Sample records for ed frcs eng

  1. Primary FRCS Eng

    PubMed Central

    Hobsley, Michael

    1974-01-01

    In five consecutive Primary Examinations for the Fellowship of the Royal College of Surgeons of England, the scores of candidates in the multiple choice question paper, written paper, and oral interview have been analysed for mutual correlations and for the reproducibility of the written paper score. The conclusions reached were that all these scores correlate with each other, that no score can be left out without reducing the reliability of the examination, that the marking of written papers in a close-marking system is remarkably reproducible, and that the oral score contributes most, the multiple choice question paper the least, to the overall assessment. PMID:4417893

  2. Primary FRCS Eng

    PubMed Central

    Tresidder, Gerald

    1974-01-01

    The importance of establishing that a candidate can communicate in English—spoken and written—is stressed. The value of written answers is that they show a candidate's understanding of the subject and his ability to express himself lucidly and logically. PMID:4417892

  3. The MCQ in the primary FRCS(Eng).

    PubMed Central

    Lumley, J. S.; Browne, P. D.; Elcock, N. J.

    1984-01-01

    Analysis of the primary fellowship results showed that on average candidates were scoring a significantly higher mark in the MCQ than in the essay or viva. The level of MCQ marking has therefore been reset to the standards of the other parts of the examination. The need for continually monitoring the results of all examinations is emphasised. PMID:6508170

  4. The MCQ in the primary FRCS(Eng).

    PubMed

    Lumley, J S; Browne, P D; Elcock, N J

    1984-11-01

    Analysis of the primary fellowship results showed that on average candidates were scoring a significantly higher mark in the MCQ than in the essay or viva. The level of MCQ marking has therefore been reset to the standards of the other parts of the examination. The need for continually monitoring the results of all examinations is emphasised.

  5. Users guide for FRCS: fuel reduction cost simulator software.

    Treesearch

    Roger D. Fight; Bruce R. Hartsough; Peter Noordijk

    2006-01-01

    The Fuel Reduction Cost Simulator (FRCS) spreadsheet application is public domain software used to estimate costs for fuel reduction treatments involving removal of trees of mixed sizes in the form of whole trees, logs, or chips from a forest. Equipment production rates were developed from existing studies. Equipment operating cost rates are from December 2002 prices...

  6. The Eng1 β-Glucanase Enhances Histoplasma Virulence by Reducing β-Glucan Exposure

    PubMed Central

    Garfoot, Andrew L.; Shen, Qian; Wüthrich, Marcel; Klein, Bruce S.

    2016-01-01

    ABSTRACT The fungal pathogen Histoplasma capsulatum parasitizes host phagocytes. To avoid antimicrobial immune responses, Histoplasma yeasts must minimize their detection by host receptors while simultaneously interacting with the phagocyte. Pathogenic Histoplasma yeast cells, but not avirulent mycelial cells, secrete the Eng1 protein, which is a member of the glycosylhydrolase 81 (GH81) family. We show that Histoplasma Eng1 is a glucanase that hydrolyzes β-(1,3)-glycosyl linkages but is not required for Histoplasma growth in vitro or for cell separation. However, Histoplasma yeasts lacking Eng1 function have attenuated virulence in vivo, particularly during the cell-mediated immunity stage. Histoplasma yeasts deficient for Eng1 show increased exposure of cell wall β-glucans, which results in enhanced binding to the Dectin-1 β-glucan receptor. Consistent with this, Eng1-deficient yeasts trigger increased tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) cytokine production from macrophages and dendritic cells. While not responsible for large-scale cell wall structure and function, the secreted Eng1 reduces levels of exposed β-glucans at the yeast cell wall, thereby diminishing potential recognition by Dectin-1 and proinflammatory cytokine production by phagocytes. In α-glucan-producing Histoplasma strains, Eng1 acts in concert with α-glucan to minimize β-glucan exposure: α-glucan provides a masking function by covering the β-glucan-rich cell wall, while Eng1 removes any remaining exposed β-glucans. Thus, Histoplasma Eng1 has evolved a specialized pathogenesis function to remove exposed β-glucans, thereby enhancing the ability of yeasts to escape detection by host phagocytes. PMID:27094334

  7. Abnormal computerized dynamic posturography findings in dizzy patients with normal ENG results.

    PubMed

    Sataloff, Robert T; Hawkshaw, Mary J; Mandel, Heidi; Zwislewski, Amy B; Armour, Jonathan; Mandel, Steven

    2005-04-01

    The complexities of the balance system create difficulties for professionals interested in testing equilibrium function objectively. Traditionally, electronystagmography (ENG) has been used for this purpose, but it provides information on only a limited portion of the equilibrium system. Computerized dynamic posturography (CDP) is less specific than ENG, but it provides more global insight into a patient's ability to maintain equilibrium under more challenging environmental circumstances. CD Palso appears to be valuable in obtaining objective confirmation of an abnormality in some dizzy patients whose ENG findings are normal. Our review of 33 patients with normal ENG results and abnormal CDP findings suggests that posturography is useful for confirming or quantifying a balance abnormality in some patients whose complaints cannot be confirmed by other tests frequently used by otologists.

  8. Development of Compact Toroid Injector for C-2 FRCs

    NASA Astrophysics Data System (ADS)

    Matsumoto, Tadafumi; Sekiguchi, Junichi; Asai, Tomohiko; Gota, Hiroshi; Garate, Eusebio; Allfrey, Ian; Valentine, Travis; Smith, Brett; Morehouse, Mark; TAE Team

    2014-10-01

    Collaborative research project with Tri Alpha Energy has been started and we have developed a new compact toroid (CT) injector for the C-2 device, mainly for fueling field-reversed configurations (FRCs). The CT is formed by a magnetized coaxial plasma-gun (MCPG), which consists of coaxial cylinder electrodes; a spheromak-like plasma is generated by discharge and pushed out from the gun by Lorentz force. The inner diameter of outer electrode is 83.1 mm and the outer diameter of inner electrode is 54.0 mm. The surface of the inner electrode is coated with tungsten in order to reduce impurities coming out from the electrode. The bias coil is mounted inside of the inner electrode. We have recently conducted test experiments and achieved a supersonic CT translation speed of up to ~100 km/s. Other typical plasma parameters are as follows: electron density ~ 5 × 1021 m-3, electron temperature ~ 40 eV, and the number of particles ~0.5-1.0 × 1019. The CT injector is now planned to be installed on C-2 and the first CT injection experiment will be conducted in the near future. The detailed MCPG design as well as the test experimental results will be presented.

  9. On cuff imbalance and tripolar ENG amplifier configurations.

    PubMed

    Triantis, Iasonas F; Demosthenous, Andreas; Donaldson, Nick

    2005-02-01

    Electroneurogram (ENG) recording techniques benefit from the use of tripolar cuffs because they assist in reducing interference from sources outside the cuff. However, in practice the performance of ENG amplifier configurations, such as the quasi-tripole and the true-tripole, has been widely reported to be degraded due to the departure of the tripolar cuff from ideal behavior. This paper establishes the presence of cuff imbalance and investigates its relationship to cuff asymmetry, cuff end-effects and interference source proximity. The paper also presents a comparison of the aforementioned amplifier configurations with a new alternative, termed the adaptive-tripole, developed to automatically compensate for cuff imbalance. The output signal-to-interference ratio of the three amplifier configurations were compared in vivo for two interference signals (stimulus artifact and M-wave) superimposed on compound action potentials. The experiments showed (for the first time) that the two interference signals result in different cuff imbalance values. Nevertheless, even with two distinct cuff imbalances present, the adaptive-tripole performed better than the other two systems in 61.9% of the trials.

  10. The influence of FRCs reinforcement on marginal adaptation of CAD/CAM composite resin endocrowns after simulated fatigue loading.

    PubMed

    Rocca, Giovanni Tommaso; Saratti, Carlo Massimo; Poncet, Antoine; Feilzer, Albert J; Krejci, Ivo

    2016-05-01

    To evaluate the marginal adaptation of endodontically treated molars restored with CAD/CAM composite resin endocrowns either with or without reinforcement by fibre reinforced composites (FRCs), used in different configurations. 32 human endodontically treated molars were cut 2 mm over the CEJ. Two interproximal boxes were created with the margins located 1 mm below the CEJ (distal box) and 1 mm over the CEJ (mesial box). All specimens were divided in four groups (n = 8). The pulp chamber was filled with: group 1 (control), hybrid resin composite (G-aenial Posterior, GC); group 2, as group 1 but covered by 3 meshes of E-glass fibres (EverStick NET, Stick Tech); group 3, FRC resin (EverX Posterior, GC); group 4, as group 3 but covered by 3 meshes of E-glass fibres. The crowns of all teeth were restored with CAD/CAM composite resin endocrowns (LAVA Ultimate, 3M). All specimens were thermo-mechanically loaded in a computer-controlled chewing machine (600,000 cycles, 1.6 Hz, 49 N and simultaneously 1500 thermo-cycles, 60 s, 5-55 °C). Marginal analysis before and after the loading was carried out on epoxy replicas by SEM at 200× magnification. For all the groups, the percentage values of perfect marginal adaptation after loading were always significantly lower than before loading (p < 0.05). The marginal adaptation before and after loading was not significantly different between the experimental groups (p > 0.05). Within the limitations of this in vitro study, the use of FRCs to reinforce the pulp chamber of devitalized molars restored with CAD/CAM composite resin restorations did not significantly influenced their marginal quality.

  11. Restructuring Graduate Engineering Education: The M.Eng. Program at Cornell.

    ERIC Educational Resources Information Center

    Cady, K. Bingham; And Others

    1988-01-01

    Discusses the restructuring of the graduate program to accommodate emerging fields in engineering. Notes half of the graduate degrees Cornell grants each year are M.Eng. degrees. Offers 12 specialties: aerospace, agriculture, chemical, civil, electrical, mechanical and nuclear engineering; computer science, engineering physics; geological…

  12. 4. "ARCHITECTURAL, FLOOR PLANELEVATIONSSECTIONS, OBSERVATION BUNKERS." Specifications No. ENG (NASA)04353631; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. "ARCHITECTURAL, FLOOR PLAN-ELEVATIONS-SECTIONS, OBSERVATION BUNKERS." Specifications No. ENG (NASA)04-353-63-1; Drawing No. 60-09-34; sheet 325. Ref. No. A-13. D.O. SERIES 1597/87. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Observation Bunker 1-D-3, Test Area 1-125, northwest end of Altair Boulevard, Boron, Kern County, CA

  13. Instrumentation and control building, architectural, floor plans. Specifications no. Eng043535572; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Instrumentation and control building, architectural, floor plans. Specifications no. Eng-04-353-55-72; Drawing No. 60-09-12' sheet 64 of 148; file no. 1321/15. Stamped: record drawing - as constructed. Below stamp: Contract no. 4338, no change. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Control Center, Test Area 1-115, near Altair & Saturn Boulevards, Boron, Kern County, CA

  14. 26. "TEST STAND, STRUCTURAL, FOUNDATION PLAN." Specifications No. ENG043535572; Drawing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    26. "TEST STAND, STRUCTURAL, FOUNDATION PLAN." Specifications No. ENG-04-353-55-72; Drawing No. 60-0912; sheet 25 of 148; file no. 1320/76. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 4338, no change. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

  15. 10. "ARCHITECTURAL, SECTIONS AND DETAILS." Specifications No. ENG043535572; Drawing No. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. "ARCHITECTURAL, SECTIONS AND DETAILS." Specifications No. ENG-04-353-55-72; Drawing No. 60-09-12; sheet 23 of 148; file no. 1320/74. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 4338, no change. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A Terminal Room, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

  16. An ENG resonator-based microwave sensor for the characterization of aqueous glucose

    NASA Astrophysics Data System (ADS)

    Kumari, Ratnesh; Patel, Piyush N.; Yadav, Rahul

    2018-02-01

    This work proposes a microwave filter with a notched frequency of transmission using an epsilon negative (ENG) unit-cell resonator as a sensor device. The device finds important application for the characterization of life-saving samples such as glucose. The ENG structure consists of two complementary geometries in the shape of ring and horn. The structure efficiently inhibits the incoming RF signal and creates a stopband resonance at 2.074 GHz. The printed circuit board of the layout was realized using FR-4 substrate of relative permittivity ɛ r  =  4.4, and height of 1.6 mm. It is experimentally seen that in the complementary area of horn and circular ring, the glucose sample perturbs the air-dielectric fringing fields which exist over the complementary area and modifies the frequency of stopband resonance. A change in sensor resonance was recorded and calibrated for different concentrations of glucose sample. The sensor exhibits a linear response for glucose concentration ranging from 20 to 100 mg ml-1 in the sensing area.

  17. Automation of the Reporting and Tracking Requirements of Architect-Engineering Type Contracts.

    DTIC Science & Technology

    1984-09-01

    Electrical Eng 03 Oceano rahers 04 -- 10 Architect 05 Estimatcrs 06-- Urban Planners 07 Chemical Eng 08 -- Geologists 09--3 Sanitary Eng 10 -25 Civil Eng...geographic dispersicn of the activities, cc:tzal centers for information exchange should L idert iEd (newsletters, regional periodic meetizgs, sol r

  18. 7. "LAUNCH SILOS; SECTIONS, DETAILS." Specifications No. ENG043535973; Drawing No. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. "LAUNCH SILOS; SECTIONS, DETAILS." Specifications No. ENG-04-353-59-73; Drawing No. 5841-S-4; D.O. SERIES AW1525/26 Rev. A.; Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract No. 6601, Rev. A., Date 11 Sep 59. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Missile Silo Type, Test Area 1-100, northeast end of Test Area 1-100 Road, Boron, Kern County, CA

  19. 30. "CONSTRUCTION PHASING, STATION '50' AREA." Specifications No. ENG043535775, Drawing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    30. "CONSTRUCTION PHASING, STATION '50' AREA." Specifications No. ENG-04-353-57-75, Drawing No. AF-4502-19, sheet 4 of 5, D.O. Series No. AF 1439/26. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 5296, Date: 10 NOV. 59. - Edwards Air Force Base, South Base Sled Track, Edwards Air Force Base, North of Avenue B, between 100th & 140th Streets East, Lancaster, Los Angeles County, CA

  20. Effects of Using a Neuroeducational Intervention to Enhance Perseverance for Online EdD and EdS Students

    ERIC Educational Resources Information Center

    Cadle, Charles R.

    2013-01-01

    Developing and maintaining a "completion mindset" is a necessary mental condition for online educational doctorate (EdD) and educational specialist (EdS) students to obtain their advanced degrees. The purpose of this research study was to examine the effect of a neuroeducational intervention on a volunteer convenience sample of EdD and…

  1. Masculinities in Organizational Cultures in Engineering Education in Europe: Results of the European Union Project WomEng

    ERIC Educational Resources Information Center

    Sagebiel, F.; Dahmen, J.

    2006-01-01

    The paper describes elements of engineering organizational cultures and structures in higher engineering education from the European project WomEng. Hypotheses, based on state of the art, refer to: women friendly presentation, attractiveness of interdisciplinary teaching methods, single sex education, perceptions of minority status, feelings of…

  2. The effect of mental alerting on peripheral vestibular nystagmus during spontaneous, gaze (30 degrees left, 30 degrees right) and body positional (left & right lateral lying) testing using electronystagmography (ENG).

    PubMed

    McGovern, Tracey N; Fitzgerald, John E

    2008-10-01

    The performance of mental alerting during caloric testing has always been considered important, however its use/benefit during electronystagmography (ENG)/videonystagmography (VNG) testing has been questioned. The aim of this study was to investigate the effect of mental alerting tasks on peripheral type vestibular nystagmus recorded during ENG. Thirty patients with significant spontaneous/gaze or positional nystagmus (slow phase velocity >or= 6 degrees /s) were recruited from consecutive referrals for vestibular assessment. Nystagmus was recorded by ENG both in the presence and absence of mental alerting for each patient. Investigation of nystagmus by analysis of variance (ANOVA) revealed significantly larger nystagmus (higher value SPV) with mental alerting than with no alerting (p<0.001), and for some patients nystagmus traces were reduced to a flat line (no nystagmus) with no alerting. The study demonstrates the importance of mental alerting in helping overcome central suppression of nystagmus and highlights its importance to help identify peripheral type nystagmus during ENG.

  3. How do ED patients with criminal justice contact compare with other ED users? A retrospective analysis of ED visits in California.

    PubMed

    McConville, Shannon; Mooney, Alyssa C; Williams, Brie A; Hsia, Renee Y

    2018-06-21

    To assess the patterns of emergency department (ED) utilisation among those with and without criminal justice contact in California in 2014, comparing variation in ED use, visit frequency, diagnoses and insurance coverage. Retrospective, cross-sectional study. Analyses included ED visits to all licensed hospitals in California using statewide data on all ED encounters in 2014. Study participants included 3 757 870 non-elderly adult ED patients who made at least one ED visit in 2014. We assessed the patterns and characteristics of ED visits among those with criminal justice contact-patients who were either admitted to or discharged from the ED by a correctional institution-with patients who did not have criminal justice contact recorded during an ED visit. ED patients with criminal justice contact had higher proportions of frequent ED users (27.2% vs 9.4%), were at higher risk of an ED visit resulting in hospitalisation (26.6% vs 15.2%) and had higher prevalence of mental health conditions (52.8% vs 30.4%) compared with patients with no criminal justice contact recorded during an ED visit. Of the top 10, four primary diagnoses among patients with criminal justice contact were related to behavioural health conditions, accounting for 19.0% of all primary diagnoses in this population. In contrast, behavioural health conditions were absent from the top 10 primary diagnoses in ED patients with no observed criminal justice contact. Despite a high burden of disease, a lack of health insurance coverage was more common among those with criminal justice contact than those without (41.3% vs 14.1%). Given that a large proportion of ED patients with criminal justice contact are frequent users with considerable mental health conditions, current efforts in California's Medicaid programme to identify individuals in need of coordinated services could reduce costly ED utilisation among this group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  4. DHPLC-based mutation analysis of ENG and ALK-1 genes in HHT Italian population.

    PubMed

    Lenato, Gennaro M; Lastella, Patrizia; Di Giacomo, Marilena C; Resta, Nicoletta; Suppressa, Patrizia; Pasculli, Giovanna; Sabbà, Carlo; Guanti, Ginevra

    2006-02-01

    Hereditary haemorrhagic telangiectasia (HHT or Rendu-Osler-Weber syndrome) is an autosomal dominant disorder characterized by localized angiodysplasia due to mutations in endoglin, ALK-1 gene, and a still unidentified locus. The lack of highly recurrent mutations, locus heterogeneity, and the presence of mutations in almost all coding exons of the two genes makes the screening for mutations time-consuming and costly. In the present study, we developed a DHPLC-based protocol for mutation detection in ALK1 and ENG genes through retrospective analysis of known sequence variants, 20 causative mutations and 11 polymorphisms, and a prospective analysis on 47 probands with unknown mutation. Overall DHPLC analysis identified the causative mutation in 61 out 66 DNA samples (92.4%). We found 31 different mutations in the ALK1 gene, of which 15 are novel, and 20, of which 12 are novel, in the ENG gene, thus providing for the first time the mutational spectrum in a cohort of Italian HHT patients. In addition, we characterized the splicing pattern of ALK1 gene in lymphoblastoid cells, both in normal controls and in two individuals carrying a mutation in the non-invariant -3 position of the acceptor splice site upstream exon 6 (c.626-3C>G). Functional essay demonstrated the existence, also in normal individuals, of a small proportion of ALK1 alternative splicing, due to exon 5 skipping, and the presence of further aberrant splicing isoforms in the individuals carrying the c.626-3C>G mutation. 2006 Wiley-Liss, Inc.

  5. TED-Ed lessons & TED-Ed clubs: Educational activities to amplify students' voices

    NASA Astrophysics Data System (ADS)

    Villias, Georgios

    2017-04-01

    TED-Ed lessons and TED-Ed clubs are two powerful educational tools that can be used in today's school classrooms in order to create an educational environment that is engaging for the students and favors their active participation, created and fostered by TED-Ed. TED-Ed is TED's educational initiative, committed to create lessons worth sharing and amplify the voices and ideas of teachers and students around the world. TED-Ed animated lessons are fully organized lessons structured around an animated video that introduces new topics to learners in an exciting, thought-provoking way. These lessons have been created as a result of the cooperation between expert educators and animators and have been uploaded at the TED-Ed platform (http://ed.ted.com). On the other hand, TED-Ed Clubs are also an interesting way to offer students the chance, the voice and the opportunity to express their thoughts, engage actively on these matters and connect with each other, both at a local, as well as at an international level (http://ed.ted.com/clubs). By developing new TED-Ed lessons or by customizing appropriately existing animated TED-Ed lessons (translating, modifying the questions asked, introducing new discussion topics), I have created and implemented in my student-centered, didactic approach, a series of TED-ED animated lessons directly connected with the Greek national science syllabus that were used to spark students curiosity and initiate a further analytical discussion or introduce other relevant educational activities (http://gvillias.wixsite.com/education). Furthermore, at my school, we established Varvakeio TED-Ed Club, an environment that supports and empowers our students to research, develop and disseminate their own personal ideas that worth spreading. During the year, our members were inspired by watching TED talks presented by experts on their field on various different areas, including social, economical, environmental and technological-scientific issues. Our aim

  6. Genetic variation in the functional ENG allele inherited from the non-affected parent associates with presence of pulmonary arteriovenous malformation in hereditary hemorrhagic telangiectasia 1 (HHT1) and may influence expression of PTPN14.

    PubMed

    Letteboer, Tom G W; Benzinou, Michael; Merrick, Christopher B; Quigley, David A; Zhau, Kechen; Kim, Il-Jin; To, Minh D; Jablons, David M; van Amstel, Johannes K P; Westermann, Cornelius J J; Giraud, Sophie; Dupuis-Girod, Sophie; Lesca, Gaetan; Berg, Jonathan H; Balmain, Allan; Akhurst, Rosemary J

    2015-01-01

    HHT shows clinical variability within and between families. Organ site and prevalence of arteriovenous malformations (AVMs) depend on the HHT causative gene and on environmental and genetic modifiers. We tested whether variation in the functional ENG allele, inherited from the unaffected parent, alters risk for pulmonary AVM in HHT1 mutation carriers who are ENG haploinsufficient. Genetic association was found between rs10987746 of the wild type ENG allele and presence of pulmonary AVM [relative risk = 1.3 (1.0018-1.7424)]. The rs10987746-C at-risk allele associated with lower expression of ENG RNA in a panel of human lymphoblastoid cell lines (P = 0.004). Moreover, in angiogenically active human lung adenocarcinoma tissue, but not in uninvolved quiescent lung, rs10987746-C was correlated with expression of PTPN14 (P = 0.004), another modifier of HHT. Quantitative TAQMAN expression analysis in a panel of normal lung tissues from 69 genetically heterogeneous inter-specific backcross mice, demonstrated strong correlation between expression levels of Eng, Acvrl1, and Ptpn14 (r2 = 0.75-0.9, P < 1 × 10(-12)), further suggesting a direct or indirect interaction between these three genes in lung in vivo. Our data indicate that genetic variation within the single functional ENG gene influences quantitative and/or qualitative differences in ENG expression that contribute to risk of pulmonary AVM in HHT1, and provide correlative support for PTPN14 involvement in endoglin/ALK1 lung biology in vivo. PTPN14 has been shown to be a negative regulator of Yap/Taz signaling, which is implicated in mechanotransduction, providing a possible molecular link between endoglin/ALK1 signaling and mechanical stress. EMILIN2, which showed suggestive genetic association with pulmonary AVM, is also reported to interact with Taz in angiogenesis. Elucidation of the molecular mechanisms regulating these interactions in endothelial cells may ultimately provide more rational choices for HHT therapy.

  7. A high-throughput screen of the GTPase activity of Escherichia coli EngA to find an inhibitor of bacterial ribosome biogenesis

    PubMed Central

    Bharat, Amrita; Blanchard, Jan E.; Brown, Eric D.

    2014-01-01

    The synthesis of ribosomes is an essential process, which is aided by a variety of transacting factors in bacteria. Among these is a group of GTPases essential for bacterial viability and emerging as promising targets for new antibacterial agents. Herein, we describe a robust high-throughput screening process for inhibitors of one such GTPase, the Escherichia coli EngA protein. The primary screen employed an assay of phosphate production in 384-well density. Reaction conditions were chosen to maximize sensitivity for the discovery of competitive inhibitors while maintaining a strong signal amplitude and low noise. In a pilot screen of 31,800 chemical compounds, 44 active compounds were identified. Further, we describe the elimination of non-specific inhibitors that were detergent-sensitive or reactive as well as those that interfered with the high-throughput phosphate assay. Four inhibitors survived these common counter-screens for non-specificity but these chemicals were also inhibitors of the unrelated enzyme dihydrofolate reductase, suggesting that they too were promiscuously active. The high-throughput screen of the EngA protein described here provides a meticulous pilot study in the search for specific inhibitors of GTPases involved in ribosome biogenesis. PMID:23606650

  8. PREFACE: EDS2010 Preface

    NASA Astrophysics Data System (ADS)

    Heggie, Malcolm I.

    2011-03-01

    The biennial international conference on Extended Defects in Semiconductors started in 1978 with a meeting in Hünfeld, Germany. Subsequent meetings rotated between Poland, France, Great Britain, Germany, Russia and Italy, culminating in EDS2004 in Chernogolovka, EDS2006 in Halle and EDS2008 in Poitiers. EDS2010 was held at the University of Sussex at Brighton, UK from September 19th to 24th. An extension of the tabulation of this history, which first appeared on the EDS2006 website, is given in the attached PDF. It is with sadness that we note one of the founders of the series, Prof. Dr Helmut Alexander, passed away on 3 December 2009 and we were proud to dedicate EDS2010 to his memory. It has become a tradition to make an award in his name, and this year it was made to Ivan Isacov for his poster "Electrical levels of dislocation networks in p- and n-type silicon". A short and warm celebration of Prof. Dr Alexander's life by his friends and colleagues, Prof. Drs Helmut Gottschalk, Eicke Weber and Wolfgang Schröter, is included in this volume. The conference was a forum for the state-of-the-art of investigation and modelling of extended defects in semiconductors. Scientists from universities, research institutes and industry made contributions to a deeper understanding of extended defects, their interaction with point defects and their role in the development of semiconductor technology. The remit of the conference included extended defects, nanostructures, nanoparticles, quantum dots and interfaces within semiconducting materials ranging from narrow to wide band gaps, including graphene-derived materials and diamond. Scientific interests range from defect geometry, electronic structure, dynamics, spectroscopy, microscopy, reactions and chemistry to introduction mechanisms, such as implantation and strained layers and the operation of devices such as integrated circuits, heterostructures, and solar cells. The organisers were confronted with a long period between

  9. Rebooting the EdD

    ERIC Educational Resources Information Center

    Wergin, Jon F.

    2011-01-01

    In this essay, Jon Wergin reminds readers of the philosophical and historical foundations of the doctor of education (EdD) degree. He argues that the EdD should be based, in large part, on John Dewey's progressive ideals of democratization and Paulo Freire's concepts of emancipatory education. Drawing on theories of reflective practice,…

  10. A Quantitative Content Analysis of Mercer University MEd, EdS, and Doctoral Theses

    ERIC Educational Resources Information Center

    Randolph, Justus J.; Gaiek, Lura S.; White, Torian A.; Slappey, Lisa A.; Chastain, Andrea; Harris, Rose Prejean

    2010-01-01

    Quantitative content analysis of a body of research not only helps budding researchers understand the culture, language, and expectations of scholarship, it helps identify deficiencies and inform policy and practice. Because of these benefits, an analysis of a census of 980 Mercer University MEd, EdS, and doctoral theses was conducted. Each thesis…

  11. What Is Ag-Ed?

    ERIC Educational Resources Information Center

    Lindley, Judy

    Ag-Ed is an agricultural education project aimed at upper primary students, held in conjunction with the Toowoomba Show (similar to a county fair) in Queensland, Australia. The program achieves its purpose of helping children understand the impact and relevance that agriculture has on their everyday lives through two components, an Ag-Ed day and a…

  12. Field-reversed configuration (FRC) experiments

    NASA Astrophysics Data System (ADS)

    Siemon, R. E.; Chrien, R. E.; Hugrass, W. N.; Okada, S.; Rej, D. J.; Taggart, D. P.; Tuszewski, M.; Webster, R. B.; Wright, B. L.; Slough, J. T.

    FRCs with equilibrium separatrix radii up to 0.18 m have been formed and studied in FRX-C/LSM. For best formation conditions at low fill pressure, the particle confinement exceeds the predictions of LHD transport calculations by up to a factor of two; however, the inferred flux confinement is more anomalous than in smaller FRCs. Higher bias field produces axial shocks and degradation in confinement, while higher fill pressure results in gross fluting during formation. FRCs have been formed in TRX with s from 2 to 6. These relatively collisional FRCs exhibit flux lifetimes of 10 yields 20 kinetic growth times for the internal tilt mode. The coaxial slow source has produced annular FRCs in a coaxial coil geometry on slow time scales using low voltages.

  13. The use of mechanical ventilation in the ED.

    PubMed

    Easter, Benjamin D; Fischer, Christopher; Fisher, Jonathan

    2012-09-01

    Although EDs are responsible for the initial care of critically ill patients and the amount of critical care provided in the ED is increasing, there are few data examining mechanical ventilation (MV) in the ED. In addition, characteristics of ED-based ventilation may affect planning for ventilator shortages during pandemic influenza or bioterrorist events. The study examined the epidemiology of MV in US EDs, including demographic, clinical, and hospital characteristics; indications for MV; ED length of stay (LOS); and in-hospital mortality. This study was a retrospective review of the 1993 to 2007 National Hospital Ambulatory Medical Care Survey ED data sets. Ventilated patients were compared with ED patients admitted to the intensive care unit (ICU) and to all other ED visits. There were 3.6 million ED MV visits (95% confidence interval [CI], 3.2-4.0 million) over the study period. Sex, age, race, and payment source were similar for mechanically ventilated and ICU patients (P > .05 for all). Approximately 12.5% of ventilated patients underwent cardiopulmonary resuscitation compared with 1.7% of ICU admissions and 0.2% of all other ED visits (P < .0001). Accordingly, in-hospital mortality was significantly higher for ventilated patients (24%; 95% CI, 13.1%-34.9%) than both comparison groups (9.3% and 2.5%, respectively). Median LOS for ventilated patients was 197 minutes (interquartile range, 112-313 minutes) compared with 224 minutes for ICU admissions and 140 minutes for all other ED visits. Patients undergoing ED MV have particularly high in-hospital mortality rates, but their ED LOS is sufficient for implementation of evidence-based ventilator interventions. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Population-based burden of COPD-related visits in the ED: return ED visits, hospital admissions, and comorbidity risks.

    PubMed

    Yeatts, Karin B; Lippmann, Steven J; Waller, Anna E; Hassmiller Lich, Kristen; Travers, Debbie; Weinberger, Morris; Donohue, James F

    2013-09-01

    Little is known about the population-based burden of ED care for COPD. We analyzed statewide ED surveillance system data to quantify the frequency of COPD-related ED visits, hospital admissions, and comorbidities. In 2008 to 2009 in North Carolina, 97,511 COPD-related ED visits were made by adults ≥ 45 years of age, at an annual rate of 13.8 ED visits/1,000 person-years. Among patients with COPD (n = 33,799), 7% and 28% had a COPD-related return ED visit within a 30- and 365-day period of their index visit, respectively. Compared with patients on private insurance, Medicare, Medicaid, and noninsured patients were more likely to have a COPD-related return visit within 30 and 365 days and have three or more COPD-related visits within 365 days. There were no differences in return visits by sex. Fifty-one percent of patients with COPD were admitted to the hospital from the index ED visit. Subsequent hospital admission risk in the cohort increased with age, peaking at 65 to 69 years (risk ratio [RR], 1.41; 95% CI, 1.26-1.57); there was no difference by sex. Patients with congestive heart failure (RR, 1.29; 95% CI, 1.22-1.37), substance-related disorders (RR, 1.35; 95% CI, 1.13-1.60), or respiratory failure/supplemental oxygen (RR, 1.25; 95% CI, 1.19-1.31) were more likely to have a subsequent hospital admission compared with patients without these comorbidities. The population-based burden of COPD-related care in the ED is significant. Further research is needed to understand variations in COPD-related ED visits and hospital admissions.

  15. Fragmented red cells reference range (Sysmex XN(®) automated blood cell counter).

    PubMed

    Lesesve, Jean-François; Daigney, Amandine; Henry, Sylvain; Speyer, Elodie

    2015-01-01

    Fragmented red cells (FRCs) is a new parameter automatedly determined by recent blood cell counters. Their count might be of interest because FRCs are supposed to reflect schistocytes counts measured on a stained peripheral blood smear observed under the microscope. But FRCs depend from the technical procedure used to detect them and thus reference ranges are device-dependent. The XN-9000(®) is one of the last model from Sysmex series. We aimed to establish reference range for FRCs, from 2389 controls. The mean ± SD was 0.32% ± 0.81, the median 0.02% (95% confidence interval ot the mean: 0.29-0.35%). We observed that the percentage of red blood cells with less than 17 pg of hemoglobin content (Hypo-He) was correlated to FRC increase, Hypo-He increase resulting in spurious FRCs majoration. FRCs reference range should be useful for: 1) laboratory staff in order to select which blood smears to check optically; 2) Sysmex company to set-up more optimal rules proposed with the counter (automated making of blood smear).

  16. Expedition 7 Crew Interview: Ed Lu

    NASA Technical Reports Server (NTRS)

    2003-01-01

    Ed Lu of Expedition Seven is seen during a pre-launch interview. He explains why he became interested in space flight. He states that this is a different type of mission and gives his reaction to the Columbia Space Shuttle tragedy. The handover of Expedition six is explained by Ed Lu. The challenges of this mission are also described by Lu. These challenges include working with a crew member reduction from three to two, and the conservation of clothing and consumables. Ed Lu talks about what it is like to work with commander Yuri Malenchenko in space. Finally, Ed Lu states that he will continue scientific experiments in space on calcium loss in bones.

  17. Characterising non-urgent users of the emergency department (ED): A retrospective analysis of routine ED data.

    PubMed

    O'Keeffe, Colin; Mason, Suzanne; Jacques, Richard; Nicholl, Jon

    2018-01-01

    The pressures of patient demand on emergency departments (EDs) continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings such as primary care. This study used routine ED data to define, measure and profile non-urgent ED attendances that were suitable for management in alternative, non-emergency settings. We undertook a retrospective analysis of three years of Hospital Episode and Statistics Accident Emergency (HES A&E) data for one large region in England, United Kingdom (April 1st 2011 to March 31st 2014). Data was collected on all adult (>16 years) ED attendances from each of the 19 EDs in the region. A validated process based definition of non-urgent attendance was refined for this study and applied to the data. Using summary statistics non-urgent attenders were examined by variables hypothesised to influence them as follows: age at arrival, time of day and day of week and mode of arrival. Odds ratios were calculated to compare non-urgent attenders between groups. There were 3,667,601 first time attendances to EDs, of which 554,564 were defined as non-urgent (15.1%). Non-urgent attendances were significantly more likely to present out of hours than in hours (OR = 1.19, 95% CI: 1.18 to 1.20, P<0.001). The odds of a non-urgent attendance were significantly higher for younger patients (aged 16-44) compared to those aged 45-64 (odds ratio: 1.42, 95% CI: 1.41 to 1.43, P<0.001) and the over 65's (odds ratio: 3.81, 95% CI: 3.78 to 3.85, P<0.001). Younger patients were significantly more likely to attend non-urgently out of hours compared to the 45-64's (OR = 1.24, 95% CI: 1.22 to 1.25, P<0.001) and the 65+'s (OR = 1.38, 95% CI: 1.35 to 1.40, P<0.001). 110,605/554,564 (19.9%) of the non-urgent attendances arrived by ambulance, increasing significantly out of hours versus in hours (OR = 2.12, 95

  18. An Instrument to Study State-Wide Implementation of edTPA: Validating the Levels of edTPA Integration Survey

    ERIC Educational Resources Information Center

    Bhatnagar, Ruchi; Kim, Jihye; Many, Joyce E.

    2017-01-01

    Use of edTPA for preservice teacher assessment is becoming increasingly common across the country, with some states, including Georgia, mandating the passing of the edTPA for initial teacher licensure. This state-wide study investigated whether edTPA as a new policy initiative was being integrated by the teacher education programs and faculty in…

  19. Mechanical Ventilation and ARDS in the ED

    PubMed Central

    Mohr, Nicholas M.; Miller, Christopher N.; Deitchman, Andrew R.; Castagno, Nicole; Hassebroek, Elizabeth C.; Dhedhi, Adam; Scott-Wittenborn, Nicholas; Grace, Edward; Lehew, Courtney; Kollef, Marin H.

    2015-01-01

    BACKGROUND: There are few data regarding mechanical ventilation and ARDS in the ED. This could be a vital arena for prevention and treatment. METHODS: This study was a multicenter, observational, prospective, cohort study aimed at analyzing ventilation practices in the ED. The primary outcome was the incidence of ARDS after admission. Multivariable logistic regression was used to determine the predictors of ARDS. RESULTS: We analyzed 219 patients receiving mechanical ventilation to assess ED ventilation practices. Median tidal volume was 7.6 mL/kg predicted body weight (PBW) (interquartile range, 6.9-8.9), with a range of 4.3 to 12.2 mL/kg PBW. Lung-protective ventilation was used in 122 patients (55.7%). The incidence of ARDS after admission from the ED was 14.7%, with a mean onset of 2.3 days. Progression to ARDS was associated with higher illness severity and intubation in the prehospital environment or transferring facility. Of the 15 patients with ARDS in the ED (6.8%), lung-protective ventilation was used in seven (46.7%). Patients who progressed to ARDS experienced greater duration in organ failure and ICU length of stay and higher mortality. CONCLUSIONS: Lung-protective ventilation is infrequent in patients receiving mechanical ventilation in the ED, regardless of ARDS status. Progression to ARDS is common after admission, occurs early, and worsens outcome. Patient- and treatment-related factors present in the ED are associated with ARDS. Given the limited treatment options for ARDS, and the early onset after admission from the ED, measures to prevent onset and to mitigate severity should be instituted in the ED. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01628523; URL: www.clinicaltrials.gov PMID:25742126

  20. CERES GEO Ed4 Available Data

    Atmospheric Science Data Center

    2017-10-11

    ... Spatial Resolution Temporal Coverage CER_GEO_Ed4_GOE08 Hourly 2-4km observation at nadir, subsampled every 8-9 km 2000-03-01 to 2003-04-01 CER_GEO_Ed4_GOE09 Hourly 2-4km observation at nadir, subsampled ...

  1. ED leadership competency matrix: an administrative management tool.

    PubMed

    Propp, Douglas A; Glickman, Seth; Uehara, Dennis T

    2003-10-01

    A successful ED relies on its leaders to master and demonstrate core competencies to be effective in the many arenas in which they interact and are responsible. A unique matrix model for the assessment of an ED leadership's key administrative skill sets is presented. The model incorporates capabilities related to the individual's cognitive aptitude, experience, acquired technical skills, behavioral characteristics, as well as the ability to manage relationships effectively. Based on the personnel inventory using the matrix, focused evaluation, development, and recruitment of ED key leaders occurs. This dynamic tool has provided a unique perspective for the evaluation and enhancement of overall ED leadership performance. It is hoped that incorporation of such a model will similarly improve the accomplishments of EDs at other institutions.

  2. Regional Energy Deployment System (ReEDS) | Energy Analysis | NREL

    Science.gov Websites

    System Model The Regional Energy Deployment System (ReEDS) model helps the U.S. Department of model. Visualize Future Capacity Expansion of Renewable Energy Watch this video of the ReEDS model audio. Model Documentation ReEDS Model Documentation: Version 2016 ReEDS Map with Numbered Regions

  3. Using Kentucky State Standards as Benchmarks: Quantifying Incoming Ed.S. Students' Knowledge as They Journey toward Principalship

    ERIC Educational Resources Information Center

    Hearn, Jessica E.

    2015-01-01

    Principal preparation programs in Kentucky can use the items in the Dispositions, Dimensions, and Functions for School Leaders (EPSB, 2008) as mastery benchmarks to quantify incoming Educational Specialist (Ed.S) students' perceived level of mastery. This can serve both internal and external purposes by providing diagnostic feedback to students…

  4. TechEdSat Nano-Satellite Series Fact Sheet

    NASA Technical Reports Server (NTRS)

    Murbach, Marcus; Martinez, Andres; Guarneros Luna, Ali

    2014-01-01

    TechEdSat-3p is the second generation in the TechEdSat-X series. The TechEdSat Series uses the CubeSat standards established by the California Polytechnic State University Cal Poly), San Luis Obispo. With typical blocks being constructed from 1-unit (1U 10x10x10 cm) increments, the TechEdSat-3p has a 3U volume with a 30 cm length. The project uniquely pairs advanced university students with NASA researchers in a rapid design-to-flight experience lasting 1-2 semesters.The TechEdSat Nano-Satellite Series provides a rapid platform for testing technologies for future NASA Earth and planetary missions, as well as providing students with an early exposure to flight hardware development and management.

  5. Janos Hunyadi: Preventing the Ottomans from Conquering Western Europe in the Fifteenth Century

    DTIC Science & Technology

    2011-12-16

    SCIENCE Military History by BARNABÁS BARTÓK, MAJOR, HUNGARIAN ARMY B.Eng., Miklós Zrínyi National Defence University, Budapest , 1998...of the Hungarian nation] ( Budapest : Atheneum, 1928), ed. Arcanum Adatbázis Kft., (2001) http://mek.oszk.hu/09400/09477/html/0002/126.html (accessed...35János Thuróczi, Chronica Hungarorum (Augsburg, 1488), ed. János Horváth, ( Budapest : Magyar Helikon, 1978), 373. János Thuróczi wrote

  6. Expression of fibronectin ED-A+ and ED-B+ isoforms by human and experimental colorectal cancer. Contribution of cancer cells and tumor-associated myofibroblasts.

    PubMed Central

    Pujuguet, P.; Hammann, A.; Moutet, M.; Samuel, J. L.; Martin, F.; Martin, M.

    1996-01-01

    Alternative splicing of primary fibronectin (FN) mRNA results in the synthesis of different isoforms. ED-A+ and ED-B+ FN isoforms are absent from plasma FN and are representative of cellular FN. Their expression was studied in human and rat normal colon, in human colorectal carcinomas, and in transplanted tumors derived from a chemically-induced rat colon cancer. In normal colon, only the ED-A+ FN isoform was expressed as a thin deposit between crypt colonocytes and pericryptal myofibroblasts. Conversely, heavy ED-A+ FN deposits and lighter ED-B+ FN expression were found in the stroma of colorectal tumors in association with myofibroblasts surrounding tumor glands. Some colonic cancer cells also contained intracellular FN isoform granules and expressed FN mRNA. Tumor-associated myofibroblasts and some cancer cell lines were able to synthesize and deposit extracellular ED-A+ and ED-B+ FN in vitro. FN isoform deposition by tumor-associated myofibroblasts was not modulated by colon cancer cell-conditioned medium, but was strongly enhanced when myofibroblasts were cultured on colon cancer cell extracellular matrix or on laminin. These results show that the ED-A+ and ED-B+ FN isoforms were overexpressed in colorectal cancer. Cancer cells can deposit these FN isoforms directly and also stimulate their deposition by tumor-associated myofibroblasts. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 7 PMID:8579120

  7. ED breast cases and other breast emergencies.

    PubMed

    Khadem, Nasim; Reddy, Sravanthi; Lee, Sandy; Larsen, Linda; Walker, Daphne

    2016-02-01

    Patients with pathologic processes of the breast commonly present in the Emergency Department (ED). Familiarity with the imaging and management of the most common entities is essential for the radiologist. Additionally, it is important to understand the limitations of ED imaging and management in the acute setting and to recognize when referrals to a specialty breast center are necessary. The goal of this article is to review the clinical presentations, pathophysiology, imaging, and management of emergency breast cases and common breast pathology seen in the ED.

  8. Completing EdTPA: TSOL Candidate Performance and Reflection

    ERIC Educational Resources Information Center

    Micek, Timothy A.

    2017-01-01

    edTPA is a pre-service assessment process designed to determine if a new teacher is ready for the job. edTPA is part of a national movement towards the use of performance assessments in teacher education. As of 2014, 41 states (a) require a state-approved performance assessment like edTPA for program completion or for state licensure and/or state…

  9. The ED use and non-urgent visits of elderly patients.

    PubMed

    Gulacti, Umut; Lok, Ugur; Celik, Murat; Aktas, Nurettin; Polat, Haci

    2016-12-01

    To evaluate the use of the emergency department (ED) by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits. This cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively. A total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patients was higher than their representation within the general population (p < 0.001). While the rate of elderly patients visiting polyclinics was 15.8%, the rate of elderly patients visiting the ED was 24.3% (p < 0.001). For both genders, the rates of ED visits for patients between 65 and 74 years old was higher than for other elderly age groups (p < 0.001). The prevalence of upper respiratory tract infection (URTI) was the highest within the elderly population (17.5%, CI: 17.1-17.9). The proportion of ED visits for non-urgent conditions was 23.4%. Most of the ED visits were during the non-business hours (51.1%), and they were highest in the winter season (25.9%) and in January (10.2%). The hospitalization rate was 9.4%, and 37.9% of hospitalized patients were admitted to intensive care units. The proportion of ED visits by elderly patients was higher than their representation within the general population. Elderly patients often visited the ED instead of a polyclinic. The rate of inappropriate ED use by elderly patients in this hospital was higher than in other countries.

  10. Erectile Dysfunction (ED)

    MedlinePlus

    ... Talking to Your Kids About VirginityTalking to Your Kids About Sex Home Diseases and Conditions Erectile Dysfunction (ED) Condition ... Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth Control ... and Toddlers Kids and Teens Pregnancy and Childbirth Women Men Seniors ...

  11. Structure of catalase determined by MicroED

    PubMed Central

    Nannenga, Brent L; Shi, Dan; Hattne, Johan; Reyes, Francis E; Gonen, Tamir

    2014-01-01

    MicroED is a recently developed method that uses electron diffraction for structure determination from very small three-dimensional crystals of biological material. Previously we used a series of still diffraction patterns to determine the structure of lysozyme at 2.9 Å resolution with MicroED (Shi et al., 2013). Here we present the structure of bovine liver catalase determined from a single crystal at 3.2 Å resolution by MicroED. The data were collected by continuous rotation of the sample under constant exposure and were processed and refined using standard programs for X-ray crystallography. The ability of MicroED to determine the structure of bovine liver catalase, a protein that has long resisted atomic analysis by traditional electron crystallography, demonstrates the potential of this method for structure determination. DOI: http://dx.doi.org/10.7554/eLife.03600.001 PMID:25303172

  12. Association of ED with chronic periodontal disease.

    PubMed

    Matsumoto, S; Matsuda, M; Takekawa, M; Okada, M; Hashizume, K; Wada, N; Hori, J; Tamaki, G; Kita, M; Iwata, T; Kakizaki, H

    2014-01-01

    To examine the relationship between chronic periodontal disease (CPD) and ED, the interview sheet including the CPD self-checklist (CPD score) and the five-item version of the International Index of Erectile Function (IIEF-5) was distributed to 300 adult men who received a comprehensive dental examination. Statistical analyses were performed by the Spearman's rank correlation coefficient and other methods. Statistical significance was accepted at the level of P<0.05. The interview sheets were collected from 88 men (response rate 29.3%, 50.9±16.6 years old). There was a statistically significant correlation between the CPD score and the presence of ED (P=0.0415). The results in the present study suggest that ED is related to the damage caused by endothelial dysfunction and the systematic inflammatory changes associated with CPD. The present study also suggests that dental health is important as a preventive medicine for ED.

  13. ED presentations of acute renal infarction.

    PubMed

    Huang, Chien-Cheng; Lo, Hong-Chang; Huang, Hsien-Hao; Kao, Wei-Fong; Yen, David Hung-Tsang; Wang, Lee-Min; Huang, Chun-I; Lee, Chen-Hsen

    2007-02-01

    The objective of the study was to investigate initial clinical characteristics that can suggest an early diagnosis of patients with acute renal infarction presenting with flank and/or abdominal pain in the emergency department (ED). From January 1, 1996, through December 31, 2005, 20 adult patients with renal infarction diagnosed by contrast-enhanced computed tomography in the ED were enrolled. Medical records, including demographic data, risk factors for thromboembolism, initial clinical presentations, laboratory data, treatment programs and outcomes, were retrospectively reviewed and analyzed. Mean patient age was 60.3 years (range, 21-80). The estimated incidence of renal infarction was 0.004% (20 of 481,540) among the ED census. The median time of onset of symptoms before the ED visit was 31 hours (range, 1-285). Eighteen patients (90%) had a history of more than 1 risk factor for thromboembolic events. In clinical presentations, all the patients had either abdominal or flank pain and tenderness. Nineteen patients (95%) had an elevated serum lactate dehydrogenase level with a mean +/- SD of 812.1 +/- 569.4 U/L. Sixteen patients (80%) presented with the triad--persisting flank or abdominal pain/tenderness, elevated serum lactate dehydrogenase level, and proteinuria. Among all 20 patients, 10 patients (50%) were diagnosed as having renal infarction at the initial ED visit. No specific clinical characteristics could be identified to distinguish those patients diagnosed early and those with delayed diagnosis. All 20 patients received medical treatment with coumadin, which was given in combination with heparin treatment in 11, peripheral intravenous and/or local intra-arterial thrombolytics with urokinase in 5, and mitral valve replacement in 1. No patient died. Although 4 patients had a mildly elevated serum creatinine level (>1.5 mg/dL) during hospitalization, none of them needs dialysis after more than 1 year of follow-up. In this study, we delineated

  14. ED"Facts" Workbook: SY 2013-14. Version 10.1

    ERIC Educational Resources Information Center

    US Department of Education, 2014

    2014-01-01

    ED"Facts" is a U.S. Department of Education (ED) initiative to govern, acquire, validate, and use high-quality, kindergarten through grade 12 (K-12) performance data for education planning, policymaking, and management and budget decision making to improve outcomes for students. ED"Facts" centralizes data provided by state…

  15. Chemical Design of Elastomers

    DTIC Science & Technology

    1987-05-19

    of the accelerated vulcanizates. In the 1960s Campbell, Wise and Coran (52) developed characterization techniques to study the effects of compounding...34, Oae, S., Ed., Plenum Press, New York, 1977. 5. Coran , A.Y., "Vulcanization", in "Science and Technology of Rubber," Eirich, F.R., Ed., Academic Press...New York, 1978. 6. Coran , A.Y., Chemtech 106(1983). 7. Coleman, M.M., Shelton J.R. and Koenig, J.L., Ind. Eng. Chem., Prod. Res. Develop. 13, 155

  16. The Impact of "ED" on Educational Research.

    ERIC Educational Resources Information Center

    Florio, David H.

    1980-01-01

    The purposes, structure, and component parts of the newly formed Department of Education (ED) organizations from which educational research programs will be administered are discussed. As the climate surrounding ED changes, opportunities to take advantage of the elevated status of research will be presented. (Author/RL)

  17. ReflectED: Evaluation Report and Executive Summary

    ERIC Educational Resources Information Center

    Motteram, Gary; Choudry, Sophina; Kalambouka, Afroditi; Hutcheson, Graeme; Barton, Hutcheson

    2016-01-01

    The ReflectED programme was developed by Rosendale Primary School to improve pupils' metacognition--their ability to think about and manage their own learning. This includes the skills of setting and monitoring goals, assessing progress, and identifying personal strengths and challenges. ReflectED consists of 28, weekly, half-hour lessons, which…

  18. The Wetting Behavior of Imidazolium-Containing, Room-Temperature Molten Salt.

    DTIC Science & Technology

    1984-08-28

    America, Inc.), Celgard 2500 and 3501 polypropylene film (Celanese Corp.) with 45% porosity and 0.04-pm pore size, and reticulated vitreous carbon or...E. Matijevic, ed., Wiley-Interscience, New York, pp. 85-153 (1969). (9) A. M. Schwartz , "Capillarity: Theory and Practice," Ind. Eng. Chem., 61, 10

  19. Mesenteric lymph node stromal cell‐derived extracellular vesicles contribute to peripheral de novo induction of Foxp3+ regulatory T cells

    PubMed Central

    Pasztoi, Maria; Pezoldt, Joern; Beckstette, Michael; Lipps, Christoph; Wirth, Dagmar; Rohde, Manfred; Paloczi, Krisztina; Buzas, Edit Iren

    2017-01-01

    Abstract Intestinal regulatory T cells (Tregs) are fundamental in peripheral tolerance toward commensals and food‐borne antigens. Accordingly, gut‐draining mesenteric lymph nodes (mLNs) represent a site of efficient peripheral de novo Treg induction when compared to skin‐draining peripheral LNs (pLNs), and we had recently shown that LN stromal cells substantially contribute to this process. Here, we aimed to unravel the underlying molecular mechanisms and generated immortalized fibroblastic reticular cell lines (iFRCs) from mLNs and pLNs, allowing unlimited investigation of this rare stromal cell subset. In line with our previous findings, mLN‐iFRCs showed a higher Treg‐inducing capacity when compared to pLN‐iFRCs. RNA‐seq analysis focusing on secreted molecules revealed a more tolerogenic phenotype of mLN‐ as compared to pLN‐iFRCs. Remarkably, mLN‐iFRCs produced substantial numbers of microvesicles (MVs) that carried elevated levels of TGF‐β when compared to pLN‐iFRC‐derived MVs, and these novel players of intercellular communication were shown to be responsible for the tolerogenic properties of mLN‐iFRCs. Thus, stromal cells originating from mLNs contribute to peripheral tolerance by fostering de novo Treg induction using TGF‐β‐carrying MVs. This finding provides novel insights into the subcellular/molecular mechanisms of de novo Treg induction and might serve as promising tool for future therapeutic applications to treat inflammatory disorders. PMID:28833065

  20. MedEdPORTAL: Educational Scholarship for Teaching

    ERIC Educational Resources Information Center

    Reynolds, Robby J.; Candler, Christopher S.

    2008-01-01

    MedEdPORTAL is an online publication service provided at no charge by the Association of American Medical Colleges (AAMC). The intent is to promote collaboration and educational scholarship by helping educators publish and share educational resources. With MedEdPORTAL, users can quickly locate high-quality, peer-reviewed teaching materials in both…

  1. Erectile dysfunction (ED) is a shared sexual concern of couples II: association of female partner characteristics with male partner ED treatment seeking and phosphodiesterase type 5 inhibitor utilization.

    PubMed

    Fisher, William A; Eardley, Ian; McCabe, Marita; Sand, Michael

    2009-11-01

    Erectile dysfunction (ED) is a prevalent condition that impacts on both patients and their female partners. ED may therefore be regarded as a shared sexual concern for couples. The current analysis of the Female Experience of Men's Attitudes to Life Events and Sexuality (FEMALES) study data addresses women's perceptions, beliefs, and attitudes concerning their partner's ED, and whether these are associated with the likelihood of the male partner seeking medical advice and utilizing phosphodiesterase type 5 inhibitors. The current research sought to explore the association of female partners' perceptions of male partners' ED and male partners' medical consultation and treatment seeking for ED. Questionnaires were sent to partners of men who participated in the Men's Attitudes to Life Events and Sexuality (MALES) 2004 study, and who consented to their partner's involvement. A modified version of the questionnaire used in the MALES study was developed for the FEMALES study, reflecting the female partner's perspective. A 65-item questionnaire assessing women's perceptions, beliefs, and attitudes regarding various aspects of ED. Women's perceptions of the nature and causes of their partner's ED were significantly associated with men's treatment seeking and utilization. Significant associations were observed between women's level of satisfaction with the relationship before ED onset; perceptions of the impact of ED on quality of life; desire to deal with ED; attitudes to ED treatment; and the treatment-seeking behavior of the male partner. Multivariate regression analyses identified a mixture of female and male partner perceptions and attitudes that uniquely accounted for >30% of the variance in men's ED treatment-seeking behavior and treatment utilization. This study illustrates the importance of the female partner's attitudes to ED in men's ED treatment-seeking behavior. These findings strongly support the potential benefits of partner integration into ED consultation

  2. Prevalence and correlates of erectile dysfunction (ED) and treatment seeking for ED in Asian Men: the Asian Men's Attitudes to Life Events and Sexuality (MALES) study.

    PubMed

    Tan, Hui-Meng; Low, Wah Yun; Ng, Chirk Jenn; Chen, Kuang-Kuo; Sugita, Minoru; Ishii, Nobuhisa; Marumo, Ken; Lee, Sung Won; Fisher, William; Sand, Michael

    2007-11-01

    There have been limited multiregional studies in Asia examining the parameters of men's general and sexual health and quality of life in the general population vs. those in clinical cohorts of patients with erectile dysfunction (ED). The aims of the Asian Men's Attitudes to Life Events and Sexuality (Asian MALES) study were to investigate the prevalence of ED, associated health conditions, and ED treatment-seeking patterns in the general male population in five regions of Asia (China, Japan, Korea, Malaysia, and Taiwan). Standardized questionnaire previously used in a similar multiregional study and modified to ensure culturally appropriate content for Asia. Phase I of the study involved 10,934 adult men, aged 20-75 years, who were interviewed using the standardized questionnaire. Phase II of the study involved men with self-reported ED recruited from Phase I and via physician referral, invitations in general practitioner offices, and street interception (total Phase II sample, N = 1,209). The overall prevalence of self-reported ED in the Phase I study population was 6.4%. ED prevalence varied by region and significantly increased with age (P < 0.01). Men with ED reported significantly greater rates of comorbid illness (P < 0.0001) and a reduced quality of life (P = 0.0001), compared with men without ED. Phase II of the study revealed that fewer than half of men with self-reported ED had sought treatment for their problem. Men were more likely to seek help for erection difficulties from Western doctors than from traditional medicine practitioners (P = 0.0001). A man's partner/spouse was the most common influencer of treatment seeking in all regions except Malaysia. The findings confirm those of existing research on ED in both Asian and non-Asian males: ED is a prevalent condition; the prevalence of ED increases with age and is strongly associated with comorbid conditions; and the majority of men have never sought treatment for their condition. This study highlights

  3. An Analysis of EMS and ED Detection of Stroke.

    PubMed

    Medoro, Ian; Cone, David C

    2017-01-01

    Studies have shown a reduction in time-to-CT and improved process measures when EMS personnel notify the ED of a "stroke alert" from the field. However, there are few data on the accuracy of these EMS stroke alerts. The goal of this study was to examine diagnostic test performance of EMS and ED stroke alerts and related process measures. The EMS and ED records of all stroke alerts in a large tertiary ED from August 2013-January 2014 were examined and data abstracted by one trained investigator, with data accuracy confirmed by a second investigator for 15% of cases. Stroke alerts called by EMS prior to ED arrival were compared to stroke alerts called by ED physicians and nurses (for walk-in patients, and patients transported by EMS without EMS stroke alerts). Means ± SD, medians, unpaired t-tests (for continuous data), and two-tailed Fisher's exact tests (for categorical data) were used. Of 260 consecutive stroke alerts, 129 were EMS stroke alerts, and 131 were ED stroke alerts (70 called by physicians, 61 by nurses). The mean NIH Stroke Scale was higher in the EMS group (8.1 ± 7.6 vs. 3.0 ± 5.0, p < 0.0001). The positive predictive value of EMS stroke alerts was 0.60 (78/129), alerts by ED nurses was 0.25 (15/61), and alerts by ED physicians was 0.31 (22/70). The PPV for EMS was better than for nurses or physicians (both p < 0.001), and more patients in the EMS group had final diagnoses of stroke (62/129 vs. 24/131, p < 0.001). The positive likelihood ratio was 1.53 for EMS personnel, 0.45 for physicians, and 0.77 for nurses. The mean time to order the CT (8.5 ± 7.1 min vs. 23.1 ± 18.2 min, p < 0.0001) and the mean ED length of stay (248 ± 116 min vs. 283 ± 128 min, p = 0.022) were shorter for the EMS stroke alert group. More EMS stroke alert patients received tPA (16/129 vs. 6/131, p = 0.027). EMS stroke alerts have better diagnostic test performance than stroke alerts by ED staff, likely due to higher NIH Stroke Scale scores (more obvious

  4. An analysis on the roles of angiogenesis-related factors including serum vitamin D, soluble endoglin (sEng), soluble fms-like tyrosine kinase 1 (sFlt1), and vascular endothelial growth factor (VEGF) in the diagnosis and severity of late-onset preeclampsia.

    PubMed

    Cim, Numan; Kurdoglu, Mertihan; Ege, Serhat; Yoruk, Ibrahim; Yaman, Gorkem; Yildizhan, Recep

    2017-07-01

    The aim of this study was to evaluate the roles of proangiogenic factors including serum vitamin D and vascular endothelial growth factor (VEGF) and anti-angiogenic factors including soluble endoglin (sEng) and soluble fms-like tyrosine kinase 1 (sFlt1) in the diagnosis and severity of late-onset preeclampsia. The study was conducted at Yuzuncu Yil University Research and Education Hospital Department of Gynecology and Obstetrics. The study included a patient group of 40 women with late-onset preeclampsia who were pregnant at ≥32 weeks of gestation according to the last menstrual period (LMP) or ultrasonographic fetal biometric measurement and a control group of 40 healthy pregnant women who presented to our clinic for routine pregnancy examination and were at the same age and gestational period with those in the patient group. The two groups were compared in terms of maternal age, gravida, parity, week of gestation, systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, white blood cell (WBC), hemoglobin (Hgb), platelet count, urea, creatinine, liver function tests (AST, ALT, LDH), vitamin D 3 , 25(OH) vitamin D 3 , 1,25(OH) vitamin D 3 , sEng, sFlt1, and VEGF levels, mode of delivery, the infant APGAR score at 1 and 5 min after delivery, and infant weight at delivery. The groups were similar in terms of age, gravida, parity, week of gestation, serum vitamin D 3 , 25(OH) vitamin D 3 , 1,25(OH) 2 vitamin D 3 and VEGF levels, and infant weight at delivery (p > 0.05). Systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, WBC, Hgb, serum urea, creatine, AST, ALT, and LDH were significantly higher in the preeclamptic group compared to the healthy group (p < 0.05). However, thrombocyte level and the APGAR score at 1 and 5 min after delivery were significantly lower in the preeclamptic group compared to the healthy group (p < 0.05). No significant correlation was found between

  5. Electrostatic-Dipole (ED) Fusion Confinement Studies

    NASA Astrophysics Data System (ADS)

    Miley, George H.; Shrestha, Prajakti J.; Yang, Yang; Thomas, Robert

    2004-11-01

    The Electrostatic-Dipole (ED) concept significantly differs from a "pure" dipole confinement device [1] in that the charged particles are preferentially confined to the high-pressure region interior of the dipole coil by the assistance of a surrounding spherical electrostatic grid. In present ED experiments, a current carrying coil is embedded inside the grid of an IEC such as to produce a magnetic dipole field. Charged particles are injected axisymmetrically from an ion gun (or duo-plasmatron) into the center of the ED confinement grid/dipole ring where they oscillate along the magnetic field lines and pass the peak field region at the center of the dipole region. As particles begin accelerating away from the center region towards the outer electrostatic grid region, they encounter a strong electrostatic potential (order of 10's of kilovolts) retarding force. The particles then decelerate, reverse direction and re-enter the dipole field region where again magnetic confinement dominates. This process continues, emulating a complex harmonic oscillator motion. The resulting pressure profile averaged over the field curvature offers good plasma stability in the ED configuration. The basic concept and results from preliminary experiments will be described. [1] M.E. Mauel, et al. "Dipole Equilibrium and Stability," 18th IAEA Conference of Plasma Phys. and Control. Nuclear Fusion, Varenna, Italy 2000, IAEA-F1-CN-70/TH

  6. Understanding ED performance after the implementation of activity-based funding.

    PubMed

    Toloo, Ghasem-Sam; Burke, John; Crilly, Julia; Williams, Ged; McCann, Bridie; FitzGerald, Gerry; Bell, Anthony

    2017-11-29

    The aim of this study was to describe emergency department (ED) activities and staffing after the introduction of activity-based funding (ABF) to highlight the challenges of new funding arrangements and their implementation. A retrospective study of public hospital EDs in Queensland, Australia, was undertaken for 2013-2014. The ED and hospital characteristics are described to evaluate the alignment between activity and resourcing levels and their impact on performance. Twenty EDs participated (74% response rate). Weighted activity units (WAUs) and nursing staff varied based on hospital type and size. Larger hospital EDs had on average 9076 WAUs and 13 full time equivalent (FTE) nursing staff per 1000 WAUs; smaller EDs had on average 4587 WAUs and 10.3 FTE nursing staff per 1000 WAUs. Medical staff was relatively consistent (8.1-8.7 FTE per 1000 WAUs). The proportion of patients admitted, discharged, or transferred within 4 hours ranged from 73% to 79%. The ED medical and nursing staffing numbers did not correlate with the 4-hour performance. Substantial variation exists across Queensland EDs when resourcing service delivery in an activity-based funding environment. Historical inequity persists in the staffing profiles for regional and outer metropolitan departments. The lack of association between resourcing and performance metrics provides opportunity for further investigation of efficient models of care. Copyright © 2017 John Wiley & Sons, Ltd.

  7. TaEDS1 genes positively regulate resistance to powdery mildew in wheat.

    PubMed

    Chen, Guiping; Wei, Bo; Li, Guoliang; Gong, Caiyan; Fan, Renchun; Zhang, Xiangqi

    2018-04-01

    Three EDS1 genes were cloned from common wheat and were demonstrated to positively regulate resistance to powdery mildew in wheat. The EDS1 proteins play important roles in plant basal resistance and TIR-NB-LRR protein-triggered resistance in dicots. Until now, there have been very few studies on EDS1 in monocots, and none in wheat. Here, we report on three common wheat orthologous genes of EDS1 family (TaEDS1-5A, 5B and 5D) and their function in powdery mildew resistance. Comparisons of these genes with their orthologs in diploid ancestors revealed that EDS1 is a conserved gene family in Triticeae. The cDNA sequence similarity among the three TaEDS1 genes was greater than 96.5%, and they shared sequence similarities of more than 99.6% with the respective orthologs from diploid ancestors. The phylogenetic analysis revealed that the EDS1 family originated prior to the differentiation of monocots and dicots, and EDS1 members have since undergone clear structural differentiation. The transcriptional levels of TaEDS1 genes in the leaves were obviously higher than those of the other organs, and they were induced by Blumeria graminis f. sp. tritici (Bgt) infection and salicylic acid (SA) treatment. The BSMV-VIGS experiments indicated that knock-down the transcriptional levels of the TaEDS1 genes in a powdery mildew-resistant variety of common wheat compromised resistance. Contrarily, transient overexpression of TaEDS1 genes in a susceptible common wheat variety significantly reduced the haustorium index and attenuated the growth of Bgt. Furthermore, the expression of TaEDS1 genes in the Arabidopsis mutant eds1-1 complemented its susceptible phenotype to powdery mildew. The above evidences strongly suggest that TaEDS1 acts as a positive regulator and confers resistance against powdery mildew in common wheat.

  8. Treatment of Nausea and Vomiting in Pregnancy: Factors Associated with ED Revisits

    PubMed Central

    Sharp, Brian R.; Sharp, Kristen M.; Patterson, Brian; Dooley-Hash, Suzanne

    2016-01-01

    Introduction Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. Methods We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital. Demographic and treatment variables were collected using a chart review of 113 ED patient visits with a billing diagnosis of “nausea and vomiting in pregnancy” or “hyperemesis gravidarum.” Logistic regression analysis was used with a primary outcome of return visit to the ED for the same diagnoses. Results There was wide treatment variability of nausea and vomiting in pregnancy patients in the ED. Of the 113 patient visits, 38 (33.6%) had a return ED visit for NVP. High gravidity (OR 1.31, 95% CI [1.06–1.61]), high parity (OR 1.50 95% CI [1.12–2.00]), and early gestational age (OR 0.74 95% CI [0.60–0.90]) were associated with an increase in return ED visits in univariate logistic regression models, while only early gestational age (OR 0.74 95% CI [0.59–0.91]) was associated with increased return ED visits in a multiple regression model. Admission to the hospital was found to decrease the likelihood of return ED visits (p=0.002). Conclusion NVP can be difficult to manage and has a high ED return visit rate. Optimizing care with aggressive, standardized treatment in the ED and upon discharge, particularly if factors predictive of return ED visits are present, may improve quality of care and reduce ED utilization for this condition. PMID:27625723

  9. Impact of a low intensity and broadly inclusive ED care coordination intervention on linkage to primary care and ED utilization.

    PubMed

    Foster, Sean D; Hart, Kim; Lindsell, Christopher J; Miller, Christopher N; Lyons, Michael S

    2018-04-05

    We aim to evaluate the effectiveness of a broadly inclusive, comparatively low intensity intervention linking ED patients to a primary care home. This retrospective cohort study evaluated ED patients referred for primary care linkage in a large, urban, academic ED. A care coordination specialist performed a brief interview to gauge access barriers and provide a clinic referral with optional scheduling assistance. Data were abstracted from program records and the electronic medical record. The primary outcome was the proportion of referred individuals who attended at least one primary care appointment. Secondary outcomes included return ED encounters within one year, and factors associated with linkage outcomes. There were 2142 referrals made for 2064 patients; 1688/2142 accepted assistance. Linkage was successful for 1059/1688 (63%, CI95 60% to 65%). Among patients accepting assistance, those without successful linkage were younger (41 vs 45years, difference 3years, CI95 2 to 3), more often male (62% vs 55%,difference 7%, CI95 2% to 12%), and less likely to have a chronic medical condition (37% vs 45%, difference 8%; CI95 3% to 12%) or to have had an appointment scheduled within two weeks (26% vs 33%, difference 7%, CI95 2% to 12%). Insurance status and self-reported barriers to care were not associated with linkage success. Patterns of subsequent ED use were similar, regardless of referral status or linkage outcome. Low intensity, broadly inclusive, ED care coordination linked nearly 50% of patients referred for intervention, and two-thirds of willing participants, with a primary care home. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Moments of disaster response in the emergency department (ED).

    PubMed

    Hammad, Karen S; Arbon, Paul; Gebbie, Kristine; Hutton, Alison

    2017-11-01

    We experience our lives as a series of memorable moments, some good and some bad. Undoubtedly, the experience of participating in disaster response, is likely to stand out as a memorable moment in a nurses' career. This presentation will describe five distinct moments of nursing in the emergency department (ED) during a disaster response. A Hermeneutic Phenomenological approach informed by van Manen underpins the research process. Thirteen nurses from different countries around the world participated in interviews about their experience of working in the ED during a disaster. Thematic analysis resulted in five moments of disaster response which are common to the collective participant experience. The 5 themes emerge as Notification (as a nurse finds out that the ED will be receiving casualties), Waiting (waiting for the patients to arrive to the ED), Patient Arrival (the arrival of the first patients to the ED), Caring for patients (caring for people affected by the disaster) and Reflection (the moment the disaster response comes to an end). This paper provides an in-depth insight into the experience of nursing in the ED during a disaster response which can help generate awareness and inform future disaster preparedness of emergency nurses. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  11. About Regional Energy Deployment System Model-ReEDS | Regional Energy

    Science.gov Websites

    Deployment System Model | Energy Analysis | NREL About Regional Energy Deployment System Model -ReEDS About Regional Energy Deployment System Model-ReEDS The Regional Energy Deployment System (ReEDS ) is a long-term, capacity-expansion model for the deployment of electric power generation technologies

  12. An analysis of ED utilization by adults with intellectual disability.

    PubMed

    Venkat, Arvind; Pastin, Rene B; Hegde, Gajanan G; Shea, John M; Cook, Jeffrey T; Culig, Carl

    2011-05-01

    We sought to identify factors increasing the odds of ED utilization among intellectually disabled (ID) adults and differentiate their discharge diagnoses from the general adult ED population. This was a retrospective, observational open cohort study of all ID adults residing at an intermediate care facility and their ED visits to a tertiary center (January 1, 2007-July 30, 2008). We abstracted from the intermediate care facility database subjects' demographic, ID, health and adaptive status variables, and their requirement of ED care/hospitalization. We obtained from the hospital database the primary International Classification of Diseases 9 ED/hospital discharge diagnoses for the study and general adult population. Using multivariate logistic regression, we computed odds ratios (OR) for ED utilization/hospitalization in the cohort. Using the conditional large-sample binomial test, we differentiated the study and general populations' discharge diagnoses. A total of 433 subjects met the inclusion criteria. Gastrostomy/jejunostomy increased the odds of ED utilization (OR, 4.16; confidence interval [CI], 1.64-10.58). Partial help to feed (OR, 2.59; CI, 1.14-5.88), gastrostomy/jejunostomy (OR, 3.26; CI, 1.30-8.18), and increasing number of prescribed medications (OR, 1.08; CI, 1.03-1.14) increased the odds of hospitalization. Auditory impairment (OR, 0.45; CI, 0.23-0.88) decreased the odds of hospitalization. For ED discharge diagnoses, ID adults were more likely (P < .05) than the general population to have diagnoses among digestive disorders and ill-defined symptoms/signs. For hospital discharge diagnoses, ID adults were more likely (P < .05) to have diagnoses among infectious/parasitic, nervous system, and respiratory disorders. Among ID adults, feeding status increased the odds of ED utilization, feeding status, and increasing number of prescribed medications of that hospitalization. Intellectually disabled adults' discharge diagnoses differed significantly from

  13. The Use of Autonomous Vehicles for Spatially Measuring Mean Velocity Profiles in Rivers and Estuaries

    DTIC Science & Technology

    2011-09-01

    Advisor: Jaime MacMahan Second Reader: Ed Thornton THIS PAGE INTENTIONALLY LEFT BLANK i REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188...Currents. IEEE J. Ocean. Eng. 26(4), 752–768. Eriksen, C. C., Osse, T. J., Light, R. D., Wen, T., Lehman, T. W., Sabin , P. L., Ballard, J. W., Chiodi

  14. An overview of development and status of fiber-reinforced composites as dental and medical biomaterials

    PubMed Central

    Vallittu, Pekka K.

    2018-01-01

    Abstract Fibr-reinforced composites (FRC) have been used successfully for decades in many fields of science and engineering applications. Benefits of FRCs relate to physical properties of FRCs and versatile production methods, which can be utilized. Conventional hand lamination of prefabricated FRC prepregs is utilized still most commonly in fabrication of dental FRC devices but CAD-CAM systems are to be come for use in certain production steps of dental constructions and medical FRC implants. Although metals, ceramics and particulate filler resin composites have successfully been used as dental and medical biomaterials for decades, devices made out of these materials do not meet all clinical requirements. Only little attention has been paid to FRCs as dental materials and majority of the research in dental field has been focusing on particulate filler resin composites and in medical biomaterial research to biodegradable polymers. This is paradoxical because FRCs can potentially resolve many of the problems related to traditional isotropic dental and medical materials. This overview reviews the rationale and status of using biostable glass FRC in applications from restorative and prosthetic dentistry to cranial surgery. The overview highlights also the critical material based factors and clinical requirement for the succesfull use of FRCs in dental reconstructions. PMID:29707613

  15. An overview of development and status of fiber-reinforced composites as dental and medical biomaterials.

    PubMed

    Vallittu, Pekka K

    2018-01-01

    Fibr-reinforced composites (FRC) have been used successfully for decades in many fields of science and engineering applications. Benefits of FRCs relate to physical properties of FRCs and versatile production methods, which can be utilized. Conventional hand lamination of prefabricated FRC prepregs is utilized still most commonly in fabrication of dental FRC devices but CAD-CAM systems are to be come for use in certain production steps of dental constructions and medical FRC implants. Although metals, ceramics and particulate filler resin composites have successfully been used as dental and medical biomaterials for decades, devices made out of these materials do not meet all clinical requirements. Only little attention has been paid to FRCs as dental materials and majority of the research in dental field has been focusing on particulate filler resin composites and in medical biomaterial research to biodegradable polymers. This is paradoxical because FRCs can potentially resolve many of the problems related to traditional isotropic dental and medical materials. This overview reviews the rationale and status of using biostable glass FRC in applications from restorative and prosthetic dentistry to cranial surgery. The overview highlights also the critical material based factors and clinical requirement for the succesfull use of FRCs in dental reconstructions.

  16. Population-Based Burden of COPD-Related Visits in the ED

    PubMed Central

    Lippmann, Steven J.; Waller, Anna E.; Hassmiller Lich, Kristen; Travers, Debbie; Weinberger, Morris; Donohue, James F.

    2013-01-01

    Background: Little is known about the population-based burden of ED care for COPD. Methods: We analyzed statewide ED surveillance system data to quantify the frequency of COPD-related ED visits, hospital admissions, and comorbidities. Results: In 2008 to 2009 in North Carolina, 97,511 COPD-related ED visits were made by adults ≥ 45 years of age, at an annual rate of 13.8 ED visits/1,000 person-years. Among patients with COPD (n = 33,799), 7% and 28% had a COPD-related return ED visit within a 30- and 365-day period of their index visit, respectively. Compared with patients on private insurance, Medicare, Medicaid, and noninsured patients were more likely to have a COPD-related return visit within 30 and 365 days and have three or more COPD-related visits within 365 days. There were no differences in return visits by sex. Fifty-one percent of patients with COPD were admitted to the hospital from the index ED visit. Subsequent hospital admission risk in the cohort increased with age, peaking at 65 to 69 years (risk ratio [RR], 1.41; 95% CI, 1.26-1.57); there was no difference by sex. Patients with congestive heart failure (RR, 1.29; 95% CI, 1.22-1.37), substance-related disorders (RR, 1.35; 95% CI, 1.13-1.60), or respiratory failure/supplemental oxygen (RR, 1.25; 95% CI, 1.19-1.31) were more likely to have a subsequent hospital admission compared with patients without these comorbidities. Conclusions: The population-based burden of COPD-related care in the ED is significant. Further research is needed to understand variations in COPD-related ED visits and hospital admissions. PMID:23579283

  17. Faculty Members' Responses to Implementing Re-Envisioned EdD Programs

    ERIC Educational Resources Information Center

    Buss, Ray R.; Zambo, Ron; Zambo, Debby; Perry, Jill A.; Williams, Tiffany R.

    2017-01-01

    Limitations of the education doctorate (EdD) and the emergence of professional practice doctorates have influenced those offering the EdD to re-envision, re-define, and reclaim the EdD as the degree of choice for the next generation of educational leaders. Colleges of education faculty members have used the Carnegie Project on the Education…

  18. Screening and detection of delirium in older ED patients: performance of the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). A two-step tool.

    PubMed

    Hasemann, Wolfgang; Grossmann, Florian F; Stadler, Rahel; Bingisser, Roland; Breil, Dieter; Hafner, Martina; Kressig, Reto W; Nickel, Christian H

    2017-12-30

    Delirium is frequent in older Emergency Department (ED) patients, but detection rates for delirium in the ED are low. To aid in identifying delirium, we developed and implemented a two-step systematic delirium screening and assessment tool in our ED: the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). Components of the mCAM-ED include: (1) screening for inattention, the main feature of delirium, which was performed with the Months Backwards Test (MBT); (2) delirium assessment based on a structured interview with questions from the Mental Status Questionnaire by Kahn et al. and the Comprehension Test by Hart et al. The aims of our study are (1) to investigate the performance criteria of the mCAM-ED tool in a consecutive sample of older ED patients, (2) to evaluate the performance of the mCAM-ED in patients with and without dementia and (3) to test whether this tool is efficient in keeping evaluation time to a minimum and reducing screening and assessment burden on the patient. For this prospective validation study, we recruited a consecutive sample of ED patients aged 65 and older during an 11-day period in November 2015. Trained nurses assessed patients with the mCAM-ED. Results were compared to the reference standard [i.e. the geriatricians' delirium diagnosis based on the criteria of the Text Revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)]. Performance criteria were computed. We included 286 consecutive ED patients aged 65 and older. The median age was 80.02 (Q 1  = 72.15; Q 3  = 86.76), 58.7% of included patients were female, 14.3% had dementia. We found a delirium prevalence of 7.0%. In patients with dementia, specificity and positive likelihood ratio were lower. When compared to the reference standard, delirium assessment with the mCAM-ED has a 0.98 specificity and a 39.9 positive likelihood ratio. In 80.0% of all cases, the first step of the mCAM-ED, i.e. screening for inattention with the

  19. ExpandED Options: Learning beyond High School Walls

    ERIC Educational Resources Information Center

    ExpandED Schools, 2014

    2014-01-01

    Through ExpandED Options by TASC, New York City high school students get academic credit for learning career-related skills that lead to paid summer jobs. Too many high school students--including those most likely to drop out--are bored or see classroom learning as irrelevant. ExpandED Options students live the connection between mastering new…

  20. Improving ED efficiency to capture additional revenue.

    PubMed

    Mandavia, Sujal; Samaniego, Loretta

    2016-06-01

    An increase in the number of patients visiting emergency departments (EDs) presents an opportunity for additional revenue if hospitals take four steps to optimize resources: Streamline the patient pathway and reduce the amount of time each patient occupies a bed in the ED. Schedule staff according to the busy and light times for patient arrivals. Perform registration and triage bedside, reducing initial wait times. Create an area for patients to wait for test results so beds can be freed up for new arrivals.

  1. Molecular cloning and characterization of enhanced disease susceptibility 1 (EDS1) from Gossypium barbadense.

    PubMed

    Su, Xiaofeng; Qi, Xiliang; Cheng, Hongmei

    2014-06-01

    Arabidopsis enhanced disease susceptibility 1 (EDS1) plays an important role in plant defense against biotrophic and necrotrophic pathogens. The necrotrophic pathogen Verticillium dahliae infection of Gossypium barbadense could lead to Verticillium wilt which seriously reduces the cotton production. Here, we cloned and characterized a G. barbadense homolog of EDS1, designated as GbEDS1. The full-length cDNA of the GbEDS1 gene was obtained by the technique of rapid-amplification of cDNA ends. The open reading frame of the GbEDS1 gene was 1,647 bp long and encoded a protein of 548 amino acids residues. Comparison of the cDNA and genomic DNA sequence of GbEDS1 indicated that this gene contained a single intron and two exons. Like other EDS1s, GbEDS1 contained a conserved N-terminal lipase domain and an EDS1-specific KNEDT motif. Subcellular localization assay revealed that GbEDS1-green fluorescence protein fusion protein was localized in both cytosol and nucleus. Interestingly, the transcript levels of GbEDS1 were dramatically increased in response to pathogen V. dahliae infection. To investigate the role of GbEDS1 in plant resistance against V. dahliae, a conserved fragment derived from GbEDS1 was used to knockdown the endogenous EDS1 in Nicotiana benthamiana by heterologous virus-induced gene silencing. Our data showed that silencing of NbEDS1 resulted in increased susceptibility to V. dahliae infection in N. benthamiana, suggesting a possible involvement of the novelly isolated GbEDS1 in the regulation of plant defense against V. dahliae.

  2. Redefining the EdD: Seeking a Separate Identity

    ERIC Educational Resources Information Center

    Boyce, Barbara Ann

    2012-01-01

    The purpose of this manuscript was to discuss the recommendations and guidelines of the Carnegie Group's 2007 effort to "Reclaim the EdD" as well as to outline the work completed at the University of Virginia related to their re-design of the Doctor of Education (EdD) degree. In order to address the re-envision and re-formulation of the…

  3. Evaluation Options for Family Resource Centers.

    ERIC Educational Resources Information Center

    Horsch, Karen, Ed.; Weiss, Heather B., Ed.

    Family resource centers (FRC) are emerging as a promising program approach to solving urgent social problems. Evaluation plays an important role in learning how these programs work, what their impact is, and whether they should be expanded. However, FRCs pose unique challenges to evaluation. This report considers the challenges to evaluating FRCs,…

  4. Trends in diabetes-related visits to US EDs from 1997 to 2007.

    PubMed

    Menchine, Michael D; Wiechmann, Warren; Peters, Anne L; Arora, Sanjay

    2012-06-01

    The aims of the study were to describe temporal trends in the number, proportion, and per capita use of diabetes-related emergency department (ED) visits and to examine any racial/ethnic disparity in ED use for diabetes-related reasons. We analyzed the ED portion of the National Hospital Ambulatory Medical Care Survey from 1997 through 2007. Diabetes-related ED visits were identified by International Classification of Diseases, Ninth Revision codes. Descriptive statistics were developed. Weighted linear and logistic regression models were used to determine significance of temporal trends, and multivariate logistic regression was used to examine racial/ethnic disparities. A total of 20.2 million (1.69%; 95% confidence interval [CI], 1.59%-1.78%) ED visits were diabetes-related during the study period. We observed significant increases in the number and proportion of diabetes-related ED visits. Overall, there was a 5.6% relative annual increase in the proportion of ED visits that were diabetes-related during the study period. However, the per capita ED use among the population with diabetes did not change over time (P>.05 for trend). On multivariate analysis, black race (odds ratio, 1.8; 95% CI, 1.7-2.0), Hispanic ethnicity (odds ratio, 1.6; 95% CI, 1.4-1.8), and advancing age were associated with significantly higher odds of having a diabetes-related visit. Despite a marked increase in number and proportion of diabetes-related ED visits during the study period, the per capita use of ED services for diabetes-related visits among the diabetic population remained stable. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Survivable Propagation.

    DTIC Science & Technology

    1984-11-01

    Electromagnetic Radiation, -Meteor Burst Propagation , 20 14 Electromagnetic Transients Tranverse Electric,, A- .(Se2ee Rverse) 1S. ABSTRACT Continue on mrverm if...Camn1w1caft.Ofl and IntelZigence (C3 1) act Lvitie.. Technco2 and eng.LnevLxing 6uPPo~t wi~thin wteaz oj techniZcat competence i6s ptov-𔃾ed to ESV Ptrogtam

  6. Toward reliable and repeatable automated STEM-EDS metrology with high throughput

    NASA Astrophysics Data System (ADS)

    Zhong, Zhenxin; Donald, Jason; Dutrow, Gavin; Roller, Justin; Ugurlu, Ozan; Verheijen, Martin; Bidiuk, Oleksii

    2018-03-01

    New materials and designs in complex 3D architectures in logic and memory devices have raised complexity in S/TEM metrology. In this paper, we report about a newly developed, automated, scanning transmission electron microscopy (STEM) based, energy dispersive X-ray spectroscopy (STEM-EDS) metrology method that addresses these challenges. Different methodologies toward repeatable and efficient, automated STEM-EDS metrology with high throughput are presented: we introduce the best known auto-EDS acquisition and quantification methods for robust and reliable metrology and present how electron exposure dose impacts the EDS metrology reproducibility, either due to poor signalto-noise ratio (SNR) at low dose or due to sample modifications at high dose conditions. Finally, we discuss the limitations of the STEM-EDS metrology technique and propose strategies to optimize the process both in terms of throughput and metrology reliability.

  7. Prevalence of Clostridium difficile infection presenting to US EDs.

    PubMed

    Smith, Aaron M; Wuerth, Brandon A; Wiemken, Timothy L; Arnold, Forest W

    2015-02-01

    The objective of the study is to determine the prevalence of Clostridium difficile infection (CDI) presenting to emergency departments (EDs) in the United States. Secondary objectives included defining the burden of CDI. This is a retrospective, observational cohort study of 2006-2010 Nationwide Emergency Department Sample database of 980 US hospital EDs in 29 states. Prevalence, mortality rate, length of stay, hospital charges, and endemicity were measured. A total of 474513 patients with CDI-related ED visits were identified. From 2006 to 2010, the prevalence of CDI increased from 26.2 to 33.1 per 100,000 population (P<.001). The number of CDI-related ED cases increased 26.1% (P<.001) over the study period: 18.6% from 2006 to 2007 (P<.001), 4.3% from 2007 to 2008 (P=.46), 1.8% from 2008 to 2009 (P=.73), and 0.13% from 2009 to 2010 (P=.95). Emergency department visits occurred more frequently with individuals 85 years or older (relative risk [RR], 13.74; P<.001), females (RR, 1.77; P<.001) and in the northeast United States (RR, 1.42; P<.001). From 2009 to 2010, the mortality rate decreased 17.9% (P=.01). The prevalence of CDI presenting to EDs increased each year from 2006 to 2010; however, the rate of increase slowed from each year to the next. The mortality rate increased from 2006 to 2009 and decreased significantly from 2009 to 2010. C difficile infection visits presenting to EDs occurred more frequently with older individuals, females, and in the northeast. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Threats to Validity in the edTPA Video Component

    ERIC Educational Resources Information Center

    Choppin, Jeffrey; Meuwissen, Kevin

    2017-01-01

    The edTPA, a performance assessment designed to generate reliable and valid measures of teaching practice, increasingly is used as a gatekeeping mechanism for beginning teacher licensure in various states, including New York, Washington State, Wisconsin, and Georgia. One of the edTPA's key components is the demonstration of instructional practice…

  9. KSC-2011-2423

    NASA Image and Video Library

    2011-03-22

    CAPE CANAVERAL, Fla. - Crews in Orbiter Processing Facility-2 at NASA's Kennedy Space Center in Florida remove space shuttle Discovery's forward reaction control system (FRCS), which helped steer the shuttle in orbit. To maneuver, the FRCS used hypergolic fuel and oxidizer, which were purged from Discovery after its final spaceflight, STS-133. Next, the FRCS will be shipped to a maintenance facility at White Sands Space Harbor in New Mexico, where additional inspections will be performed and its components made safe to go on public display. The transition and retirement processing is expected to help rocket designers build next-generation spacecraft and prepare the shuttle for display. Photo credit: NASA/Jim Grossmann

  10. KSC-2011-2425

    NASA Image and Video Library

    2011-03-22

    CAPE CANAVERAL, Fla. - Crews in Orbiter Processing Facility-2 at NASA's Kennedy Space Center in Florida remove space shuttle Discovery's forward reaction control system (FRCS), which helped steer the shuttle in orbit. To maneuver, the FRCS used hypergolic fuel and oxidizer, which were purged from Discovery after its final spaceflight, STS-133. Next, the FRCS will be shipped to a maintenance facility at White Sands Space Harbor in New Mexico, where additional inspections will be performed and its components made safe to go on public display. The transition and retirement processing is expected to help rocket designers build next-generation spacecraft and prepare the shuttle for display. Photo credit: NASA/Jim Grossmann

  11. KSC-2011-2427

    NASA Image and Video Library

    2011-03-22

    CAPE CANAVERAL, Fla. - Space shuttle Discovery's forward reaction control system (FRCS), which helped steer the shuttle in orbit, is removed in Orbiter Processing Facility-2 at NASA's Kennedy Space Center in Florida. To maneuver, the FRCS used hypergolic fuel and oxidizer, which were purged from Discovery after its final spaceflight, STS-133. Next, the FRCS will be shipped to a maintenance facility at White Sands Space Harbor in New Mexico, where additional inspections will be performed and its components made safe to go on public display. The transition and retirement processing is expected to help rocket designers build next-generation spacecraft and prepare the shuttle for display. Photo credit: NASA/Jim Grossmann

  12. KSC-2011-2431

    NASA Image and Video Library

    2011-03-22

    CAPE CANAVERAL, Fla. - Space shuttle Discovery's forward reaction control system (FRCS), which helped steer the shuttle in orbit, is moved to a transporter in Orbiter Processing Facility-2 at NASA's Kennedy Space Center in Florida. To maneuver, the FRCS used hypergolic fuel and oxidizer, which were purged from Discovery after its final spaceflight, STS-133. Next, the FRCS will be shipped to a maintenance facility at White Sands Space Harbor in New Mexico, where additional inspections will be performed and its components made safe to go on public display. The transition and retirement processing is expected to help rocket designers build next-generation spacecraft and prepare the shuttle for display. Photo credit: NASA/Jim Grossmann

  13. KSC-2011-2433

    NASA Image and Video Library

    2011-03-22

    CAPE CANAVERAL, Fla. - Space shuttle Discovery's forward reaction control system (FRCS), which helped steer the shuttle in orbit, is atop a transporter in Orbiter Processing Facility-2 at NASA's Kennedy Space Center in Florida. To maneuver, the FRCS used hypergolic fuel and oxidizer, which were purged from Discovery after its final spaceflight, STS-133. Next, the FRCS will be shipped to a maintenance facility at White Sands Space Harbor in New Mexico, where additional inspections will be performed and its components made safe to go on public display. The transition and retirement processing is expected to help rocket designers build next-generation spacecraft and prepare the shuttle for display. Photo credit: NASA/Jim Grossmann

  14. KSC-2011-2430

    NASA Image and Video Library

    2011-03-22

    CAPE CANAVERAL, Fla. - Space shuttle Discovery's forward reaction control system (FRCS), which helped steer the shuttle in orbit, is moved to a transporter in Orbiter Processing Facility-2 at NASA's Kennedy Space Center in Florida. To maneuver, the FRCS used hypergolic fuel and oxidizer, which were purged from Discovery after its final spaceflight, STS-133. Next, the FRCS will be shipped to a maintenance facility at White Sands Space Harbor in New Mexico, where additional inspections will be performed and its components made safe to go on public display. The transition and retirement processing is expected to help rocket designers build next-generation spacecraft and prepare the shuttle for display. Photo credit: NASA/Jim Grossmann

  15. KSC-2011-2426

    NASA Image and Video Library

    2011-03-22

    CAPE CANAVERAL, Fla. - Crews in Orbiter Processing Facility-2 at NASA's Kennedy Space Center in Florida remove space shuttle Discovery's forward reaction control system (FRCS), which helped steer the shuttle in orbit. To maneuver, the FRCS used hypergolic fuel and oxidizer, which were purged from Discovery after its final spaceflight, STS-133. Next, the FRCS will be shipped to a maintenance facility at White Sands Space Harbor in New Mexico, where additional inspections will be performed and its components made safe to go on public display. The transition and retirement processing is expected to help rocket designers build next-generation spacecraft and prepare the shuttle for display. Photo credit: NASA/Jim Grossmann

  16. Coast Guard Cutter Procurement: Background and Issues for Congress

    DTIC Science & Technology

    2016-04-04

    and 58 Fast Response Cutters (FRCs) as replacements for 90 aging Coast Guard cutters and patrol craft. The Coast Guard’s proposed FY2017 budget...Offshore Patrol Cutter (Generic Conceptual Rendering) ................................................. 5 Figure 3. Fast Response Cutter...National Security Cutters (NSCs), 25 Offshore Patrol Cutters (OPCs), and 58 Fast Response Cutters (FRCs). These 91 planned cutters are intended as

  17. 8 Different approaches needed to manage ED demand among different age-groups.

    PubMed

    Rimmer, Melanie; Ablard, Suzanne; O'Keeffe, Colin; Mason, Suzanne

    2017-12-01

    A variety of interventions have been proposed to manage rising demand for Emergency and Urgent Care, described by an NHS England review as unsustainable in the long term. However it is unlikely that any suggested approach will be equally suitable for the diverse population of ED users.We aimed to understand the patterns of demand amongst different types of patients attending ED. We also sought to understand the intended and unintended effects of demand management initiatives. Our study combined insights from routine data, a survey of ED patients, and qualitative interviews with ED staff. This paper describes the results of our analysis of the interviews. We conducted semi-structured interviews with 25 ED and Urgent Care Centre staff across 7 hospital sites in Yorkshire and Humber between 25 April and 11 July 2016. The interview topic guide asked about 4 broad areas; job role, description of patients and their impact on demand, description of inappropriate attendance, and current/future initiatives to deal with rising demand. Interviews were transcribed verbatim and analysed using framework analysis. We analysed the results to identify groups of patients with different patterns of use of ED services. We also explored ED staff experiences of demand management initiatives, and their suggestions for future initiatives. Although we did not ask specifically about patients' age, our analysis revealed that ED staff categorised attenders as children and young people, working age people, and older people. These groups had different reasons for attendance, different routes to the ED, different rate of non-urgent attendance, and different issues driving demand. Staff also described variation in the time taken to treat patients of different ages, with the oldest and youngest patients described as requiring the most time.There was no consensus amongst staff about the effectiveness of initiatives for managing demand. A strikingly wide variety of initiatives were mentioned

  18. A 5-year comparison of ED visits by homeless and nonhomeless patients.

    PubMed

    Tadros, Allison; Layman, Shelley M; Brewer, Marissa Pantaleone; Davis, Stephen M

    2016-05-01

    A 2005 study examined emergency department (ED) utilization by homeless patients in the United States. Within the following 5 years, unemployment increased by 5%. The objective was to analyze changes in ED utilization between 2005 and 2010 by homeless patients and compare with nonhomeless visits. Data from the 2010 National Hospital Ambulatory Medical Care Survey were evaluated. Approximately 679854 visits were made by homeless patients, the majority of which were made by men (72.3%) and patients between the ages of 45 and 64 (50.5%). Homeless patients were twice as likely to be uninsured. ED visits by homeless patients had increased by 44% during the 5-year period. Arrival to the ED by ambulance increased by 14% between the study years, and homeless patients were less likely to be admitted. The number of visits by homeless patients in the ED increased proportionally to an overall increase in ED visits between 2005 and 2010. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Agricultural Education Teacher Candidates' Perceptions of the edTPA

    ERIC Educational Resources Information Center

    Lunsford, Amanda; Warner, Wendy J.; Park, Travis D.; Morgan, Joy E.

    2016-01-01

    The edTPA has recently emerged within the past few years as an innovative Teacher Performance Assessment and is currently adopted to some extent in 34 states. Researchers conducted four focus groups with 16 teacher candidates during and immediately after completion of the edTPA at North Carolina State University. When asked to articulate about…

  20. Splenic artery aneurysms encountered in the ED: 10 years' experience.

    PubMed

    Liu, Chu-Feng; Kung, Chia-Te; Liu, Ber-Ming; Ng, Shu-Hang; Huang, Chung-Cheng; Ko, Sheung-Fat

    2007-05-01

    Our objective was to report 7 cases of splenic artery aneurysm (SAA) encountered in the emergency department (ED). A retrospective survey of our ED database revealed 7 cases of SAA (6 men, 1 woman; mean age, 56 years) of 651,347 ED visits over the last decade. Their clinical and imaging features, management, and outcomes were evaluated. Splenic artery aneurysm in the ED was rare (prevalence, 0.011%). Common presentations included acute abdomen (n = 5) and shock (n = 2). Five cases had liver cirrhosis and portal hypertension. Abdominal radiographs (n = 7) revealed 2 atherosclerotic patients with SAA. Abdominal computed tomography (n = 7) depicted all SAAs (size, 1.5-8 cm; mean, 3.8 cm). Four ruptured SAAs were successfully managed with coils embolization. Among them, 1 patient with ruptured mycotic SAA also received surgery, but the patient died of Klebsiella sepsis 3 months later. In the ED, ruptured SAA should be included as a rare differential consideration of acute abdomen, especially in middle-aged men with liver cirrhosis and portal hypertension. Although SAA may be an unexpected computed tomographic finding, once diagnosed, endovascular treatment is recommended.

  1. Teaching Elementary School Social Studies Methods under edTPA

    ERIC Educational Resources Information Center

    An, Sohyun

    2016-01-01

    This article reports a self-study that analyzes my experience as a teacher educator navigating a turbulent educational landscape with the advent of edTPA. The data consist of my journal entries, the syllabi, handouts, work submitted by my students, and course evaluations. Data were analyzed by using an inductive process to describe how the edTPA…

  2. Feasibility of an ED-to-Home Intervention to Engage Patients: A Mixed-Methods Investigation.

    PubMed

    Schumacher, Jessica R; Lutz, Barbara J; Hall, Allyson G; Pines, Jesse M; Jones, Andrea L; Hendry, Phyllis; Kalynych, Colleen; Carden, Donna L

    2017-06-01

    Older, chronically ill patients with limited health literacy are often under-engaged in managing their health and turn to the emergency department (ED) for healthcare needs. We tested the impact of an ED-initiated coaching intervention on patient engagement and follow-up doctor visits in this high-risk population. We also explored patients' care-seeking decisions. We conducted a mixed-methods study including a randomized controlled trial and in-depth interviews in two EDs in northern Florida. Participants were chronically ill older ED patients with limited health literacy and Medicare as a payer source. Patients were assigned to an evidence-based coaching intervention (n= 35) or usual post-ED care (n= 34). Qualitative interviews (n=9) explored patients' reasons for ED use. We assessed average between-group differences in patient engagement over time with the Patient Activation Measure (PAM) tool, using logistic regression and a difference-in-difference approach. Between-group differences in follow-up doctor visits were determined. We analyzed qualitative data using open coding and thematic analysis. PAM scores fell in both groups after the ED visit but fell significantly more in "usual care" (average decline -4.64) than "intervention" participants (average decline -2.77) (β=1.87, p=0.043). There were no between-group differences in doctor visits. Patients described well-informed reasons for ED visits including onset and severity of symptoms, lack of timely provider access, and immediate and comprehensive ED care. The coaching intervention significantly reduced declines in patient engagement observed after usual post-ED care. Patients reported well-informed reasons for ED use and will likely continue to make ED visits unless strategies, such as ED-initiated coaching, are implemented to help vulnerable patients better manage their health and healthcare.

  3. Feasibility of an ED-to-Home Intervention to Engage Patients: A Mixed-Methods Investigation

    PubMed Central

    Schumacher, Jessica R.; Lutz, Barbara J.; Hall, Allyson G.; Pines, Jesse M.; Jones, Andrea L.; Hendry, Phyllis; Kalynych, Colleen; Carden, Donna L.

    2017-01-01

    Introduction Older, chronically ill patients with limited health literacy are often under-engaged in managing their health and turn to the emergency department (ED) for healthcare needs. We tested the impact of an ED-initiated coaching intervention on patient engagement and follow-up doctor visits in this high-risk population. We also explored patients’ care-seeking decisions. Methods We conducted a mixed-methods study including a randomized controlled trial and in-depth interviews in two EDs in northern Florida. Participants were chronically ill older ED patients with limited health literacy and Medicare as a payer source. Patients were assigned to an evidence-based coaching intervention (n= 35) or usual post-ED care (n= 34). Qualitative interviews (n=9) explored patients’ reasons for ED use. We assessed average between-group differences in patient engagement over time with the Patient Activation Measure (PAM) tool, using logistic regression and a difference-in-difference approach. Between-group differences in follow-up doctor visits were determined. We analyzed qualitative data using open coding and thematic analysis. Results PAM scores fell in both groups after the ED visit but fell significantly more in “usual care” (average decline −4.64) than “intervention” participants (average decline −2.77) (β=1.87, p=0.043). There were no between-group differences in doctor visits. Patients described well-informed reasons for ED visits including onset and severity of symptoms, lack of timely provider access, and immediate and comprehensive ED care. Conclusion The coaching intervention significantly reduced declines in patient engagement observed after usual post-ED care. Patients reported well-informed reasons for ED use and will likely continue to make ED visits unless strategies, such as ED-initiated coaching, are implemented to help vulnerable patients better manage their health and healthcare. PMID:28611897

  4. ED antibiotic use for acute respiratory illnesses since pneumonia performance measure inception.

    PubMed

    Fee, Christopher; Metlay, Joshua P; Camargo, Carlos A; Maselli, Judith H; Gonzales, Ralph

    2010-01-01

    The study aimed to determine if emergency department (ED)-administered antibiotics for patients discharged home with nonpneumonia acute respiratory tract infections (ARIs) have increased since national pneumonia performance measure implementation, including antibiotic administration within 4 hours of arrival. Time series analysis. Six university and 7 Veterans Administration EDs participating in the Improving Antibiotic Use for Acute Care Treatment (IMPAACT) trial (randomized educational intervention to reduce antibiotics for bronchitis). Randomly selected adult (age >18 years) ED visits for acute cough, diagnosed with nonpneumonia ARIs, discharged home during winters (November-February) of 2003 to 2007. Time trend in ED-administered antibiotics, adjusted for patient demographics, comorbidities, vital signs, ED length of stay, IMPAACT intervention status, geographic region, Veterans Administration/university setting, and site and provider level clustering. Six thousand four hundred seventy-six met study criteria. Three hundred ninety-four (6.1%) received ED-administered antibiotics. Emergency department-administered antibiotics did not increase across the study period among all IMPAACT sites (odds ratio [OR], 0.88; 95% confidence interval [CI], 0.76-1.01) after adjusting for age, congestive heart failure history, temperature higher than 100 degrees F, heart rate more than 100, blood cultures obtained, diagnoses, and ED length of stay. The ED-administered antibiotic rate decreased at IMPAACT intervention (OR, 0.80; 95% CI, 0.69-0.93) but not nonintervention sites (OR, 1.04; 95% CI, 0.91-1.19). Adjusted proportions receiving ED-administered antibiotics were 6.1% (95% CI, 2.7%-13.2%) for 2003 to 2004; 4.8% (95% CI, 2.2%-10.0%) for 2004 to 2005; 4.6% (95% CI, 2.7%-7.8%) for 2005 to 2006; and 4.2% (95% CI, 2.2%-8.0%) for 2006 to 2007. Emergency department-administered antibiotics did not increase for patients with acute cough discharged home with nonpneumonia ARIs since

  5. Plant Growth/Plant Phototropism - Skylab Student Experiment ED-61/62

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This chart describes the Skylab student experiment ED-61, Plant Growth, and experiment ED-62, Plant Phototropism. Two similar proposals were submitted by Joel G. Wordekemper of West Point, Nebraska, and Donald W. Schlack of Downey, California. Wordekemper's experiment (ED-61) was to see how the lack of gravity would affect the growth of roots and stems of plants. Schlack's experiment (ED-62) was to study the effect of light on a seed developing in zero gravity. The growth container of the rice seeds for their experiment consisted of eight compartments arranged in two parallel rows of four. Each had two windowed surfaces to allow periodic photography of the developing seedlings. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  6. Suicide Prevention in an Emergency Department Population: The ED-SAFE Study.

    PubMed

    Miller, Ivan W; Camargo, Carlos A; Arias, Sarah A; Sullivan, Ashley F; Allen, Michael H; Goldstein, Amy B; Manton, Anne P; Espinola, Janice A; Jones, Richard; Hasegawa, Kohei; Boudreaux, Edwin D

    2017-06-01

    Suicide is a leading cause of deaths in the United States. Although the emergency department (ED) is an opportune setting for initiating suicide prevention efforts, ED-initiated suicide prevention interventions remain underdeveloped. To determine whether an ED-initiated intervention reduces subsequent suicidal behavior. This multicenter study of 8 EDs in the United States enrolled adults with a recent suicide attempt or ideation and was composed of 3 sequential phases: (1) a treatment as usual (TAU) phase from August 2010 to December 2011, (2) a universal screening (screening) phase from September 2011 to December 2012, and (3) a universal screening plus intervention (intervention) phase from July 2012 to November 2013. Screening consisted of universal suicide risk screening. The intervention phase consisted of universal screening plus an intervention, which included secondary suicide risk screening by the ED physician, discharge resources, and post-ED telephone calls focused on reducing suicide risk. The primary outcome was suicide attempts (nonfatal and fatal) over the 52-week follow-up period. The proportion and total number of attempts were analyzed. A total of 1376 participants were recruited, including 769 females (55.9%) with a median (interquartile range) age of 37 (26-47) years. A total of 288 participants (20.9%) made at least 1 suicide attempt, and there were 548 total suicide attempts among participants. There were no significant differences in risk reduction between the TAU and screening phases (23% vs 22%, respectively). However, compared with the TAU phase, patients in the intervention phase showed a 5% absolute reduction in suicide attempt risk (23% vs 18%), with a relative risk reduction of 20%. Participants in the intervention phase had 30% fewer total suicide attempts than participants in the TAU phase. Negative binomial regression analysis indicated that the participants in the intervention phase had significantly fewer total suicide attempts

  7. Developing an Identity as an EdD Leader: A Reflexive Narrative Account

    ERIC Educational Resources Information Center

    Tupling, Claire L.; Outhwaite, Deborah

    2017-01-01

    This article considers the challenges encountered by a recently appointed assistant programme leader in establishing an identity as a leader of an EdD programme. In discussing literature on the development of the EdD, the article recognizes an existing concern with student identity but highlights a need to consider the development of the EdD…

  8. Initial mechanical ventilator settings and lung protective ventilation in the ED.

    PubMed

    Wilcox, Susan R; Richards, Jeremy B; Fisher, Daniel F; Sankoff, Jeffrey; Seigel, Todd A

    2016-08-01

    Mechanical ventilation with low tidal volumes has been shown to improve outcomes for patients both with and without acute respiratory distress syndrome. This study aims to characterize mechanically ventilated patients in the emergency department (ED), describe the initial ED ventilator settings, and assess for associations between lung protective ventilation strategies in the ED and outcomes. This was a multicenter, prospective, observational study of mechanical ventilation at 3 academic EDs. We defined lung protective ventilation as a tidal volume of less than or equal to 8 mL/kg of predicted body weight and compared outcomes for patients ventilated with lung protective vs non-lung protective ventilation, including inhospital mortality, ventilator days, intensive care unit length of stay, and hospital length of stay. Data from 433 patients were analyzed. Altered mental status without respiratory pathology was the most common reason for intubation, followed by trauma and respiratory failure. Two hundred sixty-one patients (60.3%) received lung protective ventilation, but most patients were ventilated with a low positive end-expiratory pressure, high fraction of inspired oxygen strategy. Patients were ventilated in the ED for a mean of 5 hours and 7 minutes but had few ventilator adjustments. Outcomes were not significantly different between patients receiving lung protective vs non-lung protective ventilation. Nearly 40% of ED patients were ventilated with non-lung protective ventilation as well as with low positive end-expiratory pressure and high fraction of inspired oxygen. Despite a mean ED ventilation time of more than 5 hours, few patients had adjustments made to their ventilators. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. SED-ED, a workflow editor for computational biology experiments written in SED-ML.

    PubMed

    Adams, Richard R

    2012-04-15

    The simulation experiment description markup language (SED-ML) is a new community data standard to encode computational biology experiments in a computer-readable XML format. Its widespread adoption will require the development of software support to work with SED-ML files. Here, we describe a software tool, SED-ED, to view, edit, validate and annotate SED-ML documents while shielding end-users from the underlying XML representation. SED-ED supports modellers who wish to create, understand and further develop a simulation description provided in SED-ML format. SED-ED is available as a standalone Java application, as an Eclipse plug-in and as an SBSI (www.sbsi.ed.ac.uk) plug-in, all under an MIT open-source license. Source code is at https://sed-ed-sedmleditor.googlecode.com/svn. The application itself is available from https://sourceforge.net/projects/jlibsedml/files/SED-ED/.

  10. 34 CFR 110.17 - Age distinctions contained in ED's regulations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Age distinctions contained in ED's regulations. 110.17..., DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Standards for Determining Age Discrimination § 110.17 Age distinctions contained in ED...

  11. 34 CFR 110.17 - Age distinctions contained in ED's regulations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Age distinctions contained in ED's regulations. 110.17..., DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Standards for Determining Age Discrimination § 110.17 Age distinctions contained in ED...

  12. 34 CFR 110.17 - Age distinctions contained in ED's regulations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Age distinctions contained in ED's regulations. 110.17..., DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Standards for Determining Age Discrimination § 110.17 Age distinctions contained in ED...

  13. The Consequences of edTPA

    ERIC Educational Resources Information Center

    Greenblatt, Deborah

    2016-01-01

    States and teacher preparation programs across the country are increasingly using a teacher candidate assessment called edTPA. The purpose? To make sure that teacher candidates are ready and able to teach before they begin their careers. The teacher performance assessment requires candidates to compile a portfolio that consists of lesson plans,…

  14. ED pharmacist monitoring of provider antibiotic selection aids appropriate treatment for outpatient UTI.

    PubMed

    Lingenfelter, Erin; Drapkin, Zachary; Fritz, Kelly; Youngquist, Scott; Madsen, Troy; Fix, Megan

    2016-08-01

    We sought to determine whether an emergency department (ED) pharmacist could aid in the monitoring and correction of inappropriate empiric antibiotic selection for urinary tract infections in an outpatient ED population. Urine cultures with greater than 100 000 CFU/mL bacteria from the University of Utah Emergency Department over 1 year (October 2011-Sept 2012) were identified using our electronic medical record system. Per ED protocol, an ED pharmacist reviews all cultures and performs a chart review of patient symptoms, diagnosis, and discharge antibiotics to determine whether the treatment was appropriate. A retrospective review of this process was performed to identify how often inappropriate treatment was recognized and intervened on by an ED pharmacist. Of the 180 cultures included, a total of 42 (23%) of empiric discharge treatments were considered inappropriate and required intervention. In 35 (83%) of 42 patients, the ED pharmacist was able to contact the patient and make appropriate changes; the remaining 7 patients were unable to be contacted, and no change could be made in their treatment. A chart review of all urine cultures with greater than 100 000 CFU/mL performed by an ED pharmacist helped identify inappropriate treatment in 23% of patients discharged to home with the diagnosis of urinary tract infection. Of these patients who had received inappropriate treatment, an ED pharmacist was able to intervene in 83% of cases. These data highlight the role of ED pharmacists in improving patient care after discharge. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Operational and financial impact of physician screening in the ED.

    PubMed

    Soremekun, Olanrewaju A; Biddinger, Paul D; White, Benjamin A; Sinclair, Julia R; Chang, Yuchiao; Carignan, Sarah B; Brown, David F M

    2012-05-01

    Physician screening is one of many front-end interventions being implemented to improve emergency department (ED) efficiency. We aimed to quantify the operational and financial impact of this intervention at an urban tertiary academic center. We conducted a 2-year before-after analysis of a physician screening system at an urban tertiary academic center with 90 000 annual visits. Financial impact consisted of the ED and inpatient revenue generated from the incremental capacity and the reduction in left without being seen (LWBS) rates. The ED and inpatient margin contribution as well as capital expenditure were based on available published data. We summarized the financial impact using net present value of future cash flows performing sensitivity analysis on the assumptions. Operational outcome measures were ED length of stay and percentage of LWBS. During the first year, we estimate the contribution margin of the screening system to be $2.71 million and the incremental operational cost to be $1.86 million. Estimated capital expenditure for the system was $1 200 000. The NPV of this investment was $2.82 million, and time to break even from the initial investment was 13 months. Operationally, despite a 16.7% increase in patient volume and no decrease in boarding hours, there was a 7.4% decrease in ED length of stay and a reduction in LWBS from 3.3% to 1.8%. In addition to improving operational measures, the implementation of a physician screening program in the ED allowed for an incremental increase in patient care capacity leading to an overall positive financial impact. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Fragmented red cells reference range for the Sysmex XN®-series of automated blood cell counters.

    PubMed

    Lesesve, J-F; Speyer, E; Perol, J-P

    2015-10-01

    Fragmented red cells (FRCs) are a new parameter determined automatically by the latest generation of blood cell counters. FRC counts may be of interest as they may reflect schistocyte counts measured on a stained peripheral blood smear observed under the microscope. However, FRC counts depend on the technical procedure used to detect them so that reference ranges are device dependent. The XN-9000® is one of the latest models from the Sysmex series of analysers. We aimed to establish a reference range for FRCs based on 1366 normal patient samples. The mean ± SD was 0.14 ± 0.35% and the median was 0% (95% confidence interval of the mean: 0.12-0.16%). We observed that the percentage of red blood cells with <17 pg of haemoglobin content (Hypo-He) was correlated to an FRC increase and that flagged results relating to red blood cells, reticulocytes or platelets might have presented with artefactually increased FRCs. The FRCs reference range (healthy subjects) should be useful for laboratory staff for selecting which blood smears to check optically. © 2015 John Wiley & Sons Ltd.

  17. The NOURISHED randomised controlled trial comparing mentalisation-based treatment for eating disorders (MBT-ED) with specialist supportive clinical management (SSCM-ED) for patients with eating disorders and symptoms of borderline personality disorder.

    PubMed

    Robinson, Paul; Hellier, Jennifer; Barrett, Barbara; Barzdaitiene, Daiva; Bateman, Anthony; Bogaardt, Alexandra; Clare, Ajay; Somers, Nadia; O'Callaghan, Aine; Goldsmith, Kimberley; Kern, Nikola; Schmidt, Ulrike; Morando, Sara; Ouellet-Courtois, Catherine; Roberts, Alice; Skårderud, Finn; Fonagy, Peter

    2016-11-17

    In this multi-centre randomized controlled trial (RCT) we compared modified mentalisation-based treatment (MBT-ED) to specialist supportive clinical management (SSCM-ED) in patients with eating disorders (EDs) and borderline personality disorder symptoms (BPD). This group of patients presents complex challenges to clinical services, and a treatment which addresses their multiple problems has the potential to improve outcome. MBT has been shown to be effective in improving outcome in patients with BPD, but its use has not been reported in ED. Sixty-eight eligible participants were randomised to MBT-ED or SSCM-ED. The primary outcome measure was the global score on the Eating Disorder Examination. Secondary outcomes included measures of BPD symptoms (the Zanarini Rating Scale for Borderline Personality Disorder), general psychiatric state, quality of life and service utilisation. Participants were assessed at baseline and at 6, 12 and 18 months after randomisation. Analysis was performed using linear mixed models. Only 15 participants (22 %) completed the 18 month follow-up. Early drop-out occurred significantly more in the SSCM-ED group. Drop-out did not vary with treatment model later in therapy and was sometimes attributed to participants moving away. There was higher drop--out amongst smokers and those with higher neuroticism scores. 47.1 % of participants in the MBT-ED arm and 37.1 % in the SSCM-ED arm attended at least 50 % of therapy sessions offered. Amongst those remaining in the trial, at 12 and 18 months MBT-ED was associated with a greater reduction in Shape Concern and Weight Concern in the Eating Disorder Examination compared to SSCM-ED. At 6, 12 and 18 months there was a decline of ED and BPD symptoms in both groups combined. Ten participants were reported as having had adverse events during the trial, mostly self-harm, and there was one death, attributed as 'unexplained' by the coroner. The high drop-out rate made interpretation of the results

  18. Alcohol Interventions Among Underage Drinkers in the ED: A Randomized Controlled Trial.

    PubMed

    Cunningham, Rebecca M; Chermack, Stephen T; Ehrlich, Peter F; Carter, Patrick M; Booth, Brenda M; Blow, Frederic C; Barry, Kristen L; Walton, Maureen A

    2015-10-01

    This study examined the efficacy of emergency department (ED)-based brief interventions (BIs), delivered by a computer or therapist, with and without a post-ED session, on alcohol consumption and consequences over 12 months. Patients (ages 14-20 years) screening positive for risky drinking were randomized to: BI (n = 277), therapist BI (n = 278), or control (n = 281). After the 3-month follow-up, participants were randomized to receive a post-ED BI session or control. Incorporating motivational interviewing, the BIs addressed alcohol consumption and consequences, including driving under the influence (DUI), and alcohol-related injury, as well as other concomitant drug use. The computer BI was an offline, Facebook-styled program. Among 4389 patients screened, 1054 patients reported risky drinking and 836 were enrolled in the randomized controlled trial. Regression models examined the main effects of the intervention conditions (versus control) and the interaction effects (ED condition × post-ED condition) on primary outcomes. The therapist and computer BIs significantly reduced consumption at 3 months, consequences at 3 and 12 months, and prescription drug use at 12 months; the computer BI reduced the frequency of DUI at 12 months; and the therapist BI reduced the frequency of alcohol-related injury at 12 months. The post-ED session reduced alcohol consequences at 6 months, benefiting those who had not received a BI in the ED. A single-session BI, delivered by a computer or therapist in the ED, shows promise for underage drinkers. Findings for the fully automated stand-alone computer BI are particularly appealing given the ease of future implementation. Copyright © 2015 by the American Academy of Pediatrics.

  19. Fulfilling Our Educative Mission: A Response to edTPA Critique

    ERIC Educational Resources Information Center

    Whittaker, Andrea; Pecheone, Raymond; Stansbury, Kendyll

    2018-01-01

    Stanford Center for Assessment, Learning, and Equity (SCALE) provides a commentary on the manuscripts in this special issue, responding to criticisms of edTPA as an assessment that narrows the curriculum, heavily relies on students' academic writing skills, and creates additional burdens for teacher candidates. The commentary highlights how edTPA…

  20. The role of charity care and primary care physician assignment on ED use in homeless patients.

    PubMed

    Wang, Hao; Nejtek, Vicki A; Zieger, Dawn; Robinson, Richard D; Schrader, Chet D; Phariss, Chase; Ku, Jocelyn; Zenarosa, Nestor R

    2015-08-01

    Homeless patients are a vulnerable population with a higher incidence of using the emergency department (ED) for noncrisis care. Multiple charity programs target their outreach toward improving the health of homeless patients, but few data are available on the effectiveness of reducing ED recidivism. The aim of this study is to determine whether inappropriate ED use for nonemergency care may be reduced by providing charity insurance and assigning homeless patients to a primary care physician (PCP) in an outpatient clinic setting. A retrospective medical records review of homeless patients presenting to the ED and receiving treatment between July 2013 and June 2014 was completed. Appropriate vs inappropriate use of the ED was determined using the New York University ED Algorithm. The association between patients with charity care coverage, PCP assignment status, and appropriate vs inappropriate ED use was analyzed and compared. Following New York University ED Algorithm standards, 76% of all ED visits were deemed inappropriate with approximately 77% of homeless patients receiving charity care and 74% of patients with no insurance seeking noncrisis health care in the ED (P=.112). About 50% of inappropriate ED visits and 43.84% of appropriate ED visits occurred in patients with a PCP assignment (P=.019). Both charity care homeless patients and those without insurance coverage tend to use the ED for noncrisis care resulting in high rates of inappropriate ED use. Simply providing charity care and/or PCP assignment does not seem to sufficiently reduce inappropriate ED use in homeless patients. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Using Telemedicine to Address Crowding in the ED.

    PubMed

    Guss, Benjamin; Mishkin, David; Sharma, Rahul

    2016-11-01

    Some health systems are piloting telemedicine solutions in the ED to address crowding and decrease patient wait times. One new program, implemented at the Lisa Perry Emergency Center at New York Presbyterian (NYP) Weill Cornell Medical Center in New York, involves offering low-acuity patients the option of visiting an off-site physician via telemedicine hookup. Administrators note that the approach can get patients in and out of the ED within 30 minutes, and patients have thus far been highly satisfied with the approach. However, an earlier telemedicine program piloted at the University of San Diego Health System’s (UCSD) Hillcrest Hospital in 2013 got bogged down due to administrative and insurance reimbursement hurdles, although the approach showed enough promise that there is interest in restarting the program. In the NYP program, patients are identified as appropriate candidates for the program at triage. They can opt to be seen remotely or through traditional means in the ED’s fast-track section. Administrators note that patients with complex problems requiring extensive workups are not suitable for the telemedicine approach. The most challenging aspect of implementing a successful telemedicine program in the ED is getting the workflows right, according to administrators. An earlier ED-based telemedicine program piloted at UCSD ran into difficulties because the model required the involvement of two physicians, and some insurers did not want to pay for the telemedicine visits. However, patients were receptive.

  2. Rapid Assessment of the ED Institutional Eligibility and Compliance Monitoring Systems. Final Report.

    ERIC Educational Resources Information Center

    Jung, Steven M.

    Two U.S. Department of Education (ED) systems for establishing the initial eligibility and monitoring the performance of postsecondary institutions that participate in ED financial assistance programs were assessed. The evaluation was designed to describe and evaluate the eligibility and certification functions of ED's Eligibility and Agency…

  3. I Failed the edTPA

    ERIC Educational Resources Information Center

    Kuranishi, Adam; Oyler, Celia

    2017-01-01

    In this article, co-written by a teacher and a professor, the authors examine possible explanations for why Adam (first author), a New York City public school special educator, failed the edTPA, a teacher performance assessment required by all candidates for state certification. Adam completed a yearlong teaching residency where he was the special…

  4. Mitigating Higher Ed Cyber Attacks

    ERIC Educational Resources Information Center

    Rogers, Gary; Ashford, Tina

    2015-01-01

    In this presentation we will discuss the many and varied cyber attacks that have recently occurred in the higher ed community. We will discuss the perpetrators, the victims, the impact and how these institutions have evolved to meet this threat. Mitigation techniques and defense strategies will be covered as will a discussion of effective security…

  5. Arabidopsis EDS1 connects pathogen effector recognition to cell compartment-specific immune responses.

    PubMed

    Heidrich, Katharina; Wirthmueller, Lennart; Tasset, Céline; Pouzet, Cécile; Deslandes, Laurent; Parker, Jane E

    2011-12-09

    Pathogen effectors are intercepted by plant intracellular nucleotide binding-leucine-rich repeat (NB-LRR) receptors. However, processes linking receptor activation to downstream defenses remain obscure. Nucleo-cytoplasmic basal resistance regulator EDS1 (ENHANCED DISEASE SUSCEPTIBILITY1) is indispensible for immunity mediated by TIR (Toll-interleukin-1 receptor)-NB-LRR receptors. We show that Arabidopsis EDS1 molecularly connects TIR-NB-LRR disease resistance protein RPS4 recognition of bacterial effector AvrRps4 to defense pathways. RPS4-EDS1 and AvrRps4-EDS1 complexes are detected inside nuclei of living tobacco cells after transient coexpression and in Arabidopsis soluble leaf extracts after resistance activation. Forced AvrRps4 localization to the host cytoplasm or nucleus reveals cell compartment-specific RPS4-EDS1 defense branches. Although nuclear processes restrict bacterial growth, programmed cell death and transcriptional resistance reinforcement require nucleo-cytoplasmic coordination. Thus, EDS1 behaves as an effector target and activated TIR-NB-LRR signal transducer for defenses across cell compartments.

  6. Effect of fiber diameter on flexural properties of fiber-reinforced composites.

    PubMed

    Rezvani, Mohammad Bagher; Atai, Mohammad; Hamze, Faeze

    2013-01-01

    Flexural strength (FS) is one of the most important properties of restorative dental materials which could be improved in fiber-reinforced composites (FRCs) by several methods including the incorporation of stronger reinforcing fibers. This study evaluates the influence of the glass fiber diameter on the FS and elastic modulus of FRCs at the same weight percentage. A mixture of 2,2-bis-[4-(methacryloxypropoxy)-phenyl]-propaneand triethyleneglycol dimethacrylate (60/40 by weight) was prepared as the matrix phase in which 0.5 wt. % camphorquinone and 0.5 wt. % N-N'-dimethylaminoethyl methacrylate were dissolved as photoinitiator system. Glass fibers with three different diameters (14, 19, and 26 μm) were impregnated with the matrix resin using a soft brush. The FRCs were inserted into a 2 × 2 × 25 mm3 mold and cured using a light curing unit with an intensity of ca. 600 mW/cm2 . The FS of the FRCs was measured in a three-point bending method. The elastic modulus was determined from the slope of the initial linear part of stress-strain curve. The fracture surface of the composites was observed using scanning electron microscopy to study the fiber-matrix interface. The results were analyzed and compared using one-way ANOVA and Tukey's post-hoc test. Although the FS increased as the diameter of fibers increased up to 19 μm (P < 0.05), no significant difference was observed between the composites containing fibers with diameters of 19 and 26 μm. The diameter of the fibers influences the mechanical properties of the FRCs.

  7. Are we there yet? A Practitioner's View of DO-178C/ED-12C

    NASA Astrophysics Data System (ADS)

    Daniels, Dewi

    RTCA DO-178B/EUROCAE ED-12B is the industry-accepted guidance for determining that the software aspects of airborne systems and equipment comply with airworthiness requirements. DO-178B/ED-12B, published in 1992, is being updated to DO-178C/ED-12C. Nearly six years in the making, DO- 178C/ED-12C is expected to be completed in December 2010. It will be accompanied by a new set of supplements providing additional and much-needed guidance on tool qualification, model based development and verification, objectoriented technologies, and formal methods. Written by a member of the DO-178C/ED-12C editorial team who is also a practising software developer and verifier, this paper provides a practitioner's view of the new standard and its supplements. It explains how they will affect your organisation, focusing on the practical implications of the many changes between DO-178B/ED-12B and DO-178C/ED-12C.

  8. EDs find physical therapists are an underused asset for musculoskeletal injuries, patient education.

    PubMed

    2011-04-01

    Some EDs are finding that the unique skill sets offered by physical therapists (PT) can be an asset to emergency care while also improving the patient experience. Experts say PTs are particularly valuable in the management of musculoskeletal pain and injuries, but they are also being used for wound care, gait training, and balance assessment. ED administrators say consistent, daily coverage is essential to making a PT program successful; otherwise, ED clinicians will neglect to use their services. PTs need to be comfortable with proactively marketing their skills to other ED clinicians who may not be used to having access to this resource. Experts say PT services in the ED can be reimbursed at a level that is consistent with reimbursement in other inpatient and outpatient settings.

  9. Modelling the growth of Populus species using Ecosystem Demography (ED) model

    NASA Astrophysics Data System (ADS)

    Wang, D.; Lebauer, D. S.; Feng, X.; Dietze, M. C.

    2010-12-01

    Hybrid poplar plantations are an important source being evaluated for biomass production. Effective management of such plantations requires adequate growth and yield models. The Ecosystem Demography model (ED) makes predictions about the large scales of interest in above- and belowground ecosystem structure and the fluxes of carbon and water from a description of the fine-scale physiological processes. In this study, we used a workflow management tool, the Predictive Ecophysiological Carbon flux Analyzer (PECAn), to integrate literature data, field measurement and the ED model to provide predictions of ecosystem functioning. Parameters for the ED ensemble runs were sampled from the posterior distribution of ecophysiological traits of Populus species compiled from the literature using a Bayesian meta-analysis approach. Sensitivity analysis was performed to identify the parameters which contribute the most to the uncertainties of the ED model output. Model emulation techniques were used to update parameter posterior distributions using field-observed data in northern Wisconsin hybrid poplar plantations. Model results were evaluated with 5-year field-observed data in a hybrid poplar plantation at New Franklin, MO. ED was then used to predict the spatial variability of poplar yield in the coterminous United States (United States minus Alaska and Hawaii). Sensitivity analysis showed that root respiration, dark respiration, growth respiration, stomatal slope and specific leaf area contribute the most to the uncertainty, which suggests that our field measurements and data collection should focus on these parameters. The ED model successfully captured the inter-annual and spatial variability of the yield of poplar. Analyses in progress with the ED model focus on evaluating the ecosystem services of short-rotation woody plantations, such as impacts on soil carbon storage, water use, and nutrient retention.

  10. A preliminary examination of Loss of Control Eating Disorder (LOC-ED) in middle childhood.

    PubMed

    Matherne, Camden E; Tanofsky-Kraff, Marian; Altschul, Anne M; Shank, Lisa M; Schvey, Natasha A; Brady, Sheila M; Galescu, Ovidiu; Demidowich, Andrew P; Yanovski, Susan Z; Yanovski, Jack A

    2015-08-01

    Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6-12years with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29years±1.54, 53.8% female, 57.8% White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n=19), LOC in the absence of the full disorder (subLOC, n=33), and youth not reporting LOC (noLOC, n=199). LOC-ED youth had higher BMIz (p=0.001) and adiposity (p=0.003) and reported greater disordered eating concerns (p<0.001) compared to noLOC youth. Compared to subLOC youth, LOC-ED youth had non-significantly higher BMIz (p=0.11), and significantly higher adiposity (p=0.04) and disordered eating attitudes (p=0.02). SubLOC youth had greater disordered eating concerns (p<0.001) and BMIz (p=0.03) but did not differ in adiposity (p=0.33) compared to noLOC youth. These preliminary data suggest that LOC-ED youth are elevated on disordered eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain. Published by Elsevier Ltd.

  11. A Preliminary Examination of Loss of Control Eating Disorder (LOC-ED) in Middle Childhood

    PubMed Central

    Matherne, Camden E.; Tanofsky-Kraff, Marian; Altschul, Anne M.; Shank, Lisa M.; Schvey, Natasha A.; Brady, Sheila M.; Galescu, Ovidiu; Demidowich, Andrew P.; Yanovski, Susan Z.; Yanovski, Jack A.

    2015-01-01

    Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6–12y with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29y ± 1.54, 53.8% female, 57.8 % White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n = 19), LOC in the absence of the full disorder (subLOC, n = 33), and youth not reporting LOC (noLOC, n = 199). LOC-ED youth had higher BMIz (p = 0.001) and adiposity (p = 0.003) and reported greater disordered eating concerns (p < 0.001) compared to noLOC youth. Compared to subLOC youth, LOC-ED youth had non-significantly higher BMIz (p = 0.11), and significantly higher adiposity (p = 0.04) and disordered eating attitudes (p = 0.02). SubLOC youth had greater disordered eating concerns (p < 0.001) and BMIz (p = 0.03) but did not differ in adiposity (p = 0.33) compared to noLOC youth. These preliminary data suggest that LOC-ED youth are elevated on disordered eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain. PMID:25913008

  12. A Chinese translation of the EdFED-Q and assessment of equivalence.

    PubMed

    Lin, Li-Chan; Chang, Chia-Chi

    2003-01-01

    The purpose of this study was to translate the Edinburgh Feeding Evaluation in Dementia Questionnaire (EdFED-Q) from the original English into a Chinese language version and to assess the equivalence of the English and Chinese EdFED-Q versions. To use a directly translated instrument without minimal explanation of the procedures for determining the equivalence between the original and secondary language instrument is questionable. Ensuring equivalence of a translated Chinese version of the EdFED-Q for patients with dementia is an essential prerequisite for identifying culturally specific expressions of feeding difficulty under investigation. Phase 1 consisted of experts doing the initial translation into Chinese and then English back-translations of the questionnaire. Six experts determined the equality of the Chinese and English versions, and five monolingual nurses provided information for the C-EdFED-Q. In phase 2, two bilingual gerontological nurses rated 33 residents with dementia to determine equivalence across time. In phase 3, three groups of bilingual nurses used the Chinese, English, and finally both versions simultaneously to judge a model case's feeding behavior on the videotape. In phase 1, the rating on the equality of the items on the Chinese and English versions was 0.969. In phase 2, kappa coefficients for all items on the C-EdFED-Q and E-EdFED-Q ranged from 0.44 to 1.00. In determining the consistency of the scores for the C-EdFED-Q and E-EdFED-Q between the two raters across time, the intraclass correlation coefficient for the absolute agreement was found to range from 0.85 to 0.90. In phase 3, except for items 6 and 9, all items showed no significant difference among the three groups. Further studies to assess the relationship between constructs and to compare it with known and predicted relationships are recommended.

  13. Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED.

    PubMed

    Zanobetti, Maurizio; Scorpiniti, Margherita; Gigli, Chiara; Nazerian, Peiman; Vanni, Simone; Innocenti, Francesca; Stefanone, Valerio T; Savinelli, Caterina; Coppa, Alessandro; Bigiarini, Sofia; Caldi, Francesca; Tassinari, Irene; Conti, Alberto; Grifoni, Stefano; Pini, Riccardo

    2017-06-01

    Acute dyspnea is a common symptom in the ED. The standard approach to dyspnea often relies on radiologic and laboratory results, causing excessive delay before adequate therapy is started. Use of an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis, while maintaining an acceptable safety profile. Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled. The gold standard was the final diagnosis assessed by two expert reviewers. Two physicians independently evaluated the patient; a sonographer performed an ultrasound evaluation of the lung, heart, and inferior vena cava, while the treating physician requested traditional tests as needed. Time needed to formulate the ultrasound and the ED diagnoses was recorded and compared. Accuracy and concordance of the ultrasound and the ED diagnoses were calculated. A total of 2,683 patients were enrolled. The average time needed to formulate the ultrasound diagnosis was significantly lower than that required for ED diagnosis (24 ± 10 min vs 186 ± 72 min; P = .025). The ultrasound and the ED diagnoses showed good overall concordance (κ = 0.71). There were no statistically significant differences in the accuracy of PoCUS and the standard ED evaluation for the diagnosis of acute coronary syndrome, pneumonia, pleural effusion, pericardial effusion, pneumothorax, and dyspnea from other causes. PoCUS was significantly more sensitive for the diagnosis of heart failure, whereas a standard ED evaluation performed better in the diagnosis of COPD/asthma and pulmonary embolism. PoCUS represents a feasible and reliable diagnostic approach to the patient with dyspnea, allowing a reduction in time to diagnosis. This protocol could help to stratify patients who should undergo a more detailed evaluation. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  14. Internet-Based Economic Education: The Case of EconEdLink

    ERIC Educational Resources Information Center

    VanFossen, Phillip J.; Herman-Ellison, Lisa C.

    2006-01-01

    The National Council on Economic Education's (NCEE) EconEdLink site provides lessons and classroom learning activities based on economics topics in the news, as well as access to real-time economic data. EconEdLink's content is designed to help integrate economic concepts across the curriculum as outlined in the Voluntary National Content…

  15. Project LOGgED ON: Advanced Science Online for Gifted Learners

    ERIC Educational Resources Information Center

    Reed, Christine; Urquhart, Jill

    2007-01-01

    Gifted students are often underserved because they do not have access to highly challenging curriculum. In October, 2002, Project LOGgED ON (www.scrolldown.com/loggedon/) at University of Virginia received federal funding from the Jacob Javits Act to tackle this issue. Those who were part of the LOGgED ON project developed advanced science…

  16. Acute cognitive impairment in elderly ED patients: etiologies and outcomes.

    PubMed

    Wofford, J L; Loehr, L R; Schwartz, E

    1996-11-01

    Despite the common occurrence of acute cognitive impairment in elderly emergency department (ED) patients, there is much uncertainty regarding the evaluation and management of this syndrome. We performed a retrospective cohort study of all patients 60 years of age and older transported by emergency medical services (EMS) to hospital EDs in Forsyth County, North Carolina, during 1990 specifically for evaluation of acute cognitive impairment. Five percent (227 of 4,688) of EMS transports during this time period were for the purpose of evaluation of acute cognitive impairment. Compared with community-dwelling patients (n = 105), nursing home patients (n = 47) had a higher prevalence of final ED diagnoses indicative of infection (42.5% v 13.3%) and a lower prevalence of diagnoses indicative of cerebrovascular disease (10.6% v 22.9%) as the etiology of cognitive impairment. The rates of hospitalization and mortality were 74.3% and 28.9%, respectively. The projected aging of the US population and the high prevalence of this syndrome among elderly patients make better understanding of this syndrome essential for ED providers.

  17. Safety of an ED High-Dose Opioid Protocol for Sickle Cell Disease Pain.

    PubMed

    Tanabe, Paula; Martinovich, Zoran; Buckley, Barbara; Schmelzer, Annie; Paice, Judith A

    2015-05-01

    A nurse-initiated high dose, opioid protocol for vaso-occlusive crisis (VOC) was implemented. Total intravenous morphine sulfate equivalents (IVMSE) in mgs] and safety was evaluated. A medical record review was conducted for all ED visits in adult patients with VOC post protocol implementation. Opioids doses and routes administered during the ED stay, and six hours into the hospital admission were abstracted and total IVMSE administered calculated. Oxygen saturation (SPO2), respiratory rate (RR), administration of naloxone or vasoactive medications, evidence of respiratory arrest, or any other types of resuscitation effort were abstracted. A RR of <10 or SPO2 <92% were coded as abnormal. Descriptive statistics report the total dose. Logistic regression was used to predict abnormal events. Predictors were age, gender, ED dose (10 mg increments) administered, and time from 1st dose to discharge from ED. 72 patients, 603 visits, 276 admitted. The total (ED & hospital dose) mean (95% CI) mg IVMSE administered for all visits was 93 mg (CI 86, 100), ED visit 63 mg (CI 59, 67) and hospital 66 mg (CI 59, 72). The mean (SD) time from administration of 1st analgesic dose to discharge from the ED was 203 (143) minutes, (range = 30-1396 minutes). During two visits, patients experienced a RR <10; while 61 visits were associated with a SPO2 <92%. No medications were administered, or resuscitative measures required. Controlling for demographics and evaluated at the average total ED dose, the longer patients were in the ED, patients were 1.359 times more likely to experience an abnormal vital sign. Controlling for demographics and evaluated at the average total time in the ED, for every 10 mg increase in IVMSE, patients were 1.057 times more likely to experience an abnormal vital sign. The effect of ED dose on the odds of experiencing an abnormal vital sign decreased by a multiplicative factor of 0.0970 for every 1 hour increase in time until discharge. The larger the dose

  18. EdU induces DNA damage response and cell death in mESC in culture.

    PubMed

    Kohlmeier, Fanni; Maya-Mendoza, Apolinar; Jackson, Dean A

    2013-03-01

    Recently, a novel DNA replication precursor analogue called 5-ethynyl-2'-deoxyuridine (EdU) has been widely used to monitor DNA synthesis as an alternative to bromodeoxyuridine. Use of EdU benefits from simplicity and reproducibility and the simple chemical detection systems allows excellent preservation of nuclear structure. However, the alkyne moiety is highly reactive, raising the possibility that incorporation might compromise genome stability. To assess the extent of possible DNA damage, we have analysed the effect of EdU incorporation into DNA during short- and long-term cell culture using a variety of cell lines. We show that EdU incorporation has no measurable impact on the rate of elongation of replication forks during synthesis. However, using different cell lines we find that during long-term cell culture variable responses to EdU incorporation are seen, which range from delayed cell cycle progression to complete cell cycle arrest. The most profound phenotypes were seen in mouse embryonic stem cells, which following incorporation of EdU accumulated in the G2/M-phase of the cell cycle before undergoing apoptosis. In long-term cell culture, EdU incorporation also triggered a DNA damage response in all cell types analysed. Our study shows that while EdU is extremely useful to tag sites of on-going replication, for long-term studies (i.e. beyond the cell cycle in which labelling is performed), a careful analysis of cell cycle perturbations must be performed in order to ensure that any conclusions made after EdU treatment are not a direct consequence of EdU-dependent activation of cell stress responses.

  19. Occupational stress in the ED: a systematic literature review.

    PubMed

    Basu, Subhashis; Qayyum, Hasan; Mason, Suzanne

    2017-07-01

    Occupational stress is a major modern health and safety challenges. While the ED is known to be a high-pressure environment, the specific organisational stressors which affect ED staff have not been established. We conducted a systematic review of literature examining the sources of organisational stress in the ED, their link to adverse health outcomes and interventions designed to address them. A narrative review of contextual factors that may contribute to occupational stress was also performed. All articles written in English, French or Spanish were eligible for conclusion. Study quality was graded using a modified version of the Newcastle-Ottawa Scale. Twenty-five full-text articles were eligible for inclusion in our systematic review. Most were of moderate quality, with two low-quality and two high-quality studies, respectively. While high demand and low job control were commonly featured, other studies demonstrated the role of insufficient support at work, effort-reward imbalance and organisational injustice in the development of adverse health and occupational outcomes. We found only one intervention in a peer-reviewed journal evaluating a stress reduction programme in ED staff. Our review provides a guide to developing interventions that target the origins of stress in the ED. It suggests that those which reduce demand and increase workers' control over their job, improve managerial support, establish better working relationships and make workers' feel more valued for their efforts could be beneficial. We have detailed examples of successful interventions from other fields which may be applicable to this setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Causes and costs for ED visits after pediatric adenotonsillectomy.

    PubMed

    Curtis, Jonathan L; Harvey, D Brandon; Willie, Scott; Narasimhan, Evan; Andrews, Seth; Henrichsen, Jake; Van Buren, Nicholas C; Srivastava, Rajendu; Meier, Jeremy D

    2015-04-01

    (1) Review the reasons, timing, and costs for children presenting to the emergency department (ED) after adenotonsillectomy (T&A). Case series with chart review. Tertiary care children's hospital. A standardized activity-based hospital accounting system was used to identify 437 children from an academic pediatric otolaryngology practice presenting to the ED after T&A from 2009 to 2012. The reason for presentation, timing after surgery, and facility costs were recorded. The study cohort represented 13.3% of the 3198 patients who underwent T&A during that time period. Overall, 133 (4.2%) presented for dehydration, 106 (3.3%) presented for post-tonsillectomy hemorrhage, 65 (2.0%) for poorly controlled pain, 42 (1.3%) for fever, 29 (1.0%) for vomiting/nausea/GI discomfort, 22 (0.7%) for respiratory complications, and 12 (0.4%) for miscellaneous reasons related to the operation; 28 (0.8%) were unrelated to the T&A and excluded. Mean postoperative day at the time of ED presentation was 4.4 (95% CI, 4.1-4.7). The mean cost per patient presenting to the ED was $1420 (95% CI, $1104-$1737), the most costly subgroups being those presenting with respiratory complications ($2855; 95% CI, $1434-$4277), hemorrhage ($1502; 95% CI, $1216-$1787), and dehydration ($1372; 95% CI, $995-$1750). The least costly subgroup was acute postoperative pain ($781; 95% CI, $282-$1200). A significant portion of children present to the ED after T&A for poorly controlled pain, dehydration, or fever. The costs from these visits are significant. Accounting for these costs in the global care for pediatric T&A could assist in calculating appropriate reimbursement for bundled payments in this climate of health care reform. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  1. Ectodermal dysplasia (ED) syndrome.

    PubMed

    Chee, Siew-Yin; Wanga, Chung-Hsing; Lina, Wei-De; Tsaia, Fuu-Jen

    2014-01-01

    Ectodermal dysplasia (ED) syndrome comprises a large, heterogeneous group of inherited disorders that are defined by primary defects in the development of 2 or more tissues derived from the embryonic ectoderm. The tissues primarily involved are the skin and its appendages (including hair follicles, eccrine glands, sebaceous glands, nails) and teeth. The clinical features include sparse hair, abnormal or missing teeth, and an inability to sweat due to lack of sweat glands. One such case report of ectodermal dysplasia is presented here.

  2. Ph.D. and Ed.D. Program Adaptations for College Teachers.

    ERIC Educational Resources Information Center

    Dressel, Paul L.; Guiste, Evelyn B.

    The extent to which the Ph.D. and/or Ed.D. programs have been adapted to assist in preparing students for college teaching was surveyed. Of 309 universities, 122 responded, and of these, 72 had no adaptations. However, 50 universities indicated the availability, in at least one discipline or field, of modifications in the Ph.D. and/or Ed.D.…

  3. Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse Perceptions.

    PubMed

    Flanigan, Moira; Heilman, James A; Johnson, Tom; Yarris, Lalena M

    2015-11-01

    The Accreditation Council for Graduate Medical Education requires that residency programs ensure resident competency in performing safe, effective handoffs. Understanding resident, attending, and nurse perceptions of the key elements of a safe and effective emergency department (ED) handoff is a crucial step to developing feasible, acceptable educational interventions to teach and assess this fundamental competency. The aim of our study was to identify the essential themes of ED-based handoffs and to explore the key cultural and interprofessional themes that may be barriers to developing and implementing successful ED-based educational handoff interventions. Using a grounded theory approach and constructivist/interpretivist research paradigm, we analyzed data from three primary and one confirmatory focus groups (FGs) at an urban, academic ED. FG protocols were developed using open-ended questions that sought to understand what participants felt were the crucial elements of ED handoffs. ED residents, attendings, a physician assistant, and nurses participated in the FGs. FGs were observed, hand-transcribed, audio-recorded and subsequently transcribed. We analyzed data using an iterative process of theme and subtheme identification. Saturation was reached during the third FG, and the fourth confirmatory group reinforced the identified themes. Two team members analyzed the transcripts separately and identified the same major themes. ED providers identified that crucial elements of ED handoff include the following: 1) Culture (provider buy-in, openness to change, shared expectations of sign-out goals); 2) Time (brevity, interruptions, waiting); 3) Environment (physical location, ED factors); 4) Process (standardization, information order, tools). Key participants in the ED handoff process perceive that the crucial elements of intershift handoffs involve the themes of culture, time, environment, and process. Attention to these themes may improve the feasibility and

  4. Crystal structures of the components of the Staphylococcus aureus leukotoxin ED

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

    Nocadello, S.; Minasov, G.; Shuvalova, L.

    Staphylococcal leukotoxins are a family of β-barrel, bicomponent, pore-forming toxins with membrane-damaging functions. These bacterial exotoxins share sequence and structural homology and target several host-cell types. Leukotoxin ED (LukED) is one of these bicomponent pore-forming toxins thatStaphylococcus aureusproduces in order to suppress the ability of the host to contain the infection. The recent delineation of the important role that LukED plays inS. aureuspathogenesis and the identification of its protein receptors, combined with its presence inS. aureusmethicillin-resistant epidemic strains, establish this leukocidin as a possible target for the development of novel therapeutics. Here, the crystal structures of the water-soluble LukE andmore » LukD components of LukED have been determined. Lastly, the two structures illustrate the tertiary-structural variability with respect to the other leukotoxins while retaining the conservation of the residues involved in the interaction of the protomers in the bipartite leukotoxin in the pore complex.« less

  5. Crystal structures of the components of the Staphylococcus aureus leukotoxin ED

    DOE PAGES

    Nocadello, S.; Minasov, G.; Shuvalova, L.; ...

    2016-01-01

    Staphylococcal leukotoxins are a family of β-barrel, bicomponent, pore-forming toxins with membrane-damaging functions. These bacterial exotoxins share sequence and structural homology and target several host-cell types. Leukotoxin ED (LukED) is one of these bicomponent pore-forming toxins thatStaphylococcus aureusproduces in order to suppress the ability of the host to contain the infection. The recent delineation of the important role that LukED plays inS. aureuspathogenesis and the identification of its protein receptors, combined with its presence inS. aureusmethicillin-resistant epidemic strains, establish this leukocidin as a possible target for the development of novel therapeutics. Here, the crystal structures of the water-soluble LukE andmore » LukD components of LukED have been determined. Lastly, the two structures illustrate the tertiary-structural variability with respect to the other leukotoxins while retaining the conservation of the residues involved in the interaction of the protomers in the bipartite leukotoxin in the pore complex.« less

  6. Electroencephalography findings in patients presenting to the ED for evaluation of seizures.

    PubMed

    Kadambi, Pooja; Hart, Kimberly W; Adeoye, Opeolu M; Lindsell, Christopher J; Knight, William A

    2015-01-01

    Status epilepticus is a life-threatening, time-sensitive emergency. Acquiring an electroencephalogram (EEG) in the emergency department (ED) could impact therapeutic and disposition decisions for patients with suspected status epilepticus. The objective of this study is to estimate the proportion of EEGs diagnostic for seizures in patients presenting to an ED with a complaint of seizures. This retrospective chart review included adults presenting to the ED of an urban, academic, tertiary care hospital with suspected seizures or status epilepticus, who received an EEG within 24 hours of hospital admission. Data abstraction was performed by a single, trained, nonblinded abstractor. Seizures were defined as an epileptologist's diagnosis of either seizures or status epilepticus on EEG. The proportion of patients with seizures is given with confidence interval95 (CI95). Of 120 included patients, 67 (56%) had a history of epilepsy. Mean age was 52 years (SD, 16), 58% were White, and 61% were male. Within 24 hours, 3% had an EEG diagnostic for seizures. Electroencephalogram was obtained in the ED in 32 (27%) of 120 (CI95, 19%-35%), and 2 (6%) of 32 (CI95, 1%-19%) had seizures. Electroencephalogram was performed inpatient for 88 (73%) of 120 (CI95, 65%-81%), and 2 (2%) of 88 (CI95, 0.5%-7.1%) had seizures. Only 3% of ED patients with suspected seizures or status epilepticus had EEG confirmation of seizures within 24 hours. Early EEG acquisition in the ED may identify a group of patients amenable to ED observation and subsequent discharge from the hospital. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Active Intervention Can Decrease Burnout In Ed Nurses.

    PubMed

    Wei, Rong; Ji, Hong; Li, Jianxin; Zhang, Liyao

    2017-03-01

    The aim of this study was to evaluate whether active intervention can decrease job burnout and improve performance among ED nurses. This study was carried out in the emergency departments of 3 hospitals randomly selected from 8 comprehensive high-level hospitals in Jinan, China. A total of 102 nurses were enrolled and randomly divided into control and intervention groups. For 6 months, nurses in intervention groups were treated with ordinary treatment plus comprehensive management, whereas nurses in the control group were treated with ordinary management, respectively. Questionnaires were sent and collected at baseline and at the end of the study. The Student t test was used to evaluate the effect of comprehensive management in decreasing burnout. All ED nurses showed symptoms of job burnout at different levels. Our data indicated that comprehensive management significantly decreased emotional exhaustion and depersonalization (P < .01). The findings suggest that active intervention with comprehensive management may effectively reduce job burnout in ED nurses and contribute to relieving work-related stress and may further protect against potential mental health problems. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  8. 78 FR 55684 - ConnectED Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... schools for digital learning. The ConnectED Workshop will discuss the growing bandwidth needs of K-12 schools as more schools use mobile devices to enrich the learning experience; as teachers increasingly... Distance Learning and Telemedicine Program; and the U.S. Department of Education. The meeting will be open...

  9. Experimental Study on the Fire Performance of Tubular Steel Columns with Membrane Protections for Prefabricated and Modular Steel Construction

    PubMed Central

    Zhang, Xin; Peng, Lei; Ni, Zhao-peng; Ni, Tian-xiao; Huang, Yi-liang; Zhou, Yang

    2018-01-01

    Experimental research was conducted to study the fire resistance of steel tubular columns used in prefabricated and modular construction. In order to achieve high-efficient prefabrication and fast on-site installation, membrane protections using board products and thermal insulation blankets are adopted as the favorable protection method. Three protected tubular columns were tested in a full-scale column furnace with axial load applied. The study variables were different membranes, including fiber reinforced calcium silicate (FRCS) boards, rock wool and aluminum silica (Fiberfrax) insulations. The results suggest that one layer of 12 mm FRCS board with rock wool insulation has insufficient fire protection. However, steel columns protected with two layers of 12 mm FRCS boards with insulation appeared to have good fire resistances and could achieve a fire resistance rating as high as 2.5~3.0 h. PMID:29547574

  10. Automated SEM-EDS GSR Analysis for Turkish Ammunitions

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

    Cakir, Ismail; Uner, H. Bulent

    2007-04-23

    In this work, Automated Scanning Electron Microscopy with Energy Dispersive X-ray Spectrometry (SEM-EDS) was used to characterize 7.65 and 9mm cartridges Turkish ammunition. All samples were analyzed in a SEM Jeol JSM-5600LV equipped BSE detector and a Link ISIS 300 (EDS). A working distance of 20mm, an accelerating voltage of 20 keV and gunshot residue software was used in all analysis. Automated search resulted in a high number of particles analyzed containing gunshot residues (GSR) unique elements (PbBaSb). The obtained data about the definition of characteristic GSR particles was concordant with other studies on this topic.

  11. Multiple Intelligence and Digital Learning Awareness of Prospective B.Ed Teachers

    ERIC Educational Resources Information Center

    Gracious, F. L. Antony; Shyla, F. L. Jasmine Anne

    2012-01-01

    The present study Multiple Intelligence and Digital Learning Awareness of prospective B.Ed teachers was probed to find the relationship between Multiple Intelligence and Digital Learning Awareness of Prospective B.Ed Teachers. Data for the study were collected using self made Multiple Intelligence Inventory and Digital Learning Awareness Scale.…

  12. Mechanical Ventilation and ARDS in the ED: A Multicenter, Observational, Prospective, Cross-sectional Study.

    PubMed

    Fuller, Brian M; Mohr, Nicholas M; Miller, Christopher N; Deitchman, Andrew R; Levine, Brian J; Castagno, Nicole; Hassebroek, Elizabeth C; Dhedhi, Adam; Scott-Wittenborn, Nicholas; Grace, Edward; Lehew, Courtney; Kollef, Marin H

    2015-08-01

    There are few data regarding mechanical ventilation and ARDS in the ED. This could be a vital arena for prevention and treatment. This study was a multicenter, observational, prospective, cohort study aimed at analyzing ventilation practices in the ED. The primary outcome was the incidence of ARDS after admission. Multivariable logistic regression was used to determine the predictors of ARDS. We analyzed 219 patients receiving mechanical ventilation to assess ED ventilation practices. Median tidal volume was 7.6 mL/kg predicted body weight (PBW) (interquartile range, 6.9-8.9), with a range of 4.3 to 12.2 mL/kg PBW. Lung-protective ventilation was used in 122 patients (55.7%). The incidence of ARDS after admission from the ED was 14.7%, with a mean onset of 2.3 days. Progression to ARDS was associated with higher illness severity and intubation in the prehospital environment or transferring facility. Of the 15 patients with ARDS in the ED (6.8%), lung-protective ventilation was used in seven (46.7%). Patients who progressed to ARDS experienced greater duration in organ failure and ICU length of stay and higher mortality. Lung-protective ventilation is infrequent in patients receiving mechanical ventilation in the ED, regardless of ARDS status. Progression to ARDS is common after admission, occurs early, and worsens outcome. Patient- and treatment-related factors present in the ED are associated with ARDS. Given the limited treatment options for ARDS, and the early onset after admission from the ED, measures to prevent onset and to mitigate severity should be instituted in the ED. ClinicalTrials.gov; No.: NCT01628523; URL: www.clinicaltrials.gov.

  13. [Update of PDE5 inhibitors as treatment of ED].

    PubMed

    Lu, Yong-ning; Chen, Bin

    2005-07-01

    Erectile dysfunction is a common ailment in middle-aged and old men. The management of ED has entered a new stage since sildenafil was used to treat ED in 1998. Sildenafil became the first-line treatment for its efficacy and safety. In recent years, new PDE5 inhibitors--vardenafil and tadalafil came into market in succession, providing more options available for oral therapy. This review is about the development of preclinical and clinical medicine research on the three PDE5 inhibitors, and provide information for clinical choices.

  14. Multivariate statistical analysis of low-voltage EDS spectrum images

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

    Anderson, I.M.

    1998-03-01

    Whereas energy-dispersive X-ray spectrometry (EDS) has been used for compositional analysis in the scanning electron microscope for 30 years, the benefits of using low operating voltages for such analyses have been explored only during the last few years. This paper couples low-voltage EDS with two other emerging areas of characterization: spectrum imaging and multivariate statistical analysis. The specimen analyzed for this study was a finished Intel Pentium processor, with the polyimide protective coating stripped off to expose the final active layers.

  15. KSC-05pd2537

    NASA Image and Video Library

    2005-11-30

    KENNEDY SPACE CENTER, FLA. - The Forward Reaction Control System (FRCS) of space shuttle Atlantis sits in the transfer aisle of Orbiter Processing Facility Bay 1 in anticipation of being installed. The FRCS provides the thrust for attitude (rotational) maneuvers (pitch, yaw and roll) and for small velocity changes along the orbiter axis (translation maneuvers). Processing of Atlantis is under way for mission STS-115, the 19th flight to the International Space Station.

  16. KSC-05pd2536

    NASA Image and Video Library

    2005-11-30

    KENNEDY SPACE CENTER, FLA. - The Forward Reaction Control System (FRCS) of space shuttle Atlantis sits in the transfer aisle of Orbiter Processing Facility Bay 1 in anticipation of being installed. The FRCS provides the thrust for attitude (rotational) maneuvers (pitch, yaw and roll) and for small velocity changes along the orbiter axis (translation maneuvers). Processing of Atlantis is under way for mission STS-115, the 19th flight to the International Space Station.

  17. Balanced nuclear and cytoplasmic activities of EDS1 are required for a complete plant innate immune response.

    PubMed

    García, Ana V; Blanvillain-Baufumé, Servane; Huibers, Robin P; Wiermer, Marcel; Li, Guangyong; Gobbato, Enrico; Rietz, Steffen; Parker, Jane E

    2010-07-01

    An important layer of plant innate immunity to host-adapted pathogens is conferred by intracellular nucleotide-binding/oligomerization domain-leucine rich repeat (NB-LRR) receptors recognizing specific microbial effectors. Signaling from activated receptors of the TIR (Toll/Interleukin-1 Receptor)-NB-LRR class converges on the nucleo-cytoplasmic immune regulator EDS1 (Enhanced Disease Susceptibility1). In this report we show that a receptor-stimulated increase in accumulation of nuclear EDS1 precedes or coincides with the EDS1-dependent induction and repression of defense-related genes. EDS1 is capable of nuclear transport receptor-mediated shuttling between the cytoplasm and nucleus. By enhancing EDS1 export from inside nuclei (through attachment of an additional nuclear export sequence (NES)) or conditionally releasing EDS1 to the nucleus (by fusion to a glucocorticoid receptor (GR)) in transgenic Arabidopsis we establish that the EDS1 nuclear pool is essential for resistance to biotrophic and hemi-biotrophic pathogens and for transcriptional reprogramming. Evidence points to post-transcriptional processes regulating receptor-triggered accumulation of EDS1 in nuclei. Changes in nuclear EDS1 levels become equilibrated with the cytoplasmic EDS1 pool and cytoplasmic EDS1 is needed for complete resistance and restriction of host cell death at infection sites. We propose that coordinated nuclear and cytoplasmic activities of EDS1 enable the plant to mount an appropriately balanced immune response to pathogen attack.

  18. Evaluating Prospective Teachers: Testing the Predictive Validity of the EdTPA

    ERIC Educational Resources Information Center

    Goldhaber, Dan; Cowan, James; Theobald, Roddy

    2017-01-01

    We use longitudinal data from Washington State to provide estimates of the extent to which performance on the edTPA, a performance-based, subject-specific assessment of teacher candidates, is predictive of the likelihood of employment in the teacher workforce and value-added measures of teacher effectiveness. While edTPA scores are highly…

  19. Characteristics of Reading Disability Types in Middle School Students Classified ED

    ERIC Educational Resources Information Center

    Mattison, Richard E.

    2008-01-01

    Types of reading disabilities (RD) have not yet been investigated in students classified with emotional disturbance (ED). The prevalence of RD and differentiating characteristics were examined in 118 middle school students attending a self-contained school for ED students by defining RDs with reading standard scores less than 85 on the two…

  20. How do clinicians with different training backgrounds manage walk-in patients in the ED setting?

    PubMed

    Harris, Tim; McDonald, Keith

    2014-12-01

    To compare the initial assessment and management of walk-in emergency department (ED) patients between different types of healthcare providers. A large teaching hospital with an annual ED census of 140 000 adult patients. A random sample of 384 patients who self-presented to the ED was obtained. A detailed analysis of each patient record was performed by two clinicians. Data were obtained on the presenting condition, and disposition of each patient, either into the ED for further assessment, or discharge. GPs were significantly more likely to discharge patients home as compared to emergency nurses. ED senior nurses were more likely than GPs to stream patients into the ED for further assessment. Of the patients referred into the ED for further assessment by senior ED nurses, the majority were discharged home. There were insufficient numbers of emergency physician assessments for meaningful statistical analysis. The clinician groups studied here demonstrated different patterns of discharge and referral, reflecting their training and experience. When planning operational procedures, the training and background of the staff allocated to each area should be considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Using demand analysis and system status management for predicting ED attendances and rostering.

    PubMed

    Ong, Marcus Eng Hock; Ho, Khoy Kheng; Tan, Tiong Peng; Koh, Seoh Kwee; Almuthar, Zain; Overton, Jerry; Lim, Swee Han

    2009-01-01

    It has been observed that emergency department (ED) attendances are not random events but rather have definite time patterns and trends that can be observed historically. To describe the time demand patterns at the ED and apply systems status management to tailor ED manpower demand. Observational study of all patients presenting to the ED at the Singapore General Hospital during a 3-year period was conducted. We also conducted a time series analysis to determine time norms regarding physician activity for various severities of patients. The yearly ED attendances increased from 113387 (2004) to 120764 (2005) and to 125773 (2006). There was a progressive increase in severity of cases, with priority 1 (most severe) increasing from 6.7% (2004) to 9.1% (2006) and priority 2 from 33.7% (2004) to 35.1% (2006). We noticed a definite time demand pattern, with seasonal peaks in June, weekly peaks on Mondays, and daily peaks at 11 to 12 am. These patterns were consistent during the period of the study. We designed a demand-based rostering tool that matched doctor-unit-hours to patient arrivals and severity. We also noted seasonal peaks corresponding to public holidays. We found definite and consistent patterns of patient demand and designed a rostering tool to match ED manpower demand.

  2. Development and Validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: The ED Prevention Quality Indicators for General Health Conditions.

    PubMed

    Davies, Sheryl; Schultz, Ellen; Raven, Maria; Wang, Nancy Ewen; Stocks, Carol L; Delgado, Mucio Kit; McDonald, Kathryn M

    2017-10-01

    To develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health. Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project 2008-2010 State Inpatient Databases and State Emergency Department Databases. Empirical analyses and structured panel reviews. Panels of 14-17 clinicians and end users evaluated a set of ED Prevention Quality Indicators (PQIs) using a Modified Delphi process. Empirical analyses included assessing variation in ED PQI rates across counties and sensitivity of those rates to county-level poverty, uninsurance, and density of primary care physicians (PCPs). ED PQI rates varied widely across U.S. communities. Indicator rates were significantly associated with county-level poverty, median income, Medicaid insurance, and levels of uninsurance. A few indicators were significantly associated with PCP density, with higher rates in areas with greater density. A clinical and an end-user panel separately rated the indicators as having strong face validity for most uses evaluated. The ED PQIs have undergone initial validation as indicators of community health with potential for use in public reporting, population health improvement, and research. © Health Research and Educational Trust.

  3. Uncovering the Identities of Students and Graduates in a CPED-Influenced EdD Program

    ERIC Educational Resources Information Center

    Zambo, Debby; Buss, Ray R.; Zambo, Ron

    2015-01-01

    The educational doctorate (EdD) is being re-envisioned as a distinct professional degree. Today's EdD graduates are envisioned as scholarly practitioners. Given this it may be reasoned these individuals have unique identities comprised of several layers. In this study, we examined how 18 entering students and 17 graduating students from an EdD…

  4. Chemical Quantification of Atomic-Scale EDS Maps under Thin Specimen Conditions

    DOE PAGES

    Lu, Ping; Romero, Eric; Lee, Shinbuhm; ...

    2014-10-13

    We report our effort to quantify atomic-scale chemical maps obtained by collecting energy-dispersive X-ray spectra (EDS) using scanning transmission electron microscopy (STEM) (STEM-EDS). Under a thin specimen condition and when the EDS scattering potential is localized, the X-ray counts from atomic columns can be properly counted by fitting Gaussian peaks at the atomic columns, and can then be used for site-by-site chemical quantification. The effects of specimen thickness and X-ray energy on the Gaussian peak-width are investigated by using SrTiO 3 (STO) as a model specimen. The relationship between the peak-width and spatial-resolution of an EDS map is also studied.more » Furthermore, the method developed by this work is applied to study a Sm-doped STO thin film and antiphase boundaries present within the STO film. We find that Sm atoms occupy both Sr and Ti sites but preferably the Sr sites, and Sm atoms are relatively depleted at the antiphase boundaries likely due to the effect of strain.« less

  5. An introduction to the Emergency Department Adult Clinical Escalation protocol: ED-ACE.

    PubMed

    Coughlan, Eoin; Geary, Una; Wakai, Abel; O'Sullivan, Ronan; Browne, John; McAuliffe, Eilish; Ward, Marie; McDaid, Fiona; Deasy, Conor

    2017-09-01

    This study demonstrates how a participatory action research approach was used to address the challenge of the early and effective detection of the deteriorating patient in the ED setting. The approach enabled a systematic approach to patient monitoring and escalation of care to be developed to address the wide-ranging spectrum of undifferentiated presentations and the phases of ED care from triage to patient admission. This paper presents a longitudinal patient monitoring system, which aims to provide monitoring and escalation of care, where necessary, of adult patients from triage to admission to hospital in a manner that is feasible in the unique ED environment. An action research approach was taken to designing a longitudinal patient monitoring system appropriate for the ED. While the first draft protocol for post-triage monitoring and escalation was designed by a core research group, six clinical sites were included in iterative cycles of planning, action, reviewing and further planning. Reasons for refining the system at each site were collated and the protocol was adjusted accordingly before commencing the process at the next site. The ED Adult Clinical Escalation longitudinal patient monitoring system (ED-ACE) evolved through iterative cycles of design and testing to include: (1) a monitoring chart for adult patients; (2) a standardised approach to the monitoring and reassessment of patients after triage until they are assessed by a clinician; (3) the ISBAR (I=Identify, S=Situation, B=Background, A=Assessment, R=Recommendation) tool for interprofessional communication relating to clinical escalation; (4) a template for prescribing a patient-specific monitoring plan to be used by treating clinicians to guide patient monitoring from the time the patient is assessed until when they leave the ED and (5) a protocol for clinical escalation prompted by single physiological triggers and clinical concern. This tool offers a link in the 'Chain of Prevention' between

  6. Self-Esteem and Emotional Intelligence among B.Ed Trainees of Tsunami Affected Coastal Belt

    ERIC Educational Resources Information Center

    Babu M, Sameer

    2008-01-01

    Through this study the author investigates the relationship between self-esteem and emotional intelligence among B.Ed trainees of Tsunami affected coastal belt of Alappey district of Kerala, India. Stream of study, marital status and age based comparisons were made among the B.Ed trainees. 92 B.Ed trainees were the participants in the study. It…

  7. NetSciEd: Network Science and Education for the Interconnected World

    ERIC Educational Resources Information Center

    Sayama, Hiroki; Cramer, Catherine; Sheetz, Lori; Uzzo, Stephen

    2017-01-01

    This short article presents a summary of the NetSciEd (Network Science and Education) initiative that aims to address the need for curricula, resources, accessible materials, and tools for introducing K-12 students and the general public to the concept of networks, a crucial framework in understanding complexity. NetSciEd activities include (1)…

  8. ED becomes 'lean' and cuts LBTC, LOS times.

    PubMed

    2008-04-01

    Lean manufacturing techniques, first developed by Toyota, can be successfully adapted to help improve processes in your ED. St. Luke's Episcopal Hospital in Houston, has used Lean to reduce median length of stay, frequency of diversions, and the percentage of patients who left before treatment was complete (LBTC). Here's why "Lean" can help improve the performance of your ED: It enables you and your staff to see things from the patient's point of view. Lean tools enable you to view the status of your department in real-time and to compare that status with your performance goals. Exercises help identify areas where your processes break down and determine the most likely solutions.

  9. KSC-2009-4794

    NASA Image and Video Library

    2009-08-19

    CAPE CANAVERAL, Fla. – In NASA Kennedy Space Center's Orbiter Processing Facility 2, workers begin removing the forward reaction control system, or FRCS, from space shuttle Endeavour's forward fuselage nose area. The FRCS provides the thrust for attitude (rotational) maneuvers (pitch, yaw and roll) and for small velocity changes along the orbiter axis (translation maneuvers). Endeavour is designated as the shuttle for the STS-130 mission, targeted for launch in February 2010. Photo credit: NASA/Jack Pfaller

  10. KSC-2009-4795

    NASA Image and Video Library

    2009-08-19

    CAPE CANAVERAL, Fla. – In NASA Kennedy Space Center's Orbiter Processing Facility 2, a worker removes the forward reaction control system, or FRCS, from space shuttle Endeavour's forward fuselage nose area. The FRCS provides the thrust for attitude (rotational) maneuvers (pitch, yaw and roll) and for small velocity changes along the orbiter axis (translation maneuvers). Endeavour is designated as the shuttle for the STS-130 mission, targeted for launch in February 2010. Photo credit: NASA/Jack Pfaller

  11. KSC-2009-4792

    NASA Image and Video Library

    2009-08-19

    CAPE CANAVERAL, Fla. – The forward reaction control system, or FRCS, will be removed from space shuttle Endeavour's forward fuselage nose area in NASA Kennedy Space Center's Orbiter Processing Facility 2. The FRCS provides the thrust for attitude (rotational) maneuvers (pitch, yaw and roll) and for small velocity changes along the orbiter axis (translation maneuvers). Endeavour is designated as the shuttle for the STS-130 mission, targeted for launch in February 2010. Photo credit: NASA/Jack Pfaller

  12. Why Do Cancer Patients Die in the Emergency Department? An Analysis of 283 Deaths in NC EDs

    PubMed Central

    Leak, Ashley; Mayer, Deborah K.; Wyss, Annah; Travers, Debbie; Waller, Anna

    2013-01-01

    Emergency department (ED) visits are made by cancer patients for symptom management, treatment effects, oncologic emergencies, or end of life care. While most patients prefer to die at home, many die in health care institutions. The purpose of this study is to describe visit characteristics of cancer patients who died in the ED and their most common chief complaints using 2008 ED visit data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). Of the 37,760 cancer-related ED visits, 283 resulted in death. For lung cancer patients, 104 died in the ED with 70.9% dying on their first ED visit. Research on factors precipitating ED visits by cancer patients is needed to address end of life care needs. PMID:22556288

  13. ED utilization trends in sports-related traumatic brain injury.

    PubMed

    Hanson, Holly R; Pomerantz, Wendy J; Gittelman, Mike

    2013-10-01

    Emergency department (ED) visits for sports-related traumatic brain injuries (TBIs) have risen. This study evaluated how the number and severity of admissions have changed as ED visits for sports-related TBIs have increased. A retrospective study of children aged 0 to 19 years at a level 1 trauma center was performed. Patients from 2002 to 2011 with a primary or secondary diagnosis of TBI were identified from the hospital's inpatient and outpatient trauma registries. Frequencies were used to characterize the population, χ(2) analysis was performed to determine differences between groups, and regression analysis looked at relationship between year and injury severity score or length of stay. Sport was responsible for injury in 3878 (15.4%) cases during the study period; 3506 (90.4%) were discharged from the hospital, and 372 (9.6%) were admitted. Seventy-three percent were male patients and 78% Caucasian; mean age was 13 ± 3.5 years. ED visits for sports-related TBIs increased 92% over the study period, yet there was no significant change (χ(2) = 9.8, df = 9, P = .37) in the percentage of children admitted. Mean injury severity score for those admitted decreased from 7.8 to 4.8 (β = -0.46; P = .006); length of stay trended downward (β = -0.05; P = .05). The percentage of children being admitted from the ED with sports-related TBI has not changed over the past 10 years. The severity of admitted sports-related TBI is decreasing. Additional research is needed to correlate these trends with other TBI mechanisms.

  14. Mental Health and Academic Achievement among M.Ed. Students in Kerala

    ERIC Educational Resources Information Center

    Moradi Sheykhjan, Tohid; K., Rajeswari; Jabari, Kamran

    2017-01-01

    The present research endeavor was aimed to assess relationship between Mental Health and Academic Achievement among M.Ed. students in Kerala. The sample of the study consisted of 314 M.Ed. students in Kerala. The method used for the present study was survey method. Mental Health Status Scale (M.H.S. Scale) was used and the study used the total…

  15. The EdD Cohort Experience: Students' Reflection on the Program

    ERIC Educational Resources Information Center

    Atabay, Kyle; Cravalho, Erika K.; Demirbag, Jocelyn Romero; Ka'ai, Elsa Pua; Kaneshiro, Alyson; Nakasato, Steve

    2017-01-01

    Presented as a collection of short essays, the authors of this article reflect on their experience in the University of Hawaii at Manoa EdD program and the questions, "What have you been able to take away from the experience?" and "What are you doing now that the EdD made possible?" The authors entered the program with a wealth…

  16. Treatment motivation of men with ED: what motivates men with ED to seek professional help and how can women support their partners?

    PubMed

    Gerster, S; Günzler, C; Roesler, C; Leiber, C; Berner, M M

    2013-01-01

    Although ED can impair sexual satisfaction as well as the quality of partnership and life, men affected often avoid seeking treatment. There is growing evidence that women have an influence on their partner's help-seeking behavior. This qualitative study examined men with ED and their female partners in order to detect motivational factors for men to seek treatment and motivational actions of the women to support their partners. Twelve couples took part in a semi-structured telephone interview, which was performed separately in men and women. Analysis was on the basis of the Grounded Theory. The identified motivational factors could be divided into extrinsic (for example, media, female partner) and intrinsic (for example, desire to clarify the cause of the ED, hope for improvement) factors. Women can support their partners in treatment-seeking through various motivational actions such as talking with each other, showing interest and dealing actively with the problem, appealing to the male self-esteem, supporting the doctor's visit, forcing the treatment, active cooperation and participation in the treatment or initiating sexual intercourse. On the basis of these findings, recommendations for women were developed to support their partners and increase the probability of help-seeking behavior.

  17. Patient-Centered Care Transition for Patients Admitted through the ED: Improving Patient and Employee Experience

    PubMed Central

    Algauer, Andrea; Rivera, Stephanie; Faurote, Robert

    2015-01-01

    With increasing wait times in emergency departments (ED) across America, there is a need to streamline the inpatient admission process in order to decrease wait times and more important, to increase patient and employee satisfaction. One inpatient unit at New York-Presbyterian Weill Cornell Medical Center initiated a program to help expedite the inpatient admission process from the ED. The goal of the ED Bridge program is to ease the patient's transition from the ED to an inpatient unit by visiting the patient in the ED and introducing and setting expectations for the inpatient environment (i.e. telemetry alarms, roommates, hourly comfort rounds). Along with improving the patient experience, this program intends to improve the collaboration between ED nurses and inpatient nurses. With the continued support of our nurse management, hospital administrators and most important, our staff, this concept is aimed to increase patient satisfaction scores and subsequently employee satisfaction. PMID:28725813

  18. Differential cDNA cloning by enzymatic degrading subtraction (EDS).

    PubMed Central

    Zeng, J; Gorski, R A; Hamer, D

    1994-01-01

    We describe a new method, called enzymatic degrading subtraction (EDS), for the construction of subtractive libraries from PCR amplified cDNA. The novel features of this method are that i) the tester DNA is blocked by thionucleotide incorporation; ii) the rate of hybridization is accelerated by phenol-emulsion reassociation; and iii) the driver cDNA and hybrid molecules are enzymatically removed by digestion with exonucleases III and VII rather than by physical partitioning. We demonstrate the utility of EDS by constructing a subtractive library enriched for cDNAs expressed in adult but not in embryonic rat brains. Images PMID:7971268

  19. Risk Factors for Increased ED Utilization in a Multinational Cohort of Children with Sickle Cell Disease

    PubMed Central

    Glassberg, Jeffrey A.; Wang, Jason; Cohen, Robyn; Richardson, Lynne D.; DeBaun, Michael R.

    2012-01-01

    Objectives To identify clinical, social, and environmental risk factors for increased emergency department (ED) use in children with sickle cell disease (SCD). Methods This study was a secondary analysis of ED utilization data from the international multicenter Silent Cerebral Infarct Transfusion (SIT) trial. Between December 2004 and June 2010, baseline demographic, clinical, and laboratory data were collected from children with SCD participating in the trial. The primary outcome was the frequency of ED visits for pain. A secondary outcome was the frequency of ED visits for acute chest syndrome. Results The sample included 985 children from the US, Canada, England, and France, for a total of 2,955 patient-years of data. There were 0.74 ED visits for pain per patient-year. A past medical history of asthma was associated with an increased risk of ED utilization for both pain (RR = 1.28, 95% CI = 1.04 to 1.58) and acute chest syndrome (RR = 1.60, 95% CI = 1.03 to 2.49). Exposure to environmental tobacco smoke in the home was associated with 73% more ED visits for acute chest syndrome (RR 1.73, 95% CI = 1.09 to 2.74). Each $10,000 increase in household income was associated with 5% fewer ED visits for pain (RR 0.95, 95% CI = 0.91 to 1.00, p = 0.05). The association between low income and ED utilization was not significantly different in the USA vs. countries with universal health care (p = 0.51). Conclusions Asthma and exposure to environmental tobacco smoke are potentially modifiable risk factors for greater ED use in children with SCD. Low income is associated with greater ED use for SCD pain in countries with and without universal health care. PMID:22687181

  20. A Randomized Controlled Trial of a Citywide Emergency Department Care Coordination Program to Reduce Prescription Opioid Related ED Visits

    PubMed Central

    Paulozzi, Leonard J.; Howell, Donelle; McPherson, Sterling; Murphy, Sean M.; Grohs, Becky; Marsh, Linda; Lederhos, Crystal; Roll, Jon

    2017-01-01

    Background Increasing prescription overdose deaths have demonstrated the need for safer ED prescribing practices for patients who are frequent ED users. Objectives We hypothesized that the care of frequent ED users would improve using a citywide care coordination program combined with an ED care coordination information system, as measured by fewer ED visits by and decreased controlled substance prescribing to these patients. Methods We conducted a multi-site randomized controlled trial (RCT) across all EDs in a metropolitan area. 165 patients with the most ED visits for complaints of pain were randomized. For the treatment arm, drivers of ED use were identified by medical record review. Patients and their primary care providers were contacted by phone. Each patient was discussed at a community multidisciplinary meeting where recommendations for ED care were formed. The ED care recommendations were stored in an ED information exchange system that faxed them to the treating ED provider when the patient presented to the ED. The control arm was subjected to treatment as usual. Results The intervention arm experienced a 34% decrease (IRR = 0.66, p < 0.001; 95% CI: 0.57 – 0.78) in ED visits and an 80% decrease (OR = 0.21, p = 0.001) in the odds of receiving an opioid prescription from the ED relative to the control group. Declines of 43.7%, 53.1%, 52.9%, and 53.1% were observed in the treatment group for morphine milligram equivalents, controlled substance pills, prescriptions, and prescribers. Conclusion This RCT showed the effectiveness of a citywide ED care coordination program in reducing ED visits and controlled substance prescribing. PMID:27624507

  1. Cytoplasmic Streaming - Skylab Student Experiment ED-63

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This chart describes the Skylab student experiment (ED-63), Cytoplasmic Streaming, proposed by Cheryl A. Peitz of Arapahoe High School, Littleton, Colorado. Experiment ED-63 was to observe the effect of zero-gravity on cytoplasmic streaming in the aquatic plant named Elodea, commonly called water weed or water thyme. The phenomenon of cytoplasmic streaming is not well understood, but it is recognized as the circulation mechanism of the internal materials or cytoplasm of a cell. Cytoplasm is a gelatinous substance that has the ability to change its viscosity and flow, carrying various cell materials with it. The activity can be stimulated by sunlight or heat. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  2. Using Google Flu Trends data in forecasting influenza-like-illness related ED visits in Omaha, Nebraska.

    PubMed

    Araz, Ozgur M; Bentley, Dan; Muelleman, Robert L

    2014-09-01

    Emergency department (ED) visits increase during the influenza seasons. It is essential to identify statistically significant correlates in order to develop an accurate forecasting model for ED visits. Forecasting influenza-like-illness (ILI)-related ED visits can significantly help in developing robust resource management strategies at the EDs. We first performed correlation analyses to understand temporal correlations between several predictors of ILI-related ED visits. We used the data available for Douglas County, the biggest county in Nebraska, for Omaha, the biggest city in the state, and for a major hospital in Omaha. The data set included total and positive influenza test results from the hospital (ie, Antigen rapid (Ag) and Respiratory Syncytial Virus Infection (RSV) tests); an Internet-based influenza surveillance system data, that is, Google Flu Trends, for both Nebraska and Omaha; total ED visits in Douglas County attributable to ILI; and ILI surveillance network data for Douglas County and Nebraska as the predictors and data for the hospital's ILI-related ED visits as the dependent variable. We used Seasonal Autoregressive Integrated Moving Average and Holt Winters methods with3 linear regression models to forecast ILI-related ED visits at the hospital and evaluated model performances by comparing the root means square errors (RMSEs). Because of strong positive correlations with ILI-related ED visits between 2008 and 2012, we validated the use of Google Flu Trends data as a predictor in an ED influenza surveillance tool. Of the 5 forecasting models we have tested, linear regression models performed significantly better when Google Flu Trends data were included as a predictor. Regression models including Google Flu Trends data as a predictor variable have lower RMSE, and the lowest is achieved when all other variables are also included in the model in our forecasting experiments for the first 5 weeks of 2013 (with RMSE = 57.61). Google Flu Trends data

  3. Are triage questions sufficient to assign fall risk precautions in the ED?

    PubMed

    Southerland, Lauren T; Slattery, Lauren; Rosenthal, Joseph A; Kegelmeyer, Deborah; Kloos, Anne

    2017-02-01

    The American College of Emergency Physicians Geriatric Emergency Department (ED) Guidelines and the Center for Disease Control recommend that older adults be assessed for risk of falls. The standard ED assessment is a verbal query of fall risk factors, which may be inadequate. We hypothesized that the addition of a functional balance test endorsed by the Center for Disease Control Stop Elderly Accidents, Deaths, and Injuries Falls Prevention Guidelines, the 4-Stage Balance Test (4SBT), would improve the detection of patients at risk for falls. Prospective pilot study of a convenience sample of ambulatory adults 65 years and older in the ED. All participants received the standard nursing triage fall risk assessment. After patients were stabilized in their ED room, the 4SBT was administered. The 58 participants had an average age of 74.1 years (range, 65-94), 40.0% were women, and 98% were community dwelling. Five (8.6%) presented to the ED for a fall-related chief complaint. The nursing triage screen identified 39.7% (n=23) as at risk for falls, whereas the 4SBT identified 43% (n=25). Combining triage questions with the 4SBT identified 60.3% (n=35) as at high risk for falls, as compared with 39.7% (n=23) with triage questions alone (P<.01). Ten (17%) of the patients at high risk by 4SBT and missed by triage questions were inpatients unaware that they were at risk for falls (new diagnoses). Incorporating a quick functional test of balance into the ED assessment for fall risk is feasible and significantly increases the detection of older adults at risk for falls. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Incorporating Alternative Care Site Characteristics Into Estimates of Substitutable ED Visits.

    PubMed

    Trueger, Nathan Seth; Chua, Kao-Ping; Hussain, Aamir; Liferidge, Aisha T; Pitts, Stephen R; Pines, Jesse M

    2017-07-01

    Several recent efforts to improve health care value have focused on reducing emergency department (ED) visits that potentially could be treated in alternative care sites (ie, primary care offices, retail clinics, and urgent care centers). Estimates of the number of these visits may depend on assumptions regarding the operating hours and functional capabilities of alternative care sites. However, methods to account for the variability in these characteristics have not been developed. To develop methods to incorporate the variability in alternative care site characteristics into estimates of ED visit "substitutability." Our approach uses the range of hours and capabilities among alternative care sites to estimate lower and upper bounds of ED visit substitutability. We constructed "basic" and "extended" criteria that captured the plausible degree of variation in each site's hours and capabilities. To illustrate our approach, we analyzed data from 22,697 ED visits by adults in the 2011 National Hospital Ambulatory Medical Care Survey, defining a visit as substitutable if it was treat-and-release and met both the operating hours and functional capabilities criteria. Use of the combined basic hours/basic capabilities criteria and extended hours/extended capabilities generated lower and upper bounds of estimates. Our criteria classified 5.5%-27.1%, 7.6%-20.4%, and 10.6%-46.0% of visits as substitutable in primary care offices, retail clinics, and urgent care centers, respectively. Alternative care sites vary widely in operating hours and functional capabilities. Methods such as ours may help incorporate this variability into estimates of ED visit substitutability.

  5. New Zealand's emergency department target - did it reduce ED length of stay, and if so, how and when?

    PubMed

    Tenbensel, Tim; Chalmers, Linda; Jones, Peter; Appleton-Dyer, Sarah; Walton, Lisa; Ameratunga, Shanthi

    2017-09-26

    In 2009, the New Zealand government introduced a hospital emergency department (ED) target - 95% of patients seen, treated or discharged within 6 h - in order to alleviate crowding in public hospital EDs. While these targets were largely met by 2012, research suggests that such targets can be met without corresponding overall reductions in ED length-of-stay (LOS). Our research explores whether the NZ ED time target actually reduced ED LOS, and if so, how and when. We adopted a mixed-methods approach with integration of data sources. After selecting four hospitals as case study sites, we collected all ED utilisation data for the period 2006 to 2012. ED LOS data was derived in two forms-reported ED LOS, and total ED LOS - which included time spent in short-stay units. This data was used to identify changes in the length of ED stay, and describe the timing of these changes to these indicators. Sixty-eight semi-structured interviews and two surveys of hospital clinicians and managers were conducted between 2011 and 2013. This data was then explored to identify factors that could account for ED LOS changes and their timing. Reported ED LOS reduced in all sites after the introduction of the target, and continued to reduce in 2011 and 2012. However, total ED LOS only decreased from 2008 to 2010, and did not reduce further in any hospital. Increased use of short-stay units largely accounted for these differences. Interview and survey data showed changes to improve patient flow were introduced in the early implementation period, whereas increased ED resources, better information systems to monitor target performance, and leadership and social marketing strategies mainly took throughout 2011 and 2012 when total ED LOS was not reducing. While the ED target clearly stimulated improvements in patient flow, our analysis also questions the value of ED targets as a long term approach. Increased use of short-stay units suggests that the target became less effective in 'standing

  6. Efficient Round-Trip Time Optimization for Replica-Exchange Enveloping Distribution Sampling (RE-EDS).

    PubMed

    Sidler, Dominik; Cristòfol-Clough, Michael; Riniker, Sereina

    2017-06-13

    Replica-exchange enveloping distribution sampling (RE-EDS) allows the efficient estimation of free-energy differences between multiple end-states from a single molecular dynamics (MD) simulation. In EDS, a reference state is sampled, which can be tuned by two types of parameters, i.e., smoothness parameters(s) and energy offsets, such that all end-states are sufficiently sampled. However, the choice of these parameters is not trivial. Replica exchange (RE) or parallel tempering is a widely applied technique to enhance sampling. By combining EDS with the RE technique, the parameter choice problem could be simplified and the challenge shifted toward an optimal distribution of the replicas in the smoothness-parameter space. The choice of a certain replica distribution can alter the sampling efficiency significantly. In this work, global round-trip time optimization (GRTO) algorithms are tested for the use in RE-EDS simulations. In addition, a local round-trip time optimization (LRTO) algorithm is proposed for systems with slowly adapting environments, where a reliable estimate for the round-trip time is challenging to obtain. The optimization algorithms were applied to RE-EDS simulations of a system of nine small-molecule inhibitors of phenylethanolamine N-methyltransferase (PNMT). The energy offsets were determined using our recently proposed parallel energy-offset (PEOE) estimation scheme. While the multistate GRTO algorithm yielded the best replica distribution for the ligands in water, the multistate LRTO algorithm was found to be the method of choice for the ligands in complex with PNMT. With this, the 36 alchemical free-energy differences between the nine ligands were calculated successfully from a single RE-EDS simulation 10 ns in length. Thus, RE-EDS presents an efficient method for the estimation of relative binding free energies.

  7. Intoxication-Related AmED (Alcohol Mixed with Energy Drink) Expectancies Scale: Initial Development and Validation

    PubMed Central

    Miller, Kathleen E.; Dermen, Kurt H.; Lucke, Joseph F.

    2017-01-01

    BACKGROUND Young adult use of alcohol mixed with energy drinks (AmEDs) has been linked with elevated risks for a constellation of problem behaviors. These risks may be conditioned by expectancies regarding the effects of caffeine in conjunction with alcohol consumption. The aim of this study was to describe the construction and psychometric evaluation of the Intoxication-Related AmED Expectancies Scale (AmED_EXPI), 15 self-report items measuring beliefs about how the experience of AmED intoxication differs from the experience of noncaffeinated alcohol (NCA) intoxication. METHODS Scale development and testing were conducted using data from a U.S. national sample of 3,105 adolescents and emerging adults aged 13–25. Exploratory and confirmatory factor analyses were conducted to evaluate the factor structure and establish factor invariance across gender, age, and prior experience with AmED use. Cross-sectional and longitudinal analyses examining correlates of AmED use were used to assess construct and predictive validity. RESULTS In confirmatory factor analyses, fit indices for the hypothesized four-factor structure (i.e., Intoxication Management [IM], Alertness [AL], Sociability [SO], and Jitters [JT]) revealed a moderately good fit to the data. Together, these factors accounted for 75.3% of total variance. The factor structure was stable across male/female, teen/young adult, and AmED experience/no experience subgroups. The resultant unit-weighted subscales showed strong internal consistency and satisfactory convergent validity. Baseline scores on the IM, SO, and JT subscales predicted changes in AmED use over a subsequent three-month period. CONCLUSIONS The AmED_EXPI appears to be a reliable and valid tool for measuring expectancies about the effects of caffeine during alcohol intoxication. PMID:28421613

  8. Adopting the edTPA as a High-Stakes Assessment: Resistance, Advocacy, and Reflection in Illinois

    ERIC Educational Resources Information Center

    Olson, Jennifer D.; Rao, Arthi B.

    2017-01-01

    The edTPA, a national performance assessment for teacher candidates, has seen rapid adoption across the country since its development in 2009. Against the national backdrop of high stakes testing and accountability, the edTPA was developed to be an indicator of teachers' readiness to teach. The varying perspectives and responses to edTPA in…

  9. Debunking the Myths. Research Offers Ammunition to Fight Misperceptions of Voc Ed.

    ERIC Educational Resources Information Center

    Stone, Jim

    1993-01-01

    Debunks seven myths: vocational students are low achievers, they do not pursue higher education, voc ed does not help academic competence, it does not make a difference in the labor market, vocational students are economically rich and psychologically poor, student employment engenders poor work attitudes, and voc ed is a poor investment. (SK)

  10. Passive damping in EDS maglev systems.

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

    Rote, D. M.

    2002-05-03

    There continues to be strong interest in the subjects of damping and drag forces associated with electrodynamic suspension (EDS) systems. While electromagnetic drag forces resist the forward motion of a vehicle and therefore consume energy, damping forces control, at least in part, the response of the vehicle to disturbances. Ideally, one would like to reduce the drag forces as much as possible while retaining adequate damping forces to insure dynamic stability and satisfactory ride quality. These two goals turn out to be difficult to achieve in practice. It is well known that maglev systems tend to be intrinsically under damped.more » Consequently it is often necessary in a practical system design to enhance the damping passively or actively. For reasons of cost and simplicity, it is desirable to rely as much as possible on passive damping mechanisms. In this paper, rough estimates are made of the passive damping and drag forces caused by various mechanisms in EDS systems. No attention will be given to active control systems or secondary suspension systems which are obvious ways to augment passive damping mechanisms if the latter prove to be inadequate.« less

  11. The University Supervisor, edTPA, and the New Making of the Teacher

    ERIC Educational Resources Information Center

    Donovan, Martha K.; Cannon, Susan O.

    2018-01-01

    As university supervisors at a large, urban university in the southern US, we examined the ways that the Education Teacher Performance Assessment (edTPA) shaped the pedagogic relationships and decision-making processes of our students and ourselves during the spring of 2016. We situated this study of edTPA within the framework of critical policy…

  12. New guidelines for geriatric EDs: guidance focused on boosting environment, care processes.

    PubMed

    2014-05-01

    A cadre of prominent medical groups, including the ACEP, ENA, AGS, and SAEM, has unveiled a comprehensive set of Geriatric Emergency Department Guidelines to aid hospitals that are either in the process of opening senior-focused EDs or revamping their policies and procedures to better meet the needs of an aging population. The guidelines offer recommendations related to staffing, infrastructure, education, and transition-of-care strategies. In addition, they outline a host of screenings that studies have shown are beneficial for older adults. Experts note that hospital systems around the country have already opened 50 geriatric EDs, with many more facilities in development. Guideline authors state that the guidelines take an evidence-based approach to managing senior patients. While more cost and outcomes data are needed, experts say that senior-focused improvements to emergency care can reduce admissions and return visits to the ED while also boosting patient satisfaction. Future efforts will focus on prioritizing the guideline recommendations so that ED administrators concerned with improving senior care will tackle the most important changes first.

  13. The NASA Exoplanet Science Institute Archives: KOA and NStED

    NASA Astrophysics Data System (ADS)

    Berriman, G. B.; Ciardi, D.; Abajian, M.; Barlow, T.; Bryden, G.; von Braun, K.; Good, J.; Kane, S.; Kong, M.; Laity, A.; Lynn, M.; Elroy, D. M.; Plavchan, P.; Ramirez, S.; Schmitz, M.; Stauffer, J.; Wyatt, P.; Zhang, A.; Goodrich, R.; Mader, J.; Tran, H.; Tsubota, M.; Beekley, A.; Berukoff, S.; Chan, B.; Lau, C.; Regelson, M.; Saucedo, M.; Swain, M.

    2010-12-01

    The NASA Exoplanet Science Institute (NExScI) maintains a series of archival services in support of NASA’s planet finding and characterization goals. Two of the larger archival services at NExScI are the Keck Observatory Archive (KOA) and the NASA Star and Exoplanet Database (NStED). KOA, a collaboration between the W. M. Keck Observatory and NExScI, serves raw data from the High Resolution Echelle Spectrograph (HIRES) and extracted spectral browse products. As of June 2009, KOA hosts over 28 million files (4.7 TB) from over 2,000 nights. In Spring 2010, it will begin to serve data from the Near-Infrared Echelle Spectrograph (NIRSPEC). NStED is a general purpose archive with the aim of providing support for NASA’s planet finding and characterization goals, and stellar astrophysics. There are two principal components of NStED: a database of (currently) all known exoplanets, and images; and an archive dedicated to high precision photometric surveys for transiting exoplanets. NStED is the US portal to the CNES mission CoRoT, the first space mission dedicated to the discovery and characterization of exoplanets. These archives share a common software and hardware architecture with the NASA/IPAC Infrared Science Archive (IRSA). The software architecture consists of standalone utilities that perform generic query and retrieval functions. They are called through program interfaces and plugged together to form applications through a simple executive library.

  14. A high performance field-reversed configuration

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

    Binderbauer, M. W.; Tajima, T.; Steinhauer, L. C.

    2015-05-15

    Conventional field-reversed configurations (FRCs), high-beta, prolate compact toroids embedded in poloidal magnetic fields, face notable stability and confinement concerns. These can be ameliorated by various control techniques, such as introducing a significant fast ion population. Indeed, adding neutral beam injection into the FRC over the past half-decade has contributed to striking improvements in confinement and stability. Further, the addition of electrically biased plasma guns at the ends, magnetic end plugs, and advanced surface conditioning led to dramatic reductions in turbulence-driven losses and greatly improved stability. Together, these enabled the build-up of a well-confined and dominant fast-ion population. Under such conditions,more » highly reproducible, macroscopically stable hot FRCs (with total plasma temperature of ∼1 keV) with record lifetimes were achieved. These accomplishments point to the prospect of advanced, beam-driven FRCs as an intriguing path toward fusion reactors. This paper reviews key results and presents context for further interpretation.« less

  15. On the derivation of flow rating curves in data-scarce environments

    NASA Astrophysics Data System (ADS)

    Manfreda, Salvatore

    2018-07-01

    River monitoring is a critical issue for hydrological modelling that relies strongly on the use of flow rating curves (FRCs). In most cases, these functions are derived by least-squares fitting which usually leads to good performance indices, even when based on a limited range of data that especially lack high flow observations. In this context, cross-section geometry is a controlling factor which is not fully exploited in classical approaches. In fact, river discharge is obtained as the product of two factors: 1) the area of the wetted cross-section and 2) the cross-sectionally averaged velocity. Both factors can be expressed as a function of the river stage, defining a viable alternative in the derivation of FRCs. This makes it possible to exploit information about cross-section geometry limiting, at least partially, the uncertainty in the extrapolation of discharge at higher flow values. Numerical analyses and field data confirm the reliability of the proposed procedure for the derivation of FRCs.

  16. Global power balance on high density field reversed configurations for use in magnetized target fusion

    NASA Astrophysics Data System (ADS)

    Renneke, Richard M.

    Field Reversed Configuration plasmas (FRCs) have been created in the Field Reversed Experiment-Liner (FRX-L) with density 2--6 x 10 22 m-3, total temperature 300--400 eV, and lifetime on the order of 10 micros. This thesis investigates global energy balance on high-density FRCs for the first time. The zero-dimensional approach to global energy balance developed by Rej and Tuszewski (Phys. Fluids 27, p. 1514, 1984) is utilized here. From the shots analyzed with this method, it is clear that energy loss from these FRCs is dominated by particle and thermal (collisional) losses. The percentage of radiative losses versus total loss is an order of magnitude lower than previous FRC experiments. This is reasonable for high density based on empirical scaling from the extensive database of tokamak plasma experiments. Ohmic dissipation, which heats plasma when trapped magnetic field decays to create electric field, is an important source of heating for the plasma. Ohmic heating shows a correlation with increasing the effective Lundquist number (S*). Empirical evidence suggest S* can be increased by lowering the density, which does not achieve the goals of FRX-L. A better way to improve ohmic heating is to trap more poloidal flux. This dissertation shows that FRX-L follows a semi-empirical scaling law which predicts plasma temperature gains for larger poloidal flux. Flux (tauφ) and particle (tauN) lifetimes for these FRCs were typically shorter than 10 micros. Approximately 1/3 of the particle and flux lifetimes for these FRCs did not scale with the usual tauN ≈ tauφ scaling of low-density FRCs, but instead showed tauN ≥ tau φ. However, scatter in the data indicates that the average performance of FRCs on FRX-L yields the typical (for FRCs) relationship tau N ≈ tauφ. Fusion energy gain Q was extrapolated for the shots analyzed in this study using a zero-dimensional scaling code with liner effects. The predicted Q is below the desired value of 0.1 (Schoenberg et al

  17. EdTrAc Teacher Education Program: First-Year Implementation Evaluation (2005-2006)

    ERIC Educational Resources Information Center

    Pittman, Brian; Shelton, Ellen

    2006-01-01

    The Educational Training Academy (EdTrAc) is an NSF-funded project of Normandale Community College to increase the number, diversity, and skills of students preparing to be elementary and middle school teachers with a specialty in math and science. Overall, this evaluation indicates that the EdTrAc implementation is on track after its first year…

  18. Staphylococcus aureus leukocidin ED contributes to systemic infection by targeting neutrophils and promoting bacterial growth in vivo

    PubMed Central

    Alonzo, Francis; Benson, Meredith A.; Chen, John; Novick, Richard P.; Shopsin, Bo; Torres, Victor J.

    2011-01-01

    SUMMARY Bloodstream infection with Staphylococcus aureus is common and can be fatal. However, virulence factors that contribute to lethality in S. aureus bloodstream infection are poorly defined. We discovered that LukED, a commonly overlooked leukotoxin, is critical for S. aureus bloodstream infection in mice. We also determined that LukED promotes S. aureus replication in vivo by directly killing phagocytes recruited to sites of hematogenously-seeded tissue. Furthermore, we established that murine neutrophils are the primary target of LukED, as the greater virulence of wild type S. aureus compared to a lukED mutant was abrogated by depleting neutrophils. The in vivo toxicity of LukED toward murine phagocytes is unique among S. aureus leukotoxins, implying its crucial role in pathogenesis. Moreover, the tropism of LukED for murine phagocytes highlights the utility of murine models to study LukED pathobiology, including development and testing of strategies to inhibit toxin activity and control bacterial infection. PMID:22142035

  19. Process modeling of emergency department patient flow: effect of patient length of stay on ED diversion.

    PubMed

    Kolker, Alexander

    2008-10-01

    A discreet event simulation methodology has been used to establish a quantitative relationship between Emergency Department (ED) performance characteristics, such as percent of time on ambulance diversion and the number of patients in queue in the waiting room, and the upper limits of patient length of stay (LOS). A simulation process model of ED patient flow has been developed that took into account a significant difference between LOS distributions of patients discharged home and patients admitted into the hospital. Using simulation model it has been identified that ED diversion could be negligible (less than approximately 0.5%) if patients discharged home stay in ED not more than 5 h, and patients admitted into the hospital stay in ED not more than 6 h Using full factorial design of experiments with two factors and the model's predicted percent diversion as a response function, other combinations of LOS upper limits have been determined that would result in low ED percent diversion as well. It has also been determined that if the number of patients exceeds 11 in queue in ED waiting room then the diversion percent is rapidly increasing.

  20. MedEdPORTAL: a report on oral health resources for health professions educators.

    PubMed

    Chickmagalur, Nithya S; Allareddy, Veerasathpurush; Sandmeyer, Sue; Valachovic, Richard W; Candler, Christopher S; Saleh, Michael; Cahill, Emily; Karimbux, Nadeem Y

    2013-09-01

    MedEdPORTAL is a unique web-based peer-reviewed publication venue for clinical health educators sponsored by the Association of American Medical Colleges (AAMC). The open exchange of educational resources promotes professional collaboration across health professions. In 2008, the American Dental Education Association (ADEA) collaborated with AAMC to allow dental educators to use the platform to publish dental curriculum resources. Oral health is integral to general health; hence, collaboration among health care professionals brings enormous value to patient-centered care. The aim of this study was to conduct a current survey of metrics and submission statistics of MedEdPORTAL resources. The data were collected using the MedEdPORTAL search engine and ADEA and AAMC staff. The data collected were categorized and reported in tables and charts. Results showed that at the time of this study there were over 2,000 medical and dental resources available to anyone worldwide. Oral health resources constituted approximately 30 percent of the total resources, which included cross-indexing with information relevant to both medical and dental audiences. There were several types of dental resources available; the most common were the ones focusing on critical thinking. The usage of MedEdPORTAL has been growing, with participation from over 190 countries and 10,000 educational institutions around the world. The findings of this report suggest that MedEdPORTAL is succeeding in its aim to foster global collaborative education, professional education, and educational scholarship. As such, MedEdPORTAL is providing a new forum for collaboration and opens venues for promising future work in professional education.

  1. Nuclear Medicine Physics: The Basics. 7th ed.

    PubMed

    Mihailidis, Dimitris

    2012-10-01

    Nuclear Medicine Physics: The Basics. 7th ed. Ramesh Chandra, Lippincott Williams and Wilkins, a Wolters Kluwer Business. Philadelphia, 2012. Softbound, 224 pp. Price: $69.99. ISBN: 9781451109412. © 2012 American Association of Physicists in Medicine.

  2. Impact of prospective verification of intravenous antibiotics in an ED.

    PubMed

    Hunt, Allyson; Nakajima, Steven; Hall Zimmerman, Lisa; Patel, Manav

    2016-12-01

    Delay in appropriate antibiotic therapy is associated with an increase in mortality and prolonged length of stay. Automatic dispensing machines decrease the delivery time of intravenous (IV) antibiotics to patients in the emergency department (ED). However, when IV antibiotics are not reviewed by pharmacists before being administered, patients are at risk for receiving inappropriate antibiotic therapy. The objective of this study was to determine if a difference exists in the time to administration of appropriate antibiotic therapy before and after implementation of prospective verification of antibiotics in the ED. This retrospective, institutional review board-approved preimplementation vs postimplementation study evaluated patients 18years or older who were started on IV antibiotics in the ED. Patients were excluded if pregnant, if the patient is a prisoner, if no cultures were drawn, or if the patient was transferred from an outside facility. Appropriate antibiotic therapy was based on empiric source-specific evidence-based guidelines, appropriate pharmacokinetic and pharmacodynamic properties, and microbiologic data. The primary end point was the time from ED arrival to administration of appropriate antibiotic therapy. Of the 1628 evaluated, 128 patients met the inclusion criteria (64 pre vs 64 post). Patients were aged 65.2±17.0years, with most of infections being pneumonia (44%) and urinary tract infections (18%) and most patients being noncritically ill. Time to appropriate antibiotic therapy was reduced in the postgroup vs pregroup (8.1±8.6 vs 15.2±22.8hours, respectively, P=.03). In addition, appropriate empiric antibiotics were initiated more frequently after the implementation (92% post vs 66% pre; P=.0001). There was no difference in mortality or length of stay between the 2 groups. Prompt administration of the appropriate antibiotics is imperative in patients with infections presenting to the ED. The impact of prospective verification of

  3. oneED: Embedding a mindfulness-based wellness programme into an emergency department.

    PubMed

    Braganza, Shahina; Young, Jessica; Sweeny, Amy; Brazil, Victoria

    2018-03-30

    ED staff are subject to many stressors, but there are few descriptions of collective approaches to enhancing wellness in this setting. We aim to describe a programme developed to address these issues at department level, to report the feasibility and sustainability of the programme, and its impact on staff. The oneED programme was developed and delivered in a tertiary ED. The programme included a 1 day mindfulness workshop, followed by ongoing mindfulness activities embedded in clinical areas over the subsequent 12 months. A mixed-methods evaluation of the programme was conducted, which included quantitative validated psychological tools to measure anxiety, depression and emotional exhaustion, and pragmatic evaluation using surveys of participants and iterative appreciative inquiry. Eighty staff members attended the mindfulness workshop; 66 from ED. Following the workshop, understanding and frequency of mindfulness practice increased significantly in 47% of participants. Free-text survey results demonstrated that staff found the programme to be acceptable (80% survey participants) and of perceived value to themselves (50%) and the ED (60%). Appreciative inquiry led to modification of the programme: the 4 min pause is now conducted weekly rather than daily, the pause consists of a variety of activities, and group activities are made more overtly optional. A departmental wellness programme embedding mindfulness practice is feasible and sustainable. Potential for success is enhanced by an approach that is open to modification according to each institution's culture. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  4. The relative contribution of provider and ED-level factors to variation among the top 15 reasons for ED admission.

    PubMed

    Khojah, Imad; Li, Suhui; Luo, Qian; Davis, Griffin; Galarraga, Jessica E; Granovsky, Michael; Litvak, Ori; Davis, Samuel; Shesser, Robert; Pines, Jesse M

    2017-09-01

    We examine adult emergency department (ED) admission rates for the top 15 most frequently admitted conditions, and assess the relative contribution in admission rate variation attributable to the provider and hospital. This was a retrospective, cross-sectional study of ED encounters (≥18years) from 19 EDs and 603 providers (January 2012-December 2013), linked to the Area Health Resources File for county-level information on healthcare resources. "Hospital admission" was the outcome, a composite of inpatient, observation, or intra-hospital transfer. We studied the 15 most commonly admitted conditions, and calculated condition-specific risk-standardized hospital admission rates (RSARs) using multi-level hierarchical generalized linear models. We then decomposed the relative contribution of provider-level and hospital-level variation for each condition. The top 15 conditions made up 34% of encounters and 49% of admissions. After adjustment, the eight conditions with the highest hospital-level variation were: 1) injuries, 2) extremity fracture (except hip fracture), 3) skin infection, 4) lower respiratory disease, 5) asthma/chronic obstructive pulmonary disease (A&C), 6) abdominal pain, 7) fluid/electrolyte disorders, and 8) chest pain. Hospital-level intra-class correlation coefficients (ICC) ranged from 0.042 for A&C to 0.167 for extremity fractures. Provider-level ICCs ranged from 0.026 for abdominal pain to 0.104 for chest pain. Several patient, hospital, and community factors were associated with admission rates, but these varied across conditions. For different conditions, there were different contributions to variation at the hospital- and provider-level. These findings deserve consideration when designing interventions to optimize admission decisions and in value-based payment programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Test Review: Epstein, M. H., & Cullinan, D. (2010). "Scales for Assessing Emotional Disturbance" (2nd Ed.). Austin, TX: Pro-Ed

    ERIC Educational Resources Information Center

    Lamb, Gordon D.

    2011-01-01

    The author reviews "Scales for Assessing Emotional Disturbance-Second Edition" (SAED-2; Epstein & Cullinan, 2010), an assessment system primarily designed to assist in determining eligibility for special education services under the category of emotional disturbance (ED), as defined by the "Individuals with Disabilities…

  6. Pathogen effectors target Arabidopsis EDS1 and alter its interactions with immune regulators.

    PubMed

    Bhattacharjee, Saikat; Halane, Morgan K; Kim, Sang Hee; Gassmann, Walter

    2011-12-09

    Plant resistance proteins detect the presence of specific pathogen effectors and initiate effector-triggered immunity. Few immune regulators downstream of resistance proteins have been identified, none of which are known virulence targets of effectors. We show that Arabidopsis ENHANCED DISEASE SUSCEPTIBILITY1 (EDS1), a positive regulator of basal resistance and of effector-triggered immunity specifically mediated by Toll-interleukin-1 receptor-nucleotide binding-leucine-rich repeat (TIR-NB-LRR) resistance proteins, forms protein complexes with the TIR-NB-LRR disease resistance proteins RPS4 and RPS6 and with the negative immune regulator SRFR1 at a cytoplasmic membrane. Further, the cognate bacterial effectors AvrRps4 and HopA1 disrupt these EDS1 complexes. Tight association of EDS1 with TIR-NB-LRR-mediated immunity may therefore derive mainly from being guarded by TIR-NB-LRR proteins, and activation of this branch of effector-triggered immunity may directly connect to the basal resistance signaling pathway via EDS1.

  7. Pediatric prescription pick-up rates after ED visits.

    PubMed

    Kajioka, Eric H; Itoman, Erick M; Li, M Lily; Taira, Deborah A; Li, Gaylyn G; Yamamoto, Loren G

    2005-07-01

    To determine the compliance rate in filling outpatient medication prescriptions written upon discharge from the emergency department (ED). Emergency department records of children during a 3-month period were examined along with pharmacy claim data obtained in cooperation with the largest insurance carrier in the community (private and Medicaid). Pharmacy claim data were used to validate the prescription pick-up date. Overall, 65% of high-urgency prescriptions were filled. The prescription pick-up rate in the 0-to 3-year age group (75%) was significantly higher than in the rest of the cohort (55%) ( P < .001). Children with private insurance were more likely to fill their prescriptions (68%) compared to children with Medicaid insurance (57%) ( P = .03). This study demonstrates that filling a prescription after discharge from an ED represents a substantial barrier to medication compliance.

  8. Cooperating Teachers: Stakeholders in the edTPA?

    ERIC Educational Resources Information Center

    Seymour, Clancy A.; Burns, Barbara A.; Henry, Julie J.

    2018-01-01

    The educative Teacher Performance Assessment (edTPA) is a performance-based assessment designed for beginning teachers to demonstrate their readiness to teach (SCALE, 2014). As more states come to adopt this assessment, many facets of its implementation need to be reviewed. One component is the role of the cooperating teacher in the implementation…

  9. Base excess is an accurate predictor of elevated lactate in ED septic patients.

    PubMed

    Montassier, Emmanuel; Batard, Eric; Segard, Julien; Hardouin, Jean-Benoît; Martinage, Arnaud; Le Conte, Philippe; Potel, Gille

    2012-01-01

    Prior studies showed that lactate is a useful marker in sepsis. However, lactate is often not routinely drawn or rapidly available in the emergency department (ED). The study aimed to determine if base excess (BE), widely and rapidly available in the ED, could be used as a surrogate marker for elevated lactate in ED septic patients. This was a prospective and observational cohort study. From March 2009 to March 2010, consecutive patients 18 years or older who presented to the ED with a suspected severe sepsis were enrolled in the study. Lactate and BE measurements were performed. We defined, a priori, a clinically significant lactate to be greater than 3 mmol/L and BE less than -4 mmol/L. A total of 224 patients were enrolled in the study. The average BE was -4.5 mmol/L (SD, 4.9) and the average lactate was 3.5 mmol/L (SD, 2.9). The sensitivity of a BE less than -4 mmol/L in predicting elevated lactate greater than 3 mmol/L was 91.1% (95% confidence interval, 85.5%-96.6%) and the specificity was 88.6% (95% confidence interval, 83.0%-94.2%). The area under the curve was 0.95. Base excess is an accurate marker for the prediction of elevated lactate in the ED. The measurement of BE, obtained in a few minutes in the ED, provides a secure and quick method, similar to the electrocardiogram at triage for patients with chest pain, to determine the patients with sepsis who need an early aggressive resuscitation. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Perceived social support among adults seeking care for acute respiratory tract infections in US EDs.

    PubMed

    Levin, Sara K; Metlay, Joshua P; Maselli, Judith H; Kersey, Ayanna S; Camargo, Carlos A; Gonzales, Ralph

    2009-06-01

    Emergency departments (EDs) provide a disproportionate amount of care to disenfranchised and vulnerable populations. We examined social support levels among a diverse population of adults seeking ED care for acute respiratory tract infections. A convenience sample of adults seeking care in 1 of 15 US EDs was telephone interviewed 1 to 6 weeks postvisit. The Multidimensional Scale of Perceived Social Support (7-point Likert) assessed social support across 3 domains: friends, family, and significant others. Higher scores indicate higher support. Of 1104 subjects enrolled, 704 (64%) completed the follow-up interview. Factor analysis yielded 3 factors. Mean social support score was 5.54 (SD 1.04). Female sex, greater household income, and better health status were independently associated with higher levels of social support. Social support levels among adults seeking care in the ED for acute respiratory tract infections are similar to general population cohorts, suggesting that social support is not a strong determinant of health care seeking in EDs.

  11. The administration sequence of propofol and remifentanil does not affect the ED50 and ED95 of rocuronium in rapid sequence induction of anesthesia: a double-blind randomized controlled trial.

    PubMed

    Ozcelik, M; Guclu, C; Bermede, O; Baytas, V; Altay, N; Karahan, M A; Erdogan, B; Can, O

    2016-04-01

    The topic of drug administration sequence in rapid sequence induction (RSI) is still an object of interest in terms of rocuronium effectiveness. The aim of this prospective, randomized trial was to evaluate the effect of administration sequence of propofol and remifentanil on ED50 and ED95 of rocuronium in a RSI model. Eighty-four patients were randomized into Group Remifentanil (Group R, n = 43), where induction of general anesthesia started with remifentanil (2 µg/kg) and followed by propofol (2 mg/kg) and rocuronium administrations; and Group Propofol (Group P, n = 41), where induction of general anesthesia started with propofol and followed by remifentanil and rocuronium. First patients in each group were paralyzed by 0.8 mg/kg rocuronium. In case of acceptable intubation as evaluated according to the criteria described by Viby-Mogensen et al, rocuronium dose was decreased by 0.1 mg/kg for the next patient; otherwise, rocuronium dose was increased by 0.1 mg/kg. After three crossover points, increments or decrements in rocuronium dosage were set to 0.05 mg/kg. The process was repeated until a total of ten crossover points were obtained. The ED50 and ED95 doses of rocuronium were similar in Group R (0.182 mg/kg, and 0.244 mg/kg, respectively) and Group P (0.121 mg/kg, and 0.243 mg/kg, respectively) according to 95% CI of the estimates. There was no statistically significant difference in terms of clinically acceptable intubation conditions between the two groups (56.1% in Group R vs. 59% in Group P, p = 0.795). The choice of administration sequence of propofol and remifentanil does not have an impact on estimated ED50 and ED95 of rocuronium in providing acceptable intubation conditions in the RSI technique.

  12. Is scanning electron microscopy/energy dispersive X-ray spectrometry (SEM/EDS) quantitative?

    PubMed

    Newbury, Dale E; Ritchie, Nicholas W M

    2013-01-01

    Scanning electron microscopy/energy dispersive X-ray spectrometry (SEM/EDS) is a widely applied elemental microanalysis method capable of identifying and quantifying all elements in the periodic table except H, He, and Li. By following the "k-ratio" (unknown/standard) measurement protocol development for electron-excited wavelength dispersive spectrometry (WDS), SEM/EDS can achieve accuracy and precision equivalent to WDS and at substantially lower electron dose, even when severe X-ray peak overlaps occur, provided sufficient counts are recorded. Achieving this level of performance is now much more practical with the advent of the high-throughput silicon drift detector energy dispersive X-ray spectrometer (SDD-EDS). However, three measurement issues continue to diminish the impact of SEM/EDS: (1) In the qualitative analysis (i.e., element identification) that must precede quantitative analysis, at least some current and many legacy software systems are vulnerable to occasional misidentification of major constituent peaks, with the frequency of misidentifications rising significantly for minor and trace constituents. (2) The use of standardless analysis, which is subject to much broader systematic errors, leads to quantitative results that, while useful, do not have sufficient accuracy to solve critical problems, e.g. determining the formula of a compound. (3) EDS spectrometers have such a large volume of acceptance that apparently credible spectra can be obtained from specimens with complex topography that introduce uncontrolled geometric factors that modify X-ray generation and propagation, resulting in very large systematic errors, often a factor of ten or more. © Wiley Periodicals, Inc.

  13. Connecting Teachers and Ed-Tech Developers: Lessons from NYC's "Gap App" Program. Report

    ERIC Educational Resources Information Center

    Villavicencio, Adriana; Siman, Nina; Lafayette, Camille; Kang, David

    2016-01-01

    In 2011, with support from a federal Investing in Innovation grant, the NYC Department of Education launched Innovate NYC Schools. The initiative was designed to address two, related challenges to effectively integrating education technology (ed-tech) into classrooms: First, procurement of ed-tech tools is often hampered by a disconnect between…

  14. Improving ED specimen TAT using Lean Six Sigma.

    PubMed

    Sanders, Janet H; Karr, Tedd

    2015-01-01

    Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. The purpose of this paper is to discuss a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens. This case study provides details on the completion of a Lean Six Sigma project in a 1,000 bed tertiary care teaching hospital. Six Sigma's Define, Measure, Analyze, Improve, and Control methodology is very similar to good medical practice: first, relevant information is obtained and assembled; second, a careful and thorough diagnosis is completed; third, a treatment is proposed and implemented; and fourth, checks are made to determine if the treatment was effective. Lean's primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change. The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50 percent decrease in vials used for testing, a 50 percent decrease in unused or extra specimens, a 90 percent decrease in ED specimens without orders, a 30 percent decrease in complete blood count analysis (CBCA) Median TAT, a 50 percent decrease in CBCA TAT Variation, a 10 percent decrease in Troponin TAT Variation, a 18.2 percent decrease in URPN TAT Variation, and a 2-5 minute decrease in ED registered nurses rainbow draw time. This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve

  15. Effect of a redesigned fracture management pathway and 'virtual' fracture clinic on ED performance.

    PubMed

    Vardy, J; Jenkins, P J; Clark, K; Chekroud, M; Begbie, K; Anthony, I; Rymaszewski, L A; Ireland, A J

    2014-06-13

    Collaboration between the orthopaedic and emergency medicine (ED) services has resulted in standardised treatment pathways, leaflet supported discharge and a virtual fracture clinic review. Patients with minor, stable fractures are discharged with no further follow-up arranged. We aimed to examine the time taken to assess and treat these patients in the ED along with the rate of unplanned reattendance. A retrospective study was undertaken that covered 1 year before the change and 1 year after. Prospectively collected administrative data from the electronic patient record system were analysed and compared before and after the change. An ED and orthopaedic unit, serving a population of 300 000, in a publicly funded health system. 2840 patients treated with referral to a traditional fracture clinic and 3374 patients managed according to the newly redesigned protocol. Time for assessment and treatment of patients with orthopaedic injuries not requiring immediate operative management, and 7-day unplanned reattendance. Where plaster backslabs were replaced with removable splints, the consultation time was reduced. There was no change in treatment time for other injuries treated by the new discharge protocol. There was no increase in unplanned ED attendance, related to the injury, within 7 days (p=0.149). There was a decrease in patients reattending the ED due to a missed fracture clinic appointment. This process did not require any new time resources from the ED staff. This process brought significant benefits to the ED as treatment pathways were agreed. The pathway reduced unnecessary reattendance of patients at face-to-face fracture clinics for a review of stable, self-limiting injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Statistical analysis of low-voltage EDS spectrum images

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

    Anderson, I.M.

    1998-03-01

    The benefits of using low ({le}5 kV) operating voltages for energy-dispersive X-ray spectrometry (EDS) of bulk specimens have been explored only during the last few years. This paper couples low-voltage EDS with two other emerging areas of characterization: spectrum imaging of a computer chip manufactured by a major semiconductor company. Data acquisition was performed with a Philips XL30-FEG SEM operated at 4 kV and equipped with an Oxford super-ATW detector and XP3 pulse processor. The specimen was normal to the electron beam and the take-off angle for acquisition was 35{degree}. The microscope was operated with a 150 {micro}m diameter finalmore » aperture at spot size 3, which yielded an X-ray count rate of {approximately}2,000 s{sup {minus}1}. EDS spectrum images were acquired as Adobe Photoshop files with the 4pi plug-in module. (The spectrum images could also be stored as NIH Image files, but the raw data are automatically rescaled as maximum-contrast (0--255) 8-bit TIFF images -- even at 16-bit resolution -- which poses an inconvenience for quantitative analysis.) The 4pi plug-in module is designed for EDS X-ray mapping and allows simultaneous acquisition of maps from 48 elements plus an SEM image. The spectrum image was acquired by re-defining the energy intervals of 48 elements to form a series of contiguous 20 eV windows from 1.25 kV to 2.19 kV. A spectrum image of 450 x 344 pixels was acquired from the specimen with a sampling density of 50 nm/pixel and a dwell time of 0.25 live seconds per pixel, for a total acquisition time of {approximately}14 h. The binary data files were imported into Mathematica for analysis with software developed by the author at Oak Ridge National Laboratory. A 400 x 300 pixel section of the original image was analyzed. MSA required {approximately}185 Mbytes of memory and {approximately}18 h of CPU time on a 300 MHz Power Macintosh 9600.« less

  17. On making cuts for magnetic scalar potentials in multiply connected regions

    NASA Astrophysics Data System (ADS)

    Kotiuga, P. R.

    1987-04-01

    The problem of making cuts is of importance to scalar potential formulations of three-dimensional eddy current problems. Its heuristic solution has been known for a century [J. C. Maxwell, A Treatise on Electricity and Magnetism, 3rd ed. (Clarendon, Oxford, 1981), Chap. 1, Article 20] and in the last decade, with the use of finite element methods, a restricted combinatorial variant has been proposed and solved [M. L. Brown, Int. J. Numer. Methods Eng. 20, 665 (1984)]. This problem, in its full generality, has never received a rigorous mathematical formulation. This paper presents such a formulation and outlines a rigorous proof of existence. The technique used in the proof expose the incredible intricacy of the general problem and the restrictive assumptions of Brown [Int. J. Numer. Methods Eng. 20, 665 (1984)]. Finally, the results make rigorous Kotiuga's (Ph. D. Thesis, McGill University, Montreal, 1984) heuristic interpretation of cuts and duality theorems via intersection matrices.

  18. Barriers and Facilitators to Implementing the HEADS-ED: A Rapid Screening Tool for Pediatric Patients in Emergency Departments.

    PubMed

    MacWilliams, Kate; Curran, Janet; Racek, Jakub; Cloutier, Paula; Cappelli, Mario

    2017-12-01

    This study sought to identify barriers and facilitators to the implementation of the HEADS-ED, a screening tool appropriate for use in the emergency department (ED) that facilitates standardized assessments, discharge planning, charting, and linking pediatric mental health patients to appropriate community resources. A qualitative theory-based design was used to identify barriers and facilitators to implementing the HEADS-ED tool. Focus groups were conducted with participants recruited from 6 different ED settings across 2 provinces (Ontario and Nova Scotia). The Theoretical Domains Framework was used as a conceptual framework to guide data collection and to identify themes from focus group discussions. The following themes spanning 12 domains were identified as reflective of participants' beliefs about the barriers and facilitators to implementing the HEADS-ED tool: knowledge, skills, beliefs about capabilities, social professional role and identity, optimism, beliefs about consequences, reinforcement, environmental context and resources, social influences, emotion, behavioral regulation and memory, and attention and decision process. The HEADS-ED has the potential to address the need for better discharge planning, complete charting, and standardized assessments for the increasing population of pediatric mental health patients who present to EDs. This study has identified potential barriers and facilitators, which should be considered when developing an implementation plan for adopting the HEADS-ED tool into practice within EDs.

  19. PopED lite: An optimal design software for preclinical pharmacokinetic and pharmacodynamic studies.

    PubMed

    Aoki, Yasunori; Sundqvist, Monika; Hooker, Andrew C; Gennemark, Peter

    2016-04-01

    Optimal experimental design approaches are seldom used in preclinical drug discovery. The objective is to develop an optimal design software tool specifically designed for preclinical applications in order to increase the efficiency of drug discovery in vivo studies. Several realistic experimental design case studies were collected and many preclinical experimental teams were consulted to determine the design goal of the software tool. The tool obtains an optimized experimental design by solving a constrained optimization problem, where each experimental design is evaluated using some function of the Fisher Information Matrix. The software was implemented in C++ using the Qt framework to assure a responsive user-software interaction through a rich graphical user interface, and at the same time, achieving the desired computational speed. In addition, a discrete global optimization algorithm was developed and implemented. The software design goals were simplicity, speed and intuition. Based on these design goals, we have developed the publicly available software PopED lite (http://www.bluetree.me/PopED_lite). Optimization computation was on average, over 14 test problems, 30 times faster in PopED lite compared to an already existing optimal design software tool. PopED lite is now used in real drug discovery projects and a few of these case studies are presented in this paper. PopED lite is designed to be simple, fast and intuitive. Simple, to give many users access to basic optimal design calculations. Fast, to fit a short design-execution cycle and allow interactive experimental design (test one design, discuss proposed design, test another design, etc). Intuitive, so that the input to and output from the software tool can easily be understood by users without knowledge of the theory of optimal design. In this way, PopED lite is highly useful in practice and complements existing tools. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Stroke Risk After Non-Stroke ED Dizziness Presentations: A Population-Based Cohort Study

    PubMed Central

    Kerber, Kevin A.; Zahuranec, Darin B.; Brown, Devin L.; Meurer, William J.; Burke, James F.; Smith, Melinda A.; Lisabeth, Lynda D.; Fendrick, A. Mark; McLaughlin, Thomas; Morgenstern, Lewis B.

    2014-01-01

    Objective Acute stroke is a serious concern in Emergency Department (ED) dizziness presentations. Prior studies, however, suggest that stroke is actually an unlikely cause of these presentations. Lacking are data on short- and long-term follow-up from population-based studies to establish stroke risk after presumed non-stroke ED dizziness presentations. Methods From 5/8/2011 to 5/7/2012, patients ≥ 45 years of age presenting to EDs in Nueces County, Texas, with dizziness, vertigo, or imbalance were identified, excluding those with stroke as the initial diagnosis. Stroke events after the ED presentation up to 10/2/2012 were determined using the Brain Attack Surveillance in Corpus Christi (BASIC) study, which uses rigorous surveillance and neurologist validation. Cumulative stroke risk was calculated using Kaplan-Meier estimates. Results 1,245 patients were followed for a median of 347 days (IQR 230- 436 days). Median age was 61.9 years (IQR, 53.8-74.0 years). After the ED visit, fifteen patients (1.2%) had a stroke. Stroke risk was 0.48% (95% CI, 0.22%-1.07%) at 2 days; 0.48% (95% CI, 0.22%-1.07%) at 7 days; 0.56% (95% CI, 0.27%-1.18%) at 30 days; 0.56% (95% CI, 0.27%-1.18%) at 90 days; and 1.42% (95% CI, 0.85%-2.36%) at 12 months. Interpretation Using rigorous case ascertainment and outcome assessment in a population-based design, we found that the risk of stroke after presumed non-stroke ED dizziness presentations is very low, supporting a non-stroke etiology to the overwhelming majority of original events. High-risk subgroups likely exist, however, because most of the 90-day stroke risk occurred within 2-days. Vascular risk stratification was insufficient to identify these cases. PMID:24788511

  1. G. ED. Paper-Book 1974-1984. The Process of Growth of an Innovation.

    ERIC Educational Resources Information Center

    Verduin-Muller, Henriette, Ed.

    Fifteen papers presented at conferences throughout Europe and in the USSR, Nigeria, Japan, Jamaica, and Tunesia provide an introduction to the research work being done by the graduate level Department of Geography for Education (G.ED.) at the University of Utrecht in the Netherlands. An introductory chapter describes the three G.ED. modules, which…

  2. Improvement in Student Science Proficiency Through InSciEd Out

    PubMed Central

    Sonju, James D.; Leicester, Jean E.; Hoody, Maggie; LaBounty, Thomas J.; Frimannsdottir, Katrin R.; Ekker, Stephen C.

    2012-01-01

    Abstract Integrated Science Education Outreach (InSciEd Out) is a collaboration formed between Mayo Clinic, Winona State University, and Rochester Public Schools (MN) with the shared vision of achieving excellence in science education. InSciEd Out employs an equitable partnership model between scientists, teachers, education researchers, and the community. Teams of teachers from all disciplines within a single school experience cutting-edge science using the zebrafish model system, as well as current pedagogical methods, during a summer internship at the Mayo Clinic. Within the internship, the teachers produce new curriculum that directly addresses opportunities for science education improvement at their own school. Zebrafish are introduced within the new curriculum to support a living model of the practice of science. Following partnership with the InSciEd Out program and 2 years of implementation in the classroom, teacher-interns from a K–8 public school reported access to local scientific technology and expertise they had not previously recognized. Teachers also reported improved integration of other disciplines into the scientific curriculum and a flow of concepts vertically from K through 8. Students more than doubled selection of an Honors science track in high school to nearly 90%. 98% of students who took the Minnesota Comprehensive Assessments in their 5th and 8th grade year (a span that includes 2 years of InSciEd Out) showed medium or high growth in science proficiency. These metrics indicate that cooperation between educators and scientists can result in positive change in student science proficiency and demonstrate that a higher expectation in science education can be achieved in US public schools. PMID:23244687

  3. Arc-Ed Curriculum: Applicability for Severely Handicapped Pupils.

    ERIC Educational Resources Information Center

    Chaffin, Jerry D.

    1982-01-01

    The Arc Ed Curriculum uses video game formats to teach math and language arts content. Four motivational features (feedback, improvement, high response rates, and unlimited ceiling on performance along with adapted content could make the system applicable for use with severely handicapped learners. (CL)

  4. The Customers' Perspective: The EdNET 98 Survey of Buyers and Managers of Educational Technology. Constructive Input for the Educational Technology Industry from the EdNET 98 Education Executives Advisory Board.

    ERIC Educational Resources Information Center

    Craighead, Donna; Bigham, Vicki Smith; Heller, Nelson B.

    The EdNET 98 Education Executives Advisory Board, also known as Partners in Education Program (PEP), is a featured activity of the EdNET 98 Conference. Its focus is to bring educators and vendors together to share their perspectives about technology in education and discussion technology-related concerns and issues. This report presents results…

  5. Two-Step Process for ED UTI Screening in Febrile Young Children: Reducing Catheterization Rates.

    PubMed

    Lavelle, Jane M; Blackstone, Mercedes M; Funari, Mary Kate; Roper, Christine; Lopez, Patricia; Schast, Aileen; Taylor, April M; Voorhis, Catherine B; Henien, Mira; Shaw, Kathy N

    2016-07-01

    Urinary tract infection (UTI) screening in febrile young children can be painful and time consuming. We implemented a screening protocol for UTI in a high-volume pediatric emergency department (ED) to reduce urethral catheterization, limiting catheterization to children with positive screens from urine bag specimens. This quality-improvement initiative was implemented using 3 Plan-Do-Study-Act cycles, beginning with a small test of the proposed change in 1 ED area. To ensure appropriate patients received timely screening, care teams discussed patient risk factors and created patient-specific, appropriate procedures. The intervention was extended to the entire ED after providing education. Finally, visual cues were added into the electronic health record, and nursing scripts were developed to enlist family participation. A time-series design was used to study the impact of the 6-month intervention by using a p-chart to determine special cause variation. The primary outcome measure for the study was defined as the catheterization rate in febrile children ages 6 to 24 months. The ED reduced catheterization rates among febrile young children from 63% to <30% over a 6-month period with sustained results. More than 350 patients were spared catheterization without prolonging ED length of stay. Additionally, there was no change in the revisit rate or missed UTIs among those followed within the hospital's network. A 2-step less-invasive process for screening febrile young children for UTI can be instituted in a high-volume ED without increasing length of stay or missing cases of UTI. Copyright © 2016 by the American Academy of Pediatrics.

  6. Air pollution and ED visits for asthma in Australian children: a case-crossover analysis.

    PubMed

    Jalaludin, Bin; Khalaj, Behnoosh; Sheppeard, Vicky; Morgan, Geoff

    2008-08-01

    We aimed to determine the effects of ambient air pollutants on emergency department (ED) visits for asthma in children. We obtained routinely collected ED visit data for asthma (ICD9 493) and air pollution (PM(10), PM(2.5), O(3), NO(2), CO and SO(2)) and meteorological data for metropolitan Sydney for 1997-2001. We used the time stratified case-crossover design and conditional logistic regression to model the association between air pollutants and ED visits for four age-groups (1-4, 5-9, 10-14 and 1-14 years). Estimated relative risks for asthma ED visits were calculated for an exposure corresponding to the inter-quartile range in pollutant level. We included same day average temperature, same day relative humidity, daily temperature range, school holidays and public holidays in all models. Associations between ambient air pollutants and ED visits for asthma in children were most consistent for all six air pollutants in the 1-4 years age-group, for particulates and CO in the 5-9 years age-group and for CO in the 10-14 years age-group. The greatest effects were most consistently observed for lag 0 and effects were greater in the warm months for particulates, O(3) and NO(2). In two pollutant models, effect sizes were generally smaller compared to those derived from single pollutant models. We observed the effects of ambient air pollutants on ED attendances for asthma in a city where the ambient concentrations of air pollutants are relatively low.

  7. A comparison of ED and direct admission care of cancer patients with febrile neutropenia.

    PubMed

    Owolabi, Diwura K; Rowland, Richard; King, Lauren; Miller, Rick; Hegde, Gajanan G; Shang, Jennifer; Lister, John; Venkat, Arvind

    2015-07-01

    We compared the quality of care in admitted febrile neutropenic cancer patients presenting through the emergency department (ED) vs those directly admitted (DA) from the clinic or infusion center. We hypothesized that the quality of care would be comparable between these 2 pathways. We conducted a retrospective, observational cohort study of all adult cancer patients hospitalized with subjective or objective fever (≥100.4°F) and documented neutropenia (absolute neutrophil count ≤1000/mm(3)) from January 1, 2011 to June 30, 2013, at 2 hospitals. Two investigators retrieved data including patient age, sex, race, tumor type, blood culture growth, temperature (actual or reported), pathway to admission (ED or DA), time to antibiotic administration, length of stay, and the Multinational Association for Supportive Care in Cancer (MASCC) risk score. The primary outcome measures were time to antibiotic administration, appropriateness of antibiotic(s) administered based on published guidelines, length of stay, and MASCC score-based risk assessment. We used the t test for the difference between 2 means with unequal population variances to compare these outcome measures between ED and DA patients. One hundred twenty-seven visits met inclusion criteria (42 [33%] ED visits, 85 [67%] DA visits). Mean time to antibiotic administration, mean length of stay, appropriateness of antibiotics, and MASCC score-based risk assessment were comparable between ED and DA visits (P>.05 for all comparisons). The quality of care for febrile neutropenia in patients presenting through the ED was comparable to those directly admitted to the hospital in this 2-center study. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Barriers and facilitators to ED physician use of the test and treatment for BPPV

    PubMed Central

    Forman, Jane; Damschroder, Laura; Telian, Steven A.; Fagerlin, Angela; Johnson, Patricia; Brown, Devin L.; An, Lawrence C.; Morgenstern, Lewis B.; Meurer, William J.

    2017-01-01

    Abstract Background: The test and treatment for benign paroxysmal positional vertigo (BPPV) are evidence-based practices supported by clinical guideline statements. Yet these practices are underutilized in the emergency department (ED) and interventions to promote their use are needed. To inform the development of an intervention, we interviewed ED physicians to explore barriers and facilitators to the current use of the Dix-Hallpike test (DHT) and the canalith repositioning maneuver (CRM). Methods: We conducted semi-structured in-person interviews with ED physicians who were recruited at annual ED society meetings in the United States. We analyzed data thematically using qualitative content analysis methods. Results: Based on 50 interviews with ED physicians, barriers that contributed to infrequent use of DHT/CRM that emerged were (1) prior negative experiences or forgetting how to perform them and (2) reliance on the history of present illness to identify BPPV, or using the DHT but misattributing patterns of nystagmus. Based on participants' responses, the principal facilitator of DHT/CRM use was prior positive experiences using these, even if infrequent. When asked which clinical supports would facilitate more frequent use of DHT/CRM, participants agreed supports needed to be brief, readily accessible, and easy to use, and to include well-annotated video examples. Conclusions: Interventions to promote the use of the DHT/CRM in the ED need to overcome prior negative experiences with the DHT/CRM, overreliance on the history of present illness, and the underuse and misattribution of patterns of nystagmus. Future resources need to be sensitive to provider preferences for succinct information and video examples. PMID:28680765

  9. Impact of ED management on hospital quality measures: the negative case of atrial fibrillation.

    PubMed

    Piela, Nicole E; Sacchetti, Alfred; Sholevar, Darius; Blaber, Reginald; Levi, Steven

    2013-05-01

    Emergency department (ED) cardioversion and discharge of atrial fibrillation (AF) is an evolving treatment. Emergency department cardioversion patients have few comorbidities, and their discharge directly from the ED leads to a sicker in-patient population of AF patients. This study examines whether the quality care markers, hospital charges (HC) and length of stay (LOS), negatively reflect the practice of ED cardioversion. Median HC and LOS were determined for 2 different quality assessment reporting models. In a standard model (SM), patients discharged from the ED were not included in any hospital statistics and only admitted, or observation patients were used to calculate the HC and LOS of AF patients. In an inclusive model (IM), patients discharged from the ED were also included in the hospital statistics but given the same LOS as observation patients. Differences across medians were analyzed using Wilcoxon rank sum tests. A total of 312 patients were evaluated for AF over an 18-month period. Of these, 197 (62%) were admitted, 21 (7%) were placed in observation status, and 95 (31%) were discharged from the ED. Median values for LOS were 3 days (interquartile range [IQR], 1-5) for the SM and 1 day (IQR, 0-4) for the IM. Median values for HC were $33062 (IQR, $19267-$60614) for the SM and $20059 (IQR, $4249-$47195) for the IM. Emergency department cardioversion selects out a less sick cohort of patients whose removal from a hospital's admission numbers negatively skews quality performance profiles. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Multidisciplinary intervention decreases the use of opioid medication discharge packs from 2 urban EDs.

    PubMed

    Gugelmann, Hallam; Shofer, Frances S; Meisel, Zachary F; Perrone, Jeanmarie

    2013-09-01

    Prescription opioid overdoses and deaths constitute a public health epidemic, and recent studies show that emergency department (ED) prescribers may contribute to this crisis. We hypothesized that a multidisciplinary educational intervention would decrease ED opioid packs dispensed at discharge. This prospective study implemented a "bundle" of interdisciplinary educational modalities: lectures, journal clubs, case discussions, and an electronic medical record decision support tool. Implementation occurred in 2 urban EDs in the same health system at different times ("affiliate," September 2011; "primary," January 2012) to better distinguish its effects. The primary outcome was preintervention/postintervention change in opioid discharge packs dispensed to all patients treated and discharged through August 2012 and was assessed by 2-way analysis of variance. The secondary outcome was bivariate analysis (using Fisher exact test) of change in opioid dispensing among patients with known risk factors for prescription opioid dependence: age less than 65 years, history of substance abuse, chronic pain, or psychiatric disorders. A total of 71,512 and 45,746 patients were evaluated and discharged from primary and affiliate EDs, respectively. Orders for opioid discharge packs decreased from 13.9% to 8.4% and 4.7% to 1.9% at the primary and affiliate hospitals (P < .0001). Dispensing among individuals at risk for opioid dependence at the primary ED decreased from 21.8% to 13.9%. A staged, multidisciplinary intervention targeting nurses, residents, nurse practitioners, and attending physicians was associated with decreased orders for opioid discharge packs in 2 urban EDs. Opioid discharge pack orders decreased slightly more among patients with risk factors for prescription opioid dependence. © 2013.

  11. The attitudes and awareness of emergency department (ED) physicians towards the management of common dentofacial emergencies.

    PubMed

    Trivedy, Chetan; Kodate, Naonori; Ross, Alastair; Al-Rawi, Harrith; Jaiganesh, Thiagarajan; Harris, Tim; Anderson, Janet E

    2012-04-01

    Dentofacial emergencies are a common presentation to the emergency department (ED) but there is little recent data on physicians' knowledge, confidence and attitudes in handling these cases. A questionnaire was administered to 103 ED physicians. The sample was primarily drawn from London hospitals as well a smaller contribution from around the UK and included physicians with a range of experience and at different grades. The majority of the 102 participants (76.5%) did not receive any formal training in managing dentofacial emergencies. The percentage of participants who were happy to manage common dentofacial emergencies is as follows: dental trauma (20.4%); major facial trauma (39.8%); interpreting facial X-rays (68.0%); and facial suturing (85.4%). When questioned 12.1% of the participants felt that ED physicians should be responsible for managing dental emergencies compared to 22.4% who felt that ED physicians should manage maxillofacial emergencies. Only 3.9% of the participants would opt to be treated by an ED doctor in the event of them presenting to the ED with a dental injury. The remaining 72.5% would prefer to be seen by a maxillofacial surgeon, 23.5% by a dentist and none of the participants opted to be seen by the emergency nurse practitioner. ED physicians do not feel confident in managing some dentofacial emergencies. This may be attributed to a lack of training in this area as well as exposure to these types of emergencies. There is a need for greater awareness, validated guidelines and training resources for ED physicians to treat dentofacial emergencies as well more research in this field of emergency medicine. © 2011 John Wiley & Sons A/S.

  12. Bacteremia in nonneutropenic pediatric oncology patients with central venous catheters in the ED.

    PubMed

    Moskalewicz, Risha L; Isenalumhe, Leidy L; Luu, Cindy; Wee, Choo Phei; Nager, Alan L

    2017-01-01

    To examine clinical characteristics associated with bacteremia in febrile nonneutropenic pediatric oncology patients with central venous catheters (CVCs) in the emergency department (ED). Fever is the primary reason pediatric oncology patients present to the ED. The literature states that 0.9% to 39% of febrile nonneutropenic oncology patients are bacteremic, yet few studies have investigated infectious risk factors in this population. This was a retrospective cohort study in a pediatric ED, reviewing medical records from 2002 to 2014. Inclusion criteria were patients with cancer, temperature at least 38°C, presence of a CVC, absolute neutrophil count greater than 500 cells/μL, and age less than 22 years. Exclusion criteria were repeat ED visits within 72 hours, bloodwork results not reported by the laboratory, and patients without oncologic history documented at the study hospital. The primary outcome measure is a positive blood culture (+BC). Other variables include age, sex, CVC type, cancer diagnosis, absolute neutrophil count, vital signs, upper respiratory infection (URI) symptoms, and amount of intravenous (IV) normal saline (NS) administered in the ED. Data were analyzed using descriptive statistics and a multiple logistic regression model. A total of 1322 ED visits were sampled, with 534 enrolled, and 39 visits had +BC (7.3%). Variables associated with an increased risk of +BC included the following: absence of URI symptoms (odds ratio [OR], 2.30; 95% CI, 1.13-4.69), neuroblastoma (OR, 3.65; 95% CI, 1.47-9.09), "other" cancer diagnosis (OR, 4.56; 95% CI, 1.93-10.76), tunneled externalized CVC (OR, 5.04; 95% CI, 2.25-11.28), and receiving at least 20 mL/kg IV NS (OR, 2.34; 95% CI, 1.2-4.55). The results of a multiple logistic regression model also showed these variables to be associated with +BC. The absence of URI symptoms, presence of an externalized CVC, neuroblastoma or other cancer diagnosis, and receiving at least 20 mL/kg IV NS in the ED are

  13. ReEDS-Mexico: A Capacity Expansion Model of the Mexican Power System

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

    Ho, Jonathan L; Cole, Wesley J; Spyrou, Evangelia

    This report documents the ReEDS-Mexico capacity expansion model, which is an extension of the ReEDS model to the Mexican power system. In recent years Mexico’s power sector has undergone considerable reform that has significant potential to impact the future electricity mix (Alpizar–Castro and Rodríguez–Monroy 2016). Day-ahead and real-time trading in Mexico’s power markets opened in early 2016. In addition to this reform, Mexico is striving to ensure that 35% of its electricity is generated from clean energy sources by 2024, 40% by 2035, and 50% by 2050 (Presidencia de la República 2016). These rapid changes in both the market andmore » the generation mix create a need for robust tools that can help electricity sector stakeholders make informed decisions. The purpose of this report is to document the extension of the National Renewable Energy Laboratory’s (NREL’s) Regional Energy Deployment System (ReEDS) model (Eurek et al. 2016) to cover the Mexico power system. This extension, which we will refer to throughout this paper as ReEDS-Mexico, provides a model of the Mexico power sector using a system-wide, least-cost optimization framework.« less

  14. Developing a multidisciplinary approach within the ED towards domestic violence presentations.

    PubMed

    Basu, Subhashis; Ratcliffe, Giles

    2014-03-01

    To improve the detection and quality of care of patients who attend the emergency department (ED) with confirmed or suspected domestic abuse (DA). A quality improvement report on the design, implementation and evaluation of a specialised service and structured training programme to detect and manage DA presentations within an emergency medicine department. The study was set in the ED at the Northern General Hospital, Sheffield, UK. Key measures for improvement included introducing a service within the ED to help staff manage DA and coordinate responses; improve staff confidence in detecting DA; develop a structured and consistent process by which to manage DA presentations. An Independent Domestic Violence Advocate service was introduced into the department in July 2011 through a multiagency agreement. A structured training and education programme was delivered to ED staff. A 'communications form' was developed for DA risk assessment and case management. The process was reviewed quarterly. One hundred and seventy-two referrals were made to the service (121 distinct clients) over a 12-month period. Staff reported greater confidence in detecting DA, and community partners highlighted the role the service had in improving DA detection and care quality within the city. Strong leadership and prioritising the issue within the department has facilitated the development of the process and contributed substantially to its success. Support from community partners has been invaluable in tailoring the service and education programme to the needs of staff and patients within the department.

  15. Solving the worldwide emergency department crowding problem - what can we learn from an Israeli ED?

    PubMed

    Pines, Jesse M; Bernstein, Steven L

    2015-01-01

    ED crowding is a prevalent and important issue facing hospitals in Israel and around the world, including North and South America, Europe, Australia, Asia and Africa. ED crowding is associated with poorer quality of care and poorer health outcomes, along with extended waits for care. Crowding is caused by a periodic mismatch between the supply of ED and hospital resources and the demand for patient care. In a recent article in the Israel Journal of Health Policy Research, Bashkin et al. present an Ishikawa diagram describing several factors related to longer length of stay (LOS), and higher levels of ED crowding, including management, process, environmental, human factors, and resource issues. Several solutions exist to reduce ED crowding, which involve addressing several of the issues identified by Bashkin et al. This includes reducing the demand for and variation in care, and better matching the supply of resources to demands in care in real time. However, what is needed to reduce crowding is an institutional imperative from senior leadership, implemented by engaged ED and hospital leadership with multi-disciplinary cross-unit collaboration, sufficient resources to implement effective interventions, access to data, and a sustained commitment over time. This may move the culture of a hospital to facilitate improved flow within and across units and ultimately improve quality and safety over the long-term.

  16. The Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE): method and design considerations.

    PubMed

    Boudreaux, Edwin D; Miller, Ivan; Goldstein, Amy B; Sullivan, Ashley F; Allen, Michael H; Manton, Anne P; Arias, Sarah A; Camargo, Carlos A

    2013-09-01

    Due to the concentration of individuals at-risk for suicide, an emergency department visit represents an opportune time for suicide risk screening and intervention. The Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) uses a quasi-experimental, interrupted time series design to evaluate whether (1) a practical approach to universally screening ED patients for suicide risk leads to improved detection of suicide risk and (2) a multi-component intervention delivered during and after the ED visit improves suicide-related outcomes. This paper summarizes the ED-SAFE's study design and methods within the context of considerations relevant to effectiveness research in suicide prevention and pertinent human participants concerns. 1440 suicidal individuals, from 8 general ED's nationally will be enrolled during three sequential phases of data collection (480 individuals/phase): (1) Treatment as Usual; (2) Universal Screening; and (3) Intervention. Data from the three phases will inform two separate evaluations: Screening Outcome (Phases 1 and 2) and Intervention (Phases 2 and 3). Individuals will be followed for 12 months. The primary study outcome is a composite reflecting completed suicide, attempted suicide, aborted or interrupted attempts, and implementation of rescue procedures during an outcome assessment. While 'classic' randomized control trials (RCT) are typically selected over quasi-experimental designs, ethical and methodological issues may make an RCT a poor fit for complex interventions in an applied setting, such as the ED. ED-SAFE represents an innovative approach to examining the complex public health issue of suicide prevention through a multi-phase, quasi-experimental design embedded in 'real world' clinical settings. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Creating a Minnesota Statewide SNAP-Ed Program Evaluation

    ERIC Educational Resources Information Center

    Gold, Abby; Barno, Trina Adler; Sherman, Shelley; Lovett, Kathleen; Hurtado, G. Ali

    2013-01-01

    Systematic evaluation is an essential tool for understanding program effectiveness. This article describes the pilot test of a statewide evaluation tool for the Supplemental Nutrition Assistance Program-Education (SNAP-Ed). A computer algorithm helped Community Nutrition Educators (CNEs) build surveys specific to their varied educational settings…

  18. Safe Handling of Snakes in an ED Setting.

    PubMed

    Cockrell, Melanie; Swanson, Kristofer; Sanders, April; Prater, Samuel; von Wenckstern, Toni; Mick, JoAnn

    2017-01-01

    Efforts to improve consistency in management of snakes and venomous snake bites in the emergency department (ED) can improve patient and staff safety and outcomes, as well as improve surveillance data accuracy. The emergency department at a large academic medical center identified an opportunity to implement a standardized process for snake disposal and identification to reduce staff risk exposure to snake venom from snakes patients brought with them to the ED. A local snake consultation vendor and zoo Herpetologist assisted with development of a process for snake identification and disposal. All snakes have been identified and securely disposed of using the newly implemented process and no safety incidents have been reported. Other emergency department settings may consider developing a standardized process for snake disposal using listed specialized consultants combined with local resources and suppliers to promote employee and patient safety. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  19. 75 FR 11937 - EDS, HP Company, Fairfield Township, OH; Notice of Termination of Investigation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-72,710] EDS, HP Company, Fairfield Township, OH; Notice of Termination of Investigation Pursuant to Section 223 of the Trade Act of... the State on behalf of workers of EDS, HP Company, Fairfield Township, Ohio. The petitioners have...

  20. Economic Development Network (ED>Net): 1995-96 Report to the Governor and the Legislature.

    ERIC Educational Resources Information Center

    California Community Colleges, Sacramento. Office of the Chancellor.

    The Economic Development Network (ED>Net) of the California Community Colleges was designed to advance the state's economic growth and competitiveness by coordinating and facilitating workforce improvement, technology deployment, and business development initiatives. This report reviews outcomes for ED>Net for 1995-96 based on reports…

  1. Nanotwins in Nanocrystalline Mg-Al Alloys: An Insight from High-Resolution TEM and Molecular Dynamics Simulation

    DTIC Science & Technology

    2013-09-25

    Mathaudhu, C.Y.A. Tsao and E.J. Lavernia, Mater. Sci. Eng. A528 (2011) p. 2180. [21] S . Plimpton , J. Comput. Phys. 117 (1995) p. 1. [22] X.-Y. Liu, J.B...grained Mg are identi ? ed and supported with atomistic The views, opinions and/or findings contained in this report are those of the author( s ) and should...MONITORING AGENCY NAME( S ) AND ADDRESS (ES) U.S. Army Research Office P.O. Box 12211 Research Triangle Park, NC 27709-2211 nanocrystalline Mg – Al alloys

  2. 500 Contractors Receiving the Largest Dollar Volume of Prime Contract Awards for RDT&E, Fiscal Year 1992

    DTIC Science & Technology

    1992-01-01

    201 F CANADIAN COMMERCIAL CORPORATI 268 B AMTEC CORPORATION 67 N CARNEGIE MELLON UNIVERSITY 118 B ANALYSIS & TECHNOLOGY INC 192 B CAS INC 86 N...LAB INC 342 F GENERAL ELECTRIC CO PLC THE 356 B DU PONT E I DE NEMOURS & CO 3 B GENERAL ELECTRIC COMPANY 325 N DUKE UNIVERSITY 295 N GENERAL HOSPITAL...F SOREQ NUCLEAR RESEARCH CENTER 260 F PORTON INTERNATIONAL INC 55 N SOUTH CAROLINA RESCH AUTHORITY 82 B PRC INC 206 N SOUrTHEASTN CTR ELECTR ENG ED

  3. Dendritic Cells Control Fibroblastic Reticular Network Tension and Lymph Node Expansion

    PubMed Central

    Acton, Sophie E.; Farrugia, Aaron J.; Astarita, Jillian L.; Mourão-Sá, Diego; Jenkins, Robert P.; Nye, Emma; Hooper, Steven; van Blijswijk, Janneke; Rogers, Neil C.; Snelgrove, Kathryn J.; Rosewell, Ian; Moita, Luis F.; Stamp, Gordon; Turley, Shannon J.; Sahai, Erik; Sousa, Caetano Reis e

    2014-01-01

    Following immunogenic challenge, infiltrating and dividing lymphocytes significantly increase lymph node (LN) cellularity leading to organ expansion1,2. Here we report that the physical elasticity of LNs is maintained in part by podoplanin (PDPN) signalling in stromal fibroblastic reticular cells (FRCs) and its modulation by CLEC-2 expressed on dendritic cells (DCs). We show that PDPN induces actomyosin contractility in FRCs via activation of RhoA/C and downstream Rho-kinase. Engagement by CLEC-2 causes PDPN clustering and rapidly uncouples PDPN from RhoA/C activation, relaxing the actomyosin cytoskeleton and permitting FRC stretching. Notably, administration of CLEC-2 protein to immunised mice augments LN expansion. In contrast, the latter is significantly constrained in mice selectively lacking CLEC-2 expression in DCs. Thus, the same DCs that initiate immunity by presenting antigens to T lymphocytes3 also initiate remodeling of LNs by delivering CLEC-2 to FRCs. CLEC-2 modulation of PDPN signalling permits FRC network stretching and allows for the rapid LN expansion driven by lymphocyte influx and proliferation that is the critical hallmark of adaptive immunity. PMID:25341788

  4. NIMROD simulations of the IPA FRC experiment

    NASA Astrophysics Data System (ADS)

    Milroy, Richard

    2015-11-01

    The IPA experiment created a high temperature plasma by merging and compressing supersonic θ-pinch formed FRCs. The NIMROD code has been used to simulate this process. These calculations include the θ-pinch formation and acceleration of two FRC's using the dynamic formation methodology, and their translation to a central compression chamber where they merge and are magnetically compressed. Transport coefficients have been tuned so simulation results agree well with experimental observation. The inclusion of the Hall term is essential for the FRCs merge quickly, as observed experimentally through the excluded flux profiles. The inclusion of a significant anisotropic viscosity is required for the excluded flux profiles to agree well with the experiment. We plan to extend this validation work using the new ARPA-E funded Venti experiment at Helion Energy in Redmond WA. This will be a very well diagnosed experiment where two FRCs merge (like the IPA experiment) and are then compressed to near-fusion conditions. Preliminary calculations with parameters relevant to this experiment have been made, and some numerical issues identified.

  5. Institutionalizing Environmental Scanning in the ED QUEST Process.

    ERIC Educational Resources Information Center

    Morrison, James L.

    An environmental scanning system is structured to identify and evaluate trends, events, and emerging issues. QUEST represents the quick environmental scanning technique, and an ED QUEST process enables an educational organization to clarify its future and define its options. This paper describes how an educational organization can establish an…

  6. Power and Professionalism: Reconstruction of Medical Educators' Practice by Way of a MA(Ed).

    ERIC Educational Resources Information Center

    Elmer, Roger

    England's King Alfred's College offers a MA(Ed) professional enquiry for teachers. In 1997, four medical doctors expressed interest in developing educational perspectives. Critical examination of the MA(Ed) indicated close parallels with the work of medical educators. The congruity was in an educational philosophy: people's internal values and…

  7. 34 CFR 84.400 - What are my responsibilities as a(n) ED awarding official?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What are my responsibilities as a(n) ED awarding official? 84.400 Section 84.400 Education Office of the Secretary, Department of Education GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of ED Awarding Officials § 84.400...

  8. A Successful ED Fall Risk Program Using the KINDER 1 Fall RiskAssessment Tool.

    PubMed

    Townsend, Ann B; Valle-Ortiz, Marisol; Sansweet, Tracy

    2016-11-01

    Emergency nurses did not perform falls risk assessments routinely on our ED patients; the instrument used was aimed at inpatients. We identified a need to revise fall assessment practices specific to our emergency department. The purpose of the performance improvement project was to reduce ED falls and evaluate the use of an ED-specific fall risk tool, the KINDER 1 Fall Risk Assessment. The plan was to establish fall risk assessment practices at point of ED entry and to decrease total falls. We retrospectively reviewed ED fall data for each quarter of 2013, which included risk assessments scores, the total number of falls, and the circumstances of each fall. Using Kotter's framework to guide a successful change process, we implemented the KINDER 1 to assess fall risk. During the first 4 weeks of the project, 937 patients (27%) were identified as high risk for falls using the KINDER 1. During the subsequent 3 quarters, the total number of falls decreased; reported falls without injuries dropped from 0.21 to 0.07 per 1000 patients, and falls with injuries were reduced from 0.21 to 0.0 per 1000 patients. The results of this project represented a valuable step toward achieving our goal to keep ED patients safe from injuries as a result of falls. The findings add to the body of nursing knowledge on the application of clinical-based performance improvement projects to improve patient outcomes and to provide data on the use of the KINDER 1 tool, which has not been extensively tested. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  9. Mid-term NEAT review: analysing the improvements in hospital ED performance.

    PubMed

    Khanna, Sankalp; Boyle, Justin; Good, Norm; Lind, James

    2014-01-01

    Introduced with a promise to reduce overcrowding in the Emergency Department (ED) and the associated morbidity and mortality linked to bed access difficulties, the National Emergency Access Target (NEAT) is now over halfway through transitionary arrangements towards a target of 90% of patients that visit a hospital ED being admitted or discharged within 4 hours. Facilitation and reward funding has ensured hospitals around the country are remodelling workflows to ensure compliance. Recent reports however show that the majority of hospitals are still far from being able to meet this target. We investigate the NEAT journey of 30 Queensland hospitals over the past two years and compare this performance to a previous study that investigated the 4 hour ED discharge performance of these hospitals at various times of day and under varying occupancy conditions. Our findings reveal that, while most hospitals have made significant improvements to their 4 hour discharge performance in 2013, the underlying flow patterns and periods of poor NEAT compliance remain largely unchanged. The work identifies areas for targeted improvement to inform system redesign and workflow planning.

  10. Test Review: Gilliam, J. E. (2015), "Attention-Deficit/Hyperactivity Disorder Test" (2nd Ed) [Assessment Instrument]. Austin, TX: Pro-Ed.

    ERIC Educational Resources Information Center

    Perdue, Elizabeth A.

    2016-01-01

    The "Attention-Deficit/Hyperactivity Disorder Test-Second Edition" (ADHDT-2) is published through Pro-Ed in Austin, Texas. It was formally published in 2014, following critical revisions of the ADHDT, the reportedly popular initial version of this test that was published in 1995. The ADHDT-2 purports to act as a screener for individuals…

  11. Exploring Older Adult ED Fall Patients' Understanding of Their Fall: A Qualitative Study.

    PubMed

    Shankar, Kalpana N; Taylor, Devon; Rizzo, Caroline T; Liu, Shan W

    2017-12-01

    We sought to understand older patients' perspectives about their fall, fall risk factors, and attitude toward emergency department (ED) fall-prevention interventions. We conducted semistructured interviews between July 2015 and January 2016 of community-dwelling, nondemented patients in the ED, who presented with a fall to an urban, teaching hospital. Interviews were halted once we achieve thematic saturation with the data coded and categorized into themes. Of the 63 patients interviewed, patients blamed falls on the environment, accidents, a medical condition, or themselves. Three major themes were generated: (1) patients blamed falls on a multitude of things but never acknowledged a possible multifactorial rationale, (2) patients have variable level of concerns regarding their current fall and future fall risk, and (3) patients demonstrated a range of receptiveness to ED interventions aimed at preventing falls but provided little input as to what those interventions should be. Many older patients who fall do not understand their fall risk. However, based on the responses provided, older adults tend to be more receptive to intervention and more concerned about their future fall risk, making the ED an appropriate setting for intervention.

  12. Exploring the limits of EDS microanalysis: rare earth element analyses

    NASA Astrophysics Data System (ADS)

    Ritchie, N. W. M.; Newbury, D. E.; Lowers, H.; Mengason, M.

    2018-01-01

    It is a great time to be a microanalyst. After a few decades of incremental progress in energy-dispersive X-ray spectrometry (EDS), the last decade has seen the accuracy and precision surge forward. Today, the question is not whether EDS is generally useful but to identify the types of problems for which wavelength-dispersive X-ray spectrometry remains the better choice. The full extent of EDS’s capabilities has surprised many. Low Z, low energy, and trace element detection have been demonstrated even in the presence of extreme peak interferences. In this paper, we will summarise the state-of-the-art and investigate a challenging problem domain, the analysis of minerals bearing multiple rare-earth elements.

  13. System Level Health Disparities in California Emergency Departments: Minorities and Medicaid Patients are at Higher Risk of Losing Their EDs

    PubMed Central

    Hsia, Renee Y.; Srebotnjak, Tanja; Kanzaria, Hemal K.; McCulloch, Charles; Auerbach, Andrew D.

    2015-01-01

    Study Objective Emergency Department (ED) closures threaten community access to emergency services, but few data exist to describe factors associated with closure. We evaluated factors associated with ED closure in California and sought to determine if hospitals serving more vulnerable populations have a higher rate of ED closure. Methods Retrospective cohort study of California hospital EDs between 1998 and 2008, using hospital and patient level data from the California Office of Statewide Planning and Development (OSHPD), as well as OSHPD Patient Discharge Data. We examined the effects of hospital and patient factors on the hospital's likelihood of ED closure using Cox proportional hazards models. Results In 4,411 hospital-years of observation, 29 of 401 (7.2%) EDs closed. In a model adjusted for total ED visits, hospital discharges, trauma center and teaching status, ownership, operating margin, and urbanicity, hospitals with more black patients (OR 1.41 per increase in proportion of blacks by 0.1, 95% CI 1.16-1.72) and Medi-Cal recipients (OR 1.17 per increase in proportion insured by Medi-Cal by 0.1, 95% CI 1.02-1.34) had higher odds for ED closure, as did for-profit institutions (OR 1.65, 95% CI 1.13-2.41). Conclusion The population served by EDs and hospitals’ profit model are associated with ED closure. Whether our findings are a manifestation of poorer reimbursement in at-risk EDs is unclear. PMID:22093435

  14. Standalone engine simulator (SAES), Engine Dynamics simulator (EDS) Xerox Sigma 5 interface hardware manual

    NASA Technical Reports Server (NTRS)

    Kirshten, P. M.; Black, S.; Pearson, R.

    1979-01-01

    The ESS-EDS and EDS-Sigma interfaces within the standalone engine simulator are described. The operation of these interfaces, including the definition and use of special function signals and data flow paths within them during data transfers, is presented along with detailed schematics and circuit layouts of the described equipment.

  15. Connecting Teachers and Ed-Tech Developers: Lessons from NYC's "Gap App" Program. Technical Appendices

    ERIC Educational Resources Information Center

    Villavicencio, Adriana; Siman, Nina; Lafayette, Camille; Kang, David

    2016-01-01

    In 2011, with support from a federal Investing in Innovation grant, the NYC Department of Education launched Innovate NYC Schools. The initiative was designed to address two, related challenges to effectively integrating education technology (ed-tech) into classrooms: First, procurement of ed-tech tools is often hampered by a disconnect between…

  16. Atypical presentations of dengue disease in the elderly visiting the ED.

    PubMed

    Lee, Ching-Chi; Hsu, Hsiang-Chin; Chang, Chia-Ming; Hong, Ming-Yuan; Ko, Wen-Chien

    2013-05-01

    The objective was to compare the clinical characteristics of elderly and young adult patients with dengue in the emergency department (ED). Demographic characteristics, clinical presentation, disease severity, laboratory characteristics, and outcomes were analyzed prospectively as a case-control study. Of the 193 adults with serologically confirmed dengue disease in 2007, 31 (16.1%) were elderly patients (aged ≥65) and 162 were young adults (aged <65). More dengue hemorrhagic fever (12.9% vs 2.5%, P = .02), a longer ED stay (13.3 vs 8.6 hours, P = .004), a longer hospital stay (7.4 vs 3.4 days, P < .001), a higher Simplified Acute Physiology Score II in the ED (29.7 vs 17.4, P < .001), and a higher rate of at least 1 comorbidity (61.8 vs 22.8%, P < .001) were found in the elderly. However, the length of the intensive care unit stay (elderly 0.7 vs young adults 0.3 day, P = .47) and the 14-day mortality rate (0% vs 0.6%, P = 1.00) were similar. Of note, in terms of clinical presentations of dengue in the ED, there were more elderly patients with isolated fever (41.9% vs 17.9%, P = .003) and fewer with typical presentation (41.9% vs 75.9%, P = <.001) than there were young adults. The present study found a higher number of atypical presentations, a longer hospitalization, and a higher degree of clinical illness in elderly patients with dengue. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Self-Instructional Workbook for the ED Form 799.

    ERIC Educational Resources Information Center

    Office of Postsecondary Education, Washington DC. Student Financial Assistance Programs.

    To assist in making funds available for student higher education loans and to keep their interest rates as low as possible, the Department of Education compensates participating lending institutions using a combination of interest subsidies and special allowance payments. Lenders use ED Form 799, Lender's Interest and Special Allowance Request and…

  18. Inpatient admissions from the ED for adults with injuries: the role of clinical and nonclinical factors.

    PubMed

    Spector, William D; Limcangco, Rhona; Mutter, Ryan L; Pines, Jesse M; Owens, Pamela

    2015-06-01

    Inpatient hospital costs represent nearly a third of heath care spending. The proportion of inpatients visits that originate in the emergency department (ED) has been growing, approaching half of all inpatient admissions. Injury is the most common reason for adult ED visits, representing nearly one-quarter of all ED visits. The objective was to explore the association of clinical and nonclinical factors with the decision to admit ED patients with injury. This is a retrospective cohort study of injury-related ED encounters by adults in select states in 2009. We limited the study to ED visits of persons with moderately severe injuries. We used logistic regression to calculate the marginal effects, estimating 4 equations to account for different risk patterns for older and younger adults, and types of injuries. Regression models controlled for comorbidities, injury characteristics, demographic characteristics, and state fixed effects. Injury location, type, and mechanism and comorbidities had large effects on hospitalization rates as expected. We found higher inpatient admission rates by level of trauma center designation and hospital size, but findings differed by age and type of injury. For younger adults, patients with private insurance and patients who traveled more than 30 miles were more likely to be admitted. There is great variation in inpatient admission decisions for moderately injured patients in the ED. Decisions appear to be dominated by clinical factors such as injury characteristics and comorbidities; however, nonclinical factors, such as type of insurance, hospital size, and trauma center designation, also play an important role. Published by Elsevier Inc.

  19. Evaluating Prospective Teachers: Testing the Predictive Validity of the edTPA. Working Paper 157

    ERIC Educational Resources Information Center

    Goldhaber, Dan; Cowan, James; Theobald, Roddy

    2016-01-01

    We use longitudinal data from Washington State to provide estimates of the extent to which performance on the edTPA, a performance-based, subject-specific assessment of teacher candidates, is predictive of the likelihood of employment in the teacher workforce and value-added measures of teacher effectiveness. While edTPA scores are highly…

  20. ISCCP-D2like-GEO Ed3A

    Atmospheric Science Data Center

    2018-05-16

    ISCCP-D2like-GEO Ed3A Project Title:  CERES Discipline:  ... Order Data Guide Documents:  GEO Description/Abstract Detailed CERES ISCCP-D2like Product ... Data Products Catalog:  DPC_ISCCP-D2like-GEO_R5V3  (PDF) Readme Files:  Readme GEO R5-987 ...

  1. Preparing Ed.D. Students to Conduct Group Dissertations

    ERIC Educational Resources Information Center

    Browne-Ferrigno, Tricia; Jensen, Jane McEldowney

    2012-01-01

    In this article we present an overview of a recently launched cohort-based Ed.D. program that prepares participants to conduct group dissertations. The program, a hybrid model of online learning activities and monthly face-to-face class sessions, is delivered through a partnership between a university's college of education and the administrative…

  2. Effect of advanced age and vital signs on admission from an ED observation unit.

    PubMed

    Caterino, Jeffrey M; Hoover, Emily M; Moseley, Mark G

    2013-01-01

    The primary objective was to determine the relationship between advanced age and need for admission from an emergency department (ED) observation unit. The secondary objective was to determine the relationship between initial ED vital signs and admission. We conducted a prospective, observational cohort study of ED patients placed in an ED-based observation unit. Multivariable penalized maximum likelihood logistic regression was used to identify independent predictors of need for hospital admission. Age was examined continuously and at a cutoff of 65 years or more. Vital signs were examined continuously and at commonly accepted cutoffs.We additionally controlled for demographics, comorbid conditions, laboratory values, and observation protocol. Three hundred patients were enrolled, 12% (n = 35) were 65 years or older, and 11% (n = 33) required admission. Admission rates were 2.9% (95% confidence interval [CI], 0.07%-14.9%) in older adults and 12.1% (95% CI, 8.4%-16.6%) in younger adults. In multivariable analysis, age was not associated with admission (odds ratio [OR], 0.30; 95% CI, 0.05-1.67). Predictors of admission included systolic pressure 180 mm Hg or greater (OR, 4.19; 95% CI, 1.08-16.30), log Charlson comorbidity score (OR, 2.93; 95% CI, 1.57-5.46), and white blood cell count 14,000/mm(3) or greater (OR, 11.35; 95% CI, 3.42-37.72). Among patients placed in an ED observation unit, age 65 years or more is not associated with need for admission. Older adults can successfully be discharged from these units. Systolic pressure 180 mm Hg or greater was the only predictive vital sign. In determining appropriateness of patients selected for an ED observation unit, advanced age should not be an automatic disqualifying criterion. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. A Review of "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only"

    ERIC Educational Resources Information Center

    Garrity, Joan Mogul

    2010-01-01

    While virtually all sex ed curricula are designed to be used with children, teens and young adults, "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only" ([C] 2009, Planned Parenthood of Greater Northern New Jersey) offers lessons to help participants fully embrace the possibility of sexual pleasure and intimacy from mid-life through…

  4. Borrowing yet another technique from manufacturing, investigators find that 'operational flexibility' can offer dividends to ED operations.

    PubMed

    2015-03-01

    Through the use of a sophisticated modeling technique, investigators at the University of Cincinnati have found that the creation of a so-called "flex track" that includes beds that can be assigned to either high-acuity or Iow-acuity- patients has the potential to lower mean wait times for patients when it is i added to the traditional fast-track and high-acuity areas of a 50-bed ED that sees 85,000 patients per year. Investigators used discrete-event simulation to model the patient flow and characteristics of the ED at the University of Cincinnati Medical Center, and to test out various operational scenarios without disrupting real-world operations. The investigators concluded that patient wait times were lowest when three flex beds were appropriated from the 10-bed fast track area of the EDs. In light of the results, three flex rooms are being incorporated into a newly remodeled ED scheduled for completion laterthis spring. Investigators suggest the modeling technique could be useful to other EDs interested in optimizing their operational plans. Further, they suggest that ED administrators consider ways to introduce flexibility into departments that are now more rigidly divided between high- and low-acuity areas.

  5. Communication and Influencing for ED Professionals: A training programme developed in the emergency department for the emergency department.

    PubMed

    Rixon, Andrew; Rixon, Sascha; Addae-Bosomprah, Hansel; Ding, Mingshuang; Bell, Anthony

    2016-08-01

    The objective of the present study is to develop and pilot a communication and influencing skills training programme that meets ED health professionals' needs at an urban district hospital. Qualitative methods within a participatory action research framework were utilised. An interdisciplinary team guided the programme's design and development. A training needs analysis saw team meetings, interviews, focus groups and observations conducted across the ED. Thematic analysis of the data identified health professionals' communication and influencing challenges. The training needs analysis informed the training programme curriculum's development. The pilot programme involved an interdisciplinary group of seven health professionals across 5 × 2 h sessions over 3 months, followed by a post-training survey. Five themes of communication and influencing challenges were identified: participating in effective handovers, involving patients in bedside handovers, effectively communicating with interdepartmental colleagues, asking ED colleagues to do tasks and understanding ED colleagues' roles, expectations and assumptions. Based on these challenges, the formulated RESPECT model (which stands for Relationships, Expectations, Styles, Partnerships, Enquiry, Coaching and Teamwork) informed the training curriculum. The peer coaching model used in the training programme was highly regarded by participants. Communication and Influencing for ED Professionals™ (Babel Fish Group Pty Ltd, Melbourne, Victoria, Australia) addresses a gap for communication programmes developed in the ED for the ED. Future research will evaluate the programme's impact in this ED. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  6. Disruption of the Arabidopsis Defense Regulator Genes SAG101, EDS1, and PAD4 Confers Enhanced Freezing Tolerance

    PubMed Central

    Chen, Qin-Fang; Xu, Le; Tan, Wei-Juan; Chen, Liang; Qi, Hua; Xie, Li-Juan; Chen, Mo-Xian; Liu, Bin-Yi; Yu, Lu-Jun; Yao, Nan; Zhang, Jian-Hua; Shu, Wensheng; Xiao, Shi

    2017-01-01

    In Arabidopsis, three lipase-like regulators, SAG101, EDS1, and PAD4, act downstream of resistance protein-associated defense signaling. Although the roles of SAG101, EDS1, and PAD4 in biotic stress have been extensively studied, little is known about their functions in plant responses to abiotic stresses. Here, we show that SAG101, EDS1, and PAD4 are involved in the regulation of freezing tolerance in Arabidopsis. With or without cold acclimation, the sag101, eds1, and pad4 single mutants, as well as their double mutants exhibited similarly enhanced tolerance to freezing temperatures. Upon cold exposure, the sag101, eds1, and pad4 mutants showed increased transcript levels of C-REPEAT/DRE BINDING FACTORs and their regulons, compared with wild type. Moreover, freezing-induced cell death and accumulation of hydrogen peroxide were ameliorated in sag101, eds1, and pad4 mutants. The sag101, eds1, and pad4 mutants had much lower salicylic acid (SA) and diacylglycerol (DAG) contents than wild type and exogenous application of SA and DAG compromised the freezing tolerance of the mutants. Furthermore, SA suppressed the cold-induced expression of DGATs and DGKs in wild-type leaves. These findings indicate that SAG101, EDS1, and PAD4 are involved in freezing response in Arabidopsis, at least in part, by modulating the homeostasis of SA and DAG. PMID:26149542

  7. Care plan program reduces the number of visits for challenging psychiatric patients in the ED.

    PubMed

    Abello, Arthur; Brieger, Ben; Dear, Kim; King, Ben; Ziebell, Chris; Ahmed, Atheer; Milling, Truman J

    2012-09-01

    A small number of patients representing a significant demand on emergency department (ED) services present regularly for a variety of reasons, including psychiatric or behavioral complaints and lack of access to other services. A care plan program was created as a database of ED high users and patients of concern, as identified by ED staff and approved by program administrators to improve care and mitigate ED strain. A list of medical record numbers was assembled by searching the care plan program database for adult patients initially enrolled between the dates of November 1, 2006, and October 21, 2007. Inclusion criteria were the occurrence of a psychiatric International Classification Diseases, Ninth Revision, code in their medical record and a care plan level implying a serious psychiatric disorder causing harmful behavior. Additional data about these patients were acquired using an indigent care tracking database and electronic medical records. Variables collected from these sources were analyzed for changes before and after program enrollment. Of 501 patients in the database in the period studied, 48 patients fulfilled the criteria for the cohort. There was a significant reduction in the number of visits to the ED from the year before program enrollment to the year after enrollment (8.9, before; 5.9, after; P < .05). There was also an increase in psychiatric hospital visits (2%, before; 25%, after; P < .05). An alert program that identifies challenging ED patients with psychiatric conditions and creates a care plan appears to reduce visits and lead to more appropriate use of other resources. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Paid sick leave is associated with fewer ED visits among US private sector working adults.

    PubMed

    Bhuyan, Soumitra S; Wang, Yang; Bhatt, Jay; Dismuke, S Edward; Carlton, Erik L; Gentry, Dan; LaGrange, Chad; Chang, Cyril F

    2016-05-01

    The United States (US) is the only developed country that does not guarantee short-term or longer-term paid sick leave. This study used a multiyear nationally representative database to examine the association between availability of paid sick leave and frequency of emergency department (ED) use among US private sector employees. We used the National Health Interview Survey data (2012-2014). The final study sample consists of 42,460 US adults between 18 and 64years of age and working in nongovernmental private sector. Our results suggest that availability of paid sick leave is significantly associated with lower likelihood of ED use, for both moderate (1-3 times/year) and repeated users (4 or more times/year). After controlling for confounding factors, respondents with paid sick leave are 14% less likely to be moderate ED users (adjusted odds ratio, 0.86; 95% CI, 0.79-0.93) and 32% less likely to be repeated ED users (adjusted odds ratio, 0.68; 95% CI, 0.50-0.91). Although expansion of health insurance coverage under the Affordable Care Act has not been shown to reduce utilization of high cost health care services such as the ED, our study suggests other factors such as the availability of paid sick leave may do so, by allowing patients to seek care through other more cost-effective mechanisms (eg, primary care providers). To reduce ED utilization, health policymakers should consider alternative reforms including paid sick leave. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. HAZ-ED Classroom Activities for Understanding Hazardous Waste.

    ERIC Educational Resources Information Center

    Environmental Protection Agency, Washington, DC.

    The Federal Superfund Program investigates and cleans up hazardous waste sites throughout the United States. Part of this program is devoted to informing the public and involving people in the process of cleaning up hazardous waste sites from beginning to end. The Haz-Ed program was developed to assist the Environmental Protection Agency's (EPA)…

  10. Impact of a bronchiolitis guideline on ED resource use and cost: a segmented time-series analysis.

    PubMed

    Akenroye, Ayobami T; Baskin, Marc N; Samnaliev, Mihail; Stack, Anne M

    2014-01-01

    Bronchiolitis is a major cause of infant morbidity and contributes to millions of dollars in health care costs. Care guidelines may cut costs by reducing unnecessary resource utilization. Through the implementation of a guideline, we sought to reduce unnecessary resource utilization and improve the value of care provided to infants with bronchiolitis in a pediatric emergency department (ED). We conducted an interrupted time series that examined ED visits of 2929 patients with bronchiolitis, aged 1 to 12 months old, seen between November 2007 and April 2013. Outcomes were proportion having a chest radiograph (CXR), respiratory syncytial virus (RSV) testing, albuterol or antibiotic administration, and the total cost of care. Balancing measures included admission rate, returns to the ED resulting in admission within 72 hours of discharge, and ED length of stay (LOS). There were no significant preexisting trends in the outcomes. After guideline implementation, there was an absolute reduction of 23% in CXR (95% confidence interval [CI]: 11% to 34%), 11% in RSV testing (95% CI: 6% to 17%), 7% in albuterol use (95% CI: 0.2% to 13%), and 41 minutes in ED LOS (95% CI: 16 to 65 minutes). Mean cost per patient was reduced by $197 (95% CI: $136 to $259). Total cost savings was $196,409 (95% CI: $135,592 to $258,223) over the 2 bronchiolitis seasons after guideline implementation. There were no significant differences in antibiotic use, admission rates, or returns resulting in admission within 72 hours of discharge. A bronchiolitis guideline was associated with reductions in CXR, RSV testing, albuterol use, ED LOS, and total costs in a pediatric ED.

  11. A Disability Studies in Education Analysis of the edTPA through Teacher Candidate Perspectives

    ERIC Educational Resources Information Center

    Bacon, Jessica; Blachman, Sheila

    2017-01-01

    This analysis of the Special Education edTPA is written by two professors who co-taught a student teaching seminar at one institution and supported the first groups of teacher candidates required to submit the edTPA for certification in New York State. Data were gathered over three semesters and included open-ended student surveys, student…

  12. SEM/EDS Characterization of Ambient PM during Agricultural Burns

    NASA Astrophysics Data System (ADS)

    Wagner, J.; Wall, S.

    2010-12-01

    Ambient particulate matter (PM) samples were collected with UNC passive samplers during agricultural burns in Imperial Valley, California. Four Bermuda grass field burn events were sampled at 3-8 locations surrounding each burn. Sampling began at the start of each burn (30-60 min) and continued for 24-120 hours. During 3 of the 4 burn events, winds were calm and plumes were observed to travel straight up to the inversion layer. In one event, winds created a ground-level plume that enveloped two UNC samplers mounted on telephone poles very close to the field (0.2-0.3 miles away). Computer-controlled scanning electron microscopy / energy-dispersive x-ray spectroscopy (CCSEM/EDS) was used to measure particle sizes and elemental composition, from which mass concentrations and size distributions were calculated. The median PM2.5 and PM10 levels measured in this study were 3.4 and 20 ug/m3, respectively. To determine quantitative accuracy, UNC sampler PM2.5 results (PM< 2.5 um) were compared to PM2.5 results from four co-located, continuous-reading beta-attenuation monitors (EBAMs). The median agreement (EBAM - UNC) was 3.8 ug/m3. Manual SEM/EDS detected various distinctive species in these samples, including sea salt, spores, plant fragments, and large soot agglomerates. During the ‘plume event’, 24-hour PM2.5 exposures downwind were up to 17 times higher than that measured upwind. Numerous submicron combustion particles with carbon and oxygen only were directly observed by manual SEM/EDS in the two plume-impacted samples, along with larger ash particles enriched in potassium, sulfur, chlorine, calcium, sodium, and phosphorus. CCSEM/EDS data from this event was grouped into 5 particle classes to generate size-fraction-specific pie charts. Burn-related particle types contributed 95% of the PM2.5 in the location directly impacted by the ground-level plume, compared to only 12% in the upwind location. A sample of Imperial County Bermuda grass analyzed in bulk and

  13. Adaptation of Lorke's method to determine and compare ED50 values: the cases of two anticonvulsants drugs.

    PubMed

    Garrido-Acosta, Osvaldo; Meza-Toledo, Sergio Enrique; Anguiano-Robledo, Liliana; Valencia-Hernández, Ignacio; Chamorro-Cevallos, Germán

    2014-01-01

    We determined the median effective dose (ED50) values for the anticonvulsants phenobarbital and sodium valproate using a modification of Lorke's method. This modification allowed appropriate statistical analysis and the use of a smaller number of mice per compound tested. The anticonvulsant activities of phenobarbital and sodium valproate were evaluated in male CD1 mice by maximal electroshock (MES) and intraperitoneal administration of pentylenetetrazole (PTZ). The anticonvulsant ED50 values were obtained through modifications of Lorke's method that involved changes in the selection of the three first doses in the initial test and the fourth dose in the second test. Furthermore, a test was added to evaluate the ED50 calculated by the modified Lorke's method, allowing statistical analysis of the data and determination of the confidence limits for ED50. The ED50 for phenobarbital against MES- and PTZ-induced seizures was 16.3mg/kg and 12.7mg/kg, respectively. The sodium valproate values were 261.2mg/kg and 159.7mg/kg, respectively. These results are similar to those found using the traditional methods of finding ED50, suggesting that the modifications made to Lorke's method generate equal results using fewer mice while increasing confidence in the statistical analysis. This adaptation of Lorke's method can be used to determine median letal dose (LD50) or ED50 for compounds with other pharmacological activities. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Micro Slot Generation by μ-ED Milling

    NASA Astrophysics Data System (ADS)

    Dave, H. K.; Mayanak, M. K.; Rajpurohit, S. R.; Mathai, V. J.

    2016-08-01

    Micro electro discharge machining is one of the most widely used advanced micro machining technique owing to its capability to fabricate micro features on any electrically conductive materials irrespective of its material properties. Despite its wide acceptability, the process is always adversely affected by issues like wear that occurred on the tool electrode, which results into generation of inaccurate features. Micro ED milling, a process variant in which the tool electrode simultaneously rotated and scanned during machining, is reported to have high process efficiency for generation of 3D complicated shapes and features with relatively less electrode wear intensity. In the present study an attempt has been made to study the effect of two process parameters viz. capacitance and scanning speed of tool electrode on end wear that occurs on the tool electrode and overcut of micro slots generated by micro ED milling. The experiment has been conducted on Al 1100 alloy with tungsten electrode having diameter of 300 μm. Results suggest that wear on the tool electrode and overcut of the micro features generated are highly influenced by the level of the capacitance employed during machining. For the parameter usage employed for present study however, no significant effect of variation of scanning speed has been observed on both responses.

  15. IV crystalloid fluid for acute alcoholic intoxication prolongs ED length of stay.

    PubMed

    Homma, Yosuke; Shiga, Takashi; Hoshina, Yuiko; Numata, Kenji; Mizobe, Michiko; Nakashima, Yoshiyuki; Takahashi, Jin; Inoue, Tetsuya; Takahashi, Osamu; Funakoshi, Hiraku

    2018-04-01

    Acute alcohol intoxication is often treated in emergency departments by intravenous crystalloid fluid (IVF), but it is not clear that this shortens the time to achieving sobriety. The study aim was to investigate the association of IVF infusion and length of stay in the ED. This single-center retrospective cohort study was conducted in Japan and included patients aged ≥20years of age and treated for acute alcohol intoxication without or with IVF. The primary outcome was the length of the ED stay and the treatments were compared by time-to-event analysis. A total of 106 patients, 42 treated without IVF and 64 with IVF. The baseline characteristics of the two groups were similar. Kaplan-Meier analysis and the generalized Wilcoxon test found no significant difference between the two treatments in the time to ED discharge. The median time was 189 (IQR 160-230) minutes without IVF and 254.5 (203-267 minutes with IVF; p=0.052). A Cox proportional hazards regression model adjusted for potential confounding variables found that patients treated with IVF were less likely to be discharged earlier than those treated without IVF (HR 0.54, 95% CI: 0.35-0.84, p=0.006). IVF for treatment of acute alcoholic intoxication prolonged ED length of stay even after adjustment for potential confounders. Patients given IVF for acute alcohol intoxication should be selected with care. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. New 'patent accelerated care environment' aims to facilitate work flow, free up ED for acute care needs.

    PubMed

    2012-02-01

    Faced with rising acuity levels and surging demand, Virginia Mason Medical Center modified the Clinical Decision Unit concept used in many EDs, and developed a new Patient Accelerated Care Environment (PACE) to care for observation patients, process patients for discharge, and to prepare patients for admission.The approach is designed to utilize ED beds for initial processing of patients, allowing resuscitative care if needed, and treating and releasing the patients with quick care needs. Using the Virginia Mason Production System, a methodology that is modeled after Toyota production techniques, developers designed an optimal work flow pattern and then built infrastructure to facilitate that process. All patients who present to the ED for care are seen by the ED team through a "team greet" approach. Approximately 35% to 40% of patients who come to the ED for care are transferred to the PACE unit. Patients assigned to the PACE unit typically remain there for 4 to 48 hours, depending on their care needs.

  17. 5 Ways That edX Could Change Education

    ERIC Educational Resources Information Center

    Parry, Marc

    2012-01-01

    Since MIT and Harvard started edX, their joint experiment with free online courses, the venture has attracted enormous attention for opening the ivory tower to the world. But in the process, the world will become part of an expensive and ambitious experiment testing some of the most interesting--and difficult--questions in digital education. Can…

  18. Improved Early Detection of Sepsis in the ED With a Novel Monocyte Distribution Width Biomarker.

    PubMed

    Crouser, Elliott D; Parrillo, Joseph E; Seymour, Christopher; Angus, Derek C; Bicking, Keri; Tejidor, Liliana; Magari, Robert; Careaga, Diana; Williams, JoAnna; Closser, Douglas R; Samoszuk, Michael; Herren, Luke; Robart, Emily; Chaves, Fernando

    2017-09-01

    Sepsis most often presents to the ED, and delayed detection is harmful. WBC count is often used to detect sepsis, but changes in WBC count size also correspond to sepsis. We sought to determine if volume increases of circulating immune cells add value to the WBC count for early sepsis detection in the ED. A blinded, prospective cohort study was conducted in two different ED populations within a large academic hospital. Neutrophil and monocyte volume parameters were measured in conjunction with routine CBC testing on a UniCel DxH 800 analyzer at the time of ED admission and were evaluated for the detection of sepsis. There were 1,320 subjects in the ED consecutively enrolled and categorized as control subjects (n = 879) and those with systemic inflammatory response syndrome (SIRS) (n = 203), infection (n = 140), or sepsis (n = 98). Compared with other parameters, monocyte distribution width (MDW) best discriminated sepsis from all other conditions (area under the curve [AUC], 0.79; 95% CI, 0.73-0.84; sensitivity, 0.77; specificity, 0.73; MDW threshold, 20.50), sepsis from SIRS (AUC, 0.74; 95% CI, 0.67-0.84), and severe sepsis from noninfected patients in the ED (AUC, 0.88; 95% CI, 0.75-0.99; negative predictive value, 99%). The added value of MDW to WBC count was statistically significant (AUC, 0.89 for MDW + WBC vs 0.81 for WBC alone; P < .01); a decision curve analysis also showed improved performance compared with WBC count alone. The incorporation of MDW with WBC count is shown in this prospective cohort study to improve detection of sepsis compared with WBC count alone at the time of admission in the ED. ClinicalTrials.gov; No.: NCT02232750; URL: www.clinicaltrials.gov. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  19. Detection of glass particles on bone lesions using SEM-EDS.

    PubMed

    Montoriol, Romain; Guilbeau-Frugier, Céline; Chantalat, Elodie; Roumiguié, Mathieu; Delisle, Marie-Bernadette; Payré, Bruno; Telmon, Norbert; Savall, Frédéric

    2017-09-01

    The problem of identifying the wounding agent in forensic cases is recurrent. Moreover, when several tools are involved, distinguishing the origin of lesions can be difficult. Scanning electron microscopy (SEM)/energy dispersive X-ray analysis (EDS) equipment is increasingly available to the scientific and medical community, and some studies have reported its use in forensic anthropology. However, at our knowledge, no study has reported the use of SEM-EDS in forensic cases involving glass tools, whether in case reports or experiments. We performed an experimental study on human rib fragments, on which we manually created wounds using fragments of window and mirror glass. SEM-EDS was executed on samples without any further preparation on low vacuum mode, then on the same samples after defleshing them completely by boiling them. Window and mirror glass particles were detected on experimental wounds. Both had silica in their spectra, and the opaque side of the mirror contained titanium, allowing for their identification. Boiling and defleshing the bone samples involved a loss of information in terms of the number of wounds detected as positive for glass particles and in the number of glass particles detected, for both window and mirror glass. We suggest the analysis of wounds with suspected glass particles using low vacuum mode and with no defleshment by boiling.

  20. Terrorism drill shows ED response plan flaws.

    PubMed

    2005-07-01

    Valuable lessons can be learned by paying attention to your processes and communication equipment during a disaster drill. Did your radios and pagers work adequately? If not, it may be time for a new vendor. Going through the drill helps remind the entire ED staff to funnel all communications and key decisions through the disaster response leader. Make sure to update your disaster response handbook to reflect important lessons learned during the drill.

  1. Cost-Sharing for Emergency Care and Unfavorable Clinical Events: Findings from the Safety and Financial Ramifications of ED Copayments Study

    PubMed Central

    Hsu, John; Price, Mary; Brand, Richard; Ray, G Thomas; Fireman, Bruce; Newhouse, Joseph P; Selby, Joseph V

    2006-01-01

    Objective To evaluate the effect of emergency department (ED) copayment levels on ED use and unfavorable clinical events. Data Source/Study Setting Kaiser Permanente–Northern California (KPNC), a prepaid integrated delivery system. Study Design In a quasi-experimental longitudinal study with concurrent controls, we estimated rates of ED visits, hospitalizations, ICU admissions, and deaths associated with higher ED copayments relative to no copayment, using Poisson random effects and proportional hazard models, controlling for patient characteristics. The study period began in January 1999; more than half of the population experienced an employer-chosen increase in their ED copayment in January 2000. Data Collection/Extraction Methods Using KPNC automated databases, the 2000 U.S. Census, and California state death certificates, we collected data on ED visits and unfavorable clinical events over a 36-month period (January 1999 through December 2001) among 2,257,445 commercially insured and 261,091 Medicare insured health system members. Principal Findings Among commercially insured subjects, ED visits decreased 12 percent with the $20–35 copayment (95 percent confidence interval [CI]: 11–13 percent), and 23 percent with the $50–100 copayment (95 percent CI: 23–24 percent) compared with no copayment. Hospitalizations, ICU admissions, and deaths did not increase with copayments. Hospitalizations decreased 4 percent (95 percent CI: 2–6 percent) and 10 percent (95 percent CI: 7–13 percent) with ED copayments of $20–35 and $50–100, respectively, compared with no copayment. Among Medicare subjects, ED visits decreased by 4 percent (95 percent CI: 3–6 percent) with the $20–50 copayments compared with no copayment; unfavorable clinical events did not increase with copayments, e.g., hospitalizations were unchanged (95 percent CI: −3 percent to +2 percent) with $20–50 ED copayments compared with no copayment. Conclusions Relatively modest levels of

  2. Race to the Top District Competition: The Data Quality Campaign's Comments on ED's Proposed Criteria

    ERIC Educational Resources Information Center

    Data Quality Campaign, 2012

    2012-01-01

    The Data Quality Campaign (DQC) submits these comments in response to the US Department of Education's (ED) draft requirements, priorities, selection criteria, and definitions for the Race to the Top District (RTT-D) competition. DQC applauds ED for including the following components of the proposal: (1) Data is acknowledged throughout the…

  3. Lifeworld and Textualism: Reassembling the Researcher/ed and "Others"

    ERIC Educational Resources Information Center

    Payne, Phillip G.

    2005-01-01

    This response to McKenzie's "post-post" concerns about environmental education research draws upon empirical, conceptual, anecdotal, metaphorical, imaged and poetic means to help the researcher "reassemble" the researcher/ed by attending to her/his relational body and embodiment of various, often hegemonic, socially constructed environmental…

  4. Hardiness Mediates Stress and Impact Level in ED Nurses Who Experienced a Violent Event.

    PubMed

    Park, Jin Hee; Lee, Eun Nam; Kong, Kyung Ran; Jang, Moon Jung

    2017-11-01

    This secondary analysis examined the mediating effect of hardiness between stress and impact level in ED nurses who experienced a violent event. This correlational study was conducted from June to August 2014. We used the visual analog scale to measure stress level, the Impact of Event Scale-Revised to measure impact level after the violent event, and the Dispositional Resilience Scale to measure hardiness. We then analyzed mediating effects with the Sobel test. Data were collected in 31 emergency medical centers located in B city in Korea. Data from 321 ED nurses who experienced a violent event were analyzed. Most nurses (91.9%) were women, with a mean age of 28.73 years. The main outcome measure was the mediating effect of hardiness between stress and impact level after ED nurses experienced violence. We found that both violence-related stress (B = 0.22, P < .001) and hardiness (B = -0.33, P = .037) were significant predictors of impact level from a violent event. Based on results of a Sobel test, hardiness partially mediated the relationship between violence-related stress and impact level from a violent event (Z = 2.03, P = .044). Hardiness had an effect on reducing the impact level of ED nurses who had experienced a violent event and had a mediating role in mitigating their stress. Therefore, we recommend the development of an intervention program that emphasizes the improvement of hardiness in ED nurses. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  5. Embracing the Common Cause Advocating for Ed Tech

    ERIC Educational Resources Information Center

    Roland, Jennifer

    2006-01-01

    This is a common response from educators confronted with the notion of advocating for educational technology funding. But, in a time when U.S. funding for Ed Tech is in danger of being cut from the budget, ISTE believes that all of its members, and in fact, all U.S. educators, must become advocates for our common cause. "Effective advocacy from…

  6. Packaged Food Purchases at Walmart and Other Food Retail Chains Changes In Nutritional Profile From 2000 to 2013

    PubMed Central

    Taillie, Lindsey Smith; Ng, Shu Wen; Popkin, Barry M.

    2015-01-01

    Introduction Proliferation of food retail chains has created an environment in which a few food retailers account for the majority of U.S. packaged food purchases (PFPs). Despite the major potential for these food retail chains (FRCs) to impact what U.S. consumers buy and eat, little is known about the nutritional profile of PFPs from these retailers, particularly PFPs from Walmart, the U.S.’ largest grocer. Methods A data set of household PFPs from Nielsen Homescan was linked to data from the Nutrition Facts Panel (N=164,315), analyzed in 2014. Fixed effects models and inverse probability weights accounting for selectivity of shopping at a retailer were used to examine shifts in nutrient densities and key food groups purchased at Walmart and other FRCs from 2000 to 2013, and whether these changes differed for low-income or race/ethnic minority households. Results There were substantial declines in energy (−73 kcal/100 g), total sugar (−8 g/100 g), and sodium density (−33 mg/100 g) of Walmart PFPs, coupled with decreases in percentage volume purchased from sweets (−11%), grain-based desserts (−2%), and savory snacks (−3%) and increases in fruits (+3%) and vegetables (+1%). PFPs from other FRCs had a more favorable nutritional profile than Walmart PFPs in 2000, but demonstrated smaller shifts over time. Disparities in the nutritional profile of Walmart PFPs by race/ethnicity but not by income level shrank over time. Conclusions The nutritional profile of Walmart purchases has improved over time and in 2013 was similar to PFPs from other FRCs. PMID:26497262

  7. Walmart and Other Food Retail Chains: Trends and Disparities in the Nutritional Profile of Packaged Food Purchases.

    PubMed

    Taillie, Lindsey Smith; Ng, Shu Wen; Popkin, Barry M

    2016-02-01

    Proliferation of food retail chains has created an environment in which a few food retailers account for the majority of U.S. packaged food purchases (PFPs). Despite the major potential for these food retail chains (FRCs) to impact what U.S. consumers buy and eat, little is known about the nutritional profile of PFPs from these retailers, particularly PFPs from Walmart, the largest U.S. grocer. A data set of household PFPs from Nielsen Homescan was linked to data from the Nutrition Facts Panel (N=164,315), analyzed in 2014. Fixed effects models and inverse probability weights accounting for selectivity of shopping at a retailer were used to examine shifts in nutrient densities and key food groups purchased at Walmart and other FRCs from 2000 to 2013, and whether these changes differed for low-income or racial/ethnic-minority households. There were substantial declines in energy (-73 kcal/100 g); total sugar (-8 g/100 g); and sodium density (-33 mg/100 g) of Walmart PFPs, coupled with decreases in percentage volume purchased from sweets (-11%); grain-based desserts (-2%); and savory snacks (-3%) and increases in fruits (+3%) and vegetables (+1%). PFPs from other FRCs had a more favorable nutritional profile than Walmart PFPs in 2000, but demonstrated smaller shifts over time. Disparities in the nutritional profile of Walmart PFPs by race/ethnicity but not by income level shrank over time. The nutritional profile of Walmart purchases has improved over time and in 2013 was similar to PFPs from other FRCs. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  8. EDS1 contributes to nonhost resistance of Arabidopsis thaliana against Erwinia amylovora.

    PubMed

    Moreau, Manon; Degrave, Alexandre; Vedel, Régine; Bitton, Frédérique; Patrit, Oriane; Renou, Jean-Pierre; Barny, Marie-Anne; Fagard, Mathilde

    2012-03-01

    Erwinia amylovora causes fire blight in rosaceous plants. In nonhost Arabidopsis thaliana, E. amylovora triggers necrotic symptoms associated with transient bacterial multiplication, suggesting either that A. thaliana lacks a susceptibility factor or that it actively restricts E. amylovora growth. Inhibiting plant protein synthesis at the time of infection led to an increase in necrosis and bacterial multiplication and reduced callose deposition, indicating that A. thaliana requires active protein synthesis to restrict E. amylovora growth. Analysis of the callose synthase-deficient pmr4-1 mutant indicated that lack of callose deposition alone did not lead to increased sensitivity to E. amylovora. Transcriptome analysis revealed that approximately 20% of the genes induced following E. amylovora infection are related to defense and signaling. Analysis of mutants affected in NDR1 and EDS1, two main components of the defense-gene activation observed, revealed that E. amylovora multiplied ten times more in the eds1-2 mutant than in the wild type but not in the ndr1-1 mutant. Analysis of mutants affected in three WRKY transcription factors showing EDS1-dependent activation identified WRKY46 and WRKY54 as positive regulators and WRKY70 as a negative regulator of defense against E. amylovora. Altogether, we show that EDS1 is a positive regulator of nonhost resistance against E. amylovora in A. thaliana and hypothesize that it controls the production of several effective defenses against E. amylovora through the action of WRKY46 and WRKY54, while WRKY70 acts as a negative regulator.

  9. KSC-2009-6720

    NASA Image and Video Library

    2009-12-10

    CAPE CANAVERAL, Fla. - In Orbiter Processing Facility Bay 3 at NASA's Kennedy Space Center in Florida, United Space Alliance technicians align space shuttle Discovery's Forward Reaction Control System, or FRCS, into position on the shuttle's frame. The FRCS is being reinstalled in the forward fuselage nose area of the shuttle after refurbishment. The FRCS provides the thrust for attitude (rotational) maneuvers (pitch, yaw and roll) and for small velocity changes along the orbiter axis (translation maneuvers). Discovery is being prepared for the STS-131 mission, the 33rd flight to the International Space Station. The seven-member STS-131 crew will deliver a Multi-Purpose Logistics Module filled with resupply stowage platforms and racks to be transferred to locations around the station. Three spacewalks will include work to attach a spare ammonia tank assembly to the station's exterior and return a European experiment from outside the station's Columbus module. Discovery's launch is targeted for March 18, 2010. For information on the STS-131 mission and crew, visit http://www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts131/index.html. Photo credit: NASA/Amanda Diller

  10. KSC-2009-6721

    NASA Image and Video Library

    2009-12-10

    CAPE CANAVERAL, Fla. - In Orbiter Processing Facility Bay 3 at NASA's Kennedy Space Center in Florida, United Space Alliance technicians check the alignment of space shuttle Discovery's Forward Reaction Control System, or FRCS, onto the shuttle's frame. The FRCS is being reinstalled in the forward fuselage nose area of the shuttle after refurbishment. The FRCS provides the thrust for attitude (rotational) maneuvers (pitch, yaw and roll) and for small velocity changes along the orbiter axis (translation maneuvers). Discovery is being prepared for the STS-131 mission, the 33rd flight to the International Space Station. The seven-member STS-131 crew will deliver a Multi-Purpose Logistics Module filled with resupply stowage platforms and racks to be transferred to locations around the station. Three spacewalks will include work to attach a spare ammonia tank assembly to the station's exterior and return a European experiment from outside the station's Columbus module. Discovery's launch is targeted for March 18, 2010. For information on the STS-131 mission and crew, visit http://www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts131/index.html. Photo credit: NASA/Amanda Diller

  11. Dendritic cells control fibroblastic reticular network tension and lymph node expansion.

    PubMed

    Acton, Sophie E; Farrugia, Aaron J; Astarita, Jillian L; Mourão-Sá, Diego; Jenkins, Robert P; Nye, Emma; Hooper, Steven; van Blijswijk, Janneke; Rogers, Neil C; Snelgrove, Kathryn J; Rosewell, Ian; Moita, Luis F; Stamp, Gordon; Turley, Shannon J; Sahai, Erik; Reis e Sousa, Caetano

    2014-10-23

    After immunogenic challenge, infiltrating and dividing lymphocytes markedly increase lymph node cellularity, leading to organ expansion. Here we report that the physical elasticity of lymph nodes is maintained in part by podoplanin (PDPN) signalling in stromal fibroblastic reticular cells (FRCs) and its modulation by CLEC-2 expressed on dendritic cells. We show in mouse cells that PDPN induces actomyosin contractility in FRCs via activation of RhoA/C and downstream Rho-associated protein kinase (ROCK). Engagement by CLEC-2 causes PDPN clustering and rapidly uncouples PDPN from RhoA/C activation, relaxing the actomyosin cytoskeleton and permitting FRC stretching. Notably, administration of CLEC-2 protein to immunized mice augments lymph node expansion. In contrast, lymph node expansion is significantly constrained in mice selectively lacking CLEC-2 expression in dendritic cells. Thus, the same dendritic cells that initiate immunity by presenting antigens to T lymphocytes also initiate remodelling of lymph nodes by delivering CLEC-2 to FRCs. CLEC-2 modulation of PDPN signalling permits FRC network stretching and allows for the rapid lymph node expansion--driven by lymphocyte influx and proliferation--that is the critical hallmark of adaptive immunity.

  12. Medical Mondays: ED Utilization for Medicaid Recipients Depends on the Day of the Week, Season, and Holidays.

    PubMed

    Castner, Jessica; Yin, Yong; Loomis, Dianne; Hewner, Sharon

    2016-07-01

    The purpose of this study is to describe and explain the temporal and seasonal trends in ED utilization for a low-income population. A retrospective analysis of 66,487 ED Medicaid-insured health care claims in 2009 was conducted for 2 Western New York Counties using time-series analysis with autoregressive moving average (ARMA) models. The final ARMA (2,0) model indicated an autoregressive structure with up to a 2-day lag. ED volume is lower on weekends than on weekdays, and the highest volumes are on Mondays. Summer and fall seasons demonstrated higher volumes, whereas lower volume outliers were associated with holidays. Day of the week was an influential predictor of ED utilization in low-income persons. Season and holidays are also predictors of ED utilization. These calendar-based patterns support the need for ongoing and future emergency leaders' collaborations in community-based care system redesign to meet the health care access needs of low-income persons. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  13. Candidate Success and edTPA: Looking at the Data

    ERIC Educational Resources Information Center

    Evans, Lesley A.; Kelly, Mary K.; Baldwin, Joni L.; Arnold, Jackie M.

    2016-01-01

    This descriptive study looks at the correlations between Teacher Performance Assessment (edTPA) data and numerous program data points, including GPA, major GPA, and benchmark assignment scores, gathered in an Early Childhood Education (ECE) program. Previous studies have looked to correlate grade point average (GPA) with pre-service teacher…

  14. Influenza-Related Hospitalization and ED Visits in Children Less Than 5 Years: 2000–2011

    PubMed Central

    Jules, Astride; Grijalva, Carlos G.; Zhu, Yuwei; Talbot, H. Keipp; Williams, John V.; Poehling, Katherine A.; Chaves, Sandra S.; Edwards, Kathryn M.; Schaffner, William; Shay, David K.

    2015-01-01

    BACKGROUND AND OBJECTIVES: In the United States, recommendations for annual influenza vaccination gradually expanded from 2004 to 2008, to include all children aged ≥6 months. The effects of these policies on vaccine uptake and influenza-associated health care encounters are unclear. The objectives of the study were to examine the annual incidence of influenza-related health care encounters and vaccine uptake among children age 6 to 59 months from 2000–2001 through 2010–2011 in Davidson County, TN. METHODS: We estimated the proportion of laboratory-confirmed influenza-related hospitalizations and emergency department (ED) visits by enrolling and testing children with acute respiratory illness or fever. We estimated influenza-related health care encounters by multiplying these proportions by the number of acute respiratory illness/fever hospitalizations and ED visits for county residents. We assessed temporal trends in vaccination coverage, and influenza-associated hospitalizations and ED visit rates. RESULTS: The proportion of fully vaccinated children increased from 6% in 2000–2001 to 38% in 2010–2011 (P < .05). Influenza-related hospitalizations ranged from 1.9 to 16.0 per 10 000 children (median 4.5) per year. Influenza-related ED visits ranged from 89 to 620 per 10 000 children (median 143) per year. Significant decreases in hospitalizations (P < .05) and increases in ED visits (P < .05) over time were not clearly related to vaccination trends. Influenza-related encounters were greater when influenza A(H3N2) circulated than during other years with median rates of 8.2 vs 3.2 hospitalizations and 307 vs 143 ED visits per 10 000 children, respectively. CONCLUSIONS: Influenza vaccination increased over time; however, the proportion of fully vaccinated children remained <50%. Influenza was associated with a substantial illness burden particularly when influenza A(H3N2) predominated. PMID:25489015

  15. EDS V26 Containment Vessel Explosive Qualification Test Report

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

    Crocker, Robert W.; Haroldsen, Brent L.; Stofleth, Jerome H.

    2013-11-01

    The objective of the test was to qualify the vessel for its intended use by subjecting it to a 1.25 times overtest. The criteria for success are that the measured strains do not exceed the calculated strains from the vessel analysis, there is no significant additional plastic strain on subsequent tests at the rated design load (shakedown), and there is no significant damage to the vessel and attached hardware that affect form, fit, or function. Testing of the V25 Vessel in 2011 established a precedent for testing V26 [2]. As with V25, two tests were performed to satisfy this objective.more » The first test used 9 pounds of Composition C-4 (11.25 lbs. TNT-equivalent), which is 125 percent of the design basis load. The second test used 7.2 pounds of Composition C-4 (9 lbs. TNT-equivalent) which is 100 percent of the design basis load. The first test provided the required overtest while the second test served to demonstrate shakedown and the absence of additional plastic deformation. Unlike the V25 vessel, which was mounted in a shipping cradle during testing, the V26 vessel was mounted on the EDS P2U3 trailer prior to testing. Visual inspections of the EDS vessel, surroundings, and diagnostics were completed before and after each test event. This visual inspection included analyzing the seals, fittings, and interior surfaces of the EDS vessel and documenting any abnormalities or damages. Photographs were used to visually document vessel conditions and findings before and after each test event.« less

  16. Unstandardized Responses to a "Standardized" Test: The edTPA as Gatekeeper and Curriculum Change Agent

    ERIC Educational Resources Information Center

    Ledwell, Katherine; Oyler, Celia

    2016-01-01

    We examine edTPA (a teacher performance assessment) implementation at one private university during the first year that our state required this exam for initial teaching certification. Using data from semi-structured interviews with 19 teacher educators from 12 programs as well as public information on edTPA pass rates, we explore whether the…

  17. Is your ED a medical department or a business? Survey says...both.

    PubMed

    2009-07-01

    Taking a solid business-like approach to the management of your ED involves--but is certainly not limited to--getting a handle on revenues and expenses. Here are a few strategies some ED managers say help them run a tighter, and better, ship: Have a clinical audit specialist review charts, and have a clerical person "check the checker." Use a "cultural fit" interview with prospective staff members to ensure you're on the same page when it comes to service. Develop a charge structure with numerical values for clinical activities and services, to help ensure optimal reimbursement.

  18. IT in the ED: a new section of Pediatric Emergency Care.

    PubMed

    Zorc, Joseph J; Hoffman, Jeffrey M; Harper, Marvin B

    2012-12-01

    Information technology (IT) has profoundly changed the delivery of health care during the past decade. The pediatric emergency department (ED) represents a specific challenge for applying IT systems to the patient bedside. The rapid pace and unscheduled nature of the ED, the breadth of care delivered, and the range of medical, ethical, cultural, and process issues presented by pediatric patients make this a setting in particular need of thoughtfully designed and usable IT systems. However, reviews of the current state of health IT have documented mixed outcomes, including safety risks introduced by IT systems, significant deficits in usability for clinicians, and unrealized potential. Although some publications have presented methods and outcomes of IT systems in the pediatric ED, the current medical literature is sparse. Professional organizations have not developed successful methods to share best practices across institutions and IT vendors. The authors propose a new section of this journal focused on the application of IT systems to Pediatric Emergency Care. The section will include original research articles and reviews focusing on the application of IT to improve care of acutely ill and injured children. Innovative approaches and articles by physicians in training are particularly encouraged to develop new expertise in informatics within this and related specialties.

  19. Integrated Canada-U.S. Power Sector Modeling with the Regional Energy Deployment System (ReEDS)

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

    Martinez, A.; Eurek, K.; Mai, T.

    2013-02-01

    The electric power system in North America is linked between the United States and Canada. Canada has historically been a net exporter of electricity to the United States. The extent to which this remains true will depend on the future evolution of power markets, technology deployment, and policies. To evaluate these and related questions, we modify the Regional Energy Deployment System (ReEDS) model to include an explicit representation of the grid-connected power system in Canada to the continental United States. ReEDS is unique among long-term capacity expansion models for its high spatial resolution and statistical treatment of the impact ofmore » variable renewable generation on capacity planning and dispatch. These unique traits are extended to new Canadian regions. We present example scenario results using the fully integrated Canada-U.S. version of ReEDS to demonstrate model capabilities. The newly developed, integrated Canada-U.S. ReEDS model can be used to analyze the dynamics of electricity transfers and other grid services between the two countries under different scenarios.« less

  20. Chemical analysis and biological testing of materials from the EDS coal liquefaction process: a status report

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

    Later, D.W.; Pelroy, R.A.; Wilson, B.W.

    1984-05-01

    Representative process materials were obtained from the EDS pilot plant for chemical and biological analyses. These materials were characterized for biological activity and chemical composition using a microbial mutagenicity assay and chromatographic and mass spectrometric analytical techniques. The two highest boiling distillation cuts, as well as process solvent (PS) obtained from the bottoms recycle mode operation, were tested for initiation of mouse skin tumorigenicity. All three materials were active; the crude 800/sup 0 +/F cut was substantially more potent than the crude bottoms recycle PS or 750 to 800/sup 0/F distillate cut. Results from chemical analyses showed the EDS materials,more » in general, to be more highly alkylated and have higher hydroaromatic content than analogous SRC II process materials (no in-line process hydrogenation) used for comparison. In the microbial mutagenicity assays the N-PAC fractions showed greater activity than did the aliphatic hydrocarbon, hydroxy-PAH, or PAH fractions, although mutagenicity was detected in certain PAH fractions by a modified version of the standard microbial mutagenicity assay. Mutagenic activities for the EDS materials were lower, overall, than those for the corresponding materials from the SRC II process. The EDS materials produced under different operational modes had distinguishable differences in both their chemical constituency and biological activity. The primary differences between the EDS materials studied here and their SRC II counterparts used for comparison are most likely attributable to the incorporation of catalytic hydrogenation in the EDS process. 27 references, 28 figures, 27 tables.« less

  1. Progress and opportunities in EELS and EDS tomography.

    PubMed

    Collins, Sean M; Midgley, Paul A

    2017-09-01

    Electron tomography using energy loss and X-ray spectroscopy in the electron microscope continues to develop in rapidly evolving and diverse directions, enabling new insight into the three-dimensional chemistry and physics of nanoscale volumes. Progress has been made recently in improving reconstructions from EELS and EDS signals in electron tomography by applying compressed sensing methods, characterizing new detector technologies in detail, deriving improved models of signal generation, and exploring machine learning approaches to signal processing. These disparate threads can be brought together in a cohesive framework in terms of a model-based approach to analytical electron tomography. Models incorporate information on signal generation and detection as well as prior knowledge of structures in the spectrum image data. Many recent examples illustrate the flexibility of this approach and its feasibility for addressing challenges in non-linear or limited signals in EELS and EDS tomography. Further work in combining multiple imaging and spectroscopy modalities, developing synergistic data acquisition, processing, and reconstruction approaches, and improving the precision of quantitative spectroscopic tomography will expand the frontiers of spatial resolution, dose limits, and maximal information recovery. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Poor Dietary Guidelines Compliance among Low-Income Women Eligible for Supplemental Nutrition Assistance Program-Education (SNAP-Ed).

    PubMed

    Jun, Shinyoung; Thuppal, Sowmyanarayanan V; Maulding, Melissa K; Eicher-Miller, Heather A; Savaiano, Dennis A; Bailey, Regan L

    2018-03-08

    The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) program aims to improve nutritional intakes of low-income individuals (<185% poverty threshold). The objective of this study was to describe the compliance with Dietary Guidelines for Americans (DGA) recommendations for fruits, vegetables, and whole grains among SNAP-Ed eligible ( n = 3142) and ineligible ( n = 3168) adult women (19-70 years) nationwide and SNAP-Ed participating women in Indiana ( n = 2623), using the NHANES 2007-2012 and Indiana SNAP-Ed survey data, respectively. Sensitivity analysis further stratified women by race/ethnicity and by current SNAP participation (<130% poverty threshold). Nationally, lower-income women were less likely to meet the fruit (21% vs. 25%) and vegetable (11% vs. 19%) guidelines than higher-income women, but did not differ on whole grains, which were ~5% regardless of income. The income differences in fruit and vegetable intakes were driven by non-Hispanic whites. Fewer SNAP-Ed-eligible U.S. women met fruit (21% vs. 55%) and whole grain (4% vs. 18%) but did not differ for vegetable recommendations (11% vs. 9%) when compared to Indiana SNAP-Ed women. This same trend was observed among current SNAP participants. Different racial/ethnic group relationships with DGA compliance were found in Indiana compared to the nation. Nevertheless, most low-income women in the U.S. are at risk of not meeting DGA recommendations for fruits (79%), vegetables (89%), and whole grains (96%); SNAP-Ed participants in Indiana had higher compliance with DGA recommendations. Increased consumption of these three critical food groups would improve nutrient density, likely reduce calorie consumption by replacing high calorie choices, and improve fiber intakes.

  3. Should we fear "flu fear" itself? Effects of H1N1 influenza fear on ED use.

    PubMed

    McDonnell, William M; Nelson, Douglas S; Schunk, Jeff E

    2012-02-01

    Surges in patient volumes compromise emergency departments' (EDs') ability to deliver care, as shown by the recent H1N1 influenza (flu) epidemic. Media reports are important in informing the public about health threats, but the effects of media-induced anxiety on ED volumes are unclear. The aim of this study is to examine the effect of widespread public concern about flu on ED use. We reviewed ED data from an integrated health system operating 18 hospital EDs. We compared ED visits during three 1-week periods: (a) a period of heightened public concern regarding flu before the disease was present ("Fear Week"), (b) a subsequent period of active disease ("Flu Week"), and (c) a week before widespread concern ("Control Week"). Fear Week was identified from an analysis of statewide Google electronic searches for "swine flu" and from media announcements about flu. Flu Week was identified from statewide epidemiological data. Data were reviewed from 22 608 visits during the study periods. Fear Week (n = 7712) and Flu Week (n = 7687) were compared to Control Week (n = 7209). Fear Week showed a 7.0% increase in visits (95% confidence interval, 6-8). Pediatric visits increased by 19.7%, whereas adult visits increased by 1%. Flu Week showed an increase over Control Week of 6.6% (95% confidence interval, 6-7). Pediatric visits increased by 10.6%, whereas adult visits increased by 4.8%. At a time of heightened public concern regarding flu but little disease prevalence, EDs experienced substantial increases in patient volumes. These increases were significant and comparable to the increases experienced during the subsequent epidemic of actual disease. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Use of a midstream clean catch mobile application did not lower urine contamination rates in an ED.

    PubMed

    Jacob, Mary S; Kulie, Paige; Benedict, Cameron; Ordoobadi, Alexander J; Sikka, Neal; Steinmetz, Erika; McCarthy, Melissa L

    2018-01-01

    Urine microscopy is a common test performed in emergency departments (EDs). Urine specimens can easily become contaminated by different factors, including the collection method. The midstream clean-catch (MSCC) collection technique is commonly used to reduce urine contamination. The urine culture contamination rate from specimens collected in our ED is 30%. We developed an instructional application (app) to show ED patients how to provide a MSCC urine sample. We hypothesized that ED patients who viewed our instructional app would have significantly lower urine contamination rates compared to patients who did not. We prospectively enrolled 257 subjects with a urinalysis and/or urine culture test ordered in the ED and asked them to watch our MSCC instructional app. After prospective enrollment was complete, we retrospectively matched each enrolled subject to an ED patient who did not watch the instructional app. Controls were matched to cases based on gender, type of urine specimen provided, ED visit date and shift. Urinalysis and urine culture contamination results were compared between the matched pairs using McNemar's test. The overall urine culture contamination rate of the 514 subjects was 38%. The majority of the matched pairs had a urinalysis (63%) or urinalysis plus urine culture (35%) test done. There were no significant differences in our urine contamination rates between the matched pairs overall or when stratified by gender, by prior knowledge of the clean catch process or by type of urine specimen. We did not see a lower contamination rate for patients who viewed our instructional app compared to patients who did not. It is possible that MSCC is not effective for decreasing urine specimen contamination. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Field reversed configuration confinement enhancement through edge biasing and neutral beam injection.

    PubMed

    Tuszewski, M; Smirnov, A; Thompson, M C; Korepanov, S; Akhmetov, T; Ivanov, A; Voskoboynikov, R; Schmitz, L; Barnes, D; Binderbauer, M W; Brown, R; Bui, D Q; Clary, R; Conroy, K D; Deng, B H; Dettrick, S A; Douglass, J D; Garate, E; Glass, F J; Gota, H; Guo, H Y; Gupta, D; Gupta, S; Kinley, J S; Knapp, K; Longman, A; Hollins, M; Li, X L; Luo, Y; Mendoza, R; Mok, Y; Necas, A; Primavera, S; Ruskov, E; Schroeder, J H; Sevier, L; Sibley, A; Song, Y; Sun, X; Trask, E; Van Drie, A D; Walters, J K; Wyman, M D

    2012-06-22

    Field reversed configurations (FRCs) with high confinement are obtained in the C-2 device by combining plasma gun edge biasing and neutral beam injection. The plasma gun creates an inward radial electric field that counters the usual FRC spin-up. The n = 2 rotational instability is stabilized without applying quadrupole magnetic fields. The FRCs are nearly axisymmetric, which enables fast ion confinement. The plasma gun also produces E × B shear in the FRC edge layer, which may explain the observed improved particle transport. The FRC confinement times are improved by factors 2 to 4, and the plasma lifetimes are extended from 1 to up to 4 ms.

  6. A new e-learning platform for radiology education (RadEd).

    PubMed

    Xiberta, Pau; Boada, Imma

    2016-04-01

    One of the key elements of e-learning platforms is the content provided to the students. Content creation is a time demanding task that requires teachers to prepare material taking into account that it will be accessed on-line. Moreover, the teacher is restricted by the functionalities provided by the e-learning platforms. In contexts such as radiology where images have a key role, the required functionalities are still more specific and difficult to be provided by these platforms. Our purpose is to create a framework to make teacher's tasks easier, specially when he has to deal with contents where images have a main role. In this paper, we present RadEd, a new web-based teaching framework that integrates a smart editor to create case-based exercises that support image interaction such as changing the window width and the grey scale used to render the image, taking measurements on the image, attaching labels to images and selecting parts of the images, amongst others. It also provides functionalities to prepare courses with different topics, exercises and theory material, and also functionalities to control students' work. Different experts have used RadEd and all of them have considered it a very useful and valuable tool to prepare courses where radiological images are the main component. RadEd provides teachers functionalities to prepare more realistic cases and students the ability to make a more specific diagnosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Application of Standards-Based Quantitative SEM-EDS Analysis to Oxide Minerals

    NASA Astrophysics Data System (ADS)

    Mengason, M. J.; Ritchie, N. W.; Newbury, D. E.

    2016-12-01

    SEM and EPMA analysis are powerful tools for documenting and evaluating the relationships between minerals in thin sections and for determining chemical compositions in-situ. The time and costs associated with determining major, minor, and some trace element concentrations in geologic materials can be reduced due to advances in EDS spectrometer performance and the availability of software tools such as NIST DTSA II to perform multiple linear least squares (MLLS) fitting of energy spectra from standards to the spectra from samples recorded under the same analytical conditions. MLLS fitting is able to overcome spectral peak overlaps among the transition-metal elements that commonly occur in oxide minerals, which had previously been seen as too difficult for EDS analysis, allowing for rapid and accurate determination of concentrations. The quantitative use of EDS is demonstrated in the chemical analysis of magnetite (NMNH 114887) and ilmenite (NMNH 96189) from the Smithsonian Natural History Museum Microbeam Standards Collection. Average concentrations from nine total spots over three grains are given in mass % listed as (recommended; measured concentration ± one standard deviation). Spectra were collected for sixty seconds live time at 15 kV and 10 nA over a 12 micrometer wide scan area. Analysis of magnetite yielded Magnesium (0.03; 0.04 ± 0.01), Aluminum (none given; 0.040 ± 0.006), Titanium (0.10; 0.11 ± 0.02), Vanadium (none given; 0.16 ± 0.01), Chromium (0.17; 0.14 ± 0.02), and Iron (70.71, 71.4 ± 0.2). Analysis of ilmenite yielded Magnesium (0.19; 0.183 ± 0.008), Aluminum (none given; 0.04 ± 0.02), Titanium (27.4, 28.1 ± 0.1), Chromium (none given; 0.04 ± 0.01), Manganese (3.69; 3.73 ± 0.03), Iron (36.18; 35.8 ± 0.1), and Niobium (0.64; 0.68 ± 0.03). The analysis of geologic materials by standards-based quantitative EDS can be further illustrated with chemical analyses of oxides from ocean island basalts representing several locations globally to

  8. All-Natural Tips to Improve Your Sex Life: Exercise, Diet Changes May Help Reverse ED (Erectile Dysfunction)

    MedlinePlus

    ... your inbox ! All-natural tips to improve your sex life Exercise, diet changes may help reverse ED ... problem , may reverse your ED and improve your sex life. They are easy to adopt and enrich ...

  9. Why a disaster is not just normal business ramped up: Disaster response among ED nurses.

    PubMed

    Hammad, Karen S; Arbon, Paul; Gebbie, Kristine; Hutton, Alison

    2017-11-15

    The emergency department (ED) is a familiar place for the emergency nurse who spends their working days inside it. A disaster threatens that familiarity and creates changes that make working in the ED during a disaster response different from the everyday experience of working in the ED. This research reports on an aspect of the findings from a larger study about the experience of working as a nurse in the ED during a disaster response. Thirteen nurses from 8 different countries were interviewed about their experience. The findings from this research demonstrate that a disaster event leads to a chain reaction of changes in process, space and practice. Nurses' respond to the news of a disaster event with shock and disbelief. The ED may change as a result of the event requiring nurses to work in an altered environment or a completely different setting. These changes provoke nurses to alter their behaviour and practice and reflect on the experience after the response. Emergency nurses have a high likelihood of participating in disaster response and as such should be adequately prepared. This highlights how disaster response is different and leads to recommendations to enhance training for emergency nurses which will better prepare them Disasterresponse is not normal business ramped up. There are a number of challenges and changes that should be considered when preparing emergency nurses for the realities of disaster response. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.

  10. Structural basis for signaling by exclusive EDS1 heteromeric complexes with SAG101 or PAD4 in plant innate immunity.

    PubMed

    Wagner, Stephan; Stuttmann, Johannes; Rietz, Steffen; Guerois, Raphael; Brunstein, Elena; Bautor, Jaqueline; Niefind, Karsten; Parker, Jane E

    2013-12-11

    Biotrophic plant pathogens encounter a postinfection basal resistance layer controlled by the lipase-like protein enhanced disease susceptibility 1 (EDS1) and its sequence-related interaction partners, senescence-associated gene 101 (SAG101) and phytoalexin deficient 4 (PAD4). Maintainance of separate EDS1 family member clades through angiosperm evolution suggests distinct functional attributes. We report the Arabidopsis EDS1-SAG101 heterodimer crystal structure with juxtaposed N-terminal α/β hydrolase and C-terminal α-helical EP domains aligned via a large conserved interface. Mutational analysis of the EDS1-SAG101 heterodimer and a derived EDS1-PAD4 structural model shows that EDS1 signals within mutually exclusive heterocomplexes. Although there is evolutionary conservation of α/β hydrolase topology in all three proteins, a noncatalytic resistance mechanism is indicated. Instead, the respective N-terminal domains appear to facilitate binding of the essential EP domains to create novel interaction surfaces on the heterodimer. Transitions between distinct functional EDS1 heterodimers might explain the central importance and versatility of this regulatory node in plant immunity. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. EdMOO: One Approach to a Multimedia Collaborative Environment.

    ERIC Educational Resources Information Center

    Holkner, Bernard

    The nature of the multiuser object oriented (MOO) environment lends itself to flexible and rich interactive collaboration space providing interactive discussion, mail, mailing list, and news features to its virtual denizens. EdMOO (HREF1) was created in mid-1995 as an environment for teachers to experience the text based virtual reality…

  12. Exercise training improves erectile dysfunction (ED) in patients with metabolic syndrome on phosphodiesterase-5 (PDE-5) inhibitors.

    PubMed

    Maresca, Luigi; D'Agostino, Mariantonietta; Castaldo, Luigi; Vitelli, Alessandra; Mancini, Maria; Torella, Giorgio; Lucci, Rosa; Albano, Giovanna; Del Forno, Domenico; Ferro, Matteo; Altieri, Vincenzo; Giallauria, Francesco; Vigorito, Carlo

    2013-12-01

    Erectile dysfunction (ED) affects about 50% of males aged 40-70 years old. ED shares with atherosclerotic disease several common risk factors; therefore, it may be considered a surrogate marker of atherosclerosis. Since phosphodiesterase-5 inhibitors are well known pharmacologic agents capable of significant improvement in ED, we designed this study to evaluate whether exercise training is of added value in patients with ED who are already on PDE-5 inhibitors. We recruited 20 male patients affected by ED with metabolic syndrome. At baseline, all patients underwent Cardio-Pulmonary Exercise Testing (CPET) and the International Index of Erectile Function (IIEF) test. After the initial evaluation, patients were subdivided into two groups: tadalafil group (group T, n = 10), who were maintained only on tadalafil therapy, and a tadalafil/exercise training group (T/E group, n = 10) who continued tadalafil but in addition underwent a2-month structured exercise training program. Basal anthropometric characteristics of study population showed no significant differences. Although both-groups showed at 2 months an improvement of the IIEF score, this was more evident in the T/E group (T group: 11.2 vs 14.2, P = 0.02; T/E group: 10.8 vs 20.1, P < 0.001). There was an improvement of oxygen consumption at peak exercise (VO(2peak)) only in the T/E group patients (T group: 13.63 +/- 2.03 vs 14.24 +/- 2.98 mL/kg/min; P = 0.521; T/E group: 13.41 +/- 2.97 vs 16.58 +/- 3.17 mL/kg/min; P = 0.006). A significant correlation was found between the changes in VO(2peak) and the modifications in IIEF score (r = 0.575; P = 0.001). Exercise training in ED patients treated with PDE-5 inhibitors is of added value since further improves ED, as evaluated by IIEF score, and increases functional capacity.

  13. European convergence towards higher standards in dental education: the DentEd Thematic Network Project.

    PubMed

    Shanley, Diarmuid B; Dowling, Paul A; Claffey, Noel; Nattestad, Anders

    2002-02-01

    This paper describes a Thematic Network Project (TNP) funded by the European Union's Directorate for Education and Culture. It focused on convergence towards higher standards in dental education in the European Union and included those 'Associate Countries' seeking membership of an expanding EU. The DentEd Project sought to use peer influence in promoting convergence towards higher standards in European dental education and training. There is evidence of serious differences in standards despite the European Union's Dental Directives and the series of guidelines and recommendations of their Advisory Committee on the Training of Dental Practitioners. The DentEd TNP sought to improve communication, better understanding of different systems and to pool intellectual resources. A central objective of the network was to promote outcome analysis and the implementation of evidence-based treatments. DentEd sought to identify and disseminate innovations and best practices in European dental schools and stomatological institutions. This was achieved by instigating 30 self-assessments of dental schools throughout Europe. Self-assessment was followed by a visit from a team of international peers. Each assessment comprised 19 sections and was placed on the DentEd web site (www.dented.org) after it was jointly approved by the visitors and host school. The 30 self-assessment reports together with the visitors comments and recommendations were then divided into their component sections and analysed. Responsibility for each section was allocated to one of 19 different international working groups of between 8 and 12 people. Preliminary analyses from these working groups were presented and debated on the DentEd interactive web site. They finalised their findings in the DentEd Report at a Plenary meeting in the Nobel Forum in the Karolinska Institute in Stockholm. The meeting was organised in such a way that each working group finalised their report. This was followed by the rotation

  14. Overall ED efficiency is associated with decreased time to percutaneous coronary intervention for ST-segment elevation myocardial infarction.

    PubMed

    Jones, Christopher W; Sonnad, Seema S; Augustine, James J; Reese, Charles L

    2014-10-01

    Performance of percutaneous coronary intervention (PCI) within 90 minutes of hospital arrival for ST-segment elevation myocardial infarction patients is a commonly cited clinical quality measure. The Centers for Medicare and Medicaid Services use this measure to adjust hospital reimbursement via the Value-Based Purchasing Program. This study investigated the relationship between hospital performance on this quality measure and emergency department (ED) operational efficiency. Hospital-level data from Centers for Medicare and Medicaid Services on PCI quality measure performance was linked to information on operational performance from 272 US EDs obtained from the Emergency Department Benchmarking Alliance annual operations survey. Standard metrics of ED size, acuity, and efficiency were compared across hospitals grouped by performance on the door-to-balloon time quality measure. Mean hospital performance on the 90-minute arrival to PCI measure was 94.0% (range, 42-100). Among hospitals failing to achieve the door-to-balloon time performance standard, median ED length of stay was 209 minutes, compared with 173 minutes among those hospitals meeting the benchmark standard (P < .001). Similarly, median time from ED patient arrival to physician evaluation was 39 minutes for hospitals below the performance standard and 23 minutes for hospitals at the benchmark standard (P < .001). Markers of ED size and acuity, including annual patient volume, admission rate, and the percentage of patients arriving via ambulance did not vary with door-to-balloon time. Better performance on measures associated with ED efficiency is associated with more timely PCI performance. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Is There a Future for Teacher Ed Curriculum? An Answer from History and Moral Philosophy

    ERIC Educational Resources Information Center

    Null, J. Wesley

    2008-01-01

    Is there a future for teacher ed "curriculum"? The author contends that he is not sure if there is a future for teacher ed curriculum, but if such a future is to exist, the answer will come only from history and moral philosophy. In this article, the author opines that individuals cannot make good decisions about the future of teacher ed…

  16. Patient comes back to ED in scrubs and works an entire shift as a temp.

    PubMed

    2007-05-01

    A former patient in a Tampa, FL, ED, returned to the department in scrubs, claimed to be a temp, and was allowed to work despite not having any ID. To avoid similar problems, your ED should have a well-defined set of rules for people who report for work without an ID and/or do not demonstrate the requisite skills to treat patients. No badge, no work" is a good rule, unless the person is well known to you. All ED staff, including physicians and ancillary workers, should be prepared to produce photo ID immediately upon request. If staff cannot reach you, they should be encouraged to report interlopers to security or local police, as they are guilty of trespassing.

  17. Teaching Russian Via Distance Learning, the EdNet Experience.

    ERIC Educational Resources Information Center

    Zsiray, Stephen W., Jr.; And Others

    In Utah, the statewide distance education network (EdNet) enables students from five rural and suburban high schools to learn Russian and earn college credits. Courses in Russian are offered through a partnership involving the Cache County School District, Utah State University, and the Utah State Office of Education. Classes are taught on one…

  18. TechEdSat 5 PhoneSat 5 Team Photo

    NASA Image and Video Library

    2016-07-28

    TechEdSat 5 PhoneSat 5 Team photo on July 26, 2016. Taken in fron of the 1/3 scale Shuttle Orbiter Model, in front of the Parade Ground on Clark Road at NASA Research Park. Mark Murbach Sarosh Hussain Ali Guarneros Luna David Handy Jonathan Hanson Jakqueline Granillo Sarah Chu Alejandro Sales

  19. Evidence of salicylic acid pathway with EDS1 and PAD4 proteins by molecular dynamics simulation for grape improvement.

    PubMed

    Tandon, Gitanjali; Jaiswal, Sarika; Iquebal, M A; Kumar, Sunil; Kaur, Sukhdeep; Rai, Anil; Kumar, Dinesh

    2015-01-01

    Biotic stress is a major cause of heavy loss in grape productivity. In order to develop biotic stress-resistant grape varieties, the key defense genes along with its pathway have to be deciphered. In angiosperm plants, lipase-like protein phytoalexin deficient 4 (PAD4) is well known to be essential for systemic resistance against biotic stress. PAD4 functions together with its interacting partner protein enhanced disease susceptibility 1 (EDS1) to promote salicylic acid (SA)-dependent and SA-independent defense pathway. Existence and structure of key protein of systemic resistance EDS1 and PAD4 are not known in grapes. Before SA pathway studies are taken in grape, molecular evidence of EDS1: PAD4 complex is to be established. To establish this, EDS1 protein sequence was retrieved from NCBI and homologous PAD4 protein was generated using Arabidopsis thaliana as template and conserved domains were confirmed. In this study, computational methods were used to model EDS1 and PAD4 and simulated the interactions of EDS1 and PAD4. Since no structural details of the proteins were available, homology modeling was employed to construct three-dimensional structures. Further, molecular dynamic simulations were performed to study the dynamic behavior of the EDS1 and PAD4. The modeled proteins were validated and subjected to molecular docking analysis. Molecular evidence of stable complex of EDS1:PAD4 in grape supporting SA defense pathway in response to biotic stress is reported in this study. If SA defense pathway genes are explored, then markers of genes involved can play pivotal role in grape variety development especially against biotic stress leading to higher productivity.

  20. Dexmedetomidine use in the ED for control of methamphetamine-induced agitation.

    PubMed

    Lam, Rex Pui Kin; Yip, Wai Lam; Wan, Chi Keung; Tsui, Matthew Sik Hon

    2017-04-01

    Chemical restraint is often required to control agitation induced by methamphetamine. Dexmedetomidine is an α-2 adrenergic receptor agonist with sedative, analgesic, and sympatholytic properties. Its use in the emergency department (ED) to control methamphetamine-induced agitation has not been reported. To report two cases of methamphetamine-induced agitation successfully sedated with dexmedetomidine in the ED. The first case was a 42-year-old man with unstable emotion and violent behaviours after smoking methamphetamine. His agitation did not respond to a large cumulative dose of benzodiazepines (10mg of diazepam and 332mg of midazolam) administered over 48h and sedation was achieved with dexmedetomidine. The second case was a 38-year-old methamphetamine user with unstable emotion and recurrent episodes of agitation despite repeated doses of benzodiazepines, whose agitation was controlled with dexmedetomidine infusion. In both cases, dexmedetomidine apparently reduced the dose of benzodiazepines needed to achieve adequate sedation. Transient falls in blood pressure and slowing of the heart rate were noted, which resolved either spontaneously or after reducing the infusion rate without requiring drug treatment. Dexmedetomidine can be considered as an adjunct for chemical restraint when standard treatment fails to control the agitation induced by methamphetamine, but patient's hemodynamic state should be monitored closely during administration. Its efficacy and safety in the ED warrant further evaluation with prospective controlled trials. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Patient passports aim to speed appropriate care for medically complex children presenting to ED.

    PubMed

    2015-05-01

    Mattel Children's Hospital at Ronald Reagan UCLA Medical Center in Los Angeles, CA, has developed a "patient passport" to improve the timely and appropriate care of medically complex children who present to the ED. The one-page form, which parents can keep in their wallets, highlights any special indications or sensitivities that the child has as well as contact information for the patient's primary care provider. The form also includes special instructions for the triage nurse. Creation of the tool was prompted by the parents who complained that their medically complex children were receiving different care in the ED than on the pediatric floor of the hospital. The tool was developed by a group comprised of parents, pediatric providers, and ED representatives. Physicians must create and sign the passports, either in the hospital or in their outpatient clinics, although parents may request a passport for their children.

  2. Is the case-mix of patients who self-present to ED similar to general practice and other acute-care facilities?

    PubMed

    Harris, Tim; McDonald, Keith

    2014-12-01

    To benchmark walk-in presentations to emergency departments (ED) with those presenting to other local acute healthcare facilities. A large teaching hospital with an annual ED census of 140, 000 adult patients and surrounding associated acute healthcare providers. A random sample of 384 patients who self-presented to the ED was obtained. Benchmarking data were drawn from two general practices; the Tower Hamlets Community Services walk-in centre (co-located on-site with the ED) and the GP-run out-of-hours service. The case-mix presenting to the ED was characterised by a higher proportion of injuries and chest pain, but fewer simple infections and non-traumatic musculoskeletal conditions as compared to other acute care facilities in our region. Patients with injuries and possible cardiac chest pain were more likely to attend the ED, and those with infection or musculoskeletal problems less likely, as compared with other acute healthcare facilities. The population presenting to the ED is distinct from that presenting to general practice, out-of-hours clinics, or walk-in centres. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. The relationship between the thermoelectric generator efficiency and the device engineering figure of merit Zd,eng. The maximum efficiency 𝜼max

    NASA Astrophysics Data System (ADS)

    Hapenciuc, C. L.; Borca-Tasciuc, T.; Mihailescu, I. N.

    2017-04-01

    Thermoelectric materials are used today in thermoelectric devices for heat to electricity(thermoelectric generators-TEG) or electricity to heat(heat pumps) conversion in a large range of applications. In the case of TEGs the final measure of their performance is given by a quantity named the maximum efficiency which shows how much from the heat input is converted into electrical power. Therefore it is of great interest to know correctly how much is the efficiency of a device to can make commercial assessments. The concept of engineering figure of merit, Zeng, and engineering power factor, Peng, were already introduced in the field to quantify the efficiency of a single material under temperature dependent thermoelectric properties, with the mention that the formulas derivation was limited to one leg of the thermoelectric generator. In this paper we propose to extend the concept of engineering figure of merit to a thermoelectric generator by introducing a more general concept of device engineering thermoelectric figure of merit, Zd,eng, which depends on the both TEG materials properties and which shall be the right quantity to be used when we are interested in the evaluation of the efficiency. Also, this work takes into account the electrical contact resistance between the electrodes and thermoelement legs in an attempt to quantify its influence upon the performance of a TEG. Finally, a new formula is proposed for the maximum efficiency of a TEG.

  4. Three Ways edTPA Prepared Me for the Classroom

    ERIC Educational Resources Information Center

    Butler, Matthew

    2015-01-01

    edTPA, a capstone assessment designed to assess whether new teachers are ready for the job by evaluating their teaching and their analysis of their teaching, helped prepare the author for the classroom in three ways. First, he became accountable to his students. Second, he learned to analyze his teaching. Third, he discovered how to relate…

  5. Being Written: Thinking the Normative in the EdD

    ERIC Educational Resources Information Center

    Chua, S. M. J.

    2018-01-01

    In this paper, I give various reasons why the doctorate in education (EdD) programme helpfully heightens our normative senses. The writing of a thesis in time, and hence the realization that the same time--that window of opportunity--to do other things and enjoy other experiences is traded off, comports the student in a manner that heightens his…

  6. Tackling causes and costs of ED presentation for American football injuries: a population-level study.

    PubMed

    Smart, Blair J; Haring, R Sterling; Asemota, Anthony O; Scott, John W; Canner, Joseph K; Nejim, Besma J; George, Benjamin P; Alsulaim, Hatim; Kirsch, Thomas D; Schneider, Eric B

    2016-07-01

    American tackle football is the most popular high-energy impact sport in the United States, with approximately 9 million participants competing annually. Previous epidemiologic studies of football-related injuries have generally focused on specific geographic areas or pediatric age groups. Our study sought to examine patient characteristics and outcomes, including hospital charges, among athletes presenting for emergency department (ED) treatment of football-related injury across all age groups in a large nationally representative data set. Patients presenting for ED treatment of injuries sustained playing American tackle football (identified using International Classification of Diseases, Ninth Revision, Clinical Modification code E007.0) from 2010 to 2011 were studied in the Nationwide Emergency Department Sample. Patient-specific injuries were identified using the primary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code and categorized by type and anatomical region. Standard descriptive methods examined patient demographics, diagnosis categories, and ED and inpatient outcomes and charges. During the study period 397363 football players presented for ED treatment, 95.8% of whom were male. Sprains/strains (25.6%), limb fractures (20.7%), and head injuries (including traumatic brain injury; 17.5%) represented the most presenting injuries. Overall, 97.9% of patients underwent routine ED discharge with 1.1% admitted directly and fewer than 11 patients in the 2-year study period dying prior to discharge. The proportion of admitted patients who required surgical interventions was 15.7%, of which 89.9% were orthopedic, 4.7% neurologic, and 2.6% abdominal. Among individuals admitted to inpatient care, mean hospital length of stay was 2.4days (95% confidence interval, 2.2-2.6) and 95.6% underwent routine discharge home. The mean total charge for all patients was $1941 (95% confidence interval, $1890-$1992) with substantial

  7. Evaluating the HATCH score for predicting progression to sustained atrial fibrillation in ED patients with new atrial fibrillation.

    PubMed

    Barrett, Tyler W; Self, Wesley H; Wasserman, Brian S; McNaughton, Candace D; Darbar, Dawood

    2013-05-01

    Atrial fibrillation (AF) is often first detected in the emergency department (ED). Not all AF patients progress to sustained AF (ie, episodes lasting >7 days), which is associated with increased morbidity. The HATCH score stratifies patients with paroxysmal AF according to their risk for progression to sustained AF within 1 year. The HATCH score has previously never been tested in ED patients. We evaluated the accuracy of the HATCH score to predict progression to sustained AF within 1 year of initial AF diagnosis in the ED. We conducted a retrospective cohort study of 253 ED patients with new onset AF and known rhythm status for 1 year following the initial AF detection. The exposure variable was the HATCH score at initial ED evaluation. The primary outcome was rhythm status at 1 year following initial AF diagnosis. We constructed a receiver operating characteristic curve and calculated the area under the curve to estimate the HATCH score's accuracy of predicting progression to sustained AF. Overall, 61 (24%) of 253 of patients progressed to sustained AF within 1 year of initial detection, and the HATCH score receiver operating characteristic area under the curve was 0.62 (95% confidence interval, 0.54-0.70). Among ED patients with new onset AF, the HATCH score was a modest predictor of progression to sustained AF. Because only 2 patients had a HATCH greater than 5, this previously recommended cut-point was not useful in identifying high-risk patients in this cohort. Refinement of this decision aid is needed to improve its prognostic accuracy in the ED population. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Preparation and characterisation of poly p-phenylene-2,6-benzobisoxazole fibre-reinforced resin matrix composite for endodontic post material: a preliminary study.

    PubMed

    Hu, Chen; Wang, Feng; Yang, Huiyong; Ai, Jun; Wang, Linlin; Jing, Dongdong; Shao, Longquan; Zhou, Xingui

    2014-12-01

    Currently used fibre-reinforced composite (FRC) intracanal posts possess low flexural strength which usually causes post fracture when restoring teeth with extensive loss. To improve the flexural strength of FRC, we aimed to apply a high-performance fibre, poly p-phenylene-2, 6-benzobisoxazole (PBO), to FRCs to develop a new intracanal post material. To improve the interfacial adhesion strength, the PBO fibre was treated with coupling agent (Z-6040), argon plasma, or a combination of above two methods. The effects of the surface modifications on PBO fibre were characterised by determining the single fibre tensile strength and interfacial shear strength (IFSS). The mechanical properties of PBO FRCs were characterised by flexural strength and flexural modulus. The cytotoxicity of PBO FRC was evaluated by the MTT assay. Fibres treated with a combination of Z-6040 and argon plasma possessed a significantly higher IFSS than untreated fibres. Fibre treated with the combination of Z-6040-argon-plasma FRC had the best flexural strength (531.51 ± 26.43MPa) among all treated fibre FRCs and had sufficient flexural strength and appropriate flexural moduli to be used as intracanal post material. Furthermore, an in vitro cytotoxicity assay confirmed that PBO FRCs possessed an acceptable level of cytotoxicity. In summary, our study verified the feasibility of using PBO FRC composites as new intracanal post material. Although the mechanical property of PBO FRC still has room for improvement, our study provides a new avenue for intracanal post material development in the future. To our knowledge, this is the first study to verify the feasibility of using PBO FRC composites as new intracanal post material. Our study provided a new option for intracanal post material development. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. The utility of the AusEd driving simulator in the clinical assessment of driver fatigue.

    PubMed

    Desai, Anup V; Wilsmore, Brad; Bartlett, Delwyn J; Unger, Gunnar; Constable, Ben; Joffe, David; Grunstein, Ronald R

    2007-08-01

    Several driving simulators have been developed which range in complexity from PC based driving tasks to advanced "real world" simulators. The AusEd driving simulator is a PC based task, which was designed to be conducive to and test for driver fatigue. This paper describes the AusEd driving simulator in detail, including the technical requirements, hardware, screen and file outputs, and analysis software. Some aspects of the test are standardized, while others can be modified to suit the experimental situation. The AusEd driving simulator is sensitive to performance decrement from driver fatigue in the laboratory setting, potentially making it useful as a laboratory or office based test for driver fatigue risk management. However, more research is still needed to correlate laboratory based simulator performance with real world driving performance and outcomes.

  10. ED adds business center to wait area.

    PubMed

    2007-10-01

    Providing your patients with Internet access in the waiting area can do wonders for their attitudes and make them much more understanding of long wait times. What's more, it doesn't take a fortune to create a business center. The ED at Florida Hospital Celebration (FL) Health made a world of difference with just a couple of computers and a printer. Have your information technology staff set the computers up to preserve the privacy of your internal computer system, and block out offensive sites. Access to medical sites can help reinforce your patient education efforts.

  11. Shifting Interests: Changes in the Lexical Semantics of ED-MEDIA

    ERIC Educational Resources Information Center

    Wild, Fridolin; Valentine, Chris; Scott, Peter

    2010-01-01

    Large research networks naturally form complex communities with overlapping but not identical expertise. To map the distribution of professional competence in field of "technology-enhanced learning", the lexical semantics expressed in research articles published in a representative, large-scale conference (ED-MEDIA) can be investigated and changes…

  12. Competencies for Effective School Leadership: To What Extent Are They Included in Ed.D. Leadership Programs?

    ERIC Educational Resources Information Center

    Dunlap, Jody; Li, Jinyi; Kladifko, Robert

    2015-01-01

    Purpose: With the increasing need for well-­-prepared and leading practitioners in the field of education as well as the renewed efforts to further distinguish the EdD from the PhD in higher education in recent years, the curriculum of EdD programs nationwide has been questioned and criticized for its disconnection from the needs of leading…

  13. Exploring personality clusters among parents of ED subjects. Relationship with parents' psychopathology, attachment, and family dynamics.

    PubMed

    Amianto, Federico; Daga, Giovanni Abbate; Bertorello, Antonella; Fassino, Secondo

    2013-10-01

    Eating disorders are some of the most difficult mental disorders to treat and manage. Family interacts with genetic dispositions and other pathogenic factors, and may influence the outburst, development and outcome of EDs. The present study explores with a cluster analysis the personality traits of parents of ED subjects. One-hundred-eight mothers and 104 fathers were tested with Temperament Character Inventory (TCI), Eating Disorder Inventory-2 (EDI-2), State-Trait Anger Expression Inventory (STAX), Family Assessment Device (FAD), Attachment Style Questionnaire (ASQ), Symptom Questionnaire (SQ), Psychological Well-Being scales (PWB). The cluster distribution of parents based on personality traits was explored. Parents' clusters TCI scores were compared as regards personality, psychopathology, attachment and family features. Cross distribution of temperament and character clusters in mothers and fathers, among couples and ED diagnoses of the daughters was explored. Two clusters of mothers and fathers were identified with temperament clustering. Character traits led to two mothers and three fathers clusters. Mothers temperament cluster 1 (MTC1) correspond to a explosive/adventurous profile, MTC2 to a cautious/passive-dependent profile. Fathers temperament cluster 1 (FTC1) was explosive/methodic, FTC2 was independent/methodic. Character clustering distinguished very immature mothers (MCC1) and majority (65%) of character mature mothers with low self-transcendence (MCC2). A third of fathers was severely immature (FCC1), a third impaired as regards relationships (poor cooperativeness and self-transcendence; FCC2), and one third character mature fathers with low self-transcendence (FCC3). Each cluster evidences specific psychopathology and attachment characteristics. FTC1 was more frequently associated with character immaturity. No significant clusters' cross correlation was found in parental couples. Parents' clusters analyze in depth the univocal picture of

  14. A method to test the performance of an energy-dispersive X-ray spectrometer (EDS).

    PubMed

    Hodoroaba, Vasile-Dan; Procop, Mathias

    2014-10-01

    A test material for routine performance evaluation of energy-dispersive X-ray spectrometers (EDS) is presented. It consists of a synthetic, thick coating of C, Al, Mn, Cu, and Zr, in an elemental composition that provides interference-free characteristic X-ray lines of similar intensities at 10 kV scanning electron microscope voltage. The EDS energy resolution at the C-K, Mn-Lα, Cu-Lα, Al-K, Zr-Lα, and Mn-Kα lines, the calibration state of the energy scale, and the Mn-Lα/Mn-Kα intensity ratio as a measure for the low-energy detection efficiency are calculated by a dedicated software package from the 10 kV spectrum. Measurements at various input count rates and processor shaping times enable an estimation of the operation conditions for which the X-ray spectrum is not yet corrupted by pile-up events. Representative examples of EDS systems characterized with the test material and the related software are presented and discussed.

  15. Dependence and physical exercise: Spanish validation of the Exercise Dependence Scale-Revised (EDS-R).

    PubMed

    Sicilia, Alvaro; González-Cutre, David

    2011-05-01

    The purpose of this study was to validate the Spanish version of the Exercise Dependence Scale-Revised (EDS-R). To achieve this goal, a sample of 531 sport center users was used and the psychometric properties of the EDS-R were examined through different analyses. The results supported both the first-order seven-factor model and the higher-order model (seven first-order factors and one second-order factor). The structure of both models was invariant across age. Correlations among the subscales indicated a related factor model, supporting construct validity of the scale. Alpha values over .70 (except for Reduction in Other Activities) and suitable levels of temporal stability were obtained. Users practicing more than three days per week had higher scores in all subscales than the group practicing with a frequency of three days or fewer. The findings of this study provided reliability and validity for the EDS-R in a Spanish context.

  16. Factorial Structure and Preliminary Validation of the Schema Mode Inventory for Eating Disorders (SMI-ED)

    PubMed Central

    Simpson, Susan G.; Pietrabissa, Giada; Rossi, Alessandro; Seychell, Tahnee; Manzoni, Gian Mauro; Munro, Calum; Nesci, Julian B.; Castelnuovo, Gianluca

    2018-01-01

    Objective: The aim of this study was to examine the psychometric properties and factorial structure of the Schema Mode Inventory for Eating Disorders (SMI-ED) in a disordered eating population. Method: 573 participants with disordered eating patterns as measured by the Eating Disorder Examination Questionnaire (EDE-Q) completed the 190-item adapted version of the Schema Mode Inventory (SMI). The new SMI-ED was developed by clinicians/researchers specializing in the treatment of eating disorders, through combining items from the original SMI with a set of additional questions specifically representative of the eating disorder population. Psychometric testing included Confirmatory Factor Analysis (CFA) and internal consistency (Cronbach's α). Multivariate Analyses of Covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED modes, while controlling for possible confounding variables. Results: Factorial analysis confirmed an acceptable 16-related-factors solution for the SMI-ED, thus providing preliminary evidence for the adequate validity of the new measure based on internal structure. Concurrent validity was also established through moderate to high correlations on the modes most relevant to eating disorders with EDE-Q subscales. This study represents the first step in creating a psychometrically sound instrument for measuring schema modes in eating disorders, and provides greater insight into the relevant schema modes within this population. Conclusion: This research represents an important preliminary step toward understanding and labeling the schema mode model for this clinical group. Findings from the psychometric evaluation of SMI-ED suggest that this is a useful tool which may further assist in the measurement and conceptualization of schema modes in this population. PMID:29740379

  17. Factorial Structure and Preliminary Validation of the Schema Mode Inventory for Eating Disorders (SMI-ED).

    PubMed

    Simpson, Susan G; Pietrabissa, Giada; Rossi, Alessandro; Seychell, Tahnee; Manzoni, Gian Mauro; Munro, Calum; Nesci, Julian B; Castelnuovo, Gianluca

    2018-01-01

    Objective: The aim of this study was to examine the psychometric properties and factorial structure of the Schema Mode Inventory for Eating Disorders (SMI-ED) in a disordered eating population. Method: 573 participants with disordered eating patterns as measured by the Eating Disorder Examination Questionnaire (EDE-Q) completed the 190-item adapted version of the Schema Mode Inventory (SMI). The new SMI-ED was developed by clinicians/researchers specializing in the treatment of eating disorders, through combining items from the original SMI with a set of additional questions specifically representative of the eating disorder population. Psychometric testing included Confirmatory Factor Analysis (CFA) and internal consistency (Cronbach's α). Multivariate Analyses of Covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED modes, while controlling for possible confounding variables. Results: Factorial analysis confirmed an acceptable 16-related-factors solution for the SMI-ED, thus providing preliminary evidence for the adequate validity of the new measure based on internal structure. Concurrent validity was also established through moderate to high correlations on the modes most relevant to eating disorders with EDE-Q subscales. This study represents the first step in creating a psychometrically sound instrument for measuring schema modes in eating disorders, and provides greater insight into the relevant schema modes within this population. Conclusion: This research represents an important preliminary step toward understanding and labeling the schema mode model for this clinical group. Findings from the psychometric evaluation of SMI-ED suggest that this is a useful tool which may further assist in the measurement and conceptualization of schema modes in this population.

  18. 48 CFR 3452.232-70 - Prohibition against the use of ED funds to influence legislation or appropriations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... use of ED funds to influence legislation or appropriations. 3452.232-70 Section 3452.232-70 Federal... funds to influence legislation or appropriations. The following clause is to be used in accordance with 3432.770: Prohibition Against the Use of ED Funds To Influence Legislation or Appropriations (APR 1987...

  19. The impact of age and gender on resource utilization and profitability in ED patients seen and released.

    PubMed

    Henneman, Philip L; Nathanson, Brian H; Ribeiro, Kara; Balasubramanian, Hari

    2014-10-01

    To determine how age and gender impact resource utilization and profitability in patients seen and released from an Emergency Department (ED). Billing data for patients seen and released from an Emergency Department (ED) with >100,000 annual visits between 2003 and 2009 were collected. Resource utilization was measured by length of stay (placement in ED bed to leaving the bed) and direct clinical costs (e.g., ED nursing salary and benefits, pharmacy and supply costs, etc.) estimated using relative value unit cost accounting. The primary outcome of profitability was defined as contribution margin per hour. A patient's contribution margin by insurance type (excluding self-pay) was determined by subtracting direct clinical costs from facility contractual revenue. Results are expressed as medians and US dollars. In 523 882 outpatient ED encounters, as patients' aged, length of stay and direct clinical cost increased while the contribution margin and contribution margin by hour decreased. Women of childbearing age (15-44) had higher median length of stay (2.1 hours), direct clinical cost ($149), and contribution margin per hour ($103/hour) than men of same age (1.7, $131, $85/hour, respectively). Resource utilization and profitability by gender were similar in children and adults over 45. Resource utilization increased and profitability decreased with increasing age in patients seen and released from an ED. The care of women of childbearing age resulted in higher resource utilization and higher profitability than men of the same age. No differences in resource utilization or profitability by gender were observed in children and adults over 45. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Inside the Sex Ed Studio: An Interview with Peggy Brick

    ERIC Educational Resources Information Center

    Taverner, William J.

    2008-01-01

    "Inside the Sex Ed Studio" profiles leaders in the field of sexuality education. Peggy Brick, former director of Planned Parenthood of Greater Northern New Jersey's Center for Family Life Education (CFLE) and author of numerous sexuality education resources used worldwide, is the subject of this interview. Ms. Brick was interviewed by…

  1. Antibiotic and Diagnostic Discordance Between ED Physicians and Hospitalists for Pediatric Respiratory Illness.

    PubMed

    Coon, Eric R; Maloney, Christopher G; Shen, Mark W

    2015-03-01

    Imperfect diagnostic tools make it difficult to know the extent to which a bacterial process is contributing to respiratory illness, complicating the decision to prescribe antibiotics. We sought to quantify diagnostic and antibiotic prescribing disagreements between emergency department (ED) and pediatric hospitalist physicians for children admitted with respiratory illness. Manual chart review was used to identify testing, diagnostic, and antibiotic prescribing decisions for consecutive children admitted for respiratory illness in a winter (starting February 20, 2012) and a summer (starting August 20, 2012) season to a tertiary, freestanding children's hospital. Respiratory illness diagnoses were grouped into 3 categories: bacterial, viral, and asthma. A total of 181 children admitted for respiratory illness were studied. Diagnostic discordance was significant for all 3 types of respiratory illness but greatest for bacterial (P<.001). Antibiotic prescribing discordance was significant (P<.001), with pediatric hospitalists changing therapy for 93% of patients prescribed antibiotics in the ED, including stopping antibiotics altogether for 62% of patients. Significant diagnostic and antibiotic discordance between ED and pediatric hospitalist physicians exists for children admitted to the hospital for respiratory illness. Copyright © 2015 by the American Academy of Pediatrics.

  2. Elemental analysis using ED-XRF and 14C dating of Cuman wall paintings samples

    NASA Astrophysics Data System (ADS)

    Brocchieri, J.; Sabbarese, C.; Marzaioli, F.; Passariello, I.; Terrasi, F.; De Maio, C.; Ferrara, L.

    2018-04-01

    The aim of the present research was to analyse pigments and mortars of fresco fragments located at Cuma (Naples, Italy). The ED-XRF technique and 14C dating were used to establish the nature of the pigments and the age of mortars, respectively. ED-XRF results allowed to determine the elemental composition of the pigments that identified the colours and, hence, the historical period of completion. The 14C dating, applied to mortars using a particular preparation, provided results that are in accordance with the archaeological information within the 2σ interval range.

  3. The Reduction in ED and Hospital Admissions in Medical Home Practices Is Specific to Primary Care-Sensitive Chronic Conditions.

    PubMed

    Green, Lee A; Chang, Hsiu-Ching; Markovitz, Amanda R; Paustian, Michael L

    2018-04-01

    To determine whether the Patient-Centered Medical Home (PCMH) transformation reduces hospital and ED utilization, and whether the effect is specific to chronic conditions targeted for management by the PCMH in our setting. All patients aged 18 years and older in 2,218 primary care practices participating in a statewide PCMH incentive program sponsored by Blue Cross Blue Shield of Michigan (BCBSM) in 2009-2012. Quantitative observational study, jointly modeling PCMH-targeted versus other hospital admissions and ED visits on PCMH score, patient, and practice characteristics in a hierarchical multivariate model using the generalized gamma distribution. Claims data and PCMH scores held by BCBSM. Both hospital and ED utilization were reduced proportionately to PCMH score. Hospital utilization was reduced by 13.9 percent for PCMH-targeted conditions versus only 3.8 percent for other conditions (p = .003), and ED utilization by 11.2 percent versus 3.7 percent (p = .010). Hospital PMPM cost was reduced by 17.2 percent for PCMH-targeted conditions versus only 3.1 percent for other conditions (p < .001), and ED PMPM cost by 9.4 percent versus 3.6 percent (p < .001). PCMH transformation reduces hospital and ED use, and the majority of the effect is specific to PCMH-targeted conditions. © Health Research and Educational Trust.

  4. Environmental Baseline Survey Report for the Title Transfer of Parcel ED-9 at the East Tennessee Technology Park, Oak Ridge, Tennessee

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

    SAIC

    2010-05-01

    This environmental baseline survey (EBS) report documents the baseline environmental conditions of the U. S. Department of Energy's (DOE's) Parcel ED-9 at the East Tennessee Technology Park (ETTP). Parcel ED-9 consists of about 13 acres that DOE proposes to transfer to Heritage Center, LLC (hereafter referred to as 'Heritage Center'), a subsidiary of the Community Reuse Organization of East Tennessee (CROET). The 13 acres include two tracts of land, referred to as ED-9A (7.06 acres) and ED-9B (5.02 acres), and a third tract consisting of about 900 linear feet of paved road and adjacent right-of-way, referred to as ED-9C (0.98more » acres). Transfer of the title to ED-9 will be by deed under a Covenant Deferral Request (CDR) pursuant to Section 120(h)(3)(C) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). This report provides a summary of information to support the transfer of this government-owned property at ETTP to a non-federal entity.« less

  5. Evaluating Prospective Teachers: Testing the Predictive Validity of the edTPA. CEDR Working Paper. WP #2016-7

    ERIC Educational Resources Information Center

    Goldhaber, Dan; Cowan, James; Theobald, Roddy

    2016-01-01

    We use longitudinal data from Washington State to provide estimates of the extent to which performance on the edTPA, a performance-based, subject-specific assessment of teacher candidates, is predictive of the likelihood of employment in the teacher workforce and value-added measures of teacher effectiveness. While edTPA scores are highly…

  6. Simulating fire-induced ecological succession with the dynamically coupled fire-vegetation model, ED-SPIFTIRE

    NASA Astrophysics Data System (ADS)

    Spessa, A.; Fisher, R.

    2009-04-01

    The simulation of fire-vegetation feedbacks is crucial for determining fire-induced changes to ecosystem structure and function, and emissions of trace gases and aerosols under future climate change. A new global fire model SPITFIRE (SPread and InTensity of FIRE) has been designed to overcome many of the limitations in existing fire models set within DGVM frameworks (Thonicke et al. 2008). SPITFIRE has been applied in coupled mode globally (Thonicke et al. 2008) and northern Australia (Spessa et al. unpubl.) as part of the LPJ DGVM. It has also been driven with MODIS burnt area data applied to sub-Saharan Africa (Lehsten et al. 2008) as part of the LPJ-GUESS vegetation model (Smith et al. 2001). Recently, Spessa & Fisher (unpubl.) completed the coupling of SPIFTIRE to the Ecosystem Demography (ED) model (Moorecroft et al. 2001), which has been globalised by Dr R. Fisher as part of the development of the new land surface scheme JULES (Joint UK Environment Simulator) within the QUEST Earth System Model (http://www.quest-esm.ac.uk/). In contrast to the LPJ DGVM, ED is a ‘size and age structured' approximation of an individual based gap model. The major innovation of the ED-SPITFIRE model compared with LPJ-SPITFIRE is the categorisation of each climatic grid cell into a series of non-spatially contiguous patches which are defined by a common ‘age since last disturbance'. In theory, the age-class structure of ED facilitates ecologically realistic processes of succession and re-growth to be represented. By contrast, LPJ DGVM adopts an ‘area-based approach' that implicitly averages individual and patch differences across a wider area and across ‘populations' of PFTs. This presentation provides an overview of SPITFIRE, and provides preliminary results from ED-SPITFIRE applied to northern Australian savanna ecosystems which, due to spatio-temporal variation in fire disturbance, comprise a patchwork of grasses and trees at different stages of post-fire succession

  7. The Theater of Confrontation: Ed Bullins, Up Against the Wall

    ERIC Educational Resources Information Center

    Evans, Don

    1974-01-01

    Discusses ed Bullins' role in bringing together in the summer of 1968 a representative collection of works from the Black Arts Movement; the controversy surrounding his 1971 Lincoln Center production of his play, "The Duplex"; and his play, "House Party," a collage of voices and images from Blacktown mounted at The American…

  8. Sex Ed for Caring Schools: Creating an Ethics-Based Curriculum

    ERIC Educational Resources Information Center

    Lamb, Sharon

    2013-01-01

    While arguments for and against teaching abstinence, the use of contraceptives, and sexual identity are becoming more and more polarized, most people agree that students must learn to navigate an increasingly sexual world. "Sex Ed for Caring Schools" presents a curriculum that goes beyond the typical health education most students receive today.…

  9. Massively Open Online Course for Educators (MOOC-Ed) Network Dataset

    ERIC Educational Resources Information Center

    Kellogg, Shaun; Edelmann, Achim

    2015-01-01

    This paper presents the Massively Open Online Course for Educators (MOOC-Ed) network dataset. It entails information on two online communication networks resulting from two consecutive offerings of the MOOC called "The Digital Learning Transition in K-12 Schools" in spring and fall 2013. The courses were offered to educators from the USA…

  10. What Do We Really Know about the EdTPA? Research, PACT, and Packaging a Local Teacher Performance Assessment for National Use

    ERIC Educational Resources Information Center

    Hébert, Cristyne

    2017-01-01

    This article calls attention to the overreliance on research about the Performance Assessment for California Teachers (PACT)--often labeled edTPA's predecessor--as justification for the edTPA. The article argues that the distinctions between the assessments are too vast to rely on PACT data to support the edTPA, given the localized nature of PACT…

  11. Audit of deaths less than a week after admission through an emergency department: how accurate was the ED diagnosis and were any deaths preventable?

    PubMed

    Nafsi, Tabassum; Russell, Rob; Reid, Cilla M; Rizvi, Syed M M

    2007-10-01

    To review the causes of death in patients admitted via the emergency department (ED) who died within 7 days of admission and to identify any ways in which ED care could have been better. The study also aims to compare the diagnosis made in the ED and the mortality diagnosis. A retrospective study; subjects were all patients who attended the ED over 4 months and died within 7 days of admission. The paramedics' notes, ED case cards, inpatient medical notes and details of postmortem findings were examined to identify the time and date of arrival in the ED, presenting complaint, provisional diagnosis made by the ED, treatment plan devised by the ED, diagnosis made in wards, and the cause of death as issued on death certificates or from postmortem findings. Summary sheets of cases where the care provided by the emergency department could have been improved were reviewed, errors were identified and deaths were classified as preventable or unpreventable. Database revealed 3521 admissions via the ED over 4 months, of which 95 cases (2.69%) died within 7 days of admission. 78 patients (82.1% of cases) were appropriately diagnosed and managed whereas 17 (17.87% of cases) were identified with deficiencies in either the diagnosis or the management provided in the ED. We reviewed the quality of care provided in the ED for these cases and rated deaths according to our preventability criteria: 5 (5.26%) deaths were unpreventable despite the deficiency in care provided in the ED; 3 (3.15%) deaths were definitely preventable; 3 (3.15%) were probably preventable; and 6 (6.31%) were possibly preventable deaths. The ED is playing a good role in the management of critically ill patients, with appropriate diagnosis and management in 82% of cases. Training of junior doctors is required to prevent occurrence of errors and thus preventable deaths, but all deaths are not preventable. New guidelines for sepsis management and management of undifferentiated clinical presentations are being

  12. EarthEd Online: Open Source Online Software to Support Large Courses

    NASA Astrophysics Data System (ADS)

    Prothero, W. A.

    2003-12-01

    The purpose of the EarthEd Online software project is to support a modern instructional pedagogy in a large, college level, earth science course. It is an ongoing development project that has evolved in a large general education oceanography course over the last decade. Primary goals for the oceanography course are to support learners in acquiring a knowledge of science process, an appreciation for the relevance of science to society, and basic content knowledge. In order to support these goals, EarthEd incorporates: a) integrated access to various kinds of real earth data (and links to web-based data browsers), b) online discussions, live chat, with integrated graphics editing, linking, and upload, c) online writing, reviewing, and grading, d) online homework assignments, e) on demand grade calculation, and f) instructor grade entry and progress reports. The software was created using Macromedia Director. It is distributed to students on a CDROM and updates are downloaded and installed automatically. Data browsers for plate tectonics relevant data ("Our Dynamic Planet"), a virtual exploration of the East Pacific Rise, the World Ocean Atlas-98, and a fishing simulation game are integrated with the EarthEd software. The system is modular which allows new capabilities, such as new data browsers, to be added. Student reactions to the software are positive overall. They are especially appreciative of the on demand grade computation capability. The online writing, commenting and grading is particularly effective in managing the large number of papers that get submitted. The TA's grade the papers, but the instructor can provide feedback to them as they grade the papers, and a record is maintained of all comments and rubric item grades. Commenting is made easy by simply "dragging" a selection of pre-defined comments into the student's text. Scoring is supported by an integrated scoring rubric. All assignments, rubrics, etc. are configured in text files that are downloaded

  13. Activities during the "Bob Hope Special" for the Ed White Memorial Benefit.

    NASA Image and Video Library

    2009-10-08

    Activities during the "Bob Hope Special" for the Ed White Memorial Benefit. Left to right : Mayor of Houston Louie Welch, Bob Hope, Astronaut Jack Swigert , Astronaut Deke Slayton, Sig Sjoberg, Astronaut Fred Haise.

  14. Erectile dysfunction in the community: trends over time in incidence, prevalence, GP consultation and medication use--the Krimpen study: trends in ED.

    PubMed

    Schouten, Boris W V; Bohnen, Arthur M; Groeneveld, Frans P M J; Dohle, Gert R; Thomas, Siep; Bosch, J L H Ruud

    2010-07-01

    In the general population, erectile dysfunction (ED) is surrounded by a "taboo." Epidemiologists studying this problem have to be aware of the phenomenon of the "tip-of-the-iceberg." Our aim is to describe the iceberg phenomenon for ED and their help-seeking behavior in the general population during a period when public interest in ED heightened and waned after the introduction of the drug sildenafil. The data were obtained as part of a large longitudinal community-based study, i.e., the Krimpen study. With four rounds of data collection with an approximate 2.1 years interval, the local pharmacists provided data on medication use, whereas abstracts from the medical record and history were provided by the local general practitioners (GPs). The data from the questionnaires were entered into the Krimpen study database but were not communicated to the GPs. ED: according to the ICS-questionnaire, GP consultation: search of electronic medical dossier for ED or reports from any specialist, use of ED medication as delivered by the pharmacy. The age-standardized prevalence of ED is stable, i.e., around 40%. During the period 1995 to 2000, the incidence increased from 5% to 6.5%, then it stabilizes around 5% per year. The first-time use of ED medication increases exponentially between 1995 and 2000, then it stabilizes at about 3.5% per year. The number of GP consultations by men with ED increases up to 1999, after which it stabilizes at about 1.8% per year. We suggest that the availability and awareness of a new pharmacological option induced a change of behavior among GPs and their patients.

  15. Seven Years after the Call: Students' and Graduates' Perceptions of the Re-Envisioned Ed.D.

    ERIC Educational Resources Information Center

    Zambo, Ron; Zambo, Debby; Buss, Ray R.; Perry, Jill A.; Williams, Tiffany R.

    2014-01-01

    Given continued confusion about the Ed.D.degree, universities affiliated with the Carnegie Project on the Education Doctorate (CPED) have re-envisioned it using a set of guiding principles and design features. In this study, we investigated why students and graduates chose to pursue the Ed.D., what and how they learned, how they viewed themselves,…

  16. Study of a patient population investigated for excessive daytime sleepiness (EDS).

    PubMed

    Laffont, F; Mallet, A; Mayer, G; Meunier, S; Minz, M; N'Doye, S; Quilfen-Buzare, M A

    2002-12-01

    This study included all patients referred to the out-patient department of our sleep disorders centre from 1993 to 1999 on account of excessive daytime sleepiness (EDS). As a first step, patients in whom a diagnosis was established following appropriate polysomnography were excluded: this included sleep apnea syndrome, increased upper airway resistance syndrome, narcolepsy, periodic movements during sleep or other parasomnia, and epilepsy. Patients regularly taking psychotropic substances or with psychiatric disorders were also excluded. Finally, 128 patients remained in whom no clear diagnosis had been established for EDS, 70 women and 58 men, their ages ranging from 16 to 77 years. They underwent a 48-h recording (night 1-MSLT-night 2-continuous day). The aim of the study was to establish, define and characterise different groups of undiagnosed EDS patients using clinical, electrophysiological and immunological data with the help of hierarchical cluster analysis. Eight groups were characterised: group 1: mild hypersomnia type 1 (n = 11); group 2: hypersomnia frequently associated with HLA type DR2-DQw1 (n = 11); group 3: mild hypersomnia type 2 (n = 28); group 4: morning recovery from disrupted sleep (n = 19); group 5: young "long sleepers with difficulty at waking up" (n = 17); group 6: idiopathic hypersomnia (n = 15); group 7: poor or short sleepers since childhood (n = 8); group 8: older poor sleepers with a late onset of symptoms (n = 19). Characteristic features of these different groups provided consistent and objective arguments leading to a more precise diagnosis for these patients, and helped the initiation of appropriate management and treatment.

  17. Unexplained chest pain in the ED: could it be panic?

    PubMed

    Foldes-Busque, Guillaume; Marchand, André; Chauny, Jean-Marc; Poitras, Julien; Diodati, Jean; Denis, Isabelle; Lessard, Marie-Josée; Pelland, Marie-Ève; Fleet, Richard

    2011-09-01

    This study aimed at (1) establishing the prevalence of paniclike anxiety in emergency department (ED) patients with unexplained chest pain (UCP); (2) describing and comparing the sociodemographic, medical, and psychiatric characteristics of UCP patients with and without paniclike anxiety; and (3) measuring the rate of identification of panic in this population. A structured interview, the Anxiety Disorders Interview Schedule for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, was administered to identify paniclike anxiety and evaluate patients' psychiatric status. Anxious and depressive symptoms were evaluated with self-report questionnaires. Medical information was extracted from patients' medical records. The prevalence of paniclike anxiety was 44% (95% CI, 40%-48%) in the sample (n = 771). Psychiatric disorders were more common in panic patients (63.4% vs 20.1%), as were suicidal thoughts (21.3% vs 11.3%). Emergency physician diagnosed only 7.4% of panic cases. Paniclike anxiety is common in ED patients with UCP, and this condition is rarely diagnosed in this population. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Characterization of an antigenic site that contains a dominant, type-specific neutralization determinant on the envelope protein domain III (ED3) of dengue 2 virus

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

    Gromowski, Gregory D.; Barrett, Alan D.T.

    2007-09-30

    The surface of the mature dengue virus (DENV) particle consists of 90 envelope (E) protein dimers that mediate both receptor binding and fusion. The E protein ectodomain can be divided into three structural domains designated ED1, ED2, and ED3, of which ED3 contains the critical and dominant virus-specific neutralization sites. In this study the ED3 epitopes recognized by seven, murine, IgG1 DENV-2 type-specific, monoclonal antibodies (MAbs) were determined using site-directed mutagenesis of a recombinant DENV-2 ED3 (rED3) protein. A total of 41 single amino acid substitutions were introduced into the rED3 at 30 different surface accessible residues. The affinity ofmore » each MAb with the mutant rED3s was assessed by indirect ELISA and the results indicate that all seven MAbs recognize overlapping epitopes with residues K305 and P384 critical for binding. These residues are conserved among DENV-2 strains and cluster together on the upper lateral face of ED3. A linear relationship was observed between relative occupancy of ED3 on the virion by MAb and neutralization of the majority of virus infectivity ({approx} 90%) for all seven MAbs. Depending on the MAb, it is predicted that between 10% and 50% relative occupancy of ED3 on the virion is necessary for virus neutralization and for all seven MAbs occupancy levels approaching saturation were required for 100% neutralization of virus infectivity. Overall, the conserved antigenic site recognized by all seven MAbs is likely to be a dominant DENV-2 type-specific, neutralization determinant.« less

  19. Assessing human health response in life cycle assessment using ED10s and DALYs: part 1--Cancer effects.

    PubMed

    Crettaz, Pierre; Pennington, David; Rhomberg, Lorenz; Brand, Kevin; Jolliet, Olivier

    2002-10-01

    Life cycle assessment (LCA) is a framework for comparing products according to their total estimated environmental impact, summed over all chemical emissions and activities associated with a product at all stages in its life cycle (from raw material acquisition, manufacturing, use, to final disposal). For each chemical involved, the exposure associated with the mass released into the environment, integrated over time and space, is multiplied by a toxicological measure to estimate the likelihood of effects and their potential consequences. In this article, we explore the use of quantitative methods drawn from conventional single-chemical regulatory risk assessments to create a procedure for the estimation of the cancer effect measure in the impact phase of LCA. The approach is based on the maximum likelihood estimate of the effect dose inducing a 10% response over background, ED10, and default linear low-dose extrapolation using the slope betaED10 (0.1/ED10). The calculated effects may correspond to residual risks below current regulatory compliance requirements that occur over multiple generations and at multiple locations; but at the very least they represent a "using up" of some portion of the human population's ability to accommodate emissions. Preliminary comparisons are performed with existing measures, such as the U.S. Environmental Protection Agency's (U.S. EPA's) slope factor measure q1*. By analyzing bioassay data for 44 chemicals drawn from the EPA's Integrated Risk Information System (IRIS) database, we explore estimating ED10 from more readily available information such as the median tumor dose rate TD50 and the median single lethal dose LD50. Based on the TD50, we then estimate the ED10 for more than 600 chemicals. Differences in potential consequences, or severity, are addressed by combining betaED10 with the measure disability adjusted life years per affected person, DALYp. Most of the variation among chemicals for cancer effects is found to be due

  20. The ED95 of Nalbuphine in Outpatient-Induced Abortion Compared to Equivalent Sufentanil.

    PubMed

    Chen, Limei; Zhou, Yamei; Cai, Yaoyao; Bao, Nana; Xu, Xuzhong; Shi, Beibei

    2018-04-07

    This prospective study evaluated the 95% effective dose (ED 95 ) of nalbuphine in inhibiting body movement during outpatient-induced abortion and its clinical efficacy versus the equivalent of sufentanil. The study was divided into two parts. For the first part, voluntary first-trimester patients who needed induced abortions were recruited to measure the ED 95 of nalbuphine in inhibiting body movement during induced abortion using the sequential method (the Dixon up-and-down method). In the second part, this was a double-blind, randomized study. Sixty cases of first-trimester patients were recruited and were randomly divided into two groups (n = 30), including group N (nalbuphine at the ED 95 dose) and group S (sufentanil at an equivalent dose). Propofol was given to both groups as the sedative. The circulation, respiration and body movement of the two groups in surgery were observed. The amount of propofol, the awakening time, the time to leave the hospital and the analgesic effect were recorded. The ED 95 of nalbuphine in inhibiting body movement during painless surgical abortion was 0.128 mg/kg (95% confidence intervals 0.098-0.483 mg/kg). Both nalbuphine and the equivalent dose of sufentanil provided a good intraoperative and post-operative analgesic effect in outpatient-induced abortion. However, the post-operative morbidity of dizziness for nalbuphine was less than for sufentanil (p < 0.05), and the awakening time and the time to leave the hospital were significantly shorter than those of sufentanil (p < 0.05). Nalbuphine at 0.128 mg/kg was used in outpatient-induced abortion as an intraoperative and post-operative analgesic and showed a better effect compared with sufentanil. © 2018 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  1. ExpandED Schools National Demonstration: Lessons for Scale and Sustainability

    ERIC Educational Resources Information Center

    Russell, Christina A.; Hildreth, Jeanine L.; Stevens, Pamela

    2016-01-01

    The ExpandED Schools model for expanded learning is designed to transform schools by changing the use of time, both as experienced by students in learning and by teachers in instruction. The model is grounded in the belief that strategically adding time to the school day can enhance skills and knowledge and broaden horizons by engaging students in…

  2. Problems encountered with conventional fiber-reinforced composites

    NASA Technical Reports Server (NTRS)

    Landel, R. F.

    1981-01-01

    Preparational, computational, and operational problems associated with fiber-reinforced composites (FRC) are reviewed. Initial preparation of FRCs is shown to involve consideration of the type of prepreg, the setting time, cure conditions and cycles, and cure temperatures. The effects of the choice of bonding agents, the fiber transfer length, and individual fiber responses to bonding agents are noted to have an impact on fiber strength, moisture uptake, and fatigue resistance. The deformation prior to failure and the failure region are modeled through models of mini-, micro- and macro mechanics formulations employing a stiffness matrix, failure criterion, or fracture mechanics. The detection, evaluation, and repair of defects comprises the operational domain, and it is stressed that no good repair techniques exist for FRCs.

  3. Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?

    PubMed

    McManus, Moira C; Cramer, Robert J; Boshier, Maureen; Akpinar-Elci, Muge; Van Lunen, Bonnie

    2018-01-13

    Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. Concerning moderating effects, Spanish/Hispanic origin was associated with increased likelihood for emergent ED use in the rural living location model, and non-emergent ED use for the no non-emergent source model. 'Other' ethnic origin increased the likelihood of emergent ED use for rural living location and no non-emergent source models. The findings reveal 'need', including mental health admissions, as the largest driver for ED use. This may be due to mental healthcare access, or patients with mental health emergencies being transported via first responders to the ED, as in the case of suicide, self-harm, manic episodes or psychotic episodes. Further educating ED staff on this patient population through gatekeeper training may ensure patients receive the best treatment and aid in driving access to mental healthcare delivery changes.

  4. The Phosphodiesterase 5-Inhibitors (PDE-5i) for ERECTILE DYSFUNCTION (ED): A Therapeutic Challenge For Psychiatrists.

    PubMed

    Koon, Chong Siew; Sidi, Hatta; Kumar, Jaya; Das, Srijit; Xi, Ong Wan; Hatta, Muhammad Hizri; Alfonso, Cesar

    2017-02-15

    Erectile function (EF) is a prerequisite for satisfactory sexual intercourse (SI) and central to male sexual functioning. Satisfactory SI eventually leads to orgasm - a biopsychophysiological state of euphoria - leading to a sense of bliss, enjoyment and positive mental well being. For a psychiatrist, treating ED is self-propelled to harmonize these pleasurable experiences alongside with encouragement of physical wellness and sensuality. Hence, the role of PDE-5i is pivotal in the context of treating ED constitutes a therapeutic challenge. PDE-5i work via the dopaminergic-oxytocin-nitric oxide pathway by increasing the availability of endothelial's guanosine monophosphate (GMP), immediately causing relaxation of the penile smooth muscle and an erection. The PDE-5i, like sildenafil, vardenafil and tadalafil, are effective in the treatment of ED with some benefits and disadvantages compared to other treatment modalities. Prescribed PDE-5i exclusively improve EF, fostering male's self-confidence and self-esteem. Treatment failures are associated with factors such as absent (or insufficient) sexual stimulation, psychosexual conflicts and the co-existence of medical disorders. Managing ED requires dealing with underlying medical diseases, addressing other co-morbid sexual dysfunctions like premature ejaculation (PE), and educating the patient on healthy life-styles beside being cautious with the potential side-effects and drug-drug interactions. Furthermore, by dealing with interpersonal dynamics within the couple and embracing adequate lifestyles (managing stress and revising one's sexual scripts), PDE-5i treatment benefits may be enhanced. In this review, we propose a holistic conceptual framework approach for psychiatric management of patients with ED. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. Cardiac patients' perceptions of neighboring patients' risk: influence on psychological stress in the ED and subsequent posttraumatic stress.

    PubMed

    Konrad, Beatrice; Hiti, David; Chang, Bernard P; Retuerto, Jessica; Julian, Jacob; Edmondson, Donald

    2017-11-06

    As many as 12% of acute coronary syndrome (ACS) patients screen positive for post-traumatic stress disorder (PTSD) symptoms due to their cardiac event, and emergency department (ED) factors such as overcrowding have been associated with risk for PTSD. We tested the association of patients' perceptions of their proximity to a critically ill patient during ED evaluation for ACS with development of posttraumatic stress symptoms (PSS) in the month after hospital discharge. Participants were enrolled in the REactions to Acute Care and Hospitalization (REACH) study during evaluation for ACS in an urban ED. Participants reported whether they perceived a patient near them was close to death. They also reported their current fear, concern they may die, perceived control, and feelings of vulnerability on an Emergency Room Perceptions questionnaire. One month later, participants reported on PTSD symptoms specific to the cardiac event and ED hospitalization. Of 763 participants, 12% reported perceiving a nearby patient was likely to die. In a multivariate linear regression model [F(9757) = 19.69, p < .001, R 2 adjusted = .18] with adjustment for age, sex, GRACE cardiac risk score, discharge ACS diagnosis, Charlson comorbidity index, objective ED crowding, and depression symptoms at baseline, perception of a nearby patients' likely death was associated with a 2.33 point (95% CI, 0.60-4.61) increase in 1 month PTSD score. A post hoc mediation analysis with personal threat perceptions [F(10,756) = 25.28, p < .001, R 2 adjusted = .24] showed increased personal threat perceptions during the ED visit, B = 0.71 points on the PCL per point on the personal threat perception questionnaire, β = 0.27, p = .001, fully mediated association of participants' perceptions of nearby patients' likely death with 1-month PTSD score (after adjustment for ED threat perceptions,) B = 0.89 (95% CI, -1.33 to 3.12), β = 0.03, p = .43, accounting for 62% of the adjusted effect

  6. Obsessional and Eating Disorder-related Intrusive Thoughts: Differences and Similarities Within and Between Individuals Vulnerable to OCD or to EDs.

    PubMed

    Belloch, Amparo; Roncero, María; Perpiñá, Conxa

    2016-11-01

    Unwanted intrusive cognitions constitute the normal variant of clinically significant intrusive cognitions found in disorders such as obsessive-compulsive disorder (OCD) and eating disorders (EDs). This study investigates whether individuals who are vulnerable to OCD or EDs experience more intrusions than people with no vulnerability to these disorders, and it examines the consequences of obsessional (OITs) and eating disorder (EDITs) intrusions in the same individuals, taking into account their susceptibility to OCD, EDs or neither of the two. From a sample of 922 participants, three groups were formed: risk of OCD (n = 92), risk of EDs (n = 41) and a no-risk group (n = 100). EDITs were more frequent than OITs in the two risk groups. Within-group comparisons showed that in the OCD-risk group, the OIT had more negative consequences (interference, emotional distress, dysfunctional appraisals and neutralizing strategies) than the EDIT, whereas in the ED-risk group, the OIT and the EDIT instigated similar negative consequences. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  7. Predicting tularemia with clinical, laboratory and demographical findings in the ED.

    PubMed

    Yapar, Derya; Erenler, Ali Kemal; Terzi, Özlem; Akdoğan, Özlem; Ece, Yasemin; Baykam, Nurcan

    2016-02-01

    We aimed to determine clinical, laboratory and demographical characteristics of tularemia on admission to Emergency Department (ED). Medical data of 317 patients admitted to ED and subsequently hospitalized with suspected tularemia between January 1, 2011, and May 31, 2015, were collected. Patients were divided into 2 groups according to microagglutination test results, as tularemia (+) and tularemia (-). Of the 317 patients involved, 49 were found to be tularemia (+) and 268 were tularemia (-). Mean age of the tularemia (+) patients was found to be higher than that of tularemia (-) patients. When compared to tularemia (-) patients, a significant portion of patients in tularemia (+) patients were elderly, living in rural areas and had contact with rodents. When clinical and laboratory findings of the 2 groups were compared, any statistical significance could not be determined. Tularemia is a disease of elderly people living in rural areas. Contact with rodents also increases risk of tularemia in suspected patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Replica exchange enveloping distribution sampling (RE-EDS): A robust method to estimate multiple free-energy differences from a single simulation.

    PubMed

    Sidler, Dominik; Schwaninger, Arthur; Riniker, Sereina

    2016-10-21

    In molecular dynamics (MD) simulations, free-energy differences are often calculated using free energy perturbation or thermodynamic integration (TI) methods. However, both techniques are only suited to calculate free-energy differences between two end states. Enveloping distribution sampling (EDS) presents an attractive alternative that allows to calculate multiple free-energy differences in a single simulation. In EDS, a reference state is simulated which "envelopes" the end states. The challenge of this methodology is the determination of optimal reference-state parameters to ensure equal sampling of all end states. Currently, the automatic determination of the reference-state parameters for multiple end states is an unsolved issue that limits the application of the methodology. To resolve this, we have generalised the replica-exchange EDS (RE-EDS) approach, introduced by Lee et al. [J. Chem. Theory Comput. 10, 2738 (2014)] for constant-pH MD simulations. By exchanging configurations between replicas with different reference-state parameters, the complexity of the parameter-choice problem can be substantially reduced. A new robust scheme to estimate the reference-state parameters from a short initial RE-EDS simulation with default parameters was developed, which allowed the calculation of 36 free-energy differences between nine small-molecule inhibitors of phenylethanolamine N-methyltransferase from a single simulation. The resulting free-energy differences were in excellent agreement with values obtained previously by TI and two-state EDS simulations.

  9. Comparing the detection of iron-based pottery pigment on a carbon-coated sherd by SEM-EDS and by Micro-XRF-SEM.

    PubMed

    Pendleton, Michael W; Washburn, Dorothy K; Ellis, E Ann; Pendleton, Bonnie B

    2014-03-01

    The same sherd was analyzed using a scanning electron microscope with energy dispersive spectroscopy (SEM-EDS) and a micro X-ray fluorescence tube attached to a scanning electron microscope (Micro-XRF-SEM) to compare the effectiveness of elemental detection of iron-based pigment. To enhance SEM-EDS mapping, the sherd was carbon coated. The carbon coating was not required to produce Micro-XRF-SEM maps but was applied to maintain an unbiased comparison between the systems. The Micro-XRF-SEM analysis was capable of lower limits of detection than that of the SEM-EDS system, and therefore the Micro-XRF-SEM system could produce elemental maps of elements not easily detected by SEM-EDS mapping systems. Because SEM-EDS and Micro-XRF-SEM have been used for imaging and chemical analysis of biological samples, this comparison of the detection systems should be useful to biologists, especially those involved in bone or tooth (hard tissue) analysis.

  10. Comparing the Detection of Iron-Based Pottery Pigment on a Carbon-Coated Sherd by SEM-EDS and by Micro-XRF-SEM

    PubMed Central

    Pendleton, Michael W.; Washburn, Dorothy K.; Ellis, E. Ann; Pendleton, Bonnie B.

    2014-01-01

    The same sherd was analyzed using a scanning electron microscope with energy dispersive spectroscopy (SEM-EDS) and a micro X-ray fluorescence tube attached to a scanning electron microscope (Micro-XRF-SEM) to compare the effectiveness of elemental detection of iron-based pigment. To enhance SEM-EDS mapping, the sherd was carbon coated. The carbon coating was not required to produce Micro-XRF-SEM maps but was applied to maintain an unbiased comparison between the systems. The Micro-XRF-SEM analysis was capable of lower limits of detection than that of the SEM-EDS system, and therefore the Micro-XRF-SEM system could produce elemental maps of elements not easily detected by SEM-EDS mapping systems. Because SEM-EDS and Micro-XRF-SEM have been used for imaging and chemical analysis of biological samples, this comparison of the detection systems should be useful to biologists, especially those involved in bone or tooth (hard tissue) analysis. PMID:24600333

  11. SEM-EDS Observation of Structure Changes in Synthetic Zeolites Modified for CO2 Capture Needs

    NASA Astrophysics Data System (ADS)

    Wdowin, Magdalena; Panek, Rafal; Franus, Wojciech

    Carbon dioxide is the main greenhouse gas and its amount still increase in the atmosphere. Air pollution and greenhouse effect caused by CO2 emission have become a major threat to the environment on a global scale. Carbon dioxide sequestration (i.e. capture and consequently geological storage) is the key strategy within the portfolio of actions to reduce CO2 emission to the atmosphere. The most costly stage is capture of CO2, therefore there is a need to search new solutions of this technology. For this purpose it was examined Na-X synthetic zeolites, that were silver and PEI (polyethyleneimine) activated. SEM-EDS investigation enable to find a changes in structure of this materials after treatment. Where, as a result of silver activation from EDS analysis it is seen that Ag occur in Na-X structure, what indicate a substitution of Ag2+ for Na+ ions in crystal lattice. Analysing wt% the EDS analysis has shown that zeolite Na-X after silver impregnation becomes Ag-X zeolite. For Na-X-PEI activated it is observed a distinct organic compound in the form of coatings on Na-X crystals causing a sealing of pores in tested zeolite. Further examination of these materials concern determination of surface properties and experiments of CO2 sorption. But SEM-EDS analysis enable to determine the extent of activation, what is very important in determination of optimal conditions for such treatment in order to obtain better sorbent of CO2.

  12. Faults and foibles of quantitative scanning electron microscopy/energy dispersive x-ray spectrometry (SEM/EDS)

    NASA Astrophysics Data System (ADS)

    Newbury, Dale E.; Ritchie, Nicholas W. M.

    2012-06-01

    Scanning electron microscopy with energy dispersive x-ray spectrometry (SEM/EDS) is a powerful and flexible elemental analysis method that can identify and quantify elements with atomic numbers > 4 (Be) present as major constituents (where the concentration C > 0.1 mass fraction, or 10 weight percent), minor (0.01<= C <= 0.1) and trace (C < 0.01, with a minimum detectable limit of ~+/- 0.0005 - 0.001 under routine measurement conditions, a level which is analyte and matrix dependent ). SEM/EDS can select specimen volumes with linear dimensions from ~ 500 nm to 5 μm depending on composition (masses ranging from ~ 10 pg to 100 pg) and can provide compositional maps that depict lateral elemental distributions. Despite the maturity of SEM/EDS, which has a history of more than 40 years, and the sophistication of modern analytical software, the method is vulnerable to serious shortcomings that can lead to incorrect elemental identifications and quantification errors that significantly exceed reasonable expectations. This paper will describe shortcomings in peak identification procedures, limitations on the accuracy of quantitative analysis due to specimen topography or failures in physical models for matrix corrections, and quantitative artifacts encountered in xray elemental mapping. Effective solutions to these problems are based on understanding the causes and then establishing appropriate measurement science protocols. NIST DTSA II and Lispix are open source analytical software available free at www.nist.gov that can aid the analyst in overcoming significant limitations to SEM/EDS.

  13. The EdUReP approach plus manual therapy for the management of insertional Achilles tendinopathy.

    PubMed

    Sartorio, Francesco; Zanetta, Anna; Ferriero, Giorgio; Bravini, Elisabetta; Vercelli, Stefano

    2018-05-01

    Insertional Achilles tendinopathy (IAT) is a challenging overuse disorder. The aim of this case report was to study the feasibility of a comprehensive rehabilitative approach according to the Education, Unloading, Reloading, and Prevention (EdUReP) framework combined with Instrument-Augmented Soft Tissue Mobilization (I-ASTM). An active 51-year-old man patient with chronic IAT was studied. Clinical assessment battery was composed by visual analogue scale for pain during the Achilles tendon palpation test, passive straight leg raise test, single leg hop test, Patient-Specific Functional Scale, and Foot and Ankle Ability Measure. The patient was treated over a 8 weeks period using the EdUReP guidelines plus 8 sessions of I-ASTM, applied with a solid instrument to the Achilles tendon and to the muscle fibrotic areas previously identified during evaluation. Clinically significant improvements were observed in all outcome measures, and a resume of patient's usual sports activities without pain or limitations was possible after treatment. Results lasted over a 6-month follow-up. To the best of our knowledge, this is the first study applying a comprehensive approach based on accurate physical assessment, and using the EdUReP theoretical model. The combination of the EdUReP model and manual therapy was effective in resolving the patient's symptoms and restore his usual sport activities. While these results cannot be generalized, the present findings could provide a valuable foundation for future researches.

  14. Mount Sinai leverages smartphone technology, aiming to boost care, coordination of ED patients while also trimming costs.

    PubMed

    2015-05-01

    Mount Sinai Hospital in New York, NY, is using smartphone technology to enhance follow-up calls to senior patients who have visited the ED, and to help provide acute-level care to select patients in their own homes. Investigators are hoping to show that these approaches can improve care and coordination while trimming costs, and they expect that patients will approve of these new approaches as well. While senior patients are still in the ED, nurse coordinators will work with them to load a HIPAA-compliant application to their smartphones so they can conduct face-to-face follow-up calls that meet HIPAA standards. Nurses say the face-to-face communications enhance their ability to assess how patients are doing following their ED visit. The hospital is also testing a program that enables some ED patients who meet inpatient criteria to receive this care in the home setting through the use of a mobile acute care team (MACT). In the case of emergencies, the MACT team relies on community paramedics who will visit the patients' homes and provide care under the direction of MACT physicians who are linked in to these visits via smartphone technology.

  15. Effectiveness of Mathematics Teaching and Learning Experiences through Wireless Technology as Recent Style to Enhance B.Ed. Trainees

    ERIC Educational Resources Information Center

    Joan, D. R. Robert

    2015-01-01

    The objective of the study was to find out the effect of learning through Wireless technologies and the traditional method in teaching and learning Mathematics. The investigator adopted experimental research to find the effectiveness of implementing Wireless technologies in the population of B.Ed. trainees. The investigator selected 32 B.Ed.…

  16. Evaluating Prospective Teachers: Testing the Predictive Validity of the edTPA. CEDR Working Paper. WP #2016-2.2

    ERIC Educational Resources Information Center

    Goldhaber, Dan; Cowan, James; Theobald, Roddy

    2016-01-01

    We use longitudinal data from Washington State to provide estimates of the extent to which performance on the edTPA, a performance-based, subject-specific assessment of teacher candidates, is predictive of the likelihood of employment in the teacher workforce and value-added measures of teacher effectiveness. While edTPA scores are highly…

  17. Mentoring from Different Social Spheres: How Can Multiple Mentors Help in Doctoral Student Success in Ed.D Programs?

    ERIC Educational Resources Information Center

    Terry, Tarae; Ghosh, Rajashi

    2015-01-01

    Doctoral students leave their programs early due to lack of mentoring relationships needed to support degree completion and success. However, how mentoring contributes to Ed.D degree completion is not widely studied. In this qualitative narrative study, we sought to explore how multiple mentoring relationships reduced attrition in an Ed.D program.…

  18. Towards Understanding the DO-178C / ED-12C Assurance Case

    NASA Technical Reports Server (NTRS)

    Holloway, C M.

    2012-01-01

    This paper describes initial work towards building an explicit assurance case for DO-178C / ED-12C. Two specific questions are explored: (1) What are some of the assumptions upon which the guidance in the document relies, and (2) What claims are made concerning test coverage analysis?

  19. Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients.

    PubMed

    Silva, Mauro Prado DA; Matsui, Christiano; Kim, Daniel Dongiou; Vieira, Joaquim Edson; Malheiros, Carlos Alberto; Mathias, Ligia Andrade Silva Telles

    2017-01-01

    to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg. determinar a ED90 (dose mínima eficaz em 90% dos pacientes) de sugamadex para a reversão de bloqueio neuromuscular (BNM) moderado induzido pelo rocurônio em pacientes com obesidade grau III submetidos à cirurgia bariátrica. estudo prospectivo com o método de projeção sequencial para cima e para baixo da moeda enviesada. As seguintes doses foram escolhidas: 2,0mg/kg-1, 2,2mg/kg-1, 2,4mg/kg-1, 2,6mg/kg-1, 2,8mg/kg-1. A reversão completa de BNM induzido por rocurônio considerou uma relação T4/T1 ≥0,9 na medida do TOF. Após a indução da anestesia geral e calibração do estimulador de nervo periférico e acelerômetro, rocurônio 0,6mg/kg-1 foi injetado. Infusão contínua de propofol e remifentanil, e bolus intermitente de rocurônio foram injetados durante todo o procedimento. trinta e um pacientes foram

  20. FETC, TCEA Commemorate 25 Years of Serving Ed Tech Industry

    ERIC Educational Resources Information Center

    T.H.E. Journal, 2005

    2005-01-01

    There's only one way to prepare for all of the exciting things that the ed tech market has in store for 2005-- by attending a conference. That's why T.H.E. Journal hopes readers will join them at this year's FETC (Booth 1505) and TCEA (Booth 1934) conferences to help celebrate their 25th anniversaries. Overviews are provided for both conferences…

  1. The detection of metallic residues in skin stab wounds by means of SEM-EDS: A pilot study.

    PubMed

    Palazzo, Elisa; Amadasi, Alberto; Boracchi, Michele; Gentile, Guendalina; Maciocco, Francesca; Marchesi, Matteo; Zoja, Riccardo

    2018-05-01

    The morphological analysis of stab wounds may often not be accurate enough to link it with the type of wounding weapon, but a further evaluation may be performed with the search for metallic residues left during the contact between the instrument and the skin. In this study, Scanning Electron Microscopy-Energy Dispersive Spectroscopy (SEM-EDS) was applied to the study of cadaveric stab wounds performed with kitchen knives composed of iron, chromium and nickel, in order to verify the presence of metallic residues on the wound's edge. Two groups of 10 corpses were selected: group A, including victims of stab wounds and a control group B (died of natural causes). Samplings were performed on the lesions and in intact areas of group A, whereas in group B sampling were performed in non-exposed intact skin. Samples were then analysed with optical microscopy and SEM-EDS. In group A, optical microscopic analysis showed the presence of vital haemorrhagic infiltration, while SEM-EDS showed evidence of microscopic metal traces, isolated or clustered, consisting of iron, chromium and nickel. Moreover, in two cases organic residues of calcium and phosphate were detected, as a probable sign of bone lesion. Control samples (group A in intact areas and group B), were negative for the search of exogenous material to optical microscopy and SEM-EDS. The results show the utility and possible application of the SEM-EDS in theidentification of metallic residues from sharp weapons on the skin. Copyright © 2017 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.

  2. Risk factors associated with difficult venous access in adult ED patients.

    PubMed

    Fields, J Matthew; Piela, Nicole E; Au, Arthur K; Ku, Bon S

    2014-10-01

    The objective was to determine risk factors associated with difficult venous access (DVA) in the emergency department (ED). This was a prospective, observational study conducted in the ED of an urban tertiary care hospital. Adult patients undergoing intravenous (IV) placement were consecutively enrolled during periods of block enrollment. The primary outcome was DVA, defined as 3 or more IV attempts or use of a method of rescue vascular access to establish IV access. Univariate and multivariate analyses for factors predicting DVA were performed using logistic regression. A total of 743 patients were enrolled, of which 88 (11.8%) met the criteria for DVA. In the adjusted analysis, only 3 medical conditions were significantly associated with DVA: diabetes (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.1-2.8), sickle cell disease (OR 3.8, 95% CI 1.5-9.5), and history of IV drug abuse (OR 2.5, 95% CI 1.1-5.7). Notably, age, body mass index, and dialysis were not. Of patients who reported a history of requiring multiple IV attempts in the past for IV access, 14% met criteria for DVA on this visit (OR 7.7 95% CI 3-18). Of the patients who reported a history of IV insertion into the external jugular, ultrasound-guided IV placement, or a central venous catheter for IV access, 26% had DVA on this visit (OR 16.7, 95% CI 6.8-41). Nearly 1 of every 9 to 10 adults in an urban ED had DVA. Diabetes, IV drug abuse, and sickle cell disease were found to be significantly associated with DVA. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Urine culture guided antibiotic interventions: A pharmacist driven antimicrobial stewardship effort in the ED.

    PubMed

    Zhang, Xi; Rowan, Nicole; Pflugeisen, Bethann Mangel; Alajbegovic, Sanjin

    2017-04-01

    Antibiotics are overprescribed for abnormal urine tests including asymptomatic bacteriuria (AB), contributing to rising antimicrobial resistance rates. Pharmacists reviewed urine cultures daily from emergency department (ED) encounters to assess antibiotic appropriateness. We studied antibiotic prescribing practices and assessed compliance to national guidelines, correlations with urine analysis (UA) components, and opportunities for antimicrobial stewardship in the ED. This quality improvement project (QIP) was a prospective cohort study at a community hospital ED, with data collected from finalized urine cultures resulting October 30, 2014 through January 5, 2015. Analyses were conducted using Chi-squared and Fisher Exact tests and stepwise multiple logistic regression. Urine cultures from 457 encounters were reviewed, of which 136 met the inclusion criteria as non-pregnant and asymptomatic for urinary tract infection (UTI). 43% of 136 patients were treated with antibiotics, for a total of 426 antibiotic days. Pharmacist interventions for these patients resulted in 122/426 (29%) of potential antibiotic days saved. Factors found to significantly increase the odds of antibiotic prescribing in asymptomatic patients included presence of leukocyte esterase (OR=4.5, 95% CI: 1.2-17.2; p=0.03) or nitrites (OR=10.8, 95% CI: 1.7-68.1; p=0.01) in the urine and age≥75 (OR=3.5, 95% CI: 1.2-9.6, p=0.02). Pharmacist intervention in discontinuing or modifying antibiotics for asymptomatic patients with urine cultures reduced unnecessary antibiotic exposure and was a first step in antimicrobial stewardship efforts in the ED. Future work includes limiting urine tests and subsequent antibiotic therapy for non-pregnant asymptomatic patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. EdREC: Design and Development of Adaptive Platform for Scaling-up Flipped Mastery Learning

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

    Gautam, Thakur

    EdREC is an adaptive learning and management platform designed to enhance the adoption of differential classroom and mastery flipped learning in K-12 school system. The platform is an innovative approach to teaching and learning that addresses education needs of each student separately by providing customized education plans and adaptive learning methodologies that tunes to the students abilities as well as giving students freedom to learn in their own way. On one side, EdREC provides innovative ways to help students learn; on the other side, it reduces educators' workload and empowers them to understand their students better. EdREC comes with amore » state-of-the-art computer algorithm package that enables educators to store and retrieve their students' information and augment their abilities to individualize student attention, get real-time feedback about student education progress, and provide corrective actions. The platform provides approaches to design and develop a differential classroom concept that frees much needed time by the teachers to focus more on the students at the individual level and to increase communication and collaboration opportunities among them.« less

  5. Effectiveness of Mutual Learning Approach in the Academic Achievement of B.Ed Students in Learning Optional II English

    ERIC Educational Resources Information Center

    Arulselvi, Evangelin

    2013-01-01

    The present study aims at finding out the effectiveness of Mutual learning approach over the conventional method in learning English optional II among B.Ed students. The randomized pre-test, post test, control group and experimental group design was employed. The B.Ed students of the same college formed the control and experimental groups. Each…

  6. Comparative evaluation between glass and polyethylene fiber reinforced composites: A review of the current literature

    PubMed Central

    Mangoush, Enas; Säilynoja, Eija; Prinssi, Roosa; Lassila, Lippo; Vallittu, Pekka K.

    2017-01-01

    Background Fiber reinforced composite (FRC) is a promising class of material that gives clinicians alternative treatment options. There are many FRC products available in the market based on either glass or polyethylene fiber type. The aim of this study was to present a comparison between glass and polyethylene fiber reinforced composites based on available literature review. Material and Methods A thorough literature search, with no limitation, was done up to June 2017. The range of relevant publications was surveyed using PubMed and Google Scholar. From the search results, articles related to our search terms were only considered. An assessment of these articles was done by two individuals in order to include only articles directly compare between glass and polyethylene FRCs. The search terms used were “fiber reinforced dental composites” and “glass and polyethylene fibers in dentistry”. Results The search provided 276 titles. Full-text analysis was performed for 29 articles that met the inclusion criteria. Most were laboratory-based research with various test specimen designs prepared according to ISO standard or with extracted teeth and only three articles were clinical studies. Most of studies (n=23) found superior characteristics of glass FRCs over polyethylene FRCs. Conclusions Significant reinforcement differences between commercial glass and polyethylene fiber reinforced composites were found. Key words:Fiber reinforced composite, glass fiber, polyethylene fiber. PMID:29410756

  7. Coupled transport in field-reversed configurations

    NASA Astrophysics Data System (ADS)

    Steinhauer, L. C.; Berk, H. L.; TAE Team

    2018-02-01

    Coupled transport is the close interconnection between the cross-field and parallel fluxes in different regions due to topological changes in the magnetic field. This occurs because perpendicular transport is necessary for particles or energy to leave closed field-line regions, while parallel transport strongly affects evolution of open field-line regions. In most toroidal confinement systems, the periphery, namely, the portion with open magnetic surfaces, is small in thickness and volume compared to the core plasma, the portion with closed surfaces. In field-reversed configurations (FRCs), the periphery plays an outsized role in overall confinement. This effect is addressed by an FRC-relevant model of coupled particle transport that is well suited for immediate interpretation of experiments. The focus here is particle confinement rather than energy confinement since the two track together in FRCs. The interpretive tool yields both the particle transport rate χn and the end-loss time τǁ. The results indicate that particle confinement depends on both χn across magnetic surfaces throughout the plasma and τǁ along open surfaces and that they provide roughly equal transport barriers, inhibiting particle loss. The interpretation of traditional FRCs shows Bohm-like χn and inertial (free-streaming) τǁ. However, in recent advanced beam-driven FRC experiments, χn approaches the classical rate and τǁ is comparable to classic empty-loss-cone mirrors.

  8. An Analysis of Professional Practice Ed.D. Dissertations in Educational Technology

    ERIC Educational Resources Information Center

    Dawson, Kara; Kumar, Swapna

    2014-01-01

    The University of Florida offers an online professional practice Ed.D. focused on Educational Technology. Twenty-three students have completed professional practice dissertations and graduated since the program's inception in 2008. The purpose of this article is to share what these dissertations have looked like and to begin a dialogue about…

  9. ED QUEST: A Model Procedure for Futures Planning in Educational Organizations.

    ERIC Educational Resources Information Center

    Adams, Charles F.

    Most educational planning models are weak at identifying future events and assessing their impact on education. At best they assume a surprise-free future in which present trends continue unabated and interrelationships among social, economic, political, and technological forces stay the same. The ED QUEST model was developed to ameliorate these…

  10. Environmental Baseline Survey Report for the Title Transfer of Land Parcel ED-4 at the East Tennessee Technology Park, Oak Ridge, Tennessee

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

    SAIC

    2008-05-01

    This environmental baseline survey (EBS) report documents the baseline environmental conditions of a land parcel referred to as 'ED-4' (ED-4) at the U. S. Department of Energy's (DOE's) East Tennessee Technology Park (ETTP). DOE is proposing to transfer the title of this land to the Heritage Center, LLC. Parcel ED-4 is a land parcel that consists of two noncontiguous areas comprising a total of approximately 18 acres located east of the ETTP. The western tract of ED-4 encompasses approximately 8.5 acres in the northeastern quadrant of the intersection of Boulevard Road and Highway 58. The eastern tract encompasses an areamore » of approximately 9.5 acres in the northwestern quadrant of the intersection of Blair Road and Highway 58 (the Oak Ridge Turnpike). Aerial photographs and site maps from throughout the history of the ETTP, going back to its initial development in the 1940s as the Oak Ridge Gaseous Diffusion Plant (ORGDP), indicate that this area has been undeveloped woodland with the exception of three support facilities for workers constructing the ORGDP since federal acquisition in 1943. These three support facilities, which were located in the western tract of ED-4, included a recreation hall, the Town Hall Camp Operations Building, and the Property Warehouse. A railroad spur also formerly occupied a portion of Parcel ED-4. These former facilities only occupied approximately 5 percent of the total area of Parcel ED-4. This report provides supporting information for the transfer of this government-owned property at ETTP to a non-federal entity. This EBS is based upon the requirements of Sect. 120(h) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). In order to support a Clean Parcel Determination (CPD) in accordance with CERCLA Sect. 120(h)(4)(d), groundwater and sediment samples were collected within, and adjacent to, the Parcel ED-4 study area. The potential for DOE to make a CPD for ED-4 is further supported

  11. Investigation of fiber-reinforced concrete for use in transportation structures.

    DOT National Transportation Integrated Search

    1997-01-01

    This report presents the results of a laboratory investigation to determine the properties of fiber-reinforced concretes (FRCs) with steel (hooked-end), polypropylene (monofilament and fibrillated), and the recently introduced polyolefin fibers (mono...

  12. Academic Degree Recognition in a Global Era: The Case of The Doctorate of Education (EdD) in Israel

    ERIC Educational Resources Information Center

    Bamberger, Annette

    2018-01-01

    The current discussion around recognition of the doctorate of education (EdD) typically focuses on a national context, usually in relation to the PhD; however, relatively little is known about recognition of the EdD degree in countries that do not offer the qualification. As international cohorts and online delivery of doctoral education grows, it…

  13. The effects of alcohol mixed with energy drinks (AmED) on traffic behaviors among Brazilian college students: a national survey.

    PubMed

    Eckschmidt, Frederico; de Andrade, Arthur Guerra; dos Santos, Bernardo; de Oliveira, Lúcio Garcia

    2013-01-01

    Drinking alcohol mixed with energy drinks (AmED) may be contributing to hazardous drinking practices and risk-taking behaviors among college students. In this regard, this study aimed to assess the frequency of AmED consumption in a national sample of Brazilian college students and to estimate the risk that energy drinks pose on drinking and traffic behaviors. A sample of 12,711 college students from across the country was asked to complete a research questionnaire on the use of drugs and other behaviors. Students who reported drinking in the previous 12 months (N = 8672) were divided into 2 groups: (a) those who reported drinking only alcohol (N = 4192) and (b) those who reported drinking AmED (N = 1119). The college students who reported the use of at least one illicit drug were excluded from data analysis. Descriptive and inferential analyses were subsequently carried out using the R library survey software 2.15.0. The null hypothesis was rejected at the level of P < .05. AmED users are more likely to be hazardous drinkers. Being male, single, and involved with high-risk drinking behaviors are associated to AmED. After adjusting for demographic and drinking variables, the odds of being involved in high-risk traffic behaviors--for example, driving at high speed (odds ratio [OR] = 2.6; P < .001) and driving after binge drinking (OR = 2.8; P < .001)--were higher among AmED users than alcohol only users (AUs). The current findings are consistent with the results of previous studies. Drinking AmED may make college students more vulnerable to the occurrence of risky drinking and traffic behaviors. Educational campaigns targeted to young people should be developed warning them about the potential risks of mixing alcohol with energy drinks.

  14. Is the EdTPA the Right Choice for Evaluating Teacher Readiness?

    ERIC Educational Resources Information Center

    Parkes, Kelly A.; Powell, Sean R.

    2015-01-01

    The purpose of this article is to describe and analyze the edTPA, a performance assessment created by the Stanford Center for Assessment, Learning, and Equity (SCALE) and administered by Pearson, Inc., to assess the professional readiness of student teachers. We challenge claims made in support of using this assessment, specifically within the…

  15. Measuring relative performance of an EDS detector using a NiO standard.

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

    Sugar, Joshua Daniel; Kotula, Paul Gabriel

    2013-09-01

    A method for measuring the relative performance of energy dispersive spectrometers (EDS) on a TEM is discussed. A NiO thin-film standard fabricated at Sandia CA is used. A performance parameter,, is measured and compared to values on several TEM systems.

  16. ED-WAVE tool design approach: Case of a textile wastewater treatment plant in Blantyre, Malawi

    NASA Astrophysics Data System (ADS)

    Chipofya, V.; Kraslawski, A.; Avramenko, Y.

    The ED-WAVE tool is a PC based package for imparting training on wastewater treatment technologies. The system consists of four modules viz. Reference Library, Process Builder, Case Study Manager, and Treatment Adviser. The principles of case-based design and case-based reasoning as applied in the ED-WAVE tool are utilised in this paper to evaluate the design approach of the wastewater treatment plant at Mapeto David Whitehead & Sons (MDW&S) textile and garments factory, Blantyre, Malawi. The case being compared with MDW&S in the ED-WAVE tool is Textile Case 4 in Sri Lanka (2003). Equalisation, coagulation and rotating biological contactors is the sequencing of treatment units at Textile Case 4 in Sri Lanka. Screening, oxidation ditches and sedimentation is the sequencing of treatment units at MDW&S textile and garments factory. The study suggests that aerobic biological treatment is necessary in the treatment of wastewater from a textile and garments factory. MDW&S incorporates a sedimentation process which is necessary for the removal of settleable matter before the effluent is discharged to the municipal wastewater treatment plant. The study confirmed the practical use of the ED-WAVE tool in the design of wastewater treatment systems, where after encountering a new situation; already collected decision scenarios (cases) are invoked and modified in order to arrive at a particular design alternative. What is necessary, however, is to appropriately modify the case arrived at through the Case Study Manager in order to come up with a design appropriate to the local situation taking into account technical, socio-economic and environmental aspects.

  17. The collection of MicroED data for macromolecular crystallography.

    PubMed

    Shi, Dan; Nannenga, Brent L; de la Cruz, M Jason; Liu, Jinyang; Sawtelle, Steven; Calero, Guillermo; Reyes, Francis E; Hattne, Johan; Gonen, Tamir

    2016-05-01

    The formation of large, well-ordered crystals for crystallographic experiments remains a crucial bottleneck to the structural understanding of many important biological systems. To help alleviate this problem in crystallography, we have developed the MicroED method for the collection of electron diffraction data from 3D microcrystals and nanocrystals of radiation-sensitive biological material. In this approach, liquid solutions containing protein microcrystals are deposited on carbon-coated electron microscopy grids and are vitrified by plunging them into liquid ethane. MicroED data are collected for each selected crystal using cryo-electron microscopy, in which the crystal is diffracted using very few electrons as the stage is continuously rotated. This protocol gives advice on how to identify microcrystals by light microscopy or by negative-stain electron microscopy in samples obtained from standard protein crystallization experiments. The protocol also includes information about custom-designed equipment for controlling crystal rotation and software for recording experimental parameters in diffraction image metadata. Identifying microcrystals, preparing samples and setting up the microscope for diffraction data collection take approximately half an hour for each step. Screening microcrystals for quality diffraction takes roughly an hour, and the collection of a single data set is ∼10 min in duration. Complete data sets and resulting high-resolution structures can be obtained from a single crystal or by merging data from multiple crystals.

  18. Optimization of SEM-EDS to determine the C–A–S–H composition in matured cement paste samples

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

    Rossen, J.E., E-mail: john.rossen@alumni.epfl.ch

    Microanalysis of characteristic X-rays in the SEM is a powerful method to assess the chemical composition of phases in cement pastes, in particular the calcium silicate hydrate containing aluminium (C–A–S–H). Nevertheless, many variables may influence the results obtained, due mainly to the intimate mixing of C–A–S–H with other hydrate phases and the susceptibility of this phase to damage by the electron beam. In this study the effect of various acquisition parameters was examined, along with methods to determine an “average” C–A–S–H composition. The results acquired in the SEM were compared with the analysis of the same samples in the TEM,more » where phases can be analyzed without intermixing. A simple method was used to obtain compositions from SEM based analysis that are very close to those which can be obtained in the TEM. - Highlights: •The intermixing of phases is the limiting factor in the analysis of C–A–S–H composition by SEM-EDS •Guidelines to limit beam damage and properly analyze C–A–S–H composition by SEM-EDS are given •SEM-EDS and TEM-EDS give similar results when proper data treatment is made.« less

  19. Free and Reduced-Price Lunch Eligibility Data in Ed"Facts": A White Paper on Current Status and Potential Changes

    ERIC Educational Resources Information Center

    Hoffman, Lee

    2012-01-01

    ED"Facts" is an initiative of the U. S. Department of Education to base education policy on reliable performance data provided by state education agencies. Among its many data items, ED"Facts" houses school-level counts of students disaggregated by state-defined student economic status, typically free and reduced-price lunch…

  20. Snow shovel-related injuries and medical emergencies treated in US EDs, 1990 to 2006.

    PubMed

    Watson, Daniel S; Shields, Brenda J; Smith, Gary A

    2011-01-01

    Injuries and medical emergencies associated with snow shovel use are common in the United States. This is a retrospective analysis of data from the National Electronic Injury Surveillance System. This study analyzes the epidemiologic features of snow shovel-related injuries and medical emergencies treated in US emergency departments (EDs) from 1990 to 2006. An estimated 195 100 individuals (95% confidence interval, 140 400-249 800) were treated in US EDs for snow shovel-related incidents during the 17-year study period, averaging 11 500 individuals annually (SD, 5300). The average annual rate of snow shovel-related injuries and medical emergencies was 4.15 per 100 000 population. Approximately two thirds (67.5%) of these incidents occurred among males. Children younger than 18 years comprised 15.3% of the cases, whereas older adults (55 years and older) accounted for 21.8%. The most common diagnosis was soft tissue injury (54.7%). Injuries to the lower back accounted for 34.3% of the cases. The most common mechanism of injury/nature of medical emergency was acute musculoskeletal exertion (53.9%) followed by slips and falls (20.0%) and being struck by a snow shovel (15.0%). Cardiac-related ED visits accounted for 6.7% of the cases, including all of the 1647 deaths in the study. Patients required hospitalization in 5.8% of the cases. Most snow shovel-related incidents (95.6%) occurred in and around the home. This is the first study to comprehensively examine snow shovel-related injuries and medical emergencies in the United States using a nationally representative sample. There are an estimated 11 500 snow shovel-related injuries and medical emergencies treated annually in US EDs. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Predictors of 30-day mortality in patients admitted to ED for acute heart failure.

    PubMed

    Marchetti, Matthieu; Benedetti, Antoine; Mimoz, Olivier; Lardeur, Jean-Yves; Guenezan, Jérémy; Marjanovic, Nicolas

    2017-03-01

    Acute heart failure (AHF) is a leading cause of admission in emergency departments (ED). It is associated with significant in-hospital mortality, suggesting that there is room for improvement of care. Our aims were to investigate clinical patterns, biological characteristics and determinants of 30-day mortality. We conducted a single site, retrospective review of adult patients (≥18years) admitted to ED for AHF over a 12-month period. Data collected included demographics, clinical, biological and outcomes data. Epidemiologic data were collected at baseline, and patients were followed up during a 30-day period. There were a total of 322 patients. Mean age was 83.9±9.1years, and 47% of the patients were men. Among them, 59 patients (18.3%) died within 30days of admission to the ED. The following three characteristics were associated with increased mortality: age>85years (OR=1.5[95%CI:0.8-2.7], p=0.01), creatinine clearance <30mL/min (OR=2.6[95%CI:1.4-5], p<0.001) and Nt-proBNP >5000pg/mL (OR=2.2[95%CI:1.2-4], p<0.001). The best Nt-proBNP cut-off value to predict first-day mortality was 9000pg/mL (area under the curve (AUC) [95%CI] of 0.790 [0.634-0.935], p<0.001). For 7-day mortality, it was 7900pg/mL (0.698 [0.578-0.819], p<0.001) and for 30-day mortality, 5000pg/mL (0.667 [0.576-0.758], p<0.001). Nt-proBNP level on admission, age and creatinine clearance, are predictive of 30-day mortality in adult patients admitted to ED for AHF. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Cost-effectiveness of influenza vaccination of older adults in the ED setting.

    PubMed

    Patterson, Brian W; Khare, Rahul K; Courtney, D Mark; Lee, Todd A; Kyriacou, Demetrios N

    2012-09-01

    Adults older than 50 years are at greater risk for death and severe disability from influenza. Persons in this age group, however, are frequently not vaccinated, despite extensive efforts by physicians to provide this preventive measure in primary care settings. We performed this study to determine if influenza vaccination of older adults in the emergency department (ED) may be cost-effective. Using a probabilistic decision model with quasi-Markov modeling of a typical influenza season, we calculated costs and health outcomes for a hypothetical cohort of patients using parameters from the literature. Three ED-based intervention strategies were compared: (1) no vaccination offered, (2) vaccination offered to patients older than 65 years (limited strategy), and (3) vaccination offered to all patients who are 50 years and older (inclusive strategy). Outcomes were measured as costs, lives saved, and incremental costs per life saved. We performed deterministic and probabilistic sensitivity analyses. Vaccination of patients 50 years of age and older results in an incremental cost of $34,610 per life saved when compared with the no-vaccination strategy. Limiting vaccination to only those older than 65 years results in an incremental cost of $13,084 per life saved. Results were sensitive to changes in vaccine cost but were insensitive to changes in other model parameters. Vaccination of older adults against influenza in the ED setting is cost-effective, especially for those older than 65 years. Emergency departments may be an important setting for providing influenza vaccination to adults who may otherwise have remained unvaccinated. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Collaborative effort in Washington state slashes non-essential use of the ED by Medicaid patients, delivering millions in projected savings.

    PubMed

    2013-04-01

    Early data suggest a coordinated, state-wide effort has reduced non-essential use of the ED by 10% among Medicaid recipients in Washington state, and is projected to save the state an estimated $31 million in the first year of the approach. The effort includes the adoption of seven best practices by hospitals across the state.These include the creation of an Emergency Department Information Exchange, so that EDs can immediately access a patient's utilization history, strict narcotic prescribing guidelines, and regular feedback reports to hospitals regarding ED utilization patterns. The effort was prompted by threats by the state legislature to limit Medicaid payments for ED visits deemed not medically necessary in the emergency setting. The legislature backed down when emergency physicians in the state countered with their own proposal to reduce nonessential use of the ED. They worked with other health care groups in the state to develop the plan. Data on the first six months of the effort are included in a report to the state legislature by the Washington State Health Care Authority. Among the findings are a 23% reduction in ED visits among Medicaid recipients with five or more visits, a 250% increase in providers who have registered with the state's Prescription Monitoring Program, aimed at identifying patients with narcotic-seeking behavior, and a doubling in the number of shared care plans, intended to improve care coordination. Emergency providers say big challenges remain, including a need for more resources for patients with mental health and dental care needs.

  4. Point prevalence of access block and overcrowding in New Zealand emergency departments in 2010 and their relationship to the 'Shorter Stays in ED' target.

    PubMed

    Jones, Peter G; Olsen, Sarah

    2011-10-01

    To document the extent of access block and ED overcrowding in New Zealand in 2010 and to determine whether these were linked to the hospital's ability to meet the Shorter Stays in ED target. Surveys of all New Zealand EDs were undertaken at two points in time in 2010 to determine ED occupancy. Data on target achievement during corresponding time periods were obtained from the Ministry of Health. In tertiary and secondary hospitals, respectively, access block was seen in 64% versus 23% (P= 0.05) and overcrowding was seen in 57.1% versus 39% (P= 0.45). No hospital with access block met the 'Shorter Stays' target, compared with 60% without access block (P= 0.001). Twenty-three per cent of hospitals with ED overcrowding met the target compared with 43% without ED overcrowding (P= 0.42). The number of patients experiencing ≥8 h delay to admission were 25 in May and 59 in August (P= 0.04). This represented 45.5% and 79.7% of patients waiting for admission, respectively (P= 0.08). Hospital access block was seen more often in larger hospitals and significantly associated with failure to meet the 'Shorter Stays in ED' health target, whereas ED overcrowding was seen in both small and large hospitals, but not associated with failure to meet the target. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  5. Treatment expectations of men with ED and their female partners: an exploratory qualitative study based on grounded theory.

    PubMed

    Henninger, S; Höhn, C; Leiber, C; Berner, M M

    2015-01-01

    Erectile dysfunction (ED) can impair the quality of life and the relationship. An early treatment is necessary to avoid the development of comorbid complaints. To arise the help-seeking behavior and to improve the treatment of affected men, it is necessary to be aware of the treatment expectations. The objective of this study was to investigate the treatment expectations of men with ED and their female partners. This is an explorative qualitative study using semistructured telephone interviews with 12 men with ED and their female partners. Interviews were tape-recorded, transcribed and analyzed on the basis of the grounded theory. We could identify various treatment expectations, which could be differentiated into expectations according to the conditions (for example, low costs and an early access), the handling of the practitioner (for example, showing interest and taking the patient seriously or incorporate the female partner), the treatment itself (for example, clearing the causes and helpful medication) and the treatment outcome (for example, having no ED and more sexual desire). Considering the identified expectations could increase treatment motivation and compliance. We derive five theses from our data, how to implement our findings.

  6. Comparison of secure messaging application (WhatsApp) and standard telephone usage for consultations on Length of Stay in the ED. A prospective randomized controlled study.

    PubMed

    Gulacti, Umut; Lok, Ugur

    2017-07-19

    Consultation, the process of an Emergency Physician seeking an opinion from other specialties, occurs frequently in the Emergency Department (ED). The aim of this study was to determine the effect of secure messaging application (WhatsApp) usage for medical consultations on Emergency Department Length of Stay (ED LOS) and consult time. We conducted a prospective, randomized controlled trial in the ED using allocation concealment over three months. Consultations requested in the ED were allocated into two groups: consultations requested via the secure messaging application and consultations requested by telephone as verbal. A total of 439 consultations requested in the ED were assessed for eligibility and 345 were included in the final analysis: 173 consultations were conducted using secure messaging application and 172 consultations were conducted using standard telephone communications. The median ED LOS was 240 minutes (IQR:230-270, 95% CI:240 to 255.2) for patients in the secure messaging application group and 277 minutes (IQR:270-287.8, 95% CI:277 to 279) for patients in the telephone group. The median total ED LOS was significantly lower among consults conducted using Secure messaging application relative to consults conducted by telephone (median dif: -30, 95%CI:-37to-25, p<0.0001). The median consult time was 158 minutes (IQR:133 to 177.25, 95% CI:150 to 169) for patients in the Secure messaging application group and 170 minutes (IQR:165 to 188.5, 95% CI:170-171) for patients in the Telephone group (median dif: -12, 95%CI:-19 to-7,p<0.0001). Consultations completed without ED arrival was 61.8% in the secure messaging group and 33.1% in the Telephone group (dif: 28.7, 95% CI:48.3 to 66, p<0.001). Use of secure messaging application for consultations in the ED reduces the total ED LOS and consultation time. Consultation with secure messaging application eliminated more than half of in-person ED consultation visits.

  7. Racist Ordering, Settler Colonialism, and EdTPA: A Participatory Policy Analysis

    ERIC Educational Resources Information Center

    Tuck, Eve; Gorlewski, Julie

    2016-01-01

    This article tells the story of an intervention by a collective of teacher educators on New York State's adoption of edTPA. Too often in education policy analysis, issues of race are discussed briefly, if at all. This article argues that attending to constructions of race specific to settler colonialism is an important approach to education policy…

  8. ED QUEST: A Process for Linking Environmental Changes with Strategic Management. [Revised].

    ERIC Educational Resources Information Center

    Morrison, James L.; Mecca, Thomas V.

    Educational Quick Environmental Scanning Technique (ED QUEST) is a process designed to identify emerging issues and events that indicate potential threats and opportunities to educational organizations, to analyze the probable impact of these variables on the organization, and to facilitate the development of appropriate organizational strategies.…

  9. PAD4, LSD1 and EDS1 regulate drought tolerance, plant biomass production, and cell wall properties.

    PubMed

    Szechyńska-Hebda, Magdalena; Czarnocka, Weronika; Hebda, Marek; Bernacki, Maciej J; Karpiński, Stanisław

    2016-03-01

    Arabidopsis and poplar with modified PAD4, LSD1 and EDS1 genes exhibit successful growth under drought stress. The acclimatory strategies depend on cell division/cell death control and altered cell wall composition. The increase of plant tolerance towards environmental stresses would open much opportunity for successful plant cultivation in these areas that were previously considered as ineligible, e.g. in areas with poor irrigation. In this study, we performed functional analysis of proteins encoded by PHYTOALEXIN DEFICIENT 4 (PAD4), LESION SIMULATING DISEASE 1 (LSD1) and ENHANCED DISEASE SUSCEPTIBILITY 1 (EDS1) genes to explain their role in drought tolerance and biomass production in two different species: Arabidopsis thaliana and Populus tremula × tremuloides. Arabidopsis mutants pad4-5, lsd1-1, eds1-1 and transgenic poplar lines PAD4-RNAi, LSD1-RNAi and ESD1-RNAi were examined in terms of different morphological and physiological parameters. Our experiments proved that Arabidopsis PAD4, LSD1 and EDS1 play an important role in survival under drought stress and regulate plant vegetative and generative growth. Biomass production and acclimatory strategies in poplar were also orchestrated via a genetic system of PAD4 and LSD1 which balanced the cell division and cell death processes. Furthermore, improved rate of cell division/cell differentiation and altered physical properties of poplar wood were the outcome of PAD4- and LSD1-dependent changes in cell wall structure and composition. Our results demonstrate that PAD4, LSD1 and EDS1 constitute a molecular hub, which integrates plant responses to water stress, vegetative biomass production and generative development. The applicable goal of our research was to generate transgenic plants with regulatory mechanism that perceives stress signals to optimize plant growth and biomass production in semi-stress field conditions.

  10. Sex and age differences in ED patients with mental and behavioral disorders due to psychoactive substance use.

    PubMed

    Le Querrec, Fanny; Bounes, Vincent; Mestre, Maryse Lapeyre; Azema, Olivier; Longeaux, Nicolas; Gallart, Jean-Christophe

    2015-11-01

    The objectives of this study are to describe an emergency department (ED) adult population with the chief complaint of mental and behavioral disorders due to psychoactive substance use and to investigate sex- and age-related differences. We analyzed data (2009-2011) from the Regional Observatory of Emergency Medicine ORU-MiP (700000 patients per year) for all patients with a primary diagnosis of mental and behavioral disorders due to psychoactive substance use. Day data were weighted by the number of days in the year and expressed for 100000 inhabitants of the area. Pearson χ(2) test and Fisher tests were used. The Brown-Mood test was used to compare medians. Of the 1411597 ED visits analyzed, 20838 consults (1.3%) were for primary diagnosis of mental and behavioral disorders due to psychoactive substance use. The median age (interquartile range) was 41 (28-51) years; 69.5% were men. More women consulted the ED for sedative or hypnotic use (4.9% vs 1.5%, P < 10(-4)) than men, and more men consulted for alcohol consumption (93.5% vs 90%, P < 10(-4)) and cannabinoids (1.4% vs 1.0%, P < 10(-3)) than women. Young consumer visits dramatically increased during weekends (average of 88 visits a day per 100000 inhabitants vs 34 on Mondays to Thursdays). Another difference was found between young adults and middle-aged adults, with a peak in visits at 2 am and 9 pm respectively. Mental and behavioral disorders due to psychoactive substance use account for 1.3% of ED visits. Older people should be screened for chronic alcohol consumption. Our findings underscore the opportunity provided by the ED for screening and brief intervention in drug- and alcohol-related problems. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. RSV in adult ED patients: Do emergency providers consider RSV as an admission diagnosis?

    PubMed

    Binder, William; Thorsen, Jill; Borczuk, Pierre

    2017-08-01

    Respiratory Syncytial Virus (RSV) has been recognized for over half a century as a cause of morbidity in infants and children. Over the past 20years, data has emerged linking RSV as a cause of illness in adults resulting in 177,000 annual hospitalizations and up to 14,000 deaths among older adults. Characterize clinical variables in a cohort of adult RSV patients. We hypothesize that emergency physicians do not routinely consider RSV in the differential diagnosis (DDx) of influenza like illness. Observational study of all adult inpatients, age≥19, with a positive RSV swab ordered within 48h of their hospital visit, including their emergency department (ED) visit, and who initially presented to a university affiliated urban 100,000 annual visit emergency department from 2007 to 2014. A data collection form was created, and a single trained clinical research assistant abstracted demographic, clinical variables. ED providers were given credit for RSV DDx if an RSV swab was ordered as part of the diagnostic ED workup. 295 consecutive inpatients (mean age=66.5years, range, 19-97, 53% male) were RSV positive during the 7-year study period. 207 cases (70%) were age≥60. 76 (26%) had fever, 86 (29%) had O2sat <92% and 145 (49%) had wheezing. 279 patients required admission, 30 needed ICU stay and overall mortality was 12 patients (4%). Age≥60 was associated with overall mortality (p=0.09). There were 106 (36%) immunocompromised patients (23% transplant, 40% cancer, 33% steroid use) in the cohort. A diagnosis of RSV was considered in the ED in 105 (36%) of patients. Being immunocompromised, having COPD/asthma, O2sat <92, or wheezing did not alert the ED provider to order an RSV test. Adults can harbor RSV as this can lead to significant mobility and mortality, especially in individuals who are over the age of 60. RSV is not being considered in the DDx diagnosis, and this was especially surprising in the transplant/immunocompromised subgroups. Given antiviral treatment

  12. ENHANCED DISEASE SUSCEPTIBILITY 1 (EDS1) affects development, photosynthesis, and hormonal homeostasis in hybrid aspen (Populus tremula L. × P. tremuloides).

    PubMed

    Bernacki, Maciej Jerzy; Czarnocka, Weronika; Witoń, Damian; Rusaczonek, Anna; Szechyńska-Hebda, Magdalena; Ślesak, Ireneusz; Dąbrowska-Bronk, Joanna; Karpiński, Stanisław

    2018-04-25

    ENHANCED DISEASE SUSCEPTIBILITY 1 (EDS1) was first described as a protein involved in salicylic acid (SA)-, ethylene-, and reactive oxygen species (ROS)-dependent defense and acclimation responses. It is a molecular regulator of biotic and abiotic stress-induced programmed cell death. Its role is relatively well known in annual plants, such as Arabidopsis thaliana or Nicotiana benthamiana. However, little is known about its functions in woody plants. Therefore, in this study, we aimed to characterize the function of EDS1 in the Populus tremula L. × P. tremuloides hybrid grown for several seasons in the natural environment. We used two transgenic lines, eds1-7 and eds1-12, with decreased EDS1 expression levels in this study. The observed changes in physiological and biochemical parameters corresponded with the EDS1 silencing level. Both transgenic lines produced more lateral shoots in comparison to the wild-type (WT) plants, which resulted in the modification of tree morphology. Photosynthetic parameters, such as quantum yield of photosystem II (ϕPSII), photochemical and non-photochemical quenching (qP and NPQ, respectively), as well as chlorophyll content were found to be increased in both transgenic lines, which resulted in changes in photosynthetic efficiency. Our data also revealed lower foliar concentrations of SA and ROS, the latter resulting most probably from more efficient antioxidant system in both transgenic lines. In addition, our data indicated significantly decreased rate of leaf senescence during several autumn seasons. Transcriptomic analysis revealed deregulation of 2215 and 376 genes in eds1-12 and eds1-7, respectively, and also revealed 207 genes that were commonly deregulated in both transgenic lines. The deregulation was primarily observed in the genes involved in photosynthesis, signaling, hormonal metabolism, and development, which was found to agree with the results of biochemical and physiological tests. In general, our data proved

  13. Incidental findings of elevated random plasma glucose in the ED as a prompt for outpatient diabetes screening: a retrospective study.

    PubMed

    Friedman, Steven Marc; Vallipuram, Janaki; Baswick, Brenda

    2013-12-18

    To determine whether random plasma glucose (RPG) collected from patients without known impaired glucose metabolism (IGM) in the emergency department (ED) is a useful screen for diabetes or prediabetes. Retrospective cohort study. ED of a Canadian teaching hospital over 1 month. Adult patients in ED with RPG over 7 mmol/L were recruited for participation. Exclusion criteria included known diabetes, hospital admission and inability to consent. Participants were contacted by mail, encouraged to follow-up with their family physician (FP) for further testing and subsequently interviewed. The primary outcome measure was the proportion of patients in the ED with RPG over 7 mmol/L and no previous diagnosis of IGM who were diagnosed with diabetes or prediabetes after secondary testing by FP with oral glucose tolerance test or fasting plasma glucose (FPG). Secondary outcomes included patient characteristics (age, gender, body mass index and language) and (2) compliance with advice to seek an appropriate follow-up care. RPG was drawn on approximately one-third (33%, n=1149) of the 3470 patients in the ED in March 2010. RPG over 7 mmol/L was detected in 24% (n=278) of patients, and after first telephone follow-up, 32% (n=88/278) met the inclusion criteria and were advised to seek confirmatory testing. 41% (n=114/278) of patients were excluded for known diabetes. 73% of patients contacted (n=64/88) followed up with their FP. 12.5% (n=11/88) of patients had abnormal FPG, and of these 11% (n=10/88) were encouraged to initiate lifestyle modifications and 1% (n=1/88) was started on an oral hypoglycaemic agent. For 7% (n=6/88) of patients, FP's declined to do follow-up fasting blood work. Elevated RPG in the ED is useful for identification of patients at risk for IGM and in need of further diabetic screening. Emergency physicians should advise patients with elevated RPG to consider screening for diabetes. For ED screening to be successful, patient education and collaboration with

  14. Impact of prescription drug-monitoring program on controlled substance prescribing in the ED.

    PubMed

    McAllister, Matthew W; Aaronson, Patrick; Spillane, Joe; Schreiber, Mark; Baroso, Genelyn; Kraemer, Dale; Smotherman, Carmen; Gray-Eurom, Kelly

    2015-06-01

    In 2009, Florida initiated a statewide prescription drug-monitoring program (PDMP) to encourage safer prescribing of controlled substances and reduce drug abuse and diversion. Data supporting the utility of such programs in the emergency department (ED) is scarce. This study sought to determine the effect of PDMP data on controlled substance prescribing from the ED. In this pre-post study utilizing a historical control, pharmacists in the ED provided prescribers with a summary of the PDMP data for their patients. The number of controlled substances prescribed in the intervention group was compared with that prescribed in the historical control to determine if the intervention resulted in a change in the average number of controlled substance prescribed. Among the 710 patients evaluated, providing prescribers with PDMP data did not alter the average number of controlled substance per patient prescribed (0.23 controlled substances per patient in the historical control compared with 0.28 controlled substances per patient in the intervention group; 95% confidence interval [CI], -0.016 to 0.116; P = .125). All prescribers surveyed indicated that having PDMP data altered their controlled substance prescribing and felt more comfortable prescribing controlled substances. Although the results did not demonstrate a change in the average number of controlled substances prescribed when prescribers were provided with PDMP data, results from the survey indicate that prescribers felt the data altered their prescribing of controlled substances, and thus were more contented prescribing controlled substances. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. LinkEHR-Ed: a multi-reference model archetype editor based on formal semantics.

    PubMed

    Maldonado, José A; Moner, David; Boscá, Diego; Fernández-Breis, Jesualdo T; Angulo, Carlos; Robles, Montserrat

    2009-08-01

    To develop a powerful archetype editing framework capable of handling multiple reference models and oriented towards the semantic description and standardization of legacy data. The main prerequisite for implementing tools providing enhanced support for archetypes is the clear specification of archetype semantics. We propose a formalization of the definition section of archetypes based on types over tree-structured data. It covers the specialization of archetypes, the relationship between reference models and archetypes and conformance of data instances to archetypes. LinkEHR-Ed, a visual archetype editor based on the former formalization with advanced processing capabilities that supports multiple reference models, the editing and semantic validation of archetypes, the specification of mappings to data sources, and the automatic generation of data transformation scripts, is developed. LinkEHR-Ed is a useful tool for building, processing and validating archetypes based on any reference model.

  16. Quantification of cell cycle kinetics by EdU (5-ethynyl-2′-deoxyuridine)-coupled-fluorescence-intensity analysis

    PubMed Central

    Cabrita, Marisa; Bekman, Evguenia; Braga, José; Rino, José; Santus, Renè; Filipe, Paulo L.; Sousa, Ana E.; Ferreira, João A.

    2017-01-01

    We propose a novel single-deoxynucleoside-based assay that is easy to perform and provides accurate values for the absolute length (in units of time) of each of the cell cycle stages (G1, S and G2/M). This flow-cytometric assay takes advantage of the excellent stoichiometric properties of azide-fluorochrome detection of DNA substituted with 5-ethynyl-2′-deoxyuridine (EdU). We show that by pulsing cells with EdU for incremental periods of time maximal EdU-coupled fluorescence is reached when pulsing times match the length of S phase. These pulsing times, allowing labelling for a full S phase of a fraction of cells in asynchronous populations, provide accurate values for the absolute length of S phase. We characterized additional, lower intensity signals that allowed quantification of the absolute durations of G1 and G2 phases. Importantly, using this novel assay data on the lengths of G1, S and G2/M phases are obtained in parallel. Therefore, these parameters can be estimated within a time frame that is shorter than a full cell cycle. This method, which we designate as EdU-Coupled Fluorescence Intensity (E-CFI) analysis, was successfully applied to cell types with distinctive cell cycle features and shows excellent agreement with established methodologies for analysis of cell cycle kinetics. PMID:28465489

  17. Buyer Beware: Lessons Learned from EdTPA Implementation in New York State

    ERIC Educational Resources Information Center

    Greenblatt, Deborah; O'Hara, Kate E.

    2015-01-01

    As states across the country continue their implementation of the Teacher Performance Assessment Portfolio (edTPA), a complex and high-stakes certification requirement for teacher certification, there are important lessons for educators and education advocates to learn from New York State's implementation. As Linda Darling-Hammond, developer and…

  18. Breakers, Benders, and Obeyers: Inquiring into Teacher Educators' Mediation of edTPA

    ERIC Educational Resources Information Center

    Ratner, Andrew R.; Kolman, Joni S.

    2016-01-01

    This article reflects a qualitative exploratory inquiry into the lived experiences of faculty members working within a system of urban schools of education as they supported diverse teacher candidates in completing the Educative Teacher Performance Assessment (edTPA) during its first semesters of high-stakes implementation. Drawing upon…

  19. Stakeholder Perspectives. Proceedings of the Ed-ICT International Network Symposium (Dawson College Montreal, Quebec, Canada, May 30-Jun 1, 2017)

    ERIC Educational Resources Information Center

    Jorgensen, Mary; Fichten, Catherine; King, Laura; Havel, Alice

    2018-01-01

    The purpose of these conference proceedings is to provide an in-depth understanding of what was presented and discussed at the Ed-ICT International Network Montreal Symposium: Stakeholder Perspectives. The focus of the Ed-ICT International Network is to explore the role that information and communication technologies (ICTs)--including computers,…

  20. ESSEA On-Line Courses and the WestEd Eisenhower Regional Consortium (WERC)

    NASA Astrophysics Data System (ADS)

    Rognier, E.

    2001-12-01

    The WestEd Eisenhower Regional Consortium (WERC) is in its second year of offering two Earth Systems Science On-line Graduate courses from IGES - one for High School teachers, and one for Middle School teachers. These high-quality courses support WERC's commitment to "supporting increased scientific and mathematical literacy among our nation's youth through services and other support aimed at enhancing the efforts of those who provide K-12 science and mathematics education." WERC has been able to use its EdGateway online community network to offer these courses to environmental education and science teachers nationwide. Through partnerships with the North American Association for Environmental Education (NAAEE), the National Environmental Education Advancement Project (NEEAP), and other regional, state and local science and environmental education organizations, WERC has a broad reach in connecting with science educators nationwide. WERC manages several state and national listservs, which enable us to reach thousands of educators with information about the courses. EdGateway also provides a private online community in which we offer the courses. WERC partners with two Master Teachers from Utah, who facilitate the courses, and with the Center for Science and Mathematics Education at Weber State University, who provides low-cost graduate credit for the courses. Our students have included classroom teachers from upper elementary through high school, community college science teachers, and environmental science center staff who provide inservice for teachers. Educators from Hawaii to New Jersey have provided diverse personal experiences of Earth Systems Science events, and add richness to the online discussions. Two Earth Science Experts, Dr. Rick Ford from Weber State University, and Dr. Art Sussman from WestEd also contribute to the high caliber of learning the students experience in the courses. (Dr. Sussman's book, Dr. Art's Guide to Planet Earth, is used as one of

  1. Testing the effects of educational toilet posters: a novel way of reducing haemolysis of blood samples within ED.

    PubMed

    Corkill, David

    2012-02-01

    Haemolysed blood samples are an unnecessary burden on Emergency Departments (ED) as they increase workloads and drive down efficiencies. Little empirical data exists that demonstrates the effectiveness of educational posters displayed in staff toilet cubicles. This study explored the impact educational toilet posters have on reducing haemolysis rates within the ED. A time series study of the clinical effect of educational toilet posters on reducing haemolysis rates throughout a 12 month period at the Gold Coast Hospital ED was undertaken. The GCH ED is a tertiary emergency service that has approximately 66,000 patient presentations per year. Data was collected prospectively. Analysis was undertaken to investigate the effects on total number of haemolysed samples and those clinically significant samples with a haemolytic index >3. Further investigation explored the specific effects on medical and nursing staff. Analysis undertaken using an independent t-test found that the pre-intervention data demonstrates a medium haemolysis rate of 4.92% (SD=1.04). This is a statistically significantly different (t=3.56, df=50, p=0.001) from the median post intervention data of 3.95% (SD=0.84). The difference of 0.97% (95%CI=0.42, 1.52) represents a 19.72% reduction in clinically significant haemolysed samples over the study period. This study reveals that the use of educational toilet posters had a positive impact on reducing the rates of haemolysed samples collected within the ED. This simple and cost effective educational initiative changed the behaviour of clinical staff. Further investigation is warranted to examine the impact of educational toilet posters on additional clinical scenarios. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  2. Impact of Curricular Reforms on Educational Philosophy Courses in M.Ed Programmes

    ERIC Educational Resources Information Center

    Gafoor, K. Abdul; Remia, K. R.

    2014-01-01

    In the context of Vision of Teacher Education envisaged in National Curriculum Framework for Teacher Education, this study probes "Do M.Ed programmes provide for the prerequisites of educational philosophy for teacher educators?" and "whether the syllabi following credit and non credit pattern vary in their coverage of content of…

  3. Do new workforce roles reduce waiting times in ED? A difference-in-difference evaluation using hospital administrative data.

    PubMed

    Scott, Anthony; Yong, Jongsay

    2015-04-01

    This paper evaluates the effect of introducing two new workforce roles under a pilot program conducted in Victoria, Australia. The trial took place at a regional hospital's emergency department (ED) between 1 July 2008 and 30 June 2009. The evaluation is based on three outcome measures: waiting time (in minutes) at ED before treatment; proportion of presentations with waiting time on target; and length of stay (in days), for ED presentations that led to in-patient admissions. The technique of difference-in-differences analysis is used. A total of 142,980 patient records from the pilot hospital and three comparison hospitals were extracted from the Victorian Emergency Minimum Dataset (VEMD). Further, 21,925 records of patients whose ED presentations led to in-patient admissions were extracted from the Victorian Admitted Episodes Dataset (VAED). The evaluation finds the piloted roles have lowered waiting time and raised the proportion of on-target presentations. These effects were found to be the strongest for less urgent triage categories. However, the evidence on in-patient length of stay was mixed. The results provide positive evidence that new workforce roles can be effective in improving the efficiency of emergency care delivery. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Anisakiasis presenting to the ED: clinical manifestations, time course, hematologic tests, computed tomographic findings, and treatment.

    PubMed

    Takabayashi, Takeshi; Mochizuki, Toshiaki; Otani, Norio; Nishiyama, Kei; Ishimatsu, Shinichi

    2014-12-01

    The prevalence of anisakiasis is rare in the United States and Europe compared with that in Japan, with few reports of its presentation in the emergency department (ED). This study describes the clinical, hematologic, computed tomographic (CT) characteristics, and treatment in gastric and small intestinal anisakiasis patients in the ED. We retrospectively reviewed the data of 83 consecutive anisakiasis presentations in our ED between 2003 and 2012. Gastric anisakiasis was endoscopically diagnosed with the Anisakis polypide. Small intestinal anisakiasis was diagnosed based on both hematologic (Anisakis antibody) and CT findings. Of the 83 cases, 39 had gastric anisakiasis and 44 had small intestinal anisakiasis based on our diagnostic criteria. Although all patients had abdominal pain, the gastric anisakiasis group developed symptoms significantly earlier (peaking within 6 hours) than the small intestinal anisakiasis group (peaking within 48 hours), and fewer patients with gastric anisakiasis needed admission therapy (5% vs 57%, P<.01). All patients in the gastric and 40 (91%) in the small intestinal anisakiasis group had a history of raw seafood ingestion. Computed tomographic findings revealed edematous wall thickening in all patients, and ascites and phlegmon of the mesenteric fat were more frequently observed in the small intestinal anisakiasis group. In the ED, early and accurate diagnosis of anisakiasis is important to treat and explain to the patient, and diagnosis can be facilitated by a history of raw seafood ingestion, evaluation of the time-to-symptom development, and classic CT findings. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. PathEdEx - Uncovering High-explanatory Visual Diagnostics Heuristics Using Digital Pathology and Multiscale Gaze Data.

    PubMed

    Shin, Dmitriy; Kovalenko, Mikhail; Ersoy, Ilker; Li, Yu; Doll, Donald; Shyu, Chi-Ren; Hammer, Richard

    2017-01-01

    Visual heuristics of pathology diagnosis is a largely unexplored area where reported studies only provided a qualitative insight into the subject. Uncovering and quantifying pathology visual and nonvisual diagnostic patterns have great potential to improve clinical outcomes and avoid diagnostic pitfalls. Here, we present PathEdEx, an informatics computational framework that incorporates whole-slide digital pathology imaging with multiscale gaze-tracking technology to create web-based interactive pathology educational atlases and to datamine visual and nonvisual diagnostic heuristics. We demonstrate the capabilities of PathEdEx for mining visual and nonvisual diagnostic heuristics using the first PathEdEx volume of a hematopathology atlas. We conducted a quantitative study on the time dynamics of zooming and panning operations utilized by experts and novices to come to the correct diagnosis. We then performed association rule mining to determine sets of diagnostic factors that consistently result in a correct diagnosis, and studied differences in diagnostic strategies across different levels of pathology expertise using Markov chain (MC) modeling and MC Monte Carlo simulations. To perform these studies, we translated raw gaze points to high-explanatory semantic labels that represent pathology diagnostic clues. Therefore, the outcome of these studies is readily transformed into narrative descriptors for direct use in pathology education and practice. PathEdEx framework can be used to capture best practices of pathology visual and nonvisual diagnostic heuristics that can be passed over to the next generation of pathologists and have potential to streamline implementation of precision diagnostics in precision medicine settings.

  6. Involvement of citizens in hazardous waste management and use of recycling centres in the city of Madrid (Spain).

    PubMed

    Díaz, María José; Martínez, Elvira; Piñeiro, Concepción; Palavecinos, Mireya; Benayas, Javier; Toribio, M Angeles

    2012-07-01

    In Spain, hazardous household waste management by citizens occurs via fixed recycling centres (FRC) and mobile recycling centres (MRC) which usually depend on local governments. This paper addresses a request by the Madrid City Council, in an attempt to improve the service it provides to the city of Madrid. The aim of the study involved analysing the information people possess in relation to hazardous waste and to the use of available equipment, and conducting a post-evaluation of the effectiveness of an environmental communication campaign conducted by the Madrid City Council and aimed at providing awareness of the existence of new FRCs and MRCs. To this end, a questionnaire was conducted with 5644 inhabitants of the city of Madrid. Qualitative data was categorized using content analysis followed by chi-squared tests, considering some socio-demographic characteristics of the sample, such as age or place of residence (district). Communication campaigns influenced citizen awareness of what constituted hazardous waste, of how to properly separate waste and of the existence of FRCs and MRCs. However, few citizens actually used FRCs or MRC (18% across four districts), a fact that might be related to a lack of knowledge of downstream waste treatment issues, or to self-limiting hindrances to householders, such as distance to recycling centres. It is recommended that future communication campaigns investigate householder needs and pre-conceptions in relation to recycling, as well as tailored education aimed at addressing the barriers, perceived or otherwise, facing citizens.

  7. "They Shouldn't Be Coming to the ED, Should They?": A Descriptive Service Evaluation of Why Patients With Palliative Care Needs Present to the Emergency Department.

    PubMed

    Green, Emilie; Ward, Sarah; Brierley, Will; Riley, Ben; Sattar, Henna; Harris, Tim

    2017-12-01

    Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED. This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period. Demographic and clinical data were collected from electronic health records. A total of 105 patients made 112 presentations to the ED. The 2 most common presenting complaints were shortness of breath (35%) and pain (28%). Eighty-three percent of presentations required care in the ED according to a priori defined criteria. They either underwent urgent investigation or received immediate interventions that could not be delivered in another setting, were referred by a health-care professional, or were admitted. Findings challenge the misconception that patients known to a palliative care team should be cared for outside the ED. The importance and necessity of the ED for patients in their last years of life has been highlighted, specifically in terms of managing acute, unpredictable crises. Future service provision should not be based solely on a patient's presenting complaint. Further qualitative research exploring patient perspective is required in order to explore the decision-making process that leads patients with palliative care needs to the ED.

  8. ED services: the impact of caring behaviors on patient loyalty.

    PubMed

    Liu, Sandra S; Franz, David; Allen, Monette; Chang, En-Chung; Janowiak, Dana; Mayne, Patricia; White, Ruth

    2010-09-01

    This article describes an observational study of caring behaviors in the emergency departments of 4 Ascension Health hospitals and the impact of these behaviors on patient loyalty to the associated hospital. These hospitals were diverse in size and geography, representing 3 large urban community hospitals in metropolitan areas and 1 in a midsized city. Research assistants from Purdue University (West Lafayette, IN) conducted observations at the first study site and validated survey instruments. The Purdue research assistants trained contracted observers at the subsequent study sites. The research assistants conducted observational studies of caregivers in the emergency departments at 4 study sites using convenience sampling of patients. Caring behaviors were rated from 0 (did not occur) to 5 (high intensity). The observation included additional information, for example, caregiver roles, timing, and type of visit. Observed and unobserved patients completed exit surveys that recorded patient responses to the likelihood-to-recommend (loyalty) questions, patient perceptions of care, and demographic information. Common themes across all study sites emerged, including (1) the area that patients considered most important to an ED experience (prompt attention to their needs upon arrival to the emergency department); (2) the area that patients rated as least positive in their actual ED experience (prompt attention to their needs upon arrival to the emergency department); (3) caring behaviors that significantly affected patient loyalty (eg, making sure that the patient is aware of care-related details, working with a caring touch, and making the treatment procedure clearly understood by the patient); and (4) the impact of wait time to see a caregiver on patient loyalty. A number of correlations between caring behaviors and patient loyalty were statistically significant (P < .05) at all sites. The study results raised considerations for ED caregivers, particularly with regard

  9. GESTATIONAL EXPOSURE TO ETHANE DIMETHANESULFONATE (EDS) ALTERS DEVELOPMENT OF THE MOUSE TESTIS

    EPA Science Inventory

    GESTATIONAL EXPOSURE TO ETHANE DIMETHANESULFONATE (EDS) ALTERS DEVELOPMENT OF THE MOUSE TESTIS. D.K. Tarka*1,2, J.D. Suarez*2, N.L. Roberts*2, J.M. Rogers*1,2, M.P. Hardy3, and G.R. Klinefelter1,2. 1University of North Carolina, Curriculum in Toxicology, Chapel Hill, NC; 2USEPA,...

  10. ED physicians group ousted, sues--power struggle with CEO blamed.

    PubMed

    2007-07-01

    Serious contract problems with administration should never come as a surprise. The ED manager who is part of a physicians group should communicate regularly with key audiences within the hospital, and keep an ear to the ground for potential issues. Have routine meetings with senior administration, and work to gain a seat on the hospital's executive committee. Participate in community activities with hospital leadership, including family activities. Work to develop a professional working relationship with the nurse manager.

  11. The cost of fall related presentations to the ED: a prospective, in-person, patient-tracking analysis of health resource utilization.

    PubMed

    Woolcott, J C; Khan, K M; Mitrovic, S; Anis, A H; Marra, C A

    2012-05-01

    We prospectively collected data on elderly fallers to estimate the total cost of a fall requiring an Emergency Department presentation. Using data collected on 102 falls, we found the average cost per fall causing an Emergency Department presentation of $11,408. When hospitalization was required, the average cost per fall was $29,363. For elderly persons, falls are a major source of mortality, morbidity, and disability. Previous Canadian cost estimates of seniors' falls were based upon administrative data that has been shown to underestimate the incidence of falls. Our objective was to use a labor-intensive, direct observation patient-tracking method to accurately estimate the total cost of falls among seniors who presented to a major urban Emergency Department (ED) in Canada. We prospectively collected data from seniors (>70 years) presenting to the Vancouver General Hospital ED after a fall. We excluded individuals who where cognitively impaired or unable to read/write English. Data were collected on the care provided including physician assessments/consultations, radiology and laboratory tests, ED/hospital time, rehabilitation facility time, and in-hospital procedures. Unit costs of health resources were taken from a fully allocated hospital cost model. Data were collected on 101 fall-related ED presentations. The most common diagnoses were fractures (n = 33) and lacerations (n = 11). The mean cost of a fall causing ED presentation was $11,408 (SD: $19,655). Thirty-eight fallers had injuries requiring hospital admission with an average total cost of $29,363 (SD: $22,661). Hip fractures cost $39,507 (SD: $17,932). Among the 62 individuals not admitted to the hospital, the average cost of their ED visit was $674 (SD: $429). Among the growing population of Canadian seniors, falls have substantial costs. With the cost of a fall-related hospitalization approaching $30,000, there is an increased need for fall prevention programs.

  12. Improving timeliness for acute asthma care for paediatric ED patients using a nurse driven intervention: an interrupted time series analysis.

    PubMed

    Brown, Kathleen; Iqbal, Sabah; Sun, Su-Lin; Fritzeen, Jennifer; Chamberlain, James; Mullan, Paul C

    2016-01-01

    Asthma is the most common chronic paediatric disease treated in the emergency department (ED). Rapid corticosteroid administration is associated with improved outcomes, but our busy ED setting has made it challenging to achieve this goal. Our primary aim was to decrease the time to corticosteroid administration in a large, academic paediatric ED. We conducted an interrupted time series analysis for moderate to severe asthma exacerbations of one to 18 year old patients. A multidisciplinary team designed the intervention of a bedside nurse initiated administration of oral dexamethasone, to replace the prior system of a physician initiated order for oral prednisone. Our baseline and intervention periods were 12 month intervals. Our primary process measure was the time to corticosteroid administration. Other process measures included ED length of stay, admission rate, and rate of emesis. The balance measures included rate of return visits to the ED or clinic within five days, as well as the proportion of discharged patients who were admitted within five days. No special cause variation occurred in the baseline period. The mean time to corticosteroid administration decreased significantly, from 98 minutes in the baseline period to 59 minutes in the intervention period (p < 0.01), and showed special cause variation improvement within two months after the intervention using statistical process control methodology. We sustained the improvement and demonstrated a stable process. The intervention period had a significantly lower admission rate (p<0.01) and emesis rate (p<0.01), with no unforeseen harm to patients found with any of our balance measures. In summary, the introduction of a nurse initiated, standardized protocol for corticosteroid therapy for asthma exacerbations in a paediatric ED was associated with decreased time to corticosteroid administration, admission rates, and post-corticosteroid emesis.

  13. Facilitation of endoglin-targeting cancer therapy by development/utilization of a novel genetically engineered mouse model expressing humanized endoglin (CD105).

    PubMed

    Toi, Hirofumi; Tsujie, Masanori; Haruta, Yuro; Fujita, Kanako; Duzen, Jill; Seon, Ben K

    2015-01-15

    Endoglin (ENG) is a TGF-β coreceptor and essential for vascular development and angiogenesis. A chimeric antihuman ENG (hENG) monoclonal antibody (mAb) c-SN6j (also known as TRC105) shows promising safety and clinical efficacy features in multiple clinical trials of patients with various advanced solid tumors. Here we developed a novel genetically engineered mouse model to optimize the ENG-targeting clinical trials. We designed a new targeting vector that contains exons 4-8 of hENG gene to generate novel genetically engineered mice (GEMs) expressing functional human/mouse chimeric (humanized) ENG with desired epitopes. Genotyping of the generated mice confirmed that we generated the desired GEMs. Immunohistochemical analysis demonstrated that humanized ENG protein of the GEMs expresses epitopes defined by 7 of our 8 anti-hENG mAbs tested. Surprisingly the homozygous GEMs develop normally and are healthy. Established breast and colon tumors as well as metastasis and tumor microvessels in the GEMs were effectively suppressed by systemic administration of anti-hENG mAbs. Additionally, test result indicates that synergistic potentiation of antitumor efficacy can be induced by simultaneous targeting of two distinct epitopes by anti-hENG mAbs. Sorafenib and capecitabine also showed antitumor efficacy in the GEMs. The presented novel GEMs are the first GEMs that express the targetable humanized ENG. Test results indicate utility of the GEMs for the clinically relevant studies. Additionally, we generated GEMs expressing a different humanized ENG containing exons 5-6 of hENG gene, and the homozygous GEMs develop normally and are healthy. © 2014 UICC.

  14. Intimate partner violence and mental health symptoms in African American female ED patients.

    PubMed

    Houry, Debra; Kemball, Robin; Rhodes, Karin V; Kaslow, Nadine J

    2006-07-01

    Intimate partner violence (IPV) victims often seek care in the ED, whether for an injury from abuse or other sequelae such as mental health symptoms. The objective of the study was to assess whether depressive symptoms, posttraumatic stress disorder (PTSD), and suicidality were associated with physical, sexual, or emotional IPV in African American female ED patients and to determine if experiencing multiple types of abuse was associated with increased mental health symptoms. All eligible African American female patients were approached in the ED waiting room during study periods. Patients participated in the screening process via a computer kiosk. Questions regarding IPV and mental health symptoms were asked using validated tools. In this prospective cohort, 569 participated and 36% of those in a relationship in the past year (n=461) disclosed that there were victims of IPV in the past year. In the past year, 22% experienced recent physical abuse, 9% recent sexual abuse, and 32% recent emotional abuse. A Pearson correlation was conducted and showed that all mental health symptoms were positively correlated with each type of IPV and each type of mental health symptom category. Mental health symptoms increased significantly with amount of abuse: depression (odds ratio [OR], 5.9 for 3 types of abuse), PTSD (OR, 9.4 for 3), and suicidality (OR, 17.5 for 3). Emotional, sexual, and physical IPV were significantly associated with mental health symptoms. Each type of abuse was independently associated with depression, suicidality, and PTSD. Experiencing more than 1 type of abuse was also correlated with increased mental health symptoms.

  15. Bibliography on Cold Regions Science and Technology. Volume 52. Part 2,

    DTIC Science & Technology

    1998-12-01

    eng] 52-5087 spheric gases from antarctic ice cores. Gillaik, T., et al, in sediments and biota from four US arctic lakes. Allen-Gil, Study of the...1996,eng] 52-2678 52-690 Solomon , S., et at, [1997,eng] 52-879 Studies of cloud ice water path and optical thickness during Homogeneous ice...of clouds: a wave ota, D., et al, [1995,eng] 52-5364 flash rate. Solomon , R.C., [1997,eng] 52-1070 cloud case study . Ackerman, S.A., et al, [1998,eng

  16. A natural driven membrane process for brackish and wastewater treatment: photovoltaic powered ED and FO hybrid system.

    PubMed

    Zhang, Yang; Pinoy, Luc; Meesschaert, Boudewijn; Van der Bruggen, Bart

    2013-09-17

    In isolated locations, remote areas, or islands, potable water is precious because of the lack of drinking water treatment facilities and energy supply. Thus, a robust and reliable water treatment system based on natural energy is needed to reuse wastewater or to desalinate groundwater/seawater for provision of drinking water. In this work, a hybrid membrane system combining electrodialysis (ED) and forward osmosis (FO), driven by renewable energy (solar energy), denoted as EDFORD (ED-FO Renewable energy Desalination), is proposed to produce high-quality water (potable) from secondary wastewater effluent or brackish water. In this hybrid membrane system, feedwater (secondary wastewater effluent or synthetic brackish water) was drawn to the FO draw solution while the organic and inorganic substances (ions, compounds, colloids and particles) were rejected. The diluted draw solution was then pumped to the solar energy driven ED. In the ED unit, the diluted draw solution was desalted and high-quality water was produced; the concentrate was recycled to the FO unit and reused as the draw solution. Results show that the water produced from this system contains a low concentration of total organic carbon (TOC), carbonate, and cations derived from the feedwater; had a low conductivity; and meets potable water standards. The water production cost considering the investment for membranes and solar panel is 3.32 to 4.92 EUR m(-3) (for 300 days of production per year) for a small size potable water production system.

  17. Cops and docs: The challenges for ED physicians balancing the police, state laws, and EMTALA.

    PubMed

    Malcolm, Kristin E; Malcolm, James G; Wu, Daniel T; Spainhour, Kevin A; Race, Kevin P

    2017-10-01

    State laws are awash with discord concerning whether a police officer's request or court order necessarily obligates physicians to perform a body fluid analysis of an arrested, conscious, nonconsenting suspect. Police typically bring arrestees directly to the emergency department (ED), and federal courts have begun to wrestle with the implications of the Emergency Medical Treatment and Labor Act (EMTALA), which requires that anyone presenting to the ED be screened for treatment. Some state laws require health care providers to comply with any police request for lab analysis, while other states offer more leeway to physicians. Recent trends in federal case law interpreting EMTALA suggest that a medical screening exam is not required for patients brought by police specifically for a blood or urine sample unless either the arrestee requests medical care or a prudent observer would believe medical care was indicated. This article answers two questions: What happens when a police officer presents to the ED requesting service on behalf of an arrestee? What does EMTLA require of physicians in response? We survey current state statutes, review recent state and federal case law, describe example policies from various hospitals, and conclude with recommendations for hospital risk managers. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  18. From Curricular Alignment to the Culminating Project: The Peabody College Ed.D. Capstone

    ERIC Educational Resources Information Center

    Smrekar, Claire; McGraner, Kristin

    2009-01-01

    The Department of Leadership, Policy, and Organizations (LPO) at Peabody College, Vanderbilt University, recently replaced the conventional Ed.D. dissertation with a team-produced, client-consultant oriented, culminating report. This article describes the purpose and principles associated with the "capstone" project and describes the…

  19. Incidental findings of elevated random plasma glucose in the ED as a prompt for outpatient diabetes screening: a retrospective study

    PubMed Central

    Friedman, Steven Marc; Vallipuram, Janaki; Baswick, Brenda

    2013-01-01

    Objective To determine whether random plasma glucose (RPG) collected from patients without known impaired glucose metabolism (IGM) in the emergency department (ED) is a useful screen for diabetes or prediabetes. Design Retrospective cohort study. Setting ED of a Canadian teaching hospital over 1 month. Participants Adult patients in ED with RPG over 7 mmol/L were recruited for participation. Exclusion criteria included known diabetes, hospital admission and inability to consent. Participants were contacted by mail, encouraged to follow-up with their family physician (FP) for further testing and subsequently interviewed. Outcome measures The primary outcome measure was the proportion of patients in the ED with RPG over 7 mmol/L and no previous diagnosis of IGM who were diagnosed with diabetes or prediabetes after secondary testing by FP with oral glucose tolerance test or fasting plasma glucose (FPG). Secondary outcomes included patient characteristics (age, gender, body mass index and language) and (2) compliance with advice to seek an appropriate follow-up care. Results RPG was drawn on approximately one-third (33%, n=1149) of the 3470 patients in the ED in March 2010. RPG over 7 mmol/L was detected in 24% (n=278) of patients, and after first telephone follow-up, 32% (n=88/278) met the inclusion criteria and were advised to seek confirmatory testing. 41% (n=114/278) of patients were excluded for known diabetes. 73% of patients contacted (n=64/88) followed up with their FP. 12.5% (n=11/88) of patients had abnormal FPG, and of these 11% (n=10/88) were encouraged to initiate lifestyle modifications and 1% (n=1/88) was started on an oral hypoglycaemic agent. For 7% (n=6/88) of patients, FP's declined to do follow-up fasting blood work. Conclusions Elevated RPG in the ED is useful for identification of patients at risk for IGM and in need of further diabetic screening. Emergency physicians should advise patients with elevated RPG to consider screening for

  20. Using Ontological Engineering to Overcome AI-ED Problems: Contribution, Impact and Perspectives

    ERIC Educational Resources Information Center

    Mizoguchi, Riichiro; Bourdeau, Jacqueline

    2016-01-01

    This article reflects on the ontology engineering methodology discussed by the paper entitled "Using Ontological Engineering to Overcome AI-ED Problems" published in this journal in 2000. We discuss the achievements obtained in the last 10 years, the impact of our work as well as recent trends and perspectives in ontology engineering for…

  1. Arabidopsis thaliana DM2h (R8) within the Landsberg RPP1-like Resistance Locus Underlies Three Different Cases of EDS1-Conditioned Autoimmunity

    PubMed Central

    Garcia, Ana V.; Wagner, Christine; Choudhury, Sayan R.; Wang, Yiming; James, Geo Velikkakam; Griebel, Thomas; Alcázar, Ruben; Tsuda, Kenichi; Schneeberger, Korbinian; Parker, Jane E.

    2016-01-01

    Plants have a large panel of nucleotide-binding/leucine rich repeat (NLR) immune receptors which monitor host interference by diverse pathogen molecules (effectors) and trigger disease resistance pathways. NLR receptor systems are necessarily under tight control to mitigate the trade-off between induced defenses and growth. Hence, mis-regulated NLRs often cause autoimmunity associated with stunting and, in severe cases, necrosis. Nucleocytoplasmic ENHANCED DISEASE SUSCEPTIBILITY1 (EDS1) is indispensable for effector-triggered and autoimmune responses governed by a family of Toll-Interleukin1-Receptor-related NLR receptors (TNLs). EDS1 operates coincidently or immediately downstream of TNL activation to transcriptionally reprogram cells for defense. We show here that low levels of nuclear-enforced EDS1 are sufficient for pathogen resistance in Arabidopsis thaliana, without causing negative effects. Plants expressing higher nuclear EDS1 amounts have the genetic, phenotypic and transcriptional hallmarks of TNL autoimmunity. In a screen for genetic suppressors of nuclear EDS1 autoimmunity, we map multiple, independent mutations to one gene, DM2h, lying within the polymorphic DANGEROUS MIX2 cluster of TNL RPP1-like genes from A. thaliana accession Landsberg erecta (Ler). The DM2 locus is a known hotspot for deleterious epistatic interactions leading to immune-related incompatibilities between A. thaliana natural accessions. We find that DM2hLer underlies two further genetic incompatibilities involving the RPP1-likeLer locus and EDS1. We conclude that the DM2hLer TNL protein and nuclear EDS1 cooperate, directly or indirectly, to drive cells into an immune response at the expense of growth. A further conclusion is that regulating the available EDS1 nuclear pool is fundamental for maintaining homeostatic control of TNL immune pathways. PMID:27082651

  2. A retrospective cross-sectional study of patients treated in US EDs and ambulatory care clinics with sexually transmitted infections from 2001 to 2010.

    PubMed

    Ware, Chelsea E; Ajabnoor, Yasser; Mullins, Peter M; Mazer-Amirshahi, Maryann; Pines, Jesse M; May, Larissa

    2016-09-01

    Sexually transmitted infections (STIs) are commonly seen in the ambulatory health care settings such as emergency departments (EDs) and outpatient clinics. Our objective was to assess trends over time in the incidence and demographics of STIs seen in the ED and outpatient clinics compared with office-based clinics using the National Hospital Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey. This study was conducted using 10 years of National Hospital Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey data (2001-2010). We compared data from 2001-2005 to data from 2006-2010. Patients were included in analyses if they were 15 years and older and had an International Classification of Diseases, Ninth Revision code consistent with cervicitis, urethritis, chlamydia, gonorrhea, or trichomonas. We analyzed 82.4 million visits for STIs, with 16.5% seen in hospital-based EDs and 83.5% seen in office-based clinics between 2001 and 2010. Compared with patients seen in office-based clinics, ED patients were younger (P< .05), more likely to be male (P< .001) and nonwhite (P< .001), and less likely to have private insurance (P< .05). We found a significant increase in adolescent (15-18 years) ED visits (P< .05) from 2001-2015 to 2006-2010 and a decrease in adolescent and male STI visits in office-based settings (P< .05). Although patients with STI are most commonly seen in office-based clinics, EDs represent an important site of care. In particular, ED patients are relatively younger, male, and nonwhite, and less likely to be private insured. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Xu Bing, Ed Pien and Gu Xiong: Lost and Found in Translation

    ERIC Educational Resources Information Center

    Mahon, Patrick

    2008-01-01

    The works of contemporary artists Xu Bing, Ed Pien and Gu Xiong are involved in bringing to light some of the factors inherent in social, cultural and linguistic translation. In doing so, each artist is also engaged in the nuanced activity of moving between historical and contemporary aesthetic strategies in order to interrogate the way meaning is…

  4. Studying Learning in the Worldwide Classroom Research into edX's First MOOC

    ERIC Educational Resources Information Center

    Breslow, Lori; Pritchard, David E.; DeBoer, Jennifer; Stump, Glenda S.; Ho, Andrew D.; Seaton, Daniel T.

    2013-01-01

    "Circuits and Electronics" (6.002x), which began in March 2012, was the first MOOC developed by edX, the consortium led by MIT and Harvard. Over 155,000 students initially registered for 6.002x, which was composed of video lectures, interactive problems, online laboratories, and a discussion forum. As the course ended in June 2012,…

  5. Does the Broad Categories for the Diagnosis of Eating Disorders (BCD-ED) Scheme Reduce the Frequency of Eating Disorder not Otherwise Specified?

    PubMed Central

    Sysko, Robyn; Walsh, B. Timothy

    2010-01-01

    Objective This study evaluated whether the Broad Categories for the Diagnosis of Eating Disorders (BCD-ED) proposal (Walsh & Sysko, 2009) reduces the number of individuals who receive a DSM-IV eating disorder not otherwise specified (EDNOS) diagnosis. Method Individuals calling a tertiary care facility completed a brief telephone interview and were classified into a DSM-IV eating disorder category (anorexia nervosa, bulimia nervosa, EDNOS). Subsequently, the proposed DSM-5 criteria for eating disorders and the BCD-ED scheme were also applied. Results A total of 247 individuals with telephone interview data met criteria for an eating disorder, including 97 (39.3%) with an EDNOS. Of patients with an EDNOS diagnosis, 97.6% were re-classified using the BCD-ED scheme. Discussion The BCD-ED scheme has the potential to virtually eliminate the use of DSM-IV EDNOS; however, additional data are needed to document its validity and clinical utility. PMID:21997426

  6. SEM/EDS and optical microscopy analyses of microplastics in ocean trawl and fish guts.

    PubMed

    Wang, Zhong-Min; Wagner, Jeff; Ghosal, Sutapa; Bedi, Gagandeep; Wall, Stephen

    2017-12-15

    Microplastic particles from Atlantic and Pacific Ocean trawls, lab-fed fish guts and ocean fish guts have been characterized using optical microscopy and SEM/EDS in terms of size, morphology, and chemistry. We assessed whether these measurements could serve as a rapid screening process for subsequent identification of the likely microplastic candidates by micro-spectroscopy. Optical microscopy enabled morphological classification of the types of particles or fibers present in the sample, as well as the quantification of particle size ranges and fiber lengths. SEM/EDS analysis was used to rule out non-plastic particles and screen the prepared samples for potential microplastic, based on their element signatures and surface characteristics. Chlorinated plastics such as polyvinyl chloride (PVC) could be easily identified with SEM/EDS due to their unique elemental signatures including chlorine, as could mineral species that are falsely identified as plastics by optical microscopy. Particle morphology determined by optical microscopy and SEM suggests the fish ingested particles contained both degradation fragments from larger plastic pieces and also manufactured microplastics. SEM images of microplastic particle surfaces revealed characteristic cracks consistent with environmental exposure, as well as pigment particles consistent with manufactured materials. Most of the microplastic surfaces in the fish guts and ocean trawls were covered with biofilms, radiolarians, and crustaceans. Many of the fish stomachs contained micro-shell pieces which visually resembled microplastics. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Preservice Teachers' Adaptations to Tensions Associated with the edTPA during Its Early Implementation in New York and Washington States

    ERIC Educational Resources Information Center

    Meuwissen, Kevin W.; Choppin, Jeffrey M.

    2015-01-01

    The edTPA is a teaching performance assessment (TPA) that the states of New York and Washington implemented as a licensure requirement in 2013. While TPAs are not new modes of assessment, New York and Washington are the first states to use the edTPA specifically as a compulsory, high-stakes policy lever in an effort to strengthen the quality and…

  8. Applying the ED QUEST Planning Model in a School of Management: A Case Study.

    ERIC Educational Resources Information Center

    Ptaszynski, James Garner; Morrison, James L.

    1990-01-01

    The Strategic Planning Committee at the Graduate School of Management, Wake Forest University, identified what issues, trends, and possible events might affect the school in the future. The implementation of the ED QUEST planning model is described. (MLW)

  9. The Ed Media Center: A Second Life Professional Development Model for Relational Aesthetics

    ERIC Educational Resources Information Center

    Julian, June; Crooks, Julian Glynn

    2014-01-01

    The Ed Media Center in Second Life provides multiple professional development opportunities for art educators to explore the educational potential of virtual worlds together. Since it's launch in 2009, it has hosted numerous events that address contemporary students' learning preferences and that enable artists and art educators to become…

  10. APA Reporting Standards in Quantitative Research Dissertations from an Online EdD Program

    ERIC Educational Resources Information Center

    Salgado, Griselle

    2013-01-01

    This study was an investigation of the reporting practices in dissertations with quantitative research designs produced by students enrolled in an online Doctor of Education (EdD) program, one that follows the American Psychological Association (APA) standards for reporting research. Limited, empirical information exists about the competencies in…

  11. Escherichia coli Probiotic Strain ED1a in Pigs Has a Limited Impact on the Gut Carriage of Extended-Spectrum-β-Lactamase-Producing E. coli

    PubMed Central

    Mourand, G.; Paboeuf, F.; Fleury, M. A.; Jouy, E.; Bougeard, S.; Denamur, E.

    2016-01-01

    ABSTRACT Four trials were conducted to evaluate the impact of Escherichia coli probiotic strain ED1a administration to pigs on the gut carriage or survival in manure of extended-spectrum-β-lactamase-producing E. coli. Groups of pigs were orally inoculated with strain E. coli M63 carrying the blaCTX-M-1 gene (n = 84) or used as a control (n = 26). In the first two trials, 24 of 40 E. coli M63-inoculated pigs were given E. coli ED1a orally for 6 days starting 8 days after oral inoculation. In the third trial, 10 E. coli M63-inoculated pigs were given either E. coli ED1a or probiotic E. coli Nissle 1917 for 5 days. In the fourth trial, E. coli ED1a was given to a sow and its 12 piglets, and these 12 piglets plus 12 piglets that had not received E. coli ED1a were then inoculated with E. coli M63. Fecal shedding of cefotaxime-resistant Enterobacteriaceae (CTX-RE) was studied by culture, and blaCTX-M-1 genes were quantified by PCR. The persistence of CTX-RE in manure samples from inoculated pigs or manure samples inoculated in vitro with E. coli M63 with or without probiotics was studied. The results showed that E. coli M63 and ED1a were good gut colonizers. The reduction in the level of fecal excretion of CTX-RE in E. coli ED1a-treated pigs compared to that in nontreated pigs was usually less than 1 log10 CFU and was mainly observed during the probiotic administration period. The results obtained with E. coli Nissle 1917 did not differ significantly from those obtained with E. coli ED1a. CTX-RE survival did not differ significantly in manure samples with or without probiotic treatment. In conclusion, under our experimental conditions, E. coli ED1a and E. coli Nissle 1917 could not durably prevent CTX-RE colonization of the pig gut. PMID:27795372

  12. Escherichia coli Probiotic Strain ED1a in Pigs Has a Limited Impact on the Gut Carriage of Extended-Spectrum-β-Lactamase-Producing E. coli.

    PubMed

    Mourand, G; Paboeuf, F; Fleury, M A; Jouy, E; Bougeard, S; Denamur, E; Kempf, I

    2017-01-01

    Four trials were conducted to evaluate the impact of Escherichia coli probiotic strain ED1a administration to pigs on the gut carriage or survival in manure of extended-spectrum-β-lactamase-producing E. coli Groups of pigs were orally inoculated with strain E. coli M63 carrying the bla CTX-M-1 gene (n = 84) or used as a control (n = 26). In the first two trials, 24 of 40 E. coli M63-inoculated pigs were given E. coli ED1a orally for 6 days starting 8 days after oral inoculation. In the third trial, 10 E. coli M63-inoculated pigs were given either E. coli ED1a or probiotic E. coli Nissle 1917 for 5 days. In the fourth trial, E. coli ED1a was given to a sow and its 12 piglets, and these 12 piglets plus 12 piglets that had not received E. coli ED1a were then inoculated with E. coli M63. Fecal shedding of cefotaxime-resistant Enterobacteriaceae (CTX-RE) was studied by culture, and bla CTX-M-1 genes were quantified by PCR. The persistence of CTX-RE in manure samples from inoculated pigs or manure samples inoculated in vitro with E. coli M63 with or without probiotics was studied. The results showed that E. coli M63 and ED1a were good gut colonizers. The reduction in the level of fecal excretion of CTX-RE in E. coli ED1a-treated pigs compared to that in nontreated pigs was usually less than 1 log 10 CFU and was mainly observed during the probiotic administration period. The results obtained with E. coli Nissle 1917 did not differ significantly from those obtained with E. coli ED1a. CTX-RE survival did not differ significantly in manure samples with or without probiotic treatment. In conclusion, under our experimental conditions, E. coli ED1a and E. coli Nissle 1917 could not durably prevent CTX-RE colonization of the pig gut. Copyright © 2016 American Society for Microbiology.

  13. PathEdEx – Uncovering High-explanatory Visual Diagnostics Heuristics Using Digital Pathology and Multiscale Gaze Data

    PubMed Central

    Shin, Dmitriy; Kovalenko, Mikhail; Ersoy, Ilker; Li, Yu; Doll, Donald; Shyu, Chi-Ren; Hammer, Richard

    2017-01-01

    Background: Visual heuristics of pathology diagnosis is a largely unexplored area where reported studies only provided a qualitative insight into the subject. Uncovering and quantifying pathology visual and nonvisual diagnostic patterns have great potential to improve clinical outcomes and avoid diagnostic pitfalls. Methods: Here, we present PathEdEx, an informatics computational framework that incorporates whole-slide digital pathology imaging with multiscale gaze-tracking technology to create web-based interactive pathology educational atlases and to datamine visual and nonvisual diagnostic heuristics. Results: We demonstrate the capabilities of PathEdEx for mining visual and nonvisual diagnostic heuristics using the first PathEdEx volume of a hematopathology atlas. We conducted a quantitative study on the time dynamics of zooming and panning operations utilized by experts and novices to come to the correct diagnosis. We then performed association rule mining to determine sets of diagnostic factors that consistently result in a correct diagnosis, and studied differences in diagnostic strategies across different levels of pathology expertise using Markov chain (MC) modeling and MC Monte Carlo simulations. To perform these studies, we translated raw gaze points to high-explanatory semantic labels that represent pathology diagnostic clues. Therefore, the outcome of these studies is readily transformed into narrative descriptors for direct use in pathology education and practice. Conclusion: PathEdEx framework can be used to capture best practices of pathology visual and nonvisual diagnostic heuristics that can be passed over to the next generation of pathologists and have potential to streamline implementation of precision diagnostics in precision medicine settings. PMID:28828200

  14. The correlation between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED): results from a survey in males from Mexico City (MexiLUTS).

    PubMed

    Gonzalez-Sanchez, Benjamin; Cendejas-Gomez, Jesus; Alejandro Rivera-Ramirez, J; Herrera-Caceres, Jaime O; Olvera-Posada, Daniel; Villeda-Sandoval, Christian I; Castillejos-Molina, Ricardo A; Feria-Bernal, Guillermo; Garcia-Mora, Arturo; Rodriguez-Covarrubias, Francisco

    2016-07-01

    ED and LUTS affect a high proportion of male population. Although Hispanics are suspected to have a higher risk of experiencing LUTS, detailed information on its frequency and association with ED in this population is scarce. To determine the frequency of LUTS and ED, and its correlation in Mexican males. A cross-sectional analytical survey was answered by 1041 men. It included the International Prostate Symptom Score and the quality of life question (IPSS/QoL); International Index of Erectile Function (IIEF-5); the short form of the International Consultation of Incontinence Questionnaire (ICIQ-SF); and demographic data. For the analysis, we divided our population into 2 groups (18-39 and 40 and older), and then an exploratory correlation analysis was performed to search for significant differences among IPSS severity groups, and finally a multivariate regression model was applied. Mean age was 48.6 ± 14.5 years. One hundred twenty-three individuals (11.8 %) were asymptomatic, and 611 (58.7 %) had mild, 226 (21.7 %) had moderate, and 81 (7.8 %) had severe IPSS score. The most common symptoms were nocturia (72.4 %), increased urinary frequency (58.3 %), and slow urinary stream (42.6 %). Two hundred fifty-eight (24.7 %) complained of incontinence. Of 765 individuals, 484(63.2 %) reported some degree of ED. Severe LUTS, DM, and age were independent risk factors for ED severity. LUTS and ED may represent one of the largest sources of morbidity in our population, and their association was demonstrated. Awareness on these entities should be raised, and further research is required to determine the higher frequency of LUTS and ED in Hispanics.

  15. Right to know: reducing risks of fecal pathogen exposure for ED patients and staff.

    PubMed

    Delaney, Molly Bridget

    2014-07-01

    The purpose of this article is to review the literature regarding the multiple challenges that contribute to ED bedside toileting and examine best practices that will reduce fecal exposure, cross-contamination among patients, and employee splash injuries. We searched the Cumulative Index to Nursing and Allied Health Literature, MEDLINE, and Cochrane database for information about the multiple challenges involved in bedside toileting, using the following search terms: bedside toileting, gastroenteritis, macerator, sluice machine, fecal pathogen exposure, and splash injury. In addition, costs and benefits of reusable versus disposable bedside toileting equipment were compared and contrasted. Emergency departments have a higher exposure rate to fecal pathogens with current methods of bedside toileting. Short incubation periods may not allow the proper lead time needed for patients to access primary care providers. As a result, emergency departments and urgent care centers become a likely point of entry into the health care system. Although most inpatient rooms have built-in bathrooms, most emergency departments and outpatient examination rooms do not. Although many patients are ambulatory, restrictive monitoring equipment is required. For safety reasons, staff must bring toileting equipment to the bedsides of both ambulatory and non-ambulatory patients. Hopper dependence creates longer walking distances and delays. These delays may lead to incontinence events, skin breakdown, more frequent bed changes, and higher linen and labor costs. Reusable bedside toileting equipment is associated with at-risk behaviors. Examples are procrastination and sanitization shortcuts. These behaviors risk cross-contamination of patients especially when urgent situations require equipment to be reused in the interim. ED patients and staff are 5 times more likely to undergo fecal exposure. The 5 phases of ED bedside toileting at which risks occur are as follows: equipment setup, transport

  16. The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals.

    PubMed

    Raup, Glenn H

    2008-10-01

    Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.

  17. The ED-inpatient dashboard: Uniting emergency and inpatient clinicians to improve the efficiency and quality of care for patients requiring emergency admission to hospital.

    PubMed

    Staib, Andrew; Sullivan, Clair; Jones, Matt; Griffin, Bronwyn; Bell, Anthony; Scott, Ian

    2017-06-01

    Patients who require emergency admission to hospital require complex care that can be fragmented, occurring in the ED, across the ED-inpatient interface (EDii) and subsequently, in their destination inpatient ward. Our hospital had poor process efficiency with slow transit times for patients requiring emergency care. ED clinicians alone were able to improve the processes and length of stay for the patients discharged directly from the ED. However, improving the efficiency of care for patients requiring emergency admission to true inpatient wards required collaboration with reluctant inpatient clinicians. The inpatient teams were uninterested in improving time-based measures of care in isolation, but they were motivated by improving patient outcomes. We developed a dashboard showing process measures such as 4 h rule compliance rate coupled with clinically important outcome measures such as inpatient mortality. The EDii dashboard helped unite both ED and inpatient teams in clinical redesign to improve both efficiencies of care and patient outcomes. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  18. Morphological, chemical and structural characterisation of deciduous enamel: SEM, EDS, XRD, FTIR and XPS analysis.

    PubMed

    Zamudio-Ortega, C M; Contreras-Bulnes, R; Scougall-Vilchis, R J; Morales-Luckie, R A; Olea-Mejía, O F; Rodríguez-Vilchis, L E

    2014-09-01

    The purpose of this study was to characterise the enamel surface of sound deciduous teeth in terms of morphology, chemical composition, structure and crystalline phases. The enamel of 30 human deciduous teeth was examined by: Scanning Electron Microscopy (SEM), Energy Dispersive X-Ray Spectroscopy (EDS), X-ray Powder Diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), and X-ray Photoelectron Spectroscopy (XPS). Chemical differences between incisors and canines were statistically evaluated using the Mann-Whitney U test (p ≤ 0.05). Three enamel patterns were observed by SEM: 'mostly smooth with some groves', 'abundant microporosities' and 'exposed prisms'. The average Ca/P molar ratios were 1.37 and 1.03 by EDS and XPS, respectively. The crystallite size determined by XRD was 210.82 ± 16.78 Å. The mean ratio between Ca bonded to phosphate and Ca bonded to hydroxyl was approximately 10:1. The enamel of sound deciduous teeth showed two main patterns: 'mostly smooth with some groves' and 'abundant microporosities'. 'Exposed prisms' was a secondary pattern. There were slight variations among the Ca/P molar ratios found by EDS and XPS, suggesting differences in the mineral content from the enamel surface to the interior. The crystalline phases found in enamel were hydroxyapatite and carbonate apatite, with major type B than type A carbonate incorporation.

  19. The Ed.D. in Educational Leadership and Administration: The Students' and Alumni's Experiences

    ERIC Educational Resources Information Center

    Vera, Edith B.

    2012-01-01

    The doctoral experience unfolds many complexities and challenges for students, faculty, and institutions that contribute toward degree completion. The purpose of this study is to investigate the students' and alumni's experiences afforded by the Ed.D. in Educational Leadership and Administration at the University of Texas at El Paso (UTEP). The…

  20. Time to Grow: Year Two Report on ExpandED Schools. A TASC Report

    ERIC Educational Resources Information Center

    Traill, Saskia; Brohawn, Katie

    2014-01-01

    An analysis of data from the second year of The After-School Corporation's (TASC's) national demonstration of an expanded school day for elementary and middle school students shows that ExpandED Schools improved school culture, decreased rates of students' chronic absenteeism and helped students develop positive learning habits and attitudes.…

  1. 34 CFR 110.1 - What is the purpose of ED's age discrimination regulations?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What is the purpose of ED's age discrimination regulations? 110.1 Section 110.1 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR...

  2. Pain management trend of vaso-occulsive crisis (VOC) at a community hospital emergency department (ED) for patients with sickle cell disease.

    PubMed

    Inoue, Susumu; Khan, Isra'a; Mushtaq, Rao; Sanikommu, Srinivasa Reddy; Mbeumo, Carline; LaChance, Jenny; Roebuck, Michael

    2016-01-01

    Pain management at the emergency department (ED) for vaso-occulsive crisis (VOC) for patients with sickle cell disease has not been optimum, with a long delay in giving the initial analgesic. We conducted a retrospective survey over a 7-year period to determine our ED's timing in giving pain medication to patients with VOC as a quality improvement project. We compared different periods, children vs adults, and the influence of gender in the analgesic administration timing. This is a retrospective chart review of three different periods: (1) years 2007-2008, (2) years 2011-2012, and (3) year 2013. We extracted relevant information from ED records. Data were analyzed using Student t test, chi-square analysis, and the Kruskal-Wallis test. There was a progressive improvement in the time interval to the 1st analgesic over these three periods. Children received analgesics more quickly than adults in all periods. Male adult patients received pain medication faster than female adult patients, although initial pain scores were higher in female than in male patients. Progressively fewer pediatric patients utilized ED over these three periods, but no difference for adult patients was observed. The proportion of pediatric patients admitted to the hospital increased with each period. The progressive decrease in both the number of patients and the number of visits to the ED by children suggested that the collective number of VOC in children has decreased, possibly secondary to the dissemination of hydroxyurea use. We failed to observe the same trend in adult patients. The need for IV access, and ordering laboratory tests or imaging studies tends to delay analgesic administration. Delay in administration of the first analgesic was more pronounced for female adult patients than male adult patients in spite of their higher pain score. Health care providers working in ED should make conscious efforts to respect pain in women as well as pain in men. Though not proven from this study

  3. Softball injuries treated in US EDs, 1994 to 2010.

    PubMed

    Birchak, John C; Rochette, Lynne M; Smith, Gary A

    2013-06-01

    Softball is a popular participant sport in the United States. This study investigated the epidemiology of softball injuries with comparisons between children and adults. Data from the National Electronic Injury Surveillance System for patients 7 years and older treated in an emergency department (ED) for a softball injury from 1994 through 2010 were analyzed. An estimated 2107823 (95% confidence interval [CI], 1736417-2479229) patients were treated in US EDs for a softball injury during the 17-year study period. The annual number of injuries decreased by 23.0% from 1994 to 2010 (P < .001); however, during the last 6 years of the study, injuries increased by 11.7% (P = .008). The annual rate of softball injuries increased significantly during the study period (P = .035). The most commonly injured body regions were the hand/wrist (22.2%) and face (19.3%). Being hit by a ball was the most common mechanism of injury (52.4%) and accounted for most of face (89.6%) and head (75.7%) injuries. Injuries associated with running (relative risk, 2.36; 95% CI, 1.97-2.82) and diving for a ball (relative risk, 4.61; 95% CI, 3.50-6.09) were more likely to occur among adult than pediatric patients. To our knowledge, this is the first study to investigate softball injuries using a nationally representative sample. Softball is a common source of injury among children and adults. Increased efforts are needed to promote safety measures, such as face guards, mouth guards, safety softballs, and break-away bases, to decrease these injuries. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Mass Measurement - Skylab Student Experiment ED-74

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Vincent W. Converse of Rockford, Illinois proposed Skylab's student experiment ED-74, Mass Measurement, to measure mass in a weightless environment. This chart describes Converse's experiment. Mass is the quantity of matter in any object. The gravitational force between an object and the Earth is called weight, which is a result of the Earth's gravity acting upon the object's mass. Even though objects in Skylab were apparently weightless, their mass properties were unchanged. Measurement of mass is therefore an acceptable alternative to measurement of weight. The devices used in this experiment provided accurate mass measurements of the astronauts' weights, intakes, and body wastes throughout the missions. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  5. Arsenic and Old Mustard: Chemical Problems of Old Arsenical and 'Mustard' Munitions (Joseph F. Bunnett and Marian Mikotajczyk, Eds.)

    NASA Astrophysics Data System (ADS)

    Garrett, Benjamin

    1999-10-01

    technologies; and international obligations attendant to the Chemical Weapons Convention, which entered into force in 1997. Hermann Martens's presentation of German arsenical and mustard munitions and of technical approaches to their destruction is similarly detailed, thorough, and engaging. W. R. Cullen's chapter "Arsenic in the Environment" and Shigeru Maeda's chapter "Biotransformation of Arsenic in Freshwater Organisms" help place the problems associated with the arsenicals in their environmental context and, hence, should appeal to a large audiencenot merely those specialists dealing with chemical weapon destruction. The reports of the three discussion groupsYperite,3 Arsenicals, and Recovered Munitionsprovide useful summaries of current knowledge and needs for additional research. The Arsenicals report observes that "destruction of arsenical agents appears to have received little attention." This situation may change if searches in Washington, DC, should uncover caches of old arsenicals at CUA and, especially, when the governments of the People's Republic of China and Japan agree on funding for destruction of the chemical munitions Japan caused to be abandoned on what is now the territory of the PRC. A conservative estimate is that there are 2,000,000 of these abandoned munitions, most of them being arsenicals and mustards.4 Notes and References 1. Nieuwland (1878-1936) hired Rockne in 1914 as a chemistry instructor. According to Father Nieuwland, Rockne owed much of his prowess as one of the greatest coaches of all time to his training in chemistry, which taught him the method of reasoning (Ind. Eng. Chem. New Ed., April 20, 1931). W. Lee Lewis, Lewisite's eponym, credits Nieuwland's unpublished dissertation as the source for his 1918 synthesis (Lewis, W. L.; Perkins, G. A. The beta-Chlorovinyl Chloroarsines; Ind. Eng. Chem. 1923, 15, 290-295). Lewisite itself is actually the group of mono-, di-, and tri-substituted 2-chloroethenyl derivatives of arsenic(III) chloride

  6. Comparative Analgesic Efficacy of Oxycodone/Acetaminophen Versus Hydrocodone/Acetaminophen for Short-term Pain Management in Adults Following ED Discharge.

    PubMed

    Chang, Andrew K; Bijur, Polly E; Holden, Lynne; Gallagher, E John

    2015-11-01

    The objective was to test the hypothesis that oxycodone/acetaminophen provides superior analgesia to hydrocodone/acetaminophen for the treatment of acute extremity pain following emergency department (ED) discharge. This was a prospective, randomized, double-blind clinical trial of nonelderly adult ED patients with acute musculoskeletal extremity pain, randomly allocated at discharge to receive oxycodone/acetaminophen (5 mg/325 mg) or hydrocodone/acetaminophen (5 mg/325 mg). The primary outcome was the between-group difference in improvement in numerical rating scale (NRS) pain scores over a 2-hour period following the most recent ingestion of study drug, obtained during telephone contact 24 hours after ED discharge. Secondary outcomes included proportionate decrease in pain, comparative side-effect profiles, and patient satisfaction. A total of 240 patients were enrolled. The final sample consisted of 220 patients, 107 randomly allocated to oxycodone/acetaminophen and 113 to hydrocodone/acetaminophen. At 24 hours after ED discharge, the mean NRS pain scores prior to the most recent dose of outpatient pain medication were 7.8 and 7.9 in the oxycodone/acetaminophen and hydrocodone/acetaminophen groups, respectively. The mean decreases in pain scores over 2 hours were 4.4 NRS units in the oxycodone/acetaminophen group versus 4.0 NRS units in the hydrocodone/acetaminophen group, for a difference of 0.4 NRS units (95% confidence interval = -0.2 to 1.1 NRS units). Satisfaction with the analgesics was similar. This study design could not detect a clinically or statistically significant difference in analgesic efficacy between oxycodone/acetaminophen (5 mg/325 mg) and hydrocodone/acetaminophen (5 mg/325 mg) for treatment of acute musculoskeletal extremity pain in adults following ED discharge. Both opioids reduced pain scores by approximately 50%. © 2015 by the Society for Academic Emergency Medicine.

  7. Is there a misplaced focus on AmED? Associations between caffeine mixers and bar patron intoxication.

    PubMed

    Thombs, Dennis; Rossheim, Matthew; Barnett, Tracey E; Weiler, Robert M; Moorhouse, Michael D; Coleman, Blair N

    2011-07-01

    Previous research on alcohol mixed with energy drinks (AmED) suffers from measurement problems. Missing from the research literature are studies that assess caffeine-alcohol co-ingestion in natural drinking environments. This field study collected data in a U.S. college bar district from 328 randomly selected patrons. Anonymous data were obtained from face-to-face interviews and self-administered surveys, and from breath tests. Cola-caffeinated alcoholic beverage consumers left bars in a more highly intoxicated state than those who consumed alcohol only. There was no significant difference between the intoxication level of the AmED group and the cola-caffeinated alcoholic beverage group. Results from a multivariate regression model indicated that quantity of caffeinated alcoholic beverage consumption had a significant, positive association with bar patron intoxication after adjusting for potential confounders. Findings indicate that caffeine may have a dose-dependent relationship with alcohol intoxication in the bar/nightclub setting. In addition, results revealed that cola-caffeinated alcoholic drinks may pose similar levels of risk to bar patrons as those associated with AmED beverage consumption. Product labeling requirements about alcohol risks may need to be extended not only to energy drinks, but to caffeinated soft drinks as well. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  8. ED's Proposed Changes to SFSF Data Collection and Reporting Requirements: DQC's Submitted Comments

    ERIC Educational Resources Information Center

    Data Quality Campaign, 2011

    2011-01-01

    This letter is submitted to comment on the U.S. Department of Education's (ED) proposed revisions to the American Recovery and Reinvestment Act's (ARRA) State Fiscal Stabilization Fund (SFSF), as published in the September 23, 2011, Federal Register. Overall, the Data Quality Campaign believes the proposed changes strike a sensible balance: they…

  9. Developing Scientific Literacy Skills through Interdisciplinary, Technology-Based Global Simulations: GlobalEd 2

    ERIC Educational Resources Information Center

    Lawless, Kimberly A.; Brown, Scott W.

    2015-01-01

    GlobalEd 2 (GE2) is a set of technology-mediated, problem-based learning (PBL) simulations for middle-grade students, that capitalises on the multidisciplinary nature of the social sciences as an expanded curricular space for students to learn and apply scientific literacies and concepts, while simultaneously also enriching their understanding of…

  10. WORK-ED. (World of Related Knowledge and Educational Development). A Manual for Trainers.

    ERIC Educational Resources Information Center

    Fraleigh, Virginia A.

    This manual is designed to assist personnel responsible for training teachers in the implementation of the World of Related Knowledge and Educational Development (WORK-ED). (The program is a career education course for ninth graders developed to enable students who have not chosen the traditional college-prep high school course to make career…

  11. Comparative Analgesic Efficacy of Oxycodone/Acetaminophen vs Codeine/Acetaminophen for Short-Term Pain Management Following ED Discharge.

    PubMed

    Chang, Andrew K; Bijur, Polly E; Lupow, Jason B; Gallagher, E John

    2015-12-01

    To test the hypothesis that oxycodone/acetaminophen provides analgesia superior to codeine/acetaminophen following emergency department (ED) discharge. Prospective, randomized, double-blind, trial. Adult inner city ED. ED patients with acute extremity pain who were discharged home. Patients randomized to oxycodone/acetaminophen (5 mg/325 mg) or codeine/acetaminophen (30 mg/300 mg). The primary outcome, obtained via telephone one day after ED discharge, was the between-group difference in improvement in numerical rating scale (NRS) pain scores over a 2-hour period following the most recent ingestion of study drug. Secondary outcomes included proportion of patients with >50% pain reduction, side-effect profile, and patient satisfaction. Two hundred and forty patients were enrolled. Mean baseline NRS scores were 7.9 in both groups. Mean decrease over 2 hours was 4.5 NRS units in the oxycodone/acetaminophen group vs 4.2 NRS units in the codeine/acetaminophen group, for a clinically and statistically nonsignificant difference of 0.2 NRS units (95% CI -0.4-0.9 NRS units). Similarly, 66% vs 61% achieved >50% pain relief for a nonsignificant difference of 5% (95% CI -8% to 17%). Side-effect profile and patient satisfaction were similar. Our hypothesis that oxycodone/acetaminophen provides analgesia superior to codeine/acetaminophen was rejected. Although pain within each group was reduced by more than half, the between-group difference was not significant. Pending independent validation, these unexpected findings suggest that codeine/acetaminophen, a Schedule III agent, may be a clinically reasonable outpatient opioid alternative to oxycodone/acetaminophen, a more tightly restricted Schedule II agent thought to be more prone to misuse. Wiley Periodicals, Inc.

  12. Hepatitis C virus infection in the 1945-1965 birth cohort (baby boomers) in a large urban ED.

    PubMed

    Allison, Waridibo E; Chiang, William; Rubin, Ada; O'Donnell, Lauren; Saldivar, Miguel A; Maurantonio, Michael; Dela Cruz, Jeffrey; Duvidovich, Svetlana; Carmody, Ellie

    2016-04-01

    The US Preventive Services Task Force recommends one-time screening of the 1945-1965 birth cohort (baby boomers) for hepatitis C (HCV) infection. New York State legislation mandates screening of baby boomers for HCV in most patient care settings except the emergency department (ED). This cross-sectional study explores baby boomer knowledge of HCV, prevalence of HCV infection, and linkage to care from a large urban ED. Patients participated in a researcher-administered structured interview and were offered an HCV screening test. If HCV antibody reactive, a follow-up clinic appointment was made within 6 weeks. Reminder telephone calls were made a week before the appointment. Attendance at the follow-up appointment was considered successful linkage to care. A total of 915 eligible patients were approached between October 21, 2014, and July 13, 2015. A total of 427 patients participated in the structured interview; 383 agreed to an HCV rapid test. Prevalence of HCV antibody reactivity was 7.3%. Four patients were successfully linked to care. General knowledge about HCV was fair. Misconceptions about transmission were apparent. Beliefs that "if someone is infected with HCV they will most likely carry the virus all their lives unless treated" and that "someone with hepatitis can look and feel fine" were significantly associated with agreement to testing. Better linkage to care is needed to justify HCV screening in the 1945-1965 birth cohort in this particular ED setting. Linkage to care from the ED is challenging but can potentially be improved with specific measures including simplified screening algorithms and supportive resources. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Sell, Sell, Sell or Learn, Learn, Learn? The EdTech Market in New Zealand's Education System--Privatisation by Stealth?

    ERIC Educational Resources Information Center

    Wright, Noeline; Peters, Michael

    2017-01-01

    An article in "The Atlantic" "Quantifying the Ed-Tech Market" (2015), which draws on a review by the Education Technology Industry Network, reports that the U.S. Ed-tech market totalled $8.38 billion in the 2012-2013 academic year, which is up from $7.9 billion the year before, and up 11.7 per cent from 2009. K-12 online course…

  14. An Evidence-Based Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) Curriculum for Emergency Department (ED) Providers Improves Skills and Utilization

    ERIC Educational Resources Information Center

    Substance Abuse, 2007

    2007-01-01

    Objective: Emergency Departments (EDs) offer an opportunity to improve the care of patients with at-risk and dependent drinking by teaching staff to screen, perform brief intervention and refer to treatment (SBIRT). We describe here the implementation at 14 Academic EDs of a structured SBIRT curriculum to determine if this learning experience…

  15. Hemodynamic changes after propacetamol administration in patients with febrile UTI in the ED.

    PubMed

    Kang, Soo; Durey, Areum; Suh, Young Ju; Kim, Ah Jin

    2018-06-01

    Clinical studies have indicated that transient hypotension can occur after propacetamol administration. This study aimed to analyze the hemodynamic changes after propacetamol administration in patients visiting the ED due to febrile UTI. We also examined the incidence of propacetamol-induced hypotension and compared the clinical characteristics of patients with persistent hypotension, defined as requiring additional fluids or vasopressors, to those with transient hypotension. A retrospective analysis of the electronic medical records of patients who visited the ED between June 2015 and May 2016, were diagnosed with febrile UTI, and treated with propacetamol, was conducted. We included 195 patients in this study; of these, 87 (44.6%) showed hypotension. In all patients, significant decreases in systolic blood pressure (SBP; 135.06±20.45mmHg vs 117.70±16.41mmHg), diastolic blood pressure (DBP; 79.74±12.17mmHg vs 69.69±10.96mmHg), and heart rate (97.46±17.14mmHg vs 90.72±14.90mmHg) were observed after propacetamol administration. The basal SBP and DBP were higher in the hypotension than in the non-hypotension group (basal SBP: 144.4±22.3mmHg vs 127.6±15.3mmHg; basal DBP: 83.3±12.6mmHg vs 76.9±11.0mmHg). Patients with persistent hypotension had a lower baseline BP, which was not elevated despite fever, and a higher rate of bacteremia than those with transient hypotension. Although febrile UTI patients treated with propacetamol in the ED showed hemodynamic changes, these changes did not have a large effect on their prognosis. However, in patients who showed bacteremia or a normal initial BP despite fever, the possibility of developing persistent hypotension should be considered. Copyright © 2017. Published by Elsevier Inc.

  16. Low-intensity extracorporeal shock wave therapy--a novel effective treatment for erectile dysfunction in severe ED patients who respond poorly to PDE5 inhibitor therapy.

    PubMed

    Gruenwald, Ilan; Appel, Boaz; Vardi, Yoram

    2012-01-01

    Low-intensity shock wave therapy (LI-ESWT) has been reported as an effective treatment in men with mild and moderate erectile dysfunction (ED). The aim of this study is to determine the efficacy of LI-ESWT in severe ED patients who were poor responders to phosphodiesterase type 5 inhibitor (PDE5i) therapy. This was an open-label single-arm prospective study on ED patients with an erection hardness score (EHS) ≤ 2 at baseline. The protocol comprised two treatment sessions per week for 3 weeks, which were repeated after a 3-week no-treatment interval. Patients were followed at 1 month (FU1), and only then an active PDE5i medication was provided for an additional month until final follow-up visit (FU2). At each treatment session, LI-ESWT was applied on the penile shaft and crus at five different anatomical sites (300 shocks, 0.09 mJ/mm(2) intensity at 120 shocks/min). Each subject underwent a full baseline assessment of erectile function using validated questionnaires and objective penile hemodynamic testing before and after LI-ESWT. Outcome measures used are changes in the International Index of Erectile Function-erectile function domain (IIEF-ED) scores, the EHS measurement, and the three parameters of penile hemodynamics and endothelial function. Twenty-nine men (mean age of 61.3) completed the study. Their mean IIEF-ED scores increased from 8.8 ± 1 (baseline) to 12.3 ± 1 at FU1 (P = 0.035). At FU2 (on active PDE5i treatment), their IIEF-ED further increased to 18.8 ± 1 (P < 0.0001), and 72.4% (P < 0.0001) reached an EHS of ≥ 3 (allowing full sexual intercourse). A significant improvement (P = 0.0001) in penile hemodynamics was detected after treatment and this improvement significantly correlated with increases in the IIEF-ED (P < 0.05). No noteworthy adverse events were reported. Penile LI-ESWT is a new modality that has the potential to treat a subgroup of severe ED patients. These preliminary data need to be reconfirmed by multicenter sham control

  17. Culture, Knowledge and Power: What the Conservatives Have Learnt from E.D. Hirsch

    ERIC Educational Resources Information Center

    Yandell, John

    2017-01-01

    British Conservatives happily acknowledge the debt that they owe to E.D. Hirsch. To understand the nature of their curricular project, and how it is located within the wider goals of education and social policy, we need to attend carefully to the character of this transatlantic borrowing. Its emphases and omissions reveal much about the…

  18. Communicative Learning Outcomes and World Language edTPA: Characteristics of High-Scoring Portfolios

    ERIC Educational Resources Information Center

    Swanson, Pete; Hildebrandt, Susan A.

    2017-01-01

    Teacher accountability continues to be at the forefront of educational policy in the United States, with the current focus on the Outcomes of K-12 teaching and teacher education (Cochran-Smith 2000). edTPA, a high-stakes assessment used in many states to make licensure or certification decisions, purports to measure those content-specific…

  19. Assessing Risk for Future Firearms Violence in Young People Who Present to ED.

    PubMed

    2017-06-01

    A new clinical index tool designed specifically for the emergency environment predicts the risk for future firearms violence in young people 14-24 years of age. The approach employs a brief, 10-point instrument that can be administered in one to two minutes, according to investigators. They also note that while the tool is based on data from a single ED in Flint, Ml, the tool should be applicable to urban EDs in regions that have similar characteristics. To create the tool, investigators used data from the Flint Youth Injury Study, an investigation of a group of patients 14-24 years of age who reported using drugs in the previous six months and accessed care at a Level I trauma center. Using a machine learning classification approach, investigators combed through the data, finding that the most predictive factors for firearm violence could be categorized into four domains: peer and partner violence victimization, community violence exposure, peer/family influences, and fighting. Ideally, investigators note the tool will be employed along with interventions targeted toward patients at high risk for future firearms violence.

  20. Impact of seasonal and lunar cycles on psychological symptoms in the ED: an empirical investigation of widely spread beliefs.

    PubMed

    Belleville, Geneviève; Foldes-Busque, Guillaume; Dixon, Mélanie; Marquis-Pelletier, Evelyne; Barbeau, Sarah; Poitras, Julien; Chauny, Jean-Marc; Diodati, Jean G; Fleet, Richard; Marchand, André

    2013-01-01

    This study evaluates the impacts of seasonal and lunar cycles on anxiety and mood disorders, panic and suicidal ideation in patients consulting the emergency department (ED) with a complaint of unexplained chest pain (UCP). Patients with UCP were recruited from two EDs. Psychiatric diagnoses were evaluated with the Anxiety Disorders Interview Schedule for DSM-IV. Significant seasonal effects were observed on panic and anxiety disorders, with panic more frequently encountered during spring [odds ratio (OR)=1.378, 95% confidence interval (CI)=1.002-1.896] and anxiety disorders during summer (OR=1.586, 95% CI=1.037-2.425). Except for one significant finding, no significant effects of lunar cycles were observed. These findings encourage ED professionals and physicians to abandon their beliefs about the influence of lunar cycles on the mental health of their patients. Such unfounded beliefs are likely to be maintained by self-fulfilling prophecies. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. SNAP-Ed (Supplemental Nutrition Assistance Program-Education) Increases Long-Term Food Security among Indiana Households with Children in a Randomized Controlled Study.

    PubMed

    Rivera, Rebecca L; Maulding, Melissa K; Abbott, Angela R; Craig, Bruce A; Eicher-Miller, Heather A

    2016-11-01

    Food insecurity is negatively associated with US children's dietary intake and health. The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) aims to alleviate food insecurity by offering nutrition, budgeting, and healthy lifestyle education to low-income individuals and families. The objective of this study was to evaluate the long-term impact of the Indiana SNAP-Ed on food security among households with children. A randomized, controlled, parallel study design with SNAP-Ed as an intervention was carried out during a 4- to 10-wk intervention period. Intervention group participants received the first 4 Indiana SNAP-Ed curriculum lessons. Study participants (n = 575) were adults aged ≥18 y from low-income Indiana households with ≥1 child living in the household. Both treatment groups completed an assessment before and after the intervention period and 1 y after recruitment. The 18-item US Household Food Security Survey Module was used to classify the primary outcomes of food security for the household and adults and children in the household. A linear mixed model was used to compare intervention with control group effects over time on food security. Mean ± SEM changes in household food security score and food security score among household adults from baseline to 1-y follow-up were 1.2 ± 0.4 and 0.9 ± 0.3 units lower, respectively, in the intervention group than in the control group (P < 0.01). The mean change in food security score from baseline to 1-y follow-up among household children was not significantly different in the intervention group compared with the control group. SNAP-Ed improved food security over a longitudinal time frame among low-income Indiana households with children in this study. SNAP-Ed may be a successful intervention to improve food security. © 2016 American Society for Nutrition.

  2. Multicultural Teacher Education as a Community of Practice: M.Ed./PDS Graduates' Perceptions of Their Preparation to Work with Diverse Students

    ERIC Educational Resources Information Center

    Lee, Young Ah; Chen, Shwu-Meei; Chang, Chen-Ni; Yoneda, Fusako

    2017-01-01

    This study used qualitative case study methods to investigate how a particular community of practice located in a Midwest university influenced the M.Ed./PDS graduates' perceptions of working with diverse students. We use the term multicultural education to refer to the orientations and practices of the M.Ed. program and how the graduates thought…

  3. Segregation Behavior of Sulfur and Other Impurities Onto the Free Surfaces of ED-Ni Deposits

    NASA Technical Reports Server (NTRS)

    Panda, Binayak; Jerman, Gregory; Gentz, Steven J. (Technical Monitor)

    2000-01-01

    Most researchers attribute grain boundary embrittlement in electro-deposited Nickel (ED-Ni) to the presence of small quantities of Sulfur as an impurity. It occurs in a highly mobile form that segregates to the grain boundaries. Evaluation of Sulfur segregation requires that a sample be fractured through the grain boundaries. However, this action may not always be possible. ED-Ni is inherently tough at ambient temperature, especially if a low level of Sulfur was intentionally maintained. A new method was developed to study Sulfur and other migrant species to the grain boundaries, which also migrate to free surfaces. A test specimen is heated by a quartz lamp within the sample preparation chamber, allowing the mobile species to migrate to polished free surfaces. There the mobile species are analyzed using X-ray photoelectron spectroscopy (XPS) also known as Electron Spectroscopy for Chemical Analysis (ESCA).

  4. ED accreditation update. Physicians, medical staff may report safety concerns without fear of disciplinary action.

    PubMed

    2007-11-01

    Educating your staff about The Joint Commission's requirements for concerns about hospital safety and quality of care requires the ED manager to set a tone of openness and cooperation, while at the same time emphasizing your department's role in addressing such concerns: * The ED should be the first place that staff members communicate quality and safety concerns. It is only when a problem is not addressed that they should take the issue to hospital administration and, if necessary, The Joint Commission. * A single event should not trigger a report to The Joint Commission, unless it is unusually serious. Otherwise, only a series of events should trigger a report. * Reassure your staff that you care about what is reported and will act quickly on it. Educate your staff about the reporting forms, and follow up with random audits to ensure compliance.

  5. Segregation Behavior of Sulfur and Other Impurities onto the Free Surfaces of ED-NI Deposits

    NASA Technical Reports Server (NTRS)

    Panda, B.; Jerman, G.

    2001-01-01

    Most researchers attribute grain boundary embrittlement in electro-deposited nickel (ED-Ni) to the presence of small quantities of sulfur as an impurity. It occurs in a highly mobile form that segregates to the grain boundaries. Evaluation of sulfur segregation requires that a sample be fractured through the grain boundaries. However, this action may not always be possible. ED-Ni is inherently tough at ambient temperature, especially if a low level of sulfur was intentionally maintained. A new method was developed to study sulfur and other migrant species to the grain boundaries, which also migrate to free surfaces. A test specimen is heated by a quartz lamp within the sample preparation chamber, allowing the mobile species to migrate to polished free surfaces. There the mobile species are analyzed using X-ray photoelectron spectroscopy (XPS) also known as Electron Spectroscopy for Chemical Analysis (ESCA).

  6. Preventing avoidable incidents leading to a presentation to the emergency department (ED) by older adults with cognitive impairment: protocol for a scoping review

    PubMed Central

    Provencher, Véronique; Généreux, Mélissa; Gagnon-Roy, Mireille; Veillette, Nathalie; Egan, Mary; Sirois, Marie-Josée; Lacasse, Francis; Rose, Kathy; Stocco, Stéphanie

    2016-01-01

    Introduction Older adults with cognitive impairment represent a large portion (21–42%) of people (65+) who consult at an emergency department (ED). Because this sub-group is at higher risk for hospitalisation and mortality following an ED visit, awareness about ‘avoidable’ incidents should be increased in order to prevent presentations to the ED due to such incidents. This study aims to synthetise the actual knowledge related to ‘avoidable’ incidents (ie, traumatic injuries, poisoning and other consequences of external causes) (WHO, 2016) leading to ED presentations in older people with cognitive impairment. Methodology and analysis A scoping review will be performed. Scientific and grey literature (1996–2016) will be searched using a combination of key words pertaining to avoidable incidents, ED presentations, older adults and cognitive impairment. A variety of databases (MEDLINE, CINAHL, Ageline, SCOPUS, ProQuest Dissertations/theses, EBM Reviews, Healthstar), online library catalogues, governmental websites and published statistics will be examined. Included sources will pertain to community-dwelling older adults presenting to the ED as a result of an avoidable incident, with the main focus on those with cognitive impairment. Data (eg, type, frequency, severity, circumstances of incidents, preventive measures) will be extracted and analysed using a thematic chart and content analysis. Discussion and dissemination This scoping review will provide a picture of the actual knowledge on the subject and identify knowledge gaps in existing literature to be filled by future primary researches. Findings will help stakeholders to develop programmes in order to promote safe and healthy environments and behaviours aimed at reducing avoidable incidents in seniors, especially those with cognitive impairment. PMID:26873049

  7. MetEd Learning Resources from COMET: Assisting With User Readiness for the JPSS Era

    NASA Astrophysics Data System (ADS)

    Bol, A.; Page, E. M.; Dills, P. N.; Lee, T.; Weingroff, M.; Stevermer, A.

    2017-12-01

    The COMET® Program (www.comet.ucar.edu) is funded by NOAA NESDIS as well as EUMETSAT and the Meteorological Service of Canada to develop and deliver education and training in satellite meteorology. COMET's self-paced online training resources are freely available 24/7/365 via the MetEd Website (meted.ucar.edu) to help learners stay current regarding new instruments, capabilities, products and applications. Experts from NOAA-NESDIS and its Cooperative Institutes, the Meteorological Service of Canada, EUMETSAT, the Naval Research Laboratory and others, work with COMET staff to create lessons that encourage greater use of current and future satellite observations and products. As of fall 2017, over 90 satellite-focused, interactive lessons are available in English via the MetEd Web site at http://meted.ucar.edu/topics/satellite. Many of these lessons are also available in Spanish and French, with some Portuguese offerings also available, making learning resources more accessible to a larger international audience. This presentation will focus on COMET's satellite training offerings that are directly applicable to helping users learn more about the capabilities of the S-NPP and JPSS satellite series just in time for JPSS-1 becoming operational. MetEd's educational offerings include lessons on the VIIRS imager and its applications, and a recently updated lesson on nighttime visible observation using the VIIRS Day-Night Band. We'll show how the lessons introduce users to the advances these systems bring to forecasting, numerical weather prediction, and environmental monitoring. We'll also highlight newly developed lessons covering various aspects of JPSS for National Weather Service forecasters, and discuss current and future work.

  8. Hemispheric dispersion of radioactive plume laced with fission nuclides from the Fukushima nuclear event

    NASA Astrophysics Data System (ADS)

    Hsu, Shih-Chieh; Huh, Chih-An; Chan, Chuen-Yu; Lin, Shuen-Hsin; Lin, Fei-Jan; Liu, Shaw Chen

    2012-01-01

    Radioactivities of particulate 131I and 137Cs released from the Fukushima nuclear accident were monitored in a regional aerosol network including two high mountain sites (central Taiwan and Tibetan Plateau). The results were integrated with data measured elsewhere around the world, with special focus on the mid-latitudes. The hemispheric transport of the Fukushima radiation clouds (FRCs) by the westerlies took ˜18 days, displaying an exponential-like decrease eastward, with a dilution factor of at least five orders of magnitude following a full circuit around the globe. The initial two waves of FRCs may travel at different atitudes: the first one at ˜3-4 km, whereas the second one up to 5 km or more. 131I and 137Cs were fractionated during transport, with 137Cs concentrated in the shallower layer, susceptible to depositional removal, while 131I moving faster and higher. This accident may be exemplified to identify some atmospheric processes on the hemispheric scale.

  9. Seventeen Years of Using Flowable Resin Restoratives--A Dental Practitioner's Personal Clinical Review.

    PubMed

    Firla, Markus Th

    2015-04-01

    Seen through the author's eyes on the basis of his practising dentistry for almost three decades, light-activated flowable resin restoratives (FRCs) or, in common clinical dental terminology, flowable composites have gradually gained major importance in restorative dentistry. Inputs to this ongoing trend are coming from continuous improvements in material properties and the favourable handling characteristics experienced with this particular group of restoratives. Intended to be used in direct adhesive filling procedures, the number and variety of recent generations of flowable composites for lining, restoration of all cavity classes (I-V), core build-ups and, more recently, 'bulk-fill-restorations', however, necessitates a profound clinical understanding of the selective use of flowable composites to ensure clinical success and guarantee long-term high quality results. Clinical relevance: Today's flowable composites allow for reliable restoration of all kinds of defects. However, both the handling characteristics and the material properties of FRCs must be fully understood before taking advantage of their potentially excellent clinical performance.

  10. Evaluation of Ohio's EdChoice Scholarship Program: Selection, Competition, and Performance Effects

    ERIC Educational Resources Information Center

    Figlio, David; Karbownik, Krzysztof

    2016-01-01

    In June 2005, the State of Ohio enacted the Educational Choice Scholarship Program (EdChoice, initially called the Educational Choice Scholarship Pilot Program), which offered scholarships to students assigned to public schools considered consistently poor-performing by the Ohio Department of Education, to take effect during the 2006-07 academic…

  11. Examining Internet Access and Social Media Application Use for Online Nutrition Education in SNAP-Ed Participants in Rural Illinois.

    PubMed

    Loehmer, Emily; Smith, Sylvia; McCaffrey, Jennifer; Davis, Jeremy

    2018-01-01

    To examine Internet access and interest in receiving nutrition education via social media applications among low-income adults participating in the Supplemental Nutrition Assistance Program Education (SNAP-Ed). A cross-sectional survey was distributed during 25 SNAP-Ed classes throughout the 16 southernmost counties of Illinois. From 188 responses, the majority of participants had Internet access (76%). Among participants aged 18-32 years (n = 51), 92% owned a smartphone with Internet access and 57% indicated that they would use online nutrition education, with most interest in e-mail (41%), Facebook (40%), and text messaging (35%). There was little interest in using blogs, Vine, Twitter, Tumblr, and Pinterest. Overall, 49% of middle-aged adults aged 33-64 years and 87% of seniors aged ≥65 years reported they would not use online nutrition education. Results indicated similar Internet accessibility in southern Illinois among low-income populations compared with national rural rates. Interest in using online nutrition education varied among SNAP-Ed participants according to age. Young adults appeared to be the most captive audience regarding online nutrition education. Results may be useful to agencies implementing SNAP-Ed to supplement current curriculum with online nutrition education for audiences aged ≤32 years. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  12. Risk factors associated with methicillin-resistant Staphylococcus aureus infection in patients admitted to the ED.

    PubMed

    Viallon, Alain; Marjollet, Olivier; Berthelot, Philippe; Carricajo, Anne; Guyomarc'h, Stéphane; Robert, Florianne; Zeni, Fabrice; Bertrand, Jean Claude

    2007-10-01

    The objective of our study was to define the characteristics of patients admitted to the emergency department (ED) presenting with a methicillin-resistant Staphylococcus aureus (MRSA) infection. The study included all patients admitted to the ED between January 2003 and December 2004 in whom a staphylococcal infection was documented. The risk factors associated with carriage of MRSA, the diagnosis made in the ED, and the treatment administered were established from the patients' medical files. The sites from which the bacteria were isolated, the spectrum of resistance of the staphylococci to different antibiotics, and the presence or absence of the gene coding for Panton-Valentin leukocidin for certain S aureus isolates were determined from the reports issued by the bacteriologic department. Two groups of patients were compared: those with an infection caused by MRSA and those with an infection due to methicillin-susceptible S aureus (MSSA). A total of 238 patients were included, 93 presenting with an infection caused by MRSA and 145 an infection due to MSSA. The patients harboring MRSA had a higher median age than those carrying MSSA (74 vs 61 years, P = .0001), experienced a greater loss of autonomy (according to the Knauss index), and had more comorbidity factors. Nine patients, younger than 40 years, presented with an infection due to MRSA in the absence of any comorbidity factor or any factor associated with carriage of these bacteria. Seven patients in the MRSA group were tested for Panton-Valentine leukocidin genes, and a positive result was obtained in 2 of them. Regardless of whether the infection was caused by MRSA or by MSSA, the bacteria were most frequently isolated from a cutaneous site, in 40% and 65% of the patients, respectively. Irrespective of the group, 28% of the patients presented with bacteremia. The spectrum of resistance of these MRSA strains suggested a hospital rather than community origin. The initial antibiotic therapy was rarely

  13. Effect of shape and thickness of asbestos bundles and fibres on EDS microanalysis: A Monte Carlo simulation

    NASA Astrophysics Data System (ADS)

    Moro, D.; Valdre, G.

    2016-02-01

    Quantitative microanalysis of tiny asbestos mineral fibres by scanning electron microscopy equipped with energy-dispersive X-ray spectroscopy (SEM-EDS) still represents a complex analytical issue. This complexity arises from the variable fibre shape and small thickness (< 5 μm) compared with the penetration of the incident electron beam. Here, we present the results of Monte Carlo simulations of chrysotile, crocidolite and amosite fibres (and bundles of fibres) of circular and square section and thicknesses from 0.1 μm to 10 μm, to investigate the effect of shape and thickness on SEM-EDS microanalysis. The influence of shape and thickness on the simulated spectrum was investigated for electron beam energies of 5, 15 and 25 keV, respectively. A strong influence of the asbestos bundles and fibres shape and thickness on the detected EDS X-ray intensity was observed. The X-ray intensity trends as a function of fibre thickness showed a non-linear dependence for all the elements and minerals. In general, the X-ray intensities showed a considerable reduction for thicknesses below about 5 μm at 5 keV, 2 μm at 15 keV, and 5 μm at 25 keV. Correction parameters, k-ratios, for the asbestos fibre thickness effect, are reported.

  14. In-situ XRD and EDS method study on the oxidation behaviour of Ni-Cu sulphide ore.

    PubMed

    Li, Guangshi; Cheng, Hongwei; Xiong, Xiaolu; Lu, Xionggang; Xu, Cong; Lu, Changyuan; Zou, Xingli; Xu, Qian

    2017-06-12

    The oxidation mechanism of sulfides is the key issue during the sulphide-metallurgy process. In this study, the phase transformation and element migration were clearly demonstrated by in-situ laboratory-based X-ray diffraction (XRD) and energy-dispersive X-ray spectroscopy (EDS), respectively. The reaction sequence and a four-step oxidation mechanism were proposed and identified. The elemental distribution demonstrated that at a low temperature, the Fe atoms diffused outward and the Ni/Cu atoms migrated toward the inner core, whereas the opposite diffusion processes were observed at a higher temperature. Importantly, the unique visual presentation of the oxidation behaviour provided by the combination of in-situ XRD and EDS might be useful for optimising the process parameters to improve the Ni/Cu extraction efficiency during Ni-Cu sulphide metallurgy.

  15. The Field Assessment Stroke Triage for Emergency Destination (FAST-ED): a Simple and Accurate Pre-Hospital Scale to Detect Large Vessel Occlusion Strokes

    PubMed Central

    Lima, Fabricio O.; Silva, Gisele S.; Furie, Karen L.; Frankel, Michael R.; Lev, Michael H.; Camargo, Érica CS; Haussen, Diogo C.; Singhal, Aneesh B.; Koroshetz, Walter J.; Smith, Wade S.; Nogueira, Raul G.

    2016-01-01

    Background and Purpose Patients with large vessel occlusion strokes (LVOS) may be better served by direct transfer to endovascular capable centers avoiding hazardous delays between primary and comprehensive stroke centers. However, accurate stroke field triage remains challenging. We aimed to develop a simple field scale to identify LVOS. Methods The FAST-ED scale was based on items of the NIHSS with higher predictive value for LVOS and tested in the STOPStroke cohort, in which patients underwent CT angiography within the first 24 hours of stroke onset. LVOS were defined by total occlusions involving the intracranial-ICA, MCA-M1, MCA-2, or basilar arteries. Patients with partial, bi-hemispheric, and/or anterior + posterior circulation occlusions were excluded. Receiver operating characteristic (ROC) curve, sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of FAST-ED were compared with the NIHSS, Rapid Arterial oCclusion Evaluation (RACE) scale and Cincinnati Prehospital Stroke Severity Scale (CPSSS). Results LVO was detected in 240 of the 727 qualifying patients (33%). FAST-ED had comparable accuracy to predict LVO to the NIHSS and higher accuracy than RACE and CPSS (area under the ROC curve: FAST-ED=0.81 as reference; NIHSS=0.80, p=0.28; RACE=0.77, p=0.02; and CPSS=0.75, p=0.002). A FAST-ED ≥4 had sensitivity of 0.60, specificity 0.89, PPV 0.72, and NPV 0.82 versus RACE ≥5 of 0.55, 0.87, 0.68, 0.79 and CPSS ≥2 of 0.56, 0.85, 0.65, 0.78, respectively. Conclusions FAST-ED is a simple scale that if successfully validated in the field may be used by medical emergency professionals to identify LVOS in the pre-hospital setting enabling rapid triage of patients. PMID:27364531

  16. Preventing avoidable incidents leading to a presentation to the emergency department (ED) by older adults with cognitive impairment: protocol for a scoping review.

    PubMed

    Provencher, Véronique; Généreux, Mélissa; Gagnon-Roy, Mireille; Veillette, Nathalie; Egan, Mary; Sirois, Marie-Josée; Lacasse, Francis; Rose, Kathy; Stocco, Stéphanie

    2016-02-12

    Older adults with cognitive impairment represent a large portion (21-42%) of people (65+) who consult at an emergency department (ED). Because this sub-group is at higher risk for hospitalisation and mortality following an ED visit, awareness about 'avoidable' incidents should be increased in order to prevent presentations to the ED due to such incidents. This study aims to synthetise the actual knowledge related to 'avoidable' incidents (ie, traumatic injuries, poisoning and other consequences of external causes) (WHO, 2016) leading to ED presentations in older people with cognitive impairment. A scoping review will be performed. Scientific and grey literature (1996-2016) will be searched using a combination of key words pertaining to avoidable incidents, ED presentations, older adults and cognitive impairment. A variety of databases (MEDLINE, CINAHL, Ageline, SCOPUS, ProQuest Dissertations/theses, EBM Reviews, Healthstar), online library catalogues, governmental websites and published statistics will be examined. Included sources will pertain to community-dwelling older adults presenting to the ED as a result of an avoidable incident, with the main focus on those with cognitive impairment. Data (eg, type, frequency, severity, circumstances of incidents, preventive measures) will be extracted and analysed using a thematic chart and content analysis. This scoping review will provide a picture of the actual knowledge on the subject and identify knowledge gaps in existing literature to be filled by future primary researches. Findings will help stakeholders to develop programmes in order to promote safe and healthy environments and behaviours aimed at reducing avoidable incidents in seniors, especially those with cognitive impairment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Laboratory sample turnaround times: do they cause delays in the ED?

    PubMed

    Gill, Dipender; Galvin, Sean; Ponsford, Mark; Bruce, David; Reicher, John; Preston, Laura; Bernard, Stephani; Lafferty, Jessica; Robertson, Andrew; Rose-Morris, Anna; Stoneham, Simon; Rieu, Romelie; Pooley, Sophie; Weetch, Alison; McCann, Lloyd

    2012-02-01

    Blood tests are requested for approximately 50% of patients attending the emergency department (ED). The time taken to obtain the results is perceived as a common reason for delay. The objective of this study was therefore to investigate the turnaround time (TAT) for blood results and whether this affects patient length of stay (LOS) and to identify potential areas for improvement. A time-in-motion study was performed at the ED of the John Radcliffe Hospital (JRH), Oxford, UK. The duration of each of the stages leading up to receipt of 101 biochemistry and haematology results was recorded, along with the corresponding patient's LOS. The findings reveal that the mean time for haematology results to become available was 1 hour 6 minutes (95% CI: 29 minutes to 2 hours 13 minutes), while biochemistry samples took 1 hour 42 minutes (95% CI: 1 hour 1 minute to 4 hours 21 minutes), with some positive correlation noted with the patient LOS, but no significant variation between different days or shifts. With the fastest 10% of samples being reported within 35 minutes (haematology) and 1 hour 5 minutes (biochemistry) of request, our study showed that delays can be attributable to laboratory TAT. Given the limited ability to further improve laboratory processes, the solutions to improving TAT need to come from a collaborative and integrated approach that includes strategies before samples reach the laboratory and downstream review of results. © 2010 Blackwell Publishing Ltd.

  18. Confirmatory factor analysis and psychometric properties of the Yale-Brown-Cornell Eating Disorders Scale Self-Report version (SR-YBC-EDS) in Spanish clinical and non-clinical samples.

    PubMed

    Perpiñá, Conxa; Giraldo-O'Meara, Martha; Roncero, María; Martínez-Gómez, Mónica

    2015-04-01

    The aim of the study was to adapt and validate the Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS) transformed into a self-report format in Spanish clinical and non-clinical samples. Eighty-three eating disordered patients and 358 non-clinical participants completed the Self Report-YBC-EDS version (SR-YBC-EDS), the Eating Attitudes Test (EAT), and the Penn State Worry Questionnaire (PSWQ). Confirmatory factor analyses of a two-factor second-order model showed adequate values of goodness-of-fit indices for non-clinical (normed χ(2)=13.4578; df =18; NFI=0.980; GFI=1.00; RMSEA=0.00) and clinical samples (normed χ(2)=26.5913; df =18; NFI=0.944; GFI=0.981; RMSEA=0.076). The factor loadings were high (preoccupations range: 0.69-0.91; rituals range: 0.61-0.94). Cronbach's alpha (range α=0.85-0.90) and test-retest 2weeks later (range: 0.84-0.91) were excellent in both samples. SR-YBC-EDS showed moderate-high indices of convergent validity with PSWQ and EAT. For the total score, a cutoff of 13 showed a sensitivity of 90.4%, a specificity of 91.6%, and a diagnostic accuracy of 91.4%. Positive and negative predictive values were excellent (71.4% and 97.6%, respectively). Findings indicate that the SR-YBC-EDS is a reliable and valid instrument to identify symptoms and assess the severity of ED, and it can be used as a faster and less costly alternative to the YBC-EDS interview. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. JPRS Report, Science & Technology, Japan, 1987 S&T Paper

    DTIC Science & Technology

    1988-08-26

    council recommended in its report increasing the amount of subsidies for scientific research, vitalizing the scientific research systems at...activities that have recently been progressing in Japan. Greatest importance was attached to "the development of an effective means of preventing cancer...natter COKPENDEX (Engineering —Civil enginsering, environmental eng, —Hetal, resource eng —Hechanical eng. —ChBnical, agric . eng —Agricultural, nana

  20. 43 Management of acute low back pain in the ED: a systematic review.

    PubMed

    Ashbrook, Jane; Rodgdakis, Nikos; Goodwin, Peter; Yeowell, Gill; Callaghan, Michael

    2017-12-01

    There is no consensus on the management of low back pain in the ED and evidence suggests that these patients are likely to receive unwarranted imaging and inappropriate opioid prescription.The purpose of this study is to review the available literature pertaining to the clinical management of acute low back pain in the ED. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines were observed during this review.Trials were included if the population studied were adults with acute low back pain in an emergency setting. All diagnostic tests and therapeutic interventions were evaluated.Methodological quality and risk of bias was appraised using the Downs and Black checklist. 19 articles were identified including 1896 patients that were sub-grouped according to management.In the pharmacological subgroup corticosteroids were effective in patients with radicular pain, NSAIDs were as effective as other medication with less adverse events, Phenyramidol was not superior to placebo, promethazine and morhpine combined was not more effective than morphine alone and ketamine was no more effective than morphine but had a worse adverse effect profile.In the emergency transport group TENS and active warming both showed effects in reducing pain, anxiety and heart rate.In the physical therapy management group less pain and greater satisfaction were reported.In the adjunct interventions group showed a trend towards pain reduction in the use of heat/ice packs and short term pain relief in acupuncture and auricular acupuncture. More high quality trials are needed to determine an evidence-based management protocol for the treatment of acute low back pain in the ED. © 2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.