Sample records for center comparison study

  1. Comparison of Node-Centered and Cell-Centered Unstructured Finite-Volume Discretizations: Viscous Fluxes

    NASA Technical Reports Server (NTRS)

    Diskin, Boris; Thomas, James L.; Nielsen, Eric J.; Nishikawa, Hiroaki; White, Jeffery A.

    2010-01-01

    Discretization of the viscous terms in current finite-volume unstructured-grid schemes are compared using node-centered and cell-centered approaches in two dimensions. Accuracy and complexity are studied for four nominally second-order accurate schemes: a node-centered scheme and three cell-centered schemes - a node-averaging scheme and two schemes with nearest-neighbor and adaptive compact stencils for least-square face gradient reconstruction. The grids considered range from structured (regular) grids to irregular grids composed of arbitrary mixtures of triangles and quadrilaterals, including random perturbations of the grid points to bring out the worst possible behavior of the solution. Two classes of tests are considered. The first class of tests involves smooth manufactured solutions on both isotropic and highly anisotropic grids with discontinuous metrics, typical of those encountered in grid adaptation. The second class concerns solutions and grids varying strongly anisotropically over a curved body, typical of those encountered in high-Reynolds number turbulent flow simulations. Tests from the first class indicate the face least-square methods, the node-averaging method without clipping, and the node-centered method demonstrate second-order convergence of discretization errors with very similar accuracies per degree of freedom. The tests of the second class are more discriminating. The node-centered scheme is always second order with an accuracy and complexity in linearization comparable to the best of the cell-centered schemes. In comparison, the cell-centered node-averaging schemes may degenerate on mixed grids, have a higher complexity in linearization, and can fail to converge to the exact solution when clipping of the node-averaged values is used. The cell-centered schemes using least-square face gradient reconstruction have more compact stencils with a complexity similar to that of the node-centered scheme. For simulations on highly anisotropic

  2. Comparison of Node-Centered and Cell-Centered Unstructured Finite-Volume Discretizations. Part 1; Viscous Fluxes

    NASA Technical Reports Server (NTRS)

    Diskin, Boris; Thomas, James L.; Nielsen, Eric J.; Nishikawa, Hiroaki; White, Jeffery A.

    2009-01-01

    Discretization of the viscous terms in current finite-volume unstructured-grid schemes are compared using node-centered and cell-centered approaches in two dimensions. Accuracy and efficiency are studied for six nominally second-order accurate schemes: a node-centered scheme, cell-centered node-averaging schemes with and without clipping, and cell-centered schemes with unweighted, weighted, and approximately mapped least-square face gradient reconstruction. The grids considered range from structured (regular) grids to irregular grids composed of arbitrary mixtures of triangles and quadrilaterals, including random perturbations of the grid points to bring out the worst possible behavior of the solution. Two classes of tests are considered. The first class of tests involves smooth manufactured solutions on both isotropic and highly anisotropic grids with discontinuous metrics, typical of those encountered in grid adaptation. The second class concerns solutions and grids varying strongly anisotropically over a curved body, typical of those encountered in high-Reynolds number turbulent flow simulations. Results from the first class indicate the face least-square methods, the node-averaging method without clipping, and the node-centered method demonstrate second-order convergence of discretization errors with very similar accuracies per degree of freedom. The second class of tests are more discriminating. The node-centered scheme is always second order with an accuracy and complexity in linearization comparable to the best of the cell-centered schemes. In comparison, the cell-centered node-averaging schemes are less accurate, have a higher complexity in linearization, and can fail to converge to the exact solution when clipping of the node-averaged values is used. The cell-centered schemes using least-square face gradient reconstruction have more compact stencils with a complexity similar to the complexity of the node-centered scheme. For simulations on highly

  3. Reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) among suicide attempters and comparison residents in rural China.

    PubMed

    Yang, Li; Jia, Cun-Xian; Qin, Ping

    2015-04-09

    Depression is an important public health problem and is closely associated with suicidal behavior in the population. Although the Center for Epidemiologic Studies Depression Scale (CES-D) is widely used for assessment of depression, the psychometric characteristics of this scale have not been explored in studies of suicide attempters and local residents in rural areas. In this study, reliability and validity of CES-D were assessed in 409 suicide attempters and 409 comparison residents from rural China and through internal consistency analysis and confirmatory factor analysis (CFA). Cronbach's alpha values of the CES-D were 0.940 and 0.895 in, respectively, suicide attempters and comparison residents. CES-D scores were significantly correlated with the scores of Trait Anxiety Inventory (TAI) and Beck Hopelessness Scale (BHS) in both the suicide attempters and the comparison residents. Confirmatory factor analyses indicated that 3-factor structure (positive affect, interpersonal problems, depressive mood and somatic symptoms combined) with 14 items (excluding items 9, 10, 13, 15, 17, and 19) had the best fit in these two populations. The CES-D scale has satisfactory reliability and validity when used for assessing depression in suicide attempters and comparison residents in rural China.

  4. Comparison of CyTOF assays across sites: Results of a six-center pilot study.

    PubMed

    Leipold, Michael D; Obermoser, Gerlinde; Fenwick, Craig; Kleinstuber, Katja; Rashidi, Narges; McNevin, John P; Nau, Allison N; Wagar, Lisa E; Rozot, Virginie; Davis, Mark M; DeRosa, Stephen; Pantaleo, Giuseppe; Scriba, Thomas J; Walker, Bruce D; Olsen, Lars R; Maecker, Holden T

    2018-02-01

    For more than five years, high-dimensional mass cytometry has been employed to study immunology. However, these studies have typically been performed in one laboratory on one or few instruments. We present the results of a six-center study using healthy control human peripheral blood mononuclear cells (PBMCs) and commercially available reagents to test the intra-site and inter-site variation of mass cytometers and operators. We used prestained controls generated by the primary center as a reference to compare against samples stained at each individual center. Data were analyzed at the primary center, including investigating the effects of two normalization methods. All six sites performed similarly, with CVs for both Frequency of Parent and median signal intensity (MSI) values<30%. Increased background was seen when using the premixed antibody cocktail aliquots at each site, suggesting that cocktails are best made fresh. Both normalization methods tested performed adequately for normalizing MSI values between centers. Clustering algorithms revealed slight differences between the prestained and the sites-stained samples, due mostly to the increased background of a few antibodies. Therefore, we believe that multicenter mass cytometry assays are feasible. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  5. Cesarean Outcomes in US Birth Centers and Collaborating Hospitals: A Cohort Comparison.

    PubMed

    Thornton, Patrick; McFarlin, Barbara L; Park, Chang; Rankin, Kristin; Schorn, Mavis; Finnegan, Lorna; Stapleton, Susan

    2017-01-01

    High rates of cesarean birth are a significant health care quality issue, and birth centers have shown potential to reduce rates of cesarean birth. Measuring this potential is complicated by lack of randomized trials and limited observational comparisons. Cesarean rates vary by provider type, setting, and clinical and nonclinical characteristics of women, but our understanding of these dynamics is incomplete. We sought to isolate labor setting from other risk factors in order to assess the effect of birth centers on the odds of cesarean birth. We generated low-risk cohorts admitted in labor to hospitals (n = 2527) and birth centers (n = 8776) using secondary data obtained from the American Association of Birth Centers (AABC). All women received prenatal care in the birth center and midwifery care in labor, but some chose hospital admission for labor. Analysis was intent to treat according to site of admission in spontaneous labor. We used propensity score adjustment and multivariable logistic regression to control for cohort differences and measured effect sizes associated with setting. There was a 37% (adjusted odds ratio [OR], 0.63; 95% confidence interval [CI], 0.50-0.79) to 38% (adjusted OR, 0.62; 95% CI, 0.49-0.79) decreased odds of cesarean in the birth center cohort and a remarkably low overall cesarean rate of less than 5% in both cohorts. These findings suggest that low rates of cesarean in birth centers are not attributable to labor setting alone. The entire birth center care model, including prenatal preparation and relationship-based midwifery care, should be studied, promoted, and implemented by policy makers interested in achieving appropriate cesarean rates in the United States. © 2016 by the American College of Nurse-Midwives.

  6. Family-Centered Care in Juvenile Justice Institutions: A Mixed Methods Study Protocol.

    PubMed

    Simons, Inge; Mulder, Eva; Rigter, Henk; Breuk, René; van der Vaart, Wander; Vermeiren, Robert

    2016-09-12

    Treatment and rehabilitation interventions in juvenile justice institutions aim to prevent criminal reoffending by adolescents and to enhance their prospects of successful social reintegration. There is evidence that these goals are best achieved when the institution adopts a family-centered approach, involving the parents of the adolescents. The Academic Workplace Forensic Care for Youth has developed two programs for family-centered care for youth detained in groups for short-term and long-term stay, respectively. The overall aim of our study is to evaluate the family-centered care program in the first two years after the first steps of its implementation in short-term stay groups of two juvenile justice institutions in the Netherlands. The current paper discusses our study design. Based on a quantitative pilot study, we opted for a study with an explanatory sequential mixed methods design. This pilot is considered the first stage of our study. The second stage of our study includes concurrent quantitative and qualitative approaches. The quantitative part of our study is a pre-post quasi-experimental comparison of family-centered care with usual care in short-term stay groups. The qualitative part of our study involves in-depth interviews with adolescents, parents, and group workers to elaborate on the preceding quantitative pilot study and to help interpret the outcomes of the quasi-experimental quantitative part of the study. We believe that our study will result in the following findings. In the quantitative comparison of usual care with family-centered care, we assume that in the latter group, parents will be more involved with their child and with the institution, and that parents and adolescents will be more motivated to take part in therapy. In addition, we expect family-centered care to improve family interactions, to decrease parenting stress, and to reduce problem behavior among the adolescents. Finally, we assume that adolescents, parents, and the

  7. Literature review of outcome parameters used in studies of Geriatric Fracture Centers.

    PubMed

    Liem, I S L; Kammerlander, C; Suhm, N; Kates, S L; Blauth, M

    2014-02-01

    A variety of multidisciplinary treatment models have been described to improve outcome after osteoporotic hip fractures. There is a tendency toward better outcomes after implementation of the most sophisticated model with a shared leadership for orthopedic surgeons and geriatricians; the Geriatric Fracture Center. The purpose of this review is to evaluate the use of outcome parameters in published literature on the Geriatric Fracture Center evaluation studies. A literature search was performed using Medline and the Cochrane Library to identify Geriatric Fracture Center evaluation studies. The outcome parameters used in the included studies were evaluated. A total of 16 outcome parameters were used in 11 studies to evaluate patient outcome in 8 different Geriatric Fracture Centers. Two of these outcome parameters are patient-reported outcome measures and 14 outcome parameters were objective measures. In-hospital mortality, length of stay, time to surgery, place of residence and complication rate are the most frequently used outcome parameters. The patient-reported outcomes included activities of daily living and mobility scores. There is a need for generally agreed upon outcome measures to facilitate comparison of different care models.

  8. A Brief Study on Autonomous Learning Mode in Self-study Center Based on Web

    NASA Astrophysics Data System (ADS)

    Tian, Xian Zhi

    In the paper, the author has studied the autonomous learning ability and its reform of linguistic-major students. All of the studies are based on web in self-study center. As for the author, she has used the method of comparison and at the same time, she also used showing examples. In order to show the views clearly, the author has made investigation in English major and law major students. Thus she thinks that teaching reform is necessary for development of students and some effective ways can be used in improving teaching efficiency.

  9. Seeking Humanizing Care in Patient-Centered Care Process: A Grounded Theory Study.

    PubMed

    Cheraghi, Mohammad Ali; Esmaeili, Maryam; Salsali, Mahvash

    Patient-centered care is both a goal in itself and a tool for enhancing health outcomes. The application of patient-centered care in health care services globally however is diverse. This article reports on a study that sought to introduce patient-centered care. The aim of this study is to explore the process of providing patient-centered care in critical care units. The study used a grounded theory method. Data were collected on 5 critical care units in Tehran University of Medical Sciences. Purposive and theoretical sampling directed the collection of data using 29 semistructured interviews with 27 participants (nurses, patients, and physician). Data obtained were analyzed according to the analysis stages of grounded theory and constant comparison to identify the concepts, context, and process of the study. The core category of this grounded theory is "humanizing care," which consisted of 4 interrelated phases, including patient acceptance, purposeful patient assessment and identification, understanding patients, and patient empowerment. A core category of humanizing care integrated the theory. Humanizing care was an outcome and process. Patient-centered care is a dynamic and multifaceted process provided according to the nurses' understanding of the concept. Patient-centered care does not involve repeating routine tasks; rather, it requires an all-embracing understanding of the patients and showing respect for their values, needs, and preferences.

  10. Evaluation and Comparison of Changes in Microhardness of Primary and Permanent Enamel on Exposure to Acidic Center-filled Chewing Gum: An in vitro Study

    PubMed Central

    Muppa, Radhika; Srinivas, NCH; Kumar, Duddu Mahesh

    2014-01-01

    ABSTRACT Objectives: The study is to evaluate changes in microhardness of enamel after exposure to acidic center filled chewing gum on primary and permanent teeth. Methods: Thirty primary and 30 permanent molar extracted teeth were painted with acid resistant varnish except a small window over buccal surface. Teeth were divided into four groups according to type of teeth and type of chewing gum (Center fresh and Bubbaloo) (D1, P1, D2 and P2); each tooth was exposed to whole chewing gum mashed with 5 ml of artificial saliva for five minutes at room temperature twice a day for 5 days. After the exposure, teeth were stored in deionized water and submitted for microhardness tests. Results: Paired t-test and independent sample t-test were used for statistical analysis. A significant reduction in microhardness was found between exposed and unexposed areas in all groups. There was no statistically significant difference in reduction of microhardness to chewing gums, and between primary and permanent enamel. Conclusion: There is a definite reduction in microhardness in all groups exposed to chewing gums. Both the chewing gums are equally erosive; both permanent and primary teeth were affected. How to cite this article: Mudumba VL, Muppa R, Srinivas NCH, Kumar DM. Evaluation and Comparison of Changes in Microhardness of Primary and Permanent Enamel on Exposure to Acidic Center-filled Chewing Gum: An in vitro Study. Int J Clin Pediatr Dent 2014;7(1):24-29. PMID:25206233

  11. Serramonte Transit Center Study

    DOT National Transportation Integrated Search

    1983-06-01

    The purposes of the study are to determine, from this particular case -- the : Serramonte Center Plan -- guidelines for achieving the successful design and : operation of a bus station and bus access arrangement on a shopping center site, : including...

  12. Cost-Effectiveness of High Dose Hemodialysis in Comparison to Conventional In-Center Hemodialysis in the Netherlands.

    PubMed

    Beby, Anna Trisia; Cornelis, Tom; Zinck, Raymund; Liu, Frank Xiaoqing

    2016-11-01

    In the Netherlands, the current standard of care for treating patients with end-stage renal disease is three sessions of in-center hemodialysis (conventional ICHD). However, the literature indicates that high dose hemodialysis (high dose HD) may provide better health outcome such as survival and quality of life. The objective of this study was to determine the cost-effectiveness of high dose HD, both in-center and at home, in comparison to conventional ICHD from a Dutch payer's perspective over a 5 year period. Additionally, the cost-effectiveness of conventional HD at home in comparison to conventional ICHD will be analysed. A Markov model was developed assuming 28-day treatment cycles and was populated with data from Dutch and international renal registries, official tariffs and medical literature. Univariable and probabilistic sensitivity analyses were performed to test the robustness of the results. Using publicly available tariffs from the Dutch Healthcare Authority (Nederlandse Zorgautoriteit) of 2015, doing high dose ICHD instead of conventional ICHD shows an incremental cost-effectiveness ratio (ICER) of €275,747 per quality-adjusted life year (QALY) gained. In contrast, the ICER of high dose HD at home in comparison to conventional ICHD is €3248 per gained QALY. The final analysis shows that conventional HD at home is less costly per patient (-€3063) than conventional ICHD and results in health benefit improvement (+0.249 QALYs), and is therefore regarded as cost saving. Treating dialysis patients with conventional HD at home shows to be cost saving in comparison to conventional ICHD. However, the magnitude of clinical benefit of high dose HD at home is over two times greater than the clinical benefit of conventional HD at home. According to our analysis, from a payer's perspective, high dose HD should be offered as a home therapy to obtain its clinical benefits in a cost-effective manner. Future research should consider our findings alongside

  13. Los Angeles International Airport Runway Incursion Studies: Phase III--Center-Taxiway Simulation

    NASA Technical Reports Server (NTRS)

    Madson, Michael D.

    2004-01-01

    Phase III of the Los Angeles International Airport Runway Incursion Studies was conducted, under an agreement with HNTB Corporation, at the NASA Ames FutureFlight Central (FFC) facility in June 2003. The objective of the study was the evaluation of a new center-taxiway concept at LAX. This study is an extension of the Phase I and Phase II studies previously conducted at FFC. This report presents results from Phase III of the study, in which a center-taxiway concept between runways 25L and 25R was simulated and evaluated. Phase III data were compared objectively against the Baseline data. Subjective evaluations by participating LAX controllers were obtained with regard to workload, efficiency, and safety criteria. To facilitate a valid comparison between Baseline and Phase III data, the same scenarios were used for Phase III that were tested during Phases I and II. This required briefing participating controllers on differences in airport and airline operations between 2001 and today.

  14. Study of Lyndon B. Johnson Space Center utility systems

    NASA Technical Reports Server (NTRS)

    Redding, T. E.; Huber, W. C.

    1977-01-01

    The results of an engineering study of potential energy saving utility system modifications for the NASA Lyndon B. Johnson Space Center are presented. The objective of the study was to define and analyze utility options that would provide facility energy savings in addition to the approximately 25 percent already achieved through an energy loads reduction program. A systems engineering approach was used to determine total system energy and cost savings resulting from each of the ten major options investigated. The results reported include detailed cost analyses and cost comparisons of various options. Cost are projected to the year 2000. Also included are a brief description of a mathematical model used for the analysis and the rationale used for a site survey to select buildings suitable for analysis.

  15. Comparison of Node-Centered and Cell-Centered Unstructured Finite-Volume Discretizations: Inviscid Fluxes

    NASA Technical Reports Server (NTRS)

    Diskin, Boris; Thomas, James L.

    2010-01-01

    Cell-centered and node-centered approaches have been compared for unstructured finite-volume discretization of inviscid fluxes. The grids range from regular grids to irregular grids, including mixed-element grids and grids with random perturbations of nodes. Accuracy, complexity, and convergence rates of defect-correction iterations are studied for eight nominally second-order accurate schemes: two node-centered schemes with weighted and unweighted least-squares (LSQ) methods for gradient reconstruction and six cell-centered schemes two node-averaging with and without clipping and four schemes that employ different stencils for LSQ gradient reconstruction. The cell-centered nearest-neighbor (CC-NN) scheme has the lowest complexity; a version of the scheme that involves smart augmentation of the LSQ stencil (CC-SA) has only marginal complexity increase. All other schemes have larger complexity; complexity of node-centered (NC) schemes are somewhat lower than complexity of cell-centered node-averaging (CC-NA) and full-augmentation (CC-FA) schemes. On highly anisotropic grids typical of those encountered in grid adaptation, discretization errors of five of the six cell-centered schemes converge with second order on all tested grids; the CC-NA scheme with clipping degrades solution accuracy to first order. The NC schemes converge with second order on regular and/or triangular grids and with first order on perturbed quadrilaterals and mixed-element grids. All schemes may produce large relative errors in gradient reconstruction on grids with perturbed nodes. Defect-correction iterations for schemes employing weighted least-square gradient reconstruction diverge on perturbed stretched grids. Overall, the CC-NN and CC-SA schemes offer the best options of the lowest complexity and secondorder discretization errors. On anisotropic grids over a curved body typical of turbulent flow simulations, the discretization errors converge with second order and are small for the CC

  16. Standardized morbidity ratios of four chronic health conditions among World Trade Center responders: Comparison to the National Health Interview Survey.

    PubMed

    Kim, Hyun; Kriebel, David; Liu, Bian; Baron, Sherrry; Mongin, Steven; Baidwan, Navneet K; Moline, Jacqueline M

    2018-05-01

    We conducted external comparisons for the prevalence of asthma, hypertension, diabetes, and cancer among World Trade Center (WTC) general responders using the National Health Interview Survey (NHIS) as the reference, along with internal comparisons for the incidence of asthma. Standardized Morbidity Ratios (SMRs) were calculated for the prevalence of the health conditions, and risk ratios (RRs) for asthma incidence. Relative to the NHIS, asthma prevalence was in excess in responders over the study years (age-adjusted SMRs = 1.3-2.8). Hypertension prevalence began to exceed expected from 2006 while diabetes was lower than expected. An upward trend towards excess cancer prevalence was observed. Internal comparisons showed elevated asthma incidence among protective service and utility workers compared to construction workers; while those who arrived at the WTC site in the morning of 9/11 had a lower asthma risk than those who arrived in the afternoon. The use of NHIS data as a reference population demonstrates and reconfirms several important patterns of excess risk in WTC responders. External comparisons are an alternative for disaster cohorts without an established comparison group. © 2018 Wiley Periodicals, Inc.

  17. Prospective multi-center study of an automatic online seizure detection system for epilepsy monitoring units.

    PubMed

    Fürbass, F; Ossenblok, P; Hartmann, M; Perko, H; Skupch, A M; Lindinger, G; Elezi, L; Pataraia, E; Colon, A J; Baumgartner, C; Kluge, T

    2015-06-01

    A method for automatic detection of epileptic seizures in long-term scalp-EEG recordings called EpiScan will be presented. EpiScan is used as alarm device to notify medical staff of epilepsy monitoring units (EMUs) in case of a seizure. A prospective multi-center study was performed in three EMUs including 205 patients. A comparison between EpiScan and the Persyst seizure detector on the prospective data will be presented. In addition, the detection results of EpiScan on retrospective EEG data of 310 patients and the public available CHB-MIT dataset will be shown. A detection sensitivity of 81% was reached for unequivocal electrographic seizures with false alarm rate of only 7 per day. No statistical significant differences in the detection sensitivities could be found between the centers. The comparison to the Persyst seizure detector showed a lower false alarm rate of EpiScan but the difference was not of statistical significance. The automatic seizure detection method EpiScan showed high sensitivity and low false alarm rate in a prospective multi-center study on a large number of patients. The application as seizure alarm device in EMUs becomes feasible and will raise the efficiency of video-EEG monitoring and the safety levels of patients. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  18. PSI-Center Validation Studies

    NASA Astrophysics Data System (ADS)

    Nelson, B. A.; Akcay, C.; Glasser, A. H.; Hansen, C. J.; Jarboe, T. R.; Marklin, G. J.; Milroy, R. D.; Morgan, K. D.; Norgaard, P. C.; Shumlak, U.; Sutherland, D. A.; Victor, B. S.; Sovinec, C. R.; O'Bryan, J. B.; Held, E. D.; Ji, J.-Y.; Lukin, V. S.

    2014-10-01

    The Plasma Science and Innovation Center (PSI-Center - http://www.psicenter.org) supports collaborating validation platform experiments with 3D extended MHD simulations using the NIMROD, HiFi, and PSI-TET codes. Collaborators include the Bellan Plasma Group (Caltech), CTH (Auburn U), HBT-EP (Columbia), HIT-SI (U Wash-UW), LTX (PPPL), MAST (Culham), Pegasus (U Wisc-Madison), SSX (Swarthmore College), TCSU (UW), and ZaP/ZaP-HD (UW). The PSI-Center is exploring application of validation metrics between experimental data and simulations results. Biorthogonal decomposition (BOD) is used to compare experiments with simulations. BOD separates data sets into spatial and temporal structures, giving greater weight to dominant structures. Several BOD metrics are being formulated with the goal of quantitive validation. Results from these simulation and validation studies, as well as an overview of the PSI-Center status will be presented.

  19. Finite Element Analysis and Test Results Comparison for the Hybrid Wing Body Center Section Test Article

    NASA Technical Reports Server (NTRS)

    Przekop, Adam; Jegley, Dawn C.; Rouse, Marshall; Lovejoy, Andrew E.

    2016-01-01

    This report documents the comparison of test measurements and predictive finite element analysis results for a hybrid wing body center section test article. The testing and analysis efforts were part of the Airframe Technology subproject within the NASA Environmentally Responsible Aviation project. Test results include full field displacement measurements obtained from digital image correlation systems and discrete strain measurements obtained using both unidirectional and rosette resistive gauges. Most significant results are presented for the critical five load cases exercised during the test. Final test to failure after inflicting severe damage to the test article is also documented. Overall, good comparison between predicted and actual behavior of the test article is found.

  20. Maternal and neonatal outcomes in birth centers versus hospitals among women with low-risk pregnancies in Japan: A retrospective cohort study.

    PubMed

    Kataoka, Yaeko; Masuzawa, Yuko; Kato, Chiho; Eto, Hiromi

    2018-01-01

    In order for low-risk pregnant women to base birth decisions on the risks and benefits, they need evidence of birth outcomes from birth centers. The purpose of this study was to describe and compare the maternal and neonatal outcomes of low-risk women who gave birth in birth centers and hospitals in Japan. The participants were 9588 women who had a singleton vaginal birth at 19 birth centers and two hospitals in Tokyo. The data were collected from their medical records, including their age, parity, mode of delivery, maternal position at delivery, duration of labor, intrapartum blood loss, perineal trauma, gestational weeks at birth, birth weight, Apgar score, and stillbirths. For the comparison of birth centers with hospitals, adjusted odds ratios for the birth outcomes were estimated by using a logistic regression analysis. The number of women who had a total blood loss of >1 L was higher in the midwife-led birth centers than in the hospitals but the incidence of perineal lacerations was lower. There were fewer infants who were born at the midwife-led birth centers with Apgar scores of <7, compared to the hospitals. This study was the first to compare important maternal and neonatal outcomes of birth centers and hospitals. Additional research, using matched baseline characteristics, could clarify the comparisons for maternal and neonatal outcomes. © 2017 Japan Academy of Nursing Science.

  1. An Intercenter Comparison of Nasolabial Appearance Including a Center Using Nasoalveolar Molding.

    PubMed

    Peanchitlertkajorn, Supakit; Mercado, Ana; Daskalogiannakis, John; Hathaway, Ronald; Russell, Kathleen; Semb, Gunvor; Shaw, William; Lamichane, Manish; Cohen, Marilyn; Long, Ross E

    2018-05-01

    To compare nasolabial appearance outcomes of patients with complete unilateral cleft lip and palate (CUCLP) in preadolescence from 4 cleft centers including a center using nasoalveolar molding (NAM) and primary nasal reconstruction. Retrospective cohort study. Four cleft centers in North America. 135 subjects with repaired CUCLP. Frontal and profile facial pictures were assessed using the Asher-McDade rating scale. Intra- and interrater reliability were tested using weighted Kappa statistics. Median scores by center were compared with Kruskal-Wallis statistics. Intrarater reliability scores were moderate to good. Interrater reliability scores were moderate. Significant differences ( P < .05) among centers were found. For nasal form, center G (median = 2.83) had better scores than centers C and D (C median = 3.33, D median = 3.17). For nose symmetry, center G had better scores (median = 2.33) than all other centers (B median = 2.67, C median = 2.83, D median = 2.83). For vermillion border, center G had better scores (median = 2.58) than centers B and C (B median = 3.17, C median = 3.17). For nasolabial profile, center G (median score = 2.67) had better scores than center C (median = 3.00). For total nasolabial score, center G (median = 2.67) had better scores than all other centers (B median = 2.83, C median = 3, D median = 2.83). The protocol followed by center G, the only center that performed NAM and primary nasal reconstruction, produced better results in all categories when compared to center C, the only center that did not perform presurgical orthopedics or lip/nose revisions. When compared to centers that performed traditional presurgical orthopedics and surgical revisions (B and D), center G was not consistently better in all categories. As with other uncontrolled, retrospective intercenter studies, it is not possible to attribute the outcomes to a specific protocol component.

  2. Comparison of air-driven vs electric torque control motors on canal centering ability by ProTaper NiTi rotary instruments.

    PubMed

    Zarei, Mina; Javidi, Maryam; Erfanian, Mahdi; Lomee, Mahdi; Afkhami, Farzaneh

    2013-01-01

    Cleaning and shaping is one of the most important phases in root canal therapy. Various rotary NiTi systems minimize accidents and facilitate the shaping process. Todays NiTi files are used with air-driven and electric handpieces. This study compared the canal centering after instrumentation using the ProTaper system using Endo IT, electric torque-control motor, and NSK air-driven handpiece. This ex vivo randomized controlled trial study involved 26 mesial mandibular root canals with 10 to 35° curvature. The roots were randomly divided into 2 groups of 13 canals each. The roots were mounted in an endodontic cube with acrylic resin, sectioned horizontally at 2, 6 and 10 mm from the apex and then reassembled. The canals were instrumented according to the manufacturer's instructions using ProTaper rotary files and electric torque-control motors (group 1) or air-driven handpieces (group 2). Photographs of the cross-sections included shots before and after instrumentation, and image analysis was performed using Photoshop software. The centering ability and canal transportation was also evaluated. Repeated measurement and independent t-test provided statistical analysis of canal transportation. The comparison of the rate of transportation toward internal or external walls between the two groups was not statistically significant (p = 0.62). Comparison of the rate of transportation of sections within one group was not significant (p = 0.28). Use of rotary NiTi file with either electric torquecontrol motor or air-driven handpiece had no effect on canal centering. NiTi rotary instruments can be used with air-driven motors without any considerable changes in root canal anatomy, however it needs the clinician to be expert.

  3. A Comparison of Ambulatory Surgery Center Production Costs and Medicare Payments: Evidence on Colonoscopy and Endoscopy.

    PubMed

    Mitchell, Jean M; Carey, Kathleen

    2016-02-01

    Ambulatory surgery centers (ASCs) are freestanding facilities that specialize in surgical and diagnostic procedures that do not require an overnight stay. While it is generally assumed that ASCs are less costly than hospital outpatient surgery departments, there is sparse empirical evidence regarding their relative production costs. To estimate ASC production costs using financial and claims records for procedures performed by surgery centers that specialize in gastroenterology procedures (colonoscopy and endoscopy). We estimate production costs in ASCs that specialize in gastroenterology procedures using financial cost and patient discharge data from Pennsylvania for the time period 2004-2013. We focus on the 2 primary procedures (colonoscopies and endoscopies) performed at each ASC. We use our estimates to predict average costs for each procedure and then compare predicted costs to Medicare ACS payments for these procedures. Comparisons of the costs of each procedure with 2013 national Medicare ASC payment rates suggest that Medicare payments exceed production costs for both colonoscopy and endoscopy. This study demonstrated that it is feasible to estimate production costs for procedures performed in freestanding surgery centers. The procedure-specific cost estimates can then be compared with ASC payment rates to ascertain if payments are aligned with costs. This approach can serve as an evaluation template for CMS and private insurers who are concerned that ASC facility payments for specific procedures may be excessive.

  4. The BirthPlace collaborative practice model: results from the San Diego Birth Center Study.

    PubMed

    Swartz; Jackson; Lang; Ecker; Ganiats; Dickinson; Nguyen

    1998-07-01

    Objective: The search for quality, cost-effective health care programs in the United States is now a major focus in the era of health care reform. New programs need to be evaluated as alternatives are developed in the health care system. The BirthPlace program provides comprehensive perinatal services with certified nurse-midwives and obstetricians working together in an integrated collaborative practice serving a primarily low-income population. Low-risk women are delivered by nurse-midwives in a freestanding birth center (The BirthPlace), which is one component of a larger integrated health network. All others are delivered by team obstetricians at the affiliated tertiary hospital. Wellness, preventive measures, early intervention, and family involvement are emphasized. The San Diego Birth Center Study is a 4-year research project funded by the U.S. Federal Agency for Health Care Policy and Research (#R01-HS07161) to evaluate this program. The National Birth Center Study (NEJM, 1989; 321(26): 1801-11) described the advantages and safety of freestanding birth centers. However, a prospective cohort study with a concurrent comparison group of comparable risk had not been conducted on a collaborative practice-freestanding birth center model to address questions of safety, cost, and patient satisfaction.Methods: The specific aims of this study are to compare this collaborative practice model to the traditional model of perinatal health care (physician providers and hospital delivery). A prospective cohort study comparing these two health care models was conducted with a final expected sample size of approximately 2,000 birth center and 1,350 traditional care subjects. Women were recruited from both the birth center and traditional care programs (private physicians offices and hospital based clinics) at the beginning of prenatal care and followed through the end of the perinatal period. Prenatal, intrapartum, postpartum and infant morbidity and mortality are being

  5. Laser Spot Center Detection and Comparison Test

    NASA Astrophysics Data System (ADS)

    Zhu, Jun; Xu, Zhengjie; Fu, Deli; Hu, Cong

    2018-04-01

    High efficiency and precision of the pot center detection are the foundations of avionics instrument navigation and optics measurement basis for many applications. It has noticeable impact on overall system performance. Among them, laser spot detection is very important in the optical measurement technology. In order to improve the low accuracy of the spot center position, the algorithm is improved on the basis of the circle fitting. The pretreatment is used by circle fitting, and the improved adaptive denoising filter for TV repair technology can effectively improves the accuracy of the spot center position. At the same time, the pretreatment and de-noising can effectively reduce the influence of Gaussian white noise, which enhances the anti-jamming capability.

  6. Comparison of Responsiveness Level in Iranian Public and Private Physiotherapy Clinics: a Cross-Sectional Multi-center Study.

    PubMed

    Torabipour, Amin; Gharacheh, Laleh; Lorestani, Leila; Salehi, Reza

    2017-09-01

    Responsiveness is a main goal of health systems. Responsiveness focus on the non-medical aspects of health services delivery. This study was aimed to assess responsiveness level in public and private physiography clinics. In this multicenter cross sectional study, 403 patients refers to 16 public and 64 private physical therapy clinics were studied randomly in Ahvaz, Iran, from 2013 to 2014. Data were collected based on a valid health system responsiveness questionnaire that was developed by WHO. Health system responsiveness questionnaire for outpatients care includes seven components and 25 questions. Statistical relationship between responsiveness level of centers and patients characteristics was analyzed using Pearson coefficient, Independent t-test and one-way ANOVA. Out of 403 patients, 299 (74.19%) patients were women. The mean (±SD) age of the patients was 42(±14.18) years and 92.1% of patients were 65> years. Responsiveness status in private and public physiotherapy clinics was assessed excellent (26.93±5.2) and very well (21.08±5.8) respectively. In private clinics, the mean score of communication dimension (3.96±1) and autonomy dimension (3.95±0.9) was higher than other dimensions. In public clinics the mean score of dignity (3.30±0.8), autonomy (3.16±0.9), and prompt attention (3.12±1) was higher than other areas respectively. In public and private clinics, quality of basic amenities area had the lowest score. The results showed that the some patients and center characteristics such as gender and work shift were factors affecting assessment of responsiveness. Responsiveness level in private centers was better than publics.

  7. Community health centers and primary care access and quality for chronically-ill patients - a case-comparison study of urban Guangdong Province, China.

    PubMed

    Shi, Leiyu; Lee, De-Chih; Liang, Hailun; Zhang, Luwen; Makinen, Marty; Blanchet, Nathan; Kidane, Ruth; Lindelow, Magnus; Wang, Hong; Wu, Shaolong

    2015-11-30

    Reform of the health care system in urban areas of China has prompted concerns about the utilization of Community Health Centers (CHC). This study examined which of the dominant primary care delivery models, i.e., the public CHC model, the 'gate-keeper' CHC model, or the hospital-owned CHC models, was most effective in enhancing access to and quality of care for patients with chronic illness. The case-comparison design was used to study nine health care organizations in Guangzhou, Dongguan, and Shenzhen cities within Guangdong province, China. 560 patients aged 50 or over with hypertension or diabetes who visited either CHCs or hospitals in these three cities were surveyed by using face-to-face interviews. Bivariate analyses were performed to compare quality and value of care indicators among subjects from the three cities. Multivariate analyses were used to assess the association between type of primary care delivery and quality as well as value of chronic care after controlling for patients' demographic and health status characteristics. Patients from all three cities chose their current health care providers primarily out of concern for quality of care (both provider expertise and adequate medical equipment), patient-centered care, and insurance plan requirement. Compared with patients from Guangzhou, those from Dongguan performed significantly better on most quality and value of care indicators. Most of these indicators remained significantly better even after controlling for patients' demographic and health status characteristics. The Shenzhen model (hospital-owned and -managed CHC) was generally effective in enhancing accessibility and continuity. However, coordination suffered due to seemingly duplicating primary care outpatients at the hospital setting. Significant associations between types of health care facilities and quality of care were also observed such that patients from CHCs were more likely to be satisfied with traveling time and follow-up care by

  8. A Comparative Evaluation of Public Health Centers with Private Health Training Centers on Primary Healthcare Parameters in India: a Study by Data Envelopment Analysis Technique

    PubMed Central

    Davey, Sanjeev; Raghav, Santosh Kumar; Singh, Jai Vir; Davey, Anuradha; Singh, Nirankar

    2015-01-01

    Background: The evaluation of primary healthcare services provided by health training centers of a private medical college has not been studied in comparison with government health facilities in Indian context. Data envelopment analysis (DEA) is one such technique of operations research, which can be used on health facilities for identifying efficient operating practices and strategies for relatively efficient or inefficient health centers by calculating their efficiency scores. Materials and Methods: This study was carried out by DEA technique by using basic radial models (constant ratio to scale (CRS)) in linear programming via DEAOS free online Software among four decision making units (DMUs; by comparing efficiency of two private health centers of a private medical college of India with two public health centers) in district Muzaffarnagar of state Uttar Pradesh. The input and output records of all these health facilities (two from private and two from Government); for 6 months duration from 1st Jan 2014 to 1st July 2014 was taken for deciding their efficiency scores. Results: The efficiency scores of primary healthcare services in presence of doctors (100 vs 30%) and presence of health staff (100 vs 92%) were significantly better from government health facilities as compared to private health facilities (P < 0.0001). Conclusions: The evaluation of primary healthcare services delivery by DEA technique reveals that the government health facilities group were more efficient in delivery of primary healthcare services as compared to private training health facilities group, which can be further clarified in by more in-depth studies in future. PMID:26435598

  9. Cash Incentives and Turnover in Center-Based Child Care Staff

    ERIC Educational Resources Information Center

    Gable, Sara; Rothrauff, Tanja C.; Thornburg, Kathy R.; Mauzy, Denise

    2007-01-01

    The current study evaluates the Workforce INcentive Project (WIN), a programmatic effort to increase child care workforce stability in center- and home-based child care providers via the provision of bi-annual cash incentives based on educational attainment. Five hundred and thirteen center-based teaching staff (304 WIN and 209 comparison) and 167…

  10. Serum perfluoroalkyl substances and cardiometabolic consequences in adolescents exposed to the World Trade Center disaster and a matched comparison group.

    PubMed

    Koshy, Tony T; Attina, Teresa M; Ghassabian, Akhgar; Gilbert, Joseph; Burdine, Lauren K; Marmor, Michael; Honda, Masato; Chu, Dinh Binh; Han, Xiaoxia; Shao, Yongzhao; Kannan, Kurunthachalam; Urbina, Elaine M; Trasande, Leonardo

    2017-12-01

    Large amounts of various chemical contaminants, including perfluoroalkyl substances (PFASs), were released at the time of the World Trade Center (WTC) disaster. Thousands of children who lived and/or attended school near the disaster site were exposed to these substances but few studies have examined the possible consequences related to these exposures. To examine the relationship of PFASs serum levels with cardiometabolic profile in children and adolescents enrolled in the World Trade Center Health Registry (WTCHR) and a matched comparison group. We evaluated WTCHR enrollees who resided in New York City and were born between September 11, 1993 and September 10, 2001, and a matched comparison group consisting of individuals who were ineligible for WTCHR participation upon distance of their home, school or work from the WTC and lack of participation in rescue and recovery activities. Matching was based on date of birth, sex, race, ethnicity, and income. We assessed exposure to PFASs, as measured by serum levels and association with cardiometabolic profile as measured by arterial wall stiffness, body mass index, insulin resistance, fasting total cholesterol, HDL, LDL and triglycerides. A total of 402 participants completed the study and serum samples were analyzed from 308 participants, 123 in the WTCHR group and 185 in the comparison group. In multivariable regression analysis, after adjusting for relevant confounders, we observed a significant, positive association of perfluorooctanoic acid (PFOA) with triglycerides (beta coefficient=0.14, 95% CI: 0.02, 0.27, 15.1% change), total cholesterol (beta coefficient=0.09, 95% CI: 0.04, 0.14, 9.2% change), and LDL cholesterol (beta coefficient=0.11, 95% CI: 0.03, 0.19, 11.5% change). Perfluorohexanesulfonic acid levels were associated with decreased insulin resistance (beta coefficient=-0.09, 95% CI: -0.18, -0.003, -8.6% change); PFOA and perfluorononanoic acid were associated with increased brachial artery distensibility

  11. Photofragment slice imaging studies of pyrrole and the Xe{center_dot}{center_dot}{center_dot}pyrrole cluster

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rubio-Lago, L.; Zaouris, D.; Sakellariou, Y.

    The photolysis of pyrrole has been studied in a molecular beam at wavelengths of 250, 240, and 193.3 nm, using two different carrier gases, He and Xe. A broad bimodal distribution of H-atom fragment velocities has been observed at all wavelengths. Near threshold at both 240 and 250 nm, sharp features have been observed in the fast part of the H-atom distribution. Under appropriate molecular beam conditions, the entire H-atom loss signal from the photolysis of pyrrole at both 240 and 250 nm (including the sharp features) disappear when using Xe as opposed to He as the carrier gas. Wemore » attribute this phenomenon to cluster formation between Xe and pyrrole, and this assumption is supported by the observation of resonance enhanced multiphoton ionization spectra for the (Xe{center_dot}{center_dot}{center_dot}pyrrole) cluster followed by photofragmentation of the nascent cation cluster. Ab initio calculations are presented for the ground states of the neutral and cationic (Xe{center_dot}{center_dot}{center_dot}pyrrole) clusters as a means of understanding their structural and energetic properties.« less

  12. MacMillan Pier Transportation Center Feasibility Study.

    DOT National Transportation Integrated Search

    2006-06-01

    The MacMillan Pier Transportation Center Feasibility Study examines two potential sites (landside and waterside) for a transportation center that provides a range of tourist and traveler information. It would serve as a gateway for Provincetown and t...

  13. An Intercenter Comparison of Dental Arch Relationships and Craniofacial Form Including a Center Using Nasoalveolar Molding.

    PubMed

    Peanchitlertkajorn, Supakit; Mercado, Ana; Daskalogiannakis, John; Hathaway, Ronald; Russell, Kathleen; Semb, Gunvor; Shaw, William; Lamichane, Manish; Fessler, Jennifer; Long, Ross E

    2018-01-01

    Objective To compare dental arch relationship and craniofacial morphology of patients with CUCLP in pre-adolescence from five cleft centers including a center using NAM. Design Retrospective cohort study. Setting Five cleft centers in North America. Patients One hundred eighty-two subjects with repaired CUCLP from the five cleft centers participated in the craniofacial form study. One hundred forty-eight subjects from four of the five centers participated in the dental arch relationship study. Methods Digital dental models were assessed using the GOSLON Yardstick. Eighteen cephalometric measurements were performed. Measurement means, by center, were compared. Analysis of variance and Tukey-Kramer analysis were used to compare GOSLON scores and cephalometric measurements. Results The center that performed neither PSOT (including NAM) nor primary bone grafting exhibited the most favorable mean GOSLON score. The same center also showed the highest mean SNA, ANB, and ANS-N-Pg angles. However, the mean ANB and ANS-N-Pg angles were not significantly different from those of the center using NAM. No statistically significant differences were seen for mandibular prominence, vertical dimensions, or dental inclinations. The center with NAM also showed a significantly smaller nasoform angle than two of the four other centers. Conclusion The centers that used NAM and other forms of PSOT did not have better dental arch relationships or craniofacial morphology compared with the centers that performed only primary lip repair. However, this study was not designed to investigate the cause-and-effect relationship between specific outcomes and particular features of those protocols.

  14. A Study of Operating Costs of Branch Campuses and Centers at State Universities and Community Colleges. Report and Recommendations of the Postsecondary Education Planning Commission, 1988, Report 2.

    ERIC Educational Resources Information Center

    Florida State Postsecondary Education Planning Commission, Tallahassee.

    In 1988, a study was conducted of the operating costs of the 15 branch campuses and centers operated by the six Florida State universities and of nine representative community colleges in the state. Information provided by the colleges revealed that: (1) in comparison to their main campuses, branch campuses and centers tended to be less expensive…

  15. AFTER-SCHOOL STUDY CENTERS, VOLUNTEER WORK IN READING.

    ERIC Educational Resources Information Center

    JANOWITZ, GAYLE

    A STUDY CENTER IN HYDE PARK, CHICAGO, WAS OPENED IN SEPTEMBER 1962. IT CONSISTED OF A DEPOSIT COLLECTION FROM THE PUBLIC LIBRARY, A STUDY ROOM EQUIPPED WITH REFERENCE MATERIAL, AND SPACE FOR INDIVIDUAL TUTORING. THE PURPOSE OF THE STUDY CENTER WAS TO HELP CHILDREN FEEL THAT SUCCESS IS POSSIBLE SO THAT THEY COULD BEGIN TO FEEL MORE SELF-CONFIDENT…

  16. Student-Centered and Teacher-Centered Classroom Management: A Case Study of Three Elementary Teachers

    ERIC Educational Resources Information Center

    Garrett, Tracey

    2008-01-01

    The major purpose of this case study was to document the classroom management beliefs and practices of three teachers reputed to implement student-centered instruction and to examine the relationship between their instructional and managerial approaches. More specifically, do teachers who use student-centered instruction also implement…

  17. Comparison of cell centered and cell vertex scheme in the calculation of high speed compressible flows

    NASA Astrophysics Data System (ADS)

    Rahman, Syazila; Yusoff, Mohd. Zamri; Hasini, Hasril

    2012-06-01

    This paper describes the comparison between the cell centered scheme and cell vertex scheme in the calculation of high speed compressible flow properties. The calculation is carried out using Computational Fluid Dynamic (CFD) in which the mass, momentum and energy equations are solved simultaneously over the flow domain. The geometry under investigation consists of a Binnie and Green convergent-divergent nozzle and structured mesh scheme is implemented throughout the flow domain. The finite volume CFD solver employs second-order accurate central differencing scheme for spatial discretization. In addition, the second-order accurate cell-vertex finite volume spatial discretization is also introduced in this case for comparison. The multi-stage Runge-Kutta time integration is implemented for solving a set of non-linear governing equations with variables stored at the vertices. Artificial dissipations used second and fourth order terms with pressure switch to detect changes in pressure gradient. This is important to control the solution stability and capture shock discontinuity. The result is compared with experimental measurement and good agreement is obtained for both cases.

  18. The Location of Community Mental Health Centers in Texas: Some Descriptions and Comparisons.

    ERIC Educational Resources Information Center

    Valdez, Ramiro

    Part of a series of studies designed to lead to policy recommendations to improve mental health services to Mexican Americans in Texas, this monograph explores the availability and accessibility of community mental health centers (CMHCs) throughout the state. In hopes of explaining the underutilization of the centers statewide, the locations of…

  19. Handbook. Midwest Center for Off-Campus Studies.

    ERIC Educational Resources Information Center

    Midwest Center for Off-Campus Studies, Lincoln, IL.

    The Midwest Center for Off-Campus Studies offers students the opportunity to learn in a holistic manner by inserting them into a new community, either domestic or foreign, so that they can not only see the physical characteristics of the site, but can experience learning. Although the Center is at present an association of five Illinois two-year…

  20. Center for the Study of Rhythmic Processes

    DTIC Science & Technology

    1990-12-01

    NO. ;hington, D.C. 20332-6448 161103F 13484 1A4 iE (incude Security Ca--sficarion) iter for the Study of Rhythmic Processes ER$ONAL A~~S Kopell TYPE 9F...Djock number) The Center for the Study of Rhythmic Processes began operation in the academic year 1986-1989 and was supported as a Center of Excellence... Processes Personnel, 1986-1990 1. Nancy Kopell, Department of Mathematics, Boston University, P.I. Steven Strogatz, Postdoctoral Fellow Stephane Laederich

  1. Outcomes of antiretroviral treatment: a comparison between hospitals and health centers in Ethiopia.

    PubMed

    Balcha, Taye T; Jeppsson, Anders

    2010-01-01

    the objective of this study was to compare the outcomes of antiretroviral therapy (ART) between hospital and health center levels in Ethiopia. medical records of 1709 ART patients followed for 24 months at 2 hospitals and 3 health centers in the Oromia region of Ethiopia were reviewed. Noted outcomes of ART were currently alive and on treatment; lost to follow-up (LTFU); transferred out (TO); and died (D). of 1709 HIV-positive patients started on ART between September 2006 and February 2007, 1044 (61%) remained alive and were on treatment after 24-month follow-up. In all, 835 (57%) of ART patients at hospitals and 209 (83%) at health centers were retained in the program. Of those who were alive and receiving ART, 79% of patients at health centers and 72% at hospitals were clinically or immunologically improving. In addition, 331 (23%) patients at hospitals were LFTU as compared to 24 (10%) of patients at health centers (relative risk [RR] at 95% confidence interval [CI]: .358 [.231-.555]). While 11% was the mortality rate at hospitals, 5% of patients at health centers also died (RR at 95% CI: .360 [.192-.673]). antiretroviral therapy at health centers was associated with more favorable outcomes than at hospitals.

  2. SU-G-206-03: CTDI Per KV at Phantom Center and Periphery: Comparison Between Major CT Manufacturers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Al-Senan, R; Demirkaya, O

    Purpose: The purpose of this study was to: 1) compare scanners output by measuring normalized CTDIw (mGy/100mAs) in different CT makes and models and at different kV’s, and 2) quantify the relationship between kV and CTDI and compare this relationship between the different manufacturers. Methods: Study included forty scanners of major CT manufacturers and of various models. Exposure was measured at center and 12 o’clock holes of head and body CTDI phantoms, at all available kV’s, and with the largest or second largest available collimation in each scanner. Average measured CTDI’s from each CT manufacturer were also plotted against kVmore » and the fitting equation: CTDIw (normalized) = a.kVb was calculated. The power (b) value may be considered as an indicator of spectral filtration, which affects the degree of beam hardening. Also, HVLs were measured at several scanners. Results: Results showed GE scanners, on average, had higher normalized CTDIw than those of Siemens and Philips, in both phantom sizes and at all kV’s. ANOVA statistic indicated the difference was statistically significant (p < 0.05). Comparison between Philips and Siemens, however, was not statistically significant. Curve fitting showed b values ranged from 2.4 to 2.9 (for Head periphery and center, respectively); and was about 2.8 for Body phantom periphery, and 3.2 at the center of Body phantom. Fitting equations (kV vs. CTDI) will be presented and discussed. GE’s CTDIw vs. HVL showed very strong correlation (r > 0.99). Conclusion: Partial characterization of scanners output was performed which may be helpful in dose estimation to internal organs. The relatively higher output from GE scanners may be attributed to lower filtration. Work is still in progress to obtain CTDI values from other scanners as well as to measure their HVLs.« less

  3. The Center for Star Formation Studies

    NASA Technical Reports Server (NTRS)

    Hollenbach, D.; Bell, K. R.; Laughlin, G.

    2002-01-01

    The Center for Star Formation Studies, a consortium of scientists from the Space Science Division at Ames and the Astronomy Departments of the University of California at Berkeley and Santa Cruz, conducts a coordinated program of theoretical research on star and planet formation. Under the directorship of D. Hollenbach (Ames), the Center supports postdoctoral fellows, senior visitors, and students; meets regularly at Ames to exchange ideas and to present informal seminars on current research; hosts visits of outside scientists; and conducts a week-long workshop on selected aspects of star and planet formation each summer.

  4. Fair comparison of complexity between a multi-band CAP and DMT for data center interconnects.

    PubMed

    Wei, J L; Sanchez, C; Giacoumidis, E

    2017-10-01

    We present, to the best of our knowledge, the first known detailed analysis and fair comparison of complexity of a 56 Gb/s multi-band carrierless amplitude and phase (CAP) and discrete multi-tone (DMT) over 80 km dispersion compensation fiber-free single-mode fiber links based on intensity modulation and direct detection for data center interconnects. We show that the matched finite impulse response filters and inverse fast Fourier transform (IFFT)/FFT take the majority of the complexity of the multi-band CAP and DMT, respectively. The choice of the multi-band CAP sub-band count and the DMT IFFT/FFT size makes significant impact on the system complexity or performance, and trade-off must be considered.

  5. The impact of drop-in centers on the health of street children in New Delhi, India: A cross-sectional study.

    PubMed

    Nath, Ronita; Shannon, Harry; Georgiades, Kathy; Sword, Wendy; Raina, Parminder

    2016-12-01

    (1) To determine whether street children who visit drop-in centers experience better physical and mental health, and engage in less substance use than street children who do not visit centers. (2) To determine whether the duration of attendance at a center has an impact on the above outcomes. We conducted a cross-sectional study with 69 street children from two drop-in centers in New Delhi, India (attenders) and a comparison group of 65 street children who did not visit drop-in centers (non-attenders). We used pretested questionnaires to assess their physical health, substance use status and mental health. Attenders experienced fewer ill health outcomes, engaged in less substance use, and had better mental health outcomes than non-attenders (p<0.01). For every month of attendance at a drop-in center, street children experienced 2.1% (95% CI 0% to 4.1%, p=0.05) fewer ill health outcomes per month and used 4.6% (95% CI 1.3% to 8%, p=0.01) fewer substances. Street children were also less likely to have been a current substance user than a never substance user for every additional month of attendance at a center (OR: 0.79, 95% CI: 0.66-0.96, p=0.02). Duration of drop-in center attendance was not a significant factor in predicting mental health problems. Drop-in centers may improve the physical health of street children and reduce their substance abuse. Rigorous longitudinal studies are needed to better determine if drop-in centers impact the health and substance use status of street children in LMICs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Epidemiology, surgical management and early postoperative outcome in a cohort of gastric cancer patients of a tertiary referral center in relation to multi-center quality assurance studies.

    PubMed

    Garlipp, Benjamin; Schwalenberg, Jens; Adolf, Daniela; Lippert, Hans; Meyer, Frank

    2011-03-01

    The aim of the study was to analyze epidemiologic parameters, treatment-related data and prognostic factors in the management of gastric cancer patients of a university surgical center under conditions of routine clinical care before the onset of the era of multimodal therapies. By analyzing our data in relation with multi-center quality assurance trials [German Gastric Cancer Study - GGCS (1992) and East German Gastric Cancer Study - EGGCS (2004)] we aimed at providing an instrument of internal quality control at our institution as well as a base for comparison with future analyses taking into account the implementation of evolving (multimodal) therapies and their influence on treatment results. Retrospective analysis of prospectively gathered data of gastric cancer patients treated at a single institution during a defined 10-year time period with multivariate analysis of risk factors for early postoperative outcome. From 04/01/1993 through 03/31/2003, a total of 328 gastric cancer patients were treated. In comparison with the EGGCS cohort there was a larger proportion of patients with locally advanced and proximally located tumors. 272 patients (82.9%) underwent surgery with curative intent; in 88.4% of these an R0 resection was achieved (EGGCS/GGCS: 82.5%/71.5%). 68.2% of patients underwent preoperative endoluminal ultrasound (EUS) (EGGCS: 27.4%); the proportion of patients undergoing EUS increased over the study period. Diagnostic accuracy of EUS for T stage was 50.6% (EGGCS: 42.6%). 77.2% of operated patients with curative intent underwent gastrectomy (EGGCS/GGCS: 79.8%/71.1%). Anastomotic leaks at the esophagojejunostomy occurred slightly more frequently (8.8%) than in the EGGCS (5.9%) and GGCS (7.2%); however, postoperative morbidity (36.1%) and early postoperative mortality (5.3%) were not increased compared to the multi-center quality assurance study results (EGGCS morbidity, 45%); EGGCS/GGCS mortality, 8%/8.9%). D2 lymphadenectomy was performed in 72

  7. Active surveillance of abused and misused prescription opioids using poison center data: a pilot study and descriptive comparison.

    PubMed

    Hughes, Alice A; Bogdan, Gregory M; Dart, Richard C

    2007-01-01

    Prescription opioids are abused throughout the United States. Several monitoring programs are in existence, however, none of these systems provide up-to-date information on prescription opioid abuse. This article describes the use of poison centers as a real-time, geographically specific, surveillance system for prescription opioid abuse and compares our system with an existing prescription drug abuse monitoring program, the Drug Abuse Warning Network (DAWN). Data were collected from eight geographically dispersed poison centers for a period of twelve months. Any call involving buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, and oxycodone was considered a case. Any case coded as intentional exposure (abuse, intentional misuse, suicide, or intentional unknown) was regarded as misuse and abuse. Comparative data were obtained from DAWN. Poison center rates of abuse and misuse were highest for hydrocodone at 3.75 per 100,000 population, followed by oxycodone at 1.81 per 100,000 population. DAWN emergency department (ED) data illustrate a similar pattern of abuse with most mentions involving hydrocodone and oxycodone. Poison center data indicate that people aged 18 to 25 had the highest rates of abuse. DAWN reported the majority of ED mentions among 35 to 44-year-olds. Geographically, Kentucky had the uppermost rates of abuse and misuse for all opioids combined at 20.69 per 100,000 population. CONCLUSIONS. Comparing poison center data to DAWN yielded mostly comparable results, including hydrocodone as the most commonly mentioned drug. Our results suggest poison center data can be used as an indicator for prescription opioid abuse and misuse and can provide timely, geographically specific information on prescription drug abuse.

  8. Center for the Study of Traumatic Stress

    DTIC Science & Technology

    2016-06-15

    skills for both deployed and garrison experiences.” — Quote from a participant Soldier “The communication skills I learned from TEAM can be applied...problem solving, communication , and goal-setting skills . Data were collected from military families from Washing- ton, DC, San Antonio, TX and...to war, disasters, terrorism, community violence and public health threats. Dear Center Colleagues and Friends, The Center for the Study of Traumatic

  9. 40 CFR 761.326 - Conducting the comparison study.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Conducting the comparison study. 761...-liquid PCB Remediation Waste Samples § 761.326 Conducting the comparison study. Extract or analyze the comparison study samples using the alternative method. For an alternative extraction method or alternative...

  10. 40 CFR 761.326 - Conducting the comparison study.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Conducting the comparison study. 761...-liquid PCB Remediation Waste Samples § 761.326 Conducting the comparison study. Extract or analyze the comparison study samples using the alternative method. For an alternative extraction method or alternative...

  11. Starburst clusters in the Galactic center

    NASA Astrophysics Data System (ADS)

    Habibi, Maryam

    2014-09-01

    an overpopulation of massive stars in the core (r<0.2 pc) with a flat slope of α_{Nishi}=-1.50 ±0.35 in comparison to the Salpeter slope of α=-2.3. The slope of the mass function increases to α_{Nishi}=-2.21 ±0.27 in the intermediate annulus (0.2 comparison between the observed trend in the present-day mass function of the Arches cluster to existing N-body simulations of the cluster shows that this picture is consistent with mass segregation owing to the dynamical evolution of the cluster. Recently, more than 100 Wolf-Rayet and OB stars were identified in the Galactic center. About a third of these sources are not spatially associated with any of the known star clusters in this region. As the comparison of our observational study to N-body models of the cluster revealed, the clusters in the Galactic center region are dynamically evolved at younger ages due to their high cluster mass and the special Galactic center environment. Therefore, I probed the contribution of drifted sources from numerical models of the massive clusters in the Galactic center to the observed distribution of isolated massive sources in this region. This study shows that stars as massive as 100 M_⊙ drift away from the center of each cluster by up to ˜60 pc using the cluster models. The best analyzed model reproduces ˜60% of the known isolated massive stars out to 80 pc from the center of the Arches cluster. This number increases to 70-80% when we only consider the region that is ˜ 20 pc from the Arches cluster. Our finding shows that most of the apparently isolated high-mass stars might originate from the known star clusters. This result, together with the fact that no top-heavy mass function is required to explain the spatial variation of the mass function in the Arches cluster, implies that no evidence is

  12. 2005 Workforce Study: Ohio Early Childhood Centers. General Analysis

    ERIC Educational Resources Information Center

    Stoneburner, Chris

    2006-01-01

    The purpose of this study was to understand the characteristics of the current workforce in early childhood. This report highlights key characteristics of the 2005 early childhood center workforce in Ohio. Survey packets were sent to 3.600 randomly selected centers in April 2005, representing centers licensed by the Ohio Department of Job and…

  13. A comparison of health behaviors of women in centering pregnancy and traditional prenatal care.

    PubMed

    Shakespear, Kaylynn; Waite, Phillip J; Gast, Julie

    2010-03-01

    Researchers sought to determine the difference in health behaviors between women who receive prenatal care via the Centering Pregnancy approach and those involved in traditional prenatal care. Using a cross-sectional design, adult pregnant women (n = 125) were surveyed from at least 28 weeks gestation to delivery. The sample was comprised of primarily white low income women. Using multiple linear regression it was determined that women in Centering Pregnancy had significantly lower index health behavior scores compared with the traditional care group showing that those in Centering Pregnancy reported engaging in fewer health promoting behaviors. Furthermore, no differences were observed for smoking or weight gain behaviors between groups. Additionally, those in Centering Pregnancy reported a lower perceived value of prenatal care. The results of this study suggest that Centering Pregnancy is not adequately aiding its patients in adopting healthy behaviors during pregnancy.

  14. Development of the Jackson Heart Study Coordinating Center

    PubMed Central

    Campbell-Jenkins, Brenda W.; Addison, Clifton C.; Young, Lavon; Anugu, Pramod; Wilson, Gregory; Sarpong, Daniel

    2009-01-01

    The public health burden caused by cardiovascular disease (CVD) continues to adversely affect individuals in terms of cost, life expectancy, medical, pharmaceutical and hospital care. This burden has been excessive in the case of African Americans. The objective of this paper is to chronicle the procedures and processes that were implemented in the development of the Jackson Heart Study Coordinating Center. The Jackson Heart Study (JHS) is a population-based investigation of traditional and emerging risk factors that predict progression to CVD among African Americans. In response to the struggle against CVD, the Jackson Heart Study has convened a professional, technical, and administrative staff with specific competence in the operation of a coordinating center to handle the wide variety of areas related to CVD studies. The Jackson Heart Study Coordinating Center (JHSCC) was created to assure validity of the JHS findings and provide the resources necessary to meet comprehensive statistical needs (planning, implementing and monitoring data analysis); data management (designing, implementing and managing data collection and quality control), and administrative support. The JHSCC began with a commitment to support study functions in order to increase participant recruitment, retention and safety, meet regulatory requirements, prepare progress reports, and facilitate effective communication with the community and between all JHS centers. The JHSCC facilitates the efforts of the JHS scientists through the development and implementation of the study protocol. The efforts of the JHSCC have resulted in the successful preparation of scientific reports and manuscripts for publication and presentation of study findings and results. In summary, the JHSCC has emerged as an effective research mechanism that serves as the driving force behind the Jackson Heart Study activities. PMID:19543408

  15. Administrators' Understanding and Use of Family-Centered Practices

    ERIC Educational Resources Information Center

    Mandell, Colleen J.; Murray, Mary M.

    2009-01-01

    Employing qualitative methods, administrators' understanding and use of family-centered practices were examined. Results indicate differences in role perceptions and service delivery based on their level of understanding. Administrators with a comprehensive understanding of family-centered practices, in comparison to administrators with limited or…

  16. About feeding children: mealtimes in child-care centers in four western states.

    PubMed

    Sigman-Grant, Madeleine; Christiansen, Elizabeth; Branen, Laurel; Fletcher, Janice; Johnson, Susan L

    2008-02-01

    This study was conducted to describe mealtimes and explore routines, policies, and training in child-care centers. Following an intensive review of mealtimes, staff and director questionnaires were created. Using a stratified random sampling protocol and following the Tailored Design Method, directors and staff from licensed child-care centers from California, Colorado, Idaho, and Nevada were surveyed. Center and staff characteristics were compared among the four states and three census areas using analysis of variance and chi(2) analyses, as appropriate. To adjust for multiple comparisons, a stringent P value of <0.001 was used for post hoc comparisons. Responses were received from 568 centers (representing 1,190 staff and 464 directors). Mealtimes generally occurred in the classroom, where an adult sat at the table with the children, served some food, poured the drinks, and ate some of the center-provided food. Less than half of centers reported using "family-style" service, although this style allows children the opportunity to self-serve food. Staff received substantially less training on feeding children (42%) than on nutrition (68%) and child development (95%). These findings bring focus to the need to educate child-care staff and directors about the impact of mealtime environments on child health and development.

  17. Lunar phases and crisis center telephone calls.

    PubMed

    Wilson, J E; Tobacyk, J J

    1990-02-01

    The lunar hypothesis, that is, the notion that lunar phases can directly affect human behavior, was tested by time-series analysis of 4,575 crisis center telephone calls (all calls recorded for a 6-month interval). As expected, the lunar hypothesis was not supported. The 28-day lunar cycle accounted for less than 1% of the variance of the frequency of crisis center calls. Also, as hypothesized from an attribution theory framework, crisis center workers reported significantly greater belief in lunar effects than a non-crisis-center-worker comparison group.

  18. Health information security: a case study of three selected medical centers in iran.

    PubMed

    Hajrahimi, Nafiseh; Dehaghani, Sayed Mehdi Hejazi; Sheikhtaheri, Abbas

    2013-03-01

    Health Information System (HIS) is considered a unique factor in improving the quality of health care activities and cost reduction, but today with the development of information technology and use of internet and computer networks, patients' electronic records and health information systems have become a source for hackers. This study aims at checking health information security of three selected medical centers in Iran using AHP fuzzy and TOPSIS compound model. To achieve that security measures were identified, based on the research literature and decision making matrix using experts' points of view. Among the 27 indicators, seven indicators were selected as effective indicators and Fuzzy AHP technique was used to determine the importance of security indicators. Based on the comparisons made between the three selected medical centers to assess the security of health information, it is concluded that Chamran hospital has the most acceptable level of security and attention in three indicators of "verification and system design, user access management, access control system", Al Zahra Hospital in two indicators of "access management and network access control" and Amin Hospital in "equipment safety and system design". In terms of information security, Chamran Hospital ranked first, Al-Zahra Hospital ranked second and Al- Zahra hospital has the third place.

  19. Health Information Security: A Case Study of Three Selected Medical Centers in Iran

    PubMed Central

    Hajrahimi, Nafiseh; Dehaghani, Sayed Mehdi Hejazi; Sheikhtaheri, Abbas

    2013-01-01

    Health Information System (HIS) is considered a unique factor in improving the quality of health care activities and cost reduction, but today with the development of information technology and use of internet and computer networks, patients’ electronic records and health information systems have become a source for hackers. Methods This study aims at checking health information security of three selected medical centers in Iran using AHP fuzzy and TOPSIS compound model. To achieve that security measures were identified, based on the research literature and decision making matrix using experts’ points of view. Results and discussion Among the 27 indicators, seven indicators were selected as effective indicators and Fuzzy AHP technique was used to determine the importance of security indicators. Based on the comparisons made between the three selected medical centers to assess the security of health information, it is concluded that Chamran hospital has the most acceptable level of security and attention in three indicators of “verification and system design, user access management, access control system”, Al Zahra Hospital in two indicators of “access management and network access control” and Amin Hospital in “equipment safety and system design”. In terms of information security, Chamran Hospital ranked first, Al-Zahra Hospital ranked second and Al- Zahra hospital has the third place. PMID:23572861

  20. Venus' Chasmata and Earth's Spreading Centers: A Topographic Comparison

    NASA Astrophysics Data System (ADS)

    Stoddard, P. R.; Jurdy, D. M.

    2008-12-01

    Like the Earth, Venus has a global rift system, which has been cited as evidence of tectonic activity, despite the apparent lack of Earth-style plate tectonics. Both systems are marked by large ridges, usually with central grabens. On Earth, the topography of the rifts can be modeled well by a cooling half-space and the spreading of two divergent plates. The origin of the topographic signature on Venus, however, remains enigmatic. Venus' rift zones (termed "chasmata") can be fit by four great circle arcs extending 1000s of kilometers. The Venus chasmata system measures 54,464 km, which when corrected for the smaller size of the planet, nearly matches the 59,200-km total length of the spreading ridges determined for Earth. As on Earth, the chasmata with the greatest relief (7 km in just a 30-km run for Venus) represent the most recent tectonic activity. We use topographic profiles to look for well-understood terrestrial analogs to Venusian features. Focusing on mid-ocean ridge systems on Earth, we examine the variation along individual ridges, or rises, due to the gradual change in spreading rate (and thus cooling times). We then analyze the difference between fast and slow ridges, and propose that this technique may also be used to pick plate boundaries along spreading centers (SAM/AFR vs. NAM/AFR, e.g.). These profiles are then compared to those for Venus' rifts. Topographic profiles are based on the Magellan (Venus) and ETOPO5 (Earth) data sets. Long wavelength features appear similar to spreading systems on Earth, suggesting a deep, thermal cause. Short wavelength features, such as rift troughs and constructional edifices, are quite different, however, as expected from the vastly different surface conditions. Comparison of topographic profiles from Venus and Earth may lend insight into tectonic features and activity on our sister planet.

  1. NASA-Langley Research Center's participation in a round-robin comparison between some current crack-propagation prediction methods

    NASA Technical Reports Server (NTRS)

    Hudson, C. M.; Lewis, P. E.

    1979-01-01

    A round-robin study was conducted which evaluated and compared different methods currently in practice for predicting crack growth in surface-cracked specimens. This report describes the prediction methods used by the Fracture Mechanics Engineering Section, at NASA-Langley Research Center, and presents a comparison between predicted crack growth and crack growth observed in laboratory experiments. For tests at higher stress levels, the correlation between predicted and experimentally determined crack growth was generally quite good. For tests at lower stress levels, the predicted number of cycles to reach a given crack length was consistently higher than the experimentally determined number of cycles. This consistent overestimation of the number of cycles could have resulted from a lack of definition of crack-growth data at low values of the stress intensity range. Generally, the predicted critical flaw sizes were smaller than the experimentally determined critical flaw sizes. This underestimation probably resulted from using plane-strain fracture toughness values to predict failure rather than the more appropriate values based on maximum load.

  2. [Space for the new. Archive - library - study center].

    PubMed

    Weber, Danny

    2014-01-01

    This article features a short outline of both the architectural history and the inventories of Leopoldina's archive and library. Moreover, the article presents the construction plans that will--when implemented in the near future--generate and provide outstanding working facilities in the form of a building ensemble consisting of an archive, library and study center. The future infrastructure of these Leopoldina buildings, located in the area of Emil-Abderhalden-/August-Bebel-Strasse, will sustainably foster and support the establishment of research projects at the Leopoldina Study Center.

  3. [Clinical safety audits for primary care centers. A pilot study].

    PubMed

    Ruiz Sánchez, Míriam; Borrell-Carrió, Francisco; Ortodó Parra, Cristina; Fernàndez I Danés, Neus; Fité Gallego, Anna

    2013-01-01

    To identify organizational processes, violations of rules, or professional performances that pose clinical levels of insecurity. Descriptive cross-sectional survey with customized externally-behavioral verification and comparison of sources, conducted from June 2008 to February 2010. Thirteen of the 53 primary care teams (PCT) of the Catalonian Health Institute (ICS Costa de Ponent, Barcelona). Employees of 13 PCT classified into: director, nurse director, customer care administrators, and general practitioners. Non-random selection, teaching (TC)/non-teaching, urban (UC)/rural and small/large (LC) health care centers (HCC). A total of 33 indicators were evaluated; 15 of procedures, 9 of attitude, 3 of training, and 6 of communication. Level of uncertainty: <50% positive answers for each indicator. no collaboration. A total of 55 professionals participated (84.6% UC, 46.2% LC and 76.9% TC). Rank distribution: 13 customer care administrators, 13 nurse directors, 13 HCC directors, and 16 general practitioners. Levels of insecurity emerged from the following areas: reception of new medical professionals, injections administration, nursing weekend home calls, urgent consultations to specialists, aggressive patients, critical incidents over the agenda of the doctors, communication barriers with patients about treatment plans, and with immigrants. Clinical safety is on the agenda of the health centers. Identified areas of uncertainty are easily approachable, and are considered in the future system of accreditation of the Catalonian Government. General practitioners are more critical than directors, and teaching health care centers, rural and small HCC had a better sense of security. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  4. Key success factors of health research centers: A mixed method study.

    PubMed

    Tofighi, Shahram; Teymourzadeh, Ehsan; Heydari, Majid

    2017-08-01

    In order to achieve success in future goals and activities, health research centers are required to identify their key success factors. This study aimed to extract and rank the factors affecting the success of research centers at one of the medical universities in Iran. This study is a mixed method (qualitative-quantitative) study, which was conducted between May to October in 2016. The study setting was 22 health research centers. In qualitative phase, we extracted the factors affecting the success in research centers through purposeful interviews with 10 experts of centers, and classified them into themes and sub-themes. In the quantitative phase, we prepared a questionnaire and scored and ranked the factors recognized by 54 of the study samples by Friedman test. Nine themes and 42 sub-themes were identified. Themes included: strategic orientation, management, human capital, support, projects, infrastructure, communications and collaboration, paradigm and innovation and they were rated respectively as components of success in research centers. Among the 42 identified factors, 10 factors were ranked respectively as the key factors of success, and included: science and technology road map, strategic plan, evaluation indexes, committed human resources, scientific evaluation of members and centers, innovation in research and implementation, financial support, capable researchers, equipment infrastructure and teamwork. According to the results, the strategic orientation was the most important component in the success of research centers. Therefore, managers and authorities of research centers should pay more attention to strategic areas in future planning, including the science and technology road map and strategic plan.

  5. Key success factors of health research centers: A mixed method study

    PubMed Central

    Tofighi, Shahram; Teymourzadeh, Ehsan; Heydari, Majid

    2017-01-01

    Background In order to achieve success in future goals and activities, health research centers are required to identify their key success factors. Objective This study aimed to extract and rank the factors affecting the success of research centers at one of the medical universities in Iran. Methods This study is a mixed method (qualitative-quantitative) study, which was conducted between May to October in 2016. The study setting was 22 health research centers. In qualitative phase, we extracted the factors affecting the success in research centers through purposeful interviews with 10 experts of centers, and classified them into themes and sub-themes. In the quantitative phase, we prepared a questionnaire and scored and ranked the factors recognized by 54 of the study samples by Friedman test. Results Nine themes and 42 sub-themes were identified. Themes included: strategic orientation, management, human capital, support, projects, infrastructure, communications and collaboration, paradigm and innovation and they were rated respectively as components of success in research centers. Among the 42 identified factors, 10 factors were ranked respectively as the key factors of success, and included: science and technology road map, strategic plan, evaluation indexes, committed human resources, scientific evaluation of members and centers, innovation in research and implementation, financial support, capable researchers, equipment infrastructure and teamwork. Conclusion According to the results, the strategic orientation was the most important component in the success of research centers. Therefore, managers and authorities of research centers should pay more attention to strategic areas in future planning, including the science and technology road map and strategic plan. PMID:28979733

  6. Accounting for center in the Early External Cephalic Version trials: an empirical comparison of statistical methods to adjust for center in a multicenter trial with binary outcomes.

    PubMed

    Reitsma, Angela; Chu, Rong; Thorpe, Julia; McDonald, Sarah; Thabane, Lehana; Hutton, Eileen

    2014-09-26

    Clustering of outcomes at centers involved in multicenter trials is a type of center effect. The Consolidated Standards of Reporting Trials Statement recommends that multicenter randomized controlled trials (RCTs) should account for center effects in their analysis, however most do not. The Early External Cephalic Version (EECV) trials published in 2003 and 2011 stratified by center at randomization, but did not account for center in the analyses, and due to the nature of the intervention and number of centers, may have been prone to center effects. Using data from the EECV trials, we undertook an empirical study to compare various statistical approaches to account for center effect while estimating the impact of external cephalic version timing (early or delayed) on the outcomes of cesarean section, preterm birth, and non-cephalic presentation at the time of birth. The data from the EECV pilot trial and the EECV2 trial were merged into one dataset. Fisher's exact method was used to test the overall effect of external cephalic version timing unadjusted for center effects. Seven statistical models that accounted for center effects were applied to the data. The models included: i) the Mantel-Haenszel test, ii) logistic regression with fixed center effect and fixed treatment effect, iii) center-size weighted and iv) un-weighted logistic regression with fixed center effect and fixed treatment-by-center interaction, iv) logistic regression with random center effect and fixed treatment effect, v) logistic regression with random center effect and random treatment-by-center interaction, and vi) generalized estimating equations. For each of the three outcomes of interest approaches to account for center effect did not alter the overall findings of the trial. The results were similar for the majority of the methods used to adjust for center, illustrating the robustness of the findings. Despite literature that suggests center effect can change the estimate of effect in

  7. Comparison of pediatric motor vehicle collision injury outcomes at Level I trauma centers.

    PubMed

    Dreyfus, Jill; Flood, Andrew; Cutler, Gretchen; Ortega, Henry; Kreykes, Nathan; Kharbanda, Anupam

    2016-10-01

    Examine the association of American College of Surgeons Level I pediatric trauma center designation with outcomes of pediatric motor vehicle collision-related injuries. Observational study of the 2009-2012 National Trauma Data Bank, including n=28,145 patients <18years directly transported to a Level I trauma center. Generalized estimating equations estimated odds ratios (ORs) for injury outcomes, comparing freestanding pediatric trauma centers (PTCs) with adult centers having added Level I pediatric qualifications (ATC+PTC) and general adult trauma centers (ATC). Models were stratified by age following PTC designation guidelines, and adjusted for demographic and clinical risk factors. Analyses included n=16,643 children <15 and n=11,502 adolescents 15-17years. Among children, odds of laparotomy (OR=1.88, 95% CI 1.28-2.74) and pneumonia (OR=2.13, 95% CI 1.32-3.46) were greater at ATCs vs. freestanding PTCs. Adolescents treated at ATC+PTCs or ATCs experienced greater odds of death (OR=2.18, 95% CI 1.30-3.67; OR=1.98, 95% CI 1.37-2.85, respectively) and laparotomy (OR=4.33, 95% CI 1.56-12.02; OR=5.11, 95% CI 1.92-13.61, respectively). Compared with freestanding PTCs, children treated at general ATCs experienced more complications; adolescents treated at ATC+PTCs or general ATCs had greater odds of death. Identification and sharing of best practices among Level I trauma centers may reduce variation in care and improve outcomes for children. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Center for dielectric studies

    NASA Astrophysics Data System (ADS)

    Cross, L. E.; Newnham, R. E.; Biggers, J. V.

    1984-05-01

    This report focuses upon the parts of the Center program which have drawn most extensively upon Navy funds. In the basic study of polarization processes in high K dielectrics, major progress has been made in understanding the mechanisms in relaxor ferroelectric in the perovskite structure families. A new effort is also being mounted to obtain more precise evaluation of the internal stress effects in fine grained barium titanate. Related to reliability, studies of the effects of induced macro-defects are described, and preparation for the evaluation of space charge by internal potential distribution measurements discussed. To develop new processing methods for very thin dielectric layers, a new type of single barrier layer multilayer is discussed, and work on the thermal evaporation of oriented crystalline antimony sulphur iodide describe.

  9. PRB CHEMISTRY CASE STUDY: DENVER FEDERAL CENTER

    EPA Science Inventory

    The Denver Federal Center permeable reactive barrier is a funnel-and-gate system with four reactive gates, each separated by up to about 120 m of metal sheet pile. In this study, ground water sampling, core collection, and solid phase characterization studies were carried out in...

  10. Next-generation optical wireless communications for data centers

    NASA Astrophysics Data System (ADS)

    Arnon, Shlomi

    2015-01-01

    Data centers collect and process information with a capacity that has been increasing from year to year at an almost exponential pace. Traditional fiber/cable data center network interconnections suffer from bandwidth overload, as well as flexibility and scalability issues. Therefore, a technology-shift from the fiber and cable to wireless has already been initiated in order to meet the required data-rate, flexibility and scalability demands for next-generation data center network interconnects. In addition, the shift to wireless reduces the volume allocated to the cabling/fiber and increases the cooling efficiency. Optical wireless communication (OWC), or free space optics (FSO), is one of the most effective wireless technologies that could be used in future data centers and could provide ultra-high capacity, very high cyber security and minimum latency, due to the low index of refraction of air in comparison to fiber technologies. In this paper we review the main concepts and configurations for next generation OWC for data centers. Two families of technologies are reviewed: the first technology regards interconnects between rack units in the same rack and the second technology regards the data center network that connects the server top of rack (TOR) to the switch. A comparison between different network technologies is presented.

  11. Tonal Centers and Expectancy: Facilitation or Inhibition of Chords at the Top of the Harmonic Hierarchy?

    ERIC Educational Resources Information Center

    Tillmann, Barbara; Janata, Petr; Birk, Jeffrey; Bharucha, Jamshed J.

    2008-01-01

    Harmonic priming studies have shown that a musical context with its tonal center influences target chord processing. In comparison with targets following baseline contexts, which do not establish a specific tonal center, processing is facilitated for a strongly related target functioning as the tonic, but inhibited for unrelated (out-of-key) and…

  12. Implementing the Data Center Energy Productivity Metric in a High Performance Computing Data Center

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sego, Landon H.; Marquez, Andres; Rawson, Andrew

    2013-06-30

    As data centers proliferate in size and number, the improvement of their energy efficiency and productivity has become an economic and environmental imperative. Making these improvements requires metrics that are robust, interpretable, and practical. We discuss the properties of a number of the proposed metrics of energy efficiency and productivity. In particular, we focus on the Data Center Energy Productivity (DCeP) metric, which is the ratio of useful work produced by the data center to the energy consumed performing that work. We describe our approach for using DCeP as the principal outcome of a designed experiment using a highly instrumented,more » high-performance computing data center. We found that DCeP was successful in clearly distinguishing different operational states in the data center, thereby validating its utility as a metric for identifying configurations of hardware and software that would improve energy productivity. We also discuss some of the challenges and benefits associated with implementing the DCeP metric, and we examine the efficacy of the metric in making comparisons within a data center and between data centers.« less

  13. The Willowbrook futures project: a longitudinal analysis of person-centered planning.

    PubMed

    Holburn, Steve; Jacobson, John W; Schwartz, Allen A; Flory, Michael J; Vietze, Peter M

    2004-01-01

    We conducted a longitudinal comparative evaluation of person-centered planning processes and outcomes for 20 individuals with intellectual disabilities and problem behavior (former residents of Willowbrook) and a matched contrast group, who received traditional interdisciplinary service planning (ISP). At the inception of the study, all participants were living in one of four other developmental centers (institutions) in New York City. Process and outcome data obtained from questionnaires completed by team members approximately every 8 months at four time periods showed that the rate of improvement in both person-centered planning process and outcomes for the intervention group was significantly greater than that of the comparison group. Eighteen of 19 person-centered planning participants moved to community living arrangements, as did 5 of 18 in the contrast group.

  14. Comparison of the distribution of large magmatic centers on Earth, Venus, and Mars

    NASA Technical Reports Server (NTRS)

    Crumpler, L. S.

    1993-01-01

    Volcanism is widely distributed over the surfaces of the major terrestrial planets: Venus, Earth, and Mars. Anomalous centers of magmatic activity occur on each planet and are characterized by evidence for unusual concentrations of volcanic centers, long-lived activity, unusual rates of effusion, extreme size of volcanic complexes, compositionally unusual magmatism, and evidence for complex geological development. The purpose of this study is to compare the characteristics and distribution of these magmatic anomalies on Earth, Venus, and Mars in order to assess these characteristics as they may relate to global characteristics and evolution of the terrestrial planets.

  15. Weekend Study Buddies: Using Portable Learning Centers.

    ERIC Educational Resources Information Center

    Stephens, Harristina; Jairrels, Veda

    2003-01-01

    This article discusses how one teacher uses a weekend study buddy as a portable learning center for students (ages 5-9) with mild disabilities. The study buddy is a colorful cloth or paper bag that the students take home over the weekend. It can also be individualized to target particular needs. (Contains 8 references.) (CR)

  16. Comparison of semi-automated center-dot and fully automated endothelial cell analyses from specular microscopy images.

    PubMed

    Maruoka, Sachiko; Nakakura, Shunsuke; Matsuo, Naoko; Yoshitomi, Kayo; Katakami, Chikako; Tabuchi, Hitoshi; Chikama, Taiichiro; Kiuchi, Yoshiaki

    2017-10-30

    To evaluate two specular microscopy analysis methods across different endothelial cell densities (ECDs). Endothelial images of one eye from each of 45 patients were taken by using three different specular microscopes (three replicates each). To determine the consistency of the center-dot method, we compared SP-6000 and SP-2000P images. CME-530 and SP-6000 images were compared to assess the consistency of the fully automated method. The SP-6000 images from the two methods were compared. Intraclass correlation coefficients (ICCs) for the three measurements were calculated, and parametric multiple comparisons tests and Bland-Altman analysis were performed. The ECD mean value was 2425 ± 883 (range 516-3707) cells/mm 2 . ICC values were > 0.9 for all three microscopes for ECD, but the coefficients of variation (CVs) were 0.3-0.6. For ECD measurements, Bland-Altman analysis revealed that the mean difference was 42 cells/mm 2 between the SP-2000P and SP-6000 for the center-dot method; 57 cells/mm 2 between the SP-6000 measurements from both methods; and -5 cells/mm 2 between the SP-6000 and CME-530 for the fully automated method (95% limits of agreement: - 201 to 284 cell/mm 2 , - 410 to 522 cells/mm 2 , and - 327 to 318 cells/mm 2 , respectively). For CV measurements, the mean differences were - 3, - 12, and 13% (95% limits of agreement - 18 to 11, - 26 to 2, and - 5 to 32%, respectively). Despite using three replicate measurements, the precision of the center-dot method with the SP-2000P and SP-6000 software was only ± 10% for ECD data and was even worse for the fully automated method. Japan Clinical Trials Register ( http://www.umin.ac.jp/ctr/index/htm9 ) number UMIN 000015236.

  17. Comparison of CDE data in phacoemulsification between an open hospital-based ambulatory surgical center and a free-standing ambulatory surgical center.

    PubMed

    Chen, Ming; Chen, Mindy

    2010-11-12

    Mean CDE (cumulative dissipated energy) values were compared for an open hospital- based surgical center and a free-standing surgical center. The same model of phacoemulsifier (Alcon Infiniti Ozil) was used. Mean CDE values showed that surgeons (individual private practice) at the free-standing surgical center were more efficient than surgeons (individual private practice) at the open hospital-based surgical center (mean CDE at the hospital-based surgical center 18.96 seconds [SD = 12.51]; mean CDE at the free-standing surgical center 13.2 seconds [SD = 9.5]). CDE can be used to monitor the efficiency of a cataract surgeon and surgical center in phacoemulsification. The CDE value may be used by institutions as one of the indicators for quality control and audit in phacoemulsification.

  18. Interindividual uniformity and variety of the "Writing center": a functional MRI study.

    PubMed

    Sugihara, Genichi; Kaminaga, Tatsuro; Sugishita, Morihiro

    2006-10-01

    Our aim is to investigate the neural substrates for writing using fMRI (twenty right-handed subjects). We assumed that common areas involved in both writing with right and left hands are crucial to the central process of writing. We employed Japanese phonograms (Kana), in which phoneme-grapheme conversion would be extremely simple. Brain activation was examined under three conditions: (1) written naming with the right hand (WR), (2) written naming with the left hand (WL), and (3) naming silently (NA). While the comparison of WR to NA (WR>NA) exhibited activation only in the left frontoparietal area, the WL>NA comparison exhibited broader activation than the WR>NA comparison, i.e., the left frontoparietal area except the motor and sensory areas and the right frontoparietal area. A conjunction analysis in SPM2 revealed common areas of activation across the WR>NA and WL>NA comparisons, which are assumed to be crucial to writing. In the group analysis, three areas were found to be activated: the posterior end of the left superior frontal gyrus, which is superior and posterior to Exner's center; the anterior part of the left superior parietal lobule; and the lower part of the anterior limb of the left supramarginal gyrus. In the single-subject analysis, whereas the first two of the above three areas were found to be crucial for writing in all individuals, an interindividual inconsistency of involvement with writing was observed in three areas: the lower part of the anterior limb of the left supramarginal gyrus (60% involved); the right frontal region (47%); and the right intraparietal sulcus (47%).

  19. Cosmos, an international center for advanced studies

    NASA Technical Reports Server (NTRS)

    Ryzhov, Iurii; Alifanov, Oleg; Sadin, Stanley; Coleman, Paul

    1990-01-01

    The concept of Cosmos, a Soviet operating center for aerospace activities, is presented. The main Cosmos participants are the Institute for Aerospace Education, the Institute for Research and Commercial Development, and the Department of Space Policy and Socio-Economic Studies. Cosmos sponsors a number of educational programs, basic research, and studies of the social impact of space-related technologies.

  20. Center for Japanese Study Abroad. Fastback 386.

    ERIC Educational Resources Information Center

    Jassey, William

    The Center for Japanese Study Abroad (CJSA) is a Japanese immersion and study abroad program implemented as a magnet program at inner-city Brien MacMahon High School in Norwalk, Connecticut. The program is supported by a grant from the state department of education. Attended by 60-70 students from high schools in southern Fairfield County…

  1. Child Day Care Center Licensing Study, 1997.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    The 1997 Child Care Center Licensing Study contains an update of information compiled in 1991 by the Children's Foundation. The data was obtained from the central regulatory office of each of the 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands. The study is organized in alphabetical order by states and territories. The…

  2. Comparison of CDE data in phacoemulsification between an open hospital-based ambulatory surgical center and a free-standing ambulatory surgical center

    PubMed Central

    Chen, Ming; Chen, Mindy

    2010-01-01

    Mean CDE (cumulative dissipated energy) values were compared for an open hospital- based surgical center and a free-standing surgical center. The same model of phacoemulsifier (Alcon Infiniti Ozil) was used. Mean CDE values showed that surgeons (individual private practice) at the free-standing surgical center were more efficient than surgeons (individual private practice) at the open hospital-based surgical center (mean CDE at the hospital-based surgical center 18.96 seconds [SD = 12.51]; mean CDE at the free-standing surgical center 13.2 seconds [SD = 9.5]). CDE can be used to monitor the efficiency of a cataract surgeon and surgical center in phacoemulsification. The CDE value may be used by institutions as one of the indicators for quality control and audit in phacoemulsification. PMID:21151334

  3. Comparison of Clinicopathological Characteristics in the Patients with Cardiac Cancer with or without Esophagogastric Junctional Invasion: A Single-Center Retrospective Cohort Study

    PubMed Central

    Ito, Hiroaki; Inoue, Haruhiro; Odaka, Noriko; Satodate, Hitoshi; Suzuki, Michitaka; Mukai, Shumpei; Takehara, Yusuke; Omoto, Tomokatsu; Kudo, Shin-ei

    2013-01-01

    Background. This study addresses clinicopathological differences between patients with gastric cardia and subcardial cancer with and without esophagogastric junctional invasion. Methods. We performed a single-center, retrospective cohort study. We studied patients who underwent curative surgery for gastric cardia and subcardial cancers. Tumors centered in the proximal 5 cm of the stomach were classed into two types, according to whether they did (Ge) or did not (G) invade the esophagogastric junction. Results. A total of 80 patients were studied; 19 (73.1%) of 26 Ge tumors and 16 (29.6%) of 54 G tumors had lymph nodes metastases. Incidence of nodal metastasis in pT1 tumors was significantly higher in the Ge tumor group. No nodal metastasis in cervical lymph nodes was recognized. Only two patients with Ge tumors had mediastinal lymph node metastases. Incidence of perigastric lymph node metastasis was significantly higher in those with Ge tumors. Ge tumors tended to be staged as progressive disease using the esophageal cancer staging manual rather than the gastric cancer staging manual. Conclusion. Because there are some differences in clinicopathological characteristics, it is thought to be adequate to distinguish type Ge from type G tumor. PMID:23365732

  4. 40 CFR 761.326 - Conducting the comparison study.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Conducting the comparison study. 761.326 Section 761.326 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC...-liquid PCB Remediation Waste Samples § 761.326 Conducting the comparison study. Extract or analyze the...

  5. 40 CFR 761.326 - Conducting the comparison study.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Conducting the comparison study. 761.326 Section 761.326 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC...-liquid PCB Remediation Waste Samples § 761.326 Conducting the comparison study. Extract or analyze the...

  6. 40 CFR 761.326 - Conducting the comparison study.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Conducting the comparison study. 761.326 Section 761.326 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC...-liquid PCB Remediation Waste Samples § 761.326 Conducting the comparison study. Extract or analyze the...

  7. Interrater reliability among epilepsy centers: multicenter study of epilepsy surgery.

    PubMed

    Haut, Sheryl R; Berg, Anne T; Shinnar, Shlomo; Cohen, Hillel W; Bazil, Carl W; Sperling, Michael R; Langfitt, John T; Pacia, Steven V; Walczak, Thaddeus S; Spencer, Susan S

    2002-11-01

    To measure the interrater reliability of presurgical testing and surgical decisions among epilepsy centers. Seven centers participating in an ongoing, prospective multicenter study of resective epilepsy surgery agreed to conform to a detailed protocol regarding presurgical evaluation and surgery. To assess quality assurance, each center independently reviewed 21 randomly selected surgical cases for preoperative study lateralization and localization, and surgical decisions. Interrater reliability was assessed by using intraclass correlation coefficients (ICCs), validated for use with multiple raters, and calculated in a two-way random model based on absolute agreement. Agreement for ICC values: > or = 0.75, excellent; 0.60-0.74, good; 0.40-0.59, fair; < or = 0.39, poor. One center was excluded for missing data. Agreement was excellent for extracranial EEG lateralization (0.8039), magnetic resonance imaging (MRI) lateralization (0.9521) and localization (0.9130), Wada lateralization (0.9453), and intracranial EEG localization (0.7905). Agreement was good for extracranial EEG localization (0.7384) and neuropsychological testing lateralization (0.7178) and localization (0.6891). Consensus about the decision to perform intracranial monitoring was fair (0.5397), in part reflecting one center's tendency toward intracranial monitoring. Overall agreements on whether to perform surgery (0.8311) and specific surgery recommended (0.8164) were excellent. High interrater reliability among six epilepsy centers was present for interpretation of most components of presurgical testing. Although consensus for the decision to perform intracranial monitoring was only fair, agreements for the ultimate decision about resective surgery and specific choice of resection were excellent. We believe that this study demonstrates the feasibility of implementing multicenter protocols for neurologic management, especially those involving localization, as well as protocols combining study results

  8. A Comparative Study of Leadership Characteristics of Virginia Regional Technical Center Principals

    ERIC Educational Resources Information Center

    Davis, Bernard Trey S., III

    2015-01-01

    The purpose of this study was to identify leadership characteristics of technical school principals as perceived by technical center school principals, the superintendents, and the center's Joint Control Board of the regional technical centers of the Commonwealth of Virginia. A regional technical center principal position deals with a different…

  9. Study of a conceptual nuclear energy center at Green River, Utah. Power demand, load center assessment and transmission

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Smith, D.R.; Thaik, A.; Pingel, P.

    This document constitutes a segment of a feasibility study investigating the ramification of constructing a nuclear energy center in an arid western region. In this phase of the study. The projected power demands and load center locations were reviewed and assessed. Alternative transmission systems were analysed and a conceptual transmission for bulk power transportation is proposed with potential line routes. Environmental impacts of the proposed transmission were also identified.

  10. 21st Century Community Learning Centers Descriptive Study of Program Practices

    ERIC Educational Resources Information Center

    Penuel, William R.; McGhee, Raymond, Jr.

    2010-01-01

    In 2004, the U.S. Department of Education's Policy and Program Studies Service contracted with SRI International and its partner, Policy Studies Associates, to undertake an evaluation of the 21st Century Community Learning Centers. The following evaluation questions informed this study: (1) What is the nature of activities in centers that are…

  11. The Poynter Center for the Study of Ethics and American Institutions.

    ERIC Educational Resources Information Center

    Granbois, Judith A.

    1994-01-01

    Describes the background and activities of the Poynter Center for the Study of Ethics and American Institutions at Indiana University. Maintains that the center's programs focus on topics such as ethics and the professions, medical ethics, research ethics, and religion and the morality of professions. Provides a list of center publications. (CFR)

  12. A comparison of center-based vs. home-based daily hemodialysis for patients with end-stage renal disease.

    PubMed

    Kraus, Michael; Burkart, John; Hegeman, Rebecca; Solomon, Richard; Coplon, Norman; Moran, John

    2007-10-01

    Home hemodialysis has been a therapeutic option for almost 4 decades. The complexity of dialysis equipment has been a factor-limiting adoption of this modality. We performed a feasibility study to demonstrate the safety of center-based vs. home-based daily hemodialysis with the NxStage System One portable hemodialysis device. We also performed a retrospective analysis to determine if clinical effects previously associated with short-daily dialysis were also seen using this novel device. We conducted a prospective, 2-treatment, 2-period, open-label, crossover study of in-center hemodialysis vs. home hemodialysis in 32 patients treated at 6 U.S. centers. The 8-week In-Center Phase (6 days/week) was followed by a 2-week transition period and then followed by the 8-week Home Phase (6 days/week). We retrospectively collected data on hemodialysis treatment parameters immediately preceding the study in a subset of patients. Twenty-six out of 32 patients (81%) successfully completed the study. Successful delivery of at least 90% of prescribed fluid volume (primary endpoint) was achieved in 98.5% of treatments in-center and 97.3% at home. Total effluent volume as a percentage of prescribed volume was between 94% and 100% for all study weeks. The composite rate of intradialytic and interdialytic adverse events per 100 treatments was significantly higher for the In-Center Phase (5.30) compared with the Home Phase (2.10; p=0.007). Compared with the period immediately preceding the study, there were reductions in blood pressure, antihypertensive medications, and interdialytic weight gain. Daily home hemodialysis with a small, easy-to-use hemodialysis device is a viable dialysis option for end-stage renal disease patients capable of self/partner-administered dialysis.

  13. A Comparison of Delivery Formats to Encourage Student-Centered Learning in a Power Engineering Technology Course

    ERIC Educational Resources Information Center

    Turner, Mathew J.; Webster, Rustin D.

    2017-01-01

    This paper describes a student-centered approach to a power engineering technology course using the flipped or inverted classroom as well as active learning in the form of group discussions and team problem solving. The study compares student performance and perceptions of a traditional, teaching-centered classroom to two different flipped…

  14. Multi-vendor reliability of arterial spin labeling perfusion MRI using a near-identical sequence: implications for multi-center studies.

    PubMed

    Mutsaerts, Henri J M M; van Osch, Matthias J P; Zelaya, Fernando O; Wang, Danny J J; Nordhøy, Wibeke; Wang, Yi; Wastling, Stephen; Fernandez-Seara, Maria A; Petersen, E T; Pizzini, Francesca B; Fallatah, Sameeha; Hendrikse, Jeroen; Geier, Oliver; Günther, Matthias; Golay, Xavier; Nederveen, Aart J; Bjørnerud, Atle; Groote, Inge R

    2015-06-01

    A main obstacle that impedes standardized clinical and research applications of arterial spin labeling (ASL), is the substantial differences between the commercial implementations of ASL from major MRI vendors. In this study, we compare a single identical 2D gradient-echo EPI pseudo-continuous ASL (PCASL) sequence implemented on 3T scanners from three vendors (General Electric Healthcare, Philips Healthcare and Siemens Healthcare) within the same center and with the same subjects. Fourteen healthy volunteers (50% male, age 26.4±4.7years) were scanned twice on each scanner in an interleaved manner within 3h. Because of differences in gradient and coil specifications, two separate studies were performed with slightly different sequence parameters, with one scanner used across both studies for comparison. Reproducibility was evaluated by means of quantitative cerebral blood flow (CBF) agreement and inter-session variation, both on a region-of-interest (ROI) and voxel level. In addition, a qualitative similarity comparison of the CBF maps was performed by three experienced neuro-radiologists. There were no CBF differences between vendors in study 1 (p>0.1), but there were CBF differences of 2-19% between vendors in study 2 (p<0.001 in most gray matter ROIs) and 10-22% difference in CBF values obtained with the same vendor between studies (p<0.001 in most gray matter ROIs). The inter-vendor inter-session variation was not significantly larger than the intra-vendor variation in all (p>0.1) but one of the ROIs (p<0.001). This study demonstrates the possibility to acquire comparable cerebral CBF maps on scanners of different vendors. Small differences in sequence parameters can have a larger effect on the reproducibility of ASL than hardware or software differences between vendors. These results suggest that researchers should strive to employ identical labeling and readout strategies in multi-center ASL studies. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. The evolutionary pathway from anoxygenic to oxygenic photosynthesis examined by comparison of the properties of photosystem II and bacterial reaction centers.

    PubMed

    Allen, J P; Williams, J C

    2011-01-01

    In photosynthetic organisms, such as purple bacteria, cyanobacteria, and plants, light is captured and converted into energy to create energy-rich compounds. The primary process of energy conversion involves the transfer of electrons from an excited donor molecule to a series of electron acceptors in pigment-protein complexes. Two of these complexes, the bacterial reaction center and photosystem II, are evolutionarily related and structurally similar. However, only photosystem II is capable of performing the unique reaction of water oxidation. An understanding of the evolutionary process that lead to the development of oxygenic photosynthesis can be found by comparison of these two complexes. In this review, we summarize how insight is being gained by examination of the differences in critical functional properties of these complexes and by experimental efforts to alter pigment-protein interactions of the bacterial reaction center in order to enable it to perform reactions, such as amino acid and metal oxidation, observable in photosystem II.

  16. The Center for the Study of Terrestrial and Extraterrestrial Atmospheres (CSTEA)

    NASA Technical Reports Server (NTRS)

    Thorpe, Arthur N.; Morris, Vernon R.

    1997-01-01

    The Center for the Study of Terrestrial and Extraterrestrial Atmospheres (CSTEA) was established in 1992. The center began with 14 active Principal Investigators (PI's). The research of the Center's PIs has, for the most part, continued in the same four areas as presented in the original proposal: Remote Sensing, Atmospheric Chemistry, Sensors and Detectors, and Spacecraft Dynamics.

  17. Off-Campus Study Centers for Federal Employees, Fiscal Year 1969.

    ERIC Educational Resources Information Center

    Civil Service Commission, Washington, DC. Bureau of Training.

    One of three major training and educational resource publications from the Civil Service Commission, this directory provides information on individual off campus study centers for Federal Employees. Numbers of centers and participants are tabulated by agency and by state or other geographic location. Cooperating institutions, programs or course…

  18. A Study of Flood Evacuation Center Using GIS and Remote Sensing Technique

    NASA Astrophysics Data System (ADS)

    Mustaffa, A. A.; Rosli, M. F.; Abustan, M. S.; Adib, R.; Rosli, M. I.; Masiri, K.; Saifullizan, B.

    2016-07-01

    This research demonstrated the use of Remote Sensing technique and GIS to determine the suitability of an evacuation center. This study was conducted in Batu Pahat areas that always hit by a series of flood. The data of Digital Elevation Model (DEM) was obtained by ASTER database that has been used to delineate extract contour line and elevation. Landsat 8 image was used for classification purposes such as land use map. Remote Sensing incorporate with GIS techniques was used to determined the suitability location of the evacuation center from contour map of flood affected areas in Batu Pahat. GIS will calculate the elevation of the area and information about the country of the area, the road access and percentage of the affected area. The flood affected area map may provide the suitability of the flood evacuation center during the several levels of flood. The suitability of evacuation centers can be determined based on several criteria and the existing data of the evacuation center will be analysed. From the analysis among 16 evacuation center listed, there are only 8 evacuation center suitable for the usage during emergency situation. The suitability analysis was based on the location and the road access of the evacuation center toward the flood affected area. There are 10 new locations with suitable criteria of evacuation center proposed on the study area to facilitate the process of rescue and evacuating flood victims to much safer and suitable locations. The results of this study will help in decision making processes and indirectly will help organization such as fire-fighter and the Department of Social Welfare in their work. Thus, this study can contribute more towards the society.

  19. The NASA Lewis Research Center: An Economic Impact Study

    NASA Technical Reports Server (NTRS)

    Austrian, Ziona

    1996-01-01

    The NASA Lewis Research Center (LeRC), established in 1941, is one of ten NASA research centers in the country. It is situated on 350 acres of land in Cuyahoga County and occupies more than 140 buildings and over 500 specialized research and test facilities. Most of LeRC's facilities are located in the City of Cleveland; some are located within the boundaries of the cities of Fairview Park and Brookpark. LeRC is a lead center for NASA's research, technology, and development in the areas of aeropropulsion and selected space applications. It is a center of excellence for turbomachinery, microgravity fluid and combustion research, and commercial communication. The base research and technology disciplines which serve both aeronautics and space areas include materials and structures, instrumentation and controls, fluid physics, electronics, and computational fluid dynamics. This study investigates LeRC's economic impact on Northeast Ohio's economy. It was conducted by The Urban Center's Economic Development Program in Cleveland State University's Levin College of Urban Affairs. The study measures LeRC's direct impact on the local economy in terms of jobs, output, payroll, and taxes, as well as the indirect impact of these economic activities when they 'ripple' throughout the economy. To fully explain LeRC's overall impact on the region, its contributions in the areas of technology transfer and education are also examined. The study uses a highly credible and widely accepted research methodology. First, regional economic multipliers based on input-output models were used to estimate the effect of LERC spending on the Northeast Ohio economy. Second, the economic models were complemented by interviews with industrial, civic, and university leaders to qualitatively assess LeRC's impact in the areas of technology transfer and education.

  20. Comparison of arterial spin labeling registration strategies in the multi-center GENetic frontotemporal dementia initiative (GENFI).

    PubMed

    Mutsaerts, Henri J M M; Petr, Jan; Thomas, David L; De Vita, Enrico; Cash, David M; van Osch, Matthias J P; Golay, Xavier; Groot, Paul F C; Ourselin, Sebastien; van Swieten, John; Laforce, Robert; Tagliavini, Fabrizio; Borroni, Barbara; Galimberti, Daniela; Rowe, James B; Graff, Caroline; Pizzini, Francesca B; Finger, Elizabeth; Sorbi, Sandro; Castelo Branco, Miguel; Rohrer, Jonathan D; Masellis, Mario; MacIntosh, Bradley J

    2018-01-01

    To compare registration strategies to align arterial spin labeling (ASL) with 3D T1-weighted (T1w) images, with the goal of reducing the between-subject variability of cerebral blood flow (CBF) images. Multi-center 3T ASL data were collected at eight sites with four different sequences in the multi-center GENetic Frontotemporal dementia Initiative (GENFI) study. In a total of 48 healthy controls, we compared the following image registration options: (I) which images to use for registration (perfusion-weighted images [PWI] to the segmented gray matter (GM) probability map (pGM) (CBF-pGM) or M0 to T1w (M0-T1w); (II) which transformation to use (rigid-body or non-rigid); and (III) whether to mask or not (no masking, M0-based FMRIB software library Brain Extraction Tool [BET] masking). In addition to visual comparison, we quantified image similarity using the Pearson correlation coefficient (CC), and used the Mann-Whitney U rank sum test. CBF-pGM outperformed M0-T1w (CC improvement 47.2% ± 22.0%; P < 0.001), and the non-rigid transformation outperformed rigid-body (20.6% ± 5.3%; P < 0.001). Masking only improved the M0-T1w rigid-body registration (14.5% ± 15.5%; P = 0.007). The choice of image registration strategy impacts ASL group analyses. The non-rigid transformation is promising but requires validation. CBF-pGM rigid-body registration without masking can be used as a default strategy. In patients with expansive perfusion deficits, M0-T1w may outperform CBF-pGM in sequences with high effective spatial resolution. BET-masking only improves M0-T1w registration when the M0 image has sufficient contrast. 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:131-140. © 2017 International Society for Magnetic Resonance in Medicine.

  1. Teacher Curriculum Work Center: A Descriptive Study.

    ERIC Educational Resources Information Center

    Feiman, Sharon

    This monograph is one of a continuing series initiated to provide materials for teachers, parents, school administrators, and governmental decision-makers that might encourage reexamination of a range of evaluation issues and perspectives about schools and schooling. This monograph is a descriptive study of the Teacher Curriculum Work Center,…

  2. Evaluation of Participant Needs in a Regional Center for Security Studies

    ERIC Educational Resources Information Center

    Schmoker, Oliver E., III.

    2009-01-01

    This research study was implemented within the subject headquarters of a regional center, an organization responsible for security cooperation in Europe and Eurasia. The focus of the study was the center's program of security education. This program was designed to support evolving security objectives of foreign countries in order to increase the…

  3. Learning Center and Study Carrels: A Comparative Study. Technical Report #18.

    ERIC Educational Resources Information Center

    Chun, Sherlyn; And Others

    This Kamehameha Early Education Program (KEEP) report presents a comparative study of the work rates of kindergarten and first grade children in two classroom environments: a learning-center and a study-carrel environment. The subjects, seven matched pairs of kindergarten and first grade students, were chosen on the basis of the results of a…

  4. Autism Center First to Study Minimally Verbal Children

    MedlinePlus

    ... on. Feature: Taste, Smell, Hearing, Language, Voice, Balance Autism Center First to Study Minimally Verbal Children Past ... research exploring the causes, diagnosis, and treatment of autism spectrum disorder (ASD), a complex developmental disorder that ...

  5. Which sexual abuse victims receive a forensic medical examination? The impact of Children's Advocacy Centers.

    PubMed

    Walsh, Wendy A; Cross, Theodore P; Jones, Lisa M; Simone, Monique; Kolko, David J

    2007-10-01

    This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of Children's Advocacy Centers, which evaluated four CACs relative to within-state non-CAC comparison communities. Case abstractors collected data on forensic medical exams in 1,220 child sexual abuse cases through review of case records. Suspected sexual abuse victims at CACs were two times more likely to have forensic medical examinations than those seen at comparison communities, controlling for other variables. Girls, children with reported penetration, victims who were physically injured while being abused, White victims, and younger children were more likely to have exams, controlling for other variables. Non-penetration cases at CACs were four times more likely to receive exams as compared to those in comparison communities. About half of exams were conducted the same day as the reported abuse in both CAC and comparison communities. The majority of caregivers were very satisfied with the medical professional. Receipt of a medical exam was not associated with offenders being charged. Results of this study suggest that CACs are an effective tool for furthering access to forensic medical examinations for child sexual abuse victims.

  6. Anterior center-edge angle on sagittal CT: a comparison of normal hips to dysplastic hips.

    PubMed

    Monazzam, Shafagh; Williams, Karly Ann; Shelton, Trevor J; Calafi, Arash; Haus, Brian M

    2018-05-01

    The anterior center-edge angle (ACEA) describes anterior acetabular coverage on false profile radiographs. Variability associated with pelvic tilt, radiographic projection, and identifying the true anterior edge, causes discrepancies in measuring an accurate ACEA. Computed tomography (CT) has the potential of improving the accuracy of ACEA. However, because the ACEA on sagittal CT has been shown to not be equivalent to ACEA on false profile radiographs, the normal range of ACEA on CT currently remains unknown and cannot reliably be used to determine over/under coverage. We therefore asked: what is the normal variation of ACEA corrected for pelvic tilt on sagittal CT and how does this compare to dysplastic hips? A retrospective review was conducted on patients 10-35 who underwent CT for non-orthopedic related issues and patients with known hip dysplasia. The ACEA was measured on a sagittal slice corresponding to the center of the femoral head on the axial slice and adjusted for pelvic tilt. A statistical comparison was then performed. A total of 320 normal patients and 22 patients with hip dysplasia were reviewed. The mean ACEA for all ages was 50° ± 8°, (range: 23-81º), with a larger mean ACEA for males (51°) than females (49°). The ACEA mean for dysplastic hips was 30° ± 11° with a statistically significant difference in mean from the normal hip group ( p < 0.0001). The ACEA can be reliably measured on sagittal CT and significantly differs from dysplastic hips. ACEA measurements above 66° or below 34° may represent anterior over and under coverage.

  7. Comparison of Sofia Legionella FIA and BinaxNOW® Legionella urinary antigen card in two national reference centers.

    PubMed

    Beraud, L; Gervasoni, K; Freydiere, A M; Descours, G; Ranc, A G; Vandenesch, F; Lina, G; Gaia, V; Jarraud, S

    2015-09-01

    The Sofia Legionella Fluorescence Immunoassay (FIA; Quidel) is a recently introduced rapid immunochromatographic diagnostic test for Legionnaires' disease using immunofluorescence technology designed to enhance its sensitivity. The aim of this study was to evaluate its performance for the detection of urinary antigens for Legionella pneumophila serogroup 1 in two National Reference Centers for Legionella. The sensitivity and specificity of the Sofia Legionella FIA test were determined in concentrated and nonconcentrated urine samples, before and after boiling, in comparison with the BinaxNOW® Legionella Urinary Antigen Card (UAC; Alere). Compared with BinaxNOW® Legionella UAC, the sensitivity of the Sofia Legionella test was slightly higher in nonconcentrated urine samples and was identical in concentrated urine samples. The specificity of the Sofia Legionella FIA test was highly reduced by the concentration of urine samples. In nonconcentrated samples, a lack of specificity was observed in 2.3 % of samples, all of them resolved by heat treatment. The Sofia Legionella FIA is a sensitive test for detecting Legionella urinary antigens with no previous urine concentration. However, all positive samples have to be re-tested after boiling to reach a high specificity. The reading is automatized on the Sofia analyzer, which can be connected to laboratory information systems, facilitating accurate and rapid reporting of results.

  8. A Holistic Emphasis: The UCLA American Indian Studies Research Center.

    ERIC Educational Resources Information Center

    Champagne, Duane

    2001-01-01

    At UCLA, the American Indian Studies Center's structure as an organized research unit allows a platform for many activities not normally within the purview of departments. The Center implements a holistic, Native view of research, policy, community engagement, and education; has a library and publications; and is a gathering place for American…

  9. Environmental Studies. Plano Outdoor Learning Center.

    ERIC Educational Resources Information Center

    Plano Independent School District, TX.

    This curriculum guide for the Plano Intermediate School District (Texas) Outdoor Learning Center is divided into three major sections. Section I provides information on the numbered stations/posts found along the perimeter and inner trails of the center and includes brief comments on the philosophy of environmental education and the history…

  10. Comparison of Acute Ischemic Stroke Care and Outcomes Between Comprehensive Stroke Centers and Primary Stroke Centers in the United States.

    PubMed

    Man, Shumei; Zhao, Xin; Uchino, Ken; Hussain, M Shazam; Smith, Eric E; Bhatt, Deepak L; Xian, Ying; Schwamm, Lee H; Shah, Shreyansh; Khan, Yosef; Fonarow, Gregg C

    2018-06-01

    To improve stroke care, the Brain Attack Coalition recommended establishing primary stroke center (PSC) and comprehensive stroke center (CSC) certification. This study aimed to compare ischemic stroke care and in-hospital outcomes between CSCs and PSCs. We analyzed patients with acute ischemic stroke who were hospitalized at stroke centers participating in Get With The Guidelines-Stroke from 2013 to 2015. Multivariable logistic regression models were generated to examine the association between stroke center certification (CSC versus PSC) and performances and outcomes. This study included 722 941 patients who were admitted to 134 CSCs and 1047 PSCs. Both CSCs and PSCs had good conformity to 7 performance measures and the summary defect-free care measure. Among emergency department admissions, CSCs had higher intravenous tPA (tissue-type plasminogen activator) and endovascular thrombectomy rates than PSCs (14.3% versus 10.3%, 4.1% versus 1.0%, respectively). Door to intravenous tPA time was shorter at CSCs (median, 52 versus 61 minutes; adjusted risk ratio, 0.92; 95% confidence interval, 0.89-0.95). More patients at CSCs had door to intravenous tPA time ≤60 minutes (79.7% versus 65.1%; adjusted odds ratio, 1.48; 95% confidence interval, 1.25-1.75). For transferred patients, CSCs and PSCs had comparable overall performance in defect-free care, except higher endovascular thrombectomy therapy rates. The overall in-hospital mortality was higher at CSCs in both emergency department admissions (4.6% versus 3.8%; adjusted odds ratio, 1.14; 95% confidence interval, 1.01-1.29) and transferred patients (7.7% versus 6.8%; adjusted odds ratio, 1.17; 95% confidence interval, 1.05-1.32). In-hospital outcomes were comparable between CSCs and PSCs in patients who received intravenous tPA or endovascular thrombectomy. CSCs and PSCs achieved similar overall care quality for patients with acute ischemic stroke. CSCs exceeded PSCs in timely acute reperfusion therapy for emergency

  11. Addressing underutilization of consumer health information resource centers: a formative study.

    PubMed

    Kennedy, May G; Kiken, Laura; Shipman, Jean P

    2008-01-01

    Four consumer health information centers in Richmond, Virginia, provide one-on-one assistance in accessing health information. Because they may not be fully utilized at present, an exploratory marketing study of factors affecting usage of the centers was conducted. Observers counted center passers-by and tracked their paths. Also, brief intercept interviews were conducted with people who had just used a center, people nearby who could have used one but did not, and people on the street. Finally, in-depth individual interviews were conducted with key informants. There was a high degree of satisfaction with the centers among users. Nonusers universally endorsed the center concept. However, most passers-by did not even glance at the centers, and intercept interviewees suggested better signage and promoting the resource centers through various media channels. Key informants added suggestions about interpersonal strategies (e.g., physician referrals) for center usage promotion but cautioned that a large increase in traffic could not be accommodated without increasing staff size or shifting from a model of individualized service. Triangulating findings from multiple data collection methods can provide useful guidance for efforts to promote center utilization. At minimum, steps should be taken to make the largest centers more noticeable. Because center utilization is not only associated with consumer satisfaction with hospitals, but may also foster health literacy, both hospital-based and community-based usage promotion strategies may be warranted. All such promotional strategies should be audience-tested before they are adopted.

  12. Critical thinking in patient centered care.

    PubMed

    Mitchell, Shannon H; Overman, Pamela; Forrest, Jane L

    2014-06-01

    Health care providers can enhance their critical thinking skills, essential to providing patient centered care, by use of motivational interviewing and evidence-based decision making techniques. The need for critical thinking skills to foster optimal patient centered care is being emphasized in educational curricula for health care professions. The theme of this paper is that evidence-based decision making (EBDM) and motivational interviewing (MI) are tools that when taught in health professions educational programs can aid in the development of critical thinking skills. This paper reviews the MI and EBDM literature for evidence regarding these patient-centered care techniques as they relate to improved oral health outcomes. Comparisons between critical thinking and EBDM skills are presented and the EBDM model and the MI technique are briefly described followed by a discussion of the research to date. The evidence suggests that EBDM and MI are valuable tools; however, further studies are needed regarding the effectiveness of EBDM and MI and the ways that health care providers can best develop critical thinking skills to facilitate improved patient care outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study.

    PubMed

    Cnossen, Maryse C; Polinder, Suzanne; Lingsma, Hester F; Maas, Andrew I R; Menon, David; Steyerberg, Ewout W

    2016-01-01

    The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches.

  14. How is Family Centered Care Perceived by Healthcare Providers from Different Countries? An International Comparison Study.

    PubMed

    Feeg, Veronica D; Paraszczuk, Ann Marie; Çavuşoğlu, Hicran; Shields, Linda; Pars, Hatice; Al Mamun, Abdullah

    2016-01-01

    Family-centered care (FCC) is a healthcare delivery model in which planning care for a child incorporates the entire family. The purpose of this study was to describe and compare how healthcare providers from three countries with varied cultural and healthcare systems perceive the concept FCC by measuring attitudes, and to psychometrically identify a measure that would reflect "family-centeredness." The Working with Families questionnaire, translated when appropriate, was used to capture participants' perceptions of caring for hospitalized children and their parents from pediatric healthcare providers in the United States, Australia and Turkey (n=476). The results indicated significantly more positive attitudes reported for working with children than parents for all countries and individual score differences across countries: the U.S. and Turkey child scores were significantly higher than Australia, whereas the U.S. and Australia parent scores were both significantly higher than Turkey. Perceptions of working with families were different for nurses from the three countries that call for a clearer understanding about perceptions in relation to delivery systems. Further analyses revealed FCS scores to be significantly different between nurses and physicians and significantly correlated with age, number of children and education. The results of this study add to our understanding of influences on practice from different countries and healthcare systems. The FCS score may be useful to determine baseline beliefs and ascertain effectiveness of interventions designed to improve FCC implementation. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Finding the Center of Volume of the Forearm

    NASA Astrophysics Data System (ADS)

    Klein, Stacy S.; Roselli, Robert J.

    2008-04-01

    A typical first-year physics course teaches students about the center of mass using both regular and irregularly shaped objects. Students often suspend an object in each of two dimensions from a string with the intersection determining the center of mass of the object. While these methods can be effective, they are not particularly exciting or motivating. Wouldn't it be more interesting to find the center of mass of a body part, such as the forearm? Through a series of simple measurements and assumptions, students can generate a first-order approximation of the center of volume and center of mass of their forearm. Comparisons can be made between the muscular forearm of the football player in the class with the scrawniest arm in the room, creating a deeper understanding of center of mass and how it relates to the human body.

  16. The Teaching of Afro-Asian Literature: A Comparison between the Nonconventional Learner-Centered and the Conventional Teacher-Centered Approaches

    ERIC Educational Resources Information Center

    Wong Gonzales, Wilkinson Daniel O.

    2014-01-01

    In the past few decades, nonconventional learner-centered (NLC) trends in ELT have emerged amidst the current and probably dominant conventional teacher-centered (CTC) approaches used by majority of private and public schools in the Philippines. With the implementation of the K-12 curriculum, Afro-Asian literature remained the focus of the eighth…

  17. Western Fisheries Research Center--Forage fish studies in Puget Sound

    USGS Publications Warehouse

    Liedtke, Theresa L.

    2012-01-01

    Researchers at the Western Fisheries Research Center are working with other U.S. Geological Survey (USGS) Centers to better understand the interconnected roles of forage fishes throughout the ecosystem of Puget Sound, Washington. Support for these studies primarily is from the USGS Coastal Habitats in Puget Sound (CHIPS) program, which supports studies of the nearshore areas of Puget Sound. Human perturbations in the nearshore area such as shoreline armoring or urban development can affect the nearshore habitats critical to forage fish.

  18. 34 CFR 413.33 - What substantive studies must the National Center or Centers conduct and submit?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Secretary of Labor, the Secretary of Health and Human Services, the Committee on Labor and Human Resources... apprenticeship or mentoring approaches. (b) The National Center conducting dissemination and training activities shall annually prepare a study of its dissemination and training activities. (c) Annual studies...

  19. Addressing underutilization of consumer health information resource centers: a formative study*

    PubMed Central

    Kennedy, May G.; Kiken, Laura; Shipman, Jean P.

    2008-01-01

    Problem: Four consumer health information centers in Richmond, Virginia, provide one-on-one assistance in accessing health information. Because they may not be fully utilized at present, an exploratory marketing study of factors affecting usage of the centers was conducted. Method: Observers counted center passers-by and tracked their paths. Also, brief intercept interviews were conducted with people who had just used a center, people nearby who could have used one but did not, and people on the street. Finally, in-depth individual interviews were conducted with key informants. Results: There was a high degree of satisfaction with the centers among users. Nonusers universally endorsed the center concept. However, most passers-by did not even glance at the centers, and intercept interviewees suggested better signage and promoting the resource centers through various media channels. Key informants added suggestions about interpersonal strategies (e.g., physician referrals) for center usage promotion but cautioned that a large increase in traffic could not be accommodated without increasing staff size or shifting from a model of individualized service. Conclusions: Triangulating findings from multiple data collection methods can provide useful guidance for efforts to promote center utilization. At minimum, steps should be taken to make the largest centers more noticeable. Because center utilization is not only associated with consumer satisfaction with hospitals, but may also foster health literacy, both hospital-based and community-based usage promotion strategies may be warranted. All such promotional strategies should be audience-tested before they are adopted. PMID:18219380

  20. The NASA-Ames Research Center stratospheric aerosol model. 2. Sensitivity studies and comparison with observatories

    NASA Technical Reports Server (NTRS)

    Toon, O. B.; Turco, R. P.; Hamill, P.; Kiang, C. S.; Whitten, R. C.

    1979-01-01

    Sensitivity tests were performed on a one-dimensional, physical-chemical model of the unperturbed stratospheric aerosols, and model calculations were compared with observations. The tests and comparisons suggest that coagulation controls the particle number mixing ratio, although the number of condensation nuclei at the tropopause and the diffusion coefficient at high altitudes are also important. The sulfur gas source strength and the aerosol residence time are much more important than the supply of condensation nuclei in establishing mass and large particle concentrations. The particle size is also controlled mainly by gas supply and residence time. In situ observations of the aerosols and laboratory measurements of aerosols, parameters that can provide further information about the physics and chemistry of the stratosphere and the aerosols found there are provided.

  1. Staff retention after the privatization of township-village health centers: a case study from the Haimen City of East China.

    PubMed

    Huang, Jiayan; Shi, Lu; Chen, Yingyao

    2013-04-12

    Township-village health centers in rural areas play an important role in health service system in China. In East China's Jiangsu Province, the City of Haimen privatized all 25 township-village health centers in 2002. This study assesses the effect of privatization on staff retention among these health centers. This is a retrospective study based on 10-year administrative data from Haimen City. Three waves of administrative data were collected in 2000 (2 years before privatization), 2005 (3 years after privatization) and 2009 (7 years after privatization) for all health care providers in Haimen City, including 3 county hospitals, 6 central township health centers (CTHC) and 25 township-village health centers (TVHC). The effect of privatization on TVHCs' staff retention was evaluated in comparison with the other two types of health care providers. We conducted focus groups with people from Haimen Bureau of Health and various health care providers to help understand the context of these administrative statistics. Each township-village health centers had an average of 40 staff members before the privatization, and the majority of those staff members were their permanent staff. In 2005, three years after the privatization, a substantial amount of staff decrease (from 39.7 staff members per TVHC to 27.5 per TVHC) occurred in these township-village health centers. From 2000 to 2009, the total payroll in TVHCs decreased by almost 29%, while the number of their permanent staff members and nurses decreased by more than 40%. Among the two types of health care providers that did not go through a privatization, those central township health centers had no significant change on their payroll size during this period whereas the county hospitals' average payroll size actually increased by 20%, especially for the number of doctors. In addition, the average salary and caseload in TVHC showed similar decreasing trends from 2000 to 2009, while no such trends can be observed among the

  2. Staff retention after the privatization of township-village health centers: a case study from the Haimen City of East China

    PubMed Central

    2013-01-01

    Background Township-village health centers in rural areas play an important role in health service system in China. In East China’s Jiangsu Province, the City of Haimen privatized all 25 township-village health centers in 2002. This study assesses the effect of privatization on staff retention among these health centers. Methods This is a retrospective study based on 10-year administrative data from Haimen City. Three waves of administrative data were collected in 2000 (2 years before privatization), 2005 (3 years after privatization) and 2009 (7 years after privatization) for all health care providers in Haimen City, including 3 county hospitals, 6 central township health centers (CTHC) and 25 township-village health centers (TVHC). The effect of privatization on TVHCs’ staff retention was evaluated in comparison with the other two types of health care providers. We conducted focus groups with people from Haimen Bureau of Health and various health care providers to help understand the context of these administrative statistics. Results Each township-village health centers had an average of 40 staff members before the privatization, and the majority of those staff members were their permanent staff. In 2005, three years after the privatization, a substantial amount of staff decrease (from 39.7 staff members per TVHC to 27.5 per TVHC) occurred in these township-village health centers. From 2000 to 2009, the total payroll in TVHCs decreased by almost 29%, while the number of their permanent staff members and nurses decreased by more than 40%. Among the two types of health care providers that did not go through a privatization, those central township health centers had no significant change on their payroll size during this period whereas the county hospitals’ average payroll size actually increased by 20%, especially for the number of doctors. In addition, the average salary and caseload in TVHC showed similar decreasing trends from 2000 to 2009, while no

  3. Center for Nonlinear Studies

    Science.gov Websites

    Los Alamos National Laboratory Search Site submit About Mission Business Newsroom Publications Los Innovation in New Mexico Los Alamos Collaboration for Explosives Detection (LACED) SensorNexus Exascale Computing Project (ECP) User Facilities Center for Integrated Nanotechnologies (CINT) Los Alamos Neutron

  4. Using Qualitative Research to Inform Development of Professional Guidelines: A Case Study of the Society of Critical Care Medicine Family-Centered Care Guidelines.

    PubMed

    Coombs, Maureen A; Davidson, Judy E; Nunnally, Mark E; Wickline, Mary A; Curtis, J Randall

    2017-08-01

    To explore the importance, challenges, and opportunities using qualitative research to enhance development of clinical practice guidelines, using recent guidelines for family-centered care in the ICU as an example. In developing the Society of Critical Care Medicine guidelines for family-centered care in the neonatal ICU, PICU, and adult ICU, we developed an innovative adaptation of the Grading of Recommendations, Assessments, Development and Evaluations approach to explicitly incorporate qualitative research. Using Grading of Recommendations, Assessments, Development and Evaluations and the Council of Medical Specialty Societies principles, we conducted a systematic review of qualitative research to establish family-centered domains and outcomes. Thematic analyses were undertaken on study findings and used to support Population, Intervention, Comparison, Outcome question development. We identified and employed three approaches using qualitative research in these guidelines. First, previously published qualitative research was used to identify important domains for the Population, Intervention, Comparison, Outcome questions. Second, this qualitative research was used to identify and prioritize key outcomes to be evaluated. Finally, we used qualitative methods, member checking with patients and families, to validate the process and outcome of the guideline development. In this, a novel report, we provide direction for standardizing the use of qualitative evidence in future guidelines. Recommendations are made to incorporate qualitative literature review and appraisal, include qualitative methodologists in guideline taskforce teams, and develop training for evaluation of qualitative research into guideline development procedures. Effective methods of involving patients and families as members of guideline development represent opportunities for future work.

  5. A comparison of methods and results in recruiting white and black women into reproductive studies: the MMC-PSU cooperative center on reproduction experience.

    PubMed

    Sweet, Stephanie; Legro, Richard S; Coney, PonJola

    2008-07-01

    Establishing a holistic approach for the enrollment of subjects into clinical trials that includes strategies for the recruitment of non-traditional and minority populations has been an elusive task. The existence of such a design, that is understood and embraced by investigators and the target communities, would streamline the current level of commitment of time, energy and resources. This is necessary to successfully encourage individual and community participation in research studies. The Center for Research in Reproduction at Meharry set out to recruit a large number of African American women volunteers of reproductive age into clinical trials. The experience, of recruiting volunteers from the African American community for clinical trials in the Meharry Medical College/Pennsylvania State University (MMC/PSU)'s Cooperative Center for Research in Reproduction at Meharry, is presented.

  6. Restless Leg Syndrome in Different Types of Demyelinating Neuropathies: A Single-Center Pilot Study

    PubMed Central

    Luigetti, Marco; Del Grande, Alessandra; Testani, Elisa; Bisogni, Giulia; Losurdo, Anna; Giannantoni, Nadia Mariagrazia; Mazza, Salvatore; Sabatelli, Mario; Della Marca, Giacomo

    2013-01-01

    Objective: to determine the prevalence of restless legs syndrome (RLS) in a cohort of patients with demyelinating neuropathies. Methods: Patients were retrospectively recruited from our cohort of different forms of demyelinating neuropathies, including chronic inflammatory demyelinating neuropathy (CIDP), Charcot-Marie-Tooth 1A (CMT1A), and hereditary neuropathy with liability to pressure palsies (HNPP) referred to our Department of Neurology in a 10-year period. The validated 4-item RLS questionnaire was used for diagnosis of RLS. All patients with RLS who fulfilled criteria underwent a suggested immobilization test to confirm the diagnosis. A group of outpatients referred to the sleep disorders unit and data from published literature were used as controls. Results: Prevalence of RLS in demyelinating neuropathy group was higher than prevalence observed in control population (p = 0.0142) or in the literature data (p = 0.0007). In particular, in comparison with both control population and literature data, prevalence of RLS was higher in CIDP group (p = 0.0266 and p = 0.0063, respectively) and in CMT1A group (p = 0.0312 and p = 0.0105, respectively), but not in HNPP (p = 1.000 and p = 0.9320, respectively). Conclusions: our study confirms a high prevalence of RLS in inflammatory neuropathies as CIDP and, among inherited neuropathies, in CMT1A but not in HNPP. Considering that this is only a small cohort from a single-center retrospective experience, the link between RLS and neuropathy remains uncertain, and larger multicenter studies are probably needed to clarify the real meaning of the association between RLS and neuropathy. Citation: Luigetti M; Del Grande A; Testani E; Bisogni G; Losurdo A; Giannantoni NM; Mazza S; Sabatelli M; Della Marca G. Restless leg syndrome in different types of demyelinating neuropathies: a single-center pilot study. J Clin Sleep Med 2013;9(9):945-949. PMID:23997707

  7. Variable-centered and person-centered approaches to studying Mexican-origin mother-daughter cultural orientation dissonance.

    PubMed

    Bámaca-Colbert, Mayra Y; Gayles, Jochebed G

    2010-11-01

    The overall aim of the current study was to identify the methodological approach and corresponding analytic procedure that best elucidated the associations among Mexican-origin mother-daughter cultural orientation dissonance, family functioning, and adolescent adjustment. To do so, we employed, and compared, two methodological approaches (i.e., variable-centered and person-centered) via four analytic procedures (i.e., difference score, interactive, matched/mismatched grouping, and latent profiles). The sample consisted of 319 girls in the 7th or 10th grade and their mother or mother figure from a large Southwestern, metropolitan area in the US. Family factors were found to be important predictors of adolescent adjustment in all models. Although some findings were similar across all models, overall, findings suggested that the latent profile procedure best elucidated the associations among the variables examined in this study. In addition, associations were present across early and middle adolescents, with a few findings being only present for one group. Implications for using these analytic procedures in studying cultural and family processes are discussed.

  8. The Woodlands Metro Center energy study. Case studies of project planning and design for energy conservation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1980-03-01

    Appendix II of The Woodlands Metro Center Energy Study near Houston consists of the following: Metro Center Program, Conventional Plan Building Prototypes and Detail Parcel Analysis, Energy Plan Building Prototypes, and Energy Plan Detail Parcel Analysis.

  9. Making the Change: From a Teacher-Centered to a Learner-Centered Environment--A Phenomenological Study

    ERIC Educational Resources Information Center

    Roof, Patty L.

    2012-01-01

    Nursing education is calling for transformation in teaching practices which includes learner-centered environments. The purpose of this qualitative phenomenological study was to explore 15 nursing faculty life experiences as they relate to the choice of a learning environment. Participants expressed their life experiences through interview…

  10. Optical wireless communication in data centers

    NASA Astrophysics Data System (ADS)

    Arnon, Shlomi

    2018-01-01

    In the last decade data centers have become a crucial element in modern human society. However, to keep pace with internet data rate growth, new technologies supporting data center should develop. Integration of optical wireless communication (OWC) in data centers is one of the proposed technologies as augmented technology to the fiber network. One implementation of the OWC technology is deployment of optical wireless transceiver on top of the existing cable/fiber network as extension to the top of rack (TOR) switch; in this way, a dynamic and flexible network is created. Optical wireless communication could reduce energy consumption, increase the data rate, reduce the communication latency, increase flexibility and scalability, and reduce maintenance time and cost, in comparison to extra fiber network deployment. In this paper we review up to date literature in the field, propose an implementation scheme of OWC network, discuss ways to reduce energy consumption by parallel link communication and report preliminary measurement result of university data center environment.

  11. Improving Staff Productivity in Mental Health Centers.

    ERIC Educational Resources Information Center

    Southern Regional Education Board, Atlanta, GA.

    This guide is concerned with productivity measurement and improvement in mental health centers, and focuses on the relationship between service outputs and available clinical staff, i.e., staff productivity. Staff productivity measures are described as useful in identifying existing levels of productivity, making comparisons to determine the…

  12. A Comparison of Mental Health Care Systems in Northern and Southern Europe: A Service Mapping Study.

    PubMed

    Sadeniemi, Minna; Almeda, Nerea; Salinas-Pérez, Jose A; Gutiérrez-Colosía, Mencía R; García-Alonso, Carlos; Ala-Nikkola, Taina; Joffe, Grigori; Pirkola, Sami; Wahlbeck, Kristian; Cid, Jordi; Salvador-Carulla, Luis

    2018-05-31

    Mental health services (MHS) have gone through vast changes during the last decades, shifting from hospital to community-based care. Developing the optimal balance and use of resources requires standard comparisons of mental health care systems across countries. This study aimed to compare the structure, personnel resource allocation, and the productivity of the MHS in two benchmark health districts in a Nordic welfare state and a southern European, family-centered country. The study is part of the REFINEMENT (Research on Financing Systems' Effect on the Quality of Mental Health Care) project. The study areas were the Helsinki and Uusimaa region in Finland and the Girona region in Spain. The MHS were mapped by using the DESDE-LTC (Description and Evaluation of Services and Directories for Long Term Care) tool. There were 6.7 times more personnel resources in the MHS in Helsinki and Uusimaa than in Girona. The resource allocation was more residential-service-oriented in Helsinki and Uusimaa. The difference in mental health personnel resources is not explained by the respective differences in the need for MHS among the population. It is important to make a standard comparison of the MHS for supporting policymaking and to ensure equal access to care across European countries.

  13. Helium ions at the heidelberg ion beam therapy center: comparisons between FLUKA Monte Carlo code predictions and dosimetric measurements.

    PubMed

    Tessonnier, T; Mairani, A; Brons, S; Sala, P; Cerutti, F; Ferrari, A; Haberer, T; Debus, J; Parodi, K

    2017-08-01

    In the field of particle therapy helium ion beams could offer an alternative for radiotherapy treatments, owing to their interesting physical and biological properties intermediate between protons and carbon ions. We present in this work the comparisons and validations of the Monte Carlo FLUKA code against in-depth dosimetric measurements acquired at the Heidelberg Ion Beam Therapy Center (HIT). Depth dose distributions in water with and without ripple filter, lateral profiles at different depths in water and a spread-out Bragg peak were investigated. After experimentally-driven tuning of the less known initial beam characteristics in vacuum (beam lateral size and momentum spread) and simulation parameters (water ionization potential), comparisons of depth dose distributions were performed between simulations and measurements, which showed overall good agreement with range differences below 0.1 mm and dose-weighted average dose-differences below 2.3% throughout the entire energy range. Comparisons of lateral dose profiles showed differences in full-width-half-maximum lower than 0.7 mm. Measurements of the spread-out Bragg peak indicated differences with simulations below 1% in the high dose regions and 3% in all other regions, with a range difference less than 0.5 mm. Despite the promising results, some discrepancies between simulations and measurements were observed, particularly at high energies. These differences were attributed to an underestimation of dose contributions from secondary particles at large angles, as seen in a triple Gaussian parametrization of the lateral profiles along the depth. However, the results allowed us to validate FLUKA simulations against measurements, confirming its suitability for 4 He ion beam modeling in preparation of clinical establishment at HIT. Future activities building on this work will include treatment plan comparisons using validated biological models between proton and helium ions, either within a Monte Carlo

  14. Helium ions at the heidelberg ion beam therapy center: comparisons between FLUKA Monte Carlo code predictions and dosimetric measurements

    NASA Astrophysics Data System (ADS)

    Tessonnier, T.; Mairani, A.; Brons, S.; Sala, P.; Cerutti, F.; Ferrari, A.; Haberer, T.; Debus, J.; Parodi, K.

    2017-08-01

    In the field of particle therapy helium ion beams could offer an alternative for radiotherapy treatments, owing to their interesting physical and biological properties intermediate between protons and carbon ions. We present in this work the comparisons and validations of the Monte Carlo FLUKA code against in-depth dosimetric measurements acquired at the Heidelberg Ion Beam Therapy Center (HIT). Depth dose distributions in water with and without ripple filter, lateral profiles at different depths in water and a spread-out Bragg peak were investigated. After experimentally-driven tuning of the less known initial beam characteristics in vacuum (beam lateral size and momentum spread) and simulation parameters (water ionization potential), comparisons of depth dose distributions were performed between simulations and measurements, which showed overall good agreement with range differences below 0.1 mm and dose-weighted average dose-differences below 2.3% throughout the entire energy range. Comparisons of lateral dose profiles showed differences in full-width-half-maximum lower than 0.7 mm. Measurements of the spread-out Bragg peak indicated differences with simulations below 1% in the high dose regions and 3% in all other regions, with a range difference less than 0.5 mm. Despite the promising results, some discrepancies between simulations and measurements were observed, particularly at high energies. These differences were attributed to an underestimation of dose contributions from secondary particles at large angles, as seen in a triple Gaussian parametrization of the lateral profiles along the depth. However, the results allowed us to validate FLUKA simulations against measurements, confirming its suitability for 4He ion beam modeling in preparation of clinical establishment at HIT. Future activities building on this work will include treatment plan comparisons using validated biological models between proton and helium ions, either within a Monte Carlo

  15. Cardiometabolic profiles of adolescents and young adults exposed to the World Trade Center Disaster.

    PubMed

    Trasande, Leonardo; Koshy, Tony T; Gilbert, Joseph; Burdine, Lauren K; Marmor, Michael; Han, Xiaoxia; Shao, Yongzhao; Chemtob, Claude; Attina, Teresa M; Urbina, Elaine M

    2018-01-01

    Few studies have examined the possible cardiometabolic consequences of World Trade Center-related exposures on children who lived and/or attended school near the disaster site. Our objective was to compare cardiometabolic profiles of participants in the World Trade Center Health Registry (WTCHR) with a matched comparison group. We evaluated WTCHR enrollees who resided in New York City and were born between September 11, 1993 and September 10, 2001, and a matched comparison group. We assessed exposure to dust cloud, home dust, as well as traumatic exposure, and associations with blood pressure, arterial wall stiffness, body mass index (BMI), total cholesterol, triglycerides, HDL, and LDL. A total of 402 participants completed the study, 222 in the comparison group and 180 in the WTCHR group. In multivariable regression analysis, after adjusting for relevant confounders we detected a weak association between participation in the WTCHR group and lower BMI (-1.12kg/m 2 , 95% CI -2.11, -0.12; p = 0.03), which became non-significant after adjusting for multiple comparisons. With respect to traumatic and psychosocial exposures, the only association that persisted in our multivariable model, below our predefined level of significance, was between post-traumatic stress disorder and higher BMI (2.06kg/m2, 95% CI 0.37, 3.74; p = 0.02). Our findings do not support an association between self-reported exposures to the WTC disaster and adverse cardiometabolic profile. However, further longitudinal studies may better inform the full extent of WTC-related conditions associated with exposure to the disaster. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Characterization of anthropometric assessment studies of Brazilian children attending daycare centers

    PubMed Central

    Pedraza, Dixis Figueroa; de Menezes, Tarciana Nobre

    2016-01-01

    Abstract Objective: To obtain an overview of available information on the anthropometric assessment of Brazilian children attending daycare centers. Data source: A literature search was carried out in the PubMed, LILACS and SciELO databases of studies published from 1990 to 2013 in Portuguese and English languages. The following search strategy was used: (nutritional status OR anthropometrics OR malnutrition OR overweight) AND daycare centers, as well as the equivalent terms in Portuguese. In the case of MEDLINE search, the descriptor Brazil was also used. Data synthesis: It was verified that the 33 studies included in the review were comparable from a methodological point of view. The studies, in general, were characterized by their restrictive nature, geographical concentration and dispersion of results in relation to time. Considering the studies published from 2010 onwards, low prevalence of acute malnutrition and significant rates of stunting and overweight were observed. Conclusions: Despite the limitations, considering the most recent studies that used the WHO growth curves (2006), it is suggested that the anthropometric profile of Brazilian children attending daycare centers is characterized by a nutritional transition process, with significant prevalence of overweight and short stature. We emphasize the need to develop a multicenter survey that will more accurately define the current anthropometric nutritional status of Brazilian children attending daycare centers. PMID:26553574

  17. A linguistic study of patient-centered interviewing: emergent interactional effects.

    PubMed

    Hesson, Ashley M; Sarinopoulos, Issidoros; Frankel, Richard M; Smith, Robert C

    2012-09-01

    To evaluate interactional effects of patient-centered interviewing (PCI) compared to isolated clinician-centered interviewing (CCI). We conducted a pilot study comparing PCI (N=4) to CCI (N=4) for simulated new-patient visits. We rated interviews independently and measured patient satisfaction with the interaction via a validated questionnaire. We conducted interactional sociolinguistic analysis on the interviews and compared across three levels of analysis: turn, topic, and interaction. We found significant differences between PCI and CCI in physician responses to patients' psychosocial cues and concerns. The number and type of physician questions also differed significantly across PCI and CCI sets. Qualitatively, we noted several indicators of physician-patient attunement in the PCI interviews that were not present in the CCI interviews. They spanned diverse aspects of physician and patient speech, suggesting interactional accommodation on the part of both participants. This small pilot study highlights a variety of interactional variables that may underlie the effects associated with patient-centered interviewing (e.g., positive relationships, health outcomes). Question form, phonological accommodation processes, and use of stylistic markers are relatively unexplored in controlled studies of physician-patient interaction. This study characterizes several interactional variables for larger scale studies and contributes to models of patient-centeredness in practice. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. Reference Charts for Height and Weight of School Children from West Malaysia in Comparison with the United States Centers for Disease Control and Prevention

    PubMed Central

    Bong, YB; Shariff, AA; Majid, AM; Merican, AF

    2012-01-01

    Background: Reference charts are widely used in healthcare as a screening tool. This study aimed to produce reference growth charts for school children from West Malaysia in comparison with the United States Centers for Disease Control and Prevention (CDC) chart. Methods: A total of 14,360 school children ranging from 7 to 17 years old from six states in West Malaysia were collected. A two-stage stratified random sampling technique was used to recruit the subjects. Curves were adjusted using Cole’s LMS method. The LOWESS method was used to smooth the data. Results: The means and standard deviations for height and weight for both genders are presented. The results showed good agreement with growth patterns in other countries, i.e., males tend to be taller and heavier than females for most age groups. Height and weight of females reached a plateau at 17 years of age; however, males were still growing at this age. The growth charts for West Malaysian school children were compared with the CDC 2000 growth charts for school children in the United States. Conclusion: The height and weight for males and females at the start of school-going ages were almost similar. The comparison between the growth charts from this study and the CDC 2000 growth charts indicated that the growth patterns of West Malaysian school children have improved, although the height and weight of American school children were higher than those for West Malaysian school children. PMID:23113132

  19. Prospective randomized comparison of rotational angiography with three-dimensional reconstruction and computed tomography merged with electro-anatomical mapping: a two center atrial fibrillation ablation study.

    PubMed

    Anand, Rishi; Gorev, Maxim V; Poghosyan, Hermine; Pothier, Lindsay; Matkins, John; Kotler, Gregory; Moroz, Sarah; Armstrong, James; Nemtsov, Sergei V; Orlov, Michael V

    2016-08-01

    To compare the efficacy and accuracy of rotational angiography with three-dimensional reconstruction (3DATG) image merged with electro-anatomical mapping (EAM) vs. CT-EAM. A prospective, randomized, parallel, two-center study conducted in 36 patients (25 men, age 65 ± 10 years) undergoing AF ablation (33 % paroxysmal, 67 % persistent) guided by 3DATG (group 1) vs. CT (group 2) image fusion with EAM. 3DATG was performed on the Philips Allura Xper FD 10 system. Procedural characteristics including time, radiation exposure, outcome, and navigation accuracy were compared between two groups. There was no significant difference between the groups in total procedure duration or time spent for various procedural steps. Minor differences in procedural characteristics were present between two centers. Segmentation and fusion time for 3DATG or CT-EAM was short and similar between both centers. Accuracy of navigation guided by either method was high and did not depend on left atrial size. Maintenance of sinus rhythm between the two groups was no different up to 24 months of follow-up. This study did not find superiority of 3DATG-EAM image merge to guide AF ablation when compared to CT-EAM fusion. Both merging techniques result in similar navigation accuracy.

  20. Center for Creative Studies, Detroit

    ERIC Educational Resources Information Center

    AIA Journal, 1976

    1976-01-01

    One of the ten buildings chosen to receive 1976 AIA honor awards, the arts center houses the departments of sculpture, painting, graphics, advertising art, photography, and industrial design. (Author/MLF)

  1. Recovering Physical Activity Missing Data Measured by Accelerometers: A Comparison of Individual and Group-Centered Recovery Methods

    ERIC Educational Resources Information Center

    Zhuang, Jie; Chen, Peijie; Wang, Chao; Jin, Jing; Zhu, Zheng; Zhang, Wenjie

    2013-01-01

    Purpose: The purpose of this study was to determine which method, individual information-centered (IIC) or group information-centered (GIC), is more efficient in recovering missing physical activity (PA) data. Method: A total of 2,758 Chinese children and youth aged 9 to 17 years old (1,438 boys and 1,320 girls) wore ActiGraph GT3X/GT3X+…

  2. The role of CEUS in characterization of superficial lymph nodes: a single center prospective study

    PubMed Central

    de Stefano, Giorgio; Scognamiglio, Umberto; Di Martino, Filomena; Parrella, Roberto; Scarano, Francesco; Signoriello, Giuseppe; Farella, Nunzia

    2016-01-01

    Accurate lymph node characterization is important in a large number of clinical settings. We evaluated the usefulness of Contrast Enhanced Ultrasound (CEUS) in distinguishing between benign and malignant lymph nodes compared with conventional ultrasonography in the differential diagnosis of superficial lymphadenopathy. We present our experience for 111 patients enrolled in a single center. 111 superficial lymph nodes were selected and only 1 lymph node per patient underwent CEUS. A definitive diagnosis for all lymph nodes was obtained by ultrasonographically guided biopsy and/or excision biopsy. The size of the lymph nodes, the site (neck, axilla, inguinal region) being easily accessible for biopsy, and the US and color Doppler US characteristics guided us in selecting the nodes to be evaluated by CEUS. In our study we identified different enhancement patterns in benign and malignant lymph nodes, with a high degree of diagnostic accuracy for superficial lymphadenopathy in comparison with conventional US. PMID:27191746

  3. A Study Identifying the Components of a Quality Child Care Center.

    ERIC Educational Resources Information Center

    Panetta, Sandra J.

    Specific characteristics of a quality day care center are identified through a survey of parents, teachers, and directors utilizing or working in day care centers. The introduction to this descriptive research study offers background information on the history of the child care movement in America and a review of related research projects. A…

  4. Estimating relative risks in multicenter studies with a small number of centers - which methods to use? A simulation study.

    PubMed

    Pedroza, Claudia; Truong, Van Thi Thanh

    2017-11-02

    Analyses of multicenter studies often need to account for center clustering to ensure valid inference. For binary outcomes, it is particularly challenging to properly adjust for center when the number of centers or total sample size is small, or when there are few events per center. Our objective was to evaluate the performance of generalized estimating equation (GEE) log-binomial and Poisson models, generalized linear mixed models (GLMMs) assuming binomial and Poisson distributions, and a Bayesian binomial GLMM to account for center effect in these scenarios. We conducted a simulation study with few centers (≤30) and 50 or fewer subjects per center, using both a randomized controlled trial and an observational study design to estimate relative risk. We compared the GEE and GLMM models with a log-binomial model without adjustment for clustering in terms of bias, root mean square error (RMSE), and coverage. For the Bayesian GLMM, we used informative neutral priors that are skeptical of large treatment effects that are almost never observed in studies of medical interventions. All frequentist methods exhibited little bias, and the RMSE was very similar across the models. The binomial GLMM had poor convergence rates, ranging from 27% to 85%, but performed well otherwise. The results show that both GEE models need to use small sample corrections for robust SEs to achieve proper coverage of 95% CIs. The Bayesian GLMM had similar convergence rates but resulted in slightly more biased estimates for the smallest sample sizes. However, it had the smallest RMSE and good coverage across all scenarios. These results were very similar for both study designs. For the analyses of multicenter studies with a binary outcome and few centers, we recommend adjustment for center with either a GEE log-binomial or Poisson model with appropriate small sample corrections or a Bayesian binomial GLMM with informative priors.

  5. Economic analysis of centralized vs. decentralized electronic data capture in multi-center clinical studies.

    PubMed

    Walden, Anita; Nahm, Meredith; Barnett, M Edwina; Conde, Jose G; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E; Eisenstein, Eric L

    2011-01-01

    New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs.

  6. Case studies of individualized professional development at an outdoor education center

    NASA Astrophysics Data System (ADS)

    Pearsall, Marjorie

    various activities and lessons while at the center, and the assessment of the student's learning following the experience. The staff works with each teacher to prepare them to use transdisciplinary science lessons which were planned to satisfy and enrich state, district, and school expectations (Outdoor Education Guidebook, 1997). The staff members believe that if the teachers are prepared to do these things, not only will the current students learn more, but that the teacher will experience growth professionally and this will impact more children over time. The teachers gain science content knowledge and learn constructivist teaching strategies while learning how to use the facilities and equipment safely and confidently. Ideas for preparatory and follow-up activities are made available. This study looked closely at the individualization of the professional development provided by this informal science institution. Data from observations of professional development sessions as well as the on-site experiences with the children were used in the study. Teachers were asked to reflect on the degree to which the Arlington Echo approach to professional development was beneficial in building their confidence about providing science-based, interdisciplinary experiences for their students, with comparisons made between the responses of veteran teachers and those of teachers with fewer years of experience. Through the reflections of the participant teachers, it was possible to gather data about whether their beliefs about science and about how science is best taught were modified by this experience.

  7. Meeting the Expectations of the Social Studies Teacher at a Teacher Center.

    ERIC Educational Resources Information Center

    Schober, Helen

    1984-01-01

    Teacher centers respond to a teacher's own defined needs by offering assistance, instruction, and materials to help enrich classroom learning experiences. Services provided social studies educators by the Teacher Center in Humboldt County, California, are described. (RM)

  8. Products for Improving Educational Evaluation. Center for the Study of Evaluation. Fifth Annual Report.

    ERIC Educational Resources Information Center

    Alkin, Marvin C.

    This publication provides background information on the functions and operations of the Center for the Study of Evaluation and reports on such center products as Insructional Objectives Exchange (IOX), CSE Elementary School Test Evaluations, and Evaluation Workshop I. Appendixes include: a summary of center accomplishments; a list of the center's…

  9. Assessing the Accuracy of Generalized Inferences From Comparison Group Studies Using a Within-Study Comparison Approach: The Methodology.

    PubMed

    Jaciw, Andrew P

    2016-06-01

    Various studies have examined bias in impact estimates from comparison group studies (CGSs) of job training programs, and in education, where results are benchmarked against experimental results. Such within-study comparison (WSC) approaches investigate levels of bias in CGS-based impact estimates, as well as the success of various design and analytic strategies for reducing bias. This article reviews past literature and summarizes conditions under which CGSs replicate experimental benchmark results. It extends the framework to, and develops the methodology for, situations where results from CGSs are generalized to untreated inference populations. Past research is summarized; methods are developed to examine bias in program impact estimates based on cross-site comparisons in a multisite trial that are evaluated against site-specific experimental benchmarks. Students in Grades K-3 in 79 schools in Tennessee; students in Grades 4-8 in 82 schools in Alabama. Grades K-3 Stanford Achievement Test (SAT) in reading and math scores; Grades 4-8 SAT10 reading scores. Past studies show that bias in CGS-based estimates can be limited through strong design, with local matching, and appropriate analysis involving pretest covariates and variables that represent selection processes. Extension of the methodology to investigate accuracy of generalized estimates from CGSs shows bias from confounders and effect moderators. CGS results, when extrapolated to untreated inference populations, may be biased due to variation in outcomes and impact. Accounting for effects of confounders or moderators may reduce bias. © The Author(s) 2016.

  10. Economic Analysis of Centralized vs. Decentralized Electronic Data Capture in Multi-Center Clinical Studies

    PubMed Central

    Walden, Anita; Nahm, Meredith; Barnett, M. Edwina; Conde, Jose G.; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E.; Eisenstein, Eric L.

    2012-01-01

    Background New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. Methods We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. Main Outcome Measures The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Results Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Conclusion Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs. PMID:21335692

  11. Comparison of clinical outcomes of incidental and non- incidental gallbladder cancers: a single-center cross- sectional study.

    PubMed

    Cha, Byung Hyo; Bae, Jong-Myun

    2014-01-01

    Gallbladder cancer (GBC) is a rare malignancy characterized by high invasiveness and poor survival. In a nation-wide cancer survey, the age-standardized incidence rate of GBC was the highest in Jeju Island compared to 15 other provinces in Korea. The purpose of this study was to compare the clinical outcomes of GBC according to the nature of diagnosis, that is, incidental versus non-incidental. Consecutive patients who were newly diagnosed with GBC at the Digestive Disease Center and Department of Internal Medicine, Cheju Halla General Hospital, between November 2008 and November 2011, were enrolled and divided into 2 groups: incidental gallbladder cancer (IGBC) and non-incidental gallbladder cancer (NIGBC). Clinical outcomes were retrospectively compared between the two groups. Seventy-nine patients were enrolled and analyzed in our study. Thirty-three (41.8%) and 46 (58.2%) were identified as IGBC and NIGBC, respectively. The proportions of patients with gallstone disease, gallbladder polyp, and cholecystectomy were significantly different between the two groups. Additionally, the median survival rate was significantly higher for patients with IGBC than for those with NIGBC (11.4, 95% confidence interval, 5.6-13.7 vs 4.0, 95% confidence interval 3.03-5.96 months; p=0.01) during a median follow-up period of 5.7 months. Patients with IGBC showed better clinical prognosis than those with NIGBC. Therefore, patients with gallstone disease or gallbladder polyps, major predictive risk factors for IGBC, should undergo advanced work-up for chelecystectomy.

  12. Patient-centered care, nurse work environment and implicit rationing of nursing care in Swiss acute care hospitals: A cross-sectional multi-center study.

    PubMed

    Bachnick, Stefanie; Ausserhofer, Dietmar; Baernholdt, Marianne; Simon, Michael

    2018-05-01

    Patient-centered care is a key element of high-quality healthcare and determined by individual, structural and process factors. Patient-centered care is associated with improved patient-reported, clinical and economic outcomes. However, while hospital-level characteristics influence patient-centered care, little evidence is available on the association of patient-centered care with characteristic such as the nurse work environment or implicit rationing of nursing care. The aim of this study was to describe patient-centered care in Swiss acute care hospitals and to explore the associations with nurse work environment factors and implicit rationing of nursing care. This is a sub-study of the cross-sectional multi-center "Matching Registered Nurse Services with Changing Care Demands" study. We included 123 units in 23 acute care hospitals from all three of Switzerland's language regions. The sample consisted of 2073 patients, hospitalized for at least 24 h and ≥18 years of age. From the same hospital units, 1810 registered nurses working in direct patient care were also included. Patients' perceptions of patient-centered care were assessed using four items from the Generic Short Patient Experiences Questionnaire. Nurses completed questionnaires assessing perceived staffing and resource adequacy, adjusted staffing, leadership ability and level of implicit rationing of nursing care. We applied a Generalized Linear Mixed Models for analysis including individual-level patient and nurse data aggregated to the unit level. Patients reported high levels of patient-centered care: 90% easily understood nurses, 91% felt the treatment and care were adapted for their situation, 82% received sufficient information, and 70% felt involved in treatment and care decisions. Higher staffing and resource adequacy was associated with higher levels of patient-centered care, e.g., sufficient information (β 0.638 [95%-CI: 0.30-0.98]). Higher leadership ratings were associated with

  13. [Predictors of success of external cephalic version: Bi-center study].

    PubMed

    Dochez, V; Delbos, L; Esbelin, J; Volteau, C; Winer, N; Sentilhes, L

    2016-05-01

    In the literature, success rate of external cephalic version (ECV) is 39 to 65%. This study aims to identify potential predictors of a successful ECV. Retrospective bi-center study performed from January 2011 through December 2012 at Angers University Hospital and Nantes University Hospital from January 2011 through December 2011. Were identified the demographic and ultrasonography characteristics of patients and the data of the process. One hundred and seventy-eight patients were included, 88 in Angers and 90 in Nantes; 16.3% of ECV were successful. Multiparity (OR 28.45; P<0.01) and transverse position (OR 0.63; P<0.01) are the two significant predictors. There is no significant difference found for center, operator, position of the placenta, amniotic fluid or presence of a uterine scar. The success rate in our two French university centers is much lower than that reported in the literature. Parity and transverse position are the only 2 significant predictors of ECV success. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Latent Profile and Cluster Analysis of Infant Temperament: Comparisons across Person-Centered Approaches

    ERIC Educational Resources Information Center

    Gartstein, Maria A.; Prokasky, Amanda; Bell, Martha Ann; Calkins, Susan; Bridgett, David J.; Braungart-Rieker, Julia; Leerkes, Esther; Cheatham, Carol L.; Eiden, Rina D.; Mize, Krystal D.; Jones, Nancy Aaron; Mireault, Gina; Seamon, Erich

    2017-01-01

    There is renewed interest in person-centered approaches to understanding the structure of temperament. However, questions concerning temperament types are not frequently framed in a developmental context, especially during infancy. In addition, the most common person-centered techniques, cluster analysis (CA) and latent profile analysis (LPA),…

  15. Flight Test Results of an Axisymmetric Channeled Center Body Supersonic Inlet at Off-Design Conditions

    NASA Technical Reports Server (NTRS)

    St. John, Clinton W.; Frederick, Michael Alan

    2013-01-01

    Flight-testing of a channeled center-body axisymmetric supersonic inlet design concept was conducted at the National Aeronautics and Space Administration (NASA) Dryden Flight Research Center in collaboration with the NASA Glenn Research Center (Cleveland, Ohio) and TechLand Research, Inc. (North Olmsted, Ohio). This testing utilized the Propulsion Flight Test Fixture, flown on the NASA F-15B research test bed airplane (NASA tail number 836) at local experiment Mach numbers up to 1.50. The translating channeled center-body inlet was designed by TechLand Research, Inc. (U.S. Patent No. 6,276,632 B1) to allow for a novel method of off-design flow matching, with original test planning conducted under a NASA Small Business Innovative Research study. Data were collected in flight at various off-design Mach numbers for fixed-geometry representations of both the channeled center-body design and an equivalent area smooth center-body design for direct comparison of total pressure recovery and limited distortion measurements.

  16. Structural Studies of Bacterioferritin B from Pseudomonas aeruginosa Suggest a Gating Mechanism for Iron Uptake via the Ferroxidase Center

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Weeratunga, Saroja K.; Lovell, Scott; Yao, Huili

    2010-03-16

    The structure of recombinant Pseudomonas aeruginosa bacterioferritin B (Pa BfrB) has been determined from crystals grown from protein devoid of core mineral iron (as-isolated) and from protein mineralized with {approx}600 iron atoms (mineralized). Structures were also obtained from crystals grown from mineralized BfrB after they had been soaked in an FeSO{sub 4} solution (Fe soak) and in separate experiments after they had been soaked in an FeSO{sub 4} solution followed by a soak in a crystallization solution (double soak). Although the structures consist of a typical bacterioferritin fold comprised of a nearly spherical 24-mer assembly that binds 12 heme molecules,more » comparison of microenvironments observed in the distinct structures provided interesting insights. The ferroxidase center in the as-isolated, mineralized, and double-soak structures is empty. The ferroxidase ligands (except His130) are poised to bind iron with minimal conformational changes. The His130 side chain, on the other hand, must rotate toward the ferroxidase center to coordinate iron. In comparison, the structure obtained from crystals soaked in an FeSO{sub 4} solution displays a fully occupied ferroxidase center and iron bound to the internal, Fe{sub (in)}, and external, Fe{sub (out)}, surfaces of Pa BfrB. The conformation of His130 in this structure is rotated toward the ferroxidase center and coordinates an iron ion. The structures also revealed a pore on the surface of Pa BfrB that likely serves as a port of entry for Fe{sup 2+} to the ferroxidase center. On its opposite end, the pore is capped by the side chain of His130 when it adopts its 'gate-closed' conformation that enables coordination to a ferroxidase iron. A change to its 'gate-open', noncoordinative conformation creates a path for the translocation of iron from the ferroxidase center to the interior cavity. These structural observations, together with findings obtained from iron incorporation measurements in solution

  17. Research and development support for the Center for Seismic Studies

    NASA Astrophysics Data System (ADS)

    Romney, C. F.; Huszar, L.; Frazier, G. A.

    1984-07-01

    Work during the second and third quarters of FY1984 continued to be focused on the development of the Center for Seismic Studies, and on planning and developments to prepare for a test of Seismic data exchange and event determination, as proposed by the group of Scientific Experts, UN Committee on Disarmament. A help system was designed and partially completed, and other aids for new users of the Center's data and facilities were developed. An introduction to Ingres was prepared, and new experimental data bases were installed.

  18. Public Health Potential of Farmers’ Markets on Medical Center Campuses: A Case Study From Penn State Milton S. Hershey Medical Center

    PubMed Central

    Kraschnewski, Jennifer L.; Rovniak, Liza S.

    2011-01-01

    There are currently 7175 farmers’ markets in the United States, and these organizations are increasingly viewed as one facet of the solution to national health problems. There has been a recent trend toward establishing markets on medical center campuses, and such partnerships can augment a medical center's ability to serve community health. However, to our knowledge no studies have described the emergence of a market at a medical center, the barriers and challenges such an initiative has faced, or the nature of programming it may foster. We provide a qualitative description of the process of starting a seasonal, once-a-week, producers-only market at the Pennsylvania State Hershey Medical Center, and we call for greater public health attention to these emerging community spaces. PMID:22021298

  19. Public health potential of farmers' markets on medical center campuses: a case study from Penn State Milton S. Hershey Medical Center.

    PubMed

    George, Daniel R; Kraschnewski, Jennifer L; Rovniak, Liza S

    2011-12-01

    There are currently 7175 farmers' markets in the United States, and these organizations are increasingly viewed as one facet of the solution to national health problems. There has been a recent trend toward establishing markets on medical center campuses, and such partnerships can augment a medical center's ability to serve community health. However, to our knowledge no studies have described the emergence of a market at a medical center, the barriers and challenges such an initiative has faced, or the nature of programming it may foster. We provide a qualitative description of the process of starting a seasonal, once-a-week, producers-only market at the Pennsylvania State Hershey Medical Center, and we call for greater public health attention to these emerging community spaces.

  20. Solution of multi-center molecular integrals of Slater-type orbitals

    NASA Technical Reports Server (NTRS)

    Tai, H.

    1989-01-01

    The troublesome multi-center molecular integrals of Slater-type orbitals (STO) in molecular physics calculations can be evaluated by using the Fourier transform and proper coupling of the two center exchange integrals. A numerical integration procedure is then readily rendered to the final expression in which the integrand consists of well known special functions of arguments containing the geometrical arrangement of the nuclear centers and the exponents of the atomic orbitals. A practical procedure was devised for the calculation of a general multi-center molecular integrals coupling arbitrary Slater-type orbitals. Symmetry relations and asymptotic conditions are discussed. Explicit expressions of three-center one-electron nuclear-attraction integrals and four-center two-electron repulsion integrals for STO of principal quantum number n=2 are listed. A few numerical results are given for the purpose of comparison.

  1. The USGS National Wildlife Health Center: Advancing wildlife and ecosystem health

    USGS Publications Warehouse

    Moede Rogall, Gail; Sleeman, Jonathan M.

    2017-01-11

    In 1975, the Federal government responded to the need for establishing national expertise in wildlife health by creating the National Wildlife Health Center (NWHC), a facility within the Department of the Interior; the NWHC is the only national center dedicated to wildlife disease detection, control, and prevention. Its mission is to provide national leadership to safeguard wildlife and ecosystem health through active partnerships and exceptional science. Comparisons are often made between the NWHC, which strives to protect the health of our Nation’s wildlife, and the Centers for Disease Control and Prevention (CDC), which strive to protect public health. The NWHC, a science center of the U.S. Geological Survey (USGS) with specialized laboratories, works to safeguard the Nation’s wildlife from diseases by studying the causes and drivers of these threats, and by developing strategies to prevent and manage them. In addition to the main campus, located in Madison, Wisconsin, the NWHC also operates the Honolulu Field Station that addresses wildlife health issues in Hawaii and the Pacific Region.

  2. Patient-centered recruitment and retention for a randomized controlled study.

    PubMed

    Chhatre, Sumedha; Jefferson, Ashlie; Cook, Ratna; Meeker, Caitlin R; Kim, Ji Hyun; Hartz, Kayla Marie; Wong, Yu-Ning; Caruso, Adele; Newman, Diane K; Morales, Knashawn H; Jayadevappa, Ravishankar

    2018-03-27

    Recruitment and retention strategies for patient-centered outcomes research are evolving and research on the subject is limited. In this work, we present a conceptual model of patient-centered recruitment and retention, and describe the recruitment and retention activities and related challenges in a patient-centered comparative effectiveness trial. This is a multicenter, longitudinal randomized controlled trial in localized prostate cancer patients. We recruited 743 participants from three sites over 15 months period (January 2014 to March 2015), and followed them for 24 months. At site 1, of the 773 eligible participants, 551 (72%) were enrolled. At site 2, 34 participants were eligible and 23 (68%) enrolled. Of the 434 eligible participants at site 3, 169 (39%) enrolled. We observed that strategies related to the concepts of trust (e.g., physician involvement, ensuring protection of information), communication (e.g., brochures and pamphlets in physicians' offices, continued contact during regular clinic visits and calling/emailing assessment), attitude (e.g., emphasizing the altruistic value of research, positive attitude of providers and research staff), and expectations (e.g., full disclosure of study requirements and time commitment, update letters) facilitated successful patient recruitment and retention. A stakeholders' advisory board provided important input for the recruitment and retention activities. Active engagement, reminders at the offices, and personalized update letters helped retention during follow-up. Usefulness of telephone recruitment was site specific and, at one site, the time requirement for telephone recruitment was a challenge. We have presented multilevel strategies for successful recruitment and retention in a clinical trial using a patient-centered approach. Our strategies were flexible to accommodate site-level requirements. These strategies as well as the challenges can aid recruitment and retention efforts of future large

  3. Parameter identification studies on the NASA/Ames Research Center Advanced Concepts Flight Simulator. M.S. Thesis

    NASA Technical Reports Server (NTRS)

    Mckavitt, Thomas P., Jr.

    1990-01-01

    The results of an aircraft parameters identification study conducted on the National Aeronautics and Space Administration/Ames Research Center Advanced Concepts Flight Simulator (ACFS) in conjunction with the Navy-NASA Joint Institute of Aeronautics are given. The ACFS is a commercial airline simulator with a design based on future technology. The simulator is used as a laboratory for human factors research and engineering as applied to the commercial airline industry. Parametric areas examined were engine pressure ratio (EPR), optimum long range cruise Mach number, flap reference speed, and critical take-off speeds. Results were compared with corresponding parameters of the Boeing 757 and 767 aircraft. This comparison identified two areas where improvements can be made: (1) low maximum lift coefficients (on the order of 20-25 percent less than those of a 757); and (2) low optimum cruise Mach numbers. Recommendations were made to those anticipated with the application of future technologies.

  4. Metropolitan transportation management center : a case study : COMPASS : effectively managing traffic and incidents

    DOT National Transportation Integrated Search

    1999-10-01

    The following case study provides a snapshot of the Downsview, Ontario transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting ...

  5. A comparison of command center activations versus disaster drills at three institutions from 2013 to 2015.

    PubMed

    Ebbeling, Laura G; Goralnick, Eric; Bivens, Matthew J; Femino, Meg; Berube, Claire G; Sears, Bryan; Sanchez, Leon D

    2016-01-01

    Disaster exercises often simulate rare, worst-case scenario events that range from mass casualty incidents to severe weather events. In actuality, situations such as information system downtimes and physical plant failures may affect hospital continuity of operations far more significantly. The objective of this study is to evaluate disaster drills at two academic and one community hospital to compare the frequency of planned drills versus real-world events that led to emergency management command center activation. Emergency management exercise and command center activation data from January 1, 2013 to October 1, 2015 were collected from a database. The activations and drills were categorized according to the nature of the event. Frequency of each type of event was compared to determine if the drills were representative of actual activations. From 2013 to 2015, there were a total of 136 command center activations and 126 drills at the three hospital sites. The most common reasons for command center activations included severe weather (25 percent, n = 34), maintenance failure (19.9 percent, n = 27), and planned mass gathering events (16.9 percent, n = 23). The most frequent drills were process tests (32.5 percent, n = 41), hazardous material-related events (22.2 percent, n = 28), and in-house fires (15.10 percent, n = 19). Further study of the reasons behind why hospitals activate emergency management plans may inform better preparedness drills. There is no clear methodology used among all hospitals to create drills and their descriptions are often vague. There is an opportunity to better design drills to address specific purposes and events.

  6. Comparison of body's center of mass motion relative to center of pressure between treadmill and over-ground walking.

    PubMed

    Lu, Hsuan-Lun; Lu, Tung-Wu; Lin, Hsiu-Chen; Chan, Wing P

    2017-03-01

    Treadmills have been used in rehabilitation settings to provide convenient protocols and continuous monitoring of movement over multiple cycles at well-controlled speeds for gait and balance training. However, the potential differences in the movement control may affect the translation of the training outcomes to real life over-ground walking (OW). The similarities and differences in the balance control between treadmill walking (TW) and OW have largely been unexplored. The current study bridged the gap by comparing the motions of the body's center of mass (COM) relative to the center of pressure (COP) between TW and OW, in terms of the COM-COP inclination angle (IA) and its rate of change (RCIA). The movement of the COM and COP separately were quite different between OW and TW, but when describing the COM motion relative to the COP, the COM motions became similar qualitatively with similar butterfly patterns. However, significantly increased peak values in themediolateral RCIA and greater ranges of mediolateral IA were found during TW (p<0.004). In the sagittal plane, the posterior velocity of the belt led to an anterior RCIA (posterior RCIA in OW) with increasing anterior IA during early double-limb support phase, and reduced posterior RCIA (p<0.009) with an increased anterior IA (p<0.001) during the remainder of the phase. These differences between TW and OW may have to be taken into account in future designs of strategies to optimize the translation of treadmill gait training outcomes into real life over-ground walking. Copyright © 2017. Published by Elsevier B.V.

  7. Study of Mechanization in DOD Libraries and Information Centers.

    ERIC Educational Resources Information Center

    Booz, Allen Applied Research, Inc., Bethesda, MD.

    This report summarizes the on-site study of mechanization in DoD libraries and information centers. Included are presentations and evaluations on thesaurus building, file structure, input processing, serial control, selective dissemination of information, circulation control, equipments being used, recommendations on information retrieval systems,…

  8. The Story of the Hawaiian Studies Center on the Brigham Young University-Hawaii Campus.

    ERIC Educational Resources Information Center

    Benham, Maenette K. P.

    2002-01-01

    With an advisory committee of native community members, elders, educators, and students, the Center for Hawaiian Language and Cultural Studies has successfully founded, within a mainstream institution with strong religious foundations, a cultural center that teaches native values and language. The center creates cultural/educational projects that…

  9. Perceived job stress and health complaints at a bank call center: comparison between inbound and outbound services.

    PubMed

    Lin, Yen-Hui; Chen, Chih-Yong; Hong, Wei-Hsien; Lin, Yu-Chao

    2010-01-01

    This study investigated how perceived job stress and health status differ, as well as the relationships to inbound (incoming calls) versus outbound (outgoing calls) calling activities, for call center workers in a bank in Taiwan. The sample bank employed 289 call center workers at the time of the survey, ranging in age from 19 to 54 yr old. Data were obtained on individual factors, health complaints, perceived level job stress, and major job stressors. Overall, 33.5% of outbound operators and 27.1% of inbound operators reported frequently or always experiencing high stress at work, however, the differences between inbound and outbound operators were insignificant. "Having to deal with difficult customers" was the most frequent job stressor for all workers. Musculoskeletal discomfort, eye strain, and hoarse or sore throat were the most prevalent complaints among call center workers. The relationship between perceived job stress and health complaints indicated that workers who perceived higher job stress had significantly increased risk of multiple health problems, including eye strain, tinnitus, hoarse or sore throat, chronic cough with phlegm, chest tightness, irritable stomach or peptic ulcers, and musculoskeletal discomfort (with odds ratios ranging from 2.13 to 8.24). These analytical results suggest that perceived job stress in the call center profoundly affected worker health. This study identified main types of job stressors requiring further investigation.

  10. Usability of patient-centered health IT: mixed-methods usability study of ePill.

    PubMed

    Schmidt-Kraepelin, Manuel; Dehling, Tobias; Sunyaev, Ali

    2014-01-01

    To facilitate use of patient-centered health IT applications in everyday life, a high degree of usability is required. Based on the example of a patient-centered web application, we propose a usability study design enabling developers and researchers to assess usability of patient-centered health IT applications and derive implications for their improvement. Our study design integrates tasks that subjects have to process, an associated questionnaire based on Perceived Ease of Use, Perceived Usefulness, Attitude Toward Using, and Behavioral Intention to Use, a System Usability Scale questionnaire, and focus groups. Application of the usability study design demonstrates its feasibility and provides insights for assessment of usability in related projects in research and practice.

  11. Identifying the Local Impacts of National ATE Centers on Their Host Institutions: An Exploratory Study

    ERIC Educational Resources Information Center

    Henderson, Charles; Fynewever, Herb; Petcovic, Heather; Bierema, Andrea

    2012-01-01

    The purpose of this study is to identify the local impacts of national advanced technological education (ATE) centers on their host institutions. A sample of three mature, national ATE centers are chosen, with each center serving as a case for a mixed-methods, collective case study research design. Results, drawn from interviews and surveys,…

  12. Rotational Spectroscopy of Reactive Species at the Center for Astrochemical Studies.

    NASA Astrophysics Data System (ADS)

    Lattanzi, Valerio; Spezzano, Silvia; Caselli, Paola

    2017-06-01

    The Center for Astrochemical Studies at the Max Planck Institute for Extraterrestrial Physics in Garching, is a recently established group which collects scientists with very diverse backgrounds. In the same group observers, theoreticians, chemists and molecular astrophysicists join their efforts with the ultimate goal of properly interpreting observations with the new generation telescopes and unveiling our astrochemical/physical heritage. Among these tasks, the gas-phase spectroscopic characterisation of molecular species of astrophysical relevance is one of the main goals of the laboratory sub-group. This talk will mainly focus on the first experiment built in our center, the CASAC (CAS Absorption Cell) spectrometer: this experiment has been optimised on the production and probe of small molecular ions and radicals. The main laboratory techniques along with the more prominent outcomes of recent studies will be presented. Finally, a brief update on the status of the other instruments available in our center will be given, including their planned upgrades.

  13. Experimental parametric study of servers cooling management in data centers buildings

    NASA Astrophysics Data System (ADS)

    Nada, S. A.; Elfeky, K. E.; Attia, Ali M. A.; Alshaer, W. G.

    2017-06-01

    A parametric study of air flow and cooling management of data centers servers is experimentally conducted for different design conditions. A physical scale model of data center accommodating one rack of four servers was designed and constructed for testing purposes. Front and rear rack and server's temperatures distributions and supply/return heat indices (SHI/RHI) are used to evaluate data center thermal performance. Experiments were conducted to parametrically study the effects of perforated tiles opening ratio, servers power load variation and rack power density. The results showed that (1) perforated tile of 25% opening ratio provides the best results among the other opening ratios, (2) optimum benefit of cold air in servers cooling is obtained at uniformly power loading of servers (3) increasing power density decrease air re-circulation but increase air bypass and servers temperature. The present results are compared with previous experimental and CFD results and fair agreement was found.

  14. [Female patients with fibromyalgia syndrome in somatic and psychosomatic rehabilitation center - an exploratory study on access routes and differences in patient characteristics].

    PubMed

    Ullrich, A; Glattacker, M; Sibold, M; Egle, U T; Ehlebracht-König, I; Geigges, W; Köllner, V; Kruse, M; Jäckel, W H

    2013-10-01

    Fibromyalgia syndrome (FMS) is characterized by e. g. chronic, multilocular pain, and mental health problems. In Germany, patients with FMS are treated in somatic and psychosomatic rehabilitation centers - specialized for rheumatic diseases (somatic) or psychosomatic diseases. The aim of this study is to identify the status quo of FMS patients' access routes to the rehabilitation system, and to identify their predictors for being assigned to one or the other indication group. Our cohort consists of 197 FMS patients from 3 psychosomatic (M=49.9 years) and 223 FMS patients (M=50.2 years) from 3 somatic rehabilitation centers. At the beginning of rehabilitation, patients filled out a questionnaire packet to identify their access routes to the rehabilitation centers and to record patients' disease-related, psychosocial and socio-demographic characteristics. To analyze the results we used descriptive calculations, calculated bivariate correlations, and conducted binary logistic regression analysis for the prediction of group membership. The access routes of FMS patients to a somatic or a psychosomatic rehabilitation center were often similar. Some items revealed significant group differences, i. e., a higher primary -rejection rate, longer waiting period between application for rehabilitation and its approval, and between the application itself and initiation of psychosomatic rehabilitation in comparison to somatic FMS patients. Prior experience of out-patient psychotherapy, and expectations ("psychological support") for the rehabilitation were predictive patient characteristics for the assignment into a psychosomatic rehabilitation center. Marriage, motivation, and expectations ("physical improvement" and "interaction with other patients") for the rehabilitation were predictive patient characteristics for the assignment in a somatic rehabilitation center. The predictors clarified 32% of the variance of group membership. Our results provide initial evidence of how FMS

  15. An analytical and experimental study of crack extension in center-notched composites

    NASA Technical Reports Server (NTRS)

    Beuth, Jack L., Jr.; Herakovich, Carl T.

    1987-01-01

    The normal stress ratio theory for crack extension in anisotropic materials is studied analytically and experimentally. The theory is applied within a microscopic-level analysis of a single center notch of arbitrary orientation in a unidirectional composite material. The bulk of the analytical work of this study applies an elasticity solution for an infinite plate with a center line to obtain critical stress and crack growth direction predictions. An elasticity solution for an infinite plate with a center elliptical flaw is also used to obtain qualitative predictions of the location of crack initiation on the border of a rounded notch tip. The analytical portion of the study includes the formulation of a new crack growth theory that includes local shear stress. Normal stress ratio theory predictions are obtained for notched unidirectional tensile coupons and unidirectional Iosipescu shear specimens. These predictions are subsequently compared to experimental results.

  16. X-ray crystal structure and theoretical study of a new dinuclear Cu(II) complex with two different geometry centers bridged with an oxo group

    NASA Astrophysics Data System (ADS)

    Golbedaghi, Reza; Azimi, Saeid; Molaei, Atefeh; Hatami, Masoud; Notash, Behrouz

    2017-10-01

    A new Schiff base ligand HL, 1,3-bis(2-((Z)-(2-aminoethylimino)methyl)phenoxy)ethylene di amine, has been synthesized from the reaction of a new aldehyde and ethylenediamine. After preparation the Schiff base, a new dinuclear Cu(II) complex with two different geometry for each metal ion was synthesized. Single crystal X-ray structure analysis of the complex Cu(II) showed that the complex is binuclear and all nitrogen and oxygen atoms of ligand (N4O3) are coordinated to two Cu(II) center ions. The crystal structure studying shows, a perchlorate ion has been coordinated to the two Cu(II) metal centers as bridged and another perchlorate coordinated to the one of Cu(II) ion as terminal. However, two interesting structures square pyramidal and distorted octahedral Cu(II) ions are bridged asymmetrically by a perchlorate ion and oxygen of hydroxyl group of Schiff base ligand. In addition, we had a theoretical study to have a comparison of experimental and theoretical results we determined the HOMO and LUMO orbitals.

  17. THE ENGLISH PROGRAM OF THE USOE CURRICULUM STUDY AND DEMONSTRATION CENTER MATERIALS CURRENTLY AVAILABLE.

    ERIC Educational Resources Information Center

    1967

    AFTER FIVE YEARS OF FEDERALLY-SUPPORTED CURRICULUM RESEARCH IN ENGLISH, 14 STUDY CENTERS AND FIVE DEMONSTRATION CENTERS ARE NOW MAKING THE RESULTS OF THEIR WORK AVAILABLE TO THE PUBLIC. THIS PAMPHLET LISTS TITLES OF REPORTS AND INSTRUCTIONAL MATERIALS PREPARED BY THE FOLLOWING CENTERS--(1) CARNEGIE-MELLON UNIVERSITY, (2) TEACHERS COLLEGE, COLUMBIA…

  18. Improving Pain Care with Project ECHO in Community Health Centers.

    PubMed

    Anderson, Daren; Zlateva, Ianita; Davis, Bennet; Bifulco, Lauren; Giannotti, Tierney; Coman, Emil; Spegman, Douglas

    2017-10-01

    Pain is an extremely common complaint in primary care, and patient outcomes are often suboptimal. This project evaluated the impact of Project ECHO Pain videoconference case-based learning sessions on knowledge and quality of pain care in two Federally Qualified Health Centers. Quasi-experimental, pre-post intervention, with comparison group. Two large, multisite federally qualified health centers in Connecticut and Arizona. Intervention (N = 10) and comparison (N = 10) primary care providers. Primary care providers attended 48 weekly Project ECHO Pain sessions between January and December 2013, led by a multidisciplinary pain specialty team. Surveys and focus groups assessed providers' pain-related knowledge and self-efficacy. Electronic health record data were analyzed to evaluate opioid prescribing and specialty referrals. Compared with control, primary care providers in the intervention had a significantly greater increase in pain-related knowledge and self-efficacy. Providers who attended ECHO were more likely to use formal assessment tools and opioid agreements and refer to behavioral health and physical therapy compared with control providers. Opioid prescribing decreased significantly more among providers in the intervention compared with those in the control group. Pain is an extremely common and challenging problem, particularly among vulnerable patients such as those cared for at the more than 1,200 Federally Qualified Health Centers in the United States. In this study, attendance at weekly Project ECHO Pain sessions not only improved knowledge and self-efficacy, but also altered prescribing and referral patterns, suggesting that knowledge acquired during ECHO sessions translated into practice changes. © 2017 American Academy of Pain Medicine.

  19. Disaster preparedness of poison control centers in the USA: a 15-year follow-up study.

    PubMed

    Darracq, Michael A; Clark, Richard F; Jacoby, Irving; Vilke, Gary M; DeMers, Gerard; Cantrell, F Lee

    2014-03-01

    There is limited published literature on the extent to which United States (US) Poison Control Centers (PCCs) are prepared for responding to disasters. We describe PCCs' disaster preparedness activities and compare and contrast these results to those previously reported in the medical literature. We also describe the extent to which PCCs are engaged in disaster and terrorism preparedness planning and other public health roles such as surveillance. An electronic questionnaire was sent via email to the managing directors of the 57 member PCCs of the American Association of Poison Control Centers. Collected data included the population served and number of calls received, extent of disaster preparedness including the presence of a written disaster plan and elements included in that plan, the presence and nature of regular disaster drills, experience with disaster including periods of inability to operate, involvement in terrorism and disaster preparedness/response policy development, and public health surveillance of US PCCs. Descriptive statistics were performed on collected data. Comparisons with the results from a previously published survey were performed. A response was obtained from 40/57 (70 %) PCCs. Each PCC serves a larger population (p < 0.0001) and receives more calls per year (p = 0.0009) than the previous descriptions of PCC preparedness. More centers report the presence of a written disaster plan (p < 0.0001), backup by another center (p < 0.0001), regular disaster drills (p < 0.0001), and comfort with ability to operate in a disaster (p < 0.0001) than previously described. PCCs are involved in disaster (34/40, 85 %) and terrorism (29/40, 73 %) preparedness at the local, state, or federal levels. PCCs (36/40, 90 %) are also involved in public health functions (illness surveillance or answering "after hours" public health calls). Despite an increase in calls received and population served per center as compared to previous

  20. Loss of Life, Evacuation and Emergency Management: Comparison and Application to Case Studies in the USA

    DTIC Science & Technology

    2013-01-22

    eK ay a nd M cC le lla nd G ra ha m Katrina HEC -FIA LifeSim Figure 1: Comparison of loss of life models (based on Johnstone et al., 2005...Katrina HEC FIA Lifesim Application: flood types Levee breaching, river , coastal Levee breaching, river , coastal levee breaching, dam failure...Mortality – Overtopping with breach Center Side of American River (OTSC) Figure 31: Mortality for the HEC -FIA method for the two

  1. A Case Study Documenting the Process by Which Biology Instructors Transition from Teacher-Centered to Learner-Centered Teaching

    PubMed Central

    Marbach-Ad, Gili; Hunt Rietschel, Carly

    2016-01-01

    In this study, we used a case study approach to obtain an in-depth understanding of the change process of two university instructors who were involved with redesigning a biology course. Given the hesitancy of many biology instructors to adopt evidence-based, learner-centered teaching methods, there is a critical need to understand how biology instructors transition from teacher-centered (i.e., lecture-based) instruction to teaching that focuses on the students. Using the innovation-decision model for change, we explored the motivation, decision-making, and reflective processes of the two instructors through two consecutive, large-enrollment biology course offerings. Our data reveal that the change process is somewhat unpredictable, requiring patience and persistence during inevitable challenges that arise for instructors and students. For example, the change process requires instructors to adopt a teacher-facilitator role as opposed to an expert role, to cover fewer course topics in greater depth, and to give students a degree of control over their own learning. Students must adjust to taking responsibility for their own learning, working collaboratively, and relinquishing the anonymity afforded by lecture-based teaching. We suggest implications for instructors wishing to change their teaching and administrators wishing to encourage adoption of learner-centered teaching at their institutions. PMID:27856550

  2. Parent-Child Center Short-Term Assessment Study. Final Report.

    ERIC Educational Resources Information Center

    Hubbell, Ruth; Barrett, Barbara

    A short-term descriptive assessment, this study provides summary data on the Parent-Child Center (PCC) comprehensive early childhood intervention programs initiated in 1967 and operated by the Administration for Children, Youth, and Families. PCCs provide low income families with children under three with social service, health, and educational…

  3. Assessment of Knowledge of Day-Care Center Workers in Basic Aspects of Child Care: A Pilot Study.

    DTIC Science & Technology

    1980-06-01

    to make a score of at least 70 percent on the multiple choice portion of the questionnaire used in this study . %~u CHAPTER II THE REVIEW OF LITERATURE...employees. These factors would automatically introduce a source of bias into the study . Of the centers contacted, one for-profit center, a franchise center...order to obtain consent. These centers were subsequently exclu- ded from the study leaving only three strata: operated for- profit centers (from her on

  4. Seismometer readings studied in Mission Control Center

    NASA Technical Reports Server (NTRS)

    1971-01-01

    The seismometer reading from the impact made by the Apollo 15 Saturn S-IVB stage when it struck the lunar surface is studied by scientists in the Mission Control Center. Dr. Gary Latham (dark suit, wearing lapel button) of Columbia University is responsible for the design and experiment data analysis of the Passive Seismic Experiment of the Apollo Lunar Surface Experiment Package (ALSEP). The man on the left, writing, is Nafi Toksos of the Massachusetts Institute of Technology. Looking on at upper left is Dave Lammlein, also with Columbia.

  5. Seismometer readings studied in Mission Control Center

    NASA Image and Video Library

    1971-07-29

    The seismometer reading from the impact made by the Apollo 15 Saturn S-IVB stage when it struck the lunar surface is studied by scientists in the Mission Control Center. Dr. Gary Latham (dark suit, wearing lapel button) of Columbia University is responsible for the design and experiment data analysis of the Passive Seismic Experiment of the Apollo Lunar Surface Experiment Package (ALSEP). The man on the left, writing, is Nafi Toksos of the Massachusetts Institute of Technology. Looking on at upper left is Dave Lamneline, also with Columbia.

  6. Comparison of Both Sides for Retroperitoneal Laparoscopic Donor Nephrectomy: Experience From a Single Center in China.

    PubMed

    Qiu, Y; Wang, X; Song, T; Rao, Z; Liu, J; Huang, Z; Lin, T

    Laparoscopic donor nephrectomy (LDN) has gradually become the main approach to obtain live donor kidneys. However, the shorter right renal vein limits its wider application. The aim of this study was to compare the outcomes of left- and right-side retroperitoneal LDN. We reviewed the perioperative data of 527 consecutive donors receiving retroperitoneal pure LDN with a new method at our center between April 2009 and April 2014. The patients were divided into group A (the first 100 patients) and group B (the remaining 427 patients). A total of 423 cases of left donor surgery and 104 cases of right donor surgery were compared. The comparison of the laterality of LDN was also performed between group A and group B. This is currently the largest case series of LDN in our country. Although right-side LDN patients had longer operation time and a slightly higher incidence of intraoperative complications compared with left-side LDN patients, the operation time was shorter in both the groups compared with previous reports. In group B, patients undergoing right-side LDN had longer operation time and more frequent complications. Once the learning curve of 100 cases was completed, the incidence of complications and operation time were greatly reduced in both sides for LDN. There was no significant difference in the serum creatinine levels in recipients at 6 months of follow-up. Despite a slightly higher incidence of complications and longer operation time, right-side LDN can achieve equally safe and effective transplantation outcomes. This expands the source of potential donor kidneys. Copyright © 2017. Published by Elsevier Inc.

  7. A Preliminary Test of a Student-Centered Intervention on Increasing Physical Activity in Underserved Adolescents

    PubMed Central

    Wilson, Dawn K.; Evans, Alexandra E.; Williams, Joel; Mixon, Gary; Sirard, John R.; Pate, Russell

    2008-01-01

    Background Previous studies have shown that choice and self-initiated behavior change are important for increasing intrinsic motivation and physical activity (PA), however, little of this research has focused on underserved adolescents. Purpose This study examined the effects of a 4-week student-centered intervention on increasing PA in underserved adolescents. Methods Twenty-eight students in the intervention school were matched (on race, percentage on free or reduced-price lunch program, gender, and age) with 20 students from another school who served as the comparison group (30 girls, 18 boys; ages 10–12 years; 83% African American; 83% on free or reduced-price lunch). The student-centered intervention was consistent with self-determination (motivation) theory and social cognitive theory in that it emphasized increasing intrinsic motivation and behavioral skills for PA. Intervention adolescents took ownership in selecting a variety of PA activities in which to participate, and they generated coping strategies for making effective PA behavior changes. Results Intervention participants showed greater increases in accelerometer estimates of time spent in moderate PA, moderate-to-vigorous PA, and vigorous PA from baseline to Week 4 of the intervention than the comparison group. Intervention participants also showed greater increases in PA motivation and positive self-concept for PA than comparison adolescents. Conclusions This study provides preliminary evidence that increasing adolescent involvement and choice of activities may be important in developing future PA interventions for underserved adolescents. PMID:16173908

  8. Comparison of Menus to Actual Foods and Beverages Served in North Carolina Child-Care Centers

    PubMed Central

    BENJAMIN NEELON, SARA E.; COPELAND, KRISTEN A.; BALL, SARAH C.; BRADLEY, LAUREN; WARD, DIANNE S

    2011-01-01

    Menus from child-care centers are an important source of information for parents, researchers, and child-care regulators, but previous research suggests that menus do not accurately represent foods served. The purpose of this study was to compare menus with actual foods and beverages served to children in child-care centers. Menus were collected and a dietary observation was conducted to document all foods and beverages served to children during the course of 1 day in 84 child-care centers in North Carolina in the fall of 2005. Frequencies of foods and beverages on the menus vs those served were computed by eating occasion, food category, and individual foods and beverages. Of the 254 meals and snacks served, 131 (52%) meals and snacks matched entirely what was stated on the menu. Of the 820 individual foods and beverages served, 710 (86.6%) matched those listed on the menus. An additional 110 foods and beverages were served but not listed on the menus. Grains, juice, and vegetables were served less often than indicated on the menus, and milk, protein-rich foods, fruits, mixed dishes, and foods of low nutritional value were served more often than listed on the menus. Overall, just over half of all meals and snacks matched menus, and nearly 90% of individual foods and beverages served matched those stated on menus. Parents of children in child care and dietetics practitioners providing consultation to child-care centers can encourage not only provision of healthy foods and beverages, but also accurate menus in child care. PMID:21111096

  9. Centers for Professional Development and Technology (CPDT) State-Wide Evaluation Study. Final Summary Report.

    ERIC Educational Resources Information Center

    Macy Research Associates, Wills Point, TX.

    The Texas Centers for Professional Development and Technology (CPDT) study gathered evaluative data about the progress and contribution of the centers toward their goal of systematic change in teacher preparation and student learning during four years of funding (1992-93 through 1995-96). The 21 centers in the sample included 35 universities, 15…

  10. Centering prayer for women receiving chemotherapy for recurrent ovarian cancer: a pilot study.

    PubMed

    Johnson, Mary E; Dose, Ann M; Pipe, Teri Britt; Petersen, Wesley O; Huschka, Mashele; Gallenberg, Mary M; Peethambaram, Prema; Sloan, Jeff; Frost, Marlene H

    2009-07-01

    To explore the feasibility of implementing centering prayer in chemotherapy treatment and assess its influence on mood, spiritual well-being, and quality of life in women with recurrent ovarian cancer. Descriptive pilot study. Outpatient chemotherapy treatment suite in a large cancer center in the midwestern United States. A convenience sample of 10 women receiving outpatient chemotherapy for recurrent ovarian cancer. A centering prayer teacher led participants through three one-hour sessions over nine weeks. Data were collected prior to the first session, at the conclusion of the final session, and at three and six months after the final session. Feasibility and influence of centering prayer on mood, spiritual well-being, and quality of life. Most participants identified centering prayer as beneficial. Emotional well-being, anxiety, depression, and faith scores showed improvement. Centering prayer can potentially benefit women with recurrent ovarian cancer. Additional research is needed to assess its feasibility and effectiveness. Nurses may promote or suggest centering prayer as a feasible intervention for the psychological and spiritual adjustment of patients with recurrent ovarian cancer.

  11. A Case Study Documenting the Process by Which Biology Instructors Transition from Teacher-Centered to Learner-Centered Teaching

    ERIC Educational Resources Information Center

    Marbach-Ad, Gili; Rietschel, Carly Hunt

    2016-01-01

    In this study, we used a case study approach to obtain an in-depth understanding of the change process of two university instructors who were involved with redesigning a biology course. Given the hesitancy of many biology instructors to adopt evidence-based, learner-centered teaching methods, there is a critical need to understand how biology…

  12. Mendenhall Glacier Visitor Center vehicular and pedestrian traffic congestion study

    DOT National Transportation Integrated Search

    2007-05-01

    The Mendenhall Glacier Visitor Center of Tongass National Forest in Juneau, Alaska is experiencing vehicular and pedestrian congestion. This study was initiated by the United States Forest Service, Alaska Region, in cooperation with Western Federal L...

  13. A model for evaluating academic research centers: Case study of the Asian/Pacific Islander Youth Violence Prevention Center.

    PubMed

    Nishimura, Stephanie T; Hishinuma, Earl S; Goebert, Deborah A; Onoye, Jane M M; Sugimoto-Matsuda, Jeanelle J

    2018-02-01

    To provide one model for evaluating academic research centers, given their vital role in addressing public health issues. A theoretical framework is described for a comprehensive evaluation plan for research centers. This framework is applied to one specific center by describing the center's Logic Model and Evaluation Plan, including a sample of the center's activities. Formative and summative evaluation information is summarized. In addition, a summary of outcomes is provided: improved practice and policy; reduction of risk factors and increase in protective factors; reduction of interpersonal youth violence in the community; and national prototype for prevention of interpersonal youth violence. Research centers are important mechanisms to advance science and improve people's quality of life. Because of their more infrastructure-intensive and comprehensive approach, they also require substantial resources for success, and thus, also require careful accountability. It is therefore important to comprehensively evaluate these centers. As provided herein, a more systematic and structured approach utilizing logic models, an evaluation plan, and successful processes can provide research centers with a functionally useful method in their evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The Center for Coastal Studies: Sustainable Development Education in Mexico

    ERIC Educational Resources Information Center

    Ollervides, F.; Farrell, T.

    2007-01-01

    Purpose: The purpose of this paper is to present The School for Field Studies-Center for Coastal Studies (SFS-CCS) as a success story in sustainable development education. This success is based on a unique academic model, which incorporates sustainable development opportunities and challenges faced by the local community into the program…

  15. Usability Studies and User-Centered Design in Digital Libraries

    ERIC Educational Resources Information Center

    Comeaux, David J.

    2008-01-01

    Digital libraries continue to flourish. At the same time, the principles of user-centered design and the practice of usability testing have been growing in popularity, spreading their influence into the library sphere. This article explores the confluence of these two trends by surveying the current literature on usability studies of digital…

  16. Social Work Information Center 2.0: A Case Study

    ERIC Educational Resources Information Center

    Xu, F. Grace

    2009-01-01

    The social work library at USC provides a case study of an academic library's transition to an information center service model. Analysis of the collection, user community, Web 2.0 applications, and Web usage data demonstrates how the changes facilitated library services and information literacy instruction. (Contains 6 tables and 3 figures.)

  17. Comparison of Ramadan-specific education level in patients with diabetes seen at a Primary and a Tertiary care center of Karachi-Pakistan.

    PubMed

    Masood, Shabeen Naz; Alvi, Syed Faraz Danish; Ahmedani, Muhammad Yakoob; Kiran, Shazia; Zeeshan, Nimra Fatima; Basit, Abdul; Shera, A Samad

    2014-01-01

    To compare Ramadan-specific education level in fasting patients with diabetes at a Primary and a Tertiary care center. An observational study was conducted in the Outpatient departments of a Primary care center and a Tertiary care center in Karachi-Pakistan. Recruitment of patients started at the end of Ramadan 2011 and continued till three months after Ramadan 2011. All patients with diabetes who observed fast during the month of Ramadan 2011 were included in the study. In Primary care center, patients were attended by physicians only, while at Tertiary care center patients were seen by physicians, diabetes educator and dietician. For data collection, standardized questionnaire based interview was conducted on one to one basis by trained healthcare professionals. Same questionnaire was used at both the centers. A total of 392 and 199 patients with diabetes recruited at Primary and Tertiary care centers, respectively. Ramadan-specific diabetes education received by 213 (55%) and 123 (61.80%) patients with diabetes at Primary and Tertiary care centers, respectively. Compared to Primary care center, patients at Tertiary care centers were more aware about components of Ramadan-specific diabetes education such as signs and symptoms of hypoglycemia and hyperglycemia, dose of medicines/insulin during Ramadan fasting, dose of medicines/insulin when not fasting, self-monitoring of blood glucose, dietary modifications, physical activity, adequate nutrition and adequate hydration during Ramadan (p<0.05). It was observed that Ramadan-specific education level of patients at Tertiary care center was significantly better compared to patients at Primary care center. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  18. Health Care Use and Spending for Medicaid Enrollees in Federally Qualified Health Centers Versus Other Primary Care Settings

    PubMed Central

    Lee, Sang Mee; Sharma, Ravi; Ngo-Metzger, Quyen; Mukamel, Dana B.; Gao, Yue; White, Laura M.; Shi, Leiyu; Chin, Marshall H.; Laiteerapong, Neda; Huang, Elbert S.

    2016-01-01

    Objectives. To compare health care use and spending of Medicaid enrollees seen at federally qualified health centers versus non–health center settings in a context of significant growth. Methods. Using fee-for-service Medicaid claims from 13 states in 2009, we compared patients receiving the majority of their primary care in federally qualified health centers with propensity score–matched comparison groups receiving primary care in other settings. Results. We found that health center patients had lower use and spending than did non–health center patients across all services, with 22% fewer visits and 33% lower spending on specialty care and 25% fewer admissions and 27% lower spending on inpatient care. Total spending was 24% lower for health center patients. Conclusions. Our analysis of 2009 Medicaid claims, which includes the largest sample of states and more recent data than do previous multistate claims studies, demonstrates that the health center program has provided a cost-efficient setting for primary care for Medicaid enrollees. PMID:27631748

  19. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: a survey in 66 neurotrauma centers participating in the CENTER-TBI study.

    PubMed

    Cnossen, Maryse C; Huijben, Jilske A; van der Jagt, Mathieu; Volovici, Victor; van Essen, Thomas; Polinder, Suzanne; Nelson, David; Ercole, Ari; Stocchetti, Nino; Citerio, Giuseppe; Peul, Wilco C; Maas, Andrew I R; Menon, David; Steyerberg, Ewout W; Lingsma, Hester F

    2017-09-06

    No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI. A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n = 60, 91%) and designated level I trauma centers (n = 44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n = 58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n = 32, 48%), whereas the others were considered more conservative (n = 34, 52%). Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research.

  20. A Study of Community College Learner-Centered Teaching Styles and Students' Motivation to Learn

    ERIC Educational Resources Information Center

    Rossi, Cindy M.

    2010-01-01

    The purpose of this study was to investigate the relationship between community college business faculty members' perceptions of their use of learner-centered teaching practices and their students' perceptions of their motivation to learn. Learner-centered teaching practices have been linked to students' motivation. This study used on-line survey…

  1. The catalytic center of ferritin regulates iron storage via Fe(II)-Fe(III) displacement.

    PubMed

    Honarmand Ebrahimi, Kourosh; Bill, Eckhard; Hagedoorn, Peter-Leon; Hagen, Wilfred R

    2012-11-01

    A conserved iron-binding site, the ferroxidase center, regulates the vital iron storage role of the ubiquitous protein ferritin in iron metabolism. It is commonly thought that two Fe(II) simultaneously bind the ferroxidase center and that the oxidized Fe(III)-O(H)-Fe(III) product spontaneously enters the cavity of ferritin as a unit. In contrast, in some bacterioferritins and in archaeal ferritins a persistent di-iron prosthetic group in this center is believed to mediate catalysis of core formation. Using a combination of binding experiments and isotopically labeled (57)Fe(II), we studied two systems in comparison: the ferritin from the hyperthermophilic archaeal anaerobe Pyrococcus furiosus (PfFtn) and the eukaryotic human H ferritin (HuHF). The results do not support either of the two paradigmatic models; instead they suggest a unifying mechanism in which the Fe(III)-O-Fe(III) unit resides in the ferroxidase center until it is sequentially displaced by Fe(II).

  2. Online reporting of adverse drug reactions: a study from a French regional pharmacovigilance center.

    PubMed

    Abadie, Delphine; Chebane, Leyla; Bert, Max; Durrieu, Geneviève; Montastruc, Jean-Louis

    2014-01-01

    In France, online reporting via a website is a new method for notifying adverse drug reactions (ADRs). The French Midi-Pyrénées Regional Pharmacovigilance Center (RPVC) set up in July, 2010 a Web-based ADR reporting tool in order to improve ADR reporting rate. To assess feasibility, use and performances of this new ADR reporting system. To evaluate the main characteristics of these online reports. In a retrospective study, we evaluated characteristics (numbers, ADR reporting and file processing times, type of reporters, suspected drugs, "seriousness" and nature of ADRs) of online notifications reported to the RPVC between July 7(th), 2010 (first online notification) and December 31(th), 2011. We performed comparisons to a random sample of "conventional" notifications, i.e. spontaneously reported to the RPVC via traditional tools (post, fax, e-mail or telephone) during the same period. The total number of online reports was 312 over the 18-month period. There was a 45% increase in numbers of reports from ambulatory healthcare professionals after the implementation of the new reporting tool. Online reports were transmitted to the French Medicine Agency on average almost one month (26 days) earlier than "conventional" ones. This difference was mainly due to a faster ADR notification process via the online form (on average, the reporting period was decreased by 19 days with the new tool). In comparison to "conventional" notifications, online reports came more often from ambulatory healthcare professionals, and involved more frequently neuropsychiatric drugs and neuropsychiatric ADRs. None difference was observed for "seriousness" of ADRs. It is feasible to deploy an online ADR reporting system used by health professionals in current practice. We underline the efficiency of this new online reporting tool for increasing ADRs reporting. Moreover, this is the first published study demonstrating that an online reporting tool can help to save time on the ADR reporting

  3. Social comparison in the brain: A coordinate-based meta-analysis of functional brain imaging studies on the downward and upward comparisons.

    PubMed

    Luo, Yi; Eickhoff, Simon B; Hétu, Sébastien; Feng, Chunliang

    2018-01-01

    Social comparison is ubiquitous across human societies with dramatic influence on people's well-being and decision making. Downward comparison (comparing to worse-off others) and upward comparison (comparing to better-off others) constitute two types of social comparisons that produce different neuropsychological consequences. Based on studies exploring neural signatures associated with downward and upward comparisons, the current study utilized a coordinate-based meta-analysis to provide a refinement of understanding about the underlying neural architecture of social comparison. We identified consistent involvement of the ventral striatum and ventromedial prefrontal cortex in downward comparison and consistent involvement of the anterior insula and dorsal anterior cingulate cortex in upward comparison. These findings fit well with the "common-currency" hypothesis that neural representations of social gain or loss resemble those for non-social reward or loss processing. Accordingly, we discussed our findings in the framework of general reinforcement learning (RL) hypothesis, arguing how social gain/loss induced by social comparisons could be encoded by the brain as a domain-general signal (i.e., prediction errors) serving to adjust people's decisions in social settings. Although the RL account may serve as a heuristic framework for the future research, other plausible accounts on the neuropsychological mechanism of social comparison were also acknowledged. Hum Brain Mapp 39:440-458, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  4. Assessing Latina/o Undergraduates' Depressive Symptomatology: Comparisons of the Beck Depression Inventory-II, the Center for Epidemiological Studies-Depression Scale, and the Self-Report Depression Scale

    ERIC Educational Resources Information Center

    Gloria, Alberta M.; Castellanos, Jeanett; Kanagui-Munoz, Marlen; Rico, Melissa A.

    2012-01-01

    The use of depression scales as screening tools at university and college centers is increasing and thus, the question of whether scales are culturally valid for different student groups is increasingly more relevant with increased severity of depression for students and changing student demographics. As such, this study examined the reliability…

  5. [Study of the work and of working in Family Health Care Support Center].

    PubMed

    Lancman, Selma; Gonçalves, Rita Maria de Abreu; Cordone, Nicole Guimarães; Barros, Juliana de Oliveira

    2013-10-01

    To understand the organization of and the working conditions in family health care support centers, as well as subjective experiences related to work in two of these centers. This was a case study carried out during 2011 and 2012 in two family health care support centers in Sao Paulo, Southeastern Brazil. Data were collected and analyzed using two theoretical-methodological references from ergonomics and work psychodynamics influenced, respectively, by ergonomic work analysis, developed based on open observations of a variety of tasks and on interviews and in practice in work psychodynamics, carried out using think tanks about the work. The work of the Family Health Care Support Centers in question is constituted on the bases of complex, diversified actions to be shared among the various professionals and teams involved. Innovative technological tools, which are not often adopted by primary health care professionals, are used and the parameters and productivity measures do not encompass the specificity and the complexity of the work performed. These situations require constant organizational rearrangement, especially between the Family Health Care Support Centers and the Family Health Care Teams, causing difficulties in carrying out the work as well as in constituting the identity of the professionals studied. The study attempts to lend greater visibility to the work processes at the Family Health Care Support Centers in order to contribute to advances in public policy on primary healthcare. It is important to stress that introducing changes at work, which affect both its organization and work conditions, is above all a commitment, which to be effective, must be permanent and must involve the different levels of hierarchy.

  6. Environmental Studies Center Teacher Books. 1st Grade - Habitats.

    ERIC Educational Resources Information Center

    Martin County Schools, Jensen Beach, FL. Environmental Studies Center.

    This teacher's guide, one of nine teacher packages developed for use in the sequential, hands-on, field-oriented, K-8 environmental education program of the Martin County Schools in Florida, was developed for use with elementary children in grade one prior to and after a visit to an environmental studies center located near an estuarine area. This…

  7. Group Time in Early Childhood Centers: An Exploratory Study.

    ERIC Educational Resources Information Center

    McAfee, Oralie

    To investigate the current status of group time in early childhood centers, a small-scale exploratory study was designed and executed. Results of interviews with 35 teachers and observations in five classrooms serving children ages 2 1/2 through kindergarten revealed that all classrooms had at least one group time or circle time, usually in the…

  8. The 2006 Kennedy Space Center Range Reference Atmosphere Model Validation Study and Sensitivity Analysis to the Performance of the National Aeronautics and Space Administration's Space Shuttle Vehicle

    NASA Technical Reports Server (NTRS)

    Burns, Lee; Decker, Ryan; Harrington, Brian; Merry, Carl

    2008-01-01

    The Kennedy Space Center (KSC) Range Reference Atmosphere (RRA) is a statistical model that summarizes wind and thermodynamic atmospheric variability from surface to 70 km. The National Aeronautics and Space Administration's (NASA) Space Shuttle program, which launches from KSC, utilizes the KSC RRA data to evaluate environmental constraints on various aspects of the vehicle during ascent. An update to the KSC RRA was recently completed. As part of the update, the Natural Environments Branch at NASA's Marshall Space Flight Center (MSFC) conducted a validation study and a comparison analysis to the existing KSC RRA database version 1983. Assessments to the Space Shuttle vehicle ascent profile characteristics were performed by JSC/Ascent Flight Design Division to determine impacts of the updated model to the vehicle performance. Details on the model updates and the vehicle sensitivity analyses with the update model are presented.

  9. Health status, resource consumption, and costs of dysthymia. A multi-center two-year longitudinal study.

    PubMed

    Barbui, Corrado; Motterlini, Nicola; Garattini, Livio

    2006-02-01

    In this study we estimated the health status, resource consumption and costs of a large cohort of patients with early and late-onset dysthymia. The DYSCO (DYSthymia COsts) project is a multi-center observational study which prospectively followed for two years a randomly chosen sample of patients with dysthymia in the Italian primary health care system. A total of 501 patients were followed for two years; 81% had early-onset dysthymic disorder. During the study, improvement was seen in most domains of the 36-Item Short Form Health Survey (SF-36) questionnaire. Comparison of the SF-36 scores for the two groups showed that only the physical health index significantly differed during the two years. The use of outpatient consultations, laboratory tests and diagnostic procedures was similar in the two groups, but patients with early-onset dysthymia were admitted significantly more than late-onset cases. Hospital admissions were almost entirely responsible for the higher total cost per patient per year of early-onset dysthymia. A first limitation of this study is that general practitioners were selected on the basis of their willingness to participate, not at random; secondly, no information was collected on concomitant psychiatric comorbidities. The present study provides the first prospective, long-term data on service use and costs in patients with dysthymia. Differently from patients with early-onset dysthymia, patients with late-onset dysthymia were admitted less and cost less.

  10. Comparison of canal transportation and centering ability of rotary protaper, one shape system and wave one system using cone beam computed tomography: An in vitro study

    PubMed Central

    Tambe, Varsha Harshal; Nagmode, Pradnya Sunil; Abraham, Sathish; Patait, Mahendra; Lahoti, Pratik Vinod; Jaju, Neha

    2014-01-01

    Aim: The aim of the present study was to compare the canal transportation and centering ability of Rotary ProTaper, One Shape and Wave One systems using cone beam computed tomography (CBCT) in curved root canals to find better instrumentation technique for maintaining root canal geometry. Materials and Methods: Total 30 freshly extracted premolars having curved root canals with at least 10 degrees of curvature were divided into three groups of 10 teeth each. All teeth were scanned by CBCT to determine the root canal shape before instrumentation. In Group 1, the canals were prepared with Rotary ProTaper files, in Group 2 the canals were prepared with One Shape files and in Group 3 canals were prepared with Wave One files. After preparation, post-instrumentation scan was performed. Pre-instrumentation and post-instrumentation images were obtained at three levels, 3 mm apical, 3 mm coronal and 8 mm apical above the apical foramen were compared using CBCT software. Amount of transportation and centering ability were assessed. The three groups were statistically compared with analysis of variance and Tukey honestly significant. Results: All instruments maintained the original canal curvature with significant differences between the different files. Data suggested that Wave One files presented the best outcomes for both the variables evaluated. Wave One files caused lesser transportation and remained better centered in the canal than One Shape and Rotary ProTaper files. Conclusion: The canal preparation with Wave One files showed lesser transportation and better centering ability than One Shape and ProTaper. PMID:25506145

  11. Benefits Analysis of Multi-Center Dynamic Weather Routes

    NASA Technical Reports Server (NTRS)

    Sheth, Kapil; McNally, David; Morando, Alexander; Clymer, Alexis; Lock, Jennifer; Petersen, Julien

    2014-01-01

    Dynamic weather routes are flight plan corrections that can provide airborne flights more than user-specified minutes of flying-time savings, compared to their current flight plan. These routes are computed from the aircraft's current location to a flight plan fix downstream (within a predefined limit region), while avoiding forecasted convective weather regions. The Dynamic Weather Routes automation has been continuously running with live air traffic data for a field evaluation at the American Airlines Integrated Operations Center in Fort Worth, TX since July 31, 2012, where flights within the Fort Worth Air Route Traffic Control Center are evaluated for time savings. This paper extends the methodology to all Centers in United States and presents benefits analysis of Dynamic Weather Routes automation, if it was implemented in multiple airspace Centers individually and concurrently. The current computation of dynamic weather routes requires a limit rectangle so that a downstream capture fix can be selected, preventing very large route changes spanning several Centers. In this paper, first, a method of computing a limit polygon (as opposed to a rectangle used for Fort Worth Center) is described for each of the 20 Centers in the National Airspace System. The Future ATM Concepts Evaluation Tool, a nationwide simulation and analysis tool, is used for this purpose. After a comparison of results with the Center-based Dynamic Weather Routes automation in Fort Worth Center, results are presented for 11 Centers in the contiguous United States. These Centers are generally most impacted by convective weather. A breakdown of individual Center and airline savings is presented and the results indicate an overall average savings of about 10 minutes of flying time are obtained per flight.

  12. Alternate Propulsion Subsystem Concepts Tripropellant Comparison Study

    NASA Technical Reports Server (NTRS)

    Levack, Daniel

    1995-01-01

    A study was conducted under MSFC contract NAS8-39210 to compare tripropellant and bipropellant engine configurations for the SSTO mission. The objective was to produce an 'apples-to-apples' comparison to isolate the effects of design implementation, designing company, year of design, or technologies included from the basic tripropellant/bipropellant comparison. Consequently, identical technologies were included (e.g., jet pumps) and the same design groundrules and practices were used. Engine power cycles were examined as were turbomachinery/preburner arrangements for each cycle. The bipropellant approach and two tripropellant approaches were separately optimized in terms of operating parameters: exit pressures, mixture ratios, thrust splits, etc. This briefing presents the results of the study including engine weights for both tripropellant and bipropellant engines; dry vehicle weight performance for a range of engine chamber pressures; discusses the basis for the results; examines vehicle performance due to engine cycles and the margin characteristics of various cycles; and identifies technologies with significant payoffs for this application.

  13. Comparison of mean climate trends in the Northern Hemisphere between National Centers for Environmental Prediction and two atmosphere-ocean model forced runs

    NASA Astrophysics Data System (ADS)

    Lucarini, Valerio; Russell, Gary L.

    2002-08-01

    Results are presented for two greenhouse gas experiments of the Goddard Institute for Space Studies atmosphere-ocean model (AOM). The computed trends of surface pressure; surface temperature; 850, 500, and 200 mbar geopotential heights; and related temperatures of the model for the time frame 1960-2000 are compared with those obtained from the National Centers for Enviromental Prediction (NCEP) observations. The domain of interest is the Northern Hemisphere because of the higher reliability of both the model results and the observations. A spatial correlation analysis and a mean value comparison are performed, showing good agreement in terms of statistical significance for most of the variables considered in the winter and annual means. However, the 850 mbar temperature trends do not show significant positive correlation, and the surface pressure and 850 mbar geopotential height mean trends confidence intervals do not overlap. A brief general discussion about the statistics of trend detection is presented. The accuracy that this AOM has in describing the regional and NH mean climate trends inferred from NCEP through the atmosphere suggests that it may be reliable in forecasting future climate changes.

  14. Inconsistency between direct and indirect comparisons of competing interventions: meta-epidemiological study.

    PubMed

    Song, Fujian; Xiong, Tengbin; Parekh-Bhurke, Sheetal; Loke, Yoon K; Sutton, Alex J; Eastwood, Alison J; Holland, Richard; Chen, Yen-Fu; Glenny, Anne-Marie; Deeks, Jonathan J; Altman, Doug G

    2011-08-16

    To investigate the agreement between direct and indirect comparisons of competing healthcare interventions. Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Data sources Cochrane Database of Systematic Reviews and PubMed. Inclusion criteria Systematic reviews that provided sufficient data for both direct comparison and independent indirect comparisons of two interventions on the basis of a common comparator and in which the odds ratio could be used as the outcome statistic. Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods. The study included 112 independent trial networks (including 1552 trials with 478,775 patients in total) that allowed both direct and indirect comparison of two interventions. Indirect comparison had already been explicitly done in only 13 of the 85 Cochrane reviews included. The inconsistency between the direct and indirect comparison was statistically significant in 16 cases (14%, 95% confidence interval 9% to 22%). The statistically significant inconsistency was associated with fewer trials, subjectively assessed outcomes, and statistically significant effects of treatment in either direct or indirect comparisons. Owing to considerable inconsistency, many (14/39) of the statistically significant effects by direct comparison became non-significant when the direct and indirect estimates were combined. Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Direct and indirect estimates should be combined in mixed treatment comparisons only after adequate assessment of the consistency of the evidence.

  15. Protein structure, electron transfer and evolution of prokaryotic photosynthetic reaction centers

    NASA Technical Reports Server (NTRS)

    Blankenship, R. E.

    1994-01-01

    Photosynthetic reaction centers from a variety of organisms have been isolated and characterized. The groups of prokaryotic photosynthetic organisms include the purple bacteria, the filamentous green bacteria, the green sulfur bacteria and the heliobacteria as anoxygenic representatives as well as the cyanobacteria and prochlorophytes as oxygenic representatives. This review focuses on structural and functional comparisons of the various groups of photosynthetic reaction centers and considers possible evolutionary scenarios to explain the diversity of existing photosynthetic organisms.

  16. The neural correlates of internal and external comparisons: an fMRI study.

    PubMed

    Wen, Xue; Xiang, Yanhui; Cant, Jonathan S; Wang, Tingting; Cupchik, Gerald; Huang, Ruiwang; Mo, Lei

    2017-01-01

    Many previous studies have suggested that various comparisons rely on the same cognitive and neural mechanisms. However, little attention has been paid to exploring the commonalities and differences between the internal comparison based on concepts or rules and the external comparison based on perception. In the present experiment, moral beauty comparison and facial beauty comparison were selected as the representatives of internal comparison and external comparison, respectively. Functional magnetic resonance imaging (fMRI) was used to record brain activity while participants compared the level of moral beauty of two scene drawings containing moral acts or the level of facial beauty of two face photos. In addition, a physical size comparison task with the same stimuli as the beauty comparison was included. We observed that both the internal moral beauty comparison and external facial beauty comparison obeyed a typical distance effect and this behavioral effect recruited a common frontoparietal network involved in comparisons of simple physical magnitudes such as size. In addition, compared to external facial beauty comparison, internal moral beauty comparison induced greater activity in more advanced and complex cortical regions, such as the bilateral middle temporal gyrus and middle occipital gyrus, but weaker activity in the putamen, a subcortical region. Our results provide novel neural evidence for the comparative process and suggest that different comparisons may rely on both common cognitive processes as well as distinct and specific cognitive components.

  17. Treatment Seeking and Ebola Community Care Centers in Sierra Leone: A Qualitative Study.

    PubMed

    Carter, Simone E; O'Reilly, Marion; Frith-Powell, Jack; Umar Kargbo, Alpha; Byrne, Daniel; Niederberger, Eva

    2017-01-01

    Ebola Treatment Units were able to provide only 60% of necessary treatment beds in Sierra Leone. As a result, the Government of Sierra Leone decided to construct Community Care Centers. These were intended to increase treatment-seeking behavior and reduce the community-level spread of Ebola by facilitating access to care closer to communities. Through qualitative data collection in 3 districts, this study seeks to understand the perceived impact that proximity to such Centers had on treatment-seeking behavior. Feedback from community members and Community Health Volunteers indicates that proximity to treatment reduced fears, especially those arising from the use of ambulances, lack of familiarity with medical Centers, and loss of contact with family members taken for treatment. Participants report that having a Center close to their home enables them to walk to treatment and witness survivors being discharged. Living close to Centers also enables communities to be involved in their design and daily operation, helping to build trust in them as acceptable treatment facilities. Further research is required to understand the appropriate design, operation, and epidemiological impact of Centers. Further investigation should incorporate the effect of an outbreak's severity and the stage (duration) of the outbreak on potential acceptance of Centers.

  18. Center-Specific Factors Associated with Peritonitis Risk-A Multi-Center Registry Analysis.

    PubMed

    Nadeau-Fredette, Annie-Claire; Johnson, David W; Hawley, Carmel M; Pascoe, Elaine M; Cho, Yeoungjee; Clayton, Philip A; Borlace, Monique; Badve, Sunil V; Sud, Kamal; Boudville, Neil; McDonald, Stephen P

    ♦ Previous studies have reported significant variation in peritonitis rates across dialysis centers. Limited evidence is available to explain this variability. The aim of this study was to assess center-level predictors of peritonitis and their relationship with peritonitis rate variations. ♦ All incident peritoneal dialysis (PD) patients treated in Australia between October 2003 and December 2013 were included. Data were accessed through the Australia and New Zealand Dialysis and Transplant Registry. The primary outcome was peritonitis rate, evaluated in a mixed effects negative binomial regression model. Peritonitis-free survival was assessed as a secondary outcome in a Cox proportional hazards model. ♦ Overall, 8,711 incident PD patients from 51 dialysis centers were included in the study. Center-level predictors of lower peritonitis rates included smaller center size, high proportion of PD, low peritoneal equilibration test use at PD start, and low proportion of hospitalization for peritonitis. In contrast, a low proportion of automated PD exposure, high icodextrin exposure and low or high use of antifungal prophylaxis at the time of peritonitis were associated with a higher peritonitis rate. Similar results were obtained for peritonitis-free survival. Overall, accounting for center-level characteristics appreciably decreased peritonitis variability among dialysis centers (p = 0.02). ♦ This study identified specific center-level characteristics associated with the variation in peritonitis risk. Whether these factors are directly related to peritonitis risk or surrogate markers for other center characteristics is uncertain and should be validated in further studies. Copyright © 2016 International Society for Peritoneal Dialysis.

  19. Medical waste management in Jordan: A study at the King Hussein Medical Center

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Oweis, Rami; Al-Widyan, Mohamad; Al-Limoon, Ohood

    2005-07-01

    As in many other developing countries, the generation of regulated medical waste (RMW) in Jordan has increased significantly over the last few decades. Despite the serious impacts of RMW on humans and the environment, only minor attention has been directed to its proper handling and disposal. This study was conducted in the form of a case study at one of Jordan's leading medical centers, namely, the King Hussein Medical Center (KHMC). Its purpose was to report on the current status of medical waste management at KHMC and propose possible measures to improve it. In general, it was found that themore » center's administration was reasonably aware of the importance of medical waste management and practiced some of the measures to adequately handle waste generated at the center. However, it was also found that significant voids were present that need to be addressed in the future including efficient segregation, the use of coded and colored bags, better handling and transfer means, and better monitoring and tracking techniques, as well as the need for training and awareness programs for the personnel.« less

  20. Patient-centered boundary mechanisms to foster intercultural partnerships in health care: a case study in Guatemala.

    PubMed

    Hitziger, Martin; Berger Gonzalez, Mónica; Gharzouzi, Eduardo; Ochaíta Santizo, Daniela; Solis Miranda, Regina; Aguilar Ferro, Andrea Isabel; Vides-Porras, Ana; Heinrich, Michael; Edwards, Peter; Krütli, Pius

    2017-08-08

    traditional health care due to refined diagnoses and adapted treatment strategies. In individual cases, the beneficial effects of traditional treatments were remarkable, and the doctors continued to collaborate with healers after the study was completed. Comparison of the two linguistic groups illustrated that the outcomes are highly context-dependent. If well adapted to local context, patient-centered boundary mechanisms can enable intercultural partnerships by creating access, building trust and fostering mutual learning, even in circumstances as complex as those in Guatemala. Creating multilateral patient-centered boundary mechanisms is thus a promising approach to improve health care in medically pluralistic developing countries.

  1. Geology orbiter comparison study

    NASA Technical Reports Server (NTRS)

    Cutts, J. A. J.; Blasius, K. R.; Davis, D. R.; Pang, K. D.; Shreve, D. C.

    1977-01-01

    Instrument requirements of planetary geology orbiters were examined with the objective of determining the feasibility of applying standard instrument designs to a host of terrestrial targets. Within the basic discipline area of geochemistry, gamma-ray, X-ray fluorescence, and atomic spectroscopy remote sensing techniques were considered. Within the discipline area of geophysics, the complementary techniques of gravimetry and radar were studied. Experiments using these techniques were analyzed for comparison at the Moon, Mercury, Mars and the Galilean satellites. On the basis of these comparative assessments, the adaptability of each sensing technique was judged as a basic technique for many targets, as a single instrument applied to many targets, as a single instrument used in different mission modes, and as an instrument capability for nongeoscience objectives.

  2. Vegetation studies, National Training Center, Fort Irwin, California

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brandt, C.A.; Rickard, W.H.; Cadoret, N.A.

    1997-09-01

    During the spring of 1992, the Pacific Northwest National Laboratory (PNNL) conducted surveys of the Avawatz and Granite mountains springs for the National Training Center (NTC) to evaluate the occurrence of sensitive plant species in these areas. PNNL also conducted a survey of the eastern outwash of the Paradise Range for the occurrence of Lane Mountain milk vetch (Astragalus jaegerianus). In spring of 1993, PNNL conducted an additional study of Lane Mountain milk vetch on the NTC to determine habitat characteristics for this plant and to develop a method for predicting its potential occurrence, based on simple habitat attributes. Themore » results of these studies are itemized.« less

  3. Inconsistency between direct and indirect comparisons of competing interventions: meta-epidemiological study

    PubMed Central

    Xiong, Tengbin; Parekh-Bhurke, Sheetal; Loke, Yoon K; Sutton, Alex J; Eastwood, Alison J; Holland, Richard; Chen, Yen-Fu; Glenny, Anne-Marie; Deeks, Jonathan J; Altman, Doug G

    2011-01-01

    Objective To investigate the agreement between direct and indirect comparisons of competing healthcare interventions. Design Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Data sources Cochrane Database of Systematic Reviews and PubMed. Inclusion criteria Systematic reviews that provided sufficient data for both direct comparison and independent indirect comparisons of two interventions on the basis of a common comparator and in which the odds ratio could be used as the outcome statistic. Main outcome measure Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods. Results The study included 112 independent trial networks (including 1552 trials with 478 775 patients in total) that allowed both direct and indirect comparison of two interventions. Indirect comparison had already been explicitly done in only 13 of the 85 Cochrane reviews included. The inconsistency between the direct and indirect comparison was statistically significant in 16 cases (14%, 95% confidence interval 9% to 22%). The statistically significant inconsistency was associated with fewer trials, subjectively assessed outcomes, and statistically significant effects of treatment in either direct or indirect comparisons. Owing to considerable inconsistency, many (14/39) of the statistically significant effects by direct comparison became non-significant when the direct and indirect estimates were combined. Conclusions Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Direct and indirect estimates should be combined in mixed treatment comparisons only after adequate assessment of the consistency of the evidence. PMID:21846695

  4. The Impact of Wireless Technology on Order Selection Audits at an Auto Parts Distribution Center

    ERIC Educational Resources Information Center

    Goomas, David T.

    2012-01-01

    Audits of store order pallets or totes performed by auditors at five distribution centers (two experimental and three comparison distribution centers) were used to check for picking accuracy prior to being loaded onto a truck for store delivery. Replacing the paper audits with wireless handheld computers that included immediate auditory and visual…

  5. The Minnesota Project English Center: Selected Materials. Unit 701: Introduction to the Study of Language.

    ERIC Educational Resources Information Center

    Minnesota Univ., Minneapolis. Center for Curriculum Development in English.

    This Minnesota Curriculum Center report recounts the development of teaching materials on the nature and uses of language for grades 7-12 and presents the first of five seventh-grade units. A description of the origins, purposes, and personnel of the Center is followed by brief discussions of (1) the Center's underlying assumption that a study of…

  6. Unintentional Epinephrine Auto-injector Injuries: A National Poison Center Observational Study.

    PubMed

    Anshien, Marco; Rose, S Rutherfoord; Wills, Brandon K

    2016-11-24

    Epinephrine is the only first-line therapeutic agent used to treat life-threatening anaphylaxis. Epinephrine auto-injectors are commonly carried by patients at risk for anaphylaxis, and reported cases of unintentional auto-injector injury have increased over the last decade. Modifications of existing designs and release of a new style of auto-injector are intended to reduce epinephrine auto-injector misuse. The aim of the study was to characterize reported cases of unintentional epinephrine auto-injector exposures from 2013 to 2014 and compare demographics, auto-injector model, and anatomical site of such exposures. The American Association of Poison Control Center's National Poison Data System was searched from January 1, 2013, to December 31, 2014, for cases of unintentional epinephrine auto-injector exposures. Anatomical site data were obtained from all cases reported to the Virginia Poison Center and participating regional poison center for Auvi-Q cases. A total of 6806 cases of unintentional epinephrine auto-injector exposures were reported to US Poison Centers in 2013 and 2014. Of these cases, 3933 occurred with EpiPen, 2829 with EpiPen Jr, 44 with Auvi-Q, and no case reported of Adrenaclick. The most common site of unintentional injection for traditional epinephrine auto-injectors was the digit or thumb, with 58% of cases for EpiPen and 39% of cases with EpiPen Jr. With Auvi-Q, the most common site was the leg (78% of cases). The number of unintentional epinephrine auto-injector cases reported to American Poison Centers in 2013-2014 has increased compared with previous data. Most EpiPen exposures were in the digits, whereas Auvi-Q was most frequently in the leg. Because of the limitations of Poison Center data, more research is needed to identify incidence of unintentional exposures and the effectiveness of epinephrine auto-injector redesign.

  7. WHY THEY CAME TO THE EAST-WEST CENTER, A COMPARISON OF ASIAN PACIFIC AND AMERICAN GRANTEES.

    ERIC Educational Resources Information Center

    MEREDITH, GERALD M.

    MAJOR COMPONENTS IN REASONS GIVEN BY ASIAN-PACIFIC AND AMERICAN GRANTEES FOR THE DECISION TO ATTEND THE EAST-WEST CENTER ARE IDENTIFIED. THE STUDY HELPED TO--(1) IDENTIFY MAJOR FACTORS IN REASONS GIVEN FOR ATTENDANCE, (2) CLARIFY THE SELF-REPORTED MOTIVATIONAL STRUCTURE BEHIND EDUCATIONAL-VOCATIONAL DECISIONS, AND (3) EXAMINE THE RELATIONSHIP OF…

  8. The NASA Lewis Research Center's Expendable Launch Vehicle Program: An Economic Impact Study

    NASA Technical Reports Server (NTRS)

    Austrian, Ziona

    1996-01-01

    This study investigates the economic impact of the Lewis Research Center's (LeRC) Expendable Launch Vehicle Program (ELVP) on Northeast Ohio's economy. It was conducted by The Urban Center's Economic Development Program in Cleveland State University's Levin College of Urban Affairs. The study measures ELVP's direct impact on the local economy in terms of jobs, output, payroll, and taxes, as well as the indirect impact of these economic activities when they "ripple" throughout the economy. The study uses regional economic multipliers based on input-output models to estimate the effect of ELVP spending on the Northeast Ohio economy.

  9. The NASA Lewis Research Center's Expendable Launch Vehicle Program: An Economic Impact Study

    NASA Technical Reports Server (NTRS)

    Austrian, Ziona

    1996-01-01

    This study investigates the economic impact of the Lewis Research Center's (LeRC) Expendable Launch Vehicle Program (ELVP) on Northeast Ohio's economy. It was conducted by The Urban Center's Economic Development Program in Cleveland State University's Levin College of Urban Affairs. The study measures ELVP's direct impact on the local economy in terms of jobs, output, payroll, and taxes, as well as the indirect impact of these economic activities when they 'ripple' throughout the economy. The study uses regional economic multipliers based on input-output models to estimate the effect of ELVP spending on the Northeast Ohio economy.

  10. Asthma Outcomes at an Inner-City School-Based Health Center.

    ERIC Educational Resources Information Center

    Lurie, Nicole; Bauer, Ellen Jones; Brady, Cynthia

    2001-01-01

    Measured asthma outcomes after initiating an inner-city elementary school health center that emphasized asthma detection and treatment. Pre- and post-intervention comparison of students indicated that: hospitalization rates for asthma decreased; outpatient visits for care in the absence of symptoms doubled; numbers of students seeing an asthma…

  11. [Fetal bradycardia: a retrospective study in 9 Spanish centers].

    PubMed

    Perin, F; Rodríguez Vázquez del Rey, M M; Deiros Bronte, L; Ferrer Menduiña, Q; Rueda Nuñez, F; Zabala Arguelles, J I; García de la Calzada, D; Teodoro Marin, S; Centeno Malfaz, F; Galindo Izquierdo, A

    2014-11-01

    The aim of this study is to review the current management and outcomes of fetal bradycardia in 9 Spanish centers. Retrospective multicenter study: analysis of all fetuses with bradycardia diagnosed between January 2008 and September 2010. Underlying mechanisms of fetal bradyarrhythmias were studied with echocardiography. A total of 37 cases were registered: 3 sinus bradycardia, 15 blocked atrial bigeminy, and 19 high grade atrioventricular blocks. Sinus bradycardia: 3 cases (100%) were associated with serious diseases. Blocked atrial bigeminy had an excellent outcome, except for one case with post-natal tachyarrhythmia. Of the atrioventricular blocks, 16% were related to congenital heart defects with isomerism, 63% related to the presence of maternal SSA/Ro antibodies, and 21% had unclear etiology. Overall mortality was 20% (37%, if terminations of pregnancy are taken into account). Risk factors for mortality were congenital heart disease, hydrops and/or ventricular dysfunction. Management strategies differed among centers. Steroids were administrated in 73% of immune-mediated atrioventricular blocks, including the only immune-mediated IInd grade block. More than half (58%) of atrioventricular blocks had a pacemaker implanted in a follow-up of 18 months. Sustained fetal bradycardia requires a comprehensive study in all cases, including those with sinus bradycardia. Blocked atrial bigeminy has a good prognosis, but tachyarrhythmias may develop. Heart block has significant mortality and morbidity rates, and its management is still highly controversial. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  12. The official websites of blood centers in China: A nationwide cross-sectional study.

    PubMed

    Hu, Huiying; Wang, Jing; Zhu, Ming

    2017-01-01

    Blood collection agencies worldwide are facing ongoing and increasing medical demands for blood products. Many potential donors would search related information online before making decision of whether or not to donate blood. However, there is little knowledge of the online information and services provided by blood centers in China, despite the constantly increase of internet users. Our research investigates the number of blood centers' official websites and their quality, and highlights the deficiencies that required future advances. Identified official websites of blood centers were scored using a newly developed evaluation instrument with 42 items concerning technical aspects, information quality, information comprehensiveness and interactive services. Scores of websites were compared between blood centers with different level (provincial vs. regional blood centers) and location (blood centers located in economically developed vs. developing region). For the 253 working official websites all the 350 blood centers in China, and the mean overall score of websites was 24.7 out of 42. 79.1% websites were rated as fair (50-75% of maximum), 5.5% as good (≥75% of maximum) and 15.4% as poor(25-50% of maximum;). Websites got very low sub-scores in information quality (mean = 3.8; range 1-8; maximum = 9) and interactive services (3.3; 0-10; 10). Higher proportions of provincial (vs. regional) blood centers and economically developed (vs. developing) blood centers had official websites (p = 0.044 and p = 0.001; respectively) with better overall quality (p<0.001 and p <0.01) and better sub-scores (in all of the four sections and in technical aspects and information quality). Website overall scores was positively correlated with the number of people served by each blood center (p< 0.001) and the donation rate of each province (p = 0.046). This study suggests there is a need to further develop and improve official websites in China, especially for regional and inland blood

  13. A Comparison of the Preventive Health Care Provided by Women's Health Centers and General Internal Medicine Practices

    PubMed Central

    Harpole, Linda H; Mort, Elizabeth A; Freund, Karen M; Orav, John; Brennan, Troyen A

    2000-01-01

    OBJECTIVE To evaluate women's health centers as alternatives to traditional internal medicine practices. DESIGN Cross-sectional mailed survey. SETTING A women's health center and an internal medicine practice at each of three university-affiliated teaching hospitals. PATIENTS There were 3,035 female patients randomly selected to receive a mailed survey after their office visits. MEASUREMENTS AND MAIN RESULTS The survey asked for patient characteristics, patient satisfaction, and rates of gender-specific preventive health services. The survey response rate was 64% (1,942/3,035). Patients at women's health centers were younger, more educated, had higher physical functioning but lower mental health functioning, and more of them were single and employed. Patient satisfaction was similar at the two types of practices, although patients at women's health centers were more satisfied with certain aspects of the patient-provider interaction. After adjusting for measured differences in patient characteristics and site, patients at women's health centers were more likely to receive discussions on hormone replacement therapy (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.1, 2.2) and dietary calcium (OR 1.3; 95% CI 1.1, 1.6). They were also more likely to receive their gender-specific preventive health services from their primary care provider: breast examination (OR 2.0; 95% CI 1.5, 2.6), Pap smear (OR 2.4; 95% CI 1.9, 3.1), hormone replacement therapy discussion (OR 2.2; 95% CI 1.5, 3.3), and dietary calcium discussion (OR 2.6; 95% CI 1.7, 3.9). These findings remained when the analyses were limited to patients of female providers only. CONCLUSIONS In this study, patients at women's health centers were more likely to receive gender-specific health prevention counseling than patients at internal medicine practices. Moreover, patients were more likely to receive their gender-specific preventive health services from their primary care providers. PMID:10632827

  14. Structural Studies of Bacterioferritin B (BfrB) from Pseudomonas aeruginosa Suggest a Gating Mechanism for Iron Uptake via the Ferroxidase Center¥

    PubMed Central

    Weeratunga, Saroja K.; Lovell, Scott; Yao, Huili; Battaile, Kevin P.; Fischer, Christopher J.; Gee, Casey E.; Rivera, Mario

    2010-01-01

    The structure of recombinant P. aeruginosa bacterioferritin B (Pa BfrB) has been solved from crystals grown from protein devoid of core mineral iron (as-isolated) and from protein mineralized with ~ 600 iron atoms (mineralized). Structures were also obtained from crystals grown from mineralized BfrB after soaking them in FeSO4 solution (Fe soak) and in separate experiments after soaking them in FeSO4 solution followed by soaking in crystallization solution (double soak). Although the structures consist of a typical bacterioferritin fold comprised of a nearly spherical 24-mer assembly that binds 12 heme molecules, comparison of microenvironments observed in the distinct structures provided interesting insights: The ferroxidase center in the as-isolated, mineralized and double soak structures is empty. The ferroxidase ligands (except His130) are poised to bind iron with minimal conformational changes. The His130 side chain, on the other hand, must rotate toward the ferroxidase center to coordinate iron. In comparison, the structure obtained from crystals soaked in an FeSO4 solution display a fully occupied ferroxidase center and iron bound to the internal, Fe(in), and external, Fe(out), surfaces of Pa BfrB. The conformation of His130 in this structure is rotated toward the ferroxidase center and coordinates an iron ion. The structures also revealed a pore on the surface of Pa BfrB that likely serves as an entry port for Fe2+ to the ferroxidase center. On its opposite end the pore is capped by the side chain of His130 when it adopts its “gate closed” conformation that enables coordination to a ferroxidase iron. A change to its “gate-open”, non-coordinative conformation, creates a path for the translocation of iron from the ferroxidase center to the interior cavity. These structural observations, together with findings obtained from iron incorporation measurements in solution suggest that the ferroxidase pore is the dominant entry route for the uptake of iron

  15. [Health behaviors between a health promotion demonstration health center and a general health center].

    PubMed

    Lee, Taewha; Lee, Chung-Yul; Kim, Hee-Soon; Ham, Ok-Kyung

    2005-06-01

    The purpose of the study was to compare community residents' perceptions, participation, satisfaction, and behavioral changes between a health promotion demonstration health center and general health center. The design of the study was ex-post facto that compared community residents in demonstration health centers and general health centers. The sample included 2,261 community residents who were conveniently selected from demonstration (792 participants) and general health centers (1,496 participants). The results of the study were as follows: 1) Perception and participation rates of exercise, nutrition, and hypertension management programs were significantly higher in the participants of demonstration health centers than those of general health centers.; 2) Satisfaction rates of all programs except the smoking cessation program were significantly higher in the participants of demonstration health centers than those of general health centers. However, only the exercise rate among risk behaviors of participants was significantly higher in demonstration health centers than general health centers. Systematic efforts for health promotion were effective not only in improving the community's awareness, participation, and satisfaction of the program, but also in changing health behaviors. This evidence should be used to foster and disseminate health promotion programs to other health centers to improve community residents' health status and quality of life.

  16. OOSTT: a Resource for Analyzing the Organizational Structures of Trauma Centers and Trauma Systems

    PubMed Central

    Utecht, Joseph; Judkins, John; Otte, J. Neil; Colvin, Terra; Rogers, Nicholas; Rose, Robert; Alvi, Maria; Hicks, Amanda; Ball, Jane; Bowman, Stephen M.; Maxson, Robert T.; Nabaweesi, Rosemary; Pradhan, Rohit; Sanddal, Nels D.; Tudoreanu, M. Eduard; Winchell, Robert J.; Brochhausen, Mathias

    2017-01-01

    Organizational structures of healthcare organizations has increasingly become a focus of medical research. In the CAFÉ project we aim to provide a web-service enabling ontology-driven comparison of the organizational characteristics of trauma centers and trauma systems. Trauma remains one of the biggest challenges to healthcare systems worldwide. Research has demonstrated that coordinated efforts like trauma systems and trauma centers are key components of addressing this challenge. Evaluation and comparison of these organizations is essential. However, this research challenge is frequently compounded by the lack of a shared terminology and the lack of effective information technology solutions for assessing and comparing these organizations. In this paper we present the Ontology of Organizational Structures of Trauma systems and Trauma centers (OOSTT) that provides the ontological foundation to CAFÉ's web-based questionnaire infrastructure. We present the usage of the ontology in relation to the questionnaire and provide the methods that were used to create the ontology. PMID:28217041

  17. Community Involvement: A Case Study of the Education Resource Center.

    ERIC Educational Resources Information Center

    Wilson, Stephen; And Others

    The Education Resource Center (ERC) is a community-based teachers' resource center located in Chicago (Illinois). Its conceptual base is broader than that of a typical teachers center as ERC represents a community-based social movement with a wider orientation than teacher training. ERC's policy board reflects community organizations and the…

  18. Miami-Dade Community College 1984 Institutional Self-Study. Volume VIII: Medical Center Campus Studies.

    ERIC Educational Resources Information Center

    Miami-Dade Community Coll., FL.

    Part of a systematic, in-depth assessment of Miami-Dade Community College's (MDCC's) educational programs, student support systems, and selected campus-level activities, this volume of the college's institutional self-study report examines the impact and effectiveness of the Medical Center Campus. The report contains the results of a campus study…

  19. Center Size and Center Performance.

    ERIC Educational Resources Information Center

    Helburn, Suzanne; Morris, John

    1996-01-01

    Examined the impact of child care center size on cost, quality, and profits per child. Examined centers ranging from 40 to 80 children and found total cost and revenue per child were similar for small, medium, and large centers. Found profits per child were highest in large centers and that there was no relationship between center quality and…

  20. Comparison Among Methods of Retinopathy Assessment (CAMRA) Study

    PubMed Central

    Ryan, Martha E.; Rajalakshmi, Ramachandran; Prathiba, Vijayaraghavan; Anjana, Ranjit Mohan; Ranjani, Harish; Narayan, K.M. Venkat; Olsen, Timothy W.; Mohan, Viswanathan; Ward, Laura A.; Lynn, Michael J.; Hendrick, Andrew M.

    2015-01-01

    Purpose We compared smartphone fundus photography, nonmydriatic fundus photography, and 7-field mydriatic fundus photography for their abilities to detect and grade diabetic retinopathy (DR). Design This was a prospective, comparative study of 3 photography modalities. Participants Diabetic patients (n = 300) were recruited at the ophthalmology clinic of a tertiary diabetes care center in Chennai, India. Methods Patients underwent photography by all 3 modalities, and photographs were evaluated by 2 retina specialists. Main Outcome Measures The sensitivity and specificity in the detection of DR for both smartphone and nonmydriatic photography were determined by comparison with the standard method, 7-field mydriatic fundus photography. Results The sensitivity and specificity of smartphone fundus photography, compared with 7-field mydriatic fundus photography, for the detection of any DR were 50% (95% confidence interval [CI], 43–56) and 94% (95% CI, 92–97), respectively, and of nonmydriatic fundus photography were 81% (95% CI, 75–86) and 94% (95% CI, 92–96%), respectively. The sensitivity and specificity of smartphone fundus photography for the detection of vision-threatening DR were 59% (95% CI, 46–72) and 100% (95% CI, 99–100), respectively, and of nonmydriatic fundus photography were 54% (95% CI, 40–67) and 99% (95% CI, 98–100), respectively. Conclusions Smartphone and nonmydriatic fundus photography are each able to detect DR and sight-threatening disease. However, the nonmydriatic camera is more sensitive at detecting DR than the smartphone. At this time, the benefits of the smartphone (connectivity, portability, and reduced cost) are not offset by the lack of sufficient sensitivity for detection of DR in most clinical circumstances. PMID:26189190

  1. Report on Advanced Life Support Activities at Kennedy Space Center

    NASA Technical Reports Server (NTRS)

    Wheeler, Raymond M.

    2004-01-01

    Plant studies at Kennedy Space Center last year focused on selecting cultivars of lettuce, tomato, and pepper for further testing as crops for near-term space flight applications. Other testing continued with lettuce, onion, and radish plants grown at different combinations of light (PPF), temperature, and CO2 concentration. In addition, comparisons of mixed versus mono culture approaches for vegetable production were studied. Water processing testing focused on the development and testing of a rotating membrane bioreactor to increase oxygen diffusion levels for reducing total organic carbon levels and promoting nitrification. Other testing continued to study composting testing for food wastes (NRA grant) and the use of supplemental green light with red/blue LED lighting systems for plant production (NRC fellowship).

  2. Metropolitan transportation management center : a case study : Long Island INFORM : identifying incidents and informing travelers

    DOT National Transportation Integrated Search

    1999-10-01

    The following case study provides a snapshot of Long Island's INFORM transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting St...

  3. Comparison study and thoron interference test of different radon monitors.

    PubMed

    Sumesh, C G; Kumar, A Vinod; Tripathi, R M; Puranik, V D

    2013-03-01

    A comparison study and thoron interference test for different continuous radon monitors were carried out. The comparison study includes three passive diffusion monitors [one pulse ionisation chamber based-Alpha Guard and two silicon semi-conductor based-Radon Scout Plus (RSP)] and one silicon semi-conductor-based active radon thoron discriminating monitor--RAD 7. Radon emanation standard, supplied by National Institute of Science and Technology, has been utilised for the comparison study to qualify the calibration of the continuous radon monitors. All the instruments showed good agreement with the estimated radon concentration using (226)Ra/(222)Rn emanation standard. It was found that the active radon monitoring system is having a higher initial response towards the transient radon concentration than the passive radon monitors studied. The instruments measuring radon concentration without energy discrimination are likely to have some sensitivity towards the thoron concentration. Thus, thoron interference study was carried out in the above monitors. Nine percent interference in measured radon concentration in the Alpha Guard monitor and 4 % interference in the semi-conductor-based RSP monitors was observed. Study indicates that the interference of thoron in radon monitors depends on the area of diffusion of gas, volume of detection and sensitivity factor.

  4. Space Shuttle hypersonic aerodynamic and aerothermodynamic flight research and the comparison to ground test results

    NASA Technical Reports Server (NTRS)

    Iliff, Kenneth W.; Shafer, Mary F.

    1993-01-01

    Aerodynamic and aerothermodynamic comparisons between flight and ground test for the Space Shuttle at hypersonic speeds are discussed. All of the comparisons are taken from papers published by researchers active in the Space Shuttle program. The aerodynamic comparisons include stability and control derivatives, center-of-pressure location, and reaction control jet interaction. Comparisons are also discussed for various forms of heating, including catalytic, boundary layer, top centerline, side fuselage, OMS pod, wing leading edge, and shock interaction. The jet interaction and center-of-pressure location flight values exceeded not only the predictions but also the uncertainties of the predictions. Predictions were significantly exceeded for the heating caused by the vortex impingement on the OMS pods and for heating caused by the wing leading-edge shock interaction.

  5. Cross-cultural comparison of fertility specific quality of life in German, Hungarian and Jordanian couples attending a fertility center.

    PubMed

    Sexty, Réka E; Hamadneh, Jehan; Rösner, Sabine; Strowitzki, Thomas; Ditzen, Beate; Toth, Bettina; Wischmann, Tewes

    2016-02-24

    Only a few studies have reported cross-cultural comparisons regarding psychosocial consequences of infertility. Differences between societies with different cultural backgrounds were revealed and seemed to be based on the importance of pronatalism. Our aim was to measure cross-cultural differences in fertility specific quality of life of infertile couples in Germany, Hungary and Jordan who attend a fertility center in a cross-sectional study. A cross-sectional study was conducted in one fertility clinic in Germany, in five fertility clinics in Hungary and in one fertility clinic in Jordan. Overall 750 couples (252 couples in Jordan, 246 couples in Germany and 252 couples in Hungary) attending the first medical infertility consultation were asked to fill out our questionnaire set. Fertility specific quality of life (FertiQoL) and sociodemographic differences were measured between couples from three countries. Jordanian couples had the shortest relationship (5.8 ± 4.3 yrs.), though they reported the longest duration of child wish (4.2 ± 3.6 yrs.) and fertility treatments (3.0 ± 3.3 yrs.). The proportion of high education was considerably higher in Jordanian women and men (60 % and 66 %, respectively) compared to the other two samples. First, marked cross-country differences were obtained on Emotional, Mind/Body and Relational subscales of the FertiQoL, indicating that Jordanian couples reported poorer fertility-related quality of life than Germans and Hungarians (p < 0.001). After controlling for the sociodemographic and medical variables, a significant difference only in the Emotional domain was observed (p < 0.001). The study revealed only a few cultural based differences in fertility specific quality of life between the couples of the three countries. Thus, infertility counselors should pay attention to psychosocial problems rooted in individual sociocultural aspects of the infertile couple regardless of cultural stereotypes. Further studies should identify

  6. Stockbridge Munsee Community Health and Wellness Center and the Mohican Family Center Renewable Energy and Energy Efficiency Feasibility Study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    DeRocher, Andy; Barrnett, Michael

    2014-03-14

    The results of the Renewable Energy and Energy Efficiency Feasibility Study of Stockbridge Munsee Community’s Health and Wellness Center (HWC) indicate that a variety of renewable energy options and energy conservation measures (ECMs) exist for the facility. A requirement of the Request for Proposal for this study was to assess renewable energy options that could offset 30 to 100 percent of the HWC’s energy use. This study identifies that a geothermal system is the most cost effective renewable energy option available to decrease the HWC’s energy consumption by 30 to 100 percent. Currently the HWC performs in the lowest 8more » percent of buildings in its building category, as scored in the EPA portfolio manager benchmarking tool. Multiple ECM opportunities have been identified with paybacks of less than five years to yield an estimated 25-percent decrease in annual energyconsumption. The ECMs within this payback period are estimated to save $26,800 per year with an implementation cost of just $4,650 (0.2 year payback). For the Mohican Family Center document: The results of the Renewable Energy and Energy Efficiency Feasibility Study of Stockbridge Munsee Community’s Mohican Family Center (MFC) indicate that a variety of renewable energy options and energy conservation measures (ECMs) exist for the facility. A requirement of the Request for Proposal for this study was to assess renewable energy options that could offset 30 to 100 percent of the MFC’s energy use. This study identifies that a geothermal system is the most cost effective renewable energy option available to decrease the MFC’s energy consumption by 30 to 100 percent. Currently the MFC performs better than 80 percent of buildings in its building category, as scored in the EPA portfolio manager benchmarking tool. Multiple ECM opportunities have been identified with short term paybacks to yield an estimated 13-percent decrease in energy consumption. The ECMs within this payback period are

  7. Specialized stroke rehabilitation services in seven countries: Preliminary results from nine rehabilitation centers.

    PubMed

    Langhammer, Birgitta; Becker, Frank; Sunnerhagen, Katharina S; Zhang, Tong; Du, Xiaoxia; Bushnik, Tamara; Panchenko, Maria; Keren, Ofer; Banura, Samir; Elessi, Khamis; Luzon, Fuad; Lundgren-Nilsson, Åsa; Li, Xie; Sällström, Susanne; Stanghelle, Johan Kvalvik

    2015-12-01

    There is a lack of defined levels of rehabilitation, indicating possibly random content and access to specialized services. The aim of the study was to perform a multinational descriptive study of specialized rehabilitation in persons with stroke, to elucidate what the different centers define as prerequisites for specialized rehabilitation, and to analyze whether these descriptions map to currently applied standards or constructs of specialized rehabilitation. A secondary aim was to look for similarities and differences between therapies and services for persons with stroke in the sub-acute stage in the different institutions. Descriptive data of the collaborating centers regarding structure and processes of services were recorded and compared with the British Society of Rehabilitation Medicine and Specialized Services National Definitions sets. Comparisons of the definitions showed that all centers admitted severely disabled persons with stroke, in need of complex rehabilitation, and provided high levels of physical services, with specialized equipment and facilities. However, funding, size, university affiliation, quality accreditation, staffing levels, specialist training, cognitive and vocational services, coordination of the professional teams, admission procedures, time and type of therapies, estimated length of stay, and follow-up procedures differed between the centers. This multinational study of specialized stroke rehabilitation centers shows that a universal definition of specialized rehabilitation is possible, even in quite different countries and settings, in terms of general principles. There were however differences in structures and procedures, which may influence patients' outcomes, indicating a need for refinement of the definitions to be globally applicable. © 2015 World Stroke Organization.

  8. Conventional over-the-top-aiming devices with short offset fail to hit the center of the human femoral ACL footprint in medial portal technique, whereas medial-portal-aiming devices with larger offset hit the center reliably.

    PubMed

    Domnick, Christoph; Herbort, Mirco; Raschke, Michael J; Bremer, Susanne; Schliemann, Benedikt; Petersen, Wolf; Zantop, Thore

    2016-04-01

    Aim of this study was to investigate the accuracy of a conventional over-the-top-guide (OTG) with a typically short offset to hit the center of the native femoral ACL footprint through the anteromedial portal in comparison to a specific medial-portal-aimer (MPA) with larger offset. In 20 matched human cadaveric knees, insertion sites of the ACL were marked in medial arthrotomy. An OTG with an offset of 5.5 mm, respectively, the MPA with 9 mm offset was used in a medial portal approach to locate the center of a single bundle ACL reconstruction tunnel with k-wires. Distances from the footprint center, the OTG drilling and the MPA drilling to the roof of the intercondylar notch and to the deep cartilage margin were determined. After positioning of radiological markers, radiographic analysis was performed according to the quadrant technique as described by Bernard and Hertel. The distance from ACL origin to the roof of the notch was 10.3 (±2.1) mm, in the OTG group 6.7 (±1.5) mm and in the MPA group 9.6 (±1.9) mm. The distance to the deep cartilage margin was 9.5 (±1.7) mm from ACL origin, 4.8 (±1.3) mm with OTG and 8.7 (±1.4) mm with MPA. There were statistically significant differences between the distances of the footprint center and the OTG group after measuring and also after radiographic analysis (p < 0.0001). Using the MPA, no significant different distances in comparison to the anatomical ACL center were found (p > 0.0001). There was an increased risk for femoral blow (9/10 vs. 0/10) in the OTG group after overdrilling with a 9 mm drill. Short (5.5 mm) offset femoral aiming devices fail to locate the native ACL footprint center in medial portal approach with an increased risk for femoral blowout when overdrilling. The special medial-portal-aiming device with 9 mm offset hit the center reliably.

  9. Case-mix adjustment and the comparison of community health center performance on patient experience measures.

    PubMed

    Johnson, M Laura; Rodriguez, Hector P; Solorio, M Rosa

    2010-06-01

    To assess the effect of case-mix adjustment on community health center (CHC) performance on patient experience measures. A Medicaid-managed care plan in Washington State collected patient survey data from 33 CHCs over three fiscal quarters during 2007-2008. The survey included three composite patient experience measures (6-month reports) and two overall ratings of care. The analytic sample includes 2,247 adult patients and 2,859 adults reporting for child patients. We compared the relative importance of patient case-mix adjusters by calculating each adjuster's predictive power and variability across CHCs. We then evaluated the impact of case-mix adjustment on the relative ranking of CHCs. Important case-mix adjusters included adult self-reported health status or parent-reported child health status, adult age, and educational attainment. The effects of case-mix adjustment on patient reports and ratings were different in the adult and child samples. Adjusting for race/ethnicity and language had a greater impact on parent reports than adult reports, but it impacted ratings similarly across the samples. The impact of adjustment on composites and ratings was modest, but it affected the relative ranking of CHCs. To ensure equitable comparison of CHC performance on patient experience measures, reports and ratings should be adjusted for adult self-reported health status or parent-reported child health status, adult age, education, race/ethnicity, and survey language. Because of the differential impact of case-mix adjusters for child and adult surveys, initiatives should consider measuring and reporting adult and child scores separately.

  10. The management approach to the NASA space station definition studies at the Manned Spacecraft Center

    NASA Technical Reports Server (NTRS)

    Heberlig, J. C.

    1972-01-01

    The overall management approach to the NASA Phase B definition studies for space stations, which were initiated in September 1969 and completed in July 1972, is reviewed with particular emphasis placed on the management approach used by the Manned Spacecraft Center. The internal working organizations of the Manned Spacecraft Center and its prime contractor, North American Rockwell, are delineated along with the interfacing techniques used for the joint Government and industry study. Working interfaces with other NASA centers, industry, and Government agencies are briefly highlighted. The controlling documentation for the study (such as guidelines and constraints, bibliography, and key personnel) is reviewed. The historical background and content of the experiment program prepared for use in this Phase B study are outlined and management concepts that may be considered for future programs are proposed.

  11. Volpe Center Report on Advanced Automation System Benefit-Cost Study: Final Report

    DOT National Transportation Integrated Search

    1993-10-25

    The Volpe Center study of the benefits and costs of the AAS approached the analysis by segments rather than as a whole system. The study concentrated on the automation aspects of the A TC system and applied conservative assumptions to the estimation ...

  12. Comparison of immune manifestations between refractory cytopenia of childhood and aplastic anemia in children: A single-center retrospective study.

    PubMed

    Wu, Jun; Cheng, Yifei; Zhang, Leping

    2015-12-01

    This retrospective single-center study assessed the incidence and clinical features of immune manifestations of refractory cytopenia of childhood (RCC) and childhood aplastic anemia (AA). We evaluated 72 children with RCC and 123 with AA between February 2008 and March 2013. RCC was associated with autoimmune disease in 4 children, including 1 case each with autoimmune hemolytic anemia, rheumatoid arthritis, systemic lupus erythematosus, and anaphylactoid purpura. No children with AA were diagnosed with autoimmune diseases. Immune abnormalities were common in both RCC and AA; the most significant reductions were in the relative numbers of CD3-CD56+ subsets found in RCC. Despite the many similar immunologic abnormalities in AA and RCC, the rate of autoimmune disease was significantly lower in childhood AA than RCC (p=0.008, χ2=6.976). The relative numbers of natural killer cells were significantly lower in RCC patients than AA patients. By month 6, there was no significant difference in autoimmune manifestations between RCC and AA in relation to the response to immunosuppressive therapy (p=0.907, χ2=0.014). The large overlap of analogous immunologic abnormalities indicates that RCC and childhood AA may share the same pathogenesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. A Case Study Documenting the Process by Which Biology Instructors Transition from Teacher-Centered to Learner-Centered Teaching.

    PubMed

    Marbach-Ad, Gili; Hunt Rietschel, Carly

    2016-01-01

    In this study, we used a case study approach to obtain an in-depth understanding of the change process of two university instructors who were involved with redesigning a biology course. Given the hesitancy of many biology instructors to adopt evidence-based, learner-centered teaching methods, there is a critical need to understand how biology instructors transition from teacher-centered (i.e., lecture-based) instruction to teaching that focuses on the students. Using the innovation-decision model for change, we explored the motivation, decision-making, and reflective processes of the two instructors through two consecutive, large-enrollment biology course offerings. Our data reveal that the change process is somewhat unpredictable, requiring patience and persistence during inevitable challenges that arise for instructors and students. For example, the change process requires instructors to adopt a teacher-facilitator role as opposed to an expert role, to cover fewer course topics in greater depth, and to give students a degree of control over their own learning. Students must adjust to taking responsibility for their own learning, working collaboratively, and relinquishing the anonymity afforded by lecture-based teaching. We suggest implications for instructors wishing to change their teaching and administrators wishing to encourage adoption of learner-centered teaching at their institutions. © 2016 G. Marbach-Ad and C. H. Rietschel. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  14. Environmental Studies Center Teacher Books. 6th Grade - River Investigation.

    ERIC Educational Resources Information Center

    Martin County Schools, Jensen Beach, FL. Environmental Studies Center.

    This teacher's guide, one of nine teacher packages developed for use in the sequential, hands-on, field-oriented, K-8 environmental education program of the Martin County Schools in Florida, was developed for use with elementary children in grade six prior to and after a visit to an environmental studies center located near an estuarine area. The…

  15. Environmental Studies Center Teacher Books. 4th Grade - Mangrove Communities.

    ERIC Educational Resources Information Center

    Martin County Schools, Jensen Beach, FL. Environmental Studies Center.

    This teacher's guide, one of nine teacher packages developed for use in the sequential, hands-on, field-oriented, K-8 environmental education program of the Martin County Schools in Florida, was developed for use with elementary children in grade four prior to and after a visit to an environmental studies center located near an estuarine area. The…

  16. The Neighborhood Study Center Teacher Aide Program. 1969-1970 Evaluation.

    ERIC Educational Resources Information Center

    Community Services Planning Council, Sacramento, CA.

    The program is designed to help provide the extra help with schoolwork that educationally and economically disadvantaged children need. The project has study centers in every low-income neighborhood in Sacramento, opened at the request of an organization or agency in the area, and staffed by volunteer tutors contribute one to two hours per week to…

  17. Nursing Reference Center: a point-of-care resource.

    PubMed

    Vardell, Emily; Paulaitis, Gediminas Geddy

    2012-01-01

    Nursing Reference Center is a point-of-care resource designed for the practicing nurse, as well as nursing administrators, nursing faculty, and librarians. Users can search across multiple resources, including topical Quick Lessons, evidence-based care sheets, patient education materials, practice guidelines, and more. Additional features include continuing education modules, e-books, and a new iPhone application. A sample search and comparison with similar databases were conducted.

  18. Quality of Prostate Cancer Treatment Information on Cancer Center Websites.

    PubMed

    Dulaney, Caleb; Barrett, Olivia Claire; Rais-Bahrami, Soroush; Wakefield, Daniel; Fiveash, John; Dobelbower, Michael

    2016-04-20

    Cancer center websites are trusted sources of internet information about treatment options for prostate cancer. The quality of information on these websites is unknown. The objective of this study was to evaluate the quality of information on cancer center websites addressing prostate cancer treatment options, outcomes, and toxicity. We evaluated the websites of all National Cancer Institute-designated cancer centers to determine if sufficient information was provided to address eleven decision-specific knowledge questions from the validated Early Prostate Cancer Treatment Decision Quality Instrument. We recorded the number of questions addressed, the number of clicks to reach the prostate cancer-specific webpage, evaluation time, and Spanish and mobile accessibility. Correlation between evaluation time and questions addressed were calculated using the Pearson coefficient. Sixty-three websites were reviewed. Eighty percent had a prostate cancer-specific webpage reached in a median of three clicks. The average evaluation time was 6.5 minutes. Information was available in Spanish on 24% of sites and 59% were mobile friendly. Websites provided sufficient information to address, on average, 19% of questions. No website addressed all questions. Evaluation time correlated with the number of questions addressed (R(2) = 0.42, p < 0.001). Cancer center websites provide insufficient information for men with localized prostate cancer due to a lack of information about and direct comparison of specific treatment outcomes and toxicities. Information is also less accessible in Spanish and on mobile devices. These data can be used to improve the quality and accessibility of prostate cancer treatment information on cancer center websites.

  19. Are comparisons of patient experiences across hospitals fair? A study in Veterans Health Administration hospitals.

    PubMed

    Cleary, Paul D; Meterko, Mark; Wright, Steven M; Zaslavsky, Alan M

    2014-07-01

    Surveys are increasingly used to assess patient experiences with health care. Comparisons of hospital scores based on patient experience surveys should be adjusted for patient characteristics that might affect survey results. Such characteristics are commonly drawn from patient surveys that collect little, if any, clinical information. Consequently some hospitals, especially those treating particularly complex patients, have been concerned that standard adjustment methods do not adequately reflect the challenges of treating their patients. To compare scores for different types of hospitals after making adjustments using only survey-reported patient characteristics and using more complete clinical and hospital information. We used clinical and survey data from a national sample of 1858 veterans hospitalized for an initial acute myocardial infarction (AMI) in a Department of Veterans Affairs (VA) medical center during fiscal years 2003 and 2004. We used VA administrative data to characterize hospitals. The survey asked patients about their experiences with hospital care. The clinical data included 14 measures abstracted from medical records that are predictive of survival after an AMI. Comparisons of scores across hospitals adjusted only for patient-reported health status and sociodemographic characteristics were similar to those that also adjusted for patient clinical characteristics; the Spearman rank-order correlations between the 2 sets of adjusted scores were >0.97 across 9 dimensions of inpatient experience. This study did not support concerns that measures of patient care experiences are unfair because commonly used models do not adjust adequately for potentially confounding patient clinical characteristics.

  20. Center for Adaptive Optics | Center

    Science.gov Websites

    Center for Adaptive Optics A University of California Science and Technology Center home Contact Us Director: Claire Max Office: Room 205, Center for Adaptive Optics Phone: (831) 459-2049 Fax: (831 ) 459-5717 Email: max@ucolick.org Associate Director: Donald Gavel Office: Room 209, Center for Adaptive

  1. Model-It: A Case Study of Learner-Centered Software Design for Supporting Model Building.

    ERIC Educational Resources Information Center

    Jackson, Shari L.; Stratford, Steven J.; Krajcik, Joseph S.; Soloway, Elliot

    Learner-centered software design (LCSD) guides the design of tasks, tools, and interfaces in order to support the unique needs of learners: growth, diversity and motivation. This paper presents a framework for LCSD and describes a case study of its application to the ScienceWare Model-It, a learner-centered tool to support scientific modeling and…

  2. The feasibility study for development of an ITS center in Lafayette : summary report.

    DOT National Transportation Integrated Search

    2002-11-01

    This report documents the development of a feasibility study of the Lafayette Intelligent Transportation Systems (ITS) Center. Due to the size of Lafayette, the study was done with an approach slightly different from the majority of ITS studies condu...

  3. Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

    PubMed

    Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine

    2017-04-01

    Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current

  4. Center for the Study of Traumatic Stress

    MedlinePlus

    ... by clicking HERE US Army Culture for Researchers Book The Center has developed "US Army Culture: An ... of research involving soldiers and their families. The book provides information on a range of Army topics ...

  5. The official websites of blood centers in China: A nationwide cross-sectional study

    PubMed Central

    Hu, Huiying; Wang, Jing

    2017-01-01

    Background Blood collection agencies worldwide are facing ongoing and increasing medical demands for blood products. Many potential donors would search related information online before making decision of whether or not to donate blood. However, there is little knowledge of the online information and services provided by blood centers in China, despite the constantly increase of internet users. Our research investigates the number of blood centers’ official websites and their quality, and highlights the deficiencies that required future advances. Methods Identified official websites of blood centers were scored using a newly developed evaluation instrument with 42 items concerning technical aspects, information quality, information comprehensiveness and interactive services. Scores of websites were compared between blood centers with different level (provincial vs. regional blood centers) and location (blood centers located in economically developed vs. developing region). Results For the 253 working official websites all the 350 blood centers in China, and the mean overall score of websites was 24.7 out of 42. 79.1% websites were rated as fair (50–75% of maximum), 5.5% as good (≥75% of maximum) and 15.4% as poor(25–50% of maximum;). Websites got very low sub-scores in information quality (mean = 3.8; range 1–8; maximum = 9) and interactive services (3.3; 0–10; 10). Higher proportions of provincial (vs. regional) blood centers and economically developed (vs. developing) blood centers had official websites (p = 0.044 and p = 0.001; respectively) with better overall quality (p<0.001 and p <0.01) and better sub-scores (in all of the four sections and in technical aspects and information quality). Website overall scores was positively correlated with the number of people served by each blood center (p< 0.001) and the donation rate of each province (p = 0.046). Conclusions This study suggests there is a need to further develop and improve official websites

  6. Technology utilization in a non-urban region: Further impact and technique of the Technology Use Studies Center

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Updated information is given pertaining to Technology Use Studies Center (TUSC) clients who are those that receive/use information as disseminated by the center. The client information is presented as a continuation of client data as set forth in the center's previous annual report.

  7. Prospective Relations between Social Comparison Orientation and Weight Loss Outcomes.

    PubMed

    Arigo, Danielle; Butryn, Meghan L

    2018-06-26

    Maintenance of weight loss after behavioral intervention tends to be poor, and there is need for an improved understanding of factors that are associated with successful maintenance. Social comparison is known to be a powerful influence on treatment outcomes for group-based behavioral weight loss programs, but little is known about the role of individual differences in social comparison orientation (i.e., tendency to value comparison information) in this context. The goal of this study was to examine prospective relations between social comparison orientation and long-term weight loss outcomes (percent weight loss, aerobic-intensity physical activity) among participants in behavioral weight loss treatment. Participants (n = 161, M Age = 54, M BMI = 34.4░kg/m 2 ) completed a measure of social comparison orientation at pre-treatment baseline. Height and weight were measured in the research center and aerobic-intensity physical activity was assessed via accelerometer at baseline, mid- and end-of-treatment, and at 6 and 12 months post-treatment (representing maintenance). Multilevel models tested prospective relations between comparison orientation and treatment outcomes over time, with emphasis on differences during the post-treatment maintenance phase. Stronger (vs. weaker) general comparison orientation was associated with better maintenance of aerobic-intensity physical activity. However, stronger (vs. weaker) orientation toward comparisons with better-off others (i.e., upward comparison) was associated with less weight loss success during and after treatment. Social comparison orientation thus shows meaningful relations with long-term maintenance of key outcomes in group-based behavioral weight loss treatment, and warrants further investigation in this context.

  8. Aerial Measuring System (AMS)/Israel Atomic Energy Commission (IAEC) Joint Comparison Study Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wasiolek, P.; Halevy, I.

    Under the 13th Bilateral Meeting to Combat Nuclear Terrorism conducted on January 8–9, 2013, the committee approved the development of a cost-effective proposal to conduct a Comparison Study of the Aerial Measuring System (AMS) of the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA) and Israel Atomic Energy Commission (IAEC). The study was to be held at the Remote Sensing Laboratory (RSL), Nellis Air Force Base, Las Vegas, Nevada, with measurements at the Nevada National Security Site (NNSS). The goal of the AMS and the IAEC joint survey was to compare the responses of the two agencies’ aerialmore » radiation detection systems to varied radioactive surface contamination levels and isotopic composition experienced at the NNSS, and the differing data processing techniques utilized by the respective teams. Considering that for the comparison both teams were using custom designed and built systems, the main focus of the short campaign was to investigate the impact of the detector size and data analysis techniques used by both teams. The AMS system, SPectral Advanced Radiological Computer System, Model A (SPARCS-A), designed and built by RSL, incorporates four different size sodium iodide (NaI) crystals: 1" × 1", 2" × 4" × 4", 2" × 4" ×16", and an “up-looking” 2" × 4" × 4". The Israel AMS System, Air RAM 2000, was designed by the IAEC Nuclear Research Center – Negev (NRCN) and built commercially by ROTEM Industries (Israel) and incorporates two 2" diameter × 2" long NaI crystals. The operational comparison was conducted at RSL-Nellis in Las Vegas, Nevada, during week of June 24–27, 2013. The Israeli system, Air RAM 2000, was shipped to RSL-Nellis and mounted together with the DOE SPARCS on a DOE Bell-412 helicopter for a series of aerial comparison measurements at local test ranges, including the Desert Rock Airport and Area 3 at the NNSS. A 4-person Israeli team from the IAEC NRCN supported the activity together

  9. Experimental study of high density foods for the Space Operations Center

    NASA Technical Reports Server (NTRS)

    Ahmed, S. M.

    1981-01-01

    The experimental study of high density foods for the Space Operations Center is described. A sensory evaluation of the high density foods was conducted first to test the acceptability of the products. A shelf-life study of the high density foods was also conducted for three different time lengths at three different temperatures. The nutritional analysis of the high density foods is at present incomplete.

  10. Discussion of comparison study of hydraulic fracturing models -- Test case: GRI Staged Field Experiment No. 3

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cleary, M.P.

    This paper provides comments to a companion journal paper on predictive modeling of hydraulic fracturing patterns (N.R. Warpinski et. al., 1994). The former paper was designed to compare various modeling methods to demonstrate the most accurate methods under various geologic constraints. The comments of this paper are centered around potential deficiencies in the former authors paper which include: limited actual comparisons offered between models, the issues of matching predictive data with that from related field operations was lacking or undocumented, and the relevance/impact of accurate modeling on the overall hydraulic fracturing cost and production.

  11. Clinical outcomes in male patients with lactotroph adenomas who required pituitary surgery: a retrospective single center study.

    PubMed

    Liu, Winnie; Zahr, Roula Shraiky; McCartney, Shirley; Cetas, Justin S; Dogan, Aclan; Fleseriu, Maria

    2018-06-23

    Lactotroph adenomas (LA) are the most frequently encountered pituitary tumors. Although more frequently observed in women, LAs in men were recently included in a more aggressive category regardless of histological grading, by the WHO. We aimed to perform a rigorous retrospective review of a single center's pre-operative evaluation, patient characteristics and outcomes of male LAs patients requiring pituitary surgery. A retrospective review, over 11 years, of patients who underwent resection of a pituitary adenoma at a single center was conducted. Predictors of persistent disease in male LAs patients along with a comparison to predictors of silent corticotroph adenomas (SCAs) patients who also underwent surgery at the center was also conducted. Thirty-one male patients with LAs were identified. When compared to SCAs patients, LAs male patients were younger (41 vs. 50 years of age, p = 0.01). Men with LAs had more invasive tumors (75% vs. 44.7% p = 0.02). More LAs in men had residual tumor after surgery than patients with SCA (92.6% vs. 42.1%, p < 0.001). Male patients with LAs and patients with SCA had similar rates of requiring additional surgery (28.9% vs. 24.1%, p = NS) and radiation therapy (18.4% vs. 19.4%, p = NS). High rates of DA resistance, invasive tumors and postoperative residual disease in male patients with LA who required surgery are shown. Surgery improved optic chiasm compression, PRL level and central hypogonadism but, not surprisingly, failed to normalize other pituitary hormones and/or eliminate need for DA therapy.

  12. Hydrogen bonding and spin density distribution in the QB semiquinone of bacterial reaction centers and comparison with the QA site

    PubMed Central

    Martin, Erik; Samoilova, Rimma I.; Narasimhulu, Kupala V.; Lin, Tzu-Jen; O’Malley, Patrick J.; Wraight, Colin A.; Dikanov, Sergei A.

    2011-01-01

    In the photosynthetic reaction center from Rhodobacter sphaeroides, the primary (QA) and secondary (QB) electron acceptors are both ubiquinone-10, but with very different properties and functions. To investigate the protein environment that imparts these functional differences, we have applied X-band HYSCORE, a 2D pulsed EPR technique, to characterize the exchangeable protons around the semiquinone (SQ) in the QA and QB sites, using samples of 15N-labeled reaction centers, with the native high spin Fe2+ exchanged for diamagnetic Zn2+, prepared in 1H2O and 2H2O solvent. The powder HYSCORE method is first validated against the orientation-selected Q-band ENDOR study of the QA SQ by Flores et al. (Biophys. J. 2007, 92, 671–682), with good agreement for two exchangeable protons with anisotropic hyperfine tensor components, T, both in the range 4.6–5.4 MHz. HYSCORE was then applied to the QB SQ where we found proton lines corresponding to T~5.2, 3.7 MHz and T~1.9 MHz. Density functional-based quantum mechanics/molecular mechanics (QM/MM) calculations, employing a model of the QB site, were used to assign the observed couplings to specific hydrogen bonding interactions with the QB SQ. These calculations allow us to assign the T=5.2 MHz proton to the His-L190 NδH…O4 (carbonyl) hydrogen bonding interaction. The T =3.7 MHz spectral feature most likely results from hydrogen bonding interactions of O1 (carbonyl) with both Gly-L225 peptide NH and Ser-L223 hydroxyl OH, which possess calculated couplings very close to this value. The smaller 1.9 MHz coupling is assigned to a weakly bound peptide NH proton of Ile-L224. The calculations performed with this structural model of the QB site show less asymmetric distribution of unpaired spin density over the SQ than seen for the QA site, consistent with available experimental data for 13C and 17O carbonyl hyperfine couplings. The implications of these interactions for QB function and comparisons with the QA site are discussed

  13. Restless leg syndrome in different types of demyelinating neuropathies: a single-center pilot study.

    PubMed

    Luigetti, Marco; Del Grande, Alessandra; Testani, Elisa; Bisogni, Giulia; Losurdo, Anna; Giannantoni, Nadia Mariagrazia; Mazza, Salvatore; Sabatelli, Mario; Della Marca, Giacomo

    2013-09-15

    to determine the prevalence of restless legs syndrome (RLS) in a cohort of patients with demyelinating neuropathies. Patients were retrospectively recruited from our cohort of different forms of demyelinating neuropathies, including chronic inflammatory demyelinating neuropathy (CIDP), Charcot-Marie-Tooth 1A (CMT1A), and hereditary neuropathy with liability to pressure palsies (HNPP) referred to our Department of Neurology in a 10-year period. The validated 4-item RLS questionnaire was used for diagnosis of RLS. All patients with RLS who fulfilled criteria underwent a suggested immobilization test to confirm the diagnosis. A group of outpatients referred to the sleep disorders unit and data from published literature were used as controls. Prevalence of RLS in demyelinating neuropathy group was higher than prevalence observed in control population (p = 0.0142) or in the literature data (p = 0.0007). In particular, in comparison with both control population and literature data, prevalence of RLS was higher in CIDP group (p = 0.0266 and p = 0.0063, respectively) and in CMT1A group (p = 0.0312 and p = 0.0105, respectively), but not in HNPP (p = 1.000 and p = 0.9320, respectively). our study confirms a high prevalence of RLS in inflammatory neuropathies as CIDP and, among inherited neuropathies, in CMT1A but not in HNPP. Considering that this is only a small cohort from a single-center retrospective experience, the link between RLS and neuropathy remains uncertain, and larger multicenter studies are probably needed to clarify the real meaning of the association between RLS and neuropathy.

  14. A Multi-center Milestone Study of Clinical Vertebral CT Segmentation

    PubMed Central

    Yao, Jianhua; Burns, Joseph E.; Forsberg, Daniel; Seitel, Alexander; Rasoulian, Abtin; Abolmaesumi, Purang; Hammernik, Kerstin; Urschler, Martin; Ibragimov, Bulat; Korez, Robert; Vrtovec, Tomaž; Castro-Mateos, Isaac; Pozo, Jose M.; Frangi, Alejandro F.; Summers, Ronald M.; Li, Shuo

    2017-01-01

    A multiple center milestone study of clinical vertebra segmentation is presented in this paper. Vertebra segmentation is a fundamental step for spinal image analysis and intervention. The first half of the study was conducted in the spine segmentation challenge in 2014 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) Workshop on Computational Spine Imaging (CSI 2014). The objective was to evaluate the performance of several state-of-the-art vertebra segmentation algorithms on computed tomography (CT) scans using ten training and five testing dataset, all healthy cases; the second half of the study was conducted after the challenge, where additional 5 abnormal cases are used for testing to evaluate the performance under abnormal cases. Dice coefficients and absolute surface distances were used as evaluation metrics. Segmentation of each vertebra as a single geometric unit, as well as separate segmentation of vertebra substructures, was evaluated. Five teams participated in the comparative study. The top performers in the study achieved Dice coefficient of 0.93 in the upper thoracic, 0.95 in the lower thoracic and 0.96 in the lumbar spine for healthy cases, and 0.88 in the upper thoracic, 0.89 in the lower thoracic and 0.92 in the lumbar spine for osteoporotic and fractured cases. The strengths and weaknesses of each method as well as future suggestion for improvement are discussed. This is the first multi-center comparative study for vertebra segmentation methods, which will provide an up-to-date performance milestone for the fast growing spinal image analysis and intervention. PMID:26878138

  15. Mental health status and its predictors among call center employees: A cross-sectional study.

    PubMed

    Oh, Hyunjin; Park, Heyeon; Boo, Sunjoo

    2017-06-01

    In this study, we assessed the mental health of Korean call center employees and investigated the potential predictors of their mental health status. A cross-sectional study using self-completing questionnaire was conducted for employees working for a credit card call center. A total of 306 call center employees completed the Depression Anxiety Stress Scale, the Emotion Labor Scale, and the Korean Occupational Stress Scale. The results showed that more than half of the participants reported high levels of depression, anxiety, and stress. A multiple regression analysis indicated that the total scores on the Depression Anxiety Stress Scale were predicted by perceived health, job satisfaction, job demands, organizational injustice, and emotional dissonance suggesting that, in the interest of improving the mental health of call center employees, their job demands and emotional dissonance should be reduced and the work environment be improved. Consideration should be given to providing routine assessments of mental health, including depression, anxiety, and stress, and the corresponding need for the development of an intervention program and other work-related policies that would protect employees from the risk of poor mental health outcomes. © 2017 John Wiley & Sons Australia, Ltd.

  16. Patient engagement and study design of PROP UP: A multi-site patient-centered prospective observational study of patients undergoing hepatitis C treatment.

    PubMed

    Evon, Donna M; Golin, Carol E; Stewart, Paul; Fried, Michael W; Alston, Shani; Reeve, Bryce; Lok, Anna S; Sterling, Richard K; Lim, Joseph K; Reau, Nancy; Sarkar, Souvik; Nelson, David R; Reddy, K R; Di Bisceglie, Adrian M

    2017-06-01

    New highly efficacious direct-acting antiviral (DAA) therapies are available to treat chronic hepatitis C viral (HCV) infection. Real-world, patient-centered data on harms and benefits associated with these therapies are needed. PROP UP is a multi-center prospective observational study that plans to enroll 1600 patients starting treatment with recently-approved DAA regimens. Informed by extensive input from a HCV patient engagement group who prioritized outcomes most important to them, patient-reported outcomes will be characterized using surveys at five time points: Baseline (T1), treatment week 4 (T2), end of treatment (T3), 12weeks post-treatment (T4), 12months post-treatment (T5). (1) Changes in side effects, functioning, pre-existing conditions, and out-of-pocket costs during therapy (T1 vs T2/T3); (2) Medication adherence in relation to a history of mental health/substance abuse, treatment regimens, pill burden, reasons for missed doses, and cure rates; (3) Short term impact of cure on functioning and amelioration of symptoms (T1 vs T4); (4) Long-term treatment harms or benefits of cure on symptoms, side effects, pre-existing conditions, and functioning (T1 vs T5). Similarities between regimens will be examined where comparisons are appropriate and meaningful. PROP UP complements previous clinical trials by focusing on patient-reported outcomes in a representative sample of patients treated in clinical practice, by collaborating with a patient engagement group, by characterizing the experiences of vulnerable subgroups, and by investigating long-term harms and benefits of treatments. PROP UP is designed to provide novel and detailed information to support informed decision-making for patients and providers contemplating HCV treatment (PCORI CER-1408-20,660; NCT02601820). Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Patient Engagement and Study Design of PROP UP: A multi-site patient-centered prospective observational study of patients undergoing hepatitis C treatment

    PubMed Central

    Evon, Donna M.; Golin, Carol E.; Stewart, Paul; Fried, Michael W.; Alston, Shani; Reeve, Bryce; Lok, Anna S.; Sterling, Richard K.; Lim, Joseph K.; Reau, Nancy; Sarkar, Souvik; Nelson, David R.; Reddy, K. Rajender; Di Bisceglie, Adrian M.

    2017-01-01

    Background New highly efficacious direct-acting antiviral (DAA) therapies are available to treat chronic hepatitis C viral (HCV) infection. Real-world, patient-centered data on harms and benefits associated with these therapies are needed. Methods PROP UP is a multi-center prospective observational study that plans to enroll 1,600 patients starting treatment with recently-approved DAA regimens. Informed by extensive input from a HCV patient engagement group who prioritized outcomes most important to them, patient-reported outcomes will be characterized using surveys at five time points: Baseline (T1), treatment week 4 (T2), end of treatment (T3), 12 weeks post-treatment (T4), 12 months post-treatment (T5). Outcomes (1) Changes in side effects, functioning, pre-existing conditions, and out-of-pocket costs during therapy (T1 vs T2/T3); (2) Medication adherence in relation to a history of mental health/substance abuse, treatment regimens, pill burden, reasons for missed doses, and cure rates; (3) Short term impact of cure on functioning and amelioration of symptoms (T1 vs T4); (4) Long-term treatment harms or benefits of cure on symptoms, side effects, pre-existing conditions, and functioning (T1 vs T5). Similarities between regimens will be examined where comparisons are appropriate and meaningful. Conclusion PROP UP complements previous clinical trials by focusing on patient-reported outcomes in a representative sample of patients treated in clinical practice, by collaborating with a patient engagement group, by characterizing the experiences of vulnerable subgroups, and by investigating long-term harms and benefits of treatments. PROP UP is designed to provide novel and detailed information to support informed decision-making for patients and providers contemplating HCV treatment (PCORI CER-1408-20660; NCT02601820). PMID:28342989

  18. Groups of galaxies in the Center for Astrophysics redshift survey

    NASA Technical Reports Server (NTRS)

    Ramella, Massimo; Geller, Margaret J.; Huchra, John P.

    1989-01-01

    By applying the Huchra and Geller (1982) objective group identification algorithm to the Center for Astrophysics' redshift survey, a catalog of 128 groups with three or more members is extracted, and 92 of these are used as a statistical sample. A comparison of the distribution of group centers with the distribution of all galaxies in the survey indicates qualitatively that groups trace the large-scale structure of the region. The physical properties of groups may be related to the details of large-scale structure, and it is concluded that differences among group catalogs may be due to the properties of large-scale structures and their location relative to the survey limits.

  19. Does Matching Quality Matter in Mode Comparison Studies?

    ERIC Educational Resources Information Center

    Zeng, Ji; Yin, Ping; Shedden, Kerby A.

    2015-01-01

    This article provides a brief overview and comparison of three matching approaches in forming comparable groups for a study comparing test administration modes (i.e., computer-based tests [CBT] and paper-and-pencil tests [PPT]): (a) a propensity score matching approach proposed in this article, (b) the propensity score matching approach used by…

  20. A comparison of patient-centered and case-mix reimbursement for nursing home care.

    PubMed

    Willemain, T R

    1980-01-01

    The trend in payment for nursing home services has been toward making finer distinctions amont patients and the rates at which their care is reimbursed. The ultimate in differentiation is patient-centered reimbursement, whereas each patient's rate is individually determined. This paper introduces a model of overpayment and under-payment for comparing the potential performance of alternative reimbursement schemes. The model is used in comparing the patient-centered approach with case-mix reimbursement, which assigns a single rate to all patients in a nursing home on the basis of the facility's case mix. Roughly speaking, the case-mix approach is preferable whenever the differences between patient's needs are smaller than the errors in needs assessment. Since this condition appears to hold in practice today, case-mix reimbursement seems preferable for the short term.

  1. A comparison of patient-centered and case-mix reimbursement for nursing home care.

    PubMed Central

    Willemain, T R

    1980-01-01

    The trend in payment for nursing home services has been toward making finer distinctions amont patients and the rates at which their care is reimbursed. The ultimate in differentiation is patient-centered reimbursement, whereas each patient's rate is individually determined. This paper introduces a model of overpayment and under-payment for comparing the potential performance of alternative reimbursement schemes. The model is used in comparing the patient-centered approach with case-mix reimbursement, which assigns a single rate to all patients in a nursing home on the basis of the facility's case mix. Roughly speaking, the case-mix approach is preferable whenever the differences between patient's needs are smaller than the errors in needs assessment. Since this condition appears to hold in practice today, case-mix reimbursement seems preferable for the short term. PMID:7461971

  2. A Comparison of Center/TRACON Automation System and Airline Time of Arrival Predictions

    NASA Technical Reports Server (NTRS)

    Heere, Karen R.; Zelenka, Richard E.

    2000-01-01

    Benefits from information sharing between an air traffic service provider and a major air carrier are evaluated. Aircraft arrival time schedules generated by the NASA/FAA Center/TRACON Automation System (CTAS) were provided to the American Airlines System Operations Control Center in Fort Worth, Texas, during a field trial of a specialized CTAS display. A statistical analysis indicates that the CTAS schedules, based on aircraft trajectories predicted from real-time radar and weather data, are substantially more accurate than the traditional airline arrival time estimates, constructed from flight plans and en route crew updates. The improvement offered by CTAS is especially advantageous during periods of heavy traffic and substantial terminal area delay, allowing the airline to avoid large predictive errors with serious impact on the efficiency and profitability of flight operations.

  3. Technostress in Libraries and Media Centers: Case Studies and Coping Strategies.

    ERIC Educational Resources Information Center

    Hickey, Kate D., Ed.

    1992-01-01

    Discusses technostress--i.e., stress brought on by changes in technology--in libraries and media centers. Case studies are presented that show stress in community college libraries caused by the rapid implementation of new technologies; coping strategies for librarians and media specialists are discussed; and strategies for managers are suggested.…

  4. Evolution of Triplet Paramagnetic Centers in Diamonds Obtained by Sintering of Detonation Nanodiamonds at High Pressure and Temperature

    NASA Astrophysics Data System (ADS)

    Osipov, V. Yu.; Shames, A. I.; Efimov, N. N.; Shakhov, F. M.; Kidalov, S. V.; Minin, V. V.; Vul', A. Ya.

    2018-04-01

    The electron paramagnetic resonance (EPR) spectra of triplet centers in detonation nanodiamonds (DNDs) and diamond single crystals of submicrometer size, synthesized from those DNDs at high pressures and temperatures, are studied. In the EPR spectra of DNDs, signals from negatively charged nitrogen- vacancy centers (NV)/sup(-) with a g factor of g 1 = 4.24 and multivacancies with g 2 = 4.00 are observed. The signals from (NV)/sup(-) centers disappear in the spectra of diamond single crystals, and a quintet signal with g = 4.00 is detected at the position of the signal from multivacancies. Analysis of the shape and position of the quintet' lines showed that this ESR signal is due to the pairs of nitrogen substitution centers in diamond, separated from each other by distances not exceeding 0.7 nm, between which a strong exchange interaction takes place. A comparison of the experimental data and the simulation results allows determining the spin-Hamiltonian parameters of the exchange-coupled pairs of paramagnetic impurity nitrogen atoms.

  5. An Anatomic Study on Whether the Immature Patella is Centered on an Anteroposterior Radiograph.

    PubMed

    Kyriakedes, James C; Liu, Raymond W

    2017-03-01

    In the operating room, after first obtaining a proper lateral radiograph with the condyles superimposed, a 90-degree rotation of the intraoperative fluoroscopy unit does not always produce an anteroposterior (AP) image with the patella centered. The orthogonality of these 2 views has not been well determined in children. This study was comprised of a radiographic group (35 knees) and a cadaveric group (59 knees). Both cadaveric and clinical images were obtained by resting or positioning the femur with the posterior condyles overlapped, and then taking an orthogonal AP image. Centering of the patella was calculated and multiple regression analysis was performed to determine the relationship between patellar centering and age, sex, ethnicity, mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), and contralateral centering. Mean patellar centering, expressed as the lateral position of the patella with respect to the total condylar width, was 0.08±0.10 in the radiographic group and 0.06±0.03 in the cadaveric group. Positive (lateral) patellar centering in 1 knee had a statistically significant correlation with positive patellar centering in the contralateral knee in both the radiographs and the cadavers. In the radiographic group, there was a statistically significant correlation between femoral varus and valgus deformities and positive patellar centering. In the cadaveric group, there was a statistically significant correlation between tibial valgus and negative (medial) patellar centering. The patella in an immature knee is rarely perfectly centered on a true AP image, and is usually seated slightly laterally within the femoral condyles. Obtaining a true AP intraoperative radiograph is critical to analyzing and correcting valgus and varus deformities, and in the proper placement of implants. When addressing knee deformity one should consider obtaining an AP view orthogonal either to a perfect lateral of the knee or orthogonal to the

  6. Height, social comparison, and paranoia: An immersive virtual reality experimental study

    PubMed Central

    Freeman, Daniel; Evans, Nicole; Lister, Rachel; Antley, Angus; Dunn, Graham; Slater, Mel

    2014-01-01

    Mistrust of others may build upon perceptions of the self as vulnerable, consistent with an association of paranoia with perceived lower social rank. Height is a marker of social status and authority. Therefore we tested the effect of manipulating height, as a proxy for social rank, on paranoia. Height was manipulated within an immersive virtual reality simulation. Sixty females who reported paranoia experienced a virtual reality train ride twice: at their normal and reduced height. Paranoia and social comparison were assessed. Reducing a person's height resulted in more negative views of the self in comparison with other people and increased levels of paranoia. The increase in paranoia was fully mediated by changes in social comparison. The study provides the first demonstration that reducing height in a social situation increases the occurrence of paranoia. The findings indicate that negative social comparison is a cause of mistrust. PMID:24924485

  7. Self-Study and Evaluation Guide/1968 Edition. Section D-3: Rehabilitation Centers.

    ERIC Educational Resources Information Center

    National Accreditation Council for Agencies Serving the Blind and Visually Handicapped, New York, NY.

    This self-study and evaluation guide on rehabilitation centers is one of 28 guides designed for organizations undertaking a self-study as part of the process for accreditation from the National Accreditation Council (NAC) for agencies serving the blind and visually handicapped. Provided are lists of standards to be appraised by the self-evaluation…

  8. A Study of Family Centered Help Giving Practices in Early Intervention

    ERIC Educational Resources Information Center

    Coogle, Christan Grygas

    2012-01-01

    The purpose of this qualitative study is to investigate the early intervention experiences of mothers who have a young child at risk for an autism spectrum disorder (ASD). More specifically, the goal was to explore the family centered help giving practices mothers identify and how these practices affect their early intervention experiences. Five…

  9. Impulsive and compulsive behaviors in Parkinson Study Group (PSG) centers performing deep brain stimulation surgery.

    PubMed

    Hack, Nawaz; Akbar, Umer; Thompson-Avila, Amanda; Fayad, Sarah M; Hastings, Erin M; Moro, Elena; Nestor, Kelsey; Ward, Herbert; York, Michele; Okun, Michael S

    2014-01-01

    Impulse control disorders (ICDs), dopamine dysregulation syndrome (DDS), and dopamine agonist withdrawal syndrome (DAWS) have been reported commonly in Parkinson's disease (PD) populations. The treatment approaches may be widely variable and there is not much information on these syndromes in the setting of deep brain stimulation (DBS). To evaluate (1) ICDs, DAWS and DDS pre- and post DBS in PD and (2) to investigate pre-DBS treatment strategies regarding these behaviors among Parkinson Study Group (PSG) centers. Forty-eight PSG centers were surveyed on ICDs, DAWS and DDS, as well as on potential relationships to DBS and treatment approaches. Sixty-seven percent of PSG centers reported that they served a population of over 500 PD patients per year, and 94% of centers performed DBS surgery. Most centers (92%) reported screening for ICDs, DAWS and DDS. Of the centers screening for these symptoms, 13% reported always employing a formal battery of pre-operative tests, 46% of sites inconsistently used a formal battery, while 23% of sites reported never using a formal battery to screen for these symptoms. The estimated numbers of centers observing ICDs, DAWS and DDS pre-operatively in individuals with PD were 71%, 69%, and 69%, respectively. PSG DBS centers observing at least one case of a new de novo occurrence of an ICD, DAWS or DDS after DBS surgery were 67%, 65% and 65%, respectively. The results suggest that addiction-like syndromes and withdrawal syndromes are prevalent in expert PSG centers performing DBS. Most centers reported screening for these issues without the use of a formal battery, and there were a large number of centers reporting ICDs, DAWS and DDS post-DBS. A single treatment strategy did not emerge.

  10. Comparability of clinical wear measurements by optical 3D laser scanning in two different centers.

    PubMed

    Stober, Thomas; Heuschmid, Navina; Zellweger, Gaby; Rousson, Valentin; Rues, Stefan; Heintze, Siegward D

    2014-05-01

    The purpose of this study was to compare the use of different variables to measure the clinical wear of two denture tooth materials in two analysis centers. Twelve edentulous patients were provided with full dentures. Two different denture tooth materials (experimental material and control) were placed randomly in accordance with the split-mouth design. For wear measurements, impressions were made after an adjustment phase of 1-2 weeks and after 6, 12, 18, and 24 months. The occlusal wear of the posterior denture teeth of 11 subjects was assessed in two study centers by use of plaster replicas and 3D laser-scanning methods. In both centers sequential scans of the occlusal surfaces were digitized and superimposed. Wear was described by use of four different variables. Statistical analysis was performed after log-transformation of the wear data by use of the Pearson and Lin correlation and by use of a mixed linear model. Mean occlusal vertical wear of the denture teeth after 24 months was between 120μm and 212μm, depending on wear variable and material. For three of the four variables, wear of the experimental material was statistically significantly less than that of the control. Comparison of the two study centers, however, revealed correlation of the wear variables was only moderate whereas strong correlation was observed among the different wear variables evaluated by each center. Moderate correlation was observed for clinical wear measurements by optical 3D laser scanning in two different study centers. For the two denture tooth materials, wear measurements limited to the attrition zones led to the same qualitative assessment. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  11. Are Comparisons of Patient Experiences Across Hospitals Fair? A Study in Veterans Health Administration Hospitals

    PubMed Central

    Cleary, Paul D.; Meterko, Mark; Wright, Steven M.; Zaslavsky, Alan M.

    2015-01-01

    Background Surveys are increasingly used to assess patient experiences with health care. Comparisons of hospital scores based on patient experience surveys should be adjusted for patient characteristics that might affect survey results. Such characteristics are commonly drawn from patient surveys that collect little, if any, clinical information. Consequently some hospitals, especially those treating particularly complex patients, have been concerned that standard adjustment methods do not adequately reflect the challenges of treating their patients. Objectives To compare scores for different types of hospitals after making adjustments using only survey-reported patient characteristics and using more complete clinical and hospital information. Research Design We used clinical and survey data from a national sample of 1858 veterans hospitalized for an initial acute myocardial infarction (AMI) in a Department of Veterans Affairs (VA) medical center during fiscal years 2003 and 2004. We used VA administrative data to characterize hospitals. The survey asked patients about their experiences with hospital care. The clinical data included 14 measures abstracted from medical records that are predictive of survival after an AMI. Results Comparisons of scores across hospitals adjusted only for patient-reported health status and sociodemographic characteristics were similar to those that also adjusted for patient clinical characteristics; the Spearman rank-order correlations between the 2 sets of adjusted scores were >0.97 across 9 dimensions of inpatient experience. Conclusions This study did not support concerns that measures of patient care experiences are unfair because commonly used models do not adjust adequately for potentially confounding patient clinical characteristics. PMID:24926709

  12. 77 FR 12598 - Notice Correction; A Multi-Center International Hospital-Based Case-Control Study of Lymphoma in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Notice Correction; A Multi-Center International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) The Federal... project titled, ``A multi-center international hospital-based case-control study of lymphoma in Asia (Asia...

  13. Multiple comparisons in drug efficacy studies: scientific or marketing principles?

    PubMed

    Leo, Jonathan

    2004-01-01

    When researchers design an experiment to compare a given medication to another medication, a behavioral therapy, or a placebo, the experiment often involves numerous comparisons. For instance, there may be several different evaluation methods, raters, and time points. Although scientifically justified, such comparisons can be abused in the interests of drug marketing. This article provides two recent examples of such questionable practices. The first involves the case of the arthritis drug celecoxib (Celebrex), where the study lasted 12 months but the authors only presented 6 months of data. The second case involves the NIMH Multimodal Treatment Study (MTA) study evaluating the efficacy of stimulant medication for attention-deficit hyperactivity disorder where ratings made by several groups are reported in contradictory fashion. The MTA authors have not clarified the confusion, at least in print, suggesting that the actual findings of the study may have played little role in the authors' reported conclusions.

  14. Center vortices in confinement

    NASA Astrophysics Data System (ADS)

    Alexandru, Viorel-Andrei

    2001-11-01

    The confinement property of quarks is still one of the puzzles of today's physics. Although QCD is believed to accurately describe the interaction between quarks, due to the peculiar nature of the theory we are still unable to prove that it confines the quarks. Most analytical efforts in QCD are based on perturbative techniques which are useless in studying confinement. Lattice gauge theory enables us to get non-perturbative results. We use lattice techniques to investigate one of the proposed mechanisms of quark confinement, namely the center vortex idea. We first present a cursory introduction to lattice theory and the methods used to detect confinement on the lattices. We then show how the center vortices are suppose to produce confinement using center vortices to study Z2 lattice gauge theory. A review of the current studies regarding the idea of center vortices follows. The last chapter is dedicated to studying a particular definition of center vortices due to Tomboulis. We show how to implement this definition of vortices in numerical simulations and use numerical simulations to check the assumptions underlying the formalism. We also compare Tomboulis definition with other methods used to identify vortices on lattice.

  15. Studies on the Magnetic Center of the Mu2e Solenoid System

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lopes, M. L.; Ambrosio, G.; Buehler, M.

    2014-01-01

    The definition of the magnetic center in the Mu2e solenoid system is not trivial given the S-shaped nature of the transport solenoid. Moreover, due to the fringe field of the larger bore adjacent magnets-production solenoid and the detector solenoid-the magnetic center does not coincide with the geometric center of the system. The reference magnetic center can be obtained by tracking a low-momentum charged particle through the whole system. This paper will discuss this method and will evaluate the deviations from the nominal magnetic center given the tolerances in the manufacturing and the alignment of the coils. Methods for the correctionmore » of the magnetic center will also be presented.« less

  16. Northeastern IPM Center - Northeastern IPM Center

    Science.gov Websites

    Management Case Study: School IPM Risk Management Case Study: School IPM Since children spend much of their Management How IPM Works as Risk Management IPM can reduce actual risks-not just the financial effects of Center promotes and funds integrated pest management for environmental, human health, and economic

  17. Improved Outcomes After Autologous Hematopoietic Cell Transplantation for Light Chain Amyloidosis: A Center for International Blood and Marrow Transplant Research Study

    PubMed Central

    D'Souza, Anita; Dispenzieri, Angela; Wirk, Baldeep; Zhang, Mei-Jie; Huang, Jiaxing; Gertz, Morie A.; Kyle, Robert A.; Kumar, Shaji; Comenzo, Raymond L.; Peter Gale, Robert; Lazarus, Hillard M.; Savani, Bipin N.; Cornell, Robert F.; Weiss, Brendan M.; Vogl, Dan T.; Freytes, César O.; Scott, Emma C.; Landau, Heather J.; Moreb, Jan S.; Costa, Luciano J.; Ramanathan, Muthalagu; Callander, Natalie S.; Kamble, Rammurti T.; Olsson, Richard F.; Ganguly, Siddhartha; Nishihori, Taiga; Kindwall-Keller, Tamila L.; Wood, William A.; Mark, Tomer M.; Hari, Parameswaran

    2015-01-01

    Purpose Autologous hematopoietic cell transplantation, or autotransplantation, is effective in light-chain amyloidosis (AL), but it is associated with a high risk of early mortality (EM). In a multicenter randomized comparison against oral chemotherapy, autotransplantation was associated with 24% EM. We analyzed trends in outcomes after autologous hematopoietic cell transplantation for AL in North America. Patients and Methods Between 1995 and 2012, 1,536 patients with AL who underwent autotransplantation at 134 centers were identified in the Center for International Blood and Marrow Transplant Research database. EM and overall survival (OS) were analyzed in three time cohorts: 1995 to 2000 (n = 140), 2001 to 2006 (n = 596), and 2007 to 2012 (n = 800). Hematologic and renal responses and factors associated with EM, relapse and/or progression, progression-free survival and OS were analyzed in more recent subgroups from 2001 to 2006 (n = 197) and from 2007 to 2012 (n = 157). Results Mortality at 30 and 100 days progressively declined over successive time periods from 11% and 20%, respectively, in 1995 to 2000 to 5% and 11%, respectively, in 2001 to 2006, and to 3% and 5%, respectively, in 2007 to 2012. Correspondingly, 5-year OS improved from 55% in 1995 to 2000 to 61% in 2001 to 2006 and to 77% in 2007 to 2012. Hematologic response to transplantation improved in the latest cohort. Renal response rate was 32%. Centers performing more than four AL transplantations per year had superior survival outcomes. In the multivariable analysis, cardiac AL was associated with high EM and inferior progression-free survival and OS. Autotransplantation in 2007 to 2012 and use of higher dosages of melphalan were associated with a lowered relapse risk. A Karnofsky score less than 80 and creatinine levels 2 mg/m2 or greater were associated with worsened OS. Conclusion Post-transplantation survival in AL has improved, with a dramatic reduction in early post-transplantation mortality

  18. American Overseas Research Centers Program

    ERIC Educational Resources Information Center

    Office of Postsecondary Education, US Department of Education, 2012

    2012-01-01

    The American Overseas Research Centers Program provides grants to overseas research centers that are consortia of U.S. institutions of higher education to enable the centers to promote postgraduate research, exchanges, and area studies. Eligible applicants are those consortia of U.S. institutions of higher education centers that: (1) Receive more…

  19. Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

    PubMed

    Sasnett, Bonita; Harris, Susie T; White, Shelly

    Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

  20. A Multi-center Comparison of the Safety of Oral versus Intravenous Acetylcysteine for Treatment of Acetaminophen Overdose

    PubMed Central

    2010-01-01

    Oral and intravenous (IV) acetylcysteine are used for treatment of acetaminophen poisoning. The objective of this multi-center study was to compare the safety of these two routes of administration. METHODS We conducted a multi-center chart review of all patients treated with acetylcysteine for acetaminophen poisoning. The primary safety outcome was the percentage of patients with of acetylcysteine-related adverse events. RESULTS A total of 503 subjects were included in the safety analysis (306 IV only, 145 oral only and 52 both routes).There were no serious adverse events related to acetylcysteine for either route. Nausea and vomiting were the most common related adverse events and were more common with oral treatment (23% vs 9%). Anaphylactoid reactions were more common with IV administration (6% vs 2%). Conclusions Intravenous and oral acetylcysteine are both associated with minimal side effects and are safe for treatment of acetaminophen toxicity. PMID:20524832

  1. An exploratory study of alternative configurations of governing boards of substance abuse treatment centers

    PubMed Central

    Blum, Terry C.; Roman, Paul M.

    2011-01-01

    Boards of directors are the ultimate governing authorities for most organizations providing substance abuse treatment. A governing board may establish policies, monitor and improve operations, and represent a treatment organization to the public. This paper explores alternative configurations of governing boards in a national sample of 500 substance abuse treatment centers. The study proceeds from the premise that boards may be configured with varying levels of engagement in five aspects of internal management and external connections in treatment center operating environments. Based on interviews with treatment center administrative directors, four clusters emerge, describing boards that are: (1) active and balanced across internal and external domains; (2) active boundary spanners concentrating primarily on external relationships; (3) focused primarily on internal organizational management; and (4) relatively inactive. In post hoc analysis, we found that placement in these clusters is associated with treatment center attributes such as rate of growth and financial results, use of evidence based practices and provision of integrated care. PMID:21489737

  2. The changing nature of admissions to a spinal cord injury center: violence on the rise.

    PubMed

    Farmer, J C; Vaccaro, A R; Balderston, R A; Albert, T J; Cotler, J

    1998-10-01

    The purpose of this study was to analyze changing etiologies for admission to a spinal cord injury center. This study was designed to retrospectively analyze the etiology of admissions to a spinal cord injury center during a 15-year period, specifically gunshot versus nongunshot wound injuries. Gunshot wounds are a well-recognized cause of spinal cord injury. In some centers, up to 52% of admissions are due to this, and these trends are believed to be increasing. All patients with spinal cord injury admitted to our center between 1979 and 1993 were analyzed. Frequencies of specific etiologies were determined and then comparisons were made between gunshot wound and nongunshot wound groups. Factors analyzed included age, male/female ratio, ethnic make-up, marital status, employment status, level of injury, and neurologic status. One thousand eight hundred seventeen patients were included. Overall, gunshot wound spinal cord injuries compromised 16.9% of injuries. A clear trend of increasing numbers of admissions was seen between 1984 and 1993 because of this. Gunshot wounds and nongunshot wounds differed dramatically in terms of age, ethnic make-up, marital status, employment status, and neurologic status. Cost attributed to treating gunshot wound injuries at our center for 1993 was 5.4 million dollars. Gunshot wounds as a cause of spinal cord injury are increasing at an alarming rate. The demographics of the gunshot wounds and nongunshot wound spine cord injuries differ significantly.

  3. A Comparison of Three Online Information Retrieval Services.

    ERIC Educational Resources Information Center

    Zais, Harriet W.

    Three firms which offer online information retrieval are compared. The firms are Lockheed Information Service, System Development Corporation and the Western Research Application Center. Comparison tables provide information such as hours accessible, coverage, file update, search elements and cost figures for 15 data bases. In addition, general…

  4. The false memory syndrome: Experimental studies and comparison to confabulations

    PubMed Central

    Mendez, M.F.; Fras, I.A.

    2011-01-01

    False memories, or recollections that are factually incorrect but strongly believed, remain a source of confusion for both psychiatrists and neurologists. We propose model for false memories based on recent experimental investigations, particularly when analyzed in comparison to confabulations, which are the equivalent of false memories from neurological disease. Studies using the Deese/Roedinger–McDermott experimental paradigm indicate that false memories are associated with the need for complete and integrated memories, self-relevancy, imagination and wish fulfillment, familiarity, emotional facilitation, suggestibility, and sexual content. In comparison, confabulations are associated with the same factors except for emotional facilitation, suggestibility, and sexual content. Both false memories and confabulations have an abnormal sense of certainty for their recollections, and neuroanatomical findings implicate decreased activity in the ventromedial frontal lobe in this certainty. In summary, recent studies of false memories in comparison to confabulations support a model of false memories as internally-generated but suggestible and emotionally-facilitated fantasies or impulses, rather than repressed memories of real events. Furthermore, like confabulations, in order for false memories to occur there must be an attenuation of the normal, nonconscious, right frontal “doubt tag” regarding their certainty. PMID:21177042

  5. Language-Centered Social Studies: A Natural Integration.

    ERIC Educational Resources Information Center

    Barrera, Rosalinda B.; Aleman, Magdalena

    1983-01-01

    Described is a newspaper project in which elementary students report life as it was in the Middle Ages. Students are involved in a variety of language-centered activities. For example, they gather and evaluate information about medieval times and write, edit, and proofread articles for the newspaper. (RM)

  6. Environmental Studies Center Teacher Books. 7th Grade - Spoil Island Investigation.

    ERIC Educational Resources Information Center

    Martin County Schools, Jensen Beach, FL. Environmental Studies Center.

    This teacher's guide, one of nine teacher packages developed for use in the sequential, hands-on, field-oriented, K-8 environmental education program of the Martin County Schools in Florida, was developed for use with secondary students in grade seven prior to and after a visit to an environmental studies center located near an estuarine area. The…

  7. The Effects of Policy Changes on the Educational Opportunity Centers: A Case Study

    ERIC Educational Resources Information Center

    Fountain-Ellis, Debra L.

    2011-01-01

    The purpose of this study is to explore the programmatic changes that occurred in the Educational Opportunity Centers (EOC) and how those changes influenced educational opportunities for adults. A case study design was used for this investigation. The directors of three EOCs were selected and interviewed for the study. These directors combined…

  8. Hospital-acquired pneumonia in patients undergoing coronary artery bypass graft; comparison of the center for disease control clinical criteria with physicians' judgment.

    PubMed

    Baghban, Mahboubeh; Paknejad, Omalbanin; Yousefshahi, Fardin; Gohari Moghadam, Keivan; Bina, Payvand; Samimi Sadeh, Saghar

    2014-08-01

    Following coronary artery bypass graft (CABG), patients are at high risk (3.2%-8.3%) for developing hospital-acquired pneumonia (HAP) with mortality rate of 24% to 50%. Some of routine features in patients undergoing CABG are similar to clinical criteria of Center of Disease Control (CDC) for diagnosis of pneumonia. This may lead to over-diagnosis of pneumonia in these patients. This study aimed to assess the frequency of CDC criteria for diagnosis of pneumonia in patients undergoing CABG. This study was performed on CABG candidates admitted to post cardiac surgery Intensive Care Unit (ICU) in a six-month period. Patient's records, Chest-X-Ray, and Laboratory tests were assessed for PNU1-CDC criteria for HAP diagnosis. At the same time, a physician who was unaware of the study protocol assessed the clinical diagnosis. Then the results were compared with CDC criteria-based diagnosis. Of total 300 patients, 9 (3%) met CDC criteria for diagnosis of pneumonia while none of the cases were diagnosed as HAP according to the physicians' clinical diagnosis. All nine patients were discharged with proper general condition and no need of antibiotic therapy. This study showed that loss of consciousness, tachypnea, dyspnea, PaO2 < 60 mm Hg, PaO2/FiO2 < 240, and local infiltration in 24 hours of operation were misleading features of CDC criteria, which were not considered in physicians' clinical judgment to establish the diagnosis. Our findings suggest that in Post-CABG patients, physicians could judge the occurrence of HAP more accurately in comparison to making the diagnosis based on CDC criteria alone. Expert physician may intentionally do not take some of these criteria into account according the patients' course of disease. Therefore, it is suggested that the value of these criteria in special group of patients like those undergoing CABG should be re-evaluated.

  9. Final report, on-going key comparison BIPM.QM-K1, ozone at ambient level, comparison with CMS-ITRI, June 2016

    NASA Astrophysics Data System (ADS)

    Viallon, Joële; Idrees, Faraz; Moussay, Philippe; Wielgosz, Robert; Lin, Tsai-Yin; Norris, James E.; Hodges, Joseph T.

    2017-01-01

    As part of the on-going key comparison BIPM.QM-K1, a comparison has been performed between the ozone national standard of the ITRI Center for Measurement Standards (CMS-ITRI) and the common reference standard of the key comparison, maintained by the Bureau International des Poids et Mesures (BIPM), via a transfer standard maintained by the National Institute of Standards and Technology (NIST). The instruments have been compared over a nominal ozone amount-of-substance fraction range of 0 nmol/mol to 500 nmol/mol. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  10. Impact of a transfer center on interhospital referrals and transfers to a tertiary care center.

    PubMed

    Southard, Patricia A; Hedges, Jerris R; Hunter, John G; Ungerleider, Ross M

    2005-07-01

    The partnership of faculty physicians and senior clinical hospital administrators in the decision to accept interhospital transfers has not been fully studied. Transfers to academic medical centers on the basis of economics have been of particular concern. To evaluate the impact of joint decision making on transfer acceptance, and to evaluate the basis for decisions to transfer patients to an academic medical center. This was a database study of requested adult interhospital transfers, excluding psychiatric transfers, occurring between January 1, 2003, and December 31, 2003, by using data from a computerized patient-tracking system. Where possible, comparisons with the prior calendar year (i.e., prior to implementation of the administrative review process) were made. Incidence of refusal to accept requested transfers and payer mix of transfer patients were the main outcomes of interest. More than 90% of the adult patients were transferred for conditions that required tertiary care or met Emergency Medical Treatment and Labor Act (EMTALA) requirements. The patient conditions that did not meet tertiary care needs included obstetric patients who did not have prenatal care, patients who had hand and facial trauma, and patients who weighed more than 300 pounds. The payer mix of transfer patients remained stable when using the administrator and physician team to determine acceptance of transfers. During the evaluation period, approximately 91,500 patients statewide lost some level of Medicaid coverage. The value of an administrator and physician team as partners in the interhospital transfer process was demonstrated. Active management of interhospital transfers supports transfer of patients who require tertiary care or who meet EMTALA criteria, thus conserving limited bed capacity and ensuring financial equity, while caring for the uninsured and underinsured patients throughout the state.

  11. Metropolitan transportation management center : a case study : Milwaukee MONITOR : addressing congestion while improving safety and air quality

    DOT National Transportation Integrated Search

    1999-10-01

    The following case study provides a snapshot of Milwaukee's MONITOR transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting Stu...

  12. The study of atmospheric CO pollution over the center of Moscow in autumn period

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fokeeva, E.V.; Pekour, M.S.

    1996-12-31

    The results of CO near-ground concentration measurements are presented which were taken by virtue of electrochemical method at the center of Moscow during one autumn month in 1993. Simultaneous measurements were performed of the total column content of CO over Moscow making use of sun radiation absorption detection in the infrared (in the wavelength range of 4.6 mcm). To determine an urban increment of CO content over regional background the data of analogous measurements were used which were collected in the rural suburb 45 km west from Moscow center One-hour averaged near-ground CO concentration were in the limits 0.4 tomore » 5.8 mg/m{sup 3}, and an average total column CO content vary from 0.09 to 0.167 atm*cm. The measurements were accompanied by acoustic sounding of the atmosphere boundary layer with the use of three component Doppler SODAR. The peculiarities of average and concrete diurnal variation of near-ground CO concentrations can well be interpreted by virtue of SODAR data indicating the type of stratification, the mixing height and the wind velocity during a whole day. Comparison and analysis are performed of the average diurnal variations of near-ground CO concentration in autumn and summer periods in account to the occurrence frequency of surface inversion within selected periods. Almost complete coincidence has been found of the shape of CO concentration diurnal variations with those of NO and soot. An estimate of specific CO source power in the city is performed in account to the data on the mixing height and wind velocity mean within a layer of 250 m.« less

  13. Johnson Space Center

    NASA Astrophysics Data System (ADS)

    Murdin, P.

    2000-11-01

    The Johnson Space Center (JSC) in Houston is NASA's lead center for the space shuttle and the International Space Station programs and for biomedical research. Areas of study include Earth sciences and solar system exploration, astromaterials and space medicine. About 14 000 people, including 3000 civil servants, work at JSC....

  14. THE NORTH AMERICAN MERCURY MODEL INTER-COMPARISON STUDY (NAMMIS)

    EPA Science Inventory

    This paper describes the North American Mercury Model Inter-comparison Study (NAMMIS). The NAMMIS is an effort to apply atmospheric Hg models in a tightly constrained testing environment with a focus on North America. With each model using the same input data sets for initial co...

  15. Center for Epidemiologic Studies Depression Scale for Children: psychometric testing of the Chinese version.

    PubMed

    Li, Ho Cheung William; Chung, Oi Kwan Joyce; Ho, Ka Yan

    2010-11-01

    This paper is a report of psychometric testing of the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children. The availability of a valid and reliable instrument that accurately detects depressive symptoms in children is crucial before any psychological intervention can be appropriately planned and evaluated. There is no such an instrument for Chinese children. A test-retest, within-subjects design was used. A total of 313 primary school students between the ages of 8 and 12 years were invited to participate in the study in 2009. Participants were asked to respond to the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children, short form of the State Anxiety Scale for Children and Rosenberg's Self-Esteem Scale. The internal consistency, content validity and construct validity and test-retest reliability of the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children were assessed. The newly-translated scale demonstrated adequate internal consistency, good content validity and appropriate convergent and discriminant validity. Confirmatory factor analysis added further evidence of the construct validity of the scale. Results suggest that the newly-translated scale can be used as a self-report assessment tool in detecting depressive symptoms of Chinese children aged between 8 and 12 years. © 2010 Blackwell Publishing Ltd.

  16. Metropolitan Transportation Management Center : a case study : Houston TranStar maximizing safety and mobility for the public

    DOT National Transportation Integrated Search

    1999-10-01

    The following case study provides a snapshot of Houston's TranStar transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting Stud...

  17. Information sharing guidebook for transportation management centers, emergency operations centers, and fusion centers.

    DOT National Transportation Integrated Search

    2010-06-01

    This guidebook provides an overview of the mission and functions of transportation management centers, emergency operations centers, and fusion centers. The guidebook focuses on the types of information these centers produce and manage and how the sh...

  18. Information sharing guidebook for transportation management centers, emergency operations centers, and fusion centers

    DOT National Transportation Integrated Search

    2010-06-01

    This guidebook provides an overview of the mission and functions of transportation management centers, emergency operations centers, and fusion centers. The guidebook focuses on the types of information these centers produce and manage and how the sh...

  19. Meaning-centered dream work with hospice patients: A pilot study.

    PubMed

    Wright, Scott T; Grant, Pei C; Depner, Rachel M; Donnelly, James P; Kerr, Christopher W

    2015-10-01

    Hospice patients often struggle with loss of meaning, while many experience meaningful dreams. The purpose of this study was to conduct a preliminary exploration into the process and therapeutic outcomes of meaning-centered dream work with hospice patients. A meaning-centered variation of the cognitive-experiential model of dream work (Hill, 1996; 2004) was tested with participants. This variation was influenced by the tenets of meaning-centered psychotherapy (Breitbart et al., 2012). A total of 12 dream-work sessions were conducted with 7 hospice patients (5 women), and session transcripts were analyzed using the consensual qualitative research (CQR) method (Hill, 2012). Participants also completed measures of gains from dream interpretation in terms of existential well-being and quality of life. Participants' dreams generally featured familiar settings and living family and friends. Reported images from dreams were usually connected to feelings, relationships, and the concerns of waking life. Participants typically interpreted their dreams as meaning that they needed to change their way of thinking, address legacy concerns, or complete unfinished business. Generally, participants developed and implemented action plans based on these interpretations, despite their physical limitations. Participants described dream-work sessions as meaningful, comforting, and helpful. High scores on a measure of gains from dream interpretation were reported, consistent with qualitative findings. No adverse effects were reported or indicated by assessments. Our results provided initial support for the feasibility and helpfulness of dream work in this population. Implications for counseling with the dying and directions for future research were also explored.

  20. Vasopressor use following traumatic injury - A single center retrospective study.

    PubMed

    Hylands, Mathieu; Godbout, Marie-Pier; Mayer, Sandeep K; Fraser, William D; Vanasse, Alain; Leclair, Marc-André; Turgeon, Alexis F; Lauzier, François; Charbonney, Emmanuel; Trottier, Vincent; Razek, Tarek S; Roy, André; D'Aragon, Frédérick; Belley-Côté, Emilie; Day, Andrew G; Le Guillan, Soazig; Sabbagh, Robert; Lamontagne, François

    2017-01-01

    Vasopressors are not recommended by current trauma guidelines, but recent reports indicate that they are commonly used. We aimed to describe the early hemodynamic management of trauma patients outside densely populated urban centers. We conducted a single-center retrospective cohort study in a Canadian regional trauma center. All adult patients treated for traumatic injury in 2013 who died within 24 hours of admission or were transferred to the intensive care unit were included. A systolic blood pressure <90 mmHg, a mean arterial pressure <60 mmHg, the use of vasopressors or ≥2 L of intravenous fluids defined hemodynamic instability. Main outcome measures were use of intravenous fluids and vasopressors prior to surgical or endovascular management. Of 111 eligible patients, 63 met our criteria for hemodynamic instability. Of these, 60 (95%) had sustained blunt injury and 22 (35%) had concomitant severe traumatic brain injury. The subgroup of patients referred from a primary or secondary hospital (20 of 63, 32%) had significantly longer transport times (243 vs. 61 min, p<0.01). Vasopressors, used in 26 patients (41%), were independently associated with severe traumatic brain injury (odds ratio 10.2, 95% CI 2.7-38.5). In this cohort, most trauma patients had suffered multiple blunt injuries. Patients were likely to receive vasopressors during the early phase of trauma care, particularly if they exhibited signs of neurologic injury. While these results may be context-specific, determining the risk-benefit trade-offs of fluid resuscitation, vasopressors and permissive hypotension in specific patients subgroups constitutes a priority for trauma research going forwards.

  1. Nanotube Activities at NASA-Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Arepalli, Sivaram

    2004-01-01

    Nanotube activities at NASA-Johnson Space Center include production, purification, characterization as well as applications of single wall carbon nanotubes (SWCNTs). A parametric study of the pulsed laser ablation process is recently completed to monitor the effect of production parameters including temperature, buffer gas, flow rate, pressure, and laser fluence. Enhancement of production is achieved by rastering the graphite target and by increasing the target surface temperature with a cw laser. In-situ diagnostics during production included time resolved passive emission and laser induced fluorescence from the plume. The improvement of the purity by a variety of steps in the purification process is monitored by characterization techniques including SEM, TEM, Raman, UV-VIS-NIR and TGA. A recently established NASA-JSC protocol for SWCNT characterization is undergoing revision with feedback from nanotube community. Efforts at JSC over the past five years in composites have centered on structural polymer/nanotube systems. Recent activities broadened this focus to multifunctional materials, supercapacitors, fuel cells, regenerable CO2 absorbers, electromagnetic shielding, radiation dosimetry and thermal management systems of interest for human space flight. Preliminary tests indicate improvement of performance in most of these applications because of the large Surface area as well as high electrical and thermal conductivity exhibited by SWCNTs. Comparison with existing technologies and possible future improvements in the SWCNT materials sill be presented.

  2. A Market Study for the Center for the Performing Arts.

    ERIC Educational Resources Information Center

    Rae, John; And Others

    In fall 1983, a telephone survey was conducted by Macomb Community College (MCC) to assess community perceptions of the college's Center for the Performing Arts (CPA) and to aid in developing marketing strategies for the Center. Interviews were conducted with 500 randomly selected Macomb County (Michigan) residents to determine if they had…

  3. Center for the Study of Rhythmic Processes

    DTIC Science & Technology

    1990-12-01

    Mathematical modeling Neuromodulators . Regaerti-n Sensory feedback -9. A35𔄁ACT (Convtinue an reverse if necesusy and4 4onTify by WJoo number) The Center for...activation and movement, and the ability of the network to regenerate. Work on the STG included results on neuromodulators that change the output of the

  4. Vomiting Center reanalyzed: An electrical stimulation study

    NASA Technical Reports Server (NTRS)

    Miller, A. D.; Wilson, V. J.

    1982-01-01

    Electrical stimulation of the brainstem of 15 decerebrate cats produced stimulus-bound vomiting in only 4 animals. Vomiting was reproducible in only one cat. Effective stimulating sites were located in the solitary tract and reticular formation. Restricted localization of a vomiting center, stimulation of which evoked readily reproducible results, could not be obtained.

  5. Patient-centered innovation in health care organizations: a conceptual framework and case study application.

    PubMed

    Hernandez, Susan E; Conrad, Douglas A; Marcus-Smith, Miriam S; Reed, Peter; Watts, Carolyn

    2013-01-01

    Patient-centered innovation is spreading at the federal and state levels. A conceptual framework can help frame real-world examples and extract systematic learning from an array of innovative applications currently underway. The statutory, economic, and political environment in Washington State offers a special contextual laboratory for observing the interplay of these factors. We propose a framework for understanding the process of initiating patient-centered innovations-particularly innovations addressing patient-centered goals of improved access, continuity, communication and coordination, cultural competency, and family- and person-focused care over time. The framework to a case study of a provider organization in Washington State actively engaged in such innovations was applied in this article. We conducted a selective review of peer-reviewed evidence and theory regarding determinants of organizational change. On the basis of the literature review and the particular examples of patient-centric innovation, we developed a conceptual framework. Semistructured key informant interviews were conducted to illustrate the framework with concrete examples of patient-centered innovation. The primary determinants of initiating patient-centered innovation are (a) effective leadership, with the necessary technical and professional expertise and creative skills; (b) strong internal and external motivation to change; (c) clear and internally consistent organizational mission; (d) aligned organizational strategy; (e) robust organizational capability; and (f) continuous feedback and organizational learning. The internal hierarchy of actors is important in shaping patient-centered innovation. External financial incentives and government regulations also significantly shape innovation. Patient-centered care innovation is a complex process. A general framework that could help managers and executives organize their thoughts around innovation within their organization is presented.

  6. RAN/RANBP2 polymorphisms and neuroblastoma risk in Chinese children: a three-center case-control study.

    PubMed

    Wang, Juxiang; Zhuo, Zhenjian; Chen, Min; Zhu, Jinhong; Zhao, Jie; Zhang, Jiao; Chen, Shanshan; He, Jing; Zhou, Haixia

    2018-04-28

    The genetic etiology of sporadic neuroblastoma remains largely obscure. RAN and RANBP2 genes encode Ras-related nuclear protein and Ran-binding protein 2, respectively. These two proteins form Ran-RanBP2 complex that regulate various cellular activities including nuclear transport. Aberrant functions of the two proteins are implicated in carcinogenesis. Given the unknown role of RAN/RANBP2 single nucleotide polymorphisms (SNPs) in neuroblastoma risk, we performed a multi-center case-control study in Chinese children to assess the association of the RAN/RANBP2 SNPs with neuroblastoma risk. We analyzed three potentially functional SNPs in RAN gene (rs56109543 C>T, rs7132224 A>G, rs14035 C>T) and one in RANBP2 (rs2462788 C>T) in 429 cases and 884 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to access the association between these four polymorphisms and neuroblastoma risk. No single variant was found to statistically significantly associate with neuroblastoma risk. However, individuals with 3 protective genotypes were less likely to develop neuroblastoma, in comparison to non-carriers (adjusted OR=0.33; 95% CI=0.12-0.96; P =0.042), as well as those with 0-2 protective genotypes (adjusted OR=0.33; 95% CI=0.11-0.94; P =0.038). Stratified analysis revealed no significant association for any of the four polymorphisms. Further studies are warranted to validate the weak impact of RAN/RANBP2 SNPs on neuroblastoma risk.

  7. Presence of Observable Conditions of Positive Self-Concept in Elementary School Media Centers: A Descriptive Study.

    ERIC Educational Resources Information Center

    Williams, Dianne McAfee

    In order to focus on important contributions of elementary school instructional media centers (IMC's) to the educational program, a study was conducted to determine the presence of conditions of positive self-concept--cooperation, independence, success, positive atmosphere, challenge, feeling of value or acceptance--in such centers. A descriptive,…

  8. A comparison of two experimental design approaches in applying conjoint analysis in patient-centered outcomes research: a randomized trial.

    PubMed

    Kinter, Elizabeth T; Prior, Thomas J; Carswell, Christopher I; Bridges, John F P

    2012-01-01

    While the application of conjoint analysis and discrete-choice experiments in health are now widely accepted, a healthy debate exists around competing approaches to experimental design. There remains, however, a paucity of experimental evidence comparing competing design approaches and their impact on the application of these methods in patient-centered outcomes research. Our objectives were to directly compare the choice-model parameters and predictions of an orthogonal and a D-efficient experimental design using a randomized trial (i.e., an experiment on experiments) within an application of conjoint analysis studying patient-centered outcomes among outpatients diagnosed with schizophrenia in Germany. Outpatients diagnosed with schizophrenia were surveyed and randomized to receive choice tasks developed using either an orthogonal or a D-efficient experimental design. The choice tasks elicited judgments from the respondents as to which of two patient profiles (varying across seven outcomes and process attributes) was preferable from their own perspective. The results from the two survey designs were analyzed using the multinomial logit model, and the resulting parameter estimates and their robust standard errors were compared across the two arms of the study (i.e., the orthogonal and D-efficient designs). The predictive performances of the two resulting models were also compared by computing their percentage of survey responses classified correctly, and the potential for variation in scale between the two designs of the experiments was tested statistically and explored graphically. The results of the two models were statistically identical. No difference was found using an overall chi-squared test of equality for the seven parameters (p = 0.69) or via uncorrected pairwise comparisons of the parameter estimates (p-values ranged from 0.30 to 0.98). The D-efficient design resulted in directionally smaller standard errors for six of the seven parameters, of which

  9. Towards protein-crystal centering using second-harmonic generation (SHG) microscopy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kissick, David J.; Dettmar, Christopher M.; Becker, Michael

    2013-05-01

    The potential of second-harmonic generation (SHG) microscopy for automated crystal centering to guide synchrotron X-ray diffraction of protein crystals has been explored. The potential of second-harmonic generation (SHG) microscopy for automated crystal centering to guide synchrotron X-ray diffraction of protein crystals was explored. These studies included (i) comparison of microcrystal positions in cryoloops as determined by SHG imaging and by X-ray diffraction rastering and (ii) X-ray structure determinations of selected proteins to investigate the potential for laser-induced damage from SHG imaging. In studies using β{sub 2} adrenergic receptor membrane-protein crystals prepared in lipidic mesophase, the crystal locations identified by SHGmore » images obtained in transmission mode were found to correlate well with the crystal locations identified by raster scanning using an X-ray minibeam. SHG imaging was found to provide about 2 µm spatial resolution and shorter image-acquisition times. The general insensitivity of SHG images to optical scatter enabled the reliable identification of microcrystals within opaque cryocooled lipidic mesophases that were not identified by conventional bright-field imaging. The potential impact of extended exposure of protein crystals to five times a typical imaging dose from an ultrafast laser source was also assessed. Measurements of myoglobin and thaumatin crystals resulted in no statistically significant differences between structures obtained from diffraction data acquired from exposed and unexposed regions of single crystals. Practical constraints for integrating SHG imaging into an active beamline for routine automated crystal centering are discussed.« less

  10. Comparison of the adaptive implementation and evaluation of the Meeting Centers Support Program for people with dementia and their family carers in Europe; study protocol of the MEETINGDEM project.

    PubMed

    Dröes, R M; Meiland, F J M; Evans, S; Brooker, D; Farina, E; Szcześniak, D; Van Mierlo, L D; Orrell, M; Rymaszewska, J; Chattat, R

    2017-04-04

    The MEETINGDEM study aims to implement and evaluate an innovative, inclusive, approach to supporting community dwelling people with mild to moderate dementia and their family carers, called the Meeting Centers Support Program (MCSP), in three countries in the European Union (EU): Italy, Poland and United Kingdom. Demonstrated benefits of this person-centered approach, developed in The Netherlands, include high user satisfaction, reduced behavioral and mood problems, delayed admission to residential care, lower levels of caregiving-related stress, higher carer competence, and improved collaboration between care and welfare organizations. The project will be carried out over a 36 month period. Project partners in the three countries will utilize, and adapt, strategies and tools developed in the Netherlands. In Phase One (month 1-18) activities will focus on establishing an initiative group of relevant organizations and user representatives in each country, exploring pathways to care and potential facilitators and barriers to implementing the program, and developing country specific implementation plans and materials. In Phase Two (month 19‑36) training will be provided to organizations and staff, after which the meeting centers will be established and evaluated for impact on behavior, mood and quality of life of people with dementia and carers, cost-effectiveness, changes in service use, user satisfaction and implementation process. An overall evaluation will draw together findings from the three countries to develop recommendations for successful implementation of MCSP across the EU. If the Meeting Centers approach can be widely implemented, this could lead to major improvements in dementia care across Europe and beyond. The trial was retrospectively registered in May 2016: trial number: NTR5936 .

  11. Comparative evaluation of canal transportation, centering ability, and remaining dentin thickness between WaveOne and ProTaper rotary by using cone beam computed tomography: An in vitro study

    PubMed Central

    Jain, Aditi; Asrani, Hemant; Singhal, Abhinav Chand; Bhatia, Taranjeet Kaur; Sharma, Vaibhav; Jaiswal, Pragya

    2016-01-01

    Aims: To compare the canal transportation, centering ability, and remaining dentin thickness of WaveOne and ProTaper systems using cone beam computed tomography. Subjects and Methods: Forty extracted human single-rooted premolars were used in the present study. Preinstrumentation scanning of all teeth was taken; canal curvatures were calculated, and the samples were randomly divided into two groups, with twenty samples in each group; one group was instrumented with WaveOne system and the other group with ProTaper rotary system. Postinstrumentation scans were performed, and the two scans were compared to determine canal transportation, centering ability, and remaining dentin thickness at 3 mm, 6 mm, and 9 mm from the root apex. Statistical Analysis Used: Student's unpaired t-test. Results: Using Student's unpaired t-test, results were as follows: for canal transportation, Group 1 showed significant difference at 3 mm and 6 mm and insignificant difference at 9 mm while Group 2 showed insignificant difference in all the three regions. For centering ability and remaining dentin thickness, Group 1 showed insignificant difference at 3 mm and 9 mm while significant difference at 6 mm was obtained. When comparison of remaining dentin thickness was done at three levels using two groups WaveOne and ProTaper, there was no significant difference between two groups. Conclusions: (1) WaveOne single reciprocation file system respected better canal anatomy better than ProTaper. (2) Individually, centering ability of WaveOne was better at 3 mm, 6 mm, and 9 mm levels. (3) However, ProTaper individually was better centered at 3 mm (apical third) and 9 mm (coronal 3rd) levels than 6 mm level (middle third). PMID:27656063

  12. Quality of laparoscopic radical hysterectomy in developing countries: a comparison of surgical and oncologic outcomes between a comprehensive cancer center in the United States and a cancer center in Colombia.

    PubMed

    Pareja, Rene; Nick, Alpa M; Schmeler, Kathleen M; Frumovitz, Michael; Soliman, Pamela T; Buitrago, Carlos A; Borrero, Mauricio; Angel, Gonzalo; Reis, Ricardo Dos; Ramirez, Pedro T

    2012-05-01

    To help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a cancer center in Colombia. Records of the first 50 consecutive patients who underwent laparoscopic radical hysterectomy at The University of Texas MD Anderson Cancer Center in Houston (between April 2004 and July 2007) and the first 50 consecutive patients who underwent the same procedure at the Instituto de Cancerología-Clínica las Américas in Medellín (between December 2008 and October 2010) were retrospectively reviewed. Surgical and oncologic outcomes were compared between the 2 groups. There was no significant difference in median patient age (US 41.9 years [range 23-73] vs. Colombia 44.5 years [range 24-75], P=0.09). Patients in Colombia had a lower median body mass index than patients in the US (24.4 kg/m(2) vs. 28.7 kg/m(2), P=0.002). Compared to patients treated in Colombia, patients who underwent surgery in the US had a greater median estimated blood loss (200 mL vs. 79 mL, P<0.001), longer median operative time (328.5 min vs. 235 min, P<0.001), and longer postoperative hospital stay (2 days vs. 1 day, P<0.001). Surgical and oncologic outcomes of laparoscopic radical hysterectomy were not worse at a cancer center in a developing country than at a large comprehensive cancer center in the United States. These results support consideration of developing countries for inclusion in collaborations for prospective surgical studies. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Unbiased Causal Inference from an Observational Study: Results of a Within-Study Comparison

    ERIC Educational Resources Information Center

    Pohl, Steffi; Steiner, Peter M.; Eisermann, Jens; Soellner, Renate; Cook, Thomas D.

    2009-01-01

    Adjustment methods such as propensity scores and analysis of covariance are often used for estimating treatment effects in nonexperimental data. Shadish, Clark, and Steiner used a within-study comparison to test how well these adjustments work in practice. They randomly assigned participating students to a randomized or nonrandomized experiment.…

  14. Study Skills and Critical Thinking Curriculum for Adolescents in a Psychiatric Treatment Center.

    ERIC Educational Resources Information Center

    Peniston, Lorraine C.

    This report discusses the need to teach critical thinking and study skill strategies to improve the problem-solving ability, study habits, and knowledge of subject content to students in psychiatric treatment centers. The report asserts that this type of curriculum will assist students in comprehending new information and utilizing thinking skills…

  15. History of Outreach in National Centers for Foreign Languages and International Studies.

    ERIC Educational Resources Information Center

    Wiley, Marylee

    Over the past decade, university-based outreach programs, established under the Title VI Higher Education Act in National Centers for Foreign Language and International Studies, have offered a variety of services to schools, community groups, the media, and other colleges and universities. Those outreach programs working in elementary and…

  16. Preliminary results of VISX excimer laser myopic photorefractive keratectomy at Cedars-Sinai Medical Center

    NASA Astrophysics Data System (ADS)

    Maguen, Ezra I.; Berlin, Michael S.; Hofbauer, John; Macy, Jonathan I.; Nesburn, Anthony B.; Papaioannou, Thanassis; Salz, James J.

    1992-08-01

    Sixty-two eyes underwent excimer laser photorefractive keratectomy (PRK) for the correction of myopia at Cedars-Sinai-Medical-Center. The first group of 12 patients are presented with follow up data of ten months postoperatively. The second group of 50 patients are presented with follow up data of three months postoperatively. An in-depth comparison of pre and postoperative refractive data is presented. Comparisons between pre and postoperative corrected and uncorrected Snellen visual acuities are provided in order to asses the functional visual result of the procedure.

  17. Person-centered care planning and service engagement: a study protocol for a randomized controlled trial.

    PubMed

    Stanhope, Victoria; Tondora, Janis; Davidson, Larry; Choy-Brown, Mimi; Marcus, Steven C

    2015-04-22

    Service disengagement is a pervasive challenge the mental health care system faces. Mental health services are of little value should persons with mental illnesses continue to opt out of receiving them. Consumers attribute disengagement from care to an absence of choice in their treatment. In response, the mental health system is adopting a person-centered model, based upon recovery principles, to engage consumers more actively in their care. Person-centered care planning is a promising practice involving collaboration to develop and implement an actionable plan to assist the person in achieving personal recovery goals. This study design combines a parallel-group randomized controlled trial of community mental health organizations with qualitative methods to assess the effectiveness of person-centered care planning. Participants at 14 sites in Delaware and Connecticut will be randomized to treatment as usual or the person-centered care planning intervention. Participants will be in leadership (n = 70) or supervisory or direct care (n = 210) roles. The person-centered care planning intervention involves intensive staff training and 12 months of ongoing technical assistance. Quantitative survey data will be collected at baseline, 6 months and 12 months measuring person-centered care planning competency and organizational factors. Consumer outcomes (engagement, medication adherence, functioning and consumer satisfaction) will be assessed by Medicaid and state-level data. Qualitative data focused on process factors will include staff and consumer interviews and focus groups. In this intent-to-treat analysis, we will use mixed-effects multivariate regression models to evaluate the differential impact of the person-centered care planning intervention on each consumer and implementation outcome as well as the extent to which clinician assessments of organizational factors are associated with the implementation outcome. Mixed methods will triangulate and strengthen the

  18. THE TRAINING CENTER, DIFFERENT PURPOSES, DIFFERENT DESIGNS, A LOOK AT SELECTED CORPORATE TRAINING CENTERS.

    ERIC Educational Resources Information Center

    MAHLER, HARRY B.

    UNIQUE FEATURES AND FLOOR PLANS OF FUNCTIONALLY DESIGNED CORPORATE TRAINING CENTERS ARE DESICRIBED. THE TRAVELERS EDUCATION CENTER HAS SIMPLY DESIGNED ROOMS AND FEW AUDIOVISUAL AIDS (AV). BUTLER MANUFACTURING HAS ITS STUDY CENTER IN A WING OF A MOTEL WHICH IS CONVENIENT TO THE GENERAL OFFICES AND DOWNTOWN AREA. SINCE COMPANY PERSONNEL USE THE…

  19. Evaluation of employees in public day care centers knowledge about breastfeeding and complementary feeding.

    PubMed

    Souza, Joelânia Pires de O; Prudente, Amanda Moura; Silva, Dyene Aparecida; Pereira, Leandro Alves; Rinaldi, Ana Elisa M

    2013-12-01

    To evaluate the knowledge of public day care centers employees about breastfeeding and complementary feeding. A cross-sectional study was conducted in 15 public day care centers randomly selected in the city of Uberlandia, Southeast Brazil. A questionnaire applied to school principals, teachers, educators and general services assistants (GSA) included demographic and socioeconomic variables and questions about knowledge on breastfeeding, complementary feeding besides employees' perceptions about these subjects. Kruskal-Wallis with multiple comparison and chi-square tests were used to compare variables by professional category. 304 employees participated in the study. The highest percentages of correct answers were noted for questions about exclusive breastfeeding: definition - 97% (n=296) and duration - 65% (n=199). Regarding complementary feeding, 61% (n=187) correctly answered about the appropriate age to introduce it, with a lower percentage for meat (56%; n=170) and sugar (16%; n=50). Concerning employees' perceptions, 9% (n=29) believed that there is weak breast milk, 79% (n=241) and 51% (n=157) reported the negative influence of bottle feeding and pacifier use on breastfeeding. Among the interviewed subjects, 77% (n=234) answered that they had a positive influence on the quality of the food given to the children. There were no differences in the answers according to professional category, except for the negative influence of pacifiers on breastfeeding. Employees of public day care centers knew more about breastfeeding than about complementary feeding. Educational activities about breastfeeding and complementary feeding are necessary for day care centers employees.

  20. Identification of the iron-sulfur center of spinach ferredoxin-nitrite reductase as a tetranuclear center, and preliminary EPR studies of mechanism.

    PubMed

    Lancaster, J R; Vega, J M; Kamin, H; Orme-Johnson, N R; Orme-Johnson, W H; Krueger, R J; Siegel, L M

    1979-02-25

    EPR spectroscopic and chemical analyses of spinach nitrite reductase show that the enzyme contains one reducible iron-sulfur center, and one site for binding either cyanide or nitrite, per siroheme. The heme is nearly all in the high spin ferric state in the enzyme as isolated. The extinction coefficient of the enzyme has been revised to E386 = 7.6 X 10(4) cm-1 (M heme)-1. The iron-sulfur center is reduced with difficulty by agents such as reduced methyl viologen (equilibrated with 1 atm of H2 at pH 7.7 in the presence of hydrogenase) or dithionite. Complexation of the enzyme with CO (a known ligand for nitrite reductase heme) markedly increases the reducibility of the iron-sulfur center. New chemical analyses and reinterpretation of previous data show that the enzyme contains 6 mol of iron and 4 mol of acid-labile S2-/mol of siroheme. The EPR spectrum of reduced nitrite reductase in 80% dimethyl sulfoxide establishes clearly that the enzyme contains a tetranuclear iron-sulfur (Fe4S4) center. The ferriheme and Fe4S4 centers are reduced at similar rates (k = 3 to 4 s-1) by dithionite. The dithionite-reduced Fe4S4 center is rapidly (k = 100 s-1) reoxidized by nitrite. These results indicate a role for the Fe4S4 center in catalysis.

  1. Contributions of South American research centers to Carbohydrate Research.

    PubMed

    Stortz, Carlos A

    2014-03-24

    The present article shows the objective figures of the contributions of South American research centers to Carbohydrate Research during its 50years of history, measured in terms of members of the Editorial Board, number of articles and citations to them, together with a country-based comparison, and the progression of these contributions with time. In addition, it also shows the subjective feelings of the author toward the same journal. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Contributions of South American research centers to Carbohydrate Research.

    PubMed

    Stortz, Carlos A

    2015-02-11

    The present article shows the objective figures of the contributions of South American research centers to Carbohydrate Research during its 50 years of history, measured in terms of members of the Editorial Board, number of articles and citations to them, together with a country-based comparison, and the progression of these contributions with time. In addition, it also shows the subjective feelings of the author toward the same journal. Copyright © 2015. Published by Elsevier Ltd.

  3. An Analysis of Factors that Inhibit Business Use of User-Centered Design Principles: A Delphi Study

    ERIC Educational Resources Information Center

    Hilton, Tod M.

    2010-01-01

    The use of user-centered design (UCD) principles has a positive impact on the use of web-based interactive systems in customer-centric organizations. User-centered design methodologies are not widely adopted in organizations due to intraorganizational factors. A qualitative study using a modified Delphi technique was used to identify the factors…

  4. User-Centered Design through Learner-Centered Instruction

    ERIC Educational Resources Information Center

    Altay, Burçak

    2014-01-01

    This article initially demonstrates the parallels between the learner-centered approach in education and the user-centered approach in design disciplines. Afterward, a course on human factors that applies learner-centered methods to teach user-centered design is introduced. The focus is on three tasks to identify the application of theoretical and…

  5. Exploratory Study of Perceived Barriers to Learning in an Urban Educational Opportunity Center

    ERIC Educational Resources Information Center

    Lee, Jung Min

    2017-01-01

    The purpose of this study was to identify the perceived barriers of adult learners to program in the State University of New York (SUNY) Manhattan Educational Opportunity Center (MEOC) from the perspectives of students and teachers. The study also sought to determine teachers' insights regarding means of motivating adult students to continue…

  6. A Case Study: An ACT Stress Management Group in a University Counseling Center

    ERIC Educational Resources Information Center

    Daltry, Rachel M.

    2015-01-01

    The aim of this study was to examine the effectiveness of an acceptance and commitment therapy (ACT) stress management group in a college counseling center setting. This study explored (a) the effectiveness of ACT in increasing participants' ability to tolerate distress, which directly affects their ability to function in a stressful college…

  7. A Patient Learning Center for an Army MEDDAC - A Feasibility Study. Final Report.

    ERIC Educational Resources Information Center

    Kucha, Deloros H.

    A feasibility study was conducted to examine in detail, analyze, and describe the development and operation (system effectiveness and efficiency) of a patient learning center in a MEDDAC, and to provide such information to the Surgeon General for use in planning future health care delivery to military-care eligible beneficiaries. Study objectives…

  8. Transport coefficients of dense fluids composed of globular molecules. Equilibrium molecular dynamics investigations using more-center Lennard-Jones potentials

    NASA Astrophysics Data System (ADS)

    Hoheisel, C.

    1988-09-01

    Equilibrium molecular dynamics calculations with constraints have been performed for model liquids SF6 and CF4. The computations were carried out with four- and six-center Lennard-Jones potentials and up to 2×105 integration steps. Shear, bulk viscosity and the thermal conductivity have been calculated with use of Green-Kubo relations in the formulation of ``molecule variables.'' Various thermodynamic states were investigated. For SF6, a detailed comparison with experimental data was possible. For CF4, the MD results could only be compared with experiment for one liquid state. For the latter liquid, a complementary comparison was performed using MD results obtained with a one-center Lennard-Jones potential. A limited test of the particle number dependence of the results is presented. Partial and total correlations functions are shown and discussed with respect to findings obtained for the one-center Lennard-Jones liquid.

  9. Services and information for sexually compulsive students on college counseling center websites: results from a national sample.

    PubMed

    Wright, Paul J; McKinley, Christopher J

    2010-09-01

    One factor that may prevent a small but significant percentage of college students from achieving sexual health is sexual compulsivity, a problem of sexual control that is associated with a number of negative health outcomes, including high HIV risk behavior. In this study we content analyzed a randomly selected stratified national sample of 203 4-year U.S. colleges' counseling center websites to assess the degree to which such sites feature information and reference services for sexually compulsive students. Results revealed that sexual compulsivity communications were rare, especially in comparison with communications for other mental health issues. For instance, less than 5% of counseling centers spoke of individual counseling opportunities for students struggling with sexual compulsivity, while between 60% and 80% of counseling centers advertised their capacity to provide individual counseling for students struggling with alcohol and substance abuse, depression, stress/anxiety, and pathological eating. Possible explanations for the paucity of sexual compulsivity messages are discussed.

  10. Prevalence of nosocomial infection in long-term-care Veterans Administration medical centers.

    PubMed

    Steinmiller, A M; Robb, S S; Muder, R R

    1991-06-01

    Prevention and control of nosocomial infections are major goals of institutional risk-management programs. However, variations in criteria and denominator parameters make comparison of rates across settings difficult. This study addressed those problems by reporting criteria used to identify infections and applying the same denominator across long-term-care facilities. Findings demonstrated a 9.8% prevalence rate for nosocomial infections in four long-term-care VA facilities. Most of the identified infections were consistent with Centers for Disease Control definitions of nosocomial infections. The most frequent indicators of nosocomial infections that did not fully meet those definitions were (1) documented symptoms, (2) antibiotic therapy, and (3) physician diagnosis.

  11. Assessment of Landscape Fragmentation Associated With Urban Centers Using ASTER Data

    NASA Astrophysics Data System (ADS)

    Stefanov, W. L.

    2002-12-01

    The role of humans as an integral part of the environment and ecosystem processes has only recently been accepted into mainstream ecological thought. The realization that virtually all ecosystems on Earth have experienced some degree of human alteration or impact has highlighted the need to incorporate humans (and their environmental effects) into ecosystem models. A logical starting point for investigation of human ecosystem dynamics is examination of the land cover characteristics of large urban centers. Land cover and land use changes associated with urbanization are important drivers of local geological, hydrological, ecological, and climatic change. Quantification and monitoring of urban land cover/land use change is part of the primary mission of the ASTER instrument on board the NASA Terra satellite, and comprises the fundamental research objective of the Urban Environmental Monitoring (UEM) Program at Arizona State University. The UEM program seeks to acquire day/night, visible through thermal infrared data twice per year for 100 global urban centers (with an emphasis on semi-arid cities) over the nominal six-year life of the Terra mission. Data have been acquired for the majority of the target urban centers and are used to compare landscape fragmentation patterns on the basis of land cover classifications. Land cover classifications of urban centers are obtained using visible through mid-infrared reflectance and emittance spectra together with calculated vegetation index and spatial variance texture information (all derived from raw ASTER data). This information is combined within a classification matrix, using an expert system framework, to obtain final pixel classifications. Landscape fragmentation is calculated using a pixel per unit area metric for comparison between 55 urban centers with varying geographic and climatic settings including North America, South America, Europe, central and eastern Asia, and Australia. Temporal variations in land cover

  12. A Study of Time Spent Working at Learning Centers. Technical Report #17.

    ERIC Educational Resources Information Center

    Omori, Sharon; And Others

    This study examined the proportion of time children in the Kamehameha Early Education Program schools spend at actual school work in learning centers. Systematic time-sampled observations using multiple observers were conducted in December-January and again in March-April. The subjects, 12 children (6 kindergarteners and 6 first graders) were…

  13. Qualitative Delphi Study of Factors Influencing Data Center Investment in Eco-Innovations

    ERIC Educational Resources Information Center

    Stewart, M. Bennett

    2016-01-01

    This qualitative investigation explored the diffusion of eco-innovations within the U.S. data center industry from 2007 to 2015 whose adoption was intended to decouple digital economy growth from environmental impact. Using diffusion of innovation theory to inform the study, and synthesizing subject matter expert input from a Delphi panel…

  14. [Obstacles and facilitators of conducting studies - the perspective of colorectal cancer centers' coordinators].

    PubMed

    Kowalski, C; Ferencz, J; Benz, S; Post, S; Seufferlein, T; Stinner, B; Penzes, O; Wesselmann, S

    2016-05-01

    Clinical trials and health services research are crucial pillars for improving patient care. This paper examines factors inhibiting and promoting the study activity and the knowledge and use of trial registries (e. g. DRKS, StudyBox) as an opportunity to learn about existing studies. The coordinators of 274 cancer center sites certified according to the requirements of the German Cancer Society were surveyed using a standardized online questionnaire. Data were analyzed using descriptive and bivariate statistics to identify associations with characteristics of the sites (e. g. patient volume, ownership, teaching status). 176 sites participated in the survey (64.2 %). The central obstacle to study participa-tion from the centers' view is the low number of existing studies. General knowledge of the population about studies was considered low. Trial registries are known to almost all respondents, but are rarely used. The results of the survey suggest that comprehensive measures are needed to sustainably increase the study activity. These include, for example, better information about studies, for example through appropriate databases, and (industry-independent) research funding. One possible way to sensitize patients for studies could be the comprehensive education of the population about the purpose of studies. © Georg Thieme Verlag KG Stuttgart · New York.

  15. A Study Investigating the Perceived Service Quality Levels of Sport Center Members: A Kano Model Perspective

    ERIC Educational Resources Information Center

    Yildiz, Kadir; Polat, Ercan; Güzel, Pinar

    2018-01-01

    The purpose of this study is to investigate sport center members' perceived service quality levels with a view to Kano customer expectations and requirements model. To that end, a descriptive approach and a correlational research design featuring survey method is adopted. Research group consists of 680 (300 women, 380 men) sport center members who…

  16. TU-EF-304-06: A Comparison of CT Number to Relative Linear Stopping Power Conversion Curves Used by Proton Therapy Centers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Taylor, P; Lowenstein, J; Kry, S

    Purpose: To compare the CT Number (CTN) to Relative Linear Stopping Power (RLSP) conversion curves used by 14 proton institutions in their dose calculations. Methods: The proton institution’s CTN to RLSP conversion curves were collected by the Imaging and Radiation Oncology Core (IROC) Houston QA Center during its on-site dosimetry review audits. The CTN values were converted to scaled CT Numbers. The scaling assigns a CTN of 0 to air and 1000 to water to allow intercomparison. The conversion curves were compared and the mean curve was calculated based on institutions’ predicted RLSP values for air (CTN 0), lung (CTNmore » 250), fat (CTN 950), water (1000), liver (CTN 1050), and bone (CTN 2000) points. Results: One institution’s curve was found to have a unique curve shape between the scaled CTN of 1025 to 1225. This institution modified its curve based on the findings. Another institution had higher RLSP values than expected for both low and high CTNs. This institution recalibrated their two CT scanners and the new data placed their curve closer to the mean of all institutions. After corrections were made to several conversion curves, four institutions still fall outside 2 standard deviations at very low CTNs (100–200), and two institutions fall outside between CTN 850–900. The largest percent difference in RLSP values between institutions for the specific tissues reviewed was 22% for the lung point. Conclusion: The review and comparison of CTN to RLSP conversion curves allows IROC Houston to identify any outliers and make recommendations for improvement. Several institutions improved their clinical dose calculation accuracy as a Result of this review. There is still area for improvement, particularly in the lung area of the curve. The IROC Houston QA Center is supported by NCI grant CA180803.« less

  17. [Science cultures in the global perspective. Thoughts on content design and operation of the Leopoldina Study Center].

    PubMed

    Labisch, Alfons

    2014-01-01

    The Leopoldina Center for the Study of the History of Science and Science Academies is a place to openly discuss the cooperation between science and society across all of the disciplines represented at the Leopoldina and beyond. This dialogue shall, by all means, also include researchers who are not members of the Leopoldina and people from outside of the academia who are interested in the topic. Like the Leopoldina, its Study Center builds bridges: between various academic disciplines, across generations and in local, national, and international communities. All interested members of the Leopoldina--not just members from the humanities, the social sciences or the behavioral sciences, but also scientists from the areas of the natural sciences, technology, the life sciences and physicians--are kindly invited to incorporate their research interests, with regard to the history and theory of their respective academic disciplines, in the research portfolio of the Leopoldina Study Center. In so doing, the Leopoldina Center for the Study of the History of Science and Science Academies should and will become a source of energy for permanent reflection and innovation when contemplating the issues of science and society.

  18. Comparison of patients with multivessel disease treated at centers with and without on-site cardiac surgery.

    PubMed

    Ram, Eilon; Goldenberg, Ilan; Kassif, Yigal; Segev, Amit; Lavee, Jakob; Shlomo, Nir; Raanani, Ehud

    2018-03-01

    The regional needs and consolidation of cardiac surgery services (CSS) result in an increased number of stand-alone interventional cardiology units. We aimed to explore the impact of a heart team on the decision making and outcomes of patients with multivessel coronary artery disease referred for coronary revascularization in stand-alone interventional cardiology units. This prospective study included 1063 consecutive patients with multivessel disease enrolled between January and April 2013 from all 22 hospitals in Israel that perform coronary angiography and percutaneous coronary intervention (PCI), with or without on-site CSS. Of the 1063 patients, 487 (46%) underwent coronary artery bypass grafting (CABG) and 576 (54%) underwent PCI. A higher proportion of patients underwent PCI in hospitals without on-site CSS compared with those with on-site CSS (65% vs 46%; P < .001). Furthermore, patients referred to CABG from hospitals without on-site CSS had a significantly higher mean SYNTAX score compared with those who underwent CABG in centers with on-site CSS (29 vs 26; P = .018). Multivariate logistic regression analysis consistently showed that the absence of on-site cardiac surgery and a heart team was independently associated with a 2.5-fold increased likelihood for predicting the referral of PCI rather than CABG (odds ratio, 2.54; 95% confidence interval, 1.8-3.6). Patients with multivessel coronary artery disease treated in centers without on-site cardiac surgery services receive a lower rate of appropriate guideline-based intervention with CABG. These findings suggest that a heart team approach should be mandatory even in centers with stand-alone interventional cardiology units. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  19. Fixation method does not affect restoration of rotation center in hip replacements: A single-site retrospective study

    PubMed Central

    2012-01-01

    Background Aseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique. Methods We retrospectively compared pre- and post-operative positions of the hip rotation center in 25 and 68 patients who underwent artificial hip replacements in our department in 2007 using cemented or cementless cup fixation, respectively, with digital radiographic image analysis. Results The mean horizontal and vertical distances between the rotation center and the acetabular teardrop were compared in radiographic images taken pre- and post-operatively. The mean horizontal difference was −2.63 mm (range: -11.00 mm to 10.46 mm, standard deviation 4.23 mm) for patients who underwent cementless fixation, and −2.84 mm (range: -10.87 to 5.30 mm, standard deviation 4.59 mm) for patients who underwent cemented fixation. The mean vertical difference was 0.60 mm (range: -20.15 mm to 10.00 mm, standard deviation 3.93 mm) and 0.41 mm (range: -9.26 mm to 6.54 mm, standard deviation 3.58 mm) for the cementless and cemented fixation groups, respectively. The two fixation techniques had no significant difference on the position of the hip rotation center in the 93 patients in this study. Conclusions The hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation. To completely answer this question further studies with more patients are needed. PMID:22686355

  20. The Chinese family-centered care survey for adult intensive care unit: A psychometric study.

    PubMed

    Wang, Wen-Ling; Feng, Jui-Ying; Wang, Chi-Jen; Chen, Jing-Huei

    2016-02-01

    This study aimed to develop a family-centered care survey for Chinese adult intensive care units and to establish the survey's psychometric properties. Family-centered care (FCC) is widely recognized as an ideal model of care. Few studies have explored FCC perceptions among family members of adult critical care patients in Asian countries, and no Chinese FCC measurement has been developed. An English version of the 3-factor family-centered care survey for adult intensive care units (FCCS-AICU) was translated into Chinese using a modified back translation procedure. Based on the literature review, two additional concepts, information and empowerment, were added to the Chinese FCCS-AICU. The psychometric properties of the Chinese FCCS-AICU were determined with 249 family members from a medical center in Taiwan and were tested for construct and convergent validity, and internal consistency. Both the monolingual and bilingual equivalence tests of the English and Chinese versions of the 3-factor FCCS-AICU were supported. Exploratory factor analysis supported the 5-factor structure of the Chinese FCCS-AICU with a total explained variance of 58.34%. The Chinese FCCS-AICU was correlated with the Chinese Critical Care Family Needs Inventory. Internal consistency, determined by Cronbach's α, for the overall scale was .94. The Chinese FCCS-AICU is a valid and reliable tool for measuring perceptions of FCC by family members of adult intensive care patients within Chinese-speaking communities. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Plasmon resonance enhanced temperature-dependent photoluminescence of Si-V centers in diamond

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cheng, Shaoheng; State Key Laboratory on Integrated Optoelectronics, College of Electronic Science and Engineering, Jilin University, Changchun 130012; Song, Jie

    2015-11-23

    Temperature dependent optical property of diamond has been considered as a very important factor for realizing high performance diamond-based optoelectronic devices. The photoluminescence feature of the zero phonon line of silicon-vacancy (Si-V) centers in Si-doped chemical vapor deposited single crystal diamond (SCD) with localized surface plasmon resonance (LSPR) induced by gold nanoparticles has been studied at temperatures ranging from liquid nitrogen temperature to 473 K, as compared with that of the SCD counterpart in absence of the LSPR. It is found that with LSPR the emission intensities of Si-V centers are significantly enhanced by factors of tens and the magnitudes ofmore » the redshift (width) of the emissions become smaller (narrower), in comparison with those of normal emissions without plasmon resonance. More interestingly, these strong Si-V emissions appear remarkably at temperatures up to 473 K, while the spectral feature was not reported in previous studies on the intrinsic Si-doped diamonds when temperatures are higher than room temperature. These findings would lead to reaching high performance diamond-based devices, such as single photon emitter, quantum cryptography, biomarker, and so forth, working under high temperature conditions.« less

  2. Comparison of Symptom Severity between Clients at a University Counseling Center and a Community Mental Health Agency

    ERIC Educational Resources Information Center

    Gunn, Joshua E.; Grieve, Frederick G.; Greer, Richard M.; Thomas, Adrian

    2005-01-01

    University counseling centers have been in a constant state of transition since their inception. Many variables, including economics, the social and political climate on and off campus, staff interests, and changing consumer needs have driven the direction of the modern counseling center. Throughout the more than 70 years that university…

  3. Validating the Center for Epidemiological Studies Depression Scale for Children in Rwanda

    ERIC Educational Resources Information Center

    Betancourt, Theresa; Scorza, Pamela; Meyers-Ohki, Sarah; Mushashi, Christina; Kayiteshonga, Yvonne; Binagwaho, Agnes; Stulac, Sara; Beardslee, William R.

    2012-01-01

    Objective: We assessed the validity of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) as a screen for depression in Rwandan children and adolescents. Although the CES-DC is widely used for depression screening in high-income countries, its validity in low-income and culturally diverse settings, including sub-Saharan…

  4. Building America Case Study: New Town Builders' Power of Zero Energy Center, Denver, Colorado (Brochure)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    New Town Builders, a builder of energy efficient homes in Denver, Colorado, offers a zero energy option for all the homes it builds. To attract a wide range of potential homebuyers to its energy efficient homes, New Town Builders created a 'Power of Zero Energy Center' linked to its model home in the Stapleton community of Denver. This case study presents New Town Builders' marketing approach, which is targeted to appeal to homebuyers' emotions rather than overwhelming homebuyers with scientific details about the technology. The exhibits in the Power of Zero Energy Center focus on reduced energy expenses for themore » homeowner, improved occupant comfort, the reputation of the builder, and the lack of sacrificing the homebuyers' desired design features to achieve zero net energy in the home. The case study also contains customer and realtor testimonials related to the effectiveness of the Center in influencing homebuyers to purchase a zero energy home.« less

  5. The effect of nurse navigation on timeliness of breast cancer care at an academic comprehensive cancer center.

    PubMed

    Basu, Mohua; Linebarger, Jared; Gabram, Sheryl G A; Patterson, Sharla Gayle; Amin, Miral; Ward, Kevin C

    2013-07-15

    A patient navigation process is required for accreditation by the National Accreditation Program for Breast Centers (NAPBC). Patient navigation has previously been shown to improve timely diagnosis in patients with breast cancer. This study sought to assess the effect of nurse navigation on timeliness of care following the diagnosis of breast cancer by comparing patients who were treated in a comprehensive cancer center with and without the assistance of nurse navigation. Navigation services were initiated at an NAPBC-accredited comprehensive breast center in July 2010. Two 9-month study intervals were chosen for comparison of timeliness of care: October 2009 through June 2010 and October 2010 through June 2011. All patients with breast cancer diagnosed in the cancer center with stage 0 to III disease during the 2 study periods were identified by retrospective cancer registry review. Time from diagnosis to initial oncology consultation was measured in business days, excluding holidays and weekends. Overall, 176 patients met inclusion criteria: 100 patients prior to and 76 patients following nurse navigation implementation. Nurse navigation was found to significantly shorten time to consultation for patients older than 60 years (B = -4.90, P = .0002). There was no change in timeliness for patients 31 to 60 years of age. Short-term analysis following navigation implementation showed decreased time to consultation for older patients, but not younger patients. Further studies are indicated to assess the long-term effects and durability of this quality improvement initiative. © 2013 American Cancer Society.

  6. Evaluation of infrastructure, equipment and training of 28 burn units/burn centers in Germany, Austria and Switzerland.

    PubMed

    Vogt, Peter M; Busche, Marc N

    2011-03-01

    Treatment of burn patients requires special training and skills, and an adequate infrastructure. In the United States, burn center referral criteria and requirements of burn centers are defined by the American Burn Association (ABA) in the Guidelines for the Operation of Burn Centers, and in Germany, by the German Society for Burn Treatment (DGV). The European Burn centers in Austria and the German-speaking part of Switzerland share the standards in the setting of the German-speaking Association for Burn Therapy (DAV) with some modifications. The aim of this study was to evaluate the current infrastructure of burn centers in the three German-speaking countries with respect to the existing guidelines. Therefore, guidelines for burn center referral criteria and burn center requirements were compared between the USA (ABA) and Germany (DGV). In addition, a questionnaire was sent to all burn centers in Germany, Austria and the German-speaking part of Switzerland, in order to collect current information regarding the architectural and medical infrastructure, available equipment and care-providing personnel. The comparison of guidelines for the USA and Germany revealed similar burn center referral criteria for both countries. With respect to burn center requirements, both the USA and Germany have similar requirements, albeit with different focus points. In Germany, the main focus lies on the infrastructural requirements for burn centers, while in the US, the main focus lies on the requirements for medical and nursing personnel. Critical review of the responses from the burn centers of German-speaking countries revealed that the biggest infrastructural differences among centers were observed in burn units providing pediatric care, as compared to adult burn centers. In summary, the DGV guidelines for German-speaking countries reflect an overall adoption of the ABA guidelines, and the burn centers included in this study met those requirements. As a result of the positive

  7. Research and Clinical Center for Child Development Annual Report, 1998-1999. No. 22.

    ERIC Educational Resources Information Center

    Chen, Shing-Jen, Ed.; Furutsuka, Takashi, Ed.; Shirotani, Yukari, Ed.

    This annual report presents several articles related to the work of the Clinical Center for Child Development at Hokkaido University in Sapporo, Japan. The articles are: (1) "Maternal Speech and Behavior during Mother-Infant Play: Comparison between the United States and Japan" (Sueko Toda, Marc H. Bornstein, and Hiroshi Azuma); (2)…

  8. Fluorescence Imaging of Underexpanded Jets and Comparison with CFD

    NASA Technical Reports Server (NTRS)

    Wilkes, Jennifer A.; Glass, Christopher E.; Danehy, Paul M.; Nowak, Robert J.

    2006-01-01

    An experimental study of underexpanded and highly underexpanded axisymmetric nitrogen free jets seeded with 0.5% nitric oxide (NO) and issuing from a sonic orifice was conducted at NASA Langley Research Center. Reynolds numbers based on nozzle exit conditions ranged from 770 to 35,700, and nozzle exit-to-ambient jet pressure ratios ranged from 2 to 35. These flows were non-intrusively visualized with a spatial resolution of approximately 0.14 mm x 0.14 mm x 1 mm thick and a temporal resolution of 1 s using planar laser-induced fluorescence (PLIF) of NO, with the laser tuned to the strongly-fluorescing UV absorption bands of the Q1 band head near 226.256 nm. Three laminar cases were selected for comparison with computational fluid dynamics (CFD). The cases were run using GASP (General Aerodynamic Simulation Program) Version 4. Comparisons of the fundamental wavelength of the jet flow showed good agreement between CFD and experiment for all three test cases, while comparisons of Mach disk location and Mach disk diameter showed good agreement at lower jet pressure ratios, with a tendency to slightly underpredict these parameters with increasing jet pressure ratio.

  9. Metropolitan transportation management center : a case study : Arizona Trailmaster : providing a safe and efficient travel environment for users

    DOT National Transportation Integrated Search

    1999-10-01

    The following case study provides a snapshot of Arizona's TrailMaster statewide transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross...

  10. PARCS: A Safety Net Community-Based Fitness Center for Low-Income Adults

    PubMed Central

    Keith, NiCole; de Groot, Mary; Mi, Deming; Alexander, Kisha; Kaiser, Stephanie

    2015-01-01

    Background Physical activity (PA) and fitness are critical to maintaining health and avoiding chronic disease. Limited access to fitness facilities in low-income urban areas has been identified as a contributor to low PA participation and poor fitness. Objectives This research describes community-based fitness centers established for adults living in low-income, urban communities and characterizes a sample of its members. Methods The community identified a need for physical fitness opportunities to improve residents’ health. Three community high schools were host sites. Resources were combined to renovate and staff facilities, acquire equipment, and refer patients to exercise. The study sample included 170 members ≥ age 18yr who completed demographic, exercise self-efficacy, and quality of life surveys and a fitness evaluation. Neighborhood-level U.S. Census data were obtained for comparison. Results The community-based fitness centers resulted from university, public school, and hospital partnerships offering safe, accessible, and affordable exercise opportunities. The study sample mean BMI was 35 ± 7.6 (Class II obesity), mean age was 50yr ± 12.5, 66% were black, 72% were female, 66% completed some college or greater, and 71% had an annual household income < $25K and supported 2.2 dependents. Participants had moderate confidence for exercise participation and low fitness levels. When compared to census data, participants were representative of their communities. Conclusion This observational study reveals a need for affordable fitness centers for low-income adults. We demonstrate a model where communities and organizations strategically leverage resources to address disparities in physical fitness and health. PMID:27346764

  11. Leaders' Experiences with High School-College Writing Center Collaborations: A Qualitative Multiple-Case Study

    ERIC Educational Resources Information Center

    Story, Julie A.

    2014-01-01

    The purpose of this qualitative multiple-case study was to explore academic leaders' experiences with the organizational elements of their own high school-college writing center collaborations. Conjoining theories framed this study: collaborative leadership theory, Kenneth Bruffee's notion of social constructionism and collaborative learning…

  12. 1979-80 Internal Revenue Service Comparison Study. Final Report.

    ERIC Educational Resources Information Center

    Applied Management Sciences, Inc., Silver Spring, MD.

    Application forms for the Basic Educational Opportunity Grant (BEOG) program for 1979-1980 were compared to 1978 tax forms filed with the Internal Revenue Service (IRS). Comparisons were also made to data from similar 1974-1975 and 1976-1977 studies. Based on a sample of 407,596 applicants, findings include the following: between 1976-1977 and…

  13. Feasibility of Establishing a Major Hemispheric Studies Center. Report and Recommendations of the Postsecondary Education Planning Commission: Report 2.

    ERIC Educational Resources Information Center

    Florida State Postsecondary Education Commission, Tallahassee.

    This report contains a study of the feasibility of establishing a major hemispheric studies center affiliated with a consortium of public and private institutions of higher education. The purpose of the Center will be to study hemispheric policies related to social science, commerce, and cultural issues confronting the Western Hemisphere. The…

  14. Metropolitan transportation management center : a case study : Georgia NaviGAtor : accurate and timely information to navigate Georgia roads

    DOT National Transportation Integrated Search

    1999-10-01

    The following case study provides a snapshot of Atlanta's NaviGAtor transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting Stu...

  15. Using a Pattern-Centered Approach to Assess Sexual Risk-Taking in Study Abroad Students

    ERIC Educational Resources Information Center

    Marcantonio, Tiffany; Angelone, D. J.; Sledjeski, Eve

    2016-01-01

    Objectives: The purpose of this study was to examine the impact of several potential factors related to sexually risky behaviors in study abroad students. The authors utilized a pattern-centered analysis to identify specific groups that can be targeted for intervention. Participants: The sample consisted of 173 students who studied abroad in a…

  16. Using Learner-Centered Education to Improve Fruit and Vegetable Intake in California WIC Participants

    ERIC Educational Resources Information Center

    Gerstein, Dana E.; Martin, Anna C.; Crocker, Nancy; Reed, Heather; Elfant, Michael; Crawford, Pat

    2010-01-01

    Objective: To examine the effectiveness of learner-centered education in conveying the message to change participants' fruit and vegetable consumption. Design: Focus groups were conducted with sites participating in the Finding the Teacher Within (FTW) program and comparison sites 4-6 months after participants attended the Special Supplemental…

  17. Comparison of the socioeconomic impacts of international fuel service centers versus dispersed nuclear facilities

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Braid, Jr., R. B.

    1979-01-01

    The paper investigates a variety of community impacts including: public services, fiscal issues, economic matters, land and water use, political and social cohesion, and legal considerations. Comparisons of socioeconomic impacts of colocated versus dispersed sites are made on the basis of the size of the impacted communities, the size and type of nuclear facility, and the facility's construction time frame. The paper concludes that, under similar circumstances, most of the socioeconomic impacts of colocated nuclear facilities would be somewhat less than the sum of the impacts associated with equivalent dispersed sites. While empirical data is non-existent, the paper contends, however,more » that because the socioeconomic impacts of colocated facilities are so great and readily identifiable to a public unskilled in making comparisons with the dispersed alternative, the facilities will likely generate so much public opposition that IFSCs will probably prove infeasible.« less

  18. Comparison of outcomes in severely injured patients between a South Korean trauma center and matched patients treated in the United States.

    PubMed

    Jung, Kyoungwon; Matsumoto, Shokei; Smith, Alan; Hwang, Kyungjin; Lee, John Cook-Jong; Coimbra, Raul

    2018-06-05

    The South Korean government recently developed a master plan for establishing a national trauma system based on the implementation of regional trauma centers. We aimed to compare outcomes between severely injured patients treated at a recently established South Korean trauma center and matched patients treated in American level-1 trauma centers. Two cohorts were selected from an institutional trauma database at Ajou University Medical Center (AUMC) and the American National Trauma Data Bank. Adult patients with an Injury Severity Score of ≥9 were included. Patients were matched based on covariates that affect mortality, using 1:1 propensity score matching. We compared outcomes between the two datasets and performed survival analyses. We created 1,451 and 2,103 matched pairs for the pre-trauma center and post-trauma center periods, respectively. The in-hospital mortality rate was higher in the institutional trauma database pre-trauma center period compared with the American National Trauma Data Bank (11.6% versus 8.1%, P<.001). However, the mortality rate decreased in the institutional trauma database post-trauma center period and was similar to that in the American National Trauma Data Bank (6.9% versus 6.8%, P=.903). Being treated at Ajou University Medical Center Trauma Center was significantly associated with higher mortality during the pre-trauma center period (OR: 1.842, 95% CI: 1.336-2.540; P<.001), although no significant association was observed during the post-trauma center period (OR: 1.102, 95% CI: 0.827-1.468; P=.509). The mortality rate improved after a trauma center was established in a South Korean hospital and is similar to that from matched cases treated at American level-1 trauma centers. Thus, creating trauma centers and a regional trauma system may improve outcomes in major trauma cases. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Relation of people-centered public health and person-centered healthcare management: a case study to reduce burn-out.

    PubMed

    Stoyanov, Drozdstoj S; Cloninger, C Robert

    2012-01-01

    Healthcare management is one practical tool for mediation and implementation of public health into clinical healthcare outcomes and is taken in our case study as an exemplar arena to demonstrate the vital importance of the person-centered approach. Healthcare personnel are frequently at risk for the 'burn-out' syndrome. However, modern measures of burn-out recognize burn-out only at a late stage when it is fully developed. There are no available methods to assess the risk for vulnerability to burnout in healthcare systems. Our aim was therefore to design a complex person-centered model for detection of high risk for burn-out at an early stage, that has been termed 'flame-out'. We accept the observation that decreased personal performance is one crucial expression of burn-out. Low personal performance and negative emotions are strongly related to low self-directedness as measured by the Temperament and Character Inventory (TCI). At the same time, burn-out is characterized by decreased interest and positive emotions from work. Decreased positive emotion is directly related to low self-transcendence as measured by the TCI. Burn-out is also frequently associated with feelings of social alienation or inadequacy of support, which is in turn related to low TCI Cooperativeness. However, high Persistence and Harm Avoidance are predisposing traits for burn-out in healthcare professionals who are often overly perfectionistic and compulsive, predisposing them to anxiety, depression, suicide and burn-out. Hence, people at risk for future burn-out are often highly conscientious over-achievers with intense mixtures of positive and negative emotions. The high demand for perfection comes from both intrinsic characteristics and from features of the social milieu in their psychological climate. Letting go of the unfulfillable desire to be perfect by increasing self-transcendence allows acceptance of the imperfection of the human condition, thereby preventing burn-out and other

  20. Ebstein's anomaly in children: a single-center study in Angola.

    PubMed

    Manuel, Valdano; Morais, Humberto; Magalhães, Manuel Pedro; Nunes, Maria Ana Sampaio; Leon, Gilberto; Ferreira, Manuel; Filipe Júnior, António Pedro

    2015-10-01

    Ebstein's anomaly is a rare complex congenital heart defect of the tricuspid valve. We aimed to describe the frequency, clinical profile, and early and short-term post-operative results in patients under the age of 18 years operated for this anomaly in a tertiary center in Angola. A retrospective cross-sectional study was conducted over a period of 37 months. We analyzed all patients diagnosed with congenital heart defects. Of the 1362 patients studied, eight (0.6%) had Ebstein's anomaly; six patients (75%) were female. Mean age was 69±59 months. Five patients were in NYHA functional class III or IV. Mean cardiothoracic index was 0.72. Seven patients (87.5%) had severe tricuspid regurgitation and five (62.5%) had another associated congenital heart defect. All patients were operated: two had complications and one (12.5%) died in the early post-operative period. The mean follow-up time was 1.22±0.6 years, and mortality during follow-up was 12.5% (n=1). At the end of the study, of the five patients in whom cone reconstruction was performed, four (80%) were in functional class I. Mean cardiothoracic index decreased to 0.64. Three patients had mild and two had moderate tricuspid regurgitation. The patient who underwent cone reconstruction and a Glenn procedure was in functional class I. The frequency of Ebstein's anomaly was similar to that in other centers. Cone reconstruction was viable in the majority of patients, with good early and short-term results. Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  1. Inter-ethnic variation of ocular traits-design and methodology of comparison study among American Caucasians, American Chinese and mainland Chinese.

    PubMed

    Wang, Dan Dan; Huang, Guo Fu; He, Ming Guang; Wu, Ling Ling; Lin, Shan

    2011-03-01

    To summarize the design and methodology of a multi-center study. With the existed ethnic differences of glaucoma, this survey will explore the differences with regard to anterior and posterior ocular segment parameters between Caucasians and Chinese. In this study, four cohorts including American Caucasians and American Chinese from San Francisco, southern mainland Chinese from Guangzhou, and northern mainland Chinese from Beijing were prospectively enrolled for a series of eye examinations and tests from May 2008 to December 2010. A total of 120 subjects including 15 of each gender in each age decade from 40s to 70s were recruited for each group. Data of the following tests were collected: a questionnaire eliciting systemic and ocular disease history, blood pressure, presenting and best corrected visual acuity, auto-refraction, Goldmann applanation tonometry, gonioscopy, A-scan, anterior segment optical coherence tomography (ASOCT), ultrasound biomicroscopy (UBM), visual field (VF), Heidelberg retinal tomography (HRT), OCT for optic nerve, and digital fundus photography. this study will provide insights to the etiologies of glaucoma especially PACG through inter-ethnic comparisons of relevant ocular anatomic and functional parameters.

  2. Virtual Visits and Patient-Centered Care: Results of a Patient Survey and Observational Study

    PubMed Central

    2017-01-01

    Background Virtual visits are clinical interactions in health care that do not involve the patient and provider being in the same room at the same time. The use of virtual visits is growing rapidly in health care. Some health systems are integrating virtual visits into primary care as a complement to existing modes of care, in part reflecting a growing focus on patient-centered care. There is, however, limited empirical evidence about how patients view this new form of care and how it affects overall health system use. Objective Descriptive objectives were to assess users and providers of virtual visits, including the reasons patients give for use. The analytic objective was to assess empirically the influence of virtual visits on overall primary care use and costs, including whether virtual care is with a known or a new primary care physician. Methods The study took place in British Columbia, Canada, where virtual visits have been publicly funded since October 2012. A survey of patients who used virtual visits and an observational study of users and nonusers of virtual visits were conducted. Comparison groups included two groups: (1) all other BC residents, and (2) a group matched (3:1) to the cohort. The first virtual visit was used as the intervention and the main outcome measures were total primary care visits and costs. Results During 2013-2014, there were 7286 virtual visit encounters, involving 5441 patients and 144 physicians. Younger patients and physicians were more likely to use and provide virtual visits (P<.001), with no differences by sex. Older and sicker patients were more likely to see a known provider, whereas the lowest socioeconomic groups were the least likely (P<.001). The survey of 399 virtual visit patients indicated that virtual visits were liked by patients, with 372 (93.2%) of respondents saying their virtual visit was of high quality and 364 (91.2%) reporting their virtual visit was “very” or “somewhat” helpful to resolve their

  3. Virtual Visits and Patient-Centered Care: Results of a Patient Survey and Observational Study.

    PubMed

    McGrail, Kimberlyn Marie; Ahuja, Megan Alyssa; Leaver, Chad Andrew

    2017-05-26

    Virtual visits are clinical interactions in health care that do not involve the patient and provider being in the same room at the same time. The use of virtual visits is growing rapidly in health care. Some health systems are integrating virtual visits into primary care as a complement to existing modes of care, in part reflecting a growing focus on patient-centered care. There is, however, limited empirical evidence about how patients view this new form of care and how it affects overall health system use. Descriptive objectives were to assess users and providers of virtual visits, including the reasons patients give for use. The analytic objective was to assess empirically the influence of virtual visits on overall primary care use and costs, including whether virtual care is with a known or a new primary care physician. The study took place in British Columbia, Canada, where virtual visits have been publicly funded since October 2012. A survey of patients who used virtual visits and an observational study of users and nonusers of virtual visits were conducted. Comparison groups included two groups: (1) all other BC residents, and (2) a group matched (3:1) to the cohort. The first virtual visit was used as the intervention and the main outcome measures were total primary care visits and costs. During 2013-2014, there were 7286 virtual visit encounters, involving 5441 patients and 144 physicians. Younger patients and physicians were more likely to use and provide virtual visits (P<.001), with no differences by sex. Older and sicker patients were more likely to see a known provider, whereas the lowest socioeconomic groups were the least likely (P<.001). The survey of 399 virtual visit patients indicated that virtual visits were liked by patients, with 372 (93.2%) of respondents saying their virtual visit was of high quality and 364 (91.2%) reporting their virtual visit was "very" or "somewhat" helpful to resolve their health issue. Segmented regression analysis

  4. Radiometric Measurement Comparison Using the Ocean Color Temperature Scanner (OCTS) Visible and Near Infrared Integrating Sphere

    PubMed Central

    Johnson, B. Carol; Sakuma, F.; Butler, J. J.; Biggar, S. F.; Cooper, J. W.; Ishida, J.; Suzuki, K.

    1997-01-01

    As a part of the pre-flight calibration and validation activities for the Ocean Color and Temperature Scanner (OCTS) and the Sea-viewing Wide Field-of-view Sensor (SeaWiFS) ocean color satellite instruments, a radiometric measurement comparison was held in February 1995 at the NEC Corporation in Yokohama, Japan. Researchers from the National Institute of Standards and Technology (NIST), the National Aeronautics and Space Administration/Goddard Space Flight Center (NASA/GSFC), the University of Arizona Optical Sciences Center (UA), and the National Research Laboratory of Metrology (NRLM) in Tsukuba, Japan used their portable radiometers to measure the spectral radiance of the OCTS visible and near-infrared integrating sphere at four radiance levels. These four levels corresponded to the configuration of the OCTS integrating sphere when the calibration coefficients for five of the eight spectral channels, or bands, of the OCTS instrument were determined. The measurements of the four radiometers differed by −2.7 % to 3.9 % when compared to the NEC calibration of the sphere and the overall agreement was within the combined measurement uncertainties. A comparison of the measurements from the participating radiometers also resulted in agreement within the combined measurement uncertainties. These results are encouraging and demonstrate the utility of comparisons using laboratory calibration integrating sphere sources. Other comparisons will focus on instruments that are scheduled for spacecraft in the NASA study of climate change, the Earth Observing System (EOS). PMID:27805113

  5. Space Operations Center, Shuttle Interaction Study. Volume 2: Appendices, Book 1 of 2

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The feasibility of shuttle orbiter docking to the Space Operations Center (SOC) is studied. The in-orbit relative motion of the free flying orbiter and SOC was simulated, accounting for the Orbiter RCS and digital autopilot (DAP) systems, orbital mechanics, center of gravity offset of the orbiter docking port, aero and gravity gradient effects, and other pertinent natural and man-made phenomena. Since there is no specified flight path and procedure for docking, terminal closure sensitivities were investigated. Orbiter approach direction, Orbiter approach attitude out of plane, DAP thruster compensation mode, final ballistic docking distance and time to dock, rate and excursion attitude deadbands, and selection of various thruster combinations (differing from nominal) for translational pulses are considered.

  6. Patient Satisfaction with Spanish Pain Centers: Observational Study with More than 3,000 Patients

    PubMed Central

    Hernández-Puiggròs, Patricia; Tesedo Nieto, Javier; Acín Lázaro, María Pilar; Carrera González, Alfredo; Soler, Miguel José Arranz; Maldonado Vega, Sergio

    2016-01-01

    Chronic pain is a serious problem in Spain. This multicenter, epidemiological 3-month follow-up study investigates pain management efficacy in Spanish centers using patient satisfaction criteria. 3,414 eligible adult patients (65,6% female) with moderate to severe chronic pain from 146 pain centers were included. Patient satisfaction was assessed based onto question 18 of Spanish healthcare barometer-CSI. Pain evolution (Brief Pain Inventory-Short Form (BPI-SF) and visual analog scale (VAS)), quality of life/EuroQol-5, and pain control expectations fulfillment were also assessed. Mean age was 61.3 years. 64.4% of participating centers employed multidisciplinary pain management approach. After 3 months, mean patient satisfaction was 7.8 (1–10) on the CIS barometer. Medical staff received the highest scores, whereas waiting for tests, appointment request to appointment date time, and waiting times at the center the lowest. Mean pain decreased from 7.4 to 4.0; BPI-SF intensity decreased from 6.5 to 3.8; pain control expectations were met in 78.7% of patients; EuroQoL-5D utility index increased from 0.37 to 0.62, p < 0.001, and health status (VAS) from 40.6 to 61.9, p < 0.001. Chronic pain patients (90%) are satisfied with Spanish centers care; 80% had their pain control expectations met. Quality of life improved remarkably: 71% felt moderately to significantly better. However, waiting times need improvement. PMID:27516902

  7. PET studies of d-methamphetamine pharmacokinetics in primates: comparison with l-methamphetamine and ( --)-cocaine.

    PubMed

    Fowler, Joanna S; Kroll, Carsten; Ferrieri, Richard; Alexoff, David; Logan, Jean; Dewey, Stephen L; Schiffer, Wynne; Schlyer, David; Carter, Pauline; King, Payton; Shea, Colleen; Xu, Youwen; Muench, Lisa; Benveniste, Helene; Vaska, Paul; Volkow, Nora D

    2007-10-01

    The methamphetamine molecule has a chiral center and exists as 2 enantiomers, d-methamphetamine (the more active enantiomer) and l-methamphetamine (the less active enantiomer). d-Methamphetamine is associated with more intense stimulant effects and higher abuse liability. The objective of this study was to measure the pharmacokinetics of d-methamphetamine for comparison with both l-methamphetamine and (-)-cocaine in the baboon brain and peripheral organs and to assess the saturability and pharmacologic specificity of binding. d- and l-methamphetamine and (-)-cocaine were labeled with (11)C via alkylation of the norprecursors with (11)C-methyl iodide using literature methods. Six different baboons were studied in 11 PET sessions at which 2 radiotracer injections were administered 2-3 h apart to determine the distribution and kinetics of (11)C-d-methamphetamine in brain and peripheral organs. Saturability and pharmacologic specificity were assessed using pretreatment with d-methamphetamine, methylphenidate, and tetrabenazine. (11)C-d-Methamphetamine pharmacokinetics were compared with (11)C-l-methamphetamine and (11)C-(-)-cocaine in both brain and peripheral organs in the same animal. (11)C-d- and l-methamphetamine both showed high uptake and widespread distribution in the brain. Pharmacokinetics did not differ between enantiomers, and the cerebellum peaked earlier and cleared more quickly than the striatum for both. (11)C-d-Methamphetamine distribution volume ratio was not substantially affected by pretreatment with methamphetamine, methylphenidate, or tetrabenazine. Both enantiomers showed rapid, high uptake and clearance in the heart and lungs and slower uptake and clearance in the liver and kidneys. A comparison of (11)C-d-methamphetamine and (11)C-(-)-cocaine showed that (11)C-d-methamphetamine peaked later in the brain than did (11)C-(-)-cocaine and cleared more slowly. The 2 drugs showed similar behavior in all peripheral organs examined except the kidneys and

  8. Diagnosis, Treatment and Long-Term Follow Up of Patients with ADA Deficiency: a Single-Center Experience.

    PubMed

    Baffelli, Renata; Notarangelo, Lucia D; Imberti, Luisa; Hershfield, Michael S; Serana, Federico; Santisteban, Ines; Bolda, Federica; Porta, Fulvio; Lanfranchi, Arnalda

    2015-10-01

    We carried out a retrospective analysis of 27 patients with Adenosine Deaminase (ADA) deficiency diagnosed in a single center from 1997 to the 2013, for evaluating whether data regarding types of disease-inducing mutations, biochemical and immunological features as well as clinical outcomes of patients treated with enzyme replacement or transplantation, were comparable to those obtained in multicenter studies. The ADA deficiency diagnosis was performed with biochemical, immunological and molecular techniques. Ten patients treated with hematopoietic stem cell transplantation and three in treatment with enzyme replacement were followed up in our center. Twenty-four different mutations were identified and five were not previously reported. Identical mutations were found among patients from the same Romani ethnic group or from the same geographical region. A more rapid recovery was observed in enzyme replacement treated patients in comparison with those transplanted that, however, showed a continuous and long-lasting improvement both in terms of immune and metabolic recovery. The data obtained in our single center are comparable with those that have been reported in multicenter surveys.

  9. Patient-centered medical home transformation with payment reform: patient experience outcomes.

    PubMed

    Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R

    2014-01-01

    To examine changes in patient experience across key domains of the patient-centered medical home (PCMH) following practice transformation with Lean quality improvement methodology inclusive of payment reform. Pre-intervention/post-intervention analysis of intervention with a comparison group, a quasi-experimental design. We surveyed patients following office visits at the intervention (n = 2502) and control (n = 1622) practices during the 15-month period before and 14-month period after PCMH Lean transformation (April-October 2009). We measured and compared pre-intervention and post-intervention levels of patient satisfaction and other indicators of patient-centered care. Propensity weights adjusted for potential case-mix differences in intervention and control groups; propensity-adjusted proportions accounted for physician-level clustering. More intervention patients were very satisfied with their care after the PCMH Lean intervention (68%) compared with pre-intervention (62%). Among control patients, there was no corresponding increase in satisfaction (63% very satisfied pre-intervention vs 64% very satisfied post-intervention). This comparison resulted in a statistical trend (P = .10) toward greater overall satisfaction attributable to the intervention. Post-intervention, patients in the intervention practice consistently rated indicators of patient-centered care higher than patients in the control practice, particularly in the personal physician and communication domain. In this domain, intervention patients reported superior provider explanations, time spent, provider concern, and follow-up instructions compared with control participants, whereas control group ratings fell in the post-intervention period (P for difference <.05). In a pilot PCMH transformation including Lean enhancement with payment reform, patient experience was sustained or improved across key PCMH domains.

  10. A Simulation-Based Study on the Comparison of Statistical and Time Series Forecasting Methods for Early Detection of Infectious Disease Outbreaks.

    PubMed

    Yang, Eunjoo; Park, Hyun Woo; Choi, Yeon Hwa; Kim, Jusim; Munkhdalai, Lkhagvadorj; Musa, Ibrahim; Ryu, Keun Ho

    2018-05-11

    Early detection of infectious disease outbreaks is one of the important and significant issues in syndromic surveillance systems. It helps to provide a rapid epidemiological response and reduce morbidity and mortality. In order to upgrade the current system at the Korea Centers for Disease Control and Prevention (KCDC), a comparative study of state-of-the-art techniques is required. We compared four different temporal outbreak detection algorithms: the CUmulative SUM (CUSUM), the Early Aberration Reporting System (EARS), the autoregressive integrated moving average (ARIMA), and the Holt-Winters algorithm. The comparison was performed based on not only 42 different time series generated taking into account trends, seasonality, and randomly occurring outbreaks, but also real-world daily and weekly data related to diarrhea infection. The algorithms were evaluated using different metrics. These were namely, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), F1 score, symmetric mean absolute percent error (sMAPE), root-mean-square error (RMSE), and mean absolute deviation (MAD). Although the comparison results showed better performance for the EARS C3 method with respect to the other algorithms, despite the characteristics of the underlying time series data, Holt⁻Winters showed better performance when the baseline frequency and the dispersion parameter values were both less than 1.5 and 2, respectively.

  11. [Comparison study between biological vision and computer vision].

    PubMed

    Liu, W; Yuan, X G; Yang, C X; Liu, Z Q; Wang, R

    2001-08-01

    The development and bearing of biology vision in structure and mechanism were discussed, especially on the aspects including anatomical structure of biological vision, tentative classification of reception field, parallel processing of visual information, feedback and conformity effect of visual cortical, and so on. The new advance in the field was introduced through the study of the morphology of biological vision. Besides, comparison between biological vision and computer vision was made, and their similarities and differences were pointed out.

  12. A study of flight control requirements for advanced, winged, earth-to-orbit vehicles with far-aft center-of-gravity locations

    NASA Technical Reports Server (NTRS)

    Hepler, A. K.; Zeck, H.; Walker, W. H.; Polack, A.

    1982-01-01

    Control requirements of Controlled Configured Design Approach vehicles with far-aft center of gravity locations are studied. The baseline system investigated is a fully reusable vertical takeoff/horizontal landing single stage-to-orbit vehicle with mission requirements similar to that of the space shuttle vehicle. Evaluations were made to determine dynamic stability boundaries, time responses, trim control, operational center-of-gravity limits, and flight control subsystem design requirements. Study tasks included a baseline vehicle analysis, an aft center of gravity study, a payload size study, and a technology assessment.

  13. Relationships among person-centered care, nursing home adjustment, and life satisfaction: a cross-sectional survey study.

    PubMed

    Yoon, Ju Young

    2018-04-02

    ABSTRACTBackground:The purpose of this study was to examine whether a perceived person-centered nursing home environment has a direct relationship with nursing home adjustment and life satisfaction, and whether a perceived person-centered nursing home environment has an indirect relationship with life satisfaction through improved nursing home adjustment. 203 nursing home residents who were able to read and speak English and were physically and cognitively able to respond to questionnaires were included in this study. Data were collected from six nursing homes in the Midwestern US. Higher levels of a perceived person-centered nursing home environment had a significantly direct relationship with increased life satisfaction of residents (β = 0.35), and this relationship was mediated by residents' improved nursing home adjustment (β = 0.10). In-depth exploration using sub-domains of the main variables demonstrated that "safety" and "everydayness" of a person-centered nursing home environment were directly related to higher levels of life satisfaction (β = 0.15 and β = 0.16, respectively); and "everydayness" was related to three sub-domains of nursing home adjustment: better "relationship development," "acceptance of the new residence" (β = 0.32 and β = 0.24, respectively), and lower "depressed mood" (β = 0.05). The positive relationship between "everydayness" and life satisfaction was partially mediated by the "relationship development" sub-domain of nursing home adjustment (β = 0.07). The findings provide new evidence for the positive association between person-centered care and nursing home adjustment. The findings also provide insights into the mechanism through which the specific sub-domains of person-centered care and nursing home adjustment operate in the path model.

  14. Gender and Women Development Initiatives in Bangladesh: A Study of Rural Mother Center.

    PubMed

    Karim, K M Rabiul; Emmelin, Maria; Lindberg, Lene; Wamala, Sarah

    2016-01-01

    Women-focused development initiatives have become a controversial issue connected with women's health and welfare. Previous studies indicated that development initiatives might increase women's workload, family conflict, and marital violence. This study explored the gendered characteristics of a development initiative Rural Mother Center in Bangladesh. Data incorporated policy document and interviews of social workers working with the mother centers in two northwest subdistricts. The qualitative content analysis of data emerged a general theme of expanding women's responsibility while maintaining male privilege explaining gendered design and practice of the development initiative. The theme was supported by two gendered categories related to the design: (a) essentializing women's participation; (b) maintaining traditional gender, and four categories related to the practice; (c) inadequate gender knowledge and skills; (d) reinforcing traditional gender; (e) using women for improving office performance; and (f) upholding male privilege. The study suggests that though women-focused development initiatives need to be embraced with gender-redistributive policies, the social workers should be trained for attaining gender-transformative motivation and competencies.

  15. Measuring Efficiency of Knowledge Production in Health Research Centers Using Data Envelopment Analysis (DEA): A Case Study in Iran

    PubMed Central

    Amiri, Mohammad Meskarpour; Nasiri, Taha; Saadat, Seyed Hassan; Anabad, Hosein Amini; Ardakan, Payman Mahboobi

    2016-01-01

    Introduction Efficiency analysis is necessary in order to avoid waste of materials, energy, effort, money, and time during scientific research. Therefore, analyzing efficiency of knowledge production in health areas is necessary, especially for developing and in-transition countries. As the first step in this field, the aim of this study was the analysis of selected health research center efficiency using data envelopment analysis (DEA). Methods This retrospective and applied study was conducted in 2015 using input and output data of 16 health research centers affiliated with a health sciences university in Iran during 2010–2014. The technical efficiency of health research centers was evaluated based on three basic data envelopment analysis (DEA) models: input-oriented, output-oriented, and hyperbolic-oriented. The input and output data of each health research center for years 2010–2014 were collected from the Iran Ministry of Health and Medical Education (MOHE) profile and analyzed by R software. Results The mean efficiency score in input-oriented, output-oriented, and hyperbolic-oriented models was 0.781, 0.671, and 0.798, respectively. Based on results of the study, half of the health research centers are operating below full efficiency, and about one-third of them are operating under the average efficiency level. There is also a large gap between health research center efficiency relative to each other. Conclusion It is necessary for health research centers to improve their efficiency in knowledge production through better management of available resources. The higher level of efficiency in a significant number of health research centers is achievable through more efficient management of human resources and capital. Further research is needed to measure and follow the efficiency of knowledge production by health research centers around the world and over a period of time. PMID:28344756

  16. Measuring Efficiency of Knowledge Production in Health Research Centers Using Data Envelopment Analysis (DEA): A Case Study in Iran.

    PubMed

    Amiri, Mohammad Meskarpour; Nasiri, Taha; Saadat, Seyed Hassan; Anabad, Hosein Amini; Ardakan, Payman Mahboobi

    2016-11-01

    Efficiency analysis is necessary in order to avoid waste of materials, energy, effort, money, and time during scientific research. Therefore, analyzing efficiency of knowledge production in health areas is necessary, especially for developing and in-transition countries. As the first step in this field, the aim of this study was the analysis of selected health research center efficiency using data envelopment analysis (DEA). This retrospective and applied study was conducted in 2015 using input and output data of 16 health research centers affiliated with a health sciences university in Iran during 2010-2014. The technical efficiency of health research centers was evaluated based on three basic data envelopment analysis (DEA) models: input-oriented, output-oriented, and hyperbolic-oriented. The input and output data of each health research center for years 2010-2014 were collected from the Iran Ministry of Health and Medical Education (MOHE) profile and analyzed by R software. The mean efficiency score in input-oriented, output-oriented, and hyperbolic-oriented models was 0.781, 0.671, and 0.798, respectively. Based on results of the study, half of the health research centers are operating below full efficiency, and about one-third of them are operating under the average efficiency level. There is also a large gap between health research center efficiency relative to each other. It is necessary for health research centers to improve their efficiency in knowledge production through better management of available resources. The higher level of efficiency in a significant number of health research centers is achievable through more efficient management of human resources and capital. Further research is needed to measure and follow the efficiency of knowledge production by health research centers around the world and over a period of time.

  17. Federal Health Care Center: VA and DOD Need to Address Ongoing Difficulties and Better Prepare for Future Integrations

    DTIC Science & Technology

    2016-02-01

    Based on Small- Group Interviews with Captain James A. Lovell Federal Health Care Center (FHCC) Staff, April–May 2015 34 Figure 7: Comparison of...Effects of Workforce Integration on Staff Efficiency, Quality of Work, and Job Satisfaction between Civilian and Active Duty Staff, Based on Small- Group ...Integration on Daily Work Based on Small- Group Interviews with Captain Page iii GAO-16-280 VA and DOD Federal Health Care Center

  18. Maryland Multipayor Patient-centered Medical Home Program

    PubMed Central

    Marsteller, Jill A.; Hsu, Yea-Jen; Gill, Christine; Kiptanui, Zippora; Fakeye, Oludolapo A.; Engineer, Lilly D.; Perlmutter, Donna; Khanna, Niharika; Rattinger, Gail B.; Nichols, Donald

    2018-01-01

    Objective: To evaluate impact of the Maryland Multipayor Patient-centered Medical Home Program (MMPP) on: (1) quality, utilization, and costs of care; (2) beneficiaries’ experiences and satisfaction with care; and (3) perceptions of providers. Design: 4-year quasiexperimental design with a difference-in-differences analytic approach to compare changes in outcomes between MMPP practices and propensity score-matched comparisons; pre-post design for patient-reported outcomes among MMPP beneficiaries. Subjects: Beneficiaries (Medicaid-insured and privately insured) and providers in 52 MMPP practices and 104 matched comparisons in Maryland. Intervention: Participating practices received unconditional financial support and coaching to facilitate functioning as medical homes, membership in a learning collaborative to promote education and dissemination of best practices, and performance-based payments. Measures: Sixteen quality, 20 utilization, and 13 cost measures from administrative data; patient-reported outcomes on care delivery, trust in provider, access to care, and chronic illness management; and provider perceptions of team operation, team culture, satisfaction with care provided, and patient-centered medical home transformation. Results: The MMPP had mixed impact on site-level quality and utilization measures. Participation was significantly associated with lower inpatient and outpatient payments in the first year among privately insured beneficiaries, and for the entire duration among Medicaid beneficiaries. There was indication that MMPP practices shifted responsibility for certain administrative tasks from clinicians to medical assistants or care managers. The program had limited effect on measures of patient satisfaction (although response rates were low) and on provider perceptions. Conclusions: The MMPP demonstrated mixed results of its impact and indicated differential program effects for privately insured and Medicaid beneficiaries. PMID:29462077

  19. Family-Centered Service Delivery.

    ERIC Educational Resources Information Center

    Higgins, Cindy, Ed.

    1997-01-01

    This theme issue focuses on family-centered practices and policies for service delivery. The first article, "Family-Centered Service Delivery," reports on a study of 130 published sources in education, social work, nursing, psychology, occupational therapy, and related disciplines, which found that the key components of family-centered…

  20. The Comparison Of Dome And HMD Delivery Systems: A Case Study

    NASA Technical Reports Server (NTRS)

    Chen, Jian; Harm, Deborah L.; Loftin, R. Bowen; Tyalor, Laura C.; Leiss, Ernst L.

    2002-01-01

    For effective astronaut training applications, choosing the right display devices to present images is crucial. In order to assess what devices are appropriate, it is important to design a successful virtual environment for a comparison study of the display devices. We present a comprehensive system, a Virtual environment testbed (VET), for the comparison of Dome and Head Mounted Display (HMD) systems on an SGI Onyx workstation. By writing codelets, we allow a variety of virtual scenarios and subjects' information to be loaded without programming or changing the code. This is part of an ongoing research project conducted by the NASA / JSC.

  1. Alternative Fuels Data Center: Johnson Space Center Explores Alternative

    Science.gov Websites

    Fuel Vehicles Johnson Space Center Explores Alternative Fuel Vehicles to someone by E-mail Share Alternative Fuels Data Center: Johnson Space Center Explores Alternative Fuel Vehicles on Facebook Tweet about Alternative Fuels Data Center: Johnson Space Center Explores Alternative Fuel Vehicles on

  2. Evaluation of employees in public day care centers knowledge about breastfeeding and complementary feeding

    PubMed Central

    Souza, Joelânia Pires de O.; Prudente, Amanda Moura; Silva, Dyene Aparecida; Pereira, Leandro Alves; Rinaldi, Ana Elisa M.

    2013-01-01

    OBJECTIVE: To evaluate the knowledge of public day care centers employees about breastfeeding and complementary feeding. METHODS: A cross-sectional study was conducted in 15 public day care centers randomly selected in the city of Uberlandia, Southeast Brazil. A questionnaire applied to school principals, teachers, educators and general services assistants (GSA) included demographic and socioeconomic variables and questions about knowledge on breastfeeding, complementary feeding besides employees' perceptions about these subjects. Kruskal-Wallis with multiple comparison and chi-square tests were used to compare variables by professional category. RESULTS: 304 employees participated in the study. The highest percentages of correct answers were noted for questions about exclusive breastfeeding: definition - 97% (n=296) and duration - 65% (n=199). Regarding complementary feeding, 61% (n=187) correctly answered about the appropriate age to introduce it, with a lower percentage for meat (56%; n=170) and sugar (16%; n=50). Concerning employees' perceptions, 9% (n=29) believed that there is weak breast milk, 79% (n=241) and 51% (n=157) reported the negative influence of bottle feeding and pacifier use on breastfeeding. Among the interviewed subjects, 77% (n=234) answered that they had a positive influence on the quality of the food given to the children. There were no differences in the answers according to professional category, except for the negative influence of pacifiers on breastfeeding. CONCLUSIONS: Employees of public day care centers knew more about breastfeeding than about complementary feeding. Educational activities about breastfeeding and complementary feeding are necessary for day care centers employees. PMID:24473953

  3. Burns in mobile home fires--descriptive study at a regional burn center.

    PubMed

    Mullins, Robert F; Alarm, Badrul; Huq Mian, Mohammad Anwarul; Samples, Jancie M; Friedman, Bruce C; Shaver, Joseph R; Brandigi, Claus; Hassan, Zaheed

    2009-01-01

    Death from fires and burns are the sixth most common cause of unintentional injury death in the United States. More than (3/4) of burn deaths occurring in the United States are in the home. Mobile home fires carry twice the death rate as other dwellings. The aim of the study was to describe the characteristics of deaths and injuries in mobile home fire admitted in a regional Burn Center and to identify possible risk factors. A cross-sectional retrospective study was carried out among all burn patients admitted to a regional Burn Center between January 2002 and December 2004 (3469 patients). The study included patients who suffered a burn injury from a mobile home fire. The demographic characteristics of the patients, location of mobile home, associated inhalation injury, source of fire, comorbidity of the victims, employment status, insurance status, family history of burns, and outcomes of the treatment were incorporated in a data collection record. There were 65 burn patients in mobile home fires admitted to the Burn Center during the studied period. The average age of the patients was 39 years (ranging from 2 to 81 years, SD=16.06), 77% were male, 67% were white, and 79% were the residents in the suburban areas of Georgia, South Carolina, North Carolina, and Florida. The average TBSA of burns was about 21% (ranging from 1 to 63%, SD=17.66), 63% of the patients had associated inhalation, three inhalation injury only, and 69% patients required ventilator support. The average length of stay per TBSA percentage of burn was 1.01 days (P=0.00), controlling for age, preexisting medical comorbidities, and inhalation injury. About 88% of the patients had preexisting medical comorbid conditions, 74% were smokers, 64% reported as alcoholic, and 72% had at least some form of health insurance coverage. In 40% of the cases, the cause of the fire was unknown, 31% were caused by accidental explosions, such as electric, gasoline, or kerosene appliances, and 29% were due to other

  4. The Family Value of Information, Community Support, and Experience Study: Rationale, Design, and Methods of a "Family-Centered" Research Study.

    PubMed

    Reeves, Gloria M; Wehring, Heidi J; Connors, Kathleen M; Bussell, Kristin; Schiffman, Jason; Medoff, Deborah R; Tsuji, Thomas; Walker, Jane; Brown, Alicia; Strobeck, Danielle; Clough, Tammy; Rush, Caitlin B; Riddle, Mark A; Love, Raymond C; Zachik, Albert; Hoagwood, Kimberly; Olin, S Serene; Stephan, Sharon; Okuzawa, Nana; Edwards, Sarah; Baquet, Claudia; dosReis, Susan

    2015-12-01

    The Patient Protection and Affordable Care Act focuses on improving consumer engagement and patient-centered care. This article describes the design and rationale of a study targeting family engagement in pediatric mental health services. The study is a 90-day randomized trial of a telephone-delivered Family Navigator services versus usual care for parents of Medicaid-insured youth younger than 13 years with serious mental illness. Youth are identified through a pediatric antipsychotic medication preauthorization program. Family Navigators offer peer support to empower and engage parents in their child's recovery. Outcomes include parent report of empowerment, social support, satisfaction with child mental health services, and child functioning as well as claims-based measures of psychotherapy service utilization and antipsychotic medication dosage. The focus on "family-centered" care in this study is strongly supported by the active role of consumers in study design and implementation.

  5. Participatory action research methodology in disaster research: results from the World Trade Center evacuation study.

    PubMed

    Gershon, Robyn R M; Rubin, Marcie S; Qureshi, Kristine A; Canton, Allison N; Matzner, Frederick J

    2008-10-01

    Participatory action research (PAR) methodology is an effective tool in identifying and implementing risk-reduction interventions. It has been used extensively in occupational health research, but not, to our knowledge, in disaster research. A PAR framework was incorporated into the World Trade Center evacuation study, which was designed to identify the individual, organizational, and structural (environmental) factors that affected evacuation from the World Trade Center Towers 1 and 2 on September 11, 2001. PAR teams-comprising World Trade Center evacuees, study investigators, and expert consultants-worked collaboratively to develop a set of recommendations designed to facilitate evacuation from high-rise office buildings and reduce risk of injury among evacuees. Two PAR teams worked first separately and then collectively to identify data-driven strategies for improvement of high-rise building evacuation. The teams identified interventions targeting individual, organizational, and structural (environmental) barriers to safe and rapid evacuation. PAR teams were effective in identifying numerous feasible and cost-effective strategies for improvement of high-rise emergency preparedness and evacuation. This approach may have utility in other workplace disaster prevention planning and response programs.

  6. Quantifying center of pressure variability in chondrodystrophoid dogs.

    PubMed

    Blau, S R; Davis, L M; Gorney, A M; Dohse, C S; Williams, K D; Lim, J-H; Pfitzner, W G; Laber, E; Sawicki, G S; Olby, N J

    2017-08-01

    The center of pressure (COP) position reflects a combination of proprioceptive, motor and mechanical function. As such, it can be used to quantify and characterize neurologic dysfunction. The aim of this study was to describe and quantify the movement of COP and its variability in healthy chondrodystrophoid dogs while walking to provide a baseline for comparison to dogs with spinal cord injury due to acute intervertebral disc herniations. Fifteen healthy adult chondrodystrophoid dogs were walked on an instrumented treadmill that recorded the location of each dog's COP as it walked. Center of pressure (COP) was referenced from an anatomical marker on the dogs' back. The root mean squared (RMS) values of changes in COP location in the sagittal (y) and horizontal (x) directions were calculated to determine the range of COP variability. Three dogs would not walk on the treadmill. One dog was too small to collect interpretable data. From the remaining 11 dogs, 206 trials were analyzed. Mean RMS for change in COPx per trial was 0.0138 (standard deviation, SD 0.0047) and for COPy was 0.0185 (SD 0.0071). Walking speed but not limb length had a significant effect on COP RMS. Repeat measurements in six dogs had high test retest consistency in the x and fair consistency in the y direction. In conclusion, COP variability can be measured consistently in dogs, and a range of COP variability for normal chondrodystrophoid dogs has been determined to provide a baseline for future studies on dogs with spinal cord injury. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. A Qualitative Study of Information Technology Managers' Experiences and Perceptions Regarding Outsourced Data Centers

    ERIC Educational Resources Information Center

    Reid, Eric Justin

    2015-01-01

    This qualitative study explored the perceptions and experiences of IT Managers in publicly traded companies within the San Antonio, Texas area about outsourced data centers. Narrative data was collected using open-ended questions and face-to-face interviews within semi-structured environments. The research questions guided the study: (1)…

  8. Center of Pressure Trajectory during Gait: A Comparison of Four Foot Positions

    PubMed Central

    Lugade, Vipul; Kaufman, Kenton

    2014-01-01

    Knowledge of the center of pressure (COP) trajectory during stance can elucidate possible foot pathology, provide comparative effectiveness of foot orthotics, and allow for appropriate calculation of balance control and joint kinetics during gait. Therefore, the goal of this study was to investigate the COP movement when walking at self-selected speeds with plantigrade, equinus, inverted, and everted foot positions. A total of 13 healthy subjects were asked to walk barefoot across an 8 meter walkway with embedded force plates. The COP was computed for each stance limb using the ground reaction forces and moments collected from three force plates. Results demonstrated that the COP excursion was 83% of the foot length and 27% of the foot width in the anterior-posterior and medial lateral directions for plantigrade walking, respectively. Regression equations explained 94% and 44% of the anterior-posterior and medial-lateral COP variability during plantigrade walking. While the range of motion and COP velocity was similar for inverted and everted walking, the COP remained on the lateral and medial aspects of the foot for these two walking conditions, respectively. A reduced anterior-posterior COP range of motion and velocity was demonstrated during equinus walking. Ankle joint motion in the frontal and sagittal planes supported this COP movement, with increased inversion and plantar flexion demonstrated during inverted and equinus conditions, respectively. Results from this study demonstrated the COP kinematics during simulated pathological gait conditions, with the COP trajectory providing an additional tool for the evaluation of patients with pathology. PMID:24447906

  9. Wavelength Locking to CO2 Absorption Line-Center for 2-Micron Pulsed IPDA Lidar Application

    NASA Technical Reports Server (NTRS)

    Refaat, Tamer F.; Petros, Mulugeta; Antill, Charles W.; Singh, Upendra N.; Yu, Jirong

    2016-01-01

    An airborne 2-micron triple-pulse integrated path differential absorption (IPDA) lidar is currently under development at NASA Langley Research Center (LaRC). This IPDA lidar system targets both atmospheric carbon dioxide (CO2) and water vapor (H2O) column measurements. Independent wavelength control of each of the transmitted laser pulses is a key feature for the success of this instrument. The wavelength control unit provides switching, tuning and locking for each pulse in reference to a 2-micron CW (Continuous Wave) laser source locked to CO2 line-center. Targeting the CO2 R30 line center, at 2050.967 nanometers, a wavelength locking unit has been integrated using semiconductor laser diode. The CO2 center-line locking unit includes a laser diode current driver, temperature controller, center-line locking controller and CO2 absorption cell. This paper presents the CO2 center-line locking unit architecture, characterization procedure and results. Assessment of wavelength jitter on the IPDA measurement error will also be addressed by comparison to the system design.

  10. Hospital-Acquired Pneumonia in Patients Undergoing Coronary Artery Bypass Graft; Comparison of the Center for Disease Control Clinical Criteria With Physicians’ Judgment

    PubMed Central

    Baghban, Mahboubeh; Paknejad, Omalbanin; Yousefshahi, Fardin; Gohari Moghadam, Keivan; Bina, Payvand; Samimi Sadeh, Saghar

    2014-01-01

    Background: Following coronary artery bypass graft (CABG), patients are at high risk (3.2%-8.3%) for developing hospital-acquired pneumonia (HAP) with mortality rate of 24% to 50%. Some of routine features in patients undergoing CABG are similar to clinical criteria of Center of Disease Control (CDC) for diagnosis of pneumonia. This may lead to over-diagnosis of pneumonia in these patients. Objectives: This study aimed to assess the frequency of CDC criteria for diagnosis of pneumonia in patients undergoing CABG. Patients and Methods: This study was performed on CABG candidates admitted to post cardiac surgery Intensive Care Unit (ICU) in a six-month period. Patient’s records, Chest-X-Ray, and Laboratory tests were assessed for PNU1-CDC criteria for HAP diagnosis. At the same time, a physician who was unaware of the study protocol assessed the clinical diagnosis. Then the results were compared with CDC criteria-based diagnosis. Results: Of total 300 patients, 9 (3%) met CDC criteria for diagnosis of pneumonia while none of the cases were diagnosed as HAP according to the physicians’ clinical diagnosis. All nine patients were discharged with proper general condition and no need of antibiotic therapy. This study showed that loss of consciousness, tachypnea, dyspnea, PaO2 < 60 mm Hg, PaO2/FiO2 < 240, and local infiltration in 24 hours of operation were misleading features of CDC criteria, which were not considered in physicians’ clinical judgment to establish the diagnosis. Conclusions: Our findings suggest that in Post-CABG patients, physicians could judge the occurrence of HAP more accurately in comparison to making the diagnosis based on CDC criteria alone. Expert physician may intentionally do not take some of these criteria into account according the patients’ course of disease. Therefore, it is suggested that the value of these criteria in special group of patients like those undergoing CABG should be re-evaluated. PMID:25289379

  11. A Multi-Center Diabetes Eye Screening Study in Community Settings: Study Design and Methodology.

    PubMed

    Murchison, Ann P; Friedman, David S; Gower, Emily W; Haller, Julia A; Lam, Byron L; Lee, David J; McGwin, Gerald; Owsley, Cynthia; Saaddine, Jinan; Insight Study Group

    2016-01-01

    Diabetes is the leading cause of new cases of blindness among adults aged 20-74 years within the United States. The Innovative Network for Sight Research group (INSIGHT) designed the Diabetic Eye Screening Study (DESS) to examine the feasibility and short-term effectiveness of non-mydriatic diabetic retinopathy (DR) screening for adults with diabetes in community-based settings. Study enrollment began in December 2011 at four sites: an internal medicine clinic at a county hospital in Birmingham, Alabama; a Federally-qualified community healthcare center in Miami-Dade County, Florida; a university-affiliated outpatient pharmacy in Philadelphia, Pennsylvania; and a medical home in Winston-Salem, North Carolina. People 18 years or older with previously diagnosed diabetes were offered free DR screening using non-mydriatic retinal photography that was preceded by a brief questionnaire addressing demographic information and previous eye care use. Visual acuity was also measured for each eye. Images were evaluated at a telemedicine reading center by trained evaluators using the National Health System DR grading classification. Participants and their physicians were sent screening report results and telephoned for a follow-up survey 3 months post-screening to determine whether participants had sought follow-up comprehensive eye care and their experiences with the screening process. Target enrollment at each site was a minimum of 500 persons. Three of the four sites met this enrollment goal. The INSIGHT/DESS is intended to establish the feasibility and short-term effectiveness of DR screening using non-mydriatic retinal photography in persons with diabetes who seek services in community-based clinic and pharmacy settings.

  12. Evaluating the ductility characteristics of self-centering buckling-restrained shape memory alloy braces

    NASA Astrophysics Data System (ADS)

    Abou-Elfath, Hamdy

    2017-05-01

    Recently, self-centering earthquake resistant systems have attracted attention because of their promising potential in controlling the residual drifts and reducing repair costs after earthquake events. Considerable portion of self-centering research is based on using short-segment superelastic shape memory alloy (SMA) braces as strengthening technique because of the lower modulus of elasticity of SMA in comparison with that of steel. The goal of this study is to investigate the ductility characteristics of these newly proposed short-segment SMA braces to evaluate their safety levels against fracture failures under earthquake loading. This goal has been achieved by selecting an appropriate seismic performance criterion for steel frames equipped with SMA braces, defining the level of strain capacity of SMA and calculating the strain demands in the SMA braces by conducting a series of pushover and earthquake time history analyzes on typical frame structure. The results obtained in this study indicated the inability of short-segment SMA designs to provide adequate ductility to the lateral resistant systems. An alternative approach is introduced by using hybrid steel-SMA braces that are capable of controlling the residual drifts and providing the structure with adequate lateral stiffness.

  13. What Equivocal Data from Single Case Comparison Studies Reveal about Evidence-Based Practices in Early Childhood Special Education

    ERIC Educational Resources Information Center

    Ledford, Jennifer R.; Barton, Erin E.; Hardy, Jessica K.; Elam, Katie; Seabolt, Jordan; Shanks, Meredith; Hemmeter, M. L.; Kaiser, Ann

    2016-01-01

    Although comparison studies are important in early intervention/early childhood special education (EI/ECSE), results of well-designed comparison studies are likely to be unpublished because of undifferentiated or differently differentiated results across participants. The purpose of this article is to highlight the utility of comparison designs in…

  14. Desire to Have Children Among Transgender People in Germany: A Cross-Sectional Multi-Center Study.

    PubMed

    Auer, Matthias K; Fuss, Johannes; Nieder, Timo O; Briken, Peer; Biedermann, Sarah V; Stalla, Günter K; Beckmann, Matthias W; Hildebrandt, Thomas

    2018-05-01

    regarding fertility preservation options. To our knowledge, this is the first study that addresses desire to have children in a clinical sample of trans women. It is also the first that investigates this issue among trans men who have not started medical treatment, and the first comparison of both genders. A limitation for the generalization of our results is the special legal context in Germany that forbids oocyte donation for reciprocal in vitro fertilization. Reproductive desire is high among trans individuals, but the use of reproductive options is surprisingly low. Auer MK, Fuss J, Nieder TO, et al. Desire to Have Children Among Transgender People in Germany: A Cross-Sectional Multi-Center Study. J Sex Med 2018;15:757-767. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  15. Moral Dilemmas/Value Sheets: Writing for Content-Centered Social Studies Classrooms.

    ERIC Educational Resources Information Center

    Stahl, Robert J.; And Others

    The purpose of the paper is to stress the development of content-centered classroom activities useful for attaining values clarification and/or moral development goals. The objective is to help teachers understand the formulation of content-centered learning activities so that they will be able to plan and produce their own value sheets or moral…

  16. Anti-HMGCR antibodies as a biomarker for immune-mediated necrotizing myopathies: A history of statins and experience from a large international multi-center study.

    PubMed

    Musset, Lucile; Allenbach, Yves; Benveniste, Olivier; Boyer, Olivier; Bossuyt, Xavier; Bentow, Chelsea; Phillips, Joe; Mammen, Andrew; Van Damme, Philip; Westhovens, René; Ghirardello, Anna; Doria, Andrea; Choi, May Y; Fritzler, Marvin J; Schmeling, Heinrike; Muro, Yoshinao; García-De La Torre, Ignacio; Ortiz-Villalvazo, Miguel A; Bizzaro, Nicola; Infantino, Maria; Imbastaro, Tiziana; Peng, Qinglin; Wang, Guochun; Vencovský, Jiří; Klein, Martin; Krystufkova, Olga; Franceschini, Franco; Fredi, Micaela; Hue, Sophie; Belmondo, Thibaut; Danko, Katalin; Mahler, Michael

    2016-10-01

    In an effort to find naturally occurring substances that reduce cholesterol by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), statins were first discovered by Endo in 1972. With the widespread prescription and use of statins to decrease morbidity from myocardial infarction and stroke, it was noted that approximately 5% of all statin users experienced muscle pain and weakness during treatment. In a smaller proportion of patients, the myopathy progressed to severe morbidity marked by proximal weakness and severe muscle wasting. Remarkably, Mammen and colleagues were the first to discover that the molecular target of statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), is an autoantibody target in patients that develop an immune-mediated necrotizing myopathy (IMNM). These observations have been confirmed in a number of studies but, until today, a multi-center, international study of IMNM, related idiopathic inflammatory myopathies (IIM), other auto-inflammatory conditions and controls has not been published. Accordingly, an international, multi-center study investigated the utility of anti-HMGCR antibodies in the diagnosis of statin-associated IMNM in comparison to different forms of IIM and controls. This study included samples from patients with different forms of IIM (n=1250) and patients with other diseases (n=656) that were collected from twelve sites and tested for anti-HMGCR antibodies by ELISA. This study confirmed that anti-HMGCR autoantibodies, when found in conjunction with statin use, characterize a subset of IIM who are older and have necrosis on muscle biopsy. Taken together, the data to date indicates that testing for anti-HMGCR antibodies is important in the differential diagnosis of IIM and might be considered for future classification criteria. Copyright © 2016. Published by Elsevier B.V.

  17. Identifying Conditions That Support Causal Inference in Observational Studies in Education: Empirical Evidence from within Study Comparisons

    ERIC Educational Resources Information Center

    Hallberg, Kelly

    2013-01-01

    This dissertation is a collection of three papers that employ empirical within study comparisons (WSCs) to identify conditions that support causal inference in observational studies. WSC studies empirically estimate the extent to which a given observational study reproduces the result of a randomized clinical trial (RCT) when both share the same…

  18. Validation for Global Solar Wind Prediction Using Ulysses Comparison: Multiple Coronal and Heliospheric Models Installed at the Community Coordinated Modeling Center

    NASA Technical Reports Server (NTRS)

    Jian, L. K.; MacNeice, P. J.; Mays, M. L.; Taktakishvili, A.; Odstrcil, D.; Jackson, B.; Yu, H.-S.; Riley, P.; Sokolov, I. V.

    2016-01-01

    The prediction of the background global solar wind is a necessary part of space weather forecasting. Several coronal and heliospheric models have been installed and/or recently upgraded at the Community Coordinated Modeling Center (CCMC), including the Wang-Sheely-Arge (WSA)-Enlil model, MHD-Around-a-Sphere (MAS)-Enlil model, Space Weather Modeling Framework (SWMF), and Heliospheric tomography using interplanetary scintillation data. Ulysses recorded the last fast latitudinal scan from southern to northern poles in 2007. By comparing the modeling results with Ulysses observations over seven Carrington rotations, we have extended our third-party validation from the previous near-Earth solar wind to middle to high latitudes, in the same late declining phase of solar cycle 23. Besides visual comparison, wehave quantitatively assessed the models capabilities in reproducing the time series, statistics, and latitudinal variations of solar wind parameters for a specific range of model parameter settings, inputs, and grid configurations available at CCMC. The WSA-Enlil model results vary with three different magnetogram inputs.The MAS-Enlil model captures the solar wind parameters well, despite its underestimation of the speed at middle to high latitudes. The new version of SWMF misses many solar wind variations probably because it uses lower grid resolution than other models. The interplanetary scintillation-tomography cannot capture the latitudinal variations of solar wind well yet. Because the model performance varies with parameter settings which are optimized for different epochs or flow states, the performance metric study provided here can serve as a template that researchers can use to validate the models for the time periods and conditions of interest to them.

  19. Validation for global solar wind prediction using Ulysses comparison: Multiple coronal and heliospheric models installed at the Community Coordinated Modeling Center

    NASA Astrophysics Data System (ADS)

    Jian, L. K.; MacNeice, P. J.; Mays, M. L.; Taktakishvili, A.; Odstrcil, D.; Jackson, B.; Yu, H.-S.; Riley, P.; Sokolov, I. V.

    2016-08-01

    The prediction of the background global solar wind is a necessary part of space weather forecasting. Several coronal and heliospheric models have been installed and/or recently upgraded at the Community Coordinated Modeling Center (CCMC), including the Wang-Sheely-Arge (WSA)-Enlil model, MHD-Around-a-Sphere (MAS)-Enlil model, Space Weather Modeling Framework (SWMF), and heliospheric tomography using interplanetary scintillation data. Ulysses recorded the last fast latitudinal scan from southern to northern poles in 2007. By comparing the modeling results with Ulysses observations over seven Carrington rotations, we have extended our third-party validation from the previous near-Earth solar wind to middle to high latitudes, in the same late declining phase of solar cycle 23. Besides visual comparison, we have quantitatively assessed the models' capabilities in reproducing the time series, statistics, and latitudinal variations of solar wind parameters for a specific range of model parameter settings, inputs, and grid configurations available at CCMC. The WSA-Enlil model results vary with three different magnetogram inputs. The MAS-Enlil model captures the solar wind parameters well, despite its underestimation of the speed at middle to high latitudes. The new version of SWMF misses many solar wind variations probably because it uses lower grid resolution than other models. The interplanetary scintillation-tomography cannot capture the latitudinal variations of solar wind well yet. Because the model performance varies with parameter settings which are optimized for different epochs or flow states, the performance metric study provided here can serve as a template that researchers can use to validate the models for the time periods and conditions of interest to them.

  20. Consensus building for interlaboratory studies, key comparisons, and meta-analysis

    NASA Astrophysics Data System (ADS)

    Koepke, Amanda; Lafarge, Thomas; Possolo, Antonio; Toman, Blaza

    2017-06-01

    Interlaboratory studies in measurement science, including key comparisons, and meta-analyses in several fields, including medicine, serve to intercompare measurement results obtained independently, and typically produce a consensus value for the common measurand that blends the values measured by the participants. Since interlaboratory studies and meta-analyses reveal and quantify differences between measured values, regardless of the underlying causes for such differences, they also provide so-called ‘top-down’ evaluations of measurement uncertainty. Measured values are often substantially over-dispersed by comparison with their individual, stated uncertainties, thus suggesting the existence of yet unrecognized sources of uncertainty (dark uncertainty). We contrast two different approaches to take dark uncertainty into account both in the computation of consensus values and in the evaluation of the associated uncertainty, which have traditionally been preferred by different scientific communities. One inflates the stated uncertainties by a multiplicative factor. The other adds laboratory-specific ‘effects’ to the value of the measurand. After distinguishing what we call recipe-based and model-based approaches to data reductions in interlaboratory studies, we state six guiding principles that should inform such reductions. These principles favor model-based approaches that expose and facilitate the critical assessment of validating assumptions, and give preeminence to substantive criteria to determine which measurement results to include, and which to exclude, as opposed to purely statistical considerations, and also how to weigh them. Following an overview of maximum likelihood methods, three general purpose procedures for data reduction are described in detail, including explanations of how the consensus value and degrees of equivalence are computed, and the associated uncertainty evaluated: the DerSimonian-Laird procedure; a hierarchical Bayesian

  1. [RABIN MEDICAL CENTER - A TERTIARY CENTER OF EXCELLENCE IN SERVICE, TEACHING AND RESEARCH].

    PubMed

    Niv, Yaron; Halpern, Eyran

    2017-04-01

    Rabin Medical Center (RMC) belongs to Clalit Health Services and is a tertiary, academic medical center with all the facilities of modern and advanced medicine. Annually in the RMC, 650,000 patients are treated in the outpatient clinics, and 100,000 patients are hospitalized in the hospital departments. All these patients are treated by 4500 devoted staff members, including 1000 physicians and 2000 nurses. RMC is one of the largest, centrally located medical centers for medical and nursing students' education in Israel, taking place in clinical departments, as well as in basic sciences courses. We also have a nursing school attached to the hospital. Our vision supports excellence in research. We have a special Research Department that supports RMC researchers, with research coordinators, and all the relevant facilities to assist in clinical and basic science studies. We also promote collaboration efforts with many academic centers in Israel and abroad. The scope of RMC research is broad, including 700 new studies every year and 1500 active studies currently. This issue of Harefuah is dedicated to the clinical and basic science research conducted at RMC with original papers presenting research performed by our departments and laboratories.

  2. Length of stay and medical stability for spinal cord-injured patients on admission to an inpatient rehabilitation hospital: a comparison between a model SCI trauma center and non-SCI trauma center.

    PubMed

    Ploumis, A; Kolli, S; Patrick, M; Owens, M; Beris, A; Marino, R J

    2011-03-01

    Retrospective database review. To compare lengths of stay (LOS), pressure ulcers and readmissions to the acute care hospital of patients admitted to the inpatient rehabilitation facility (IRF) from a model spinal cord injury (SCI) trauma center or from a non-SCI acute hospital. Only sparse data exist comparing the status of patients admitted to IRF from a model SCI trauma center or from a non-SCI acute hospital. Acute care, IRF and total LOS were compared between patients transferred to IRF from the SCI center (n=78) and from non-SCI centers (n=131). The percentages of pressure ulcers on admission to IRF and transfer back to acute care were also compared. Patients admitted to IRF from the SCI trauma center (SCI TC) had significantly shorter (P=0.01) acute care LOS and total LOS compared with patients admitted from non-SCI TCs. By neurological category, acute-care LOS was less for all groups admitted from the SCI center, but statistically significant only for tetraplegia. There was no significant difference in the incidence of readmissions to acute care from IRF. More patients from non-SCI centers (34%) than SCI centers (12%) had pressure ulcers (P<0.001). Acute care in organized SCI TCs before transfer to IRF can significantly lower acute-care LOS or total LOS and incidence of pressure ulcers compared with non-SCI TCs. Patients admitted to IRF from SCI TCs are no more likely to be sent back to an acute hospital than those from non-SCI TCs.

  3. Abnormal tibiofemoral contact stress and its association with altered kinematics following center-center ACL reconstruction: an in vitro study

    PubMed Central

    Imhauser, Carl; Mauro, Craig; Choi, Daniel; Rosenberg, Eric; Mathew, Stephen; Nguyen, Joseph; Ma, Yan; Wickiewicz, Thomas

    2014-01-01

    Background Abnormal tibiofemoral contact stress and aberrant kinematics may influence the progression of osteoarthritis in the ACL-deficient and the ACL-reconstructed knee. However, relationships between contact stress and kinematics following ACL reconstruction are poorly understood. Therefore, we posed the following research questions: (1) How do ACL deficiency and reconstruction affect kinematics of and contact stress in the tibiofemoral joint? (2) What kinematic differences are associated with abnormal contact stress following ACL reconstruction? Hypothesis/Purpose Center-center ACL reconstruction will not restore knee kinematics and contact stress. Correlations will exist between abnormal contact stress and aberrant kinematics following ACL reconstruction will exist. Study Design Controlled laboratory study Methods Clinical tests of anterior and rotational stability were simulated on eleven cadaveric knees using an industrial robot. Tests were conducted with the ACL intact, sectioned, and after single bundle ACL reconstruction using a quadrupled hamstring autograft with tunnels drilled through the center of the native footprints. Kinematics were recorded during the tests. Contact stress was continuously recorded from a stress transducer fixed to the tibial plateau and mean contact stress was calculated regionally. Results ACL deficiency resulted in increased mean contact stress in the posterior sectors of the medial and lateral compartments under anterior and rotational loads, respectively. Reconstruction reduced stress in these locations; however contact stress abnormalities remained. On average, kinematics were overconstrained following ACL reconstruction (≤1.8mm and ≤2.6° in all directions). However, combinations of overconstrained and underconstrained motions in ab/adduction and medial-lateral translation in response to combined moments, and axial rotation, anterior-posterior and medial-lateral translation in response to an anterior load were

  4. Linguistic adaptation, validation and comparison of 3 routinely used neuropathic pain questionnaires.

    PubMed

    Li, Jun; Feng, Yi; Han, Jisheng; Fan, Bifa; Wu, Dasheng; Zhang, Daying; Du, Dongping; Li, Hui; Lim, Jian; Wang, Jiashuang; Jin, Yi; Fu, Zhijian

    2012-01-01

    Neuropathic pain questionnaires are efficient diagnostic tools for neuropathic pain and play an important role in neuropathic pain epidemiologic studies in China. No comparison data was available in regards to the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), the Neuropathic Pain Questionnaire (NPQ) and ID Pain within and among the same population. To achieve a linguistic adaptation, validation, and comparison of Chinese versions of the 3 neuropathic pain questionnaires (LANSS, NPQ and ID Pain). A nonrandomized, controlled, prospective, multicenter trial. Ten pain centers in China. Two forward translations followed by comparison and reconciliation of the translations. Comparison of the 2 backward translations with the original version was made to establish consistency and accuracy of the translations. Pilot testing and pain specialists' evaluations were also required. A total of 140 patients were enrolled in 10 centers throughout China: 70 neuropathic pain patients and 70 nociceptive pain patients. Reliability (Cronbach's alpha coefficients and Guttman split-half coefficients) and validity (sensitivity, specificity, positive and negative predictive values, receiver operating characteristic [ROC] curves and the area under the ROC curves) of the 3 questionnaires were determined. ROC curves and the area under the ROC curves of the 3 questionnaires were also compared. Chinese versions of LANSS, NPQ and ID Pain had a good reliability (Cronbach's alpha coefficients and Guttman split-half coefficients were greater than 0.7). Sensitivity, specificity, positive and negative predictive values of the Chinese versions of LANSS and ID Pain were considerably high ( > 80%). The area under the ROC curves of LANSS and ID Pain was significantly higher than that of NPQ (P < 0.05). There was no statistically significant difference between the area under the ROC curves of LANSS and ID Pain (P > 0.05). The study was based on patients with a high school degree or above

  5. Willingness to pay and willingness to accept in a patient-centered blood pressure control study.

    PubMed

    Gleason-Comstock, Julie; Streater, Alicia; Goodman, Allen; Janisse, James; Brody, Aaron; Mango, LynnMarie; Dawood, Rachelle; Levy, Phillip

    2017-08-07

    Elevated blood pressure is a major risk factor for cardiovascular disease and stroke but patients often discount recommended behavioral changes and prescribed medications. While effective interventions to promote adherence have been developed, cost-effectiveness from the patient's perspective, has not been well studied. The valuation of patient time and out of pocket expenses should be included while performing cost effectiveness evaluation. The Achieve BP study uses the contingent valuation method to assess willingness to accept (WTA) and willingness to pay (WTP) among patients with a history of uncontrolled blood pressure discharged from an urban emergency department and enrolled in a larger randomized controlled trial. WTA and WTP were assessed by asking patients a series of questions about time and travel costs and time value related to their study participation. A survey was conducted during the final study visit with patients to investigate the effectiveness of a kiosk-based educational intervention on blood pressure control. All study patients, regardless of study arm, received the same clinical protocol of commonly prescribed antihypertensive medication and met with research clinicians four times as part of the study procedures. Thirty-eight patients were offered the opportunity to participate in the cost-effectiveness study and all completed the survey. Statistical comparisons revealed these 38 patients were similar in representation to the entire RCT study population. All 38 (100.0%) were African-American, with an average age of 49.1 years; 55.3% were male, 21.1% were married, 78.9% had a high school or higher education, and 44.7% were working. 55.9% did not have a primary care provider and 50.0% did not have health insurance. Time price linear regression analysis was performed to estimate predictors of WTA and WTP. WTP and WTA may generate different results, and the elasticities were proportional to the estimated coefficients, with WTP about twice as

  6. Recent progress in the NASA-Goddard Space Flight Center atomic hydrogen standards program

    NASA Technical Reports Server (NTRS)

    Reinhardt, V. S.

    1981-01-01

    At NASA Goddard Space Flight Center and through associated contractors, a broad spectrum of work is being carried out to develop improved hydrogen maser frequency standards for field use, improved experimental hydrogen maser frequency standards, and improved frequency and time distribution and measurement systems for hydrogen maser use. Recent progress in the following areas is reported: results on the Nr masers built by the Applied Physics Laboratory of Johns Hopkins University, the development of a low cost hydrogen maser at Goddard Space Flight Center, and work on a low noise phase comparison system and digitally phase locked crystal oscillator called the distribution and measurement system.

  7. Research on Subjective Response to Simulated Sonic Booms at NASA Langley Research Center

    NASA Technical Reports Server (NTRS)

    Sullivan, Brenda M.

    2005-01-01

    Over the past 15 years, NASA Langley Research Center has conducted many tests investigating subjective response to simulated sonic booms. Most tests have used the Sonic Boom Booth, an airtight concrete booth fitted with loudspeakers that play synthesized sonic booms pre-processed to compensate for the response of the booth/loudspeaker system. Tests using the Booth have included investigations of shaped booms, booms with simulated ground reflections, recorded booms, outdoor and indoor booms, booms with differing loudness for bow and tail shocks, and comparisons of aircraft flyover recordings with sonic booms. Another study used loudspeakers placed inside people s houses, so that they could experience the booms while in their own homes. This study investigated the reactions of people to different numbers of booms heard within a 24-hour period. The most recent Booth test used predicted boom shapes from candidate low-boom aircraft. At present, a test to compare the Booth with boom simulators constructed by Gulfstream Aerospace Corporation and Lockheed Martin Aeronautics Company is underway. The Lockheed simulator is an airtight booth similar to the Langley booth; the Gulfstream booth uses a traveling wave method to create the booms. Comparison of "realism" as well as loudness and other descriptors is to be studied.

  8. Building a Student-Centered Culture in Times of Natural Disaster: A Case Study

    ERIC Educational Resources Information Center

    Hlinka, Karen Ramey

    2013-01-01

    Increased rates of student success and persistence have been positively linked to community colleges with student-centered cultures. A student-centered culture is one in which policies and practices promote a consistent message of concern and respect while expecting high standards of academic accomplishment. Developing a student-centered culture…

  9. Modelling Simulation and Comparison of Refractory Corrosion at RHI's Technology Center

    NASA Astrophysics Data System (ADS)

    Gregurek, Dean; Ressler, Angelika; Franzkowiak, Anna; Spanring, Alfred

    In order to determine the most suitable refractory products and improve the lining lifetime for the diverse furnaces used in the nonferrous metal industry, corrosion tests are performed at RHF's Technology Center. The practical facilities include the cup test, induction furnace, rotary kiln, and drip slag test described in this paper, which enable a comprehensive understanding of the chemo-thermal brick wear on a pilot scale. The corrosion trials are performed with actual slags generated during operations at a customer's plant. To determine the highest influencing wear parameter, every single test is combined with a detailed mineralogical investigation and thermochemical calculations performed using FactSage. Based on the results, tailored refractory solutions for the nonferrous metal industry can be provided in combination with trials conducted at the customer's site.

  10. International Comparisons of Teachers' Salaries: An Exploratory Study. Survey Report.

    ERIC Educational Resources Information Center

    Barro, Steven M.; Suter, Larry

    This paper, the final product of a study, "International Comparison of Teachers' Salaries," on an exploratory effort to compare salaries of elementary and secondary school teachers in the United States with those in other economically advanced countries. Data was obtained from Canada, Denmark, Federal Republic of Germany, France, Italy, Japan,…

  11. Learner-Centered Principles in Teacher-Centered Practices?

    ERIC Educational Resources Information Center

    Schuh, K.L.

    2004-01-01

    In the study reported here, I compare Learner-Centered Battery (a questionnaire of students' perceptions of the classroom) results and the observation and interview data gathered in one sixth-grade classroom noting first a discrepancy between the descriptions of the classroom that stems from each. I review this discrepancy, highlighting a need for…

  12. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    PubMed

    Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E

    2017-01-01

    Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

  13. Evaluative Study of the Neighborhood Information Center Project.

    ERIC Educational Resources Information Center

    Franklin, Hardy R.; Summers, F. William

    The 1972-1974 Neighborhood Information Center (NIC) Project was undertaken in Atlanta, Cleveland, Detroit, Houston, and Queens Borough to demonstrate that urban public libraries could be a vital force in daily living by providing free information and referrals to low income communities, and by adapting in non-traditional ways to meet neighborhood…

  14. Television-Centered, Instructional Delivery Systems: Costs and Case Studies. A Review of Research.

    ERIC Educational Resources Information Center

    Maher, Thomas G.

    This paper reviews the post-1975 research on the capacities, logistics, and costs of the various delivery technologies used in educational television, and details case studies of television-centered operations, particularly in relationship to adult learners. The paper begins with a section on general definitions and the capacities of various…

  15. Lidar Wind Profiler Comparison to Weather Balloon for Support of Orion Crew Exploration Vehicle Landings

    NASA Technical Reports Server (NTRS)

    Houtas, Franzeska F.; Teets, Edward H.

    2010-01-01

    A comparison study by the National Aeronautics and Space Administration Dryden Flight Research Center (Edwards, California) and the Naval Post Graduate School Center for Interdisciplinary Remotely-Piloted Aircraft Studies (Marina, California) was conducted to show the advantages of an airborne wind profiling light detection and ranging (lidar) system in reducing drift uncertainty along a reentry vehicle descent trajectory. This effort was in support of the once planned Orion Crew Exploration Vehicle ground landing. A Twin Otter Doppler Wind Lidar was flown on multiple flights along the approximate ground track of each ascending weather balloon launched from the Marina Municipal Airport (Marina, California). The airborne lidar used was a 5-mJ, 2-micron infrared laser with a 10-cm telescope and a two-axis scanner. Each lidar wind profile contains data for an altitude range between the surface and flight altitude of 2.7 km, processed on board every 20 s. In comparison, a typical weather balloon would traverse that same altitude range with a similar data set available in approximately 15 to 20 min. These tests were conducted on November 15 and 16, 2007. Results show a best-case absolute difference of 0.18 m/s (0.35 knots) in speed and 1 degree in direct

  16. Faculty Members' Perceptions of Community College Centers for Teaching and Learning: A Qualitative Study

    ERIC Educational Resources Information Center

    Frey, Sandra A.

    2012-01-01

    The purpose of this study was to explore faculty members' perceptions of community college Centers for Teaching and Learning (CTLs); whose main purpose is to promote, facilitate, and honor excellence in teaching and learning through the support of full-time and adjunct faculty, at all career stages. A generic qualitative study with a grounded…

  17. R&D Characteristics and Organizational Structure: Case Studies of University-Industry Research Centers

    ERIC Educational Resources Information Center

    Hart, Maureen McArthur

    2013-01-01

    Within the past few decades, university-industry research centers have been developed in large numbers and emphasized as a valuable policy tool for innovation. Yet little is known about the heterogeneity of organizational structure within these centers, which has implications regarding policy for and management of these centers. This dissertation…

  18. Verified Centers, Nonverified Centers or Other Facilities: A National Analysis of Burn Patient Treatment Location

    PubMed Central

    Zonies, David; Mack, Christopher; Kramer, Bradley; Rivara, Frederick; Klein, Matthew

    2009-01-01

    Background Although comprehensive burn care requires significant resources, patients may be treated at verified burn centers, non-verified burn centers, or other facilities due to a variety of factors. The purpose of this study was to evaluate the association between patient and injury characteristics and treatment location using a national database. Study Design We performed an analysis of all burn patients admitted to United States hospitals participating in the Healthcare Cost and Utilization Project over 2 years. Univariate and multivariate analyses were performed to identify patient and injury factors associated with the likelihood of treatment at designated burn care facilities. Definitve care facilities were categorized as American Burn Association verified centers, non-verified burn centers, or other facilities. Results Over the two years, 29,971 burn patients were treated in 1,376 hospitals located in 19 participating states. A total of 6,712 (22%) patients were treated at verified centers, with 26% and 52% treated at non-verified or other facilities, respectively. Patients treated at verified centers were younger than those at non-verified or other facilities (33.1 years vs. 33.7 years vs. 41.9 years, p<0.001) and had a higher rate of inhalation injury (3.4% vs. 3.2% vs. 2.2%, p<0.001). Independent factors associated with treatment at verified centers include burns to the head/neck (RR 2.4, CI 2.1-2.7), hand (RR 1.8, CI 1.6-1.9), electrical injury (RR 1.4, CI 1.4, CI 1.2-1.7), and fewer co-morbidities (RR 0.55, CI 0.5-0.6). Conclusions More than two-thirds of significantly burned patients are treated at non-verified burn centers in the U.S. Many patients meeting ABA criteria for transfer to a burn center are being treated at non-burn center facilities. PMID:20193892

  19. Lift and center of pressure of wing-body-tail combinations at subsonic, transonic, and supersonic speeds

    NASA Technical Reports Server (NTRS)

    Pitts, William C; Nielsen, Jack N; Kaattari, George E

    1957-01-01

    A method is presented for calculating the lift and centers of pressure of wing-body and wing-body-tail combinations at subsonic, transonic, and supersonic speeds. A set of design charts and a computing table are presented which reduce the computations to routine operations. Comparison between the estimated and experimental characteristics for a number of wing-body and wing-body-tail combinations shows correlation to within + or - 10 percent on lift and to within about + or - 0.02 of the body length on center of pressure.

  20. New Whole-House Solutions Case Study: New Town Builders' Power of Zero Energy Center - Denver, Colorado

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    New Town Builders, a builder of energy efficient homes in Denver, Colorado, offers a zero energy option for all the homes it builds. To attract a wide range of potential homebuyers to its energy efficient homes, New Town Builders created a "Power of Zero Energy Center" linked to its model home in the Stapleton community. This case study presents New Town Builders' marketing approach, which is targeted to appeal to homebuyers' emotions rather than overwhelming homebuyers with scientific details about the technology. The exhibits in the Power of Zero Energy Center focus on reduced energy expenses for the homeowner, improvedmore » occupant comfort, the reputation of the builder, and the lack of sacrificing the homebuyers' desired design features to achieve zero net energy in the home. This case study also contains customer and realtor testimonials related to the effectiveness of the Center in influencing homebuyers to purchase a zero energy home.« less

  1. Comparison of clinical and biochemical markers of dehydration with the clinical dehydration scale in children: a case comparison trial.

    PubMed

    Tam, Ron K; Wong, Hubert; Plint, Amy; Lepage, Nathalie; Filler, Guido

    2014-06-16

    The clinical dehydration scale (CDS) is a quick, easy-to-use tool with 4 clinical items and a score of 1-8 that serves to classify dehydration in children with gastroenteritis as no, some or moderate/severe dehydration. Studies validating the CDS (Friedman JN) with a comparison group remain elusive. We hypothesized that the CDS correlates with a wide spectrum of established markers of dehydration, making it an appropriate and easy-to-use clinical tool. This study was designed as a prospective double-cohort trial in a single tertiary care center. Children with diarrhea and vomiting, who clinically required intravenous fluids for rehydration, were compared with minor trauma patients who required intravenous needling for conscious sedation. We compared the CDS with clinical and urinary markers (urinary electrolytes, proteins, ratios and fractional excretions) for dehydration in both groups using receiver operating characteristic (ROC) curves to determine the area under the curve (AUC). We enrolled 73 children (male = 36) in the dehydration group and 143 (male = 105) in the comparison group. Median age was 32 months (range 3-214) in the dehydration and 96 months (range 2.6-214 months, p < 0.0001) in the trauma group. Median CDS was 3 (range 0-8) within the dehydration group and 0 in the comparison group (p < 0.0001). The following parameters were statistically significant (p < 0.05) between the comparison group and the dehydrated group: difference in heart rate, diastolic blood pressure, urine sodium/potassium ratio, urine sodium, fractional sodium excretion, serum bicarbonate, and creatinine measurements. The best markers for dehydration were urine Na and serum bicarbonate (ROC AUC = 0.798 and 0.821, respectively). CDS was most closely correlated with serum bicarbonate (Pearson r = -0.3696, p = 0.002). Although serum bicarbonate is not the gold standard for dehydration, this study provides further evidence for the usefulness of the CDS as a dehydration marker in

  2. Development of a NEW Vector Magnetograph at Marshall Space Flight Center

    NASA Technical Reports Server (NTRS)

    West, Edward; Hagyard, Mona; Gary, Allen; Smith, James; Adams, Mitzi; Rose, M. Franklin (Technical Monitor)

    2001-01-01

    This paper will describe the Experimental Vector Magnetograph that has been developed at the Marshall Space Flight Center (MSFC). This instrument was designed to improve linear polarization measurements by replacing electro-optic and rotating waveplate modulators with a rotating linear analyzer. Our paper will describe the motivation for developing this magnetograph, compare this instrument with traditional magnetograph designs, and present a comparison of the data acquired by this instrument and original MSFC vector magnetograph.

  3. Interruptions in a level one trauma center: a case study.

    PubMed

    Brixey, Juliana J; Tang, Zhihua; Robinson, David J; Johnson, Craig W; Johnson, Todd R; Turley, James P; Patel, Vimla L; Zhang, Jiajie

    2008-04-01

    The emergency department has been characterized as interrupt-driven. Government agencies and patient safety organizations recognize that interruptions contribute to medical errors. The purpose of this study was to observe, record, and contextualize activities and interruptions experienced by physicians and Registered Nurses (RNs) working in a Level One Trauma Center. A case study that relied on an ethnographic study design using the shadowing method. A convenience sample of physicians and RNs, each with at least 6 months of experience in the Emergency Department (ED), were asked to participate. In these kinds of detailed qualitative investigations, it is quite common to have a small sample size. Ethical approval: Approval was obtained from institutional ethic committees prior to initiating the study. Community consent was obtained from the ED staff through in-service education. All observations were made in the trauma section of the ED of a tertiary teaching hospital. The hospital is situated in a major medical center in the Gulf Coast region of the United States of America (USA). Five attending ED physicians were observed for a total of 29h, 31min. Eight RNs were shadowed for a total of 40 h, 9min. Interruptions and activities were categorized using the Hybrid Method to Categorize Interruptions and Activities (HyMCIA). Registered Nurses received slightly more interruptions per hour than physicians. People, pagers, and telephones were identified as mediums through which interruptions were delivered. The physical environment was found to contribute to interruptions in workflow because of physical design and when supplies were not available. Physicians and RNs usually returned to the original, interrupted activity more often than leaving the activity unfinished. This research provides an enhanced understanding of interruptions in workflow in the ED, the identification of work constraints, and the need to develop interventions to manage interruptions. It is crucial

  4. In vitro antifungal activity of isavuconazole against 345 mucorales isolates collected at study centers in eight countries.

    PubMed

    Verweij, P E; González, G M; Wiedrhold, N P; Lass-Flörl, C; Warn, P; Heep, M; Ghannoum, M A; Guinea, J

    2009-06-01

    Although mucormycoses (formerly zygomycoses) are relatively uncommon, they are associated with high mortality and treatment options are limited. Isavuconazole is a novel, water soluble, broad-spectrum azole in clinical development for the treatment of invasive aspergillosis and candidiasis. The objective of this report was to collate data on the in vitro activity of isavuconazole against a collection of 345 diverse mucorales isolates, collected and tested at eight study centers in europe, mexico and North America. Each study center undertook minimum inhibitory concentration (MIC) susceptibility testing of their isolates, according to EUCAST or CLSI guidelines. Across all study centers, isavuconazole exhibited MIC(50 )values of 1-4 mg/l and MIC(90 )values of 4-16 mg/l against the five genera. There were also marked differences in MIC distributions, which could be ascribed to differences in inoculum and/or endpoint. EUCAST guidelines appeared to generate modal MICs 2-fold higher than CLSI. These results confirm that isavuconazole possesses at least partial antifungal activity against mucorales.

  5. Comparison of acarbose and voglibose in diabetes patients who are inadequately controlled with basal insulin treatment: randomized, parallel, open-label, active-controlled study.

    PubMed

    Lee, Mi Young; Choi, Dong Seop; Lee, Moon Kyu; Lee, Hyoung Woo; Park, Tae Sun; Kim, Doo Man; Chung, Choon Hee; Kim, Duk Kyu; Kim, In Joo; Jang, Hak Chul; Park, Yong Soo; Kwon, Hyuk Sang; Lee, Seung Hun; Shin, Hee Kang

    2014-01-01

    We studied the efficacy and safety of acarbose in comparison with voglibose in type 2 diabetes patients whose blood glucose levels were inadequately controlled with basal insulin alone or in combination with metformin (or a sulfonylurea). This study was a 24-week prospective, open-label, randomized, active-controlled multi-center study. Participants were randomized to receive either acarbose (n=59, 300 mg/day) or voglibose (n=62, 0.9 mg/day). The mean HbA1c at week 24 was significantly decreased approximately 0.7% from baseline in both acarbose (from 8.43% ± 0.71% to 7.71% ± 0.93%) and voglibose groups (from 8.38% ± 0.73% to 7.68% ± 0.94%). The mean fasting plasma glucose level and self-monitoring of blood glucose data from 1 hr before and after each meal were significantly decreased at week 24 in comparison to baseline in both groups. The levels 1 hr after dinner at week 24 were significantly decreased in the acarbose group (from 233.54 ± 69.38 to 176.80 ± 46.63 mg/dL) compared with the voglibose group (from 224.18 ± 70.07 to 193.01 ± 55.39 mg/dL). In conclusion, both acarbose and voglibose are efficacious and safe in patients with type 2 diabetes who are inadequately controlled with basal insulin. (ClinicalTrials.gov number, NCT00970528).

  6. Comparison of Acarbose and Voglibose in Diabetes Patients Who Are Inadequately Controlled with Basal Insulin Treatment: Randomized, Parallel, Open-Label, Active-Controlled Study

    PubMed Central

    Lee, Mi Young; Lee, Moon Kyu; Lee, Hyoung Woo; Park, Tae Sun; Kim, Doo Man; Chung, Choon Hee; Kim, Duk Kyu; Kim, In Joo; Jang, Hak Chul; Park, Yong Soo; Kwon, Hyuk Sang; Lee, Seung Hun; Shin, Hee Kang

    2014-01-01

    We studied the efficacy and safety of acarbose in comparison with voglibose in type 2 diabetes patients whose blood glucose levels were inadequately controlled with basal insulin alone or in combination with metformin (or a sulfonylurea). This study was a 24-week prospective, open-label, randomized, active-controlled multi-center study. Participants were randomized to receive either acarbose (n=59, 300 mg/day) or voglibose (n=62, 0.9 mg/day). The mean HbA1c at week 24 was significantly decreased approximately 0.7% from baseline in both acarbose (from 8.43% ± 0.71% to 7.71% ± 0.93%) and voglibose groups (from 8.38% ± 0.73% to 7.68% ± 0.94%). The mean fasting plasma glucose level and self-monitoring of blood glucose data from 1 hr before and after each meal were significantly decreased at week 24 in comparison to baseline in both groups. The levels 1 hr after dinner at week 24 were significantly decreased in the acarbose group (from 233.54 ± 69.38 to 176.80 ± 46.63 mg/dL) compared with the voglibose group (from 224.18 ± 70.07 to 193.01 ± 55.39 mg/dL). In conclusion, both acarbose and voglibose are efficacious and safe in patients with type 2 diabetes who are inadequately controlled with basal insulin. (ClinicalTrials.gov number, NCT00970528) PMID:24431911

  7. Eye center localization and gaze gesture recognition for human-computer interaction.

    PubMed

    Zhang, Wenhao; Smith, Melvyn L; Smith, Lyndon N; Farooq, Abdul

    2016-03-01

    This paper introduces an unsupervised modular approach for accurate and real-time eye center localization in images and videos, thus allowing a coarse-to-fine, global-to-regional scheme. The trajectories of eye centers in consecutive frames, i.e., gaze gestures, are further analyzed, recognized, and employed to boost the human-computer interaction (HCI) experience. This modular approach makes use of isophote and gradient features to estimate the eye center locations. A selective oriented gradient filter has been specifically designed to remove strong gradients from eyebrows, eye corners, and shadows, which sabotage most eye center localization methods. A real-world implementation utilizing these algorithms has been designed in the form of an interactive advertising billboard to demonstrate the effectiveness of our method for HCI. The eye center localization algorithm has been compared with 10 other algorithms on the BioID database and six other algorithms on the GI4E database. It outperforms all the other algorithms in comparison in terms of localization accuracy. Further tests on the extended Yale Face Database b and self-collected data have proved this algorithm to be robust against moderate head poses and poor illumination conditions. The interactive advertising billboard has manifested outstanding usability and effectiveness in our tests and shows great potential for benefiting a wide range of real-world HCI applications.

  8. Overview of the Center for Space Construction

    NASA Technical Reports Server (NTRS)

    Hearth, Donald P.

    1990-01-01

    The purpose of this overview is to summarize the objectives and structure of the Center. The center is a major element of the University's initiative to upgrade space-related research and education on the Boulder campus. With the support of NASA's University Space Engineering Research Centers Program, we provide a mechanism for interdisciplinary and system-level space engineering research and training. Twenty faculty members and 56 students from seven academic units are associated with the Center and are interacting with each other and with the CSC Associates. As a result of feedback from the 1989 symposium, we have focused the efforts of the Center during the past several months on Lunar Base construction. This included a system level study of a Lunar Base in an Independent Study Project by a group of students from across the Center during the spring semester. This project is being continued this fall. During the two-year history of the Center, 13 students previously affiliated with the Center have graduated and there have been 55 publications from the Center.

  9. Vasopressor use following traumatic injury – A single center retrospective study

    PubMed Central

    Hylands, Mathieu; Godbout, Marie-Pier; Mayer, Sandeep K.; Fraser, William D.; Vanasse, Alain; Leclair, Marc-André; Turgeon, Alexis F.; Lauzier, François; Charbonney, Emmanuel; Trottier, Vincent; Razek, Tarek S.; Roy, André; D’Aragon, Frédérick; Belley-Côté, Emilie; Day, Andrew G.; Le Guillan, Soazig; Sabbagh, Robert

    2017-01-01

    Objectives Vasopressors are not recommended by current trauma guidelines, but recent reports indicate that they are commonly used. We aimed to describe the early hemodynamic management of trauma patients outside densely populated urban centers. Methods We conducted a single-center retrospective cohort study in a Canadian regional trauma center. All adult patients treated for traumatic injury in 2013 who died within 24 hours of admission or were transferred to the intensive care unit were included. A systolic blood pressure <90 mmHg, a mean arterial pressure <60 mmHg, the use of vasopressors or ≥2 L of intravenous fluids defined hemodynamic instability. Main outcome measures were use of intravenous fluids and vasopressors prior to surgical or endovascular management. Results Of 111 eligible patients, 63 met our criteria for hemodynamic instability. Of these, 60 (95%) had sustained blunt injury and 22 (35%) had concomitant severe traumatic brain injury. The subgroup of patients referred from a primary or secondary hospital (20 of 63, 32%) had significantly longer transport times (243 vs. 61 min, p<0.01). Vasopressors, used in 26 patients (41%), were independently associated with severe traumatic brain injury (odds ratio 10.2, 95% CI 2.7–38.5). Conclusions In this cohort, most trauma patients had suffered multiple blunt injuries. Patients were likely to receive vasopressors during the early phase of trauma care, particularly if they exhibited signs of neurologic injury. While these results may be context-specific, determining the risk-benefit trade-offs of fluid resuscitation, vasopressors and permissive hypotension in specific patients subgroups constitutes a priority for trauma research going forwards. PMID:28448605

  10. Reliability centered maintenance : a case study of railway transit maintenance to achieve optimal performance.

    DOT National Transportation Integrated Search

    2010-12-01

    The purpose of this qualitative case study was to identify the types of obstacles and patterns experienced by a single heavy rail transit agency located in North America that embedded a Reliability Centered Maintenance (RCM) Process. The outcome of t...

  11. A Case Study of Spirituality in Senior Center Education: Qualitative Research in Adult Education

    ERIC Educational Resources Information Center

    Demarse, Laura

    2016-01-01

    This article presents a case study on the role of spirituality in adult education at a suburban senior center located in the southeast region of the country. The purpose of the case study was to understand the deeply personal role of spirituality in adult education as seen through teaching seniors and examine the personal manifestation of…

  12. Weather: A Learning Center Approach to the Teaching of Social Studies. Instructional Activities Series.

    ERIC Educational Resources Information Center

    Bravard, Peggy

    This unit, one in a series of teacher-developed materials for elementary geography, is based on a part of a social studies textbook, "Topics of Life," Book Two. One section proposes a learning center environment to make learning experiences in social studies possible throughout the entire school day. The text's section has been expanded for this…

  13. Characteristics of ACS-verified Level I and Level II trauma centers: A study linking trauma center verification review data and the National Trauma Data Bank of the American College of Surgeons Committee on Trauma.

    PubMed

    Shafi, Shahid; Barnes, Sunni; Ahn, Chul; Hemilla, Mark R; Cryer, H Gill; Nathens, Avery; Neal, Melanie; Fildes, John

    2016-10-01

    The Trauma Quality Improvement Project of the American College of Surgeons (ACS) has demonstrated variations in trauma center outcomes despite similar verification status. The purpose of this study was to identify structural characteristics of trauma centers that affect patient outcomes. Trauma registry data on 361,187 patients treated at 222 ACS-verified Level I and Level II trauma centers were obtained from the National Trauma Data Bank of ACS. These data were used to estimate each center's observed-to-expected (O-E) mortality ratio with 95% confidence intervals using multivariate logistic regression analysis. De-identified data on structural characteristics of these trauma centers were obtained from the ACS Verification Review Committee. Centers in the lowest quartile of mortality based on O-E ratio (n = 56) were compared to the rest (n = 166) using Classification and Regression Tree (CART) analysis to identify institutional characteristics independently associated with high-performing centers. Of the 72 structural characteristics explored, only 3 were independently associated with high-performing centers: annual patient visits to the emergency department of fewer than 61,000; proportion of patients on Medicare greater than 20%; and continuing medical education for emergency department physician liaison to the trauma program ranging from 55 and 113 hours annually. Each 5% increase in O-E mortality ratio was associated with an increase in total length of stay of one day (r = 0.25; p < 0.001). Very few structural characteristics of ACS-verified trauma centers are associated with risk-adjusted mortality. Thus, variations in patient outcomes across trauma centers are likely related to variations in clinical practices. Therapeutic study, level III.

  14. Auto-DR and Pre-cooling of Buildings at Tri-City Corporate Center

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yin, Rongxin; Xu, Peng; Kiliccote, Sila

    2008-11-01

    Over the several past years, Lawrence Berkeley National Laboratory (LBNL) has conducted field tests for different pre-cooling strategies in different commercial buildings within California. The test results indicated that pre-cooling strategies were effective in reducing electric demand in these buildings during peak periods. This project studied how to optimize pre-cooling strategies for eleven buildings in the Tri-City Corporate Center, San Bernardino, California with the assistance of a building energy simulation tool -- the Demand Response Quick Assessment Tool (DRQAT) developed by LBNL's Demand Response Research Center funded by the California Energy Commission's Public Interest Energy Research (PIER) Program. From themore » simulation results of these eleven buildings, optimal pre-cooling and temperature reset strategies were developed. The study shows that after refining and calibrating initial models with measured data, the accuracy of the models can be greatly improved and the models can be used to predict load reductions for automated demand response (Auto-DR) events. This study summarizes the optimization experience of the procedure to develop and calibrate building models in DRQAT. In order to confirm the actual effect of demand response strategies, the simulation results were compared to the field test data. The results indicated that the optimal demand response strategies worked well for all buildings in the Tri-City Corporate Center. This study also compares DRQAT with other building energy simulation tools (eQUEST and BEST). The comparison indicate that eQUEST and BEST underestimate the actual demand shed of the pre-cooling strategies due to a flaw in DOE2's simulation engine for treating wall thermal mass. DRQAT is a more accurate tool in predicting thermal mass effects of DR events.« less

  15. Hyperspectral landcover classification for the Yakima Training Center, Yakima, Washington

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Steinmaus, K.L.; Perry, E.M.; Petrie, G.M.

    1998-04-01

    The US Department of Energy`s (DOE`s) Pacific Northwest National Laboratory (PNNL) was tasked in FY97-98 to conduct a multisensor feature extraction project for the Terrain Modeling Project Office (TMPO) of the National Imagery and Mapping Agency (NIMA). The goal of this research is the development of near-autonomous methods to remotely classify and characterize regions of military interest, in support of the TMPO of NIMA. These methods exploit remotely sensed datasets including hyperspectral (HYDICE) imagery, near-infrared and thermal infrared (Daedalus 3600), radar, and terrain datasets. The study site for this project is the US Army`s Yakima Training Center (YTC), a 326,741-acremore » training area located near Yakima, Washington. Two study areas at the YTC were selected to conduct and demonstrate multisensor feature extraction, the 2-km x 2-km Cantonment Area and the 3-km x 3-km Choke Point area. Classification of the Cantonment area afforded a comparison of classification results at different scales.« less

  16. Family-centered rounds in Pakistani pediatric intensive care settings: non-randomized pre- and post-study design.

    PubMed

    Ladak, Laila Akbar; Premji, Shahirose Sadrudin; Amanullah, Muhammad Muneer; Haque, Anwarul; Ajani, Khairulnissa; Siddiqui, Fahad Javaid

    2013-06-01

    Involvement of family in bedside rounds is one strategy to implement family-centered care to help families get clear information about their child, and be actively involved in decision-making about care. However in developing countries such as Pakistan, daily bedside rounds include the physician, residents, medical students and a nurse/technician. Parents are not currently a part of these rounds. To assess whether family-centered rounds improve parents' and health care professionals' satisfaction, decrease patient length of stay, and improve time utilization when compared to traditional practice rounds in a population with a low literacy rate, socioeconomic status, and different cultural values and beliefs. A non-randomized before-after study design. A private hospital in Karachi, Pakistan. A convenience sample of 82 parents, whose children were hospitalized for a minimum of 48h, and 25 health care professionals able to attend two consecutive rounds. During the before phase, traditional bedside rounds were practiced; and during after phase, family-centered rounds were practiced. Parents and health care professionals completed a questionnaire on the second day of rounds. An observational form facilitated data collection on length of stay and time utilization during. Parents' ratings during the family-centered rounds were significantly higher for some parental satisfaction items: evidence of team work (p=0.007), use of simple language during the rounds (p=0.002), feeling of inclusion in discussion at rounds (p=0.03), decision making (p=0.01), and preference for family-centered rounds (p=<0.001). No significant differences were found in health care professionals' satisfaction between rounds. Patient length of stay was significantly reduced in the family-centered rounds group, while no significant difference was found in the duration of rounds. Family-centered rounds served as an opportunity for parents to correct/add to patient history or documentation. Parents were

  17. A PRELIMINARY INVESTIGATION TO ESTABLISH A REGIONAL CENTER FOR EDUCATIONAL DEVELOPMENTAL STUDIES OF DISADVANTAGED PRESCHOOL CHILDREN. FINAL REPORT.

    ERIC Educational Resources Information Center

    LEVINE, LOUIS S.

    THIS REPORT DESCRIBES SEVERAL STEPS UNDERTAKEN BY A RESEARCH GROUP FROM SAN FRANCISCO STATE COLLEGE PRELIMINARY TO THE PROPOSED CREATION OF A RESEARCH CENTER FOR STUDIES OF DISADVANTAGED PRESCHOOL CHILDREN. THE PLANS ANTICIPATE FORMATION OF A COMPREHENSIVE SERVICE, RESEARCH, AND TRAINING CENTER FOR DISADVANTAGED CHILDREN AND THEIR FAMILIES. THE…

  18. The elderly in the shopping centers: the usability study of semipublic spaces as attractiveness generator.

    PubMed

    Bittencourt, Maria Cristina; do Valle Pereira, Vera Lúcia Duarte; Pacheco, Waldemar

    2012-01-01

    This article aims to study the importance of the attributes of usability and attractiveness for the semi-public spaces of Shopping Centers considering the elderly users, the psycho-cognitive and bio-physiological changes resulting from the aging process, as well as their expectations of the built space. Through a qualitative study of theoretical review with a multidisciplinary focus in architecture, ergonomics, gerontology, environmental psychology and management, the conditions of the elderly users were identified, and also the attributes related to usability and attractiveness, collected in order to understand and organize their interrelationships, to suggest recommendations about the drafting of Shopping Centers, aiming to generate projects and environments that should promote the efficient and satisfactory use for elderly and may also create a competitive advantage for these enterprises.

  19. National Aeronautics and Space Administration Manned Spacecraft Center data base requirements study

    NASA Technical Reports Server (NTRS)

    1971-01-01

    A study was conducted to evaluate the types of data that the Manned Spacecraft Center (MSC) should automate in order to make available essential management and technical information to support MSC's various functions and missions. In addition, the software and hardware capabilities to best handle the storage and retrieval of this data were analyzed. Based on the results of this study, recommendations are presented for a unified data base that provides a cost effective solution to MSC's data automation requirements. The recommendations are projected through a time frame that includes the earth orbit space station.

  20. When teacher-centered instructors are assigned to student-centered classrooms

    NASA Astrophysics Data System (ADS)

    Lasry, Nathaniel; Charles, Elizabeth; Whittaker, Chris

    2014-06-01

    Technology-rich student-centered classrooms such as SCALE-UP and TEAL are designed to actively engage students. We examine what happens when the design of the classroom (conventional or teacher-centered versus student-centered classroom spaces) is consistent or inconsistent with the teacher's epistemic beliefs about learning and teaching (traditional or teacher-centered versus student-centered pedagogies). We compare two types of pedagogical approaches and two types of classroom settings through a quasiexperimental 2×2 factorial design. We collected data from 214 students registered in eight sections of an introductory calculus-based mechanics course given at a Canadian publicly funded two-year college. All students were given the Force Concept Inventory at the beginning and at the end of the 15-week-long course. We then focused on six teachers assigned to teach in the student-centered classroom spaces. We used qualitative observations and the Approaches to Teaching Inventory (ATI), a self-reported questionnaire, to determine the teachers' epistemic beliefs (teacher-centered or student-centered) and how these beliefs affected their use of the space and their students' conceptual learning. We report four main findings. First, the student-centered classroom spaces are most effective when used with student-centered pedagogies. Second, student-centered classrooms are ineffective when used with teacher-centered pedagogies and may have negative effects for students with low prior knowledge. Third, we find a strong correlation between six instructors' self-reported epistemic beliefs of student centeredness and their classes' average normalized gain (r =0.91; p =0.012). Last, we find that some instructors are more willing to adopt student-centered teaching practices after using student-centered classroom spaces. These data suggest that student-centered classrooms are effective only when instructors' epistemic framework of teaching and learning is consistent with a student-centered

  1. PET Studies of d-Methamphetamine Pharmacokinetics in Primates: Comparison with l-Methamphetamine and (—)-Cocaine

    PubMed Central

    Fowler, Joanna S.; Kroll, Carsten; Ferrieri, Richard; Alexoff, David; Logan, Jean; Dewey, Stephen L.; Schiffer, Wynne; Schlyer, David; Carter, Pauline; King, Payton; Shea, Colleen; Xu, Youwen; Muench, Lisa; Benveniste, Helene; Vaska, Paul; Volkow, Nora D.

    2009-01-01

    The methamphetamine molecule has a chiral center and exists as 2 enantiomers, d-methamphetamine (the more active enantiomer) and l-methamphetamine (the less active enantiomer). d-Methamphetamine is associated with more intense stimulant effects and higher abuse liability. The objective of this study was to measure the pharmacokinetics of d-methamphetamine for comparison with both l-methamphetamine and (—)-cocaine in the baboon brain and peripheral organs and to assess the saturability and pharmacologic specificity of binding. Methods d- and l-methamphetamine and (—)-cocaine were labeled with 11C via alkylation of the norprecursors with 11C-methyl iodide using literature methods. Six different baboons were studied in 11 PET sessions at which 2 radiotracer injections were administered 2–3 h apart to determine the distribution and kinetics of 11C-d-methamphetamine in brain and peripheral organs. Saturability and pharmacologic specificity were assessed using pretreatment with d-methamphetamine, methylphenidate, and tetrabenazine. 11C-d-Methamphetamine pharmacokinetics were compared with 11C-l-methamphetamine and 11C-(—)-cocaine in both brain and peripheral organs in the same animal. Results 11C-d- and l-methamphetamine both showed high uptake and widespread distribution in the brain. Pharmacokinetics did not differ between enantiomers, and the cerebellum peaked earlier and cleared more quickly than the striatum for both. 11C-d-Methamphetamine distribution volume ratio was not substantially affected by pretreatment with methamphetamine, methylphenidate, or tetrabenazine. Both enantiomers showed rapid, high uptake and clearance in the heart and lungs and slower uptake and clearance in the liver and kidneys. A comparison of 11C-d-methamphetamine and 11C-(—)-cocaine showed that 11C-d-methamphetamine peaked later in the brain than did 11C-(—)-cocaine and cleared more slowly. The 2 drugs showed similar behavior in all peripheral organs examined except the kidneys

  2. Family Care Map: Sustaining family-centered care in Polytrauma Rehabilitation Centers

    PubMed Central

    Ford, James H.; Wise, Meg; Krahn, Dean; Oliver, Karen Anderson; Hall, Carmen; Sayer, Nina

    2015-01-01

    The study assessed sustainability of the Family Care Map, a family-centered approach to providing care for Veterans with polytrauma-related injuries, in four Department of Veterans Affairs Polytrauma Rehabilitation Centers. We applied a mixed-methods approach. Staff surveys used standardized measures of sustainability, commitment to change, information, and participation during implementation. Qualitative inquiry assessed Family Care Map implementation and facilitators and barriers to sustainability. Staff sustainability perceptions had a significant positive correlation with affective commitment to change, participation, and information received about the change process. Family Care Map integration into standard practices and use of its concepts with patients and families related to staff perceptions about sustainability. The degree of use and integration of the Family Care Map in traumatic brain injury/polytrauma care varied among the Polytrauma Rehabilitation Centers. Some successful sustainability strategies included integration into daily workflow and organizational culture. Examples of sustainability barriers included staff awareness and use and outdated information. Some practices, such as measuring and documenting the use of the Family Care Map in treatment plans, may not routinely occur. The focus on family-centered care will require further evaluation of organization-, staff-, and innovation-level attributes that influence sustainability of changes designed to improve family-centered care. PMID:25671632

  3. Growing up Active: A Study into Physical Activity in Long Day Care Centers

    ERIC Educational Resources Information Center

    Cashmore, Aaron W.; Jones, Sandra C.

    2008-01-01

    The child care center is an ideal setting in which to implement strategies to promote physical activity and healthy weight, but there is a paucity of empirical evidence on factors that influence physical activity in these settings. The current study gathered initial qualitative data to explore these factors. Child care workers from five long day…

  4. Restrictive Access to Books in School Library Media Centers in Georgia. Research Study.

    ERIC Educational Resources Information Center

    DuPree, Vi

    This study sought to determine the extent of restrictive access to books in Georgia school library media centers and to discover by whose authority and for what reason these books might be placed on restrictive shelves. Questionnaires were completed and received from a stratified random sampling of 119 media specialists in high schools, middle or…

  5. SU-F-J-36: Comparison of Ball Bearing and Iso-Cube Phantoms for KV-MV Iso-Center Coincidence Check

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Markovich, A; Yang, C

    Purpose: To compare two different quality assurance tools for kV-MV isocenter coincidence check. Methods: Ball-Bearing device (BBD) (Elekta) provided along with a CBCT equipped LINAC and isocenter cube phantom (CP) (a commercial product of Modus Medical Devices) are utilized to check the coincidence between the MV and kV beam isocenters. The microstepping meter of the BBD allows precision adjustment to better than 0.01mm in three directions. The BBD is aligned to the MV-isocenter with the lasers and followed by taking MV-images of at two collimator angles at each cardinal gantry, then its position adjusted. This process takes in iterative stepsmore » until 0.25mm tolerance is achieved. Four planar kV-images are taken at cardinal angles and deviations of BBD position from kVisocenter are evaluated. CP is positioned on the couch with the lasers at known offset from the isocenter. CBCT is utilized to set the cube to its kV isocenter with the precision of linac’s couch (1mm). MV-images are taken at various gantry, collimator, and couch angles and evaluated with the CP manufacturer provided QA software to determine coincidence of the 6mm steel ball at cube center with MV-isocenter. Three sets of measurements, one after another, were performed on the same day for each phantom on the same linac. Results: Assuming little variation between kV and MV isocenters in a short time, BBD measurements are more reproducible than CP. With comparable conditions both methods agree within 0.5 mm in each direction, while for BBD average standard deviation was 0.07mm and for iso-cube 0.3mm. Conclusion: Since BBD is more reliable and its results are more reproducible, it should be used during the monthly QA. Since CP is a more efficient device, it should be used for daily QA. A comparison study between the two devices should be periodically performed.« less

  6. Estimating neighborhood variability with a binary comparison matrix.

    USGS Publications Warehouse

    Murphy, D.L.

    1985-01-01

    A technique which utilizes a binary comparison matrix has been developed to implement a neighborhood function for a raster format data base. The technique assigns an index value to the center pixel of 3- by 3-pixel neighborhoods. The binary comparison matrix provides additional information not found in two other neighborhood variability statistics; the function is sensitive to both the number of classes within the neighborhood and the frequency of pixel occurrence in each of the classes. Application of the function to a spatial data base from the Kenai National Wildlife Refuge, Alaska, demonstrates 1) the numerical distribution of the index values, and 2) the spatial patterns exhibited by the numerical values. -Author

  7. A Case Study Using Child-Centered Play Therapy Approach to Treat Enuresis and Encopresis.

    ERIC Educational Resources Information Center

    Cuddy-Casey, Maria

    1997-01-01

    Demonstrates an alternative method (nondirective child-centered therapy) in treating enuresis and encopresis resulting from emotional disturbances. Examines various etiologies and approaches to treating these conditions. Provides a case study example. Claims that professionals must differentiate between primary and secondary occurrences of these…

  8. The impact of short prehospital times on trauma center performance benchmarking: An ecologic study.

    PubMed

    Byrne, James P; Mann, N Clay; Hoeft, Christopher J; Buick, Jason; Karanicolas, Paul; Rizoli, Sandro; Hunt, John P; Nathens, Avery B

    2016-04-01

    Emergency medical service (EMS) prehospital times vary between regions, yet the impact of local prehospital times on trauma center (TC) performance is unknown. To inform external benchmarking efforts, we explored the impact of EMS prehospital times on the risk-adjusted rate of emergency department (ED) death and overall hospital mortality at urban TCs across the United States. We used a novel ecologic study design, linking EMS data from the National EMS Information System to TCs participating in the American College of Surgeons' Trauma Quality Improvement Program (TQIP) by destination zip code. This approach provided EMS times for populations of injured patients transported to TQIP centers. We defined the exposure of interest as the 90th percentile total prehospital time (PHT) for each TC. TCs were then stratified by PHT quartile. Analyses were limited to adult patients with severe blunt or penetrating trauma, transported directly by land to urban TQIP centers. Random-intercept multilevel modeling was used to evaluate the risk-adjusted relationship between PHT quartile and the outcomes of ED death and overall hospital mortality. During the study period, 119,740 patients met inclusion criteria at 113 TCs. ED death occurred in 1% of patients, and overall mortality was 7.2%. Across all centers, the median PHT was 61 minutes (interquartile range, 53-71 minutes). After risk adjustment, TCs in regions with the shortest quartile of PHTs (<53 minutes) had significantly greater odds of ED death compared with those with the longest PHTs (odds ratio, 2.00; 95% confidence interval, 1.43-2.78). However, there was no association between PHT and overall TC mortality. At urban TCs, local EMS prehospital times are a significant predictor of ED death. However, no relationship exists between prehospital time and overall TC risk-adjusted mortality. Therefore, there is no evidence for the inclusion of EMS prehospital time in external benchmarking analyses.

  9. Acceptability of quality reporting and pay for performance among primary health centers in Lebanon.

    PubMed

    Saleh, Shadi S; Alameddine, Mohamad S; Natafgi, Nabil M

    2013-01-01

    Primary health care (PHC) is emphasized as the cornerstone of any health care system. Enhancing PHC performance is considered a strategy to enhance effective and equitable access to care. This study assesses the acceptability of and factors associated with quality reporting among PHC centers (PHCCs) in Lebanon. The managers of 132 Lebanese Ministry of Health PHCCs were surveyed using a cross-sectional design. Managers' willingness to report quality, participate in comparative quality assessments, and endorse pay-for-performance schemes was evaluated. Collected data were matched to the infrastructural characteristics and services database. Seventy-six percent of managers responded to the questionnaire, 93 percent of whom were willing to report clinical performance. Most expressed strong support for peer-performance comparison and pay-for-performance schemes. Willingness to report was negatively associated with the religious affiliation of centers and presence of health care facilities in the catchment area and favorably associated with use of information systems and the size of population served. The great willingness of PHCC managers to employ quality-enhancing initiatives flags a policy priority for PHC stakeholders to strengthen PHCC infrastructure and to enable reporting in an easy, standardized, and systematic way. Enhancing equity necessitates education and empowerment of managers in remote areas and those managing religiously affiliated centers.

  10. [Use of topical non-steroidal anti-inflammatory agents in an urban health center. Comparison with the current evidence].

    PubMed

    Yagüe-Sebastián, M M; Coscollar-Escartín, I; Muñoz-Albadalejo, P; López-Canales, M C; Villaverde-Royo, M V; Gutiérrez-Moreno, F

    2013-09-01

    To describe the prescribing of topical non-steroidal anti-inflammatory drugs (NSAIDs) in an urban health center (Zaragoza, Spain). A cross-sectional descriptive study was conducted on subjects who belonged to an urban center and were studied during the year 2010. The sample size with a confidence level of 95%, was calculated, a total of 843 prescriptions were analyzed. The sample was single random, and 150 cases were selected. The prevalence and confidence intervals were calculated. The statistical package STATA 9.1 was used for the calculations. The most used drug was diclofenac, in 27.33% (95% CI: 20.65-34.88). NSAIDs were most used in females. In 18% of the cases the area of application was the knee, followed by the 15% in the lower back area (95% CI: 10,22-21,78). There were no adverse reactions. Frequent use is made of topical NSAIDs in a basic health area. Current recommendations support the use in the knee and in the hand, but not in the back, where its use is common. The use of topical NSAIDs decreases side effects and drug interactions, therefore their use is recommended in patients on multiple drug therapy and in the elderly. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  11. [Primary care centers and breast-feeding].

    PubMed

    Nacher Fernández, A; Sanantonio Valdearcos, F; Barreda Simó, I; Palau Fuster, G; Palomares Gimeno, M J; Agramunt Soler, G; Fabregat Julve, I; Labordena Barceló, C

    2001-09-01

    To study activities that promote, maintain and support breast feeding in primary care centers in our health district and to evaluate the commitment of health center directors' to breast feeding, their knowledge of the subject, and programs involved in the promotion of natural breast-feeding. A cross-sectional study was carried out through surveys to those in charge of health centers, nursing, pediatric programs and pregnancy programs. Eighty surveys were sent to center and program directors. Answers were obtained from 66.2 %. A total of 6.9 % of the centers had no program or protocol for the promotion and maintenance of breast-feeding, nor did they seek the collaboration of support groups. Only 28.8 % of the centers surveyed carried out activities that provided special support to mothers with difficulties in breast-feeding. In contrast, 80.4 % possessed an adequate register on the incidence of breast-feeding. In 74.5 % of the centers, health professionals were given no specific training on the subject. Only 14.9 % of the centers had rules prohibiting visible leaflets, posters or samples of formula milk. In 84.6 % of the centers, no place was provided where breast-feeding could be carried out, observed, and possible problems corrected. Most of the primary care centers surveyed do not promote programmed activities favoring the promotion and maintenance of breast-feeding. Nevertheless, many centers provide advice on breast-feeding. Collaboration with support groups or other resources that might exist in the community is not generally sought. Specific training in breast-feeding is not given to the centers' health professionals. Only a minority of the centers possesses an appropriate place where mothers can breast-feed if they wish and where the process of breast-feeding can be observed and modified. The results suggest that primary care centers do not provide the necessary support to ensure successful breast-feeding and that they lack the resources necessary to achieve

  12. Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home.

    PubMed

    Flieger, Signe Peterson

    This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and

  13. Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home

    PubMed Central

    Flieger, Signe Peterson

    2017-01-01

    Background This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. Purpose The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Methodology/Approach Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Findings Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. Practice Implications (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking

  14. A Map of Clinical Dermatology Research Centers in Spain: Results of the MaIND Study.

    PubMed

    Molina-Leyva, A; Descalzo, M A; García-Doval, I

    2017-11-01

    Bibliometric indicators and analyses of clinical research articles can help to quantify the scientific production of hospitals and institutions and identify their main areas of research. The aim of this study was to draw up a bibliometric map of clinical research in dermatology by Spanish hospitals and institutions through an analysis of quantitative, qualitative, and topic-based variables. Bibliometric study of clinical research articles that met the inclusion criteria and had a definitive publication date between 2005 and 2014 in PubMed or Embase in which the corresponding author's affiliation was a Spanish dermatology department or institution. Barcelona and Madrid were the provinces with the highest number of articles and citations. The centers with the most articles and citations were Hospital Clínic and Instituto Valenciano de Oncología. Those 2 hospitals also produced the highest number of articles on the most common research topic identified: melanoma. Because the articles were selected on the basis of the affiliation of the corresponding author to a Spanish dermatology center, this analysis does not include collaborative studies or clinical research studies led by nondermatology centers. We have created a bibliometric map of clinical dermatology research in Spain that shows the distribution of scientific production and the main areas of research by province and hospital/institution. This map could be useful for education and research purposes. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study

    PubMed Central

    Shrestha, Khadka Narayan; Homer, Caroline S. E.

    2017-01-01

    Background Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. Methods We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Results Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. Conclusion The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries. PMID:28493987

  16. Comparison versus reminding.

    PubMed

    Tullis, Jonathan G; Goldstone, Robert L

    2016-01-01

    Comparison and reminding have both been shown to support learning and transfer. Comparison is thought to support transfer because it allows learners to disregard non-matching features of superficially different episodes in order to abstract the essential structure of concepts. Remindings promote memory for the individual episodes and generalization because they prompt learners to retrieve earlier episodes during the encoding of later related episodes and to compare across episodes. Across three experiments, we compared the consequences of comparison and reminding on memory and transfer. Participants studied a sequence of related, but superficially different, proverb pairs. In the comparison condition, participants saw proverb pairs presented together and compared their meaning. In the reminding condition, participants viewed proverbs one at a time and retrieved any prior studied proverb that shared the same deep meaning as the current proverb. Experiment 1 revealed that participants in the reminding condition recalled more proverbs than those in the comparison condition. Experiment 2 showed that the mnemonic benefits of reminding persisted over a one-week retention interval. Finally, in Experiment 3, we examined the ability of participants to generalize their remembered information to new items in a task that required participants to identify unstudied proverbs that shared the same meaning as studied proverbs. Comparison led to worse discrimination between proverbs related to studied proverbs and proverbs unrelated to studied proverbs than reminding. Reminding supported better memory for individual instances and transfer to new situations than comparison.

  17. A novel patient-centered "intention-to-treat" metric of U.S. lung transplant center performance.

    PubMed

    Maldonado, Dawn A; RoyChoudhury, Arindam; Lederer, David J

    2018-01-01

    Despite the importance of pretransplantation outcomes, 1-year posttransplantation survival is typically considered the primary metric of lung transplant center performance in the United States. We designed a novel lung transplant center performance metric that incorporates both pre- and posttransplantation survival time. We performed an ecologic study of 12 187 lung transplant candidates listed at 56 U.S. lung transplant centers between 2006 and 2012. We calculated an "intention-to-treat" survival (ITTS) metric as the percentage of waiting list candidates surviving at least 1 year after transplantation. The median center-level 1-year posttransplantation survival rate was 84.1%, and the median center-level ITTS was 66.9% (mean absolute difference 19.6%, 95% limits of agreement 4.3 to 35.1%). All but 10 centers had ITTS values that were significantly lower than 1-year posttransplantation survival rates. Observed ITTS was significantly lower than expected ITTS for 7 centers. These data show that one third of lung transplant candidates do not survive 1 year after transplantation, and that 12% of centers have lower than expected ITTS. An "intention-to-treat" survival metric may provide a more realistic expectation of patient outcomes at transplant centers and may be of value to transplant centers and policymakers. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  18. Feasibility study of an integrated optic switching center. [satellite tracking application

    NASA Technical Reports Server (NTRS)

    1979-01-01

    The design of a high data rate switching center for a satellite tracking station is discussed. The feasibility of a switching network using an integrated switching matrix is assessed. The preferred integrated optical switching scheme was found to be an electro-optic Bragg diffraction switch. To ascertain the advantages of the integrated optics switching center, its properties are compared to those of opto-electronic and to electronics switching networks.

  19. The impact of user centered design on student motivation

    NASA Astrophysics Data System (ADS)

    Locker, Craig T.

    There is a current push for STEM education within the U.S.; however current studies show that students' interest to pursue STEM fields is decreasing as they progress through high school. This lose in interest has shown to have a strong tie to students' perceived levels of motivation towards the subject. The question that this studied set out to answer was if user centered design (UCD) would affect students perceived level of motivation. For this study a treatment of UCD was compared to a traditional high school engineering design curriculum, with the goal to identify if UCD would have a positive effect on the students perceived level of motivation. 59 9th grade high school students from an urban Midwestern city were selected to participate. Students were given a pre and posttest to determine their levels of motivation before and after the comparison or treatment. Analysis showed that students perceived level of intrinsic and extrinsic motivation significantly went up in the treatment group. The study concluded that due to the ease of implementation and low cost of deployment that UCD should be introduced into high school design challenges that focus on developing a solution for an external stakeholder.

  20. Integrating a Nurse-Midwife-Led Oral Health Intervention Into CenteringPregnancy Prenatal Care: Results of a Pilot Study.

    PubMed

    Adams, Sally H; Gregorich, Steven E; Rising, Sharon S; Hutchison, Margaret; Chung, Lisa H

    2017-07-01

    National and professional organizations recommend oral health promotion in prenatal care to improve women's oral health. However, few prenatal programs include education about oral health promotion. The objective of this study was to determine if women receiving a brief, low-cost, and sustainable educational intervention entitled CenteringPregnancy Oral Health Promotion had clinically improved oral health compared to women receiving standard CenteringPregnancy care. Women attending CenteringPregnancy, a group prenatal care model, at 4 health centers in the San Francisco Bay Area, participated in this nonrandomized controlled pilot study in 2010 to 2011. The intervention arm received the CenteringPregnancy Oral Health Promotion intervention consisting of two 15-minute skills-based educational modules addressing maternal and infant oral health, each module presented in a separate CenteringPregnancy prenatal care session. The present analysis focused on the maternal module that included facilitated discussions and skills-building activities including proper tooth brushing. The control arm received standard CenteringPregnancy prenatal care. Dental examinations and questionnaires were administered prior to and approximately 9 weeks postintervention. Primary outcomes included the Plaque Index, percent bleeding on probing, and percent of gingival pocket depths 4 mm or greater. Secondary outcomes were self-reported oral health knowledge, attitudes (importance and self-efficacy), and behaviors (tooth brushing and flossing). Regression models tested whether pre to post changes in outcomes differed between the intervention versus the control arms. One hundred and one women participated in the study; 49 were in the intervention arm, and 52 were in the control arm. The control and intervention arms did not vary significantly at baseline. Significant pre to post differences were noted between the arms with significant improvements in the intervention arm for the Plaque Index

  1. Rationale and Design of the Lung Cancer Screening Implementation. Evaluation of Patient-Centered Care Study.

    PubMed

    Miranda, Leah S; Datta, Santanu; Melzer, Anne C; Wiener, Renda Soylemez; Davis, James M; Tong, Betty C; Golden, Sara E; Slatore, Christopher G

    2017-10-01

    Screening for lung cancer using low-dose computed tomography has been demonstrated to reduce lung cancer-related mortality and is being widely implemented. Further research in this area is needed to assess the impact of screening on patient-centered outcomes. Here, we describe the design and rationale for a new study entitled Lung Cancer Screening Implementation: Evaluation of Patient-Centered Care. The protocol is composed of an interconnected series of studies evaluating patients and clinicians who are engaged in lung cancer screening in real-world settings. The primary goal of this study is to evaluate communication processes that are being used in routine care and to identify best practices that can be readily scaled up for implementation in multiple settings. We hypothesize that higher overall quality of patient-clinician communication processes will be associated with lower levels of distress and decisional conflict as patients decide whether or not to participate in lung cancer screening. This work is a critical step toward identifying modifiable mechanisms that are associated with high quality of care for the millions of patients who will consider lung cancer screening. Given the enormous potential benefits and burdens of lung cancer screening on patients, clinicians, and the healthcare system, it is important to identify and then scale up quality communication practices that positively influence patient-centered care.

  2. Nucleophilic substitution at phosphorus centers (SN2@p).

    PubMed

    van Bochove, Marc A; Swart, Marcel; Bickelhaupt, F Matthias

    2007-12-03

    We have studied the characteristics of archetypal model systems for bimolecular nucleophilic substitution at phosphorus (SN2@P) and, for comparison, at carbon (SN2@C) and silicon (SN2@Si) centers. In our studies, we applied the generalized gradient approximation (GGA) of density functional theory (DFT) at the OLYP/TZ2P level. Our model systems cover nucleophilic substitution at carbon in X(-)+CH3Y (SN2@C), at silicon in X(-)+SiH3Y (SN2@Si), at tricoordinate phosphorus in X(-)+PH2Y (SN2@P3), and at tetracoordinate phosphorus in X(-)+POH2Y (SN2@P4). The main feature of going from SN2@C to SN2@P is the loss of the characteristic double-well potential energy surface (PES) involving a transition state [X--CH3--Y]- and the occurrence of a single-well PES with a stable transition complex, namely, [X--PH2--Y]- or [X--POH2--Y](-). The differences between SN2@P3 and SN2@P4 are relatively small. We explored both the symmetric and asymmetric (i.e. X, Y=Cl, OH) SN2 reactions in our model systems, the competition between backside and frontside pathways, and the dependence of the reactions on the conformation of the reactants. Furthermore, we studied the effect, on the symmetric and asymmetric SN2@P3 and S(N)2@P4 reactions, of replacing hydrogen substituents at the phosphorus centers by chlorine and fluorine in the model systems X(-)+PR2Y and X(-)+POR2Y, with R=Cl, F. An interesting phenomenon is the occurrence of a triple-well PES not only in the symmetric, but also in the asymmetric SN2@P4 reactions of X(-)+POCl2--Y.

  3. 13. SAC command center, weather center, underground structure, building 501, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. SAC command center, weather center, underground structure, building 501, undated - Offutt Air Force Base, Strategic Air Command Headquarters & Command Center, Command Center, 901 SAC Boulevard, Bellevue, Sarpy County, NE

  4. Enhancing Localized Evaporation through Separated Light Absorbing Centers and Scattering Centers

    PubMed Central

    Zhao, Dengwu; Duan, Haoze; Yu, Shengtao; Zhang, Yao; He, Jiaqing; Quan, Xiaojun; Tao, Peng; Shang, Wen; Wu, Jianbo; Song, Chengyi; Deng, Tao

    2015-01-01

    This report investigates the enhancement of localized evaporation via separated light absorbing particles (plasmonic absorbers) and scattering particles (polystyrene nanoparticles). Evaporation has been considered as one of the most important phase-change processes in modern industries. To improve the efficiency of evaporation, one of the most feasible methods is to localize heat at the top water layer rather than heating the bulk water. In this work, the mixture of purely light absorptive plasmonic nanostructures such as gold nanoparticles and purely scattering particles (polystyrene nanoparticles) are employed to confine the incident light at the top of the solution and convert light to heat. Different concentrations of both the light absorbing centers and the light scattering centers were evaluated and the evaporation performance can be largely enhanced with the balance between absorbing centers and scattering centers. The findings in this study not only provide a new way to improve evaporation efficiency in plasmonic particle-based solution, but also shed lights on the design of new solar-driven localized evaporation systems. PMID:26606898

  5. Ocular Pseudoexfoliation and Cardiovascular Disease: A National Cross-Section Comparison Study

    PubMed Central

    French, Dustin D; Margo, Curtis E; Harman, Lynn E

    2012-01-01

    Background: Pseudoexfoliation is a systemic disorder characterized by the deposition of extracellular matrix material. The microfibrillar material that gives rise to the condition is visible clinically in the anterior segment of the eye, and is also found in other tissues, including blood vessels, skin, gallbladder, kidneys, lungs, and heart. Aims: The present study aims to determine whether ocular pseudoexfoliation is associated with selected cardiovascular diseases. Materials and Methods: A cross-section comparison study was conducted with the help of the Veterans Health Administration databases, using the International Classification of Diseases, Ninth revision, Clinical Modification for pseudoexfoliation of lens capsule and pseudoexfoliation glaucoma. Selected cardiovascular diseases and risk factors for cardiovascular disease were identified using the appropriate medical codes. Patients with primary open-angle glaucoma, chronic sinusitis, and benign prostatic hyperplasia served as the comparison groups. A logistic regression model was used to control for age, gender, race, and major cardiovascular risk factors. Results: There were 6,046 case patients with pseudoexfoliation; approximately half were diagnosed with pseudoexfoliation glaucoma. Various stages of ischemic heart disease, cardiomyopathy, and aortic aneurysm were significantly associated with ocular pseudoexfoliation, after controlling for age, gender, race, and major cardiovascular risk factors. Associations, in general, were less demonstrable relative to the primary open-angle glaucoma comparison group. Conclusion: Associations of ocular pseudoexfoliation with cardiovascular diseases were generally fewer and less pronounced when compared to patients with primary open-angle glaucoma. These results add to the results of earlier studies, which suggest that open-angle glaucoma itself might be a risk factor for certain cardiovascular disorders. PMID:23112968

  6. Retrofit energy studies of a recreation center

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Haberl, J.S.; Claridge, D.

    1985-01-01

    Retrofit energy options for the Student Recreation Center at the University of Colorado have been evaluated using the DOE-2.1b simulation program. This building has two major systems that are not included in the program - an ice rink and a swimming pool. The approach used to model these systems and the use of the program for other applications not included in the program, such as duty cycling and night cycling of fans for freeze protection, are emphasized. Measures that help streamline the usage of the program on a minicomputer are also discussed.

  7. Doing the month in a Taiwanese postpartum nursing center: an ethnographic study.

    PubMed

    Yeh, Yueh-Chen; St John, Winsome; Venturato, Lorraine

    2014-09-01

    Traditionally Chinese and Taiwanese postpartum women conducted postpartum ritual practices, called "doing the month," at home. Today, many Taiwanese women undertake this ritual in postpartum nursing centers. However, little is known about how the traditional practices are being transformed in relation to contemporary health care in Taiwan. In this ethnographic study observations were carried out in a large post-partum center attached to a major hospital in Taipei for nine months, and 27 postpartum women were interviewed. Data were analyzed using ethnographic approaches to extract codes and categories. Doing the month was reshaped by being relocated from the home to a healthcare setting. Midwives took on roles traditionally taken by family members, which had an impact on family roles and relationships. Some postpartum practices were maintained, based on traditional explanations. However, many were modified or challenged, based on explanations from contemporary scientific knowledge. Midwives need to be aware that there could be differences between their culture of care and the cultural values of the women they care for. This study informs culturally appropriate postpartum care and support for women with traditional and contemporary cultural beliefs and attitudes to doing the month in a range of healthcare contexts. © 2013 Wiley Publishing Asia Pty Ltd.

  8. A study of the remote neighborhood office center concept

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The substitution of communications for commuting to work is examined from several aspects. Attention is focused on the possibility of certain groups of white collar workers conducting their business affairs through a network of Remote Neighborhood Office Centers (RNOC's) located near their homes. Typically, employees would communicate with their headquarters organizations by means of voice and digital circuits. Although current technology is readily able to support such an RNOC network, the main problems confronting would-be implementers center around the need for demonstrating that a sufficient number of business operations can be carried out in such a decentralized configuration as efficiently as they are under more conventional circumstances. The description of a pilot program is presented which is intended to identify pacing issues that must be settled before firm conclusions can be reached on whether the concept is operationally viable.

  9. 5. Command center doors at command center entry, building 501, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. Command center doors at command center entry, building 501, looking north - Offutt Air Force Base, Strategic Air Command Headquarters & Command Center, Command Center, 901 SAC Boulevard, Bellevue, Sarpy County, NE

  10. The Effects of Process-Centered and Form-Centered Instruction on the Coherence of College Freshman Writing.

    ERIC Educational Resources Information Center

    Davis, Wesley K.

    This comparative study evaluated the writing growth of 97 college freshman before and after instruction to determine if a process-centered mode of teaching had a more significant impact than a traditional form-centered mode of instruction on discourse coherence in composition. The study used a pretest/posttest, quasi-experimental design with both…

  11. An Overview of Hydrologic Studies at Center for Forested Wetlands Research, USDA Forest Service

    Treesearch

    Devendra M. Amatya; Carl C. Trettin; R. Wayne Skaggs; Timothy J. Callahan; Ge Sun; Masato Miwa; John E. Parsons

    2004-01-01

    Managing forested wetland landscapes for water quality improvement and productivity requires a detailed understanding of functional linkages between ecohydrological processes and management practices. Studies are being conducted at Center for Forested Wetlands Research (CFWR), USDA Forest Service to understand the fundamental hydrologic and biogeochemical processes...

  12. Comparison of Survival at Adult versus Pediatric Treatment Centers for Rare Pediatric Tumors in an Adolescent and Young Adult (AYA) Population in the State of Georgia

    PubMed Central

    Cash, Thomas; Qayed, Muna; Ward, Kevin C.; Mertens, Ann C.; Rapkin, Louis

    2014-01-01

    Background The type of treatment center where 15-21-year-old adolescent and young adult (AYA) patients with rare pediatric tumors achieve their best clinical outcome is unknown. Procedure We performed a retrospective analysis using the Georgia Cancer Registry (GCR) of 15-21-year-old patients with a malignant, rare pediatric tumor diagnosed during the period from 2000-2009. Patients were identified as being treated at one of five Georgia pediatric cancer centers or at an adult center. Data were analyzed for 10-year overall survival, patient characteristics associated with death, and patient characteristics present at diagnosis associated with choice of treatment center. Results There was a total of 479 patients in our final study population, of which 379 (79.1%) were treated at an adult center and 100 (20.9%) were treated at a pediatric center. Patients treated at an adult center had a 10-year overall survival of 86% compared to 85% for patients treated at a pediatric center (p= 0.31). Race and poverty were not significantly associated with death. Patients with nasopharyngeal carcinoma (OR=7.38; 95% CI=2.30 – 23.75) and ‘other carcinomas’ (OR=2.64; 95% CI=1.25 – 5.60) were more likely to be treated at a pediatric center. Patients with higher-stage disease (OR=4.24; 95% CI=1.71 – 10.52) and higher poverty (OR=2.32; 95% CI=1.23 – 4.37) were also more likely to be treated at a pediatric center. Conclusion Our data suggest that there is no difference in survival for 15-21-year-old patients with rare pediatric tumors when treated at an adult or pediatric center. PMID:25393593

  13. Are Career Centers Worthwhile?: Predicting Unique Variance in Career Outcomes through Career Center Usage

    ERIC Educational Resources Information Center

    Brotheridge, Celeste M.; Power, Jacqueline L.

    2008-01-01

    Purpose: This study seeks to examine the extent to which the use of career center services results in the significant incremental prediction of career outcomes beyond its established predictors. Design/methodology/approach: The authors survey the clients of a public agency's career center and use hierarchical multiple regressions in order to…

  14. Motivation to volunteer among senior center participants.

    PubMed

    Pardasani, Manoj

    2018-04-01

    Senior centers in the United States play a vital role in the aging continuum of care as the focal points of a community-based system of services targeting independent older adults to promote their social integration and civically engagement. Although several studies have evaluated the diversity of senior center programs, demographic characteristics of participants, and benefits of participation, very few have explored motivations to volunteer among participants. Many senior centers rely on a cadre of participants who volunteer there to assist with programs and meal services. However, a systematic examination of volunteering interests and the rationale for volunteering among senior center participants has been missing from the literature. This mixed-methods study, conducted at a large suburban senior center, explores the interests and motivations of volunteerism among the participants. The study found that there was limited interest in volunteering among senior center participants. Those who were motivated to volunteer wanted to do so in order to stay connected with their community. There was strong interest in volunteering for single events or projects rather than a long-term commitment. Implications for senior centers are discussed.

  15. China Patient-centered Evaluative Assessment of Cardiac Events Prospective Study of Acute Myocardial Infarction: Study Design.

    PubMed

    Li, Jing; Dreyer, Rachel P; Li, Xi; Du, Xue; Downing, Nicholas S; Li, Li; Zhang, Hai-Bo; Feng, Fang; Guan, Wen-Chi; Xu, Xiao; Li, Shu-Xia; Lin, Zhen-Qiu; Masoudi, Frederick A; Spertus, John A; Krumholz, Harlan M; Jiang, Li-Xin

    2016-01-05

    Despite the rapid growth in the incidence of acute myocardial infarction (AMI) in China, there is limited information about patients' experiences after AMI hospitalization, especially on long-term adverse events and patient-reported outcomes (PROs). The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Prospective AMI Study will enroll 4000 consecutive AMI patients from 53 diverse hospitals across China and follow them longitudinally for 12 months to document their treatment, recovery, and outcomes. Details of patients' medical history, treatment, and in-hospital outcomes are abstracted from medical charts. Comprehensive baseline interviews are being conducted to characterize patient demographics, risk factors, presentation, and healthcare utilization. As part of these interviews, validated instruments are administered to measure PROs, including quality of life, symptoms, mood, cognition, and sexual activity. Follow-up interviews, measuring PROs, medication adherence, risk factor control, and collecting hospitalization events are conducted at 1, 6, and 12 months after discharge. Supporting documents for potential outcomes are collected for adjudication by clinicians at the National Coordinating Center. Blood and urine samples are also obtained at baseline, 1- and 12-month follow-up. In addition, we are conducting a survey of participating hospitals to characterize their organizational characteristics. The China PEACE-Prospective AMI study will be uniquely positioned to generate new information regarding patient's experiences and outcomes after AMI in China and serve as a foundation for quality improvement activities.

  16. Traumatic Brain Injury Practice-Based Evidence Study: Design and Patients, Centers, Treatments, and Outcomes

    PubMed Central

    Horn, Susan D.; Corrigan, John D.; Bogner, Jennifer; Hammond, Flora M.; Seel, Ronald T.; Smout, Randall J.; Barrett, Ryan S.; Dijkers, Marcel P.; Whiteneck, Gale G.

    2015-01-01

    Objective To describe study design, patients, centers, treatments, and outcomes of a traumatic brain injury (TBI) practice-based evidence (PBE) study and to evaluate the generalizability of the findings to the US TBI inpatient rehabilitation population. Design Prospective, longitudinal observational study Setting 10 inpatient rehabilitation centers (9 US, 1 Canada) Participants Patients (n=2130) enrolled between October 2008 and Sept 2011, and admitted for inpatient rehabilitation after an index TBI injury Interventions Not applicable Main Outcome Measures Return to acute care during rehabilitation, rehabilitation length of stay, Functional Independence Measure (FIM) at discharge, residence at discharge, and 9 months post-discharge rehospitalization, FIM, participation, and subjective wellbeing. Results Level of admission FIM Cognitive score was found to create relatively homogeneous subgroups for subsequent analysis of best treatment combinations. There were significant differences in patient and injury characteristics, treatments, rehabilitation course, and outcomes by admission FIM Cognitive subgroups. TBI-PBE study patients overall were similar to US national TBI inpatient rehabilitation populations. Conclusions This TBI-PBE study succeeded in capturing naturally occurring variation within patients and treatments, offering opportunities to study best treatments for specific patient deficits. Subsequent papers in this issue report differences between patients and treatments and associations with outcomes in greater detail. PMID:26212396

  17. Alternative Fuels Data Center: About the Alternative Fuels Data Center

    Science.gov Websites

    About Printable Version Share this resource Send a link to Alternative Fuels Data Center: About the Alternative Fuels Data Center to someone by E-mail Share Alternative Fuels Data Center: About the Alternative Fuels Data Center on Facebook Tweet about Alternative Fuels Data Center: About the Alternative Fuels

  18. A clinicopathologic study of glomerular disease: A single-center, five-year retrospective study from Northwest India.

    PubMed

    Beniwal, Pankaj; Pursnani, Lalit; Sharma, Sanjeev; Garsa, R K; Mathur, Mohit; Dharmendra, Prasad; Malhotra, Vinay; Agarwal, Dhanajai

    2016-01-01

    Studies published from centers across India have reported different and contradicting patterns of glomerular disease. In this retrospective study, we report our experience from a Tertiary Care Center in Northwest India. A total of 702 renal biopsies performed between 2008 and 2013 were reviewed of which 80 were excluded from the study because of having insufficient records or if the biopsies were taken from an allograft. The study included 411 males (66.1 %) and 211 females (33.9%) with an age range of 12-70 years (mean 30.34 ± 7.04 years). Majority of the biopsies (93.9%) showed some form of glomerulonephritis (GN), either primary (79.4%) or secondary glomerular disease (SGD) (14.5%). Minimal change disease (MCD) was the most common type of primary GN (26.5% of primary GN), followed by membranous nephropathy (MN; 18.8%) and focal and segmental glomerulosclerosis (FSGS; 13.2%). Lupus nephritis (LN) was the most frequent SGD (52.2% of secondary GN). Amyloidosis was found in 41.1% and diabetic glomerulosclerosis in 4.4%. LN was also the second most common diagnosis in females after MCD, seen in 19.4% of females. MCD followed by membranoproliferative GN and diffuse proliferative GN were the most common entities in individuals <20 years of age. In the 20-39 years age group, MN was the most common pathology seen. MN was again the most common pathology seen in patients aged above 40 years followed by amyloidosis and FSGS. In this study, MCD was the most common primary GN observed overall from this part of India. MN was the most common GN in individuals above 20 years of age presenting with the nephrotic syndrome. The geographical and regional differences in the pattern of GNs point to the necessity of having a central biopsy registry.

  19. Concept Study for the Establishment of the Harry Diamond Development Center - An AMC Electronic Development Center - An AMC Electronic Development Center.

    DTIC Science & Technology

    Acquisition Review Committee (AMARC). The proposed Harry Diamond Development Center (HDDC), reporting directly to Headquarters, AMC, is to be primarily...This report summarizes three alternatives which have been formulated to provide the Department of the Army and the Army Materiel Command (AMC) with...concerned with electronics. It would consolidate and integrate the present Harry Diamond Laboratories (HDL); selected portions of the U.S. Army Security

  20. A Study of Certain Characteristics of Students and Graduates of Occupation-Centered Curricula. Supplemental Report.

    ERIC Educational Resources Information Center

    Stewart, Lawrence H.

    This document supplements ED 025 264, a study of 2,459 individuals enrolled in one of 43 occupation-centered curricula in 20 California junior colleges. The parent study compared students' questionnaire responses about home and educational backgrounds, and about attitudes presumably related to both vocational choice and choice of curricula leading…