Science.gov

Sample records for adults design setting

  1. The design of worm gear sets

    NASA Technical Reports Server (NTRS)

    Razzaghi, Andrea I.

    1987-01-01

    A method is presented for designing worm gear sets to meet torque multiplication requirements. First, the fundamentals of worm gear design are discussed, covering worm gear set nomenclature, kinematics and proportions, force analysis, and stress analysis. Then, a suggested design method is discussed, explaining how to take a worm gear set application, and specify a complete worm gear set design. The discussions are limited to cylindrical worm gear sets that have a 90 deg shaft angle between the worm and the mating gear.

  2. Existential Design Applied in Universal Design Settings.

    PubMed

    Torkildsby, Anne Britt

    2016-01-01

    The critical design method aims to discuss ways of opening up the (design) brief when planning, designing, building, operating and maintaining the future of the built environment - public as well as private, indoor as well as outdoor. Focusing on "designials" (fundamental forms of design being), the methodology intends to illustrate the fact that objects; including buildings, parks, transportation systems, etc. may directly encroach upon certain "existentials" (fundamental forms of human being) - thus shed light on how a design process is normally conducted, and furthermore, how that affects people's existential well-being. PMID:27534284

  3. Existential Design Applied in Universal Design Settings.

    PubMed

    Torkildsby, Anne Britt

    2016-01-01

    The critical design method aims to discuss ways of opening up the (design) brief when planning, designing, building, operating and maintaining the future of the built environment - public as well as private, indoor as well as outdoor. Focusing on "designials" (fundamental forms of design being), the methodology intends to illustrate the fact that objects; including buildings, parks, transportation systems, etc. may directly encroach upon certain "existentials" (fundamental forms of human being) - thus shed light on how a design process is normally conducted, and furthermore, how that affects people's existential well-being.

  4. Realities of Adult Literacy in Work Settings.

    ERIC Educational Resources Information Center

    Tenopyr, Mary L.

    While the need for improved literacy in the work force is generally accepted, questions still remain as to what levels of literacy are required for different jobs and who will provide the necessary adult literacy training. To answer these questions, researchers must develop a database of information about literacy needs and deficiences. Developing…

  5. TMX Upgrade magnet-set geometry design

    SciTech Connect

    Wong, R.L.

    1981-09-24

    A magnet set, consisting of 24 coils, has been designed for the TMX Upgrade. Like the coil set designed for the TMX experiment, the coils for TMX Upgrade consist of a central-cell set with a minimum-B plug set on each end. Between the central cell and each end plug, there is a flux bundle recircularizing transition set. Physics considerations require that the TMX Upgrade magnet set be almost twice as long as the TMX magnet set (14 m between the outer mirrors). The central circular coils are the only coils used from TMX. The TMX transition set of two C-coils and an octupole is replaced by a C-coil and an Ioffe coil. The TMX plug composed of a baseball coil and two C-coils is replaced by an Ioffe coil, two C-coils and two circular coils. A comparison between the TMX and TMX Upgrade magnet sets is shown.

  6. Preventing Falls in Older Adults Who Live in Community Settings

    MedlinePlus

    ... Preventing Falls in Older Adults Who Live in Community Settings: U.S. Preventive Services Task Force Recommendation Summaries ... full report is titled “Prevention of Falls in Community-Dwelling Older Adults: U.S. Preventive Services Task Force ...

  7. Adults' Learning about Science in Free-Choice Settings

    ERIC Educational Resources Information Center

    Rennie, Leonie J.; Williams, Gina F.

    2006-01-01

    This paper synthesizes findings from three studies to answer a general question: What do casual, adult visitors learn about science from their science-related experiences in free-choice settings? Specifically we asked whether there are changes in how people think about science in their daily lives, the nature and use of scientific knowledge, and…

  8. Design of Structurally Efficient Tapered Struts (SETS)

    NASA Technical Reports Server (NTRS)

    Deo, Ravi; Benner, Harry; Vincent, Dawson; Olason, Eric; Harrison, Richard

    2010-01-01

    A study was conducted to develop mass efficient composite struts. A closed-form design methodology for composite struts was developed using well established analyses to predict Euler buckling, local wall buckling; compression strength, damage tolerance, and interlaminar shear at geometric gradients. The methodology was coded in a spreadsheet suitable for convenient and rapid sizing of tapered composite struts. This spreadsheet analysis was used to determine the influence of several variables such as material stiffness, strut diameter, and material allowables on strut weight for given loading conditions. The comparison showed that, while the Park Aerospace design method was well suited to preliminary sizing for a conservative design, the closed-form-analyses-based spreadsheet accounts for all possible failure modes and is a good optimum strut design tool. The report concludes with a set of recommendations for future work in analytical design and analysis methodology enhancements.

  9. Polar narcosis: Designing a suitable training set

    SciTech Connect

    Ramos, E.U.; Vaes, W.H.J.; Verhaar, H.J.M.; Hermens, L.M.

    1995-12-31

    Substituted phenols, anilines, pyridines and nitrobenzenes can be classified as polar narcotics. These chemicals differ from non-polar narcotic compounds not only in that they exhibit a 5 to 10 times higher toxicity, but also in their Fish Acute Toxic Syndromes, together suggesting a different mode of action. For 97 polar narcotics, which are not ionized under physiological conditions, 11 physico-chemical and quantum-chemical descriptors were calculated. Using Principal Components Analysis 91% of the total variance could be explained by three Principal Components, which were subsequently used as factors in a Statistical Design. Eleven compounds were selected based on a two-level full factorial design, including three compounds near the center (2{sup 3} + 3). QSARs were developed for both, the design set and a set of 63 polar narcotics for which guppy and/or fathead minnow data were available in the literature. Both QSAR, based on PLS, resulted in good models (R{sup 2} = 0.96 and Q{sup 2} = 0.8{sup 2}; R{sup 2}= 0.86 and Q{sup 2} = 0.83 respectively) and gave similar Pseudo Regression Coefficients. In addition the model based on the designed chemicals was able to predict the toxicity of the 63 compounds (R{sup 2} = 0.85). These results show that these 11 chemicals are a well-balanced set for further studies of polar narcosis.

  10. Teaching Cafe' Waiter Skills to Adults with Intellectual Disability: A Real Setting Study

    ERIC Educational Resources Information Center

    Cavkaytar, Atilla

    2012-01-01

    The purpose of the study was to examine effectiveness of the Cafe' Waiter Education Program by providing the least prompting to three adult subjects with intellectual disability in a real-life setting. A multiple probe research design across subjects was used. Cafe' waiter skills included five main tasks incorporating 125 skill steps. Task…

  11. Set membership experimental design for biological systems

    PubMed Central

    2012-01-01

    Background Experimental design approaches for biological systems are needed to help conserve the limited resources that are allocated for performing experiments. The assumptions used when assigning probability density functions to characterize uncertainty in biological systems are unwarranted when only a small number of measurements can be obtained. In these situations, the uncertainty in biological systems is more appropriately characterized in a bounded-error context. Additionally, effort must be made to improve the connection between modelers and experimentalists by relating design metrics to biologically relevant information. Bounded-error experimental design approaches that can assess the impact of additional measurements on model uncertainty are needed to identify the most appropriate balance between the collection of data and the availability of resources. Results In this work we develop a bounded-error experimental design framework for nonlinear continuous-time systems when few data measurements are available. This approach leverages many of the recent advances in bounded-error parameter and state estimation methods that use interval analysis to generate parameter sets and state bounds consistent with uncertain data measurements. We devise a novel approach using set-based uncertainty propagation to estimate measurement ranges at candidate time points. We then use these estimated measurements at the candidate time points to evaluate which candidate measurements furthest reduce model uncertainty. A method for quickly combining multiple candidate time points is presented and allows for determining the effect of adding multiple measurements. Biologically relevant metrics are developed and used to predict when new data measurements should be acquired, which system components should be measured and how many additional measurements should be obtained. Conclusions The practicability of our approach is illustrated with a case study. This study shows that our

  12. Implementation of Evidence-Based HIV Interventions for Young Adult African American Women in Church Settings

    PubMed Central

    Stewart, Jennifer M.

    2015-01-01

    Objective To assess the barriers and facilitators to using African American churches as sites for implementation of evidence-based HIV interventions among young African American women. Design Mixed methods cross-sectional design. Setting African American churches in Philadelphia, PA. Participants 142 African American pastors, church leaders, and young adult women ages 18 to 25. Methods Mixed methods convergent parallel design. Results The majority of young adult women reported engaging in high-risk HIV-related behaviors. Although church leaders reported willingness to implement HIV risk-reduction interventions, they were unsure of how to initiate this process. Key facilitators to the implementation of evidence-based interventions included the perception of the leadership and church members that HIV interventions were needed and that the church was a promising venue for them. A primary barrier to implementation in this setting is the perception that discussions of sexuality should be private. Conclusion Implementation of evidence-based HIV interventions for young adult African American women in church settings is feasible and needed. Building a level of comfort in discussing matters of sexuality and adapting existing evidence-based interventions to meet the needs of young women in church settings is a viable approach for successful implementation. PMID:25139612

  13. Adults' Learning about Science in Free-choice Settings

    NASA Astrophysics Data System (ADS)

    Rennie, Léonie J.; Williams, Gina F.

    2006-06-01

    This paper synthesizes findings from three studies to answer a general question: What do casual, adult visitors learn about science from their science-related experiences in free-choice settings? Specifically we asked whether there are changes in how people think about science in their daily lives, the nature and use of scientific knowledge, and its communication by scientists. The three studies involved samples of visitors to an interactive science centre, visitors to a traditional natural history museum, and attendees at a series of public lectures, each given by an expert scientist in human genetics. Pretest and post-test data collected by parallel questionnaires indicated that, despite the different nature of their experience in the three different settings, participants became more positive about the value of science and the work done by scientists and their ability to communicate with the public. At all venues, however, participants became less scientific in their thinking about the nature of scientific knowledge, becoming more likely to believe it to be infallible. The consistency of these findings was surprising, and participants’ changed views about the nature of scientific knowledge were unexpected. Possible explanations for theses outcomes were suggested in terms of participants’ reasons for attending the venue, the nature of their engagement, and the non-controversial ways in which the exhibitions and lectures were structured. The findings suggest that the educational role of free-choice settings should be considered carefully, particularly with regard to the representation of science.

  14. Design of instructions for evacuating disabled adults.

    PubMed

    Boyce, Michael W; Al-Awar Smither, Janan; Fisher, Daniel O; Hancock, P A

    2017-01-01

    We investigated how the design of instructions can affect performance in preparing emergency stair travel devices for the evacuation of disable individuals. We had three hypotheses: 1) Design of instructions would account for a significant portion of explained performance variance, 2) Improvements in design of instructions would reduce time on task across device type and age group, and 3) There would be a performance decrement for older adults compared to younger adults based on the slowing of older adult information processing abilities. Results showed that design of instructions does indeed account for a large portion of explained variance in the operation of emergency stair travel devices, and that improvements in design of instructions can reduce time on task across device type and age group. However, encouragingly for real-world operations, results did not indicate any significant differences between older versus younger adults. We look to explore ways that individuals with disabilities can exploit these insights to enhance the performance of emergency stair travel devices for use. PMID:27633197

  15. Design of instructions for evacuating disabled adults.

    PubMed

    Boyce, Michael W; Al-Awar Smither, Janan; Fisher, Daniel O; Hancock, P A

    2017-01-01

    We investigated how the design of instructions can affect performance in preparing emergency stair travel devices for the evacuation of disable individuals. We had three hypotheses: 1) Design of instructions would account for a significant portion of explained performance variance, 2) Improvements in design of instructions would reduce time on task across device type and age group, and 3) There would be a performance decrement for older adults compared to younger adults based on the slowing of older adult information processing abilities. Results showed that design of instructions does indeed account for a large portion of explained variance in the operation of emergency stair travel devices, and that improvements in design of instructions can reduce time on task across device type and age group. However, encouragingly for real-world operations, results did not indicate any significant differences between older versus younger adults. We look to explore ways that individuals with disabilities can exploit these insights to enhance the performance of emergency stair travel devices for use.

  16. Designing Personalized Treatment Engagement Interventions for Depressed Older Adults

    PubMed Central

    Raue, Patrick J.; Sirey, Jo Anne

    2011-01-01

    SYNOPSIS Despite the benefits of treatment for late-life depression, we are faced with the challenges of underutilization of mental health services by older adults and non-adherence to offered interventions. This paper describes psychosocial and interactional barriers and facilitators of treatment engagement among depressed older adults served by community health care settings. We describe the need to engage older adults in treatment using interventions that: 1. target psychological barriers such as stigma and other negative beliefs about depression and its treatment; and 2. increase individuals’ involvement in the treatment decision-making process. We then present personalized treatment engagement interventions that our group has designed for a variety of community settings. PMID:21536170

  17. Design Principles to Accommodate Older Adults

    PubMed Central

    Farage, Miranda A.; Miller, Kenneth W.; Ajayi, Funmi; Hutchins, Deborah

    2012-01-01

    The global population is aging. In many industrial countries, almost one in five people are over age 65. As people age, gradual changes ensue in vision, hearing, balance, coordination, and memory. Products, communication materials, and the physical environment must be thoughtfully designed to meet the needs of people of all ages. This article summarizes normal changes in sensory function, mobility, balance, memory, and attention that occur with age. It presents practical guidelines that allow design professionals to accommodate these changes and better meet the needs of older adults. Designing for older adults is inclusive design: it accommodates a range of physical and cognitive abilities and promotes simplicity, flexibility, and ease of use for people of any age. PMID:22980147

  18. Designing User Interfaces for Older Adults.

    ERIC Educational Resources Information Center

    Hutchison, Douglas; And Others

    1997-01-01

    Of 45 adults over 50 who had computer experience, 44% reported difficulty reading screens, 53% were frustrated by complex software, and 27% had difficulty with the mouse. The physical characteristics of aging should be considered in designing special software features such as dynamic text resizing and menu buttons instead of pull-down menus. (SK)

  19. Universal Design in a Zoological Setting.

    PubMed

    Trieglaff, Mark

    2016-01-01

    Universal Design in planning for exhibiting animal collections for the public has been a part of the culture of one particular zoo in the US. This paper looks at the steps in designing a zoological park that is universally accessible to all visitors. PMID:27534338

  20. Universal Design in a Zoological Setting.

    PubMed

    Trieglaff, Mark

    2016-01-01

    Universal Design in planning for exhibiting animal collections for the public has been a part of the culture of one particular zoo in the US. This paper looks at the steps in designing a zoological park that is universally accessible to all visitors.

  1. Change in settings for early-season influenza vaccination among US adults, 2012 to 2013.

    PubMed

    Clark, Sarah J; Gebremariam, Acham; Cowan, Anne E

    2016-12-01

    Vaccination in non-medical settings is recommended as a strategy to increase access to seasonal influenza vaccine. To evaluate change in early-season influenza vaccination setting, we analyzed data from the National Internet Flu Survey. Bivariate comparison of respondent characteristics by location of vaccination was assessed using chi-square tests. Multinomial logistic regression was performed to compare the predicted probability of being vaccinated in medical, retail, and mobile settings in 2012 vs 2013. In both 2012 and 2013, vaccination in medical settings was more likely among elderly adults, those with chronic conditions, and adults with a high school education or less. Adults 18-64 without a chronic condition had a lower probability of vaccination in the medical setting, and higher probability of vaccination in a retail or mobile setting, in 2013 compared to 2012. Adults 18-64 with a chronic condition had no change in their location of flu vaccination. Elderly adults had a lower probability of vaccination in the medical setting, and higher probability of vaccination in a retail setting, in 2013 compared to 2012. Non-medical settings continue to play an increasing role in influenza vaccination of adults, particularly for adults without a chronic condition and elderly adults. Retail and mobile settings should continue to be viewed as important mechanisms to ensure broad access to influenza vaccination. PMID:27486562

  2. Effects of Live Adult Modeled Sex-Inappropriate Play Behavior in a Naturalistic Setting

    ERIC Educational Resources Information Center

    Wolf, Thomas M.

    1976-01-01

    In a naturalistic setting, boys and girls were exposed to a same- or opposite-sex live adult model who played with sex inappropriate toys. The results are explained in terms of the inappropriateness of toy playing for adults and the theoretical importance of adult vs. peer influences. (GO)

  3. Adult 4-H Volunteer Empowerment in 4-H Youth Development Settings

    ERIC Educational Resources Information Center

    Olsen, Pamela

    2009-01-01

    The primary purpose of this study was to determine which factors related to adult 4-H volunteer empowerment in 4-H youth development settings. This study examined the relationship of adult 4-H volunteers' perceived leadership styles of Oregon 4-H Youth Development Educators (YDE) to the adult 4-H volunteer sense of empowerment. In addition,…

  4. Case Studies of Action Research in Various Adult Education Settings.

    ERIC Educational Resources Information Center

    Kuhne, Gary W.; Weirauch, Drucie; Fetterman, David J.; Mearns, Raiana M.; Kalinosky, Kathy; Cegles, Kathleen A.; Ritchey, Linda

    1997-01-01

    Six case studies illustrate action research in adult education: faculty development in a museum, participation in a church congregation, retention of literacy volunteers in a corrections center, learner participation in a homeless shelter, technology innovation in a university, and infection control in a hospital. (SK)

  5. Adult Musicians' Experiences in a Homogeneous Ensemble Setting

    ERIC Educational Resources Information Center

    Taylor, Donald M.; Kruse, Nathan B.; Nickel, Bethany J.; Lee, Betty B.; Bowen, Tiffany N.

    2011-01-01

    The purpose of this study was to describe the experiences of adult musicians in two long-standing flute choirs. Data were collected through observations, field notes, and in-depth interviews with 16 ensemble members. Salient statements were grouped into meaning units and clustered into 5 themes: Serendipity, Rewards, Challenges, Directors'…

  6. Designing a Weight Gain Prevention Trial for Young Adults: The CHOICES Study

    ERIC Educational Resources Information Center

    Lytle, Leslie A.; Moe, Stacey G.; Nanney, M. Susie; Laska, Melissa N.; Linde, Jennifer A.; Petrich, Christine A.; Sevcik, Sarah M.

    2014-01-01

    Background: Young adults are at risk for weight gain. Little is known about how to design weight control programs to meet the needs of young adults and few theory-based interventions have been evaluated in a randomized control trial. The Choosing Healthy Options in College Environments and Settings (CHOICES) study was funded to create a…

  7. Enteral Nutrition for Adults in the Hospital Setting.

    PubMed

    Kozeniecki, Michelle; Fritzshall, Rebecca

    2015-10-01

    In patients unable to tolerate oral intake, multiple options of nutrient delivery are available to the clinician. Administration of enteral nutrition (EN) has long been considered the standard of care for nutrition support among patients unable to meet energy and protein requirements orally. Healthcare practitioners must make careful decisions related to ordering, administering, and monitoring EN therapy. In the hospital setting, the registered dietitian is a key resource in enteral formula selection and method of administration, monitoring for and troubleshooting EN-related complications, and transitioning to oral feeding. The hospital setting also presents many unique challenges in providing optimal nutrition to the enterally fed patient.

  8. Designing application software in wide area network settings

    NASA Technical Reports Server (NTRS)

    Makpangou, Mesaac; Birman, Ken

    1990-01-01

    Progress in methodologies for developing robust local area network software has not been matched by similar results for wide area settings. The design of application software spanning multiple local area environments is examined. For important classes of applications, simple design techniques are presented that yield fault tolerant wide area programs. An implementation of these techniques as a set of tools for use within the ISIS system is described.

  9. Remediating minimal progress on teaching programs by adults with severe disabilities in a congregate day setting.

    PubMed

    Parsons, Marsha B; Reid, Dennis H; Towery, Donna; England, Peggy; Darden, Michaela

    2008-01-01

    We evaluated a modified teaching approach for improving the performance of adults with severe disabilities who were making minimal progress on teaching programs in a congregate day setting. An approach for enhancing progress was developed for implementation within the ongoing routine of the adult day setting using resources indigenous to the setting. The teaching approach, based on early intensive teaching programs, involved increasing teaching trials, adding another consequence to the reinforcement component, and reducing distractions. Improved progress accompanied the approach with each of 4 participating adults. Measures of happiness and problem behavior showed no detrimental effect on quality of life. Advantages and disadvantages of the teaching approach are discussed regarding implications for practitioners.

  10. Mobility assessment: Sensitivity and specificity of measurement sets in older adults

    PubMed Central

    Panzer, Victoria P.; Wakefield, Dorothy B.; Hall, Charles B.; Wolfson, Leslie I.

    2011-01-01

    Objective To identify quantitative measurement variables that characterize mobility in older adults, meet reliability and validity criteria, distinguish fall-risk and predict future falls. Design Observational study with 1-year weekly falls follow-up Setting Mobility laboratory Participants Community-dwelling volunteers (n=74; 65–94 years old) categorized at entry as 27 ‘Non-fallers’ or 47 ‘Fallers’ by Medicare criteria (1 injury fall or >1 non-injury falls in the previous year). Interventions None Outcome Measures Test-retest and within-subject reliability, criterion and concurrent validity; predictive ability indicated by observed sensitivity and specificity to entry fall-risk group (Falls-status), Tinetti Performance Oriented Mobility Assessment (POMA), Computerized Dynamic Posturography Sensory Organization Test (SOT) and subsequent falls reported weekly. Results Measurement variables were selected that met reliability (ICC > 0.6) and/or discrimination (p<.01) criteria (Clinical variables- Turn- steps, time, Gait- velocity, Step-in-tub-time, and Downstairs- time; Force plate variables- Quiet standing Romberg ratio sway-area, Maximal lean- anterior-posterior excursion, Sit-to-stand medial-lateral excursion and sway-area). Sets were created (3 clinical, 2 force plate) utilizing combinations of variables appropriate for older adults with different functional activity levels and composite scores were calculated. Scores identified entry Falls-status and concurred with POMA and SOT. The Full clinical set (5 measurement variables) produced sensitivity/specificity (.80/.74) to Falls-status. Composite scores were sensitive and specific in predicting subsequent injury falls and multiple falls compared to Falls-status, POMA or SOT. Conclusions Sets of quantitative measurement variables obtained with this mobility battery provided sensitive prediction of future injury falls and screening for multiple subsequent falls using tasks that should be appropriate to

  11. Adult Learning in Nonformal Settings: Cultural Festivals as Spaces for Socially Situated Cognition

    ERIC Educational Resources Information Center

    Ambrosino, Audrey M.

    2009-01-01

    Recent years have witnessed a renewed interest in the role of museums and cultural festivals in adult learning. Once considered the keepers of physical and cultural history, there was only limited concern for if and how adults learned from these settings. The conventional view held that museums provided knowledge, and it was an individual's…

  12. Central venous catheter infection in adults in acute hospital settings.

    PubMed

    Jones, Clare A

    As well as the human cost, central venous catheter (CVC)-related bloodstream infections significantly inflate hospital costs, mainly through increased length of stay in hospital, particularly in intensive care. This literature review appraises recent research on measures used to minimize CVC-related infection and compares it with current best practice. Randomized controlled trials and systematic reviews published on the subject between 2000 and 2005 were reviewed, concentrating on non-tunnelled, short-term CVCs in the acute hospital setting. The new evidence mainly backs up current best practice. However, skin disinfection could be improved by using alcoholic chlorhexidine followed by aqueous povidone-iodine before CVC insertion. Also, alcoholic chlorhexidine is the preferred solution for cleaning the hubs/connectors before accessing the CVC. Good hand hygiene and quality control and education programmes are vital to improve patient care. More research is needed to clarify the effectiveness of certain interventions and technologies, such as antimicrobial CVCs.

  13. Inattentional blindness in older adults: Effects of attentional set and to-be-ignored distractors.

    PubMed

    Horwood, Sally; Beanland, Vanessa

    2016-04-01

    Inattentional blindness (IB) involves failing to detect an unexpected visual stimulus while undertaking another task. Previous research has predominantly investigated IB using young adult samples, with few studies exploring whether or how an observer's age affects their detection of unexpected events. To help address this gap, we compared younger adults (18-25 years of age) and older adults (60-80 years of age) on two IB tasks: one dynamic, one static. In the static task, older age was associated with substantially increased IB rates: 89 % for older adults versus 5 % for younger adults. In the dynamic task, we systematically manipulated the presence of to-be-ignored distractors and whether the unexpected stimulus color matched the observers' attentional set. We found a main effect of age on IB: As in the static task, older age was associated with increased IB rates (38 % for older adults vs. 8 % for younger adults). The presence of to-be-ignored distractors and attentional set mismatch interacted to substantially increase IB rates, but age did not interact with either factor. Overall, the results indicate that older age is associated with large increases in IB rates across a range of tasks. The pattern of results is consistent with attentional capacity models of cognitive aging, suggesting that older adults' reduced cognitive resources result in failure to consciously process stimuli that are inconsistent with their attentional set.

  14. Goal-setting, self-efficacy, and memory performance in older and younger adults.

    PubMed

    West, R L; Thorn, R M

    2001-01-01

    Research in field and laboratory settings has shown that goals lead to improved self-efficacy and performance, especially when individuals also receive positive feedback. The present study extended goal-setting theory to examine self-set goals and feedback in relation to younger and older adults' memory performance and self-efficacy. Following a baseline recall trial, participants completed three shopping list recall trials. Half of the participants were instructed to set goals for the three experimental trials, and half in each goal condition received performance feedback after each trial. Young adults' self-efficacy, clustering, and recall exceeded that of older adults. Goal setting increased self-efficacy for younger but not older adults, and it did not affect performance. Younger adults and participants in the feedback condition increased their goals across trials, as did participants for whom feedback indicated success. These data provide a first look at the motivational impact of feedback and self-set recall goals in memory aging. Additional study is needed to understand the interactive effects of type of feedback, memory task difficulty, and type of goal setting at different ages.

  15. Adult Career Counseling Using Possible Selves--A Quasi-Experimental Field Study in Naturalistic Settings

    ERIC Educational Resources Information Center

    Plimmer, Geoff

    2012-01-01

    This study examined the effectiveness of an adult career development program designed to reflect the diversity and demands of career choices, the low level of comfort many have with career choices, and the limited resources available to resolve complex adult career problems. A possible selves process was used, delivered through a blend of computer…

  16. Measuring health-related quality of life in adults with chronic conditions in primary care settings

    PubMed Central

    Hand, Carri

    2016-01-01

    Abstract Objective To describe health-related quality of life (HRQOL) conceptual frameworks, critically review 3 commonly used HRQOL scales relevant to adults with chronic conditions in primary care settings, and make recommendations for using HRQOL scales in primary care practice. Data sources Information was accessed regarding HRQOL conceptual and theoretical approaches. A comprehensive search strategy identified 3 commonly used scales that met the review criteria and evidence regarding use of the scales in adults with chronic conditions in community settings. Scale selection Scales were selected if they were designed for clinical use; were easy to administer; were generic and broad in content areas; and contained some individualized items. Scales were critiqued according to content development, theoretical basis, psychometric properties, scoring, feasibility, the concepts being measured, and the number of items that measured an individualized concept. Synthesis Early HRQOL approaches focused on health and functional status while recent approaches incorporate individualized concepts such as the person’s own values and the environment. The abbreviated World Health Organization Quality of Life Scale (WHOQOL-BREF), the 36-Item Short Form Health Survey (SF-36), and the Duke Health Profile were critiqued. All address physical, mental, and social domains, while the WHOQOL-BREF also addresses environment. Psychometric evidence supports use of the SF-36 and WHOQOL-BREF with this population. The SF-36 has the most evidence of responsiveness but has some floor and ceiling effects, while the WHOQOL-BREF does not appear to have floor or ceiling effects but has limited evidence of responsiveness. The WHOQOL-BREF has the highest proportion of individualized items. Conclusion Measurement of HRQOL in adults with chronic conditions can support patient management and contribute to primary care service evaluation. Scales that are based on a broad definition of health and that

  17. Performance of the measures of processes of care for adults and service providers in rehabilitation settings

    PubMed Central

    Bamm, Elena L; Rosenbaum, Peter; Wilkins, Seanne; Stratford, Paul

    2015-01-01

    Introduction In recent years, client-centered care has been embraced as a new philosophy of care by many organizations around the world. Clinicians and researchers have identified the need for valid and reliable outcome measures that are easy to use to evaluate success of implementation of new concepts. Objective The current study was developed to complete adaptation and field testing of the companion patient-reported measures of processes of care for adults (MPOC-A) and the service provider self-reflection measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Design A validation study Settings In-patient rehabilitation facilities. Main outcome measures MPOC-A and measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Results Three hundred and eighty-four health care providers, 61 patients, and 16 family members completed the questionnaires. Good to excellent internal consistency (0.71–0.88 for health care professionals, 0.82–0.90 for patients, and 0.87–0.94 for family members), as well as moderate to good correlations between domains (0.40–0.78 for health care professionals and 0.52–0.84 for clients) supported internal reliability of the tools. Exploratory factor analysis of the MPOC-SP(A) responses supported the multidimensionality of the questionnaire. Conclusion MPOC-A and MPOC-SP(A) are valid and reliable tools to assess patient and service-provider accounts, respectively, of the extent to which they experience, or are able to provide, client-centered service. Research should now be undertaken to explore in more detail the relationships between client experience and provider reports of their own behavior. PMID:26089710

  18. The Child Affective Facial Expression (CAFE) set: validity and reliability from untrained adults.

    PubMed

    LoBue, Vanessa; Thrasher, Cat

    2014-01-01

    Emotional development is one of the largest and most productive areas of psychological research. For decades, researchers have been fascinated by how humans respond to, detect, and interpret emotional facial expressions. Much of the research in this area has relied on controlled stimulus sets of adults posing various facial expressions. Here we introduce a new stimulus set of emotional facial expressions into the domain of research on emotional development-The Child Affective Facial Expression set (CAFE). The CAFE set features photographs of a racially and ethnically diverse group of 2- to 8-year-old children posing for six emotional facial expressions-angry, fearful, sad, happy, surprised, and disgusted-and a neutral face. In the current work, we describe the set and report validity and reliability data on the set from 100 untrained adult participants.

  19. The Child Affective Facial Expression (CAFE) set: validity and reliability from untrained adults

    PubMed Central

    LoBue, Vanessa; Thrasher, Cat

    2014-01-01

    Emotional development is one of the largest and most productive areas of psychological research. For decades, researchers have been fascinated by how humans respond to, detect, and interpret emotional facial expressions. Much of the research in this area has relied on controlled stimulus sets of adults posing various facial expressions. Here we introduce a new stimulus set of emotional facial expressions into the domain of research on emotional development—The Child Affective Facial Expression set (CAFE). The CAFE set features photographs of a racially and ethnically diverse group of 2- to 8-year-old children posing for six emotional facial expressions—angry, fearful, sad, happy, surprised, and disgusted—and a neutral face. In the current work, we describe the set and report validity and reliability data on the set from 100 untrained adult participants. PMID:25610415

  20. A Structured Set of Design Patterns for Learner's Assessment

    ERIC Educational Resources Information Center

    Delozanne, E.; Le Calvez, F.; Merceron, A.; Labat, J.

    2007-01-01

    In this article we present a structured set of Design Patterns (DPs) that deals with tracking students while they solve problem in specific domains such as programming or mathematics. Our collection of 17 DPs yields a three step approach: First step: to collect and analyze information on each student for each exercise; Second step: to build a…

  1. A set-associative, fault-tolerant cache design

    NASA Technical Reports Server (NTRS)

    Lamet, Dan; Frenzel, James F.

    1992-01-01

    The design of a defect-tolerant control circuit for a set-associative cache memory is presented. The circuit maintains the stack ordering necessary for implementing the Least Recently Used (LRU) replacement algorithm. A discussion of programming techniques for bypassing defective blocks is included.

  2. NASA'S RPS Design Reference Mission Set for Solar System Exploration

    NASA Astrophysics Data System (ADS)

    Balint, Tibor S.

    2007-01-01

    NASA's 2006 Solar System Exploration (SSE) Strategic Roadmap identified a set of proposed large Flagship, medium New Frontiers and small Discovery class missions, addressing key exploration objectives. These objectives respond to the recommendations by the National Research Council (NRC), reported in the SSE Decadal Survey. The SSE Roadmap is down-selected from an over-subscribed set of missions, called the SSE Design Reference Mission (DRM) set Missions in the Flagship and New Frontiers classes can consider Radioisotope Power Systems (RPSs), while small Discovery class missions are not permitted to use them, due to cost constraints. In line with the SSE DRM set and the SSE Roadmap missions, the RPS DRM set represents a set of missions, which can be enabled or enhanced by RPS technologies. At present, NASA has proposed the development of two new types of RPSs. These are the Multi-Mission Radioisotope Thermoelectric Generator (MMRTG), with static power conversion; and the Stirling Radioisotope Generator (SRG), with dynamic conversion. Advanced RPSs, under consideration for possible development, aim to increase specific power levels. In effect, this would either increase electric power generation for the same amount of fuel, or reduce fuel requirements for the same power output, compared to the proposed MMRTG or SRG. Operating environments could also influence the design, such that an RPS on the proposed Titan Explorer would use smaller fins to minimize heat rejection in the extreme cold environment; while the Venus Mobile Explorer long-lived in-situ mission would require the development of a new RPS, in order to tolerate the extreme hot environment, and to simultaneously provide active cooling to the payload and other electric components. This paper discusses NASA's SSE RPS DRM set, in line with the SSE DRM set. It gives a qualitative assessment regarding the impact of various RPS technology and configuration options on potential mission architectures, which could

  3. Goal Setting as a Facilitator of Work Performance of Retarded Adults and College Students Differing in Locus of Control.

    ERIC Educational Resources Information Center

    Gardner, David C.; Warren, Sue Allen

    One experiment investigated the relationship of goal setting and locus of control to the work performance of mentally retarded adults and a second experiment was a semi-replication study done on college adults. Two main effects were studied: (1) Method of goal setting (whether a worker set his own goal, had a goal set by a supervisor, or simply…

  4. [Democratic institutional design in health care priority setting and rationing].

    PubMed

    Landwehr, Claudia

    2012-01-01

    Decisions on priority setting and rationing in health care have both informational and distributional aspects, which is why they require expert knowledge and specialised bodies on the one hand and democratic consent on the other hand. The paper presents normative criteria for the evaluation and empirical categories for the description and comparison of respective bodies. As procedural decisions always have implications for resulting distributional decisions, the bodies charged with priority setting and rationing decisions must be subject to democratic institutional design. (As supplied by publisher).

  5. Derivation of safety factors for setting harvest quotas on adult walleyes from past estimates of abundance

    USGS Publications Warehouse

    Hansen, Michael J.; Staggs, Michael D.; Hoff, Michael H.

    1991-01-01

    Past population estimates of adult walleyes Stizostedion vitreum can be used to set harvest quotas, provided that temporal variability in abundance of adult walleyes is accounted for. We used a long-term data set from Escanaba Lake, Wisconsin, to evaluate the accuracy of past population estimates for setting current-year quotas for adult walleyes. The results from Escanaba Lake were corroborated by comparison with other lakes where adult walleye abundance was estimated in more than 1 year. The accuracy of estimates of adult walleye abundance declined over time from the year the estimate was obtained to the year it was used to set a harvest quota. We derived safety factors for application to past estimates of population size; these factors limit the occurrence of an exploitation rate exceeding the maximum sustainable rate (35%) to approximately 1 in 40. These safety factors declined from 35% for 1-year-old estimates to less than 20% for 10-year-old estimates.

  6. Recovery-oriented care in older-adult acute inpatient mental health settings in Australia: an exploratory study.

    PubMed

    McKenna, Brian; Furness, Trentham; Dhital, Deepa; Ireland, Susan

    2014-10-01

    Recovery-oriented care acknowledges the unique journey that consumers lead with the aim of regaining control of their lives in order to live a good life. Recovery has become a dominant policy-directed model of many mental health care organizations, but in older-adult acute mental health inpatient settings, nurses do not have a clear description of how to be recovery-oriented. The aims of this study were to determine the extent to which elements of existing nursing practice resemble the domains of recovery-oriented care and provide a baseline understanding of practice in preparation for transformation to recovery-oriented mental health care provision. An exploratory, qualitative research design was used to meet the research aims. A purposive sample of mental health nurses (N = 12) participated in focus groups in three older-adult inpatient settings in Australia. A general inductive approach was used to analyze the qualitative data. The mental health nurses in this study readily discussed aspects of their current practice within the recovery domains. They described pragmatic ways to promote a culture of hope, collaborative partnerships, meaningful engagement, autonomy and self-determination, and community participation and citizenship. Nurses also discussed challenges and barriers to recovery-oriented care in older-adult acute mental health settings. This study identified a reasonable baseline understanding of practice in preparation for transformation to recovery-oriented older-adult mental healthcare provision. A concerted drive focused on recovery education is required to effectively embed a recovery-orientated paradigm into older-adult mental health settings.

  7. Plant computer applications 'design and implementation tools' set

    SciTech Connect

    Anikanov, S. S.; Stolyetniy, I. V.; Tregubov, M. I.; Guslyakov, O. L.; Gladkov, Y. I.

    2006-07-01

    This paper describes functionality of the application programs' development tool, which is intended to support the full scope of the NPP plant computer applications' design process. The Application Development Tools' Set (ADTS), described in this paper, refers to a set of tools intended to capture functional requirements for applications and support design process from definition of design basis up to final testing of developed applications. There are several tools developed by Westinghouse that facilitate design of application software on different stages of design process. Those are: NAPDT - Nuclear Application Development Tool; SDODT - Simplified Display Object Development Tool; OPAL - Test case execution and documenting tool; The main idea of ADTS is to combine the aforementioned tools into one software environment with other Common out-of-shelf (COT) software to facilitate and expedite NPP plant computer applications. Combination of the software tools included into ADTS satisfies industry requirements for the application software intended for use in the Category B and C systems /2 - 4/. (authors)

  8. Setting a research agenda for perioperative systems design.

    PubMed

    Sandberg, Warren S; Ganous, Timothy J; Steiner, Charles

    2003-06-01

    Perioperative care may be considered as a system amenable to industrial design approaches. The current care model is disjointed, prone to breakdown by failure of one component, and hostile to personnel. Moving a patient as a person and data set through the flow of perioperative care is not only possible, but it is essential for efficiency and safety. Perioperative systems design integrates the research agenda in technology, safety, informatics, and even telemedicine by putting all the pieces that constitute patient care into a cogent, flexible, and well-managed model.

  9. A Lead User Approach to Universal Design - Involving Older Adults in the Design Process.

    PubMed

    Raviselvam, Sujithra; Wood, Kristin L; Hölttä-Otto, Katja; Tam, Victoria; Nagarajan, Kamya

    2016-01-01

    The concept of Universal Design has received increasing appreciation over the past two decades. Yet, there are very few existing designs that cater to the needs of extraordinary users who experience some form of physical challenge. Previous work has shown promising results on involving users with physical challenges as lead users - users who have the potential to identify needs that could be latent among the general population. It has also been shown that older adults can act as such lead users. They can help design universal product ideas that satisfy both older adults and the general population. In this paper we build on this and examine if involving older adults in the design phase can result in universal products, products preferred by both older adults and the general population over a current option. Eighty-nine older adult participants and thirty-four general population participants took part in the study. Products were redesigned and prototyped based on the needs of older adults and tested among both populations. Results show that, although older adults and the general population did share certain needs and demands, the majority of older adults had needs and demands that were different from those of the general population. However, even though the needs differed between the populations, on average 89% of the general population participants preferred products designed based on design needs expressed by older adults over the current option. This provides further evidence supporting the use of older adults in designing products for all.

  10. A Lead User Approach to Universal Design - Involving Older Adults in the Design Process.

    PubMed

    Raviselvam, Sujithra; Wood, Kristin L; Hölttä-Otto, Katja; Tam, Victoria; Nagarajan, Kamya

    2016-01-01

    The concept of Universal Design has received increasing appreciation over the past two decades. Yet, there are very few existing designs that cater to the needs of extraordinary users who experience some form of physical challenge. Previous work has shown promising results on involving users with physical challenges as lead users - users who have the potential to identify needs that could be latent among the general population. It has also been shown that older adults can act as such lead users. They can help design universal product ideas that satisfy both older adults and the general population. In this paper we build on this and examine if involving older adults in the design phase can result in universal products, products preferred by both older adults and the general population over a current option. Eighty-nine older adult participants and thirty-four general population participants took part in the study. Products were redesigned and prototyped based on the needs of older adults and tested among both populations. Results show that, although older adults and the general population did share certain needs and demands, the majority of older adults had needs and demands that were different from those of the general population. However, even though the needs differed between the populations, on average 89% of the general population participants preferred products designed based on design needs expressed by older adults over the current option. This provides further evidence supporting the use of older adults in designing products for all. PMID:27534296

  11. Setting up and Running a Loss and Bereavement Support Group for Adults with Learning Disabilities

    ERIC Educational Resources Information Center

    Boyden, Paul; Freeman, Adele; Offen, Liz

    2010-01-01

    Following evidence based literature, the Birmingham Clinical Psychology Service for People with Learning Disabilities ran a Loss and Bereavement Psychotherapy Group. The group consisted of five adults with mild learning disabilities, who met for 8 consecutive weeks. This paper reports the process of setting up a bereavement group for people with…

  12. Using Public Posting as a Motivation Strategy in Physical Education, Sport, and Adult Exercise Settings

    ERIC Educational Resources Information Center

    Martin, Matt; Sharpe, Tom

    2009-01-01

    One of the ongoing challenges that physical educators, coaches, and fitness professionals face is discovering and implementing motivational strategies that encourage long-term participation and effort. This challenge exists in public school physical education classes, on the playing field, and in structured adult physical activity settings. In…

  13. A Guide To Setting Up a Creative Art Experiences Program for Older Adults with Developmental Disabilities.

    ERIC Educational Resources Information Center

    Harlan, Jane E.

    This guide is intended to help agencies serving older adults with mental retardation and other developmental disabilities in setting up a relatively inexpensive creative art program. The first section presents a rationale for creative art experiences for this population and then provides specific information on program development, including…

  14. Sources of Cognitive Inflexibility in Set-Shifting Tasks: Insights into Developmental Theories from Adult Data

    ERIC Educational Resources Information Center

    Dick, Anthony Steven

    2012-01-01

    Two experiments examined processes underlying cognitive inflexibility in set-shifting tasks typically used to assess the development of executive function in children. Adult participants performed a Flexible Item Selection Task (FIST) that requires shifting from categorizing by one dimension (e.g., color) to categorizing by a second orthogonal…

  15. Characteristics Associated with Genital Herpes Testing among Young Adults: Assessing Factors from Two National Data Sets

    ERIC Educational Resources Information Center

    Gilbert, Lisa K.; Levandowski, Brooke A.; Roberts, Craig M.

    2010-01-01

    Objectives and Participants: In the United States, genital herpes (GH) prevalence is 10.6% among 20- to 29-year-olds and about 90% of seropositive persons do not know their status. This study investigated individual characteristics associated with GH screening and diagnosis in sexually active young adults aged 18 to 24. Methods: Two data sets were…

  16. Mathematical extrapolation of image spectrum for constraint-set design and set-theoretic superresolution.

    PubMed

    Bhattacharjee, Supratik; Sundareshan, Malur K

    2003-08-01

    Several powerful iterative algorithms are being developed for the restoration and superresolution of diffraction-limited imagery data by use of diverse mathematical techniques. Notwithstanding the mathematical sophistication of the approaches used in their development and the potential for resolution enhancement possible with their implementation, the spectrum extrapolation that is central to superresolution comes in these algorithms only as a by-product and needs to be checked only after the completion of the processing steps to ensure that an expansion of the image bandwidth has indeed occurred. To overcome this limitation, a new approach of mathematically extrapolating the image spectrum and employing it to design constraint sets for implementing set-theoretic estimation procedures is described. Performance evaluation of a specific projection-onto-convex-sets algorithm by using this approach for the restoration and superresolution of degraded images is outlined. The primary goal of the method presented is to expand the power spectrum of the input image beyond the range of the sensor that captured the image.

  17. Clinical Setting and Management Approach Matters: Metabolic Testing Rates in Antipsychotic-Treated Youth and Adults

    PubMed Central

    Nicol, Ginger; Campagna, Elizabeth J; Garfield, Lauren D; Newcomer, John W; Parks, Joe; Morrato, Elaine

    2015-01-01

    Background Guidelines recommend increased metabolic monitoring in antipsychotic-treated patients. State and federal agencies are striving to address under-screening. Methods Rates of glucose and lipid testing among antipsychotic-treated youth and adults in Missouri Medicaid (N=9,473) in Community Mental Health Centers (CMHCs), with and without case management, versus other care settings were evaluated. Multivariable logistic regressions determined which characteristics were independently associated with metabolic testing. Results Rates of glucose and lipid testing were 37.0% and 17.3% in youth and 68.7% and 34.9% in adults, respectively. Adjusted odds of glucose and lipid testing were higher in patients receiving care in a CMHC with case management [youth: AOR=1.68 (95% CI=1.37-2.04), 2.40(1.91-3.02); adults: 1.43(1.18-1.74), 1.97(1.64-2.36)], or without [youth: 1.89(1.61-2.22), 2.35(1.94-2.85); adults: 1.44(1.22-1.70), 1.48(1.27-1.74)] versus other settings. Conclusions Within Missouri Medicaid, receiving care at a CMHC was associated with higher rates of metabolic testing, possibly reflecting state efforts to promote health homes in these settings. PMID:26325456

  18. Optimization of massive countermeasure design in complex rockfall settings

    NASA Astrophysics Data System (ADS)

    Agliardi, Federico; Crosta, Giovanni B.

    2015-04-01

    Rockfall protection is a major need in areas impended by subvertical rockwalls with complex 3D morphology and little or no talus to provide natural rockfall attenuation. The design of massive embankments, usually required to ensure such protection, is particularly difficult in complex rockfall settings, due to: widespread occurrence of rockfall sources; difficult characterization of size distribution and location of unstable volumes; variability of failure mechanisms; spatial scattering of rockfall trajectories; high expected kinetic energies. Moreover, rockwalls in complex lithological and structural settings are often prone to mass falls related to rock mass sector collapses. All these issues may hamper a safe application of classic embankment analysis approaches, using empirical rules or 2D-based height/energy statistics, and point to the need of integrated analyses of rock slope instability and rockfall runout in 3D. We explore the potential of combining advanced rock mass characterisation techniques and 3D rockfall modelling to support challenging countermeasure design at a site near Lecco (Southern Alps, Italy). Here subvertical cliffs up to 600 m high impend on a narrow (< 150 m) strip of flat land along the Como Lake shore. Rock is thickly bedded limestone (Dolomia Principale Fm) involved in a ENE-trending, S-verging kilometre-scale anticline fold. The spatial variability of bedding attitude and fracture intensity is strongly controlled by the geological structure, with individual block sizes varying in the range 0.2-15 m3. This results in spatially variable rockfall susceptibility and mechanisms, from single block falls to mass falls. Several rockfall events occurred between 1981 and 2010 motivated the design of slope benching and a massive embankment. To support reliable design verification and optimization we performed a 3D assessment of both rock slope instability and rockfall runout. We characterised fracture patterns and rock mass quality associated

  19. Design for a Performance Based Adult Education Community Coordinating Agency.

    ERIC Educational Resources Information Center

    Stambler, Moses

    A plan is described for a project to establish an adult education coordinating and change agency in the New Haven, Connecticut area to coordinate activities of existing organizations; provide a research staff to establish a computerized data base; disseminate information and provide technological services to local agencies; set up a communications…

  20. Effects of neurofeedback on adult patients with psychiatric disorders in a naturalistic setting.

    PubMed

    Cheon, Eun-Jin; Koo, Bon-Hoon; Seo, Wan-Seok; Lee, Jun-Yeob; Choi, Joong-Hyeon; Song, Shin-Ho

    2015-03-01

    Few well-controlled studies have considered neurofeedback treatment in adult psychiatric patients. In this regard, the present study investigates the characteristics and effects of neurofeedback on adult psychiatric patients in a naturalistic setting. A total of 77 adult patients with psychiatric disorders participated in this study. Demographic data and neurofeedback states were retrospectively analyzed, and the effects of neurofeedback were evaluated using clinical global impression (CGI) and subjective self-rating scales. Depressive disorders were the most common psychiatric disorders (19; 24.7 %), followed by anxiety disorders (18; 23.4 %). A total of 69 patients (89.6 %) took medicine, and the average frequency of neurofeedback was 17.39 ± 16.64. Neurofeedback was applied to a total of 39 patients (50.6 %) more than 10 times, and 48 patients (62.3 %) received both β/SMR and α/θ training. The discontinuation rate was 33.8 % (26 patients). There was significant difference between pretreatment and posttreatment CGI scores (<.001), and the self-rating scale also showed significant differences in depressive symptoms, anxiety, and inattention (<.001). This is a naturalistic study in a clinical setting, and has several limitations, including the absence of a control group and a heterogenous sample. Despite these limitations, the study demonstrates the potential of neurofeedback as an effective complimentary treatment for adult patients with psychiatric disorders.

  1. Clowning in Health Care Settings: The Point of View of Adults

    PubMed Central

    Dionigi, Alberto; Canestrari, Carla

    2016-01-01

    Within the past decade, there has been a surge of interest in investigating the effects of clown intervention in a large variety of clinical settings. Many studies have focused on the effects of clown intervention on children. However, few studies have investigated clowning effects on adults. This paper presents an overview of the concept of medical clowning followed by a literature review conducted on the empirical studies drawn from three data bases (PubMed, PsycINFO, and Google Scholar), with the aim of mapping and discussing the evidence of clowning effects on non-children, namely adults. The following areas were investigated: Adult and elderly patients (mainly those with dementia), observers of clowning, namely non-hospitalized adults who are at the hospital as relatives of patients or health-care staff, and finally clowns themselves. The main results are that 1) clown intervention induces positive emotions, thereby enhancing the patient’s well-being, reduces psychological symptoms and emotional reactivity, and prompts a decrease in negative emotions, such as anxiety and stress; 2) clown doctors are also well-perceived by relatives and healthcare staff and their presence appears to be useful in creating a lighter atmosphere in the health setting; 3) few pilot studies have been conducted on clown doctors and this lacuna represents a subject for future research. PMID:27547261

  2. Clowning in Health Care Settings: The Point of View of Adults.

    PubMed

    Dionigi, Alberto; Canestrari, Carla

    2016-08-01

    Within the past decade, there has been a surge of interest in investigating the effects of clown intervention in a large variety of clinical settings. Many studies have focused on the effects of clown intervention on children. However, few studies have investigated clowning effects on adults. This paper presents an overview of the concept of medical clowning followed by a literature review conducted on the empirical studies drawn from three data bases (PubMed, PsycINFO, and Google Scholar), with the aim of mapping and discussing the evidence of clowning effects on non-children, namely adults. The following areas were investigated: Adult and elderly patients (mainly those with dementia), observers of clowning, namely non-hospitalized adults who are at the hospital as relatives of patients or health-care staff, and finally clowns themselves. The main results are that 1) clown intervention induces positive emotions, thereby enhancing the patient's well-being, reduces psychological symptoms and emotional reactivity, and prompts a decrease in negative emotions, such as anxiety and stress; 2) clown doctors are also well-perceived by relatives and healthcare staff and their presence appears to be useful in creating a lighter atmosphere in the health setting; 3) few pilot studies have been conducted on clown doctors and this lacuna represents a subject for future research. PMID:27547261

  3. Effects of neurofeedback on adult patients with psychiatric disorders in a naturalistic setting.

    PubMed

    Cheon, Eun-Jin; Koo, Bon-Hoon; Seo, Wan-Seok; Lee, Jun-Yeob; Choi, Joong-Hyeon; Song, Shin-Ho

    2015-03-01

    Few well-controlled studies have considered neurofeedback treatment in adult psychiatric patients. In this regard, the present study investigates the characteristics and effects of neurofeedback on adult psychiatric patients in a naturalistic setting. A total of 77 adult patients with psychiatric disorders participated in this study. Demographic data and neurofeedback states were retrospectively analyzed, and the effects of neurofeedback were evaluated using clinical global impression (CGI) and subjective self-rating scales. Depressive disorders were the most common psychiatric disorders (19; 24.7 %), followed by anxiety disorders (18; 23.4 %). A total of 69 patients (89.6 %) took medicine, and the average frequency of neurofeedback was 17.39 ± 16.64. Neurofeedback was applied to a total of 39 patients (50.6 %) more than 10 times, and 48 patients (62.3 %) received both β/SMR and α/θ training. The discontinuation rate was 33.8 % (26 patients). There was significant difference between pretreatment and posttreatment CGI scores (<.001), and the self-rating scale also showed significant differences in depressive symptoms, anxiety, and inattention (<.001). This is a naturalistic study in a clinical setting, and has several limitations, including the absence of a control group and a heterogenous sample. Despite these limitations, the study demonstrates the potential of neurofeedback as an effective complimentary treatment for adult patients with psychiatric disorders. PMID:25740085

  4. Clowning in Health Care Settings: The Point of View of Adults.

    PubMed

    Dionigi, Alberto; Canestrari, Carla

    2016-08-01

    Within the past decade, there has been a surge of interest in investigating the effects of clown intervention in a large variety of clinical settings. Many studies have focused on the effects of clown intervention on children. However, few studies have investigated clowning effects on adults. This paper presents an overview of the concept of medical clowning followed by a literature review conducted on the empirical studies drawn from three data bases (PubMed, PsycINFO, and Google Scholar), with the aim of mapping and discussing the evidence of clowning effects on non-children, namely adults. The following areas were investigated: Adult and elderly patients (mainly those with dementia), observers of clowning, namely non-hospitalized adults who are at the hospital as relatives of patients or health-care staff, and finally clowns themselves. The main results are that 1) clown intervention induces positive emotions, thereby enhancing the patient's well-being, reduces psychological symptoms and emotional reactivity, and prompts a decrease in negative emotions, such as anxiety and stress; 2) clown doctors are also well-perceived by relatives and healthcare staff and their presence appears to be useful in creating a lighter atmosphere in the health setting; 3) few pilot studies have been conducted on clown doctors and this lacuna represents a subject for future research.

  5. Real-time infrared test set: system design and development

    NASA Astrophysics Data System (ADS)

    Johnson, R. Barry; Martin, Diehl H.; Chung, Ronald; Geist, Jon C.; Burrell, Jack O.; Slemp, Jim L.; Umstead, Jeffrey R.; Mann, Allen; Marlin, H. Ronald; Bates, Richard L.; Sweet, Miles H.; Williams, Donald N.; Carlson, Rowena M.; Gaitan, Michael; Marshall, Janet C.; Mulford, Charles D.; Zakar, Eugene S.; Zeto, Robert J.; Olson, Russ; Perkins, Gordon C.

    1997-07-01

    During the past several years, the technology for designing and fabricating thermal pixel arrays (TPAs) using silicon micromachined CMOS devices has been developed adequately to support the development of a real-time infrared test set (RTIR) for sensors and seekers. The TPA is a custom application-specific integrated circuit device that is fabricated using a low-cost commercial CMOS process. The system architecture and development of the initial RTIR Test Set is described. The RTIR is a compact, self-contained test instrument that is intended for test and evaluation of infrared systems in the field. In addition to the TPA, the RTIR contains projection optics and electronics which drive the TPA, provide TPA nonuniformity compensation, data translation, data transformation, and user interface. The RTIR can display internal test patterns (static and dynamic), external digital video data, and NTSC video. The initial RTIR unit incorporates a 64 X 64 TPA to provide flickerless infrared scenes at 30 frames per second. Additional TPAs are under development with formats of 128 X 128, 256 X 256, and 512 X 512 pixels.

  6. Computer-Based Video Instruction to Teach Young Adults with Moderate Intellectual Disabilities to Perform Multiple Step, Job Tasks in a Generalized Setting

    ERIC Educational Resources Information Center

    Mechling, Linda C.; Ortega-Hurndon, Fanny

    2007-01-01

    This study evaluated the effectiveness of computer-based video instruction (CBVI) to teach three young adults with moderate intellectual disabilities to perform complex, multiple step, job tasks in a generalized setting. A multiple probe design across three job tasks and replicated across three students was used to evaluate the effectiveness of…

  7. The Effective Early Learning Project: The Quality of Adult Engagement in Early Childhood Settings in the UK.

    ERIC Educational Resources Information Center

    Pascal, Christine; Bertram, Tony

    Based on the view that the quality of adult educative interactions with young children is critical in determining the effectiveness of educational provision and in improving early childhood settings, this paper examines the quality of adult engagement experienced by 3- and 4-year-olds in 9 types of early education and care settings from the…

  8. Designing Instruction for Adult Learners. Second Edition. Professional Practices in Adult Education and Human Resource Development Series.

    ERIC Educational Resources Information Center

    Dean, Gary J.

    This book focuses on applying instructional design to development of classroom learning for adults. Chapter 1 presents an overview of the model and addresses concerns about use of instructional design in adult education. Chapter 2 deals with assessing and developing skills as an adult educator; a literature review on behavior, beliefs, knowledge,…

  9. The Design of Online Learning Communities for Older Adults.

    ERIC Educational Resources Information Center

    Snyder, Marti M.

    2002-01-01

    Describes the creation of SeniorSage, an eight week facilitated online learning community for older adult volunteers in a Florida learning center. Discusses how members were prepared to participate in the community, explains the instructional design theory that guided the development of SeniorSage, and recommends future research. (Author/LRW)

  10. Correlation of a set of gene variants, life events and personality features on adult ADHD severity.

    PubMed

    Müller, Daniel J; Chiesa, Alberto; Mandelli, Laura; De Luca, Vincenzo; De Ronchi, Diana; Jain, Umesh; Serretti, Alessandro; Kennedy, James L

    2010-07-01

    Increasing evidence suggests that symptoms of attention deficit hyperactivity disorder (ADHD) could persist into adult life in a substantial proportion of cases. The aim of the present study was to investigate the impact of (1) adverse events, (2) personality traits and (3) genetic variants chosen on the basis of previous findings and (4) their possible interactions on adult ADHD severity. One hundred and ten individuals diagnosed with adult ADHD were evaluated for occurrence of adverse events in childhood and adulthood, and personality traits by the Temperament and Character Inventory (TCI). Common polymorphisms within a set of nine important candidate genes (SLC6A3, DBH, DRD4, DRD5, HTR2A, CHRNA7, BDNF, PRKG1 and TAAR9) were genotyped for each subject. Life events, personality traits and genetic variations were analyzed in relationship to severity of current symptoms, according to the Brown Attention Deficit Disorder Scale (BADDS). Genetic variations were not significantly associated with severity of ADHD symptoms. Life stressors displayed only a minor effect as compared to personality traits. Indeed, symptoms' severity was significantly correlated with the temperamental trait of Harm avoidance and the character trait of Self directedness. The results of the present work are in line with previous evidence of a significant correlation between some personality traits and adult ADHD. However, several limitations such as the small sample size and the exclusion of patients with other severe comorbid psychiatric disorders could have influenced the significance of present findings.

  11. Sources of Cognitive Inflexibility in Set-Shifting Tasks: Insights Into Developmental Theories From Adult Data.

    PubMed

    Dick, Anthony Steven

    2012-01-01

    Two experiments examined processes underlying cognitive inflexibility in set-shifting tasks typically used to assess the development of executive function in children. Adult participants performed a Flexible Item Selection Task (FIST) that requires shifting from categorizing by one dimension (e.g., color) to categorizing by a second orthogonal dimension (e.g., shape). The experiments showed performance of the FIST involves suppression of the representation of the ignored dimension; response times for selecting a target object in an immediately-following oddity task were slower when the oddity target was the previously-ignored stimulus of the FIST. However, proactive interference from the previously relevant stimulus dimension also impaired responding. The results are discussed with respect to two prominent theories of the source of difficulty for children and adults on dimensional shifting tasks: attentional inertia and negative priming. In contrast to prior work emphasizing one over the other process, the findings indicate that difficulty in the FIST, and by extension other set-shifting tasks, can be attributed to both the need to shift away from the previously attended representation (attentional inertia), and the need to shift to the previously ignored representation (negative priming). Results are discussed in relation to theoretical explanations for cognitive inflexibility in adults and children.

  12. DITDOS: A set of design specifications for distributed data inventories

    NASA Technical Reports Server (NTRS)

    King, T. A.; Walker, R. J.; Joy, S. P.

    1995-01-01

    The analysis of space science data often requires researchers to work with many different types of data. For instance, correlative analysis can require data from multiple instruments on a single spacecraft, multiple spacecraft, and ground-based data. Typically, data from each source are available in a different format and have been written on a different type of computer, and so much effort must be spent to read the data and convert it to the computer and format that the researchers use in their analysis. The large and ever-growing amount of data and the large investment by the scientific community in software that require a specific data format make using standard data formats impractical. A format-independent approach to accessing and analyzing disparate data is key to being able to deliver data to a diverse community in a timely fashion. The system in use at the Planetary Plasma Interactions (PPI) node of the NASA Planetary Data System (PDS) is based on the object-oriented Distributed Inventory Tracking and Data Ordering Specification (DITDOS), which describes data inventories in a storage independent way. The specifications have been designed to make it possible to build DITDOS compliant inventories that can exist on portable media such as CD-ROM's. The portable media can be moved within a system, or from system to system, and still be used without modification. Several applications have been developed to work with DITDOS compliant data holdings. One is a windows-based client/server application, which helps guide the user in the selection of data. A user can select a data base, then a data set, then a specific data file, and then either order the data and receive it immediately if it is online or request that it be brought online if it is not. A user can also view data by any of the supported methods. DITDOS makes it possible to use already existing applications for data-specific actions, and this is done whenever possible. Another application is a stand

  13. Antiepileptic drug use in a nursing home setting: a retrospective study in older adults

    PubMed Central

    Callegari, Camilla; Ielmini, Marta; Bianchi, Lucia; Lucano, Melissa; Bertù, Lorenza; Vender, Simone

    2016-01-01

    Summary The authors set out to examine qualitatively the use of antiepileptic drugs (AEDs) in a population of older adults in a nursing home setting, evaluating aspects such as specialist prescriptions and changes in dosage. This retrospective prevalence study was carried out in a state-funded nursing home that provides care and rehabilitation for elderly people. The first objective of the study was to determine the prevalence of AED use in this population. The second objective was to monitor AED dosage modifications during the fifteen-month study period, focusing on the safety and the tolerability of AEDs. In the period of time considered, 129 of 402 monitored patients received at least one anti-epileptic therapy. The prevalence of AED use was therefore 32%. Gabapentin was found to be the most commonly prescribed drug, with a frequency of 29%, and it was used mainly for anxiety disorders, psychosis, neuropathic pain and mood disorders. PMID:27358221

  14. Set shifting and working memory in adults with attention-deficit/hyperactivity disorder.

    PubMed

    Rohlf, Helena; Jucksch, Viola; Gawrilow, Caterina; Huss, Michael; Hein, Jakob; Lehmkuhl, Ulrike; Salbach-Andrae, Harriet

    2012-01-01

    Compared to the high number of studies that investigated executive functions (EF) in children with attention-deficit/hyperactivity disorder (ADHD), a little is known about the EF performance of adults with ADHD. This study compared 37 adults with ADHD (ADHD(total)) and 32 control participants who were equivalent in age, intelligence quotient (IQ), sex, and years of education, in two domains of EF--set shifting and working memory. Additionally, the ADHD(total) group was subdivided into two subgroups: ADHD patients without comorbidity (ADHD(-), n = 19) and patients with at least one comorbid disorder (ADHD(+), n = 18). Participants fulfilled two measures for set shifting (i.e., the trail making test, TMT and a computerized card sorting test, CKV) and one measure for working memory (i.e., digit span test, DS). Compared to the control group the ADHD(total) group displayed deficits in set shifting and working memory. The differences between the groups were of medium-to-large effect size (TMT: d = 0.48; DS: d = 0.51; CKV: d = 0.74). The subgroup comparison of the ADHD(+) group and the ADHD(-) group revealed a poorer performance in general information processing speed for the ADHD(+) group. With regard to set shifting and working memory, no significant differences could be found between the two subgroups. These results suggest that the deficits of the ADHD(total) group are attributable to ADHD rather than to comorbidity. An influence of comorbidity, however, could not be completely ruled out as there was a trend of a poorer performance in the ADHD(+) group on some of the outcome measures.

  15. Designing Groups to Meet Evolving Challenges in Health Care Settings

    ERIC Educational Resources Information Center

    McCarthy, Christopher J.; Hart, Sonia

    2011-01-01

    This article provides an overview of the special issue on groups in health care settings and describes how each contribution addresses challenges and opportunities in the health care field for group work. Fundamental criteria for evaluating groups in such settings are applied to each contribution. Finally, trends and opportunities about the future…

  16. A Set of Patterns for the Structured Design of MOOCs

    ERIC Educational Resources Information Center

    Warburton, Steven; Mor, Yishay

    2015-01-01

    A design pattern approach, in the form of participatory pattern workshops, has been used to explore the design approaches that experts in the field of online learning have used to develop and deliver Massive Open Online Courses (MOOCs). Over the course of 3 intensive workshops a total of 20 design patterns were developed from shared narratives of…

  17. Self-management priority setting and decision-making in adults with multimorbidity: A narrative review of literature

    PubMed Central

    Bratzke, Lisa C.; Muehrer, Rebecca J.; Kehl, Karen A.; Lee, Kyoung Suk; Ward, Earlise C.; Kwekkeboom, Kristine L.

    2014-01-01

    Objectives The purpose of this narrative review was to synthesize current research findings related to self-management, in order to better understand the processes of priority setting and decision-making in among adults with multimorbidity. Design A narrative literature review was undertaken, synthesizing findings from published, peer-reviewed empirical studies that addressed priority setting and/or decision-making in self-management of multimorbidity. Data sources A search of PubMed, PsychINFO, CINAHL and SocIndex databases was conducted from database inception through December 2013. References lists from selected empirical studies and systematic reviews were evaluated to identify any additional relevant articles. Review methods Full text of potentially eligible articles were reviewed and selected for inclusion if they described empirical studies that addressed priority setting or decision-making in self-management of multimorbidity among adults. Two independent reviewers read each selected article and extracted relevant data to an evidence table. Processes and factors and processes of multimorbidity self-management were identified and sorted into categories of priority setting, decision-making, and facilitators/barriers. Results Thirteen articles were selected for inclusion; most were qualitative studies describing processes, facilitators, and barriers of multimorbidity self-management. The findings revealed that patients prioritize a dominant chronic illness and re-prioritize over time as conditions and treatments change; that multiple facilitators (e.g. support programs) and barriers (e.g. lack of financial resources) impact individuals’ self-management priority setting and decision-making ability; as do individual beliefs, preferences, and attitudes (e.g., perceived personal control, preferences regarding treatment). Conclusions Health care providers need to be cognizant that individuals with multimorbidity engage in day-to-day priority setting and decision

  18. The ORP basis set designed for optical rotation calculations.

    PubMed

    Baranowska-Łączkowska, Angelika; Łączkowski, Krzysztof Z

    2013-09-01

    Details of generation of the optical rotation prediction (ORP) basis set developed for accurate optical rotation (OR) calculations are presented. Specific rotation calculations carried out at the density functional theory (DFT) level for model chiral methane molecule, fluorooxirane, methyloxirane, and dimethylmethylenecyclopropane reveal that the ORP set outperforms larger basis sets, among them the aug-cc-pVTZ basis set of Dunning (J. Chem. Phys. 1989, 90, 1007) and the aug-pc-2 basis set of Jensen (J. Chem. Phys. 2002, 117, 9234; J. Chem. Theory Comput. 2008, 4, 719). It is shown to be an attractive choice also in the case of larger systems, namely norbornanone, β-pinene, trans-pinane, and nopinone. The ORP basis set is further used in OR calculations for 24 other systems, and the results are compared to the aug-cc-pVDZ values. Whenever large discrepancies of results are observed, the ORP values are in an excellent agreement with the aug-cc-pVTZ results. The ORP basis set enables accurate specific rotation calculations at a reduced cost and thus can be recommended for routine DFT OR calculations, also for large and conformationally flexible molecules.

  19. Modeling the oldest old: personas to design technology-based solutions for older adults.

    PubMed

    Reeder, Blaine; Zaslavksy, Oleg; Wilamowska, Katarzyna M; Demiris, George; Thompson, Hilaire J

    2011-01-01

    There is a recognized need to develop information technology for the delivery of care services to older adults. However, little attention has been paid to the design of information technology for the oldest old demographic. We made novel use of data from observations, focus groups and cluster analysis of oldest old participant characteristics from a pilot study in a community setting to iteratively construct personas for the design of information technology for the oldest old. The resulting two personas, "Hazel" and "Rose", capture different abilities of members of the oldest old demographic group. In addition, we provide a list of eleven design recommendations to guide the design of technology that supports the abilities of people like Hazel and Rose. The resulting personas, design recommendations and persona construction method can be useful tools for informaticians and designers of new systems for the oldest old.

  20. SET Detection and Compensation and Its Application in PLL Design

    NASA Astrophysics Data System (ADS)

    You, Y.; Chen, J.; Feng, Y.; Tang, Y.; Huang, D.; Wang, R.; Gong, D.; Liu, T.; Ye, J.

    2015-05-01

    This paper presents a new charge compensation (CC) scheme to mitigate single event transient (SET) effect at the output node of the charge pump (CP), the most SET vulnerable node in a Phase-Locked Loop (PLL). It achieves a 4X less SET-induced voltage disturbance at the ring oscillator control node as well as a faster PLL recovery time. During the normal operation, the CC circuit does not affect the PLL dynamics. Its control block ensures that the CC circuit is enabled only when the CP output voltage is disturbed by SET strikes. This avoids the conflict between SET charge compensation and normal PLL phase correction. The PLL covers a 12.5 MHz to 500 MHz tuning range with a root-mean-square (RMS) jitter of 4.9 ps. It consumes 21.5 mW of power under a 1.5 V power supply. The CC circuit consumes 4.5 mW power and occupies 5.3% of the PLL area.

  1. Designing Multimedia for Ecological Tourism in an Educational Setting.

    ERIC Educational Resources Information Center

    Passerini, Katia; Granger, Mary J.

    This paper describes the development process of multimedia software designed to educate and provide awareness of ecotourism in Costa Rica. Ecotourism is a form of nature-based travel and recreational experience combining a respect for nature and local cultures with economic development incentives. The software intends to pursue the goals of…

  2. Depression in older adults: exploring the relationship between goal setting and physical health.

    PubMed

    Street, Helen; O'Connor, Moira; Robinson, Hayley

    2007-11-01

    Depression in older adults is associated with a decreased quality of life, increased physical and emotional suffering and an increased risk of death and is often associated with declining physical health. Older people with physical illness have higher rates of depression and studies have also noted the particularly high rate of co-morbidity between depressive disorder and general medical conditions. However, other studies have shown those suffering from poor physical health do not necessarily become depressed and, in particular, the goal setting style of the individual impacts on the relationship between poor physical health and depression. This study argues that those who are conditional goal setters and suffer from poorer physical health will be more prone to depression as their perceived ability to achieve their goals is negatively impacted. One hundred and eighty-seven participants were recruited for this study. The participants completed the Centre for Epidemiological Studies Depression Inventory and the physical health subscale of the SF-12 Health Survey. Participants were asked to rank their three most important goals and to give the main reason for setting each of their top three goals. The results showed that poorer physical health is associated with higher depression scores. Correlations revealed significant negative associations between physical health and depression, physical health and progress towards goal and progress towards goal and depression. A partial correlation between physical health and depression scores controlling for progress demonstrated that the relationship between physical health and depression is mediated through perceived progress. Implications for clinical practice are highlighted.

  3. Designing a Weight Gain Prevention Trial for Young Adults: The CHOICES Study

    PubMed Central

    Lytle, Leslie A.; Moe, Stacey G.; Nanney, M. Susie; Laska, Melissa N.; Linde, Jennifer A.

    2014-01-01

    Background Young adults are at risk for weight gain. Little is known about how to design weight control programs to meet the needs of young adults and few theory-based interventions have been evaluated in a randomized control trial. The Choosing Healthy Options in College Environments and Settings (CHOICES) study was funded to create a technology-based program for 2-year community college students to help prevent unhealthy weight gain. The purpose of this paper is to: 1) provide a brief background on weight-related interventions in young adults; 2) describe the study design for the CHOICES study, the conceptual model guiding the research and the CHOICES intervention; and 3) discuss implications of this research for health educators. Translation to Health Education Practice Our experiences from the CHOICES study will be useful in suggesting other theory-based models and intervention strategies that might be helpful in programs attempting to prevent unhealthy weight gain in young adults. In addition, this paper discusses important considerations for working with 2-year colleges on this type of health promotion work. PMID:24910855

  4. A designed screening study with prespecified combinations of factor settings

    SciTech Connect

    Anderson-cook, Christine M; Robinson, Timothy J

    2009-01-01

    In many applications, the experimenter has limited options about what factor combinations can be chosen for a designed study. Consider a screening study for a production process involving five input factors whose levels have been previously established. The goal of the study is to understand the effect of each factor on the response, a variable that is expensive to measure and results in destruction of the part. From an inventory of available parts with known factor values, we wish to identify a best collection of factor combinations with which to estimate the factor effects. Though the observational nature of the study cannot establish a causal relationship involving the response and the factors, the study can increase understanding of the underlying process. The study can also help determine where investment should be made to control input factors during production that will maximally influence the response. Because the factor combinations are observational, the chosen model matrix will be nonorthogonal and will not allow independent estimation of factor effects. In this manuscript we borrow principles from design of experiments to suggest an 'optimal' selection of factor combinations. Specifically, we consider precision of model parameter estimates, the issue of replication, and abilities to detect lack of fit and to estimate two-factor interactions. Through an example, we present strategies for selecting a subset of factor combinations that simultaneously balance multiple objectives, conduct a limited sensitivity analysis, and provide practical guidance for implementing our techniques across a variety of quality engineering disciplines.

  5. Beyond Traditional Art Education: Transformative Lifelong Learning in Community-Based Settings with Older Adults

    ERIC Educational Resources Information Center

    Lawton, Pamela Harris; La Porte, Angela M.

    2013-01-01

    Quality community-based art education programs for older adults over the age of 50 should exploit the broad range of interests and cognitive abilities of participants by utilizing adult education theory, brain research, and the best practices of adult art education programs. We consider a developing paradigm on the cognitive abilities of the…

  6. Defining Success in Adult Basic Education Settings: Multiple Stakeholders, Multiple Perspectives

    PubMed Central

    Tighe, Elizabeth L.; Barnes, Adrienne E.; Connor, Carol M.; Steadman, Sharilyn C.

    2015-01-01

    This study employed quantitative and qualitative research approaches to investigate what constitutes “success” in Adult Basic Education (ABE) programs from the perspectives of multiple educational stakeholders: the state funding agency, the teachers, and the students. Success was defined in multiple ways. In the quantitative section of the study, we computed classroom value-added scores (used as a metric of the state’s definition of success) to identify more and less effective ABE classrooms in two Florida counties. In the qualitative section of the study, we observed and conducted interviews with teachers and students in the selected classrooms to investigate how these stakeholders defined success in ABE. Iterative consideration of the qualitative data revealed three principal markers of success: (a) instructional strategies and teacher-student interactions; (b) views on standardized testing; and (c) student motivational factors. In general, classrooms with higher value-added scores were characterized by multiple instructional approaches, positive and collaborative teacher-student interactions, and students engaging in goal setting and citing motivational factors such as family and personal fulfillment. The implications for ABE programs are discussed. PMID:26279590

  7. Design Considerations for Patient Portal Adoption by Low-Income, Older Adults

    PubMed Central

    Latulipe, Celine; Gatto, Amy; Nguyen, Ha T.; Miller, David P.; Quandt, Sara A.; Bertoni, Alain G.; Smith, Alden; Arcury, Thomas A.

    2016-01-01

    This paper describes the results of an interview study investigating facilitators and barriers to adoption of patient portals among low-income, older adults in rural and urban populations in the southeastern United States. We describe attitudes of this population of older adults and their current level of technology use and patient portal use. From qualitative analysis of 36 patient interviews and 16 caregiver interviews within these communities, we derive themes related to benefits of portals, barriers to use, concerns and desired features. Based on our initial findings, we present a set of considerations for designing the patient portal user experience, aimed at helping healthcare clinics to meet U.S. federally-mandated ‘meaningful use’ requirements. PMID:27077140

  8. The Design of a Doctoral Degree Program in Adult Education Based on the Expressed Adult Education Needs of Professional Practitioners.

    ERIC Educational Resources Information Center

    Veri, Clive Chester

    The purpose of this investigation was to design a program of studies leading to the doctor's degree in adult education based on the expressed educational needs of professional adult educators in the field. The data provided by 90 respondents were analyzed to determine the reliability of, or extent of agreement among, the respondents' ratings of 60…

  9. Processor and method for developing a set of admissible fixture designs for a workpiece

    DOEpatents

    Brost, Randolph C.; Goldberg, Kenneth Y.; Canny, John; Wallack, Aaron S.

    1999-01-01

    Methods and apparatus are provided for developing a complete set of all admissible Type I and Type II fixture designs for a workpiece. The fixture processor generates the set of all admissible designs based on geometric access constraints and expected applied forces on the workpiece. For instance, the fixture processor may generate a set of admissible fixture designs for first, second and third locators placed in an array of holes on a fixture plate and a translating clamp attached to the fixture plate for contacting the workpiece. In another instance, a fixture vise is used in which first, second, third and fourth locators are used and first and second fixture jaws are tightened to secure the workpiece. The fixture process also ranks the set of admissible fixture designs according to a predetermined quality metric so that the optimal fixture design for the desired purpose may be identified from the set of all admissible fixture designs.

  10. Processor and method for developing a set of admissible fixture designs for a workpiece

    DOEpatents

    Brost, Randolph C.; Goldberg, Kenneth Y.; Wallack, Aaron S.; Canny, John

    1996-01-01

    A fixture process and method is provided for developing a complete set of all admissible fixture designs for a workpiece which prevents the workpiece from translating or rotating. The fixture processor generates the set of all admissible designs based on geometric access constraints and expected applied forces on the workpiece. For instance, the fixture processor may generate a set of admissible fixture designs for first, second and third locators placed in an array of holes on a fixture plate and a translating clamp attached to the fixture plate for contacting the workpiece. In another instance, a fixture vice is used in which first, second, third and fourth locators are used and first and second fixture jaws are tightened to secure the workpiece. The fixture process also ranks the set of admissible fixture designs according to a predetermined quality metric so that the optimal fixture design for the desired purpose may be identified from the set of all admissible fixture designs.

  11. Processor and method for developing a set of admissible fixture designs for a workpiece

    DOEpatents

    Brost, R.C.; Goldberg, K.Y.; Canny, J.; Wallack, A.S.

    1999-01-05

    Methods and apparatus are provided for developing a complete set of all admissible Type 1 and Type 2 fixture designs for a workpiece. The fixture processor generates the set of all admissible designs based on geometric access constraints and expected applied forces on the workpiece. For instance, the fixture processor may generate a set of admissible fixture designs for first, second and third locators placed in an array of holes on a fixture plate and a translating clamp attached to the fixture plate for contacting the workpiece. In another instance, a fixture vise is used in which first, second, third and fourth locators are used and first and second fixture jaws are tightened to secure the workpiece. The fixture process also ranks the set of admissible fixture designs according to a predetermined quality metric so that the optimal fixture design for the desired purpose may be identified from the set of all admissible fixture designs. 44 figs.

  12. Processor and method for developing a set of admissible fixture designs for a workpiece

    DOEpatents

    Brost, R.C.; Goldberg, K.Y.; Wallack, A.S.; Canny, J.

    1996-08-13

    A fixture process and method is provided for developing a complete set of all admissible fixture designs for a workpiece which prevents the workpiece from translating or rotating. The fixture processor generates the set of all admissible designs based on geometric access constraints and expected applied forces on the workpiece. For instance, the fixture processor may generate a set of admissible fixture designs for first, second and third locators placed in an array of holes on a fixture plate and a translating clamp attached to the fixture plate for contacting the workpiece. In another instance, a fixture vice is used in which first, second, third and fourth locators are used and first and second fixture jaws are tightened to secure the workpiece. The fixture process also ranks the set of admissible fixture designs according to a predetermined quality metric so that the optimal fixture design for the desired purpose may be identified from the set of all admissible fixture designs. 27 figs.

  13. Associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults

    PubMed Central

    Makino, Keitaro; Ihira, Hikaru; Mizumoto, Atsushi; Shimizu, Kotaro; Ishida, Toyoaki; Furuna, Taketo

    2015-01-01

    [Purpose] The purpose of this study was to examine the associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults. [Subjects] A total of 304 Japanese community-dwelling older adults (70.3 ± 4.1 years; 113 males and 191 females) participated in this study. [Methods] Demographic characteristics, medical conditions, exercise habits, and health-related outcomes were assessed by face-to-face interviews and self-reported questionnaires. Older adults who had exercise habits were classified into two groups: individual- and group-based exercise habits groups, and the health-related outcomes were compared between groups. [Results] The scores for the Geriatric Depression Scale, exercise self-efficacy, and dietary variety of older adults who had group-based exercise habits were better than those of older adults who had individual-based exercise habits. In addition, the exercise settings (individual- and group-based) were significantly associated with scores for the Geriatric Depression Scale (odds ratio = 0.76) and exercise self-efficacy (odds ratio = 1.26), even after adjusting for age and gender. [Conclusion] These results implied that habitual exercise in group settings may have an effective role in promoting exercise self-efficacy and mental health. PMID:26311955

  14. Change You Can Believe In: Changes in Goal Setting During Emerging and Young Adulthood Predict Later Adult Well-Being

    PubMed Central

    Hill, Patrick L.; Jackson, Joshua J.; Roberts, Brent W.; Lapsley, Daniel K.; Brandenberger, Jay W.

    2013-01-01

    A widely held assumption is that changes in one’s goals and motives for life during emerging and young adulthood have lasting influences on well-being into adulthood. However, this claim has yet to receive rigorous empirical testing. The current study examined the effects of prosocial and occupational goal change during college on adult well-being in a 17-year study of goal setting (N = 416). Using a latent growth model across three time points, both level and growth in goal setting predicted later well-being. Moreover, goal changes both during college and in young adulthood uniquely predicted adult well-being, controlling for goal levels entering college. These findings suggest that what matters for attaining adult well-being is both how you enter adulthood and how you change in response to it. PMID:23493639

  15. Cognitive Behavioral Treatment for Older Adults with Generalized Anxiety Disorder: A Therapist Manual for Primary Care Settings

    ERIC Educational Resources Information Center

    Stanley, Melinda A.; Diefenbach, Gretchen J.; Hopko, Derek R.

    2004-01-01

    At least four academic clinical trials have demonstrated the utility of cognitive behavior therapy (CBT) for older adults with generalized anxiety disorder (GAD). These data may not generalize, however, to more heterogeneous and functionally impaired patients and the medical settings in which they typically receive care. A recent pilot project…

  16. Removing the Bedroom Television Set: A Possible Method for Decreasing Television Viewing Time in Overweight and Obese Adults

    ERIC Educational Resources Information Center

    Jones, Katherine E.; Otten, Jennifer J.; Johnson, Rachel K.; Harvey-Berino, Jean R.

    2010-01-01

    U.S. adults watch television (TV) for an average of 5 hours per day, an amount associated with increased obesity risk. Studies in children have found bedroom TV sets, which result in greater time spent by watching TV and shorter sleep durations, both of which increase a child's odds of becoming overweight. The authors examined associations between…

  17. The Processes that Promote Learning in Adult Mentoring and Coaching Dyadic Settings

    ERIC Educational Resources Information Center

    Marx, Michael J.

    2009-01-01

    This is a study of 10 adults participating in one-to-one mentoring and/or coaching. Participants were selected for interviewing through a purposive sampling process from leading international mentoring and coaching organizations. Selection criteria included (a) being an adult, (b) participating in a dyadic learning, and (c) regarding that…

  18. Identifying a Common Set of Key Competences for Adult Learning Staff: An Inventory of European Practices

    ERIC Educational Resources Information Center

    Buiskool, Bert-Jan; Broek, Simon

    2011-01-01

    Professional development and improvement in the quality of adult learning staff has been recognized as a priority at a European level. However, at European and national levels there is no clear view on the standard competences needed to fulfill the professional tasks in adult learning. In some European countries competence profiles and standards…

  19. Adolescent Dating Violence Prevention and Intervention in a Community Setting: Perspectives of Young Adults and Professionals

    ERIC Educational Resources Information Center

    Martsolf, Donna S.; Colbert, Crystal; Draucker, Claire B.

    2012-01-01

    Adolescent dating violence (ADV) is a significant community problem. In this study, we examine the perspectives of two groups (young adults who experienced ADV as teens and professionals who work with teens) on ADV prevention/intervention in a community context. We interviewed 88 young adults and 20 professionals. Our research team used Thorne's…

  20. Supporting Nutrition in Early Care and Education Settings: The Child and Adult Care Food Program (CACFP)

    ERIC Educational Resources Information Center

    Stephens, Samuel A.

    2016-01-01

    Child care centers, Head Start programs, and family child care providers serving young children--as well as after school programs and homeless shelters that reach older children, adults, and families--are supported in providing healthy meals and snacks by reimbursements through the Child and Adult Care Food Program (CACFP). Administered by the…

  1. A Teacher's Guide to Metrics. A Series of In-Service Booklets Designed for Adult Educators.

    ERIC Educational Resources Information Center

    Wendel, Robert, Ed.; And Others

    This series of seven booklets is designed to train teachers of adults in metrication, as a prerequisite to offering metrics in adult basic education and general educational development programs. The seven booklets provide a guide representing an integration of metric teaching methods and metric materials to place the adult in an active learning…

  2. The Effects of Mastery Training and Explicit Feedback on Task Design Preference in a Vocational Setting.

    ERIC Educational Resources Information Center

    Lee, David L.; Belfiore, Phillip J.; Toro-Zambrana, Wanda

    2001-01-01

    A study examined the effects of mastery training and explicit feedback on the selection behavior of two adults with severe mental retardation across two different vocational task designs. Selection behavior was affected by task efficiency only when efficiency was made more salient by pairing task cues with work incentives. (Contains references.)…

  3. Measurement of the severity of disability in community-dwelling adults and older adults: interval-level measures for accurate comparisons in large survey data sets

    PubMed Central

    Buz, José; Cortés-Rodríguez, María

    2016-01-01

    Objectives To (1) create a single metric of disability using Rasch modelling to be used for comparing disability severity levels across groups and countries, (2) test whether the interval-level measures were invariant across countries, sociodemographic and health variables and (3) examine the gains in precision using interval-level measures relative to ordinal scores when discriminating between groups known to differ in disability. Design Cross-sectional, population-based study. Setting/participants Data were drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE), including comparable data across 16 countries and involving 58 489 community-dwelling adults aged 50+. Main outcome measures A single metric of disability composed of self-care and instrumental activities of daily living (IADLs) and functional limitations. We examined the construct validity through the fit to the Rasch model and the know-groups method. Reliability was examined using person separation reliability. Results The single metric fulfilled the requirements of a strong hierarchical scale; was able to separate persons with different levels of disability; demonstrated invariance of the item hierarchy across countries; and was unbiased by age, gender and different health conditions. However, we found a blurred hierarchy of ADL and IADL tasks. Rasch-based measures yielded gains in relative precision (11–116%) in discriminating between groups with different medical conditions. Conclusions Equal-interval measures, with person-invariance and item-invariance properties, provide epidemiologists and researchers with the opportunity to gain better insight into the hierarchical structure of functional disability, and yield more reliable and accurate estimates of disability across groups and countries. Interval-level measures of disability allow parametric statistical analysis to confidently examine the relationship between disability and continuous measures so frequent in health sciences

  4. Effect of pedometer use and goal setting on walking and functional status in overweight adults with multimorbidity: a crossover clinical trial

    PubMed Central

    Takahashi, Paul Y; Quigg, Stephanie M; Croghan, Ivana T; Schroeder, Darrell R; Ebbert, Jon O

    2016-01-01

    Background Walking can improve functional status, and a pedometer and goal setting can increase walking and, potentially, gait speed. The efficacy of pedometer use and goal setting for increasing step counts among overweight and obese adults with multiple comorbid conditions has not been evaluated. Methods We recruited and randomly assigned obese or overweight adults with multimorbidity to immediate pedometer use with goal setting or delayed pedometer use, using a crossover design. The primary outcome of interest was step count, with secondary outcomes of gait speed and grip strength, with comparison between the intervention and delayed pedometer groups. Results Mean (standard deviation [SD]) age of the 130 participants was 63.4 (15.0) years. At 2 months, mean (SD) steps for the immediate pedometer use group (n=64) was 5,337 (3,096), compared with 4,446 (2,422) steps in the delayed pedometer group (n=66) (P=0.08). Within-group step count increased nonsignificantly, by 179 steps in the immediate pedometer group and 212 steps in the delayed pedometer group after 2 months of intervention, with no significant difference between the groups. Gait speed significantly increased by 0.08 m/s (P<0.05) and grip strength significantly increased by 1.6 kg (P<0.05) in the immediate pedometer group. Conclusion Pedometer use and goal setting did not significantly increase step count among overweight and obese adults with multimorbidity. The absolute step count was lower than many reported averages. Gait speed and grip strength increased with immediate pedometer use. The use of pedometers and goal setting may have an attenuated response in this population. PMID:27621602

  5. Effect of pedometer use and goal setting on walking and functional status in overweight adults with multimorbidity: a crossover clinical trial

    PubMed Central

    Takahashi, Paul Y; Quigg, Stephanie M; Croghan, Ivana T; Schroeder, Darrell R; Ebbert, Jon O

    2016-01-01

    Background Walking can improve functional status, and a pedometer and goal setting can increase walking and, potentially, gait speed. The efficacy of pedometer use and goal setting for increasing step counts among overweight and obese adults with multiple comorbid conditions has not been evaluated. Methods We recruited and randomly assigned obese or overweight adults with multimorbidity to immediate pedometer use with goal setting or delayed pedometer use, using a crossover design. The primary outcome of interest was step count, with secondary outcomes of gait speed and grip strength, with comparison between the intervention and delayed pedometer groups. Results Mean (standard deviation [SD]) age of the 130 participants was 63.4 (15.0) years. At 2 months, mean (SD) steps for the immediate pedometer use group (n=64) was 5,337 (3,096), compared with 4,446 (2,422) steps in the delayed pedometer group (n=66) (P=0.08). Within-group step count increased nonsignificantly, by 179 steps in the immediate pedometer group and 212 steps in the delayed pedometer group after 2 months of intervention, with no significant difference between the groups. Gait speed significantly increased by 0.08 m/s (P<0.05) and grip strength significantly increased by 1.6 kg (P<0.05) in the immediate pedometer group. Conclusion Pedometer use and goal setting did not significantly increase step count among overweight and obese adults with multimorbidity. The absolute step count was lower than many reported averages. Gait speed and grip strength increased with immediate pedometer use. The use of pedometers and goal setting may have an attenuated response in this population.

  6. Performance of low-pressure-ratio fan stage at two off-design blade setting angles

    NASA Technical Reports Server (NTRS)

    Kovich, G.; Tysl, E. R.; Moore, R. D.

    1977-01-01

    The overall and blade-element performance of a low pressure ratio, low tip speed fan stage at design speed is presented for tow off-design rotor blade angle settings. The rotor design tip speed is 243.8 m/sec and weight flow per unit annulus area is 175.8 kg/sec. Design weight flow and pressure ratio are 29.9 kg/sec and 1.151, respectively.

  7. State Regulation of Medication Administration by Unlicensed Assistive Personnel in Residential Care and Adult Day Services Settings.

    PubMed

    Carder, Paula C; O'Keeffe, Janet

    2016-09-01

    Residential care settings and adult day services are two community-based care options used by older adults with chronic health conditions. Most states have regulatory provisions that allow unlicensed assistive personnel (UAP) to administer medications. The current national policy study examined state regulations to identify which states permit UAP to administer medications, as well as staffing and training requirements. Key findings include states lack clear and adequate provisions for nurse oversight of UAP who administer medications, although adult day service regulations provide a greater level of nurse oversight than residential care settings. Specifically, 32 states require residential care to hire a nurse, but only six include provisions regarding nurse availability (e.g., on-call, on-site, number of hours). In contrast, 10 of 20 states that require adult day service programs to hire a nurse provide availability provisions. Nurse oversight of UAP is an important means of assuring quality care and reducing errors; thus, state regulatory agencies might need to strengthen nurse oversight provisions. [Res Gerontol Nurs. 2016; 9(5):209-222.]. PMID:27054368

  8. Goal-setting protocol in adherence to exercise by Italian adults.

    PubMed

    Annesi, James J

    2002-04-01

    A goal-setting protocol, based on research in goal setting and performance and personal construct theory, was tested for its effect on adherence to a new exercise program. The Goal-setting group (n = 50) had significantly less dropout (30%) than the control group (n = 50) (74%). The Goal-setting group also had significantly better attendance (p<.0001). Suggestions for increasing confidence in findings through further research and practical implications of using the protocol to improve exercise maintenance across settings were discussed.

  9. Connecting Generations: Developing Co-Design Methods for Older Adults and Children

    ERIC Educational Resources Information Center

    Xie, Bo; Druin, Allison; Fails, Jerry; Massey, Sheri; Golub, Evan; Franckel, Sonia; Schneider, Kiki

    2012-01-01

    As new technologies emerge that can bring older adults together with children, little has been discussed by researchers concerning the design methods used to create these new technologies. Giving both children and older adults a voice in a shared design process comes with many challenges. This paper details an exploratory study focusing on…

  10. Formulating a Serious-Games Design Project for Adult Offenders with the Probation Service

    ERIC Educational Resources Information Center

    Bates, Matthew Ian; Brown, David; Cranton, Wayne; Lewis, James

    2011-01-01

    This paper documents an investigation evaluating if adult offenders can benefit from a facilitated serious-games design project as part of their probation program. Research has observed a participatory design group of adult offenders working with their probation managers and a PhD researcher to create a new serious-game for use by the probation…

  11. Readability and Test-Retest Reliability of a Psychometric Instrument Designed to Assess HIV/AIDS Attitudes, Beliefs, Behaviours and Sources of HIV Prevention Information of Young Adults

    ERIC Educational Resources Information Center

    Balogun, Joseph; Abiona, Titilayo; Lukobo-Durrell, Mainza; Adefuye, Adedeji; Amosun, Seyi; Frantz, Jose; Yakut, Yavuz

    2011-01-01

    Objective: This comparative study evaluated the readability and test-retest reliability of a questionnaire designed to assess the attitudes, beliefs behaviours and sources of information about HIV/AIDS among young adults recruited from universities in the United States of America (USA), Turkey and South Africa. Design/Setting: The instrument was…

  12. Measurement properties of the Non-Communicating Adult Pain Checklist (NCAPC): a pain scale for adults with Intellectual and Developmental Disabilities, scored in a clinical setting.

    PubMed

    Lotan, M; Moe-Nilssen, R; Ljunggren, A E; Strand, L I

    2010-01-01

    The 18 items' Non-Communicating Adult Pain Checklist (NCAPC) has been developed from the 27 items Non-Communicating Children Pain Checklist to better capture pain behavior of adults with Intellectual and Developmental Disabilities (IDD). As part of the NCAPC's measurement properties, internal consistency, reliability and sensitivity to pain have been evaluated and found satisfactory, using scores based on video-uptakes. The aim of the article therefore was to examine the instrument's discriminative ability and sensitivity to pain of adults at different levels of IDD when scored within a clinical situation as well as through video-uptakes. Participants were 59 adults at different levels of IDD who were observed for pain behavior, before and during dental hygiene treatment (scored directly) and influenza injection (scored from video-uptakes), using the NCAPC. The results suggest that the NCAPC differentiated between pain and non-pain situations, as well as between pain reaction during two different medical procedures expected to cause more or less pain, and it was found sensitive to pain at all levels of IDD. We conclude that the present findings add to previous findings of measurement properties of the NCAPC, and support that it can be scored directly in a clinical setting.

  13. Designing a Pediatric Study for an Antimalarial Drug by Using Information from Adults.

    PubMed

    Petit, Caroline; Jullien, Vincent; Samson, Adeline; Guedj, Jérémie; Kiechel, Jean-René; Zohar, Sarah; Comets, Emmanuelle

    2016-03-01

    The objectives of this study were to design a pharmacokinetic (PK) study by using information about adults and evaluate the robustness of the recommended design through a case study of mefloquine. PK data about adults and children were available from two different randomized studies of the treatment of malaria with the same artesunate-mefloquine combination regimen. A recommended design for pediatric studies of mefloquine was optimized on the basis of an extrapolated model built from adult data through the following approach. (i) An adult PK model was built, and parameters were estimated by using the stochastic approximation expectation-maximization algorithm. (ii) Pediatric PK parameters were then obtained by adding allometry and maturation to the adult model. (iii) A D-optimal design for children was obtained with PFIM by assuming the extrapolated design. Finally, the robustness of the recommended design was evaluated in terms of the relative bias and relative standard errors (RSE) of the parameters in a simulation study with four different models and was compared to the empirical design used for the pediatric study. Combining PK modeling, extrapolation, and design optimization led to a design for children with five sampling times. PK parameters were well estimated by this design with few RSE. Although the extrapolated model did not predict the observed mefloquine concentrations in children very accurately, it allowed precise and unbiased estimates across various model assumptions, contrary to the empirical design. Using information from adult studies combined with allometry and maturation can help provide robust designs for pediatric studies. PMID:26711749

  14. Designing a Pediatric Study for an Antimalarial Drug by Using Information from Adults.

    PubMed

    Petit, Caroline; Jullien, Vincent; Samson, Adeline; Guedj, Jérémie; Kiechel, Jean-René; Zohar, Sarah; Comets, Emmanuelle

    2015-12-28

    The objectives of this study were to design a pharmacokinetic (PK) study by using information about adults and evaluate the robustness of the recommended design through a case study of mefloquine. PK data about adults and children were available from two different randomized studies of the treatment of malaria with the same artesunate-mefloquine combination regimen. A recommended design for pediatric studies of mefloquine was optimized on the basis of an extrapolated model built from adult data through the following approach. (i) An adult PK model was built, and parameters were estimated by using the stochastic approximation expectation-maximization algorithm. (ii) Pediatric PK parameters were then obtained by adding allometry and maturation to the adult model. (iii) A D-optimal design for children was obtained with PFIM by assuming the extrapolated design. Finally, the robustness of the recommended design was evaluated in terms of the relative bias and relative standard errors (RSE) of the parameters in a simulation study with four different models and was compared to the empirical design used for the pediatric study. Combining PK modeling, extrapolation, and design optimization led to a design for children with five sampling times. PK parameters were well estimated by this design with few RSE. Although the extrapolated model did not predict the observed mefloquine concentrations in children very accurately, it allowed precise and unbiased estimates across various model assumptions, contrary to the empirical design. Using information from adult studies combined with allometry and maturation can help provide robust designs for pediatric studies.

  15. Cognitive behavioral therapy for depression among adults in Japanese clinical settings: a single-group study

    PubMed Central

    2010-01-01

    Background Empirical support for cognitive behavioral therapy (CBT) for treating Japanese patients with major depression is lacking, therefore, a feasibility study of CBT for depression in Japanese clinical settings is urgently required. Findings A culturally adapted, 16-week manualized individual CBT program for Japanese patients with major depressive disorder was developed. A total of 27 patients with major depression were enrolled in a single-group study with the purpose of testing the feasibility of the program. Twenty six patients (96%) completed the study. The mean total score on the Beck Depression Inventory-II (BDI-II) for all patients (Intention-to-treat sample) improved from 32.6 to 11.7, with a mean change of 20.8 (95% confidence interval: 17.0 to 24.8). Within-group effect size at the endpoint assessment was 2.64 (Cohen's d). Twenty-one patients (77.7%) showed treatment response and 17 patients (63.0%) achieved remission at the end of the program. Significant improvement was observed in measurement of subjective and objective depression severity (assessed by BDI-II, Quick Inventory of Depressive Symptomatology-Self Rated, and Hamilton Depression Rating Scale), dysfunctional attitude (assessed by Dysfunctional Attitude Scale), global functioning (assessed by Global Assessment of Functioning of DSM-IV) and subjective well-being (assessed by WHO Subjective Well-being Inventory) (all p values < 0.001). Conclusions Our manualized treatment comprised of a 16-week individual CBT program for major depression appears feasible and may achieve favorable treatment outcomes among Japanese patients with major depression. Further research involving a larger sample in a randomized, controlled trial design is warranted. Trial registration UMIN-CTR UMIN000002542. PMID:20529252

  16. The New, Modern Practice of Adult Education: Online Instruction in a Continuing Professional Education Setting

    ERIC Educational Resources Information Center

    Donavant, Brian W.

    2009-01-01

    Within the field of adult education a paradigm shift, or at least a paradigm creep, is taking place as a result of advances in technology. This comprehensive, quasiexperimental study examining the efficacy of online education (OE) for professional development, conducted among American police officers, compares OE to traditional delivery methods,…

  17. Adult Children of Alcoholics: Characteristics of Students in a University Setting.

    ERIC Educational Resources Information Center

    Jones, Judith P.; Kinnick, Bernard C.

    1995-01-01

    Characteristics of adult children of alcoholics (ACOAs) among traditional-age college students were investigated. Personality characteristics were examined based on birth order, gender of alcoholic parent, and honor society membership. Differences between ACOAs and non-ACOAs are discussed. (Author)

  18. Setting the Stage for Literacy. An Anthology of Adult Student Scripts. Volume 1, Number 1.

    ERIC Educational Resources Information Center

    Setting the Stage for Literacy, 1994

    1994-01-01

    This document describes a collaborative learning project that investigated how theater and improvisational drama can help adult learners to develop basic literacy and English language abilities. Three teachers, working with an average of 10 students each for 6 months, conducted classes to increase students' skills in improvisation, creative…

  19. The Relationship between Learning Styles and Learning Outcomes for Adults in an Informal Educational Setting

    ERIC Educational Resources Information Center

    Roberts, Larry N.

    2013-01-01

    With more adults seeking unique and meaningful learning experiences in both recreational and professional arenas, informal learning institutions, such as museums, zoos, and botanical gardens are a natural source. Informal learning opportunities are the business of these institutions; moreover, a goal in education mission statements of many of…

  20. Adverse Childhood Experiences (ACE) and Health-Risk Behaviors among Adults in a Developing Country Setting

    ERIC Educational Resources Information Center

    Ramiro, Laurie S.; Madrid, Bernadette J.; Brown, David W.

    2010-01-01

    Objective: This study aimed to examine the association among adverse childhood experiences, health-risk behaviors, and chronic disease conditions in adult life. Study population: One thousand and sixty-eight (1,068) males and females aged 35 years and older, and residing in selected urban communities in Metro Manila participated in the…

  1. More than a Set of Teeth: Assessing and Enhancing Dental Students' Perceptions of Older Adults

    ERIC Educational Resources Information Center

    Waldrop, Deborah P.; Fabiano, Jude A.; Nochajski, Thomas H.; Zittel-Palamara, Kimberly; Davis, Elaine L.; Goldberg, Louis J.

    2006-01-01

    Dental professionals play a key role in maintaining the well-being of older adults by identifying problems that disturb systemic health. A 3-part instrument was used to assess dental students' knowledge of aging, comfort with patient diversity and patient care strategies (Years 1-4; N = 321). Collaborative education and services were developed by…

  2. Defining Success in Adult Basic Education Settings: Multiple Stakeholders, Multiple Perspectives

    ERIC Educational Resources Information Center

    Tighe, Elizabeth L.; Barnes, Adrienne E.; Connor, Carol M.; Steadman, Sharilyn C.

    2013-01-01

    This study employed quantitative and qualitative research approaches to investigate what constitutes success in adult basic education (ABE) programs from the perspectives of multiple educational stakeholders: the state funding agency, the teachers, and the students. Success was defined in multiple ways. In the quantitative section of the study, we…

  3. Inter-Rater Reliability of the Developmental Behaviour Checklist for Adults in Community Accommodation Settings

    ERIC Educational Resources Information Center

    Mohr, C.; Tonge, B. J.; Taffe, J.; Rymill, A.; Collins, D.; Keating, C.; Einfeld, S. L.

    2011-01-01

    Background: With the publication of the Developmental Behaviour Checklist for Adults (DBC-A), people of all ages with intellectual disability (ID) can now be assessed using a carer-completed screening checklist of emotional and behavioural disturbance. This provides a broad assessment framework across the life span, assists the process of clinical…

  4. Baseball Stadium Design: Teaching Engineering Economics and Technical Communication in a Multi-Disciplinary Setting.

    ERIC Educational Resources Information Center

    Dahm, Kevin; Newell, James

    2001-01-01

    Reports on a course at Rowan University, based on the economic design of a baseball stadium, that offers an introduction to multidisciplinary engineering design linked with formal training in technical communication. Addresses four pedagogical goals: (1) developing public speaking skills in a realistic, business setting; (2) giving students…

  5. A candidate-set-free algorithm for generating D-optimal split-plot designs

    PubMed Central

    Jones, Bradley; Goos, Peter

    2007-01-01

    We introduce a new method for generating optimal split-plot designs. These designs are optimal in the sense that they are efficient for estimating the fixed effects of the statistical model that is appropriate given the split-plot design structure. One advantage of the method is that it does not require the prior specification of a candidate set. This makes the production of split-plot designs computationally feasible in situations where the candidate set is too large to be tractable. The method allows for flexible choice of the sample size and supports inclusion of both continuous and categorical factors. The model can be any linear regression model and may include arbitrary polynomial terms in the continuous factors and interaction terms of any order. We demonstrate the usefulness of this flexibility with a 100-run polypropylene experiment involving 11 factors where we found a design that is substantially more efficient than designs that are produced by using other approaches. PMID:21197132

  6. Changes in Adult Behavior to Decrease Disruption from Students in Nonclassroom Settings

    ERIC Educational Resources Information Center

    Bohanon, Hank

    2015-01-01

    Decreasing classroom disruptions that result from hallway-related behavior in high school settings can be very challenging for high school staff. This article presents a case example of preventing problem behavior related to hallway settings in a high school with over 1,200 students. The interventions are described, and the results of the plan are…

  7. Classifying foods in contexts: How adults categorize foods for different eating settings

    PubMed Central

    Blake, C.E.; Bisogni, C.A.; Sobal, J.; Devine, C.M.; Jastran, M.

    2008-01-01

    This project examined adults' food cognitions by applying schema theory to explain how adults categorized foods for different contexts. Qualitative interviews and repeated card sort activities for different eating contexts were conducted to elicit as many food categories as possible from 42 US adults. Participants labeled card sort piles with their own words, providing 991 card sort labels. Qualitative analysis of the labels resulted in the emergence of 12 category types. Personal-experience-based types were specific to the individual (e.g. Preference). Context-based types were related to situational aspects of eating episodes (e.g. Location). Food-based types were related to intrinsic properties of the foods (e.g. Physical characteristics). Different combinations of the 12 category types were used for different eating contexts. Personal-experience and context-based types were used most frequently overall. Some category types were used more frequently for specific contexts (e.g. Convenience for work contexts). Food-based taxonomic category types were used most frequently when no context was defined. Script-oriented categories were more often used in response to specific eating contexts. These findings provide a framework to consider how individuals classify foods in real-life eating contexts. Attention to personal-experience and context-based category types may help improve understanding of relationships between knowledge and food choice behaviors. PMID:17512088

  8. Epidemiology and Genetic Characterization of Noroviruses among Adults in an Endemic Setting, Peruvian Amazon Basin, 2004–2011

    PubMed Central

    Ballard, Sarah-Blythe; Reaves, Erik J.; Luna, C. Giannina; Silva, Maria E.; Rocha, Claudio; Heitzinger, Kristen; Saito, Mayuko; Apaza, Sonia; Espetia, Susan; Blazes, David L.; Tilley, Drake H.; Guzmán Aguilar, Rene C.; Gilman, Robert H.; Bausch, Daniel G.

    2015-01-01

    Background Successful vaccination strategies against norovirus will require understanding the burden of disease and relevant genotypes in populations. However, few data are available from cohort studies of adults living in low- and middle-income countries (LMIC). Materials and Methods We conducted a nested case-control study within a Peruvian military cohort to characterize the burden of norovirus infection, predominant genotypes, and associated symptoms from 2004 through 2011. Randomly selected case and control stools were tested for norovirus, bacteria, and parasites. The odds ratio of the association between norovirus infection and diarrhea was estimated using multiple logistic regression and co-infection adjusted attributable fractions were calculated. Results Of the 3,818 cohort study participants, 624 developed diarrhea. Overall and norovirus-associated diarrhea incidence rates were 42.3 and 6.0 per 100 person-years, respectively. The most prevalent norovirus genogroup was GII (72.5%, 29/40), which was associated with diarrhea (AOR 3.4, 95% CI: 1.3–8.7, P = 0.012). The co-infection adjusted GII attributable fraction was 6.4%. Discussion Norovirus was a frequent cause of diarrhea in an adult population followed longitudinally in an LMIC setting. Vaccine strategies should consider targeting adults in endemic settings and special populations that could serve as community transmission sources. PMID:26161556

  9. Well-Being With Objects: Evaluating a Museum Object-Handling Intervention for Older Adults in Health Care Settings.

    PubMed

    Thomson, Linda J M; Chatterjee, Helen J

    2016-03-01

    The extent to which a museum object-handling intervention enhanced older adult well-being across three health care settings was examined. The program aimed to determine whether therapeutic benefits could be measured objectively using clinical scales. Facilitator-led, 30 to 40 min sessions handling and discussing museum objects were conducted in acute and elderly care (11 one-to-ones), residential (4 one-to-ones and 1 group of five), and psychiatric (4 groups of five) settings. Pre-post measures of psychological well-being (Positive Affect and Negative Affect Schedule) and subjective wellness and happiness (Visual Analogue Scales) were compared. Positive affect and wellness increased significantly in acute and elderly and residential care though not psychiatric care whereas negative affect decreased and happiness increased in all settings. Examination of audio recordings revealed enhanced confidence, social interaction, and learning. The program allowed adults access to a museum activity who by virtue of age and ill health would not otherwise have engaged with museum objects.

  10. Risk factors for opioid misuse in adolescents and young adults with focus on oncology setting.

    PubMed

    Peck, Kelly R; Ehrentraut, Jennifer Harman; Anghelescu, Doralina L

    2016-01-01

    Prescription opioid use has increased in recent decades. Although opioids provide effective pain control, their use may be associated with the risk of misuse. Opioid misuse (OM) is prevalent among adolescents and young adults (AYAs). Opioids are necessary to treat cancer-related pain; however, oncology patients are not immune to medication misuse. Research examining OM among AYAs with cancer is scarce. This article examines the risk factors described in the general adult and adolescent medication abuse literature and aims to provide recommendations for practice in the AYA oncology population. The following risk factors should be examined in AYA oncology patients to determine their relevance: age, sex, behavioral and academic problems, psychological conditions, and a history of illicit drug use/abuse. To maintain the delicate balance of providing adequate pain relief while protecting patients from the risk of OM, clinicians must consider potential risk factors, motivating factors, and individual behaviors. Placing these challenges in perspective, this review provides clinical considerations, recommendations, and intervention strategies for OM prevention in AYA oncology patients. PMID:27435441

  11. Food Environment Interventions to Improve the Dietary Behavior of Young Adults in Tertiary Education Settings: A Systematic Literature Review.

    PubMed

    Roy, Rajshri; Kelly, Bridget; Rangan, Anna; Allman-Farinelli, Margaret

    2015-10-01

    The current obesity-promoting food environment, typified by highly accessible unhealthy foods and drinks, may lead to an increased risk of chronic disease, particularly within young adults. A number of university-based intervention trials have been conducted in the United States and Europe to improve the food environment in this setting. However, there are no systematic reviews focusing on these interventions conducted exclusively in tertiary education settings. Our objective was to conduct a systematic literature review evaluating food environment interventions targeting dietary behavior in young adults in college and university settings. Eight databases were searched for randomized controlled trials, pre- and postintervention studies, quasiexperimental studies, cross-sectional studies, and other nonexperimental studies from 1998 to December 2014 that were conducted in tertiary education settings (ie, colleges and universities). Studies that evaluated a food environment intervention and reported healthier food choices, reductions in unhealthy food choices, nutrition knowledge, and/or food and drink sales as primary outcomes were included. Fifteen studies of high (n=5), medium (n=7), and poor quality (n=3) met the inclusion criteria, 13 of which showed positive improvements in outcome measures. Information relating to healthy foods through signage and nutrition labels (n=10) showed improvements in outcomes of interest. Increasing the availability of healthy foods (n=1) and decreasing the portion size of unhealthy foods (n=2) improved dietary intake. Price incentives and increased availability of healthy foods combined with nutrition information to increase purchases of healthy foods (n=2) were identified as having a positive effect on nutrition-related outcomes. Potentially useful interventions in tertiary education settings were nutrition messages/nutrient labeling, providing healthy options, and portion size control of unhealthy foods. Price decreases for and

  12. Innovation in Doctoral Degrees Designed for Adult Learners: A Hybrid Model in Personal Financial Planning

    ERIC Educational Resources Information Center

    Grable, John E.

    2011-01-01

    Innovation in doctoral degree program development and delivery provides an effective counterpoint to the expert-apprentice model established in the Middle Ages. The author outlines the importance of innovation in reaching adult learners and describes an innovative hybrid PhD program designed to allow aspiring doctoral adult-age students to pursue…

  13. The Design of Education. Second Edition. Jossey-Bass Higher and Adult Education Series.

    ERIC Educational Resources Information Center

    Houle, Cyril O.

    This book, which is intended primarily for specialists in the field of adult education (AE) who wish to improve their performance, presents a systematic plan for designing, establishing, and evaluating successful programs for adult learners. The following topics are among those discussed in the book's six chapters: credos and systems (growth of…

  14. Influences of large sets of environmental exposures on immune responses in healthy adult men

    PubMed Central

    Yi, Buqing; Rykova, Marina; Jäger, Gundula; Feuerecker, Matthias; Hörl, Marion; Matzel, Sandra; Ponomarev, Sergey; Vassilieva, Galina; Nichiporuk, Igor; Choukèr, Alexander

    2015-01-01

    Environmental factors have long been known to influence immune responses. In particular, clinical studies about the association between migration and increased risk of atopy/asthma have provided important information on the role of migration associated large sets of environmental exposures in the development of allergic diseases. However, investigations about environmental effects on immune responses are mostly limited in candidate environmental exposures, such as air pollution. The influences of large sets of environmental exposures on immune responses are still largely unknown. A simulated 520-d Mars mission provided an opportunity to investigate this topic. Six healthy males lived in a closed habitat simulating a spacecraft for 520 days. When they exited their “spacecraft” after the mission, the scenario was similar to that of migration, involving exposure to a new set of environmental pollutants and allergens. We measured multiple immune parameters with blood samples at chosen time points after the mission. At the early adaptation stage, highly enhanced cytokine responses were observed upon ex vivo antigen stimulations. For cell population frequencies, we found the subjects displayed increased neutrophils. These results may presumably represent the immune changes occurred in healthy humans when migrating, indicating that large sets of environmental exposures may trigger aberrant immune activity. PMID:26306804

  15. Influences of large sets of environmental exposures on immune responses in healthy adult men.

    PubMed

    Yi, Buqing; Rykova, Marina; Jäger, Gundula; Feuerecker, Matthias; Hörl, Marion; Matzel, Sandra; Ponomarev, Sergey; Vassilieva, Galina; Nichiporuk, Igor; Choukèr, Alexander

    2015-08-26

    Environmental factors have long been known to influence immune responses. In particular, clinical studies about the association between migration and increased risk of atopy/asthma have provided important information on the role of migration associated large sets of environmental exposures in the development of allergic diseases. However, investigations about environmental effects on immune responses are mostly limited in candidate environmental exposures, such as air pollution. The influences of large sets of environmental exposures on immune responses are still largely unknown. A simulated 520-d Mars mission provided an opportunity to investigate this topic. Six healthy males lived in a closed habitat simulating a spacecraft for 520 days. When they exited their "spacecraft" after the mission, the scenario was similar to that of migration, involving exposure to a new set of environmental pollutants and allergens. We measured multiple immune parameters with blood samples at chosen time points after the mission. At the early adaptation stage, highly enhanced cytokine responses were observed upon ex vivo antigen stimulations. For cell population frequencies, we found the subjects displayed increased neutrophils. These results may presumably represent the immune changes occurred in healthy humans when migrating, indicating that large sets of environmental exposures may trigger aberrant immune activity.

  16. Valuing the Adult Learner in E-Learning: A Conceptual Model for Corporate Settings

    ERIC Educational Resources Information Center

    Waight, Consuelo L.; Stewart, Barbara

    2005-01-01

    The framework describes that e-Learning engagement, learning and transfer within corporate settings can possibly be achieved if antecedents such as needs assessment, learner analysis, for example, and moderators such as return on investment, learning theories, for example, are adhered. The realization of antecedents and moderators, however, are…

  17. Household Income during Childhood and Young Adult Weight Status: Evidence from a Nutrition Transition Setting

    ERIC Educational Resources Information Center

    Schmeer, Kammi K.

    2010-01-01

    This article explores whether household income at different stages of childhood is associated with weight status in early adulthood in a nutrition transition setting (a developing country with both underweight and overweight populations). I use multinomial logistic regression to analyze prospective, longitudinal data from Cebu, Philippines.…

  18. Curriculum on Resident Education in Care of Older Adults in Acute, Transitional and Extended Care Settings

    ERIC Educational Resources Information Center

    Kumar, Chandrika; Bensadon, Benjamin A.; Van Ness, Peter H.; Cooney, Leo M.

    2016-01-01

    Most geriatric care is provided in non-hospital settings. Internal Medicine and Family Medicine residents should therefore learn about these different clinical sites and acuity levels of care. To help facilitate this learning, a geriatrics training curriculum for internal medicine residents was developed that focused on cognition, function, goals…

  19. Influences of large sets of environmental exposures on immune responses in healthy adult men.

    PubMed

    Yi, Buqing; Rykova, Marina; Jäger, Gundula; Feuerecker, Matthias; Hörl, Marion; Matzel, Sandra; Ponomarev, Sergey; Vassilieva, Galina; Nichiporuk, Igor; Choukèr, Alexander

    2015-01-01

    Environmental factors have long been known to influence immune responses. In particular, clinical studies about the association between migration and increased risk of atopy/asthma have provided important information on the role of migration associated large sets of environmental exposures in the development of allergic diseases. However, investigations about environmental effects on immune responses are mostly limited in candidate environmental exposures, such as air pollution. The influences of large sets of environmental exposures on immune responses are still largely unknown. A simulated 520-d Mars mission provided an opportunity to investigate this topic. Six healthy males lived in a closed habitat simulating a spacecraft for 520 days. When they exited their "spacecraft" after the mission, the scenario was similar to that of migration, involving exposure to a new set of environmental pollutants and allergens. We measured multiple immune parameters with blood samples at chosen time points after the mission. At the early adaptation stage, highly enhanced cytokine responses were observed upon ex vivo antigen stimulations. For cell population frequencies, we found the subjects displayed increased neutrophils. These results may presumably represent the immune changes occurred in healthy humans when migrating, indicating that large sets of environmental exposures may trigger aberrant immune activity. PMID:26306804

  20. FPGA wavelet processor design using language for instruction-set architectures (LISA)

    NASA Astrophysics Data System (ADS)

    Meyer-Bäse, Uwe; Vera, Alonzo; Rao, Suhasini; Lenk, Karl; Pattichis, Marios

    2007-04-01

    The design of an microprocessor is a long, tedious, and error-prone task consisting of typically three design phases: architecture exploration, software design (assembler, linker, loader, profiler), architecture implementation (RTL generation for FPGA or cell-based ASIC) and verification. The Language for instruction-set architectures (LISA) allows to model a microprocessor not only from instruction-set but also from architecture description including pipelining behavior that allows a design and development tool consistency over all levels of the design. To explore the capability of the LISA processor design platform a.k.a. CoWare Processor Designer we present in this paper three microprocessor designs that implement a 8/8 wavelet transform processor that is typically used in today's FBI fingerprint compression scheme. We have designed a 3 stage pipelined 16 bit RISC processor (NanoBlaze). Although RISC μPs are usually considered "fast" processors due to design concept like constant instruction word size, deep pipelines and many general purpose registers, it turns out that DSP operations consume essential processing time in a RISC processor. In a second step we have used design principles from programmable digital signal processor (PDSP) to improve the throughput of the DWT processor. A multiply-accumulate operation along with indirect addressing operation were the key to achieve higher throughput. A further improvement is possible with today's FPGA technology. Today's FPGAs offer a large number of embedded array multipliers and it is now feasible to design a "true" vector processor (TVP). A multiplication of two vectors can be done in just one clock cycle with our TVP, a complete scalar product in two clock cycles. Code profiling and Xilinx FPGA ISE synthesis results are provided that demonstrate the essential improvement that a TVP has compared with traditional RISC or PDSP designs.

  1. Assessing quality of life among adults with mental retardation living in various settings.

    PubMed

    Schwartz, C; Ben-Menachem, Y

    1999-06-01

    Fifty-eight Israeli adults with mild to moderate mental retardation, living in Jerusalem, either in a residential institution, various sheltered apartments or in their parents' home, were studied with respect to their quality of life. Quality of life was evaluated through the assessment of individual's satisfaction with different elements of life. The results are presented in this article. Overall, significant differences were found in satisfaction with: current residence, friends and free time, and total lifestyle satisfaction. Residents of sheltered apartments expressed the most satisfaction in these three domains. Persons living in the residential institution expressed the least satisfaction with current residence, and people living in their parents' home expressed the least satisfaction with friends and free time and with total lifestyle satisfaction. The three groups differ significantly on the three domains of life satisfaction even after controlling for background and environmental characteristics such as: age, health limitations, adaptive behaviour, participation in leisure activities, and opportunity to choose and decide.

  2. Assessing quality of life among adults with mental retardation living in various settings.

    PubMed

    Schwartz, C; Ben-Menachem, Y

    1999-06-01

    Fifty-eight Israeli adults with mild to moderate mental retardation, living in Jerusalem, either in a residential institution, various sheltered apartments or in their parents' home, were studied with respect to their quality of life. Quality of life was evaluated through the assessment of individual's satisfaction with different elements of life. The results are presented in this article. Overall, significant differences were found in satisfaction with: current residence, friends and free time, and total lifestyle satisfaction. Residents of sheltered apartments expressed the most satisfaction in these three domains. Persons living in the residential institution expressed the least satisfaction with current residence, and people living in their parents' home expressed the least satisfaction with friends and free time and with total lifestyle satisfaction. The three groups differ significantly on the three domains of life satisfaction even after controlling for background and environmental characteristics such as: age, health limitations, adaptive behaviour, participation in leisure activities, and opportunity to choose and decide. PMID:10448624

  3. Demonstration of a software design and statistical analysis methodology with application to patient outcomes data sets

    PubMed Central

    Mayo, Charles; Conners, Steve; Warren, Christopher; Miller, Robert; Court, Laurence; Popple, Richard

    2013-01-01

    Purpose: With emergence of clinical outcomes databases as tools utilized routinely within institutions, comes need for software tools to support automated statistical analysis of these large data sets and intrainstitutional exchange from independent federated databases to support data pooling. In this paper, the authors present a design approach and analysis methodology that addresses both issues. Methods: A software application was constructed to automate analysis of patient outcomes data using a wide range of statistical metrics, by combining use of C#.Net and R code. The accuracy and speed of the code was evaluated using benchmark data sets. Results: The approach provides data needed to evaluate combinations of statistical measurements for ability to identify patterns of interest in the data. Through application of the tools to a benchmark data set for dose-response threshold and to SBRT lung data sets, an algorithm was developed that uses receiver operator characteristic curves to identify a threshold value and combines use of contingency tables, Fisher exact tests, Welch t-tests, and Kolmogorov-Smirnov tests to filter the large data set to identify values demonstrating dose-response. Kullback-Leibler divergences were used to provide additional confirmation. Conclusions: The work demonstrates the viability of the design approach and the software tool for analysis of large data sets. PMID:24320426

  4. Two decades (1993-2012) of adult intensive care unit design: a comparative study of the physical design features of the best practice examples.

    PubMed

    Rashid, Mahbub

    2014-01-01

    In 2006, Critical Care Nursing Quarterly published a study of the physical design features of a set of best practice example adult intensive care units (ICUs). These adult ICUs were awarded between 1993 and 2003 by the Society of Critical Care Medicine (SCCM), the American Association of Critical-Care Nurses, and the American Institute of Architects/Academy of Architecture for Health for their efforts to promote the critical care unit environment through design. Since 2003, several more adult ICUs were awarded by the same organizations for similar efforts. This study includes these newer ICUs along with those of the previous study to cover a period of 2 decades from 1993 to 2012. Like the 2006 study, this study conducts a systematic content analysis of the materials submitted by the award-winning adult ICUs. On the basis of the analysis, the study compares the 1993-2002 and 2003-2012 adult ICUs in relation to construction type, unit specialty, unit layout, unit size, patient room size and design, support and service area layout, and family space design. The study also compares its findings with the 2010 Guidelines for Design and Construction of Health Care Facilities of the Facility Guidelines Institute and the 2012 Guidelines for Intensive Care Unit Design of the SCCM. The study indicates that the award-winning ICUs of both decades used several design features that were associated with positive outcomes in research studies. The study also indicates that the award-winning ICUs of the second decade used more evidence-based design features than those of the first decades. In most cases, these ICUs exceeded the requirements of the Facility Guidelines Institute Guidelines to meet those of the SCCM Guidelines. Yet, the award-winning ICUs of both decades also used several features that had very little or no supporting research evidence. Since they all were able to create an optimal critical care environment for which they were awarded, having knowledge of the physical

  5. Burden of Hepatitis C Virus Infection Among Older Adults in Long-Term Care Settings: a Systematic Review of the Literature and Meta-Analysis

    PubMed Central

    Alvarez, Kimberly J.; Smaldone, Arlene; Larson, Elaine L.

    2016-01-01

    Hepatitis C virus (HCV) infection is a significant cause of morbidity and mortality worldwide. The magnitude of the HCV burden has previously been the subject of debate, as representative data tend to exclude high-risk populations, including institutionalized persons. The purpose of this systematic review and meta-analysis was to estimate the prevalence of HCV infection among older adults in long-term care (LTC) and assess factors associated with the prevalence of HCVin this setting. The Preferred Reporting Items for Systematic Review and Meta-Analyses checklist was used as the methodological guide. Two reviewers independently assessed the study quality using a validated modified quality assessment tool. Six articles met inclusion criteria; the majority were cross-sectional studies (83.3 %) designed to estimate HCV infection prevalence rates and identify associated risk factors. HCV prevalence ranged from 1.4 to 11.8 %. A pooled HCV infection prevalence of 3.3 % (95 % confidence interval: 1.5–7.2 %) was estimated based on 1920 LTC residents with substantial heterogeneity noted (Q=51.1, p<0.001; I2=90.2). Three of six studies reported statistically significant factors associated with an increased risk for HCV infection, including older age, female gender, history of blood transfusions, short duration of LTC residence, and hepatitis B virus positivity. This study reports a higher prevalence of HCV infection among older adults in LTC settings compared to community-dwelling older adults; however, accurate estimation of prevalence is limited by heterogeneity between and within studies, variation in sampling and recruitment methodologies, and absence of the HCV-RNA test to confirm active infection. PMID:26915098

  6. Use of instruments to measure quality of life among healthy and ill adults in community settings.

    PubMed

    Kalfoss, Mary

    2016-05-01

    International interest in quality of life (QoL) has been affected by patients' prolonged survival, the increasingly aging population, the increase in chronic conditions and the increasing costs of health care. This has also led to the development of QoL instruments that meet the psychometric criteria necessary for reliable and valid outcome measures in research, health policy decision-making and, increasingly, in clinical practice. Despite the proliferation of QoL instruments available to inform best practice, clinicians seldom routinely apply them. One of the barriers to using QoL instruments is the unfamiliarity nurses have with existing instruments. In order to increase community health nurses' familiarity with existing QoL assessments, the aim of this paper is to describe five instruments and modules that have been developed by the World Health Organization's Quality of Life Assessment Group for the assessment of QoL among healthy and ill adults and to describe how their applicability could enhance evidence-based practice in community nursing. PMID:27170407

  7. Rapid Design Space Exploration of a Reconfigurable Instruction-Set Processor

    NASA Astrophysics Data System (ADS)

    Mehdipour, Farhad; Noori, Hamid; Inoue, Koji; Murakami, Kazuaki

    Multitude parameters in the design process of a reconfigurable instruction-set processor (RISP) may lead to a large design space and remarkable complexity. Quantitative design approach uses the data collected from applications to satisfy design constraints and optimize the design goals while considering the applications' characteristics; however it highly depends on designer observations and analyses. Exploring design space can be considered as an effective technique to find a proper balance among various design parameters. Indeed, this approach would be computationally expensive when the performance evaluation of the design points is accomplished based on the synthesis-and-simulation technique. A combined analytical and simulation-based model (CAnSO) is proposed and validated for performance evaluation of a typical RISP. The proposed model consists of an analytical core that incorporates statistics collected from cycle-accurate simulation to make a reasonable evaluation and provide a valuable insight. CAnSO has clear speed advantages and therefore it can be used for easing a cumbersome design space exploration of a reconfigurable RISP processor and quick performance evaluation of slightly modified architectures.

  8. Reading Intervention Outcomes for Adults with Disabilities in a Vocational Rehabilitation Setting: Results of a 3-Year Research and Demonstration Grant

    ERIC Educational Resources Information Center

    Vanderberg, Laura E.; Pierce, Margaret E.; Disney, Laurel J.

    2011-01-01

    This study reports on an examination of the effectiveness of a reading intervention for adults with disabilities in a vocational rehabilitation setting. Participants were 57 adults with disabilities and low reading skills enrolled at the Reading Clinic at the Michigan Career and Technical Institute. As part of a 3-year research and demonstration…

  9. Adapting evidence-based, cognitive-behavioral interventions for anxiety for use with adults in integrated primary care settings.

    PubMed

    Shepardson, Robyn L; Funderburk, Jennifer S; Weisberg, Risa B

    2016-06-01

    Evidence-based treatments for adult patients with anxiety are greatly needed within primary care settings. Psychotherapy protocols, including those for cognitive-behavioral therapy (CBT), are often disorder-specific and were developed for specialty mental health settings, rendering them infeasible in primary care. Behavioral health consultants (BHCs) integrated into primary care settings are uniquely positioned to provide anxiety treatment. However, due to the dearth of empirically supported brief treatments for anxiety, BHCs are tasked with adapting existing treatments for use in primary care, which is quite challenging due to the abbreviated format and population-based approach to care. CBT protocols are highly effective in the treatment of anxiety and fit well with the self-management emphasis of integrated primary care. We review the rationale and procedure for 6 evidence-based CBT intervention techniques (psycho-education, mindfulness and acceptance-based behavioral techniques, relaxation training, exposure, cognitive restructuring, and behavioral activation) that can be adapted for use in the brief format typical of integrated primary care. We offer tips based on our clinical experience, highlight resources (e.g., handouts, websites, apps), and discuss 2 case examples to aid BHCs in their everyday practice. Our goal is to provide BHCs with practical knowledge that will facilitate the use of evidence-based interventions to improve the treatment of anxiety in primary care settings. (PsycINFO Database Record PMID:27064434

  10. Human Centred Design Considerations for Connected Health Devices for the Older Adult

    PubMed Central

    Harte, Richard P.; Glynn, Liam G.; Broderick, Barry J.; Rodriguez-Molinero, Alejandro; Baker, Paul M. A.; McGuiness, Bernadette; O’Sullivan, Leonard; Diaz, Marta; Quinlan, Leo R.; ÓLaighin, Gearóid

    2014-01-01

    Connected health devices are generally designed for unsupervised use, by non-healthcare professionals, facilitating independent control of the individuals own healthcare. Older adults are major users of such devices and are a population significantly increasing in size. This group presents challenges due to the wide spectrum of capabilities and attitudes towards technology. The fit between capabilities of the user and demands of the device can be optimised in a process called Human Centred Design. Here we review examples of some connected health devices chosen by random selection, assess older adult known capabilities and attitudes and finally make analytical recommendations for design approaches and design specifications. PMID:25563225

  11. A set of observational measures for rating support and participation in conversation between adults with aphasia and their conversation partners.

    PubMed

    Kagan, Aura; Winckel, Joanne; Black, Sandra; Duchan, Judith Felson; Simmons-Mackie, Nina; Square, Paula

    2004-01-01

    Conversation partners of individuals with aphasia, including health care professionals, families, and others, play a role that is as important for communication as the language disorder suffered by individuals with aphasia. Two complementary measures designed to capture elements of conversation between adults with aphasia and their speaking conversation partners have been developed. The first measure provides an index of the conversation partner's skill in providing conversational support. The second provides an index of the level of participation in conversation by the person with aphasia. This article describes the development of the measures, including preliminary psychometric data, and discusses applications. PMID:14872401

  12. Development of a wheelchair skills home program for older adults using a participatory action design approach.

    PubMed

    Giesbrecht, Edward M; Miller, William C; Mitchell, Ian M; Woodgate, Roberta L

    2014-01-01

    Restricted mobility is the most common impairment among older adults and a manual wheelchair is often prescribed to address these limitations. However, limited access to rehabilitation services results in older adults typically receiving little or no mobility training when they receive a wheelchair. As an alternative and novel approach, we developed a therapist-monitored wheelchair skills home training program delivered via a computer tablet. To optimize efficacy and adherence, principles of self-efficacy and adult learning theory were foundational in the program design. A participatory action design approach was used to engage older adult wheelchair users, care providers, and prescribing clinicians in an iterative design and development process. A series of prototypes were fabricated and revised, based on feedback from eight stakeholder focus groups, until a final version was ready for evaluation in a clinical trial. Stakeholder contributions affirmed and enhanced the foundational theoretical principles and provided validation of the final product for the target population. PMID:25276768

  13. Development of a Wheelchair Skills Home Program for Older Adults Using a Participatory Action Design Approach

    PubMed Central

    Giesbrecht, Edward M.; Miller, William C.; Mitchell, Ian M.; Woodgate, Roberta L.

    2014-01-01

    Restricted mobility is the most common impairment among older adults and a manual wheelchair is often prescribed to address these limitations. However, limited access to rehabilitation services results in older adults typically receiving little or no mobility training when they receive a wheelchair. As an alternative and novel approach, we developed a therapist-monitored wheelchair skills home training program delivered via a computer tablet. To optimize efficacy and adherence, principles of self-efficacy and adult learning theory were foundational in the program design. A participatory action design approach was used to engage older adult wheelchair users, care providers, and prescribing clinicians in an iterative design and development process. A series of prototypes were fabricated and revised, based on feedback from eight stakeholder focus groups, until a final version was ready for evaluation in a clinical trial. Stakeholder contributions affirmed and enhanced the foundational theoretical principles and provided validation of the final product for the target population. PMID:25276768

  14. Enhancing adult therapeutic interpersonal relationships in the acute health care setting: an integrative review

    PubMed Central

    Kornhaber, Rachel; Walsh, Kenneth; Duff, Jed; Walker, Kim

    2016-01-01

    Therapeutic interpersonal relationships are the primary component of all health care interactions that facilitate the development of positive clinician–patient experiences. Therapeutic interpersonal relationships have the capacity to transform and enrich the patients’ experiences. Consequently, with an increasing necessity to focus on patient-centered care, it is imperative for health care professionals to therapeutically engage with patients to improve health-related outcomes. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO databases of peer-reviewed research, limited to the English language with search terms developed to reflect therapeutic interpersonal relationships between health care professionals and patients in the acute care setting. This study found that therapeutic listening, responding to patient emotions and unmet needs, and patient centeredness were key characteristics of strategies for improving therapeutic interpersonal relationships. PMID:27789958

  15. Relational Autonomy in Assisted Living: A Focus on Diverse Care Settings for Older Adults

    PubMed Central

    Perkins, Molly M.; Ball, Mary M.; Whittington, Frank J.; Hollingsworth, Carole

    2012-01-01

    Consistent with Western cultural values, the traditional liberal theory of autonomy, which places emphasis on self-determination, liberty of choice, and freedom from interference by others, has been a leading principle in health care discourse for several decades. In context to aging, chronic illness, disability, and long-term care, increasingly there has been a call for a relational conception of autonomy that acknowledges issues of dependency, interdependence, and care relationships. Although autonomy is a core philosophy of assisted living (AL) and a growing number of studies focus on this issue, theory development in this area is lagging and little research has considered race, class, or cultural differences, despite the growing diversity of AL. We present a conceptual model of autonomy in AL based on over a decade of research conducted in diverse facility settings. This relational model provides an important conceptual lens for understanding the dynamic linkages between varieties of factors at multiple levels of social structure that shape residents' ability to maintain a sense of autonomy in this often socially challenging care environment. Social and institutional change, which is ongoing, as well as the multiple and ever-changing cultural contexts within which residents are embedded, are important factors that shape residents' experiences over time and impact resident-facility fit and residents' ability to age in place. PMID:22707852

  16. Computer-aided design of a BPSK spread-spectrum chip set

    NASA Astrophysics Data System (ADS)

    Jain, Rajeev; Samueli, Henry; Yang, Paul T.; Chien, Charles; Chen, Gloria G.; Lau, Linda K.; Chung, Bong-Young; Cohen, Etan G.

    1992-01-01

    The design of a binary-phase shift-keyed (BPSK) spread-spectrum chip set with an integrated CAD environment called VANDA is described. VANDA uses the functional compiler concept to integrate system and physical designs, thus allowing complex high-performance integrated circuit chips to be implemented easily. Three functional compilers have been designed and implemented for the design of a spread-spectrum transceiver: a pseudonoise (PN) generator compiler, a direct digital frequency synthesizer (DDFS) compiler, and a Costas loop compiler. Three test chips for a BPSK digital intermediate frequency (IF) spread-spectrum system generated by these compilers have been fabricated and tested. Details of each of the functional compilers and the test chips are described. In addition, the measurement results for digital IF transceiver test boards constructed using these chips are presented.

  17. Statistical plant set estimation using Schroeder-phased multisinusoidal input design

    NASA Technical Reports Server (NTRS)

    Bayard, D. S.

    1992-01-01

    A frequency domain method is developed for plant set estimation. The estimation of a plant 'set' rather than a point estimate is required to support many methods of modern robust control design. The approach here is based on using a Schroeder-phased multisinusoid input design which has the special property of placing input energy only at the discrete frequency points used in the computation. A detailed analysis of the statistical properties of the frequency domain estimator is given, leading to exact expressions for the probability distribution of the estimation error, and many important properties. It is shown that, for any nominal parametric plant estimate, one can use these results to construct an overbound on the additive uncertainty to any prescribed statistical confidence. The 'soft' bound thus obtained can be used to replace 'hard' bounds presently used in many robust control analysis and synthesis methods.

  18. Topology optimized design of carpet cloaks based on a level set approach

    NASA Astrophysics Data System (ADS)

    Fujii, Garuda; Nakamura, Masayuki

    2015-09-01

    This paper presents topology optimized designs of carpet cloaks made of dielectrics modeled by a level set boundary expression. The objective functional, evaluating the performance of the carpet cloaks, is defined as the integrated intensity of the difference between electric field reflected by the flat plane and that controlled by a carpet cloak covering a bump. The dielectric structures of carpet cloak are designed to minimize the objective functional value and, in some cases, the value reach 0.34% of that when a bare bump exists. Dielectric structures of carpet cloaks are expressed by level set functions given on grid points. The function becomes positive in dielectrics, negative in air and zero on air-dielectric interfaces and express air-dielectric interfaces explicitly.

  19. Recommendations for a Core Outcome Set for Measuring Standing Balance in Adult Populations: A Consensus-Based Approach

    PubMed Central

    Sibley, Kathryn M.; Howe, Tracey; Lamb, Sarah E.; Lord, Stephen R.; Maki, Brian E.; Rose, Debra J.; Scott, Vicky; Stathokostas, Liza; Straus, Sharon E.; Jaglal, Susan B.

    2015-01-01

    Background Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice. Objective To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults. Methodology A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria. Data sources The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS. Results Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations. Limitations Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate. Conclusions The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally. PMID:25768435

  20. A Model for Designing Instructional Narratives for Adult Learners: Connecting the Dots

    ERIC Educational Resources Information Center

    Smith, Debra M.

    2013-01-01

    The purpose of this study was to develop a research-based model for designing and deploying instructional narratives based on principles derived from narrative theory, development theory, communication theory, learning theory and instructional design theory to enable adult learning and retention and the effective transfer of that retained learning…

  1. Discover Shoowa Design: Gallery Activities for Children and Adults, Ages 8 to Adult.

    ERIC Educational Resources Information Center

    Blechman, Margaret

    This booklet contains examples of textile designs created by the Shoowa, a subgroup of the Kuba people of Zaire, Africa; the examples were part of the National Museum of African Art exhibition, "Shoowa Design: Raffia Textiles from Zaire." Additional information is provided about the Shoowa people and how Shoowa textiles are used, made, colored,…

  2. ABAEnrichment: an R package to test for gene set expression enrichment in the adult and developing human brain

    PubMed Central

    Prüfer, Kay; Kelso, Janet; Dannemann, Michael

    2016-01-01

    Summary: We present ABAEnrichment, an R package that tests for expression enrichment in specific brain regions at different developmental stages using expression information gathered from multiple regions of the adult and developing human brain, together with ontologically organized structural information about the brain, both provided by the Allen Brain Atlas. We validate ABAEnrichment by successfully recovering the origin of gene sets identified in specific brain cell-types and developmental stages. Availability and Implementation: ABAEnrichment was implemented as an R package and is available under GPL (≥ 2) from the Bioconductor website (http://bioconductor.org/packages/3.3/bioc/html/ABAEnrichment.html). Contacts: steffi_grote@eva.mpg.de, kelso@eva.mpg.de or michael_dannemann@eva.mpg.de Supplementary information: Supplementary data are available at Bioinformatics online. PMID:27354695

  3. Community-acquired diarrhea among children and adults in urban settings in Senegal: clinical, epidemiological and microbiological aspects

    PubMed Central

    2013-01-01

    Background Only limited data are available relating to the etiology of diarrhea in children and adults in Senegal. The aim of this prospective study was to describe the epidemiology and etiology of community-acquired diarrheal infections in children and adults living in urban settings. Methods A prospective study was carried out from March 2009 to December 2010, in the urban region of Dakar, Senegal. Patients with acute diarrhea were enrolled, interviewed to collect their clinical history, and their stools were tested for bacteria, virus and parasites. Results A total of 223 patients (including 112 children younger than five years old) with diarrhea were included. At least one enteropathogen was detected in 81% (180/223) of the patients: 29% (64/223) had bacterial infections (mainly diarrheagenic E. coli and Shigella spp), 21% (39/185) viral infections (mainly rotavirus) and 14% (31/223) parasitic infections. Co-infection was identified in 17.8% (32/180) of the patients. Viral infection was significantly more frequent in children under five years old during the dry season. Bacteria and parasites were equally frequent in all age groups. There was a seasonal variation of bacterial infections during the study period, with a higher proportion of infections being bacterial, and due to Salmonella spp. in particular, during the rainy season. Conclusion Our study suggests that in urban settings in Senegal, rotavirus is the principal cause of pediatric diarrhea during the dry season and that the proportion of bacterial infections seems to be higher during the rainy season. Further work is needed to document the burden of diarrheal diseases in sub-Saharan urban communities and to identify risk factors, including those linked to the rapid and unplanned urbanization in Africa. PMID:24321175

  4. Why does Japan use the probability method to set design flood?

    NASA Astrophysics Data System (ADS)

    Nakamura, S.; Oki, T.

    2015-12-01

    Design flood is hypothetical flood to make flood prevention plan. In Japan, a probability method based on precipitation data is used to define the scale of design flood: Tone River, the biggest river in Japan, is 1 in 200 years, Shinano River is 1 in 150 years, and so on. It is one of important socio-hydrological issue how to set reasonable and acceptable design flood in a changing world. The method to set design flood vary among countries. Although the probability method is also used in Netherland, but the base data is water level or discharge data and the probability is 1 in 1250 years (in fresh water section). On the other side, USA and China apply the maximum flood method which set the design flood based on the historical or probable maximum flood. This cases can leads a question: "what is the reason why the method vary among countries?" or "why does Japan use the probability method?" The purpose of this study is to clarify the historical process which the probability method was developed in Japan based on the literature. In the late 19the century, the concept of "discharge" and modern river engineering were imported by Dutch engineers, and modern flood prevention plans were developed in Japan. In these plans, the design floods were set based on the historical maximum method. Although the historical maximum method had been used until World War 2, however, the method was changed to the probability method after the war because of limitations of historical maximum method under the specific socio-economic situations: (1) the budget limitation due to the war and the GHQ occupation, (2) the historical floods: Makurazaki typhoon in 1945, Kathleen typhoon in 1947, Ione typhoon in 1948, and so on, attacked Japan and broke the record of historical maximum discharge in main rivers and the flood disasters made the flood prevention projects difficult to complete. Then, Japanese hydrologists imported the hydrological probability statistics from the West to take account of

  5. Universal Design for Instruction: A New Paradigm for Adult Instruction in Postsecondary Education.

    ERIC Educational Resources Information Center

    Scott, Sally S.; McGuire, Joan M.; Shaw, Stan F.

    2003-01-01

    Universal design for instruction is presented as a new paradigm for approaching equal educational access for college students with learning disabilities. Topics covered include changing student demographics, instructional challenges, the universal design concept, universal design in educational settings, and applying universal design to college…

  6. Cognitive design of a digital desk for the emergency room setting

    PubMed Central

    Bang, Magnus; Prytz, Erik; Rybing, Jonas; Timpka, Toomas

    2014-01-01

    Digital desk technology has a still mainly unexplored potential to support the everyday work of collaborating clinicians. This paper presents ER Desk – a digital desk that was designed to specifically support a team of healthcare professionals working in an emergency room setting. The underlying design requirements were elicited in a comprehensive distributed cognition study of paper-based practices in an emergency room of a middle-sized Swedish hospital. We present the user interface and visualization requirements for digital desks for small clinical emergency room teams. Moreover, we discuss key design issues more generally with a focus on supporting team awareness, cognition, and collaborative routines of healthcare personnel working in clinical environments such as emergency rooms and intensive care units. PMID:25954329

  7. Design of the control set in the framework of variational data assimilation

    NASA Astrophysics Data System (ADS)

    Gejadze, I. Yu.; Malaterre, P.-O.

    2016-11-01

    Solving data assimilation problems under uncertainty in basic model parameters and in source terms may require a careful design of the control set. The task is to avoid such combinations of the control variables which may either lead to ill-posedness of the control problem formulation or compromise the robustness of the solution procedure. We suggest a method for quantifying the performance of a control set which is formed as a subset of the full set of uncertainty-bearing model inputs. Based on this quantity one can decide if the chosen 'safe' control set is sufficient in terms of the prediction accuracy. Technically, the method presents a certain generalization of the 'variational' uncertainty quantification method for observed systems. It is implemented as a matrix-free method, thus allowing high-dimensional applications. Moreover, if the Automatic Differentiation is utilized for computing the tangent linear and adjoint mappings, then it could be applied to any multi-input 'black-box' system. As application example we consider the full Saint-Venant hydraulic network model SIC2, which describes the flow dynamics in river and canal networks. The developed methodology seem useful in the context of the future SWOT satellite mission, which will provide observations of river systems the properties of which are known with quite a limited precision.

  8. Effects of goal-setting interventions on selected basketball skills: a single-subject design.

    PubMed

    Swain, A; Jones, G

    1995-03-01

    The purpose of this investigation was to examine the effects of a goal-setting intervention program on selected components of basketball performance over the course of a competitive season. A multiple-baseline, single-subject design was used with baseline observations on various performance components (e.g., turnovers, rebounds), collected for four elite college basketball players during their first eight games of the season. At the midseason break, these players selected one aspect of their play that they felt would benefit from improvement. A goal-setting program was designed based on the goal attainment scaling procedure recommended by Smith (1988), whereby subjects generated numerical targets for their chosen components. Performance components were then assessed for the next eight games as they had been in the preintervention phase. Following the intervention, 3 of the 4 subjects showed consistent improvements in their targeted areas of performance. Also, there were no outcome changes in the performance components that weren't targeted by the subjects. The findings suggest that future studies may benefit from achieving greater ecological validity and utilizing alternative designs to the traditional nomothetic approaches which may tend to mask positive intervention effects on certain individuals.

  9. Minimum incidence of adult invasive pneumococcal disease in Blantyre, Malawi an urban african setting: a hospital based prospective cohort study.

    PubMed

    Bar-Zeev, Naor; Mtunthama, Neema; Gordon, Stephen B; Mwafulirwa, Gershom; French, Neil

    2015-01-01

    Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV) programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old) population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI): 53.7, 62.7) per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7) mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5) per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9). We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population level indirect

  10. Minimum Incidence of Adult Invasive Pneumococcal Disease in Blantyre, Malawi an Urban African Setting: A Hospital Based Prospective Cohort Study

    PubMed Central

    Bar-Zeev, Naor; Mtunthama, Neema; Gordon, Stephen B; Mwafulirwa, Gershom; French, Neil

    2015-01-01

    Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV) programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old) population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI): 53.7, 62.7) per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7) mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5) per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9). We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population level indirect

  11. A design for a high voltage magnet coil ringer test set

    SciTech Connect

    Koska, W. ); Sims, R.E. )

    1992-04-01

    By discharging a bank of charged capacitors through a high power SCR switch into an SSC dipole magnet assembly, it is possible to ring'' the coil and develop a voltage stress of greater than 50 volts turn-to-turn, thereby verifying the insulation integrity. We will present an overview of the test set design for a 2 kV isolated SCR firing circuit, including safety features, selectable capacitor banks, and digital waveform storage system. Results from testing typical coils and magnets will be included. Possible upgrades are also discussed.

  12. A design for a high voltage magnet coil ringer test set

    SciTech Connect

    Koska, W.; Sims, R.E.

    1992-04-01

    By discharging a bank of charged capacitors through a high power SCR switch into an SSC dipole magnet assembly, it is possible to ``ring`` the coil and develop a voltage stress of greater than 50 volts turn-to-turn, thereby verifying the insulation integrity. We will present an overview of the test set design for a 2 kV isolated SCR firing circuit, including safety features, selectable capacitor banks, and digital waveform storage system. Results from testing typical coils and magnets will be included. Possible upgrades are also discussed.

  13. Involving Older Adults in the Technology Design Process: A Case Study on Mobility and Wellbeing in the Built Environment.

    PubMed

    Swallow, David; Petrie, Helen; Power, Christopher; Lewis, Andrew; Edwards, Alistair D N

    2016-01-01

    Older adults benefit from unstructured, lifestyle-based activity that can be carried out in people's houses, neighbourhoods, and the built environment. Technological solutions may support physical activity and encourage wellbeing. To ensure such technology is suitable for, and usable by, older adults, it is crucial they are involved in all stages of design. Participatory design methodologies facilitate collaboration and engagement with potential users. We examine the suitability of participatory design for collaborating and engaging with older adults. Participatory design workshops were conducted with 33 older adults in the UK with the aim of designing mobile applications to support and promote physical activity and wellbeing in the built environment. As well as summarising the outcome of these workshops, the paper outlines several methodological issues relating to the suitability of participatory design for involving older adults in the technology design process. PMID:27534357

  14. Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review

    PubMed Central

    Martín Cantera, Carlos; Puigdomènech, Elisa; Ballvé, Jose Luis; Arias, Olga Lucía; Clemente, Lourdes; Casas, Ramon; Roig, Lydia; Pérez-Tortosa, Santiago; Díaz-Gete, Laura; Granollers, Sílvia

    2015-01-01

    Objective The objective of the present review is to evaluate multicomponent/complex primary care (PC) interventions for their effectiveness in continuous smoking abstinence by adult smokers. Design A systematic review of randomised and non-randomised controlled trials was undertaken. Eligibility criteria for included studies Selected studies met the following criteria: evaluated effects of a multicomponent/complex intervention (with 2 or more intervention components) in achieving at least 6-month abstinence in adult smokers who visited a PC, biochemical confirmation of abstinence, intention-to-treat analysis and results published in English/Spanish. Methods We followed PRISMA statement to report the review. We searched the following data sources: MEDLINE, Web of Science, Scopus (from inception to February 2014), 3 key journals and a tobacco research bulletin. The Scottish Intercollegiate Guidelines Network checklists were used to evaluate methodological quality. Data selection, evaluation and extraction were done independently, using a paired review approach. Owing to the heterogeneity of interventions in the studies included, a meta-analysis was not conducted. Results Of 1147 references identified, 9 studies were selected (10 204 participants, up to 48 months of follow-up, acceptable methodological quality). Methodologies used were mainly individual or group sessions, telephone conversations, brochures or quit-smoking kits, medications and economic incentives for doctors and no-cost medications for smokers. Complex interventions achieved long-term continuous abstinence ranging from 7% to 40%. Behavioural interventions were effective and had a dose–response effect. Both nicotine replacement and bupropion therapy were safe and effective, with no observed differences. Conclusions Multicomponent/complex interventions in PC are effective and safe, appearing to achieve greater long-term continuous smoking cessation than usual care and counselling alone. Selected

  15. Analysis of perceptual confusions between nine sets of consonant-vowel sounds in normal and dyslexic adults.

    PubMed

    Cornelissen, P L; Hansen, P C; Bradley, L; Stein, J F

    1996-06-01

    It is widely accepted that most developmental dyslexics perform poorly on tasks which assess phonological awareness. One reason for this association might be that the early or "input" phonological representations of speech sounds are distorted or noisy in some way. We have attempted to test this hypothesis directly. In Experiment 1, we measured the confusions that adult dyslexics and controls made when they listened to nine randomly presented consonant-vowel (CV) segments [sequence: see text] under four conditions of increasing white noise masking. Subjects could replay stimuli and were under no obligation to respond quickly. Responses were selected with a computer mouse from a set of nine letter-strings, corresponding to the auditory stimuli, presented on a VDU. While the overall pattern of confusions made by dyslexics and controls was very similar for this stimulus set, dyslexics confused [sequence: see text] significantly more than did controls. In Experiment 2, subjects heard each stimulus once only and were forced to respond as quickly as possible. Under these timed conditions, the pattern of confusions made by dyslexics and controls was the same as before, but dyslexics took longer to respond than controls. The slower responses of dyslexics in Experiment 2 could have arisen because: (a) they were slower at processing the auditory stimuli than controls, (b) they had worse visual pattern memory for letter strings than controls, (c) they were slower than controls at using the computer mouse. In Experiments 3, 4 and 5 subjects carried out control tasks which eliminated each of these possibilities and confirmed that the results from the auditory tasks genuinely reflected subjects' speech perception. We propose that the fine structure of dyslexics' input phonological representations should be further explored with this confusion paradigm by using other speech sounds containing VCs, CCVs and VCCs. PMID:8706379

  16. Architectural approaches to the design of LISP-oriented reduced-instruction set machines

    SciTech Connect

    Abo Alsamh, H.A.

    1987-01-01

    The Reduced Instruction Set Computers (RISC) architectural concept was applied to the Artificial Intelligence (AI) applications, namely, the List Processing language, LISP. The study investigates the most important aspects of the RISC architecture (i.e., Instruction Set, Call/Return Mechanism, and Pipeline Organization). These architectural features are, then, tailored to fit the nature the LISP language. Thus a software tool was developed to experiment with the dynamic execution of many programs determined to represent the LISP language applications in artificial intelligence. The most-frequently used machine instructions were found, and an instruction set for a new RISC-oriented LISP was proposed based on these results. A complete analysis of the frequency of memory and register usage by LISP programs, as well as the frequency of different addressing modes, is presented. It was found that Call/Return operations consumed more than 50% of the total execution time of LISP programs due to the recursive nature of LISP. This factor prompted the study and development of an efficient Call/Return mechanism designed especially for LISP execution. An Overlapping Register Windows (ORW) scheme was introduced, and a replacement strategy was found as a result of simulating the ORW.

  17. Setting a standard for the initiation of steroid therapy in refractory or severe Mycoplasma pneumoniae pneumonia in adolescents and adults.

    PubMed

    Miyashita, Naoyuki; Kawai, Yasuhiro; Inamura, Norikazu; Tanaka, Takaaki; Akaike, Hiroto; Teranishi, Hideto; Wakabayashi, Tokio; Nakano, Takashi; Ouchi, Kazunobu; Okimoto, Niro

    2015-03-01

    Serum interleukin (IL)-18 level was thought to be a useful as a predictor of refractory or severe Mycoplasma pneumoniae pneumonia, and steroid administration is reported to be effective in this situation. The serum levels of IL-18 correlated significantly with those of lactate dehydrogenase (LDH). The purpose of this study was to set a standard for the initiation of steroid therapy in M. pneumoniae pneumonia using a simple serum marker. We analyzed 41 adolescent and adult patients with refractory or severe M. pneumoniae pneumonia who received steroid therapy, and compared them with 108 patients with M. pneumoniae pneumonia who responded to treatment promptly (control group). Serum LDH levels were significantly higher in the refractory and severe group than in the control group at the initiation of steroid therapy (723 vs 210 IU/L, respectively; p < 0.0001). From receiver operating characteristic curve analysis, we calculated serum LDH cut-off levels of 364 IU/L at initiation of steroid therapy and 302 IU/L at 1-3 days before the initiation of steroid therapy. The administration of steroids to patients in the refractory and severe group resulted in the rapid improvement of symptoms and a decrease in serum LDH levels in all patients. Serum LDH level can be used as a useful parameter to determine the initiation of steroid therapy in refractory or severe M. pneumoniae pneumonia. A serum LDH level of 302-364 IU/L seems to be an appropriate criterion for the initiation of steroid therapy.

  18. Evaluation of the Effectiveness of a Web-Based Learning Design for Adult Computer Science Courses

    ERIC Educational Resources Information Center

    Antonis, Konstantinos; Daradoumis, Thanasis; Papadakis, Spyros; Simos, Christos

    2011-01-01

    This paper reports on work undertaken within a pilot study concerned with the design, development, and evaluation of online computer science training courses. Drawing on recent developments in e-learning technology, these courses were structured around the principles of a learner-oriented approach for use with adult learners. The paper describes a…

  19. An Annotated Bibliography of Materials Designed and Organized for Adult Use in Discussion Groups.

    ERIC Educational Resources Information Center

    Ellison, John W.

    This first annotated bibliography of materials designed and organized for adult use in disucssion groups includes both book and nonbook material. Areas dealt with are: art, censorship, change, child guidance, communication, crime, democracy, economics, education, evolution, food, foreign affairs, forgetting, generation gap, gold, good and evil,…

  20. Measurement Properties of the Non-Communicating Adult Pain Checklist (NCAPC): A Pain Scale for Adults with Intellectual and Developmental Disabilities, Scored in a Clinical Setting

    ERIC Educational Resources Information Center

    Lotan, M.; Moe-Nilssen, R.; Ljunggren, A. E.; Strand, L. I.

    2010-01-01

    The 18 items' Non-Communicating Adult Pain Checklist (NCAPC) has been developed from the 27 items Non-Communicating Children Pain Checklist to better capture pain behavior of adults with Intellectual and Developmental Disabilities (IDD). As part of the NCAPC's measurement properties, internal consistency, reliability and sensitivity to pain have…

  1. Challenges in Identifying and Managing Attention-Deficit/Hyperactivity Disorder in Adults in the Primary Care Setting: A Review of the Literature

    PubMed Central

    Mattingly, Gregory

    2010-01-01

    Objective: To examine how to screen for and establish a correct diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adults and to identify the outcomes associated with untreated ADHD. Data Sources: PubMed was searched using the key words ADHD, adult, diagnosis, and primary care from the years 1999 to 2009. Study Selection: This search produced 50 publications. Data Extraction: Publications were screened for data specific to the diagnosis or management of adult patients with ADHD in the primary care setting. Data Synthesis: The estimated prevalence of ADHD in adults throughout the United States is 4.4% or approximately 10 million adults. Adults with ADHD by definition must experience impairment from the symptoms of ADHD in at least 2 areas of their life. Despite significant impairment, only 1 in 10 adults with ADHD have received ADHD treatment within the past year. Given the high rates of undertreatment, primary care physicians, who provide much of the general adult mental health care in the United States, are increasingly charged with making the diagnosis of ADHD in adults. ADHD symptoms are often masked by comorbid psychiatric conditions or patient adaptations such as choice of occupation. One of the ADHD assessment tools, a short 6-item screener, can simplify identification and management of ADHD in adults and help identify which patients may require further evaluation. Conclusions: Primary care physicians should consult with other members of the health care community such as psychiatrists and psychologists when necessary, but should also develop a level of comfort with diagnosing and treating ADHD. PMID:21494335

  2. The Study and Design of Adaptive Learning System Based on Fuzzy Set Theory

    NASA Astrophysics Data System (ADS)

    Jia, Bing; Zhong, Shaochun; Zheng, Tianyang; Liu, Zhiyong

    Adaptive learning is an effective way to improve the learning outcomes, that is, the selection of learning content and presentation should be adapted to each learner's learning context, learning levels and learning ability. Adaptive Learning System (ALS) can provide effective support for adaptive learning. This paper proposes a new ALS based on fuzzy set theory. It can effectively estimate the learner's knowledge level by test according to learner's target. Then take the factors of learner's cognitive ability and preference into consideration to achieve self-organization and push plan of knowledge. This paper focuses on the design and implementation of domain model and user model in ALS. Experiments confirmed that the system providing adaptive content can effectively help learners to memory the content and improve their comprehension.

  3. Design and performance of a multistream MPEG-I system layer encoder/player set

    NASA Astrophysics Data System (ADS)

    Boucher, James A.; Yaar, Ziv; Rubin, Elisa J.; Palmer, John D.; Little, Thomas D.

    1995-03-01

    Current efforts in the area of MPEG-I audio/video synchronization have been limited to single audio, single video applications. The MPEG-I specification includes provisions for the interleaving of up to 16 separate video streams with up to 32 distinct audio streams. This paper explores the possible uses of this capability as well as the design of a robust encoder and playback system. Perceived shortfalls within the specification are discussed including the usefulness of time stamps and the lack of sequence start and end codes within the audio stream format. We also describe our implementation of a software-only MPEG-I encoder/player set and describe its performance under various configurations.

  4. Design, construction, and characterization of a set of biosensors for aromatic compounds.

    PubMed

    Xue, Haoran; Shi, Hailing; Yu, Zhou; He, Shuaixin; Liu, Shiyu; Hou, Yuhang; Pan, Xingjie; Wang, Huan; Zheng, Pu; Cui, Can; Viets, Helena; Liang, Jing; Zhang, Yihao; Chen, Shuobing; Zhang, Haoqian M; Ouyang, Qi

    2014-12-19

    Aromatic pollutants in the environments pose significant threat to human health due to their persistence and toxicity. Here, we report the design and comprehensive characterization of a set of aromatic biosensors constructed using green fluorescence protein as the reporter and aromatics-responsive transcriptional regulators, namely, NahR, XylS, HbpR, and DmpR, as the detectors. The genetic connections between the detectors and the reporter were carefully adjusted to achieve fold inductions far exceeding those reported in previous studies. For each biosensor, the functional characteristics including the dose-responses, dynamic range, and the detection spectrum of aromatic species were thoroughly measured. In particular, the interferences that nontypical inducers exert on each biosensor's response to its strongest inducer were evaluated. These well-characterized biosensors might serve as potent tools for environmental monitoring as well as quantitative gene regulation.

  5. Substance Abuse Treatment in Adult and Juvenile Correctional Facilities: Findings from the Uniform Facility Data Set 1997 Survey of Correctional Facilities.

    ERIC Educational Resources Information Center

    Marsden, Mary Ellen, Ed.; Straw, Richard S., Ed.

    This report presents methodology and findings from the Uniform Facility Data Set (UFDS) 1997 Survey of Correctional Facilities, which surveyed about 7,600 adult and juvenile correctional facilities to identify those that provide on-site substance abuse treatment to their inmates or residents. The survey assesses substance abuse treatment provided…

  6. Narratives of the Leadership Development of Adults Who Served as Summer Camp Staff in the Mennonite Setting: A Multiple Case Study

    ERIC Educational Resources Information Center

    Harrison, Jason

    2013-01-01

    Problem: Leaders today need a new set of knowledge and skills to be effective in collaborative environments. The focus of this study was to investigate how collaborative environments can contribute to leadership development. The purpose of this study was to describe how the collaborative environment of summer camp helped shape emerging adults as…

  7. Feasibility of activity-promoting video games among obese adolescents and young adults in a clinical setting.

    PubMed

    Radon, Katja; Fürbeck, Barbara; Thomas, Silke; Siegfried, Wolfgang; Nowak, Dennis; von Kries, Rüdiger

    2011-01-01

    One component of the recent obesity epidemic is the sedentary behaviour of children and adolescents e.g., use of video games consoles. The new generation of video games requires body movements and might thus increase activity. The aim of this study was to evaluate whether such games could have an effect on physical activity in obese adolescents in a clinical setting. Between March and May 2007 activity-promoting video games ("apvg") were offered to all 84 inpatients (aged 13-28 years) registered in a long-term rehabilitation programme on a voluntary base. Reasons for (non-)attendance were assessed. Frequency and duration of use of the activity-promoting video game sessions were documented. Furthermore, heart rate and activity counts during use of "apvg", endurance training, and strength training were measured. Of 84 inpatients, 51 used the "apvg" at least once (69%) over the study period. The median weekly use of the intervention was 27 min during the first week (range 0-182 min), declining to zero (range 0-74 min) in week four. Mean heart rate during the sessions (mean 115 bpm; 95% confidence interval 108-122 bpm) was similar to the heart rate during strength training (106 bpm; 101-112 bpm). The results indicate that the video games could have an impact on the activity of obese adolescents and young adults. However, as the interest in the devices seems to be too low the suitability of them for weight reduction programmes in young people cannot be ensured. PMID:20837400

  8. Feasibility of activity-promoting video games among obese adolescents and young adults in a clinical setting.

    PubMed

    Radon, Katja; Fürbeck, Barbara; Thomas, Silke; Siegfried, Wolfgang; Nowak, Dennis; von Kries, Rüdiger

    2011-01-01

    One component of the recent obesity epidemic is the sedentary behaviour of children and adolescents e.g., use of video games consoles. The new generation of video games requires body movements and might thus increase activity. The aim of this study was to evaluate whether such games could have an effect on physical activity in obese adolescents in a clinical setting. Between March and May 2007 activity-promoting video games ("apvg") were offered to all 84 inpatients (aged 13-28 years) registered in a long-term rehabilitation programme on a voluntary base. Reasons for (non-)attendance were assessed. Frequency and duration of use of the activity-promoting video game sessions were documented. Furthermore, heart rate and activity counts during use of "apvg", endurance training, and strength training were measured. Of 84 inpatients, 51 used the "apvg" at least once (69%) over the study period. The median weekly use of the intervention was 27 min during the first week (range 0-182 min), declining to zero (range 0-74 min) in week four. Mean heart rate during the sessions (mean 115 bpm; 95% confidence interval 108-122 bpm) was similar to the heart rate during strength training (106 bpm; 101-112 bpm). The results indicate that the video games could have an impact on the activity of obese adolescents and young adults. However, as the interest in the devices seems to be too low the suitability of them for weight reduction programmes in young people cannot be ensured.

  9. Child and Setting Characteristics Affecting the Adult Talk Directed at Preschoolers with Autism Spectrum Disorder in the Inclusive Classroom

    ERIC Educational Resources Information Center

    Irvin, Dwight W.; Boyd, Brian A.; Odom, Samuel L.

    2015-01-01

    Difficulty with social competence is a core deficit of autism spectrum disorder. Research on typically developing children and children with disabilities, in general, suggests the adult talk received in the classroom is related to their social development. The aims of this study were to examine (1) the types and amounts of adult talk children with…

  10. Innovative group-decoupling design of a segment erector based on G F set theory

    NASA Astrophysics Data System (ADS)

    Guo, Wentao; Guo, Weizhong; Gao, Feng; Mo, Pinxi

    2013-03-01

    The segment erector is a key part of the shield machines for tunnel engineering. The available segment erectors are all of serial configuration which is suffering from the problems of low rigidity and accumulative motion errors. The current research mainly focuses on improving assembly accuracy and control performance of serial segment erectors. An innovative design method is proposed featuring motion group-decoupling, based on which a new type of segment erector is developed and investigated. Firstly, the segment installation manipulation is analyzed and decomposed into three motion groups that are decoupled. Then the type synthesis for the 4-DOF motion group is performed based on the general function( G F ) set theory and a new configuration of (1T⊕1R⊕1PS&3UPS) is attained according to the segment manipulation requirements. Consequently, the kinematic models are built and the reducibility and accuracy are analyzed. The dexterity is verified though numerical simulation and no singular points appear in the workspace. Finally, a positioning experiment is carried out by using the prototype developed in the lab that demonstrates a 13.1% improvement of positioning accuracy and the feasibility of the new segment erector. The presented group-decoupling design method is able to invent new type of hybrid segment erectors that avoid the accumulative motion error of erecting.

  11. Action-oriented use of ergonomic checkpoints for healthy work design in different settings.

    PubMed

    Kogi, Kazutaka

    2007-12-01

    Recent experiences in the action-oriented use of ergonomic checkpoints in different work settings are reviewed. The purpose is to know what features are useful for healthy work design adjusted to each local situation. Based on the review results, common features of ergonomic checkpoints used in participatory training programs for improving workplace conditions in small enterprises, construction sites, home work and agriculture in industrially developing countries in Asia are discussed. These checkpoints generally compile practical improvement options in a broad range of technical areas, such as materials handling, workstation design, physical environment and work organization. Usually, "action checklists" comprising the tiles of the checkpoints are used together. A clear focus is placed on readily applicable low-cost options. Three common features of these various checkpoints appear to be important. First, the checkpoints represent typical good practices in multiple areas. Second, each how-to section of these checkpoints presents simple improvements reflecting basic ergonomic principles. Examples of these principles include easy reach, fewer and faster transport, elbow-level work, coded displays, isolated or screened hazards and shared teamwork. Third, the illustrated checkpoints accompanied by corresponding checklists are used as group work tools in short-term training courses. Many practical improvements achieved are displayed in websites for inter-country work improvement networks. It is suggested to promote the use of locally adjusted checkpoints in various forms of participatory action-oriented training in small-scale workplaces and in agriculture particularly in industrially developing countries.

  12. A decade of adult intensive care unit design: a study of the physical design features of the best-practice examples.

    PubMed

    Rashid, Mahbub

    2006-01-01

    This article reports a study of the physical design characteristics of a set of adult intensive care units (ICUs), built between 1993 and 2003. These ICUs were recognized as the best-practice examples by the Society of Critical Care Medicine, the American Association of Critical Care Nurses, and the American Institute of Architects. This study is based on a systematic analysis of the materials found on these ICUs in the booklet and videos jointly published by the above organizations in 2005. The study finds that most of these examples of best-practice adult ICUs have the following negative characteristics: (1) they are built as renovation projects with more health and safety hazards during construction; (2) most of them are mixed-service units with more safety and staffing problems; (3) the overall layout and the layout of staff work areas in these ICUs do not have any common design solutions for improved patient and staff outcomes; and (4) in these ICUs, family space is often located outside the unit, and family access to the patient room is restricted, even though family presence at the bedside may be important for improved patient outcomes. Some of these negative characteristics are offset by the following positive characteristics in most ICUs: (1) they have only private patient rooms for improved patient care, safety, privacy, and comfort; (2) most patient beds are freestanding for easy access to patients from all sides; (3) they have handwashing sinks and waste disposal facilities in the patient room for improved safety; and (4) most patient rooms have natural light to help patients with circadian rhythms. The article discusses, in detail, the implications of its findings, and the role of the ICU design community in a very complicated design context. PMID:17063097

  13. Proposal for a candidate core-set of fitness and strength tests for patients with childhood or adult idiopathic inflammatory myopathies

    PubMed Central

    van der Stap, Djamilla K.D.; Rider, Lisa G.; Alexanderson, Helene; Huber, Adam M.; Gualano, Bruno; Gordon, Patrick; van der Net, Janjaap; Mathiesen, Pernille; Johnson, Liam G.; Ernste, Floranne C.; Feldman, Brian M.; Houghton, Kristin M.; Singh-Grewal, Davinder; Kutzbach, Abraham Garcia; Munters, Li Alemo; Takken, Tim

    2015-01-01

    OBJECTIVES Currently there are no evidence-based recommendations regarding which fitness and strength tests to use for patients with childhood or adult idiopathic inflammatory myopathies (IIM). This hinders clinicians and researchers in choosing the appropriate fitness- or muscle strength-related outcome measures for these patients. Through a Delphi survey, we aimed to identify a candidate core-set of fitness and strength tests for children and adults with IIM. METHODS Fifteen experts participated in a Delphi survey that consisted of five stages to achieve a consensus. Using an extensive search of published literature and through the expertise of the experts, a candidate core-set based on expert opinion and clinimetric properties was developed. Members of the International Myositis Assessment and Clinical Studies Group (IMACS) were invited to review this candidate core-set during the final stage, which led to a final candidate core-set. RESULTS A core-set of fitness- and strength-related outcome measures was identified for children and adults with IIM. For both children and adults, different tests were identified and selected for maximal aerobic fitness, submaximal aerobic fitness, anaerobic fitness, muscle strength tests and muscle function tests. CONCLUSIONS The core-set of fitness and strength-related outcome measures provided by this expert consensus process will assist practitioners and researchers in deciding which tests to use in IIM patients. This will improve the uniformity of fitness and strength tests across studies, thereby facilitating the comparison of study results and therapeutic exercise program outcomes among patients with IIM. PMID:26568594

  14. Design and methods for evaluating an early childhood obesity prevention program in the childcare center setting

    PubMed Central

    2013-01-01

    Background Many unhealthy dietary and physical activity habits that foster the development of obesity are established by the age of five. Presently, approximately 70 percent of children in the United States are currently enrolled in early childcare facilities, making this an ideal setting to implement and evaluate childhood obesity prevention efforts. We describe here the methods for conducting an obesity prevention randomized trial in the child care setting. Methods/design A randomized, controlled obesity prevention trial is currently being conducted over a three year period (2010-present). The sample consists of 28 low-income, ethnically diverse child care centers with 1105 children (sample is 60% Hispanic, 15% Haitian, 12% Black, 2% non-Hispanic White and 71% of caregivers were born outside of the US). The purpose is to test the efficacy of a parent and teacher role-modeling intervention on children’s nutrition and physical activity behaviors. . The Healthy Caregivers-Healthy Children (HC2) intervention arm schools received a combination of (1) implementing a daily curricula for teachers/parents (the nutritional gatekeepers); (2) implementing a daily curricula for children; (3) technical assistance with meal and snack menu modifications such as including more fresh and less canned produce; and (4) creation of a center policy for dietary requirements for meals and snacks, physical activity and screen time. Control arm schools received an attention control safety curriculum. Major outcome measures include pre-post changes in child body mass index percentile and z score, fruit and vegetable and other nutritious food intake, amount of physical activity, and parental nutrition and physical activity knowledge, attitudes, and beliefs, defined by intentions and behaviors. All measures were administered at the beginning and end of the school year for year one and year two of the study for a total of 4 longitudinal time points for assessment. Discussion Although few

  15. Experiments and other methods for developing expertise with design of experiments in a classroom setting

    NASA Technical Reports Server (NTRS)

    Patterson, John W.

    1990-01-01

    The only way to gain genuine expertise in Statistical Process Control (SPC) and the design of experiments (DOX) is with repeated practice, but not on canned problems with dead data sets. Rather, one must negotiate a wide variety of problems each with its own peculiarities and its own constantly changing data. The problems should not be of the type for which there is a single, well-defined answer that can be looked up in a fraternity file or in some text. The problems should match as closely as possible the open-ended types for which there is always an abundance of uncertainty. These are the only kinds that arise in real research, whether that be basic research in academe or engineering research in industry. To gain this kind of experience, either as a professional consultant or as an industrial employee, takes years. Vast amounts of money, not to mention careers, must be put at risk. The purpose here is to outline some realistic simulation-type lab exercises that are so simple and inexpensive to run that the students can repeat them as often as desired at virtually no cost. Simulations also allow the instructor to design problems whose outcomes are as noisy as desired but still predictable within limits. Also the instructor and the students can learn a great deal more from the postmortum conducted after the exercise is completed. One never knows for sure what the true data should have been when dealing only with real life experiments. To add a bit more realism to the exercises, it is sometimes desirable to make the students pay for each experimental result from a make-believe budget allocation for the problem.

  16. Analogies designed to enhance understanding of earthquake science: Their identification, characterization, and use in instructional settings

    NASA Astrophysics Data System (ADS)

    Deridder, Mauritz A.

    A priori prediction of rocket engine combustor flowfields is extremely difficult due to a number of complicating effects including multiple property phases, unsteadiness due to high rates of energy release and turbulence, and three-dimensionality. Proof of predictive accuracy is limited by the severe environment that precludes direct measurement of most validating parameters. This dissertation describes an experiment undertaken to provide benchmark data for the validation of computational models by measuring the local wall heat flux and axial pressure variations in a multielement rocket combustor operating at pressures between 300 and 1200 psia and mixture ratios between 3 and 6. The experimental combustor comprised seven liquid oxygen/gaseous hydrogen shear coaxial injector elements and a heat-sink cooled thrust chamber instrumented with 41 coaxial thermocouple pairs to measure axial and circumferential variations and 8 pressure transducers to measure axial variations. An additional three coaxial thermocouples were placed on the injector face. Chamber pressure was varied from 300 to 1200 psia and the O/F ratio was varied from three to six. A total of 19 tests were conducted. Maximum measured wall temperatures were kept near 1000 degrees Fahrenheit. To calculate local heat flux, the thermocouple data were modeled using methods including numerical differentiation formulas and inverse methods including Tikhonov Regularization. Calculated wall heat flux ranged from 8 to 20 Btu/in2/sec. Although difficulties were encountered with thermocouple reliability, a high-quality data set was obtained with with experimental uncertainty in the heat flux of approximately 0.06 Btu/in2/sec and demonstrated repeatability. The results of the benchmark study have been assembled for transfer to CFD modelers for validation. Recommendations for improved validation experiments are provided including revised thermocouple design and installation methods, heat flux determination methods, and

  17. Designing therapeutic clinical trials for older and frail adults with cancer: U13 conference recommendations.

    PubMed

    Hurria, Arti; Dale, William; Mooney, Margaret; Rowland, Julia H; Ballman, Karla V; Cohen, Harvey J; Muss, Hyman B; Schilsky, Richard L; Ferrell, Betty; Extermann, Martine; Schmader, Kenneth E; Mohile, Supriya G

    2014-08-20

    A majority of cancer diagnoses and deaths occur in patients age ≥ 65 years. With the aging of the US population, the number of older adults with cancer will grow. Although the coming wave of older patients with cancer was anticipated in the early 1980s, when the need for more research on the cancer-aging interface was recognized, many knowledge gaps remain when it comes to treating older and/or frailer patients with cancer. Relatively little is known about the best way to balance the risks and benefits of existing cancer therapies in older patients; however, these patients continue to be underrepresented in clinical trials. Furthermore, the available clinical trials often do not include end points pertinent to the older adult population, such as preservation of function, cognition, and independence. As part of its ongoing effort to advance research in the field of geriatric oncology, the Cancer and Aging Research Group held a conference in November 2012 in collaboration with the National Cancer Institute, the National Institute on Aging, and the Alliance for Clinical Trials in Oncology. The goal was to develop recommendations and establish research guidelines for the design and implementation of therapeutic clinical trials for older and/or frail adults. The conference sought to identify knowledge gaps in cancer clinical trials for older adults and propose clinical trial designs to fill these gaps. The ultimate goal of this conference series is to develop research that will lead to evidence-based care for older and/or frail adults with cancer.

  18. Designing Therapeutic Clinical Trials for Older and Frail Adults With Cancer: U13 Conference Recommendations

    PubMed Central

    Hurria, Arti; Dale, William; Mooney, Margaret; Rowland, Julia H.; Ballman, Karla V.; Cohen, Harvey J.; Muss, Hyman B.; Schilsky, Richard L.; Ferrell, Betty; Extermann, Martine; Schmader, Kenneth E.; Mohile, Supriya G.

    2014-01-01

    A majority of cancer diagnoses and deaths occur in patients age ≥ 65 years. With the aging of the US population, the number of older adults with cancer will grow. Although the coming wave of older patients with cancer was anticipated in the early 1980s, when the need for more research on the cancer-aging interface was recognized, many knowledge gaps remain when it comes to treating older and/or frailer patients with cancer. Relatively little is known about the best way to balance the risks and benefits of existing cancer therapies in older patients; however, these patients continue to be underrepresented in clinical trials. Furthermore, the available clinical trials often do not include end points pertinent to the older adult population, such as preservation of function, cognition, and independence. As part of its ongoing effort to advance research in the field of geriatric oncology, the Cancer and Aging Research Group held a conference in November 2012 in collaboration with the National Cancer Institute, the National Institute on Aging, and the Alliance for Clinical Trials in Oncology. The goal was to develop recommendations and establish research guidelines for the design and implementation of therapeutic clinical trials for older and/or frail adults. The conference sought to identify knowledge gaps in cancer clinical trials for older adults and propose clinical trial designs to fill these gaps. The ultimate goal of this conference series is to develop research that will lead to evidence-based care for older and/or frail adults with cancer. PMID:25071116

  19. Design and Implementation of a Set-Top Box–Based Homecare System Using Hybrid Cloud

    PubMed Central

    Lin, Bor-Shing; Hsiao, Pei-Chi; Cheng, Po-Hsun; Jan, Gene Eu

    2015-01-01

    Abstract Introduction: Telemedicine has become a prevalent topic in recent years, and several telemedicine systems have been proposed; however, such systems are an unsuitable fit for the daily requirements of users. Materials and Methods: The system proposed in this study was developed as a set-top box integrated with the Android™ (Google, Mountain View, CA) operating system to provide a convenient and user-friendly interface. The proposed system can assist with family healthcare management, telemedicine service delivery, and information exchange among hospitals. To manage the system, a novel type of hybrid cloud architecture was also developed. Results: Updated information is stored on a public cloud, enabling medical staff members to rapidly access information when diagnosing patients. In the long term, the stored data can be reduced to improve the efficiency of the database. Conclusions: The proposed design offers a robust architecture for storing data in a homecare system and can thus resolve network overload and congestion resulting from accumulating data, which are inherent problems in centralized architectures, thereby improving system efficiency. PMID:26075333

  20. Visual Communication in Transition: Designing for New Media Literacies and Visual Culture Art Education across Activities and Settings

    ERIC Educational Resources Information Center

    Zuiker, Steven J.

    2014-01-01

    As an example of design-based research, this case study describes and analyses the enactment of a collaborative drawing and animation studio in a Singapore secondary school art classroom. The design embodies principles of visual culture art education and new media literacies in order to organize transitions in the settings of participation and…

  1. External Validation of an Instructional Design Model for High Fidelity Simulation: Model Application in a Hospital Setting

    ERIC Educational Resources Information Center

    Wilson, Rebecca D.

    2011-01-01

    The purpose of this study was to investigate the use of the design characteristics component of the Jeffries/National League for Nursing Framework for Designing, Implementing, and Evaluating Simulations when developing a simulation-based approach to teaching structured communication to new graduate nurses. The setting for the study was a medium…

  2. A Combination Regimen Design Program Based on Pharmacodynamic Target Setting for Childhood Tuberculosis: Design Rules for the Playground

    PubMed Central

    Srivastava, Shashikant; Deshpande, Devyani; Pasipanodya, Jotam G.; Thomas, Tania; Swaminathan, Soumya; Nuermberger, Eric; Gumbo, Tawanda

    2016-01-01

    Children with tuberculosis are treated with drug regimens copied from adults despite significant differences in antibiotic pharmacokinetics, pathology, and the microbial burden between childhood and adult tuberculosis. We sought to develop a new and effective oral treatment regimen specific to children of different ages. We investigated and validated the concept that target drug concentrations associated with therapy failure and death in children are different from those of adults. On that basis, we proposed a 4-step program to rapidly develop treatment regimens for children. First, target drug concentrations for optimal efficacy are derived from preclinical models of disseminated tuberculosis that recapitulate pediatric pharmacokinetics, starting with monotherapy. Second, 2-drug combinations were examined for zones of synergy, antagonism, and additivity based on a whole exposure–response surface. Exposures associated with additivity or synergy were then combined and the regimen was compared to standard therapy. Third, several exposures of the third drug were added, and a 3-drug regimen was identified based on kill slopes in comparison to standard therapy. Fourth, computer-aided clinical trial simulations are used to identify clinical doses that achieve these kill rates in children in different age groups. The proposed program led to the development of a 3-drug combination regimen for children from scratch, independent of adult regimens, in <2 years. The regimens and doses can be tested in animal models and in clinical trials. PMID:27742637

  3. Analytic design method for optimal imaging: coupling three ray sets using two free-form lens profiles.

    PubMed

    Duerr, Fabian; Benítez, Pablo; Miñano, Juan C; Meuret, Youri; Thienpont, Hugo

    2012-02-27

    In this work, a new two-dimensional optics design method is proposed that enables the coupling of three ray sets with two lens surfaces. The method is especially important for optical systems designed for wide field of view and with clearly separated optical surfaces. Fermat's principle is used to deduce a set of functional differential equations fully describing the entire optical system. The presented general analytic solution makes it possible to calculate the lens profiles. Ray tracing results for calculated 15th order Taylor polynomials describing the lens profiles demonstrate excellent imaging performance and the versatility of this new analytic design method. PMID:22418364

  4. Child and setting characteristics affecting the adult talk directed at preschoolers with autism spectrum disorder in the inclusive classroom.

    PubMed

    Irvin, Dwight W; Boyd, Brian A; Odom, Samuel L

    2015-02-01

    Difficulty with social competence is a core deficit of autism spectrum disorder. Research on typically developing children and children with disabilities, in general, suggests the adult talk received in the classroom is related to their social development. The aims of this study were to examine (1) the types and amounts of adult talk children with autism spectrum disorder are exposed to in the preschool classroom and (2) the associations between child characteristics (e.g. language), activity area, and adult talk. Kontos' Teacher Talk classification was used to code videos approximately 30 min in length of 73 children with autism spectrum disorder (ages 3-5) in inclusive classrooms (n = 33) during center time. The results indicated practical/personal assistance was the most common type of adult talk coded, and behavior management talk least often coded. Child characteristics (i.e. age and autism severity) and activity area were found to be related to specific types of adult talk. Given the findings, implications for future research are discussed.

  5. Child and setting characteristics affecting the adult talk directed at preschoolers with autism spectrum disorder in the inclusive classroom.

    PubMed

    Irvin, Dwight W; Boyd, Brian A; Odom, Samuel L

    2015-02-01

    Difficulty with social competence is a core deficit of autism spectrum disorder. Research on typically developing children and children with disabilities, in general, suggests the adult talk received in the classroom is related to their social development. The aims of this study were to examine (1) the types and amounts of adult talk children with autism spectrum disorder are exposed to in the preschool classroom and (2) the associations between child characteristics (e.g. language), activity area, and adult talk. Kontos' Teacher Talk classification was used to code videos approximately 30 min in length of 73 children with autism spectrum disorder (ages 3-5) in inclusive classrooms (n = 33) during center time. The results indicated practical/personal assistance was the most common type of adult talk coded, and behavior management talk least often coded. Child characteristics (i.e. age and autism severity) and activity area were found to be related to specific types of adult talk. Given the findings, implications for future research are discussed. PMID:24463432

  6. Designing, Implementing, and Evaluating Mobile Health Technologies for Managing Chronic Conditions in Older Adults: A Scoping Review

    PubMed Central

    Harris, Lauren; Ploeg, Jenny; Markle-Reid, Maureen; Valaitis, Ruta; Ibrahim, Sarah; Gafni, Amiram; Isaacs, Sandra

    2016-01-01

    Background The current landscape of a rapidly aging population accompanied by multiple chronic conditions presents numerous challenges to optimally support the complex needs of this group. Mobile health (mHealth) technologies have shown promise in supporting older persons to manage chronic conditions; however, there remains a dearth of evidence-informed guidance to develop such innovations. Objectives The purpose of this study was to conduct a scoping review of current practices and recommendations for designing, implementing, and evaluating mHealth technologies to support the management of chronic conditions in community-dwelling older adults. Methods A 5-stage scoping review methodology was used to map the relevant literature published between January 2005 and March 2015 as follows: (1) identified the research question, (2) identified relevant studies, (3) selected relevant studies for review, (4) charted data from selected literature, and (5) summarized and reported results. Electronic searches were conducted in 5 databases. In addition, hand searches of reference lists and a key journal were completed. Inclusion criteria were research and nonresearch papers focused on mHealth technologies designed for use by community-living older adults with at least one chronic condition, or health care providers or informal caregivers providing care in the home and community setting. Two reviewers independently identified articles for review and extracted data. Results We identified 42 articles that met the inclusion criteria. Of these, described innovations focused on older adults with specific chronic conditions (n=17), chronic conditions in general (n=6), or older adults in general or those receiving homecare services (n=18). Most of the mHealth solutions described were designed for use by both patients and health care providers or health care providers only. Thematic categories identified included the following: (1) practices and considerations when designing m

  7. Career and Self-Construction of Emerging Adults: The Value of Life Designing.

    PubMed

    Maree, Jacobus G; Twigge, Adeline

    2015-01-01

    This article describes a potential way of counseling emerging adults from a life design perspective to construct a self that could enable them to be agents of both their own development and the development of others. Theoretical issues relating to a dynamic, developmental and systems framework of the understanding of wellbeing are described and the process involved is delineated. The research design was qualitative and comprised case studies. Six participants who subscribed to the definition of "emerging adults" and were comparatively representative of the ethnic diversity of South Africa, were selected purposively from a group of individuals who applied for career counseling in a private practice context. The intervention involved life design counseling and occurred over a period of 6 weeks. Information related to participants' self-construction was gathered using qualitative techniques, including the Career Interest Profile, the Career Construction Interview, a timeline, video clips, a collage, and semi-structured interviews. Following the intervention, the participants revealed heightened insights with regard to aspects of their sense of a relational-moral self. Results indicated that life design counseling could enhance elaborative personal development (enhancing self-awareness and reaping the benefits of developing an improved relational-moral self) and the promotion of an awareness of the importance to promote social justice in work-related contexts. PMID:26793152

  8. Career and Self-Construction of Emerging Adults: The Value of Life Designing.

    PubMed

    Maree, Jacobus G; Twigge, Adeline

    2015-01-01

    This article describes a potential way of counseling emerging adults from a life design perspective to construct a self that could enable them to be agents of both their own development and the development of others. Theoretical issues relating to a dynamic, developmental and systems framework of the understanding of wellbeing are described and the process involved is delineated. The research design was qualitative and comprised case studies. Six participants who subscribed to the definition of "emerging adults" and were comparatively representative of the ethnic diversity of South Africa, were selected purposively from a group of individuals who applied for career counseling in a private practice context. The intervention involved life design counseling and occurred over a period of 6 weeks. Information related to participants' self-construction was gathered using qualitative techniques, including the Career Interest Profile, the Career Construction Interview, a timeline, video clips, a collage, and semi-structured interviews. Following the intervention, the participants revealed heightened insights with regard to aspects of their sense of a relational-moral self. Results indicated that life design counseling could enhance elaborative personal development (enhancing self-awareness and reaping the benefits of developing an improved relational-moral self) and the promotion of an awareness of the importance to promote social justice in work-related contexts.

  9. Considerations in Applying the Results of Randomized Controlled Clinical Trials to the Care of Older Adults With Kidney Disease in the Clinical Setting: The SHARP Trial.

    PubMed

    Butler, Catherine R; O'Hare, Ann M

    2016-01-01

    The Study of Heart and Renal Protection (SHARP) found that treatment with ezetemibe and low-dose simvastatin reduced the incidence of major atherosclerotic events in patients with kidney disease. Due to the paucity of evidence-based interventions that lower cardiovascular morbidity in this high-risk population, the SHARP trial will likely have a large impact on clinical practice. However, applying the results of clinical trials conducted in select populations to the care of individual patients in real-world settings can be fraught with difficulty. This is especially true when caring for older adults with complex comorbidity and limited life expectancy. These patients are often excluded from clinical trials, frequently have competing health priorities, and may be less likely to benefit and more likely to be harmed by medications. We discuss key considerations in applying the results of the SHARP trial to the care of older adults with CKD in real-world clinical settings using guiding principles set forth by the American Geriatrics Society's Expert Panel on the Care of Older Adults with Multimorbidity. Using this schema, we emphasize the importance of evaluating trial results in the unique context of each patient's goals, values, priorities, and circumstances.

  10. Program Descriptions and Research Findings: The Parent Readers Program and Its Adaptations in Schools and Adult Literacy Settings.

    ERIC Educational Resources Information Center

    Handel, Ruth D.

    An intergenerational literacy program addresses the needs of adult students enrolled in remedial reading classes at a community college. Their classroom behavior marked by passivity or anxiety, these students are usually able to derive the surface meanings of familiar text, but demonstrate little analytic or reflective thinking about what was…

  11. Differences in Childhood Sexual Abuse Experience between Adult Hispanic and Anglo Women in a Primary Care Setting

    ERIC Educational Resources Information Center

    Katerndahl, David A.; Burge, Sandra K.; Kellogg, Nancy; Parra, Juan M.

    2005-01-01

    The literature on racial and ethnic factors in childhood sexual abuse is limited. The purpose of this exploratory study was to document Hispanic-Anglo differences in childhood sexual abuse experiences and assess whether these differences may be explained by socio-demographic and family environmental differences. Adult Hispanic (n = 69) and Anglo…

  12. Adult age differences in memory for schema-consistent and schema-inconsistent objects in a real-world setting.

    PubMed

    Prull, Matthew W

    2015-01-01

    The present study examined age-related differences in the inconsistency effect, in which memory is enhanced for schema-inconsistent information compared to schema-consistent information. Young and older adults studied schema-consistent and schema-inconsistent objects in an academic office under either intentional or incidental encoding instructions, and were given two recognition tests either immediately or after 48 hr: A yes/no item recognition test that included modified remember/know judgments and a token recognition test that required determining whether an original object was replaced with a different object with the same name. Young and older adults showed equivalent inconsistency effects in both item and token recognition tests, although older adults reported phenomenologically less rich memories of schema-inconsistent objects relative to young adults. These findings run counter to previous reports suggesting that aging is associated with processing declines at encoding that impair memory for details of schema-inconsistent or distinctive events. The results are consistent with a retrieval-based account in which age-related difficulties in retrieving contextual details can be offset by environmental support. PMID:25915577

  13. Medication Use among Australian Adults with Intellectual Disability in Primary Healthcare Settings: A Cross-Sectional Study

    ERIC Educational Resources Information Center

    Doan, Tan N.; Lennox, Nicholas G.; Taylor-Gomez, Miriam; Ware, Robert S.

    2013-01-01

    Background: There is concern about widespread medication use by people with intellectual disability (ID), especially psychotropic and anticonvulsant agents. However, there is sparse information on prescribing patterns in Australia. Method: This cross-sectional study was conducted between 2000 and 2002 among adults with ID who live in the community…

  14. Adult Trade Apprentices: Exploring the Significance of Recognition of Prior Learning and Skill Sets for Earlier Completion. Research Report

    ERIC Educational Resources Information Center

    Hargreaves, Jo; Blomberg, Davinia

    2015-01-01

    The nature of apprenticeships is changing. Increasing proportions of adult apprentices are prompting demand for various alternative pathways to completion. One option for an alternative pathway to accelerate completion is the use of recognition of prior learning (RPL) to identify existing skills and knowledge in combination with gap training. This…

  15. CMOS Integrated Single Electron Transistor Electrometry (CMOS-SET) circuit design for nanosecond quantum-bit read-out.

    SciTech Connect

    Gurrieri, Thomas M.; Lilly, Michael Patrick; Carroll, Malcolm S.; Levy, James E.

    2008-08-01

    Novel single electron transistor (SET) read-out circuit designs are described. The circuits use a silicon SET interfaced to a CMOS voltage mode or current mode comparator to obtain a digital read-out of the state of the qubit. The design assumes standard submicron (0.35 um) CMOS SOI technology using room temperature SPICE models. Implications and uncertainties related to the temperature scaling of these models to 100mK operation are discussed. Using this technology, the simulations predict a read-out operation speed of approximately Ins and a power dissipation per cell as low as 2nW for single-shot read-out, which is a significant advantage over currently used radio frequency SET (RF-SET) approaches.

  16. Identifying Instructional Strategies Used to Design Mobile Learning in a Corporate Setting

    ERIC Educational Resources Information Center

    Jackson-Butler, Uletta

    2016-01-01

    The purpose of this qualitative embedded multiple case study was to describe what instructional strategies corporate instructional designers were using to design mobile learning and to understand from their experiences which instructional strategies they believed enhance learning. Participants were five instructional designers who were actively…

  17. Would Having a Lead Instructional Designer Position Encourage Change in a K-12 Educational Setting?

    ERIC Educational Resources Information Center

    Morris, John

    2011-01-01

    Adding the position Lead Instructional Designer (LID) will help an educational company or school district to work with principals and instructional designers to implement better instructional design strategies. This type of change creates more jobs and takes added pressure away from schools. The vision is to create better customer service to the…

  18. Selection of appropriate training and validation set chemicals for modelling dermal permeability by U-optimal design.

    PubMed

    Xu, G; Hughes-Oliver, J M; Brooks, J D; Yeatts, J L; Baynes, R E

    2013-01-01

    Quantitative structure-activity relationship (QSAR) models are being used increasingly in skin permeation studies. The main idea of QSAR modelling is to quantify the relationship between biological activities and chemical properties, and thus to predict the activity of chemical solutes. As a key step, the selection of a representative and structurally diverse training set is critical to the prediction power of a QSAR model. Early QSAR models selected training sets in a subjective way and solutes in the training set were relatively homogenous. More recently, statistical methods such as D-optimal design or space-filling design have been applied but such methods are not always ideal. This paper describes a comprehensive procedure to select training sets from a large candidate set of 4534 solutes. A newly proposed 'Baynes' rule', which is a modification of Lipinski's 'rule of five', was used to screen out solutes that were not qualified for the study. U-optimality was used as the selection criterion. A principal component analysis showed that the selected training set was representative of the chemical space. Gas chromatograph amenability was verified. A model built using the training set was shown to have greater predictive power than a model built using a previous dataset [1].

  19. An exploration of social connectedness as perceived by older adults in a long-term care setting in Ireland.

    PubMed

    Buckley, Catherine; McCarthy, Geraldine

    2009-01-01

    Social connectedness-that is, the relationships people have with family friends and others-is an important aspect of resident's adjustment to and participation in community living. Little is known about older adult's perceptions of social connectedness in long-term care. The aim of this study was to explore the relationships older adults living in long-term care have with family, friends, the outside world, other residents, and staff. A qualitative phenomenological approach was used to collect data from a purposive sample of 10 older adults using audiotaped semi-structured interviews. Findings revealed 6 themes: superficial relationships, substitution, outside world connection, mental ability, attitudes/actions of carers, and isolation. The study supports the understanding that the more social ties people have, the more socially connected they feel. Preventing social isolation among older people is an important area for practice, and older peoples' services should be shaped around maintaining connectedness and promoting integration of residents in long-term care. PMID:19963148

  20. Designing and standardizing a questionnaire for evaluating knowledge, attitude, and practice of Iranian adults with cardiovascular diseases about oral health

    PubMed Central

    Rasouli-Ghahroudi, Amir Alireza; Rokn, Amir Reza; Khorsand, Afshin; Aghajani, Hasan; Amini, Afshin; Shamshiri, Ahmad Reza; Rahimi, Hamed; Kabir, Ali

    2013-01-01

    BACKGROUND Cardiovascular diseases are the most common cause of death in Iran. Moreover, periodontal diseases are very common in our country. In this study, we have designed a standardized questionnaire for evaluating knowledge, attitude, and practice (KAP) of Iranian adult patients with cardiovascular diseases about oral health. METHODS For designing and standardizing a self-administered questionnaire, we performed a cross-sectional pilot study on 51 cases with periodontal complaints. A dentist carried out the physical examination to determine oral health indicators. Twelve experts and ten lay people of the target population answered questions about validity. Cronbach’s alpha, factor analysis, and Pearson correlation coefficients were used in the analysis. RESULTS The cases of this pilot study were middle aged, with moderate financial and health status, but low oral health and educational level. Debris score was correlated with all other physical exam findings except decay, missing, and filled (DMF). Reliability was 0.826 according to Cronbach’s alpha score. Face validity was higher than 80%. Content validities of the whole of the questionnaire were 85.98% for clarity, 78.05% for relevancy, 85.16% for simplicity, and 82.32% for consistency of each question with the question set. Factor analysis showed that 15 components explain 74% of the total variance. CONCLUSION This questionnaire is culturally adjusted and appropriate for our community, valid and reliable, and sufficiently estimates the variance of the oral health status. It can be used as a standard tool in further studies in adult population of the Iranian middle aged patients with low level of education and moderate socioeconomic status. PMID:24575138

  1. Inkwari: An Emerging High-Risk Place Potentiating HIV Spread Among Young Adults in a Hyper-Endemic South African Setting

    PubMed Central

    Closson, Elizabeth F.; Safren, Steven A.; Mabude, Zonke; Mosery, Nzwakie; Taylor, Scott W.; Perez-Brumer, Amaya; Matthews, Lynn T.; Psaros, Christina; Harrison, Abigail; Grelotti, David J.; Bangsberg, David R.; Smit, Jennifer A.

    2015-01-01

    Young adults in South Africa are at the epicenter of the HIV epidemic. The prevalence of HIV among young people in the province of KwaZulu-Natal (KZN) is particularly high. This study characterizes inkwari (Zulu word for raves or weekend-long parties) in eThekwini District, KZN and explored how these place-based dynamics shape the risk environment for the young adult attendees. In 2011, 13 qualitative interviews were conducted with men and women between 18 and 30 years-old who reported unprotected sex with at least one casual partner in the prior 3 months and attended an inkwari in the same time period. Interviews were analyzed using qualitative content analysis. Nine key informant interviews helped to triangulate these data. Five women and eight men were interviewed and the mean age was 25 years (SD 3.24). Ten reported meeting a sexual partner at an inkwari. Inkwari were characterized as sexualized settings with limited adult supervision. Participants attended inkwari to socialize with peers, use drugs and alcohol, and meet sexual partners. Sexual and physical violence also occurred at inkwari. Given the convergence of social, sexual, and substance- using networks at inkwari, further inquiry is needed to determine how this place may potentiate HIV transmission risk in an endemic setting. PMID:25091214

  2. Maintaining Exercise and Healthful Eating in Older Adults: The SENIOR Project II: Study Design and Methodology

    PubMed Central

    Clark, Phillip G.; Blissmer, Bryan J.; Greene, Geoffrey W.; Lees, Faith D.; Riebe, Deborah A.; Stamm, Karen E.

    2015-01-01

    The Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR) Project II is an intervention study to promote the maintenance of both exercise and healthful eating in older adults. It is the second phase of an earlier study, SENIOR Project I, that originally recruited 1,277 community-dwelling older adults to participate in behavior-specific interventions designed to increase exercise and/or fruit and vegetable consumption. The general theoretical framework for this research is the Transtheoretical Model (TTM) of Health Behavior Change. The current intervention occurs over a 48-month period, using a manual, newsletters, and phone coaching calls. Annual assessments collect standardized data on behavioral outcomes (exercise and diet), TTM variables (stage of change and self-efficacy), psychosocial variables (social support, depression, resilience, and life satisfaction), physical activity and functioning (SF-36, Up and Go, Senior Fitness Test, and disability assessment), cognitive functioning (Trail Making Test and Forward and Backward Digit Span), physical measures (height, weight, and waist circumference), and demographics. The SENIOR Project II is designed to answer the following question as its primary objective: (1) Does an individualized active-maintenance intervention with older adults maintain greater levels of healthful exercise and dietary behaviors for four years, compared to a control condition? In addition, there are two secondary objectives: (2) What are the psychosocial factors associated with the maintenance of health-promoting behaviors in the very old? and (3) What are the effects of the maintenance of health-promoting behaviors on reported health outcomes, psychosocial measures, anthropometrics, and cognitive status? PMID:20955821

  3. A Digital Tool Set for Systematic Model Design in Process-Engineering Education

    ERIC Educational Resources Information Center

    van der Schaaf, Hylke; Tramper, Johannes; Hartog, Rob J.M.; Vermue, Marian

    2006-01-01

    One of the objectives of the process technology curriculum at Wageningen University is that students learn how to design mathematical models in the context of process engineering, using a systematic problem analysis approach. Students find it difficult to learn to design a model and little material exists to meet this learning objective. For these…

  4. Effects of sampling design on the estimation of adult mosquito abundance.

    PubMed

    Reisen, W K; Lothrop, H D

    1999-06-01

    During 1994-5, Culex tarsalis comprised 75% of the 902,643 adult female mosquitoes collected by 63 dry-ice-baited Centers for Disease Control (CDC)-style traps operated biweekly in a uniform sampling grid that covered the southern Coachella Valley, Riverside County, California. The ln(y + 1) transformation successfully controlled the variance and normalized the distribution of catch size among trap nights. When tested by analysis of variance, abundance varied significantly among months, years, and trap sites. Although the trap by months interaction was not significant, female distribution changed seasonally as larval habitats shifted from wetlands along the Salton Sea to agriculture to managed duck marshes. Conditional simulations utilized subsets of trap sites to compare sampling designs that required no (uniform, random, and transect designs) or prior (best-estimate and stratified random designs) knowledge of mosquito spatial distribution. All designs provided similar information on population seasonal trends, but a stratified random design provided the most accurate and precise simulation. A uniform trap grid that employed every 2nd trap site subsequently was adopted by the Coachella Valley Mosquito and Vector Control District to provide information on focal changes in abundance indicative of missed or newly created larval habitats or control failures. PMID:10412106

  5. Using Mutual Information Criterion to Design an Efficient Phoneme Set for Chinese Speech Recognition

    NASA Astrophysics Data System (ADS)

    Zhang, Jin-Song; Hu, Xin-Hui; Nakamura, Satoshi

    Chinese is a representative tonal language, and it has been an attractive topic of how to process tone information in the state-of-the-art large vocabulary speech recognition system. This paper presents a novel way to derive an efficient phoneme set of tone-dependent units to build a recognition system, by iteratively merging a pair of tone-dependent units according to the principle of minimal loss of the Mutual Information (MI). The mutual information is measured between the word tokens and their phoneme transcriptions in a training text corpus, based on the system lexical and language model. The approach has a capability to keep discriminative tonal (and phoneme) contrasts that are most helpful for disambiguating homophone words due to lack of tones, and merge those tonal (and phoneme) contrasts that are not important for word disambiguation for the recognition task. This enables a flexible selection of phoneme set according to a balance between the MI information amount and the number of phonemes. We applied the method to traditional phoneme set of Initial/Finals, and derived several phoneme sets with different number of units. Speech recognition experiments using the derived sets showed its effectiveness.

  6. A Standard Setting Method Designed for Complex Performance Assessments with Multiple Performance Categories: Categorical Assignments of Student Work.

    ERIC Educational Resources Information Center

    Plake, Barbara S.; Hambleton, Ronald K.

    This paper reports on a standard-setting method designed for complex performance assessments with multiple performance categories. The method studied, the Analytical Judgment Method, involves panelists' making analytical classification decisions for each of the test's components individually. It also allows for discussion and reconsideration of…

  7. Outdoor Settings for Playing and Learning: Designing School Grounds to Meet the Needs of the Whole Child and Whole Curriculum.

    ERIC Educational Resources Information Center

    Moore, Robin C.

    1996-01-01

    Presents a list of imaginative design options for optimal outdoor learning as well as intimate contact with nature. Focuses on entrances, pathways, signage and displays, barriers and enclosures, manufactured equipment and play structures, multipurpose game settings, groundcovers and safety surfaces, landforms and topography, trees and vegetation,…

  8. A set of innovative immersed grating based spectrometer designs for METIS

    NASA Astrophysics Data System (ADS)

    Agócs, Tibor; Navarro, Ramon; Venema, Lars; van Amerongen, Aaldert H.; Tol, Paul J. J.; van Brug, Hedser; Brandl, Bernhard R.; Molster, Frank; Todd, Stephen

    2014-07-01

    We present innovative, immersed grating based optical designs for the SMO (Spectrograph Main Optics) module of the Mid-infrared E-ELT Imager and Spectrograph, METIS. The immersed grating allows a significant reduction of SMO volume compared to conventional echelle grating designs, because the diffraction takes place in high refractive index silicon. Additionally, using novel optimization techniques and technical solutions in silicon micromachining offered by the semiconductor industry, further improvements can be achieved. We show optical architectures based on compact, double-pass Three Mirror Anastigmat (TMA) designs, which appear advantageous in terms of one or several of the following: optical performance, reduction of volume, ease of manufacturing and testing. We explore optical designs, where the emphasis is put on manufacturability and we investigate optical solutions, where the ultimate goal is the highest possible optical performance. These novel, silicon immersed grating based design concepts are applicable for future earth and space based spectrometers.

  9. The Joyful Aging Club: An Example of Universal Design Practice on Architectural and Urban Settings.

    PubMed

    Guimarães, Marcelo Pinto; Picceli, Angelica Baldin; Pereira, Carolina Furtado

    2016-01-01

    Universal Design is a very simple idea that is based on complex decisions and it involves user satisfaction during performance of activities and socially inclusive interaction. Generally, the design guidelines for application in architecture requires that both students and professionals explore their imagination about the situations in which the design of a certain building becomes more pleasant and inviting than simply accessible to the needs of people with permanent and temporary disabilities. In this paper, the aim is to discuss peculiar aspects in the design of a three storey building that make it special. The result of technical solutions create environments that are not restricted to the boundaries of a site. It also encompasses the street, the crossing, the corner square and traffic signals and marks beside some accessible parking areas. The building design is an academic exploration of potential usage to an actual site. It belongs to an institution for social network of people aging above sixty-five year old.

  10. Living longer with adult high-grade glioma: setting a research agenda for patients and their caregivers.

    PubMed

    Russell, Bethany; Collins, Anna; Dally, Michael; Dowling, Anthony; Gold, Michelle; Murphy, Michael; Philip, Jennifer

    2014-10-01

    The long-term survival of patients with adult high-grade glioma (HGG) remains poor, but for those who do live longer functional status and neurocognitive ability may be influenced by residual or recurrent tumour, or treatment-related complications. The aim of this review was to examine the current literature regarding the quality of life and experience of patients living longer with adult HGG and their caregivers, with a view to understanding the burden of treatment on patient abilities and deficits over time. Medline, PsychINFO and CINAHL databases were searched for the core concept of HGG in combination with an aspect of quality of long-term survival. Key findings of the 12 included studies were identified and synthesised thematically. There is a paucity of dedicated studies which have investigated the experiences of this cohort. The strength of existing literature is limited by the systematic exclusion of the poorest functioning patients and the under-representation of caregiver perspectives. Discrepancies in how patients view their quality of life were highlighted, despite consistent findings of significant physical and functional impairment. This review confirmed the presence of important differences between patient and caregiver views regarding patient abilities following treatment. Caregiver burden was found to be high, due to multiple dynamic and relentless stressors. The true experience of patients living longer with adult HGG and their caregivers remains unclear, particularly for patients with poorer neurocognitive and functional outcomes. Further research is required to clarify and replicate findings, explore discrepancies between patient and caregiver views, and to specifically investigate how caregiver needs and experiences may evolve over time. PMID:24980038

  11. Design and evaluation of a computer game to promote a healthy diet for young adults.

    PubMed

    Peng, Wei

    2009-03-01

    This article reports the development and evaluation of a computer game (RightWay Café) as a special medium to promote a healthy diet for young adults. Structural features of computer games, such as interactive tailoring, role playing, the element of fun, and narrative, were operationalized in the RightWay Café game to afford behavior rehearsal in a safe and entertaining way. Theories such as the health belief model, social cognitive theory, and theory of reasoned action guided the content design of the game to influence mediators of behavior change, including self-efficacy, perceived benefits, perceived barriers, and behavior change intention. A randomized controlled evaluation study with pretest, posttest, and follow-up design demonstrated that this game was effective in teaching nutrition and weight management knowledge and increasing people's self-efficacy and perceived benefits of healthy eating, as well as their intention to be on a healthy diet. Limited long-term effects were also found: participants in the game-playing group had greater self-efficacy than participants in the control group after 1 month. This study validates the computer game-based approach to health promotion for young adults. Limitations and implications are also discussed.

  12. Continuous quality improvement (CQI) in addiction treatment settings: design and intervention protocol of a group randomized pilot study

    PubMed Central

    2014-01-01

    Background Few studies have designed and tested the use of continuous quality improvement approaches in community based substance use treatment settings. Little is known about the feasibility, costs, efficacy, and sustainment of such approaches in these settings. Methods/Design A group-randomized trial using a modified stepped wedge design is being used. In the first phase of the study, eight programs, stratified by modality (residential, outpatient) are being randomly assigned to the intervention or control condition. In the second phase, the initially assigned control programs are receiving the intervention to gain additional information about feasibility while sustainment is being studied among the programs initially assigned to the intervention. Discussion By using this design in a pilot study, we help inform the field about the feasibility, costs, efficacy and sustainment of the intervention. Determining information at the pilot stage about costs and sustainment provides value for designing future studies and implementation strategies with the goal to reduce the time between intervention development and translation to real world practice settings. PMID:24467770

  13. Design of the Testing Set-up for a Nuclear Fuel Rod by Neutron Radiography at CARR

    NASA Astrophysics Data System (ADS)

    Wei, Guohai; Han, Songbai; Wang, Hongli; Hao, Lijie; Wu, Meimei; He, Linfeng; Wang, Yu; Liu, Yuntao; Sun, Kai; Chen, Dongfeng

    In this paper, an experimental set-up dedicated to non-destructively test a 15cm-long Pressurized Water Reactor (PWR) nuclear fuel rod by neutron radiography (NR) is described. It consists of three parts: transport container, imaging block and steel support. The design of the transport container was optimized with Monte-Carlo Simulation by the MCNP code. The material for the shell of the transport container was chosen to be lead with the thickness of 13 cm. Also, the mechanical devices were designed to control fuel rod movement inside the container. The imaging block was designed as the exposure platform, with three openings for the neutron beam, neutron converter foil, and specimen. Development and application of this experimental set-up will help gain much experience for investigating the actual irradiated fuel rod by neutron radiography at CARR in the future.

  14. An Experimental Design for Examining Thermoregulatory Set Points in Ectothermic Animals.

    ERIC Educational Resources Information Center

    Kingsbury, Bruce A.

    1999-01-01

    Provides a protocol for examining the mechanisms of animal thermoregulation in a straightforward but more sophisticated manner than using a thermal gradient. Describes a methodology for conducting operant conditioning to examine thermal set points for ectothermic animals. Contains 20 references. (WRM)

  15. An Application of the Shewart Time Series Design in an Educational Setting.

    ERIC Educational Resources Information Center

    1977

    A time series procedure, the Shewart Technique, was used in an educational setting with eight academically deficient students to increase the percent of assignments completed. Ss were given mediation training and behavior contracts. The Shewart Technique was found to be useful in providing a formative analysis for intervention. (Tables and graphs…

  16. Exploring Organized and Visionary Approaches to Designing an Advent Fun Day in an Educational Setting

    ERIC Educational Resources Information Center

    Francis, Leslie J.; Smith, Greg

    2015-01-01

    This study draws on one of the four components of psychological type theory (the distinction between judging and perceiving attitudes toward the outside world) to examine the implications of these two contrasting psychological perspectives for shaping approaches to Christian ministry within an educational setting. Qualitative data were generated…

  17. Comparison of nine PCR primer sets designed to detect Pantoea stewartii subsp. stewartii in maize

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pantoea stewartii subsp. stewartii, the causal agent of Stewart's bacterial wilt of maize, is a major quarantine pest in maize seed. Verifying freedom from P. stewartii remains a significant hurdle in exporting corn seed from the U.S. Several PCR primer sets have been developed and suggested as bein...

  18. Cataloging the Confederate Imprints, 1861-1865 Major Microfilm Set: Designing a Successful Workflow.

    ERIC Educational Resources Information Center

    Schmitz, Cecilia M.

    1995-01-01

    Details the flexible assembly-line approach used by Auburn University to catalog the "Confederate Imprints, 1861-1865" major microform set. Five thousand nine hundred sixty-six (5966) distinct items were cataloged over a 3-year period by one professional, one library assistant and two student workers. (Author/JKP)

  19. Enumerating a Diverse Set of Building Designs Using Discrete Optimization: Preprint

    SciTech Connect

    Hale, E.; Long, N.

    2010-08-01

    Numerical optimization is a powerful method for identifying energy-efficient building designs. Automating the search process facilitates the evaluation of many more options than is possible with one-off parametric simulation runs. However, input data uncertainties and qualitative aspects of building design work against standard optimization formulations that return a single, so-called optimal design. This paper presents a method for harnessing a discrete optimization algorithm to obtain significantly different, economically viable building designs that satisfy an energy efficiency goal. The method is demonstrated using NREL's first-generation building analysis platform, Opt- E-Plus, and two example problems. We discuss the information content of the results, and the computational effort required by the algorithm.

  20. Risks with older adults in acute care settings: UK occupational therapists' and physiotherapists' perceptions of risks associated with discharge and professional practice.

    PubMed

    Atwal, Anita; McIntyre, Anne; Wiggett, Claire

    2012-06-01

    Internationally, there is evidence that hospital discharge to home for older adults is a complex and challenging process that is dependent upon multidisciplinary team working. At the centre of the discharge process is the management of risk, which involves occupational therapists and other healthcare professionals managing perceived dangers and determining why some dangers are seen as presenting risks while others are not. This study did not aim to explore interprofessional differences but to ascertain a greater understanding of professionals' perceptions of risk in acute care settings. This qualitative study utilised 12 semi-structured interviews with seven occupational therapists and five physiotherapists in the United Kingdom (UK). During the interview, therapists were asked to read and answer questions on a validated vignette. The interview data were subjected to thematic content analysis and the vignettes to template analysis. Our research is one of the first studies to explore therapists' perceptions of risk with older adults in acute care settings. Our study has highlighted that perception of risk does have an impact on discharge decision-making and location. Therapists used negative terminology to refer to patients who wanted to take risks, which could be a reflection of the therapists' anxiety. Mental capacity, and patients' functioning and safety were key factors in risk decision-making with older adults. Our research has highlighted the potential value of multidisciplinary working to manage risk situations and the need for reflection and discussion regarding how persons who do not have capacity wishes are managed within acute care settings. There is a need to develop an interprofessional care pathway to guide clinicians through the risk decision-making process which needs to ensure that the client's opinions and wishes are taken into account throughout.

  1. Career and Self-Construction of Emerging Adults: The Value of Life Designing

    PubMed Central

    Maree, Jacobus G.; Twigge, Adeline

    2016-01-01

    This article describes a potential way of counseling emerging adults from a life design perspective to construct a self that could enable them to be agents of both their own development and the development of others. Theoretical issues relating to a dynamic, developmental and systems framework of the understanding of wellbeing are described and the process involved is delineated. The research design was qualitative and comprised case studies. Six participants who subscribed to the definition of “emerging adults” and were comparatively representative of the ethnic diversity of South Africa, were selected purposively from a group of individuals who applied for career counseling in a private practice context. The intervention involved life design counseling and occurred over a period of 6 weeks. Information related to participants' self-construction was gathered using qualitative techniques, including the Career Interest Profile, the Career Construction Interview, a timeline, video clips, a collage, and semi-structured interviews. Following the intervention, the participants revealed heightened insights with regard to aspects of their sense of a relational-moral self. Results indicated that life design counseling could enhance elaborative personal development (enhancing self-awareness and reaping the benefits of developing an improved relational-moral self) and the promotion of an awareness of the importance to promote social justice in work-related contexts. PMID:26793152

  2. Designing Websites for Displaying Large Data Sets and Images on Multiple Platforms

    NASA Astrophysics Data System (ADS)

    Anderson, A.; Wolf, V. G.; Garron, J.; Kirschner, M.

    2012-12-01

    The desire to build websites to analyze and display ever increasing amounts of scientific data and images pushes for web site designs which utilize large displays, and to use the display area as efficiently as possible. Yet, scientists and users of their data are increasingly wishing to access these websites in the field and on mobile devices. This results in the need to develop websites that can support a wide range of devices and screen sizes, and to optimally use whatever display area is available. Historically, designers have addressed this issue by building two websites; one for mobile devices, and one for desktop environments, resulting in increased cost, duplicity of work, and longer development times. Recent advancements in web design technology and techniques have evolved which allow for the development of a single website that dynamically adjusts to the type of device being used to browse the website (smartphone, tablet, desktop). In addition they provide the opportunity to truly optimize whatever display area is available. HTML5 and CSS3 give web designers media query statements which allow design style sheets to be aware of the size of the display being used, and to format web content differently based upon the queried response. Web elements can be rendered in a different size, position, or even removed from the display entirely, based upon the size of the display area. Using HTML5/CSS3 media queries in this manner is referred to as "Responsive Web Design" (RWD). RWD in combination with technologies such as LESS and Twitter Bootstrap allow the web designer to build web sites which not only dynamically respond to the browser display size being used, but to do so in very controlled and intelligent ways, ensuring that good layout and graphic design principles are followed while doing so. At the University of Alaska Fairbanks, the Alaska Satellite Facility SAR Data Center (ASF) recently redesigned their popular Vertex application and converted it from a

  3. The Joyful Aging Club: An Example of Universal Design Practice on Architectural and Urban Settings.

    PubMed

    Guimarães, Marcelo Pinto; Picceli, Angelica Baldin; Pereira, Carolina Furtado

    2016-01-01

    Universal Design is a very simple idea that is based on complex decisions and it involves user satisfaction during performance of activities and socially inclusive interaction. Generally, the design guidelines for application in architecture requires that both students and professionals explore their imagination about the situations in which the design of a certain building becomes more pleasant and inviting than simply accessible to the needs of people with permanent and temporary disabilities. In this paper, the aim is to discuss peculiar aspects in the design of a three storey building that make it special. The result of technical solutions create environments that are not restricted to the boundaries of a site. It also encompasses the street, the crossing, the corner square and traffic signals and marks beside some accessible parking areas. The building design is an academic exploration of potential usage to an actual site. It belongs to an institution for social network of people aging above sixty-five year old. PMID:27534307

  4. Assessing the effectiveness of electronic brainstorming in an industrial setting : experimental design document.

    SciTech Connect

    Dornburg, Courtney C.; Stevens, Susan Marie; Davidson, George S.; Forsythe, James Chris

    2007-09-01

    An experiment is proposed which will compare the effectiveness of individual versus group brainstorming in addressing difficult, real world challenges. Previous research into electronic brainstorming has largely been limited to laboratory experiments using small groups of students answering questions irrelevant to an industrial setting. The proposed experiment attempts to extend current findings to real-world employees and organization-relevant challenges. Our employees will brainstorm ideas over the course of several days, echoing the real-world scenario in an industrial setting. The methodology and hypotheses to be tested are presented along with two questions for the experimental brainstorming sessions. One question has been used in prior work and will allow calibration of the new results with existing work. The second question qualifies as a complicated, perhaps even wickedly hard, question, with relevance to modern management practices.

  5. Relationship between obesity and antipsychotic drug use in the adult population: A longitudinal, retrospective claim database study in Primary Care settings

    PubMed Central

    Sicras-Mainar, Antoni; Navarro-Artieda, Ruth; Rejas-Gutiérrez, Javier; Blanca-Tamayo, Milagrosa

    2008-01-01

    Objective To describe the association between obesity and the use of antipsychotic drugs (APDs) in adult outpatients followed-up on in five Primary Care settings. Methods A longitudinal, retrospective design study carried out between July 2004 and June 2005, in patients who were included in a claim database and for whom an APD treatment had been registered. A body mass index (BMI) <30 kg/m2 was defined as obesity. The main measurements were: use of APDs, demographics, medical background and co-morbidities, and clinical parameters. Logistic regression analysis and ANCOVA with Bonferroni adjustment were applied to correct the model. Results A total of 42,437 subjects (mean age: 50.8 (18.4) years; women: 54.5%; obesity: 27.3% [95% confidence intervals (CI), 26.9%–27.7%]) were analyzed. A total of 1.3% of the patients were receiving APDs, without statistical differences in distribution by type of drug (typical: 48.8%; atypical: 51.2%). Obesity was associated with the use of APDs [OR = 1.5 (CI: 1.3–1.8)], hypertension [OR = 2.4 (CI: 2.2–2.5)], diabetes [OR = 1.4 (CI: 1.3–1.5)] and dyslipidemia [OR = 1.3 (CI: 1.2–1.4)], p < 0.0001 in all cases. BMI was significantly higher in subjects on APDs; 28.8 vs. 27.3 kg/m2, p = 0.002, and remained higher after adjusting by age and sex (mean difference 0.4 (CI: 0.1–0.7), p < 0.01). After adjusting by age, sex and the Charlson index, obese subjects generated higher average annual total costs than nonobese subjects; 811 (CI: 787–835) vs. 694 (CI: 679–709), respectively, p < 0.001. Conclusions Obesity was associated with the use of APDs, regardless of the type of drug, and with the presence of hypertension, diabetes and dyslipidemia. Obesity was also associated with substantially higher health care costs. PMID:18728769

  6. Biostatistical methods for demonstrating efficacy in the regulatory setting. An epistemological approach to adaptive designs.

    PubMed

    Koch, A

    2005-05-01

    Adaptive designs are one of the most promising developments in statistics with applications to clinical trials. Obviously the knowledge at the beginning of a clinical trial will always be limited. In consequence it may be considered necessary that the knowledge from accumulating information should be used to optimize the design of the trial. This paper discusses conditions under which this may be possible in phase III clinical trials where the principle aim is confirmation of hypotheses that have been developed in earlier stages of drug development.

  7. Analytic free-form lens design in 3D: coupling three ray sets using two lens surfaces.

    PubMed

    Duerr, Fabian; Benítez, Pablo; Miñano, Juan C; Meuret, Youri; Thienpont, Hugo

    2012-05-01

    The two-dimensional analytic optics design method presented in a previous paper [Opt. Express 20, 5576-5585 (2012)] is extended in this work to the three-dimensional case, enabling the coupling of three ray sets with two free-form lens surfaces. Fermat's principle is used to deduce additional sets of functional differential equations which make it possible to calculate the lens surfaces. Ray tracing simulations demonstrate the excellent imaging performance of the resulting free-form lenses described by more than 100 coefficients. PMID:22565708

  8. Computer Enabled Neuroplasticity Treatment: A Clinical Trial of a Novel Design for Neurofeedback Therapy in Adult ADHD

    PubMed Central

    Cowley, Benjamin; Holmström, Édua; Juurmaa, Kristiina; Kovarskis, Levas; Krause, Christina M.

    2016-01-01

    Background: We report a randomized controlled clinical trial of neurofeedback therapy intervention for ADHD/ADD in adults. We focus on internal mechanics of neurofeedback learning, to elucidate the primary role of cortical self-regulation in neurofeedback. We report initial results; more extensive analysis will follow. Methods: Trial has two phases: intervention and follow-up. The intervention consisted of neurofeedback treatment, including intake and outtake measurements, using a waiting-list control group. Treatment involved ~40 h-long sessions 2–5 times per week. Training involved either theta/beta or sensorimotor-rhythm regimes, adapted by adding a novel “inverse-training” condition to promote self-regulation. Follow-up (ongoing) will consist of self-report and executive function tests. Setting: Intake and outtake measurements were conducted at University of Helsinki. Treatment was administered at partner clinic Mental Capital Care, Helsinki. Randomization: We randomly allocated half the sample then adaptively allocated the remainder to minimize baseline differences in prognostic variables. Blinding: Waiting-list control design meant trial was not blinded. Participants: Fifty-four adult Finnish participants (mean age 36 years; 29 females) were recruited after screening by psychiatric review. Forty-four had ADHD diagnoses, 10 had ADD. Measurements: Symptoms were assessed by computerized attention test (T.O.V.A.) and self-report scales, at intake and outtake. Performance during neurofeedback trials was recorded. Results: Participants were recruited and completed intake measurements during summer 2012, before assignment to treatment and control, September 2012. Outtake measurements ran April-August 2013. After dropouts, 23 treatment and 21 waiting-list participants remained for analysis. Initial analysis showed that, compared to waiting-list control, neurofeedback promoted improvement of self-reported ADHD symptoms, but did not show transfer of learning to T

  9. How should nations measure the quality of end-of-life care for older adults? Recommendations for an international minimum data set.

    PubMed

    Casarett, David J; Teno, Joan; Higginson, Irene

    2006-11-01

    Nations face numerous challenges in providing high-quality end-of-life care for their citizens, and an aging population that has a prolonged trajectory of decline and substantial needs for care magnifies these challenges. As nations begin to address these challenges, it will be essential to determine whether their responses are effective, but current national data collection efforts are sporadic, and data are often collected only for patients who receive care through certain funding programs or provider organizations or in selected sites of care. Therefore, governments do not know whether their citizens are receiving adequate care, whether current programs are improving care, or how their outcomes compare with those of other countries. This article describes the importance of developing national minimum data sets that can be used to assess the quality of end-of-life care that older adults receive and recommends key variables that these data sets should include.

  10. Design of the Prevention of Adult Caries Study (PACS): A randomized clinical trial assessing the effect of a chlorhexidine dental coating for the prevention of adult caries

    PubMed Central

    2010-01-01

    Background Dental caries is one of the primary causes of tooth loss among adults. It is estimated to affect a majority of Americans aged 55 and older, with a disproportionately higher burden in disadvantaged populations. Although a number of treatments are currently in use for caries prevention in adults, evidence for their efficacy and effectiveness is limited. Methods/Design The Prevention of Adult Caries Study (PACS) is a multicenter, placebo-controlled, double-blind, randomized clinical trial of the efficacy of a chlorhexidine (10% w/v) dental coating in preventing adult caries. Participants (n = 983) were recruited from four different dental delivery systems serving four diverse communities, including one American Indian population, and were randomized to receive either chlorhexidine or a placebo treatment. The primary outcome is the net caries increment (including non-cavitated lesions) from baseline to 13 months of follow-up. A cost-effectiveness analysis also will be considered. Discussion This new dental treatment, if efficacious and approved for use by the Food and Drug Administration (FDA), would become a new in-office, anti-microbial agent for the prevention of adult caries in the United States. Trial Registration Number NCT00357877 PMID:20923557

  11. Prevalence and Predictors of Intestinal Helminth Infections Among Human Immunodeficiency Virus Type 1–Infected Adults in an Urban African Setting

    PubMed Central

    Modjarrad, Kayvon; Zulu, Isaac; Redden, David T.; Njobvu, Lungowe; Freedman, David O.; Vermund, Sten H.

    2009-01-01

    Sub-Saharan Africa is disproportionately burdened by intestinal helminth and human immunodeficiency virus (HIV)-1 infection. Recent evidence suggests detrimental immunologic effects from concomitant infection with the two pathogens. Few studies, however, have assessed the prevalence of and predictors for intestinal helminth infection among HIV-1–infected adults in urban African settings where HIV infection rates are highest. We collected and analyzed sociodemographic and parasitologic data from 297 HIV-1–infected adults (mean age = 31.1 years, 69% female) living in Lusaka, Zambia to assess the prevalence and associated predictors of helminth infection. We found at least one type of intestinal helminth in 24.9% of HIV-infected adults. Thirty-nine (52.7%) were infected with Ascaris lumbricoides, and 29 (39.2%) were infected with hookworm. More than 80% were light-intensity infections. A recent visit to a rural area, food shortage, and prior history of helminth infection were significant predictors of current helminth status. The high helminth prevalence and potential for adverse interactions between helminths and HIV suggests that helminth diagnosis and treatment should be part of routine HIV care. PMID:16222025

  12. Examining the effects of adult and peer mediated goal setting and feedback interventions for writing: Two studies.

    PubMed

    Alitto, Julianna; Malecki, Christine K; Coyle, Samantha; Santuzzi, Alecia

    2016-06-01

    The current study investigated the effects of goal setting and performance feedback on Curriculum Based Measurement in Written Expression (CBM-WE). This two-study investigation examined the utility of the intervention using two different delivery mechanisms. In Study 1, fourth grade students (n=114) were provided both with (a) feedback from their teachers regarding their performance on CBM-WE probes and (b) new weekly goals or no feedback and goals, once a week for a ten-week intervention period. Study 2 examined the effects of this intervention with a sample of fifth grade students (n=106) when feedback and individual goals were provided by peers within their classrooms twice weekly over the course of eight weeks compared to a practice only control condition. Results in both studies indicated that students receiving the goal setting and feedback intervention performed significantly higher on production-dependent writing indices post-intervention than control groups (ES=.12-.28). Implications regarding the usefulness of goal setting and feedback utilizing CBM procedures are discussed.

  13. Examining the effects of adult and peer mediated goal setting and feedback interventions for writing: Two studies.

    PubMed

    Alitto, Julianna; Malecki, Christine K; Coyle, Samantha; Santuzzi, Alecia

    2016-06-01

    The current study investigated the effects of goal setting and performance feedback on Curriculum Based Measurement in Written Expression (CBM-WE). This two-study investigation examined the utility of the intervention using two different delivery mechanisms. In Study 1, fourth grade students (n=114) were provided both with (a) feedback from their teachers regarding their performance on CBM-WE probes and (b) new weekly goals or no feedback and goals, once a week for a ten-week intervention period. Study 2 examined the effects of this intervention with a sample of fifth grade students (n=106) when feedback and individual goals were provided by peers within their classrooms twice weekly over the course of eight weeks compared to a practice only control condition. Results in both studies indicated that students receiving the goal setting and feedback intervention performed significantly higher on production-dependent writing indices post-intervention than control groups (ES=.12-.28). Implications regarding the usefulness of goal setting and feedback utilizing CBM procedures are discussed. PMID:27268571

  14. Use of CADD (Computer Aided Drafting and Design) in a construction setting

    SciTech Connect

    Ketcham, D.L.

    1988-01-01

    At the outset of the design for the Defense Waste Processing Facility (DWPF) it was determined to complete over 70 percent of the more than 7000 drawings on a Computer Aided Drafting and Design (CADD) system. This ambitious goal required the development of an integrated data base for plant design software systems to service a multi-discipline, engineering and management environment for the complex one-of-a-kind mega project. The implementation involved extensive training, special accounting and security provisions to meet QA requirements. It was found to be effective to train engineers as well as operators so that technical personnel could have direct access to the drawing files. This was particularly useful when designing and laying out close tolerance equipment in remotely maintained cells where clearances are critical. It was also beneficial to have the terminals located in the same areas as the engineering staff. Background drawings were maintained by one discipline and used as a reference file by the other disciplines. This reduced the chances of interferences and insured that the latest revisions were in use. 2 figs.

  15. Designing Serious Games for People with Disabilities: Game, Set and Match to the Wii™

    ERIC Educational Resources Information Center

    Evett, Lindsay; Ridley, Allan; Keating, Liz; Merritt, Liz; Merritt, Patrick; Shopland, Nick; Brown, David

    2011-01-01

    Serious games are effective and engaging learning resources for people with disabilities, and guidelines exist to make games accessible to people with disabilities. During research into designing accessible interfaces and games, it was noted that people who are blind often report enjoying playing Wii Sports. These games are pick-upand- play games…

  16. Analysis of variance of designed chromatographic data sets: The analysis of variance-target projection approach.

    PubMed

    Marini, Federico; de Beer, Dalene; Joubert, Elizabeth; Walczak, Beata

    2015-07-31

    Direct application of popular approaches, e.g., Principal Component Analysis (PCA) or Partial Least Squares (PLS) to chromatographic data originating from a well-designed experimental study including more than one factor is not recommended. In the case of a well-designed experiment involving two or more factors (crossed or nested), data are usually decomposed into the contributions associated with the studied factors (and with their interactions), and the individual effect matrices are then analyzed using, e.g., PCA, as in the case of ASCA (analysis of variance combined with simultaneous component analysis). As an alternative to the ASCA method, we propose the application of PLS followed by target projection (TP), which allows a one-factor representation of the model for each column in the design dummy matrix. PLS application follows after proper deflation of the experimental matrix, i.e., to what are called the residuals under the reduced ANOVA model. The proposed approach (ANOVA-TP) is well suited for the study of designed chromatographic data of complex samples. It allows testing of statistical significance of the studied effects, 'biomarker' identification, and enables straightforward visualization and accurate estimation of between- and within-class variance. The proposed approach has been successfully applied to a case study aimed at evaluating the effect of pasteurization on the concentrations of various phenolic constituents of rooibos tea of different quality grades and its outcomes have been compared to those of ASCA.

  17. Foregrounding Knowledge in E-Learning Design: An Illustration in a Museum Setting

    ERIC Educational Resources Information Center

    Carvalho, Lucila; Dong, Andy; Maton, Karl

    2015-01-01

    The nature of knowledge, and the various forms knowledge may take, is a neglected aspect of the development of e-learning environments. This paper uses Legitimation Code Theory (LCT) to conceptualise the organising principles of knowledge practices. As we will illustrate, when it comes to the design of e-learning, the organising principles of the…

  18. Mathematical Practices in a Technological Setting: A Design Research Experiment for Teaching Circle Properties

    ERIC Educational Resources Information Center

    Akyuz, Didem

    2016-01-01

    This article documents the classroom mathematical practices observed in a collegiate level teacher education course related to the circle topic. The course, which was prepared as design research, utilized a dynamic geometry environment which influenced the type and nature of the evolved mathematical practices. The study uses emergent perspective…

  19. Using the NIATx Model to Implement User-Centered Design of Technology for Older Adults

    PubMed Central

    Maus, Adam; Judkins, Julianne; Dinauer, Susan; Isham, Andrew; Johnson, Roberta; Landucci, Gina; Atwood, Amy K

    2016-01-01

    What models can effectively guide the creation of eHealth and mHealth technologies? This paper describes the use of the NIATx model as a framework for the user-centered design of a new technology for older adults. The NIATx model is a simple framework of process improvement based on the following principles derived from an analysis of decades of research from various industries about why some projects fail and others succeed: (1) Understand and involve the customer; (2) fix key problems; (3) pick an influential change leader; (4) get ideas from outside the field; (5) use rapid-cycle testing. This paper describes the use of these principles in technology development, the strengths and challenges of using this approach in this context, and lessons learned from the process. Overall, the NIATx model enabled us to produce a user-focused technology that the anecdotal evidence available so far suggests is engaging and useful to older adults. The first and fourth principles were especially important in developing the technology; the fourth proved the most challenging to use. PMID:27025985

  20. A model for the design and implementation of a participant recruitment registry for clinical studies of older adults

    PubMed Central

    Dowling, N Maritza; Olson, Nevin; Mish, Thomas; Kaprakattu, Preethy; Gleason, Carey

    2012-01-01

    Background The identification and enlistment of suitable participants into clinical studies is often challenging, requiring a large commitment of time and staff resources. The recruitment and retention of populations typically underrepresented in research present additional challenges to enrollment of sufficient numbers of participants in clinical studies. Inadequate participation may undermine the pace and direction of new treatment discoveries. Purpose Registries of potential research participants are powerful tools to support research by providing a framework to streamline screening and recruitment and to maintain a communication history with potential research participants. The authors present a model for the development and implementation of a web-based database system to support recruitment, enrollment, and retention of potential study participants in close alignment with the goals of the Wisconsin Alzheimer’s Disease Research Center (ADRC). Methods The required data elements and major information domains for the registry were identified using a structured problem-solving and system design approach and the collaboration of a multidisciplinary team of stakeholders. The system performance, utility, and usability were assessed through multiple iterations with the users. Results The process-oriented approach culminated in a multifaceted tool that combined contact management and potential research participant registration to assist with the challenges of recruitment and retention in clinical research. A unique feature of the registry design model was its contact management capabilities for efficient tracking of all contacts with registrants. Limitations We have focused on the development and implementation of a system for the recruitment of older adults with specific cognitive and medical characteristics. However, our procedures for identifying data needs and database system utility and functionality can be transferred easily to other populations and settings

  1. The effects of two physical fitness programs designed for mentally retarded adults.

    PubMed

    Montgomery, D L; Reid, G; Seidl, C

    1988-03-01

    The purpose of this study was to design a systematic program of fitness training that enhances physical fitness of mentally retarded adults in sheltered workshops. The first phase of the study was a six-month program conducted by physical education graduate students while the second phase was four months in duration and led by workshop employees. Instructors followed a manual containing 48 lesson plans that were specifically prepared for mentally retarded participants. The physical fitness programs were evaluated using the Canadian Standardized Test of Fitness. MANOVA results revealed that both the six-month and four-month programs increased the physical fitness of the mentally retarded workers, although cardiovascular endurance improved only as a function of the four-month program. PMID:3359364

  2. Reforming private drug coverage in Canada: inefficient drug benefit design and the barriers to change in unionized settings.

    PubMed

    O'Brady, Sean; Gagnon, Marc-André; Cassels, Alan

    2015-02-01

    Prescription drugs are the highest single cost component for employees' benefits packages in Canada. While industry literature considers cost-containment for prescription drug costs to be a priority for insurers and employers, the implementation of cost-containment measures for private drug plans in Canada remains more of a myth than a reality. Through 18 semi-structured phone interviews conducted with experts from private sector companies, unions, insurers and plan advisors, this study explores the reasons behind this incapacity to implement cost-containment measures by examining how private sector employers negotiate drug benefit design in unionized settings. Respondents were asked questions on how employee benefits are negotiated; the relationships between the players who influence drug benefit design; the role of these players' strategies in influencing plan design; the broad system that underpins drug benefit design; and the potential for a universal pharmacare program in Canada. The study shows that there is consensus about the need to educate employees and employers, more collaboration and data-sharing between these two sets of players, and for external intervention from government to help transform established norms in terms of private drug plan design. PMID:25498311

  3. Malaria is related to decreased nutritional status among male adolescents and adults in the setting of intense perennial transmission.

    PubMed

    Friedman, Jennifer F; Kurtis, Jonathan D; Mtalib, Ramadhan; Opollo, Malachi; Lanar, David E; Duffy, Patrick E

    2003-08-01

    We studied the impact of Plasmodium falciparum on nutritional status in a longitudinal cohort of 147 young men in western Kenya, where malaria transmission is intense and perennial. All volunteers received treatment to eradicate parasitemia and then provided weekly blood smears during a 16-week transmission season. We measured body mass index (BMI), pubertal development, frequency and density of parasitemia, and tumor necrosis factor (TNF)-alpha production by peripheral blood mononuclear cells. During early puberty, mean parasite density had a strong negative effect on the natural increase in BMI. Among older individuals, TNF-alpha production in response to malarial antigen predicted a significantly lower BMI (P<.03), equal to 4.6 kg for a man of average height. Our data indicate that burden of parasitemia has a detrimental effect on the nutritional status of early adolescents and that malaria may continue to influence nutritional status among older adolescents and adults via host elaboration of proinflammatory cytokines. These effects of malaria may have pervasive health and socioeconomic consequences in areas where malaria is endemic.

  4. A double blind, randomised controlled trial of glycerol adjuvant therapy in adult bacterial meningitis in a high HIV seroprevalence setting in Malawi

    PubMed Central

    Ajdukiewicz, Katherine M.B.; Cartwright, Katharine E.; Scarborough, Matthew; Mwambene, James B.; Goodson, Patrick; Molyneux, Malcolm E.; Zijlstra, Eduard E.; French, Neil; Whitty, Christopher J.M.; Lalloo, David G.

    2014-01-01

    Summary Background Southern Africa has a high incidence of bacterial meningitis in adults, often associated with HIV co-infection. Even with appropriate antibiotic therapy, mortality exceeds 50% and is not improved with corticosteroids. Glycerol adjuvant therapy reduced mortality and long-term morbidity (deafness) in bacterial meningitis in children and is being promoted. If similarly effective in adults, glycerol would provide a cheap, available adjuvant therapy in Africa. Methods Following a dose-finding study, we conducted a randomised double-blind placebo-controlled trial of oral glycerol in adults with bacterial meningitis. Patients with clinical and CSF findings suggestive of bacterial meningitis were randomised either to glycerol or an equivalent volume of sugar solution. The primary outcome was mortality at 40 days with secondary outcomes including disability and mortality restricted to pneumococcal disease. Findings 75ml glycerol QDS was best tolerated and was used for the main study. 265 patients were randomised to receive glycerol or placebo. The trial was stopped early on the advice of the Data and Safety Monitoring Board (DSMB) following a planned interim analysis. Mortality by day 40 was 61/125 (49%) in the placebo and 86/136 (69%) in the glycerol arms, Adjusted Odds Ratio 2·4 (95% CI 1·3-4·2 p0·003). There was no benefit from glycerol for death and disability by day 40 by intention to treat or in predefined subgroups. Two serious adverse events occurred possibly due to study drug. Interpretation Oral glycerol therapy did not improve mortality in adults with bacterial meningitis and cannot be recommended as a suitable adjuvant therapy in resource-poor settings with a high HIV prevalence. PMID:21334262

  5. A cross-culturally standardized set of pictures for younger and older adults: American and Chinese norms for name agreement, concept agreement, and familiarity.

    PubMed

    Yoon, Carolyn; Feinberg, Fred; Luo, Ting; Hedden, Trey; Gutchess, Angela Hall; Chen, Hiu-Ying Mary; Mikels, Joseph A; Jiao, Shulan; Park, Denise C

    2004-11-01

    The present study presents normative measures for 260 line drawings of everyday objects, found in Snodgrass and Vanderwart (1980), viewed by individuals in China and the United States. Within each cultural group, name agreement, concept agreement, and familiarity measures were obtained separately for younger adults and older adults. For a subset of 57 pictures (22%), there was equivalence in both name agreement and concept agreement, and for an additional subset of 29 pictures (11%), there was nonequivalent name agreement but equivalent concept agreement, across all culture-by-age groups. The data indicate substantial differences across culture-by-age groups in name agreement percentages and number of distinct name responses provided. We discovered significant differences between older and younger American adults in both name agreement percentages (67 pictures, or 26%) and concept agreement percentages (44 pictures, or 17%). Written naming responses collected for the entire set of Snodgrass and Vanderwart pictures showed shifts in both naming and concept agreement percentages over the intervening decades: Although correlations in name agreement were strong (r = .71, p < .001) between our younger American samples and those of Snodgrass and Vanderwart, name agreement percentages have changed for a substantial proportion (33%) of the 260 pictures; moreover, 63% of the stimuli for which Snodgrass and Vanderwart reported concept agreement now appear to differ. We provide comprehensive comparison statistics and tests for both the present study and prior ones, finding differences across numerous item-level measures. The corpus of data suggests that substantial differences in all measures can be found across age as well as culture, so that unequivocal conclusions with respect to cross-cultural or age-related differences in cognition can be made only when appropriate stimuli are selected for studies. Data for all 260 pictures, for each of the four groups, and all supporting

  6. Efficacies of designer biochars in improving biomass and nutrient uptake of winter wheat grown in a hard setting subsoil layer.

    PubMed

    Sigua, G C; Novak, J M; Watts, D W; Johnson, M G; Spokas, K

    2016-01-01

    In the Coastal Plains region of the United States, the hard setting subsoil layer of Norfolk soils results in low water holding capacity and nutrient retention, which often limits root development. In this region, the Norfolk soils are under intensive crop production that further depletes nutrients and reduces organic carbon (C). Incorporation of pyrolyzed organic residues or "biochars" can provide an alternative recalcitrant C source. However, biochar quality and effect can be inconsistent and different biochars react differently in soils. We hypothesized that addition of different designer biochars will have variable effects on biomass and nutrient uptake of winter wheat. The objective of this study was to investigate the effects of designer biochars on biomass productivity and nutrient uptake of winter wheat (Triticum aestivum L.) in a Norfolk's hard setting subsoil layer. Biochars were added to Norfolk's hard setting subsoil layer at the rate of 40 Mg ha(-1). The different sources of biochars were: plant-based (pine chips, PC); animal-based (poultry litter, PL); 50:50 blend (50% PC:50% PL); 80:20 blend (80% PC:20% PL); and hardwood (HW). Aboveground and belowground biomass and nutrient uptake of winter wheat varied significantly (p⩽0.0001) with the different designer biochar applications. The greatest increase in the belowground biomass of winter wheat over the control was from 80:20 blend of PC:PL (81%) followed by HW (76%), PC (59%) and 50:50 blend of PC:PL (9%). However, application of PL resulted in significant reduction of belowground biomass by about 82% when compared to the control plants. The average uptake of P, K, Ca, Mg, Na, Al, Fe, Cu and Zn in both the aboveground and belowground biomass of winter wheat varied remarkably with biochar treatments. Overall, our results showed promising significance for the treatment of a Norfolk's hard setting subsoil layer since designer biochars did improve both aboveground/belowground biomass and nutrient uptake

  7. Is it design or is it inquiry? Exploring technology research in a Filipino school setting

    NASA Astrophysics Data System (ADS)

    Yazon, Jessamyn Marie Olivares

    My case study explored Filipino secondary students' and teachers' experiences with technology research, project-based pedagogy. The study was conducted to examine the nature of a Technology Research (TR) Curriculum, and how it mediates non-Western students' learning, and interest in technology-based careers. The context for my study is Philippine Science High School's (PSHS) TR program wherein students outline a proposal, design an experiment or a device, and implement their design to address a real world problem. My data sources included semi-structured interviews of 27 students and 2 teachers; participant observations of classroom and group activities, teacher-student consultations, and Science-Technology Fair presentations; TR curriculum documents; and researcher journal logs. My examination of curriculum documents revealed that since the 1960s, the Philippine government has implemented specialized educational programs, such as the PSHS Science/Technology Streaming and TR programs, to support Filipino youth interested in science and technology courses and careers. Data analyses showed that the TR program provided a rich, practical learning environment where 'doing technology design' blended with 'doing science inquiry'. The TR activities enhanced student understanding of science and technology; helped them integrate and apply knowledge and skills learned from other school subjects; encouraged them to be creative, problem-solvers; and helped develop their lifelong learning skills. Students recognized that TR teachers adopted alternative instructional strategies that prompted students to adopt more active roles in their learning. Research findings revealed that student interest in pursuing technology-related careers was supported by their participation in the streaming and the TR programs. Data also showed that Filipino cultural practices mediated student learning, and career decision-making. My research findings suggest that present notions of scientific inquiry

  8. Designing and Evaluating Standard-Setting Procedures for Licensure and Certification Tests.

    PubMed

    Kane, M.T.; Crooks, T.J.; Cohen, A.S.

    1999-01-01

    Passing scores for licensure and certification tests are justified by showing that decisions based on the passing score achieve the purposes of the credentialing program while avoiding any serious negative consequences. The standard should be high enough to provide adequate protection for the public, and not so high as to unnecessarily restrict the supply of qualified practitioners or to exclude competent candidates from practicing. This paper begins by examining the intended outcomes of licensure and certification programs and by outlining the interpretive argument that is typically used for written credentialing examinations. Criteria are then developed for evaluating standard-setting methods in terms of how well they serve the goals of protecting the public, maintaining an adequate supply of practitioners, and protecting the rights of candidates. Finally, the criteria are used to evaluate the Angoff method. This analysis identifies two potential sources of bias in the Angoff method, and suggests ways to control these weaknesses.

  9. [Evidence-based health promotion and prevention in settings: which types of study designs are needed?].

    PubMed

    Gerhardus, Ansgar; Rehfuess, Eva; Zeeb, Hajo

    2015-01-01

    Health promotion and health prevention are cornerstones of public health. In Germany, a draft health prevention law was rejected in 2013, partly because it almost exclusively focused on measures at the individual level. Many health promotion and prevention measures, by contrast, (also) address the societal level and the environment, but there are few robust studies on their effectiveness, not least because of a lack of resources, the complexity of the measures, or randomisation problems. For example, regulations that protect non-smokers from smoke are subject to political processes where the majority of decision-makers would decline consent for randomisation. In a workshop at the 15(th) Annual Meeting of the German Network for Evidence-based Medicine (DNEbM) two case studies on controlled before-and-after studies (CBA) and interrupted time series (ITS) were developed by the audience as possible alternatives to randomised controlled trials for the evaluation of health promotion and health prevention programmes. The suggestions made by the audience were compared to the study designs chosen in published studies, and the strengths and weaknesses of the different study designs were discussed. The wide array of suggestions for effectiveness studies illustrated the potential of evidence-based health promotion and prevention, but also the specific challenges to be faced.

  10. Validation of Five Minimally Obstructive Methods to Estimate Physical Activity Energy Expenditure in Young Adults in Semi-Standardized Settings

    PubMed Central

    Schneller, Mikkel B.; Pedersen, Mogens T.; Gupta, Nidhi; Aadahl, Mette; Holtermann, Andreas

    2015-01-01

    We compared the accuracy of five objective methods, including two newly developed methods combining accelerometry and activity type recognition (Acti4), against indirect calorimetry, to estimate total energy expenditure (EE) of different activities in semi-standardized settings. Fourteen participants performed a standardized and semi-standardized protocol including seven daily life activity types, while having their EE measured by indirect calorimetry. Simultaneously, physical activity was quantified by an ActivPAL3, two ActiGraph GT3X+’s and an Actiheart. EE was estimated by the standard ActivPAL3 software (ActivPAL), ActiGraph GT3X+ (ActiGraph) and Actiheart (Actiheart), and by a combination of activity type recognition via Acti4 software and activity counts per minute (CPM) of either a hip- or thigh-worn ActiGraph GT3X+ (AGhip + Acti4 and AGthigh + Acti4). At group level, estimated physical activities EE by Actiheart (MSE = 2.05) and AGthigh + Acti4 (MSE = 0.25) were not significantly different from measured EE by indirect calorimetry, while significantly underestimated by ActiGraph, ActivPAL and AGhip + Acti4. AGthigh + Acti4 and Actiheart explained 77% and 45%, of the individual variations in measured physical activity EE by indirect calorimetry, respectively. This study concludes that combining accelerometer data from a thigh-worn ActiGraph GT3X+ with activity type recognition improved the accuracy of activity specific EE estimation against indirect calorimetry in semi-standardized settings compared to previously validated methods using CPM only. PMID:25781506

  11. Acceptance of an assistive robot in older adults: a mixed-method study of human–robot interaction over a 1-month period in the Living Lab setting

    PubMed Central

    Wu, Ya-Huei; Wrobel, Jérémy; Cornuet, Mélanie; Kerhervé, Hélène; Damnée, Souad; Rigaud, Anne-Sophie

    2014-01-01

    Background There is growing interest in investigating acceptance of robots, which are increasingly being proposed as one form of assistive technology to support older adults, maintain their independence, and enhance their well-being. In the present study, we aimed to observe robot-acceptance in older adults, particularly subsequent to a 1-month direct experience with a robot. Subjects and methods Six older adults with mild cognitive impairment (MCI) and five cognitively intact healthy (CIH) older adults were recruited. Participants interacted with an assistive robot in the Living Lab once a week for 4 weeks. After being shown how to use the robot, participants performed tasks to simulate robot use in everyday life. Mixed methods, comprising a robot-acceptance questionnaire, semistructured interviews, usability-performance measures, and a focus group, were used. Results Both CIH and MCI subjects were able to learn how to use the robot. However, MCI subjects needed more time to perform tasks after a 1-week period of not using the robot. Both groups rated similarly on the robot-acceptance questionnaire. They showed low intention to use the robot, as well as negative attitudes toward and negative images of this device. They did not perceive it as useful in their daily life. However, they found it easy to use, amusing, and not threatening. In addition, social influence was perceived as powerful on robot adoption. Direct experience with the robot did not change the way the participants rated robots in their acceptance questionnaire. We identified several barriers to robot-acceptance, including older adults’ uneasiness with technology, feeling of stigmatization, and ethical/societal issues associated with robot use. Conclusion It is important to destigmatize images of assistive robots to facilitate their acceptance. Universal design aiming to increase the market for and production of products that are usable by everyone (to the greatest extent possible) might help to

  12. The Direct Assignment Option as a Modular Design Component: An Example for the Setting of Two Predefined Subgroups

    PubMed Central

    An, Ming-Wen; Lu, Xin; Sargent, Daniel J.; Mandrekar, Sumithra J.

    2015-01-01

    Background. A phase II design with an option for direct assignment (stop randomization and assign all patients to experimental treatment based on interim analysis, IA) for a predefined subgroup was previously proposed. Here, we illustrate the modularity of the direct assignment option by applying it to the setting of two predefined subgroups and testing for separate subgroup main effects. Methods. We power the 2-subgroup direct assignment option design with 1 IA (DAD-1) to test for separate subgroup main effects, with assessment of power to detect an interaction in a post-hoc test. Simulations assessed the statistical properties of this design compared to the 2-subgroup balanced randomized design with 1 IA, BRD-1. Different response rates for treatment/control in subgroup 1 (0.4/0.2) and in subgroup 2 (0.1/0.2, 0.4/0.2) were considered. Results. The 2-subgroup DAD-1 preserves power and type I error rate compared to the 2-subgroup BRD-1, while exhibiting reasonable power in a post-hoc test for interaction. Conclusion. The direct assignment option is a flexible design component that can be incorporated into broader design frameworks, while maintaining desirable statistical properties, clinical appeal, and logistical simplicity. PMID:25649690

  13. A multimedia adult literacy program: Combining NASA technology, instructional design theory, and authentic literacy concepts

    NASA Technical Reports Server (NTRS)

    Willis, Jerry W.

    1993-01-01

    be the most effective or most desirable way to use computer technology in literacy programs. This project is developing a series of instructional packages that are based on a different instructional model - authentic instruction. The instructional development model used to create these packages is also different. Instead of using the traditional five stage linear, sequential model based on behavioral learning theory, the project uses the recursive, reflective design and development model (R2D2) that is based on cognitive learning theory, particularly the social constructivism of Vygotsky, and an epistemology based on critical theory. Using alternative instructional and instructional development theories, the result of the summer faculty fellowship is LiteraCity, a multimedia adult literacy instructional package that is a simulation of finding and applying for a job. The program, which is about 120 megabytes, is distributed on CD-ROM.

  14. Calculation set for design and optimization of vegetative soil covers Sandia National Laboratories, Albuquerque, New Mexico.

    SciTech Connect

    Peace, Gerald L.; Goering, Timothy James (GRAM, Inc., Albuquerque, NM)

    2005-02-01

    This study demonstrates that containment of municipal and hazardous waste in arid and semiarid environments can be accomplished effectively without traditional, synthetic materials and complex, multi-layer systems. This research demonstrates that closure covers combining layers of natural soil, native plant species, and climatic conditions to form a sustainable, functioning ecosystem will meet the technical equivalency criteria prescribed by the U. S. Environmental Protection Agency. In this study, percolation through a natural analogue and an engineered cover is simulated using the one-dimensional, numerical code UNSAT-H. UNSAT-H is a Richards. equation-based model that simulates soil water infiltration, unsaturated flow, redistribution, evaporation, plant transpiration, and deep percolation. This study incorporates conservative, site-specific soil hydraulic and vegetation parameters. Historical meteorological data are used to simulate percolation through the natural analogue and an engineered cover, with and without vegetation. This study indicates that a 3-foot (ft) cover in arid and semiarid environments is the minimum design thickness necessary to meet the U. S. Environmental Protection Agency-prescribed technical equivalency criteria of 31.5 millimeters/year and 1 x 10{sup -7} centimeters/second for net annual percolation and average flux, respectively. Increasing cover thickness to 4 or 5 ft results in limited additional improvement in cover performance.

  15. Designer Self-Assembling Peptide Nanofiber Scaffolds for Adult Mouse Neural Stem Cell 3-Dimensional Cultures

    PubMed Central

    Gelain, Fabrizio; Bottai, Daniele; Vescovi, Angleo; Zhang, Shuguang

    2006-01-01

    Biomedical researchers have become increasingly aware of the limitations of conventional 2-dimensional tissue cell culture systems, including coated Petri dishes, multi-well plates and slides, to fully address many critical issues in cell biology, cancer biology and neurobiology, such as the 3-D microenvironment, 3-D gradient diffusion, 3-D cell migration and 3-D cell-cell contact interactions. In order to fully understand how cells behave in the 3-D body, it is important to develop a well-controlled 3-D cell culture system where every single ingredient is known. Here we report the development of a 3-D cell culture system using a designer peptide nanofiber scaffold with mouse adult neural stem cells. We attached several functional motifs, including cell adhesion, differentiation and bone marrow homing motifs, to a self-assembling peptide RADA16 (Ac-RADARADARADARADA-COHN2). These functionalized peptides undergo self-assembly into a nanofiber structure similar to Matrigel. During cell culture, the cells were fully embedded in the 3-D environment of the scaffold. Two of the peptide scaffolds containing bone marrow homing motifs significantly enhanced the neural cell survival without extra soluble growth and neurotrophic factors to the routine cell culture media. In these designer scaffolds, the cell populations with β-Tubulin+, GFAP+ and Nestin+ markers are similar to those found in cell populations cultured on Matrigel. The gene expression profiling array experiments showed selective gene expression, possibly involved in neural stem cell adhesion and differentiation. Because the synthetic peptides are intrinsically pure and a number of desired function cellular motifs are easy to incorporate, these designer peptide nanofiber scaffolds provide a promising controlled 3-D culture system for diverse tissue cells, and are useful as well for general molecular and cell biology. PMID:17205123

  16. A training program designed to improve interprofessional knowledge, skills and attitudes in chronic disease settings.

    PubMed

    Bain, Lorna; Kennedy, Carol; Archibald, Douglas; LePage, Jennifer; Thorne, Carter

    2014-09-01

    For over 25 years, The Arthritis Program (TAP) at Southlake Regional Health Centre has worked within a successful interprofessional model. TAP recognized the need to teach its model and developed The Arthritis Program - Interprofessional Training Program (TAP-ITP). This pilot study evaluated perceptions of 22 TAP-ITP participants related to effectiveness and satisfaction. The study employed a longitudinal survey design and data were collected at the baseline (T1), post-program (T2), and at one year (T3) by use of the following instruments: W(e)Learn Program Assessment; Interprofessional (IP) Learner and Team Contracts; Interprofessional Collaborative Competencies Attainment Survey (ICCAS); Bruyère Clinical Team Self Assessment Scale; and Attitudes Toward Health Care Teams (ATHCT). Data analysis included descriptive, non-parametric and parametric tests. Results indicated participants were very satisfied with TAP-ITP. ICCAS scores revealed statistically significant differences (Wilcoxon rank sum tests) from T1 to T2 in perceptions of IPC competencies (p < 0.05). Paired t-tests for each T1 to post (T2 and T3) scores were all significant (p < 0.05) for each Bruyère subscale and overall scores. For ATHCT, paired t-tests for each T1 to T2 were significant for Quality of Care/Process (p = 0.04) and borderline significant for Physician Centrality scale (p = 0.06). At T3, improvement in both scales was maintained. This pilot study suggests that TAP-ITP improves self-assessed scores of knowledge and skills, as well as attitudes in interprofessional care post-program and sustained at one year. PMID:24646204

  17. A basis set of de novo coiled-coil peptide oligomers for rational protein design and synthetic biology.

    PubMed

    Fletcher, Jordan M; Boyle, Aimee L; Bruning, Marc; Bartlett, Gail J; Vincent, Thomas L; Zaccai, Nathan R; Armstrong, Craig T; Bromley, Elizabeth H C; Booth, Paula J; Brady, R Leo; Thomson, Andrew R; Woolfson, Derek N

    2012-06-15

    Protein engineering, chemical biology, and synthetic biology would benefit from toolkits of peptide and protein components that could be exchanged reliably between systems while maintaining their structural and functional integrity. Ideally, such components should be highly defined and predictable in all respects of sequence, structure, stability, interactions, and function. To establish one such toolkit, here we present a basis set of de novo designed α-helical coiled-coil peptides that adopt defined and well-characterized parallel dimeric, trimeric, and tetrameric states. The designs are based on sequence-to-structure relationships both from the literature and analysis of a database of known coiled-coil X-ray crystal structures. These give foreground sequences to specify the targeted oligomer state. A key feature of the design process is that sequence positions outside of these sites are considered non-essential for structural specificity; as such, they are referred to as the background, are kept non-descript, and are available for mutation as required later. Synthetic peptides were characterized in solution by circular-dichroism spectroscopy and analytical ultracentrifugation, and their structures were determined by X-ray crystallography. Intriguingly, a hitherto widely used empirical rule-of-thumb for coiled-coil dimer specification does not hold in the designed system. However, the desired oligomeric state is achieved by database-informed redesign of that particular foreground and confirmed experimentally. We envisage that the basis set will be of use in directing and controlling protein assembly, with potential applications in chemical and synthetic biology. To help with such endeavors, we introduce Pcomp, an on-line registry of peptide components for protein-design and synthetic-biology applications. PMID:23651206

  18. Design and fabrication of a novel porous implant with pre-set channels based on ceramic stereolithography for vascular implantation.

    PubMed

    Bian, Weiguo; Li, Dichen; Lian, Qin; Zhang, Weijie; Zhu, Linzhong; Li, Xiang; Jin, Zhongmin

    2011-09-01

    Being a multi-etiological factors disease, osteonecrosis of the femoral head affects many young people, leading to the collapse of the femur head; eventually the hip arthroplasty is needed if not treated in time. Unfortunately, as yet, no satisfactory therapy to repair necrotic bone at an early stage is present. Novel implants with pre-set channels were designed for the treatment of early femoral head necrosis. Ceramic stereolithography was applied to fabricate the green part from β-TCP powder. Other processes, such as dehydration, rinsing, drying and sintering, were processed successively. The final ceramic part remains the same as the engineered part in both shape and internal structure. No significant deformation or crack occurred. X-ray diffraction showed that no facies changed or chemical reaction occurred during the fabrication process. The chemical composition remains the same as that of the original β-TCP powder. The compressive strength is 23.54 MPa, close to that of natural cancellous bone. Novel implants with a pre-set channel were designed and fabricated for blood vessel implantation. Bioceramic stereolithography technology based directly on the CAD model in this research shows advantages in accurate design, optimization of 3D scaffold and critical control of the fabrication process. This proposed implant shows promising clinical application in the restoration of early femoral head necrosis.

  19. Influenza and Seasonal Patterns of Hospital Use by Older Adults in Long-Term Care and Community Settings in Ontario, Canada

    PubMed Central

    Kwong, Jeff C.; Campitelli, Michael A.; Newman, Alice; Anderson, Geoffrey M.; Rochon, Paula A.; Mor, Vincent

    2014-01-01

    Objectives. We compared seasonal influenza hospital use among older adults in long-term care (LTC) and community settings. Methods. We used provincial administrative data from Ontario to identify all emergency department (ED) visits and hospital admissions for pneumonia and influenza among adults older than 65 years between 2002 and 2008. We used sentinel laboratory reports to define influenza and summer seasons and estimated mean annual event rates and influenza-associated rates. Results. Mean annual pneumonia and influenza ED visit rates were higher in LTC than the community (rate ratio [RR] for influenza season = 3.9; 95% confidence interval [CI] = 3.8, 4.0; for summer = 4.9; 95% CI = 4.8, 5.1) but this was attenuated in influenza-associated rates (RR = 2.4; 95% CI = 2.1, 2.8). The proportion of pneumonia and influenza ED visits attributable to seasonal influenza was 17% (15%–20%) in LTC and 28% (27%–29%) in the community. Results for hospital admissions were comparable. Conclusions. We found high rates of hospital use from LTC but evidence of lower impact of circulating influenza in the community. This differential impact of circulating influenza between the 2 environments may result from different influenza control policies. PMID:24328631

  20. Improving Medication Knowledge among Older Adults with Heart Failure: A Patient-Centered Approach to Instruction Design

    ERIC Educational Resources Information Center

    Morrow, Daniel G.; Weiner, Michael; Young, James; Steinley, Douglas; Deer, Melissa; Murray, Michael D.

    2005-01-01

    Purpose: We investigated whether patient-centered instructions for chronic heart failure medications increase comprehension and memory for medication information in older adults diagnosed with chronic heart failure. Design and Methods: Patient-centered instructions for familiar and unfamiliar medications were compared with instructions for the…

  1. Enantiodivergent Fluorination of Allylic Alcohols: Data Set Design Reveals Structural Interplay between Achiral Directing Group and Chiral Anion.

    PubMed

    Neel, Andrew J; Milo, Anat; Sigman, Matthew S; Toste, F Dean

    2016-03-23

    Enantioselectivity values represent relative rate measurements that are sensitive to the structural features of the substrates and catalysts interacting to produce them. Therefore, well-designed enantioselectivity data sets are information rich and can provide key insights regarding specific molecular interactions. However, if the mechanism for enantioselection varies throughout a data set, these values cannot be easily compared. This premise, which is the crux of free energy relationships, exposes a challenging issue of identifying mechanistic breaks within multivariate correlations. Herein, we describe an approach to addressing this problem in the context of a chiral phosphoric acid catalyzed fluorination of allylic alcohols using aryl boronic acids as transient directing groups. By designing a data set in which both the phosphoric and boronic acid structures were systematically varied, key enantioselectivity outliers were identified and analyzed. A mechanistic study was executed to reveal the structural origins of these outliers, which was consistent with the presence of several mechanistic regimes within the data set. While 2- and 4-substituted aryl boronic acids favored the (R)-enantiomer with most of the studied catalysts, meta-alkoxy substituted aryl boronic acids resulted in the (S)-enantiomer when used in combination with certain (R)-phosphoric acids. We propose that this selectivity reversal is the result of a lone pair-π interaction between the substrate ligated boronic acid and the phosphate. On the basis of this proposal, a catalyst system was identified, capable of producing either enantiomer in high enantioselectivity (77% (R)-2 to 92% (S)-2) using the same chiral catalyst by subtly changing the structure of the achiral boronic acid.

  2. Obesity Prevention Practices and Policies in Child Care Settings Enrolled and Not Enrolled in the Child and Adult Care Food Program.

    PubMed

    Liu, Sherry T; Graffagino, Cheryl L; Leser, Kendall A; Trombetta, Autumn L; Pirie, Phyllis L

    2016-09-01

    Objectives The United States Department of Agriculture's Child and Adult Care Food Program (CACFP) provides meals and snacks to low-income children in child care. This study compared nutrition and physical activity practices and policies as well as the overall nutrition and physical activity environments in a sample of CACFP and non-CACFP child care settings. Methods A random stratified sample of 350 child care settings in a large Midwestern city and its suburbs, was mailed a survey on obesity prevention practices and policies concerning menu offerings, feeding practices, nutrition and physical activity education, activity levels, training, and screen time. Completed surveys were obtained from 229 of 309 eligible child care settings (74.1 % response rate). Chi square tests were used to compare practices and policies in CACFP and non-CACFP sites. Poisson and negative binomial regression were used to examine associations between CACFP and total number of practices and policies. Results Sixty-nine percent of child care settings reported CACFP participation. A significantly higher proportion of CACFP sites reported offering whole grain foods daily and that providers always eat the same foods that are offered to the children. CACFP sites had 1.1 times as many supportive nutrition practices as non-CACFP sites. CACFP participation was not associated with written policies or physical activity practices. Conclusions for Practice There is room for improvement across nutrition and physical activity practices and policies. In addition to food reimbursement, CACFP participation may help promote child care environments that support healthy nutrition; however, additional training and education outreach activities may be needed.

  3. Addressing the Complexity of Mobile App Design in Hospital Setting with a Tailored Software Development Life Cycle Model.

    PubMed

    Ehrler, Frederic; Lovis, Christian; Blondon, Katherine

    2016-01-01

    Recent studies on workflow processes in hospital settings have shown that, since the introduction of EHRs, care-providers spend an increasing amount of their time on documentation rather than on bedside patient care. In order to improve the bedside work process and facilitate bedside documentation, we are developing an evidence-based mobile app for healthcare providers. In this paper, we present a tailored software development life cycle model that we created and validated during the design and development of this smartphone application. PMID:27577371

  4. Transitions between child and adult mental health services: service design, philosophy and meaning at uncertain times.

    PubMed

    Murcott, W J

    2014-09-01

    A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services.

  5. Sex Differences in Biopsychosocial Correlates of Binge Eating Disorder: A Study of Treatment-Seeking Obese Adults in Primary Care Setting

    PubMed Central

    Udo, Tomoko; McKee, Sherry A.; White, Marney A.; Masheb, Robin M.; Barnes, Rachel D.; Grilo, Carlos M.

    2013-01-01

    Objective Although community-based studies suggest equivalent levels of physical and psychological impairment by BED in men and women, men with binge eating disorder (BED) are still underrepresented in clinical studies. This study aimed to provide a comprehensive analysis of sex differences in biopsychosocial correlates of treatment-seeking obese patients with BED in primary care. Method One-hundred-ninety obese adults (26% men) were recruited in primary care settings for a treatment study for obesity and BED. Results Very few significant sex differences were found in the developmental history and in current levels of eating-disorder features, as well as psychosocial factors. Women reported significantly earlier age at onset of overweight and dieting, and greater frequency of dieting. Men reported more frequent strenuous exercise. Men were more likely than women to meet criteria for metabolic syndrome (MetS); men were more likely to show clinically elevated levels of triglycerides, blood pressure, and fasting glucose levels. Conclusion Despite few sex differences in behavioral and psychosocial factors, metabolic problems associated with obesity were more common among treatment-seeking obese men with BED than women. The findings highlight the importance of including men in clinical studies of BED, and active screening of BED in obese men at primary care settings. PMID:23969142

  6. Ameliorating soil chemical properties of a hard setting subsoil layer in Coastal Plain USA with different designer biochars.

    PubMed

    Sigua, G C; Novak, J M; Watts, D W

    2016-01-01

    Biochar application is an emerging management option to increase soil fertility. Biochars could improve chemical properties of soils with hard setting subsoil layer. However, biochar effect can be inconsistent because different biochars react differently in soils. We hypothesized that addition of designer biochars will have variable effects on improving the chemical properties of hard setting layers. The objective of this study was to investigate the effects of biochars on soil properties in Norfolk's soil with a hard setting subsoil layer grown with winter wheat (Triticum aestivum L.). All designer biochars were added at the rate of 40 Mg ha(-1). Feedstocks used for biochars production were: plant-based (pine chips, 100% PC); animal-based (poultry litter, 100% PL); 50:50 blend (50% PC:50% PL); 80:20 blend (80% PC:20% PL); and hardwood (100% HW). Higher nutrient availability was found after additions of biochars especially additions of 100% PL and 50:50 blend of PC and PL. On the average, applications of 100% PL and 50:50 blend of PC:PL had the greatest amount of soil total nitrogen with means of 1.94±0.3% and 1.44±0.3%, respectively. When compared with the control and other biochars, 50:50 blend of PC:PL additions resulted in increase of 669% for P, 830% for K, 307% for Ca, 687% for Mg and 2315% for Na while application of 100% PL increased the concentration of extractable P, K, Ca, Mg, and Na by 363%, 1349%, 152%, 363%, and 3152%, respectively. Overall, our results showed promising significance since biochars did improve chemical properties of a Norfolk's soil.

  7. Alignment-Free Design of Highly Discriminatory Diagnostic Primer Sets for Escherichia coli O104:H4 Outbreak Strains

    PubMed Central

    Bielaszewska, Martina; Karch, Helge; Toth, Ian K.

    2012-01-01

    Background An Escherichia coli O104:H4 outbreak in Germany in summer 2011 caused 53 deaths, over 4000 individual infections across Europe, and considerable economic, social and political impact. This outbreak was the first in a position to exploit rapid, benchtop high-throughput sequencing (HTS) technologies and crowdsourced data analysis early in its investigation, establishing a new paradigm for rapid response to disease threats. We describe a novel strategy for design of diagnostic PCR primers that exploited this rapid draft bacterial genome sequencing to distinguish between E. coli O104:H4 outbreak isolates and other pathogenic E. coli isolates, including the historical hæmolytic uræmic syndrome (HUSEC) E. coli HUSEC041 O104:H4 strain, which possesses the same serotype as the outbreak isolates. Methodology/Principal Findings Primers were designed using a novel alignment-free strategy against eleven draft whole genome assemblies of E. coli O104:H4 German outbreak isolates from the E. coli O104:H4 Genome Analysis Crowd-Sourcing Consortium website, and a negative sequence set containing 69 E. coli chromosome and plasmid sequences from public databases. Validation in vitro against 21 ‘positive’ E. coli O104:H4 outbreak and 32 ‘negative’ non-outbreak EHEC isolates indicated that individual primer sets exhibited 100% sensitivity for outbreak isolates, with false positive rates of between 9% and 22%. A minimal combination of two primers discriminated between outbreak and non-outbreak E. coli isolates with 100% sensitivity and 100% specificity. Conclusions/Significance Draft genomes of isolates of disease outbreak bacteria enable high throughput primer design and enhanced diagnostic performance in comparison to traditional molecular assays. Future outbreak investigations will be able to harness HTS rapidly to generate draft genome sequences and diagnostic primer sets, greatly facilitating epidemiology and clinical diagnostics. We expect that high throughput

  8. Older Adults' Training Courses: Considerations for Course Design and the Development of Learning Materials

    ERIC Educational Resources Information Center

    du Plessis, Karin; Anstey, Kaarin J.; Schlumpp, Arianne

    2011-01-01

    Demographic trends indicate that older adults live longer and maintain active lifestyles. The majority are educated and many enjoy the stimulation that ongoing learning opportunities present. In order for these older adults to benefit from learning opportunities, circumstances specific to these individuals (e.g. age-related decline) need to be…

  9. Student Perceptions of Active Instructional Designs in Four Inner City Adult Education Math Classes

    ERIC Educational Resources Information Center

    Johnson, LaToya S.

    2010-01-01

    The focus of this study was to examine the attitudes, experiences, and opinions of adult math students in Adult Basic Education programs. Sixty students participated in the study, by completing observations, questionnaires, and completing the Attitude Towards Mathematics Survey (ATMS). The ATMS survey analyzed four factors. These factors included…

  10. Bringing Adults Back to College: Designing and Implementing a Statewide Concierge Model

    ERIC Educational Resources Information Center

    Michelau, Demaree K.; Lane, Patrick

    2010-01-01

    A ready adult (or reentry) concierge is a single-point of contact at a college or university who helps returning adult students navigate the application, enrollment, and registration processes and overcome barriers to college success. To better understand the barriers faced by students in the reenrollment process and how the Concierge Model can…

  11. Are decreases in drug use risk associated with reductions in HIV sex risk behaviors among adults in an urban hospital primary care setting?

    PubMed

    Walter, Angela Wangari; Cheng, Debbie M; Lloyd-Travaglini, Christine A; Samet, Jeffrey H; Bernstein, Judith; Saitz, Richard

    2016-12-01

    Drug use is associated with increased sexual risk behaviors. We examined whether decreases in drug use risk are associated with reduction in HIV-related sex risk behaviors among adults. Data was from a cohort of participants (n = 574) identified by drug use screening in a randomized trial of brief intervention for drug use in an urban primary care setting. Inverse probability of treatment weighted (IPTW) logistic regression models were used to examine the relationship between decreases in drug use risk and sex-related HIV risk behavior reduction from study entry to six months. Weights were derived from propensity score modeling of decreases in drug use risk as a function of potential confounders. Thirty seven percent of the study participants (213/574) reported a decrease in drug use risk, and 7% (33/505) reported decreased sex-related HIV risk behavior at the six-month follow-up point. We did not detect a difference in reduction of risky sexual behaviors for those who decreased drug use risk (unadjusted: OR 1.32, 95% CI 0.65-2.70; adjusted OR [AOR] 1.12, 95% CI 0.54-2.36). Adults who screened positive for high drug use risk had greater odds of reducing sex risk behavior in unadjusted analyses OR 3.71, 95% CI 1.81-7.60; but the results were not significant after adjusting for confounding AOR 2.50, 95% CI 0.85-7.30). In this primary care population, reductions in HIV sex risk behaviors have complex etiologies and reductions in drug use risk do not appear to be an independent predictor of them. PMID:27570734

  12. Mindfulness-based intervention for prodromal sleep disturbances in older adults: design and methodology of a randomized controlled trial.

    PubMed

    Black, David S; O'Reilly, Gillian A; Olmstead, Richard; Breen, Elizabeth C; Irwin, Michael R

    2014-09-01

    Sleep problems are prevalent among older adults, often persist untreated, and are predictive of health detriments. Given the limitations of conventional treatments, non-pharmacological treatments such as mindfulness-based interventions (MBIs) are gaining popularity for sleep ailments. However, nothing is yet known about the impact of MBIs on sleep in older adults with prodromal sleep disturbances. This article details the design and methodology of a 6-week parallel-group RCT calibrated to test the treatment effect of the Mindful Awareness Practices (MAPs) program versus sleep hygiene education for improving sleep quality, as the main outcome, in older adults with prodromal sleep disturbances. Older adults with current sleep disturbances will be recruited from the urban Los Angeles community. Participants will be randomized into two standardized treatment conditions, MAPs and sleep hygiene education. Each condition will consist of weekly 2-hour group-based classes over the course of the 6-week intervention. The primary objective of this study is to determine if mindfulness meditation practice as engaged through the MAPs program leads to improved sleep quality relative to sleep hygiene education in older adults with prodromal sleep disturbances.

  13. The South Asian Heart Lifestyle Intervention (SAHELI) study to improve cardiovascular risk factors in a community setting: design and methods.

    PubMed

    Kandula, Namratha R; Patel, Yasin; Dave, Swapna; Seguil, Paola; Kumar, Santosh; Baker, David W; Spring, Bonnie; Siddique, Juned

    2013-11-01

    Disseminating and implementing evidence-based, cardiovascular disease (CVD) prevention lifestyle interventions in community settings and in ethnic minority populations is a challenge. We describe the design and methods for the South Asian Heart Lifestyle Intervention (SAHELI) study, a pilot study designed to determine the feasibility and initial efficacy of a culturally-targeted, community-based lifestyle intervention to improve physical activity and diet behaviors among medically underserved South Asians (SAs). Participants with at least one CVD risk factor will be randomized to either a lifestyle intervention or a control group. Participants in both groups will be screened in a community setting and receive a primary care referral after randomization. Intervention participants will receive 6weeks of group classes, followed by 12weeks of individual telephone support where they will be encouraged to initiate and maintain a healthy lifestyle goal. Control participants will receive their screening results and monthly mailings on CVD prevention. Primary outcomes will be changes in moderate/vigorous physical activity and saturated fat intake between baseline, 3-, and 6-month follow-up. Secondary outcomes will be changes in weight, clinical risk factors, primary care visits, self-efficacy, and social support. This study will be one of the first to pilot-test a lifestyle intervention for SAs, one of the fastest growing racial/ethnic groups in the U.S. and one with disparate CVD risk. Results of this pilot study will provide preliminary data about the efficacy of a lifestyle intervention on CVD risk in SAs and inform community-engaged CVD prevention efforts in an increasingly diverse U.S. population.

  14. An engineer at AeroVironment's Design Development Center inspects a set of silicon solar cells for p

    NASA Technical Reports Server (NTRS)

    2000-01-01

    An engineer at AeroVironment's Design Development Center in Simi Valley, California, closely inspects a set of silicon solar cells for potential defects. The cells, fabricated by SunPower, Inc., of Sunnyvale, California, are among 64,000 solar cells which have been installed on the Helios Prototype solar-powered aircraft to provide power to its 14 electric motors and operating systems. Developed by AeroVironment under NASA's Environmental Research Aircraft and Sensor Technology (ERAST) project, the Helios Prototype is the forerunner of a planned fleet of slow-flying, long duration, high-altitude aircraft which can perform atmospheric science missions and serve as telecommunications relay platforms in the stratosphere. Target goals set by NASA for the giant 246-foot span flying wing include reaching and sustaining subsonic horizontal flight at 100,000 feet altitude in 2001, and sustained continuous flight for at least four days and nights in 2003 with the aid of a regenerative fuel cell-based energy storage system now in development.

  15. Genome-wide association data suggest ABCB1 and immune-related gene sets may be involved in adult antisocial behavior.

    PubMed

    Salvatore, J E; Edwards, A C; McClintick, J N; Bigdeli, T B; Adkins, A; Aliev, F; Edenberg, H J; Foroud, T; Hesselbrock, V; Kramer, J; Nurnberger, J I; Schuckit, M; Tischfield, J A; Xuei, X; Dick, D M

    2015-04-28

    Adult antisocial behavior (AAB) is moderately heritable, relatively common and has adverse consequences for individuals and society. We examined the molecular genetic basis of AAB in 1379 participants from a case-control study in which the cases met criteria for alcohol dependence. We also examined whether genes of interest were expressed in human brain. AAB was measured using a count of the number of Antisocial Personality Disorder criteria endorsed under criterion A from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Participants were genotyped on the Illumina Human 1M BeadChip. In total, all single-nucleotide polymorphisms (SNPs) accounted for 25% of the variance in AAB, although this estimate was not significant (P=0.09). Enrichment tests indicated that more significantly associated genes were over-represented in seven gene sets, and most were immune related. Our most highly associated SNP (rs4728702, P=5.77 × 10(-7)) was located in the protein-coding adenosine triphosphate-binding cassette, sub-family B (MDR/TAP), member 1 (ABCB1). In a gene-based test, ABCB1 was genome-wide significant (q=0.03). Expression analyses indicated that ABCB1 was robustly expressed in the brain. ABCB1 has been implicated in substance use, and in post hoc tests we found that variation in ABCB1 was associated with DSM-IV alcohol and cocaine dependence criterion counts. These results suggest that ABCB1 may confer risk across externalizing behaviors, and are consistent with previous suggestions that immune pathways are associated with externalizing behaviors. The results should be tempered by the fact that we did not replicate the associations for ABCB1 or the gene sets in a less-affected independent sample.

  16. Genome-wide association data suggest ABCB1 and immune-related gene sets may be involved in adult antisocial behavior

    PubMed Central

    Salvatore, J E; Edwards, A C; McClintick, J N; Bigdeli, T B; Adkins, A; Aliev, F; Edenberg, H J; Foroud, T; Hesselbrock, V; Kramer, J; Nurnberger, J I; Schuckit, M; Tischfield, J A; Xuei, X; Dick, D M

    2015-01-01

    Adult antisocial behavior (AAB) is moderately heritable, relatively common and has adverse consequences for individuals and society. We examined the molecular genetic basis of AAB in 1379 participants from a case–control study in which the cases met criteria for alcohol dependence. We also examined whether genes of interest were expressed in human brain. AAB was measured using a count of the number of Antisocial Personality Disorder criteria endorsed under criterion A from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Participants were genotyped on the Illumina Human 1M BeadChip. In total, all single-nucleotide polymorphisms (SNPs) accounted for 25% of the variance in AAB, although this estimate was not significant (P=0.09). Enrichment tests indicated that more significantly associated genes were over-represented in seven gene sets, and most were immune related. Our most highly associated SNP (rs4728702, P=5.77 × 10−7) was located in the protein-coding adenosine triphosphate-binding cassette, sub-family B (MDR/TAP), member 1 (ABCB1). In a gene-based test, ABCB1 was genome-wide significant (q=0.03). Expression analyses indicated that ABCB1 was robustly expressed in the brain. ABCB1 has been implicated in substance use, and in post hoc tests we found that variation in ABCB1 was associated with DSM-IV alcohol and cocaine dependence criterion counts. These results suggest that ABCB1 may confer risk across externalizing behaviors, and are consistent with previous suggestions that immune pathways are associated with externalizing behaviors. The results should be tempered by the fact that we did not replicate the associations for ABCB1 or the gene sets in a less-affected independent sample. PMID:25918995

  17. Using the WHO-ICF with talking mats to enable adults with long-term communication difficulties to participate in goal setting.

    PubMed

    Murphy, Joan; Boa, Sally

    2012-03-01

    The World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) provides a framework that helps rehabilitation staff to take a holistic view of the patient. However, it is used predominantly by professionals rather than by active participation on behalf of the person with the disability. In addition, the language used within the framework can be difficult for patients to understand. In order to address these issues the Activities and Participation section of the ICF has been adapted by using graphic symbols. It has been used in conjunction with Talking Mats(™ 1 ), a low-tech communication framework, to help adults with long-term conditions participate in goal setting. This paper describes how this was done and provides examples from clinical practice. The paper discusses how this combined framework can empower people with communication difficulties and long-term conditions to become active participants in the rehabilitation process by identifying their own goals, indicating changing priorities and tracking their progress.

  18. Macronutrient Supplementation for Malnourished HIV-infected Adults: A Review of the Evidence in Resource-Adequate and Resource-Constrained Settings

    PubMed Central

    Koethe, John R.; Chi, Benjamin H.; Megazzini, Karen M.; Heimburger, Douglas C.; Stringer, Jeffrey S. A.

    2011-01-01

    Access to antiretroviral therapy (ART) for HIV infection has expanded rapidly throughout sub-Saharan Africa, but malnutrition and food insecurity have emerged as major barriers to program success. Protein-calorie malnutrition (a common form in the region) hastens HIV disease progression, and food insecurity is a barrier to medication adherence. Analyses of patient outcomes have identified a low body mass index (BMI) at ART initiation as an independent predictor of early mortality, but the causes of low BMI are multi-factorial may represent normal anthropometric variation, chronic inadequate food intake, or wasting associated with HIV and other infections. While there is much experience population-level humanitarian food assistance, few data exist to measure the effectiveness of macronutrient supplementation or to identify individuals most likely to benefit. In this report, we review the current evidence supporting macronutrient supplementation for HIV-infected adults; clinical trials in resource-adequate and resource-constrained settings; and highlight priority areas for future research. PMID:19624276

  19. Design of Embedded Wireless Sensor and its Soft Encapsulation for Embedded Monitoring of Helicopter Planetary Gear Set

    NASA Astrophysics Data System (ADS)

    Qin, Guojun; Hu, Niaoqing

    2012-05-01

    Planetary gear set, as an important part of helicopter, is with the characteristics of multi-point and time-varying position engagement. For the revolution of planetary gears round sun gear, directions of vibration and pulse created by tooth damage change continuously. If an accelerometer fixed on the surface of gearbox, the angle between the directions of pulse force and accelerometer sensitivity will change continuously, which will causes that the components of pulse force on the sensitivity direction vary with time and the features of damage are very difficult to extract from the signals. Aiming at this problem, a type of embedded wireless sensor node was designed firstly, which can be fixed on the carrier of planetary gear, and acquires the damage-related vibration signals in a fixed direction of pulse force. Then, to avoid the corrosion of electronic components by the lubrication oil in gearbox, the protect restrictions of the sensor node was investigated and a kind of soft encapsulation method is applied. Finally, real vibration signal is measured and transmitted by the designed and/or encapsulated sensor node. The experiments show that the sensor can measure vibration effectively.

  20. A Model for the Roll-Out of Comprehensive Adult Male Circumcision Services in African Low-Income Settings of High HIV Incidence: The ANRS 12126 Bophelo Pele Project

    PubMed Central

    Lissouba, Pascale; Taljaard, Dirk; Rech, Dino; Doyle, Sean; Shabangu, Daniel; Nhlapo, Cynthia; Otchere-Darko, Josephine; Mashigo, Thabo; Matson, Caitlin; Lewis, David; Billy, Scott; Auvert, Bertran

    2010-01-01

    Background World Health Organization (WHO)/Joint United Nations Programme on AIDS (UNAIDS) has recommended adult male circumcision (AMC) for the prevention of heterosexually acquired HIV infection in men from communities where HIV is hyperendemic and AMC prevalence is low. The objective of this study was to investigate the feasibility of the roll-out of medicalized AMC according to UNAIDS/WHO operational guidelines in a targeted African setting. Methods and Findings The ANRS 12126 “Bophelo Pele” project was implemented in 2008 in the township of Orange Farm (South Africa). It became functional in 5 mo once local and ethical authorizations were obtained. Project activities involved community mobilization and outreach, as well as communication approaches aimed at both men and women incorporating broader HIV prevention strategies and promoting sexual health. Free medicalized AMC was offered to male residents aged 15 y and over at the project's main center, which had been designed for low-income settings. Through the establishment of an innovative surgical organization, up to 150 AMCs under local anesthesia, with sterilized circumcision disposable kits and electrocautery, could be performed per day by three task-sharing teams of one medical circumciser and five nurses. Community support for the project was high. As of November 2009, 14,011 men had been circumcised, averaging 740 per month in the past 12 mo, and 27.5% of project participants agreed to be tested for HIV. The rate of adverse events, none of which resulted in permanent damage or death, was 1.8%. Most of the men surveyed (92%) rated the services provided positively. An estimated 39.1% of adult uncircumcised male residents have undergone surgery and uptake is steadily increasing. Conclusion This study demonstrates that a quality AMC roll-out adapted to African low-income settings is feasible and can be implemented quickly and safely according to international guidelines. The project can be a model for

  1. The Building Bridges Project: Involving Older Adults in the Design of a Communication Technology to Support Peer-to-Peer Social Engagement

    NASA Astrophysics Data System (ADS)

    Wherton, Joseph; Prendergast, David

    There are a variety of factors that can lead to social isolation and loneliness in old age, including decline in physical and mental health, as well as change to social environment. The Building Bridges project explores how communication technology can help older adults remain socially connected. This paper will first provide an overview of a prototype communication system designed to support peer-to-peer group interaction. A description of the user-centered design process will be provided to demonstrate the importance of involving older adults at the earliest stages. The implications for designing new technology for older adults are discussed.

  2. Design and evaluation of a wireless electronic health records system for field care in mass casualty settings

    PubMed Central

    Kirsh, D; Griswold, W G; Buono, C; Lyon, J; Rao, R; Chan, T C

    2011-01-01

    Background There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD). Materials and methods WIISARD combined advanced networking technology with electronic triage tags that reported victims' position and recorded medical information, with wireless pulse-oximeters that monitored patient vital signs, and a wireless electronic medical record (EMR) for disaster care. The EMR system included WiFi handheld devices with barcode scanners (used by front-line responders) and computer tablets with role-tailored software (used by managers of the triage, treatment, transport and medical communications teams). An additional software system provided situational awareness for the incident commander. The WIISARD system was evaluated in a large-scale simulation exercise designed for training first responders. A randomized trial was overlaid on this exercise with 100 simulated victims, 50 in a control pathway (paper-based), and 50 in completely electronic WIISARD pathway. All patients in the electronic pathway were cared for within the WIISARD system without paper-based workarounds. Results WIISARD reduced the rate of the missing and/or duplicated patient identifiers (0% vs 47%, p<0.001). The total time of the field was nearly identical (38:20 vs 38:23, IQR 26:53–1:05:32 vs 18:55–57:22). Conclusion Overall, the results of WIISARD show that wireless EMR systems for care of the victims of disasters would be complex to develop but potentially feasible to build and deploy, and likely to improve the quality of information available for the delivery of care during disasters. PMID:21709162

  3. The Counseling Older Adults to Control Hypertension (COACH) trial: design and methodology of a group-based lifestyle intervention for hypertensive minority older adults.

    PubMed

    Ogedegbe, Gbenga; Fernandez, Senaida; Fournier, Leanne; Silver, Stephanie A; Kong, Jian; Gallagher, Sara; de la Calle, Franze; Plumhoff, Jordan; Sethi, Sheba; Choudhury, Evelyn; Teresi, Jeanne A

    2013-05-01

    The disproportionately high prevalence of hypertension and its associated mortality and morbidity in minority older adults is a major public health concern in the United States. Despite compelling evidence supporting the beneficial effects of therapeutic lifestyle changes on blood pressure reduction, these approaches remain largely untested among minority elders in community-based settings. The Counseling Older Adults to Control Hypertension trial is a two-arm randomized controlled trial of 250 African-American and Latino seniors, 60 years and older with uncontrolled hypertension, who attend senior centers. The goal of the trial is to evaluate the effect of a therapeutic lifestyle intervention delivered via group classes and individual motivational interviewing sessions versus health education, on blood pressure reduction. The primary outcome is change in systolic and diastolic blood pressure from baseline to 12 months. The secondary outcomes are blood pressure control at 12 months; changes in levels of physical activity; body mass index; and number of daily servings of fruits and vegetables from baseline to 12 months. The intervention group will receive 12 weekly group classes followed by individual motivational interviewing sessions. The health education group will receive an individual counseling session on healthy lifestyle changes and standard hypertension education materials. Findings from this study will provide needed information on the effectiveness of lifestyle interventions delivered in senior centers. Such information is crucial in order to develop implementation strategies for translation of evidence-based lifestyle interventions to senior centers, where many minority elders spend their time, making the centers a salient point of dissemination.

  4. Adult Museum Programs: Designing Meaningful Experiences. American Association for State and Local History Book Series.

    ERIC Educational Resources Information Center

    Sachatello-Sawyer, Bonnie; Fellenz, Robert A.; Burton, Hanly; Gittings-Carlson, Laura; Lewis-Mahony, Janet; Woolbaugh, Walter

    A three-year national study of adult museum programs used a qualitative research approach and naturalistic inquiry and interviewed 508 museum program participants, 75 instructors, and 143 museum program planners in all types and sizes of museums, including art institutes, natural and cultural historical museums, science centers, historic houses,…

  5. Young Adult Male Satisfaction with Drug & Alcohol Rehabilitation Facilities: Interior Design Implications.

    ERIC Educational Resources Information Center

    Potthoff, Joy K.

    1991-01-01

    Examined young adult male patient (n=18) satisfaction with interior environments of three different in-patient drug and alcohol rehabilitation facilities: renovated Elk's Club; hospital wing; and facility built for drug and alcohol treatment. Findings indicated satisfaction declined over four-week treatment period; familiar objects were missed;…

  6. A Curriculum Structured Design for Educating Adults in Detecting Deception and Eliciting Information

    ERIC Educational Resources Information Center

    McManus, Barry L.

    2013-01-01

    This dissertation describes the overall effectiveness of deception detection training and identifies conditions that may enhance training effectiveness through understanding how adults learn and utilizing scenario-based training. The analysis was based on a total of 1,788 evaluation data sheets (archival records). The major aim of the research is…

  7. Design of set-point weighting PIλ + Dμ controller for vertical magnetic flux controller in Damavand tokamak.

    PubMed

    Rasouli, H; Fatehi, A

    2014-12-01

    In this paper, a simple method is presented for tuning weighted PI(λ) + D(μ) controller parameters based on the pole placement controller of pseudo-second-order fractional systems. One of the advantages of this controller is capability of reducing the disturbance effects and improving response to input, simultaneously. In the following sections, the performance of this controller is evaluated experimentally to control the vertical magnetic flux in Damavand tokamak. For this work, at first a fractional order model is identified using output-error technique in time domain. For various practical experiments, having desired time responses for magnetic flux in Damavand tokamak, is vital. To approach this, at first the desired closed loop reference models are obtained based on generalized characteristic ratio assignment method in fractional order systems. After that, for the identified model, a set-point weighting PI(λ) + D(μ) controller is designed and simulated. Finally, this controller is implemented on digital signal processor control system of the plant to fast/slow control of magnetic flux. The practical results show appropriate performance of this controller.

  8. Rational design of heat-set and specific-ion-responsive supramolecular hydrogels based on the Hofmeister effect.

    PubMed

    Nebot, Vicent J; Ojeda-Flores, Juan J; Smets, Johan; Fernández-Prieto, Susana; Escuder, Beatriu; Miravet, Juan F

    2014-10-27

    Smart supramolecular hydrogels have been prepared from a bolaamphiphilic L-valine derivative in aqueous solutions of different salts. The hydrogels respond selectively to different ions and are either reinforced or weakened. In one case, in contrast to conventional systems, the hydrogels are formed upon heating of the system. The use of the hydrogels in the controlled release of an entrapped dye is described as a proof of the potential applications of these systems. The responsive hydrogels were rationally designed by taking into account the noticeable effect of different ions from the Hofmeister series in the solubility of the hydrogelator, which was assessed by using NMR experiments. On the one hand, kosmotropic anions such as sulfate produce a remarkable solubility decrease in the gelator, which is associated with gel reinforcement, as measured by rheological experiments. On the other hand, chaotropic species such as perchlorate weaken the gel. A dramatic effect was observed in the presence of guanidinium chloride, which boosted the solubility of the gelator, in accordance with its chaotropic behaviour reported in protein science. In this case, a direct interaction of the guanidinium species with the carbonyl groups of the hydrogelator is detected by (13) C NMR spectroscopy. The weakening of this interaction upon a temperature increase allows for the preparation of heat-set hydrogelating systems. PMID:25220485

  9. L'education des adultes comme strategie d'implantation de l'education permanente en milieu universitaire: la lecon de la France (Adult Education as Strategy for Implementing Continuing Education in the University Setting: The Lesson of France).

    ERIC Educational Resources Information Center

    Ferland, Mario

    1981-01-01

    Lessons learned from the French experience in integrating continuing education into the universities include these: politically and ideologically, adult and continuing education are different and must be treated thus; autonomy is necessary; the university has no monopoly; and marginalization of adult education is a hazard of this approach. (MSE)

  10. Model of Adult Career Education in Corrections.

    ERIC Educational Resources Information Center

    Ryan, T. A.; And Others

    The model was designed to provide a guide for systematic planning, implementation, and evaluation of adult career education in correctional settings, utilizing a systems approach. It consists of seven chapters and a flowchart presenting seven major functions which must be carried out: (1) establishing a conceptual framework, (2) setting up an…

  11. Operable Unit 3-13, Group 3, Other Surface Soils Remediation Sets 4-6 (Phase II) Remedial Design/Remedial Action Work Plan

    SciTech Connect

    D. E. Shanklin

    2006-06-01

    This Remedial Design/Remedial Action Work Plan provides the framework for defining the remedial design requirements, preparing the design documentation, and defining the remedial actions for Waste Area Group 3, Operable Unit 3-13, Group 3, Other Surface Soils, Remediation Sets 4-6 (Phase II) located at the Idaho Nuclear Technology and Engineering Center at the Idaho National Laboratory. This plan details the design developed to support the remediation and disposal activities selected in the Final Operable Unit 3-13, Record of Decision.

  12. Instructional-Design Theory to Guide the Creation of Online Learning Communities for Adults

    ERIC Educational Resources Information Center

    Snyder, Martha M.

    2009-01-01

    The Internet provides a powerful delivery system for learning. With improvements in web-based applications and information technology come new opportunities and challenges for educators to design, develop, and deliver effective instruction. Over the past few years, an increasing amount of research has been devoted to the design of online learning…

  13. The Multicenter Pediatric and Adult Congenital EP Quality (MAP-IT) Initiative-rationale and design: report from the pediatric and congenital electrophysiology society's MAP-IT taskforce.

    PubMed

    Seslar, Stephen P; Kugler, John; Batra, Anjan S; Collins, Kathryn K; Crosson, Jane; Dubin, Anne M; Etheridge, Susan; Kanter, Ronald; Papez, Andrew; Radbill, Andrew E; Serwer, Gerald A; Tanel, Ronn E; Tsao, Sabrina; Webster, Gregory; Saarel, Elizabeth V

    2013-01-01

    Multicenter clinical registries are increasingly recognized as valuable tools for establishing benchmarks, facilitating patient-centered quality improvement and research. In 2010, the Pediatric and Congenital Electrophysiology Society convened a taskforce of its members to design, construct, and implement a clinical registry known as the Multicenter Pediatric and Adult Congenital EP Quality (MAP-IT) Initiative. The present aim of the MAP-IT Initiative is to create an infrastructure by which we can measurably improve patient-centered outcomes and reduce complications associated with electrophysiology studies and catheter ablation in pediatric and congenital heart disease patients. The purpose of this writing is to report the progress to date from three of the four subcommittees of the MAP-IT taskforce. Specifically, we present our initial set of key data elements and definitions, recommended database table structure, and considerations regarding wide-scale implementation of the registry. Development of a risk/complexity score for use in the MAP-IT registry is presented in a separate companion manuscript. It is our intent that these manuscripts will serve to introduce the electrophysiology and pediatric cardiology community to the MAP-IT initiative and provide a rationale for its design and recommended implementation strategy.

  14. V-TIME: a treadmill training program augmented by virtual reality to decrease fall risk in older adults: study design of a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Recent work has demonstrated that fall risk can be attributed to cognitive as well as motor deficits. Indeed, everyday walking in complex environments utilizes executive function, dual tasking, planning and scanning, all while walking forward. Pilot studies suggest that a multi-modal intervention that combines treadmill training to target motor function and a virtual reality obstacle course to address the cognitive components of fall risk may be used to successfully address the motor-cognitive interactions that are fundamental for fall risk reduction. The proposed randomized controlled trial will evaluate the effects of treadmill training augmented with virtual reality on fall risk. Methods/Design Three hundred older adults with a history of falls will be recruited to participate in this study. This will include older adults (n=100), patients with mild cognitive impairment (n=100), and patients with Parkinson’s disease (n=100). These three sub-groups will be recruited in order to evaluate the effects of the intervention in people with a range of motor and cognitive deficits. Subjects will be randomly assigned to the intervention group (treadmill training with virtual reality) or to the active-control group (treadmill training without virtual reality). Each person will participate in a training program set in an outpatient setting 3 times per week for 6 weeks. Assessments will take place before, after, and 1 month and 6 months after the completion of the training. A falls calendar will be kept by each participant for 6 months after completing the training to assess fall incidence (i.e., the number of falls, multiple falls and falls rate). In addition, we will measure gait under usual and dual task conditions, balance, community mobility, health related quality of life, user satisfaction and cognitive function. Discussion This randomized controlled trial will demonstrate the extent to which an intervention that combines treadmill training augmented

  15. Variability and reliability of diurnal cortisol in younger and older adults: implications for design decisions.

    PubMed

    Segerstrom, Suzanne C; Boggero, Ian A; Smith, Gregory T; Sephton, Sandra E

    2014-11-01

    The extant research is inconclusive regarding the best sampling methods to construct reliable measures of between-person differences in derived parameters of diurnal cortisol, and no study provides such recommendations for detecting within-person changes. These studies determined how many days of sampling are necessary to assess between-person differences and within-person changes over multiple occasions in diurnal mean, diurnal slope, and area under the curve (AUC). Generalizability and decision analyses were conducted on diurnal salivary cortisol data from two separate longitudinal studies, one with younger adults (N=124) and one with older adults (N=148). In both studies, results indicated that 3 days of data collection provided the minimal level of reliability in mean cortisol to detect between-person differences; 4-8 days were necessary to reliably assess AUC, and 10 days for cortisol slope. Similarly, in order to reliably characterize within-person changes across occasions, at least 3 days of data collection were needed for mean cortisol and AUC and 5-8 days for slope. Results also indicated that only two samples per day, taken morning and evening, could faithfully reproduce the diurnal slope calculated from 3 or 4 samples (r=.97-.99). Instead of having participants provide many samples per day over the course of a few days, we recommend collecting fewer samples per day over more days.

  16. Variability and reliability of diurnal cortisol in younger and older adults: Implications for design decisions

    PubMed Central

    Segerstrom, Suzanne C.; Boggero, Ian A.; Smith, Gregory T.; Sephton, Sandra E.

    2014-01-01

    The extant research is inconclusive regarding the best sampling methods to construct reliable measures of between-person differences in derived parameters of diurnal cortisol, and no study provides such recommendations for detecting within-person changes. These studies determined how many days of sampling are necessary to assess between-person differences and within-person changes over multiple occasions in diurnal mean, diurnal slope, and area under the curve (AUC). Generalizability and decision analyses were conducted on diurnal salivary cortisol data from two separate longitudinal studies, one with younger adults (N = 124) and one with older adults (N = 148). In both studies, results indicated that 3 days of data collection provided the minimal level of reliability in mean cortisol to detect between-person differences; 4–8 days were necessary to reliably assess AUC, and 10 days for cortisol slope. Similarly, in order to reliably characterize within-person changes across occasions, at least 3 days of data collection were needed for mean cortisol and AUC and 5–8 days for slope. Results also indicated that only two samples per day, taken morning and evening, could faithfully reproduce the diurnal slope calculated from 3 or 4 samples (r = .97–.99). Instead of having participants provide many samples per day over the course of a few days, we recommend collecting fewer samples per day over more days. PMID:25137484

  17. Internalized representations of early interpersonal experience and adult relationships: a test of copy process theory in clinical and non-clinical settings.

    PubMed

    Critchfield, Kenneth L; Benjamin, Lorna Smith

    2008-01-01

    Studies connecting childhood experience and adult psychopathology often focus on consequences of abuse and neglect. Copy process theory (Benjamin, 2003) states that constructive as well as destructive experiences shape adult behavior with surprising interpersonal specificity. Childhood perceptions and social learning are encoded in memory and then "copied" in 3 basic ways in subsequent relationships: Identification (behaving as he or she behaved), Recapitulation (behaving as one behaved when with him or her), and Introjection (treating oneself as he or she was treated). The first step in evaluating copy process theory is to verify that the predicted correspondence between adult relational patterns and internal representation of early experience can be observed in different adult samples. Remembered interpersonal patterns from childhood and perceptions of adult relational patterns were measured using the Structural Analysis of Social Behavior (SASB). Strong evidence was found for each copy process in a sample of psychiatric inpatients (N = 161) and a college sample (N = 133). Positive and negative behaviors were copied in both. Evidence suggests that gender, patient status, and rated state may influence whether, and in which forms, copying occurs. PMID:18377207

  18. SETS. Set Equation Transformation System

    SciTech Connect

    Worrell, R.B.

    1992-01-13

    SETS is used for symbolic manipulation of Boolean equations, particularly the reduction of equations by the application of Boolean identities. It is a flexible and efficient tool for performing probabilistic risk analysis (PRA), vital area analysis, and common cause analysis. The equation manipulation capabilities of SETS can also be used to analyze noncoherent fault trees and determine prime implicants of Boolean functions, to verify circuit design implementation, to determine minimum cost fire protection requirements for nuclear reactor plants, to obtain solutions to combinatorial optimization problems with Boolean constraints, and to determine the susceptibility of a facility to unauthorized access through nullification of sensors in its protection system.

  19. The Use of Melatonin to Treat Sleep Disorder in Adults with Intellectual Disabilities in Community Settings -- the Evaluation of Three Cases Using Actigraphy

    ERIC Educational Resources Information Center

    Dodd, A.; Hare, D. J.; Arshad, P.

    2008-01-01

    Background: Sleep disorders are known to be very prevalent in adults with intellectual disabilities (ID) but to date there has been limited objective assessment of either sleep disorders or of interventions such as the use of melatonin. Methodology: A protocol-driven assessment and intervention procedure was followed with three people with…

  20. Knowledge and Emotions in Cross-Racial Dialogues: Challenges and Opportunities for Adult Educators Committed to Racial Justice in Educational Settings

    ERIC Educational Resources Information Center

    Manglitz, Elaine; Guy, Talmadge C.; Merriweather, Lisa R.

    2014-01-01

    Our society reflects a kaleidoscope of differences in terms of race, ethnicity, class, religion, and gender identity. These differences are evident from the boardroom to the classroom in higher education and can result in impaired communication when race is the topic of discussion. To effectively facilitate race-based dialogues, adult educators…

  1. Contributions of Response Set and Semantic Relatedness to Cross-Modal Stroop-Like Picture--Word Interference in Children and Adults

    ERIC Educational Resources Information Center

    Hanauer, John B.; Brooks, Patricia J.

    2005-01-01

    Resistance to interference from irrelevant auditory stimuli undergoes development throughout childhood. To test whether semantic processes account for age-related changes in a Stroop-like picture-word interference effect, children (3-to 12-year-olds) and adults named pictures while listening to words varying in terms of semantic relatedness to the…

  2. Cold-air performance of free-power turbine designed for 112-kilowatt automotive gas-turbine engine. 1: Design Stator-vane-chord setting angle of 35 deg

    NASA Technical Reports Server (NTRS)

    Kofskey, M. G.; Nusbaum, W. J.

    1978-01-01

    A cold air experimental investigation of a free power turbine designed for a 112-kW automotive gas-turbine was made over a range of speeds from 0 to 130 percent of design equivalent speeds and over a range of pressure ratio from 1.11 to 2.45. Results are presented in terms of equivalent power, torque, mass flow, and efficiency for the design power point setting of the variable stator.

  3. Design, development, and formative evaluation of "put nutrition into practice," a multimedia nutrition education program for adults.

    PubMed

    Carlton, D J; Kicklighter, J R; Jonnalagadda, S S; Shoffner, M B

    2000-05-01

    The purpose of this study was to design, develop, and formatively evaluate a computer-based multi-media nutrition education program for adults based on the Dick and Carey model of instructional design. The 4 phases of the study included analysis, design, development, and evaluation. Seventy-two volunteers from the US Air Force, aged 18 to 50 years, participated in focus groups, an E-mail survey, or a dietitian survey to establish the program's instructional goal of applying the principles of the Food Guide Pyramid to daily food choices. Objectives, assessment instruments, content, examples, and practice questions with feedback were written in the design phase. Four modules of instruction--Familiarization with Food Groups, Serving Sizes, Modifying a Menu, and Vitamins and Minerals--were programmed using Hyper-studio. Eighteen subjects aged 22 to 40 years, with at least a high school education and an average knowledge of nutrition volunteered to participate in 1 of 2 formative evaluation phases. All subjects completed a pretest, 2 posttests, 3 embedded tests, and an attitude questionnaire to ascertain program weaknesses. One module was deleted after phase 1 because the material lacked relevance to subjects. In phase 2, only 4 of 15 subjects could identify serving sizes in module 2 and only 6 of 15 subjects could do the same on posttest 1. Back buttons and review screens were added to modules 2 and 3 to facilitate identification of serving sizes. We conclude that dietetics professionals should use systematic models of instructional design, such as the Dick and Carey model, to design effective nutrition education programs for the public. PMID:10812381

  4. Acceptability of a Personally Controlled Health Record in a Community-Based Setting: Implications for Policy and Design

    PubMed Central

    Kaci, Liljana; Mandl, Kenneth D

    2009-01-01

    Background Consumer-centered health information systems that address problems related to fragmented health records and disengaged and disempowered patients are needed, as are information systems that support public health monitoring and research. Personally controlled health records (PCHRs) represent one response to these needs. PCHRs are a special class of personal health records (PHRs) distinguished by the extent to which users control record access and contents. Recently launched PCHR platforms include Google Health, Microsoft’s HealthVault, and the Dossia platform, based on Indivo. Objective To understand the acceptability, early impacts, policy, and design requirements of PCHRs in a community-based setting. Methods Observational and narrative data relating to acceptability, adoption, and use of a personally controlled health record were collected and analyzed within a formative evaluation of a PCHR demonstration. Subjects were affiliates of a managed care organization run by an urban university in the northeastern United States. Data were collected using focus groups, semi-structured individual interviews, and content review of email communications. Subjects included: n = 20 administrators, clinicians, and institutional stakeholders who participated in pre-deployment group or individual interviews; n = 52 community members who participated in usability testing and/or pre-deployment piloting; and n = 250 subjects who participated in the full demonstration of which n = 81 initiated email communications to troubleshoot problems or provide feedback. All data were formatted as narrative text and coded thematically by two independent analysts using a shared rubric of a priori defined major codes. Sub-themes were identified by analysts using an iterative inductive process. Themes were reviewed within and across research activities (ie, focus group, usability testing, email content review) and triangulated to identify patterns. Results Low levels of familiarity with

  5. Teacher and Researcher Co-Design Self-Management Content for an Inclusive Setting: Research Training, Intervention, and Generalization Effects on Student Performance.

    ERIC Educational Resources Information Center

    King-Sears, Margaret E.

    1999-01-01

    This study with a second-grade child with multiple disabilities in an inclusive setting applied (1) self-management instruction, (2) generalization methodologies (general case programming and multiple exemplars), and (3) a high level of teacher involvement in designing and monitoring the self-management plan. Implications for researchers and…

  6. Utility of the MMPI-2-RF (Restructured Form) Validity Scales in Detecting Malingering in a Criminal Forensic Setting: A Known-Groups Design

    ERIC Educational Resources Information Center

    Sellbom, Martin; Toomey, Joseph A.; Wygant, Dustin B.; Kucharski, L. Thomas; Duncan, Scott

    2010-01-01

    The current study examined the utility of the recently released Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) validity scales to detect feigned psychopathology in a criminal forensic setting. We used a known-groups design with the Structured Interview of Reported Symptoms (SIRS; Rogers,…

  7. "Words of Wisdom" for Youth and Adults: The Cultural Context of Program Design.

    ERIC Educational Resources Information Center

    Bhola, H. S.

    Program design in nonformal education must take into account the cultural context in which it exists. In developing countries, it can neither reject all values of Western civilization (an impossible task), nor can it embrace Western values without regard to native cultures. The challenge, especially in literacy education, is to become culturally…

  8. Situated and Socially Shared Cognition in Practice. Designing a Collaborative Network Learning Experience for Adult Learners.

    ERIC Educational Resources Information Center

    Korhonen, Vesa

    The main purpose of this paper is to draw attention to assumptions that guide the instructional design process when implementing and organizing network-based learning environments in practice. In this case, the situated and socially shared cognition model and participation metaphor create the guiding paradigm for collaborative learning action,…

  9. Design and Evaluation of an Interactive Exercise Coaching System for Older Adults: Lessons Learned.

    PubMed

    Ofli, Ferda; Kurillo, Gregorij; Obdržálek, Štěpán; Bajcsy, Ruzena; Jimison, Holly Brugge; Pavel, Misha

    2016-01-01

    Although the positive effects of exercise on the well-being and quality of independent living for older adults are well accepted, many elderly individuals lack access to exercise facilities, or the skills and motivation to perform exercise at home. To provide a more engaging environment that promotes physical activity, various fitness applications have been proposed. Many of the available products, however, are geared toward a younger population and are not appropriate or engaging for an older population. To address these issues, we developed an automated interactive exercise coaching system using the Microsoft Kinect. The coaching system guides users through a series of video exercises, tracks and measures their movements, provides real-time feedback, and records their performance over time. Our system consists of exercises to improve balance, flexibility, strength, and endurance, with the aim of reducing fall risk and improving performance of daily activities. In this paper, we report on the development of the exercise system, discuss the results of our recent field pilot study with six independently living elderly individuals, and highlight the lessons learned relating to the in-home system setup, user tracking, feedback, and exercise performance evaluation. PMID:25594988

  10. Perceptions of Physical Activity by Older Adults: A Qualitative Study

    ERIC Educational Resources Information Center

    Jancey, Jonine M.; Clarke, Ann; Howat, Peter; Maycock, Bruce; Lee, Andy H.

    2009-01-01

    Objective: To identify issues and perceptions concerning physical activity in older adults. Design: Qualitative study. Setting: Perth, Western Australia. Methods: Sixteen adults aged 65 to 74 years were interviewed in their own homes using a semi-structured interview schedule. Data were analysed using a descriptive qualitative methodology.…

  11. Different Modes of Digital Learning Object Use in School Settings: Do We Design for Individual or Collaborative Learning?

    ERIC Educational Resources Information Center

    Akpinar, Yavuz

    2014-01-01

    The aim of the studies reported in this paper is to gain classroom based empirical evidence on the learning effectiveness of learning objects used in two types of study settings: Collaborative and individual. A total of 127 seventh and ninth grade students participated in the experiments. They were assigned into one of the study modes and worked…

  12. HIV Prevention for Adults With Criminal Justice Involvement: A Systematic Review of HIV Risk-Reduction Interventions in Incarceration and Community Settings

    PubMed Central

    Dumont, Dora; Operario, Don

    2014-01-01

    We summarized and appraised evidence regarding HIV prevention interventions for adults with criminal justice involvement. We included randomized and quasi-randomized controlled trials that evaluated an HIV prevention intervention, enrolled participants with histories of criminal justice involvement, and reported biological or behavioral outcomes. We used Cochrane methods to screen 32 271 citations from 16 databases and gray literature. We included 37 trials enrolling n = 12 629 participants. Interventions were 27 psychosocial, 7 opioid substitution therapy, and 3 HIV-testing programs. Eleven programs significantly reduced sexual risk taking, 4 reduced injection drug risks, and 4 increased testing. Numerous interventions may reduce HIV-related risks among adults with criminal justice involvement. Future research should consider process evaluations, programs involving partners or families, and interventions integrating biomedical, psychosocial, and structural approaches. PMID:25211725

  13. HIV prevention for adults with criminal justice involvement: a systematic review of HIV risk-reduction interventions in incarceration and community settings.

    PubMed

    Underhill, Kristen; Dumont, Dora; Operario, Don

    2014-11-01

    We summarized and appraised evidence regarding HIV prevention interventions for adults with criminal justice involvement. We included randomized and quasi-randomized controlled trials that evaluated an HIV prevention intervention, enrolled participants with histories of criminal justice involvement, and reported biological or behavioral outcomes. We used Cochrane methods to screen 32,271 citations from 16 databases and gray literature. We included 37 trials enrolling n = 12,629 participants. Interventions were 27 psychosocial, 7 opioid substitution therapy, and 3 HIV-testing programs. Eleven programs significantly reduced sexual risk taking, 4 reduced injection drug risks, and 4 increased testing. Numerous interventions may reduce HIV-related risks among adults with criminal justice involvement. Future research should consider process evaluations, programs involving partners or families, and interventions integrating biomedical, psychosocial, and structural approaches. PMID:25211725

  14. Health status and well-being of older adults living in the community and in residential care settings: are differences influenced by age?

    PubMed

    Rodriguez-Blazquez, Carmen; Forjaz, Maria João; Prieto-Flores, Maria-Eugenia; Rojo-Perez, Fermina; Fernandez-Mayoralas, Gloria; Martinez-Martin, Pablo

    2012-01-01

    The objective is to identify the differences and the main factors influencing health status and well-being variables between institutionalized and non-institutionalized older adults, as well as the interaction effect of institutionalization and age. Data on a total of 468 older adults from a national survey on non-institutionalized and from a study on institutionalized older people were analyzed. Socio-demographic variables and measures on well-being (Personal Well-being Index, PWI), health status (EQ-5D), functional ability (Barthel Index), depression (Hospital Anxiety and Depression Scale-Depression subscale), loneliness and comorbidity were used. Analysis of variance and Kruskal-Wallis tests to examine differences between groups and multiple regression analyses to identify factors associated to health and well-being were performed. Significant differences in health status variables, but not in well-being were detected between groups. Controlling for age, differences in health status (EQ-VAS) were found to be not significant in both groups. In the non-institutionalized group, people aged 78 years or more reported a significantly lower well-being (PWI) than younger counterparts. Step-wise multiple regression analysis showed that depression, functional dependence, loneliness and sex were associated with health status; while depression, health status, loneliness and the interaction of age-institutionalization were related to well-being. The results suggest that age influences community-dwelling older adults' well-being to a greater extent than it does to institutionalized older people. This finding has implications for resource allocation and interventions addressed to improve health and well-being in older adults.

  15. DSIR: assessing the design of highly potent siRNA by testing a set of cancer-relevant target genes.

    PubMed

    Filhol, Odile; Ciais, Delphine; Lajaunie, Christian; Charbonnier, Peggy; Foveau, Nicolas; Vert, Jean-Philippe; Vandenbrouck, Yves

    2012-01-01

    Chemically synthesized small interfering RNA (siRNA) is a widespread molecular tool used to knock down genes in mammalian cells. However, designing potent siRNA remains challenging. Among tools predicting siRNA efficacy, very few have been validated on endogenous targets in realistic experimental conditions. We previously described a tool to assist efficient siRNA design (DSIR, Designer of siRNA), which focuses on intrinsic features of the siRNA sequence. Here, we evaluated DSIR's performance by systematically investigating the potency of the siRNA it designs to target ten cancer-related genes. mRNA knockdown was measured by quantitative RT-PCR in cell-based assays, revealing that over 60% of siRNA sequences designed by DSIR silenced their target genes by at least 70%. Silencing efficacy was sustained even when low siRNA concentrations were used. This systematic analysis revealed in particular that, for a subset of genes, the efficiency of siRNA constructs significantly increases when the sequence is located closer to the 5'-end of the target gene coding sequence, suggesting the distance to the 5'-end as a new feature for siRNA potency prediction. A new version of DSIR incorporating these new findings, as well as the list of validated siRNA against the tested cancer genes, has been made available on the web (http://biodev.extra.cea.fr/DSIR).

  16. Strategy for design NIR calibration sets based on process spectrum and model space: An innovative approach for process analytical technology.

    PubMed

    Cárdenas, V; Cordobés, M; Blanco, M; Alcalà, M

    2015-10-10

    The pharmaceutical industry is under stringent regulations on quality control of their products because is critical for both, productive process and consumer safety. According to the framework of "process analytical technology" (PAT), a complete understanding of the process and a stepwise monitoring of manufacturing are required. Near infrared spectroscopy (NIRS) combined with chemometrics have lately performed efficient, useful and robust for pharmaceutical analysis. One crucial step in developing effective NIRS-based methodologies is selecting an appropriate calibration set to construct models affording accurate predictions. In this work, we developed calibration models for a pharmaceutical formulation during its three manufacturing stages: blending, compaction and coating. A novel methodology is proposed for selecting the calibration set -"process spectrum"-, into which physical changes in the samples at each stage are algebraically incorporated. Also, we established a "model space" defined by Hotelling's T(2) and Q-residuals statistics for outlier identification - inside/outside the defined space - in order to select objectively the factors to be used in calibration set construction. The results obtained confirm the efficacy of the proposed methodology for stepwise pharmaceutical quality control, and the relevance of the study as a guideline for the implementation of this easy and fast methodology in the pharma industry.

  17. Design of specific hardware to obtain embryos and maintain adult urodele amphibians aboard a space station

    NASA Astrophysics Data System (ADS)

    Husson, D.; Chaput, D.; Bautz, A.; Davet, J.; Durand, D.; Dournon, C.; Duprat, A. M.; Gualandris-Parisot, L.

    The study of the influence of weightlessness on fertilization and embryonic development of a vertebrate is of importance in the understanding of basic embryogenesis and in the preparation of the future exploration of space. Accordingly, specific hardware was designed to perform experiments on board the MIR space station with an amphibian vertebrate model, taking into account the biological requirements and the multiple constraints of a longterm space mission. This paper describes the biological uses and presents the technological specifications of the device developed under CNES management. The hardware was adapted to and is compatible with biological requirements as confirmed by three experiments performed in space on board the orbital MIR station.

  18. Design of specific hardware to obtain embryos and maintain adult urodele amphibians aboard a space station.

    PubMed

    Husson, D; Chaput, D; Bautz, A; Davet, J; Durand, D; Dournon, C; Duprat, A M; Gualandris-Parisot, L

    2001-01-01

    The study of the influence of weightlessness on fertilization and embryonic development of a vertebrate is of importance in the understanding of basic embryogenesis and in the preparation of the future exploration of space. Accordingly, specific hardware was designed to perform experiments on board the MIR space station with an amphibian vertebrate model, taking into account the biological requirements and the multiple constraints of a long-term mission. This paper describes the biological uses and presents the technological specifications of the device developed under CNES management. The hardware was adapted to and is compatible with biological requirements as confirmed by three experiments performed in space on board the orbital MIR station.

  19. New Design Strategy for Development of Specific Primer Sets for PCR-Based Detection of Chlorophyceae and Bacillariophyceae in Environmental Samples▿ †

    PubMed Central

    Valiente Moro, Claire; Crouzet, Olivier; Rasconi, Séréna; Thouvenot, Antoine; Coffe, Gérard; Batisson, Isabelle; Bohatier, Jacques

    2009-01-01

    Studying aquatic microalgae is essential for monitoring biodiversity and water quality. We designed new sets of 18S rRNA PCR primers for Chlorophyceae and Bacillariophyceae by using the ARB software and implementing a virtual PCR program. The results of specificity analysis showed that most of the targeted algal families were identified and nontargeted organisms, such as fungi or ciliates, were excluded. These newly developed PCR primer sets were also able to amplify microalgal rRNA genes from environmental samples with accurate specificity. These tools could be of great interest for studying freshwater microalgal ecology and for developing bioindicators of the health status of aquatic environments. PMID:19592531

  20. New design strategy for development of specific primer sets for PCR-based detection of Chlorophyceae and Bacillariophyceae in environmental samples.

    PubMed

    Moro, Claire Valiente; Crouzet, Olivier; Rasconi, Séréna; Thouvenot, Antoine; Coffe, Gérard; Batisson, Isabelle; Bohatier, Jacques

    2009-09-01

    Studying aquatic microalgae is essential for monitoring biodiversity and water quality. We designed new sets of 18S rRNA PCR primers for Chlorophyceae and Bacillariophyceae by using the ARB software and implementing a virtual PCR program. The results of specificity analysis showed that most of the targeted algal families were identified and nontargeted organisms, such as fungi or ciliates, were excluded. These newly developed PCR primer sets were also able to amplify microalgal rRNA genes from environmental samples with accurate specificity. These tools could be of great interest for studying freshwater microalgal ecology and for developing bioindicators of the health status of aquatic environments. PMID:19592531

  1. Testing the Development of Linguistic Knowledge in Adult Naive Learners of American Sign Language

    ERIC Educational Resources Information Center

    Von Pein, Margreta; Altarriba, Jeanette

    2011-01-01

    The present study was designed to investigate the ways in which notions of semantics and phonology are acquired by adult naive learners of American Sign Language (ASL) when they are first exposed to a set of simple signs. First, a set of ASL signs was tested for nontransparency and a set of signs was selected for subsequent use. Next, a set of…

  2. Learning Progressions in Instructional Design: Expectations and Practice of Scientists Becoming Teachers in the Preservice and First-Year Settings

    ERIC Educational Resources Information Center

    Peters-Burton, Erin

    2012-01-01

    The purpose of this study was to ascertain the ways former professional scientists who are learning to become teachers understand the planning and implementation of instructional design 1) while they are in a university program learning to become teachers and 2) during their first year of full-time teaching in a secondary classroom. The study used…

  3. Design of a Novel Low Cost Point of Care Tampon (POCkeT) Colposcope for Use in Resource Limited Settings

    PubMed Central

    Lam, Christopher T.; Krieger, Marlee S.; Gallagher, Jennifer E.; Asma, Betsy; Muasher, Lisa C.; Schmitt, John W.; Ramanujam, Nimmi

    2015-01-01

    Introduction Current guidelines by WHO for cervical cancer screening in low- and middle-income countries involves visual inspection with acetic acid (VIA) of the cervix, followed by treatment during the same visit or a subsequent visit with cryotherapy if a suspicious lesion is found. Implementation of these guidelines is hampered by a lack of: trained health workers, reliable technology, and access to screening facilities. A low cost ultra-portable Point of Care Tampon based digital colposcope (POCkeT Colposcope) for use at the community level setting, which has the unique form factor of a tampon, can be inserted into the vagina to capture images of the cervix, which are on par with that of a state of the art colposcope, at a fraction of the cost. A repository of images to be compiled that can be used to empower front line workers to become more effective through virtual dynamic training. By task shifting to the community setting, this technology could potentially provide significantly greater cervical screening access to where the most vulnerable women live. The POCkeT Colposcope’s concentric LED ring provides comparable white and green field illumination at a fraction of the electrical power required in commercial colposcopes. Evaluation with standard optical imaging targets to assess the POCkeT Colposcope against the state of the art digital colposcope and other VIAM technologies. Results Our POCkeT Colposcope has comparable resolving power, color reproduction accuracy, minimal lens distortion, and illumination when compared to commercially available colposcopes. In vitro and pilot in vivo imaging results are promising with our POCkeT Colposcope capturing comparable quality images to commercial systems. Conclusion The POCkeT Colposcope is capable of capturing images suitable for cervical lesion analysis. Our portable low cost system could potentially increase access to cervical cancer screening in limited resource settings through task shifting to community

  4. Wellness Partners: Design and Evaluation of a Web-Based Physical Activity Diary with Social Gaming Features for Adults

    PubMed Central

    Wang, Hua; Spruijt-Metz, Donna; Jordan-Marsh, Maryalice; Valente, Thomas William

    2013-01-01

    Background The United States is currently in an age of obesity and inactivity despite increasing public awareness and scientific knowledge of detrimental long-term health effects of this lifestyle. Behavior-tracking diaries offer an effective strategy for physical activity adherence and weight management. Furthermore, Web-based physical activity diaries can engage meaningful partners in people’s social networks through fun online gaming interactions and generate motivational mechanisms for effective behavioral change and positive health outcomes. Objective Wellness Partners (WP) is a Web-based intervention in the form of a physical activity diary with social networking and game features. Two versions were designed and developed for the purpose of this study—“Diary” only and “Diary+Game”. The objectives of this study included pilot testing the research process of this intervention design, implementation, evaluation, and exploring the effectiveness of social gaming features on adult participants’ physical activity and anthropometric measures. Methods We conducted a field experiment with randomized crossover design. Assessments occurred at baseline, first follow-up (FU, 5-8 weeks after using one version of WP), and second FU (5-8 weeks of using the other version of WP). In the control condition, participants started with the “Diary” version of WP while in the experimental condition, participants started with the “Diary+Game” version of WP. A total of 54 adults (egos) ages 44-88, and their family and friends (alters) ages 17-69 participated in the study in ego-network groups. Both egos and their alters completed online surveys about their exercise habits. In addition, egos completed anthropometric measurements of BMI, fat percentage, and fat mass by bioimpedance. Results From October 2009 to May 2010, flyers, emails, and Web advertisements yielded 335 volunteers who were screened. Rolling recruitment resulted in enrollment of 142 qualified

  5. A proposed design and fabrication of lenses and mirrors from a set of spherical rings that produce desired energy distributions for solar energy applications

    SciTech Connect

    Gonzalez-Garcia, Jorge; Vazquez-Montiel, Sergio; Santiago-Alvarado, Agustin; Cordero-Davila, Alberto; Castro-Gonzalez, Graciela

    2009-12-15

    The amount of energy contained in the solar aureole affects the performance of solar systems. Solar optical systems are, therefore, dependent on the characteristics of the shape of the sun in a specific geographical location. For this reason, the present study proposes the design of solid lenses and mirrors modelled from a set of concentric spherical rings that give a desired distribution of energy in the focal plane. One hundred spherical rings, whose optimum curvature radius values were calculated by Genetic Algorithms, were employed in the modelling process. The study also proposes a design of a petal tool to polish lens and mirror surfaces. (author)

  6. Design and synthesis of new antioxidants predicted by the model developed on a set of pulvinic acid derivatives.

    PubMed

    Le Roux, Antoine; Kuzmanovski, Igor; Habrant, Damien; Meunier, Stéphane; Bischoff, Pierre; Nadal, Brice; Thetiot-Laurent, Sophie A-L; Le Gall, Thierry; Wagner, Alain; Novič, Marjana

    2011-12-27

    Antioxidative activity expressed as protection of thymidine has been investigated for a set of 30 pulvinic acid derivatives. A combination of in vitro testing and in silico modeling was used for synthesis of new potential antioxidants. Experimental data obtained from a primary screening test based on oxidation under Fenton conditions and by an UV exposure followed by back-titration of the amount of thymidine remaining intact have been used to develop a computer model for prediction of antioxidant activity. Structural descriptors of 30 compounds tested for their thymidine protection activity were calculated in order to define the structure-property relationship and to construct predictive models. Due to the potential nonlinearity, the counter-propagation artificial neural networks were assessed for modeling of the antioxidant activity of these compounds. The optimized model was challenged with 80 new molecules not present in the initial training set. The compounds with the highest predicted antioxidant activity were considered for synthesis. Among the predicted structures, some coumarine derivatives appeared to be especially interesting. One of them was synthesized and tested on in vitro assays and showed some antioxidant and radioprotective activities, which turned out as a promising lead toward more potent antioxidants. PMID:22077795

  7. Optimal design for sustainable development of a material recovery facility in a fast-growing urban setting

    SciTech Connect

    Chang, Ni-Bin . E-mail: nchang@even.tamuk.edu; Davila, Eric; Dyson, Brian; Brown, Ron

    2005-10-15

    Installing material recovery facilities (MRFs) in a solid waste management system could be a feasible alternative to achieve sustainable development goals in urban areas if current household and curbside recycling cannot prove successful in the long run. This paper addresses the optimal site selection and capacity planning for a MRF in conjunction with an optimal shipping strategy of solid waste streams in a multi-district urban region. Screening of material recovery and disposal capacity alternatives can be achieved in terms of economic feasibility, technology limitation, recycling potential, and site availability. The optimization objectives include economic impacts characterized by recycling income and cost components for waste management, while the constraint set consists of mass balance, capacity limitation, recycling limitation, scale economy, conditionality, and relevant screening constraints. A case study for the City of San Antonio, Texas (USA) presents a vivid example where scenario planning demonstrates the robustness and flexibility of this modeling analysis. It proves especially useful when determining MRF ownership structure. Each scenario experiences two case settings: (1) two MRF sites are proposed for selection and (2) a single MRF site is sought. Cost analysis confirms processing fees are not the driving force in the City's operation, but rather shipping cost. Sensitivity analysis solidifies the notion that significant public participation plays the most important role in minimizing solid waste management expenses.

  8. Water-quality assessment of part of the Upper Mississippi River basin, Minnesota and Wisconsin, environmental setting and study design

    USGS Publications Warehouse

    Stark, J.R.; Andrews, W.J.; Fallon, J.D.; Fong, A.L.; Goldstein, R.M.; Hanson, P.E.; Kroening, S.E.; Lee, K.E.

    1996-01-01

    Environmental stratification consists of dividing the study unit into subareas with homogeneous characteristics to assess natural and anthropogenic factors affecting water quality. The assessment of water quality in streams and in aquifers is based on the sampling design that compares water quality within homogeneous subareas defined by subbasins or aquifer boundaries. The study unit is stratified at four levels for the surface-water component: glacial deposit composition, surficial geology, general land use and land cover, and secondary land use. Ground-water studies emphasize shallow ground water where quality is most likely influenced by overlying land use and land cover. Stratification for ground-water sampling is superimposed on the distribution of shallow aquifers. For each aquifer and surface-water basin this stratification forms the basis for the proposed sampling design used in the Upper Mississippi River Basin National Water-Quality Assessment.

  9. Introducing the Oxford Vocal (OxVoc) Sounds database: a validated set of non-acted affective sounds from human infants, adults, and domestic animals

    PubMed Central

    Parsons, Christine E.; Young, Katherine S.; Craske, Michelle G.; Stein, Alan L.; Kringelbach, Morten L.

    2014-01-01

    Sound moves us. Nowhere is this more apparent than in our responses to genuine emotional vocalizations, be they heartfelt distress cries or raucous laughter. Here, we present perceptual ratings and a description of a freely available, large database of natural affective vocal sounds from human infants, adults and domestic animals, the Oxford Vocal (OxVoc) Sounds database. This database consists of 173 non-verbal sounds expressing a range of happy, sad, and neutral emotional states. Ratings are presented for the sounds on a range of dimensions from a number of independent participant samples. Perceptions related to valence, including distress, vocalizer mood, and listener mood are presented in Study 1. Perceptions of the arousal of the sound, listener motivation to respond and valence (positive, negative) are presented in Study 2. Perceptions of the emotional content of the stimuli in both Study 1 and 2 were consistent with the predefined categories (e.g., laugh stimuli perceived as positive). While the adult vocalizations received more extreme valence ratings, rated motivation to respond to the sounds was highest for the infant sounds. The major advantages of this database are the inclusion of vocalizations from naturalistic situations, which represent genuine expressions of emotion, and the inclusion of vocalizations from animals and infants, providing comparison stimuli for use in cross-species and developmental studies. The associated website provides a detailed description of the physical properties of each sound stimulus along with cross-category descriptions. PMID:25009511

  10. Design and Implementation of a Randomized Controlled Social and Mobile Weight Loss Trial for Young Adults (project SMART)

    PubMed Central

    Patrick, K; Marshall, SJ; Davila, EP; Kolodziejczyk, JK; Fowler, J; Calfas, KJ; Huang, J; Rock, CL; Griswold, W; Gupta, A; Merchant, G; Norman, GJ; Raab, F; Donohue, M; Fogg, BJ; Robinson, TN

    2014-01-01

    Purpose To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media. Methods A total of 404 overweight or obese college students from three Southern California universities (Mage = 22(±4) years; MBMI=29(±2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, SMS, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, physical activity (PA), sedentary behavior (SED), diet, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24 months. Currently, all participants have been recruited, and all are in the final year of the trial. Conclusion Theory-driven, evidence-based strategies for PA, SED, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults. PMID:24215774

  11. Design and validation of a pericentromeric BAC clone set aimed at improving diagnosis and phenotype prediction of supernumerary marker chromosomes

    PubMed Central

    2013-01-01

    Background Small supernumerary marker chromosomes (sSMCs) are additional, structurally abnormal chromosomes, generally smaller than chromosome 20 of the same metaphase spread. Due to their small size, they are difficult to characterize by conventional cytogenetics alone. In regard to their clinical effects, sSMCs are a heterogeneous group: in particular, sSMCs containing pericentromeric euchromatin are likely to be associated with abnormal outcomes, although exceptions have been reported. To improve characterization of the genetic content of sSMCs, several approaches might be applied based on different molecular and molecular-cytogenetic assays, e.g., fluorescent in situ hybridization (FISH), array-based comparative genomic hybridization (array CGH), and multiplex ligation-dependent probe amplification (MLPA). To provide a complementary tool for the characterization of sSMCs, we constructed and validated a new, FISH-based, pericentromeric Bacterial Artificial Chromosome (BAC) clone set that with a high resolution spans the most proximal euchromatic sequences of all human chromosome arms, excluding the acrocentric short arms. Results By FISH analysis, we assayed 561 pericentromeric BAC probes and excluded 75 that showed a wrong chromosomal localization. The remaining 486 probes were used to establish 43 BAC-based pericentromeric panels. Each panel consists of a core, which with a high resolution covers the most proximal euchromatic ~0.7 Mb (on average) of each chromosome arm and generally bridges the heterochromatin/euchromatin junction, as well as clones located proximally and distally to the core. The pericentromeric clone set was subsequently validated by the characterization of 19 sSMCs. Using the core probes, we could rapidly distinguish between heterochromatic (1/19) and euchromatic (11/19) sSMCs, and estimate the euchromatic DNA content, which ranged from approximately 0.13 to more than 10 Mb. The characterization was not completed for seven sSMCs due to a

  12. Moving Toward Implementation of Person-Centered Care for Older Adults in Community-Based Medical and Social Service Settings: "You Only Get Things Done When Working in Concert with Clients".

    PubMed

    Coulourides Kogan, Alexis; Wilber, Kathleen; Mosqueda, Laura

    2016-01-01

    Specialized, fragmented acute care is not aligned optimally to serve older adults. Person-centered care (PCC) has emerged as an evidence-based solution that involves enlisting patients as partners in treatment planning. Although several efforts have captured person-centered voices in outpatient care, more information is needed at the organizational and provider level to better understand the feasibility, challenges, and effect of PCC in community-based and social services settings. To assess themes and emerging trends, researchers conducted telephone interviews with leaders at nine organizations providing PCC for older adults. Questions were focused on the legacy of PCC services, whether and how PCC was connected to better quality care, and what tools were used for measuring PCC. Three themes on PCC for older adults emerged. (1) Each organization ascribed to a unique definition and operational structure for PCC. (2) Despite these differences, all organizations specified a strong commitment to PCC. Most noted financial resources and staffing as challenges and opportunities affecting feasibility. (3) Terms such as "patient-centered" care and other PCC synonyms may warrant greater clarification, because ideological differences set these classifications apart. Results from this analysis indicate the lack of a single, established definition for PCC. As interest in and support for PCC mounts, organizations in outpatient medical and community-based settings clearly have undertaken individual efforts to interpret what PCC is and how to provide it. Interview responses reflect this inconsistency, highlighting how staff and financing in particular can bolster or burden the PCC paradigm and what a consensus definition could do for the field.

  13. Moving Toward Implementation of Person-Centered Care for Older Adults in Community-Based Medical and Social Service Settings: "You Only Get Things Done When Working in Concert with Clients".

    PubMed

    Coulourides Kogan, Alexis; Wilber, Kathleen; Mosqueda, Laura

    2016-01-01

    Specialized, fragmented acute care is not aligned optimally to serve older adults. Person-centered care (PCC) has emerged as an evidence-based solution that involves enlisting patients as partners in treatment planning. Although several efforts have captured person-centered voices in outpatient care, more information is needed at the organizational and provider level to better understand the feasibility, challenges, and effect of PCC in community-based and social services settings. To assess themes and emerging trends, researchers conducted telephone interviews with leaders at nine organizations providing PCC for older adults. Questions were focused on the legacy of PCC services, whether and how PCC was connected to better quality care, and what tools were used for measuring PCC. Three themes on PCC for older adults emerged. (1) Each organization ascribed to a unique definition and operational structure for PCC. (2) Despite these differences, all organizations specified a strong commitment to PCC. Most noted financial resources and staffing as challenges and opportunities affecting feasibility. (3) Terms such as "patient-centered" care and other PCC synonyms may warrant greater clarification, because ideological differences set these classifications apart. Results from this analysis indicate the lack of a single, established definition for PCC. As interest in and support for PCC mounts, organizations in outpatient medical and community-based settings clearly have undertaken individual efforts to interpret what PCC is and how to provide it. Interview responses reflect this inconsistency, highlighting how staff and financing in particular can bolster or burden the PCC paradigm and what a consensus definition could do for the field. PMID:26626544

  14. Monoamines and protein intake: are control mechanisms designed to monitor a threshold intake or a set point?

    PubMed

    Fernstrom, J D; Fernstrom, M H

    2001-08-01

    The concentration of TYR in brain changes directly with dietary protein content in the 0-10% PE range, but not higher. The effect is large: TYR concentrations rise as much as two- to threefold between 0% and 10% dietary protein content. This increase produces a clear stimulation of the rate of catecholamine synthesis, observed both for DA and NE, and notably in the hypothalamus, a brain area involved in appetite regulation. A similar relationship to chronic dietary protein intake may also exist for tryptophan and its neurotransmitter product, 5HT. Because the natural diet of rats, the animal model most commonly used in such studies, typically contains between 6% and 14% protein, and may contain less under unfavorable environmental circumstances, rats in the wild may frequently operate on the portion of the protein intake curve producing maximal changes in brain TYR (and perhaps TRP) concentrations. If so, then the production of catecholamines and 5HT may be similarly affected. By such a scenario, the brain might receive information regarding the animal's success in acquiring adequate amounts of protein in its diet. A similar argument can also be made for monkeys in the wild, based on their dietary habits, and thus possibly for humans. From this perspective, animals are hypothesized to monitor/regulate their intake of protein based on a threshold, rather than a set-point model. This notion is not new or unique to amino acids. For example, one current notion of leptin action is that it serves as a signal for energy intake important during periods of deficiency, but not excess. More generally, given the primacy in nature of the need to acquire adequate amounts of food in order to survive and reproduce, and the difficulty in achieving this nutritional goal, it may be that appetite control mechanisms have evolved in nature to center more on attaining and exceeding adequacy than on maintaining intake around a set-point well in excess of adequacy.

  15. Donepezil Treatment of Older Adults with Cognitive Impairment and Depression (DOTCODE study): clinical rationale and design

    PubMed Central

    Pelton, Gregory H.; Andrews, Howard; Roose, Steven P.; Marcus, Sue M.; D’Antonio, Kristina; Husn, Hala; Petrella, Jeffrey R.; Zannas, Anthony S.; Doraiswamy, P. Murali; Devanand, D. P.

    2014-01-01

    Treatment strategies for patients with depression and cognitive impairment (DEP-CI), who are at high risk to develop a clinical diagnosis of dementia, are not established. This issue is addressed in the donepezil treatment of cognitive impairment and depression (DOTCODE) pilot clinical trial. The DOTCODE study is the first long-term treatment trial that assesses differences in conversion to dementia and cognitive change in DEP-CI patients using a study design of open antidepressant medication plus add-on randomized, double-blind, placebo-controlled treatment with the acetylcholinesterase inhibitor donepezil. In Phase 1, DEP-CI patients receive optimized antidepressant treatment for 16 weeks. In Phase 2, antidepressant treatment is continued with the addition of randomized, double-blind treatment with donepezil or placebo. The total study duration for each patient is 78 weeks (18 months). Eighty DEP-CI outpatients (age 55 to 95 years) are recruited: 40 at New York State Psychiatric Institute/Columbia University and 40 at Duke University Medical Center. The primary outcome is conversion to a clinical diagnosis of dementia. The secondary outcomes are cognitive change scores in Selective Reminding Test (SRT) total recall and the modified Alzheimer’s Disease Assessment Scale (ADAS-cog). Other key assessments include the 24-item Hamilton Depression Rating Scale and antidepressant response; Clinical Global Impression (CGI) for depression, cognition, and global status; neuropsychological test battery for diagnosis; informant report of functional abilities (Pfeffer FAQ); Treatment Emergent Symptom Scale (TESS) for somatic side effects. Apolipoprotein E ε4 status, odor identification deficits, and MRI entorhinal/hippocampal cortex atrophy at baseline are evaluated as neurobiological moderators of donepezil treatment effects. PMID:24315979

  16. Design, Development, and Evaluation of Career Education Materials for Adult Farmworkers with Limited English-Speaking Ability Who Return to Formal Education. Final Report, Volume I.

    ERIC Educational Resources Information Center

    Atkinson, Donald R.

    A project was conducted to design, develop, and evaluate the effectiveness of bilingual (Spanish and English) career education materials for adult farmworkers with limited English-speaking ability. A career education manual, a series of audio- and video-taped interviews with former farmworkers employed in various job cluster areas, and a…

  17. Finding the Words to Work Together: Developing a Research Design to Explore Risk and Adult Protection in Co-Produced Research

    ERIC Educational Resources Information Center

    Brookes, Ian; Archibald, Sylvia; McInnes, Kerry; Cross, Beth; Daniel, Brigid; Johnson, Fiona

    2012-01-01

    Although co-production of research with people who access support services is increasingly common, details about how people who access support services can take more of an assertive role in developing research proposals and method design remains sketchy. This article reflects on the development of a research project on adult protection practice in…

  18. Keeping patient beds in a low position: an exploratory descriptive study to continuously monitor the height of patient beds in an adult acute surgical inpatient care setting.

    PubMed

    Tzeng, Huey-Ming; Prakash, Atul; Brehob, Mark; Devecsery, David Andrew; Anderson, Allison; Yin, Chang-Yi

    2012-06-01

    This descriptive study was intended to measure the percentage of the time that patient beds were kept in high position in an adult acute inpatient surgical unit with medical overflow in a community hospital in Michigan, United States. The percentage of the time was calculated for morning, evening, and night shifts. The results showed that overall, occupied beds were in a high position 5.6% of the time: 5.40% in the day shift, 6.88% in the evening shift, and 4.38% in the night shift. It is recognized that this study was unable to differentiate whether those times patient beds being kept in a high position were appropriate for an elevated bed height (e.g., staff were working with the patient). Further research is warranted. Falls committees may conduct high-bed prevalence surveys in a regular basis as a proxy to monitor staff members' behaviors in keeping beds in a high position.

  19. Adverse Events Profile of PrePex a Non-Surgical Device for Adult Male Circumcision in a Ugandan Urban Setting

    PubMed Central

    Galukande, Moses; Duffy, Kevin; Bitega, Jean Paul; Rackara, Sam; Bbaale, Denis Sekavuga; Nakaggwa, Florence; Nagaddya, Teddy; Wooding, Nick; Dea, Monica; Coutinho, Alex

    2014-01-01

    Background Safe Male Circumcision is a proven approach for partial HIV prevention. Several sub Saharan African countries have plans to reach a prevalence of 80% of their adult males circumcised by 2015. These targets require out of ordinary organization, demand creation, timely execution and perhaps the use of SMC devices. Objective To profile Adverse Events rate and acceptance of PrePex, a non surgical device for adult male circumcision. Methods A prospective study, conducted at International Hospital Kampala, Uganda, between August and October 2012. Ethical approval was obtained from Uganda National Council of Science and Technology. Results Of 1,040 men received to undergo SMC, 678 opted for PrePex, 36 were excluded at an initial physical examination screening. 642 were enrolled and consented, and another 17 were excluded before device placement. 625 underwent the procedure. Average age was 24 years (±7). Twelve moderate AEs occurred among 10 participants 12/625, (1.9%). These were all reversible. Five had device displacement, one had an everted foreskin; five had bleeding after the device was removed and one had voiding difficulties. The majority (279 out of 300) of men interviewed complained of some pain within the week of placement. Mean pain score at device placement (using visual analogue scale) was 0.5, at device removal 4.5 and within 2 min of removal the pain score was 1.4. Over 70% of the devices were placed and removed by non-physician clinicians. Presented with a choice, 60% of men chose PrePex over surgical SMC. Close to 90% would recommend the device to their friends. Odour from the necrotic skin was a concern. Removals done 1–2 days earlier than day 7 were beneficial and conferred no extra risk. Conclusion AEs of a moderate or severe nature associated with PrePex were low and reversible. PrePex is feasible for mass safe male circumcision scaling up. PMID:24489754

  20. A mobile/web app for long distance caregivers of older adults: functional requirements and design implications from a user centered design process.

    PubMed

    Williamson, Steven S; Gorman, Paul N; Jimison, Holly B

    2014-01-01

    Recent trends of population aging and globalization have required an increasing number of individuals to act as long distance caregivers (LDCs) to aging family members. Information technology solutions may ease the burden placed on LDCs by providing remote monitoring, easier access to information and enhanced communication. While some technology tools have been introduced, the information and technology needs of LDCs in particular are not well understood. Consequently, a needs assessment was performed by using video conferencing software to conduct semi-structured interviews with 10 LDCs. Interviews were enriched through the use of stimulus materials that included the demonstration of a prototype LDC health management web/mobile app. Responses were recorded, transcribed and then analyzed. Subjects indicated that information regarding medication regimens and adherence, calendaring, and cognitive health were most needed. Participants also described needs for video calling, activity data regarding sleep and physical exercise, asynchronous communication, photo sharing, journaling, access to online health resources, real-time monitoring, an overall summary of health, and feedback/suggestions to help them improve as caregivers. In addition, all respondents estimated their usage of a LDC health management website would be at least once per week, with half indicating a desire to access the website from a smartphone. These findings are being used to inform the design of a LDC health management website to promote the meaningful involvement of distant family members in the care of older adults.

  1. A Mobile/Web App for Long Distance Caregivers of Older Adults: Functional Requirements and Design Implications from a User Centered Design Process

    PubMed Central

    Williamson, Steven S.; Gorman, Paul N.; Jimison, Holly B.

    2014-01-01

    Recent trends of population aging and globalization have required an increasing number of individuals to act as long distance caregivers (LDCs) to aging family members. Information technology solutions may ease the burden placed on LDCs by providing remote monitoring, easier access to information and enhanced communication. While some technology tools have been introduced, the information and technology needs of LDCs in particular are not well understood. Consequently, a needs assessment was performed by using video conferencing software to conduct semi-structured interviews with 10 LDCs. Interviews were enriched through the use of stimulus materials that included the demonstration of a prototype LDC health management web/mobile app. Responses were recorded, transcribed and then analyzed. Subjects indicated that information regarding medication regimens and adherence, calendaring, and cognitive health were most needed. Participants also described needs for video calling, activity data regarding sleep and physical exercise, asynchronous communication, photo sharing, journaling, access to online health resources, real-time monitoring, an overall summary of health, and feedback/suggestions to help them improve as caregivers. In addition, all respondents estimated their usage of a LDC health management website would be at least once per week, with half indicating a desire to access the website from a smartphone. These findings are being used to inform the design of a LDC health management website to promote the meaningful involvement of distant family members in the care of older adults. PMID:25954469

  2. A mobile/web app for long distance caregivers of older adults: functional requirements and design implications from a user centered design process.

    PubMed

    Williamson, Steven S; Gorman, Paul N; Jimison, Holly B

    2014-01-01

    Recent trends of population aging and globalization have required an increasing number of individuals to act as long distance caregivers (LDCs) to aging family members. Information technology solutions may ease the burden placed on LDCs by providing remote monitoring, easier access to information and enhanced communication. While some technology tools have been introduced, the information and technology needs of LDCs in particular are not well understood. Consequently, a needs assessment was performed by using video conferencing software to conduct semi-structured interviews with 10 LDCs. Interviews were enriched through the use of stimulus materials that included the demonstration of a prototype LDC health management web/mobile app. Responses were recorded, transcribed and then analyzed. Subjects indicated that information regarding medication regimens and adherence, calendaring, and cognitive health were most needed. Participants also described needs for video calling, activity data regarding sleep and physical exercise, asynchronous communication, photo sharing, journaling, access to online health resources, real-time monitoring, an overall summary of health, and feedback/suggestions to help them improve as caregivers. In addition, all respondents estimated their usage of a LDC health management website would be at least once per week, with half indicating a desire to access the website from a smartphone. These findings are being used to inform the design of a LDC health management website to promote the meaningful involvement of distant family members in the care of older adults. PMID:25954469

  3. Through the looking glass: making the design and output of economic models useful for setting medical policy.

    PubMed

    Ollendorf, Daniel A; Pearson, Steven D

    2014-01-01

    Economic modeling has rarely been considered to be an essential component of healthcare policy-making in the USA, due to a lack of transparency in model design and assumptions, as well as political interests that equate examination of cost with unfair rationing. The Institute for Clinical and Economic Review has been involved in several efforts to bring economic modeling into public discussion of the comparative value of healthcare interventions, efforts that have evolved over time to suit the needs of multiple public forums. In this article, we review these initiatives and present a template that attempts to 'unpack' model output and present the major drivers of outcomes and cost. We conclude with a series of recommendations for effective presentation of economic models to US policy-makers.

  4. Designing an optical set-up of differential laser triangulation for oil film thickness measurement on water.

    PubMed

    Ge, Baozhene; Sun, Jingbin; Liu, Pengcheng; Lü, Qieni; Wu, Di

    2013-01-01

    Based on the differential laser triangulation principle, an optical system configuration for measuring the oil film thickness on water is designed and developed. A semiconductor laser of 650 nm wavelength with the maximum power of 5 mW is used as a light source, the magnification of the imaging system is 1.4; the range of the measurement is 0.1 mm-10 mm; the resolution is 2.3 μm and the measurement accuracy is 10 μm theoretically. Experiments are conducted with block gauges and feeler gauges, and the experimental results, with absolute error less than ±25 μm and the maximal measurable thickness 12 mm, indicate that this system presented in this paper can fulfill high accuracy.

  5. Evaluation of multiple hydraulic models in generating design/near-real time flood inundation extents under various geophysical settings

    NASA Astrophysics Data System (ADS)

    Liu, Z.; Rajib, M. A.; Jafarzadegan, K.; Merwade, V.

    2015-12-01

    Application of land surface/hydrologic models within an operational flood forecasting system can provide probable time of occurrence and magnitude of streamflow at specific locations along a stream. Creating time-varying spatial extent of flood inundation and depth requires the use of a hydraulic or hydrodynamic model. Models differ in representing river geometry and surface roughness which can lead to different output depending on the particular model being used. The result from a single hydraulic model provides just one possible realization of the flood extent without capturing the uncertainty associated with the input or the model parameters. The objective of this study is to compare multiple hydraulic models toward generating ensemble flood inundation extents. Specifically, relative performances of four hydraulic models, including AutoRoute, HEC-RAS, HEC-RAS 2D, and LISFLOOD are evaluated under different geophysical conditions in several locations across the United States. By using streamflow output from the same hydrologic model (SWAT in this case), hydraulic simulations are conducted for three configurations: (i) hindcasting mode by using past observed weather data at daily time scale in which models are being calibrated against USGS streamflow observations, (ii) validation mode using near real-time weather data at sub-daily time scale, and (iii) design mode with extreme streamflow data having specific return periods. Model generated inundation maps for observed flood events both from hindcasting and validation modes are compared with remotely sensed images, whereas the design mode outcomes are compared with corresponding FEMA generated flood hazard maps. The comparisons presented here will give insights on probable model-specific nature of biases and their relative advantages/disadvantages as components of an operational flood forecasting system.

  6. Design and Recruitment of the Chicago Healthy Living Study: A Study of Health Behaviors in a Diverse Cohort of Adult Childhood Cancer Survivors

    PubMed Central

    Stolley, Melinda R.; Sharp, Lisa K.; Arroyo, Claudia; Ruffin, Cherese; Restrepo, Jacqueline; Campbell, Richard

    2009-01-01

    Background Adult childhood cancer survivors are at higher risk for developing late medical effects related to their cancer treatments. Health promoting behaviors may reduce the risk of some late effects and the severity of others. This paper describes the design and recruitment of the Chicago Healthy Living Study (CHLS), an on-going study designed to examine the health behaviors and BMI of minority adult childhood cancer survivors as compared to non-minority survivors and non-cancer controls. Methods Survivors are identified by the hospital cancer registries at five treating institutions in the Chicago area, after which a multilevel recruitment plan is implemented with the goal of enrolling 450 adult survivors of childhood cancer (150 in each racial/ethnic group). Simultaneously, 300 African-American, Hispanic and Non-Hispanic White adult non-cancer controls (100 in each racial/ethnic group) living in the Chicago area are being recruited via listed, targeted digit dial. All participants complete a 2-hour interview of questionnaires related to diet, physical activity, smoking and associated mediators. Height and weight are also measured. Conclusions The Chicago Healthy Living Study will provide important information on the health behaviors of adult minority childhood cancer survivors that can be used to inform the development of interventions to improve modifiable risks. PMID:19731351

  7. The Walking Interventions Through Texting (WalkIT) Trial: Rationale, Design, and Protocol for a Factorial Randomized Controlled Trial of Adaptive Interventions for Overweight and Obese, Inactive Adults

    PubMed Central

    Hurley, Jane C; Hollingshead, Kevin E; Todd, Michael; Jarrett, Catherine L; Tucker, Wesley J; Angadi, Siddhartha S

    2015-01-01

    Background Walking is a widely accepted and frequently targeted health promotion approach to increase physical activity (PA). Interventions to increase PA have produced only small improvements. Stronger and more potent behavioral intervention components are needed to increase time spent in PA, improve cardiometabolic risk markers, and optimize health. Objective Our aim is to present the rationale and methods from the WalkIT Trial, a 4-month factorial randomized controlled trial (RCT) in inactive, overweight/obese adults. The main purpose of the study was to evaluate whether intensive adaptive components result in greater improvements to adults’ PA compared to the static intervention components. Methods Participants enrolled in a 2x2 factorial RCT and were assigned to one of four semi-automated, text message–based walking interventions. Experimental components included adaptive versus static steps/day goals, and immediate versus delayed reinforcement. Principles of percentile shaping and behavioral economics were used to operationalize experimental components. A Fitbit Zip measured the main outcome: participants’ daily physical activity (steps and cadence) over the 4-month duration of the study. Secondary outcomes included self-reported PA, psychosocial outcomes, aerobic fitness, and cardiorespiratory risk factors assessed pre/post in a laboratory setting. Participants were recruited through email listservs and websites affiliated with the university campus, community businesses and local government, social groups, and social media advertising. Results This study has completed data collection as of December 2014, but data cleaning and preliminary analyses are still in progress. We expect to complete analysis of the main outcomes in late 2015 to early 2016. Conclusions The Walking Interventions through Texting (WalkIT) Trial will further the understanding of theory-based intervention components to increase the PA of men and women who are healthy, insufficiently

  8. Design and Analysis of Salmonid Tagging Studies in the Columbia Basin, Volume XVI; Alternative Designs for Future Adult PIT-Tag Detection Studies, 2000 Technical Report.

    SciTech Connect

    Perez-Comas, Jose A.; Skalski, John R.

    2000-09-25

    In the advent of the installation of a PIT-tag interrogation system in the Cascades Island fish ladder at Bonneville Dam (BON), and other CRB dams, this overview describes in general terms what can and cannot be estimated under seven different scenarios of adult PIT-tag detection capabilities in the CRB. Moreover, this overview attempted to identify minimal adult PIT-tag detection configurations required by the ten threatened Columbia River Basin (CRB) chinook and steelhead ESUs. A minimal adult PIT-tag detection configuration will require the installation of adult PIT-tag detection facilities at Bonneville Dam and another dam above BON. Thus, the Snake River spring/summer and fall chinook salmon, and the Snake River steelhead will require a minimum of three dams with adult PIT-tag detection capabilities to guarantee estimates of ''ocean survival'' and at least of one independent, in-river returning adult survival (e.g., adult PIT-tag detection facilities at BON and LGR dams and at any other intermediary dam such as IHR). The Upper Columbia River spring chinook salmon and steelhead will also require a minimum of three dams with adult PIT-tag detection capabilities: BON and two other dams on the BON-WEL reach. The current CRB dam system configuration and BPA's and COE's commitment to install adult PIT-tag detectors only in major CRB projects will not allow the estimation of an ''ocean survival'' and of any in-river adult survival for the Lower Columbia River chinook salmon and steelhead. The Middle Columbia River steelhead ESU will require a minimum of two dams with adult PIT-tag detection capabilities: BON and another upstream dam on the BON-McN reach. Finally, in spite of their importance in terms of releases, PIT-tag survival studies for the Upper Willamette chinook and Upper Willamette steelhead ESUs cannot be perform with the current CRB dam system configuration and PIT-tag detection capabilities.

  9. Design considerations for a higher-order-mode dielectric-loaded power extractor set for millimeter-wave generation.

    SciTech Connect

    Gai, W.; Liu, W.; Gao, F.; Wong, T.; Jing, C.; High Energy Physics; Illinois Inst. of Tech.; Euclid Techlabs LLC

    2009-10-11

    The design of an electron-beam excited device for millimeter-wave generation is presented. Referred to as a dielectric-loaded power extractor, it is based on the higher-order-mode operation of a dielectric-loaded waveguide. With a matching transition, the unit can deliver power to the output waveguide at one of two frequencies, 20.8 and 35.1 GHz, corresponding to the TM{sub 02} and TM{sub 03} modes, respectively. By properly choosing the thickness of the dielectric lining, both modes are tuned to synchronize with an ultra-relativistic electron beam traversing the unit so that the wakefield generated by the beam is excited at these modes, chosen to be at 20.8 and 35.1 GHz, respectively, both corresponding to a harmonic of the 1.3 GHz operating frequency at an accelerator facility. Power generated in the unintended TM{sub 01} mode is effectively suppressed for bunch train operation by a novel technique. The device consists of a dielectric-loaded decelerating structure and two changeable output couplers to deliver the millimeter-wave power to a standard waveguide. For a drive beam with 50 nC of charge per bunch, power levels of 90.4 and 8.68 MW are expected to be delivered by the device at 20.8 and 35.1 GHz, respectively.

  10. On-line diagnostics of washing machines: design issues for the optimization of the measurement set-up

    NASA Astrophysics Data System (ADS)

    Agostinelli, G.; Paone, N.; Cristalli, C.; Torcianti, B.

    2008-06-01

    This paper discusses some of the relevant aspects that a designer of an on-line test station for washing machine diagnostics based on a single-point laser Doppler vibrometer should consider. In particular, the paper presents a series of experiments useful to answer the two following questions: a) Where to locate the measurement point? b) Does the test need to be done with an external load to be inserted into the rotating drum? Tests have been done on a "good" washing machine and on a machine exhibiting the most frequent defects to be detected in production line. The study of the Operating Deflection Shapes (ODS) of the machine has been used to determine the best area of the machine cabinet where to position the single point laser vibrometer for on-line diagnostics. In order to support the decision whether or not to employ an artificial unbalance load inserted into the drum during the dynamic test, measurements have been repeated with and without load. Results have been analysed to highlight pros and cons of the use of an external load.

  11. 5-SPICE: the application of an original framework for community health worker program design, quality improvement and research agenda setting

    PubMed Central

    Palazuelos, Daniel; DaEun Im, Dana; Peckarsky, Matthew; Schwarz, Dan; Farmer, Didi Bertrand; Dhillon, Ranu; Johnson, Ari; Orihuela, Claudia; Hackett, Jill; Bazile, Junior; Berman, Leslie; Ballard, Madeleine; Panjabi, Raj; Ternier, Ralph; Slavin, Sam; Lee, Scott; Selinsky, Steve; Mitnick, Carole Diane

    2013-01-01

    Introduction Despite decades of experience with community health workers (CHWs) in a wide variety of global health projects, there is no established conceptual framework that structures how implementers and researchers can understand, study and improve their respective programs based on lessons learned by other CHW programs. Objective To apply an original, non-linear framework and case study method, 5-SPICE, to multiple sister projects of a large, international non-governmental organization (NGO), and other CHW projects. Design Engaging a large group of implementers, researchers and the best available literature, the 5-SPICE framework was refined and then applied to a selection of CHW programs. Insights gleaned from the case study method were summarized in a tabular format named the ‘5×5-SPICE chart’. This format graphically lists the ways in which essential CHW program elements interact, both positively and negatively, in the implementation field. Results The 5×5-SPICE charts reveal a variety of insights that come from a more complex understanding of how essential CHW projects interact and influence each other in their unique context. Some have been well described in the literature previously, while others are exclusive to this article. An analysis of how best to compensate CHWs is also offered as an example of the type of insights that this method may yield. Conclusions The 5-SPICE framework is a novel instrument that can be used to guide discussions about CHW projects. Insights from this process can help guide quality improvement efforts, or be used as hypothesis that will form the basis of a program's research agenda. Recent experience with research protocols embedded into successfully implemented projects demonstrates how such hypothesis can be rigorously tested. PMID:23561023

  12. Faculty Development Program on Teaching Adults.

    ERIC Educational Resources Information Center

    Cooper, John D., Comp.

    In response to a growing concern over how adult students' needs can be met effectively, Lansing Community College has produced two videotapes and accompanying materials for use with faculty development programs. These 3/4 inch color videocassettes are designed to be used in a workshop setting as well as on a cable or closed television system for…

  13. A Consciousness-Raising Program for Adult Women.

    ERIC Educational Resources Information Center

    Kincaid, Marylou B.

    This program is a structured, 16-session consciousness-raising group for adult women which can be used in a university setting with women in continuing education or in a community setting with noncollege women. The program is designed to help women identify the influence of sex-role stereotyping on their lives, learn ways for effective sex-role…

  14. Neurofeedback of slow cortical potentials: neural mechanisms and feasibility of a placebo-controlled design in healthy adults

    PubMed Central

    Gevensleben, Holger; Albrecht, Björn; Lütcke, Henry; Auer, Tibor; Dewiputri, Wan Ilma; Schweizer, Renate; Moll, Gunther; Heinrich, Hartmut; Rothenberger, Aribert

    2014-01-01

    To elucidate basic mechanisms underlying neurofeedback we investigated neural mechanisms of training of slow cortical potentials (SCPs) by considering EEG- and fMRI. Additionally, we analyzed the feasibility of a double-blind, placebo-controlled design in NF research based on regulation performance during treatment sessions and self-assessment of the participants. Twenty healthy adults participated in 16 sessions of SCPs training: 9 participants received regular SCP training, 11 participants received sham feedback. At three time points (pre, intermediate, post) fMRI and EEG/ERP-measurements were conducted during a continuous performance test (CPT). Performance-data during the sessions (regulation performance) in the treatment group and the placebo group were analyzed. Analysis of EEG-activity revealed in the SCP group a strong enhancement of the CNV (electrode Cz) at the intermediate assessment, followed by a decrease back to baseline at the post-treatment assessment. In contrast, in the placebo group a continuous but smaller increase of the CNV could be obtained from pre to post assessment. The increase of the CNV in the SCP group at intermediate testing was superior to the enhancement in the placebo group. The changes of the CNV were accompanied by a continuous improvement in the test performance of the CPT from pre to intermediate to post assessment comparable in both groups. The change of the CNV in the SCP group is interpreted as an indicator of neural plasticity and efficiency while an increase of the CNV in the placebo group might reflect learning and improved timing due to the frequent task repetition. In the fMRI analysis evidence was obtained for neuronal plasticity. After regular SCP neurofeedback activation in the posterior parietal cortex decreased from the pre- to the intermediate measurement and increased again in the post measurement, inversely following the U-shaped increase and decrease of the tCNV EEG amplitude in the SCP-trained group

  15. Neurofeedback of slow cortical potentials: neural mechanisms and feasibility of a placebo-controlled design in healthy adults.

    PubMed

    Gevensleben, Holger; Albrecht, Björn; Lütcke, Henry; Auer, Tibor; Dewiputri, Wan Ilma; Schweizer, Renate; Moll, Gunther; Heinrich, Hartmut; Rothenberger, Aribert

    2014-01-01

    To elucidate basic mechanisms underlying neurofeedback we investigated neural mechanisms of training of slow cortical potentials (SCPs) by considering EEG- and fMRI. Additionally, we analyzed the feasibility of a double-blind, placebo-controlled design in NF research based on regulation performance during treatment sessions and self-assessment of the participants. Twenty healthy adults participated in 16 sessions of SCPs training: 9 participants received regular SCP training, 11 participants received sham feedback. At three time points (pre, intermediate, post) fMRI and EEG/ERP-measurements were conducted during a continuous performance test (CPT). Performance-data during the sessions (regulation performance) in the treatment group and the placebo group were analyzed. Analysis of EEG-activity revealed in the SCP group a strong enhancement of the CNV (electrode Cz) at the intermediate assessment, followed by a decrease back to baseline at the post-treatment assessment. In contrast, in the placebo group a continuous but smaller increase of the CNV could be obtained from pre to post assessment. The increase of the CNV in the SCP group at intermediate testing was superior to the enhancement in the placebo group. The changes of the CNV were accompanied by a continuous improvement in the test performance of the CPT from pre to intermediate to post assessment comparable in both groups. The change of the CNV in the SCP group is interpreted as an indicator of neural plasticity and efficiency while an increase of the CNV in the placebo group might reflect learning and improved timing due to the frequent task repetition. In the fMRI analysis evidence was obtained for neuronal plasticity. After regular SCP neurofeedback activation in the posterior parietal cortex decreased from the pre- to the intermediate measurement and increased again in the post measurement, inversely following the U-shaped increase and decrease of the tCNV EEG amplitude in the SCP-trained group

  16. Design of clinical trials in AKI: a report from an NIDDK workshop. Trials of patients with sepsis and in selected hospital settings.

    PubMed

    Molitoris, Bruce A; Okusa, Mark D; Palevsky, Paul M; Chawla, Lakhmir S; Kaufman, James S; Devarajan, Prasad; Toto, Robert M; Hsu, Chi-yuan; Greene, Tom H; Faubel, Sarah G; Kellum, John A; Wald, Ron; Chertow, Glenn M; Levin, Adeera; Waikar, Sushrut S; Murray, Patrick T; Parikh, Chirag R; Shaw, Andrew D; Go, Alan S; Chinchilli, Vernon M; Liu, Kathleen D; Cheung, Alfred K; Weisbord, Steven D; Mehta, Ravindra L; Stokes, John B; Thompson, Aliza M; Thompson, B Taylor; Westenfelder, Christof S; Tumlin, James A; Warnock, David G; Shah, Sudhir V; Xie, Yining; Duggan, Emily G; Kimmel, Paul L; Star, Robert A

    2012-05-01

    AKI remains an important clinical problem, with a high mortality rate, increasing incidence, and no Food and Drug Administration-approved therapeutics. Advances in addressing this clinical need require approaches for rapid diagnosis and stratification of injury, development of therapeutic agents based on precise understanding of key pathophysiological events, and implementation of well designed clinical trials. In the near future, AKI biomarkers may facilitate trial design. To address these issues, the National Institute of Diabetes and Digestive and Kidney Diseases sponsored a meeting, "Clinical Trials in Acute Kidney Injury: Current Opportunities and Barriers," in December of 2010 that brought together academic investigators, industry partners, and representatives from the National Institutes of Health and the Food and Drug Administration. Important issues in the design of clinical trials for interventions in AKI in patients with sepsis or AKI in the setting of critical illness after surgery or trauma were discussed. The sepsis working group discussed use of severity of illness scores and focus on patients with specific etiologies to enhance homogeneity of trial participants. The group also discussed endpoints congruent with those endpoints used in critical care studies. The second workgroup emphasized difficulties in obtaining consent before admission and collaboration among interdisciplinary healthcare groups. Despite the difficult trial design issues, these clinical situations represent a clinical opportunity because of the high event rates, severity of AKI, and poor outcomes. The groups considered trial design issues and discussed advantages and disadvantages of several short- and long-term primary endpoints in these patients.

  17. A task shifting approach to primary mental health care for adults in South Africa: human resource requirements and costs for rural settings.

    PubMed

    Petersen, Inge; Lund, Crick; Bhana, Arvin; Flisher, Alan J

    2012-01-01

    BACKGROUND A recent situational analysis suggests that post-apartheid South Africa has made some gains with respect to the decentralization and integration of mental health into primary health care. However, service gaps within and between provinces remain, with rural areas particularly underserved. Aim This study aims to calculate and cost a hypothetical human resource mix required to populate a framework for district adult mental health services. This framework embraces the concept of task shifting, where dedicated low cost mental health workers at the community and clinic levels supplement integrated care. METHOD The expected number and cost of human resources was based on: (a) assumptions of service provision derived from existing services in a sub-district demonstration site and a literature review of evidence-based packages of care in low- and middle-income countries; and (b) assumptions of service needs derived from other studies. RESULTS For a nominal population of 100 000, minimal service coverage estimates of 50% for schizophrenia, bipolar affective disorder, major depressive disorder and 30% for post-traumatic stress disorder and maternal depression would require that the primary health care staffing package include one post for a mental health counsellor or equivalent and 7.2 community mental health worker posts. The cost of these personnel amounts to £28 457 per 100 000 population. This cost can be offset by a reduction in the number of other specialist and non-specialist health personnel required to close service gaps at primary care level. CONCLUSION The adoption of the concept of task shifting can substantially reduce the expected number of health care providers otherwise needed to close mental health service gaps at primary health care level in South Africa at minimal cost and may serve as a model for other middle-income countries.

  18. A gene-environment investigation on personality traits in two independent clinical sets of adult patients with personality disorder and attention deficit/hyperactive disorder.

    PubMed

    Jacob, Christian P; Nguyen, Thuy Trang; Dempfle, Astrid; Heine, Monika; Windemuth-Kieselbach, Christine; Baumann, Katarina; Jacob, Florian; Prechtl, Julian; Wittlich, Maike; Herrmann, Martin J; Gross-Lesch, Silke; Lesch, Klaus-Peter; Reif, Andreas

    2010-06-01

    While an interactive effect of genes with adverse life events is increasingly appreciated in current concepts of depression etiology, no data are presently available on interactions between genetic and environmental (G x E) factors with respect to personality and related disorders. The present study therefore aimed to detect main effects as well as interactions of serotonergic candidate genes (coding for the serotonin transporter, 5-HTT; the serotonin autoreceptor, HTR1A; and the enzyme which synthesizes serotonin in the brain, TPH2) with the burden of life events (#LE) in two independent samples consisting of 183 patients suffering from personality disorders and 123 patients suffering from adult attention deficit/hyperactivity disorder (aADHD). Simple analyses ignoring possible G x E interactions revealed no evidence for associations of either #LE or of the considered polymorphisms in 5-HTT and TPH2. Only the G allele of HTR1A rs6295 seemed to increase the risk of emotional-dramatic cluster B personality disorders (p = 0.019, in the personality disorder sample) and to decrease the risk of anxious-fearful cluster C personality disorders (p = 0.016, in the aADHD sample). We extended the initial simple model by taking a G x E interaction term into account, since this approach may better fit the data indicating that the effect of a gene is modified by stressful life events or, vice versa, that stressful life events only have an effect in the presence of a susceptibility genotype. By doing so, we observed nominal evidence for G x E effects as well as main effects of 5-HTT-LPR and the TPH2 SNP rs4570625 on the occurrence of personality disorders. Further replication studies, however, are necessary to validate the apparent complexity of G x E interactions in disorders of human personality.

  19. Determination of organic additives in mortars by near-IR spectroscopy. A novel approach to designing a sample set with high-variability components.

    PubMed

    Blanco, Marcelo; Peguero, Anna

    2007-02-01

    Industrial mortars consist primarily of a mixture of cement and an aggregate plus a small amount of additives that are used to modify specific properties. Using too high or too low additive rates usually results in the loss of desirable properties in the end product. This entails carefully controlling the amounts of additives added to mortar in order to ensure correct dosing and/or adequate homogeneity in the final mixture. Near-IR (NIR) spectroscopy has proved effective for this purpose as it requires no sample pretreatment and affords expeditious analyses. The purpose of this work was to determine two organic additives (viz. Ad1 and Ad2) in mortars by using partial least squares regression multivariate calibration models constructed from NIR spectroscopic data. The additives are used to expedite setting and increase cohesion between particles in the mortar. In order to ensure that the sample set contained natural variability in the samples, we used a methodology based on experimental design to construct a representative set of samples. This novel design is based on a hexagonal antiprism that encompasses the concentration ranges spanned by the analytes and the variability inherent in each additive. The D-optimality criterion was used to obtain various combinations between Ad1 and Ad2 additive classes. The partial least squares calibration models thus constructed for each additive provided accurate predictions: the intercept and the slope of the plots of predicted values versus reference values for each additive were close to 0 and 1, respectively, and their confidence ranges included the respective value. The ensuing analytical methods were validated by using an external sample set.

  20. The Ecology of Human Performance Framework: A Model for Identifying and Designing Appropriate Accommodations for Adult Learners.

    ERIC Educational Resources Information Center

    Dunn, Winnie; Gilbert, Mary Pat; Parker, Kathy

    This paper proposes a model framework, The Ecology of Human Performance (EHP) framework, for organizing adult basic education to utilize the skills of occupational therapists. The paper also includes two responses to the proposed framework by Janet S. Stotts and Cheryl Keenan. Reasons for the inclusion of occupational therapy in adult education…

  1. Developing the Botswana Primary Care Guideline: an integrated, symptom-based primary care guideline for the adult patient in a resource-limited setting

    PubMed Central

    Tsima, Billy M; Setlhare, Vincent; Nkomazana, Oathokwa

    2016-01-01

    Background Botswana’s health care system is based on a primary care model. Various national guidelines exist for specific diseases. However, most of the guidelines address management at a tertiary level and often appear nonapplicable for the limited resources in primary care facilities. An integrated symptom-based guideline was developed so as to translate the Botswana national guidelines to those applicable in primary care. The Botswana Primary Care Guideline (BPCG) integrates the care of communicable diseases, including HIV/AIDS and noncommunicable diseases, by frontline primary health care workers. Methods The Department of Family Medicine, Faculty of Medicine, University of Botswana, together with guideline developers from the Knowledge Translation Unit (University of Cape Town) collaborated with the Ministry of Health to develop the guideline. Stakeholder groups were set up to review specific content of the guideline to ensure compliance with Botswana government policy and the essential drug list. Results Participants included clinicians, academics, patient advocacy groups, and policymakers from different disciplines, both private and public. Drug-related issues were identified as necessary for implementing recommendations of the guideline. There was consensus by working groups for updating the essential drug list for primary care and expansion of prescribing rights of trained nurse prescribers in primary care within their scope of practice. An integrated guideline incorporating common symptoms of diseases seen in the Botswana primary care setting was developed. Conclusion The development of the BPCG took a broad consultative approach with buy in from relevant stakeholders. It is anticipated that implementation of the BPCG will translate into better patient outcomes as similar projects elsewhere have done. PMID:27570457

  2. Designing the Game: How a Project-Based Media Production Program Approaches STEAM Career Readiness for Underrepresented Young Adults

    NASA Astrophysics Data System (ADS)

    Bass, Kristin M.; Hu Dahl, Ingrid; Panahandeh, Shirin

    2016-07-01

    Numerous studies have indicated a need for a diverse workforce that is more highly educated in STEM and ICT fields, and one that is capable of responding creatively to demands for continual innovation. This paper, in response, chronicles the implementation of the Digital Pathways (DP) program, a two-time ITEST recipient and an ongoing initiative of the Bay Area Video Coalition. DP has provided low-income, underrepresented minority young people with 180 contact hours of activities in digital media production to prepare them to pursue higher education and technology careers. A design-based research approach synthesizes staff interviews with student observations, interviews and artifacts to identify a set of generalizable best practices or design principles for empowering young people to move from being consumers of digital media to producers. These principles are illustrated with a case study of the 3D Animation and Gaming track from the second ITEST grant. Researchers argue for the importance of attending to the noncognitive elements of learning and illustrate ways in which instructors encouraged creative expression, personal agency, and collaboration through long-term projects. They also identify strategies for sustaining young people's participation through the establishment of a supportive community environment.

  3. Weight loss intervention for young adults using mobile technology: design and rationale of a randomized controlled trial – Cell phone Intervention for You (CITY)

    PubMed Central

    Batch, Bryan C.; Tyson, Crystal; Bagwell, Jacqueline; Corsino, Leonor; Intille, Stephen; Lin, Pao-Hwa; Lazenka, Tony; Bennett, Gary; Bosworth, Hayden B.; Voils, Corrine; Grambow, Steven; Sutton, Aziza; Bordogna, Rachel; Pangborn, Matthew; Schwager, Jenifer; Pilewski, Kate; Caccia, Carla; Burroughs, Jasmine; Svetkey, Laura P.

    2014-01-01

    Background The obesity epidemic has spread to young adults, leading to significant public health implications later in adulthood. Intervention in early adulthood may be an effective public health strategy for reducing the long-term health impact of the epidemic. Few weight loss trials have been conducted in young adults. It is unclear what weight loss strategies are beneficial in this population. Purpose To describe the design and rationale of the NHLBI-sponsored Cell Phone Intervention for You (CITY) study, which is a single center, randomized three-arm trial that compares the impact on weight loss of 1) a behavioral intervention that is delivered almost entirely via cell phone technology (Cell Phone group); and 2) a behavioral intervention delivered mainly through monthly personal coaching calls enhanced by self-monitoring via cell phone (Personal Coaching group), each compared to; 3) a usual care, advice-only control condition. Methods A total of 365 community-dwelling overweight/obese adults aged 18–35 years were randomized to receive one of these three interventions for 24 months in parallel group design. Study personnel assessing outcomes were blinded to group assignment. The primary outcome is weight change at 12 months. We hypothesize that each active intervention will cause more weight loss than the usual care condition. Study completion is anticipated in 2014. Conclusions If effective, implementation of the CITY interventions could mitigate the alarming rates of obesity in young adults through promotion of weight loss. PMID:24462568

  4. Examining the Disability Model From the International Classification of Functioning, Disability, and Health Using a Large Data Set of Community-Dwelling Malaysian Older Adults

    PubMed Central

    Loke, Seng Cheong; Lim, Wee Shiong; Someya, Yoshiko; Hamid, Tengku A.; Nudin, Siti S. H.

    2015-01-01

    Objective: This study examines the International Classification of Functioning, Disability, and Health model (ICF) using a data set of 2,563 community-dwelling elderly with disease-independent measures of mobility, physical activity, and social networking, to represent ICF constructs. Method: The relationship between chronic disease and disability (independent and dependent variables) was examined using logistic regression. To demonstrate variability in activity performance with functional impairment, graphing was used. The relationship between functional impairment, activity performance, and social participation was examined graphically and using ANOVA. The impact of cognitive deficits was quantified through stratifying by dementia. Results: Disability is strongly related to chronic disease (Wald 25.5, p < .001), functional impairment with activity performance (F = 34.2, p < .001), and social participation (F= 43.6, p < .001). With good function, there is considerable variability in activity performance (inter-quartile range [IQR] = 2.00), but diminishes with high impairment (IQR = 0.00) especially with cognitive deficits. Discussion: Environment modification benefits those with moderate functional impairment, but not with higher grades of functional loss. PMID:26472747

  5. Active Aging: Exploration into Self-Ratings of "Being Active," Out-of-Home Physical Activity, and Participation among Older Australian Adults Living in Four Different Settings.

    PubMed

    Aird, Rosemary L; Buys, Laurie

    2015-01-01

    We examined whether self-ratings of "being active" among older people living in four different settings (major city high and lower density suburbs, a regional city, and a rural area) were associated with out-of-home participation and outdoor physical activity. A mixed-methods approach (survey, travel diary, and GPS tracking over a one-week period) was used to gather data from 48 individuals aged over 55 years. Self-ratings of "being active" were found to be positively correlated with the number of days older people spent time away from home but unrelated to time traveled by active means (walking and biking). No significant differences in active travel were found between the four study locations, despite differences in their respective built environments. The findings suggest that additional strategies to the creation of "age-friendly" environments are needed if older people are to increase their levels of outdoor physical activity. "Active aging" promotion campaigns may need to explicitly identify the benefits of walking outdoors to ambulatory older people as a means of maintaining their overall health, functional ability, and participation within society in the long-term and also encourage the development of community-based programs in order to facilitate regular walking for this group. PMID:26346381

  6. Real time RT-PCR with a newly designed set of primers confirmed the presence of 2b and 2x/d myosin heavy chain mRNAs in the rat slow soleus muscle.

    PubMed

    Zurmanová, J; Půta, F; Stopková, R; Soukup, T

    2008-01-01

    In order to re-evaluate the presence and relative quantity of 2b and 2x/d myosin heavy chain (MyHC) transcripts in rat slow soleus muscle by using real time RT-PCR we have compared the available relevant cDNA sequences and designed a new set of primers having similar melting temperatures, matching separate MyHC exons in the regions of maximal differences in MyHC coding sequences, and containing G or C at the 3 -end. These also yielded PCR products of corresponding length, which is an important requirement for real time RT-PCR quantification. The experiments were performed on 8-month-old inbred female Lewis strain rats used in our current study of regenerating transplanted muscles. The real time RT-PCR measurement confirmed the expression of all four MyHC mRNAs (type 1, 2a, 2x/d and 2b) in both fast extensor digitorum longus and slow soleus muscles, although in the soleus muscle of adult rats, only type 1 and 2a protein isoforms can be usually detected.

  7. Planning Programs for Adult Learners: A Practical Guide for Educators, Trainers, and Staff Developers. Second Edition. The Jossey-Bass Higher and Adult Education Series.

    ERIC Educational Resources Information Center

    Caffarella, Rosemary S.

    This how-to guide and resource book is designed to help in planning educational and training programs for adults in settings from the corporate sector to educational organizations. Chapters 1-3 lay the groundwork for the rest of the guide by introducing the 12-component Interactive Model of Program Planning. Chapter 1 describes adult programs and…

  8. Sero-epidemiology of Hepatitis B Surface Antigenaemia among Adult Nigerians with Clinical Features of Liver Diseases Attending a Primary-Care Clinic in a Resource-Constrained Setting of Eastern Nigeria

    PubMed Central

    Iloh, Gabriel Uche Pascal; Ikwudinma, Austin Obiora

    2013-01-01

    Background: Hepatitis-B infection is not commonly perceived as a serious medical problem in Nigeria. However, chronic hepatitis-B infection, which is a subject of global concern, may lead to lethal liver diseases. Aim: The study was to determine the sero-epidemiology of hepatitis-B surface antigenaemia among adult Nigerians with clinical features of liver diseases attending a primary-care clinic in a resource-constrained setting of Eastern Nigeria. Materials and Methods: A cross-sectional study was carried out on 140 adult Nigerians with clinical features of liver diseases at the primary-care clinic of Federal Medical Centre, Owerri. They made up three groups: 44 patients, 62 patients and 34 patients with clinical features of hepatitis, liver cirrhosis and hepatocellular carcinoma, respectively. Hepatitis-B surface antigen (HBsAg) was assayed using an immunochromatographic method. Demographic variables were collected. Results: The overall sero-positivity rate was 50.7%. The sero-positivity rates for these patients were 23.9%, 39.5% and 36.6% for hepatitis, liver cirrhosis and hepatocellular carcinoma, respectively. The age group 40-60 years (P = 0.048) and artisans (P = 0.019) were significantly infected. Abdominal swelling (86.4%) and ascites (67.1%) were the most common symptoms and signs, respectively. Conclusion: HBsAg prevalence was high and has significant association with age and occupation. PMID:23724405

  9. Design of a Randomized Controlled Trial of a Web-Based Intervention to Reduce Cardiovascular Disease Risk Factors Among Remote Reservation–Dwelling American Indian Adults with Type 2 Diabetes

    PubMed Central

    Chubak, Jessica; O’Connell, Joan; Ramos, Maria C.; Jensen, Julie; Jobe, Jared B.

    2012-01-01

    We describe a randomized controlled trial, the Lakota Oyate Wicozani Pi Kte (LOWPK) trial, which was designed to determine whether a Web-based diabetes and nutritional intervention can improve risk factors related to cardiovascular disease (CVD) among a group of remote reservation–dwelling adult American Indian men and women with type 2 diabetes who are at high risk for CVD. Enrollment on a rolling basis of 180 planned participants began during 2009; an average 18-month follow-up was completed by June 2011. The primary outcome variable is change in glycosylated hemoglobin level after an average 18-month follow-up period. Secondary outcome variables include changes in low-density lipoprotein cholesterol, systolic blood pressure, body mass index, and smoking status, as well as an evaluation of intervention cost-effectiveness. If effective, the LOWPK trial may serve as a guide for future chronic disease intervention trials in remote, technologically challenged settings. PMID:23001642

  10. Establishment of Biosafety Level-3 (BSL-3) laboratory: important criteria to consider while designing, constructing, commissioning & operating the facility in Indian setting.

    PubMed

    Mourya, Devendra T; Yadav, Pragya D; Majumdar, Triparna Dutta; Chauhan, Devendra S; Katoch, Vishwa Mohan

    2014-08-01

    Since the enactment of Environmental Protection Act in 1989 and Department of Biotechnology (DBT) guidelines to deal with genetically modified organisms, India has embarked on establishing various levels of biosafety laboratories to deal with highly infectious and pathogenic organisms. Occurrence of outbreaks due to rapidly spreading respiratory and haemorrhagic fever causing viruses has caused an urgency to create a safe laboratory environment. This has thus become a mandate, not only to protect laboratory workers, but also to protect the environment and community. In India, technology and science are progressing rapidly. Several BSL-3 [=high containment] laboratories are in the planning or execution phase, to tackle biosafety issues involved in handling highly infectious disease agents required for basic research and diagnosis. In most of the developing countries, the awareness about biocontainment has increased but planning, designing, constructing and operating BSL-3 laboratories need regular updates about the design and construction of facilities and clear definition of risk groups and their handling which should be in harmony with the latest international practices. This article describes the major steps involved in the process of construction of a BSL-3 laboratory in Indian settings, from freezing the concept of proposal to operationalization phase. The key to success of this kind of project is strong institutional commitment to biosafety norms, adequate fund availability, careful planning and designing, hiring good construction agency, monitoring by experienced consultancy agency and involvement of scientific and engineering personnel with biocontainment experience in the process.

  11. Establishment of Biosafety Level-3 (BSL-3) laboratory: Important criteria to consider while designing, constructing, commissioning & operating the facility in Indian setting

    PubMed Central

    Mourya, Devendra T.; Yadav, Pragya D.; Majumdar, Triparna Dutta; Chauhan, Devendra S.; Katoch, Vishwa Mohan

    2014-01-01

    Since the enactment of Environmental Protection Act in 1989 and Department of Biotechnology (DBT) guidelines to deal with genetically modified organisms, India has embarked on establishing various levels of biosafety laboratories to deal with highly infectious and pathogenic organisms. Occurrence of outbreaks due to rapidly spreading respiratory and haemorrhagic fever causing viruses has caused an urgency to create a safe laboratory environment. This has thus become a mandate, not only to protect laboratory workers, but also to protect the environment and community. In India, technology and science are progressing rapidly. Several BSL-3 [=high containment] laboratories are in the planning or execution phase, to tackle biosafety issues involved in handling highly infectious disease agents required for basic research and diagnosis. In most of the developing countries, the awareness about biocontainment has increased but planning, designing, constructing and operating BSL-3 laboratories need regular updates about the design and construction of facilities and clear definition of risk groups and their handling which should be in harmony with the latest international practices. This article describes the major steps involved in the process of construction of a BSL-3 laboratory in Indian settings, from freezing the concept of proposal to operationalization phase. The key to success of this kind of project is strong institutional commitment to biosafety norms, adequate fund availability, careful planning and designing, hiring good construction agency, monitoring by experienced consultancy agency and involvement of scientific and engineering personnel with biocontainment experience in the process. PMID:25297350

  12. Establishment of Biosafety Level-3 (BSL-3) laboratory: important criteria to consider while designing, constructing, commissioning & operating the facility in Indian setting.

    PubMed

    Mourya, Devendra T; Yadav, Pragya D; Majumdar, Triparna Dutta; Chauhan, Devendra S; Katoch, Vishwa Mohan

    2014-08-01

    Since the enactment of Environmental Protection Act in 1989 and Department of Biotechnology (DBT) guidelines to deal with genetically modified organisms, India has embarked on establishing various levels of biosafety laboratories to deal with highly infectious and pathogenic organisms. Occurrence of outbreaks due to rapidly spreading respiratory and haemorrhagic fever causing viruses has caused an urgency to create a safe laboratory environment. This has thus become a mandate, not only to protect laboratory workers, but also to protect the environment and community. In India, technology and science are progressing rapidly. Several BSL-3 [=high containment] laboratories are in the planning or execution phase, to tackle biosafety issues involved in handling highly infectious disease agents required for basic research and diagnosis. In most of the developing countries, the awareness about biocontainment has increased but planning, designing, constructing and operating BSL-3 laboratories need regular updates about the design and construction of facilities and clear definition of risk groups and their handling which should be in harmony with the latest international practices. This article describes the major steps involved in the process of construction of a BSL-3 laboratory in Indian settings, from freezing the concept of proposal to operationalization phase. The key to success of this kind of project is strong institutional commitment to biosafety norms, adequate fund availability, careful planning and designing, hiring good construction agency, monitoring by experienced consultancy agency and involvement of scientific and engineering personnel with biocontainment experience in the process. PMID:25297350

  13. Cold-air performance of free power turbine designed for 112-kilowatt automotive gas-turbine engine. 2: Effects of variable stator-vane-chord setting angle on turbine performance

    NASA Technical Reports Server (NTRS)

    Mclallin, K. L.; Kofskey, M. G.

    1979-01-01

    The cold-air performance of an axial-flow power turbine with a variable stator designed for a 112-kW automotive gas-turbine engine was determined at speeds from 30 to 110 percent of design and at pressure ratios from 1.11 to 2.67. Performance is presented in terms of equivalent mass flow, torque, power, and efficiency for stator-vane-chord setting angles of 26 degs, 30 degs, 35 degs (design), 40 degs, 45 degs, and 50 degs. Turbine braking performance at a nominal stator setting angle of 107 degs is also presented. Turbine efficiency increased with increasing stator setting angle. A 10-point efficiency increase was obtained by opening the stator from the design setting angle of 35 degs to a setting angle of 45 degs.

  14. Adult Numeracy Core Curriculum.

    ERIC Educational Resources Information Center

    Steeds, Andrew, Ed.

    Designed primarily for adult literacy teachers and tutors, this curriculum describes the content of what should be taught in numeracy programs in order to meet the individual needs of adults through the selection and teaching of skills appropriate to those adults' needs. An introduction describes national standards and qualifications, learners,…

  15. An Adult ESL Curriculum.

    ERIC Educational Resources Information Center

    South Carolina Literacy Resource Center, Columbia.

    This curriculum framework for adult literacy was written by 21 South Carolina adult English-as-a-Second-Language (ESL) instructors, as submitted to the South Carolina Literacy Resource Center. It is based on current theories in the fields of adult education and second language acquisition and is designed to be flexible so that it may be adapted to…

  16. Young Adult Services Manual.

    ERIC Educational Resources Information Center

    Boegen, Anne, Ed.

    Designed to offer guidelines, ideas and help to those who provide library service to young adults, this manual includes information about the provision of young adult (YA) services in six sections. The first section, which addresses planning and administration, includes a definition of a young adult and a checklist for determining community needs…

  17. Comparison of Two Theory-Based, Fully Automated Telephone Interventions Designed to Maintain Dietary Change in Healthy Adults: Study Protocol of a Three-Arm Randomized Controlled Trial

    PubMed Central

    Quintiliani, Lisa M; Turner-McGrievy, Gabrielle M; Migneault, Jeffrey P; Heeren, Timothy; Friedman, Robert H

    2014-01-01

    Background Health behavior change interventions have focused on obtaining short-term intervention effects; few studies have evaluated mid-term and long-term outcomes, and even fewer have evaluated interventions that are designed to maintain and enhance initial intervention effects. Moreover, behavior theory has not been developed for maintenance or applied to maintenance intervention design to the degree that it has for behavior change initiation. Objective The objective of this paper is to describe a study that compared two theory-based interventions (social cognitive theory [SCT] vs goal systems theory [GST]) designed to maintain previously achieved improvements in fruit and vegetable (F&V) consumption. Methods The interventions used tailored, interactive conversations delivered by a fully automated telephony system (Telephone-Linked Care [TLC]) over a 6-month period. TLC maintenance intervention based on SCT used a skills-based approach to build self-efficacy. It assessed confidence in and barriers to eating F&V, provided feedback on how to overcome barriers, plan ahead, and set goals. The TLC maintenance intervention based on GST used a cognitive-based approach. Conversations trained participants in goal management to help them integrate their newly acquired dietary behavior into their hierarchical system of goals. Content included goal facilitation, conflict, shielding, and redundancy, and reflection on personal goals and priorities. To evaluate and compare the two approaches, a sample of adults whose F&V consumption was below public health goal levels were recruited from a large urban area to participate in a fully automated telephony intervention (TLC-EAT) for 3-6 months. Participants who increase their daily intake of F&V by ≥1 serving/day will be eligible for the three-arm randomized controlled trial. A sample of 405 participants will be randomized to one of three arms: (1) an assessment-only control, (2) TLC-SCT, and (3) TLC-GST. The maintenance

  18. One-year routine opportunistic screening for hypertension in formal medical settings and potential improvements in hypertension awareness among older persons in developing countries: evidence from the Study on Global Ageing and Adult Health (SAGE).

    PubMed

    Maurer, Jürgen; Ramos, Alejandra

    2015-02-01

    Hypertension is a leading risk factor in the global disease burden. Limited hypertension awareness is a major determinant of widespread gaps in hypertension treatment and control, especially in developing countries. We analyzed data on persons aged 50 years or older from 6 low- and middle-income countries participating in the first wave (2007-2010) of the World Health Organization's Survey of Global Ageing and Adult Health (SAGE). Our estimates suggest that just 1 year of routine opportunistic hypertension screening during formal visits to medical-care providers could yield significant increases in hypertension awareness among seniors in the developing world. We also show that eliminating missed opportunities for hypertension screening in medical settings would not necessarily exacerbate existing socioeconomic differences in hypertension awareness, despite requiring at least occasional contact with a formal health-care provider for obtaining a hypertension diagnosis. Thus, routine opportunistic screening for hypertension in formal medical settings may provide a simple but reliable way to increase hypertension awareness. Moreover, the proposed approach has the added advantage of leveraging existing resources and infrastructures, as well as facilitating a direct transition from the point of diagnosis to subsequent expert counseling and clinical care for newly identified hypertension patients.

  19. Unprecedently Large-Scale Kinase Inhibitor Set Enabling the Accurate Prediction of Compound-Kinase Activities: A Way toward Selective Promiscuity by Design?

    PubMed

    Christmann-Franck, Serge; van Westen, Gerard J P; Papadatos, George; Beltran Escudie, Fanny; Roberts, Alexander; Overington, John P; Domine, Daniel

    2016-09-26

    Drug discovery programs frequently target members of the human kinome and try to identify small molecule protein kinase inhibitors, primarily for cancer treatment, additional indications being increasingly investigated. One of the challenges is controlling the inhibitors degree of selectivity, assessed by in vitro profiling against panels of protein kinases. We manually extracted, compiled, and standardized such profiles published in the literature: we collected 356 908 data points corresponding to 482 protein kinases, 2106 inhibitors, and 661 patents. We then analyzed this data set in terms of kinome coverage, results reproducibility, popularity, and degree of selectivity of both kinases and inhibitors. We used the data set to create robust proteochemometric models capable of predicting kinase activity (the ligand-target space was modeled with an externally validated RMSE of 0.41 ± 0.02 log units and R02 0.74 ± 0.03), in order to account for missing or unreliable measurements. The influence on the prediction quality of parameters such as number of measurements, Murcko scaffold frequency or inhibitor type was assessed. Interpretation of the models enabled to highlight inhibitors and kinases properties correlated with higher affinities, and an analysis in the context of kinases crystal structures was performed. Overall, the models quality allows the accurate prediction of kinase-inhibitor activities and their structural interpretation, thus paving the way for the rational design of compounds with a targeted selectivity profile.

  20. Unprecedently Large-Scale Kinase Inhibitor Set Enabling the Accurate Prediction of Compound–Kinase Activities: A Way toward Selective Promiscuity by Design?

    PubMed Central

    2016-01-01

    Drug discovery programs frequently target members of the human kinome and try to identify small molecule protein kinase inhibitors, primarily for cancer treatment, additional indications being increasingly investigated. One of the challenges is controlling the inhibitors degree of selectivity, assessed by in vitro profiling against panels of protein kinases. We manually extracted, compiled, and standardized such profiles published in the literature: we collected 356 908 data points corresponding to 482 protein kinases, 2106 inhibitors, and 661 patents. We then analyzed this data set in terms of kinome coverage, results reproducibility, popularity, and degree of selectivity of both kinases and inhibitors. We used the data set to create robust proteochemometric models capable of predicting kinase activity (the ligand–target space was modeled with an externally validated RMSE of 0.41 ± 0.02 log units and R02 0.74 ± 0.03), in order to account for missing or unreliable measurements. The influence on the prediction quality of parameters such as number of measurements, Murcko scaffold frequency or inhibitor type was assessed. Interpretation of the models enabled to highlight inhibitors and kinases properties correlated with higher affinities, and an analysis in the context of kinases crystal structures was performed. Overall, the models quality allows the accurate prediction of kinase-inhibitor activities and their structural interpretation, thus paving the way for the rational design of compounds with a targeted selectivity profile. PMID:27482722

  1. Unprecedently Large-Scale Kinase Inhibitor Set Enabling the Accurate Prediction of Compound-Kinase Activities: A Way toward Selective Promiscuity by Design?

    PubMed

    Christmann-Franck, Serge; van Westen, Gerard J P; Papadatos, George; Beltran Escudie, Fanny; Roberts, Alexander; Overington, John P; Domine, Daniel

    2016-09-26

    Drug discovery programs frequently target members of the human kinome and try to identify small molecule protein kinase inhibitors, primarily for cancer treatment, additional indications being increasingly investigated. One of the challenges is controlling the inhibitors degree of selectivity, assessed by in vitro profiling against panels of protein kinases. We manually extracted, compiled, and standardized such profiles published in the literature: we collected 356 908 data points corresponding to 482 protein kinases, 2106 inhibitors, and 661 patents. We then analyzed this data set in terms of kinome coverage, results reproducibility, popularity, and degree of selectivity of both kinases and inhibitors. We used the data set to create robust proteochemometric models capable of predicting kinase activity (the ligand-target space was modeled with an externally validated RMSE of 0.41 ± 0.02 log units and R02 0.74 ± 0.03), in order to account for missing or unreliable measurements. The influence on the prediction quality of parameters such as number of measurements, Murcko scaffold frequency or inhibitor type was assessed. Interpretation of the models enabled to highlight inhibitors and kinases properties correlated with higher affinities, and an analysis in the context of kinases crystal structures was performed. Overall, the models quality allows the accurate prediction of kinase-inhibitor activities and their structural interpretation, thus paving the way for the rational design of compounds with a targeted selectivity profile. PMID:27482722

  2. Training Teaching Staff to Facilitate Spontaneous Communication in Children with Autism: Adult Interactive Style Intervention (AISI)

    ERIC Educational Resources Information Center

    Kossyvaki, Lila; Jones, Glenys; Guldberg, Karen

    2016-01-01

    Previous research has demonstrated that the way adults interact with children with autism can have a great impact on their spontaneous communication. However, to date, few studies have focused on modifying adults' behaviour and even fewer have been conducted in school settings which actively involve teaching staff in designing the intervention.…

  3. Gender Differences in Beliefs about Condom Use among Young, Heterosexual Australian Adults

    ERIC Educational Resources Information Center

    Newton, Fiona J.; Newton, Joshua D.; Windisch, Lydia; Ewing, Michael T.

    2013-01-01

    Objective: To investigate gender differences in beliefs about condom use among young, sexually active, heterosexual Australian adults. Design: Cross-sectional survey of 1,113 adults aged 18-26 years. Setting: Higher education institutions across New South Wales and Victoria, Australia. Method: Participants were recruited during higher-education…

  4. Applying the adult Education Framework to ESP Curriculum Development: An Integrative Model.

    ERIC Educational Resources Information Center

    Sifakis, N. C.

    2003-01-01

    Presents recent work in English for specific purposes (ESP)/languages for specific purposes (LSP) and adult education and puts forward an integrative model for ESP curriculum design. Outlines a set of characteristics that identify the ESP learner within the general adult learning framework. (Author/VWL)

  5. Sensory Modulation and Sleep Quality among Adults with Learning Disabilities: A Quasi-Experimental Case-Control Design Study

    PubMed Central

    Sharfi, Kineret; Rosenblum, Sara

    2015-01-01

    Purpose Following the International Classification of Functioning, Disability and Health (ICF) concepts, this study examines body functions such as sensory modulation and sleep quality among adults with learning disabilities (LD). Methods One hundred and ten participants, 55 adults with LD and 55 matched controls (mean age 30 years) filled in a socio-demographic questionnaire, the Adults/Adolescents Sensory Profile (AASP), and the Mini Sleep Questionnaire (MSQ). Chi-tests, Mann-Whitney tests, and Kolmogorov-Smirnov tests were conducted to examine group differences related to socio-demographic characteristics and body functions. Correlation and regression analyses were conducted to examine relationships between body functions. Results Significant differences were found between the groups in: (a) unique socio-demographic variables: high-schools attended, family status and number of children; (b) body functions: low registration and sensory sensitivity (p < .001), sensory avoiding (p = .002), sensory seeking (p = .021) and sleep quality (p < .001). Significant correlations were found between AASP subscale scores and the MSQ final score in each group. Regression analysis revealed that for the entire sample (N = 108), low registration accounted for 10.2% of the variance of sleep quality above group membership (p < .001), while in a separate examination of adults with LD (n = 53), low registration accounted for 19.9% of the variance of sleep quality (p < .001). Conclusions Adults with LD need to be studied through a health-related perspective such as the ICF model to gain further understanding of their unique characteristics and daily needs. Sensory and sleep functions of adults with LD should be further studied in the context of health related quality of life. PMID:25658647

  6. Design of a National Cost-Benefit Study of Vocational Education at the Secondary, Postsecondary and Adult Levels: Final Report.

    ERIC Educational Resources Information Center

    Simison, Diane; And Others

    A study examined the feasibility of performing a national cost-benefit analysis of secondary, postsecondary, and adult vocational education. The study involved three components: a survey of the state of the art of utilizing cost-benefit methodologies to evaluate the returns on investments in vocational education; an overview of the potential…

  7. Text Sets.

    ERIC Educational Resources Information Center

    Giorgis, Cyndi; Johnson, Nancy J.

    2002-01-01

    Presents annotations of approximately 30 titles grouped in text sets. Defines a text set as five to ten books on a particular topic or theme. Discusses books on the following topics: living creatures; pirates; physical appearance; natural disasters; and the Irish potato famine. (SG)

  8. Identifying Consumer’s Needs of Health Information Technology through an Innovative Participatory Design Approach among English- and Spanish-speaking Urban Older Adults

    PubMed Central

    Sheehan, B.; Yen, P.; Velez, O.; Nobile-Hernandez, D.; Tiase, V.

    2014-01-01

    Summary Objectives We describe an innovative community-centered participatory design approach, Consumer-centered Participatory Design (C2PD), and the results of applying C2PD to design and develop a web-based fall prevention system. Methods We conducted focus groups and design sessions with English- and Spanish-speaking community-dwelling older adults. Focus group data were summarized and used to inform the context of the design sessions. Descriptive content analysis methods were used to develop categorical descriptions of design session informant’s needs related to information technology. Results The C2PD approach enabled the assessment and identification of informant’s needs of health information technology (HIT) that informed the development of a falls prevention system. We learned that our informants needed a system that provides variation in functions/content; differentiates between actionable/non-actionable information/structures; and contains sensory cues that support wide-ranging and complex tasks in a varied, simple, and clear interface to facilitate self-management. Conclusions The C2PD approach provides community-based organizations, academic researchers, and commercial entities with a systematic theoretically informed approach to develop HIT innovations. Our community-centered participatory design approach focuses on consumer’s technology needs while taking into account core public health functions. PMID:25589909

  9. Medication Adherence among Older Adults with Schizophrenia

    PubMed Central

    Leutwyler, Heather C.; Fox, Patrick J.; Wallhagen, Margaret

    2014-01-01

    Older adults with schizophrenia are a growing segment of the population yet their physical and mental health status is extremely poor. The paper presents findings from a qualitative study that explored the understanding older adults with schizophrenia have of their physical health status. The study was conducted among 28 older adults with schizophrenia from a variety of settings using semi-structured interviews and participant observation. Self-management of psychiatric and non-psychiatric medications and its affect on their health status was one of the central themes that emerged from the study. Different styles of medication adherence were identified and factors associated with each style are presented. The findings provide insights into the design of clinical interventions aimed at promoting medication adherence among older adults with schizophrenia. PMID:23327119

  10. Medication adherence among older adults with schizophrenia.

    PubMed

    Leutwyler, Heather C; Fox, Patrick J; Wallhagen, Margaret

    2013-02-01

    Older adults with schizophrenia are a growing segment of the population, yet their physical and mental health status is extremely poor. This article presents findings from a qualitative study that explored the understanding older adults with schizophrenia have of their physical health status. The study was conducted among 28 older adults with schizophrenia from a variety of settings using semi-structured interviews and participant observation. Self-management of psychiatric and non-psychiatric medications and its effect on participants' health status was one of the central themes that emerged from the study. Different styles of medication adherence were identified and factors associated with each style are presented. The findings provide insights into the design of clinical interventions aimed at promoting medication adherence among older adults with schizophrenia.

  11. The Resist Diabetes trial: Rationale, design, and methods of a hybrid efficacy/effectiveness intervention trial for resistance training maintenance to improve glucose homeostasis in older prediabetic adults

    PubMed Central

    Marinik, Elaina L.; Kelleher, Sarah; Savla, Jyoti; Winett, Richard A.; Davy, Brenda M.

    2014-01-01

    Advancing age is associated with reduced levels of physical activity, increased body weight and fat, decreased lean body mass, and a high prevalence of type 2 diabetes (T2D). Resistance training (RT) increases muscle strength and lean body mass, and reduces risk of T2D among older adults. The Resist Diabetes trial will determine if a social cognitive theory (SCT)-based intervention improves RT maintenance in older, prediabetic adults, using a hybrid efficacy/effectiveness approach. Sedentary, overweight/obese (BMI 25-39.9 kg/m2) adults aged 50-69 (N=170) with prediabetes (impaired fasting glucose and/or impaired glucose tolerance) completed a supervised 3-month RT (2x/wk) Initiation Phase and were then randomly assigned (n=159; 94% retention) to one of two 6-month maintenance conditions: SCT or Standard care. The SCT intervention consisted of faded contacts compared to Standard care. Participants continue RT at an approved, self-selected community facility during maintenance. A subsequent 6-month period involves no contact for both conditions. Assessments occur at baseline and months 3 (post-initiation), 9 (post-intervention), and 15 (six months after no contact). Primary outcomes are prediabetes indices (i.e., impaired fasting and 2-hour glucose concentration) and strength. Secondary measures include insulin sensitivity, beta-cell responsiveness, and disposition index (oral glucose and C-peptide minimal model); adherence; body composition; and SCT measures. Resist Diabetes is the first trial to examine the effectiveness of a high fidelity SCT-based intervention for maintaining RT in older adults with prediabetes to improve glucose homeostasis. Successful application of SCT constructs for RT maintenance may support translation of our RT program for diabetes prevention into community settings. PMID:24252311

  12. Results from a preliminary review of scientific evidence for appropriateness of preparations, dosage forms and other product design elements for older adult patients.

    PubMed

    Messina, Rossella; Becker, Robert; van Riet-Nales, Diana A; Stegemann, Sven

    2015-01-30

    The aging population and the growing multimorbidity of the major patient population as well as the advanced (pharmaco)therapeutic treatment options are increasing the complexity of independent drug therapy management and administration. The increased complexity may have an impact on drug adherence (including any need for patients initiated coping strategies), and consequently on the safety and efficacy of the medicine. To overcome adherence issues caused by the design of the medicine, it is crucial that developers consider the age appropriateness of the medicine (route of administration, dosage form, excipients in the composition, frequency of dosing) in meeting patients' needs to manage their therapy without the support of a care giver. In order to understand the scientific evidence on such age appropriately designed medicines for use by older adults, a literature search was performed in the Medline database (all languages included). The search produced 34 publications that met the inclusion and exclusion criteria for the patient population of 65 years an older. An in-depth analysis of the included publications with respect to the methodological quality (study design, data collection, endpoints chosen) and results showed that none of these publications had adequately investigated the age appropriateness of the medicine for use by older adults. The authors consider that the knowledge gap in this area requires attention of all stakeholders in the healthcare community.

  13. Adult Books for Young Adults.

    ERIC Educational Resources Information Center

    Carter, Betty

    1997-01-01

    Considers the differences between young adult and adult books and maintains that teachers must be familiar with young adults' tastes for both. Suggests that traffic between these publishing divisions is a two-way street, with young adults reading adult books and adults reading young adult books. (TB)

  14. Educational Needs in the Psychiatric Setting.

    ERIC Educational Resources Information Center

    Sluckin, Andy; Hanna, Bob

    1991-01-01

    Case studies in Norwich, England, identified issues in the provision of adult education in psychiatric settings: differing definitions of the role of adult education; role conflict between adult educators and health professionals; and opposing beliefs about outsiders entering an institution. The cases also affirmed the therapeutic value of…

  15. Fluorescence multi-scale endoscopy and its applications in the study and diagnosis of gastro-intestinal diseases: set-up design and software implementation

    NASA Astrophysics Data System (ADS)

    Gómez-García, Pablo Aurelio; Arranz, Alicia; Fresno, Manuel; Desco, Manuel; Mahmood, Umar; Vaquero, Juan José; Ripoll, Jorge

    2015-06-01

    Endoscopy is frequently used in the diagnosis of several gastro-intestinal pathologies as Crohn disease, ulcerative colitis or colorectal cancer. It has great potential as a non-invasive screening technique capable of detecting suspicious alterations in the intestinal mucosa, such as inflammatory processes. However, these early lesions usually cannot be detected with conventional endoscopes, due to lack of cellular detail and the absence of specific markers. Due to this lack of specificity, the development of new endoscopy technologies, which are able to show microscopic changes in the mucosa structure, are necessary. We here present a confocal endomicroscope, which in combination with a wide field fluorescence endoscope offers fast and specific macroscopic information through the use of activatable probes and a detailed analysis at cellular level of the possible altered tissue areas. This multi-modal and multi-scale imaging module, compatible with commercial endoscopes, combines near-infrared fluorescence (NIRF) measurements (enabling specific imaging of markers of disease and prognosis) and confocal endomicroscopy making use of a fiber bundle, providing a cellular level resolution. The system will be used in animal models exhibiting gastro-intestinal diseases in order to analyze the use of potential diagnostic markers in colorectal cancer. In this work, we present in detail the set-up design and the software implementation in order to obtain simultaneous RGB/NIRF measurements and short confocal scanning times.

  16. Design of set-point weighting PI{sup λ} + D{sup μ} controller for vertical magnetic flux controller in Damavand tokamak

    SciTech Connect

    Rasouli, H.; Fatehi, A.

    2014-12-15

    In this paper, a simple method is presented for tuning weighted PI{sup λ} + D{sup μ} controller parameters based on the pole placement controller of pseudo-second-order fractional systems. One of the advantages of this controller is capability of reducing the disturbance effects and improving response to input, simultaneously. In the following sections, the performance of this controller is evaluated experimentally to control the vertical magnetic flux in Damavand tokamak. For this work, at first a fractional order model is identified using output-error technique in time domain. For various practical experiments, having desired time responses for magnetic flux in Damavand tokamak, is vital. To approach this, at first the desired closed loop reference models are obtained based on generalized characteristic ratio assignment method in fractional order systems. After that, for the identified model, a set-point weighting PI{sup λ} + D{sup μ} controller is designed and simulated. Finally, this controller is implemented on digital signal processor control system of the plant to fast/slow control of magnetic flux. The practical results show appropriate performance of this controller.

  17. Fit and Strong! Plus: design of a comparative effectiveness evaluation of a weight management program for older adults with osteoarthritis.

    PubMed

    Smith-Ray, Renae L; Fitzgibbon, Marian L; Tussing-Humphreys, Lisa; Schiffer, Linda; Shah, Amy; Huber, Gail M; Braunschweig, Carol; Campbell, Richard T; Hughes, Susan L

    2014-03-01

    Osteoarthritis (OA) is the most common chronic condition and principal cause of disability among older adults. The current obesity epidemic has contributed to this high prevalence rate. Fortunately both OA symptoms and obesity can be ameliorated through lifestyle modifications. Physical activity (PA) combined with weight management improves physical function among obese persons with knee OA but evidence-based interventions that combine PA and weight management are limited for this population. This paper describes a comparative effectiveness trial testing an evidence-based PA program for adults with lower extremity (LE) OA, Fit and Strong!, against an enhanced version that also addresses weight management based on the evidence-based Obesity Reduction Black Intervention Trial (ORBIT). Adult participants (n=400) with LE OA, age 60+, overweight/obese, and not meeting PA requirements of ≥ 150 min per week, are randomized to one of the two programs. Both 8-week interventions meet 3 times per week and include 60 min of strength, flexibility, and aerobic exercise instruction followed by 30 min of education/group discussion. The Fit and Strong! education sessions focus on using PA to manage OA; whereas Fit and Strong! Plus addresses PA and weight loss management strategies. Maintenance of behavior change is reinforced in both groups during months 3-24 through telephone calls and mailed newsletters. Outcomes are assessed at baseline, and 2, 6, 12, 18, and 24 months. Primary outcomes are dietary change at 2 months followed by weight loss at 6 months that is maintained at 24 months. Secondary outcomes assess PA, physical performance, and anxiety/depression.

  18. Fit and Strong! Plus: Design of a Comparative Effectiveness Evaluation of a Weight Management Program for Older Adults with Osteoarthritis

    PubMed Central

    Smith-Ray, Renae L.; Fitzgibbon, Marian L.; Tussing-Humphreys, Lisa; Schiffer, Linda; Shah, Amy; Huber, Gail M.; Braunschweig, Carol; Campbell, Richard T.; Hughes, Susan L.

    2014-01-01

    Osteoarthritis (OA) is the most common chronic condition and principal cause of disability among older adults. The current obesity epidemic has contributed to this high prevalence rate. Fortunately both OA symptoms and obesity can be ameliorated through lifestyle modifications. Physical activity (PA) combined with weight management improves physical function among obese persons with knee OA but evidence-based interventions that combine PA and weight management are limited for this population. This paper describes a comparative effectiveness trial testing an evidence-based PA program for adults with lower extremity (LE) OA, Fit and Strong!, against an enhanced version that also addresses weight management based on the evidence-based Obesity Reduction Black Intervention Trial (ORBIT). Adult participants (n=400) with LE OA, age 60+, overweight/obese, and not meeting PA requirements of >=150 minutes per week, are randomized to one of the two programs. Both 8-week interventions meet 3 times per week and include 60 minutes of strength, flexibility, and aerobic exercise instruction followed by 30 minutes of education/group discussion. The Fit and Strong! education sessions focus on using PA to manage OA; whereas Fit and Strong! Plus addresses PA and weight loss management strategies. Maintenance of behavior change is reinforced in both groups during months 3 - 24 through telephone calls and mailed newsletters. Outcomes are assessed at baseline, and 2, 6, 12, 18, and 24 months. Primary outcomes are dietary change at 2 months followed by weight loss at 6 months that is maintained at 24 months. Secondary outcomes assess PA, physical performance, and anxiety/depression. PMID:24316240

  19. Fit and Strong! Plus: design of a comparative effectiveness evaluation of a weight management program for older adults with osteoarthritis.

    PubMed

    Smith-Ray, Renae L; Fitzgibbon, Marian L; Tussing-Humphreys, Lisa; Schiffer, Linda; Shah, Amy; Huber, Gail M; Braunschweig, Carol; Campbell, Richard T; Hughes, Susan L

    2014-03-01

    Osteoarthritis (OA) is the most common chronic condition and principal cause of disability among older adults. The current obesity epidemic has contributed to this high prevalence rate. Fortunately both OA symptoms and obesity can be ameliorated through lifestyle modifications. Physical activity (PA) combined with weight management improves physical function among obese persons with knee OA but evidence-based interventions that combine PA and weight management are limited for this population. This paper describes a comparative effectiveness trial testing an evidence-based PA program for adults with lower extremity (LE) OA, Fit and Strong!, against an enhanced version that also addresses weight management based on the evidence-based Obesity Reduction Black Intervention Trial (ORBIT). Adult participants (n=400) with LE OA, age 60+, overweight/obese, and not meeting PA requirements of ≥ 150 min per week, are randomized to one of the two programs. Both 8-week interventions meet 3 times per week and include 60 min of strength, flexibility, and aerobic exercise instruction followed by 30 min of education/group discussion. The Fit and Strong! education sessions focus on using PA to manage OA; whereas Fit and Strong! Plus addresses PA and weight loss management strategies. Maintenance of behavior change is reinforced in both groups during months 3-24 through telephone calls and mailed newsletters. Outcomes are assessed at baseline, and 2, 6, 12, 18, and 24 months. Primary outcomes are dietary change at 2 months followed by weight loss at 6 months that is maintained at 24 months. Secondary outcomes assess PA, physical performance, and anxiety/depression. PMID:24316240

  20. Design of the Neuro-ECAT: A high-resolution, high efficiency positron tomography for imaging the adult head or infant torso

    SciTech Connect

    Williams, C.W.; Burgiss, S.G.; Burke, M.R.; Crabtree, M.C.; Hoffman, E.J.; Keyser, R.M.; Phelps, M.E.

    1981-04-01

    The Neuro-ECAT scanner is a positron emission tomograph designed for high resolution cross-sectional imaging of the adult human head, or the complete torso of a child or small animal. The Neuro-ECAT scanner performs both rectilinear and tomographic scans, in both transmission and emission modes. There are three detector planes, producing five images. Each detector plane contains 88 bismuth germanate detectors, arranged in an octagonal array of 11 detectors per bank. Retained and electrically operated shadow shields provide two choices of reconstructed tomographic resolution, nominally 8.0 and 10.5 mm. Interplane septa, also retained and electrically operated, may be inserted between the detector planes for low noise, highly quantitative measurements, or moved aside for high efficiency scanning of low activity levels. The paper presents the Neuro-ECAT scanner design criteria and a description of the scanner. Data from phantom studies are presented to illustrate system performance.

  1. Multi-modal intervention to reduce cardiovascular risk among hypertensive older adults: Design of a randomized clinical trial

    PubMed Central

    Buford, Thomas W.; Anton, Stephen D.; Bavry, Anthony; Carter, Christy S.; Daniels, Michael J.; Pahor, Marco

    2015-01-01

    Persons aged over 65 years account for over 75% of healthcare expenditures and deaths attributable to cardiovascular disease (CVD). Accordingly, reducing CVD risk among older adults is an important public health priority. Functional status, determined by measures of physical performance, is an important predictor of cardiovascular outcomes in older adults and declines more rapidly in seniors with hypertension. To date, physical exercise is the primary strategy for attenuating declines in functional status. Yet despite the general benefits of training, exercise alone appears to be insufficient for preventing this decline. Thus, alternative or adjuvant strategies are needed to preserve functional status among seniors with hypertension. Prior data suggest that angiotensin converting enzyme inhibitors (ACEi) may be efficacious in enhancing exercise-derived improvements in functional status yet this hypothesis has not been tested in a randomized controlled trial. The objective of this randomized, double-masked pilot trial is to gather preliminary efficacy and safety data necessary for conducting a full-scale trial to test this hypothesis. Sedentary men and women ≥ 65 years of age with functional limitations and hypertension are being recruited into this 24 week intervention study. Participants are randomly assigned to one of three conditions: (1) ACEi plus exercise training, (2) thiazide diuretic plus exercise training, or (3) AT1 receptor antagonist plus exercise training. The primary outcome is change in walking speed and secondary outcomes consist of other indices of CV risk including exercise capacity, body composition, as well as circulating indices of metabolism, inflammation and oxidative stress. PMID:26115878

  2. Multi-modal intervention to reduce cardiovascular risk among hypertensive older adults: Design of a randomized clinical trial.

    PubMed

    Buford, Thomas W; Anton, Stephen D; Bavry, Anthony A; Carter, Christy S; Daniels, Michael J; Pahor, Marco

    2015-07-01

    Persons aged over 65 years account for over 75% of healthcare expenditures and deaths attributable to cardiovascular disease (CVD). Accordingly, reducing CVD risk among older adults is an important public health priority. Functional status, determined by measures of physical performance, is an important predictor of cardiovascular outcomes in older adults and declines more rapidly in seniors with hypertension. To date, physical exercise is the primary strategy for attenuating declines in functional status. Yet despite the general benefits of training, exercise alone appears to be insufficient for preventing this decline. Thus, alternative or adjuvant strategies are needed to preserve functional status among seniors with hypertension. Prior data suggest that angiotensin converting enzyme inhibitors (ACEi) may be efficacious in enhancing exercise-derived improvements in functional status yet this hypothesis has not been tested in a randomized controlled trial. The objective of this randomized, double-masked pilot trial is to gather preliminary efficacy and safety data necessary for conducting a full-scale trial to test this hypothesis. Sedentary men and women ≥ 65 years of age with functional limitations and hypertension are being recruited into this 24 week intervention study. Participants are randomly assigned to one of three conditions: (1) ACEi plus exercise training, (2) thiazide diuretic plus exercise training, or (3) AT1 receptor antagonist plus exercise training. The primary outcome is change in walking speed and secondary outcomes consist of other indices of CV risk including exercise capacity, body composition, as well as circulating indices of metabolism, inflammation and oxidative stress. PMID:26115878

  3. A discussion of key values to inform the design and delivery of services for HIV-affected women and couples attempting pregnancy in resource-constrained settings

    PubMed Central

    Heffron, Renee; Davies, Natasha; Cooke, Ian; Kaida, Angela; Mergler, Reid; van der Poel, Sheryl; Cohen, Craig R; Mmeje, Okeoma

    2015-01-01

    . Conclusions Programmes, policies and guidelines that integrate HIV treatment and prevention, sexual and reproductive health and fertility care services in a manner responsive to user values and preferences offer opportunities to maximize demand for and use of these services. For HIV-affected women and couples attempting pregnancy, the provision of comprehensive services using available tools – and the development of new tools that are adaptable to many settings and follow consensus recommendations – is a public health imperative. The impetus now is to design and deliver value-driven inclusive programming to achieve the greatest coverage and impact to reduce HIV transmission during pregnancy attempts. PMID:26643454

  4. Talking Health, A pragmatic randomized-controlled health literacy trial targeting sugar-sweetened beverage consumption among adults: Rationale, design & methods

    PubMed Central

    Zoellner, Jamie; Chen, Yvonnes; Davy, Brenda; You, Wen; Hedrick, Valisa; Corsi, Terri; Estabrooks, Paul

    2014-01-01

    High consumption of sugar-sweetened beverages (SSB) contributes to a wide range of poor health outcomes. Further, few US adults drink less than the recommended ≤8 ounces per day; and individuals with low socioeconomic, low health literacy status, and in rural areas are even less likely to meet recommendations. Unfortunately, few SSB behavioral interventions exist targeting adults, and none focus on low health literacy in rural areas. Talking Health, a type 1 effectiveness-implementation hybrid trial targeting adults in rural southwest Virginia, was developed using the RE-AIM planning and evaluation framework (reach, effectiveness, adoption, implementation, maintenance). The primary aim of this pragmatic randomized-controlled trial was to determine the effectiveness of a scalable 6-month intervention aimed at decreasing SSB consumption (SIPsmartER) when compared to a matched contact physical activity promotion control group (MoveMore). SIPsmartER was developed based upon the Theory of Planned Behavior and uses health literacy strategies to improve comprehension of the intervention content among participants. MoveMore is based on a research-tested intervention that was adapted to address all theory of planned behavior constructs and health literacy principles. Secondary aims include additional health outcomes (e.g., physical activity, weight) and reach, adoption, implementation, and maintenance indicators. This paper highlights the opportunities and considerations for developing health behavior trials that aim to determine intervention effectiveness, provide all study participants an opportunity to benefit from research participation, and collect key information on reach and the potential for organizational adoption, implementation, and maintenance with the longer-term goal of speeding translation into practice settings. PMID:24246819

  5. Tsunami Summer! 2003 Young Adult Summer Library Program.

    ERIC Educational Resources Information Center

    Alabama Public Library Service, Montgomery.

    This manual is designed to assist public libraries in Alabama with setting up "Tsunami Summer!," a summer program for young adults, i.e., students in grades 6 through 12. The manual contains the following sections: (1) Publicity and Promotion; (2) Working with Schools; (3) Involving the Students, including teen volunteers, teen advisory councils,…

  6. Which Food Patterns Are Predictors of Obesity in Tehranian Adults?

    ERIC Educational Resources Information Center

    Hosseini-Esfahani, Firoozeh; Djazaieri, Seyed-Abolghasem; Mirmiran, Parvin; Mehrabi, Yadollah; Azizi, Fereidoun

    2012-01-01

    Objectives: To determine whether changes in food patterns over a period of 6 years were related to obesity in Tehranian adults. Design: Data on dietary intake, using the food frequency questionnaire, and anthropometry were obtained in 2 periods of the survey (1999-2001 and 2005-2007). Setting: Participants of the Tehran Lipid and Glucose Study.…

  7. Promoting a healthy diet and physical activity in adults with intellectual disabilities living in community residences: Design and evaluation of a cluster-randomized intervention

    PubMed Central

    2010-01-01

    Background Many adults with intellectual disabilities have poor dietary habits, low physical activity and weight disturbances. This study protocol describes the design and evaluation of a health intervention aiming to improve diet and physical activity in this target group. In Sweden, adults with intellectual disabilities often live in community residences where the staff has insufficient education regarding the special health needs of residents. No published lifestyle interventions have simultaneously targeted both residents and staff. Methods/Design The intervention is designed to suit the ordinary work routines of community residences. It is based on social cognitive theory and takes 12-15 months to complete. The intervention includes three components: 1) Ten health education sessions for residents in their homes; 2) the appointment of a health ambassador among the staff in each residence and formation of a network; and 3) a study circle for staff in each residence. The intervention is implemented by consultation with managers, training of health educators, and coaching of health ambassadors. Fidelity is assessed based on the participation of residents and staff in the intervention activities. The study design is a cluster-randomised trial with physical activity as primary outcome objectively assessed by pedometry. Secondary outcomes are dietary quality assessed by digital photography, measured weight, height and waist circumference, and quality of life assessed by a quality of life scale. Intermediate outcomes are changes in work routines in the residences assessed by a questionnaire to managers. Adults with mild to moderate intellectual disabilities living in community residences in Stockholm County are eligible for inclusion. Multilevel analysis is used to evaluate effects on primary and secondary outcomes. The impact of the intervention on work routines in community residences is analysed by ordinal regression analysis. Barriers and facilitators of

  8. Kaatsu training to enhance physical function of older adults with knee osteoarthritis: Design of a randomized controlled trial

    PubMed Central

    Buford, Thomas W.; Fillingim, Roger B.; Manini, Todd M.; Sibille, Kimberly T.; Vincent, Kevin R.; Wu, Samuel S.

    2015-01-01

    As the U.S. population ages, efficacious interventions are needed to manage pain and maintain physical function among older adults with osteoarthritis (OA). Skeletal muscle weakness is a primary contributory factor to pain and functional decline among persons with OA, thus interventions are needed that improve muscle strength. High-load resistance exercise is the best-known method of improving muscle strength; however high-compressive loads commonly induce significant joint pain among persons with OA. Thus interventions with low-compressive loads are needed which improve muscle strength while limiting joint stress. This study is investigating the potential of an innovative training paradigm, known as Kaatsu, for this purpose. Kaatsu involves performing low-load exercise while externally-applied compression partially restricts blood flow to the active skeletal muscle. The objective of this randomized, single-masked pilot trial is to evaluate the efficacy and feasibility of chronic Kaatsu training for improving skeletal muscle strength and physical function among older adults. Participants aged ≥ 60 years with physical limitations and symptomatic knee OA will be randomly assigned to engage in a 3-month intervention of either (1) center-based, moderate-load resistance training, or (2) Kaatsu training matched for overall workload. Study dependent outcomes include the change in 1) knee extensor strength, 2) objective measures of physical function, and 3) subjective measures of physical function and pain. This study will provide novel information regarding the therapeutic potential of Kaatsu training while also informing about the long-term clinical viability of the paradigm by evaluating participant safety, discomfort, and willingness to continually engage in the intervention. PMID:26111922

  9. A New Social Capital Paradigm for Adult Literacy: Partnerships, Policy and Pedagogy. An Adult Literacy National Project Report

    ERIC Educational Resources Information Center

    Balatti, Jo; Black, Stephen; Falk, Ian

    2009-01-01

    The primary purpose of this project is to produce a set of guidelines on how to deliver adult literacy and numeracy education and training using a social capital approach. Social capital in this project refers to the networks that operate during resourcing, course design, recruitment, teaching and evaluation. The study focused on three specific…

  10. Design and Weighting Methods for a Nationally Representative Sample of HIV-infected Adults Receiving Medical Care in the United States-Medical Monitoring Project

    PubMed Central

    Iachan, Ronaldo; H. Johnson, Christopher; L. Harding, Richard; Kyle, Tonja; Saavedra, Pedro; L. Frazier, Emma; Beer, Linda; L. Mattson, Christine; Skarbinski, Jacek

    2016-01-01

    Background: Health surveys of the general US population are inadequate for monitoring human immunodeficiency virus (HIV) infection because the relatively low prevalence of the disease (<0.5%) leads to small subpopulation sample sizes. Objective: To collect a nationally and locally representative probability sample of HIV-infected adults receiving medical care to monitor clinical and behavioral outcomes, supplementing the data in the National HIV Surveillance System. This paper describes the sample design and weighting methods for the Medical Monitoring Project (MMP) and provides estimates of the size and characteristics of this population. Methods: To develop a method for obtaining valid, representative estimates of the in-care population, we implemented a cross-sectional, three-stage design that sampled 23 jurisdictions, then 691 facilities, then 9,344 HIV patients receiving medical care, using probability-proportional-to-size methods. The data weighting process followed standard methods, accounting for the probabilities of selection at each stage and adjusting for nonresponse and multiplicity. Nonresponse adjustments accounted for differing response at both facility and patient levels. Multiplicity adjustments accounted for visits to more than one HIV care facility. Results: MMP used a multistage stratified probability sampling design that was approximately self-weighting in each of the 23 project areas and nationally. The probability sample represents the estimated 421,186 HIV-infected adults receiving medical care during January through April 2009. Methods were efficient (i.e., induced small, unequal weighting effects and small standard errors for a range of weighted estimates). Conclusion: The information collected through MMP allows monitoring trends in clinical and behavioral outcomes and informs resource allocation for treatment and prevention activities. PMID:27651851

  11. Design and Weighting Methods for a Nationally Representative Sample of HIV-infected Adults Receiving Medical Care in the United States-Medical Monitoring Project

    PubMed Central

    Iachan, Ronaldo; H. Johnson, Christopher; L. Harding, Richard; Kyle, Tonja; Saavedra, Pedro; L. Frazier, Emma; Beer, Linda; L. Mattson, Christine; Skarbinski, Jacek

    2016-01-01

    Background: Health surveys of the general US population are inadequate for monitoring human immunodeficiency virus (HIV) infection because the relatively low prevalence of the disease (<0.5%) leads to small subpopulation sample sizes. Objective: To collect a nationally and locally representative probability sample of HIV-infected adults receiving medical care to monitor clinical and behavioral outcomes, supplementing the data in the National HIV Surveillance System. This paper describes the sample design and weighting methods for the Medical Monitoring Project (MMP) and provides estimates of the size and characteristics of this population. Methods: To develop a method for obtaining valid, representative estimates of the in-care population, we implemented a cross-sectional, three-stage design that sampled 23 jurisdictions, then 691 facilities, then 9,344 HIV patients receiving medical care, using probability-proportional-to-size methods. The data weighting process followed standard methods, accounting for the probabilities of selection at each stage and adjusting for nonresponse and multiplicity. Nonresponse adjustments accounted for differing response at both facility and patient levels. Multiplicity adjustments accounted for visits to more than one HIV care facility. Results: MMP used a multistage stratified probability sampling design that was approximately self-weighting in each of the 23 project areas and nationally. The probability sample represents the estimated 421,186 HIV-infected adults receiving medical care during January through April 2009. Methods were efficient (i.e., induced small, unequal weighting effects and small standard errors for a range of weighted estimates). Conclusion: The information collected through MMP allows monitoring trends in clinical and behavioral outcomes and informs resource allocation for treatment and prevention activities.

  12. Teaching Social Skills to Enhance Work Performance in a Child Care Setting

    ERIC Educational Resources Information Center

    Gear, Sabra; Bobzien, Jonna; Judge, Sharon; Raver, Sharon A.

    2011-01-01

    Adults with intellectual disabilities face difficulty seeking employment in the community workforce. Using a single-subject design, this study examined the utility of role playing and self-management strategies to enhance work performance by promoting the social skills of a young woman with Down syndrome working in a community child care setting.…

  13. Guatemala Project: The Traditional Laundering Place as a Non-Formal Health Education Setting

    ERIC Educational Resources Information Center

    Colle, Royal D.

    1977-01-01

    Describes a nonformal adult education project designed to improve the health and nutrition of rural Guatemalan residents through the use of a traditional setting--the pila (an outdoor laundering place found throughout Guatemala), a modern medium (audio cassette and cassette player), and content which was a combination of modern and indigenous. (SH)

  14. Incorporating prosocial behavior to promote physical activity in older adults: Rationale and design of the Program for Active Aging and Community Engagement (PACE)☆, ☆☆

    PubMed Central

    Foy, Capri G.; Vitolins, Mara Z.; Case, L. Douglas; Harris, Susan J.; Massa-Fanale, Carol; Hopley, Richard J.; Gardner, Leah; Rudiger, Nicole; Yamamoto, Kathryn; Swain, Brittany; Goff, David C.; Danhauer, Suzanne C.; Booth, Deborah; Gaspari, Jamie

    2014-01-01

    Despite the benefits of regular physical activity among older adults, physical activity rates are low in this population. The Program for Active Aging and Community Engagement (PACE) is an ongoing randomized controlled trial designed to compare the effects of two interventions on physical activity at 12 months among older adults. A total of 300 men and women aged 55 years or older will be randomized into either a healthy aging (HA) control intervention (n = 150), which is largely based upon educational sessions, or a prosocial behavior physical activity (PBPA) intervention (n = 150), which incorporates structured physical activity sessions, cognitive-behavioral counseling, and opportunities to earn food for donation to a regional food bank based on weekly physical activity and volunteering. The PBPA intervention is delivered at a local YMCA, and a regional grocery store chain donates the food to the food bank. Data will be collected at baseline, 3, 6, and 12 months. The primary outcome is physical activity as assessed by the Community Healthy Activities Model Program for Seniors (CHAMPS) Questionnaire at 12 months. Secondary outcomes include physical function and health-related quality of life. If successful, the PACE study will demonstrate that prosocial behavior and volunteerism may be efficaciously incorporated into interventions and will provide evidence for a novel motivating factor for physical activity. PMID:23876672

  15. The use of a co-design model in improving timely bleed reporting by adults with haemophilia living in the Auckland region of New Zealand.

    PubMed

    d'Young, A I; Young, L; Ockelford, P A; Brasser, M; Slavin, K; Manson, L; Preston, S

    2014-05-01

    Many adult patients diagnosed with phenotypically moderate and severe haemophilia living in the Auckland region of New Zealand do not report bleeding episodes within a timeframe that allows for optimal assessment and management. This can result in poor clinical outcomes for patients and poor oversight of the use of expensive clotting factor concentrates. Our goal was to improve both the number and speed at which bleeding episodes were reported to our centre, improving access to care and clinical oversight of the use of expensive factor concentrates and aiding the development of a care partnership with patients. We worked with 70 adult PWH living in the Auckland region of New Zealand with moderate and severe haemophilia A and B. Over a 5-month period between March and July 2013 we used a co-design model to develop and implement a range of strategies to improve the timing and frequency of bleed reporting. Mean bleed reporting time was reduced threefold, with a threefold increase in the number of bleeds reported per month. We reduced the number of bleeding episodes reported outside of a prespecified 48-h time limit by 68%. We significantly improved bleed reporting and time to report, indicating improved access to our services, improved clinical oversight and improved accountability to our national funder. We have achieved a care partnership and a reduction in factor consumption for the study population without compromising the quality of care they receive.

  16. The use of a co-design model in improving timely bleed reporting by adults with haemophilia living in the Auckland region of New Zealand.

    PubMed

    d'Young, A I; Young, L; Ockelford, P A; Brasser, M; Slavin, K; Manson, L; Preston, S

    2014-05-01

    Many adult patients diagnosed with phenotypically moderate and severe haemophilia living in the Auckland region of New Zealand do not report bleeding episodes within a timeframe that allows for optimal assessment and management. This can result in poor clinical outcomes for patients and poor oversight of the use of expensive clotting factor concentrates. Our goal was to improve both the number and speed at which bleeding episodes were reported to our centre, improving access to care and clinical oversight of the use of expensive factor concentrates and aiding the development of a care partnership with patients. We worked with 70 adult PWH living in the Auckland region of New Zealand with moderate and severe haemophilia A and B. Over a 5-month period between March and July 2013 we used a co-design model to develop and implement a range of strategies to improve the timing and frequency of bleed reporting. Mean bleed reporting time was reduced threefold, with a threefold increase in the number of bleeds reported per month. We reduced the number of bleeding episodes reported outside of a prespecified 48-h time limit by 68%. We significantly improved bleed reporting and time to report, indicating improved access to our services, improved clinical oversight and improved accountability to our national funder. We have achieved a care partnership and a reduction in factor consumption for the study population without compromising the quality of care they receive. PMID:24286288

  17. How Design of Places Promotes or Inhibits Mobility of Older Adults: Realist Synthesis of 20 Years of Research

    PubMed Central

    Yen, Irene H.; Flood, Johnna Fandel; Thompson, Hannah; Anderson, Lynda A.; Wong, Geoff

    2015-01-01

    Objective The objective of this study was to determine the environmental features that best support aging in place. Method We conducted a realist synthesis, a theory-driven interpretive method of evidence synthesis, of 120+ articles (published 1991–2011) that attempts to explain how place may influence older adults’ decisions about mobility (e.g., physical activity). We developed an initial program theory, reviewed the literature, identified outcomes, analyzed and synthesized patterns, and created a final program theory. Results Safety was a central mechanism, serving as one of the bridges between environmental components (e.g., connectivity, aesthetics, retail and services) and decisions about mobility. Population density, sidewalk presence, and park proximity did not emerge as key factors. Discussion Safety considerations are one of the most prominent influences of older adults’ decisions about mobility. Street connectivity, pedestrian access and transit, and retail and services were also important. These factors are amenable to change and can help promote mobility for older adults. PMID:24788714

  18. Career Advising for Adults.

    ERIC Educational Resources Information Center

    Miles, Johnnie H., Ed.; Clouse, James, Ed.

    This manual is designed to provide information and structural exercises for teachers who assist adults in career advising and career development. The materials, which can be shared with students individually or in small groups, are based on needs of adult students identified from the literature and from local needs assessment surveys. Topics…

  19. Libraries and Adult Learners.

    ERIC Educational Resources Information Center

    Josey, E. J., Ed.

    1982-01-01

    Of the 13 essays presented in this special issue on libraries and adult education, 8 focus on programs and services from the public library for adult learners. These essays provide information on: (1) an Education Information Centers Program (EIC) designed to complement employment skills training provided under the Comprehensive Employment and…

  20. Nutrition Students Improve Attitudes after a Guided Experiential Assignment with Older Adults

    ERIC Educational Resources Information Center

    Lee, Seung-Yeon; Hoerr, Sharon L.; Weatherspoon, Lorraine; Schiffman, Rachel F.

    2008-01-01

    Objective: Develop, implement, and evaluate an intervention (a guided experiential assignment) to improve nutrition students' attitudes toward working with older adults. Design: A quasi-experimental design with an additional qualitative component (mixed methods). Setting: A North Central land-grant university. Participants: 100 college students…

  1. Tailored weight loss intervention in obese adults within primary care practice: rationale, design, and methods of Choose to Lose.

    PubMed

    Hartman, Sheri J; Risica, Patricia M; Gans, Kim M; Marcus, Bess H; Eaton, Charles B

    2014-07-01

    Although there are efficacious weight loss interventions that can improve health and delay onset of diabetes and hypertension, these interventions have not been translated into clinical practice. The primary objective of this study is to evaluate the effectiveness and cost effectiveness of a tailored lifestyle intervention in primary care patients. Patients were recruited by their primary care physicians and eligible participants were randomized to an enhanced intervention or standard intervention. All participants met with a lifestyle counselor to set calorie and physical activity goals and to discuss behavioral strategies at baseline, 6 and 12 months. During the first year, enhanced intervention participants receive monthly counseling phone calls to assist in attaining and maintaining their goals. Enhanced intervention participants also receive weekly mailings consisting of tailored and non-tailored print materials and videos focusing on weight loss, physical activity promotion and healthy eating. The second year focuses on maintenance with enhanced intervention participants receiving tailored and non-tailored print materials and videos regularly throughout the year. Standard intervention participants receive five informational handouts on weight loss across the two years. This enhanced intervention that consists of multiple modalities of print, telephone, and video with limited face-to-face counseling holds promise for being effective for encouraging weight loss, increasing physical activity and healthy eating, and also for being cost effective and generalizable for wide clinical use. This study will fill an important gap in our knowledge regarding the translation and dissemination of research from efficacy studies to best practices in clinical settings. PMID:24937016

  2. Tailored weight loss intervention in obese adults within primary care practice: rationale, design, and methods of Choose to Lose.

    PubMed

    Hartman, Sheri J; Risica, Patricia M; Gans, Kim M; Marcus, Bess H; Eaton, Charles B

    2014-07-01

    Although there are efficacious weight loss interventions that can improve health and delay onset of diabetes and hypertension, these interventions have not been translated into clinical practice. The primary objective of this study is to evaluate the effectiveness and cost effectiveness of a tailored lifestyle intervention in primary care patients. Patients were recruited by their primary care physicians and eligible participants were randomized to an enhanced intervention or standard intervention. All participants met with a lifestyle counselor to set calorie and physical activity goals and to discuss behavioral strategies at baseline, 6 and 12 months. During the first year, enhanced intervention participants receive monthly counseling phone calls to assist in attaining and maintaining their goals. Enhanced intervention participants also receive weekly mailings consisting of tailored and non-tailored print materials and videos focusing on weight loss, physical activity promotion and healthy eating. The second year focuses on maintenance with enhanced intervention participants receiving tailored and non-tailored print materials and videos regularly throughout the year. Standard intervention participants receive five informational handouts on weight loss across the two years. This enhanced intervention that consists of multiple modalities of print, telephone, and video with limited face-to-face counseling holds promise for being effective for encouraging weight loss, increasing physical activity and healthy eating, and also for being cost effective and generalizable for wide clinical use. This study will fill an important gap in our knowledge regarding the translation and dissemination of research from efficacy studies to best practices in clinical settings.

  3. The effectiveness of including support people in a cognitive behavioural weight loss maintenance programme for obese adults: study rationale and design.

    PubMed

    Rieger, E; Treasure, J; Swinbourne, J; Adam, B; Manns, C; Caterson, I

    2014-04-01

    The well-documented finding that obese adults have a high likelihood of weight regain following participation in behavioural weight loss programmes highlights the importance of developing more effective approaches for weight loss maintenance. One promising approach is to improve the quality of social support for effective weight control available to an obese individual by including support people in behavioural weight loss programmes. This paper describes the rationale and design of a randomized controlled trial that evaluates the effectiveness of training support people to assist obese adults in their weight management. The study entails a two-arm randomized controlled trial in which obese participants take part in a 1-year (26-session) cognitive behaviour therapy group weight management programme, including motivational interviewing strategies (CBT-MI). In one arm, participants receive CBT-MI alone, while in the second arm (CBT-MI-SP), participants also have a support person who attends 10 group sessions designed to teach effective skills for supporting an individual in healthy weight control. More specifically, support people will be trained in skills that aim to promote self-motivation for weight management. Assessments of anthropometric, medical, behavioural, motivational, psychological and social functioning take place at pre-treatment, post-treatment and a 1-year follow-up. By helping obese participants to increase and sustain their motivation and skills for weight control both during treatment and in the crucial period after treatment cessation through the ongoing input of support people, the CBT-MI-SP approach of the current study has the potential to effectively help patients to achieve sustained weight loss while minimizing the patient's need for ongoing, intensive weight control treatment with its attendant costs. PMID:25826731

  4. Innovative Research Design Exploring the Effects of Physical Activity and Genetics on Cognitive Performance in Community-Based Older Adults.

    PubMed

    Etnier, Jennifer L; Labban, Jeffrey D; Karper, William B; Wideman, Laurie; Piepmeier, Aaron T; Shih, Chia-Hao; Castellano, Michael; Williams, Lauren M; Park, Se-Yun; Henrich, Vincent C; Dudley, William N; Rulison, Kelli L

    2015-10-01

    Physical activity is predictive of better cognitive performance and lower risk of Alzheimer's disease (AD). The apolipoprotein E gene (APOE) is a susceptibility gene for AD with the e4 allele being associated with a greater risk of AD. Cross-sectional and prospective research shows that physical activity is predictive of better cognitive performance for those at greater genetic risk for AD. However, the moderating role of APOE on the effects of a physical activity intervention on cognitive performance has not been examined. The purpose of this manuscript is to justify the need for such research and to describe the design, methods, and recruitment tactics used in the conductance of a study designed to provide insight as to the extent to which cognitive benefits resulting from an 8-month physical activity program are differentiated by APOE e4 status. The effectiveness of the recruitment strategies and the feasibility of recruiting APOE e4 carriers are discussed.

  5. Is Real-Time Feedback of Burn-Specific Patient-Reported Outcome Measures in Clinical Settings Practical and Useful? A Pilot Study Implementing the Young Adult Burn Outcome Questionnaire.

    PubMed

    Ryan, Colleen M; Lee, Austin F; Kazis, Lewis E; Shapiro, Gabriel D; Schneider, Jeffrey C; Goverman, Jeremy; Fagan, Shawn P; Wang, Chao; Kim, Julia; Sheridan, Robert L; Tompkins, Ronald G

    2016-01-01

    Long-term follow-up care of survivors after burn injuries can potentially be improved by the application of patient-reported outcome measures (PROMs). PROMs can inform clinical decision-making and foster communication between the patient and provider. There are no previous reports using real-time, burn-specific PROMs in clinical practice to track and benchmark burn recovery over time. This study examines the feasibility of a computerized, burn-specific PROM, the Young Adult Burn Outcome Questionnaire (YABOQ), with real-time benchmarking feedback in a burn outpatient practice. The YABOQ was redesigned for formatting and presentation purposes using images and transcribed to a computerized format. The redesigned questionnaire was administered to young adult burn survivors (ages 19-30 years, 1-24 months from injury) via an ipad platform in the office before outpatient visits. A report including recovery curves benchmarked to a nonburned relatively healthy age-matched population and to patients with similar injuries was produced for the domains of physical function and social function limited by appearance. A copy of the domain reports as well as a complete copy of the patient's responses to all domain questions was provided for use during the clinical visit. Patients and clinicians completed satisfaction surveys at the conclusion of the visit. Free-text responses, included in the satisfaction surveys, were treated as qualitative data adding contextual information about the assessment of feasibility. Eleven patients and their providers completed the study for 12 clinical visits. All patients found the ipad survey and report "easy" or "very easy" to use. In nine instances, patients "agreed" or "strongly agreed" that it helped them communicate their situation to their doctor/nurse practitioner. Patients "agreed" or "strongly agreed" that the report helped them understand their course of recovery in 10 visits. In 11 visits, the patients "agreed" or "strongly agreed" that

  6. Is Real-Time Feedback of Burn-Specific Patient-Reported Outcome Measures in Clinical Settings Practical and Useful? A Pilot Study Implementing the Young Adult Burn Outcome Questionnaire.

    PubMed

    Ryan, Colleen M; Lee, Austin F; Kazis, Lewis E; Shapiro, Gabriel D; Schneider, Jeffrey C; Goverman, Jeremy; Fagan, Shawn P; Wang, Chao; Kim, Julia; Sheridan, Robert L; Tompkins, Ronald G

    2016-01-01

    Long-term follow-up care of survivors after burn injuries can potentially be improved by the application of patient-reported outcome measures (PROMs). PROMs can inform clinical decision-making and foster communication between the patient and provider. There are no previous reports using real-time, burn-specific PROMs in clinical practice to track and benchmark burn recovery over time. This study examines the feasibility of a computerized, burn-specific PROM, the Young Adult Burn Outcome Questionnaire (YABOQ), with real-time benchmarking feedback in a burn outpatient practice. The YABOQ was redesigned for formatting and presentation purposes using images and transcribed to a computerized format. The redesigned questionnaire was administered to young adult burn survivors (ages 19-30 years, 1-24 months from injury) via an ipad platform in the office before outpatient visits. A report including recovery curves benchmarked to a nonburned relatively healthy age-matched population and to patients with similar injuries was produced for the domains of physical function and social function limited by appearance. A copy of the domain reports as well as a complete copy of the patient's responses to all domain questions was provided for use during the clinical visit. Patients and clinicians completed satisfaction surveys at the conclusion of the visit. Free-text responses, included in the satisfaction surveys, were treated as qualitative data adding contextual information about the assessment of feasibility. Eleven patients and their providers completed the study for 12 clinical visits. All patients found the ipad survey and report "easy" or "very easy" to use. In nine instances, patients "agreed" or "strongly agreed" that it helped them communicate their situation to their doctor/nurse practitioner. Patients "agreed" or "strongly agreed" that the report helped them understand their course of recovery in 10 visits. In 11 visits, the patients "agreed" or "strongly agreed" that

  7. Care of adults with developmental disabilities

    PubMed Central

    Balogh, Robert; Wood, Jessica; Lunsky, Yona; Isaacs, Barry; Ouellette-Kuntz, Hélène; Sullivan, William

    2015-01-01

    Abstract Objective To evaluate the effects of an interdisciplinary, guideline-based continuing education course on measures related to the care of adults with developmental disabilities (DD). Design Before-and-after study with a control group. Setting Ontario. Participants Forty-seven primary care providers (physicians, registered nurses, and nurse practitioners). Intervention Participants either only received reference material about primary care of people with DD (control group) or participated in a continuing education course on primary care of people with DD in addition to receiving the reference material (intervention group). Main outcome measures Participants reported on 5 key measures related to care of adults with DD: frequency of using guidelines, frequency of performing periodic health examinations, frequency of assessing patients who present with behaviour changes, level of comfort while caring for adults with DD, and knowledge of primary care related to adults with DD. Results Over time, the intervention group showed significant increases in 4 of the 5 key measures of care compared with the control group: the frequency of guideline use (P < .001), frequency of assessment of patients’ behaviour change (P = .03), comfort level in caring for people with DD (P = .01), and knowledge of primary care related to adults with DD (P = .01). Conclusion A continuing education course on primary care of adults with DD is a useful interdisciplinary model to train health professionals who provide primary care services to these patients. PMID:26380855

  8. Tailored weight loss intervention in obese adults within primary care practice: Rationale, design, and methods of Choose to Lose

    PubMed Central

    Hartman, Sheri J.; Risica, Patricia M.; Gans, Kim M.; Marcus, Bess H.; Eaton, Charles B.

    2014-01-01

    Although there are efficacious weight loss interventions that can improve health and delay onset of diabetes and hypertension, these interventions have not been translated into clinical practice. The primary objective of this study is to evaluate the effectiveness and cost effectiveness of a tailored lifestyle intervention in primary care patients. Patients were recruited by their primary care physicians and eligible participants were randomized to an enhanced intervention or augmented usual care. All participants met with a lifestyle counselor to set calorie and physical activity goals and to discuss behavioral strategies at baseline, 6 and 12 months. During the first year, enhanced intervention participants receive monthly counseling phone calls to assist in attaining and maintaining their goals. Enhanced intervention participants also receive weekly mailings consisting of tailored and non-tailored print materials and videos focusing on weight loss, physical activity promotion and healthy eating. The second year focuses on maintenance with enhanced intervention participants receiving tailored and non-tailored print materials and videos regularly throughout the year. Augmented usual care participants receive five informational handouts on weight loss across the two years. This enhanced intervention that consists of multiple modalities of print, telephone, and video with limited face-to-face counseling holds promise for being effective for encouraging weight loss, increasing physical activity and healthy eating, and also for being cost effective and generalizable for wide clinical use. This study will fill an important gap in our knowledge regarding the translation and dissemination of research from efficacy studies to best practices in clinical settings. PMID:24937016

  9. TRANSFER EFFECTS IN TASK-SET COST AND DUAL-TASK COST AFTER DUAL-TASK TRAINING IN OLDER AND YOUNGER ADULTS: FURTHER EVIDENCE FOR COGNITIVE PLASTICITY IN ATTENTIONAL CONTROL IN LATE ADULTHOOD

    PubMed Central

    Bherer, Louis; Kramer, Arthur F.; Peterson, Matthew S.; Colcombe, Stanley; Erickson, Kirk; Becic, Ensar

    2010-01-01

    Older adults’ difficulties in performing two tasks concurrently have been well documented (Kramer & Madden, 2008). It has been observed that the age-related differences in dual-task performance are larger when the two tasks require similar motor responses (Hartley, 2001) and that in some conditions older adults also show greater susceptibility than younger adults to input interference (Hein & Schubert, 2004). The authors recently observed that even when the two tasks require motor responses, both older and younger adults can learn to perform a visual discrimination task and an auditory discrimination task faster and more accurately (Bherer et al., 2005). In the present study, the authors extended this finding to a dual-task condition that involves two visual tasks requiring two motor responses. Older and younger adults completed a dual-task training program in which continuous individualized adaptive feedback was provided to enhance performance. The results indicate that, even with similar motor responses and two visual stimuli, both older and younger adults showed substantial gains in performance after training and that the improvement generalized to new task combinations involving new stimuli. These results suggest that dual-task skills can be substantially improved in older adults and that cognitive plasticity in attentional control is still possible in old age. PMID:18568979

  10. Tests of a Direct Effect of Childhood Abuse on Adult Borderline Personality Disorder Traits: A Longitudinal Discordant Twin Design

    PubMed Central

    Bornovalova, Marina A.; Huibregtse, Brooke M.; Hicks, Brian M.; Keyes, Margaret; McGue, Matt; Iacono, William

    2012-01-01

    We used a longitudinal twin design to examine the causal association between sexual, emotional, and physical abuse in childhood (before age 18) and borderline personality disorder (BPD) traits at age 24 using a discordant twin design and biometric modeling. Additionally, we examined the mediating and moderating effects of symptoms of childhood externalizing and internalizing disorders on the link between childhood abuse and BPD traits. Although childhood abuse, BPD traits, and internalizing and externalizing symptoms were all correlated, the discordant twin analyses and biometric modeling showed little to no evidence that consistent with a causal effect of childhood abuse on BPD traits. Instead, our results indicate that the association between childhood abuse and BPD traits stems from common genetic influences that, in some cases, also overlap with internalizing and externalizing disorders. These findings are inconsistent with the widely held assumption that childhood abuse causes BPD, and suggests that BPD traits in adulthood are better accounted for by heritable vulnerabilities to internalizing and externalizing disorders. PMID:22686871

  11. Innovative Research Design Exploring the Effects of Physical Activity and Genetics on Cognitive Performance in Community-Based Older Adults

    PubMed Central

    Etnier, Jennifer L.; Labban, Jeffrey D.; Karper, William B.; Wideman, Laurie; Piepmeier, Aaron T.; Shih, Chia-Hao; Castellano, Michael; Williams, Lauren M.; Park, Se-Yun; Henrich, Vincent C.; Dudley, William N.; Rulison, Kelli L.

    2015-01-01

    Physical activity is predictive of better cognitive performance and lower risk of Alzheimer’s disease (AD). The apolipoprotein E gene (APOE) is a susceptibility gene for AD with the e4 allele being associated with a greater risk of AD. Cross-sectional and prospective research shows that physical activity is predictive of better cognitive performance for those at greater genetic risk for AD. However, the moderating role of APOE on the effects of a physical activity intervention on cognitive performance has not been examined. The purpose of this manuscript is to justify the need for such research and to describe the design, methods, and recruitment tactics used in the conductance of a study designed to provide insight as to the extent to which cognitive benefits resulting from an 8-month physical activity program are differentiated by ApoEe4 status. The effectiveness of the recruitment strategies and the feasibility of recruiting ApoE e4 carriers are discussed. PMID:25594264

  12. [The first wave of the German Health Interview and Examination Survey for Adults (DEGS1): sample design, response, weighting and representativeness].

    PubMed

    Kamtsiuris, P; Lange, M; Hoffmann, R; Schaffrath Rosario, A; Dahm, S; Kuhnert, R; Kurth, B M

    2013-05-01

    The "German Health Interview and Examination Survey for Adults" (DEGS) is part of the health monitoring program of the Robert Koch Institute (RKI) and is designed as a combined cross-sectional and longitudinal survey. The first wave (DEGS1; 2008-2011) comprised interviews and physical examinations. The target population were 18- to 79-year olds living in Germany. The mixed design consisted of a new sample randomly chosen from local population registries which was supplemented by participants from the "German National Health Interview and Examination Survey 1998" (GNHIES98). In total, 8,152 persons took part, among them 4,193 newly invited (response 42%) and 3,959 who had previously taken part in GNHIES98 (response 62%). 7,238 participants visited one of the 180 local study centres, 914 took part in the interview-only programme. The comparison of the net sample with the group of non-participants and with the resident population of Germany suggests a high representativeness regarding various attributes. To account for certain aspects of the population structure cross-sectional, trend and longitudinal analyses are corrected by weighting factors. Furthermore, different participation probabilities of the former participants of GNHIES98 are compensated for. An English full-text version of this article is available at SpringerLink as supplemental.

  13. A Community-Based, Technology-Supported Health Service for Detecting and Preventing Frailty among Older Adults: A Participatory Design Development Process.

    PubMed

    van Velsen, Lex; Illario, Maddalena; Jansen-Kosterink, Stephanie; Crola, Catherine; Di Somma, Carolina; Colao, Annamaria; Vollenbroek-Hutten, Miriam

    2015-01-01

    Frailty is a multifaceted condition that affects many older adults and marks decline on areas such as cognition, physical condition, and nutritional status. Frail individuals are at increased risk for the development of disability, dementia, and falls. There are hardly any health services that enable the identification of prefrail individuals and that focus on prevention of further functional decline. In this paper, we discuss the development of a community-based, technology-supported health service for detecting prefrailty and preventing frailty and further functional decline via participatory design with a wide range of stakeholders. The result is an innovative service model in which an online platform supports the integration of traditional services with novel, Information Communication Technology supported tools. This service is capable of supporting the different phases of screening and offers training services, by also integrating them with community-based services. The service model can be used as a basis for developing similar services within a wide range of healthcare systems. We present the service model, the general functioning of the technology platform, and the different ways in which screening for and prevention of frailty has been localized. Finally, we reflect on the added value of participatory design for creating such health services.

  14. A Community-Based, Technology-Supported Health Service for Detecting and Preventing Frailty among Older Adults: A Participatory Design Development Process

    PubMed Central

    van Velsen, Lex; Illario, Maddalena; Jansen-Kosterink, Stephanie; Crola, Catherine; Di Somma, Carolina; Colao, Annamaria; Vollenbroek-Hutten, Miriam

    2015-01-01

    Frailty is a multifaceted condition that affects many older adults and marks decline on areas such as cognition, physical condition, and nutritional status. Frail individuals are at increased risk for the development of disability, dementia, and falls. There are hardly any health services that enable the identification of prefrail individuals and that focus on prevention of further functional decline. In this paper, we discuss the development of a community-based, technology-supported health service for detecting prefrailty and preventing frailty and further functional decline via participatory design with a wide range of stakeholders. The result is an innovative service model in which an online platform supports the integration of traditional services with novel, Information Communication Technology supported tools. This service is capable of supporting the different phases of screening and offers training services, by also integrating them with community-based services. The service model can be used as a basis for developing similar services within a wide range of healthcare systems. We present the service model, the general functioning of the technology platform, and the different ways in which screening for and prevention of frailty has been localized. Finally, we reflect on the added value of participatory design for creating such health services. PMID:26346580

  15. Assessment Tools for Adult Education.

    ERIC Educational Resources Information Center

    Shefrin, Carol; Shafer, Dehra; Forlizzi, Lori

    The Assessment Tools for Adult Education project was designed to provide training and support to staff of the Pennsylvania Bureau of Adult Basic and Literacy Education (ABLE) funded programs to help them use assessment tools and procedures to document the learning gains of the adult students they serve. The following candidate assessment…

  16. 38 CFR 18.434 - Education setting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Education setting. 18.434... Adult Education § 18.434 Education setting. (a) Academic setting. A recipient shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who...

  17. 38 CFR 18.434 - Education setting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Education setting. 18.434... Adult Education § 18.434 Education setting. (a) Academic setting. A recipient shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who...

  18. 38 CFR 18.434 - Education setting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Education setting. 18.434... Adult Education § 18.434 Education setting. (a) Academic setting. A recipient shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who...

  19. 38 CFR 18.434 - Education setting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Education setting. 18.434... Adult Education § 18.434 Education setting. (a) Academic setting. A recipient shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who...

  20. 38 CFR 18.434 - Education setting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Education setting. 18.434... Adult Education § 18.434 Education setting. (a) Academic setting. A recipient shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who...

  1. Designing Cross-Functional Business Processes. The Jossey-Bass Management Series. From Training to Performance in the Twenty-First Century. Set 2, Redesigning Work Processes.

    ERIC Educational Resources Information Center

    Johann, Bernard

    This guide offers a comprehensive set of practical tools to lead novice and veteran practitioners through the complexities of business process redesign. This hands-on kit integrates systems theory, economics, and psychology to provide the detailed procedures, checklists, data analysis worksheets, and other resources essential to identify, analyze,…

  2. Program ACTIVE II: Design and Methods for a Multi-Center Community-Based Depression Treatment for Rural and Urban Adults with Type 2 Diabetes

    PubMed Central

    de Groot, Mary; Shubrook, Jay; Schwartz, Frank; Hornsby, W. Guyton; Pillay, Yegan; Saha, Chandan

    2015-01-01

    Objective Depression affects one in four adults with type 2 diabetes (T2DM) and is associated with worsened diabetes complications, increased health care costs and early mortality. Rural and low-income urban areas, including the Appalachian region, represent an epicenter of the T2DM epidemic. Program ACTIVE II is a comparative effectiveness treatment trial designed to test whether a combination of cognitive behavioral therapy (CBT) and community-based exercise (EXER) will offer greater improvements in diabetes and depression outcomes compared to individual treatment approaches and usual care (UC). The secondary aims are to assess changes in cardiovascular risk factors across groups and to conduct a cost-effectiveness analysis of predicted incidence of cardiovascular complications across groups. Methods The study is a 2-by-2 factorial randomized controlled trial consisting of 4 treatment groups: CBT alone, EXER alone, combination of CBT and EXER, and UC. Adults with T2DM for > 1 year and who meet DSM-IVTR criteria for Major Depressive Disorder (MDD) are eligible to participate at two rural Appalachian sites (southeastern Ohio and West Virginia) and one urban site (Indianapolis). This type II behavioral translation study uses a community-engaged research (CEnR) approach by incorporating community fitness centers and mental health practices as interventionists. Conclusions This is the first study to evaluate the comparative effectiveness of combined CBT and exercise in the treatment of depression using community-based intervention delivery. This approach may serve as a national model for expanding depression treatment for patients with T2DM. PMID:27500279

  3. The Effects on Children of the Organization and the Design of the Day Care Physical Environment: Appropriateness of the Federal Inter-Agency Day Care Requirements. Final Report.

    ERIC Educational Resources Information Center

    Kruvant, Charito; And Others

    This paper presents a discussion of the impact of the physical design of day care settings on children and adults. Specifically addressed is the question of how the location and design of the facility, the arrangement of indoor and outdoor space, and the organization of the furniture and materials affect the behavior of the adults and children who…

  4. Using the MCoTI-II Cyclotide Scaffold To Design a Stable Cyclic Peptide Antagonist of SET, a Protein Overexpressed in Human Cancer.

    PubMed

    D'Souza, Charlotte; Henriques, Sónia Troeira; Wang, Conan K; Cheneval, Olivier; Chan, Lai Yue; Bokil, Nilesh J; Sweet, Matthew J; Craik, David J

    2016-01-19

    The SET protein is a promising drug target in cancer therapy, because of its ability to inhibit the function of the tumor suppressor gene protein phosphatase 2A (PP2A). COG peptides, derived from apolipoprotein E (apoE), are potent antagonists of SET; they induce cytotoxicity in cancer cells upon binding to intracellular SET and modulate the nuclear factor kappa B (NF-κB) signaling pathway. However, the therapeutic potential of COG peptides is limited, because of their poor proteolytic stability and low bioavailability. In this study, the COG peptide, COG1410, was stabilized by grafting it onto the ultrastable cyclic peptide scaffold, Momordica cochinchinensis trypsin inhibitor-II (MCoTI-II). The grafted MCoTI-II peptides were cytotoxic to a cancer cell line and showed high stability in human serum. The most potent grafted MCoTI-II peptide inhibited lipopolysaccharide (LPS)-mediated activation of NF-κB in murine macrophages. Overall, this study demonstrates the application of the MCoTI-II scaffold for the development of stable peptide drugs for cancer therapy. PMID:26685975

  5. Using the MCoTI-II Cyclotide Scaffold To Design a Stable Cyclic Peptide Antagonist of SET, a Protein Overexpressed in Human Cancer.

    PubMed

    D'Souza, Charlotte; Henriques, Sónia Troeira; Wang, Conan K; Cheneval, Olivier; Chan, Lai Yue; Bokil, Nilesh J; Sweet, Matthew J; Craik, David J

    2016-01-19

    The SET protein is a promising drug target in cancer therapy, because of its ability to inhibit the function of the tumor suppressor gene protein phosphatase 2A (PP2A). COG peptides, derived from apolipoprotein E (apoE), are potent antagonists of SET; they induce cytotoxicity in cancer cells upon binding to intracellular SET and modulate the nuclear factor kappa B (NF-κB) signaling pathway. However, the therapeutic potential of COG peptides is limited, because of their poor proteolytic stability and low bioavailability. In this study, the COG peptide, COG1410, was stabilized by grafting it onto the ultrastable cyclic peptide scaffold, Momordica cochinchinensis trypsin inhibitor-II (MCoTI-II). The grafted MCoTI-II peptides were cytotoxic to a cancer cell line and showed high stability in human serum. The most potent grafted MCoTI-II peptide inhibited lipopolysaccharide (LPS)-mediated activation of NF-κB in murine macrophages. Overall, this study demonstrates the application of the MCoTI-II scaffold for the development of stable peptide drugs for cancer therapy.

  6. Designing and Validating Procedures for Insuring Quality Adult Education in Nursing Homes and Convalescent Centers. Toward a Theory of Practice for Insuring Quality Education in Nursing Homes: A Section 310 Final Report, May 15, 1980-June 12, 1981.

    ERIC Educational Resources Information Center

    McDermott, Bill P.

    The Senior Adult Education Program (SAEP) for Monroe County, Michigan, conducted a documentation and analysis of the program component that provides high school completion classes in two local nursing homes. Three general research questions were (1) benefits to nursing home residents from the programs, (2) design of classes in nursing homes…

  7. Design of a Randomized Controlled Trial of a Web-Based Intervention to Reduce Cardiovascular Disease Risk Factors among Remote Reservation-Dwelling American Indian Adults with Type 2 Diabetes

    ERIC Educational Resources Information Center

    Henderson, Jeffrey A.; Chubak, Jessica; O'Connell, Joan; Ramos, Maria C.; Jensen, Julie; Jobe, Jared B.

    2012-01-01

    We describe a randomized controlled trial, the Lakota Oyate Wicozani Pi Kte (LOWPK) trial, which was designed to determine whether a Web-based diabetes and nutritional intervention can improve risk factors related to cardiovascular disease (CVD) among a group of remote reservation-dwelling adult American Indian men and women with type 2 diabetes…

  8. Settings: In a Variety of Place. . .

    ERIC Educational Resources Information Center

    Cairo, Peter; And Others

    This document consists of the fourth section of a book of readings on issues related to adult career development. The four chapters in this fourth section focus on settings in which adult career development counseling may take place. "Career Planning and Development in Organizations" (Peter Cairo) discusses several concepts and definitions…

  9. Automated International Information Networks; Systems Design Concepts, Goal-Setting and Priorities. FID/TM Panel at the ASIS Meeting in San Francisco, 2 October, 1969.

    ERIC Educational Resources Information Center

    Samuelson, Kjell

    An invitation to participate in this panel discussion was sent to official representatives of organizations which had an expressed interest in information networks. Since some of the represented international bodies had started preliminary planning for network communication, the discussion was centered around systems design concepts. However, as…

  10. Navigating the Problem Space of Academia: Exploring Processes of Course Design and Classroom Teaching in Postsecondary Settings. WCER Working Paper No. 2014-1

    ERIC Educational Resources Information Center

    Hora, Matthew T.

    2014-01-01

    Policymakers and educators alike increasing focus on faculty adoption of interactive teaching techniques as a way to improve undergraduate education. Yet, little empirical research exists that examines the processes whereby faculty make decisions about curriculum design and classroom teaching in real-world situations. In this study, I use the idea…

  11. A Comparison of Lecture-Based and Challenge-Based Learning in a Workplace Setting: Course Designs, Patterns of Interactivity, and Learning Outcomes

    ERIC Educational Resources Information Center

    O'Mahony, Timothy K.; Vye, Nancy J.; Bransford, John D.; Sanders, Elizabeth A.; Stevens, Reed; Stephens, Richard D.; Richey, Michael C.; Lin, Kuen Y.; Soleiman, Moe K.

    2012-01-01

    We describe findings from a research partnership involving a global airline manufacturing company (The Boeing Company), and learning scientists and aeronautical engineers from the University of Washington. Our starting point for the partnership focused on an 8-hour introductory composites course that was designed for company employees. In phase…

  12. Design

    ERIC Educational Resources Information Center

    Buchanan, Richard; Cross, Nigel; Durling, David; Nelson, Harold; Owen, Charles; Valtonen, Anna; Boling, Elizabeth; Gibbons, Andrew; Visscher-Voerman, Irene

    2013-01-01

    Scholars representing the field of design were asked to identify what they considered to be the most exciting and imaginative work currently being done in their field, as well as how that work might change our understanding. The scholars included Richard Buchanan, Nigel Cross, David Durling, Harold Nelson, Charles Owen, and Anna Valtonen. Scholars…

  13. Use of Patient Portals: Personal Health Information Management in Older Adults.

    PubMed

    Turner, Anne; Osterhage, Katie; Joe, Jonathan; Hartzler, Andrea; Lin, Lorelei; Demiris, George

    2015-01-01

    The personal health information management (PHIM) of older adults is poorly understood. We describe initial results from the SOARING (Studying Older Adults & Researching Information Needs and Goals) study at the University of Washington, a participatory design investigation of PHIM in older adults. We conducted in-depth interviews with older adults (n=71) living in a variety of residential settings. A surprising 21% of participants reported using patient portals. Another 17% of participants reported prior use or anticipated use of portals in the future. We identified preferences and needs as well as barriers and facilitators to portal use. Our findings indicate that patient portals designed to target the specific needs for older adults can suport PHIM. We offer recommendations for expanded research. PMID:26262280

  14. The design and evaluation of a system for improved surveillance and prevention programmes in resource-limited settings using a hospital-based burn injury questionnaire

    PubMed Central

    Peck, Michael; Falk, Henry; Meddings, David; Sugerman, David; Mehta, Sumi; Sage, Michael

    2016-01-01

    Background Limited and fragmented data collection systems exist for burn injury. A global registry may lead to better injury estimates and identify risk factors. A collaborative effort involving the WHO, the Global Alliance for Clean Cookstoves, the CDC and the International Society for Burn Injuries was undertaken to simplify and standardise inpatient burn data collection. An expert panel of epidemiologists and burn care practitioners advised on the development of a new Global Burn Registry (GBR) form and online data entry system that can be expected to be used in resource-abundant or resource-limited settings. Methods International burn organisations, the CDC and the WHO solicited burn centre participation to pilot test the GBR system. The WHO and the CDC led a webinar tutorial for system implementation. Results During an 8-month period, 52 hospitals in 30 countries enrolled in the pilot and were provided the GBR instrument, guidance and a data visualisation tool. Evaluations were received from 29 hospitals (56%). Key findings Median time to upload completed forms was <10 min; physicians most commonly entered data (64%), followed by nurses (25%); layout, clarity, accuracy and relevance were all rated high; and a vast majority (85%) considered the GBR ‘highly valuable’ for prioritising, developing and monitoring burn prevention programmes. Conclusions The GBR was shown to be simple, flexible and acceptable to users. Enhanced regional and global understanding of burn epidemiology may help prioritise the selection, development and testing of primary prevention interventions for burns in resource-limited settings. PMID:27044496

  15. Constructing and Validating 3D-pharmacophore Models to a Set of MMP-9 Inhibitors for Designing Novel Anti-melanoma Agents.

    PubMed

    Medeiros Turra, Kely; Pineda Rivelli, Diogo; Berlanga de Moraes Barros, Silvia; Mesquita Pasqualoto, Kerly Fernanda

    2016-07-01

    A receptor-independent (RI) four-dimensional structure-activity relationship (4D-QSAR) formalism was applied to a set of sixty-four β-N-biaryl ether sulfonamide hydroxamate derivatives, previously reported as potent inhibitors against matrix metalloproteinase subtype 9 (MMP-9). MMP-9 belongs to a group of enzymes related to the cleavage of several extracellular matrix components and has been associated to cancer invasiveness/metastasis. The best RI 4D-QSAR model was statistically significant (N=47; r(2) =0.91; q(2) =0.83; LSE=0.09; LOF=0.35; outliers=0). Leave-N-out (LNO) and y-randomization approaches indicated the QSAR model was robust and presented no chance correlation, respectively. Furthermore, it also had good external predictability (82 %) regarding the test set (N=17). In addition, the grid cell occupancy descriptors (GCOD) of the predicted bioactive conformation for the most potent inhibitor were successfully interpreted when docked into the MMP-9 active site. The 3D-pharmacophore findings were used to predict novel ligands and exploit the MMP-9 calculated binding affinity through molecular docking procedure. PMID:27492238

  16. Effectiveness and cost-effectiveness of an injury prevention programme for adult male amateur soccer players: design of a cluster-randomised controlled trial

    PubMed Central

    Krist, Mark R; Schmikli, Sandor L; Stubbe, Janine H; de Wit, G Ardine; Inklaar, Han; van de Port, Ingrid G L; Backx, Frank J G

    2010-01-01

    Background and aims Approximately 16% of all sports injuries in the Netherlands are caused by outdoor soccer. A cluster-randomised controlled trial has been designed to investigate the effectiveness and cost-effectiveness of an injury prevention programme (‘The11’) for male amateur soccer players. The injury prevention programme The11, developed with the support of the World Football Association FIFA, aims to reduce the impact of intrinsic injury risk factors in soccer. Methods Teams playing at first-class amateur level in two districts in the Netherlands are participating in the study. Teams in the intervention group were instructed to apply The11 during each practice session throughout the 2009–10 season. All participants of the control group continued their practice sessions as usual. All soccer-related injuries and related costs for each team were systematically reported online by a member of the medical staff. Player exposure to practice sessions and matches was reported weekly by the coaches. Also the use of The11 during the season after the intervention season will be monitored. Discussion Our hypothesis is that integrating the The11 exercises in the warm-up for each practice session is effective in terms of injury incidence, injury severity, healthcare use, and its associated costs and/or absenteeism. Prevention of soccer injuries is expected to be beneficial to adult soccer players, soccer clubs, the Royal Dutch Football Association (KNVB), health insurance companies and society. PMID:21177664

  17. [Instrument for the assessment of middle-aged and older adults' physical activity: design, eliability and application of the German-PAQ-50+].

    PubMed

    Huy, Christina; Schneider, Sven

    2008-06-01

    Existing physical activity questionnaires have focused either on young and middle-aged adults or on the elderly. They have mainly assessed only a portion of possible physical activities or contained nation-specific sports. As there is no gold standard for a questionnaire-based assessment of physical activity in the over-50 population, recommendations for such a questionnaire relating to German-speaking countries were developed. This work included a systematic literature research, a survey of experts, and the design of a questionnaire based on validated measuring instruments. Finally, to test its reliability and application in the field, the complete questionnaire, including a retest, was applied by telephone interview (n = 57). The test-retest-correlation was r = 0.60 for the total time of physical activity and r = 0.52 for total energy expenditure. The researchers determined that the instrument is comprehensive in its coverage of all relevant domains of physical activity for the over-50 population; it is economically feasible and showed good acceptance.

  18. Childhood obesity prevention in rural settings: background, rationale, and study design of ‘4-Health,’ a parent-only intervention

    PubMed Central

    2012-01-01

    Background Childhood obesity in rural communities is a serious but understudied problem. The current experiment aims to assess a wide range of obesity risk factors among rural youth and to offer an 8-month intervention program for parents to reduce obesity risk in their preteen child. Methods/Design A two-group, repeated measures design is used to assess the effectiveness of the 4-Health intervention program. Assessments include anthropometric measures, child self-evaluations, parent self-evaluations, and parent evaluations of child. County Extension agents from 21 rural Montana counties recruit approximately 150 parent–child dyads and counties are semi-randomly assigned to the active intervention group (4-Health Educational Program) or a “best-practices” (Healthy Living Information) control group. Discussion This study will shed light on the effectiveness of this parent-only intervention strategy in reducing obesity risk factors among rural preteens. The 4-Health program is designed to provide information and skills development for busy rural parents that will increase healthy lifestyles of their preteen children and improve the parents’ ability to intervene effectively in the lives of their families during this critical developmental period. Trial registration ClinicalTrials.gov ID: NCT01510587 PMID:22471650

  19. Talker intelligibility: Child and adult listener performance

    NASA Astrophysics Data System (ADS)

    Markham, Duncan; Hazan, Valerie

    2002-05-01

    In a study of talker intelligibility, 45 voices (adults, 11-12 year old children) were presented to 135 listeners (adults, 11-12, and 7-8 year olds). Word materials were presented in a ``single-word'' condition, and in a ``triplet'' condition, where a ``normalizing'' precursor sentence preceded three keywords. In both conditions, voices were randomized, with no consecutive presentations from the same speaker. The specially designed word-set consisted of 124 words chosen to maximize consonant confusions. Adult female speakers were significantly more intelligible than other groups, as predicted by previous research, but the difference was small. The error rates for 7-8 year olds were slightly but significantly higher than those for the older children and adults. The effect of presentation condition, however, was not significant for any listener group. Across all listener groups, rankings of speakers by error rates were strikingly consistent, with a distinct cluster of eight low-intelligibility speakers common to all listener groups. This suggests that speaker intelligibility is little influenced by listener-related factors. In terms of their perception of speaker characteristics, children aged seven and above are showing similar patterns of behavior to adults, even though the younger children showed marginally higher error rates. [Work funded by the Wellcome Trust.

  20. Simulation in Adult Education.

    ERIC Educational Resources Information Center

    Knolle, Lawrence M.; Nicely, Robert F., Jr.

    Various simulations designed for adult learning experiences are described. A simulation is defined as "an operating model that displays processes over time and thus may develop dynamically." It is stated that this definition implies that the teacher can design a simulation that he can manage and then can increase its complexity. One simulation…

  1. TRACKING ACCELERATOR SETTINGS.

    SciTech Connect

    D OTTAVIO,T.; FU, W.; OTTAVIO, D.P.

    2007-10-15

    Recording setting changes within an accelerator facility provides information that can be used to answer questions about when, why, and how changes were made to some accelerator system. This can be very useful during normal operations, but can also aid with security concerns and in detecting unusual software behavior. The Set History System (SHS) is a new client-server system developed at the Collider-Accelerator Department of Brookhaven National Laboratory to provide these capabilities. The SHS has been operational for over two years and currently stores about IOOK settings per day into a commercial database management system. The SHS system consists of a server written in Java, client tools written in both Java and C++, and a web interface for querying the database of setting changes. The design of the SHS focuses on performance, portability, and a minimal impact on database resources. In this paper, we present an overview of the system design along with benchmark results showing the performance and reliability of the SHS over the last year.

  2. Internet-Based Interventions Have Potential to Affect Short-Term Mediators and Indicators of Dietary Behavior of Young Adults

    ERIC Educational Resources Information Center

    Park, Amanda; Nitzke, Susan; Kritsch, Karen; Kattelmann, Kendra; White, Adrienne; Boeckner, Linda; Lohse, Barbara; Hoerr, Sharon; Greene, Geoffrey; Zhang, Zhumin

    2008-01-01

    Objective: Evaluate a theory-based, Internet-delivered nutrition education module. Design: Randomized, treatment-control design with pre-post intervention assessments. Setting and Participants: Convenience sample of 160 young adults (aged 18-24) recruited by community educators in 4 states. Study completers (n = 96) included a mix of…

  3. Theory-Driven Intervention Improves Calcium Intake, Osteoporosis Knowledge, and Self-Efficacy in Community-Dwelling Older Black Adults

    ERIC Educational Resources Information Center

    Babatunde, Oyinlola T.; Himburg, Susan P.; Newman, Frederick L.; Campa, Adriana; Dixon, Zisca

    2011-01-01

    Objective: To assess the effectiveness of an osteoporosis education program to improve calcium intake, knowledge, and self-efficacy in community-dwelling older Black adults. Design: Randomized repeated measures experimental design. Setting: Churches and community-based organizations. Participants: Men and women (n = 110) 50 years old and older…

  4. Design considerations for NDE systems in a factory setting and the application to transmission manufacture at the Chrysler Transmission Plant in Kokomo, Indiana

    SciTech Connect

    LaChapell, M.; Perkins, D.E.; Schneberk, D.J.; Erb, S.H.; Nicholson, R.E.

    1994-10-01

    Chrysler Corp. and LLNL have entered into a collaboration to enhance the NDE technology at the Kokomo transmission plant. The project spans 3 years and a wide variety of different projects. Goals are making NDE automated, reliable, and capable of avoiding destructive testing. This requires NDE systems to be better utilized by quality teams on the shop floor and better connected for providing in one place a sufficient set of data for identifying problems in a manufacturing operation, and prescribing an adjustment. The approach is illustrated on two different processes, laser welding and pressure die casting; in each case data are combined from different NDE systems to enable a decision on an adjustment in process variables.

  5. Weight gain prevention in young adults: design of the study of novel approaches to weight gain prevention (SNAP) randomized controlled trial

    PubMed Central

    2013-01-01

    Background Weight gain during young adulthood is common and is associated with increased cardiovascular risk. Preventing this weight gain from occurring may be critical to improving long-term health. Few studies have focused on weight gain prevention, and these studies have had limited success. SNAP (Study of Novel Approaches to Weight Gain Prevention) is an NIH-funded randomized clinical trial examining the efficacy of two novel self-regulation approaches to weight gain prevention in young adults compared to a minimal treatment control. The interventions focus on either small, consistent changes in eating and exercise behaviors, or larger, periodic changes to buffer against expected weight gains. Methods/Design SNAP targets recruitment of six hundred young adults (18–35 years) with a body mass index between 21.0-30.0 kg/m2, who will be randomly assigned with equal probability to: (1) minimal intervention control; (2) self-regulation with Small Changes; or (3) self-regulation with Large Changes. Both interventions receive 8 weekly face-to-face group sessions, followed by 2 monthly sessions, with two 4-week refresher courses in each of subsequent years. Participants are instructed to report weight via web at least monthly thereafter, and receive monthly email feedback. Participants in Small Changes are taught to make small daily changes (~100 calorie changes) in how much or what they eat and to accumulate 2000 additional steps per day. Participants in Large Changes are taught to create a weight loss buffer of 5–10 pounds once per year to protect against anticipated weight gains. Both groups are encouraged to self-weigh daily and taught a self-regulation color zone system that specifies action depending on weight gain prevention success. Individualized treatment contact is offered to participants who report weight gains. Participants are assessed at baseline, 4 months, and then annually. The primary outcome is weight gain over an average of 3 years of follow

  6. Set Equation Transformation System.

    2002-03-22

    Version 00 SETS is used for symbolic manipulation of Boolean equations, particularly the reduction of equations by the application of Boolean identities. It is a flexible and efficient tool for performing probabilistic risk analysis (PRA), vital area analysis, and common cause analysis. The equation manipulation capabilities of SETS can also be used to analyze noncoherent fault trees and determine prime implicants of Boolean functions, to verify circuit design implementation, to determine minimum cost fire protectionmore » requirements for nuclear reactor plants, to obtain solutions to combinatorial optimization problems with Boolean constraints, and to determine the susceptibility of a facility to unauthorized access through nullification of sensors in its protection system. Two auxiliary programs, SEP and FTD, are included. SEP performs the quantitative analysis of reduced Boolean equations (minimal cut sets) produced by SETS. The user can manipulate and evaluate the equations to find the probability of occurrence of any desired event and to produce an importance ranking of the terms and events in an equation. FTD is a fault tree drawing program which uses the proprietary ISSCO DISSPLA graphics software to produce an annotated drawing of a fault tree processed by SETS. The DISSPLA routines are not included.« less

  7. Adult immunization

    PubMed Central

    Mehta, Bharti; Chawla, Sumit; Kumar Dharma, Vijay; Jindal, Harashish; Bhatt, Bhumika

    2014-01-01

    Vaccination is recommended throughout life to prevent vaccine-preventable diseases and their sequel. The primary focus of vaccination programs has historically been directed to childhood immunizations. For adults, chronic diseases have been the primary focus of preventive and medical health care, though there has been increased emphasis on preventing infectious diseases. Adult vaccination coverage, however, remains low for most of the routinely recommended vaccines. Though adults are less susceptible to fall prey to traditional infectious agents, the probability of exposure to infectious agents has increased manifold owing to globalization and increasing travel opportunities both within and across the countries. Thus, there is an urgent need to address the problem of adult immunization. The adult immunization enterprise is more complex, encompassing a wide variety of vaccines and a very diverse target population. There is no coordinated public health infrastructure to support an adult immunization program as there is for children. Moreover, there is little coordination among adult healthcare providers in terms of vaccine provision. Substantial improvement in adult vaccination is needed to reduce the health consequences of vaccine-preventable diseases among adults. Routine assessment of adult patient vaccination needs, recommendation, and offer of needed vaccines for adults should be incorporated into routine clinical care of adults. PMID:24128707

  8. Recruitment of Minority Adolescents and Young Adults into Randomised Clinical Trials: Testing the Design of the Technology Enhanced Community Health Nursing (TECH-N) Pelvic Inflammatory Disease Trial

    PubMed Central

    Trent, Maria; Chung, Shang-en; Gaydos, Charlotte; Frick, Kevin D.; Anders, Jennifer; Huettner, Steven; Rothman, Richard; Butz, Arlene

    2016-01-01

    Purpose Pelvic inflammatory disease (PID) disproportionately affects adolescent and young adult (AYA) women and can negatively influence reproductive health trajectories. Few randomized controlled trials (RCTs) have focused on strategies to improve outpatient adherence or to reduce reproductive morbidity in this population. This paper describes the research methods and preliminary effectiveness of recruitment, retention, and intervention strategies employed in a novel RCT designed to test a technology-enhanced community-health nursing (TECH-N) intervention among urban AYA with PID. Methods AYA women aged 13–25 years were recruited during acute PID visits in outpatient clinics and emergency departments (ED) to participate in this IRB-approved trial. Participants completed an audio-computerized self-interview (ACASI), provided vaginal specimens, and were randomized to standard treatment or the intervention. Intervention participants received text-messaging support for 30 days and a community health nurse (CHN) interventionist performed a home visit with clinical assessment within 5 days after enrollment. All patients received a full course of medications and completed research visits at 14-days (adherence), 30 days and 90 days with by an outreach worker. STI testing performed at the 30-and 90-day visits. Exploratory analyses using descriptive statistics were conducted to examine recruitment, retention, and follow-up data to test the overall design of the intervention. Results In the first 48 months, 64% of 463 patients were eligible for the study and 81.2% of 293 eligible patients were recruited for the study (63.3%); 238 (81.2%) of eligible patients were enrolled. Most participants were African American (95.6%) with a mean age of 18.6 (2.3). Ninety-four percent of individuals assigned to the TECH-N intervention completed the nursing visits. All completed visits have been within the 5-day window and over 90% of patients in both arms have been retained over the 3

  9. Recruitment of Minority Adolescents and Young Adults into Randomised Clinical Trials: Testing the Design of the Technology Enhanced Community Health Nursing (TECH-N) Pelvic Inflammatory Disease Trial

    PubMed Central

    Trent, Maria; Chung, Shang-en; Gaydos, Charlotte; Frick, Kevin D.; Anders, Jennifer; Huettner, Steven; Rothman, Richard; Butz, Arlene

    2016-01-01

    Purpose Pelvic inflammatory disease (PID) disproportionately affects adolescent and young adult (AYA) women and can negatively influence reproductive health trajectories. Few randomized controlled trials (RCTs) have focused on strategies to improve outpatient adherence or to reduce reproductive morbidity in this population. This paper describes the research methods and preliminary effectiveness of recruitment, retention, and intervention strategies employed in a novel RCT designed to test a technology-enhanced community-health nursing (TECH-N) intervention among urban AYA with PID. Methods AYA women aged 13–25 years were recruited during acute PID visits in outpatient clinics and emergency departments (ED) to participate in this IRB-approved trial. Participants completed an audio-computerized self-interview (ACASI), provided vaginal specimens, and were randomized to standard treatment or the intervention. Intervention participants received text-messaging support for 30 days and a community health nurse (CHN) interventionist performed a home visit with clinical assessment within 5 days after enrollment. All patients received a full course of medications and completed research visits at 14-days (adherence), 30 days and 90 days with by an outreach worker. STI testing performed at the 30-and 90-day visits. Exploratory analyses using descriptive statistics were conducted to examine recruitment, retention, and follow-up data to test the overall design of the intervention. Results In the first 48 months, 64% of 463 patients were eligible for the study and 81.2% of 293 eligible patients were recruited for the study (63.3%); 238 (81.2%) of eligible patients were enrolled. Most participants were African American (95.6%) with a mean age of 18.6 (2.3). Ninety-four percent of individuals assigned to the TECH-N intervention completed the nursing visits. All completed visits have been within the 5-day window and over 90% of patients in both arms have been retained over the 3

  10. Microville: A Simulation-Gaming Device Design to Instruct Leaders of Adult Education in the Community-Wide Program Development Process.

    ERIC Educational Resources Information Center

    Snider, John C.; Schroeder, Wayne L.

    Microville is a simulation-game device which has proven its usefulness as a functional instructional instrument in the field of adult education. This study of Microville is concerned with the effectiveness and efficiency with which such a device might instruct adult education to analyze the program concept and to make those decisions which would…

  11. One Approach to the Synthesis, Design and Manufacture of Hyperboloid Gear Sets with Face Mating Gears. Part 2: Review of Practical Realization

    NASA Astrophysics Data System (ADS)

    Abadjiev, Valentin; Abadjieva, Emilia

    2016-09-01

    Hyperboloid gear drives with face mating gears are used to transform rotations between shafts with non-parallel and non-intersecting axes. A special case of these transmissions are Spiroid1 and Helicon gear drives. The classical gear drives of this type are Archimedean ones. The objective of this study are hyperboloid gear drives with face meshing, when the pinion has threads of conic convolute, Archimedean and involute types, or the pinion has threads of cylindrical convolute, Archimedean and involute types. For simplicity, all three type transmissions with face mating gears and a conic pinion are titled Spiroid and all three type trans- missions with face mating gears and a cylindrical pinion are titled Helicon. Principles of the mathematical modelling of tooth contact synthesis are discussed in Part 1: Basic theoretical and CAD experience of this study. The second part of this article is a brief overview of the innovations and inventions created in this field at the Institute of Mechanics - Bulgarian Academy of Sciences in the last three decades. This study is also dedicated on elaboration of the specialized face gear sets for implementation into bio-robot hand. It is based on the application of 3D software technology, using 3D print for the realization of the physical models of the gear drives.

  12. A Controlled Design of Aligned and Random Nanofibers for 3D Bi-functionalized Nerve Conduits Fabricated via a Novel Electrospinning Set-up

    PubMed Central

    Kim, Jeong In; Hwang, Tae In; Aguilar, Ludwig Erik; Park, Chan Hee; Kim, Cheol Sang

    2016-01-01

    Scaffolds made of aligned nanofibers are favorable for nerve regeneration due to their superior nerve cell attachment and proliferation. However, it is challenging not only to produce a neat mat or a conduit form with aligned nanofibers but also to use these for surgical applications as a nerve guide conduit due to their insufficient mechanical strength. Furthermore, no studies have been reported on the fabrication of aligned nanofibers and randomly-oriented nanofibers on the same mat. In this study, we have successfully produced a mat with both aligned and randomly-oriented nanofibers by using a novel electrospinning set up. A new conduit with a highly-aligned electrospun mat is produced with this modified electrospinning method, and this proposed conduit with favorable features, such as selective permeability, hydrophilicity and nerve growth directional steering, were fabricated as nerve guide conduits (NGCs). The inner surface of the nerve conduit is covered with highly aligned electrospun nanofibers and is able to enhance the proliferation of neural cells. The central part of the tube is double-coated with randomly-oriented nanofibers over the aligned nanofibers, strengthening the weak mechanical strength of the aligned nanofibers. PMID:27021221

  13. One Approach to the Synthesis, Design and Manufacture of Hyperboloid Gear Sets with Face Mating Gears. Part 2: Review of Practical Realization

    NASA Astrophysics Data System (ADS)

    Abadjiev, Valentin; Abadjieva, Emilia

    2016-06-01

    Hyperboloid gear drives with face mating gears are used to transform rotations between shafts with non-parallel and non-intersecting axes. A special case of these transmissions are Spiroid1 and Helicon gear drives. The classical gear drives of this type are Archimedean ones. The objective of this study are hyperboloid gear drives with face meshing, when the pinion has threads of conic convolute, Archimedean and involute types, or the pinion has threads of cylindrical convolute, Archimedean and involute types. For simplicity, all three type transmissions with face mating gears and a conic pinion are titled Spiroid and all three type trans- missions with face mating gears and a cylindrical pinion are titled Helicon. Principles of the mathematical modelling of tooth contact synthesis are discussed in Part 1: Basic theoretical and CAD experience of this study. The second part of this article is a brief overview of the innovations and inventions created in this field at the Institute of Mechanics - Bulgarian Academy of Sciences in the last three decades. This study is also dedicated on elaboration of the specialized face gear sets for implementation into bio-robot hand. It is based on the application of 3D software technology, using 3D print for the realization of the physical models of the gear drives.

  14. Transitions from Pediatric to Adult Care: Programs and Resources.

    PubMed

    Schlucter, Juliette; Dokken, Deborah; Ahmann, Elizabeth

    2015-01-01

    This third article in a series on the critical issue of the transition from pediatric to adult care for young adults with complex chronic conditions offers resources, including information about exemplary programs, to pediatric nurses. Three hospital-based programs are highlighted, four key Internet resources are identified, and five relevant articles are annotated. This information can support pediatric nurses in considering transition support options for individual teens and their families as well as in developing resources and designing programs in their own settings.

  15. Three Case Studies on Methods of Working with Older People on the Design of New Technologies.

    PubMed

    Sani, Zaidatol Haslinda Abdullah; Petrie, Helen; Swallow, David; Lewis, Andrew

    2016-01-01

    The proportion of older adults in the population is rapidly increasing and the proportion of younger adults to care for them is decreasing. Part of the solution to support older adults in living independently is to provide them with appropriate assistive technologies. To develop technologies that are effective for older adults we need methodologies that are appropriate for working with this user group. Yet there is little systematic research on how to work with older adults and how to adapt methods already used with younger adults. This paper reports on three case studies which investigated the use focus groups, expert evaluations and user evaluations with older adults. In the case of focus groups, the size of the focus group was investigated; for expert evaluations, an existing set of heuristics for evaluating apps for older adults was investigated; for user evaluations, a low-fidelity prototype design was evaluated using think-aloud protocols. PMID:27534299

  16. Adult Education in India & Abroad.

    ERIC Educational Resources Information Center

    Roy, Nikhil Ranjan

    A survey is made of various aspects of adult education in India since 1947, together with comparative accounts of the origin, development, and notable features of adult education in Denmark, Great Britain, the Soviet Union, and the United States. Needs and objectives in India, largely in the eradication of illiteracy, are set forth, and pertinent…

  17. Alternatives for Staff Development of Adult Educators.

    ERIC Educational Resources Information Center

    Burrichter, Arthur W.; Gardner, Daniel L.

    The product of a three-year adult education teacher training project conducted for Florida's adult educators, this guide is designed to assist planners, facilitators, evaluators, and administrators of staff development programs for adult education teachers to design and conduct effective personal and professional learning experiences. It provides…

  18. One Approach to the Synthesis, Design and Manufacture of Hyperboloid Gear Sets With Face Mating Gears. Part 1: Basic Theoretical and Cad Experience

    NASA Astrophysics Data System (ADS)

    Abadjiev, Valentin; Abadjieva, Emilia

    2016-06-01

    Hyperboloid gear drives with face mating gears are used to transform rotations between shafts with non-parallel and non-intersecting axes. A special case of these transmissions are Spiroid and Helicon gear drives. The classical gear drives of this type are the Archimedean ones. The objective of this study are hyperboloid gear drives with face meshing, when the pinion possesses threads of conic convolute, Archimedean and involute types, or the pinion has threads of cylindrical convolute, Archimedean and involute types. For simplicity, all three types transmis- sions with face mating gears and a conic pinion are titled Spiroid and all three types transmissions with face mating gears and a cylindrical pinion are titled Helicon. Principles of the mathematical modelling of tooth contact synthesis are discussed in this study. The presented research shows that the synthesis is realized by application of two mathematical models: pitch contact point and mesh region models. Two approaches for synthesis of the gear drives in accordance with Olivier's principles are illustrated. The algorithms and computer programs for optimization synthesis and design of the studied hyperboloid gear drives are presented.

  19. Promoting smoking cessation in Bangladeshi and Pakistani male adults: design of a pilot cluster randomised controlled trial of trained community smoking cessation workers

    PubMed Central

    2009-01-01

    Background The prevalence of smoking is higher among Pakistani and Bangladeshi males than among the general population. Smokers who receive behavioural support and medication quadruple their chances of stopping smoking, but evidence suggests that these populations do not use National Health Service run stop smoking clinics as frequently as would be expected given their high prevalence of smoking. This study aims to tackle some of the main barriers to use of stop smoking services and adherence to treatment programmes by redesigning service delivery to be more acceptable to these adult male populations. The study compares the effectiveness of trained Pakistani and Bangladeshi smoking cessation workers operating in an outreach capacity ('clinic + outreach') with standard care ('clinic only') to improve access to and success of National Health Service smoking cessation services. Methods/design This is a pilot cluster randomised controlled trial based in Birmingham, UK. Super output areas of Birmingham will be identified in which more than 10% of the population are of Pakistani and/or Bangladeshi origin. From these areas, 'natural geographical communities' will be identified. Sixteen aggregated agglomerations of super output areas will be identified, separating areas from each other using buffer regions in order to reduce potential contamination. These natural communities will be randomised to 'clinic + outreach' (intervention) or 'clinic only' (control) arms. The use of stop smoking services and the numbers of people quitting smoking (defined as prolonged self-reported abstinence at four weeks, three months and six months) will be assessed in each area. In addition, we will assess the impact of the intervention on adherence to smoking cessation treatments and patient satisfaction. Trial registration Current Controlled Trials ISRCTN 82127540. PMID:19682374

  20. Psychotherapy Outcome in a Private Practice Setting.

    ERIC Educational Resources Information Center

    Kirkhart, Kathryn A.; And Others

    Although almost one-third of licensed psychologists who work in health care settings are employed primarily in private practice, no major study of outcomes in this setting has been undertaken. Outcomes in a private practice were investigated with 33 adult clients who planned to pursue psychotherapy until release by their therapist. The clients…