Since 2001, the NDA and other Irish government bodies, have been using the ICF in national surveys, administrative databases and needs assessment processes. The NDA has also been participating in two international exercises examining the ICF as an instrument across a range of data collection settings. These are the EU 6 th Framework project entitled Measuring Health and Disability in Europe (Mhadie) which has been assessing the ICF as a tool for improving the comparability and consistency of EU wide data collection exercises in health, education and clinical settings, in relation to disability (www.mhadie.com). At United Nations level, the NDA has participated with the CSO in the UN Washington Group on Disability Statistics (www.cdc.gov/nchs/citygroup.htm). This City Group was given the task of improving global disability statistics, most importantly those collected in national censuses, using the ICF as the framework. Thus there is an emerging body of experience to evaluate ICF and propose revisions if necessary. This now includes our two disability surveys.
53 Read more
The patients received appropriate treatment according to their COPD status. Prospective exacerbation data were col- lected according to the KOCOSS protocol. The patients were required to visit the hospital every 6 months, and spirometry was performed every year during the follow-up period. When patients could not visit the hospital, we contacted them by telephone to acquire data. During follow-up, the doctors assessed the disease status, conducted physical examinations, and asked patients to complete questionnaires. December 31, 2014 was used as the cutoff date for available longitudinal data. We gathered exacerbation data according to severity of airflow limitation and GOLD risk group and compared the baseline characteristics of patients stratified by the presence or absence of a previous acute exacerbation history.
Second, the prevalence of mMRC grade 1 patients was about two-thirds of group A and, compared with the mMRC 0 patients, mMRC 1 patients had a tendency to have a higher proportion of exacerbations and had a significantly lower pulmonary function. Regardless of the mMRC grade, there was not much difference in the physicians’ pharmacotherapy selection in group A. To our best knowledge, this is the first study to examine the characteristics, by stratifying according to the mMRC scale (grade 0 or 1), of group A patients. Our findings concerning the severity of the spirometric airflow limitation in group A were compatible with those of a pre- vious study. 5 In our study, the GOLD 1 rate in the mMRC
this study presents the limitation of no placebo control group (for ethical reasons), the results of this study indi- cate a favorable impact of propatyl nitrate therapy on quality of life among patients presenting with chronic sta- ble angina. Indeed, treatment with propatyl nitrate yielded favorable, statistically significant improvements in each of the SAQ scales, with the exception of Physical Limitation, where improvement did not reach statistical significance. This result may be due to the treatment group not having presented a great deal of physical limita- tion to begin with; pretreatment mean scores for this subcategory were 85.06 compared to post-treatment scores of 85.48.
A number of limitations are noted here. First, Chapter 2 faces complications with identifying a clear pre- and post-policy period and therefore cannot disentangle effects of any one particular policy, but instead assesses the effects of the combination of trans fat reduction policies, all of which contributed to reductions in trans fat content of food prepared away from home. Because individuals consume foods from a variety of different sources outside of a laboratory setting, and because of the multitude of overlapping policies and changes in food formulation, this work suggests that research attempting to assess the effects on any one particular policy at the national level may possibly over-estimate its effects. A second limitation of this work is in identifying the treated group; consumers of restaurant meals are considered to be the most exposed to trans-fat-containing foods; this work shows these individuals are also more likely to consume other types of FAFH, however a clearer identification of overall food consumption provided by food diary data may provide an improved estimate of effects of trans fat reduction policies. Another key limitation of this data is the lack of geographic variables available – because many trans fat policies were implemented at the local level, a difference-in- difference approach could be used to single out effectiveness of particular policies relative to changes in the overall food environment. At the national level, controlling for geographic variation might reduce noise in the estimates in this work because geographic variation exists in health and eating behaviors. This work does not attempt to assess cost-effectiveness of these policies, however with the addition of geographic data and food pricing or cost data, more work could be done to asses cost- effectiveness of individual policies.
156 Read more
Until recently, the Harveyi clade (Sawabe et al., 2007) included seven species: V. harveyi, V. campbellii, V. rotiferianus, V. alginolyticus, V. parahaemolyticus, V. mytili, and V. natriegens. Within this clade, the closely related ubiquitous and potentially pathogenic species of the V. harveyi group, form, as stated above, a tight cluster of cryptic strains characterised by highly similar phenotypes and almost indistinguishable phenotypes (Gomez-Gil et al., 2004; Owens and Busico-Salcedo, 2006). These characteristics, together with the limitation of standard identification techniques for this complex group (biochemical tests, 16S rRNA gene sequencing and specific PCR-based detection protocols), and the description of new species over the last few years suggest that several misidentifications of environmental and clinical isolates may have occurred in the past. (Pedersen et al., 1998; Gomez-Gil et al., 2004; Lin et al., 2010). For example, misclassification of V. harveyi and its sister species V. campbellii and V. rotiferianus is common (Gauger and Gomez-Chiarri, 2002; Gomez-Gil et al., 2004) and it has undervalued V. campbellii as an important pathogen of marine reared organisms. In fact, later studies confirmed pathogenicity of both V. rotiferianus and V. campbellii strains to marine fish and crustacea (Austin et al., 2005; Defoirdt et al., 2007b; Haldar et al., 2010).
210 Read more
The first limitation of the present study was the small number of treated patients for each group: 50 sarcopenic obese older women were treated with a hypocaloric diet containing 0.8 g/kg DBW/day proteins, while 54 sarcopenic obese older females were administered with a hypocaloric diet containing 1.2 g/kg DBW/day proteins. Therefore, it will be important to increase the sample size to confirm the present data. A second limitation could have been confounding by comorbidity, because the observed effects of dieting and increased physical activity were restricted to a relatively healthy study sample. Furthermore, another limitation may have been the limited period of observation; indeed, 3 months’ dieting was a short time to obtain good correlation between the decrease in food intake and the MM loss. Therefore, we plan to increase observation time up to 6 and 12 months. In conclusion, the results of the present study appear to be encouraging, even though further studies are required. However, our data sug- gest that adequate protein intake, according to DBW, and physical activity may prevent lean-mass losses associated with voluntary weight loss.
Current tests for variances have various limitations. Those such as the chi-square test for one variance or the F test for two variances require the assumption of normality. The Hartley test for multiple variances requires equal sample sizes as well as the assumption of normality. Levene’s test has the limitation that if the variance of one group increases relative to the variance of the other groups, the variation within groups can increase at a greater rate than the variation between groups resulting in the ironic situation of a smaller test statistic. The purpose of this paper is to present a nonparametric test for variances that can be used for any number of populations without the restriction of normality or equal sample sizes.
Parents of subjects in the unvaccinated control group were also contacted by phone for the same survey assessment. As it was not feasible to contact the entire control population, control subjects were age matched in a 2:1 ratio to the affected group for comparison. Parents or guardians of this control group were contacted using the same survey. Vaccine knowledge, reasons for nonvaccination, and perception of vaccine safety and importance were compared between groups. Between group data was analyzed comparing proportions using Pearson Chi Square or Fishers exact test when appropriate. The T-test was used for continuous variables. SPSS version 22 was used for all statistical analyses. Institutional Review Board approval was obtained prior to the study.
11 Read more
In public health and in medicine, the concept of health- related quality of life refers to a person ’ s or group ’ s per- ceived physical and mental health over time. In this study HRQoL data were collected using the Finnish Rand 36-item health survey 1.0, which was developed from the original 36-Item Short Form Health Survey (SF-36) . RAND-36 measures eight dimensions: gen- eral health, physical functioning, role limitation physical, role limitation emotional, vitality, mental health, social functioning, and bodily pain. There is a 0-100 range in each subscale, with higher scores indicating higher HRQoL. The reliability and validity of the scale has reported to be good (Cronbach’s alpha coefficients for 8 dimensions varied between 0.80 and 0.94), but ceiling effects were detected for physical functioning, role lim- itation physical and social functioning dimensions and floor effect for role limitation physical, role limitation emotional dimensions . The age- and sex-weighted
whether correction of inspiratory flow limitation during nasal CPAP therapy could have clinical benefits. The evolution of nocturnal polysomnographic parameters and objective day- time vigilance (maintenance of wakefulness tests; MWT) was compared in two groups of OSAHS patients. In the first group, P eff was determined on the regression of apnoea, hypopnoea and snoring in one group, while the P eff level was set to suppress flow limitation in the other group. The evaluation of CPAP therapy was performed after a 3-week period of home treatment at a P eff level that depended on the group they were randomly allocated to. A similar improvement was found in both groups in terms of apnoea/hypopnoea regression and nocturnal oxygenation saturation improvement, as well as normalisation of mean MWT values. However, the two groups were different in terms of variance of MWT values, with a significantly greater scattering of final results in the group of patients treated with a conventionally determined P eff level, when flow limitation was not suppressed by nasal CPAP, corresponding to a less homogeneous improvement of objective daytime performances in this case. All the patients treated with a nasal CPAP level that also controlled flow limitation had total normalisation of individual MWT values, while the MWT values of 30% of the patients in the other group remained at a low value. Furthermore, a positive correlation was found between final MWT values and the duration of CPAP use for all patients. It was speculated that the regression of flow limitation accounted for the better compliance with CPAP therapy.
The main limitation of the study was the absence of an active comparator group, which allowed only indirect com- parison of the results with other similar clinical studies. Also, since the study population was carefully chosen based on specific selection criteria and closely monitored throughout the trial, treatment compliance reported in this study may not be an accurate reflection of the real-world clinical practice. In conclusion, EV/DNG showed high contraceptive efficacy in healthy Asian women. Over 13 cycles, EV/DNG was associated with good cycle control, stable bleeding pattern, and high levels of overall satisfaction. The treatment was well tolerated and may be an effective option for use as an oral contraceptive in this population.
10 Read more
In the Lifestyle Interventions and Independence for El- ders (LIFE) Study, in comparison with a health education program, a structured moderate-intensity physical activity program significantly reduced the occurrence of a major mobility disability (MMD; hazard ratio [HR] 0.82), defined as the inability to walk 400 m, over an average follow-up of 2.6 years among 1635 sedentary persons aged 70 – 89 years who had functional limitations . A subsequent analysis demonstrated that the physical activity program reduced the amount of time spent with MMD over the entire 3.5-year follow-up by 25% . This reduction was accomplished not only by decreasing the initial occur- rence of MMD, as shown in the earlier report , but also through enhanced recovery after an MMD episode and a diminished risk for subsequent MMD episodes. The LIFE physical activity intervention was not designed to prevent hospital admissions. In fact, participants who were ran- domized to the physical activity group were more likely to be hospitalized than those who were randomized to the health education group, although this difference did not achieve statistical significance .
13 Read more
After forty minutes one member of this group came in to ask the tutor to go to see them. The tutor went in to find the group extremely unhappy: ‘You know we’re just spending far too long on this sort of stuff and we’re not getting anything out of it. We don’t understand what’s going on.’ The tutor replied forcefully, ‘It sounds like you are blaming me.’ Immediately, two of them countered, defensively, ‘No, no, that’s not what we are saying.’ ‘What we’re saying is - we don’t know what we are getting out of this.’ Another member continued, ‘We look at some of the other groups and they just get on with this stuff and they seem to get loads out of it. We’re not getting anything and we feel stuck in this group. What we would like is to move into some of the other groups a bit more and work with different people, but we’re not allowed to.’ One group member said, ‘I went in there just now and went up to a table and Kevin looked at me and said ‘What do you want?’. All I wanted was to go and say ‘Hi’ but he just told me to ‘Get lost’. That’s what the group is like.’
15 Read more
The authors are grateful to all the anonymous patients who participated in the trial. We also wish to thank all the therapists (Yuichi Kawamura, MD, PhD; Yuko Goto, MD; Fuminobu Imai, MD; Chie Nakamura, MD; Yuko Ishiguro, MSW; Yukari Shimada, BA; Miho Hagiwara, BA; Hiromi Taguchi, ST; Yasunori Goto, OT; Chikako Otaki, RN; Shoko Yoshimi, RN; and Natsuki Miwa, MAP); the administrative staff (Kaori Kobori and Kozue Maki at Nagoya City University Graduate School of Medical Sciences); the controller for data entry (Ms Kazuyo Mori); the members of the cognitive behavior therapy group and the child psychiatry group at Nagoya City University Graduate School of Medical Sciences (Sei Ogawa, MD, PhD; Masaki Kondo, MD; Akiko Kawaguchi, MD; Nao Shiraishi, MD; Shinkichi Maki, MD; and Mine Hirata, MD) for their valuable support throughout the research; and the supervisor of the additional statistical analysis (Hisashi Noma, MPH, DPH, The Institute of Statistical Mathematics). None of the acknowledged individuals have any financial or other conflicts of interest to report in relation to the subject of this article. The authors report no conflicts of interest in this work.
13 Read more
Poor understanding of the starting point of the limitation period has led to frustration amongst the various parties in construction contract when time is already barred. The purpose of this study is to give an insight into the issues regarding when the cause of action accrues as well as the point where the time is barred and the court reaction and its decision concerning the issue. It is hoped that the findings of this study will assist the players in the construction industry to understand the significance of the statutory limitation period, plus understand the period that they are still liable to the contract and put their best effort to adhere to the timeline.
32 Read more
This study reveals a marked variability in agreement between the measurements of % predicted FEV 1 and % predicted PEFR values in COPD patients. The results provide strong evidence that the two estimates are not equivalent in the assessment of severity of airflow limitation in COPD patients. The severity classification of airflow limitation between the two estimates was concordant in only 59.7% of patients evaluated, while % predicted FEV 1 and % predicted PEFR values were apart more than 10% in 40% of patients. The strong correlation between the two estimates in this study was also observed in prior studies in limited subjects with asthma and COPD, 3 subjects with asthma, 12 or subjects
Using biplane, fluoroscopic road map guidance, one or more stents were deployed across the involved portions of the ex- tracranial carotid artery after placement of an appropriate 0.014- or 0.018-in exchange length (330 cm) guidewire. The choice of a particular stent was determined by its availability and by both the diameter and length of the target lesion. The following stents were used: Palmaz (Cordis Corp., Miami, FL), Precise (Cordis Corp.), SMART (Cordis Corp.), AVE (Arte- rial Vascular Engineering, Inc., Santa Rosa, CA), NIR (Scimed Life Systems, Inc., Maple Grove, MN), Wallstent (Boston Sci- entific, Minneapolis, MN), and Wallgraft (Boston Scientific). Platinum coils (GDC) (Target Therapeutics, Fremont, CA) or n-butyl cyanoacrylate (Histoacryl; Braun, Melsungen, Ger- many) were used with stent placement to manage five patients with extracranial carotid pseudoaneurysms. At the conclusion of the surgery, control cerebral and carotid angiograms were obtained for all patients. Prophylactic heparin was not admin- istered to any patient at high risk for re-hemorrhage (groups II and III) during or after ERCA. An antiplatelet regimen con- sisting of clopidogrel (Plavix; Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership, New York, NY) (75 mg admin- istered orally every day) and aspirin (325 mg administered orally every day) was begun immediately in group I patients and in the recipients of the Wallgraft stent. ERCA and rCBS outcomes were reviewed for ⱕ2 years.
Many public key encryption schemes are remained secure based on the hardness of some mathematical problems in a large and finite abelian group (more precisely, finite cyclic groups) (Fiat et al. 1986; Merkle et al. 1978). Some well studied hard problems that have been used are the integer factorization and discrete logarithm problems (Rivest et al. 1978; Zhang et al. 2004). However, deal to Shor's algorithm (Shor 1997), many conventional number theories based hard problems become feasible to solve. Hence, alternative hard problems must be proposed which avoid the attack by Shor's algorithm. In recent year, there are plenty of code-based, lattice-based and hash- based cryptographic primitives being constructed which might resist the Shor's attack. There are plenty of claims stated that the advent of quantum computers may cause many well-known hard problems used in various signature schemes to become vulnerable to various attacks. In this paper, we investigate an alternative direction, which is known as the group-based cryptography. In short, this direction of studies arise deal to the attempt to generalize current cryptographic primitives defined