ERIC Educational Resources Information Center
Tou, Erik R
2013-01-01
This project classifies groups of small order using a group's center as the key feature. Groups of a given order "n" are typed based on the order of each group's center. Students are led through a sequence of exercises that combine proof-writing, independent research, and an analysis of specific classes of finite groups…
Using Configural Frequency Analysis as a Person-Centered Analytic Approach with Categorical Data
ERIC Educational Resources Information Center
Stemmler, Mark; Heine, Jörg-Henrik
2017-01-01
Configural frequency analysis and log-linear modeling are presented as person-centered analytic approaches for the analysis of categorical or categorized data in multi-way contingency tables. Person-centered developmental psychology, based on the holistic interactionistic perspective of the Stockholm working group around David Magnusson and Lars…
Cost analysis helps evaluate contract profitability.
Sides, R W
2000-02-01
A cost-accounting analysis can help group practices assess their costs of doing business and determine the profitability of managed care contracts. Group practices also can use cost accounting to develop budgets and financial benchmarks. To begin a cost analysis, group practices need to determine their revenue and cost centers. Then they can allocate their costs to each center, using an appropriate allocation basis. The next step is to calculate costs per procedure. The results can be used to evaluate operational cost efficiency as well as help negotiate managed care contracts.
GSFC VLBI Analysis Center Annual Report
NASA Technical Reports Server (NTRS)
Gordon, David; Ma, Chopo; MacMillan, Dan
1999-01-01
The GSFC VLBI group, located at NASA's Goddard Space Flight Center in Greenbelt, MD, is a part of the NASA Space Geodesy Program. Since its inception in the mid 1970's, this group has been involved with and been a leader in most aspects of geodetic and astrometric VLBI. Current major activities include coordination of the international geodetic observing program; coordination and analysis of the CORE program; VLBI technique development; and all types of data processing, analysis, and research activities.
Analytical Microscopy and Imaging Science | Materials Science | NREL
Microanalysis (EPMA) for quantitative compositional analysis. It relies on wavelength-dispersive spectroscopy to Science group in NREL's Materials Science Center. Mowafak Al-Jassim Group Manager Dr. Al-Jassim manages the Analytical Microscopy and Imaging Science group with the Materials Science Center. Email | 303-384
The Willowbrook futures project: a longitudinal analysis of person-centered planning.
Holburn, Steve; Jacobson, John W; Schwartz, Allen A; Flory, Michael J; Vietze, Peter M
2004-01-01
We conducted a longitudinal comparative evaluation of person-centered planning processes and outcomes for 20 individuals with intellectual disabilities and problem behavior (former residents of Willowbrook) and a matched contrast group, who received traditional interdisciplinary service planning (ISP). At the inception of the study, all participants were living in one of four other developmental centers (institutions) in New York City. Process and outcome data obtained from questionnaires completed by team members approximately every 8 months at four time periods showed that the rate of improvement in both person-centered planning process and outcomes for the intervention group was significantly greater than that of the comparison group. Eighteen of 19 person-centered planning participants moved to community living arrangements, as did 5 of 18 in the contrast group.
Overview of MSFC's Applied Fluid Dynamics Analysis Group Activities
NASA Technical Reports Server (NTRS)
Garcia, Roberto; Griffin, Lisa; Williams, Robert
2003-01-01
TD64, the Applied Fluid Dynamics Analysis Group, is one of several groups with high-fidelity fluids design and analysis expertise in the Space Transportation Directorate at Marshall Space Flight Center (MSFC). TD64 assists personnel working on other programs. The group participates in projects in the following areas: turbomachinery activities, nozzle activities, combustion devices, and the Columbia accident investigation.
Morphofunctional changes in distribution of pressure center in multiple sclerosis.
Neamţu, Marius Cristian; Neamţu, Oana Maria; Enescu Bieru, Denisa; Marin, Mihnea Ion; Rusu, Mihai Robert; Tudorache, Ştefania; Brăila, Anca Daniela; Poiană, Cătălina; Rusu, Ligia
2018-01-01
Gait evaluation and assessment of motor performance are of utmost importance in the clinical management of multiple sclerosis (MS). A new approach to the analysis of static and dynamic balance of MS patients is the use of complex biomechanical analysis that includes an analysis of the distribution of the center of pressure (DCP) and loading, measured by using the pressure and force platforms. The study was conducted on a total of 18 patients with MS, with the mean age of 41.2 years old, divided into two groups, according to the presence of clinically detectable gait disturbances. The biomechanical analysis that included the assessment of the loading and DPC was performed using the platform of force distribution. DPC represented the center of all the forces applied and its value could appreciate the mediolateral stability, hence the pronation or, respectively, the supination. Group 1, consisting of 12 patients with MS with clinically detectable gait disorders, including six men and six women, and group 2, of six MS patients without clinically detectable gait disorders, including two men and four women. For group 1, the center of pressure had a left-right asymmetric distribution, and also an anterior-posterior one. There was a predominant distribution at the medial heel, at metatarsals 1-3 and at the hallux. For group 2, the analysis of the plantograms recorded in our study indicated a tendency of the distribution of the pressure center in the metatarsals 2, 3 and less in the heel. The analysis of the loading and distribution of the pressure center was important not only to appreciate the static equilibrium disorders but also to appreciate how these disorders affected the gait initiation, since the patients suffered from anterior-posterior and mediolateral disorders, which produced spatial and temporal distortion preventing gait initiation. In the study of pressure and force, we noticed a predominant distribution on the lateral region of the heel, explained by an attempt of the body to compensate the disorders of balance and orientation of the reaction force of the ground to normalize the gait.
Emission properties of body-centered cubic elemental metal photocathodes
DOE Office of Scientific and Technical Information (OSTI.GOV)
Li, Tuo; Rickman, Benjamin L., E-mail: brickm2@uic.edu; Schroeder, W. Andreas
2015-04-07
A first principles analysis of photoemission is developed to explain the lower than expected rms transverse electron momentum measured using the solenoid scan technique for the body-centered cubic Group Vb (V, Nb, and Ta) and Group VIb (Cr, Mo, and W) metallic photocathodes. The density functional theory based analysis elucidates the fundamental role that the electronic band structure (and its dispersion) plays in determining the emission properties of solid-state photocathodes and includes evaluation of work function anisotropy using a thin-slab method.
Johnson Space Center's Risk and Reliability Analysis Group 2008 Annual Report
NASA Technical Reports Server (NTRS)
Valentine, Mark; Boyer, Roger; Cross, Bob; Hamlin, Teri; Roelant, Henk; Stewart, Mike; Bigler, Mark; Winter, Scott; Reistle, Bruce; Heydorn,Dick
2009-01-01
The Johnson Space Center (JSC) Safety & Mission Assurance (S&MA) Directorate s Risk and Reliability Analysis Group provides both mathematical and engineering analysis expertise in the areas of Probabilistic Risk Assessment (PRA), Reliability and Maintainability (R&M) analysis, and data collection and analysis. The fundamental goal of this group is to provide National Aeronautics and Space Administration (NASA) decisionmakers with the necessary information to make informed decisions when evaluating personnel, flight hardware, and public safety concerns associated with current operating systems as well as with any future systems. The Analysis Group includes a staff of statistical and reliability experts with valuable backgrounds in the statistical, reliability, and engineering fields. This group includes JSC S&MA Analysis Branch personnel as well as S&MA support services contractors, such as Science Applications International Corporation (SAIC) and SoHaR. The Analysis Group s experience base includes nuclear power (both commercial and navy), manufacturing, Department of Defense, chemical, and shipping industries, as well as significant aerospace experience specifically in the Shuttle, International Space Station (ISS), and Constellation Programs. The Analysis Group partners with project and program offices, other NASA centers, NASA contractors, and universities to provide additional resources or information to the group when performing various analysis tasks. The JSC S&MA Analysis Group is recognized as a leader in risk and reliability analysis within the NASA community. Therefore, the Analysis Group is in high demand to help the Space Shuttle Program (SSP) continue to fly safely, assist in designing the next generation spacecraft for the Constellation Program (CxP), and promote advanced analytical techniques. The Analysis Section s tasks include teaching classes and instituting personnel qualification processes to enhance the professional abilities of our analysts as well as performing major probabilistic assessments used to support flight rationale and help establish program requirements. During 2008, the Analysis Group performed more than 70 assessments. Although all these assessments were important, some were instrumental in the decisionmaking processes for the Shuttle and Constellation Programs. Two of the more significant tasks were the Space Transportation System (STS)-122 Low Level Cutoff PRA for the SSP and the Orion Pad Abort One (PA-1) PRA for the CxP. These two activities, along with the numerous other tasks the Analysis Group performed in 2008, are summarized in this report. This report also highlights several ongoing and upcoming efforts to provide crucial statistical and probabilistic assessments, such as the Extravehicular Activity (EVA) PRA for the Hubble Space Telescope service mission and the first fully integrated PRAs for the CxP's Lunar Sortie and ISS missions.
A practical radial basis function equalizer.
Lee, J; Beach, C; Tepedelenlioglu, N
1999-01-01
A radial basis function (RBF) equalizer design process has been developed in which the number of basis function centers used is substantially fewer than conventionally required. The reduction of centers is accomplished in two-steps. First an algorithm is used to select a reduced set of centers that lie close to the decision boundary. Then the centers in this reduced set are grouped, and an average position is chosen to represent each group. Channel order and delay, which are determining factors in setting the initial number of centers, are estimated from regression analysis. In simulation studies, an RBF equalizer with more than 2000-to-1 reduction in centers performed as well as the RBF equalizer without reduction in centers, and better than a conventional linear equalizer.
Dawson, Emily
2014-01-01
This paper explores how people from low-income, minority ethnic groups perceive and experience exclusion from informal science education (ISE) institutions, such as museums and science centers. Drawing on qualitative data from four focus groups, 32 interviews, four accompanied visits to ISE institutions, and field notes, this paper presents an analysis of exclusion from science learning opportunities during visits alongside participants’ attitudes, expectations, and conclusions about participation in ISE. Participants came from four community groups in central London: a Sierra Leonean group (n = 21), a Latin American group (n = 18), a Somali group (n = 6), and an Asian group (n = 13). Using a theoretical framework based on the work of Bourdieu, the analysis suggests ISE practices were grounded in expectations about visitors’ scientific knowledge, language skills, and finances in ways that were problematic for participants and excluded them from science learning opportunities. It is argued that ISE practices reinforced participants preexisting sense that museums and science centers were “not for us.” The paper concludes with a discussion of the findings in relation to previous research on participation in ISE and the potential for developing more inclusive informal science learning opportunities. PMID:25574059
ERIC Educational Resources Information Center
Heyne, Thomas; Bogner, Franz X.
2013-01-01
Our study focused on an educational intervention designed to increase the self-esteem of low-achieving eighth graders. The intervention was a substance-specific life skills program built upon teacher-centered versus student-centered teaching methods. A cluster analysis identified four consumption groups prior to the intervention: A potentially…
The John Wesley Powell Center for Analysis and Synthesis
Baron, Jill S.; Goldhaber, Martin
2011-01-01
The Powell Center provides an environment for cross-disciplinary scientific collaboration. The Center expands U.S. Geological Survey earth system science synthesis research activities by fostering the innovation that results from accumulated knowledge, constructive errors, and the "information spillover" that emerges from collaborative settings. Working Groups at the Powell Center use existing data to produce new knowledge..
Chernyakhovskiy is member of the Markets & Policy Analysis Group in the Strategic Energy Analysis Center . Areas of Expertise Energy policy and market analysis Data analysis and statistical modeling Research
Agarwal, Rolly S; Agarwal, Jatin; Jain, Pradeep; Chandra, Anil
2015-05-01
The ability of an endodontic instrument to remain centered in the root canal system is one of the most important characteristic influencing the clinical performance of a particular file system. Thus, it is important to assess the canal centering ability of newly introduced single file systems before they can be considered a viable replacement of full-sequence rotary file systems. The aim of the study was to compare the canal transportation, centering ability, and time taken for preparation of curved root canals after instrumentation with single file systems One Shape and Wave One, using cone-beam computed tomography (CBCT). Sixty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 20(o) to 35(o) were divided into three groups of 20 samples each: ProTaper PT (group I) - full-sequence rotary control group, OneShape OS (group II)- single file continuous rotation, WaveOne WO - single file reciprocal motion (group III). Pre instrumentation and post instrumentation three-dimensional CBCT images were obtained from root cross-sections at 3mm, 6mm and 9mm from the apex. Scanned images were then accessed to determine canal transportation and centering ability. The data collected were evaluated using one-way analysis of variance (ANOVA) with Tukey's honestly significant difference test. It was observed that there were no differences in the magnitude of transportation between the rotary instruments (p >0.05) at both 3mm as well as 6mm from the apex. At 9 mm from the apex, Group I PT showed significantly higher mean canal transportation and lower centering ability (0.19±0.08 and 0.39±0.16), as compared to Group II OS (0.12±0.07 and 0.54±0.24) and Group III WO (0.13±0.06 and 0.55±0.18) while the differences between OS and WO were not statistically significant. It was concluded that there was minor difference between the tested groups. Single file systems demonstrated average canal transportation and centering ability comparable to full sequence Protaper system in curved root canals.
2011-06-05
progress, quarterly, research, special, group study , etc. 3. DATES COVERED. Indicate the time during which the work was performed and the report was...the General/Flag officers’ Study Group . Palm Center White Paper, University of California, 2008. Center for Military Readiness, Open Letter to...of Military Studies Research Paper September 2010- May 2011 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER An Analysis of Opinion of the Impact of Don’t
Overview of MSFC's Applied Fluid Dynamics Analysis Group Activities
NASA Technical Reports Server (NTRS)
Garcia, Roberto; Wang, Tee-See; Griffin, Lisa; Turner, James E. (Technical Monitor)
2001-01-01
This document is a presentation graphic which reviews the activities of the Applied Fluid Dynamics Analysis Group at Marshall Space Flight Center (i.e., Code TD64). The work of this group focused on supporting the space transportation programs. The work of the group is in Computational Fluid Dynamic tool development. This development is driven by hardware design needs. The major applications for the design and analysis tools are: turbines, pumps, propulsion-to-airframe integration, and combustion devices.
Chen, Ruijun; Desai, Nihar R; Ross, Joseph S; Zhang, Weiwei; Chau, Katherine H; Wayda, Brian; Murugiah, Karthik; Lu, Daniel Y; Mittal, Amit; Krumholz, Harlan M
2016-02-17
To determine rates of publication and reporting of results within two years for all completed clinical trials registered in ClinicalTrials.gov across leading academic medical centers in the United States. Cross sectional analysis. Academic medical centers in the United States. Academic medical centers with 40 or more completed interventional trials registered on ClinicalTrials.gov. Using the Aggregate Analysis of ClinicalTrials.gov database and manual review, we identified all interventional clinical trials registered on ClinicalTrials.gov with a primary completion date between October 2007 and September 2010 and with a lead investigator affiliated with an academic medical center. The proportion of trials that disseminated results, defined as publication or reporting of results on ClinicalTrials.gov, overall and within 24 months of study completion. We identified 4347 interventional clinical trials across 51 academic medical centers. Among the trials, 1005 (23%) enrolled more than 100 patients, 1216 (28%) were double blind, and 2169 (50%) were phase II through IV. Overall, academic medical centers disseminated results for 2892 (66%) trials, with 1560 (35.9%) achieving this within 24 months of study completion. The proportion of clinical trials with results disseminated within 24 months of study completion ranged from 16.2% (6/37) to 55.3% (57/103) across academic medical centers. The proportion of clinical trials published within 24 months of study completion ranged from 10.8% (4/37) to 40.3% (31/77) across academic medical centers, whereas results reporting on ClinicalTrials.gov ranged from 1.6% (2/122) to 40.7% (72/177). Despite the ethical mandate and expressed values and mission of academic institutions, there is poor performance and noticeable variation in the dissemination of clinical trial results across leading academic medical centers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Rashid, Tasnuva; Ranjit, Nalini; Byrd-Williams, Courtney; Chuang, Ru-Jye; Roberts-Gray, Cindy; Briley, Margaret; Sweitzer, Sara; Hoelscher, Deanna M.
2015-01-01
Objective To evaluate the effectiveness of the parent- and early care education (ECE) center-based Lunch is in the Bag program on communication between parent, child, and their ECE center providers around fruits, vegetables and whole grain foods (FVWG). Method A total of n=30 ECE center; 577 parent-child dyads participated in this group-randomized controlled trial conducted from 2011–2013 in Texas (n=15 ECE center, 327 dyads intervention group; n=15 ECE center, 250 dyads comparison group). Parent-child and parent-ECE center provider communication was measured using a parent-reported survey administered at baseline and end of the five-week intervention period. Multilevel linear regression analysis was used to compare the pre-to-post intervention changes in the parent-child and parent-ECE center provider communication scales. Significance was set at p<0.05. Results At baseline, parent-child and parent-ECE center provider communication scores were low. There was a significant increase post-intervention in the parent-ECE center provider communication around vegetables (Adjusted β = 0.78, 95%CI: 0.13, 1.43, p=0.002), and around fruit (Adjusted β = 0.62, 95%CI: 0.04, 0.20, p=0.04) among the parents in the intervention group as compared to those in the comparison group. There were no significant intervention effects on parent-child communication. Conclusion Lunch is in the Bag had significant positive effects on improving communication between the parents and ECE center providers around FVWG. PMID:26190371
Overview af MSFC's Applied Fluid Dynamics Analysis Group Activities
NASA Technical Reports Server (NTRS)
Garcia, Roberto; Griffin, Lisa; Williams, Robert
2004-01-01
This paper presents viewgraphs on NASA Marshall Space Flight Center's Applied Fluid Dynamics Analysis Group Activities. The topics include: 1) Status of programs at MSFC; 2) Fluid Mechanics at MSFC; 3) Relevant Fluid Dynamics Activities at MSFC; and 4) Shuttle Return to Flight.
Correlation of Site of Embryo Transfer with IVF Outcome: Analysis of 743 Cycles from a Single Center
Singh, Neeta; Lata, Kusum; Malhotra, Neena; Vanamail, P.
2017-01-01
Objective: To investigate the influence of site of embryo transfer (ET) on reproductive outcome. Materials and Methods: A retrospective analysis of 743 ultrasound-guided ET in fresh in vitro fertilization (IVF) cycles from a single center over a period of 4 years was conducted. The distance between the fundal endometrial surface and the air bubble was measured, and accordingly, patients were divided into four groups (≤10 mm; >10 and ≤15 mm; >15 and 20 mm; >20 and <25 mm). Setting: Tertiary Assisted Reproductive Technology (ART) center. Patient(s): All patients enrolled in the IVF program undergoing ET. Intervention(s): Controlled ovarian hyperstimulation (OS), IVF, and ET. Main Outcome Measure(s): Cleavage rate and clinical pregnancy rate. Result(s): Clinical pregnancy rate was significantly more in groups 2 and 3 compared to the other groups. Logistic regression analysis showed that one unit increase in embryos transfer will enhance the pregnancy outcome about 3.7 (adjusted odds ratio) times with 95% confidence limits 2.6 to 5.4. Similarly, pregnancy outcome will be 3.1 (95% confidence limits: 1.5–6.4) times higher for distance group >15 and <20 mm compared to less than 10-mm distance group. Ectopic pregnancy rates were similar in all the four groups. Conclusion: The present study demonstrates that site of ET has significant difference on reproductive outcome. PMID:28904498
ERIC Educational Resources Information Center
Malcom-Piqueux, Lindsey
2014-01-01
This chapter discusses the utility of person-centered approaches to critical quantitative researchers. These techniques, which identify groups of individuals who share similar attributes, experiences, or outcomes, are contrasted with more commonly used variable-centered approaches. An illustrative example of a latent class analysis of the college…
Program Analysis and Design Requirements for tne National Science Center
1991-02-01
shell of an old exposition building with secondhand furniture to display exhibit items, to the Ontario Science Center, which is a more modem building...Storage Area Pigeonhole storage cabinets for children’s school books , coats, and boots are provided at the Indianapolis Center. The Ontario center...used shopping carts for school groups to store their coats and books . They do not work well according to center staff and are cumbersome and unsightly
ERIC Educational Resources Information Center
Vermillion, James E.
The presence of artifactual bias in analysis of covariance (ANCOVA) and in matching nonequivalent control group (NECG) designs was empirically investigated. The data set was obtained from a study of the effects of a television program on children from three day care centers in Mexico in which the subjects had been randomly selected within centers.…
Overview of MSFC's Applied Fluid Dynamics Analysis Group Activities
NASA Technical Reports Server (NTRS)
Garcia, Roberto; Griffin, Lisa; Williams, Robert
2002-01-01
This viewgraph report presents an overview of activities and accomplishments of NASA's Marshall Space Flight Center's Applied Fluid Dynamics Analysis Group. Expertise in this group focuses on high-fidelity fluids design and analysis with application to space shuttle propulsion and next generation launch technologies. Topics covered include: computational fluid dynamics research and goals, turbomachinery research and activities, nozzle research and activities, combustion devices, engine systems, MDA development and CFD process improvements.
Gaze distribution analysis and saliency prediction across age groups.
Krishna, Onkar; Helo, Andrea; Rämä, Pia; Aizawa, Kiyoharu
2018-01-01
Knowledge of the human visual system helps to develop better computational models of visual attention. State-of-the-art models have been developed to mimic the visual attention system of young adults that, however, largely ignore the variations that occur with age. In this paper, we investigated how visual scene processing changes with age and we propose an age-adapted framework that helps to develop a computational model that can predict saliency across different age groups. Our analysis uncovers how the explorativeness of an observer varies with age, how well saliency maps of an age group agree with fixation points of observers from the same or different age groups, and how age influences the center bias tendency. We analyzed the eye movement behavior of 82 observers belonging to four age groups while they explored visual scenes. Explorative- ness was quantified in terms of the entropy of a saliency map, and area under the curve (AUC) metrics was used to quantify the agreement analysis and the center bias tendency. Analysis results were used to develop age adapted saliency models. Our results suggest that the proposed age-adapted saliency model outperforms existing saliency models in predicting the regions of interest across age groups.
Forghani, Masoomeh; Ghanbari Hashem Abadi, Bahram Ali
2016-06-01
The aim of the present study was to evaluate the effect of group psychotherapy with transactional analysis (TA) approach on emotional intelligence (EI), executive functions and substance dependency among drug-addicts at rehabilitation centers in Mashhad city, Iran, in 2013. In this quasi-experimental study with pretest, posttest, case- control stages, 30 patients were selected from a rehabilitation center and randomly divided into two groups. The case group received 12 sessions of group psychotherapy with transactional analysis approach. Then the effects of independent variable (group psychotherapy with TA approach) on EI, executive function and drug dependency were assessed. The Bar-on test was used for EI, Stroop test for measuring executive function and morphine test, meth-amphetamines and B2 test for evaluating drug dependency. Data were analyzed using multifactorial covariance analysis, Levenes' analysis, MANCOVA, t-student and Pearson correlation coefficient tests t with SPSS software. Our results showed that group psychotherapy with the TA approach was effective in improving EI, executive functions and decreasing drug dependency (P < 0.05). The result of this study showed that group psychotherapy with TA approach has significant effects on addicts and prevents addiction recurrence by improving the coping capabilities and some mental functions of the subjects. However, there are some limitations regarding this study including follow-up duration and sample size.
Sharma, Shreela V; Rashid, Tasnuva; Ranjit, Nalini; Byrd-Williams, Courtney; Chuang, Ru-Jye; Roberts-Gray, Cynthia; Briley, Margaret; Sweitzer, Sara; Hoelscher, Deanna M
2015-12-01
To evaluate the effectiveness of the parent- and early care education (ECE) center-based Lunch is in the Bag program on communication between parent, child, and their ECE center providers around fruits, vegetables and whole grain foods (FVWG). A total of n=30 ECE center; 577 parent-child dyads participated in this group-randomized controlled trial conducted from 2011 to 2013 in Texas (n=15 ECE center, 327 dyads intervention group; n=15 ECE center, 250 dyads comparison group). Parent-child and parent-ECE center provider communication was measured using a parent-reported survey administered at baseline and end of the five-week intervention period. Multilevel linear regression analysis was used to compare the pre-to-post intervention changes in the parent-child and parent-ECE center provider communication scales. Significance was set at p<0.05. At baseline, parent-child and parent-ECE center provider communication scores were low. There was a significant increase post-intervention in the parent-ECE center provider communication around vegetables (Adjusted β=0.78, 95%CI: 0.13, 1.43, p=0.002), and around fruit (Adjusted β=0.62, 95%CI: 0.04, 0.20, p=0.04) among the parents in the intervention group as compared to those in the comparison group. There were no significant intervention effects on parent-child communication. Lunch is in the Bag had significant positive effects on improving communication between the parents and ECE center providers around FVWG. Copyright © 2015 Elsevier Inc. All rights reserved.
Change Mechanisms of Schema-Centered Group Psychotherapy with Personality Disorder Patients
Tschacher, Wolfgang; Zorn, Peter; Ramseyer, Fabian
2012-01-01
Background This study addressed the temporal properties of personality disorders and their treatment by schema-centered group psychotherapy. It investigated the change mechanisms of psychotherapy using a novel method by which psychotherapy can be modeled explicitly in the temporal domain. Methodology and Findings 69 patients were assigned to a specific schema-centered behavioral group psychotherapy, 26 to social skills training as a control condition. The largest diagnostic subgroups were narcissistic and borderline personality disorder. Both treatments offered 30 group sessions of 100 min duration each, at a frequency of two sessions per week. Therapy process was described by components resulting from principal component analysis of patients' session-reports that were obtained after each session. These patient-assessed components were Clarification, Bond, Rejection, and Emotional Activation. The statistical approach focused on time-lagged associations of components using time-series panel analysis. This method provided a detailed quantitative representation of therapy process. It was found that Clarification played a core role in schema-centered psychotherapy, reducing rejection and regulating the emotion of patients. This was also a change mechanism linked to therapy outcome. Conclusions/Significance The introduced process-oriented methodology allowed to highlight the mechanisms by which psychotherapeutic treatment became effective. Additionally, process models depicted the actual patterns that differentiated specific diagnostic subgroups. Time-series analysis explores Granger causality, a non-experimental approximation of causality based on temporal sequences. This methodology, resting upon naturalistic data, can explicate mechanisms of action in psychotherapy research and illustrate the temporal patterns underlying personality disorders. PMID:22745811
The Molecular and Cellular Characterization of Screen‐Detected Lesions ‐ Coordinating Center and Data Management Group will provide support for the participating studies responding to RFA CA14‐10. The coordinating center supports three main domains: network coordination, statistical support and computational analysis and protocol development and database support. Support for
Cost-effectiveness analysis of a patient-centered care model for management of psoriasis.
Parsi, Kory; Chambers, Cindy J; Armstrong, April W
2012-04-01
Cost-effectiveness analyses help policymakers make informed decisions regarding funding allocation of health care resources. Cost-effectiveness analysis of technology-enabled models of health care delivery is necessary to assess sustainability of novel online, patient-centered health care models. We sought to compare cost-effectiveness of conventional in-office care with a patient-centered, online model for follow-up treatment of patients with psoriasis. Cost-effectiveness analysis was performed from a societal perspective on a randomized controlled trial comparing a patient-centered online model with in-office visits for treatment of patients with psoriasis during a 24-week period. Quality-adjusted life expectancy was calculated using the life table method. Costs were generated from the original study parameters and national averages for salaries and services. No significant difference existed in the mean change in Dermatology Life Quality Index scores between the two groups (online: 3.51 ± 4.48 and in-office: 3.88 ± 6.65, P value = .79). Mean improvement in quality-adjusted life expectancy was not significantly different between the groups (P value = .93), with a gain of 0.447 ± 0.48 quality-adjusted life years for the online group and a gain of 0.463 ± 0.815 quality-adjusted life years for the in-office group. The cost of follow-up psoriasis care with online visits was 1.7 times less than the cost of in-person visits ($315 vs $576). Variations in travel time existed among patients depending on their distance from the dermatologist's office. From a societal perspective, the patient-centered online care model appears to be cost saving, while maintaining similar effectiveness to standard in-office care. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
Shah, Dipali Yogesh; Wadekar, Swati Ishwara; Dadpe, Ashwini Manish; Jadhav, Ganesh Ranganath; Choudhary, Lalit Jayant; Kalra, Dheeraj Deepak
2017-01-01
The purpose of this study was to compare and evaluate the shaping ability of ProTaper (PT) and Self-Adjusting File (SAF) system using cone-beam computed tomography (CBCT) to assess their performance in oval-shaped root canals. Sixty-two mandibular premolars with single oval canals were divided into two experimental groups ( n = 31) according to the systems used: Group I - PT and Group II - SAF. Canals were evaluated before and after instrumentation using CBCT to assess centering ratio and canal transportation at three levels. Data were statistically analyzed using one-way analysis of variance, post hoc Tukey's test, and t -test. The SAF showed better centering ability and lesser canal transportation than the PT only in the buccolingual plane at 6 and 9 mm levels. The shaping ability of the PT was best in the apical third in both the planes. The SAF had statistically significant better centering and lesser canal transportation in the buccolingual as compared to the mesiodistal plane at the middle and coronal levels. The SAF produced significantly less transportation and remained centered than the PT at the middle and coronal levels in the buccolingual plane of oval canals. In the mesiodistal plane, the performance of both the systems was parallel.
Agarwal, Jatin; Jain, Pradeep; Chandra, Anil
2015-01-01
Background The ability of an endodontic instrument to remain centered in the root canal system is one of the most important characteristic influencing the clinical performance of a particular file system. Thus, it is important to assess the canal centering ability of newly introduced single file systems before they can be considered a viable replacement of full-sequence rotary file systems. Aim The aim of the study was to compare the canal transportation, centering ability, and time taken for preparation of curved root canals after instrumentation with single file systems One Shape and Wave One, using cone-beam computed tomography (CBCT). Materials and Methods Sixty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 20o to 35o were divided into three groups of 20 samples each: ProTaper PT (group I) – full-sequence rotary control group, OneShape OS (group II)- single file continuous rotation, WaveOne WO – single file reciprocal motion (group III). Pre instrumentation and post instrumentation three-dimensional CBCT images were obtained from root cross-sections at 3mm, 6mm and 9mm from the apex. Scanned images were then accessed to determine canal transportation and centering ability. The data collected were evaluated using one-way analysis of variance (ANOVA) with Tukey’s honestly significant difference test. Results It was observed that there were no differences in the magnitude of transportation between the rotary instruments (p >0.05) at both 3mm as well as 6mm from the apex. At 9 mm from the apex, Group I PT showed significantly higher mean canal transportation and lower centering ability (0.19±0.08 and 0.39±0.16), as compared to Group II OS (0.12±0.07 and 0.54±0.24) and Group III WO (0.13±0.06 and 0.55±0.18) while the differences between OS and WO were not statistically significant Conclusion It was concluded that there was minor difference between the tested groups. Single file systems demonstrated average canal transportation and centering ability comparable to full sequence Protaper system in curved root canals. PMID:26155551
The Joint Physics Analysis Center: Recent results
NASA Astrophysics Data System (ADS)
Fernández-Ramírez, César
2016-10-01
We review some of the recent achievements of the Joint Physics Analysis Center, a theoretical collaboration with ties to experimental collaborations, that aims to provide amplitudes suitable for the analysis of the current and forthcoming experimental data on hadron physics. Since its foundation in 2013, the group is focused on hadron spectroscopy in preparation for the forthcoming high statistics and high precision experimental data from BELLEII, BESIII, CLAS12, COMPASS, GlueX, LHCb and (hopefully) PANDA collaborations. So far, we have developed amplitudes for πN scattering, KN scattering, pion and J/ψ photoproduction, two kaon photoproduction and three-body decays of light mesons (η, ω, ϕ). The codes for the amplitudes are available to download from the group web page and can be straightforwardly incorporated to the analysis of the experimental data.
ERIC Educational Resources Information Center
Minnesota Governor's Planning Council on Developmental Disabilities, St. Paul.
This paper reports the results of analyzing financial, program, and client data collected from Minnesota's Developmental Achievement Centers (DACs) for 1986. A total of 4,883 adults were receiving services, with the largest group being severely mentally retarded. Persons with additional disabilities numbered 1,263, with severe behavior problems,…
Marathon Group Therapy: Potential for University Counseling Centers and Beyond
ERIC Educational Resources Information Center
Stanger, Thomas; Harris, Rafael S., Jr.
2005-01-01
A descriptive analysis of marathon group therapy was conducted, specifying issues of set-up, screening, preparation, start-up, introduction to group process, facilitating therapeutic moments throughout the weekend, termination, and follow-up. Factors and dynamics unique to this modality are outlined for marathon groups in university counseling…
14 CFR Appendix C to Part 420 - Risk Analysis
Code of Federal Regulations, 2013 CFR
2013-01-01
... within the populated area (A) Carbon Dioxide Information Analysis Center (CDIAC) Oak Ridge National... including 100 nm from the launch point are required at the U.S. census block group level. Population data... populated area (N) Within 100 nm of the launch point: U.S. census data at the census block-group level...
14 CFR Appendix C to Part 420 - Risk Analysis
Code of Federal Regulations, 2014 CFR
2014-01-01
... within the populated area (A) Carbon Dioxide Information Analysis Center (CDIAC) Oak Ridge National... including 100 nm from the launch point are required at the U.S. census block group level. Population data... populated area (N) Within 100 nm of the launch point: U.S. census data at the census block-group level...
14 CFR Appendix C to Part 420 - Risk Analysis
Code of Federal Regulations, 2012 CFR
2012-01-01
... within the populated area (A) Carbon Dioxide Information Analysis Center (CDIAC) Oak Ridge National... including 100 nm from the launch point are required at the U.S. census block group level. Population data... populated area (N) Within 100 nm of the launch point: U.S. census data at the census block-group level...
14 CFR Appendix C to Part 420 - Risk Analysis
Code of Federal Regulations, 2011 CFR
2011-01-01
... within the populated area (A) Carbon Dioxide Information Analysis Center (CDIAC) Oak Ridge National... including 100 nm from the launch point are required at the U.S. census block group level. Population data... populated area (N) Within 100 nm of the launch point: U.S. census data at the census block-group level...
Trudnak, Tara E; Arboleda, Elizabeth; Kirby, Russell S; Perrin, Karin
2013-01-01
CenteringPregnancy is a client-centered model of group prenatal care that brings women together into small groups to receive care through assessment, education, and support. As Spanish-speaking CenteringPregnancy groups become more common, outcomes of Latinas who attend these groups must be assessed. The purpose of this retrospective cohort study was to compare pregnancy outcomes of Latina women who completed CenteringPregnancy in a public health clinic with women who completed individual care in the same clinic during the same time. Medical charts were reviewed retrospectively to examine differences in pregnancy outcomes and maternal factors in both prenatal care groups. Latina Spanish-speaking women who completed CenteringPregnancy were matched with Latina Spanish-speaking women who completed individual care within the same time frame. Logistic regression analysis was conducted to examine maternal and birth outcomes. A total of 487 patient charts were obtained for data collection (CenteringPregnancy n = 247, individual n = 240). No differences in low-birth-weight or preterm births were observed between the groups. Compared with women in individual care, women in CenteringPregnancy had higher odds of giving birth vaginally (adjusted odds ratio [aOR], 2.57; 95% confidence interval [CI], 1.23-5.36), attending prenatal care visits (aOR, 11.03; 95% CI, 4.53-26.83), attending postpartum care visits (aOR, 2.20; 95% CI, 1.20-4.05), and feeding their infants formula only (aOR, 6.07; 95% CI, 2.57-14.3). Women in CenteringPregnancy also had lower odds of gaining below the recommended amount of gestational weight (aOR, 0.41; 95% CI, 0.22-0.78). Women in CenteringPregnancy had higher health care utilization, but there were no differences in preterm birth or low birth weight. Randomized studies are needed to eliminate selection bias. © 2013 by the American College of Nurse-Midwives.
Martel, Michelle M.; Goth-Owens, Timothy; Martinez-Torteya, Cecilia; Nigg, Joel T.
2010-01-01
Person-centered personality approaches are an underutilized means of illuminating clinical heterogeneity of Attention-Deficit/Hyperactivity Disorder (ADHD). In this study, latent profile analysis was conducted with personality traits to identify homogeneous profiles within the ADHD population. Participants were 548 children ages six to 18 years (302 with ADHD). Personality traits were measured via parent report on the California Q-Sort. Latent profile analysis was conducted on the Big Five Factors. A six profile solution best fit the data. Resulting groups were characterized as “disagreeable,” “introverted,” “poor control,” “well-adjusted,” “extraverted,” and “perfectionistic.” External validation of this model using ADHD diagnosis, subtypes, and comorbid psychopathology suggested that children with ADHD could be parsed into four groups: 1) an introverted group with high rates of the ADHD-inattentive type, 2) a group characterized by poor control, with high rates of ADHD-combined type (ADHD-C) and comorbid disruptive behavior disorders, 3) an extraverted group, with ADHD-C and few associated comorbid disorders, and 4) possibly, a very rare “perfectionistic” group, exhibiting obsessive traits. A person-centered personality approach may be one promising way to capture homogeneous subgroups within the ADHD population. PMID:20141255
Okely, Anthony D; Collins, Clare E; Morgan, Philip J; Jones, Rachel A; Warren, Janet M; Cliff, Dylan P; Burrows, Tracy L; Colyvas, Kim; Steele, Julie R; Baur, Louise A
2010-09-01
To evaluate whether a child-centered physical activity program, combined with a parent-centered dietary program, was more efficacious than each treatment alone, in preventing unhealthy weight-gain in overweight children. An assessor-blinded randomized controlled trial involving 165 overweight/obese 5.5- to 9.9- year-old children. Participants were randomly assigned to 1 of 3 interventions: a parent-centered dietary program (Diet); a child-centered physical activity program (Activity); or a combination of both (Diet+Activity). All groups received 10 weekly face-to-face sessions followed by 3 monthly relapse-prevention phone calls. Analysis was by intention-to-treat. The primary outcome was change in body mass index z-score at 6 and 12 months (n=114 and 106, respectively). Body mass index z-scores were reduced at 12-months in all groups, with the Diet (mean [95% confidence interval]) (-0.39 [-0.51 to 0.27]) and Diet + Activity (-0.32, [-0.36, -0.23]) groups showing a greater reduction than the Activity group (-0.17 [-0.28, -0.06]) (P=.02). Changes in other outcomes (waist circumference and metabolic profile) were not statistically significant among groups. Relative body weight decreased at 6 months and was sustained at 12 months through treatment with a child-centered physical activity program, a parent-centered dietary program, or both. The greatest effect was achieved when a parent-centered dietary component was included. Copyright (c) 2010 Mosby, Inc. All rights reserved.
An Anatomic Study on Whether the Immature Patella is Centered on an Anteroposterior Radiograph.
Kyriakedes, James C; Liu, Raymond W
2017-03-01
In the operating room, after first obtaining a proper lateral radiograph with the condyles superimposed, a 90-degree rotation of the intraoperative fluoroscopy unit does not always produce an anteroposterior (AP) image with the patella centered. The orthogonality of these 2 views has not been well determined in children. This study was comprised of a radiographic group (35 knees) and a cadaveric group (59 knees). Both cadaveric and clinical images were obtained by resting or positioning the femur with the posterior condyles overlapped, and then taking an orthogonal AP image. Centering of the patella was calculated and multiple regression analysis was performed to determine the relationship between patellar centering and age, sex, ethnicity, mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), and contralateral centering. Mean patellar centering, expressed as the lateral position of the patella with respect to the total condylar width, was 0.08±0.10 in the radiographic group and 0.06±0.03 in the cadaveric group. Positive (lateral) patellar centering in 1 knee had a statistically significant correlation with positive patellar centering in the contralateral knee in both the radiographs and the cadavers. In the radiographic group, there was a statistically significant correlation between femoral varus and valgus deformities and positive patellar centering. In the cadaveric group, there was a statistically significant correlation between tibial valgus and negative (medial) patellar centering. The patella in an immature knee is rarely perfectly centered on a true AP image, and is usually seated slightly laterally within the femoral condyles. Obtaining a true AP intraoperative radiograph is critical to analyzing and correcting valgus and varus deformities, and in the proper placement of implants. When addressing knee deformity one should consider obtaining an AP view orthogonal either to a perfect lateral of the knee or orthogonal to the flexion axis of the knee, particularly when evaluating distal femoral deformity.
Comparing Person-Centered Communication Education in Long-Term Care Using Onsite and Online Formats.
Coleman, Carissa K; Fanning, Kim; Williams, Kristine N
2015-11-01
Educating nursing home (NH) staff to provide person-centered care is complicated by scheduling, costs, and other feasibility issues. The current study compared outcomes for an in-service program focused on person-centered communication provided in onsite and online formats. The Changing Talk program was provided onsite in seven NHs (n = 327 staff). The online program included eight NHs (n = 211 staff). Analysis of variance revealed an interaction between format type and pre-/post-test scores with improved recognition of person-centered communication in the onsite group only. Group program evaluations based on the modified Diffusion of Innovation in Long-Term Care Battery indicated no significant differences between training formats. Staff perception of the program was similar. Although statistically significant gains were noted in posttest scores indicating awareness of person-centered communication for the onsite group, gains were of limited clinical significance. Feasibility and effectiveness are important considerations for in-service education supporting NH culture change. Copyright 2015, SLACK Incorporated.
Jacobs, Jeffrey Phillip; O'Brien, Sean M.; Pasquali, Sara K.; Jacobs, Marshall Lewis; Lacour-Gayet, François G.; Tchervenkov, Christo I.; Austin III, Erle H.; Pizarro, Christian; Pourmoghadam, Kamal K.; Scholl, Frank G.; Welke, Karl F.; Gaynor, J. William; Clarke, David R.; Mayer, John E.; Mavroudis, Constantine
2013-01-01
Background. We evaluated outcomes for groups of risk-stratified operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database to provide contemporary benchmarks and examine variation between centers. Methods. Patients undergoing surgery from 2005 to 2009 were included. Centers with more than 10% missing data were excluded. Discharge mortality and postoperative length of stay (PLOS) among patients discharged alive were calculated for groups of risk-stratified operations using the five Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery mortality categories (STAT Mortality Categories). Power for analyzing between-center differences in outcome was determined for each STAT Mortality Category. Variation was evaluated using funnel plots and Bayesian hierarchical modeling. Results. In this analysis of risk-stratified operations, 58,506 index operations at 73 centers were included. Overall discharge mortality (interquartile range among programs with more than 10 cases) was as follows: STAT Category 1 = 0.55% (0% to 1.0%), STAT Category 2 = 1.7% (1.0% to 2.2%), STAT Category 3 = 2.6% (1.1% to 4.4%), STAT Category 4 = 8.0% (6.3% to 11.1%), and STAT Category 5 = 18.4% (13.9% to 27.9%). Funnel plots with 95% prediction limits revealed the number of centers characterized as outliers by STAT Mortality Categories was as follows: Category 1 = 3 (4.1%), Category 2 = 1 (1.4%), Category 3 = 7 (9.7%), Category 4 = 13 (17.8%), and Category 5 = 13 (18.6%). Between-center variation in PLOS was analyzed for all STAT Categories and was greatest for STAT Category 5 operations. Conclusions. This analysis documents contemporary benchmarks for risk-stratified pediatric cardiac surgical operations grouped by STAT Mortality Categories and the range of outcomes among centers. Variation was greatest for the more complex operations. These data may aid in the design and planning of quality assessment and quality improvement initiatives. PMID:22704799
Jacobs, Jeffrey Phillip; O'Brien, Sean M; Pasquali, Sara K; Jacobs, Marshall Lewis; Lacour-Gayet, François G; Tchervenkov, Christo I; Austin, Erle H; Pizarro, Christian; Pourmoghadam, Kamal K; Scholl, Frank G; Welke, Karl F; Gaynor, J William; Clarke, David R; Mayer, John E; Mavroudis, Constantine
2012-08-01
We evaluated outcomes for groups of risk-stratified operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database to provide contemporary benchmarks and examine variation between centers. Patients undergoing surgery from 2005 to 2009 were included. Centers with more than 10% missing data were excluded. Discharge mortality and postoperative length of stay (PLOS) among patients discharged alive were calculated for groups of risk-stratified operations using the five Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery mortality categories (STAT Mortality Categories). Power for analyzing between-center differences in outcome was determined for each STAT Mortality Category. Variation was evaluated using funnel plots and Bayesian hierarchical modeling. In this analysis of risk-stratified operations, 58,506 index operations at 73 centers were included. Overall discharge mortality (interquartile range among programs with more than 10 cases) was as follows: STAT Category 1=0.55% (0% to 1.0%), STAT Category 2=1.7% (1.0% to 2.2%), STAT Category 3=2.6% (1.1% to 4.4%), STAT Category 4=8.0% (6.3% to 11.1%), and STAT Category 5=18.4% (13.9% to 27.9%). Funnel plots with 95% prediction limits revealed the number of centers characterized as outliers by STAT Mortality Categories was as follows: Category 1=3 (4.1%), Category 2=1 (1.4%), Category 3=7 (9.7%), Category 4=13 (17.8%), and Category 5=13 (18.6%). Between-center variation in PLOS was analyzed for all STAT Categories and was greatest for STAT Category 5 operations. This analysis documents contemporary benchmarks for risk-stratified pediatric cardiac surgical operations grouped by STAT Mortality Categories and the range of outcomes among centers. Variation was greatest for the more complex operations. These data may aid in the design and planning of quality assessment and quality improvement initiatives. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Jain, Aditi; Asrani, Hemant; Singhal, Abhinav Chand; Bhatia, Taranjeet Kaur; Sharma, Vaibhav; Jaiswal, Pragya
2016-01-01
Aims: To compare the canal transportation, centering ability, and remaining dentin thickness of WaveOne and ProTaper systems using cone beam computed tomography. Subjects and Methods: Forty extracted human single-rooted premolars were used in the present study. Preinstrumentation scanning of all teeth was taken; canal curvatures were calculated, and the samples were randomly divided into two groups, with twenty samples in each group; one group was instrumented with WaveOne system and the other group with ProTaper rotary system. Postinstrumentation scans were performed, and the two scans were compared to determine canal transportation, centering ability, and remaining dentin thickness at 3 mm, 6 mm, and 9 mm from the root apex. Statistical Analysis Used: Student's unpaired t-test. Results: Using Student's unpaired t-test, results were as follows: for canal transportation, Group 1 showed significant difference at 3 mm and 6 mm and insignificant difference at 9 mm while Group 2 showed insignificant difference in all the three regions. For centering ability and remaining dentin thickness, Group 1 showed insignificant difference at 3 mm and 9 mm while significant difference at 6 mm was obtained. When comparison of remaining dentin thickness was done at three levels using two groups WaveOne and ProTaper, there was no significant difference between two groups. Conclusions: (1) WaveOne single reciprocation file system respected better canal anatomy better than ProTaper. (2) Individually, centering ability of WaveOne was better at 3 mm, 6 mm, and 9 mm levels. (3) However, ProTaper individually was better centered at 3 mm (apical third) and 9 mm (coronal 3rd) levels than 6 mm level (middle third). PMID:27656063
Shah, Dipali Yogesh; Wadekar, Swati Ishwara; Dadpe, Ashwini Manish; Jadhav, Ganesh Ranganath; Choudhary, Lalit Jayant; Kalra, Dheeraj Deepak
2017-01-01
Context and Aims: The purpose of this study was to compare and evaluate the shaping ability of ProTaper (PT) and Self-Adjusting File (SAF) system using cone-beam computed tomography (CBCT) to assess their performance in oval-shaped root canals. Materials and Methods: Sixty-two mandibular premolars with single oval canals were divided into two experimental groups (n = 31) according to the systems used: Group I – PT and Group II – SAF. Canals were evaluated before and after instrumentation using CBCT to assess centering ratio and canal transportation at three levels. Data were statistically analyzed using one-way analysis of variance, post hoc Tukey's test, and t-test. Results: The SAF showed better centering ability and lesser canal transportation than the PT only in the buccolingual plane at 6 and 9 mm levels. The shaping ability of the PT was best in the apical third in both the planes. The SAF had statistically significant better centering and lesser canal transportation in the buccolingual as compared to the mesiodistal plane at the middle and coronal levels. Conclusions: The SAF produced significantly less transportation and remained centered than the PT at the middle and coronal levels in the buccolingual plane of oval canals. In the mesiodistal plane, the performance of both the systems was parallel. PMID:28855757
COGNITIVE PERFORMANCE OF STUNTED PRE-SCHOOL CHILDREN UNDERGOING NUTRITIONAL RECOVERY TREATMENT.
Silva, Thaíse Morais; Bueno, Nassib Bezerra; Azevedo, Maria de Lourdes da Silva Gomes de; Clemente, Ana Paula Grotti; Florêncio, Telma Maria de Menezes Toledo
2018-01-01
To determine if the treatment of stunted children offered at a specialized center influences their cognitive performance. Two groups of children from vulnerable families were selected, one consisting of stunted children being treated at the Nutrition Education and Recovery Center (CREN), and the other group of eutrophic children from a local, public day care center. At CREN, children are treated in a day-hospital system (9 hours/day, 5 days/week), receiving medical, nutritional and psycho-pedagogical support. All children were submitted to the Denver-II Development Screening Test and had their development and the height-for-age index assessed at 3 moments: at the beginning of the follow-up, and after 6 and 12 months. The socioeconomic status, according to the Brazilian Economic Classification Criteria, was assessed at the beginning of the follow-up. Data were treated by prevalence ratios for cross-sectional baseline analysis, using the Poisson regression, and by pooled prevalence ratios for longitudinal analysis, using a generalized equation estimation model, both adjusted by age, sex and economic status. Seventy-four children were included, 37 for each group. There were no differences in age, sex and socioeconomic status between groups. In the longitudinal analysis, the CREN group showed better performance in the personal-social domain (pooled prevalence ratio: 0.89; 95% confidence interval - 95%IC 0.82-0.95), with no differences in the other domains. The treatment offered at CREN satisfactorily improved the social skills of the treated children, without changing other domains.
Lunar phases and crisis center telephone calls.
Wilson, J E; Tobacyk, J J
1990-02-01
The lunar hypothesis, that is, the notion that lunar phases can directly affect human behavior, was tested by time-series analysis of 4,575 crisis center telephone calls (all calls recorded for a 6-month interval). As expected, the lunar hypothesis was not supported. The 28-day lunar cycle accounted for less than 1% of the variance of the frequency of crisis center calls. Also, as hypothesized from an attribution theory framework, crisis center workers reported significantly greater belief in lunar effects than a non-crisis-center-worker comparison group.
Stenov, Vibeke; Wind, Gitte; Skinner, Timothy; Reventlow, Susanne; Hempler, Nana Folmann
2017-09-18
Healthcare professionals' person-centered communication skills are pivotal for successful group-based diabetes education. However, healthcare professionals are often insufficiently equipped to facilitate person-centeredness and many have never received post-graduate training. Currently, assessing professionals' skills in conducting group-based, person-centered diabetes education primarily focus on experts measuring and coding skills on various scales. However, learner-centered approaches such as adequate self-reflective tools have been shown to emphasize professional autonomy and promote engagement. The aim of this study was to explore the potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education. The study entails of two components: 1) Field observations of five different educational settings including 49 persons with diabetes and 13 healthcare professionals, followed by interviews with 5 healthcare professionals and 28 persons with type 2 diabetes. 2) One professional development workshop involving 14 healthcare professionals. Healthcare professionals were asked to assess their person-centered communication skills using a self-assessment tool based on challenges and skills related to four educator roles: Embracer, Facilitator, Translator, and Initiator. Data were analyzed by hermeneutic analysis. Theories derived from theoretical model 'The Health Education Juggler' and techniques from 'Motivational Interviewing in Groups' were used as a framework to analyze data. Subsequently, the analysis from the field notes and interview transcript were compared with healthcare professionals' self-assessments of strengths and areas in need to effectively facilitate group-based, person-centered diabetes education. Healthcare professionals self-assessed the Translator and the Embracer to be the two most skilled roles whereas the Facilitator and the Initiator were identified to be the most challenged roles. Self-assessments corresponded to observations of professional skills in educational programs and were confirmed in the interviews. Healthcare professionals self-assessed the same professional skills as observed in practice. Thus, a tool to self-assess professional skills in facilitating group-based diabetes education seems to be useful as a starting point to promote self-reflections and identification of healthcare professionals' strengths and areas of need of professional development.
Root canal centering ability of rotary cutting nickel titanium instruments: A meta-analysis
Gundappa, Mohan; Bansal, Rashmi; Khoriya, Sarvesh; Mohan, Ranjana
2014-01-01
Aim: To systematically review articles on canal centering ability of endodontic rotary cutting Nickel-Titanium (Ni-Ti) instruments and subject results to meta-analysis. Materials and Methods: A comprehensive search was initiated on canal centering ability of different rotary cutting Ni-Ti files such as Protaper, Hero Shaper, K3, Mtwo, Race, Wave One by selecting articles published in peer reviewed journals during 1991-2013 using “Pub Med” database. Inclusion and exclusion criteria were established. A data was created by tabulating: Author name, publication year, sample size, number of experimental groups, methods to evaluate canal centering ability, instrument cross section, taper, tip design, rake angle, mean and standard deviation. The data generated was subjected to meta-analysis. Results: Maximum studies were found to be conducted on mesiobuccal canal of mandibular 1st molar with curvature ranging from 15-60°. The difference in canal centering ability of different rotary cutting Ni-Ti instruments was not statistically significant. Conclusion: All endodontic rotary cutting Ni-Ti instruments are capable of producing centered preparations. Protaper depicted the best centering ability. Computed tomography is an effective method of evaluating canal centering ability. PMID:25506134
Raheb, Ghoncheh; Khaleghi, Esmat; Moghanibashi-Mansourieh, Amir; Farhoudian, Ali; Teymouri, Robab
2016-01-01
This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. This is an experimental plan (pretest to posttest with a control group); the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30) and control (30) groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. A covariance analysis test and independent and dependent t -test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients' self-understanding and self-recognition, and enhancing social functioning.
Raheb, Ghoncheh; Khaleghi, Esmat; Moghanibashi-Mansourieh, Amir; Farhoudian, Ali; Teymouri, Robab
2016-01-01
Purpose This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. Patients and methods This is an experimental plan (pretest to posttest with a control group); the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30) and control (30) groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. Results A covariance analysis test and independent and dependent t-test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Conclusion Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients’ self-understanding and self-recognition, and enhancing social functioning. PMID:27895520
ERIC Educational Resources Information Center
Ganotice, Fraide A., Jr.; Datu, Jesus Alfonso D.; King, Ronnel B.
2016-01-01
Previous studies on academic emotions have mostly used variable-centered approaches. Although these studies have elucidated the relationships between academic emotions and key academic outcomes, they cannot identify naturally-occurring groups of students defined by distinct academic emotion profiles. In this study, we adopted a person-centered…
Final report : oceanic surveillance and navigation analysis, FY 71.
DOT National Transportation Integrated Search
1971-06-01
The report summarizes the oceanic surveillance and navigation analysis performed at Transportation Systems Center under PPA FA-04 for FY 71. Three major efforts are reviewed and discussed herein: summary of the North Atlantic Systems Planning Group c...
Abbasi, Khadijeh; Hazrati, Maryam; Mohamadi, Nasrin Pourali; Rajaeefard, Abdolreza
2013-11-01
Several studies have established that all nurses need continuing education, especially those who are working in oncology wards. In the current programs, there are just two general patterns for teaching: Teacher-centered and student-centered patterns. In this study, the effect of teacher-centered (lecture) and student-centered (module) teaching methods in relation to safety standards with cytotoxic drugs on the knowledge and practice of oncology nurses was compared. This research was a quasi-experimental study with two intervention groups (module and lecture) and a control group. In this study, 86 nurses in Shiraz, Fars province in 2011, who participated in the prescription of cytotoxic drugs to patients were selected and randomly divided into three groups. The module group used a self-directed module, the lecture group was taught by an experienced lecturer in the classroom and the control group did not receive any intervention. Data in relation to knowledge and practice of oncology nurses in the three groups were collected before and 8 weeks after the intervention by using a questionnaire and checklist. To analyze the data paired-samples t-test and one way ANOVA analysis were used. Knowledge and practice scores increased significantly from baseline in both intervention groups, but there was no significant difference between the scores of the two groups. No considerable changes were observed in the control group. Both module and lecture methods have similar effects on improving the knowledge and practice of nurses in oncology wards. Therefore, considering the advantages of student-centered educational methods, the work load of nurses and the sensitivity of their jobs, we suggest using module.
Ran Fu Photo of Ran Fu Ran Fu Researcher IV-Economic/Financial Analysis Ran.Fu@nrel.gov | 303-384 -7522 Ran Fu is a member of the Techno-Economic Analysis Group in the Strategic Energy Analysis Center . Areas of Expertise Technology, policy, and economic analysis for public- and private-sector's R&D
Impact of support groups on well-being of older women.
Segrist, Kathleen A
2008-01-01
The goal of this study was to determine whether differences in incidence of depression and level of well-being are manifested between older women, aged 60 and older, who attend either (a) a peer-run support group, (b) a staff-run support group, or (c) a comparison group (i.e., who do not attend a support group). Thirty-six women participating in peer-run and staff-run support groups and 9 women receiving nongroup support were administered the Geriatric Depression Scale and the Philadelphia Geriatric Center Morale Scale. Separate analyses of variance were employed on each scale to determine the significance of differences in scores according to facilitator type (i.e., peer-run vs. staff-run vs. comparison group). Analysis of scores on the Geriatric Depression Scale indicated significant differences between women in the peer-run groups and women in the comparison group, but no significant differences between women in the peer-run groups and women in the staff-run groups or between women in the staff-run groups and women in the comparison group. Analysis of scores on the Philadelphia Geriatric Center Morale Scale did not indicate any significant differences between women based on facilitator type. Results of this study have implications for those who run face-to-face support groups for older adults, for those who train peer group facilitators, and for community agencies that desire to initiate a support group system for their clientele.
1990-07-20
certain specified parameters. A method of establishing parameters for exceptions to the routine is called the ABC analysis of inventory control...Undcr ABC analysis, the A group is the 20% of line items which are most expensive per item, the B group is the next 20%, and the C group is the...part of a rational, orderly sytem which delivers the health care outputs required by the users, but allows the system managers to maintain control
Overview of Fluid Dynamics Activities at the Marshall Space Flight Center
NASA Technical Reports Server (NTRS)
Garcia, Roberto; Griffin, Lisa W.; Wang, Ten-See
1999-01-01
Since its inception 40 years ago, Marshall Space Flight Center (MSFC) has had the need to maintain and advance state-of-the-art flow analysis and cold-flow testing capability to support its roles and missions. This overview discusses the recent organizational changes that have occurred at MSFC with emphasis on the resulting three groups that form the core of fluid dynamics expertise at MSFC: the Fluid Physics and Dynamics Group, the Applied Fluid Dynamics Analysis Group, and the Experimental Fluid Dynamics Group. Recently completed activities discussed include the analysis and flow testing in support of the Fastrac engine design, the X-33 vehicle design, and the X34 propulsion system design. Ongoing activities include support of the RLV vehicle design, Liquid Fly Back Booster aerodynamic configuration definition, and RLV focused technologies development. Other ongoing activities discussed are efforts sponsored by the Center Director's Discretionary Fund (CDDF) to develop an advanced incompressible flow code and to develop optimization techniques. Recently initiated programs and their anticipated required fluid dynamics support are discussed. Based on recent experiences and on the anticipated program needs, required analytical and experimental technique improvements are presented. Due to anticipated budgetary constraints, there is a strong need to leverage activities and to pursue teaming arrangements in order to advance the state-of-the-art and to adequately support concept development. Throughout this overview there is discussion of the lessons learned and of the capabilities demonstrated and established in support of the hardware development programs.
[The Dose Effect of Isocenter Selection during IMRT Dose Verification with the 2D Chamber Array].
Xie, Chuanbin; Cong, Xiaohu; Xu, Shouping; Dai, Xiangkun; Wang, Yunlai; Han, Lu; Gong, Hanshun; Ju, Zhongjian; Ge, Ruigang; Ma, Lin
2015-03-01
To investigate the dose effect of isocenter difference during IMRT dose verification with the 2D chamber array. The samples collected from 10 patients were respectively designed for IMRT plans, the isocenter of which was independently defined as P(o), P(x) and P(y). P(o) was fixed on the target center and the other points shifted 8cm from the target center in the orientation of x/y. The PTW729 was used for 2D dose verification in the 3 groups which beams of plans were set to 0 degrees. The γ-analysis passing rates for the whole plan and each beam were gotten using the different standards in the 3 groups, The results showed the mean passing rate of γ-analysis was highest in the P(o) group, and the mean passing rate of the whole plan was better than that of each beam. In addition, it became worse with the increase of dose leakage between the leaves in P(y) group. Therefore, the determination of isocenter has a visible effect for IMRT dose verification of the 2D chamber array, The isocenter of the planning design should be close to the geometric center of target.
Cargill, Stephanie Solomon; Baker, Lauren Lyn; Goold, Susan Dorr
2017-07-01
Develop an accessible exercise to engage underserved populations about research funding priorities; analyze the criteria they use to prioritize research; contrast these criteria to those currently used by Patient Centered Outcomes Research Institute (PCORI). Academic and community partners collaborated to develop an Ipad exercise to facilitate group deliberation about PCOR funding priorities. 16 groups (n = 183) of underserved individuals in both urban and rural areas participated. Recordings were qualitatively analyzed for prioritization criteria. Analysis yielded ten codes, many of which were similar to PCORI criteria, but all of which challenged or illuminated these criteria. Directly involving underserved populations in determining funding criteria is both feasible and important, and can better fulfill PCORI's goal of incorporating patient priorities.
Flynn Longmire, Crystal V.; Knight, Bob G.
2012-01-01
Objectives In order to better understand if measurement problems underlie the inconsistent findings that exist regarding differences in depression levels between Black and White caregivers, this study examined the factor structure and invariance of the Center for Epidemiologic Studies-Depression scale (CES-D). Method A confirmatory factor analysis of the 20-item CES-D was performed on a sample of 167 Black and 214 White family caregivers of older adults with dementia from Los Angeles County. Results The relationships between the 20 items and the four factors, as well as the relationships among each of the factors, were equivalent across both caregiver groups, indicating that the four-factor model fit the data for both racial groups. Conclusion These findings offer further evidence that the standard four-factor model is the best fitting model for the CES-D and is invariant across racial groups. PMID:21069602
Flynn Longmire, Crystal V; Knight, Bob G
2010-11-01
In order to better understand if measurement problems underlie the inconsistent findings that exist regarding differences in depression levels between Black and White caregivers, this study examined the factor structure and invariance of the Center for Epidemiologic Studies-Depression (CES-D) Scale. A confirmatory factor analysis of the 20-item CES-D was performed on a sample of 167 Black and 214 White family caregivers of older adults with dementia from Los Angeles County. The relationships between the 20 items and the four factors, as well as the relationships among each of the factors, were equivalent across both caregiver groups, indicating that the four-factor model fit the data for both the racial groups. These findings offer further evidence that the standard four-factor model is the best fitting model for the CES-D and is invariant across racial groups.
Analysis of surgical outcomes of diverticular disease of the colon.
Miyaso, Hideaki; Iwakawa, Kazuhide; Kitada, Koji; Kimura, Yuji; Isoda, Kenta; Nishie, Manabu; Hamano, Ryosuke; Tokunaga, Naoyuki; Tsunemitsu, Yosuke; Ohtsuka, Shinya; Inagawaki, Masaru; Iwagaki, Hiromi
2012-01-01
We analyzed retrospectively the surgical outcomes of diverticular diseases of the colon at the surgical division of Fukuyama Medical Center. Data were collected from 39 patients who underwent surgery for diverticular disease at Fukuyama Medical Center. Thirty-nine patients were admitted between 2005 and 2010. The mean age of the 39 patients was 63.6 years. The collected data included patient demographics, patient history, type of surgery and complications. Patients were divided into 2 groups, Elective vs. Emergent group, right vs. left colon group and laparotomy vs. laparoscopic approach. Multivariate analysis of the logistic model of morbidity revealed a significantly higher rate in the left colon and the Cox proportional hazards model clearly showed fewer postoperative hospital days with the laparoscopic approach. Surgical procedures should be decided in reference to the particular clinical and pathological features of diverticular disease to gain an acceptable morbidity and mortality rates.
Using a Pattern-Centered Approach to Assess Sexual Risk-Taking in Study Abroad Students
ERIC Educational Resources Information Center
Marcantonio, Tiffany; Angelone, D. J.; Sledjeski, Eve
2016-01-01
Objectives: The purpose of this study was to examine the impact of several potential factors related to sexually risky behaviors in study abroad students. The authors utilized a pattern-centered analysis to identify specific groups that can be targeted for intervention. Participants: The sample consisted of 173 students who studied abroad in a…
The Virtual Data Center Tagged-Format Tool - Introduction and Executive Summary
Evans, John R.; Squibb, Melinda; Stephens, Christopher D.; Savage, W.U.; Haddadi, Hamid; Kircher, Charles A.; Hachem, Mahmoud M.
2008-01-01
This Report introduces and summarizes the new Virtual Data Center (VDC) Tagged Format (VTF) Tool, which was developed by a diverse group of seismologists, earthquake engineers, and information technology professionals for internal use by the COSMOS VDC and other interested parties for the exchange, archiving, and analysis of earthquake strong-ground-motion data.
Beauchamp, Gillian A; McKeown, Nathanael J; Rodriguez, Sergio; Spyker, Daniel A
2016-03-01
The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000-2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R(2 )=( )0.489 (min R(2 )=( )0.248, max R(2 )=( )0.717), with mean ± SD of R(2 )=( )0.494 ± 0.121. Median number of parameters used (degrees of freedom - 1) was 7. NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.
NASA Technical Reports Server (NTRS)
Roberts, Barry C.; Batts, Wade
1997-01-01
The National Aeronautics and Space Administration (NASA) designated Marshall Space Flight Center (MSFC) the center of excellence for space transportation. The Aerospace Environments and Effects (AEE) team of the Electromagnetics and Aerospace Environments Branch (EL23) in the Systems Analysis and Integration Laboratory at MSFC, supports the center of excellence designation by providing near-Earth space, deep space, planetary, and terrestrial environments expertise to projects as required. The Terrestrial Environment (TE) group within the AEE team maintains an extensive TE data base. Statistics and models derived from this data are applied to the design and development of new aerospace vehicles, as well as performance enhancement of operational vehicles such as the Space Shuttle. The TE is defined as the Earth's atmospheric environment extending from the surface to orbital insertion altitudes (approximately 90 km).
ERIC Educational Resources Information Center
Covay Minor, Elizabeth; Porter, Andrew C.; Murphy, Joseph; Goldring, Ellen B.; Cravens, Xiu; Elloitt, Stephen N.
2014-01-01
The Vanderbilt Assessment of Leadership in Education (VAL-ED) provides educators with a tool for principal evaluation based on principal, teacher, and supervisor reports of principals' learning-centered leadership. In this study, we conduct a known group analysis as part of a larger argument for the validity of the VAL-ED in US elementary and…
& Impacts Analysis Group in the Strategic Energy Analysis Center. Areas of Expertise Life cycle environmental impacts of energy technologies, including externalities Life cycle assessment Sustainability ;Life Cycle Assessment of a Parabolic Trough Concentrating Solar Power Plant and the Impacts of Key
Zarei, Mina; Javidi, Maryam; Erfanian, Mahdi; Lomee, Mahdi; Afkhami, Farzaneh
2013-01-01
Cleaning and shaping is one of the most important phases in root canal therapy. Various rotary NiTi systems minimize accidents and facilitate the shaping process. Todays NiTi files are used with air-driven and electric handpieces. This study compared the canal centering after instrumentation using the ProTaper system using Endo IT, electric torque-control motor, and NSK air-driven handpiece. This ex vivo randomized controlled trial study involved 26 mesial mandibular root canals with 10 to 35° curvature. The roots were randomly divided into 2 groups of 13 canals each. The roots were mounted in an endodontic cube with acrylic resin, sectioned horizontally at 2, 6 and 10 mm from the apex and then reassembled. The canals were instrumented according to the manufacturer's instructions using ProTaper rotary files and electric torque-control motors (group 1) or air-driven handpieces (group 2). Photographs of the cross-sections included shots before and after instrumentation, and image analysis was performed using Photoshop software. The centering ability and canal transportation was also evaluated. Repeated measurement and independent t-test provided statistical analysis of canal transportation. The comparison of the rate of transportation toward internal or external walls between the two groups was not statistically significant (p = 0.62). Comparison of the rate of transportation of sections within one group was not significant (p = 0.28). Use of rotary NiTi file with either electric torquecontrol motor or air-driven handpiece had no effect on canal centering. NiTi rotary instruments can be used with air-driven motors without any considerable changes in root canal anatomy, however it needs the clinician to be expert.
Cognitive Stimulation of Elderly Residents in Social Protection Centers in Cartagena, 2014.
Melguizo Herrera, Estela; Bertel De La Hoz, Anyel; Paternina Osorio, Diego; Felfle Fuentes, Yurani; Porto Osorio, Leidy
To determine the effectiveness of a program of cognitive stimulation of the elderly residents in Social Protection Centers in Cartagena, 2014. Quasi-experimental study with pre and post tests in control and experimental groups. A sample of 37 elderly residents in Social Protection Centers participated: 23 in the experimental group and 14 in the control group. A survey and a mental evaluation test (Pfeiffer) were applied. The experimental group participated in 10 sessions of cognitive stimulation. The paired t-test showed statistically significant differences in the Pfeiffer test, pre and post intervention, compared to the experimental group (P=.0005). The unpaired t-test showed statistically significant differences in Pfeiffer test results to the experimental and control groups (P=.0450). The analysis of the main components showed that more interrelated variables were: age, diseases, number of errors and test results; which were grouped around the disease variable, with a negative association. The intervention demonstrated a statistically significant improvement in cognitive functionality of the elderly. Nursing can lead this type of intervention. It should be studied further to strengthen and clarify these results. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Evaluating food menus from daycare centers in Guatemala City: descriptive and analytical approaches.
Doak, Colleen M; Hamelinck, Victoria; Vossenaar, Marieke; Panday, Bindiya; Soto-Méndez, María José; Campos Ponce, Maiza; Solomons, Noel W
2012-09-01
This objective of this study was a methodological analysis of the variety and diversity of dietary items and their different origins offered in institutional menus across four daycare centers serving low-income families in Guatemala City. Foods, as served in daycare centers, were used to explore and illustrate the different approaches to evaluating food quality. Foods served at daycare centers were analyzed for variety (number of different items) and diversity (using three food-classification systems). The weight and energy contributions for each meal were reported for animal, plant, mixed, or water; modern versus traditional foods; fortified versus non-fortified foods; and processed versus unprocessed foods. During 5 d of observation, three of the four daycare centers served 100% of the food groups of the current Guatemalan and international classification systems. In addition, the results showed the four daycare centers provided mainly traditional and non-fortified plant-based foods. However, although the traditional foods contributed more by weight, the modern foods contributed more energy. These findings showed that the "modern" foods served at daycare centers are energy dense compared with traditional foods. These daycare centers contributed to variety and diversity while serving mainly traditional, plant-based foods. Our analysis went beyond the simple existence (mention) of a food as consumed to weight in grams or calories to provide potentially new and useful perspectives for understanding how guidelines for healthful eating patterns can be promoted and assessed, not only in children or in institutions but across all age groups, and settings. Copyright © 2012 Elsevier Inc. All rights reserved.
Domnick, Christoph; Herbort, Mirco; Raschke, Michael J; Bremer, Susanne; Schliemann, Benedikt; Petersen, Wolf; Zantop, Thore
2016-04-01
Aim of this study was to investigate the accuracy of a conventional over-the-top-guide (OTG) with a typically short offset to hit the center of the native femoral ACL footprint through the anteromedial portal in comparison to a specific medial-portal-aimer (MPA) with larger offset. In 20 matched human cadaveric knees, insertion sites of the ACL were marked in medial arthrotomy. An OTG with an offset of 5.5 mm, respectively, the MPA with 9 mm offset was used in a medial portal approach to locate the center of a single bundle ACL reconstruction tunnel with k-wires. Distances from the footprint center, the OTG drilling and the MPA drilling to the roof of the intercondylar notch and to the deep cartilage margin were determined. After positioning of radiological markers, radiographic analysis was performed according to the quadrant technique as described by Bernard and Hertel. The distance from ACL origin to the roof of the notch was 10.3 (±2.1) mm, in the OTG group 6.7 (±1.5) mm and in the MPA group 9.6 (±1.9) mm. The distance to the deep cartilage margin was 9.5 (±1.7) mm from ACL origin, 4.8 (±1.3) mm with OTG and 8.7 (±1.4) mm with MPA. There were statistically significant differences between the distances of the footprint center and the OTG group after measuring and also after radiographic analysis (p < 0.0001). Using the MPA, no significant different distances in comparison to the anatomical ACL center were found (p > 0.0001). There was an increased risk for femoral blow (9/10 vs. 0/10) in the OTG group after overdrilling with a 9 mm drill. Short (5.5 mm) offset femoral aiming devices fail to locate the native ACL footprint center in medial portal approach with an increased risk for femoral blowout when overdrilling. The special medial-portal-aiming device with 9 mm offset hit the center reliably.
Toapanta-Gaibor, N G; Suñer-Poblet, M; Cintra-Cabrera, M; Pérez-Valdivia, M Á; Suárez-Benjumea, A; Gonzalez-Roncero, F M; Bernal-Blanco, G; Rocha-Castilla, J L; Gentil-Govantes, M Á
2018-03-01
End-stage renal disease patients' access to the renal transplant (RT) waiting list (WL) depends on general criteria and their specific application in the different treatment units. Study in nonhospital hemodialysis centers (n = 9), dependent on an adult RT center. Cases included 228 patients considered to have nonactive status on the WL due to incomplete immunologic data (no blood group or HLA typing) or temporary contraindication from an incomplete pretransplant study (nonimmunologic) or comorbidity. Each individual situation was studied by reviewing the center's clinical history with the nephrologist in charge. Three situations were classified three groups. (1) Patients in this group had incomplete basic study (65 patients, 28.5%) pending cardiologic evaluation in 34%; urologic evaluation, 26%; both 18%; others, 9%; study not initiated, 12%. (2) Patients in this group had pre-existing or onset comorbidities (117 patients, 51.3%) pending studies or confirmed resolution: obesity, 30%; cancer, 17%; cardiovascular disease, 14%; digestive pathology, 10%; infection, 9%; neuropsychiatric disorders, 7%; multiple, 13%. (3) Patients in this group had other situations contraindicating RT (46 patients, 20.2%): poor therapeutic adherence, 30%; negative will of the patient, 26%; social issues, 9%; excluded by the center (not reported), 35%. We detected a high incidence of cases pending basic tests for inclusion on the WL. Obesity can be highlighted as the most frequent cause for noninclusion. Further support and coordination is required with referral hospital centers to increase and refine the RT WL. Copyright © 2017 Elsevier Inc. All rights reserved.
Matsumoto, Shokei; Jung, Kyoungwon; Smith, Alan; Coimbra, Raul
2018-06-23
To establish the preventable and potentially preventable death rates in a mature trauma center and to identify the causes of death and highlight the lessons learned from these cases. We analyzed data from a Level-1 Trauma Center Registry, collected over a 15-year period. Data on demographics, timing of death, and potential errors were collected. Deaths were judged as preventable (PD), potentially preventable (PPD), or non-preventable (NPD), following a strict external peer-review process. During the 15-year period, there were 874 deaths, 15 (1.7%) and 6 (0.7%) of which were considered PPDs and PDs, respectively. Patients in the PD and PPD groups were not sicker and had less severe head injury than those in the NPD group. The time-death distribution differed according to preventability. We identified 21 errors in the PD and PPD groups, but only 61 (7.3%) errors in the NPD group (n = 853). Errors in judgement accounted for the majority and for 90.5% of the PD and PPD group errors. Although the numbers of PDs and PPDs were low, denoting maturity of our trauma center, there are important lessons to be learned about how errors in judgment led to deaths that could have been prevented.
Intercomparison and Assessment of GRACE Temporal Gravity Solutions Performance
NASA Astrophysics Data System (ADS)
Choe, J.; Nerem, R. S.; Leuliette, E. W.
2006-12-01
The GRACE mission has been producing monthly estimates of changes in the Earth's gravity field since April 2002. Converting the raw GRACE range, accelerometer, and GPS measurements into estimates of the gravity field is a complex process, and therefore different analysis groups use various "recipes" resulting in different models of the time-varying gravity field. We have intercompared the solutions generated by a number of groups: Center for Space Research (CSR), Jet Propulsion Laboratory (JPL), Goddard Space Flight Center (GSFC), Centre National d'Etudes Spatiales (CNES) and GeoForschungsZentrum (GFZ), to determine the characteristics of each group's solutions as applied to different scientific applications. For different scales of gaussian smoothing, we have examined the power spectrum of each model, the pattern of seasonal gravity variations, the residuals from a seasonal fit, and results from locations in the Sahara desert and Atlantic Ocean where the signals are known to be small. We have also characterized the level of "striping" in each center's solutions. In addition, we have compared each center's solutions for changes in Greenland and Antarctic ice mass, global ocean mass, and hydrologic changes over the continents. Using these tests and evaluations, we have been able to characterize the performance of each center's gravity solutions.
2015-09-30
microwave sea ice information for improved sea ice forecasts and ship routing W. Meier NASA Goddard Space Flight Center, Cryospheric Sciences Laboratory...updating the initial ice concentration analysis fields along the ice edge. In the past year, NASA Goddard and NRL have generated a merged 4 km AMSR-E...collaborations of three groups: NASA Goddard Space Flight Center ( NASA /GSFC) in Greenbelt, MD, NRL/Oceanography Division located at Stennis Space Center (SSC
Trauma center variation in splenic artery embolization and spleen salvage: a multicenter analysis.
Banerjee, Aman; Duane, Therese M; Wilson, Sean P; Haney, Starre; O'Neill, Patrick J; Evans, Heather L; Como, John J; Claridge, Jeffrey A
2013-07-01
This study aimed to evaluate if variation in management of blunt splenic injury (BSI) among Level I trauma centers is associated with different outcomes related to the use of splenic artery embolization (SAE). All adult patients admitted for BSI from 2008 to 2010 at 4 Level I trauma centers were reviewed. Use of SAE was determined, and outcomes of spleen salvage and nonoperative management (NOM) failure were evaluated. A priori, a 10% SAE rate was used to group centers into high- or low-use groups. There were 1,275 BSI patients. There were intercenter differences in age, injury severity, and grade of spleen injury (Spleen Injury Scale [SIS]). Mortality was similar by center; however, BSI treatment varied significantly by center. Overall, SAE use was highest at center A compared with B, C, and D (19%, 11%, 1%, and 4%, respectively; p < 0.01). High SAE use centers had significantly higher spleen salvage rates and fewer NOM failures. Differences in the use of SAE (25% vs. 2%, p < 0.01) and salvage rate (67% vs. 56%, p = 0.03) were most dramatic between high- and low-use SAE centers for Grade 3 and 4 injured spleens. In patients who received initial NOM, multivariate logistic regression analysis showed that SAE was an independent predictor of spleen salvage (odds ratio, 5; 95% confidence interval, 1.8-13.5; p < 0.01) as were lower age, lower SIS, and Injury Severity Score (ISS). Patients treated at high SAE use centers were more likely to leave the hospital with their spleen in situ (odds ratio, 3; 95% confidence interval, 1.7-6.3; p < 0.01). Significant practice variation exists in the use of SAE in treating BSI at Level I trauma centers. Centers with higher rates of SAE use have higher spleen salvage and less NOM failure. SAE was shown to be an independent predictor of spleen salvage. Therapeutic study, level IV.
Bormann, Jill E; Thorp, Steven R; Smith, Eric; Glickman, Mark; Beck, Danielle; Plumb, Dorothy; Zhao, Shibei; Ackland, Princess E; Rodgers, Carie S; Heppner, Pia; Herz, Lawrence R; Elwy, A Rani
2018-06-20
Previous studies suggest that group "mantram" (sacred word) repetition therapy, a non-trauma-focused complementary therapy for posttraumatic stress disorder (PTSD), may be an effective treatment for veterans. The authors compared individually delivered mantram repetition therapy and another non-trauma-focused treatment for PTSD. The study was a two-site, open-allocation, blinded-assessment randomized trial involving 173 veterans diagnosed with military-related PTSD from two Veterans Affairs outpatient clinics (January 2012 to March 2014). The mantram group (N=89) learned skills for silent mantram repetition, slowing thoughts, and one-pointed attention. The comparison group (N=84) received present-centered therapy, focusing on currently stressful events and problem-solving skills. Both treatments were delivered individually in eight weekly 1-hour sessions. The primary outcome measure was change in PTSD symptom severity, as measured by the Clinician-Administered PTSD Scale (CAPS) and by self-report. Secondary outcome measures included insomnia, depression, anger, spiritual well-being, mindfulness, and quality of life. Intent-to-treat analysis was conducted using linear mixed models. The mantram group had significantly greater improvements in CAPS score than the present-centered therapy group, both at the posttreatment assessment (between-group difference across time, -9.98, 95% CI=-3.63, -16.00; d=0.49) and at the 2-month follow-up (between-group difference, -9.34, 95% CI=-1.50, -17.18; d=0.46). Self-reported PTSD symptom severity was also lower in the mantram group compared with the present-centered therapy group at the posttreatment assessment, but there was no difference at the 2-month follow-up. Significantly more participants in the mantram group (59%) than in the present-centered therapy group (40%) who completed the 2-month follow-up no longer met criteria for PTSD (p<0.04). However, the percentage of participants in the mantram group (75%) compared with participants in the present-centered therapy group (61%) who experienced clinically meaningful changes (≥10-point improvements) in CAPS score did not differ significantly between groups. Reductions in insomnia were significantly greater for participants in the mantram group at both posttreatment assessment and 2-month follow-up. In a sample of veterans with PTSD, individually delivered mantram repetition therapy was generally more effective than present-centered therapy for reducing PTSD symptom severity and insomnia.
Rose is a member of the Markets & Policy Analysis Group in the Strategic Energy Analysis Center integration of renewable energy Research Interests Energy policy and regulation Decision support tools to inform power sector policy and regulatory decisions Energy and development International energy policy
Motivational Profiles of Adult Learners
ERIC Educational Resources Information Center
Rothes, Ana; Lemos, Marina S.; Gonçalves, Teresa
2017-01-01
This study investigated profiles of autonomous and controlled motivation and their effects in a sample of 188 adult learners from two Portuguese urban areas. Using a person-centered approach, results of cluster analysis and multivariate analysis of covariance revealed four motivational groups with different effects in self-efficacy, engagement,…
National Centers for Environmental Prediction
Modeling Mesoscale Modeling Marine Modeling and Analysis Teams Climate Data Assimilation Ensembles and Post Ice group works on sea ice analysis from satellite, sea ice modeling, and ice-atmosphere-ocean / VISION | About EMC Analysis Drift Model KISS Model Numerical Forecast Systems The Polar and Great Lakes
75 FR 74069 - Center for Scientific Review; Notice of Closed Meetings
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-30
...: Bioengineering Sciences & Technologies Integrated Review Group Modeling and Analysis of Biological Systems Study... of Federal Domestic Assistance Program Nos. 93.306, Comparative Medicine; 93.333, Clinical Research...
ERIC Educational Resources Information Center
Poole, Deborah
2008-01-01
This paper focuses on the process of literacy socialization in several 5th grade reading groups. Through close analysis of spoken interaction, which centers on a heavily illustrated, non-fiction text, the paper proposes that these reading groups can be seen as complex sites of socialization to the values associated with essayist literacy (i.e.,…
Focus for Area Development Analysis: Urban Orientation of Counties.
ERIC Educational Resources Information Center
Bluestone, Herman
The orientation of counties to metropolitan systems and urban centers is identified by population density and percentage of urban population. This analytical framework differentiates 6 kinds of counties, ranging from most urban-oriented (group 1) to least urban-oriented (group 6). With this framework, it can be seen that the economic well-being of…
Understanding Responsive Web Design in Higher Education. ECAR Working Group Paper
ERIC Educational Resources Information Center
Bollens, Eric; Rocchio, Rosemary A.; Peterson, Jill Eleanor; Pollack, Brett; Tirpak, Lori; Ward, Christopher Matthew
2014-01-01
This paper is a publication of the EDUCAUSE Center for Analysis and Research (ECAR) Mobile Strategy and Application Development (MSAD) Working Group. In higher education, nearly every user interaction that takes place on a desktop or laptop browser is also attempted using phones, tablets, watches, and more. As students, faculty, and staff…
Research Data Storage: A Framework for Success. ECAR Working Group Paper
ERIC Educational Resources Information Center
Blair, Douglas; Dawson, Barbara E.; Fary, Michael; Hillegas, Curtis W.; Hopkins, Brian W.; Lyons, Yolanda; McCullough, Heather; McMullen, Donald F.; Owen, Kim; Ratliff, Mark; Williams, Harry
2014-01-01
The EDUCAUSE Center for Analysis and Research Data Management Working Group (ECAR-DM) has created a framework for research data storage as an aid for higher education institutions establishing and evaluating their institution's research data storage efforts. This paper describes areas for consideration and suggests graduated criteria to assist in…
Cost and Quality Issues in Day Care: A Practical Approach to Assessment. (A Working Paper).
ERIC Educational Resources Information Center
Settles, Barbara H.; Cripps, Jean Helmkamp
Cost and quality issues are analyzed as they relate to provision of group day care. A series of assessment tables for self-evaluation of centers is presented. Three specific aspects are considered: cost of care, quality of care delivered to children and staff use in day care centers. Cost analysis focuses on: (1) the total cost of care per…
Profiles of Intrinsic and Extrinsic Motivations in Elementary School: A Longitudinal Analysis
ERIC Educational Resources Information Center
Corpus, Jennifer Henderlong; Wormington, Stephanie V.
2014-01-01
The authors used a person-centered, longitudinal approach to identify and evaluate naturally occurring combinations of intrinsic and extrinsic motivations among 490 third- through fifth-grade students. Cluster analysis revealed 3 groups, characterized by high levels of both motivations ("high quantity"): high intrinsic motivation but low…
The BirthPlace collaborative practice model: results from the San Diego Birth Center Study.
Swartz; Jackson; Lang; Ecker; Ganiats; Dickinson; Nguyen
1998-07-01
Objective: The search for quality, cost-effective health care programs in the United States is now a major focus in the era of health care reform. New programs need to be evaluated as alternatives are developed in the health care system. The BirthPlace program provides comprehensive perinatal services with certified nurse-midwives and obstetricians working together in an integrated collaborative practice serving a primarily low-income population. Low-risk women are delivered by nurse-midwives in a freestanding birth center (The BirthPlace), which is one component of a larger integrated health network. All others are delivered by team obstetricians at the affiliated tertiary hospital. Wellness, preventive measures, early intervention, and family involvement are emphasized. The San Diego Birth Center Study is a 4-year research project funded by the U.S. Federal Agency for Health Care Policy and Research (#R01-HS07161) to evaluate this program. The National Birth Center Study (NEJM, 1989; 321(26): 1801-11) described the advantages and safety of freestanding birth centers. However, a prospective cohort study with a concurrent comparison group of comparable risk had not been conducted on a collaborative practice-freestanding birth center model to address questions of safety, cost, and patient satisfaction.Methods: The specific aims of this study are to compare this collaborative practice model to the traditional model of perinatal health care (physician providers and hospital delivery). A prospective cohort study comparing these two health care models was conducted with a final expected sample size of approximately 2,000 birth center and 1,350 traditional care subjects. Women were recruited from both the birth center and traditional care programs (private physicians offices and hospital based clinics) at the beginning of prenatal care and followed through the end of the perinatal period. Prenatal, intrapartum, postpartum and infant morbidity and mortality are being compared along with cost-effectiveness and acceptance of the model by patients. Data collection occurred primarily through medical record abstraction with the addition of two patient questionnaires. Comparability of the cohorts was established by using a validated methodology to determine medical/perinatal risk and birth center eligibility, which included assessment by two CNMs and an independent blind review by a perinatologist. The cost analysis uses a resource-utilization approach and new methodologies such as activity-based-costing to compare costs from both the perspective of the payor and the health care provider. Patient satisfaction was measured using a self-administered patient questionnaire.Results: Current preliminary results from approximately 38% of the final expected study sample are available. Crude and adjusted analysis have been conducted. Overall, the preliminary results suggest similar morbidity and mortality in the two groups. Fetal deaths are 0.75% in the index and 0.64% in the comparison group, with early neonatal deaths at 0.26% and 0.23%, respectively. The traditional care group showed adjusted rate differences of 5.83% more major maternal intrapartum complications and 9% more NICU admissions. While the birth center group showed adjusted rate differences of 5.5% more low birth weight and 0.95% more preterm birth. For other outcomes, the birth center group showed an adjusted rate difference of 22.34% more exclusive breastfeeding at discharge. Also, there was less utilization of cesarean section and assisted delivery in the birth center group as compared to the traditional care group. The adjusted rate difference for normal spontaneous vaginal deliveries in nulliparas was 10.23% more in the birth center group, with similar results in multiparas with and without history of cesarean (28.88% and 7.84%, respectively). Preliminary results also show that the average total cost for pregnancy-related services paid by California Medicaid was $4,550 for the birth center and $5,535 for the traditional care group. Final results based on the full study sample (full data available February 1998) details of payor costs such as provider, facility, NICU, and ancillary along with costs from the health care system perspective and patient satisfaction results will be presented.Conclusion: Current results suggest similar morbidity and mortality between the birth center program and traditional care groups, with less resource utilization translating to lower costs in the collaborative practice model. Results suggest that collaborative practice using a freestanding birth center as an adjunct to an integrated perinatal health care system may provide a quality, lower-cost alternative for the provision of perinatal services.
Creehan, Sue; Cuddigan, Janet; Gonzales, Dana; Nix, Denise; Padula, William; Pittman, Joyce; Pontieri-Lewis, Vicky; Walden, Christine; Wells, Belinda; Wheeler, Robinetta
2016-01-01
Hospital-acquired pressure ulcer occurrences have declined over the past decade as reimbursement policies have changed, evidence-based practice guidelines have been implemented, and quality improvement initiatives have been launched. However, the 2006-2008 Institute for Healthcare Improvement goal of zero pressure ulcers remains difficult to achieve and even more challenging to sustain. Magnet hospitals tend to have lower hospital-acquired pressure ulcer rates than non-Magnet hospitals, yet many non-Magnet hospitals also have robust pressure ulcer prevention programs. Successful programs share commonalities in structure, processes, and outcomes. A national summit of 55 pressure ulcer experts was convened at the Virginia Commonwealth University Medical Center in March 2014. The group was divided into 3 focus groups; each was assigned a task to develop a framework describing components of a proposed Magnet-designated Center of Pressure Ulcer Prevention Excellence. Systematic literature reviews, analysis of exemplars, and nominal group process techniques were used to create the framework. This article presents a framework describing the proposed Magnet-designated Centers of Pressure Ulcer Prevention Excellence. Critical attributes of Centers of Excellence are identified and organized according to the 4 domains of the ANCC model for the Magnet Recognition Program: transformational leadership; structural empowerment; exemplary professional practice; and new knowledge innovation and improvements. The structures, processes, and outcome measures necessary to become a proposed Center of Pressure Ulcer Prevention Excellence are discussed.
Women-Centered and Culturally Responsive Heart Health Promotion Among Indigenous Women in Canada.
Ziabakhsh, Shabnam; Pederson, Ann; Prodan-Bhalla, Natasha; Middagh, Diane; Jinkerson-Brass, Sharon
2016-11-01
Most women in Canada confront a combination of bio-psychosocial factors that put them at risk for cardiovascular disease. The challenge for health planners is to address these factors while contextualizing interventions that meet the specific needs of particular social and cultural groupings. The article will discuss a women-centered, group-based heart health pilot initiative designed to engage with indigenous approaches to healing. The nurse practitioners co-led the group with a representative from the indigenous community to balance women-centered practices with more traditional and culturally appropriate ones. In particular, indigenous processes, such as a Talking Circle, combined with indigenous knowledge/content were integrated into the pilot program. The project was evaluated to investigate its outcomes (how the intervention impacted the participants) and processes (how participants perceived the intervention). Evaluation involved analysis of the Talking Circle's content, a focus group, field observations, and self-completed surveys. Most women made changes regarding their diet, some began physical activities, and others focused on better managing their emotional health. Women viewed the group as successful because it embraced both women-centered and culturally appropriate health promotion practices. The intervention created a culturally safe space for learning and transformation. The findings confirm the need for employing culturally relevant, gender-specific approaches to heart health promotion that are situated in and responsive to community needs. © 2016 Society for Public Health Education.
Kim, Dong-Jun; Cho, Nam-Han; Noh, Jung-Hyun; Kim, Hyun-Jin; Choi, Yoon-Ho; Jung, Jae-Hoon; Min, Yong-Ki; Lee, Myung-Shik; Lee, Moon-Kyu; Kim, Kwang-Won
2005-08-01
We determined optimal fasting plasma glucose (FPG) cutoff values predictive of future diabetes development in a group of middle-aged Koreans who visited a health promotion center. The medical records of 2,964 subjects, who attended the Health Promotion Center in 1998 and 2003, were examined. Subjects were classified into four groups according to their baseline FPG values (Group 1:FPG <5.0 mM/L; Group 2: 5.0< or =FPG <5.6 mM/L; Group 3: 5.6< or =FPG <6.1 mM/L; Group 4: 6.1< or =FPG <7.0 mM/L). No significant difference was observed between Group 1 and Group 2 in terms of diabetes incidence. However, incidence in Group 3 was significantly higher than that in Group 1 [hazards ratio 4.88 (1.65-14.41), p=0.004] and the hazards ratio in Group 4 for diabetes was 36.91 (13.11-103.61), p<0.001, versus Group 1. Receiver operator characteristics curve analysis showed that an FPG of 5.97 mM/L represents the lower limit and gives the best combination of sensitivity and specificity. Our data shows that the risk of future diabetes development started to increase below an FPG of 6.1 mM/L and suggests the importance of efforts to modify diabetes development risk factors at lower impaired fasting glucose levels.
SWOT analysis in Sina Trauma and Surgery Research Center.
Salamati, Payman; ashraf Eghbali, Ali; Zarghampour, Manijeh
2014-01-01
The present study was conducted with the aim of identifying and evaluating the internal and external factors, affecting the Sina Trauma and Surgery Research Center, affiliated to Tehran University of Medical Sciences and propose some of related strategies to senior managers. We used a combined quantitative and qualitative methodology. Our study population consisted of personnel (18 individuals) at Sina Trauma and Surgery Research Center. Data-collection tools were the group discussions and the questionnaires. Data were analyzed with descriptive statistics and SWOT (Strength, Weakness, Opportunities and Threats) analysis. 18 individuals participated in sessions, consisting of 8 women (44.4%) and 10 men (55.6%). The final scores were 2.45 for internal factors (strength-weakness) and 2.17 for external factors (opportunities-threats). In this study, we proposed 36 strategies (10 weakness-threat strategies, 10 weakness-opportunity strategies, 7 strength-threat strategies, and 9 strength-opportunity strategies). The current status of Sina Trauma and Surgery Research Center is threatened weak. We recommend the center to implement the proposed strategies.
ERISTAR: Earth Resources Information Storage, Transformation, Analysis, and Retrieval
NASA Technical Reports Server (NTRS)
1972-01-01
The National Aeronautics and Space Administration (NASA) and the American Society for Engineering Education (ASEE) have sponsored faculty fellowship programs in systems engineering design for the past several years. During the summer of 1972 four such programs were conducted by NASA, with Auburn University cooperating with Marshall Space Flight Center (MSFC). The subject for the Auburn-MSFC design group was ERISTAR, an acronym for Earth Resources Information Storage, Transformation, Analysis and Retrieval, which represents an earth resources information management network of state information centers administered by the respective states and linked to federally administered regional centers and a national center. The considerations for serving the users and the considerations that must be given to processing data from a variety of sources are described. The combination of these elements into a national network is discussed and an implementation plan is proposed for a prototype state information center. The compatibility of the proposed plan with the Department of Interior plan, RALI, is indicated.
Description of MSFC engineering photographic analysis
NASA Technical Reports Server (NTRS)
Earle, Jim; Williams, Frank
1988-01-01
Utilizing a background that includes development of basic launch and test photographic coverage and analysis procedures, the MSFC Photographic Evaluation Group has built a body of experience that enables it to effectively satisfy MSFC's engineering photographic analysis needs. Combining the basic soundness of reliable, proven techniques of the past with the newer technical advances of computers and computer-related devices, the MSFC Photo Evaluation Group is in a position to continue to provide photo and video analysis service center-wide and NASA-wide to supply an improving photo analysis product to meet the photo evaluation needs of the future; and to provide new standards in the state-of-the-art of photo analysis of dynamic events.
Damsgaard, Camilla T; Papadaki, Angeliki; Jensen, Signe M; Ritz, Christian; Dalskov, Stine-Mathilde; Hlavaty, Petr; Saris, Wim H M; Martinez, J Alfredo; Handjieva-Darlenska, Teodora; Andersen, Malene R; Stender, Steen; Larsen, Thomas M; Astrup, Arne; Mølgaard, Christian; Michaelsen, Kim F
2013-06-01
Dietary strategies to improve early cardiovascular markers in overweight children are needed. We investigated the effect of dietary protein and glycemic index (GI) on cardiovascular markers and metabolic syndrome (MetS) scores in 5- to 18-y-old children of overweight/obese parents from 8 European centers. Families were randomized to 1 of 5 diets consumed ad libitum: high protein (HP) or low protein (LP) combined with high GI (HGI) or low GI (LGI), or a control diet. At 6 centers, families received dietary instruction (instruction centers); at 2 centers, free foods were also provided (supermarket centers). Diet, anthropometry, blood pressure, and serum cardiovascular markers (lipid profile, glucose regulation, and inflammation) were measured in 253 children at baseline, 1 mo, and/or 6 mo. Protein intake was higher in the HP groups (19.9 ± 1.3% energy) than in the LP groups at 6 mo (16.8 ± 1.2% energy) (P = 0.001). The GI was 4.0 points lower (95% CI: 2.1, 6.1) in the LGI compared with the HGI groups (P < 0.001). In the supermarket centers, the HP and LP groups differed more in protein intake than did the groups in the instruction centers (P = 0.009), indicating better compliance. The HP diets evoked a 2.7-cm (95% CI: 0.9, 5.1) smaller waist circumference and a 0.25-mmol/L (95% CI: 0.09, 0.41) lower serum LDL cholesterol compared with the LP diets at 6 mo (P < 0.007). In a separate supermarket center analysis, the HP compared with LP diets reduced waist circumference (P = 0.004), blood pressure (P < 0.01), serum insulin (P = 0.013), and homeostasis model of assessment-insulin resistance (P = 0.016). In the instruction centers, the HP compared with the LP diets reduced LDL cholesterol (P = 0.004). No consistent effect of GI was seen and the MetS scores were not affected. In conclusion, increased protein intake improved cardiovascular markers in high-risk children, particularly in those undergoing most intensive intervention.
Software Engineering Improvement Activities/Plan
NASA Technical Reports Server (NTRS)
2003-01-01
bd Systems personnel accomplished the technical responsibilities for this reporting period, as planned. A close working relationship was maintained with personnel of the MSFC Avionics Department Software Group (ED14). Work accomplishments included development, evaluation, and enhancement of a software cost model, performing literature search and evaluation of software tools available for code analysis and requirements analysis, and participating in other relevant software engineering activities. Monthly reports were submitted. This support was provided to the Flight Software Group/ED 1 4 in accomplishing the software engineering improvement engineering activities of the Marshall Space Flight Center (MSFC) Software Engineering Improvement Plan.
Self-regulated learning and self-directed study in a pre-college sample
Abar, Beau; Loken, Eric
2009-01-01
Self-regulated learning (SRL) is a multi-dimensional construct that has been difficult to operationalize using traditional, variable-centered methodologies. The current paper takes a person-centered approach to the study of SRL in a sample of 205 high-school students. Using latent profile analysis on self-reports of seven aspects of SRL, three groups were identified: high SRL, low SRL, and average SRL. Student self-reports of goal orientation were used as validation for the profile solution, with the high academic self- regulation group reporting the highest levels of mastery orientation while the low self-regulation group reported highest levels of avoidant orientation. Profiles were also compared on independently collected, behavioral measures of study behaviors, with the highly self-regulated group tending to study more material and for a longer time than less self-regulated individuals. PMID:20161484
Center of Excellence for Remote and Medically Under-Served Areas
2008-04-11
was an experimental, quantitative , qualitative, descriptive research study related to audio, data and video transmission from the ambulance to the... posttest score. Both the pretest and posttest questions were generated randomly from a bank of XXX course-related test questions. The analysis below...shows the mean for the pretest , posttest , and difference scores for the classroom group, the virtual group, and the total group. (Note: Two of the
Officer Career Development: An Overview of Analytic Concerns
1989-07-01
some form of quasi-experimental analysis with nonequivalent control groups may be implemented. We shall not attempt to explic te all the variables...Development Center. 5. University of San Diego (1984, October 23-25). Pro z.ings: Volume I. Group reports. Tri-service career research workshop. San Die... design rather than a repeated measures design , where differences among diverse groups of different individuals (at different career stages) are used to
Experiments with Analytic Centers: A confluence of data, tools and help in using them.
NASA Astrophysics Data System (ADS)
Little, M. M.; Crichton, D. J.; Hines, K.; Cole, M.; Quam, B. M.
2017-12-01
Traditional repositories have been primarily focused on data stewardship. Over the past two decades, data scientists have attempted to overlay a superstructure to make these repositories more amenable to analysis tasks, with limited success. This poster will summarize lessons learned and some realizations regarding what it takes to create an analytic center. As the volume of Earth Science data grows and the sophistication of analytic tools improves, a pattern has emerged that indicates different science communities uniquely apply a selection of tools to the data to produce scientific results. Infrequently do the experiences of one group help steer other groups. How can the information technology community seed these domains with tools that conform to the thought processes and experiences of that particular science group? What types of succcessful technology infusions have occured and how does technology get adopted. AIST has been experimenting with the management of this analytic center process; this paper will summarize the results and indicate a direction for future infusion attempts.
To Jump the Wave or Not: Teachers' Perceptions of Research Evidence in Education
ERIC Educational Resources Information Center
Mausethagen, Sølvi; Raaen, Finn Daniel
2017-01-01
This article presents a microanalysis of how a group of primary school teachers deals with research evidence in their work. Based on analysis of a group of Norwegian teachers' interactions over issues of educational research and research-based knowledge, we find that teachers' representations of educational research particularly center on the…
Big Data: Laying the Groundwork. ECAR Working Group Paper
ERIC Educational Resources Information Center
Almes, Guy T.; Hillegas, Curtis W.; Lance, Timothy; Lynch, Clifford A.; Monaco, Gregory E.; Mundrane, Michael R.; Zottola, Ralph J.
2014-01-01
This paper is part of series of the EDUCAUSE Center for Analysis and Research Campus Cyberinfrastructure (ECAR-CCI) Working Group. The topic of big data continues to receive a great deal of publicity because of its promise for opening new avenues of scholarly discovery and commercial opportunity. The ability to sift rapidly through massive amounts…
Big Data in the Campus Landscape: Curation. ECAR Working Group Paper
ERIC Educational Resources Information Center
Lynch, Clifford A.
2015-01-01
This paper is part of series of the EDUCAUSE Center for Analysis and Research Campus Cyberinfrastructure (ECAR-CCI) Working Group. The topic of big data continues to receive a great deal of publicity because of its promise for opening new avenues of scholarly discovery and commercial opportunity. The ability to sift rapidly through massive amounts…
76 FR 19952 - Not Applying the Mark of Inspection Pending Certain Test Results
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-11
... analysis. Human Health Benefits Introduction The Centers for Disease Control and Prevention (CDC) has... groups: (1) E. coli O157:H7 in raw, non-intact beef produced by domestic official establishments,\\17\\ (2... size for the first 8 months of year 2006 for the five test groups described above. Table 3--Percent of...
ERIC Educational Resources Information Center
Smith, Martin M.; Saklofske, Donald H.; Yan, Gonggu; Sherry, Simon B.
2016-01-01
This study investigated the generalizability of the tripartite model of perfectionism across Canadian and Chinese university students. Using latent profile analysis and indicators of perfectionistic strivings, perfectionistic concerns, and neuroticism in both groups, the authors derived a 3-profile solution: adaptive perfectionists, maladaptive…
Denholm Photo of Paul Denholm Paul Denholm Principal Energy Analyst Paul.Denholm@nrel.gov | 303-384 -7488 Paul Denholm is a member of the Grid Systems Analysis Group in the Strategic Energy Analysis Center. Paul is a leading researcher in grid applications for energy storage and solar energy. He
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-12
..., Cer-Cad Engineering Resources, Computer Consultants of America, Computer Engrg Services, Compuware..., Automated Analysis Corp/Belcan, Bartech Group, CAE Tech, CDI Information Services, CER-CAD Engineering...
The Structure of Character Strengths: Variable- and Person-Centered Approaches
Najderska, Małgorzata; Cieciuch, Jan
2018-01-01
This article examines the structure of character strengths (Peterson and Seligman, 2004) following both variable-centered and person-centered approaches. We used the International Personality Item Pool-Values in Action (IPIP-VIA) questionnaire. The IPIP-VIA measures 24 character strengths and consists of 213 direct and reversed items. The present study was conducted in a heterogeneous group of N = 908 Poles (aged 18–78, M = 28.58). It was part of a validation project of a Polish version of the IPIP-VIA questionnaire. The variable-centered approach was used to examine the structure of character strengths on both the scale and item levels. The scale-level results indicated a four-factor structure that can be interpreted based on four of the five personality traits from the Big Five theory (excluding neuroticism). The item-level analysis suggested a slightly different and limited set of character strengths (17 not 24). After conducting a second-order analysis, a four-factor structure emerged, and three of the factors could be interpreted as being consistent with the scale-level factors. Three character strength profiles were found using the person-centered approach. Two of them were consistent with alpha and beta personality metatraits. The structure of character strengths can be described by using categories from the Five Factor Model of personality and metatraits. They form factors similar to some personality traits and occur in similar constellations as metatraits. The main contributions of this paper are: (1) the validation of IPIP-VIA conducted in variable-centered approach in a new research group (Poles) using a different measurement instrument; (2) introducing the person-centered approach to the study of the structure of character strengths. PMID:29515482
Kane, Patrick; Vopat, Bryan; Heard, Wendell; Thakur, Nikhil; Paller, David; Koruprolu, Sarath; Born, Christopher
2014-08-01
Intertrochanteric hip fractures pose a significant challenge for the orthopaedic community as optimal surgical treatment continues to be debated. Currently, varus collapse with lag screw cutout is the most common mode of failure. Multiple factors contribute to cutout. From a surgical technique perspective, a tip apex distance less than 25 mm has been suggested to decrease the risk of cutout. We hypothesized that a low-center lag screw position in the femoral head, with a tip apex distance greater than 25 mm will provide equal, if not superior, biomechanical stability compared with a center-center position with a tip apex distance less than 25 mm in an unstable intertrochanteric hip fracture stabilized with a long cephalomedullary nail. We attempted to examine the biomechanical characteristics of intertrochanteric fractures instrumented with long cephalomedullary nails with two separate lag screw positions, center-center and low-center. Our first research purpose was to examine if there was a difference between the center-center and low-center groups in cycles to failure and failure load. Second, we analyzed if there was a difference in fracture translation between the study groups during loading. Nine matched pairs of femurs were assigned to one of two treatment groups: low-center lag screw position and center-center lag screw position. Cephalomedullary nails were placed and tip apex distance was measured. A standard unstable four-part intertrochanteric fracture was created in all samples. The femurs were loaded dynamically until failure. Cycles to failure and load and displacement data were recorded, and three-dimensional (3-D) motion was recorded using an Optotrak(®) motion tracking system. There were no significant differences between the low-center and center-center treatment groups regarding the mean number of cycles to failure and mean failure load. The 3-D kinematic data showed significantly increased motion in the center-center group compared with the low-center group. At the time of failure, the magnitude of fracture translation was statistically significantly greater in the center-center group (20 ± 2.8 mm) compared with the low-center group (15 ± 3.4 mm; p = 0.004). Additionally, there was statistically significantly increased fracture gap distraction (center-center group, 13 ± 2.8 versus low-center group, 7 ± 4; p < 0.001) and shear fracture gap translation (center-center group, 12 ± 2.3 mm; low-center group, 6 ± 2.7 mm; p < 0.001). Positioning of the lag screw inferior in the head and neck was found to be at least as biomechanically stable as the center-center group although the tip apex distance was greater than 25 mm. Our findings challenge previously accepted principles of optimal lag screw placement.
Lobykina, E N; Tatarnikova, I S; Rusaev, Yu W; Naydenova, N E; Maklakova, T P
2015-01-01
The development of the program of group preventive consultation of visitors of the centers of health concerning nutrition and assessment of its efficiency was the purpose of the work. The analysis of the results of inspection of 2569 visitors of the Health сenter at the age of 18–78 years and randomized, open, cross research of 242 women (27–72 years old) who passed group preventive consultation in the Center of health at «School of a balanced nutrition » were carried out. Anthropometrical data and the actual nutrition with use of the computer program «Analysis of the Person Nutrition» were studied. The study of nutritional status of 242 women with different body mass revealed an excess consumption of fats and carbohydrates, dietary energy supply in obese. Basing on the structural features of patient’s nutrition the School nutrition program was developed. Сomparing of laboratory, diagnostic and resource capabilities of Health сenter with algorithm of overweight and obesity patients treatment has shown wide opportunities of Health сenter, not only in the diagnosis (the study of nutrient, metabolic status), but also in the complex treatment of patients with different body mass. Due to group preventive counseling in the School of a balanced nutrition the efficiency of such an approach contributed 1-month weight loss (2.18±1.28 kg) in 64.4% of the participants.
Connell, Georgianne L.; Donovan, Deborah A.; Chambers, Timothy G.
2016-01-01
Student-centered strategies are being incorporated into undergraduate classrooms in response to a call for reform. We tested whether teaching in an extensively student-centered manner (many active-learning pedagogies, consistent formative assessment, cooperative groups; the Extensive section) was more effective than teaching in a moderately student-centered manner (fewer active-learning pedagogies, less formative assessment, without groups; the Moderate section) in a large-enrollment course. One instructor taught both sections of Biology 101 during the same quarter, covering the same material. Students in the Extensive section had significantly higher mean scores on course exams. They also scored significantly higher on a content postassessment when accounting for preassessment score and student demographics. Item response theory analysis supported these results. Students in the Extensive section had greater changes in postinstruction abilities compared with students in the Moderate section. Finally, students in the Extensive section exhibited a statistically greater expert shift in their views about biology and learning biology. We suggest our results are explained by the greater number of active-learning pedagogies experienced by students in cooperative groups, the consistent use of formative assessment, and the frequent use of explicit metacognition in the Extensive section. PMID:26865643
Lin, Yen-Chun; Huang, Lian-Hua; Young, Heather M; Chen, Ya-Mei
2007-01-01
The purpose of this study was to identify the beliefs about physical activity held by Chinese immigrant older adults in Seattle and to compare them with the beliefs held by Chinese elderly in Taipei. Researchers conducted 2 focus groups of Chinese older adults to explore their behavioral beliefs, normative beliefs, and perceived control beliefs. The first group included 10 elderly recruited from the Chinese Information and Service Center in Seattle, Washington. The second group included 14 elderly adults recruited from a health center in Taipei, Taiwan. This study used a qualitative study design, and deductive content analysis was used for analyzing information gathered. The results showed that Chinese immigrant older adults in Seattle had positive attitudes toward physical activity and that, compared with the group in Taipei, the group in Seattle perceived more positive social and environmental supports. The factors influencing Chinese older adults' physical activity and behaviors both in Seattle and in Taipei are discussed.
DNA Data Bank of Japan: 30th anniversary.
Kodama, Yuichi; Mashima, Jun; Kosuge, Takehide; Kaminuma, Eli; Ogasawara, Osamu; Okubo, Kousaku; Nakamura, Yasukazu; Takagi, Toshihisa
2018-01-04
The DNA Data Bank of Japan (DDBJ) Center (http://www.ddbj.nig.ac.jp) has been providing public data services for 30 years since 1987. We are collecting nucleotide sequence data and associated biological information from researchers as a member of the International Nucleotide Sequence Database Collaboration (INSDC), in collaboration with the US National Center for Biotechnology Information and the European Bioinformatics Institute. The DDBJ Center also services the Japanese Genotype-phenotype Archive (JGA) with the National Bioscience Database Center to collect genotype and phenotype data of human individuals. Here, we outline our database activities for INSDC and JGA over the past year, and introduce submission, retrieval and analysis services running on our supercomputer system and their recent developments. Furthermore, we highlight our responses to the amended Japanese rules for the protection of personal information and the launch of the DDBJ Group Cloud service for sharing pre-publication data among research groups. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.
Gathering Real World Evidence with Cluster Analysis for Clinical Decision Support.
Xia, Eryu; Liu, Haifeng; Li, Jing; Mei, Jing; Li, Xuejun; Xu, Enliang; Li, Xiang; Hu, Gang; Xie, Guotong; Xu, Meilin
2017-01-01
Clinical decision support systems are information technology systems that assist clinical decision-making tasks, which have been shown to enhance clinical performance. Cluster analysis, which groups similar patients together, aims to separate patient cases into phenotypically heterogenous groups and defining therapeutically homogeneous patient subclasses. Useful as it is, the application of cluster analysis in clinical decision support systems is less reported. Here, we describe the usage of cluster analysis in clinical decision support systems, by first dividing patient cases into similar groups and then providing diagnosis or treatment suggestions based on the group profiles. This integration provides data for clinical decisions and compiles a wide range of clinical practices to inform the performance of individual clinicians. We also include an example usage of the system under the scenario of blood lipid management in type 2 diabetes. These efforts represent a step toward promoting patient-centered care and enabling precision medicine.
Yamaguchi, Yoshie
2010-01-01
The purpose of this study was to identify the current status of operations at community general support centers which provide coordination for elderly care and the correlation of personal traits, work environment and the occupational stress of the staff. Subjects of the study were 251 staff members of community general support centers. The current status of operations at the community general support centers and the personal traits, work environment, effort-remuneration imbalance model (ERI) and general health questionnaire (GHQ) were surveyed. The initial analysis involved a comparison by a chi-square test on: The effort-remuneration ratio (E/R ratio) of personal traits and work environment, risk of over-commitment (OC), and GHQ score. To explore the correlation between the E/R ratio of the three GHQ groups (low, middle and high score groups) and the OC value, one-way analysis of variance was performed. Out of the four basic functions of the community general support centers, 22.0% of the respondents noted that "establishment of a regional, comprehensive/multi-tiered service network" was functioning, and 50.4% of respondents noted that "comprehensive and continuous care management" was functioning. The average effort score was 15.5 +/- 5.3, approximately double the average value of preceding studies. Significant differences found in GHQ scores were related to working hours (p<0.001) and anxiety was related to task content (p<0.001). Moreover, a higher GHQ score was accompanied by a higher E/R ratio and as a result of the multiple comparison, a marked difference was observed between the GHQ low score group and the GHQ high score group (p<0.001), and a significant difference was also found between the GHQ low score group and GHQ medium score group (p=0.012). Items observed to have significant correlation with high E/R ratio were: "Weekly working hours of 50 h or more" (OR: 10.38, 95% CI: 2.52-42.70), "Unstable employment" (OR: 2.75, 95% CI: 1.22-6.21) and "Anxiety related to task content" (OR: 17.04, 95% CI: 3.57-81.24). Items observed to have significant correlation with OC value risk factors were: "Weekly working hours of 50 h or more" (OR: 8.04, 95% CI: 1.99-32.41) and "Anxiety related to task content" (OR: 4.60, 95% CI: 2.04-10.37). We conclude that the basic functions of the community general support centers are not presently very functional. The stress levels of the community general support center staff are high and their health levels are low. This indicates that staff are forced to work with anxiety related to task content under conditions of poor pay and long working hours.
Sheng, Zhi-Feng; Dai, Ru-Chun; Wu, Xian-Ping; Ma, Yu-Lin; Xu, Kang; Zhang, Yu-Hai; Jiang, Ye-Bin; Liao, Er-Yuan
2008-12-01
The center of rotation is a physical location in the microCT scanner, defined by the axis of rotation of the sample stage. This physical location is always well defined during calibration of the instrument and fitted by an appropriate algorithm. However, in real images of limited contrast and with X-ray photon noise, this algorithm exhibits poorer precision and the optimum center of rotation cannot be always acquired. Thus, adjustment by operator is necessary to determine whether the center of rotation was correct, in order that the structural information of the sample can be correctly interpreted. In this paper, the effect of center of rotation on the assessment of densitometric and structural properties of trabecular bone was firstly evaluated. Twenty female Sprague-Dawley rats of 7-month-old were randomly assigned to ovariectomized (OVX) and SHAM-operated (SHAM) groups. The left tibiae were harvested at 3 weeks postoperatively. High resolution microCT was used to identify the densitometric and microstructural properties of trabeculae in the proximal ends of tibia. After CT scanning, the best artificial center of rotation for each scan was obtained. Bone parameters analyses were performed on the centers at different places away from the best artificial center of +/-0.2, +/-0.5, +/-1.0, +/-1.5, and +/-2.0 pixels, respectively. The general linear model (GLM) repeated measures procedure was used to investigate the difference in the parameters between the two groups (OVX vs. SHAM) and the possible effects of center displacements. A significant difference between OVX and SHAM groups was found in all parameters (p < 0.05) except Tb.Th, DA, and BS/BV. TBMD, DA, BS/BV, and Conn.D were decreased while BV/TV and Tb.Th were increased with the center deflection. Variations of these parameters were acceptable when the displacements were limited within +/-1.5 pixels for tBMD, BV/TV, DA, and Conn.D, and +/-1.0 pixels for Tb.Th and BS/BV. These changes were similar in both OVX and SHAM groups. The changing curves of bone parameters vs. centers could be well fitted by quadric regression models, by which the real center could be acquired, and thus the precision of microCT analysis would be improved. There were some inevitable differences between the best artificial and real centers.
Economic burden of clinical trials in lung cancer in a German Comprehensive Cancer Center.
Kron, F; Kostenko, A; Scheffler, M; Müller, D; Glossmann, J-P; Fischer, R; Michels, S; Nogova, L; Hallek, M; Zander, T; Wolf, J
2017-06-01
The recent success of individualized lung cancer therapy has triggered fundamental changes in clinical research strategies. To date there is a strong focus on early proof of concept trials in genetically preselected small patient subgroups. This analysis focuses on the economic burden caused by such trials for advanced lung cancer patients in a German Comprehensive Cancer Center (CCC). The profit margins between recruiting groups with ≤3 and >3 patients were compared. Clinical and economic data from clinical trials for advanced lung cancer (LC), pharma-sponsored trials (PhST) as well as investigator initiated trials (IIT), conducted between 2011 and 2015 at the Center for Integrated Oncology (CIO) Cologne, were analyzed using a profit-center calculation model. 161 patients were enrolled in 27 clinical trials. The key economic parameter determining costs and payments was the 'trial visits'. In comparison of the two groups (A≤3; B>3 patients enrolled) we found negative profit margins for the low recruiting group (€ -1444). Concerning the number of visits significant differences were found between PhST and IIT (p=0.009). Additionally, sub-analysis show structural differences in cost composition by conducting PhST and IIT. Trials with low patient numbers and IIT, do not cover the cost. To ensure adequate, cost-covering compensation by pharmaceutical companies CCCs have to thoroughly calculate the cost of early proof of concept trials. The findings of this study also underline the need for novel structures in public funding for investigator-initiated clinical trials in precision medicine. Copyright © 2017 Elsevier B.V. All rights reserved.
Hernán García, M; Gutiérrez Cuadra, J L; Lineros González, C; Ruiz Barbosa, C; Rabadán Asensio, A
2002-10-31
To report the opinions of practitioners at health centers on dimensions of quality that affect user satisfaction. Cross-sectional study of focus groups (FG). Bahía de Cádiz and La Janda health centers in southwestern Spain. We studied 4 FG whose participants were staff members of the two health centers: FG1, physicians; FG2, user satisfaction service staff; FG3, social workers; FG4, nurses. The groups were based on the different functions of staff at the two centers. The analysis was based on variables in the SERCAL model (an adaptation of the SERVQUAL model for the Spanish health care system) of opinions regarding service quality: access, comfort (tangibles), personalized service (courtesy), competence, and loyalty. The data were analyzed with version N-Vivo of the NUDIST program. All dimensions of the theoretical model were identified by practitioners as constructs of users' perceptions of service quality. Users' and practitioners' views contrasted with and complemented each other to generate a model that could be validated. Access, personalized service and problem-solving (responsiveness) were key variables. Practitioners' opinions provided information of use in improving the quality model. Differences in opinion between users and practitioners merit further study based on an understanding of these groups' values and interests, and on the care provision context. Practitioners identified access, personalized service and problem-solving as features that influenced users' opinions of the quality of the health center.
Shin, Sang Soo; Shin, Young-Jeon
2016-01-01
With an increasing number of studies highlighting regional social capital (SC) as a determinant of health, many studies are using multi-level analysis with merged and averaged scores of community residents' survey responses calculated from community SC data. Sufficient examination is required to validate if the merged and averaged data can represent the community. Therefore, this study analyzes the validity of the selected indicators and their applicability in multi-level analysis. Within and between analysis (WABA) was performed after creating community variables using merged and averaged data of community residents' responses from the 2013 Community Health Survey in Korea, using subjective self-rated health assessment as a dependent variable. Further analysis was performed following the model suggested by WABA result. Both E-test results (1) and WABA results (2) revealed that single-level analysis needs to be performed using qualitative SC variable with cluster mean centering. Through single-level multivariate regression analysis, qualitative SC with cluster mean centering showed positive effect on self-rated health (0.054, p<0.001), although there was no substantial difference in comparison to analysis using SC variables without cluster mean centering or multi-level analysis. As modification in qualitative SC was larger within the community than between communities, we validate that relational analysis of individual self-rated health can be performed within the group, using cluster mean centering. Other tests besides the WABA can be performed in the future to confirm the validity of using community variables and their applicability in multi-level analysis.
Big Data in the Campus Landscape: Basic Infrastructure Support. ECAR Working Group Paper
ERIC Educational Resources Information Center
Almes, Guy T.; Zottola, Ralph J.
2014-01-01
This paper is part of series of the EDUCAUSE Center for Analysis and Research Campus Cyberinfrastructure (ECAR-CCI) Working Group. The topic of big data continues to receive a great deal of publicity because of its promise for opening new avenues of scholarly discovery and commercial opportunity. The ability to sift rapidly through massive amounts…
Big Data in the Campus Landscape: Security and Privacy. ECAR Working Group Paper
ERIC Educational Resources Information Center
Barnett, William; Corn, Mike; Hillegas, Curt; Wada, Kent
2015-01-01
This paper is part of series of the EDUCAUSE Center for Analysis and Research Campus Cyberinfrastructure (ECAR-CCI) Working Group. The topic of big data continues to receive a great deal of publicity because of its promise for opening new avenues of scholarly discovery and commercial opportunity. The ability to sift rapidly through massive amounts…
NASA Technical Reports Server (NTRS)
Ruf, Joseph; Holt, James B.; Canabal, Francisco
1999-01-01
This paper presents the status of analyses on three Rocket Based Combined Cycle configurations underway in the Applied Fluid Dynamics Analysis Group (TD64). TD64 is performing computational fluid dynamics analysis on a Penn State RBCC test rig, the proposed Draco axisymmetric RBCC engine and the Trailblazer engine. The intent of the analysis on the Penn State test rig is to benchmark the Finite Difference Navier Stokes code for ejector mode fluid dynamics. The Draco engine analysis is a trade study to determine the ejector mode performance as a function of three engine design variables. The Trailblazer analysis is to evaluate the nozzle performance in scramjet mode. Results to date of each analysis are presented.
Blincoe, William D; Rodriguez-Granillo, Agustina; Saurí, Josep; Pierson, Nicholas A; Joyce, Leo A; Mangion, Ian; Sheng, Huaming
2018-04-01
Benzoic acid/ester/amide derivatives are common moieties in pharmaceutical compounds and present a challenge in positional isomer identification by traditional tandem mass spectrometric analysis. A method is presented for exploiting the gas-phase neighboring group participation (NGP) effect to differentiate ortho-substituted benzoic acid/ester derivatives with high resolution mass spectrometry (HRMS 1 ). Significant water/alcohol loss (>30% abundance in MS 1 spectra) was observed for ortho-substituted nucleophilic groups; these fragment peaks are not observable for the corresponding para and meta-substituted analogs. Experiments were also extended to the analysis of two intermediates in the synthesis of suvorexant (Belsomra) with additional analysis conducted with nuclear magnetic resonance (NMR), density functional theory (DFT), and ion mobility spectrometry-mass spectrometry (IMS-MS) studies. Significant water/alcohol loss was also observed for 1-substituted 1, 2, 3-triazoles but not for the isomeric 2-substituted 1, 2, 3-triazole analogs. IMS-MS, NMR, and DFT studies were conducted to show that the preferred orientation of the 2-substituted triazole rotamer was away from the electrophilic center of the reaction, whereas the 1-subtituted triazole was oriented in close proximity to the center. Abundance of NGP product was determined to be a product of three factors: (1) proton affinity of the nucleophilic group; (2) steric impact of the nucleophile; and (3) proximity of the nucleophile to carboxylic acid/ester functional groups. Graphical Abstract ᅟ.
Liang, Yuexiang; Wu, Liangliang; Wang, Xiaona; Ding, Xuewei; Liang, Han
2015-10-01
Many studies have affirmed the survival benefit for cancer patients treated by specialized surgeons. A total of 967 patients with gastric cancer (GC) who underwent gastrectomy with curative intent in our center were enrolled. Patients were categorized into two groups based on surgeon specialization: the specialized group (SG) and nonspecialized group (NSG). To overcome bias due to the different distribution of covariates for the two groups, a one-to-one match was applied using propensity score analysis. After matching, prognosis and recurrence data were analyzed. After one-to-one matching, 261 patients in the SG and 261 patients in the NSG had the same characteristics excluding factors associated with surgery. In multivariate analysis for the whole study series, surgeon specialization was an independent prognostic factor for GC patients after surgery. Patients in the SG demonstrated a significantly higher 5-year overall survival than those in the NSG (50.7 vs. 37.2 %, p = 0.001). With the strata analysis, significant prognostic differences between the two groups were only observed in patients at stage IIIa-b or N1-2. The proportion of locoregional recurrence was greater in the NSG than in the SG. GC patients treated by specialized surgeons tended to have a better prognosis and lower locoregional recurrence rate. Surgeon specialization was an independent prognostic factor for GC patients after surgery. GC should be treated by specialized surgeons in large-volume centers.
NASA Astrophysics Data System (ADS)
Blincoe, William D.; Rodriguez-Granillo, Agustina; Saurí, Josep; Pierson, Nicholas A.; Joyce, Leo A.; Mangion, Ian; Sheng, Huaming
2018-02-01
Benzoic acid/ester/amide derivatives are common moieties in pharmaceutical compounds and present a challenge in positional isomer identification by traditional tandem mass spectrometric analysis. A method is presented for exploiting the gas-phase neighboring group participation (NGP) effect to differentiate ortho-substituted benzoic acid/ester derivatives with high resolution mass spectrometry (HRMS1). Significant water/alcohol loss (>30% abundance in MS1 spectra) was observed for ortho-substituted nucleophilic groups; these fragment peaks are not observable for the corresponding para and meta-substituted analogs. Experiments were also extended to the analysis of two intermediates in the synthesis of suvorexant (Belsomra) with additional analysis conducted with nuclear magnetic resonance (NMR), density functional theory (DFT), and ion mobility spectrometry-mass spectrometry (IMS-MS) studies. Significant water/alcohol loss was also observed for 1-substituted 1, 2, 3-triazoles but not for the isomeric 2-substituted 1, 2, 3-triazole analogs. IMS-MS, NMR, and DFT studies were conducted to show that the preferred orientation of the 2-substituted triazole rotamer was away from the electrophilic center of the reaction, whereas the 1-subtituted triazole was oriented in close proximity to the center. Abundance of NGP product was determined to be a product of three factors: (1) proton affinity of the nucleophilic group; (2) steric impact of the nucleophile; and (3) proximity of the nucleophile to carboxylic acid/ester functional groups. [Figure not available: see fulltext.
Tambe, Varsha Harshal; Nagmode, Pradnya Sunil; Abraham, Sathish; Patait, Mahendra; Lahoti, Pratik Vinod; Jaju, Neha
2014-01-01
Aim: The aim of the present study was to compare the canal transportation and centering ability of Rotary ProTaper, One Shape and Wave One systems using cone beam computed tomography (CBCT) in curved root canals to find better instrumentation technique for maintaining root canal geometry. Materials and Methods: Total 30 freshly extracted premolars having curved root canals with at least 10 degrees of curvature were divided into three groups of 10 teeth each. All teeth were scanned by CBCT to determine the root canal shape before instrumentation. In Group 1, the canals were prepared with Rotary ProTaper files, in Group 2 the canals were prepared with One Shape files and in Group 3 canals were prepared with Wave One files. After preparation, post-instrumentation scan was performed. Pre-instrumentation and post-instrumentation images were obtained at three levels, 3 mm apical, 3 mm coronal and 8 mm apical above the apical foramen were compared using CBCT software. Amount of transportation and centering ability were assessed. The three groups were statistically compared with analysis of variance and Tukey honestly significant. Results: All instruments maintained the original canal curvature with significant differences between the different files. Data suggested that Wave One files presented the best outcomes for both the variables evaluated. Wave One files caused lesser transportation and remained better centered in the canal than One Shape and Rotary ProTaper files. Conclusion: The canal preparation with Wave One files showed lesser transportation and better centering ability than One Shape and ProTaper. PMID:25506145
Analysis of the Relation of Teachers' Organizational Identification and Organizational Communication
ERIC Educational Resources Information Center
Yildiz, Kaya
2013-01-01
In this study the relationship between the organizational identification and organizational communication of primary school teachers is examined through path analysis. The study group in the study is formed by (n = 362) primary school teachers working at primary schools located in the center of Bolu in the 2011-2012 academic year. In the study,…
Azkhosh, Manoochehr; Farhoudianm, Ali; Saadati, Hemn; Shoaee, Fateme; Lashani, Leila
2016-10-01
Objective: Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran. Method: This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz. Sixty individuals were evaluated according to inclusion/ exclusion criteria and were divided into three equal groups randomly (20 participants per group). One group received acceptance and commitment group therapy (Twelve 90-minute sessions) and the other group was provided with the 12-steps Narcotics Anonymous program and the control group received the usual methadone maintenance treatment. During the treatment process, seven participants dropped out. Data were collected using the psychological well-being questionnaire and AAQ questionnaire in the three groups at pre-test, post-test and follow-up visits. Data were analyzed using repeated measure analysis of variance. Results: Repeated measure analysis of variance revealed that the mean difference between the three groups was significant (P<0.05) and that acceptance and commitment therapy group showed improvement relative to the NA and control groups on psychological well-being and psychological flexibility. Conclusion : The results of this study revealed that acceptance and commitment therapy can be helpful in enhancing positive emotions and increasing psychological well-being of addicts who seek treatment.
Young Vs Old Colorectal Cancer in Indian Subcontinent: a Tertiary Care Center Experience.
Pokharkar, Ashish B; Bhandare, Manish; Patil, Prachi; Mehta, Shaesta; Engineer, Reena; Saklani, Avanish P
2017-12-01
This study aims to compare patient, tumor, treatment-related factors and survival between young (<45 years) and old (>45 years) Indian colorectal cancer (CRC) patients. Total 778 patients of CRC were registered at tertiary cancer center in India between 1 August 2013 and 31 July 2014. Patients were followed up for median period of 27.73 months. Data regarding patient, tumor, treatment and survival-related factors were collected. Patients were divided in young (≤45 years) and old (>45 years) age groups. Statistical analysis was done with SPSS software version 23. Young age group patients presented more commonly with poor histology, node-positive disease, and rectal site. Younger age group patients received multiple lines of neoadjuvant treatment. There was no significant overall survival difference in both groups of patients. On stratified stage-wise analysis, no significant overall survival (OS) difference was found between two groups (young vs old-1- and 3-year OS: 85.2 and 61.5% vs 81.5 and 64.5%, respectively; P = 0.881). On univariate analysis, gender, performance status, site, stage, differentiation, TRG, CRM status, signet ring type, and CEA level were significant prognostic factors. In disease-free survival (DFS) analysis, it is found that there is statistically significant difference in DFS (young vs old: 1 and 3 years; 77.6 and 62.8% vs 85.8 and 74.1%, respectively; P value, 0.02), but when OS was analyzed for same group of patient, there was no statistical difference ( P = 0.302). This study confirms the high incidence rates of CRC in young Indian patients. There is no OS difference between two age groups. In operated group of patients, there is higher DFS in older patients but no OS advantage at 3 years follow-up. Further long-term follow-up is required to see any OS difference.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cole, Jacqueline M.; Blood-Forsythe, Martin A.; Lin, Tze-Chia
Donor-pi-acceptor dyes containing thiophenyl pi-conjugated units and cyanoacrylate acceptor groups are among the best-performing organic chromophores used in dye-sensitized solar cell (DSC) applications. Yet, the molecular origins of their high photovoltaic output have remained unclear until now. This synchrotron-based X-ray diffraction study elucidates these origins for the high-performance thiophenylcyanoacrylate-based dye MK-2 (7.7% DSC device efficiency) and its molecular building block, MK-44. The crystal structures of MK-2 and MK-44 are both determined, while a high-resolution charge-density mapping of the smaller molecule was also possible, enabling the nature of its bonding to be detailed. A strong S center dot center dot centermore » dot C equivalent to N intramolecular interaction is discovered, which bears a bond critical point, thus proving that this interaction should be formally classified as a chemical bond. A topological analysis of the pi-conjugated portion of MK-44 shows that this S center dot center dot center dot C equivalent to N bonding underpins the highly efficient intramolecular charge transfer(ICT) in thiophenylcyanoacrylate dyes. This manifests as two bipartite ICT pathways bearing carboxylate and nitrile end points. In turn, these pathways dictate a preferred COO/CN anchoring mode for the dye as it adsorbs onto TiO2 surfaces, to form the dye TiO2 interface that constitutes the DSC working electrode. These results corroborate a recent proposal that all cyanoacrylate groups anchor onto TiO2 in this COO/CN binding configuration. Conformational analysis of the MK-44 and MK-2 crystal structures reveals that this S center dot center dot center dot C equivalent to N bonding will persist in MK-2. Accordingly, this newly discovered bond affords a rational explanation for the attractive photovoltaic properties of,MK-2. More generally, this study provides the first unequivocal evidence for an S center dot center dot center dot C equivalent to N interaction, confirming previous speculative assignments of such interactions in other compounds.« less
Morgan, Paul L; Farkas, George; Maczuga, Steve
2015-06-01
We used population-based, longitudinal data to investigate the relation between mathematics instructional practices used by 1 st grade teachers in the U.S. and the mathematics achievement of their students. Factor analysis identified four types of instructional activities (i.e., teacher-directed, student-centered, manipulatives/calculators, movement/music) and eight types of specific skills taught (e.g., adding two-digit numbers). First-grade students were then classified into five groups on the basis of their fall and/or spring of kindergarten mathematics achievement-three groups with mathematics difficulties (MD) and two without MD. Regression analysis indicated that a higher percentage of MD students in 1 st grade classrooms was associated with greater use by teachers of manipulatives/calculators and movement/music to teach mathematics. Yet follow-up analysis for each of the MD and non-MD groups indicated that only teacher-directed instruction was significantly associated with the achievement of students with MD (covariate-adjusted ES s = .05-.07). The largest predicted effect for a specific instructional practice was for routine practice and drill. In contrast, for both groups of non-MD students, teacher-directed and student-centered instruction had approximately equal, statistically significant positive predicted effects (covariate-adjusted ES s = .03-.04). First-grade teachers in the U.S. may need to increase their use of teacher-directed instruction if they are to raise the mathematics achievement of students with MD.
Pseudosymmetric features of non-centrosymmetric AB type crystals
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gazhulina, A.P., E-mail: asyagazhulina@yandex.ru; Marychev, M.O.
2016-07-15
This work is supplement to our previous investigation (Gazhulina and Marychev, 2015) [1]. We have considered pseudosymmetric features with respect to the operation of inversion (pseudoinversion) for 340 non-centrosymmetric AB type crystals. Analysis of the features of particular structure types allowed us to determine the positions of pseudoinversion centers, subdivide them into separate types, and classify the entire set of crystals studied with respect to the types of pseudoinversion centers and peculiarities of the behavior of the degree of pseudoinversion depending on the ratio of atomic numbers of A and B components. For each group of crystals, average values andmore » lower boundaries of the maximum pseudoinversion are determined and distribution with respect to the degree of pseudoinversion is constructed. - Graphical abstract: A group of 340 non-centrosymmetric AB type crystals have been considered for their pseudosymmetry features with respect to the operation of inversion. Positions of pseudoinversion centers, subdivision of them into separate types, classification of the entire set of crystals studied with respect to the types of pseudoinversion centers and peculiarities of the behavior of the degree of pseudoinversion are established and discussed. Display Omitted - Highlights: • We consider pseudoinversion of 340 non-centrosymmetric AB type crystals. • AB type crystals are divided into three groups with respect to pseudoinversion. • Positions and types of pseudoinversion centers are determined. • Lower boundaries of the maximum pseudoinversion are determined.« less
Schneider, Bruce A.; Avivi-Reich, Meital; Mozuraitis, Mindaugas
2015-01-01
A number of statistical textbooks recommend using an analysis of covariance (ANCOVA) to control for the effects of extraneous factors that might influence the dependent measure of interest. However, it is not generally recognized that serious problems of interpretation can arise when the design contains comparisons of participants sampled from different populations (classification designs). Designs that include a comparison of younger and older adults, or a comparison of musicians and non-musicians are examples of classification designs. In such cases, estimates of differences among groups can be contaminated by differences in the covariate population means across groups. A second problem of interpretation will arise if the experimenter fails to center the covariate measures (subtracting the mean covariate score from each covariate score) whenever the design contains within-subject factors. Unless the covariate measures on the participants are centered, estimates of within-subject factors are distorted, and significant increases in Type I error rates, and/or losses in power can occur when evaluating the effects of within-subject factors. This paper: (1) alerts potential users of ANCOVA of the need to center the covariate measures when the design contains within-subject factors, and (2) indicates how they can avoid biases when one cannot assume that the expected value of the covariate measure is the same for all of the groups in a classification design. PMID:25954230
Chocron, Richard; Bougouin, Wulfran; Beganton, Frankie; Juvin, Philippe; Loeb, Thomas; Adnet, Frédéric; Lecarpentier, Eric; Lamhaut, Lionel; Jost, Daniel; Marijon, Eloi; Cariou, Alain; Jouven, Xavier; Dumas, Florence
2017-09-01
As post-cardiac arrest care may influence patients' outcome, characteristics of receiving hospitals should be integrated in the evaluation of survival. We aimed at assessing the influence of care level center on patients' survival at hospital discharge using a regional registry of out-of-hospital cardiac arrest patients (OHCA). We retrospectively analysed a Utstein and in-hospital data prospectively collected for all non-traumatic OHCA patients, in whom a successful return of spontaneous circulation (ROSC) had been obtained, from a large metropolitan area (Great Paris). Receiving hospitals were categorized in 3 groups as follows: A centers (High-case volume with cath-lab 24/7), B centers (Intermediate-case volume with cath-lab partly available) and C centers (Low-case volume and no cath-lab) We compared patients' characteristics and outcome in the 3 groups and performed a multivariate logistic regression using survival to discharge as primary endpoint. Between May 2011 and December 2013, 1476 patients were admitted in 48 hospitals (group A: n=917; group B: n=428; group C: n=91). Overall survival rate at discharge was 433/1436 (30%). Patients' baseline characteristics significantly differed, as hospitals from group A received younger patients with a higher rate of shockable cardiac rhythms (p<0.001). Unadjusted survival rate differed significantly among the 3 groups of hospitals (respectively 34%, 25% and 15.4% for A-C, p<0.01). In multivariate analysis, the category of receiving hospital was no longer associated with survival, even in the subgroup of witnessed arrest and shockable patients. In this population-based study, characteristics of receiving hospitals are not associated with survival rate at discharge. This might be partially explained by the prehospital triage organization used in France. Copyright © 2017. Published by Elsevier B.V.
Teixeira, Flavia C; de Almeida, Carlos E; Saiful Huq, M
2016-01-01
The goal of this study was to evaluate the safety and quality management program for stereotactic radiosurgery (SRS) treatment processes at three radiotherapy centers in Brazil by using three industrial engineering tools (1) process mapping, (2) failure modes and effects analysis (FMEA), and (3) fault tree analysis. The recommendations of Task Group 100 of American Association of Physicists in Medicine were followed to apply the three tools described above to create a process tree for SRS procedure for each radiotherapy center and then FMEA was performed. Failure modes were identified for all process steps and values of risk priority number (RPN) were calculated from O, S, and D (RPN = O × S × D) values assigned by a professional team responsible for patient care. The subprocess treatment planning was presented with the highest number of failure modes for all centers. The total number of failure modes were 135, 104, and 131 for centers I, II, and III, respectively. The highest RPN value for each center is as follows: center I (204), center II (372), and center III (370). Failure modes with RPN ≥ 100: center I (22), center II (115), and center III (110). Failure modes characterized by S ≥ 7, represented 68% of the failure modes for center III, 62% for center II, and 45% for center I. Failure modes with RPNs values ≥100 and S ≥ 7, D ≥ 5, and O ≥ 5 were considered as high priority in this study. The results of the present study show that the safety risk profiles for the same stereotactic radiotherapy process are different at three radiotherapy centers in Brazil. Although this is the same treatment process, this present study showed that the risk priority is different and it will lead to implementation of different safety interventions among the centers. Therefore, the current practice of applying universal device-centric QA is not adequate to address all possible failures in clinical processes at different radiotherapy centers. Integrated approaches to device-centric and process specific quality management program specific to each radiotherapy center are the key to a safe quality management program.
NASA Technical Reports Server (NTRS)
Ruf, Joseph H.; Holt, James B.; Canabal, Francisco
2001-01-01
This paper presents the status of analyses on three Rocket Based Combined Cycle (RBCC) configurations underway in the Applied Fluid Dynamics Analysis Group (TD64). TD64 is performing computational fluid dynamics (CFD) analysis on a Penn State RBCC test rig, the proposed Draco axisymmetric RBCC engine and the Trailblazer engine. The intent of the analysis on the Penn State test rig is to benchmark the Finite Difference Navier Stokes (FDNS) code for ejector mode fluid dynamics. The Draco analysis was a trade study to determine the ejector mode performance as a function of three engine design variables. The Trailblazer analysis is to evaluate the nozzle performance in scramjet mode. Results to date of each analysis are presented.
Sedo, J; Bláha, M; Pavlík, T; Klika, P; Dušek, L; Büchler, T; Abrahámová, J; Srámek, V; Slampa, P; Komínek, L; Pospíšil, P; Sláma, O; Vyzula, R
2014-01-01
As a part of the development of a new prospective payment model for radiotherapy we analyzed data on costs of care provided by three comprehensive cancer centers in the Czech Republic. Our aim was to find a combination of variables (predictors) which could be used to sort hospitalization cases into groups according to their costs, with each group having the same reimbursement rate. We tested four variables as possible predictors - number of fractions, stage of disease, radiotherapy technique and diagnostic group. We analyzed 7,440 hospitalization cases treated in three comprehensive cancer centers from 2007 to 2011. We acquired data from the I COP database developed by Institute of Biostatistics and Analyses of Masaryk University in cooperation with oncology centers that contains records from the National Oncological Registry along with data supplied by healthcare providers to insurance companies for the purpose of retrospective reimbursement. When comparing the four variables mentioned above we found that number of fractions and radiotherapy technique were much stronger predictors than the other two variables. Stage of disease did not prove to be a relevant indicator of cost distinction. There were significant differences in costs among diagnostic groups but these were mostly driven by the technique of radiotherapy and the number of fractions. Within the diagnostic groups, the distribution of costs was too heterogeneous for the purpose of the new payment model. The combination of number of fractions and radiotherapy technique appears to be the most appropriate cost predictors to be involved in the prospective payment model proposal. Further analysis is planned to test the predictive value of intention of radiotherapy in order to determine differences in costs between palliative and curative treatment.
Álvarez-Sandoval, Brenda A.; Manzanilla, Linda R.; González-Ruiz, Mercedes; Malgosa, Assumpció; Montiel, Rafael
2015-01-01
Multiethnicity in Teopancazco, Teotihuacan, is supported by foreign individuals found in the neighborhood center as well as by the diversity observed in funerary rituals at the site. Studies of both stable and strontium isotopes as well as paleodietary analysis, suggest that the population of Teopancazco was composed by three population groups: people from Teotihuacan, people from nearby sites (Tlaxcala-Hidalgo-Puebla), and people from afar, including the coastal plains. In an attempt to understand the genetic dynamics in Teopancazco we conducted an ancient DNA (aDNA) analysis based on mtDNA. Our results show that the level of genetic diversity is consistent with the multiethnicity phenomenon at the neighborhood center. Levels of genetic diversity at different time periods of Teopancazco’s history show that multiethnicity was evident since the beginning and lasted until the collapse of the neighborhood center. However, a PCA and a Neighbor-Joining tree suggested the presence of a genetically differentiated group (buried at the Transitional phase) compared to the population from the initial phase (Tlamimilolpa) as well as the population from the final phase (Xolalpan) of the history of Teopancazco. Genetic studies showed no differences in genetic diversity between males and females in the adult population of Teopancazco, this data along with ample archaeological evidence, suggest a neolocal post-marital pattern of residence in Teopancazco. Nevertheless, genetic analyses on the infant population showed that the males are significantly more heterogeneous than the females suggesting a possible differential role in cultural practices by sex in the infant sector. Regarding interpopulation analysis, we found similar indices of genetic diversity between Teopancazco and heterogeneous native groups, which support the multiethnic character of Teopancazco. Finally, our data showed a close genetic relationship between Teopancazco and populations from the “Teotihuacan corridor” and from Oaxaca and the Maya region, in agreement with previous archaeological evidence. PMID:26200455
Álvarez-Sandoval, Brenda A; Manzanilla, Linda R; González-Ruiz, Mercedes; Malgosa, Assumpció; Montiel, Rafael
2015-01-01
Multiethnicity in Teopancazco, Teotihuacan, is supported by foreign individuals found in the neighborhood center as well as by the diversity observed in funerary rituals at the site. Studies of both stable and strontium isotopes as well as paleodietary analysis, suggest that the population of Teopancazco was composed by three population groups: people from Teotihuacan, people from nearby sites (Tlaxcala-Hidalgo-Puebla), and people from afar, including the coastal plains. In an attempt to understand the genetic dynamics in Teopancazco we conducted an ancient DNA (aDNA) analysis based on mtDNA. Our results show that the level of genetic diversity is consistent with the multiethnicity phenomenon at the neighborhood center. Levels of genetic diversity at different time periods of Teopancazco's history show that multiethnicity was evident since the beginning and lasted until the collapse of the neighborhood center. However, a PCA and a Neighbor-Joining tree suggested the presence of a genetically differentiated group (buried at the Transitional phase) compared to the population from the initial phase (Tlamimilolpa) as well as the population from the final phase (Xolalpan) of the history of Teopancazco. Genetic studies showed no differences in genetic diversity between males and females in the adult population of Teopancazco, this data along with ample archaeological evidence, suggest a neolocal post-marital pattern of residence in Teopancazco. Nevertheless, genetic analyses on the infant population showed that the males are significantly more heterogeneous than the females suggesting a possible differential role in cultural practices by sex in the infant sector. Regarding interpopulation analysis, we found similar indices of genetic diversity between Teopancazco and heterogeneous native groups, which support the multiethnic character of Teopancazco. Finally, our data showed a close genetic relationship between Teopancazco and populations from the "Teotihuacan corridor" and from Oaxaca and the Maya region, in agreement with previous archaeological evidence.
Davey, Sanjeev; Raghav, Santosh Kumar; Singh, Jai Vir; Davey, Anuradha; Singh, Nirankar
2015-01-01
Background: The evaluation of primary healthcare services provided by health training centers of a private medical college has not been studied in comparison with government health facilities in Indian context. Data envelopment analysis (DEA) is one such technique of operations research, which can be used on health facilities for identifying efficient operating practices and strategies for relatively efficient or inefficient health centers by calculating their efficiency scores. Materials and Methods: This study was carried out by DEA technique by using basic radial models (constant ratio to scale (CRS)) in linear programming via DEAOS free online Software among four decision making units (DMUs; by comparing efficiency of two private health centers of a private medical college of India with two public health centers) in district Muzaffarnagar of state Uttar Pradesh. The input and output records of all these health facilities (two from private and two from Government); for 6 months duration from 1st Jan 2014 to 1st July 2014 was taken for deciding their efficiency scores. Results: The efficiency scores of primary healthcare services in presence of doctors (100 vs 30%) and presence of health staff (100 vs 92%) were significantly better from government health facilities as compared to private health facilities (P < 0.0001). Conclusions: The evaluation of primary healthcare services delivery by DEA technique reveals that the government health facilities group were more efficient in delivery of primary healthcare services as compared to private training health facilities group, which can be further clarified in by more in-depth studies in future. PMID:26435598
Ullrich, A; Glattacker, M; Sibold, M; Egle, U T; Ehlebracht-König, I; Geigges, W; Köllner, V; Kruse, M; Jäckel, W H
2013-10-01
Fibromyalgia syndrome (FMS) is characterized by e. g. chronic, multilocular pain, and mental health problems. In Germany, patients with FMS are treated in somatic and psychosomatic rehabilitation centers - specialized for rheumatic diseases (somatic) or psychosomatic diseases. The aim of this study is to identify the status quo of FMS patients' access routes to the rehabilitation system, and to identify their predictors for being assigned to one or the other indication group. Our cohort consists of 197 FMS patients from 3 psychosomatic (M=49.9 years) and 223 FMS patients (M=50.2 years) from 3 somatic rehabilitation centers. At the beginning of rehabilitation, patients filled out a questionnaire packet to identify their access routes to the rehabilitation centers and to record patients' disease-related, psychosocial and socio-demographic characteristics. To analyze the results we used descriptive calculations, calculated bivariate correlations, and conducted binary logistic regression analysis for the prediction of group membership. The access routes of FMS patients to a somatic or a psychosomatic rehabilitation center were often similar. Some items revealed significant group differences, i. e., a higher primary -rejection rate, longer waiting period between application for rehabilitation and its approval, and between the application itself and initiation of psychosomatic rehabilitation in comparison to somatic FMS patients. Prior experience of out-patient psychotherapy, and expectations ("psychological support") for the rehabilitation were predictive patient characteristics for the assignment into a psychosomatic rehabilitation center. Marriage, motivation, and expectations ("physical improvement" and "interaction with other patients") for the rehabilitation were predictive patient characteristics for the assignment in a somatic rehabilitation center. The predictors clarified 32% of the variance of group membership. Our results provide initial evidence of how FMS patients access the German rehabilitation system and which of their characteristics are responsible for being assigned to a particular rehabilitation setting. © Georg Thieme Verlag KG Stuttgart · New York.
Ackel-D'Elia, Carolina; Vancini, Rodrigo Luiz; Castelo, Adauto; Nouailhetas, Viviane Louise Andrée; Silva, Antonio Carlos da
2010-01-01
The aim of this study was to evaluate the occurrence of the well-known predisposing factors and signs and symptoms usually associated with either overreaching or overtraining syndrome in physical fitness centers in São Paulo City, Brazil. A questionnaire consisting of 13 question groups pertaining to either predisposing factors (1-7) or signs and symptoms (8-13) was given to 413 subjects. The general training schedule of the volunteers was characterized by workout sessions of 2.18 ± 0.04 h for a total of 11.0 ± 0.3 h/week for 33 ± 2 months independent of the type of exercise performed (walking, running, spinning, bodybuilding and stretching). A mean score was calculated ranging from 1 (completely absent) to 5 (severe) for each question group. A low occurrence was considered to be a question group score lower than 4, which was observed in all 13 question groups. The psychological evaluation by POMS Mood State Questionnaire indicated a normal non-inverted iceberg. The hematological parameters, creatine kinase activity, cortisol, total testosterone and free testosterone concentrations were within the normal ranges for the majority of the volunteers selected for this analysis (n = 60). According to the questionnaire score analysis, no predisposing factors or signs and symptoms usually associated with either overreaching or overtraining were detected among the members of physical fitness centers in São Paulo City, Brazil. This observation was corroborated by the absence of any significant hematological or stress hormone level alterations in blood analyses of the majority of the selected volunteers (n = 60).
Lee, Sang Mee; Sharma, Ravi; Ngo-Metzger, Quyen; Mukamel, Dana B.; Gao, Yue; White, Laura M.; Shi, Leiyu; Chin, Marshall H.; Laiteerapong, Neda; Huang, Elbert S.
2016-01-01
Objectives. To compare health care use and spending of Medicaid enrollees seen at federally qualified health centers versus non–health center settings in a context of significant growth. Methods. Using fee-for-service Medicaid claims from 13 states in 2009, we compared patients receiving the majority of their primary care in federally qualified health centers with propensity score–matched comparison groups receiving primary care in other settings. Results. We found that health center patients had lower use and spending than did non–health center patients across all services, with 22% fewer visits and 33% lower spending on specialty care and 25% fewer admissions and 27% lower spending on inpatient care. Total spending was 24% lower for health center patients. Conclusions. Our analysis of 2009 Medicaid claims, which includes the largest sample of states and more recent data than do previous multistate claims studies, demonstrates that the health center program has provided a cost-efficient setting for primary care for Medicaid enrollees. PMID:27631748
Knerr, Sarah; Hohl, Sarah D; Molina, Yamile; Neuhouser, Marian L; Li, Christopher I; Coronado, Gloria D; Fullerton, Stephanie M; Thompson, Beti
Research dissemination is a priority for The Partnership for Understanding and Eliminating Disparate Outcomes (PUEDO) for Latinas, a Center for Population Health and Health Disparities located at the Fred Hutchinson Cancer Research Center (FHCRC). We aimed to identify types of PUEDO research findings our participants wanted and why, dissemination audiences beyond PUEDO participants, and strategies to communicate diverse findings about breast cancer and breast cancer disparities. Five focus groups with PUEDO study participants (N = 25) were transcribed for qualitative content analysis (average participants per focus group, 5; range, 2-11). Participants reported wanting to learn aggregate and personal results and were influenced by their life experiences, their experiences as study participants, and the relevance they believed specific results would have for their lives. Women advocated for broad dissemination and inclusive communication using a simple paper-based strategy that would be accessible to diverse audiences (e.g., study participants, policymakers, recent immigrants). Focus groups informed PUEDO's dissemination strategy, which concentrates on study participants and the regional Latino community. This approach to dissemination should maximize information uptake and community benefit.
Innovation in survivor care: group visits.
Trotter, Kathryn; Frazier, Alana; Hendricks, Colleen K; Scarsella, Heidi
2011-04-01
The Centering Cancer Survivorship (CCS) follow-up care program is an innovation in healthcare delivery that meets the needs of cancer survivors and cancer centers. Piloted in a breast cancer clinic, the program provides an avenue for provision of psychological support and health-promotion activities, as well as surveillance for recurrence or late effects. The program empowers each survivor by enlisting her to produce a written breast cancer survivorship care plan for personal use and to share with her primary care provider. Concurrently, this innovation should enhance the viability of the primary cancer center by freeing appointment slots for oncologists who provide expensive therapies to newly diagnosed patients. The CCS program's central feature is the implementation of a multidisciplinary clinic designated specifically for breast cancer survivors in which follow-up care is provided through a group visit medical model. This model of care provides opportunities for health assessment, patient empowerment, and patient education within a framework of social support from peers with similar issues. The group visit model may be well suited to addressing the unique chronic healthcare needs of breast cancer survivors. Further evaluation is needed to verify cost-benefit analysis.
Preparing for Antibiotic Resistance Campaigns: A Person-centered Approach to Audience Segmentation
Smith, Rachel A.; Quesnell, Madisen; Glick, Lydia; Hackman, Nicole; M’ikanatha, Nkuchia M.
2015-01-01
Antibiotic resistance is growing threat to public health threat that calls for urgent attention. However, creating campaigns to slow the emergence and spread of drug-resistant pathogens is challenging because the goal—antibiotic stewardship—encompasses multiple behaviors. This study provided a novel approach to audience segmentation for a multifaceted goal, by using a person-centered approach to identify profiles of US adults based on shared stewardship intentions. The latent class analysis identified three groups: Stewards, Stockers, and Demanders. The findings suggest campaigns with goals aimed at encouraging Stewards to follow through on their intentions, encouraging Stockers to dispose of their leftover antibiotics, and convincing Demanders to accept provider’s evidence-based judgment when a prescription for antibiotics is not indicated. Covariate analysis showed that people who held more inaccurate beliefs about what antibiotics can treat had higher odds of being Demanders and Stockers instead of Stewards. People with stronger health mavenism also had higher odds of being Stockers instead of Stewards. The covariate analysis provided theoretical insight into the strategies to pursue in campaigns targeting these three groups. PMID:26181623
Integrating software architectures for distributed simulations and simulation analysis communities.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Goldsby, Michael E.; Fellig, Daniel; Linebarger, John Michael
2005-10-01
The one-year Software Architecture LDRD (No.79819) was a cross-site effort between Sandia California and Sandia New Mexico. The purpose of this research was to further develop and demonstrate integrating software architecture frameworks for distributed simulation and distributed collaboration in the homeland security domain. The integrated frameworks were initially developed through the Weapons of Mass Destruction Decision Analysis Center (WMD-DAC), sited at SNL/CA, and the National Infrastructure Simulation & Analysis Center (NISAC), sited at SNL/NM. The primary deliverable was a demonstration of both a federation of distributed simulations and a federation of distributed collaborative simulation analysis communities in the context ofmore » the same integrated scenario, which was the release of smallpox in San Diego, California. To our knowledge this was the first time such a combination of federations under a single scenario has ever been demonstrated. A secondary deliverable was the creation of the standalone GroupMeld{trademark} collaboration client, which uses the GroupMeld{trademark} synchronous collaboration framework. In addition, a small pilot experiment that used both integrating frameworks allowed a greater range of crisis management options to be performed and evaluated than would have been possible without the use of the frameworks.« less
Hershenfeld, Samantha A; Maki, Kimberly; Rothfels, Lana; Murray, Cindy S; Nixon, Shannon; Schimmer, Aaron D; Doherty, Mary C
2017-08-01
Acute myeloid leukemia (AML) is frequently treated with induction and consolidation chemotherapy. Consolidation chemotherapy can be delivered on an ambulatory basis, requiring some patients to travel long distances for treatment at specialized centers. We developed a shared care model where patients receive consolidation chemotherapy at a quaternary center, but post-consolidation supportive care at local hospitals. To evaluate the impact of our model on patient travel and outcomes we conducted a retrospective analysis of AML and acute promyelocytic leukemia patients receiving consolidation over four years at our quaternary center. 73 patients received post-consolidation care locally, and 344 at the quaternary center. Gender, age and cytogenetic risk did not significantly differ between groups. Shared care patients saved mean round trip distance of 146.5km±99.6 and time of 96.7min±63.4 compared to travelling to quaternary center. There was no significant difference in overall survival between groups, and no increased hazard of death for shared care patients. 30, 60, and 90day survival from start of consolidation was 98.6%, 97.2%, and 95.9% for shared care and 98.8%, 97.1%, and 95.3% for quaternary center patients. Thus, a model utilizing regional partnerships for AML post-consolidation care reduces travel burden while maintaining safety. Copyright © 2017 Elsevier Ltd. All rights reserved.
Air versus ground transport of the major trauma patient: a natural experiment.
McVey, Jennifer; Petrie, David A; Tallon, John M
2010-01-01
1) To compare the outcomes of adult trauma patients transported to a level I trauma center by helicopter vs. ground ambulance. 2) To determine whether using a unique "natural experiment" design to obtain the ground comparison group will reduce potential confounders. Outcomes in adult trauma patients transported to a tertiary care trauma center by air were compared with outcomes in a group of patients who were accepted by the online medical control physician for air transport, but whose air missions were aborted for aviation reasons (weather, maintenance, out on a mission); these patients were subsequently transported by ground ambulance instead. Outcomes were also analyzed for a third ground control group composed of all other adult trauma patients transported by ground during this time period. Data were collected by retrospective database review of trauma patients transferred between July 1, 1997, and June 30, 2003. Outcomes were measured by Trauma Injury Severity Score (TRISS) analysis. Z and W scores were calculated. Three hundred ninety-seven missions were flown by LifeFlight during the study period vs. 57 in the clinical accept-aviation abort ground transport group. The mean ages, gender distributions, mechanisms of injury, and Injury Severity Scores (ISSs) were similar in the two groups. Per 100 patients transported, 5.61 more lives were saved in the air group vs. the clinical accept-aviation abort ground transport group (Z = 3.37). As per TRISS analysis, this is relative to the expected mortality seen with a similar group in the Major Trauma Outcomes Study (MTOS). The Z score for the clinical accept-aviation abort ground transport group was 0.4. The 1,195 patients in the third all-other ground control group had a higher mean age, lower mean ISS, and worse outcomes according to TRISS analysis (W = -2.02). This unique natural experiment led to better matched air vs. ground cohorts for comparison. As per TRISS analysis, air transport of the adult major trauma patient is associated with significantly improved survival as compared with ground transport.
Jasuja, S.; Gupta, A. K.; Choudhry, R.; Kher, V.; Aggarwal, D. K.; Mishra, A.; Agarwal, M.; Sarin, A.; Mishra, M. K.; Raina, V.
2009-01-01
Hepatitis C virus (HCV) infection in hemodialysis (HD) is a significant problem. We evaluated the prevalence and associations of HCV viremia in our HD patients. All patients undergoing maintenance HD at our center were tested for HCV RNA by PCR after written informed consent. Detailed history regarding age, sex, and duration of dialysis, frequency of dialysis, blood transfusions in one year, number of dialysis centers, dialyzer reuse/fresh use, and recent laboratory data was recorded. A total of 119 patients (77 males and 42 females) were tested for HCV RNA. Thirty three (27.7%) tested positive. Duration of dialysis was significantly longer in HCV RNA positive group (P = 0.001). 45.2% of patients with duration of dialysis more than 16 months were HCV RNA positive while only 7.4% of patients with dialysis duration ≤16 months were HCV RNA positive (P < 0.001). In univariate analysis, in HCV RNA group patients, ALT, AST, and GGTP were significantly elevated and albumin was significantly lower. 39% of patients who had dialysis at more than one center were HCV RNA positive as compared to 20% for patients undergoing dialysis at single center (P = 0.024). Binary logistic regression analysis showed albumin, duration of dialysis, and serum ALT to be significant variables. Sensitivity and specificity of anti-HCV ELISA was 72.7 and 97.7%, respectively. Prevalence of HCV RNA in the HD population is 27.7%. Duration of dialysis, getting dialysis at more than one center, elevated transaminase levels, and low serum albumin are important associations for HCV RNA positivity. PMID:20368926
Gottschalck, J.; Wheeler, M.; Weickmann, K.; ...
2010-09-01
The U.S. Climate Variability and Predictability (CLIVAR) MJO Working Group (MJOWG) has taken steps to promote the adoption of a uniform diagnostic and set of skill metrics for analyzing and assessing dynamical forecasts of the MJO. Here we describe the framework and initial implementation of the approach using real-time forecast data from multiple operational numerical weather prediction (NWP) centers. The objectives of this activity are to provide a means to i) quantitatively compare skill of MJO forecasts across operational centers, ii) measure gains in forecast skill over time by a given center and the community as a whole, and iii)more » facilitate the development of a multimodel forecast of the MJO. The MJO diagnostic is based on extensive deliberations among the MJOWG in conjunction with input from a number of operational centers and makes use of the MJO index of Wheeler and Hendon. This forecast activity has been endorsed by the Working Group on Numerical Experimentation (WGNE), the international body that fosters the development of atmospheric models for NWP and climate studies. The Climate Prediction Center (CPC) within the National Centers for Environmental Prediction (NCEP) is hosting the acquisition of the forecast data, application of the MJO diagnostic, and real-time display of the standardized forecasts. The activity has contributed to the production of 1–2-week operational outlooks at NCEP and activities at other centers. Further enhancements of the diagnostic's implementation, including more extensive analysis, comparison, illustration, and verification of the contributions from the participating centers, will increase the usefulness and application of these forecasts and potentially lead to more skillful predictions of the MJO and indirectly extratropical and other weather variability (e.g., tropical cyclones) influenced by the MJO. The purpose of this article is to inform the larger scientific and operational forecast communities of the MJOWG forecast effort and invite participation from additional operational centers.« less
Geometric analysis of root canals prepared by four rotary NiTi shaping systems.
Hashem, Ahmed Abdel Rahman; Ghoneim, Angie Galal; Lutfy, Reem Ahmed; Foda, Manar Yehia; Omar, Gihan Abdel Fatah
2012-07-01
A great number of nickel-titanium (NiTi) rotary systems with noncutting tips, different cross-sections, superior resistance to torsional fracture, varying tapers, and manufacturing method have been introduced to the market. The purpose of this study was to evaluate and compare the effect of 4 rotary NiTi preparation systems, Revo-S (RS; Micro-Mega, Besancon Cedex, France), Twisted file (TF; SybronEndo, Amersfoort, The Netherlands), ProFile GT Series X (GTX; Dentsply, Tulsa Dental Specialties, Tulsa, OK), and ProTaper (PT; Dentsply Maillefer, Ballaigues, Switzerland), on volumetric changes and transportation of curved root canals. Forty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 25° to 40° were divided according to the instrument used in canal preparation into 4 groups of 10 samples each: group RS, group TF, group GTX, and group PT. Canals were scanned using an i-CAT CBCT scanner (Imaging Science International, Hatfield, PA) before and after preparation to evaluate the volumetric changes. Root canal transportation and centering ratio were evaluated at 1.3, 2.6, 5.2, and 7.8 mm from the apex. The significance level was set at P ≤ .05. The PT system removed a significantly higher amount of dentin than the other systems (P = .025). At the 1.3-mm level, there was no significant difference in canal transportation and centering ratio among the groups. However, at the other levels, TF maintained the original canal curvature recording significantly the least degree of canal transportation as well as the highest mean centering ratio. The TF system showed superior shaping ability in curved canals. Revo-S and GTX were better than ProTaper regarding both canal transportation and centering ability. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Issues Related to Effects of New Maintenance Concept on AF Specialists Working in the Field
DOT National Transportation Integrated Search
1990-03-07
This working paper was prepared by the Transportation Systems Center, Operator : performance and Safety Analysis Division (DTS-45) for the Federal Aviation Ad : ministration. The paper provides initial thinking on groups of human resource issues : re...
Scientific computations section monthly report, November 1993
DOE Office of Scientific and Technical Information (OSTI.GOV)
Buckner, M.R.
1993-12-30
This progress report from the Savannah River Technology Center contains abstracts from papers from the computational modeling, applied statistics, applied physics, experimental thermal hydraulics, and packaging and transportation groups. Specific topics covered include: engineering modeling and process simulation, criticality methods and analysis, plutonium disposition.
Northridge, Mary E.; Schenkel, Andrew B.; Birenz, Shirley; Estrada, Ivette; Metcalf, Sara S.; Wolff, Mark S.
2017-01-01
To help eliminate reported racial/ethnic and socioeconomic inequities in oral health care, listening to the perspectives of racial/ethnic minority older adults on their experiences with dental school clinics is needed. The aim of this study was to examine the experiences of African American, Puerto Rican, and Dominican older adults who attend senior centers in upper Manhattan, New York City, regarding the care received at dental school clinics. Focus groups were conducted from 2013 to 2015 with 194 racial/ethnic minority men and women aged 50 years and older living in upper Manhattan. All of the 24 focus group sessions were digitally audiorecorded and transcribed for analysis. Groups conducted in Spanish were transcribed first in Spanish and then translated into English. Analysis of the transcripts was conducted using thematic content analysis. Seven subthemes were manifest in the data related to these adults’ positive experiences with dental school clinics: excellent outcomes and dentists, painless and safe treatment, affordable care, honest and reputable, benefits of student training, accepting and helpful, and recommended by family and friends. Negative experiences centered around four subthemes: multiple visits required for treatment, loss of interpersonal communication due to use of technology, inconvenient location, and perceived stigma with Medicaid. This study provided novel evidence of the largely positive experiences with dental schools of racial/ethnic minority senior center attendees. Interventions targeted at the organization and provider level, including organizational motivation, resources, staff attributes, climate, and teamwork plus payment programs and services, insurance and affordability, and provider- and system-level supports, may improve health care processes and patient experiences of care. PMID:29093140
Northridge, Mary E; Schenkel, Andrew B; Birenz, Shirley; Estrada, Ivette; Metcalf, Sara S; Wolff, Mark S
2017-11-01
To help eliminate reported racial/ethnic and socioeconomic inequities in oral health care, listening to the perspectives of racial/ethnic minority older adults on their experiences with dental school clinics is needed. The aim of this study was to examine the experiences of African American, Puerto Rican, and Dominican older adults who attend senior centers in upper Manhattan, New York City, regarding the care received at dental school clinics. Focus groups were conducted from 2013 to 2015 with 194 racial/ethnic minority men and women aged 50 years and older living in upper Manhattan. All of the 24 focus group sessions were digitally audiorecorded and transcribed for analysis. Groups conducted in Spanish were transcribed first in Spanish and then translated into English. Analysis of the transcripts was conducted using thematic content analysis. Seven subthemes were manifest in the data related to these adults' positive experiences with dental school clinics: excellent outcomes and dentists, painless and safe treatment, affordable care, honest and reputable, benefits of student training, accepting and helpful, and recommended by family and friends. Negative experiences centered around four subthemes: multiple visits required for treatment, loss of interpersonal communication due to use of technology, inconvenient location, and perceived stigma with Medicaid. This study provided novel evidence of the largely positive experiences with dental schools of racial/ethnic minority senior center attendees. Interventions targeted at the organization and provider level, including organizational motivation, resources, staff attributes, climate, and teamwork plus payment programs and services, insurance and affordability, and provider- and system-level supports, may improve health care processes and patient experiences of care.
Federated Giovanni: A Distributed Web Service for Analysis and Visualization of Remote Sensing Data
NASA Technical Reports Server (NTRS)
Lynnes, Chris
2014-01-01
The Geospatial Interactive Online Visualization and Analysis Interface (Giovanni) is a popular tool for users of the Goddard Earth Sciences Data and Information Services Center (GES DISC) and has been in use for over a decade. It provides a wide variety of algorithms and visualizations to explore large remote sensing datasets without having to download the data and without having to write readers and visualizers for it. Giovanni is now being extended to enable its capabilities at other data centers within the Earth Observing System Data and Information System (EOSDIS). This Federated Giovanni will allow four other data centers to add and maintain their data within Giovanni on behalf of their user community. Those data centers are the Physical Oceanography Distributed Active Archive Center (PO.DAAC), MODIS Adaptive Processing System (MODAPS), Ocean Biology Processing Group (OBPG), and Land Processes Distributed Active Archive Center (LP DAAC). Three tiers are supported: Tier 1 (GES DISC-hosted) gives the remote data center a data management interface to add and maintain data, which are provided through the Giovanni instance at the GES DISC. Tier 2 packages Giovanni up as a virtual machine for distribution to and deployment by the other data centers. Data variables are shared among data centers by sharing documents from the Solr database that underpins Giovanni's data management capabilities. However, each data center maintains their own instance of Giovanni, exposing the variables of most interest to their user community. Tier 3 is a Shared Source model, in which the data centers cooperate to extend the infrastructure by contributing source code.
Effects of Glide Path on the Centering Ability and Preparation Time of Two Reciprocating Instruments
Coelho, Marcelo Santos; Fontana, Carlos Eduardo; Kato, Augusto Shoji; de Martin, Alexandre Sigrist; da Silveira Bueno, Carlos Eduardo
2016-01-01
Introduction: The aim of this in vitro study was to evaluate the effects of establishing glide path on the centering ability and preparation time of two single-file reciprocating systems in mesial root canals of mandibular molars. Methods and Materials: Sixty extracted mandibular molars with curvatures of 25-39 degrees and separate foramina for the mesiobuccal and mesiolingual canals, were divided into four groups (n=15); WaveOne+glide path; WaveOne; Reciproc+glide path and Reciproc. Non-patent canals were excluded and only one canal in each tooth was instrumented. A manual glide path was established in first and third groups with #10, 15 and 20 hand K-files. Preparation was performed with reciprocating in-and-out motion, with a 3-4 mm amplitude and slight apical pressure. Initial and final radiographs were taken to analyze the amount of dentin removed in the instrumented canals. The radiographs were superimposed with an image editing software and examined to assess discrepancies at 3-, 6- and 9-mm distances from the apex. The Kruskal-Wallis test was used for statistical analysis. The level of significance was set at 0.05. Results: Preparation in groups without glide paths was swifter than the other groups (P=0.001). However, no difference was observed regarding centering ability. Conclusion: Establishing a glide path increased the total instrumentation time for preparing curved canals with WaveOne and Reciproc instruments. Glide path had no influence on the centering ability of these systems. PMID:26843875
Conveyor Performance based on Motor DC 12 Volt Eg-530ad-2f using K-Means Clustering
NASA Astrophysics Data System (ADS)
Arifin, Zaenal; Artini, Sri DP; Much Ibnu Subroto, Imam
2017-04-01
To produce goods in industry, a controlled tool to improve production is required. Separation process has become a part of production process. Separation process is carried out based on certain criteria to get optimum result. By knowing the characteristics performance of a controlled tools in separation process the optimum results is also possible to be obtained. Clustering analysis is popular method for clustering data into smaller segments. Clustering analysis is useful to divide a group of object into a k-group in which the member value of the group is homogeny or similar. Similarity in the group is set based on certain criteria. The work in this paper based on K-Means method to conduct clustering of loading in the performance of a conveyor driven by a dc motor 12 volt eg-530-2f. This technique gives a complete clustering data for a prototype of conveyor driven by dc motor to separate goods in term of height. The parameters involved are voltage, current, time of travelling. These parameters give two clusters namely optimal cluster with center of cluster 10.50 volt, 0.3 Ampere, 10.58 second, and unoptimal cluster with center of cluster 10.88 volt, 0.28 Ampere and 40.43 second.
Tagliaferri, Luca; Kovács, György; Autorino, Rosa; Budrukkar, Ashwini; Guinot, Jose Luis; Hildebrand, Guido; Johansson, Bengt; Monge, Rafael Martìnez; Meyer, Jens E; Niehoff, Peter; Rovirosa, Angeles; Takàcsi-Nagy, Zoltàn; Dinapoli, Nicola; Lanzotti, Vito; Damiani, Andrea; Soror, Tamer; Valentini, Vincenzo
2016-08-01
Aim of the COBRA (Consortium for Brachytherapy Data Analysis) project is to create a multicenter group (consortium) and a web-based system for standardized data collection. GEC-ESTRO (Groupe Européen de Curiethérapie - European Society for Radiotherapy & Oncology) Head and Neck (H&N) Working Group participated in the project and in the implementation of the consortium agreement, the ontology (data-set) and the necessary COBRA software services as well as the peer reviewing of the general anatomic site-specific COBRA protocol. The ontology was defined by a multicenter task-group. Eleven centers from 6 countries signed an agreement and the consortium approved the ontology. We identified 3 tiers for the data set: Registry (epidemiology analysis), Procedures (prediction models and DSS), and Research (radiomics). The COBRA-Storage System (C-SS) is not time-consuming as, thanks to the use of "brokers", data can be extracted directly from the single center's storage systems through a connection with "structured query language database" (SQL-DB), Microsoft Access(®), FileMaker Pro(®), or Microsoft Excel(®). The system is also structured to perform automatic archiving directly from the treatment planning system or afterloading machine. The architecture is based on the concept of "on-purpose data projection". The C-SS architecture is privacy protecting because it will never make visible data that could identify an individual patient. This C-SS can also benefit from the so called "distributed learning" approaches, in which data never leave the collecting institution, while learning algorithms and proposed predictive models are commonly shared. Setting up a consortium is a feasible and practicable tool in the creation of an international and multi-system data sharing system. COBRA C-SS seems to be well accepted by all involved parties, primarily because it does not influence the center's own data storing technologies, procedures, and habits. Furthermore, the method preserves the privacy of all patients.
Surveillance of home environment in children with atopic dermatitis: a questionnaire survey
Lee, Jung Hyun; Suh, Jungmin; Kim, Eun Hye; Cho, Joong Bum; Park, Hwa Young; Kim, Jihyun; Cheong, Hae Kwan
2012-01-01
Background The increasing prevalence of atopic dermatitis (AD) suggests a role for environmental factors in triggering a genetic predisposition in sufferers. Objective The purpose of this study was to investigate home environmental factors related to AD severity. Methods We conducted a questionnaire survey about the home environmental factors in 380 children from two daycare centers and the Samsung Medical Center outpatient clinic. AD was diagnosed by Hanifin and Rajka's criteria and its severity was assessed by the Severity Scoring of Atopic Dermatitis index. Children were divided into normal control group, mild AD group and severe AD group. Home environmental factors were compared among the three groups and were statistically analyzed using analysis of variance, Chi-square test, Fisher's exact test, and multiple logistic analysis. Results Indoor remodeling activities, such as painting (p = 0.004), floor covering (p = 0.001) and wallpaper changing (p = 0.002) were associated with severity of AD. Those in the severe AD group were more likely to live in an apartment (p < 0.001). Severe AD was observed more frequently when the monthly income of household (p = 0.027) and final educational status of mother (p = 0.001) were higher. Conclusion Some home environmental factors were associated with AD severity, but its causal relationship is not clear. Further research is needed to confirm these associations and to clarify whether they are causative. PMID:22348208
Prabhakar, Attiguppe R; Yavagal, Chandrashekar; Dixit, Kratika; Naik, Saraswathi V
2016-01-01
Primary root canals are considered to be most challenging due to their complex anatomy. "Wave one" and "one shape" are single-file systems with reciprocating and rotary motion respectively. The aim of this study was to evaluate and compare dentin thickness, centering ability, canal transportation, and instrumentation time of wave one and one shape files in primary root canals using a cone beam computed tomographic (CBCT) analysis. This is an experimental, in vitro study comparing the two groups. A total of 24 extracted human primary teeth with minimum 7 mm root length were included in the study. Cone beam computed tomographic images were taken before and after the instrumentation for each group. Dentin thickness, centering ability, canal transportation, and instrumentation times were evaluated for each group. A significant difference was found in instrumentation time and canal transportation measures between the two groups. Wave one showed less canal transportation as compared with one shape, and the mean instrumentation time of wave one was significantly less than one shape. Reciprocating single-file systems was found to be faster with much less procedural errors and can hence be recommended for shaping the root canals of primary teeth. How to cite this article: Prabhakar AR, Yavagal C, Dixit K, Naik SV. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-File Systems. Int J Clin Pediatr Dent 2016;9(1):45-49.
Soutome, Sakiko; Yanamoto, Souichi; Funahara, Madoka; Hasegawa, Takumi; Komori, Takahide; Oho, Takahiko; Umeda, Masahiro
2016-08-01
Post-operative pneumonia is a frequent and possibly fatal complication of esophagectomy and is likely caused by aspiration of oropharyngeal fluid that contains pathogenic micro-organisms. We conducted a multi-center retrospective study to investigate the preventive effect of oral health care on post-operative pneumonia among patients with esophageal cancer who underwent esophagectomy. A total of 280 patients underwent esophagectomy at three university hospitals. These patients were divided retrospectively into those who received pre-operative oral care from dentists and dental hygienists (oral care group; n = 173) and those who did not receive such care (control group; n = 107). We evaluated the correlations between the occurrence of post-operative pneumonia and 18 predictive variables (patient factors, tumor factors, treatment factors, and pre-operative oral care) using the χ(2) test and logistic regression analysis. The differences of mean hospital days and mortality rate in both groups were analyzed by the Student t-test. Age, post-operative dysphagia, and absence of pre-operative oral care were correlated significantly with post-operative pneumonia in the univariable analysis. Multivariable analysis revealed that diabetes mellitus, post-operative dysphagia, and the absence of pre-operative oral care were independent risk factors for post-operative pneumonia. The mean hospital stay and mortality rate did not differ between the oral care and control groups. Pre-operative oral care may be an effective and easy method to prevent post-operative pneumonia in patients who are undergoing esophagectomy.
Morgan, Paul L.; Farkas, George; Maczuga, Steve
2015-01-01
We used population-based, longitudinal data to investigate the relation between mathematics instructional practices used by 1st grade teachers in the U.S. and the mathematics achievement of their students. Factor analysis identified four types of instructional activities (i.e., teacher-directed, student-centered, manipulatives/calculators, movement/music) and eight types of specific skills taught (e.g., adding two-digit numbers). First-grade students were then classified into five groups on the basis of their fall and/or spring of kindergarten mathematics achievement—three groups with mathematics difficulties (MD) and two without MD. Regression analysis indicated that a higher percentage of MD students in 1st grade classrooms was associated with greater use by teachers of manipulatives/calculators and movement/music to teach mathematics. Yet follow-up analysis for each of the MD and non-MD groups indicated that only teacher-directed instruction was significantly associated with the achievement of students with MD (covariate-adjusted ESs = .05–.07). The largest predicted effect for a specific instructional practice was for routine practice and drill. In contrast, for both groups of non-MD students, teacher-directed and student-centered instruction had approximately equal, statistically significant positive predicted effects (covariate-adjusted ESs = .03–.04). First-grade teachers in the U.S. may need to increase their use of teacher-directed instruction if they are to raise the mathematics achievement of students with MD. PMID:26180268
Okamoto, Janet
2015-03-01
The past decade has seen dramatic shifts in the way that scientific research is conducted as networks, consortia, and large research centers are funded as transdisciplinary, team-based enterprises to tackle complex scientific questions. Key investigators (N = 167) involved in ten health disparities research centers completed a baseline social network and collaboration readiness survey. Collaborative ties existed primarily between investigators from the same center, with just 7 % of ties occurring across different centers. Grants and work groups were the most common types of ties between investigators, with shared presentations the most common tie across different centers. Transdisciplinary research orientation was associated with network position and reciprocity. Center directors/leaders were significantly more likely to form ties with investigators in other roles, such as statisticians and trainees. Understanding research collaboration networks can help to more effectively design and manage future team-based research, as well as pinpoint potential issues and continuous evaluation of existing efforts.
NASA Technical Reports Server (NTRS)
Roberts, Barry C.
2004-01-01
Supported Return-to-Flight activities by providing surface climate data from Kennedy Space Center used primarily for ice and dew formation studies, and upper air wind analysis primarily used for ascent loads analyses. The MSFC Environments Group's Terrestrial and Planetary Environments Team documented Space Shuttle day-of-launch support activities by publishing a document in support of SSP Return-to-Flight activities entitled "Space Shuttle Program Flight Operations Support". The team also formalized the Shuttle Natural Environments Technical Panel and chaired the first special session of the SSP Natural Environments Panel meeting at KSC, November 4-7,2003.58 participants from NASA, DOD and other government agencies from across the country attended the meeting.
Ferrari, Andrea; Rondelli, Roberto; Pession, Andrea; Mascarin, Maurizio; Buzzoni, Carlotta; Mosso, Maria Luisa; Maule, Milena; Barisone, Elena; Bertolotti, Marina; Clerici, Carlo Alfredo; Jankovic, Momcilo; Fagioli, Franca; Biondi, Andrea
2016-06-01
This analysis compared the numbers of patients treated at Italian pediatric oncology group (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP]) centers with the numbers of cases predicted according to the population-based registry. It considered 32,431 patients registered in the AIEOP database (1989-2012). The ratio of observed (O) to expected (E) cases was 0.79 for children (0-14 years old) and 0.15 for adolescents (15-19 years old). The proportion of adolescents increased significantly over the years, however, from 0.05 in the earliest period to 0.10, 0.18, and then 0.28 in the latest period of observation, suggesting a greater efficacy of local/national programs dedicated to adolescents. © 2016 Wiley Periodicals, Inc.
Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn
2014-01-01
Instrumented postural control analysis plays an important role in evaluating the effects of injury on dynamic stability during balance tasks, and is often conveyed with measures based on the displacement of the center-of-pressure (COP) assessed with a force platform. However, the desired outcome of the task is frequently characterized by a loss of dynamic stability, secondary to injury. Typically, these failed trials are discarded during research investigations, with the potential loss of informative data pertaining to task success. The novelty of the present study is that COP characteristics of failed trials in injured participants are compared to successful trial data in another injured group, and a control group of participants, using the fractal dimension (FD) method. Three groups of participants attempted a task of eyes closed single limb stance (SLS): twenty-nine participants with acute ankle sprain successfully completed the task on their non-injured limb (successful injury group); twenty eight participants with acute ankle sprain failed their attempt on their injured limb (failed injury group); sixteen participants with no current injury successfully completed the task on their non-dominant limb (successful non-injured group). Between trial analyses of these groups revealed significant differences in COP trajectory FD (successful injury group: 1.58±0.06; failed injury group: 1.54±0.07; successful non-injured group: 1.64±0.06) with a large effect size (0.27). These findings demonstrate that successful eyes-closed SLS is characterized by a larger FD of the COP path when compared to failed trials, and that injury causes a decrease in COP path FD. Copyright © 2014 Elsevier B.V. All rights reserved.
NASA Technical Reports Server (NTRS)
Grosveld, Ferdinand W.; Schiller, Noah H.; Cabell, Randolph H.
2011-01-01
Comet Enflow is a commercially available, high frequency vibroacoustic analysis software founded on Energy Finite Element Analysis (EFEA) and Energy Boundary Element Analysis (EBEA). Energy Finite Element Analysis (EFEA) was validated on a floor-equipped composite cylinder by comparing EFEA vibroacoustic response predictions with Statistical Energy Analysis (SEA) and experimental results. Statistical Energy Analysis (SEA) predictions were made using the commercial software program VA One 2009 from ESI Group. The frequency region of interest for this study covers the one-third octave bands with center frequencies from 100 Hz to 4000 Hz.
Profiles of Adolescent Religiousness using Latent Profile Analysis: Implications for Psychopathology
Longo, Gregory S.; Bray, Bethany; Kim-Spoon, Jungmeen
2017-01-01
Prior research has documented robust associations between adolescent religiousness/spirituality (R/S) and psychopathology outcomes including externalizing and internalizing symptomatology, yet no previous studies have examined these associations with adolescent R/S profiles using a person-centered approach. We examined if there are identifiable subgroups characterized by unique multidimensional patterns of R/S experiences and how these experiences may be related to externalizing and internalizing symptomatology. The sample consisted of 220 Appalachian adolescents between 12 and 18 years old who were primarily White and primarily Christian. Latent profile analysis revealed three profiles of adolescent R/S; high religiousness (28.4%), introjectors (47.6%), and low religiousness (24.0%). These profiles were differentially related to internalizing and externalizing symptomatology such that the high religiousness group was significantly lower than the introjectors with respect to internalizing and externalizing symptomatology and lower than the low religiousness group in externalizing symptomatology. Implications and suggestions for future research using person-centered approaches to better understand differential developmental trajectories of religious development are provided. PMID:28220955
Optical Fiber Assemblies for Space Flight from the NASA Goddard Space Flight Center, Photonics Group
NASA Technical Reports Server (NTRS)
Ott, Melanie N.; Thoma, William Joe; LaRocca, Frank; Chuska, Richard; Switzer, Robert; Day, Lance
2009-01-01
The Photonics Group at NASA Goddard Space Flight Center in the Electrical Engineering Division of the Advanced Engineering and Technologies Directorate has been involved in the design, development, characterization, qualification, manufacturing, integration and anomaly analysis of optical fiber subsystems for over a decade. The group supports a variety of instrumentation across NASA and outside entities that build flight systems. Among the projects currently supported are: The Lunar Reconnaissance Orbiter, the Mars Science Laboratory, the James Webb Space Telescope, the Express Logistics Carrier for the International Space Station and the NASA Electronic Parts. and Packaging Program. A collection of the most pertinent information gathered during project support over the past year in regards to space flight performance of optical fiber components is presented here. The objective is to provide guidance for future space flight designs of instrumentation and communication systems.
Bahremand, Mostafa; Alikhani, Mostafa; Zakiei, Ali; Janjani, Parisa; Aghaei, Abbas
2016-01-01
Application of psychological interventions is essential in classic treatments for patient with cardiac diseases. The present study compared cognitive emotion regulation strategies, positive affect, and negative affect for cardiac patients with healthy subjects. This study was a case-control study. Fifty subjects were selected using convenient sampling method from cardiac (coronary artery disease) patients presenting in Imam Ali medical center of Kermanshah, Iran in the spring 2013. Fifty subjects accompanied the patients to the medical center, selected as control group, did not have any history of cardiac diseases. For collecting data, the cognitive emotion regulation questionnaire and positive and negative affect scales were used. For data analysis, multivariate analysis of variance (MANOVA) was applied using the SPSS statistical software (ver. 19.0). In all cognitive emotion regulation strategies, there was a significant difference between the two groups. A significant difference was also detected regarding positive affect between the two groups, but no significant difference was found regarding negative affect. We found as a result that, having poor emotion regulation strategies is a risk factor for developing heart diseases. PMID:26234976
Bahremand, Mostafa; Alikhani, Mostafa; Zakiei, Ali; Janjani, Parisa; Aghei, Abbas
2015-05-17
Application of psychological interventions is essential in classic treatments for patient with cardiac diseases. The present study compared cognitive emotion regulation strategies, positive affect, and negative affect for cardiac patients with healthy subjects. This study was a case-control study. Fifty subjects were selected using convenient sampling method from cardiac (coronary artery disease) patients presenting in Imam Ali medical center of Kermanshah, Iran in the spring 2013. Fifty subjects accompanied the patients to the medical center, selected as control group, did not have any history of cardiac diseases. For collecting data, the cognitive emotion regulation questionnaire and positive and negative affect scales were used. For data analysis, multivariate analysis of variance (MANOVA) Was applied using the SPSS statistical software (ver. 19.0). In all cognitive emotion regulation strategies, there was a significant difference between the two groups. A significant difference was also detected regarding positive affect between the two groups, but no significant difference was found regarding negative affect. We found as a result that, having poor emotion regulation strategies is a risk factor for developing heart diseases.
Ackel‐D'Elia, Carolina; Vancini, Rodrigo Luiz; Castelo, Adauto; Nouailhetas, Viviane Louise Andrée; da Silva, Antonio Carlos
2010-01-01
OBJECTIVE: The aim of this study was to evaluate the occurrence of the well‐known predisposing factors and signs and symptoms usually associated with either overreaching or overtraining syndrome in physical fitness centers in São Paulo City, Brazil. METHOD: A questionnaire consisting of 13 question groups pertaining to either predisposing factors (1‐7) or signs and symptoms (8‐13) was given to 413 subjects. The general training schedule of the volunteers was characterized by workout sessions of 2.18 ± 0.04 h for a total of 11.0 ± 0.3 h/week for 33 ± 2 months independent of the type of exercise performed (walking, running, spinning, bodybuilding and stretching). A mean score was calculated ranging from 1 (completely absent) to 5 (severe) for each question group. A low occurrence was considered to be a question group score lower than 4, which was observed in all 13 question groups. RESULTS: The psychological evaluation by POMS Mood State Questionnaire indicated a normal non‐inverted iceberg. The hematological parameters, creatine kinase activity, cortisol, total testosterone and free testosterone concentrations were within the normal ranges for the majority of the volunteers selected for this analysis (n = 60). CONCLUSION: According to the questionnaire score analysis, no predisposing factors or signs and symptoms usually associated with either overreaching or overtraining were detected among the members of physical fitness centers in São Paulo City, Brazil. This observation was corroborated by the absence of any significant hematological or stress hormone level alterations in blood analyses of the majority of the selected volunteers (n = 60). PMID:21243291
Konietzko, Raffael; Frank, Luca; Maudanz, Nils; Binder, Johannes
2016-01-01
Interprofessional education (IPE) is receiving growing significance both nationally and internationally. Despite this, organizational and curricular changes are posing challenges. The level of need for IPE and how changes can be made to curricula and infrastructure were investigated at the University of Erlangen in Germany. The student working group for interprofessional teaching (AGIL) has turned its attention to these issues. This group is composed of students from medicine, dentistry, molecular medicine, medical technology and speech therapy. In June, 2015, a needs analysis was carried out among the students in the study programs represented in the working group to assess the actual and target situation concerning IPE (n=1,105). In the search for answers and to better measure any needs, contact was sought with instructors. The majority of students feel that they are insufficiently educated in terms of interprofessional skills. A large proportion of the students wish to see expansion of the IPE offerings. Students also expressed a desire for additional spaces and welcomed the idea of an interprofessional learning center. AGIL began establishing interprofessional electives in October 2015. A concept for an interprofessional learning center was developed. Based on the survey results, a need for improvements to curricula and infrastructure can be seen; however, the results are limited to the student point of view. AGIL would like to establish more interprofessional electives. These courses would then facilitate curricular implementation. Modern ideas about study environments could be applied to IPE, in particular to promote informal forms of learning. Contact with instructors was crucial for the project work and should be expanded. Realizing and financing the learning center in Erlangen are now the future goals of AGIL. The aim is to create a foundation for this purpose.
Varma, N K; Kushwaha, R; Beydoun, A; Williams, W J; Drury, I
1997-10-01
The purpose of this paper is to compare the morphological features of interictal epileptiform discharges (IED) in patients with benign epilepsy of childhood with centrotemporal spikes to IED of those with symptomatic localization related epilepsies using information theory. Three patients from each clinical group were selected. Two-second epochs centered at the peak negativity of the sharp waves were analyzed from a referential montage during stage I sleep. The epochs from the two groups were compared using parametric and information theory analysis. Information analysis determined the likelihood of correctly identifying the clinical group based on the IED. Standard parametric, morphological and spectral analyses were also performed. We found no significant difference in the morphology of the sharp wave between the two groups. The after-going slow wave contained the greatest information that separated the two groups. This result was supported by morphological and spectral differences in the after-going slow wave. Greater distinguishing information is held in the after-going slow wave than the sharp wave for the identification of clinical groups. Information analysis may assist in differentiating clinical syndromes from EEG signals.
Badaczewski, Adam; Bauman, Laurie J; Blank, Arthur E; Dreyer, Benard; Abrams, Mary Ann; Stein, Ruth E K; Roter, Debra L; Hossain, Jobayer; Byck, Hal; Sharif, Iman
2017-07-01
We proposed and tested a theoretical framework for how use of Teach-back could influence communication during the pediatric clinical encounter. Audio-taped pediatric primary care encounters with 44 children with asthma were coded using the Roter Interaction Analysis System to measure patient-centered communication and affective engagement of the parent. A newly created Teach-back Loop Score measured the extent to which Teach-back occurred during the clinical encounter; parental health literacy was measured by Newest Vital Sign. Logistic regression was used to test the relationship between Teach-back and features of communication. Focus groups held separately with clinicians and parents elicited perceptions of Teach-back usefulness. Teach-back was used in 39% of encounters. Visits with Teach-back had more patient centered communication (p=0.01). Adjusting for parent health literacy, parent age, and child age, Teach-back increased the odds of both patient centered communication [proportional AOR (95% CI)=4.97 (4.47-5.53)]and negative affect [AOR (95% CI)=5.39 (1.68-17.31)]. Focus group themes common to clinicians and parents included: Teach-back is effective, could cause discomfort, should be used with children, and nurses should use it. Teach-back was associated with more patient-centered communication and increased affective engagement of parents. Standardizing Teach-back use may strengthen patient-centered communication. Copyright © 2017 Elsevier B.V. All rights reserved.
Jo, Woo Lam; Lee, Woo Suk; Chae, Dong Sik; Yang, Ick Hwan; Lee, Kyoung Min; Koo, Kyung Hoi
2016-10-01
Subchondral insufficiency fracture (SIF) of the femoral head occurs in the elderly and recipients of organ transplantation. Osteoporosis and deficient lateral coverage of the acetabulum are known risk factors for SIF. There has been no study about relation between spinopelvic alignment and anterior acetabular coverage with SIF. We therefore asked whether a decrease of lumbar lordosis and a deficiency in the anterior acetabular coverage are risk factors. We investigated 37 patients with SIF. There were 33 women and 4 men, and their mean age was 71.5 years (59-85 years). These 37 patients were matched with 37 controls for gender, age, height, weight, body mass index and bone mineral density. We compared the lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope, acetabular index, acetabular roof angle, acetabular head index, anterior center-edge angle and lateral center-edge angle. Lumbar lordosis, pelvic tilt, sacral slope, lateral center edge angle, anterior center edge angle, acetabular index and acetabular head index were significantly different between SIF group and control group. Lumbar lordosis (OR = 1.11), lateral center edge angle (OR = 1.30) and anterior center edge angle (OR = 1.27) had significant associations in multivariate analysis. Decreased lumbar lordosis and deficient anterior coverage of the acetabulum are risk factors for SIF as well as decreased lateral coverage of the acetabulum.
Adjuvant mitotane treatment for adrenocortical carcinoma.
Terzolo, Massimo; Angeli, Alberto; Fassnacht, Martin; Daffara, Fulvia; Tauchmanova, Libuse; Conton, Pier Antonio; Rossetto, Ruth; Buci, Lisa; Sperone, Paola; Grossrubatscher, Erika; Reimondo, Giuseppe; Bollito, Enrico; Papotti, Mauro; Saeger, Wolfgang; Hahner, Stefanie; Koschker, Ann-Cathrin; Arvat, Emanuela; Ambrosi, Bruno; Loli, Paola; Lombardi, Gaetano; Mannelli, Massimo; Bruzzi, Paolo; Mantero, Franco; Allolio, Bruno; Dogliotti, Luigi; Berruti, Alfredo
2007-06-07
Adrenocortical carcinoma is a rare neoplasm characterized by a high risk of recurrence after radical resection. Whether the use of mitotane is beneficial as an adjuvant treatment has been controversial. Our aim was to evaluate the efficacy of adjuvant mitotane in prolonging recurrence-free survival. We performed a retrospective analysis involving 177 patients with adrenocortical cancer who had undergone radical surgery at 8 centers in Italy and 47 centers in Germany between 1985 and 2005. Adjuvant mitotane was administered to 47 Italian patients after radical surgery (mitotane group), whereas 55 Italian patients and 75 German patients (control groups 1 and 2, respectively) did not receive adjuvant treatment after surgery. Baseline features in the mitotane group and the control group from Italy were similar; the German patients were significantly older (P=0.03) and had more stage I or II adrenocortical carcinomas (P=0.02) than did patients in the mitotane group. Recurrence-free survival was significantly prolonged in the mitotane group, as compared with the two control groups (median recurrence-free survival, 42 months, as compared with 10 months in control group 1 and 25 months in control group 2). Hazard ratios for recurrence were 2.91 (95% confidence interval [CI], 1.77 to 4.78; P<0.001) and 1.97 (95% CI, 1.21 to 3.20; P=0.005), respectively. Multivariate analysis indicated that mitotane treatment had a significant advantage for recurrence-free survival. Adverse events associated with mitotane were mainly of grade 1 or 2, but temporary dose reduction was needed in 13% of patients. Adjuvant mitotane may prolong recurrence-free survival in patients with radically resected adrenocortical carcinoma. Copyright 2007 Massachusetts Medical Society.
Zhao, Peng-Fei; Zhou, Yue-Hua; Zhang, Jing; Wei, Wen-Bin
2017-09-20
Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with refractive amblyopia who underwent femtosecond laser-assisted LASIK (FS-LASIK). In this study, we included 56 eyes of 32 patients with refractive amblyopia who underwent FS-LASIK in our hospital from January 2012 to December 2016. Foveal (foveal center retinal, parafoveal retinal, and perifoveal), macular inner retinal (superior and inferior), and peripapillary RNFL thicknesses (superior, inferior, temporal, and nasal) were measured using Fourier-domain optical coherence tomography before surgery and 1 day, 3 days, and 1 week after surgery. We divided these patients into three groups based on their refractive error: High myopic group with 22 eyes (equivalent sphere, >6.00 D), mild myopic group with 19 eyes (equivalent sphere, 0-6.00 D), and hyperopic group with 15 eyes (equivalent sphere, >+0.50 D). We compared the macular retina and RNFL thickness before and after LASIK. A paired simple t-test was used for data analysis. One week after surgery, the visual acuity for all 56 eyes of the 32 patients reached their preoperative best-corrected vision. Visual acuity improved two lines or better for 31% of the patients. The residual refractive errors in 89% of the patients were within ±0.5 D. In the high myopic group, the foveal center retinal and parafoveal retinal thicknesses were thicker 1 day and 3 days after surgery than before surgery (t = 2.689, P = 0.012; t = 2.383, P = 0.018, respectively); no significant difference was found 1 week after surgery (P > 0.05). The foveal center retinal and parafoveal retinal thicknesses were greater 1 day after surgery than they were before surgery (P = 0.000 and P = 0.005, respectively) in the mild myopic and hyperopic groups. No significant difference was found 3 days or 1 week after surgery (P > 0.05). In all three groups, no significant difference was found in the macular inner retinal or peripapillary RNFL thickness 1 day, 3 days, or 1 week after surgery (P > 0.05). The foveal center retinal edema after FS-LASIK is mild and reversible in children, that mostly occurred in the high myopic group with no effect on the visual acuity, and is always relieved within 1 week.
Fernando, Julian W; Kashima, Yoshihisa; Laham, Simon M
2014-08-01
Although a great deal of research has investigated the relationship between emotions and action orientations, most studies to date have used variable-centered techniques to identify the best emotion predictor(s) of a particular action. Given that people frequently report multiple or blended emotions, a profitable area of research may be to adopt person-centered approaches to examine the action orientations elicited by a particular combination of emotions or "emotion profile." In two studies, across instances of intergroup inequality in Australia and Canada, we examined participants' experiences of six intergroup emotions: sympathy, anger directed at three targets, shame, and pride. In both studies, five groups of participants with similar emotion profiles were identified by cluster analysis and their action orientations were compared; clusters indicated that the majority of participants experienced multiple emotions. Each action orientation was also regressed on the six emotions. There were a number of differences in the results obtained from the person-centered and variable-centered approaches. This was most apparent for sympathy: the group of participants experiencing only sympathy showed little inclination to perform prosocial actions, yet sympathy was a significant predictor of numerous action orientations in regression analyses. These results imply that sympathy may only prompt a desire for action when experienced in combination with other emotions. We suggest that the use of person-centered and variable-centered approaches as complementary analytic strategies may enrich research into not only the affective predictors of action, but emotion research in general.
Institutional Variation in Traumatic Brain Injury Acute Rehabilitation Practice.
Seel, Ronald T; Barrett, Ryan S; Beaulieu, Cynthia L; Ryser, David K; Hammond, Flora M; Cullen, Nora; Garmoe, William; Sommerfeld, Teri; Corrigan, John D; Horn, Susan D
2015-08-01
To describe institutional variation in traumatic brain injury (TBI) inpatient rehabilitation program characteristics and evaluate to what extent patient factors and center effects explain how TBI inpatient rehabilitation services are delivered. Secondary analysis of a prospective, multicenter, cohort database. TBI inpatient rehabilitation programs. Patients with complicated mild, moderate, or severe TBI (N=2130). Not applicable. Mean minutes; number of treatment activities; use of groups in occupational therapy, physical therapy, speech therapy, therapeutic recreation, and psychology inpatient rehabilitation sessions; and weekly hours of treatment. A wide variation was observed between the 10 TBI programs, including census size, referral flow, payer mix, number of dedicated beds, clinician experience, and patient characteristics. At the centers with the longest weekday therapy sessions, the average session durations were 41.5 to 52.2 minutes. At centers with the shortest weekday sessions, the average session durations were approximately 30 minutes. The centers with the highest mean total weekday hours of occupational, physical, and speech therapies delivered twice as much therapy as the lowest center. Ordinary least-squares regression modeling found that center effects explained substantially more variance than patient factors for duration of therapy sessions, number of activities administered per session, use of group therapy, and amount of psychological services provided. This study provides preliminary evidence that there is significant institutional variation in rehabilitation practice and that center effects play a stronger role than patient factors in determining how TBI inpatient rehabilitation is delivered. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
the System Modeling & Geospatial Data Science Group in the Strategic Energy Analysis Center. Areas Publications Oliveira, R and Moreno, R. 2016. Harvesting, Integrating and Distributing Large Open Geospatial Datasets Using Free and Open-Source Software. Int. Arch. Photogramm. Remote Sens. Spatial Inf. Sci., XLI-B7
Lee, Alexander D; Szabo, Kaitlyn; McDowell, Kirstie; Granger, Sydney
2016-01-01
Introduction: A Canadian sports chiropractic research agenda has yet to be defined. The Delphi method can be utilized to achieve this purpose; however, the sample of experts who participate can influence the results. To better inform sample selection for future research agenda development, we set out to determine if differences in opinions about research priorities exist between chiropractors who have their sports specialty designation and those who do not. Methods: Fifteen sports clinical practice chiropractors who have their sports fellowship designation and fifteen without, were interviewed with a set of standardized questions about sports chiropractic research priorities. A centering resonance analysis and cluster analysis were conducted on the interview responses. Results: The two practitioner groups differed in their opinions about the type of research that they would like to see conducted, the research that would impact their clinical practice the most, and where they believed research was lacking. However, both groups were similar in their opinions about research collaborations. Conclusion: Sports clinical practice chiropractors, with their sports specialty designation and those without, differed in their opinions about sports chiropractic research priorities; however, they had similar opinions about research collaborations. These results suggest that it may be important to sample from both practitioner groups in future studies aimed at developing research agendas for chiropractic research in sport. PMID:28065995
The Effect of Cognitive Behavioral Therapy on Marital Quality among Women.
Shayan, Arezoo; Taravati, Masumeh; Garousian, Maryam; Babakhani, Narges; Faradmal, Javad; Masoumi, Seyedeh Zahra
2018-07-01
Marital quality reflects the individual's overall evaluation of marital relationship. The aim of study was examine the effect of cognitive behavioral counseling on marital quality among women. The experimental study was a randomized clinical trial with two groups, on 198 qualified women who referred to selected health care centers in Hamadan, Iran in 2016. The intervention participants attended four 90-minute sessions of cognitive behavioral counseling. Demographic information questionnaire and marital quality scale [Revised Dyadic Adjustment Scale (RDAS)] were completed by the two groups before and after the intervention. To perform the comparisons, t test, Chi-square test and Fisher's test, Logistic Regression and covariance analysis were used. Covariance analysis or change analysis were employed. Statistical analysis was done using SPSS Software, version 21.0. The significance level was set at 5% (P<0.05). According to the results of the present study, the mean age in the control group and the intervention group was 23.58 ± 7.54 and 35.04 ± 7.91 years old, respectively. Covariance analysis was utilized to examine the marital quality scores. In this analysis, after modification of the variables of age, marital quality score of agreement and satisfaction before the intervention, and income status, the total marital quality score experienced a significant change in all dimensions (P<0.05) and the mean scores increased remarkably. Moreover, according to the cut-off point of the dimensions, the scores of all dimensions increased remarkably and the proportion of individuals with high marital quality before and after the intervention changed significantly (P<0.05). Due to the role of sexual relations in stabilizing marriage, cognitive behavioral consultation was effective in improving marital quality especially after agreement and can be used in health care centers in order to improve the relationship between couples and reduce divorce rates (Registration number: IRCT201610209014N125). Copyright© by Royan Institute. All rights reserved.
Surgical center: challenges and strategies for nurses in managerial activities.
Martins, Fabiana Zerbieri; Dall'Agnoll, Clarice Maria
2017-02-23
Analyze the challenges and strategies of nurses performing managerial activities in a surgical center. Exploratory, descriptive study with a qualitative approach, involving six nurses by means of the Focus Group Technique, between April and August 2013. Data were submitted to thematic content analysis. The main challenges noted were deficiency of material resources, communication noise, adequacy of personnel downsizing, and relationships with the multidisciplinary team. Key strategies include construction of co-management spaces to promote integration among professionals, conflict resolution and exchange of knowledge. Managerial activities involve the promotion of dialogic moments to coordinate the different processes in the surgical center to provide inputs to expand safety and quality of services provided.
NASA Astrophysics Data System (ADS)
Zhao, Xin; Kastlunger, Georg; Stadler, Robert
2017-08-01
In our theoretical study where we combine a nonequilibrium Green's function approach with density functional theory we investigate branched compounds containing ferrocene moieties in both branches which, due to their metal centers, are designed to allow for asymmetry induced by local charging. In these compounds the ferrocene moieties are connected to pyridyl anchor groups either directly or via acetylenic spacers in a metaconnection, where we also compare our results with those obtained for the respective single-branched molecules with both meta- and paraconnections between the metal center and the anchors. We find a destructive quantum interference (DQI) feature in the transmission function slightly below the lowest unoccupied molecular orbital, which dominates the conductance even for the uncharged branched compound with spacer groups inserted. In an analysis based on mapping the structural characteristics of the range of molecules in our article onto tight-binding models, we identify the structural source of the DQI minimum as the through-space coupling between the pyridyl anchor groups. We also find that local charging in one of the branches changes the conductance only by about one order of magnitude, which we explain in terms of the spatial distributions of the relevant molecular orbitals for the branched compounds.
A Civilian/Military Trauma Institute: National Trauma Coordinating Center
2015-12-01
zip codes was used in “proximity to violence” analysis. Data were analyzed using SPSS (version 20.0, SPSS Inc., Chicago, IL). Multivariable linear...number of adverse events and serious events was not statistically higher in one group, the incidence of deep venous thrombosis (DVT) was statistically ...subjects the lack of statistical difference on multivariate analysis may be related to an underpowered sample size. It was recommended that the
Pre-clinical cognitive phenotypes for Alzheimer disease: a latent profile approach.
Hayden, Kathleen M; Kuchibhatla, Maragatha; Romero, Heather R; Plassman, Brenda L; Burke, James R; Browndyke, Jeffrey N; Welsh-Bohmer, Kathleen A
2014-11-01
Cognitive profiles for pre-clinical Alzheimer disease (AD) can be used to identify groups of individuals at risk for disease and better characterize pre-clinical disease. Profiles or patterns of performance as pre-clinical phenotypes may be more useful than individual test scores or measures of global decline. To evaluate patterns of cognitive performance in cognitively normal individuals to derive latent profiles associated with later onset of disease using a combination of factor analysis and latent profile analysis. The National Alzheimer Coordinating Centers collect data, including a battery of neuropsychological tests, from participants at 29 National Institute on Aging-funded Alzheimer Disease Centers across the United States. Prior factor analyses of this battery demonstrated a four-factor structure comprising memory, attention, language, and executive function. Factor scores from these analyses were used in a latent profile approach to characterize cognition among a group of cognitively normal participants (N = 3,911). Associations between latent profiles and disease outcomes an average of 3 years later were evaluated with multinomial regression models. Similar analyses were used to determine predictors of profile membership. Four groups were identified; each with distinct characteristics and significantly associated with later disease outcomes. Two groups were significantly associated with development of cognitive impairment. In post hoc analyses, both the Trail Making Test Part B, and a contrast score (Delayed Recall - Trails B), significantly predicted group membership and later cognitive impairment. Latent profile analysis is a useful method to evaluate patterns of cognition in large samples for the identification of preclinical AD phenotypes; comparable results, however, can be achieved with very sensitive tests and contrast scores. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
Analysis of Stability in Verbal Interaction Types of Science-Gifted Students
ERIC Educational Resources Information Center
Kim, Youngshin; Kim, Myunghee; Ha, Minsu; Lim, Soo-Min
2017-01-01
Science inquiry activities carried out in a small group are learner-centered activities operating under the premise of collaborative interaction between members through various types of communication and consultation in the process of resolving issues. The changes in the types of interactions in the three exploratory activities targeting…
Qualitative Collection Analysis: The Conspectus Methodology. SPEC Kit 151.
ERIC Educational Resources Information Center
Jakubs, Deborah
The introduction to this Systems and Procedures Exchange Center (SPEC) kit explains the Conspectus method, which was developed in 1980 by the Research Libraries Group (RLG) as a means of systematically and qualitatively evaluating large library collections. The discussion considers advantages and disadvantages of this tool, which evaluates past…
Center for the Built Environment: Research on Indoor Environmental Quality
Comfort System Speech Privacy Task Ambient Conditioning Team Space Design Study Thermal Comfort Automotive resulting from HVAC, building, and facade design decisions. Acoustical Analysis in Office Environments Using building energy. The Impact of Team Space Design on Collaboration Assessing individual and group worker
technique Wildlife and energy technology interactions Geothermal technology Education M.S., Certificate in . Estimate of the Geothermal Energy Resource in the Major Sedimentary Basins in the United States. Paper the Systems Modeling & Geospatial Data Science Group in the Strategic Energy Analysis Center
; Innovation Group in the Strategic Energy Analysis Center. Areas of Expertise Data Management Solutions Geothermal Data Repository and the Future of Geothermal Data. Paper presented at the 41st Workshop on Geothermal Reservoir Engineering (SGW 2016), Stanford, California, February 2016. NREL/CP-6A20-65967. Weers
@nrel.gov | 303-384-7315 Meghan Mooney is a member of the Geospatial Data Science team within the Systems Modeling & Geospatial Data Science Group in the Strategic Energy Analysis Center. Areas of Expertise and resiliency Education M.A., Geography, University of Denver B.S., Geographic Science, James Madison
DGIC Interconnection Insights | Distributed Generation Interconnection
Center and Energy Analysis Group. NREL researchers examined PV project data from more than 30,000 solar permission to operate. "This report represents the first data-driven evaluation of how PV deployment additional insights on the research effort and report findings, check out STAT Chat (the "Solar
Ethnicity, Denomination and Inequality.
ERIC Educational Resources Information Center
Greeley, Andrew M.
This report relies on a composite sample of 12 National Opinion Research Center surveys (with a total sample of 17,700) to trace out the basic outlines of the achievements of American denominational and ethnic groups. There are three fundamental questions addressed in this analysis: (1) whether there are inequalities of achievement among the…
Street Sex Work: Re/Constructing Discourse from Margin to Center
ERIC Educational Resources Information Center
McCracken, Jill Linnette
2009-01-01
Newspaper media create interpretations of marginalized groups that require rhetorical analysis so that we can better understand these representations. This article focuses on how newspaper articles create interpretations of sex work that affect both the marginalized and mainstream communities. My ethnographic case study argues that the material…
Sun, Xiaojie; Zhang, Nan; Liu, Kun; Li, Wen; Oksanen, Tuula; Shi, Lizheng
2014-01-01
To examine whether workplace social capital improved after implementing a workplace social capital intervention in community health centers in China. This study was conducted in 20 community health centers of similar size in Jinan of China during 2012-2013. Using the stratified site randomization, 10 centers were randomized into the intervention group; one center was excluded due to leadership change in final analyses. The baseline survey including 447 staff (response rate: 93.1%) was conducted in 2012, and followed by a six-month workplace social capital intervention, including team building courses for directors of community health centers, voluntarily public services, group psychological consultation, and outdoor training. The follow-up survey in July 2013 was responded to by 390 staff members (response rate: 86.9%). Workplace social capital was assessed with the translated and culturally adapted scale, divided into vertical and horizontal dimensions. The facility-level intervention effects were based on all baseline (n = 427) and follow-up (n = 377) respondents, except for Weibei respondents. We conducted a bivariate Difference-in-Difference analysis to estimate the facility-level intervention effects. No statistically significant intervention effects were observed at the center level; the intervention increased the facility-level workplace social capital, and its horizontal and vertical dimensions by 1.0 (p = 0.24), 0.4 (p = 0.46) and 0.8 (p = 0.16), respectively. The comprehensive intervention seemed to slightly improve workplace social capital in community health centers of urban China at the center level. High attrition rate limits any causal interpretation of the results. Further studies are warranted to test these findings.
Sun, Xiaojie; Zhang, Nan; Liu, Kun; Li, Wen; Oksanen, Tuula; Shi, Lizheng
2014-01-01
Objective To examine whether workplace social capital improved after implementing a workplace social capital intervention in community health centers in China. Methods This study was conducted in 20 community health centers of similar size in Jinan of China during 2012–2013. Using the stratified site randomization, 10 centers were randomized into the intervention group; one center was excluded due to leadership change in final analyses. The baseline survey including 447 staff (response rate: 93.1%) was conducted in 2012, and followed by a six-month workplace social capital intervention, including team building courses for directors of community health centers, voluntarily public services, group psychological consultation, and outdoor training. The follow-up survey in July 2013 was responded to by 390 staff members (response rate: 86.9%). Workplace social capital was assessed with the translated and culturally adapted scale, divided into vertical and horizontal dimensions. The facility-level intervention effects were based on all baseline (n = 427) and follow-up (n = 377) respondents, except for Weibei respondents. We conducted a bivariate Difference-in-Difference analysis to estimate the facility-level intervention effects. Results No statistically significant intervention effects were observed at the center level; the intervention increased the facility-level workplace social capital, and its horizontal and vertical dimensions by 1.0 (p = 0.24), 0.4 (p = 0.46) and 0.8 (p = 0.16), respectively. Conclusions The comprehensive intervention seemed to slightly improve workplace social capital in community health centers of urban China at the center level. High attrition rate limits any causal interpretation of the results. Further studies are warranted to test these findings. PMID:25503627
Schmitt, J F; Meline, T J
1990-12-01
We reviewed the 1983-1988 issues of six journals that frequently publish papers including specifically language-impaired (LI) subjects. A total of 92 research reports provided data for our review. The research reports included experimental studies, ex post facto studies, and intervention studies. These studies represent a broad spectrum of the theoretical and empirical foundations of knowledge regarding LI children. The analysis of the published research centered on subject descriptions and the use of control groups. A descriptive analysis of the data showed few consistent trends among the studies with respect to subject selection, subject description, and the number and types of control groups. We discuss the importance of more complete subject descriptions in studies of LI children as well as the importance of the choice of matching criteria for control groups in between-subjects designs.
Ashong, Chester N.; Hunter, Andrew S.; Mansouri, M. David; Cadle, Richard M.; Hamill, Richard J.; Musher, Daniel M.
2017-01-01
Objectives: The primary objective of this study was to examine the appropriateness of candidemia management at a Veterans Affairs Medical Center as recommended by the 2009 Infectious Diseases Society of America (IDSA) guidelines for treatment of Candida infections. Methods: A retrospective analysis of 94 adult patients with blood cultures positive for Candida spp. was performed. Patients were stratified by severity of disease into two groups: non-neutropenic, mild-moderate disease (Group 1, n = 54, 56%) and non-neutropenic, moderate-severe disease (Group 2, n = 40, 42%). Results: Adherence to the IDSA recommendations for recommended antifungal drug, dose, and duration of therapy was low in both groups (16.7% in Group 1 and 17.5% in Group 2). Although adherence was not associated with higher clinical resolution of infection (P = 0.111), it was associated with a significantly lower mortality rate (P = 0.001) when compared to variance from the guidelines at 6 weeks. Conclusion: Although adherence to published guidelines for treating patients with candidemia was suboptimal at our institution, patients that were managed based on the guidelines had a statistically lower mortality rate. PMID:28936146
Takeda, Kenta; Mani, Hiroki; Hasegawa, Naoya; Sato, Yuki; Tanaka, Shintaro; Maejima, Hiroshi; Asaka, Tadayoshi
2017-07-19
The benefit of visual feedback of the center of pressure (COP) on quiet standing is still debatable. This study aimed to investigate the adaptation effects of visual feedback training using both the COP and center of gravity (COG) during quiet standing. Thirty-four healthy young adults were divided into three groups randomly (COP + COG, COP, and control groups). A force plate was used to calculate the coordinates of the COP in the anteroposterior (COP AP ) and mediolateral (COP ML ) directions. A motion analysis system was used to calculate the coordinates of the center of mass (COM) in both directions (COM AP and COM ML ). The coordinates of the COG in the AP direction (COG AP ) were obtained from the force plate signals. Augmented visual feedback was presented on a screen in the form of fluctuation circles in the vertical direction that moved upward as the COP AP and/or COG AP moved forward and vice versa. The COP + COG group received the real-time COP AP and COG AP feedback simultaneously, whereas the COP group received the real-time COP AP feedback only. The control group received no visual feedback. In the training session, the COP + COG group was required to maintain an even distance between the COP AP and COG AP and reduce the COG AP fluctuation, whereas the COP group was required to reduce the COP AP fluctuation while standing on a foam pad. In test sessions, participants were instructed to keep their standing posture as quiet as possible on the foam pad before (pre-session) and after (post-session) the training sessions. In the post-session, the velocity and root mean square of COM AP in the COP + COG group were lower than those in the control group. In addition, the absolute value of the sum of the COP - COM distances in the COP + COG group was lower than that in the COP group. Furthermore, positive correlations were found between the COM AP velocity and COP - COM parameters. The results suggest that the novel visual feedback training that incorporates the COP AP -COG AP interaction reduces postural sway better than the training using the COP AP alone during quiet standing. That is, even COP AP fluctuation around the COG AP would be effective in reducing the COM AP velocity.
Using a pattern-centered approach to assess sexual risk-taking in study abroad students.
Marcantonio, Tiffany; Angelone, D J; Sledjeski, Eve
2016-01-01
The purpose of this study was to examine the impact of several potential factors related to sexually risky behaviors in study abroad students. The authors utilized a pattern-centered analysis to identify specific groups that can be targeted for intervention. The sample consisted of 173 students who studied abroad in a variety of international locations for an average of 4 months. Participants completed questionnaires informed by the Triandis Theory of Interpersonal Behavior that have been predictive of risky sex in traditional traveling environments. The analyses revealed 3 different pathways for risky sexual behavior: Environmental involvement, historical condom use, and intentions to engage in risky sex. These findings can be used for identification of specific high-risk groups of students who can be targeted for predeparture prevention programs.
Duchesne, Juan C; Simmons, Jon D; Schmieg, Robert E; McSwain, Norman E; Bellows, Charles F
2008-12-01
Although splenic angioembolization (SAE) has been introduced and adopted in many trauma centers, the appropriate selection for and utility of SAE in trauma patients remains under debate. This study examined the outcomes of proximal SAE as part of a management algorithm for adult traumatic splenic injury compared with splenectomy. A retrospective cohort analysis was performed on all hemodynamically stable (HDS) blunt trauma patients with isolated splenic injury and computed tomographic (CT) evidence of active contrast extravasation that presented to a level 1 Trauma Center over a period of 5 years. The cohorts were defined by two separate 30 month periods and included 78 patients seen before (group I) and 76 patients seen after (group II) the introduction of an institutional SAE protocol. Demographics, splenic injury grade, and outcomes of the two groups were compared using Student's t test, or chi2 test. Analysis was by intention-to-treat. Six hundred eighty-two patients with blunt splenic injury were identified; 154 patients (29%) were HDS with CT evidence of active contrast extravasation. Group I (n = 78) was treated with splenectomy and group II (n = 76) was treated with proximal SAE. There was no difference in age (33 +/- 14 vs. 37 +/- 17 years), Injury Severity Score (31 +/- 13 vs. 29 +/- 11), or mortality (18% vs. 15%) between the two groups. However, the incidence of Adult Respiratory Distress Syndrome (ARDS) was 4-fold higher in those patients that underwent proximal SAE compared with those that underwent splenectomy (22% vs. 5%, p = 0.002). Twenty two patients failed nonoperative management (NOM) after SAE. This failure appeared to be directly related to the grade of splenic organ injury (grade I and II: 0%; grade III: 24%; grade IV: 53%; and grade V: 100%). Introduction of proximal SAE in NOM of HDS splenic trauma patients with active extravasation did not alter mortality rates at a Level 1 Trauma Center. Increased incidence of ARDS and association of failure of NOM with higher splenic organ injury score identify areas for cautionary application of proximal SAE in the more severely injured trauma patient population. Better patient selection guidelines for proximal SAE are needed. Without these guidelines, outcomes from SAE will still lack transparency.
Gergi, Richard; Rjeily, Joe Abou; Sader, Joseph; Naaman, Alfred
2010-05-01
The purpose of this study was to compare canal transportation and centering ability of 2 rotary nickel-titanium (NiTi) systems (Twisted Files [TF] and Pathfile-ProTaper [PP]) with conventional stainless steel K-files. Ninety root canals with severe curvature and short radius were selected. Canals were divided randomly into 3 groups of 30 each. After preparation with TF, PP, and stainless steel files, the amount of transportation that occurred was assessed by using computed tomography. Three sections from apical, mid-root, and coronal levels of the canal were recorded. Amount of transportation and centering ability were assessed. The 3 groups were statistically compared with analysis of variance and Tukey honestly significant difference test. Less transportation and better centering ability occurred with TF rotary instruments (P < .0001). K-files showed the highest transportation followed by PP system. PP system showed significant transportation when compared with TF (P < .0001). The TF system was found to be the best for all variables measured in this study. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Transplantation of spinal cord-derived neural stem cells for ALS: Analysis of phase 1 and 2 trials.
Glass, Jonathan D; Hertzberg, Vicki S; Boulis, Nicholas M; Riley, Jonathan; Federici, Thais; Polak, Meraida; Bordeau, Jane; Fournier, Christina; Johe, Karl; Hazel, Tom; Cudkowicz, Merit; Atassi, Nazem; Borges, Lawrence F; Rutkove, Seward B; Duell, Jayna; Patil, Parag G; Goutman, Stephen A; Feldman, Eva L
2016-07-26
To test the safety of spinal cord transplantation of human stem cells in patients with amyotrophic lateral sclerosis (ALS) with escalating doses and expansion of the trial to multiple clinical centers. This open-label trial included 15 participants at 3 academic centers divided into 5 treatment groups receiving increasing doses of stem cells by increasing numbers of cells/injection and increasing numbers of injections. All participants received bilateral injections into the cervical spinal cord (C3-C5). The final group received injections into both the lumbar (L2-L4) and cervical cord through 2 separate surgical procedures. Participants were assessed for adverse events and progression of disease, as measured by the ALS Functional Rating Scale-Revised, forced vital capacity, and quantitative measures of strength. Statistical analysis focused on the slopes of decline of these phase 2 trial participants alone or in combination with the phase 1 participants (previously reported), comparing these groups to 3 separate historical control groups. Adverse events were mostly related to transient pain associated with surgery and to side effects of immunosuppressant medications. There was one incident of acute postoperative deterioration in neurologic function and another incident of a central pain syndrome. We could not discern differences in surgical outcomes between surgeons. Comparisons of the slopes of decline with the 3 separate historical control groups showed no differences in mean rates of progression. Intraspinal transplantation of human spinal cord-derived neural stem cells can be safely accomplished at high doses, including successive lumbar and cervical procedures. The procedure can be expanded safely to multiple surgical centers. This study provides Class IV evidence that for patients with ALS, spinal cord transplantation of human stem cells can be safely accomplished and does not accelerate the progression of the disease. This study lacks the precision to exclude important benefit or safety issues. © 2016 American Academy of Neurology.
PSI-Center Final Progress Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jarboe, Thomas R.; Shumlak, Uri; Sovinec, Carl
This is the Final Progress Report of the Plasma Science and Innovation Center (PSI-Center) covering March 2014 through February 2017. The Center has accomplished a great deal during this period. The PSI-Center is organized into four groups: Edge and Dynamic Neutrals; Transport and Kinetic Effects; Equilibrium, Stability, and Kinetic Effects in 3D Topologies; and Interface for Validation. Each group has made good progress and the results from each group are given in detail.
NASA Astrophysics Data System (ADS)
Luna, Aderval S.; da Silva, Arnaldo P.; Pinho, Jéssica S. A.; Ferré, Joan; Boqué, Ricard
Near infrared (NIR) spectroscopy and multivariate classification were applied to discriminate soybean oil samples into non-transgenic and transgenic. Principal Component Analysis (PCA) was applied to extract relevant features from the spectral data and to remove the anomalous samples. The best results were obtained when with Support Vectors Machine-Discriminant Analysis (SVM-DA) and Partial Least Squares-Discriminant Analysis (PLS-DA) after mean centering plus multiplicative scatter correction. For SVM-DA the percentage of successful classification was 100% for the training group and 100% and 90% in validation group for non transgenic and transgenic soybean oil samples respectively. For PLS-DA the percentage of successful classification was 95% and 100% in training group for non transgenic and transgenic soybean oil samples respectively and 100% and 80% in validation group for non transgenic and transgenic respectively. The results demonstrate that NIR spectroscopy can provide a rapid, nondestructive and reliable method to distinguish non-transgenic and transgenic soybean oils.
The NGC 4839 group falling into the Coma cluster observed by XMM-Newton
NASA Astrophysics Data System (ADS)
Neumann, D. M.; Arnaud, M.; Gastaud, R.; Aghanim, N.; Lumb, D.; Briel, U. G.; Vestrand, W. T.; Stewart, G. C.; Molendi, S.; Mittaz, J. P. D.
2001-01-01
We present here the first analysis of the XMM-Newton EPIC-MOS data of the galaxy group around NGC 4839, which lies at a projected distance to the Coma cluster center of 1.6h50-1 Mpc. In our analysis, which includes imaging, spectro-imaging and spectroscopy we find compelling evidence for the sub group being on its first infall onto the Coma cluster. The complex temperature structure around NGC 4839 is consistent with simulations of galaxies falling into a cluster environment. We see indications of a bow shock and of ram pressure stripping around NGC 4839. Furthermore our data reveal a displacement between NGC 4839 and the center of the hot gas in the group of about 300h50-1 kpc. With a simple approximation we can explain this displacement by the pressure force originating from the infall, which acts much stronger on the group gas than on the galaxies. Based on observations obtained with XMM-Newton, an ESA science mission with instruments and contributions directly funded by ESA Member States and the USA (NASA). EPIC was developed by the EPIC Consortium led by the Principal Investigator, Dr. M. J. L. Turner. The consortium comprises the following Institutes: University of Leicester, University of Birmingham, (UK); CEA/Saclay, IAS Orsay, CESR Toulouse, (France); IAAP Tuebingen, MPE Garching, (Germany); IFC Milan, ITESRE Bologna, IAUP Palermo, Italy. EPIC is funded by: PPARC, CEA, CNES, DLR and ASI.
Annual Research Briefs, 2004: Center for Turbulence Research
NASA Technical Reports Server (NTRS)
Moin, Parviz; Mansour, Nagi N.
2004-01-01
This report contains the 2004 annual progress reports of the Research Fellows and students of the Center for Turbulence Research in its eighteenth year of operation. Since its inception in 1987, the objective of the CTR has been to advance the physical understanding of turbulent flows and development of physics based predictive tools for engineering analysis and turbulence control. Turbulence is ubiquitous in nature and in engineering devices. The studies at CTR have been motivated by applications where turbulence effects are significant; these include a broad range of technical areas such as planetary boundary layers, formation of planets, solar convection, magnetohydrodynamics, environmental and eco systems, aerodynamic noise, propulsion systems and high speed transportation. Numerical simulation has been the predominant research tool at CTR which has required a critical mass of researchers in numerical analysis and computer science in addition to core disciplines such as applied mathematics, chemical kinetics and fluid mechanics. Maintaining and promoting this interdisciplinary culture has been a hallmark of CTR and has been responsible for the realization of the results of its basic research in applications. The first group of reports in this volume are directed towards development, analysis and application of novel numerical methods for ow simulations. Development of methods for large eddy simulation of complex flows has been a central theme in this group. The second group is concerned with turbulent combustion, scalar transport and multi-phase ows. The nal group is devoted to geophysical turbulence where the problem of solar convection has been a new focus of considerable attention recently at CTR.
Prabhakar, Attiguppe R; Yavagal, Chandrashekar; Naik, Saraswathi V
2016-01-01
ABSTRACT Background: Primary root canals are considered to be most challenging due to their complex anatomy. "Wave one" and "one shape" are single-file systems with reciprocating and rotary motion respectively. The aim of this study was to evaluate and compare dentin thickness, centering ability, canal transportation, and instrumentation time of wave one and one shape files in primary root canals using a cone beam computed tomographic (CBCT) analysis. Study design: This is an experimental, in vitro study comparing the two groups. Materials and methods: A total of 24 extracted human primary teeth with minimum 7 mm root length were included in the study. Cone beam computed tomographic images were taken before and after the instrumentation for each group. Dentin thickness, centering ability, canal transportation, and instrumentation times were evaluated for each group. Results: A significant difference was found in instrumentation time and canal transportation measures between the two groups. Wave one showed less canal transportation as compared with one shape, and the mean instrumentation time of wave one was significantly less than one shape. Conclusion: Reciprocating single-file systems was found to be faster with much less procedural errors and can hence be recommended for shaping the root canals of primary teeth. How to cite this article: Prabhakar AR, Yavagal C, Dixit K, Naik SV. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-File Systems. Int J Clin Pediatr Dent 2016;9(1):45-49. PMID:27274155
Pros and cons of practice-owned and office-based ambulatory surgery centers.
Bert, J M
2000-01-01
A detailed feasibility analysis is imperative to ensure the success of a practice-owned ASC. Analysis of the payer mix and the market relating to surgical volume that can be performed at the ASC is imperative. If overbuilding, overequipping, and overstaffing are avoided and the group has adequate volume that can be managed at the ASC, the facility should be a success. Building a practice-owned ASC without an accurate and detailed financial feasibility and payer study can place the endeavor at risk. A well-planned, economically constructed and properly managed ASC will result in an efficient and successful ancillary service for the orthopedic group practice.
Towards a cultural adaptation of family psychoeducation: findings from three latino focus groups.
Hackethal, Veronica; Spiegel, Scott; Lewis-Fernández, Roberto; Kealey, Edith; Salerno, Anthony; Finnerty, Molly
2013-10-01
This study was undertaken among Latinos receiving treatment from a community mental health center in New York City. The primary mental health concern was schizophrenia. We conducted three focus groups and present the viewpoints of consumers, family members, and providers. Using qualitative content analysis we identified four predominant categories: (1) the importance of family ties; (2) stigma about mental illness; (3) respect and trust in interpersonal relationships; and (4) facilitators and barriers to implementing Family Psychoeducation. Analysis of transcripts revealed specific subthemes for each category. Implications for imparting culturally sensitive material into mental health services for Latinos are discussed.
Formica, Richard N; Barrantes, Fidel; Asch, William S; Bia, Margaret J; Coca, Steven; Kalyesubula, Robert; McCloskey, Barbara; Leary, Tucker; Arvelakis, Antonios; Kulkarni, Sanjay
2012-08-01
Waiting time for a kidney transplant is calculated from the date the patient is placed on the UNOS (United Network for Organ Sharing) waitlist to the date the patient undergoes transplant. Time from transplant evaluation to listing represents unaccounted waiting time, potentially resulting in longer dialysis exposure for some patients with prolonged evaluation times. There are established disparities demonstrating that groups of patients take longer to be placed on the waitlist and thus have less access to kidney transplant. Quality improvement report. 905 patients from a university-based hospital were evaluated for kidney transplant candidacy, and analysis was performed from July 1, 2004, to January 31, 2010. A 1-day centralized work-up was implemented on July 1, 2007, whereby the transplant center coordinated the necessary tests needed to fulfill minimal listing criteria. Time from evaluation to UNOS listing was compared between the 2 cohorts. Multivariable Cox proportional hazards models were created to assess the relative hazards of waitlist placement comparing 1-day versus conventional work-up and were adjusted for age, sex, race, and education. Of 905 patients analyzed, 378 underwent conventional evaluation and 527 underwent a 1-day center-coordinated evaluation. Median time to listing in the 1-day center-coordinated evaluation compared with conventional was significantly less (46 vs 226 days, P < 0.001). On multivariable analysis controlling for age, sex, and education level, the 1-day in-center group was 3 times more likely to place patients on the wait list (adjusted HR, 3.08; 95% CI, 2.64-3.59). Listing time was significantly decreased across race, sex, education, and ethnicity. Single center, retrospective. Variables that may influence transplant practitioners, such as comorbid conditions or functional status, were not assessed. A 1-day center-coordinated pretransplant work-up model significantly decreased time to listing for kidney transplant. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Siddharthan, Trishul; Rabin, Tracy; Canavan, Maureen E; Nassali, Faith; Kirchhoff, Phillip; Kalyesubula, Robert; Coca, Steven; Rastegar, Asghar; Knauf, Felix
2016-01-01
The majority of non-communicable disease related deaths occur in low- and middle-income countries. Patient-centered care is an essential component of chronic disease management in high income settings. To examine feasibility of implementation of a validated patient-centered education tool among patients with heart failure in Uganda. Mixed-methods, prospective cohort. A private and public cardiology clinic in Mulago National Referral and Teaching Hospital, Kampala, Uganda. Adults with a primary diagnosis of heart failure. PocketDoktor Educational Booklets with patient-centered health education. The primary outcomes were the change in Patient Activation Measure (PAM-13), as well as the acceptability of the PocketDoktor intervention, and feasibility of implementing patient-centered education in outpatient clinical settings. Secondary outcomes included the change in satisfaction with overall clinical care and doctor-patient communication. A total of 105 participants were enrolled at two different clinics: the Mulago Outpatient Department (public) and the Uganda Heart Institute (private). 93 participants completed follow up at 3 months and were included in analysis. The primary analysis showed improved patient activation measure scores regarding disease-specific knowledge, treatment options and prevention of exacerbations among both groups (mean change 0.94 [SD = 1.01], 1.02 [SD = 1.15], and 0.92 [SD = 0.89] among private paying patients and 1.98 [SD = 0.98], 1.93 [SD = 1.02], and 1.45 [SD = 1.02] among public paying patients, p<0.001 for all values) after exposure to the intervention; this effect was significantly larger among indigent patients. Participants reported that materials were easy to read, that they had improved knowledge of disease, and stated improved communication with physicians. Patient-centered medical education can improve confidence in self-management as well as satisfaction with doctor-patient communication and overall care in Uganda. Our results show that printed booklets are locally appropriate, highly acceptable and feasible to implement in an LMIC outpatient setting across socioeconomic groups.
2013-10-01
correct group assignment of samples in unsupervised hierarchical clustering by the Unweighted Pair-Group Method using Arithmetic averages ( UPGMA ) based on...centering of log2 transformed MAS5.0 signal values; probe set clustering was performed by the UPGMA method using Cosine correlation as the similarity met...A) The 108 differentially-regulated genes identified were subjected to unsupervised hierarchical clustering analysis using the UPGMA algorithm with
Sex expression and floral diversity in Jatropha curcas: a population study in its center of origin
Adriano-Anaya, María de Lourdes; Pérez-Castillo, Edilma; Salvador-Figueroa, Miguel; Ruiz-González, Sonia; Vázquez-Ovando, Alfredo; Grajales-Conesa, Julieta
2016-01-01
Sex expression and floral morphology studies are central to understand breeding behavior and to define the productive potential of plant genotypes. In particular, the new bioenergy crop Jatropha curcas L. has been classified as a monoecious species. Nonetheless, there is no information about its reproductive diversity in the Mesoamerican region, which is considered its center of origin and diversification. Thus, we determined sex expression and floral morphology in J. curcas populations from southern Mexico and Guatemala. Our results showed that most of J. curcas specimens had typical inflorescences with separate sexes (monoecious); meanwhile, the rest were atypical (gynoecious, androecious, andromonoecious, androgynomonoecious). The most important variables to group these populations, based on a discriminant analysis, were: male flower diameter, female petal length and male nectary length. From southern Mexico “Guerrero” was the most diverse population, and “Centro” had the highest variability among the populations from Chiapas. A cluster analysis showed that the accessions from southern Mexico were grouped without showing any correlation with the geographical origin, while those accessions with atypical sexuality were grouped together. To answer the question of how informative are floral morphological traits compared to molecular markers, we perform a Mantel correlation test between the distance matrix generated in this study and the genetic distance matrix (AFLP) previously reported for the same accessions. We found significant correlation between data at the level of accessions. Our results contribute to design genetic improvement programs by using sexually and morphologically contrasting plants from the center of origin. PMID:27257548
Financing of certified centers: a willingness-to-pay analysis.
Thiel, Falk C; Scharl, Anton; Hildebrandt, Thomas; Kotziabassis, Efstratios; Schrauder, Michael G; Bani, Mayada R; Müller, Andreas; Hauzenberger, Tanja; Loehberg, Christian R; Jud, Sebastian M; Fasching, Peter A; Hartmann, Arndt; Schulz-Wendtland, Rüdiger; Strnad, Vratislav; Beckmann, Matthias W; Lux, Michael Patrick
2013-03-01
Although care in certified breast centers is now established throughout Germany, numerous services are still not being reimbursed. This also affects other centers involved in the specialty of gynecology such as gynecological cancer centers, perinatal centers, and endometriosis centers. Although a certified center is entitled to charge additional fees, these are in most cases not reimbursed. Calculation of additional costs is limited by the fact that data from the Institute for the Hospital Reimbursement System (Institut für das Entgeltsystem im Krankenhaus, InEK) do not reflect interdisciplinary services and procedures. For decision-makers, society's willingness to pay is an important factor in guiding decisions on the basis of social priorities. A hypothetical maximum willingness to pay can be calculated using a willingness-to-pay analysis, making it possible to identify deficiencies in the arbitrary setting of health budgets at the macro-level. In a multicenter study conducted between November 2009 and December 2010, 2,469 patients at a university hospital and at a non-university hospital were asked about the extent of their awareness of certified centers, the influence of centers on hospital presentation, and about personal attitudes toward quality-oriented reimbursement. A subjective assessment of possible additional charges was calculated using a willingness-to-pay analysis. In the overall group, 53.4 % of the patients were aware of what a certified center is and 27.4 % had specific information (obstetrics 40.0/32.3 %; mastology 66.8/23.2 %; gynecological oncology 54.7/27.3 %; P < 0.001). For 43.8 %, a certified center was one reason or the major reason for presentation (obstetrics 26.2 %; mastology 66.8 %; gynecological oncology 46.6 %; P < 0.001). A total of 72.6 % were in favor of quality-oriented reimbursement and 69.7 % were in favor of an additional charge for a certified center amounting to €538.56 (mastology €643.65, obstetrics €474.67, gynecological oncology €532.47). In all, 33.9 % would accept an increase in health-insurance fees (averaging 0.3865 %), and 28.3 % were in favor of reduced remuneration for non-certified centers. The existence of certified centers is being increasingly recognized by patients. Additional charges for certified centers are generally supported. There is therefore a clear demand for them-from patients as well. This may be useful when negotiations are being conducted.
Kurowski, Brad G.; Taylor, H. Gerry; Yeates, Keith Owen; Walz, Nicolay C.; Stancin, Terry; Wade, Shari L.
2013-01-01
Objective To evaluate the relationship of family and parenting factors to long-term executive dysfunction and attention problems after early childhood traumatic brain injury (TBI). We hypothesized that the magnitude of executive dysfunction and attention problems would be moderated by family and parenting factors. Design A multicenter, prospective cohort study that included an orthopedic injury (OI) reference group. Setting Three tertiary academic children’s hospital medical centers and one general medical center. Participants Children, ages 3–7 years, hospitalized for OI, moderate TBI, or severe TBI. Methods and Outcome Measurements Parental ratings of family functioning and parenting styles were obtained 18 months after the injury occurred. The main outcome measurements, which were parental ratings of children’s executive function and attention, were performed at least 24 months after the injury occurred (mean, 39 months; range, 25–63 months). Analysis Group comparisons were conducted with use of t-tests, χ2 analysis, analysis of variance, and Pearson and Spearman correlations. Regression analysis was used to examine associations of the outcomes with family functioning and parenting styles and to test moderating effects of these factors on group differences. Results Participants with severe TBI demonstrated increased executive dysfunction and attention problems compared with those who sustained moderate TBI or OI. Lower levels of family dysfunction were associated with better executive function and attention across groups but did not moderate group differences. However, attention deficits after severe TBI were exacerbated under conditions of more permissive parenting relative to attention deficits after OIs. Conclusions Executive function and attention problems persisted on a long-term basis (>24 months) after early childhood TBI, and positive global family functioning and nonpermissive parenting were associated with better outcomes. Better characterization of the optimal family environment for recovery from early childhood TBI could help target future interventions. PMID:21944301
[Analysis of the factors related to the needs of patients with cancer].
Lee, Jung A; Lee, Sun Hee; Park, Jong Hyock; Park, Jae Hyun; Kim, Sung Gyeong; Seo, Ju Hyun
2010-05-01
Limited research has investigated the specific needs of patients with cancer. This study was performed to explore patients needs and the related factors. The data were collected by 1 National Cancer Center and 9 regional cancer centers in Korea. An interview survey was performed with using a structured questionnaire for the subjects (2,661 patients who gave written informed consent to participate) survey 4 months after diagnosis and review of medical records. Data were analyzed using t-test, ANOVA and multiple regression analysis. When comparing the relating factors related with patient needs to the sociodemographic characteristics, the female group showed a higher level of recognition for physical symptoms, social support needs. The younger group showed a significantly higher level of recognition for health care staff, psychological problems, information and education, social support, hospital services needs. In addition, the higher educated group showed a higher level of recognition for health care staff, physical symptoms, social support needs. The higher income and office workers group showed a higher level of recognition for hospital services needs. When comparing the relating factors related with patient needs to the cancer, the breast cancer group showed a higher level of recognition for all needs excluding physical symptoms, accessibility and financial support needs. The combined radiotherapy with surgery and chemotherapy group showed a higher level of recognition for psychological problems, information and education, social support needs. This study showed that needs on patient with cancer was significantly influenced by female, higher education, lower income, having religion, office worker, liver cancer, breast cancer, colon cancer, chemotherapy, and combined therapy.
Effectiveness of a training programme to improve hand hygiene compliance in primary healthcare
2009-01-01
Background Hand hygiene is the most effective measure for preventing infections related to healthcare, and its impact on the reduction of these infections is estimated at 50%. Non-compliance has been highlighted in several studies in hospitals, although none have been carried out in primary healthcare. Main objective To evaluated the effect of a "Hand Hygiene for the reduction of healthcare-associated infections" training program for primary healthcare workers, measured by variation from correct hand hygiene compliance, according to regulatory and specific criteria, 6 months after the baseline, in the intervention group (group receiving a training program) and in the control group (a usual clinical practice). Secondary objectives -To describe knowledges, attitudes and behaviors as regards hand hygiene among the professionals, and their possible association with "professional burnout", stratifying the results by type of group (intervention and usual clinical practice). -To estimate the logistic regression model that best explains hand hygiene compliance. Methods/Design Experimental study of parallel groups, with a control group, and random assignment by Health Center. Area of study.- Health centers in north-eastern Madrid (Spain). Sample studied.- Healthcare workers (physicians, odontostomatologists, pediatricians, nurses, dental hygienists, midwife and nursing auxiliaries). Intervention.- A hand hygiene training program, including a theoretical-practical workshop, provision of alcohol-based solutions and a reminder strategy in the workplace. Other variables: sociodemographic and professional knowledges, attitudes, and behaviors with regard to hand hygiene. Statistical Analysis: descriptive and inferential, using multivariate methods (covariance analysis and logistic regression). Discussion This study will provide valuable information on the prevalence of hand hygiene non-compliance, and improve healthcare. PMID:20015368
Yang, Zi-Feng; Wu, De-Qing; Wang, Jun-Jiang; Lv, Ze-Jian; Li, Yong
2018-01-07
To evaluate the short-term and long-term outcomes following laparoscopic vs open surgery for pathological T4 (pT4) colorectal cancer. We retrospectively analyzed the short- and long-term outcomes of proven pT4 colorectal cancer patients who underwent complete resection by laparoscopic or open surgery from 2006 to 2015 at Guangdong General Hospital. A total of 211 pT4 colorectal cancer patients were included in this analysis, including 101 cases in the laparoscopy (LAP) group and 110 cases in the open surgery (OPEN) group [including 15 (12.9%) cases of conversion to open surgery]. Clinical information (age, gender, body mass index, comorbidities, American Society of Anesthesiologists score, etc .) did not differ between the two groups. In terms of blood loss, postoperative complications and rate of recovery, the LAP group performed significantly more favorably ( P < 0.05). With regard to pT4a/b and combined organ resection, there were significantly more cases in the OPEN group ( P < 0.05). The 3- and 5-year overall survival rates were 74.9% and 60.5%, respectively, for the LAP group and 62.4% and 46.5%, respectively, for the OPEN group ( P = 0.060). The 3- and 5-year disease-free survival rates were 68.0% and 57.3%, respectively, for the LAP group and 55.8% and 39.8%, respectively, for the OPEN group ( P = 0.053). Multivariate analysis showed that IIIB/IIIC stage, lymph node status, and CA19-9 were significant predictors of overall survival. PT4a/b, IIIC stage, histological subtypes, CA19-9, and adjuvant chemotherapy were independent factors affecting disease-free survival. Laparoscopy is safely used in the treatment of pT4 colorectal cancer while offering advantages of minimal invasiveness and faster recovery. Laparoscopy is able to achieve good oncologic outcomes similar to those of open surgery. We recommend that laparoscopy be carried out in experienced centers. It is still required to screen the appropriate cases for laparoscopic surgery, optimize the preoperative diagnosis process, and reduce the conversion rate. Multi-center, prospective, and large-sample studies are required to assess these issues.
The role of laser determined orbits in geodesy and geophysics
NASA Technical Reports Server (NTRS)
Kolenkiewicz, R.; Smith, D. E.; Dunn, P. J.; Torrence, M. H.; Robbins, J. W.
1991-01-01
Some of the results of orbit analysis from the NASA SLR analysis group are presented. The earth's orientation was determined for 5-day intervals to 1.9 mas for the pole and 0.09 msec for length of day. The 3d center of mass station positions was determined to 33 mm over a period of 3 months, and geodesic rates of SLR tracking sites were determined to 5 mm/yr.
Lunar Transportation Facilities and Operations Study, option 2
NASA Technical Reports Server (NTRS)
1992-01-01
During the Option 2 period of the Lunar Transportation Facilities and Operations Study (LTFOS), a joint McDonnell Douglas Space Systems Company Kennedy Space Center (MDSSC-KSC) and National Aeronautics and Space Administration Kennedy Space Center (NASA-KSC) Study team conducted a comparison of the functional testing of the RL-10 and Space Shuttle Main Engine, a quick-look impact assessment of the Synthesis Group Report, and a detailed assessment of the Synthesis Group Report. The results of these KSC LTFOS team efforts are included. The most recent study task effort was a detailed assessment of the Synthesis Group Report. The assessment was conducted to determine the impact on planetary launch and landing facilities and operations. The result of that effort is a report entitled 'Analysis of the Synthesis Group Report, its Architectures and their Impacts on PSS Launch and Landing Operations' and is contained in Appendix A. The report is structured in a briefing format with facing pages as opposed to a narrative style. A quick-look assessment of the Synthesis Group Report was conducted to determine the impact of implementing the recommendations of the Synthesis Group on KSC launch facilities and operations. The data was documented in a presentation format as requested by Kennedy Space Center Technology and Advanced Projects Office and is included in Appendix B. Appendix C is a white paper on the comparison of the functional testing of the RL-10 and Space Shuttle Main Engine. The comparison was undertaken to provide insight regarding common test requirements that would be applicable to Lunar and Mars Excursion Vehicles (LEV and MEV).
Fort, Meredith P; Murillo, Sandra; López, Erika; Dengo, Ana Laura; Alvarado-Molina, Nadia; de Beausset, Indira; Castro, Maricruz; Peña, Liz; Ramírez-Zea, Manuel; Martínez, Homero
2015-12-28
Previous healthy lifestyle interventions based on the Salud para Su Corazón curriculum for Latinos in the United States, and a pilot study in Guatemala, demonstrated improvements in patient knowledge, behavior, and clinical outcomes for adults with hypertension. This article describes the implementation of a healthy lifestyle group education intervention at the primary care health center level in the capital cities of Costa Rica and Chiapas, Mexico for patients with hypertension and/or type 2 diabetes and presents impact evaluation results. Six group education sessions were offered to participants at intervention health centers from November 2011 to December 2012 and participants were followed up for 8 months. The study used a prospective, longitudinal, nonequivalent pretest-posttest comparison group design, and was conducted in parallel in the two countries. Cognitive and behavioral outcome measures were knowledge, self-efficacy, stage-of-change, dietary behavior and physical activity. Clinical outcomes were: body mass index, systolic and diastolic blood pressure, and fasting blood glucose. Group by time differences were assessed using generalized estimating equation models, and a dose-response analysis was conducted for the intervention group. The average number of group education sessions attended in Chiapas was 4 (SD: 2.2) and in Costa Rica, 1.8 (SD: 2.0). In both settings, participation in the study declined by 8-month follow-up. In Costa Rica, intervention group participants showed significant improvements in systolic and diastolic blood pressure and borderline significant improvement for fasting glucose, and significant improvement in the stages-of-change measure vs. the comparison group. In Chiapas, the intervention group showed significant improvement in the stages-of-change measure in relation to the comparison group. Significant improvements were not observed for knowledge, self-efficacy, dietary behavior or physical activity. In Chiapas only, a significant dose-response relationship was observed for systolic and diastolic blood pressure. Group education interventions at health centers have the potential to improve stage-of-change activation, and may also improve clinical outcomes. In the future, it will be essential to dedicate resources to understand ways to reach a representative group of the patient population, tailor the intervention so that patients are engaged to participate, and consider the broader family and community context that influences patients' capacity to manage their condition.
Steele Gray, Carolyn; Khan, Anum Irfan; Kuluski, Kerry; McKillop, Ian; Sharpe, Sarah; Bierman, Arlene S; Lyons, Renee F; Cott, Cheryl
2016-02-18
Many mHealth technologies do not meet the needs of patients with complex chronic disease and disabilities (CCDDs) who are among the highest users of health systems worldwide. Furthermore, many of the development methodologies used in the creation of mHealth and eHealth technologies lack the ability to embrace users with CCDD in the specification process. This paper describes how we adopted and modified development techniques to create the electronic Patient-Reported Outcomes (ePRO) tool, a patient-centered mHealth solution to help improve primary health care for patients experiencing CCDD. This paper describes the design and development approach, specifically the process of incorporating qualitative research methods into user-centered design approaches to create the ePRO tool. Key lessons learned are offered as a guide for other eHealth and mHealth research and technology developers working with complex patient populations and their primary health care providers. Guided by user-centered design principles, interpretive descriptive qualitative research methods were adopted to capture user experiences through interviews and working groups. Consistent with interpretive descriptive methods, an iterative analysis technique was used to generate findings, which were then organized in relation to the tool design and function to help systematically inform modifications to the tool. User feedback captured and analyzed through this method was used to challenge the design and inform the iterative development of the tool. Interviews with primary health care providers (n=7) and content experts (n=6), and four focus groups with patients and carers (n=14) along with a PICK analysis-Possible, Implementable, (to be) Challenged, (to be) Killed-guided development of the first prototype. The initial prototype was presented in three design working groups with patients/carers (n=5), providers (n=6), and experts (n=5). Working group findings were broken down into categories of what works and what does not work to inform modifications to the prototype. This latter phase led to a major shift in the purpose and design of the prototype, validating the importance of using iterative codesign processes. Interpretive descriptive methods allow for an understanding of user experiences of patients with CCDD, their carers, and primary care providers. Qualitative methods help to capture and interpret user needs, and identify contextual barriers and enablers to tool adoption, informing a redesign to better suit the needs of this diverse user group. This study illustrates the value of adopting interpretive descriptive methods into user-centered mHealth tool design and can also serve to inform the design of other eHealth technologies. Our approach is particularly useful in requirements determination when developing for a complex user group and their health care providers.
Data Basin: Expanding Access to Conservation Data, Tools, and People
NASA Astrophysics Data System (ADS)
Comendant, T.; Strittholt, J.; Frost, P.; Ward, B. C.; Bachelet, D. M.; Osborne-Gowey, J.
2009-12-01
Mapping and spatial analysis are a fundamental part of problem solving in conservation science, yet spatial data are widely scattered, difficult to locate, and often unavailable. Valuable time and resources are wasted locating and gaining access to important biological, cultural, and economic datasets, scientific analysis, and experts. As conservation problems become more serious and the demand to solve them grows more urgent, a new way to connect science and practice is needed. To meet this need, an open-access, web tool called Data Basin (www.databasin.org) has been created by the Conservation Biology Institute in partnership with ESRI and the Wilburforce Foundation. Users of Data Basin can gain quick access to datasets, experts, groups, and tools to help solve real-world problems. Individuals and organizations can perform essential tasks such as exploring and downloading from a vast library of conservation datasets, uploading existing datasets, connecting to other external data sources, create groups, and produce customized maps that can be easily shared. Data Basin encourages sharing and publishing, but also provides privacy and security for sensitive information when needed. Users can publish projects within Data Basin to tell more complete and rich stories of discovery and solutions. Projects are an ideal way to publish collections of datasets, maps and other information on the internet to reach wider audiences. Data Basin also houses individual centers that provide direct access to data, maps, and experts focused on specific geographic areas or conservation topics. Current centers being developed include the Boreal Information Centre, the Data Basin Climate Center, and proposed Aquatic and Forest Conservation Centers.
Taming the Anxious Mind: An 8-Week Mindfulness Meditation Group at a University Counseling Center
ERIC Educational Resources Information Center
Murphy, Michael C.
2006-01-01
This article describes an eight-week mindfulness meditation-based group that took place at a university counseling center. The group is patterned after the Mindfulness-Based Stress Reduction (MBSR) program developed by Dr. Jon Kabat-Zinn at the Stress Reduction Clinic at the University of Massachusetts Medical Center. Group members are taught…
Chelidze, P V; Dzidziguri, D V; Tumanishvili, G D
1998-05-01
Ultrastructural 3-D analysis of nucleolar architecture and Ag-NOR protein distribution in mouse kidney-cortex proximal-tubule epithelium has been performed. A principal scheme of structural changes of the nucleolus and organization of its components during the intensification of pre-rRNA synthesis (dynamic model of a nucleolus) based on computer spatial modelling has been advanced. According to the nucleolar composition, three groups of cells, which differ from each other by rRNA synthesis, are defined in normal kidney. Most nephron proximal-section cells (about 52%) are characterized by lower activity of RNA synthesis. Such kind of cells are defined as group I (nucleolar diameter 0.7-1.5 microm) and always contain resting, ring-shaped or close to ring-shaped dense nucleoli, which have 2 or 3 fibrillar centers. Nucleoli of group II cells (about 37%, nucleolar diameter 1.5-2.5 microm) have a higher level of activity, contain 4-7 fibrillar centers, and their structural organization is close to reticulated forms due to the first indications of vacuolar network (identified as prereticulated nucleoli). The most active cells of group III (about 11%, nucleolar diameter 2.5-3.5 microm) include cells with typical reticulated nucleoli with a well expressed vacuolar network and numerous fibrillar centers (18-22). Increased functional load of the epithelium caused by unilateral nephrectomy and diuretic (4-chlor-H [2-furylmethyl] 5-sulphamyl-antranic acid) injection changed the proportion of the different cell groups: group I decreased (about 25%), whereas groups II and III increased (about 8% and 17%, respectively). The increase of nucleolar activity first causes a deformation of the individual fibrillar centers as well as complication and growth of their surface. Further, a progressive fragmentation of the fibrillar centers and the growth of their total volume is observed. The complication and growth of the total volume of Ag-positive zones is another indication of the nucleolar activation. The vacuolar system develops by a gradual fusion of small isolated cavities into a united vacuolar network. Nucleoli with 2-7 fibrillar centers are considered to be intermediate forms reflecting successive stages of its activation or inactivation: from the resting ring-shaped nucleolus via transient stages of increasing functional activity to the active reticulated nucleoli and vice versa. The observed differences in the nucleolar ultrastructure are regarded as evidence of the functional heterogeneity of cell populations within one functional segment of nephron.
Pérula-de-Torres, Luis Á; Martínez-Adell, Miguel Á; González-Blanco, Virginia; Baena-Díez, José M; Martín-Rioboó, Enrique; Parras-Rejano, Juan M; González-Lama, Jesús; Martín-Alvarez, Remedios; Ruiz-Moral, Roger; Fernández-García, José Á; Pérez-Díaz, Modesto; Ruiz-de-Castroviejo, Joaquin; Pérula-de-Torres, Carlos; Valero-Martín, Antonio; Roldán-Villalobos, Ana; Criado-Larumbe, Margarita; Burdoy-Joaquín, Emili; Coma-Solé, Montserrat; Cervera-León, Mercè; Cuixart-Costa, Lluís
2012-10-30
Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers. An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis). If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines. The study is registered as NCT01291953 (ClinicalTrials.gob).
Then we all fall down: fall mortality by trauma center level.
Roubik, Daniel; Cook, Alan D; Ward, Jeanette G; Chapple, Kristina M; Teperman, Sheldon; Stone, Melvin E; Gross, Brian; Moore, Forrest O
2017-09-01
Ground-level falls (GLFs) are the predominant mechanism of injury in US trauma centers and accompany a spectrum of comorbidities, injury severity, and physiologic derangement. Trauma center levels define tiers of capability to treat injured patients. We hypothesized that risk-adjusted observed-to-expected mortality (O:E) by trauma center level would evaluate the degree to which need for care was met by provision of care. This retrospective cohort study used National Trauma Data Bank files for 2007-2014. Trauma center level was defined as American College of Surgeons (ACS) level I/II, ACS III/IV, State I/II, and State III/IV for within-group homogeneity. Risk-adjusted expected mortality was estimated using hierarchical, multivariable regression techniques. Analysis of 812,053 patients' data revealed the proportion of GLF in the National Trauma Data Bank increased 8.7% (14.1%-22.8%) over the 8 y studied. Mortality was 4.21% overall with a three-fold increase for those aged 60 y and older versus younger than 60 y (4.93% versus 1.46%, P < 0.001). O:E was lowest for ACS III/IV, (0.973, 95% CI: 0.971-0.975) and highest for State III/IV (1.043, 95% CI: 1.041-1.044). Risk-adjusted outcomes can be measured and meaningfully compared among groups of trauma centers. Differential O:E for ACS III/IV and State III/IV centers suggests that factors beyond case mix alone influence outcomes for GLF patients. More work is needed to optimize trauma care for GLF patients across the spectrum of trauma center capability. Copyright © 2017 Elsevier Inc. All rights reserved.
Evaluation of a new filing system's ability to maintain canal morphology.
Thompson, Matthew; Sidow, Stephanie J; Lindsey, Kimberly; Chuang, Augustine; McPherson, James C
2014-06-01
The manufacturer of the Hyflex CM endodontic files claims the files remain centered within the canal, and if unwound during treatment, they will regain their original shape after sterilization. The purpose of this study was to evaluate and compare the canal centering ability of the Hyflex CM and the ProFile ISO filing systems after repeated uses in simulated canals, followed by autoclaving. Sixty acrylic blocks with a canal curvature of 45° were stained with methylene blue, photographed, and divided into 2 groups, H (Hyflex CM) and P (ProFile ISO). The groups were further subdivided into 3 subgroups: H1, H2, H3; P1, P2, P3 (n = 10). Groups H1 and P1 were instrumented to 40 (.04) with the respective file system. Used files were autoclaved for 26 minutes at 126°C. After sterilization, the files were used to instrument groups H2 and P2. The same sterilization and instrumentation procedure was repeated for groups H3 and P3. Post-instrumentation digital images were taken and superimposed over the pre-instrumentation images. Changes in the location of the center of the canal at predetermined reference points were recorded and compared within subgroups and between filing systems. Statistical differences in intergroup and intragroup transportation measures were analyzed by using the Kruskal-Wallis analysis of variance of ranks with the Bonferroni post hoc test. There was a difference between Hyflex CM and ProFile ISO groups, although it was not statistically significant. Intragroup differences for both Hyflex CM and ProFile ISO groups were not significant (P < .05). The Hyflex CM and ProFile ISO files equally maintained the original canal's morphology after 2 sterilization cycles. Published by Elsevier Inc.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-05
... Research and Analysis, Food and Nutrition Service, U.S. Department of Agriculture, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302. Comments may also be submitted via fax to the attention of Steven... free or reduced-price school meals will be divided into treatment and control groups. Affected Public...
An Analysis of the U.S. Army’s T-11 Advanced Tactical Parachute System and Potential Path Forward
2016-12-01
Oversight Council JRTC Joint Readiness Training Center JWG Joint Working Group kias Knots indicated air speed KPP Key Performance Parameter KSA Key...AGL +/- 125 feet altitude holding error) at 130 - 150 knots indicated airspeed ( KIAS ) with a parachutist weighing 332 pounds including equipment
Hettinger Photo of Dylan Hettinger Dylan Hettinger Geospatial Data Scientist Dylan.Hettinger @nrel.gov | 303-275-3750 Dylan Hettinger is a member of the Geospatial Data Science team within the Systems Modeling & Geospatial Data Science Group in the Strategic Energy Analysis Center. Areas of Expertise
Genetic diversity, structure and differentiation in cultivate walnut (Juglans regia L.)
M. Aradhya; K. Woeste; D. Velasco
2012-01-01
An analysis of genetic structure and differentiation in cultivated walnut (Juglans regia) using 15 microsatellite loci revealed a considerable amount of genetic variation with a mild genetic structure indicating five genetic groups corresponding to the centers of diversity within the home range of walnut in Eurasia. Despite the narrow genetic...
Women in Authority: A Sociopsychological Analysis
ERIC Educational Resources Information Center
Bayes, Marjorie; Newton, Peter M.
1978-01-01
A case study of a woman manager and her staff within a mental health center is analyzed in an attempt to interrelate organizational structure, leadership style, and staff group dynamics. The approach to the exercise of authority is sociopsychological. Available from: JAB S Order Dept., NTL Institute for Applied Behavioral Science, P.O. Box 9155,…
Unique educational opportunities at the Missouri University research reactor
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ketring, A.R.; Ross, F.K.; Spate, V.
1997-12-01
Since the Missouri University Research Reactor (MURR) went critical in 1966, it has been a center where students from many departments conduct their graduate research. In the past three decades, hundreds of graduate students from the MU departments of chemistry, physics, anthropology, nuclear engineering, etc., have received masters and doctoral degrees based on research using neutrons produced at MURR. More recently, the educational opportunities at MURR have been expanded to include undergraduate students and local high school students. Since 1989 MURR has participated in the National Science Foundation-funded Research Experience for Undergraduates (REU) program. As part of this program, undergraduatemore » students from universities and colleges throughout the United States come to MURR and get hands-on research experience during the summer. Another program, started in 1994 by the Nuclear Analysis Program at MURR, allows students from a local high school to conduct a neutron activation analysis (NAA) experiment. We also conduct tours of the center, where we describe the research and educational programs at MURR to groups of elementary school children, high school science teachers, state legislators, professional organizations, and many other groups.« less
Shepard, Donald S.; Zeng, Wu; Amico, Peter; Rwiyereka, Angelique K.; Avila-Figueroa, Carlos
2012-01-01
Because human inmmunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) receives more donor funding globally than that for all other diseases combined, some critics allege this support undermines general health care. This empirical study evaluates the impact of HIV/AIDS funding on the primary health care system in Rwanda. Using a quasi-experimental design, we randomly selected 25 rural health centers (HCs) that started comprehensive HIV/AIDS services from 2002 through 2006 as the intervention group. Matched HCs with no HIV/AIDS services formed the control group. The analysis compared growth in inputs and services between intervention and control HCs with a difference-in-difference analysis in a random-effects model. Intervention HCs performed better than control HCs in most services (seven of nine), although only one of these improvements (Bacille Calmette-Guérin vaccination) reached or approached statistical significance. In conclusion, this six-year controlled study found no adverse effects of the expansion of HIV/AIDS services on non-HIV services among rural health centers in Rwanda. PMID:22556094
Shepard, Donald S; Zeng, Wu; Amico, Peter; Rwiyereka, Angelique K; Avila-Figueroa, Carlos
2012-05-01
Because human inmmunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) receives more donor funding globally than that for all other diseases combined, some critics allege this support undermines general health care. This empirical study evaluates the impact of HIV/AIDS funding on the primary health care system in Rwanda. Using a quasi-experimental design, we randomly selected 25 rural health centers (HCs) that started comprehensive HIV/AIDS services from 2002 through 2006 as the intervention group. Matched HCs with no HIV/AIDS services formed the control group. The analysis compared growth in inputs and services between intervention and control HCs with a difference-in-difference analysis in a random-effects model. Intervention HCs performed better than control HCs in most services (seven of nine), although only one of these improvements (Bacille Calmette-Guérin vaccination) reached or approached statistical significance. In conclusion, this six-year controlled study found no adverse effects of the expansion of HIV/AIDS services on non-HIV services among rural health centers in Rwanda.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Teixeira, Flavia C., E-mail: flavitiz@gmail.com; Almeida, Carlos E. de; Saiful Huq, M.
Purpose: The goal of this study was to evaluate the safety and quality management program for stereotactic radiosurgery (SRS) treatment processes at three radiotherapy centers in Brazil by using three industrial engineering tools (1) process mapping, (2) failure modes and effects analysis (FMEA), and (3) fault tree analysis. Methods: The recommendations of Task Group 100 of American Association of Physicists in Medicine were followed to apply the three tools described above to create a process tree for SRS procedure for each radiotherapy center and then FMEA was performed. Failure modes were identified for all process steps and values of riskmore » priority number (RPN) were calculated from O, S, and D (RPN = O × S × D) values assigned by a professional team responsible for patient care. Results: The subprocess treatment planning was presented with the highest number of failure modes for all centers. The total number of failure modes were 135, 104, and 131 for centers I, II, and III, respectively. The highest RPN value for each center is as follows: center I (204), center II (372), and center III (370). Failure modes with RPN ≥ 100: center I (22), center II (115), and center III (110). Failure modes characterized by S ≥ 7, represented 68% of the failure modes for center III, 62% for center II, and 45% for center I. Failure modes with RPNs values ≥100 and S ≥ 7, D ≥ 5, and O ≥ 5 were considered as high priority in this study. Conclusions: The results of the present study show that the safety risk profiles for the same stereotactic radiotherapy process are different at three radiotherapy centers in Brazil. Although this is the same treatment process, this present study showed that the risk priority is different and it will lead to implementation of different safety interventions among the centers. Therefore, the current practice of applying universal device-centric QA is not adequate to address all possible failures in clinical processes at different radiotherapy centers. Integrated approaches to device-centric and process specific quality management program specific to each radiotherapy center are the key to a safe quality management program.« less
Multiple attachments and group psychotherapy: implications for college counseling centers.
Marmarosh, Cheri L
2009-10-01
A large body of literature has supported the application of attachment theory to the understanding of college student development and the process of individual psychotherapy. Despite group treatment being one of the major methods of intervention in college counseling centers, there has been very little research guided by attachment theory that has been applied to the area of group psychotherapy. Many current assessment instruments used in college counseling centers can be supported with attachment theory, and many group therapy interventions are aimed at facilitating secure working models of self, other, and groups. This paper explores the importance of personal and group attachments in group psychotherapy and specifically addresses implications for clinical training and research in university counseling centers.
NASA Astrophysics Data System (ADS)
Amirsalari, A.; Farjami Shayesteh, S.
2015-06-01
In this study, we describe the synthesis of alumina nanoparticles using a chemical wet method in at varying pH. The optimized prepared particles with pH equals to 9 were calcined at various temperatures. For characterization of structural and optical properties of nanoparticles had been used X-ray diffraction, Infrared Fourier transform spectroscopy, field effect-scanning electron microscopy, photoluminescence and ultraviolet-visible spectroscopy. The results revealed that the nanoparticles calcined at 500 °C consist of an Al2O3 tetragonal structure and tetragonal distortion decreases with increasing calcination temperature up to 750 °C then increased with increasing temperature. Another phase similar to γ-Al2O3 was formed instead of δ-Al2O3 in the transition sequence from the γ to θ phase. FT-IR analysis; suggests that there are a few different types of functional groups on the surface of the alumina nanoparticles such as hydroxy groups and oxy groups. The transmittance spectra showed that the absorption bands in the UV region strongly depend on the calcination temperature. Moreover, the results showed that alumina has an optical direct band gap and that the energy gap decreases with increasing the calcination temperature and pH of the reaction. Luminescence spectra showed that some luminescent centers such as OH-related radiative centers and oxygen vacancies (F, F22+ and F2 centers) centers exist in the nanoparticles.
Abbasi, Soheila; Rojhani-Shirazi, Zahra; Shokri, Esmaeil; García-Muro San José, Francisco
2018-04-01
The aim of this study was to investigate the possible alterations in postural control during upright standing in subjects with non-specific chronic low back pain and the effect of Kinesio taping on the postural control. Twenty subjects with non-specific chronic low back pain and twenty healthy subjects participated in this study. The center of pressure excursion was evaluated before the intervention for both groups, and immediately after intervention for the low back pain group. Independent sample t-test, Mann-Whitney test and repeated measure ANOVA were used for the statistical analysis of the data. There were significant differences in the center of pressure excursion between the low back pain group versus the healthy group. The results of the ANOVA demonstrated a statistically significant difference in the mean COP displacement and velocity before Kinesio Taping, immediately after, and 24 h after in the low back pain group. There are poor postural control mechanisms in subjects with non-specific chronic low back pain. Kinesio taping seems to change postural control immediately and have lasting effects until the day after. Copyright © 2017 Elsevier Ltd. All rights reserved.
Martínez García, José Manuel; Martín López, María Jesús
2015-10-30
Group violence among Latin American immigrant youth has led to ongoing debates in political, legal, and media circles, yet none of those many perspectives has arrived at a solid, empirically supported definition for the phenomenon. This study aims to explore the relationship between the immigrant experience and violent group behavior in youths from Latin America serving prison sentences in Justice Enforcement Centers in the Community of Madrid. Semi-structured interviews were conducted with 19 juveniles, and content analysis was applied to the resulting transcripts, employing Grounded Theory to create an axial codification of intra- and inter-categorical contents, and Delphi panels for quality control. The research team delved into 62 topics, addressing participants' perceptions of the immigrant experience and its effects on five socialization settings (neighborhood, school, family, peer group, and significant other), and each one's relationship to violent behavior. The results led us to believe the young people's immigration experiences had been systematically examined. Their personal and social development was influenced by negative socioeconomic conditions, ineffective parental supervision, maladjustment and conflict at school, and experiences of marginalization and xenophobia. All those conditions favored affiliation with violent groups that provided them instrumental (economic and material), expressive, or affective support.
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
2015-06-15
Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less
Ghosh, Nilanjan; Karmali, Reem; Rocha, Vanderson; Ahn, Kwang Woo; DiGilio, Alyssa; Hari, Parameswaran N; Bachanova, Veronika; Bacher, Ulrike; Dahi, Parastoo; de Lima, Marcos; D'Souza, Anita; Fenske, Timothy S; Ganguly, Siddhartha; Kharfan-Dabaja, Mohamed A; Prestidge, Tim D; Savani, Bipin N; Smith, Sonali M; Sureda, Anna M; Waller, Edmund K; Jaglowski, Samantha; Herrera, Alex F; Armand, Philippe; Salit, Rachel B; Wagner-Johnston, Nina D; Fuchs, Ephraim; Bolaños-Meade, Javier; Hamadani, Mehdi
2016-09-10
Related donor haploidentical hematopoietic cell transplantation (Haplo-HCT) using post-transplantation cyclophosphamide (PT-Cy) is increasingly used in patients lacking HLA-matched sibling donors (MSD). We compared outcomes after Haplo-HCT using PT-Cy with MSD-HCT in patients with lymphoma, using the Center for International Blood and Marrow Transplant Research registry. We evaluated 987 adult patients undergoing either Haplo-HCT (n = 180) or MSD-HCT (n = 807) following reduced-intensity conditioning regimens. The haploidentical group received graft-versus-host disease (GVHD) prophylaxis with PT-Cy with or without a calcineurin inhibitor and mycophenolate. The MSD group received calcineurin inhibitor-based GVHD prophylaxis. Median follow-up of survivors was 3 years. The 28-day neutrophil recovery was similar in the two groups (95% v 97%; P = .31). The 28-day platelet recovery was delayed in the haploidentical group compared with the MSD group (63% v 91%; P = .001). Cumulative incidence of grade II to IV acute GVHD at day 100 was similar between the two groups (27% v 25%; P = .84). Cumulative incidence of chronic GVHD at 1 year was significantly lower after Haplo-HCT (12% v 45%; P < .001), and this benefit was confirmed on multivariate analysis (relative risk, 0.21; 95% CI, 0.14 to 0.31; P < .001). For Haplo-HCT v MSD-HCT, 3-year rates of nonrelapse mortality (15% v 13%; P = .41), relapse/progression (37% v 40%; P = .51), progression-free survival (48% v 48%; P = .96), and overall survival (61% v 62%; P = .82) were similar. Multivariate analysis showed no significant difference between Haplo-HCT and MSD-HCT in terms of nonrelapse mortality (P = .06), progression/relapse (P = .10), progression-free survival (P = .83), and overall survival (P = .34). Haplo-HCT with PT-Cy provides survival outcomes comparable to MSD-HCT, with a significantly lower risk of chronic GVHD. © 2016 by American Society of Clinical Oncology.
Ghosh, Nilanjan; Karmali, Reem; Rocha, Vanderson; Ahn, Kwang Woo; DiGilio, Alyssa; Hari, Parameswaran N.; Bachanova, Veronika; Bacher, Ulrike; Dahi, Parastoo; de Lima, Marcos; D’Souza, Anita; Fenske, Timothy S.; Ganguly, Siddhartha; Kharfan-Dabaja, Mohamed A.; Prestidge, Tim D.; Savani, Bipin N.; Smith, Sonali M.; Sureda, Anna M.; Waller, Edmund K.; Jaglowski, Samantha; Herrera, Alex F.; Armand, Philippe; Salit, Rachel B.; Wagner-Johnston, Nina D.; Fuchs, Ephraim; Bolaños-Meade, Javier
2016-01-01
Purpose Related donor haploidentical hematopoietic cell transplantation (Haplo-HCT) using post-transplantation cyclophosphamide (PT-Cy) is increasingly used in patients lacking HLA-matched sibling donors (MSD). We compared outcomes after Haplo-HCT using PT-Cy with MSD-HCT in patients with lymphoma, using the Center for International Blood and Marrow Transplant Research registry. Materials and Methods We evaluated 987 adult patients undergoing either Haplo-HCT (n = 180) or MSD-HCT (n = 807) following reduced-intensity conditioning regimens. The haploidentical group received graft-versus-host disease (GVHD) prophylaxis with PT-Cy with or without a calcineurin inhibitor and mycophenolate. The MSD group received calcineurin inhibitor–based GVHD prophylaxis. Results Median follow-up of survivors was 3 years. The 28-day neutrophil recovery was similar in the two groups (95% v 97%; P = .31). The 28-day platelet recovery was delayed in the haploidentical group compared with the MSD group (63% v 91%; P = .001). Cumulative incidence of grade II to IV acute GVHD at day 100 was similar between the two groups (27% v 25%; P = .84). Cumulative incidence of chronic GVHD at 1 year was significantly lower after Haplo-HCT (12% v 45%; P < .001), and this benefit was confirmed on multivariate analysis (relative risk, 0.21; 95% CI, 0.14 to 0.31; P < .001). For Haplo-HCT v MSD-HCT, 3-year rates of nonrelapse mortality (15% v 13%; P = .41), relapse/progression (37% v 40%; P = .51), progression-free survival (48% v 48%; P = .96), and overall survival (61% v 62%; P = .82) were similar. Multivariate analysis showed no significant difference between Haplo-HCT and MSD-HCT in terms of nonrelapse mortality (P = .06), progression/relapse (P = .10), progression-free survival (P = .83), and overall survival (P = .34). Conclusion Haplo-HCT with PT-Cy provides survival outcomes comparable to MSD-HCT, with a significantly lower risk of chronic GVHD. PMID:27269951
DOE Office of Scientific and Technical Information (OSTI.GOV)
Shin, Jaejin; Woo, Jong-Hak; Mulchaey, John S.
We perform a comprehensive study of X-ray cavities using a large sample of X-ray targets selected from the Chandra archive. The sample is selected to cover a large dynamic range including galaxy clusters, groups, and individual galaxies. Using β -modeling and unsharp masking techniques, we investigate the presence of X-ray cavities for 133 targets that have sufficient X-ray photons for analysis. We detect 148 X-ray cavities from 69 targets and measure their properties, including cavity size, angle, and distance from the center of the diffuse X-ray gas. We confirm the strong correlation between cavity size and distance from the X-raymore » center similar to previous studies. We find that the detection rates of X-ray cavities are similar among galaxy clusters, groups and individual galaxies, suggesting that the formation mechanism of X-ray cavities is independent of environment.« less
Student-centered tutoring as a model for patient-centeredness and empathy.
Meirovich, Adaya; Ber, Rosalie; Moore, Michael; Rotschild, Avi
2016-01-01
Curriculum planners and medical teachers attempt to enhance medical students' empathy and patient-centeredness. Despite educational efforts, there is stability in medical students' empathy and patient-centered medicine during the preclinical stage and a decline in both of them throughout the clinical years. Student-tutor relationship plays a key role in students' learning. This study tests the effect of learner-centered tutoring on students' empathy, patient-centeredness, and behavior. The cohort of 55 students was divided into groups of seven or eight. The experimental group's tutors underwent LC mentoring. Empathy was assessed with the Jefferson Scale of Physician Empathy for Students; PC attitude was assessed with the Patient-Provider Orientation Scale (PPOS). Behavior was assessed by simulations of doctor-patient encounters with 32 students at the end of the third year. Each student participated in three such simulations, during which we analyzed ten aspects of physician-patient communication via Roter interaction analysis system (RIAS)-coded audiotapes. A significant group difference was found for three RIAS categories: building a relationship and patient-centeredness, where the mean percentage of the experimental group was significantly higher than that of the control group, and gathering data, where the mean percentage of the experimental group was significantly lower than that of the control group. A significant correlation was found in the experimental group between empathy and positive talk and between PPOS and three of the RIAS categories: gathering data, psychosocial talk, and patient-centeredness. A significant negative correlation was found in the experimental group between PPOS and two of the RIAS categories: negative talk and doctor-centeredness. Two significant negative correlations were found in the control group: between empathy and patient-centeredness and PPOS and negative talk. The LC approach supports two of the RIAS categories, corresponding to clinical empathy and PC care and the link between certain behaviors and the PPOS.
Zhao, Peng-Fei; Zhou, Yue-Hua; Zhang, Jing; Wei, Wen-Bin
2017-01-01
Background: Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with refractive amblyopia who underwent femtosecond laser-assisted LASIK (FS-LASIK). Methods: In this study, we included 56 eyes of 32 patients with refractive amblyopia who underwent FS-LASIK in our hospital from January 2012 to December 2016. Foveal (foveal center retinal, parafoveal retinal, and perifoveal), macular inner retinal (superior and inferior), and peripapillary RNFL thicknesses (superior, inferior, temporal, and nasal) were measured using Fourier-domain optical coherence tomography before surgery and 1 day, 3 days, and 1 week after surgery. We divided these patients into three groups based on their refractive error: High myopic group with 22 eyes (equivalent sphere, >6.00 D), mild myopic group with 19 eyes (equivalent sphere, 0–6.00 D), and hyperopic group with 15 eyes (equivalent sphere, >+0.50 D). We compared the macular retina and RNFL thickness before and after LASIK. A paired simple t-test was used for data analysis. Results: One week after surgery, the visual acuity for all 56 eyes of the 32 patients reached their preoperative best-corrected vision. Visual acuity improved two lines or better for 31% of the patients. The residual refractive errors in 89% of the patients were within ±0.5 D. In the high myopic group, the foveal center retinal and parafoveal retinal thicknesses were thicker 1 day and 3 days after surgery than before surgery (t = 2.689, P = 0.012; t = 2.383, P = 0.018, respectively); no significant difference was found 1 week after surgery (P > 0.05). The foveal center retinal and parafoveal retinal thicknesses were greater 1 day after surgery than they were before surgery (P = 0.000 and P = 0.005, respectively) in the mild myopic and hyperopic groups. No significant difference was found 3 days or 1 week after surgery (P > 0.05). In all three groups, no significant difference was found in the macular inner retinal or peripapillary RNFL thickness 1 day, 3 days, or 1 week after surgery (P > 0.05). Conclusions: The foveal center retinal edema after FS-LASIK is mild and reversible in children, that mostly occurred in the high myopic group with no effect on the visual acuity, and is always relieved within 1 week. PMID:28875960
ERIC Educational Resources Information Center
Galassi, John P., Ed.
Several authors describe group counseling programs provided by a university counseling center to meet student needs for developing interpersonal communication skills and self-assertion behavior. In response to these needs, the counseling center provided personal growth groups, a proactive black group, a women's group, a marriage growth group, and…
An analysis of the effects of suicide prevention facilities on suicide rates in the United States.
Miller, H L; Coombs, D W; Leeper, J D; Barton, S N
1984-01-01
Since the 1960s, there has been a massive effort to reduce suicide mortality in the United States through prevention centers which invite suicidal persons to phone for supportive services. In spite of virtually total lack of evidence concerning the efficacy of these services, they proliferated until, by 1973, nearly every metropolitan area in the United States had at least one. Suicide rates increased slightly throughout this time. We studied 1968 through 1973, the years of greatest growth of suicide prevention facilities, comparing suicide rates in counties that added these centers with counties that did not do so. An association of centers with the reduction of suicides in young white females emerged. This finding was replicated on a different set of counties for a different time span. The results are discussed in light of the fact that this group constitutes the major clients of these centers. PMID:6703161
Fleuriet, K Jill
2009-09-01
In this article, I contrast conceptualizations of authoritative knowledge in pregnancy and birth between U.S. midwives and their Mexican immigrant clients at a religious birthing center in south Texas. Although the two groups share certain orientations to pregnancy management, essential differences in prenatal care and birth epistemologies underscore distinct social and economic positions. I use narrative data to document and explain these differences, which throw into relief the hierarchies of identity and need that structure immigrant women's reproductive experiences. Unveiling the different epistemologies can also help to explain sometimes radically divergent ideas that have impacted the very survivability of the birthing center. By focusing on Mexican immigrant women's reproductive decision making in an alternative birthing center, this analysis responds to feminists' call to look to the margins to understand the diversity of women's responses to what Rapp and Ginsburg have called "stratified reproduction".
Relevance of spirituality for people with mental illness attending consumer-centered services.
Bellamy, Chyrell D; Jarrett, Nicole C; Mowbray, Orion; MacFarlane, Peter; Mowbray, Carol T; Holter, Mark C
2007-01-01
Spirituality has been cited in the literature as having a positive effect on mental health outcomes. This paper explores the relationship of spirituality to demographic, psychiatric illness history and psychological constructs for people with mental illness (N=1835) involved in consumer-centered services (CCS-Clubhouses and Consumer run drop-in centers). Descriptive statistics indicate that spirituality is important for at least two thirds of the members in the study. Members primarily indicated participation in public spiritual activities (i.e., church, bible study groups), followed by private activities (prayer, reading the bible, and meditation) (both of which were centered on belief in the transcendent). A logistic regression analysis was done to explore variables related to spirituality (i.e., demographics, psychiatric illness history, and psychological constructs). Results suggest that age, gender, having psychotic symptoms, having depressive symptoms, and having a higher global quality of life, hope and sense of community were all significant correlates of spirituality.
Susong, David D.; Gallegos, Tanya J.; Oelsner, Gretchen P.
2012-01-01
The U.S. Geological Survey (USGS) John Wesley Powell Center for Analysis and Synthesis is hosting an interdisciplinary working group of USGS scientists to conduct a temporal and spatial analysis of surface-water and groundwater quality in areas of unconventional oil and gas development. The analysis uses existing national and regional datasets to describe water quality, evaluate water-quality changes over time where there are sufficient data, and evaluate spatial and temporal data gaps.
NASA Technical Reports Server (NTRS)
Dow, Marvin B.
1987-01-01
Composites research conducted at the Langley Research Center during the period from 1975 to 1986 is described, and an annotated bibliography of over 600 documents (with their abstracts) is presented. The research includes Langley basic technology and the composite primary structures element of the NASA Aircraft Energy Efficiency (ACEE) Program. The basic technology documents cited in the bibliography are grouped according to the research activity such as design and analysis, fatigue and fracture, and damage tolerance. The ACEE documents cover development of composite structures for transport aircraft.
Bagaturiia, G O; Chanov, V L; Kutushev, F Kh
1989-02-01
The authors make an analysis of treatment of 188 patients with noncomplicated compressive fractures of the vertebral column in the thoracolumbar part performed at the stationary rehabilitation center. The course of restorative treatment was as long as 31-40 days and included individual and group trainings of exercise therapy, massage, hydrokinesotherapy, thermo-, electro-, photo- and magnetotherapy. Results of the treatment were followed in 81 patients. Excellent and good results were obtained in 43 patients (53%), unsatisfactory--in 7 patients (8.6%). The period of follow-up observation was from 1 month to 1 year.
2008-12-12
Raymond, Jr., PhD _____________________________________, Member COL(R) David Hunter- Chester Accepted this 12th day of December 2008 by...Ph.D., and COL(R) David Hunter- Chester for their insightful and instructive direction; LTG William B. Caldwell IV, Commanding General of the US...J. McCollum and Dr. Constance A. Lowe, CGSC MMAS seminar instructors, LTC Scott Nester PhD Director, Center for Data Analysis & Statistics, West
Lodge, Amy C; Kaufman, Laura; Stevens Manser, Stacey
2017-05-01
Despite being an established practice in the disabilities service systems, person-centered planning is a relatively new practice in the behavioral health system. As a result, little is known about the barriers that mental health organizations face in implementing person-centered recovery planning (PCRP). To fill this gap, results are presented from a qualitative analysis of nine focus groups at three public mental health organizations in Texas that have been implementing PCRP for at least 2 years. Findings suggest that organizations experienced 12 distinct barriers to PCRP implementation which were categorized into the Consolidated Framework for Implementation Research domains of intervention characteristics, the outer setting, the inner setting, characteristics of individuals, and the implementation process. Half of these 12 barriers fell within the inner setting domain, suggesting that implementation efforts should be flexible and adaptable to organizational culture and context. One-quarter of the barriers fell into the domain of characteristics of individuals involved in the intervention, which further suggests implementation efforts should assess the impact that both staff and consumers have on implementation success.
NASA Astrophysics Data System (ADS)
Golbedaghi, Reza; Azimi, Saeid; Molaei, Atefeh; Hatami, Masoud; Notash, Behrouz
2017-10-01
A new Schiff base ligand HL, 1,3-bis(2-((Z)-(2-aminoethylimino)methyl)phenoxy)ethylene di amine, has been synthesized from the reaction of a new aldehyde and ethylenediamine. After preparation the Schiff base, a new dinuclear Cu(II) complex with two different geometry for each metal ion was synthesized. Single crystal X-ray structure analysis of the complex Cu(II) showed that the complex is binuclear and all nitrogen and oxygen atoms of ligand (N4O3) are coordinated to two Cu(II) center ions. The crystal structure studying shows, a perchlorate ion has been coordinated to the two Cu(II) metal centers as bridged and another perchlorate coordinated to the one of Cu(II) ion as terminal. However, two interesting structures square pyramidal and distorted octahedral Cu(II) ions are bridged asymmetrically by a perchlorate ion and oxygen of hydroxyl group of Schiff base ligand. In addition, we had a theoretical study to have a comparison of experimental and theoretical results we determined the HOMO and LUMO orbitals.
Keshvari, Mahrokh; Mohammadi, Eesa; Boroujeni, Ali Zargham; Farajzadegan, Ziba
2012-01-01
Objectives: Health care providers in the rural centers offer the primary health services in the form of proficiencies and professions to the most required target population in the health system. These services are provided in certain condition and population with a verity of limitations. This study aimed to describe and interpret the experiences of the employees from their own working condition in the rural health centers. Methods: The present study conducted in a qualitative research approach and content analysis method through individual and group interviews with 26 employed primary health care providers (including 7 family physicians, 7 midwives, and 12 health workers) in the rural health centers in Isfahan in 2009. Sampling was done using purposive sampling method. The data were analyzed using qualitative content analysis as constant comparative basis. Results: During the content analysis process, six themes were obtained; “instability and frequent changes”, “involved in laws and regulations”, “pressure and stress due to unbalanced workload and manpower”, “helplessness in performing the tasks and duties”, “sense of identity threat and low self-concept”, and “deprivation of professional development”. The mentioned themes indicate a main and more important theme called “burnout”. Conclusions: Health services providers in the rural health centers are working in stressful and challenging work conditions and are suffered from deprivation of something for which are responsible to the community. PMID:22826774
Motion Analysis System for Instruction of Nihon Buyo using Motion Capture
NASA Astrophysics Data System (ADS)
Shinoda, Yukitaka; Murakami, Shingo; Watanabe, Yuta; Mito, Yuki; Watanuma, Reishi; Marumo, Mieko
The passing on and preserving of advanced technical skills has become an important issue in a variety of fields, and motion analysis using motion capture has recently become popular in the research of advanced physical skills. This research aims to construct a system having a high on-site instructional effect on dancers learning Nihon Buyo, a traditional dance in Japan, and to classify Nihon Buyo dancing according to style, school, and dancer's proficiency by motion analysis. We have been able to study motion analysis systems for teaching Nihon Buyo now that body-motion data can be digitized and stored by motion capture systems using high-performance computers. Thus, with the aim of developing a user-friendly instruction-support system, we have constructed a motion analysis system that displays a dancer's time series of body motions and center of gravity for instructional purposes. In this paper, we outline this instructional motion analysis system based on three-dimensional position data obtained by motion capture. We also describe motion analysis that we performed based on center-of-gravity data obtained by this system and motion analysis focusing on school and age group using this system.
Addiction research centres and the nurturing of creativity. RAND's Drug Policy Research Center.
Reuter, Peter; Pacula, Rosalie Liccardo; Caulkins, Jonathan P
2011-02-01
In September 1989, amid an emotional and ideological debate regarding problematic drug use in the United States and the 'war on drugs', RAND's Drug Policy Research Center (DPRC) was created through private foundation funds. The purpose of this new research center was to provide objective empirical analysis on which to base sound drug policy. Twenty years later, RAND's DPRC continues its work, drawing on a broad range of analytical expertise to evaluate, compare and assess the effectiveness of a similarly broad range of drug policies. More than 60 affiliated researchers in the United States and Europe make up the Center, which attempts to provide objective empirical analyses to better inform drug policies within the United States and abroad. This paper provides a look back at the creation, evolution and growth of the Center. It then describes how the Center operates today and how it has maintained its clear identity and focus by drawing on the analytical capabilities of a talented group of researchers from a broad range of academic disciplines. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.
Provision of Telemedicine Services by Community Health Centers
Sharac, Jessica; Jacobs, Feygele
2014-01-01
The objective of this study was to assess the use of telemedicine services at community health centers. A national survey was distributed to all federally qualified health centers to gather data on their use of health information technology, including telemedicine services. Over a third of responding health centers (37%) provided some type of telemedicine service while 63% provided no telemedicine services. A further analysis that employed ANOVA and chi-square tests to assess differences by the provision of telemedicine services (provided no telemedicine services, provided one telemedicine service, and provided two or more telemedicine services) found that the groups differed by Meaningful Use compliance, location, percentage of elderly patients, mid-level provider, medical, and mental health staffing ratios, the percentage of patients with diabetes with good blood sugar control, and state and local funds per patient and per uninsured patient. This article presents the first national estimate of the use of telemedicine services at community health centers. Further study is needed to determine how to address factors, such as reimbursement and provider shortages, that may serve as obstacles to further expansion of telemedicine services use by community health centers. PMID:25422721
Burns, Melissa K; Andeway, Kathleen; Eppenstein, Paula; Ruroede, Kathleen
2014-06-01
This study was designed to establish balance parameters for the Nintendo(®) (Redmond, WA) "Wii Fit™" Balance Board system with three common games, in a sample of healthy adults, and to evaluate the balance measurement reproducibility with separation by age. This was a prospective, multivariate analysis of variance, cohort study design. Seventy-five participants who satisfied all inclusion criteria and completed an informed consent were enrolled. Participants were grouped into age ranges: 21-35 years (n=24), 36-50 years (n=24), and 51-65 years (n=27). Each participant completed the following games three consecutive times, in a randomized order, during one session: "Balance Bubble" (BB) for distance and duration, "Tight Rope" (TR) for distance and duration, and "Center of Balance" (COB) on the left and right sides. COB distributed weight was fairly symmetrical across all subjects and trials; therefore, no influence was assumed on or interaction with other "Wii Fit" measurements. Homogeneity of variance statistics indicated the assumption of distribution normality of the dependent variables (rates) were tenable. The multivariate analysis of variance included dependent variables BB and TR rates (distance divided by duration to complete) with age group and trials as the independent variables. The BB rate was statistically significant (F=4.725, P<0.005), but not the TR rate. The youngest group's BB rate was significantly larger than those of the other two groups. "Wii Fit" can discriminate among age groups across trials. The results show promise as a viable tool to measure balance and distance across time (speed) and center of balance distribution.
De Jesus, Maria; Sprunck-Harrild, Kim M.; Tellez, Trinidad; Bastani, Roshan; Battaglia, Tracy A.; Michaelson, James S.; Emmons, Karen M.
2014-01-01
Introduction Cancer screening rates among Latinas are suboptimal. The objective of this study was to explore how Latinas perceive cancer screening and the use and design of interactive voice response (IVR) messages to prompt scheduling of 1 or more needed screenings. Methods Seven focus groups were conducted with Latina community health center patients (n = 40) in need of 1 or more cancer screenings: 5 groups were of women in need of 1 cancer screening (breast, cervical, or colorectal), and 2 groups were of women in need of multiple screenings. A bilingual researcher conducted all focus groups in Spanish using a semistructured guide. Focus groups were recorded, transcribed, and translated into English for analysis. Emergent themes were identified by using thematic content analysis. Results Participants were familiar with cancer screening and viewed it positively, although barriers to screening were identified (unaware overdue for screening, lack of physician referral, lack of insurance or insufficient insurance coverage, embarrassment or fear of screening procedures, fear of screening outcomes). Women needing multiple screenings voiced more concern about screening procedures, whereas women in need of a single screening expressed greater worry about the screening outcome. Participants were receptive to receiving IVR messages and believed that culturally appropriate messages that specified needed screenings while emphasizing the benefit of preventive screening would motivate them to schedule needed screenings. Conclusion Participants’ receptiveness to IVR messages suggests that these messages may be an acceptable strategy to promote cancer screening among underserved Latina patients. Additional research is needed to determine the effectiveness of IVR messages in promoting completion of cancer screening. PMID:24625364
Villa, S; Bertoni, F; Bossi, A; Caraffini, B; Corbella, F; Di Lorenzo, I; Italia, C; Leoni, M; Nava, S; Sarti, E; Vavassori, V; Villa, E; Palazzi, M
1998-01-01
We report the results of a survey performed in 1994 by the AIRO-Lombardia Cooperative Group, on the clinical patterns of radiation treatment for prostatic carcinoma in Lombardy, Italy, involving all radiotherapy centers serving an overall local population of about 8,800,000 people. A questionnaire was sent to all 13 radiotherapy centers throughout Lombardy, asking for demographic and treatment details concerning the local population of patients with a localized (T1-4, N0-1, M0) carcinoma of the prostate treated with radiotherapy; 12 centers responded, making the basis for the present report. Analysis of collected data showed that in Lombardy: a) approximately 400 patients per year are irradiated for a localized carcinoma of the prostate, accounting for less than 30% of the total expected number of patients with this disease presentation; b) a complete staging (with PSA, transrectal ultrasonography, abdomino-pelvic CT or MRI scan and total-body bone scan) is performed in over 95% of patients before initiating radiotherapy; c) significant differences exist between radiotherapy centers as regards treatment planning and delivery. An urgent need exists for implementing procedures aimed at standardizing radiotherapy procedures within Lombardy.
Patient-centered communication and health assessment with youth.
Martyn, Kristy K; Munro, Michelle L; Darling-Fisher, Cynthia S; Ronis, David L; Villarruel, Antonia M; Pardee, Michelle; Faleer, Hannah E; Fava, Nicole M
2013-01-01
Patient-centered communication is fundamental to individualizing healthcare, but there has been limited evaluation of provider communication with youth. The aim was to compare communication outcomes after use of an event history calendar (EHC) and Guidelines for Adolescent Preventive Services (GAPS) to structure interactions during a clinic visit. Patient and provider descriptions of EHC and GAPS communication experiences were also obtained. This is a secondary analysis of data obtained during a randomized controlled trial. A sequential explanatory mixed-methods approach was used. A split-plot design with one between factor (EHC, GAPS) and one within factor (pretest, posttest) was used for the quantitative portion. Qualitative data were collected from open-ended questions, audiotaped visits, and exit interviews. Providers (n = 9) at three clinics were assigned at random and trained to implement either the EHC or GAPS protocol. Male and female youth (n = 186) were randomly assigned to the EHC or GAPS intervention. Before their clinic visit, youth completed assessments of past communication experiences with healthcare providers (pretest); communication during the current visit was assessed immediately after the visit (posttest). Communication outcomes from pretest to posttest improved for youth in both the EHC and GAPS groups. Post hoc subgroup analysis suggested that men and Arab Americans derived more benefit from the EHC intervention in some aspects of communication. Qualitatively, the EHC group identified improved outcomes in validating patient perspective, being viewed in context, reaching a shared understanding of needs and preferences, and being helped to share power in the healthcare interaction. EHC and GAPS provided effective frameworks for structuring communication during a clinic visit. Compared with GAPS, the integrated time-linked assessment captured by the EHC enhanced patient-centered communication in select groups.
Surface contamination analysis technology team overview
NASA Astrophysics Data System (ADS)
Burns, H. Dewitt, Jr.
1996-11-01
The surface contamination analysis technology (SCAT) team was originated as a working roup of NASA civil service, Space Shuttle contractor, and university groups. Participating members of the SCAT Team have included personnel from NASA Marshall Space Flight Center's Materials and Processes Laboratory and Langley Research Center's Instrument Development Group; contractors-Thiokol Corporation's Inspection Technology Group, AC Engineering support contractor, Aerojet, SAIC, and Lockheed MArtin/Oak Ridge Y-12 support contractor and Shuttle External Tank prime contractor; and the University of Alabama in Huntsville's Center for Robotics and Automation. The goal of the SCAT team as originally defined was to develop and integrate a multi-purpose inspection head for robotic application to in-process inspection of contamination sensitive surfaces. One area of interest was replacement of ozone depleting solvents currently used for surface cleanliness verification. The team approach brought together the appropriate personnel to determine what surface inspection techniques were applicable to multi-program surface cleanliness inspection. Major substrates of interest were chosen to simulate space shuttle critical bonding surface or surfaces sensitive to contamination such as fuel system component surfaces. Inspection techniques evaluated include optically stimulated electron emission or photoelectron emission; Fourier transform infrared spectroscopy; near infrared fiber optic spectroscopy; and, ultraviolet fluorescence. Current plans are to demonstrate an integrated system in MSFC's Productivity Enhancement Complex within five years from initiation of this effort in 1992. Instrumentation specifications and designs developed under this effort include a portable diffuse reflectance FTIR system built by Surface Optics Corporation and a third generation optically stimulated electron emission system built by LaRC. This paper will discuss the evaluation of the various techniques on a number of substrate materials contaminated with hydrocarbons, silicones, and fluorocarbons. Discussion will also include standards development for instrument calibration and testing.
Waxman, Michael J; Popick, Rachel S; Merchant, Roland C; Rothman, Richard E; Shahan, Judy B; Almond, Gregory
2011-07-01
We seek to identify and analyze, from a group of participants experienced with HIV screening, the perceived challenges and solutions to the ethical, financial, and legal considerations of emergency department (ED)-based HIV screening. We performed a qualitative analysis of the focus group discussions from the ethical, financial, and legal considerations portion of the inaugural National Emergency Department HIV Testing Consortium conference. Four groups composed of 20 to 25 consortium participants engaged in semistructured, facilitated focus group discussions. The focus group discussions were audiotaped and transcribed. A primary reader identified major themes and subthemes and representative quotes from the transcripts and summarized the discussions. Secondary and tertiary readers reviewed the themes, subthemes, and summaries for accuracy. The focus group discussions centered on the following themes. Ethical considerations included appropriateness of HIV screening in the ED and ethics of key elements of the 2006 Centers for Disease Control and Prevention HIV testing recommendations. Financial considerations included models of payment and support, role of health care insurance, financial ethics and downstream financial burdens, and advocacy approaches. Legal considerations included the adequacy of obtaining consent, partner notification, disclosure of HIV results, difficulties in addressing special populations, failure of not performing universal screening, failure to notify a person of being tested, failure to notify someone of their test results, liability of inaccurate tests, and failure to link to care. This qualitative analysis provides a broadly useful foundation to the ethical, financial, and legal considerations of implementing HIV screening programs in EDs throughout the United States. Copyright © 2011. Published by Mosby, Inc.
75 FR 34458 - National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG)
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG) Correction: This notice was... (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC), announces the following meeting...
75 FR 34459 - National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG)
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG) Correction: This notice was... (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC), announces the following meeting...
75 FR 34458 - National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG)
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG) Correction: This notice was... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC...
75 FR 34459 - National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG)
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG) Correction: This notice was... Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC), announces...
Student-centered tutoring as a model for patient-centeredness and empathy
Meirovich, Adaya; Ber, Rosalie; Moore, Michael; Rotschild, Avi
2016-01-01
Background Curriculum planners and medical teachers attempt to enhance medical students’ empathy and patient-centeredness. Despite educational efforts, there is stability in medical students’ empathy and patient-centered medicine during the preclinical stage and a decline in both of them throughout the clinical years. Student–tutor relationship plays a key role in students’ learning. This study tests the effect of learner-centered tutoring on students’ empathy, patient-centeredness, and behavior. Participants and methods The cohort of 55 students was divided into groups of seven or eight. The experimental group’s tutors underwent LC mentoring. Empathy was assessed with the Jefferson Scale of Physician Empathy for Students; PC attitude was assessed with the Patient–Provider Orientation Scale (PPOS). Behavior was assessed by simulations of doctor–patient encounters with 32 students at the end of the third year. Each student participated in three such simulations, during which we analyzed ten aspects of physician–patient communication via Roter interaction analysis system (RIAS)-coded audiotapes. Results A significant group difference was found for three RIAS categories: building a relationship and patient-centeredness, where the mean percentage of the experimental group was significantly higher than that of the control group, and gathering data, where the mean percentage of the experimental group was significantly lower than that of the control group. A significant correlation was found in the experimental group between empathy and positive talk and between PPOS and three of the RIAS categories: gathering data, psychosocial talk, and patient-centeredness. A significant negative correlation was found in the experimental group between PPOS and two of the RIAS categories: negative talk and doctor–centeredness. Two significant negative correlations were found in the control group: between empathy and patient-centeredness and PPOS and negative talk. Conclusion The LC approach supports two of the RIAS categories, corresponding to clinical empathy and PC care and the link between certain behaviors and the PPOS. PMID:27555803
Cardiometabolic profiles of adolescents and young adults exposed to the World Trade Center Disaster.
Trasande, Leonardo; Koshy, Tony T; Gilbert, Joseph; Burdine, Lauren K; Marmor, Michael; Han, Xiaoxia; Shao, Yongzhao; Chemtob, Claude; Attina, Teresa M; Urbina, Elaine M
2018-01-01
Few studies have examined the possible cardiometabolic consequences of World Trade Center-related exposures on children who lived and/or attended school near the disaster site. Our objective was to compare cardiometabolic profiles of participants in the World Trade Center Health Registry (WTCHR) with a matched comparison group. We evaluated WTCHR enrollees who resided in New York City and were born between September 11, 1993 and September 10, 2001, and a matched comparison group. We assessed exposure to dust cloud, home dust, as well as traumatic exposure, and associations with blood pressure, arterial wall stiffness, body mass index (BMI), total cholesterol, triglycerides, HDL, and LDL. A total of 402 participants completed the study, 222 in the comparison group and 180 in the WTCHR group. In multivariable regression analysis, after adjusting for relevant confounders we detected a weak association between participation in the WTCHR group and lower BMI (-1.12kg/m 2 , 95% CI -2.11, -0.12; p = 0.03), which became non-significant after adjusting for multiple comparisons. With respect to traumatic and psychosocial exposures, the only association that persisted in our multivariable model, below our predefined level of significance, was between post-traumatic stress disorder and higher BMI (2.06kg/m2, 95% CI 0.37, 3.74; p = 0.02). Our findings do not support an association between self-reported exposures to the WTC disaster and adverse cardiometabolic profile. However, further longitudinal studies may better inform the full extent of WTC-related conditions associated with exposure to the disaster. Copyright © 2017 Elsevier Inc. All rights reserved.
Carlozzi, Noelle E.; Fyffe, Denise; Morin, Kel G.; Byrne, Rachel; Tulsky, David S.; Victorson, David; Lai, Jin-Shei; Wecht, Jill M.
2015-01-01
Objectives To identify medically relevant aspects of blood pressure dysregulation (BPD) related to quality of life in individuals with spinal cord injury (SCI), and to propose an integrated conceptual framework based on input from both individuals with SCI and their clinical providers. This framework will serve as a guide for the development of a patient-reported outcome (PRO) measure specifically related to BPD. Design Three focus groups with individuals with SCI and 3 groups with SCI providers were analyzed using grounded-theory based qualitative analysis to ascertain how blood pressure impacts health-related quality of life (HRQOL) in individuals with SCI. Setting Focus groups were conducted at 2 Veterans Affairs medical centers and a research center. Participants Individuals with SCI (n=27) in 3 focus groups and clinical providers (n=25) in 3 focus groups. Interventions Not applicable. Main Outcome Measures Not applicable. Results Qualitative analysis indicated that all focus groups spent the highest percentage of time discussing symptoms of BPD (39%), followed by precipitators/causes of BPD (16%), preventative actions (15%), corrective actions (12%), and the impact that BPD has on social or emotional functioning (8%). While patient/consumer focus groups and provider focus groups raised similar issues, providers spent more time discussing precipitators/causes of BPD and preventative actions (38%) than patient/consumer groups (24%). Conclusions These results suggest that BPD uniquely and adversely impacts HRQOL in persons with SCI. While both individuals with SCI and their providers highlighted the relevant symptoms of BPD, the SCI providers offered additional detailed information regarding the precipitators/causes and what can be done to prevent/treat BPD. Further, the results suggest that persons with SCI are aware of how BPD impacts their HRQOL and are able to distinguish between subtle signs and symptoms. These findings exemplify the need for a validated and sensitive clinical measurement tool that can assess the extent to which BPD impacts HRQOL in patients with SCI. PMID:23499779
Impact of helicopter transport and hospital level on mortality of polytrauma patients.
Biewener, Achim; Aschenbrenner, Ulf; Rammelt, Stefan; Grass, René; Zwipp, Hans
2004-01-01
Despite numerous studies analyzing this topic, specific advantages of helicopter transport of blunt polytrauma patients as compared with ground ambulances have not yet been identified unequivocally. Four possible pathways in 403 polytrauma patients (Injury Severity Score [ISS] > 16) who were in reach of the helicopter emergency medical service (HEMS) Dresden were analyzed as follows: HEMS-UNI group (n = 140), transfer by HEMS into a university hospital; AMB-REG group (n = 102), transfer by ground ambulance into a regional (Level II or III) hospital; AMB-UNI group (n = 70), transfer by ground ambulance into the university hospital; and INTER group (n = 91), transfer by ground ambulance into a regional hospital, followed by transfer to the university hospital. Scores used were the ISS and the TRISS. Tests used for statistical analysis included chi2 and Fisher's tests. Statistical significance was set at p > 0.05. Age, gender, and mean ISS (range, 33.3-35.6) revealed extensive homogeneity of the groups. Mortality of the AMB-REG group was almost doubled (41.2%) compared with HEMS-UNI (22.1%) patients (p = 0.002). The AMB-UNI group displayed the lowest mortality (15.7%, p = not significant). TRISS analysis (PRE-Chart) revealed identical outcome for AMB-UNI and HEMS-UNI patients. Rescue time averaged 90 +/- 29 minutes for HEMS-UNI patients, 68 +/- 25 minutes for AMB-UNI patients, and 69 +/- 26 minutes for the AMB-REG group. Primary transfer by HEMS into a Level I trauma center reduces mortality markedly. In principle, this benefit can be attributed to superior preclinical therapy, primary admission to a Level I trauma center, or both. However, the identical probability of survival of the AMB-UNI and HEMS-UNI groups in this and comparable studies does not confirm generally better survival rates on account of a more aggressive on-site approach.
Zuchowski, Jessica L; Hamilton, Alison B; Pyne, Jeffrey M; Clark, Jack A; Naik, Aanand D; Smith, Donna L; Kanwal, Fasiha
2015-10-01
In this era of a constantly changing landscape of antiviral treatment options for chronic viral hepatitis C (CHC), shared clinical decision-making addresses the need to engage patients in complex treatment decisions. However, little is known about the decision attributes that CHC patients consider when making treatment decisions. We identify key patient-centered decision attributes, and explore relationships among these attributes, to help inform the development of a future CHC shared decision-making aid. Semi-structured qualitative interviews with CHC patients at four Veterans Health Administration (VHA) hospitals, in three comparison groups: contemplating CHC treatment at the time of data collection (Group 1), recently declined CHC treatment (Group 2), or recently started CHC treatment (Group 3). Participant descriptions of decision attributes were analyzed for the entire sample as well as by patient group and by gender. Twenty-nine Veteran patients participated (21 males, eight females): 12 were contemplating treatment, nine had recently declined treatment, and eight had recently started treatment. Patients on average described eight (range 5-13) decision attributes. The attributes most frequently reported overall were: physical side effects (83%); treatment efficacy (79%), new treatment drugs in development (55%); psychological side effects (55%); and condition of the liver (52%), with some variation based on group and gender. Personal life circumstance attributes (such as availability of family support and the burden of financial responsibilities) influencing treatment decisions were also noted by all participants. Multiple decision attributes were interrelated in highly complex ways. Participants considered numerous attributes in their CHC treatment decisions. A better understanding of these attributes that influence patient decision-making is crucial in order to inform patient-centered clinical approaches to care (such as shared decision-making augmented with relevant decision-making aids) that respond to patients' needs, preferences, and circumstances.
Prieto, Jose Antonio; Del Valle, Miguel; Nistal, Paloma; Méndez, David; Abelairas-Gómez, Cristian; Barcala-Furelos, Roberto
2014-12-17
The objective of this study was to analyze the influence of aerobic exercise on body composition and aerobic capacity of a sample of older, sedentary adults with obesity rates by three different models of intervention (recommendation, prescription at home and monitoring). A total of 76 older adults with a mean age 67.1+/-1.2 years, sedentary, with a BMI> 30 kg/ m2 were randomized in to four groups: Control (CON) recommendation (REC), prescription home (PRES) and monitoring in a sports center (MON). The same program of aerobic exercise for groups of home and sports center for 24 weeks, 3 days a week was developed. It was determined before and after the intervention BMI, Waist- Hip-index (ICC), the% fat ( Σ folds) and aerobic capacity (T6M) throughout the sample. MON and PRES groups showed significant improvements in the ICC, Σ folds and T 6M variables, not the case in BMI. However the MON group presented significant differences from group PRES between-group analysis (p <0.001). The recommendation did not get positive effects. Monitoring is the most effective exercise programs in adults with obesity methodology. However the exercise prescription at home since early intervention is an important approach for people with physical and/ or psychological reasons such as obesity cannot access the sports centers to participate in activities led by a monitor. Unknowns of aerobic exercise are cleared in the home that are of great impact for social policies regarding the health of the elderly population. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
An Analysis of the Communist Insurgency in the Philippines
2006-06-16
Territorial Defense System ix JUSMAG Joint United States Military Advisory Group KALAHI-CIDSS Kapit Bisig Laban sa Kahirapan – Comprehensive Delivery...Committee RRPC Regional Revolutionary Party Committee SDG Sentro de Gravidad; enemy center of gravity SHA Strategy of Holistic...pilots, doctors, lawyers, accountants, and businessmen. According to Guillermo de Joya, spokesman for Filipino-Chinese Chamber of Commerce and
Home Safety, Safe Behaviors of Elderly People, and Fall Accidents At Home
ERIC Educational Resources Information Center
Erkal, Sibel
2010-01-01
The present study analyzed home safety and safe behaviors against fall accidents of elderly people living at home. The study group comprised 121 people aged 65+ living in the catchment area of Ankara Mamak Halil Ulgen Health Center. Data were collected via a personal information form and Home-Screen Scale. Statistical analysis used an independent…
ERIC Educational Resources Information Center
Chapman, Linda M.; Morabito, Diane; Ladakakos, Chris; Schreier, Herbert; Knudson, M. Margaret
2001-01-01
Chapman Art Therapy Intervention (CATTI), an art therapy research project at an urban trauma center, was designed to reduce Post Traumatic Stress Disorder (PTSD) symptoms in pediatric patients. Early analysis does not indicate statistically significant differences in reduction of PTSD symptoms between experimental and control groups. Children…
Special Education Funding in New Jersey: A Policy Analysis
ERIC Educational Resources Information Center
Kolbe, Tammy; McLaughlin, Margaret J.; Mason, Loretta M.
2007-01-01
The Education Law Center (ELC) sought an independent review of special education funding in New Jersey as part of a larger group of studies intended to critique the cost study conducted by Augenblick and Palaich and Associates (APA) and the New Jersey Department of Education (NJDOE) and inform the ongoing public debate. In doing so, ELC recognized…
The Structure of Student Satisfaction with College Services: A Latent Class Model
ERIC Educational Resources Information Center
Adwere-Boamah, Joseph
2011-01-01
Latent Class Analysis (LCA) was used to identify distinct groups of Community college students based on their self-ratings of satisfaction with student service programs. The programs were counseling, financial aid, health center, student programs and student government. The best fitting model to describe the data was a two Discrete-Factor model…
75 FR 27794 - Center for Scientific Review; Notice of Closed Meetings
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-18
...; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5... Review Group; Modeling and Analysis of Biological Systems Study Section. Date: June 10-11, 2010. Time: 8...: June 10, 2010. Time: 8 a.m. to 5 p.m. Agenda: To review and evaluate grant applications. Place: Gaylord...
Kathiresan, Anupama S Q; Ibrahim, Emad; Aballa, Teodoro C; Attia, George R; Ory, Steven J; Hoffman, David I; Maxson, Wayne S; Barrionuevo, Marcelo J; Lynne, Charles M; Brackett, Nancy L
2011-09-01
To determine if outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI) using sperm from men with spinal cord injury (SCI group) differ from those of other etiologies of male factor infertility (non-SCI group). In men with SCI, to determine if IVF/ICSI outcomes differ with sperm obtained by penile vibratory stimulation (PVS group) versus electroejaculation (EEJ group). Retrospective analysis. University medical center and major infertility center. Couples with male factor infertility due to SCI versus other etiologies. PVS, EEJ, surgical sperm retrieval, and IVF/ICSI. Rates of fertilization, pregnancy, and live birth. A total of 31 couples in the SCI group underwent 48 cycles of IVF/ICSI, and a total of 297 couples in the non-SCI group underwent 443 cycles of IVF/ICSI. The SCI group had lower fertilization rates but similar pregnancy and live birth rates compared with the non-SCI group. These rates, however, did not differ significantly when the PVS group was compared with the EEJ group. IVF/ICSI of sperm from men with SCI yield lower fertilization rates but similar pregnancy and live birth outcomes as IVF/ICSI of sperm from men with other etiologies of male factor infertility. Sperm collected by PVS versus EEJ in men with SCI appear to result in similar IVF/ICSI success rates. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Tarasova, O. A.; Jalkanen, L.
2010-12-01
The WMO Global Atmosphere Watch (GAW) Programme is the only existing long-term international global programme providing an international coordinated framework for observations and analysis of the chemical composition of the atmosphere. GAW is a partnership involving contributors from about 80 countries. It includes a coordinated global network of observing stations along with supporting facilities (Central Facilities) and expert groups (Scientific Advisory Groups, SAGs and Expert Teams, ETs). Currently GAW coordinates activities and data from 27 Global Stations and a substantial number of Regional and Contributing Stations. Station information is available through the GAW Station Information System GAWSIS (http://gaw.empa.ch/gawsis/). There are six key groups of variables which are addressed by the GAW Programme, namely: ozone, reactive gases, greenhouse gases, aerosols, UV radiation and precipitation chemistry. GAW works to implement integrated observations unifying measurements from different platforms (ground based in situ and remote, balloons, aircraft and satellite) supported by modeling activities. GAW provides data for ozone assessments, Greenhouse Gas Bulletins, Ozone Bulletins and precipitation chemistry assessments published on a regular basis and for early warnings of changes in the chemical composition and related physical characteristics of the atmosphere. To ensure that observations can be used for global assessments, the GAW Programme has developed a Quality Assurance system. Five types of Central Facilities dedicated to the six groups of measurement variables are operated by WMO Members and form the basis of quality assurance and data archiving for the GAW global monitoring network. They include Central Calibration Laboratories (CCLs) that host primary standards (PS), Quality Assurance/Science Activity Centres (QA/SACs), World Calibration Centers (WCCs), Regional Calibration Centers (RCCs), and World Data Centers (WDCs) with responsibility for archiving and access to GAW data. Education, training, workshops, comparison campaigns, station audits/visits and twinning are also provided to build capacities in atmospheric sciences in Member countries.
Riaz, Summaira; De Lorenzis, Gabriella; Velasco, Dianne; Koehmstedt, Anne; Maghradze, David; Bobokashvili, Zviad; Musayev, Mirza; Zdunic, Goran; Laucou, Valerie; Andrew Walker, M; Failla, Osvaldo; Preece, John E; Aradhya, Mallikarjuna; Arroyo-Garcia, Rosa
2018-06-27
The mountainous region between the Caucasus and China is considered to be the center of domestication for grapevine. Despite the importance of Central Asia in the history of grape growing, information about the extent and distribution of grape genetic variation in this region is limited in comparison to wild and cultivated grapevines from around the Mediterranean basin. The principal goal of this work was to survey the genetic diversity and relationships among wild and cultivated grape germplasm from the Caucasus, Central Asia, and the Mediterranean basin collectively to understand gene flow, possible domestication events and adaptive introgression. A total of 1378 wild and cultivated grapevines collected around the Mediterranean basin and from Central Asia were tested with a set of 20 nuclear SSR markers. Genetic data were analyzed (Cluster analysis, Principal Coordinate Analysis and STRUCTURE) to identify groups, and the results were validated by Nei's genetic distance, pairwise F ST analysis and assignment tests. All of these analyses identified three genetic groups: G1, wild accessions from Croatia, France, Italy and Spain; G2, wild accessions from Armenia, Azerbaijan and Georgia; and G3, cultivars from Spain, France, Italy, Georgia, Iran, Pakistan and Turkmenistan, which included a small group of wild accessions from Georgia and Croatia. Wild accessions from Georgia clustered with cultivated grape from the same area (proles pontica), but also with Western Europe (proles occidentalis), supporting Georgia as the ancient center of grapevine domestication. In addition, cluster analysis indicated that Western European wild grapes grouped with cultivated grapes from the same area, suggesting that the cultivated proles occidentalis contributed more to the early development of wine grapes than the wild vines from Eastern Europe. The analysis of genetic relationships among the tested genotypes provided evidence of genetic relationships between wild and cultivated accessions in the Mediterranean basin and Central Asia. The genetic structure indicated a considerable amount of gene flow, which limited the differentiation between the two subspecies. The results also indicated that grapes with mixed ancestry occur in the regions where wild grapevines were domesticated.
Gorin, Michael A; Kates, Max; Mullins, Jeffrey K; Pierorazio, Phillip M; Matlaga, Brian R; Schoenberg, Mark P; Bivalacqua, Trinity J
2014-02-01
The objective of this study was to evaluate the impact of hospital case volume on perioperative outcomes and costs of radical cystectomy (RC) after controlling for differences in patient case mix. The Maryland Health Services Cost Review Commission database was queried for patients who underwent an open RC between 2000 and 2011. Patients were divided into tertiles based on hospital case volume. Groups were compared for differences in length of intensive care unit (ICU) stay, length of total hospital stay, rate of in-hospital deaths and procedure-related costs. In total, 1620 patients underwent a RC during the study period. Of these patients, 457 (28.2%) underwent surgery at 37 low volume centers, 465 (28.7%) at six mid volume centers and 698 (43.1%) at a single high volume center. The mean case volume of each group was 1.1, 7.0 and 63.5 RC/center/year, respectively. After controlling for marked differences in patient case mix, having surgery at the single high-volume center was independently associated with a decrease in length of ICU stay (coefficient = -0.41 days, 95% CI -0.78--0.05, p = 0.03), in-hospital mortality (OR 0.18, 95% CI 0.04-0.80, p = 0.02) and total medical costs (coefficient = -2.91k USD, 95% CI -4.15--1.67, p < 0.001). Decreased total costs were driven by reductions in charges associated with the operating room, drugs, radiology tests, labs, supplies and physical/occupational therapy (all p < 0.001). Undergoing RC at a high volume medical center was associated with improved outcomes and reduced costs. These data support the centralization of RC to high volume centers.
Beauvillard, D; Perrin, A; Drapier, H; Ravel, C; Fréour, T; Férec, C; De Braekeleer, M; Amice, V
2015-05-01
To review the management with assisted reproductive technologies (ART) of men with congenital bilateral absence of vas deferens (CBAVD), associated with cystic fibrosis or not, after surgical retrieval [epididymal aspiration (MESA) or testicular biopsy (TESE)]. Multicenter retrospective study made of 2 groups: CBAVD and cystic fibrosis (CF) or CBAVD only (CF-RD). Two centers performed MESA (Brest and Nantes) and one TESE (Rennes). Sperm numeration, motility, vitality, morphology and nuclear maturity were measured in both centers performing MESA. Fertilization rate (TF) and cumulated progressive pregnancy rate by retrieved oocyte (TGC) were compared between centers following ART. Ninety patients underwent surgical retrieval between January 1996 and March 2013, 30 in the CF group and 60 in the CF-RD group. Semen parameters were comparable between groups and centers. Fifty-eight (22 in the CF group and 36 in the CF-RD group) patients received ART between April 1996 and October 2014. TF was 50% and 52% and TGC 26% and 32% in the CF group and CF-RD groups, respectively. The results did not differ between groups but TGC was higher in Rennes than in the other two centers. Both semen parameters and ART results are comparable and similar to those reported in the literature. As shown by the results obtained in Rennes, TESE seems to be more effective. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Freisling, Heinz; Moskal, Aurelie; Ferrari, Pietro; Nicolas, Geneviève; Knaze, Viktoria; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie-Christine; Nailler, Laura; Teucher, Birgit; Grote, Verena A; Boeing, Heiner; Clemens, Matthias; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Quirós, J Ramón; Duell, Eric J; Sánchez, María-José; Amiano, Pilar; Chirlaque, Maria-Dolores; Barricarte, Aurelio; Khaw, Kay-Tee; Wareham, Nicholas J; Crowe, Francesca L; Gallo, Valentina; Oikonomou, Eleni; Naska, Androniki; Trichopoulou, Antonia; Palli, Domenico; Agnoli, Claudia; Tumino, Rosario; Polidoro, Silvia; Mattiello, Amalia; Bueno-de-Mesquita, H Bas; Ocké, Marga C; Peeters, Petra H M; Wirfält, Elisabet; Ericson, Ulrika; Bergdahl, Ingvar A; Johansson, Ingegerd; Hjartåker, Anette; Engeset, Dagrun; Skeie, Guri; Riboli, Elio; Slimani, Nadia
2013-06-01
Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intake across populations. Our aim was to describe the mean dietary AA intake in 27 centers of 10 European countries according to selected lifestyle characteristics and its contributing food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. In this cross-sectional analysis, 36 994 men and women, aged 35-74 years completed a single, standardized 24-hour dietary recall using EPIC-Soft. Food consumption data were matched to a harmonized AA database. Intake was computed by gender and center, and across categories of habitual alcohol consumption, smoking status, physical activity, education, and body mass index (BMI). Adjustment was made for participants' age, height, weight, and energy intake using linear regression models. Adjusted mean AA intake across centers ranged from 13 to 47 μg/day in men and from 12 to 39 μg/day in women; intakes were higher in northern European centers. In most centers, intake in women was significantly higher among alcohol drinkers compared with abstainers. There were no associations between AA intake and physical activity, BMI, or education. At least 50 % of AA intake across centers came from two food groups "bread, crisp bread, rusks" and "coffee." The third main contributing food group was "potatoes". Dietary AA intake differs greatly among European adults residing in different geographical regions. This observed heterogeneity in AA intake deserves consideration in the design and interpretation of population-based studies of dietary AA intake and health outcomes.
YouTube as a potential training method for laparoscopic cholecystectomy.
Lee, Jun Suh; Seo, Ho Seok; Hong, Tae Ho
2015-08-01
The purpose of this study was to analyze the educational quality of laparoscopic cholecystectomy (LC) videos accessible on YouTube, one of the most important sources of internet-based medical information. The keyword 'laparoscopic cholecystectomy' was used to search on YouTube and the first 100 videos were analyzed. Among them, 27 videos were excluded and 73 videos were included in the study. An arbitrary score system for video quality, devised from existing LC guidelines, were used to evaluate the quality of the videos. Video demographics were analyzed by the quality and source of the video. Correlation analysis was performed. When analyzed by video quality, 11 (15.1%) were evaluated as 'good', 40 (54.8%) were 'moderate', and 22 (30.1%) were 'poor', and there were no differences in length, views per day, or number of likes, dislikes, and comments. When analyzed by source, 27 (37.0%) were uploaded by primary centers, 20 (27.4%) by secondary centers, 15 (20.5%) by tertiary centers, 5 (6.8%) by academic institutions, and 6 (8.2%) by commercial institutions. The mean score of the tertiary center group (6.0 ± 2.0) was significantly higher than the secondary center group (3.9 ± 1.4, P = 0.001). The video score had no correlation with views per day or number of likes. Many LC videos are accessible on YouTube with varying quality. Videos uploaded by tertiary centers showed the highest educational value. This discrepancy in video quality was not recognized by viewers. More videos with higher quality need to be uploaded, and an active filtering process is necessary.
Treatment of odontogenic infections: An analysis of two antibiotic regimens.
Bhagania, Manish; Youseff, Wael; Mehra, Pushkar; Figueroa, Ruben
2018-01-01
Retrospective analysis of the efficacy for two commonly used antibiotic regimens in the management of severe odontogenic infections. Evaluation of records of patients admitted to the Oral and Maxillofacial Surgery service at Boston University Medical Center from 2009 to 2014 with severe infections of odontogenic origin (SOI). Patients were divided into two groups based on the administered intravenous antibiotic: 1) Group I: Clindamycin only and 2) Group II: Penicillin and Metronidazole. Variables evaluated included demographic characteristics, ASA status, and anatomic site of infection risk, length of hospital stay, antibiotic failure, and pharmaceutical treatment cost. 78 patients (46 males and 32 females) were included in the study. There were 57 patients in group I (average age 32.6 years) and 21 in Group II (average age 32.8 years). The average white cell count at time of admission count was higher in Group I (19.3) versus Group II (17.4). Antibiotic failure rate was 3.5% in Group I and 4.7% for group 2 patients. Clindamycin alone and combination of Penicillin with Metronidazole are both effective pharmaceutical regimens for SOI. Clindamycin therapy resulted in shorter hospital stay and lower net treatment costs with a slightly higher success rate.
Morphology and luminosity segregation of galaxies in nearby loose groups
NASA Astrophysics Data System (ADS)
Girardi, M.; Rigoni, E.; Mardirossian, F.; Mezzetti, M.
2003-08-01
We study morphology and luminosity segregation of galaxies in loose groups. We analyze the two catalogs of groups identified in the Nearby Optical Galaxy (NOG) sample, by means of hierarchical and percolation ``friends-of-friends'' methods (HG and PG catalogs, respectively). In the first part of our analysis we consider 387 and 436 groups of HG and PG and compare morphology- (luminosity-) weighted to unweighted group properties: velocity dispersion, mean pairwise distance, and mean groupcentric distance of member galaxies. The second part of our analysis is based on two ensemble systems, one for each catalog, built by suitably combining together galaxies of all groups (1584 and 1882 galaxies for HG and PG groups). We find that earlier-type (brighter) galaxies are more clustered and lie closer to the group centers, both in position and in velocity, than later-type (fainter) galaxies. Spatial segregations are stronger than kinematical segregations. These effects are generally detected at the >˜ 3-sigma level. Luminosity segregation is shown to be independent of morphology segregation. Our main conclusions are strengthened by the detection of segregation in both hierarchical and percolation catalogs. Our results agree with a continuum of segregation properties of galaxies in systems, from low-mass groups to massive clusters.
75 FR 19983 - National Center for Injury Prevention and Control Initial Review Group
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-16
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Injury Prevention and Control Initial Review Group In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC...
75 FR 7281 - National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG)
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-18
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and...
75 FR 7150 - National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG)
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and...
75 FR 5089 - National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG)
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-01
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and...
75 FR 7284 - National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG)
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-18
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Injury Prevention and Control/Initial Review Group, (NCIPC/IRG) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and...
Burn care delivery in a sub-saharan african unit: A cost analysis study.
Gallaher, Jared R; Mjuweni, Stephen; Cairns, Bruce A; Charles, Anthony G
2015-07-01
There are significant resource challenges to burn surgical care delivery in low and middle-income countries at baseline and only a few burn cost analysis studies from sub-Saharan Africa have been performed. This is a retrospective database analysis of prospectively collected data from all patients recorded in the burn registry between June 2011 and August 2014 located at the Kamuzu Central Hospital Burn Unit in Lilongwe, Malawi. We utilized activity-based costing, a bottom-up cost analysis methodology with cost allocation that allows determination of unit cost or cost per service. 905 patients were admitted to the burn unit during the study period. The calculated total monthly burn expenditure for all cost centers was $11,622.66. Per day, the total unit cost was $387.42 with a mean daily per-patient cost of $24.26 (SD ± $6.44). Consequently, the mean cost per in-patient admission was $559.85 (SD ± $736.17). The mean daily cost per 1% total burn surface per patient at our center is $2.65 (SD ± $3.01). This burn care cost analysis study helps quantify the relative contribution of differing cost centers that comprise burn care delivery and hospital costs in a sub-Saharan African setting. Accurate and relevant cost information on hospital services at the patient level is therefore fundamental for policy makers, payers, and hospitals. Our study has demonstrated that comprehensive burn care is possible at a cost much lower than found in other burn centers in low or middle-income countries and can be sustained with moderate funding. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.
Influence of the Rh (D) blood group system on graft survival in renal transplantation.
Bryan, C F; Mitchell, S I; Lin, H M; Nelson, P W; Shield, C F; Luger, A M; Pierce, G E; Ross, G; Warady, B A; Aeder, M I; Helling, T S; Landreneau, M D; Harrell, K M
1998-02-27
The Rh (D) blood group system has not traditionally been considered to be a clinically relevant histocompatibility barrier in transplantation since conflicting results of its clinical importance have been reported. We analyzed 786 consecutive primary cadaveric renal transplants performed by transplant centers in our Organ Procurement Organization (OPO) between 1990 and 1997. We also analyzed United Network for Organ Sharing (UNOS) data on 26,469 kidney transplants done from April 1994 to June 1996. Multivariate analysis revealed that Rh identity between the recipient and donor was significantly related to better graft outcome (risk ratio, 0.43; 95% confidence interval, 0.30 to 0.61; P=0.0001). Multivariate analysis of the UNOS data revealed that the Rh -/- group may have a positive influence on graft survival with a risk ratio of 0.43 (P=0.14). Multivariate analysis of primary cadaveric renal allografts performed within the Midwest Organ Bank OPO indicates that Rh (D) is a clinically relevant histocompatibility barrier that influences 7-year graft survival.
Covalent enzyme immobilization onto carbon nanotubes using a membrane reactor
NASA Astrophysics Data System (ADS)
Voicu, Stefan Ioan; Nechifor, Aurelia Cristina; Gales, Ovidiu; Nechifor, Gheorghe
2011-05-01
Composite porous polysulfone-carbon nanotubes membranes were prepared by dispersing carbon nanotubes into a polysulfone solution followed by the membrane formation by phase inversion-immersion precipitation technique. The carbon nanotubes with amino groups on surface were functionalized with different enzymes (carbonic anhydrase, invertase, diastase) using cyanuric chloride as linker between enzyme and carbon nanotube. The composite membrane was used as a membrane reactor for a better dispersion of carbon nanotubes and access to reaction centers. The membrane also facilitates the transport of enzymes to active carbon nanotubes centers for functionalization (amino groups). The functionalized carbon nanotubes are isolated by dissolving the membranes after the end of reaction. Carbon nanotubes with covalent immobilized enzymes are used for biosensors fabrications. The obtained membranes were characterized by Scanning Electron Microscopy, Thermal analysis, FT-IR Spectroscopy, Nuclear Magnetic Resonance, and functionalized carbon nanotubes were characterized by FT-IR spectroscopy.
Gayer, Christopher C; Crowley, Matthew J; Lawrence, William F; Gierisch, Jennifer M; Gaglio, Bridget; Williams, John W; Myers, Evan R; Kendrick, Amy; Slutsky, Jean; Sanders, Gillian D
2016-07-01
Decision aids (DAs) help patients make informed healthcare decisions in a manner consistent with their values and preferences. Despite their promise, DAs developed with public research dollars are not being implemented and adopted in real-world patient care settings at a rate consistent with which they are being developed. To appraise the sum of the parts of the portfolio and create a strategic imperative surrounding future funding, the Patient-Centered Outcomes Research Institute (PCORI) tasked the Duke Evidence Synthesis Group with evaluating its DA portfolio. This paper describes PCORI's portfolio of DAs according to the Duke Evidence Synthesis Group's analysis in the context of PCORI's mission and the field of decision science. The results revealed a diversity within PCORI's portfolio of funded DA projects. Findings support the movement toward more rigorous DA development, assessment and maintenance. PCORI's funding priorities related to DAs are clarified and comparative questions of interest are posed.
Theta EEG source localization using LORETA in partial epilepsy patients with and without medication.
Clemens, B; Bessenyei, M; Fekete, I; Puskás, S; Kondákor, I; Tóth, M; Hollódy, K
2010-06-01
To investigate and localize the sources of spontaneous, scalp-recorded theta activity in patients with partial epilepsy (PE). Nine patients with beginning, untreated PE (Group 1), 31 patients with already treated PE (Group 2), and 14 healthy persons were investigated by means of spectral analysis and LORETA, low resolution electromagnetic tomography (1 Hz very narrow band analysis, age-adjusted, Z-scored values). The frequency of main interest was 4-8 Hz. Group analysis: Group 1 displayed bilateral theta maxima in the temporal theta area (TTA), parietal theta area (PTA), and frontal theta area (FTA). In Group 2, theta activity increased all over the scalp as compared to the normative mean (Z=0) and also to Group 1. Maximum activity was found in the TTA, PTA, and FTA. However, in the PTA and FTA the centers of the abnormality shifted towards the medial cortex. Individual analysis: all the patients showed preferential activation (maximum Z-values) within one of the three theta areas. EEG activity in the theta band is increased in anatomically meaningful patterns in PE patients, which differs from the anatomical distribution of theta in healthy persons. The findings contribute to our understanding of the sources of theta rhythms and the pathophysiology of PE. Copyright 2010 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Tagliaferri, Salvatore; Esposito, Francesca Giovanna; Ippolito, Adelaide; Mereghini, Flavia; Magenes, Giovanni; Martinelli, Pasquale; Campanile, Marta; Signorini, Maria Gabriella
2017-03-01
The objective of this article is to provide an overview of the clinical experience of our telemedicine network (TOCOMAT) for fetal well-being assessment through computerized Cardiotocography (cCTG), analyzing cultural, socioeconomic, and environmental conditions of pregnant women and its economic sustainability over time. We used the central data store, including all cCTG records collected in Campania region (Italy) during 17 years of activity. The Operations Center acquires the traces recorded in the Remote Units and simultaneously performs a complex fetal heart rate analysis. An Internet or phone conference calling is available to discuss the information transmitted. Finally, the report is send back to the Remote Units. The number of cCTG traces performed was constantly increasing, despite the progressive reduction in the number of peripheral units involved. Pregnant women in Remote Unit group were younger and overweight and showed a higher incidence of diabetes and fetal defects than Operations Center ones. Moreover, a high rate of African migrant women and low socioeconomic and cultural standards were found in Remote Unit group. The cost analysis showed an economic advantage both in the reduction of inappropriate admissions and in the improvement of admission indicators (hospital stay days) for pregnant women. The global economic recession has had a significant impact on the Italian regional healthcare system and socioeconomic deprivation. Telemedicine could avoid unnecessary referral to Level III centers (Hospital) in Campania region, where the average population density is very high, allowing equal access to ultra-specialist assessment irrespective of the geographical location of the pregnant woman with medium to high risk, as well as rationalizing the costs for maternal and fetal care.
Patient-centered medical home transformation with payment reform: patient experience outcomes.
Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R
2014-01-01
To examine changes in patient experience across key domains of the patient-centered medical home (PCMH) following practice transformation with Lean quality improvement methodology inclusive of payment reform. Pre-intervention/post-intervention analysis of intervention with a comparison group, a quasi-experimental design. We surveyed patients following office visits at the intervention (n = 2502) and control (n = 1622) practices during the 15-month period before and 14-month period after PCMH Lean transformation (April-October 2009). We measured and compared pre-intervention and post-intervention levels of patient satisfaction and other indicators of patient-centered care. Propensity weights adjusted for potential case-mix differences in intervention and control groups; propensity-adjusted proportions accounted for physician-level clustering. More intervention patients were very satisfied with their care after the PCMH Lean intervention (68%) compared with pre-intervention (62%). Among control patients, there was no corresponding increase in satisfaction (63% very satisfied pre-intervention vs 64% very satisfied post-intervention). This comparison resulted in a statistical trend (P = .10) toward greater overall satisfaction attributable to the intervention. Post-intervention, patients in the intervention practice consistently rated indicators of patient-centered care higher than patients in the control practice, particularly in the personal physician and communication domain. In this domain, intervention patients reported superior provider explanations, time spent, provider concern, and follow-up instructions compared with control participants, whereas control group ratings fell in the post-intervention period (P for difference <.05). In a pilot PCMH transformation including Lean enhancement with payment reform, patient experience was sustained or improved across key PCMH domains.
Muppa, Radhika; Srinivas, NCH; Kumar, Duddu Mahesh
2014-01-01
ABSTRACT Objectives: The study is to evaluate changes in microhardness of enamel after exposure to acidic center filled chewing gum on primary and permanent teeth. Methods: Thirty primary and 30 permanent molar extracted teeth were painted with acid resistant varnish except a small window over buccal surface. Teeth were divided into four groups according to type of teeth and type of chewing gum (Center fresh and Bubbaloo) (D1, P1, D2 and P2); each tooth was exposed to whole chewing gum mashed with 5 ml of artificial saliva for five minutes at room temperature twice a day for 5 days. After the exposure, teeth were stored in deionized water and submitted for microhardness tests. Results: Paired t-test and independent sample t-test were used for statistical analysis. A significant reduction in microhardness was found between exposed and unexposed areas in all groups. There was no statistically significant difference in reduction of microhardness to chewing gums, and between primary and permanent enamel. Conclusion: There is a definite reduction in microhardness in all groups exposed to chewing gums. Both the chewing gums are equally erosive; both permanent and primary teeth were affected. How to cite this article: Mudumba VL, Muppa R, Srinivas NCH, Kumar DM. Evaluation and Comparison of Changes in Microhardness of Primary and Permanent Enamel on Exposure to Acidic Center-filled Chewing Gum: An in vitro Study. Int J Clin Pediatr Dent 2014;7(1):24-29. PMID:25206233
Bellanova, Giovanni; Buccelletti, Francesco; Berletti, Riccardo; Cavana, Marco; Folgheraiter, Giorgio; Groppo, Francesca; Marchetti, Chiara; Marzano, Amelia; Massè, Alessandro; Musetti, Antonio; Pelanda, Tina; Ricci, Nicola; Tugnoli, Gregorio; Papadia, Damiano; Ramponi, Claudio
2016-01-01
Aim of this study is to analyze how the starting of Course of Trauma in our hospital improved survival and organization in management of polytraumatized patients. We analysed all major trauma patients (Injury Severity Score (Injury Severity Score (ISS)> 15) treated at Emergency Department of the Santa Chiara Hospital between January 2011 and December 2014. The training courses (TC) were named "management of polytrauma" (MP) and "clinical cases discussion" (CCD), and started in November 2013. We divided the patients between two groups: before November 2013 (pre-TC group) and after November 2013 (post-TC group). MTG's courses (EMC accredited), CCD and MP courses started in November 2013. The target of these courses was the multidisciplinary management of polytrauma patient; the courses were addressed to general surgeons, anaesthesiologists, radiologists, orthopaedics and emergency physicians. Respectively 110 and 78 doctors were formed in CCD's and MP's courses. Patients directly transported to our trauma centre rose from 67.5% to 83% (p<0,005), and E-FAST grew from 15.6% in the pre-TC group to 51.3% in the post-TC group. Time of access in operatory theatre decreased from 62 to 44 minutes. Early Mortality (within 48 hours from the hospital arrival) was 9% in the pre-TC group and 4.5% in the post-tc group (p<0.005). Be needed to complete our goal. Further analysis and possible comparison with other trauma centers be needed to complete our goal Our results show that in our experience the multidisciplinary approach to polytrauma patients increased early survival and improved outcome with an evidence of worker's satisfaction. However, the best practice would ask to start with the approval of procedures and guidelines by the hospital governance, followed by clinical practice changes, in order to create a dedicated emergency and trauma surgery group. Damage Control Surgery, Non Operative Management, Trauma Course, Trauma Team, Trauma Center.
Liu, Chuan-Chuan; Hung, Chung-Lieh; Shih, Shou-Chuan; Ko, Hung-Ju; Chang, Ray-E
2015-08-20
Health intervention program (HIP) based on diet and lifestyle modifications had been shown to improve cardiovascular risks. The effects of such program on a variety of cardiometabolic outcome measures conducted in a strict analysis remained relatively unexplored. A total of 2,660 participants (mean age: 43.3 ± 10 years, 63.6% male) underwent annual health survey from our health evaluation department. We implemented health intervention program (HIP) in which diet and lifestyle modifications including smoking cessation and advised physical activities were introduced. We further studied the effects of HIP on several cardiometabolic outcome measures including Framingham, metabolic scores and renal function in terms of Egfr with a mean follow-up period of 38.5 months. Propensity score (PS) matching (HIP vs non-HIP group) was used to avoid effects of case selection bias. Totally 1,004 (502 subjects for each group) left after PS matching protocol (both HIP and non-HIP group). The HIP group showed significant decline of waist circumference (-1.46 ± 0.61, p = 0.016), post-prandial glucose (-6.77 ± 2.06, p = 0.001), and total cholesterol level (-4.42 ± 2.15, p = 0.04), with borderline increase in eGFR (1.72 ± 0.94, p = 0.068) after an average of 1.91 ± 1.14 year follow up period. Exercise behavior significantly increased for those who received HIP when compared to the non-HIP group (44.6 vs 52.4 %, p = 0.014). PS matching and difference-in-difference (DID) analysis further confirmed the beneficial effects of ATP III reduction by HIP (-0.36 ± 0.06, p < 0.05). We demonstrated in our study that several cardiometabolic profiles can be substantially improved after health intervention introduction at the health evaluation center, supporting the beneficial evidence of such health intervention programs implementation based on primary prevention view points.
Kurowski, Brad G; Taylor, H Gerry; Yeates, Keith Owen; Walz, Nicolay C; Stancin, Terry; Wade, Shari L
2011-09-01
To evaluate the relationship of family and parenting factors to long-term executive dysfunction and attention problems after early childhood traumatic brain injury (TBI). We hypothesized that the magnitude of executive dysfunction and attention problems would be moderated by family and parenting factors. A multicenter, prospective cohort study that included an orthopedic injury (OI) reference group. Three tertiary academic children's hospital medical centers and one general medical center. Children, ages 3-7 years, hospitalized for OI, moderate TBI, or severe TBI. METHODS AND OUTCOME MEASUREMENTS: Parental ratings of family functioning and parenting styles were obtained 18 months after the injury occurred. The main outcome measurements, which were parental ratings of children's executive function and attention, were performed at least 24 months after the injury occurred (mean, 39 months; range, 25-63 months). Group comparisons were conducted with use of t-tests, χ(2) analysis, analysis of variance, and Pearson and Spearman correlations. Regression analysis was used to examine associations of the outcomes with family functioning and parenting styles and to test moderating effects of these factors on group differences. Participants with severe TBI demonstrated increased executive dysfunction and attention problems compared with those who sustained moderate TBI or OI. Lower levels of family dysfunction were associated with better executive function and attention across groups but did not moderate group differences. However, attention deficits after severe TBI were exacerbated under conditions of more permissive parenting relative to attention deficits after OIs. Executive function and attention problems persisted on a long-term basis (>24 months) after early childhood TBI, and positive global family functioning and nonpermissive parenting were associated with better outcomes. Better characterization of the optimal family environment for recovery from early childhood TBI could help target future interventions. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Yu, Doris S F; Lee, Diana T F; Stewart, Simon; Thompson, David R; Choi, Kai-Chow; Yu, Cheuk-Man
2015-08-01
To determine the effect of nurse-implemented transitional care (TC) on readmission and mortality rates in Chinese individuals with chronic heart failure (CHF) in Hong Kong. Single-center randomized controlled trial of TC versus usual care (UC). University-affiliated hospital in Hong Kong. Hospitalized Chinese individuals with CHF (N = 178; aged 78.6 ± 6.9, 45% male). The TC group received a predischarge visit, two home visits, and then regular telephone calls over 9 months to provide self-care education and support, optimized health surveillance, and facilitation in use of community services. Primary endpoints were event-free survival, all-cause hospital readmission, and mortality during the 9-month follow-up. Secondary endpoints were length of hospital stay, self-care, and health-related quality of life (HRQL). Data were analyzed using survival analysis and generalized estimating equations, following an intention-to-treat principle. Survival analysis indicated no significant differences in event-free survival, hospital readmission, or mortality between the TC and UC groups, although the TC group had a lower hospital readmission rate at 6 weeks (8.1% vs 16.3%, P = .048) and lower mortality at 9 months (4.1% vs 13.8%, P = .03). The TC group also had a shorter hospital stay (P = .006) and significantly better self-care and HRQL. Because of attrition, sensitivity analyses were conducted to examine whether the intention-to-treat assumption affected the results. Per-protocol population analyses (hazard ratio (HR) = 0.40, 95% confidence interval (CI) = 0.17-0.93) and worst-case-scenario analysis (HR = 0.44, 95% CI = 0.25-0.77) suggested a lower mortality risk in the TC group. The translation of individual-centered nurse-implemented TC to the Chinese culture and healthcare context of Hong Kong appears beneficial. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.
Patient-Centered Communication and Health Assessment with Youth
Munro, Michelle L.; Darling-Fisher, Cynthia S.; Ronis, David L.; Villarruel, Antonia M.; Pardee, Michelle; Faleer, Hannah; Fava, Nicole M.
2014-01-01
Background Patient-centered communication is the hallmark of care that incorporates the perspective of patients to provide tailored care that meets their needs and desires. However, at this time there has been limited evaluation of patient-provider communication involving youth. Objectives This manuscript will report on results from secondary analysis of data obtained during a participatory research-based randomized control trial designed to test a sexual risk event history calendar intervention with youth to address the following research questions: (a) Based on the event history calendar’s (EHC) inclusion of contextual factors, does the EHC demonstrate improved communication outcomes (i.e., amount, satisfaction, mutuality, client involvement, client satisfaction, patient-provider interaction, and patient-centeredness) when compared to the Guidelines for Adolescent Preventive Services (GAPS) tool? and (b) How do patients and providers describe the characteristics of each tool in regards to patient-centered communication? Method This report will utilize a sequential explanatory mixed methods approach to evaluate communication. A split plot design with one between factor (i.e., communication structure between EHC and GAPS) and one within factor (i.e., time between pretest and posttest) was used for analyses of data collection from male and female youth (n=186) and providers (n=9). Quantitative analysis of survey data evaluated changes in communication from pre-test to post-test. Qualitative data collected from open-ended questions, audio-taped visits, and exit interviews was employed to enhance interpretation of quantitative findings. Results Patient-centered communication using assessment tools (EHC and GAPS) with youth demonstrated improved communication outcomes both quantitatively and qualitatively. Additional analyses with subgroups of males and Arab-Americans demonstrated better post-intervention scores among the EHC group in certain aspects of communication. Qualitative results revealed that the EHC demonstrated improved outcomes in the four components of patient-centered communication including: validation of the patient’s perspective; viewing the patient within context; reaching a shared understanding on needs and preferences; and helping the patient share power in the healthcare interaction. Discussion Though both tools provided a framework from which to conduct a clinical visit, the integrated time-linked assessment captured by the EHC enhanced the patient-centered communication in select groups compared to GAPS. PMID:24165214
Clinical Outcomes of Root Reimplantation and Bentall Procedure: Propensity Score Matching Analysis.
Lee, Heemoon; Cho, Yang Hyun; Sung, Kiick; Kim, Wook Sung; Park, Kay-Hyun; Jeong, Dong Seop; Park, Pyo Won; Lee, Young Tak
2018-03-26
This study aimed to evaluate the clinical outcomes of aortic root replacement(ARR) surgery:Root reimplantation as valve-sparing root replacement(VSR) and the Bentall procedure. We retrospectively reviewed 216 patients who underwent ARR between 1995 and 2013 at Samsung Medical Center. Patients were divided into two groups, depending on the procedure they underwent: Bentall(n=134) and VSR(n=82). The mean follow-up duration was 100.9±56.4 months. There were 2 early deaths in the Bentall group and none in the VSR group(p=0.53). Early morbidities were not different between the groups. Overall mortality was significantly lower in the VSR group (HR=0.12,p=0.04). Despite the higher reoperation rate in the VSR group(p=0.03), major adverse valve-related events(MAVRE) did not differ between the groups(p=0.28). Bleeding events were significantly higher in the Bentall group during follow-up(10 in Bentall group, 0 in VSR group, p=0.04). here were 6 thromboembolic events only in the Bentall group(p=0.11). We performed a propensity score matching analysis comparing the groups(134 Bentall vs 43 VSR). Matched analysis gave similar results, i.e. HR=0.17 and p=0.10 for overall mortality and HR=1.01 and p=0.99 for MAVRE. Although there was marginal significance in the propensity matched analysis, it is plausible to anticipate a survival benefit with VSR during long-term follow-up. Despite a higher reoperation for aortic valves, VSR can be a viable option in patients who decline life-long anticoagulation, especially the young or the patients in whom anticoagulation is contraindicated. Copyright © 2018. Published by Elsevier Inc.
[Positive psychology orientation: an intervention proposal for group work in mental health].
Lemos, Patrícia Mendes; Cavalcante Júnior, Francisco Silva
2009-01-01
This investigation aims at presenting a positive approach to psychology applied to the field of mental health in the treatment of patients with mental disorders. The intervention here presented was conducted in therapeutic groups with patients from a psychosocial care center (called CAPS). The analysis of the group work was based on three basic concepts: the humanistic approach and its vision of men and the world, the (con)text method of multiple literacies, and positive psychology. Quantitative and qualitative phenomenological research methodologies were used. The research results were divided into categories based on the group work with patients with depression-related disorders. Seeking for a new model of mental health care aimed at preserving the humanistic approach and the rights of the citizen, the Psychosocial Care Center (CAPS) emerges as a historical result of the construction of the health/disease concept in order to put into practice the principles guiding the psychiatric reform in Brazil. Within this process, a positive approach to psychology is opening horizons for a practice based on a new view of the subject, emphasizing and developing ' virtuous' aspects like the possibility of achieving health in its broader meaning, together health promotion and the employment of different psychological practices.
Benefits of Laparoscopy in Elderly Patients Requiring Major Liver Resection.
Cauchy, François; Fuks, David; Nomi, Takeo; Dokmak, Safi; Scatton, Olivier; Schwarz, Lilian; Barbier, Louise; Belghiti, Jacques; Soubrane, Olivier; Gayet, Brice
2016-02-01
Although recent reports have suggested the potential advantages of laparoscopy in patients undergoing major hepatectomy, the benefits of this approach in elderly patients remain unclear. This study aimed to compare the short-term outcomes of laparoscopic major hepatectomy (LMH) and open major hepatectomy (OMH) in elderly patients. All patients aged 55 years and older undergoing laparoscopic LMH between 2000 and 2013 at 2 centers were retrospectively analyzed and divided into 3 groups (group 1: 55 to 64 years old; group 2: 65 to 74 years old; and group 3: 75 years and older). Risk factors for postoperative complications were determined on multivariable analysis in the overall LMH population and in each LMH group. Outcomes of LMH patients were compared with those of patients of similar age undergoing OMH at another center after propensity score matching. Laparoscopic major hepatectomy was performed in 174 patients, including 72 (41.4%) in group 1, 67 (38.5%) in group 2, and 35 (20.1%) in group 3. On multivariable analysis, diabetes (odds ratio [OR] = 2.349; 95% CI, 1.251-2.674; p = 0.047), American Society of Anesthesiologists status (OR = 2.881; 95% CI, 2.193-3.71; p = 0.017), cirrhosis (OR = 1.426; 95% CI, 1.092-2.025; p = 0.043), right-sided resection (OR = 2.001; 95% CI, 1.492-2.563; p = 0.037), conversion (OR = 1.950; 95% CI, 1.331-2.545; p = 0.024), and intraoperative transfusion (OR = 2.338, 95% CI, 1.738-2.701, p = 0.032) were associated with increased risk of postoperative complications in the whole LMH population. After propensity score matching, laparoscopy was associated with significantly decreased rates of pulmonary complications and shorter hospital stays in all groups, decreased rates of overall complications in group 2 and group 3, and decreased rates of postoperative confusion in group 3. The current study supports the benefits of laparoscopy in decreasing postoperative complications in elderly patients requiring major hepatectomy. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Ho, Ming-Jung; Yao, Grace; Lee, Keng-Lin; Beach, Mary Catherine; Green, Alexander R
2008-01-01
No evidence addresses the effectiveness of patient-centered cultural competence training in non-Western settings. To examine whether a patient-centered cultural competency curriculum improves medical students' skills in eliciting the patients' perspective and exploring illness-related social factors. Fifty-seven medical students in Taiwan were randomly assigned to either the control (n = 27) or one of two intervention groups: basic (n = 15) and extensive (n = 15). Both intervention groups received two 2-hour patient-centered cultural competency workshops. In addition, the extensive intervention group received a 2-hour practice session. The control group received no training. At the end of the clerkship, all students were evaluated with an objective structured clinical examination (OSCE). Students in the extensive intervention group scored significantly higher than the basic intervention and control groups in eliciting the patient's perspective (F = 18.38, p < 0.001, eta(2) = 0.40). Scores of both intervention groups were significantly higher than the control group in the exploring social factors (F = 6.66, p = 0.003, eta(2) = 0.20). Patient-centered cultural competency training can produce improvement in medical students' cross-cultural communication skills in non-Western settings, especially when adequate practice is provided.
Concurrent Mission and Systems Design at NASA Glenn Research Center: The Origins of the COMPASS Team
NASA Technical Reports Server (NTRS)
McGuire, Melissa L.; Oleson, Steven R.; Sarver-Verhey, Timothy R.
2012-01-01
Established at the NASA Glenn Research Center (GRC) in 2006 to meet the need for rapid mission analysis and multi-disciplinary systems design for in-space and human missions, the Collaborative Modeling for Parametric Assessment of Space Systems (COMPASS) team is a multidisciplinary, concurrent engineering group whose primary purpose is to perform integrated systems analysis, but it is also capable of designing any system that involves one or more of the disciplines present in the team. The authors were involved in the development of the COMPASS team and its design process, and are continuously making refinements and enhancements. The team was unofficially started in the early 2000s as part of the distributed team known as Team JIMO (Jupiter Icy Moons Orbiter) in support of the multi-center collaborative JIMO spacecraft design during Project Prometheus. This paper documents the origins of a concurrent mission and systems design team at GRC and how it evolved into the COMPASS team, including defining the process, gathering the team and tools, building the facility, and performing studies.
NASA Technical Reports Server (NTRS)
Sapp, C. A.; Dragg, J. L.; Snyder, M. W.; Gaunce, M. T.; Decker, J. E.
1998-01-01
This report documents the photogrammetric assessment of the Hubble Space Telescope (HST) solar arrays conducted by the NASA c Center Image Science and Analysis Group during Second Servicing Mission 2 (SM-2) on STS-82 in February 1997. Two type solar array analyses were conducted during the mission using Space Shuttle payload bay video: (1) measurement of solar array motion due to induced loads, and (2) measurement of the solar array static or geometric twist caused by the cumulative array loading. The report describes pre-mission planning and analysis technique development activities conducted to acquire and analyze solar array imagery data during SM-2. This includes analysis of array motion obtained during SM-1 as a proof-of-concept of the SM-2 measurement techniques. The report documents the results of real-time analysis conducted during the mission and subsequent analysis conducted post-flight. This report also provides a summary of lessons learned on solar array imagery analysis from SM-2 and recommendations for future on-orbit measurements applicable to HST SM-3 and to the International Space Station. This work was performed under the direction of the Goddard Space Flight Center HST Flight Systems and Servicing Project.
Monterde, David; Vela, Emili; Clèries, Montse; García Eroles, Luis; Pérez Sust, Pol
2018-02-09
To compare the performance in terms of goodness of fit and explanatory power of 2morbidity groupers in primary care (PC): adjusted morbidity groups (AMG) and clinical risk groups (CRG). Cross-sectional study. PC in the Catalan Institute for the Health (CIH), Catalonia, Spain. Population allocated in primary care centers of the CIH for the year 2014. Three indicators of interest are analyzed such as urgent hospitalization, number of visits and spending in pharmacy. A stratified analysis by centers is applied adjusting generalized lineal models from the variables age, sex and morbidity grouping to explain each one of the 3variables of interest. The statistical measures to analyze the performance of the different models applied are the Akaike index, the Bayes index and the pseudo-variability explained by deviance change. The results show that in the area of the primary care the explanatory power of the AMGs is higher to that offered by the CRGs, especially for the case of the visits and the pharmacy. The performance of GMAs in the area of the CIH PC is higher than that shown by the CRGs. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.
Compendium of NASA Langley reports on hypersonic aerodynamics
NASA Technical Reports Server (NTRS)
Sabo, Frances E.; Cary, Aubrey M.; Lawson, Shirley W.
1987-01-01
Reference is made to papers published by the Langley Research Center in various areas of hypersonic aerodynamics for the period 1950 to 1986. The research work was performed either in-house by the Center staff or by other personnel supported entirely or in part by grants or contracts. Abstracts have been included with the references when available. The references are listed chronologically and are grouped under the following general headings: (1) Aerodynamic Measurements - Single Shapes; (2) Aerodynamic Measurements - Configurations; (3) Aero-Heating; (4) Configuration Studies; (5) Propulsion Integration Experiment; (6) Propulsion Integration - Study; (7) Analysis Methods; (8) Test Techniques; and (9) Airframe Active Cooling Systems.
2003-08-05
KENNEDY SPACE CENTER, FLA. - In the Columbia Debris Hangar, members of the Stafford-Covey Return to Flight Task Group (SCTG) look at tiles recovered. Chairing the task group are Richard O. Covey, former Space Shuttle commander, and Thomas P. Stafford (center), Apollo commander. Chartered by NASA Administrator Sean O’Keefe, the task group will perform an independent assessment of NASA’s implementation of the final recommendations by the Columbia Accident Investigation Board.
Park, Mi Jin; Park, Nan Sook; Chiriboga, David A
2018-05-01
This study presents an empirical typology of social activity and its association with the depressive symptoms and self-rated health of community-dwelling older adults (n = 464) in South Korea. Latent class analysis (LCA) was used to classify the types of social activities. Data analyses were conducted using Mplus 7.2 program for LCA and SPSS 22.0 for multiple regression analyses. LCA identified people who fell into one of the four activity groups: Diverse, Community Center/Disengaged, Religion Plus, and Friendship/Leisure. Membership in these four groups predicted differences in depressive symptoms and self-rated health. Results indicate that typologies of social activity could enhance practitioners' understanding of activity patterns and their associations with health and well-being.
ERIC Educational Resources Information Center
Landsberger, Betty H.
To locate possible causes for the gender and race differences observed in adolescent health status, an analysis was made of the relationship between the scores of a national sample of 12- to 17-year-old adolescents on selected items of the National Center for Health Statistics' Health Examination Survey. Thirty survey items indicating social…
ERIC Educational Resources Information Center
Mouratidis, Athanasios; Vansteenkiste, Maarten; Lens, Willy; Michou, Aikaterini; Soenens, Bart
2013-01-01
Grounded in self-determination theory, this longitudinal study examined the academic correlates of middle and high school students' (N = 923; 33.4% male) intrinsic and extrinsic aspirations (i.e., life goals) and the type of aspirations that they perceive their parents to promote to them. Person-centered analysis revealed 3 meaningful groups: a…
ERIC Educational Resources Information Center
Rethinam, Vasuki; Lynch, Sharon J.
2011-01-01
This study is an evaluation of "Exploring Motion and Forces: Speed, Acceleration, and Friction" ("M&F") developed by ARIES of the Harvard-Smithsonian Center for Astrophysics (2001). Although "M&F" has been used in many schools and field-tested, it has never been evaluated in rigorous experimental or…
M. M. Foley; J. R. Bellmore; J. E. O' Connor; J. J. Duda; A. E. East; G. E. Grant; C. W. Anderson; J. A. Bountry; M. J. Collins; P. J. Connolly; L. S. Craig; J. E. Evans; S. L. Greene; F. J. Magilligan; C. S. Magirl; J. J. Major; G. R. Pess; T. J. Randle; P. B. Shafroth; C. E. Torgersen; D. Tullos; A. C. Wilcox
2017-01-01
Dam removal is widely used as an approach for river restoration in the United States. The increase in dam removalsâparticularly large damsâand associated dam-removal studies over the last few decades motivated a working group at the USGS John Wesley Powell Center for Analysis and Synthesis to review and synthesize available studies of dam removals and their findings....
ERIC Educational Resources Information Center
Cabell, Sonia Q.; Justice, Laura M.; Konold, Timothy R.; McGinty, Anita S.
2011-01-01
The purpose of this study was to explore patterns of within-group variability in the emergent literacy skills of preschoolers who are at risk for academic difficulties. We used the person-centered approach of cluster analysis to identify profiles of emergent literacy skills, taking into account both oral language and code-related skills.…
Flores-Peña, Yolanda; He, Meizi; Sosa, Erica T; Avila-Alpirez, Hermelinda; Trejo-Ortiz, Perla M
2018-05-30
Childhood obesity is a public health issue negatively affecting children's physical and psychosocial health. Mothers are children's primary caregivers, thus key players in childhood obesity prevention. Studies have indicated that mothers underestimate their children's weight. If mothers are unaware of their children's weight problem, they are less likely to participate in activities preventing and treating excess weight. The "Healthy Change" intervention is designed to change maternal perception of child's weight (MPCW) through peer-led group health education in childcare settings. The "Healthy Change" is a multicenter two-arm randomized trial in four centers. Three centers are in Mexican States (Nuevo Leon, Tamaulipas, and Zacatecas). The fourth center is in San Antonio, Texas, USA. A total of 360 mother-child pairs (90 pairs per center) are to be randomly and evenly allocated to either the intervention or the control group. Intervention group will receive four-session group obesity prevention education. Control group will receive a four-session personal and food hygiene education. The education is delivered by trained peer-mother promotoras. Data will be collected using questionnaires and focus groups. The primary outcome is a change in proportion of mothers with accurate MPCW. Secondary outcomes include change in maternal feeding styles and practices, maternal self-efficacy and actions for managing child excessive weight gain. McNemar's Test will be used to test the primary outcome. The GLM Univariate procedure will be used to determine intervention effects on secondary outcomes. The models will include the secondary outcome measures as the dependent variables, treatment condition (intervention/control) as the fixed factor, and confounding factors (e.g., mother's education, children's gender and age) as covariates. Sub-analyses will be performed to compare intervention effects on primary and secondary outcomes between the samples from Mexico and Texas, USA. Qualitative data will be analyzed through analysis of inductive content. A combined coding model will be developed and used to code transcripts using the NVivo software. Healthy Change intervention could help change MPCW, an initial step for obesity prevention among preschoolers. This study presents a first of its kind intervention available in Spanish and English targeting Mexican and Mexican-American mothers in Mexico and USA. ISRCTN12281648.
Poon, Shi Sum; Theologou, Thomas; Harrington, Deborah; Kuduvalli, Manoj; Oo, Aung
2016-01-01
Background Despite recent advances in aortic surgery, acute type A aortic dissection remains a surgical emergency associated with high mortality and morbidity. Appropriate management is crucial to achieve satisfactory outcomes but the optimal surgical approach is controversial. The present systematic review and meta-analysis sought to access cumulative data from comparative studies between hemiarch and total aortic arch replacement in patients with acute type A aortic dissection. Methods A systematic review of the literature using six databases. Eligible studies include comparative studies on hemiarch versus total arch replacement reporting short, medium and long term outcomes. A meta-analysis was performed on eligible studies reporting outcome of interest to quantify the effects of hemiarch replacement on mortality and morbidity risk compared to total arch replacement. Result Fourteen retrospective studies met the inclusion criteria and 2,221 patients were included in the final analysis. Pooled analysis showed that hemiarch replacement was associated with a lower risk of post-operative renal dialysis [risk ratio (RR) =0.72; 95% confidence interval (CI): 0.56–0.94; P=0.02; I2=0%]. There was no significant difference in terms of in-hospital mortality between the two groups (RR =0.84; 95% CI: 0.65–1.09; P=0.20; I2=0%). Cardiopulmonary bypass, aortic cross clamp and circulatory arrest times were significantly longer in total arch replacement. During follow up, no significant difference was reported from current studies between the two operative approaches in terms of aortic re-intervention and freedom from aortic reoperation. Conclusions Within the context of publication bias by high volume aortic centres and non-randomized data sets, there was no difference in mortality outcomes between the two groups. This analysis serves to demonstrate that for those centers doing sufficient total aortic arch activity to allow for publication, excellent and equivalent outcomes are achievable. Conclusions on differences in longer term outcome data are required. We do not, however, advocate total arch as a primary approach by all centers and surgeons irrespective of patient characteristics, but rather, a tailored approach based on surgeon and center experience and patient presentation. PMID:27386403
Effects of Water-Based Training on Static and Dynamic Balance of Older Women.
Bento, Paulo Cesar Barauce; Lopes, Maria de Fátima A; Cebolla, Elaine Cristine; Wolf, Renata; Rodacki, André L F
2015-08-01
The aim of this study was to evaluate the effects of a water-based exercise program on static and dynamic balance. Thirty-six older women were randomly assigned to a water-based training (3 days/week for 12 weeks) or control group. Water level was kept at the level of the xiphoid process and temperature at ∼28-30°C. Each session included aerobic activities and lower limb strength exercises. The medial-lateral, the anterior-posterior amplitude, and displacement of the center of pressure (CP-D) were measured in a quiet standing position (60 sec eyes opened and closed). The dynamic balance and 8-Foot Up-and-Go tests were also applied. Group comparisons were made using two-way analysis of variance (ANOVA) with repeated measures. No differences were found in the center of pressure variables; however, the WBT group showed better performance in the 8 Foot Up-and-Go Test after training (5.61±0.76 vs. 5.18±0.42; p<0.01). The water-based training was effective in improving dynamic balance, but not static balance.
Formation of the lamellar structure in Group IA and IIID iron meteorites
NASA Technical Reports Server (NTRS)
Kowalik, J. A.; Williams, D. B.; Goldstein, J. I.
1988-01-01
Analytical EM, light microscopy, and electron microprobe analysis are used to study the lamellar plessite structure of Group IA and IIID iron meteorites. The alpha lamellae in IIID structures contained a compositional gradient from 6.1 + or - 0.7 wt pct Ni at the center of the alpha lamellae to 3.6 + or - 0.5 wt pct at the alpha/gamma interface. For the Group IA irons, compositions of 4 wt pct Ni in alpha and about 48 wt pct Ni in gamma are found. Convergent beam electron diffraction was used to characterize the orientation relations at the alpha/gamma interface in the lamellar regions of both Group IA and IIID. The phase transformations responsible for the observed lamellar structure in the IA and IIID chemical groups were also investigated.
NASA Technical Reports Server (NTRS)
Rodgers, T. E.; Johnson, J. F.
1977-01-01
The logic and methodology for a preliminary grouping of Spacelab and mixed-cargo payloads is proposed in a form that can be readily coded into a computer program by NASA. The logic developed for this preliminary cargo grouping analysis is summarized. Principal input data include the NASA Payload Model, payload descriptive data, Orbiter and Spacelab capabilities, and NASA guidelines and constraints. The first step in the process is a launch interval selection in which the time interval for payload grouping is identified. Logic flow steps are then taken to group payloads and define flight configurations based on criteria that includes dedication, volume, area, orbital parameters, pointing, g-level, mass, center of gravity, energy, power, and crew time.
Mapping analysis and planning system for the John F. Kennedy Space Center
NASA Technical Reports Server (NTRS)
Hall, C. R.; Barkaszi, M. J.; Provancha, M. J.; Reddick, N. A.; Hinkle, C. R.; Engel, B. A.; Summerfield, B. R.
1994-01-01
Environmental management, impact assessment, research and monitoring are multidisciplinary activities which are ideally suited to incorporate a multi-media approach to environmental problem solving. Geographic information systems (GIS), simulation models, neural networks and expert-system software are some of the advancing technologies being used for data management, query, analysis and display. At the 140,000 acre John F. Kennedy Space Center, the Advanced Software Technology group has been supporting development and implementation of a program that integrates these and other rapidly evolving hardware and software capabilities into a comprehensive Mapping, Analysis and Planning System (MAPS) based in a workstation/local are network environment. An expert-system shell is being developed to link the various databases to guide users through the numerous stages of a facility siting and environmental assessment. The expert-system shell approach is appealing for its ease of data access by management-level decision makers while maintaining the involvement of the data specialists. This, as well as increased efficiency and accuracy in data analysis and report preparation, can benefit any organization involved in natural resources management.
Perspectives: When the Centers Do Not Hold
ERIC Educational Resources Information Center
Rosen, Lawrence
2010-01-01
During the last twenty years or so, the number of endowed centers at many universities has increased enormously--to as many as fifty or more at a single institution. There are centers for every region (or sub-region) of the world and every ethnic/religious group (or sub-group) known to history. There are centers for the study of illness and…
NASA Technical Reports Server (NTRS)
Lo, Yunnhon; Johnson, Stephen B.; Breckenridge, Jonathan T.
2014-01-01
SHM/FM theory has been successfully applied to the selection of the baseline set Abort Triggers for the NASA SLS center dot Quantitative assessment played a useful role in the decision process ? M&FM, which is new within NASA MSFC, required the most "new" work, as this quantitative analysis had never been done before center dot Required development of the methodology and tool to mechanize the process center dot Established new relationships to the other groups ? The process is now an accepted part of the SLS design process, and will likely be applied to similar programs in the future at NASA MSFC ? Future improvements center dot Improve technical accuracy ?Differentiate crew survivability due to an abort, vs. survivability even no immediate abort occurs (small explosion with little debris) ?Account for contingent dependence of secondary triggers on primary triggers ?Allocate "? LOC Benefit" of each trigger when added to the previously selected triggers. center dot Reduce future costs through the development of a specialized tool ? Methodology can be applied to any manned/unmanned vehicle, in space or terrestrial
Origin and early evolution of photosynthesis
NASA Technical Reports Server (NTRS)
Blankenship, R. E.
1992-01-01
Photosynthesis was well-established on the earth at least 3.5 thousand million years ago, and it is widely believed that these ancient organisms had similar metabolic capabilities to modern cyanobacteria. This requires that development of two photosystems and the oxygen evolution capability occurred very early in the earth's history, and that a presumed phase of evolution involving non-oxygen evolving photosynthetic organisms took place even earlier. The evolutionary relationships of the reaction center complexes found in all the classes of currently existing organisms have been analyzed using sequence analysis and biophysical measurements. The results indicate that all reaction centers fall into two basic groups, those with pheophytin and a pair of quinones as early acceptors, and those with iron sulfur clusters as early acceptors. No simple linear branching evolutionary scheme can account for the distribution patterns of reaction centers in existing photosynthetic organisms, and lateral transfer of genetic information is considered as a likely possibility. Possible scenarios for the development of primitive reaction centers into the heterodimeric protein structures found in existing reaction centers and for the development of organisms with two linked photosystems are presented.
WOCE Working Group on Numerical Modeling
NASA Astrophysics Data System (ADS)
Nowlin, Worth
A U.S. WOCE (World Ocean Circulation Experiment) Working Group on Numerical Modeling has been established to serve as a forum for the discussion of progress in numerical general circulation modeling and its relationship to WOCE design and data analysis and as an advisory body on resource and manpower requirements for large-scale ocean modeling. The first meeting of this working group was held at the National Center for Atmospheric Research in Boulder, Colo., on Monday, December 10, 1984. The working group members who attended were K. Bryan, Y.-J. Han, D. Haidvogel (chairman), W. Holland, H. Hurlburt, J. O'Brien, A. Robinson, B. Semtner, and J. Sarmiento. Observers included F. Bretherton, A. Colin de Verdiere, C. Collins, L. Hua, P. Rizzoli, T. Spence, R. Wall, and S. Wilson.
Yang, Yi-Feng
2013-12-01
The present paper evaluates the relation between transformational leadership and market orientation along with the mediating and moderating effects of change commitment for employees in customer centers in Taiwan. 327 questionnaires were returned by personnel at several customer centers in four different insurance companies. Inter-rater agreement was acceptable based on the multiple raters (i.e., the consumer-related employees from the division groups) of one individual (i.e., a manager)--indicating the aggregated measures were acceptable. The multi-source sample comprised data taken from the four division centers: phone services, customer representatives, financial specialists, and front-line salespeople. The relations were assessed using a multiple mediation procedure incorporating bootstrap techniques and PRODCLIN2 with structural equation modeling analysis. The results reflect a mediating role for change commitment.
Value of chiropractic services at an on-site health center.
Krause, Curt A; Kaspin, Lisa; Gorman, Kathleen M; Miller, Ross M
2012-08-01
Chiropractic care offered at an on-site health center could reduce the economic and clinical burden of musculoskeletal conditions. A retrospective claims analysis and clinical evaluation were performed to assess the influence of on-site chiropractic services on health care utilization and outcomes. Patients treated off-site were significantly more likely to have physical therapy (P < 0.0001) and outpatient visits (P < 0.0001). In addition, the average total number of health care visits, radiology procedures, and musculoskeletal medication use per patient with each event were significantly higher for the off-site group (all P < 0.0001). Last, headache, neck pain, and low back pain-functional status improved significantly (all P < 0.0001). These results suggest that chiropractic services offered at on-site health centers may promote lower utilization of certain health care services, while improving musculoskeletal function.
Groups of galaxies in the Center for Astrophysics redshift survey
NASA Technical Reports Server (NTRS)
Ramella, Massimo; Geller, Margaret J.; Huchra, John P.
1989-01-01
By applying the Huchra and Geller (1982) objective group identification algorithm to the Center for Astrophysics' redshift survey, a catalog of 128 groups with three or more members is extracted, and 92 of these are used as a statistical sample. A comparison of the distribution of group centers with the distribution of all galaxies in the survey indicates qualitatively that groups trace the large-scale structure of the region. The physical properties of groups may be related to the details of large-scale structure, and it is concluded that differences among group catalogs may be due to the properties of large-scale structures and their location relative to the survey limits.
Alvarez, Kiara; Wang, Ye; Alegria, Margarita; Ault-Brutus, Andrea; Ramanayake, Natasha; Yeh, Yi-Hui; Jeffries, Julia R.; Shrout, Patrick E.
2017-01-01
Shared decision-making (SDM) and effective patient-provider communication are key and interrelated elements of patient-centered care that impact health and behavioral health outcomes. Measurement of SDM and communication from the patient’s perspective is necessary in order to ensure that health care systems and individual providers are responsive to patient views. However, there is a void of research addressing the psychometric properties of these measures with diverse patients, including non-English speakers, and in the context of behavioral health encounters. This study evaluated the psychometric properties of two patient-centered outcome measures, the Shared Decision Making Questionnaire-9 (SDM-Q) and the Kim Alliance Scale-Communication Subscale (KAS-CM), in a sample of 239 English and Spanish-speaking behavioral health patients. One dominant factor was found for each scale and this structure was used to examine whether there was measurement invariance across the two language groups. One SDM-Q item was inconsistent with the configural invariance comparison and was removed. The remaining SDM-Q items exhibited strong invariance, meaning that item loadings and item means were similar across the two groups. The KAS-CM items had limited variability, with most respondents indicating high communication levels, and the invariance analysis was done on binary versions of the items. These had metric invariance (loadings the same over groups) but several items violated the strong invariance test. In both groups, the SDM-Q had high internal consistency, whereas the KAS-CM was only adequate. These findings help interpret results for individual patients, taking into account cultural and linguistic differences in how patients perceive SDM and patient-provider communication. PMID:27537002
Alvarez, Kiara; Wang, Ye; Alegria, Margarita; Ault-Brutus, Andrea; Ramanayake, Natasha; Yeh, Yi-Hui; Jeffries, Julia R; Shrout, Patrick E
2016-09-01
Shared decision making (SDM) and effective patient-provider communication are key and interrelated elements of patient-centered care that impact health and behavioral health outcomes. Measurement of SDM and communication from the patient's perspective is necessary in order to ensure that health care systems and individual providers are responsive to patient views. However, there is a void of research addressing the psychometric properties of these measures with diverse patients, including non-English speakers, and in the context of behavioral health encounters. This study evaluated the psychometric properties of 2 patient-centered outcome measures, the Shared Decision-Making Questionnaire-9 (SDM-Q) and the Kim Alliance Scale-Communication subscale (KAS-CM), in a sample of 239 English and Spanish-speaking behavioral health patients. One dominant factor was found for each scale and this structure was used to examine whether there was measurement invariance across the 2 language groups. One SDM-Q item was inconsistent with the configural invariance comparison and was removed. The remaining SDM-Q items exhibited strong invariance, meaning that item loadings and item means were similar across the 2 groups. The KAS-CM items had limited variability, with most respondents indicating high communication levels, and the invariance analysis was done on binary versions of the items. These had metric invariance (loadings the same over groups) but several items violated the strong invariance test. In both groups, the SDM-Q had high internal consistency, whereas the KAS-CM was only adequate. These findings help interpret results for individual patients, taking into account cultural and linguistic differences in how patients perceive SDM and patient-provider communication. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Gendering of day center occupations as perceived by people with psychiatric disabilities in Sweden.
Widerberg, Stefan; Eklund, Mona
2018-05-01
The aim was to explore the experiences and views of people attending day centers for people with psychiatric disabilities concerning the occurrence and nature of gendering of the occupations performed there. Twenty-five day center attendees were interviewed regarding occupational choices at the day centers, whether they would describe day center occupations as gendered, and if so what the consequences were of the gendering of occupations. The transcribed texts were analyzed by thematic analysis. Three main themes were identified: Thinking and doing gender; Understandings of gendering of day center occupations; and Consequences of gendered occupation. The participants were more open-minded in their reasoning than in what they were doing. They understood gendering to be a result of traditions, role models from childhood, ideas about typically male and female innate capacities, lack of knowledge and low self-confidence. Doing seemed to reproduce gender, but being in a group of the same sex could shape unity and a relaxed atmosphere. The findings could be understood as a set of gender frames, which might prevent either of the sexes from developing their full potentials and transgress into e.g. the employment market. Gendering should be highlighted and debated in psychosocial rehabilitation.
Improvements to PATRIC, the all-bacterial Bioinformatics Database and Analysis Resource Center
Davis, James J.; Brettin, Thomas; Dietrich, Emily M.; ...
2016-11-28
Here, the Pathosystems Resource Integration Center (PATRIC) is the bacterial Bioinformatics Resource Center. Recent changes to PATRIC include a redesign of the web interface and some new services that provide users with a platform that takes them from raw reads to an integrated analysis experience. The redesigned interface allows researchers direct access to tools and data, and the emphasis has changed to user-created genome-groups, with detailed summaries and views of the data that researchers have selected. Perhaps the biggest change has been the enhanced capability for researchers to analyze their private data and compare it to the available public data.more » Researchers can assemble their raw sequence reads and annotate the contigs using RASTtk. PATRIC also provides services for RNA-Seq, variation, model reconstruction and differential expression analysis, all delivered through an updated private workspace. Private data can be compared by `virtual integration' to any of PATRIC's public data. The number of genomes available for comparison in PATRIC has expanded to over 80 000, with a special emphasis on genomes with antimicrobial resistance data. PATRIC uses this data to improve both subsystem annotation and k-mer classification, and tags new genomes as having signatures that indicate susceptibility or resistance to specific antibiotics.« less
Improvements to PATRIC, the all-bacterial Bioinformatics Database and Analysis Resource Center
Wattam, Alice R.; Davis, James J.; Assaf, Rida; Boisvert, Sébastien; Brettin, Thomas; Bun, Christopher; Conrad, Neal; Dietrich, Emily M.; Disz, Terry; Gabbard, Joseph L.; Gerdes, Svetlana; Henry, Christopher S.; Kenyon, Ronald W.; Machi, Dustin; Mao, Chunhong; Nordberg, Eric K.; Olsen, Gary J.; Murphy-Olson, Daniel E.; Olson, Robert; Overbeek, Ross; Parrello, Bruce; Pusch, Gordon D.; Shukla, Maulik; Vonstein, Veronika; Warren, Andrew; Xia, Fangfang; Yoo, Hyunseung; Stevens, Rick L.
2017-01-01
The Pathosystems Resource Integration Center (PATRIC) is the bacterial Bioinformatics Resource Center (https://www.patricbrc.org). Recent changes to PATRIC include a redesign of the web interface and some new services that provide users with a platform that takes them from raw reads to an integrated analysis experience. The redesigned interface allows researchers direct access to tools and data, and the emphasis has changed to user-created genome-groups, with detailed summaries and views of the data that researchers have selected. Perhaps the biggest change has been the enhanced capability for researchers to analyze their private data and compare it to the available public data. Researchers can assemble their raw sequence reads and annotate the contigs using RASTtk. PATRIC also provides services for RNA-Seq, variation, model reconstruction and differential expression analysis, all delivered through an updated private workspace. Private data can be compared by ‘virtual integration’ to any of PATRIC's public data. The number of genomes available for comparison in PATRIC has expanded to over 80 000, with a special emphasis on genomes with antimicrobial resistance data. PATRIC uses this data to improve both subsystem annotation and k-mer classification, and tags new genomes as having signatures that indicate susceptibility or resistance to specific antibiotics. PMID:27899627
Faculty development to improve teaching at a health sciences center: a needs assessment.
Scarbecz, Mark; Russell, Cynthia K; Shreve, Robert G; Robinson, Melissa M; Scheid, Cheryl R
2011-02-01
There has been increasing interest at health science centers in improving the education of health professionals by offering faculty development activities. In 2007-08, as part of an effort to expand education-related faculty development offerings on campus, the University of Tennessee Health Science Center surveyed faculty members in an effort to identify faculty development activities that would be of interest. Factor analysis of survey data indicated that faculty interests in the areas of teaching and learning can be grouped into six dimensions: development of educational goals and objectives, the use of innovative teaching techniques, clinical teaching, improving traditional teaching skills, addressing teaching challenges, and facilitating participation. There were significant differences in the level of interest in education-related faculty development activities by academic rank and by the college of appointment. Full professors expressed somewhat less interest in faculty development activities than faculty members of lower ranks. Faculty members in the Colleges of Medicine and Dentistry expressed somewhat greater interest in faculty development to improve traditional teaching skills. The policy implications of the survey results are discussed, including the need for faculty development activities that target the needs of specific faculty groups.
Design and implementation of a pilot orientation program for new NASA engineering employees
NASA Technical Reports Server (NTRS)
Graham, Ronald E.; Furnas, Randall B.; Babula, Maria
1993-01-01
This paper describes the design and field testing of an orientation program for new employees of NASA Lewis Research Center's Engineering Directorate. A group of new employees designed the program using a series of TQM analysis techniques. The program objectives were: provide consistent treatment for new employees; assist management and clerical staff with their responsibility for orientation; introduce the employee to as many facets of the organization as possible; allow the employee to feel like a member of the organization as early as possible; maximize the use of existing services; and use up-to-date information. The major aspects of the program included: training of management and clerical staff; lab tours and briefings describing the organization; shepherding, using senior employees as shepherds; a handbook of information about the center and the directorate; a package of information about northeast Ohio; and social activities involving the new employees and shepherds. The program was tested on a pilot group of six new employees over a four month period and was considered to be highly successful by both the employees and management. Aspects of the program have subsequently been adopted for center-wide use.
Regev, Sivan; Hadas-Lidor, Noami; Rosenberg, Limor
2016-08-01
In this study, the assessment tool "Internet and Computer User Profile" questionnaire (ICUP) is presented and validated. It was developed in order to gather information for setting intervention goals to meet current demands. Sixty-eight subjects aged 23-68 participated in the study. The study group (n = 28) was sampled from two vocational centers. The control group consisted of 40 participants from the general population that were sampled by convenience sampling based on the demographics of the study group. Subjects from both groups answered the ICUP questionnaire. Subjects of the study group answered the General Self- Efficacy (GSE) questionnaire and performed the Assessment of Computer Task Performance (ACTP) test in order to examine the convergent validity of the ICUP. Twenty subjects from both groups retook the ICUP questionnaire in order to obtain test-retest results. Differences between groups were tested using multiple analysis of variance (MANOVA) tests. Pearson and Spearman's tests were used for calculating correlations. Cronbach's alpha coefficient and k equivalent were used to assess internal consistency. The results indicate that the questionnaire is valid and reliable. They emphasize that the layout of the ICUP items facilitates in making a comprehensive examination of the client's perception regarding his participation in computer and internet activities. Implications for Rehabiliation The assessment tool "Internet and Computer User Profile" (ICUP) questionnaire is a novel assessment tool that evaluates operative use and individual perception of computer activities. The questionnaire is valid and reliable for use with participants of vocational centers dealing with mental illness. It is essential to facilitate access to computers for people with mental illnesses, seeing that they express similar interest in computers and internet as people from the general population of the same age. Early intervention will be particularly effective for young adults dealing with mental illness, since the digital gap between them and young people in general is relatively small.
Age and sex-related differences in 431 pediatric facial fractures at a level 1 trauma center.
Hoppe, Ian C; Kordahi, Anthony M; Paik, Angie M; Lee, Edward S; Granick, Mark S
2014-10-01
Age and sex-related changes in the pattern of fractures and concomitant injuries observed in this patient population is helpful in understanding craniofacial development and the treatment of these unique injuries. The goal of this study was to examine all facial fractures occurring in a child and adolescent population (age 18 or less) at a trauma center to determine any age or sex-related variability amongst fracture patterns and concomitant injuries. All facial fractures occurring at a trauma center were collected over a 12-year period based on International Classification of Disease, rev. 9 codes. This was delimited to include only those patients 18 years of age or younger. Age, sex, mechanism, and fracture types were collected and analyzed. During this time period, there were 3147 patients with facial fractures treated at our institution, 353 of which were in children and adolescent patients. Upon further review 68 patients were excluded due to insufficient data for analysis, leaving 285 patients for review, with a total of 431 fractures. The most common etiology of injury was assault for males and motor vehicle accidents (MVA) for females. The most common fracture was of the mandible in males and of the orbit in females. The most common etiology in younger age groups includes falls and pedestrian struck. Older age groups exhibit a higher incidence of assault-related injuries. Younger age groups showed a propensity for orbital fractures as opposed to older age groups where mandibular fractures predominated. Intracranial hemorrhage was the most common concomitant injury across most age groups. The differences noted in etiology of injury, fracture patterns, and concomitant injuries between sexes and different age groups likely reflects the differing activities that each group engages in predominantly. In addition the growing facial skeleton offers varying degrees of protection to the cranial contents as force-absorbing mechanisms develop. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Graphic indicators of pedagogic style in Greek children's drawings.
Bonoti, Fotini; Misailidi, Plousia; Gregoriou, Fotini
2003-08-01
311 Greek children's drawings of classroom life were employed to investigate the diagnostic validity of this measure in identifying teachers' pedagogic style. The sample was divided into three age groups, 6-, 8-, and 10-yr. olds, who were asked to draw pictures of themselves and their teachers in their classroom. Drawings were scored using as criteria the four graphic indicators (ratings of size, detailing, centrality, and social distance) proposed by Aronsson and Anderson in 1996. Analysis showed three out of the four indicators discriminated teacher-centered vs student-centered pedagogic style. More specifically, in the teacher-centered setting children drew the teacher of dominant size, in a central position, and as remote, while in the student-centered setting the teacher was depicted closer to the student, in a less central position, and less emphasized relative to the student. The findings are discussed with respect to the absence of age-related effects and the possibility of using children's drawings of classroom life as a measure for tapping into children's representations of pedagogic style.
Park, Jiyoung
2018-03-01
In this study, we investigated the ecological factors that influence health-promoting behaviors in children from low-income families in South Korea using a descriptive correlational design. The participants included 297 elementary school students who used community childcare centers, 297 caregivers, and 68 teachers at the centers. Data were collected using a structured self-report survey, and were subjected to a multi-level regression analysis. The factors influencing the health-promoting behaviors of children were as follows: self-efficacy and self-regulation as intrapersonal factors; caregivers' parenting behavior and peer relationships as interpersonal factors; and the number of months since the centers' establishment, teachers workloads, and centers' perceived environments as institutional factors. The findings emphasize the need to create a healthy environment to promote the health of children from vulnerable groups, and that community-based participatory research might be an effective strategy to address these environmental problems, and ultimately help reduce health disparities between children. © 2018 John Wiley & Sons Australia, Ltd.
[Latent Class Analysis of Gambling Activities among Korean Adolescents].
Kang, Kyonghwa; Kim, Hyeongsu; Park, Ae Ran; Kim, Hee Young; Lee, Kunsei
2018-04-01
The aim of this study is to identify the types of gambling among adolescents and provide basic prevention information regarding adolescents' gambling problems. Secondary data from representative national survey on 2015 Youth Gambling Problems of Korea Center on Gambling Problems were used. Using latent class analysis (LCA), 13 gambling types such as offline and online games of 14,011 adolescents were classified, and gambling experiences and characteristics were analyzed. The subgroups of adolescent gambling were identified as four latent classes: a rare group (84.5% of the sample), a risk group (1.0%), an offline group (11.9%), and an expanded group (2.6%). The types and characteristics of gambling among the latent classes differed. In the risk group, adolescents participated in online illegal sports betting and internet casino, and gambling time, gambling expenses, and the number of gambling types were higher than other groups. Gambling frequently occur among adolescent, and the subtypes of gambling did not reveal homogeneous characteristics. In order to prevent adolescent gambling problems, it is a necessary to develop tailored prevention intervention in the nursing field, which is appropriate to the characteristics of adolescent gambling group and can help with early identification. © 2018 Korean Society of Nursing Science.
Research centers and institutes in U.S. medical schools: a descriptive analysis.
Mallon, William T; Bunton, Sarah A
2005-11-01
Research centers and institutes are a common mechanism to organize and facilitate biomedical research at medical schools and universities. The authors report the results of a study on the size, scope, and range of activities of 604 research centers and institutes at research-intensive U.S. medical schools and their parent universities. Centers and institutes with primary missions of patient care, education, or outreach were not included. The findings indicate that, in addition to research, centers and institutes are involved in a range of activities, including education, service, and technology transfer. The centers and institutes the authors studied were more interdisciplinary than those included in previous studies on this topic. Most research centers and institutes did not have authority comparable to academic departments. Only 22% of centers directly appointed faculty members, and most center directors reported to a medical school dean or a department chair. A small group of centers and institutes ("power centers"), however, reported to a university president or provost, and may have considerable power and influence in academic decision making and resource allocation. Two main types of centers and institutes emerge from this research. The first type, which includes the vast of majority of centers, is modest in its scope and marginal in its influence. The second type--with greater amounts of funding, larger staffs, and direct access to institutional decisionmakers--may have a more significant role in the organization and governance of the medical school and university and in the ways that researchers interact within and across academic divisions.
Experiences of Opium Dependents from Performance of Methadone Centers of Kerman, Iran
Banazadeh Mahani, Nabi; Kheradmand, Ali; Abedi, Heidarali
2009-01-01
Background: To assess patients' satisfaction and to evaluate methadone therapy program, it is important to understand the experiences of opium dependents during the treatment period in methadone centers and determine the quality of this program and revise standards based on that. This study aimed to describe the nature and structure of patients' experiences during treatment in methadone centers. Methods: This was a qualitative method using phenomenology. Sampling was purposive and the participants were selected from opium dependents referred to Kerman methadone centers during 2007. Sampling continued until data saturation and the sample size was 32. Colaizzi's method was applied for data analysis. Findings: The findings of this study included 27 codes categorized in four main groups: experiences of structure, personnel, patients, and regulations. These four categories showed the main structure of experiences in methadone centers. Conclusion: Lack of treatment centers in near-by cities or the problems of those centers suggest that it is necessary to establish new centers or solve the problems of centers in near-by cities. The type of patients referring to the centers plays a role in treatment process. The regular presence of physicians and other personnel and their concerns and care for patients as well as longer working hours of the centers have roles in patients' satisfaction and increase of consistency with treatment. Discussing the rules and regulations of the center with patients including the obligatory of daily reference to the center to obtain medicine and injections sound necessary. Also, it is necessary to find ways for solving problems of urine tests. PMID:24494087
Zhang, Guo-Fang; Cai, Mei-Yu; Jing, Ping; He, Chong; Li, Ping; Zhao, Feng-Qi; Li, Ji-Zhen; Fan, Xue-Zhong; Ng, Seik Weng
2010-01-01
Two transition-metal compounds derived from 2,4-dinitroimidazole, {[Ni(DNI)2(H2O)3][Ni(DNI)2 (H2O)4]}·6H2O, 1, and Pb(DNI)2(H2O)4, 2, were characterized by elemental analysis, FT-IR, TG-DSC and X-ray single-crystal diffraction analysis. Crystal data for 1: monoclinic, space group C2/c, a = 26.826(3), b = 7.7199(10), c = 18.579(2) Å, β = 111.241(2)° and Z = 4; 2: monoclinic, space group C2/c, a = 6.5347(6), b = 17.1727(17), c = 14.1011(14) Å, β = 97.7248(10) and Z = 4. Compound 1 contains two isolated nickel centers in its structure, one being six-coordinate and another five-coordinate. The structure of 2 contains a lead (II) center surrounded by two chelating DNI ligands and four water molecules in distorted square-antiprism geometry. The abundant hydrogen bonds in two compounds link the molecules into three-dimensional network and stabilize the molecules. The TG-DSC analysis reveals that the first step is the loss of water molecules and the final residue is the corresponding metal oxides and carbon. PMID:20526419
A DICOM based radiotherapy plan database for research collaboration and reporting
NASA Astrophysics Data System (ADS)
Westberg, J.; Krogh, S.; Brink, C.; Vogelius, I. R.
2014-03-01
Purpose: To create a central radiotherapy (RT) plan database for dose analysis and reporting, capable of calculating and presenting statistics on user defined patient groups. The goal is to facilitate multi-center research studies with easy and secure access to RT plans and statistics on protocol compliance. Methods: RT institutions are able to send data to the central database using DICOM communications on a secure computer network. The central system is composed of a number of DICOM servers, an SQL database and in-house developed software services to process the incoming data. A web site within the secure network allows the user to manage their submitted data. Results: The RT plan database has been developed in Microsoft .NET and users are able to send DICOM data between RT centers in Denmark. Dose-volume histogram (DVH) calculations performed by the system are comparable to those of conventional RT software. A permission system was implemented to ensure access control and easy, yet secure, data sharing across centers. The reports contain DVH statistics for structures in user defined patient groups. The system currently contains over 2200 patients in 14 collaborations. Conclusions: A central RT plan repository for use in multi-center trials and quality assurance was created. The system provides an attractive alternative to dummy runs by enabling continuous monitoring of protocol conformity and plan metrics in a trial.
Reuschel, Anna; Bogatsch, Holger; Barth, Thomas; Wiedemann, Renate
2010-11-01
To compare the intraoperative and postoperative outcomes of conventional longitudinal phacoemulsification and torsional phacoemulsification. Department of Ophthalmology, University of Leipzig, Germany. Randomized single-center clinical trial. Eyes with senile cataract were randomized to have phacoemulsification using the Infiniti Vision System and the torsional mode (OZil) or conventional longitudinal mode. Primary outcomes were corrected distance visual acuity (CDVA) and central endothelial cell density (ECD), calculated according to the Conference on Harmonisation-E9 Guidelines in which missing values were substituted by the median in each group (primary analysis) and the loss was then calculated using actual data (secondary analysis). Secondary outcomes were ultrasound (US) time, cumulative dissipated energy (CDE), and percentage total equivalent power in position 3. Postoperative follow-up was at 3 months. The mean preoperative CDVA was 0.41 logMAR in the torsional group and 0.38 logMAR in the longitudinal group, improving to 0.07 logMAR postoperatively in both groups. The mean ECD loss was 7.2% ± 4.6% in the torsional group (72 patients) and 7.1% ± 4.4% in the longitudinal group (76 patients), with no statistically significant differences in the primary analysis (P = .342) or secondary analysis (P = .906). The mean US time, CDE, and percentage total equivalent power in position 3 were statistically significantly lower in the torsional group (98 patients) than in the longitudinal group (94 patients) (P<.001). The torsional mode was as safe as the longitudinal mode in phacoemulsification for age-related cataract. Copyright © 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
Bossick, Andrew S; Sangha, Roopina; Olden, Heather; Alexander, Gwen L; Wegienka, Ganesa
2018-01-01
Hysterectomy is the most common non-obstetrical surgery for women in the United States. Few investigations comparing hysterectomy surgical approaches include patient-centered outcomes. The study was performed at Henry Ford Health System in Detroit, Michigan between February 2015 and May 2015. The data were collected through structured focus groups with 24 post-hysterectomy women in order to identify PCOs to employ in a subsequent cohort study of hysterectomy surgical approaches. One pilot focus group and five additional focus groups were held. Qualitative data analysis, using data from coded transcripts of focus groups, was used to identify themes.Eligible women, aged between 18 and 65 years and had an EMR documented Current Procedural Terminology (CPT™) code or an International Statistical Classification of Diseases and Related Health Problems - Ninth Edition (ICD-9) code of hysterectomy between December 2012 and December 2014 (N=1,381, N=307 after exclusions) were selected and recruited. A question guide was developed to investigate women's experiences and feelings about the experience prior and subsequent to their hysterectomy. Analysis utilized the Framework Method. Focus groups with women who previously had a hysterectomy revealed their pre- and post-hysterectomy perceptions. Responses grouped into topics of pre- and post-surgical experiences, and information all women should know. Responses grouped into themes of 1) decision making, 2) the procedure - surgical experience, 3) recovery, 4) advice to past self, and 5) recommendations to other women. These findings about perceptions, beliefs, and attitudes of women having undergone hysterectomy could support health care providers deliver patient-centered care. These results informed data collection for a prospective longitudinal cohort study that is now underway. The data suggest a need for increased education and empowerment in the decision making process, while expanding on information given for post-operative expectations and somatic changes that occur post-hysterectomy.
2012-01-01
Background Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers. Methods/design An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis). Discussion If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines. Trial registration The study is registered as NCT01291953 (ClinicalTrials.gob) PMID:23130754
YouTube as a potential training method for laparoscopic cholecystectomy
Lee, Jun Suh; Seo, Ho Seok
2015-01-01
Purpose The purpose of this study was to analyze the educational quality of laparoscopic cholecystectomy (LC) videos accessible on YouTube, one of the most important sources of internet-based medical information. Methods The keyword 'laparoscopic cholecystectomy' was used to search on YouTube and the first 100 videos were analyzed. Among them, 27 videos were excluded and 73 videos were included in the study. An arbitrary score system for video quality, devised from existing LC guidelines, were used to evaluate the quality of the videos. Video demographics were analyzed by the quality and source of the video. Correlation analysis was performed. Results When analyzed by video quality, 11 (15.1%) were evaluated as 'good', 40 (54.8%) were 'moderate', and 22 (30.1%) were 'poor', and there were no differences in length, views per day, or number of likes, dislikes, and comments. When analyzed by source, 27 (37.0%) were uploaded by primary centers, 20 (27.4%) by secondary centers, 15 (20.5%) by tertiary centers, 5 (6.8%) by academic institutions, and 6 (8.2%) by commercial institutions. The mean score of the tertiary center group (6.0 ± 2.0) was significantly higher than the secondary center group (3.9 ± 1.4, P = 0.001). The video score had no correlation with views per day or number of likes. Conclusion Many LC videos are accessible on YouTube with varying quality. Videos uploaded by tertiary centers showed the highest educational value. This discrepancy in video quality was not recognized by viewers. More videos with higher quality need to be uploaded, and an active filtering process is necessary. PMID:26236699
Active-learning versus teacher-centered instruction for learning acids and bases
NASA Astrophysics Data System (ADS)
Acar Sesen, Burcin; Tarhan, Leman
2011-07-01
Background and purpose: Active-learning as a student-centered learning process has begun to take more interest in constructing scientific knowledge. For this reason, this study aimed to investigate the effectiveness of active-learning implementation on high-school students' understanding of 'acids and bases'. Sample The sample of this study was 45 high-school students (average age 17 years) from two different classes, which were randomly assigned to the experimental (n = 21) and control groups (n = 25), in a high school in Turkey. Design and methods A pre-test consisting of 25 items was applied to both experimental and control groups before the treatment in order to identify student prerequisite knowledge about their proficiency for learning 'acids and bases'. A one-way analysis of variance (ANOVA) was conducted to compare the pre-test scores for groups and no significant difference was found between experimental (ME = 40.14) and control groups (MC = 41.92) in terms of mean scores (F 1,43 = 2.66, p > 0.05). The experimental group was taught using an active-learning curriculum developed by the authors and the control group was taught using traditional course content based on teacher-centered instruction. After the implementation, 'Acids and Bases Achievement Test' scores were collected for both groups. Results ANOVA results showed that students' 'Acids and Bases Achievement Test' post-test scores differed significantly in terms of groups (F 1,43 = 102.53; p < 0.05). Additionally, in this study 54 misconceptions, 14 of them not reported in the literature before, were observed in the following terms: 'acid and base theories'; 'metal and non-metal oxides'; 'acid and base strengths'; 'neutralization'; 'pH and pOH'; 'hydrolysis'; 'acid-base equilibrium'; 'buffers'; 'indicators'; and 'titration'. Based on the achievement test and individual interview results, it was found that high-school students in the experimental group had fewer misconceptions and understood the concepts more meaningfully than students in control group. Conclusion The study revealed that active-learning implementation is more effective at improving students' learning achievement and preventing misconceptions.
Etemadi-Chardah, Niloofar; Matinpour, Bahman; Heshmati, Rasoul
2017-07-01
Addiction brings about severe and profound physical, psychological and social damages such as divorce, crime, and unemployment. The present study was to investigate the effectiveness of transactional analysis (TA) therapy on addiction intensity of woman patients treated with methadone. The research design was quasi-experimental with a pretest-posttest and a control group. The statistical population consisted of all the addicted women who referred to any drug rehabilitation center of Tehran, Iran, in 2016. They were selected using available sampling. Forty addicted patients were placed randomly in both the experimental and control groups. Addiction severity index (ASI) and demographic questionnaires were used. Group therapy using TA approach was executed on the experimental group for 10 sessions, each session for 2 hours (one session per week). The results of covariance analysis after controlling pretest showed that the difference between test and control group was significant for three subscales of psychological, drug abuse and alcohol consumption status (P < 0.001). The difference between test and control groups was significant considering the seven-variable centroid (P < 0.001). The difference in dimensions of addiction intensity between the two groups was significant (P < 0.001). Also, analysis of the variables separately showed significant differences in psychiatric condition, drug and alcohol use dimensions (P < 0.001). Based on these findings, it seems that group therapy using TA approach is effective in reducing addiction intensity of woman patients treated with methadone. Therefore, it can be concluded that TA group interventions account for 76% of the changes in psychological status, 43% of the changes in drug abuse status, and 49% of the changes in alcohol consumption status in woman patients under methadone treatment.
Katz, M; Levine, A Adar; Kol-Degani, H; Kav-Venaki, L
2010-11-01
Evaluation of the efficacy of a patented, compound herbal preparation (CHP) in improving attention, cognition, and impulse control in children with ADHD. A randomized, double-blind, placebo-controlled trial. University-affiliated tertiary medical center. 120 children newly diagnosed with ADHD, meeting DSM-IV criteria. Random assignment to the herbal treatment group (n = 80) or control group (placebo; n = 40); 73 patients in the treatment group (91%) and 19 in the control group (48%) completed the 4-month trial. Test of Variables of Attention (TOVA) administered before and after the treatment period; overall score and 4 subscales. The treatment group showed substantial, statistically significant improvement in the 4 subscales and overall TOVA scores, compared with no improvement in the control group, which persisted in an intention-to-treat analysis. The well-tolerated CHP demonstrated improved attention, cognition, and impulse control in the intervention group, indicating promise for ADHD treatment in children.
Friend, Mary Louanne; Sieloff, Christina Leibold; Murphy, Shannon; Leeper, James
2016-07-01
Nursing education programs have responsibilities to their stakeholders to prepare graduates who can provide safe, effective patient centered care while leading health care changes. Empowered nurses have been associated with low nurse turnover and higher patient satisfaction; however, less is currently known about group empowerment in nursing education. In order to examine group empowerment in schools of nursing, the Sieloff-King Assessment of Group Empowerment in Organizations (SKAGEO©) was adapted and tested for content validity and confirmatory factor analysis. The adapted instrument, the Sieloff-King-Friend Assessment of Group Empowerment within Educational Organizations (SKFAGEEO) was first reviewed by nurse experts who provided quantitative and qualitative data regarding each item. A total of 320 nurse deans and faculty comprised the final sample for the second order confirmatory 8 factor analysis. Findings revealed factor loadings ranging from .455 to .960.The overall fit of the propose model was Chi Square=1383. 24, df=566, p<.001; GFI=.786, RMSEA=0.69. The study results indicated that the SKFAGEEO has acceptable psychometric properties. Copyright © 2016 Elsevier Ltd. All rights reserved.
Bernardino, Ítalo Macedo; Barbosa, Kevan Guilherme Nóbrega; Nóbrega, Lorena Marques; Cavalcante, Gigliana Maria Sobral; Ferreira, Efigenia Ferreira E; d'Ávila, Sérgio
2017-09-01
The aim of this study was to determine the circumstances of aggressions and patterns of maxillofacial injuries among victims of interpersonal violence. This was a cross-sectional and exploratory study conducted from the analysis of 7,132 medical-legal and social records of interpersonal violence victims seen in a Forensic Medicine and Dentistry Center. Descriptive and multivariate statistics were performed using Multiple Correspondence Analysis. Three groups with different victimization profiles were identified. The first group was mainly composed of men of different age groups, victims of community violence that resulted in facial bones or dentoalveolar fracture. The second group was mainly composed of adolescents (10-19 years) of both sexes, victims of interpersonal violence and without specific pattern of injuries. The third group was composed of adult women (≥ 20 years) victims of domestic violence that resulted in injuries of soft tissues of face or other body regions. The results suggest that sociodemographic and circumstantial characteristics are important factors in victimization by maxillofacial injuries and interpersonal violence.
Analysis and characterization of graphene-on-substrate devices
NASA Astrophysics Data System (ADS)
Berdebes, Dionisis
The purpose of this MS Thesis is the analysis and characterization of graphene on substrate structures prepared at the Birck Nanotechnology Center-Purdue University/IBM Watson Research Center-N.Y., and characterized under low-field transport conditions. First, a literature survey is conducted, both in theoretical and experimental work on graphene transport phenomena, and the open issues are reported. Next, the theory of low-field transport in graphene is reviewed within a Landauer framework. Experimental results of back-gated graphene-on-substrate devices, prepared by the Appenzeller group, are then presented, followed by an extraction of an energy/temperature dependent backscattering mean free path as the main characterization parameter. A key conclusion is the critical role of contacts in two-probe measurements. In this framework, a non-self-consistent Non Equilibrium Green's Function method is employed for the calculation of the odd and even metal-graphene ballistic interfacial resistance. A good agreement with the relevant experimental work is observed.
MIPS: a database for protein sequences and complete genomes.
Mewes, H W; Hani, J; Pfeiffer, F; Frishman, D
1998-01-01
The MIPS group [Munich Information Center for Protein Sequences of the German National Center for Environment and Health (GSF)] at the Max-Planck-Institute for Biochemistry, Martinsried near Munich, Germany, is involved in a number of data collection activities, including a comprehensive database of the yeast genome, a database reflecting the progress in sequencing the Arabidopsis thaliana genome, the systematic analysis of other small genomes and the collection of protein sequence data within the framework of the PIR-International Protein Sequence Database (described elsewhere in this volume). Through its WWW server (http://www.mips.biochem.mpg.de ) MIPS provides access to a variety of generic databases, including a database of protein families as well as automatically generated data by the systematic application of sequence analysis algorithms. The yeast genome sequence and its related information was also compiled on CD-ROM to provide dynamic interactive access to the 16 chromosomes of the first eukaryotic genome unraveled. PMID:9399795
Maslow, Carey B; Caramanica, Kimberly; Welch, Alice E; Stellman, Steven D; Brackbill, Robert M; Farfel, Mark R
2015-06-01
The longitudinal course of posttraumatic stress disorder (PTSD) over 8-9 years was examined among 16,488 rescue and recovery workers who responded to the events of September 11, 2001 (9/11) at the World Trade Center (WTC; New York, NY), and were enrolled in the World Trade Center Health Registry. Latent class growth analysis identified 5 groups of rescue and recovery workers with similar score trajectories at 3 administrations of the PTSD Checklist (PCL): low-stable (53.3%), moderate- stable (28.7%), moderate-increasing (6.4%), high-decreasing (7.7%), and high-stable (4.0%). Relative to the low-stable group, membership in higher risk groups was associated with 9/11-related exposures including duration of WTC work, with adjusted odds ratios ranging from 1.3 to 2.0, witnessing of horrific events (range = 1.3 to 2.1), being injured (range = 1.4 to 2.3), perceiving threat to life or safety (range = 2.2 to 5.2), bereavement (range = 1.6 to 4.8), and job loss due to 9/11 (range = 2.4 to 15.8). Within groups, higher PCL scores were associated with adverse social circumstances including lower social support, with B coefficients ranging from 0.2 to 0.6, divorce, separation, or widowhood (range = 0.4-0.7), and unemployment (range = 0.4-0.5). Given baseline, exposure-related, and contextual influences that affect divergent PTSD trajectories, screening for both PTSD and adverse circumstances should occur immediately, and at regular intervals postdisaster. © 2015 International Society for Traumatic Stress Studies.
Cariati, P; Cabello-Serrano, A; Perez-de Perceval-Tara, M; Monsalve-Iglesias, F; Martínez-Lara, I
2017-11-01
This study aims to evaluate and analyze the clinical features and outcomes of oral and oropharyngeal squamous cell carcinoma (SCC) in patients < 45-years old in our center. A retrospective analysis was conducted using the records of patients diagnosed with oral and oropharyngeal SCC between 1998 and 2011 in the University Hospital of Granada (Spain). The analysis identified 33 patients with oral and oropharyngeal SCC with an age of <45 years. Moreover, during the years studied, a further 472 patients were diagnosed with oral and oropharyngeal SCC in our center. Thus, 100 SCC patients with an age of >45 years were randomly selected from the same database. A retrospective analysis was conducted to determine specific features including sites of occurrence, risk factors, sex distribution, socio-economic status, T stage at diagnosis, nodal involvement, degree of tumor differentiation, locoregional failure and overall survival at 5 years was. Further, the results of both groups were compared. The male-female ratio was 1.2:1 in the group of young adults and 2.03:1 in the group of patients with an age of >45 years. No significant differences were found in terms of site, nodal involvement, locoregional failure, and overall survival. However, there were statistically significant differences between the two groups in terms of features such as risk factors, socio-economic status, T stage at diagnosis, and degree of tumor differentiation. The overall 5-year survival rate was 62% for patients >45 years old, whilst for the group of young adults this rate was 48.4% (p= 0.17). The poor association between the common risk factors and oral and oropharyngeal cancers in young adults suggests that other pathogenic mechanisms should be investigated. For young patients, the data show evidence of poorer outcomes in terms of overall survival (p=0.17), and locoregional failure (p=0.23). Nevertheless, the literature shows that the results in this field are particularly inconsistent, and further research is therefore needed to provide more in-depth knowledge of the disease in this age group.
Reasons for discharges against medical advice: a qualitative study
Onukwugha, Eberechukwu; Saunders, Elijah; Mullins, C. Daniel; Pradel, Françoise G.; Zuckerman, Marni; Weir, Matthew R.
2013-01-01
Background There is limited information in the literature about reasons for discharges against medical advice (DAMA) as supplied by patients and providers. Information about the reasons for DAMA is necessary for identifying workable strategies to reduce the likelihood and health consequences of DAMA. The objective of this study is to identify the reasons for DAMA based on patient and multi-category provider focus group interviews (FGIs). Methods Patients who discharged against medical advice between 2006 and 2008 from a large, academic medical center along with hospital providers reporting contact with patients who left against medical advice were recruited. Three patient-only groups, one physician-only group, and one nurse/social worker group were held. Focus group interviews were transcribed and a thematic analysis was performed to identify themes within and across groups. Participants discussed the reasons for patient DAMA and identified potential solutions. Results Eighteen patients, 5 physicians, 6 nurses and 4 social workers participated in the FGIs. Seven themes emerged across the separate patient, doctor, nurse/social worker group FGIs of reasons why patients leave against medical advice: 1) drug addiction, 2) pain management, 3) external obligations, 4) wait time, 5) doctor’s bedside manner, 6) teaching hospital setting, and 7) communication. Solutions to tackle DAMA identified by participants revolve mainly around enhanced communication and provider education. Conclusions In a large, academic medical center we find some differences and many similarities across patients and providers in identifying the causes of and solutions to DAMA, many of which relate to communication. PMID:20538627
Incipient Social Groups: An Analysis via In-Vivo Behavioral Tracking
Halberstadt, Jamin; Jackson, Joshua Conrad; Bilkey, David; Jong, Jonathan; Whitehouse, Harvey; McNaughton, Craig; Zollmann, Stefanie
2016-01-01
Social psychology is fundamentally the study of individuals in groups, yet there remain basic unanswered questions about group formation, structure, and change. We argue that the problem is methodological. Until recently, there was no way to track who was interacting with whom with anything approximating valid resolution and scale. In the current study we describe a new method that applies recent advances in image-based tracking to study incipient group formation and evolution with experimental precision and control. In this method, which we term “in vivo behavioral tracking,” we track individuals’ movements with a high definition video camera mounted atop a large field laboratory. We report results of an initial study that quantifies the composition, structure, and size of the incipient groups. We also apply in-vivo spatial tracking to study participants’ tendency to cooperate as a function of their embeddedness in those crowds. We find that participants form groups of seven on average, are more likely to approach others of similar attractiveness and (to a lesser extent) gender, and that participants’ gender and attractiveness are both associated with their proximity to the spatial center of groups (such that women and attractive individuals are more likely than men and unattractive individuals to end up in the center of their groups). Furthermore, participants’ proximity to others early in the study predicted the effort they exerted in a subsequent cooperative task, suggesting that submergence in a crowd may predict social loafing. We conclude that in vivo behavioral tracking is a uniquely powerful new tool for answering longstanding, fundamental questions about group dynamics. PMID:27007952
EZ and GOSSIP, two new VO compliant tools for spectral analysis
NASA Astrophysics Data System (ADS)
Franzetti, P.; Garill, B.; Fumana, M.; Paioro, L.; Scodeggio, M.; Paltani, S.; Scaramella, R.
2008-10-01
We present EZ and GOSSIP, two new VO compliant tools dedicated to spectral analysis. EZ is a tool to perform automatic redshift measurement; GOSSIP is a tool created to perform the SED fitting procedure in a simple, user friendly and efficient way. These two tools have been developed by the PANDORA Group at INAF-IASF (Milano); EZ has been developed in collaboration with Osservatorio Monte Porzio (Roma) and Integral Science Data Center (Geneve). EZ is released to the astronomical community; GOSSIP is currently in beta-testing.
Two-Bin Kanban: Ordering Impact at Navy Medical Center San Diego
2016-06-17
pretest (2013 data set) and posttest (2015 data set) analysis to avoid having the findings influenced by price changes. DMLSS does not track shipping...statistics based on those observations (Kabacoff, 2011, p. 112). Replacing the groups of observations with summary statistics allows the analyst...listed on the Acquisition Research Program website (www.acquisitionresearch.net). Acquisition Research Program Graduate School of Business & Public
Container Management During Desert Shield/Storm: An Analysis and Critique of Lessons Learned
1993-04-15
across the distribution spectrum.14 These issues were grouped into five major categories: Containerization and Packaging, Distribution Management , Automation...of containers is needed, according to TDAP. Distribution - Management issues. The Desert Shield experience identified three general distribution ...recommended the formation of a 19 Theater Distribution Management Center from the assets of the Movement Control Agency (MCA) and Material Management
78 FR 27246 - Center for Scientific Review; Notice of Closed Meetings
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-09
...; Modeling and Analysis of Biological Systems Study Section. Date: June 6-7, 2013. Time: 8:00 a.m. to 5:00 p...; Psychosocial Development, Risk and Prevention Study Section. Date: June 6-7, 2013. Time: 8:00 a.m. to 6:00 p.m... Review Group; Behavioral Genetics and Epidemiology Study Section. Date: June 6, 2013. Time: 8:00 a.m. to...
Airwaves and Microblogs: A Statistical Analysis of Al-Shabaab’s Propaganda Effectiveness
2014-12-01
manifests itself through conflicts between belligerents’ power, resolve, and trustworthiness . This is combined with the need of a terrorist group to...commenting on Eid festivals and praying for martyrs.80 Heightened messaging during religious celebrations is also displayed with al-Shabaab praising pilgrims...during the Eid- al Adha celebrations in Mecca in October 2012.81 75 Open Source Center
ERIC Educational Resources Information Center
Kambon, Kobi K. K.; Hopkins, Reginald
1993-01-01
In "On the Desirability of Own-Group Preference" (1993), Michael L. Penn, Stanley O. Gaines, and Layli Phillips argue that misguided and mythical ideal of racial-social integration in America is the only reasonable and effective foundation for real African empowerment in American society. Serious intellectual battle will be required to…
Applying APA's Learner-Centered Principles to School-Based Group Counseling.
ERIC Educational Resources Information Center
Stroh, Heather R.; Sink, Christopher A.
2002-01-01
This article introduces the American Psychological Association's learner-centered principles and provides a brief rationale for infusing them into comprehensive guidance and counseling programs. Using small group counseling as an illustration, explains how counselors can apply a learner-centered approach to their work. (Contains 43 references.)…
Youm, Sekyoung
2015-01-01
Abstract Objective: The objectives of this study are (1) to establish a ubiquitous healthcare (u-healthcare) center for those who wish to use u-healthcare, allowing them to experience the service, and (2) to evaluate the users' awareness and expectations of the service based on their overall assessment. Materials and Methods: To establish the u-healthcare center, a kiosk, devices for health checkup, a body-type examination system, and a physical fitness assessment system were installed. Also, a u-healthcare Web site was developed. A survey was conducted on 280 individuals who visited the u-healthcare center and used the service, to determine (1) individual awareness of u-healthcare before using the service and their change of perception after use, (2) factors that affect the use of u-healthcare, and (3) the effects of disease awareness on exercise habits. Results: Only 25.4% of the participants were aware of u-healthcare, and only 36% who saw the u-healthcare center recognized that it was where the u-healthcare service was provided. The group of individuals who were willing to use the u-healthcare showed statistically significant differences in their satisfaction with the overall environment of the center, as well as the specificity of the descriptions, examination results, kindness of the staff, and their responses. Additionally, the group of individuals who were diagnosed with chronic diseases and the group who were not showed statistically significant differences in the number of days on which they exercised lightly or took a walk. Conclusions: To promote the usage of u-healthcare service, the understanding of the service and the credibility of examination results need to be increased by sharing successful cases. Furthermore, to expand the use of the system that allows a person to regularly check his or her state of health, a lifelong periodical management system linked with another medical welfare program will be needed. PMID:25635473
Stabilometric parameters analysis in children with visual disorder
2014-01-01
Background Although postural changes were already reported in blind adults, no previous study has investigated postural stability in blind children. Moreover, there are few studies which used a stabilometric instrument to measure postural balance. In this study we evaluated stabilometric paramaters in blind children. Methods We evaluated children between 7 to 12 years old, they were divided into two groups: Blind (n = 11) and age-matched control (n = 11) groups by using computerized stabilometry. The stabilometric examination was performed taking the gravity centers displacement of the individual projected into the platform. Thirthy seconds after the period in which this information was collected, the program defined a medium-pressure center, which was used to define x and y axes displacement and the distance between the pressure center and the platform center. Furthermore, the average sway rate and the body sway area were obtained by dividing the pressure center displacement and the time spent on the task; and by an ellipse function (95% percentille), respectively. Percentages of anterior, posterior, left and right feet weight also were calculated. Variables were compared by using the Student’s t test for unpaired data. Significance level was considered for p <0.05. Results Displacement of the x axis (25.55 ± 9.851 vs. -3.545 ± 7.667; p <0.05) and average sway rate (19.18 ± 2.7 vs. -10.55 ± 1.003; p <0.001) were increased in the blind children group. Percentage of left foot weight was reduced (45.82 ± 2.017 vs. 52.36 ± 1.33; p <0.05) while percentage of right foot weight was increased (54.18 ± 2.17 vs. 47.64 ± 1.33; p <0.05) in blind children. Other variables did not show differences. Conclusions Blind children present impaired stabilometric parameters. PMID:24387244
Youm, Sekyoung; Park, Seung-Hun
2015-04-01
The objectives of this study are (1) to establish a ubiquitous healthcare (u-healthcare) center for those who wish to use u-healthcare, allowing them to experience the service, and (2) to evaluate the users' awareness and expectations of the service based on their overall assessment. To establish the u-healthcare center, a kiosk, devices for health checkup, a body-type examination system, and a physical fitness assessment system were installed. Also, a u-healthcare Web site was developed. A survey was conducted on 280 individuals who visited the u-healthcare center and used the service, to determine (1) individual awareness of u-healthcare before using the service and their change of perception after use, (2) factors that affect the use of u-healthcare, and (3) the effects of disease awareness on exercise habits. Only 25.4% of the participants were aware of u-healthcare, and only 36% who saw the u-healthcare center recognized that it was where the u-healthcare service was provided. The group of individuals who were willing to use the u-healthcare showed statistically significant differences in their satisfaction with the overall environment of the center, as well as the specificity of the descriptions, examination results, kindness of the staff, and their responses. Additionally, the group of individuals who were diagnosed with chronic diseases and the group who were not showed statistically significant differences in the number of days on which they exercised lightly or took a walk. To promote the usage of u-healthcare service, the understanding of the service and the credibility of examination results need to be increased by sharing successful cases. Furthermore, to expand the use of the system that allows a person to regularly check his or her state of health, a lifelong periodical management system linked with another medical welfare program will be needed.
NASA Astrophysics Data System (ADS)
Estes, M. G., Jr.; Griffin, R.; Al-Hamdan, M. Z.; Estes, S. M.; Crosson, W. L.; Chiao, S.
2016-12-01
Funding from The NASA MUREP Institutional Research Opportunity (MIRO) Program established the Center for Applied Atmospheric Research and Education (CAARE) to promote STEM literacy and enhance the capability to support NASA's Earth Science Mission Directorate. Through CAARE opportunities for STEM students at minority and underserved institutions were provided to enhance their undergraduate education with summer internship experiences at NASA Centers. The University of Alabama in Huntsville and the Universities Space Research Association scientists developed internship opportunities for students in applied atmospheric research at the National Space Science and Technology Center near the NASA Marshall Space Flight Center. Project opportunities focused on the use of NASA remotely sensed data, geospatial technologies and statistical analyses to evaluate problems related to urban heat islands and air quality. Students received training in the fundamentals of remote sensing and geospatial analysis to establish a foundation from which to pursue research projects. An approach was designed for the students to work initially in groups and then focus on individual projects in the latter part of the ten week internship. Working in groups benefitted the transition of the students from their respective academic institutions to the NASA work environment and provided the students with useful professional experience in a collegial environment. As knowledge was gained through the group project and areas of interest identified the students were able to explore further research questions of interest, evaluate research applications and determine the benefits of using NASA remotely sensed data. Students found that urban heat islands (UHI) did exist in both San Jose, CA and Huntsville, AL and methods to evaluate the magnitude of the UHI seasonally, diurnally and spatially were explored. Regression models of PM 2.5 based on remotely-sensed aerosol optical depth and meteorological data were also developed for selected urban areas and public health implications evaluated.
Taguchi, Alexander T; O'Malley, Patrick J; Wraight, Colin A; Dikanov, Sergei A
2013-07-09
Ubiquinone is an almost universal, membrane-associated redox mediator. Its ability to accept either one or two electrons allows it to function in critical roles in biological electron transport. The redox properties of ubiquinone in vivo are determined by its environment in the binding sites of proteins and by the dihedral angle of each methoxy group relative to the ring plane. This is an attribute unique to ubiquinone among natural quinones and could account for its widespread function with many different redox complexes. In this work, we use the photosynthetic reaction center as a model system for understanding the role of methoxy conformations in determining the redox potential of the ubiquinone/semiquinone couple. Despite the abundance of X-ray crystal structures for the reaction center, quinone site resolution has thus far been too low to provide a reliable measure of the methoxy dihedral angles of the primary and secondary quinones, QA and QB. We performed 2D ESEEM (HYSCORE) on isolated reaction centers with ubiquinones (13)C-labeled at the headgroup methyl and methoxy substituents, and have measured the (13)C isotropic and anisotropic components of the hyperfine tensors. Hyperfine couplings were compared to those derived by DFT calculations as a function of methoxy torsional angle allowing estimation of the methoxy dihedral angles for the semiquinones in the QA and QB sites. Based on this analysis, the orientation of the 2-methoxy groups are distinct in the two sites, with QB more out of plane by 20-25°. This corresponds to an ≈50 meV larger electron affinity for the QB quinone, indicating a substantial contribution to the experimental difference in redox potentials (60-75 mV) of the two quinones. The methods developed here can be readily extended to ubiquinone-binding sites in other protein complexes.
Connell, Georgianne L; Donovan, Deborah A; Chambers, Timothy G
2016-01-01
Student-centered strategies are being incorporated into undergraduate classrooms in response to a call for reform. We tested whether teaching in an extensively student-centered manner (many active-learning pedagogies, consistent formative assessment, cooperative groups; the Extensive section) was more effective than teaching in a moderately student-centered manner (fewer active-learning pedagogies, less formative assessment, without groups; the Moderate section) in a large-enrollment course. One instructor taught both sections of Biology 101 during the same quarter, covering the same material. Students in the Extensive section had significantly higher mean scores on course exams. They also scored significantly higher on a content postassessment when accounting for preassessment score and student demographics. Item response theory analysis supported these results. Students in the Extensive section had greater changes in postinstruction abilities compared with students in the Moderate section. Finally, students in the Extensive section exhibited a statistically greater expert shift in their views about biology and learning biology. We suggest our results are explained by the greater number of active-learning pedagogies experienced by students in cooperative groups, the consistent use of formative assessment, and the frequent use of explicit metacognition in the Extensive section. © 2016 G. L. Connell, D. A. Donovan, and T. G. Chambers. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).
Biffi, Roberto; Fattori, Luca; Bertani, Emilio; Radice, Davide; Rotmensz, Nicole; Misitano, Pasquale; Cenciarelli, Sabine; Chiappa, Antonio; Tadini, Liliana; Mancini, Marina; Pesenti, Giovanni; Andreoni, Bruno; Nespoli, Angelo
2012-05-23
An antimicrobial dressing containing ionic silver was found effective in reducing surgical-site infection in a preliminary study of colorectal cancer elective surgery. We decided to test this finding in a randomized, double-blind trial. Adults undergoing elective colorectal cancer surgery at two university-affiliated hospitals were randomly assigned to have the surgical incision dressed with Aquacel Ag Hydrofiber dressing or a common dressing. To blind the patient and the nursing and medical staff to the nature of the dressing used, scrub nurses covered Aquacel Ag Hydrofiber with a common wound dressing in the experimental arm, whereas a double common dressing was applied to patients of control group. The primary end-point of the study was the occurrence of any surgical-site infection within 30 days of surgery. A total of 112 patients (58 in the experimental arm and 54 in the control group) qualified for primary end-point analysis. The characteristics of the patient population and their surgical procedures were similar. The overall rate of surgical-site infection was lower in the experimental group (11.1% center 1, 17.5% center 2; overall 15.5%) than in controls (14.3% center 1, 24.2% center 2, overall 20.4%), but the observed difference was not statistically significant (P = 0.451), even with respect to surgical-site infection grade 1 (superficial) versus grades 2 and 3, or grade 1 and 2 versus grade 3. This randomized trial did not confirm a statistically significant superiority of Aquacel Ag Hydrofiber dressing in reducing surgical-site infection after elective colorectal cancer surgery. Clinicaltrials.gov: NCT00981110.
de Carvalho, Guilherme Moreira; Sponchiado Junior, Emílio Carlos; Garrido, Angela Delfina Bittencourt; Lia, Raphael Carlos Comelli; Garcia, Lucas da Fonseca Roberti; Marques, André Augusto Franco
2015-12-01
The aim of this study was to evaluate the apical transportation, the centering ability, and the cleaning effectiveness of a reciprocating single-file system associated to different glide path techniques. The mesial root canals of 52 mandibular molars were randomly distributed into 4 groups (n = 13) according to the different glide path techniques used before biomechanical preparation with Reciproc System (RS): KF/RS (sizes 10 and 15 K-files), NGP/RS (no glide path, only reciprocating system), PF/RS (sizes 13, 16, and 19 PathFile instruments), and NP (no preparation). Cone-beam computed tomography analysis was performed before and after instrumentation for apical third images acquisition. Apical transportation and its direction were evaluated by using the formula D = (X1 - X2) - (Y1 - Y2), and the centering ability was analyzed by the formula CC = (X1 - X2/Y1 - Y2 or Y1 - Y2/X1 - X2). The samples were submitted to histologic processing and analyzed under a digital microscope for debris quantification. The values were statistically analyzed (Kruskal-Wallis, the Dunn multiple comparisons test, P < .05). All groups had similar apical transportation values, with no significant difference among them (P > .05). Groups had a tendency toward transportation in the mesial direction. No technique had perfect centering ability (=1.0), with no significant difference among them. KF/RS had larger amount of debris, with statistically significant difference in comparison with NGP/RS (P > .05). The different glide path techniques promoted minimal apical transportation, and the reciprocating single-file system tested remained relatively centralized within the root canal. Also, the different techniques interfered in the cleaning effectiveness of the reciprocating system. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Self-referrals versus physician referrals: What new patient visit yields an actual surgical case?
Herring, Eric Z; Peck, Matthew R; Vonck, Caroline E; Smith, Gabriel A; Mroz, Thomas E; Steinmetz, Michael P
2018-06-15
OBJECTIVE Spine surgeons in the United States continue to be overwhelmed by an aging population, and patients are waiting weeks to months for appointments. With a finite number of clinic visits per surgeon, analysis of referral sources needs to be explored. In this study, the authors evaluated patient referrals and their yield for surgical volume at a tertiary care center. METHODS This is a retrospective study of new patient visits by the spine surgery group at the Cleveland Clinic Center for Spine Health from 2011 to 2016. Data on all new or consultation visits for 5 identified spinal surgeons at the Center for Spine Health were collected. Patients with an identifiable referral source and who were at least 18 years of age at initial visit were included in this study. Univariate analysis was used to identify demographic differences among referral groups, and then multivariate analysis was used to evaluate those referral groups as significant predictors of surgical yield. RESULTS After adjusting for demographic differences across all referrals, multivariate analysis identified physician referrals as more likely (OR 1.48, 95% CI 1.04-2.10, p = 0.0293) to yield a surgical case than self-referrals. General practitioner referrals (OR 0.5616, 95% CI 0.3809-0.8278, p = 0.0036) were identified as less likely to yield surgical cases than referrals from interventionalists (OR 1.5296, p = 0.058) or neurologists (OR 1.7498, 95% CI 1.0057-3.0446, p = 0.0477). Additionally, 2 demographic factors, including distance from home and age, were identified as predictors of surgery. Local patients (OR 1.21, 95% CI 1.13-1.29, p = 0.018) and those 65 years of age or older (OR 0.80, 95% CI 0.72-0.87, p = 0.0023) were both more likely to need surgery after establishing care with a spine surgeon. CONCLUSIONS In conclusion, referrals from general practitioners and self-referrals are important areas where focused triaging may be necessary. Further research into midlevel providers and nonsurgical spine provider's role in these referrals for spine pathology is needed. Patients from outside of the state or younger than 65 years could benefit from pre-visit screening as well to optimize a surgeon's clinic time use and streamline patient care.
ERIC Educational Resources Information Center
Keister, Mary Elizabeth
This document is the final report of Phase One (1967-1970) of the Group Care of Infants Demonstration (Center) Project. This report devotes major attention to the problems of establishing, operating, and evaluating a group day care center for infant and toddler care. The Center project describes what is required to provide housing, equipment,…
Small Group Conflict: A Look at Equity, Satisfaction, and Styles of Conflict Management.
ERIC Educational Resources Information Center
Wall, Victor D., Jr.; Nolan, Linda L.
1987-01-01
Study of 71 task-oriented groups revealed that perceived inequity was negatively related to amount of expressed satisfaction with the group and positively related to amount of perceived conflict within the group. Inequity was associated more strongly with conflict centered around people than with conflict centered around task; least associated…
ERIC Educational Resources Information Center
Kendall, Earline D.
Children under 3 years of age who are in group care face special health risks. The U.S. Centers for Disease Control indicate the existence of a causal relationship between infant group day care and certain diseases that are spread through contact at day care centers. Children in group care who are still in diapers are especially vulnerable to…
Is There an Association between Keloids and Blood Groups?
Mouhari-Toure, Abas; Saka, Bayaki; Kombaté, Koussaké; Akakpo, Sefako; Egbohou, Palakiyem; Tchangaï-Walla, Kissem; Pitche, Palokinam
2012-01-01
Objective. The aim of the study is to investigate the possible associations between the blood groups ABO and Rhesus systems and the presence of keloids in patients with black skin. Method. This case-control study was conducted between September 2007 and August 2011 comparing dermatologic outpatients with keloids to matched controls recruited in preanesthetic consultation at Tokoin Teaching Hospital of Lomé (Togo). Results. The distribution of different ABO blood groups and Rhesus blood groups in both groups (cases versus controls) was not significantly different. This distribution of different blood groups was superimposed on the general population of blood donors at the National Blood Transfusion Center of Lomé. Univariate analysis between each blood group and the presence of keloid does not yield any statistically significant association between blood groups and presence of keloids in the subjects. Conclusion. The study shows no significant association between blood groups and the presence of keloids in our patients. Further investigation needs to be conducted to elucidate this hypothesis further by conducting multicenter studies of several ethnic groups.
Physician retention in community and migrant health centers: who stays and for how long?
Singer, J D; Davidson, S M; Graham, S; Davidson, H S
1998-08-01
This study used discrete-time survival analysis to estimate the tenure of primary care physicians in Community Health Centers (CHCs), to identify the changing risk of leaving Community Health Center employment as time passes, and to identify factors associated with a physician's likelihood of remaining in a Community Health Center. Because of dramatic differences in physician career trajectories, much of the focus was on differences between physicians with and without National Health Service Corps obligations. Beginning with an administrative dataset at the Bureau of Primary Health Care that listed primary care physicians for each Community Health Center, the completeness and accuracy of the information provided were verified and an analytic database of all physicians working in those centers during a 21-month measurement window from January 1, 1990 through September 30, 1992 was constructed. The data included start and end dates, percent full-time equivalent status, and certain demographic characteristics. In addition, several data elements describing the Community Health Center were merged onto each physician record. These included urban or rural location, expenditure level, productivity, and federal grade. Through the use of discrete-time survival analysis, it was possible to include in the analytic sample all 2,654 physicians who worked during the period, even those who started working before January 1, 1990 and those who were still working on September 30, 1992. Survivor functions were estimated showing the proportion of physicians remaining after each quarter of their tenure (ie, after the fourth quarter of work, after the 12th quarter of work, etc). In addition, hazard functions were estimated showing the risk that a physician who had worked through the end of one quarter would leave during the following quarter. Finally, multivariate analysis demonstrated the relation of certain physician and center characteristics to the likelihood of the physician's leaving the center during each quarter. The median tenure of primary care physicians in Community Health Centers was approximately 3 years regardless of whether or not the physician had a National Health Service Corps obligation. But the career trajectories for the two groups of physicians varied dramatically. Most physicians left on or about their anniversary date, probably because it coincided with the end of their contract, but the effect was much more pronounced for National Health Service Corps physicians than for non-National Health Service Corps physicians. By the end of 5 years, approximately 36% of physicians who started without an National Health Service Corps obligation were still working compared with only approximately 17% of those with an National Health Service Corps obligation. The study demonstrates the value of discrete-time survival analysis in addressing questions related to the tenure of primary care physicians in Community Health Centers, making it possible to use data from physicians whose Community Health Center careers began before or ended after a give measurement window. Second, the study measured primary care physician tenure, providing center directors with a yard-stick against which to compare their own center's performance. Finally, the data provided some help in trying to explain differences in the propensity to stay or leave employment in Community Health Centers.
Parsapure, Roxana; Rahimiforushani, Abbas; Majlessi, Fereshteh; Montazeri, Ali; Sadeghi, Roya; Garmarudi, Gholamreza
2016-10-01
Vaginitis is one of the most common diseases in reproductive-aged women (15 - 49 years of age). Side effects of vaginitis can affect other aspects of health, which could be prevented by promoting a healthy lifestyle related to vaginal health. This study aimed at determining the impact of health-promoting educational intervention on lifestyle (nutrition behaviors, physical activities, and mental health) related to vaginal health among reproductive-aged women with vaginitis. The data set was collected as part of an experimental study conducted on 350 reproductive-aged women with vaginitis. Participants were selected through a stratified two-stage clustered sampling and simple randomization from 10 attending health centers affiliated with Kermanshah University of Medical Sciences in five regions (North, South, East, West, and Center) of Kermanshah (a city in western Iran) in 2015. Two clinics in each region were selected; patients from the first center were chosen as the intervention group and patients from the second center made up the control group. To collect data, a questionnaire including socio-demographic and lifestyle questions was used. The questionnaire was designed and validated via the psychometric process. Educational intervention was performed over twenty sessions of 25 to 35 minutes. The intervention group was followed up with face-to-face education, a pamphlet, phone contact, and by social media. The control group continued the routine treatment without contacting the intervention group. Data were collected from both groups before the intervention and six months after the intervention. Data were analyzed using the SPSS-20 package, using the independent t-test, paired t-test, chi-square test, and analysis of covariance (ANCOVA) test. The confidence interval was 95% and P < 0.05 was considered statistically significant. ANCOVA showed that after adjusting for effects of pretest scores, the difference between mean scores on the scale of lifestyle related to vaginal health in the intervention group (28.48 ± 0.38) and control group (23.65 ± 1.23) was significant (P < 0.001). Intervention has a positive significant effect on increasing the mean scores of lifestyle in the intervention group (P < 0.001). Comparing mean differences between the two groups indicated significant difference between them (P < 0.001). Results of the paired t-test in the control group did not show significant changes in lifestyle scores after 6 months (P > 0.05). The independent t-test did not show significant statistical differences between the two groups in terms of demographic characteristics (P > 0.05). According to the findings, educational intervention is beneficial in promoting three aspects of women's lifestyle related to vaginal health. Therefore, a health-promoting lifestyle seems essential for having a healthy vagina and for preventing vaginitis.
Tongtawee, Taweesak; Dechsukhum, Chavaboon; Leeanansaksiri, Wilairat; Kaewpitoon, Soraya; Kaewpitoon, Natthawut; Loyd, Ryan A; Matrakool, Likit; Panpimanmas, Sukij
2015-01-01
Helicobacter pylori plays an important role in gastric cancer and typical eradication regimens are no longer effective in many countries, including Thailand. The aim of our study was to compare the effect of Lactobacillus delbrueckii and Streptococcus thermophillus on tailored triple therapy for Helicobacter pylori eradication. This prospective single-center study was conducted in Thailand. Helicobacter pylori associated gastritis patients were randomized to 2 groups: group 1 (n=100) was tailored triple therapy with placebo (esomeprazole 20 mg bid, clarithromycin 500 mg bid or metronidazole 400 mg tid if clarithromycin resistance and amoxicillin 1000 mg bid), and group 2 was tailored triple therapy plus pretreatment with probiotic containing yogurt. Successful eradication was defined as both negative histology and negative rapid urease test at four weeks after treatment. A total of 200 infected patients were enrolled. PP analysis involved 194 patients: 96 in the tailored triple therapy with placebo group (group 1) and 98 the in tailored triple therapy plus pretreatment with probiotic containing yogurt group (group 2). Successful eradication was observed in 170 (87.6%) patients; by PP analysis, the eradication rate was significantly higher in group 2 (P=0.04, 95%CI; 0.02-0.13) than in group 1. ITT analysis also showed that the value was significantly higher in the tailored triple threapy plus pretreatment with probiotic containing yogurt group (group 2) (89/100; 89%) than in the tailored triple therapy with placebo group (group 1) (P=0.01, 95%CI; 0.04-0.15). In terms of adverse events, there was no significant difference between the two groups. Pretreatment with probiotic containing yogurt can improve Helicobacter pylori eradication rates with tailored triple therapy. Adding probiotics does not reduce adverse effects of the medication.
Energy Frontier Research With ATLAS: Final Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Butler, John; Black, Kevin; Ahlen, Steve
2016-06-14
The Boston University (BU) group is playing key roles across the ATLAS experiment: in detector operations, the online trigger, the upgrade, computing, and physics analysis. Our team has been critical to the maintenance and operations of the muon system since its installation. During Run 1 we led the muon trigger group and that responsibility continues into Run 2. BU maintains and operates the ATLAS Northeast Tier 2 computing center. We are actively engaged in the analysis of ATLAS data from Run 1 and Run 2. Physics analyses we have contributed to include Standard Model measurements (W and Z cross sections,more » t\\bar{t} differential cross sections, WWW^* production), evidence for the Higgs decaying to \\tau^+\\tau^-, and searches for new phenomena (technicolor, Z' and W', vector-like quarks, dark matter).« less
Peroperative Gastrograffin bowel lavage in gastroschisis.
Cherian, Abraham; Hallows, Ruth M; Singh, Shalinder J; McCallion, William A; Stewart, Richard J
2006-10-01
The aim of the study was to evaluate potential benefits in the use of peroperative bowel lavage with Gastrograffin in neonates with gastroschisis. A retrospective analysis of newborns with gastroschisis was performed over a 10-year period in 2 centers in the United Kingdom. Two groups were studied wherein one had peroperative bowel lavage with Gastrograffin and the other did not. Data were collected on 116 patients of whom 93 were suitable for analysis. There were no statistically significant differences in primary closure rate, duration of ventilation, parenteral nutrition, or hospital stay. Intestinal obstruction occurred more frequently in the nonlavage group. Gastrograffin lavage peroperatively in gastroschisis offers no potential advantage in reducing ventilatory requirements, parenteral nutrition, and hospital stay. It also does not achieve greater primary closure rates, but may reduce the incidence of intestinal obstruction.
Metals and Ceramics Information Center.
1983-07-01
Continue on revrse side if necessary and identify by block number) Technical Information Center Ceramics DoD Information Analysis Center Information...Metals and Ceramics Information Center (MCIC) is one of the technical Information Analysis Centers (IACs) chartered and sponsored by the Department of...engineering programs for the DoD. The Center is responsible for the collection, review, analysis , appraisal, and summary of the available scientific and
Farhadi, Mehran; Reisi-Dehkordi, Negar; Kalantari, Mehrdad; Zargham-Boroujeni, Ali
2014-05-01
Quality of life (QOL) is a multidimensional concept which has nowadays turned to a supportive interventional goal in chronic diseases like cancer. Numerous interventions have been carried out to improve the QOL in patients with cancer, but the effect of indirect interventions on the patients' QOL has not been investigated yet. This study aimed to compare the efficacy of group meaning centered hope therapy of cancer patients and their families on the patients' QOL. This is a clinical trial conducted in three groups with a pre-test post-test design in which the effect of independent variable of meaning centered hope therapy on the dependent variable of QOL was investigated. The subjects were selected from the cancer patients who were aware of their diagnosis, were in primary stages of the disease, and had passed one period of chemotherapy. In this study, 42 patients (16 in control group, 14 in patients' group therapy, and 12 in patients' families' group therapy) were studied, and WHOQOL was adopted to investigate their QOL. Data were analyzed in two forms of descriptive and inferential statistical tests. The results obtained showed that group meaning centered hope therapy of cancer patients and their families had a positive effect on patients' QOL compared to the control group. The notable finding of the present study was that holding group sessions either for the patients or for their families equally improved patients' QOL. QOL of the cancer patients can be improved by either group meaning centered hope therapy for patients or group meaning centered hope therapy for their families. This finding is important for therapists, as when the patients cannot attend group therapy sessions due to complications of chemotherapy, these sessions can be held for their families to improve patients' QOL. This conclusion is very helpful in nurses' interaction with the patients and their families.
F4 , E6 and G2 exceptional gauge groups in the vacuum domain structure model
NASA Astrophysics Data System (ADS)
Shahlaei, Amir; Rafibakhsh, Shahnoosh
2018-03-01
Using a vacuum domain structure model, we calculate trivial static potentials in various representations of F4 , E6, and G2 exceptional groups by means of the unit center element. Due to the absence of the nontrivial center elements, the potential of every representation is screened at far distances. However, the linear part is observed at intermediate quark separations and is investigated by the decomposition of the exceptional group to its maximal subgroups. Comparing the group factor of the supergroup with the corresponding one obtained from the nontrivial center elements of S U (3 ) subgroup shows that S U (3 ) is not the direct cause of temporary confinement in any of the exceptional groups. However, the trivial potential obtained from the group decomposition into the S U (3 ) subgroup is the same as the potential of the supergroup itself. In addition, any regular or singular decomposition into the S U (2 ) subgroup that produces the Cartan generator with the same elements as h1, in any exceptional group, leads to the linear intermediate potential of the exceptional gauge groups. The other S U (2 ) decompositions with the Cartan generator different from h1 are still able to describe the linear potential if the number of S U (2 ) nontrivial center elements that emerge in the decompositions is the same. As a result, it is the center vortices quantized in terms of nontrivial center elements of the S U (2 ) subgroup that give rise to the intermediate confinement in the static potentials.
International GPS Service for Geodynamics
NASA Technical Reports Server (NTRS)
Zumberge, J. F. (Editor); Urban, M. P. (Editor); Liu, R. (Editor); Neilan, R. E. (Editor)
1996-01-01
This 1995 annual report of the IGS International GPS (Global Positioning System) Service for Geodynamics - describes the second operational year of the service. It provides the many IGS contributing agencies and the rapidly growing user community with essential information on current organizational and technical matters promoting the IGS standards and products (including organizational framework, data processing strategies, and statistics showing the remarkable expansion of the GPS monitoring network, the improvement of IGS performance, and product quality). It also introduces important practical concepts for network densification by integration of regional stations and the combination of station coordinate solutions. There are groups of articles describing general aspects of the IGS, the Associate Analysis Centers (AACs), Data Centers, and IGS stations.
Experimental verification of using nanostructured ceramic implants and osteograft
NASA Astrophysics Data System (ADS)
Rerikh, V. V.; Lastevskiy, A. D.; Sadovoy, M. A.; Zaidman, A. M.; Bataev, A. V.; Predein, Yu. A.; Avetisyan, A. R.; Romanenko, V. V.; Mamonova, E. V.; Nikulina, A. A.; Semantsova, E. S.; Smirnov, A. I.
2017-09-01
Ventral interbody fusion was carried out in 8 mini pigs in order to determine the effectiveness of anterior stabilization of the vertebral unit with implants made of nanostructured alumina ceramics using cellular technologies to form a bone block. A ceramic cage with a through cylindrical orifice in the center was implanted into the interbody gap; either cellular osteograft (group 1) or cellular autograft (group 2) was placed in it. The adjacent vertebrae were fixed anteriorly with a ceramic plate containing 4 screws. Bone block formation was studied radiographically, morphologically, and by MSCT. The signs of osteointegration of ceramic implants were observed in both groups after 90 days. MSCT and morphological analysis revealed the formation of the osteoceramic block and completed osteogenesis in the bone-graft contact region in group 1 compared to the control group (p < 0.05).
Alsharif, Abdelhamid M; Potts, Michelle; Laws, Regina; Freire, Amado X; Sultan-Ali, Ibrahim
2016-10-01
Obstructive sleep apnea (OSA) is a prevalent disorder that is associated with multiple medical consequences. Although in-laboratory polysomnography is the gold standard for the diagnosis of OSA, portable monitors have been developed and studied to help increase efficiency and ease of diagnosis. We aimed to assess the adequacy of a midlevel provider specializing in sleep medicine to risk-stratify patients for OSA based on a chart review versus a comprehensive clinic evaluation before scheduling an unattended sleep study. This study was an observational, nonrandomized, retrospective data collection by chart review of patients accrued prospectively who underwent an unattended sleep study at the Sleep Health Center at the Memphis Veterans Affairs Medical Center during the first 13 months of the program (May 1, 2011-May 31, 2012). A total of 205 patients were included in the data analysis. Analysis showed no statistically significant differences between chart review and clinic visit groups ( P = 0.54) in terms of OSA diagnosis. Although not statistically significant, the analysis shows a trend toward higher mean age (50.3 vs 47.4 years; P = 0.10) and lower mean body mass index (34.4 vs 36.0; P = 0.08) in individuals who were evaluated during a comprehensive clinic visit. A statistically significant difference is seen in terms of the pretest clinical probability of OSA being moderate or high in 62.2% of patients in the clinic visit group and 95.7% in the chart review group, with a χ 2 P ≤ 0.0001. In the Veterans Health Administration's system, the assessment of pretest probability may be determined by a midlevel provider using chart review with equal efficacy to a comprehensive face-to-face evaluation in terms of OSA diagnosis via unattended sleep studies.
Structural study of Cu(II) complexes with benzo[b]furancarboxylic acids
NASA Astrophysics Data System (ADS)
Kalinowska, Diana; Klepka, Marcin T.; Wolska, Anna; Drzewiecka-Antonik, Aleksandra; Ostrowska, Kinga; Struga, Marta
2017-11-01
Four Cu(II) complexes with 2- and 3-benzo[b]furancarboxylic acids have been synthesized and characterized using combination of two spectroscopic techniques. These techniques were: (i) FTIR and (ii) XAFS. FTIR analysis confirmed that complexes were formed and gave insight into identification of possible coordinating groups to the metallic center. XANES analysis indicated that the oxidation state of Cu is +2. EXAFS analysis allowed to identify that the first coordination sphere is formed by 4-5 oxygen atoms with the Cu-O distances around 2 Å. Combining these techniques it was possible to structurally describe novel Cu(II) complexes with benzo[b]furancarboxylic acids.
Another collision for the Coma cluster
NASA Technical Reports Server (NTRS)
Vikhlinin, A.; Forman, W.; Jones, C.
1996-01-01
The wavelet transform analysis of the Rosat position sensitive proportional counter (PSPC) images of the Coma cluster are presented. The analysis shows, on small scales, a substructure dominated by two extended sources surrounding the two bright clusters NGC 4874 and NGC 4889. On scales of about 2 arcmin to 3 arcmin, the analysis reveals a tail of X-ray emission originating near the cluster center, curving to the south and east for approximately 25 arcmin and ending near the galaxy NGC 4911. The results are interpreted in terms of a merger of a group, having a core mass of approximately 10(exp 13) solar mass, with the main body of the Coma cluster.
Funding Opportunity: Genomic Data Centers
Funding Opportunity CCG, Funding Opportunity Center for Cancer Genomics, CCG, Center for Cancer Genomics, CCG RFA, Center for cancer genomics rfa, genomic data analysis network, genomic data analysis network centers,
Solmaz, Ilknur; Kacar, Yildiz Aka; Simsek, Ozhan; Sari, Nebahat
2016-08-01
Snake melon is an important cucurbit crop especially in the Southeastern and the Mediterranean region of Turkey. It is consumed as fresh or pickled. The production is mainly done with the local landraces in the country. Turkey is one of the secondary diversification centers of melon and possesses valuable genetic resources which have different morphological characteristics in case of snake melon. Genetic diversity of snake melon genotypes collected from different regions of Turkey and reference genotypes obtained from World Melon Gene Bank in Avignon-France was examined using 13 simple sequence repeat (SSR) markers. A total of 69 alleles were detected, with an average of 5.31 alleles per locus. The polymorphism information content of SSR markers ranged from 0.19 to 0.57 (average 0.38). Based on cluster analysis, two major groups were defined. The first major group included only one accession (61), while the rest of all accessions grouped in the second major group and separated into different sub-clusters. Based on SSR markers, cluster analysis indicated that considerably high genetic variability exists among the examined accessions; however, Turkish snake melon accessions were grouped together with the reference snake melon accessions.
NASA Astrophysics Data System (ADS)
Alluwimi, Muhammed Saad
Purpose: To investigate the use of asymmetry analysis to reduce normal between-subject variability of macular thickness measurements using SD-OCT. Methods: 63 volunteers free of eye disease were recruited: 33 young subjects (ages 21 to 35 years with mean and SD of 25 +/- 1.7), and 30 older subjects (ages 45 to 85 years with mean and SD of 66.7 +/- 9.0). All participants passed a comprehensive ophthalmic examination within the past two years. Macular images were gathered with the Spectralis OCT (V 5.4, Heidelberg Engineering, GmbH). The overlay 8x8 grid was manually centered on the fovea and aligned with the foveal-disc axis, then divided into five zones per hemifield following the method of Um et al (2012 IOVS 53:1139); asymmetry was computed as the difference between superior and inferior zone thicknesses. We assumed that the lowest variation and the highest density of ganglion cells will be found ~3° to 6° from the foveal center, corresponding to zones 1 and 2. For each zone and age group, between-subject standard deviations (SDs) were compared for retinal thickness (RT) versus asymmetry using an F-test. To account for repeated measures, a probability of p < 0.0125 was required for statistical significance. Axial length (AL) and corneal curvature (CC) were measured with an IOLMaster by the same operator and during the same imaging session. Results: For OD, asymmetry analysis reduced between-subject variability in zones 1 and 2 in both groups (F > 3.2, p < 0.001). SD for zone 1 dropped from 12.0 to 3.0 mum in the young group and from 11.7 to 2.6 mum in the older group. SD for zone 2 dropped from 13.6 to 5.3 mum (young) and from 11.1 to 5.8 mum (older). Combining all subjects, neither RT nor asymmetry showed a strong correlation with AL or CC (R2 < 0.01). Analysis for OS yielded the same pattern of results, as did asymmetry analyses between eyes (F > 3.8, p < 0.0001). Conclusions: Asymmetry analysis reduced between-subject variability. These findings demonstrate the potential usefulness of the RT asymmetry analysis for improving ability to detect glaucomatous damage to the macula.
Pattern formation in three-dimensional reaction-diffusion systems
NASA Astrophysics Data System (ADS)
Callahan, T. K.; Knobloch, E.
1999-08-01
Existing group theoretic analysis of pattern formation in three dimensions [T.K. Callahan, E. Knobloch, Symmetry-breaking bifurcations on cubic lattices, Nonlinearity 10 (1997) 1179-1216] is used to make specific predictions about the formation of three-dimensional patterns in two models of the Turing instability, the Brusselator model and the Lengyel-Epstein model. Spatially periodic patterns having the periodicity of the simple cubic (SC), face-centered cubic (FCC) or body-centered cubic (BCC) lattices are considered. An efficient center manifold reduction is described and used to identify parameter regimes permitting stable lamellæ, SC, FCC, double-diamond, hexagonal prism, BCC and BCCI states. Both models possess a special wavenumber k* at which the normal form coefficients take on fixed model-independent ratios and both are described by identical bifurcation diagrams. This property is generic for two-species chemical reaction-diffusion models with a single activator and inhibitor.
TU-AB-BRD-03: Fault Tree Analysis
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dunscombe, P.
2015-06-15
Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less
TU-AB-BRD-02: Failure Modes and Effects Analysis
DOE Office of Scientific and Technical Information (OSTI.GOV)
Huq, M.
2015-06-15
Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less
Du, Yan; Roberts, Penny; Xu, Qingwen
2016-03-07
This study examined whether practicing Tai Chi (TC) along with music can maximize the effects of TC on compliance and fall-related risk factors (Dynamic Gait Index and fear of falling). A convenient sample was recruited in a community senior center. Eighteen women aged 50 to 84 years (9 White, 9 Black) were block randomly assigned to a TC in silence (TC + S; n = 6) or a TC with music (TC + M; n = 12) class. Thirteen participants (4 in TC + S group, 9 in TC + M group) with completed pre- and posttests were included in the final analysis. Paired t tests were conducted to examine changes within groups over time and analysis of covariance was used to assess group differences. After 15 weeks of intervention, balance increased in both groups with significantly higher benefits in the TC + M group (p < .05). Fear of falling scores improved in TC + M group and compliance rate was higher in this group. Practicing TC + M may help increase adherence in White and Black middle-aged and older women, and maximize the effects of TC on fall-related risk factors. Studies with more rigorous study design, including musical considerations, are warranted. © The Author(s) 2016.
Developing Community-Based Learning Centers for Older Adults. A Technical Assistance Manual.
ERIC Educational Resources Information Center
Sprouse, Betsy M.; Brown, Karen
Designed for community groups and organizations, groups of older adults, senior clubs, and agencies, this manual documents the process of developing community education programs for older adults. The first section introduces the concept of a community learning center, while the second section considers whether a learning center should be…
Report of the Army Scientific Advisory Panel AD HOC Group for Logistics and Research and Development
1975-01-01
where the Group met with the commanding officers and staff of the Army Logistics Management Center (ALMC) and the Army Logistics Center (ALOGC...has been completad; i.e., retrospectively, and a new program being con- sidered . It is our understanding that the Army Logistics Management Center
State Education Activities to Support Mission Growth. NGA Center for Best Practices. Issue Brief
ERIC Educational Resources Information Center
Butler, Tara A.
2009-01-01
The National Governors Association Center for Best Practices (NGA Center) leads a Mission Growth Working Group, which consists of states that are significantly impacted by the growth of military bases. The group includes state representatives appointed by the governors of Alabama, Colorado, Florida, Georgia, Hawaii, Kansas, Kentucky, Louisiana,…
Family diabetes matters: a view from the other side.
Samuel-Hodge, Carmen D; Cene, Crystal W; Corsino, Leonor; Thomas, Chelsea; Svetkey, Laura P
2013-03-01
Typically, chronic disease self-management happens in a family context, and for African American adults living with diabetes, family seems to matter in self-management processes. Many qualitative studies describe family diabetes interactions from the perspective of adults living with diabetes, but we have not heard from family members. To explore patient and family perspectives on family interactions around diabetes. Qualitative study using focus group methodology. PARTICIPANTS & APPROACH: We conducted eight audiotaped focus groups among African Americans (four with patients with diabetes and four with family members not diagnosed with diabetes), with a focus on topics of family communication, conflict, and support. The digital files were transcribed verbatim, coded, and analyzed using qualitative data analysis software. Directed content analysis and grounded theory approaches guided the interpretation of code summaries. Focus groups included 67 participants (81 % female, mean age 64 years). Family members primarily included spouses, siblings, and adult children/grandchildren. For patients with diabetes, central issues included shifting family roles to accommodate diabetes and conflicts stemming from family advice-giving. Family members described discomfort with the perceived need to police or "stand over" the diabetic family member, not wanting to "throw diabetes in their [relative's] face," perceiving their communications as unhelpful, and confusion about their role in diabetes care. These concepts generated an emergent theme of "family diabetes silence." Diabetes silence, role adjustments, and conflict appear to be important aspects to address in family-centered diabetes self-management interventions. Contextual data gathered through formative research can inform such family-centered intervention development.
Kaimura, Michiko; Oda, Masako; Mitsubuchi, Hiroshi; Ohba, Takashi; Katoh, Takahiko
2017-01-01
The purpose of this study was to identify participant characteristics in the Kumamoto University Regional Center of the Japan Environment and Children's Study (K-JECS) and to investigate the association of pregnancy outcomes with pregestational maternal body mass index (BMI) and maternal weight gain during pregnancy (MWG). The subjects were women with singleton birth, who had been recruited by the K-JECS, and were registered in the data systems for the first and second questionnaires and transcripts of medical records. The subjects were categorized by BMI with further classification by MWG. The chi-squared test and one-way analysis of variance were performed to determine the correlations of BMI and MWG with perinatal outcomes. Logistic regression analysis was performed to examine perinatal outcome risks. The subject characteristics were similar to the trends observed in the Japanese general population. The odds ratio for natural delivery was low in the overweight groups (OW) and normal weight groups (NW) with excessive weight gain. On the other hand, the risk of cesarean section was high in the OW, and risk of induced or accelerated delivery was high in the NW with excessive weight gain. The risks of preterm birth and LBW were high in the insufficient weight gain groups regardless of BMI. The risks of pregnancy-induced hypertension and gestational diabetes were high in the OW.
Atwood, Molly E; Friedman, Aliza; Meisner, Brad A; Cassin, Stephanie E
2018-05-01
Bariatric surgery patients often experience physical and psychosocial stressors, and difficulty adjusting to significant lifestyle changes. As a result, social support groups that provide patients with support, coping skills, and nutritional information are valuable components of bariatric care. Support group attendance at bariatric centers is associated with greater post-surgery weight loss; however, several barriers hinder attendance at in-person support groups (e.g., travel distance to bariatric centers). Consequently, online support forums are an increasingly utilized resource for patients both before and after surgery. This study examined and described the type and frequency of social support provided on a large online bariatric surgery forum. A total of 1,412 messages in the pre- (n = 822) and post-surgery (n = 590) sections of the forum were coded using qualitative content analysis according to Cutrona and Suhr's (1992) Social Support Behavior Code model (i.e., including informational, tangible, esteem, network, and emotional support types). The majority of messages provided informational and emotional support regarding: a) factual information about the bariatric procedure and nutrition; b) advice for coping with the surgery preparation process, and physical symptoms; and c) encouragement regarding adherence to surgical guidelines, and weight loss progress. Network, esteem, and tangible support types were less frequent than informational and emotional support types. The results inform healthcare providers about the types of social support available to bariatric patients on online support forums and, thus, encourage appropriate referrals to this resource.
Gong, Jie; Xu, Yunan; Chen, Xinguang; Yang, Niannian; Li, Fang; Yan, Yaqiong
2018-01-02
The effect of the Keep Moving toward Healthy Heart and Healthy Brain (KM2H2) program at 6-month post intervention has been assessed. The purpose of this study is to evaluate the KM2H 2 program at 30-month post intervention. A total of 450 senior hypertensive patients from 12 community health centers were randomized by center to either receive KM2H 2 plus standard care (6 centers, n = 232) or standard care only (6 centers, n = 218). Data for outcome measures at 30-month post intervention were analyzed. New cases of stroke and heart attack were verified with medical records; levels of physical activity were assessed using self-reported questionnaire. In addition to comparative analysis, adjusted incidence rate and program effects were determined using mixed effects modeling method. At the 30-month follow-up, the adjusted incidence rate [95% CI] of stroke was 11.81% [5.90, 17.72] for patients in the intervention group and 19.78% [14.07, 25.50] (p = 0.03) for the control group. The adjusted incidence rate of heart attack was 3.34% [1.91, 8.58] and 6.68% [1.64, 11.73] for the intervention and control groups (p = 0.16), respectively; the proportion and the duration of engaging in regular physical activity were significantly greater for the intervention group than the control group. The reductions in blood pressure between the intervention and the control was not statistically significant. The KM2H 2 program showed a persistent effect up to 30 months post intervention in enhancing physical activity and reducing the risk of cardio-cerebrovascular events, particularly stroke. These findings demonstrate the persistent effect of the KM2H 2 and suggest the need for a full-scale evaluation of the intervention program for practical use. ISRCTN Register ISRCTN12608966 . Registered 03 March 2015. Retrospectively registered.
Soccer players have a better standing balance in nondominant one-legged stance
Barone, Rosario; Macaluso, Filippo; Traina, Marcello; Leonardi, Vincenza; Farina, Felicia; Di Felice, Valentina
2011-01-01
The purpose of this study was to analyze the differences in standing balance during dominant and nondominant one-legged stance among athletes of different sports and sedentary subjects. The right-footed subjects of four groups (sedentary, n = 20; soccer, n = 20; basketball, n = 20; windsurfer n = 20) underwent 5-sec unipedal (left and right foot) stabilometric analysis with open eyes and closed eyes to measure center of pressure (COP) sway path and COP velocity (mean value, anteroposterior, and laterolateral in millimeters per second). The soccer group showed better standing balance on the left leg than the sedentary group (P < 0.05). No other significant differences were observed within and amongst groups. The soccer players have a better standing balance on the nondominant leg because of soccer activity. PMID:24198563
On the practice of ignoring center-patient interactions in evaluating hospital performance.
Varewyck, Machteld; Vansteelandt, Stijn; Eriksson, Marie; Goetghebeur, Els
2016-01-30
We evaluate the performance of medical centers based on a continuous or binary patient outcome (e.g., 30-day mortality). Common practice adjusts for differences in patient mix through outcome regression models, which include patient-specific baseline covariates (e.g., age and disease stage) besides center effects. Because a large number of centers may need to be evaluated, the typical model postulates that the effect of a center on outcome is constant over patient characteristics. This may be violated, for example, when some centers are specialized in children or geriatric patients. Including interactions between certain patient characteristics and the many fixed center effects in the model increases the risk for overfitting, however, and could imply a loss of power for detecting centers with deviating mortality. Therefore, we assess how the common practice of ignoring such interactions impacts the bias and precision of directly and indirectly standardized risks. The reassuring conclusion is that the common practice of working with the main effects of a center has minor impact on hospital evaluation, unless some centers actually perform substantially better on a specific group of patients and there is strong confounding through the corresponding patient characteristic. The bias is then driven by an interplay of the relative center size, the overlap between covariate distributions, and the magnitude of the interaction effect. Interestingly, the bias on indirectly standardized risks is smaller than on directly standardized risks. We illustrate our findings by simulation and in an analysis of 30-day mortality on Riksstroke. © 2015 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.
Does Alport syndrome affect the basement membrane of peritoneal vessels?
Sampimon, Denise E; Vlijm, Anniek; Struijk, Dirk G; Krediet, Raymond T
2010-01-01
Alport syndrome and encapsulating peritoneal sclerosis (EPS) are both rare diseases. Their joint occurrence is highly unlikely. Two patients at our center with Alport syndrome developed EPS. We therefore hypothesized that Alport syndrome might predispose to the development of EPS and that this predisposition might be reflected in a fast peritoneal transport rate at baseline. We compared the mass transfer area coefficient (MTAC) of creatinine and the clearances of albumin, immunoglobulin G, and alpha2-macroglobulin at baseline and for all subsequent available measurements in four patient groups: EPS patients with Alport syndrome, EPS patients without Alport syndrome, Alport patients without EPS, and long-term peritoneal dialysis (PD) patients without EPS. The transport characteristics were obtained during a standard peritoneal permeability analysis. Between July 1995 and December 2008, 5 of 417 PD patients treated at our center had Alport syndrome as their primary kidney disease, and 13 of the 417 developed EPS. Of those 13 EPS patients, 2 had Alport syndrome. We observed no differences in the baseline transport characteristics of the four groups under consideration. Taking all measures of transport characteristics into account, only the MTAC of creatinine was higher in the two EPS groups than in the other two groups (p = 0.01). We could not confirm our hypothesis that Alport syndrome affects peritoneal solute clearances.
Burdick, J. S.; Ogola, Gerald O.; Ontiveros, Estrellita
2017-01-01
Achalasia is a rare disorder that has several treatment options. The gold standard of treatment is a surgical myotomy called a laparoscopic Heller myotomy (LHM). More recently, an endoscopic myotomy has become an option as well, called per-oral endoscopic myotomy (POEM). An achalasia registry was queried for patients undergoing either LHM or POEM at Baylor University Medical Center at Dallas. Patient demographics, preoperative and postoperative data points, and Eckardt scores were collected. The patients were further stratified into their follow-up intervals, immediate postoperative and long-term follow-up, to assess surgical success. A subset analysis was done for success of treatment for patients who had redo surgery versus those undergoing the procedure for the first time. There were 12 patients in the POEM group and 11 patients in the LHM group. Both groups demonstrated mean lower esophageal sphincter pressures with failure to relax. Procedure length and hospital length of stay were similar between the two groups. There were three adverse events in each group, but none altered the patient's postoperative clinical course. Eckardt scores, used to assess success of the surgery, were 82% for POEM patients and 66% for LHM patients after 6 months. The outcomes for POEM and LHM in our early experience are similar to those reported in the literature for high-volume centers managing achalasia. PMID:28966450
Leeds, Steven G; Burdick, J S; Ogola, Gerald O; Ontiveros, Estrellita
2017-10-01
Achalasia is a rare disorder that has several treatment options. The gold standard of treatment is a surgical myotomy called a laparoscopic Heller myotomy (LHM). More recently, an endoscopic myotomy has become an option as well, called per-oral endoscopic myotomy (POEM). An achalasia registry was queried for patients undergoing either LHM or POEM at Baylor University Medical Center at Dallas. Patient demographics, preoperative and postoperative data points, and Eckardt scores were collected. The patients were further stratified into their follow-up intervals, immediate postoperative and long-term follow-up, to assess surgical success. A subset analysis was done for success of treatment for patients who had redo surgery versus those undergoing the procedure for the first time. There were 12 patients in the POEM group and 11 patients in the LHM group. Both groups demonstrated mean lower esophageal sphincter pressures with failure to relax. Procedure length and hospital length of stay were similar between the two groups. There were three adverse events in each group, but none altered the patient's postoperative clinical course. Eckardt scores, used to assess success of the surgery, were 82% for POEM patients and 66% for LHM patients after 6 months. The outcomes for POEM and LHM in our early experience are similar to those reported in the literature for high-volume centers managing achalasia.
Moiety, Fady M Shawky; Azzam, Amal Z
2014-04-01
To ascertain whether uterine fundal pressure should have a role in the management of the second stage of labor and to determine its prevalence, benefits and adverse maternal-fetal outcomes. This was a prospective observational study set in a tertiary teaching and research obstetric hospital. A total of 8097 women in labor between 37 and 42 gestational weeks with a singleton cephalic presentation were enrolled. Subjects were subdivided into two groups: fundal pressure group (n=1974 women) and control group (n=6123 women). The primary outcome measure was the duration of the second stage. The secondary outcome measures were maternal outcomes (immediate or delayed) and neonatal outcomes. The prevalence of fundal pressure in our center was 24.38%. Fundal pressure maneuver significantly shortened the duration of the second stage among primiparous women, increased the risk of severe perineal laceration and admission to neonatal intensive care unit in comparison to the non-fundal group. Delayed maternal outcomes showed significant increase in dyspareunia and de novo stress urinary incontinence in the fundal pressure group. Although fundal pressure maneuver shortens the duration of the second stage of labor among primiparous women, it should not be used except when indicated, and under strict guidelines owing to its adverse maternal and fetal outcomes. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.
Health care provider communication: an empirical model of therapeutic effectiveness.
Chochinov, Harvey M; McClement, Susan E; Hack, Thomas F; McKeen, Nancy A; Rach, Amanda M; Gagnon, Pierre; Sinclair, Shane; Taylor-Brown, Jill
2013-05-01
Patients who are facing life-threatening and life-limiting cancer almost invariably experience psychological distress. Responding effectively requires therapeutic sensitivity and skill. In this study, we examined therapeutic effectiveness within the setting of cancer-related distress with the objective of understanding its constituent parts. Seventy-eight experienced psychosocial oncology clinicians from 24 health care centers across Canada were invited to participate in 3 focus groups each. In total, 29 focus groups were held over 2 years, during which clinicians articulated the therapeutic factors deemed most helpful in mitigating patient psychosocial distress. The content of each focus group was summarized into major themes and was reviewed with participants to confirm their accuracy. Upon completion of the focus groups, workshops were held in various centers, eliciting participant feedback on an empirical model of therapeutic effectiveness based on the qualitative analysis of focus group data. Three primary, interrelated therapeutic domains emerged from the data, forming a model of optimal therapeutic effectiveness: 1) personal growth and self-care (domain A), 2) therapeutic approaches (domain B), and 3) creation of a safe space (domain C). Areas of domain overlap were identified and labeled accordingly: domain AB, therapeutic humility; domain BC, therapeutic pacing; and domain AC, therapeutic presence. This empirical model provides detailed insights regarding the elements and pedagogy of effective communication and psychosocial care for patients who are experiencing cancer-related distress. Copyright © 2012 American Cancer Society.
Jack, Megan C; Kenkare, Sonya B; Saville, Benjamin R; Beidler, Stephanie K; Saba, Sam C; West, Alisha N; Hanemann, Michael S; van Aalst, John A
2010-01-01
Faced with work-hour restrictions, educators are mandated to improve the efficiency of resident and medical student education. Few studies have assessed learning styles in medicine; none have compared teaching and learning preferences. Validated tools exist to study these deficiencies. Kolb describes 4 learning styles: converging (practical), diverging (imaginative), assimilating (inductive), and accommodating (active). Grasha Teaching Styles are categorized into "clusters": 1 (teacher-centered, knowledge acquisition), 2 (teacher-centered, role modeling), 3 (student-centered, problem-solving), and 4 (student-centered, facilitative). Kolb's Learning Style Inventory (HayGroup, Philadelphia, Pennsylvania) and Grasha-Riechmann's TSS were administered to surgical faculty (n = 61), residents (n = 96), and medical students (n = 183) at a tertiary academic medical center, after informed consent was obtained (IRB # 06-0612). Statistical analysis was performed using χ(2) and Fisher exact tests. Surgical residents preferred active learning (p = 0.053), whereas faculty preferred reflective learning (p < 0.01). As a result of a comparison of teaching preferences, although both groups preferred student-centered, facilitative teaching, faculty preferred teacher-centered, role-modeling instruction (p = 0.02) more often. Residents had no dominant teaching style more often than surgical faculty (p = 0.01). Medical students preferred converging learning (42%) and cluster 4 teaching (35%). Statistical significance was unchanged when corrected for gender, resident training level, and subspecialization. Significant differences exist between faculty and residents in both learning and teaching preferences; this finding suggests inefficiency in resident education, as previous research suggests that learning styles parallel teaching styles. Absence of a predominant teaching style in residents suggests these individuals are learning to be teachers. The adaptation of faculty teaching methods to account for variations in resident learning styles may promote a better learning environment and more efficient faculty-resident interaction. Additional, multi-institutional studies using these tools are needed to elucidate these findings fully. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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Child-Centered Group Play Therapy: Impact on Social-Emotional Assets of Kindergarten Children
ERIC Educational Resources Information Center
Cheng, Yi-Ju; Ray, Dee C.
2016-01-01
The current study explored the effects of child-centered group play therapy (CCGPT) on social-emotional assets of kindergarten children and the therapeutic aspect of group sizes in CCGPT outcome. A total of 43 participants were randomly assigned to either the intervention or waitlist control groups. We used Parent and Teacher forms of Social…
Extended Sessions in Ongoing Process Groups at University Counseling Centers.
ERIC Educational Resources Information Center
Reinhardt, Brian
Common in the 1960s, marathon groups are now rarely used. With the emerging effects of managed care, short-term brief focused therapies have become the therapeutic norm, and group counseling has become popular because of its low cost and therapeutic effectiveness. Most groups at university counseling centers run for one semester. A strategically…
Zanesco, Caroline; Só, Marcus Vinicius Reis; Schmidt, Sabrina; Fontanella, Vania Regina Camargo; Grazziotin-Soares, Renata; Barletta, Fernando Branco
2017-03-01
This study aimed to evaluate apical transportation (AT), centering ratio (CR), and volume increase (VI) produced after instrumentation of mesiobuccal canals of maxillary molars with hand files, rotary, and reciprocating instruments using micro-computed tomographic (micro-CT) imaging and to demonstrate the ability of digital subtraction radiography (DSR) to evaluate AT. Forty-five canals were randomly assigned to either group K, manual K-files; PTN, ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland); or Rec, Reciproc (n = 15 for each group) for preparation. Master apical files were #25, X2 (#25/06), and R25 (#25/08), respectively. Micro-CT imaging was used to measure AT (mm) and CR (mm) at 3 different locations (1, 4, and 7 mm from the apex). VI (mm 3 ) was measured for each root third and for the whole canal. DSR (mesiodistal and buccolingual projections) was used to measure AT at 1 mm from the apex. AT and CR values were statistically similar across the groups at 1, 4, and 7 mm. AT results obtained for the different locations were similar within each group; CR, in turn, showed statistically lower values at 1 mm. VI was statistically similar in all groups. Both DSR and micro-CT imaging showed that AT always occurred on the outside of canal curvature. The highest mean value obtained for AT was 0.215 mm. AT, CR, and VI were similar for the K, PTN, and Rec groups. AT results were clinically irrelevant. DSR was as effective as micro-CT imaging in AT analysis and could be considered as an alternative method for assessing this outcome. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Strouse, Christopher; Richardson, Paul; Prentice, Grant; Korman, Sandra; Hume, Robin; Nejadnik, Bijan; Horowitz, Mary M; Saber, Wael
2016-07-01
Veno-occlusive disease (VOD) is an early and serious complication of hematopoietic cell transplantation (HCT) that is associated with inferior survival, particularly when it is complicated by multiorgan failure (severe VOD). We evaluated the efficacy of defibrotide in the treatment of severe VOD using observational data from the Center for International Blood and Marrow Transplant Research (CIBMTR). Eight thousand three hundred forty-one patients treated by HCT between 2008 and 2011 were identified from the CIBMTR clinical database; 3.2% met criteria for VOD and 1.2% met criteria for severe VOD. Patients with a diagnosis of VOD as reported to the CIBMTR by their transplanting centers, who had no prior history of cirrhosis, and who had a maximum total bilirubin level > 2.0 mg/dL by day +100 post-HCT were selected for study. Severe VOD was defined as VOD occurring in the setting of renal impairment requiring dialysis or any noninfectious pulmonary abnormality. Patients with severe VOD were divided into 2 groups for analysis: those treated with defibrotide (n = 41) and those not treated with defibrotide (n = 55). Patients in the nondefibrotide group were older, were more likely to be male, were more likely to have a history of previous fungal infection, and had a higher proportion of clinically significant pre-existing disease or organ impairment. Survival rate at day +100 was 39% (95% CI, 24.8% to 54.3%) in patients receiving defibrotide and 30.9% (95% CI, 19.5% to 43.6%) in those not receiving defibrotide. Resolution rate of VOD at day +100 was 51% in the defibrotide group and 29% in the nondefibrotide group (difference, 22.1%; 95% CI, 2.6% to 42%). The results of our study are consistent with previously reported experiences with defibrotide, confirm the poor outcome of this syndrome, and suggest defibrotide is effective in the treatment of severe VOD. Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
Segmentation decreases the magnitude of the tilt illusion
Qiu, Cheng; Kersten, Daniel; Olman, Cheryl A.
2013-01-01
In the tilt illusion, the perceived orientation of a target grating depends strongly on the orientation of a surround. When the orientations of the center and surround gratings differ by a small angle, the center grating appears to tilt away from the surround orientation (repulsion), whereas for a large difference in angle, the center appears to tilt toward the surround orientation (attraction). In order to understand how segmentation/perceptual grouping of the center and surround affect the magnitude of the tilt illusion, we conducted three psychophysical experiments in which we measured observers' perception of center orientation as a function of center-surround relative contrast, relative disparity depth, and geometric features such as occlusion and collinearity. All of these manipulations affected the strength of perceived orientation bias in the center. Our results suggest that if stronger segmentation/perceptual grouping is induced between the center and surround, the tilt repulsion bias decreases/increases. A grouping-dependent tilt illusion plays an important role in visual search and detection by enhancing the sensitivity of our visual system to feature discrepancies, especially in relatively homogenous environments. PMID:24259671
Hydrogen Implementation Working Group A hydrogen implementation working group, consisting of hydrogen-based energy in Hawaii. The Director of the Hawaii Center for Advanced Transportation Technologies
Martinez, Catalina; Bacigalupe, Gonzalo; Cortada, Josep M; Grandes, Gonzalo; Sanchez, Alvaro; Pombo, Haizea; Bully, Paola
2017-02-17
The impact of lifestyle on health is undeniable and effective healthy lifestyle promotion interventions do exist. However, this is not a fundamental part of routine primary care clinical practice. We describe factors that determine changes in performance of primary health care centers involved in piloting the health promotion innovation 'Prescribe Vida Saludable' (PVS) phase II. We engaged four primary health care centers of the Basque Healthcare Service in an action research project aimed at changing preventive health practices. Prescribe Healthy Life (PVS from the Spanish "Prescribe Vida Saludable) is focused on designing, planning, implementing and evaluating innovative programs to promote multiple healthy habits, feasible to be performed in routine primary health care conditions. After 2 years of piloting, centers were categorized as having high, medium, or low implementation effectiveness. We completed qualitative inductive and deductive analysis of five focus groups with the staff of the centers. Themes generated through consensual grounded qualitative analysis were compared between centers to identify the dimensions that explain the variation in actual implementation of PVS, and retrospectively organized and assessed against the Consolidated Framework for Implementation Research (CFIR). Of the 36 CFIR constructs, 11 were directly related to the level of implementation performance: intervention source, evidence strength and quality, adaptability, design quality and packaging, tension for change, learning climate, self-efficacy, planning, champions, executing, and reflecting and evaluating, with -organizational tracking added as a new sub-construct. Additionally, another seven constructs emerged in the participants' discourse but were not related to center performance: relative advantage, complexity, patients' needs and resources, external policy and incentives, structural characteristics, available resources, and formally appointed internal implementation leaders. Our findings indicate that the success of the implementation seems to be associated with the following components: the context, the implementation process, and the collaborative modelling. Identifying barriers and enablers is useful for designing implementation strategies for health promotion in primary health care centers that are essential for innovation success. An implementation model is proposed to highlight the relationships between the CFIR constructs in the context of health promotion in primary care.
Sims-Gould, Joanie; McKay, Heather A.; Feldman, Fabio; Scott, Victoria; Robinovitch, Stephen N.
2013-01-01
The purpose of this study was to examine long-term care (LTC) resident and staff perceptions on the decision to use hip protectors and identify the factors that influence attitudes toward hip protector use. Staff (N = 39) and residents (N = 27) at two residential care facilities in British Columbia, Canada were invited to participate in focus groups on fall prevention and hip protector use. A total of 11 focus groups were conducted. Using framework analysis results show that residents and staff shared concerns on aesthetic and comfort issues with hip protectors. Residents also generally felt they did not need, or want to use, hip protectors. However, they also had desire to be cooperative within the LTC environment. Staff underscored their role in advocating for hip protector use and their desire to protect residents from harm. Practice considerations for facilities wishing to promote hip protectors within a patient centered framework are highlighted. PMID:24652886
NASA Astrophysics Data System (ADS)
Bates, Alyssa Victoria
Tornado outbreaks have significant human impact, so it is imperative forecasts of these phenomena are accurate. As a synoptic setup lays the foundation for a forecast, synoptic-scale aspects of Storm Prediction Center (SPC) outbreak forecasts of varying accuracy were assessed. The percentages of the number of tornado outbreaks within SPC 10% tornado probability polygons were calculated. False alarm events were separately considered. The outbreaks were separated into quartiles using a point-in-polygon algorithm. Statistical composite fields were created to represent the synoptic conditions of these groups and facilitate comparison. Overall, temperature advection had the greatest differences between the groups. Additionally, there were significant differences in the jet streak strengths and amounts of vertical wind shear. The events forecasted with low accuracy consisted of the weakest synoptic-scale setups. These results suggest it is possible that events with weak synoptic setups should be regarded as areas of concern by tornado outbreak forecasters.
Usery, E. Lynn
2011-01-01
The U.S. Geological Survey (USGS) produces geospatial databases and topographic maps for the United States of America. A part of that mission includes conducting research in geographic information science (GIScience) and cartography to support mapping and improve the design, quality, delivery, and use of geospatial data and topographic maps. The Center of Excellence for Geospatial Information Science (CEGIS) was established by the USGS in January 2006 as a part of the National Geospatial Program Office. CEGIS (http://cegis.usgs.gov) evolved from a team of cartographic researchers at the Mid-Continent Mapping Center. The team became known as the Cartographic Research group and was supported by the Cooperative Topographic Mapping, Geographic Analysis and Monitoring, and Land Remote Sensing programs of the Geography Discipline of the USGS from 1999-2005. In 2006, the Cartographic Research group and its projects (http://carto-research.er.usgs.gov/) became the core of CEGIS staff and research. In 2006, CEGIS research became focused on The National Map (http://nationalmap.gov).
The Effect of Yoga on Functional Recovery Level in Schizophrenic Patients.
Kavak, Funda; Ekinci, Mine
2016-12-01
The objective of this study is to determine the effect of yoga on functional recovery level in schizophrenic patients. The study was conducted in quasi-experimental design with pretest-posttest control group. The population of the study consisted of schizophrenic patients with registered in Malatya and Elazığ Community Mental Health Centers and regularly going to these centers. The sample group of the study consisted of totally 100 patients including 50 patients in the experimental group and 50 patients in the control group who were specified through power analysis and chosen by using random sampling method from this population. The data were collected between April 2015 and August 2015. 'Patient Description Form' and 'FROGS' were used to collect the data. Yoga was applied to patients in the experimental group. Any intervention was not made to patients in the control group. Percentage distribution, arithmetic mean, standard deviation, chi-square, independent samples t test, and paired t test were used to assess the data. Patients in the control and experimental group pretest subscale and the total means scores of FROGS was found to be low. In the posttest subscale and total means scores of FROGS in the experimental group were higher than in the control group and the differences between them were found to be statistically significant (p<0.05). In the experimental group pretest and posttest subscale and total means scores of FR0GS was determined to be statistically significant (p<0.05). Yoga that applied to schizophrenic patients it was determined to increased the level of functional recovery. It can be suggested that yoga should be used as an complementary method in nursing practise in order to increase the effectiveness of the treatment. Copyright © 2016 Elsevier Inc. All rights reserved.
San-Juan, Rafael; Aguado, Jose M; Lumbreras, Carlos; Fortun, Jesus; Len, Oscar; Munoz, Patricia; Montejo, Miguel; Moreno, Asunción; Cordero, Elisa; Blanes, Marino; Ramos, Antonio; Torre-Cisneros, Julian; López-Medrano, Francisco; Carratala, Jordi; Moreno, Enrique
2011-08-01
The role of selective intestinal decontamination with fluoroquinolones (FQ-SID) in the prevention of early bacterial infections (EBIs) in liver transplant recipients (LTRs) is unknown. We used the online database of the Spanish Network of Infection in Transplantation/Spanish Network for Research in Infectious Diseases, which prospectively analyzed 1010 LTRs from 12 Spanish hospitals from September 2003 to February 2005. We compared the incidence and etiology of EBIs (30 days after transplantation) in 415 LTRs from 4 centers that used FQ-SID (>7 days) and in 595 LTRs from 8 hospitals that did not use FQ-SID. A multivariate logistic regression analysis (including an adjustment for the transplant center factor) was performed to evaluate the potential protective factor of FQ-SID in the development of EBIs. We reported 266 EBI episodes in 252 LTRs (incidence = 24.9%). There were no differences in the incidence of EBIs between patients in the FQ-SID group and patients not in the FQ-SID group [109/415 (26.3%) versus 143/595 (24%), P = 0.9]. Although LTRs who received FQ-SID had a lower incidence of infections due to enteric bacteria (2.7% versus 6.5%, P = 0.007) and a higher incidence of infections due to nonfermenting gram-negative bacilli (6.6% versus 2.6%, P = 0.004), these findings could not be confirmed after an adjustment by the center factor in the multivariate models. We found no significant differences in the incidence of enterococcal infections (3.4% with FQ-SID versus 3.9% without FQ-SID, P = 0.5). Multivariate analysis did not confirm any protective effect of FQ-SID against the development of EBIs by enteric bacteria. In conclusion, FQ-SID does not reduce the incidence of EBIs in LTRs and could be withheld from this group of patients. Copyright © 2011 American Association for the Study of Liver Diseases.
Regulation of autonomic nervous system in space and magnetic storms.
Baevsky, R M; Petrov, V M; Chernikova, A G
1998-01-01
Variations in the earth's magnetic field and magnetic storms are known to be a risk factor for the development of cardiovascular disorders. The main "targets" for geomagnetic perturbations are the central nervous system and the neural regulation of vascular tone and heart rate variability. This paper presents the data about effect of geomagnetic fluctuations on human body in space. As a method for research the analysis of heart rate variability was used, which allows evaluating the state of the sympathetic and parasympathetic parts of the autonomic nervous system, vasomotor center and subcortical neural centers activity. Heart rate variability data were analyzed for 30 cosmonauts at the 2nd day of space flight on transport spaceship Soyuz (32nd orbit). There were formed three groups of cosmonauts: without magnetic storm (n=9), on a day with magnetic storm (n=12) and 1-2 days after magnetic storm (n=9). The present study was the first to demonstrate a specific impact of geomagnetic perturbations on the system of autonomic circulatory control in cosmonauts during space flight. The increasing of highest nervous centers activity was shown for group with magnetic storms, which was more significant on 1-2 days after magnetic storm. The use of discriminate analysis allowed to classify indicated three groups with 88% precision. Canonical variables are suggested to be used as criterions for evaluation of specific and non-specific components of cardiovascular reactions to geomagnetic perturbations. The applied aspect of the findings from the present study should be emphasized. They show, in particular, the need to supplement the medical monitoring of cosmonauts with predictions of probable geomagnetic perturbations in view of the prevention of unfavorable states appearances if the adverse reactions to geomagnetic perturbations are added to the tension experienced by regulatory systems during various stresses situations (such as work in the open space).
Timmermans, Catherine; Doffagne, Erik; Venet, David; Desmet, Lieven; Legrand, Catherine; Burzykowski, Tomasz; Buyse, Marc
2016-01-01
Data quality may impact the outcome of clinical trials; hence, there is a need to implement quality control strategies for the data collected. Traditional approaches to quality control have primarily used source data verification during on-site monitoring visits, but these approaches are hugely expensive as well as ineffective. There is growing interest in central statistical monitoring (CSM) as an effective way to ensure data quality and consistency in multicenter clinical trials. CSM with SMART™ uses advanced statistical tools that help identify centers with atypical data patterns which might be the sign of an underlying quality issue. This approach was used to assess the quality and consistency of the data collected in the Stomach Cancer Adjuvant Multi-institutional Trial Group Trial, involving 1495 patients across 232 centers in Japan. In the Stomach Cancer Adjuvant Multi-institutional Trial Group Trial, very few atypical data patterns were found among the participating centers, and none of these patterns were deemed to be related to a quality issue that could significantly affect the outcome of the trial. CSM can be used to provide a check of the quality of the data from completed multicenter clinical trials before analysis, publication, and submission of the results to regulatory agencies. It can also form the basis of a risk-based monitoring strategy in ongoing multicenter trials. CSM aims at improving data quality in clinical trials while also reducing monitoring costs.
Failure mode and effects analysis drastically reduced potential risks in clinical trial conduct.
Lee, Howard; Lee, Heechan; Baik, Jungmi; Kim, Hyunjung; Kim, Rachel
2017-01-01
Failure mode and effects analysis (FMEA) is a risk management tool to proactively identify and assess the causes and effects of potential failures in a system, thereby preventing them from happening. The objective of this study was to evaluate effectiveness of FMEA applied to an academic clinical trial center in a tertiary care setting. A multidisciplinary FMEA focus group at the Seoul National University Hospital Clinical Trials Center selected 6 core clinical trial processes, for which potential failure modes were identified and their risk priority number (RPN) was assessed. Remedial action plans for high-risk failure modes (RPN >160) were devised and a follow-up RPN scoring was conducted a year later. A total of 114 failure modes were identified with an RPN score ranging 3-378, which was mainly driven by the severity score. Fourteen failure modes were of high risk, 11 of which were addressed by remedial actions. Rescoring showed a dramatic improvement attributed to reduction in the occurrence and detection scores by >3 and >2 points, respectively. FMEA is a powerful tool to improve quality in clinical trials. The Seoul National University Hospital Clinical Trials Center is expanding its FMEA capability to other core clinical trial processes.
Khan, Muhammad; Jehan, Faisal; O'Keeffe, Terence; Pandit, Viraj; Kulvatunyou, Narong; Tang, Andrew; Gries, Lynn; Joseph, Bellal
2017-12-01
Management of colonic injuries (colostomy [CO] versus primary anastomosis [PA]) among pediatric patients remains controversial. The aim of this study was to assess outcomes in pediatric trauma patient with colonic injury undergoing operative intervention. The National Trauma Data Bank (2011-2012) was queried including patients with isolated colonic injury undergoing exploratory laparotomy with PA or CO with age ≤18 y. Missing value analysis was performed. Patients were stratified into two groups: PA and CO. Outcome measures were mortality, in-hospital complications, and hospital length of stay. Multivariate regression analysis was performed. A total of 1151 patients included. Mean ± standard deviation age was 11.61 ± 2.8 y, and median [IQR] Injury Severity Score was 12 [8-16]; 39% (n = 449) of the patients had CO, and 35.6% (n = 410) were managed in pediatric trauma centers (PC). Patients with CO had a higher Injury Severity Score (P < 0.001), a trend toward lower blood pressure (P = 0.40), and an older age (P < 0.001). There was no difference in mortality between the PA and CO groups. However, patients who underwent PA had a shorter length of stay (P < 0.001) and lower in-hospital complications (P < 0.001). A subanalysis shows that, after controlling for all confounding factors, patients managed in PC were 1.2 times (1.2 [1.1-2.1], P = 0.04) more likely to receive a CO than those patients managed in adult trauma centers (AC). Moreover, there was no difference in mortality between the AC and the PC (P = 0.79). Our data demonstrate no difference in mortality in pediatric trauma patients with colonic injury who undergo primary repair or CO. However, adult trauma centers had lower rates of CO performed as compared to a similar cohort of patients managed in pediatric trauma centers. Further assessment of the reasons underlying such differences will help improve patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.
Kim, Won Hwa; Singh, Vikas; Chung, Moo K.; Hinrichs, Chris; Pachauri, Deepti; Okonkwo, Ozioma C.; Johnson, Sterling C.
2014-01-01
Statistical analysis on arbitrary surface meshes such as the cortical surface is an important approach to understanding brain diseases such as Alzheimer’s disease (AD). Surface analysis may be able to identify specific cortical patterns that relate to certain disease characteristics or exhibit differences between groups. Our goal in this paper is to make group analysis of signals on surfaces more sensitive. To do this, we derive multi-scale shape descriptors that characterize the signal around each mesh vertex, i.e., its local context, at varying levels of resolution. In order to define such a shape descriptor, we make use of recent results from harmonic analysis that extend traditional continuous wavelet theory from the Euclidean to a non-Euclidean setting (i.e., a graph, mesh or network). Using this descriptor, we conduct experiments on two different datasets, the Alzheimer’s Disease NeuroImaging Initiative (ADNI) data and images acquired at the Wisconsin Alzheimer’s Disease Research Center (W-ADRC), focusing on individuals labeled as having Alzheimer’s disease (AD), mild cognitive impairment (MCI) and healthy controls. In particular, we contrast traditional univariate methods with our multi-resolution approach which show increased sensitivity and improved statistical power to detect a group-level effects. We also provide an open source implementation. PMID:24614060
Cost analysis of in-home telerehabilitation for post-knee arthroplasty.
Tousignant, Michel; Moffet, Hélène; Nadeau, Sylvie; Mérette, Chantal; Boissy, Patrick; Corriveau, Hélène; Marquis, François; Cabana, François; Ranger, Pierre; Belzile, Étienne L; Dimentberg, Ronald
2015-03-31
Rehabilitation provided through home visits is part of the continuum of care after discharge from hospital following total knee arthroplasty (TKA). As demands for rehabilitation at home are growing and becoming more difficult to meet, in-home telerehabilitation has been proposed as an alternate service delivery method. However, there is a need for robust data concerning both the effectiveness and the cost of dispensing in-home telerehabilitation. The objective of this study was to document, analyze, and compare real costs of two service delivery methods: in-home telerehabilitation and conventional home visits. The economic analysis was conducted as part of a multicenter randomized controlled trial (RCT) on telerehabilitation for TKA, and involved data from 197 patients, post-TKA. Twice a week for 8 weeks, participants received supervised physiotherapy via two delivery methods, depending on their study group allocation: in-home telerehabilitation (TELE) and home-visit rehabilitation (VISIT). Patients were recruited from eight hospitals in the province of Quebec, Canada. The TELE group intervention was delivered by videoconferencing over high-speed Internet. The VISIT group received the same intervention at home. Costs related to the delivery of the two services (TELE and VISIT) were calculated. Student's t tests were used to compare costs per treatment between the two groups. To take distance into account, the two treatment groups were compared within distance strata using two-way analyses of variance (ANOVAs). The mean cost of a single session was Can $93.08 for the VISIT group (SD $35.70) and $80.99 for the TELE group (SD $26.60). When comparing both groups, real total cost analysis showed a cost differential in favor of the TELE group (TELE minus VISIT: -$263, 95% CI -$382 to -$143). However, when the patient's home was located less than 30 km round-trip from the health care center, the difference in costs between TELE and VISIT treatments was not significant (P=.25, .26, and .11 for the <10, 10-19, and 20-29 km strata, respectively). The cost of TELE treatments was lower than VISIT treatments when the distance was 30 km or more (30-49 km: $81<$103, P=.002; ≥50 km: $90<$152, P<.001). To our knowledge, this is the first study of the actual costs of in-home telerehabilitation covering all subcosts of telerehabilitation and distance between the health care center and the patient's home. The cost for a single session of in-home telerehabilitation compared to conventional home-visit rehabilitation was lower or about the same, depending on the distance between the patient's home and health care center. Under the controlled conditions of an RCT, a favorable cost differential was observed when the patient was more than 30 km from the provider. Stakeholders and program planners can use these data to guide decisions regarding introducing telerehabilitation as a new service in their clinic. International Standard Registered Clinical Study Number (ISRCTN): 66285945; http://www.isrctn.com/ISRCTN66285945 (Archived by WebCite at http://www.webcitation.org/6WlT2nuX4).
2016-02-01
Based on Small- Group Interviews with Captain James A. Lovell Federal Health Care Center (FHCC) Staff, April–May 2015 34 Figure 7: Comparison of...Effects of Workforce Integration on Staff Efficiency, Quality of Work, and Job Satisfaction between Civilian and Active Duty Staff, Based on Small- Group ...Integration on Daily Work Based on Small- Group Interviews with Captain Page iii GAO-16-280 VA and DOD Federal Health Care Center
Effect of Islam-based religious program on spiritual wellbeing in elderly with hypertension.
Moeini, Mahin; Sharifi, Somaye; Kajbaf, Mohamed Bagher
2016-01-01
Lack of spiritual health in patients with hypertension leads to many mental, social, and physical effects, On the other hand, considering the prevalence of hypertension among the elderly, interventions to enhance their spiritual wellbeing is essential. Therefore, the aim of this study was to examine the effect of religious programs based on Islam on spiritual wellbeing in elderly patients with hypertension who referred to the health centers of Isfahan in 2014. This study was a randomized clinical trial. The participants (52 elderly patients with hypertension) were randomly divided in to experimental and control groups. Religious program was implemented for the experimental group in eight sessions in two Isfahan health centers. Spirituality wellbeing survey (SWB) questionnaire was completed in three steps, namely, pretest, posttest and follow-up (1 month) in two groups. In the study, Chi-square test, independent t -test, and repeated-measures analysis of variance were performed for analyzing the data. Before the intervention, there was no significant difference between the mean scores of spiritual wellbeing, the religious dimension, and the existential aspect of spiritual wellbeing of the two groups. However in the posttest step and follow-up stage, the mean scores of spiritual wellbeing, the religious dimension, and the existential aspect of spiritual wellbeing in the experimental group was significantly higher than in the control group ( P < 0.001). The religious program based on Islam promoted the SWB of elderly patients with hypertension; further, nurses can use these programs to promote the SWB of elderly patients with hypertension.
Data and Analysis Center for Software.
1980-06-01
can make use of it in their day- to -day activities of developing, maintaining, and managing software. The biblio- graphic collection is composed of...which refer to development, design, or programming approaches whicn view a software system component, or module in terms of its required or intended... practices " are also included In this group. PROCEDURES (I keyword) Procedures is a term used ambiguously in the literature to refer to functions
ERIC Educational Resources Information Center
James Irvine Foundation, 2016
2016-01-01
Between 2009 and 2014, The James Irvine Foundation invested $13.4 million through the Arts Regional Initiative to build the capacity of a group of nonprofit arts organizations in California locales outside of major arts centers. The aim was two-fold: to increase cultural participation and improve financial sustainability. The following lessons,…
Personalized Medicine in Veterans with Traumatic Brain Injuries
2013-05-01
Pair-Group Method using Arithmetic averages ( UPGMA ) based on cosine correlation of row mean centered log2 signal values; this was the top 50%-tile...cluster- ing was performed by the UPGMA method using Cosine correlation as the similarity metric. For comparative purposes, clustered heat maps included...non-mTBI cases were subjected to unsupervised hierarchical clustering analysis using the UPGMA algorithm with cosine correlation as the similarity
ERIC Educational Resources Information Center
Remley, Dirk
2009-01-01
This essay presents a case study of the modes used in training employees at a munitions plant in Ohio between 1940 and 1945. Theories of multimodal discourse and learning advanced by The New London Group (1996), Gunther Kress and Theo Van Leeuwen (2001) and Richard Mayer (2001) inform this analysis. With an unskilled labor force and many workers…
Prior, Fred W; Erickson, Bradley J; Tarbox, Lawrence
2007-11-01
The Cancer Bioinformatics Grid (caBIG) program was created by the National Cancer Institute to facilitate sharing of IT infrastructure, data, and applications among the National Cancer Institute-sponsored cancer research centers. The program was launched in February 2004 and now links more than 50 cancer centers. In April 2005, the In Vivo Imaging Workspace was added to promote the use of imaging in cancer clinical trials. At the inaugural meeting, four special interest groups (SIGs) were established. The Software SIG was charged with identifying projects that focus on open-source software for image visualization and analysis. To date, two projects have been defined by the Software SIG. The eXtensible Imaging Platform project has produced a rapid application development environment that researchers may use to create targeted workflows customized for specific research projects. The Algorithm Validation Tools project will provide a set of tools and data structures that will be used to capture measurement information and associated needed to allow a gold standard to be defined for the given database against which change analysis algorithms can be tested. Through these and future efforts, the caBIG In Vivo Imaging Workspace Software SIG endeavors to advance imaging informatics and provide new open-source software tools to advance cancer research.
Effect of Learner-Centered Education on the Academic Outcomes of Minority Groups
ERIC Educational Resources Information Center
Salinas, Moises F.; Garr, Johanna
2009-01-01
The purpose of the present study is to determine the effect that learner-centered classrooms and schools have on the academic performance of minority and nonminority groups. A diverse sample of schools at the elementary school level were selected. Teachers were also asked to complete the Assessment of Learner Centered Practices questionnaire, an…
Chen, Chin-Lan; Yen, David H-T; Lin, Chin-Sheng; Tsai, Shih-Hung; Chen, Sy-Jou; Sheu, Wayne H-H; Hsu, Chin-Wang
2017-05-01
The effect of glycemic control on the prognosis of nondiabetic patients after acute myocardial infarction (AMI) remains uncertain. We investigated whether glycated hemoglobin (HbA1c) is associated with adverse outcomes after AMI in nondiabetic patients. In this observational study, we enrolled nondiabetic patients with AMI in the emergency department of 2 medical centers from January 2011 to September 2014. All patients received primary percutaneous coronary intervention and were divided into 4 groups according to the interquartile range of average HbA1c level (Group I, ≤5.6%; Group II, 5.6%-5.8%; Group III, 5.8%-6.0%; and Group IV, >6.0%). Multivariate logistic analysis was performed to estimate the correlation of HbA1c with major adverse cardiac events (MACEs) after AMI. In total, 267 eligible patients were enrolled; 48 patients (18%) developed MACEs within a median follow-up of 178 days. Univariate analysis showed HbA1c > 6.0%, with a higher risk of MACEs in Group IV than in Group I (odds ratio [OR]: 2.733; 95% confidence interval [CI]: 1.123-6.651 vs OR: 1.511; 95% CI: 0.595-3.835). Multivariate analysis revealed an approximately 3.8 times higher risk of MACEs in Group IV than in Group I (OR: 3.769; 95% CI: 1.30-10.86). The HbA1 level is a significant predictor of MACEs after AMI in nondiabetic patients.
Aphasia centers in North America: a survey.
Simmons-Mackie, Nina; Holland, Audrey L
2011-08-01
There is a growing trend toward dedicated programs designed to improve the lives of people with aphasia and their families. We are referring to these programs collectively as "aphasia centers." These programs purportedly differ from more traditional medically based aphasia rehabilitation. However, there is no directory of aphasia centers and no definition of what constitutes such a program. Therefore, an online survey was designed to identify and describe aphasia centers in the United States and Canada. A 37-question survey was posted online via SurveyMonkey. An introductory letter was distributed by electronic mail to a listserv and mailing lists of programs associated with aphasia. Potential respondents who considered themselves an aphasia center were asked to complete the survey. A total of 33 survey responses were analyzed, and descriptive data were compiled resulting in a description of the following aspects of aphasia centers: demographic information, mission, admission and discharge policies, assessment practices, program logistics, staffing patterns, marketing, funding, and services offered. In addition, a qualitative analysis of written text responses revealed the following key themes that appear to characterize the responding programs: services that differ from traditional aphasia rehabilitation; a sense of community; a holistic focus on quality of life, psychosocial well-being, participation, and social support; the centrality of group interaction; and variety/intensity of services. © Thieme Medical Publishers.
Evolution of heliobacteria: implications for photosynthetic reaction center complexes
NASA Technical Reports Server (NTRS)
Vermaas, W. F.; Blankenship, R. E. (Principal Investigator)
1994-01-01
The evolutionary position of the heliobacteria, a group of green photosynthetic bacteria with a photosynthetic apparatus functionally resembling Photosystem I of plants and cyanobacteria, has been investigated with respect to the evolutionary relationship to Gram-positive bacteria and cyanobacteria. On the basis of 16S rRNA sequence analysis, the heliobacteria appear to be most closely related to Gram-positive bacteria, but also an evolutionary link to cyanobacteria is evident. Interestingly, a 46-residue domain including the putative sixth membrane-spanning region of the heliobacterial reaction center protein show rather strong similarity (33% identity and 72% similarity) to a region including the sixth membrane-spanning region of the CP47 protein, a chlorophyll-binding core antenna polypeptide of Photosystem II. The N-terminal half of the heliobacterial reaction center polypeptide shows a moderate sequence similarity (22% identity over 232 residues) with the CP47 protein, which is significantly more than the similarity with the Photosystem I core polypeptides in this region. An evolutionary model for photosynthetic reaction center complexes is discussed, in which an ancestral homodimeric reaction center protein (possibly resembling the heliobacterial reaction center protein) with 11 membrane-spanning regions per polypeptide has diverged to give rise to the core of Photosystem I, Photosystem II, and of the photosynthetic apparatus in green, purple, and heliobacteria.
Roux, Perrine; Rojas Castro, Daniela; Ndiaye, Khadim; Debrus, Marie; Protopopescu, Camélia; Le Gall, Jean-Marie; Haas, Aurélie; Mora, Marion; Spire, Bruno; Suzan-Monti, Marie; Carrieri, Patrizia
2016-01-01
Aims The community-based AERLI intervention provided training and education to people who inject drugs (PWID) about HIV and HCV transmission risk reduction, with a focus on drug injecting practices, other injection-related complications, and access to HIV and HCV testing and care. We hypothesized that in such a population where HCV prevalence is very high and where few know their HCV serostatus, AERLI would lead to increased HCV testing. Methods The national multisite intervention study ANRS-AERLI consisted in assessing the impact of an injection-centered face-to-face educational session offered in volunteer harm reduction (HR) centers (“with intervention”) compared with standard HR centers (“without intervention”). The study included 271 PWID interviewed on three occasions: enrolment, 6 and 12 months. Participants in the intervention group received at least one face-to-face educational session during the first 6 months. Measurements The primary outcome of this analysis was reporting to have been tested for HCV during the previous 6 months. Statistical analyses used a two-step Heckman approach to account for bias arising from the non-randomized clustering design. This approach identified factors associated with HCV testing during the previous 6 months. Findings Of the 271 participants, 127 and 144 were enrolled in the control and intervention groups, respectively. Of the latter, 113 received at least one educational session. For the present analysis, we selected 114 and 88 participants eligible for HCV testing in the control and intervention groups, respectively. In the intervention group, 44% of participants reported having being tested for HCV during the previous 6 months at enrolment and 85% at 6 months or 12 months. In the control group, these percentages were 51% at enrolment and 78% at 12 months. Multivariable analyses showed that participants who received at least one educational session during follow-up were more likely to report HCV testing, compared with those who did not receive any intervention (95%[CI] = 4.13[1.03;16.60]). Conclusion The educational intervention AERLI had already shown efficiency in reducing HCV at-risk practices and associated cutaneous complications and also seems to have a positive impact in increasing HCV testing in PWID. PMID:27294271
Petrak, Frank; Herpertz, Stephan; Albus, Christian; Hermanns, Norbert; Hiemke, Christoph; Hiller, Wolfgang; Kronfeld, Kai; Kruse, Johannes; Kulzer, Bernd; Ruckes, Christian; Müller, Matthias J
2013-08-06
Depression is common in diabetes and associated with hyperglycemia, diabetes related complications and mortality. No single intervention has been identified that consistently leads to simultaneous improvement of depression and glycemic control. Our aim is to analyze the efficacy of a diabetes-specific cognitive behavioral group therapy (CBT) compared to sertraline (SER) in adults with depression and poorly controlled diabetes. This study is a multi-center parallel arm randomized controlled trial currently in its data analysis phase. We included 251 patients in 70 secondary care centers across Germany. Key inclusion criteria were: type 1 or 2 diabetes, major depression (diagnosed with the Structured Clinical Interview for DSM-IV, SCID) and hemoglobin A1C >7.5% despite current insulin therapy. During the initial phase, patients received either 50-200 mg/d sertraline or 10 CBT sessions aiming at the remission of depression and enhanced adherence to diabetes treatment and coping with diabetes. Both groups received diabetes treatment as usual. After 12 weeks of this initial open-label therapy, only the treatment-responders (50% depression symptoms reduction, Hamilton Depression Rating Scale, 17-item version [HAMD]) were included in the subsequent one year study phase and represented the primary analysis population. CBT-responders received no further treatment, while SER-responders obtained a continuous, flexible-dose SER regimen as relapse prevention. Adherence to treatment was analyzed using therapeutic drug monitoring (measurement of sertraline and N-desmethylsertraline concentrations in blood serum) and by counting the numbers of CBT sessions received. Outcome assessments were conducted by trained psychologists blinded to group assignment. Group differences in HbA1c (primary outcome) and depression (HAMD, secondary outcome) between 1-year follow-up and baseline will be analyzed by ANCOVA controlling for baseline values. As primary hypothesis we expect that CBT leads to significantly greater improvement of glycemic control in the one year follow-up in treatment responders of the short term phase. The DAD study is the first randomized controlled trial comparing antidepressants to a psychological treatment in diabetes patients with depression. Current controlled trials ISRCTN89333241.
Results of the Arizona Medicaid health information technology pharmacy focus groups.
Warholak, Terri L; Murcko, Anita; McKee, Megan; Urbine, Terry
2011-12-01
In 2007, a federal Medicaid Transformation Grant was awarded to design, develop, and deploy a statewide Health Information Exchange and Electronic Health Record in Arizona, United States. To explore the health information technology needs, knowledge, and expectations of Arizona's health care professionals, moderated focus groups were conducted. This article describes the results of the pharmacist focus groups. Focus group activities included a brief presentation, completion of a paper-based survey, and group discussion. The methods included solicitation by invitation, participant selection, meeting content, collaterals, focus group execution, recording, analysis, and discerning comparability among groups. Pharmacy focus group discussions centered on electronic prescribing, including the anticipated advantages: reducing handwriting interpretation errors, improving formulary compliance, improving communication with prescribers, increasing efficiency, and ensuring data accuracy. Disadvantages included: medication errors, inadequate training and knowledge of software applications, and inflated patient expectations. Pharmacists ranked e-prescribing as the highest priority feature of an electronic health system. Copyright © 2011 Elsevier Inc. All rights reserved.
NBME subject examination in surgery scores correlate with surgery clerkship clinical experience.
Myers, Jonathan A; Vigneswaran, Yalini; Gabryszak, Beth; Fogg, Louis F; Francescatti, Amanda B; Golner, Christine; Bines, Steven D
2014-01-01
Most medical schools in the United States use the National Board of Medical Examiners Subject Examinations as a method of at least partial assessment of student performance, yet there is still uncertainty of how well these examination scores correlate with clinical proficiency. Thus, we investigated which factors in a surgery clerkship curriculum have a positive effect on academic achievement on the National Board of Medical Examiners Subject Examination in Surgery. A retrospective analysis of 83 third-year medical students at our institution with 4 unique clinical experiences on the general surgery clerkship for the 2007-2008 academic year was conducted. Records of the United States Medical Licensing Examination Step 1 scores, National Board of Medical Examiners Subject Examination in Surgery scores, and essay examination scores for the groups were compared using 1-way analysis of variance testing. Rush University Medical Center, Chicago IL, an academic institution and tertiary care center. Our data demonstrated National Board of Medical Examiners Subject Examination in Surgery scores from the group with the heavier clinical loads and least time for self-study were statistically higher than the group with lighter clinical services and higher rated self-study time (p = 0.036). However, there was no statistical difference of National Board of Medical Examiners Subject Examination in Surgery scores between the groups with equal clinical loads (p = 0.751). Students experiencing higher clinical volumes on surgical services, but less self-study time demonstrated statistically higher academic performance on objective evaluation, suggesting clinical experience may be of higher value than self-study and reading. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Liu, Ru; Gao, Zhan; Chen, Jue; Gao, Lijian; Song, Lei; Qiao, Shubin; Yang, Yuejin; Gao, Runlin; Xu, Bo; Yuan, Jinqing
2017-08-01
In recent years, most drug-eluting stents (DESs) were domestically produced in China, but how domestic DESs perform compared to imported DESs was still unknown. A total of 9011 consecutive cases with DESs implantation in a single center throughout 2013 were prospectively collected. Two-year clinical outcomes were evaluated between patients implanted with imported and domestic DESs. During 2-year follow-up, the rates of all-cause death, cardiac death, myocardial infarction, stroke, and stent thrombosis were not significantly different between two groups. However, the rate of revascularization was significantly higher in domestic DES group, shown as higher rates of overall revascularization, target vessel revascularization (TVR), and target lesion revascularization (TLR) (9.7% vs 6.4%, P < 0.001; 5.6% vs 3.2%, P < 0.001; 4.5% vs 2.2%, P < 0.001, respectively). Accordingly, major adverse cardiac events (MACE) rate was significantly higher in domestic DES group (12.1% vs 8.5%, P < 0.001). Multivariable Cox regression analysis indicated that domestic DES was an independent risk factor of MACE (HR [95%CI]: 1.22 [1.05-1.41]), overall revascularization (HR [95%CI]: 1.29 [1.09-1.53]), TVR (HR [95%CI]: 1.54 [1.22-1.94]), and TLR (HR [95%CI]: 1.85 [1.41-2.42]). After propensity score matching, the rates of overall revascularization, TVR, and TLR were still significantly higher in domestic DES group, and domestic DES was still predictive of overall revascularization, TVR, and TLR in multivariate Cox regression analysis. Domestic DESs showed the same safety as imported DESs in this real-world cohort. But, patients implanted with domestic DESs had a higher risk of revascularization than imported DESs. © 2017, Wiley Periodicals, Inc.
Marketing the academic medical center group practice.
Eudes, J A; Divis, K L
1992-01-01
From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.
Ten common errors beginning substance abuse workers make in group treatment.
Greif, G L
1996-01-01
Beginning therapists sometimes make mistakes when working with substance abusers in groups. This article discusses ten common errors that the author has observed. Five center on the therapist's approach and five center on the nuts and bolts of group leadership. Suggestions are offered for how to avoid them.
INTERIOR OF THE CENTER HUT IN THE GROUPING OF FIVE. ...
INTERIOR OF THE CENTER HUT IN THE GROUPING OF FIVE. NOTE THE STRUCTURE'S FRAMING SYSTEM OF STEEL ARCHED RIBS AND PURLINS AND THE HISTORIC PENDANT LIGHT FIXTURES WITH GREEN AND WHITE ENAMELED SHADES. VIEW FACING SOUTHEAST - Kahului Cannery, Quonset Hut Grouping, 120 Kane Street, Kahului, Maui County, HI
Alternative Fuels Data Center: Sea-Tac and Alaska Air Group Achieve
pilot project, Alaska Air Group encountered a few hurdles during the switch to eGSE. One was Sky-High Results with Electric Ground Support Equipment Sea-Tac and Alaska Air Group Achieve Data Center: Sea-Tac and Alaska Air Group Achieve Sky-High Results with Electric Ground Support
Kim, Bo; Lucatorto, Michelle A; Hawthorne, Kara; Hersh, Janis; Myers, Raquel; Elwy, A Rani; Graham, Glenn D
2015-01-01
Care coordination between the specialty care provider (SCP) and the primary care provider (PCP) is a critical component of safe, efficient, and patient-centered care. Veterans Health Administration conducted a series of focus groups of providers, from specialty care and primary care clinics at VA Medical Centers nationally, to assess 1) what SCPs and PCPs perceive to be current practices that enable or hinder effective care coordination with one another and 2) how these perceptions differ between the two groups of providers. A qualitative thematic analysis of the gathered data validates previous studies that identify communication as being an important enabler of coordination, and uncovers relationship building between specialty care and primary care (particularly through both formal and informal relationship-building opportunities such as collaborative seminars and shared lunch space, respectively) to be the most notable facilitator of effective communication between the two sides. Results from this study suggest concrete next steps that medical facilities can take to improve care coordination, using as their basis the mutual understanding and respect developed between SCPs and PCPs through relationship-building efforts. PMID:25653538
Kim, Bo; Lucatorto, Michelle A; Hawthorne, Kara; Hersh, Janis; Myers, Raquel; Elwy, A Rani; Graham, Glenn D
2015-01-01
Care coordination between the specialty care provider (SCP) and the primary care provider (PCP) is a critical component of safe, efficient, and patient-centered care. Veterans Health Administration conducted a series of focus groups of providers, from specialty care and primary care clinics at VA Medical Centers nationally, to assess 1) what SCPs and PCPs perceive to be current practices that enable or hinder effective care coordination with one another and 2) how these perceptions differ between the two groups of providers. A qualitative thematic analysis of the gathered data validates previous studies that identify communication as being an important enabler of coordination, and uncovers relationship building between specialty care and primary care (particularly through both formal and informal relationship-building opportunities such as collaborative seminars and shared lunch space, respectively) to be the most notable facilitator of effective communication between the two sides. Results from this study suggest concrete next steps that medical facilities can take to improve care coordination, using as their basis the mutual understanding and respect developed between SCPs and PCPs through relationship-building efforts.
Badreldin, Hisham
2018-07-01
This study was conducted to describe the real-world hospital length of stay in patients treated with all of the U.S. Food and Drug Administration approved direct oral anticoagulants (DOACs) versus warfarin for new-onset venous thromboembolism (VTE) at a large, tertiary, academic medical center. A retrospective cohort analysis of all adult patients diagnosed with acute onset VTE was conducted. Of the 441 patients included, 261 (57%) patients received DOACs versus 180 (41%) patients received warfarin. In the DOAC group, a total of 92 (35%) patients received rivaroxaban, followed by 83 (32%) patients received apixaban, 50 (19%) patients received dabigatran, and 36 (14%) patients received edoxaban. Patients initiated on DOACs had a statistically significant shorter hospital length of stay compared to patients initiated on warfarin (median 3 days, [IQR 0-5] vs. 8 days [IQR 5-11], P < 0.05). Despite the shorter hospital length of stay in patients receiving DOACs, the overall reported differences between the DOACs group and the warfarin group in terms of recurrent VTE, major bleeding, intracranial bleeding, and gastrointestinal bleeding at 3 and 6 months were deemed to be statistically insignificant.
The retrospective analysis of patients with uterine sarcomas: A single-center experience.
Terek, Mustafa Cosan; Akman, Levent; Hursitoglu, Behiye Seda; Sanli, Ulus Ali; Ozsaran, Zeynep; Tekindal, Mustafa Agah; Dikmen, Yilmaz; Zekioglu, Osman; Ozsaran, Ahmet Aydin
2016-01-01
Uterine sarcomas are rare, malignant, gynecological tumors and show diverse histopathological features. Therefore, there is no consensus on risk factors for poor outcome and optimal treatment. The aim of this retrospective analysis is to report the clinical outcome of patients with uterine sarcoma treated at a single center. The data was obtained regarding the patient's demographic characteristics, pathological results, treatments given, survival, and complications of all uterine sarcoma patients treated in a single center between the years 2000 and 2012. The 80.month overall survival. (OS) was determined with respect to prognostic factors including age, stage of disease, histopathological type, and adjuvant treatment. A total of 57 case records are retrieved for this retrospective analysis. The mean age of the patients is 62.5 ± 11.2 years. International Federation of Gynecology and Obstetrics (FIGO) stage distribution is stage I: 29; stage II: 13; stage III: 9; stage IV: 6. Fifty-seven patients underwent surgery, 33 received postoperative radiotherapy (PORT), and 32 received chemotherapy. Median follow-up period was 25 months (range 2-85 months). The 80-month OS for the entire group of patients was 36.7%. The significant prognostic factors for survival are age under 50 years, stage of disease, and adjuvant chemotherapy. Although limited by small sample size and retrospective nature, age under 50 years, stage of disease, and adjuvant chemotherapy are significant prognostic factors for survival for uterine sarcomas.
Outcomes analysis of radioactive iodine and total thyroidectomy for pediatric Graves' disease.
Cohen, Reuven Zev; Felner, Eric I; Heiss, Kurt F; Wyly, J Bradley; Muir, Andrew B
2016-03-01
The majority of pediatric patients with Graves' disease will ultimately require definitive therapy in the form of radioactive iodine (RAI) ablation or thyroidectomy. There are few studies that directly compare the efficacy and complication rates between RAI and thyroidectomy. We compared the relapse rate as well as the acute and long-term complications of RAI and total thyroidectomy among children and adolescents with Graves' disease treated at our center. Medical records from 81 children and adolescents with a diagnosis of Graves' disease who received definitive therapy over a 12-year period were reviewed. Fifty one patients received RAI and 30 patients underwent thyroidectomy. The relapse rate was not significantly different between RAI and thyroidectomy (12.1% vs. 0.0%, p=0.28). There were no acute or long-term complications in the RAI group, but there were eight cases of hypoparathyroidism (two transient and six permanent) in the thyroidectomy group. None of the patients developed a recurrent laryngeal nerve injury. RAI is a safe and effective option for treatment of children and adolescents with Graves' disease. In light of the rate of permanent hypoparathyroidism seen at our center with thyroidectomy and previously published long-term safety of RAI, we recommend RAI as the first line treatment for children and adolescents with Graves' disease. For those centers performing thyroidectomies, we recommend that each center select 1-2 high-volume pediatric surgeons to perform all thyroid procedures, allowing individuals to increases case volume and potentially decrease long-term complications of thyroidectomy.
Extending surgeon response times in tier 2 traumas does not adversely affect patient outcomes.
Zimmerman, Steven Anthony; Reed, Christopher S; Reed, Alexander N; Jones, Ronald J; Chard, Annette; Reed, Donald N
2018-06-01
The presence of a trauma surgeon during patient resuscitations is required at most American College of Surgeons-verified trauma centers despite little evidence showing improved patient outcomes in the less-than-critically injured (Tier 2) trauma patients. This study was designed to identify the impact of extending required surgeon response times on outcomes in tier 2 trauma patients. An American College of Surgeons-verified level 2 trauma center extended the maximum allowed surgeon response time for tier 2 activations from 60 min to 120 min on November 1, 2011. Surgeon response time and patient outcomes of the retrospective control group (January 1, 2008-October 31, 2011) were then compared with the prospective test group (November 1, 2011-December 31, 2014). Primary outcomes included mortality and hospital length of stay (HLOS). Secondary outcomes were emergency department length of stay, and time from ED arrival to CT scan. A subset analysis of all patients evaluated by a surgeon within 60 min of arrival versus those evaluated by a surgeon after 60 min was also performed. The control and test groups were composed of 757 and 792 patients, and their mean injury severity score was 9.0 and 6.0, respectively. Emergency department length of stay showed a statistically significant increase of 12 min, whereas HLOS was unchanged throughout the study. Mortality was not significantly different between the groups. Subset analysis revealed a median surgeon arrival time of 15 min in the <60-min group and 85 min in the >60-min group, whereas the injury severity score, HLOS, and mortality were not significantly different between these subsets. No correlation existed between these outcomes and surgeon arrival time. Doubling required surgeon response time in tier 2 trauma patients does not produce negative outcomes in this patient group. Mandatory surgeon response times in similar patient groups can be re-evaluated to allow for greater flexibility of a limited surgeon workforce while still providing safe care. Copyright © 2018 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Gligor, M.; Ausloos, M.
2007-05-01
The statistical distances between countries, calculated for various moving average time windows, are mapped into the ultrametric subdominant space as in classical Minimal Spanning Tree methods. The Moving Average Minimal Length Path (MAMLP) algorithm allows a decoupling of fluctuations with respect to the mass center of the system from the movement of the mass center itself. A Hamiltonian representation given by a factor graph is used and plays the role of cost function. The present analysis pertains to 11 macroeconomic (ME) indicators, namely the GDP (x1), Final Consumption Expenditure (x2), Gross Capital Formation (x3), Net Exports (x4), Consumer Price Index (y1), Rates of Interest of the Central Banks (y2), Labour Force (z1), Unemployment (z2), GDP/hour worked (z3), GDP/capita (w1) and Gini coefficient (w2). The target group of countries is composed of 15 EU countries, data taken between 1995 and 2004. By two different methods (the Bipartite Factor Graph Analysis and the Correlation Matrix Eigensystem Analysis) it is found that the strongly correlated countries with respect to the macroeconomic indicators fluctuations can be partitioned into stable clusters.
Is usage of a wellness center associated with improved quality of life?
Clark, Matthew M; Jenkins, Sarah M; Limoges, Katherine A; Hagen, Philip T; Lackore, Kandace A; Harris, Ann M; Werneburg, Brooke L; Warren, Beth A; Olsen, Kerry D
2013-01-01
There is limited documentation regarding the potential quality of life (QOL) benefits associated with use of a worksite wellness center. Therefore, the aim of this study was to examine the relationship between potential QOL change and use of a worksite wellness center during a 12-month period. Analysis of an annual QOL wellness center member survey and wellness center use during a 12-month time period. A worksite wellness center. A total of 1151 employee wellness center members, average age of 39.5 years, 69.7% female, and 43.5% reported being overweight. Members of the worksite wellness center have access to a range of fitness options, including exercise classes, water aerobics, an indoor track, strength training, and aerobic conditioning equipment. Additionally, nutritional classes are offered, and there is a wellness café. For resiliency, members can participate in wellness coaching or a stress-reduction group program. Participants completed a baseline QOL survey and a second QOL survey 1 year later. An electronic entry system tracked use of the wellness center. Participants were divided into four wellness center use quartiles: low users (less than once every 2 weeks), below-average users, above-average users, and high users (two to three visits per week). High users reported experiencing improvements in their physical QOL (p < .0001) compared with the low users. Additionally, low users experienced a greater decline in their mental QOL (p = .05) compared with high users. In a large sample of employees, use of a wellness center during a 12-month period was associated with benefits for physical QOL. QOL is an important domain of wellness; therefore, in addition to measuring physiologic changes, examining potential QOL changes may be another important outcome measure for wellness centers.
Asher, Ilan; Elbirt, Daniel; Mahlev-Guri, Keren; Rozenberg-Bezalet, Shira; Werner, Ben; Sthoeger, Zev
2013-04-01
Major changes happened in the last decade in the HIV/AIDS pandemic. The disease is no longer limited to young age. Due to the effectiveness of HAART (Highly Active Anti-Retroviral Therapy) as well as new diagnosis in older age groups, many patients in AIDS centers are above 50 years of age. To determine the prevalence, demographics and clinical characteristics of newly diagnosed HIV/AIDS patients older than 50 years compared to younger newly diagnosed patients. Retrospective single center analysis of the demographics and clinical characterizations of 62 newly diagnosed HIV/AIDS patients over 50 years of age. The average age at diagnosis of the whole cohort was 39+/-16 years. There was a gradual increase in the age at diagnosis over the years, as well as the percent of patients above the age of 50 diagnosed with the disease. In comparison to younger patients, in the older group there were more males compared to females and less patients who acquired the HIV/AIDS in unprotected homosexual sex. Furthermore, CD4 cells counts were lower and viral load leveLs were higher at diagnosis in the older group. Despite good adherence, patients above the age of 50 don't achieve adequate immunological response and many are left with significant immunodeficiency (CD4<200). The prevaLence of patients above the age of 50 Living with HIV/AIDS in Israel is rising. Programs aimed at prevention, education and screening for this unique group are mandatory. An AIDS center should adopt new programs and routines to cope with the increasing number of patients over the age of 50 Living with HIV/AIDS.
González, Patricia; Nuñez, Alicia; Merz, Erin; Brintz, Carrie; Weitzman, Orit; Navas, Elena; Camacho, Alvaro; Buelna, Christina; Penedo, Frank J.; Wassertheil-Smoller, Sylvia; Perreira, Krista; Isasi, Carmen; Choca, James; Talavera, Gregory A.; Gallo, Linda C.
2016-01-01
The Center for Epidemiologic Studies Depression Scale (CES-D) is a widely used self-report measure of depression symptomatology. This study evaluated the reliability, validity, and measurement invariance of the CES-D 10 in a diverse cohort of Hispanics/Latinos from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The sample consisted of 16,415 Hispanic/Latino adults recruited from four field centers (Miami, FL; San Diego, CA; Bronx, NY; Chicago, IL). Participants completed interview administered measures in English or Spanish. The CES-D 10 was examined for internal consistency, test-retest reliability, convergent validity, and measurement invariance. The total score for the CES-D 10 displayed acceptable internal consistencies (Cronbach α’s = .80 – .86) and test-retest reliability (r’s = .41 – .70) across the total sample, language group and ethnic background group. The total CES-D 10 scores correlated in a theoretically consistent manner with the Spielberger State-Trait Anxiety Inventory (r = .72, p < .001), the Patient Health Questionnaire-9 depression measure (r = .80, p < .001) the Short Form-12’s Mental Component Summary (r = −.65, p < .001) and Physical Component Summary score (r = −.25, p < .001). A confirmatory factor analysis showed that a one-factor model fit the CES-D 10 data well (CFI = .986, RMSEA = .047) after correlating one pair of item residual variances. Multiple group analyses showed the one-factor structure to be invariant across English and Spanish speaking responders and partially invariant across Hispanic/Latino background groups. The total score of the CES-D 10 can be recommended for use with Hispanics/Latinos in English and Spanish. PMID:27295022
NASA Astrophysics Data System (ADS)
Temi, Pasquale; Amblard, Alexandre; Gitti, Myriam; Brighenti, Fabrizio; Gaspari, Massimo; Mathews, William G.; David, Laurence
2018-05-01
We present new ALMA CO(2–1) observations of two well-studied group-centered elliptical galaxies: NGC 4636 and NGC 5846. In addition, we include a revised analysis of Cycle 0 ALMA observations of the central galaxy in the NGC 5044 group. We find evidence that molecular gas is a common presence in bright group-centered galaxies (BGG). CO line widths are broader than Galactic molecular clouds, and using the reference Milky Way X CO, the total molecular mass ranges from 2.6 × 105 M ⊙ in NGC 4636 to 6.1 × 107 M ⊙ in NGC 5044. Complementary observations using the ALMA Compact Array do not exhibit any detection of a CO diffuse component at the sensitivity level achieved by current exposures. The origin of the detected molecular features is still uncertain, but these ALMA observations suggest that they are the end product of the hot gas cooling process and not the result of merger events. Some of the molecular clouds are associated with dust features as revealed by HST dust extinction maps, suggesting that these clouds formed from dust-enhanced cooling. The global nonlinear condensation may be triggered via the chaotic turbulent field or buoyant uplift. The large virial parameter of the molecular structures and correlation with the warm ({10}3{--}{10}5 {{K}})/hot (≥106) phase velocity dispersion provide evidence that they are unbound giant molecular associations drifting in the turbulent field, consistent with numerical predictions of the chaotic cold accretion process. Alternatively, the observed large CO line widths may be generated by molecular gas flowing out from cloud surfaces due to heating by the local hot gas atmosphere.
Wahner-Roedler, Dietlind L.; Thompson, Jeffrey M.; Luedtke, Connie A.; King, Susan M.; Cha, Stephen S.; Elkin, Peter L.; Bruce, Barbara K.; Townsend, Cynthia O.; Bergeson, Jody R.; Eickhoff, Andrea L.; Loehrer, Laura L.; Sood, Amit; Bauer, Brent A.
2011-01-01
Most patients with fibromyalgia use complementary and alternative medicine (CAM). Properly designed controlled trials are necessary to assess the effectiveness of these practices. This study was a randomized, double-blind, placebo-controlled, early phase trial. Fifty patients seen at a fibromyalgia outpatient treatment program were randomly assigned to a daily soy or placebo (casein) shake. Outcome measures were scores of the Fibromyalgia Impact Questionnaire (FIQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline and after 6 weeks of intervention. Analysis was with standard statistics based on the null hypothesis, and separation test for early phase CAM comparative trials. Twenty-eight patients completed the study. Use of standard statistics with intent-to-treat analysis showed that total FIQ scores decreased by 14% in the soy group (P = .02) and by 18% in the placebo group (P < .001). The difference in change in scores between the groups was not significant (P = .16). With the same analysis, CES-D scores decreased in the soy group by 16% (P = .004) and in the placebo group by 15% (P = .05). The change in scores was similar in the groups (P = .83). Results of statistical analysis using the separation test and intent-to-treat analysis revealed no benefit of soy compared with placebo. Shakes that contain soy and shakes that contain casein, when combined with a multidisciplinary fibromyalgia treatment program, provide a decrease in fibromyalgia symptoms. Separation between the effects of soy and casein (control) shakes did not favor the intervention. Therefore, large-sample studies using soy for patients with fibromyalgia are probably not indicated. PMID:18990724
Social Networking in an Agricultural Research Center: Using Data to Enhance Outcomes.
Cramer, Mary E; Araz, Ozgur M; Wendl, Mary J
2017-01-01
The purpose of this article is to present a case study of one midwestern Agricultural Center (Ag Center) that used social network analysis (SNA) to (1) evaluate its collaborations with extramural stakeholders and (2) strategically plan for extending outreach for goal achievement. An evaluation team developed a data collection instrument based on SNA principles. It was administered to the Ag Center's intramural stakeholders (N = 9), who were asked to identify the key extramural stakeholders with whom they had collaborated within the previous 12 months. Additional questions about each extramural stakeholder helped to categorize them according to SNA network measures for degree of centrality, betweenness centrality, and closeness centrality. Findings showed the Ag Center had N = 305 extramural stakeholders. Most of these were other researchers and did not represent the diverse group of stakeholders that the Ag Center had targeted for engagement. Only a few of the intramural stakeholders had national or international connections. Findings were used to improve and diversify connections in order to leverage the Ag Center's expertise and ability to translate research into new best practices and policies. The SNA case study has implications for other evaluators and project directors looking for methodologies that can monitor networks in large science consortia and help leaders plan for translating research into practice and policies by networking with those who can influence such change.
Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E
2017-01-01
Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.
Staff nurse commitment, work relationships, and turnover intentions: a latent profile analysis.
Gellatly, Ian R; Cowden, Tracy L; Cummings, Greta G
2014-01-01
The three-component model of organization commitment has typically been studied using a variable-centered rather than a person-centered approach, preventing a more complete understanding of how these forms of commitment are felt and expressed as a whole. Latent profile analysis was used to identify qualitatively distinct categories or profiles of staff nurses' commitment. Then, associations of the profiles with perceived work unit relations and turnover intentions were examined. Three hundred thirty-six registered nurses provided data on affective, normative, and continuance commitment, perceived work unit relations, and turnover intentions. Latent profile analysis of the nurses' commitment scores revealed six distinct profile groups. Work unit relations and turnover intentions were compared in the six profile-defined groups. Staff nurses with profiles characterized by high affective commitment and/or high normative commitment in relation to other components experienced stronger work unit relations and reported lower turnover intentions. Profiles characterized by high continuance commitment relative to other components or by low overall commitment experienced poorer work unit relations, and the turnover risk was higher. High continuance commitment in combination with high affective and normative commitment was experienced differently than high continuance commitment in combination with low affective and normative commitment. Healthcare organizations often foster commitment by using continuance commitment-enhancing strategies (e.g., offer high salaries and attractive benefits) that may inadvertently introduce behavioral risk. This work suggests the importance of changing the context in which continuance commitment occurs by strengthening the other two components.
Measuring patients' perceptions of the outcomes of treatment for early prostate cancer.
Clark, Jack A; Bokhour, Barbara G; Inui, Thomas S; Silliman, Rebecca A; Talcott, James A
2003-08-01
Compared with careful attention to the physical (eg, urinary, bowel, sexual) dysfunction that may follow treatment, little attention has been given to the behavioral, emotional, and interpersonal changes that the diagnosis of early prostate cancer and subsequent physical dysfunction may bring. To construct patient-centered measures of the outcomes of treatment for early prostate cancer. Qualitative study followed by survey of early prostate cancer patients and group of comparable patients with no history of prostate cancer. Analysis of focus groups identified relevant domains of quality of life, which were represented by Likert scale items included in survey questionnaires. Psychometric analyses of survey data defined scales evaluated with respect to internal consistency and validity. Qualitative analysis identified three domains: urinary control, sexuality, and uncertainty about the cancer and its treatment. Psychometric analysis defined 11 scales. Seven were generically relevant to most older men: urinary control (eg, embarrassment with leakage), sexual intimacy (eg, anxiety about completing intercourse), sexual confidence (eg, comfort with sexuality), marital affection (eg, emotional distance from spouse/partner), masculine self esteem (eg, feeling oneself a whole man), health worry (eg, apprehensiveness about health changes), and PSA concern (eg, closely attending to one's PSA). Four scales were specific to the treatment experience: perceived cancer control, quality of treatment decision making, regret of treatment choice, and cancer-related outlook. The scales provide definition and metrics for patient-centered research in this area. They complement measures of physical dysfunction and bring into resolution outcomes of treatment that have gone unnoticed in previous studies.
Sarría-Santamera, Antonio; Matchar, David B; Westermann-Clark, Emma V; Patwardhan, Meenal B
2006-01-01
The purpose of this study was to identify the Evidence-Based Practice Center (EPC) network participants' perceptions of the characteristics of the EPC process and the relationship of the process to the success of EPC reports. Semistructured interviews were conducted with the three groups involved in the EPC: EPC staff, Agency for Healthcare Research and Quality (AHRQ) staff, and representatives of partner organizations. The analysis of the coded transcripts revealed three related major themes, which form the conceptual basis for the interpretation presented here: the definition of a successful report, the determinants of a successful report, and the role of AHRQ in the process. A successful report is a report that is used. The ultimate success of the core health technology assessment objective, moving from research to policy, depends on balancing two values: excellence and relevance. Our findings are consistent with the "two communities thesis," which postulates the existence of two camps that confer different values to excellence and relevance, with resulting tension. A promising model for approaching this tension is integration or collaboration, which requires linking researchers and policy makers, promoting productive dialogues about the formulation and timing of analysis, and early consideration of how the resulting analysis will be used. This effort suggests that actively blurring the frontiers between these two groups will enhance their interaction. Furthermore, enhancing the role of the AHRQ as scientific broker will maximize the potential of the EPC network.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ridgley, Jennie
2001-08-21
The purpose of the phase 2 Mesaverde study part of the Department of Energy funded project ''Analysis of oil-bearing Cretaceous Sandstone Hydrocarbon Reservoirs, exclusive of the Dakota Sandstone, on the Jicarilla Apache Indian Reservation, New Mexico'' was to define the facies of the oil-producing units within the subsurface units of the Mesaverde Group and integrate these results with outcrop studies that defined the depositional environments of these facies within a sequence stratigraphic context. The focus of this report will center on (1) integration of subsurface correlations with outcrop correlations of components of the Mesaverde, (2) application of the sequence stratigraphicmore » model determined in the phase one study to these correlations, (3) determination of the facies distribution of the Mesaverde Group and their relationship to sites of oil and gas accumulation, (4) evaluation of the thermal maturity and potential source rocks for oil and gas in the Mesaverde Group, and (5) evaluation of the structural features on the Reservation as they may control sites of oil accumulation.« less
TH-EF-BRC-03: Fault Tree Analysis
DOE Office of Scientific and Technical Information (OSTI.GOV)
Thomadsen, B.
2016-06-15
This Hands-on Workshop will be focused on providing participants with experience with the principal tools of TG 100 and hence start to build both competence and confidence in the use of risk-based quality management techniques. The three principal tools forming the basis of TG 100’s risk analysis: Process mapping, Failure-Modes and Effects Analysis and fault-tree analysis will be introduced with a 5 minute refresher presentation and each presentation will be followed by a 30 minute small group exercise. An exercise on developing QM from the risk analysis follows. During the exercise periods, participants will apply the principles in 2 differentmore » clinical scenarios. At the conclusion of each exercise there will be ample time for participants to discuss with each other and the faculty their experience and any challenges encountered. Learning Objectives: To review the principles of Process Mapping, Failure Modes and Effects Analysis and Fault Tree Analysis. To gain familiarity with these three techniques in a small group setting. To share and discuss experiences with the three techniques with faculty and participants. Director, TreatSafely, LLC. Director, Center for the Assessment of Radiological Sciences. Occasional Consultant to the IAEA and Varian.« less
Department of Defense Information Analysis Centers.
ERIC Educational Resources Information Center
Rothschild, M. Cecilia
1987-01-01
Describes the establishment of Department of Defense (DOD) information analysis centers and discusses their purpose and activities, how they differ from special libraries and other information centers, and some problems resulting from the communication of classified information. A list of existing information analysis centers is provided. (CLB)
Arnuntasupakul, Vanlapa; Van Zundert, Tom C R V; Vijitpavan, Amorn; Aliste, Julian; Engsusophon, Phatthanaphol; Leurcharusmee, Prangmalee; Ah-Kye, Sonia; Finlayson, Roderick J; Tran, De Q H
2016-01-01
Epidural waveform analysis (EWA) provides a simple confirmatory adjunct for loss of resistance (LOR): when the needle tip is correctly positioned inside the epidural space, pressure measurement results in a pulsatile waveform. In this randomized trial, we compared conventional and EWA-confirmed LOR in 2 teaching centers. Our research hypothesis was that EWA-confirmed LOR would decrease the failure rate of thoracic epidural blocks. One hundred patients undergoing thoracic epidural blocks for thoracic surgery, abdominal surgery, or rib fractures were randomized to conventional LOR or EWA-LOR. The operator was allowed as many attempts as necessary to achieve a satisfactory LOR (by feel) in the conventional group. In the EWA-LOR group, LOR was confirmed by connecting the epidural needle to a pressure transducer using a rigid extension tubing. Positive waveforms indicated that the needle tip was positioned inside the epidural space. The operator was allowed a maximum of 3 different intervertebral levels to obtain a positive waveform. If waveforms were still absent at the third level, the operator simply accepted LOR as the technical end point. However, the patient was retained in the EWA-LOR group (intent-to-treat analysis).After achieving a satisfactory tactile LOR (conventional group), positive waveforms (EWA-LOR group), or a third intervertebral level with LOR but no waveform (EWA-LOR group), the operator administered a 4-mL test dose of lidocaine 2% with epinephrine 5 μg/mL. Fifteen minutes after the test dose, a blinded investigator assessed the patient for sensory block to ice. Compared with LOR, EWA-LOR resulted in a lower rate of primary failure (2% vs 24%; P = 0.002). Subgroup analysis based on experience level reveals that EWA-LOR outperformed conventional LOR for novice (P = 0.001) but not expert operators. The performance time was longer in the EWA-LOR group (11.2 ± 6.2 vs 8.0 ± 4.6 minutes; P = 0.006). Both groups were comparable in terms of operator's level of expertise, depth of the epidural space, approach, and LOR medium. In the EWA-LOR group, operators obtained a pulsatile waveform with the first level attempted in 60% of patients. However, 40% of subjects required performance at a second or third level. Compared with its conventional counterpart, EWA-confirmed LOR results in a lower failure rate for thoracic epidural blocks (2% vs 24%) in our teaching centers. Confirmatory EWA provides significant benefits for inexperienced operators.
Berthold, Elisabet; Geborek, Pierre; Gülfe, Anders
2013-10-01
Increased infection risk in inflammatory rheumatic diseases may be due to inflammation or immunosuppressive treatment. The influence of tumor necrosis factor (TNF) inhibitors on the risk of developing surgical site infections (SSIs) is not fully known. We compared the incidence of SSI after elective orthopedic surgery or hand surgery in patients with a rheumatic disease when TNF inhibitors were continued or discontinued perioperatively. We included 1,551 patients admitted for elective orthopedic surgery or hand surgery between January 1, 2003 and September 30, 2009. Patient demographic data, previous and current treatment, and factors related to disease severity were collected. Surgical procedures were grouped as hand surgery, foot surgery, implant-related surgery, and other surgery. Infections were recorded and defined according to the 1992 Centers for Disease Control definitions for SSI. In 2003-2005, TNF inhibitors were discontinued perioperatively (group A) but not during 2006-2009 (group B). In group A, there were 28 cases of infection in 870 procedures (3.2%) and in group B, there were 35 infections in 681 procedures (5.1%) (p = < 0.05). Only foot surgery had significantly more SSIs in group B, with very low rates in group A. In multivariable analysis with groups A and B merged, only age was predictive of SSI in a statistically significant manner. Overall, the SSI rates were higher after abolishing the discontinuation of anti-TNF perioperatively, possibly due to unusually low rates in the comparator group. None of the medical treatments analyzed, e.g. methotrexate or TNF inhibitors, were significant risk factors for SSI. Continuation of TNF blockade perioperatively remains a routine at our center.
Chen, Shi-Ling; Wu, Fang-Rong; Luo, Chen; Chen, Xin; Shi, Xiao-Yun; Zheng, Hai-Yan; Ni, Yun-Ping
2010-03-24
To evaluate the combined effect of endometrial thickness and pattern on clinical outcome in patients undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Cycles of IVF/ICSI-ET conducted between January 2003 and December 2008 at a university-based reproductive center were reviewed retrospectively. Endometrial ultrasonographic characteristics were recorded on the day of hCG administration. In the combined analysis, endometrial thickness groups (group 1: equal or <7 mm; group 2: 7-14 mm; group 3: >14 mm) were subdivided into two endometrial patterns (pattern A: triple-line; pattern B: no-triple line). Clinical pregnancy rate (CPR) and early miscarriage rate in different groups were analyzed. A total of 2896 cycles were reviewed. Clinical pregnancy rate (CPR) was 24.4% in group 1-A. There were no second trimester pregnancies in group 1-B. Miscarriage rate in group 2-A was significantly lower compared to group 2-B (P < 0.01), although CPR did not show any significant differences between the groups. A no-triple line endometrial pattern with moderate endometrial thickness (7-14 mm) had a detrimental effect on pregnancy outcome, but not the occurrence of pregnancy. In group 3, there was no difference in CPR and miscarriage rates between the two patterns; adequate endometrial thickness (>14 mm) seemed to mitigate the detrimental impact (high miscarriage rate) of pattern B. Combined analysis of endometrial thickness and pattern on the day of hCG administration was a better predictor of the outcome of IVF/ICSI-ET and may be more helpful for patient counseling than the separate analyses.
Lucero, R; Sheehan, B; Yen, P; Velez, O; Nobile-Hernandez, D; Tiase, V
2014-01-01
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. 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. 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. 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.
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