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  1. To What Degree Does Provider Performance Affect a Quality Indicator? The Case of Nursing Homes and ADL Change

    ERIC Educational Resources Information Center

    Phillips, Charles D.; Chen, Min; Sherman, Michael

    2008-01-01

    Purpose: This research investigates what factors affect the degree to which nursing home performance explains variance in residents' change in status of activities of daily living (ADL) after admission. Design and Methods: The database included all residents admitted in 2002 to a 10% random sample of nursing homes in the United States.…

  2. HomeADL for adaptive ADL monitoring within smart homes.

    PubMed

    Hong, Xin; Nugent, Chris D; Finlay, Dewar D; Mulvenna, Maurice

    2008-01-01

    In this paper we present homeADL: a representation standard for an inference hierarchy of activities of daily living which may be monitored in a sensor equipped smart home. The approach allows a free exchange of ADL monitoring structures between different communities who share the same concern of providing high quality healthcare to the elderly. Its ability of matching different ADL protocols enables a mapping between an ADL protocol to a suitable smart home which makes an effective management of smart homes within a community hence, not only being able to satisfy an individual's healthcare requirements but also efficiently using monitoring resources at hand.

  3. Trainee Occupational Therapists Scoring the Barthel ADL.

    PubMed

    Martin, Elizabeth; Nugent, Chris; Bond, Raymond; Martin, Suzanne

    2015-09-01

    Within medical applications there are two main types of information design; paper-based and digital information [1]. As technology is constantly changing, information within healthcare management and delivery is continually being transitioned from traditional paper documents to digital and online resources. Activity of Daily Living (ADL) charts are still predominantly paper based and are therefore prone to "human error" [2]. In light of this, an investigation has taken place into the design for reducing the amount of human error, between a paper based ADL, specifically the Barthel Index, and the same ADL created digitally. The digital ADL was developed as an online platform as this offers the best method of data capture for a large group of participants all together [3]. The aim of the study was to evaluate the usability of the Barthel Index ADL in paper format and then reproduce the same ADL digitally. This paper presents the findings of a study involving 26 participants who were familiar with ADL charts, and used three scenarios requiring them to complete both a paper ADL and a digital ADL. An evaluation was undertaken to ascertain if there were any 'human errors' in completing the paper ADL and also to find similarities/differences through using the digital ADL. The results from the study indicated that 22/26 participants agreed that the digital ADL was better, if not the same as a paper based ADL. Further results indicated that participants rate highly the added benefit of the digital ADL being easy to use and also that calculation of assessment scores were performed automatically. Statistically the digital BI offered a 100 % correction rate in the total calculation, in comparison to the paper based BI where it is more common for users to make mathematical calculation errors. Therefore in order to minimise handwriting and calculation errors, the digital BI proved superior than the traditional paper based method.

  4. Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain.

    PubMed

    Waehrens, Eva Ejlersen; Amris, Kirstine; Fisher, Anne G

    2010-09-01

    Functional ability, including the ability to perform activities of daily living (ADL), is considered a core outcome domain in chronic pain clinical trials and is usually assessed through generic or disease-specific self-report questionnaires. Research, however, indicates that self-report and performance-based assessment of ADL offer distinct but complementary information about ability. The present study, therefore, investigated the applicability of a performance-based measure of ADL ability, the Assessment of Motor and Process Skills (AMPS), among 50 women with chronic widespread pain. The investigated psychometric properties of the AMPS included discrimination between a sample of healthy women and those with chronic widespread pain, as well as stability when no intervention was provided and sensitivity to change following intervention. Data were obtained based on a repeated measures design performing AMPS evaluations twice pre- and twice post-rehabilitation. Results indicated that the ADL motor ability measures of the participants were significantly lower than those of healthy women of same age, the ADL motor and ADL process ability measures remained stable when no intervention was provided and the ADL motor ability measures were sensitive to change following a 2-week interdisciplinary rehabilitation program. A weak correlation (r(s)=-0.35) was found between self-reported ADL ability as measured by the physical function subscale of the Functional Impact Questionnaire (FIQ) and performance-based ADL motor measures, and no correlation (r(s)=-0.02) was found between FIQ ADL measures and ADL process ability, supporting the need for both performance-based and self-reported assessment of ADL.

  5. Canadian ADL Partnership Lab

    DTIC Science & Technology

    2009-08-19

    WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Canadian Defense Academy,PO Box 17000 Station Forces ,Kingston ON CANADA K7K 7B4...CMP Canadian ADL Partnership Lab Presentation by CDA Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the... Canadian ADL Partnership Lab 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f

  6. The New ADL Registry. ADL Registry Web Portal Changes

    DTIC Science & Technology

    2009-08-19

    Approaches 18 19 Primary ADL Registry Contributors Contributor Records Entry Date Navy eLearning (US Navy) 2,086 08/05/2008 Joint Knowledge Development...ADL Registry  http://adlregistry.adlnet.gov/  Navy eLearning Content Team  https://www.netc.navy.mil/ile  Joint Knowledge Online  http

  7. An Extensible ADL for Service-Oriented Architectures

    NASA Astrophysics Data System (ADS)

    Bashroush, R.; Spence, I.

    While architecture description languages (ADLs) have gained wide acceptance in the research community as a means of describing system designs, the uptake within the service-oriented architecture (SOA) domain has been slower than might have been expected. A contributory cause may be the perceived lack of flexibility and, as yet, the limited tool support. This chapter describes ALI, a new ADL that aims to address these deficiencies by providing a rich, extensible and flexible syntax for describing component and service interface types and the use of patterns and meta-information. These enhanced capabilities are intended to encourage more widespread ADL usage.

  8. Autonomous Decentralized Loop network - ADL aiming at fault-tolerance

    NASA Astrophysics Data System (ADS)

    Kanbe, Seiichiro; Ashida, Akira; Tanaka, Toshiyuki; Mori, Kinji; Ihara, Hirokazu

    An Autonomous Decentralized System (ADS) network is proposed which provides fault detection, fault recovery, transmission, and maintenance for a space system in a distributed manner. An Autonomous Decentralized Loop (ADL) network system is presented as an application of ADS. The ADL system construction, communication protocol, transmission control, and fault detection and recovery are examined. The ADS features autonomous nodes which allow no subsystem to be down without advance notice. The functional availability of ADL is compared with that of a two-redundant loop.

  9. Alternate Communications Spectrum Study (ACSS) for Aviation Data Links (ADL)

    NASA Technical Reports Server (NTRS)

    Matolak, David W.

    2003-01-01

    and parameters that must be selected in the design. Two appendices show example versions and initial results of the first few technical steps in the design approach. Some conclusions are then drawn, and in the final section, recommendations are provided, the most important of which are repeated here: 1. Continue the effort begun here. As detailed in this report, we have only uncovered much of the work that needs to be done in order to provide the foundation for a flexible, high- performance, robust ADL. 2. Seize the opportunity to begin testing in the MLS band. The wide bandwidths and low level of usage of this band make it an ideal one for proof-of-concept type testing. Other (non- aeronautical) organizations are likely to make claims on the band if it is not being used. The primary conclusion is that there is a real and pressing need for a new aviation data link. vi

  10. The Development of a Hierarchical Polychotomous ADL-IADL Scale for Noninstitutionalized Elders.

    ERIC Educational Resources Information Center

    Kempen, G. I. J. M.; Suurmeijer, T. P. B. M.

    1990-01-01

    Tested hierarchical scale comprising 18 activities of daily living (ADL) and instrumental activities of daily living (IADL) items on 101 noninstitutionalized older adults in Netherlands. Results confirmed possibility of constructing unidimensional, hierarchical. polychotomous scale measuring "functional problems on ADL-IADL." Considered…

  11. A client-centred ADL intervention: three-month follow-up of a randomized controlled trial

    PubMed Central

    Bertilsson, Ann-Sofie; Ranner, Maria; von Koch, Lena; Eriksson, Gunilla; Johansson, Ulla; Ytterberg, Charlotte; Tham, Kerstin

    2014-01-01

    Objective The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care. Methods In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit ≤3 months after stroke, dependent in ≥two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain “participation”, 280 participants were required. Intention-to-treat analysis was applied. Results At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain “emotion” in favour of CADL (p = 0.04). Conclusion The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required. PMID:24506231

  12. The Classic Measure of Disability in Activities of Daily Living Is Biased by Age but an Expanded IADL/ADL Measure Is Not

    PubMed Central

    2010-01-01

    Objectives. To evaluate, by age, the performance of 2 disability measures based on needing help: one using 5 classic activities of daily living (ADL) and another using an expanded set of 14 activities including instrumental activities of daily living (IADL), walking, getting outside, and ADL (IADL/ADL). Methods. Guttman and item response theory (IRT) scaling methods are used with a large (N = 25,470) nationally representative household survey of individuals aged 18 years and older. Results. Guttman scalability of the ADL items increases steadily with age, reaching a high level at ages 75 years and older. That is reflected in an IRT model by age-related differential item functioning (DIF) resulting in age-biased measurement of ADL. Guttman scalability of the IADL/ADL items also increases with age but is lower than the ADL. Although age-related DIF also occurs with IADL/ADL items, DIF is lower in magnitude and balances out without causing age bias. Discussion. An IADL/ADL scale measuring need for help is hierarchical, unidimensional, and unbiased by age. It has greater content validity for measuring need for help in the community and shows greater sensitivity by age than the classic ADL measure. As demand for community services is increasing among adults of all ages, an expanded IADL/ADL measure is more useful than ADL. PMID:20100786

  13. Rasch analysis of the ADL scale of the A-ONE.

    PubMed

    Arnadóttir, Gudrún; Fisher, Anne G

    2008-01-01

    The ADL-focused Occupation-based Neurobehavioral Evaluation (A-ONE; Arnadóttir, 1990) can be used to evaluate both performance of activities of daily living (ADL) tasks and neurobehavioral problems that interfere with ADL task performance among clients with neurological disorders. This study examined the rating scale structure and aspects of validity and reliability of the A-ONE's ordinal ADL scale by applying Rasch analysis methods (Bond & Fox, 2001). Rasch analysis of 209 clients' A-ONE assessments indicated that misfit of items to the ADL scale could be reduced by removing the two communication items. Threshold disordering could be corrected by combining two adjacent scoring categories (supervision and verbal assistance), thus supporting four response categories. Separation reliability for item calibrations (.98) was high and acceptable for people (.90). Finally, principal components analysis of the residuals supported unidimensionality. The study provided support for converting the ordinal ADL scale to an interval scale that has potential to be used to measure changes in ADL task performance over time.

  14. Factors favoring a degradation or an improvement in activities of daily living (ADL) performance among nursing home (NH) residents: a survival analysis.

    PubMed

    Bürge, Elisabeth; von Gunten, Armin; Berchtold, André

    2013-01-01

    Different factors influence ADL performance among nursing home (NH) residents in long term care. The aim was to investigate which factors were associated with a significant change of ADL performance in NH residents, and whether or not these factors were gender-specific. The design was a survival analysis. The 10,199 participants resided in ninety Swiss NHs. Their ADL performance had been assessed by the Resident Assessment Instrument Minimum Data Set (RAI-MDS) in the period from 1997 to 2007. Relevant change in ADL performance was defined as 2 levels of change on the ADL scale between two successive assessments. The occurrence of either an improvement or a degradation of the ADL status) was analyzed using the Cox proportional hazard model. The analysis included a total of 10,199 NH residents. Each resident received between 2 and 23 assessments. Poor balance, incontinence, impaired cognition, a low BMI, impaired vision, no daily contact with proxies, impaired hearing and the presence of depression were, by hierarchical order, significant risk factors for NH residents to experience a degradation of ADL performance. Residents, who were incontinent, cognitively impaired or had a high BMI were significantly less likely to improve their ADL abilities. Male residents with cancer were prone to see their ADL improve. The year of NH entry was significantly associated with either degradation or improvement of ADL performance. Measures aiming at improving balance and continence, promoting physical activity, providing appropriate nourishment and cognitive enhancement are important for ADL performance in NH residents.

  15. A Process for the Representation of openEHR ADL Archetypes in OWL Ontologies.

    PubMed

    Porn, Alex Mateus; Peres, Leticia Mara; Didonet Del Fabro, Marcos

    2015-01-01

    ADL is a formal language to express archetypes, independent of standards or domain. However, its specification is not precise enough in relation to the specialization and semantic of archetypes, presenting difficulties in implementation and a few available tools. Archetypes may be implemented using other languages such as XML or OWL, increasing integration with Semantic Web tools. Exchanging and transforming data can be better implemented with semantics oriented models, for example using OWL which is a language to define and instantiate Web ontologies defined by W3C. OWL permits defining significant, detailed, precise and consistent distinctions among classes, properties and relations by the user, ensuring the consistency of knowledge than using ADL techniques. This paper presents a process of an openEHR ADL archetypes representation in OWL ontologies. This process consists of ADL archetypes conversion in OWL ontologies and validation of OWL resultant ontologies using the mutation test.

  16. Substrate and Product Complexes of Escherichia Coli Adenylosuccinate Lyase Provide New Insights into the Enzymatic Mechanism

    SciTech Connect

    Tsai,M.; Koo, J.; Yip, P.; Colman, R.; Segall, M.; Howell, P.

    2007-01-01

    Adenylosuccinate lyase (ADL) catalyzes the breakdown of 5-aminoimidazole- (N-succinylocarboxamide) ribotide (SAICAR) to 5-aminoimidazole-4-carboxamide ribotide (AICAR) and fumarate, and of adenylosuccinate (ADS) to adenosine monophosphate (AMP) and fumarate in the de novo purine biosynthetic pathway. ADL belongs to the argininosuccinate lyase (ASL)/fumarase C superfamily of enzymes. Members of this family share several common features including: a mainly {alpha}-helical, homotetrameric structure; three regions of highly conserved amino acid residues; and a general acid-base catalytic mechanism with the overall {beta}-elimination of fumarate as a product. The crystal structures of wild-type Escherichia coli ADL (ec-ADL), and mutant-substrate (H171A-ADS) and -product (H171N-AMP{center_dot}FUM) complexes have been determined to 2.0, 1.85, and 2.0 {angstrom} resolution, respectively. The H171A-ADS and H171N-AMP{center_dot}FUM structures provide the first detailed picture of the ADL active site, and have enabled the precise identification of substrate binding and putative catalytic residues. Contrary to previous suggestions, the ec-ADL structures implicate S295 and H171 in base and acid catalysis, respectively. Furthermore, structural alignments of ec-ADL with other superfamily members suggest for the first time a large conformational movement of the flexible C3 loop (residues 287-303) in ec-ADL upon substrate binding and catalysis, resulting in its closure over the active site. This loop movement has been observed in other superfamily enzymes, and has been proposed to be essential for catalysis. The ADL catalytic mechanism is re-examined in light of the results presented here.

  17. Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results

    ERIC Educational Resources Information Center

    Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.

    2014-01-01

    Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

  18. EDI (electronic data interchange) provides strategy for laboratory results reporting.

    PubMed

    McLure, M; Barnett, P

    1994-01-01

    Historically, results of laboratory tests have been transmitted from hospitals to physicians' offices by mail and telephone. Two problems inherent in this system are the difficulty in notifying the physician and in the timeliness of delivery of results. Telephone messages may fail to reach the physician. Hard copies of reports may be misfiled, lost, or delayed in the mail. Today, test results can be transmitted between physicians' offices and hospitals via facsimile machines and electronic data interchange (EDI). This article examines the cost effectiveness, confidentiality, and opportunity for growth these alternative methods of transmission offer.

  19. Communication of Genetic Test Results to Family and Health Care Providers Following Disclosure of Research Results

    PubMed Central

    Graves, Kristi D.; Sinicrope, Pamela S.; Esplen, Mary Jane; Peterson, Susan K.; Patten, Christi A.; Lowery, Jan; Sinicrope, Frank A.; Nigon, Sandra K.; Borgen, Joyce; Gorin, Sherri Sheinfeld; Keogh, Louise A.; Lindor, Noralane M.

    2014-01-01

    Purpose Few studies have examined methods to promote communication following the return of DNA mismatch repair (MMR) genetic test results obtained during research. The purpose of the present study was to evaluate a telephone protocol for returning research results of MMR gene testing to identify Lynch Syndrome. Methods We invited individuals with known MMR mutations in their family who were enrolled in the Colon Cancer Family Registry at the Mayo Clinic to participate. Participants completed surveys before and 6-months after MMR test result disclosure. Results Among 107 participants, 79% opted to learn their MMR test results; of these, 44 (41%) carried MMR mutations. Post-disclosure, 54% reported screening for any type of cancer. Among carriers, >74% reported communicating results to family; communication was predicted by baseline confidence in coping with the genetic test result (Z=1.97, P=.04). Result disclosure to a physician was predicted by greater perceived cancer risk (Z=2.08, P=.03) and greater intention to share results with family (Z=3.07, P=.002). Conclusions Research vs. clinically-based gene disclosure presents challenges. A telephone disclosure process for the return of research-based results among Lynch syndrome families led to high rates of result uptake and participant communication of results to providers and family members. PMID:24091800

  20. Firearms in Frail Hands: An ADL or A Public Health Crisis!

    PubMed

    Patel, Dupal; Syed, Quratulain; Messinger-Rapport, Barbara J; Rader, Erin

    2015-06-01

    The incidence of neurocognitive disorders, which may impair the ability of older adults to perform activities of daily living (ADLs), rises with age. Depressive symptoms are also common in older adults and may affect ADLs. Safe storage and utilization of firearms are complex ADLs, which require intact judgment, executive function, and visuospatial ability, and may be affected by cognitive impairment. Depression or cognitive impairment may cause paranoia, delusions, disinhibition, apathy, or aggression and thereby limit the ability to safely utilize firearms. These problems may be superimposed upon impaired mobility, arthritis, visual impairment, or poor balance. Inadequate attention to personal protection may also cause hearing impairment and accidents. In this article, we review the data on prevalence of firearms access among older adults; safety concerns due to age-related conditions; barriers to addressing this problem; indications prompting screening for firearms access; and resources available to patients, caregivers, and health care providers.

  1. Using Rasch Analysis to Evaluate Accuracy of Individual Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) for Disability Measurement.

    PubMed

    Friedman, Bruce; Li, Yanen

    2015-01-01

    Our study objectives were to examine the accuracy of individual activities of daily living (ADLs) and instrumental ADLs (IADLs) for disability measurement, and determine whether dependence or difficulty is more useful for disability measurement. We analyzed data from 499 patients with 2+ ADLs or 3+ IADLs who participated in a home visiting nurse intervention study, and whose function had been assessed at study baseline and 22 months. Rasch analysis was used to evaluate accuracy of 24 individual ADL and IADL items. The individual items differed in the amount of information provided in measuring functional disability along the range of disability, providing much more information in (usually) one part of the range. While nearly all of the Item Information Curves (IICs) for the ADL dependence, IADL difficulty, and IADL dependence items were unimodal with one information peak each, the IICs for ADL difficulty exhibited a bimodal pattern with two peaks. Which of the individual items performed better in disability measurement varied by the extent of functional disability (i.e., by how disabled the patients were). The information peaks of most ADLs and many IADLs rise or drop steeply in a relatively short distance. Thus, whether dependence or difficulty is superior often changes very quickly along the disability continuum. There was considerable heterogeneity in which individual items provided the most and the least information at the three points of interest examined across the disability range (-2 SD units, mean, +2 SD units). While the disability region (low, medium, and high disability) for which each individual item provided the most information remained quite stable between baseline and 22 months for ADL difficulty, IADL difficulty, and IADL dependence, relatively large shifts occurred for ADL dependence items. At the disability mean dependence items offered more information for assessment than difficulty. While ADLs also provided more information at -2 and +2 SD

  2. Adl migration estimation model (for microcomputers) (release number 1). Software

    SciTech Connect

    Not Available

    1990-09-01

    ADL Migration Estimation Model (AMEM) is a user friendly software package programmed for an IBM personal computer that provides the user with the ability to estimate the weight fraction of a chemical migrating from a polymeric material. The chemical may be an additive (e.g., a plasticizer) or unreacted monomer (e.g., styrene). The program estimates the migration of chemicals based on mathematical equations derived using diffusion and mass transfer theories. The user is prompted for chemical specific data such as molecular weight and vapor pressure of the migrant. The user may enter the diffusion coefficient for the polymer of interest or may use one of the default values provided by the software for six generic types of polymers with a wide range of diffusion coefficients. Background information, model development, mathematical calculations, example scenarios, and a user's guide are provided in the documentation.

  3. The in vitro pharmacology of the peripherally restricted opioid receptor antagonists, alvimopan, ADL 08-0011 and methylnaltrexone.

    PubMed

    Beattie, D T; Cheruvu, M; Mai, N; O'Keefe, M; Johnson-Rabidoux, S; Peterson, C; Kaufman, E; Vickery, R

    2007-05-01

    This study characterized the pharmacology of the peripherally restricted opioid receptor antagonists, alvimopan, its metabolite, ADL 08-0011, and methylnaltrexone. The activities of the compounds were investigated with respect to human or guinea pig opioid receptor binding and function in recombinant cell lines and mechanical responsiveness of the guinea pig ileum. Alvimopan and ADL 08-0011 had higher binding affinity than methylnaltrexone at human mu opioid receptors (pK (i) values of 9.6, 9.6, and 8.0, respectively). The compounds had different selectivities for the mu receptor over human delta and guinea pig kappa opioid receptors. ADL 08-0011 had the highest mu receptor selectivity. With respect to their mu opioid receptor functional activity ([(35)S]GTPgammaS incorporation), methylnaltrexone had a positive intrinsic activity, consistent with partial agonism, unlike alvimopan and ADL 08-0011, which had negative intrinsic activities. Alvimopan, ADL 08-0011, and methylnaltrexone antagonized inhibitory responses mediated by the mu opioid agonist, endomorphin-1 (pA (2) values of 9.6, 9.4, and 7.6, respectively) and by U69593, a kappa opioid agonist (pA (2) values of 8.4, 7.2, and 6.7, respectively). In morphine-naive guinea pig ileum, methylnaltrexone reduced, while alvimopan and ADL 08-0011 increased, the amplitude of electrically evoked contractions and spontaneous mechanical activity. In tissue from morphine-dependent animals, alvimopan and ADL 08-0011 increased spontaneous activity to a greater degree than methylnaltrexone. The data suggested that alvimopan-induced contractions resulted predominantly from an interaction with kappa opioid receptors. It is concluded that alvimopan, ADL 08-0011, and methylnaltrexone differ in their in vitro pharmacological properties, particularly with respect to opioid receptor subtype selectivity and intrinsic activity. The clinical significance of the data from this study remains to be determined.

  4. Ambient and smartphone sensor assisted ADL recognition in multi-inhabitant smart environments.

    PubMed

    Roy, Nirmalya; Misra, Archan; Cook, Diane

    2016-02-01

    Activity recognition in smart environments is an evolving research problem due to the advancement and proliferation of sensing, monitoring and actuation technologies to make it possible for large scale and real deployment. While activities in smart home are interleaved, complex and volatile; the number of inhabitants in the environment is also dynamic. A key challenge in designing robust smart home activity recognition approaches is to exploit the users' spatiotemporal behavior and location, focus on the availability of multitude of devices capable of providing different dimensions of information and fulfill the underpinning needs for scaling the system beyond a single user or a home environment. In this paper, we propose a hybrid approach for recognizing complex activities of daily living (ADL), that lie in between the two extremes of intensive use of body-worn sensors and the use of ambient sensors. Our approach harnesses the power of simple ambient sensors (e.g., motion sensors) to provide additional 'hidden' context (e.g., room-level location) of an individual, and then combines this context with smartphone-based sensing of micro-level postural/locomotive states. The major novelty is our focus on multi-inhabitant environments, where we show how the use of spatiotemporal constraints along with multitude of data sources can be used to significantly improve the accuracy and computational overhead of traditional activity recognition based approaches such as coupled-hidden Markov models. Experimental results on two separate smart home datasets demonstrate that this approach improves the accuracy of complex ADL classification by over 30 %, compared to pure smartphone-based solutions.

  5. Ambient and smartphone sensor assisted ADL recognition in multi-inhabitant smart environments

    PubMed Central

    Misra, Archan; Cook, Diane

    2016-01-01

    Activity recognition in smart environments is an evolving research problem due to the advancement and proliferation of sensing, monitoring and actuation technologies to make it possible for large scale and real deployment. While activities in smart home are interleaved, complex and volatile; the number of inhabitants in the environment is also dynamic. A key challenge in designing robust smart home activity recognition approaches is to exploit the users' spatiotemporal behavior and location, focus on the availability of multitude of devices capable of providing different dimensions of information and fulfill the underpinning needs for scaling the system beyond a single user or a home environment. In this paper, we propose a hybrid approach for recognizing complex activities of daily living (ADL), that lie in between the two extremes of intensive use of body-worn sensors and the use of ambient sensors. Our approach harnesses the power of simple ambient sensors (e.g., motion sensors) to provide additional ‘hidden’ context (e.g., room-level location) of an individual, and then combines this context with smartphone-based sensing of micro-level postural/locomotive states. The major novelty is our focus on multi-inhabitant environments, where we show how the use of spatiotemporal constraints along with multitude of data sources can be used to significantly improve the accuracy and computational overhead of traditional activity recognition based approaches such as coupled-hidden Markov models. Experimental results on two separate smart home datasets demonstrate that this approach improves the accuracy of complex ADL classification by over 30 %, compared to pure smartphone-based solutions. PMID:27042240

  6. Correlates of ADL difficulty in a large hemodialysis cohort.

    PubMed

    Kutner, Nancy G; Zhang, Rebecca; Allman, Richard M; Bowling, C Barrett

    2014-01-01

    Needing assistance with activities of daily living (ADL) is an early indicator of functional decline and has important implications for individuals' quality of life. However, correlates of need for ADL assistance have received limited attention among patients undergoing maintenance hemodialysis (HD). A multicenter cohort of 742 prevalent HD patients was assessed in 2009-2011 and classified as frail, prefrail and nonfrail by the Fried frailty index (recent unintentional weight loss, reported exhaustion, low grip strength, slow walk speed, low physical activity). Patients reported need for assistance with 4 ADL tasks and identified contributing symptoms/conditions (pain, balance, endurance, weakness, others). Nearly 1 in 5 patients needed assistance with 1 or more ADL. Multivariable analysis showed increased odds for needing ADL assistance among frail (odds ratio [OR] 11.35; 95% confidence interval [CI] 5.50-23.41; P < 0.001) and prefrail (OR 1.93; 95% CI 1.01-3.68; P = 0.046) compared with non-frail patients. In addition, the odds for needing ADL assistance were lower among blacks compared with whites and were higher among patients with diabetes, lung disease, and stroke. Balance, weakness, and "other" (frequently dialysis-related) symptoms/conditions were the most frequently named reasons for ADL difficulty. In addition to interventions such as increasing physical activity that might delay or reverse the process of frailty, the immediate symptoms/conditions to which individuals attribute their ADL difficulty may have clinical relevance for developing targeted management and/or treatment approaches.

  7. Algorithm integration using ADL (Algorithm Development Library) for improving CrIMSS EDR science product quality

    NASA Astrophysics Data System (ADS)

    Das, B.; Wilson, M.; Divakarla, M. G.; Chen, W.; Barnet, C.; Wolf, W.

    2013-05-01

    Algorithm Development Library (ADL) is a framework that mimics the operational system IDPS (Interface Data Processing Segment) that is currently being used to process data from instruments aboard Suomi National Polar-orbiting Partnership (S-NPP) satellite. The satellite was launched successfully in October 2011. The Cross-track Infrared and Microwave Sounder Suite (CrIMSS) consists of the Advanced Technology Microwave Sounder (ATMS) and Cross-track Infrared Sounder (CrIS) instruments that are on-board of S-NPP. These instruments will also be on-board of JPSS (Joint Polar Satellite System) that will be launched in early 2017. The primary products of the CrIMSS Environmental Data Record (EDR) include global atmospheric vertical temperature, moisture, and pressure profiles (AVTP, AVMP and AVPP) and Ozone IP (Intermediate Product from CrIS radiances). Several algorithm updates have recently been proposed by CrIMSS scientists that include fixes to the handling of forward modeling errors, a more conservative identification of clear scenes, indexing corrections for daytime products, and relaxed constraints between surface temperature and air temperature for daytime land scenes. We have integrated these improvements into the ADL framework. This work compares the results from ADL emulation of future IDPS system incorporating all the suggested algorithm updates with the current official processing results by qualitative and quantitative evaluations. The results prove these algorithm updates improve science product quality.

  8. Impact on HIV test providers of giving a positive test result.

    PubMed

    Myers, Ted; Worthington, Catherine; Aguinaldo, Jeffrey P; Haubrich, Dennis J; Ryder, Karen; Rawson, Brian

    2007-09-01

    The provision of a positive HIV antibody test result and the direction and support given to the test recipient are critical components of care and prevention. There has been little research that describes what happens in such interactions between recipient and provider. The impact on the test provider of delivering the HIV test result is an important issue to consider. The discomfort experienced by some health providers in giving a positive test result may have adverse effects on the client interaction or may carry over into subsequent client interactions. Utilizing a thematic analysis on interview data from 24 HIV test providers, we describe the impact of delivering a positive test result on HIV test providers, identify the factors that influence this impact, and describe strategies used to manage the impact. As with other health care professionals communicating "bad news,"HIV test providers experience a variety of impacts. While a small number of providers indicated little or no impact of delivering the HIV positive test result because the diagnosis is ''not the end of the world,'' most indicated it was difficult as it was anticipated that the test recipient would (or did) find the news distressing. Several coping strategies were identified.

  9. The ADL Registry and CORDRA. Volume 1: General Overview

    DTIC Science & Technology

    2008-08-01

    and problems encountered by others in related fields, such as library science , computer and network systems design, and publishing. As ADL...in and exist in isolated islands, limiting their visibility, access, and reuse. 4 Compared to publishing and library science , the learning

  10. SO{sub 2} and NOx trading markets: providing flexibility and results

    SciTech Connect

    Sam Napolitano; Melanie LaCount; Daniel Chartier

    2007-06-15

    Experience with the Acid Rain and NOx Budget Trading Programs demonstrates that cap-and-trade programs are an effective means of achieving broad improvements in air quality. Results demonstrate that the combination of mandatory emissions caps, a viable allowance trading market, rigorous emissions monitoring and reporting protocols, and automatic enforcement provide accountability and ensure results in a cost-effective manner. The market developments discussed in this article demonstrate a successful environmental partnership. With a government focused on results and a private sector motivated to innovate, cap-and trade systems deliver environmental results as efficiently and effectively as possible. 3 refs., 4 figs,

  11. Association of early-onset dementia with activities of daily living (ADL) in middle-aged adults with intellectual disabilities: the caregiver's perspective.

    PubMed

    Lin, Lan-Ping; Hsu, Shang-Wei; Hsia, Yi-Chen; Wu, Chia-Ling; Chu, Cordia; Lin, Jin-Ding

    2014-03-01

    Few studies have investigated in detail which factors influence activities of daily living (ADL) in adults with intellectual disabilities (ID) comorbid with/without dementia conditions. The objective of the present study was to describe the relation between early onset dementia conditions and progressive loss of ADL capabilities and to examine the influence of dementia conditions and other possible factors toward ADL scores in adults with ID. This study was part of the "Healthy Aging Initiatives for Persons with an Intellectual Disability in Taiwan: A Social Ecological Approach" project. We analyzed data from 459 adults aged 45 years or older with an ID regarding their early onset symptoms of dementia and their ADL profile based on the perspective of the primary caregivers. Results show that a significant negative correlation was found between dementia score and ADL score in a Pearson's correlation test (r=-0.28, p<0.001). The multiple linear regression model reported that factors of male gender (β=4.187, p<0.05), marital status (β=4.79, p<0.05), education level (primary: β=5.544, p<0.05; junior high or more: β=8.147, p<0.01), Down's syndrome (β=-9.290, p<0.05), severe or profound disability level (β=-6.725, p<0.05; β=-15.773, p<0.001), comorbid condition (β=-4.853, p<0.05) and dementia conditions (β=-9.245, p<0.001) were variables that were able to significantly predict the ADL score (R(2)=0.241) after controlling for age. Disability level and comorbidity can explain 10% of the ADL score variation, whereas dementia conditions can only explain 3% of the ADL score variation in the study. The present study highlights that future studies should scrutinize in detail the reasons for the low explanatory power of dementia for ADL, particularly in examining the appropriateness of the measurement scales for dementia and ADL in aging adults with ID.

  12. Characteristics of Genomic Test Consumers Who Spontaneously Share Results with Their Health Care Provider

    PubMed Central

    Darst, Burcu F.; Madlensky, Lisa; Schork, Nicholas J.; Topol, Eric J.; Bloss, Cinnamon S.

    2013-01-01

    Purpose To evaluate the characteristics of direct-to-consumer (DTC) genomic test consumers who spontaneously shared their test results with their health care provider. Methods Utilizing data from the Scripps Genomic Health Initiative we compared demographic, behavioral, and attitudinal characteristics of DTC genomic test consumers who shared their results with their physician or health care provider versus those who did not share. We also compared genomic risk estimates between the two groups. Results Of 2024 individuals assessed at approximately 6 months post-testing, a total of 540 individuals (26.5%) reported sharing their results with their physician or health care provider. Those who shared were older (p<.001), had a higher income (p=.01), were more likely to be married (p=.005), and more likely to identify with a religion (p=.004). As assessed prior to undergoing testing, sharers also showed higher exercise (p=.003) and lower fat intake (p=.02), and expressed fewer overall concerns about testing (p=.001) and fewer concerns related to the privacy of their genomic information (p=.03). The genomic disease risk estimates disclosed were not associated with sharing. Conclusion In a DTC genomic testing context, physicians and other health care providers may be more likely to encounter patients who are more health conscious and have fewer concerns about the privacy of their genomic information. Genomic risk itself does not appear to be a primary determinant of sharing behavior among consumers. PMID:23384116

  13. Testing for neglect in right-hemispheric stroke patients using a new assessment battery based upon standardized activities of daily living (ADL).

    PubMed

    Eschenbeck, Philipp; Vossel, Simone; Weiss, Peter H; Saliger, Jochen; Karbe, Hans; Fink, Gereon R

    2010-10-01

    Spatial neglect is most frequently observed after right-hemispheric stroke and is characterized by a failure to report, to respond, or to orient to stimuli presented to the contralesional side. Although many neglect patients show difficulties in accomplishing activities of daily living (ADL), to date the clinical assessment of neglect is based upon neuropsychological paper-and-pencil tests. Thus, essential information about the patient's functional status may be missed out. Accordingly, we aimed at developing a new neglect test battery that incorporates standardized ADL. Six conventional paper-and-pencil neglect tests and eight standardized ADL with newly developed neglect-specific scoring criteria and cut-off scores were administered to 68 right-hemispheric stroke patients. According to the neuropsychological tests 22 patients showed symptoms suggesting neglect, whereas 17 patients showed symptoms suggesting neglect according to the newly developed neglect test based upon ADL. Neglect-specific impairments in the neuropsychological tests were significantly associated with those in the ADL-based tests, although dissociations were observed in seven patients. Neglect severity (as reflected in the percentage of positive subtests) was comparable for both test batteries and both test instruments showed high interrater reliability. Voxel-based lesion-symptom mapping revealed that the severity of neglect according to the neuropsychological and ADL-based tests was significantly associated with lesions within right fronto-parietal networks. We conclude that the newly developed ADL-based neglect battery provides an economic and ecologically valid tool for the assessment of neglect. The test can be used to assess and quantify neglect in everyday activities, and thus to monitor realistically rehabilitative needs of neglect patients.

  14. Ventilatory demand and dynamic hyperinflation induced during ADL-based tests in Chronic Obstructive Pulmonary Disease patients

    PubMed Central

    dos Santos, Karoliny; Gulart, Aline A.; Munari, Anelise B.; Karloh, Manuela; Mayer, Anamaria F.

    2016-01-01

    ABSTRACT Background Airflow limitation frequently leads to the interruption of activities of daily living (ADL) in patients with Chronic Obstructive Pulmonary Disease (COPD). These patients commonly show absence of ventilatory reserve, reduced inspiratory reserve volume, and dynamic hyperinflation (DH). Objective To investigate ventilatory response and DH induced by three ADL-based protocols in COPD patients and compare them to healthy subjects. Method Cross-sectional study. COPD group: 23 patients (65±6 years, FEV1 37.2±15.4%pred); control group: 14 healthy subjects (64±4 years) matched for age, sex, and body mass index. Both groups performed all three tests: Glittre-ADL test; an activity test that involved moving objects on a shelf (TSHELF); and a modified shelf protocol isolating activity with upper limbs (TSHELF-M). Ventilatory response and inspiratory capacity were evaluated. Results Baseline ventilatory variables were similar between groups (p>0.05). The ventilatory demand increased and the inspiratory capacity decreased significantly at the end of the tests in the COPD group. Ventilatory demand and DH were higher (p<0.05) in the TSHELF than in the TSHELF–M in the COPD group (p<0.05). There were no differences in DH between the three tests in the control group (p>0.05) and ventilatory demand increased at the end of the tests (p<0.05) but to a lower extent than the COPD group. Conclusion The TSHELF induces similar ventilatory responses to the Glittre-ADL test in COPD patients with higher ventilatory demand and DH. In contrast, the ventilatory response was attenuated in the TSHELF-M, suggesting that squatting and bending down during the Glittre-ADL test could trigger significant ventilatory overload. PMID:27333482

  15. Collateral Consequences of Juvenile Sex Offender Registration and Notification: Results From a Survey of Treatment Providers.

    PubMed

    Harris, Andrew J; Walfield, Scott M; Shields, Ryan T; Letourneau, Elizabeth J

    2016-12-01

    Among many in the research, policy, and practice communities, the application of sex offender registration and notification (SORN) to juveniles who sexually offend (JSO) has raised ongoing concerns regarding the potential collateral impacts on youths' social, mental health, and academic adjustment. To date, however, no published research has systematically examined these types of collateral consequences of juvenile SORN. Based on a survey of a national sample of treatment providers in the United States, this study investigates the perceived impact of registration and notification on JSO across five key domains: mental health, harassment and unfair treatment, school problems, living instability, and risk of reoffending. Results indicate that treatment providers overwhelmingly perceive negative consequences associated with registration with an incremental effect of notification indicating even greater concern across all five domains. Providers' demographics, treatment modalities, and client profile did not influence their perceptions of the collateral consequences suggesting that provider concern about the potential harm of SORN applied to juveniles is robust. Policy implications are discussed.

  16. [Reduced ADL, QOL and musculoskeletal dysfunction associated with respiratory disease.

    PubMed

    Homma, Toshiaki

    Chronic respiratory disease, such as chronic obstructive pulmonary disease(COPD)continues to cause a heavy health and economic burden in the world. Lower-limb muscle dysfunction is a prominent and major extrapulmonary features in individuals with moderate-to-very severe COPD and has important clinical implications, such as reduced exercise tolerance, activity of daily living(ADL), health related quality of life(HRQOL)and even survival. Osteoporosis is also an important systemic feature of COPD. Osteoprotic fracture cause many symptoms and complications, including the impairment of ventilation, and create a heavy economic burden. Comprehensive treatments(drug medication and non-drug treatment)for these impairments, such as pulmonary rehabilitation, are recommended. Pulmonary rehabilitation improves dyspnea, exercise capacity, ADL, and HRQOL, each of which is recognized predictors of mortality.

  17. Geological questions and significant results provided by early ERTS-1 data

    NASA Technical Reports Server (NTRS)

    Carter, W. D.

    1972-01-01

    There are no author-identified significant results in this report. The organization for evaluating the uses of Earth Resources Technology Satellite data of the United States and foreign areas is described. The implementation of a system to disseminate the data to the geographical areas of interest is discussed. Brief descriptions are included of data received for the following areas: (1) east coast, (2) central United States, (3) western mountain areas, (4) west coast areas, and (5) Alaska. It is concluded that the multiband approach is useful with each of the bands providing unique and useful information. The difficulties in handling the data if all seven bands are used are examined.

  18. Immunohistochemistry staining for mismatch repair proteins: the endoscopic biopsy material provides useful and coherent results.

    PubMed

    Vilkin, Alex; Leibovici-Weissman, Ya'ara; Halpern, Marisa; Morgenstern, Sara; Brazovski, Eli; Gingold-Belfer, Rachel; Wasserberg, Nir; Brenner, Baruch; Niv, Yaron; Sneh-Arbib, Orly; Levi, Zohar

    2015-11-01

    Immunohistochemistry (IHC) testing for mismatch repair proteins (MMRP) in patients with colorectal cancer can be performed on endoscopic biopsy material or the surgical resection material. Data are continuing to accumulate regarding the deleterious effect of neoadjuvant chemoradiation on MMRP expression. However, despite continuing rise in the use of endoscopic biopsies for IHC, most pathology departments still use mainly the surgical materials for IHC testing. In this study we compared the quality of stains among 96 colon cancer subjects with paired endoscopic and surgical material available for MLH1, MSH2, MSH6, and PMS2 stains (96 × 4, yielding 384 paired stains). Each slide received both a quantitative score (immunoreactivity [0-3] × percent positivity [0-4]) and a qualitative score (absent; weak and focal; strong). The quantitative scores of all MMRP were significantly higher among the endoscopic material (P<.001 for all). In 358 pairs (93.2%), both the endoscopic and operative material stained either strong (322, 83.9%) or absent (36, 9.4%). In 26 pairs (6.8%), the endoscopic material stained strong, whereas the operative material stained focal and weak. No endoscopic biopsy materials stained focal and weak. Our findings indicate that the biopsy material may provide more coherent results. Although these results may indicate that biopsy material provides coherent and useful results, it is yet to be determined if the demonstrated differences pose a real clinical problem in interpreting final results of IHC staining of such kind. Hence, we suggest that when available, the endoscopic material rather than the operative one should serve as the primary substrate for IHC staining.

  19. Results of advanced battery technology evaluations for electric vehicle applications

    SciTech Connect

    DeLuca, W.H.; Gillie, K.R.; Kulaga, J.E.; Smaga, J.A.; Tummillo, A.F.; Webster, C.E.

    1992-09-01

    Advanced battery technology evaluations are performed under simulated electric-vehicle operating conditions at the Analysis & Diagnostic Laboratory (ADL) of Argonne National Laboratory. The ADL results provide insight Into those factors that limit battery performance and life. The ADL facilities include a test laboratory to conduct battery experimental evaluations under simulated application conditions and a post-test analysis laboratory to determine, In a protected atmosphere if needed, component compositional changes and failure mechanisms. This paper summarizes the performance characterizations and life evaluations conducted during 1991--1992 on both single cells and multi-cell modules that encompass eight battery technologies [Na/S, Li/MS (M=metal), Ni/MH, Ni/Cd, Ni/Zn, Ni/Fe, Zn/Br, and Pb-acid]. These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division, and the Electric Power Research Institute. The ADL provides a common basis for battery performance characterization and life evaluations with unbiased application of tests and analyses. The results help identify the most-promising R&D approaches for overcoming battery limitations, and provide battery users, developers, and program managers with a measure of the progress being made in battery R&D programs, a comparison of battery technologies, and basic data for modeling.

  20. Results of advanced battery technology evaluations for electric vehicle applications

    NASA Astrophysics Data System (ADS)

    Deluca, W. H.; Gillie, K. R.; Kulaga, J. E.; Smaga, J. A.; Tummillo, A. F.; Webster, C. E.

    1992-10-01

    Advanced battery technology evaluations are performed under simulated electric-vehicle operating conditions at the Analysis and Diagnostic Laboratory (ADL) of Argonne National Laboratory. The ADL results provide insight into those factors that limit battery performance and life. The ADL facilities include a test laboratory to conduct battery experimental evaluations under simulated application conditions and a post-test analysis laboratory to determine, in a protected atmosphere if needed, component compositional changes and failure mechanisms. This paper summarizes the performance characterizations and life evaluations conducted during 1991-1992 on both single cells and multi-cell modules that encompass eight battery technologies (Na/S, Li/MS (M=metal), Ni/MH, Ni/Cd, Ni/Zn, Ni/Fe, Zn/Br, and Pb-acid). These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division, and the Electric Power Research Institute. The ADL provides a common basis for battery performance characterization and life evaluations with unbiased application of tests and analyses. The results help identify the most-promising R&D approaches for overcoming battery limitations, and provide battery users, developers, and program managers with a measure of the progress being made in battery R&D programs, a comparison of battery technologies, and basic data for modeling.

  1. Results of advanced batter technology evaluations for electric vehicle applications

    SciTech Connect

    DeLuca, W.H.; Gillie, K.R.; Kulaga, J.E.; Smaga, J.A.; Tummillo, A.F.; Webster, C.E.

    1992-01-01

    Advanced battery technology evaluations are performed under simulated electric-vehicle operating conditions at the Analysis Diagnostic Laboratory (ADL) of Argonne National Laboratory. The ADL results provide insight Into those factors that limit battery performance and life. The ADL facilities include a test laboratory to conduct battery experimental evaluations under simulated application conditions and a post-test analysis laboratory to determine, In a protected atmosphere if needed, component compositional changes and failure mechanisms. This paper summarizes the performance characterizations and life evaluations conducted during 1991--1992 on both single cells and multi-cell modules that encompass eight battery technologies (Na/S, Li/MS (M=metal), Ni/MH, Ni/Cd, Ni/Zn, Ni/Fe, Zn/Br, and Pb-acid). These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division, and the Electric Power Research Institute. The ADL provides a common basis for battery performance characterization and life evaluations with unbiased application of tests and analyses. The results help identify the most-promising R D approaches for overcoming battery limitations, and provide battery users, developers, and program managers with a measure of the progress being made in battery R D programs, a comparison of battery technologies, and basic data for modeling.

  2. [Discussion on care management operation of a visiting nurse--a case of increased ADL by the support of independent life].

    PubMed

    Shiraishi, Minako

    2002-12-01

    In addition to the visiting nursing service conventionally provided, the Department of Long-term Care Insurance Service of this hospital inaugurated the home care supporting service in April 2000. Senior citizens rated higher in the degree of necessity of care in the initial accreditation and in the renewal accreditation of the Long-term Care Insurance tend to have fewer changes in the services for the last two years. At present, care managers of various professions are involved in the home care supporting services and have no choice but to provide care in non-specialty areas. Under the situation, care management by the visiting nurse helped an elderly increase ADL and live on his own, and the case is introduced in this article. Mr. K.T. developed angina pectoris at the age of 76, had recurrences of complications and repeated transfers of hospitals and was eventually admitted to the hospital. Though he had declined muscular strength and ADL because of the long bed-ridden life, he was discharged from the hospital. Nursing services centered on visiting nursing were provided as the home care supporting service when home medical care for the patient was started. Since Mr. K.T. required medical management, he and his family members were not sure whether it is possible to provide care for him at home and required guidance about health/life and mental supports. Therefore, visiting nursing care was provided by a nurse to assess needs or condition of the person, which reduced anxiety and encouraged the person. As a result, ADL increased and the degree of necessity of care decreased from 4 to 2. This success is attributed to the visiting nurse's appropriate care management based on the medical expertise from the perspective of nursing and the introduction of necessary services at the necessary time based on the appropriate assessment of changes in the physical condition or willingness and the nursing condition of family members. Coordination with the staffs engaged in each

  3. The relation of hypertension to changes in ADL/IADL limitations of Mexican american older adults.

    PubMed

    Caskie, Grace I L; Sutton, Maryann C; Margrett, Jennifer A

    2010-05-01

    Hypertension, highly prevalent and often undiagnosed among older Mexican Americans, is associated with greater limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) that can lead to greater dependency for older adults. Using data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly study, the rate of increase in ADL/IADL limitations for a 7-year period was examined for 3,046 older Mexican Americans classified either as reporting hypertension at baseline, first reporting hypertension at subsequent waves, or never reporting hypertension. Latent growth models indicated increased ADL/IADL limitations over time; individuals with hypertension evidenced greater increases than those without hypertension. Age, comorbidities, and depression were positively related to greater ADL/IADL limitations at baseline for all groups; only age was consistently related to ADL/IADL change over time. Development of hypertension may increase the risk of ADL/IADL decline, but early diagnosis and treatment may attenuate this effect.

  4. Ultra high molecular weight polyethylene (UHMWPE) model can provide results comparable to cadaveric models.

    PubMed

    Haher, Thomas R; Ottaviano, Danielle; DeFrancis, Jason G; Merola, Andrew; Valdevit, Antonio

    2004-01-01

    The in vitro biomechanical models using a cadaveric spine specimen have long been used in understanding normal and abnormal functions of spines as well as for strength and stability testing of the spine specimen or spinal construct. Little effort has been made to describe the similarities or differences between UHMWPE and cadaveric models. Eight cadaveric lumbar spines were harvested generating six FSU and three corpectomy models. Six UHMWPE blocks were fabricated to form FSU and corpectomy models. All were tested intact, with posterior instrumentation, and with anterior instrumentation consisting of Moss-Miami 4.0 mm stainless steel rods, uni-axial stainless steel screws and DePuy Harm's cages. All models were tested in axial compression. The cadaveric model and UHMPWE model yielded axial stiffness values of comparable magnitude with respect to instrumentation applied using the posterior approach (P>0.05). Under an FSU configuration, only in the case of anterior instrumentation without the addition of a Harm's cage did both the cadaveric and UHMPWE models provide comparable axial stiffness results (P>0.05). While in vitro cadaveric models are considered the gold standard for biomechanical testing of the spine, the data suggests that under specific approaches and surgical models UHMWPE can be used to infer mechanical performance of instrumentation in cadaveric material.

  5. [ADL and actual life styles of all Japanese centenarians as determined by a visitation interview survey].

    PubMed

    Ogihara, R; Maeda, K; Tsujibayashi, K; Tomabechi, K; Ohta, T; Iwabuchi, K; Mano, Y

    2000-03-01

    A visiting interview survey was performed on all centenarians living in Japan to investigate their Activities of Daily Life (ADL). 2,851 centenarians, 92.9% of all subjects completed the interview. They were divided into three groups, good ADL (almost independent in daily life), moderate ADL (almost independent in indoor life), and inferior ADL (bed fast) by the condition of ADL. Some factors of health conditions, family size, frequency of use of public welfare services, and life styles were compared among these three groups. Both the good and the moderate ADL groups accounted for about 20% each, and the inferior ADL group was about 60% of the subjects. The condition of ADL of men was better than that of women. The inferior ADL group showed a significantly higher percentage of chronic diseases. High ratios of cerebral vascular disease and dementia were seen in this group, and many had no teeth. While two thirds of all the centenarians lived at home, over 90% of the good ADL group lived at home. The mode of family size was three including the person oneself. An average of 21% of men and 27% of women used public health welfare services. However 40% of the centenarians in the inferior ADL group used those services. Men had better dietary habits for health than women. The good ADL group showed the most desirable dietary habits among the three groups and had the highest percentage of drinkers and smokers. Men practiced a greater number of ideal habits for longevity than women. Of the ADL groups, centenarians in the good ADL group had the highest percentage of ideal habits for longevity. The centenarians who maintained good ADL had the following characteristics: There were fewer people under medical treatment. They had maintained their own teeth. Almost all of them were living at their home with their family. They had continued good dietary habits and daily life for health and longevity. For the maintenance and improvement of ADL of centenarians, adequate social welfare

  6. Evaluation of a radio based ADL interaction recognition system in a day hospital for old age psychiatry with healthy probands.

    PubMed

    Neuhaeuser, J; Diehl-Schmid, J; Lueth, T C

    2011-01-01

    In this contribution the evaluation of a system called "Eventlogger" is presented, which is installed in a day hospital for old age psychiatry. The Eventlogger is a radio based module with an adjustable communication range, able to recognize interaction of the user with objects or with other people. It is intended to function as a monitoring tool for the users' activities. Due to the demographic change monitoring systems for elderly people become more important. In this paper the "simple activities of daily living" (sADL) is introduced as well as the evaluation for the recognition of sADL in a day hospital for old age psychiatry with healthy probands is presented. Together with the first approaches of post processing for better results it is shown that the system is now ready to be used with patients of the day hospital for old age psychiatry.

  7. The tool in the brain: apraxia in ADL. Behavioral and neurological correlates of apraxia in daily living.

    PubMed

    Bieńkiewicz, Marta M N; Brandi, Marie-Luise; Goldenberg, Georg; Hughes, Charmayne M L; Hermsdörfer, Joachim

    2014-01-01

    Humans differ from other animals in the way they can skilfully and precisely operate or invent tools to facilitate their everyday life. Tools have dominated our home, travel and work environment, becoming an integral step for our motor skills development. What happens when the part of the brain responsible for tool use is damaged in our adult life due to a cerebrovascular accident? How does daily life change when we lose the previously mastered ability to make use of the objects around us? How do patients suffering from compromised tool use cope with food preparation, personal hygiene, grooming, housework, or use of home appliances? In this literature review we present a state of the art for single and multiple tool use research, with a focus on the impact that apraxia (impaired ability to perform tool-based actions) and action disorganization syndrome (ADS; impaired ability to carry out multi-step actions) have on activities of daily living (ADL). Firstly, we summarize the behavioral studies investigating the impact of apraxia and other comorbidity syndromes, such as neglect or visual extinction, on ADL. We discuss the hallmarks of the compromised tool use in terms of the sequencing of action steps, conceptual errors committed, spatial motor control, and temporal organization of the movement. In addition, we present an up-to-date overview of the neuroimaging and lesion analyses studies that provide an insight into neural correlates of tool use in the human brain and functional changes in the neural organization following a stroke, in the context of ADL. Finally we discuss the current practice in neurorehabilitation of ADL in apraxia and ADS aiming at increasing patients' independence.

  8. Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia.

    PubMed

    Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim

    2014-01-01

    The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.

  9. Audio Development Laboratory (ADL) User Test Planning Guide

    NASA Technical Reports Server (NTRS)

    Romero, Andy

    2012-01-01

    Test process, milestones and inputs are unknowns to first-time users of the ADL. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

  10. Temperature and vibration results from captive-store flight tests provide a reliability improvement tool

    NASA Astrophysics Data System (ADS)

    Calatayud, Richard; Szymkowiak, Edward A.

    The ALQ-131 electronic countermeasure (ECM) system has provided the United States Air Force with proven self-protection for many of its tactical fighter aircraft. The reliability and maintainability (R&M) improvements of the ALQ-131 Block II has produced a system with an mean time between failures (MTBF) of 120 to 180 h and greater than 95 percent availability for the 390 systems in theater during the Persian Gulf war. Classic R&M approaches have gotten the ALQ-131 to this high standard, but improved understanding of the environment experienced by the system will provide the next steps in reliability improvements. The capture of measured response data will provide a basis for development life cycle and customer warranty tests which will guarantee to the customer that the ALQ-131 system will continue to perform reliably from takeoff to landing and from mission to mission through the life of the system.

  11. Prevalence and predictors of healthcare utilization among older people (60+): focusing on ADL dependency and risk of depression.

    PubMed

    Sandberg, Magnus; Kristensson, Jimmie; Midlöv, Patrik; Fagerström, Cecilia; Jakobsson, Ulf

    2012-01-01

    The aim of this study was to investigate healthcare utilization patterns over a six-year period among older people (60+), classified as dependent/independent in Activities of Daily Living (ADL) and/or at/not at risk of depression and to identify healthcare utilization predictors. A sample (n=1402) comprising ten age cohorts aged between 60 and 96 years was drawn from the Swedish National study on Aging and Care (SNAC). Baseline data were collected between 2001 and 2003. Number and length of hospital stays were collected for six years after baseline year. Group differences and mean changes over time were investigated. Healthcare utilization predictors were explored using multiple linear regression analysis. The results revealed that 21-24% had at least one hospital stay in the six years after baseline, 29-37% among ADL dependent subjects and 24-33% among those at risk of depression. There was a significant increase of hospital stays in all groups over time. ADL-dependent subjects and those at risk of depression had significant more hospital stays, except for those at/not at risk of depression in years 2, 4 and 5. The healthcare utilization predictors 5-6 years after baseline were mainly age, previous healthcare utilization and various symptoms and, in 1-2 and 3-4 years after baseline, age, various diagnostic groups and various physical variables. Thus healthcare utilization patterns seem to be similar for the different groups, but it is difficult to find universal predictors. This suggests that different variables should be considered, including both ADL and psychosocial variables, when trying to identify future healthcare users.

  12. RET promoter variations in familial African degenerative leiomyopathy (ADL): first report of a possible genetic-environmental interaction.

    PubMed

    Van Rensburg, C; Moore, S W; Zaahl, M

    2012-12-01

    African degenerative leiomyopathy (ADL, DL, Bantu pseudo-Hirschsprung's disease) is a distinctive visceral myopathy, of unknown etiology, occurring in Africa. It has a classical clinical and histologic picture in young indigenous African children. It presents as intestinal pseudo-obstruction with a massive megacolon due to degeneration of smooth muscle without aganglionosis. Because of its late presentation and geographical and ethnic distribution, it is thought to be an acquired degenerative hollow visceral myopathy. Only one previous report of familial recurrence exists. The main Hirschsprung susceptibility gene RET is a potential candidate gene in this condition, because of its role in the development of the intrinsic innervation and ganglia of the smooth muscle layers of the gastro-intestinal tract. We report a second case of familial ADL recurrence and explore possible etiologic causes including variations of the RET gene. Multiple variations in the RET promoter were identified in this case which leads to the possibility of a genetic-environmental predisposition for this condition. We therefore hypothesize that RET may play a modulating role in ADL susceptibility (and possibly other visceral myopathies). It is possible that subtle malformations in the ENS may result from RET dysfunction which then predisposes the individual to environmental influences which initiate the later onset of muscle degeneration.

  13. A modifiable microarray-based universal sensor: providing sample-to-results automation.

    PubMed

    Yasmin, Rubina; Zhu, Hui; Chen, Zongyuan; Montagna, Richard A

    2016-10-01

    A microfluidic system consisting of generic single use cartridges which interface with a workstation allows the automatic performance of all necessary sample preparation, PCR analysis and interpretation of multiplex PCR assays. The cartridges contain a DNA array with 20 different 16mer DNA "universal" probes immobilized at defined locations. PCR amplicons can be detected via hybridization of user-defined "reporter" probes that are complementary at their 3' termini to one or more of the universal probes and complementary to the target amplicons at their 5' termini. The system was able to detect single-plex and multiplex PCR amplicons from various infectious agents as well as wild type and mutant alleles of single nucleotide polymorphisms. The system's ease of use was further demonstrated by converting a published PCR assay for the detection of Mycobacterium genitalium in a fully automated manner. Excellent correlation between traditional manual methods and the automated analysis performed by the workstation suggests that the system can provide a means to easily design and implement a variety of customized PCR-based assays. The system will be useful to researchers or clinical investigators seeking to develop their own user defined assays. As the U.S. FDA continues to pursue regulatory oversight of LDTs, the system would also allow labs to continue to develop compliant assays.

  14. A dugwell program to provide arsenic-safe water in West Bengal, India: preliminary results.

    PubMed

    Smith, Meera M Hira; Hore, Timir; Chakraborty, Protap; Chakraborty, D K; Savarimuthu, Xavier; Smith, Allan H

    2003-01-01

    In 1982, Dr. K. C. Saha, a dermatologist of Calcutta, West Bengal, identified patients with skin lesions from the district of 24 Parganas, leading him and others to search for a cause. The cause was soon identified to be arsenic in drinking water, but even today, 20 years later, large number of people continue to drink arsenic contaminated water and patients are increasing in number. Project Well is a program chosen for implementation in some villages of North 24 Parganas. Arsenic safe drinking water is provided for adopted villages by constructing shallow, concrete dugwells designed to tap the water of the unconfined aquifer, 20-30 feet below ground level, that contains low levels (< 0.05 mg/L) of arsenic in the target region. The traditional dugwell design is modified by use of tube well hand pumps to withdraw water. The project includes community involvement, programs to increase awareness of the need to drink arsenic safe water, and training in monitoring of dugwell water for arsenic and harmful pathogens. Disinfecting of the water and regulating the water hazard diagram are also included in the training program. The plan is to make the system sustainable at the village level using indigenous labor and materials.

  15. A Query Result Merging Scheme for Providing Energy Efficiency in Underwater Sensor Networks

    PubMed Central

    Kim, Yunsung; Park, Soo-Hyun

    2011-01-01

    Underwater sensor networks are emerging as a promising distributed data management system for various applications in underwater environments, despite their limited accessibility and restricted energy capacity. With the aid of recent developments in ubiquitous data computing, an increasing number of users are expected to overcome low accessibility by applying queries to underwater sensor networks. However, when multiple users send queries to an underwater sensor network in a disorganized manner, it may incur lethal energy waste and problematic network traffic. The current query management mechanisms cannot effectively deal with this matter due to their limited applicability and unrealistic assumptions. In this paper, a novel query management scheme involving query result merging is proposed for underwater sensor networks. The mechanism is based on a relational database model and is adjusted to the practical restrictions affecting underwater communication environments. Network simulations will prove that the scheme becomes more efficient with a greater number of queries and a smaller period range. PMID:22247695

  16. Quick lateral movements of the trunk in a seated position reflect mobility and activities of daily living (ADL) function in frail elderly individuals.

    PubMed

    Iwata, Akira; Higuchi, Yumi; Kimura, Daisuke; Okamoto, Kensuke; Arai, Shin; Iwata, Hiroshi; Fuchioka, Satoshi

    2013-01-01

    A novel and safe performance test for measuring mobility is described. The test, which we have named the Seated Side Tapping test (Side Tapping test), requires the subjects to move their bodies laterally to the left and right in turn as quickly as possible whilst remaining in a seated position. We examined the associations between the results of the new test and those of other mobility tests, ADL, and the use of walking aids. The participants were 75 frail elderly people who were receiving rehabilitation services. Gait speed and the timed up and go (TUG) test were employed as mobility tests, and the participants' use of walking aids was recorded. The ADL score was assessed using the Barthel Index. Significant correlations were found between the side tapping test and gait speed (r=-0.59, p<0.01), and TUG (r=0.63, p<0.01). This test also revealed significant relationships with the ADL scores and the use of walking aids. These results indicate that an ability to perform quick lateral trunk movements in a seated position reflects their mobility during standing. Thus, we concluded that since the side tapping test is simple and safe, it is useful for detecting mobility impairments, ADL levels, and the need for walking aids, especially in frail elderly individuals.

  17. Do subclinical vascular abnormalities precede impaired physical ability and ADL disability?

    PubMed

    den Ouden, Marjolein E M; Schuurmans, Marieke J; Mueller-Schotte, Sigrid; Bots, Michiel L; van der Schouw, YvonneT

    2014-10-01

    Cardiovascular disease is an important cause of disability in activities of daily living (ADL) through its effect on physical functioning. However, it is unclear whether subclinical vascular abnormalities and rate of change in subclinical vascular abnormalities is also associated with an impaired physical ability and with ADL disability. In a longitudinal study, 490 middle-aged and older persons were included. Physical ability was measured using the Short Physical Performance Battery and ADL disability using a questionnaire on self-reported basic and instrumental ADL. Subclinical vascular abnormalities were measured by pulse wave velocity (PWV) and carotid intima media thickness (CIMT, in men only). Longitudinal associations between baseline markers of subclinical vascular abnormalities, their rate of change, and change in physical ability or ADL disability were assessed using generalized estimation equation models. After adjustment for confounders, higher baseline PWV, change in PWV, baseline CIMT (in men) and change in CIMT (in men) were associated with a higher rate of change in physical ability (regression coefficients 0.035, 95% CI [0.018; 0.052]; 0.047, 95% CI [0.024; 0.069]; 0.214, 95% CI [0.070; 0.358] and 0.148, 95% CI [0.019; 0.277], respectively). No relations were found for change in ADL disability. In subjects with incident cardiovascular disease, higher change in PWV was associated with a higher rate of change in ADL disability (regression coefficient 0.054, 95% CI [0.001; 0.106]). The present study showed that subclinical vascular abnormalities and rate of change were associated with higher rate of change in physical ability. The association between (change in) subclinical vascular abnormalities and ADL disability tended to be stronger in persons with incident and prevalent cardiovascular disease. These data may suggest that ADL decline is more a direct effect of experienced clinically manifest vascular events rather than the effect of progression of

  18. Alvimopan* (ADL 8-2698) is a novel peripheral opioid antagonist.

    PubMed

    Schmidt, W K

    2001-11-01

    Alvimopan (ADL 8-2698; Adolor Corporation, Exton, PA, USA) is a novel, peripherally restricted opioid antagonist. After oral administration, it has activity specific to the gastrointestinal (GI) tract. ADL 8-2698 has low systemic absorption and a high affinity for mu-opioid receptors. In healthy subjects, ADL 8-2698 antagonized loperamide-induced changes in GI transit and prevented morphine-induced delays in oral-cecal transit time without antagonizing centrally mediated opioid effects, such as analgesia or pupillary constriction. In the treatment of opioid naive patients who underwent surgery and received opioids for acute pain, oral ADL 8-2698 (6.0 mg) improved the management of postoperative ileus (POI) by shortening the time to achieve normal bowel function and, ultimately, hospital stay. Postoperative nausea and vomiting and the overall incidence of all GI side effects were reduced in patients treated with ADL 8-2698 for POI. Analgesia was not compromised, because there were no changes in median opioid consumption or Visual Analog Scale (VAS) pain scores in patients treated with ADL 8-2698 versus patients treated with placebo. No drug-related side effects were observed in acute pain postsurgical patients in the initial POI study. In patients treated with opioids for chronic pain or opioid addiction, lower doses of oral ADL 8-2698 (0.5 to 3.0 mg) reversed opioid bowel dysfunction (OBD) and normalized GI activity. These effects were evident without compromising opioid analgesia or inducing central nervous system symptoms of withdrawal. Some chronic opioid patients receiving apparently supramaximal doses of ADL 8-2698 (> or = 3.0 mg) reported localized GI side effects, possibly indicative of a localized GI withdrawal response. The most common side effects of ADL 8-2698 in chronic pain patients with OBD were abdominal pain, flatulence, and diarrhea. These effects were not observed in most OBD patients receiving lower doses of ADL 8-2698. Overall, ADL 8-2698 was

  19. Provision of contraceptive services to homeless women: results of a survey of health care for the homeless providers.

    PubMed

    Saver, Barry G; Weinreb, Linda; Gelberg, Lillian; Zerger, Suzanne

    2012-01-01

    Homeless women have both a higher rate of pregnancy and a higher proportion of unintended pregnancies than other American women. The authors sought to learn about contraception services offered by providers of health care to homeless women and barriers to provision of long-acting, reversible contraception in these settings. A survey of the 31 member organizations in the national Health Care for the Homeless Practice-Based Research Network was conducted, inquiring about services provided and barriers to service provision. Among the 20 responding organizations (65% response rate), 17 directly provided contraceptive services; two referred patients elsewhere, and one provided no contraceptive services. All 17 that provided such services provided condoms; 15 provided oral contraceptives; 14 provided injectable contraception; 6 provided intrauterine devices, and 2 provided contraceptive implants. Barriers to providing the last two methods included lack of provider training, lack of resources for placement, costs, and concerns about complications. The present survey results suggested very limited access for homeless women across the country to the two most effective means of long-acting, reversible contraception. Modest investments of resources could reduce a number of barriers to providing these services.

  20. Listeria monocytogenes DNA Glycosylase AdlP Affects Flagellar Motility, Biofilm Formation, Virulence, and Stress Responses

    PubMed Central

    Zhang, Ting; Bae, Dongryeoul

    2016-01-01

    ABSTRACT The temperature-dependent alteration of flagellar motility gene expression is critical for the foodborne pathogen Listeria monocytogenes to respond to a changing environment. In this study, a genetic determinant, L. monocytogenes f2365_0220 (lmof2365_0220), encoding a putative protein that is structurally similar to the Bacillus cereus alkyl base DNA glycosylase (AlkD), was identified. This determinant was involved in the transcriptional repression of flagellar motility genes and was named adlP (encoding an AlkD-like protein [AdlP]). Deletion of adlP activated the expression of flagellar motility genes at 37°C and disrupted the temperature-dependent inhibition of L. monocytogenes motility. The adlP null strains demonstrated decreased survival in murine macrophage-like RAW264.7 cells and less virulence in mice. Furthermore, the deletion of adlP significantly decreased biofilm formation and impaired the survival of bacteria under several stress conditions, including the presence of a DNA alkylation compound (methyl methanesulfonate), an oxidative agent (H2O2), and aminoglycoside antibiotics. Our findings strongly suggest that adlP may encode a bifunctional protein that transcriptionally represses the expression of flagellar motility genes and influences stress responses through its DNA glycosylase activity. IMPORTANCE We discovered a novel protein that we named AlkD-like protein (AdlP). This protein affected flagellar motility, biofilm formation, and virulence. Our data suggest that AdlP may be a bifunctional protein that represses flagellar motility genes and influences stress responses through its DNA glycosylase activity. PMID:27316964

  1. Perceptions of participating in high-intensity functional exercise among older people dependent in activities of daily living (ADL).

    PubMed

    Lindelöf, N; Rosendahl, E; Gustafsson, S; Nygaard, J; Gustafson, Y; Nyberg, L

    2013-01-01

    The purpose of the study was to evaluate how older people, dependent in ADL perceive their participation in a high-intensity, functional exercise program compared to the perceptions of those participating in a control activity. Forty-eight older people living in residential care facilities answered a questionnaire about their perceptions of participating in an activity for three months. They were aged 65-98, had a mean score of 24 on Mini Mental State Examination (MMSE) and 14 on Barthel ADL Index. The participants had been randomized to exercise (n=20) or control activity (n=28). Differences in responses between exercise and control activity were evaluated using logistic and ordinal regression analyses. The results show that a majority of the exercise group perceived positive changes in lower limb strength, balance, and in the ability to move more safely and securely compared to a minority of the control group (p<0.001). Significantly more respondents in the exercise activity answered that they felt less tired due to the activity (p=0.027) and that they prioritized this activity above other activities (p=0.010). More exercise participants reported that meeting for three months was too short, and fewer that it was too long compared to the control group (p=0.038). This study shows that older people living in residential care facilities, dependent in ADL, and with mild or no cognitive impairment had positive perceptions about participating in high-intensity functional exercise. The findings support the use of a high-intensity exercise program in this population of older people.

  2. DIRECT secure messaging as a common transport layer for reporting structured and unstructured lab results to outpatient providers.

    PubMed

    Sujansky, Walter; Wilson, Tom

    2015-04-01

    This report describes a grant-funded project to explore the use of DIRECT secure messaging for the electronic delivery of laboratory test results to outpatient physicians and electronic health record systems. The project seeks to leverage the inherent attributes of DIRECT secure messaging and electronic provider directories to overcome certain barriers to the delivery of lab test results in the outpatient setting. The described system enables laboratories that generate test results as HL7 messages to deliver these results as structured or unstructured documents attached to DIRECT secure messages. The system automatically analyzes generated HL7 messages and consults an electronic provider directory to determine the appropriate DIRECT address and delivery format for each indicated recipient. The system also enables lab results delivered to providers as structured attachments to be consumed by HL7 interface engines and incorporated into electronic health record systems. Lab results delivered as unstructured attachments may be printed or incorporated into patient records as PDF files. The system receives and logs acknowledgement messages to document the status of each transmitted lab result, and a graphical interface allows searching and review of this logged information. The described system is a fully implemented prototype that has been tested in a laboratory setting. Although this approach is promising, further work is required to pilot test the system in production settings with clinical laboratories and outpatient provider organizations.

  3. AeroADL: applying the integration of the Suomi-NPP science algorithms with the Algorithm Development Library to the calibration and validation task

    NASA Astrophysics Data System (ADS)

    Houchin, J. S.

    2014-09-01

    A common problem for the off-line validation of the calibration algorithms and algorithm coefficients is being able to run science data through the exact same software used for on-line calibration of that data. The Joint Polar Satellite System (JPSS) program solved part of this problem by making the Algorithm Development Library (ADL) available, which allows the operational algorithm code to be compiled and run on a desktop Linux workstation using flat file input and output. However, this solved only part of the problem, as the toolkit and methods to initiate the processing of data through the algorithms were geared specifically toward the algorithm developer, not the calibration analyst. In algorithm development mode, a limited number of sets of test data are staged for the algorithm once, and then run through the algorithm over and over as the software is developed and debugged. In calibration analyst mode, we are continually running new data sets through the algorithm, which requires significant effort to stage each of those data sets for the algorithm without additional tools. AeroADL solves this second problem by providing a set of scripts that wrap the ADL tools, providing both efficient means to stage and process an input data set, to override static calibration coefficient look-up-tables (LUT) with experimental versions of those tables, and to manage a library containing multiple versions of each of the static LUT files in such a way that the correct set of LUTs required for each algorithm are automatically provided to the algorithm without analyst effort. Using AeroADL, The Aerospace Corporation's analyst team has demonstrated the ability to quickly and efficiently perform analysis tasks for both the VIIRS and OMPS sensors with minimal training on the software tools.

  4. Targeting adults who provide alcohol to underage youth: results from a national survey of local law enforcement agencies.

    PubMed

    Jones-Webb, Rhonda; Toomey, Traci L; Lenk, Kathleen M; Nelson, Toben F; Erickson, Darin J

    2015-06-01

    We investigated what local enforcement agencies are doing to target adults who provide alcohol to underage youth; what types of enforcement activities are being conducted to target adult providers; and factors that encourage enforcement activities that target adult providers. We surveyed 1,056 local law enforcement agencies in the US and measured whether or not the agency conducted enforcement activities that target adults who provide alcohol to underage youth. We also measured whether certain agency and jurisdiction characteristics were associated with enforcement activities that target adults who provide alcohol to underage youth. Less than half (42%) of local enforcement agencies conducted enforcement efforts targeting adults who provide alcohol to underage youth. Agencies that conducted the enforcement activities targeting adult providers were significantly more likely to have a full time officer specific to alcohol enforcement, a division specific to alcohol enforcement, a social host law, and to perceive underage drinking was very common. Results suggest that targeting social providers (i.e., adults over 21 years of age) will require greater law enforcement resources, implementation of underage drinking laws (e.g., social host policies), and changing perceptions among law enforcement regarding underage drinking. Future studies are needed to identify the most effective enforcement efforts and to examine how enforcement efforts are prospectively linked to alcohol consumption.

  5. Genome-Wide Analysis of Seed Acid Detergent Lignin (ADL) and Hull Content in Rapeseed (Brassica napus L.).

    PubMed

    Wang, Jia; Jian, Hongju; Wei, Lijuan; Qu, Cunmin; Xu, Xinfu; Lu, Kun; Qian, Wei; Li, Jiana; Li, Maoteng; Liu, Liezhao

    2015-01-01

    A stable yellow-seeded variety is the breeding goal for obtaining the ideal rapeseed (Brassica napus L.) plant, and the amount of acid detergent lignin (ADL) in the seeds and the hull content (HC) are often used as yellow-seeded rapeseed screening indices. In this study, a genome-wide association analysis of 520 accessions was performed using the Q + K model with a total of 31,839 single-nucleotide polymorphism (SNP) sites. As a result, three significant associations on the B. napus chromosomes A05, A09, and C05 were detected for seed ADL content. The peak SNPs were within 9.27, 14.22, and 20.86 kb of the key genes BnaA.PAL4, BnaA.CAD2/BnaA.CAD3, and BnaC.CCR1, respectively. Further analyses were performed on the major locus of A05, which was also detected in the seed HC examination. A comparison of our genome-wide association study (GWAS) results and previous linkage mappings revealed a common chromosomal region on A09, which indicates that GWAS can be used as a powerful complementary strategy for dissecting complex traits in B. napus. Genomic selection (GS) utilizing the significant SNP markers based on the GWAS results exhibited increased predictive ability, indicating that the predictive ability of a given model can be substantially improved by using GWAS and GS.

  6. Reduction in patient burdens with graphical computerized adaptive testing on the ADL scale: tool development and simulation

    PubMed Central

    Chien, Tsair-Wei; Wu, Hing-Man; Wang, Weng-Chung; Castillo, Roberto Vasquez; Chou, Willy

    2009-01-01

    Background The aim of this study was to verify the effectiveness and efficacy of saving time and reducing burden for patients, nurses, and even occupational therapists through computer adaptive testing (CAT). Methods Based on an item bank of the Barthel Index (BI) and the Frenchay Activities Index (FAI) for assessing comprehensive activities of daily living (ADL) function in stroke patients, we developed a visual basic application (VBA)-Excel CAT module, and (1) investigated whether the averaged test length via CAT is shorter than that of the traditional all-item-answered non-adaptive testing (NAT) approach through simulation, (2) illustrated the CAT multimedia on a tablet PC showing data collection and response errors of ADL clinical functional measures in stroke patients, and (3) demonstrated the quality control of endorsing scale with fit statistics to detect responding errors, which will be further immediately reconfirmed by technicians once patient ends the CAT assessment. Results The results show that endorsed items could be shorter on CAT (M = 13.42) than on NAT (M = 23) at 41.64% efficiency in test length. However, averaged ability estimations reveal insignificant differences between CAT and NAT. Conclusion This study found that mobile nursing services, placed at the bedsides of patients could, through the programmed VBA-Excel CAT module, reduce the burden to patients and save time, more so than the traditional NAT paper-and-pencil testing appraisals. PMID:19416521

  7. Frequency Spectrum for New Aviation Data Links: Initial Study Results

    NASA Technical Reports Server (NTRS)

    Matolak, David W.; Branstetter, James R.

    2004-01-01

    We describe results from an initial study to assess the suitability of various spectral bands for supporting the deployment of new aviation data links (ADL). The study focused on systems and spectral bands that can deliver VHF data link (VDL)-or-higher data rates in a two-way communication setting, including air-ground, ground-air, and air-air modes of operation. In the first part of our paper, we briefly discuss the current situation regarding communications, navigation, and surveillance (CNS) links and existing spectrum, and the well-known need for new aviation data links. We next provide an overview of related systems, and discuss key factors involved in the use of spectrum in various bands for any future integrated CNS data link, addressing primarily the lower few layers of the communications protocol stack. Desired attributes of a new ADL system are discussed, and the beneficial aspects of a particular transmission technique spread spectrum are summarized. We also provide a short list of several example potential spectral regions, and note that while none of the existing systems will likely meet the full range of desired features of a new ADL, several systems and spectral regions offer promise in terms of one or more characteristics. A detailed discussion and evaluation of these spectral regions is proposed as future work. We include a few brief examples to illustrate initial technical results regarding spread spectrum overlay, also a subject for future work.

  8. Structure design for a Two-DoF myoelectric prosthetic hand to realize basic hand functions in ADLs.

    PubMed

    Hoshigawa, Suguru; Jiang, Yinlai; Kato, Ryu; Morishita, Soichiro; Nakamura, Tatsuhiro; Yabuki, Yoshiko; Yokoi, Hiroshi

    2015-01-01

    Prosthetic hands are desired by those who have lost a hand or both hands not only for decoration but also for the functions to help them with their activities of daily living (ADL). Prosthetic robotic hands that are developed to fully realize the function of a human hand are usually too expensive to be economically available, difficult to operate and maintain, or over heavy for longtime wearing. The aim of this study is therefore to develop a simplified prosthetic hand (sim-PH), which is to be controlled by myoelectric signals from the user, to realize the most important grasp motions in ADL by trading off the cost and performance. This paper reports the structure design of a two-DoF sim-PH with two motors to drive the CM joint of the thumb and the interlocked MP joints of the other four fingers. In order to optimize the structure, the model of the sim-PH was proposed based on which 7 sim-PHs with different structural parameters were manufactured and tested in a pick-and-place experiment. Correspondence analysis of the experimental results clarified the relationship between the hand functions and the shapes of fingers.

  9. Making non-discrimination and equal opportunity a reality in Kenya's health provider education system: results of a gender analysis.

    PubMed

    Newman, Constance; Kimeu, Anastasiah; Shamblin, Leigh; Penders, Christopher; McQuide, Pamela A; Bwonya, Judith

    2011-01-01

    IntraHealth International's USAID-funded Capacity Kenya project conducted a performance needs assessment of the Kenya health provider education system in 2010. Various stakeholders shared their understandings of the role played by gender and identified opportunities to improve gender equality in health provider education. Findings suggest that occupational segregation, sexual harassment and discrimination based on pregnancy and family responsibilities present problems, especially for female students and faculty. To grow and sustain its workforce over the long term, Kenyan human resource leaders and managers must act to eliminate gender-based obstacles by implementing existing non-discrimination and equal opportunity policies and laws to increase the entry, retention and productivity of students and faculty. Families and communities must support girls' schooling and defer early marriage. All this will result in a fuller pool of students, faculty and matriculated health workers and, ultimately, a more robust health workforce to meet Kenya's health challenges.

  10. Framework for preventing accidental falls in hospitals - management plan for ADL, medication and medical conditions.

    PubMed

    Kato, Shogo; Tsuru, Satoko; Iizuka, Yoshinori

    2009-01-01

    Prevention and reduction of medical accidents is essential. Among medical accidents, accidental falls remain a serious problem. While "assessment score sheets" have already been used in hospitals to prevent accidental falls, satisfactory results have not actually been achieved. In this study, we aim to establish a methodology for preventing accidental falls. We consider that the 'management plan' for each patient includes three factors. A plan of instructions for patients on actions they can take for safety in their ADL (Activities of Daily Living) is essential as a base. Second, a plan to keep up with any short term change in a patient's state is needed, because the state of a hospitalized patient will usually be temporarily affected by medication and changing medical conditions. We develop a model for preventing accidental falls, which enable us to design appropriate management plan for each patient. Then, we develop a prototype system based on the designed model. Finally, we address the result of verification of the model, by applying the prototype system into actual cases in hospitals.

  11. Vision based assistive technology for people with dementia performing activities of daily living (ADLs): an overview

    NASA Astrophysics Data System (ADS)

    As'ari, M. A.; Sheikh, U. U.

    2012-04-01

    The rapid development of intelligent assistive technology for replacing a human caregiver in assisting people with dementia performing activities of daily living (ADLs) promises in the reduction of care cost especially in training and hiring human caregiver. The main problem however, is the various kinds of sensing agents used in such system and is dependent on the intent (types of ADLs) and environment where the activity is performed. In this paper on overview of the potential of computer vision based sensing agent in assistive system and how it can be generalized and be invariant to various kind of ADLs and environment. We find that there exists a gap from the existing vision based human action recognition method in designing such system due to cognitive and physical impairment of people with dementia.

  12. A Large-Scale Initiative Inviting Patients to Share Personal Fitness Tracker Data with Their Providers: Initial Results

    PubMed Central

    Pevnick, Joshua M.; Fuller, Garth; Duncan, Ray; Spiegel, Brennan M. R.

    2016-01-01

    Background Personal fitness trackers (PFT) have substantial potential to improve healthcare. Objective To quantify and characterize early adopters who shared their PFT data with providers. Methods We used bivariate statistics and logistic regression to compare patients who shared any PFT data vs. patients who did not. Results A patient portal was used to invite 79,953 registered portal users to share their data. Of 66,105 users included in our analysis, 499 (0.8%) uploaded data during an initial 37-day study period. Bivariate and regression analysis showed that early adopters were more likely than non-adopters to be younger, male, white, health system employees, and to have higher BMIs. Neither comorbidities nor utilization predicted adoption. Conclusion Our results demonstrate that patients had little intrinsic desire to share PFT data with their providers, and suggest that patients most at risk for poor health outcomes are least likely to share PFT data. Marketing, incentives, and/or cultural change may be needed to induce such data-sharing. PMID:27846287

  13. A Long-Term Perspective on Person-Environment Fit and Adl Dependence among Older Swedish Adults

    ERIC Educational Resources Information Center

    Iwarsson, Susanne

    2005-01-01

    Purpose: This study described person--environment (P-E) fit and activities of daily living (ADLs) among older adults, and it explored the relationship between P-E fit and ADL dependence, testing Lawton's docility hypothesis at two points in time. Design and Methods: From a random sample of individuals aged 75-84 living in a Swedish municipality,…

  14. Quit Smoking Experts’ Opinions toward Quality and Results of Quit Smoking Methods Provided in Tobacco Cessation Services Centers in Iran

    PubMed Central

    Heydari, Gholamreza; Masjedi, Mohammadreza; Ebn Ahmady, Arezoo; Leischow, Scott J.; Lando, Harry A.; Shadmehr, Mohammad B.; Fadaizadeh, Lida

    2015-01-01

    Background: One of the core responsibilities of health system is to treat tobacco dependence. This treatment includes different methods such as simple medical consultation, medication, and telephone counseling. To assess physicians’ opinions towards quality and result of different quit smoking methods provided in tobacco cessation services centers in Iran. Methods: In this cross-sectional and descriptive study, random sampling of all quit centers at country level was used to obtain a representative sample size of 100 physicians. Physicians completed a self-administered questionnaire which contained 10 questions regarding the quality, cost, effect, side effects, and the results of quitting methods using a 5-point Likert-type scale. Percentages, frequencies, mean, T-test, and variance analyses were computed for all study variables. Results: Most experts preferred to use combination quit smoking methods and then Nicotine Replacement Therapy (NRT) with 26 and 23, respectively. The least used methods were quit line and some methods without medication with 3 cases. The method which gained the maximum scores were telephone consultation, acupuncture, Willpower, Champix, combined method, and Interactive Voice Response (IVR) with the mean of 23.3, 23, 22.5, 22, 21.7 and 21.3, respectively. The minimum scores were related to e-cigarette, some methods without medication, and non-NRT medication with the mean of 12.3, 15.8 and 16.2, respectively. There were no significant differences in the mean of scores based on different cities (P = 0.256). Analysis of variance in mean scores showed significant differences in the means scores of different methods (P < 0.000). Conclusions: According to physicians acupuncture, personal methods and Champix are the most effective methods and these methods could be much more feasible and cost effective than other methods. PMID:26425329

  15. Key results of battery performance and life tests at Argonne National Laboratory

    NASA Astrophysics Data System (ADS)

    Deluca, W. H.; Gillie, K. R.; Kulaga, J. E.; Smaga, J. A.; Tummillo, A. F.; Webster, C. E.

    1991-12-01

    Advanced battery technology evaluations are performed under simulated electric vehicle operating conditions at Argonne National Laboratory's & Diagnostic Laboratory (ADL). The ADL provide a common basis for both performance characterization and life evaluation with unbiased application of tests and analyses. This paper summarizes the performance characterizations and life evaluations conducted in 1991 on twelve single cells and eight 3- to 360-cell modules that encompass six battery technologies (Na/S, Li/MS, Ni/MH, Zn/Br, Ni/Fe, and Pb-Acid). These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division. The results measure progress in battery R & D programs, compare battery technologies, and provide basic data for modeling and continuing R & D to battery users, developers, and program managers.

  16. Key results of battery performance and life tests at Argonne National Laboratory

    SciTech Connect

    DeLuca, W.H.; Gillie, K.R.; Kulaga, J.E.; Smaga, J.A.; Tummillo, A.F.; Webster, C.E.

    1991-12-31

    Advanced battery technology evaluations are performed under simulated electric vehicle operating conditions at Argonne National Laboratory`s & Diagnostic Laboratory (ADL). The ADL provide a common basis for both performance characterization and life evaluation with unbiased application of tests and analyses. This paper summarizes the performance characterizations and life evaluations conducted in 1991 on twelve single cells and eight 3- to 360-cell modules that encompass six battery technologies (Na/S, Li/MS, Ni/MH, Zn/Br, Ni/Fe, and Pb-Acid). These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division. The results measure progress in battery R & D programs, compare battery technologies, and provide basic data for modeling and continuing R & D to battery users, developers, and program managers.

  17. Key results of battery performance and life tests at Argonne National Laboratory

    SciTech Connect

    DeLuca, W.H.; Gillie, K.R.; Kulaga, J.E.; Smaga, J.A.; Tummillo, A.F.; Webster, C.E.

    1991-01-01

    Advanced battery technology evaluations are performed under simulated electric vehicle operating conditions at Argonne National Laboratory's Diagnostic Laboratory (ADL). The ADL provide a common basis for both performance characterization and life evaluation with unbiased application of tests and analyses. This paper summarizes the performance characterizations and life evaluations conducted in 1991 on twelve single cells and eight 3- to 360-cell modules that encompass six battery technologies (Na/S, Li/MS, Ni/MH, Zn/Br, Ni/Fe, and Pb-Acid). These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division. The results measure progress in battery R D programs, compare battery technologies, and provide basic data for modeling and continuing R D to battery users, developers, and program managers.

  18. Measuring Disability: Application of the Rasch Model to Activities of Daily Living (ADL/IADL).

    ERIC Educational Resources Information Center

    Sheehan, T. Joseph; DeChello, Laurie M.; Garcia, Ramon; Fifield, Judith; Rothfield, Naomi; Reisine, Susan

    2001-01-01

    Performed a comparative analysis of Activities of Daily Living (ADL) items administered to 4,430 older adults and Instrumental Activities of Daily Living administered to 605 people with rheumatoid arthritis scoring both with Likert and Rasch measurement models. Findings show the superiority of the Rasch approach over the Likert method. (SLD)

  19. The Advanced Distributed Learning (ADL) Vision and Getting From Here To There

    DTIC Science & Technology

    2005-07-01

    The SCORM Run-Time Environment describes the Learning Management System (LMS) (or Server) requirements needed to manage the ADL run-time...Electronics Engineers ITS Intelligent Tutoring System LMS Learning Management System LSAL Learning Systems Architecture Lab OSTP Office of Science and

  20. ADL State of the Union. Where We Are and Where We Are Going

    DTIC Science & Technology

    2009-08-18

    Contributing Factors  Community specific needs  Legacy content and systems  Advances in technologies ( Web 2.0 , mobile, etc…)  ADL will  Engage...Technologies ILT Focus Areas  Game-based Training (Serious Games)  Virtual Worlds  Mobile Devices  Web 2.0 30 Potential of Immersive Training

  1. Hospital Readmission among Older Adults Who Return Home with Unmet Need for ADL Disability

    ERIC Educational Resources Information Center

    DePalma, Glen; Xu, Huiping; Covinsky, Kenneth E.; Craig, Bruce A.; Stallard, Eric; Thomas, Joseph, III.; Sands, Laura P.

    2013-01-01

    Purpose: This study determined whether returning to the community from a recent hospitalization with unmet activities of daily living (ADL) need was associated with probability of readmission. Methods: A total of 584 respondents to the 1994, 1999, and/or 2004 National Long-Term Care Surveys (NLTCS) who were hospitalized within 90 days prior to the…

  2. JPSS Cryosphere Algorithms: Integration and Testing in Algorithm Development Library (ADL)

    NASA Astrophysics Data System (ADS)

    Tsidulko, M.; Mahoney, R. L.; Meade, P.; Baldwin, D.; Tschudi, M. A.; Das, B.; Mikles, V. J.; Chen, W.; Tang, Y.; Sprietzer, K.; Zhao, Y.; Wolf, W.; Key, J.

    2014-12-01

    JPSS is a next generation satellite system that is planned to be launched in 2017. The satellites will carry a suite of sensors that are already on board the Suomi National Polar-orbiting Partnership (S-NPP) satellite. The NOAA/NESDIS/STAR Algorithm Integration Team (AIT) works within the Algorithm Development Library (ADL) framework which mimics the operational JPSS Interface Data Processing Segment (IDPS). The AIT contributes in development, integration and testing of scientific algorithms employed in the IDPS. This presentation discusses cryosphere related activities performed in ADL. The addition of a new ancillary data set - NOAA Global Multisensor Automated Snow/Ice data (GMASI) - with ADL code modifications is described. Preliminary GMASI impact on the gridded Snow/Ice product is estimated. Several modifications to the Ice Age algorithm that demonstrates mis-classification of ice type for certain areas/time periods are tested in the ADL. Sensitivity runs for day time, night time and terminator zone are performed and presented. Comparisons between the original and modified versions of the Ice Age algorithm are also presented.

  3. MDS-Based State Medicaid Reimbursement and the ADL-Decline Quality Indicator

    ERIC Educational Resources Information Center

    Bellows, Nicole M.; Halpin, Helen A.

    2008-01-01

    Purpose: We examined the relationship between the quality indicator for decline in activities of daily living (ADL) and the use of the Minimum Data Set (MDS) for determining Medicaid skilled nursing facility reimbursement. Design and Methods: We conducted a cross-sectional analysis using the 2004 National MDS Facility Quality Indicator reports as…

  4. Using ADLs to Establish Eligibility for Long-Term Care among the Cognitively Impaired.

    ERIC Educational Resources Information Center

    Kane, Robert L.; And Others

    1991-01-01

    Used database from Oregon Medicaid program to examine differences in the potential insurance coverage of demented persons by using different formulations of Activities of Daily Living (ADL) dependencies. For those with clear dementia, 81-88 percent of the persons with significant behavioral problems were correctly identified when a cut score of…

  5. Comparing Differences in ADL Outcomes for the STOMP Intervention for Dementia in the Natural Home Environment Versus a Clinic Environment

    PubMed Central

    Ciro, CA; Poole, JL; Skipper, B; Hershey, LA

    2017-01-01

    Background Few studies have examined structured rehabilitation techniques for improving activities of daily living in people with mild-moderate dementia. We sought to examine the advantages to delivering the Skill-building through Task-Oriented Motor Practice (STOMP) intervention in the home environment (versus the clinic), hypothesizing that ADL improvement would be significantly better, time to meeting goals would be faster and fewer displays of behavior would be noted. Methods Compared results of two quasi-experimental studies of STOMP, one completed in the home, one completed previously in a clinic. Participants were English-speaking; community dwelling adults aged 50–90 diagnosed with mild-moderate dementia who could participate in an intensive rehabilitation program (5 days/week, 3 hours/day, for 2 weeks). Outcome measurements include examiner-observation of performance and proxy-report of performance and satisfaction with performance in patient-selected goals. Results No differences existed in the sociodemographic characteristics between the home and clinic groups where the groups were primarily white, married, had > high school education and had mild-moderate dementia. Results from the home group indicate that participants made significant improvement in ADL which was generally retained at the 90 day follow-up. These results were not significantly different than the clinic group. No significant advantages were noted for the home group in terms of time to meeting goals or exhibition of fewer behaviors. Discussion The STOMP intervention appeared to work equally as well in the home and in the clinic. Future studies should continue to examine the benefits of massed practice using high-dose regimens.

  6. ICPES analyses using full image spectra and astronomical data fitting algorithms to provide diagnostic and result information

    SciTech Connect

    Spencer, W.A.; Goode, S.R.

    1997-10-01

    ICP emission analyses are prone to errors due to changes in power level, nebulization rate, plasma temperature, and sample matrix. As a result, accurate analyses of complex samples often require frequent bracketing with matrix matched standards. Information needed to track and correct the matrix errors is contained in the emission spectrum. But most commercial software packages use only the analyte line emission to determine concentrations. Changes in plasma temperature and the nebulization rate are reflected by changes in the hydrogen line widths, the oxygen emission, and neutral ion line ratios. Argon and off-line emissions provide a measure to correct the power level and the background scattering occurring in the polychromator. The authors` studies indicated that changes in the intensity of the Ar 404.4 nm line readily flag most matrix and plasma condition modifications. Carbon lines can be used to monitor the impact of organics on the analyses and calcium and argon lines can be used to correct for spectral drift and alignment. Spectra of contaminated groundwater and simulated defense waste glasses were obtained using a Thermo Jarrell Ash ICP that has an echelle CID detector system covering the 190-850 nm range. The echelle images were translated to the FITS data format, which astronomers recommend for data storage. Data reduction packages such as those in the ESO-MIDAS/ECHELLE and DAOPHOT programs were tried with limited success. The radial point spread function was evaluated as a possible improved peak intensity measurement instead of the common pixel averaging approach used in the commercial ICP software. Several algorithms were evaluated to align and automatically scale the background and reference spectra. A new data reduction approach that utilizes standard reference images, successive subtractions, and residual analyses has been evaluated to correct for matrix effects.

  7. HIV medical care provider practices for reducing high-risk sexual behavior: results of a qualitative study.

    PubMed

    Drainoni, Mari-Lynn; Dekker, Debra; Lee-Hood, Elizabeth; Boehmer, Ulrike; Relf, Michael

    2009-05-01

    A first step in ensuring that HIV-infected persons practice the safer sexual behaviors that reduce disease transmission is to make certain that they receive accurate information about the relationship between sexual risk behaviors and HIV transmission. Health care providers can play a pivotal role in preventing secondary transmission of HIV; federal agencies and professional guidelines encourage providers to counsel HIV-infected patients about safer sex practices and transmission risks, particularly since the health care encounter may be the only time that HIV-infected persons receive information about prevention and risk reduction interventions. Yet research indicates that these opportunities are often missed. Prior to implementing a prevention demonstration project in an urban HIV and STD clinic, we conducted a qualitative investigation with providers, including physicians, nurse practitioners, physician assistants, and nurses. The purpose of this investigation was to examine the current status of prevention education and counseling efforts at the clinic, examine the barriers and facilitators to providing prevention counseling, and identify key areas where providers believed that they needed additional training.

  8. Physical performance as long-term predictor of onset of activities of daily living (ADL) disability: a 9-year longitudinal study among community-dwelling older women.

    PubMed

    Idland, Gro; Pettersen, Renate; Avlund, Kirsten; Bergland, Astrid

    2013-01-01

    Disability in ADL of aging women is an important public health concern. It is thus of interest to identify modifiable factors underlying onset of ADL disability. We assessed whether three physical performance-based measurements could predict ADL disability 9 years later. The participants were 113 non-disabled community-dwelling women with a mean age of 79.5 years at baseline. The baseline examinations of physical performance were: functional reach, climbing steps and comfortable walking speed. ADL disability was defined as need of personal assistance in at least one of five basic ADL items. The participants were followed for 9 years. Logistic regression models were fitted for each of the physical performance measurements together with the covariates in relation to ADL disability. At follow-up 25.7% were disabled in ADL. All three performance measurements were significantly associated with the onset of ADL disability at 9 years of follow-up, however, only walking speed remained significantly related to onset of ADL disability, when all three performance measurements were included in the same model. In conclusion all the three performance measurements were related to onset of ADL disability, with walking speed having the strongest predictive value. Systematic screening based on walking speed measurements of non-disabled older women might help health professionals to identify those at risk of ADL disability and introduce preventive measures in time.

  9. How many and which items of activities of daily living (ADL) and instrumental activities of daily living (IADL) are necessary for screening.

    PubMed

    Roehrig, Bernd; Hoeffken, Klaus; Pientka, Ludger; Wedding, Ulrich

    2007-05-01

    Geriatric assessment (GA) in elderly cancer patients serves as screening instrument to identify patients who are vulnerable or frail. To reduce the diagnostic burden for patients and caregivers, we asked how many and which items of ADL and IADL questionnaires are necessary to identify those patients with limitations in the sum score of ADL or IADL. Data of 327 elderly patients (age>or=60 years), of whom 27.9% had limitations in ADL and 36.0% in IADL score, were entered in a forward selection model. Four out of ten items of ADL identified 95.3% of patients with limitations in ADL. Two out of eight items of IADL identified 97.4% of patients with limitations in IADL. The combined use of these items recognised 98.5% of patients with limitations in ADL or IADL score. If ADL and IADL scores are used for screening, we recommend an abbreviated version with 6 instead of 18 items.

  10. Challenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya.

    PubMed

    Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M; Graham, Susan M; Price, Matt A; Sanders, Eduard J

    2013-01-01

    The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa.

  11. Knowledge of Healthcare Coverage for Refugee Claimants: Results from a Survey of Health Service Providers in Montreal

    PubMed Central

    Dunkley-Hickin, Catherine

    2016-01-01

    Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers’ knowledge of the healthcare coverage for refugee claimants living in Quebec. An online questionnaire was completed by 1,772 staff and physicians from five hospitals and two primary care centres in Montreal. Low levels of knowledge and significant associations between knowledge and occupational group, age, and contact with refugees were documented. Social workers, respondents aged 40–49 years, and those who reported previous contact with refugee claimants seeking healthcare were significantly more likely to have 2 or more correct responses. Rapid and multiple changes to the complex IFH policy have generated a high level of confusion among healthcare providers. Simplification of the system and a knowledge transfer strategy aimed at improving healthcare delivery for IFH patients are urgently needed, proposing easy avenues to access rapidly updated information and emphasizing ethical and clinical issues. PMID:26789844

  12. Towards an ADL taxonomy for occupational therapists. Previously published in Scandinavian Journal of Occupational Therapy 1994; 1:69-76.

    PubMed

    Tornquist, K; Sonn, Ulla

    2014-01-01

    One of the main concepts in occupational therapy is human occupation. In occupational therapy there is a need for a common conceptual framework to assess and describe the ability of patients to perform occupational activities of daily living. The aim of this report was to develop a taxonomy concerning the activities of daily living (ADL). In the taxonomy, occupation has been defined and related to common concepts of disability. Ordinary ADL terms have been categorized into three levels: occupational forms, activities and actions. Different actions are components of and subordinated to superior activities. Experience shows that the ADL taxonomy contributes to a valid (content and construct) assessment of ADL, a common language for OTs and to a clearer picture of the patient's performance in daily life activities.

  13. Staff commitment to providing tobacco dependence in drug treatment: Reliability, validity, and results of a national survey.

    PubMed

    Hunt, Jamie J; Cupertino, A Paula; Gajewski, Byron J; Jiang, Yu; Ronzani, Telmo M; Richter, Kimber P

    2014-06-01

    Although most people in treatment for illicit drug use smoke cigarettes, few facilities offer any form of treatment for tobacco dependence. One reason for this may be that drug treatment staff have varying levels of commitment to treat tobacco. We developed and validated a 14-item Tobacco Treatment Commitment Scale (TTCS), using 405 participants in leadership positions in drug treatment facilities. We first conducted a confirmatory factor analysis to evaluate 4 a priori domains suggested by our original set of 38 items-this did not produce a good fit (comparative fit index [CFI] = 0.782, root mean square error of approximation [RMSEA] = 0.067). We then conducted a series of exploratory factor analyses to produce a more precise and reliable scale. The final confirmatory factor analysis indicated a 3-factor solution, produced a good fit (CFI = 0.950, RMSEA = 0.058), and had substantial unified reliability of 0.975. The final TTCS contained 14 items in 3 domains: "Tobacco is less harmful than other drugs," "It's not our job to treat tobacco," and "Tobacco treatment will harm clients." These constructs account for most of the variance in the survey items and emerged as major sentiments driving staff commitment to providing tobacco services. The TTCS can be used to understand the role of staff attitudes in the adoption of tobacco services in this important treatment setting.

  14. A gravimetric approach to providing SI traceability for concentration measurement results of mercury vapor at ambient air levels

    NASA Astrophysics Data System (ADS)

    Ent, Hugo; van Andel, Inge; Heemskerk, Maurice; van Otterloo, Peter; Bavius, Wijnand; Baldan, Annarita; Horvat, Milena; Brown, Richard J. C.; Quétel, Christophe R.

    2014-11-01

    Current measurement and calibration capabilities for mercury vapor in air are maintained at levels of 0.2-40 μg Hg m-3. In this work, a mercury vapor generator has been developed to establish metrological traceability to the international system of units (SI) for mercury vapor measurement results ≤15 ng Hg m-3, i.e. closer to realistic ambient air concentrations (1-2 ng Hg m-3) [1]. Innovations developed included a modified type of diffusion cell, a new measurement method to weigh the loss in (mercury) mass of these diffusion cells during use (ca. 6-8 μg mass difference between successive weighings), and a new housing for the diffusion cells to maximize flow characteristics and to minimize temperature variations and adsorption effects. The newly developed mercury vapor generator system was tested by using diffusion cells generating 0.8 and 16 ng Hg min-1. The results also show that the filter system, to produce mercury free air, is working properly. Furthermore, and most importantly, the system is producing a flow with a stable mercury vapor content. Some additional improvements are still required to allow the developed mercury vapor generator to produce SI traceable mercury vapor concentrations, based upon gravimetry, at much lower concentration levels and reduced measurement uncertainties than have been achieved previously. The challenges to be met are especially related to developing more robust diffusion cells and better mass measurement conditions. The developed mercury vapor generator will contribute to more reliable measurement results of mercury vapor at ambient and background air levels, and also to better safety standards and cost reductions in industrial processes, such as the liquefied natural gas field, where aluminum main cryogenic heat exchangers are used which are particularly prone to corrosion caused by mercury.

  15. ADL abilities and vocational competencies: Blue-collar workers aged 45 years and over.

    PubMed

    Kikuchi, E

    1995-01-01

    A questionnaire composed of 55 items that addressed activities of daily living (ADL) abilities and 13 basic vocational competencies, such as memory and muscular power, was completed by 48 nondisabled male workers aged ≥45 years. The workers were all engaged in the manufacturing industry. All respondents found the following five tasks easy to do: wring a towel, put arms through sleeves, open and shut a door, turn a tap on and off, and open and shut a sliding door. Among basic vocational competencies, the highest performance, with but a small standard deviation, occurred with the muscular power competency; a low performance with a large standard deviation (P=0.05) occurred with concentration. No age difference was discerned in planning ability, cooperativeness, muscular power, staying power, manual adeptness, and sense of equilibrium, whereas in learning ability, agility, and concentration, people aged ≥65 years showed significantly lower performance (P=0.05). The characteristics of vocational competencies in manufacturing industry workers aged ≥45 years were fond to be linked to ADL abilities, and the effectiveness of the ADL abilities survey, prepared on an experimental basis, was confirmed for the evaluation of vocational competencies.

  16. Loneliness in elderly individuals, level of dependence in activities of daily living (ADL) and influential factors.

    PubMed

    Hacihasanoğlu, Rabia; Yildirim, Arzu; Karakurt, Papatya

    2012-01-01

    This study has been carried out to investigate the level of loneliness, determine the level of dependence in the ADL and influential factors in the elderly people. This descriptive, cross-sectional study was conducted in 5 Family Healthcare Centers (FHC) located in central Erzincan, Turkey between March and June 2010. The data of the research was collected using a questionnaire that determined the descriptive and UCLA Loneliness Scale (UCLA-LS). Mean score of the UCLA-LS was determined as 51.59 ± 4.44. It was determined that 2% of the elderly ADL were completely dependent, 14.5% were semi-dependent. Factors such as being old, a widow/divorced, having a lower level of education and/or income, living alone, having a chronic disease, poor self-perceived health, lack of visits by relatives or acquaintances, dissatisfaction with the place of living, and being fully dependent while performing daily activities were determined as factors which increased the level of loneliness. Furthermore, factors such as being old, a female, a widow/divorced, living together with a daughter/son, having a chronic disease and poor self-perceived health were found to be influential in dependency. Elderly people who are alone and dependent in fulfilling their ADL should be monitored more closely.

  17. Minimally invasive approach provides at least equivalent results for surgical correction of mitral regurgitation: A propensity-matched comparison

    PubMed Central

    Goldstone, Andrew B.; Atluri, Pavan; Szeto, Wilson Y.; Trubelja, Alen; Howard, Jessica L.; MacArthur, John W.; Newcomb, Craig; Donnelly, Joseph P.; Kobrin, Dale M.; Sheridan, Mary A.; Powers, Christiana; Gorman, Robert C.; Gorman, Joseph H.; Pochettino, Alberto; Bavaria, Joseph E.; Acker, Michael A.; Hargrove, W. Clark; Woo, Y. Joseph

    2014-01-01

    Objective Minimally invasive approaches to mitral valve surgery are increasingly used, but the surgical approach must not compromise the clinical outcome for improved cosmesis. We examined the outcomes of mitral repair performed through right minithoracotomy or median sternotomy. Methods Between January 2002 and October 2011, 1011 isolated mitral valve repairs were performed in the University of Pennsylvania health system (455 sternotomies, 556 right minithoracotomies). To account for key differences in preoperative risk profiles, propensity scores identified 201 well-matched patient pairs with mitral regurgitation of any cause and 153 pairs with myxomatous disease. Results In-hospital mortality was similar between propensity-matched groups (0% vs 0% for the degenerative cohort; 0% vs 0.5%, P = .5 for the overall cohort; in minimally invasive and sternotomy groups, respectively). Incidence of stroke, infection, myocardial infarction, exploration for postoperative hemorrhage, renal failure, and atrial fibrillation also were comparable. Transfusion was less frequent in the minimally invasive groups (11.8% vs 20.3%, P = .04 for the degenerative cohort; 14.0% vs 22.9%, P .03 for the overall cohort), but time to extubation and discharge was similar. A 99% repair rate was achieved=in patients with myxomatous disease, and a minimally invasive approach did not significantly increase the likelihood of a failed repair resulting in mitral valve replacement. Patients undergoing minimally invasive mitral repair were more likely to have no residual post-repair mitral regurgitation (97.4% vs 92.1%, P = .04 for the degenerative cohort; 95.5% vs 89.6%, P = .02 for the overall cohort). In the overall matched cohort, early readmission rates were higher in patients undergoing sternotomies (12.6% vs 4.4%, P = .01). Over 9 years of follow-up, there was no significant difference in long-term survival between groups (P = .8). Conclusions In appropriate patients with isolated mitral valve

  18. AMEM-ADL Polymer Migration Estimation Model User's Guide

    EPA Pesticide Factsheets

    The user's guide of the Arthur D. Little Polymer Migration Estimation Model (AMEM) provides the information on how the model estimates the fraction of a chemical additive that diffuses through polymeric matrices.

  19. Knowledge, Beliefs and Practices Regarding Antiretroviral Medications for HIV Prevention: Results from a Survey of Healthcare Providers in New England

    PubMed Central

    Krakower, Douglas S.; Oldenburg, Catherine E.; Mitty, Jennifer A.; Wilson, Ira B.; Kurth, Ann E.; Maloney, Kevin M.; Gallagher, Donna; Mayer, Kenneth H.

    2015-01-01

    Background Antiretroviral treatment for HIV-infection before immunologic decline (early ART) and pre-exposure chemoprophylaxis (PrEP) can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited. Methods Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices. Results Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample), 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01–1.34) and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98–11.2) were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06–1.34), whereas female gender (aOR 0.26, 95% CI 0.10–0.71) was associated

  20. Detecting Human Motion: Introducing Step, Fall and ADL Algorithms

    NASA Astrophysics Data System (ADS)

    Vermeiren, Dries; Weyn, Maarten; de Ron, Geert

    Telecare is the term given to offering remote care to elderly and vulnerable people, providing them with the care and reassurance needed to allow them to keep living at home. As telecare is gaining research interests, we'll introduce a system which can be used to monitor the steps, falls and daily activities of high risk populations in this paper. Using this system it is possible for a patient to rehabilitate at home or for elderly to keep living independently in their own house while they are still monitored. This leads to a huge cost reduction in health services and moreover it will make patients satisfied for being able to live at home as long as possible and in all comfort.

  1. Relationship between Barthel Index scores during the acute phase of rehabilitation and subsequent ADL in stroke patients.

    PubMed

    Nakao, Shigetaka; Takata, Shinjiro; Uemura, Hirokazu; Kashihara, Michiharu; Osawa, Toshifumi; Komatsu, Koji; Masuda, Yuki; Okahisa, Tetsuya; Nishikawa, Koji; Kondo, Shin; Yamada, Megumi; Takahara, Risa; Ogata, Yoshimi; Nakamura, Yuka; Nagahiro, Shinji; Kaji, Ryuji; Yasui, Natsuo

    2010-02-01

    The Barthel Index (BI) cannot be used to measure initial stroke severity or by extension, to stratify patients by severity in acute stroke trials because most patients are bedbound in the first few hours after stroke, either by their deficit or by medical directive. Our objectives were to clarify the threshold of acute BI for use in the prediction of subsequent independence in activities of daily living (ADL) and to assist in the definition of acute stroke rehabilitation goals. Subjects comprised 78 patients out of 191 inpatients admitted with acute stroke at our hospital during 2006-2007. The BI ADL score was divided into 2 ranges (BI> or =60 and < or =40), in a process similar to previous studies. During the acute period (from onset to approximately 3 weeks), all patients with a BI> or =40 could improve their ADL in 6 months. Patients with a BI< or =40 exhibited two ADL recovery outcomes (improved and no change) at 6 months. We also found that the skill level of basic activities related to standing was significant indicator of BI improvement (P<0.001). BI scores determined at approximately 3 weeks were reliable predictors of ADL disabilities at 6 months.

  2. Fabrication of Rare-earth Aluminate (ReAlO3) Glass and Crystalline phases by Aerodynamic Levitation (ADL)

    NASA Astrophysics Data System (ADS)

    Basavalingu, B.; Yoda, Shinichi; Kumar, M. S. Vijaya

    2012-07-01

    Containerless processing by levitation technique has been extensively used for material science and engineering because it suppresses inhomogeneous nucleation from the container wall and helps to produce stable, metastable and glass phases. The containerless levitation technique is widely explored for material processing because of its technological and scientific advantages. Recently, research on bulk glass and glass-ceramics have attracted the attention of material scientists as they are considered as low cost optical materials of the future. In the present study, the formation of bulk spherical glass and crystalline ReAlO _{3}(Re=La-Lu,Y) phases has been investigated due to their unique features in terms of the solidification process from an undercooled melt, glass structure and optical properties. An Aerodynamic levitation (ADL) was used to undercool the melt well below the melting temperature. Sintered bits of ReAlO _{3} sample with a diameter of ~2.5 mm and mass of ~20-25 mg was levitated by an ADL and completely melted by a CO _{2} laser and then the droplet was cooled by turning off the CO _{2} laser and solidified. The surface temperature and solidification process of the levitated droplet was monitored using pyrometer and high speed video camera, respectively. Among the rare earth aluminum perovskites Lanthanum, Neodymium and samarium aluminum perovskites solidified as glass and others YAlO _{3} and Europium to Lutetium aluminum perovskites solidified as crystalline phases. The scanning electron microscopy (SEM) images of cross-sectioned samples, TG/DTA, Transmittance and Refractive Index studies were performed for both glass and crystalline phases. The results of the above studies revealed the formation of glass and crystalline phases directly from the undercooled melt. The glass transition temperature (Tg) gradually increased with increasing ionic radius of the rare-earth elements. The NdAlO _{3} glass phase showed a high refractive index of ~1

  3. Nintendo Wii rehabilitation ("Wii-hab") provides benefits in Parkinson's disease.

    PubMed

    Herz, Nathan B; Mehta, Shyamal H; Sethi, Kapil D; Jackson, Paula; Hall, Patricia; Morgan, John C

    2013-11-01

    Parkinson's disease (PD) impairs both activities of daily living (ADLs) and motor function and has adverse effects on mood in many patients. While dopaminergic medications are quite helpful for motor and ADLs impairments in PD, complementary therapies are also important in helping patients achieve maximum benefits and quality of life. We hypothesized that the Nintendo Wii (Wii) is a useful tool in improving motor and non-motor aspects in patients with PD, given its ability to drive functional movements and interactive nature. We enrolled twenty subjects with early to mid-stage PD in an open-label within-subjects study design where each subject was evaluated at baseline and then re-evaluated after playing the Wii three times per week for four weeks. Subjects were then re-evaluated one month later after not playing the Wii for a month to see if effects carried over. Subjects demonstrated significant improvements in the primary outcome measure (Nottingham Extended Activities of Daily Living Test (NEADL)), quality of life (PDQ-39) and motor function (UPDRS), and a trend toward improved mood (HAM-D) after four weeks of Wii therapy. Follow-up assessments one month later showed continued improvement for quality of life and UPDRS scores. The results demonstrate that Wii therapy provides short-term motor, non-motor, and quality of life benefits in PD. Further studies are needed to determine if there are long-term benefits of Wii therapy in PD.

  4. EPAct Alternative Fuel Transportation Program: State and Alternative Fuel Provider Fleet Compliance Annual Report, Fleet Compliance Results for MY 2014/ FY 2015

    SciTech Connect

    2016-04-01

    This annual report of the Alternative Fuel Transportation Program, which ensures compliance with DOE regulations covering state government and alternative fuel provider fleets pursuant to the Energy Policy Act of 1992 (EPAct), as amended, provides fleet compliance results for manufacturing year 2014 / fiscal year 2015.

  5. Six-month walking program changes cognitive and ADL performance in patients with Alzheimer.

    PubMed

    Venturelli, Massimo; Scarsini, Renato; Schena, Federico

    2011-08-01

    Motor inactivity is typical in the later stages of Alzheimer's disease although there is evidence that physical exercise can reduce depression and enhance performance of daily activities. The aim of this study was to determine whether a walking program could reduce the functional and cognitive decline of elderly nursing home residents in the later stages of Alzheimer's disease. A total of 21 patients (84 ± 5 years) were randomly assigned to a walking program (WG) or to a control group (CG). A 6-minute walking test (6WT), the Barthel index of activities of daily living (ADLs), and Mini-Mental State Examination (MMSE) tests were performed before and after 24 weeks of the program. The WG showed significant improvement in the 6WT (20%) and ADLs (23%), while the CG decreased in MMSE (-47%), the WG had a slower decline (-13%). This study indicates that it is possible to stabilize the progressive cognitive dysfunctions in nursing home residents with Alzheimer's disease through a specific walking program.

  6. Examination of Children's Recess Physical Activity Patterns Using the Activities for Daily Living-Playground Participation (ADL-PP) Instrument

    ERIC Educational Resources Information Center

    Stellino, Megan Babkes; Sinclair, Christina

    2014-01-01

    Thorough assessment of children's physical activity is essential to efficacious interventions to reduce childhood obesity prevalence. The purpose of this study was to examine children's recess physical activity (RPA) patterns of behavior using the Activities of Daily Living-Playground Participation (ADL-PP: Watkinson et al., 2001) instrument.…

  7. Health Status and ADL Functioning of Older Persons with Intellectual Disability: Community Residence versus Residential Care Centers

    ERIC Educational Resources Information Center

    Lifshitz, Hefziba; Merrick, Joav; Morad, Mohammed

    2008-01-01

    The objective of the study was to study differences in aging phenomena among adults with intellectual disability (ID), who live in community residence versus their peers in residential care centers and to determine the contribution of health status, age, gender, etiology and level of ID to the decline in ADL function with age. Our study was based…

  8. The Prediction of ADL and IADL Disability Using Six Physical Indicators of Frailty: A Longitudinal Study in the Netherlands.

    PubMed

    Gobbens, Robbert J J; van Assen, Marcel A L M

    2014-01-01

    Frailty is a predictor of disability. A proper understanding of the contribution of individual indicators of frailty in the prediction of disability is a requisite for preventive interventions. The aim of this study was to determine the predictive power of the individual physical frailty indicators: gait speed, physical activity, hand grip strength, Body Mass Index (BMI), fatigue, and balance, for ADL and IADL disability. The sample consisted of 505 community-dwelling persons (≥75 years, response rate 35.1%). Respondents first participated between November 2007 and June 2008, and a subset of all respondents participated again one year later (N = 264, 52.3% response rate). ADL and IADL disability were assessed by the Groningen Activity Restriction Scale. BMI was assessed by self-report, and the other physical frailty indicators were assessed with the TUG test (gait speed), the LAPAQ (physical activity), a hand grip strength test, the SFQ (fatigue), and the Four-test balance scale. All six physical frailty indicators were associated with ADL and IADL disability. After controlling for previous disability, sociodemographic characteristics, self-perceived lifestyle, and chronic diseases, only gait speed was predictive of both ADL and IADL disability, whereas there was a small effect of fatigue on IADL disability. Hence, these physical frailty indicators should be included in frailty assessment when predicting future disability.

  9. Older Asian Americans and Pacific Islanders with Activities of Daily Living (ADL) limitations: immigration and other factors associated with institutionalization.

    PubMed

    Fuller-Thomson, Esme; Chi, Monica

    2012-09-07

    This study determined the national prevalence and profile of Asian Americans with Activities of Daily Living (ADL) limitations and identified factors associated with institutionalization. Data were obtained from 2006 American Community Survey, which replaced the long-form of the US Census. The data are nationally representative of both institutionalized and community-dwelling older adults. Respondents were Vietnamese (n = 203), Korean (n = 131), Japanese (n = 193), Filipino (n = 309), Asian Indian (n = 169), Chinese (n = 404), Hawaiian/Pacific Islander (n = 54), and non-Hispanic whites (n = 55,040) aged 55 and over who all had ADL limitations. The prevalence of institutionalized among those with ADL limitations varies substantially from 4.7% of Asian Indians to 18.8% of Korean Americans with ADL limitations. Every AAPI group had a lower prevalence of institutionalization than disabled Non-Hispanic whites older adults (23.8%) (p < 0.001). After adjustment for socio-demographic characteristics, Asian Indians, Vietnamese, Japanese, Filipino, and Chinese had significantly lower odds of institutionalization than non-Hispanic whites (OR = 0.29, 0.31, 0.58, 0.51, 0.70, respectively). When the sample was restricted to AAPIs, the odds of institutionalization were higher among those who were older, unmarried, cognitively impaired and those who spoke English at home. This variation suggests that aggregating data across the AAPI groups obscures meaningful differences among these subpopulations and substantial inter-group differences may have important implications in the long-term care setting.

  10. Client Perceptions of Occupational Health and Safety Management System Assistance Provided by OSHA On-Site Consultation: Results of a Survey of Colorado Small Business Consultation Clients.

    PubMed

    Autenrieth, Daniel A; Brazile, William J; Gilkey, David P; Reynolds, Stephen J; June, Cathy; Sandfort, Del

    2015-01-01

    The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing occupational health and safety management systems (OHSMS) to small businesses. The Safety and Health Program Assessment Worksheet (Revised OSHA Form 33) is the instrument used by consultants to assess an organization's OHSMS and provide feedback on how to improve a system. A survey was developed to determine the usefulness of the Revised OSHA Form 33 from the perspective of Colorado OSHA consultation clients. One hundred and seven clients who had received consultation services within a six-year period responded to the survey. The vast majority of respondents indicated that the Revised OSHA Form 33 accurately reflected their OHSMS and that information provided on the Revised OSHA Form 33 was helpful for improving their systems. Specific outcomes reported by the respondents included increased safety awareness, reduced injuries, and improved morale. The results indicate that the OHSMS assistance provided by OSHA consultation is beneficial for clients and that the Revised OSHA Form 33 can be an effective tool for assessing and communicating OHSMS results to business management. Detailed comments and suggestions provided on the Revised OSHA Form 33 are helpful for clients to improve their OHSMS.

  11. Results.

    ERIC Educational Resources Information Center

    Zemsky, Robert; Shaman, Susan; Shapiro, Daniel B.

    2001-01-01

    Describes the Collegiate Results Instrument (CRI), which measures a range of collegiate outcomes for alumni 6 years after graduation. The CRI was designed to target alumni from institutions across market segments and assess their values, abilities, work skills, occupations, and pursuit of lifelong learning. (EV)

  12. Do Health Care Providers Use Online Patient Ratings to Improve the Quality of Care? Results From an Online-Based Cross-Sectional Study

    PubMed Central

    Sander, Uwe

    2016-01-01

    Background Physician-rating websites have become a popular tool to create more transparency about the quality of health care providers. So far, it remains unknown whether online-based rating websites have the potential to contribute to a better standard of care. Objective Our goal was to examine which health care providers use online rating websites and for what purposes, and whether health care providers use online patient ratings to improve patient care. Methods We conducted an online-based cross-sectional study by surveying 2360 physicians and other health care providers (September 2015). In addition to descriptive statistics, we performed multilevel logistic regression models to ascertain the effects of providers’ demographics as well as report card-related variables on the likelihood that providers implement measures to improve patient care. Results Overall, more than half of the responding providers surveyed (54.66%, 1290/2360) used online ratings to derive measures to improve patient care (implemented measures: mean 3.06, SD 2.29). Ophthalmologists (68%, 40/59) and gynecologists (65.4%, 123/188) were most likely to implement any measures. The most widely implemented quality measures were related to communication with patients (28.77%, 679/2360), the appointment scheduling process (23.60%, 557/2360), and office workflow (21.23%, 501/2360). Scaled-survey results had a greater impact on deriving measures than narrative comments. Multilevel logistic regression models revealed medical specialty, the frequency of report card use, and the appraisal of the trustworthiness of scaled-survey ratings to be significantly associated predictors for implementing measures to improve patient care because of online ratings. Conclusions Our results suggest that online ratings displayed on physician-rating websites have an impact on patient care. Despite the limitations of our study and unintended consequences of physician-rating websites, they still may have the potential to

  13. Time trends in prevalence of activities of daily living (ADL) disability and survival: comparing two populations (aged 78+ years) living in a rural area in Sweden.

    PubMed

    Sjölund, Britt-Marie; Wimo, Anders; Qiu, Chengxuan; Engström, Maria; von Strauss, Eva

    2014-01-01

    The aim was to study time trends in prevalence of disability in ADL and survival among men and women 78 years and older comparing two cohorts. The study was a time trend study based on two population-based community cohorts, the Nordanstig Project (NP), collected 1995-1998 and the Swedish National Study on Aging and Care in Nordanstig (SNAC-N), collected 2001-2003. The participants were people aged 78 years and older from the NP cohort (N=303) and from the SNAC-N cohort (N=406). All were clinically examined by physicians and nurses using standardized protocols. Disability was defined as a need for assistance in one or more ADL activities. The prevalence of disability and survival were compared using logistic and Cox models. The prevalence of ADL disability was stable for men, while women became more disabled in ADL during the time period, OR 2.36 (1.12-4.94). There was no significant difference in survival time between the cohorts in either ADL disabled persons or non-disabled persons. There was a tendency for increased survival for non-disabled persons in SNAC-N compared with NP, although not significant; this was particularly true for women. In general, women survived longer than men did regardless of whether they were ADL disabled or not. The time trends for ADL disability found in the study show that ADL disability had increased in women but not in men. More studies are needed to identify risk factors for ADL disability with a view to preventing it in time.

  14. Toward the Development of a Lupus Interactive Navigator to Facilitate Patients and Their Health Care Providers in the Management of Lupus: Results of Web-Based Surveys

    PubMed Central

    Neville, Carolyn; DaCosta, Deborah; Rochon, Murray; Eng, Davy

    2014-01-01

    Background Systemic lupus erythematosus is an inflammatory autoimmune disease associated with high morbidity and unacceptable mortality. Information and management tools are needed to help persons with lupus cope with their illness and facilitate health care providers in the delivery of care. Objective The objective of the study was to assess the needs and find solutions to support persons with lupus and their health care providers. Methods Web-based surveys were distributed across Canada to persons with lupus and their relatives (n=3119), rheumatologists (n=517), and arthritis health professionals (AHPs) (n=226) by Lupus Canada, the Canadian Rheumatology Association, and the Arthritis Health Professions Association, respectively. Results The survey sample comprised 665 (21.3%) persons with lupus, 98 (19.0%) rheumatologists, and 74 (32.7%) AHPs. Among the participants with lupus, 92.4% were female, the average age was 46.8 (SD 12.7) years, 79.2% were Caucasian, and 58.8% were employed. All Canadian provinces and territories were represented. The majority (43.3%) of respondents were from Ontario. Mean disease duration was 10.2 (SD 9.5) years, and 41.9% rated their global assessment as fair or poor. There was high agreement between lupus participants and health care providers regarding disease-specific information topics. All groups rated topics related to lupus, fatigue, medications, and stress as most important. Ratings differed among lupus participants and their health care providers regarding perceived helpfulness of some of the patient tools, such as the option to view test results. Needs differed for persons with lupus based on age, sex, depression, stress, and disease activity. Differences in health care provider needs were based on amount of experience in treating lupus. Conclusions Information and support tools needed for persons with lupus and their health care providers were identified. These results will help guide us in the development of a Web

  15. Fleet Compliance Results for MY 2010/FY 2011, EPAct Alternative Fuel Transportation Program: State and Alternative Fuel Provider Fleet Compliance Annual Report (Brochure)

    SciTech Connect

    Not Available

    2012-03-01

    This annual report summarizes the compliance results of state and alternative fuel provider fleets covered by the Energy Policy Act of 1992 (EPAct) for model year 2010/fiscal year 2011. The U.S. Department of Energy (DOE) regulates covered state and alternative fuel provider (SFP) fleets under the Energy Policy Act of 1992 (EPAct), as amended. For model year (MY) 2010, the compliance rate for the 2911 covered SFP fleets was 100%. Fleets used either Standard Compliance or Alternative Compliance. The 279 fleets that used Standard Compliance exceeded their aggregate MY 2010 acquisition requirements by 61%. The 12 covered fleets that complied using Alternative Compliance exceeded their aggregate MY 2010 petroleum-use-reduction requirements by 89%. Overall, DOE saw modest decreases from MY 2009 in biodiesel fuel use credits earned and in the number of light-duty vehicles (LDVs) acquired. Compared to years before MY 2009, these rates were far lower. Because covered fleets acquired fewer new vehicles overall in MY 2010, the requirement for alternative fuel vehicles (AFVs), which is proportional to new acquisitions, also dropped.

  16. Recommendations for monitoring and evaluation of in-patient Computer-based Provider Order Entry systems: results of a Delphi survey.

    PubMed

    Sittig, Dean F; Campbell, Emily; Guappone, Ken; Dykstra, Richard; Ash, Joan S

    2007-10-11

    A survey of 20 clinical informaticists with experience in implementing Computer-based Provider Order Entry (CPOE) systems revealed the lack of easily accessible measurements of success. Using a Delphi approach, the authors, together with a group of CPOE experts, selected eight key CPOE-related measures to assess system availability, use, benefits, and e-Iatrogenesis. We suggest collecting these measures on a widespread/national basis would be wise stewardship and result in tighter feedback about both clinician workflow and patient safety. Establishing reliable benchmarks against which new implementations and existing systems can be compared will enhance organizations' ability to effectively manage and hence to realize the full benefits of their CPOE implementations.

  17. Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality.

    PubMed

    Millán-Calenti, José C; Tubío, Javier; Pita-Fernández, Salvador; González-Abraldes, Isabel; Lorenzo, Trinidad; Fernández-Arruty, Teresa; Maseda, Ana

    2010-01-01

    The aim of this study is to establish the existing relationship among variables referred to the person, specifically age and gender, and the functional dependence in basic ADL and in IADL, as well as the possible relationship it has with the increase of morbidity and mortality in a random sample of 598 individuals older than 65 years. Of these individuals, 34.6% were categorized as dependent for at least one ADL, and 53.5% if we refer to IADL. Regarding the ADL, the risk of dependence increases (odds ratio=OR=1.089) per year of age, (OR=2.48) in women's case; while there is an IADL correlation between age and the score (r=-0.527; p<0.001). A relationship exists between dependence and the days of hospitalization (for ADL: r=-0.12, p=0.018 and IADL: r=-0.97, p=0.003), the number of visits to the doctor (ADL: r=-0.27, p<0.001; IADL: r=-0.25, p<0.001) or the presence of concomitant pathologies such as dementia (ADL: p<0.001; IADL: p<0.001). There is a significant association between age, gender and dependence, as well as between dependence and morbidity and mortality, so that dependence could be used as a predictor of both.

  18. A European Network of Email and Telephone Help Lines Providing Information and Support on Rare Diseases: Results From a 1-Month Activity Survey

    PubMed Central

    Sanchez de Vega, Rosa; Brignol, Tuy Nga; Mazzucato, Monica; Polizzi, Agata

    2014-01-01

    Background Information on rare diseases are often complex to understand, or difficult to access and additional support is often necessary. Rare diseases helplines work together across Europe to respond to calls and emails from the public at large, including patients, health care professionals, families, and students. Measuring the activity of helplines can help decision makers to allocate adequate funds when deciding to create or expand an equivalent service. Objective Data presented are referred to a monthly user profile analysis, which is one of the activities that each helpline has to carry out to be part of the network. This survey aimed to explore the information requests and characteristics of users of rare diseases helplines in different European countries. Another aim was to analyze these data with respect to users’ characteristics, helpline characteristics, topics of the inquiries, and technologies used to provide information. With this survey, we measure data that are key for planning information services on rare diseases in the context of the development of national plans for rare diseases. Methods A survey was conducted based on all calls, emails, visits, or letters received from November 1 to 30, 2012 to monitor the activity represented by 12 helplines. Data were collected by a common standardized form, using ORPHA Codes for rare diseases, when applicable. No personal data identifying the inquirer were collected. It was a descriptive approach documenting on the number and purpose of inquiries, the number of respondents, the mode of contact, the category of the inquirer in relation to the patient, the inquirer’s gender, age and region of residence, the patient’s age when applicable, the type and duration of response, and the satisfaction as scored by the respondents. Results A total of 1676 calls, emails, or letters were received from November 1 to 30, 2012. Inquiries were mostly about specific diseases. An average of 23 minutes was spent for each

  19. Experiences and meanings of integration of TCAM (Traditional, Complementary and Alternative Medical) providers in three Indian states: results from a cross-sectional, qualitative implementation research study

    PubMed Central

    Nambiar, D; Narayan, V V; Josyula, L K; Porter, J D H; Sathyanarayana, T N; Sheikh, K

    2014-01-01

    Objectives Efforts to engage Traditional, Complementary and Alternative Medical (TCAM) practitioners in the public health workforce have growing relevance for India's path to universal health coverage. We used an action-centred framework to understand how policy prescriptions related to integration were being implemented in three distinct Indian states. Setting Health departments and district-level primary care facilities in the states of Kerala, Meghalaya and Delhi. Participants In each state, two or three districts were chosen that represented a variation in accessibility and distribution across TCAM providers (eg, small or large proportions of local health practitioners, Homoeopaths, Ayurvedic and/or Unani practitioners). Per district, two blocks or geographical units were selected. TCAM and allopathic practitioners, administrators and representatives of the community at the district and state levels were chosen based on publicly available records from state and municipal authorities. A total of 196 interviews were carried out: 74 in Kerala, and 61 each in Delhi and Meghalaya. Primary and secondary outcome measures We sought to understand experiences and meanings associated with integration across stakeholders, as well as barriers and facilitators to implementing policies related to integration of Traditional, Complementary and Alternative (TCA) providers at the systems level. Results We found that individual and interpersonal attributes tended to facilitate integration, while system features and processes tended to hinder it. Collegiality, recognition of stature, as well as exercise of individual personal initiative among TCA practitioners and of personal experience of TCAM among allopaths enabled integration. The system, on the other hand, was characterised by the fragmentation of jurisdiction and facilities, intersystem isolation, lack of trust in and awareness of TCA systems, and inadequate infrastructure and resources for TCA service delivery. Conclusions

  20. Phosphorylation of WRINKLED1 by KIN10 Results in its Proteasomal Degradation, Providing a Link Between Energy Homeostasis and Lipid Biosynthesis

    DOE PAGES

    Zhai, Zhiyang; Liu, Hui; Shanklin, John

    2017-03-17

    WRINKLED1 (WRI1), a member of the APETALA2 (AP2) class of transcription factors, positively regulates glycolysis and lipid biosynthesis in Arabidopsis thaliana. Here we identify mechanistic links between KIN10, the major SUCROSE NON-FERMENTATION-1 (SNF1)-RELATED KINASE 1 (SnRK1) involved in sugar/energy homeostasis and the posttranslational regulation of WRI1. Transient expression of WRI1 with OLEOSIN1 (OLE1) in Nicotiana benthamiana stimulates triacylglycerol (TAG) accumulation, but their coexpression with KIN10 abrogates this effect by inducing proteasomal degradation of WRI1. While WRI1 lacks canonical KIN10 target sequences, we demonstrated direct KIN10-dependent phosphorylation of WRI1 using purified E. coli-expressed components. The resulting phosphorylated WRI1 was more rapidlymore » degraded than native WRI1 in cell-free degradation assays. WRI1 phosphorylation was localized to two variants of the canonical KIN10 recognition sequence, one in each of its two AP2 DNA-binding domains. Conversion of the phosphorylation sites at T70 and S166 to Ala resulted in a loss of KIN10-dependent phosphorylation, and when coexpressed with KIN10 the WRI1 double mutant accumulated to 2-3 fold higher levels than native WRI1. In conclusion, KIN10-dependent degradation of WRI1 provides a homeostatic mechanism that favors lipid biosynthesis when intracellular sugar levels are elevated and KIN10 is inhibited; conversely, glycolysis and lipid biosynthesis are curtailed as sugar levels decrease and KIN10 regains activity.« less

  1. What score on the Vancouver Scar Scale constitutes a hypertrophic scar? Results from a survey of North American burn-care providers

    PubMed Central

    Thompson, Callie M.; Sood, Ravi F.; Honari, Shari; Carrougher, Gretchen J.; Gibran, Nicole S.

    2015-01-01

    Introduction Reliable characterization of a hypertrophic scar (HTS) is integral to epidemiologic studies designed to identify clinical and genetic risk factors for HTS. The Vancouver Scar Scale (VSS) has been widely used for this purpose; however, no publication has defined what score on this scale corresponds to a clinical diagnosis of HTS. Methods In a survey of 1000 burn care providers, we asked respondents what VSS score indicates a HTS and asked them to score scar photos using the VSS. We used receiver-operating-characteristic (ROC) curves to evaluate VSS subscores and their combinations in diagnosis of HTS. Results Of 130 responses (13.5%), most were physicians (43.9%) who had worked in burn care for over 10 years (63.1%) and did not use the VSS in clinical practice (58.5%). There was no consensus as to what VSS score indicates a diagnosis of HTS. VSS height score (0–3) performed best for diagnosis of HTS; using a cut-off of ≥1, height score was 99.5% sensitive and 85.9% specific for HTS. Conclusions Burn clinicians do not routinely use the VSS and perceptions vary widely regarding what constitutes a HTS. When a dichotomous variable is needed, the VSS height score with a cut-off of ≥1 may be optimal. Our findings underscore the need for an objective tool to reproducibly characterize HTS across burn centers. PMID:26141527

  2. The Role of Community Rehabilitation Providers in Employment for Persons with Intellectual and Developmental Disabilities: Results of the 2010-2011 National Survey

    ERIC Educational Resources Information Center

    Domin, Daria; Butterworth, John

    2013-01-01

    Based on the 2010-2011 National Survey of Community Rehabilitation Providers, findings are presented on people with all disabilities and people with intellectual and developmental disabilities (IDD) who are served in employment and nonwork settings by community rehabilitation providers. Findings suggest little change over the past eight years in…

  3. EPAct Alternative Fuel Transportation Program: State and Alternative Fuel Provider Fleet Compliance Annual Report; Fleet Compliance Results for MY 2013/FY 2014

    SciTech Connect

    2015-09-01

    Compliance rates for covered state government and alternative fuel provider fleets under the Alternative Fuel Transportation Program (pursuant to the Energy Policy Act or EPAct) are reported for MY 2013/FY 2014 in this publication.

  4. Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: Results of a qualitative study

    PubMed Central

    Jaiantilal, Prafulta; Gutin, Sarah A.; Cummings, Beverley; Mbofana, Francisco; Rose, Carol Dawson

    2015-01-01

    Abstract Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In-depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges

  5. Mini-Nutritional Assessment predicts functional decline of elderly Taiwanese: result of a population-representative sample.

    PubMed

    Lee, Li-Chin; Tsai, Alan C

    2012-06-01

    Nutrition is a key element in geriatric health and is important for functional ability. The present study examined the functional status-predictive ability of the Mini-Nutritional Assessment (MNA). We analysed the dataset of the 'Survey of Health and Living Status of the Elderly in Taiwan', a population-based study conducted by the Bureau of Health Promotion of Taiwan. Study subjects (≥65 years old) who completed both the 1999 and 2003 surveys were rated with the long form and short form of the MNA at baseline and with the Activities of Daily Living (ADL) and the Instrument Activities of Daily Living (IADL) scales 4 years later (end-point). The ability of the MNA to predict ADL or IADL dependency was evaluated with logistic regression models. The results showed that the elderly who were rated malnourished or at risk of malnutrition at baseline generally had significantly higher ADL or IADL scores 4 years later. Lower baseline MNA scores also predicted a greater risk of ADL or IADL dependency. These associations exist even among the elderly who were free of ADL or IADL dependency at baseline. The results clearly indicate that the MNA is able to predict ADL and IADL dependency (in addition to rating current nutritional status) of the elderly. The MNA, especially the short form, should be a valuable tool for identifying elderly at risk of functional decline and/or malnutrition in clinical practice or community programmes.

  6. Reproducibility of the six-minute walk test and Glittre ADL-test in patients hospitalized for acute and exacerbated chronic lung disease

    PubMed Central

    José, Anderson; Dal Corso, Simone

    2015-01-01

    Background: The 6-minute walk test (6MWT) and the Glittre ADL-test (GT) are used to assess functional capacity and exercise tolerance; however, the reproducibility of these tests needs further study in patients with acute lung diseases. Objectives: The aim of this study was to investigate the reproducibility of the 6MWT and GT performed in patients hospitalized for acute and exacerbated chronic lung diseases. Method: 48 h after hospitalization, 81 patients (50 males, age: 52±18 years, FEV1: 58±20% of the predicted value) performed two 6MWTs and two GTs in random order on different days. Results: There was no difference between the first and second 6MWT (median 349 m [284-419] and 363 m [288-432], respectively) (ICC: 0.97; P<0.0001). A difference between the first and second tests was found in GT (median 286 s [220-378] and 244 s [197-323] respectively; P<0.001) (ICC: 0.91; P<0.0001). Conclusion: Although both the 6MWT and GT were reproducible, the best results occurred in the second test, demonstrating a learning effect. These results indicate that at least two tests are necessary to obtain reliable assessments. PMID:26039036

  7. LabPush: A Pilot Study of Providing Remote Clinics with Laboratory Results via Short Message Service (SMS) in Swaziland, Africa

    PubMed Central

    Jian, Wen-Shan; Hsu, Min-Huei; Sukati, Hosea; Syed-Abdul, Shabbir; Scholl, Jeremiah; Dube, Nduduzo; Hsu, Chun-Kung; Wu, Tai-jung; Lin, Vera; Chi, Tex; Chang, Peter; Li, Yu-Chuan

    2012-01-01

    Background Turnaround time (TAT) is an important indicator of laboratory performance. It is often difficult to achieve fast TAT for blood tests conducted at clinics in developing countries. This is because clinics where the patient is treated are often far away from the laboratory, and transporting blood samples and test results between the two locations creates significant delay. Recent efforts have sought to mitigate this problem by using Short Message Service (SMS) to reduce TAT. Studies reporting the impact of this technique have not been published in scientific literature however. In this paper we present a study of LabPush, a system developed to test whether SMS delivery of HIV related laboratory results to clinics could shorten TAT time significantly. Method LapPush was implemented in six clinics of the Kingdom of Swaziland. SMS results were sent out from the laboratory as a supplement to normal transport of paper results. Each clinic was equipped with a mobile phone to receive SMS results. The laboratory that processes the blood tests was equipped with a system for digital input of results, and transmission of results via SMS to the clinics. Results Laboratory results were received for 1041 different clinical cases. The total number of SMS records received (1032) was higher than that of paper records (965), indicating a higher loss rate for paper records. A statistical comparison of TAT for SMS and paper reports indicates a statistically significant improvement for SMS. Results were more positive for more rural clinics, and an urban clinic with high workload. Conclusion SMS can be used to reduce TAT for blood tests taken at clinics in developing countries. Benefits are likely to be greater at clinics that are further away from laboratories, due to the difficulties this imposes on transport of paper records. PMID:23028543

  8. Fusion of Aequorea victoria GFP and aequorin provides their Ca(2+)-induced interaction that results in red shift of GFP absorption and efficient bioluminescence energy transfer.

    PubMed

    Gorokhovatsky, Andrey Yu; Marchenkov, Victor V; Rudenko, Natalia V; Ivashina, Tanya V; Ksenzenko, Vladimir N; Burkhardt, Nils; Semisotnov, Gennady V; Vinokurov, Leonid M; Alakhov, Yuli B

    2004-07-30

    The bioluminescence emitted by Aequorea victoria jellyfish is greenish while its single bioluminescent photoprotein aequorin emits blue light. This phenomenon may be explained by a bioluminescence resonance energy transfer (BRET) from aequorin chromophore to green fluorescent protein (GFP) co-localized with it. However, a slight overlapping of the aequorin bioluminescence spectrum with the GFP absorption spectrum and the absence of marked interaction between these proteins in vitro pose a question on the mechanism providing the efficient BRET in A. victoria. Here we report the in vitro study of BRET between homologous Ca(2+)-activated photoproteins, aequorin or obelin (Obelia longissima), as bioluminescence energy donors, and GFP, as an acceptor. The fusions containing donor and acceptor proteins linked by a 19 aa peptide were purified after expressing their genes in Escherichia coli cells. It was shown that the GFP-aequorin fusion has a significantly greater BRET efficiency, compared to the GFP-obelin fusion. Two main factors responsible for the difference in BRET efficiency of these fusions were revealed. First, it is the presence of Ca(2+)-induced interaction between the donor and acceptor in the aequorin-containing fusion and the absence of the interaction in the obelin-containing fusion. Second, it is a red shift of GFP absorption toward better overlapping with aequorin bioluminescence induced by the interaction of aequorin with GFP. Since the connection of the two proteins in vitro mimics their proximity in vivo, Ca(2+)-induced interaction between aequorin and GFP may occur in A. victoria jellyfish providing efficient BRET in this organism.

  9. Can repeat injection provide clinical benefit in patients with cervical disc herniation and stenosis when the first epidural injection results only in partial response?

    PubMed Central

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-01-01

    Abstract Epidural steroid injection (ESI) is known to be an effective treatment for neck or radicular pain due to herniated intervertebral disc (HIVD) and spinal stenosis (SS). Although repeat ESI has generally been indicated to provide more pain relief in partial responders after single ESI, there has been little evidence supporting the usefulness of this procedure. The purpose of this study, therefore, was to determine whether repeat ESI at a prescribed interval of 2 to 3 weeks after the first injection would provide greater clinical benefit in patients with partial pain reduction than intermittent ESI performed only when pain was aggravated. One hundred eighty-four patients who underwent transforaminal ESI (TFESI) for treatment of axial neck and radicular arm pain due to HIVD or SS and could be followed up for 1 year were enrolled. We divided the patients into 2 groups. Group A (N = 108) comprised partial responders (numeric rating scale (NRS) ≥ 3 after the first injection) who underwent repeat injection at a prescribed interval of 2 to 3 weeks after the first injection. Group B (N = 76) comprised partial responders who did not receive repeat injection at the prescribed interval, but received intermittent injections only for aggravation of pain. Various clinical data were assessed, including total number of injections during 1 year, NRS duration of <3 during 1 year (NRS < 3 duration), and time interval until pain was increased to require additional injections after repeat injection in Group A, or after first injection in Group B (time to reinjection). Groups A and B were compared in terms of total population, HIVD, and SS. In the whole population, HIVD subgroup, and SS subgroup, patients in Group A required significantly fewer injections to obtain satisfactory pain relief during the 1-year follow-up period. Group A showed a significantly longer time to reinjection and longer NRS < 3 than Group B did. Repeat TFESI conducted at 2- to 3-week

  10. Patient Perceptions of Prejudice and Discrimination by Health Care Providers and its Relationship with Mental Disorders: Results from the 2012 Canadian Community Health-Mental Health Survey Data.

    PubMed

    Marchand, Kirsten; Palis, Heather; Oviedo-Joekes, Eugenia

    2016-04-01

    Using data from a nationally representative survey, the Canadian Community Health Survey-Mental Health, this secondary analysis aimed to determine the prevalence of perceived prejudice by health care providers (HCPs) and its relationship with mental disorders. Respondents accessing HCPs in the prior year were asked if they experienced HCP prejudice. A hypothesis driven multivariable logistic regression analysis was conducted to determine the relationship between type of mental disorders and HCP prejudice. Among the 3006 respondents, 10.9 % perceived HCP prejudice, 62.4 % of whom reported a mental disorder. The adjusted odds of prejudice was highest for respondents with anxiety (OR 3.12; 95 % CI 1.60, 6.07), concurrent mood or anxiety and substance disorders (OR 3.08; 95 % CI 1.59, 5.95) and co-occurring mood and anxiety disorders (OR 2.89; 95 % CI 1.68, 4.97) compared to respondents without any mental disorders. These findings are timely for informing discussions regarding policies to address HCP prejudice towards people with mental disorders.

  11. BPI-ANCA Provides Additional Clinical Information to Anti-Pseudomonas Serology: Results from a Cohort of 117 Swedish Cystic Fibrosis Patients.

    PubMed

    Lindberg, Ulrika; Carlsson, Malin; Hellmark, Thomas; Segelmark, Mårten

    2015-01-01

    Patients with cystic fibrosis (CF) colonized with Pseudomonas aeruginosa (P. aeruginosa) have worse prognosis compared with patients who are not. BPI-ANCA is an anti-neutrophil cytoplasmic antibody against BPI (bactericidal/permeability increasing protein) correlating with P. aeruginosa colonization and adverse long time prognosis. Whether it provides additional information as compared to standard anti-P. aeruginosa serology tests is not known. 117 nontransplanted CF patients at the CF centre in Lund, Sweden, were followed prospectively for ten years. Bacterial colonisation was classified according to the Leeds criteria. IgA BPI-ANCA was compared with assays for antibodies against alkaline protease (AP), Elastase (ELA), and Exotoxin A (ExoA). Lung function and patient outcome, alive, lung transplanted, or dead, were registered. BPI-ANCA showed the highest correlation with lung function impairment with an r-value of 0.44. Forty-eight of the 117 patients were chronically colonized with P. aeruginosa. Twenty of these patients experienced an adverse outcome. Receiver operator curve (ROC) analysis revealed that this could be predicted by BPI-ANCA (AUC = 0.77), (p = 0.002) to a better degree compared with serology tests. BPI-ANCA correlates better with lung function impairment and long time prognosis than anti-P. aeruginosa serology and has similar ability to identify patients with chronic P. aeruginosa.

  12. Patients', doctors', and caregivers' assessment of disability using the UPDRS-ADL section: are these ratings interchangeable?

    PubMed

    Martínez-Martín, Pablo; Benito-León, Julian; Alonso, Fernando; Catalán, M José; Pondal, Margarita; Tobías, Aurelio; Zamarbide, Ivana

    2003-09-01

    This multicenter study sought to analyze the validity and reliability of the Unified Parkinson's Disease Rating Scale (UPDRS)-section 2 (Activities of Daily Living, ADL) as applied by patients and caregivers. Sixty pairs of PD patients-caregivers were enrolled for study purposes. Neurologists used a set of scales to determine disease severity and patients' functional state. Patients and caregivers used adapted versions of the UPDRS-section 2 in tandem with other measures. Wilcoxon and Mann-Whitney tests, weighted kappa, intraclass and Spearman's correlation coefficients, as well as multivariate linear regression models were applied. On the whole, PD patient self-assessment and caregiver evaluation of patients' disability showed close concordance with neurologists' ratings. Correlation between caregiver ratings and clinical evaluation tended to be slightly lower than that for patient-based self-assessment. Depression showed a positive correlation with disability and had a nonsystematic influence on UPDRS-section 2 (ADL) scores. As expected, there was a significant correlation between perceived disability and health-related quality of life measures. Caregiver burden did not reduce the level of agreement with neurologists as to the overall rating of any given patient's disability. In PD, UPDRS-section 2-based assessment of disability by patients themselves and caregivers is a valid and reliable outcome.

  13. Can currently available advanced combustion biomass cook-stoves provide health relevant exposure reductions? Results from initial assessment of select commercial models in India.

    PubMed

    Sambandam, Sankar; Balakrishnan, Kalpana; Ghosh, Santu; Sadasivam, Arulselvan; Madhav, Satish; Ramasamy, Rengaraj; Samanta, Maitreya; Mukhopadhyay, Krishnendu; Rehman, Hafeez; Ramanathan, Veerabhadran

    2015-03-01

    Household air pollution from use of solid fuels is a major contributor to the national burden of disease in India. Currently available models of advanced combustion biomass cook-stoves (ACS) report significantly higher efficiencies and lower emissions in the laboratory when compared to traditional cook-stoves, but relatively little is known about household level exposure reductions, achieved under routine conditions of use. We report results from initial field assessments of six commercial ACS models from the states of Tamil Nadu and Uttar Pradesh in India. We monitored 72 households (divided into six arms to each receive an ACS model) for 24-h kitchen area concentrations of PM2.5 and CO before and (1-6 months) after installation of the new stove together with detailed information on fixed and time-varying household characteristics. Detailed surveys collected information on user perceptions regarding acceptability for routine use. While the median percent reductions in 24-h PM2.5 and CO concentrations ranged from 2 to 71% and 10-66%, respectively, concentrations consistently exceeded WHO air quality guideline values across all models raising questions regarding the health relevance of such reductions. Most models were perceived to be sub-optimally designed for routine use often resulting in inappropriate and inadequate levels of use. Household concentration reductions also run the risk of being compromised by high ambient backgrounds from community level solid-fuel use and contributions from surrounding fossil fuel sources. Results indicate that achieving health relevant exposure reductions in solid-fuel using households will require integration of emissions reductions with ease of use and adoption at community scale, in cook-stove technologies. Imminent efforts are also needed to accelerate the progress towards cleaner fuels.

  14. Repellent plants provide affordable natural screening to prevent mosquito house entry in tropical rural settings--results from a pilot efficacy study.

    PubMed

    Mng'ong'o, Frank C; Sambali, Joseph J; Sabas, Eustachkius; Rubanga, Justine; Magoma, Jaka; Ntamatungiro, Alex J; Turner, Elizabeth L; Nyogea, Daniel; Ensink, Jeroen H J; Moore, Sarah J

    2011-01-01

    Sustained malaria control is underway using a combination of vector control, prompt diagnosis and treatment of malaria cases. Progress is excellent, but for long-term control, low-cost, sustainable tools that supplement existing control programs are needed. Conventional vector control tools such as indoor residual spraying and house screening are highly effective, but difficult to deliver in rural areas. Therefore, an additional means of reducing mosquito house entry was evaluated: the screening of mosquito house entry points by planting the tall and densely foliated repellent plant Lantana camara L. around houses. A pilot efficacy study was performed in Kagera Region, Tanzania in an area of high seasonal malaria transmission, where consenting families within the study village planted L. camara (Lantana) around their homes and were responsible for maintaining the plants. Questionnaire data on house design, socioeconomic status, malaria prevention knowledge, attitude and practices was collected from 231 houses with Lantana planted around them 90 houses without repellent plants. Mosquitoes were collected using CDC Light Traps between September 2008 and July 2009. Data were analysed with generalised negative binomial regression, controlling for the effect of sampling period. Indoor catches of mosquitoes in houses with Lantana were compared using the Incidence Rate Ratio (IRR) relative to houses without plants in an adjusted analysis. There were 56% fewer Anopheles gambiae s.s. (IRR 0.44, 95% CI 0.28-0.68, p<0.0001); 83% fewer Anopheles funestus s.s. (IRR 0.17, 95% CI 0.09-0.32, p<0.0001), and 50% fewer mosquitoes of any kind (IRR 0.50, 95% CI 0.38-0.67, p<0.0001) in houses with Lantana relative to controls. House screening using Lantana reduced indoor densities of malaria vectors and nuisance mosquitoes with broad community acceptance. Providing sufficient plants for one home costs US $1.50 including maintenance and labour costs, (30 cents per person). L. camara mode

  15. Repellent Plants Provide Affordable Natural Screening to Prevent Mosquito House Entry in Tropical Rural Settings—Results from a Pilot Efficacy Study

    PubMed Central

    Mng'ong'o, Frank C.; Sambali, Joseph J.; Sabas, Eustachkius; Rubanga, Justine; Magoma, Jaka; Ntamatungiro, Alex J.; Turner, Elizabeth L.; Nyogea, Daniel; Ensink, Jeroen H. J.; Moore, Sarah J.

    2011-01-01

    Sustained malaria control is underway using a combination of vector control, prompt diagnosis and treatment of malaria cases. Progress is excellent, but for long-term control, low-cost, sustainable tools that supplement existing control programs are needed. Conventional vector control tools such as indoor residual spraying and house screening are highly effective, but difficult to deliver in rural areas. Therefore, an additional means of reducing mosquito house entry was evaluated: the screening of mosquito house entry points by planting the tall and densely foliated repellent plant Lantana camara L. around houses. A pilot efficacy study was performed in Kagera Region, Tanzania in an area of high seasonal malaria transmission, where consenting families within the study village planted L. camara (Lantana) around their homes and were responsible for maintaining the plants. Questionnaire data on house design, socioeconomic status, malaria prevention knowledge, attitude and practices was collected from 231 houses with Lantana planted around them 90 houses without repellent plants. Mosquitoes were collected using CDC Light Traps between September 2008 and July 2009. Data were analysed with generalised negative binomial regression, controlling for the effect of sampling period. Indoor catches of mosquitoes in houses with Lantana were compared using the Incidence Rate Ratio (IRR) relative to houses without plants in an adjusted analysis. There were 56% fewer Anopheles gambiae s.s. (IRR 0.44, 95% CI 0.28–0.68, p<0.0001); 83% fewer Anopheles funestus s.s. (IRR 0.17, 95% CI 0.09–0.32, p<0.0001), and 50% fewer mosquitoes of any kind (IRR 0.50, 95% CI 0.38–0.67, p<0.0001) in houses with Lantana relative to controls. House screening using Lantana reduced indoor densities of malaria vectors and nuisance mosquitoes with broad community acceptance. Providing sufficient plants for one home costs US $1.50 including maintenance and labour costs, (30 cents per person). L. camara

  16. In defense of adolescents: They really do use braces for the hours prescribed, if good help is provided. Results from a prospective everyday clinic cohort using thermobrace

    PubMed Central

    2012-01-01

    Background The effectiveness of bracing relies on the quality of the brace, compliance of the patient, and some disease factors. Patients and parents tend to overestimate adherence, so an objective assessment of compliance has been developed through the use of heat sensors. In 2010 we started the everyday clinical use of a temperature sensor, and the aim of this study is to present our initial results. Methods Population: A prospective cohort of 68 scoliosis patients that finished at least 4 months of brace treatment on March 31, 2011: 48 at their first evaluation (79% females, age 14.2±2.4) and 20 already in treatment. Treatment: Bracing (SPoRT concept); physiotherapic specific exercises (SEAS School); team approach according to the SOSORT Bracing Management Guidelines. Methods. A heat sensor, “Thermobrace” (TB), has been validated and applied to the brace. The real (measured by TB) and referred (reported by the patient) compliances were calculated. Statistics. The distribution was not normal, hence median and 95% interval confidence (IC95) and non-parametric tests had to be used. Results Average TB use: 5.5±1.5 months. Brace prescription was 23 hours/day (h/d) (IC95 18–23), with a referred compliance of 100% (IC95 70.7-100%) and a real one of 91.7% (IC95 56.6-101.7%), corresponding to 20 h/d (IC95 11–23). The more the brace was prescribed, the more compliant the patient was (94.8% in 23 h/d vs. 73.2% in 18 h/d, P < 0.05). Sixty percent of the patients had at least 90% compliance, and 45% remained within 1 hour of what had been prescribed. Non-wearing days were 0 (IC95 0–12.95), and involved 29% of patients. Conclusion This is the first study using a TB in a setting of respect for the SOSORT criteria for bracing, and it states that it is possible to achieve a very good compliance, even with a full time prescription, and better than what was previously reported (80% maximum). We hypothesize that the treating team (SOSORT criteria) plays a major role

  17. Integration of Known DNA, RNA and Protein Biomarkers Provides Prediction of Anti-TNF Response in Rheumatoid Arthritis: Results from the COMBINE Study

    PubMed Central

    Folkersen, Lasse; Brynedal, Boel; Diaz-Gallo, Lina Marcela; Ramsköld, Daniel; Shchetynsky, Klementy; Westerlind, Helga; Sundström, Yvonne; Schepis, Danika; Hensvold, Aase; Vivar, Nancy; Eloranta, Maija-Leena; Rönnblom, Lars; Brunak, Søren; Malmström, Vivianne; Catrina, Anca; Moerch, Ulrik GW; Klareskog, Lars; Padyukov, Leonid; Berg, Louise

    2016-01-01

    OBJECTIVE: In rheumatoid arthritis (RA) several recent efforts have sought to discover means of predicting which patients would benefit from treatment. However, results have been discrepant with few successful replications. Our objective was to build a biobank with DNA, RNA and protein measurements to test the claim that the current state-of-the-art precision medicine will benefit RA patients. METHODS: We collected 451 blood samples from 61 healthy individuals and 185 RA patients initiating treatment, before treatment initiation and at a 3 month follow-up time. All samples were subjected to high-throughput RNA sequencing, DNA genotyping, extensive proteomics and flow cytometry measurements, as well as comprehensive clinical phenotyping. Literature review identified 2 proteins, 52 single-nucleotide polymorphisms (SNPs) and 72 gene-expression biomarkers that had previously been proposed as predictors of Tumor Necrosis Factor (TNF) inhibitor response (ΔDAS28-CRP). RESULTS: From these published TNFi biomarkers we found that 2 protein, 2 SNP and 8 mRNA biomarkers could be replicated in the 59 TNF initiating patients. Combining these replicated biomarkers into a single signature we found that we could explain 51% of the variation in ΔDAS28-CRP. This corresponds to a sensitivity of 0.73 and specificity of 0.78 for the prediction of three month ΔDAS28-CRP better than –1.2. CONCLUSIONS: The COMBINE biobank is currently the largest collection of multi-omics data from RA patients with high potential for discovery and replication. Taking advantage of this we surveyed the current state-of-the-art of drug-response stratification in RA, and identified a small set of previously published biomarkers available in peripheral blood which predicts clinical response to TNF blockade in this independent cohort. PMID:27532898

  18. Analysis of the NASA/MSFC Airborne Doppler Lidar results from San Gorgonio Pass, California

    NASA Technical Reports Server (NTRS)

    Cliff, W. C.; Skarda, J. R.; Renne, D. S.; Sandusky, W. F.

    1984-01-01

    Two days during July of 1981 the NASA/MSFC Airborne Doppler Lidar System (ADLS) was flown aboard the NASA/AMES Convair 990 on the east side of San Gorgonio Pass California, near Palm Springs, to measure and investigate the accelerated atmospheric wind field discharging from the pass. The vertical and horizontal extent of the fast moving atmospheric flow discharging from the San Gorgonio Pass were examined. Conventional ground measurements were also taken during the tests to assist in validating the ADLS results. This particular region is recognized as a high wind resource region and, as such, a knowledge of the horizontal and vertical extent of this flow was of interest for wind energy applications. The statistics of the atmospheric flow field itself as it discharges from the pass and then spreads out over the desert were also of scientific interests. This data provided the first spatial data for ensemble averaging of spatial correlations to compute longitudinal and lateral integral length scales in the longitudinal and lateral directions for both components.

  19. Adamts18 deletion results in distinct developmental defects and provides a model for congenital disorders of lens, lung, and female reproductive tract development

    PubMed Central

    Ataca, Dalya; Caikovski, Marian; Piersigilli, Alessandra; Moulin, Alexandre; Benarafa, Charaf; Earp, Sarah E.; Guri, Yakir; Kostic, Corinne; Arsenivic, Yvan; Soininen, Raija; Apte, Suneel S.

    2016-01-01

    ABSTRACT The ADAMTS family comprises 19 secreted metalloproteinases that cleave extracellular matrix components and have diverse functions in numerous disease and physiological contexts. A number of them remain ‘orphan’ proteases and among them is ADAMTS18, which has been implicated in developmental eye disorders, platelet function and various malignancies. To assess in vivo function of ADAMTS18, we generated a mouse strain with inactivated Adamts18 alleles. In the C57Bl6/Ola background, Adamts18-deficient mice are born in a normal Mendelian ratio, and are viable but show a transient growth delay. Histological examination revealed a 100% penetrant eye defect resulting from leakage of lens material through the lens capsule occurring at embryonic day (E)13.5, when the lens grows rapidly. Adamts18-deficient lungs showed altered bronchiolar branching. Fifty percent of mutant females are infertile because of vaginal obstruction due to either a dorsoventral vaginal septum or imperforate vagina. The incidence of ovarian rete is increased in the mutant mouse strain. Thus, Adamts18 is essential in the development of distinct tissues and the new mouse strain is likely to be useful for investigating ADAMTS18 function in human disease, particularly in the contexts of infertility and carcinogenesis. PMID:27638769

  20. BAP1 immunohistochemistry and p16 FISH results in combination provide higher confidence in malignant pleural mesothelioma diagnosis: ROC analysis of the two tests.

    PubMed

    Hida, Tomoyuki; Hamasaki, Makoto; Matsumoto, Shinji; Sato, Ayuko; Tsujimura, Tohru; Kawahara, Kunimitsu; Iwasaki, Akinori; Okamoto, Tatsuro; Oda, Yoshinao; Honda, Hiroshi; Nabeshima, Kazuki

    2016-10-01

    Differentiation of malignant pleural mesothelioma (MPM) from benign mesothelial proliferation remains problematic. Loss of nuclear staining of BRCA1-associated protein 1 (BAP1; detected using immunohistochemistry (IHC)) and homozygous deletion (HD) of p16 (detected using fluorescence in situ hybridization (FISH)) are useful for differentiation of MPM from reactive mesothelial hyperplasia (RMH), but the correlation between BAP1 expression loss and p16 HD has not been fully described. We performed BAP1 IHC and p16-specific FISH for 40 MPM and 20 RMH cases, and measured proportions of cells showing BAP1 expression and p16 HD for each case. The diagnostic accuracy for MPM and the cut-off values of the two methods were assessed using receiver operating characteristic (ROC) analysis. BAP1 expression loss, p16 HD and coexistence of both were present in 27 (67.5 %), 27 (67.5 %) and 17 (42.5 %) MPM cases, respectively. Three MPM cases (7.5 %) and all 20 RMH cases had neither BAP1 loss nor p16 HD. There was no correlation between the results of the two methods. Their combination showed higher sensitivity (92.5 %, 37/40) and estimated probability than BAP1 IHC and p16-specific FISH used alone. BAP1 IHC and p16-specific FISH have independent diagnostic value, and have increased reliability when used in combination, for MPM diagnosis.

  1. Providing a diet containing only maintenance levels of energy and protein during the latter stages of pregnancy resulted in a prolonged delivery time during parturition in rats.

    PubMed

    Tanaka, Y; Kadokawa, H

    2012-01-01

    In mammals, a prolonged delivery time during parturition is dangerous for both mother and fetus, although the mechanisms that prolong delivery are unclear. To investigate whether nutrition affects delivery time, we administered two feeds containing maintenance (L-feed) or higher (H-feed) levels of energy and protein at different points during the latter half of pregnancy and compared the effects of the various treatments on delivery time in rats. After the rats had been maintained on the L-feed and then copulated on pro-oestrus (Day 0), pregnant females were randomly allocated to one of three groups: (1) the no-improvement group, which was fed L-feed throughout gestation; (2) the early group, which was fed L-feed until Day 11 of gestation and then switched to H-feed; and (3) the late group, which was fed L-feed until Day 16 of gestation and then switched to H-feed. There was no significant difference in the number of pups among the three groups. However, delivery time was significantly longer in the no-improvement group (73.7±5.2 min) than the early (46.9±5.6 min) and late (55.4±5.5 min) groups. Consuming a maintenance diet during the latter half of pregnancy resulted in a prolonged delivery time.

  2. Gerontechnology: Providing a Helping Hand When Caring for Cognitively Impaired Older Adults—Intermediate Results from a Controlled Study on the Satisfaction and Acceptance of Informal Caregivers

    PubMed Central

    Mitseva, Anelia; Peterson, Carrie Beth; Karamberi, Christina; Oikonomou, Lamprini Ch.; Ballis, Athanasios V.; Giannakakos, Charalampos; Dafoulas, George E.

    2012-01-01

    The incidence of cognitive impairment in older age is increasing, as is the number of cognitively impaired older adults living in their own homes. Due to lack of social care resources for these adults and their desires to remain in their own homes and live as independently as possible, research shows that the current standard care provisions are inadequate. Promising opportunities exist in using home assistive technology services to foster healthy aging and to realize the unmet needs of these groups of citizens in a user-centered manner. ISISEMD project has designed, implemented, verified, and assessed an assistive technology platform of personalized home care (telecare) for the elderly with cognitive impairments and their caregivers by offering intelligent home support services. Regions from four European countries have carried out long-term pilot-controlled study in real-life conditions. This paper presents the outcomes from intermediate evaluations pertaining to user satisfaction with the system, acceptance of the technology and the services, and quality of life outcomes as a result of utilizing the services. PMID:22536230

  3. Risk Factors for Nursing Home Placement in Alzheimer's Disease: A Longitudinal Study of Cognition, ADL, Service Utilization, and Cholinesterase Inhibitor Treatment

    ERIC Educational Resources Information Center

    Wattmo, Carina; Wallin, Asa K.; Londos, Elisabet; Minthon, Lennart

    2011-01-01

    Purpose of the Study: To identify risk factors for early nursing home placement (NHP) in Alzheimer's disease (AD), focusing on the impact of longitudinal change in cognition, activities of daily living (ADL), service utilization, and cholinesterase inhibitor treatment (ChEI). Design and Methods: In an open, 3-year, prospective, multicenter study…

  4. Cognitive Impairment as a Strong Predictor of Incident Disability in Specific Adl-Iadl Tasks among Community-Dwelling Elders: The Azuchi Study

    ERIC Educational Resources Information Center

    Dodge, Hiroko H.; Kadowaki, Takashi; Hayakawa, Takehito; Yamakawa, Masanobu; Sekikawa, Akira; Ueshima, Hirotugu

    2005-01-01

    Purpose: We examined differential effects of cognitive impairment on each of the activities of daily living (ADL) and instrumental activities of daily living (IADL) tasks. Design and Methods: In a 3-year follow-up of community-dwelling elderly persons in Azuchi, Japan, we assessed cognition by using the Hasegawa Dementia Scale. We examined (a) the…

  5. The Glittre-ADL test reflects functional performance measured by physical activities of daily living in patients with chronic obstructive pulmonary disease

    PubMed Central

    Karloh, Manuela; Araujo, Cintia L. P.; Gulart, Aline A.; Reis, Cardine M.; Steidle, Leila J. M.; Mayer, Anamaria F.

    2016-01-01

    ABSTRACT Background The Glittre-ADL test (TGlittre) is a valid and reliable test for the evaluation of functional capacity and involves multiple physical activities of daily living (PADL), which are known to be troublesome to patients with Chronic Obstructive Pulmonary Disease (COPD). However, it is still unknown if this test is also able to reflect the functional performance of patients with COPD. Objective To investigate whether the TGlittre reflects the functional performance of COPD patients and whether the necessary time to complete the TGlittre and the PADL varies according to disease severity. Method Thirty-eight patients with COPD (age 65, SD=7 years; forced expiratory volume in the first second 41.3, SD=15.2% predicted) underwent anthropometric and lung function assessments and were submitted to the TGlittre and PADL measurement. Results TGlittre performance correlated significantly (p<0.05) with PADL variables, such as time sitting (r=0.50), walking (r=-0.46), number of steps taken (r=–0.53), walking movement intensity (r=–0.66), walking energy expenditure (r=-0.50), and total energy expenditure (r=–0.33). TGlittre performance was not significantly different in patients among the Global Initiative for COPD (GOLD) spirometric stages, but walking and sitting time were significantly lower and greater, respectively, in severe and very severe patients compared to those with moderate disease (p<0.05). Conclusion The performance on the TGlittre correlates with walking and sitting time and other real life PADL measurements. The severity of the disease is associated with the differences in the level of physical activity in daily life more than in functional capacity. PMID:27437713

  6. Synergistic antidepressant-like effects between a kappa opioid antagonist (LY2444296) and a delta opioid agonist (ADL5859) in the mouse forced swim test.

    PubMed

    Huang, Peng; Tunis, Julia; Parry, Christopher; Tallarida, Ronald; Liu-Chen, Lee-Yuan

    2016-06-15

    Kappa opioid (KOP) receptor antagonists and delta opioid (DOP) receptor agonists have antidepressant-like effects in animal tests and may be useful for treatment-resistant depression in humans. In this study, we examined whether the combination of a KOP receptor antagonist and a DOP receptor agonist would produce a better than additive effect (i.e. synergy). LY2444296 is a short-acting selective nonpeptide KOP receptor antagonist. ADL5859 is a selective nonpeptide DOP receptor agonist which does not produce seizures and EEG disturbances. Each compound and combinations of the two were examined in the forced swim test (FST) one h post injection, a screening test for antidepressant-like effect, in male adult C57BL/6J mice (Jackson Lab). LY2444296 [subcutaneous (s.c.) injection] at 10 and 30mg/kg, but not 3mg/kg, significantly decreased immobility time in a dose-dependent manner. Intraperitoneal (i.p.) injections of ADL5859 also reduced immobility time dose-dependently at doses of 3 and 10mg/kg, but not at 1mg/kg. An analysis was conducted using the method of Tallarida and Raffa (2010), which employed dose equivalence. The relative potency of the drugs was determined to be LY2444296: ADL5859=1:0.28, which was the dose ratio for combination studies. Six combinations of the two compounds were tested in mice at a fixed dose ratio. We found that LY2444296 and ADL5859 yielded significant synergistic effects for the antidepressant-like effect at the combined dose ranging from 3.84mg/kg to 9.0mg/kg. ADL5859 (10mg/kg), LY2444296 (30mg/kg) and their combined dose (3.84mg/kg) had no effects on locomotor activities. Since the two drugs have distinct pharmacological profiles, such a synergism will allow use of lower doses of both drugs to achieve desired antidepressant effects with fewer side effects.

  7. The ADL Registry and CORDRA - Volume 2: Registry Overview and User’s Guide

    DTIC Science & Technology

    2010-04-01

    contributed by the Defense Ammunition Center ( DAC ) using its repository ID. 23 Figure 16 – Search by ID Similarly, if you know the object ID or...applicable categories, such as DAC or NAVAIR, by entering them after “DOD” in the provided input field. Figure 41 – Collection information NOTE...Center ( DAC ) Directorate for Training 1 C Tree Road McAlester, OK 74501 (918) 420-8961 sjmac-ast@dac.army.mil Contribution Date (Use once only

  8. 21. Providence & Worchester RR: Freight house. Providence, Providence Co., ...

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

    21. Providence & Worchester RR: Freight house. Providence, Providence Co., RI. Sec. 4119, mp 185.66 (See HAER no. RI-3 for further documentation on this site.) - Northeast Railroad Corridor, Amtrak route between CT & MA state lines, Providence, Providence County, RI

  9. Provide, provide: the economics of aging.

    PubMed

    1998-06-26

    Most older persons face two potentially serious economic problems: (a) declining earning power and (b) declining health that can be partly offset by increased utilization of health care. The decline in earning power is largely attributable to physiological changes and to obsolescence of skills and knowledge. These adverse effects are exacerbated by public and private policies that reduce the incentives of older persons to continue work and increase the cost to employers of employing older workers. The problems of earnings replacement and health care payment are usually discussed separately, but there are several reasons why they should be considered together. First, there are often tradeoffs between the two. Money is money, and for most people there is never enough to go around. This is self-evident where private funds are concerned. Low-income elderly, for instance, frequently must choose between expensive prescription drugs and an adequate diet. For middle-income elderly, the choice may be between saving on medigap insurance or forgoing an airplane trip to a grandchild's graduation. Difficult choices are also inherent in the allocation of public funds. The same tax receipts that could be used to maintain or increase retirement benefits could be used to fund additional care, and vice versa. In discussing these tradeoffs, some analysts assert that people will gladly give up other goods and services for medical care that cures illness, relieves pain, or restores function. Others believe that some people would forgo some health insurance in order to maintain access to other goods and services. A second reason for looking at the two problems together is that they pose similar questions for public policy. How much should each generation provide for its own needs in old age, and how much should be provided by the generations that follow? How much provision should be voluntary, how much compulsory? How much intra-generational redistribution is appropriate after age 65

  10. Toward real time detection of the basic living activity in home using a wearable sensor and smart home sensors.

    PubMed

    Bang, Sunlee; Kim, Minho; Song, Sa-Kwang; Park, Soo-Jun

    2008-01-01

    As the elderly people living alone are enormously increasing recently, we need the system inferring activities of daily living (ADL) for maintaining healthy life and recognizing emergency. The system should be constructed with sensors, which are used to associate with people's living while remaining as non intrusive views as possible. To do this, the proposed system use a triaxial accelerometer sensor and environment sensors indicating contact with subject in home. Particularly, in order to robustly infer ADLs, we present component ADL, which is decided with conjunction of human motion together, not just only contacted object identification. It is an important component in inferring ADL. In special, component ADL decision firstly refines misclassified initial activities, which improves the accuracy of recognizing ADL. Preliminary experiments results for proposed system provides overall recognition rate of over 97% over 8 component ADLs, which can be effectively applicable to recognize the final ADLs.

  11. Osmotolerance provided by the alternative sigma factors σB and rpoS to Staphylococcus aureus and Escherichia coli is solute dependent and does not result in an increased growth fitness in NaCl containing media.

    PubMed

    Cebrián, G; Arroyo, C; Condón, S; Mañas, P

    2015-12-02

    The aim of this work was to examine the role of the alternative general stress sigma factors σ(B) and rpoS on the ability of Staphylococcus aureus and Escherichia coli, respectively, to grow in liquid and solid media of different osmolarity. For this purpose, S. aureus strain Newman and its isogenic ΔsigB mutant IK84 and E. coli strain BJ4 and its isogenic ΔrpoS mutant BJ4L1 were grown in media (TSBYE) with different concentrations of NaCl. Growth parameters (lag phase duration, growth rate and maximum number of microorganisms) and limiting growth concentrations (Maximum Non-Inhibitory Concentration - MNIC - and Minimum Inhibitory Concentration - MIC-) were determined. The mechanisms underlying the differences observed between parental and mutant strains were also explored. The absence of the sigma factors σ(B) and rpoS led to a decrease in the MNICs and MICs calculated for S. aureus and E. coli, respectively. Conversely, neither σ(B) nor rpoS provided with increased growth fitness to S. aureus and E. coli cells at NaCl concentrations up to 1.36M and 1M, respectively. The decreased osmotolerance of the σ(B) and rpoS deficient strains, as compared to their parental strains, was compensated by the addition of glycine-betaine (1mM) to the growth medium. It was also observed that the decreased tolerance to NaCl of the mutant strains was coincident with a decreased tolerance to sucrose, KCl, and LiCl but not to glycerol, MgCl2, and CaCl2. Results obtained also demonstrate that the increased osmotolerance of stationary growth phase E. coli cells, as compared to exponential growth phase ones, would be due to the activation of both rpoS-independent and rpoS-dependent mechanisms. This work will help to understand the mechanisms of bacterial resistance to osmotic stress and the role of the alternative sigma factors σ(B) and rpoS in this process.

  12. Association between Participation in Outpatient Cardiac Rehabilitation and Self-Reported Receipt of Lifestyle Advice from a Healthcare Provider: Results of a Population-Based Cross-Sectional Survey.

    PubMed

    Johnson, Natalie A; Inder, Kerry J; Ewald, Ben D; James, Erica L; Bowe, Steven J

    2010-01-01

    We test the hypothesis that the odds of self-reported receipt of lifestyle advice from a health care provider will be lower among outpatient cardiac rehabilitation (OCR) nonattendees and nonreferred patients compared to OCR attendees. Logistic regression was used to analyse cross-sectional data provided by 65% (4971/7678) of patients aged 20 to 84 years discharged from public hospitals with a diagnosis indicating eligibility for OCR between 2002 and 2007. Among respondents, 71% (3518) and 55% (2724) recalled advice regarding physical activity and diet, respectively, while 88% (592/674) of smokers recalled quit advice. OCR attendance was low: 36% (1764) of respondents reported attending OCR, 11% (552) did not attend following referral, and 45% (2217) did not recall being invited. The odds of recalling advice regarding physical activity and diet were significantly lower among OCR nonattendees compared to attendees (OR 0.34, 95% CI 0.21, 0.56 and OR 0.33, 95% CI 0.25, 0.44, resp.) and among nonreferred respondents compared to OCR attendees (OR 0.10, 95% CI 0.07, 0.15 and OR 0.17, 95% CI 0.14, 0.22, resp.). Patients hospitalised for coronary heart disease should be referred to OCR or a suitable alternative to improve recall of lifestyle advice that will reduce the risk of further coronary events.

  13. Routine failures in the process for blood testing and the communication of results to patients in primary care in the UK: a qualitative exploration of patient and provider perspectives

    PubMed Central

    Litchfield, Ian; Bentham, Louise; Hill, Ann; McManus, Richard J; Lilford, Richard; Greenfield, Sheila

    2015-01-01

    Background The testing and result communication process in primary care is complex. Its successful completion relies on the coordinated efforts of a range of staff in primary care and external settings working together with patients. Despite the importance of diagnostic testing in provision of care, this complexity renders the process vulnerable in the face of increasing demand, stretched resources and a lack of supporting guidance. Methods We conducted a series of focus groups with patients and staff across four primary care practices using process-improvement strategies to identify and understand areas where either unnecessary delay is introduced, or the process may fail entirely. We then worked with both patients and staff to arrive at practical strategies to improve the current system. Results A total of six areas across the process were identified where improvements could be introduced. These were: (1) delay in phlebotomy, (2) lack of a fail-safe to ensure blood tests are returned to practices and patients, (3) difficulties in accessing results by telephone, (4) role of non-clinical staff in communicating results, (5) routine communication of normal results and (6) lack of a protocol for result communication. Conclusions A number of potential failures in testing and communicating results to patients were identified, and some specific ideas for improving existing systems emerged. These included same-day phlebotomy sessions, use of modern technology methods to proactively communicate routine results and targeted training for receptionists handling sensitive data. There remains an urgent need for further work to test these and other potential solutions. PMID:26251507

  14. Dependent rational providers.

    PubMed

    Brothers, Kyle B

    2011-04-01

    Provider claims to conscientious objection have generated a great deal of heated debate in recent years. However, the conflicts that arise when providers make claims to the "conscience" are only a subset of the more fundamental challenges that arise in health care practice when patients and providers come into conflict. In this piece, the author provides an account of patient-provider conflict from within the moral tradition of St. Thomas Aquinas. He argues that the practice of health care providers should be understood as a form of practical reasoning and that this practical reasoning must necessarily incorporate both "moral" and "professional" commitments. In order to understand how the practical reasoning of provider should account for the needs and commitments of the patient and vice versa, he explores the account of dependence provided by Alasdair MacIntyre in his book Dependent Rational Animals. MacIntyre argues that St. Thomas' account of practical reasoning should be extended and adapted to account for the embodied vulnerability of all humans. In light of this insight, providers must view patients not only as the subjects of their moral reflection but also as fellow humans upon whom the provider depends for feedback on the effectiveness and relevance of her practical reasoning. The author argues that this account precludes responsive providers from adopting either moral or professional conclusions on the appropriateness of interventions outside the individual circumstances that arise in particular situations. The adoption of this orientation toward patients will neither eradicate provider-patient conflict nor compel providers to perform interventions to which they object. But this account does require that providers attend meaningfully to the suffering of patients and seek feedback on whether their intervention has effectively addressed that suffering.

  15. Associations of quality of life, pain, and self-reported arthritis with age, employment, bleed rate, and utilization of hemophilia treatment center and health care provider services: results in adults with hemophilia in the HERO study

    PubMed Central

    Forsyth, Angela L; Witkop, Michelle; Lambing, Angela; Garrido, Cesar; Dunn, Spencer; Cooper, David L; Nugent, Diane J

    2015-01-01

    Introduction Severe hemophilia and subsequent hemophilic arthropathy result in joint pain and impaired health-related quality of life (HRQoL). Assessment of HRQoL in persons with hemophilia (PWH), including underlying factors that drive HRQoL differences, is important in determining health care resource allocation and in making individualized clinical decisions. Aim To examine potential associations between HRQoL, pain interference, and self-reported arthritis and age, employment, activity, bleed frequency, and hemophilia treatment center and health care professional utilization. Methods PWH (age ≥18 years) from ten countries completed a 5-point Likert scale on pain interference over the previous 4 weeks, the EQ-5D-3L scale (mobility, usual activities, self-care, pain/discomfort, anxiety/depression) including a health-related visual analog scale (0–100, coded as an 11-point categorical response). Results Pain interference (extreme/a lot) was higher in PWH aged >40 years (31%) compared to those aged 31–40 years (27%) or ≤30 years (21%). In an analysis of eight countries with home treatment, PWH who reported EQ-5D mobility issues were less likely to be employed (53% vs 79%, with no mobility issues). Median annual bleed frequency increased with worsening EQ-5D pain or discomfort. The percentage of PWH with inhibitors reporting visual analog scale scores of 80–90–100 was lower (20%) than those without inhibitors (34%). Median bleed frequency increased with pain. Globally, nurse and social worker involvement increased with disability and pain; physiotherapist utilization was moderate regardless of the extent of disability or pain. Conclusion Increased disability and pain were associated with increased age, lower employment, higher reported bleed frequency, and lower HRQoL. PMID:26604708

  16. What HERA May Provide?

    SciTech Connect

    Jung, Hannes; De Roeck, Albert; Bartels, Jochen; Behnke, Olaf; Blumlein, Johannes; Brodsky, Stanley; Cooper-Sarkar, Amanda; Deak, Michal; Devenish, Robin; Diehl, Markus; Gehrmann, Thomas; Grindhammer, Guenter; Gustafson, Gosta; Khoze, Valery; Knutsson, Albert; Klein, Max; Krauss, Frank; Kutak, Krzysztof; Laenen, Eric; Lonnblad, Leif; Motyka, Leszek; /Hamburg U., Inst. Theor. Phys. II /Birmingham U. /Southern Methodist U. /DESY /Piemonte Orientale U., Novara /CERN /Paris, LPTHE /Hamburg U. /Penn State U.

    2011-11-10

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. The HERA accelerator and the HERA experiments H1, HERMES and ZEUS stopped running in the end of June 2007. This was after 15 years of very successful operation since the first collisions in 1992. A total luminosity of {approx} 500 pb{sup -1} has been accumulated by each of the collider experiments H1 and ZEUS. During the years the increasingly better understood and upgraded detectors and HERA accelerator have contributed significantly to this success. The physics program remains in full swing and plenty of new results were presented at DIS08 which are approaching the anticipated final precision, fulfilling and exceeding the physics plans and the previsions of the upgrade program. Most of the analyses presented at DIS08 were still based on the so called HERA I data sample, i.e. data taken until 2000, before the shutdown for the luminosity upgrade. This sample has an integrated luminosity of {approx} 100 pb{sup -1}, and the four times larger statistics sample from HERA II is still in the process of being analyzed.

  17. Do Recommendations by Healthcare Providers, Family-members, Friends, and Individual Self-Efficacy Increase Uptake of Hepatitis B Screening? Results of a Population-Based Study of Asian Americans

    PubMed Central

    Lu, Xiaoxiao; Juon, Hee-Soon; Lee, Sunmin

    2017-01-01

    Background: Hepatitis B virus (HBV) infection disproportionately affects Asian Americans but HBV screening rates among Asian American are substantially low. This study examines the impact of multiple recommendations and self-efficacy on HBV screening uptake among Asian Americans. Methods: Data for this study were from 872 Chinese, Korean and Vietnamese recruited for a liver cancer prevention program in the Washington D.C – Baltimore metropolitan area. Results: 410 (47%) respondents reported previous HBV screening. Only 19.8% recalled a physician recommendation. Higher level of HBV screening was reported among people who had physician recommendation, family member recommendation or friend recommendation. Perceived self-efficacy was also an important predictor to HBV screening. The effect of self-efficacy was significant in subgroup analyses among Chinese and Korean, but not for Vietnamese. Conclusion and Global Health Implications: The disproportional prevalence of HBV infection among Asian Americans is considered to be one of the most important health disparities for Asian population. Understanding the condition and screening behavior in this population is especially important. Our findings suggest that recommendation from physician and social networks should be encouraged for HBV screening among Asian Americans. Both recommendation and self-efficacy of HBV screening are important psychosocial constructs to be targeted in liver cancer prevention interventions. PMID:28058203

  18. Allogeneic stem cell transplantation provides durable disease control in poor-risk chronic lymphocytic leukemia: long-term clinical and MRD results of the German CLL Study Group CLL3X trial.

    PubMed

    Dreger, Peter; Döhner, Hartmut; Ritgen, Matthias; Böttcher, Sebastian; Busch, Raymonde; Dietrich, Sascha; Bunjes, Donald; Cohen, Sandra; Schubert, Jörg; Hegenbart, Ute; Beelen, Dietrich; Zeis, Matthias; Stadler, Michael; Hasenkamp, Justin; Uharek, Lutz; Scheid, Christof; Humpe, Andreas; Zenz, Thorsten; Winkler, Dirk; Hallek, Michael; Kneba, Michael; Schmitz, Norbert; Stilgenbauer, Stephan

    2010-10-07

    The purpose of this prospective multicenter phase 2 trial was to investigate the long-term outcome of reduced-intensity conditioning allogeneic stem cell transplantation (alloSCT) in patients with poor-risk chronic lymphocytic leukemia. Conditioning was fludarabine/ cyclophosphamide-based. Longitudinal quantitative monitoring of minimal residual disease (MRD) was performed centrally by MRD-flow or real-time quantitative polymerase chain reaction. One hundred eligible patients were enrolled, and 90 patients proceeded to alloSCT. With a median follow-up of 46 months (7-102 months), 4-year nonrelapse mortality, event-free survival (EFS) and overall survival (OS) were 23%, 42%, and 65%, respectively. Of 52 patients with MRD monitoring available, 27 (52%) were alive and MRD negative at 12 months after transplant. Four-year EFS of this subset was 89% with all event-free patients except for 2 being MRD negative at the most recent assessment. EFS was similar for all genetic subsets, including 17p deletion (17p-). In multivariate analyses, uncontrolled disease at alloSCT and in vivo T-cell depletion with alemtuzumab, but not 17p-, previous purine analogue refractoriness, or donor source (human leukocyte antigen-identical siblings or unrelated donors) had an adverse impact on EFS and OS. In conclusion, alloSCT for poor-risk chronic lymphocytic leukemia can result in long-term MRD-negative survival in up to one-half of the patients independent of the underlying genomic risk profile. This trial is registered at http://clinicaltrials.gov as NCT00281983.

  19. Arizona's Application Service Provider.

    ERIC Educational Resources Information Center

    Jordan, Darla

    2002-01-01

    Describes the U.S.'s first statewide K-12 application service provider (ASP). The ASP, implemented by the Arizona School Facilities Board, provides access to productivity, communications, and education software programs from any Internet-enabled device, whether in the classroom or home. (EV)

  20. Is the patient able to watch TV or read the newspaper? A functional semi-structured scale to observe Hemineglect symptoms in Activities of Daily Living (H-ADL).

    PubMed

    Piccardi, L; Magnotti, L; Tanzilli, A; Aloisi, M; Guariglia, P

    2016-01-01

    We developed a functional semi-structured scale to observe Hemineglect symptoms in Activities of Daily Living (H-ADL). The scale could assist clinicians in assessing rehabilitation priorities aimed at correcting any persisting errors or omissions. In addition, the scale could also be used by caregivers to observe patients' progress and improve their participation. Two groups of right brain-damaged patients (25 with hemineglect; 27 without hemineglect) were tested twice: at admission and before discharge from hospital. A control group of healthy individuals matched to patients for age and education and patients' caregivers also participated. Two raters (A; B), experts in neuropsychology, observed patients and healthy individuals using the H-ADL. We found that the H-ADL final scores correlated with the standard hemineglect tests. The three groups differed in performance and differences also emerged between the first and the second assessment, suggesting an improvement due to the remission of hemineglect as a consequence of the treatment. Raters A and B did not differ in their observations, but there were some discrepancies with caregivers' observations. Therefore, although caregivers could help clinicians in detecting persistent hemineglect behaviour, the assessment should be performed by experts in neuropsychology.

  1. Testing Provides Crucial Information

    ERIC Educational Resources Information Center

    Morial, Marc H.

    2015-01-01

    The National Urban League president and CEO Marc H. Morial weighs in on what he sees as the need for continued annual assessments of students, rejecting the course of opting out that has taken hold in some places across America. Assessment data provides students with the opportunity to receive personalized supports and necessary interventions to…

  2. [Providing Effective Behavior Support.

    ERIC Educational Resources Information Center

    SAIL: Technical Assistance Journal, 1996

    1996-01-01

    This theme issue addresses the provision of behavioral support for students with behavior disorders. The first article, "Providing Effective Behavior Support to All Students: Procedures and Processes" (George Sugai), summarizes the literature on the effectiveness of various interventions and offers several models for examining the…

  3. Internet Medline providers.

    PubMed

    Vine, D L; Coady, T R

    1998-01-01

    Each database in this review has features that will appeal to some users. Each provides a credible interface to information available within the Medline database. The major differences are pricing and interface design. In this context, features that cost more and might seem trivial to the occasional searcher may actually save time and money when used by the professional. Internet Grateful Med is free, but Ms. Coady and I agree the availability of only three ANDable search fields is a major functional limitation. PubMed is also free but much more powerful. The command line interface that permits very sophisticated searches requires a commitment that casual users will find intimidating. Ms. Coady did not believe the feedback currently provided during a search was sufficient for sustained professional use. Paper Chase and Knowledge Finder are mature, modestly priced Medline search services. Paper Chase provides a menu-driven interface that is very easy to use, yet permits the user to search virtually all of Medline's data fields. Knowledge Finder emphasizes the use of natural language queries but fully supports more traditional search strategies. The impact of the tradeoff between fuzzy and Boolean strategies offered by Knowledge Finder is unclear and beyond the scope of this review. Additional software must be downloaded to use all of Knowledge Finders' features. Other providers required no software beyond the basic Internet browser, and this requirement prevented Ms. Coady from evaluating Knowledge Finder. Ovid and Silver Platter offer well-designed interfaces that simplify the construction of complex queries. These are clearly services designed for professional users. While pricing eliminates these for casual use, it should be emphasized that Medline citation access is only a portion of the service provided by these high-end vendors. Finally, we should comment that each of the vendors and government-sponsored services provided prompt and useful feedback to e

  4. Achieving Provider Engagement

    PubMed Central

    Greenfield, Geva; Pappas, Yannis; Car, Josip; Majeed, Azeem; Harris, Matthew

    2014-01-01

    The literature on integrated care is limited with respect to practical learning and experience. Although some attention has been paid to organizational processes and structures, not enough is paid to people, relationships, and the importance of these in bringing about integration. Little is known, for example, about provider engagement in the organizational change process, how to obtain and maintain it, and how it is demonstrated in the delivery of integrated care. Based on qualitative data from the evaluation of a large-scale integrated care initiative in London, United Kingdom, we explored the role of provider engagement in effective integration of services. Using thematic analysis, we identified an evolving engagement narrative with three distinct phases: enthusiasm, antipathy, and ambivalence, and argue that health care managers need to be aware of the impact of professional engagement to succeed in advancing the integrated care agenda. PMID:25212855

  5. Providing plastic zone extrusion

    DOEpatents

    Manchiraju, Venkata Kiran; Feng, Zhili; David, Stan A.; Yu, Zhenzhen

    2017-04-11

    Plastic zone extrusion may be provided. First, a compressor may generate frictional heat in stock to place the stock in a plastic zone of the stock. Then, a conveyer may receive the stock in its plastic zone from the compressor and transport the stock in its plastic zone from the compressor. Next, a die may receive the stock in its plastic zone from the conveyer and extrude the stock to form a wire.

  6. Providing Contraception to Adolescents.

    PubMed

    Raidoo, Shandhini; Kaneshiro, Bliss

    2015-12-01

    Adolescents have high rates of unintended pregnancy and face unique reproductive health challenges. Providing confidential contraceptive services to adolescents is important in reducing the rate of unintended pregnancy. Long-acting contraception such as the intrauterine device and contraceptive implant are recommended as first-line contraceptives for adolescents because they are highly effective with few side effects. The use of barrier methods to prevent sexually transmitted infections should be encouraged. Adolescents have limited knowledge of reproductive health and contraceptive options, and their sources of information are often unreliable. Access to contraception is available through a variety of resources that continue to expand.

  7. The Provident Sea

    NASA Astrophysics Data System (ADS)

    Cushing, David H.

    1988-09-01

    The Provident Sea describes the history of fish stock management (including whales and seals). The book traces, on the basis of the original scientific material, the history of the management of "the provident sea" up to recent times when problems of over-exploitation have had dramatic effects upon stocks. The need for management arose mainly from the increasing industrialization of capture. Hence the preindustrial fisheries are covered, in particular the old cod fishery on the Grand Bank and the herring fishery in the North Sea, as an essential background to current problems. The origins of fisheries and whaling science are described, as is the development up to 1965 of the science and institution in fisheries, whaling, and sealing. In the sixties and seventies, certain major fishing nations took a heavy harvest of fish stocks using sophisticated and efficient gathering methods. This in turn led to conflict and one consequence was the "Law of the Sea" conference set up to try and resolve these issues.

  8. Providers target industrial areas

    SciTech Connect

    Vames, S.

    1997-06-11

    Energy customers in California are negotiating new deals now that the California Public Utilities Commission has dropped its plan to gradually phase in energy deregulation. The commission has set January 1, 1998 as the date when most energy consumers in the state will be free to choose their providers. Deals currently under negotiation are mostly long-term electrical supply contracts with entire cities. Initially, the cities most likely to enter such contracts are those that wish to use the prospect of cheap energy to keep existing industry and lure new industry. One such deal has been set in South San Francisco, and industrial suburb of San Francisco with several fine chemicals and biotechnology firms. The city has signed a five-year contract with FirstPoint (Portland, OR) to provide energy and related services for residents, businesses, and industry. But while residential and small business customers expect to see only a 10% drop in their overall bills, industrial customers foresee larger savings because of discounts to large energy users offered by FirstPoint and the city.

  9. 27. Yards north of Branch Avenue Bridge. Providence, Providence Co., ...

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

    27. Yards north of Branch Avenue Bridge. Providence, Providence Co., RI. Sec. 4116, mp 186.25. - Northeast Railroad Corridor, Amtrak route between CT & MA state lines, Providence, Providence County, RI

  10. 28. Yards north of Branch Avenue Bridge. Providence, Providence Co., ...

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

    28. Yards north of Branch Avenue Bridge. Providence, Providence Co., RI. Sec. 4116, mp 186.25. - Northeast Railroad Corridor, Amtrak route between CT & MA state lines, Providence, Providence County, RI

  11. User Evaluation: Summary of the Methodologies and Results for the Alexandria Digital Library, University of California at Santa Barbara.

    ERIC Educational Resources Information Center

    Hill, Linda L.; Dolin, Ron; Frew, James; Kemp, Randall B.; Larsgaard, Mary; Montello, Daniel R.; Rae, Mary-Anna; Simpson, Jason

    1997-01-01

    The collection and services of the Alexandria Digital Library (ADL) at the University of California Santa Barbara focus on geospatial information sources with links to geographic locations. Evaluation studies conducted within the ADL project are described as well as what was learned about user characteristics and reactions to ADL. (Author/AEF)

  12. Ecosystem services provided by bats.

    PubMed

    Kunz, Thomas H; Braun de Torrez, Elizabeth; Bauer, Dana; Lobova, Tatyana; Fleming, Theodore H

    2011-03-01

    Ecosystem services are the benefits obtained from the environment that increase human well-being. Economic valuation is conducted by measuring the human welfare gains or losses that result from changes in the provision of ecosystem services. Bats have long been postulated to play important roles in arthropod suppression, seed dispersal, and pollination; however, only recently have these ecosystem services begun to be thoroughly evaluated. Here, we review the available literature on the ecological and economic impact of ecosystem services provided by bats. We describe dietary preferences, foraging behaviors, adaptations, and phylogenetic histories of insectivorous, frugivorous, and nectarivorous bats worldwide in the context of their respective ecosystem services. For each trophic ensemble, we discuss the consequences of these ecological interactions on both natural and agricultural systems. Throughout this review, we highlight the research needed to fully determine the ecosystem services in question. Finally, we provide a comprehensive overview of economic valuation of ecosystem services. Unfortunately, few studies estimating the economic value of ecosystem services provided by bats have been conducted to date; however, we outline a framework that could be used in future studies to more fully address this question. Consumptive goods provided by bats, such as food and guano, are often exchanged in markets where the market price indicates an economic value. Nonmarket valuation methods can be used to estimate the economic value of nonconsumptive services, including inputs to agricultural production and recreational activities. Information on the ecological and economic value of ecosystem services provided by bats can be used to inform decisions regarding where and when to protect or restore bat populations and associated habitats, as well as to improve public perception of bats.

  13. Validation of the Korean version of the Bayer activities of daily living scale.

    PubMed

    Choi, Seong Hye; Na, Duk L; Lee, Byung Hwa; Kang, Sue J; Ha, Choong-Kun; Han, Seol-Heui; Erzigkeit, Hellmut

    2003-08-01

    The Bayer-activities of daily living (B-ADL) is a brief and internationally applicable ADL instrument which has been validated in three European countries. The B-ADL has been developed to provide a tool for the assessment of functional deficits in performance of every day tasks as they are observed in mild to moderate stages of dementia. The B-ADL has been constructed for use in clinical trials as well as in clinical practice. From an international perspective the major application is the evaluation of treatment effects in clinical studies and the current study was to validate the Korean version of the B-ADL. The B-ADL was administered to a total of 129 subjects with varying degrees of cognitive decline. A substantial cross-sectional correlation between B-ADL and MMSE scores was found. The internal consistency of B-ADL was above 0.98. A factor analysis revealed that a one factor solution accounted for most of the total variance. The B-ADL global score significantly increased as the severity of dementia, assessed by global deterioration scale increased from stage 1 to 5. Test-retest reliabilities of B-ADL global score and each item were very high. All of these results were very similar to those from three European countries except for the proportion of 'non-applicability' in some ADL items. These findings provide evidence that the Korean version of B-ADL can be useful not only for clinical purposes but also for international multicentre studies.

  14. Personal Assistance Providers' Mistreatment of Disabled Adults

    ERIC Educational Resources Information Center

    Oktay, Julianne S.; Tompkins, Catherine J.

    2004-01-01

    This article describes a survey of 84 adults with disabilities who received personal assistance with activities of daily living from family members, informal providers, or agency personnel. Results showed that 30 percent reported mistreatment from their primary provider, and 61 percent reported mistreatment by another provider. Verbal abuse,…

  15. Support Net for Frontline Providers

    DTIC Science & Technology

    2016-03-01

    2-0153 TITLE: SupportNet for Frontline Behavioral Health Providers PRINCIPAL INVESTIGATOR: Dr. Charles Benight CONTRACTING ORGANIZATION: Regents...military behavioral health providers who are continually exposed to extensive traumatic material on an on-going basis. Job burnout and STS potentially...readiness for soldiers. SupportNet aimed to assess the level of secondary trauma and job burnout among military behavioral health providers and to

  16. Family Day Care Provider Handbook

    ERIC Educational Resources Information Center

    New York State Office of Children and Family Services, 2006

    2006-01-01

    Family day care providers are responsible for creating a high-quality program where children have opportunities to grow, learn and thrive. Part of providing high-quality child care includes complying with the family day care regulations from the New York State Office of Children and Family Services (OCFS). This Handbook will help day care…

  17. Choosing a primary care provider

    MedlinePlus

    Family doctor - how to choose one; Primary care provider - how to choose one; Doctor - how to choose a family doctor ... A PCP is your main health care provider in non-emergency ... and teach healthy lifestyle choices Identify and treat common ...

  18. HMO partnering: the provider dilemma.

    PubMed

    Ayers, J; Benson, L; Bonhag, R

    1996-10-01

    While the growth of HMOs has slowed patient visits to doctors, it also has created a deluge of press clippings. On July 16, 1996, three articles on the subject appeared in the Wall Street Journal, front section. The headlines painted a vivid picture of the forces acting on HMOs and providers alike (Figure 1). The articles portended more change for healthcare. The "shake-out," a term applied to industries in serious transformation, brings shedding of excess capacity and loss of jobs and income. Providers, in particular, find themselves in a difficult dilemma. They must not only cut costs as reimbursement drops, but also retain patients with good outcomes and high quality service. Patient retention means keeping the individual patient from switching to another provider and keeping the insurer's group of patients as an authorized provider for that insurer. The relationship between provider and HMO lies at the heart of the provider dilemma. The HMO structure, which shifts financial risk for care, is quickly setting the standard, for healthcare pricing, medical standards, and management practices. Understanding and responding to HMO needs are vital to competitive advantage and survival. The article discusses the inherent dilemma of HMO and provider partnering and suggests provider responses.

  19. Incentives and provider payment methods.

    PubMed

    Barnum, H; Kutzin, J; Saxenian, H

    1995-01-01

    The mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee-for-service, and case-based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low-income countries should avoid complex payment systems requiring higher levels of institutional development.

  20. Digital nerve injuries: epidemiology, results, costs, and impact on daily life.

    PubMed

    Thorsén, Frida; Rosberg, Hans-Eric; Steen Carlsson, Katarina; Dahlin, Lars B

    2012-09-01

    Epidemiology, results of treatment, impact on activity of daily living (ADL), and costs for treatment of digital nerve injuries have not been considered consistently. Case notes of patients of 0-99 years of age living in Malmö municipality, Sweden, who presented with a digital nerve injury and were referred to the Department of Hand Surgery in 1995-2005 were analysed retrospectively. The incidence was 6.2/100 000 inhabitants and year. Most commonly men (75%; median age 29 years) were injured. Isolated nerve injuries and concomitant tendon injuries were equally common. The direct costs (hospital stay, operation, outpatient visits, visits to a nurse and/or a hand therapist) for a concomitant tendon injury was almost double compared with an isolated digital nerve injury (6136 EUR [range, 744-29 689 EUR] vs 2653 EUR [range, 468-6949 EUR]). More than 50% of the patients who worked were injured at work and 79% lost time from work (median 59 days [range 3-337]). Permanent nerve dysfunction for the individual patient with ADL problems and subjective complaints of fumbleness, cold sensitivity, and pain occur in the patients despite surgery. It is concluded that digital nerve injuries, often considered as a minor injury and that affect young people at productive age, cause costs, and disability. Focus should be directed against prevention of the injury and to improve nerve regeneration from different aspects.

  1. Ecosystem services provided by waterbirds.

    PubMed

    Green, Andy J; Elmberg, Johan

    2014-02-01

    Ecosystem services are ecosystem processes that directly or indirectly benefit human well-being. There has been much recent literature identifying different services and the communities and species that provide them. This is a vital first step towards management and maintenance of these services. In this review, we specifically address the waterbirds, which play key functional roles in many aquatic ecosystems, including as predators, herbivores and vectors of seeds, invertebrates and nutrients, although these roles have often been overlooked. Waterbirds can maintain the diversity of other organisms, control pests, be effective bioindicators of ecological conditions, and act as sentinels of potential disease outbreaks. They also provide important provisioning (meat, feathers, eggs, etc.) and cultural services to both indigenous and westernized societies. We identify key gaps in the understanding of ecosystem services provided by waterbirds and areas for future research required to clarify their functional role in ecosystems and the services they provide. We consider how the economic value of these services could be calculated, giving some examples. Such valuation will provide powerful arguments for waterbird conservation.

  2. Ancillary Services Provided from DER

    SciTech Connect

    Campbell, J.B.

    2005-12-21

    Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.

  3. Sensor Network Provides Environmental Data

    NASA Technical Reports Server (NTRS)

    2007-01-01

    The National Biocomputation Center, a joint partnership between the Stanford University School of Medicine's Department of Surgery and NASA's Ames Research Center, is the test bed for much of NASA's research in telemedicine, the remote delivery of medical care. In early 2005, researchers at the National Biocomputation Center formed a spinoff company, Intelesense Technologies, to use the telemedicine sensors to provide integrated global monitoring systems. Intelesense uses the systems to better understand how environments and people are linked, monitor and protect natural resources, predict and adapt to environmental changes, provide for sustainable development, reduce the costs and impacts of natural disasters, and provide an effective and intelligent response to such disasters. Current projects range from protecting the environment to tracking emerging infectious diseases like avian influenza (bird flu) and helping people from around the world connect and interact with each other to better understand their environment and themselves.

  4. Twitter for travel medicine providers.

    PubMed

    Mills, Deborah J; Kohl, Sarah E

    2016-03-01

    Travel medicine practitioners, perhaps more so than medical practitioners working in other areas of medicine, require a constant flow of information to stay up-to-date, and provide best practice information and care to their patients. Many travel medicine providers are unaware of the popularity and potential of the Twitter platform. Twitter use among our travellers, as well as by physicians and health providers, is growing exponentially. There is a rapidly expanding body of published literature on this information tool. This review provides a brief overview of the ways Twitter is being used by health practitioners, the advantages that are peculiar to Twitter as a platform of social media, and how the interested practitioner can get started. Some key points about the dark side of Twitter are highlighted, as well as the potential benefits of using Twitter as a way to disseminate accurate medical information to the public. This article will help readers develop an increased understanding of Twitter as a tool for extracting useful facts and insights from the ever increasing volume of health information.

  5. Mentor Program Provides STEM Options

    ERIC Educational Resources Information Center

    Abdul-alim, Jamaal

    2011-01-01

    The ACE Mentor Program provides early career exposure, mentoring, and scholarships to high school students in an attempt to encourage them to enter one of the three fields that make up the ACE acronym: (1) architecture; (2) construction; and (3) engineering. Founded in 1993 by longtime engineering consultant Charles Thornton, the program is…

  6. Sarcopenia-Related Parameters and Incident Disability in Older Persons: Results From the “Invecchiare in Chianti” Study

    PubMed Central

    Rolland, Yves; Abellan Van Kan, Gabor; Bandinelli, Stefania; Vellas, Bruno; Ferrucci, Luigi

    2015-01-01

    Background. Current operational definitions of sarcopenia are based on algorithms’ simultaneous considering measures of skeletal muscle mass and muscle-specific as well as global function. We hypothesize that quantitative and qualitative sarcopenia-related parameters may not be equally predictive of incident disability, thus presenting different clinical relevance. Methods. Data are from 922 elder adults (mean age = 73.9 years) with no activities of daily living (ADL) impairment recruited in the “Invecchiare in Chianti” study. Incident disability in ≥1 ADL defined the outcome of interest. The specific capacities of following sarcopenia-related parameters at predicting incident ADL disability were compared: residuals of skeletal muscle mass, fat-adjusted residuals of skeletal muscle mass, muscle density, ankle extension strength, ratio ankle extension strength/muscle mass, gait speed, and handgrip strength. Results. During the follow-up (median = 9.1 years), 188 (20.4%) incident ADL disability events were reported. Adjusted models showed that only gait speed was significantly associated with the outcome in both men (per standard deviation [SD] = 0.23 m/s increase, hazard ratio [HR] = 0.46, 95% confidence interval [CI] = 0.33–0.63; p < .001) and women (per SD = 0.24 m/s increase, HR = 0.64, 95% CI = 0.50–0.82; p < .001). In women, the fat-adjusted lean mass residual (per SD = 4.41 increase, HR = 0.79, 95% CI = 0.65–0.96; p = .02) and muscle density (per SD = 3.60 increase, HR = 0.76, 95% CI = 0.61–0.93; p = .01) were the only other parameters that predicted disability. In men, several of the tested variables (except muscle mass measures) reported significant results. Conclusions. Gender strongly influences which sarcopenia-related parameters predict disability. Gait speed was a powerful predictor of disability in both men and women, but its nonmuscle-specific nature should impose caution about its inclusion in definitions of sarcopenia. PMID:25320055

  7. Flexible Cable Providing EMI Shielding

    DTIC Science & Technology

    1999-06-07

    shielding the electronic 25 equipment by enclosing it in shielded rooms and cabinets, filling 1 any gaps therein with conductive gaskets, and also by...are found in U.S. 15 Patent Nos. 4,948,922 and 4,93 7,128 which disclose conductive 16 elastic gaskets used to fill gaps between openings in shielded...matrix binder which is filled with 5 particles of a high permeability iron-based alloy. The 6 conductive property of the matrix binder provides

  8. Huygens provides insights about Titan

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2005-01-01

    Huygens provides insights about Titan Following the Huygens probe's successful 14 January soft landing on Titan, Saturn's largest moon, scientists at a 21 January European Space Agency (ESA) news briefing announced that the moon has Earth-like meteorology and geology, and that there is evidence for liquid methane. Martin Tomasko, principal investigator for the Huygens Descent Imager-Spectral Radiometer, said, ``Geological evidence for precipitation, erosion, mechanical abrasion and other fluvial activity says that the physical processes shaping Titan are much the same as those shaping Earth.''

  9. Data Service Provider Cost Estimation Tool

    NASA Technical Reports Server (NTRS)

    Fontaine, Kathy; Hunolt, Greg; Booth, Arthur L.; Banks, Mel

    2011-01-01

    The Data Service Provider Cost Estimation Tool (CET) and Comparables Database (CDB) package provides to NASA s Earth Science Enterprise (ESE) the ability to estimate the full range of year-by-year lifecycle cost estimates for the implementation and operation of data service providers required by ESE to support its science and applications programs. The CET can make estimates dealing with staffing costs, supplies, facility costs, network services, hardware and maintenance, commercial off-the-shelf (COTS) software licenses, software development and sustaining engineering, and the changes in costs that result from changes in workload. Data Service Providers may be stand-alone or embedded in flight projects, field campaigns, research or applications projects, or other activities. The CET and CDB package employs a cost-estimation-by-analogy approach. It is based on a new, general data service provider reference model that provides a framework for construction of a database by describing existing data service providers that are analogs (or comparables) to planned, new ESE data service providers. The CET implements the staff effort and cost estimation algorithms that access the CDB and generates the lifecycle cost estimate for a new data services provider. This data creates a common basis for an ESE proposal evaluator for considering projected data service provider costs.

  10. LiDAR: Providing structure

    USGS Publications Warehouse

    Vierling, Lee A.; Martinuzzi, Sebastián; Asner, Gregory P.; Stoker, Jason M.; Johnson, Brian R.

    2011-01-01

    Since the days of MacArthur, three-dimensional (3-D) structural information on the environment has fundamentally transformed scientific understanding of ecological phenomena (MacArthur and MacArthur 1961). Early data on ecosystem structure were painstakingly laborious to collect. However, as reviewed and reported in recent volumes of Frontiers(eg Vierling et al. 2008; Asner et al.2011), advances in light detection and ranging (LiDAR) remote-sensing technology provide quantitative and repeatable measurements of 3-D ecosystem structure that enable novel ecological insights at scales ranging from the plot, to the landscape, to the globe. Indeed, annual publication of studies using LiDAR to interpret ecological phenomena increased 17-fold during the past decade, with over 180 new studies appearing in 2010 (ISI Web of Science search conducted on 23 Mar 2011: [{lidar AND ecol*} OR {lidar AND fores*} OR {lidar AND plant*}]).

  11. Actors: From Audience to Provider

    ERIC Educational Resources Information Center

    Charlier, Bernadette

    2011-01-01

    This article describes and analyzes actors' experiences of distance learning systems in a wide variety of cultural and organizational contexts. In line with the project of this special series of issues, results of research, much of which is longitudinal, allow us to suggest answers to the following questions: Who are the actors of distance…

  12. Perspectives from Marketing Internship Providers

    ERIC Educational Resources Information Center

    Swanson, Scott R.; Tomkovick, Chuck

    2011-01-01

    Internship research published in marketing and business education journals primarily examine student perspectives about internships or reports results based on other business disciplines. To more accurately understand how employers perceive marketing interns and internships, 352 managers located in the Midwestern United States were surveyed.…

  13. Environmental standards provide competitive advantage

    SciTech Connect

    Chynoweth, E.; Kirshner, E.

    1993-04-28

    Quality organizations are breaking new ground with the development of international standards for environmental management. These promise to provide the platform for chemical companies wanting to establish their environmental credibility with a global audience. [open quotes]It will be similar to auditing our customers to ISO 9000[close quote], says the environmental manager for a European chemical firm. [open quote]We will only want to deal with people who have got their environmental act together. And we'll be in a better competitive positions[close quote]. The International Organization for Standardization (ISO;Geneva) has set up a taskforce to develop an environmental management standard, which is expected to be completed by the mid-1990s. Observers think the ISO standard will draw heavily on the British Standard Institute's (BSI;London) environmental management standard, BS7750, which will likely be the first system adopted in the world. Published last year, BS7750 has been extensively piloted in the UK (CW, Sept. 30, 1992, p. 62) and is now set to be revised before being offically adopted by BSI. The UK's Chemical Industries Association (CIA;London) is anxious to prevent a proliferation of standards, and its report on BS7750 pilot projects calls for an approach integrating quality, environment, and health and safety. But standard setters, including ISO, appear to be moving in the opposite direction. In the US, the American national Standards Institute (ANSI;Washington) has started work on an environmental management standard.

  14. Vaccine hesitancy and healthcare providers.

    PubMed

    Paterson, Pauline; Meurice, François; Stanberry, Lawrence R; Glismann, Steffen; Rosenthal, Susan L; Larson, Heidi J

    2016-12-20

    While most people vaccinate according to the recommended schedule, this success is challenged by individuals and groups who delay or refuse vaccines. The aim of this article is to review studies on vaccine hesitancy among healthcare providers (HCPs), and the influences of their own vaccine confidence and vaccination behaviour on their vaccination recommendations to others. The search strategy was developed in Medline and then adapted across several multidisciplinary mainstream databases including Embase Classic & Embase, and PschInfo. All foreign language articles were included if the abstract was available in English. A total of 185 articles were included in the literature review. 66% studied the vaccine hesitancy among HCPs, 17% analysed concerns, attitudes and/or behaviour of HCPs towards vaccinating others, and 9% were about evaluating intervention(s). Overall, knowledge about particular vaccines, their efficacy and safety, helped to build HCPs own confidence in vaccines and their willingness to recommend vaccines to others. The importance of societal endorsement and support from colleagues was also reported. In the face of emerging vaccine hesitancy, HCPs still remain the most trusted advisor and influencer of vaccination decisions. The capacity and confidence of HCPs, though, are stretched as they are faced with time constraints, increased workload and limited resources, and often have inadequate information or training support to address parents' questions. Overall, HCPs need more support to manage the quickly evolving vaccine environment as well as changing public, especially those who are reluctant or refuse vaccination. Some recommended strategies included strengthening trust between HCPs, health authorities and policymakers, through more shared involvement in the establishment of vaccine recommendations.

  15. Organizational culture associated with provider satisfaction

    PubMed Central

    Scammon, Debra L.; Tabler, Jennifer; Brunisholz, Kimberly; Gren, Lisa H.; Kim, Jaewhan; Tomoaia-Cotisel, Andrada; Day, Julie; Farrell, Timothy W.; Waitzman, Norman J.; Magill, Michael K.

    2014-01-01

    Objectives Assess 1) provider satisfaction with specific elements of PCMH; 2) clinic organizational cultures; 3) associations between provider satisfaction and clinic culture. Methods Cross sectional study with surveys conducted in 2011 with providers and staff in 10 primary care clinics implementing their version of a PCMH: Care by Design™. Measures included the Organizational Culture Assessment Instrument (OCAI) and the American Medical Group Association provider satisfaction survey. Results Providers were most satisfied with quality of care (M=4.14; scale=1–5) and interactions with patients (M=4.12) and least satisfied with time spent working (M=3.47), paper work (M =3.45) and compensation (M=3.35). Culture profiles differed across clinics with family/clan and hierarchical the most common. Significant correlations (p ≤ 0.05) between provider satisfaction and clinic culture archetypes included: family/clan negatively correlated with administrative work; entrepreneurial positively correlated with the Time Spent Working dimension; market/rational positively correlated with how practices were facing economic and strategic challenges; and hierarchical negatively correlated with Relationships with Staff and Resource dimensions. Discussion Provider satisfaction is an important metric for assessing experiences with features of a PCMH model. Conclusions Identification of clinic-specific culture archetypes and archetype associations with provider satisfaction can help inform practice redesign. Attention to effective methods for changing organizational culture is recommended. PMID:24610184

  16. Do Dogs Provide Information Helpfully?

    PubMed Central

    Piotti, Patrizia; Kaminski, Juliane

    2016-01-01

    Dogs are particularly skilful during communicative interactions with humans. Dogs’ abilities to use human communicative cues in cooperative contexts outcompete those of other species, and might be the result of selection pressures during domestication. Dogs also produce signals to direct the attention of humans towards outside entities, a behaviour often referred to as showing behaviour. This showing behaviour in dogs is thought to be something dogs use intentionally and referentially. However, there is currently no evidence that dogs communicate helpfully, i.e. to inform an ignorant human about a target that is of interest to the human but not to the dog. Communicating with a helpful motive is particularly interesting because it might suggest that dogs understand the human’s goals and need for information. In study 1, we assessed whether dogs would abandon an object that they find interesting in favour of an object useful for their human partner, a random novel distractor, or an empty container. Results showed that it was mainly self-interest that was driving the dogs’ behaviour. The dogs mainly directed their behaviour towards the object they had an interest in, but dogs were more persistent when showing the object relevant to the human, suggesting that to some extent they took the humans interest into account. Another possibility is that dogs’ behaviour was driven by an egocentric motivation to interact with novel targets and that the dogs’ neophila might have masked their helpful tendencies. Therefore, in study 2 the dogs had initial access to both objects, and were expected to indicate only one (relevant or distractor). The human partner interacted with the dog using vocal communication in half of the trials, and remaining silent in the other half. Dogs from both experimental groups, i.e. indicating the relevant object or indicating the distractor, established joint attention with the human. However, the human’s vocal communication and the presence

  17. Chemical analyses of provided samples

    NASA Technical Reports Server (NTRS)

    Becker, Christopher H.

    1993-01-01

    Two batches of samples were received and chemical analysis was performed of the surface and near surface regions of the samples by the surface analysis by laser ionization (SALI) method. The samples included four one-inch optics and several paint samples. The analyses emphasized surface contamination or modification. In these studies, pulsed sputtering by 7 keV Ar+ and primarily single-photon ionization (SPI) by coherent 118 nm radiation (at approximately 5 x 10(exp 5) W/cm(sup 2) were used. For two of the samples, also multiphoton ionization (MPI) at 266 nm (approximately 5 x 10(exp 11) W/cm(sup 2) was used. Most notable among the results was the silicone contamination on Mg2 mirror 28-92, and that the Long Duration Exposure Facility (LDEF) paint sample had been enriched in K and Na and depleted in Zn, Si, B, and organic compounds relative to the control paint.

  18. Long-term Results, Functional Outcomes and Complications after Open Reduction and Internal Fixation of Neglected and Displaced Greater Tuberosity of Humerus Fractures

    PubMed Central

    Amroodi, Morteza Nakhaei; Behshad, Vahid; Motaghi, Paniz

    2016-01-01

    Background: Humerus fractures include 5% to 8% of total fractures. Non-union and delayed union of GT (GT) fractures is uncommon; however they present a challenge to the orthopedic surgeons. Significant controversy surrounds optimal treatment of neglected fractures. The purpose of this article was to perform a comparative study to evaluate the outcomes of open reduction and internal fixation (ORIF) of neglected GT fractures. Methods: We retrospectively evaluated the results of surgical intervention in 12 patients with displaced nonunion of GT fractures who were referred to our center. Before and minimally 25 months after surgery ROM, muscle forces, Constant Shoulder Score (Constant-Murley score) (CSS), Visual Analogue Scale (VAS), Activities of Daily Living (ADL) Score and American Shoulder and Elbow Surgeons (ASES) Score were all recorded. Additionally, the results were compared with undamaged shoulder. Results: Between March 2006 and January 2013, 12 patients underwent surgical intervention and followed for 36.2 months in average. All fractures healed. Anatomic reduction achieved only in 6 cases with no report of avascular necrosis or infection. All ROMs and muscle forces increased significantly (Mean Forward Flexion: 49.16 to 153.3, Mean Internal Rotation: 3 to 9, Mean External Rotation: -5 to 27.5) (P value<0.0001). All functional scores including CSS, VAS, ADL and ASES score improved significantly (Mean VAS: 6.5 to 1.3, Mean CSS: 29.83 to 86, Mean ADL: 6.6 to 27.1,: Mean ASES: 28.6 to 88.9) (P value<0.0001). Conclusion: ORIF for neglected and displaced GT fractures has satisfactory functional outcomes, despite of non-anatomical reduction of the fracture. PMID:27847845

  19. Late results.

    PubMed

    Daly, B D

    1999-08-01

    Pneumonectomy is performed for a number of benign and malignant conditions. It is most commonly performed for lung cancer. Adjuvant and neoadjuvant protocols have increased the number of these operations being performed and the long-term results are improving. Pneumonectomy may also be performed for metastases to lung and for mesothelioma with encouraging results. Some bronchial adenomas require pneumonectomy. Treatment of resistant mycobacteria or the complications of tuberculosis frequently require pneumonectomy. Late bronchopleural fistulae, esophagopleural fistulae, and empyema may occur.

  20. Germany Provides Higher Education without the Frills

    ERIC Educational Resources Information Center

    Labi, Aisha

    2009-01-01

    In Germany, tuition is low because state governments shoulder a much higher percentage of university budgets than in the United States. As a result, most German universities provide far fewer amenities and services, and require their professors to teach longer hours to larger numbers of students than their American counterparts. Because they are…

  1. Promoting wellness of peer providers through coaching.

    PubMed

    Brice, George H; Swarbrick, Margaret A; Gill, Kenneth J

    2014-01-01

    Peer wellness coaching is workforce innovation that empowers individuals with mental and substance use disorders to achieve recovery. This article briefly describes how this approach can help peer providers develop self-care skills to improve job tenure and promote satisfaction. Promising results of this new approach are presented.

  2. Volar locking distal radius plates show better short-term results than other treatment options: A prospective randomised controlled trial

    PubMed Central

    Drobetz, Herwig; Koval, Lidia; Weninger, Patrick; Luscombe, Ruth; Jeffries, Paula; Ehrendorfer, Stefan; Heal, Clare

    2016-01-01

    AIM To compare the outcomes of displaced distal radius fractures treated with volar locking plates and with immediate postoperative mobilisation with the outcomes of these fractures treated with modalities that necessitate 6 wk wrist immobilisation. METHODS A prospective, randomised controlled single-centre trial was conducted with 56 patients who had a displaced radius fracture were randomised to treatment either with a volar locking plate (n = 29), or another treatment modality (n = 27; cast immobilisation with or without wires or external fixator). Outcomes were measured at 12 wk. Functional outcome scores measured were the Patient-Rated Wrist Evaluation (PRWE) Score; Disabilities of the Arm, Shoulder and Hand and activities of daily living (ADLs). Clinical outcomes were wrist range of motion and grip strength. Radiographic parameters were volar inclination and ulnar variance. RESULTS Patients in the volar locking plate group had significantly better PRWE scores, ADL scores, grip strength and range of extension at three months compared with the control group. All radiological parameters were significantly better in the volar locking plate group at 3 mo. CONCLUSION The present study suggests that volar locking plates produced significantly better functional and clinical outcomes at 3 mo compared with other treatment modalities. Anatomical reduction was significantly more likely to be preserved in the plating group. Level of evidence: II. PMID:27795951

  3. Clinical Results of 40 Consecutive Basal Thumb Prostheses and No CRPS Type I After Vitamin C Prophylaxis

    PubMed Central

    Zollinger, Paul E; Ünal, Halil; Ellis, Maarten L; Tuinebreijer, Wim E

    2010-01-01

    Complex regional pain syndrome (CRPS) type I may occur as complication after any type of surgery for basal joint arthritis of the thumb. We investigated prospectively in an ongoing study our results after a fully standardized treatment with a total joint prosthesis under vitamin C prophylaxis. Patients with trapeziometacarpal arthritis stage II or III according to Dell, and no benefit from conservative treatment, were selected to undergo joint replacement with a semi-constrained hydroxyapatite coated prosthesis. First web opening and visual analogue scale (VAS) scores for pain, activities of daily living (ADL) and satisfaction were taken pre and postoperatively. Vitamin C 500 mg daily was started two days prior to surgery during 50 days as prevention for CRPS. Post-operative treatment was functional. We performed 40 implantations for trapeziometacarpal arthritis in 34 patients (mean age 60.8 years; 27 females, 7 males) with a mean follow-up of 44 months. Operations were performed in day care under regional (or general) anesthesia. First web opening increased with 15.4 degrees and there was a significant improvement for pain, ADL and satisfaction as well (p = 0.000). Patient satisfaction was strongly associated with the amount of pain reduction. According to the Veldman and IASP criteria, there were no cases of CRPS. The overall complication rate for this procedure is high. Literature reports 5 cases of CRPS after 38 operations with the same implant (13%). We advise vitamin C as prophylaxis against CRPS in trapeziometacarpal joint replacement. PMID:20224742

  4. Effects of gross motor function and manual function levels on performance-based ADL motor skills of children with spastic cerebral palsy

    PubMed Central

    Park, Myoung-Ok

    2017-01-01

    [Purpose] The purpose of this study was to determine effects of Gross Motor Function Classification System and Manual Ability Classification System levels on performance-based motor skills of children with spastic cerebral palsy. [Subjects and Methods] Twenty-three children with cerebral palsy were included. The Assessment of Motor and Process Skills was used to evaluate performance-based motor skills in daily life. Gross motor function was assessed using Gross Motor Function Classification Systems, and manual function was measured using the Manual Ability Classification System. [Results] Motor skills in daily activities were significantly different on Gross Motor Function Classification System level and Manual Ability Classification System level. According to the results of multiple regression analysis, children categorized as Gross Motor Function Classification System level III scored lower in terms of performance based motor skills than Gross Motor Function Classification System level I children. Also, when analyzed with respect to Manual Ability Classification System level, level II was lower than level I, and level III was lower than level II in terms of performance based motor skills. [Conclusion] The results of this study indicate that performance-based motor skills differ among children categorized based on Gross Motor Function Classification System and Manual Ability Classification System levels of cerebral palsy. PMID:28265171

  5. Effects of gross motor function and manual function levels on performance-based ADL motor skills of children with spastic cerebral palsy.

    PubMed

    Park, Myoung-Ok

    2017-02-01

    [Purpose] The purpose of this study was to determine effects of Gross Motor Function Classification System and Manual Ability Classification System levels on performance-based motor skills of children with spastic cerebral palsy. [Subjects and Methods] Twenty-three children with cerebral palsy were included. The Assessment of Motor and Process Skills was used to evaluate performance-based motor skills in daily life. Gross motor function was assessed using Gross Motor Function Classification Systems, and manual function was measured using the Manual Ability Classification System. [Results] Motor skills in daily activities were significantly different on Gross Motor Function Classification System level and Manual Ability Classification System level. According to the results of multiple regression analysis, children categorized as Gross Motor Function Classification System level III scored lower in terms of performance based motor skills than Gross Motor Function Classification System level I children. Also, when analyzed with respect to Manual Ability Classification System level, level II was lower than level I, and level III was lower than level II in terms of performance based motor skills. [Conclusion] The results of this study indicate that performance-based motor skills differ among children categorized based on Gross Motor Function Classification System and Manual Ability Classification System levels of cerebral palsy.

  6. Research Results

    NASA Astrophysics Data System (ADS)

    2010-10-01

    Relations found between human memories and similar neural patterns Double Star Program Received the IAA Laurels for Team Achievement Award Prof. Piao's Review Paper Published in Nature Arsenic Trioxide Controls the Fate of the PML-RARα Oncoprotein by Directly Binding PML Setdb2 restricts dorsal organizer territory and regulates left-right asymmetry through suppressing fgf8 activity Short-range scattering in quantum dots Single-molecule magnets may find their use in microelectronics β-Arrestin1 Regulates Zebrafish Hematopoiesis through Binding to YY1 and Relieving Polycomb Group Repression Studies shown gene present and absent complementation may contribute to the heterosis of maize Low frequency genetic variation may determine complex diseases Cation-π interaction playing vital roles in the regulation of integrin affinity, signaling, and biological functions Soybean diversity map may provide important basis for breeding Mutations related to Alzheimer's and rare skin disease

  7. Research Results

    NASA Astrophysics Data System (ADS)

    2011-12-01

    Research on Global Carbon Emission and Sequestration NSFC Funded Project Made Significant Progress in Quantum Dynamics Functional Human Blood Protein Obtained from Rice How Giant Pandas Thrive on a Bamboo Diet New Evidence of Interpersonal Violence from 129,000 Years Ago Found in China Aptamer-Mediated Efficient Capture and Release of T Lymphocytes on Nanostructured Surfaces BGI Study Results on Resequencing 50 Accessions of Rice Cast New Light on Molecular Breeding BGI Reports Study Results on Frequent Mutation of Genes Encoding UMPP Components in Kidney Cancer Research on Habitat Shift Promoting Species Diversification

  8. Do guns provide safety? At what cost?

    PubMed

    Narang, Puneet; Paladugu, Anubha; Manda, Sainath Reddy; Smock, William; Gosnay, Cynthia; Lippmann, Steven

    2010-02-01

    Many people feel that having a gun provides greater safety for them and their family. Actually, having a firearm in the home escalates the risk for death or injury, while using it to shoot someone who endangers the household is much less common. The resultant injuries, deaths, emotional turmoil, and/or disabilities lead to greater utilization of health care and legal/police services. Payment for these expenses is provided by higher insurance premiums and tax rates. This financial aspect has become a part of our country's current political concern over firearm ownership rights, gun violence or regulation, health care costs, the economy, and taxes.

  9. Health-related factors correlate with behavior trends in physical activity level in old age: longitudinal results from a population in São Paulo, Brazil

    PubMed Central

    2010-01-01

    Background Physical inactivity in leisure time is common among elderly in Brazil and this finding is particularly alarming considering that this population is greatly affected by chronic diseases. The identification of health factors that influence physical activity level (PAL) will help in the development of strategies for increasing PAL older adults. The current research aimed to identify variables that independently affect behavior trends in PAL over the course of two years among elderly. Methods A survey entitled the Epidoso Project ("Epidemiology of aging") studied 1,667 community-based older individuals in São Paulo city, Brazil over the course of two years. Physical activity level was determined through questions about frequency and duration of physical activities. Body Mass Index was calculated; functional capacity was assessed through the ADL (activities of daily living) scale; cognition was assessed by Mini-Mental State Examination; and mental health was assessed through the Dysthymia Screening. Experiences of falls and fractures were also assessed. Subjects were divided into three groups according to their self-report of Physical Activity Level: a - Regularly Active; b - Insufficiently Active and c - Physically Inactive. Behavior trends in PAL were also measured after two years. Multivariate regression model methodology was used to test associations longitudinally. Results Results from the final model demonstrated that the risk of a not favorable behavior trend in PAL, which included the group who remained physically inactive and the group that displayed decreased PAL, in this cohort of older adults was significantly increased if the individual was female (OR = 2.50; 95% CI = 1.60-3.89; P < 0.01), older (80 y vs. 65 y, OR = 6.29, 95% CI = 2.69-14.67; P < 0.01), dependent on help from others for activities in the ADL scale (moderate-severe = 4-7+ vs. 0 ADLs) (OR = 2.25, 95% CI = 1.20-4.21; P < 0.011) or had experienced a history of falls with

  10. Tevatron results

    SciTech Connect

    Lefevre, R.; /Barcelona, Autonoma U.

    2005-01-01

    Recent results obtained by the CDF and D0 experiments at the Tevatron Run II are presented. A first part is dedicated to QCD physics where inclusive jet production, dijet azimuthal decorrelations and jet shapes measurements are reported. Electroweak physics is then discussed relating measurements of the W and Z bosons productions, of the forward-backward charge asymmetry in W production, of the W width and of the top quarks mass. The extensive Run II exploration program is finally approached reporting about searches for neutral supersymmetric Higgs bosons in multijet events and for sbottom quark from gluino decays.

  11. NASA's EOSDIS: options for data providers

    NASA Astrophysics Data System (ADS)

    Khalsa, Siri J.; Ujhazy, John E.

    1995-12-01

    EOSDIS, the data and information system being developed by NASA to support interdisciplinary earth science research into the 21st century, will do more than manage and distribute data from EOS-era satellites. It will also promote the exchange of data, tools, and research results across disciplinary, agency, and national boundaries. This paper describes the options that data providers will have for interacting with the EOSDIS Core System (ECS), the infrastructure of EOSDIS. The options include: using the ECS advertising service to announce the availability of data at the provider's site; submitting a candidate data set to one of the Distributed Active Archive Centers (DAACs); establishing a data server that will make the data accessible via ECS and establishing Local Information Manager (LIM) which would make the data available for multi-site searches. One additional option is through custom gateway interfaces which would provide access to existing data archives. The gateway, data server, and LIM options require the implementation of ECS code at the provider site to insure proper protocols. The advertisement and ingest options require no part of ECS design to reside at the provider site.

  12. Use of diabetes data management software reports by health care providers, patients with diabetes, and caregivers improves accuracy and efficiency of data analysis and interpretation compared with traditional logbook data: first results of the Accu-Chek Connect Reports Utility and Efficiency Study (ACCRUES).

    PubMed

    Hinnen, Deborah A; Buskirk, Ann; Lyden, Maureen; Amstutz, Linda; Hunter, Tracy; Parkin, Christopher G; Wagner, Robin

    2015-03-01

    We assessed users' proficiency and efficiency in identifying and interpreting self-monitored blood glucose (SMBG), insulin, and carbohydrate intake data using data management software reports compared with standard logbooks. This prospective, self-controlled, randomized study enrolled insulin-treated patients with diabetes (PWDs) (continuous subcutaneous insulin infusion [CSII] and multiple daily insulin injection [MDI] therapy), patient caregivers [CGVs]) and health care providers (HCPs) who were naïve to diabetes data management computer software. Six paired clinical cases (3 CSII, 3 MDI) and associated multiple-choice questions/answers were reviewed by diabetes specialists and presented to participants via a web portal in both software report (SR) and traditional logbook (TL) formats. Participant response time and accuracy were documented and assessed. Participants completed a preference questionnaire at study completion. All participants (54 PWDs, 24 CGVs, 33 HCPs) completed the cases. Participants achieved greater accuracy (assessed by percentage of accurate answers) using the SR versus TL formats: PWDs, 80.3 (13.2)% versus 63.7 (15.0)%, P < .0001; CGVs, 84.6 (8.9)% versus 63.6 (14.4)%, P < .0001; HCPs, 89.5 (8.0)% versus 66.4 (12.3)%, P < .0001. Participants spent less time (minutes) with each case using the SR versus TL formats: PWDs, 8.6 (4.3) versus 19.9 (12.2), P < .0001; CGVs, 7.0 (3.5) versus 15.5 (11.8), P = .0005; HCPs, 6.7 (2.9) versus 16.0 (12.0), P < .0001. The majority of participants preferred using the software reports versus logbook data. Use of the Accu-Chek Connect Online software reports enabled PWDs, CGVs, and HCPs, naïve to diabetes data management software, to identify and utilize key diabetes information with significantly greater accuracy and efficiency compared with traditional logbook information. Use of SRs was preferred over logbooks.

  13. Dynamics of ecosystem services provided by subtropical ...

    EPA Pesticide Factsheets

    The trends in the provision of ecosystem services during restoration and succession of subtropical forests and plantations were quantified, in terms of both receiver and donor values, based on a case study of a 3-step secondary succession series that included a 400-year-old subtropical forest and a 23-year history of growth on 3 subtropical forest plantations in Southeastern China. The ‘People's Republic of China Forestry Standard: Forest Ecosystem Service Valuation Norms’ was revised and applied to quantify the receiver values of ecosystem services, which were then compared with the emergy-based, donor values of the services. The results revealed that the efficiencies of subtropical forests and plantations in providing ecosystem services were 2 orders of magnitude higher than similar services provided by the current China economic system, and these efficiencieskept increasing over the course of succession. As a result, we conclude that afforestation is an efficient way to accelerate both the ability and efficiency of subtropical forests to provide ecosystem services. This paper is significant because it examines the dynamics of the provision of ecosystem services by forests over a succession series that spans 400 years. The paper also examines the rate of increase of services during forest restoration over a period of 23 years. The emergy used in ecosystem services provision is compared to the provision of similar services by economic means in the Chinese e

  14. Ethics and patient-provider communication.

    PubMed

    Marks, Ray; Shive, Steven E

    2008-01-01

    Effective health educator-client communication processes are a prerequisite to the acquisition and appropriate application of new knowledge, to discussions that focus on treatment risks and options, and to the mediation of (a) optimal self-management practices, (b) adherence to health recommendations, (c) client satisfaction, (d) autonomous, responsible decision making, and (e) provision of supportive and helpful advice. But is there room for improvement? To provide more uniform high-quality communications to all citizens and to support the practice principles embedded in the Health Education Code of Ethics, this article outlines results of the related literature, the authors' research, and a specific post hoc analysis of a national sample that strongly suggests that much more needs to be done to ensure health providers effectively communicate health promotion messages without bias in at least five related communication domains.

  15. Reduction of Burnout in Mental Health Care Providers Using the Provider Resilience Mobile Application.

    PubMed

    Wood, Amanda Ernst; Prins, Annabel; Bush, Nigel E; Hsia, Jennifer F; Bourn, Laura E; Earley, Michael D; Walser, Robyn D; Ruzek, Josef

    2017-01-10

    This pilot study examined the usability, acceptability, and effectiveness of a free Provider Resilience (PR) mobile application (app) designed by the National Center for Telehealth and Technology to reduce provider burnout. Outpatient mental health providers (N = 30) used the PR app for 1 month. Participants rated the PR app on the System Usability Scale with an overall score of 79.7, which is in the top quartile for usability. Results of paired sample t tests on the Professional Quality of Life Scale indicated significant decreases on the Burnout (t = 3.65, p < .001) and Compassion Fatigue (t = 4.54, p < .001) subscales. The Provider Resilience app shows promise in reducing burnout and compassion fatigue in mental health care providers.

  16. Does a patient-managed insulin intensification strategy with insulin glargine and insulin glulisine provide similar glycemic control as a physician-managed strategy? Results of the START (Self-Titration With Apidra to Reach Target) Study: a randomized noninferiority trial.

    PubMed

    Harris, Stewart B; Yale, Jean-François; Berard, Lori; Stewart, John; Abbaszadeh, Babak; Webster-Bogaert, Susan; Gerstein, Hertzel C

    2014-01-01

    OBJECTIVE Diabetes self-management is universally regarded as a foundation of diabetes care. We determined whether comparable glycemic control could be achieved by self-titration versus physician titration of a once-daily bolus insulin dose in patients with type 2 diabetes who are unable to achieve optimal glycemia control with a basal insulin. RESEARCH DESIGN AND METHODS Patients with type 2 diabetes, an HbA1c level >7% (53 mmol/mol), and either nocturnal hypoglycemia episodes or an insufficient basal insulin glargine level (with or without oral agents) to achieve a fasting plasma glucose level ≤6 mmol/L (108 mg/dL) were studied. Participants all had bolus insulin glulisine added at breakfast and were allocated to either algorithm-guided patient self-titration or physician titration. The primary outcome was an HbA1c level ≤7% (53 mmol/mol) without severe hypoglycemia. RESULTS After a mean (SD) follow-up of 159.4 days (36.2 days), 28.4% of participants in the self-titration arm vs. 21.2% in the physician titration arm achieved an HbA1c level of ≤7% (53 mmol/mol) without severe hypoglycemia (between-group absolute difference 7.2%; 95% CI -3.2 to 17.7). The lower end of this 95% confidence interval was within the predetermined noninferiority boundary of -5% (P noninferiority = 0.011). CONCLUSIONS In stable patients with type 2 diabetes who are receiving doses of basal insulin glargine who require bolus insulin, a simple bolus insulin patient-managed titration algorithm is as effective as a physician-managed algorithm.

  17. Implementation Challenges and Results

    ERIC Educational Resources Information Center

    Walters, Kirk; Sorensen, Nicholas

    2013-01-01

    This paper describes the implementation of the online and f2f summer algebra courses that were delivered in summers 2011 and 2012. These data will be used to frame the impact results presented in an earlier paper. In particular, the paper will provide a detailed picture of how the online course was structured and the types of supports provided to…

  18. Do burn centers provide juvenile firesetter intervention?

    PubMed

    Ahrns-Klas, Karla S; Wahl, Wendy L; Hemmila, Mark R; Wang, Stewart C

    2012-01-01

    Juvenile firesetting activity accounts for a significant number of annual injuries and property damage, yet there is sparse information on intervention in the burn literature. To quantify juvenile firesetting intervention (JFSI) in burn centers, a 23-question survey was sent to all directors listed in the American Burn Association Burn Care Facilities Directory.Sixty-four out of 112 (57%) surveys were returned. This represents responses from 79% of currently verified burn centers. When queried on interventions provided to a juvenile firesetter admitted to their unit, 38% report having their own JFSI program and 38% refer the child to fire services. Two thirds of units without a JFSI program treat pediatric patients. Units that previously had a JFSI program report lack of staffing and funding as most common reasons for program discontinuation. Almost all (95%) stated that a visual tool demonstrating legal, financial, social, future, and career ramifications associated with juvenile firesetting would be beneficial to their unit. Many burn units that treat pediatric patients do not have JFSI and rely on external programs operated by fire services. Existing JFSI programs vary greatly in structure and method of delivery. Burn centers should be involved in JFSI, and most units would benefit from a new video toolkit to assist in providing appropriate JFSI. Study results highlight a need for burn centers to collaborate on evaluating effectiveness of JFSI programs and providing consistent intervention materials based on outcomes research.

  19. ADVANCED PROTEOMICS AND BIOINFORMATICS TOOLS IN TOXICOLOGY RESEARCH: OVERCOMING CHALLENGES TO PROVIDE SIGNIFICANT RESULTS

    EPA Science Inventory

    This presentation specifically addresses the advantages and limitations of state of the art gel, protein arrays and peptide-based labeling proteomic approaches to assess the effects of a suite of model T4 inhibitors on the thyroid axis of Xenopus laevis.

  20. Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

    ERIC Educational Resources Information Center

    Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.

    2010-01-01

    Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…

  1. Find a Hospice or Palliative Care Provider

    MedlinePlus

    ... Provider Name: Organization Type: Please select Hospice Multi-Location Hospice Provider Palliative Care Provider or Sitemap Contact Us Privacy Informacion en Español Copyright National Hospice and Palliative ...

  2. Teaching Health Care Providers To Provide Spiritual Care: A Pilot Study

    PubMed Central

    Trevino, Kelly M.; Cadge, Wendy; Balboni, Michael J.; Thiel, Mary Martha; Fitchett, George; Gallivan, Kathleen; VanderWeele, Tyler; Balboni, Tracy A.

    2015-01-01

    Abstract Background: Health care providers' lack of education on spiritual care is a significant barrier to the integration of spiritual care into health care services. Objective: The study objective was to describe the training program, Clinical Pastoral Education for Healthcare Providers (CPE-HP) and evaluate its impact on providers' spiritual care skills. Methods: Fifty CPE-HP participants completed self-report surveys at baseline and posttraining measuring frequency of and confidence in providing religious/spiritual (R/S) care. Four domains were assessed: (1) ability and (2) frequency of R/S care provision; (3) comfort using religious language; and (4) confidence in providing R/S care. Results: At baseline, participants rated their ability to provide R/S care and comfort with religious language as “fair.” In the previous two weeks, they reported approximately two R/S patient conversations, initiated R/S conversations less than twice, and prayed with patients less than once. Posttraining participants' reported ability to provide spiritual care increased by 33% (p<0.001). Their comfort using religious language improved by 29% (p<0.001), and frequency of R/S care increased 75% (p<0.001). Participants reported having 61% more (p<0.001) R/S conversations and more frequent prayer with patients (95% increase; p<0.001). Confidence in providing spiritual care improved by 36% overall, by 20% (p<0.001) with religiously concordant patients, and by 43% (p<0.001) with religiously discordant patients. Conclusions: This study suggests that CPE-HP is an effective approach for training health care providers in spiritual care. Dissemination of this training may improve integration of spiritual care into health care, thereby strengthening comprehensive patient-centered care. PMID:25871494

  3. Could magnetic resonance provide in vivo histology?

    PubMed

    Dominietto, Marco; Rudin, Markus

    2014-01-13

    THE DIAGNOSIS OF A SUSPECTED TUMOR LESION FACES TWO BASIC PROBLEMS: detection and identification of the specific type of tumor. Radiological techniques are commonly used for the detection and localization of solid tumors. Prerequisite is a high intrinsic or enhanced contrast between normal and neoplastic tissue. Identification of the tumor type is still based on histological analysis. The result depends critically on the sampling sites, which given the inherent heterogeneity of tumors, constitutes a major limitation. Non-invasive in vivo imaging might overcome this limitation providing comprehensive three-dimensional morphological, physiological, and metabolic information as well as the possibility for longitudinal studies. In this context, magnetic resonance based techniques are quite attractive since offer at the same time high spatial resolution, unique soft tissue contrast, good temporal resolution to study dynamic processes and high chemical specificity. The goal of this paper is to review the role of magnetic resonance techniques in characterizing tumor tissue in vivo both at morphological and physiological levels. The first part of this review covers methods, which provide information on specific aspects of tumor phenotypes, considered as indicators of malignancy. These comprise measurements of the inflammatory status, neo-vascular physiology, acidosis, tumor oxygenation, and metabolism together with tissue morphology. Even if the spatial resolution is not sufficient to characterize the tumor phenotype at a cellular level, this multiparametric information might potentially be used for classification of tumors. The second part discusses mathematical tools, which allow characterizing tissue based on the acquired three-dimensional data set. In particular, methods addressing tumor heterogeneity will be highlighted. Finally, we address the potential and limitation of using MRI as a tool to provide in vivo tissue characterization.

  4. 48 CFR 2945.302 - Providing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Providing facilities. 2945... GOVERNMENT PROPERTY Providing Government Property to Contractors 2945.302 Providing facilities. The HCA is authorized to make the determination to provide facilities to a contractor as prescribed in FAR 45.302-1(a)(4)....

  5. Dental practice satisfaction with preferred provider organizations

    PubMed Central

    Aseltine, Robert H; Reisine, Susan; Schilling, Elizabeth A; Kennedy, James

    2007-01-01

    Background Despite their increasing share of the dental insurance market, little is known about dental practices' satisfaction with preferred provider organizations (PPOs). This analysis examined practice satisfaction with dental PPOs and the extent to which satisfaction was a function of communications from the plan, claims handling and compensation. Methods Data were collected through telephone surveys with dental practices affiliated with MetLife between January 2002 and December 2004. Each respondent was asked a series of questions related to their satisfaction with a systematically selected PPO with which they were affiliated. Six different PPO plans had sufficient observations to allow for comparative analysis (total n = 4582). Multiple imputation procedures were used to adjust for item non-response. Results While the average level of overall satisfaction with the target plan fell between "very satisfied" and "satisfied," regression models revealed substantial differences in overall satisfaction across the 6 PPOs (p < .05). Statistically significant differences between plans in overall satisfaction were largely explained by differences in the perceived adequacy of compensation. However, differences in overall satisfaction involving two of the PPOs were also driven by satisfaction with claims handling. Conclusion Results demonstrate the importance of compensation to dental practice satisfaction with PPOs. However, these results also highlight the critical role of service-related factors in differentiating plans and suggest that there are important non-monetary dimensions of PPO performance that can be used to recruit and retain practices. PMID:18005426

  6. Building a safe care-providing robot.

    PubMed

    Fotoohi, Leila; Gräser, Axel

    2011-01-01

    A service robot especially a care-providing robot, works in the vicinity of a human body and is sometimes even in direct contact with it. Conventional safety methods and precautions in industrial robotics are not applicable to such robots. This paper presents a safety approach for designing the safe care-providing robot FRIEND. The approach is applied in each step of design iteratively to identify and assess the potential hazards during design. The steps are explained briefly in this work. The main contribution of this paper is verification of safety requirements using the Ramadge-Wonham (RW) framework. The greater complexity of the tasks the robot will perform, the more complex is the identification of safety requirements. Use of this framework led us to analyze the requirements and verify them formally, systematically and on a modular basis. In our approach human-robot interaction (HRI) is also modeled by a set of uncontrolled events that may happen any time during operation. Subsequently the safety requirements are modified to consider these interactions. As a result the safety module behaves like a controller, running in parallel with the system, which maintains the system safe and works according to the safety requirements by enabling the admissible sequences of events.

  7. NAP (davunetide) provides functional and structural neuroprotection.

    PubMed

    Gozes, Illana

    2011-01-01

    NAP (davunetide) is an eight amino acid peptide (NAPVSIPQ) that has been shown to provide potent neuroprotection, in vitro and in vivo. In human clinical trials, NAP has been shown to increase memory scores in patients suffering from amnestic mild cognitive impairment, a precursor to Alzheimer's disease and to enhance functional daily behaviors in schizophrenia patients. NAP is derived from activity-dependent neuroprotective protein (ADNP) a molecule that is essential for brain formation, interacting with chromatin associated protein alpha and the chromatin remodeling complex SWI/SNF and regulating >400 genes during embryonic development. Partial loss in ADNP results in cognitive deficits and pathology of the microtubule associated protein tau (tauopathy) that is ameliorated in part by NAP replacement therapy. Recent studies increased the scope of NAP neuroprotection and provided further insights into the NAP mechanisms of action. Thus, it has been hypothesized that the presence of tau on axonal microtubules renders them notably less sensitive to the microtubule-severing protein katanin, and NAP was shown to protect microtubules from katanin disruption in the face of reduced tau expression. Parallel studies showed that NAP reduced the number of apoptotic neurons through activation of PI-3K/Akt pathway in the cortical plate or both PI-3K/Akt and MAPK/MEK1 kinases in the white matter. The interaction of these disparate yet complementary pathways is the subject of future studies toward human brain neuroprotection in the clinical scenario.

  8. Health Care Providers' Perception of Their Competence in Providing Spiritual Care for Patients

    PubMed Central

    Ebrahimi, Hossein; Areshtanab, Hossein Namdar; Jafarabadi, Mohammad Asghari; Khanmiri, Soraya Golipoor

    2017-01-01

    Background: Spiritual care is an important part of health-care provision. Spiritual care can improve patients' health. One of the requirements for providing appropriate spiritual care for patients is having the required competence. Aim: This study was conducted to investigate the perception of health-care providers of their own competence in providing spiritual cares for patients hospitalized in medical-educational centers of Iran. Subjects and Methods: This study is a cross-sectional, analytical research conducted on 555 nurses of medical-educational centers in Tabriz, Iran, in 2014. Data were collected using a two-part questionnaire including demographic information and the spiritual care competence scale. Data analysis was performed using descriptive (frequency, percentage, mean, and standard deviation) and inferential (independent t-test, Pearson, Spearman, ANOVA with Tukey test) statistics in SPSS software version 13. Results: Results showed that the mean score for nurses' perception of their competence in providing spiritual care for patients was average, that is, 95.2 ± 14.4. Mean score of nurses' perception of their competence in providing spiritual care in each aspect was significantly higher than average (P < 0.05). The highest score was related to individual support and consulting with patients, that is, 21.1 (4.0), and the lowest score was related to reference to experts, that is, 9.5 (2.3). The type of employment and participation in workshops had significant relationships with nurses' perception of their competence for providing spiritual care (P < 0.05). Conclusion: The findings indicate that authorities and policymakers should take steps in planning for nurses' training for promoting their competence in providing spiritual care for patients; therefore, holding workshops is necessary. PMID:28216864

  9. Multicultural Nursing: Providing Better Employee Care.

    PubMed

    Rittle, Chad

    2015-12-01

    Living in an increasingly multicultural society, nurses are regularly required to care for employees from a variety of cultural backgrounds. An awareness of cultural differences focuses occupational health nurses on those differences and results in better employee care. This article explores the concept of culturally competent employee care, some of the non-verbal communication cues among cultural groups, models associated with completing a cultural assessment, and how health disparities in the workplace can affect delivery of employee care. Self-evaluation of the occupational health nurse for personal preferences and biases is also discussed. Development of cultural competency is a process, and occupational health nurses must develop these skills. By developing cultural competence, occupational health nurses can conduct complete cultural assessments, facilitate better communication with employees from a variety of cultural backgrounds, and improve employee health and compliance with care regimens. Tips and guidelines for facilitating communication between occupational health nurses and employees are also provided.

  10. Providing better indoor environmental quality brings economicbenefits

    SciTech Connect

    Fisk, William; Seppanen, Olli

    2007-06-01

    This paper summarizes the current scientific evidence that improved indoor environmental quality can improve work performance and health. The review indicates that work and school work performance is affected by indoor temperature and ventilation rate. Pollutant source removal can sometimes improve work performance. Based on formal statistical analyses of existing research results, quantitative relationships are provided for the linkages of work performance with indoor temperature and outdoor air ventilation rate. The review also indicates that improved health and related financial savings are obtainable from reduced indoor tobacco smoking, prevention and remediation of building dampness, and increased ventilation. Example cost-benefit analyses indicate that many measures to improve indoor temperature control and increase ventilation rates will be highly cost effective, with benefit-cost ratios as high as 80 and annual economic benefits as high as $700 per person.

  11. Role of patient treatment beliefs and provider characteristics in establishing patient–provider relationships

    PubMed Central

    Lee King, Patricia A; Cederbaum, Julie A; Kurzban, Seth; Norton, Timothy; Palmer, Steven C; Coyne, James C

    2015-01-01

    Background. Positive patient–provider relationships have been associated with improved depression treatment outcomes. Little is known about how patient treatment beliefs influence patient–provider relationships, specifically treatment alliance and shared decision making in primary care (PC). Objective. We evaluated the relationship between patient treatment beliefs and patient–provider relationships by gender, race and current depression. Methods. We used a deductive parallel convergent mixed method design with cross-sectional data. Participants were 227 Black and White patients presenting with depression symptoms in PC settings. Individuals were randomized into either a quantitative survey (n = 198) or qualitative interview (n = 29) group. We used multiple ordinary least squares regression to evaluate the association between patient beliefs, as measured by the Treatment Beliefs Scale and the Medication Beliefs Scale, and treatment alliance or shared decision making. We concurrently conducted thematic analyses of qualitative semistructured interview data to explicate the nature of patient–provider relationships. Results. We found that patients who believed their provider would respectfully facilitate depression treatment reported greater bond, openness and shared decision making with their provider. We also identified qualitative themes of physicians listening to, caring about and respecting patients. Empathy and emotive expression increased patient trust in PC providers as facilitators of depression treatment. Conclusions. This work systematically demonstrated what many providers anecdotally believe: PC environments in which individuals feel safe sharing psychological distress are essential to early identification and treatment of depression. Interprofessional skills-based training in attentiveness and active listening may influence the effectiveness of depression intervention. PMID:25556196

  12. How Do Health Care Providers Diagnose Hypoparathyroidism?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose hypoparathyroidism? Skip sharing on social media links Share this: Page Content A health care provider will order a blood test to determine ...

  13. How Do Health Care Providers Diagnose Pheochromocytoma?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose pheochromocytoma? Skip sharing on social media links Share this: Page Content A health care provider uses blood and urine tests that measure ...

  14. How Do Health Care Providers Diagnose Endometriosis?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose endometriosis? Skip sharing on social media ... under a microscope, to confirm the diagnosis. 1 Health care providers may also use imaging methods to produce ...

  15. How Do Health Care Providers Diagnose Vaginitis?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose vaginitis? Skip sharing on social media ... out the cause of a woman's symptoms, her health care provider will Examine the vagina, the vulva, and ...

  16. Discussing Diabetes with Your Healthcare Provider

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Diabetes Discussing Diabetes with Your Healthcare Provider Past Issues / Fall 2009 Table of Contents Diabetes Medicines—Always Discuss Them with Your Healthcare Provider ...

  17. Provider Expectations for Recovery Scale: Refining a measure of provider attitudes

    PubMed Central

    Salyers, Michelle P.; Brennan, Madeline; Kean, Jacob

    2014-01-01

    Objective The purpose of this study was to refine and test the psychometric properties of a scale to measure provider attitudes about recovery. Methods This was a secondary data analysis that combined survey data from 1,128 mental health providers from 3 state hospitals, 6 community mental health centers, and 1 VA Medical Center. Rasch analyses were used to examine item-level functioning to reduce the scale to a briefer, unidimensional construct. Convergent validity was assessed through correlations with related measures. Results The Provider Expectations for Recovery scale had strong internal consistency, was related to education and setting in expected ways, and was associated with lower levels of burnout and higher levels of job satisfaction. Conclusions and Implications for Practice A 10-item scale of Provider Expectations for Recovery appears to be a useful tool to measure an important construct in recovery-oriented care. The process of refining the measure also highlights potential factors in how providers view recovery. PMID:23834613

  18. 75 FR 48273 - Technical Service Provider Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ... provisions by expanding the definition Technical Service Provider Assistance, which contained an error in the omission of ``Indian Tribe'' in the definition of Technical Service Provider. DATES: Effective Date: This... page 6846, in the third column, the Technical Service Provider definition reads ``Technical...

  19. Co-providing: understanding the logistics.

    PubMed

    Dickerson, Pamela S

    2011-11-01

    Continuing nursing education providers have sometimes said that they don't want to co-provide because "it's too much trouble" or they "won't be able to control what happens" or because they don't understand the process. This column clarifies the logistics of the co-provider relationship.

  20. 5 CFR 890.910 - Provider information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Provider information. 890.910 Section 890.910 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS..., and FEHB Benefit Payments § 890.910 Provider information. The hospital provider information used...

  1. 48 CFR 445.302 - Providing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Providing facilities. 445.302 Section 445.302 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE CONTRACT MANAGEMENT GOVERNMENT PROPERTY Providing Government Property to Contractors 445.302 Providing facilities....

  2. 48 CFR 645.302 - Providing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Providing facilities. 645.302 Section 645.302 Federal Acquisition Regulations System DEPARTMENT OF STATE CONTRACT MANAGEMENT GOVERNMENT PROPERTY Providing Government Property to Contractors 645.302 Providing facilities....

  3. Group Family Day Care Provider Handbook

    ERIC Educational Resources Information Center

    New York State Office of Children and Family Services, 2006

    2006-01-01

    Group family day care providers need to create high-quality programs where children have opportunities to grow, learn and thrive. Part of providing high-quality child care includes complying with the group family day care regulations from the New York State Office of Children and Family Services (OCFS). This Handbook will help day care providers:…

  4. 78 FR 14034 - Health Insurance Providers Fee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-04

    ... Internal Revenue Service 26 CFR Part 57 RIN 1545-BL20 Health Insurance Providers Fee AGENCY: Internal... covered entities engaged in the business of providing health insurance for United States health risks... regulations affect persons engaged in the business of providing health insurance for United States...

  5. Suspension System Provides Independent Translation And Rotation

    NASA Technical Reports Server (NTRS)

    Heeg, Jennifer

    1994-01-01

    Spring suspension provides one translational and one rotational degree of freedom. Suspension used to provide for pitching and plunging movements of airfoil in wind tunnel. Translational freedom provided by two thin, flat steel spring tines, clamped at one end to stationary block fixed to ceiling of wind tunnel, and clamped to movable block at other end.

  6. Access to Dental Providers in Pennsylvania

    PubMed Central

    Baird, Matthew D.; Baird, Michelle K.; Vesely, Joseph V.

    2016-01-01

    Abstract Ensuring access to dental care, particularly for children, is a significant policy concern in the United States. Many factors affect access on both the provider and patient sides. This study examines an important factor in the ability to access dental care: the distribution and availability of dental health providers. The authors assess providers across the counties of Pennsylvania, primarily using data from the 2013 Survey of Dentists and Dental Hygienists administered by the Pennsylvania Department of Health. To identify possible dental provider shortages in Pennsylvania counties, the authors assessed ten indicators of access to dental providers. They find significant variation in the indicators across Pennsylvania counties. PMID:28083429

  7. Moral Distress in Pediatric Healthcare Providers.

    PubMed

    Trotochaud, Karen; Coleman, Joyce Ramsey; Krawiecki, Nicolas; McCracken, Courtney

    2015-01-01

    Pediatric providers across professions and clinical settings experience moral distress. Higher moral distress correlates with intent to leave for all professionals. Physicians as professional group had the highest moral distress. Intensive care nurses had the highest moral distress for nurses. While all providers describe distressing scenarios as disturbing, physicians report situations as occurring more frequently. The most distressing situations include requests for aggressive treatments not in child's best interest, poor team communication and lack of provider continuity. Understanding moral distress as experienced by all pediatric providers is needed to create interventions with a goal of reducing provider turnover.

  8. The ethics of providing hope in psychotherapy.

    PubMed

    Dembo, Justine Sarah; Clemens, Norman A

    2013-07-01

    The instillation of hope is a common factor in most psychotherapies. A considerable literature exists on the ethics of providing false or positively biased hope in non-psychiatric medical settings, and ethicists have generally concluded that this practice is unethical. However, the literature on the ethics of encouraging hope in psychotherapy, especially in the case of treatment-resistant mental illness, is sparse. The author explores two clinical cases with the intention of examining the nature of hope, false hope, positive illusions, and denial, as they relate to our definitions of mental health and psychotherapy. The cases highlight the ethics of balancing an acknowledgment of likely treatment futility with a desire to hope. Clinical psychological studies on depressive realism and optimistic bias indicate that some degree of positive bias, referred to by some authors as "the optimal margin of illusion," is in fact necessary to promote what we define as "good mental health;" conversely, stark realism is correlated with mild to moderate depression. An examination of the existential literature, including Ernest Becker's work, The Denial of Death, indicates that without the defense mechanism of denial, human beings tend to experience paralytic despair as a result of being fallible, mortal creatures in a frightening world. The combination of these diverse bodies of literature, along with the surprising outcomes of our case examples, leads to an unexpected conclusion: it may occasionally be ethical to encourage some degree of optimistic bias, and perhaps even positive illusion, when treating patients in psychotherapy.

  9. Providing primary standard calibrations beyond 20 MHz

    NASA Astrophysics Data System (ADS)

    Bickley, C. J.; Zeqiri, B.; Robinson, S. P.

    2004-01-01

    The number of applications of medical ultrasound utilising frequencies in excess of 20 MHz has shown a consistent increase over recent years. Coupled with the commercial availability of wide-bandwidth hydrophones whose response extends beyond 40 MHz, this has driven a growing need to develop hydrophone calibration techniques at elevated frequencies. The current National Physical Laboratory primary standard method of calibrating hydrophones is based on an optical interferometer. This has been in operation for around 20 years and provides traceability over the frequency range of 0.3 to 20 MHz. More recently, calibrations carried out using the interferometer have been extended to 60 MHz, although the uncertainties associated with these calibrations are poor, being in excess of +/-20% at high frequencies. Major contributions to the degraded calibration uncertainties arise from poor signal-to-noise at higher frequencies, the frequency response of the photodiodes used and the noise floor of the instrument. To improve the uncertainty of hydrophone calibrations above 20 MHz, it has been necessary to build and commission a new interferometer. Important features of the new primary standard are its use of a higher power laser to improve the signal-to-noise ratio, along with photodiodes whose greater bandwidth to improve the overall frequency response. This paper describes the design of key aspects of the new interferometer. It also presents some initial results of the performance assessment, including a detailed comparison of calibrations of NPL reference membrane hydrophones, undertaken using old and new interferometers for calibration up to 40 MHz.

  10. Providing R-Tree Support for Mongodb

    NASA Astrophysics Data System (ADS)

    Xiang, Longgang; Shao, Xiaotian; Wang, Dehao

    2016-06-01

    Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB's features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  11. Provider documentation of patient education: a lean investigation*

    PubMed Central

    Shipman, Jean P.; Lake, Erica W.; Van Der Volgen, Jessica; Doman, Darrin

    2016-01-01

    Purpose The study evaluates how providers give patient education materials and identifies improvements to comply with Meaningful Use (MU) requirements. Methods Thirty-eight patient-provider interactions in two health care outpatient clinics were observed. Results Providers do not uniformly know MU patient education requirements. Providers have individual preferences and find gaps in what is available. Accessing and documenting patient education varies among providers. Embedded electronic health record (EHR) materials, while available, have technical access barriers. Conclusions Providers' EHR skills and knowledge levels contribute to non-standardized patient education delivery. PMID:27076805

  12. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider qualifications. For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional may provide the services. “Registered dietitian or nutrition professional” means an individual who, on...

  13. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider qualifications. For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional may provide the services. “Registered dietitian or nutrition professional” means an individual who, on...

  14. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider qualifications. For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional may provide the services. “Registered dietitian or nutrition professional” means an individual who, on...

  15. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider qualifications. For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional may provide the services. “Registered dietitian or nutrition professional” means an individual who, on...

  16. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider qualifications. For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional may provide the services. “Registered dietitian or nutrition professional” means an individual who, on...

  17. Learning Providers' Work with Neet Young People

    ERIC Educational Resources Information Center

    Beck, Vanessa

    2015-01-01

    This article investigates the impact of the relationship between learning providers and young people who have experienced Not being in Education, Employment or Training (NEET) on the latters' agency development. Agency is defined as not only bounded but generated by intra-action with relations of force, including learning providers themselves.…

  18. Providing Culturally Sensitive Care for Transgender Patients

    ERIC Educational Resources Information Center

    Maguen, Shira; Shipherd, Jillian C.; Harris, Holly N.

    2005-01-01

    Culturally sensitive information is crucial for providing appropriate care to any minority population. This article provides an overview of important issues to consider when working with transgender patients, including clarification of transgender terminology, diagnosis issues, identity development, and appropriate pronoun use. We also review…

  19. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

    This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

  20. 78 FR 71476 - Health Insurance Providers Fee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ... Internal Revenue Service 26 CFR Parts 57 and 602 RIN 1545-BL20 Health Insurance Providers Fee AGENCY... health insurance for United States health risks. This fee is imposed by section 9010 of the Patient... providing health insurance for United States health risks. DATES: Effective date: These regulations...

  1. Browsing for the Best Internet Access Provider?

    ERIC Educational Resources Information Center

    Weil, Marty

    1996-01-01

    Highlights points to consider when choosing an Internet Service Provider. Serial Line Internet Protocol (SLIP) and Point to Point Protocol (PPP) are compared regarding price, performance, bandwidth, speed, and technical support. Obtaining access via local, national, consumer online, and telephone-company providers is discussed. A pricing chart and…

  2. 12 Steps to Provide Accessible Programs.

    ERIC Educational Resources Information Center

    Hasbrouck, JoAnn

    1993-01-01

    College compliance with the Americans with Disabilities of Act of 1990 means including a statement about disabilities in publications, providing transportation for off-campus trips, eliminating physical barriers, providing nonvoice terminal telephones, using captioned films, having assistive listening devices, reserving designated seating,…

  3. Ecosystem Services Provided by Stream Fishes

    EPA Science Inventory

    Stream fish provide important services to people, including recreation and food, regulation of ecosystem processes, and aesthetic benefits. If the services provided by fish in different streams can be measured, then they can be valued and considered in restoration decisions. We...

  4. Identifying Mentors' Observations for Providing Feedback

    ERIC Educational Resources Information Center

    Hudson, Peter

    2016-01-01

    Mentors' feedback can assist preservice teachers' development; yet feedback tends to be variable from one mentor to the next. What do mentors observe for providing feedback? In this study, 24 mentors observed a final-year preservice teacher through a professionally video-recorded lesson and provided written notes for feedback. They observed the…

  5. 48 CFR 5145.303 - Providing material.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Providing material. 5145... REGULATIONS GOVERNMENT PROPERTY 5145.303 Providing material. (S-90) Existing Government material on hand or... contractors if it is determined to be in the best interest of the Government per FAR 45.303-1. If the...

  6. 48 CFR 5145.303 - Providing material.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Providing material. 5145... REGULATIONS GOVERNMENT PROPERTY 5145.303 Providing material. (S-90) Existing Government material on hand or... contractors if it is determined to be in the best interest of the Government per FAR 45.303-1. If the...

  7. 48 CFR 5145.303 - Providing material.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Providing material. 5145... REGULATIONS GOVERNMENT PROPERTY 5145.303 Providing material. (S-90) Existing Government material on hand or... contractors if it is determined to be in the best interest of the Government per FAR 45.303-1. If the...

  8. 42 CFR 438.214 - Provider selection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Structure and... providers excluded from participation in Federal health care programs under either section 1128 or section... 42 Public Health 4 2010-10-01 2010-10-01 false Provider selection. 438.214 Section 438.214...

  9. A Statewide Evaluation of Services Provided to Rape Survivors

    ERIC Educational Resources Information Center

    Wasco, Sharon M.; Campbell, Rebecca; Howard, April; Mason, Gillian E.; Staggs, Susan L.; Schewe, Paul A.; Riger, Stephanie

    2004-01-01

    This article presents the descriptive results of a statewide evaluation of hotline, advocacy, and counseling services provided to sexual assault victims in Illinois. Collaborative efforts of a multidisciplinary research team and sexual assault service providers resulted in victim-sensitive evaluation measures and data that reflect, for the first…

  10. Health service providers in Somalia: their readiness to provide malaria case-management

    PubMed Central

    Noor, Abdisalan M; Rage, Ismail A; Moonen, Bruno; Snow, Robert W

    2009-01-01

    Background Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Methods Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. Results There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT) or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53.1% prescribed chloroquine as first

  11. Price transparency for MRIs increased use of less costly providers and triggered provider competition.

    PubMed

    Wu, Sze-jung; Sylwestrzak, Gosia; Shah, Christiane; DeVries, Andrea

    2014-08-01

    To encourage patients to select high-value providers, an insurer-initiated price transparency program that focused on elective advanced imaging procedures was implemented. Patients having at least one outpatient magnetic resonance imaging (MRI) scan in 2010 or 2012 were divided according to their membership in commercial health plans participating in the program (the intervention group) or in nonparticipating commercial health plans (the reference group) in similar US geographic regions. Patients in the intervention group were informed of price differences among available MRI facilities and given the option of selecting different providers. For those patients, the program resulted in a $220 cost reduction (18.7 percent) per test and a decrease in use of hospital-based facilities from 53 percent in 2010 to 45 percent in 2012. Price variation between hospital and nonhospital facilities for the intervention group was reduced by 30 percent after implementation. Nonparticipating members residing in intervention areas also observed price reductions, which indicates increased price competition among providers. The program significantly reduced imaging costs. This suggests that patients select lower-price facilities when informed about available alternatives.

  12. New Zika Vaccine Candidate Provides Powerful Protection

    MedlinePlus

    ... medlineplus.gov/news/fullstory_163384.html New Zika Vaccine Candidate Provides Powerful Protection Made without live virus, ... News) -- A single dose of an experimental Zika vaccine protected mice and monkeys from the virus, researchers ...

  13. Soil chemical insights provided through vibrational spectroscopy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vibrational spectroscopy techniques provide a powerful approach to study environmental materials and processes. These multifunctional analysis tools can be used to probe molecular vibrations of solid, liquid, and gaseous samples for characterizing materials, elucidating reaction mechanisms, and exam...

  14. Portable lightweight cell provides controlled environment

    NASA Technical Reports Server (NTRS)

    Shelton, S.; Tarr, J.

    1966-01-01

    Inflatable, lightweight cell provides a separate, secondary environment for a spacesuited man in case of spacesuit damage or malfunction. The cell has a pressure-sealing zipper and is equipped to maintain a livable atmosphere.

  15. NASA Provides Assistance to Trapped Chilean Miners

    NASA Video Gallery

    Responding to a request received through the U.S. Department of State from the Chilean minister of health, NASA will provide advice in nutritional and behavioral sciences to assist miners trapped a...

  16. Concrete "Waffle" Provides Laser Beam Accuracy

    ERIC Educational Resources Information Center

    Building Design and Construction, 1978

    1978-01-01

    A massive concrete "waffle," riding on a bed of specially treated gravel and sand inside another building, provides the structural rigidity needed by the University of Rochester's Laboratory for Laser Energetics. (Author)

  17. Research and Practice Communications Between Oral Health Providers and Prenatal Health Providers: A Bibliometric Analysis.

    PubMed

    Skvoretz, John; Dyer, Karen; Daley, Ellen; Debate, Rita; Vamos, Cheryl; Kline, Nolan; Thompson, Erika

    2016-08-01

    Objectives We aimed to examine scholarly collaboration between oral health and prenatal providers. Oral disease is a silent epidemic with significant public health implications for pregnant women. Evidence linking poor oral health during pregnancy to adverse pregnancy and birth outcomes requires oral health and prenatal providers to communicate on the prevention, treatment and co-management matters pertaining to oral health issues among their pregnant patients. The need for inter-professional collaboration is highlighted by guidelines co-endorsed by the American College of Obstetricians and Gynecologists and the American Dental Association, stressing the importance of oral health care during pregnancy. Methods To assess if interdisciplinary communication occurs between oral health and prenatal disciplines, we conducted a network analysis of research on pregnancy-related periodontal disease. Results Social Network analysis allowed us to identify communication patterns between communities of oral health and prenatal professionals via scientific journals. Analysis of networks of citations linking journals in different fields reveals a core-periphery pattern dominated by oral health journals with some participation from medicine journals. However, an analysis of dyadic ties of citation reveals statistically significant "inbreeding" tendencies in the citation patterns: both medical and oral health journals tend to cite their own kind at greater-than-chance levels. Conclusions Despite evidence suggesting that professional collaboration benefits patients' overall health, findings from this research imply that little collaboration occurs between these two professional groups. More collaboration may be useful in addressing women's oral-systemic health concerns that result in adverse pregnancy outcomes.

  18. Teaching antenatal counseling skills to neonatal providers.

    PubMed

    Stokes, Theophil A; Watson, Katie L; Boss, Renee D

    2014-02-01

    Counseling a family confronted with the birth of a periviable neonate is one of the most difficult tasks that a neonatologist must perform. The neonatologist's goal is to facilitate an informed, collaborative decision about whether life-sustaining therapies are in the best interest of this baby. Neonatologists are trained to provide families with a detailed account of the morbidity and mortality data they believe are necessary to facilitate a truly informed decision. Yet these complicated and intensely emotional conversations require advanced communication and counseling skills that our current fellowship-training strategies are not adequately providing. We review educational models for training neonatology fellows to provide antenatal counseling at the threshold of viability. We believe that training aimed at teaching these skills should be incorporated into the neonatal-perinatal medicine fellowship. The optimal approaches for teaching these skills remain uncertain, and there is a need for continued innovation and outcomes-based research.

  19. A managed care cycle provides contract oversight.

    PubMed

    Stevenson, Paul B; Messinger, Stephen F; Welter, Terri

    2002-03-01

    In response to poor payment performance by health plans, providers are realizing that managed care contracts require systematic, ongoing management rather than a periodic focus. An effective managed care cycle that encompasses strategy development, implementation of the strategy through contracting and operations, and monitoring of contract performance can accomplish this needed oversight. Each phase requires specialized management tools, skills, and staff. Because of the importance of managed care to the provider's financial viability, a wide range of persons should be involved in the managed care cycle, including the board of directors, business office staff, senior management, and finance staff. As providers embrace a more structured approach to managed care, they will increase their chances of receiving accurate contracted payments.

  20. Nonviolent (empathic) communication for health care providers.

    PubMed

    Rosenberg, M; Molho, P

    1998-07-01

    The purpose of Nonviolent or Empathic Communication Training is to facilitate the flow of information necessary for people to work cooperatively and resolve differences effectively. Such training is widely used in medical communities where the communication with patients and the cooperation between team members are of critical importance for the effectiveness of the treatment. Communication skills are of particular importance for health care providers dealing with patients having chronic diseases such as haemophilia. In addition to the difficulties inherent to the chronicity of the disease, the HIV contamination has dramatically impaired the relationships between patients and health care providers, creating a lot of pain, still alive in both parties. The purpose of this presentation is to offer to health care providers and patients some tools to deal with their feelings and restore effective, compassionate and fulfilling communication.

  1. Preceptor Development: Providing Effective Feedback, Part 2

    PubMed Central

    Wilkinson, Samaneh T.; Phillips, Holly

    2014-01-01

    Abstract An integral part of providing effective feedback to pharmacy residents occurs during the evaluation process. Residency evaluation involves measuring and documenting performance as it relates to standardized residency outcomes, goals, and learning objectives. Evaluations may be formative or summative and include the preceptor’s evaluation of the resident’s performance, the resident’s self-assessments, and the resident’s evaluation of the preceptor and learning experience. Evaluations are more structured than feedback, and they involve documentation of the verbal feedback that was provided throughout the learning experience. This article will focus on the preceptor’s role in providing effective resident evaluations based on specific learning activities. PMID:24958969

  2. Method for providing a compliant cantilevered micromold

    DOEpatents

    Morales, Alfredo M.; Domeier, Linda A.; Gonzales, Marcela G.; Keifer, Patrick N.; Garino, Terry J.

    2008-12-16

    A compliant cantilevered three-dimensional micromold is provided. The compliant cantilevered micromold is suitable for use in the replication of cantilevered microparts and greatly simplifies the replication of such cantilevered parts. The compliant cantilevered micromold may be used to fabricate microparts using casting or electroforming techniques. When the compliant micromold is used to fabricate electroformed cantilevered parts, the micromold will also comprise an electrically conducting base formed by a porous metal substrate that is embedded within the compliant cantilevered micromold. Methods for fabricating the compliant cantilevered micromold as well as methods of replicating cantilevered microparts using the compliant cantilevered micromold are also provided.

  3. Homeless women's experiences of service provider encounters.

    PubMed

    Biederman, Donna J; Nichols, Tracy R

    2014-01-01

    Service providers are gatekeepers to health-sustaining services and resources, although little is known about service encounters from the perspective of homeless women. We conducted in-depth semistructured interviews with 15 homeless women to better understand their experiences of service encounters. Using a phenomenological method, 160 significant statements were extracted from participant transcripts; more positive than negative interactions were reported. The 10 themes that emerged fall along a dehumanizing/humanizing continuum primarily separated by the power participants experienced in the interaction and the trust they felt in the service provider. Implications for nursing practice and research are offered.

  4. Care for the Health Care Provider.

    PubMed

    Kunin, Sharon Brown; Kanze, David Mitchell

    2016-03-01

    Pretravel care for the health care provider begins with an inventory, including the destination, length of stay, logistical arrangements, type of lodging, food and water supply, team members, personal medical needs, and the needs of the community to be treated. This inventory should be created and processed well in advance of the planned medical excursion. The key thing to remember in one's planning is to be a health care provider during one's global health care travel and not to become a patient oneself. This article will help demonstrate the medical requirements and recommendations for such planning.

  5. Content and Quality of Information Provided on Canadian Dementia Websites

    PubMed Central

    Dillon, Whitney A.; Prorok, Jeanette C.; Seitz, Dallas P.

    2013-01-01

    Purpose Information about dementia is important for persons with dementia (PWD) and their caregivers and the Internet has become the key source of health information. We reviewed the content and quality of information provided on Canadian websites for Alzheimer’s disease (AD). Methods We used the terms “dementia” and “Alzheimer” in Google to identify Canadian dementia websites. The contents of websites were compared to 16 guideline recommendations provided in Canadian Consensus Conference on Diagnosis and Treatment of Dementia. The quality of information provided on websites was evaluated using the DISCERN instrument. The content and quality of information provided on selected websites were then described. Results Seven websites were identified, three of which provided relatively comprehensive and high-quality information on dementia. Websites frequently provided information about diagnosis of dementia, its natural course, and types of dementia, while other topics were less commonly addressed. The quality of information provided on the websites varied, and many websites had several areas where the quality of information provided was relatively low according to the DISCERN instrument. Conclusions There is variation in the content and quality of dementia websites, although some websites provide high-quality and relatively comprehensive information which would serve as a useful resource for PWD, caregivers, and healthcare providers. Improvements in the content and quality of information provided on AD websites would provide PWD and their caregivers with access to better information. PMID:23440180

  6. Providing Access to Justice through Service Learning

    ERIC Educational Resources Information Center

    Kubichek, Mary

    2010-01-01

    In the Casper College Legal Service (CCLS) program, Casper College paralegal students, under supervision of pro bono attorneys, use paralegal skills to provide legal services and work product. CCLS is different from other legal clinics; it is not law school based, bar based, or court based. CCLS is paralegal based.

  7. Providing Empowerment to the Person with AIDS.

    ERIC Educational Resources Information Center

    Haney, Patrick

    1988-01-01

    Describes author's experiences after his own diagnoses of Acquired Immune Deficiency Syndrome (AIDS) Related Complex (ARC) and AIDS itself. Discusses six ways for social workers to provide empowerment to persons with AIDS, which focus on the positive, the healing power of caring, reconnections, direction, victim mindset, and advocacy. (ABL)

  8. Lessons from VET Providers Delivering Degrees

    ERIC Educational Resources Information Center

    Callan, Victor J.; Bowman, Kaye

    2015-01-01

    This report is focused on the strategic, capability and operational reasons why traditional vocational education and training (VET) providers move to the delivery of higher education qualifications in their own right, in addition to their vocational qualifications. It is particularly interested in associate and bachelor degrees. By undertaking six…

  9. An Immunization Education Program for Childcare Providers

    ERIC Educational Resources Information Center

    Hayney, Mary S.; Bartell, Julie C.

    2005-01-01

    The childhood immunization schedule includes at least 17 scheduled immunizations prior to the age of 24 months. Immunization laws require childcare centers to maintain immunization records and enforce immunization standards for children who attend these centers. Childcare providers generally receive little formal education about infectious…

  10. Training To Provide for Healthy Rural Aging.

    ERIC Educational Resources Information Center

    Troisi, Joseph

    2001-01-01

    Most of the world's rapidly expanding aging population is in rural areas of developing countries. Geriatric training programs should include social, economic, and psychological aspects of aging as well as medical, and should focus on enabling primary health caregivers to care for older people in their environments. Efforts to provide rural…

  11. Emergency Food Providers in Southern Illinois.

    ERIC Educational Resources Information Center

    O'Hara, Mary

    This paper examines emergency food provider networks in rural southern Illinois. An overview focuses on recent research reports on hunger in America, official federal emergency food assistance policy and criticisms of that policy, and the role of the private sector in emergency food distribution. The review details the disagreements on policy and…

  12. Providing Adaptivity in Moodle LMS Courses

    ERIC Educational Resources Information Center

    Despotovic-Zrakic, Marijana; Markovic, Aleksandar; Bogdanovic, Zorica; Barac, Dusan; Krco, Srdjan

    2012-01-01

    In this paper, we describe an approach to providing adaptivity in e-education courses. The primary goal of the paper is to enhance an existing e-education system, namely Moodle LMS, by developing a method for creating adaptive courses, and to compare its effectiveness with non-adaptive education approach. First, we defined the basic requirements…

  13. Estate Planning: Providing for Your Child's Future.

    ERIC Educational Resources Information Center

    Beyer, Henry A.

    1986-01-01

    Parents who wish their handicapped offspring to be financially provided for after their own deaths need to explore several ways of managing and distributing their assets, including: creating a will; disinheritance (to avoid loss of benefits; joint property and life insurance; and trusts and trustees. (CB)

  14. Providence Sponsors Diocesan Teacher Recruiting Campaign.

    ERIC Educational Resources Information Center

    Dygert, William

    2001-01-01

    Addresses the issue of teacher recruitment in Providence, Rhode Island. Explains that the Catholic education staff designed a campaign that involved creating marketing materials, advertising in daily newspapers, and holding job fairs and open houses. Stresses the importance of promoting teaching at Catholic schools as both rewarding and…

  15. Improved poppet valve provides positive damageproof seal

    NASA Technical Reports Server (NTRS)

    Wallace, E. D.

    1965-01-01

    Soft-seat poppet valve provides positive closure against fluid without damage to the seating surface on repeated cycling. It incorporates two compressible soft rings and a retaining ring of hard metal. Sealing is effected when the poppet seat is forced into intimate contact with a mating surface on one of the soft rings.

  16. Using Hypertext Functionality To Provide Understanding Support.

    ERIC Educational Resources Information Center

    Davalos, Sergio

    1997-01-01

    Presents a computer-based information system developed to support information understanding based on knowledge structures in hypermedia contexts. Examines the development and implementation of an understanding support system (USS), providing computational support for representation and access of knowledge structures. Discusses adding link-based…

  17. 44 CFR 206.393 - Providing assistance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Fire Suppression Assistance § 206.393 Providing assistance. Following the Assistant Administrator for the Disaster Assistance Directorate's... requested by the State. For each fire or fire situation, the State shall prepare a separate Fire...

  18. Elder Care for Alzheimer's: Choosing a Provider

    MedlinePlus

    ... provide an opportunity for your loved one with Alzheimer's to receive assistance and therapeutic activities in a group setting. Being a full- ... t wander off Counseling Activities, such as art, music, recreation or support ... care Medication management Meals and nutrition Personal ...

  19. 75 FR 6839 - Technical Service Provider Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-12

    ... serve organic farmers and ranchers. Response: NRCS embraces the opportunity to increase the nature and quality of the technical services it can provide to farmers and ranchers who utilize organic systems of... Quality Incentives Program (EQIP) funds for an Organic Initiative. The Conservation Stewardship...

  20. ICU nurses' experiences in providing terminal care.

    PubMed

    Espinosa, Laura; Young, Anne; Symes, Lene; Haile, Brenda; Walsh, Teresa

    2010-01-01

    At least 1 in 5 Americans die while using intensive care service-a number that is expected to increase as society ages. Many of these deaths involve withholding or withdrawing life-sustaining therapies. In these situations, the role of intensive care nurses shifts from providing aggressive care to end-of-life care. While hospice and palliative care nurses typically receive specialized support to cope with death and dying, intensive care nurses usually do not receive this support. Understanding the experiences of intensive care nurses in providing care at the end of life is an important first step to improving terminal care in the intensive care unit (ICU). This phenomenological research study explores the experiences of intensive care nurses who provide terminal care in the ICU. The sample consisted of 18 registered nurses delivering terminal care in an ICU that participated in individual interviews and focus groups. Colaizzi's steps for data analysis were used to identify themes within the context of nursing. Three major themes consisted of (1) barriers to optimal care, (2) internal conflict, and (3) coping. Providing terminal care creates significant personal and professional struggles among ICU nurses.

  1. Providing Career Guidance for Young Women.

    ERIC Educational Resources Information Center

    Colby, Pamela G.

    This module is directed at personnel working or planning to work in the areas of guidance, counseling, placement and follow-through in junior and senior high school settings, grades 7-12. The module topic is career guidance for young women of junior and senior high school age, aand the focus will be on providing nonbiased career guidance which…

  2. Air Systems Provide Life Support to Miners

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Through a Space Act Agreement with Johnson Space Center, Paragon Space Development Corporation, of Tucson, Arizona, developed the Commercial Crew Transport-Air Revitalization System, designed to provide clean air for crewmembers on short-duration space flights. The technology is now being used to help save miners' lives in the event of an underground disaster.

  3. California Community Colleges as Providers of Remediation.

    ERIC Educational Resources Information Center

    Cox, Mary Ann

    Described in this paper is a proposal concerning the responsibility of the California community colleges in providing remediation services and programs. The first part of the paper concerns the proposal itself. After a brief statement of the major issues under consideration, the conditions under which student success can be ensured in open access…

  4. 24 CFR 203.508 - Providing information.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Providing information. 203.508 Section 203.508 Housing and Urban Development Regulations Relating to Housing and Urban Development... SINGLE FAMILY MORTGAGE INSURANCE Servicing Responsibilities General Requirements § 203.508...

  5. 24 CFR 203.508 - Providing information.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Providing information. 203.508 Section 203.508 Housing and Urban Development Regulations Relating to Housing and Urban Development... SINGLE FAMILY MORTGAGE INSURANCE Servicing Responsibilities General Requirements § 203.508...

  6. 24 CFR 203.508 - Providing information.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Providing information. 203.508 Section 203.508 Housing and Urban Development Regulations Relating to Housing and Urban Development... SINGLE FAMILY MORTGAGE INSURANCE Servicing Responsibilities General Requirements § 203.508...

  7. 24 CFR 203.508 - Providing information.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Providing information. 203.508 Section 203.508 Housing and Urban Development Regulations Relating to Housing and Urban Development... SINGLE FAMILY MORTGAGE INSURANCE Servicing Responsibilities General Requirements § 203.508...

  8. 24 CFR 203.508 - Providing information.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Providing information. 203.508 Section 203.508 Housing and Urban Development Regulations Relating to Housing and Urban Development... SINGLE FAMILY MORTGAGE INSURANCE Servicing Responsibilities General Requirements § 203.508...

  9. Accessibility of MOOCs: Understanding the Provider Perspective

    ERIC Educational Resources Information Center

    Iniesto, Francisco; McAndrew, Patrick; Minocha, Shailey; Coughlan, Tim

    2016-01-01

    Massive Online Open Courses (MOOCs) have become an accepted way to make learning opportunities available at large scale and with low cost to the learner. However, only if these are made accessible will they be able to offer flexibility of learning and benefits to all, irrespective of disability. Experience in providing accessible online learning…

  10. Providing Support for English Language Learner Services

    ERIC Educational Resources Information Center

    Corona, Elia; Armour, Lauren

    2007-01-01

    Encouraging literacy and academic success among English language learners (ELLs) is becoming an increasingly common challenge for educators. In the course of the authors work of training teachers or providing training for implementation of materials, they have found that the resources of the school library media center are invaluable for helping…

  11. GEAR UP: Providing Opportunities or Conflict?

    ERIC Educational Resources Information Center

    Walsh, Rachael

    2008-01-01

    Since 1965 the federal government has attempted to provide low socioeconomic status students with equal access to postsecondary education through the Higher Education Act and its multiplicative programmatic efforts. Implemented as one such program in 1998, the Gaining Early Awareness and Readiness for Undergraduate Programs, or GEAR UP, has been…

  12. Modified algesimeter provides accurate depth measurements

    NASA Technical Reports Server (NTRS)

    Turner, D. P.

    1966-01-01

    Algesimeter which incorporates a standard sensory needle with a sensitive micrometer, measures needle point depth penetration in pain tolerance research. This algesimeter provides an inexpensive, precise instrument with assured validity of recordings in those biomedical areas with a requirement for repeated pain detection or ascertaining pain sensitivity.

  13. Intentional Planning to Provide Technology to Students

    ERIC Educational Resources Information Center

    Flagg-Williams, Joan B.; Rey, Janice M.

    2016-01-01

    Mobile technology plays a prominent role in teaching and learning. To address this vital component of teacher preparation, the education department of a small college provided the freshman class with iPads. iPads were selected because they are common in public schools, lightweight, portable, touch-screen controlled and have an abundance of…

  14. MDP challenges from a software provider's perspective

    NASA Astrophysics Data System (ADS)

    Ohara, Shuichiro

    2014-10-01

    This industry faces new challenges every day. It gets tougher as process nodes shrink and the data complexity and volume increase. We are a mask data preparation (MDP) software provider, and have been providing MDP systems to mask shops since 1990. As the industry has, MDP software providers also have been facing new challenges over time, and the challenges get tougher as process nodes shrink and the data complexity and volume increase. We discuss such MDP challenges and solutions in this paper from a MDP software provider's perspective. The data volume continuously increases, and it is caused by shrinking the process node. In addition, resolution enhancement techniques (RET) such as optical proximity correction (OPC) and inverse lithography technique (ILT) induce data complexity, and it contributes considerably to the increase in data volume. The growth of data volume and complexity brings challenges to MDP system, such as the computing speed, shot count, and mask process correction (MPC). New tools (especially mask writers) also bring new challenges. Variable-shaped E-beam (VSB) mask writers demand fracturing less slivers and lower figure counts for CD accuracy and write time requirements respectively. Now multibeam mask writers are under development and will definitely bring new challenges.

  15. 75 FR 81832 - Technical Service Provider Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... [Federal Register Volume 75, Number 249 (Wednesday, December 29, 2010)] [Rules and Regulations] [Page 81832] [FR Doc No: 2010-32945] DEPARTMENT OF AGRICULTURE Natural Resources Conservation Service 7 CFR Part 652 Technical Service Provider Assistance CFR Correction In Title 7 of the Code of...

  16. Providers' Perceptions of Challenges in Obstetrical Care for Somali Women

    PubMed Central

    Lazar, Jalana N.; Johnson-Agbakwu, Crista E.; Davis, Olga I.; Shipp, Michele P.-L.

    2013-01-01

    Background. This pilot study explored health care providers' perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers' experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC). Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement. PMID:24223041

  17. Autism Screening Practices among Early Intervention Providers in Indiana

    ERIC Educational Resources Information Center

    Tomlin, Angela; Koch, Steven M; Raches, Christine; Minshawi, Noha F.; Swiezy, Naomi B.

    2013-01-01

    The purpose of this study was to identify current practices in autism spectrum disorder (ASD) screening among early intervention and care providers in Indiana. Participants were asked about their ASD screening practices within the context of overall screening for developmental delays. Results indicated that providers conduct ASD screening less…

  18. How Do Health Care Providers Diagnose Cushing's Syndrome?

    MedlinePlus

    ... mailed to a laboratory or delivered to the health care provider. A Test Using Dexamethasone (pronounced dek-suh-METH-uh-sohn ) ... Step If your results are not normal, your health care provider may do further tests or refer you to a specialist—an endocrinologist ( ...

  19. Gender Patterns in Provider Role Attitudes and Behavior

    ERIC Educational Resources Information Center

    Loscocco, Karyn; Spitze, Glenna

    2007-01-01

    Although much has been written on rapidly changing work and family roles, relatively little is known about the provider side of the work-family nexus. Using data from a study of gender, work, and family among the self-employed, we examine abstract and specific attitudes as well as behavior relating to the provider role. Results show gender…

  20. Providing family planning and reproductive healthcare to Canadian immigrants: perceptions of healthcare providers.

    PubMed

    Newbold, K Bruce; Willinsky, Jacqueline

    2009-05-01

    Cultural impacts on health experiences and behaviours are profound in the area of reproductive health and family planning. Explored through interviews with family planning healthcare professionals, this paper evaluates their experiences in providing family planning and reproductive healthcare to immigrants in the Greater Toronto and Hamilton area of Ontario, Canada. Results reveal the complexity of delivering care to members of this group, particularly when dealing with language barriers, situations when professional and non-professional interpreters are used, and instances where healthcare professionals realize that they themselves have misconceptions and misunderstandings about other cultures. The paper concludes by discussing future research options and implications for the delivery of reproductive health family planning services to this population.

  1. Resource Persons Provide Effective Learning Experiences Via Videotape

    ERIC Educational Resources Information Center

    Earp, N. Wesley; Rink, Ortho

    1970-01-01

    Discussed is using videotape as a means of providing classes with a speaker unable to visit with them in person. The results of a study comparing the effectiveness of taped to live presentations are included. (LS)

  2. Providing contact cards for relatives following bereavement.

    PubMed

    Clarke, K; Pearson, N

    This article describes the implementation of a Welsh Assembly Government policy to improve customer service and provide an opportunity for relatives to seek further information about the death of a loved one in an acute hospital setting. A new relative-centred pathway has been developed. It offers a single point of contact for recently bereaved relatives and provides an opportunity to discuss any concerns or anxieties in relation to the care and/or treatment in the final hours of their loved one's life. The pathway includes a contact card with the name and number of a designated person and is a more informal, empathetic and person-centred service than the formal complaint process.

  3. SPACEWAY: Providing affordable and versatile communication solutions

    NASA Astrophysics Data System (ADS)

    Fitzpatrick, E. J.

    1995-08-01

    By the end of this decade, Hughes' SPACEWAY network will provide the first interactive 'bandwidth on demand' communication services for a variety of applications. High quality digital voice, interactive video, global access to multimedia databases, and transborder workgroup computing will make SPACEWAY an essential component of the computer-based workplace of the 21st century. With relatively few satellites to construct, insure, and launch -- plus extensive use of cost-effective, tightly focused spot beams on the world's most populated areas -- the high capacity SPACEWAY system can pass its significant cost savings onto its customers. The SPACEWAY network is different from other proposed global networks in that its geostationary orbit location makes it a truly market driven system: each satellite will make available extensive telecom services to hundreds of millions of people within the continuous view of that satellite, providing immediate capacity within a specific region of the world.

  4. SPACEWAY: Providing affordable and versatile communication solutions

    NASA Technical Reports Server (NTRS)

    Fitzpatrick, E. J.

    1995-01-01

    By the end of this decade, Hughes' SPACEWAY network will provide the first interactive 'bandwidth on demand' communication services for a variety of applications. High quality digital voice, interactive video, global access to multimedia databases, and transborder workgroup computing will make SPACEWAY an essential component of the computer-based workplace of the 21st century. With relatively few satellites to construct, insure, and launch -- plus extensive use of cost-effective, tightly focused spot beams on the world's most populated areas -- the high capacity SPACEWAY system can pass its significant cost savings onto its customers. The SPACEWAY network is different from other proposed global networks in that its geostationary orbit location makes it a truly market driven system: each satellite will make available extensive telecom services to hundreds of millions of people within the continuous view of that satellite, providing immediate capacity within a specific region of the world.

  5. Who provides nursing services in Cambodian hospitals?

    PubMed Central

    Sakurai-Doi, Yukie; Mochizuki, Noriko; Phuong, Keat; Sung, Chao; Visoth, Pheng; Sriv, Bun; Amara, Sar Rath; Murakami, Hitoshi; Komagata, Tomoko; Fujita, Noriko

    2014-01-01

    In Cambodia, the number of nurses is insufficient and details of nursing services are unknown and undocumented. This research explored who provides nursing service activities in Cambodia. The study was conducted at nine hospitals in Cambodia. Findings indicate that non-invasive medical care such as vital signs taking was designated to nurses. In performing more complex medical interventions, nurses shared the tasks with medical doctors. Conversely, simpler nursing tasks, including maintaining bedside environment/hygiene and supporting patient activities, tasks were shared by nurses with patients' family. This study elucidated an optimal personnel mix and task shared between nurses, doctors and patients' families. There are important implications for nursing legislation related to streamlining the production of nurses to provide an adequate and qualified nursing service in Cambodia. PMID:24661282

  6. Asthma Review for Pharmacists Providing Asthma Education

    PubMed Central

    Lampkin, Stacie J.; Maslouski, Cheryl A.; Maish, William A.

    2016-01-01

    Asthma is the most common pediatric illness affecting more than 6 million children in the United States. Children with asthma have more frequent office visits and hospitalizations compared with adults. Despite advances in therapies, asthma still has a significant effect on the health care system. Regardless of the setting, pharmacists are uniquely equipped with an intimate knowledge of medications. With this knowledge, they can provide education to patients at various points throughout the health care system, from hospitalization to office visits to point of pick up at the pharmacy. The goal of this article is to equip the pharmacist with the necessary knowledge to provide education to these patients in a variety of practice settings, including community pharmacies, ambulatory care settings, and during transitions in care. PMID:27877099

  7. Asthma Review for Pharmacists Providing Asthma Education.

    PubMed

    Lampkin, Stacie J; Maslouski, Cheryl A; Maish, William A; John, Barnabas M

    2016-01-01

    Asthma is the most common pediatric illness affecting more than 6 million children in the United States. Children with asthma have more frequent office visits and hospitalizations compared with adults. Despite advances in therapies, asthma still has a significant effect on the health care system. Regardless of the setting, pharmacists are uniquely equipped with an intimate knowledge of medications. With this knowledge, they can provide education to patients at various points throughout the health care system, from hospitalization to office visits to point of pick up at the pharmacy. The goal of this article is to equip the pharmacist with the necessary knowledge to provide education to these patients in a variety of practice settings, including community pharmacies, ambulatory care settings, and during transitions in care.

  8. Providing Real Research Opoportunities to Undergraduates

    NASA Astrophysics Data System (ADS)

    Ragozzine, Darin

    2016-01-01

    The current approach to undergraduate education focuses on teaching classes which provide the foundational knowledge for more applied experiences such as scientific research. Like most programs, Florida Institute of Technology (Florida Tech or FIT) strongly encourages undergraduate research, but is dominated by content-focused courses (e.g., "Physical Mechanics"). Research-like experiences are generally offered through "lab" classes, but these are almost always reproductions of past experiments: contrived, formulaic, and lacking the "heart" of real (i.e., potentially publishable) scientific research. Real research opportunities 1) provide students with realistic insight into the actual scientific process; 2) excite students far more than end-of-chapter problems; 3) provide context for the importance of learning math, physics, and astrophysics concepts; and 4) allow unique research progress for well-chosen problems. I have provided real research opportunities as an "Exoplanet Lab" component of my Introduction to Space Science (SPS1020) class at Florida Tech, generally taken by first-year majors in our Physics, Astronomy & Astrophysics, Planetary Science, and Astrobiology degree programs. These labs are a hybrid between citizen science (e.g., PlanetHunters) and simultaneously mentoring ~60 undergraduates in similar small research projects. These projects focus on problems that can be understood in the context of the course, but which benefit from "crowdsourcing". Examples include: dividing up the known planetary systems and developing a classification scheme and organizing them into populations (Fall 2013); searching through folded light curves to discover new exoplanets missed by previous pipelines (Fall 2014); and fitting n-body models to all exoplanets with known Transit Timing Variations to estimate planet masses (Fall 2015). The students love the fact that they are doing real potentially publishable research: not many undergraduates can claim to have discovered

  9. CARAVAN: Providing Location Privacy for VANET

    DTIC Science & Technology

    2005-01-01

    vehicles. However, many challenges including the security and privacy issues remain to be addressed [ 4 ], [5], [6]. The unique requirements of maintaining...REPORT TYPE 3. DATES COVERED 00-00-2005 to 00-00-2005 4 . TITLE AND SUBTITLE CARAVAN: Providing Location Privacy for VANET 5a. CONTRACT NUMBER...pseudonym update, it is still possible to link the new and old pseudonyms of a node using temporal and spatial relation between the new and old locations of

  10. Standardized training tools for the UPDRS activities of daily living scale: newly available teaching program.

    PubMed

    Goetz, Christopher G; LeWitt, Peter A; Weidenman, Meredith

    2003-12-01

    The Unified Parkinson's Disease Rating Scale (UPDRS) is the most widely used scale for evaluation of clinical impairment in PD. Whereas the motor section has been studied intensively for clinimetric properties and has an associated training tape, the Activities of Daily Living (ADL) section has been studied less rigorously. In preparation for a multicenter study that planned to use the UPDRS ADL score as an outcome, the authors reviewed the UPDRS ADL scale and designed a teaching program to provide a uniform technique for data acquisition without changing any wording of the primary scale. The teaching program is composed of four components: overall guidelines, clarifying points, recommended strategies, and a teaching videotape. The videotape shows examples of interviewers assessing each ADL item with patients of different disability levels and provides a complete ADL assessment of a single patient. Systematic training and utilization of this teaching program offer the potential for more uniformity in results of ADL assessments conducted in clinical practice and multicenter, international studies of PD. The written materials and videotape belong to the Movement Disorder Society and are available by contacting the MDS central office.

  11. Midwives as primary care providers for women.

    PubMed

    Phillippi, Julia C; Barger, Mary K

    2015-01-01

    Midwives certified by the American Midwifery Certification Board (AMCB) are prepared to provide primary care to women from menarche across the lifespan and to well newborns to 28 days using consultation, collaboration, and referral to other providers as needed. The scope of midwifery in the United States did not always include primary care for women, although imprecise definitions of primary care make this difficult to study. The expansion of the scope of practice occurred in response to population needs and research on nurse-midwifery practice patterns. The scope of practice of midwifery is tied to educational standards through the regulation and licensure at the state level. Although the current scope of practice includes primary care for women, many certified nurse-midwives and certified midwives are unable to practice to the full extent of their education due to state-level licensure restrictions. We discuss the addition of primary care to midwifery and the current state of AMCB-certified midwives as primary care providers for women.

  12. Muscle cells provide instructions for planarian regeneration.

    PubMed

    Witchley, Jessica N; Mayer, Mirjam; Wagner, Daniel E; Owen, Jared H; Reddien, Peter W

    2013-08-29

    Regeneration requires both potential and instructions for tissue replacement. In planarians, pluripotent stem cells have the potential to produce all new tissue. The identities of the cells that provide regeneration instructions are unknown. Here, we report that position control genes (PCGs) that control regeneration and tissue turnover are expressed in a subepidermal layer of nonneoblast cells. These subepidermal cells coexpress many PCGs. We propose that these subepidermal cells provide a system of body coordinates and positional information for regeneration, and identify them to be muscle cells of the planarian body wall. Almost all planarian muscle cells express PCGs, suggesting a dual function: contraction and control of patterning. PCG expression is dynamic in muscle cells after injury, even in the absence of neoblasts, suggesting that muscle is instructive for regeneration. We conclude that planarian regeneration involves two highly flexible systems: pluripotent neoblasts that can generate any new cell type and muscle cells that provide positional instructions for the regeneration of any body region.

  13. TRAP laws and the invisible labor of US abortion providers

    PubMed Central

    Mercier, Rebecca J; Buchbinder, Mara; Bryant, Amy

    2016-01-01

    Targeted Regulations of Abortion Providers (TRAP laws) are proliferating in the United States and have increased barriers to abortion access. In order to comply with these laws, abortion providers make significant changes to facilities and clinical practices. In this article, we draw attention to an often unacknowledged area of public health threat: how providers adapt to increasing regulation, and the resultant strains on the abortion provider workforce. Current US legal standards for abortion regulations have led to an increase in laws that target abortion providers. We describe recent research with abortion providers in North Carolina to illustrate how providers adapt to new regulations, and how compliance with regulation leads to increased workload and increased financial and emotional burdens on providers. We use the concept of invisible labor to highlight the critical work undertaken by abortion providers not only to comply with regulations, but also to minimize the burden that new laws impose on patients. This labor provides a crucial bridge in the preservation of abortion access. The impact of TRAP laws on abortion providers should be included in the consideration of the public health impact of abortion laws. PMID:27570376

  14. TRAP laws and the invisible labor of US abortion providers.

    PubMed

    Mercier, Rebecca J; Buchbinder, Mara; Bryant, Amy

    Targeted Regulations of Abortion Providers (TRAP laws) are proliferating in the United States and have increased barriers to abortion access. In order to comply with these laws, abortion providers make significant changes to facilities and clinical practices. In this article, we draw attention to an often unacknowledged area of public health threat: how providers adapt to increasing regulation, and the resultant strains on the abortion provider workforce. Current US legal standards for abortion regulations have led to an increase in laws that target abortion providers. We describe recent research with abortion providers in North Carolina to illustrate how providers adapt to new regulations, and how compliance with regulation leads to increased workload and increased financial and emotional burdens on providers. We use the concept of invisible labor to highlight the critical work undertaken by abortion providers not only to comply with regulations, but also to minimize the burden that new laws impose on patients. This labor provides a crucial bridge in the preservation of abortion access. The impact of TRAP laws on abortion providers should be included in the consideration of the public health impact of abortion laws.

  15. 2012 election results

    NASA Astrophysics Data System (ADS)

    Robinson, Robert; Tetzlaff, Doerthe

    2012-10-01

    On 4 October 2012, AGU members completed voting for the 2013-2014 leadership term. Union officers, Board members, section and focus group officers, and student and early career representatives to the Council were elected. All members who joined or renewed their membership by 1 July 2012 were eligible to vote in this year's leadership election. The vote was held electronically, and access to voting was provided to all eligible voters for a period of 31 days. The voting was conducted by Survey and Ballot Systems, Inc. (SBS). SBS, which offers election planning and management services, provided unique login credentials and other support services for eligible voters throughout the election. Voting results were certified by SBS on 8 October and by the AGU Tellers Committee on 9 October. The overall participation rate was 21.9%, an increase over previous AGU elections.

  16. The effect of narrow provider networks on health care use.

    PubMed

    Atwood, Alicia; Lo Sasso, Anthony T

    2016-12-01

    Network design is an often overlooked aspect of health insurance contracts. Recent policy factors have resulted in narrower provider networks. We provide plausibly causal evidence on the effect of narrow network plans offered by a large national health insurance carrier in a major metropolitan market. Our econometric design exploits the fact that some firms offer a narrow network plan to their employees and some do not. Our results show that narrow network health plans lead to reductions in health care utilization and spending. We find evidence that narrow networks save money by selecting lower cost providers into the network.

  17. Systems and Methods for Providing Insulation

    NASA Technical Reports Server (NTRS)

    Golden, Johnny L. (Inventor)

    2015-01-01

    Systems and methods provide a multi-layer insulation (MLI) that includes a plurality of sealed metalized volumes in a stacked arrangement, wherein the plurality of sealed metalized volumes encapsulate a gas therein, with the gas having one of a thermal insulating property, an acoustic insulating property, or a combination insulating property thereof. The MLI also includes at least one spacer between adjacent sealed metalized volumes of the plurality of sealed metalized volumes and a protective cover surrounding the plurality of sealed metalized volumes.

  18. Forensic Nursing Provides Closure in Workplace Fatality.

    PubMed

    Harris, Colin

    The Workers' Compensation Board of British Columbia in Canada is the provincial agency mandated to investigate workplace injuries and fatalities. In 2012, the Fatal and Serious Injuries Investigation section of this organization initiated the integration of forensic nursing expertise into the investigation of workplace incidents. The goals were to improve investigative outcomes and aid in prevention initiatives by achieving a more accurate understanding of incident causation through the application of forensic nursing science. An unexpected outcome of the use of forensic nursing expertise was providing closure for families through a deeper understanding of their loved one's tragic workplace incident.

  19. Sensors Provide Early Warning of Biological Threats

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Early Warning Inc. of Troy, New York, licensed powerful biosensor technology from Ames Research Center. Incorporating carbon nanotubes tipped with single strands of nucleic acid from waterborne pathogens, the sensor can detect even minute amounts of targeted, disease causing bacteria, viruses, and parasites. Early Warning features the NASA biosensor in its water analyzer, which can provide advance alert of potential biological hazards in water used for agriculture, food and beverages, showers, and at beaches and lakes -- within hours instead of the days required by conventional laboratory methods.

  20. Zika Virus: Critical Information for Emergency Providers.

    PubMed

    Shastry, Siri; Koenig, Kristi L; Hirshon, Jon Mark

    2016-08-01

    Zika virus is an arbovirus of the Flaviviridae family. It is primarily a minimally symptomatic mosquito-borne infection. However, with Zika's 2015 to 2016 introduction into the Western Hemisphere and its dramatic and rapid spread, it has become a public health concern, in large part due to congenital abnormalities associated with infection in pregnant women. In early 2016, the World Health Organization declared the microcephaly and other neurologic conditions associated with Zika virus infection a public health emergency of international concern. This article discusses the current epidemiologic and clinical understanding of Zika virus, focusing on critical information needed by emergency providers.

  1. Computerized systems to provide materials selection advice

    SciTech Connect

    Krisher, A.S.

    1996-07-01

    The rapid advance of computer science has increased the ability to store and retrieve information. These new capabilities are beginning to be applied to the problem of providing sound advice to non-specialist engineers who make materials selection decisions. This paper presents an overview of the large scale systems which exist in finished or near finished form and are (or may soon be) available for use by the public. The paper focuses on systems which transfer knowledge taking into account the many qualifications which enter into the reasoning processes of materials/corrosion specialists. The paper discusses both the strengths and limitations of each system.

  2. Icy Schwedeneck field may provide reference

    SciTech Connect

    Not Available

    1985-05-01

    Situated in an icy region of the Baltic Sea, Germany's first offshore field may provide the nation with the reference needed to encroach the arctic market. Production began last winter from one platform in the Schwedeneck-See field, located about three miles off the Baltic Coast. Total reserves have been estimated at more than 18 million bbl. Yearly production by the end of 1986 has been estimated at 294,000 bbl. The first two production platforms were installed in late 1983 in water depths ranging from 50 to 80 ft. Because of the ice hazards inherent in the Baltic, the platforms are concrete designed with steel decks.

  3. Health Care Providers' Spirit at Work Within a Restructured Workplace.

    PubMed

    Wagner, Joan I J; Brooks, Denise; Urban, Ann-Marie

    2016-12-01

    Spirit at work (SAW) research emerged as a response to care provider determination to maintain a healthy and productive health care work environment, despite restructuring. The aim of this descriptive mixed-methods research is to present the care provider's perceptions of SAW. SAW is a holistic measure of care provider workplace outcomes, defined as the unique experience of individuals who are passionate about and energized by their work. A mixed group of licensed and unlicensed care providers in a continuing care workplace were surveyed. Eighteen Likert-type scale survey questions were further informed by two open-ended questions. Results indicated that unlicensed continuing care providers' perceptions of SAW are lower than licensed care providers. Responses suggest that open discussion between managers and team members, combined with structured workplace interventions, will lead to enhanced SAW and improved patient care. Further research on SAW within the continuing care workplace is required.

  4. Provider communication about HPV vaccination: A systematic review

    PubMed Central

    Gilkey, Melissa B.; McRee, Annie-Laurie

    2016-01-01

    abstract Background. Improving HPV vaccination coverage in the US will require healthcare providers to recommend the vaccine more effectively. To inform quality improvement efforts, we systematically reviewed studies of provider communication about HPV vaccination. Methods. We searched MEDLINE, CINAHL, EMBASE, and POPLINE in August 2015 to identify studies of provider communication about HPV vaccination. Results. We identified 101 qualitative and quantitative studies. Providers less often recommended HPV vaccine if they were uncomfortable discussing sex, perceived parents as hesitant, or believed patients to be low risk. Patients less often received recommendations if they were younger, male, or from racial/ethnic minorities. Despite parents' preference for unambiguous recommendations, providers often sent mixed messages by failing to endorse HPV vaccine strongly, differentiating it from other vaccines, and presenting it as an “optional” vaccine that could be delayed. Conclusion. Interventions are needed to help providers deliver effective recommendations in the complex communication environment surrounding HPV vaccination. PMID:26838681

  5. GIRAFFE test results summary

    SciTech Connect

    Yokobori, S.; Arai, K.; Oikawa, H.

    1996-03-01

    A passive system can provide engineered safety features enhancing safety system reliability and plant simplicity. Toshiba has conducted the test Program to demonstrate the feasibility of the SBWR passive safety system using a full-height, integral system test facility GIRAFFE. The test facility GIRAFFE models the SBWR in full height to correctly present the gravity driving head forces with a 1/400 volume scale. The GIRAFFE test Program includes the certification tests of the passive containment cooling system (PCCS) to remove the post-accident decay heat and the gravity driven cooling system (GDCS) to replenish the reactor coolant inventory during a LOCA. The test results have confirmed the PCCS and GDCS design and in addition, have demonstrated the operation of the pCCS with the presence of a lighter-than-steam noncondensable as well as with the presence of a heavier-than-steam, noncondensable. The GIRAFFE test Program has also provided the database to qualify a best estimate thermal-hydraulic computer code TRAC. The post test analysis results have shown that TRAC can accurately predict the PCCS heat removal Performance and the containment pressure response to a LOCA. This paper summarizes the GIRAFFE test results to investigate post-LOCA PCCS heat removal performance and post-test analysis using TRAC.

  6. Asthma disease management: a provider's perspective.

    PubMed

    Abisheganaden, J

    2002-07-01

    Asthma is a highly prevalent problem in Singapore, with an increasing societal and economic burden. However, asthma is also an eminently treatable condition, with evidence that integrated education-treatment efforts directed at important patient sub-groups can be cost-effective. What is important is a comprehensive and integrated asthma management programme, aimed at reducing the burden of asthma at all levels of the healthcare system, with the long-term goal of improving asthma care cost-effectively. This refers to asthma disease management. Asthma disease management should focus on identifying deficiencies in asthma management across the population diagnosed with the condition and establish a partnership between the patient, provider and the healthcare system to improve the overall quality of asthma care. The framework for implementing such a programme bridges key concepts and programmes that are already in place in the various institutions. These include patient and physician education, the use of clinical practice guidelines, clinical pathways, outcomes management, quality improvement processes, information technology, case management and existing asthma shared-care programmes and resources. In order to significantly reduce asthma morbidity, an integrated approach is required, involving individuals providing asthma care at various levels of care delivery. There is also a need to co-ordinate the efforts of such individuals and institutions involved so that there is good horizontal and vertical integration of care. The disease management approach described is intended to raise the overall standard of asthma care across a spectrum of patients with asthma.

  7. Social capital and trust in providers.

    PubMed

    Ahern, Melissa M; Hendryx, Michael S

    2003-10-01

    Trust in providers has been in decline in recent decades. This study attempts to identify sources of trust in characteristics of health care systems and the wider community. The design is cross-sectional. Data are from (1) the 1996 Household Survey of the Community Tracking Study, drawn from 24 Metropolitan Statistical Areas; (2) a 1996 multi-city broadcast media marketing database including key social capital indicators; (3) Interstudy; (4) the American Hospital Association; and (5) the American Medical Association. Independent variables include individual socio-demographic variables, HMO enrollment, community-level health sector variables, and social capital. The dependent variable is self-reported trust in physicians. Data are merged from the various sources and analyzed using SUDAAN. Subjects include adults in the Household Survey who responded to the items on trust in physicians (N=17,653). Trust in physicians is independently predicted by community social capital (p<0.001). Trust is also negatively related to HMO enrollment and to many individual characteristics. The effect of HMOs is not uniform across all communities. Social capital plays a role in how health care is perceived by citizens, and how health care is delivered by providers. Efforts to build trust and collaboration in a community may improve trust in physicians, health care quality, access, and preserve local health care control.

  8. 76 FR 66132 - Proposed Collection; Comment Request for Travel Service Provider and Carrier Service Provider...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-25

    ... Office of Foreign Assets Control Proposed Collection; Comment Request for Travel Service Provider and... Control (``OFAC'') within the Department of the Treasury is soliciting comments concerning OFAC's Travel...: Travel Service Provider and Carrier Service Provider Submission. OMB Number: 1505-0168. Abstract:...

  9. Hubble Provides Clear Images of Saturn's Aurora

    NASA Technical Reports Server (NTRS)

    1998-01-01

    This is the first image of Saturn's ultraviolet aurora taken by the Space Telescope Imaging Spectrograph (STIS) on board the Hubble Space Telescope (HST) in October 1998, when Saturn was a distance of 810 million miles (1.3 billion kilometers) from Earth. The new instrument, used as a camera, provides more than 10 times the sensitivity of the previous HST instruments in the ultraviolet. STIS images reveal exquisite detail never before seen in the spectacular auroral curtains of light that encircle Saturn's north and south poles which rise more than a thousand miles above the cloud tops. Saturn's auroral displays are caused by an energetic wind from the Sun that sweeps over the planet, much like the Earth's aurora that is occasionally seen in the nighttime sky. Unlike the Earth, Saturn's aurora is only seen in ultraviolet light that is invisible from the Earth's surface, hence can only be observed from space.

  10. Neurologists as primary palliative care providers

    PubMed Central

    Robinson, Maisha T.; Holloway, Robert G.

    2016-01-01

    Abstract Purpose of review: To present current knowledge and recommendations regarding communication tasks and practice approaches for neurologists as they practice primary palliative care, including discussing serious news, managing symptoms, aligning treatment with patient preferences, introducing hospice/terminal care, and using the multiprofessional approach. Recent findings: Neurologists receive little formal palliative care training yet often need to discuss prognosis in serious illness, manage intractable symptoms in chronic progressive disease, and alleviate suffering for patients and their families. Because patients with neurologic disorders often have major cognitive impairment, physical impairment, or both, with an uncertain prognosis, their palliative care needs are particularly challenging and they remain largely uncharacterized and often unmanaged. Summary: We provide an overview of neuropalliative care as a fundamental skill set for all neurologists. PMID:26918202

  11. Multiagency Initiative to Provide Greenhouse Gas Information

    NASA Astrophysics Data System (ADS)

    Boland, Stacey W.; Duren, Riley M.

    2009-11-01

    Global Greenhouse Gas Information System Workshop; Albuquerque, New Mexico, 20-22 May 2009; The second Greenhouse Gas Information System (GHGIS) workshop brought together 74 representatives from 28 organizations including U.S. government agencies, national laboratories, and members of the academic community to address issues related to the understanding, operational monitoring, and tracking of greenhouse gas emissions and carbon offsets. The workshop was held at Sandia National Laboratories and organized by an interagency collaboration among NASA centers, Department of Energy laboratories, and the U.S. National Oceanic and Atmospheric Administration. It was motivated by the perceived need for an integrated interagency, community-wide initiative to provide information about greenhouse gas sources and sinks at policy-relevant temporal and spatial scales. Such an initiative could significantly enhance the ability of national and regional governments, industry, and private citizens to implement and evaluate effective climate change mitigation policies.

  12. Physician partnering: a provider network primer.

    PubMed

    Tortolani, A J; Cascardo-Weissman, D

    1999-01-01

    The face of health care is changing daily due to pressures brought about by dissatisfied consumers, physicians, and employers. The authors of this article believe that the only way to bring about a better health care system is for physicians to take back the administration of the medical profession from the insurers. Physicians must take the financial risks necessary to innovate a medical system that will benefit themselves, their patients, and their patients' employers. This article presents the basic business concepts needed to establish physician provider networks (PPNs) as well as the benefits and pitfalls of the various types of associations into which a PPN can enter. Clearly, the future will belong to those physicians who have the foresight to invest their talents and their finances in the business aspects of managed care.

  13. Data governance for health care providers.

    PubMed

    Andronis, Katerina; Moysey, Kevin

    2013-01-01

    Data governance is characterised from broader definitions of governance. These characteristics are then mapped to a framework that provides a practical representation of the concepts. This representation is further developed with operating models and roles. Several information related scenarios covering both clinical and non-clinical domains are considered in information terms and then related back to the data governance framework. This assists the reader in understanding how data governance would help address the issues or achieve a better outcome. These elements together enable the reader to gain an understanding of the data governance framework and how it applies in practice. Finally, some practical advice is offered for establishing and operating data governance as well as approaches for justifying the investment.

  14. Hubble Provides Clear Images of Saturn's Aurora

    NASA Technical Reports Server (NTRS)

    1998-01-01

    This is the first image of Saturn's ultraviolet aurora taken by the Space Telescope Imaging Spectrograph (STIS) on board the Hubble Space Telescope in October 1997, when Saturn was a distance of 810 million miles (1.3 billion kilometers) from Earth. The new instrument, used as a camera, provides more than ten times the sensitivity of previous Hubble instruments in the ultraviolet. STIS images reveal exquisite detail never before seen in the spectacular auroral curtains of light that encircle Saturn's north and south poles and rise more than a thousand miles above the cloud tops.

    Saturn's auroral displays are caused by an energetic wind from the Sun that sweeps over the planet, much like the Earths aurora that is occasionally seen in the nighttime sky and similar to the phenomenon that causes fluorescent lamps to glow. But unlike the Earth, Saturn's aurora is only seen in ultraviolet light that is invisible from the Earths surface, hence the aurora can only be observed from space. New Hubble images reveal ripples and overall patterns that evolve slowly, appearing generally fixed in our view and independent of planet rotation. At the same time, the curtains show local brightening that often follow the rotation of the planet and exhibit rapid variations on time scales of minutes. These variations and regularities indicate that the aurora is primarily shaped and powered by a continual tug-of-war between Saturn's magnetic field and the flow of charged particles from the Sun.

    Study of the aurora on Saturn had its beginnings just seventeen years ago. The Pioneer 11 spacecraft observed a far-ultraviolet brightening on Saturn's poles in 1979. The Saturn flybys of the Voyager 1 and 2 spacecraft in the early 1980s provided a basic description of the aurora and mapped for the first time planets enormous magnetic field that guides energetic electrons into the atmosphere near the north and south poles.

    The first images of Saturn's aurora were provided in 1994-5 by the

  15. Optical fiber head for providing lateral viewing

    DOEpatents

    Everett, Matthew J.; Colston, Billy W.; James, Dale L.; Brown, Steve; Da Silva, Luiz

    2002-01-01

    The head of an optical fiber comprising the sensing probe of an optical heterodyne sensing device includes a planar surface that intersects the perpendicular to axial centerline of the fiber at a polishing angle .theta.. The planar surface is coated with a reflective material so that light traveling axially through the fiber is reflected transverse to the fiber's axial centerline, and is emitted laterally through the side of the fiber. Alternatively, the planar surface can be left uncoated. The polishing angle .theta. must be no greater than 39.degree. or must be at least 51.degree.. The emitted light is reflected from adjacent biological tissue, collected by the head, and then processed to provide real-time images of the tissue. The method for forming the planar surface includes shearing the end of the optical fiber and applying the reflective material before removing the buffer that circumscribes the cladding and the core.

  16. Outsourcing provides worry-free water

    SciTech Connect

    Wingen, S.; Verduin, D.

    1996-09-01

    This article is an overview of how water treatment partners free plant operators from the burden of maintaining treatment facilities. Deregulation and downsizing have each had significant impact within the power industry. Because of these trends, power generators need to take advantage of every competitive strategy available to them. Increasingly, this means outsourcing non-core activities. More and more power generators are realizing the benefits of outsourcing their water treatment services, particularly for boiler make-up water. Working with a water treatment partner can be a cost-effective, hassle-free way of guaranteeing a consistent flow of pure water using the latest technologies with minimal environmental impact. Since 1995, Florida Power and Light (FPL) has partnered with US Filter to provide boiler feedwater production for seven plants. Power generators that are considering water outsourcing can learn from FPL`s and US Filter`s experience.

  17. Do drug advertisements provide therapeutic information?

    PubMed

    Stimson, G V

    1977-03-01

    In this study of advertisements appearing in medical periodicals and by direct mail advertising to general practitioners, Dr. Stimson, a sociologist, concludes that from what is intended to provide therapeutic information hardly any therapeutic information is provided. He reminds the reader of the safeguards which surround all drug advertising by law and by the code of practice of the Association of the British Pharmaceutical Industry but these safeguards do not appear to control real or potential sins of omission. Frequently in these advertisements the literature relating to the drug is quoted but Dr. Stimson found that it was difficult to trace all the papers quoted in different types of medical library. (Some references quoted were to unpublished papers but surely the blame should be shared in this situation?) Dr. Stimson also gives a vivid and fascinating glimpse of what he calls the 'images and stereotypes' of the patients who, it is claimed, would benefit from the drug being advertised. Certainly most general practitioners must be aware that when they prescribe that image is displaced by an individual but the portrait gallery is indeed depressing. However, to balance these advertisements drug companies issue data sheets which must be more informative than advertisements and conform to regulations in their format. Unfortunately data sheets are only issued every 15 months whereas the 'average general practitioner is potentially exposed to 1,300 advertisements every month'. In other words, the data sheet and not the advertisement should be the guideline but it arrives too infrequently to offset the lack of therapeutic information contained in advertisements.

  18. Can liver transplantation provide the statistical cure?

    PubMed

    Cucchetti, Alessandro; Vitale, Alessandro; Cescon, Matteo; Gambato, Martina; Maroni, Lorenzo; Ravaioli, Matteo; Ercolani, Giorgio; Burra, Patrizia; Cillo, Umberto; Pinna, Antonio D

    2014-02-01

    Liver transplantation (LT) represents the only chance of long-term survival for patients with end-stage liver disease. When the mortality rate for transplant patients returns to the same level as that for the general population, they can be considered statistically cured. However, cure models in the setting of LT have never been applied. Data from 1371 adult patients undergoing LT for the first time between January 1999 and December 2012 at 2 Italian centers were reviewed in order to establish probabilities of being cured by LT. A parametric Weibull model was applied to compare the mortality rate after LT to the rate expected for the general population (matched by sex and age). The observed 3-, 5-, and 10-year overall survival rates after LT were 77.8%, 73.3%, and 65.6%, respectively, and they did not differ between the 2 centers (P = 0.37). The cure fraction for the entire study population was 63.4% (95% confidence interval = 52.6%-72.0%), and the time to cure was 10 years with a 90% confidence level. The best cure fraction was observed for younger recipients without hepatitis C virus (HCV) who had favorable donor-recipient matches, that is, low Donor Model for End-Stage Liver Disease (D-MELD) scores (90.1%); conversely, the lowest probability was observed for elderly HCV recipients with high D-MELD scores (34.6%). The time to cure was 6.22 years for non-HCV patients and 14.78 years for HCV patients. The median survival time for uncured patients was 2.29 years. Among uncured recipients, the longest survival time was observed for younger patients (7.31 years). In conclusion, we provide here a new clinical measure for LT suggesting that survival after transplantation can approximate that of the general population and provide a statistical cure.

  19. NASA works for provide business assistance

    NASA Technical Reports Server (NTRS)

    1997-01-01

    The wealth of technology resulting from space exploration is a valuable national resource and an investment in the future. Through NASA's Technology Transfer Program, the John C. Stennis Space Center in South Mississippi contributes to the U.S. economy by working with companies to help them benefit from these technologies. This is called technology transfer. Transferred technology helps fulfill the technical and business needs of the public in the form of new products-called 'spinoffs,'-new applications, new programs, and improved ways of doing business. The possible results are enhanced potential for industrial productivity, creation of jobs, and increased returns on investment for the taxpayer.

  20. Increasing Access to Health Care Providers with Nurse Practitioner Competencies

    ERIC Educational Resources Information Center

    Grace, Del Marjorie

    2014-01-01

    Emergency department visits increased from 102.8 million to 136.1 million in 2009, resulting in crowding and increased wait times, affecting U.S. hospitals' ability to provide safe, timely patient care resulting in dangerous delays and serious health problems shown by research. The purpose of this project was to determine if competencies developed…

  1. Managing Illinois Libraries: Providing Services Customers Value.

    ERIC Educational Resources Information Center

    Walzer, Norman; Stott, Karen; Sutton, Lori

    Public libraries are an important asset in virtually any size community, but especially in small towns where many social institutions are in decline or have left. Libraries increase the quality of life, help attract new residents, and support the quality of life that is essential to attracting businesses. Results from surveys of library users,…

  2. Rehearsed Oral Reading: Providing Authentic Reading Experiences.

    ERIC Educational Resources Information Center

    Matz, Karl A.

    A two-part study investigated the prevalence of unrehearsed oral reading and compared reading fluency for rehearsed and unrehearsed reading passages. In the first part of the study, a total of 21 teachers were interviewed and 24 classrooms were observed. Results indicated that by far the most prevalent practice in basal reading programs is the…

  3. Can Economics Provide Insights into Trust Infrastructure?

    NASA Astrophysics Data System (ADS)

    Vishik, Claire

    Many security technologies require infrastructure for authentication, verification, and other processes. In many cases, viable and innovative security technologies are never adopted on a large scale because the necessary infrastructure is slow to emerge. Analyses of such technologies typically focus on their technical flaws, and research emphasizes innovative approaches to stronger implementation of the core features. However, an observation can be made that in many cases the success of adoption pattern depends on non-technical issues rather than technology-lack of economic incentives, difficulties in finding initial investment, inadequate government support. While a growing body of research is dedicated to economics of security and privacy in general, few theoretical studies in this area have been completed, and even fewer that look at the economics of “trust infrastructure” beyond simple “cost of ownership” models. This exploratory paper takes a look at some approaches in theoretical economics to determine if they can provide useful insights into security infrastructure technologies and architectures that have the best chance to be adopted. We attempt to discover if models used in theoretical economics can help inform technology developers of the optimal business models that offer a better chance for quick infrastructure deployment.

  4. Synonyms Provide Semantic Preview Benefit in English

    PubMed Central

    Schotter, Elizabeth R.

    2013-01-01

    While orthographic and phonological preview benefits in reading are uncontroversial (see Schotter, Angele, & Rayner, 2012 for a review), researchers have debated the existence of semantic preview benefit with positive evidence in Chinese and German, but no support in English. Two experiments, using the gazecontingent boundary paradigm (Rayner, 1975), show that semantic preview benefit can be observed in English when the preview and target are synonyms (share the same or highly similar meaning, e.g., curlers-rollers). However, no semantic preview benefit was observed for semantic associates (e.g., curlers-styling). These different preview conditions represent different degrees to which the meaning of the sentence changes when the preview is replaced by the target. When this continuous variable (determined by a norming procedure) was used as the predictor in the analyses, there was a significant relationship between it and all reading time measures, suggesting that similarity in meaning between what is accessed parafoveally and what is processed foveally may be an important influence on the presence of semantic preview benefit. Why synonyms provide semantic preview benefit in reading English is discussed in relation to (1) previous failures to find semantic preview benefit in English and (2) the fact that semantic preview benefit is observed in other languages even for non-synonymous words. Semantic preview benefit is argued to depend on several factors—attentional resources, depth of orthography, and degree of similarity between preview and target. PMID:24347813

  5. Contingency management: perspectives of Australian service providers.

    PubMed

    Cameron, Jacqui; Ritter, Alison

    2007-03-01

    Given the very positive and extensive research evidence demonstrating efficacy and effectiveness of contingency management, it is important that Australia explore whether contingency management has a role to play in our own treatment context. Qualitative interviews were conducted with 30 experienced alcohol and drug practitioners, service managers and policy-makers in Victoria. Interviewees were selected to represent the range of drug treatment services types and included rural representation. A semi-structured interview schedule, covering their perceptions and practices of contingency management was used. All interviews were transcribed verbatim and analysed using N2 qualitative data analysis program. The majority of key informants were positively inclined toward contingency management, notwithstanding some concerns about the philosophical underpinnings. Concerns were raised in relation to the use of monetary rewards. Examples of the use of contingency management provided by key informants demonstrated an over-inclusive definition: all the examples did not adhere to the key principles of contingency management. This may create problems if a structured contingency management were to be introduced in Australia. Contingency management is an important adjunctive treatment intervention and its use in Australia has the potential to enhance treatment outcomes. No unmanageable barriers were identified in this study.

  6. Providing effective supervision in clinical neuropsychology.

    PubMed

    Stucky, Kirk J; Bush, Shane; Donders, Jacobus

    2010-01-01

    A specialty like clinical neuropsychology is shaped by its selection of trainees, educational standards, expected competencies, and the structure of its training programs. The development of individual competency in this specialty is dependent to a considerable degree on the provision of competent supervision to its trainees. In clinical neuropsychology, as in other areas of professional health-service psychology, supervision is the most frequently used method for teaching a variety of skills, including assessment, report writing, differential diagnosis, and treatment. Although much has been written about the provision of quality supervision in clinical and counseling psychology, very little published guidance is available regarding the teaching and provision of supervision in clinical neuropsychology. The primary focus of this article is to provide a framework and guidance for the development of suggested competency standards for training of neuropsychological supervisors, particularly at the residency level. In this paper we outline important components of supervision for neuropsychology trainees and suggest ways in which clinicians can prepare for supervisory roles. Similar to Falender and Shafranske (2004), we propose a competency-based approach to supervision that advocates for a science-informed, formalized, and objective process that clearly delineates the competencies required for good supervisory practice. As much as possible, supervisory competencies are related to foundational and functional competencies in professional psychology, as well as recent legislative initiatives mandating training in supervision. It is our hope that this article will foster further discussion regarding this complex topic, and eventually enhance training in clinical neuropsychology.

  7. Hubble Provides Complete View of Jupiter's Auroras

    NASA Technical Reports Server (NTRS)

    1998-01-01

    NASA's Hubble Space Telescope has captured a complete view of Jupiter's northern and southern auroras.

    Images taken in ultraviolet light by the Space Telescope Imaging Spectrograph (STIS) show both auroras, the oval-shaped objects in the inset photos. While the Hubble telescope has obtained images of Jupiter's northern and southern lights since 1990, the new STIS instrument is 10 times more sensitive than earlier cameras. This allows for short exposures, reducing the blurring of the image caused by Jupiter's rotation and providing two to five times higher resolution than earlier cameras. The resolution in these images is sufficient to show the 'curtain' of auroral light extending several hundred miles above Jupiter's limb (edge). Images of Earth's auroral curtains, taken from the space shuttle, have a similar appearance. Jupiter's auroral images are superimposed on a Wide Field and Planetary Camera 2 image of the entire planet. The auroras are brilliant curtains of light in Jupiter's upper atmosphere. Jovian auroral storms, like Earth's, develop when electrically charged particles trapped in the magnetic field surrounding the planet spiral inward at high energies toward the north and south magnetic poles. When these particles hit the upper atmosphere, they excite atoms and molecules there, causing them to glow (the same process acting in street lights).

    The electrons that strike Earth's atmosphere come from the sun, and the auroral lights remain concentrated above the night sky in response to the 'solar wind.'

  8. Keeping consumers safe: food providers' perspectives on pureed food.

    PubMed

    Keller, Heather H; Duizer, Lisa M

    2014-01-01

    Twelve focus groups were conducted in five sites with 80 allied health providers to identify their perspectives on providing pureed food to consumers. Thematic care analysis was completed to summarize and interpret these data. Providers' greatest concern was keeping consumers safe, and the right texture was prioritized over sensory appeal and acceptance. Providers recognized that these foods impacted the quality of life of consumers and worked to rationalize these diets with residents/patients and their families. In addition, offering foods they knew to be poorly accepted affected their self-concept as providers. As a result of these challenges, they did whatever they could in the kitchen and tableside to promote intake of pureed foods. Those in the "food chain" of pureed food provision suggested several ways to further improve these products. Greater communication between those who assist consumers with eating and those who produce the pureed food they consume is needed to promote acceptable pureed products.

  9. Provider knowledge, attitudes and treatment preferences for early pregnancy failure

    PubMed Central

    Dalton, Vanessa K.; Harris, Lisa H.; Gold, Katherine J.; Kane-Low, Lisa; Schulkin, Jay; Guire, Ken; Fendrick, A. Mark

    2010-01-01

    Objective To describe health care provider knowledge, attitudes and treatment preferences for early pregnancy failure (EPF). Study Design We surveyed 976 obstetrician/gynecologists, midwives and family medicine practitioners on their knowledge and attitudes toward treatment options for EPF, and barriers to adopting misoprostol and office uterine evacuations. We used descriptive statistics to compare practices by provider specialty and logistic regression to identify associations between provider factors and treatment practices. Results Seventy percent of providers have not used misoprostol and 91% have not used an office uterine evacuation to treat EPF in the past 6 months. Beliefs about safety and patient preferences, and prior induced abortion training were significantly associated with use of both of these treatments. Conclusions Increasing education and training on the use of misoprostol and office uterine evacuation, and clarifying patient treatment preferences may increase the willingness of providers to adopt new practices for EPF treatment. PMID:20227674

  10. [The applicability of results].

    PubMed

    Marín-León, I

    2015-11-01

    The ultimate aim of the critical reading of medical literature is to use the scientific advances in clinical practice or for innovation. This requires an evaluation of the applicability of the results of the studies that have been published, which begins with a clear understanding of these results. When the studies do not provide sufficient guarantees of rigor in design and analysis, the conditions necessary for the applicability of the results are not met; however, the fact that the results are reliable is not enough to make it worth trying to use their conclusions. This article explains how carrying out studies in experimental or artificial conditions often moves them away from the real conditions in which they claim to apply their conclusions. To evaluate this applicability, the article proposes evaluating a set of items that will enable the reader to determine the likelihood that the benefits and risks reported in the studies will yield the least uncertainty in the clinical arena where they aim to be applied.

  11. SupportNet for Frontline Behavioral Health Providers

    DTIC Science & Technology

    2015-07-01

    randomized controlled trial (RCT). Results showed a significant reduction in job burnout among participants who used SupportNet with a coaching component...The results of present study showed participants who used the SupportNet with coaching guidance reduced job burnout after the 8-week intervention...results indicated that the coaching component with online support was effective in this population. Behavioral healthcare providers may prefer face-to-face

  12. A fuzzy inference system to evaluate contract service provider performance.

    PubMed

    Cruz, Antonio Miguel; Denis, Ernesto Rodriguez

    2005-01-01

    This paper puts forward a fuzzy inference system for evaluating the quality performance of service contract providers. An Application Service Provider was designed and put online, featuring surveys to establish the most useful indicators to evaluate the quality of the service. This model was implemented in 10 separate hospitals. As a result, the service cost-acquisition cost ratio in these cases was reduced from 16.14% to 6.09% in the period 2001-January 2003.

  13. Provide thermogravimetric analysis data to performance assessment

    SciTech Connect

    Gdowski, G.

    1998-01-01

    Recent experimental testing has investigated the effect of a deposited mixed salt on the corrosion of carbon steel in high relative humidity air. This result is compared with previous studies where pure sodium chloride was deposited. There are aspects of the degradation process which are significantly different when the different salts are deposited. With deposited sodium chloride, corrosion occurs almost immediately after introduction of 80% RH air. With deposited mixed salts, there is an initial inhibition of corrosion in 80% RH air. After the initial inhibition period, corrosion occurs at localized regions of the specimen. At longer times, the specimen suffers extensive corrosion. A very porous and non-adherent corrosion product forms and readily spalls. The initial inhibition of the corrosion with the deposited mixed salt is most likely due to the bicarbonate component. Bicarbonate is a known inhibitor of general corrosion of carbon steel [Thomas, 1994] and a promoter of localized corrosion at moderate alkalinity when chloride ions are present [Marsh, 1985]. The results of this testing indicate that the bicarbonate component of thin water layers can initially inhibit corrosion of the carbon steel. With time, however, inhibition is lost. A mechanism for this loss of inhibition is suggested. It is plausible that moderately alkaline bicarbonate aqueous solutions could develop on the surface of a waste package due to Yucca Mountain water contacting the waste packages. Aqueous conditions might develop where carbon steel is susceptible to localized corrosion [Dunn, 1998]. The initial test results presented here suggest that the inhibition of general corrosion, and hence, the promotion of localized corrosion of carbon steel by thin aqueous bicarbonate-chloride layers may not be sustainable. Additional testing is underway to further understand the effects of thin aqueous solution chemistry on carbon steel corrosion.

  14. Clinical forensic medicine introduction for healthcare providers.

    PubMed

    Recktenwald, Kathy; Hunsaker, Donna M; Corey, Tracey S; Weakley-Jones, Barbara

    2005-09-01

    Clinical forensic medicine (CFM) is "the application of appropriate forensic practices and principles, heretofore reserved for use by the pathologist at autopsy, to living patients in a clinical setting." "Living forensic" patients include survivors of trauma and potentially catastrophic experiences resulting in injury. CFM arose from "clinically" affirming that not all abuse or assault victims sustain fatal injuries. Appropriate medical documentation and interpretation of physical findings may aid law enforcement and/or social services in the legal evaluation of a case or situation. Additionally, timely collection of pertinent evidence may be performed as the case necessitates.

  15. Providing and financing aged care in Australia

    PubMed Central

    Ergas, Henry; Paolucci, Francesco

    2011-01-01

    This article focuses on the provision and financing of aged care in Australia. Demand for aged care will increase substantially as a result of population aging, with the number of Australians aged 85 and over projected to increase from 400,000 in 2010 to over 1.8 million in 2051. Meeting this demand will greatly strain the current system, and makes it important to exploit opportunities for increased efficiency. A move to greater beneficiary co-payments is also likely, though its extent may depend on whether aged care insurance and other forms of pre-payment can develop. PMID:22312229

  16. Bacteria Provide Cleanup of Oil Spills, Wastewater

    NASA Technical Reports Server (NTRS)

    2010-01-01

    Through Small Business Innovation Research (SBIR) contracts with Marshall Space Flight Center, Micro-Bac International Inc., of Round Rock, Texas, developed a phototrophic cell for water purification in space. Inside the cell: millions of photosynthetic bacteria. Micro-Bac proceeded to commercialize the bacterial formulation it developed for the SBIR project. The formulation is now used for the remediation of wastewater systems and waste from livestock farms and food manufacturers. Strains of the SBIR-derived bacteria also feature in microbial solutions that treat environmentally damaging oil spills, such as that resulting from the catastrophic 2010 Deepwater Horizon oil rig explosion in the Gulf of Mexico.

  17. Analysis of science textbook recommendations provided for students with disabilities.

    PubMed

    Parmar, R S; Cawley, J F

    1993-05-01

    Teachers' manuals from three major elementary science textbook series were analyzed. These textbooks provided specific instructional recommendations for students with disabilities in mainstream classes. Findings reveal that (a) the textbooks did not provide recommendations for all categories of disabilities as defined in Public Law 94-142; (b) many recommendations did not specifically address the learning needs of the students for whom they were intended; and (c) there were no consistency in the nature of recommendations provided for any given category of disability. Results indicate that special education and mainstream teachers should monitor the usefulness of published materials that claim to meet the needs of students with disabilities.

  18. Primary Care Providers' HIV Prevention Practices Among Older Adults

    PubMed Central

    Davis, Tracy; Teaster, Pamela B.; Thornton, Alice; Watkins, John F.; Alexander, Linda; Zanjani, Faika

    2016-01-01

    Purpose To explore primary care providers' HIV prevention practices for older adults. Primary care providers' perceptions and awareness were explored to understand factors that affect their provision of HIV prevention materials and HIV screening for older adults. Design and Method Data were collected through 24 semistructured interviews with primary care providers (i.e., physicians, physician assistants, and nurse practitioners) who see patients older than 50 years. Results Results reveal facilitators and barriers of HIV prevention for older adults among primary care providers and understanding of providers' HIV prevention practices and behaviors. Individual, patient, institutional, and societal factors influenced HIV prevention practices among participants, for example, provider training and work experience, lack of time, discomfort in discussing HIV/AIDS with older adults, stigma, and ageism were contributing factors. Furthermore, factors specific to primary and secondary HIV prevention were identified, for instance, the presence of sexually transmitted infections influenced providers' secondary prevention practices. Implications HIV disease, while preventable, is increasing among older adults. These findings inform future research and interventions aimed at increasing HIV prevention practices in primary care settings for patients older than 50. PMID:25736425

  19. The state of the psychology health service provider workforce.

    PubMed

    Michalski, Daniel S; Kohout, Jessica L

    2011-12-01

    Numerous efforts to describe the health service provider or clinical workforce in psychology have been conducted during the past 30 years. The American Psychological Association (APA) has studied trends in the doctoral education pathway and the resultant effects on the broader psychology workforce. During this period, the creation and growth of the PsyD degree and the formalization of the predoctoral internship placement system (the APPIC Match) have been well noted, but efforts to gain a complete understanding of professional practice are lacking. Specifically, piecemeal research on the provider workforce has led to the study of specific subpopulations using varying approaches and definitions of those providing direct clinical service. Consequently, estimates of the supply and need for health service providers are distinctly divergent and generate protracted debate in organized psychology. The APA membership directory and the APA Doctorate Employment Surveys have traditionally been relied on for workforce analyses. Yet, these data have become characterized by limited generalizability in recent years because of declining survey response rates and the fact that APA member data may not be as representative of the entire psychology health service provider population as they were previously. The 2008 APA Survey of Psychology Health Service Providers targeted these limitations by including nonmember psychologists in the sampling frame. Results revealed emerging themes in the demographics, work settings, and delivery of health services of the psychology health service provider workforce. Future areas of research for APA and organized psychology to undertake in addressing need and demand are suggested.

  20. Osteophagia provide giraffes with phosphorus and calcium?

    PubMed

    Bredin, I P; Skinner, J D; Mitchell, G

    2008-03-01

    The daily requirement for calcium and phosphorus by giraffes to sustain the growth and maintenance of their skeletons is large. The source of sufficient calcium is browse. The source of necessary phosphorus is obscure, but it could be osteophagia, a frequently observed behaviour in giraffes. We have assessed whether bone ingested as a result of osteophagia can be digested in the rumen. Bone samples from cancellous (cervical vertebrae) and dense bones (metacarpal shaft) were immersed in the rumens of five sheep, for a period of up to 30 days, and the effect compared to immersion in distilled water and in artificial saliva for 30 days. Distilled water had no effect on the bones. Dense bone samples were softened by exposure to the saliva and rumen fluid, but did not lose either calcium or phosphorus. In saliva and rumen fluid the cancellous bone samples also softened, and their mass and volume decreased as a result of exposure to saliva, but in neither fluid did they lose significant amounts of calcium and phosphorus. We conclude that although saliva and rumen fluid can soften ingested bones, there is an insignificant digestion of bones in the rumen.

  1. 28 CFR 58.26 - Procedures all providers shall follow when applying to become approved providers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... be signed by a representative of the provider who is authorized under applicable law to sign on..., conceal, or cover up by any trick, scheme or device a material fact; (2) Make any materially false... authorized under applicable law to sign on behalf of the provider. (h) By the act of submitting...

  2. 22 CFR 96.14 - Providing adoption services using other providers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Providing adoption services using other... ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.14 Providing...

  3. 22 CFR 96.14 - Providing adoption services using other providers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Providing adoption services using other... ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.14 Providing...

  4. 22 CFR 96.14 - Providing adoption services using other providers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Providing adoption services using other... ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.14 Providing...

  5. A Providence History Mystery: Discover the History of Providence through Architecture. Second Edition.

    ERIC Educational Resources Information Center

    Jordan, Amy, Ed.

    This workbook, a part of the Providence (Rhode Island) Preservation Society's preservation education curriculum for elementary school students, is designed to help students appreciate the significance and the beauty of Providence's architectural heritage. (Other materials in this program are a handbook entitled, "A New Look at Old…

  6. Provider Opinions Regarding the Development of a Stigma-Reduction Intervention Tailored for Providers

    ERIC Educational Resources Information Center

    Mittal, Dinesh; Corrigan, Patrick; Drummond, Karen L.; Porchia, Sylvia; Sullivan, Greer

    2016-01-01

    Interventions involving contact with a person who has recovered from mental illness are most effective at reducing stigma. This study sought input from health care providers to inform the design of a contact intervention intended to reduce provider stigma toward persons with serious mental illness. Using a purposive sampling strategy, data were…

  7. Review of Pesticide Education Materials for Health Care Providers Providing Care to Agricultural Workers

    ERIC Educational Resources Information Center

    Hiott, Ann E.; Quandt, Sara A.; Early, Julie; Jackson, David S.; Arcury, Thomas A.

    2006-01-01

    Context: Pesticide exposure is an important environmental and occupational health risk for agricultural workers and their families, but health care providers receive little training in it. Objective: To evaluate the medical resources available to providers caring for patients, particularly farmworkers, exposed to pesticides and to recommend a…

  8. Remote Sensing May Provide Unprecedented Hydrological Data

    NASA Technical Reports Server (NTRS)

    Koster, R.; Houser, P.; Engman, E.; Kustas, W.

    1999-01-01

    Basic hydrological research and water resources management may reap tremendous benefits from remote sensing technology, studies are showing. Satellite coverage may allow unprecedented accuracy in the quantification of the global hydrological cycle, for example. Yet despite such benefits, few hydrologists currently use such data. This is partly because the needed tools and algorithms are not fully developed. Such development requires field experiments that combine remotely sensed data with detailed in situ observations. AGU's Remote Sensing in Hydrology Committee has constructed a Web site (http://Iand.gsfc.nasa.gov/RSHC.html) that gives an overview of many such experiments. Included on the site is information on each experiment's overall goal, the types of in situ and remotely sensed measurements taken, relevant climate and vegetation conditions, and so forth. Links to additional relevant Web sites are included. The site is designed to be a suitable starting point for those interested in learning more about remote sensing in hydrology. It lists members of the committee who can be contacted for further information. Hydrologists have recognized the potential of remote sensing technology since the 1970s. It offers a way to avoid the logistical and economic difficulties associated with obtaining continuous in situ measurements of various hydrological variables, difficulties that are particularly pronounced in remote regions. Microwave instruments in particular can potentially provide all-weather, areally averaged estimates of certain variables (such as precipitation, soil moisture, and snow water content) that have been essentially unattainable in the past. In remote sensing, the conversion of emitted and reflected radiances into useful hydrological data is a complex problem. The measured radiances, for example, reflect the integrated character of a pixel area, a scale inconsistent with the point measurements of traditional hydrology. To develop the needed algorithms

  9. Correlating Ratings of Health Insurance Plans to Their Providers' Attributes

    PubMed Central

    Shetty, Prajna; Hristidis, Vagelis

    2016-01-01

    Background There is a push towards quality measures in health care. As a consequence, the National Committee for Quality Assurance (NCQA) has been publishing insurance plan quality measures. Objective The objective of this study was to examine the relationship between insurance plan quality measures and the participating providers (doctors). Methods We collected and analyzed provider and insurance plan data from several online sources, including provider directories, provider referrals and awards, patient reviewing sites, and hospital rankings. The relationships between the provider attributes and the insurance plan quality measures were examined. Results Our analysis yielded several findings: (1) there is a moderate Pearson correlation (r=.376) between consumer satisfaction insurance plan scores and review ratings of the member providers, (2) referral frequency and provider awards are negligibly correlated to consumer satisfaction plan scores (correlations of r=.031 and r=.183, respectively), (3) there is weak positive correlation (r=.266) between the cost charged for the same procedures and consumer satisfaction plan scores, and (4) there is no significant correlation between member specialists’ review ratings and specialty-specific insurance plan treatment scores for most specialties, except a surprising weak negative correlation for diabetes treatment (r=-.259). Conclusions Our findings may be used by consumers to make informed choices about their insurance plans or by insurances to understand the relationship between patients’ satisfaction and their network of providers. PMID:27777217

  10. Finance, providers issue brief: insurer liability.

    PubMed

    Rothouse, M

    1999-07-01

    When a health plan denies payment for a procedure on grounds that it is not medically necessary or when it refuses a physician-ordered referral to a specialist, has it crossed the line from making an insurance judgment to practicing medicine? If the patient suffers harm as a result of the decision, is the plan liable for medical malpractice? Those are questions 29 states considered in 1998, and at least 35 states are grappling with this year as they seek to respond to physician and patient pressure to curb the power of the managed care industry. Traditionally, health insurers have been protected by state laws banning "the corporate practice of medicine," which means the patient's only recourse is to sue under a "vicarious liability" theory. Now, however, lawmakers are debating legislation to extend the scope of malpractice liability beyond individual practitioners to insurance carriers and plans themselves.

  11. Finance, providers issue brief: insurer liability.

    PubMed

    Rothouse, M; Stauffer, M

    2000-05-24

    When a health plan denies payment for a procedure on grounds that it is not medically necessary or when it refuses a physician-ordered referral to a specialist, has it crossed the line from making an insurance judgment to practicing medicine? If the patient suffers harm as a result of the decision, is the plan liable for medical malpractice? Those were questions 35 states considered in 1999, and at least 32 states are grappling with this year as they seek to respond to physician and patient pressure to curb the power of the managed care industry. Traditionally, health insurers have been protected by state laws banning "the corporate practice of medicine," which means the patient's only recourse is to sue under a "vicarious liability" theory. Now, however, lawmakers are debating legislation to extend the scope of malpractice liability beyond individual practitioners to insurance carriers and plans themselves.

  12. ICAAS piloted simulation results

    NASA Astrophysics Data System (ADS)

    Landy, R. J.; Halski, P. J.; Meyer, R. P.

    1994-05-01

    This paper reports piloted simulation results from the Integrated Control and Avionics for Air Superiority (ICAAS) piloted simulation evaluations. The program was to develop, integrate, and demonstrate critical technologies which will enable United States Air Force tactical fighter 'blue' aircraft to achieve superiority and survive when outnumbered by as much as four to one by enemy aircraft during air combat engagements. Primary emphasis was placed on beyond visual range (BVR) combat with provisions for effective transition to close-in combat. The ICAAS system was developed and tested in two stages. The first stage, called low risk ICAAS, was defined as employing aircraft and avionics technology with an initial operational date no later than 1995. The second stage, called medium risk ICAAS, was defined as employing aircraft and avionics technology with an initial operational date no later than 1998. Descriptions of the low risk and medium risk simulation configurations are given. Normalized (unclassified) results from both the low risk and medium risk ICAAS simulations are discussed. The results show the ICAAS system provided a significant improvement in air combat performance when compared to a current weapon system. Data are presented for both current generation and advanced fighter aircraft. The ICAAS technologies which are ready for flight testing in order to transition to the fighter fleet are described along with technologies needing additional development.

  13. High diving metabolism results in a short aerobic dive limit for Steller sea lions (Eumetopias jubatus).

    PubMed

    Gerlinsky, Carling D; Rosen, David A S; Trites, Andrew W

    2013-07-01

    The diving capacity of marine mammals is typically defined by the aerobic dive limit (ADL) which, in lieu of direct measurements, can be calculated (cADL) from total body oxygen stores (TBO) and diving metabolic rate (DMR). To estimate cADL, we measured blood oxygen stores, and combined this with diving oxygen consumption rates (VO2) recorded from 4 trained Steller sea lions diving in the open ocean to depths of 10 or 40 m. We also examined the effect of diving exercise on O2 stores by comparing blood O2 stores of our diving animals to non-diving individuals at an aquarium. Mass-specific blood volume of the non-diving individuals was higher in the winter than in summer, but there was no overall difference in blood O2 stores between the diving and non-diving groups. Estimated TBO (35.9 ml O2 kg(-1)) was slightly lower than previously reported for Steller sea lions and other Otariids. Calculated ADL was 3.0 min (based on an average DMR of 2.24 L O2 min(-1)) and was significantly shorter than the average 4.4 min dives our study animals performed when making single long dives-but was similar to the times recorded during diving bouts (a series of 4 dives followed by a recovery period on the surface), as well as the dive times of wild animals. Our study is the first to estimate cADL based on direct measures of VO2 and blood oxygen stores for an Otariid and indicates they have a much shorter ADL than previously thought.

  14. Martian Colors Provide Clues About Martian Water

    NASA Technical Reports Server (NTRS)

    1999-01-01

    NASA Hubble Space Telescope images of Mars taken in visible and infrared light detail a rich geologic history and provide further evidence for water-bearing minerals on the planet's surface.

    LEFT

    This 'true-color' image of Mars shows the planet as it would look to human eyes. It is clearly more Earth-toned than usually depicted in other astronomical images, including earlier Hubble pictures. The slightly bluer shade along the edges of the disk is due to atmospheric hazes and wispy water ice clouds (like cirrus clouds) in the early morning and late evening Martian sky. The yellowish-pink color of the northern polar cap indicates the presence of small iron-bearing dust particles. These particles are covering or are suspended in the air above the blue-white water ice and carbon dioxide ice, which make up the polar cap.

    Accurate colors are needed to determine the composition and mineralogy of Mars. This can tell how water has influenced the formation of rocks and minerals found on Mars today, as well as the distribution and abundance of ice and subsurface liquid water. Confirmation of the presence of certain oxidized (rusted) minerals (processed by heat or water action) would imply the possibility of different, perhaps much more Earth-like, past Martian climate periods. Because the smallest features visible in this image are only about 14 miles (22 km) across, Hubble can track small-scale variations in the distribution of minerals that do not follow global trends. The image was generated from three separate Wide Field and Planetary Camera 2 images acquired at wavelengths of 410, 502, and 673 nanometers, in March 1997.

    RIGHT

    A false-color picture taken in infrared light reveals features that cannot be seen in visible light. Hubble's unique infrared view pinpoints variations in the abundance and distribution of unknown water-bearing minerals on the planet. While it has been known for decades that small amounts of water-bearing minerals exist on the planet

  15. MARTIAN COLORS PROVIDE CLUES ABOUT MARTIAN WATER

    NASA Technical Reports Server (NTRS)

    2002-01-01

    NASA Hubble Space Telescope images of Mars taken in visible and infrared light detail a rich geologic history and provide further evidence for water-bearing minerals on the planet's surface. LEFT This 'true-color' image of Mars shows the planet as it would look to human eyes. It is clearly more earth-toned than usually depicted in other astronomical images, including earlier Hubble pictures. The slightly bluer shade along the edges of the disk is due to atmospheric hazes and wispy water ice clouds (like cirrus clouds) in the early morning and late evening Martian sky. The yellowish-pink color of the northern polar cap indicates the presence of small iron-bearing dust particles. These particles are covering or are suspended in the air above the blue-white water ice and carbon dioxide ice, which make up the polar cap. Accurate colors are needed to determine the composition and mineralogy of Mars. This can tell how water has influenced the formation of rocks and minerals found on Mars today, as well as the distribution and abundance of ice and subsurface liquid water. Confirmation of the presence of certain oxidized (rusted) minerals (processed by heat or water action) would imply the possibility of different, perhaps much more Earth-like, past Martian climate periods. Because the smallest features visible in this image are only about 14 miles (22 km) across, Hubble can track small-scale variations in the distribution of minerals that do not follow global trends. The image was generated from three separate Wide Field and Planetary Camera 2 images acquired at wavelengths of 410, 502, and 673 nanometers, in March 1997. RIGHT A false-color picture taken in infrared light reveals features that cannot be seen in visible light. Hubble's unique infrared view pinpoints variations in the abundance and distribution of unknown water-bearing minerals on the planet. While it has been known for decades that small amounts of water-bearing minerals exist on the planet's surface, the

  16. Buerger’s disease: providing integrated care

    PubMed Central

    Klein-Weigel, Peter; Volz, Theresa Sophie; Zange, Leonora; Richter, Jutta

    2016-01-01

    Buerger’s disease, also known as thromboangiitis obliterans (TAO), is a segmental inflammatory disease affecting small- and medium-sized vessels, which is strongly associated with tobacco use. Although the etiology is still unknown, recent studies suggest an immunopathogenesis. Diagnosis is based on clinical and angiomorphologic criteria, including age, history of smoking, clinical presentation with distal extremity ischemia, and the absence of other risk factors for atherosclerosis, autoimmune disease, hypercoagulable states, or embolic disease. Until now, no causative therapy exists for TAO. The most important therapeutic intervention is smoking cessations and intravenous prostanoid infusions (iloprost). Furthermore, effective analgesia is crucial for the treatment of ischemic and neuropathic pain and might be expanded by spinal cord stimulation. Revascularization procedures do not play a major role in the treatment of TAO due to the distal localization of arterial occlusion. More recently, immunoadsorption has been introduced eliminating vasoconstrictive G-protein-coupled receptor and other autoantibodies. Cell-based therapies and treatment with bosentan were also advocated. Finally, a consequent prevention and treatment of wounds and infections are essential for the prevention of amputations. To achieve better clinical results, integrated care in multidisciplinary and trans-sectoral teams with emphasis on smoking cessation, pain control, wound management, and social care by professionals, social workers, and family members is necessary. PMID:27785045

  17. Can lip prints provide biologic evidence?

    PubMed Central

    Sharma, Preeti; Sharma, Neeraj; Wadhwan, Vijay; Aggarwal, Pooja

    2016-01-01

    Background: Lip prints are unique and can be used in personal identification. Very few studies are available which establish them as biological evidence in the court of law. Thus, the objective of this study was to attempt to isolate DNA and obtain full short tandem repeat (STR) loci of the individual from the lip prints on different surfaces. Materials and Methods: Twelve lip prints were procured on different surfaces such as tissue paper, cotton cloth, ceramic tile, and glass surface. Latent lip prints were developed using fingerprint black powder. Lipstick-coated lip prints were also collected on the same supporting items. DNA was isolated, quantified, and amplified using Identifiler™ kit to type 15 STR loci. Results: Ample quantity of DNA was extracted from all the lip print impressions and 15 loci were successfully located in seven samples. Fourteen loci were successfully typed in 3 lip impressions while 13 loci were typed in 2 samples. Conclusion: This study emphasizes the relevance of lip prints at the scene of crime. Extraction of DNA followed by typing of STR loci establishes the lip prints as biological evidence too. Tissue papers, napkins, cups, and glasses may have imprints of the suspect's lips. Thus, the full genetic profile is extremely useful for the forensic team. PMID:28123277

  18. Are Anesthesia Providers Ready for Hypnosis? Anesthesia Providers' Attitudes Toward Hypnotherapy.

    PubMed

    Stone, Alexander B; Sheinberg, Rosanne; Bertram, Amanda; Seymour, Anastasia Rowland

    2016-04-01

    This study sought to measure current attitudes toward hypnosis among anesthesia providers using an in-person survey distributed at a single grand rounds at a single academic teaching hospital. One hundred twenty-six anesthesia providers (anesthesiologists and nurse anesthetists) were included in this study. A 10-question Institutional Review Board (IRB)-approved questionnaire was developed. One hundred twenty-six (73% of providers at the meeting) anesthesia providers completed the survey. Of the respondents, 54 (43%) were anesthesiologists, 42 (33%) were trainees (interns/residents/fellows) in anesthesia, and 30 (24%) were nurse anesthetists. Over 70% of providers, at each level of training, rated their knowledge of hypnosis as either below average or having no knowledge. Fifty-two (42%) providers agreed or strongly agreed that hypnotherapy has a place in the clinical practice of anesthesia, while 103 (83%) believed that positive suggestion has a place in the clinical practice of anesthesia (p < .0001). Common reasons cited against using hypnosis were that it is too time consuming (41%) and requires special training (34%). Only three respondents (2%) believed that there were no reasons for using hypnosis in their practice. These data suggest that there is a self-reported lack of knowledge about hypnosis among anesthesia providers, although many anesthesia providers are open to the use of hypnosis in their clinical practice. Anesthesia providers are more likely to support the use of positive suggestion in their practice than hypnosis. Practical concerns should be addressed if hypnosis and therapeutic verbal techniques are to gain more widespread use.

  19. HUBBLE PROVIDES COMPLETE VIEW OF JUPITER'S AURORAS

    NASA Technical Reports Server (NTRS)

    2002-01-01

    NASA's Hubble Space Telescope has captured a complete view of Jupiter's northern and southern auroras. Images taken in ultraviolet light by the Space Telescope Imaging Spectrograph (STIS) show both auroras, the oval- shaped objects in the inset photos. While the Hubble telescope has obtained images of Jupiter's northern and southern lights since 1990, the new STIS instrument is 10 times more sensitive than earlier cameras. This allows for short exposures, reducing the blurring of the image caused by Jupiter's rotation and providing two to five times higher resolution than earlier cameras. The resolution in these images is sufficient to show the 'curtain' of auroral light extending several hundred miles above Jupiter's limb (edge). Images of Earth's auroral curtains, taken from the space shuttle, have a similar appearance. Jupiter's auroral images are superimposed on a Wide Field and Planetary Camera 2 image of the entire planet. The auroras are brilliant curtains of light in Jupiter's upper atmosphere. Jovian auroral storms, like Earth's, develop when electrically charged particles trapped in the magnetic field surrounding the planet spiral inward at high energies toward the north and south magnetic poles. When these particles hit the upper atmosphere, they excite atoms and molecules there, causing them to glow (the same process acting in street lights). The electrons that strike Earth's atmosphere come from the sun, and the auroral lights remain concentrated above the night sky in response to the 'solar wind,' as Earth rotates underneath. Earth's auroras exhibit storms that extend to lower latitudes in response to solar activity, which can be easily seen from the northern U. S. But Jupiter's auroras are caused by particles spewed out by volcanoes on Io, one of Jupiter's moons. These charged particles are then magnetically trapped and begin to rotate with Jupiter, producing ovals of auroral light centered on Jupiter's magnetic poles in both the day and night skies

  20. Providing a Turn for the Better

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Engineers are tasked with designing new systems every day to meet changing or unexpected technical requirements. After the tragic explosion of the Space Shuttle Challenger on January 28, 1986, NASA engineers embarked on a complete overhaul of many of their long-standing quality systems and procedures. When the official cause of the accident was determined to be an O-ring failure in the right Solid Rocket Booster, NASA's Shuttle Program initiated a thorough redesign of the rocket boosters' clevis ends, which are the O-ring's mating surfaces. One of the unique systems that NASA engineers developed as a result of this effort included a heating assembly that is coupled to the outside of the rocket boosters. When the assembly is affixed to the external surface of the boosters, the very nature of its design allows for the warming of the O-rings prior to launch. After the engineers completed the assembly's design, however, they found that it was nearly impossible to tighten the spanner nuts required for attaching the system, given the minimum amount of clearance they had in the limited and confined space. Under these circumstances, the standard wrenches typically used for tightening these types of nuts did not work, and there were no other existing devices to solve the problem. NASA engineers embraced the challenge, developing a torque wrench tool adapter that allowed for a full rotation of spanner nuts in confined spaces. The tool, which is similar to an open-ended crowfoot wrench and a fixed-face spanner wrench, contains two dowel pins that center and lock the wrench onto the nut.

  1. SALI chemical analysis of provided samples

    NASA Technical Reports Server (NTRS)

    Becker, Christopher H.

    1993-01-01

    SRI has completed the chemical analysis of all the samples supplied by NASA. The final batch of four samples consisted of: one inch diameter MgF2 mirror, control 1200-ID-FL3; one inch diameter neat resin, PMR-15, AO171-IV-55, half exposed and half unexposed; one inch diameter chromic acid anodized, EOIM-3 120-47 aluminum disc; and AO-exposed and unexposed samples of fullerene extract material in powdered form, pressed into In foil for analysis. Chemical analyses of the surfaces were performed by the surface analysis by laser ionization (SALI) method. The analyses emphasize surface contamination or general organic composition. SALI uses nonselective photoionization of sputtered or desorbed atoms and molecules above but close (approximately one mm) to the surface, followed by time-of-flight (TOF) mass spectrometry. In these studies, we used laser-induced desorption by 5-ns pulse-width 355-nm light (10-100 mJ/sq cm) and single-photon ionization (SPI) by coherent 118-nm radiation (at approximately 5 x 10(exp 5) W/sq cm). SPI was chosen primarily for its ability to obtain molecular information, whereas multiphoton ionization (not used in the present studies) is intended primarily for elemental and small molecule information. In addition to these four samples, the Au mirror (EOIM-3 200-11, sample four) was depth profiled again. Argon ion sputtering was used together with photoionization with intense 355-nm radiation (35-ps pulsewidths). Depth profiles are similar to those reported earlier, showing reproducibility. No chromium was found in the sample above noise level; its presence could at most be at the trace level. Somewhat more Ni appears to be present in the Au layer in the unexposed side, indicating thermal diffusion without chemical enhancement. The result of the presence of oxygen is apparently to tie-up/draw out the Ni as an oxide at the surface. The exposed region has a brownish tint appearance to the naked eye.

  2. [Provide comprehensive service for state policy].

    PubMed

    Wu, X

    1991-04-01

    In recent years, Chinese insurance companies introduced family planning (FP) insurance series. These schemes originated from the "one child" and life insurance and accident insurance of the early 1980s, which were established in response to the need that came with the "one child" policy. In order to help relieve the difficulties of rural FP work, the People's Insurance Corporation extended these programs to a series of schemes. These schemes included e.g., and old age security program for the families with 1 daughter only, old age security for families with an only child, and the program for FP workers' personal safety. The purpose of these schemes was to guarantee security in old age for families with few children, to ensure compensation if accident occurs during delivery or as a result of birth control operations; and compensation for FP workers for physical assaults they encountered. As FP organizations have been directly involved in advertising the insurance programs, there has been support from local governments with human and financial resources, and these insurance programs have been expanding every year. The payment of the policy has been either entirely or partially borne by the employers of the insured. In the process of the development of the insurance program, some problems have occurred. 1st, competition between FP organizations and insurance companies have evolved in sponsoring the program for its profit. 2nd, some media reports have confused the payment of premiums with the compulsory levy of undue fees, which in a way, hindered the expansion of program enrollment. 3rd, some local administrations are short of funds to pay for the insurance premiums. 4th, the accrued income from the premiums is lower than the expected sum of the principle and interest if the same funds were deposited in a bank at current interest rate. Therefore, some schemes lack appeal. FP series insurance is a longer term program which will have an important impact on the

  3. Titanium Isotopes Provide Clues to Lunar Origin

    NASA Astrophysics Data System (ADS)

    Taylor, G. J.

    2012-05-01

    The idea that the Moon formed as the result of the giant impact of a Mars-sized impactor with the still-growing Earth explains two central facts about the Earth-Moon system: its total angular momentum (Earth's spin and the Moon's orbital motion), and the sizes of the metallic cores of the Earth (large) and Moon (tiny). This gives cosmochemists some confidence in the hypothesis, but they would greatly appreciate additional compositional tests. One undisputed point is the identical abundance of the three oxygen isotopes in Earth and Moon. Junjun Zhang and colleagues at the University of Chicago (USA) and the University of Bern (Switzerland) have added another isotopic system to the cosmochemical testing tool kit, titanium isotopes. They find that the ratio of titanium-50 to titanium-47 is identical in Earth and Moon to within four parts per million. In contrast, other solar system materials, such as carbonaceous chondrites, vary by considerably more than this-- up to 150 times as much. The identical oxygen and titanium isotopic compositions in Earth and Moon are surprising in light of what we think we know about planet formation and formation of the Moon after a giant impact. The variations in oxygen and titanium isotopes among meteorite types suggest that it is unlikely that the Moon-forming giant impactor would have had the same isotopic composition as the Earth. Simulations show that the Moon ends up constructed mostly (40-75%) from the impactor materials. Thus, the Moon ought to have different isotopic composition than does Earth. The isotopes might have exchanged in the complicated, messy proto-lunar disk (as has been suggested for oxygen isotopes), making them the same. However, Zhang and colleagues suggest that this exchange is unlikely for a refractory element like titanium. Could the impact simulations be greatly overestimating the contributions from the impactor? Was the mixing of building-block materials throughout the inner solar system much less than

  4. First results from CARIBU

    NASA Astrophysics Data System (ADS)

    Savard, Guy

    2011-10-01

    The Californium Rare Ion Breeder Upgrade (CARIBU) of the ATLAS superconducting linac facility aims at providing low energy and reaccelerated neutron-rich radioactive beams to address key nuclear physics, astrophysics and application issues. These beams are obtained from fission fragments of a 1 Ci 252Cf source, thermalized and collected into a low-energy particle beam by a helium gas catcher, mass analyzed by an isobar separator, and charge breed to higher charge states for acceleration in ATLAS. The method described is fast and universal and short-lived isotope yield scale essentially with Californium fission yields. The facility is now commissioned and operating with a 100 mCi source which has yielded extracted low-energy mass separated radioactive beams at intensities in excess of 100000 ions per second. Radioactive beams have been charge bred with an efficiency of up to 12% and reaccelerated to 6 MeV/u. Commissioning results, together with the results from first astrophysics experiments at CARIBU using the beams from the 100 mCi source will be presented. The final 1 Ci source is currently under fabrication and is expected to be installed by the end of the year. This work was supported by the US DOE, Office of Nuclear Physics, under contract DE-AC02-06CH11357.

  5. The State of the Psychology Health Service Provider Workforce

    ERIC Educational Resources Information Center

    Michalski, Daniel S.; Kohout, Jessica L.

    2011-01-01

    Numerous efforts to describe the health service provider or clinical workforce in psychology have been conducted during the past 30 years. The American Psychological Association (APA) has studied trends in the doctoral education pathway and the resultant effects on the broader psychology workforce. During this period, the creation and growth of…

  6. Using Technology to Provide Differentiated Instruction for Deaf Learners

    ERIC Educational Resources Information Center

    Shepherd, Carol M.; Alpert, Madelon

    2015-01-01

    Knowledge is power. Technological devices provide the new pathway to online learning and student retention. This is especially true for deaf learners, who have difficulty learning with the traditional pedagogies used in teaching. Results of studies have indicated that students using the suggested new technologies become more interested and…

  7. 48 CFR 2045.370 - Providing Government property (in general).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... to Government facilities with a unit cost of less than $10,000, a contractor may be provided... property (in general). 2045.370 Section 2045.370 Federal Acquisition Regulations System NUCLEAR REGULATORY... result in substantially lower costs to the Government for the items produced or services rendered...

  8. 48 CFR 2045.370 - Providing Government property (in general).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... to Government facilities with a unit cost of less than $10,000, a contractor may be provided... property (in general). 2045.370 Section 2045.370 Federal Acquisition Regulations System NUCLEAR REGULATORY... result in substantially lower costs to the Government for the items produced or services rendered...

  9. 48 CFR 2045.370 - Providing Government property (in general).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... to Government facilities with a unit cost of less than $10,000, a contractor may be provided... property (in general). 2045.370 Section 2045.370 Federal Acquisition Regulations System NUCLEAR REGULATORY... result in substantially lower costs to the Government for the items produced or services rendered...

  10. 48 CFR 2045.370 - Providing Government property (in general).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... to Government facilities with a unit cost of less than $10,000, a contractor may be provided... property (in general). 2045.370 Section 2045.370 Federal Acquisition Regulations System NUCLEAR REGULATORY... result in substantially lower costs to the Government for the items produced or services rendered...

  11. Foundation Content Knowledge: Providing Support for Pre-Service Teachers

    ERIC Educational Resources Information Center

    Linsell, Chris; Ingram, Naomi

    2014-01-01

    This paper describes the assessment of primary pre-service teachers' mathematics content knowledge and the associated support services provided at the University of Otago during 2013. Most pre-service teachers believed that the results from the assessments accurately reflected their mathematics knowledge and gave them useful feedback about…

  12. Computer-Aided Techniques for Providing Operator Performance Measures.

    ERIC Educational Resources Information Center

    Connelly, Edward M.; And Others

    This report documents the theory, structure, and implementation of a performance processor (written in FORTRAN IV) that can accept performance demonstration data representing various levels of operator's skill and, under user control, analyze data to provide candidate performance measures and validation test results. The processor accepts two…

  13. Aerobic Activity--Do Physical Education Programs Provide Enough?

    ERIC Educational Resources Information Center

    McGing, Eileen

    1989-01-01

    High school physical education curricula should concentrate less on sport skill development and competition, and more on health-related fitness and aerobic activity. Results are reported from a study of the type and amount of aerobic exercise provided in 29 high school physical education programs in a large metropolitan area. (IAH)

  14. Providing Homeless Adults with Advantage: A Sustainable University Degree Program

    ERIC Educational Resources Information Center

    Sinatra, Richard; Lanctot, Melissa Kim

    2016-01-01

    A university partnered with the New York City Department of Homeless Services (NYC DHS) to provide cohorts of adults a 60-credit Associate Degree Program in Business Administration over a 2-year period. Results of two cohorts of 30 Advantage Academy Program graduates revealed significant improvement in College Board AccuPlacer (ACPL) Arithmetic…

  15. A Workforce Design Model: Providing Energy to Organizations in Transition

    ERIC Educational Resources Information Center

    Halm, Barry J.

    2011-01-01

    The purpose of this qualitative study was to examine the change in performance realized by a professional services organization, which resulted in the Life Giving Workforce Design (LGWD) model through a grounded theory research design. This study produced a workforce design model characterized as an organizational blueprint that provides virtuous…

  16. Development of a system to provide diagnostics-while-drilling.

    SciTech Connect

    Wise, Jack LeRoy; Jacobson, Ronald David; Finger, John Travis; Mansure, Arthur James; Knudsen, Steven Dell

    2003-06-01

    This report describes development of a system that provides high-speed, real-time downhole data while drilling. Background of the project, its benefits, major technical challenges, test planning, and test results are covered by relatively brief descriptions in the body of the report, with some topics presented in more detail in the attached appendices.

  17. Providing smoking cessation counseling: a national survey among nurse anesthetists.

    PubMed

    Yankie, Vicki M; Price, Holly M; Nanfito, Emily R; Jasinski, Donna M; Crowell, Nancy A; Heath, Janie

    2006-03-01

    Current research has demonstrated that smokers have an increased incidence of intraoperative and postoperative complications. Certified registered nurse anesthetists (CRNAs) have knowledge of a patient's smoking status and are in a unique position to provide smoking cessation counseling (SCC). The results from a national survey about SCC practice among CRNAs is revealed in this article.

  18. Quality Perception within Corporate E-Learning Providers in Catalonia

    ERIC Educational Resources Information Center

    Sangra, Albert; Fernandez-Michels, Pedro

    2011-01-01

    Purpose: The paper seeks to describe the Catalan corporate e-learning providers from the perspective of quality perception, quality assessment and quality control. Design/methodology/approach: A literature review reveals key aspects of the definition of quality in e-learning. The results of the review constitute the basis for exploratory research…

  19. Providing Counseling for Individuals with Alzheimer's Disease and Their Caregivers

    ERIC Educational Resources Information Center

    Granello, Paul F.; Fleming, Matthew S.

    2008-01-01

    Alzheimer's disease is a progressive condition that results in brain wasting and eventual death. With its increasing diagnosis rate, counselors will likely acquire clients with Alzheimer's disease or their caregivers. Important background information and several practical counseling methods are provided that may assist counselors working with this…

  20. Depression and burnout symptoms among Air Force family medicine providers.

    PubMed

    Varner, Derrick F; Foutch, Brian K

    2014-05-01

    This study investigated the prevalence of depression and burnout symptoms among family medicine providers on active duty in the US Air Force. Results demonstrated that 84% of those surveyed scored positive for degrees of depression symptoms; only sex differences were significant.

  1. Managing breathlessness: providing comfort at the end of life.

    PubMed

    Tice, Martha A

    2006-04-01

    Dyspnea is a common symptom at the end of life. It occurs as the result of a complex mix of physical, biochemical, and perceptual components. When patients and their healthcare providers focus on the "numbers" related to oxygenation, rather than comfort, the individual's quality of life can suffer.

  2. Pressure locking test results

    SciTech Connect

    DeWall, K.G.; Watkins, J.C.; McKellar, M.G.; Bramwell, D.

    1996-12-01

    The U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Regulatory Research, is funding the Idaho National Engineering Laboratory (INEL) in performing research to provide technical input for their use in evaluating responses to Generic Letter 95-07, {open_quotes}Pressure Locking and Thermal Binding of Safety-Related Power-Operated Gate Valves.{close_quotes} Pressure locking and thermal binding are phenomena that make a closed gate valve difficult to open. This paper discusses only the pressure locking phenomenon in a flexible-wedge gate valve; the authors will publish the results of their thermal binding research at a later date. Pressure locking can occur when operating sequences or temperature changes cause the pressure of the fluid in the bonnet (and, in most valves, between the discs) to be higher than the pressure on the upstream and downstream sides of the disc assembly. This high fluid pressure presses the discs against both seats, making the disc assembly harder to unseat than anticipated by the typical design calculations, which generally consider friction at only one of the two disc/seat interfaces. The high pressure of the bonnet fluid also changes the pressure distribution around the disc in a way that can further contribute to the unseating load. If the combined loads associated with pressure locking are very high, the actuator might not have the capacity to open the valve. The results of the NRC/INEL research discussed in this paper show that the relationship between bonnet pressure and pressure locking stem loads appears linear. The results also show that for this valve, seat leakage affects the bonnet pressurization rate when the valve is subjected to thermally induced pressure locking conditions.

  3. Achieving health care cost containment through provider payment reform that engages patients and providers.

    PubMed

    Ginsburg, Paul B

    2013-05-01

    The best opportunity to pursue cost containment in the next five to ten years is through reforming provider payment to gradually diminish the role of fee-for-service reimbursement. Public and private payers have launched many promising payment reform pilots aimed at blending fee-for-service with payment approaches based on broader units of care, such as an episode or patients' total needs over a period of time, a crucial first step. But meaningful cost containment from payment reform will not be achieved until Medicare and Medicaid establish stronger incentives for providers to contract in this way, with discouragement of nonparticipation increasing over time. In addition, the models need to evolve to engage beneficiaries, perhaps through incentives for patients to enroll in an accountable care organization and to seek care within that organization's network of providers.

  4. Provider and Administrator Experiences With Providing HIV Treatment and Prevention Services in Rural Areas.

    PubMed

    Rodriguez, Heather R; Dobalian, Aram

    2017-02-01

    Using Andersen's behavioral model of health services use, this study analyzes data from 62 semistructured interviews of providers and administrators at health clinics and social service agencies in rural Florida. Andersen's model addresses predisposing, enabling, and need factors that influence health services use. ATLASti was used to code all interviews and to extract HIV-related themes. The aim of this study was to: (1) add a new dimension to the literature on HIV care services in rural areas, (2) reveal factors that impact ability to provide care to PLWH in rural areas, and (3) suggest ways in which providers and administrators may address any unmet health care needs of PLWH. Respondents perceived systems factors to be more important determinants of access to care for individuals living with HIV and supported ongoing trainings that would increase staff understanding of the needs of people living with HIV.

  5. Problems of providing services to people affected by HIV/AIDS: service providers and recipients perspectives.

    PubMed

    Moradi, G; Mohraz, M; Gouya, M M; Dejman, M; Alinaghi, S S; Rahmani, K; Malekafzali-Ardakani, H

    2015-02-25

    This qualitative study aimed to identify the health-care problems of people living with HIV (PLHIV) in 2 large cities: Tehran and Kermanshah. Two main groups of stakeholders - service providers (policy-makers, managers, physicians and counsellors) and service recipients (PLHIV and their relatives) - participated in focus group discussions and in-depth interviews. We identified 24 themes covering the major health problems of PLHIV, including: incomplete and inadequate coverage of health-care services; patients' substance abuse; patients' fear of stigma; occupational burnout of certain service providers; patients' dissatisfaction with some of the services provided by counselling centres/clinics; medical staff's failure to observe confidentiality; and patients' lack of access to required specialized services. The problems and needs identified can inform the design and implementation of health programmes in our country and elsewhere in the Eastern Mediterranean Region.

  6. Private Companies Providing Health Care Price Data: Who Are They and What Information do They Provide?

    PubMed Central

    Phillips, Kathryn A.; Labno, Anna

    2014-01-01

    Summary There is interest in making health care price information more transparent given the increase in enrollment in high-deductible and consumer-directed health plans, and as policy efforts intensify to engage consumers to obtain high value care. We examine the role of private companies that market price transparency tools, primarily to self-insured employers – an important yet understudied topic. What companies exist? How did they emerge? What information do they provide? Where do they get that information? How does the price and quality information provided compare across companies? PMID:25678764

  7. Sexual health service providers' perceptions of transgender youth in England.

    PubMed

    Lefkowitz, Ayla R F; Mannell, Jenevieve

    2017-01-23

    Transgender youth often face difficulties when accessing sexual health services. However, few studies investigate health service providers' perceptions of transgender youth, and fewer focus on sexual health. To fill this gap, our study draws on social representations theory to examine sexual health service providers' perceptions of transgender youth and how this influences the provision of health services for this marginalised population in England. A thematic analysis of 20 semi-structured interviews with service providers, conducted between March and June 2014, resulted in five main themes centred on: binary representations of transgender; transgender as homosexuality; uncertain bodies; unstable mental states; and too young to know. Of the service providers interviewed, many understood transgender within a male/female binary, and perceived being transgender to be synonymous with being gay. There was confusion among service providers regarding transgender youths' sexual organs, and most of those interviewed saw transgender youth as mentally unstable and confused. Finally, many service providers perceived that transgender youth are too young to know that they are transgender and make decisions about their body. Some of these representations were potentially stigmatising and many conflicted with transgender youths' representations of themselves. Training by transgender people is recommended to help address these misunderstandings.

  8. Medicaid: Medicaid: provider reimbursement--2005. End of Year Issue Brief.

    PubMed

    Johnson, Pat

    2005-12-31

    Since Title XIX of the Social Security Act was enacted in 1965, state Medicaid programs have operated under tight budget constraints. States have recognized that reimbursement rates, whether traditional fee-for-service rates or capitation rates for managed care providers, must be sufficient in order to ensure that Medicaid programs have enough providers to deliver care. However, states have often looked to save money by lowering payments to providers who deliver health care services to Medicaid beneficiaries. This cost crunch has resulted in provider payment rates that are often substantially below market rates. State legislatures, program administrators and providers have sought to find the proper balance between adequate levels of reimbursement and cost control measures. However, dissatisfaction with low reimbursement levels has caused some providers to cease participating in the Medicaid program. This has had a detrimental affect on Medicaid recipients' access to health services. States have become aware of the problem and have tried to revise their rates to find the elusive balance between adequate reimbursement and fiscal control.

  9. Infant Male Circumcision: Healthcare Provider Knowledge and Associated Factors

    PubMed Central

    Starzyk, Erin J.; Kelley, Michele A.; Caskey, Rachel N.; Schwartz, Alan; Kennelly, Joan F.; Bailey, Robert C.

    2015-01-01

    Background and Objectives The emerging science demonstrates various health benefits associated with infant male circumcision and adult male circumcision; yet rates are declining in the United States. The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend that healthcare providers present evidence-based risk and benefit information for infant male circumcision to parent(s) and guardian(s). The purpose of this study was to assess providers’ level of infant male circumcision knowledge and to identify the associated characteristics. Methods An online survey was administered to healthcare providers in the family medicine, obstetrics, and pediatrics medical specialties at an urban academic health center. To assess infant male circumcision knowledge, a 17 point summary score was constructed to identify level of provider knowledge within the survey. Results Ninety-two providers completed the survey. Providers scored high for the following knowledge items: adverse event rates, protects against phimosis and urinary tract infections, and does not prevent hypospadias. Providers scored lower for items related to more recent research: protection against cervical cancer, genital ulcer disease, bacterial vaginosis, and reduction in HIV acquisition. Two models were constructed looking at (1) overall knowledge about male circumcision, and (2) knowledge about male circumcision reduction in HIV acquisition. Pediatricians demonstrated greater overall infant male circumcision knowledge, while obstetricians exhibited significantly greater knowledge for the HIV acquisition item. Conclusion Providers’ knowledge levels regarding the risks and benefits of infant male circumcision are highly variable, indicating the need for system-based educational interventions. PMID:25635664

  10. Selecting a provider: what factors influence patients' decision making?

    PubMed

    Abraham, Jean; Sick, Brian; Anderson, Joseph; Berg, Andrea; Dehmer, Chad; Tufano, Amanda

    2011-01-01

    Each year consumers make a variety of decisions relating to their healthcare. Some experts argue that stronger consumer engagement in decisions about where to obtain medical care is an important mechanism for improving efficiency in healthcare delivery and financing. Consumers' ability and motivation to become more active decision makers are affected by several factors, including financial incentives and access to information. This study investigates the set of factors that consumers consider when selecting a provider, including attributes of the provider and the care experience and the reputation of the provider. Additionally, the study evaluates consumers awareness and use of formal sources of provider selection information. Our results from analyzing data from a survey of 467 patients at four clinics in Minnesota suggest that the factors considered of greatest importance include reputation of the physician and reputation of the healthcare organization. Contractual and logistical factors also play a role, with respondents highlighting the importance of seeing a provider affiliated with their health plan and appointment availability. Few respondents indicated that advertisements or formal sources of quality information affected their decision making. The key implication for provider organizations is to carefully manage referral sources to ensure that they consistently meet the needs of referrers. Excellent service to existing patients and to the network of referring physicians yields patient and referrer satisfaction that is critical to attracting new patients. Finally, organizations more generally may want to explore the capabilities of new media and social networking sites for building reputation.

  11. ManiWordle: providing flexible control over Wordle.

    PubMed

    Koh, Kyle; Lee, Bongshin; Kim, Bohyoung; Seo, Jinwook

    2010-01-01

    Among the multifarious tag-clouding techniques, Wordle stands out to the community by providing an aesthetic layout, eliciting the emergence of the participatory culture and usage of tag-clouding in the artistic creations. In this paper, we introduce ManiWordle, a Wordle-based visualization tool that revamps interactions with the layout by supporting custom manipulations. ManiWordle allows people to manipulate typography, color, and composition not only for the layout as a whole, but also for the individual words, enabling them to have better control over the layout result. We first describe our design rationale along with the interaction techniques for tweaking the layout. We then present the results both from the preliminary usability study and from the comparative study between ManiWordle and Wordle. The results suggest that ManiWordle provides higher user satisfaction and an efficient method of creating the desired "art work," harnessing the power behind the ever-increasing popularity of Wordle.

  12. Providing Services to Survivors of Domestic Violence: A Comparison of Rural and Urban Service Provider Perceptions

    ERIC Educational Resources Information Center

    Eastman, Brenda J.; Bunch, Shelia Grant

    2007-01-01

    Although there is a considerable body of knowledge about domestic violence, a limited proportion focuses on domestic violence in rural settings. Using a nonprobability purposive sampling technique, 93 providers of domestic violence services from rural and urban localities in North Carolina and Virginia were located and asked to complete a…

  13. Comparing Intentions to Use University-Provided vs Vendor-Provided Multibiometric Authentication in Online Exams

    ERIC Educational Resources Information Center

    Levy, Yair; Ramim, Michelle M.; Furnell, Steven M.; Clarke, Nathan L.

    2011-01-01

    Purpose: Concerns for information security in e-learning systems have been raised previously. In the pursuit for better authentication approaches, few schools have implemented students' authentication during online exams beyond passwords. This paper aims to assess e-learners' intention to provide multibiometric data and use of multibiometrics…

  14. The Reinvention of the FDLP: A Paradigm Shift from Product Provider to Service Provider

    ERIC Educational Resources Information Center

    Arrigo, Paul A.

    2004-01-01

    This article highlights the Government Printing Office's (GPO) successful transition from a producer of print publications to a service provider and how this has affected the role of Federal Depository Libraries in an increasingly electronic service environment. It discusses the identity crisis currently facing Federal Depository Libraries during…

  15. Medicaid Personal Care Services for Children with Intellectual Disabilities: What Assistance Is Provided? When Is Assistance Provided?

    ERIC Educational Resources Information Center

    Elliot, Timothy R.; Patnaik, Ashweeta; Naiser, Emily; Fournier, Constance J.; McMaughan, Darcy K.; Dyer, James A.; Phillips, Charles D.

    2014-01-01

    We report on the nature and timing of services provided to children with an intellectual disability (ID) identified by a new comprehensive assessment and care planning tool used to evaluate children's needs for Medicaid Personal Care Services (PCS) in Texas. The new assessment procedure resulted from a legal settlement with the advocacy community.…

  16. Cholesterol testing and results

    MedlinePlus

    Cholesterol test results; LDL test results; VLDL test results; HDL test results; Coronary risk profile results; Hyperlipidemia- ... Some cholesterol is considered good and some is considered bad. Different blood tests can be done to measure each ...

  17. Results from SNO

    SciTech Connect

    Chan, Yuen-dat

    2001-10-01

    The Sudbury Neutrino Observatory (SNO) is an underground heavy water Cherenkov detector for studying solar neutrinos. SNO is capable of performing both flavor sensitive and flavor blind measurements of the solar neutrino flux. The first charged current (CC) measurement is found to be: {psi}{sub SNO}{sup CC}({nu}{sub e}) = 1.75 {+-} 0.07(stat.){sub -0.11}{sup +0.12}(sys.) {+-} 0.05 (theor.) x 10{sup 6} cm{sup -2}s{sup -1} and the elastic scattering fluxes (ES) is: {psi}{sub SNO}{sup ES}({nu}{sub x}) = 2.39 {+-} 0.34(stat.){sub -0.14}{sup +0.16} (sys.) x 10{sup 6} cm{sup -2}s{sup -1}. The {psi}{sub SNO}{sup CC}({nu}{sub e}) result, when combined with the high statistics elastic scattering (ES) measurement from Super-Kamiokande, provide a strong evidence for solar neutrino flavor transformation (3.3{sigma}). The deduced total solar neutrino flux is in good agreement with standard solar model predictions. No significant distortion in the energy spectrum is observed.

  18. Latest Electroweak Results from CDF

    SciTech Connect

    Lancaster, Mark

    2010-05-01

    The latest results in electroweak physics from proton anti-proton collisions at the Fermilab Tevatron recorded by the CDF detector are presented. The results provide constraints on parton distribution functions, the mass of the Higgs boson and beyond the Standard Model physics.

  19. Expression of patients' and providers' identities during the medical interview.

    PubMed

    Scholl, Juliann C; Wilson, Jacquee B; Hughes, Patrick C

    2011-08-01

    We apply the Communication Theory of Identity to investigate how patients display their ethnic identities during intercultural patient-provider interactions. Ethnic identity displays play a large part in reflecting patients' and providers' assumptions about the other, as well as their communicative needs. We collected paper-and-pencil responses from a convenience sample of providers and their patients, and conducted a constant comparative analysis of their open-ended reports of a recent intercultural medical interview. The results revealed how both parties viewed their roles in intercultural medical encounters and how they looked for accommodative behaviors from the other party. We draw implications for new applications and future developments of the Communication Theory of Identity and Communication Accommodation Theory.

  20. Collaborative communication between psychologists and primary care providers.

    PubMed

    Knowles, Philip

    2009-03-01

    Psychologists frequently collaborate in the care of patients managed in primary care. Communication with a patient's primary care team is important to ensure coordination and continuity of care. The communication is far from seamless. Although The Health Information Privacy and Portability Act (HIPPA) is designed to promote sharing of clinical information while protecting patient confidentiality, unique problems arise when mental health records are included. Mental health records are subject to different regulations to protect the patient's confidentiality. Thus, what is communicated and how it will be accomplished are challenges. Further, psychologists and primary care providers often view documentation differently, resulting in different styles of documenting that may also impede coordinated care. Increasingly, health care systems are moving toward electronic medical records, creating greater opportunities for an integrated record. Improved communication through the record can keep other providers abreast of the mental health care being provided as well as suggestions they can use to reinforce the mental health care treatment plan.

  1. Apparatus for providing directional permeability measurements in subterranean earth formations

    DOEpatents

    Shuck, Lowell Z.

    1977-01-01

    Directional permeability measurements are provided in a subterranean earth formation by injecting a high-pressure gas from a wellbore into the earth formation in various azimuthal directions with the direction having the largest pressure drop being indicative of the maximum permeability direction. These measurements are provided by employing an inflatable boot containing a plurality of conduits in registry with a like plurality of apertures penetrating the housing at circumferentially spaced-apart locations. These conduits are, in turn, coupled through a valved manifold to a source of pressurized gas so that the high-pressure gas may be selectively directed through any conduit into the earth formation defining the bore with the resulting difference in the pressure drop through the various conduits providing the permeability measurements.

  2. Method for providing uranium with a protective copper coating

    DOEpatents

    Waldrop, Forrest B.; Jones, Edward

    1981-01-01

    The present invention is directed to a method for providing uranium metal with a protective coating of copper. Uranium metal is subjected to a conventional cleaning operation wherein oxides and other surface contaminants are removed, followed by etching and pickling operations. The copper coating is provided by first electrodepositing a thin and relatively porous flash layer of copper on the uranium in a copper cyanide bath. The resulting copper-layered article is then heated in an air or inert atmosphere to volatilize and drive off the volatile material underlying the copper flash layer. After the heating step an adherent and essentially non-porous layer of copper is electro-deposited on the flash layer of copper to provide an adherent, multi-layer copper coating which is essentially impervious to corrosion by most gases.

  3. Overview of MAST results

    NASA Astrophysics Data System (ADS)

    Chapman, I. T.; Adamek, J.; Akers, R. J.; Allan, S.; Appel, L.; Asunta, O.; Barnes, M.; Ben Ayed, N.; Bigelow, T.; Boeglin, W.; Bradley, J.; Brünner, J.; Cahyna, P.; Carr, M.; Caughman, J.; Cecconello, M.; Challis, C.; Chapman, S.; Chorley, J.; Colyer, G.; Conway, N.; Cooper, W. A.; Cox, M.; Crocker, N.; Crowley, B.; Cunningham, G.; Danilov, A.; Darrow, D.; Dendy, R.; Diallo, A.; Dickinson, D.; Diem, S.; Dorland, W.; Dudson, B.; Dunai, D.; Easy, L.; Elmore, S.; Field, A.; Fishpool, G.; Fox, M.; Fredrickson, E.; Freethy, S.; Garzotti, L.; Ghim, Y. C.; Gibson, K.; Graves, J.; Gurl, C.; Guttenfelder, W.; Ham, C.; Harrison, J.; Harting, D.; Havlickova, E.; Hawke, J.; Hawkes, N.; Hender, T.; Henderson, S.; Highcock, E.; Hillesheim, J.; Hnat, B.; Holgate, J.; Horacek, J.; Howard, J.; Huang, B.; Imada, K.; Jones, O.; Kaye, S.; Keeling, D.; Kirk, A.; Klimek, I.; Kocan, M.; Leggate, H.; Lilley, M.; Lipschultz, B.; Lisgo, S.; Liu, Y. Q.; Lloyd, B.; Lomanowski, B.; Lupelli, I.; Maddison, G.; Mailloux, J.; Martin, R.; McArdle, G.; McClements, K.; McMillan, B.; Meakins, A.; Meyer, H.; Michael, C.; Militello, F.; Milnes, J.; Morris, A. W.; Motojima, G.; Muir, D.; Nardon, E.; Naulin, V.; Naylor, G.; Nielsen, A.; O'Brien, M.; O'Gorman, T.; Ono, Y.; Oliver, H.; Pamela, S.; Pangione, L.; Parra, F.; Patel, A.; Peebles, W.; Peng, M.; Perez, R.; Pinches, S.; Piron, L.; Podesta, M.; Price, M.; Reinke, M.; Ren, Y.; Roach, C.; Robinson, J.; Romanelli, M.; Rozhansky, V.; Saarelma, S.; Sangaroon, S.; Saveliev, A.; Scannell, R.; Schekochihin, A.; Sharapov, S.; Sharples, R.; Shevchenko, V.; Silburn, S.; Simpson, J.; Storrs, J.; Takase, Y.; Tanabe, H.; Tanaka, H.; Taylor, D.; Taylor, G.; Thomas, D.; Thomas-Davies, N.; Thornton, A.; Turnyanskiy, M.; Valovic, M.; Vann, R.; Walkden, N.; Wilson, H.; van Wyk, F.; Yamada, T.; Zoletnik, S.; MAST; MAST Upgrade Teams

    2015-10-01

    The Mega Ampère Spherical Tokamak (MAST) programme is strongly focused on addressing key physics issues in preparation for operation of ITER as well as providing solutions for DEMO design choices. In this regard, MAST has provided key results in understanding and optimizing H-mode confinement, operating with smaller edge localized modes (ELMs), predicting and handling plasma exhaust and tailoring auxiliary current drive. In all cases, the high-resolution diagnostic capability on MAST is complemented by sophisticated numerical modelling to facilitate a deeper understanding. Mitigation of ELMs with resonant magnetic perturbations (RMPs) with toroidal mode number nRMP = 2, 3, 4, 6 has been demonstrated: at high and low collisionality; for the first ELM following the transition to high confinement operation; during the current ramp-up; and with rotating nRMP = 3 RMPs. nRMP = 4, 6 fields cause less rotation braking whilst the power to access H-mode is less with nRMP = 4 than nRMP = 3, 6. Refuelling with gas or pellets gives plasmas with mitigated ELMs and reduced peak heat flux at the same time as achieving good confinement. A synergy exists between pellet fuelling and RMPs, since mitigated ELMs remove fewer particles. Inter-ELM instabilities observed with Doppler backscattering are consistent with gyrokinetic simulations of micro-tearing modes in the pedestal. Meanwhile, ELM precursors have been strikingly observed with beam emission spectroscopy (BES) measurements. A scan in beta at the L-H transition shows that pedestal height scales strongly with core pressure. Gyro-Bohm normalized turbulent ion heat flux (as estimated from the BES data) is observed to decrease with increasing tilt of the turbulent eddies. Fast ion redistribution by energetic particle modes depends on density, and access to a quiescent domain with ‘classical’ fast ion transport is found above a critical density. Highly efficient electron Bernstein wave current drive (1 A W-1) has been achieved

  4. Applying the balanced scorecard in healthcare provider organizations.

    PubMed

    Inamdar, Noorein; Kaplan, Robert S; Bower, Marvin

    2002-01-01

    Several innovative healthcare executives have recently introduced a new business strategy implementation tool: the Balanced Scorecard. The scorecard's measurement and management system provides the following potential benefits to healthcare organizations: It aligns the organization around a more market-oriented, customer-focused strategy It facilitates, monitors, and assesses the implementation of the strategy It provides a communication and collaboration mechanism It assigns accountability for performance at all levels of the organization It provides continual feedback on the strategy and promotes adjustments to marketplace and regulatory changes. We surveyed executives in nine provider organizations that were implementing the Balanced Scorecard. We asked about the following issues relating to its implementation and effect: 1. The role of the Balanced Scorecard in relation to a well-defined vision, mission, and strategy 2. The motivation for adopting the Balanced Scorecard 3. The difference between the Balanced Scorecard and other measurement systems 4. The process followed to develop and implement the Balanced Scorecard 5. The challenges and barriers during the development and implementation process 6. The benefits gained by the organization from adoption and use. The executives reported that the Balanced Scorecard strategy implementation and performance management tool could be successfully applied in the healthcare sector, enabling organizations to improve their competitive market positioning, financial results, and customer satisfaction. This article concludes with guidelines for other healthcare provider organizations to capture the benefits of the Balanced Scorecard performance management system.

  5. Childhood Obesity Prevention: Fathers' Reflections with Healthcare Providers

    PubMed Central

    Perrin, Eliana M.; Berry, Diane; Vu, Maihan B.; Pullen Davis, Lisa; Cai, Jianwen; Tzeng, Janice P.; Ammerman, Alice S.

    2013-01-01

    Abstract Background To prevent childhood obesity, parents and their children's healthcare providers need to engage in effective dialogue. We know much about mothers' experiences, but very little about fathers' experiences. Methods We explored African-American, Caucasian, and Latino fathers' perceptions and experiences communicating with their children's provider during clinic visits regarding weight, diet, and physical activity. Focus groups (n=3), grouped by race/ethnicity, including a total of 24 fathers, were conducted. The men were asked open-ended questions; responses were recorded and transcribed, and analyzed using ATLAS.ti. Results Findings revealed that these fathers were involved in their children's healthcare and found providers to be helpful partners in keeping their children healthy, yet they generally felt “left out” during clinic appointments. The quality of the relationship with their children's provider influenced how receptive fathers were to discussing their children's weight, diet, and physical activity behaviors. Fathers made suggestions to help improve communication between providers and fathers, such as personalizing the discussion. Conclusions These fathers expressed strong feelings about the provider–parent relationship when discussing weight, diet, and physical activity. PMID:23472966

  6. Negative emotion provides cues for orienting auditory spatial attention

    PubMed Central

    Asutay, Erkin; Västfjäll, Daniel

    2015-01-01

    The auditory stimuli provide information about the objects and events around us. They can also carry biologically significant emotional information (such as unseen dangers and conspecific vocalizations), which provides cues for allocation of attention and mental resources. Here, we investigated whether task-irrelevant auditory emotional information can provide cues for orientation of auditory spatial attention. We employed a covert spatial orienting task: the dot-probe task. In each trial, two task-irrelevant auditory cues were simultaneously presented at two separate locations (left–right or front–back). Environmental sounds were selected to form emotional vs. neutral, emotional vs. emotional, and neutral vs. neutral cue pairs. The participants’ task was to detect the location of an acoustic target that was presented immediately after the task-irrelevant auditory cues. The target was presented at the same location as one of the auditory cues. The results indicated that participants were significantly faster to locate the target when it replaced the negative cue compared to when it replaced the neutral cue. The positive cues did not produce a clear attentional bias. Further, same valence pairs (emotional–emotional or neutral–neutral) did not modulate reaction times due to a lack of spatial attention capture by one cue in the pair. Taken together, the results indicate that negative affect can provide cues for the orientation of spatial attention in the auditory domain. PMID:26029149

  7. Medical abortion practices among private providers in Vietnam

    PubMed Central

    Park, Min Hae; Nguyen, Thang Huu; Dang, Anh Thi Ngoc; Ngo, Thoai Dinh

    2013-01-01

    Objective To describe medical abortion (MA) practices among private providers in Vietnam. Methods The study subjects were women (n = 258) undergoing early MA through 12 private providers in Hanoi during February–June 2012. The women were interviewed on the day of their procedure and were followed up by telephone 14 days after mifepristone administration. Results Of the 258 women in the study, 97% used a regimen of mifepristone plus misoprostol; 80% were instructed to administer misoprostol at home. MA resulted in a complete termination in 90.8% of cases. All women were provided with information on potential complications and were instructed to return for a follow-up visit. We successfully followed up 77.5% (n = 200) of participants by telephone, while nearly two-thirds of women returned to the clinic for a follow-up visit. At follow-up, 39.5% of women reported having used a Help line service, while 7% had sought help from a health provider. A high unmet need for postabortion family planning was identified. Conclusion Follow-up of women, postabortion care, and the provision of family planning have been identified as important areas to address for strengthening MA services in the private sector in Vietnam. PMID:24082795

  8. Functional Improvement Among Short-Stay Nursing Home Residents in the MDS 3.0

    PubMed Central

    Wysocki, Andrea; Thomas, Kali S.; Mor, Vincent

    2015-01-01

    Objectives To examine the completeness of the activities of daily living (ADL) items on admission and discharge assessments and the improvement in ADL performance among short-stay residents in the newly adopted Minimum Data Set (MDS) 3.0. Design Retrospective analysis of MDS admission and discharge assessments. Setting Nursing homes from July 1, 2011, to June 30, 2012. Participants New nursing home residents admitted from acute hospitals with corresponding admission and discharge assessments between July 1, 2011, and June 30, 2012, who had a length of stay of 100 days or less. Measurements ADL self-performance items, including bed mobility, transfer, walking in room, walking in corridor, locomotion on unit, locomotion off unit, dressing, eating, toilet use, and personal hygiene, at admission and discharge. Results The ADL self-performance items are complete at both admission and discharge, with less than 1% missing for any item. More than 60% of residents improved over the course of their post-acute stay. New short-stay nursing home residents with conditions such as cognitive impairment, delirium, dementia, heart failure, and stroke showed less improvement in ADL performance during their stay. Conclusion The discharge assessment data in the MDS 3.0 provide new information to researchers and providers to examine and track ADL performance. Nursing homes can identify and track patients who require more intensive therapies or targeted interventions to achieve functional improvement during their stay. Future research can examine facility-level measures to better understand how ADL improvement varies across facilities. PMID:25659622

  9. Operation Provide Hope: Nation-Building Through Healthcare

    DTIC Science & Technology

    2013-03-01

    including: Moscow, St. Petersburg, Kiev, Minsk, Kishinev, Yerevan, Alma Ata, Dushanbe, Ashkhabad, Baku, Tashkent, and Bishkek.27 Fifty-four additional...DoD Medical Excess Distributed by OPH41 Supported Country Dollar Value of Support Provided Number of Missions (Timeframe) Republic of Georgia ...More than 150,000 Georgians were displaced from their homes as a result of conflict between Georgia and Russia in August 2008 that saw Russian soldiers

  10. Providing services to obstetrical patients: an overview and implications.

    PubMed

    Marshall, B S; Javalgi, R G; Gombeski, W R

    1995-01-01

    Obstetrics is one of the few hospital services with the potential for developing favorable client relationships resulting in increased market share, repeat purchase behavior, and referral of other patients in a direct marketing environment. To determine what qualities women find appealing in an obstetrics service and if women's preferences for a specific type of birthing arrangement had been examined and reported, a review of the literature was carried out. After reviewing the extant literature, the article provides strategic implications for health care marketers.

  11. Functional Status Assessment of COPD Based on Ability to Perform Daily Living Activities: A Systematic Review of Paper and Pencil Instruments

    PubMed Central

    Monjazebi, Fateme; Dalvandi, Asghar; Ebadi, Abbas; Khankeh, Hamid Reza; Rahgozar, Mahdi; Richter, Jörg

    2016-01-01

    Context: Activity of daily living (ADL) is an important predictor of mortality in patients with chronic obstructive pulmonary disease (COPD). Increasing ADL is important in patients with COPD and assessment of ADL is one of the best ways to evaluate the status of COPD patients. Objectives: The objective of this systematic review was to provide an overview of the psychometric properties of paper and pencil instruments measuring ADL in patients with COPD. Data Sources: English papers published from 1980 to 2014 regarding ADL in patients with COPD were searched in Web of Science, MEDLINE, Google Scholar, Cochrane, PubMed, ProQuest, and CINAHL databases using the following keywords: “COPD”, “ADL”, “activities of daily living”, “daily activities”, “instrument”, “questionnaire”, “paper-and-pencil instruments”, and “measure”. Following the Internet search, manual search was also done to find article references. Study Selection: A total of 186 articles were found. Of those, 31 met the inclusion criteria. Full texts of articles meeting the inclusion criteria were studied. Consensus-based standards for the selection of health measurement instruments”(COSMIN) were used to assess the quality of the studies. Data Extraction: Data extraction form based on research aims developed by researchers and psychometric experts, with 17 questions was used. Results: In these articles, 14 pen and paper instruments were identified for examining ADL in patients with COPD; of which, 4 dealt directly with ADL while 9 assessed other criteria i.e. dyspnea as ADL indicator. The majority of instruments only dealt with two main dimensions of ADL: Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL), and did not consider Advanced Activities of Daily Living (AADL), which is influenced by cultural and motivational factors. Conclusion: Despite several ADL instruments identified, complete psychometric processes have only been done in

  12. Uranium azide photolysis results in C-H bond activation and provides evidence for a terminal uranium nitride

    NASA Astrophysics Data System (ADS)

    Thomson, Robert K.; Cantat, Thibault; Scott, Brian L.; Morris, David E.; Batista, Enrique R.; Kiplinger, Jaqueline L.

    2010-09-01

    Uranium nitride [U≡N]x is an alternative nuclear fuel that has great potential in the expanding future of nuclear power; however, very little is known about the U≡N functionality. We show, for the first time, that a terminal uranium nitride complex can be generated by photolysis of an azide (U-N=N=N) precursor. The transient U≡N fragment is reactive and undergoes insertion into a ligand C-H bond to generate new N-H and N-C bonds. The mechanism of this unprecedented reaction has been evaluated through computational and spectroscopic studies, which reveal that the photochemical azide activation pathway can be shut down through coordination of the terminal azide ligand to the Lewis acid B(C6F5)3. These studies demonstrate that photochemistry can be a powerful tool for inducing redox transformations for organometallic actinide complexes, and that the terminal uranium nitride fragment is reactive, cleaving strong C-H bonds.

  13. Providing maternal and child health-family planning services to a large rural population: results of the Bohol Project, Philippines.

    PubMed Central

    Williamson, N E; Parado, J P; Maturan, E G

    1983-01-01

    The Bohol Project (1975-1979) sought to improve maternal and child health and to increase the use of family planning among a rural Philippine population of 400,000. Research indicated that maternal and child health (MCH) services did become more available during the Project period and coverage of the priority populations improved. Family planning (FP) use, particularly of less effective methods, increased and fertility declined although some change could have been expected even without the Project. Deaths due to neonatal tetanus were almost eliminated by mortality rates did not decline for a number of reasons, including the fact that services were probably not tailored closely enough to local health problems, especially respiratory diseases. The Project showed that it was possible to increase health and family planning services by using low-cost strategies (such as setting up community drug stores) and by employing paramedical workers, in this case, midwives. Preventive MCH-FP services were not overwhelmed by curative services as had been feared. Perhaps the most significant contributions of the Project were the lessons learned about delivering health and family planning services and conducting evaluation research. In general, if developing countries could maintain well-evaluated field laboratories for working out health and family planning delivery approaches before going nationwide, it is likely that time and money would be saved in the long run. PMID:6848001

  14. CAM Provider Use and Expenditures by Cancer Treatment Phase

    PubMed Central

    Lafferty, William E.; Tyree, Patrick T.; Devlin, Sean M.; Andersen, M. Robyn; Diehr, Paula K.

    2008-01-01

    Objective To assess cancer patients’ utilization of complementary and alternative medical providers and the associated expenditures by specific treatment phases. Study Design Cross-sectional analysis of medical services utilization and expenditures during three therapeutic intervals: an initial treatment phase, continuing care, and end-of-life. Methods Analysis of an insurance claims database that had been matched to the Washington State SEER cancer registry. Results Of 2,900 registry-matched cancer patients 63.2% were female, the median age was 54 years, and 92.7% were white. Breast cancer was the most frequent diagnosis (52.7%), followed by prostate cancer (24.7%), lung cancer (10.1%), colon cancer (7.0%), and hematologic malignancies (5.6%). CAM provider using patients were 26.5% of the overall cohort (18.5% used chiropractors, 7.7% naturopathic physicians, 5.3% massage therapists, and 4.2% saw acupuncturists). The proportion of CAM using patients was similar during each treatment phase. All patients used some conventional care. Female gender, a breast cancer diagnosis, age, and white race were significant predictors of CAM use. Diagnosis of a musculoskeletal problem occurred at sometime during the study for 72.1% of cancer patients. CAM provider visits were 7.2% of total outpatient medical visits and 85.1% of CAM visits resulted in a musculoskeletal diagnosis. Expenditures for CAM providers were 0.3%, 1.0%, and 0.1% of all expenditures during the initial, continuing, and end-of-life phases respectively. Conclusion For cancer patients, musculoskeletal issues were the most commonly listed diagnosis made by a CAM provider. Although expenditures associated with CAM are a small proportion of the total, additional studies are necessary to determine the importance patients place on access to these services. PMID:18471036

  15. Determining depression level of caregivers providing home healthcare services

    PubMed Central

    Arican, Bilal; Guney, Murat; Akbal, Nuseybe; Demiral, Bahadir Han; Nadir, Ahmet; Kokar, Ilknur Kavci; Dabak, Mustafa Resat; Sargin, Mehmet

    2016-01-01

    OBJECTIVE: Due to increase in elderly population as result of longer life expectancy and the incidence of chronic disease, greater importance should be given to elderly care and the needs of primary caregivers. The purpose of this study was to determine depression status of caregivers who were providing in-home healthcare services. METHODS: This study was conducted with caregivers for 63 home-dependent patients who benefited from the services provided by Kartal Dr. Lutfi Kirdar Training and Research Hospital Family Practice Clinic between May 15, 2013 and July 1, 2013 using a socio-demographic variables questionnaire and the Beck Depression Inventory. Data were analyzed using Kolmogorov-Smirnov test, Mann-Whitney U test, Student’s-t test and chi-square test. RESULTS: Of the total, 87.3% of survey participants were women. Average age was 52.47 years; 73% were married, 17.5% were single, and 9.5% were widows. Monthly income of 50.8% of participants was between TL 1000 and 3000. Of all the patients, 77.8% were totally, and 22.2% were semi-dependent. Depression was detected in 61.1% of patient relatives who were responsible for patient healthcare and in 22.2% of paid professional caregivers (p=0.052). Depression was detected at rate of 37% in caregivers who had been providing nursing care for less than 1 year, 63% for those who had been caregivers for 1 to 5 years, and for those providing care for more than 5 years, rate was 63 %. Rate of depression in study participants overall was 55.6%. CONCLUSION: Duration of providing care, dependency level of patient, and level of intimacy affect caregivers. They need psychological support. PMID:28058398

  16. Doctors’ opinions of information provided by Libyan pharmaceutical company representatives

    PubMed Central

    Alssageer, Mustafa A.; Kowalski, Stefan R.

    2012-01-01

    Objective To examine the opinions of Libyan doctors regarding the quality of drug information provided by pharmaceutical company representatives (PCRs) during detailing visits. Method An anonymous survey was conducted among 1,000 doctors from selected institutes in Tripoli, Benghazi and Sebha. Doctors were asked questions regarding the quality of information provided during drug-detailing visits. Results A questionnaire return rate of 61% (608 returned questionnaires out of 1,000) was achieved. The majority (n=463, 76%) of surveyed participants graded the quality of information provided as average. Approximately, 40% of respondents indicated that contraindications, precautions, interactions and adverse effects of products promoted by PCRs were never or rarely mentioned during promotional visits, and 65% of respondents indicated that an alternative drug to the promoted product was never or rarely mentioned by the representatives. More than 50% of respondents (n=310, 51%) reported that PCRs were not always able to answer all questions about their products. Only seven respondents (1%) believed that PCRs never exaggerated the uniqueness, efficacy or safety of their product. The majority of respondents (n=342, 56%) indicated that verbal information was not always consistent with written information provided. Seven per cent of respondents (n=43) admitted that they did not know whether or not the verbal information provided by PCRs was consistent with written information. Conclusion Doctors believe that the provision of drug information by PCRs in Libya is incomplete and often exaggerated. Pharmaceutical companies should ensure that their representatives are trained to a standard to provide reliable information regarding the products they promote. PMID:23205141

  17. Promoting and Providing HPV Vaccination in Hawaii: Barriers Faced by Health Providers.

    PubMed

    Tom, Ashlyn; Robinett, Hali; Buenconsejo-Lum, Lee; Soon, Reni; Hamilton, Michael; Francisco-Natanauan, Pia; Cruz, May Rose Dela; Balajadia, Ronald; Hernandez, Brenda Y

    2016-10-01

    Despite the availability of HPV prophylactic vaccines, uptake has been suboptimal in the US. In the state of Hawaii, HPV vaccine coverage has decreased among females and remains low among males aged 13-17. The reasons for low uptake are unknown and may indicate the existence of critical barriers to HPV vaccination. The purpose of this investigation was to identify policy, system and environmental barriers and promoters of pediatric HPV vaccination in Hawaii. An online 86-item survey addressing knowledge, attitudes, beliefs, practices, and barriers to HPV vaccination was distributed to practicing physicians in Hawaii specializing in Pediatrics, Family Medicine, and Obstetrics-Gynecology. Survey responses were received from a total of 120 physicians. Private practice physicians reported more concerns with vaccine ordering and stocking costs (p < 0.0001), reimbursement levels (p < 0.0001), and insurance coverage (p < 0.0001) compared to physicians in large group practices. Eighty-three percent of providers cited lack of parent knowledge and understanding of HPV infection as a barrier. Over half of physicians (58 %) reported that completion of the 3-dose schedule was a barrier. Most physicians did not use tracking or reminder systems to ensure dose completion. A majority (58 %) of providers cited the lack of school-based vaccination requirements as a barrier. Uptake of HPV vaccination in Hawaii may be impeded by physician perception of parent knowledge and attitudes. Cost-related system barriers are particular barriers among those in private practice. Completion of the 3-dose schedule also remains a challenge.

  18. 4. View facing southwest showing the Silvertop Diner, Providence Fruit ...

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

    4. View facing southwest showing the Silvertop Diner, Providence Fruit & Produce Building, and Merchants' Cold Storage Warehouse. - Provisions Warehouse Historic District, Kinsley & Harris Avenues, Providence, Providence County, RI

  19. Your Kidney Test Results

    MedlinePlus

    ... blood vessels healthy. Vitamin D is important for bones and heart health. 1 Your Kidney Test Results Other Important Tests, continued A1C (for patients with diabetes) Results Goal: Your Result: Total Cholesterol Normal: Less ...

  20. Provider communication on perinatal depression: a population-based study.

    PubMed

    Farr, Sherry L; Ko, Jean Y; Burley, Kim; Gupta, Seema

    2016-02-01

    Women's lack of knowledge on symptoms of perinatal depression and treatment resources is a barrier to receiving care. We sought to estimate the prevalence and predictors of discussing depression with a prenatal care provider. We used the 2011 population-based data from 24 sites participating in the Pregnancy Risk Assessment Monitoring System (n = 32,827 women with recent live births) to examine associations between maternal characteristics and report that a prenatal care provider discussed with her what to do if feeling depressed during or after pregnancy. Overall, 71.9 % of women reported discussing perinatal depression with their prenatal care provider (range 60.7 % in New York City to 85.6 % in Maine). Women were more likely to report a discussion on perinatal depression with their provider if they they were 18-29 years of age than over 35 years of age compared to older (adjusted prevalence ratio [aPR] 18 to 19 y = 1.08, 20 to 24 y = 1.10, 25 to 29 y = 1.09), unmarried (aPR = 1.07) compared to married, had <12 years of education (aPR = 1.05) compared to > 12 years, and had no previous live births (aPR = 1.03) compared to ≥ 1 live births. Research is needed on effective ways to educate women about perinatal depression and whether increased knowledge on perinatal depression results in higher rates of treatment and shorter duration of symptoms.

  1. Model of Providing Assistive Technologies in Special Education Schools

    PubMed Central

    Lersilp, Suchitporn; Putthinoi, Supawadee; Chakpitak, Nopasit

    2016-01-01

    Most students diagnosed with disabilities in Thai special education schools received assistive technologies, but this did not guarantee the greatest benefits. The purpose of this study was to survey the provision, use and needs of assistive technologies, as well as the perspectives of key informants regarding a model of providing them in special education schools. The participants were selected by the purposive sampling method, and they comprised 120 students with visual, physical, hearing or intellectual disabilities from four special education schools in Chiang Mai, Thailand; and 24 key informants such as parents or caregivers, teachers, school principals and school therapists. The instruments consisted of an assistive technology checklist and a semi-structured interview. Results showed that a category of assistive technologies was provided for students with disabilities, with the highest being “services”, followed by “media” and then “facilities”. Furthermore, mostly students with physical disabilities were provided with assistive technologies, but those with visual disabilities needed it more. Finally, the model of providing assistive technologies was composed of 5 components: Collaboration; Holistic perspective; Independent management of schools; Learning systems and a production manual for users; and Development of an assistive technology center, driven by 3 major sources such as Government and Private organizations, and Schools. PMID:26234984

  2. Model of Providing Assistive Technologies in Special Education Schools.

    PubMed

    Lersilp, Suchitporn; Putthinoi, Supawadee; Chakpitak, Nopasit

    2015-05-14

    Most students diagnosed with disabilities in Thai special education schools received assistive technologies, but this did not guarantee the greatest benefits. The purpose of this study was to survey the provision, use and needs of assistive technologies, as well as the perspectives of key informants regarding a model of providing them in special education schools. The participants were selected by the purposive sampling method, and they comprised 120 students with visual, physical, hearing or intellectual disabilities from four special education schools in Chiang Mai, Thailand; and 24 key informants such as parents or caregivers, teachers, school principals and school therapists. The instruments consisted of an assistive technology checklist and a semi-structured interview. Results showed that a category of assistive technologies was provided for students with disabilities, with the highest being "services", followed by "media" and then "facilities". Furthermore, mostly students with physical disabilities were provided with assistive technologies, but those with visual disabilities needed it more. Finally, the model of providing assistive technologies was composed of 5 components: Collaboration; Holistic perspective; Independent management of schools; Learning systems and a production manual for users; and Development of an assistive technology center, driven by 3 major sources such as Government and Private organizations, and Schools.

  3. Hand Washing Practices Among Emergency Medical Services Providers

    PubMed Central

    Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan

    2015-01-01

    Introduction Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. Methods We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. Results There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Conclusion Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing. PMID:26587098

  4. 22 CFR 96.14 - Providing adoption services using other providers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...); or (ii) Has prepared or is preparing a background study on a child in a case involving immigration to the United States (incoming case) or a home study on prospective adoptive parent(s) in a case involving emigration from the United States (outgoing case), and a report on the results of such a study,...

  5. 22 CFR 96.14 - Providing adoption services using other providers.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...); or (ii) Has prepared or is preparing a background study on a child in a case involving immigration to the United States (incoming case) or a home study on prospective adoptive parent(s) in a case involving emigration from the United States (outgoing case), and a report on the results of such a study,...

  6. Providing alcohol to underage youth: The view from young adulthood

    PubMed Central

    Arria, Amelia M.; Caldeira, Kimberly M.; Moshkovich, Olga; Bugbee, Brittany A.; Vincent, Kathryn B.; O’Grady, Kevin E.

    2014-01-01

    Background Many underage drinkers obtain alcohol from legal-age family, friends, and acquaintances. This study aimed to understand the attitudes and behaviors of young adults related to providing alcohol to underage drinkers. Methods Participants were 755 current or recent college students of legal drinking age (ages 22 to 26) who were approached by a minor to provide alcohol at least once since turning 21. Interviewers assessed frequency of providing alcohol, relationship to the recipients, and general attitudes about providing alcohol to minors. Separate questions asked about younger (under 18) and older (18 to 20) minors. Correlates and predictors of provision and frequency of provision were examined via logistic regression and Poisson regression, focusing on demographics, sensation-seeking, behavioral dysregulation, age at first drink, parental history of alcohol problems, fraternity/sorority involvement, attitudes about provision, violations, peer drinking norms, and alcohol use disorder (AUD) risk during and post-college. Results Most participants (84.6%) provided alcohol to minors at least once. Provision to older minors was more prevalent (82.8%) than to younger minors (20.7%); it was also more frequent. Few (2.4%) were ever caught providing alcohol. Recipients were more commonly friends or family members rather than acquaintances or strangers. Legal concerns about providing alcohol (82.5% and 53.7% for younger and older minors, respectively) were more prevalent than health concerns (55.7% and 9.5%). Legal concerns consistently predicted lower likelihood of provision, independent of demographics. Health concerns and lower post-college AUD risk scores also independently predicted lower likelihood of provision, but only to older minors. Fraternity/sorority involvement and higher peer drinking norms were associated with higher provision frequency, whereas legal concerns and college violations were associated with lower provision frequency. Conclusions Young

  7. Classroom Animals Provide More Than Just Science Education

    NASA Astrophysics Data System (ADS)

    Herbert, Sandra; Lynch, Julianne

    2017-02-01

    Keeping classroom animals is a common practice in many classrooms. Their value for learning is often seen narrowly as the potential to involve children in learning biological science. They also provide opportunities for increased empathy, as well as socio-emotional development. Realization of their potential for enhancing primary children's learning can be affected by many factors. This paper focuses on teachers' perceptions of classroom animals, drawing on accounts and reflections provided by 19 participants located in an Australian primary school where each classroom kept an animal. This study aims to progress the conversation about classroom animals, the learning opportunities that they afford, and the issues they present. Phenomenographic analysis of data resulted in five categories of teachers' perceptions of the affordances and constraints of keeping classroom animals.

  8. Teamwork: building healthier workplaces and providing safer patient care.

    PubMed

    Clark, Paul R

    2009-01-01

    A changing healthcare landscape requires nurses to care for more patients with higher acuity during their shift than ever before. These more austere working conditions are leading to increased burnout. In addition, patient safety is not of the quality or level that is required. To build healthier workplaces where safe care is provided, formal teamwork training is recommended. Formal teamwork training programs, such as that provided by the MedTeams group, TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), or participatory action research programs such as the Healthy Workplace Intervention, have decreased errors in the workplace, increased nurse satisfaction and retention rates, and decreased staff turnover. This article includes necessary determinants of teamwork, brief overviews of team-building programs, and examples of research programs that demonstrate how teamwork brings about healthier workplaces that are safer for patients. Teamwork programs can bring about these positive results when implemented and supported by the hospital system.

  9. Providers' perspectives on treating psychogenic nonepileptic seizures: frustration and hope.

    PubMed

    McMillan, Katharine K; Pugh, Mary Jo; Hamid, Hamada; Salinsky, Martin; Pugh, Jacqueline; Noël, Polly H; Finley, Erin P; Leykum, Luci K; Lanham, Holly J; LaFrance, W Curt

    2014-08-01

    Recent diagnostic and treatment advances in psychogenic nonepileptic seizures (PNES) have the potential to improve care for patients, but little is known about the current state of PNES care delivery in the Veterans Health Administration (VA). We conducted semistructured interviews with 74 health-care clinicians and workers in the VA, eliciting provider perceptions of PNES care. Data were analyzed according to principles of Grounded Theory. The results revealed variation in care and two emergent domain themes of frustration and hope. Frustration was manifest in subthemes including Complexity, Patient Acceptance, Uncertainty About Treatment, Need for Evidence-based Treatment, and Failure of Cross-Disciplinary Collaboration between neurologists and mental health providers. Hope encompassed subthemes of Positive Attitudes, Developing Cross-Disciplinary Treatment, and Specific PNES Care. Increased resources for diagnosing, treating, and researching PNES have improved awareness of the disorder. More research is needed to understand patients' and caregivers' perceptions of PNES care.

  10. QCD results from the Tevatron

    SciTech Connect

    C. Mesropian

    2002-07-12

    The Tevatron hadron collider provides the unique opportunity to study Quantum Chromodynamics, QCD, at the highest energies. The results summarized in this talk, although representing different experimental objects, as hadronic jets and electromagnetic clusters, serve to determine the fundamental input ingredients of QCD as well as to search for new physics. The authors present results from QCD studies at the Tevatron from Run 1 data, including jet and direct photon production, and a measurement of the strong coupling constant.

  11. Healthcare provider and patient perspectives on diagnostic imaging investigations

    PubMed Central

    Bergh, Anne-Marie; Hoffmann, Willem A.

    2015-01-01

    Background: Much has been written about the patient-centred approach in doctor–patient consultations. Little is known about interactions and communication processes regarding healthcare providers’ and patients’ perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to the imaging investigation itself and then to the post-imaging consultation. Aim and setting: To explore healthcare provider and patient perspectives on interaction and communication processes during diagnostic imaging investigations as part of their clinical journey through a healthcare complex. Methods: A qualitative study was conducted, with two phases of data collection. Twenty-four patients were conveniently selected at a public district hospital complex and were followed throughout their journey in the hospital system, from admission to discharge. The second phase entailed focus group interviews conducted with providers in the district hospital and adjacent academic hospital (medical officers and family physicians, nurses, radiographers, radiology consultants and registrars). Results: Two main themes guided our analysis: (1) provider perspectives; and (2) patient dispositions and reactions. Golden threads that cut across these themes are interactions and communication processes in the context of expectations, experiences of the imaging investigations and the outcomes thereof. Conclusion: Insights from this study provide a better understanding of the complexity of the processes and interactions between providers and patients during the imaging investigations conducted as part of their clinical pathway. The interactions and communication processes are provider–patient centred when a referral for a diagnostic imaging investigation is included. PMID:26245604

  12. Preventive Services by Medical and Dental Providers and Treatment Outcomes

    PubMed Central

    Kranz, A.M.; Rozier, R.G.; Preisser, J.S.; Stearns, S.C.; Weinberger, M.; Lee, J.Y.

    2014-01-01

    Objective: Nearly all state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children; yet, little is known about how treatment outcomes compare with children visiting dentists. This study compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. Methods: We conducted a retrospective study of young children enrolled in North Carolina Medicaid during 2000 to 2006. The annual number of CRT and CRT payments per child between the ages of 3 and 5 yr were estimated with a zero-inflated negative binomial regression and a hurdle model, respectively. Models were adjusted for relevant child- and county-level characteristics and used propensity score weighting to address observed confounding. Results: We examined 41,453 children with > 1 preventive oral health visit from a PCP, dentist, or both before their third birthday. Unadjusted annual mean CRT and payments were lowest among children who had only PCP visits (CRT = 0.87, payment = $172) and higher among children with only dentist visits (CRT = 1.48, payment = $234) and both PCP and dentist visits (CRT = 1.52, payment = $273). Adjusted results indicated that children who had dentist visits (with or without PCP visits) had significantly more CRT and higher CRT payments per year during the ages of 3 and 4 yr than children who had only PCP visits. However, these differences attenuated each year after age 3 yr. Conclusions: Because of children’s increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone. This study supports guidelines and reimbursement policies that allow preventive dental visits based on individual needs. PMID:24891593

  13. Ecosystem function and services provided by the deep sea

    NASA Astrophysics Data System (ADS)

    Thurber, A. R.; Sweetman, A. K.; Narayanaswamy, B. E.; Jones, D. O. B.; Ingels, J.; Hansman, R. L.

    2014-07-01

    The deep sea is often viewed as a vast, dark, remote, and inhospitable environment, yet the deep ocean and seafloor are crucial to our lives through the services that they provide. Our understanding of how the deep sea functions remains limited, but when treated synoptically, a diversity of supporting, provisioning, regulating and cultural services becomes apparent. The biological pump transports carbon from the atmosphere into deep-ocean water masses that are separated over prolonged periods, reducing the impact of anthropogenic carbon release. Microbial oxidation of methane keeps another potent greenhouse gas out of the atmosphere while trapping carbon in authigenic carbonates. Nutrient regeneration by all faunal size classes provides the elements necessary for fueling surface productivity and fisheries, and microbial processes detoxify a diversity of compounds. Each of these processes occur on a very small scale, yet considering the vast area over which they occur they become important for the global functioning of the ocean. The deep sea also provides a wealth of resources, including fish stocks, enormous bioprospecting potential, and elements and energy reserves that are currently being extracted and will be increasingly important in the near future. Society benefits from the intrigue and mystery, the strange life forms, and the great unknown that has acted as a muse for inspiration and imagination since near the beginning of civilization. While many functions occur on the scale of microns to meters and timescales up to years, the derived services that result are only useful after centuries of integrated activity. This vast dark habitat, which covers the majority of the globe, harbors processes that directly impact humans in a variety of ways; however, the same traits that differentiate it from terrestrial or shallow marine systems also result in a greater need for integrated spatial and temporal understanding as it experiences increased use by society. In

  14. Spreading the Benefits of Audiographics Distance Learning. A Final Report.

    ERIC Educational Resources Information Center

    Bradshaw, Dean H.; Chow, Stanley H. L.

    The audiographics distance learning system (ADL) was piloted by Far West Laboratory (FWL) in 1987-1989 at four school districts in the Great Basin region of Utah. This project was designed to: (1) further develop ADL planning materials for rural schools; (2) disseminate information about ADL to regional and national audiences; and (3) provide ADL…

  15. Teaching Activities of Daily Living.

    ERIC Educational Resources Information Center

    McCormack, James E.

    Provided are strategies for teaching activities of daily living (ADL), which include dressing, eating, grooming, toileting, and basic homemakine, to severely retarded students. Reviewed are the steps necessary to teach ADL skills: ADL assessment, identification of appropriate strategies and tactics, and task analysis. Explained are four common…

  16. 24 CFR 700.105 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Living (ADL) means an activity regularly necessary for personal care. (1) The minimum requirements of... the eating ADL, the person must be able to feed himself or herself). The determination of whether a... ADL, if a spouse, relative or attendant provides assistance with feeding the person. Should...

  17. Vascular patterns provide therapeutic targets in aggressive neuroblastic tumors

    PubMed Central

    Tadeo, Irene; Bueno, Gloria; Berbegall, Ana P.; Fernández-Carrobles, M. Milagro; Castel, Victoria; García-Rojo, Marcial; Navarro, Samuel; Noguera, Rosa

    2016-01-01

    Angiogenesis is essential for tumor growth and metastasis, nevertheless, in NB, results between different studies on angiogenesis have yielded contradictory results. An image analysis tool was developed to characterize the density, size and shape of total blood vessels and vascular segments in 458 primary neuroblastic tumors contained in tissue microarrays. The results were correlated with clinical and biological features of known prognostic value and with risk of progression to establish histological vascular patterns associated with different degrees of malignancy. Total blood vessels were larger, more abundant and more irregularly-shaped in tumors of patients with associated poor prognostic factors than in the favorable cohort. Tumor capillaries were less abundant and sinusoids more abundant in the patient cohort with unfavorable prognostic factors. Additionally, size of post-capillaries & metarterioles as well as higher sinusoid density can be included as predictive factors for survival. These patterns may therefore help to provide more accurate pre-treatment risk stratification, and could provide candidate targets for novel therapies. PMID:26918726

  18. Autonomous Soaring Flight Results

    NASA Technical Reports Server (NTRS)

    Allen, Michael J.

    2006-01-01

    A viewgraph presentation on autonomous soaring flight results for Unmanned Aerial Vehicles (UAV)'s is shown. The topics include: 1) Background; 2) Thermal Soaring Flight Results; 3) Autonomous Dolphin Soaring; and 4) Future Plans.

  19. Recent results from CDF

    SciTech Connect

    Sally Carol Seidel

    2001-07-16

    During the past year, the CDF Experiment has reported on a variety of results concerning QCD and electroweak studies, studies of the top quark, and searches for new phenomena. A sample of these results is presented here.

  20. Bank, leasing agent settle bias claim by HIV service provider.

    PubMed

    1999-12-24

    The Howard Brown Health Center, the largest gay and lesbian health provider in the Midwest, has settled a suit it filed against Hyde Park Bank and Aegis Properties Corp. The center claimed that its repeated attempts to lease space in the Hyde Park Bank building were allegedly refused because the Center's services were "problematic" and could drive away present and future tenants. Aegis Properties Corp., the bank's property management, denies the discrimination charge and states the health center never submitted an application to rent in the building. The health center will receive an undisclosed sum as a result of the settlement.

  1. Method for providing oxygen ion vacancies in lanthanide oxides

    DOEpatents

    Kay, D. Alan R.; Wilson, William G.

    1989-12-05

    A method for desulfurization of fuel gases resulting from the incomplete combustion of sulfur containing hydrocarbons whereby the gases are treated with lanthanide oxides containing large numbers of oxygen-ion vacancies providing ionic porosity which enhances the ability of the lanthanide oxides to react more rapidly and completely with the sulfur in the fuel gases whereby the sulfur in such gases is reduced to low levels suitable for fuels for firing into boilers of power plants generating electricity with steam turbine driven generators, gas turbines, fuel cells and precursors for liquid fuels such as methanol and the like.

  2. Prevention of Surgical Fires: A Certification Course for Healthcare Providers.

    PubMed

    Fisher, Marquessa

    2015-08-01

    An estimated 550 to 650 surgical fires occur annually in the United States. Surgical fires may have severe consequences, including burns, disfigurement, long-term medical care, or death. This article introduces a potential certification program for the prevention of surgical fires. A pilot study was conducted with a convenience sample of 10 anesthesia providers who participated in the education module. The overall objective was to educate surgical team members and to prepare them to become certified in surgical fire prevention. On completion of the education module, participants completed the 50-question certification examination. The mean pretest score was 66%; none of the participants had enough correct responses (85%) to be considered competent in surgical fire prevention. The mean post- test score was 92.80%, with all participants answering at least 85% of questions correct. A paired-samples t test showed a statistically significant increase in knowledge: t (df = 9) = 11.40; P = .001. Results of the pilot study indicate that this course can remediate gaps in knowledge of surgical fire prevention for providers. Their poor performance on the pretest suggests that many providers may not receive sufficient instruction in surgical fire prevention.

  3. Neonicotinoid pesticide exposure impairs crop pollination services provided by bumblebees

    NASA Astrophysics Data System (ADS)

    Stanley, Dara A.; Garratt, Michael P. D.; Wickens, Jennifer B.; Wickens, Victoria J.; Potts, Simon G.; Raine, Nigel E.

    2015-12-01

    Recent concern over global pollinator declines has led to considerable research on the effects of pesticides on bees. Although pesticides are typically not encountered at lethal levels in the field, there is growing evidence indicating that exposure to field-realistic levels can have sublethal effects on bees, affecting their foraging behaviour, homing ability and reproductive success. Bees are essential for the pollination of a wide variety of crops and the majority of wild flowering plants, but until now research on pesticide effects has been limited to direct effects on bees themselves and not on the pollination services they provide. Here we show the first evidence to our knowledge that pesticide exposure can reduce the pollination services bumblebees deliver to apples, a crop of global economic importance. Bumblebee colonies exposed to a neonicotinoid pesticide provided lower visitation rates to apple trees and collected pollen less often. Most importantly, these pesticide-exposed colonies produced apples containing fewer seeds, demonstrating a reduced delivery of pollination services. Our results also indicate that reduced pollination service delivery is not due to pesticide-induced changes in individual bee behaviour, but most likely due to effects at the colony level. These findings show that pesticide exposure can impair the ability of bees to provide pollination services, with important implications for both the sustained delivery of stable crop yields and the functioning of natural ecosystems.

  4. An analysis of zoo and aquarium provided teacher professional development

    NASA Astrophysics Data System (ADS)

    Kubarek-Sandor, Joy

    Informal science institutions are a significant provider of science teacher professional development. As pressure continues to critically analyze the work of teachers and their effectiveness in the classroom, it is important to understand how informal science institutions contribute to effective change in teacher science content knowledge and pedagogy. This research study analyzed zoo and aquarium provided teacher professional development to respond to the research questions: How do zoos and aquaria determine and assess their goals for teacher professional development? How do these goals align with effective teacher change for science content knowledge and pedagogy? Theoretical frameworks for high quality teacher professional development, effective evaluation of teacher professional development, and learning in informal science settings guided the research. The sample for the study was AZA accredited zoos and aquariums providing teacher professional development (N=107). Data collection consisted of an online questionnaire, follow-up interviews, and content analysis of teacher professional development artifacts. Analysis revealed that by and large zoos and aquariums are lacking in their provision of science teacher professional development. Most professional development focuses on content or resources, neglecting pedagogy. Assessments mismatch the goals and rely heavily on self-report and satisfaction measures. The results demonstrate a marked difference between those zoos and aquariums that are larger in capacity versus those that are medium to small in size. This may be an area of research for the future, as well as analyzing the education resources produced by zoos and aquariums as these were emphasized heavily as a way they serve teachers.

  5. Neonicotinoid pesticide exposure impairs crop pollination services provided by bumblebees

    PubMed Central

    Stanley, Dara A.; Garratt, Michael P.D.; Wickens, Jennifer B.; Wickens, Victoria J.; Potts, Simon G.; Raine, Nigel E.

    2015-01-01

    Recent concern over global pollinator declines has led to considerable research on the effects of pesticides on bees1-5. Although pesticides are typically not encountered at lethal levels in the field, there is growing evidence indicating that exposure to field-realistic levels can have sub-lethal effects on bees affecting their foraging behaviour1,6,7, homing ability8,9 and reproductive success2,5. Bees are essential for the pollination of a wide variety of crops and the majority of wild flowering plants10-12, but until now research on pesticide impacts has been limited to direct effects on bees themselves and not on the pollination services they provide. Here we show the first evidence that pesticide exposure can reduce the pollination services bumblebees deliver to apples, a crop of global economic importance. Colonies exposed to a neonicotinoid pesticide provided lower visitation rates to apple trees and collected pollen less often. Most importantly these pesticide exposed colonies produced apples containing fewer seeds demonstrating a reduced delivery of pollination services. Our results also suggest reduced pollination service delivery is not due to pesticide-induced changes in individual bee behaviour but most likely due to impacts at the colony level. These findings show that pesticide exposure can impair the ability of bees to provide pollination services, with important implications for both the sustained delivery of stable crop yields and the function of natural ecosystems. PMID:26580009

  6. Neonicotinoid pesticide exposure impairs crop pollination services provided by bumblebees.

    PubMed

    Stanley, Dara A; Garratt, Michael P D; Wickens, Jennifer B; Wickens, Victoria J; Potts, Simon G; Raine, Nigel E

    2015-12-24

    Recent concern over global pollinator declines has led to considerable research on the effects of pesticides on bees. Although pesticides are typically not encountered at lethal levels in the field, there is growing evidence indicating that exposure to field-realistic levels can have sublethal effects on bees, affecting their foraging behaviour, homing ability and reproductive success. Bees are essential for the pollination of a wide variety of crops and the majority of wild flowering plants, but until now research on pesticide effects has been limited to direct effects on bees themselves and not on the pollination services they provide. Here we show the first evidence to our knowledge that pesticide exposure can reduce the pollination services bumblebees deliver to apples, a crop of global economic importance. Bumblebee colonies exposed to a neonicotinoid pesticide provided lower visitation rates to apple trees and collected pollen less often. Most importantly, these pesticide-exposed colonies produced apples containing fewer seeds, demonstrating a reduced delivery of pollination services. Our results also indicate that reduced pollination service delivery is not due to pesticide-induced changes in individual bee behaviour, but most likely due to effects at the colony level. These findings show that pesticide exposure can impair the ability of bees to provide pollination services, with important implications for both the sustained delivery of stable crop yields and the functioning of natural ecosystems.

  7. A Hepatitis C Educational Needs Assessment of Canadian Healthcare Providers

    PubMed Central

    Seto, Karen; Klassen, Carolyn; Emokpare, Didi; Conway, Brian; Kelley, Melissa

    2017-01-01

    Background and Aim. Despite advances in the treatment of chronic hepatitis C infection (CHC), it remains a major public health problem in Canada and globally. The knowledge of healthcare providers (HCPs) is critical to improve the care of CHC in Canada. To assess the current knowledge and educational needs of healthcare providers (HCPs) in the area of CHC management a national online survey was conducted. Method. An interprofessional steering committee designed a 29-question survey distributed through various direct and electronic routes. The survey assessed several domains (e.g., participant and practice demographics, access to resources, knowledge of new treatments, and educational preferences). Results. A total of 163 HCPs responded to the survey. All hepatologists and 8% of primary care providers (PCPs) reported involvement in treatment of CHC. Physicians most frequently screened patients who had abnormal liver enzymes, while nurses tended to screen based on lifestyle factors. More than 70% of PCPs were not aware of new medications and their mechanisms. Conclusion. Overall, the needs assessment demonstrated that there was a need for further education, particularly for primary care physicians, to maximize the role that they can play in screening, testing, and treatment of hepatitis C in Canada.

  8. Realignment of incentives for health-care providers in China.

    PubMed

    Yip, Winnie Chi-Man; Hsiao, William; Meng, Qingyue; Chen, Wen; Sun, Xiaoming

    2010-03-27

    Inappropriate incentives as part of China's fee-for-service payment system have resulted in rapid cost increase, inefficiencies, poor quality, unaffordable health care, and an erosion of medical ethics. To reverse these outcomes, a strategy of experimentation to realign incentives for providers with the social goals of improvement in quality and efficiency has been initiated in China. This Review shows how lessons that have been learned from international experiences have been improved further in China by realignment of the incentives for providers towards prevention and primary care, and incorporation of a treatment protocol for hospital services. Although many experiments are new, preliminary evidence suggests a potential to produce savings in costs. However, because these experiments have not been scientifically assessed in China, evidence of their effects on quality and health outcome is largely missing. Although a reform of the provider's payment can be an effective short-term strategy, professional ethics need to be re-established and incentives changed to alter the profit motives of Chinese hospitals and physicians alike. When hospitals are given incentives to achieve maximum profit, incentives for hospitals and physicians must be separated.

  9. Web Services Provide Access to SCEC Scientific Research Application Software

    NASA Astrophysics Data System (ADS)

    Gupta, N.; Gupta, V.; Okaya, D.; Kamb, L.; Maechling, P.

    2003-12-01

    Web services offer scientific communities a new paradigm for sharing research codes and communicating results. While there are formal technical definitions of what constitutes a web service, for a user community such as the Southern California Earthquake Center (SCEC), we may conceptually consider a web service to be functionality provided on-demand by an application which is run on a remote computer located elsewhere on the Internet. The value of a web service is that it can (1) run a scientific code without the user needing to install and learn the intricacies of running the code; (2) provide the technical framework which allows a user's computer to talk to the remote computer which performs the service; (3) provide the computational resources to run the code; and (4) bundle several analysis steps and provide the end results in digital or (post-processed) graphical form. Within an NSF-sponsored ITR project coordinated by SCEC, we are constructing web services using architectural protocols and programming languages (e.g., Java). However, because the SCEC community has a rich pool of scientific research software (written in traditional languages such as C and FORTRAN), we also emphasize making existing scientific codes available by constructing web service frameworks which wrap around and directly run these codes. In doing so we attempt to broaden community usage of these codes. Web service wrapping of a scientific code can be done using a "web servlet" construction or by using a SOAP/WSDL-based framework. This latter approach is widely adopted in IT circles although it is subject to rapid evolution. Our wrapping framework attempts to "honor" the original codes with as little modification as is possible. For versatility we identify three methods of user access: (A) a web-based GUI (written in HTML and/or Java applets); (B) a Linux/OSX/UNIX command line "initiator" utility (shell-scriptable); and (C) direct access from within any Java application (and with the

  10. Improving communication among healthcare providers: preparing student nurses for practice.

    PubMed

    Krautscheid, Lorretta C

    2008-01-01

    Communication errors are identified by the Joint Commission as the primary root cause of sentinel events across all categories. In addition, improving the effectiveness of communication among healthcare providers is listed as one of the Joint Commission's 2008 National Patient Safety Goals. Nursing programs are expected to graduate practice-ready nurses who demonstrate quality and safety in patient care, which includes interdisciplinary communication. Through objectively structured clinical assessment simulations, faculty evaluate each nursing student's ability to perform many aspects of care, including the ability to communicate effectively with physicians via telephone in an emergent situation. This quality improvement project reports the results of a three-year review of undergraduate student nurse performance (n = 285) related to effective clinical communication. Changes in teaching-learning strategies, implementation of a standardized communication tool, and clinical enhancements which resulted in improved student competency, will be presented.

  11. Fault Management Architectures and the Challenges of Providing Software Assurance

    NASA Technical Reports Server (NTRS)

    Savarino, Shirley; Fitz, Rhonda; Fesq, Lorraine; Whitman, Gerek

    2015-01-01

    Fault Management (FM) is focused on safety, the preservation of assets, and maintaining the desired functionality of the system. How FM is implemented varies among missions. Common to most missions is system complexity due to a need to establish a multi-dimensional structure across hardware, software and spacecraft operations. FM is necessary to identify and respond to system faults, mitigate technical risks and ensure operational continuity. Generally, FM architecture, implementation, and software assurance efforts increase with mission complexity. Because FM is a systems engineering discipline with a distributed implementation, providing efficient and effective verification and validation (V&V) is challenging. A breakout session at the 2012 NASA Independent Verification & Validation (IV&V) Annual Workshop titled "V&V of Fault Management: Challenges and Successes" exposed this issue in terms of V&V for a representative set of architectures. NASA's Software Assurance Research Program (SARP) has provided funds to NASA IV&V to extend the work performed at the Workshop session in partnership with NASA's Jet Propulsion Laboratory (JPL). NASA IV&V will extract FM architectures across the IV&V portfolio and evaluate the data set, assess visibility for validation and test, and define software assurance methods that could be applied to the various architectures and designs. This SARP initiative focuses efforts on FM architectures from critical and complex projects within NASA. The identification of particular FM architectures and associated V&V/IV&V techniques provides a data set that can enable improved assurance that a system will adequately detect and respond to adverse conditions. Ultimately, results from this activity will be incorporated into the NASA Fault Management Handbook providing dissemination across NASA, other agencies and the space community. This paper discusses the approach taken to perform the evaluations and preliminary findings from the research.

  12. The provider cost of treating tuberculosis in Bauchi State, Nigeria

    PubMed Central

    Umar, Nisser; Fordham, Richard; Abubakar, Ibrahim; Bachmnn, Max

    2011-01-01

    The study was aimed at assessing the economic cost shouldered by government, as providers, in the provision of free Tuberculosis (TB) diagnosis and treatment services in Bauchi State, northern Nigeria. A cost analysis study was designed and questionnaires administered by the principal investigators to officers in charge of 27 randomly sampled government TB services providers across the State of Bauchi. Seventeen of these centers were primary care centers, 9 secondary care providers and one was a tertiary care provider. Data was also collected from personnel and projects records in the State Ministry of Health, of Works as well as the Ministry of Budget and Planning. The cost of buildings, staff and equipment replacement, laboratory, radiology and drugs in facilities were assessed and costs attributable tuberculosis inpatient, outpatient and directly observed therapy (DOT) services were estimated from the total cost based on the proportion of TB cases in the total patient pool accessing those services. The average proportion of TB patients in facilities was 3.4% in overall, 3.3% among inpatients and 3.1% in the outpatient population. The average cost spent to treat a patient with TB was estimated at US $227.14. The cost of inpatient care averaged $16.95/patient; DOT and outpatient services was $133.34/patient, while the overhead cost per patient was $30.89. The overall cost and all computed cost elements, except for DOT services, were highest in the tertiary center and least expensive in the infectious diseases hospital partly due to the higher administrative and other overhead recurrent spending in the tertiary health facility while the lower overhead cost observed in the infectious diseases hospital could be due to the economy of scale as a result of the relative higher number of TB cases seen in the facility operating with relatively same level of resources as other facilities in the state. PMID:28299060

  13. Ecosystem function and services provided by the deep sea

    NASA Astrophysics Data System (ADS)

    Thurber, A. R.; Sweetman, A. K.; Narayanaswamy, B. E.; Jones, D. O. B.; Ingels, J.; Hansman, R. L.

    2013-11-01

    The deep sea is often viewed as a vast, dark, remote, and inhospitable environment, yet the deep ocean and seafloor are crucial to our lives through the services and provisions that they provide. Our understanding of how the deep sea functions remains limited, but when treated synoptically, a diversity of provisioning, regulating and cultural services become apparent. The biological pump transports carbon from the atmosphere into deep-ocean water masses which are separated over prolonged periods, reducing the impact of anthropogenic carbon release. Microbial oxidation of methane keeps another potent greenhouse gas out of the atmosphere while trapping carbon in authigenic carbonates. Nutrient regeneration by all faunal size classes provides the elements necessary to fuel surface productivity and fisheries, and microbial processes detoxify a diversity of compounds. Each of these processes occur on a very small scale, yet considering the vast area over which they occur they become important for the global functioning of the ocean. The deep sea also provides a diversity of resources, including fish stocks, enormous bioprospecting potential, and elements and energy reserves that are currently being extracted and will be increasingly important in the near future. Society benefits from the intrigue and mystery, the strange life forms, and the great unknown which has acted as a muse for inspiration and imagination since near the beginning of civilization. While many functions occur on the scale of microns to meters and time scales up to years, the derived services that result are only useful after centuries of integrated activity. This vast dark habitat, that covers the majority of the globe, harbors processes that directly impact humans in a diversity of ways, however the same traits that differentiate it from terrestrial or shallow marine systems also result in a greater need for integrated spatial and temporal understanding as it experiences increased use by society.

  14. Outpatient provider contact prior to unintentional opioid overdose

    PubMed Central

    Lin, Lewei (Allison); Bohnert, Amy; Ilgen, Mark; Pfeiffer, Paul Nelson; Ganoczy, Dara; Blow, Fred

    2015-01-01

    Objectives Prescribed opioid medications are the most commonly implicated substances in unintentional overdoses. Outpatient health care encounters represent a potential opportunity to intervene to reduce opioid overdose risk. This study assessed the timing and type of outpatient provider contacts prior to overdose. Methods This study examined all adult patients nationally in the Veterans Health Administration (VHA) who died from unintentional prescription opioid overdose in fiscal years 2004–2007 and used VHA services anytime within two years of their deaths (n=1,813). For those whose last treatment contact was in an outpatient setting (n=1,457), demographic, clinical and treatment characteristics were compared among patients categorized by the location of their last contact. Results 33% (N=479) of those last seen in outpatient settings were seen within one week and 62% (N=910) within one month of their overdose. A substantial proportion of patients were last seen within one month of death in mental health or substance disorder outpatient settings (30% N=438). The majority of patients did not fill an opioid prescription on their last outpatient visit prior to unintentional opioid overdose. Conclusions The majority of patients who died by unintentional overdose on prescription opioids were seen within a month of their overdose in outpatient settings. These settings may provide an opportunity to prevent patients from dying from prescription opioid overdoses, and interventions to reduce risk should not be limited to visits that resulted in an opioid prescription. PMID:26129993

  15. [Dementias and daily competence: effects beyond ADL and IADL].

    PubMed

    Wilms, H U; Baltes, M M; Kanowski, S

    1998-08-01

    Using a time-budget method in a 3 year longitudinal study with a control group design, substantial reductions in the engagement of nonobligatory instrumental, social, and leisure activities could be found in a group of mildly to moderately demented patients. Controlling these changes for differences in baseline parameters, the dementia-specific reduction was about 1 1/2 hours compared to a non-psychiatric control group. These clinically relevant changes in activity levels underscore the importance of these activity domains with regard to the development of diagnostically useful indicators at the early stages of dementia. Time-budget methods seem to be particularly useful to close the diagnostic gap with regard to the assessment of everyday competence indicators especially at early stages of the dementia illness.

  16. Developing an Adaptive ADL Solution for Training Medical Teams

    DTIC Science & Technology

    2003-01-01

    The depth and extent of this pre-exercise briefing depends on students’ mastery levels and learning styles , with some students being given... learning styles , and motivational issues. RELATED WORK [Shaw et. al. 1999] have developed an agent-based intelligent tutoring system called ADELE

  17. Getting Districtwide Results

    ERIC Educational Resources Information Center

    McBeath, Angus

    2006-01-01

    This monograph is based on a keynote presentation by Angus McBeath at the "Getting Districtwide Results" Conference in Long Beach, California, which was co-sponsored by the Cross City Campaign for Urban School Reform and Focus on Results. The author, a former superintendent of the Edmonton Public Schools, how his school district was…

  18. Recent results from TRISTAN

    SciTech Connect

    Enomoto, Ryoji

    1997-01-01

    TRISTAN results on {gamma}{gamma} physics from 1994 to 1995 are reviewed in this report. We have systematically investigated jet production, the {gamma}-structure function, and charm pair production in {gamma}{gamma} processes. The results are discussed, and future prospects are presented.

  19. Diffraction Results from CDF

    SciTech Connect

    Goulianos, Konstantin

    2012-04-01

    We present final results by the CDF II collaboration on diffractive W and Z production, report on the status of ongoing analyses on diffractive dijet production and on rapidity gaps between jets, and briefly summarize results obtained on exclusive production pointing to their relevance to calibrating theoretical models used to predict exclusive Higgs-boson production at the LHC.

  20. 34. Boston switch interlocking tower. Central Falls, Providence Co., RI. ...

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

    34. Boston switch interlocking tower. Central Falls, Providence Co., RI. Sec. 4116, mp 190.40. - Northeast Railroad Corridor, Amtrak route between CT & MA state lines, Providence, Providence County, RI