202,621 research outputs found
Maternal vitamin D deficiency and GDM risk: evidence for the case of investing more attention in antenatal clinics
No full textGestational diabetes mellitus (GDM) is a global public health problem, and in India, it affects about 20% of pregnancies. India, despite being a tropical country with abundant sunshine has a high prevalence (80%) of vitamin D deficiency (VDD) among reproductive-aged women. Global and Indian evidence links VDD with a higher risk of hyperglycaemia in pregnancy and GDM. VDD has also been implicated in gestational hypertension, preterm birth and poorer offspring health. Global scientific consensus acknowledges the need for maternal vitamin D screening and supplementation, but knowledge gaps exist about optimal blood levels (50-100 nmol/l), and the required vitamin D dosage (400-4000 IU). Diet can provide <10% of the vitamin D requirements, food fortification can deliver limited amounts, and hence optimal antenatal supplementation is key. Prenatal calcium supplements containing 400 IU of vitamin D may be sufficient for calcium absorption and bone health, but may not provide immunomodulatory benefits, including GDM prevention. Increasing evidence calls for higher maternal vitamin D requirements (2000-4000 IU) for skeletal, metabolic and immune health benefits. Current screening and supplementation for maternal VDD in India is low. We need to invest in future studies to determine optimal maternal vitamin D requirements and formulate policies for vitamin D supplementation to prevent GDM. Improving the maternal vitamin D status is an important nutritional priority for policymakers to reduce the large economic burden of non-communicable diseases (10% of India's gross domestic product), and eventually achieve the 2030 UN sustainable development goals.</p
The fetal and early life origins of adult disease
No full textThe fetal origins of adult disease (FOAD) hypothesis is based on the observation that men and women who were small at birth (low birthweight) have an increased risk of atherosclerotic cardiovascular disease (CVD) and the related diseases hypertension, type 2 diabetes and the Insulin Resistance Syndrome. Risk is increased further if they showed rapid weight gain in childhood or become obese. The hypothesis proposes that CVD is ‘programmed’ by under nutrition during critical periods of early development and that ‘poverty’ during early life creates a permanent vulnerability to ‘diseases of affluence’. This concept is arguably of greatest relevance to developing countries, where fetal growth restriction still affects large numbers of people, where economic progress is leading to the emergence of childhood and adult obesity, and where CVD and type 2 diabetes are rising rapidly. Its implication is that the prevention of adult disease should include strategies to improve maternal health and fetal growth. This paper reviews work leading to the FOAD hypothesis and the results of FOAD research in India. It also discusses some of the controversies surrounding the hypothesis, notably the debate as to whether the link between fetal growth restriction and adult CVD is mediated by environmental factors (such as maternal nutrition) or by genes
Movimenti migratori ed effetti sul territorio. Il caso di Podor (Regione di Saint Louis, Senegal)
No full textRISULTATI DI INDAGINE DIRETTA NEL TERRITORIO DI PODOR, NEL SENEGAL SETTENTRIONALE, ATTA AD EVIDENZIARE GLI EFFETTI SOCIO-TERRITORIALI DELLE RIMESSE DEI MIGRANTI
The computer simulation and prediction of rock fall
No full textThis thesis deals with the study of rock falls using a mathematical model, codified for computer use, entitled GeoFall. GeoFall, which was developed by the author, allows predictions to be made of rock fall trajectories, run out distances and kinetic energies for a rock of any arbitrary shape. Its main purpose is to assist in the design of remedial works. The mathematical model is based on rigid body mechanics, and analyses a fall in 2D space using a new theory of impact dynamics developed by Brach (1991). The main features and algorithms of the program are presented in this thesis. The performance of GeoFall was evaluated by comparing actual rock fall events described in several published papers with the output created by GeoFall. Also the output from GeoFall has been compared with the output from other rock fall simulation programs used to simulate the documented rockfalls. A new rock slope inventory system entitled the Rock Fall Risk Assessment System (RFRAS) has been developed by the author to determine the rock fall risk at specific rock fall sites. It consists of three phases of inspection, the slope survey, and the preliminary and detailed rating phases. The detailed rating phase uses 13 parameters that when assessed, evaluated and totalled, numerically differentiates slopes from the least to the most hazardous producing an overall rating in the range 21-1926. It not only allows the relative risk of rockfall between slopes to be assessed but it also categorises the rock fall risk and the potential number of future rockfalls. It has been tested on 18 slopes at ten locations in County Durham. The final part of the thesis details a new laboratory based procedure that can be used to determine the coefficients of restitution for any type of rock material. The normal coefficient of restitution has been determined for seven different types of rock, and the tangential coefficient of restitution has been determined for a local sandstone. Some tentative correlations between the normal coefficient of restitution and the rocks physical properties, such as its Unconfined Compressive Strength (UCS) have been presented
Sharp nonexistence results for a linear elliptic inequality involving Hardy and Leray potentials
No full textWe deal with nonnegative distributional supersolutions for a class of linear elliptic equations involving inverse-square potentials and logarithmic weights. We prove sharp nonexistence results
Analysis of Patient Fall Data
No full textPatient falls are common adverse events that occur in all healthcare environments. Patient falls are a common cause of morbidity ("disability caused by accident") and the leading cause of nonfatal injuries producing trauma-related hospitalizations in the United States. Patient falls result in longer hospital stays, attendant increases in medical costs and reduced quality of life for the patients who experience these events. The purpose of this thesis was to examine the patient fall data collected by a community based acute teaching hospital. These data were then analyzed by a variety of analytical methods to determine if there are correlations related to location and timing of the falls, as well as the characteristics of the patients who fell. Conclusions were then made as to possible improvements in methods to monitor patients to reduce patient fall rate. The major results of this analysis were: (1) statistical methods were found to be useful in providing an improved understanding of the characteristics of the patient fall data and thus allow hospital staff to rely on quantitative metrics to make decisions of how to try and reduce patient fall rates, (2) the time intervals between consecutive fall events were found to be distributed exponentially, (3) the hospital-wide hospital monthly fall rate goals, as well as the individual hospital unit patient fall rate goals were shown to be regularly exceeded by the measured data, and (5) review of the fall score screen values used to assess the risk for patient falls, while overall a predictor of patient who did and did not fall, was not a good predictor for determining if individual patients would fall. As a result of this study, a number of specific recommendations will proposed to the hospital as a means to potentially improve the methods for addressing patient falls. A hospital-wide cultural change had been commenced in June 2007 to attempt to reduce the rate of patient falls. The effect of implementing this program will be followed by observing whether the over-all hospital and unit monthly fall rates are reduced
An investigation of fall protection systems in the roofing industry
No full textThesis Chair, Dr. Sang D. Choi.
This file was last viewed in Adobe Reader 7.0Construction is one of most dangerous industries in the United States. One of the most hazardous areas within the construction industry is roofing. Concern for safety in roofing construction has continued to spread, as a result of falls that make up the greatest rate of fatalities in the construction industry. Previous research has found that falls have been one of the leading categories under type of occupational death and that fall protection systems are not consistently used to prevent fall accidents in the roofing industry. Research is needed in order to analyze falls and other potential hazards in roofing. The main goal for this study is to analyze commercial and residential roofers’ behaviors, attitudes, and beliefs on the fall protection systems. A survey was distributed to commercial and residential roofers in the Midwest. Information collected from roofers was compared and analyzed to find differences between residential and commercial roofers. A total of 129 roofing contractors participated in this study. The results of the survey showed that while most of commercial roofers did use fall protection devices, a significant number of residential roofers did not comply with fall protection regulations and guidelines. Two main reasons of noncompliance with fall protection regulations and guidelines in roofing construction were found: (1) fall protection devices decrease productivity; (2) fall protection equipment makes roofers uncomfortable. Results from this study revealed that personal fall arrest system (PFAS) was the most prevalent fall protection device used among residential and commercial roofers. PFAS was also the most preferred fall protection equipment among the two groups of roofers. For both residential and commercial roofing, there is a significant (p = 0.05 and p = 0.01) negative relationship between enforcing roofers to wear or install fall protection devices and having falls from roofs. In both residential and commercial roofing, there is a very significant (p= 0.001 and p = 0.001) positive relationship between the enforcement and the actual usage of fall protection equipment. This thesis presents the results of the investigation of fall protection systems in roofing construction and recommendations that ultimately would reduce fall accidents
Identifying Risk Factors of Fall Risk Increasing Drug Use and Fall and Fall Injury Risk in Racially and Ethnically Diverse Adults Over 50
No full textBACKGROUND: Over 25% of older adults (65 years) fall every year, which can lead to injuries and disability. Fall risk increasing drugs (FRIDs), frequently defined through the Swedish National Board of Health and Welfare (SNBHW) and the CDC’s STEADI-Rx, are often initiated in midlife and have increased in prevalence among older adults mainly due to antihypertensive, antidepressant, and anticonvulsant use. Whether factors associated with use of FRIDs differ by definition is unknown. Additionally, associations between FRIDs and fall/fall injury risk are not fully understood in midlife or the oldest ages.
OBJECTIVES: This dissertation aimed to: identify risk factors associated with FRID use in older adults using SNBHW and STEADI-Rx definitions; and determine the association of FRIDs on self-reported fall/fall injury risk in Black and White men and women 79 years, and in multi-ethnic middle-age and early-old-age women.
METHODS: Participants included community-dwelling older adults in the Health, Aging, and Body Composition (Health ABC) Study (n=1352, 83±3 years) and those with <=2 years follow-up (n=1273, 83±4 years) for falls/fall injuries; and community-based multi-ethnic middle-age and early-old-age women in the Study of Women’s Health Across the Nation (SWAN, n=2010, Visits 13/14 and 15, 62±4 years). Multivariable logistic regression and negative binomial regression modeled risk factors associated with FRID use (yes/no) and count, respectively, for Health ABC. Multivariable generalized estimating equations modeled FRID use/count for fall/fall injury risk in Health ABC and SWAN.
RESULTS: Risk factors of FRID use were similar across definitions, including lifestyle/behavioral factors and conditions of multimorbidity. After removing antihypertensives from the STEADI-Rx definition, other FRID use and higher FRID count were associated with higher fall and fall injury risk vs. no falls in adults >=79 years. Among midlife and early-old-age women, physical activity or depressive symptoms, body pain, and vitality attenuated the association of FRID use and count, respectively, with fall injury risk to non-significance.
CONCLUSIONS: Results suggest activity or depressive symptoms, body pain, and vitality explains the associations of FRID use with fall/fall injury risk in midlife and early-old-age women, but not among adults >=79 years. Future interventions should evaluate fall/fall injury prevention through deprescribing FRIDs in older adults
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