Simultaneous calibrations of Voyager celestial and inertial attitude control systems in flight

NASA Technical Reports Server (NTRS)

Jahanshahi, M. H.

1982-01-01

A mathematical description of the data reduction technique used to simultaneously calibrate the Voyager celestial and inertial attitude control subsystems is given. It is shown that knowledge of the spacecraft limit cycle motion, as measured by the celestial and the inertial sensors, is adequate to result in the estimates of a selected number of errors which adversely affect the spacecraft attitude knowledge.

[Comparative quality measurements part 3: funnel plots].

PubMed

Kottner, Jan; Lahmann, Nils

2014-02-01

Comparative quality measurements between organisations or institutions are common. Quality measures need to be standardised and risk adjusted. Random error must also be taken adequately into account. Rankings without consideration of the precision lead to flawed interpretations and enhances "gaming". Application of confidence intervals is one possibility to take chance variation into account. Funnel plots are modified control charts based on Statistical Process Control (SPC) theory. The quality measures are plotted against their sample size. Warning and control limits that are 2 or 3 standard deviations from the center line are added. With increasing group size the precision increases and so the control limits are forming a funnel. Data points within the control limits are considered to show common cause variation; data points outside special cause variation without the focus of spurious rankings. Funnel plots offer data based information about how to evaluate institutional performance within quality management contexts.

Optical propagation analysis in photobioreactor measurements on cyanobacteria

NASA Astrophysics Data System (ADS)

Fanjul-Vélez, F.; Arce-Diego, J. L.

2017-12-01

Biotechnology applications are nowadays increasing in many areas, from agriculture to biochemistry, or even biomedicine. Knowledge on biological processes is becoming essential in order to be able to adequately estimate and control the production of these elements. Cyanobacteria present the capability of producing oxygen and biomass, from CO2 and light irradiation. Therefore, they could be fundamental for human subsistence in adverse environments, as basic needs of breathing and food would be guaranteed. Cyanobacteria cultivation, as other microorganisms, is carried out in photo-bioreactors. The adequate design of photobioreactors greatly influences elements production throughput. This design includes optical illumination and optical measurement of cyanobacteria growth. In this work an analysis of optical measurement of cyanobacteria growth in a photobioreactor is made. As cyanobacteria are inhomogeneous elements, the influence of light scattering is significant. Several types of cyanobacteria are considered, as long as several spatial profiles and irradiances of the incident light. Depending on cyanobacteria optical properties, optical distribution of transmitted light can be estimated. These results allow an appropriate consideration, in the optical design, of the relationship between detected light and cyanobacteria growth. As a consequence, the most adequate conditions of elements production from cyanobacteria could be estimated.

School Nurse Inspections Improve Handwashing Supplies

ERIC Educational Resources Information Center

Ramos, Mary M.; Schrader, Ronald; Trujillo, Rebecca; Blea, Mary; Greenberg, Cynthia

2011-01-01

Background: Handwashing in the school setting is important for infectious disease control, yet maintaining adequate handwashing supplies is often made difficult by lack of funds, limited staff time, and student vandalism. This study measured the availability of handwashing supplies for students in New Mexico public schools and determined the…

Effects of Multiple Crimps and Cable Length on Reflection Signatures from Long Cables

DOT National Transportation Integrated Search

2002-03-19

The accuracy of time domain reflectometry (TDR) measurements of rock shearing with cable lengths greater than 60 m has not been adequately documented. This paper presents the results of controlled crimping and shearing of a 530 m long, 22.2mm diamete...

Serum albumin-adjusted glycated albumin is an adequate indicator of glycemic control in patients with Cushing's syndrome.

PubMed

Kitamura, Tetsuhiro; Otsuki, Michio; Tamada, Daisuke; Tabuchi, Yukiko; Mukai, Kosuke; Morita, Shinya; Kasayama, Soji; Bando, Yukihiro; Shimomura, Iichiro; Koga, Masafumi

2014-12-01

We recently reported that glycated albumin (GA) in patients with Cushing's syndrome is low. In the present study, we examined whether serum albumin (SA)-adjusted GA (SAaGA) is an adequate indicator of glycemic control in patients with Cushing's syndrome. We studied 26 patients with Cushing's syndrome (13 patients without diabetes and 13 patients with diabetes). Twenty six non-diabetic subjects and 26 patients with type 2 diabetes mellitus matched for age, sex and BMI were used as the controls. SAaGA was calculated using the regression formula between SA and GA in non-diabetic patients with Cushing's syndrome and non-diabetic subjects. SA showed a significant correlation with GA in non-diabetic patients with Cushing's syndrome and non-diabetic subjects. GA, but not SAaGA, in non-diabetic patients with Cushing's syndrome was significantly lower than that in the non-diabetic controls. Furthermore, the GA/HbA1c ratio, but not the SAaGA/HbA1c ratio, in diabetic patients with Cushing's syndrome was significantly lower than that in the diabetic controls. The measured GA in the patients with Cushing's syndrome was significantly lower than the estimated GA, but there was no difference between SAaGA and the estimated GA. The present findings suggest that SAaGA is an adequate indicator of the glycemic control in patients with Cushing's syndrome. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Temperature Control. Honeywell Planning Guide.

ERIC Educational Resources Information Center

Honeywell, Inc., Minneapolis, Minn.

Presents planning considerations in selecting proper temperature control systems. Various aspects are discussed including--(1) adequate environmental control, (2) adequate control area, (3) control system design, (4) operators rate their systems, (5) type of control components, (6) basic control system, (7) automatic control systems, and (8)…

Measuring coercive control: what can we learn from national population surveys?

PubMed

Myhill, Andy

2015-03-01

Numerous academic studies point to gender symmetry in the prevalence of intimate partner violence (IPV). Many of these studies report findings from surveys with small and/or unrepresentative samples that have insufficient questions to differentiate adequately between different types of abuse. Data from a large, nationally representative survey suggest that, while the prevalence of situational violence is fairly symmetrical, coercive controlling abuse is highly gendered, with women overwhelmingly the victims. The authors conclude that more comprehensive measures are required in national surveys that consider a wider range of controlling behaviors as well as the meaning and impact of abuse. © The Author(s) 2015.

A Performance of Individual Differences in Selective Attention.

ERIC Educational Resources Information Center

Wahl, Otto

A reliable, easily administered performance test of selective attentional ability was sought. A monaural listening task provided a baseline control for adequate hearing and memory; a dichotic listening task then provided indices of ability to focus attention and resist distraction while a simultaneous listening task provided measures of ability to…

Integration of Specialized Pain Control Services in Palliative Care: A Nationwide Web-based Survey.

PubMed

Page, Nivedita Dilip

2017-01-01

Pain control is an important part of palliative care (PC), and conventional analgesics do not provide adequate pain relief to all patients. Many patients present with complex pain syndromes that require interventional pain control measures usually deployed by pain specialists. There is adequate integration of specialized pain control services with PC elsewhere, but information about the same in our country is lacking. An internet survey was conducted among palliative specialists regarding the need and availability of pain specialists for their patients suffering from complex pain syndromes. Their attitude toward integrating specialized pain control services in their practice was also explored. Majority of palliative physicians came across situations where specialists in pain would control the patients' pain better. There was a poor availability of such services, and when available, the cost was significant. It is heartening to note that though there is poor integration of specialized pain control services with palliation, palliative physicians acknowledge the need for pain specialists and their techniques for providing pain relief for their patients. Effective pain control is needed in palliation, barriers however exist, and there is a need to make pain specialists and interventional techniques more freely available.

How Drug Control Policy and Practice Undermine Access to Controlled Medicines.

PubMed

Burke-Shyne, Naomi; Csete, Joanne; Wilson, Duncan; Fox, Edward; Wolfe, Daniel; Rasanathan, Jennifer J K

2017-06-01

Drug conventions serve as the cornerstone for domestic drug laws and impose a dual obligation upon states to prevent the misuse of controlled substances while ensuring their adequate availability for medical and scientific purposes. Despite the mandate that these obligations be enforced equally, the dominant paradigm enshrined in the drug conventions is an enforcement-heavy criminal justice response to controlled substances that prohibits and penalizes their misuse. Prioritizing restrictive control is to the detriment of ensuring adequate availability of and access to controlled medicines, thereby violating the rights of people who need them. This paper argues that the drug conventions' prioritization of criminal justice measures-including efforts to prevent non-medical use of controlled substances-undermines access to medicines and infringes upon the right to health and the right to enjoy the benefits of scientific progress. While the effects of criminalization under drug policy limit the right to health in multiple ways, we draw on research and documented examples to highlight the impact of drug control and criminalization on access to medicines. The prioritization and protection of human rights-specifically the right to health and the right to enjoy the benefits of scientific progress-are critical to rebalancing drug policy.

Standardized application of laxatives and physical measures in neurosurgical intensive care patients improves defecation pattern but is not associated with lower intracranial pressure.

PubMed

Kieninger, Martin; Sinner, Barbara; Graf, Bernhard; Grassold, Astrid; Bele, Sylvia; Seemann, Milena; Künzig, Holger; Zech, Nina

2014-01-01

Background. Inadequate bowel movements might be associated with an increase in intracranial pressure in neurosurgical patients. In this study we investigated the influence of a structured application of laxatives and physical measures following a strict standard operating procedure (SOP) on bowel movement, intracranial pressure (ICP), and length of hospital stay in patients with a serious acute cerebral disorder. Methods. After the implementation of the SOP patients suffering from a neurosurgical disorder received pharmacological and nonpharmacological measures to improve bowel movements in a standardized manner within the first 5 days after admission to the intensive care unit (ICU) starting on day of admission. We compared mean ICP levels, length of ICU stay, and mechanical ventilation to a historical control group. Results. Patients of the intervention group showed an adequate defecation pattern significantly more often than the patients of the control group. However, this was not associated with lower ICP values, fewer days of mechanical ventilation, or earlier discharge from ICU. Conclusions. The implementation of a SOP for bowel movement increases the frequency of adequate bowel movements in neurosurgical critical care patients. However, this seems not to be associated with reduced ICP values.

Parents' and Adolescents' Perspectives on Parenting: Evaluating Conceptual Structure, Measurement Invariance, and Criterion Validity.

PubMed

Janssens, Annelies; Goossens, Luc; Van Den Noortgate, Wim; Colpin, Hilde; Verschueren, Karine; Van Leeuwen, Karla

2015-08-01

Uncertainty persists regarding adequate measurement of parenting behavior during early adolescence. The present study aimed to clarify the conceptual structure of parenting by evaluating three different models that include support, psychological control, and various types of behavioral control (i.e., proactive, punitive, and harsh punitive control). Furthermore, we examined measurement invariance of parenting ratings by 1,111 Flemish adolescents from Grade 7 till 9, their mother, and father. Finally, criterion validity of parenting ratings was estimated in relation to adolescent problem behavior. Results supported a five-factor parenting model indicating multiple aspects of behavioral control, with punitive and harsh punitive control as more intrusive forms and proactive control as a more supportive form. Similar constructs were measured for adolescents, mothers, and fathers (i.e., configural and metric invariance), however on a different scale (i.e., scalar noninvariance). Future research and clinical practices should acknowledge these findings in order to fully grasp the parenting process. © The Author(s) 2014.

A holistic measurement model of movement competency in children.

PubMed

Rudd, J; Butson, M L; Barnett, L; Farrow, D; Berry, J; Borkoles, E; Polman, R

2016-01-01

Different countries have different methods for assessing movement competence in children; however, it is unclear whether the test batteries that are used measure the same aspects of movement competence. The aim of this paper was to (1) investigate whether the Test of Gross Motor Development (TGMD-2) and Körperkoordinations Test für Kinder (KTK) measure the same aspects of children's movement competence and (2) examine the factorial structure of the TGMD-2 and KTK in a sample of Australian children. A total of 158 children participated (M age = 9.5; SD = 2.2). First, confirmatory factor analysis examined the independent factorial structure of the KTK and TGMD-2. Second, it was investigated whether locomotor, object control and body coordination loaded on the latent variable Movement Competency. Confirmatory factor analysis indicated an adequate fit for both the KTK and TGMD-2. An adequate fit was also achieved for the final model. In this model, locomotor (r = .86), object control (r = .71) and body coordination (r = .52) loaded on movement competence. Findings support our hypothesis that the TGMD-2 and KTK measure discrete aspects of movement competence. Future researchers and practitioners should consider using a wider range of test batteries to assess movement competence.

The role of adequate reference materials in density measurements in hemodialysis

NASA Astrophysics Data System (ADS)

Furtado, A.; Moutinho, J.; Moura, S.; Oliveira, F.; Filipe, E.

2015-02-01

In hemodialysis, oscillation-type density meters are used to measure the density of the acid component of the dialysate solutions used in the treatment of kidney patients. An incorrect density determination of this solution used in hemodialysis treatments can cause several and adverse events to patients. Therefore, despite the Fresenius Medical Care (FME) tight control of the density meters calibration results, this study shows the benefits of mimic the matrix usually measured to produce suitable reference materials for the density meter calibrations.

On Cyber Warfare Command and Control Systems

DTIC Science & Technology

2004-06-01

longer adequate to rely solely on the now traditional defense-in-depth strategy. We must recognize that we are engaged in a form of warfare, cyber warfare , and... warfare . This causes security devices to be used ineffectively and responses to be untimely. Cyber warfare then becomes a one-sided battle where the... cyber warfare strategy and tactics requires a cyber warfare command and control system. Responses to cyber attacks do not require offensive measures

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

None

Case study describes how the Byron G. Rogers Federal Building replaced existing T12 and T8 luminaires with LED dedicated troffers with advanced controls. Together these measures cut lighting energy use by nearly 60% in the 18-story, 791,000-square-foot facility. The new lighting control system provides automated dimming of lights down to 0% output when daylight provides adequate light levels. The project earned GSA an award for exemplary performance from the Interior Lighting Campaign in 2016.

Improving compliance with diabetes clinical practice guidelines in military medical treatment facilities.

PubMed

McCraw, Wendy M; Kelley, Patricia Watts; Righero, Anna M; Latimer, Renee

2010-01-01

A multidisciplinary, multifaceted approach to disease management that incorporates the health system, the provider, and the patient is supported in the literature. There was a need to improve patient outcomes to meet or to exceed the Health Plan Employer Data and Information Set (HEDIS) benchmarks for the management of patients with diabetes. The purpose of this study was to implement a process improvement effort using practice guidelines on the basis of an evidence-based practice model for the management of type II diabetes mellitus at two primary care clinics at two military medical facilities in Hawaii. A retrospective review of charts, electronic records, and system data revealed that the clinics used as project sites were not compliant with established guidelines for diabetes management. After a literature review and an analysis of the current processes, a multidisciplinary care delivery model was developed and implemented to identify spheres of influence involving all members of the diabetes management team and the tasks that influenced patient outcomes. Improvements were seen for more than 6 months of initial practice change, including compliance with annual glycosylated hemoglobin (HbA1c), lipid, blood pressure, and foot checks. At Site 1, HEDIS measures increased for adequately controlled HbA1c and low-density lipoprotein (LDL) from 80% to 85% and from 49% to 58%, respectively. Site 2 showed an increase in adequate control of HbA1c from 77% to 79% at 6 months. After a steady increase in compliance, the percentage for adequately controlled LDL dropped to 56% at 9 months. At Site 1, HEDIS measures decreased slightly to 82% for HbA1c control and to 54% for LDL control at the 9-month mark. Inconsistent delivery of care and lack of staff and patient involvement influenced process outcomes. There were challenges with database accuracy, adequate staffing, computer software upgrades, and overseas site locations. Annual foot examinations showed the largest improvement over time. Site 1 had a significant increase in filament testing because of an innovative strategy to develop a competency program to educate technicians to perform the assessment during the patient check-in process. Sustainability is needed to improve overall patient quality and patient safety and to decrease variation in care among medical treatment facilities over time.

77 FR 65215 - In the Matter of Licensee Identified in Attachment 1 and all Other Persons Who Obtain Safeguards...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-25

... a computing environment that has adequate computer security controls in place to prevent... NRC intends to issue a security Order to this Licensee in the near future. The Order will require compliance with specific Additional Security Measures to enhance the security for certain radioactive...

Simulation Analysis of Computer-Controlled pressurization for Mixture Ratio Control

NASA Technical Reports Server (NTRS)

Alexander, Leslie A.; Bishop-Behel, Karen; Benfield, Michael P. J.; Kelley, Anthony; Woodcock, Gordon R.

2005-01-01

A procedural code (C++) simulation was developed to investigate potentials for mixture ratio control of pressure-fed spacecraft rocket propulsion systems by measuring propellant flows, tank liquid quantities, or both, and using feedback from these measurements to adjust propellant tank pressures to set the correct operating mixture ratio for minimum propellant residuals. The pressurization system eliminated mechanical regulators in favor of a computer-controlled, servo- driven throttling valve. We found that a quasi-steady state simulation (pressure and flow transients in the pressurization systems resulting from changes in flow control valve position are ignored) is adequate for this purpose. Monte-Carlo methods are used to obtain simulated statistics on propellant depletion. Mixture ratio control algorithms based on proportional-integral-differential (PID) controller methods were developed. These algorithms actually set target tank pressures; the tank pressures are controlled by another PID controller. Simulation indicates this approach can provide reductions in residual propellants.

Situation awareness acquired from monitoring process plants - the Process Overview concept and measure.

PubMed

Lau, Nathan; Jamieson, Greg A; Skraaning, Gyrd

2016-07-01

We introduce Process Overview, a situation awareness characterisation of the knowledge derived from monitoring process plants. Process Overview is based on observational studies of process control work in the literature. The characterisation is applied to develop a query-based measure called the Process Overview Measure. The goal of the measure is to improve coupling between situation and awareness according to process plant properties and operator cognitive work. A companion article presents the empirical evaluation of the Process Overview Measure in a realistic process control setting. The Process Overview Measure demonstrated sensitivity and validity by revealing significant effects of experimental manipulations that corroborated with other empirical results. The measure also demonstrated adequate inter-rater reliability and practicality for measuring SA based on data collected by process experts. Practitioner Summary: The Process Overview Measure is a query-based measure for assessing operator situation awareness from monitoring process plants in representative settings.

Light scattering influence in cyanobacteria suspensions inside a photobioreactor

NASA Astrophysics Data System (ADS)

Fanjul-Vélez, F.; Arce-Diego, J. L.

2018-02-01

The application of biotechnology is increasing in areas such as agriculture, biochemistry or biomedicine. Growing bacteria or algae could be beneficial for supplying fuel, drugs, food or oxygen, among other products. An adequate knowledge of biological processes is becoming essential to estimate and control products production. Cyanobacteria are particularly appropriate for producing oxygen and biomass, by consuming mainly carbon dioxide and light irradiation. These capacities could be employed to provide human subsistence in adverse environments, as basic breathing and food needs would be satisfied. Cyanobacteria growing is carried out in bioreactors. As light irradiation is quite relevant for their behavior, photobioreactors are needed. Photobioreactors are designed to supply and control the amounts of elements they need, in order to maximize growth. The adequate design of photobioreactors greatly influences production throughput. This design includes, on the optical side, optical illumination and optical measurement of cyanobacteria growth. The influence of optical scattering is fundamental for maximizing cyanobacteria growing, as long as for adequately measure this growth. In this work, optical scattering in cyanobacteria suspensions is analyzed. Optical properties of cyanobacteria and its relationship with concentration is taken into account. Several types of cyanobacteria are considered. The influence of different beam spatial profiles and irradiances is studied by a Monte Carlo approach. The results would allow the consideration of the influence of optical scattering in the detected optical signal employed for growth monitoring, as a function of cyanobacteria type and optical beam parameters.

Can we scientifically and reliably measure the level of consciousness in vegetative and minimally conscious States? Rasch analysis of the coma recovery scale-revised.

PubMed

La Porta, Fabio; Caselli, Serena; Ianes, Aladar Bruno; Cameli, Olivia; Lino, Mario; Piperno, Roberto; Sighinolfi, Antonella; Lombardi, Francesco; Tennant, Alan

2013-03-01

(1) To appraise, by the means of Rasch analysis, the internal validity and reliability of the Coma Recovery Scale-Revised (CRS-R) in a sample of patients with disorder of consciousness (DOC); and (2) to provide information about the comparability of CRS-R scores across persons with DOC across different settings and groups, including different etiologies. Multicenter observational prospective study. Two rehabilitation wards, 1 intermediate care facility, and 2 nursing homes in Italy. Consecutively admitted patients (N=129) for which assessments at 2 different time points were available, giving a total sample of 258 observations. Not applicable. CRS-R. After controlling for any possible dependency between persons' measures collected at different time points, and for uniform differential item functioning by etiology showed by the visual subscale, Rasch analysis demonstrated adequate satisfaction of all the model's requirements, including adequate ordering of scoring categories, unidimensionality, local independence, invariance (χ(2)21=27.798, P=.146), and absence of differential item functioning across patients' sex, age, time, and setting. The reliability (person separation index=.896) was adequate for individual person measurement. We devised a practical raw score to measure conversion tables based on the CRS-R calibrations. The CRS-R is a psychometrically sound and robust measurement tool. The linear measures of ability derived from the CRS-R total scores do satisfy all the principles of scientific measurement and are sufficiently reliable for high stakes assessments, such as the diagnosis of the level of consciousness in individual patients. Future studies are needed to directly explore the capabilities of the CRS-R measures to reduce the risk of vegetative state misdiagnosis. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Microhardness of light- and dual-polymerizable luting resins polymerized through 7.5-mm-thick endocrowns.

PubMed

Gregor, Ladislav; Bouillaguet, Serge; Onisor, Ioana; Ardu, Stefano; Krejci, Ivo; Rocca, Giovanni Tommaso

2014-10-01

The complete polymerization of luting resins through thick indirect restorations is still questioned. The purpose of this study was to evaluate the degree of polymerization of light- and dual-polymerizable luting resins under thick indirect composite resin and ceramic endocrowns by means of Vickers microhardness measurements. The Vickers microhardness measurements of a light-polymerizable microhybrid composite resin and a dual-polymerizable luting cement directly polymerized in a natural tooth mold for 40 seconds with a high-power light-emitting diode lamp (control) were compared with measurements after indirect irradiation through 7.5-mm-thick composite resin and ceramic endocrowns for 3 × 90 seconds. A test-to-control microhardness values ratio of 0.80 at a depth of 0.5 mm below the surface was assumed as the criterion for adequate conversion. For the Vickers microhardness measurements of a dual-polymerizable luting cement, no differences (P>.05) were found between Vickers microhardness control values and values reported after polymerization through composite resin and ceramic endocrowns. For The Vickers microhardness measurements (±SD) of a light-polymerizable microhybrid composite resin, control values were significantly (P<.05) higher (111 ±3.3) than those reported after polymerization through composite resin (100.5 ±3.8) and ceramic (99.7 ±2.3) endocrowns. However, the hardness values of The Vickers microhardness measurements of a light-polymerizable microhybrid composite resin polymerized through the endocrowns were approximately 10% to 12% lower than those of the control values. Two-way ANOVA showed the influence of the luting material on the Vickers microhardness values (P<.05). The effect of endocrown material was not significant (P>.05). Under the conditions of this in vitro study, Vickers microhardness values of the dual-polymerizable resin cement and the light-polymerizable restorative composite resin irradiated for 3 × 90 seconds with a high irradiance light-emitting diode lamp through 7.5-mm-thick endocrowns reached at least 80% of the control Vickers microhardness values, which means that both materials can be adequately polymerized when they are used for luting thick indirect restorations. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Effective Determination of Overhead Rates for Pricing Goods and Services.

ERIC Educational Resources Information Center

Smith, Christopher A.

This publication presents a system of gathering overhead data and describes several methods for assigning overhead costs to specific contract prices. It is intended to provide facility production supervisors with a means of ensuring adequate cost recovery in bid prices and gaining a measure of overhead cost control. The seven steps in the overhead…

Standardized Application of Laxatives and Physical Measures in Neurosurgical Intensive Care Patients Improves Defecation Pattern but Is Not Associated with Lower Intracranial Pressure

PubMed Central

Kieninger, Martin; Sinner, Barbara; Graf, Bernhard; Grassold, Astrid; Bele, Sylvia; Seemann, Milena; Künzig, Holger; Zech, Nina

2014-01-01

Background. Inadequate bowel movements might be associated with an increase in intracranial pressure in neurosurgical patients. In this study we investigated the influence of a structured application of laxatives and physical measures following a strict standard operating procedure (SOP) on bowel movement, intracranial pressure (ICP), and length of hospital stay in patients with a serious acute cerebral disorder. Methods. After the implementation of the SOP patients suffering from a neurosurgical disorder received pharmacological and nonpharmacological measures to improve bowel movements in a standardized manner within the first 5 days after admission to the intensive care unit (ICU) starting on day of admission. We compared mean ICP levels, length of ICU stay, and mechanical ventilation to a historical control group. Results. Patients of the intervention group showed an adequate defecation pattern significantly more often than the patients of the control group. However, this was not associated with lower ICP values, fewer days of mechanical ventilation, or earlier discharge from ICU. Conclusions. The implementation of a SOP for bowel movement increases the frequency of adequate bowel movements in neurosurgical critical care patients. However, this seems not to be associated with reduced ICP values. PMID:25628896

The detrimental effect of friction on space microgravity robotics

NASA Technical Reports Server (NTRS)

Newman, Wyatt S.; Glosser, Gregory D.; Miller, Jeffrey H.; Rohn, Douglas

1992-01-01

The authors present an analysis of why control systems are ineffective in compensating for acceleration disturbances due to Coulomb friction. Linear arguments indicate that the effects of Coulomb friction on a body are most difficult to reject when the control actuator is separated from the body of compliance. The linear arguments were illustrated in a nonlinear simulation of optimal linear tracking control in the presence of nonlinear friction. The results of endpoint acceleration measurements for four robot designs are presented and are compared with simulation and to equivalent measurements on a human. It is concluded that Coulomb friction in common bearings and transmission induces unacceptable levels of endpoint acceleration, that these accelerations cannot be adequately attenuated by control, and that robots for microgravity work will require special design considerations for inherently low friction.

A New Lebanese Medication Adherence Scale: Validation in Lebanese Hypertensive Adults.

PubMed

Bou Serhal, R; Salameh, P; Wakim, N; Issa, C; Kassem, B; Abou Jaoude, L; Saleh, N

2018-01-01

A new Lebanese scale measuring medication adherence considered socioeconomic and cultural factors not taken into account by the eight-item Morisky Medication Adherence Scale (MMAS-8). Objectives were to validate the new adherence scale and its prediction of hypertension control, compared to MMAS-8, and to assess adherence rates and factors. A cross-sectional study, including 405 patients, was performed in outpatient cardiology clinics of three hospitals in Beirut. Blood pressure was measured, a questionnaire filled, and sodium intake estimated by a urine test. Logistic regression defined predictors of hypertension control and adherence. 54.9% had controlled hypertension. 82.4% were adherent by the new scale, which showed good internal consistency, adequate questions (KMO coefficient = 0.743), and four factors. It predicted hypertension control (OR = 1.217; p value = 0.003), unlike MMAS-8, but the scores were correlated (ICC average measure = 0.651; p value < 0.001). Stress and smoking predicted nonadherence. This study elaborated a validated, practical, and useful tool measuring adherence to medications in Lebanese hypertensive patients.

[Fifty years of fluoridation of public water supplies in Brazil: benefits for the control of dental caries].

PubMed

Ramires, Irene; Buzalaf, Marília Afonso Rabelo

2007-01-01

Fluoridation of public water supplies is among the most important public health measures for control of dental caries. Through a review of the literature, this study intends to reaffirm the importance and scope of fluoridation for caries control, as this is acknowledged as one of the most effective ways of ensuring the constant presence of fluoride in the oral cavity, which is vital for controlling caries. Water fluoridation is rated as an important factor for reducing caries, meaning that it should be maintained and also monitored, ensuring adequate fluoride levels for controlling caries while avoiding dental fluorosis.

Sakai et al. is not an adequate demonstration of TFT effectiveness.

PubMed

Lohr, J M

2001-10-01

Sakai et al. (2001) report an uncontrolled case series of TFT treatments applied to a wide range of psychological complaints in a large health maintenance facility. They analyze verbal report measures of symptom severity and conclude that the specific treatment is effective for a wide range of psychological problems. A review of the theory and research on TFT efficacy indicates that the theoretical basis for the specific treatment is unfounded and that adequately controlled efficacy research has yet to be conducted. The authors' conclusions about effectiveness and applicability are not supported by either theory, prior research, or the findings of their clinical application. Copyright 2001 John Wiley & Sons, Inc.

Jumbo forceps are superior to standard large-capacity forceps in obtaining diagnostically adequate inflammatory bowel disease surveillance biopsy specimens.

PubMed

Elmunzer, B Joseph; Higgins, Peter D R; Kwon, Yong M; Golembeski, Christopher; Greenson, Joel K; Korsnes, Sheryl J; Elta, Grace H

2008-08-01

In inflammatory bowel disease (IBD) surveillance colonoscopy, an increased number of biopsy specimens correlates with a higher dysplasia detection rate. Larger biopsy specimens may also increase the diagnostic yield. To compare a new jumbo forceps with a standard large-capacity forceps in obtaining diagnostically adequate IBD surveillance biopsy specimens. Prospective single-center study. Twenty-four patients who were undergoing an IBD surveillance colonoscopy were enrolled. As part of standard IBD surveillance, 8 paired biopsy specimens were obtained from the rectosigmoid by using the jumbo forceps and a standard large-capacity forceps. Biopsy specimens were deemed adequate if they met all 3 of the following criteria: (1) length > or =3 mm, (2) penetration into the muscularis mucosa, and (3) < 20% crush artifact. The proportion of adequate biopsy specimens obtained with the jumbo forceps was significantly higher than that obtained with the large-capacity control forceps (67% vs 48%, P < .0001). The average length of the biopsy specimen obtained with the jumbo forceps was 4.00 mm (95% CI, 3.81-4.20 mm) compared with 3.19 mm (95% CI, 2.99-3.38 mm) with the large-capacity (control) forceps. (1) No validated outcome measurement for the quality of GI biopsy specimens exists and (2) in this study, interobserver variability between pathologists was high. The jumbo forceps was superior to a standard large-capacity forceps in obtaining diagnostically adequate IBD surveillance biopsy specimens. Because biopsy specimens obtained with the jumbo forceps were larger, the use of this forceps for IBD surveillance will allow the endoscopist to sample a larger colonic mucosal surface area, potentially resulting in an increased dysplasia detection rate.

Child malnutrition and mortality among families not utilizing adequately iodized salt in Indonesia.

PubMed

Semba, Richard D; de Pee, Saskia; Hess, Sonja Y; Sun, Kai; Sari, Mayang; Bloem, Martin W

2008-02-01

Salt iodization is the main strategy for reducing iodine deficiency disorders worldwide. Characteristics of families not using iodized salt need to be known to expand coverage. The objective was to determine whether families who do not use iodized salt have a higher prevalence of child malnutrition and mortality and to identify factors associated with not using iodized salt. Use of adequately iodized salt (>or =30 ppm), measured by rapid test kits, was assessed between January 1999 and September 2003 in 145 522 and 445 546 families in urban slums and rural areas, respectively, in Indonesia. Adequately iodized salt was used by 66.6% and 67.2% of families from urban slums and rural areas, respectively. Among families who used adequately iodized salt, mortality in neonates, infants, and children aged <5 y was 3.3% compared with 4.2%, 5.5% compared with 7.1%, and 6.9% compared with 9.1%, respectively (P < 0.0001 for all), in urban slums; among families who did not use adequately iodized salt, the respective values were 4.2% compared with 6.3%, 7.1% compared with 11.2%, and 8.5% compared with 13.3% (P < 0.0001 for all) in rural areas. Families not using adequately iodized salt were more likely to have children who were stunted, underweight, and wasted. In multivariate analyses that controlled for potential confounders, low maternal education was the strongest factor associated with not using adequately iodized salt. In Indonesia, nonuse of adequately iodized salt is associated with a higher prevalence of child malnutrition and mortality in neonates, infants, and children aged <5 y. Stronger efforts are needed to expand salt iodization in Indonesia.

75 FR 42786 - Accounting Guide for LSC Recipients (2010 Edition)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

... adequate accounting and financial reporting system, including the use of specific internal controls and... the Accounting Procedures and Internal Control Checklist in Appendix VII. Sections G2, G3, and M of... the responsibilities of a recipient to maintain adequate accounting records and internal control...

Racial and Ethnic Differences in ADHD Treatment Quality Among Medicaid-Enrolled Youth.

PubMed

Cummings, Janet R; Ji, Xu; Allen, Lindsay; Lally, Cathy; Druss, Benjamin G

2017-06-01

We estimated racial/ethnic differences in attention-deficit/hyperactivity disorder (ADHD) care quality and treatment continuity among Medicaid-enrolled children. Using Medicaid data from 9 states (2008 to 2011), we identified 172 322 youth (age 6 to 12) initiating ADHD medication. Outcome measures included: (1) adequate follow-up care in the (a) initiation and (b) continuation and maintenance (C&M) treatment phases; (2) combined treatment with medication and psychotherapy (versus medication alone); (3) medication discontinuation; and (4) treatment disengagement (ie, discontinued medication and received no psychotherapy). Logistic regressions controlled for confounding measures. Among those initiating medication, three-fifths received adequate follow-up care in the initiation and C&M phases, and under two-fifths received combined treatment. Compared with whites, African American youth were less likely to receive adequate follow-up in either phase ( P < .05), whereas Hispanic youth were more likely to receive adequate follow-up in the C&M phase ( P < .001). African American and Hispanic youth were more likely than whites to receive combined treatment ( P < .05). Over three-fifths discontinued medication, and over four-tenths disengaged from treatment. Compared with whites, African American and Hispanic children were 22.4% and 16.7% points more likely to discontinue medication, and 13.1% and 9.4% points more likely to disengage from treatment, respectively ( P < .001). Care quality for Medicaid-enrolled youth initiating ADHD medication is poor, and racial/ethnic differences in these measures are mixed. The most important disparities occur in the higher rates of medication discontinuation among minorities, which translate into higher rates of treatment disengagement because most youth discontinuing medication receive no psychotherapy. Copyright © 2017 by the American Academy of Pediatrics.

The Relationship between Water, Sanitation and Schistosomiasis: A Systematic Review and Meta-analysis

PubMed Central

Grimes, Jack E. T.; Croll, David; Harrison, Wendy E.; Utzinger, Jürg; Freeman, Matthew C.; Templeton, Michael R.

2014-01-01

Background Access to “safe” water and “adequate” sanitation are emphasized as important measures for schistosomiasis control. Indeed, the schistosomes' lifecycles suggest that their transmission may be reduced through safe water and adequate sanitation. However, the evidence has not previously been compiled in a systematic review. Methodology We carried out a systematic review and meta-analysis of studies reporting schistosome infection rates in people who do or do not have access to safe water and adequate sanitation. PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to 31 December 2013, without restrictions on year of publication or language. Studies' titles and abstracts were screened by two independent assessors. Papers deemed of interest were read in full and appropriate studies included in the meta-analysis. Publication bias was assessed through the visual inspection of funnel plots and through Egger's test. Heterogeneity of datasets within the meta-analysis was quantified using Higgins' I2. Principal Findings Safe water supplies were associated with significantly lower odds of schistosomiasis (odds ratio (OR) = 0.53, 95% confidence interval (CI): 0.47–0.61). Adequate sanitation was associated with lower odds of Schistosoma mansoni, (OR = 0.59, 95% CI: 0.47–0.73) and Schistosoma haematobium (OR = 0.69, 95% CI: 0.57–0.84). Included studies were mainly cross-sectional and quality was largely poor. Conclusions/Significance Our systematic review and meta-analysis suggests that increasing access to safe water and adequate sanitation are important measures to reduce the odds of schistosome infection. However, most of the studies were observational and quality was poor. Hence, there is a pressing need for adequately powered cluster randomized trials comparing schistosome infection risk with access to safe water and adequate sanitation, more studies which rigorously define water and sanitation, and new research on the relationships between water, sanitation, hygiene, human behavior, and schistosome transmission. PMID:25474705

Prevention of infectious diseases in aquaculture

USGS Publications Warehouse

Ahne, W.; Winton, J.R.; Kimura, T.

1989-01-01

Infectious diseases remain one of the most important limitations to the successful propagation of aquatic animals. Most of the losses caused by pathogens in aquaculture could be prevented by health inspection, adequate environment and sound management practices. Effective control measures, mainly based upon 1) avoidance of pathogens 2) modification of the environment 3) improvement of host resistance 4) vaccination and 5) chemoprophylaxis are described.

Public health measures to control tuberculosis in low-income countries: ethics and human rights considerations.

PubMed

Kraemer, J D; Cabrera, O A; Singh, J A; Depp, T B; Gostin, L O

2011-06-01

In low-income countries, tuberculosis (TB) control measures should be guided by ethical concerns and human rights obligations. Control programs should consider the principles of necessity, reasonableness and effectiveness of means, proportionality, distributive justice, and transparency. Certain measures-detention, infection control, and treatment to prevent transmission-raise particular concerns. While isolation is appropriate under certain circumstances, quarantine is never an acceptable control measure for TB, and any detention must be limited by necessity and conducted humanely. States have a duty to implement hospital infection control to the extent of their available resources and to provide treatment to health care workers (HCWs) infected on the job. HCWs, in turn, have an obligation to provide care unless conditions are unreasonably and unforeseeably unsafe. Finally, states have an obligation to provide adequate access to treatment, as a means of preventing transmission, as broadly as possible and in a non-discriminatory fashion. Along with treatment, states should provide support to increase treatment adherence and retention with respect for patient privacy and autonomy. Compulsory treatment is almost never acceptable. Governments should take care to respect human rights and ethical obligations as they execute TB control programs.

Medium-term methionine supplementation increases plasma homocysteine but not ADMA and improves blood pressure control in rats fed a diet rich in protein and adequate in folate and choline.

PubMed

Mariotti, François; Hammiche, Alexia; Blouet, Clémence; Daré, Sophie; Tomé, Daniel; Huneau, Jean François

2006-10-01

Hyperhomocysteinemia (HHcy) is associated with cardiovascular risk, possibly because it increases asymmetric dimethyl-arginine (ADMA), but the general association remains unclear and may vary with nutritional and physiological conditions. We aimed to monitor the effect of methionine supplementation, and subsequent HHcy, on plasma ADMA and hemodynamics in the context of a diet rich in protein and adequate in folic acid and choline. For 6 weeks, rats were fed a 29% protein diet supplemented (M) or not (C) with 8 g/kg L: -methionine. Blood pressure and plasma amino acids, including homocysteine and ADMA, were measured throughout the experiment and additional parameters, including in vivo hemodynamic response to acetylcholine, were measured at week 5-6. As compared to the C diet, the M diet induced a marked HHcy during the first 3 weeks, which lessened at week 5. In contrast, plasma ADMA stayed similar in the C and M diet. Paradoxically, M rats had lower mean and diastolic blood pressure values over the experiment, together with a lower left ventricular mass at week 6, when compared with C rats. No difference was observed between groups regarding vascular reactivity and plasma NOx at week 6. In a context of a diet rich in protein and adequate in methyl donors, rats exhibit a complex adaptation to the medium-term methionine supplementation, with improvement in blood pressure control despite marked HHcy. The lack of increase in plasma ADMA may account for the absence of detrimental effects of HHcy on hemodynamics.

Development of an active boring bar for increased chatter immunity

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

Redmond, J.; Barney, P.; Smith, D.

The development and initial evaluation of a prototype boring bar featuring active vibration control for increased chatter immunity is described. The significance of active damping both normal and tangential to the workpiece surface is evaluated, indicating the need for two axis control to ensure adequate performance over expected variations in tool mounting procedures. The prototype tool features a commercially available boring bar modified to accommodate four PZT stack actuators for two axis bending control. Measured closed-loop dynamics are combined with a computer model of the boring process to simulate increased metal removal rate and improved workpiece surface finish through activemore » control.« less

Lithologic controls on AIRSAR signatures of bedrock and alluvium, at Lunar Crater, Nevada

NASA Technical Reports Server (NTRS)

Rivard, Benoit; Diorio, Marc; Budkewitsch, Paul

1995-01-01

Radar backscatter intensity as measured by calibrated synthetic aperture radar (SAR) systems is primarily controlled by three factors: local incidence angle, wavelength-scale roughness, and dielectric permittivity of surface materials. In order to make adequate use of radar observations for geological investigations of surface type, the relationships between lithology and the above characteristics must be adequately understood. In arid terrains weathering signatures (e.g. fracturing, debris grain size and shape, slope characteristics) are controlled to some extent by lithologic characteristics of the parent bedrock. These textural features of outcrops and their associated debris control radar backscatter to varying degrees. The quad-polarization JPL AIRSAR system allows sampling of textures at three distinct wavelength scales: C-band (5.66 cm), L-band (23.98 cm), and P-band (68.13 cm). This paper presents a discussion of AIRSAR data using recent field observations of weathered felsic and basaltic volcanic rock units exposed in the southern part of the Lunar Crater Volcanic Field, in the Pancake Range of central Nevada. The focus is on the relationship of radar backscatter at multiple wavelengths to weathering style and parent bedrock lithology.

Evaluation of the reported association of obsessive-compulsive symptoms or disorder with Tourette's disorder.

PubMed

Shapiro, A K; Shapiro, E

1992-01-01

This review evaluates the evidence reporting an association of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) with Tourette's syndrome or disorder (TS). Published reports in the literature describing a relationship between OCS-OCD and TS provided the data for the review. The methodological adequacy of the studies are discussed and rated on five criteria: adequacy of the experimental sample, presence and adequacy of the control sample, whether tics are defined as OCS-OCD, whether blind procedures are used to diagnose OCS-OCD in subjects and controls, and evidence for the reliability and validity of OCS-OCD measures. Although there are considerable clinical indications suggesting an association of OCS-OCD with TS and chronic motor tic disorder (CMT), and a possible overlap between OSC-OCD and TS, our evaluation of the evidence does not provide adequate support for an association between these disorders. To meaningfully evaluate the possible relationship between OCS-OCD and TS requires development of specific criteria for classification of OCS-OCD-TS symptoms, use of adequate experimental and control samples, blind evaluation, reliable and valid measures of OCS-OCD-TS, and appropriate statistical analysis. If such studies are performed, it is possible that the strong relationship reported between OCS-OCD and TS is more likely to be artifact than fact, and recent bandwagon effect rather than the latest breakthrough.

Control of plant virus diseases in cool-season grain legume crops.

PubMed

Makkouk, Khaled M; Kumari, Safaa G; van Leur, Joop A G; Jones, Roger A C

2014-01-01

Cool-season grain legume crops become infected with a wide range of viruses, many of which cause serious diseases and major yield losses. This review starts by discussing which viruses are important in the principal cool-season grain legume crops in different parts of the world, the losses they cause and their economic impacts in relation to control. It then describes the main types of control measures available: host resistance, phytosanitary measures, cultural measures, chemical control, and biological control. Examples are provided of successful deployment of the different types of measures to control virus epidemics in cool-season grain legume crops. Next it emphasizes the need for integrated approaches to control because single control measures used alone rarely suffice to adequately reduce virus-induced yield losses in these crops. Development of effective integrated disease management (IDM) strategies depends on an interdisciplinary team approach to (i) understand the ecological and climatic factors which lead to damaging virus epidemics and (ii) evaluate the effectiveness of individual control measures. In addition to using virus-resistant cultivars, other IDM components include sowing virus-tested seed stocks, selecting cultivars with low seed transmission rates, using diverse phytosanitary or cultural practices that minimize the virus source or reduce its spread, and using selective pesticides in an environmentally responsible way. The review finishes by briefly discussing the implications of climate change in increasing problems associated with control and the opportunities to control virus diseases more effectively through new technologies.

Measuring Behavioral Outcomes Associated with Comprehensive Character Education Programs: A Practical Approach to Using Fewer Schools in School-Randomized Controlled Trials While Maintaining Adequate Statistical Power

ERIC Educational Resources Information Center

Holtzapple, Carol K.

2011-01-01

Character education programs support the development of positive character traits in children and adults. Effective violence prevention programs improve pro-social competencies and reduce negative behaviors in students by enhancing protective factors (strong bonds with teachers; clear rules of conduct that are consistently enforced) and targeting…

Expertise on Cognitive Workloads and Performance During Navigation and Target Detection

DTIC Science & Technology

2012-03-01

requiring little or no attention 1. Little confusion, risk, frustration, or anxiety exists and can be easily accomodated 2. Occasionally have spare...to confusion, frustration, or anxiety noticeably adds to workload. Significant compensation is required to maintain adequate performance. 3... anxiety . High to extreme determination and self- control required 59 Field Description elapsedTime (sec) Continuous measurement of time from the

Educatee's Thesaurus as an Object of Measuring Learned Material of the Distance Learning Course

ERIC Educational Resources Information Center

Rybanov, Alexander Aleksandrovich

2013-01-01

Monitoring and control over the process of studying the distance learning course are based on solving the problem of making out an adequate integral mark to the educatee for mastering entire study course, by testing results. It is suggested to use the degree of correspondence between educatee's thesaurus and the study course thesaurus as an…

Information processing speed and attention in multiple sclerosis: Reconsidering the Attention Network Test (ANT).

PubMed

Roth, Alexandra K; Denney, Douglas R; Lynch, Sharon G

2015-01-01

The Attention Network Test (ANT) assesses attention in terms of discrepancies between response times to items that differ in the burden they place on some facet of attention. However, simple arithmetic difference scores commonly used to capture these discrepancies fail to provide adequate control for information processing speed, leading to distorted findings when patient and control groups differ markedly in the speed with which they process and respond to stimulus information. This study examined attention networks in patients with multiple sclerosis (MS) using simple difference scores, proportional scores, and residualized scores that control for processing speed through statistical regression. Patients with relapsing-remitting (N = 20) or secondary progressive (N = 20) MS and healthy controls (N = 40) of similar age, education, and gender completed the ANT. Substantial differences between patients and controls were found on all measures of processing speed. Patients exhibited difficulties in the executive control network, but only when difference scores were considered. When deficits in information processing speed were adequately controlled using proportional or residualized score, deficits in the alerting network emerged. The effect sizes for these deficits were notably smaller than those for overall information processing speed and were also limited to patients with secondary progressive MS. Deficits in processing speed are more prominent in MS than those involving attention, and when the former are properly accounted for, differences in the latter are confined to the alerting network.

[Metabolic control in children and adolescents with type 1 diabetes].

PubMed

Díaz-Cárdenas, Claudia; Wong, Carolina; Vargas Catalán, Nelson A

2016-01-01

Type 1 diabetes mellitus (T1D) is an important disease in children and adolescent being a major risk factor for early morbidity and mortality. To know the degree of metabolic control and prevalence of cardiovascular risk factors in T1D patients. Retrospective study including patients under 19 years of age with T1D controlled at a Chilean hospital in 2011. 94 patients were evaluated (average age at diagnosis: 7.3 years; current age: 11,9 years; evolution time: 4.5 years). Seventy-nine percent (79.8%) of patients presented glycated hemoglobin (HbA1c) over the recommended level with an average of 8.9%. The group between 13 and 19 years of age exhibited the worst metabolic control (86% with HbA1c abnormal levels). Overweight or obesity occurred in 26.6% of patients, 20.3% had LDL >100mg/dl and 4.2% had hypertension. Only about twenty percent of patients had adequate metabolic control as measured by HbA1c, although cardiovascular risk profile was acceptable. Therapeutic and educational efforts must be reinforced mainly in adolescents, emphasizing the importance of adequate nutritional management as a primary method to treat this entity. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Heat dissipation in controlled environment enclosures through the application of water screens

NASA Technical Reports Server (NTRS)

Warrington, I. J.; Halligan, E. A.; Ruby, L. C.; Mcnaughton, K. G.

1994-01-01

The use of plate glass-water thermal barriers in controlled environment facilities effectively reduces the thermal load within the plant growth chamber. This allows high PPFs to be provided for plant growth and development studies, adequate simulation of daily light integrals, and simulation of peak PPF's. Further, substantial amounts of incandescent lamp supplementation can be used to achieve simulation of daylight R:FR ratios which are needed to ensure adequate stem development in some species. While the focus in this paper is on the use of entire thermal barriers which separate the lighting enclosure from the plant growth chamber, the same principles apply to the use of water jackets for cooling individual lamps (such as can occur with xenon-arc lamps). In this instance, the barrier separating the lamps from the plant chamber can be much simpler (e.g., plexiglass) as the main function of the barrier is to separate the air ventilation of the lamp enclosure from the air system within the plant growth chamber. The main advantage of water as a thermal barrier is the negligible absorption of radiation in the photosynthetically-active and near infrared wavebands. Consequently, plate glass-water barriers typically allow transmission of approximately 90% of radiation in these regions. While ventilated double and triple glazing systems appear to be attractive alternative to water barriers from an operating standpoint, their significant absorption in the biologically-important wavebands (7 - 12%) with each glass layer and longer-wave cut-offs (typically 2500 - 4000 nm) makes them a much less attractive alternative. The data presented here demonstrate clearly that measurement of PPF alone is not an adequate representation of the radiation environment being used in a controlled environment study. The amounts and proportions of long-wave and short-wave radiation in a plant growth chamber are dependent on lamp type, lamp combination, presence of a thermal barrier, the type of thermal barrier between the lamps and the plant growing area and the overall construction and design of the chamber. It is important, therefore, in reporting results of controlled environment studies, to adequately describe both the details of the lighting system used and the characteristics of the radiation produced by that system, so results of different studies can be adequately evaluated and compared.

Tuberculosis Infection Control in Health-Care Facilities: Environmental Control and Personal Protection.

PubMed

Lee, Ji Yeon

2016-10-01

Transmission of tuberculosis (TB) is a recognized risk to patients and healthcare workers in healthcare settings. The literature review suggests that implementation of combination control measures reduces the risk of TB transmission. Guidelines suggest a three-level hierarchy of controls including administrative, environmental, and respiratory protection. Among environmental controls, installation of ventilation systems is a priority because ventilation reduces the number of infectious particles in the air. Natural ventilation is cost-effective but depends on climatic conditions. Supplemented intervention such as air-cleaning methods including high efficiency particulate air filtration and ultraviolet germicidal irradiation should be considered in areas where adequate ventilation is difficult to achieve. Personal protective equipment including particulate respirators provides additional benefit when administrative and environmental controls cannot assure protection.

The adoption of IT security standards in a healthcare environment.

PubMed

Gomes, Rui; Lapão, Luís Velez

2008-01-01

Security is a vital part of daily life to Hospitals that need to ensure that the information is adequately secured. In Portugal, more CIOs are seeking that their hospital IS departments are properly protecting information assets from security threats. It is imperative to take necessary measures to ensure risk management and business continuity. Security management certification provides just such a guarantee, increasing patient and partner confidence. This paper introduces one best practice for implementing four security controls in a hospital datacenter infrastructure (ISO27002), and describes the security assessment for implementing such controls.

A New Lebanese Medication Adherence Scale: Validation in Lebanese Hypertensive Adults

PubMed Central

Wakim, N.; Issa, C.; Kassem, B.; Abou Jaoude, L.; Saleh, N.

2018-01-01

Background A new Lebanese scale measuring medication adherence considered socioeconomic and cultural factors not taken into account by the eight-item Morisky Medication Adherence Scale (MMAS-8). Objectives were to validate the new adherence scale and its prediction of hypertension control, compared to MMAS-8, and to assess adherence rates and factors. Methodology A cross-sectional study, including 405 patients, was performed in outpatient cardiology clinics of three hospitals in Beirut. Blood pressure was measured, a questionnaire filled, and sodium intake estimated by a urine test. Logistic regression defined predictors of hypertension control and adherence. Results 54.9% had controlled hypertension. 82.4% were adherent by the new scale, which showed good internal consistency, adequate questions (KMO coefficient = 0.743), and four factors. It predicted hypertension control (OR = 1.217; p value = 0.003), unlike MMAS-8, but the scores were correlated (ICC average measure = 0.651; p value < 0.001). Stress and smoking predicted nonadherence. Conclusion This study elaborated a validated, practical, and useful tool measuring adherence to medications in Lebanese hypertensive patients. PMID:29887993

Are the current Australian sun exposure guidelines effective in maintaining adequate levels of 25-hydroxyvitamin D?

PubMed

Kimlin, Michael; Sun, Jiandong; Sinclair, Craig; Heward, Sue; Hill, Jane; Dunstone, Kimberley; Brodie, Alison

2016-01-01

An adequate vitamin D status, as measured by serum 25-hydroxyvitamin D (25(OH)D) concentration, is important in humans for maintenance of healthy bones and muscle function. Serum 25(OH)D concentration was assessed in participants from Melbourne, Australia (37.81S, 144.96E), who were provided with the current Australian guidelines on sun exposure for 25(OH)D adequacy (25(OH)D ≥50 nmol/L). Participants were interviewed in February (summer, n=104) and August (winter, n=99) of 2013. Serum 25(OH)D concentration was examined as a function of measures of sun exposure and sun protection habits with control of key characteristics such as dietary intake of vitamin D, body mass index (BMI) and skin colour, that may modify this relationship. The mean 25(OH)D concentration in participants who complied with the current sun exposure guidelines was 67.3 nmol/L in summer and 41.9 nmol/L in winter. At the end of the study, 69.3% of participants who complied with the summer sun exposure guidelines were 25(OH)D adequate, while only 27.6% of participants who complied with the winter sun exposure guidelines were 25(OH)D adequate at the end of the study. The results suggest that the current Australian guidelines for sun exposure for 25(OH)D adequacy are effective for most in summer and ineffective for most in winter. This article is part of a Special Issue entitled '17th Vitamin D Workshop'. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reliability and validity of a treatment fidelity assessment for motivational interviewing targeting sexual risk behaviors in people living with HIV/AIDS.

PubMed

Seng, Elizabeth K; Lovejoy, Travis I

2013-12-01

This study psychometrically evaluates the Motivational Interviewing Treatment Integrity Code (MITI) to assess fidelity to motivational interviewing to reduce sexual risk behaviors in people living with HIV/AIDS. 74 sessions from a pilot randomized controlled trial of motivational interviewing to reduce sexual risk behaviors in people living with HIV were coded with the MITI. Participants reported sexual behavior at baseline, 3-month, and 6-months. Regarding reliability, excellent inter-rater reliability was achieved for measures of behavior frequency across the 12 sessions coded by both coders; global scales demonstrated poor intraclass correlations, but adequate percent agreement. Regarding validity, principle components analyses indicated that a two-factor model accounted for an adequate amount of variance in the data. These factors were associated with decreases in sexual risk behaviors after treatment. The MITI is a reliable and valid measurement of treatment fidelity for motivational interviewing targeting sexual risk behaviors in people living with HIV/AIDS.

Evaluation of the psychometric properties of two short forms of the social interaction anxiety scale and the social phobia scale.

PubMed

Le Blanc, Allura L; Bruce, Laura C; Heimberg, Richard G; Hope, Debra A; Blanco, Carlos; Schneier, Franklin R; Liebowitz, Michael R

2014-06-01

The Social Interaction Anxiety Scale and Social Phobia Scale are widely used measures of social anxiety. Using data from individuals with social anxiety disorder (n = 435) and nonanxious controls (n = 86), we assessed the psychometric properties of two independently developed short forms of these scales. Indices of convergent and discriminant validity, diagnostic specificity, sensitivity to treatment, and readability were examined. Comparisons of the two sets of short forms to each other and the original long forms were conducted. Both sets of scales demonstrated adequate internal consistency in the patient sample, showed expected patterns of correlation with measures of related and unrelated constructs, adequately discriminated individuals with social anxiety disorder from those without, and showed decreases in scores over the course of cognitive-behavioral therapy and/or pharmacotherapy. However, some significant differences in scale performance were noted. Implications for the clinical assessment of social anxiety are discussed. © The Author(s) 2014.

Noise assessment of unsuppressed TF-34-GE-100A engine at Warfield ANG, Baltimore, Maryland

NASA Astrophysics Data System (ADS)

Shaffer, Winston J., II; Ellis, John C., II

1987-12-01

This report presents the results of noise data measurements of an unsuppressed TF34-GE-100A engine and a community noise survey of the local area around the engine. Three recommendations were made. A two barrier design should be installed as an interim noise control measure. Justification and installation of a noise suppressor, as a long term solution, should be pursued. Day-night sound levels should continue to be monitored until adequate characterization of the airport noise environment is obtained.

Block observations of neighbourhood physical disorder are associated with neighbourhood crime, firearm injuries and deaths, and teen births.

PubMed

Wei, Evelyn; Hipwell, Alison; Pardini, Dustin; Beyers, Jennifer M; Loeber, Rolf

2005-10-01

To provide reliability information for a brief observational measure of physical disorder and determine its relation with neighbourhood level crime and health variables after controlling for census based measures of concentrated poverty and minority concentration. Psychometric analysis of block observation data comprising a brief measure of neighbourhood physical disorder, and cross sectional analysis of neighbourhood physical disorder, neighbourhood crime and birth statistics, and neighbourhood level poverty and minority concentration. Pittsburgh, Pennsylvania, US (2000 population=334 563). Pittsburgh neighbourhoods (n=82) and their residents (as reflected in neighbourhood level statistics). The physical disorder index showed adequate reliability and validity and was associated significantly with rates of crime, firearm injuries and homicides, and teen births, while controlling for concentrated poverty and minority population. This brief measure of neighbourhood physical disorder may help increase our understanding of how community level factors reflect health and crime outcomes.

Report: EPA Has Adequate Controls to Manage Advice From Science and Research Federal Advisory Committees, but Transparency Could Be Improved

EPA Pesticide Factsheets

Report #17-P-0124, March 13, 2017. Science plays an integral role in the EPA's mission. The EPA has an adequate system of controls to manage recommendations from its science and research federal advisory committees.

The development and use of respirator response functions as part of a workplace exposure monitoring program for control of potential respiratory hazards.

PubMed

Maxim, L D; Allshouse, J N; Chen, S H; Treadway, J; Venturin, D

1998-04-01

The traditional hierarchy of measures for control of potential respiratory hazards in the workplace includes (in order of preference) engineering controls, workplace practices, and use of respiratory protection. Although third in this hierarchy, respirators can be an important component of the control mix-particularly for difficult-to-control jobs, as an interim measure (pending implementation of other controls), and in cases where exposure is intermittent. One of the problems associated with the use of respirators as a control measure is that valid and adequate data on respirator usage are often not available. Absent these data it is difficult to determine the practical effectiveness of respirators and exposure calculations which include the protective effect of respirators are speculative. This paper presents models (and appropriate statistical fitting techniques) suitable for quantification of respirator usage and defines three potentially useful measures of effectiveness for a respirator program. These models are illustrated with monitoring data on refractory ceramic fiber (RCF) developed as part of a Consent Agreement between the RCF industry and the U.S. Environmental Protection Agency. For this substance there are extensive and comprehensive monitoring data available. The models and methods of analysis may prove applicable for other potential respiratory hazards in the workplace. Copyright 1998 Academic Press.

Selection of Reference Gene Expression in a Schizophrenia Brain Cohort

PubMed Central

Weickert, Cynthia Shannon; Sheedy, Donna; Rothmond, Debora A.; Dedova, Irina; Fung, Samantha; Garrick, Therese; Wong, Jenny; Harding, Antony J.; Sivagnanansundaram, Sinthuja; Hunt, Clare; Duncan, Carlotta; Sundqvist, Nina; Tsai, Shan-Yuan; Anand, Jasna; Draganic, Daren; Harper, Clive

2010-01-01

Objective To conduct postmortem human brain research into the neuropathological basis of schizophrenia, it is critical to establish cohorts that are well-characterised and well-matched. Our objective was to determine if specimen characteristics, including: diagnosis, age, postmortem interval (PMI), brain acidity (pH), and/or the agonal state of the subject at death related to RNA quality, and to determine the most appropriate reference gene mRNAs. Methods We selected a matched cohort of 74 cases (37 schizophrenia / schizoaffective disorder cases and 37 controls cases). Middle frontal gyrus tissue was pulverised, tissue pH was measured, RNA isolated for cDNA from each case, and RNA integrity number (RIN) measurements were assessed. Using RT-PCR, we measured nine housekeeper genes and calculated a geomean in each diagnostic group. Results We found that the RINs were very good (mean 7.3) and all nine housekeeper control genes were significantly correlated with RIN. Seven of nine housekeeper genes were also correlated with pH, and two clinical variables, agonal state and duration of illness did have an effect on some control mRNAs. No major impact of PMI or freezer time on housekeeper mRNAs was detected. Our results show that people with schizophrenia had significantly less PPIA, and SDHA and tended to have less GUSB and B2M mRNA suggesting that these control genes may not be good candidates for normalisation. Conclusions In our cohort, less than 10% variability in RIN values was detected and the diagnostic groups were well matched overall. Our cohort was adequately powered (0.80–0.90) to detect mRNA differences (25%) due to disease. Our study suggests that multiple factors should be considered in mRNA expression studies of human brain tissues. When schizophrenia cases are adequately matched to control cases subtle differences in gene expression can be reliably detected. PMID:20073568

Improving Jet Engine Reliability and Maintainability: A Conceptual Approach

DTIC Science & Technology

1976-05-05

MANAGEMENT COLLEGE FT. BELVOIR, VA 22060 11. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE DEFENSE SYSTEMS MANAGMNT COLLEGE 76-1 ___ FT. 1BELVOIR... relationship to the end item; identifying the failure processes that each part is susceptible to; defining the failure rate for each process, determining the...Icontractor had performed in relationship to the established goal. The above standard of measurement appears to satisfy the criteria for an adequate

Convergent and discriminant validity of measures of parenting efficacy and control.

PubMed

Lovejoy, M C; Verda, M R; Hays, C E

1997-12-01

Examined the convergent and discriminant validity of the Parent Attribution Test (PAT; Bugental, Blue, & Cruzcosa, 1989), the Parental Locus of Control Scale (PLOC; Campis, Lyman, & Prentice-Dunn, 1986), and the Parenting Sense of Competence-Efficacy Scale (PSOC-Efficacy; Johnston & Mash, 1989) in 3 samples of community mothers. In the 1st 2 samples, mothers also completed measures of negative affect and social desirability. In the 3rd sample, the PAT and PSOC-Efficacy scales were administered with measures of adult attachment style and child behavior problems. There was weak support for the convergent validity of the measures. Moreover, the discriminant validity of the measures was not adequately demonstrated. Our results suggest that PLOC and PSOC-Efficacy scores may reflect distress and response style as well as beliefs about parenting. Scores on the PAT, although less influenced by response style and distress, appear to reflect a different dimension of efficacy than that assessed by other self-report measures.

40 CFR 716.25 - Adequate file search.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a...

40 CFR 716.25 - Adequate file search.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a...

40 CFR 716.25 - Adequate file search.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a...

40 CFR 716.25 - Adequate file search.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a...

40 CFR 716.25 - Adequate file search.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a...

78 FR 21000 - Self-Regulatory Organizations; Chicago Mercantile Exchange Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-08

... adequate accounting system, internal accounting controls, and procedures for safeguarding customer and firm... an adequate accounting system, internal accounting controls, and procedures for safeguarding customer... ability to provide to the Exchange in an acceptable form a complete set of equity system reports...

Systematic behavioural observation of executive performance after brain injury.

PubMed

Lewis, Mark W; Babbage, Duncan R; Leathem, Janet M

2017-01-01

To develop an ecologically valid measure of executive functioning (i.e. Planning and Organization, Executive Memory, Initiation, Cognitive Shifting, Impulsivity, Sustained and Directed Attention, Error Detection, Error Correction and Time Management) during a functional chocolate brownie cooking task. In Study 1, the inter-rater reliability of a novel behavioural observation assessment method was assessed with 10 people with traumatic brain injury (TBI). In Study 2, 27 people with TBI and 16 healthy controls completed the functional task along with other measures of executive functioning to assess validity. Intraclass correlation coefficients for six of the nine aspects of executive functioning ranged from .54 to 1.00. Percentage agreements for the remaining aspects ranged from 70% to 90%. Significant and non-significant, moderate, correlations were found between the functional cooking task and standard neuropsychological measures. The healthy control group performed better than the TBI group in six areas (d = 0.56 to 1.23). In this initial trial of a novel assessment method, adequate inter-rater reliability was found. The measure was associated with standard neuropsychological measures, and our healthy control group performed better than the TBI group. The measure appears to be an ecologically valid measure of executive functioning.

COPD control: Can a consensus be found?

PubMed

Guimarães, M; Bugalho, A; Oliveira, A S; Moita, J; Marques, A

2016-01-01

There are currently no reliable instruments for assessing the onset and progression of chronic obstructive pulmonary disease (COPD) or predicting its prognosis. Currently, a comprehensive assessment of COPD including several objective and subjective parameters is recommended. However, the lack of biomarkers precludes a correct assessment of COPD severity, which consequently hampers adequate therapeutic approaches and COPD control. In the absence of a definition of "well-controlled disease", a consensus regarding COPD control will be difficult to reach. However, COPD patient assessment should be multidimensional, and anchored in five points: control of symptoms, decline of pulmonary function, levels of physical activity, exacerbations, and Quality of Life. Several non-pharmacological and pharmacological measures are currently available to achieve disease control. Smoking cessation, vaccination, exercise training programs and pulmonary rehabilitation are recognized as important non-pharmacological measures but bronchodilators are the pivotal therapy in the control of COPD. This paper discusses several objective and subjective parameters that may bridge the gap between disease assessment and disease control. The authors conclude that, at present, it is not possible to reach a consensus regarding COPD control, essentially due to the lack of objective instruments to measure it. Some recommendations are set forth, but true COPD control awaits further objective assessments. Copyright © 2016. Published by Elsevier España, S.L.U.

Measuring the involvement of people with HIV in treatment decision making using the control preferences scale.

PubMed

Kremer, Heidemarie; Ironson, Gail

2008-01-01

Since 1983, HIV patients have been advocating for participatory decision making. This study measures the involvement that HIV-positive people perceive in treatment decision making. A secondary objective is to assess the validity of the instrument used to examine decisional roles, the Control Preferences Scale (CPS). The authors interviewed 79 HIV-positive people, a sub-sample of a study on long survival with HIV, diverse with respect to ethnicity, age, gender, and sexual orientation. They compared the self- and researcher-rated decisional roles of participants on the CPS. They also assessed how well the CPS corresponds with Charles's paternalistic, shared- and informed-choice models of decision making about treatment based on decisional roles and information exchange. Most participants (75%) perceived collaborative/active involvement in decision making. Agreement (Kendall's tau-b) between self- and researcher-rated decisional roles on the CPS was 0.82, whereas agreement between self-ratings on the CPS and researcher ratings on Charles's classification was 0.60. Charles's classification was difficult if participants had chosen not to take their prescribed medication without being adequately informed about the risky consequences of this decision. In this study, HIV-positive people perceived a high level of involvement in decision making. Reliability and convergent validity of the CPS was high. Charles's classification was problematic because decisional roles and information exchange are distinct dimensions. Some people make risky treatment decisions on their own without being adequately informed. The CPS is a useful instrument to measure decisional role perceptions of HIV-positive people but needs to be complemented by an instrument measuring treatment knowledge.

Epidemiologic study of deaths and injuries due to tornadoes.

PubMed

Carter, A O; Millson, M E; Allen, D E

1989-12-01

A case-control study, using both matched and unmatched controls, was carried out on individuals who were injured or killed by a series of tornadoes that passed through Ontario, Canada, on May 31, 1985. Many serious injuries (25%) and almost all (83%) deaths were the result of becoming airborne, while most minor injuries (94%) were due to being struck by objects. Head injury was the most common injury type. Few (21%) of those in buildings chose the recommended location, and most (61%) were not in the least damaged part. Most (91%) had less than one minute's warning, and only 47% had a functioning radio at the time the tornado hit. The following risk factors for injury and death were identified: poor building anchorage; location other than in a basement, especially outdoors; age over 70 years; and high wind strength. These findings support previous findings and point to measures which have potential for preventing death or serious injury in future tornadoes: adequate warning systems and public education to ensure that individuals understand the warning and respond by seeking appropriate shelter. Those in adequately anchored buildings should shelter in an interior room or basement. Those who are outdoors, in poorly anchored buildings, mobile homes, or portable classrooms require access to an adequately anchored building, preferably with a basement, during severe storm warnings. This should be arranged by local authorities.

Mountain Hydrology of the Semi-Arid Western U.S.: Research Needs, Opportunities and Challenges

NASA Astrophysics Data System (ADS)

Bales, R.; Dozier, J.; Molotch, N.; Painter, T.; Rice, R.

2004-12-01

In the semi-arid Western U.S., water resources are being stressed by the combination of climate warming, changing land use, and population growth. Multiple consensus planning documents point to this region as perhaps the highest priority for new hydrologic understanding. Three main hydrologic issues illustrate research needs in the snow-driven hydrology of the region. First, despite the hydrologic importance of mountainous regions, the processes controlling their energy, water and biogeochemical fluxes are not well understood. Second, there exists a need to realize, at various spatial and temporal scales, the feedback systems between hydrological fluxes and biogeochemical and ecological processes. Third, the paucity of adequate observation networks in mountainous regions hampers improvements in understanding these processes. For example, we lack an adequate description of factors controlling the partitioning of snowmelt into runoff versus infiltration and evapotranspiration, and need strategies to accurately measure the variability of precipitation, snow cover and soil moisture. The amount of mountain-block and mountain-front recharge and how recharge patterns respond to climate variability are poorly known across the mountainous West. Moreover, hydrologic modelers and those measuring important hydrologic variables from remote sensing and distributed in situ sites have failed to bridge rifts between modeling needs and available measurements. Research and operational communities will benefit from data fusion/integration, improved measurement arrays, and rapid data access. For example, the hydrologic modeling community would advance if given new access to single rather than disparate sources of bundles of cutting-edge remote sensing retrievals of snow covered area and albedo, in situ measurements of snow water equivalent and precipitation, and spatio-temporal fields of variables that drive models. In addition, opportunities exist for the deployment of new technologies, taking advantage of research in spatially distributed sensor networks that can enhance data recovery and analysis.

21 CFR 113.40 - Equipment and procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... have adequate filter systems to ensure a supply of clean, dry air. A steam controller activated by the... ensure a supply of clean, dry air. (5) Steam introduction. Steam shall be distributed in the bottom of... temperature controllers should have adequate filter systems to ensure a supply of clean, dry air. (5) Bleeders...

21 CFR 113.40 - Equipment and procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... have adequate filter systems to ensure a supply of clean, dry air. A steam controller activated by the... ensure a supply of clean, dry air. (5) Steam introduction. Steam shall be distributed in the bottom of... temperature controllers should have adequate filter systems to ensure a supply of clean, dry air. (5) Bleeders...

21 CFR 113.40 - Equipment and procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... have adequate filter systems to ensure a supply of clean, dry air. A steam controller activated by the... ensure a supply of clean, dry air. (5) Steam introduction. Steam shall be distributed in the bottom of... temperature controllers should have adequate filter systems to ensure a supply of clean, dry air. (5) Bleeders...

Use of the Esophageal Doppler Machine to help guide the intraoperative management of two children with pheochromocytoma.

PubMed

Hack, Henrik

2006-08-01

The anesthetic management of pheochromocytoma has been based upon the intraoperative control of blood pressure and fluid balance following adequate preoperative preparation. This can be difficult, especially in the presence of significant comorbidity such as cardiac or renal dysfunction. Two cases of children with pheochromocytoma are reported where the introperative management of fluid balance and blood pressure control were guided by measurement of changes in descending aortic blood flow using an esophageal Doppler probe. The advantages of such a technique compared with more invasive monitors are discussed.

Bedtime Blood Pressure Chronotherapy Significantly Improves Hypertension Management.

PubMed

Hermida, Ramón C; Ayala, Diana E; Fernández, José R; Mojón, Artemio; Crespo, Juan J; Ríos, María T; Smolensky, Michael H

2017-10-01

Consistent evidence of numerous studies substantiates the asleep blood pressure (BP) mean derived from ambulatory BP monitoring (ABPM) is both an independent and a stronger predictor of cardiovascular disease (CVD) risk than are daytime clinic BP measurements or the ABPM-determined awake or 24-hour BP means. Hence, cost-effective adequate control of sleep-time BP is of marked clinical relevance. Ingestion time, according to circadian rhythms, of hypertension medications of 6 different classes and their combinations significantly improves BP control, particularly sleep-time BP, and reduces adverse effects. Copyright © 2017 Elsevier Inc. All rights reserved.

Model and system learners, optimal process constructors and kinetic theory-based goal-oriented design: A new paradigm in materials and processes informatics

NASA Astrophysics Data System (ADS)

Abisset-Chavanne, Emmanuelle; Duval, Jean Louis; Cueto, Elias; Chinesta, Francisco

2018-05-01

Traditionally, Simulation-Based Engineering Sciences (SBES) has relied on the use of static data inputs (model parameters, initial or boundary conditions, … obtained from adequate experiments) to perform simulations. A new paradigm in the field of Applied Sciences and Engineering has emerged in the last decade. Dynamic Data-Driven Application Systems [9, 10, 11, 12, 22] allow the linkage of simulation tools with measurement devices for real-time control of simulations and applications, entailing the ability to dynamically incorporate additional data into an executing application, and in reverse, the ability of an application to dynamically steer the measurement process. It is in that context that traditional "digital-twins" are giving raise to a new generation of goal-oriented data-driven application systems, also known as "hybrid-twins", embracing models based on physics and models exclusively based on data adequately collected and assimilated for filling the gap between usual model predictions and measurements. Within this framework new methodologies based on model learners, machine learning and kinetic goal-oriented design are defining a new paradigm in materials, processes and systems engineering.

Electric vehicle power train instrumentation: Some constraints and considerations

NASA Technical Reports Server (NTRS)

Triner, J. E.; Hansen, I. G.

1977-01-01

The application of pulse modulation control (choppers) to dc motors creates unique instrumentation problems. In particular, the high harmonic components contained in the current waveforms require frequency response accommodations not normally considered in dc instrumentation. In addition to current sensing, accurate power measurement requires not only adequate frequency response but must also address phase errors caused by the finite bandwidths and component characteristics involved. The implications of these problems are assessed.

The Effects of the Heat and Moisture Exchanger on Humidity, Airway Temperature, and Core Body Temperature

DTIC Science & Technology

1999-10-01

was added to the experimental group. Three more measurements were recorded at 10, 30 and 60 minutes after the insertion of the heat and moisture...heat and moisture exchanger provided adequate humidification of the inspired gases. In the experimental group, there was no difference in...exchanger incorporated in the ventilator Heat and Moisture Exchangers 16 circuit (the experimental group) and 10 did not (the control group

21 CFR 110.80 - Processes and controls.

Code of Federal Regulations, 2011 CFR

2011-04-01

... safe and of adequate sanitary quality. (12) Batters, breading, sauces, gravies, dressings, and other...) Cooling to an adequate temperature during manufacturing. (vi) Disposing of batters at appropriate...

Development and evaluation of the INSPIRE measure of staff support for personal recovery.

PubMed

Williams, Julie; Leamy, Mary; Bird, Victoria; Le Boutillier, Clair; Norton, Sam; Pesola, Francesca; Slade, Mike

2015-05-01

No individualised standardised measure of staff support for mental health recovery exists. To develop and evaluate a measure of staff support for recovery. initial draft of measure based on systematic review of recovery processes; consultation (n = 61); and piloting (n = 20). Psychometric evaluation: three rounds of data collection from mental health service users (n = 92). INSPIRE has two sub-scales. The 20-item Support sub-scale has convergent validity (0.60) and adequate sensitivity to change. Exploratory factor analysis (variance 71.4-85.1 %, Kaiser-Meyer-Olkin 0.65-0.78) and internal consistency (range 0.82-0.85) indicate each recovery domain is adequately assessed. The 7-item Relationship sub-scale has convergent validity 0.69, test-retest reliability 0.75, internal consistency 0.89, a one-factor solution (variance 70.5 %, KMO 0.84) and adequate sensitivity to change. A 5-item Brief INSPIRE was also evaluated. INSPIRE and Brief INSPIRE demonstrate adequate psychometric properties, and can be recommended for research and clinical use.

Wind tunnel tests of the dynamic characteristics of the fluidic rudder

NASA Technical Reports Server (NTRS)

Belsterling, C. A.

1976-01-01

The fourth phase is given of a continuing program to develop the means to stabilize and control aircraft without moving parts or a separate source of power. Previous phases have demonstrated the feasibility of (1) generating adequate control forces on a standard airfoil, (2) controlling those forces with a fluidic amplifier and (3) cascading non-vented fluidic amplifiers operating on ram air supply pressure. The foremost objectives of the fourth phase covered under Part I of this report were to demonstrate a complete force-control system in a wind tunnel environment and to measure its static and dynamic control characteristics. Secondary objectives, covered under Part II, were to evaluate alternate configurations for lift control. The results demonstrate an overall response time of 150 msec, confirming this technology as a viable means for implementing low-cost reliable flight control systems.

Touchdown: The Development of Propulsion Controlled Aircraft at NASA Dryden

NASA Technical Reports Server (NTRS)

Tucker, Tom

1999-01-01

This monograph relates the important history of the Propulsion Controlled Aircraft project at NASA's Dryden Flight Research Center. Spurred by a number of airplane crashes caused by the loss of hydraulic flight controls, a NASA-industry team lead by Frank W. Burcham and C. Gordon Fullerton developed a way to land an aircraft safely using only engine thrust to control the airplane. In spite of initial skepticism, the team discovered that, by manually manipulating an airplane's thrust, there was adequate control for extended up-and-away flight. However, there was not adequate control precision for safe runway landings because of the small control forces, slow response, and difficulty in damping the airplane phugoid and Dutch roll oscillations. The team therefore conceived, developed, and tested the first computerized Propulsion Controlled Aircraft (PCA) system. The PCA system takes pilot commands, uses feedback from airplane measurements, and computes commands for the thrust of each engine, yielding much more precise control. Pitch rate and velocity feedback damp the phugoid oscillation, while yaw rate feedback damps the Dutch roll motion. The team tested the PCA system in simulators and conducted flight research in F-15 and MD-11 airplanes. Later, they developed less sophisticated variants of PCA called PCA Lite and PCA Ultralite to make the system cheaper and therefore more attractive to industry. This monograph tells the PCA story in a non- technical way with emphasis on the human aspects of the engineering and flic,ht-research effort. It thereby supplements the extensive technical literature on PCA and makes the development of this technology accessible to a wide audience.

Improving stability margins in discrete-time LQG controllers

NASA Technical Reports Server (NTRS)

Oranc, B. Tarik; Phillips, Charles L.

1987-01-01

Some of the problems are discussed which are encountered in the design of discrete-time stochastic controllers for problems that may adequately be described by the Linear Quadratic Gaussian (LQG) assumptions; namely, the problems of obtaining acceptable relative stability, robustness, and disturbance rejection properties. A dynamic compensator is proposed to replace the optimal full state feedback regulator gains at steady state, provided that all states are measurable. The compensator increases the stability margins at the plant input, which may possibly be inadequate in practical applications. Though the optimal regulator has desirable properties the observer based controller as implemented with a Kalman filter, in a noisy environment, has inadequate stability margins. The proposed compensator is designed to match the return difference matrix at the plant input to that of the optimal regulator while maintaining the optimality of the state estimates as directed by the measurement noise characteristics.

Brain metabolite alterations in infants born preterm with intrauterine growth restriction: association with structural changes and neurodevelopmental outcome.

PubMed

Simões, Rui V; Muñoz-Moreno, Emma; Cruz-Lemini, Mónica; Eixarch, Elisenda; Bargalló, Núria; Sanz-Cortés, Magdalena; Gratacós, Eduard

2017-01-01

Intrauterine growth restriction and premature birth represent 2 independent problems that may occur simultaneously and contribute to impaired neurodevelopment. The objective of the study was to assess changes in the frontal lobe metabolic profiles of 1 year old intrauterine growth restriction infants born prematurely and adequate-for-gestational-age controls, both premature and term adequate for gestational age and their association with brain structural and biophysical parameters and neurodevelopmental outcome at 2 years. A total of 26 prematurely born intrauterine growth restriction infants (birthweight <10th centile for gestational age), 22 prematurely born but adequate for gestational age controls, and 26 term adequate-for-gestational-age infants underwent brain magnetic resonance imaging and magnetic resonance spectroscopy at 1 year of age during natural sleep, on a 3 Tesla scanner. All brain T1-weighted and diffusion-weighted images were acquired along with short echo time single-voxel proton spectra from the frontal lobe. Magnetic resonance imaging/magnetic resonance spectroscopy data were processed to derive structural, biophysical, and metabolic information, respectively. Neurodevelopment was evaluated at 2 years of age using the Bayley Scales 3rd edition, assessing cognitive, language, motor, socioemotional, and adaptive behavior. Prematurely born intrauterine growth restriction infants had slightly smaller brain volumes and increased frontal lobe white matter mean diffusivity compared with both prematurely born but adequate for gestational age and term adequate for gestational age controls. Frontal lobe N-acetylaspartate levels were significantly lower in prematurely born intrauterine growth restriction than in prematurely born but adequate for gestational age infants but increased in prematurely born but adequate for gestational age compared with term adequate-for-gestational-age infants. The prematurely born intrauterine growth restriction group also showed slightly lower choline compounds, borderline decrements of estimated glutathione levels, and increased myoinositol to choline ratios, compared with prematurely born but adequate for gestational age controls. These specific metabolite changes were locally correlated to lower gray matter content and increased mean diffusivity and reduced white matter fraction and fractional anisotropy. Prematurely born intrauterine growth restriction infants also showed a tendency for poorer neurodevelopmental outcome at 2 years, associated with lower levels of frontal lobe N-acetylaspartate at 1 year within the preterm subset. Preterm intrauterine growth restriction infants showed altered brain metabolite profiles during a critical stage of brain maturation, which correlate with brain structural and biophysical parameters and neurodevelopmental outcome. Our results suggest altered neurodevelopmental trajectories in preterm intrauterine growth restriction and adequate-for-gestational-age infants, compared with term adequate-for-gestational-age infants, which require further characterization. Copyright © 2016 Elsevier Inc. All rights reserved.

Evidence-Based Assessment of Depression in Adults

ERIC Educational Resources Information Center

Joiner, Thomas E.; Walker, Rheeda L.; Pettit, Jeremy W.; Perez, Marisol; Cukrowicz, Kelly C.

2005-01-01

From diverse perspectives, there is little doubt that depressive symptoms cohere to form a valid and distinct syndrome. Research indicates that an evidence-based assessment of depression would include (a) measures with adequate psychometric properties; (b) adequate coverage of symptoms; (c) adequate coverage of depressed mood, anhedonia, and…

Impact of telemedicine in managing type 1 diabetes among school-age children and adolescents: an integrative review.

PubMed

Guljas, Rebecca; Ahmed, Azza; Chang, Karen; Whitlock, Analei

2014-01-01

Patients with diabetes who have limited access to healthcare services are less likely to maintain adequate diabetes control. Telemedicine represents a useful solution to the strict follow up required in diabetes management. This review analyzes the impact that telemedicine has on the management of type 1 diabetes among school-age children and adolescents, as measured by compliance with blood glucose monitoring, glycemic control, satisfaction, and self management. In general, this review supports the use of telemedicine in maintaining glycemic control. Further studies are desired to observe the impact of telemedicine in managing type 1 diabetes in school-age children and adolescents. Copyright © 2014 Elsevier Inc. All rights reserved.

Infrastructure Vulnerability Assessment Model (I-VAM).

PubMed

Ezell, Barry Charles

2007-06-01

Quantifying vulnerability to critical infrastructure has not been adequately addressed in the literature. Thus, the purpose of this article is to present a model that quantifies vulnerability. Vulnerability is defined as a measure of system susceptibility to threat scenarios. This article asserts that vulnerability is a condition of the system and it can be quantified using the Infrastructure Vulnerability Assessment Model (I-VAM). The model is presented and then applied to a medium-sized clean water system. The model requires subject matter experts (SMEs) to establish value functions and weights, and to assess protection measures of the system. Simulation is used to account for uncertainty in measurement, aggregate expert assessment, and to yield a vulnerability (Omega) density function. Results demonstrate that I-VAM is useful to decisionmakers who prefer quantification to qualitative treatment of vulnerability. I-VAM can be used to quantify vulnerability to other infrastructures, supervisory control and data acquisition systems (SCADA), and distributed control systems (DCS).

Analysis and interpretation of cost data in randomised controlled trials: review of published studies

PubMed Central

Barber, Julie A; Thompson, Simon G

1998-01-01

Objective To review critically the statistical methods used for health economic evaluations in randomised controlled trials where an estimate of cost is available for each patient in the study. Design Survey of published randomised trials including an economic evaluation with cost values suitable for statistical analysis; 45 such trials published in 1995 were identified from Medline. Main outcome measures The use of statistical methods for cost data was assessed in terms of the descriptive statistics reported, use of statistical inference, and whether the reported conclusions were justified. Results Although all 45 trials reviewed apparently had cost data for each patient, only 9 (20%) reported adequate measures of variability for these data and only 25 (56%) gave results of statistical tests or a measure of precision for the comparison of costs between the randomised groups. Only 16 (36%) of the articles gave conclusions which were justified on the basis of results presented in the paper. No paper reported sample size calculations for costs. Conclusions The analysis and interpretation of cost data from published trials reveal a lack of statistical awareness. Strong and potentially misleading conclusions about the relative costs of alternative therapies have often been reported in the absence of supporting statistical evidence. Improvements in the analysis and reporting of health economic assessments are urgently required. Health economic guidelines need to be revised to incorporate more detailed statistical advice. Key messagesHealth economic evaluations required for important healthcare policy decisions are often carried out in randomised controlled trialsA review of such published economic evaluations assessed whether statistical methods for cost outcomes have been appropriately used and interpretedFew publications presented adequate descriptive information for costs or performed appropriate statistical analysesIn at least two thirds of the papers, the main conclusions regarding costs were not justifiedThe analysis and reporting of health economic assessments within randomised controlled trials urgently need improving PMID:9794854

A clinically guided approach for improving performance measurement for hypertension.

PubMed

Steinman, Michael A; Lee, Sei J; Peterson, Carolyn A; Fung, Kathy Z; Goldstein, Mary K

2012-05-01

Performance measures often fail to account for legitimate reasons why patients do not achieve recommended treatment targets. We tested a novel performance measurement system for blood pressure (BP) control that was designed to mimic clinical reasoning. This clinically guided approach focuses on (1) exempting patients for whom tight BP control may not be appropriate or feasible and (2) assessing BP over time. Trained abstractors conducted structured chart reviews of 201 adults with hypertension in 2 VA health care systems. Results were compared with traditional methods of performance measurement. Among 201 veterans, 183 (91%) were male, and the mean age was 71±11 years. Using the clinically guided approach, 61 patients (30%) were exempted from performance measurement. The most common reasons for exemption were inadequate opportunity to manage BP (35 patients, 17%) and the use of 4 or more antihypertensive medications (19 patients, 9%). Among patients eligible for performance measurement, there was little agreement on the presence of controlled versus uncontrolled BP when comparing the most recent BP (the traditional approach) with an integrated assessment of BP control (κ 0.14). After accounting for clinically guided exemptions and methods of BP assessment, only 15 of 72 patients (21%) whose last BP was ≥140/90 mm Hg were classified as problematic by the clinically guided approach. Many patients have legitimate reasons for not achieving tight BP control, and the methods used for BP assessment have marked effects on whether a patient is classified as having adequate or inadequate BP control.

Improvement in Growth After 1 Year of Growth Hormone Therapy in Well-Nourished Infants with Growth Retardation Secondary to Chronic Renal Failure: Results of a Multicenter, Controlled, Randomized, Open Clinical Trial

PubMed Central

Moreno, M. Llanos; Neto, Arlete; Ariceta, Gema; Vara, Julia; Alonso, Angel; Bueno, Alberto; Afonso, Alberto Caldas; Correia, António Jorge; Muley, Rafael; Barrios, Vicente; Gómez, Carlos; Argente, Jesús

2010-01-01

Background and objectives: Our aim was to evaluate the growth-promoting effect of growth hormone (GH) treatment in infants with chronic renal failure (CRF) and persistent growth retardation despite adequate nutritional and metabolic management. Design, setting, participants, & measurements: The study design included randomized, parallel groups in an open, multicenter trial comparing GH (0.33 mg/kg per wk) with nontreatment with GH during 12 months. Sixteen infants who had growth retardation, were aged 12 ± 3 months, had CRF (GFR ≤60 ml/min per 1.73 m2), and had adequate nutritional intake and good metabolic control were recruited from eight pediatric nephrology departments from Spain and Portugal. Main outcome measures were body length, body weight, bone age, biochemical and hormonal analyses, renal function, bone mass, and adverse effects. Results: Length gain in infants who were treated with GH was statistically greater (P < 0.05) than that of nontreated children (14.5 versus 9.5 cm/yr; SD score 1.43 versus −0.11). The GH-induced stimulation of growth was associated with no undesirable effects on bone maturation, renal failure progression, or metabolic control. In addition, GH treatment improved forearm bone mass and increased serum concentrations of total and free IGF-I and IGF-binding protein 3 (IGFBP-3), whereas IGF-II, IGFBP-1, IGFBP-2, GH-binding protein, ghrelin, and leptin were not modified. Conclusions: Infants with CRF and growth retardation despite good metabolic and nutritional control benefit from GH treatment without adverse effects during 12 months of therapy. PMID:20522533

Clinical characteristics and patient-reported outcomes in patients with inadequately controlled rheumatoid arthritis despite ongoing treatment.

PubMed

Taylor, Peter C; Alten, Rieke; Gomez-Reino, Juan J; Caporali, Roberto; Bertin, Philippe; Sullivan, Emma; Wood, Robert; Piercy, James; Vasilescu, Radu; Spurden, Dean; Alvir, Jose; Tarallo, Miriam

2018-01-01

Despite the wide array of treatments available for rheumatoid arthritis (RA), some patients continue to report unmet clinical needs. We investigated the extent of inadequate disease control in patients with RA. Data were drawn from the Adelphi 2014 RA Disease-Specific Program in France, Germany, Italy, Spain and the UK. Rheumatologists provided patient demographics, comorbidities, satisfaction with RA control and other clinical details. Patients reported their level of satisfaction and completed the EuroQoL 5-Dimensions Health Questionnaire and Work Productivity and Activity Impairment Questionnaire. Patients had been on their current therapy ≥3 months and had 28-joint disease activity scores (DAS28) reported. Adequately controlled (DAS28 ≤3.2) and inadequately controlled (DAS28 >3.2) patient cohorts were compared using univariate tests. Of 1147 patients, 74% were women, the mean age was 52 years and the mean time since RA diagnosis was 7 years. Twenty-seven percent of patients had inadequately controlled RA, whereas 73% had adequately controlled RA. Inadequately controlled patients were more affected clinically versus adequately controlled patients; 69% vs 13% had moderate/severe RA, the current level of pain was 4.6 vs 2.3, and 67% vs 41% experienced flares, respectively (all p<0.0001). Inadequately controlled patients had higher rates of depression (16% vs 5%; p<0.0001), worse health state, greater work and activity impairment, and lower satisfaction rates among the patients and their physicians than the adequately controlled cohort. RA was insufficiently controlled in over a quarter of patients despite their current therapy and this had a negative impact on the patients.

A Distributed Data Base System Concept for Defense Test and Evaluation.

DTIC Science & Technology

1983-03-01

measure adequately all variables that affect the outcome of the test. 7. Free - Play The second aspect of variable control that should be considered is the...amount of free - play permitted by a particular simulation. In a computer simulation free - play , if any, is limited to those elements designed into it by...the programmers. In operational testing of prototypes, however, a great deal of free - play can be introduced by allowing players to react to situations

Feasibility of overnight closed-loop control based on hourly blood glucose measurements.

PubMed

Patte, Caroline; Pleus, Stefan; Galley, Paul; Weinert, Stefan; Haug, Cornelia; Freckmann, Guido

2012-07-01

Safe and effective closed-loop control (artificial pancreas) is the ultimate goal of insulin delivery. In this study, we examined the performance of a closed-loop control algorithm used for the overnight time period to safely achieve a narrow target range of blood glucose (BG) concentrations prior to breakfast. The primary goal was to compare the quality of algorithm control during repeated overnight experiments. Twenty-three subjects with type 1 diabetes performed 2 overnight experiments on each of three visits at the study site, resulting in 138 overnight experiments. On the first evening, the subject's insulin therapy was applied; on the second, the insulin was delivered by an algorithm based on subcutaneous continuous glucose measurements (including meal control) until midnight. Overnight closed-loop control was applied between midnight and 6 a.m. based on hourly venous BG measurements during the first and second nights. The number of BG values within the target range (90-150 mg/dl) increased from 52.9% (219 out of 414 measurements) during the first nights to 72.2% (299 out of 414 measurements) during the second nights (p < .001, χ²-test). The occurrence of hypoglycemia interventions was reduced from 14 oral glucose interventions, the latest occurring at 2:36 a.m. during the first nights, to 1 intervention occurring at 1:02 a.m. during the second nights (p < .001, χ²-test). Overnight controller performance improved when optimized initial control was given; this was suggested by the better metabolic control during the second night. Adequate controller run-in time seems to be important for achieving good overnight control. In addition, the findings demonstrate that hourly BG data are sufficient for the closed-loop control algorithm tested to achieve appropriate glycemic control. © 2012 Diabetes Technology Society.

Velocimetry with refractive index matching for complex flow configurations, phase 1

NASA Technical Reports Server (NTRS)

Thompson, B. E.; Vafidis, C.; Whitelaw, J. H.

1987-01-01

The feasibility of obtaining detailed velocity field measurements in large Reynolds number flow of the Space Shuttle Main Engine (SSME) main injector bowl was demonstrated using laser velocimetry and the developed refractive-index-matching technique. An experimental system to provide appropriate flow rates and temperature control of refractive-index-matching fluid was designed and tested. Test results are presented to establish the feasibility of obtaining accurate velocity measurements that map the entire field including the flow through the LOX post bundles: sample mean velocity, turbulence intensity, and spectral results are presented. The results indicate that a suitable fluid and control system is feasible for the representation of complex rocket-engine configurations and that measurements of velocity characteristics can be obtained without the optical access restrictions normally associated with laser velocimetry. The refractive-index-matching technique considered needs to be further developed and extended to represent other rocket-engine flows where current methods either cannot measure with adequate accuracy or they fail.

Effect of occupational safety measures on micronucleus frequency in semiconductor workers.

PubMed

Winker, Robert; Roos, Gerhard; Pilger, Alexander; Rüdiger, Hugo W

2008-02-01

To examine whether semiconductor workers exposed to complex mixtures of chemical waste show an increase in genotoxic effects, and, if so, whether occupational safety measures protect these workers. To assess chemical exposure in the workplace, air monitoring of boron trifluoride and boron trichloride was performed and urinary concentrations of fluoride were measured. The cytokinesis-block micronucleus test on isolated lymphocytes was used for the detection of genotoxic effects. Two series of monitoring have been performed in order to assess the effect of implemented protection measures. We found a significantly higher mean frequency of micronuclei in exposed workers than in controls, whereas air monitoring and measurement of urinary fluoride failed to detect chemical exposure of these workers. Twelve years after implementation of protective measures, the mean level of micronuclei in exposed individuals was found to be as low as those from controls. These findings indicate that exposed workers in the semiconductor industry may have an increased risk of genotoxic effects from complex mixtures of chemical waste products. The decline of the mean level of micronuclei in exposed workers down to the base level of controls after implementation of protective measures points to the significance of adequate safety standards to protect against chromosomal damage in semiconductor personnel.

Heat dissipation in controlled environment enclosures through the application of water screens

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

Warrington, I.J.; Halligan, E.A.; Ruby, L.C.

1994-12-31

The use of plate glass-water thermal barriers in controlled environment facilities effectively reduces the thermal load within the plant growth chamber. This allows high PPFs to be provided for plant growth and development studies, adequate simulation of daily light integrals, and simulation of peak PPFs. Further, substantial amounts of incandescent lamp supplementation can be used to achieve simulation of daylight R:FR ratios which are needed to ensure adequate stem development in some species. While the focus in this paper has been on the use of entire thermal barriers which separate the lighting enclosure from the plant growth chamber, the samemore » principles apply to the use of water jackets for cooling individual lamps (such as can occur with xenon-arc lamps). In this instance, the barrier separating the lamps from the plant chamber can be much simpler (e.g., plexiglas) as the main function of the barrier is to separate the air ventilation of the lamp enclosure from the air system within the plant growth chamber. The main advantage of water as a thermal barrier is the negligible absorption of radiation in the photosynthetically-active and near infra-red wavebands. Consequently, plate glass-water barriers typically allow transmission of approximately 90% of radiation in these regions. While ventilated double and triple glazing systems appear to be attractive alternative to water barriers from an operating standpoint, their significant absorption in the biologically-important wavebands (7 - 12 %) with each glass layer and longer-wave cut-offs (typically 2500 - 4000 nm) makes them a much less attractive alternative. The data presented demonstrate clearly that measurement of PPF alone is not an adequate representation of the radiation environment being used in a controlled environment study.« less

An Assessment of the Adequacy of Ohio School Funding: New Performance Standards and Alternative Measurements of Adequacy

ERIC Educational Resources Information Center

Sweetland, Scott R.

2015-01-01

Reflecting upon "Rose v. Council," this research traced the development of adequate school funding in Ohio. "DeRolph v. State" centered the constitutional requirement for adequate education in Ohio. Thereafter, scholars estimated costs of adequate education and legislators adjusted those estimated costs. Plaintiffs and justices…

The effectiveness of the Screening Inventory of Psychosocial Problems (SIPP) in cancer patients treated with radiotherapy: design of a cluster randomised controlled trial.

PubMed

Braeken, Anna P B M; Lechner, Lilian; van Gils, Francis C J M; Houben, Ruud M A; Eekers, Daniëlle; Ambergen, Ton; Kempen, Gertrudis I J M

2009-06-09

The Screening Inventory of Psychosocial Problems (SIPP) is a short, validated self-reported questionnaire to identify psychosocial problems in Dutch cancer patients. The one-page 24-item questionnaire assesses physical complaints, psychological complaints and social and sexual problems. Very little is known about the effects of using the SIPP in consultation settings. Our study aims are to test the hypotheses that using the SIPP (a) may contribute to adequate referral to relevant psychosocial caregivers, (b) should facilitate communication between radiotherapists and cancer patients about psychosocial distress and (c) may prevent underdiagnosis of early symptoms reflecting psychosocial problems. This paper presents the design of a cluster randomised controlled trial (CRCT) evaluating the effectiveness of using the SIPP in cancer patients treated with radiotherapy. A CRCT is developed using a Solomon four-group design (two intervention and two control groups) to evaluate the effects of using the SIPP. Radiotherapists, instead of cancer patients, are randomly allocated to the experimental or control groups. Within these groups, all included cancer patients are randomised into two subgroups: with and without pre-measurement. Self-reported assessments are conducted at four times: a pre-test at baseline before the first consultation and a post-test directly following the first consultation, and three and 12 months after baseline measurement. The primary outcome measures are the number and types of referrals of cancer patients with psychosocial problems to relevant (psychosocial) caregivers. The secondary outcome measures are patients' satisfaction with the radiotherapist-patient communication, psychosocial distress and quality of life. Furthermore, a process evaluation will be carried out. Data of the effect-evaluation will be analysed according to the intention-to-treat principle and data regarding the types of referrals to health care providers and patient satisfaction about the with radiotherapists will be analysed by means of descriptive techniques. The process evaluation data will also be analysed by means of descriptive techniques. Using the SIPP may prevent underdiagnosis of early symptoms reflecting psychosocial problems, should facilitate communication between physicians and patients about psychosocial distress and may contribute to adequate referral to relevant (psychosocial) caregivers. NCT00859768.

A Phase IIIb, Multicentre, Randomised, Parallel-Group, Placebo-Controlled, Double-Blind Study to Investigate the Efficacy and Safety of OROS Hydromorphone in Subjects with Moderate-to-Severe Chronic Pain Induced by Osteoarthritis of the Hip or the Knee

PubMed Central

Vojtaššák, Jozef; Vojtaššák, Jozef; Jacobs, Adam; Rynn, Leonie; Waechter, Sandra; Richarz, Ute

2011-01-01

Background. Opioid analgesics are included in treatment guidelines for the symptomatic management of osteoarthritis (OA). Starting with a low dose of opioid and slowly titrating to a higher dose may help avoid intolerable side effects. Methods. Subjects aged ≥40 years, with moderate to severe pain induced by OA of the hip or knee not adequately controlled by previous non-steroidal anti-inflammatory drugs (NSAIDs) or paracetamol treatment, were enrolled. Subjects received OROS hydromorphone 4 mg or placebo once-daily. The dose was titrated every 3-4 days in case of unsatisfactory pain control during the 4-week titration phase. A 12 week maintenance phase followed. The primary efficacy endpoint was the change in “pain on average” measured on the Brief Pain Inventory (BPI) scale from baseline to the end of the maintenance phase. Results. 139 subjects received OROS hydromorphone and 149 subjects received placebo. All efficacy endpoints showed similar improvements from baseline to end of study in the 2 groups. The safety results were consistent with the safety profile of OROS hydromorphone. Conclusion.The study did not meet the primary endpoint; although many subjects' pain was not adequately controlled at inclusion, their pain may have improved with continued paracetamol or NSAID treatment. PMID:22110921

Psychometric properties of the Geriatric Anxiety Inventory (GAI) and its short-form (GAI-SF) in a clinical and non-clinical sample of older adults.

PubMed

Johnco, Carly; Knight, Ashleigh; Tadic, Dusanka; Wuthrich, Viviana M

2015-07-01

The Geriatric Anxiety Inventory is a 20-item geriatric-specific measure of anxiety severity. While studies suggest good internal consistency and convergent validity, divergent validity from measures of depression are weak. Clinical cutoffs have been developed that vary across studies due to the small clinical samples used. A six-item short form (GAI-SF) has been developed, and while this scale is promising, the research assessing the psychometrics of this scale is limited. This study examined the psychometric properties of GAI and GAI-SF in a large sample of 197 clinical geriatric participants with a comorbid anxiety and unipolar mood disorder, and a non-clinical control sample (N = 59). The internal consistency and convergent validity with other measures of anxiety was adequate for GAI and GAI-SF. Divergent validity from depressive symptoms was good in the clinical sample but weak in the total and non-clinical samples. Divergent validity from cognitive functioning was good in all samples. The one-factor structure was replicated for both measures. Receiver Operating Characteristic analyses indicated that the GAI is more accurate at identifying clinical status than the GAI-SF, although the sensitivity and specificity for the recommended cutoffs was adequate for both measures. Both GAI and GAI-SF show good psychometric properties for identifying geriatric anxiety. The GAI-SF may be a useful alternative screening measure for identifying anxiety in older adults.

MSFC Skylab contamination control systems mission evaluation

NASA Technical Reports Server (NTRS)

1974-01-01

Cluster external contamination control evaluation was made throughout the Skylab Mission. This evaluation indicated that contamination control measures instigated during the design, development, and operational phases of this program were adequate to reduce the general contamination environment external to the Cluster below the threshold senstivity levels for experiments and affected subsystems. Launch and orbit contamination control features included eliminating certain vents, rerouting vents for minimum contamination impact, establishing filters, incorporating materials with minimum outgassing characteristics and developing operational constraints and mission rules to minimize contamination effects. Prior to the launch of Skylab, contamination control math models were developed which were used to predict Cluster surface deposition and background brightness levels throughout the mission. The report summarizes the Skylab system and experiment contamination control evaluation. The Cluster systems and experiments evaluated include Induced Atmosphere, Corollary and ATM Experiments, Thermal Control Surfaces, Solar Array Systems, Windows and Star Tracker.

Occupational exposure limits for nanomaterials: state of the art

NASA Astrophysics Data System (ADS)

Schulte, P. A.; Murashov, V.; Zumwalde, R.; Kuempel, E. D.; Geraci, C. L.

2010-08-01

Assessing the need for and effectiveness of controlling airborne exposures to engineered nanomaterials in the workplace is difficult in the absence of occupational exposure limits (OELs). At present, there are practically no OELs specific to nanomaterials that have been adopted or promulgated by authoritative standards and guidance organizations. The vast heterogeneity of nanomaterials limits the number of specific OELs that are likely to be developed in the near future, but OELs could be developed more expeditiously for nanomaterials by applying dose-response data generated from animal studies for specific nanoparticles across categories of nanomaterials with similar properties and modes of action. This article reviews the history, context, and approaches for developing OELs for particles in general and nanoparticles in particular. Examples of approaches for developing OELs for titanium dioxide and carbon nanotubes are presented and interim OELs from various organizations for some nanomaterials are discussed. When adequate dose-response data are available in animals or humans, quantitative risk assessment methods can provide estimates of adverse health risk of nanomaterials in workers and, in conjunction with workplace exposure and control data, provide a basis for determining appropriate exposure limits. In the absence of adequate quantitative data, qualitative approaches to hazard assessment, exposure control, and safe work practices are prudent measures to reduce hazards in workers.

Antimisting kerosene: Base fuel effects, blending and quality control techniques

NASA Technical Reports Server (NTRS)

Yavrouian, A. H.; Ernest, J.; Sarohia, V.

1984-01-01

The problems associated with blending of the AMK additive with Jet A, and the base fuel effects on AMK properties are addressed. The results from the evaluation of some of the quality control techniques for AMK are presented. The principal conclusions of this investigation are: significant compositional differences for base fuel (Jet A) within the ASTM specification DI655; higher aromatic content of the base fuel was found to be beneficial for the polymer dissolution at ambient (20 C) temperature; using static mixer technology, the antimisting additive (FM-9) is in-line blended with Jet A, producing AMK which has adequate fire-protection properties 15 to 20 minutes after blending; degradability of freshly blended and equilibrated AMK indicated that maximum degradability is reached after adequate fire protection is obtained; the results of AMK degradability as measured by filter ratio, confirmed previous RAE data that power requirements to decade freshly blended AMK are significantly higher than equilibrated AMK; blending of the additive by using FM-9 concentrate in Jet A produces equilibrated AMK almost instantly; nephelometry offers a simple continuous monitoring capability and is used as a real time quality control device for AMK; and trajectory (jet thurst) and pressure drop tests are useful laboratory techniques for evaluating AMK quality.

On framing the research question and choosing the appropriate research design.

PubMed

Parfrey, Patrick S; Ravani, Pietro

2015-01-01

Clinical epidemiology is the science of human disease investigation with a focus on diagnosis, prognosis, and treatment. The generation of a reasonable question requires definition of patients, interventions, controls, and outcomes. The goal of research design is to minimize error, to ensure adequate samples, to measure input and output variables appropriately, to consider external and internal validities, to limit bias, and to address clinical as well as statistical relevance. The hierarchy of evidence for clinical decision-making places randomized controlled trials (RCT) or systematic review of good quality RCTs at the top of the evidence pyramid. Prognostic and etiologic questions are best addressed with longitudinal cohort studies.

Conversation with traumatically brain-injured individuals: a controlled study of behavioural changes and their impact.

PubMed

Bond, F; Godfrey, H P

1997-05-01

The conversations of 62 traumatically brain-injured (TBI) patients, assessed between 6 months and 3 years post-injury, were compared with those of an orthopaedic control (OC) group (n = 25). Conversations involving TBI subjects were rated as significantly less interesting, less appropriate, less rewarding and more effortful than interactions involving OC subjects, and were characterized by differences in the frequency of prompt usage and turn duration. Furthermore, measures of turn duration and prompt frequency were significantly associated with the perceived quality of conversation. These findings provide a microbehavioural description of the social process through which TBI individuals fail to adequately reinforce others.

On framing the research question and choosing the appropriate research design.

PubMed

Parfrey, Patrick; Ravani, Pietro

2009-01-01

Clinical epidemiology is the science of human disease investigation with a focus on diagnosis, prognosis, and treatment. The generation of a reasonable question requires the definition of patients, interventions, controls, and outcomes. The goal of research design is to minimize error, ensure adequate samples, measure input and output variables appropriately, consider external and internal validities, limit bias, and address clinical as well as statistical relevance. The hierarchy of evidence for clinical decision making places randomized controlled trials (RCT) or systematic review of good quality RCTs at the top of the evidence pyramid. Prognostic and etiologic questions are best addressed with longitudinal cohort studies.

The benefits of antiepileptic drug (AED) blood level monitoring to complement clinical management of people with epilepsy.

PubMed

Stepanova, Daria; Beran, Roy G

2015-01-01

Some argue that there is no evidence to support the use of antiepileptic drug (AED) blood level monitoring when treating people with epilepsy (PWE). This paper identifies how AED monitoring can be invaluable in such treatment. SPECIFIC EXAMPLES: (i) Compliance: Antiepileptic drug blood levels often confirm noncompliance rather than adequate seizure control, confirming subtherapeutic levels in PWE attending hospitals due to seizures. Routine monitoring of AED levels may prevent breakthrough seizures by identifying noncompliance and instituting heightened compliance measures before experiencing breakthrough seizures without modifying dosages. For PWE attending hospitals due to seizures, loading with the AED shown to be subtherapeutic may be all that is required. (ii) Cluster seizures and status epilepticus: When using long-acting AEDs to complement benzodiazepines, blood level monitoring confirms that an adequate dosage was given and, if not, a further bolus can be administered with further monitoring. This is particularly useful when using rectal administration of AEDs. (iii) Polypharmacy: Polypharmacy provokes drug interactions in which case AED monitoring helps in differentiating adequate dosing, offending AED with toxicity and free level measuring benefits when total levels are unhelpful. (iv) Generic substitution: Generic AEDs can fluctuate considerably from a parent compound, and even a parent compound, sourced from an alternative supplier, may have altered bioavailability for which blood level monitoring is very useful. While therapeutic blood level monitoring is not a substitute for good clinical judgment, it offers a valuable adjunct to patient care. Copyright © 2014 Elsevier Inc. All rights reserved.

Command and Control in a Complex World

DTIC Science & Technology

2012-05-22

definition of command and control does not adequately address changes introduced through technology trends, our understanding of the global operating...processes. The current joint definition of command and control does not adequately address changes introduced through technology trends, our...the problem is actually solved.  There are no  definitive ,  objective solutions to wicked problems.  For a complete  definition  of wicked problems, see

Optimization of incubation conditions of Plasmodium falciparum antibody multiplex assays to measure IgG, IgG1-4, IgM and IgE using standard and customized reference pools for sero-epidemiological and vaccine studies.

PubMed

Ubillos, Itziar; Jiménez, Alfons; Vidal, Marta; Bowyer, Paul W; Gaur, Deepak; Dutta, Sheetij; Gamain, Benoit; Coppel, Ross; Chauhan, Virander; Lanar, David; Chitnis, Chetan; Angov, Evelina; Beeson, James; Cavanagh, David; Campo, Joseph J; Aguilar, Ruth; Dobaño, Carlota

2018-06-01

The quantitative suspension array technology (qSAT) is a useful platform for malaria immune marker discovery. However, a major challenge for large sero-epidemiological and malaria vaccine studies is the comparability across laboratories, which requires the access to standardized control reagents for assay optimization, to monitor performance and improve reproducibility. Here, the Plasmodium falciparum antibody reactivities of the newly available WHO reference reagent for anti-malaria human plasma (10/198) and of additional customized positive controls were examined with seven in-house qSAT multiplex assays measuring IgG, IgG 1-4 subclasses, IgM and IgE against a panel of 40 antigens. The different positive controls were tested at different incubation times and temperatures (4 °C overnight, 37 °C 2 h, room temperature 1 h) to select the optimal conditions. Overall, the WHO reference reagent had low IgG2, IgG4, IgM and IgE, and also low anti-CSP antibody levels, thus this reagent was enriched with plasmas from RTS,S-vaccinated volunteers to be used as standard for CSP-based vaccine studies. For the IgM assay, another customized plasma pool prepared with samples from malaria primo-infected adults with adequate IgM levels proved to be more adequate as a positive control. The range and magnitude of IgG and IgG 1-4 responses were highest when the WHO reference reagent was incubated with antigen-coupled beads at 4 °C overnight. IgG levels measured in the negative control did not vary between incubations at 37 °C 2 h and 4 °C overnight, indicating no difference in unspecific binding. With this study, the immunogenicity profile of the WHO reference reagent, including seven immunoglobulin isotypes and subclasses, and more P. falciparum antigens, also those included in the leading RTS,S malaria vaccine, was better characterized. Overall, incubation of samples at 4 °C overnight rendered the best performance for antibody measurements against the antigens tested. Although the WHO reference reagent performed well to measure IgG to the majority of the common P. falciparum blood stage antigens tested, customized pools may need to be used as positive controls depending on the antigens (e.g. pre-erythrocytic proteins of low natural immunogenicity) and isotypes/subclasses (e.g. IgM) under study.

Negative control exposure studies in the presence of measurement error: implications for attempted effect estimate calibration

PubMed Central

Sanderson, Eleanor; Macdonald-Wallis, Corrie; Davey Smith, George

2018-01-01

Abstract Background Negative control exposure studies are increasingly being used in epidemiological studies to strengthen causal inference regarding an exposure-outcome association when unobserved confounding is thought to be present. Negative control exposure studies contrast the magnitude of association of the negative control, which has no causal effect on the outcome but is associated with the unmeasured confounders in the same way as the exposure, with the magnitude of the association of the exposure with the outcome. A markedly larger effect of the exposure on the outcome than the negative control on the outcome strengthens inference that the exposure has a causal effect on the outcome. Methods We investigate the effect of measurement error in the exposure and negative control variables on the results obtained from a negative control exposure study. We do this in models with continuous and binary exposure and negative control variables using analysis of the bias of the estimated coefficients and Monte Carlo simulations. Results Our results show that measurement error in either the exposure or negative control variables can bias the estimated results from the negative control exposure study. Conclusions Measurement error is common in the variables used in epidemiological studies; these results show that negative control exposure studies cannot be used to precisely determine the size of the effect of the exposure variable, or adequately adjust for unobserved confounding; however, they can be used as part of a body of evidence to aid inference as to whether a causal effect of the exposure on the outcome is present. PMID:29088358

Negative control exposure studies in the presence of measurement error: implications for attempted effect estimate calibration.

PubMed

Sanderson, Eleanor; Macdonald-Wallis, Corrie; Davey Smith, George

2018-04-01

Negative control exposure studies are increasingly being used in epidemiological studies to strengthen causal inference regarding an exposure-outcome association when unobserved confounding is thought to be present. Negative control exposure studies contrast the magnitude of association of the negative control, which has no causal effect on the outcome but is associated with the unmeasured confounders in the same way as the exposure, with the magnitude of the association of the exposure with the outcome. A markedly larger effect of the exposure on the outcome than the negative control on the outcome strengthens inference that the exposure has a causal effect on the outcome. We investigate the effect of measurement error in the exposure and negative control variables on the results obtained from a negative control exposure study. We do this in models with continuous and binary exposure and negative control variables using analysis of the bias of the estimated coefficients and Monte Carlo simulations. Our results show that measurement error in either the exposure or negative control variables can bias the estimated results from the negative control exposure study. Measurement error is common in the variables used in epidemiological studies; these results show that negative control exposure studies cannot be used to precisely determine the size of the effect of the exposure variable, or adequately adjust for unobserved confounding; however, they can be used as part of a body of evidence to aid inference as to whether a causal effect of the exposure on the outcome is present.

Finite element simulation and experimental verification of ultrasonic non-destructive inspection of defects in additively manufactured materials

NASA Astrophysics Data System (ADS)

Taheri, H.; Koester, L.; Bigelow, T.; Bond, L. J.

2018-04-01

Industrial applications of additively manufactured components are increasing quickly. Adequate quality control of the parts is necessary in ensuring safety when using these materials. Base material properties, surface conditions, as well as location and size of defects are some of the main targets for nondestructive evaluation of additively manufactured parts, and the problem of adequate characterization is compounded given the challenges of complex part geometry. Numerical modeling can allow the interplay of the various factors to be studied, which can lead to improved measurement design. This paper presents a finite element simulation verified by experimental results of ultrasonic waves scattering from flat bottom holes (FBH) in additive manufacturing materials. A focused beam immersion ultrasound transducer was used for both the modeling and simulations in the additive manufactured samples. The samples were SS17 4 PH steel samples made by laser sintering in a powder bed.

Perceptions on the right to adequate food after a major landslide disaster: a cross-sectional survey of two districts in Uganda.

PubMed

Rukundo, Peter M; Iversen, Per O; Andreassen, Bård A; Oshaug, Arne; Kikafunda, Joyce; Rukooko, Byaruhanga

2015-04-25

Despite the instruments on the right to adequate food adopted by the United Nations, there exists limited information on how this right is perceived. Following a major 2010 landslide disaster in the Bududa district of Eastern Uganda and the resettlement of some affected households into the Kiryandongo district in Western Uganda, we surveyed both districts to explore perceptions about the right to adequate food among households with different experiences; disaster-affected and controls. We deployed qualitative and quantitative techniques to a cross-sectional survey. The index respondent was the head of each randomly selected household from the landslide affected communities and controls from a bordering sub-county. Data was collected by interviews and focus group discussions (FGDs). Structured entries were tested statistically to report associations using Pearson's Chi-square at the 95% CI. Information from FGDs was transcribed, coded, sequenced and patterned. Findings from both techniques were triangulated to facilitate interpretations. Analysis included 1,078 interview entries and 12 FGDs. Significant differences between the affected and control households (P < 0.05) were observed with: age; education level; religious affiliation; existence of assets that complement food source; and having received relief food. Analysis between groups showed differences in responses on: whether everyone has a right to adequate food; who was supposed to supply relief food; whether relief food was adequate; and preferred choice on the means to ensure the right to adequate food. FGDs emphasized that access to land was the most important means to food and income. Affected households desired remedial interventions especially alternative land for livelihood. Despite the provision of adequate relief food being a state's obligation, there was no opportunity to exercise choice and preference. Comprehension and awareness of accountability and transparency issues was also low. Though a significant proportion of participants affirmed they have a right to adequate food, relief food was largely perceived as insufficient. Given the high regard for land as a preferred remedy, a resettlement policy is of the essence to streamline post-landslide displacement and resettlement. Information materials need to be assembled and disseminated to stimulate awareness and debate on the right to adequate food.

Occupational radiation exposure experience: Paducah Gaseous Diffusion Plant

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

Baker, R.C.

1975-01-01

The potential for significant uranium exposure in gaseous diffusion plants is very low. The potential for significant radiation exposure in uranium hexafluoride manufacturing is very real. Exposures can be controlled to low levels only through the cooperation and commitment of facility management and operating personnel. Exposure control can be adequately monitored by a combination of air analyses, urinalyses, and measurements of internal deposition as obtained by the IVRML. A program based on control of air-borne uranium exposure has maintained the internal dose of the Paducah Gaseous Diffusion Plant workman to less than one-half the RPG dose to the lung (15more » rem/year) and probably to less than one-fourth that dose. (auth)« less

Attitude towards diabetes and social and family support among type 2 diabetes patients attending a tertiary-care hospital in Bangladesh: a cross-sectional study.

PubMed

Shawon, Md Shajedur Rahman; Hossain, Fariha Binte; Adhikary, Gourab; Das Gupta, Rajat; Hashan, Mohammad Rashidul; Rabbi, Md Fazla; Ahsan, G U

2016-05-26

Bangladesh has been suffering from an epidemiological transition from infectious and maternal diseases to non-communicable lifestyle-related diseases like diabetes, cardiovascular diseases, cancers etc. The burden of diabetes has been increasing rapidly due to high incidence as well as poor glycemic control leading to various macro and micro-vascular complications. In this study, we aim to assess the attitude towards diabetes and social and family support among the Bangladeshi type 2 diabetic mellitus (T2DM) patients. This was a cross-sectional study among 144 patients with T2DM at the medicine outpatient department of Dhaka Medical College Hospital (DMCH) in Dhaka, Bangladesh between 1 July and 31 July 2014. Data collection was done by interviewing patients using structured questionnaire. Understanding diabetes, education/advice received, attitude towards diabetes, family and friend support were measured by validated scales adapted from diabetes care profile. This study includes a total of 144 patients (101 males and 43 females) with type 2 diabetes aged between 20 and 84 years. 87 % of the patients had inadequate blood glucose control (fasting blood sugar >7.2 mmol/L or >130 mg/dl). Statistically significant differences were observed in the mean scores of various attitude scales (i.e. positive, negative, care ability and self-care adherence scale) among patients with adequate and inadequate blood glucose control (p < 0.05). Statistically significant positive correlations were found between these three categories of social and family support. Self-satisfaction with diabetic care was significantly associated with adequate blood glucose control (p = 0.05). Positive attitude towards diabetes management and support from friends and family were associated with adequate diabetes management. Appropriate public health interventions should be designed to educate and motivate the family members to offer greater support to the diabetes patients.

Lung VITAL: Rationale, design, and baseline characteristics of an ancillary study evaluating the effects of vitamin D and/or marine omega-3 fatty acid supplements on acute exacerbations of chronic respiratory disease, asthma control, pneumonia and lung function in adults

PubMed Central

Gold, Diane R; Litonjua, Augusto A.; Carey, Vincent J.; Manson, JoAnn E.; Buring, Julie E; Lee, I-Min; Gordon, David; Walter, Joseph; Friedenberg, Georgina; Hankinson, John L; Copeland, Trisha; Luttmann-Gibson, Heike

2016-01-01

Laboratory and observational research studies suggest that vitamin D and marine omega-3 fatty acids may reduce risk for pneumonia, acute exacerbations of respiratory diseases including chronic obstructive lung disease (COPD) or asthma, and decline of lung function, but prevention trials with adequate dosing, adequate power, and adequate time to follow-up are lacking. The ongoing Lung VITAL study is taking advantage of a large clinical trial—the VITamin D and OmegA-3 TriaL (VITAL)—to conduct the first major evaluation of the influences of vitamin D and marine omega-3 fatty acid supplementation on pneumonia risk, respiratory exacerbation episodes, asthma control and lung function in adults. VITAL is a 5-year U.S.-wide randomized, double-blind, placebo-controlled, 2×2 factorial trial of supplementation with vitamin D3 ([cholecalciferol], 2000 IU/day) and marine omega-3 FA (Omacor® fish oil, eicosapentaenoic acid [EPA] +docosahexaenoic acid [DHA], 1 g/day) for primary prevention of CVD and cancer among men and women, at baseline aged ≥50 and ≥55, respectively, with 5107 African Americans. In a subset of 1973 participants from 11 urban U.S. centers, lung function is measured before and two years after randomization. Yearly follow-up questionnaires assess incident pneumonia in the entire randomized population, and exacerbations of respiratory disease, asthma control and dyspnea in a subpopulation of 4314 randomized participants enriched, as shown in presentation of baseline characteristics, for respiratory disease, respiratory symptoms, and history of cigarette smoking. Self-reported pneumonia hospitalization will be confirmed by medical record review, and exacerbations will be confirmed by Center for Medicare and Medicaid Services data review. PMID:26784651

Lung VITAL: Rationale, design, and baseline characteristics of an ancillary study evaluating the effects of vitamin D and/or marine omega-3 fatty acid supplements on acute exacerbations of chronic respiratory disease, asthma control, pneumonia and lung function in adults.

PubMed

Gold, Diane R; Litonjua, Augusto A; Carey, Vincent J; Manson, JoAnn E; Buring, Julie E; Lee, I-Min; Gordon, David; Walter, Joseph; Friedenberg, Georgina; Hankinson, John L; Copeland, Trisha; Luttmann-Gibson, Heike

2016-03-01

Laboratory and observational research studies suggest that vitamin D and marine omega-3 fatty acids may reduce risk for pneumonia, acute exacerbations of respiratory diseases including chronic obstructive lung disease (COPD) or asthma, and decline of lung function, but prevention trials with adequate dosing, adequate power, and adequate time to follow-up are lacking. The ongoing Lung VITAL study is taking advantage of a large clinical trial-the VITamin D and OmegA-3 TriaL (VITAL)--to conduct the first major evaluation of the influences of vitamin D and marine omega-3 fatty acid supplementation on pneumonia risk, respiratory exacerbation episodes, asthma control and lung function in adults. VITAL is a 5-year U.S.-wide randomized, double-blind, placebo-controlled, 2 × 2 factorial trial of supplementation with vitamin D3 ([cholecalciferol], 2000 IU/day) and marine omega-3 FA (Omacor® fish oil, eicosapentaenoic acid [EPA]+docosahexaenoic acid [DHA], 1g/day) for primary prevention of CVD and cancer among men and women, at baseline aged ≥50 and ≥55, respectively, with 5107 African Americans. In a subset of 1973 participants from 11 urban U.S. centers, lung function is measured before and two years after randomization. Yearly follow-up questionnaires assess incident pneumonia in the entire randomized population, and exacerbations of respiratory disease, asthma control and dyspnea in a subpopulation of 4314 randomized participants enriched, as shown in presentation of baseline characteristics, for respiratory disease, respiratory symptoms, and history of cigarette smoking. Self-reported pneumonia hospitalization will be confirmed by medical record review, and exacerbations will be confirmed by Center for Medicare and Medicaid Services data review. Copyright © 2016 Elsevier Inc. All rights reserved.

Pre- and post-flight-test models versus measured skyship-500 control responses

NASA Technical Reports Server (NTRS)

Jex, Henry R.; Magdaleno, Raymond E.; Gelhausen, Paul; Tischler, Mark B.

1987-01-01

The dynamical equations-of-motion (EOM) for cruising airships require nonconventional terms to account for buoyancy and apparent-mass-effects, but systematic validation of these equations against flight data is not available. Using a candidate set of EOM, three comparisons are made with carefully-measured describing functions derived from frequency-sweep flight tests on the Skyship-500 airship. The first compares the pre-flight predictions to the data; the second compares the 'best-fit' equations to data at each of two airspeeds and the third compared the ability to extrapolate from one condition to another via airship-specific scaling laws. Two transient responses are also compared. The generally good results demonstrate that fairly simple, perturbation equation models are adequate for many types of flight-control analysis and flying quality evaluations of cruising airships.

Evaluation of preventive and control measures for lead exposure in a South African lead-acid battery recycling smelter.

PubMed

Dyosi, Sindiswa

2007-10-01

In South Africa, new lead regulations released in February 2002 served as motivation for a cross-sectional study investigating the effectiveness of preventive and control measures implemented in a lead smelter that recycles lead-acid batteries. Twenty-two workers were observed and interviewed. Structured questionnaires were used to gather workers' personal information, perception about their work environment, health risks, and work practices. Retrospective data from air monitoring and medical surveillance programs were obtained from the plant's records. The smelter implemented a number of control measures for lead exposure, including engineering controls, administrative controls, and, as a last resort, personal protective equipment. Engineering controls were rated the best control measure and included local exhaust ventilation systems and wet methods. Positive pressure systems were used in the offices and laboratory. The local exhaust ventilation system was rated the best engineering control measure. Although control measures were used, areas such as smelting and refinery had average lead in air levels above 0.15 mg/m(3), the occupational exposure limit for lead. This was a concern especially with regard to the smelting area because those workers had the second highest mean blood lead levels; workers in the battery breaking area had the highest. Regular use of personal protective equipment by some workers in the "lead exposure zones" was not observed. Although the mean blood lead levels had been below 40 micro g/dL for more than 90% of the workers since 2001, more than 70% of workers reported concerns about their health while working in the smelter. Even though control measures were implemented, they were not adequate because in some areas lead in air exceeded the occupational exposure limit. Therefore, improvement of existing measures and regular monitoring of personal protective equipment use were included in the recommendations given to the smelter.

Control of distension of varicose veins achieved by leg bandages, as used after injection sclerotherapy.

PubMed Central

Fentem, P H; Goddard, M; Gooden, B A; Yeung, C K

1976-01-01

A study was performed to determine whether the pressures routinely produced by bandaging for compression sclerotherapy of varicose veins are adequate to maintain the superfical veins almost empty of blood. The results suggest that well-applied bandages can provide sufficient support to combat the high distending pressures found in varicose veins. The large variation among different surgeons, however, indicates that any clinical assessment of compression sclerotherapy should include measurement of the pressure at which the bandages are applied. PMID:974569

Nonmetallic materials contamination studies. [space telescope

NASA Technical Reports Server (NTRS)

Muscari, J. A.; Beverlin, G.

1980-01-01

In order to impose adequate contamination control requirements in the selection of Wide Field Planetary Camera (WFPC) materials and to develop a data base of potential optical degradation of the WFPC charge-couple device window, the outgassing properties of WFPC materials and the collected volatile condensed material (CVCM) effects on MgF2 transmittance were measured. Changes in the transmittance were monitored in the wavelength region from 115 nm to 300 nm for selected CVCM thicknesses up to 150 nm. The outgassing properties of reemitted CVCM were also studied.

Site planning and integration fiscal year 1999 multi-year work plan (MYWP) update for WBS 1.8.2.1

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

SCHULTZ, E.A.

The primary mission of the Site Planning and Integration (SP and I) project is to assist Fluor Daniel Project Direction to ensure that all work performed under the Project Hanford Management Contract (PHMC) is adequately planned, executed, controlled, and that performance is measured and reported in an integrated fashion. Furthermore, SP and I is responsible for the development, implementation, and management of systems and processes that integrate technical, schedule, and cost baselines for PHMC work.

Environmental Impact Analysis Process. Final Environmental Impact Statement for Expansion of the Melrose Air Force Range, Curry and Roosevelt Counties, New Mexico

DTIC Science & Technology

1985-04-18

discuss very briefly the logic, or substance, of the issues in this possible decision--why it might not be logical. And, third, the moral , or ethical...o’f the issue - authors advocating measurable effect and those indicating no effect. 38 CHABA has taken the position that current evidence is suggestive...but it does not provide definitive answers on the long-term health effect issue . CHABA encourages more definitive research with adequate controls

Region 9: California Adequate Letter (7/14/2017)

EPA Pesticide Factsheets

EPA approves California Air Resources Board Motor Vehicle Emissions Budgets in San Joaquin Valley Unified Air Pollution Control Districts 2016 Plan for 2008 8-Hour Ozone Standard adequate for transportation conformity purposes announced in Federal Register

Validation of the trait anxiety scale for state-trait anxiety inventory in suicide victims and living controls of Chinese rural youths.

PubMed

Zhang, Jie; Gao, Qi

2012-01-01

This study evaluated the validation of STAI Trait-Anxiety Scale in suicide cases and community living controls in rural China. The participants were 392 suicides and 416 controls. Cronbach's Alpha was computed to evaluate the internal consistency. The Spearman Correlation Coefficient between Trait-Anxiety Scale and other instrument was calculated to evaluate the external validity, and the Exploratory Factor Analysis was used to evaluate the construct validity. The results showed the Cronbach's Alpha was .891 and .787 respectively in case and control groups. Most of the correlations between instruments were significant. We found 2 factors in cases and 3 factors in controls. We could cautiously infer that the Trait Anxiety Scale was an adequate tool to measure trait anxiety through proxy data in suicide victims and living controls in rural China.

Methodological reporting quality of randomized controlled trials: A survey of seven core journals of orthopaedics from Mainland China over 5 years following the CONSORT statement.

PubMed

Zhang, J; Chen, X; Zhu, Q; Cui, J; Cao, L; Su, J

2016-11-01

In recent years, the number of randomized controlled trials (RCTs) in the field of orthopaedics is increasing in Mainland China. However, randomized controlled trials (RCTs) are inclined to bias if they lack methodological quality. Therefore, we performed a survey of RCT to assess: (1) What about the quality of RCTs in the field of orthopedics in Mainland China? (2) Whether there is difference between the core journals of the Chinese department of orthopedics and Orthopaedics Traumatology Surgery & Research (OTSR). This research aimed to evaluate the methodological reporting quality according to the CONSORT statement of randomized controlled trials (RCTs) in seven key orthopaedic journals published in Mainland China over 5 years from 2010 to 2014. All of the articles were hand researched on Chongqing VIP database between 2010 and 2014. Studies were considered eligible if the words "random", "randomly", "randomization", "randomized" were employed to describe the allocation way. Trials including animals, cadavers, trials published as abstracts and case report, trials dealing with subgroups analysis, or trials without the outcomes were excluded. In addition, eight articles selected from Orthopaedics Traumatology Surgery & Research (OTSR) between 2010 and 2014 were included in this study for comparison. The identified RCTs are analyzed using a modified version of the Consolidated Standards of Reporting Trials (CONSORT), including the sample size calculation, allocation sequence generation, allocation concealment, blinding and handling of dropouts. A total of 222 RCTs were identified in seven core orthopaedic journals. No trials reported adequate sample size calculation, 74 (33.4%) reported adequate allocation generation, 8 (3.7%) trials reported adequate allocation concealment, 18 (8.1%) trials reported adequate blinding and 16 (7.2%) trials reported handling of dropouts. In OTSR, 1 (12.5%) trial reported adequate sample size calculation, 4 (50.0%) reported adequate allocation generation, 1 (12.5%) trials reported adequate allocation concealment, 2 (25.0%) trials reported adequate blinding and 5 (62.5%) trials reported handling of dropouts. There were statistical differences as for sample size calculation and handling of dropouts between papers from Mainland China and OTSR (P<0.05). The findings of this study show that the methodological reporting quality of RCTs in seven core orthopaedic journals from the Mainland China is far from satisfaction and it needs to further improve to keep up with the standards of the CONSORT statement. Level III case control. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Measurement Assurance for End-Item Users

NASA Technical Reports Server (NTRS)

Mimbs, Scott M.

2008-01-01

The goal of a Quality Management System (QMS) as specified in ISO 9001 and AS9100 is to assure the end product meets specifications and customer requirements. Measuring devices, often called measuring and test equipments (MTE), provide the evidence of product conformity to the prescribed requirements. Therefore the processes which employ MTE can become a weak link to the overall QMS if proper attention is not given to development and execution of these processes. Traditionally, calibration of MTE is given more focus in industry standards and process control efforts than the equally important proper usage of the same equipment. It is a common complaint of calibration laboratory personnel that MTE users are only interested in "a sticker." If the QMS requires the MTE "to demonstrate conformity of the product," then the quality of the measurement process must be adequate for the task. This leads to an ad hoc definition; measurement assurance is a discipline that assures that all processes, activities, environments, standards, and procedures involved in making a measurement produce a result that can be rigorously evaluated for validity and accuracy. To evaluate that the existing measurement processes are providing an adequate level of quality to support the decisions based upon this measurement data, an understanding of measurement assurance basics is essential. This topic is complimentary to the calibration standard, ANSI/NCSL Z540.3-2006, which targets the calibration of MTE at the organizational level. This paper will discuss general measurement assurance when MTE is used to provide evidence of product conformity, therefore the target audience of this paper is end item users of MTE. A central focus of the paper will be the verification of tolerances and the associated risks, so calibration professionals may find the paper useful in communication with their customers, MTE users.

Error Correction, Control Systems and Fuzzy Logic

NASA Technical Reports Server (NTRS)

Smith, Earl B.

2004-01-01

This paper will be a discussion on dealing with errors. While error correction and communication is important when dealing with spacecraft vehicles, the issue of control system design is also important. There will be certain commands that one wants a motion device to execute. An adequate control system will be necessary to make sure that the instruments and devices will receive the necessary commands. As it will be discussed later, the actual value will not always be equal to the intended or desired value. Hence, an adequate controller will be necessary so that the gap between the two values will be closed.

Ionic Current Measurements in the Squid Giant Axon Membrane

PubMed Central

Cole, Kenneth S.; Moore, John W.

1960-01-01

The concepts, experiments, and interpretations of ionic current measurements after a step change of the squid axon membrane potential require the potential to be constant for the duration and the membrane area measured. An experimental approach to this ideal has been developed. Electrometer, operational, and control amplifiers produce the step potential between internal micropipette and external potential electrodes within 40 microseconds and a few millivolts. With an internal current electrode effective resistance of 2 ohm cm.2, the membrane potential and current may be constant within a few millivolts and 10 per cent out to near the electrode ends. The maximum membrane current patterns of the best axons are several times larger but of the type described by Cole and analyzed by Hodgkin and Huxley when the change of potential is adequately controlled. The occasional obvious distortions are attributed to the marginal adequacy of potential control to be expected from the characteristics of the current electrodes and the axon. Improvements are expected only to increase stability and accuracy. No reason has been found either to question the qualitative characteristics of the early measurements or to so discredit the analyses made of them. PMID:13694548

A case-control study of the risk factors for obstetric fistula in Tigray, Ethiopia.

PubMed

Lewis Wall, L; Belay, Shewaye; Haregot, Tesfahun; Dukes, Jonathan; Berhan, Eyoel; Abreha, Melaku

2017-12-01

We tested the null hypothesis that there were no differences between patients with obstetric fistula and parous controls without fistula. A unmatched case-control study was carried out comparing 75 women with a history of obstetric fistula with 150 parous controls with no history of fistula. Height and weight were measured for each participant, along with basic socio-demographic and obstetric information. Descriptive statistics were calculated and differences between the groups were analyzed using Student's t test, Mann-Whitney U test where appropriate, and Chi-squared or Fisher's exact test, along with backward stepwise logistic regression analyses to detect predictors of obstetric fistula. Associations with a p value <0.05 were considered significant. Patients with fistulas married earlier and delivered their first pregnancies earlier than controls. They had significantly less education, a higher prevalence of divorce/separation, and lived in more impoverished circumstances than controls. Fistula patients had worse reproductive histories, with greater numbers of stillbirths/abortions and higher rates of assisted vaginal delivery and cesarean section. The final logistic regression model found four significant risk factors for developing an obstetric fistula: age at marriage (OR 1.23), history of assisted vaginal delivery (OR 3.44), lack of adequate antenatal care (OR 4.43), and a labor lasting longer than 1 day (OR 14.84). Our data indicate that obstetric fistula results from the lack of access to effective obstetrical services when labor is prolonged. Rural poverty and lack of adequate transportation infrastructure are probably important co-factors in inhibiting access to needed care.

A Review of Evidence-Based Traffic Engineering Measures Designed to Reduce Pedestrian–Motor Vehicle Crashes

PubMed Central

Retting, Richard A.; Ferguson, Susan A.; McCartt, Anne T.

2003-01-01

We provide a brief critical review and assessment of engineering modifications to the built environment that can reduce the risk of pedestrian injuries. In our review, we used the Transportation Research Information Services database to conduct a search for studies on engineering countermeasures documented in the scientific literature. We classified countermeasures into 3 categories—speed control, separation of pedestrians from vehicles, and measures that increase the visibility and conspicuity of pedestrians. We determined the measures and settings with the greatest potential for crash prevention. Our review, which emphasized inclusion of studies with adequate methodological designs, showed that modification of the built environment can substantially reduce the risk of pedestrian–vehicle crashes. PMID:12948963

MILSBILLS: Military Standard Billing System

DTIC Science & Technology

1985-01-01

disbursing offices and w’ose adjustments will be included in their Statement of Interfund 1,ansactions. c. Ensuring that there are adequate controls over...adjustments will be included in their Statement of Interfund Transactions. c. Ensuring that there are adequate controls over interfund related...by the DSAA. 3 iAutomatic adjustments may be withheld from specific customers if there is a pattern of abuse of this authority. When such a pattern

Changing home treatment of childhood fevers by training shop keepers in rural Kenya.

PubMed

Marsh, V M; Mutemi, W M; Muturi, J; Haaland, A; Watkins, W M; Otieno, G; Marsh, K

1999-05-01

Malaria control in Africa relies primarily on early effective treatment for clinical disease, but most early treatments for fever occur through self-medication with shop-bought drugs. Lack of information to community members on over-the-counter drug use has led to widespread ineffective treatment of fevers, increased risks of drug toxicity and accelerating drug resistance. We examined the feasibility and measured the likely impact of training shop keepers in rural Africa on community drug use. In a rural area of coastal Kenya, we implemented a shop keeper training programme in 23 shops serving a population of approximately 3500, based on formative research within the community. We evaluated the training by measuring changes in the proportions of drug sales where an adequate amount of chloroquine was purchased and in the percentage of home-treated childhood fevers given an adequate amount of chloroquine. The programme was assessed qualitatively in the community following the shop keeper training. The percentage of drug sales for children with fever which included an antimalarial drug rose from 34.3% (95% CI 28.9%-40.1%) before the training to a minimum of 79.3% (95% CI 71.8%-85.3%) after the training. The percentage of antimalarial drug sales where an adequate amount of drug was purchased rose from 31.8% (95% CI 26.6%-37.6%) to a minimum of 82.9% (95% CI 76.3%-87.3%). The percentage of childhood fevers where an adequate dose of chloroquine was given to the child rose from 3.7% (95% CI 1.2%-9.7%) before the training to a minimum of 65.2% (95% CI 57.7%-72.0%) afterwards, which represents an increase in the appropriate use of over-the-counter chloroquine by at least 62% (95% CI 53.7%-69.3%). Shop keepers and community members were strongly supportive of the aims and outcome of the programme. The large shifts in behaviour observed indicate that the approach of training shop keepers as a channel for information to the community is both feasible and likely to have a significant impact. Whilst some of the impact seen may be attributable to research effects in a relatively small scale pilot study, the magnitude of the changes support further investigation into this approach as a potentially important new strategy in malaria control.

Adherence to secondary antibiotic prophylaxis for patients with rheumatic heart disease diagnosed through screening in Fiji.

PubMed

Engelman, Daniel; Mataika, Reapi L; Kado, Joseph H; Ah Kee, Maureen; Donath, Susan; Parks, Tom; Steer, Andrew C

2016-12-01

Echocardiographic screening for rheumatic heart disease (RHD) can detect subclinical cases; however, adequate adherence to secondary antibiotic prophylaxis (SAP) is required to alter disease outcomes. We aimed to investigate the adherence to SAP among young people with RHD diagnosed through echocardiographic screening in Fiji and to investigate factors associated with adherence. Patients diagnosed with RHD through echocardiographic screening in Fiji from 2006 to 2014 were included. Dates of benzathine penicillin G injections were collected from 76 health clinics nationally from December 2011 to December 2014. Adherence was measured using the proportion of days covered (PDC). Multivariate logistic regression analysis was used to identify characteristics associated with any adherence (≥1 injection received) and adequate adherence (PDC ≥0.80). Of 494 patients, 268 (54%) were female and the median age was 14 years. Overall, 203 (41%) had no injections recorded and just 33 (7%) had adequate adherence. Multivariate logistic regression showed increasing age (OR 0.93 per year, 95% CI 0.87-0.99) and time since diagnosis ≥1.5 years (OR 0.53, 95% CI 0.37-0.79) to be inversely associated with any adherence. Non-iTaukei ethnicity (OR 2.58, 95%CI 1.04-6.33) and urban residence (OR 3.36, 95% CI 1.54-7.36) were associated with adequate adherence, whereas time since diagnosis ≥1.5 years (OR 0.38, 95%CI 0.17-0.83) was inversely associated with adequate adherence. Adherence to SAP after screening in Fiji is currently inadequate for individual patient protection or population disease control. Secondary prevention should be strengthened before further screening can be justified. © 2016 John Wiley & Sons Ltd.

Piloted evaluation of an integrated propulsion and flight control simulator

NASA Technical Reports Server (NTRS)

Bright, Michelle M.; Simon, Donald L.

1992-01-01

A piloted evaluation of the integrated flight and propulsion control simulator for advanced integrated propulsion and airframe control design is described. The evaluation will cover control effector gains and deadbands, control effectiveness and control authority, and heads up display functionality. For this evaluation the flight simulator is configured for transition flight using an advanced Short Take-Off and Vertical Landing fighter aircraft model, a simplified high-bypass turbofan engine model, fighter cockpit displays, and pilot effectors. The piloted tasks used for rating displays and control effector gains are described. Pilot comments and simulation results confirm that the display symbology and control gains are very adequate for the transition flight task. Additionally, it is demonstrated that this small-scale, fixed base flight simulator facility can adequately perform a real time, piloted control evaluation.

Preliminary validation of the Spanish version of the Multiple Stimulus Types Ambiguity Tolerance Scale (MSTAT-II).

PubMed

Arquero, José L; McLain, David L

2010-05-01

Despite widespread interest in ambiguity tolerance and other information-related individual differences, existing measures are conceptually dispersed and psychometrically weak. This paper presents the Spanish version of MSTAT-II, a short, stimulus-oriented, and psychometrically improved measure of an individual's orientation toward ambiguous stimuli. Results obtained reveal adequate reliability, validity, and temporal stability. These results support the use of MSTAT-II as an adequate measure of ambiguity tolerance.

Quality of Informal Care Is Multidimensional

PubMed Central

Christie, Juliette; Smith, G. Rush; Williamson, Gail M.; Lance, Charles. E.; Shovali, Tamar E.; Silva, Luciana

2010-01-01

Purpose To demonstrate that assessing quality of informal care involves more than merely determining whether care recipient needs for assistance with activities of daily living (ADLs) are satisfied on a routine basis. Potentially harmful behavior (PHB), adequate care, and exemplary care (EC) are conceptually distinct dimensions of quality of care. We investigated the extent to which these three dimensions also are empirically distinguishable. Design 237 care recipients completed the quality of care measures, and their caregivers completed psychosocial measures of depressed affect, life events, cognitive status, and perceived pre-illness relationship quality. Results Confirmatory factor analyses indicated that PHB, adequate care, and EC are empirically distinct factors. Although PHB was moderately related to EC, adequate care was not associated with PHB and was only slightly related to EC. Psychosocial variables were not related to adequate care but were differentially associated with PHB and EC, providing further evidence for the distinction between the measures of quality of care used in this study. Conclusions Assessing quality of informal care is a complex endeavor. ADL assistance can be adequate in the presence of PHB and/or the absence of EC. Declines in EC may signal increases in PHB, independent of adequacy of care. These findings produce a brief, portable, and more comprehensive instrument for assessing quality of informal care. PMID:19469607

Monitoring land subsidence in Sacramento Valley, California, using GPS

USGS Publications Warehouse

Blodgett, J.C.; Ikehara, M.E.; Williams, Gary E.

1990-01-01

Land subsidence measurement is usually based on a comparison of bench-mark elevations surveyed at different times. These bench marks, established for mapping or the national vertical control network, are not necessarily suitable for measuring land subsidence. Also, many bench marks have been destroyed or are unstable. Conventional releveling of the study area would be costly and would require several years to complete. Differences of as much as 3.9 ft between recent leveling and published bench-mark elevations have been documented at seven locations in the Sacramento Valley. Estimates of land subsidence less than about 0.3 ft are questionable because elevation data are based on leveling and adjustment procedures that occured over many years. A new vertical control network based on the Global Positioning System (GPS) provides highly accurate vertical control data at relatively low costs, and the survey points can be placed where needed to obtain adequate areal coverage of the area affected by land subsidence.

Systematic Review of Plant-Based Homeopathic Basic Research: An Update.

PubMed

Ücker, Annekathrin; Baumgartner, Stephan; Sokol, Anezka; Huber, Roman; Doesburg, Paul; Jäger, Tim

2018-05-01

 Plant-based test systems have been described as a useful tool for investigating possible effects of homeopathic preparations. The last reviews of this research field were published in 2009/2011. Due to recent developments in the field, an update is warranted. Publications on plant-based test systems were analysed with regard to publication quality, reproducibility and potential for further research.  A literature search was conducted in online databases and specific journals, including publications from 2008 to 2017 dealing with plant-based test systems in homeopathic basic research. To be included, they had to contain statistical analysis and fulfil quality criteria according to a pre-defined manuscript information score (MIS). Publications scoring at least 5 points (maximum 10 points) were assumed to be adequate. They were analysed for the use of adequate controls, outcome and reproducibility.  Seventy-four publications on plant-based test systems were found. Thirty-nine publications were either abstracts or proceedings of conferences and were excluded. From the remaining 35 publications, 26 reached a score of 5 or higher in the MIS. Adequate controls were used in 13 of these publications. All of them described specific effects of homeopathic preparations. The publication quality still varied: a substantial number of publications (23%) did not adequately document the methods used. Four reported on replication trials. One replication trial found effects of homeopathic preparations comparable to the original study. Three replication trials failed to confirm the original study but identified possible external influencing factors. Five publications described novel plant-based test systems. Eight trials used systematic negative control experiments to document test system stability.  Regarding research design, future trials should implement adequate controls to identify specific effects of homeopathic preparations and include systematic negative control experiments. Further external and internal replication trials, and control of influencing factors, are needed to verify results. Standardised test systems should be developed. The Faculty of Homeopathy.

An Extracorporeal Artificial Placenta Supports Extremely Premature Lambs for One Week

PubMed Central

Bryner, Benjamin; Gray, Brian; Perkins, Elena; Davis, Ryan; Hoffman, Hayley; Barks, John; Owens, Gabe; Bocks, Martin; Rojas-Peña, Alvaro; Hirschl, Ronald; Bartlett, Robert; Mychaliska, George

2015-01-01

Purpose The treatment of extreme prematurity remains an unsolved problem. We developed an artificial placenta (AP) based on extracorporeal life support (ECLS) that simulates the intrauterine environment and provides gas exchange without mechanical ventilation (MV), and compared it to the current standard of neonatal care. Methods Extremely premature lambs (110-120d; term=145d) were used. AP lambs (n=9) were cannulated (jugular drainage, umbilical vein reinfusion) for ECLS .Control lambs (n=7) were intubated, ventilated, given surfactant, and transitioned to high-frequency oscillatory ventilation. All lambs received parenteral nutrition, antibiotics, and steroids. Hemodynamics, blood gases, hemoglobin, and circuit flows were measured. Results Four premature lambs survived for 1 week on the AP; one survived 6 days. Adequate oxygenation and ventilation were provided by the AP. The MV lambs survived 2-8 hours. Each of these lambs experienced a transient improvement with surfactant, but developed progressive hypercapnea and hypoxia despite high airway pressures and HFOV. Conclusions Extremely premature lambs were supported for 1 week with the AP with hemodynamic stability and adequate gas exchange; mechanically ventilated lambs succumbed within 8 hours. Further studies will assess control of fetal circulation and organ maturation on the AP. PMID:25598091

Total body nitrogen analysis. [neutron activation analysis

NASA Technical Reports Server (NTRS)

Palmer, H. E.

1975-01-01

Studies of two potential in vivo neutron activation methods for determining total and partial body nitrogen in animals and humans are described. A method using the CO-11 in the expired air as a measure of nitrogen content was found to be adequate for small animals such as rats, but inadequate for human measurements due to a slow excretion rate. Studies on the method of measuring the induced N-13 in the body show that with further development, this method should be adequate for measuring muscle mass changes occurring in animals or humans during space flight.

[Constipation in patients with diabetes mellitus].

PubMed

Rossol, Siegbert

2007-11-01

Up to 60% of the patients with diabetes mellitus suffer from gastrointestinal tract symptoms that arise pathogenetically from a disturbance of the autonomous nervous system. Patient age, disease duration and poor control of diabetes mellitus correlate positively with the presence of gastrointestinal symptoms. Chronic constipation, in addition to diarrhoea, gall bladder dysfunction and incontinence, is increasingly regarded as a serious problem and for the first time, is now considered in the current guidelines of the professional societies. Modern diagnosis and treatment facilitate systematic control of the symptoms. Treatment necessitates long-term intake of laxatives, proper diabetes control and other accompanying general measures such as adequate amounts of liquids, dietary fibre and exercise. Motility and secretion-stimulating, osmotically active or locally applied laxatives are used. Slow transit constipation, which is typically observed in diabetics, can be best controlled with polyethylene glycol, bisacodyl or sodium picosulphate.

CONTROL OF STREPTOCOCCAL THROAT INFECTIONS IN SCHOOLS—A Cooperative Program Followed in Orange County

PubMed Central

Russell, Edward Lee

1956-01-01

Attempts to identify streptococcal throat infections on clinical evidence alone do not provide an adequate or reliable index of the prevalence of these infections in the community. Epidemiologic information on streptococcal throat infections based on bacteriological identification permits a more accurate assessment of the situation and more logical and more effective control measures. Recent refinements in laboratory procedures have provided a simple, reliable and relatively inexpensive method for the identification of Group A beta hemolytic streptococci by public health or clinical laboratories. In Orange County a program for the identification of streptococcal throat infections by cooperative action of the medical profession, the health department and the school authorities greatly aided in control of the disease. A voluntary health agency (heart association) made an important contribution toward the success of the control program. PMID:13374555

Ecotechnology: basis of a new immission concept in water pollution control.

PubMed

Benndorf, J

2005-01-01

Beyond the traditional load reduction also an ecosystem-internal mechanism can be used to minimise the effects of water pollution. The control of the internal mechanisms is achieved through the optimisation of the ecosystem structure. This ecotechnology principle is based on the idea to reduce as much as possible the gap between the current (suboptimal) structural status and the optimum structure by intentional manipulations. The spectrum of such manipulations is very broad. A few examples are demonstrated. They comprise physical (e.g. stream morphology), chemical (e.g. enhancing the redox potential at the sediment-water interface) and biological (e.g. enhancing stocks of predatory fishes) control measures. It can be supposed that a new immission concept including the ecotechnology principle could be much more adequate to the demand of modern water pollution control than the traditional emission and imission concepts.

Tobacco control in India.

PubMed Central

Shimkhada, Riti; Peabody, John W.

2003-01-01

Legislation to control tobacco use in developing countries has lagged behind the dramatic rise in tobacco consumption. India, the third largest grower of tobacco in the world, amassed 1.7 million disability-adjusted life years (DALYs) in 1990 due to disease and injury attributable to tobacco use in a population where 65% of the men and 38% of the women consume tobacco. India's anti-tobacco legislation, first passed at the national level in 1975, was largely limited to health warnings and proved to be insufficient. In the last decade state legislation has increasingly been used but has lacked uniformity and the multipronged strategies necessary to control demand. A new piece of national legislation, proposed in 2001, represents an advance. It includes the following key demand reduction measures: outlawing smoking in public places; forbidding sale of tobacco to minors; requiring more prominent health warning labels; and banning advertising at sports and cultural events. Despite these measures, the new legislation will not be enough to control the demand for tobacco products in India. The Indian Government must also introduce policies to raise taxes, control smuggling, close advertising loopholes, and create adequate provisions for the enforcement of tobacco control laws. PMID:12640476

14 CFR 25.1143 - Engine controls.

Code of Federal Regulations, 2014 CFR

2014-01-01

... means of controlling its engine. (d) For each fluid injection (other than fuel) system and its controls... injection fluid is adequately controlled. (e) If a power or thrust control incorporates a fuel shutoff...

14 CFR 25.1143 - Engine controls.

Code of Federal Regulations, 2013 CFR

2013-01-01

... means of controlling its engine. (d) For each fluid injection (other than fuel) system and its controls... injection fluid is adequately controlled. (e) If a power or thrust control incorporates a fuel shutoff...

First "glass" education: telementored cardiac ultrasonography using Google Glass- a pilot study.

PubMed

Russell, Patrick M; Mallin, Michael; Youngquist, Scott T; Cotton, Jennifer; Aboul-Hosn, Nael; Dawson, Matt

2014-11-01

The objective of this study was to determine the feasibility of telementored instruction in bedside ultrasonography (US) using Google Glass. The authors sought to examine whether first-time US users could obtain adequate parasternal long axis (PSLA) views to approximate ejection fraction (EF) using Google Glass telementoring. This was a prospective, randomized, single-blinded study. Eighteen second-year medical students were randomized into three groups and tasked with obtaining PSLA cardiac imaging. Group A received real-time telementored education through Google Glass via Google Hangout from a remotely located expert. Group B received bedside education from the same expert. Group C represented the control and received no instruction. Each subject was given 3 minutes to obtain a best PSLA cardiac imaging using a portable GE Vscan. Image clips obtained by each subject were stored. A second expert, blinded to instructional mode, evaluated images for adequacy and assigned an image quality rating on a 0 to 10 scale. Group A was able to obtain adequate images six out of six times (100%) with a median image quality rating of 7.5 (interquartile range [IQR] = 6 to 10) out of 10. Group B was also able to obtain adequate views six out of six times (100%), with a median image quality rating of 8 (IQR = 7 to 9). Group C was able to obtain adequate views one out of six times (17%), with a median image quality of 0 (IQR = 0 to 2). There were no statistically significant differences between Group A and Group B in the achievement of adequate images for E-point septal separation measurement or in image quality. In this pilot/feasibility study, novice US users were able to obtain adequate imaging to determine a healthy patient's EF through telementored education using Google Glass. These preliminary data suggest telementoring as an adequate means of medical education in bedside US. This conclusion will need to be validated with larger, more powerful studies including evaluation of pathologic findings and varying body habitus among models. © 2014 by the Society for Academic Emergency Medicine.

Total and Free Fluoride Concentration in Various Brands of Toothpaste Marketed in India

PubMed Central

Siddanna, Sunitha

2015-01-01

Background For fluoridated toothpaste to be effective in controlling dental caries, an adequate concentration of soluble fluoride must be available in the oral cavity. Aim To determine the total and free fluoride concentration in various brands of toothpaste marketed in India. Materials and Methods Three samples of 12 different toothpastes were purchased from supermarkets in Mysore city, Karnataka, India. Toothpastes were analysed in duplicate using a fluoride ion-specific electrode. The concentration of total fluoride (TF) and total soluble fluoride (TSF) were determined. Results Measured TF was consistent with that declared by the manufacturer in five products. Four toothpastes showed lower TF and two higher TF than declared. Most toothpastes exhibited TSF concentrations similar to the TF content except four samples that displayed considerably lower TSF than TF. Conclusion The measurement of total and free fluoride concentrations of toothpastes available in India showed inhomogenities. Therefore there is a need for stringent regulatory control measures for the determination of fluoride content in toothpastes in developing country like India. PMID:26557607

[Quality of health care for diabetic and hypertensive patients in primary care settings servicing Mexican Seguro Popular].

PubMed

Ortiz-Domínguez, Maki E; Garrido-Latorre, Francisco; Orozco, Ricardo; Pineda-Pérez, Dayana; Rodríguez-Salgado, Marlenne

2011-01-01

To assess health care quality provided to type-2 diabetic and hypertensive patients in primary care settings from the Mexican Ministry of Health and to evaluate whether accredited clinics providing services to the Mexican Seguro Popular performed better in terms of metabolic control of those patients compared to the non-accredited. Cross-sectional study performed on 2008. Previous year clinical measures were obtained from 5 444 diabetic and 5 827 hypertensive patient's clinical records. Adequate metabolic control (glucose <110 mg/dl for diabetes and blood pressure <140/90 mmHg for hypertension) associated factors were assessed by multiple-multilevel logistic regression methods. Patients attending accredited clinics were more likely to be controlled, however, metabolic control was not constant over time of accreditation. Additional efforts are required to monitor accredited clinics' performance in order to maintain both metabolic control and clinical assessment of patients.

An easy tool to assess ventilation in health facilities as part of air-borne transmission prevention: a cross-sectional survey from Uganda.

PubMed

Brouwer, Miranda; Katamba, Achilles; Katabira, Elly Tebasoboke; van Leth, Frank

2017-05-03

No guidelines exist on assessing ventilation through air changes per hour (ACH) using a vaneometer. The objective of the study was to evaluate the position and frequency for measuring air velocity using a vaneometer to assess ventilation with ACH; and to assess influence of ambient temperature and weather on ACH. Cross-sectional survey in six urban health facilities in Kampala, Uganda. Measurements consisted of taking air velocity on nine separate moments in five positions in each opening of the TB clinic, laboratory, outpatient consultation and outpatient waiting room using a vaneometer. We assessed in addition the ventilation with the "20% rule", and compared this estimation with the ventilation in ACH assessed using the vaneometer. A total of 189 measurements showed no influence on air velocity of the position and moment of the measurement. No significant influence existed of ambient temperature and a small but significant influence of sunny weather. Ventilation was adequate in 17/24 (71%) of all measurements. Using the "20% rule", ventilation was adequate in 50% of rooms assessed. Agreement between both methods existed in 13/23 (56%) of the rooms assessed. Most rooms had adequate ventilation when assessed using a vaneometer for measuring air velocity. A single vaneometer measurement of air velocity is adequate to assess ventilation in this setting. These findings provide practical input for clear guidelines on assessing ventilation using a vaneometer. Assessing ventilation with a vaneometer differs substantially from applying the "20% rule".

Controls Over Ministry of Interior Fuel Contracts Could be Improved

DTIC Science & Technology

2016-01-20

Fiscal Year 1395 Commitment Letter improved reporting requirements designed to specify adequate documentation of the Afghan Ministry of Interior fuel...1395 Commitment Letter improved reporting requirements designed to specify adequate documentation of the Afghan Ministry of Interior fuel consumption...of Defense F r a u d , W a s t e & A b u s e FOR OFFICIAL USE ONLY FOR OFFICIAL USE ONLY Results in Brief Controls Over Ministry of Interior Fuel

The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials.

PubMed

Schmitt, Jochen; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric; Furue, Masutaka; Deckert, Stefanie; Dohil, Magdalene; Apfelbacher, Christian; Singh, Jasvinder A; Chalmers, Joanne; Williams, Hywel C

2014-10-01

The lack of core outcome sets for atopic eczema (AE) is a major obstacle for advancing evidence-based treatment. The global Harmonising Outcome Measures for Eczema (HOME) initiative has already defined clinical signs, symptoms, quality of life, and long-term control of flares as core outcome domains for AE trials. This article deals with the standardization of measurement instruments to assess clinical signs of AE. To resolve the current lack of standardization of the assessment of clinical signs of AE, we followed a structured process of systematic reviews and international consensus sessions to identify 1 core outcome measurement instrument for assessment of clinical signs in all future AE trials. Systematic reviews indicated that from 16 different instruments identified to assess clinical signs of AE, only the Eczema Area and Severity Index (EASI) and the objective Scoring Atopic Dermatitis (SCORAD) index were identified as extensively validated. The EASI has adequate validity, responsiveness, internal consistency, and intraobserver reliability. The objective SCORAD index has adequate validity, responsiveness, and interobserver reliability but unclear intraobserver reliability to measure clinical signs of AE. In an international consensus study, patients, physicians, nurses, methodologists, and pharmaceutical industry representatives agreed that the EASI is the preferred core instrument to measure clinical signs in all future AE trials. All stakeholders involved in designing, reporting, and using clinical trials on AE are asked to comply with this consensus to enable better evidence-based decision making, clearer scientific communication, and improved patient care. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

21 CFR 1404.900 - Adequate evidence.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION... support the reasonable belief that a particular act or omission has occurred. ...

21 CFR 1404.900 - Adequate evidence.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION... support the reasonable belief that a particular act or omission has occurred. ...

21 CFR 1404.900 - Adequate evidence.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION... support the reasonable belief that a particular act or omission has occurred. ...

21 CFR 1404.900 - Adequate evidence.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION... support the reasonable belief that a particular act or omission has occurred. ...

21 CFR 1404.900 - Adequate evidence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION... support the reasonable belief that a particular act or omission has occurred. ...

Advanced helicopter cockpit and control configurations for helicopter combat missions

NASA Technical Reports Server (NTRS)

Haworth, Loran A.; Atencio, Adolph, Jr.; Bivens, Courtland; Shively, Robert; Delgado, Daniel

1987-01-01

Two piloted simulations were conducted by the U.S. Army Aeroflightdynamics Directorate to evaluate workload and helicopter-handling qualities requirements for single pilot operation in a combat Nap-of-the-Earth environment. The single-pilot advanced cockpit engineering simulation (SPACES) investigations were performed on the NASA Ames Vertical Motion Simulator, using the Advanced Digital Optical Control System control laws and an advanced concepts glass cockpit. The first simulation (SPACES I) compared single pilot to dual crewmember operation for the same flight tasks to determine differences between dual and single ratings, and to discover which control laws enabled adequate single-pilot helicopter operation. The SPACES II simulation concentrated on single-pilot operations and use of control laws thought to be viable candidates for single pilot operations workload. Measures detected significant differences between single-pilot task segments. Control system configurations were task dependent, demonstrating a need for inflight reconfigurable control system to match the optimal control system with the required task.

A Procedure for Measuring Latencies in Brain-Computer Interfaces

PubMed Central

Wilson, J. Adam; Mellinger, Jürgen; Schalk, Gerwin; Williams, Justin

2011-01-01

Brain-computer interface (BCI) systems must process neural signals with consistent timing in order to support adequate system performance. Thus, it is important to have the capability to determine whether a particular BCI configuration (i.e., hardware, software) provides adequate timing performance for a particular experiment. This report presents a method of measuring and quantifying different aspects of system timing in several typical BCI experiments across a range of settings, and presents comprehensive measures of expected overall system latency for each experimental configuration. PMID:20403781

Measuring Critical Thinking in Physics: Development and Validation of a Critical Thinking Test in Electricity and Magnetism

ERIC Educational Resources Information Center

Tiruneh, Dawit Tibebu; De Cock, Mieke; Weldeslassie, Ataklti G.; Elen, Jan; Janssen, Rianne

2017-01-01

Although the development of critical thinking (CT) is a major goal of science education, adequate emphasis has not been given to the measurement of CT skills in specific science domains such as physics. Recognizing that adequately assessing CT implies the assessment of both domain-specific and domain-general CT skills, this study reports on the…

Measurement of ion thruster exhaust characteristics and interaction with simulated ATS-F spacecraft

NASA Technical Reports Server (NTRS)

Worlock, R.; Trump, G.; Sellen, J. M., Jr.; Kemp, R. F.

1973-01-01

The ATS-F ion engine was mounted on a simulated spacecraft and was operated in a 22 by 35 foot vacuum chamber, using the same neutralizer control point as in earlier small chamber tests. The control point was in the middle of a range of 16 steps and, thus, the range should be adequate for transition to space flight. Measurement of the near- and far-field ions showed that the ion beam was well defined in a cone of 18-degrees half-angle. The material deposition experiment indicated that the ATS-F solar array would accumulate less than 0.2 A of aluminum per thousand hours of thruster operation, so that the corresponding power loss could be considered negligible. An interesting result was that the coupling between the beam and spacecraft was strong enough to require relatively large increases in the beam potential as the neutralizer bias was increased.

Adaptive AOA-aided TOA self-positioning for mobile wireless sensor networks.

PubMed

Wen, Chih-Yu; Chan, Fu-Kai

2010-01-01

Location-awareness is crucial and becoming increasingly important to many applications in wireless sensor networks. This paper presents a network-based positioning system and outlines recent work in which we have developed an efficient principled approach to localize a mobile sensor using time of arrival (TOA) and angle of arrival (AOA) information employing multiple seeds in the line-of-sight scenario. By receiving the periodic broadcasts from the seeds, the mobile target sensors can obtain adequate observations and localize themselves automatically. The proposed positioning scheme performs location estimation in three phases: (I) AOA-aided TOA measurement, (II) Geometrical positioning with particle filter, and (III) Adaptive fuzzy control. Based on the distance measurements and the initial position estimate, adaptive fuzzy control scheme is applied to solve the localization adjustment problem. The simulations show that the proposed approach provides adaptive flexibility and robust improvement in position estimation.

A flexible 70 MHz phase-controlled double waveguide system for hyperthermia treatment of superficial tumours with deep infiltration.

PubMed

van Stam, Gerard; Kok, H Petra; Hulshof, Maarten C C M; Kolff, M Willemijn; van Tienhoven, Geertjan; Sijbrands, Jan; Bakker, Akke; Zum Vörde Sive Vörding, Paul J; Oldenborg, Sabine; de Greef, Martijn; Rasch, Coen R N; Crezee, Hans

2017-11-01

Superficial tumours with deep infiltration in the upper 15 cm of the trunk cannot be treated adequately with existing hyperthermia systems. The aim of this study was to develop, characterise and evaluate a new flexible two-channel hyperthermia system (AMC-2) for tumours in this region. The two-channel AMC-2 system has two horizontally revolving and height adjustable 70 MHz waveguides. Three different interchangeable antennas with sizes 20 × 34, 15 × 34 and 8.5 × 34 cm were developed and their electrical properties were determined. The performance of the AMC-2 system was tested by measurements of the electric field distribution in a saline water filled elliptical phantom, using an electric field vector probe. Clinical feasibility was demonstrated by treatment of a melanoma in the axillary region. Phantom measurements showed a good performance for all waveguides. The large reflection of the smallest antenna has to be compensated by increased forward power. Field patterns become asymmetrical when using smaller top antennas, necessitating phase corrections. The clinical application showed that tumours deeper than 4 cm can be heated adequately. A median tumour temperature of 42 °C can be reached up to 12 cm depth with adequate antenna positioning and phase-amplitude steering. This 70 MHz AMC-2 waveguide system is a useful addition to existing loco-regional hyperthermia equipment as it is capable of heating axillary tumours and other tumours deeper than 4 cm.

Lower limb strength training in children with cerebral palsy – a randomized controlled trial protocol for functional strength training based on progressive resistance exercise principles

PubMed Central

Scholtes, Vanessa A; Dallmeijer, Annet J; Rameckers, Eugene A; Verschuren, Olaf; Tempelaars, Els; Hensen, Maartje; Becher, Jules G

2008-01-01

Background Until recently, strength training in children with cerebral palsy (CP) was considered to be inappropriate, because it could lead to increased spasticity or abnormal movement patterns. However, the results of recent studies suggest that progressive strength training can lead to increased strength and improved function, but low methodological quality and incomplete reporting on the training protocols hampers adequate interpretation of the results. This paper describes the design and training protocol of a randomized controlled trial to assess the effects of a school-based progressive functional strength training program for children with CP. Methods/Results Fifty-one children with Gross Motor Function Classification Systems levels I to III, aged of 6 to 13 years, were recruited. Using stratified randomization, each child was assigned to an intervention group (strength training) or a control group (usual care). The strength training was given in groups of 4–5 children, 3 times a week, for a period of 12 weeks. Each training session focussed on four exercises out of a 5-exercise circuit. The training load was gradually increased based on the child's maximum level of strength, as determined by the 8 Repetition Maximum (8 RM). To evaluate the effectiveness of the training, all children were evaluated before, during, directly after, and 6 weeks after the intervention period. Primary outcomes in this study were gross motor function (measured with the Gross Motor Function Measure and functional muscle strength tests) and walking ability (measured with the 10-meter, the 1-minute and the timed stair test). Secondary outcomes were lower limb muscle strength (measured with a 6 RM test, isometric strength tests, and a sprint capacity test), mobility (measured with a mobility questionnaire), and sport activities (measured with the Children's Assessment of Participation and Enjoyment). Spasticity and range of motion were assessed to evaluate any adverse events. Conclusion Randomized clinical trials are considered to present the highest level of evidence. Nevertheless, it is of utmost importance to report on the design, the applied evaluation methods, and all elements of the intervention, to ensure adequate interpretation of the results and to facilitate implementation of the intervention in clinical practice if the results are positive. Trial Registration Trial Register NTR1403 PMID:18842125

Comparison of measured and calculated composition of irradiated EBR-II blanket assemblies.

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

Grimm, K. N.

1998-07-13

In anticipation of processing irradiated EBR-II depleted uranium blanket subassemblies in the Fuel Conditioning Facility (FCF) at ANL-West, it has been possible to obtain a limited set of destructive chemical analyses of samples from a single EBR-II blanket subassembly. Comparison of calculated values with these measurements is being used to validate a depletion methodology based on a limited number of generic models of EBR-II to simulate the irradiation history of these subassemblies. Initial comparisons indicate these methods are adequate to meet the operations and material control and accountancy (MC and A) requirements for the FCF, but also indicate several shortcomingsmore » which may be corrected or improved.« less

The revised scale for caregiving self-efficacy: reliability and validity studies.

PubMed

Steffen, Ann M; McKibbin, Christine; Zeiss, Antonette M; Gallagher-Thompson, Dolores; Bandura, Albert

2002-01-01

Two samples of family caregivers (Study 1: N = 169; Study 2: N = 145) of cognitively impaired older adults were used to revise, extend, and evaluate a measure of perceived self-efficacy for caregiving tasks. The Revised Scale for Caregiving Self-Efficacy measures 3 domains of caregiving self-efficacy: Obtaining Respite, Responding to Disruptive Patient Behaviors, and Controlling Upsetting Thoughts. The 3 subscales show strong internal consistency and adequate test-retest reliability. Construct validity is supported by relationships between these 3 facets of perceived caregiving efficacy and depression, anxiety, anger, perceived social support, and criticism expressed in speech samples. The Revised Scale for Caregiving Self-Efficacy has potential uses for both research and clinical purposes.

Review: Evaluation of Foot-and-Mouth Disease Control Using Fault Tree Analysis.

PubMed

Isoda, N; Kadohira, M; Sekiguchi, S; Schuppers, M; Stärk, K D C

2015-06-01

An outbreak of foot-and-mouth disease (FMD) causes huge economic losses and animal welfare problems. Although much can be learnt from past FMD outbreaks, several countries are not satisfied with their degree of contingency planning and aiming at more assurance that their control measures will be effective. The purpose of the present article was to develop a generic fault tree framework for the control of an FMD outbreak as a basis for systematic improvement and refinement of control activities and general preparedness. Fault trees are typically used in engineering to document pathways that can lead to an undesired event, that is, ineffective FMD control. The fault tree method allows risk managers to identify immature parts of the control system and to analyse the events or steps that will most probably delay rapid and effective disease control during a real outbreak. The present developed fault tree is generic and can be tailored to fit the specific needs of countries. For instance, the specific fault tree for the 2001 FMD outbreak in the UK was refined based on control weaknesses discussed in peer-reviewed articles. Furthermore, the specific fault tree based on the 2001 outbreak was applied to the subsequent FMD outbreak in 2007 to assess the refinement of control measures following the earlier, major outbreak. The FMD fault tree can assist risk managers to develop more refined and adequate control activities against FMD outbreaks and to find optimum strategies for rapid control. Further application using the current tree will be one of the basic measures for FMD control worldwide. © 2013 Blackwell Verlag GmbH.

A Macintosh-Based Scientific Images Video Analysis System

NASA Technical Reports Server (NTRS)

Groleau, Nicolas; Friedland, Peter (Technical Monitor)

1994-01-01

A set of experiments was designed at MIT's Man-Vehicle Laboratory in order to evaluate the effects of zero gravity on the human orientation system. During many of these experiments, the movements of the eyes are recorded on high quality video cassettes. The images must be analyzed off-line to calculate the position of the eyes at every moment in time. To this aim, I have implemented a simple inexpensive computerized system which measures the angle of rotation of the eye from digitized video images. The system is implemented on a desktop Macintosh computer, processes one play-back frame per second and exhibits adequate levels of accuracy and precision. The system uses LabVIEW, a digital output board, and a video input board to control a VCR, digitize video images, analyze them, and provide a user friendly interface for the various phases of the process. The system uses the Concept Vi LabVIEW library (Graftek's Image, Meudon la Foret, France) for image grabbing and displaying as well as translation to and from LabVIEW arrays. Graftek's software layer drives an Image Grabber board from Neotech (Eastleigh, United Kingdom). A Colour Adapter box from Neotech provides adequate video signal synchronization. The system also requires a LabVIEW driven digital output board (MacADIOS II from GW Instruments, Cambridge, MA) controlling a slightly modified VCR remote control used mainly to advance the video tape frame by frame.

Implementation and Operational Analysis of an Interactive Intensive Care Unit within a Smart Health Context.

PubMed

Lopez-Iturri, Peio; Aguirre, Erik; Trigo, Jesús Daniel; Astrain, José Javier; Azpilicueta, Leyre; Serrano, Luis; Villadangos, Jesús; Falcone, Francisco

2018-01-29

In the context of hospital management and operation, Intensive Care Units (ICU) are one of the most challenging in terms of time responsiveness and criticality, in which adequate resource management and signal processing play a key role in overall system performance. In this work, a context aware Intensive Care Unit is implemented and analyzed to provide scalable signal acquisition capabilities, as well as to provide tracking and access control. Wireless channel analysis is performed by means of hybrid optimized 3D Ray Launching deterministic simulation to assess potential interference impact as well as to provide required coverage/capacity thresholds for employed transceivers. Wireless system operation within the ICU scenario, considering conventional transceiver operation, is feasible in terms of quality of service for the complete scenario. Extensive measurements of overall interference levels have also been carried out, enabling subsequent adequate coverage/capacity estimations, for a set of Zigbee based nodes. Real system operation has been tested, with ad-hoc designed Zigbee wireless motes, employing lightweight communication protocols to minimize energy and bandwidth usage. An ICU information gathering application and software architecture for Visitor Access Control has been implemented, providing monitoring of the Boxes external doors and the identification of visitors via a RFID system. The results enable a solution to provide ICU access control and tracking capabilities previously not exploited, providing a step forward in the implementation of a Smart Health framework.

Studies on the Evaluation Methods for the Food Quality with a Non-contact type Capacitance Sensor.

NASA Astrophysics Data System (ADS)

Narumiya, Tadaoki; Hagura, Yoshio

Changes of capacitance and temperature of ethyl alcohol, hamburger and dough with cheese filling were measured with specially-made measuring devices during the freezing and thawing. The results of measurement of capacitance and temperature suggest a linear correlation for ethyl alcohol as a single constituent substance. The adequate correlation is too estimated from the results of food samples, though the capacitance of food sample varies greatly at the start and end of freezing and thawing process. It has been demonstrated that the quality or physical condition of food sample can be determined easily by the measurement of capacitance using the specially-made devices. Also the quality or physical condition of food can be determined easily by the non-contact and non-destructive measurements of capacitance. A variety application of the present technique is conceivable for the process control of the freezing and thawing foods.

Performance monitor system functional simulator, environmental data, orbiter 101(HFT)

NASA Technical Reports Server (NTRS)

Parker, F. W.

1974-01-01

Information concerning the environment component of the space shuttle performance monitor system simulator (PMSS) and those subsystems operational on the shuttle orbiter 101 used for horizontal flight test (HFT) is provided, along with detailed data for the shuttle performance monitor system (PMS) whose software requirements evolve from three basic PMS functions: (1) fault detection and annunciation; (2) subsystem measurement management; and (3) subsystem configuration management. Information relative to the design and operation of Orbiter systems for HFT is also presented, and the functional paths are identified to the lowest level at which the crew can control the system functions. Measurement requirements are given which are necessary to adequately monitor the health status of the system. PMS process requirements, relative to the measurements which are necessary for fault detection and annunciation of a failed functional path, consist of measurement characteristics, tolerance limits, precondition tests, and correlation measurements.

INDIVIDUO: Results from a patient-centered lifestyle intervention for obesity surgery candidates.

PubMed

Camolas, José; Santos, Osvaldo; Moreira, Pedro; do Carmo, Isabel

Preoperative nutritional counseling provides an opportunity to ameliorate patients' clinical condition and build-up adequate habits and perception of competence. Study aimed to evaluate: (a) the effect of INDIVIDUO on weight and metabolic control; (b) the impact of INDIVIDUO on psychosocial variables associated with successful weight-control. Two-arms randomised controlled single-site study, with six-month duration. Patients were recruited from an Obesity Treatment Unit's waiting list. For the intervention group (IG), an operating procedure manual was used, nutritionists received training/supervision regarding INDIVIDUO's procedures. Control group (CG) received health literacy-promoting intervention. Intention-to-treat and per-control analysis were used. Outcomes included weight, metabolic control variables (blood pressure, glycemia, insulinemia, triglycerides, cholesterol), measures of eating and physical activity patterns, hedonic hunger, autonomous/controlled regulation, perceived competence for diet (PCS-diet) and quality of life. Primary outcomes were weight and metabolic control. Effect size was estimated by odds ratio and Cohens'd coefficient. Overall, 94 patients participated (IG:45; CG:49) and 60 completed the study (IG:29; CG:31). Intervention patients lost an excess 9.68% body weight (%EWL), vs. 0.51% for CG. Adjusting for age and baseline BMI, allocation group remained an independent predictor of %EWL (B=8.43, 95%CI: 2.79-14.06). IG had a six-fold higher probability (OR: 6.35, 95%CI: 1.28-31.56) of having adequate/controlled fasting glycemia at final evaluation. PCS-diet at final evaluation was independently predicted by baseline PCS-diet (B=0.31, 95%CI: 0.06-0.64), variation in autonomous regulation (B=0.43, 95%CI: 0.15-0.71) and allocation group (B=0.26, 95%CI: 0.04-1.36). Results on weight and metabolic control support INDIVIDUO as a valuable clinical tool for obesity surgery candidates counseling. Additionally, intervention associated with perceived competence for weight-control behaviours and autonomous regulation. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

[Guideline to prevent claims due to medical malpractice, on how to act when they do occur and how to defend oneself through the courts].

PubMed

Bruguera, M; Arimany, J; Bruguera, R; Barberia, E; Ferrer, F; Sala, J; Pujol Robinat, A; Medallo Muñiz, J

2012-04-01

Claims due to presumed medical malpractice are increasing in all developed countries and many of them have no basis. To prevent legal complaints, the physicians should know the reasons why complaints are made by their patients and adopt the adequate preventive measures. In the case of a complaint, it is essential to follow the guidelines that allow for adequate legal defense and the action of the physician before the judge that inspires confidence and credibility. The risk of the claims can be reduced with adequate information to the patient, the following of the clinical guidelines, control of the risk factors and adoption of verification lists in each invasive procedure. In case of complication or serious adverse effect, explanations should be given to the patient and family and it should be reported to the facility where one works and to the insurance company. If the physician received a claim, he/she should report it to the insurance compare so that it can name a lawyer responsible for the legal defense who will advise the physician regarding the appearance in court before the judge. Copyright © 2011 Elsevier España, S.L. All rights reserved.

[Surgical treatment of secondary peritonitis: A continuing problem. German version].

PubMed

van Ruler, O; Boermeester, M A

2016-01-01

Secondary peritonitis remains associated with high mortality and morbidity rates. Treatment of secondary peritonitis is still challenging even in the era of modern medicine. Surgical intervention for source control remains the cornerstone of treatment besides adequate antimicrobial therapy and when necessary intensive medical care measures and resuscitation. A randomized clinical trial showed that relaparotomy on demand (ROD) after initial emergency surgery was the preferred treatment strategy, irrespective of the severity and extent of peritonitis. The effective and safe use of ROD requires intensive monitoring of the patient in a setting where diagnostic tests and decision making about relaparotomy are guaranteed round the clock. The lack of knowledge on timely and adequate patient selection, together with the lack of use of easy but reliable monitoring tools seem to hamper full implementation of ROD. The accuracy of the relaparotomy decision tool is reasonable for prediction of the formation of peritonitis and necessary selection of patients for computed tomography (CT). The value of CT in the early postoperative phase is unclear. Future research and innovative technologies should focus on the additive value of CT after surgical treatment for secondary peritonitis and on the further optimization of bedside prediction tools to enhance adequate patient selection for interventions in a multidisciplinary setting.

Assessing the treatment effects in apraxia of speech: introduction and evaluation of the Modified Diadochokinesis Test.

PubMed

Hurkmans, Joost; Jonkers, Roel; Boonstra, Anne M; Stewart, Roy E; Reinders-Messelink, Heleen A

2012-01-01

The number of reliable and valid instruments to measure the effects of therapy in apraxia of speech (AoS) is limited. To evaluate the newly developed Modified Diadochokinesis Test (MDT), which is a task to assess the effects of rate and rhythm therapies for AoS in a multiple baseline across behaviours design. The consistency, accuracy and fluency of speech of 24 adults with AoS and 12 unaffected speakers matched for age, gender and educational level were assessed using the MDT. The reliability and validity of the instrument were considered and outcomes compared with those obtained with existing tests. The results revealed that MDT had a strong internal consistency. Scores were influenced by syllable structure complexity, while distinctive features of articulation had no measurable effect. The test-retest and intra- and inter-rater reliabilities were shown to be adequate, and the discriminant validity was good. For convergent validity different outcomes were found: apart from one correlation, the scores on tests assessing functional communication and AoS correlated significantly with the MDT outcome measures. The spontaneous speech phonology measure of the Aachen Aphasia Test (AAT) correlated significantly with the MDT outcome measures, but no correlations were found for the repetition subtest and the spontaneous speech articulation/prosody measure of the AAT. The study shows that the MDT has adequate psychometric properties, implying that it can be used to measure changes in speech motor control during treatment for apraxia of speech. The results demonstrate the validity and utility of the instrument as a supplement to speech tasks in assessing speech improvement aimed at the level of planning and programming of speech. © 2012 Royal College of Speech and Language Therapists.

Is my bottom-up uncertainty estimation on metal measurement adequate?

NASA Astrophysics Data System (ADS)

Marques, J. R.; Faustino, M. G.; Monteiro, L. R.; Ulrich, J. C.; Pires, M. A. F.; Cotrim, M. E. B.

2018-03-01

Is the estimated uncertainty under GUM recommendation associated with metal measurement adequately estimated? How to evaluate if the measurement uncertainty really covers all uncertainty that is associated with the analytical procedure? Considering that, many laboratories frequently underestimate or less frequently overestimate uncertainties on its results; this paper presents the evaluation of estimated uncertainties on two ICP-OES procedures of seven metal measurements according to GUM approach. Horwitz function and proficiency tests scaled standard uncertainties were used in this evaluation. Our data shows that most elements expanded uncertainties were from two to four times underestimated. Possible causes and corrections are discussed herein.

Effects of Inhalation Aromatherapy on Symptoms of Sleep Disturbance in the Elderly with Dementia

PubMed Central

Watanuki, Emiko

2017-01-01

This study investigated the effects of inhalation aromatherapy on sleep disturbance in elderly individuals with dementia. In 19 subjects, normal sleep was observed for a 20-day control period, inhalation aromatherapy was then applied for a 20-day intervention period, and the control and intervention periods were compared. During the intervention period, essential oils were placed nightly on towels around the subjects' pillows. The measured sleep conditions were sleep latency, total sleep time, sleep efficacy, duration of the longest sustained sleep period, wake time after sleep onset, early morning awakening, total daytime sleep, and the Neuropsychiatric Inventory. Total sleep time was significantly longer in the intervention period than in the control period (p < 0.05). The duration of the longest sustained sleep period was significantly longer in the intervention period than in the control period (p < 0.05). Early morning awakening in the intervention period was significantly less compared to that in the control period (p < 0.05). Total daytime sleep could not be adequately measured and was omitted from the analysis. No significant differences in other sleep conditions were observed. These results indicated positive effects of inhalation aromatherapy on symptoms of sleep disturbance in elderly individuals with dementia. PMID:28400839

Smart Hand For Manipulators

NASA Astrophysics Data System (ADS)

Fiorini, Paolo

1987-10-01

Sensor based, computer controlled end effectors for mechanical arms are receiving more and more attention in the robotics industry, because commonly available grippers are only adequate for simple pick and place tasks. This paper describes the current status of the research at JPL on a smart hand for a Puma 560 robot arm. The hand is a self contained, autonomous system, capable of executing high level commands from a supervisory computer. The mechanism consists of parallel fingers, powered by a DC motor, and controlled by a microprocessor embedded in the hand housing. Special sensors are integrated in the hand for measuring the grasp force of the fingers, and for measuring forces and torques applied between the arm and the surrounding environment. Fingers can be exercised under position, velocity and force control modes. The single-chip microcomputer in the hand executes the tasks of communication, data acquisition and sensor based motor control, with a sample cycle of 2 ms and a transmission rate of 9600 baud. The smart hand described in this paper represents a new development in the area of end effector design because of its multi-functionality and autonomy. It will also be a versatile test bed for experimenting with advanced control schemes for dexterous manipulation.

[Status of measures against angiography room infection as determined by questionnaire].

PubMed

Tsukamoto, Atsuko; Ito, Makiko; Takahashi, Kanji; Watanabe, Emi; Kikuchi, Tatsuya; Tajima, Osamu; Masuda, Kazuhiro; Wakamatsu, Osamu; Sato, Tsugio; Nakazawa, Yasuo

2006-11-20

Although the cleanliness of the angiography room and that of the operating room have long been equally attended to, the concept of Standard Precautions (including the basic measures and procedures to prevent infection) of the Centers for Disease Control and Prevention (CDC), 1996, as well as the introduction of transmission-based precautions, have been changing to preventive measures that are based on concrete measures. Therefore, a questionnaire was introduced in order to determine the actual status of countermeasures against infection used in the angiography room. The questionnaire was sent to 530 institutions, and 286 responded, a response rate of 54.0%. Its results significantly revealed the following: 1) unexpectedly low recognition of the need and importance for the CDC preventive measures against infection, 2) a considerable number of institutions continuing to perform the conventional preventive measures, 3) problems with education systems on preventive measures, and 4) handwashing, the most important measure against infection, failing to be adequately carried out noticeably among radiological technologists.

The performance and efficiency of four motor/controller/battery systems for the simpler electric vehicles

NASA Technical Reports Server (NTRS)

Shipps, P. R.

1980-01-01

A test and analysis program performed on four complete propulsion systems for an urban electric vehicle (EV) is described and results given. A dc series motor and a permanent magnet (PM) motor were tested, each powered by an EV battery pack and controlled by (1) a series/parallel voltage-switching (V-switch) system; and (2) a system using a pulse width modulation, 400 Hz transistorized chopper. Dynamometer tests were first performed, followed by eV performance predictions and data correlating road tests. During dynamometer tests using chopper control; current, voltage, and power were measured on both the battery and motor sides of the chopper, using three types of instrumentation. Conventional dc instruments provided adequate accuracy for eV power and energy measurements, when used on the battery side of the controller. When using the chopper controller, the addition of a small choke inductor improved system efficiency in the lower duty cycle range (some 8% increase at 50% duty cycle) with both types of motors. Overall system efficiency rankings during road tests were: (1) series motor with V-switch; (2) PM motor with V-switch; (3) series motor with chopper; and (4) PM motor with chopper. Chopper control of the eV was smoother and required less driver skill than V-switch control.

Home blood pressure monitoring in heart transplant recipients: comparison with ambulatory blood pressure monitoring.

PubMed

Ambrosi, Pierre; Kreitmann, Bernard; Habib, Gilbert

2014-02-15

How reliable is home blood pressure monitoring (HBPM) in heart transplant recipients is not known. Possibly, it may underestimate hypertensive burden, because blood pressure (BP) nondipper profile is frequent among these patients. This prospective study has been designed to determine whether HBPM adequately identifies hypertension in heart transplant recipients. We compared HBPM with ambulatory blood pressure monitoring (ABPM) for the diagnosis of uncontrolled hypertension in 74 patients 13.5±6.7 years after heart transplantation. HBPM was measured with a validated semiautomatic device twice every morning and twice every evening on 7 consecutive days, within 15 days of ABPM. We also measured the relationship between HBPM, ABPM, and organ damage as measured by albuminuria and left ventricular mass. A nondipper profile was found in 53 (72%) patients. HBPM and ABPM were close according to Pearson bivariate correlations. There was no significant correlation between left ventricular mass and BP either at HBPM or ABPM. Proteinuria significantly correlated with systolic BP either at HBPM (R=0.42; P=0.0002) or ABPM (R=0.25; P=0.03). HBPM adequately classified 61 of 74 (82%) patients as hypertensives or as nonhypertensives or controlled hypertensives. Despite a high prevalence of nondipper profile, HBPM gives a reliable estimate of BP burden in most heart transplant recipients. Thus, our results strongly suggest that HBPM is useful for the long-term follow-up of heart transplant recipients.

Independent and Joint Effect of Brachial-Ankle Pulse Wave Velocity and Blood Pressure Control on Incident Stroke in Hypertensive Adults.

PubMed

Song, Yun; Xu, Benjamin; Xu, Richard; Tung, Renee; Frank, Eric; Tromble, Wayne; Fu, Tong; Zhang, Weiyi; Yu, Tao; Zhang, Chunyan; Fan, Fangfang; Zhang, Yan; Li, Jianping; Bao, Huihui; Cheng, Xiaoshu; Qin, Xianhui; Tang, Genfu; Chen, Yundai; Yang, Tianlun; Sun, Ningling; Li, Xiaoying; Zhao, Lianyou; Hou, Fan Fan; Ge, Junbo; Dong, Qiang; Wang, Binyan; Xu, Xiping; Huo, Yong

2016-07-01

Pulse wave velocity (PWV) has been shown to influence the effects of antihypertensive drugs in the prevention of cardiovascular diseases. Data are limited on whether PWV is an independent predictor of stroke above and beyond hypertension control. This longitudinal analysis examined the independent and joint effect of brachial-ankle PWV (baPWV) with hypertension control on the risk of first stroke. This report included 3310 hypertensive adults, a subset of the China Stroke Primary Prevention Trial (CSPPT) with baseline measurements for baPWV. During a median follow-up of 4.5 years, 111 participants developed first stroke. The risk of stroke was higher among participants with baPWV in the highest quartile than among those in the lower quartiles (6.3% versus 2.4%; hazard ratio, 1.66; 95% confidence interval, 1.06-2.60). Similarly, the participants with inadequate hypertension control had a higher risk of stroke than those with adequate control (5.1% versus 1.8%; hazard ratio, 2.32; 95% confidence interval, 1.49-3.61). When baPWV and hypertension control were examined jointly, participants in the highest baPWV quartile and with inadequate hypertension control had the highest risk of stroke compared with their counterparts (7.5% versus 1.3%; hazard ratio, 3.57; 95% confidence interval, 1.88-6.77). There was a significant and independent effect of high baPWV on stroke as shown among participants with adequate hypertension control (4.2% versus 1.3%; hazard ratio, 2.29, 95% confidence interval, 1.09-4.81). In summary, among hypertensive patients, baPWV and hypertension control were found to independently and jointly affect the risk of first stroke. Participants with high baPWV and inadequate hypertension control had the highest risk of stroke compared with other groups. © 2016 American Heart Association, Inc.

Transmission loss characteristics of aircraft sidewall systems to control cabin interior noise

NASA Astrophysics Data System (ADS)

Yesil, Oktay; Serati, Paul M.; Hofbeck, Eric V.; Glover, Billy M.

We have explored the possibility of using new, light weight, and acoustically effective materials on aircraft interiors to control noise. The sidewall system elements were evaluated for increased TL in the laboratory. Measured TL for a given configuration, relative to a baseline, was used as an indication of the TL change to be expected for modifications. Test data were in good agreement with the predicted levels. The TL contributions due to all sidewall components were important for interior cabin noise control. Polyimide foam insulation was inferior to fiberglass in the mid-frequency range; however, foam was a better performer at high frequencies. Fiberglass/polyimide foam composite blankets, with less weight, provided noise reductions similar to fiberglass. 'Premium' fiberglass was slightly better performer than the standard fiberglass. Solid fiberglass interior trim panel provided adequate noise performance. Production-type trim attachment design could be improved to control flanking path for sound transmission.

Cluster 1: commercializing additive manufacturing—hurdles in materials characterization and testing

DOE PAGES

Roach, R. A.; Gardner, S. H.

2017-10-20

A major challenge in the commercialization of additive manufactured (AM) materials and processes is the ability to achieve acceptance of processes and products. There has been some progress towards acceptance has been made by adapting legacy qualification paradigms to match with the very limited process control and monitoring offered by AM machines. The opportunity for in-situ measurement can provide process monitoring and control perhaps changing the way we qualify parts however it is limited by lack of adequate process measurement methods. New measurement techniques, sensors and correlations to relevant phenomena are needed that enable process control and monitoring for consistentlymore » producing high quality articles. Beyond process data we need to characterize uncertainties of performance in all aspects of material, process and final part. These are prerequisites to achieving articles that are indeed worthy of materials characterization efforts that establish a microstructural reference of desirable performance through process-structure-property relations. Only then can industry apply physics based understanding of the material, part and process to probabilistically predict performance of an AM part. Our paper provides a brief overview, discussion of hurdles and key areas where R&D investment is needed.« less

Cluster 1: commercializing additive manufacturing—hurdles in materials characterization and testing

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

Roach, R. A.; Gardner, S. H.

A major challenge in the commercialization of additive manufactured (AM) materials and processes is the ability to achieve acceptance of processes and products. There has been some progress towards acceptance has been made by adapting legacy qualification paradigms to match with the very limited process control and monitoring offered by AM machines. The opportunity for in-situ measurement can provide process monitoring and control perhaps changing the way we qualify parts however it is limited by lack of adequate process measurement methods. New measurement techniques, sensors and correlations to relevant phenomena are needed that enable process control and monitoring for consistentlymore » producing high quality articles. Beyond process data we need to characterize uncertainties of performance in all aspects of material, process and final part. These are prerequisites to achieving articles that are indeed worthy of materials characterization efforts that establish a microstructural reference of desirable performance through process-structure-property relations. Only then can industry apply physics based understanding of the material, part and process to probabilistically predict performance of an AM part. Our paper provides a brief overview, discussion of hurdles and key areas where R&D investment is needed.« less

Guidelines for procedural pain in the newborn

PubMed Central

Lago, Paola; Garetti, Elisabetta; Merazzi, Daniele; Pieragostini, Luisa; Ancora, Gina; Pirelli, Anna; Bellieni, Carlo Valerio

2009-01-01

Despite accumulating evidence that procedural pain experienced by newborn infants may have acute and even long-term detrimental effects on their subsequent behaviour and neurological outcome, pain control and prevention remain controversial issues. Our aim was to develop guidelines based on evidence and clinical practice for preventing and controlling neonatal procedural pain in the light of the evidence-based recommendations contained in the SIGN classification. A panel of expert neonatologists used systematic review, data synthesis and open discussion to reach a consensus on the level of evidence supported by the literature or customs in clinical practice and to describe a global analgesic management, considering pharmacological, non-pharmacological, behavioural and environmental measures for each invasive procedure. There is strong evidence to support some analgesic measures, e.g. sucrose or breast milk for minor invasive procedures, and combinations of drugs for tracheal intubation. Many other pain control measures used during chest tube placement and removal, screening and treatment for ROP, or for postoperative pain, are still based not on evidence, but on good practice or expert opinions. Conclusion: These guidelines should help improving the health care professional's awareness of the need to adequately manage procedural pain in neonates, based on the strongest evidence currently available. PMID:19484828

Piloted evaluation of an integrated propulsion and flight control simulator

NASA Technical Reports Server (NTRS)

Bright, Michelle M.; Simon, Donald L.

1992-01-01

This paper describes a piloted evaluation of the integrated flight and propulsion control simulator at NASA Lewis Research Center. The purpose of this evaluation is to demonstrate the suitability and effectiveness of this fixed based simulator for advanced integrated propulsion and airframe control design. The evaluation will cover control effector gains and deadbands, control effectiveness and control authority, and heads up display functionality. For this evaluation the flight simulator is configured for transition flight using an advanced Short Take-Off and vertical Landing fighter aircraft model, a simplified high-bypass turbofan engine model, fighter cockpit, displays, and pilot effectors. The paper describes the piloted tasks used for rating displays and control effector gains. Pilot comments and simulation results confirm that the display symbology and control gains are very adequate for the transition flight task. Additionally, it is demonstrated that this small-scale, fixed base flight simulator facility can adequately perform a real time, piloted control evaluation.

Naming Speed in Dyslexia and Dyscalculia

ERIC Educational Resources Information Center

Willburger, Edith; Fussenegger, Barbara; Moll, Kristina; Wood, Guilherme; Landerl, Karin

2008-01-01

In four carefully selected samples of 8- to 10-year old children with dyslexia (but age adequate arithmetic skills), dyscalculia (but age adequate reading skills), dyslexia/dyscalculia and controls a domain-general deficit in rapid automatized naming (RAN) was found for both dyslexia groups. Dyscalculic children exhibited a domain-specific deficit…

21 CFR 211.46 - Ventilation, air filtration, air heating and cooling.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Ventilation, air filtration, air heating and... Buildings and Facilities § 211.46 Ventilation, air filtration, air heating and cooling. (a) Adequate ventilation shall be provided. (b) Equipment for adequate control over air pressure, micro-organisms, dust...

21 CFR 211.46 - Ventilation, air filtration, air heating and cooling.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Ventilation, air filtration, air heating and... Buildings and Facilities § 211.46 Ventilation, air filtration, air heating and cooling. (a) Adequate ventilation shall be provided. (b) Equipment for adequate control over air pressure, micro-organisms, dust...

21 CFR 211.46 - Ventilation, air filtration, air heating and cooling.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Ventilation, air filtration, air heating and... Buildings and Facilities § 211.46 Ventilation, air filtration, air heating and cooling. (a) Adequate ventilation shall be provided. (b) Equipment for adequate control over air pressure, micro-organisms, dust...

21 CFR 211.46 - Ventilation, air filtration, air heating and cooling.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Ventilation, air filtration, air heating and... Buildings and Facilities § 211.46 Ventilation, air filtration, air heating and cooling. (a) Adequate ventilation shall be provided. (b) Equipment for adequate control over air pressure, micro-organisms, dust...

[Work-related fatigue in highly-educated women older than 50].

PubMed

Knoers, Nine V A M

2010-01-01

Recent findings by Verdonk et al. show that the prevalence of work-related fatigue among 47,000 Dutch employees is greatest in highly-educated women, aged 50-64 years. Although the study has several limitations, the findings are alarming, demand urgent measures and should be on the shortlist of policy makers, employers, and company doctors. Reduced time pressure and emotional demand at work, adequate support for women's ambitions, and proper consideration for the work-private life balance are needed. Coaching may help women to become more assertive and generate more job control. In addition, the problem of workplace violence must be adequately addressed. I am of the strong opinion that work-related fatigue in women would significantly decrease if women were to occupy more leadership positions and top jobs. In such positions they would have greater autonomy and more opportunities to organise their work according to their own time schedules and insights. The time is ripe for women to be given a quota of top positions in the Netherlands.

Resection Arthroplasty Compared With Total Hip Arthroplasty in Treating Chronic Hip Pain of Patients With a History of Substance Abuse.

PubMed

Curtis, William; Marmor, Meir

2018-03-16

Retrospective comparison of surgical management of severe hip pain in patients with a history of substance abuse treated by modified Girdlestone resection arthroplasty (RA) vs delayed total hip arthroplasty (THA) following yearlong sobriety pathway. Patients were identified using charts, current procedural terminology (CPT) code query, and THA sobriety pathway registry. The primary outcome was adequate pain control following surgery, defined as visual analog scale ≤ 5 or verbal description of "moderate" or lower pain. RA patients with infectious arthritis were analyzed separately. The secondary outcome was the level of mobility after surgery. In the THA pathway, 15 of 28 (53.6%) proved sobriety, 11 (39.3%) underwent THA, and 9 (32.1%) achieved adequate pain control (median 77 days). After RA, 19 (76%) achieved adequate pain control (median 119.5 days). Preoperative infection did not significantly affect time to pain control after RA (P = .94). Time to adequate pain control was not significantly different between RA and THA patients (P = .19). Three patients (30%) experienced improved level of mobility after THA and 7 (70%) experienced no change. After RA, 7 patients (29.1%) experienced improved level of mobility, 3 (13.6%) lost mobility, and 14 (63.6%) experienced no change. Three RA patients were later converted to THA without complication. Yearlong sobriety pathway leading to THA leads to successful pain control in less than one-third of enrolled patients. Compared to delayed THA, RA enables more patients with substance abuse to be treated sooner and results in successful reduction of pain in a similar proportion of patients. RA may be an effective pain-reducing procedure for these patients. Copyright © 2018 Elsevier Inc. All rights reserved.

An Examination of Principal Leadership Styles and Their Influence on School Performance as Measured by Adequate Yearly Progress at Selected Title I Elementary Schools in South Carolina

ERIC Educational Resources Information Center

Martin, Tammy Faith

2012-01-01

The purpose of this study was to examine principal leadership styles and their influence on school performance as measured by adequate yearly progress at selected Title I schools in South Carolina. The main focus of the research study was to complete descriptive statistics on principal leadership styles in schools that met or did not meet adequate…

Monitoring of HIV treatment in seven countries in the WHO Region of the Americas

PubMed Central

Belaunzarán-Zamudio, Pablo F; Shepherd, Bryan E; Crabtree-Ramírez, Brenda E; Luz, Paula M; Grinsztejn, Beatriz; Cesar, Carina; Cahn, Pedro; Cortés, Claudia; Wolff, Marcelo; Pape, Jean W; Padgett, Denis; Gotuzzo, Eduardo; McGowan, Catherine; Sierra-Madero, Juan G

2015-01-01

Abstract Objective To determine the prevalence of adequate monitoring and the costs of measuring CD4+ T-lymphocytes (CD4+ cell) and human immunodeficiency virus (HIV) viral load in people receiving antiretroviral therapy (ART) in seven countries in the WHO Region of the Americas. Methods We obtained retrospective, longitudinal data for 14 476 adults who started a first ART regimen at seven HIV clinics in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru between 2000 and 2011. We estimated the proportion of 180-day periods with adequate monitoring, which we defined as at least one CD4+ cell count and one viral load measurement. Factors associated with adequate monitoring were analysed using regression methods. The costs of the tests were estimated. Findings The median follow-up time was 50.4 months; the proportion of 180-day periods with adequate CD4+ cell counts was 69% while the proportion with adequate monitoring was 62%. Adequate monitoring was more likely in participants who were older, who started ART more recently, whose first regimen included a non-nucleoside reverse transcriptase inhibitor or who had a CD4+ cell count less than 200 cells/µl at ART initiation. The cost of one CD4+ cell count ranged from 7.37 United States dollars (US$) in Argentina to US$ 64.09 in Chile; the cost of one viral load measurement ranged from US$ 20.34 in Brazil to US$ 186.28 in Haiti. Conclusion In HIV-infected participants receiving ART in the WHO Region of the Americas, CD4+ cell count and viral load monitoring was often carried out less frequently than regional guidelines recommend. The laboratory costs of monitoring varied greatly. PMID:26478610

Monitoring of HIV treatment in seven countries in the WHO Region of the Americas.

PubMed

Belaunzarán-Zamudio, Pablo F; Caro-Vega, Yanink N; Shepherd, Bryan E; Crabtree-Ramírez, Brenda E; Luz, Paula M; Grinsztejn, Beatriz; Cesar, Carina; Cahn, Pedro; Cortés, Claudia; Wolff, Marcelo; Pape, Jean W; Padgett, Denis; Gotuzzo, Eduardo; McGowan, Catherine; Sierra-Madero, Juan G

2015-08-01

To determine the prevalence of adequate monitoring and the costs of measuring CD4+ T-lymphocytes (CD4+ cell) and human immunodeficiency virus (HIV) viral load in people receiving antiretroviral therapy (ART) in seven countries in the WHO Region of the Americas. We obtained retrospective, longitudinal data for 14 476 adults who started a first ART regimen at seven HIV clinics in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru between 2000 and 2011. We estimated the proportion of 180-day periods with adequate monitoring, which we defined as at least one CD4+ cell count and one viral load measurement. Factors associated with adequate monitoring were analysed using regression methods. The costs of the tests were estimated. The median follow-up time was 50.4 months; the proportion of 180-day periods with adequate CD4+ cell counts was 69% while the proportion with adequate monitoring was 62%. Adequate monitoring was more likely in participants who were older, who started ART more recently, whose first regimen included a non-nucleoside reverse transcriptase inhibitor or who had a CD4+ cell count less than 200 cells/µl at ART initiation. The cost of one CD4+ cell count ranged from 7.37 United States dollars (US$) in Argentina to US$ 64.09 in Chile; the cost of one viral load measurement ranged from US$ 20.34 in Brazil to US$ 186.28 in Haiti. In HIV-infected participants receiving ART in the WHO Region of the Americas, CD4+ cell count and viral load monitoring was often carried out less frequently than regional guidelines recommend. The laboratory costs of monitoring varied greatly.

Equipment modifications for perennial nutsedge control in fallow organic transition

USDA-ARS?s Scientific Manuscript database

Perennial nutsedges are extremely difficult to control in organic crop transition and production systems. Herbicides suitable for use in certified organic production do not adequately control perennial nutsedges. Cultural and mechanical control are partially effective in controlling perennial nuts...

Effectiveness of touch and feel (TAF) technique on first aid measures for visually challenged.

PubMed

Mary, Helen; Sasikalaz, D; Venkatesan, Latha

2013-01-01

There is a common perception that a blind person cannot even help his own self. In order to challenge that view, a workshop for visually-impaired people to develop the skills to be independent and productive members of society was conceived. An experimental study was conducted at National Institute of Visually Handicapped, Chennai with the objective to assess the effectiveness of Touch and Feel (TAF) technique on first aid measures for the visually challenged. Total 25 visually challenged people were selected by non-probability purposive sampling technique and data was collected using demographic variable and structured knowledge questionnaire. The score obtained was categorised into three levels: inadequate (0-8), moderately adequate (8 - 17), adequate (17 -25). The study revealed that most of the visually challenged (40%) had inadequate knowledge, and 56 percent had moderately adequate and only few (4%) had adequate knowledge in the pre-test, whereas most (68%) of them had adequate knowledge in the post-test which is statistically significant at p < 0.000 with t-value 6.779. This proves that TAF technique was effective for the visually challenged. There was no association between the demographic variables and their level of knowledge regarding first aid.

Effectiveness of voice therapy in functional dysphonia: where are we now?

PubMed

Bos-Clark, Marianne; Carding, Paul

2011-06-01

To review the recent literature since the 2009 Cochrane review regarding the effectiveness of voice therapy for patients with functional dysphonia. A range of articles report on the effects of voice therapy treatment for functional dysphonia, with a wide range of interventions described. Only one study is a randomized controlled trial. A number of excellent review articles have extended the knowledge base. In primary research, methodological issues persist: studies are small, and not adequately controlled. Studies show improved standards of outcome measurement and of description of the content of voice therapy. There is a continued need for larger, methodologically sound clinical effectiveness studies. Future studies need to be replicable and generalizable in order to inform and elucidate clinical practice.

NASA guidelines for assuring the adequacy and appropriateness of security safeguards in sensitive applications

NASA Technical Reports Server (NTRS)

Tompkins, F. G.

1984-01-01

The Office of Management and Budget (OMB) Circular A-71, transmittal Memorandum No. 1, requires that each agency establish a management control process to assure that appropriate administrative, physical and technical safeguards are incorporated into all new computer applications. In addition to security specifications, the management control process should assure that the safeguards are adequate for the application. The security activities that should be integral to the system development process are examined. The software quality assurance process to assure that adequate and appropriate controls are incorporated into sensitive applications is also examined. Security for software packages is also discussed.

The role of research in the failure of the alcopops excise in Australia: what have we learned?

PubMed

Shakeshaft, Anthony; Doran, Christopher M; Byrnes, Joshua

2009-08-17

We believe that a lack of adequate alcohol measures research is partly responsible for the failure of the Australian Government to pass legislation to equalise the excise applied to straight spirits and premixed spirits ("alcopops"). Current measures only assess total alcohol consumption rather than patterns of consumption, and do not adequately identify alcohol-related harm at a population level. Possible solutions include making further efforts to develop applied community-level measures and responding to the repeated calls for national collection and analysis of alcohol sales data. With the Australian Government able to retain the alcopops excise raised to date, there is a unique opportunity for greater collaboration between researchers and government to ensure high-quality and publicly relevant research is funded and conducted to address the current lack of adequate measures research. Measures research is a priority, as this is the basis for increasing the accuracy of data with which more cost-effective public policy and initiatives can be formulated and evaluated. The challenge is for researchers and the Australian Government to align their expertise to ensure revenue from public taxes engenders measurable public health benefit.

All-Optical Wavelength-Path Service With Quality Assurance by Multilayer Integration System

NASA Astrophysics Data System (ADS)

Yagi, Mikio; Tanaka, Shinya; Satomi, Shuichi; Ryu, Shiro; Asano, Shoichiro

2006-09-01

In the future all-optical network controlled by generalized multiprotocol label switching (GMPLS), the wavelength path between end nodes will change dynamically. This inevitably means that the fiber parameters along the wavelength path will also vary. This variation in fiber parameters influences the signal quality of high-speed-transmission system (bit rates over 40 Gb/s). Therefore, at a path setup, the fiber-parameter effect should be adequately compensated. Moreover, the path setup must be completed fast enough to meet the network-application demands. To realize the rapid setup of adequate paths, a multilayer integration system for all-optical wavelength-path quality assurance is proposed. This multilayer integration system is evaluated in a field trial. In the trial, the GMPLS control plane, measurement plane, and data plane coordinated to maintain the quality of a 40-Gb/s wavelength path that would otherwise be degraded by the influence of chromatic dispersion. It is also demonstrated that the multilayer integration system can assure the signal quality in the face of not only chromatic dispersion but also degradation in the optical signal-to-noise ratio by the use of a 2R regeneration system. Our experiments confirm that the proposed multilayer integration system is an essential part of future all-optical networks.

A randomized trial of a brief multimedia intervention to improve comprehension of food labels.

PubMed

Jay, Melanie; Adams, Jennifer; Herring, Sharon J; Gillespie, Colleen; Ark, Tavinder; Feldman, Henry; Jones, Vicky; Zabar, Sondra; Stevens, David; Kalet, Adina

2009-01-01

Food label use is associated with better food choices, an essential part of the management of many chronic diseases. Previous studies suggest lack of comprehension of food labels. We studied a multimedia intervention to improve food label comprehension in a sample of low income patients in New York City. This randomized study took place at Gouverneur Healthcare Services from 2005 until 2007. The intervention group (n=29) received a Nutrition Facts Label pocket card and viewed a video explaining card use. The control group (n=27) received written materials. Participants completed a 12-item pre- and post-intervention nutrition food label quiz. Quiz scores were analyzed using repeated measures analysis of variance. The intervention group had greater improvement on the quiz than the control group (p<0.001). There was a three way interaction by time with health literacy and treatment group where the greatest improvement occurred in patients with adequate health literacy in the intervention group (p<0.05). There was no improvement in patients with limited health literacy. A multimedia intervention is an effective way to improve short-term food label comprehension in patients with adequate health literacy. Further research is necessary to improve understanding of food labels in patients with limited health literacy.

Is height the best predictor for adequacy of semitendinosus-alone anterior cruciate ligament reconstruction? A study of hamstring graft dimensions and anthropometric measurements.

PubMed

Sundararajan, S R; Rajagopalakrishnan, Ramakanth; Rajasekaran, S

2016-05-01

To predict adequacy of semitendinosus (ST) graft dimension for ACLR from anthropometric measures. Single tendon harvest for autograft hamstring ACLR could be beneficial to limit donor site morbidity; however, concerns for reconstruction failure based upon inadequate graft size may limit this surgical technique. To predict adequacy, prospectively, 108 patients who underwent ACLR by hamstring graft (STG graft) were enrolled for the study. Mean age was 33.028 years ± 9.539 SD (14-59) with 88 males and 20 females. Anthropometric measurements (height, weight, BMI, thigh and total limb length) and intraoperative data (graft dimensions and bone tunnel measurements) were collected for analysis. Semitendinosus graft can be used as 3-strand (ST3) or 4-strand (ST4) graft. Adequacy criteria for ST3 and ST4 graft dimensions were determined from data analysis. SPSS (v.17) Pearson's correlation coefficient and ROC curves were used for statistical analyses. A total of 74 out of 108 patients (68.52 %) had adequate graft dimensions for ST3 reconstruction. Height equal or greater than 158 cm was predictive of adequate graft for ST3 reconstruction. Only 23 patients (21.3 %) had adequate graft dimensions for ST4 reconstruction. Height equal or greater than 170 cm was predictive of adequate graft for ST4 reconstruction. Height variable had the highest ROC curve area of 0.840 and 0.910 for both ST3 graft and ST4 graft, respectively. Hence, height was used as best predictor to determine adequacy of the graft. Height can be predictive of adequate graft for single tendon ACL reconstruction.

21 CFR 113.40 - Equipment and procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ensure a supply of clean, dry air. (3) Pressure gages. Each retort should be equipped with a pressure... should have adequate filter systems to ensure a supply of clean, dry air. (3) Pressure gages. (i) Each... controllers should have adequate filter systems to ensure a supply of clean, dry air. (3) Pressure gages. Each...

State University of New York Maritime College: Selected Financial Management Practices.

ERIC Educational Resources Information Center

New York State Office of the Comptroller, Albany. Div. of Management Audit.

This report presents audit findings of the financial management practices at the State University of New York (SUNY) Maritime College, which trains students to become licensed officers in the U.S. Merchant Marines. Specifically, the audit examined whether SUNY Maritime maintains an adequate internal control environment and adequate internal…

Children's Needs -- for Universal Food Service and Nutrition.

ERIC Educational Resources Information Center

Briggs, George M.

Good nutrition and adequate nutritious food are not only essential to good health but also represent the difference between life and death. Nutrition is the world's number one problem today, along with war and population control. Good nutrition means providing, with care and love, all 45 essential nutrients in adequate amounts to each child -- one…

Iodine status in pregnancy and household salt iodine content in rural Bangladesh.

PubMed

Shamim, Abu Ahmed; Christian, Parul; Schulze, Kerry J; Ali, Hasmot; Kabir, Alamgir; Rashid, Mahbubur; Labrique, Alain; Salamatullah, Qauzi; West, Keith P

2012-04-01

Adequate maternal iodine intake is essential during pregnancy for the development of the foetus. To assess the extent of iodine insufficiency and its association with household iodized salt in rural Bangladesh, we measured urinary iodine and household salt iodine content among pregnant women in early (≤16 weeks, n = 1376) and late (≥32 weeks, n = 1114) pregnancy. Salt (∼20 g) and a spot urine sample (∼10 mL) were collected from women participating in a randomized, placebo-controlled trial of vitamin A or beta-carotene supplementation in rural northwestern Bangladesh during home visits in early and late pregnancy. Salt iodine was analyzed by iodometric titration, and urinary iodine by the Ohashi method. Almost all salt samples had some detectable iodine, but over 75% contained <15 ppm. Median (interquartile range) urinary iodine concentrations were 66 (34-133) and 55 (28-110) µg L⁻¹ in early and late pregnancy, respectively; urinary iodine <150 µg L⁻¹ was found in ∼80% of women at both times in pregnancy. Although the risk of iodine insufficiency declined with increasing iodine content of household salt (P for trend <0.05), median urinary iodine did not reach 150 µg L⁻¹ until iodine in household salt was at least 32 ppm and 51 ppm during early and late pregnancy, respectively. Despite a national policy on universal salt iodization, salt iodine content remains insufficient to maintain adequate maternal iodine status throughout pregnancy in rural northern Bangladesh. Alternative measures like direct iodine supplementation during pregnancy could be considered to assure adequate iodine status during this high-risk period of life. © 2010 Blackwell Publishing Ltd.

Extrinsic and intrinsic motivation at 30: Unresolved scientific issues.

PubMed

Reiss, Steven

2005-01-01

The undermining effect of extrinsic reward on intrinsic motivation remains unproven. The key unresolved issues are construct invalidity (all four definitions are unproved and two are illogical); measurement unreliability (the free-choice measure requires unreliable, subjective judgments to infer intrinsic motivation); inadequate experimental controls (negative affect and novelty, not cognitive evaluation, may explain "undermining" effects); and biased metareviews (studies with possible floor effects excluded, but those with possible ceiling effects included). Perhaps the greatest error with the undermining theory, however, is that it does not adequately recognize the multifaceted nature of intrinsic motivation (Reiss, 2004a). Advice to limit the use of applied behavior analysis based on "hidden" undermining effects is ideologically inspired and is unsupported by credible scientific evidence.

Stability of cognition across wakefulness and dreams in psychotic major depression.

PubMed

Cavallotti, Simone; Castelnovo, Anna; Ranieri, Rebecca; D'agostino, Armando

2014-04-30

Cognitive bizarreness has been shown to be equally elevated in the dream and waking mentation of acutely symptomatic inpatients diagnosed with affective and non-affective psychoses. Although some studies have reported on dream content in non-psychotic depression, no study has previously measured this formal aspect of cognition in patients hospitalized for Psychotic Major Depression (PMD). Sixty-five dreams and 154 waking fantasy reports were collected from 11 PMD inpatients and 11 age- and sex-matched healthy controls. All narrative reports were scored by judges blind to diagnosis in terms of formal aspects of cognition (Bizarreness). Dream content was also scored (Hall/Van de Castle scoring system). Unlike controls, PMD patients had similar levels of cognitive bizarreness in their dream and waking mentation. Dreams of PMD patients also differed from those of controls in terms of content variables. In particular, Happiness, Apprehension and Dynamism were found to differ between the two groups. Whereas dream content reflects a sharp discontinuity with the depressive state, cognitive bizarreness adequately measures the stability of cognition across dreams and wakefulness in PMD inpatients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effects of hippotherapy in multiple sclerosis: pilot study on quality of life, spasticity, gait, pelvic floor, depression and fatigue.

PubMed

Muñoz-Lasa, Susana; López de Silanes, Carlos; Atín-Arratibel, M Ángeles; Bravo-Llatas, Carmen; Pastor-Jimeno, Salvador; Máximo-Bocanegra, Nuria

2018-04-19

Hippotherapy is being used as a promising method in the physical treatment of multiple sclerosis (MS). Comparative open clinical pre-post study into hippotherapy intervention during a 6-month period in patients with MS (n=6). Not randomised and with control group (n=4). The study was performed by MHG Foundation. A statistically significant improvement was observed in the therapy group in: spasticity pre-post measured by the modified Ashworth scale (P=.01). Statistically significant improvement in fatigue impact (P<.0001) measured with FIS; in general, perception of heath outcome in urinary quality of life scale KHQ (P=.033), and in subscales 2, 3 and 4 of MSQOL-54 (P=.011). Control group showed no improvement in any scale. This study reinforces current literature that supports hippotherapy as an adequate intervention for MS patients. Further studies with more participants, control groups and blinded research would be logical steps for future research in this field. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Wiener-Hopf optimal control of a hydraulic canal prototype with fractional order dynamics.

PubMed

Feliu-Batlle, Vicente; Feliu-Talegón, Daniel; San-Millan, Andres; Rivas-Pérez, Raúl

2017-06-26

This article addresses the control of a laboratory hydraulic canal prototype that has fractional order dynamics and a time delay. Controlling this prototype is relevant since its dynamics closely resembles the dynamics of real main irrigation canals. Moreover, the dynamics of hydraulic canals vary largely when the operation regime changes since they are strongly nonlinear systems. All this makes difficult to design adequate controllers. The controller proposed in this article looks for a good time response to step commands. The design criterium for this controller is minimizing the integral performance index ISE. Then a new methodology to control fractional order processes with a time delay, based on the Wiener-Hopf control and the Padé approximation of the time delay, is developed. Moreover, in order to improve the robustness of the control system, a gain scheduling fractional order controller is proposed. Experiments show the adequate performance of the proposed controller. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Empirical evaluation of the Process Overview Measure for assessing situation awareness in process plants.

PubMed

Lau, Nathan; Jamieson, Greg A; Skraaning, Gyrd

2016-03-01

The Process Overview Measure is a query-based measure developed to assess operator situation awareness (SA) from monitoring process plants. A companion paper describes how the measure has been developed according to process plant properties and operator cognitive work. The Process Overview Measure demonstrated practicality, sensitivity, validity and reliability in two full-scope simulator experiments investigating dramatically different operational concepts. Practicality was assessed based on qualitative feedback of participants and researchers. The Process Overview Measure demonstrated sensitivity and validity by revealing significant effects of experimental manipulations that corroborated with other empirical results. The measure also demonstrated adequate inter-rater reliability and practicality for measuring SA in full-scope simulator settings based on data collected on process experts. Thus, full-scope simulator studies can employ the Process Overview Measure to reveal the impact of new control room technology and operational concepts on monitoring process plants. Practitioner Summary: The Process Overview Measure is a query-based measure that demonstrated practicality, sensitivity, validity and reliability for assessing operator situation awareness (SA) from monitoring process plants in representative settings.

Coercive versus cooperative pollution control: Comparative study of state programs to reduce erosion and sedimentation pollution in urban areas

NASA Astrophysics Data System (ADS)

Burby, Raymond J.

1995-05-01

This article examines coercive and cooperative approaches to implementing state urban erosion and sedimentation pollution control programs. State administrators report serious shortfalls in their ability to control sources of pollution, but comparison of more and less successful programs provides evidence of what states can do to make programs more effective. Key ingredients for a successful state effort include the use of coercion with both the private sector and local government, adequate staffing, application of severe sanctions when violations of state standards are detected, and provision of technical assistance. Many state programs lack one or more of those elements, which explains their inability to adequately control urban erosion and sedimentation pollution.

Management of beta-thalassemia-associated osteoporosis.

PubMed

Giusti, Andrea; Pinto, Valeria; Forni, Gian Luca; Pilotto, Alberto

2016-03-01

Beta-Thalassemia-associated osteoporosis is a multifactorial and complex condition. Different acquired and genetic factors are involved in its pathogenesis. These factors produce an imbalance in bone remodeling by inhibiting osteoblast activity and increasing osteoclast function, leading to bone loss and increased fracture risk. The management of patients presenting with thalassemia-associated osteoporosis should consist of the implementation of general measures and the prescription of a specific pharmacological agent, with the aim of reducing fracture risk and preventing disability and deterioration of quality of life. General measures include control of anemia, adequate chelation therapy, healthy nutrition and lifestyle, regular exercise, adequate management of comorbid conditions, hormone replacement therapy in patients with hypogonadism, and vitamin D supplementation/therapy. Among the pharmacological agents currently available for the management of osteoporosis in postmenopausal women and men, bisphosphonates have been shown to improve bone mineral density, to reduce bone turnover, and to decrease bone/back pain in patients with thalassemia-associated osteoporosis, with a good profile of safety and tolerability. On the other hand, there are limited experiences with other pharmacological agents (e.g., denosumab or teriparatide). The complexity of this condition presents diagnostic and therapeutic challenges and underscores the importance of a comprehensive and multidisciplinary approach. © 2016 New York Academy of Sciences.

On the Extraction of Angular Velocity from Attitude Measurements

NASA Technical Reports Server (NTRS)

Bar-Itzhack, I. Y.; Harman, Richard R.; Thienel, Julie K.

2006-01-01

In this paper we research the extraction of the angular rate vector from attitude information without differentiation, in particular from quaternion measurements. We show that instead of using a Kalman filter of some kind, it is possible to obtain good rate estimates, suitable for spacecraft attitude control loop damping, using simple feedback loops, thereby eliminating the need for recurrent covariance computation performed when a Kalman filter is used. This considerably simplifies the computations required for rate estimation in gyro-less spacecraft. Some interesting qualities of the Kalman filter gain are explored, proven and utilized. We examine two kinds of feedback loops, one with varying gain that is proportional to the well known Q matrix, which is computed using the measured quaternion, and the other type of feedback loop is one with constant coefficients. The latter type includes two kinds; namely, a proportional feedback loop, and a proportional-integral feedback loop. The various schemes are examined through simulations and their performance is compared. It is shown that all schemes are adequate for extracting the angular velocity at an accuracy suitable for control loop damping.

Dimensionality of coping and its relation to depression.

PubMed

Rohde, P; Lewinsohn, P M; Tilson, M; Seeley, J R

1990-03-01

The dimensionality of coping, as measured by 65 items from 3 commonly used instruments, and the relation of coping and stress to concurrent and future depression were studied in a community sample of 742 older (greater than or equal to 50 years old) adults. Measures of coping, stress, and depression were obtained at 2 time points over a 2-year period. Depression was assessed by symptom checklist and by diagnostic interview. Three coping factors--Cognitive Self-Control, Ineffective Escapism, and Solace Seeking--that had adequate psychometric properties and accounted for 25% of the total item variance were identified. Ineffective Escapism was associated with current depression and had a direct and interactive effect on future depression, exacerbating the negative impact of stress rather than acting as a buffer. Although Cognitive Self-Control was unrelated to either concurrent or future depression, Solace Seeking significantly buffered the effect of stress in predicting a future diagnosis of depression. Stress and initial depression level predicted both measures of future depression. Gender (being female) predicted the future diagnosis of depression but not the increase of depressive symptoms.

The development of the Dutch version of the Fremantle Back Awareness Questionnaire.

PubMed

Janssens, Lotte; Goossens, Nina; Wand, Benedict M; Pijnenburg, Madelon; Thys, Tinne; Brumagne, Simon

2017-12-01

Disturbed body perception may play a role in the aetiology of chronic low back pain (LBP). The Fremantle Back Awareness Questionnaire (FreBAQ) is currently the only self-report questionnaire to assess back-specific body perception in individuals with LBP. To perform a cross-cultural adaptation of the FreBAQ into Dutch. Psychometric study. A Dutch version of the FreBAQ was generated through forward-backward translation, and was completed by 73 patients with LBP and 73 controls to assess discriminant validity. Structural validity was assessed by principal component analysis. Internal consistency was assessed by the Cronbach's alpha coefficient. Construct validity was assessed by examining the relationship with clinical measures (Numerical Rating Scale pain, Oswestry Disability Index (ODI), Tampa Scale for Kinesiophobia). Test-retest reliability was assessed in a subgroup (n = 48 with LBP and 48 controls) using intraclass correlation coefficients (ICC), standard error of measurement (SEM) and minimal detectable change (MDC 95%) RESULTS: The Dutch FreBAQ showed one component with eigenvalue >2. Cronbach's alpha values were respectively 0.82 and 0.73 for the LBP and control group. ICC values were respectively 0.69 and 0.70 for the LBP and control group. In the LBP group, the SEM was 3.9 and the MDC (95%) was 10.8. The LBP group (ODI 22 ± 21%) scored significantly higher on the Dutch FreBAQ than the control group (ODI 0%) (11 ± 7 vs. 3 ± 9, p < 0.001). Within the LBP group, higher Dutch FreBAQ scores correlated significantly with higher ODI scores (rho = 0.30, p = 0.010), although not with pain (rho = 0.10, p = 0.419) or kinesiophobia (r = 0.14, p = 0.226). The Dutch version of the FreBAQ can be considered as unidimensional and showed adequate internal consistency, sufficient test-retest reliability and adequate discriminant and construct validity in individuals with and without LBP. It can improve our understanding on back-specific perception in the Dutch-speaking population with LBP. Copyright © 2017 Elsevier Ltd. All rights reserved.

Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes.

PubMed

Zech, Astrid; Klahn, Philipp; Hoeft, Jon; zu Eulenburg, Christine; Steib, Simon

2014-02-01

Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular training effects on functional, dynamic and static balance measures. Thirty youth (14.9 ± 3 years) field hockey athletes were randomised to an intervention or control group. The intervention included a 20-min neuromuscular warm-up program performed twice weekly for 10 weeks. Balance assessments were performed at baseline, week three, week six and post-intervention. They included the star excursion balance test (SEBT), balance error scoring system (BESS), jump-landing time to stabilization (TTS) and center of pressure (COP) sway velocity during single-leg standing. No baseline differences were found between groups in demographic data and balance measures. Adherence was at 86%. All balance measures except the medial-lateral TTS improved significantly over time (p < 0.05) in both groups. Significant group by time interactions were found for the BESS score (p < 0.001). The intervention group showed greater improvements (69.3 ± 10.3%) after 10 weeks in comparison to controls (31.8 ± 22.1%). There were no significant group by time interactions in the SEBT, TTS and COP sway velocity. Neuromuscular training was effective in improving postural control in youth team athletes. However, this effect was not reflected in all balance measures suggesting that the neuromuscular training did not influence all dimensions of postural control. Further studies are needed to confirm the potential of specific warm-up programs to improve postural control.

[Hypertension in Mexican adults: prevalence, diagnosis and type of treatment. Ensanut MC 2016.

PubMed

Campos-Nonato, Ismael; Hernández-Barrera, Lucía; Pedroza-Tobías, Andrea; Medina, Catalina; Barquera, Simón

2018-01-01

To describe the prevalence, awareness and proportion of adults with an adequate control of hypertension. Blood pressure was measured at 8 352 adults who participated in the Ensanut MC 2016. The adults who reported having diagnosis of hypertension or had systolic blood pressure values (TAS) ≥140mmHg or diastolic blood pressure (TAD) ≥90mmHg were classified as hypertensive. Hypertension was considered controlled when blood pressure was TAS <140mmHg and TAD <90mmHg. The prevalence of hypertension was 25.5%. Of these, 40.0% were unaware of having high blood pressure. Of the hypertensive adults who had previous diagnosis of hypertension and receiving drug treatment (79.3%), 45.6% had blood pressure under control. A high percentage of adults are unaware of having hypertension and nearly half have inadequate control. The relevance of current programmes for diagnosing hypertension should be assessed, as well as the effectiveness of their control strategies.

Implementation and Operational Analysis of an Interactive Intensive Care Unit within a Smart Health Context

PubMed Central

Aguirre, Erik

2018-01-01

In the context of hospital management and operation, Intensive Care Units (ICU) are one of the most challenging in terms of time responsiveness and criticality, in which adequate resource management and signal processing play a key role in overall system performance. In this work, a context aware Intensive Care Unit is implemented and analyzed to provide scalable signal acquisition capabilities, as well as to provide tracking and access control. Wireless channel analysis is performed by means of hybrid optimized 3D Ray Launching deterministic simulation to assess potential interference impact as well as to provide required coverage/capacity thresholds for employed transceivers. Wireless system operation within the ICU scenario, considering conventional transceiver operation, is feasible in terms of quality of service for the complete scenario. Extensive measurements of overall interference levels have also been carried out, enabling subsequent adequate coverage/capacity estimations, for a set of Zigbee based nodes. Real system operation has been tested, with ad-hoc designed Zigbee wireless motes, employing lightweight communication protocols to minimize energy and bandwidth usage. An ICU information gathering application and software architecture for Visitor Access Control has been implemented, providing monitoring of the Boxes external doors and the identification of visitors via a RFID system. The results enable a solution to provide ICU access control and tracking capabilities previously not exploited, providing a step forward in the implementation of a Smart Health framework. PMID:29382148

Efficacy, tolerability, and safety of hypnosis in adult irritable bowel syndrome: systematic review and meta-analysis.

PubMed

Schaefert, Rainer; Klose, Petra; Moser, Gabriele; Häuser, Winfried

2014-06-01

To assess the efficacy, tolerability, and safety of hypnosis in adult irritable bowel syndrome by a meta-analysis of randomized controlled trials. Studies were identified by a literature search of the databases Allied and Complementary Medicine Database, Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PubMed, PsycINFO, and Scopus (from inception to June 30, 2013). Primary outcomes were adequate symptom relief, global gastrointestinal score, and safety. Summary relative risks (RRs) with number needed to treat (NNT) and standardized mean differences (SMDs) with 95% confidence intervals (95% CIs) were calculated using random-effects models. Eight randomized controlled trials with a total of 464 patients and a median of 8.5 (7-12) hypnosis sessions over a median of 12 (5-12) weeks were included into the analysis. At the end of therapy, hypnosis was superior to control conditions in producing adequate symptom relief (RR, 1.69 [95% CI = 1.14-2.51]; NNT, 5 [3-10]) and in reducing global gastrointestinal score (SMD, 0.32 [95% CI = -0.56 to -0.08]). At long-term follow-up, hypnosis was superior to controls in adequate symptom relief (RR, 2.17 [95% CI = 1.22-3.87]; NNT, 3 [2-10]), but not in reducing global gastrointestinal score (SMD, -0.57 [-1.40 to 0.26]). One (0.4%) of 238 patients in the hypnosis group dropped out due to an adverse event (panic attack). This meta-analysis demonstrated that hypnosis was safe and provided long-term adequate symptom relief in 54% of patients with irritable bowel syndrome refractory to conventional therapy.

76 FR 31456 - Special Conditions: Gulfstream Model GVI Airplane; Electronic Flight Control System: Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

... Control System: Control Surface Position Awareness AGENCY: Federal Aviation Administration (FAA), DOT... electronic flight control system. The applicable airworthiness regulations do not contain adequate or... regulatory adequacy pursuant to section 611 of Public Law 92-574, the ``Noise Control Act of 1972.'' The FAA...

Extending the Concept and Assessment of Teacher Efficacy.

ERIC Educational Resources Information Center

Rich, Yisrael; And Others

1996-01-01

Two teacher efficacy subscales developed by S. Gibson and M. Dembo (1984) translated into Hebrew and administered to Israeli teachers retained their factor structures and adequate reliability. A subscale developed for the study to measure teacher efficacy in enhancing student social relations specifically also had adequate reliability. (SLD)

Hemostatic Agents in Periapical Surgery: A Randomized Study of Gauze Impregnated in Epinephrine versus Aluminum Chloride.

PubMed

Menéndez-Nieto, Isabel; Cervera-Ballester, Juan; Maestre-Ferrín, Laura; Blaya-Tárraga, Juan Antonio; Peñarrocha-Oltra, David; Peñarrocha-Diago, Miguel

2016-11-01

Adequate bleeding control is essential for the success of periapical surgery. The aim of this study was to evaluate the effects of 2 hemostatic agents on the outcome of periapical surgery and their relationship with patient and teeth parameters. A prospective study was designed with 2 randomized parallel groups, depending on the hemostatic agent used: gauze impregnated in epinephrine (epinephrine group) and aluminum chloride (aluminum chloride group). The analysis of the hemorrhage control was judged before and after the application of the hemostatic agents by the surgeon, and 2 examiners independently recorded it as adequate (complete hemorrhage control) or inadequate (incomplete hemorrhage control). Ninety-nine patients with a periradicular lesion were enrolled in this study and divided into 2 groups: gauze impregnated in epinephrine in 48 patients (epinephrine group) or aluminum chloride in 51 (aluminum chloride group). In epinephrine group adequate hemostasis was achieved in 25 cases, and in aluminum chloride group it was achieved in 37 cases (P < .05). The outcome was better in the aluminum chloride group than in the gauze impregnated in epinephrine group. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The ANTOP study: focal psychodynamic psychotherapy, cognitive-behavioural therapy, and treatment-as-usual in outpatients with anorexia nervosa - a randomized controlled trial

PubMed Central

Wild, Beate; Friederich, Hans-Christoph; Gross, Gaby; Teufel, Martin; Herzog, Wolfgang; Giel, Katrin E; de Zwaan, Martina; Schauenburg, Henning; Schade-Brittinger, Carmen; Schäfer, Helmut; Zipfel, Stephan

2009-01-01

Background Anorexia nervosa is a serious eating disorder leading to high morbidity and mortality as a result of both malnutrition and suicide. The seriousness of the disorder requires extensive knowledge of effective treatment options. However, evidence for treatment efficacy in this area is remarkably weak. A recent Cochrane review states that there is an urgent need for large, well-designed treatment studies for patients with anorexia nervosa. The aim of this particular multi-centre study is to evaluate the efficacy of two standardized outpatient treatments for patients with anorexia nervosa: focal psychodynamic (FPT) and cognitive behavioural therapy (CBT). Each therapeutic approach is compared to a "treatment-as-usual" control group. Methods/Design 237 patients meeting eligibility criteria are randomly and evenly assigned to the three groups – two intervention groups (CBT and FPT) and one control group. The treatment period for each intervention group is 10 months, consisting of 40 sessions respectively. Body weight, eating disorder related symptoms, and variables of therapeutic alliance are measured during the course of treatment. Psychotherapy sessions are audiotaped for adherence monitoring. The treatment in the control group, both the dosage and type of therapy, is not regulated in the study protocol, but rather reflects the current practice of established outpatient care. The primary outcome measure is the body mass index (BMI) at the end of the treatment (10 months after randomization). Discussion The study design surmounts the disadvantages of previous studies in that it provides a randomized controlled design, a large sample size, adequate inclusion criteria, an adequate treatment protocol, and a clear separation of the treatment conditions in order to avoid contamination. Nevertheless, the study has to deal with difficulties specific to the psychopathology of anorexia nervosa. The treatment protocol allows for dealing with the typically occurring medical complications without dropping patients from the protocol. However, because patients are difficult to recruit and often ambivalent about treatment, a drop-out rate of 30% is assumed for sample size calculation. Due to the ethical problem of denying active treatment to patients with anorexia nervosa, the control group is defined as "treatment-as-usual". Trial registration Current Controlled Trials ISRCTN72809357 PMID:19389245

Addressing Challenges in Studies of Behavioral Responses of Whales to Noise.

PubMed

Cato, Douglas H; Dunlop, Rebecca A; Noad, Michael J; McCauley, Robert D; Kniest, Eric; Paton, David; Kavanagh, Ailbhe S

2016-01-01

Studying the behavioral response of whales to noise presents numerous challenges. In addition to the characteristics of the noise exposure, many factors may affect the response and these must be measured and accounted for in the analysis. An adequate sample size that includes matching controls is crucial if meaningful results are to be obtained. Field work is thus complicated, logistically difficult, and expensive. This paper discusses some of the challenges and how they are being met in a large-scale multiplatform project in which humpback whales are exposed to the noise of seismic air guns.

Prevention and treatment strategies used for the community management of childhood fever in Kampala, Uganda.

PubMed

Kemble, Sarah K; Davis, Jennifer C; Nalugwa, Talemwa; Njama-Meya, Denise; Hopkins, Heidi; Dorsey, Grant; Staedke, Sarah G

2006-06-01

To assess malaria-related prevention and treatment strategies in an urban parish of Kampala, Uganda, a questionnaire was administered to 339 randomly selected primary caregivers of children 1-10 years of age. Our study population was relatively stable and well educated, with better access to health services than many in Africa. Ownership of an insecticide-treated net (ITN) was reported by 11% of households and was predicted only by greater household wealth (highest quartile versus lowest quartile: odds ratio [OR] 21.8; 95% confidence interval [CI], 2.74-173). Among women, 5% reported use of an ITN and 11% used intermittent preventive therapy (IPT) during their last pregnancy. Use of appropriate IPT during pregnancy was predicted only by completion of secondary education or higher (OR, 2.87; 95% CI, 1.13-7.21). Children of 123 (36%) caregivers had experienced an episode of fever in the past 2 weeks. Of these, 22% received an anti-malarial that could be considered "adequate" (combination therapy or quinine). Only 1% of febrile children received adequate treatment at the correct dose within 24 hours of onset of fever. The only independent predictor of treatment with an adequate anti-malarial was accessing a clinic or hospital as the first source of care. In this urban area, use of appropriate malaria control measures occurs uncommonly.

Family Cohesion and Moderate-to-Vigorous Physical Activity Among Mexican Origin Adolescents: A Longitudinal Perspective.

PubMed

Bigman, Galya; Rajesh, Vandita; Koehly, Laura M; Strong, Larkin L; Oluyomi, Abiodun O; Strom, Sara S; Wilkinson, Anna V

2015-07-01

Existing racial/ethnic disparities in physical activity during childhood increase Hispanics' risk of developing chronic diseases, which serves to increase health disparities. This study examined associations of family cohesion and conflict with self-reported moderate-to-vigorous physical activity (MVPA), controlling for psychosocial covariates such as subjective social status, anxiety, and sensation-seeking. 1000 Mexican origin adolescents reported their MVPA levels approximately 2 years apart. Psychosocial covariates, family cohesion and conflict were measured at the first assessment. Generalized Linear Models were used to prospectively examine the relationship between family cohesion and conflict and subsequent MVPA based on 711 participants who had low levels of baseline MVPA. 35% of boys and 24% of girls reported adequate MVPA levels at follow-up; girls were less likely to report adequate MVPA (RR = 0.76; 95% CI: 0.61-0.93) than boys. Overall, family cohesion was associated with MVPA (P = .01), but family cohesion was not (P = .41). Gender-based analyses revealed that adequate MVPA was associated with family cohesion (RR = 1.40; 95% CI: 1.03-1.88), sensation seeking (RR = 1.05; 95% CI: 1.00-1.10), and age (RR = 0.85; 95% CI: 0.74-0.98) among girls and with subjective social status (RR = 1.20; 95% CI: 1.08-1.33) among boys. The family social environment and gender differences should be addressed in health promotion programs targeting MVPA.

21 CFR 226.58 - Laboratory controls.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Laboratory controls. 226.58 Section 226.58 Food...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES Product Quality Control § 226.58 Laboratory controls. Laboratory controls shall include the establishment of adequate specifications and test...

21 CFR 226.58 - Laboratory controls.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Laboratory controls. 226.58 Section 226.58 Food...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES Product Quality Control § 226.58 Laboratory controls. Laboratory controls shall include the establishment of adequate specifications and test...

21 CFR 226.58 - Laboratory controls.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Laboratory controls. 226.58 Section 226.58 Food...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES Product Quality Control § 226.58 Laboratory controls. Laboratory controls shall include the establishment of adequate specifications and test...

Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa.

PubMed

Claassens, Mareli M; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J; Enarson, Donald A; Beyers, Nulda; Borgdorff, Martien W

2013-01-01

Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB.

Tuberculosis in Healthcare Workers and Infection Control Measures at Primary Healthcare Facilities in South Africa

PubMed Central

Claassens, Mareli M.; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J.; Enarson, Donald A.; Beyers, Nulda; Borgdorff, Martien W.

2013-01-01

Background Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. Methods One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. Results The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). Conclusion The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB. PMID:24098461

Light pollution from the ground, the air and the space

NASA Astrophysics Data System (ADS)

Sánchez de Miguel, A.; Zamorano, J.; Gómez Castaño, J.; Aubé, M.; Bará, S.; Gallego, J.; Kyba, C. C. M.; Lombraña, D.; Nievas, M.; Pascual, S.; Tapia, C.

2015-05-01

The sky brightness is one of the things that most harms astronomical observation, near cities and on mountain observatories. Currently there are several initiatives to control light pollution, but the sky brightness measurements are usually local. To exercise adequate control of light pollution is necessary measurements of light pollution sources and their relation to the spatiotemporal variation of the sky brightness. We use various approaches: data taken ashore with photometers SQM and relate emissions and detected with VIIRS and DMSP satellites. We also use multispectral data taken from the International Space Station to distinguish different types of lamps that contribute to light pollution. Finally we used a spectrograph SAND for temporal analysis of the evolution of the contribution of the lights in the sky brightness of a big city like Madrid. Also we have performed a citizen science program to classify the night time images taken from the ISS (Sánchez de Miguel et al. 2014, A&G, 55, 4, 36).

[Rabies contingency plan in Japan].

PubMed

Inoue, Satoshi

2005-12-01

In Japan, rabies has been culled out since 1957 thanks to the strong implementation of measures against rabies, such as vaccination of dogs, quarantine and control of wild dogs under the 'Rabies Prevention Law' enacted in 1950. Nevertheless one cannot deny the possibility of introduction of rabies into Japan in view of the recent increase in the international movements of people and animals. Should an outbreak of rabies be suspected now in Japan, the society would probably overreact due to a decreased awareness of risks and a lack of correct knowledge about this disease. Officials of the government and the municipalities, veterinarians and doctors should exchange correct information on rabies and on prevention control and raise their awareness, while providing also information to the public on a timely basis. Besides it is needless to say that it is important to set up a crisis management system allowing a quick and adequate response in case of an outbreak of rabies and to continue to implement appropriate prevention measures in normal times.

A direct CO2 control system for ocean acidification experiments: testing effects on the coralline red algae Phymatolithon lusitanicum.

PubMed

Sordo, Laura; Santos, Rui; Reis, Joao; Shulika, Alona; Silva, Joao

2016-01-01

Most ocean acidification (OA) experimental systems rely on pH as an indirect way to control CO 2 . However, accurate pH measurements are difficult to obtain and shifts in temperature and/or salinity alter the relationship between pH and p CO 2 . Here we describe a system in which the target p CO 2 is controlled via direct analysis of p CO 2 in seawater. This direct type of control accommodates potential temperature and salinity shifts, as the target variable is directly measured instead of being estimated. Water in a header tank is permanently re-circulated through an air-water equilibrator. The equilibrated air is then routed to an infrared gas analyzer (IRGA) that measures p CO 2 and conveys this value to a Proportional-Integral-Derivative (PID) controller. The controller commands a solenoid valve that opens and closes the CO 2 flush that is bubbled into the header tank. This low-cost control system allows the maintenance of stabilized levels of p CO 2 for extended periods of time ensuring accurate experimental conditions. This system was used to study the long term effect of OA on the coralline red algae Phymatolithon lusitanicum . We found that after 11 months of high CO 2 exposure, photosynthesis increased with CO 2 as opposed to respiration, which was positively affected by temperature. Results showed that this system is adequate to run long-term OA experiments and can be easily adapted to test other relevant variables simultaneously with CO 2 , such as temperature, irradiance and nutrients.

A direct CO2 control system for ocean acidification experiments: testing effects on the coralline red algae Phymatolithon lusitanicum

PubMed Central

Santos, Rui; Reis, Joao; Shulika, Alona

2016-01-01

Most ocean acidification (OA) experimental systems rely on pH as an indirect way to control CO2. However, accurate pH measurements are difficult to obtain and shifts in temperature and/or salinity alter the relationship between pH and pCO2. Here we describe a system in which the target pCO2 is controlled via direct analysis of pCO2 in seawater. This direct type of control accommodates potential temperature and salinity shifts, as the target variable is directly measured instead of being estimated. Water in a header tank is permanently re-circulated through an air-water equilibrator. The equilibrated air is then routed to an infrared gas analyzer (IRGA) that measures pCO2 and conveys this value to a Proportional-Integral-Derivative (PID) controller. The controller commands a solenoid valve that opens and closes the CO2 flush that is bubbled into the header tank. This low-cost control system allows the maintenance of stabilized levels of pCO2 for extended periods of time ensuring accurate experimental conditions. This system was used to study the long term effect of OA on the coralline red algae Phymatolithon lusitanicum. We found that after 11 months of high CO2 exposure, photosynthesis increased with CO2 as opposed to respiration, which was positively affected by temperature. Results showed that this system is adequate to run long-term OA experiments and can be easily adapted to test other relevant variables simultaneously with CO2, such as temperature, irradiance and nutrients. PMID:27703853

Integrity management of offshore structures and its implication on computation of structural action effects and resistance

NASA Astrophysics Data System (ADS)

Moan, T.

2017-12-01

An overview of integrity management of offshore structures, with emphasis on the oil and gas energy sector, is given. Based on relevant accident experiences and means to control the associated risks, accidents are categorized from a technical-physical as well as human and organizational point of view. Structural risk relates to extreme actions as well as structural degradation. Risk mitigation measures, including adequate design criteria, inspection, repair and maintenance as well as quality assurance and control of engineering processes, are briefly outlined. The current status of risk and reliability methodology to aid decisions in the integrity management is briefly reviewed. Finally, the need to balance the uncertainties in data, methods and computational efforts and the cautious use and quality assurance and control in applying high fidelity methods to avoid human errors, is emphasized, and with a plea to develop both high fidelity as well as efficient, simplified methods for design.

Addressing Antimicrobial Resistance: An Overview of Priority Actions to Prevent Suboptimal Antimicrobial Use in Food-Animal Production

PubMed Central

Lhermie, Guillaume; Gröhn, Yrjö T.; Raboisson, Didier

2017-01-01

The growing concern regarding emergence of bacteria resistant to antimicrobials and their potential for transmission to humans via animal production has led various authorities worldwide to implement measures to decrease antimicrobial use (AMU) in livestock production. These measures are influenced by those implemented in human medicine, and emphasize the importance of antimicrobial stewardship, surveillance, infection prevention and control and research. In food producing animals, unlike human medicine, antimicrobials are used to control diseases which cause economic losses. This major difference may explain the failure of the public policies implemented to control antimicrobial usage. Here we first review the specific factors influencing AMU across the farm animal sector and highlighting the farmers’ decision-making process of AMU. We then discuss the efficiency of existing regulations implemented by policy makers, and assess the need for alternative strategies, such as substitution between antimicrobials and other measures for infectious disease control. We also discuss the interests of regulating antimicrobial prices. Finally, we emphasize the value of optimizing antimicrobial regimens, and developing veterinary precision medicine to achieve clinical efficacy in animals while limiting negative impacts on public health. The fight against antimicrobial resistance requires both a reduction and an optimization of antimicrobial consumption. The set of actions currently implemented by policy makers does not adequately address the economic interests of farmers’ use of antimicrobials. PMID:28111568

Clinical use of serum parvovirus and distemper virus antibody titers for determining revaccination strategies in healthy dogs.

PubMed

Twark, L; Dodds, W J

2000-10-01

To assess whether serum canine parvovirus (CPV) and canine distemper virus (CDV) antibody titers can be used to determine revaccination protocols in healthy dogs. Case series. 1,441 dogs between 6 weeks and 17 years old. CPV and CDV antibody titers in serum samples submitted to a commercial diagnostic laboratory were measured by use of indirect fluorescent antibody (IFA) tests. On the basis of parallel measurements of CPV and CDV serum antibody titers in 61 paired serum samples determined by use of hemagglutination inhibition and serum neutralization methods, respectively, we considered titers > or = 1:5 (IFA test) indicative of an adequate antibody response. Age, breed, and sex were not significantly associated with adequate CPV- or CDV-specific antibody responses. Of 1,441 dogs, 1,370 (95.1%) had adequate and 71 (4.9%) had inadequate antibody responses to CPV, whereas 1,346 of 1,379 (97.6%) dogs had adequate and 33 (2.4%) had inadequate responses to CDV. Vaccination histories were available for 468 dogs (468 for CPV, 457 for CDV). Interval between last vaccination and antibody measurement was 1 to 2 years for the majority (281/468; 60.0%) of dogs and 2 to 7 years for 142 of 468 (30.3%) dogs. Interval was < 1 year in only 45 of 468 (9.6%) dogs. The high prevalence of adequate antibody responses (CPV, 95.1%; CDV, 97.6%) in this large population of dogs suggests that annual revaccination against CPV and CDV may not be necessary.

14 CFR 23.1143 - Engine controls.

Code of Federal Regulations, 2014 CFR

2014-01-01

... independent of those for every other engine or supercharger. (e) For each fluid injection (other than fuel... flow of the injection fluid is adequately controlled. (f) If a power, thrust, or a fuel control (other than a mixture control) incorporates a fuel shutoff feature, the control must have a means to prevent...

14 CFR 23.1143 - Engine controls.

Code of Federal Regulations, 2013 CFR

2013-01-01

... independent of those for every other engine or supercharger. (e) For each fluid injection (other than fuel... flow of the injection fluid is adequately controlled. (f) If a power, thrust, or a fuel control (other than a mixture control) incorporates a fuel shutoff feature, the control must have a means to prevent...

Case study of odor and indoor air quality assessment in the dewatering building at the Stickney Water Reclamation Plant.

PubMed

Sharma, Manju; O'Connell, Susan; Garelli, Brett; Sattayatewa, Chakkrid; Moschandreas, Demetrios; Pagilla, Krishna

2012-01-01

Indoor air quality (IAQ) and odors were determined using sampling/monitoring, measurement, and modeling methods in a large dewatering building at a very large water reclamation plant. The ultimate goal was to determine control strategies to reduce the sensory impacts on the workforce and achieve odor reduction within the building. Study approaches included: (1) investigation of air mixing by using CO(2) as an indicator, (2) measurement of airflow capacity of ventilation fans, (3) measurement of odors and odorants, (4) development of statistical and IAQ models, and (5) recommendation of control strategies. The results showed that air quality in the building complies with occupational safety and health guidelines; however, nuisance odors that can increase stress and productivity loss still persist. Excess roof fan capacity induced odor dispersion to the upper levels. Lack of a local air exhaust system of sufficient capacity and optimum design was found to be the contributor to occasional less than adequate indoor air quality and odors. Overall, air ventilation rate in the building has less effect on persistence of odors in the building. Odor/odorant emission rates from centrifuge drops were approximately 100 times higher than those from the open conveyors. Based on measurements and modeling, the key control strategies recommended include increasing local air exhaust system capacity and relocation of exhaust hoods closer to the centrifuge drops.

30 CFR 72.630 - Drill dust control at underground areas of underground mines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... condition. Dust collectors approved under Part 33—Dust Collectors for Use in Connection with Rock Drilling...) Ventilation control. To adequately control dust from drilling rock, the air current shall be so directed that...

30 CFR 72.630 - Drill dust control at underground areas of underground mines.

Code of Federal Regulations, 2011 CFR

2011-07-01

... condition. Dust collectors approved under Part 33—Dust Collectors for Use in Connection with Rock Drilling...) Ventilation control. To adequately control dust from drilling rock, the air current shall be so directed that...

Theory of planned behaviour variables and objective walking behaviour do not show seasonal variation in a randomised controlled trial.

PubMed

Williams, Stefanie L; French, David P

2014-02-05

Longitudinal studies have shown that objectively measured walking behaviour is subject to seasonal variation, with people walking more in summer compared to winter. Seasonality therefore may have the potential to bias the results of randomised controlled trials if there are not adequate statistical or design controls. Despite this there are no studies that assess the impact of seasonality on walking behaviour in a randomised controlled trial, to quantify the extent of such bias. Further there have been no studies assessing how season impacts on the psychological predictors of walking behaviour to date. The aim of the present study was to assess seasonal differences in a) objective walking behaviour and b) Theory of Planned Behaviour (TPB) variables during a randomised controlled trial of an intervention to promote walking. 315 patients were recruited to a two-arm cluster randomised controlled trial of an intervention to promote walking in primary care. A series of repeated measures ANCOVAs were conducted to examine the effect of season on pedometer measures of walking behaviour and TPB measures, assessed immediately post-intervention and six months later. Hierarchical regression analyses were conducted to assess whether season moderated the prediction of intention and behaviour by TPB measures. There were no significant differences in time spent walking in spring/summer compared to autumn/winter. There was no significant seasonal variation in most TPB variables, although the belief that there will be good weather was significantly higher in spring/summer (F = 19.46, p < .001). Season did not significantly predict intention or objective walking behaviour, or moderate the effects of TPB variables on intention or behaviour. Seasonality does not influence objectively measured walking behaviour or psychological variables during a randomised controlled trial. Consequently physical activity behaviour outcomes in trials will not be biased by the season in which they are measured. Previous studies may have overestimated the extent of seasonality effects by selecting the most extreme summer and winter months to assess PA. In addition, participants recruited to behaviour change interventions might have higher levels of motivation to change and are less affected by seasonal barriers. Current Controlled Trials ISRCTN95932902.

24-h Efficacy of Glaucoma Treatment Options.

PubMed

Konstas, Anastasios G P; Quaranta, Luciano; Bozkurt, Banu; Katsanos, Andreas; Garcia-Feijoo, Julian; Rossetti, Luca; Shaarawy, Tarek; Pfeiffer, Norbert; Miglior, Stefano

2016-04-01

Current management of glaucoma entails the medical, laser, or surgical reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which is commensurate with either stability or delayed progression of visual loss. In the published literature, the hypothesis is often made that IOP control implies a single IOP measurement over time. Although the follow-up of glaucoma patients with single IOP measurements is quick and convenient, such measurements often do not adequately reflect the untreated IOP characteristics, or indeed the quality of treated IOP control during the 24-h cycle. Since glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous, it is logical that we should aim to understand the efficacy of all treatment options throughout the 24-h period. This article first reviews the concept and value of diurnal and 24-h IOP monitoring. It then critically evaluates selected available evidence on the 24-h efficacy of medical, laser and surgical therapy options. During the past decade several controlled trials have significantly enhanced our understanding on the 24-h efficacy of all glaucoma therapy options. Nevertheless, more long-term evidence is needed to better evaluate the 24-h efficacy of glaucoma therapy and the precise impact of IOP characteristics on glaucomatous progression and visual prognosis.

Control measures following a case of imported Lassa fever from Togo, North Rhine Westphalia, Germany, 2016.

PubMed

Lehmann, Clara; Kochanek, Matthias; Abdulla, Diana; Becker, Stephan; Böll, Boris; Bunte, Anne; Cadar, Daniel; Dormann, Arno; Eickmann, Markus; Emmerich, Petra; Feldt, Torsten; Frank, Christina; Fries, Jochen; Gabriel, Martin; Goetsch, Udo; Gottschalk, René; Günther, Stephan; Hallek, Michael; Häussinger, Dieter; Herzog, Christian; Jensen, Björn; Kolibay, Felix; Krakau, Michael; Langebartels, Georg; Rieger, Toni; Schaade, Lars; Schmidt-Chanasit, Jonas; Schömig, Edgar; Schüttfort, Gundolf; Shimabukuro-Vornhagen, Alexander; von Bergwelt-Baildon, Michael; Wieland, Ulrike; Wiesmüller, Gerhard; Wolf, Timo; Fätkenheuer, Gerd

2017-09-01

In a patient transferred from Togo to Cologne, Germany, Lassa fever was diagnosed 12 days post mortem. Sixty-two contacts in Cologne were categorised according to the level of exposure, and gradual infection control measures were applied. No clinical signs of Lassa virus infection or Lassa specific antibodies were observed in the 62 contacts. Thirty-three individuals had direct contact to blood, other body fluids or tissue of the patients. Notably, with standard precautions, no transmission occurred between the index patient and healthcare workers. However, one secondary infection occurred in an undertaker exposed to the corpse in Rhineland-Palatinate, who was treated on the isolation unit at the University Hospital of Frankfurt. After German authorities raised an alert regarding the imported Lassa fever case, an American healthcare worker who had cared for the index patient in Togo, and who presented with diarrhoea, vomiting and fever, was placed in isolation and medevacked to the United States. The event and the transmission of Lassa virus infection outside of Africa underlines the need for early diagnosis and use of adequate personal protection equipment (PPE), when highly contagious infections cannot be excluded. It also demonstrates that larger outbreaks can be prevented by infection control measures, including standard PPE.

Analysis characteristics determination of electrohydraulic control system operation to reduce the operation time of a powered roof support

NASA Astrophysics Data System (ADS)

Szurgacz, Dawid

2018-01-01

The article discusses basic functions of a powered roof support in a longwall unit. The support function is to provide safety by protecting mine workings against uncontrolled falling of rocks. The subject of the research includes the measures to shorten the time of roof support shifting. The roof support is adapted to transfer, in hazard conditions of rock mass tremors, dynamic loads caused by mining exploitation. The article presents preliminary research results on the time reduction of the unit advance to increase the extraction process and thus reduce operating costs. Conducted stand tests showed the ability to increase the flow for 3/2-way valve cartridges. The level of fluid flowing through the cartridges is adequate to control individual actuators.

Implementation of tuberculosis infection prevention and control in Mozambican health care facilities.

PubMed

Brouwer, M; Coelho, E; das Dores Mosse, C; van Leth, F

2015-01-01

District and urban health care facilities in three provinces (Manica, Sofala, Tete) in central Mozambique. To assess the level of implementation of selected tuberculosis infection prevention and control (TB-IPC) measures. In a cross-sectional study of TB-IPC implementation in 29 health care facilities, we assessed TB clinics, laboratories, out-patient departments and medical and TB wards. Assessment included selected managerial, administrative and environmental measures and the availability and use of respiratory protective equipment (N95 respirators). Guidelines for diagnosis and treatment of (presumptive) TB patients were not present in all facilities. Staff instructed patients on sputum collection in 91%, but only 4% observed it. Using a pragmatic '20% rule', 52% of the rooms assessed had adequate ventilation. Potentially, this could be increased to 76%. Three quarters of the health care workers had N95 respirators. Only 36% knew how to use it correctly. Implementation of TB-IPC measures showed wide variations within health care facilities. Relatively simple measures to improve TB-IPC include the availability of guidelines, opening doors and windows to improve ventilation, and training and support on correct N95 respirator use. However, even relatively simple measures are challenging to implement, and require careful attention in and evaluation of the implementation process.

The effect of particle size distribution on the design of urban stormwater control measures

USGS Publications Warehouse

Selbig, William R.; Fienen, Michael N.; Horwatich, Judy A.; Bannerman, Roger T.

2016-01-01

An urban pollutant loading model was used to demonstrate how incorrect assumptions on the particle size distribution (PSD) in urban runoff can alter the design characteristics of stormwater control measures (SCMs) used to remove solids in stormwater. Field-measured PSD, although highly variable, is generally coarser than the widely-accepted PSD characterized by the Nationwide Urban Runoff Program (NURP). PSDs can be predicted based on environmental surrogate data. There were no appreciable differences in predicted PSD when grouped by season. Model simulations of a wet detention pond and catch basin showed a much smaller surface area is needed to achieve the same level of solids removal using the median value of field-measured PSD as compared to NURP PSD. Therefore, SCMs that used the NURP PSD in the design process could be unnecessarily oversized. The median of measured PSDs, although more site-specific than NURP PSDs, could still misrepresent the efficiency of an SCM because it may not adequately capture the variability of individual runoff events. Future pollutant loading models may account for this variability through regression with environmental surrogates, but until then, without proper site characterization, the adoption of a single PSD to represent all runoff conditions may result in SCMs that are under- or over-sized, rendering them ineffective or unnecessarily costly.

Joint Control for Dummies: An Elaboration of Lowenkron's Model of Joint (Stimulus) Control

ERIC Educational Resources Information Center

Sidener, David W.

2006-01-01

The following paper describes Lowenkron's model of joint (stimulus) control. Joint control is described as a means of accounting for performances, especially generalized performances, for which a history of contingency control does not provide an adequate account. Examples are provided to illustrate instances in which joint control may facilitate…

76 FR 14835 - Approval and Promulgation of Air Quality Implementation Plan; Missouri; Proposed Disapproval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... the state's conclusion should be supported by an adequate technical analysis. EPA recommended the...)(2)(D)(i)(I) must be supported by an adequate technical analysis.\\5\\ EPA recommended the various..., the state did not further evaluate or demonstrate with a technical analysis that these measures...

76 FR 14831 - Approval and Promulgation of Air Quality Implementation Plan; Kansas; Proposed Disapproval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... State's conclusion should be supported by an adequate technical analysis. EPA recommended the various...) must be supported by an adequate technical analysis.\\5\\ EPA recommended the various types of... evaluate or demonstrate with a technical analysis that these measures address the requirements of 110(a)(2...

76 FR 4592 - Approval and Promulgation of Air Quality Implementation Plan; North Carolina; Disapproval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... adequate technical analysis. Second, EPA recommended the various types of information that could be... submission, it did not further evaluate or demonstrate with a technical analysis that this measure and their.... Unfortunately, without an adequate technical analysis EPA does not believe that states can sufficiently address...

14 CFR 133.33 - Operating rules.

Code of Federal Regulations, 2011 CFR

2011-01-01

... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

14 CFR 133.33 - Operating rules.

Code of Federal Regulations, 2012 CFR

2012-01-01

... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

14 CFR 133.33 - Operating rules.

Code of Federal Regulations, 2014 CFR

2014-01-01

... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

14 CFR 133.33 - Operating rules.

Code of Federal Regulations, 2013 CFR

2013-01-01

... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

40 CFR 64.3 - Monitoring design criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... that are adequate to ensure the continuing validity of the data. The owner or operator shall consider... and control device operational variability, the reliability and latitude built into the control...

A Metric and Workflow for Quality Control in the Analysis of Heterogeneity in Phenotypic Profiles and Screens

PubMed Central

Gough, Albert; Shun, Tongying; Taylor, D. Lansing; Schurdak, Mark

2016-01-01

Heterogeneity is well recognized as a common property of cellular systems that impacts biomedical research and the development of therapeutics and diagnostics. Several studies have shown that analysis of heterogeneity: gives insight into mechanisms of action of perturbagens; can be used to predict optimal combination therapies; and to quantify heterogeneity in tumors where heterogeneity is believed to be associated with adaptation and resistance. Cytometry methods including high content screening (HCS), high throughput microscopy, flow cytometry, mass spec imaging and digital pathology capture cell level data for populations of cells. However it is often assumed that the population response is normally distributed and therefore that the average adequately describes the results. A deeper understanding of the results of the measurements and more effective comparison of perturbagen effects requires analysis that takes into account the distribution of the measurements, i.e. the heterogeneity. However, the reproducibility of heterogeneous data collected on different days, and in different plates/slides has not previously been evaluated. Here we show that conventional assay quality metrics alone are not adequate for quality control of the heterogeneity in the data. To address this need, we demonstrate the use of the Kolmogorov-Smirnov statistic as a metric for monitoring the reproducibility of heterogeneity in an SAR screen, describe a workflow for quality control in heterogeneity analysis. One major challenge in high throughput biology is the evaluation and interpretation of heterogeneity in thousands of samples, such as compounds in a cell-based screen. In this study we also demonstrate that three heterogeneity indices previously reported, capture the shapes of the distributions and provide a means to filter and browse big data sets of cellular distributions in order to compare and identify distributions of interest. These metrics and methods are presented as a workflow for analysis of heterogeneity in large scale biology projects. PMID:26476369

Coal thickness guage using RRAS techniques, parts 2 and 3

NASA Technical Reports Server (NTRS)

King, J. D.; Rollwitz, W. L.

1980-01-01

Electron magnetic resonance was investigated as a sensing technique for use in measuring the thickness of the layer of coal overlying the rock substrate. The goal is development of a thickness gauge which will be usable for control of mining machinery to maintain the coal thickness within selected bounds. A sensor must be noncontracting, have a measurement range of 6 inches or more, and an accuracy of 1/2 inch or better. The sensor should be insensitive to variations in spacing between the sensor and the surface, the response speed should be adequate to permit use on continuous mining equipment, and the device should be rugged and otherwise suited for operation under conditions of high vibration, moisture, and dust. Finally, the sensor measurement must not be adversely affected by the natural effects occurring in coal such as impurities, voids, cracks, layering, high moisture level, and other conditions that are likely to be encountered.

Systematic review: The placebo effect of psychological interventions in the treatment of irritable bowel syndrome

PubMed Central

Flik, Carla E; Bakker, Laura; Laan, Wijnand; van Rood, Yanda R; Smout, André J P M; de Wit, Niek J

2017-01-01

AIM To determine the placebo response rate associated with different types of placebo interventions used in psychological intervention studies for irritable bowel syndrome. METHODS Randomized controlled trials comparing psychological interventions (stress management/relaxation therapy (cognitive) behavioral therapy, short-term psychodynamic therapy, and hypnotherapy) for the treatment of adult patients with irritable bowel syndrome (IBS) diagnosed with the Manning or Rome criteria with an adequate placebo control treatment and reporting data on IBS symptom severity were identified by searching PubMed, Embase, the Cochrane Library, CINAHL and PsycINFO databases. Full-text articles that were written in English and published between 1966 and February 2016 in peer-reviewed journals were selected for the present review. Placebo interventions were considered to be adequate if the number of sessions and the amount of time spent with the therapist were the same as in the active treatment. The placebo response rate (PRR) was computed for IBS symptom severity (primary outcome measure) as well as for anxiety, depression and quality of life (secondary outcome measures). RESULTS Six studies, with a total of 555 patients met the inclusion criteria. Four studies used an educational intervention, whereas two studies used a form of supportive therapy as the placebo intervention. The PRR for IBS symptom severity ranged from 25% to 59%, with a pooled mean of 41.4%. The relative PRR for the secondary outcome measures ranged from 0% to 267% for anxiety, 6% to 52% for depression 20% to 125% for quality of life. The PRR associated with pharmacological treatments, treatment with dietary bran and complementary medicine ranged from 37.5% to 47%. Contrary to our expectations, the PRR in studies on psychological interventions was comparable to that in studies on pharmacological, dietary and alternative medical interventions. CONCLUSION The PRR is probably determined to a larger extent by patient-related factors, such as expectations and desire for the treatment to be effective, than the content of the placebo intervention. PMID:28405151

A four-axis hand controller for helicopter flight control

NASA Technical Reports Server (NTRS)

Demaio, Joe

1993-01-01

A proof-of-concept hand controller for controlling lateral and longitudinal cyclic pitch, collective pitch and tail rotor thrust was developed. The purpose of the work was to address problems of operator fatigue, poor proprioceptive feedback and cross-coupling of axes associated with many four-axis controller designs. The present design is an attempt to reduce cross-coupling to a level that can be controlled with breakout force, rather than to eliminate it entirely. The cascaded design placed lateral and longitudinal cyclic in their normal configuration. Tail rotor thrust was placed atop the cyclic controller. A left/right twisting motion with the wrist made the control input. The axis of rotation was canted outboard (clockwise) to minimize cross-coupling with the cyclic pitch axis. The collective control was a twist grip, like a motorcycle throttle. Measurement of the amount of cross-coupling involved in pure, single-axis inputs showed cross coupling under 10 percent of full deflection for all axes. This small amount of cross-coupling could be further reduced with better damping and force gradient control. Fatigue was not found to be a problem, and proprioceptive feedback was adequate for all flight tasks executed.

14 CFR 25.253 - High-speed characteristics.

Code of Federal Regulations, 2014 CFR

2014-01-01

... sudden or excessive reduction of elevator control force as VDF/MDF is reached. (4) Adequate roll..., inadvertent control movements, low stick force gradient in relation to control friction, passenger movement... VMO/MMO, the slope of the elevator control force versus speed curve need not be stable at speeds...

14 CFR 25.253 - High-speed characteristics.

Code of Federal Regulations, 2013 CFR

2013-01-01

... sudden or excessive reduction of elevator control force as VDF/MDF is reached. (4) Adequate roll..., inadvertent control movements, low stick force gradient in relation to control friction, passenger movement... VMO/MMO, the slope of the elevator control force versus speed curve need not be stable at speeds...

Barriers to implementing infection prevention and control guidelines during crises: experiences of health care professionals.

PubMed

Timen, Aura; Hulscher, Marlies E J L; Rust, Laura; van Steenbergen, Jim E; Akkermans, Reinier P; Grol, Richard P T M; van der Meer, Jos W M

2010-11-01

Communicable disease crises can endanger the health care system and often require special guidelines. Understanding reasons for nonadherence to crisis guidelines is needed to improve crisis management. We identified and measured barriers and conditions for optimal adherence as perceived by 4 categories of health care professionals. In-depth interviews were performed (n = 26) to develop a questionnaire for a cross-sectional survey of microbiologists (100% response), infection preventionists (74% response), public health physicians (96% response), and public health nurses (82% response). The groups were asked to appraise barriers encountered during 4 outbreaks (severe acute respiratory syndrome [SARS], Clostridium difficile ribotype 027, rubella, and avian influenza) according to a 5-point Likert scale. When at least 33% of the participants responded "strongly agree," "agree," or "rather agree than disagree," a barrier was defined as "often experienced." The common ("generic") barriers were included in a univariate and multivariate model. Barriers specific to the various groups were studied as well. Crisis guidelines were found to have 4 generic barriers to adherence: (1) lack of imperative or precise wording, (2) lack of easily identifiable instructions specific to each profession, (3) lack of concrete performance targets, and (4) lack of timely and adequate guidance on personal protective equipment and other safety measures. The cross-sectional study also yielded profession-specific sets of often-experienced barriers. To improve adherence to crisis guidelines, the generic barriers should be addressed when developing guidelines, irrespective of the infectious agent. Profession-specific barriers require profession-specific strategies to change attitudes, ensure organizational facilities, and provide an adequate setting for crisis management. Copyright © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Cross-cultural adaptation and validation of a Bengali version of the modified fibromyalgia impact questionnaire.

PubMed

Muquith, Mohammed A; Islam, Md Nazrul; Haq, Syed A; Ten Klooster, Peter M; Rasker, Johannes J; Yunus, Muhammad B

2012-08-27

Currently, no validated instruments are available to measure the health status of Bangladeshi patients with fibromyalgia (FM). The aims of this study were to cross-culturally adapt the modified Fibromyalgia Impact Questionnaire (FIQ) into Bengali (B-FIQ) and to test its validity and reliability in Bangladeshi patients with FM. The FIQ was translated following cross-cultural adaptation guidelines and pretested in 30 female patients with FM. Next, the adapted B-FIQ was physician-administered to 102 consecutive female FM patients together with the Health Assessment Questionnaire (HAQ), selected subscales of the SF-36, and visual analog scales for current clinical symptoms. A tender point count (TPC) was performed by an experienced rheumatologist. Forty randomly selected patients completed the B-FIQ again after 7 days. Two control groups of 50 healthy people and 50 rheumatoid arthritis (RA) patients also completed the B-FIQ. For the final B-FIQ, five physical function sub-items were replaced with culturally appropriate equivalents. Internal consistency was adequate for both the 11-item physical function subscale (α = 0.73) and the total scale (α = 0.83). With exception of the physical function subscale, expected correlations were generally observed between the B-FIQ items and selected subscales of the SF-36, HAQ, clinical symptoms, and TPC. The B-FIQ was able to discriminate between FM patients and healthy controls and between FM patients and RA patients. Test-retest reliability was adequate for the physical function subscale (r = 0.86) and individual items (r = 0.73-0.86), except anxiety (r = 0.27) and morning tiredness (r = 0.64). This study supports the reliability and validity of the B-FIQ as a measure of functional disability and health status in Bangladeshi women with FM.

A randomized, placebo-controlled trial of risperidone augmentation for patients with difficult-to-treat unipolar, non-psychotic major depression.

PubMed

Keitner, Gabor I; Garlow, Steven J; Ryan, Christine E; Ninan, Philip T; Solomon, David A; Nemeroff, Charles B; Keller, Martin B

2009-01-01

Patients (30-50%) with non-psychotic major depression will not respond despite an adequate trial of antidepressant medication. This study evaluated risperidone as an augmenting agent for patients who failed or only partially responded to an adequate trial of an antidepressant medication. Ninety-seven patients with unipolar non-psychotic major depression who were not responsive to antidepressant monotherapy were randomized to risperidone (0.5-3mg/day) or placebo augmentation in a four-week, double-blind, placebo controlled treatment trial. The primary outcome measure was remission defined by a score of < or =10 on the Montgomery-Asberg Depression Rating Scale (MADRS). Secondary outcomes measures were the Hamilton Rating Scale for Depression, the Clinician Global Impression of Severity scale and the overall satisfaction item of the Quality of Life and Enjoyment Questionnaire. Subjects in both treatment groups improved significantly over time. The odds of remitting were significantly better for patients in the risperidone vs. placebo arm (OR=3.33, p=.011). At the end of 4 weeks of treatment 52% of the risperidone augmentation group remitted (MADRS< or =10) compared to 24% of the placebo augmentation group (CMH(1)=6.48, p=.011), but the two groups were converging. Patients in the risperidone group also reported significantly more improvement in quality-of-life than patients in the placebo group. There were no between-group differences in the number of adverse events reported, however, weight gain was significantly higher in the group receiving risperidone. Augmentation of an antidepressant with risperidone for patients with difficult-to-treat depression leads to more rapid response and a higher remission rate and better quality-of-life.

Comparison between the triglycerides standardization of routine methods used in Japan and the chromotropic acid reference measurement procedure used by the CDC Lipid Standardization Programme.

PubMed

Nakamura, Masakazu; Iso, Hiroyasu; Kitamura, Akihiko; Imano, Hironori; Noda, Hiroyuki; Kiyama, Masahiko; Sato, Shinichi; Yamagishi, Kazumasa; Nishimura, Kunihiro; Nakai, Michikazu; Vesper, Hubert W; Teramoto, Tamio; Miyamoto, Yoshihiro

2016-11-01

Background The US Centers for Disease Control and Prevention ensured adequate performance of the routine triglycerides methods used in Japan by a chromotropic acid reference measurement procedure used by the Centers for Disease Control and Prevention lipid standardization programme as a reference point. We examined standardized data to clarify the performance of routine triglycerides methods. Methods The two routine triglycerides methods were the fluorometric method of Kessler and Lederer and the enzymatic method. The methods were standardized using 495 Centers for Disease Control and Prevention reference pools with 98 different concentrations ranging between 0.37 and 5.15 mmol/L in 141 survey runs. The triglycerides criteria for laboratories which perform triglycerides analyses are used: accuracy, as bias ≤5% from the Centers for Disease Control and Prevention reference value and precision, as measured by CV, ≤5%. Results The correlation of the bias of both methods to the Centers for Disease Control and Prevention reference method was: y (%bias) = 0.516 × (Centers for Disease Control and Prevention reference value) -1.292 ( n = 495, R 2  = 0.018). Triglycerides bias at medical decision points of 1.13, 1.69 and 2.26 mmol/L was -0.71%, -0.42% and -0.13%, respectively. For the combined precision, the equation y (CV) = -0.398 × (triglycerides value) + 1.797 ( n = 495, R 2  = 0.081) was used. Precision was 1.35%, 1.12% and 0.90%, respectively. It was shown that triglycerides measurements at Osaka were stable for 36 years. Conclusions The epidemiologic laboratory in Japan met acceptable accuracy goals for 88.7% of all samples, and met acceptable precision goals for 97.8% of all samples measured through the Centers for Disease Control and Prevention lipid standardization programme and demonstrated stable results for an extended period of time.

Comparison between the triglycerides standardization of routine methods used in Japan and the chromotropic acid reference measurement procedure used by the CDC Lipid Standardization Programme

PubMed Central

Nakamura, Masakazu; Iso, Hiroyasu; Kitamura, Akihiko; Imano, Hironori; Noda, Hiroyuki; Kiyama, Masahiko; Sato, Shinichi; Yamagishi, Kazumasa; Nishimura, Kunihiro; Nakai, Michikazu; Vesper, Hubert W; Teramoto, Tamio; Miyamoto, Yoshihiro

2017-01-01

Background The US Centers for Disease Control and Prevention ensured adequate performance of the routine triglycerides methods used in Japan by a chromotropic acid reference measurement procedure used by the Centers for Disease Control and Prevention lipid standardization programme as a reference point. We examined standardized data to clarify the performance of routine triglycerides methods. Methods The two routine triglycerides methods were the fluorometric method of Kessler and Lederer and the enzymatic method. The methods were standardized using 495 Centers for Disease Control and Prevention reference pools with 98 different concentrations ranging between 0.37 and 5.15 mmol/L in 141 survey runs. The triglycerides criteria for laboratories which perform triglycerides analyses are used: accuracy, as bias ≤5% from the Centers for Disease Control and Prevention reference value and precision, as measured by CV, ≤5%. Results The correlation of the bias of both methods to the Centers for Disease Control and Prevention reference method was: y (%bias) = 0.516 × (Centers for Disease Control and Prevention reference value) −1.292 (n = 495, R2 = 0.018). Triglycerides bias at medical decision points of 1.13, 1.69 and 2.26 mmol/L was −0.71%, −0.42% and −0.13%, respectively. For the combined precision, the equation y (CV) = −0.398 × (triglycerides value) + 1.797 (n = 495, R2 = 0.081) was used. Precision was 1.35%, 1.12% and 0.90%, respectively. It was shown that triglycerides measurements at Osaka were stable for 36 years. Conclusions The epidemiologic laboratory in Japan met acceptable accuracy goals for 88.7% of all samples, and met acceptable precision goals for 97.8% of all samples measured through the Centers for Disease Control and Prevention lipid standardization programme and demonstrated stable results for an extended period of time. PMID:26680645

21 CFR 226.58 - Laboratory controls.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Laboratory controls. Laboratory controls shall include the establishment of adequate specifications and test... establishment of master records containing appropriate specifications and a description of the test procedures... necessary laboratory test procedures to check such specifications. (c) Assays which shall be made of...

Specifics of Pulsed Arc Welding Power Supply Performance Based On A Transistor Switch

NASA Astrophysics Data System (ADS)

Krampit, N. Yu; Kust, T. S.; Krampit, M. A.

2016-08-01

Specifics of designing a pulsed arc welding power supply device are presented in the paper. Electronic components for managing large current was analyzed. Strengths and shortcomings of power supply circuits based on thyristor, bipolar transistor and MOSFET are outlined. As a base unit for pulsed arc welding was chosen MOSFET transistor, which is easy to manage. Measures to protect a transistor are given. As for the transistor control device is a microcontroller Arduino which has a low cost and adequate performance of the work. Bead transfer principle is to change the voltage on the arc in the formation of beads on the wire end. Microcontroller controls transistor when the arc voltage reaches the threshold voltage. Thus there is a separation and transfer of beads without splashing. Control strategies tested on a real device and presented. The error in the operation of the device is less than 25 us, it can be used controlling drop transfer at high frequencies (up to 1300 Hz).

Adequate antipsychotic treatment normalizes serum nerve growth factor concentrations in schizophrenia with and without cannabis or additional substance abuse.

PubMed

Jockers-Scherübl, Maria C; Rentzsch, Johannes; Danker-Hopfe, Heidi; Radzei, Nicole; Schürer, Falk; Bahri, Sharif; Hellweg, Rainer

2006-06-12

Neurotrophins such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) are important for the development and maintenance of neuron function. Neurodevelopment is thought to be impaired in schizophrenia, and vulnerable schizophrenic brains may be more sensitive to toxic influences. Thus, cannabis as a neurotoxin (and other substances) may be more harmful to schizophrenic brains than to non-schizophrenic brains, when used chronically. In a previous study we demonstrated an earlier disease onset and significantly higher serum NGF concentrations in drug-naïve schizophrenic patients with previous long-term cannabis abuse than in schizophrenics without cannabis abuse or cannabis abusers without schizophrenia. We therefore investigated whether this difference is still observed after treatment. Serum NGF measured in 114 treated schizophrenic patients (schizophrenia alone, n=66; schizophrenia plus cannabis abuse, n=42; schizophrenia plus multiple substance abuse, n=6) no longer differed significantly among those groups and from the control groups (healthy controls, n=51; cannabis controls, n=24; multiple substance controls, n=6). These results were confirmed by an additional prospective study in 28 patients suffering from schizophrenia (S) or schizophrenia with cannabis abuse (SC). Previously elevated serum NGF levels in the drug-naïve state, also differing between the groups (S: 83.44+/-265.25 pg/ml; SC: 246.89+/-310.24 pg/ml, S versus SC: p=0.03) dropped to 10.72+/-14.13 pg/ml (S) and 34.19+/-38.96 pg/ml (SC) (S versus SC, p>0.05), respectively, after adequate antipsychotic treatment. We thus conclude that antipsychotic treatment leads to recovery of neural integrity, as indicated by renormalized NGF values.

Delivery of Instructions via Mobile Social Media App Increases Quality of Bowel Preparation.

PubMed

Kang, Xiaoyu; Zhao, Lina; Leung, Felix; Luo, Hui; Wang, Limei; Wu, Ji; Guo, Xiaoyang; Wang, Xiangping; Zhang, Linhui; Hui, Na; Tao, Qin; Jia, Hui; Liu, Zhiguo; Chen, Zhangqin; Liu, Junjun; Wu, Kaichun; Fan, Daiming; Pan, Yanglin; Guo, Xuegang

2016-03-01

Bowel preparation is closely linked to the quality of colonoscopy. We investigated whether delivery of instructions via a social media app increases the quality of colonoscopy by improving adequacy of bowel preparation. We performed a prospective study at 3 endoscopic centers in China of 770 colonoscopy outpatients (18-80 years old) with convenient access to Wechat (a widely used mobile social media app) from May through November 2014. Patients were randomly assigned to groups that received standard education along with delivery of interactive information via Wechat (n = 387) or standard education (controls, n = 383). The primary outcome was proportion of patients with adequate bowel preparation (Ottawa score <6). Secondary outcomes included rates of adenoma detection and cecal intubation, cecal intubation time, rates of incomplete compliance with instructions, and patient willingness to repeat bowel preparation. Demographic features were comparable between the groups. A higher proportion of patients in the group that received social media instruction had adequate bowel preparation than the control group (82.2% vs 69.5%, P < .001). Among patients with successful colonoscopies, the group that received social media instruction had lower mean total and segmental Ottawa scores (P < .05). A higher proportion of patients receiving social media instruction also had cecal intubation (97.2% vs 93.2% in controls, P = .014) and were found to have adenomas (18.6% vs 12.0% in controls, P = .012). Instruction via a mobile social media app, in conjunction with regular instruction, increases subjective measures of adequacy of bowel preparation. Use of the app significantly increased the proportion of patients with successful cecal intubation and in whom adenomas were detected, indicating increased quality of colonoscopy. ClinicalTrials.gov number: NCT02140827. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Study on real-time force feedback for a master-slave interventional surgical robotic system.

PubMed

Guo, Shuxiang; Wang, Yuan; Xiao, Nan; Li, Youxiang; Jiang, Yuhua

2018-04-13

In robot-assisted catheterization, haptic feedback is important, but is currently lacking. In addition, conventional interventional surgical robotic systems typically employ a master-slave architecture with an open-loop force feedback, which results in inaccurate control. We develop herein a novel real-time master-slave (RTMS) interventional surgical robotic system with a closed-loop force feedback that allows a surgeon to sense the true force during remote operation, provide adequate haptic feedback, and improve control accuracy in robot-assisted catheterization. As part of this system, we also design a unique master control handle that measures the true force felt by a surgeon, providing the basis for the closed-loop control of the entire system. We use theoretical and empirical methods to demonstrate that the proposed RTMS system provides a surgeon (using the master control handle) with a more accurate and realistic force sensation, which subsequently improves the precision of the master-slave manipulation. The experimental results show a substantial increase in the control accuracy of the force feedback and an increase in operational efficiency during surgery.

Integrating a piezoelectric actuator with mechanical and hydraulic devices to control camless engines

NASA Astrophysics Data System (ADS)

Mercorelli, Paolo; Werner, Nils

2016-10-01

The paper deals with some interdisciplinary aspects and problems concerning the actuation control which occur in the integration of a piezoelectric structure in an aggregate actuator consisting of a piezoelectric, a stroke ratio displacement, a mechanical and a hydraulic part. Problems like compensation of the piezo hysteresis effect, scaling force-position to obtain an adequate displacement of the actuator and finally the control of such a complex aggregate system are considered and solved. Even though this work considers a particular application, the solutions proposed in the paper are quite general. In fact, the considered technical aspects occurring in systems which utilize piezoelectric technologies can be used in a variegated gamma of actuators integrating piezoelectric technologies. A cascade controller is proposed to combine a Feedforward action with an internal and an external PI-Controller. The Feedforward Controller is based on the model of the whole actuator, so particular attention is paid to the model structure. The resulting Feedforward action is an adaptive one to compensate hydraulic pressure faults. Real measurements are shown.

Simulation of κ-Carbide Precipitation Kinetics in Aged Low-Density Fe-Mn-Al-C Steels and Its Effects on Strengthening

NASA Astrophysics Data System (ADS)

Lee, Jaeeun; Park, Siwook; Kim, Hwangsun; Park, Seong-Jun; Lee, Keunho; Kim, Mi-Young; Madakashira, Phaniraj P.; Han, Heung Nam

2018-03-01

Fe-Al-Mn-C alloy systems are low-density austenite-based steels that show excellent mechanical properties. After aging such steels at adequate temperatures for adequate time, nano-scale precipitates such as κ-carbide form, which have profound effects on the mechanical properties. Therefore, it is important to predict the amount and size of the generated κ-carbide precipitates in order to control the mechanical properties of low-density steels. In this study, the microstructure and mechanical properties of aged low-density austenitic steel were characterized. Thermo-kinetic simulations of the aging process were used to predict the size and phase fraction of κ-carbide after different aging periods, and these results were validated by comparison with experimental data derived from dark-field transmission electron microscopy images. Based on these results, models for precipitation strengthening based on different mechanisms were assessed. The measured increase in the strength of aged specimens was compared with that calculated from the models to determine the exact precipitation strengthening mechanism.

40 CFR 21.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and section 8 of the Federal Water Pollution Control Act Amendments of 1972, to the effect that... adequate to comply with requirements established under the Federal Water Pollution Control Act, 33 U.S.C...

40 CFR 21.1 - Scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and section 8 of the Federal Water Pollution Control Act Amendments of 1972, to the effect that... adequate to comply with requirements established under the Federal Water Pollution Control Act, 33 U.S.C...

40 CFR 21.1 - Scope.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and section 8 of the Federal Water Pollution Control Act Amendments of 1972, to the effect that... adequate to comply with requirements established under the Federal Water Pollution Control Act, 33 U.S.C...

40 CFR 21.1 - Scope.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and section 8 of the Federal Water Pollution Control Act Amendments of 1972, to the effect that... adequate to comply with requirements established under the Federal Water Pollution Control Act, 33 U.S.C...

12 CFR 618.8430 - Internal controls.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Internal controls. 618.8430 Section 618.8430 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Internal Controls § 618.8430 Internal controls. Each Farm Credit institution's board of directors must adopt an internal control policy, providing adequate direction to...

Should we reconsider the routine use of placebo controls in clinical research?

PubMed

Avins, Andrew L; Cherkin, Daniel C; Sherman, Karen J; Goldberg, Harley; Pressman, Alice

2012-04-27

Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. The result could be more effective, patient-centered care that makes the best use of both specific and non-specific benefits of medical interventions.

Obstructive sleep apnea devices for out-of-center (OOC) testing: technology evaluation.

PubMed

Collop, Nancy A; Tracy, Sharon L; Kapur, Vishesh; Mehra, Reena; Kuhlmann, David; Fleishman, Sam A; Ojile, Joseph M

2011-10-15

Guidance is needed to help clinicians decide which out-of-center (OOC) testing devices are appropriate for diagnosing obstructive sleep apnea (OSA). A new classification system that details the type of signals measured by these devices is presented. This proposed system categorizes OOC devices based on measurements of Sleep, Cardiovascular, Oximetry, Position, Effort, and Respiratory (SCOPER) parameters.Criteria for evaluating the devices are also presented, which were generated from chosen pre-test and post-test probabilities. These criteria state that in patients with a high pretest probability of having OSA, the OOC testing device has a positive likelihood ratio (LR+) of 5 or greater coinciding with an in-lab-polysomnography (PSG)-generated apnea hypopnea index (AHI) ≥ 5, and an adequate sensitivity (at least 0.825).Since oximetry is a mandatory signal for scoring AHI using PSG, devices that do not incorporate oximetry were excluded. English peer-reviewed literature on FDA-approved devices utilizing more than 1 signal was reviewed according to the above criteria for 6 questions. These questions specifically addressed the adequacy of different respiratory and effort sensors and combinations thereof to diagnose OSA. In summary, the literature is currently inadequate to state with confidence that a thermistor alone without any effort sensor is adequate to diagnose OSA; if a thermal sensing device is used as the only measure of respiration, 2 effort belts are required as part of the montage and piezoelectric belts are acceptable in this context; nasal pressure can be an adequate measurement of respiration with no effort measure with the caveat that this may be device specific; nasal pressure may be used in combination with either 2 piezoelectric or respiratory inductance plethysmographic (RIP) belts (but not 1 piezoelectric belt); and there is insufficient evidence to state that both nasal pressure and thermistor are required to adequately diagnose OSA. With respect to alternative devices for diagnosing OSA, the data indicate that peripheral arterial tonometry (PAT) devices are adequate for the proposed use; the device based on cardiac signals shows promise, but more study is required as it has not been tested in the home setting; for the device based on end-tidal CO(2) (ETCO(2)), it appears to be adequate for a hospital population; and for devices utilizing acoustic signals, the data are insufficient to determine whether the use of acoustic signals with other signals as a substitute for airflow is adequate to diagnose OSA.Standardized research is needed on OOC devices that report LR+ at the appropriate AHI (≥ 5) and scored according to the recommended definitions, while using appropriate research reporting and methodology to minimize bias.

An error criterion for determining sampling rates in closed-loop control systems

NASA Technical Reports Server (NTRS)

Brecher, S. M.

1972-01-01

The determination of an error criterion which will give a sampling rate for adequate performance of linear, time-invariant closed-loop, discrete-data control systems was studied. The proper modelling of the closed-loop control system for characterization of the error behavior, and the determination of an absolute error definition for performance of the two commonly used holding devices are discussed. The definition of an adequate relative error criterion as a function of the sampling rate and the parameters characterizing the system is established along with the determination of sampling rates. The validity of the expressions for the sampling interval was confirmed by computer simulations. Their application solves the problem of making a first choice in the selection of sampling rates.

Providing Hospitalized Patients With an Educational Booklet Increases the Quality of Colonoscopy Bowel Preparation.

PubMed

Ergen, William F; Pasricha, Trisha; Hubbard, Francie J; Higginbotham, Tina; Givens, Tonya; Slaughter, James C; Obstein, Keith L

2016-06-01

Inadequate bowel preparation is a problem frequently encountered by gastroenterologists who perform colonoscopies on hospitalized patients. A method is needed to increase the quality of bowel preparation in inpatients. An educational booklet has been shown to increase the overall quality of bowel preparation for outpatients. We performed a prospective study to evaluate the effects of an educational booklet on the quality of bowel preparation in a group of hospitalized patients. We performed a randomized, single-blind, controlled trial of all inpatients at a tertiary care medical center scheduled for inpatient colonoscopy from October 2013 through March 2014. They were randomly assigned to groups that were (n = 45) or were not (controls, n = 40) given the booklet before bowel preparation the evening before their colonoscopy. All patients received a standard bowel preparation (clear liquid diet the day before the procedure, followed by split-dose GoLYTELY). At the colonoscopy, the Boston Bowel preparation scale (BBPS) was used to assess bowel preparation. The primary outcome measure was adequate bowel preparation (a total BBPS score ≥6 with all segment scores ≥2). Secondary outcomes assessed included total BBPS score, BBPS segment score, and a total BBPS score of 0. There were no differences between the groups in age, race, sex, body mass index, history of colonoscopy, history of polyps, or time of colonoscopy. Twenty-eight patients who received the booklet (62%) and 14 who did not (35%) had an adequate bowel preparation (P = .012). The number needed to treat to attain adequate bowel preparation was 4. After adjusting for age and history of prior colonoscopies, the odds of achieving an adequate bowel preparation and a higher total BBPS score after receipt of the booklet were 3.14 (95% confidence interval, 1.29-7.83) and 2.27 (95% confidence interval, 1.05-4.88), respectively. Three patients in the booklet group and 9 in the no-booklet group had a BBPS score of 0 (P = .036). The mean BBPS segment score was greater for the booklet group than the no-booklet group (right colon, P = .097; transverse colon, P = .023; left colon, P = .045). In a randomized controlled trial, we found that providing hospitalized patients with an educational booklet on colonoscopy preparation increases the odds of a quality bowel preparation more than 2-fold. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

30 CFR 74.6 - Quality control.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Quality control. 74.6 Section 74.6 Mineral... control. The applicant shall describe the way in which each lot of components will be sampled and tested... of the CMDPSU will be maintained in production through adequate quality control procedures, MSHA and...

30 CFR 74.6 - Quality control.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Quality control. 74.6 Section 74.6 Mineral... control. The applicant shall describe the way in which each lot of components will be sampled and tested... of the CMDPSU will be maintained in production through adequate quality control procedures, MSHA and...

30 CFR 74.6 - Quality control.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Quality control. 74.6 Section 74.6 Mineral... control. The applicant shall describe the way in which each lot of components will be sampled and tested... of the CMDPSU will be maintained in production through adequate quality control procedures, MSHA and...

A review of outbreaks of foodborne disease associated with passenger ships: evidence for risk management.

PubMed Central

Rooney, Roisin M.; Cramer, Elaine H.; Mantha, Stacey; Nichols, Gordon; Bartram, Jamie K.; Farber, Jeffrey M.; Benembarek, Peter K.

2004-01-01

OBJECTIVE: Foodborne disease outbreaks on ships are of concern because of their potentially serious health consequences for passengers and crew and high costs to the industry. The authors conducted a review of outbreaks of foodborne diseases associated with passenger ships in the framework of a World Health Organization project on setting guidelines for ship sanitation. METHODS: The authors reviewed data on 50 outbreaks of foodborne disease associated with passenger ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and food vehicles were collected. RESULTS: The findings of this review show that the majority of reported outbreaks were associated with cruise ships and that almost 10,000 people were affected. Salmonella spp were most frequently associated with outbreaks. Foodborne outbreaks due to enterotoxigenic E. coli spp, Shigella spp, noroviruses (formally called Norwalk-like viruses), Vibrio spp, Staphylococcus aureus, Clostridium perfringens, Cyclospora sp, and Trichinella sp also occurred on ships. Factors associated with the outbreaks reviewed include inadequate temperature control, infected food handlers, contaminated raw ingredients, cross-contamination, inadequate heat treatment, and onshore excursions. Seafood was the most common food vehicle implicated in outbreaks. CONCLUSIONS: Many ship-associated outbreaks could have been prevented if measures had been taken to ensure adequate temperature control, avoidance of cross-contamination, reliable food sources, adequate heat treatment, and exclusion of infected food handlers from work. PMID:15219800

A review of outbreaks of foodborne disease associated with passenger ships: evidence for risk management.

PubMed

Rooney, Roisin M; Cramer, Elaine H; Mantha, Stacey; Nichols, Gordon; Bartram, Jamie K; Farber, Jeffrey M; Benembarek, Peter K

2004-01-01

Foodborne disease outbreaks on ships are of concern because of their potentially serious health consequences for passengers and crew and high costs to the industry. The authors conducted a review of outbreaks of foodborne diseases associated with passenger ships in the framework of a World Health Organization project on setting guidelines for ship sanitation. The authors reviewed data on 50 outbreaks of foodborne disease associated with passenger ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and food vehicles were collected. The findings of this review show that the majority of reported outbreaks were associated with cruise ships and that almost 10,000 people were affected. Salmonella spp were most frequently associated with outbreaks. Foodborne outbreaks due to enterotoxigenic E. coli spp, Shigella spp, noroviruses (formally called Norwalk-like viruses), Vibrio spp, Staphylococcus aureus, Clostridium perfringens, Cyclospora sp, and Trichinella sp also occurred on ships. Factors associated with the outbreaks reviewed include inadequate temperature control, infected food handlers, contaminated raw ingredients, cross-contamination, inadequate heat treatment, and onshore excursions. Seafood was the most common food vehicle implicated in outbreaks. Many ship-associated outbreaks could have been prevented if measures had been taken to ensure adequate temperature control, avoidance of cross-contamination, reliable food sources, adequate heat treatment, and exclusion of infected food handlers from work.

Heartburn treatment in primary care: randomised, double blind study for 8 weeks

PubMed Central

Hatlebakk, Jan G; Hyggen, Arild; Madsen, Per H; Walle, Per O; Schulz, Tom; Mowinckel, Petter; Bernklev, Tomm; Berstad, Arnold

1999-01-01

Objective To compare the effects and tolerability of omeprazole and cisapride with that of placebo for control of heartburn in primary care patients. Design Randomised, double blind, placebo controlled study. Setting 65 primary care practices in Norway. Participants 483 untreated patients with complaints of heartburn ⩾3 days a week, with at most grade 1 reflux oesophagitis. Interventions Omeprazole 20 mg once daily, cisapride 20 mg twice daily, or placebo for 8 weeks. Main outcome measures Adequate control of heartburn, defined as ⩽1 day of the past 7 days with no more than mild heartburn, after 4 weeks of treatment. Results In the all patients treated analysis, adequate control of heartburn was achieved in 71% of patients taking omeprazole, 22% taking cisapride, and 18% taking placebo after 4 weeks of treatment (omeprazole v cisapride and placebo, P<0.0001; cisapride v placebo, non-significant). Results were comparable in patients with or without reflux oesophagitis. In patients treated with omeprazole only, symptom control was achieved significantly more often in patients positive for Helicobacter pylori. Antacid use was 2-3 times greater in patients taking cisapride or placebo than in those taking omeprazole. Relief of non-reflux symptoms did not significantly differ between the three groups. Significantly more patients taking cisapride reported adverse events than those taking omeprazole or placebo. Conclusions Omeprazole 20 mg once daily was highly effective in relieving heartburn whereas cisapride 20 mg twice daily was not significantly more effective than placebo. Key messagesIn primary care patients, heartburn is commonly treated empiricallyMost randomised clinical trials of treatment for heartburn have been conducted in specialist care, and documentation for empirical treatment is limitedOmeprazole was significantly more effective than cisapride or placebo in controlling heartburn and other symptoms of gastro-oesophageal reflux after 2, 4, and 8 weeks, whereas cisapride did not differ significantly from placeboOmeprazole should be considered as a first choice for empirical treatment of heartburn in primary care PMID:10463897

76 FR 4584 - Approval and Promulgation of Air Quality Implementation Plans; Georgia; Disapproval of Interstate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... conclusion must be supported by an adequate technical analysis. Second, EPA recommended the various types of... requirement of section 110(a)(2)(D)(i)(I) must be supported by an adequate technical analysis. Additionally... evaluate or demonstrate with a technical analysis that this measure and their intention to rely to the...

A Preliminary Analysis of the Flying Qualities of the Consolidated Vultee MX-813 Delta-Wing Airplane Configuration at Transonic and Low Supersonic Speeds as Determined from Flights of Rocket-Powered Models

NASA Technical Reports Server (NTRS)

Mitcham, Grady L.

1949-01-01

A preliminary analysis of the flying qualities of the Consolidated Vultee MX-813 delta-wing airplane configuration has been made based on the results obtained from the first two 1/8 scale models flown at the NACA Pilotless Aircraft Research Station, Wallop's Island, VA. The Mach number range covered in the tests was from 0.9 to 1.2. The analysis indicates adequate elevator control for trim in level flight over the speed range investigated. Through the transonic range there is a mild trim change with a slight tucking-under tendency. The elevator control effectiveness in the supersonic range is reduced to about one-half the subsonic value although sufficient control for maneuvering is available as indicated by the fact that 10 deg elevator deflection produced 5g acceleration at Mach number of 1.2 at 40,000 feet.The elevator control forces are high and indicate the power required of the boost system. The damping. of the short-period oscillation is adequate at sea-level but is reduced at 40,000 feet. The directional stability appears adequate for the speed range and angles of attack covered.

Continuous microbial cultures maintained by electronically-controlled device

NASA Technical Reports Server (NTRS)

Eisler, W. J., Jr.; Webb, R. B.

1967-01-01

Photocell-controlled instrument maintains microbial culture. It uses commercially available chemostat glassware, provides adequate aeration through bubbling of the culture, maintains the population size and density, continuously records growth rates over small increments of time, and contains a simple, sterilizable nutrient control mechanism.

A QUALITATIVE RETROSPECTIVE ANALYSIS OF POSITIVE CONTROL DATA IN DEVELOPMENTAL NEUROTOXICITY STUDIES.

EPA Science Inventory

A manuscript reviews positive control data submitted by registrants in support of Developmental Neurotoxicity (DNT) guideline studies. Adequate positive control data are needed to evaluate laboratory proficiency in detecting changes in the structure and function of the developin...

Agility assessment using fuzzy logic approach: a case of healthcare dispensary.

PubMed

Suresh, M; Patri, Rojalin

2017-06-09

Agile concepts are not only beneficial for manufacturing sector but also for service sector such as healthcare. However, assessment of agility has been predominantly done in manufacturing enterprises. This study demonstrates a means to measure agility of a healthcare organization by assessing agility of a university dispensary. Its contribution to the knowledge base is twofold. First, it proposes a means to measure the agility of a healthcare organization and second, it identifies the attributes that prevent agile performance and outlines the suggestive measure to enhance its agile capabilities. A case study approach has been adopted and fuzzy logic has been employed to measure the agility of the case dispensary. At first, the measures of assessment which include four enablers, fifteen criteria and forty-five attributes have been identified from the literature and rated by the experts indicating the importance of the measures in the assessment. Then, the case dispensary has been assessed on those measures by collecting observed performance rating from decision makers. At last, Fuzzy logic has been applied on the performance rating data to analyze and interpret the agile capability of the dispensary. The findings suggest that transparent information flow, adequate salary and bonuses for caregivers, reading error in medical descriptions, in house/nearby pathology laboratory services, technical up-gradation of dispensary equipments and facilities, minimization of patient throughput time and adequate training programme for safety practices are the attributes that weakens agile capability of the University dispensary. The current agility of the dispensary was found to be 'Agile' which is average in relation to the agility labels. Attributes such as transparent information flow, adequate salary and bonuses for caregivers, elimination of reading error in medical descriptions, in house/nearby pathology laboratory services, technical up-gradation of dispensary equipments and facilities, minimization of patient throughput time and adequate training programme for safety practices are extremely crucial for enhancing agile capability of a healthcare organization.

[Validation of the Schizophrenia Quality Of Life Scale (SQLS) to Measure Quality of Life in Patients Diagnosed With Schizophrenia in Colombia].

PubMed

Suárez, María Fernanda; Sánchez, Ricardo; Calvo, José Manuel

2013-09-01

To validate the SQLS scale in Colombian patients diagnosed with schizophrenia. The self-report scale was applied to 251 patients. Measures of test-retest reliability, internal consistency and correlation inter-scales with the SF-12 were made by applying the scale 2 days later in 28 patients, and 30 days later in 38; 50 patients filled-out the SF-12 scale to determine the concurrent validity. Three domains were found with all of them having Cronbach's alphas >0.7. The three factors model did not show adequate fit indexes. Test-retest evaluation showed satisfactory correlation values (>0.86). Sensitivity to change did not shown significant differences between the repeated measures. As regards concurrent validity, acceptable correlation values were found only in SF-12 domains related to mental health and functioning. The SQLS has a factorial structure consistent with previous reports, adequate internal consistency and temporal stability. However, a more detailed examination of some of these items is required, considering that the measurement of the construct does not appear to be adequate. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Validity and reliability of the NAB Naming Test.

PubMed

Sachs, Bonnie C; Rush, Beth K; Pedraza, Otto

2016-05-01

Confrontation naming is commonly assessed in neuropsychological practice, but few standardized measures of naming exist and those that do are susceptible to the effects of education and culture. The Neuropsychological Assessment Battery (NAB) Naming Test is a 31-item measure used to assess confrontation naming. Despite adequate psychometric information provided by the test publisher, there has been limited independent validation of the test. In this study, we investigated the convergent and discriminant validity, internal consistency, and alternate forms reliability of the NAB Naming Test in a sample of adults (Form 1: n = 247, Form 2: n = 151) clinically referred for neuropsychological evaluation. Results indicate adequate-to-good internal consistency and alternate forms reliability. We also found strong convergent validity as demonstrated by relationships with other neurocognitive measures. We found preliminary evidence that the NAB Naming Test demonstrates a more pronounced ceiling effect than other commonly used measures of naming. To our knowledge, this represents the largest published independent validation study of the NAB Naming Test in a clinical sample. Our findings suggest that the NAB Naming Test demonstrates adequate validity and reliability and merits consideration in the test arsenal of clinical neuropsychologists.

Vaccine cold chain: Part 2. Training personnel and program management.

PubMed

Rogers, Bonnie; Dennison, Kim; Adepoju, Nikki; Dowd, Shelia; Uedoi, Kenneth

2010-09-01

The Centers for Disease Control and Prevention reports that professionals in clinic settings may not be adequately storing and handling vaccine, leading to insufficient immunity of vaccinated individuals. Part 2 of this article provides information about the importance of adequate personnel training and program management policies and procedures needed to implement and maintain an effective vaccine cold chain program. Copyright 2010, SLACK Incorporated.

Typhoid Fever surveillance and vaccine use - South-East Asia and Western Pacific regions, 2009-2013.

PubMed

Date, Kashmira A; Bentsi-Enchill, Adwoa D; Fox, Kimberley K; Abeysinghe, Nihal; Mintz, Eric D; Khan, M Imran; Sahastrabuddhe, Sushant; Hyde, Terri B

2014-10-03

Typhoid fever is a serious, systemic infection resulting in nearly 22 million cases and 216,500 deaths annually, primarily in Asia. Safe water, adequate sanitation, appropriate personal and food hygiene, and vaccination are the most effective strategies for prevention and control. In 2008, the World Health Organization (WHO) recommended use of available typhoid vaccines to control endemic disease and outbreaks and strengthening of typhoid surveillance to improve disease estimates and identify high-risk populations (e.g., persons without access to potable water and adequate sanitation). This report summarizes the status of typhoid surveillance and vaccination programs in the WHO South-East Asia (SEAR) and Western Pacific regions (WPR) during 2009-2013, after the revised WHO recommendations. Data were obtained from the WHO/United Nations Children's Fund (UNICEF) Joint Reporting Form on Immunization, a supplemental survey of surveillance and immunization program managers, and published literature. During 2009-2013, 23 (48%) of 48 countries and areas of SEAR (11) and WPR (37) collected surveillance or notifiable disease data on typhoid cases, with most surveillance activities established before 2008. Nine (19%) countries reported implementation of typhoid vaccination programs or recommended vaccine use during 2009-2013. Despite the high incidence, typhoid surveillance is weak in these two regions, and vaccination efforts have been limited. Further progress toward typhoid fever prevention and control in SEAR and WPR will require country commitment and international support for enhanced surveillance, targeted use of existing vaccines and availability of newer vaccines integrated within routine immunization programs, and integration of vaccination with safe water, sanitation, and hygiene measures.

Specific antibody deficiency in children with recurrent respiratory infections: a controlled study with follow-up

PubMed Central

Ruuskanen, O; Nurkka, A; Helminen, M; Viljanen, M K; Käyhty, H; Kainulainen, L

2013-01-01

Specific antibody deficiency (SAD) to unconjugated pneumococcal vaccine (PPV) is an established primary B cell immunodeficiency. The occurrence and natural history of SAD in children is unclear. We conducted an observational study to identify SAD in children with recurrent respiratory infections. Ninety-nine children, mean age 5·9 (range 2–16) years, with recurrent or severe infections were vaccinated with PPV; serum antibody concentrations for serotypes 4, 6B, 9V, 14, 18C, 19F and 23F were measured before and 2 weeks after vaccination with enzyme immunoassay. The retrospective control group consisted of 89 healthy children matched for age and gender. No children had received previous conjugated pneumococcal vaccine (PCV) or PPV. The structured history of infectious diseases of all participants was collected. Ten of 91 (11%) children (eight excluded due to immunoglobulin G subclass deficiency) with recurrent respiratory infections had SAD. In the control group, three children (3%) responded inadequately to PPV (P = 0·05). Most children with SAD also had many other minor immune defects. After 0·5–5 years (medium 3·8), eight children with SAD were revaccinated with PPV; five responded adequately and three inadequately. Two SAD children were revaccinated with PCV, one developed an adequate and one an inadequate response. Two children with SAD received treatment with intravenous immunoglobulin; the remaining eight children recovered without replacement therapy during the follow-up. SAD is common in young children with recurrent respiratory infections, but it is often transient and resolves itself within a few years without specific treatment. PMID:23574320

Evaluation of the tip-bending response in clinically used endoscopes.

PubMed

Rozeboom, Esther D; Reilink, Rob; Schwartz, Matthijs P; Fockens, Paul; Broeders, Ivo A M J

2016-04-01

Endoscopic interventions require accurate and precise control of the endoscope tip. The endoscope tip response depends on a cable pulling system, which is known to deliver a significantly nonlinear response that eventually reduces control. It is unknown whether the current technique of endoscope tip control is adequate for a future of high precision procedures, steerable accessories, and add-on robotics. The aim of this study was to determine the status of the tip response of endoscopes used in clinical practice. We evaluated 20 flexible colonoscopes and five gastroscopes, used in the endoscopy departments of a Dutch university hospital and two Dutch teaching hospitals, in a bench top setup. First, maximal tip bending was determined manually. Next, the endoscope navigation wheels were rotated individually in a motor setup. Tip angulation was recorded with a USB camera. Cable slackness was derived from the resulting hysteresis plot. Only two of the 20 colonoscopes (10 %) and none of the five gastroscopes reached the maximal tip angulation specified by the manufacturer. Four colonoscopes (20 %) and none of the gastroscopes demonstrated the recommended cable tension. Eight colonoscopes (40 %) had undergone a maintenance check 1 month before the measurements were made. The tip responses of these eight colonoscopies did not differ significantly from the tip responses of the other colonoscopes. This study suggests that the majority of clinically used endoscopes are not optimally tuned to reach maximal bending angles and demonstrate adequate tip responses. We suggest a brief check before procedures to predict difficulties with bending angles and tip responses.

Development and implementation of a clinical pathway for cardiac surgery in the intensive care unit: Effects on protocol adherence.

PubMed

van der Kolk, Marion; van den Boogaard, Mark; Ter Brugge-Speelman, Corine; Hol, Jeroen; Noyez, Luc; van Laarhoven, Kees; van der Hoeven, Hans; Pickkers, Peter

2017-12-01

Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report. A tailored implementation strategy was used. Primary outcome measure was protocol adherence above 80% on the domains of blood pressure control, action on chest tube blood loss and electrolyte control within the CP. In a 4-month period, 84 consecutive CP patients were included and compared with 162 matched control patients admitted in the year before implementation; 3 patients were excluded. Propensity score was used as matching parameter. CP patients were more likely to receive early adequate treatment for derangements in electrolytes (96% vs 47%, P < .001), blood pressure (90% vs 49%, P < .001) and adequate treatment for chest tube blood loss (90% vs 10%, P < .001). We found no differences in hospital and ICU LOS, ICU readmission or mortality. Use of the CP improved postoperative ICU treatment for cardiac surgical patients. Implementation of a CP and the use of a special variance report could be a blueprint for the implementation and use of a CP in low-volume high complex surgery. © 2017 John Wiley & Sons, Ltd.

Evaluation of the tip-bending response in clinically used endoscopes

PubMed Central

Rozeboom, Esther D.; Reilink, Rob; Schwartz, Matthijs P.; Fockens, Paul; Broeders, Ivo A. M. J.

2016-01-01

Background and study aims: Endoscopic interventions require accurate and precise control of the endoscope tip. The endoscope tip response depends on a cable pulling system, which is known to deliver a significantly nonlinear response that eventually reduces control. It is unknown whether the current technique of endoscope tip control is adequate for a future of high precision procedures, steerable accessories, and add-on robotics. The aim of this study was to determine the status of the tip response of endoscopes used in clinical practice. Materials and methods: We evaluated 20 flexible colonoscopes and five gastroscopes, used in the endoscopy departments of a Dutch university hospital and two Dutch teaching hospitals, in a bench top setup. First, maximal tip bending was determined manually. Next, the endoscope navigation wheels were rotated individually in a motor setup. Tip angulation was recorded with a USB camera. Cable slackness was derived from the resulting hysteresis plot. Results: Only two of the 20 colonoscopes (10 %) and none of the five gastroscopes reached the maximal tip angulation specified by the manufacturer. Four colonoscopes (20 %) and none of the gastroscopes demonstrated the recommended cable tension. Eight colonoscopes (40 %) had undergone a maintenance check 1 month before the measurements were made. The tip responses of these eight colonoscopies did not differ significantly from the tip responses of the other colonoscopes. Conclusion: This study suggests that the majority of clinically used endoscopes are not optimally tuned to reach maximal bending angles and demonstrate adequate tip responses. We suggest a brief check before procedures to predict difficulties with bending angles and tip responses. PMID:27092330

The Singaporean response to the SARS outbreak: knowledge sufficiency versus public trust.

PubMed

Deurenberg-Yap, M; Foo, L L; Low, Y Y; Chan, S P; Vijaya, K; Lee, M

2005-12-01

During the outbreak of severe acute respiratory syndrome (SARS) in Singapore from 1 March to 11 May 2003, various national prevention and control measures were undertaken to control and eliminate the transmission of the infection. During the initial period of the epidemic, public communication was effected through press releases and media coverage of the epidemic. About a month into the epidemic, a public education campaign was mounted to educate Singaporeans on SARS and adoption of appropriate behaviours to prevent the spread of the disease. A survey was conducted in late April 2003 to assess Singaporeans' knowledge about SARS and infection control measures, and their concerns and anxiety in relation to the outbreak. The survey also sought to assess their confidence in the ability of various institutions to deal with SARS and their opinion on the seemingly tough measures enforced. The study involved 853 adults selected from a telephone-sampling frame. Stratified sampling was used to ensure adequate representation from major ethnic groups and age groups. The study showed that the overall knowledge about SARS and control measures undertaken was low (mean per cent score of 24.5 +/- 8.9%). While 82% of respondents expressed confidence in measures undertaken by Tan Tock Seng Hospital (the hospital designated to manage SARS), only 36% had confidence in nursing homes. However, >80% of the public agreed that the preventive and control measures instituted were appropriate. Despite the low knowledge score, the overall mean satisfaction score of the government's response to SARS was 4.47 (out of possible highest score of 5.00), with >93% of adult Singaporeans indicating that they were satisfied or very satisfied with the government's response to SARS. Generally, Singaporeans had a high level of public trust (satisfaction with government, confidence in institutions, deeming government measures appropriate), scoring 11.4 out of possible maximum of 14. The disparity between low knowledge on the one hand and high confidence and trust in the actions of the government on the other suggests that Singaporeans do not require high knowledge sufficiency to be confident in measures undertaken by the government to control the SARS crisis.

Limited Health Literacy is a Barrier to Medication Reconciliation in Ambulatory Care

PubMed Central

Persell, Stephen D.; Osborn, Chandra Y.; Richard, Robert; Skripkauskas, Silvia

2007-01-01

Background Limited health literacy may influence patients’ ability to identify medications taken; a serious concern for ambulatory safety and quality. Objective To assess the relationship between health literacy, patient recall of antihypertensive medications, and reconciliation between patient self-report and the medical record. Design In-person interviews, literacy assessment, medical records abstraction. Participants Adults with hypertension at three community health centers. Measurement We measured health literacy using the short-form Test of Functional Health Literacy in Adults. Patients were asked about the medications they took for blood pressure. Their responses were compared with the medical record. Results Of 119 participants, 37 (31%) had inadequate health literacy. Patients with inadequate health literacy were less able to name any of their antihypertensive medications compared to those with adequate health literacy (40.5% vs 68.3%, p = 0.005). After adjusting for age and income, this difference remained (adjusted odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 1.3–6.7). Agreement between patient reported medications and the medical record was low: 64.9% of patients with inadequate and 37.8% with adequate literacy had no medications common to both lists. Conclusions Limited health literacy was associated with a greater number of unreconciled medications. Future studies should investigate how this may impact safety and hypertension control. PMID:17786521

High-temperature electronics applications in space exploration

NASA Astrophysics Data System (ADS)

Jurgens, R. F.

1982-05-01

One of the most exciting applications of high-temperature electronics is related to the exploration of the planet Venus. On this planet the atmospheric temperatures range from about 170 K at elevations of 100 km to a searing 730 K near the surface. Mechanisms for exploring the atmosphere might include balloons, airplanes, surface landers, and surface-launched probes. Balloons, for example, could fly in the region from 20 (320 C at 22 bars) to 60 km (-20 C at 0.2 bar). Suitable balloon fabrics presently exclude excursions to lower altitudes; however, adequate electronic systems could survive to 325 C. Small airplanes would require more sophisticated electronics for guidance and control. Long life surface landers would most likely be developed first, as these could be used to measure long-term variations in weather. Ranging transponders would be important for ephemeris development, measurement of spin state, and studies of general relativity. Surface temperatures of 460 C and pressures of 90 bars present a challenge to the developers of such instruments. Other space applications for high-temperature electronics include transponders for the surface of Mercury, near solar drag-free orbiters, and deep atmospheric penetrators for Jupiter and Saturn. Each of these has its own particular problems with respect to instrumentation adequate to meet the desired scientific goals. This paper is primarily concerned with defining possible mission applications, the required electronic systems, and the approaches that are currently being studied for their development.

High-temperature electronics applications in space exploration

NASA Technical Reports Server (NTRS)

Jurgens, R. F.

1982-01-01

One of the most exciting applications of high-temperature electronics is related to the exploration of the planet Venus. On this planet the atmospheric temperatures range from about 170 K at elevations of 100 km to a searing 730 K near the surface. Mechanisms for exploring the atmosphere might include balloons, airplanes, surface landers, and surface-launched probes. Balloons, for example, could fly in the region from 20 (320 C at 22 bars) to 60 km (-20 C at 0.2 bar). Suitable balloon fabrics presently exclude excursions to lower altitudes; however, adequate electronic systems could survive to 325 C. Small airplanes would require more sophisticated electronics for guidance and control. Long life surface landers would most likely be developed first, as these could be used to measure long-term variations in weather. Ranging transponders would be important for ephemeris development, measurement of spin state, and studies of general relativity. Surface temperatures of 460 C and pressures of 90 bars present a challenge to the developers of such instruments. Other space applications for high-temperature electronics include transponders for the surface of Mercury, near solar drag-free orbiters, and deep atmospheric penetrators for Jupiter and Saturn. Each of these has its own particular problems with respect to instrumentation adequate to meet the desired scientific goals. This paper is primarily concerned with defining possible mission applications, the required electronic systems, and the approaches that are currently being studied for their development.

Adapting Social Neuroscience Measures for Schizophrenia Clinical Trials, Part 2: Trolling the Depths of Psychometric Properties

PubMed Central

Kern, Robert S.

2013-01-01

The psychometric properties of 4 paradigms adapted from the social neuroscience literature were evaluated to determine their suitability for use in clinical trials of schizophrenia. This 2-site study (University of California, Los Angeles and University of North Carolina) included 173 clinically stable schizophrenia outpatients and 88 healthy controls. The social cognition battery was administered twice to the schizophrenia group (baseline, 4-week retest) and once to the control group. The 4 paradigms included 2 that assess perception of nonverbal social and action cues (basic biological motion and emotion in biological motion) and 2 that involve higher level inferences about self and others’ mental states (self-referential memory and empathic accuracy). Each paradigm was evaluated on (1) patient vs healthy control group differences, (2) test-retest reliability, (3) utility as a repeated measure, and (4) tolerability. Of the 4 paradigms, empathic accuracy demonstrated the strongest characteristics, including large between-group differences, adequate test-retest reliability (.72), negligible practice effects, and good tolerability ratings. The other paradigms showed weaker psychometric characteristics in their current forms. These findings highlight challenges in adapting social neuroscience paradigms for use in clinical trials. PMID:24072805

Challenges and opportunities in establishing scientific and regulatory standards for determining therapeutic equivalence of modified-release products: Workshop summary report.

PubMed

Chen, Mei-Ling; Shah, Vinod P; Ganes, Derek; Midha, Kamal K; Caro, James; Nambiar, Prabu; Rocci, Mario L; Thombre, Avinash G; Abrahamsson, Bertil; Conner, Dale; Davit, Barbara; Fackler, Paul; Farrell, Colm; Gupta, Suneel; Katz, Russell; Mehta, Mehul; Preskorn, Sheldon H; Sanderink, Gerard; Stavchansky, Salomon; Temple, Robert; Wang, Yaning; Winkle, Helen; Yu, Lawrence

2010-09-01

Modified-release (MR) products are complex dosage forms designed to release drug in a controlled manner to achieve the desired efficacy and safety profiles. Inappropriate control of drug release from such products may result in reduced efficacy or increased toxicity. This paper is a summary report of the American Association of Pharmaceutical Scientists, International Pharmaceutical Federation, and Product Quality Research Institute workshop titled "Challenges and Opportunities in Establishing Scientific and Regulatory Standards for Assuring Therapeutic Equivalence of Modified Release Products", held October 1-2, 2009, in Baltimore, Maryland. The workshop provided an opportunity for pharmaceutical scientists from academia, industry, and regulatory agencies to discuss current regulatory expectations and industry practices for evaluating the pharmaceutical equivalence and bioequivalence of oral MR products. In the case of conventional monophasic MR formulations, the current regulatory approaches and criteria for bioequivalence evaluation were considered adequate for the assessment of therapeutic equivalence and inter-changeability of drug products. Additional measures may occasionally be needed to determine the bioequivalence of multiphasic MR products. The metric of partial AUC proposed by the US Food and Drug Administration received broad support as an additional measure for evaluating bioequivalence of multiphasic MR products designed to have a rapid onset of drug action followed by sustained response. The cutoff for partial AUCs may be based on the pharmacokinetic/pharmacodynamic or pharmacokinetic/ response characteristics of the products under examination. If the new metric is highly variable, the bioequivalence limits may be set based on the known within-subject variability for the reference product. The current regulatory approaches and criteria for bioequivalence evaluation were considered adequate for the assessment of therapeutic equivalence and interchangeability of conventional monophasic MR products. Additional measures may occasionally be needed to establish the bioequivalence of multiphasic MR products, and development of such measures is an important objective. The metric of partial AUC was proposed for products designed to have a rapid drug action followed by sustained response. Copyright © 2010 Excerpta Medica Inc. All rights reserved.

Bone mass and vitamin D levels in Parkinson's disease: is there any difference between genders?

PubMed

Ozturk, Erhan Arif; Gundogdu, Ibrahim; Tonuk, Burak; Kocer, Bilge Gonenli; Tombak, Yasemin; Comoglu, Selcuk; Cakci, Aytul

2016-08-01

[Purpose] The aim of this study was to determine the bone mineral density, vitamin D level, and frequencies of osteopenia and osteoporosis in patients with Parkinson's disease and to compare male and female patients with the controls separately. [Subjects and Methods] One hundred fifteen Parkinson's disease patients (47 males, 68 females; age range: 55-85 years) and 117 age- and gender-matched controls (47 males, 70 females) were enrolled in the study. Bone mineral density measured by dual-energy X-ray absorptiometry and serum D vitamin levels of each participant were recorded. [Results] The mean lumbar spine, femur neck, and total femur bone mineral density levels, T-scores, and vitamin D levels were found to be significantly lower in Parkinson's disease patients in both genders. Furthermore, osteoporosis rates were found be significantly higher only in female Parkinson's disease patients compared with female controls. [Conclusion] Data from the present study revealed that while osteoporosis was significantly higher only in female Parkinson's disease patients, all Parkinson's disease patients had lower bone mineral density scores and vitamin D levels compared with the controls regardless of gender, suggesting that clinicians should pay attention to the osteoporosis risk in Parkinson's disease and that adequate preventive measures should be taken in order to limit the future risk due to osteoporotic fractures.

75 FR 16235 - Electronic Prescriptions for Controlled Substances

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-31

... 21 of the Code of Federal Regulations (CFR), Parts 1300 to 1399. These regulations are designed to ensure an adequate supply of controlled substances for legitimate medical, scientific, research, and... research or chemical analysis with controlled substances must register with DEA (unless exempt) and comply...

Multicriteria methodological approach to manage urban air pollution

NASA Astrophysics Data System (ADS)

Vlachokostas, Ch.; Achillas, Ch.; Moussiopoulos, N.; Banias, G.

2011-08-01

Managing urban air pollution necessitates a feasible and efficient abatement strategy which is characterised as a defined set of specific control measures. In practice, hard budget constraints are present in any decision-making process and therefore available alternatives need to be hierarchised in a fast but still reliable manner. Moreover, realistic strategies require adequate information on the available control measures, taking also into account the area's special characteristics. The selection of the most applicable bundle of measures rests in achieving stakeholders' consensus, while taking into consideration mutually conflicting views and criteria. A preliminary qualitative comparison of alternative control measures would be most handy for decision-makers, forming the grounds for an in-depth analysis of the most promising ones. This paper presents an easy-to-follow multicriteria methodological approach in order to include and synthesise multi-disciplinary knowledge from various stakeholders so as to result into a priority list of abatement options, achieve consensus and secure the adoption of the resulting optimal solution. The approach relies on the active involvement of public authorities and local stakeholders in order to incorporate their environmental, economic and social preferences. The methodological scheme is implemented for the case of Thessaloniki, Greece, an area considered among the most polluted cities within Europe, especially with respect to airborne particles. Intense police control, natural gas penetration in buildings and metro construction equally result into the most "promising" alternatives in order to control air pollution in the GTA. The three optimal alternatives belong to different thematic areas, namely road transport, thermal heating and infrastructure. Thus, it is obvious that efforts should spread throughout all thematic areas. Natural gas penetration in industrial units, intense monitoring of environmental standards and regular maintenance of heavy oil burners are ranked as 4th, 5th and 6th optimal alternatives, respectively.

Ares-I-X Stability and Control Flight Test: Analysis and Plans

NASA Technical Reports Server (NTRS)

Brandon, Jay M.; Derry, Stephen D.; Heim, Eugene H.; Hueschen, Richard M.; Bacon, Barton J.

2008-01-01

The flight test of the Ares I-X vehicle provides a unique opportunity to reduce risk of the design of the Ares I vehicle and test out design, math modeling, and analysis methods. One of the key features of the Ares I design is the significant static aerodynamic instability coupled with the relatively flexible vehicle - potentially resulting in a challenging controls problem to provide adequate flight path performance while also providing adequate structural mode damping and preventing adverse control coupling to the flexible structural modes. Another challenge is to obtain enough data from the single flight to be able to conduct analysis showing the effectiveness of the controls solutions and have data to inform design decisions for Ares I. This paper will outline the modeling approaches and control system design to conduct this flight test, and also the system identification techniques developed to extract key information such as control system performance (gain/phase margins, for example), structural dynamics responses, and aerodynamic model estimations.

A study of sertraline in dialysis (ASSertID): a protocol for a pilot randomised controlled trial of drug treatment for depression in patients undergoing haemodialysis.

PubMed

Friedli, Karin; Almond, Michael; Day, Clara; Chilcot, Joseph; Gane, Maria da Silva; Davenport, Andrew; Guirguis, Ayman; Fineberg, Naomi; Spencer, Benjamin; Wellsted, David; Farrington, Ken

2015-10-26

The prevalence of depression in people receiving haemodialysis is high with estimates varying between 20 and 40 %. There is little research on the effectiveness of antidepressants in dialysis patients with the few clinical trials suffering significant methodological issues. We plan to carry out a study to evaluate the feasibility of conducting a randomised controlled trial in patients on haemodialysis who have diagnosed Major Depressive Disorder. The study has two phases, a screening phase and the randomised controlled trial. Patients will be screened initially with the Beck Depression Inventory to estimate the number of patients who score 16 or above. These patients will be invited to an interview with a psychiatrist who will invite those with a diagnosis of Major Depressive Disorder to take part in the trial. Consenting patients will be randomised to either Sertraline or placebo. Patients will be followed-up for 6 months. Demographic and clinical data will be collected at screening interview, baseline interview and 2 weeks, and every month (up to 6 months) after baseline. The primary outcome is to evaluate the feasibility of conducting a randomised, double blind, placebo pilot trial in haemodialysis patients with depression. Secondary outcomes include estimation of the variability in the outcome measures for the treatment and placebo arms, which will allow for a future adequately powered definitive trial. Analysis will primarily be descriptive, including the number of patients eligible for the trial, drug exposure of Sertraline in haemodialysis patients and the patient experience of participating in this trial. There is an urgent need for this research in the dialysis population because of the dearth of good quality and adequately powered studies. Research with renal patients is particularly difficult as they often have complex medical needs. This research will therefore not only assess the outcome of anti-depressants in haemodialysis patients with depression but also the process of running a randomised controlled trial in this population. Hence, the outputs of this feasibility study will be used to inform the design and methodology of a definitive study, adequately powered to determine the efficacy of anti-depressants in patient on haemodialysis with depression. ISRCTN registry ISRCTN06146268 and EudraCT reference: 2012-000547-27.

Measuring the RC time constant with Arduino

NASA Astrophysics Data System (ADS)

Pereira, N. S. A.

2016-11-01

In this work we use the Arduino UNO R3 open source hardware platform to assemble an experimental apparatus for the measurement of the time constant of an RC circuit. With adequate programming, the Arduino is used as a signal generator, a data acquisition system and a basic signal visualisation tool. Theoretical calculations are compared with direct observations from an analogue oscilloscope. Data processing and curve fitting is performed on a spreadsheet. The results obtained for the six RC test circuits are within the expected interval of values defined by the tolerance of the components. The hardware and software prove to be adequate to the proposed measurements and therefore adaptable to a laboratorial teaching and learning context.

Exploring the Factor Structure of a Recovery Assessment Measure among Substance-Abusing Youth.

PubMed

Gonzales, Rachel; Hernandez, Mayra; Douglas, Samantha B; Yu, Chong Ho

2015-01-01

To date, the measurement of recovery in the field of substance abuse is limited. Youth recovery from substance abuse is an important area to consider, given the complexities of such issues. The Recovery Assessment Scale (RAS) has been validated with mental health patient populations; however, its measurement characteristics have not been examined for individuals in substance abuse treatment. The current study explored the factor structure of the RAS with a sample of 80 substance-abusing youth who participated in a pilot aftercare study (Mage 20.5, SD=3.5; 71.3% male). Reliability analysis showed an internal consistency of α=.90 for the entire RAS measure among the youth sample. Results of exploratory factor analysis identified the following four factors: personal determination, skills for recovery, self-control in recovery, and social support/moving beyond recovery among the substance-abusing youth sample. The RAS also demonstrated sound convergent and divergent validity in comparison to other validated measures of functioning, sobriety, and well-being. Collectively, results support that the RAS has adequate psychometric properties for measuring recovery among substance-abusing youth.

Metal composite as backing for ultrasonic transducers dedicated to non-destructive measurements in hostile

NASA Astrophysics Data System (ADS)

Boubenia, R.; Rosenkrantz, E.; Despetis, F.; P, P.; Ferrandis, J.-Y.

2016-03-01

Our team is specialized in ultrasonic measurements in hostile environment especially under high temperatures. There is a need for acoustic transducers capable of continuous measurement at temperatures up to 700°C. To improve the performances of acoustic sensors we focus our works on the realisation and characterisation of transducer backings able to operate under very high temperature. Commercially, they are produced by the incorporation of tungsten powder in a plastic matrix, which limits the working temperature. The realisation of ultrasonic transducers for non-destructive measures at high temperatures requires adequate materials, manufacturing and assembly processes. To produce the backings, composites were made using very ductile metals such as tin and tungsten. These composites are manufactured by uniaxial hot pressing. First, we studied the influence of temperature and pressure on the densification of tin pellets. Then, several specimens made of tin/W were made and characterised by measuring the specific weight, speed and attenuation of sound. The acoustic measures were realised by ultrasonic spectroscopy. This test-bench was designed and tested on control samples of PMMA and on standard backings (epoxy / tungsten).

Spacecraft Jitter Attenuation Using Embedded Piezoelectric Actuators

NASA Technical Reports Server (NTRS)

Belvin, W. Keith

1995-01-01

Remote sensing from spacecraft requires precise pointing of measurement devices in order to achieve adequate spatial resolution. Unfortunately, various spacecraft disturbances induce vibrational jitter in the remote sensing instruments. The NASA Langley Research Center has performed analysis, simulations, and ground tests to identify the more promising technologies for minimizing spacecraft pointing jitter. These studies have shown that the use of smart materials to reduce spacecraft jitter is an excellent match between a maturing technology and an operational need. This paper describes the use of embedding piezoelectric actuators for vibration control and payload isolation. In addition, recent advances in modeling, simulation, and testing of spacecraft pointing jitter are discussed.

21 CFR 314.126 - Adequate and well-controlled studies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... permits a valid comparison with a control to provide a quantitative assessment of drug effect. The... data analyses performed. (c) The Director of the Center for Drug Evaluation and Research may, on the...

21 CFR 314.126 - Adequate and well-controlled studies.

Code of Federal Regulations, 2012 CFR

2012-04-01

... permits a valid comparison with a control to provide a quantitative assessment of drug effect. The... data analyses performed. (c) The Director of the Center for Drug Evaluation and Research may, on the...

21 CFR 314.126 - Adequate and well-controlled studies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... permits a valid comparison with a control to provide a quantitative assessment of drug effect. The... data analyses performed. (c) The Director of the Center for Drug Evaluation and Research may, on the...

21 CFR 314.126 - Adequate and well-controlled studies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... permits a valid comparison with a control to provide a quantitative assessment of drug effect. The... data analyses performed. (c) The Director of the Center for Drug Evaluation and Research may, on the...

21 CFR 314.126 - Adequate and well-controlled studies.

Code of Federal Regulations, 2014 CFR

2014-04-01

... permits a valid comparison with a control to provide a quantitative assessment of drug effect. The... data analyses performed. (c) The Director of the Center for Drug Evaluation and Research may, on the...

The Contractor's Role in Competitive Bid Construction.

ERIC Educational Resources Information Center

Toy, G. Arlan

1986-01-01

In a competitive bid situation, the general contractor's first priority is controlling construction costs. The actions the general contractor take focus on adequate control, effective communication, efficient use of resources, and prevention of delays. (MLF)

Radioactivity measurement of radioactive contaminated soil by using a fiber-optic radiation sensor

NASA Astrophysics Data System (ADS)

Joo, Hanyoung; Kim, Rinah; Moon, Joo Hyun

2016-06-01

A fiber-optic radiation sensor (FORS) was developed to measure the gamma radiation from radioactive contaminated soil. The FORS was fabricated using an inorganic scintillator (Lu,Y)2SiO5:Ce (LYSO:Ce), a mixture of epoxy resin and hardener, aluminum foil, and a plastic optical fiber. Before its real application, the FORS was tested to determine if it performed adequately. The test result showed that the measurements by the FORS adequately followed the theoretically estimated values. Then, the FORS was applied to measure the gamma radiation from radioactive contaminated soil. For comparison, a commercial radiation detector was also applied to measure the same soil samples. The measurement data were analyzed by using a statistical parameter, the critical level to determine if net radioactivity statistically different from background was present in the soil sample. The analysis showed that the soil sample had radioactivity distinguishable from background.

Case study of controlled recirculation at a Wyoming trona mine

PubMed Central

Pritchard, C.; Scott, D.; Frey, G.

2015-01-01

Controlled recirculation has been used in the metal/nonmetal mining industry for energy savings when heating and cooling air, in undersea mining and for increasing airflow to mining areas. For safe and effective use of controlled district recirculation, adequate airflow to dilute contaminants must exist prior to implementation, ventilation circuit parameters must be accurately quantified, ventilation network modeling must be up to date, emergency planning scenarios must be performed and effective monitoring and control systems must be installed and used. Safety and health issues that must be considered and may be improved through the use of controlled district recirculation include blasting fumes, dust, diesel emissions, radon and contaminants from mine fires. Controlled recirculation methods are expected to become more widely used as mines reach greater working depths, requiring that these health and safety issues be well understood. The U.S. National Institute for Occupational Safety and Health (NIOSH) conducted two controlled recirculation tests over three days at a Wyoming trona mine, utilizing an inline booster fan to improve airflow to a remote and difficult-to-ventilate development section. Test results were used to determine the effect that recirculation had on air qualities and quantities measured in that section and in other adjacent areas. Pre-test conditions, including ventilation quantities and pressures, were modeled using VnetPC. During each test, ventilation quantities and pressures were measured, as well as levels of total dust. Sulfur hexafluoride (SF6) tracer gas was used to simulate a mine contaminant to monitor recirculation wave cycles. Results showed good correlation between the model results and measured values for airflows, pressure differentials, tracer gas arrival times, mine gasses and dust levels. PMID:26251567

THE EFFECTIVENESS OF QUADRATS FOR MEASURING VASCULAR PLANT DIVERSITY

EPA Science Inventory

Quadrats are widely used for measuring characteristics of vascular plant communities. It is well recognized that quadrat size affects measurements of frequency and cover. The ability of quadrats of varying sizes to adequately measure diversity has not been established. An exha...

Measurement of asthma control according to Global Initiative for Asthma guidelines: a comparison with the Asthma Control Questionnaire.

PubMed

Olaguibel, José María; Quirce, Santiago; Juliá, Berta; Fernández, Cristina; Fortuna, Ana María; Molina, Jesús; Plaza, Vicente

2012-06-22

Asthma Control Questionnaire (ACQ) is a validated tool to measure asthma control. Cut-off points that best discriminate "well-controlled" or "not well-controlled" asthma have been suggested from the analysis of a large randomized clinical trial but they may not be adequate for daily clinical practice. To establish cut-off points of the ACQ that best discriminate the level of control according to Global Initiative for Asthma (GINA) 2006 guidelines in patients with asthma managed at Allergology and Pulmonology Departments as well as Primary Care Centers in Spain. An epidemiological descriptive study, with prospective data collection. Asthma control following GINA-2006 classification and 7-item ACQ was assessed. The study population was split in two parts: 2/3 for finding the cut-off points (development population) and 1/3 for validating the results (validation population). A total of 1,363 stable asthmatic patients were included (mean age 38 ± 14 years, 60.3% women; 69.1% non-smokers). Patient classification according to GINA-defined asthma control was: controlled 13.6%, partially controlled 34.2%, and uncontrolled 52.3%. The ACQ cut-off points that better agreed with GINA-defined asthma control categories were calculated using receiver operating curves (ROC). The analysis showed that ACQ < 0.5 was the optimal cut-off point for "controlled asthma" (sensitivity 74.1%, specificity 77.5%) and 1.00 for "uncontrolled asthma" (sensitivity 73%, specificity 88.2%). Kappa index between GINA categories and ACQ was 0.62 (p < 0.001). The ACQ cut-off points associated with GINA-defined asthma control in a real-life setting were <0.5 for controlled asthma and ≥1 for uncontrolled asthma.

Possible environmental effects of increased coal use in California

NASA Technical Reports Server (NTRS)

Carey, D. L.

1978-01-01

If coal is to be utilized in California it must be made compatible with the state's drive toward restoring environmental quality. The impacts resulting from coal's mining and transportation, or from water consumption, water quality degradation and electric transmission line routing can probably be adequately mitigated through strong and early planning efforts, the use of improved control and process technologies, and sincere utility commitment. The socioeconomic impacts may prove somewhat more difficult to satisfactorily mitigate. Of greatest concern is adequate control of generated air pollutants and disposal of solid and liquid wastes since acceptable technologies or handling techniques have yet to be conclusively demonstrated.

14 CFR 139.329 - Pedestrians and ground vehicles.

Code of Federal Regulations, 2010 CFR

2010-01-01

... by an employee, tenant, or contractor; (c) When an air traffic control tower is in operation, ensure... between the tower and the pedestrian, vehicle, or escort; (d) When an air traffic control tower is not in operation, or there is no air traffic control tower, provide adequate procedures to control pedestrians and...

40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Federal agency. (a) Certain biological control agents. (1) Except as provided by paragraphs (a)(3) and (a)(4) of this section, all biological control agents are exempt from FIFRA requirements. (2) If the Agency determines that an individual biological control agent or class of biological control agents is no...

40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Federal agency. (a) Certain biological control agents. (1) Except as provided by paragraphs (a)(3) and (a)(4) of this section, all biological control agents are exempt from FIFRA requirements. (2) If the Agency determines that an individual biological control agent or class of biological control agents is no...

What Is Asthma Control? Discrepancies between Parents' Perceptions and Official Definitions

ERIC Educational Resources Information Center

Dozier, Ann; Aligne, C. Andrew; Schlabach, Mary Beth

2006-01-01

National guidelines define asthma control as the prevention of asthma symptoms rather than the treatment of asthma exacerbations. We hypothesized that we would find a discrepancy between what parents consider adequate control compared to what health care professionals mean by "control." Data from a telephone survey conducted for the…

36 CFR 72.36 - Land ownership, control and conversion.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Land ownership, control and..., Rehabilitation and Innovation § 72.36 Land ownership, control and conversion. Section 1010 of the Act provides...-grantee must demonstrate, at the time of grant approval, that it has adequate tenure and control of the...

36 CFR 72.36 - Land ownership, control and conversion.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Land ownership, control and..., Rehabilitation and Innovation § 72.36 Land ownership, control and conversion. Section 1010 of the Act provides...-grantee must demonstrate, at the time of grant approval, that it has adequate tenure and control of the...

36 CFR 72.36 - Land ownership, control and conversion.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Land ownership, control and..., Rehabilitation and Innovation § 72.36 Land ownership, control and conversion. Section 1010 of the Act provides...-grantee must demonstrate, at the time of grant approval, that it has adequate tenure and control of the...

36 CFR 72.36 - Land ownership, control and conversion.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Land ownership, control and..., Rehabilitation and Innovation § 72.36 Land ownership, control and conversion. Section 1010 of the Act provides...-grantee must demonstrate, at the time of grant approval, that it has adequate tenure and control of the...

36 CFR 72.36 - Land ownership, control and conversion.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Land ownership, control and..., Rehabilitation and Innovation § 72.36 Land ownership, control and conversion. Section 1010 of the Act provides...-grantee must demonstrate, at the time of grant approval, that it has adequate tenure and control of the...

Complementary modulation of N2 and CRN by conflict frequency.

PubMed

Grützmann, Rosa; Riesel, Anja; Klawohn, Julia; Kathmann, Norbert; Endrass, Tanja

2014-08-01

The present study investigated the modulation of the N2 and the correct-related negativity (CRN) by conflict frequency. Conflict costs, as measured by reaction times and error rate, were reduced with increasing conflict frequency, indicating improved conflict resolution. N2 amplitudes in incompatible trials increased with higher conflict frequency, while postresponse CRN amplitudes decreased. In concert with behavioral findings of reduced conflict costs and greater interference suppression, the increase of N2 might reflect enhanced conflict resolution during stimulus processing. The CRN, however, might reflect postresponse implementation of cognitive control, which is reduced when conflict is already adequately resolved during stimulus processing. Furthermore, N2 and CRN in incompatible trials were inversely related on the between- and within-subject level, implying that the two modes of implementing cognitive control are applied complementarily. Copyright © 2014 Society for Psychophysiological Research.

Discrete-time pilot model. [human dynamics and digital simulation

NASA Technical Reports Server (NTRS)

Cavalli, D.

1978-01-01

Pilot behavior is considered as a discrete-time process where the decision making has a sequential nature. This model differs from both the quasilinear model which follows from classical control theory and from the optimal control model which considers the human operator as a Kalman estimator-predictor. An additional factor considered is that the pilot's objective may not be adequately formulated as a quadratic cost functional to be minimized, but rather as a more fuzzy measure of the closeness with which the aircraft follows a reference trajectory. All model parameters, in the digital program simulating the pilot's behavior, were successfully compared in terms of standard-deviation and performance with those of professional pilots in IFR configuration. The first practical application of the model was in the study of its performance degradation when the aircraft model static margin decreases.

Measuring neuroleptic-induced akathisia by three-channel actometry.

PubMed

Tuisku, K; Lauerma, H; Holi, M; Markkula, J; Rimon, R

1999-11-30

Three-channel actometry was used to study neuroleptic-induced akathisia (NIA), a common and often serious disorder in association of traditional neuroleptic therapy. The aim was to explore the diagnostic possibilities of actometry in NIA and to examine in detail the motor phenomenology of the disorder in detail. The actometers were attached to the ankles and waists of ten patients, suffering from NIA, and to ten matched healthy controls. Five of the patients were changed to olanzapine treatment, and these patients were re-examined during the no-NIA condition. NIA was associated with manyfold movement activity during controlled rest (sitting) but not with increased daily overall motor activity. Movement frequencies in NIA seemed to be pathognomonic. Actometry is promising for investigation and clinical assessment of NIA. Olanzapine proved to be an adequate treatment choice for NIA patients.

Meeting the Challenge of Adequate Yearly Progress: How One School Is Learning to Leave No Child Behind

ERIC Educational Resources Information Center

Richardson, Jacqueline S.; Soltez, Jeff

2003-01-01

This article describes the step-by-step process Ross Elementary in Topeka, Kan., used to achieve Adequate Yearly Progress (AYP) in accordance with the No Child Left Behind Act of 2001. A simple process of using teamwork, setting specific measurable goals, and frequent monitoring of student progress toward these goals allowed Ross to significantly…

Design of a Far-Infrared Spectrometer for Atmospheric Thermal Emission Measurements

NASA Technical Reports Server (NTRS)

Johnson, David G.

2004-01-01

Global measurements of far infrared emission from the upper troposphere are required to test models of cloud radiative forcing, water vapor continuum emission, and cooling rates. Spectra with adequate resolution can also be used for retrieving atmospheric temperature and humidity profiles, and yet there are few spectrally resolved measurements of outgoing longwave flux at wavelengths longer than 16 m. It has been difficult to make measurements in the far infrared due to the need for liquid-helium cooled detectors and large optics to achieve adequate sensitivity and bandwidth. We review design considerations for infrared Fourier transform spectrometers, including the dependence of system performance on basic system parameters, and discuss the prospects for achieving useful sensitivity from a satellite platform with a lightweight spectrometer using uncooled detectors.

Multiresponse modeling of variably saturated flow and isotope tracer transport for a hillslope experiment at the Landscape Evolution Observatory

NASA Astrophysics Data System (ADS)

Scudeler, Carlotta; Pangle, Luke; Pasetto, Damiano; Niu, Guo-Yue; Volkmann, Till; Paniconi, Claudio; Putti, Mario; Troch, Peter

2016-10-01

This paper explores the challenges of model parameterization and process representation when simulating multiple hydrologic responses from a highly controlled unsaturated flow and transport experiment with a physically based model. The experiment, conducted at the Landscape Evolution Observatory (LEO), involved alternate injections of water and deuterium-enriched water into an initially very dry hillslope. The multivariate observations included point measures of water content and tracer concentration in the soil, total storage within the hillslope, and integrated fluxes of water and tracer through the seepage face. The simulations were performed with a three-dimensional finite element model that solves the Richards and advection-dispersion equations. Integrated flow, integrated transport, distributed flow, and distributed transport responses were successively analyzed, with parameterization choices at each step supported by standard model performance metrics. In the first steps of our analysis, where seepage face flow, water storage, and average concentration at the seepage face were the target responses, an adequate match between measured and simulated variables was obtained using a simple parameterization consistent with that from a prior flow-only experiment at LEO. When passing to the distributed responses, it was necessary to introduce complexity to additional soil hydraulic parameters to obtain an adequate match for the point-scale flow response. This also improved the match against point measures of tracer concentration, although model performance here was considerably poorer. This suggests that still greater complexity is needed in the model parameterization, or that there may be gaps in process representation for simulating solute transport phenomena in very dry soils.

Clinical Application of Insertion Force Sensor System for Coil Embolization of Intracranial Aneurysms.

PubMed

Matsubara, Noriaki; Miyachi, Shigeru; Izumi, Takashi; Yamada, Hiroyuki; Marui, Naoki; Ota, Keisuke; Tajima, Hayato; Shintai, Kazunori; Ito, Masashi; Imai, Tasuku; Nishihori, Masahiro; Wakabayashi, Toshihiko

2017-09-01

In endovascular embolization for intracranial aneurysms, it is important to properly control the coil insertion force. However, the force can only be subjectively detected by the subtle feedback experienced by neurointerventionists at their fingertips. The authors envisioned a system that would objectively sense and quantify that force. In this article, coil insertion force was measured in cases of intracranial aneurysm using this sensor, and its actual clinical application was investigated. The sensor consists of a hemostatic valve (Y-connector). A little flexure was intentionally added in the device, and it creates a bend in the delivery wire. The sensor measures the change in the position of the bent wire depending on the insertion force and translates it into a force value. Using this, embolization was performed for 10 unruptured intracranial aneurysms. The sensor adequately recorded the force, and it reflected the operators' usual clinical experience. The presence of the sensor did not affect the procedures. The sensor enabled the operators to objectively note and evaluate the insertion force and better cooperative handling was possible. Additionally, other members of the intervention team shared the information. Force records demonstrated the characteristic patterns according to every stage of coiling (framing, filling, and finishing). The force sensor system adequately measured coil insertion force in intracranial aneurysm coil embolization procedures. The safety of this sensor was demonstrated in clinical application for the limited number of patients. This system is useful adjunct for assisting during coil embolization for an intracranial aneurysm. Copyright © 2017 Elsevier Inc. All rights reserved.

40 CFR 725.428 - Requirements for the Tier II exemption.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SUBSTANCES CONTROL ACT REPORTING REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS General Exemptions for... material meets the criteria under § 725.421. (c) Adequate physical containment and control technologies are used. The criteria listed under § 725.422 for physical containment and control technologies of...

[Development of external quality control protocol for CyberKnife beams dosimetry: preliminary tests multicentre].

PubMed

Guinement, L; Marchesi, V; Veres, A; Lacornerie, T; Buchheit, I; Peiffert, D

2013-01-01

To develop an external quality control procedure for CyberKnife(®) beams. This work conducted in Nancy, has included a test protocol initially drawn by the medical physicist of Nancy and Lille in collaboration with Equal-Estro Laboratory. A head and neck anthropomorphic phantom and a water-equivalent homogeneous cubic plastic test-object, so-called "MiniCube", have been used. Powder and solid thermoluminescent dosimeters as well as radiochromic films have been used to perform absolute and relative dose studies, respectively. The comparison between doses calculated by Multiplan treatment planning system and measured doses have been studied in absolute dose. The dose distributions measured with films and treatment planning system calculations have been compared via the gamma function, configured with different tolerance criteria. This work allowed, via solid thermoluminescent dosimeter measurements, verifying the beam reliability with a reproducibility of 1.7 %. The absolute dose measured in the phantom irradiated by the seven participating centres has shown an error inferior to the standard tolerance limits (± 5 %), for most of participating centres. The relative dose measurements performed at Nancy and by the Equal-Estro laboratory allowed defining the most adequate parameters for gamma index (5 %/2mm--with at least 95 % of pixels satisfying acceptability criteria: γ<1). These parameters should be independent of the film analysis software. This work allowed defining a dosimetric external quality control for CyberKnife(®) systems, based on a reproducible irradiation plan through measurements performed with thermoluminescent dosimeters and radiochromic films. This protocol should be validated by a new series of measurement and taking into account the lessons of this work. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Are Substance Use Prevention Programs More Effective in Schools Making Adequate Yearly Progress? A Study of Project ALERT

ERIC Educational Resources Information Center

Clark, Heddy Kovach; Ringwalt, Chris L.; Shamblen, Stephen R.; Hanley, Sean M.; Flewelling, Robert L.

2011-01-01

This exploratory study sought to determine if a popular school-based drug prevention program might be effective in schools that are making adequate yearly progress (AYP). Thirty-four schools with grades 6 through 8 in 11 states were randomly assigned either to receive Project ALERT (n = 17) or to a control group (n = 17); of these, 10 intervention…

Army General Fund Adjustments Not Adequately Documented or Supported

DTIC Science & Technology

2016-07-26

compilation process. Finding The Office of the Assistant Secretary of the Army (Financial Management & Comptroller) (OASA[FM&C]) and the Defense Finance and...statements were unreliable and lacked an adequate audit trail. Furthermore, DoD and Army managers could not rely on the data in their accounting...systems when making management and resource decisions. Until the Army and DFAS Indianapolis correct these control deficiencies, there is considerable

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?

Code of Federal Regulations, 2013 CFR

2013-07-01

... WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People... has maximized land ownership and/or controlled land use within the watershed. Disinfection Profile ...

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?

Code of Federal Regulations, 2011 CFR

2011-07-01

... WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People... has maximized land ownership and/or controlled land use within the watershed. Disinfection Profile ...

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?

Code of Federal Regulations, 2012 CFR

2012-07-01

... WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People... has maximized land ownership and/or controlled land use within the watershed. Disinfection Profile ...

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?

Code of Federal Regulations, 2014 CFR

2014-07-01

... WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People... has maximized land ownership and/or controlled land use within the watershed. Disinfection Profile ...

Breaking down patient and physician barriers to optimize glycemic control in type 2 diabetes.

PubMed

Ross, Stuart A

2013-09-01

Approximately half of patients with type 2 diabetes (T2D) do not achieve globally recognized blood glucose targets, despite the availability of a wide range of effective glucose-lowering therapies. Failure to maintain good glycemic control increases the risk of diabetes-related complications and long-term health care costs. Patients must be brought under glycemic control to improve treatment outcomes, but existing barriers to optimizing glycemic control must first be overcome, including patient nonadherence to treatment, the failure of physicians to intensify therapy in a timely manner, and inadequacies in the health care system itself. The reasons for such barriers include treatment side effects, complex treatment regimens, needle anxiety, poor patient education, and the absence of an adequate patient care plan; however, newer therapies and devices, combined with comprehensive care plans involving adequate patient education, can help to minimize barriers and improve treatment outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

Differentiating snail intermediate hosts of Schistosoma spp. using molecular approaches: fundamental to successful integrated control mechanism in Africa.

PubMed

Abe, Eniola Michael; Guan, Wei; Guo, Yun-Hai; Kassegne, Kokouvi; Qin, Zhi-Qiang; Xu, Jing; Chen, Jun-Hu; Ekpo, Uwem Friday; Li, Shi-Zhu; Zhou, Xiao-Nong

2018-03-26

Snail intermediate hosts play active roles in the transmission of snail-borne trematode infections in Africa. A good knowledge of snail-borne diseases epidemiology particularly snail intermediate host populations would provide the necessary impetus to complementing existing control strategy. This review highlights the importance of molecular approaches in differentiating snail hosts population structure and the need to provide adequate information on snail host populations by updating snail hosts genome database for Africa, in order to equip different stakeholders with adequate information on the ecology of snail intermediate hosts and their roles in the transmission of different diseases. Also, we identify the gaps and areas where there is need for urgent intervention to facilitate effective integrated control of schistosomiasis and other snail-borne trematode infections. Prioritizing snail studies, especially snail differentiation using molecular tools will boost disease surveillance and also enhance efficient schistosomaisis control programme in Africa.

Measurement techniques for analysis of fission fragment excited gases

NASA Technical Reports Server (NTRS)

Schneider, R. T.; Carroll, E. E.; Davis, J. F.; Davie, R. N.; Maguire, T. C.; Shipman, R. G.

1976-01-01

Spectroscopic analysis of fission fragment excited He, Ar, Xe, N2, Ne, Ar-N2, and Ne-N2 have been conducted. Boltzmann plot analysis of He, Ar and Xe have indicated a nonequilibrium, recombining plasma, and population inversions have been found in these gases. The observed radiating species in helium have been adequately described by a simple kinetic model. A more extensive model for argon, nitrogen and Ar-N2 mixtures was developed which adequately describes the energy flow in the system and compares favorably with experimental measurements. The kinetic processes involved in these systems are discussed.

An application of the theory of planned behavior--a randomized controlled food safety pilot intervention for young adults.

PubMed

Milton, Alyssa C; Mullan, Barbara A

2012-03-01

Approximately 48 million Americans are affected by foodborne illness each year. Evidence suggests that the application of health psychology theory to food safety interventions can increase behaviors that reduce the incidence of illness such as adequately keeping hands, surfaces and equipment clean. This aim of this pilot study was to be the first to explore the effectiveness of a food safety intervention based on the Theory of Planned Behavior (TPB). Young adult participants (N = 45) were randomly allocated to intervention, general control or mere measurement control conditions. Food safety observations and TPB measures were taken at baseline and at 4-week follow-up. Within and between group differences on target variables were considered and regression analyses were conducted to determine the relationship between condition, behavior and the TPB intention constructs; attitude, subjective norm, perceived behavioral control (PBC). TPB variables at baseline predicted observed food safety behaviors. At follow-up, the intervention led to significant increases in PBC (p = .024) and observed behaviors (p = .001) compared to both control conditions. Furthermore, correlations were found between observed and self-reported behaviors (p = .008). The pilot intervention supports the utility of the TPB as a method of improving food safety behavior. Changes in TPB cognitions appear to be best translated to behavior via behavioral intentions and PBC. Further research should be conducted to increase effectiveness of translating TPB variables to food safety behaviors. The additional finding of a correlation between self-reported and observed behavior also has implications for future research as it provides evidence toward the construct validity of self-reported behavioral measures.

Calcium hypochlorite as a disinfecting additive for dental stone.

PubMed

Twomey, Jonathan O; Abdelaziz, Khalid M; Combe, Edward C; Anderson, Dwight L

2003-09-01

Dental casts come into direct contact with impression materials and other items that are contaminated by saliva and blood from a patient's mouth, leaving the casts susceptible to cross-contamination. Topical methods of disinfecting casts are difficult to control, while immersion methods are potentially destructive. Thus, an additional method to control cross-contamination between patients and laboratory personnel is needed. This study was undertaken in an attempt to develop a dental stone with disinfecting properties and adequate compressive and tensile strengths. Calcium hypochlorite [Ca(OCl)(2)] in aqueous solution in concentrations from 0 to 1.5% was tested as a disinfecting additive to type V dental stone. The compressive and tensile strength properties of the modified stone were measured (MPa) using a universal testing machine at a consistency similar to unmodified stone. Strength data were analyzed by 1-way ANOVA and post hoc Tukey-Kramer procedure (alpha < or =.05). To measure the disinfecting ability, the effect on Bacillis subtilis bacteriophage phi29 was tested in triplicate to find the minimum concentration at which no phage was detected. Additionally, 3 impressions were disinfected with CaviCide, and 3 impressions rinsed in water served as controls. In general, the effect of adding the disinfectant to the stone was a decrease in strength. Exceptions were the dry compressive strength, for which there was a significant increase in strength (P=.048) at 0.5%, and the wet compressive and wet tensile strength, which showed no significant difference between the 1.5% and the control. When Ca(OCl)(2) was added at the concentration 0.5% (2765 ppm available chlorine), the gypsum had acceptable mechanical properties; dry compressive strength was 78.86 +/- 4.12 MPa, and dry tensile strength was 10.64 +/- 1.27 MPa, compared to control values of 67.85 +/- 6.28 and 13.41 +/- 1.24 MPa, respectively. At concentrations of 0.3% and higher (36 1650 ppm of available chlorine), calcium hypochlorite was able to completely inactivate phi29. It is possible to prepare a type V dental stone that contains a disinfectant, has adequate mechanical properties, and will reduce numbers of residual microorganisms. For example, stone mixed with water containing 0.5% Ca(OCl)(2) meets these criteria.

A multi-level intervention in subsidized housing sites to increase fruit and vegetable access and intake: Rationale, design and methods of the 'Live Well, Viva Bien' cluster randomized trial.

PubMed

Gans, Kim M; Gorham, Gemma; Risica, Patricia M; Dulin-Keita, Akilah; Dionne, Laura; Gao, Tina; Peters, Sarah; Principato, Ludovica

2016-06-28

Adequate fruit and vegetable (F&V) intake is important for disease prevention. Yet, most Americans, especially low-income and racial/ethnic minorities, do not eat adequate amounts. These disparities are partly attributable to food environments in low-income neighborhoods where residents often have limited access to affordable, healthful food and easy access to inexpensive, unhealthful foods. Increasing access to affordable healthful food in underserved neighborhoods through mobile markets is a promising, year-round strategy for improving dietary behaviors and reducing F&V intake disparities. However, to date, there have been no randomized controlled trials studying their effectiveness. The objective of the 'Live Well, Viva Bien' (LWVB) cluster randomized controlled trial is to evaluate the efficacy of a multicomponent mobile market intervention at increasing F&V intake among residents of subsidized housing complexes. One housing complex served as a pilot site for the intervention group and the remaining 14 demographically-matched sites were randomized into either the intervention or control group. The intervention group received bimonthly, discount, mobile, fresh F&V markets in conjunction with a nutrition education intervention (two F&V campaigns, newsletters, DVDs and cooking demonstrations) for 12 months. The control group received physical activity and stress reduction interventions. Outcome measures include F&V intake (measured by two validated F&V screeners at baseline, six-month and twelve-months) along with potential psychosocial mediating variables. Extensive quantitative and qualitative process evaluation was also conducted throughout the study. Modifying neighborhood food environments in ways that increase access to affordable, healthful food is a promising strategy for improving dietary behaviors among low-income, racial and ethnic minority groups at increased risk for obesity and other food-related chronic diseases. Discount, mobile F&V markets address all the major barriers to eating more F&V (high cost, poor quality, limited access and limited time to shop and cook) and provide a year-round solution to limited access to healthful food in low-income neighborhoods. LWVB is the first randomized controlled trial evaluating the effectiveness of mobile markets at increasing F&V intake. If proven efficacious at increasing F&V consumption, LWVB could be disseminated widely to neighborhoods that have low access to fresh F&V. Clinicatrials.gov registration number: NCT02669472 First Received: January 19, 2016.

Fluid Flow Technology that Measures Up

NASA Technical Reports Server (NTRS)

2004-01-01

From 1994 to 1996, NASA s Marshall Space Flight Center conducted a Center Director's Discretionary Fund research effort to apply artificial intelligence technologies to the health management of plant equipment and space propulsion systems. Through this effort, NASA established a business relationship with Quality Monitoring and Control (QMC), of Kingwood, Texas, to provide hardware modeling and artificial intelligence tools. Very detailed and accurate Space Shuttle Main Engine (SSME) analysis and algorithms were jointly created, which identified several missing, critical instrumentation needs for adequately evaluating the engine health status. One of the missing instruments was a liquid oxygen (LOX) flow measurement. This instrument was missing since the original SSME included a LOX turbine flow meter that failed during a ground test, resulting in considerable damage for NASA. New balanced flow meter technology addresses this need with robust, safe, and accurate flow metering hardware.

Advances in the management of multiple sclerosis symptoms: pathophysiology and assessment of spasticity in multiple sclerosis.

PubMed

Tintoré, Mar

2015-01-01

Spasticity is a prevalent and troublesome symptom for people with multiple sclerosis (MS). Common instruments to measure MS spasticity include the clinician-rated (modified) Ashworth scale and the patient-rated 0-10 spasticity Numerical Rating Scale (NRS). Current opinion is that measurement of MS spasticity should incorporate the patient's perspective. Other instruments to assess spasticity-associated symptoms such as the Penn spasms frequency scale, sleep quality NRS and pain NRS can assist in tracking MS spasticity evolution and inform management choices. Worsening spasticity reduces patient autonomy, impacts negatively on quality of life and increases health resource utilization and costs. Despite the wide range of issues associated with MS spasticity, undertreatment is common and standard treatment options (physiotherapy and classical oral therapies) often fail to provide adequate symptomatic control.

Developing COSHH Essentials: dermal exposure, personal protective equipment and first aid.

PubMed

Garrod, A N I; Rajan-Sithamparanadarajah, R

2003-10-01

The 'control banding' approach in COSHH Essentials combines the potential for harm with the potential for exposure by inhalation to band measures to control exposure at source, as generic strategies. These are simply adapted to specific tasks and circumstances to produce specific control advice. Where it is not possible or practical to use this control advice, the control bands can suggest adequate respiratory protective equipment using 'protection factors'. Proposals in the paper enable the user to identify the right level of respiratory protective equipment (RPE), and to begin selecting suitable RPE. Selection is made through a formatted questionnaire, enabling the user to give the right facts to the supplier. COSHH Essentials applies mainly to exposure by inhalation. However, skin exposure is very common and uptake via the skin can be an important contributor to body dose. This paper examines the factors concerning skin exposure, and the options for banding the potential for harm to the skin or via the skin. Proposals have then been made for dermal exposure control. Planning for emergencies is an important facet of risk control. Proposals are outlined to band chemical hazards for emergency planning according to a minimum of information, i.e. the danger symbol on a product label.

Relationships between trunk performance, gait and postural control in persons with multiple sclerosis.

PubMed

Freund, Jane E; Stetts, Deborah M; Vallabhajosula, Srikant

2016-06-30

Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system. Compared to healthy individuals, persons with multiple sclerosis (PwMS) have increased postural sway in quiet stance, decreased gait speed and increased fall incidence. Trunk performance has been implicated in postural control, gait dysfunction, and fall prevention in older adults. However, the relationship of trunk performance to postural control and gait has not been adequately studied in PwMS. To compare trunk muscle structure and performance in PwMS to healthy age and gendered-matched controls (HC); to determine the effects of isometric trunk endurance testing on postural control in both populations; and to determine the relationship of trunk performance with postural control, gait and step activity in PwMS. Fifteen PwMS and HC completed ultrasound imaging of trunk muscles, 10 m walk test, isometric trunk endurance tests, and postural sway test. Participants wore a step activity monitor for 7 days. PwMS had worse isometric trunk endurance compared to HC. PwMS trunk flexion endurance negatively correlated to several postural control measures and positively correlated to gait speed and step activity. Clinicians should consider evaluation and interventions directed at impaired trunk endurance in PwMS.

Forecasting future tobacco control policy: where to next?

PubMed

Freeman, Becky; Gartner, Coral; Hall, Wayne; Chapman, Simon

2010-10-01

Effective tobacco control policies include price increases through taxes, restrictions on smoking in public and work places, adequately funded mass media campaigns, bans on advertising, health warnings on packages and cessation assistance. As these policies have been largely implemented in Australia, what next should the country do in tobacco control? Ninety-one Australian tobacco control stakeholders took part in a web-based survey about the future of tobacco control policies. The policy deemed most important in decreasing smoking was to increase excise and customs duty by 30%. Other policies receiving high support included: funding mass media campaigns through tax hypothecation; introducing retail display bans; plain packaging of tobacco products; and banning smoking in outdoor dining areas. Reintroducing the sale of smokeless tobacco products received the least support. Countries that have largely implemented the provisions of the Framework Convention on Tobacco Control must maintain commitments to proven tobacco control measures, but also provide global leadership through the adoption of innovative policies. The release of the Australian 2009 National Preventative Health Taskforce's report presents an opportunity to translate these ideas into action. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

Measurement of asthma control according to global initiative for asthma guidelines: a comparison with the asthma control questionnaire

PubMed Central

2012-01-01

Introduction Asthma Control Questionnaire (ACQ) is a validated tool to measure asthma control. Cut-off points that best discriminate “well-controlled” or “not well-controlled” asthma have been suggested from the analysis of a large randomized clinical trial but they may not be adequate for daily clinical practice. Aims To establish cut-off points of the ACQ that best discriminate the level of control according to Global Initiative for Asthma (GINA) 2006 guidelines in patients with asthma managed at Allergology and Pulmonology Departments as well as Primary Care Centers in Spain. Patients and methods An epidemiological descriptive study, with prospective data collection. Asthma control following GINA-2006 classification and 7-item ACQ was assessed. The study population was split in two parts: 2/3 for finding the cut-off points (development population) and 1/3 for validating the results (validation population). Results A total of 1,363 stable asthmatic patients were included (mean age 38 ± 14 years, 60.3% women; 69.1% non-smokers). Patient classification according to GINA-defined asthma control was: controlled 13.6%, partially controlled 34.2%, and uncontrolled 52.3%. The ACQ cut-off points that better agreed with GINA-defined asthma control categories were calculated using receiver operating curves (ROC). The analysis showed that ACQ < 0.5 was the optimal cut-off point for “controlled asthma” (sensitivity 74.1%, specificity 77.5%) and 1.00 for “uncontrolled asthma” (sensitivity 73%, specificity 88.2%). Kappa index between GINA categories and ACQ was 0.62 (p < 0.001). Conclusion The ACQ cut-off points associated with GINA-defined asthma control in a real-life setting were <0.5 for controlled asthma and ≥1 for uncontrolled asthma. PMID:22726416

Systematic review of postural control and lateral ankle instability, part I: can deficits be detected with instrumented testing.

PubMed

McKeon, Patrick O; Hertel, Jay

2008-01-01

To answer the following clinical questions: (1) Is poor postural control associated with increased risk of a lateral ankle sprain? (2) Is postural control adversely affected after acute lateral ankle sprain? (3) Is postural control adversely affected in those with chronic ankle instability? PubMed and CINAHL entries from 1966 through October 2006 were searched using the terms ankle sprain, ankle instability, balance, chronic ankle instability, functional ankle instability, postural control, and postural sway. Only studies assessing postural control measures in participants on a stable force plate performing the modified Romberg test were included. To be included, a study had to address at least 1 of the 3 clinical questions stated above and provide adequate results for calculation of effect sizes or odds ratios where applicable. We calculated odds ratios with 95% confidence intervals for studies assessing postural control as a risk factor for lateral ankle sprains. Effect sizes were estimated with the Cohen d and associated 95% confidence intervals for comparisons of postural control performance between healthy and injured groups, or healthy and injured limbs, respectively. Poor postural control is most likely associated with an increased risk of sustaining an acute ankle sprain. Postural control is impaired after acute lateral ankle sprain, with deficits identified in both the injured and uninjured sides compared with controls. Although chronic ankle instability has been purported to be associated with altered postural control, these impairments have not been detected consistently with the use of traditional instrumented measures. Instrumented postural control testing on stable force plates is better at identifying deficits that are associated with an increased risk of ankle sprain and that occur after acute ankle sprains than at detecting deficits related to chronic ankle instability.

A new test of advanced theory of mind: The "Strange Stories Film Task" captures social processing differences in adults with autism spectrum disorders.

PubMed

Murray, Kim; Johnston, Kate; Cunnane, Helen; Kerr, Charlotte; Spain, Debbie; Gillan, Nicola; Hammond, Neil; Murphy, Declan; Happé, Francesca

2017-06-01

Real-life social processing abilities of adults with autism spectrum disorders (ASD) can be hard to capture in lab-based experimental tasks. A novel measure of social cognition, the "Strange Stories Film task' (SSFt), was designed to overcome limitations of available measures in the field. Brief films were made based on the scenarios from the Strange Stories task (Happé) and designed to capture the subtle social-cognitive difficulties observed in ASD adults. Twenty neurotypical adults were recruited to pilot the new measure. A final test set was produced and administered to a group of 20 adults with ASD and 20 matched controls, alongside established social cognition tasks and questionnaire measures of empathy, alexithymia and ASD traits. The SSFt was more effective than existing measures at differentiating the ASD group from the control group. In the ASD group, the SSFt was associated with the Strange Stories task. The SSFt is a potentially useful tool to identify social cognitive dis/abilities in ASD, with preliminary evidence of adequate convergent validity. Future research directions are discussed. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1120-1132. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Healthcare-associated infections in intensive care units: epidemiology and infection control in low-to-middle income countries.

PubMed

Alp, Emine; Damani, Nizam

2015-10-29

Healthcare-associated infections (HAIs) are major patient safety problems in hospitals, especially in intensive care units (ICUs). Patients in ICUs are prone to HAIs due to reduced host defense mechanisms, low compliance with infection prevention and control (IPC) measures due to lack of education and training, and heavy workload and low staffing levels, leading to cross-transmission of microorganisms from patient to patient. Patients with HAIs have prolonged hospital stays, and have high morbidity and mortality, thus adding economic burden on the healthcare system. For various reasons, in low-to-middle income countries (LMICs), the scale of the problem is huge; each year, many people die from HAIs. In this review, epidemiology of HAIs and infection prevention and control measures in ICUs is discussed, with especial emphasis on LMICs. High rates of HAIs caused by multidrug-resistant organisms (MDROs) are serious problems in ICUs in LMICs. In view of increasing prevalence of MDROs, LMICs should establish effective IPC infrastructure, appoint IPC teams, and provide adequate training and resources. These resources to establish and appoint IPC teams can be released by avoiding ritualistic, wasteful, and unsafe IPC practices, and by diverting resources to implement basic IPC measures, including early detection of infection, isolation of patients, application of appropriate IPC precautions, adherence to hand hygiene, and implementation of HAIs care bundles and basic evidence-based practices.

The adequacy of current import and export controls on sealed radioactive sources.

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

Longley, Susan W.; Cochran, John Russell; Price, Laura L.

2003-10-01

Millions of sealed radioactive sources (SRSs) are being used for a wide variety of beneficial purposes throughout the world. Security experts are now concerned that these beneficial SRSs could be used in a radiological dispersion device to terrorize and disrupt society. The greatest safety and security threat is from those highly radioactive Category 1 and 2 SRSs. Without adequate controls, it may be relatively easy to legally purchase a Category 1 or 2 SRS on the international market under false pretenses. Additionally, during transfer, SRSs are particularly susceptible to theft since the sources are in a shielded and mobile configuration,more » transportation routes are predictable, and shipments may not be adequately guarded. To determine if government controls on SRS are adequate, this study was commissioned to review the current SRS import and export controls of six countries. Canada, the Russian Federation, and South Africa were selected as the exporting countries, and Egypt, the Philippines, and the United States were selected as importing countries. A detailed review of the controls in each country is presented. The authors found that Canada and Russia are major exporters, and are exporting highly radioactive SRSs without first determining if the recipient is authorized by the receiving country to own and use the SRSs. Available evidence was used to estimate that on average there are tens to possibly hundreds of intercountry transfers of highly radioactive SRSs each day. Based on these and other findings, this reports recommends stronger controls on the export and import of highly radioactive SRSs.« less

14 CFR 460.11 - Environmental control and life support systems.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Environmental control and life support... Crew § 460.11 Environmental control and life support systems. (a) An operator must provide atmospheric conditions adequate to sustain life and consciousness for all inhabited areas within a vehicle. The operator...

30 CFR 74.6 - Quality control.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Quality control. 74.6 Section 74.6 Mineral... of the CMDPSU will be maintained in production through adequate quality control procedures, MSHA and... DUST SAMPLING DEVICES Approval Requirements for Coal Mine Dust Personal Sampler Unit § 74.6 Quality...

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 79.64 - In vivo micronucleus assay.

Code of Federal Regulations, 2011 CFR

2011-07-01

... number and sex. At least five female and five male animals per experimental/sample and control group... control group. A single concentration of a compound known to produce micronuclei in vivo is adequate as a... in bone marrow from treated animals compared to that of control animals. The visualization of...

40 CFR 79.64 - In vivo micronucleus assay.

Code of Federal Regulations, 2014 CFR

2014-07-01

... number and sex. At least five female and five male animals per experimental/sample and control group... control group. A single concentration of a compound known to produce micronuclei in vivo is adequate as a... in bone marrow from treated animals compared to that of control animals. The visualization of...

40 CFR 79.64 - In vivo micronucleus assay.

Code of Federal Regulations, 2012 CFR

2012-07-01

... number and sex. At least five female and five male animals per experimental/sample and control group... control group. A single concentration of a compound known to produce micronuclei in vivo is adequate as a... in bone marrow from treated animals compared to that of control animals. The visualization of...

40 CFR 79.64 - In vivo micronucleus assay.

Code of Federal Regulations, 2010 CFR

2010-07-01

... number and sex. At least five female and five male animals per experimental/sample and control group... control group. A single concentration of a compound known to produce micronuclei in vivo is adequate as a... in bone marrow from treated animals compared to that of control animals. The visualization of...

40 CFR 79.64 - In vivo micronucleus assay.

Code of Federal Regulations, 2013 CFR

2013-07-01

... number and sex. At least five female and five male animals per experimental/sample and control group... control group. A single concentration of a compound known to produce micronuclei in vivo is adequate as a... in bone marrow from treated animals compared to that of control animals. The visualization of...

77 FR 58330 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... requires repetitive inspections of the aft attach lugs of the elevator tab control mechanisms, and replacement of any discrepant elevator tab control mechanism. Since we issued that AD, Boeing has developed a modification of the aft attach lugs of the elevator tab control mechanisms, which will adequately address the...

14 CFR 460.11 - Environmental control and life support systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Environmental control and life support... Crew § 460.11 Environmental control and life support systems. (a) An operator must provide atmospheric conditions adequate to sustain life and consciousness for all inhabited areas within a vehicle. The operator...

Antidepressant sales and the risk for alcohol-related and non-alcohol-related suicide in Finland--an individual-level population study.

PubMed

Moustgaard, Heta; Joutsenniemi, Kaisla; Myrskylä, Mikko; Martikainen, Pekka

2014-01-01

A marked decline in suicide rates has co-occurred with increased antidepressant sales in several countries but the causal connection between the trends remains debated. Most previous studies have focused on overall suicide rates and neglected differential effects in population subgroups. Our objective was to investigate whether increasing sales of non-tricyclic antidepressants have reduced alcohol- and non-alcohol-related suicide risk in different population subgroups. We followed a nationally representative sample of 950,158 Finnish adults in 1995-2007 for alcohol-related (n = 2,859) and non-alcohol-related (n = 8,632) suicides. We assessed suicide risk by gender and social group according to regional sales of non-tricyclic antidepressants, measured by sold doses per capita, prevalence of antidepressant users, and proportion of antidepressant users with doses reflecting minimally adequate treatment. Fixed-effects Poisson regression models controlled for regional differences and time trends that may influence suicide risk irrespective of antidepressant sales. The number of sold antidepressant doses per capita and the prevalence of antidepressant users were unrelated to male suicide risk. However, one percentage point increase in the proportion of antidepressant users receiving minimally adequate treatment reduced non-alcohol-related male suicide risk by one percent (relative risk 0.987, 95% confidence interval 0.976-0.998). This beneficial effect only emerged among men with high education, high income, and employment, among men without a partner, and men not owning their home. Alcohol-related suicides and female suicides were unrelated to all measures of antidepressant sales. We found little evidence that increase in overall sales or in the prevalence of non-tricyclic antidepressant users would have caused the fall in suicide rates in Finland in 1995-2007. However, the rise in the proportion of antidepressant users receiving minimally adequate treatment, possibly due to enhanced treatment compliance, may have prevented non-alcohol-related suicides among men.

Y-piece temperature and humidification during mechanical ventilation.

PubMed

Solomita, Mario; Daroowalla, Feroza; Leblanc, Deniese S; Smaldone, Gerald C

2009-04-01

Practitioners often presume there is adequate humidification in the ventilator circuit if the Y-piece is at a specified temperature, but control of Y-piece temperature may be inadequate to ensure adequate humidification. In an in vitro bench model we measured water-vapor delivery with several heated humidification setups and a wide range of minute volume (V (E)) values. The setup included a condenser, hygrometry, and thermometer. First, we calibrated the system with a point-source humidifier and water pump. Then we tested the water-vapor delivery during non-heated-wire humidification and during heated-wire humidification with a temperature gradient of +3 degrees C, 0 degrees C, and -3 degrees C between the humidifier and the Y-piece. We compared the results to 2 recommended humidification values: 100% saturated (absolute humidity 44 mg H(2)O/L) gas at 37 degrees C (saturated/37 degrees C); and 75% saturated (absolute humidity 33 mg H(2)O/L), which is the humidity recommended by the International Organization for Standardization (the ISO standard). In all the experiments the setup was set to provide 35 degrees C at the Y-piece. Our method for measuring water-vapor delivery closely approximated the amount delivered by a calibrated pump, but slightly underestimated the water-vapor delivery in all the experiments and the whole V (E) range. At all V (E) values, water-vapor delivery during non-heated-wire humidification matched or exceeded saturated/37 degrees C and was significantly greater than that during heated-wire humidification. During heated-wire humidification, water-vapor delivery varied with the temperature gradient and did not reach saturated/37 degrees C at V (E) > 6 L/min. Water-vapor delivery with the negative temperature gradient was below the ISO standard. Maintaining temperature at one point in the inspiratory circuit (eg, Y-piece), does not ensure adequate water-vapor delivery. Other factors (humidification system, V (E), gradient setting) are critical. At a given temperature, humidification may be significantly higher or lower than expected.

Antidepressant Sales and the Risk for Alcohol-Related and Non-Alcohol-Related Suicide in Finland—An Individual-Level Population Study

PubMed Central

Moustgaard, Heta; Joutsenniemi, Kaisla; Myrskylä, Mikko; Martikainen, Pekka

2014-01-01

Objectives A marked decline in suicide rates has co-occurred with increased antidepressant sales in several countries but the causal connection between the trends remains debated. Most previous studies have focused on overall suicide rates and neglected differential effects in population subgroups. Our objective was to investigate whether increasing sales of non-tricyclic antidepressants have reduced alcohol- and non-alcohol-related suicide risk in different population subgroups. Methods We followed a nationally representative sample of 950,158 Finnish adults in 1995–2007 for alcohol-related (n = 2,859) and non-alcohol-related (n = 8,632) suicides. We assessed suicide risk by gender and social group according to regional sales of non-tricyclic antidepressants, measured by sold doses per capita, prevalence of antidepressant users, and proportion of antidepressant users with doses reflecting minimally adequate treatment. Fixed-effects Poisson regression models controlled for regional differences and time trends that may influence suicide risk irrespective of antidepressant sales. Results The number of sold antidepressant doses per capita and the prevalence of antidepressant users were unrelated to male suicide risk. However, one percentage point increase in the proportion of antidepressant users receiving minimally adequate treatment reduced non-alcohol-related male suicide risk by one percent (relative risk 0.987, 95% confidence interval 0.976–0.998). This beneficial effect only emerged among men with high education, high income, and employment, among men without a partner, and men not owning their home. Alcohol-related suicides and female suicides were unrelated to all measures of antidepressant sales. Conclusion We found little evidence that increase in overall sales or in the prevalence of non-tricyclic antidepressant users would have caused the fall in suicide rates in Finland in 1995–2007. However, the rise in the proportion of antidepressant users receiving minimally adequate treatment, possibly due to enhanced treatment compliance, may have prevented non-alcohol-related suicides among men. PMID:24892560

Program control for mission success

NASA Technical Reports Server (NTRS)

Longanecker, G. W.

1994-01-01

This article suggests that in order to be able to exercise control over a particular program, the program itself must be controllable. A controllable program therefore, according to the author, is one that has been properly scoped technically, realistically scheduled, and adequately budgeted. The article delves indepth into each of the above aspects of a controllable program and discusses both the pros and cons of each.

The design of rapid turbidity measurement system based on single photon detection techniques

NASA Astrophysics Data System (ADS)

Yang, Yixin; Wang, Huanqin; Cao, Yangyang; Gui, Huaqiao; Liu, Jianguo; Lu, Liang; Cao, Huibin; Yu, Tongzhu; You, Hui

2015-10-01

A new rapid turbidity measurement system has been developed to measure the turbidity of drinking water. To determinate the turbidity quantitatively, the total intensity of scattering light has been measured and quantified as number of photons by adopting the single photon detection techniques (SPDT) which has the advantage of high sensitivity. On the basis of SPDT, the measurement system has been built and series of experiments have been carried out. Combining then the 90° Mie scattering theory with the principle of SPDT, a turbidity measurement model has been proposed to explain the experimental results. The experimental results show that a turbidity, which is as low as 0.1 NTU (Nephelometric Turbidity Units), can be measured steadily within 100 ms. It also shows a good linearity and stability over the range of 0.1-400 NTU and the precision can be controlled within 5% full scale. In order to improve its precision and stability, some key parameters, including the sampling time and incident light intensity, have been discussed. It has been proved that, to guarantee an excellent system performance, a good compromise between the measurement speed and the low power consumption should be considered adequately depending on the practical applications.

Obstructive Sleep Apnea Devices for Out-Of-Center (OOC) Testing: Technology Evaluation

PubMed Central

Collop, Nancy A.; Tracy, Sharon L.; Kapur, Vishesh; Mehra, Reena; Kuhlmann, David; Fleishman, Sam A.; Ojile, Joseph M.

2011-01-01

Guidance is needed to help clinicians decide which out-of-center (OOC) testing devices are appropriate for diagnosing obstructive sleep apnea (OSA). A new classification system that details the type of signals measured by these devices is presented. This proposed system categorizes OOC devices based on measurements of Sleep, Cardiovascular, Oximetry, Position, Effort, and Respiratory (SCOPER) parameters. Criteria for evaluating the devices are also presented, which were generated from chosen pre-test and post-test probabilities. These criteria state that in patients with a high pretest probability of having OSA, the OOC testing device has a positive likelihood ratio (LR+) of 5 or greater coinciding with an in-lab-polysomnography (PSG)-generated apnea hypopnea index (AHI) ≥ 5, and an adequate sensitivity (at least 0.825). Since oximetry is a mandatory signal for scoring AHI using PSG, devices that do not incorporate oximetry were excluded. English peer-reviewed literature on FDA-approved devices utilizing more than 1 signal was reviewed according to the above criteria for 6 questions. These questions specifically addressed the adequacy of different respiratory and effort sensors and combinations thereof to diagnose OSA. In summary, the literature is currently inadequate to state with confidence that a thermistor alone without any effort sensor is adequate to diagnose OSA; if a thermal sensing device is used as the only measure of respiration, 2 effort belts are required as part of the montage and piezoelectric belts are acceptable in this context; nasal pressure can be an adequate measurement of respiration with no effort measure with the caveat that this may be device specific; nasal pressure may be used in combination with either 2 piezoelectric or respiratory inductance plethysmographic (RIP) belts (but not 1 piezoelectric belt); and there is insufficient evidence to state that both nasal pressure and thermistor are required to adequately diagnose OSA. With respect to alternative devices for diagnosing OSA, the data indicate that peripheral arterial tonometry (PAT) devices are adequate for the proposed use; the device based on cardiac signals shows promise, but more study is required as it has not been tested in the home setting; for the device based on end-tidal CO2 (ETCO2), it appears to be adequate for a hospital population; and for devices utilizing acoustic signals, the data are insufficient to determine whether the use of acoustic signals with other signals as a substitute for airflow is adequate to diagnose OSA. Standardized research is needed on OOC devices that report LR+ at the appropriate AHI (≥ 5) and scored according to the recommended definitions, while using appropriate research reporting and methodology to minimize bias. Citation: Collop NA; Tracy SL; Kapur V; Mehra R; Kuhlmann D; Fleishman SA; Ojile JM. Obstructive sleep apnea devices for out-of-center (OOC) testing: technology evaluation. J Clin Sleep Med 2011;7(5):531-548. PMID:22003351

Rigid Body Rate Inference from Attitude Variation

NASA Technical Reports Server (NTRS)

Bar-Itzhack, I. Y.; Harman, Richard R.; Thienel, Julie K.

2006-01-01

In this paper we research the extraction of the angular rate vector from attitude information without differentiation, in particular from quaternion measurements. We show that instead of using a Kalman filter of some kind, it is possible to obtain good rate estimates, suitable for spacecraft attitude control loop damping, using simple feedback loops, thereby eliminating the need for recurrent covariance computation performed when a Kalman filter is used. This considerably simplifies the computations required for rate estimation in gyro-less spacecraft. Some interesting qualities of the Kalman filter gain are explored, proven and utilized. We examine two kinds of feedback loops, one with varying gain that is proportional to the well known Q matrix, which is computed using the measured quaternion, and the other type of feedback loop is one with constant coefficients. The latter type includes two kinds; namely, a proportional feedback loop, and a proportional-integral feedback loop. The various schemes are examined through simulations and their performance is compared. It is shown that all schemes are adequate for extracting the angular velocity at an accuracy suitable for control loop damping.

Craniofacial morphology in patients with velocardiofacial syndrome.

PubMed

Dalben, Gisele da Silva; Richieri-Costa, Antonio; Taveira, Luís Antônio de Assis

2010-05-01

To compare cephalometric measurements of patients with and without velocardiofacial syndrome. Cross-sectional. Public tertiary craniofacial center. Lateral cephalograms of 18 patients with velocardiofacial syndrome and 18 controls without morphofunctional alterations, matched for gender and age; all cephalograms were obtained before orthodontic intervention. The cephalograms were manually traced and digitized for the achievement of linear and angular measurements. Individuals with velocardiofacial syndrome presented a reduced length of the skull base, retrusion of nasal bones, reduced posterior height of the maxilla, increased gonial angle, increased interincisal angle, greater lingual inclination of the mandibular incisors, reduced nasolabial angle, and reduced nasal depth compared with the control group. Patients with velocardiofacial syndrome presented morphological differences compared with individuals without morphofunctional alterations, which might be considered in the evaluation of patients with suspected diagnosis of the syndrome, as well as for the establishment of treatment protocols adequate to their needs. The present findings did not support the hypothesis of differences in pharyngeal dimensions mentioned by other authors, suggesting that the velopharyngeal insufficiency in these patients may be caused by functional alterations rather than by anatomical differences.

Disability and Fatigue Can Be Objectively Measured in Multiple Sclerosis.

PubMed

Motta, Caterina; Palermo, Eduardo; Studer, Valeria; Germanotta, Marco; Germani, Giorgio; Centonze, Diego; Cappa, Paolo; Rossi, Silvia; Rossi, Stefano

2016-01-01

The available clinical outcome measures of disability in multiple sclerosis are not adequately responsive or sensitive. To investigate the feasibility of inertial sensor-based gait analysis in multiple sclerosis. A cross-sectional study of 80 multiple sclerosis patients and 50 healthy controls was performed. Lower-limb kinematics was evaluated by using a commercially available magnetic inertial measurement unit system. Mean and standard deviation of range of motion (mROM, sROM) for each joint of lower limbs were calculated in one minute walking test. A motor performance index (E) defined as the sum of sROMs was proposed. We established two novel observer-independent measures of disability. Hip mROM was extremely sensitive in measuring lower limb motor impairment, being correlated with muscle strength and also altered in patients without clinically detectable disability. On the other hand, E index discriminated patients according to disability, being altered only in patients with moderate and severe disability, regardless of walking speed. It was strongly correlated with fatigue and patient-perceived health status. Inertial sensor-based gait analysis is feasible and can detect clinical and subclinical disability in multiple sclerosis.

Flight Dynamics Modeling and Simulation of a Damaged Transport Aircraft

NASA Technical Reports Server (NTRS)

Shah, Gautam H.; Hill, Melissa A.

2012-01-01

A study was undertaken at NASA Langley Research Center to establish, demonstrate, and apply methodology for modeling and implementing the aerodynamic effects of MANPADS damage to a transport aircraft into real-time flight simulation, and to demonstrate a preliminary capability of using such a simulation to conduct an assessment of aircraft survivability. Key findings from this study include: superpositioning of incremental aerodynamic characteristics to the baseline simulation aerodynamic model proved to be a simple and effective way of modeling damage effects; the primary effect of wing damage rolling moment asymmetry may limit minimum airspeed for adequate controllability, but this can be mitigated by the use of sideslip; combined effects of aerodynamics, control degradation, and thrust loss can result in significantly degraded controllability for a safe landing; and high landing speeds may be required to maintain adequate control if large excursions from the nominal approach path are allowed, but high-gain pilot control during landing can mitigate this risk.

Comparison of cognitive flexibility and planning ability in patients with obsessive compulsive disorder, patients with obsessive compulsive personality disorder, and healthy controls

PubMed Central

PAAST, Negin; KHOSRAVI, Zohreh; MEMARI, Amir Hossein; SHAYESTEHFAR, Monir; ARBABI, Mohammad

2016-01-01

Background Cognitive functioning in individuals with Obsessive Compulsive Disorder (OCD) and with Obsessive Compulsive Personality Disorder (OCPD) has not been adequately studied. Aim Examine the cognitive flexibility and planning ability of individuals with OCD and OCPD. Methods Twenty patients with OCD and 25 patients with OCPD who had not taken medication in the previous two weeks were identified in an outpatient psychology clinic in Tehran, and 25 healthy control subjects were identified from the university staff and local community residents. All participants were administered the 28-item version of the General Health Questionnaire (GHQ-28), the Wisconsin Card Sorting Test (WCST), and the Tower of London (TOL) test. Two measures of the WCTS (number of perseverative errors and number of categories completed) were used to assess cognitive flexibility and three measures of the TOL (total number of moves in 12 trials, total response time, and planning time) were used to assess planning ability. Results The level of current psychological distress in the two patient groups was significantly greater than that in the control group. After adjusting for demographic variables and the level of psychological distress, both OCD patients and OCPD patients made more perseverative errors on the WCST than control subjects, and the OCD patients (but not the OCPD patients) completed significantly fewer categories than the control subjects. Both the OCD patients and OCPD patients required significantly more moves than control subjects to complete the 12 TOL tasks and OCD patients took significantly longer than both OCPD patients and control subjects to complete the tasks. Conclusions Individuals with OCD and OCPD have impaired cognitive flexibility and planning ability compared to healthy controls, and there are some differences in these measures of cognitive functioning between OCD and OCPD. Long term follow-up studies of OCD and OCPD that assess changes in cognitive measures as the severity of obsessive compulsive symptoms wax and wane will be needed to determine whether or not such cognitive measures have diagnostic or clinical relevance for obsessive compulsive disorders. PMID:27688641

Comparison of cognitive flexibility and planning ability in patients with obsessive compulsive disorder, patients with obsessive compulsive personality disorder, and healthy controls.

PubMed

Paast, Negin; Khosravi, Zohreh; Memari, Amir Hossein; Shayestehfar, Monir; Arbabi, Mohammad

2016-02-25

Cognitive functioning in individuals with Obsessive Compulsive Disorder (OCD) and with Obsessive Compulsive Personality Disorder (OCPD) has not been adequately studied. Examine the cognitive flexibility and planning ability of individuals with OCD and OCPD. Twenty patients with OCD and 25 patients with OCPD who had not taken medication in the previous two weeks were identified in an outpatient psychology clinic in Tehran, and 25 healthy control subjects were identified from the university staff and local community residents. All participants were administered the 28-item version of the General Health Questionnaire (GHQ-28), the Wisconsin Card Sorting Test (WCST), and the Tower of London (TOL) test. Two measures of the WCTS (number of perseverative errors and number of categories completed) were used to assess cognitive flexibility and three measures of the TOL (total number of moves in 12 trials, total response time, and planning time) were used to assess planning ability. The level of current psychological distress in the two patient groups was significantly greater than that in the control group. After adjusting for demographic variables and the level of psychological distress, both OCD patients and OCPD patients made more perseverative errors on the WCST than control subjects, and the OCD patients (but not the OCPD patients) completed significantly fewer categories than the control subjects. Both the OCD patients and OCPD patients required significantly more moves than control subjects to complete the 12 TOL tasks and OCD patients took significantly longer than both OCPD patients and control subjects to complete the tasks. Individuals with OCD and OCPD have impaired cognitive flexibility and planning ability compared to healthy controls, and there are some differences in these measures of cognitive functioning between OCD and OCPD. Long term follow-up studies of OCD and OCPD that assess changes in cognitive measures as the severity of obsessive compulsive symptoms wax and wane will be needed to determine whether or not such cognitive measures have diagnostic or clinical relevance for obsessive compulsive disorders.

Economic impact of stimulated technological activity. Part 3: Case study, knowledge additions and earth links from space crew systems

NASA Technical Reports Server (NTRS)

1971-01-01

A case study of knowledge contributions from the crew life support aspect of the manned space program is reported. The new information needed to be learned, the solutions developed, and the relation of new knowledge gained to earthly problems were investigated. Illustrations are given in the following categories: supplying atmosphere for spacecraft; providing carbon dioxide removal and recycling; providing contaminant control and removal; maintaining the body's thermal balance; protecting against the space hazards of decompression, radiation, and meteorites; minimizing fire and blast hazards; providing adequate light and conditions for adequate visual performance; providing mobility and work physiology; and providing adequate habitability.

Is the Berg Balance Scale an effective tool for the measurement of early postural control impairments in patients with Parkinson's disease? Evidence from Rasch analysis.

PubMed

La Porta, F; Giordano, A; Caselli, S; Foti, C; Franchignoni, F

2015-12-01

It is unclear whether the BBS is an effective tool for the measurement of early postural control impairments in patients with Parkinson's disease (PD). The aim of this paper was to evaluate BBS' content validity, internal construct validity, reliability and targeting in patients with PD within the Rasch analysis framework. Observational, cross-sectional study. Outpatient Rehabilitation Unit. A sample of 285 outpatients with PD. The content validity of the BBS was assessed using standard linking techniques. The BBS was administered by trained physiotherapists. The data collected then underwent Rasch analysis. Content validity analysis showed a lack of items assessing postural responses to tripping and slips and stability during walking. On Rasch analysis, the BBS failed the requirements of monotonicity, local independence, unidimensionality and invariance. After rescoring 7 items, grouping of locally dependent items into testlets, and deletion of the static sitting balance item because mistargeted and underdiscriminating, the Rasch-modified BBS for PD (BBS-PD) showed adequate internal construct validity (χ(2)24=39.693; P=0.023), including absence of differential item functioning (DIF) across gender and age, and was, as a whole, sufficiently precise for individual person measurement (PSI=0.894). However, the scale was not well targeted to the sample in view of the prevalence of higher scores. This study demonstrated the internal construct validity and reliability of the BBS-PD as a measurement tool for patients with PD within the Rasch analysis framework. However, the lack of items critical to the assessment of postural control impairments typical of PD, affected negatively the targeting, so that a significant percentage of patients was located in the higher ability range of the measurement continuum, where precision of measurement is reduced. These findings suggest that the BBS, even if modified, may not be an effective tool for the measurement of early postural control in patients with PD.

Randomized controlled trial of patient navigation for newly diagnosed cancer patients: effects on quality of life.

PubMed

Hendren, Samantha; Griggs, Jennifer J; Epstein, Ronald; Humiston, Sharon; Jean-Pierre, Pascal; Winters, Paul; Sanders, Mechelle; Loader, Starlene; Fiscella, Kevin

2012-10-01

Patient navigation is a promising intervention to ameliorate cancer health disparities. This study objective was to measure patient navigation effects on cancer-specific quality of life (QOL) among patients with newly diagnosed cancer. A randomized controlled trial of patient navigation was conducted in Rochester, NY. Patients with breast cancer and colorectal cancer were randomly assigned to receive a patient navigation intervention or usual care. QOL was measured at baseline and four subsequent time points, using the validated Functional Assessment of Cancer Therapy (FACT-B, FACT-C) instruments. Among 319 randomized patients (165 patient navigation, 154 control), median age was 57 years and 32.5% were from minority race/ethnicity groups. Patient navigation and control groups were comparable on baseline factors, except home ownership versus renting (more home ownership among controls, P = 0.05) and race (more whites among controls, P = 0.05). Total and subscale FACT scores did not differ between groups when analyzed as a change from baseline to 3 months, or at various time points. The emotional well-being subscale change from baseline approached significance (better change among patient navigation group, P = 0.05). Time trends of QOL measures did not differ significantly between groups. Adjustment for baseline patient factors did not reveal a benefit of patient navigation on QOL. In this randomized trial of patient navigation, there was no statistically significant effect on disease-specific QOL. These results suggest that patient navigation may not affect QOL during cancer treatment, that social/medical support are adequate in this study's setting, or that the trial failed to target patients likely to experience QOL benefit from patient navigation. 2012 AACR

Hot rocket plume experiment - Survey and conceptual design. [of rhenium-iridium bipropellants

NASA Technical Reports Server (NTRS)

Millard, Jerry M.; Luan, Taylor W.; Dowdy, Mack W.

1992-01-01

Attention is given to a space-borne engine plume experiment study to fly an experiment which will both verify and quantify the reduced contamination from advanced rhenium-iridium earth-storable bipropellant rockets (hot rockets) and provide a correlation between high-fidelity, in-space measurements and theoretical plume and surface contamination models. The experiment conceptual design is based on survey results from plume and contamination technologists throughout the U.S. With respect to shuttle use, cursory investigations validate Hitchhiker availability and adaptability, adequate remote manipulator system (RMS) articulation and dynamic capability, acceptable RMS attachment capability, adequate power and telemetry capability, and adequate flight altitude and attitude/orbital capability.

Theory of planned behaviour variables and objective walking behaviour do not show seasonal variation in a randomised controlled trial

PubMed Central

2014-01-01

Background Longitudinal studies have shown that objectively measured walking behaviour is subject to seasonal variation, with people walking more in summer compared to winter. Seasonality therefore may have the potential to bias the results of randomised controlled trials if there are not adequate statistical or design controls. Despite this there are no studies that assess the impact of seasonality on walking behaviour in a randomised controlled trial, to quantify the extent of such bias. Further there have been no studies assessing how season impacts on the psychological predictors of walking behaviour to date. The aim of the present study was to assess seasonal differences in a) objective walking behaviour and b) Theory of Planned Behaviour (TPB) variables during a randomised controlled trial of an intervention to promote walking. Methods 315 patients were recruited to a two-arm cluster randomised controlled trial of an intervention to promote walking in primary care. A series of repeated measures ANCOVAs were conducted to examine the effect of season on pedometer measures of walking behaviour and TPB measures, assessed immediately post-intervention and six months later. Hierarchical regression analyses were conducted to assess whether season moderated the prediction of intention and behaviour by TPB measures. Results There were no significant differences in time spent walking in spring/summer compared to autumn/winter. There was no significant seasonal variation in most TPB variables, although the belief that there will be good weather was significantly higher in spring/summer (F = 19.46, p < .001). Season did not significantly predict intention or objective walking behaviour, or moderate the effects of TPB variables on intention or behaviour. Conclusion Seasonality does not influence objectively measured walking behaviour or psychological variables during a randomised controlled trial. Consequently physical activity behaviour outcomes in trials will not be biased by the season in which they are measured. Previous studies may have overestimated the extent of seasonality effects by selecting the most extreme summer and winter months to assess PA. In addition, participants recruited to behaviour change interventions might have higher levels of motivation to change and are less affected by seasonal barriers. Trial registration Current Controlled Trials ISRCTN95932902 PMID:24499405

Linear Combinations of Multiple Outcome Measures to Improve the Power of Efficacy Analysis ---Application to Clinical Trials on Early Stage Alzheimer Disease

PubMed Central

Xiong, Chengjie; Luo, Jingqin; Morris, John C; Bateman, Randall

2018-01-01

Modern clinical trials on Alzheimer disease (AD) focus on the early symptomatic stage or even the preclinical stage. Subtle disease progression at the early stages, however, poses a major challenge in designing such clinical trials. We propose a multivariate mixed model on repeated measures to model the disease progression over time on multiple efficacy outcomes, and derive the optimum weights to combine multiple outcome measures by minimizing the sample sizes to adequately power the clinical trials. A cross-validation simulation study is conducted to assess the accuracy for the estimated weights as well as the improvement in reducing the sample sizes for such trials. The proposed methodology is applied to the multiple cognitive tests from the ongoing observational study of the Dominantly Inherited Alzheimer Network (DIAN) to power future clinical trials in the DIAN with a cognitive endpoint. Our results show that the optimum weights to combine multiple outcome measures can be accurately estimated, and that compared to the individual outcomes, the combined efficacy outcome with these weights significantly reduces the sample size required to adequately power clinical trials. When applied to the clinical trial in the DIAN, the estimated linear combination of six cognitive tests can adequately power the clinical trial. PMID:29546251

Measurement of Behavioral and Emotional Outcomes of Youth in Foster Care: Investigation of the Roles of Age and Placement Type.

PubMed

Gabrielli, Joy; Jackson, Yo; Brown, Shaquanna

2015-09-01

The Behavioral Assessment System for Children-2 (BASC-2) is used to assess behavioral and emotional outcomes for youth. Research providing evidence for use of the BASC-2 parent-report form historically has included biological parents reporting on their children (Reynolds and Kamphaus 2004). For youth residing in out-of-home placements through enrollment in foster care, caregivers reporting on their functioning may include foster parents or residential staff. Given the significant adverse mental health outcomes for youth in foster care and the need to adequately assess adjustment in foster care, the purpose of the study was to evaluate the measurement properties of caregivers' report on the parent report form (PRS) of the BASC-2 in foster care youth. Using 479 respondents, a measurement model was fit to the data demonstrating adequate fit across Internalizing Problems, Externalizing Problems, and Adaptive Skills. Further, a comparison of measurement properties across child and adolescent groups and groups of youth residing in residential facilities versus foster homes was conducted. Factorial invariance and latent means also were assessed. The BASC-2 PRS was found to be an adequate assessment of psychological outcomes for youth in foster care when completed by foster parents or residential facility staff.

Measurement of Behavioral and Emotional Outcomes of Youth in Foster Care: Investigation of the Roles of Age and Placement Type

PubMed Central

Gabrielli, Joy; Jackson, Yo; Brown, Shaquanna

2014-01-01

The Behavioral Assessment System for Children–2 (BASC-2) is used to assess behavioral and emotional outcomes for youth. Research providing evidence for use of the BASC-2 parent-report form historically has included biological parents reporting on their children (Reynolds and Kamphaus 2004). For youth residing in out-of-home placements through enrollment in foster care, caregivers reporting on their functioning may include foster parents or residential staff. Given the significant adverse mental health outcomes for youth in foster care and the need to adequately assess adjustment in foster care, the purpose of the study was to evaluate the measurement properties of caregivers’ report on the parent report form (PRS) of the BASC-2 in foster care youth. Using 479 respondents, a measurement model was fit to the data demonstrating adequate fit across Internalizing Problems, Externalizing Problems, and Adaptive Skills. Further, a comparison of measurement properties across child and adolescent groups and groups of youth residing in residential facilities versus foster homes was conducted. Factorial invariance and latent means also were assessed. The BASC-2 PRS was found to be an adequate assessment of psychological outcomes for youth in foster care when completed by foster parents or residential facility staff. PMID:26478653

Mutagenic Potential of 4-Nitrophenyl Monochloromethyl (Phenyl) Phosphinate Using the Drosophila melanogaster Sex-Linked Recessive Lethal Test.

DTIC Science & Technology

1983-08-01

chromosomes were tested from the concurrent negative control. This sample size was adequate for analysis using the Fisher’s Exact test ( personal communication...study may be regarded as adequate ( personal communication - Dr. Gildengorin, Statistician, Information Sciences, Letterman Army Institute of Research...Health Sciences 0917 Arlington Road Bethesda MD 20014 CM nd Commander US Army Euvaoomens Hygine Agency US Army Research Institute Abardan Proving Ground MD

Measures and procedures utilized to determine the added value of microprocessor-controlled prosthetic knee joints: a systematic review

PubMed Central

2013-01-01

Background The effectiveness of microprocessor-controlled prosthetic knee joints (MPKs) has been assessed using a variety of outcome measures in a variety of health and health-related domains. However, if the patient is to receive a prosthetic knee joint that enables him to function optimally in daily life, it is vital that the clinician has adequate information about the effects of that particular component on all aspects of persons’ functioning. Especially information concerning activities and participation is of high importance, as this component of functioning closely describes the person’s ability to function with the prosthesis in daily life. The present study aimed to review the outcome measures that have been utilized to assess the effects of microprocessor-controlled prosthetic knee joints (MPK), in comparison with mechanically controlled prosthetic knee joints, and aimed to classify these measures according to the components and categories of functioning defined by the International Classification of Functioning, Disability and Health (ICF). Subsequently, the gaps in the scientific evidence regarding the effectiveness of MPKs were determined. Methods A systematic literature search in 6 databases (i.e. PubMed, CINAHL, Cochrane Library, Embase, Medline and PsychInfo) identified scientific studies that compared the effects of using MPKs with mechanically controlled prosthetic knee joints on persons’ functioning. The outcome measures that have been utilized in those studies were extracted and categorized according to the ICF framework. Also, a descriptive analysis regarding all studies has been performed. Results A total of 37 studies and 72 outcome measures have been identified. The majority (67%) of the outcome measures that described the effects of using an MPK on persons’ actual performance with the prosthesis covered the ICF body functions component. Only 31% of the measures on persons’ actual performance investigated how an MPK may affect performance in daily life. Research also typically focused on young, fit and active persons. Conclusions Scientifically valid evidence regarding the performance of persons with an MPK in everyday life is limited. Future research should specifically focus on activities and participation to increase the understanding of the possible functional added value of MPKs. PMID:24279314

Measures and procedures utilized to determine the added value of microprocessor-controlled prosthetic knee joints: a systematic review.

PubMed

Theeven, Patrick J R; Hemmen, Bea; Brink, Peter R G; Smeets, Rob J E M; Seelen, Henk A M

2013-11-27

The effectiveness of microprocessor-controlled prosthetic knee joints (MPKs) has been assessed using a variety of outcome measures in a variety of health and health-related domains. However, if the patient is to receive a prosthetic knee joint that enables him to function optimally in daily life, it is vital that the clinician has adequate information about the effects of that particular component on all aspects of persons' functioning. Especially information concerning activities and participation is of high importance, as this component of functioning closely describes the person's ability to function with the prosthesis in daily life. The present study aimed to review the outcome measures that have been utilized to assess the effects of microprocessor-controlled prosthetic knee joints (MPK), in comparison with mechanically controlled prosthetic knee joints, and aimed to classify these measures according to the components and categories of functioning defined by the International Classification of Functioning, Disability and Health (ICF). Subsequently, the gaps in the scientific evidence regarding the effectiveness of MPKs were determined. A systematic literature search in 6 databases (i.e. PubMed, CINAHL, Cochrane Library, Embase, Medline and PsychInfo) identified scientific studies that compared the effects of using MPKs with mechanically controlled prosthetic knee joints on persons' functioning. The outcome measures that have been utilized in those studies were extracted and categorized according to the ICF framework. Also, a descriptive analysis regarding all studies has been performed. A total of 37 studies and 72 outcome measures have been identified. The majority (67%) of the outcome measures that described the effects of using an MPK on persons' actual performance with the prosthesis covered the ICF body functions component. Only 31% of the measures on persons' actual performance investigated how an MPK may affect performance in daily life. Research also typically focused on young, fit and active persons. Scientifically valid evidence regarding the performance of persons with an MPK in everyday life is limited. Future research should specifically focus on activities and participation to increase the understanding of the possible functional added value of MPKs.

The role of vaccination in risk mitigation and control of Newcastle disease in poultry.

PubMed

Mayers, Jo; Mansfield, Karen L; Brown, Ian H

2017-10-20

Newcastle disease is regarded as one of the most important avian diseases throughout the world and continues to be a threat and economic burden to the poultry industry. With no effective treatment, poultry producers rely primarily on stringent biosecurity and vaccination regimens to control the spread of this devastating disease. This concise review provides an historical perspective of Newcastle disease vaccination and how fundamental research has paved the way for the development of instrumental techniques which are still in use today. Although vaccination programmes have reduced the impact of clinical disease, they have historically been ineffective in controlling the spread of virulent viruses and therefore do not always offer an adequate solution to the world's food security problems. However, the continued development of novel vaccine technology and improved biosecurity measures through education may offer a solution to help reduce the global threat of Newcastle disease on the poultry industry. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Magnetic force microscopy with frequency-modulated capacitive tip-sample distance control

NASA Astrophysics Data System (ADS)

Zhao, X.; Schwenk, J.; Mandru, A. O.; Penedo, M.; Baćani, M.; Marioni, M. A.; Hug, H. J.

2018-01-01

In a step towards routinely achieving 10 nm spatial resolution with magnetic force microscopy, we have developed a robust method for active tip-sample distance control based on frequency modulation of the cantilever oscillation. It allows us to keep a well-defined tip-sample distance of the order of 10 nm within better than +/- 0.4 nm precision throughout the measurement even in the presence of energy dissipative processes, and is adequate for single-passage non-contact operation in vacuum. The cantilever is excited mechanically in a phase-locked loop to oscillate at constant amplitude on its first flexural resonance mode. This frequency is modulated by an electrostatic force gradient generated by tip-sample bias oscillating from a few hundred Hz up to a few kHz. The sum of the side bands’ amplitudes is a proxy for the tip-sample distance and can be used for tip-sample distance control. This method can also be extended to other scanning probe microscopy techniques.

Pilot application study of corridor performance indicators

DOT National Transportation Integrated Search

1998-09-16

The need for effective multimodal performance indicators (or measures) is becoming increasingly important for adequate planning in all sizes of transportation environments, including small and medium-size communities. These measures are essential for...

Regulating the path from legacy recognition, through recovery to release from regulatory control.

PubMed

Sneve, Malgorzata Karpow; Smith, Graham

2015-04-01

Past development of processes and technologies using radioactive material led to construction of many facilities worldwide. Some of these facilities were built and operated before the regulatory infrastructure was in place to ensure adequate control of radioactive material during operation and decommissioning. In other cases, controls were in place but did not meet modern standards, leading to what is now considered to have been inadequate control. Accidents and other events have occurred resulting in loss of control of radioactive material and unplanned releases to the environment. The legacy from these circumstances is that many countries have areas or facilities at which abnormal radiation conditions exist at levels that give rise to concerns about environmental and human health of potential interest to regulatory authorities. Regulation of these legacy situations is complex. This paper examines the regulatory challenges associated with such legacy management and brings forward suggestions for finding the path from: legacy recognition; implementation, as necessary, of urgent mitigation measures; development of a longer-term management strategy, through to release from regulatory control. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Psychometric properties of the Spanish version of the Controlling Coach Behaviors Scale in the sport context.

PubMed

Castillo, Isabel; Tomás, Inés; Ntoumanis, Nikos; Bartholomew, Kimberley; Duda, Joan L; Balaguer, Isabel

2014-01-01

The purpose of this research was to translate into Spanish and examine the psychometric properties of the Spanish version of the Controlling Coach Behaviors Scale (CCBS) in male soccer players. The CCBS is a questionnaire designed to assess athletes' perceptions of sports coaches' controlling interpersonal style from the perspective of the self-determination theory. Study 1 tested the factorial structure of the translated scale using confirmatory factor analysis (CFA) and provided evidence of discriminant validity. Studies 2 and 3 examined the invariance across time and across competitive level via multi-sample CFA. Reliability analyses were also conducted. The CFA results revealed that a four-factor model was acceptable, indicating that a controlling interpersonal style is a multidimensional construct represented by four separate and related controlling coaching strategies. Further, results supported the invariance of the CCBS factor structure across time and competitive level and provided support for the internal consistency of the scale. Overall, the CCBS demonstrated adequate internal consistency, as well as good factorial validity. The Spanish version of the CCBS represents a valid and reliable adaptation of the instrument, which can be confidently used to measure soccer players' perceptions of their coaches' controlling interpersonal style.

Stroke outcomes measures must be appropriately risk adjusted to ensure quality care of patients: a presidential advisory from the American Heart Association/American Stroke Association.

PubMed

Fonarow, Gregg C; Alberts, Mark J; Broderick, Joseph P; Jauch, Edward C; Kleindorfer, Dawn O; Saver, Jeffrey L; Solis, Penelope; Suter, Robert; Schwamm, Lee H

2014-05-01

Because stroke is among the leading causes of death, disability, hospitalizations, and healthcare expenditures in the United States, there is interest in reporting outcomes for patients hospitalized with acute ischemic stroke. The American Heart Association/American Stroke Association, as part of its commitment to promote high-quality, evidence-based care for cardiovascular and stroke patients, fully supports the development of properly risk-adjusted outcome measures for stroke. To accurately assess and report hospital-level outcomes, adequate risk adjustment for case mix is essential. During the development of the Centers for Medicare & Medicaid Services 30-day stroke mortality and 30-day stroke readmission measures, concerns were expressed that these measures were not adequately designed because they do not include a valid initial stroke severity measure, such as the National Institutes of Health Stroke Scale. These outcome measures, as currently constructed, may be prone to mischaracterizing the quality of stroke care being delivered by hospitals and may ultimately harm acute ischemic stroke patients. This article details (1) why the Centers for Medicare & Medicaid Services acute ischemic stroke outcome measures in their present form may not provide adequate risk adjustment, (2) why the measures as currently designed may lead to inaccurate representation of hospital performance and have the potential for serious unintended consequences, (3) what activities the American Heart Association/American Stroke Association has engaged in to highlight these concerns to the Centers for Medicare & Medicaid Services and other interested parties, and (4) alternative approaches and opportunities that should be considered for more accurately risk-adjusting 30-day outcomes measures in patients with ischemic stroke.

Quality and rural-urban comparison of tuberculosis care in Rivers State, Nigeria.

PubMed

Tobin-West, Charles Ibiene; Isodje, Anastasia

2016-01-01

Nigeria ranks among countries with the highest burden of tuberculosis. Yet evidence continues to indicate poor treatment outcomes which have been attributed to poor quality of care. This study aims to identify some of the systemic problems in order to inform policy decisions for improved quality of services and treatment outcomes in Nigeria. A comparative assessment of the quality of TB care in rural and urban health facilities was carried out between May and June 2013, employing the Donabedian model of quality assessment. Data was analysed using the SPSS software package version 20.0. The level of significance was set at p < 0.05. Health facility infrastructures were more constrained in the urban than rural settings. Both the urban and rural facilities lacked adequate facilities for infection control such as, running water, air filter respirators, hand gloves and extractor fans. Health education and HIV counselling and testing (HCT) were limited in rural facilities compared to urban facilities. Although anti-TB drugs were generally available in both settings, the DOTS strategy in patient care was completely ignored. Finally, laboratory support for diagnosis and patient monitoring was limited in the rural facilities. The study highlights suboptimal quality of TB care in Rivers State with limitations in health education and HCT of patients for HIV as well as laboratory support for TB care in rural health facilities. We, therefore, recommend that adequate infection control measures, strict observance of the DOTS strategy and sufficient laboratory support be provided to TB clinics in the State.

Launch, Low-Speed, and Landing Characteristics Determined from the First Flight of the North American X-15 Research Airplane

NASA Technical Reports Server (NTRS)

Finch, Thomas W.; Matranga, Gene J.

1959-01-01

The first flight of the North American X-15 research airplane was made on June 8, 1959. This was accomplished after completion of a series of captive flights with the X-15 attached to the B-52 carrier airplane to demonstrate the aerodynamic and systems compatibility of the X-15//B-52 combination and the X-15 subsystem operation. This flight was planned as a glide flight so that the pilot need not be concerned with the propulsion system. Discussions of the launch, low-speed maneuvering, and landing characteristics are presented, and the results are compared with predictions from preflight studies. The launch characteristics were generally satisfactory, and the X-15 vertical tail adequately cleared the B-52 wing cutout. The actual landing pattern and landing characteristics compared favorably with predictions, and the recommended landing technique of lowering the flaps and landing gear at a low altitude appears to be a satisfactory method of landing the X-15 airplane. There was a quantitative correlation between flight-measured and predicted lift-drag-ratio characteristics in the clean configuration and a qualitative correlation in the landing configuration. A longitudinal-controllability problem, which became severe in the landing configuration, was evident throughout the flight and, apparently, was aggravated by the sensitivity of the side-located control stick. In the low-to-moderate angle-of-attack range covered, the longitudinal and directional stability were indicated to be adequate.

Association between prenatal care utilization and risk of preterm birth among Chinese women.

PubMed

Zhang, Bin; Yang, Rong; Liang, Sheng-Wen; Wang, Jing; Chang, Jen Jen; Hu, Ke; Dong, Guang-Hui; Hu, Rong-Hua; Flick, Louise H; Zhang, Yi-Ming; Zhang, Dan; Li, Qing-Jie; Zheng, Tong-Zhang; Xu, Shun-Qing; Yang, Shao-Ping; Qian, Zheng-Min

2017-08-01

It is recognized that prenatal care plays an important role in reducing adverse birth. Chinese pregnant women with medical condition were required to seek additional health care based on the recommended at least 5 times health care visits. This study was to estimate the association between prenatal care utilization (PCU) and preterm birth (PTB), and to investigate if medical conditions during pregnancy modified the association. This population-based case control study sampled women with PTB as cases; one control for each case was randomly selected from women with term births. The Electronic Perinatal Health Care Information System (EPHCIS) and a questionnaire were used for data collection. The PCU was measured by a renewed Prenatal Care Utilization (APNCU) index. Logistic regression models were used to estimate odds ratios (OR) and the 95% confidence interval (95% CI). Totally, 2393 women with PTBs and 4263 women with term births were collected. In this study, 695 (10.5%) women experienced inadequate prenatal care, and 5131 (77.1%) received adequate plus prenatal care. Inadequate PCU was associated with PTB (adjusted OR: 1.41, 95% CI: 1.32-1.84); the similar positive association was found between adequate plus PCU and PTB. Among women with medical conditions, these associations still existed; but among women without medical conditions, the association between inadequate PCU and PTB disappeared. Our data suggests that women receiving inappropriate PCU are at an increased risk of having PTB, but it does depend on whether the woman has a medical condition during pregnancy.

What do Demand-Control and Effort-Reward work stress questionnaires really measure? A discriminant content validity study of relevance and representativeness of measures.

PubMed

Bell, Cheryl; Johnston, Derek; Allan, Julia; Pollard, Beth; Johnston, Marie

2017-05-01

The Demand-Control (DC) and Effort-Reward Imbalance (ERI) models predict health in a work context. Self-report measures of the four key constructs (demand, control, effort, and reward) have been developed and it is important that these measures have good content validity uncontaminated by content from other constructs. We assessed relevance (whether items reflect the constructs) and representativeness (whether all aspects of the construct are assessed, and all items contribute to that assessment) across the instruments and items. Two studies examined fourteen demand/control items from the Job Content Questionnaire and seventeen effort/reward items from the Effort-Reward Imbalance measure using discriminant content validation and a third study developed new methods to assess instrument representativeness. Both methods use judges' ratings and construct definitions to get transparent quantitative estimates of construct validity. Study 1 used dictionary definitions while studies 2 and 3 used published phrases to define constructs. Overall, 3/5 demand items, 4/9 control items, 1/6 effort items, and 7/11 reward items were uniquely classified to the appropriate theoretical construct and were therefore 'pure' items with discriminant content validity (DCV). All pure items measured a defining phrase. However, both the DC and ERI assessment instruments failed to assess all defining aspects. Finding good discriminant content validity for demand and reward measures means these measures are usable and our quantitative results can guide item selection. By contrast, effort and control measures had limitations (in relevance and representativeness) presenting a challenge to the implementation of the theories. Statement of contribution What is already known on this subject? While the reliability and construct validity of Demand-Control and Effort-Reward-Imbalance (DC and ERI) work stress measures are routinely reported, there has not been adequate investigation of their content validity. This paper investigates their content validity in terms of both relevance and representativeness and provides a model for the investigation of content validity of measures in health psychology more generally. What does this study add? A new application of an existing method, discriminant content validity, and a new method of assessing instrument representativeness. 'Pure' DC and ERI items are identified, as are constructs that are not fully represented by their assessment instruments. The findings are important for studies attempting to distinguish between the main DC and ERI work stress constructs. The quantitative results can be used to guide item selection for future studies. © 2017 The British Psychological Society.

Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension.

PubMed

Kario, Kazuomi; Tomitani, Naoko; Matsumoto, Yuri; Hamasaki, Haruna; Okawara, Yukie; Kondo, Maiko; Nozue, Ryoko; Yamagata, Hiromi; Okura, Ayako; Hoshide, Satoshi

2016-01-01

Asians have specific characteristics of hypertension (HTN) and its relationship with cardiovascular disease. The morning surge in blood pressure (BP) in Asians is more extended, and the association slope between higher BP and the risk for cardiovascular events is steeper in this population than in whites. Thus, 24-hour BP control including at night and in the morning is especially important for Asian patients with HTN. There are 3 components of "perfect 24-hour BP control": the 24-hour BP level, adequate dipping of nocturnal BP (dipper type), and adequate BP variability such as the morning BP surge. The morning BP-guided approach using home BP monitoring (HBPM) is the first step toward perfect 24-hour BP control. After controlling morning HTN, nocturnal HTN is the second target. We have been developing HBPM that can measure nocturnal BP. First, we developed a semiautomatic HBPM device with the function of automatic fixed-interval BP measurement during sleep. In the J-HOP (Japan Morning Surge Home Blood Pressure) study, the largest nationwide home BP cohort, we successfully measured nocturnal home BP using this device with data memory, 3 times during sleep (2, 3, and 4 am), and found that nocturnal home BP is significantly correlated with organ damage independently of office and morning BP values. The second advance was the development of trigger nocturnal BP (TNP) monitoring with an added trigger function that initiates BP measurements when oxygen desaturation falls below a variable threshold continuously monitored by pulse oximetry. TNP can detect the specific nocturnal BP surges triggered by hypoxic episodes in patients with sleep apnea syndrome. We also added the lowest heart rate-trigger function to TNP to detect the "basal nocturnal BP," which is determined by the circulating volume and structural cardiovascular system without any increase in sympathetic tonus. This double TNP is a novel concept for evaluating the pathogenic pressor mechanism of nocturnal BP. These data are now collected using an information and communication technology (ICT)-based monitoring system. The BP variability includes different time-phase variability from the shortest beat-by-beat, positional, diurnal, day-by-day, visit-to-visit, seasonal, and the longest yearly changes. The synergistic resonance of each type of BP variability would produce great dynamic BP surges, which trigger cardiovascular events. Thus, in the future, the management of HTN based on the simultaneous assessment of the resonance of all of the BP variability phenotypes using a wearable "surge" BP monitoring device with an ICT-based data analysis system will contribute to the ultimate individualized medication for cardiovascular disease. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Coverage of Adequately Iodized Salt Is Suboptimal and Rice Fortification Using Public Distribution Channels Could Reach Low-Income Households: Findings from a Cross-Sectional Survey of Anganwadi Center Catchment Areas in Telangana, India.

PubMed

Wirth, James P; Leyvraz, Magali; Sodani, Prahlad R; Aaron, Grant J; Sharma, Narottam D; Woodruff, Bradley A

2016-01-01

Food fortification is a cost-effective approach to prevent and control of micronutrient deficiencies in India. A cross-sectional survey of children 0-35 months of age residing in the catchment areas of anganwadi centers in the state of Telangana was conducted to assess the coverage of adequately iodized salt and the potential for rice fortification. Salt samples were collected and tested for iodine concentration using iodometric titration. Information on demographics, household rice consumption, and Telangana's rice sector was collected and interpreted. In households of selected children, 79% of salt samples were found to be adequately iodized. Salt brand and district were significant predictors of inadequately iodized salt. Daily rice consumption among children and women averaged 122 grams and 321 grams per day, respectively. Approximately 28% of households reported consuming rice produced themselves or purchased from a local farmer, 65% purchased rice from a market or shop, 6% got rice from a public distribution system site, and 2% obtained it from a rice mill. In the catchment areas of Telangana's anganwadi centers, there is significant variation in the coverage of adequately iodized salt by district. Future surveys in Telangana should measure the coverage of salt iodization in the general population using quantitative methods. Nonetheless, increasing the adequacy of iodization of smaller salt manufacturers would help achieve universal salt iodization in Telangana. Despite high consumption of rice, our findings suggest that large-scale market-based rice fortification is not feasible in Telangana due to a large proportion of households producing their own rice and highly fragmented rice distribution. Distributing fortified rice via Telangana's public distribution system may be a viable approach to target low-income households, but would only reach a small proportion of the population in Telangana.

Coverage of Adequately Iodized Salt Is Suboptimal and Rice Fortification Using Public Distribution Channels Could Reach Low-Income Households: Findings from a Cross-Sectional Survey of Anganwadi Center Catchment Areas in Telangana, India

PubMed Central

Wirth, James P.; Leyvraz, Magali; Sodani, Prahlad R.; Aaron, Grant J.; Sharma, Narottam D.; Woodruff, Bradley A.

2016-01-01

Food fortification is a cost-effective approach to prevent and control of micronutrient deficiencies in India. A cross-sectional survey of children 0–35 months of age residing in the catchment areas of anganwadi centers in the state of Telangana was conducted to assess the coverage of adequately iodized salt and the potential for rice fortification. Salt samples were collected and tested for iodine concentration using iodometric titration. Information on demographics, household rice consumption, and Telangana’s rice sector was collected and interpreted. In households of selected children, 79% of salt samples were found to be adequately iodized. Salt brand and district were significant predictors of inadequately iodized salt. Daily rice consumption among children and women averaged 122 grams and 321 grams per day, respectively. Approximately 28% of households reported consuming rice produced themselves or purchased from a local farmer, 65% purchased rice from a market or shop, 6% got rice from a public distribution system site, and 2% obtained it from a rice mill. In the catchment areas of Telangana’s anganwadi centers, there is significant variation in the coverage of adequately iodized salt by district. Future surveys in Telangana should measure the coverage of salt iodization in the general population using quantitative methods. Nonetheless, increasing the adequacy of iodization of smaller salt manufacturers would help achieve universal salt iodization in Telangana. Despite high consumption of rice, our findings suggest that large-scale market-based rice fortification is not feasible in Telangana due to a large proportion of households producing their own rice and highly fragmented rice distribution. Distributing fortified rice via Telangana’s public distribution system may be a viable approach to target low-income households, but would only reach a small proportion of the population in Telangana. PMID:27447925

Exercise in Young Adulthood with Simultaneous and Future Changes in Fruit and Vegetable Intake.

PubMed

Jayawardene, Wasantha P; Torabi, Mohammad R; Lohrmann, David K

2016-01-01

Regarding weight management, changes in exercise behavior can also influence nutrition behavior by application of self-regulatory psychological resources across behaviors (transfer effect). This study aimed to determine: (1) if changes in exercise frequency in young adulthood predict simultaneous changes in fruit/vegetable intake (transfer as co-occurrence); and (2) if exercise frequency affects future fruit/vegetable intake (transfer as carry-over). 6244 respondents of the National Longitudinal Survey of Youth 1997 were followed at ages 18-22 (Time-1), 23-27 (Time-2), and 27-31 (Time-3). Repeated measures analysis of variance and hierarchical multiple regression determined if the change in exercise frequency between Time-1 and Time-2 was associated with simultaneous and sequential changes in fruit/vegetable intake frequency, controlling for sex, race/ethnicity, education, income, body mass index, and baseline fruit/vegetable intake. Only 9% continued exercising for 30 minutes more than 5 days/week, while 15% transitioned to adequate exercise and another 15% transitioned to inadequate exercise; for both fruits and vegetables, intake of once per day or more increased with age. Males were more likely to exercise adequately and females to consume fruits/vegetables adequately. Exercise frequency transition was linearly associated with concurrent fruit/vegetable intake during Time-1 and Time-2. The highest increase in mean fruit/vegetable intake occurred for participants who transitioned from inadequate to adequate exercise. A significant Time-2 exercise frequency effect on Time-3 fruit/vegetable intake emerged, after accounting for baseline intake. Increase in Time-2 exercise by one day/week resulted in increased Time-3 fruit and vegetable intakes by 0.17 and 0.13 times/week, respectively. Transfer effects, although usually discussed in interventions, may also be applicable to voluntary behavior change processes. Newly engaging in and continuing exercise behavior over time may establish exercise habits that facilitate improved fruit/vegetable consumption. Interventions that facilitate transferring resources across behaviors likely will enhance this effect.

Dynamics and controls working group summary

NASA Technical Reports Server (NTRS)

Oglevie, R. E.

1984-01-01

The technology status of the dynamics and controls discipline as it applies to energy storage wheel systems was evaluated. No problems were identified for which an adequate solution could not be proposed. Design issues that influence control were addressed. The dynamics and control aspects associated with the energy storage system concept and its various constituent parts, and the control tasks attendant to large, manned spacecraft are discussed.

Teaching residents to use asthma devices. Assessing family residents' skills and a brief intervention.

PubMed Central

Kelcher, S.; Brownoff, R.

1994-01-01

OBJECTIVE: To evaluate an educational program for family medicine residents on using selected inhaler devices for delivery of asthma medications. DESIGN: A prospective analysis using pretests and posttests of a nonrandomized study group and control group. The study group of residents was given an instructional manual and a set of devices for home study, followed by a 1-hour tutorial session with a clinical instructor that included a video and hands-on practice. SETTING: Family medicine centres in Edmonton hospitals. PARTICIPANTS: The study group consisted of a convenience sample of 23 first- and second-year family medicine residents at the Misericordia Hospital Family Medicine Centre. The control group consisted of a convenience sample of 22 first- and second-year family medicine residents at the Royal Alexandra Hospital Family Medicine Centre. Nine residents did not take the posttest; one was absent because of injury, one missed the in-service, and seven had left the city on other rotations, had completed their program, or declined to participate. MAIN OUTCOME MEASURES: Improvements in scores on a multiple-choice test and in techniques of using the devices. RESULTS: Using an average of scores on seven different devices, only 36% of residents showed adequate knowledge of how to use the devices on the pretest. Posttest scores improved for both the control (P < 0.001) and study (P < 0.001) groups, but improvement was significantly greater for the study group (P < 0.001). CONCLUSIONS: Residents lacked adequate knowledge of asthma devices. More study is needed to confirm the long-term effectiveness of formal teaching about the devices. Images Figure 1 PMID:7888821

Dietary Zinc Deficiency Affects Blood Linoleic Acid: Dihomo-γ-linolenic Acid (LA:DGLA) Ratio; a Sensitive Physiological Marker of Zinc Status in Vivo (Gallus gallus)

PubMed Central

Reed, Spenser; Qin, Xia; Ran-Ressler, Rinat; Brenna, James Thomas; Glahn, Raymond P.; Tako, Elad

2014-01-01

Zinc is a vital micronutrient used for over 300 enzymatic reactions and multiple biochemical and structural processes in the body. To date, sensitive and specific biological markers of zinc status are still needed. The aim of this study was to evaluate Gallus gallus as an in vivo model in the context of assessing the sensitivity of a previously unexplored potential zinc biomarker, the erythrocyte linoleic acid: dihomo-γ-linolenic acid (LA:DGLA) ratio. Diets identical in composition were formulated and two groups of birds (n = 12) were randomly separated upon hatching into two diets, Zn(+) (zinc adequate control, 42.3 μg/g zinc), and Zn(−) (zinc deficient, 2.5 μg/g zinc). Dietary zinc intake, body weight, serum zinc, and the erythrocyte fatty acid profile were measured weekly. At the conclusion of the study, tissues were collected for gene expression analysis. Body weight, feed consumption, zinc intake, and serum zinc were higher in the Zn(+) control versus Zn(−) group (p < 0.05). Hepatic TNF-α, IL-1β, and IL-6 gene expression were higher in the Zn(+) control group (p < 0.05), and hepatic Δ6 desaturase was significantly higher in the Zn(+) group (p < 0.001). The LA:DGLA ratio was significantly elevated in the Zn(−) group compared to the Zn(+) group (22.6 ± 0.5 and 18.5 ± 0.5, % w/w, respectively, p < 0.001). This study suggests erythrocyte LA:DGLA is able to differentiate zinc status between zinc adequate and zinc deficient birds, and may be a sensitive biomarker to assess dietary zinc manipulation. PMID:24658588

Cost-Effective Control Systems for Colleges and Universities: A New Paradigm.

ERIC Educational Resources Information Center

Hubbell, Loren Loomis; Dougherty, Jennifer Dowling

This report addresses the issue of maintaining adequate controls within a streamlined or restructured financial affairs environment at an institution of higher education. It presents a new paradigm for control structures designed to more effectively meet administrators' needs--both in terms of cost and risk management. The first section: (1)…

21 CFR 1301.73 - Physical security controls for non-practitioners; compounders for narcotic treatment programs...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Physical security controls for non-practitioners..., DISTRIBUTORS, AND DISPENSERS OF CONTROLLED SUBSTANCES Security Requirements § 1301.73 Physical security... adequate security for the area or building. If such security requires an alarm, such alarm, upon...

21 CFR 212.50 - What production and process controls must I have?

Code of Federal Regulations, 2012 CFR

2012-04-01

... must have adequate production and process controls to ensure the consistent production of a PET drug... all steps in the PET drug production process. The master production and control records must include the following information: (1) The name and strength of the PET drug; (2) If applicable, the name and...

21 CFR 212.50 - What production and process controls must I have?

Code of Federal Regulations, 2014 CFR

2014-04-01

... must have adequate production and process controls to ensure the consistent production of a PET drug... all steps in the PET drug production process. The master production and control records must include the following information: (1) The name and strength of the PET drug; (2) If applicable, the name and...

21 CFR 212.50 - What production and process controls must I have?

Code of Federal Regulations, 2013 CFR

2013-04-01

... must have adequate production and process controls to ensure the consistent production of a PET drug... all steps in the PET drug production process. The master production and control records must include the following information: (1) The name and strength of the PET drug; (2) If applicable, the name and...

The utility of P300 as a schizophrenia endophenotype and predictive biomarker: clinical and socio-demographic modulators in COGS-2.

PubMed

Turetsky, Bruce I; Dress, Erich M; Braff, David L; Calkins, Monica E; Green, Michael F; Greenwood, Tiffany A; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Nuechterlein, Keith H; Radant, Allen D; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Sprock, Joyce; Stone, William S; Sugar, Catherine A; Swerdlow, Neal R; Tsuang, Debby W; Tsuang, Ming T; Light, Gregory

2015-04-01

Reduced auditory P300 amplitude is a robust schizophrenia deficit exhibiting the qualities of a viable genetic endophenotype. These include heritability, test-retest reliability, and trait-like stability. Recent evidence suggests that P300 may also serve as a predictive biomarker for transition to psychosis during the schizophrenia prodrome. Historically, the utility of the P300 has been limited by its clinical nonspecificity, cross-site measurement variability, and required EEG expertise. The Consortium on the Genetics of Schizophrenia (COGS-2) study provided an opportunity to examine the consistency of the measure across multiple sites with varying degrees of EEG experience, and to identify important modulating factors that contribute to measurement variability. Auditory P300 was acquired from 649 controls and 587 patients at 5 sites. An overall patient deficit was observed with effect size 0.62. Each site independently observed a significant patient deficit, but site differences also existed. In patients, site differences reflected clinical differences in positive symptomatology and functional capacity. In controls, site differences reflected differences in racial stratification, smoking and substance use history. These factors differentially suppressed the P300 response, but only in control subjects. This led to an attenuated patient-control difference among smokers and among African Americans with history of substance use. These findings indicate that the P300 can be adequately assessed quantitatively, across sites, without substantial EEG expertise. Measurements are suitable for both genetic endophenotype analyses and studies of psychosis risk and conversion. However, careful attention must be given to selection of appropriate comparison samples to avoid misleading false negative results. Copyright © 2014 Elsevier B.V. All rights reserved.

The Utility of P300 as a Schizophrenia Endophenotype and Predictive Biomarker: Clinical and Socio-Demographic Modulators in COGS-2

PubMed Central

Turetsky, Bruce I.; Dress, Erich M.; Braff, David L.; Calkins, Monica E.; Green, Michael F.; Greenwood, Tiffany A.; Gur, Raquel E.; Gur, Ruben C.; Lazzeroni, Laura C.; Nuechterlein, Keith H.; Radant, Allen D.; Seidman, Larry J.; Siever, Larry J.; Silverman, Jeremy M.; Sprock, Joyce; Stone, William S.; Sugar, Catherine A.; Swerdlow, Neal R.; Tsuang, Debby W.; Tsuang, Ming T.; Light, Gregory

2014-01-01

Reduced auditory P300 amplitude is a robust schizophrenia deficit exhibiting the qualities of a viable genetic endophenotype. These include heritability, test-retest reliability, and trait-like stability. Recent evidence suggests that P300 may also serve as a predictive biomarker for transition to psychosis during the schizophrenia prodrome. Historically, the utility of the P300 has been limited by its clinical nonspecificity, cross-site measurement variability, and required EEG expertise. The Consortium on the Genetics of Schizophrenia (COGS-2) study provided an opportunity to examine the consistency of the measure across multiple sites with varying degrees of EEG experience, and to identify important modulating factors that contribute to measurement variability. Auditory P300 was acquired from 649 control and 587 patients at 5 sites. An overall patient deficit was observed with effect size 0.62. Each site independently observed a significant patient deficit, but site differences also existed. In patients, site differences reflected clinical differences in positive symptomatology and functional capacity. In controls, site differences reflected differences in racial stratification, smoking and substance use history. These factors differentially suppressed the P300 response, but only in control subjects. This led to an attenuated patient-control difference among smokers and among African Americans with history of substance use. These findings indicate that the P300 can be adequately assessed quantitatively, across sites, without substantial EEG expertise. Measurements are suitable for both genetic endophenotype analyses and studies of psychosis risk and conversion. However, careful attention must be given to selection of appropriate comparison samples to avoid misleading false negative results. PMID:25306203

Effect of individual blade control on noise radiation

NASA Technical Reports Server (NTRS)

Swanson, S. M.; Jacklin, Stephen A.; Niesl, G.; Blaas, Achim; Kube, R.

1995-01-01

In a joint research program of NASA Ames Research Center, ZF Luftfahrttechnik, the German Aerospace Research Establishment (DLR), and EUROCOPTER Deutschland, a wind tunnel test was performed to evaluate the effects of Individual Blade Control (IBC) on rotor noise. This test was conducted in the 40x80 ft wind tunnel at NASA Ames Research Center, utilizing a full scale MBB-BO 105 four-bladed rotor system. Three microphones were installed for determination of the radiated noise, two of them on a moveable traverse below the advancing blade side and one in a fixed location below the retreating side. Acoustic results are presented for flight conditions with Blade-Vortex-Interaction (BVI) noise radiation. High noise level reductions were measured for single harmonic control inputs. In addition to the single harmonic inputs, multi-harmonic inputs were evaluated by superimposing 2/rev to 6/rev harmonics. For the first time the efficiency of sharp wavelets (60 deg and 90 deg width) on acoustic noise were measured. In order to achieve an adequate wavelet shape at the blade tip, corrections were made to account for the blade torsional behavior. In parallel with the acoustic measurements, vibratory loads were measured during the BVI flight condition to correlate the effects of IBC on noise and vibrations. It is shown how noise levels and vibrations are affected by specific IBC control inputs. In addition, correlations are made between noise levels and acoustic time histories with IBC phase and amplitude variations. For one IBC input mode with high noise reducing efficiency, a sweep of the moveable microphone traverse below the advancing side shows the effect on BVI noise directivity.

Complementary and alternative medicine whole systems research: beyond identification of inadequacies of the RCT.

PubMed

Verhoef, Marja J; Lewith, George; Ritenbaugh, Cheryl; Boon, Heather; Fleishman, Susan; Leis, Anne

2005-09-01

Complementary and alternative medicine (CAM) often consists of whole systems of care (such as naturopathic medicine or traditional Chinese medicine (TCM)) that combine a wide range of modalities to provide individualised treatment. The complexity of these interventions and their potential synergistic effect requires innovative evaluative approaches. Model validity, which encompasses the need for research to adequately address the unique healing theory and therapeutic context of the intervention, is central to whole systems research (WSR). Classical randomised controlled trials (RCTs) are limited in their ability to address this need. Therefore, we propose a mixed methods approach that includes a range of relevant and holistic outcome measures. As the individual components of most whole systems are inseparable, complementary and synergistic, WSR must not focus only on the "active" ingredients of a system. An emerging WSR framework must be non-hierarchical, cyclical, flexible and adaptive, as knowledge creation is continuous, evolutionary and necessitates a continuous interplay between research methods and "phases" of knowledge. Finally, WSR must hold qualitative and quantitative research methods in equal esteem to realize their unique research contribution. Whole systems are complex and therefore no one method can adequately capture the meaning, process and outcomes of these interventions.

Performance of the upgraded LTP-II at the ALS Optical Metrology Laboratory

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

Advanced Light Source; Yashchuk, Valeriy V; Kirschman, Jonathan L.

2008-07-14

The next generation of synchrotrons and free electron laser facilities requires x-ray optical systems with extremely high performance, generally of diffraction limited quality. Fabrication and use of such optics requires adequate, highly accurate metrology and dedicated instrumentation. Previously, we suggested ways to improve the performance of the Long Trace Profiler (LTP), a slope measuring instrument widely used to characterize x-ray optics at long spatial wavelengths. The main way is use of a CCD detector and corresponding technique for calibration of photo-response non-uniformity [J. L. Kirschman, et al., Proceedings of SPIE 6704, 67040J (2007)]. The present work focuses on the performancemore » and characteristics of the upgraded LTP-II at the ALS Optical Metrology Laboratory. This includes a review of the overall aspects of the design, control system, the movement and measurement regimes for the stage, and analysis of the performance by a slope measurement of a highly curved super-quality substrate with less than 0.3 microradian (rms)slope variation.« less

Relationships between Contextual and Task Performance and Interrater Agreement: Are There Any?

PubMed

Díaz-Vilela, Luis F; Delgado Rodríguez, Naira; Isla-Díaz, Rosa; Díaz-Cabrera, Dolores; Hernández-Fernaud, Estefanía; Rosales-Sánchez, Christian

2015-01-01

Work performance is one of the most important dependent variables in Work and Organizational Psychology. The main objective of this paper was to explore the relationships between citizenship performance and task performance measures obtained from different appraisers and their consistency through a seldom-used methodology, intraclass correlation coefficients. Participants were 135 public employees, the total staff in a local government department. Jobs were clustered into job families through a work analysis based on standard questionnaires. A task description technique was used to develop a performance appraisal questionnaire for each job family, with three versions: self-, supervisor-, and peer-evaluation, in addition to a measure of citizenship performance. Only when the self-appraisal bias is controlled, significant correlations appeared between task performance rates. However, intraclass correlations analyses show that only self- (contextual and task) performance measures are consistent, while interrater agreement disappears. These results provide some interesting clues about the procedure of appraisal instrument development, the role of appraisers, and the importance of choosing adequate consistency analysis methods.

Relationships between Contextual and Task Performance and Interrater Agreement: Are There Any?

PubMed Central

Díaz-Cabrera, Dolores; Hernández-Fernaud, Estefanía; Rosales-Sánchez, Christian

2015-01-01

Work performance is one of the most important dependent variables in Work and Organizational Psychology. The main objective of this paper was to explore the relationships between citizenship performance and task performance measures obtained from different appraisers and their consistency through a seldom-used methodology, intraclass correlation coefficients. Participants were 135 public employees, the total staff in a local government department. Jobs were clustered into job families through a work analysis based on standard questionnaires. A task description technique was used to develop a performance appraisal questionnaire for each job family, with three versions: self-, supervisor-, and peer-evaluation, in addition to a measure of citizenship performance. Only when the self-appraisal bias is controlled, significant correlations appeared between task performance rates. However, intraclass correlations analyses show that only self- (contextual and task) performance measures are consistent, while interrater agreement disappears. These results provide some interesting clues about the procedure of appraisal instrument development, the role of appraisers, and the importance of choosing adequate consistency analysis methods. PMID:26473956

Treatments for somnambulism in adults: assessing the evidence.

PubMed

Harris, Melanie; Grunstein, Ronald R

2009-08-01

Somnambulism, or sleepwalking, is a parasomnia of non-rapid eye movement (NREM) sleep where movement behaviours usually confined to wakefulness are displayed during sleep. Generally, if sleepwalking is causing distress or danger in spite of safety measures, medical or psychological treatment is indicated. Clinicians will need to assess the evidence for treatment options. MEDLINE, EMBASE, PsycINFO and the Ovid Evidence-Based Medicine Reviews (EBM) multifile databases were searched. No properly powered rigorous controlled trials were found for treatment of sleepwalking in adults. Seven reports described small trials with some kind of control arm, or retrospective case series which included 30 or more patients. With no high quality evidence to underpin recommendations for treatments of somnambulism, full discussion with patients is advised. Adequately powered, well-designed clinical trials are now needed, and multi-centre collaborations may be required to obtain the sample sizes required.

Does the therapy manual or the therapist matter most in treatment of obsessive-compulsive disorder? A randomized controlled trial of exposure with response or ritual prevention in 118 patients.

PubMed

van Oppen, Patricia; van Balkom, Anton J L M; Smit, Johannes H; Schuurmans, Josien; van Dyck, Richard; Emmelkamp, Paul M G

2010-09-01

The importance of the therapist's education and experience for the successful behavior treatment of obsessive-compulsive disorder (OCD) has not been investigated. Data on the relative effectiveness of self-controlled versus therapist-controlled in vivo exposure with response or ritual prevention (ERP) have yielded conflicting results. The present study compared the effectiveness of 4 different modes of delivery of ERP in a referred sample of OCD patients. Of the 146 eligible OCD outpatients, 118 patients enrolled in this randomized controlled trial and were randomly assigned to (1) therapist-controlled ERP performed by experienced behavior therapists; (2) therapist-controlled ERP performed by master's students of clinical psychology; (3) self-controlled ERP performed by experienced behavior therapists; and (4) self-controlled ERP performed by master's students of clinical psychology. This trial was performed from January 1999 to January 2005. Our analyses revealed no significant differences in clinical outcome between any of the different modes of delivery of ERP at posttreatment. The different ERP modes of delivery were associated with significant pretreatment to posttreatment improvement on all measurements, with large effect sizes on the primary outcome measure, the Yale-Brown Obsessive Compulsive Scale. Our results indicate that clinically inexperienced master's students with no postgraduate training can be as capable as experienced and certified behavior therapists in treating OCD patients, as long as therapists adhere to a standardized treatment manual and adequate training and supervision is provided. In contrast to other studies, we did not find a supposed benefit of therapist-controlled ERP versus self-controlled ERP in patients with OCD. www.trialregister.nl Identifier: NTR1444. © Copyright 2010 Physicians Postgraduate Press, Inc.

Primary Care Practices' Abilities And Challenges In Using Electronic Health Record Data For Quality Improvement.

PubMed

Cohen, Deborah J; Dorr, David A; Knierim, Kyle; DuBard, C Annette; Hemler, Jennifer R; Hall, Jennifer D; Marino, Miguel; Solberg, Leif I; McConnell, K John; Nichols, Len M; Nease, Donald E; Edwards, Samuel T; Wu, Winfred Y; Pham-Singer, Hang; Kho, Abel N; Phillips, Robert L; Rasmussen, Luke V; Duffy, F Daniel; Balasubramanian, Bijal A

2018-04-01

Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical quality measures that their electronic health records (EHRs) generate. To determine whether EHRs produce reports adequate to the task, we examined survey responses from 1,492 practices across twelve states, supplemented with qualitative data. Meaningful-use participation, which requires the use of a federally certified EHR, was associated with the ability to generate reports-but the reports did not necessarily support quality improvement initiatives. Practices reported numerous challenges in generating adequate reports, such as difficulty manipulating and aligning measurement time frames with quality improvement needs, lack of functionality for generating reports on electronic clinical quality measures at different levels, discordance between clinical guidelines and measures available in reports, questionable data quality, and vendors that were unreceptive to changing EHR configuration beyond federal requirements. The current state of EHR measurement functionality may be insufficient to support federal initiatives that tie payment to clinical quality measures.

Primary Care Practices’ Abilities And Challenges In Using Electronic Health Record Data For Quality Improvement

PubMed Central

Cohen, Deborah J.; Dorr, David A.; Knierim, Kyle; DuBard, C. Annette; Hemler, Jennifer R.; Hall, Jennifer D.; Marino, Miguel; Solberg, Leif I.; McConnell, K. John; Nichols, Len M.; Nease, Donald E.; Edwards, Samuel T.; Wu, Winfred Y.; Pham-Singer, Hang; Kho, Abel N.; Phillips, Robert L.; Rasmussen, Luke V.; Duffy, F. Daniel; Balasubramanian, Bijal A.

2018-01-01

Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical quality measures that their electronic health records (EHRs) generate. To determine whether EHRs produce reports adequate to the task, we examined survey responses from 1,492 practices across twelve states, supplemented with qualitative data. Meaningful-use participation, which requires the use of a federally certified EHR, was associated with the ability to generate reports—but the reports did not necessarily support quality improvement initiatives. Practices reported numerous challenges in generating adequate reports, such as difficulty manipulating and aligning measurement time frames with quality improvement needs, lack of functionality for generating reports on electronic clinical quality measures at different levels, discordance between clinical guidelines and measures available in reports, questionable data quality, and vendors that were unreceptive to changing EHR configuration beyond federal requirements. The current state of EHR measurement functionality may be insufficient to support federal initiatives that tie payment to clinical quality measures. PMID:29608365

Polyphenol-based nutraceuticals for the prevention and treatment of cardiovascular disease: Review of human evidence.

PubMed

Tomé-Carneiro, Joao; Visioli, Francesco

2016-10-15

In addition to prescription drugs, nutraceuticals/functional foods/medical foods are being increasingly added as adjunct treatment of cardiovascular disease (CVD), even though most of them have been exclusively studied in vitro. We review the available evidence (focusing on when the amount of polyphenols' intake was measured) coming from randomized controlled trials (RCTs) of (poly)phenol-based supplements. We conclude that (poly)phenol-based nutraceuticals and functional foods might be indeed used as adjunct therapy of CVD, but additional long-term RCTs with adequate numerosity and with clinically relevant end points are needed to provide unequivocal evidence of their clinical usefulness. Copyright © 2015. Published by Elsevier GmbH.

Relaxing the rule of ten events per variable in logistic and Cox regression.

PubMed

Vittinghoff, Eric; McCulloch, Charles E

2007-03-15

The rule of thumb that logistic and Cox models should be used with a minimum of 10 outcome events per predictor variable (EPV), based on two simulation studies, may be too conservative. The authors conducted a large simulation study of other influences on confidence interval coverage, type I error, relative bias, and other model performance measures. They found a range of circumstances in which coverage and bias were within acceptable levels despite less than 10 EPV, as well as other factors that were as influential as or more influential than EPV. They conclude that this rule can be relaxed, in particular for sensitivity analyses undertaken to demonstrate adequate control of confounding.

Privacy and Security Issues Surrounding the Protection of Data Generated by Continuous Glucose Monitors.

PubMed

Britton, Katherine E; Britton-Colonnese, Jennifer D

2017-03-01

Being able to track, analyze, and use data from continuous glucose monitors (CGMs) and through platforms and apps that communicate with CGMs helps achieve better outcomes and can advance the understanding of diabetes. The risks to patients' expectation of privacy are great, and their ability to control how their information is collected, stored, and used is virtually nonexistent. Patients' physical security is also at risk if adequate cybersecurity measures are not taken. Currently, data privacy and security protections are not robust enough to address the privacy and security risks and stymies the current and future benefits of CGM and the platforms and apps that communicate with them.

Privacy and Security Issues Surrounding the Protection of Data Generated by Continuous Glucose Monitors

PubMed Central

Britton, Katherine E.; Britton-Colonnese, Jennifer D.

2017-01-01

Being able to track, analyze, and use data from continuous glucose monitors (CGMs) and through platforms and apps that communicate with CGMs helps achieve better outcomes and can advance the understanding of diabetes. The risks to patients’ expectation of privacy are great, and their ability to control how their information is collected, stored, and used is virtually nonexistent. Patients’ physical security is also at risk if adequate cybersecurity measures are not taken. Currently, data privacy and security protections are not robust enough to address the privacy and security risks and stymies the current and future benefits of CGM and the platforms and apps that communicate with them. PMID:28264188

The Economics of Pollution; Part Three: Can Pollution Be Controlled? Teaching About: Can Pollution Be Controlled?

ERIC Educational Resources Information Center

Wolozin, Harold; Reilly, Patricia R.

In this third of three articles on the economics of pollution control general statements from several sources present a background which questions our ability to devise the necessary tools to fight pollution, even if adequate expenditures of money are provided. In the struggle to control pollution, the economist, it is believed, can provide…

How Drug Control Policy and Practice Undermine Access to Controlled Medicines

PubMed Central

Csete, Joanne; Wilson, Duncan; Fox, Edward; Wolfe, Daniel; Rasanathan, Jennifer J. K.

2017-01-01

Abstract Drug conventions serve as the cornerstone for domestic drug laws and impose a dual obligation upon states to prevent the misuse of controlled substances while ensuring their adequate availability for medical and scientific purposes. Despite the mandate that these obligations be enforced equally, the dominant paradigm enshrined in the drug conventions is an enforcement-heavy criminal justice response to controlled substances that prohibits and penalizes their misuse. Prioritizing restrictive control is to the detriment of ensuring adequate availability of and access to controlled medicines, thereby violating the rights of people who need them. This paper argues that the drug conventions’ prioritization of criminal justice measures—including efforts to prevent non-medical use of controlled substances—undermines access to medicines and infringes upon the right to health and the right to enjoy the benefits of scientific progress. While the effects of criminalization under drug policy limit the right to health in multiple ways, we draw on research and documented examples to highlight the impact of drug control and criminalization on access to medicines. The prioritization and protection of human rights—specifically the right to health and the right to enjoy the benefits of scientific progress—are critical to rebalancing drug policy. PMID:28630556

Counterinsurgency and Operational Art: Is the Joint Campaign Planning Model Adequate?

DTIC Science & Technology

2003-01-01

ART: IS THE JOINT CAMAPIGN PLANNING MODEL ADEQUATE? by MAJ Thomas Erik Miller, USA, 90 pages. The United States has conducted or supported more than a...increase. Some of the effects of the fall of the Soviet Union were a loosening of internal and external political and social controls in formerly Soviet...order” in the social , economic and political arena through rapid growth in population and urbanization in the underdeveloped world, globalization and

Controlling the potential hazards of government-sponsored technology. [such as weather modification and the supersonic transports

NASA Technical Reports Server (NTRS)

Wollan, M. J.

1975-01-01

The ability was examined of governmental agencies to adequately assess technological programs or projects to which they are committed. The hazards of government-sponsored activities are discussed; these include weather modification, supersonic transport noise, and the value conflicts involved in the fluoridation controversy. These three case studies indicate that the Federal vested interests in the continuation of its technological programs limit its ability to provide adequate technology assessment.

PROCEDURE FOR ESTIMATING PERMANENT TOTAL ENCLOSURE COSTS

EPA Science Inventory

The paper discusses a procedure for estimating permanent total enclosure (PTE) costs. (NOTE: Industries that use add-on control devices must adequately capture emissions before delivering them to the control device. One way to capture emissions is to use PTEs, enclosures that mee...

Use of an intravascular fluorescent continuous glucose sensor in subjects with type 1 diabetes mellitus.

PubMed

Romey, Matthew; Jovanovič, Lois; Bevier, Wendy; Markova, Kateryna; Strasma, Paul; Zisser, Howard

2012-11-01

Stress hyperglycemia in the critically ill is associated with increased morbidity and mortality. Continuous glucose monitoring offers a solution to the difficulties of dosing intravenous insulin properly to maintain glycemic control. The purpose of this study was to evaluate an intravascular continuous glucose monitoring (IV-CGM) system with a sensing element based on the concept of quenched fluorescence. A second-generation intravascular continuous glucose sensor was evaluated in 13 volunteer subjects with type 1 diabetes mellitus. There were 21 study sessions of up to 24 h in duration. Sensors were inserted into peripheral veins of the upper extremity, up to two sensors per subject per study session. Sensor output was compared with temporally correlated reference measurements obtained from venous samples on a laboratory glucose analyzer. Data were obtained from 23 sensors in 13 study sessions with 942 paired reference values. Fourteen out of 23 sensors (60.9%) had a mean absolute relative difference ≤ 10%. Eighty-nine percent of paired points were in the clinically accurate A zone of the Clarke error grid and met ISO 15197 performance criteria. Adequate venous blood flow was identified as a necessary condition for accuracy when local sensor readings are compared with venous blood glucose. The IV-CGM system was capable of achieving a high level of glucose measurement accuracy. However, superficial peripheral veins may not provide adequate blood flow for reliable indwelling blood glucose monitoring. © 2012 Diabetes Technology Society.

Use of an Intravascular Fluorescent Continuous Glucose Sensor in Subjects with Type 1 Diabetes Mellitus

PubMed Central

Romey, Matthew; Jovanovič, Lois; Bevier, Wendy; Markova, Kateryna; Strasma, Paul; Zisser, Howard

2012-01-01

Background Stress hyperglycemia in the critically ill is associated with increased morbidity and mortality. Continuous glucose monitoring offers a solution to the difficulties of dosing intravenous insulin properly to maintain glycemic control. The purpose of this study was to evaluate an intravascular continuous glucose monitoring (IV-CGM) system with a sensing element based on the concept of quenched fluorescence. Method A second-generation intravascular continuous glucose sensor was evaluated in 13 volunteer subjects with type 1 diabetes mellitus. There were 21 study sessions of up to 24 h in duration. Sensors were inserted into peripheral veins of the upper extremity, up to two sensors per subject per study session. Sensor output was compared with temporally correlated reference measurements obtained from venous samples on a laboratory glucose analyzer. Results Data were obtained from 23 sensors in 13 study sessions with 942 paired reference values. Fourteen out of 23 sensors (60.9%) had a mean absolute relative difference ≤ 10%. Eighty-nine percent of paired points were in the clinically accurate A zone of the Clarke error grid and met ISO 15197 performance criteria. Adequate venous blood flow was identified as a necessary condition for accuracy when local sensor readings are compared with venous blood glucose. Conclusions The IV-CGM system was capable of achieving a high level of glucose measurement accuracy. However, superficial peripheral veins may not provide adequate blood flow for reliable indwelling blood glucose monitoring. PMID:23294770

Human Auditory and Adjacent Nonauditory Cerebral Cortices Are Hypermetabolic in Tinnitus as Measured by Functional Near-Infrared Spectroscopy (fNIRS)

PubMed Central

Issa, Mohamad; Bisconti, Silvia; Kovelman, Ioulia; Kileny, Paul

2016-01-01

Tinnitus is the phantom perception of sound in the absence of an acoustic stimulus. To date, the purported neural correlates of tinnitus from animal models have not been adequately characterized with translational technology in the human brain. The aim of the present study was to measure changes in oxy-hemoglobin concentration from regions of interest (ROI; auditory cortex) and non-ROI (adjacent nonauditory cortices) during auditory stimulation and silence in participants with subjective tinnitus appreciated equally in both ears and in nontinnitus controls using functional near-infrared spectroscopy (fNIRS). Control and tinnitus participants with normal/near-normal hearing were tested during a passive auditory task. Hemodynamic activity was monitored over ROI and non-ROI under episodic periods of auditory stimulation with 750 or 8000 Hz tones, broadband noise, and silence. During periods of silence, tinnitus participants maintained increased hemodynamic responses in ROI, while a significant deactivation was seen in controls. Interestingly, non-ROI activity was also increased in the tinnitus group as compared to controls during silence. The present results demonstrate that both auditory and select nonauditory cortices have elevated hemodynamic activity in participants with tinnitus in the absence of an external auditory stimulus, a finding that may reflect basic science neural correlates of tinnitus that ultimately contribute to phantom sound perception. PMID:27042360

Lack of nephrotoxicity of gadodiamide in unselected hospitalized patients.

PubMed

Trivedi, Hariprasad; Raman, Lakshmi; Benjamin, Heather; Batwara, Ruchika

2009-09-01

The nephrotoxicity of gadolinium-based magnetic resonance contrast media has not been adequately studied. We evaluated the nephrotoxicity of gadolinium-based contrast media in hospitalized patients who underwent magnetic resonance imaging (MRI) as part of routine clinical care. Subjects who had a serum creatinine measurement during the 7 days before MRI and at least 1 other measurement 2 to 3 days after MRI were included. Patients who underwent noncontrasted MRI served as controls. There were 162 subjects (mean age, 57.8 +/- 16.9 years; 91 men and 71 women) and 125 controls (mean age, 64.6 +/- 18 years; 62 men and 63 women). All contrast-enhanced MRI studies utilized gadodiamide (Omniscan; GE Healthcare, Waukesha, WI). Subjects who received gadodiamide showed no difference in the incidence of acute renal insufficiency compared with controls (increase in serum creatinine >or= 25%, 11.1% vs 12.9%, respectively; P = 0.6; increase in serum creatinine by 0.5 mg/dL, 5.6% vs 3.2%, respectively; P = 0.4). There was no significant increase in serum creatinine baseline versus 48 hours in either the subjects who received gadodiamide (0.95 +/- 0.58 vs 0.96 +/- 0.65 mg/dL; P = 0.7) or controls (0.96 +/- 0.65 vs 0.88 +/- 0.43 mg/dL; P = 0.7). Our findings showed a lack of significant nephrotoxicity of gadodiamide in unselected hospitalized patients.

Bone mass and vitamin D levels in Parkinson’s disease: is there any difference between genders?

PubMed Central

Ozturk, Erhan Arif; Gundogdu, Ibrahim; Tonuk, Burak; Kocer, Bilge Gonenli; Tombak, Yasemin; Comoglu, Selcuk; Cakci, Aytul

2016-01-01

[Purpose] The aim of this study was to determine the bone mineral density, vitamin D level, and frequencies of osteopenia and osteoporosis in patients with Parkinson’s disease and to compare male and female patients with the controls separately. [Subjects and Methods] One hundred fifteen Parkinson’s disease patients (47 males, 68 females; age range: 55–85 years) and 117 age- and gender-matched controls (47 males, 70 females) were enrolled in the study. Bone mineral density measured by dual-energy X-ray absorptiometry and serum D vitamin levels of each participant were recorded. [Results] The mean lumbar spine, femur neck, and total femur bone mineral density levels, T-scores, and vitamin D levels were found to be significantly lower in Parkinson’s disease patients in both genders. Furthermore, osteoporosis rates were found be significantly higher only in female Parkinson’s disease patients compared with female controls. [Conclusion] Data from the present study revealed that while osteoporosis was significantly higher only in female Parkinson’s disease patients, all Parkinson’s disease patients had lower bone mineral density scores and vitamin D levels compared with the controls regardless of gender, suggesting that clinicians should pay attention to the osteoporosis risk in Parkinson’s disease and that adequate preventive measures should be taken in order to limit the future risk due to osteoporotic fractures. PMID:27630398

Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study

PubMed Central

Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Wylie, Kevan; Muir, Gordon

2015-01-01

Introduction Little is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis. Aim To compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns. Methods An opportunistic sample of 90 men from the community were recruited and divided into three groups: BDD (n = 26); SPA (n = 31) and controls (n = 33). Main Outcome Measures The Index of Erectile Function (IEF), sexual identity and history; and interventions to alter the size of their penis. Results Men with BDD compared with controls had reduced erectile dysfunction, orgasmic function, intercourse satisfaction and overall satisfaction on the IEF. Men with SPA compared with controls had reduced intercourse satisfaction. There were no differences in sexual desire, the frequency of intercourse or masturbation across any of the three groups. Men with BDD and SPA were more likely than the controls to attempt to alter the shape or size of their penis (for example jelqing, vacuum pumps or stretching devices) with poor reported success. Conclusion Men with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures. PMID:26468378

Barriers to free antiretroviral treatment access for female sex workers in Chennai, India.

PubMed

Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; Kurian, Abraham K; Dubrow, Robert

2009-11-01

India's National AIDS Control Organization (NACO) provides free first-line antiretroviral treatment (ART) at government centers for people living with HIV. To assist in developing policies and programs to ensure equity in ART access, we explored barriers to ART access among female sex workers (FSWs) living with HIV in Chennai. Between August and November 2007, we conducted three focus group discussions and two key informant interviews. Data were explored using framework analysis to identify categories and derive themes. We found interrelated barriers at the family/social, health care system/programmatic, and individual levels. Major barriers included fear of adverse consequences of disclosure of HIV status due to stigma and discrimination associated with HIV and sex work, lack of family support, negative experiences with health care providers, lack of adequate counseling services at government centers and by outreach workers employed by nongovernmental organizations (NGOs), perceived biased treatment of FSWs who are not referred by NGOs, lack of adequate knowledge about ART, and fatalism. Barriers can be addressed by: creating effective measures to reduce stigma associated with HIV/AIDS and sex work at the familial, societal, and health care system levels; incorporating information about ART into targeted interventions among FSWs; training counselors at government hospitals and NGO outreach workers on treatment issues; improving infrastructure and staffing levels at government centers to allow adequate time and privacy for counseling; and implementing government mass media campaigns on ART availability. Finally, it is crucial that NACO begin monitoring ART coverage of FSWs and other marginalized populations to ensure equitable ART access.

Effects of external potassium (k) supply on drought tolerances of two contrasting winter wheat cultivars.

PubMed

Wei, Jiguang; Li, Caihong; Li, Yong; Jiang, Gaoming; Cheng, Guanglei; Zheng, Yanhai

2013-01-01

Drought is a common stress limiting crops growth and productivities worldwide. Water deficit may increase cellular membrane permeability, resulting in K outflow. Internal K starvation may disorder plant metabolism and limit plant growth. However, it is seldom reported about the effects of external K on drought tolerance of contrasting wheat cultivars. A hydroponics experiment was carried out in a non-controlled greenhouse. Seedlings of drought-tolerant SN16 and intolerant JM22 were simultaneously treated by five levels of K2CO3 (0, 2.5, 5, 7.5, 10 mM) and two levels of PEG6000 (0, 20%) for 7 days. External K2CO3 significantly increased shoot K(+) content, water potential, chlorophyll content as well as gas exchange, but decreased electrolyte leakage (EL) and MDA content in both cultivars under PEG6000 stress. Antioxidant enzymes activities were up-regulated by PEG6000 while external K2CO3 reduced those changes. Molecular basis was explained by measuring the expression levels of antioxidant enzymes related genes. Shoot and root biomass were also increased by K2CO3 supply under drought stress. Although adequate K2CO3 application enhanced plant growth for both cultivars under drought stress, SN16 was better than JM22 due to its high drought tolerance. Adequate external K may effectively protect winter wheat from drought injuries. We conclude that drought-tolerant wheat combined with adequate external K supply may be a promising strategy for better growth in arid and semi-arid regions.

The Effects of Acute Sleep Restriction on Adolescents' Pedestrian Safety in a Virtual Environment

PubMed Central

Davis, Aaron L.; Avis, Kristin T.; Schwebel, David C.

2013-01-01

Purpose Over 8,000 American adolescents ages 14-15 require medical attention due to pedestrian injury annually. Cognitive factors contributing to pedestrian safety include reaction time, impulsivity, risk-taking, attention, and decision-making. These characteristics are also influenced by sleep restriction. Experts recommend adolescents obtain 8.5 hours of uninterrupted sleep each night, but most American adolescents do not. Inadequate sleep may place adolescents at risk for pedestrian injury. Method Using a within-subjects design, fifty-five 14- and 15-year-olds engaged in a virtual reality pedestrian environment in two conditions, scheduled a week apart: sleep-restricted (4 hours sleep previous night) and adequate sleep (8.5 hours). Sleep was assessed using actigraphy and pedestrian behavior via four outcome measures: time to initiate crossing, time before contact with vehicle while crossing, virtual hits/close calls and attention to traffic (looks left and right). Results While acutely sleep restricted, adolescents took more time to initiate pedestrian crossings, crossed with less time before contact with vehicles, experienced more virtual hits/close calls and looked left and right more often compared to when adequately rested. Results were maintained after controlling for age, gender, ethnicity and average total sleep duration prior to each condition. Discussion Adolescent pedestrian behavior in the simulated virtual environment was markedly different, and generally more risky, when acutely sleep restricted compared to adequately rested. Inadequate sleep may influence cognitive functioning to the extent that pedestrian safety is jeopardized among adolescents capable of crossing streets safely when rested. Policy decisions might be educated by these results. PMID:24012066

State of Modern Measurement Approaches in Social Work Research Literature

ERIC Educational Resources Information Center

Unick, George J.; Stone, Susan

2010-01-01

The need to develop measures that tap into constructs of interest to social work, refine existing measures, and ensure that measures function adequately across diverse populations of interest is critical. Item response theory (IRT) is a modern measurement approach that is increasingly seen as an essential tool in a number of allied professions.…

[Difficulties and concerns identified by Puerto Rican youth with insulin-dependent diabetes mellitus (IDDM): their relationship with metabolic control, hopelessness, social support, and depressive symptoms].

PubMed

Rosselló, Jeannette; Maysonet Guzmán, Marielisa

2006-12-01

Insulin-dependent diabetes mellitus (IDDM) is a chronic health condition that affects 18 of every 100,000 Puerto Rican youth. Few research studies have been performed on the problems that youth with diabetes encounter and how they are related to adherence to treatment and adequate metabolic control. Adequate metabolic control is associated with fewer short and long-term medical complications, as well as better quality of life. Adapting to the demands and stressors associated with IDDM and its treatment is a task that can prove to be difficult for youth with diabetes due to having to make adjustments, alterations, and following a prescribed regimen in their daily activities. The main purpose of this investigation was to explore difficulties and worries identified by Puerto Rican youth with IDDM. This study examined whether there is a relationship between difficulties and worries, and adequate metabolic control, hopelessness, social support and depressive symptomatology. One hundred and one youth with IDDM between the ages of 8 and 17 (45 male, 56 female) were evaluated. Analysis of frequencies, correlations, and comparison tests were performed by group (gender, age, diabetes duration, and metabolic control. Results reveal that some of the difficulties identified by Puerto Rican youth with IDDM were: not eating candy and/or cake, self-monitoring blood glucose at school, doing things on time, and waking up early. Among the worries they reported were: insulin reactions and thinking that they might have to go to the hospital.

Associations of government health expenditures, the supply of health care professionals, and country literacy with prenatal care use in ten West African countries.

PubMed

Taylor, Yhenneko J; Laditka, Sarah B; Laditka, James N; Brunner Huber, Larissa R; Racine, Elizabeth F

2017-03-01

Social and health care context may influence prenatal care use. We studied associations of government health expenditures, supply of health care professionals, and country literacy rates with prenatal care use in ten West African countries, controlling for individual factors. We used data from Demographic and Health Surveys (n = 58,512) and random effect logistic regression models to estimate the likelihood of having any prenatal care and adequate prenatal care. Each percentage increase in the literacy rate was associated with 4% higher odds of having adequate prenatal care (p = .029). Higher literacy rates among women may help to promote adequate prenatal care.

Increased colonic bile acid exposure: a relevant factor for symptoms and treatment in IBS.

PubMed

Bajor, Antal; Törnblom, Hans; Rudling, Mats; Ung, Kjell-Arne; Simrén, Magnus

2015-01-01

Bile acids may play a role in the pathogenesis of IBS. We investigated the potential effects of bile acids entering the colon and its role in the symptom pattern in IBS. We measured 75Se-labelled homocholic acid-taurine (75SeHCAT) retention, and serum levels of 7α-hydroxy-4-cholesten-3-one (C4) and fibroblast growth factor (FGF) 19 in patients with IBS (n=141) and control subjects (75SeHCAT n=29; C4 and FGF19 n=435). In patients with IBS stool frequency and form, as well as GI symptom severity were registered, and in a proportion of patients colonic transit time and rectal sensitivity were measured (n=66). An 8-week open-label treatment with colestipol was offered to patients with 75SeHCAT <20%, and the effect of treatment was evaluated with IBS severity scoring system and adequate relief of IBS symptoms. Compared with controls, patients with IBS had lower 75SeHCAT values (p=0.005), higher C4c levels (C4 corrected for cholesterol) (p<0.001), but similar FGF19 levels. Abnormal 75SeHCAT retention (<10%) was seen in 18% of patients, whereas 23% had elevated C4c levels. Patients with IBS with 75SeHCAT retention <10% had more frequent stools, accelerated colonic transit time, rectal hyposensitivity, a higher body mass index, higher C4c and lower FGF19 levels. Colestipol treatment improved IBS symptoms (IBS severity scoring system 220±109 vs. 277±106; p<0.01), and 15/27 patients fulfilled criteria for treatment response (adequate relief ≥50% of weeks 5-8). Increased colonic bile acid exposure influences bowel habit and colonic transit time in patients with IBS. A high response rate to open label treatment with colestipol supports this, but placebo-controlled studies are warranted. 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.

Measurement methods and accuracy in copy number variation: failure to replicate associations of beta-defensin copy number with Crohn's disease.

PubMed

Aldhous, Marian C; Abu Bakar, Suhaili; Prescott, Natalie J; Palla, Raquel; Soo, Kimberley; Mansfield, John C; Mathew, Christopher G; Satsangi, Jack; Armour, John A L

2010-12-15

The copy number variation in beta-defensin genes on human chromosome 8 has been proposed to underlie susceptibility to inflammatory disorders, but presents considerable challenges for accurate typing on the scale required for adequately powered case-control studies. In this work, we have used accurate methods of copy number typing based on the paralogue ratio test (PRT) to assess beta-defensin copy number in more than 1500 UK DNA samples including more than 1000 cases of Crohn's disease. A subset of 625 samples was typed using both PRT-based methods and standard real-time PCR methods, from which direct comparisons highlight potentially serious shortcomings of a real-time PCR assay for typing this variant. Comparing our PRT-based results with two previous studies based only on real-time PCR, we find no evidence to support the reported association of Crohn's disease with either low or high beta-defensin copy number; furthermore, it is noteworthy that there are disagreements between different studies on the observed frequency distribution of copy number states among European controls. We suggest safeguards to be adopted in assessing and reporting the accuracy of copy number measurement, with particular emphasis on integer clustering of results, to avoid reporting of spurious associations in future case-control studies.

Hydrotherapy as a recovery strategy after exercise: a pragmatic controlled trial

PubMed Central

2013-01-01

Background Our aim was to evaluate the recovery effects of hydrotherapy after aerobic exercise in cardiovascular, performance and perceived fatigue. Methods A pragmatic controlled repeated measures; single-blind trial was conducted. Thirty-four recreational sportspeople visited a Sport-Centre and were assigned to a Hydrotherapy group (experimental) or rest in a bed (control) after completing a spinning session. Main outcomes measures including blood pressure, heart rate, handgrip strength, vertical jump, self-perceived fatigue, and body temperature were assessed at baseline, immediately post-exercise and post-recovery. The hypothesis of interest was the session*time interaction. Results The analysis revealed significant session*time interactions for diastolic blood pressure (P=0.031), heart rate (P=0.041), self perceived fatigue (P=0.046), and body temperature (P=0.001); but not for vertical jump (P=0.437), handgrip (P=0.845) or systolic blood pressure (P=0.266). Post-hoc analysis revealed that hydrotherapy resulted in recovered heart rate and diastolic blood pressure similar to baseline values after the spinning session. Further, hydrotherapy resulted in decreased self-perceived fatigue after the spinning session. Conclusions Our results support that hydrotherapy is an adequate strategy to facilitate cardiovascular recovers and perceived fatigue, but not strength, after spinning exercise. Trial registration ClinicalTrials.gov Identifier: NCT01765387 PMID:23866725

Measurement methods and accuracy in copy number variation: failure to replicate associations of beta-defensin copy number with Crohn's disease

PubMed Central

Aldhous, Marian C.; Abu Bakar, Suhaili; Prescott, Natalie J.; Palla, Raquel; Soo, Kimberley; Mansfield, John C.; Mathew, Christopher G.; Satsangi, Jack; Armour, John A.L.

2010-01-01

The copy number variation in beta-defensin genes on human chromosome 8 has been proposed to underlie susceptibility to inflammatory disorders, but presents considerable challenges for accurate typing on the scale required for adequately powered case–control studies. In this work, we have used accurate methods of copy number typing based on the paralogue ratio test (PRT) to assess beta-defensin copy number in more than 1500 UK DNA samples including more than 1000 cases of Crohn's disease. A subset of 625 samples was typed using both PRT-based methods and standard real-time PCR methods, from which direct comparisons highlight potentially serious shortcomings of a real-time PCR assay for typing this variant. Comparing our PRT-based results with two previous studies based only on real-time PCR, we find no evidence to support the reported association of Crohn's disease with either low or high beta-defensin copy number; furthermore, it is noteworthy that there are disagreements between different studies on the observed frequency distribution of copy number states among European controls. We suggest safeguards to be adopted in assessing and reporting the accuracy of copy number measurement, with particular emphasis on integer clustering of results, to avoid reporting of spurious associations in future case–control studies. PMID:20858604

Hydrotherapy as a recovery strategy after exercise: a pragmatic controlled trial.

PubMed

Cuesta-Vargas, Antonio I; Travé-Mesa, Alvaro; Vera-Cabrera, Alberto; Cruz-Terrón, Dario; Castro-Sánchez, Adelaida M; Fernández-de-las-Peñas, Cesar; Arroyo-Morales, Manuel

2013-07-18

Our aim was to evaluate the recovery effects of hydrotherapy after aerobic exercise in cardiovascular, performance and perceived fatigue. A pragmatic controlled repeated measures; single-blind trial was conducted. Thirty-four recreational sportspeople visited a Sport-Centre and were assigned to a Hydrotherapy group (experimental) or rest in a bed (control) after completing a spinning session. Main outcomes measures including blood pressure, heart rate, handgrip strength, vertical jump, self-perceived fatigue, and body temperature were assessed at baseline, immediately post-exercise and post-recovery. The hypothesis of interest was the session*time interaction. The analysis revealed significant session*time interactions for diastolic blood pressure (P=0.031), heart rate (P=0.041), self perceived fatigue (P=0.046), and body temperature (P=0.001); but not for vertical jump (P=0.437), handgrip (P=0.845) or systolic blood pressure (P=0.266). Post-hoc analysis revealed that hydrotherapy resulted in recovered heart rate and diastolic blood pressure similar to baseline values after the spinning session. Further, hydrotherapy resulted in decreased self-perceived fatigue after the spinning session. Our results support that hydrotherapy is an adequate strategy to facilitate cardiovascular recovers and perceived fatigue, but not strength, after spinning exercise. ClinicalTrials.gov Identifier: NCT01765387.

A re-view of cognitive mediators in learned helplessness.

PubMed

Tennen, H

1982-12-01

The findings of Oakes and Curtis (1982), Tennen, Drum, Gillen, and Stanton (1982), and Tennen, Gillen, and Drum (1982) provide a challenge to learned helplessness theory's focus on cognitive mediators of the helplessness phenomenon. In response to these findings, Alloy (1982) argues that these studies do not challenge helplessness theory because they do not measure expected control and because they confuse necessary and sufficient causes of learned helplessness. Silver, Wortman, and Klos (1982) contend that these studies provide an inadequate test of the model because subjects are confronted with experiences which are unlike those in their natural environment. The present article argues that by Alloy's (1982) criteria, an adequate test of the learned helplessness model has not yet been conducted. Previous studies which measured expected control have not supported the model's predictions. Moreover, if perceived response-outcome independence is a sufficient, but not a necessary cause of learned helplessness, the model loses much of its heuristic value. In response to the argument that these studies lack ecological validity, this article clarifies the distinction between experimental realism and mundane realism. While real-world studies have discovered intriguing relations between perceptions of control, attributions, and coping with illness or victimization, they have not tested predictions of the learned helplessness model.

Automation of servicibility of radio-relay station equipment

NASA Astrophysics Data System (ADS)

Uryev, A. G.; Mishkin, Y. I.; Itkis, G. Y.

1985-03-01

Automation of the serviceability of radio relay station equipment must ensure central gathering and primary processing of reliable instrument reading with subsequent display on the control panel, detection and recording of failures soon enough, advance enough warning based on analysis of detertioration symptoms, and correct remote measurement of equipment performance parameters. Such an inspection will minimize transmission losses while reducing nonproductive time and labor spent on documentation and measurement. A multichannel automated inspection system for this purpose should operate by a parallel rather than sequential procedure. Digital data processing is more expedient in this case than analog method and, therefore, analog to digital converters are required. Spepcial normal, above limit and below limit test signals provide means of self-inspection, to which must be added adequate interference immunization, stabilization, and standby power supply. Use of a microcomputer permits overall refinement and expansion of the inspection system while it minimizes though not completely eliminates dependence on subjective judgment.

Saving water in showers

NASA Astrophysics Data System (ADS)

Alkhaddar, R. A.; Phipps, D.; Morgan, R.; Karci, B.; Hordesseux, J.

2007-07-01

This project is part of a programme aimed at reducing water consumption. Power showers are water inefficient, but in order to persuade the user to accept a lower water use it will be necessary to sustain the "shower experience" to maintain user satisfaction. Previous work has indicated that users' requirements include temperature stability, adequate water volume and distribution, and skin pressure, all of which are substantially controlled by the showerhead. In the present phase of the project several commercially available domestic showerheads have been examined to determine pressure-volume characteristics, radial spray distributions at different flow rates, direct and indirect measures of "skin pressure" and measurements of vertical temperature profiles. Part of the practical work at LJMU has supported extensive theoretical studies by CFD carried out by staff at Arup (consulting engineers) for the Market Transformation Programme. A future phase will study user satisfaction in their own homes where user satisfaction will be surveyed and linked to the physical performance of the shower.

Appropriateness Measurement with Polychotomous Item Response Models and Standardized Indices. Measurement Series, 84-1.

ERIC Educational Resources Information Center

Drasgow, Fritz; And Others

The test scores of some examinees on a multiple-choice test may not provide adequate measures of their abilities. The goal of appropriateness measurement is to identify such individuals. Earlier theoretical and experimental work considered examinees answering all, or almost all, test items. This article reports research that extends…

Evaluation of health literacy among Spanish-speaking primary care patients along the US--Mexico border.

PubMed

Penaranda, Eribeth; Diaz, Marco; Noriega, Oscar; Shokar, Navkiran

2012-07-01

Health literacy (HL) is a measure of the communication skills that are needed by an individual to effectively navigate the healthcare system. Hispanic adults have lower average levels of HL than any other racial/ethnic group; however, the prevalence of adequate HL among Hispanics along the US-Mexico border is unknown. We performed a cross-sectional survey of 200 adult primary care patients who attended four low-income community clinics along the US-Mexico border. Patients were included in the study if they were self-described Hispanics whose first language was Spanish or bilingual patients who reported that they were primarily Spanish speakers. Adequate HL was defined as having a score of ≥38 on the Short Assessment of Health Literacy for Spanish Adults-50. Three patients (1.5%) had inadequate HL. Because of the high proportion of patients having adequate HL, we found no statistical differences between patients with adequate HL versus inadequate HL by age, sex, educational attainment, health coverage, or self-reported health status; however, all three patients with inadequate HL were found to be 60 years old or older and had less than a high school education. The results of HL assessment varied according to the tool and setting used in measuring Spanish-speaking Hispanics. In certain clinical scenarios, current tools may underestimate the actual prevalence of adequate HL. Further development and assessment of HL tools appropriate for Spanish-speaking Hispanics is needed as a first step in developing interventions to limit disparities in health care among all Americans.

Quality of radiotherapy reporting in randomized controlled trials of prostate cancer.

PubMed

Soon, Yu Yang; Chen, Desiree; Tan, Teng Hwee; Tey, Jeremy

2018-06-07

Good radiotherapy reporting in clinical trials of prostate radiotherapy is important because it will allow accurate reproducibility of radiotherapy treatment and minimize treatment variations that can affect patient outcomes. The aim of our study is to assess the quality of prostate radiotherapy (RT) treatment reporting in randomized controlled trials in prostate cancer. We searched MEDLINE for randomized trials of prostate cancer, published from 1996 to 2016 and included prostate RT as one of the intervention arms. We assessed if the investigators reported the ten criteria adequately in the trial reports: RT dose prescription method; RT dose-planning procedures; organs at risk (OAR) dose constraints; target volume definition, simulation procedures; treatment verification procedures; total RT dose; fractionation schedule; conduct of quality assurance (QA) as well as presence or absence of deviations in RT treatment planning and delivery. We performed multivariate logistic regression to determine the factors that may influence the quality of reporting. We found 59 eligible trials. There was significant variability in the quality of reporting. Target volume definition, total RT dose and fractionation schedule were reported adequately in 97% of included trials. OAR constraints, simulation procedures and presence or absence of deviations in RT treatment planning and delivery were reported adequately in 30% of included trials. Twenty-four trials (40%) reported seven criteria or more adequately. Multivariable logistic analysis showed that trials that published their quality assurance results and cooperative group trials were more likely to have adequate quality in reporting in at least seven criteria. There is significant variability in the quality of reporting on prostate radiotherapy treatment in randomized trials of prostate cancer. We need to have consensus guidelines to standardize the reporting of radiotherapy treatment in randomized trials.

Structure and Measurement of Acculturation/Enculturation for Asian Americans Using the ARSMA-II

ERIC Educational Resources Information Center

Lee, Richard M.; Yoon, Eunju; Liu-Tom, Hsin-Tine Tina

2006-01-01

The structure and measurement of acculturation/enculturation was investigated on 2 Asian American samples. Factor analyses revealed similar 2-factor structures for both acculturation and enculturation. The factor-analytic-derived measure yielded scores with adequate reliability and marginal construct validity. Acculturation/enculturation…

Environmental Chemical Exposures and Autism Spectrum Disorders: A Review of the Epidemiological Evidence

PubMed Central

Kalkbrenner, Amy E.; Schmidt, Rebecca J.; Penlesky, Annie C.

2016-01-01

In the past decade, the number of epidemiological publications addressing environmental chemical exposures and autism has grown tremendously. These studies are important because it is now understood that environmental factors play a larger role in causing autism than previously thought and because they address modifiable risk factors that may open up avenues for the primary prevention of the disability associated with autism. In this review, we covered studies of autism and estimates of exposure to tobacco, air pollutants, volatile organic compounds and solvents, metals (from air, occupation, diet, dental amalgams, and thimerosal-containing vaccines), pesticides, and organic endocrine-disrupting compounds such as flame retardants, non-stick chemicals, phthalates, and bisphenol A. We included studies that had individual-level data on autism, exposure measures pertaining to pregnancy or the 1st year of life, valid comparison groups, control for confounders, and adequate sample sizes. Despite the inherent error in the measurement of many of these environmental exposures, which is likely to attenuate observed associations, some environmental exposures showed associations with autism, especially traffic-related air pollutants, some metals, and several pesticides, with suggestive trends for some volatile organic compounds (e.g., methylene chloride, trichloroethylene, and styrene) and phthalates. Whether any of these play a causal role requires further study. Given the limited scope of these publications, other environmental chemicals cannot be ruled out, but have not yet been adequately studied. Future research that addresses these and additional environmental chemicals, including their most common routes of exposures, with accurate exposure measurement pertaining to several developmental windows, is essential to guide efforts for the prevention of the neurodevelopmental damage that manifests in autism symptoms. PMID:25199954