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Report On The U.S. Summit: "Chronic Care At The Crossroads: Exploring Solutions For Chronic Care Management", Janice L. Clarke

College of Population Health Faculty Papers

On Tuesday, July 17, 2007 in Washington, DC, Intel Corporation assembled a group of the nation’s most respected health leaders to discuss the issues surrounding chronic care and an aging population and explore solutions to these highly complex and increasingly urgent challenges for the US health care system. The highlevel summit, hosted by Intel Chairman Craig Barrett, was held in the auditorium of the National Museum for Women in the Arts and attended, either in person or via the simultaneous webcast, by presidents, chairmen, and executive directors of influential organizations including the National Business Coalition on Health, the National Medical …

Petroleum Act Chapter 62:01, Parliament Of The Republic Of Trinidad And Tobago

Latin American Energy Policies

This is the most recent version of the Petroleum Act, which has been amended several times over. The provisions of this act cover private/public petroleum rights and licensing.

The Limnology Of The Lake Tanganyika Sub Catchment, H. H. Nkotagu, C. B. Athuman

Tanzania Journal of Science

A limnological study covering the Lake Tanganyika sub catchment was conducted during the dry season at 20 accessible sites on 8 rivers, 2 lakes and a dam. Standard methods were used to determine the levels of abiotic parameters from water samples. Physical parameters including EC, Eh, turbidity, temperature, pH and secchi transparency were measured in situ while chlorophyll a was determined in the laboratory. Nutrients such as NO3-, SiO2, PO4 3- and Fe2+ were determined along with HCO3-. Significant changes in the levels of the abiotic parameters and nutrients have been observed at various sampling sites throughout the study area. …

Continuity Of Care : Literature Review And Implications, Mohammed Alazri, Philip Heywood, Richard D. Leese, Brenda

Sultan Qaboos University Medical Journal

Continuity of care is widely regarded as a core value of primary care. The objective of this article is to explore the literature about the concept of continuity of care focusing on factors that influence continuity; advantages and disadvantages of continuity and the effect of continuity on outcomes, hence on the quality of care. Electronic databases and other websites were searched for relevant literature. The results of this review showed that continuity of care is influenced by demographic factors, factors related to patients and healthcare professionals, patient-healthcare professional relationship, inter-professional factors, role of receptionists and organisational factors. Several advantages were …

Effect Of Zinc Supplementation On Morbidity Due To Acute Diarrhoea In Infants And Children In Sanaa, Yemen : A Randomized Controlled Double Blind Clinical Trial, Muna Am Elnemr, Ahmed K. Abdullah

Sultan Qaboos University Medical Journal

Objectives: To study the impact of zinc administration on the morbidity and mortality attributed to diarrhoea among children less than 5 years old. Methods: The study design was a randomized double blinded controlled clinical trial, held at Elsabeen Hospital for Maternity and Childhood, Sana’a, Yemen. The study was conducted during the period September 2005 to October 2006 on 180 children less than 5 years old with acute diarrhoeal episodes. They were randomly allocated to two groups; one of them received a placebo and the other received zinc acetate syrup for 14 days. Both groups were followed up for 2 months. …

From Hiv Abandonment To Adoption Case Study Of New Life Home For Abandoned Babies, Kenya, Abdul Majid Wangai Jr, Maryam Wangai, Mary Beckenham, Clive

Sultan Qaboos University Medical Journal

Objective: The number of orphaned and vulnerable children (OVC) worldwide has increased as a result of the Human Immunodeficiency Virus (HIV) pandemic. New Life Home (NLH) specialises in the care of infants who have been orphaned or abandoned, often because of their exposure to HIV and places them for adoption. This paper documents the lessons learnt from the Home’s first 8.5 years of existence. Methods: This retrospective study analyses the pattern of the 490 infants admitted at NLH. The characteristics of the infants’ stay are analysed: bio-data, weight, HIV exposure, referring organisation/agent and outcome. This study ceased to follow infants …

Belching As A Presenting Symptom Of Angina Pectoris, Kawther El-Shafie

Sultan Qaboos University Medical Journal

Symptoms of angina pectoris can present with the typical specific symptoms, which are easy to recognize, or vague symptoms like chills, nausea, dizziness, belching and mild chest pain. Both the typical and atypical forms of angina symptoms may rarely be associated with or masked by predominantly extra cardiac manifestations, which are occasionally referred to the abdomen. We report here an unusual presentation of angina. A 62 years old male who had been healthy all his life, presented at Sultan Qaboos University, Oman, with a two month history of belching episodes as the chief and the only complaint. He was found …

Health Consequences Of Iodine Deficiency, Umesh Kapil

Sultan Qaboos University Medical Journal

Iodine Deficiency Disorders (IDD) are one of the biggest worldwide public health problem of today. Their effect is hidden and profoundly affects the quality of human life. Iodine deficiency occurs when the soil is poor in iodine, causing a low concentration in food products and insufficient iodine intake in the population. When iodine requirements are not met, the thyroid may no longer be able to synthesize sufficient amounts of thyroid hormone. The resulting low-level of thyroid hormones in the blood is the principal factor responsible for the series of functional and developmental abnormalities, collectively referred to as IDD. Iodine deficiency …

Harrison’S Neurology In Clinical Medicine, Abdullah Al-Asmi

Sultan Qaboos University Medical Journal

No abstract provided.

Hiv/Aids Vaccines : How Long Must Humanity Wait?, Ali A. Al-Jabri

Sultan Qaboos University Medical Journal

No abstract provided.

Cerebrospinal Fluid Involvement In A Case Of Visceral Leishmaniasis Associated With Hemophagocytic Lymphohistiocytosis, Mahmoud Fathalla, Javad Hashim, Hussein Wali, Yasser

Sultan Qaboos University Medical Journal

Hemophagocytic Lymphohistiocytosis (HLH) implies a benign generalized histiocytic proliferate with erythrophagocytosis and it includes familial hemophagocytic lymphohistiocytosis and secondary hemophgocytosis. Spinal fluid changes like mild to moderate pleocytosis (most of the cells are lymphocytes and macrophages) and sometimes hemophagocytosis are seen in primary HLH but are not reported in secondary HLH. Here we report a case of a previously healthy 10 months old male infant who was diagnosed as familial HLH with evidence of CSF hemophagocytosis. He was started on the HLH 2004 treatment protocol with no improvement. A second bone marrow aspiration revealed leshmania donovani antibodies and he was …

Nevada Interagency Volunteer Program: Helping Hands Across Public Lands – Phase Ii: Quarterly Progress Report, Period Covering October 1 – December 31, 2007, Margaret N. Rees

Get Outdoors Nevada

• The number of records in the volunteer database increased 12% over last quarter. The database now contains 4,937 records.
• Website activity decreased, recording an average of 82,859 hits per month, a decrease of 31% from last quarter, with an average of 8,191 pages viewed per month.
• Volunteer fall training has been completed.
• Three National Public Land Day Events have been completed.
• Two hundred and ten people attended the Volunteer Recognition Event.

Interagency Science And Research: Quarterly Progress Report, Period Ending December 31, 2007, Margaret N. Rees

Interagency Science and Research Strategy

• Meetings were held with the SNAP Recreation Team and the SNAP Cultural Resources Team to request assistance in the development of the science strategy. Draft versions of interagency goals, subgoals, science questions, and associated tasks were given to each team for review and input.
• Plans were prepared for the peer review of science proposals submitted for consideration as Conservations Initiatives in SNPLMA Round 9.
• Proceedings of the natural resources management workshop held on September 13 were completed and sent to the Science & Research Team for review by members.
• An important focus of the Science and Research Team was the …

Limnological Assistance For The Lake Mead National Recreation Area In Meeting The Challenge Of The Water 2025 Initiative: Quarterly Progress Report, Period Ending: December 31, 2007, Margaret N. Rees

Limnological Studies

• The limnologist position has been announced.
• Project 1: Review of the draft Boulder Basin Adaptive Management Plan is underway.
• Project 2: Development of a white paper expressing the joint needs of the entities involved in Water 2025 projects is being coordinated.
• Project 3: A bibliographic reference spreadsheet organizing literature citations related to quagga and zebra mussel research has been completed.
• Project 4: A comprehensive literature search of Lake Mead limnology is well underway; an Access database has been designed to organize reference citations; and a special collections library at UNLV is being established to house original rare documents and other …

Southern Nevada Agency Partnership Cultural Site Stewardship Program – Program Expansion And Steward Retention: Quarterly Progress Report, Period Ending December 31, 2007, Margaret N. Rees

Cultural Site Stewardship Program

• An ATV safety class was conducted to certify Clark County site stewards.

• Stewards reported ten major cultural site impacts and nine lesser impacts.

• Technical design for the new CSSP database is 80% complete.

Exercise Training May Enhance Functional Capacity And Improve Heart Rate Impairment In Coronary Artery Disease Patients With Chronotropic Incompetence, Chen-Jung Hsu, Ssu-Yuan Chen, Ching Lan, Der-Sheng Han, Jin-Shin Lai

Rehabilitation Practice and Science

This study investigated whether coronary artery disease patients with chronotropic incompetence (CI) can significantly improve their functional capacity after exercise training. Forty-two men (mean age: 55.3±9.3yr) underwent coronary revascularization and without beta-blockade participated in a threemonth outpatient exercise training program. Patients were separated into a CI group (n=18) and a non-CI group (n=24) based on whether they could reach 85% of the age-predicted peak heart rate (HR). Chronotropic incompetence was defined as failure to achieve 85% of the age-predicted maximal HR. Bicycle exercise workouts were conducted three times weekly. The exercise duration was 30 minutes per session included 5 minutes …

A Psuedo-Mass Of Shoulder Girdle Due To Spinal Accessory Nerve Injury After Neck Lymph Node Biopsy: A Casereport, Yen-Nung Lin, Jing-Hwa Wey, Mei-Chun Huang, Kwang-Hwa Chang, Chun-Chieh Chiu

Rehabilitation Practice and Science

Shoulder problems such as pain, weakness, limited range of motion and palpable mass are common complaints in PM&R clinic. This casereport describes a less common but not rare condition: iatrogenic accessory nerve injury after neck lymph node biopsy. The patient in this study presented symptoms of shoulder girdle pain and weakness and also complained of a ”hard palpated mass” over her shoulder girdle.A 49-year-old female complained of gradually worsening left shoulder pain accompanied by weakness and limited range of motion in her left shoulder for many months. She had sought medical advice for many times and rotator cuff pathology was …

Argininosuccinic Acidemia: A Casereport, Chih-Wei Lin, Huey-Jen Lay, I-Ju Chen

Rehabilitation Practice and Science

Urea cycle disorder (UCD) is one of inborn error diseases. Citrullinemia is the most common disease (1/57000) among them, followed by argininosuccinic acidemia (ASA) (1/70000). The common characteristic of UCD is hyperammonemia induced by the abnormal liver function. Common symptoms at the onset of diseases include altered consciousness, respiratory insufficiency and seizures. Developmental delay, mental retardation, cerebral palsy, and learning disability are common findings in long-term follow-ups. In this report, we give an account of a patient with ASA. Besides the aforementioned symptoms and long-term sequelae, this patient also has the problem of ataxia. However, the patient's conditions and developments …

A Novel Runx2 Missense Mutation Predicted To Disrupt Dna Binding Causes Cleidocranial Dysplasia In A Large Chinese Family With Hyperplastic Nails, Shaohua Tang, Qiyu Xu, Xueqin Xu, Jicheng Du, Xuemei Yang, Yusheng Jiang, Xiaoqin Wang, Nancy Speck, Taosheng Huang

Dartmouth Scholarship

Background: Cleidocranial dysplasia (CCD) is a dominantly inherited disease characterized by hypoplastic or absent clavicles, large fontanels, dental dysplasia, and delayed skeletal development. The purpose of this study is to investigate the genetic basis of Chinese family with CCD.

Methods: Here, a large Chinese family with CCD and hyperplastic nails was recruited. The clinical features displayed a significant intrafamilial variation. We sequenced the coding region of the RUNX2 gene for the mutation and phenotype analysis.

Results: The family carries a c.T407C (p.L136P) mutation in the DNA- and CBFβ-binding Runt domain of RUNX2. Based on the crystal structure, we predict this …

Mice Deficient In Involucrin, Envoplakin, And Periplakin Have A Defective Epidermal Barrier., Lisa M Sevilla, Rachida Nachat, Karen R Groot, John F Klement, Jouni Uitto, Philippe Djian, Arto Määttä, Fiona M Watt

Department of Dermatology and Cutaneous Biology Faculty Papers

The cornified envelope is assembled from transglutaminase cross-linked proteins and lipids in the outermost epidermal layers and is essential for skin barrier function. Involucrin, envoplakin, and periplakin form the protein scaffold on which the envelope assembles. To examine their combined function, we generated mice deficient in all three genes. The triple knockouts have delayed embryonic barrier formation and postnatal hyperkeratosis (abnormal accumulation of cornified cells) resulting from impaired desquamation. Cornified envelopes form but are ultrastructurally abnormal, with reduced lipid content and decreased mechanical integrity. Expression of proteases is reduced and the protease inhibitor, serpina1b, is highly upregulated, resulting in defective …

Chemical Constituents And Biological Activity Of Three Tanzanian Wild Mushroom Species, L.D. Baraza, C. C. Joseph, M. J. Moshi, M. H. H. Nkunya

Tanzania Journal of Science

The three Tanzanian wild mushroom species Termitomyces letestui, Lactarius edulis and Agaricus sp. aff. arvensis yielded ergosterol, 5,8-peroxyergosterol and ergosta-5,22-dien-3β-ol, and a mixture of ergosterol, ergosta-7,22-dien-3β-ol and ergosta-7-en-3β-ol whose composition was deduced from gas chromatography/mass spectroscopic (GC/MS) analysis of the trimethysilylated mixture. GC/MS analysis of the lipid fraction from T. letestu revealed the presence of linoleic (C18:2), stearic (C18:0), oleic (C18:1), palmitic (C16:0), pentadecanoic (C15:0) and myristic (C14:0) acid. Polar T. letestui and L. edulis fractions yielded α,α,1'trehalose andmannitol. Some of the crude extracts from the three mushroom species showed mild antimicrobial, mosquito larvicidal and cytotoxic activities. The chemical composition …

The Learning Organisation And Health Care Education, Rashid K. Al-Abri, Intisar S. Al-Hashmi

Sultan Qaboos University Medical Journal

The ‘Learning Organisation’ is a concept first described by Peter Senge as an organisation where people continuously learn and enhance their capabilities to create. It consists of five main disciplines: team learning, shared vision, mental models, personal mastery and systems thinking. These disciplines are dynamic and interact with each other. System thinking is the cornerstone of a true learning organisation and is described as the discipline used to implement the disciplines. In a learning organisation, health care education aims to educate its members with up to date knowledge to produce competent and safe personnel, who can promote quality in health …

Jawetz, Melnick & Adelberg’S Medical Microbiology 24th Edition, Muhannad F. Al-Kobaisi

Sultan Qaboos University Medical Journal

No abstract provided.

Hyperbaric Oxygen Treatment For Osteomyelitis, Osteoradionecrosis And Recurrent Ear Infections, Susie Debus

Sultan Qaboos University Medical Journal

No abstract provided.

Self-Assessment Examination For Residents In Physical Medicine And Rehabilitation: First Experience In Taiwan, I-Nan Lien, Tyng-Guey Wang, Shin-Liang Pan, Rai-Chi Chan

Rehabilitation Practice and Science

Objective: The national Self-Assessment Examination (SAE) for residents has been held in the United States for many years. However, no similar test has been held by any medical specialty association in Taiwan. The first national SAE in Physical Medicine and Rehabilitation (PM & R) aimed to provide a benchmark for residents and medical institutes.Material and Methods: The written questions of the Certification Examination 2005 of the Taiwan Board of PM & R were used in the SAE for residents. Participants were first to third year residents in PM & R from various medical institutes and candidates for the board examination …

Medical Service Needs Of Special Education Students In Chiayi County, Taiwan, Shu-Yi Wang, Yuh-Chin Jean

Rehabilitation Practice and Science

The Buddist Tzu Chi Dalin Hospital was responsible for providing medical services to special education students of Chiayi County in 2004. We evaluated the cognitive skills, activities of daily living, language skills, and gross and fine motor functions of 160 disabled students, 113 male and 47 female. Students with mental retardation were the most frequent, followed by students with dyslalia, then autism, and attention deficit and hyperactivity disorder. A needs assessment revealed that 155, 132, and 107 students fed, dressed, and bathed themselves independently, respectively. Ninety-three students had a language disorder, 75 students had fine motor impairment, and 52 students …

Computer Alert System That Promotes Patient Safety By Identifying Possible Contraindications Of Prescribed Physical Agents, Hong-Nan Shih, Jing-Hwa Wey, Chun-Chieh Chiu, Po-Wei Lin, Tsan-Hon Liou, Chi-Hsien Chen

Rehabilitation Practice and Science

This study investigated and analyzed the prevalence of contraindications that can co-exist with a prescribed physical agent. To prevent likely complications, this study implemented a computer warning system, which prompts physiatrists to possible contraindications. Once a physical agent is prescribed, the system automatically reviewarticles the ICD-9 codes in the patients’ medical chart. Two pre-established databases are used in the warning system: one contains contraindications for each physical agent and the other has possible contraindications for each selected ICD-9 code. By cross-referencing between ICD-9 codes in a patient's chart and the two databases, the warning system was able to identify possible …

Bladder Management And Urologic Outcome In Patients With Chronic Spinal Cord Lesions, Je-Kuei Yang, Su-Ju Tsai, I-Chun Chen, Liu-Ing Bih

Rehabilitation Practice and Science

Between February and September 2004, 73 patients with spinal cord lesions of greater than 2 years duration were enrolled in this study. A chart reviewarticle was conducted to record the manner in which the patients' bladder management, previous urologic complications, and any corresponding treatments and effects. Among the patients, 55 were male and 18 were female, with an average age of 29.3±12.1 and 32.0±13.0 years, respectively. The mean duration of the patients' injuries was 9.5±6.9 years in men, and 7.0±4.5 years in women, respectively.Group Ⅰ included 8 patients (11.0%) who had indwelling catheters since the time of their injury and …

Intensive Cardiopulmonary Rehabilitation Program For Patients With Severe Heart Failure And Acute Stroke: A Report Of Two Cases, Chyi-Yann Wang, Jue-Long Wang, Ai-Lun Yang, Ko-Long Lin

Rehabilitation Practice and Science

Cardiovascular disease is a major factor restricting successful outcomes after stroke rehabilitation. While neurological recovery after stroke has been extensively investigated, cardiovascular adaptations to physical activities poststroke have received little attention. Severe heart failure patients have been well known for limitation of ambulation, but the influence over acute poststroke patients have rarely been investigated. Exercise testing has become a mainstay for the prognostic assessment of patients with heart failure. Various studies have shown that patients with impaired exercise capacity, as measured by low peak oxygen consumption (Vo2), have an unfavorable outcome, independent of other parameters. Whether parameters from submaximal test …

Low Back Pain Due To Infective Discitis: A Casereport, Hung Chi Lin, Chin-Liang Liu, The-Chen Wang, Mu-Jung Kao

Rehabilitation Practice and Science

Infective discitis accompanying low back pain is uncommon. In general, risk factors for infective discitis include an age greater than 50 years, a history of cancer, unexplained weight loss, pain that lasts more than 1 month, a history of intravenous drug abuse, presence of a urinary tract infection or other infections, diabetes mellitus, and recent invasive procedures. The presence of an elevated erythrocyte sedimentation rate (ESR) and a C-reactive protein (CRP) level have proven to be reliable laboratory criteria consistent with infective discitis. Moreover, magnetic resonance (MR) imaging findings have been shown to have a good sensitivity for infective discitis. …