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Regional Differences (regional + difference)
Kinds of Regional Differences Selected AbstractsLanguage and Regional Differences in Evaluations of Medicare Managed Care by HispanicsHEALTH SERVICES RESEARCH, Issue 2 2008Robert Weech-Maldonado Objectives. This study uses the Consumer Assessments of Healthcare Providers and Systems (CAHPS®) survey to examine the experiences of Hispanics enrolled in Medicare managed care. Evaluations of care are examined in relationship to primary language (English or Spanish) and region of the country. Data Sources. CAHPS 3.0 Medicare managed care survey data collected in 2002. Study Design. The dependent variables consist of five CAHPS multi-item scales measuring timeliness of care, provider communication, office staff helpfulness, getting needed care, and health plan customer service. The main independent variables are Hispanic primary language (English or Spanish) and region (California, Florida, New York/New Jersey, and other states). Ordinary least squares regression is used to model the effect of Hispanic primary language and region on CAHPS scales, controlling for age, gender, education, and self-rated health. Data Collection/Extraction Methods. The analytic sample consists of 125,369 respondents (82 percent response rate) enrolled in 181 Medicare managed care plans across the U.S. Of the 125,369 respondents, 8,463 (7 percent) were self-identified as Hispanic. The survey was made available in English and Spanish, and 1,353 Hispanics completed one in Spanish. Principal Findings. Hispanic English speakers had less favorable reports of care than whites for all dimensions of care except provider communication. Hispanic Spanish speakers reported more negative experiences than whites with timeliness of care, provider communication, and office staff helpfulness, but better reports of care for getting needed care. Spanish speakers in all regions except Florida had less favorable scores than English-speaking Hispanics for provider communication and office staff helpfulness, but more positive assessments for getting needed care. There were greater regional variations in CAHPS scores among Hispanic Spanish speakers than among Hispanic English speakers. Spanish speakers in Florida had more positive experiences than Spanish speakers in other regions for most dimensions of care. Conclusions. Hispanics in Medicare managed care face barriers to care; however, their experiences with care vary by language and region. Spanish speakers (except FL) have less favorable experiences with provider communication and office staff helpfulness than their English-speaking counterparts, suggesting language barriers in the clinical encounter. On the other hand, Spanish speakers reported more favorable experiences than their English-speaking counterparts with the managed care aspects of their care (getting needed care and plan customer service). Medicare managed care plans need to address the observed disparities in patient experiences among Hispanics as part of their quality improvement efforts. Plans can work with their network providers to address issues related to timeliness of care and office staff helpfulness. In addition, plans can provide incentives for language services, which have the potential to improve communication with providers and staff among Spanish speakers. Finally, health plans can reduce the access barriers faced by Hispanics, especially among English speakers. [source] Regional Differences in Arrhythmogenic Aftereffects of High Intensity DC Stimulation in the VentriclesPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2000ITSUO KODAMA Regional differences of the aftereffects of high intensity DC stimulation were investigated in isolated rabbit hearts stained with a voltage-sensitive dye (di-4-ANEPPS). Optical action potential signals were recorded from the epicardial surface of the right and left ventricular free wall (RVep, LVep) and from the right endocardial surface of the interventricular septum (IVS). Ten-millisecond monophasic DC stimulation (S2, 20,120 V) was applied to the signal recording spots during the early plateau phase of the action potential induced by basic stimuli (S1, 2.5 Hz). There was a linear relationship between S2 voltage and the S2 field intentisy (FI). S2 caused postshock additional depolarization. giving rise to a prolongation of the shocked action potential. With S2, 40 V (FI ,,20 V/cm), terminal repolarization of action potential was inhibited, and subsequent postshock S1 action potentials for 1,5 minutes were characterized by a decrease in the maximum diastolic potential and a decrease in the amplitude and a slowing of their upstroke phase. The higher the S2 voltage, the larger the aftereffects. The changes in postshock action potential configuration in RVep were significantly greater than those observed in LVep and IVS when compared at the same levels of S2 intensity. In RVep, 12 of 20 shocks of 120 V resulted in a prolonged refractoriness to S1 (> 1 s), and the arrest was often followed by oscillation of membrane potential. Ventricular tachycardia or fibrillation ensued from the oscillation in five cases. No such long arrest or serious arrhythmias were elicited in LVep and IVS. These results suggest that RVep is more susceptible than LVep and IVS for arrhythmogenic aftereffects of high intensity DC stimulation. [source] Role of shear stress on nitrite and NOS protein content in different size conduit arteries of swineACTA PHYSIOLOGICA, Issue 2 2009X. Guo Abstract Aim:, Inherent fundamental difference exists among arteries of different sizes. The purpose of this study was to evaluate the relation between regional difference of wall shear stress (WSS) in various sizes arteries and contents of nitrite and NO synthase (NOS) isoforms. Methods:, Five different conduit arteries in a wide range of diameter (1,8 mm) were examined in the hind limbs of 13 pigs. Blood flow rate and outer diameter were measured in vivo to determine WSS. Arterial tissues were harvested for the measurement of nitrite and NOS protein contents. The concentration of nitrite, a product of NO synthesis, was determined by high-performance liquid chromatography method. Western blot analysis was used to assess the protein contents of endothelial NOS (eNOS), inducible NOS (iNOS) and neuronal NOS (nNOS). Results:, Our data show that WSS increases with a decrease in artery diameter. Nitrite level increases with increasing WSS and hence decreases with artery diameter. The eNOS protein contents decrease with an increase in diameter. No significant difference for iNOS and nNOS protein contents was found with different artery diameter. A significant positive correlation between tissue nitrite and eNOS protein contents was also observed. Finally, the WSS-normalized eNOS is not significantly different in various size vessels. Conclusion:, Regional difference in blood flow has no effect on iNOS and nNOS protein contents in these conduit arteries. Regional difference in eNOS expression and nitrite contents may be related to the WSS-induced NO by the endothelium under normal physiological conditions. [source] National Study on Emergency Department Visits for Transient Ischemic Attack, 1992,2001ACADEMIC EMERGENCY MEDICINE, Issue 6 2006Jonathan A. Edlow MD Abstract Objectives: To describe the epidemiology of U.S. emergency department (ED) visits for transient ischemic attack (TIA) and to measure rates of antiplatelet medication use, neuroimaging, and hospitalization during a ten-year time period. Methods: The authors obtained data from the 1992,2001 National Hospital Ambulatory Medical Care Survey. TIA cases were identified by having ICD-9 code 435. Results: From 1992 to 2001, there were 769 cases, representing 2,969,000 ED visits for TIA. The population rate of 1.1 ED visits per 1,000 U.S. population (95% CI = 0.92 to 1.30) was stable over time. TIA was diagnosed in 0.3% of all ED visits. Physicians administered aspirin and other antiplatelet agents to a small percentage of patients, and 42% of TIA patients (95% CI = 29% to 55%) received no medications at all in the ED. Too few data points existed to measure a statistically valid trend over time. Physicians performed computed tomography scanning in 56% (95% CI = 45% to 66%) of cases and performed magnetic resonance imaging (MRI) in < 5% of cases, and there was a trend toward increased imaging over time. Admission rates did not increase during the ten-year period, with 54% (95% CI = 42% to 67%) admitted. Regional differences were noted, however, with the highest admission rate found in the Northeast (68%). Conclusions: Between 1992 and 2001, the population rate of ED visits for TIA was stable, as were admission rates (54%). Antiplatelet medications appear to be underutilized and to be discordant with published guidelines. Neuroimaging increased significantly. These findings may reflect the limited evidence base for the guidelines, educational deficits, or other barriers to guideline implementation. [source] Regional differences in kelp-associated algal assemblages on temperate limestone reefs in south-western AustraliaDIVERSITY AND DISTRIBUTIONS, Issue 6 2003Thomas Wernberg Abstract.,Ecklonia radiata (C. Agardh) J. Agardh kelp beds , a characteristic feature of the nearshore environment along the south-west Australian coastline , contribute significantly to the coastal biodiversity in temperate Australia, yet, little is known about the organization of these macroalgal assemblages. By compiling existing and new data sets from habitat surveys, we have characterized and compared the structure of kelp-associated macroalgal assemblages in three regions (Marmion Lagoon, Hamelin Bay and the marine environment neighbouring the Fitzgerald River National Park) across more than 1000 kilometres of the south-west Australian coastline. 152 macroalgal taxa had been recognized within the three regions and this is in the range of species richness reported from other Australian and African kelp beds. The kelp-associated algal assemblages were regionally distinct, 66% of all taxa were only found in one region and only 17 taxa were found in all three regions. Adjacent regions shared an additional 13,15 taxa. The regional shifts in assemblage structure were evident in species composition of both canopy and understorey. The organization of assemblages followed a spatial hierarchy where differences in assemblage structure were larger among regions (hundreds of kilometres apart) than among sites within regions (kilometres apart) and differences among sites within region were larger than differences among quadrats within sites (metres apart). Despite this hierarchy each level of nesting contributed approximately the same to total variation in assemblage structure and these spatial patterns were stronger than temporal differences from seasons to 2,3 years. Our results suggest that local and small-scale processes contribute considerably to heterogeneity in macroalgal assemblages throughout south-western Australia, and, in particular, our results are consistent with E. radiata exerting a strong influence on macroalgal assemblage structure. Further, our study contradicts the existence of a general south-west Australian kelp assemblage, although a few species may form the core of E. radiata associations across regions. [source] Oceanic influence on the precipitation of the south-east of VenezuelaENVIRONMETRICS, Issue 3 2002Lelys Guenni Abstract The Caroní catchment located in the south-east of Venezuela accounts for 70 per cent of the total hydropower energy of the country. On a year to year basis, it has been shown that low frequency large scale ocean-atmosphere phenomena are highly coupled to the hydroclimatology of the region, El Niño-Southern Oscillation (ENSO) being a major forcing mechanism of climatic and hydrological anomalies. Regional differences in amplitude and timing are due to complex orographic interactions, land surface-atmosphere feedback mechanisms and the evolution of dominant synoptic meteorological conditions. A detailed analysis of the relationship between rainfall and several large scale ocean-atmospheric variables was carried out to determine the potential use of large scale climatic information as predictors of the rainfall anomalies over the region. The problem was tackled in two ways: (a) first a seasonal dynamic rainfall model was fitted to monthly rainfall for different locations. In this case rainfall is assumed as a normal variate w which has been transformed to account for its departure from normality and truncated to account for the positive probability mass of zero values, which corresponds to negative values of the normal variable. The time series of the model parameters and the macroclimatic variables are inspected for their potential relationship with local rainfall via the stochastic model. (b) Second, dynamic linear regression models between the macroclimatic variables as predictors and the rainfall anomalies as predictant were fitted to evaluate and quantify the significance of these dependencies. Consistent patterns are observed with the Tropical Atlantic and Pacific ocean temperature anomalies, in which a significant negative relationship has been present since 1976, indicating an overall decrease (increase) in rainfall when the Pacific and the Tropical Atlantic are warmer (colder) than normal. In all cases the results suggest that the relationships between rainfall anomalies and the macroclimatic variables are not constant with time. Copyright © 2002 John Wiley & Sons, Ltd. [source] Effects of hydrogeomorphic region, catchment storage and mature forest on baseflow and snowmelt stream water quality in second-order Lake Superior Basin tributariesFRESHWATER BIOLOGY, Issue 5 2003Naomi E. Detenbeck SUMMARY 1. In this study we predict stream sensitivity to non-point source pollution based on the non-linear responses of hydrological regimes and associated loadings of non-point source pollutants to catchment properties. We assessed two hydrologically based thresholds of impairment, one for catchment storage (5,10%) and one for mature forest (<50% versus >60% of catchment in mature forest cover) across two different hydrogeomorphic regions within the Northern Lakes and Forest (NLF) ecoregion: the North Shore [predominantly within the North Shore Highlands Ecological Unit] and the South Shore (predominantly within the Lake Superior Clay Plain Ecological Unit). Water quality samples were collected and analysed during peak snowmelt and baseflow conditions from 24 second-order streams grouped as follows: three in each region × catchment storage × mature forest class. 2. Water quality was affected by a combination of regional influences, catchment storage and mature forest. Regional differences were significant for suspended solids, phosphorus, nitrogen: phosphorus ratios, dissolved organic carbon (DOC) and alkalinity. Catchment storage was significantly correlated with dissolved silica during the early to mid-growing season, and with DOC, specific conductance and alkalinity during all seasons. Total nitrogen and dissolved nitrogen were consistently less in low mature forest than in high mature forest catchments. Catchment storage interacted with the influence of mature forest for only two metrics: colour and the soluble inorganic nitrogen : phosphorus ratio. 3. Significant interaction terms (region by mature forest or region by storage) suggest differences in regional sensitivity for conductance, alkalinity, total organic carbon, and colour, as well as possible shifts in thresholds of impact across region or mature forest class. 4. Use of the NLF Ecoregion alone as a basis for setting regional water quality criteria would lead to the misinterpretation of reference condition and assessment of condition. There were pronounced differences in background water quality between the North and South Shore streams, particularly for parameters related to differences in soil parent material and glacial history. A stratified random sampling design for baseflow and snowmelt stream water quality based on both hydrogeomorphic region and catchment attributes improves assessments of both reference condition and differences in regional sensitivity. [source] Regional differences in hippocampal PKA immunoreactivity after training and reversal training in a spatial Y-maze taskHIPPOCAMPUS, Issue 5 2007Robbert Havekes Abstract It is suggested that the hippocampus functions as a comparator by making a comparison between the internal representation and actual sensory information from the environment (for instance, comparing a previously learned location of a food reward with an actual novel location of a food reward in a Y-maze). However, it remains unclear to what extent the various hippocampal regions contribute to this comparator function. One of the proteins known to be crucially involved in the formation of hippocampus-dependent long-term memory is the adenosine 3,,5, cyclic monophosphate dependent protein kinase (PKA). Here, we examined region-specific changes in immunoreactivity (ir) of the regulatory II,,, subunits of PKA (PKA RII,,,-ir) in the hippocampus during various stages of spatial learning in a Y-maze reference task. Thereafter, we compared changes in hippocampal PKA RII,,,-ir induced by training and reversal training in which the food reward was relocated to the previously unrewarded arm. We show that: (1) There was a clear correlation between behavioral performance and elevated PKA RII,,,-ir during the acquisition phase of both training and reversal training in area CA3 and dentate gyrus (DG), (2) PKA RII,,,-ir was similarly enhanced in area CA1 during the acquisition phase of reversal training, but did not correlate with behavioral performance, (3) PKA RII,,,-ir did not change during training or reversal training in the subiculum (SUB), (4) No changes in PKA RII,,, protein levels were found using Western blotting, and (5) AMPA receptor phosphorylation at serine 845 (S845p; the PKA site on the glutamate receptor 1 subunit (GluR1)), was enhanced selectively during the acquisition phase of reversal training. These findings reveal that training and reversal training induce region-specific changes in hippocampal PKA RII,,,-ir and suggest a differential involvement of hippocampal subregions in match-mismatch detection in case of Y-maze reference learning. Alterations in AMPA receptor regulation at the S845 site seems specifically related to the novelty detector function of the hippocampus important for match-mismatch detection. © 2007 Wiley-Liss, Inc. [source] Regional differences in fiber characteristics in the rat temporalis muscleJOURNAL OF ANATOMY, Issue 6 2008E. Tanaka Abstract The behavioral differences in muscle use are related to the fiber type composition of the muscles among other variables. The aim of this study was to examine the degree of heterogeneity in the fiber type composition in the rat temporalis muscle. The temporalis muscle was taken from 10-week-old Wistar strain male rats (n = 5). Fiber types were classified by immunohistochemical staining according to their myosin heavy chain content. The anterior temporalis revealed an obvious regional difference of the fiber type distribution, whereas the posterior temporalis was homogeneous. The deep anterior temporalis showed a predominant proportion of type IIA fibers and was the only muscle portion displaying slow type fibers (< 10%). The other two muscle portions, the superficial anterior and posterior temporalis, did not differ significantly from each other and contained mainly type IIB fibers. Moreover, the deep anterior temporalis was the only muscle portion showing slow type fibers (< 10%). In the deep portion, type IIX fibers revealed the largest cross-sectional area (1943.1 ± 613.7 µm2), which was significantly (P < 0.01) larger than those of type IIA and I + IIA fibers. The cross-sectional area of type IIB fibers was the largest in the remaining two muscle portions and was significantly (P < 0.01) larger than that of type IIX fibers. In conclusion, temporalis muscle in rats showed an obvious heterogeneity of fiber type composition and fiber cross-sectional area, which suggests multiple functions of this muscle. [source] Iloprost inhalation redistributes pulmonary perfusion and decreases arterial oxygenation in healthy volunteersACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2009D. RIMEIKA Background: Previous studies have shown that ventilation,perfusion matching is improved in the prone as compared with that in the supine position. Regional differences in the regulation of vascular tone may explain this. We have recently demonstrated higher production of nitric oxide in dorsal compared with ventral human lung tissue. The purpose of the present study was to investigate regional differences in actions by another vasoactive mediator, namely prostacyclin. The effects on gas exchange and regional pulmonary perfusion in different body positions were investigated at increased prostacyclin levels by inhalation of a synthetic prostacyclin analogue and decreased prostacyclin levels by unselective cyclooxygenase (COX) inhibition. Methods: In 19 volunteers, regional pulmonary perfusion in the prone and supine position was assessed by single photon emission computed tomography using 99mTc macro-aggregated albumin before and after inhalation of iloprost, a stable prostacyclin analogue, or an intravenous infusion of a non-selective COX inhibitor, diclofenac. In addition, gas distribution was assessed in seven subjects using 99mTc-labelled ultra-fine carbon particles before and after iloprost inhalation in the supine position. Results: Iloprost inhalation decreased arterial PaO2 in both prone (from 14.2±0.5 to 11.7±1.7 kPa, P<0.01) and supine (from 13.7±1.4 to 10.9±2.1 kPa, P<0.01) positions. Iloprost inhalation redistributed lung perfusion from non-dependent to dependent lung regions in both prone and supine positions, while ventilation in the supine position was distributed in the opposite direction. No significant effects of non-selective COX inhibition were found in this study. Conclusions: Iloprost inhalation decreases arterial oxygenation and results in a more gravity-dependent pulmonary perfusion in both supine and prone positions in healthy humans. [source] A Tissue-Specific Model of Reentry in the Right Atrial AppendageJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 6 2009JICHAO ZHAO Ph.D. Introduction: Atrial fibrillation is prevalent in the elderly and contributes to mortality in congestive heart failure. Development of computer models of atrial electrical activation that incorporate realistic structures provides a means of investigating the mechanisms that initiate and maintain reentrant atrial arrhythmia. As a step toward this, we have developed a model of the right atrial appendage (RAA) including detailed geometry of the pectinate muscles (PM) and crista terminalis (CT) with high spatial resolution, as well as complete fiber architecture. Methods and Results: Detailed structural images of a pig RAA were acquired using a semiautomated extended-volume imaging system. The generally accepted anisotropic ratio of 10:1 was adopted in the computer model. To deal with the regional action potential duration heterogeneity in the RAA, a Courtemanche cell model and a Luo-Rudy cell model were used for the CT and PM, respectively. Activation through the CT and PM network was adequately reproduced with acceptable accuracy using reduced-order computer models. Using a train of reducing cycle length stimuli applied to a CT/PM junction, we observed functional block both parallel with and perpendicular to the axis of the CT. Conclusion: With stimulation from the CT at the junction of a PM, we conclude: (a) that conduction block within the CT is due to a reduced safety factor; and (b) that unidirectional block and reentry within the CT is due to its high anisotropy. Regional differences in effective refractive period do not explain the observed conduction block. [source] Determination of Regional Flavor Differences in U.S. Cheddar Cheeses Aged for 6 Mo or LongerJOURNAL OF FOOD SCIENCE, Issue 5 2008M.A. Drake ABSTRACT:, Cheddar cheese is a widely popular food in the United States. This product is produced in facilities across the United States and often marketed based on region of manufacture, implying that regional differences in flavor character of the cheese exist. This study was conducted to determine if regional differences in flavor exist in the aged U.S. Cheddar cheeses. Three times per year for 2 y, triplicate 18-kg blocks of Cheddar cheese (< 60 d old) were obtained from 19 manufacturing facilities located in 4 major cheese- producing regions/states: California, Northwest, Midwest, and Northeast. A trained sensory panel documented the flavor characteristics of cheeses after 6-, 9-, 12-, 18-, and 24-mo ripening at 7 °C. Regional differences were observed for specific flavors for cheeses manufactured in the Northwest, Midwest, and Northeast across ripening (P < 0.05), but the specific flavors responsible for these effects were not consistent across ripening. Similarly, cheese make procedure effects were also observed for specific flavors across ripening (P < 0.05), but these differences were also not consistent across ripening. The impact of region and cheese make procedure on flavor of the aged Cheddar cheeses was small in comparison to consistently documented, facility-specific flavor differences (P < 0.0001). Flavor profiles of aged Cheddar cheeses were most strongly influenced by practices specific to manufacturing facility rather than region of manufacture. [source] Lack of protein expression of the simian virus 40 large T antigen in human lymphomas,,JOURNAL OF MEDICAL VIROLOGY, Issue 6 2008Philip Went Abstract Several studies have detected Simian virus 40 (SV40) deoxyribonucleic acid sequences in human tumor tissues, including lymphomas, mainly by the polymerase chain reaction, but these data were not confirmed by subsequent investigations. Regional differences in the distribution of the SV40 and/or technical difficulties have been taken into account to explain these divergent results, but because only a few such studies dealt with the expression of SV40 proteins in tumor tissues, we investigated the expression of the SV40 large T antigen in human lymphomas by immunohistochemistry. Tissue microarrays containing Non-Hodgkin's-lymphomas and Hodgkin's-lymphomas were constructed utilizing archival samples encompassing the years 1974,2001 from Italian, Swiss and Austrian patients. Expression of the SV40 large T antigen was analysed by highly specific and sensitive immunohistochemistry using a mouse monoclonal antibody. Protein expression of the large T antigen was not detected in 655 Non-Hodgkin's-lymphomas or in 337 Hodgkin's- lymphomas. The results suggest the absence of an association between SV40 large T antigen and human lymphomas. J. Med. Virol. 80:1112,1115, 2008. © 2008 Wiley-Liss, Inc. [source] Assessment of regional differences in myocardial blood flow using T2 -weighted 3D BOLD imagingMAGNETIC RESONANCE IN MEDICINE, Issue 3 2001Kara B. Wright Abstract The feasibility of detecting regional differences in myocardial blood flow based on the blood oxygen level-dependent (BOLD) effect was evaluated in vivo in dogs (N = 9) using a 3D T2 -prepared segmented gradient-echo sequence at 1.5 T. Regional differences in myocardial blood flow were created by administering adenosine through a catheter placed in the left circumflex coronary artery (LCX). The difference in the R2 (1/T2) relaxation rate between the left ventricular myocardial region supplied by the LCX and regions supplied by the left anterior descending coronary artery (LAD) or septal artery during adenosine administration was correlated to the corresponding regional myocardial blood flow difference determined using fluorescent microspheres. A correlation coefficient of 0.80 was found between the MR BOLD measurements and the myocardial flow assessment. Our results show that the sequence used in this study allows fast 3D BOLD imaging of the heart, and is a promising technique for detecting regional myocardial perfusion differences. Magn Reson Med 46:573,578, 2001. © 2001 Wiley-Liss, Inc. [source] The buoyancy of the integument of Atlantic bottlenose dolphins (Tursiops truncatus): Effects of growth, reproduction, and nutritional stateMARINE MAMMAL SCIENCE, Issue 3 2010Robin C. Dunkin Abstract In Atlantic bottlenose dolphins (Tursiops truncatus) the thickness and lipid content of blubber (the integument's specialized hypodermis) varies across ontogeny and with reproductive and nutritional state. Because the integument comprises up to 25% of total body mass in this species, ontogenetic changes in its lipid content may influence whole body buoyancy. The density and volume of the integument were measured and its buoyancy calculated across an ontogenetic series of dolphins and in pregnant and emaciated adults (total n= 45). Regional differences between the metabolically labile trunk integument and the structural tailstock integument were also investigated. Mean densities of both trunk and tailstock integument were similar across life history categories (trunk = 1,040.7 ± 14.1 kg/m3; tailstock = 1,077.1 ± 21.2 kg/m3) and were statistically similar to the density of seawater (1,026 kg/m3). The mean buoyant force of integument from the trunk (,1.01 ± 1.74 N) and tailstock (,0.30 ± 0.21 N) did not vary significantly across ontogeny. In contrast, pregnancy and emaciation did influence the integument's buoyancy, which ranged between 9 N and ,45 N in these categories. Although neutral during growth, the integument's contribution to whole body buoyancy can be influenced by an individual's reproductive and nutritional status. [source] Support and faculty mentoring programmes for medical students in Germany, Switzerland and AustriaMEDICAL EDUCATION, Issue 6 2000Woessner Objectives To study what is being done at German-speaking universities regarding the counselling and tutoring of students, we carried out a survey among the deans of medical faculties in Germany, Austria and Switzerland. Our main concern was if any such projects were already available to the medical student or whether efforts to this purpose were under way. Design We focused in particular on faculty mentoring programmes, a continuous tutoring by designated members of the faculty on a person-to-person basis. Setting German, Austrian and Swiss medical faculties. Subjects Medical faculty deans. Results The return rate was 80%. While general student counselling is, if required, available at nearly all of the faculties, faculty mentoring programmes are offered by only 36·1% of the medical schools, and individualized career counselling by 30·6%. Conclusions Compared to other countries, such as the United Kingdom or the United States, counselling and tutoring programmes, e.g. career planning or faculty mentoring, are not generally available to the German medical student. Regional differences are evident, which can be attributed to differences in the universities' legal and financial situation. The medical faculties at German-speaking universities should make it their priority to offer these services to the student on a permanent basis. [source] Regional Differences in Arrhythmogenic Aftereffects of High Intensity DC Stimulation in the VentriclesPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2000ITSUO KODAMA Regional differences of the aftereffects of high intensity DC stimulation were investigated in isolated rabbit hearts stained with a voltage-sensitive dye (di-4-ANEPPS). Optical action potential signals were recorded from the epicardial surface of the right and left ventricular free wall (RVep, LVep) and from the right endocardial surface of the interventricular septum (IVS). Ten-millisecond monophasic DC stimulation (S2, 20,120 V) was applied to the signal recording spots during the early plateau phase of the action potential induced by basic stimuli (S1, 2.5 Hz). There was a linear relationship between S2 voltage and the S2 field intentisy (FI). S2 caused postshock additional depolarization. giving rise to a prolongation of the shocked action potential. With S2, 40 V (FI ,,20 V/cm), terminal repolarization of action potential was inhibited, and subsequent postshock S1 action potentials for 1,5 minutes were characterized by a decrease in the maximum diastolic potential and a decrease in the amplitude and a slowing of their upstroke phase. The higher the S2 voltage, the larger the aftereffects. The changes in postshock action potential configuration in RVep were significantly greater than those observed in LVep and IVS when compared at the same levels of S2 intensity. In RVep, 12 of 20 shocks of 120 V resulted in a prolonged refractoriness to S1 (> 1 s), and the arrest was often followed by oscillation of membrane potential. Ventricular tachycardia or fibrillation ensued from the oscillation in five cases. No such long arrest or serious arrhythmias were elicited in LVep and IVS. These results suggest that RVep is more susceptible than LVep and IVS for arrhythmogenic aftereffects of high intensity DC stimulation. [source] Regional differences in craniofacial diversity and the population history of Jomon JapanAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 3 2009Tsunehiko Hanihara Abstract The people associated with the Jomon culture, the Neolithic inhabitants of Japan, are one of the key groups in the population history of East Asia, because they retain many archaic characters that may be traced back to Eurasian Upper Palaeolithic hunter,gatherers. In this study, the regional diversity of the Jomon skeletal series was estimated by applying the R-matrix method to 34 craniofacial measurements. The patterns of intraregional variation indicate little effect on the genetic structure of the Jomon from long-term gene flow stemming from an outside source. The regional diversities were further estimated by pooling all individuals into regional aggregates, and by computing the mean variance within local groups in each region. Although the pattern of phenotypic variation differs depending on the unit of analysis, the gradient of the diversity retains its identity. The Hokkaido region, the northernmost part of the Japanese archipelago, has the highest variance, followed by the regions of eastern Japan, while the southwestern regions have the lowest variance. These findings suggest that the Jomon ancestors of the northern part of Japan might have expanded southward to Honshu Island. Global analyses including samples from Eurasia, Africa, and Australia dating roughly to the same chronological periods as those of the Jomon samples, indicate that the Jomon cranial series share part of their ancestral gene pool with early northeastern Asians. The present findings support the archeologically suggested population growth and expansion in the northern half of the Eurasian continent during the late Pleistocene and early Holocene periods. Am J Phys Anthropol, 2009. © 2008 Wiley-Liss, Inc. [source] Changes in Vein Dynamics Ranging from Low to High Pressure Levels as a Determinant of the Differences in Vein Adaptation to Arterial Hemodynamic ConditionsARTIFICIAL ORGANS, Issue 7 2007Yanina Zócalo Abstract:, The causes of the regional differences in venous grafts patency rates are partially understood. Differences in vein dynamics during physiological situations could determine differences in veins' capability to face arterial conditions and could contribute to the dissimilar performance of veins as arterial grafts. In vitro pressure and diameter were measured in four different veins during physiological and arterial (graft) pressure conditions. A diameter,pressure transfer function was designed. Compliance, viscous and inertial properties; circumferential stresses and deformation; and buffering function were calculated. Regional differences in veins' dynamics, but not in buffering function were found during physiological and arterial conditions. The back vein (femoral) showed the least changes when submitted to arterial conditions. Arterial conditions represent different changes in vein dynamics depending on the segment considered. The regional differences in vein dynamics, both at physiological and graft conditions, could contribute to explain the dissimilar results of venous grafts. [source] Regional differences among employed nurses: A Queensland studyAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2009Tim Henwood Abstract Objective:,To ascertain differences in the working lives of geographically dispersed nurses. Design:,Cross-sectional. Setting:,Registered, enrolled and assistants-in-nursing members of the Queensland Nurses' Union employed in nursing in Queensland, Australia. Participants:,A total of 3000 members of the Union, equally stratified by sector (public, private, aged care). Among them, 1192 responded and 1039 supplied postcodes matching the Australian Standard Geographical Classification. Main outcome measures:,Statistically significant differences in working lives of nurses employed in different geographical locations. Results:,Nurses in outer regional/remote/very remote localities are more likely to be employed as permanent full-time staff and self-report higher levels of work stress. These levels could be explained by: lack of replacement staff for leave, longer working and on call hours and lack of support for new staff. Distance remains a major barrier to accessing continuing professional education. However, outer regional/remote/very remote nurses were more likely to be provided employer support for professional education. Inner regional nurses were more likely to work part time, would work more hours if offered and were more likely to have taken a break from nursing as a result of family commitments. Conclusion:,The data confirm that current policies are not addressing the differences in the working lives of geographically dispersed nurses. Policies addressing orientation, mentoring and workloads should be implemented to address these issues. [source] Surgery for menorrhagia within English regions: variation in rates of endometrial ablation and hysterectomyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2009DA Cromwell Objective, To examine variation between English regions in the use of surgery (endometrial ablation or hysterectomy) for the treatment of menorrhagia. Design, Analysis of Hospital Episodes Statistics (HES) data to produce rates of surgery for English Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs). Population, Women aged between 25 and 59 years who had endometrial ablation or hysterectomy for menorrhagia between April 2003 and March 2006 in English NHS hospitals. Methods, Multilevel Poisson regression was used to determine the level of systematic variation in the regional rates of surgery and their association with regional characteristics (deprivation, service provision and mix of surgical procedures). Main outcome measure, Age-standardised annual rates of surgery. Results, The English rate of surgery for menorrhagia was 143 procedures per 100 000 women. Surgical rates within SHAs ranged from 52 to 230 procedures per 100 000 women, while rates within PCTs ranged from 20 to 420 procedures per 100 000 women. While, 60% of all procedures were endometrial ablations, the proportion across SHAs varied, ranging from 46% to 75%. Surgery rates were associated with the regional characteristics, but only weakly, and risk adjustment reduced the amount of unexplained variation by <15% at both SHA and PCT levels. Conclusion, Regional differences in surgical rates for menorrhagia have persisted despite changes in practice and improved evidence, suggesting there is scope for improving the management of menorrhagia within England. [source] 5-HT4 receptors on cholinergic nerves involved in contractility of canine and human large intestine longitudinal muscleBRITISH JOURNAL OF PHARMACOLOGY, Issue 5 2000N H Prins 5-HT4 receptors mediate circular muscle relaxation in both human and canine large intestine, but this phenomenon alone can not explain the improvement in colonic motility induced by selective 5-HT4 receptor agonists in vivo. We set out to characterize 5-HT4 receptor-mediated effects in longitudinal muscle strips of canine and human large intestine. Electrical field stimulation (EFS) was applied providing submaximal isotonic contractions. L -NOARG (0.1 mM) was continuously present in the organ bath to preclude nitric oxide-induced relaxation to EFS. The selective 5-HT4 receptor agonist prucalopride (0.3 ,M) enhanced EFS-evoked contractions, that were antagonized in both preparations by the selective 5-HT4 receptor antagonist GR 113808 (0.1 ,M). The prucalopride-induced increase was present in canine ascending and descending colon, but absent in rectum. Regional differences in response to prucalopride were not observed in human ascending and sigmoid colon and rectum. Incubation with atropine (1 ,M) or tetrodotoxin (0.3 ,M) inhibited EFS-induced contractions, which were then unaffected by prucalopride (0.3 ,M) in both tissues. In the presence of methysergide (3 ,M; both tissues) and granisetron (0.3 ,M; only human tissues), 5-HT (0.3 ,M) enhanced EFS-induced contractions, an effect that was antagonized by GR 113808 (0.1 ,M). In the presence of atropine or tetrodotoxin, EFS-induced contractions were inhibited, leaving 5-HT (0.3 ,M) ineffective in both preparations. This study demonstrates for the first time that in human and canine large intestine, 5-HT4 receptors are located on cholinergic neurones, presumably mediating facilitating release of acetylcholine, resulting in enhanced longitudinal muscle contractility. This study and previous circular muscle strip studies suggest that 5-HT4 receptor agonism facilitates colonic propulsion via a coordinated combination of inhibition of circumferential resistance and enhancement of longitudinal muscle contractility. British Journal of Pharmacology (2000) 131, 927,932; doi:10.1038/sj.bjp.0703615 [source] International comparison of blood pressure and BMI values in schoolchildren aged 11,16 yearsACTA PAEDIATRICA, Issue 2 2010Á Baráth Abstract Aims:, This study comprised part of a larger cross-sectional survey performed in Hungary in the period 2005,2006, which was designed first to reveal the representative age-, gender- and height-specific percentile values for the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) in Hungarian children aged 11,16 years. The second aim was to determine the prevalence of overweight and obesity. Methods:, Analyses were performed on 14 290 Hungarian children aged 11,16 years. All blood pressure (BP) measurements were made with a validated, automated, digital device. The criteria recommended by international guidelines were used. Results:, The prevalence of overweight and obesity among the Hungarian children was found to be 23.4% (3347 adolescents; International Obesity Task Force criteria). Previous studies have reported that the strongest correlation is observed between the BP values and weight, and our results are in accordance with this. Conclusions:, Regional differences in morphometry (different prevalences of overweight and obesity) and the genetic background, disparate eating habits and other cultural factors may account for the differences in BP levels during childhood. As the prevalence of overweight and obesity is increasing worldwide, it is important that countries carefully monitor the weight and BP status of their children and adolescents. [source] Regional differences in maturation of germ cells of cryptorchid testes: role of environmentACTA PAEDIATRICA, Issue 8 2009Dragana Zivkovic Abstract Objective:, To investigate differences in maturation of germ cells in cryptorchid testes in three different regions. Patients and methods:, A total of 103 consecutive patients were operated for unilateral undescended testis in Vojvodina, from March 2006 until September 2007, and had a testicular biopsy performed. Germ cells were counted, and the presence of Ad spermatogonia was noted. Biopsies were compared to biopsies of similar patients from two different regions: Philadelphia, USA (130), and Liestal, Switzerland (55 patients). Results:, In Vojvodina, 84.5% of patients had Sertoli cells only, or some spermatogonia, but no Ad spermatogonia, and 15.5% had Ad spermatogonia. In Philadelphia, 59.3% of patients had poor testicular histology, and 40.7% had Ad spermatogonia. In Liestal, 61.8% of patients had no, or some, spermatogonia, but no Ad spermatogonia, and 38.2% had Ad spermatogonia. There was a difference (p = 0.000025) between the patients with normal testicular histology from Philadelphia and those from Vojvodina, as well as between the patients from Vojvodina and Liestal (p = 0.0027). Conclusion:, The reduction in the number of germ cells in patients with cryptorchidism from Vojvodina is more pronounced than patients from either Switzerland or USA. This is a unique observation, since such a study has not been published yet. [source] Policy interpretation network on children's health and environmentACTA PAEDIATRICA, Issue 2006PETER VAN DEN HAZEL Abstract Aim: The main objective of PINCHE is to provide policy recommendations aiming at protecting children's health and environment based on completed scientific research. The project focused on four themes: indoor and outdoor air pollutants, carcinogens, neurotoxicants, and noise. The data were evaluated in workpackages on exposure assessment, epidemiology, toxicology, and risk and health impact assessment. The data were analysed according to a framework of questions. The workpackage on socioeconomic factors studied the influence of socioeconomic status on exposures and on health effects. In the workpackage on science-policy interface, recommendations on how to improve children's environmental health were formulated. Results: The policy recommendations resulting from the analysis were grouped according to relevant policy levels: European Commission or the European Parliament, member states and other stakeholders at regional or local level. These recommendations are general guidelines for taking action. Regional differences and variation must be reflected when policy is actually implemented. In addition, recommendations related to education and personal behaviour are presented in the reports. Conclusions: The policy recommendations are important input for policy advisers, policy makers and public health authorities at all policy levels. The recommendations are also of direct relevance to interest groups, such as environmental NGOs including child health and advocacy groups. The policy recommendations for each policy level were prioritized. High priorities were given to reduce exposure to environmental tobacco smoke, transport related air pollution, indoor air and mercury. [source] NEURAL CONTROL OF RENAL MEDULLARY PERFUSIONCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 5-6 2004Gabriela A Eppel Summary 1.,There is strong evidence that the renal medullary circulation plays a key role in long-term blood pressure control. This, and evidence implicating sympathetic overactivity in development of hypertension, provides the need for understanding how sympathetic nerves affect medullary blood flow (MBF). 2.,The precise vascular elements that regulate MBF under physiological conditions are unknown, but likely include the outer medullary portions of descending vasa recta and afferent and efferent arterioles of juxtamedullary glomeruli, all of which receive dense sympathetic innervation. 3.,Many early studies of the impact of sympathetic drive on MBF were flawed, both because of the methods used for measuring MBF and because single and often intense neural stimuli were tested. 4.,Recent studies have established that MBF is less sensitive than cortical blood flow (CBF) to electrical renal nerve stimulation, particularly at low stimulus intensities. Indeed, MBF appears to be refractory to increases in endogenous renal sympathetic nerve activity within the physiological range in all but the most extreme cases. 5.,Multiple mechanisms appear to operate in concert to blunt the impact of sympathetic drive on MBF, including counter-regulatory roles of nitric oxide and perhaps even paradoxical angiotensin II-induced vasodilatation. Regional differences in the geometry of glomerular arterioles are also likely to predispose MBF to be less sensitive than CBF to any given vasoconstrictor stimulus. 6.,Failure of these mechanisms would promote reductions in MBF in response to physiological activation of the renal nerves, which could, in turn, lead to salt and water retention and hypertension. [source] Role of shear stress on nitrite and NOS protein content in different size conduit arteries of swineACTA PHYSIOLOGICA, Issue 2 2009X. Guo Abstract Aim:, Inherent fundamental difference exists among arteries of different sizes. The purpose of this study was to evaluate the relation between regional difference of wall shear stress (WSS) in various sizes arteries and contents of nitrite and NO synthase (NOS) isoforms. Methods:, Five different conduit arteries in a wide range of diameter (1,8 mm) were examined in the hind limbs of 13 pigs. Blood flow rate and outer diameter were measured in vivo to determine WSS. Arterial tissues were harvested for the measurement of nitrite and NOS protein contents. The concentration of nitrite, a product of NO synthesis, was determined by high-performance liquid chromatography method. Western blot analysis was used to assess the protein contents of endothelial NOS (eNOS), inducible NOS (iNOS) and neuronal NOS (nNOS). Results:, Our data show that WSS increases with a decrease in artery diameter. Nitrite level increases with increasing WSS and hence decreases with artery diameter. The eNOS protein contents decrease with an increase in diameter. No significant difference for iNOS and nNOS protein contents was found with different artery diameter. A significant positive correlation between tissue nitrite and eNOS protein contents was also observed. Finally, the WSS-normalized eNOS is not significantly different in various size vessels. Conclusion:, Regional difference in blood flow has no effect on iNOS and nNOS protein contents in these conduit arteries. Regional difference in eNOS expression and nitrite contents may be related to the WSS-induced NO by the endothelium under normal physiological conditions. [source] Sale, price and valuation in Galicia and Castile,León in the tenth centuryEARLY MEDIEVAL EUROPE, Issue 2 2002Wendy Davies The number of sale transactions recorded by northern Spanish charters of the tenth century is very striking, especially in the 930s to 960s. A record of price paid was a consistent element of such documents, although words used to express price varied from silver solidi to goats, shirts and grain. Valuations, in solidi and in other units of account such as cattle, were often stated when objects were used as payment. While it looks as if some silver was really used in deals in urban León and its hinterland, using pieces of silver called argenzos, argenteos etc., elsewhere this was rare. Comparing the transactions in the three very different monastic collections of Celanova in the north,west, Sahagún in the central meseta and Cardeña in the foothills of the sierras in the north,east, regional difference is also striking. Sahagún is notable for the volume and early date of its sales and for increasing use of silver,based expressions of price and value. Round Celanova, by contrast, although there were also many sales, people used several modes of valuation simultaneously, but metal,based notions very rarely. Round Cardeña, close to urban Burgos, far fewer sales are recorded, and they come later in the century, but silver,based notions of value were the only ones used. This latter sub,urban context seems to have been much less commercially active than that of León and Sahagún, with exchange by gift and countergift a more prominent characteristic. [source] Regional differences in fiber characteristics in the rat temporalis muscleJOURNAL OF ANATOMY, Issue 6 2008E. Tanaka Abstract The behavioral differences in muscle use are related to the fiber type composition of the muscles among other variables. The aim of this study was to examine the degree of heterogeneity in the fiber type composition in the rat temporalis muscle. The temporalis muscle was taken from 10-week-old Wistar strain male rats (n = 5). Fiber types were classified by immunohistochemical staining according to their myosin heavy chain content. The anterior temporalis revealed an obvious regional difference of the fiber type distribution, whereas the posterior temporalis was homogeneous. The deep anterior temporalis showed a predominant proportion of type IIA fibers and was the only muscle portion displaying slow type fibers (< 10%). The other two muscle portions, the superficial anterior and posterior temporalis, did not differ significantly from each other and contained mainly type IIB fibers. Moreover, the deep anterior temporalis was the only muscle portion showing slow type fibers (< 10%). In the deep portion, type IIX fibers revealed the largest cross-sectional area (1943.1 ± 613.7 µm2), which was significantly (P < 0.01) larger than those of type IIA and I + IIA fibers. The cross-sectional area of type IIB fibers was the largest in the remaining two muscle portions and was significantly (P < 0.01) larger than that of type IIX fibers. In conclusion, temporalis muscle in rats showed an obvious heterogeneity of fiber type composition and fiber cross-sectional area, which suggests multiple functions of this muscle. [source] Why is violent crime so common in the Americas?AGGRESSIVE BEHAVIOR, Issue 5 2006Nigel BarberArticle first published online: 11 JUL 200 Abstract Violent crimes, including murders, rapes, and assaults are substantially higher in the Americas than other regions of the world. This study investigated the role of single parenthood ratios in accounting for this regional variation in violent crime of 39 countries using INTERPOL data. It pitted the prediction of parental investment (calling for a delayed relationship between single parenthood and crime) against a mating aggression hypothesis that predicted a contemporaneous effect. Regression analyses found that current single parenthood ratios were strongly and consistently predictive of violent crimes whereas single parenthood ratios 18 years earlier were not and this conclusion remained following controls for income inequality and the population sex ratio. The results indicate that the regional difference in violent crime is best explained in terms of mating competition rather than reduced parental investment. Aggr. Behav. 32:1,9, 2006. © 2006 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||||||||||||||||||||