Facteurs de risque pour les maladies diarrhéiques chez les enfants à Dakar : une analyse multi-niveaux avec variables latentes

Au Sénégal, les maladies diarrhéiques constituent un fardeau important, qui pèse encore lourdement sur la santé des enfants. Ces maladies sont influencées par un large éventail de facteurs, appartenant à différents niveaux et sphères d'analyse. Cet article analyse ces facteurs de risque et leur rôle relatif dans les maladies diarrhéiques de l'enfant à Dakar. Ce faisant, elle illustre une nouvelle approche pour synthétiser le réseau de ces déterminants. Une analyse en classes latentes (LCA) est d’abord menée, puis les variables latentes ainsi construites sont utilisées comme variables explicatives dans une régression logistique sur trois niveaux. Les résultats confirment que les déterminants des diarrhées chez l'enfant appartiennent aux trois niveaux d'analyse et que les facteurs comportementaux et l'assainissement du quartier jouent un rôle prépondérant. Les résultats illustrent aussi l'utilité des LCA pour synthétiser plusieurs indicateurs, afin de créer une image causale intégrée, tout en utilisant des modèles statistiques parcimonieux.

Lipid and lipid carbon stable isotope composition of the hydrothermal vent shrimp Mirocaris fortunata: evidence for nutritional dependence on photosynthetically fixed carbon

Mirocaris fortunata were sampled from the Lucky Strike hydrothermal vent area (Eiffel Tower site) on the mid-Atlantic ridge during the French DIVA 2 cruise (June 1994). Small adults (17 to 22 mm total length), although morphologically identical, could be divided into 2 categories on the basis of pigmentation, lipid composition and C-13/C-12 stable isotope ratios of fatty acids. Highly pigmented small adults (8.6 to 9.2 mu g carotenoid shrimp(-1)) contained higher levels of total lipid than similar-sized individuals containing lower levels of pigment (0.9 to 2.9 mu g carotenoid shrimp(-1)). Lipid class analysis indicated that wax esters comprised 62.5% of total lipid in the former group. These pigmented shrimp also contained high proportions of polyunsaturated fatty acids (PUFA), particularly the phototrophic microplanktonic markers 20:5(n-3) and 22:6(n-3) (14.0 and 33.5% respectively). By contrast small adults (22 mm) and adult shrimp (25 to 26 mm) with low levels of carotenoid pigmentation contained lower amounts of total lipid, little or no wax ester and low levels of 20:5(n-3) and 22:6(n-3), but did contain 16:2(n-4) and 18:2(n-4) and the non-methylene interrupted dienes 20:2 Delta 5,13 and 22:2 Delta 7,15. GC-IRMS analysis of all fatty acids and fatty alcohols in the pigmented small adults indicated delta(13)C values of -18.2 to -27.7 parts per thousand, which is consistent with a photosynthetic carbon source for these compounds. The C-13/C-12 isotope composition of fatty acids from low-pigmented small adults and adults was more variable (-12.5 to -33.1 parts per thousand) and suggests a bimodal distribution which may be attributable to differing nutritional sources or the physiological/reproductive status of these shrimp. Samples of eggs, which are carried by the female on the pleopods, represented approximately 57% of total somatic lipid which indicates a substantial reproductive investment by this species. The egg lipids comprised high proportions of triacylglycerols (64.4 to 78.0% of total lipid) whilst the fatty acid composition was dominated by the monounsaturated fatty acids 16:1(n-7), 18:1(n-7) and 18:1(n-9), which accounted for 65.7 to 33.5% of total fatty acids. By contrast, PUFA were relatively minor components of egg lipids, particularly 20:5(n-3) and 22:6(n-3), which accounted for only 1.1 and 2.9% of total egg fatty acids respectively. This indicates that the reproductive investment by this species is supported mainly by material derived from bacterial chemosynthesis. The potential for M. fortunata hedge betting by producing larvae which either metamorphose at the vent site or adopt a bathypelagic lifestyle and delay metamorphosis to facilitate more widespread dispersal is discussed.

Job satisfaction among Australian general practitioners and specialists

OBJECTIVE:
To identify patterns of job satisfaction among Australian doctors using latent class analysis, and to determine the relationships of these patterns to personal and professional characteristics so as to improve satisfaction and minimize medical wastage.
METHODS:
MABEL (Medicine in Australia: Balancing Employment and Life) data in 2011 were used. The study collected information on 5764 doctors about their job satisfaction, demographic characteristics, their health, country of medical training, opportunities for professional development and social interaction, taking time off work, views of patients' expectations, unpredictable working hours, hours worked per week, preference to reduce hours and intention to leave the medical workforce.
RESULTS:
Four latent classes of job satisfaction were identified: 5.8% had high job satisfaction; 19.4% had low satisfaction with working hours; 16.1% had high satisfaction with working hours but felt undervalued; and 6.5% had low job satisfaction. Low job satisfaction was associated with reporting poor health, having trained outside Australia, having poor opportunities for professional development and working longer hours. Low satisfaction was associated with a preference to reduce work hours and an intention to leave the medical workforce.
CONCLUSION:
To improve job satisfaction and minimize medical wastage, policies need to address needs of overseas trained doctors, provide continuing professional development and provide good health care for doctors.

The relationship between psychological distress and adolescent polydrug use.

Polydrug use is relatively common among adolescents. Psychological distress is associated with the use of specific drugs, and may be uniquely associated with polydrug use. The purpose of this study was to test the association of psychological distress with polydrug use using a large adolescent sample. The sample consisted of 10,273 students aged 12-17 years from the State of Victoria, Australia. Participants completed frequency measures of tobacco, alcohol, cannabis, inhalant, and other drug use in the past 30 days, and psychological distress. Control variables included age, gender, family socioeconomic status, school suspensions, academic failure, cultural background, and peer drug use. Drug-use classes were derived using latent-class analysis, then the association of psychological distress and controls with drug-use classes was modeled using multinomial ordinal regression. There were 3 distinct classes of drug use: no drug use (47.7%), mainly alcohol use (44.1%), and polydrug use (8.2%). Independent of all controls, psychological distress was higher in polydrug users and alcohol users, relative to nondrug users, and polydrug users reported more psychological distress than alcohol users. Psychological distress was most characteristic of polydrug users, and targeted prevention outcomes may be enhanced by a collateral focus on polydrug use and depression and/or anxiety.

A profile of four patterns of vulnerability to functional decline in older general medicine patients in Victoria, Australia: a cross sectional survey

BACKGROUND: There are limited published data reporting Australian hospitalized elders' vulnerability to functional decline to guide best practice interventions. The objectives of this study were to describe the prevalence of vulnerability to functional decline and explore profiles of vulnerability related to the performance of physical activity in a representative group of elders in a single centre in Victoria, Australia.

METHODS: A cross-sectional survey of patients aged ≥ 70 years (Mean age 82.4, SD 7 years) admitted to a general medical ward of an Australian tertiary-referral metropolitan public hospital from March 2010 to March 2011 (n = 526). Patients were screened using the Vulnerable Elders Survey (VES-13). Distinct typologies of physical difficulties were identified using latent class analysis.

RESULTS: Most elders scored ≥3/10 on the VES-13 and were rated vulnerable to functional decline (n = 480, 89.5 %). Four distinct classes of physical difficulty were identified: 1) Elders with higher physical functioning (n = 114, 21.7 %); 2) Ambulant elders with diminished strength (n = 24, 4.6 %); 3) Elders with impaired mobility, strength and ability to stoop (n = 267, 50.8 %) and 4) Elders with extensive physical impairment (n = 121, 23 %) Vulnerable elders were distributed through all classes.

CONCLUSIONS: Older general medicine patients in Victoria, Australia, are highly vulnerable to functional decline. We identified four distinct patterns of physical difficulties associated with vulnerability to functional decline that can inform health service planning, delivery and education.

Keys on the Formation and Human Development in Pedagogy

This paper is based on the experiences of the author, who has worked in the various levels of the Venezuelan educational system. This has been a very important platform to understand the ideas of education and human development within the Venezuelan institutionality in the educational field. The idea of education that we have, as teachers, should be rethought in order to consider the personal stories of those who share with us their time, interests and willingness: children, young people or adults, all with particular identities, differences and coincidences. The teachers, the schools and the State cannot consider an education for someone they do not know. In this sense, we provide some reflections resulting from our ethnographic work, based on the school life, interviews, class analysis, observations, and stories, among others. Our thoughts are classified as formation, hope, dialogue, attitude, and school life.

Multifractal analysis of geomagnetic storm and solar flare indices and their class dependence

The multifractal properties of two indices of geomagnetic activity, D st (representative of low latitudes) and a p (representative of the global geomagnetic activity), with the solar X-ray brightness, X l , during the period from 1 March 1995 to 17 June 2003 are examined using multifractal detrended fluctuation analysis (MF-DFA). The h(q) curves of D st and a p in the MF-DFA are similar to each other, but they are different from that of X l , indicating that the scaling properties of X l are different from those of D st and a p . Hence, one should not predict the magnitude of magnetic storms directly from solar X-ray observations. However, a strong relationship exists between the classes of the solar X-ray irradiance (the classes being chosen to separate solar flares of class X-M, class C, and class B or less, including no flares) in hourly measurements and the geomagnetic disturbances (large to moderate, small, or quiet) seen in D st and a p during the active period. Each time series was converted into a symbolic sequence using three classes. The frequency, yielding the measure representations, of the substrings in the symbolic sequences then characterizes the pattern of space weather events. Using the MF-DFA method and traditional multifractal analysis, we calculate the h(q), D(q), and τ (q) curves of the measure representations. The τ (q) curves indicate that the measure representations of these three indices are multifractal. On the basis of this three-class clustering, we find that the h(q), D(q), and τ (q) curves of the measure representations of these three indices are similar to each other for positive values of q. Hence, a positive flare storm class dependence is reflected in the scaling exponents h(q) in the MF-DFA and the multifractal exponents D(q) and τ (q). This finding indicates that the use of the solar flare classes could improve the prediction of the D st classes.

Numerical methods and analysis for a class of fractional advection-dispersion models

In this paper, a class of fractional advection–dispersion models (FADMs) is considered. These models include five fractional advection–dispersion models, i.e., the time FADM, the mobile/immobile time FADM with a time Caputo fractional derivative 0 < γ < 1, the space FADM with two sides Riemann–Liouville derivatives, the time–space FADM and the time fractional advection–diffusion-wave model with damping with index 1 < γ < 2. These equations can be used to simulate the regional-scale anomalous dispersion with heavy tails. We propose computationally effective implicit numerical methods for these FADMs. The stability and convergence of the implicit numerical methods are analysed and compared systematically. Finally, some results are given to demonstrate the effectiveness of theoretical analysis.

A differential transformation technique for the analysis of a class of non-linear time varying systems

The scope of the differential transformation technique, developed earlier for the study of non-linear, time invariant systems, has been extended to the domain of time-varying systems by modifications to the differential transformation laws proposed therein. Equivalence of a class of second-order, non-linear, non-autonomous systems with a linear autonomous model of second order is established through these transformation laws. The feasibility of application of this technique in obtaining the response of such non-linear time-varying systems is discussed.

On the performance analysis of a class of neuron circuits

A new performance metric, Peak-Error Ratio (PER) has been presented to benchmark the performance of a class of neuron circuits to realize neuron activation function (NAF) and its derivative (DNAF). Neuron circuits, biased in subthreshold region, based on the asymmetric cross-coupled differential pair configuration and conventional configuration of applying small external offset voltage at the input have been compared on the basis of PER. It is shown that the technique of using transistor asymmetry in a cross-coupled differential pair performs on-par with that of applying external offset voltage. The neuron circuits have been experimentally prototyped and characterized as a proof of concept on the 1.5 mu m AMI technology.

On the performance analysis of a class of neuron circuits

A new performance metric, Peak-Error Ratio (PER) has been presented to benchmark the performance of a class of neuron circuits to realize neuron activation function (NAF) and its derivative (DNAF). Neuron circuits, biased in subthreshold region, based on the asymmetric cross-coupled differential pair configuration and conventional configuration of applying small external offset voltage at the input have been compared on the basis of PER. It is shown that the technique of using transistor asymmetry in a cross-coupled differential pair performs on-par with that of applying external offset voltage. The neuron circuits have been experimentally prototyped and characterized as a proof of concept on the 1.5 mu m AMI technology.

Electromagnetic analysis of novel class of multiple core/multiple clad step index single mode optical fiber by analytical means

General propagation properties and universal curves are given for double clad single mode fibers with inner cladding index higher or lower than the outer cladding index, using the parameter: inner cladding/core radii ratio. Mode cut-off conditions are also examined for the cases. It is shown that dispersion properties largely differ from the single clad single mode fiber case, leading to large new possibilities for extension of single mode operation for large wavelength tange. Paper demonstrates that how substantially we can extend the single mode operation range by using the raised inner cladding fiber. Throughout we have applied our own computations technique to find out the eigenvalue for a given modes. Detail derivations with all trivial mathematics for eigenmode equation are derived for each case. Paper also demonstrates that there is not much use of using depressed inner cladding fiber. We have also concluded that using the large inner cladding/inner core radius we can significantly increase the single mode operation range for the large wavelength region. (C) 2015 Elsevier GmbH. All rights reserved.

Design and Performance Analysis of a 2.5 MW-Class HTS Synchronous Motor for Ship Propulsion

The development of cryogenic technology and high temperature superconducting (HTS) materials has seen continued interest worldwide in the development of HTS machines since the late 1980s. In this paper, the authors present a conceptual design of a 2.5 MW class synchronous motor. The structure of the motor is specified and the motor performance is analyzed via a three-dimensional model using the finite element method (FEM). Rotor optimization is carried out to decrease the harmonic components in the air gap field generated by HTS tapes. Based on the results of this 3D simulation, the determination of the operating conditions and load angle is discussed with consideration to the HTS material properties. The economic viability of air-core and iron-core designs is compared. The results show that this type of HTS machine has the potential to achieve an economic, efficient and effective machine design, which operates at a low load angle, and this design process provides a practical way to simulate and analyze the performance of such machines.