the first year. A paper giving some background to the project and describing initial thinking on how it might be implemented was presented at the 53rd session of the International Statistical Institute in Seoul, Korea, in August 2001 in a session on The future of statistics education research [2]. It sounded easy. I considered that I was something of an expert on surveys having lectured on the topic for many years and having helped students and others who were doing surveys, particularly with the design of their questionnaires. Surely all I had to do was to draft a few questions, send them electronically to colleagues in statistical education who would be only to happy to respond, and summarise their responses? I should have learnt from my experience of advising all those students who thought that doing a survey was easy and to whom I had to explain that their ideas were too ambitious. There are several inter-related stages in survey research and it is important to think about these before rushing into the collection of data. In the case of the survey in question, this planning stage revealed several challenges. Surveys are usually done for a purpose so even before planning how to do them, it is advisable to think about the final product and the dissemination of results. This is the route I followed.

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A survey of teaching and assessment methods employed in UK Higher Education programmes for Human-Computer Interaction (HCI) courses was conducted in April 2003. The findings from this survey are presented, and conclusions drawn.

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Scheduling has become a major field within operational research with several hundred publications appearing each year. This paper explores the historical development of the subject since the mid-1950s when the landmark publications started to appear. A discussion of the main topics of scheduling research for the past five decades is provided, highlighting the key contributions that helped shape the subject. The main topics covered in the respective decades are combinatorial analysis, branch and bound, computational complexity and classification, approximate solution algorithms and enhanced scheduling models.

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This paper uses a case study approach to consider the effectiveness of the electronic survey as a research tool to measure the learner voice about experiences of e-learning in a particular institutional case. Two large scale electronic surveys were carried out for the Student Experience of e-Learning (SEEL) project at the University of Greenwich in 2007 and 2008, funded by the UK Higher Education Academy (HEA). The paper considers this case to argue that, although the electronic web-based survey is a convenient method of quantitative and qualitative data collection, enabling higher education institutions swiftly to capture multiple views of large numbers of students regarding experiences of e-learning, for more robust analysis, electronic survey research is best combined with other methods of in-depth qualitative data collection. The advantages and disadvantages of the electronic survey as a research method to capture student experiences of e-learning are the focus of analysis in this short paper, which reports an overview of large-scale data collection (1,000+ responses) from two electronic surveys administered to students using surveymonkey as a web-based survey tool as part of the SEEL research project. Advantages of web-based electronic survey design include flexibility, ease of design, high degree of designer control, convenience, low costs, data security, ease of access and guarantee of confidentiality combined with researcher ability to identify users through email addresses. Disadvantages of electronic survey design include the self-selecting nature of web-enabled respondent participation, which tends to skew data collection towards students who respond effectively to email invitations. The relative inadequacy of electronic surveys to capture in-depth qualitative views of students is discussed with regard to prior recommendations from the JISC-funded Learners' Experiences of e-Learning (LEX) project, in consideration of the results from SEEL in-depth interviews with students. The paper considers the literature on web-based and email electronic survey design, summing up the relative advantages and disadvantages of electronic surveys as a tool for student experience of e-learning research. The paper concludes with a range of recommendations for designing future electronic surveys to capture the learner voice on e-learning, contributing to evidence-based learning technology research development in higher education.

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Whereas common infectious and parasitic diseases such as malaria and the HIV/AIDS pandemic remain major unresolved health problems in many developing countries, emerging non-communicable diseases relating to diet and lifestyle have been increasing over the last two decades, thus creating a double burden of disease and impacting negatively on already over-stretched health services in these countries. Prevalence rates for type 2 diabetes mellitus and CVD in sub-Saharan Africa have seen a 10-fold increase in the last 20 years. In the Arab Gulf current prevalence rates are between 25 and 35% for the adult population, whilst evidence of the metabolic syndrome is emerging in children and adolescents. The present review focuses on the concept of the epidemiological and nutritional transition. It looks at historical trends in socio-economic status and lifestyle and trends in nutrition-related non-communicable diseases over the last two decades, particularly in developing countries with rising income levels, as well as the other extreme of poverty, chronic hunger and coping strategies and metabolic adaptations in fetal life that predispose to non-communicable disease risk in later life. The role of preventable environmental risk factors for obesity and the metabolic syndrome in developing countries is emphasized and also these challenges are related to meeting the millennium development goals. The possible implications of these changing trends for human and economic development in poorly-resourced healthcare settings and the implications for nutrition training are also discussed.