One-year Period (one-year + period)

Distribution by Scientific Domains


Selected Abstracts


Close association of CD8+/CD38bright with HIV-1 replication and complex relationship with CD4+ T-cell count,

CYTOMETRY, Issue 4 2009
Edouard Tuaillon
Abstract Background: Measuring lymphocyte activation provides information in addition to CD4+ T-cell count for immune monitoring of HIV-1 infected patients. CD38 is a well-established activation marker that is generally analyzed on the whole population of CD8+ T-cells. Focusing specifically on CD38 high expression (CD8+/CD38bright) may be an interesting surrogate gating strategy because CD38bright characterizes principally activated memory cells. Methods: CD8+/CD38bright was investigated in 1,353 HIV-1 infected patients over a one-year period to establish relevant cutoff values and clarify the relationships of this marker with HIV-1 RNA viral load (VL) and CD4+ T-cell count. Results: The CD8+/CD38bright (>8,500 CD38 binding site per cells) is well correlated with HIV-1 VL (r = 0.87, P < 0.001) in this longitudinal follow-up of nonimmunodepressed patients that initiated antiviral therapy (ART). In aviremic patients on ART, the marker was highly predictive of VL rebound (sensitivity 93%, specificity 64% for a VL level of detection >200 copies/ml). While the CD8+/CD38bright moderately correlated with CD4+ T-cell count independently of the VL (r = ,0.37, P < 0.001), it increased dramatically in aviremic patient groups that exhibited profound CD4+ T-cell depletion (median 39% for CD4+ T-cell counts <50/mm3). This result indicates that other additional immunological and/or viral factors than readily detectable HIV-1 replication appears to be involved in T-cell activation of immunodepressed individuals. Conclusions: CD8+/CD38bright is an effective marker for monitoring T-cell activation, which is a central factor of HIV-1 pathogenesis. This gating strategy requires only a single additional staining in conventional four color CD4 protocols. © 2008 Clinical Cytometry Society [source]


Comparison of the Medical Priority Dispatch System to an Out-of-hospital Patient Acuity Score

ACADEMIC EMERGENCY MEDICINE, Issue 9 2006
Michael J. Feldman MD
Abstract Background: Although the Medical Priority Dispatch System (MPDS) is widely used by emergency medical services (EMS) dispatchers to determine dispatch priority, there is little evidence that it reflects patient acuity. The Canadian Triage and Acuity Scale (CTAS) is a standard patient acuity scale widely used by Canadian emergency departments and EMS systems to prioritize patient care requirements. Objectives: To determine the relationship between MPDS dispatch priority and out-of-hospital CTAS. Methods: All emergency calls on a large urban EMS communications database for a one-year period were obtained. Duplicate calls, nonemergency transfers, and canceled calls were excluded. Sensitivity and specificity to detect high-acuity illness, as well as positive predictive value (PPV) and negative predictive value (NPV), were calculated for all protocols. Results: Of 197,882 calls, 102,582 met inclusion criteria. The overall sensitivity of MPDS was 68.2% (95% confidence interval [CI] = 67.8% to 68.5%), with a specificity of 66.2% (95% CI = 65.7% to 66.7%). The most sensitive protocol for detecting high acuity of illness was the breathing-problem protocol, with a sensitivity of 100.0% (95% CI = 99.9% to 100.0%), whereas the most specific protocol was the one for psychiatric problems, with a specificity of 98.1% (95% CI = 97.5% to 98.7%). The cardiac-arrest protocol had the highest PPV (92.6%, 95% CI = 90.3% to 94.3%), whereas the convulsions protocol had the highest NPV (85.9%, 95% CI = 84.5% to 87.2%). The best-performing protocol overall was the cardiac-arrest protocol, and the protocol with the overall poorest performance was the one for unknown problems. Sixteen of the 32 protocols performed no better than chance alone at identifying high-acuity patients. Conclusions: The Medical Priority Dispatch System exhibits at least moderate sensitivity and specificity for detecting high acuity of illness or injury. This performance analysis may be used to identify target protocols for future improvements. [source]


Characteristics and dynamics of multiple intertidal bars, north Lincolnshire, England

EARTH SURFACE PROCESSES AND LANDFORMS, Issue 4 2006
Selma van Houwelingen
Abstract Multiple intertidal bars and troughs, often referred to as ,ridges and runnels', are significant features on many macrotidal sandy beaches. Along the coastline of England and Wales, they are particularly prevalent in the vicinity of estuaries, where the nearshore gradient is gentle and a large surplus of sediment is generally present. This paper examines the dynamics of such bar systems along the north Lincolnshire coast. A digital elevation model of the intertidal morphology obtained using LIDAR demonstrates that three to five intertidal bars are consistently present with a spacing of approximately 100 m. The largest and most pronounced bars (height = 0·5,0·8 m) are found around mean sea level, whereas the least developed bars (height = 0·2,0·5 m) occur in the lower intertidal zone. Annual aerial photographs of the intertidal bar morphology were inspected to try to track individual bars from year to year to derive bar migration rates; however, there is little resemblance between concurrent photographs, and ,resetting' of the intertidal profile occurs on an annual basis. Three-dimensional beach surveys were conducted monthly at three locations along the north Lincolnshire coast over a one-year period. The intertidal bar morphology responds strongly to the seasonal variation in the forcing conditions, and bars are least numerous and flattest during the more energetic winter months. Morphological changes over the monthly time scale are strongly affected by longshore sediment transport processes and the intertidal bar morphology can migrate along the beach at rates of up to 30 m per month. The behaviour of intertidal bars is complex and varies over a range of spatial and temporal scales in response to a combination of forcing factors (e.g. incident wave energy, different types of wave processes, longshore and cross-shore sediment transport), relaxation time and morphodynamic feedback. Copyright © 2005 John Wiley & Sons, Ltd. [source]


Perception and integration of people living with type 1 diabetes , an empirical study

EUROPEAN DIABETES NURSING, Issue 1 2006
M Due-christensen RN Diabetes Nurse
Abstract Background: The chronic complications of type 1 diabetes impose a heavy physical, psychological and social burden on people living with the condition. Improved metabolic control reduces the risk of developing chronic complications and could lead to improved well-being for people with diabetes. Aims: The aim of this study was to explore the perceptions of adults with type 1 diabetes who have improved their metabolic control with respect to acceptance, knowledge, social support and their relationships with healthcare providers. Methods: The study included ten people with type 1 diabetes who had achieved and maintained a reduction of 1.5% in their HbA1C during a one-year period. A phenomenological qualitative semi-structured interview was used in the collection of information from the participants. The interviews were analysed using the method of meaning condensation; these were interpreted from a perspective of integration. Results: The study shows differences among people living with diabetes regarding their perceptions of living with the condition. The people have at least three different strategies of integrating diabetes, based on their perception. Conclusions: Integration is a life-long process and in this process, the person with diabetes has to learn to integrate diabetes into both behavioural and psychosocial aspects of life. [source]


Examining the Utility of In-Clinic "Rescue" Therapy for Acute Migraine

HEADACHE, Issue 6 2008
Veronica Morey RN
Background., Management options currently are limited for patients with acute migraine whose symptoms prove refractory to self-administered therapy. Objective., To evaluate the clinical utility and cost-effectiveness of a management program offering in-clinic "rescue" treatment for patients with acute migraine. Methods., Two hundred consecutive migraine patients presenting to a university-based headache clinic were randomized to receive either optimal self-administered medical therapy for acute migraine ("standard therapy") or similar therapy plus the option of in-clinic parenteral drug administration should self-administered therapy prove ineffective ("rescue therapy"). Patients randomized to the latter group were restricted to a maximum of 2 "rescue visits" per month, and all patients were followed for one year. Patients "rescued" in clinic were contacted by telephone 24 hours following treatment to evaluate their treatment response. The primary analysis involved a comparison of the number of emergency department (ED) visits for headache recorded within each group over the one-year period of study. For all ED visits in the rescue group and for a randomly selected and equal number of ED visits within the standard group, the direct costs associated with those visits were assessed, and the direct costs of all in-clinic rescue visits also were recorded and analyzed. Results., The 2 groups studied were similar in terms of age, gender ratio, migraine subtype, migraine-related disability status at baseline and type/extent of medical insurance coverage. Over the one-year study period, the rescue group recorded 423 in-clinic rescue visits and reported 27 ED visits for headache treatment. The standard therapy group reported 73 ED visits (27 vs 73 visits; P < .01). The total direct costs associated with ED visits were $45,330 for the rescue group (mean $1690 per ED visit) and (by extrapolation from the sample selected) $147,971 for the standard therapy group (mean $2027 per ED visit). The total direct cost of the 423 "rescue visits" was $33,647 (mean $80 per visit). In 79% of the 423 rescue encounters, the patients involved reported no residual functional disability 24 hours following treatment. Of those in the rescue group who sought in-clinic rescue, 89% reported themselves "very satisfied" with such management. Conclusion., Providing the alternative of in-clinic "rescue" for acute migraine refractory to self-administered therapy offers an attractive alternative for patients and appears to substantially lower use of an ED for headache treatment and the cost associated with that use. [source]


Trustworthiness, friendships and self-control: factors that contribute to young children's school adjustment

INFANT AND CHILD DEVELOPMENT, Issue 5 2007
Lucy R. Betts
Abstract The aim of present study was to examine the relationship between young children's peer-reported trustworthiness and their school adjustment. Two hundred and eleven (103 male and 108 female) children in the United Kingdom (mean age = 6 years 2 months) took part in this study. Measures of peer-reported trustworthiness, child-rated school adjustment, and teacher-rated school adjustment were administered twice across a one-year period. Also, children's number of friendships, peer acceptance, and self-control were assessed at Time 2. Multisample path analyses were conducted separately by sex. For both samples there were direct longitudinal paths between peer-reported trustworthiness and changes in teacher-rated school adjustment. For boys, the longitudinal path between peer-reported trustworthiness and changes in child-rated loneliness was mediated by peer acceptance, and peer-reported trustworthiness mediated the relationship between self-control and teacher-rated school adjustment. Sex differences in peer-reported trustworthiness also emerged: girls were rated as more trustworthy by their peers than were boys. The findings support the hypothesis that young children's trustworthiness contributes to school adjustment, which is due in part to peer acceptance. Copyright © 2007 John Wiley & Sons, Ltd. [source]


The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer

INTERNAL MEDICINE JOURNAL, Issue 12 2009
S. Bydder
Abstract Patients with inoperable non-small cell lung cancer diagnosed and managed at a single institution over a one-year period were identified. Those whose case had been discussed at a multidisciplinary meeting had better survival than those whose case was not discussed (mean survival; 280 days vs. 205 days, log-rank P= 0.048). [source]


Feeding ecology of silverperch, Terapon plumbeus Kner, and the impact of fish-pens in Laguna de Bay, Philippines

JOURNAL OF APPLIED ICHTHYOLOGY, Issue 6 2000
M. Kock
Summary Aquaculture is an important factor in the fishery of Laguna de Bay in the Philippines; fish-pens and net-cages covered ,10% of the lake surface in the late 1990s. The present study was carried out to assess the possible influences of aquaculture on a wild fish species, silverperch, Terapon plumbeus Kner, with a special emphasis on the feeding ecology of this fish. For the purposes of the investigation, 24-h samples were taken at 2-month intervals close to a fish-pen as well as in open water over a one-year period to acquire more information on this species. Significant differences in standard length and total weight were found between stations and sampling months. In open water, a mean standard length of 53.6 mm and a mean total weight of 4.2 g were found, whereas close to the fish-pen, the corresponding values were 57.6 mm and 5.4 g, respectively. The maximum mean standard length was attained around December 1996 and February 1997 (59.5 mm in open water; 66.1 mm close to the fish-pen), and the minimum was found in June 1996 (49.1 mm in open water; 46.2 mm close to the fish-pen). Noticeable differences were found in the food spectrum between the two sampling stations. Zooplankton, the major food source at both stations, was more important in the stomach content of fish in open water. The same was true for insects (i.e. chironomid larvae), although these did not make up such a large fraction of the diet. On the other hand, close to the fish-pen, aufwuchs- algae, phytoplankton and fish were more important. Generally, benthic organisms were consumed more frequently close to the fish-pen. Zooplankton was more important in the diet of smaller fish. In all size groups, the importance of zooplankton decreased during the rainy season. [source]


God's will, God's punishment, or God's limitations?

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 6 2007
Religious coping strategies reported by young adults living with serious mental illness
Qualitative research has demonstrated that religious meaning-making coping, defined as attributions of a stressful life event that involve the sacred, is particularly relevant to persons with serious mental illness. However, recent research advances in the study of religious coping have yet to be employed in clinical samples. This longitudinal study examines religious meaning-making coping in a sample of 48 young adults diagnosed with schizophrenia or bipolar disorder over a one-year period. Young adults with mental illness generally reported using religious meaning-making coping in levels comparable to nonpsychiatric samples. Reports of benevolent religious reappraisals were associated with perceptions of positive mental health, whereas punishing God reappraisals and reappraisals of God's power were associated with self-reported distress and personal loss. Religious coping variables accounted for variation in adults' reports of psychiatric symptoms and personal loss one year later over and above demographic and global religious variables. Implications of findings for clinical practice are discussed. © 2007 Wiley Periodicals, Inc. J Clin Psychol. [source]


Mentoring relationships for youth: Investigation of a process-oriented model

JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 4 2002
Gilbert R. Parra
We investigated a process-oriented model of mentoring using data on 50 relationships in a Big Brothers/Big Sisters program. Data were collected on a monthly basis from both mentors and youth over a one-year period; relationship benefits for youth were assessed at the end of the year by each type of informant. The degree to which relationships were continued throughout the one-year period also was assessed. Path analyses using both youth and mentor report data revealed relations among study variables consistent with the proposed model. Mentors' ratings of their efficacy, obtained prior to the start of relationships, predicted greater amounts of mentor/youth contact as well as more positive experiences in relationships (e.g., fewer obstacles). Feelings of closeness between mentors and youth, in turn, were a final common component in model pathways that linked mentor/youth contact and most other measures to greater perceived benefits and relationship continuation. Implications for the design and evaluation of mentoring programs for youth are discussed. © 2002 Wiley Periodicals, Inc. [source]


The application of product measures in directing software maintenance activity

JOURNAL OF SOFTWARE MAINTENANCE AND EVOLUTION: RESEARCH AND PRACTICE, Issue 2 2007
M. P. Ware
Abstract This paper is concerned with enhancing aspects of project-management techniques in relation to maintenance in commercial object-oriented software. Maintenance forms a significant proportion of the lifecycle of a product and consequently its costs. Techniques such as lean production attempt to reduce cost by focusing team effort and to pre-empt issues by the use of early detection and resolution strategies. This study involves a commercial application written in C++ and its evolution over a one-year period. Software product measures are used in conjunction with Pareto analysis to determine effective predictive class targeting in a release cycle. We assess the capability of the measures and consider how the results can be used by the project team. The study extends the work of others in this field in three ways. First, other studies have analysed procedural code, whereas we use an object-oriented code base. Second, most studies assess the predictive capability of measures against the number of software issues; we examine these factors, but uniquely test for change density using density modified measures and we also test for revision volume. Finally, we examine the implications of these results and offer a cohesive framework of recommendations placed within the lean management philosophy. Copyright © 2007 John Wiley & Sons, Ltd. [source]


An alternate-day corticosteroid regimen for pemphigus vulgaris.

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2007
A 13-year prospective study
Abstract Background, Pemphigus vulgaris (PV) at the early, usually oral and relatively stable stage, represents the majority of PV patients. Treatment modalities usually do not differ compared to those for the fully established disease. Objectives, To prospectively assess a standardized and effective therapeutic approach that aims at less morbidity due to adverse reactions. Methods, The following regimen, also known as Lever's mini treatment (LMT), was used. Forty mg of oral prednisone on alternate days plus 100 mg azathioprine every day were administered until the complete healing of all lesions. A gradual monthly and later bimonthly decrease of prednisone was followed by the tapering of a second immunosuppressive agent, in a one-year period. Results, Seventy-four patients suffering from early-stage-PV, and representing 70% of all PV patients seen through the years 1991,2003, were eligible in the study. Total follow-up period was 76 ± 37 (26,180) months. During the 53 ± 26 months of LMT, 6 (8%) patients dropped out of therapy, 9 (12%) required a change to another treatment, two (3%) died and 57 (77%) achieved a lesion-free condition. Forty-five (61%) patients were in complete remission for 27 ± 29 months. Significant morbidity was estimated 4/74 (5.2%). Disease ,breakthroughs' necessitating treatment adjustments occurred in 30 patients, usually throughout the last phase of therapy and post-treatment follow-up. Conclusion, LMT may be a standardized therapeutic approach for the early and relatively stable stage of PV, resulting in high efficacy, safety and quality of life profile. [source]


Seasonal changes in prevalence and intensity of Hypoderma actaeon in Cervus elaphus from central Spain

MEDICAL AND VETERINARY ENTOMOLOGY, Issue 2 2001
C. De La Fuente-López
Summary Hypodermosis in red deer, Cervus elaphus Linnaeus (Artilodactyla: Cervidae), caused by the warble fly, Hypoderma actaeon Latreille (Diptera: Oestridae), was studied at Quintos de Mora (Toledo, Spain) over a one-year period between October 1994 and September 1995. One hundred and twenty-five red deer were examined for the presence of warble fly larvae. The prevalence of warbles was 44.8% and the intensity of infection was 38.29 (SD ± 61.32) warbles/deer infected. Clear seasonal variations were observed in prevalence and intensity, with the highest values in the autumn and winter. Statistically significant differences were observed in prevalence and intensity among age groups. In contrast, no differences were found in prevalence and intensity between males and females. [source]


A method for modeling the current,voltage curve of a PV module for outdoor conditions,

PROGRESS IN PHOTOVOLTAICS: RESEARCH & APPLICATIONS, Issue 3 2002
B. Marion
A method has been developed for modeling the current,voltage curve of a photovoltaic (PV) module for outdoor conditions. An indoor characterization procedure determines a PV module's temperature and irradiance correction factors, which are used in conjunction with equations to translate a reference curve to outdoor conditions of PV module temperature and irradiance. A PV technology's spectral response characteristics are accommodated in the equation for irradiance. The modeled and measured energy is compared for a one-year period for seven PV modules of different technologies. The results validate the method's use for modeling the hourly performance of PV modules, and for modeling daily energy production for PV module energy rating purposes. Published in 2002 by John Wiley & Sons, Ltd. [source]


The temporal stability of electrodermal variables over a one-year period in patients with recent-onset schizophrenia and in normal subjects

PSYCHOPHYSIOLOGY, Issue 2 2002
Anne M. Schell
Test,retest stability of electrodermal (EDA) variables indexing both general autonomic arousal (e.g., skin conductance level, number of nonspecific skin conductance responses) and attention to external stimuli (e.g., number of skin conductance orienting responses, electrodermal responder/nonresponder status) was assessed in 71 young, recent-onset schizophrenia patients and 36 demographically matched normal subjects. Significant stability over a 1-year period was found for both patients and normal subjects for most EDA variables and for responder/nonresponder status, with test,retest correlations generally being higher for normal subjects. The lower reliability for patients was not attributable to symptomatic fluctuations during the follow-up period and may reflect poorer arousal regulation among the patients. Among measures of responding to nontask stimuli, a simple count of the number of orienting responses occurring was more stable than was a traditional trials-to-habituation measure. [source]


Social contextual links to emotion regulation in an adolescent psychiatric inpatient population: do gender and symptomatology matter?

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 11 2009
Molly Adrian
Background:, The regulation of emotion is essential for adaptive functioning. However, delineating the pathways of emotion regulation (ER) processes that lead to psychological adaptation remains under-studied, with mixed evidence for the specificity vs. generality of ER deficits in relation to specific forms of psychopathology. To examine this issue, this study investigated links among ER, social-contextual factors (family, peer), and psychological adjustment (internalizing, externalizing). Method:, Participants were 140 adolescents (71% female, 83.3% Caucasian, M age = 16.03 years) who were consecutive psychiatric admissions over a one-year period. Adolescents completed measures on family environment and peer relationship experiences. Both adolescents and parents reported on adolescents' characteristic patterns of ER and psychopathology. Results:, Discriminant analyses revealed that two functions, ER skills and impulsivity/lability, differentiated among adolescents who were elevated in internalizing symptoms only, in externalizing symptoms only, in both domains, or in neither domain. Regarding social contextual variables, family cohesion was associated with adaptive ER behaviors for girls along the internalizing dimension and all adolescents reporting externalizing behaviors. Relational victimization predicted difficulties with ER in both symptom domains for all adolescents. Within the internalizing domain, friendship support was related to adaptive ER. Conclusion:, Facets of ER do differentiate between global indices of internalizing and externalizing behaviors and suggest that both general and specific factors contribute to adolescents' unique learning history with emotions and characteristic patterns for managing emotions. [source]


Water supply and sanitation in remote Indigenous communities-priorities for health development

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2004
Ross S. Bailie
Objective:To review available national and State/Territory survey data on water supply and sanitation in remote Indigenous Australian communities and to discuss the findings in terms of priorities for health and infrastructure development. Methods:Descriptive analysis of data on relevant variables from available data sources. Results:All relevant published reports arose from only two data sources: the Community Housing and Infrastructure Needs Surveys, and from a Northern Territory-wide survey of community-owned dwellings. The data show that many communities do not have a reliable water supply and experience frequent and prolonged breakdown in sewerage systems. For example, 12% of communities of 50 people or more experienced five or more periods of water restrictions in a one-year period, and 10% of communities experienced sewage overflow or leakage 20 or more times in a one-year period. Items of basic household infrastructure regarded as essential for household hygiene are missing or not functional in many community-owned dwellings. For example, in about one-third of houses bathroom taps and toilet drainage required major repairs. Conclusion and Implications:Given the widely accepted importance of water and sanitation to health, the data support the contention that poor environmental conditions are a major cause of poor health in remote communities and provide some measure at a national level of the magnitude of the problem. Action to ensure easy access to adequate quantities of water and secure sanitation should receive greater priority. There is need for better quality information systems to monitor progress, equity and accountability in the delivery of water and sanitation services. [source]


Suicide-related behavior after psychiatric hospital discharge: implications for risk assessment and management,

BEHAVIORAL SCIENCES & THE LAW, Issue 6 2006
Jennifer L. Skeem Ph.D.
Suicide-related behavior (SRB), including suicide attempts and instrumental SRB, occurs far more often than completed suicide and exacts a toll on patients, their loved ones, and society. Nevertheless, few prospective studies of SRB have been conducted. In this study, 954 patients were interviewed in a psychiatric hospital and then followed for one year after discharge. During this one-year period, nearly one-quarter of patients (23%) engaged in SRB, with the rate of suicide attempts (18%) three times greater than the rate of instrumental SRB (5%). Risk factors for SRB were demographic (White ethnicity, female gender), clinical (past SRB, depression, impaired functioning), and contextual (unemployment, large social networks). In contrast with other studies, there was no "peak" in the risk of SRB shortly after hospital discharge. Instead, patients' rate of SRB was relatively constant over the one-year follow-up. Implications for risk assessment and management in acute inpatient settings are discussed. Copyright © 2006 John Wiley & Sons, Ltd. [source]


Long-term InHM simulations of hydrologic response and sediment transport for the R-5 catchment

EARTH SURFACE PROCESSES AND LANDFORMS, Issue 9 2007
Christopher S. Heppner
Abstract The physics-based model known as the Integrated Hydrology Model (InHM) is used to simulate continuous hydrologic response and event-based sediment transport for the R-5 catchment (Oklahoma, USA). For the simulations reported herein the R-5 boundary-value problem was refined, from that reported by Loague et al. (2005), to include (i) an improved conceptualization of the local hydrogeologic setting, (ii) a more accurate topographical representation of the catchment, (iii) improved boundary conditions for surface-water outflow, subsurface-water outflow and evapotranspiration, (iv) improved characterization of surface and subsurface hydraulic parameters and (v) improved initial conditions. The hydrologic-response simulations were conducted in one-year periods, for a total of six years. The sediment-transport simulations were conducted for six selected events. The multi-year water-balance results from the hydrologic-response simulations match the observed aggregate behavior of the catchment. Event hydrographs were generally simulated best for the larger events. Soil-water content was over-estimated during dry periods compared with the observed data. The sediment-transport simulations were more successful in reproducing the total sediment mass than the peak sediment discharge rate. The results from the effort reported here reinforce the contention that comprehensive and detailed datasets are crucial for testing physics-based hydrologic-response models. Copyright © 2007 John Wiley & Sons, Ltd. [source]


Maternal and neonatal outcomes in the Torres Strait Islands with a sixfold increase in type 2 diabetes in pregnancy over six years

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2010
Henrik FALHAMMAR
Background:, Torres Strait Islander population has a high prevalence of type 2 diabetes (T2DM). Aims:, To review pregnancy data of women and their newborns living in the Torres Strait area. Methods:, All medical charts of mothers and their neonates delivered in two one-year periods (1999 and 2005/2006) were reviewed. The initial screening test for diabetes in pregnancy (DIP) was a random blood glucose level followed by an oral glucose challenge test in 1999 and from 2000 an oral glucose tolerance test. Results:, Diabetes in pregnancy increased by 4.3,13.3% and T2DM by 0.8,4.6%. During the two periods, 258 and 196 mothers delivered respectively 84,92% by midwives/general practitioners at the local hospital and 7,16% by midwives/obstetricians at the regional hospital; in 2005/2006, 58% of women with DIP delivered at the regional hospital. Screening increased from 89.2 to 99.5%. DIP mothers were older and heavier with more hypertension and previous miscarriages. Parity decreased in the DIP mother during the two periods. Caesarean section was five times more common for DIP in 2005/2006 versus non-DIP, while in 1999, there was no difference. In 1999, the DIP infants were heavier, longer (P = 0.053) and had a larger head circumference not seen 2005/2006. There was more neonatal trauma, hypoglycaemia and IV dextrose in the DIP infants. Breastfeeding numbers increased in DIP. In 2005/2006, follow-up of gestational diabetes occurred in 47% (all normal). Conclusion:, A massive increase in DIP was seen. The neonatal outcomes improved slightly. There is need for improvement in follow-up of gestational diabetes. [source]