Early Risk Reduction Phase 1 FLIR/Laser Designator Window. Revision

DTIC Science & Technology

1991-12-31

Sandwich-Type FLIR Windows," Air Force AFWAL-TR-83- 4122, Nov 1983. 4-1 Hughes Danbury Optical Systems Final Report, "ATA Window Technology Program," PRBll...Risk Reduction -- Phase I, Optical Properties Measurement Techniques of Three Wide Band Window Materials," 22 August 1991. xii I i 86PR0869 30... Optical Systems, Lexington, MA, 02173, 1 Feb 1991. 5-7 McDonnell Aircraft Company Technical Memorandum TM 256.91.0056.01, "Early Risk Reduction -- Phase

Report: EPA Needs to Reinforce Its National Pretreatment Program

EPA Pesticide Factsheets

Report #2004-P-00030, September 28, 2004. The reductions in industrial waste discharges to the nation’s sewer systems that characterized the early years of the pretreatment program have not endured.

77 FR 51807 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

... Minimum Data Elements (MDEs) for the National Breast and Cervical Cancer Early Detection Program (NBCCEDP... screening and early detection tests for breast and cervical cancer. Mammography is extremely valuable as an early detection tool because it can detect breast cancer well before the woman can feel the lump, when...

An Analysis of Enlisted Early Separations Under the Air Force’s and Navy’s VSI/SSB Programs: A Comparative Study

DTIC Science & Technology

1994-03-01

were contained in the 1992 National Defense Authorization Act as an important policy tool of DoD’s force reduction strategy. As a result of the FY92...National Defense Authorization Act , the Department of Defense faced a large scale personnel strength reduction. The bonus programs were implemented in an...had many concerns. One of course, was the concern with how successful the incentive programs would be in inducing separations. Given the high

Multimodel Substance Use Intervention Program for Male Delinquents.

ERIC Educational Resources Information Center

Friedman, Alfred S.; Terras, Arlene; Glassman, Kimberly

2002-01-01

In this prevention-early intervention project, court-adjudicated male adolescents were randomly assigned to either a program participant group, or to a control group. Results showed that the program group reported a significantly greater degree of reduction in drug use/abuse, and in the selling of drugs, but not in alcohol use, or in illegal…

Adolescent Sexuality: Pregnancy, Sexually Transmitted Diseases, and Prevention.

ERIC Educational Resources Information Center

Santelli, John S.; And Others

1992-01-01

Special edition discusses adolescent sexuality, focusing on pregnancy, sexually transmitted diseases, and prevention. The articles focus on demographics, risk factors, school-based risk reduction programs, contraception, early intervention, options, school-based prenatal and postpartum care programs, teenage parenting, abortion, HIV and AIDS,…

Small Class Size and Its Effects.

ERIC Educational Resources Information Center

Biddle, Bruce J.; Berliner, David C.

2002-01-01

Describes several prominent early grades small-class-size projects and their effects on student achievement: Indiana's Project Prime Time, Tennessee's Project STAR (Student/Teacher Achievement Ratio), Wisconsin's SAGE (Student Achievement Guarantee in Education) Program, and the California class-size-reduction program. Lists several conclusions,…

Effect of Mindfulness Based Stress Reduction on Immune Function, Quality of Life and Coping In Women Newly Diagnosed with Early Stage Breast Cancer

PubMed Central

Witek-Janusek, Linda; Albuquerque, Kevin; Chroniak, Karen Rambo; Chroniak, Christopher; Durazo, Ramon; Mathews, Herbert L.

2008-01-01

This investigation used a non-randomized controlled design to evaluate the effect and feasibility of a mindfulness based stress reduction (MBSR) program on immune function, quality of life (QOL), and coping in women recently diagnosed with breast cancer. Early stage breast cancer patients, who did not receive chemotherapy, self-selected into an 8-week MBSR program or into an assessment only, control group. Outcomes were evaluated over time. The first assessment was at least 10 days after surgery and prior to adjuvant therapy, as well as before the MBSR start-up. Further assessments were mid-MBSR, at completion of MBSR, and at 4-weeks post MBSR completion. Women with breast cancer enrolled in the control group (Non-MBSR) were assessed at similar times. At the first assessment (i.e., before MBSR start), reductions in peripheral blood mononuclear cell NK cell activity (NKCA) and IFN gamma production with increases in IL-4, IL-6, and IL-10 production and plasma cortisol levels were observed for both the MBSR and Non-MBSR groups of breast cancer patients. Over time women in the MBSR group re-established their NKCA and cytokine production levels. In contrast, breast cancer patients in the Non-MBSR group exhibited continued reductions in NKCA and IFN gamma production with increased IL-4, IL-6, and IL-10 production. Moreover, women enrolled in the MBSR program had reduced cortisol levels, improved QOL, and increased coping effectiveness compared to the Non-MBSR group. In summary, MBSR is a program that is feasible for women recently diagnosed with early stage breast cancer and the results provide preliminary evidence of beneficial effects of MBSR on immune function, QOL, and coping effectiveness. PMID:18359186

40 CFR 71.25 - Permit content.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 16 2013-07-01 2013-07-01 false Permit content. 71.25 Section 71.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL OPERATING PERMIT PROGRAMS Permits for Early Reductions Sources § 71.25 Permit content. (a) Standard permit requirements. Each permit issued under...

40 CFR 71.25 - Permit content.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Permit content. 71.25 Section 71.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL OPERATING PERMIT PROGRAMS Permits for Early Reductions Sources § 71.25 Permit content. (a) Standard permit requirements. Each permit issued under...

40 CFR 71.25 - Permit content.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Permit content. 71.25 Section 71.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL OPERATING PERMIT PROGRAMS Permits for Early Reductions Sources § 71.25 Permit content. (a) Standard permit requirements. Each permit issued under...

40 CFR 71.25 - Permit content.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Permit content. 71.25 Section 71.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL OPERATING PERMIT PROGRAMS Permits for Early Reductions Sources § 71.25 Permit content. (a) Standard permit requirements. Each permit issued under...

40 CFR 71.4 - Program implementation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... effective date. (3) Any complete permit application containing an early reduction demonstration under... under this paragraph (m) and of the approval or rejection of such petition and the basis for such action...

40 CFR 71.4 - Program implementation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... effective date. (3) Any complete permit application containing an early reduction demonstration under... under this paragraph (m) and of the approval or rejection of such petition and the basis for such action...

Lessons Learned From Community-Based Approaches to Sodium Reduction

PubMed Central

Kane, Heather; Strazza, Karen; Losby PhD, Jan L.; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S.; Frost, Corey; Margolis, Marjorie; Hersey, James

2017-01-01

Purpose This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. Design A multiple case study design was used. Setting This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Subjects Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. Analysis The project team conducted a document review of program materials and semi structured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Results Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. Conclusion The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption. PMID:24575726

The Promise of Preschool: Why We Need Early Education for All

ERIC Educational Resources Information Center

Barnett, W. Steven; Frede, Ellen

2010-01-01

It's fairly well known that high-quality preschool programs can have life-altering impacts on disadvantaged children, including reductions in school dropout and crime, and increased earnings. Not as well known is that terrific preschool programs have important academic and social benefits for middle-class children too. Decades of research indicate…

Moving base Gravity Gradiometer Survey System (GGSS) program

NASA Astrophysics Data System (ADS)

Pfohl, Louis; Rusnak, Walter; Jircitano, Albert; Grierson, Andrew

1988-04-01

The GGSS program began in early 1983 with the objective of delivering a landmobile and airborne system capable of fast, accurate, and economical gravity gradient surveys of large areas anywhere in the world. The objective included the development and use of post-mission data reduction software to process the survey data into solutions for the gravity disturbance vector components (north, east and vertical). This document describes the GGSS equipment hardware and software, integration and lab test procedures and results, and airborne and land survey procedures and results. Included are discussions on test strategies, post-mission data reduction algorithms, and the data reduction processing experience. Perspectives and conclusions are drawn from the results.

Promoting the University Social Responsibility in the Capacity Development Program for Landslide Risk Reduction in Indonesia

NASA Astrophysics Data System (ADS)

Karnawati, D.; Wilopo, W.; Verrier, M.; Fathani, T. F.; Andayani, B.

2011-12-01

One of the most challenges efforts for landslides disaster risk reduction in Indonesia is to provide an effective program for capacity development of the community living in the vulnerable area. Limited access for appropriate information and knowledge about the geology and landslide phenomena as well as the social-security constrains are the major challenges in capacity development program in the landslide prone area. Accordingly, an action for conducting community-based research and education program with respect to landslide mitigation and disaster risk reduction at the village level was established by implementing the University Social Responsibility Program. Such program has been conducted regularly in every academic semester as a part of the formal academic program at Universitas Gadjah Mada , Indonesia. Twenty students with multi-discipline backgrounds and supported by their lectures/advisers have to be deployed at the village for two months to carry out such mission. This action is also conducted under the coordination with the local/ national Government together with the local community, and may also with the private sectors. A series of research actions such as landslide investigation and hazard-risk mapping, social mapping and development of landslide early warning system were carried out in parallel with public education and evacuation drill for community empowerment and landslide risk reduction. A Community Task Force for Disaster Risk Reduction was also established during the community empowerment program, in order to guarantee the affectivity and sustainability of the disaster risk reduction program at the village level. It is crucial that this program is not only beneficial for empowering the village community to tackle the landslide problems, but also important to support the education for sustainable development program at the disaster prone area. Indeed, this capacity development program may also be considered as one best practice for transforming the knowledge into action and the action into knowledge enhancement, with respect to landslide disaster risk reduction.
Scope of problems and the actions conducted by Universitas Gadjah Mada as The University Social Responsibility Program for Landslide Disaster Risk Reduction in Indonesia

Focus on California's Class-Size Reduction: Smaller Classes Aim To Launch Early Literacy.

ERIC Educational Resources Information Center

McRobbie, Joan

Smaller class sizes in California were viewed as a way to improve K-3 education, especially in the area of literacy. The urgency to act prompted state leaders to adopt class-size reduction (CSR) without knowing for sure that it would work and without establishing a formal procedure for evaluating the program. This report looks at past research on…

CANCER PREVENTION AND CONTROL (CP) DATABASE

EPA Science Inventory

This database focuses on breast, cervical, skin, and colorectal cancer emphasizing the application of early detection and control program activities and risk reduction efforts. The database provides bibliographic citations and abstracts of various types of materials including jou...

Understanding Acceptable Level of Risk: Incorporating the Economic Cost of Under-Managing Invasive Species.

PubMed

Davidson, Alisha D; Hewitt, Chad L; Kashian, Donna R

2015-01-01

Management of nonindigenous species includes prevention, early detection and rapid response and control. Early detection and rapid response depend on prioritizing and monitoring sites at risk for arrival or secondary spread of nonindigenous species. Such monitoring efforts require sufficient biosecurity budgets to be effective and meet management or policy directives for reduced risk of introduction. Such consideration of risk reduction is rarely considered, however. Here, we review the concepts of acceptable level of risk (ALOR) and associated costs with respect to nonindigenous species and present a framework for aligning risk reduction priorities with available biosecurity resources. We conclude that available biosecurity resources may be insufficient to attain stated and desired risk reduction. This outcome highlights the need to consider policy and management directives when beginning a biosecurity program to determine the feasibility of risk reduction goals, given available resources.

Liquid radwaste in-leakage reduction at TVA's Browns Ferry nuclear plant

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

Smith, A.C.; Roccasano, J.J.

1987-01-01

Early in 1985, Tennessee Valley Authority's (TVA's) Browns Ferry Nuclear Plant (BFNP) decided to initiate a liquid radwaste in-leakage reduction project as part of their chemistry improvement program. The purpose of this project was to reduce the overall volume of water processed by the radwaste system at BFNP by restricting uncontrolled in-leakage through the floor drain system. Impell Corporation was contracted to perform the project, which consisted of several tasks, each design to provide data for the reduction of in-leakage or to reduce the in-leakage directly. The program was begun in March 1985. Buy July of that same year, liquidmore » input to radwaste through the floor drain system had been reduced by --30%.« less

Report: Early-Outs and Buyouts Aided OIG Workforce Reduction, but Weak Management Controls Led to Misused Authority

EPA Pesticide Factsheets

Report #17-P-0362, August 14, 2017. The OIG should implement management controls for high-risk operations such as a VERA-VSIP program to prevent future noncompliance and support improved workforce outcomes.

Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior

PubMed Central

Shaw, Daniel S.; Connell, Arin; Dishion, Thomas J.; Wilson, Melvin N.; Gardner, Frances

2009-01-01

Maternal depression has been consistently linked to the development of child problem behavior, particularly in early childhood, but few studies have examined whether reductions in maternal depression serve as a mediator in relation to changes associated with a family-based intervention. The current study addressed this issue with a sample of 731 families receiving services from a national food supplement and nutrition program. Families with toddlers between ages 2 and 3 were sereened and then randomized to a brief family intervention, the Family Check-Up, which included linked interventions that were tailored and adapted to the families needs. Follow-up intervention services were provided at age 3 and follow-up of child outcomes oecurred at ages 3 and 4. Latent growth models revealed intervention effects for early externalizing and internalizing problems from 2 to 4, and reductions in maternal depression from ages 2 to 3. In addition, reductions in maternal depression mediated improvements in both child externalizing and internalizing problem behavior after accounting for the potential mediating effects of improvements in positive parenting. The results are discussed with respect to targeting maternal depression in future intervention studies aimed at improving early child problem behavior. PMID:19338691

Motivational contracting in space programs - Government and industry prospectives

NASA Technical Reports Server (NTRS)

Clough, D. R.

1985-01-01

NASA's Marshall Space Flight Center has used incentive-free policies in contracting for Apollo's Saturn Launch vehicle hardware, as well as award-fee contracts for major development and early production programs in the case of the Space Shuttle Program. These programs have evolved to a point at which multiple incentive fees are useful in motivating cost reductions and assuring timely achievement of delivery requirements and flight mission goals. An examination is presently conducted of the relative success of these motivation-oriented techniques, drawing on the comments of both government and industry personnel.

A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers.

PubMed

Lattermann, Christina; Euler, Harald A; Neumann, Katrin

2008-03-01

In order to investigate whether the Lidcombe Program effects a short-term reduction of stuttered speech beyond natural recovery, 46 German preschool children were randomly assigned to a wait-contrast group or to an experimental group which received the Lidcombe Program for 16 weeks. The children were between 3;0 and 5;11 years old, their and both of their parents' native language was German, stuttering onset had been at least 6 months before, and their stuttering frequency was higher than 3% stuttered syllables. Spontaneous speech samples were recorded at home and in the clinic prior to treatment and after 4 months. Compared to the wait-contrast group, the treatment group showed a significantly higher decrease in stuttered syllables in home-measurements (6.9%SS vs. 1.6%SS) and clinic-measurements (6.8%SS vs. 3.6%SS), and the same increase in articulation rate. The program is considered an enrichment of currently applied early stuttering interventions in Germany. Readers will discuss and evaluate: (1) the short-term effects of the Lidcombe Program in comparison to natural recovery on stuttering; (2) the impact of the Lidcombe Program on early stuttering in German-speaking preschool children.

Los Angeles congestion reduction demonstration (Metro ExpressLanes) program. National evaluation : surveys, interviews, and workshops test plan.

DOT National Transportation Integrated Search

1997-09-01

Integration of intelligent transportation systems (ITS) within a metropolitan area is crucial for effective deployment. The Early Deployment Planning (EDP) Process is one tool that allows transportation officials to plan for and implement ITS technol...

To Legislate or Not to Legislate? A Comparison of the UK and South African Approaches to the Development and Implementation of Salt Reduction Programs

PubMed Central

Charlton, Karen; Webster, Jacqui; Kowal, Paul

2014-01-01

The World Health Organization promotes salt reduction as a best-buy strategy to reduce chronic diseases, and Member States have agreed to a 30% reduction target in mean population salt intake by 2025. Whilst the UK has made the most progress on salt reduction, South Africa was the first country to pass legislation for salt levels in a range of processed foods. This paper compares the process of developing salt reduction strategies in both countries and highlights lessons for other countries. Like the UK, the benefits of salt reduction were being debated in South Africa long before it became a policy priority. Whilst salt reduction was gaining a higher profile internationally, undoubtedly, local research to produce context-specific, domestic costs and outcome indicators for South Africa was crucial in influencing the decision to legislate. In the UK, strong government leadership and extensive advocacy activities initiated in the early 2000s have helped drive the voluntary uptake of salt targets by the food industry. It is too early to say which strategy will be most effective regarding reductions in population-level blood pressure. Robust monitoring and transparent mechanisms for holding the industry accountable will be key to continued progress in each of the countries. PMID:25230210

ACCOMPLISHMENTS OF THE AMERICAN-POLISH PROGRAM FOR ELIMINATION OF LOW EMISSIONS IN KRAKOW

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

BUTCHER,T.A.; PIERCE,B.

1998-11-05

In 1991, US and Polish officials signed a Memorandum of Understanding formally initiating and directing the Cracow Clean Fossil Fuels and Energy Efficiency Program. Developing a program approach for the most effective use of the available funds required considerable effort on the part of all project participants. The team recognized early that the cost of solving the low emissions problem even in only one city far exceeded the amount of available US funds. Economic conditions in Poland limited availability of local capital funds for environmental projects. Imposing environmental costs on struggling companies or city residents under difficult conditions of themore » early 1990's required careful consideration of the economic and political impacts. For all of these reasons the program sought to identify technologies for achieving air quality goals which, through improved efficiency and/or reduced fuel cost, could be so attractive economically as to lead to self-sustaining activities beyond the end of the formal project. The effort under this program has been focused into 5 main areas of interest as follows: (1) Energy Conservation and Extension of Central Station District Heating; (2) Replacement of Coal- and Coke-Fired Boilers with Natural Gas-Fired Boilers; (3) Replacement of Coal-Fired Home Stoves with Electric Heating Appliances; (4) Reduction of Emissions from Stoker-Fired Boiler Houses; and (5) Reduction of Emissions from Coal-Fired Home Heating Stoves.« less

Continuity and Change From Full-Inclusion Early Childhood Programs Through the Early Elementary Period

PubMed Central

Guralnick, Michael J.; Neville, Brian; Hammond, Mary A.; Connor, Robert T.

2010-01-01

A large and well-characterized group of children with mild developmental delays initially enrolled in full-inclusion preschool or kindergarten programs was followed for 3 years. Changes in the type of inclusive placements as children transitioned to first and second grades were monitored, and associations between placement type and child and family characteristics were examined. Results revealed a high level of continuity in that most children remained in partial or full inclusion settings over time. However, a substantial reduction in full-inclusion placements occurred between the 2nd and 3rd year when children were completing the transition to first and second grades. Placements in less inclusive settings were associated with children’s levels of cognitive and language development but not their adaptive, social, or behavioral characteristics. A hypothesis was put forward that placement in full-inclusion programs during the early childhood years creates a momentum to continue maximum participation in inclusive settings over time. PMID:20890373

40 CFR 63.78 - Early reduction demonstration evaluation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Early reduction demonstration... Regulations Governing Compliance Extensions for Early Reductions of Hazardous Air Pollutants § 63.78 Early reduction demonstration evaluation. (a) The permitting authority will evaluate an early reduction...

40 CFR 63.78 - Early reduction demonstration evaluation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Early reduction demonstration... Regulations Governing Compliance Extensions for Early Reductions of Hazardous Air Pollutants § 63.78 Early reduction demonstration evaluation. (a) The permitting authority will evaluate an early reduction...

Development of a Low Cost 10kW Tubular SOFC Power System

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

Bessette, Norman; Litka, Anthony; Rawson, Jolyon

The DOE program funded from 2003 through early 2013 has brought the Acumentrics SOFC program from an early stage R&D program to an entry level commercial product offering. The development work started as one of the main core teams under the DOE Solid State Energy Conversion Alliance (SECA) program administered by the National Energy Technology Laboratory (NETL) of the DOE. During the first phase of the program, lasting approximately 3-4 years, a 5kW machine was designed, manufactured and tested against the specification developed by NETL. This unit was also shipped to NETL for independent verification testing which validated all ofmore » the results achieved while in the laboratory at Acumentrics. The Acumentrics unit passed all criteria established from operational stability, efficiency, and cost projections. Passing of the SECA Phase I test allowed the program to move into Phase II of the program. During this phase, the overall objective was to further refine the unit meeting a higher level of performance stability as well as further cost reductions. During the first year of this new phase, the NETL SECA program was refocused towards larger size units and operation on coal gasification due to the severe rise in natural gas prices and refocus on the US supply of indigenous coal. At this point, the program was shifted to the U.S. DOE’s Energy Efficiency and Renewable Energy (EERE) division located in Golden, Colorado. With this shift, the focus remained on smaller power units operational on gaseous fuels for a variety of applications including micro combined heat and power (mCHP). To achieve this goal, further enhancements in power, life expectancy and reductions in cost were necessary. The past 5 years have achieved these goals with machines that can now achieve over 40% electrical efficiency and field units that have now operated for close to a year and a half with minimal maintenance. The following report details not only the first phase while under the SECA program and the key achievements but also the results while under EERE’s leadership and the transition to an early commercial product offering.« less

Fit5Kids TV reduction program and Latino preschoolers' TV viewing behaviors: A pilot cluster RCT

USDA-ARS?s Scientific Manuscript database

Excessive television (TV) viewing has been associated with a greater risk of childhood obesity. Latino children watch higher amounts of TV than their peers and are disproportionately affected by childhood obesity. Since TV viewing and obesity track from preschool into adolescence, early intervention...

Breaking the Cycle: A Special Report by Arkansas Kids Count.

ERIC Educational Resources Information Center

Huddleston, Rich; Duran, Angela

In response to federal welfare reform legislation, Arkansas created the Transitional Employment Assistance (TEA) program in April 1997. The goal of this Kids Count report is to increase awareness regarding issues underlying the early implementation of TEA, focusing on caseload reductions, demographic composition of the caseload, level of support…

Health economic potential of early nutrition programming: a model calculation of long-term reduction in blood pressure and related morbidity costs by use of long-chain polyunsaturated fatty acid-supplemented formula.

PubMed

Straub, Niels; Grunert, Philipp; von Kries, Rüdiger; Koletzko, Berthold

2011-12-01

The reported effect sizes of early nutrition programming on long-term health outcomes are often small, and it has been questioned whether early interventions would be worthwhile in enhancing public health. We explored the possible health economic consequences of early nutrition programming by performing a model calculation, based on the only published study currently available for analysis, to evaluate the effects of supplementing infant formula with long-chain polyunsaturated fatty acids (LC-PUFAs) on lowering blood pressure and lowering the risk of hypertension-related diseases in later life. The costs and health effects of LC-PUFA-enriched and standard infant formulas were compared by using a Markov model, including all relevant direct and indirect costs based on German statistics. We assessed the effect size of blood pressure reduction from LC-PUFA-supplemented formula, the long-term persistence of the effect, and the effect of lowered blood pressure on hypertension-related morbidity. The cost-effectiveness analysis showed an increased life expectancy of 1.2 quality-adjusted life-years and an incremental cost-effectiveness ratio of -630 Euros (discounted to present value) for the LC-PUFA formula in comparison with standard formula. LC-PUFA nutrition was the superior strategy even when the blood pressure-lowering effect was reduced to the lower 95% CI. Breastfeeding is the recommended feeding practice, but infants who are not breastfed should receive an appropriate infant formula. Following this model calculation, LC-PUFA supplementation of infant formula represents an economically worthwhile prevention strategy, based on the costs derived from hypertension-linked diseases in later life. However, because our analysis was based on a single randomized controlled trial, further studies are required to verify the validity of this thesis.

The Effect of a Workplace-Based Early Intervention Program on Work-Related Musculoskeletal Compensation Outcomes at a Poultry Meat Processing Plant.

PubMed

Donovan, Michael; Khan, Asaduzzaman; Johnston, Venerina

2017-03-01

Introduction The aim of this study is to determine whether a workplace-based early intervention injury prevention program reduces work-related musculoskeletal compensation outcomes in poultry meat processing workers. Methods A poultry meatworks in Queensland, Australia implemented an onsite early intervention which included immediate reporting and triage, reassurance, multidisciplinary participatory consultation, workplace modifica tion and onsite physiotherapy. Secondary pre-post analyses of the meatworks' compensation data over 4 years were performed, with the intervention commencing 2 years into the study period. Outcome measures included rate of claims, costs per claim and work days absent at an individual claim level. Where possible, similar analyses were performed on data for Queensland's poultry meat processing industry (excluding the meatworks used in this study). Results At the intervention meatworks, in the post intervention period an 18 % reduction in claims per 1 million working hours (p = 0.017) was observed. Generalized linear modelling revealed a significant reduction in average costs per claim of $831 (OR 0.74; 95 % CI 0.59-0.93; p = 0.009). Median days absent was reduced by 37 % (p = 0.024). For the poultry meat processing industry over the same period, generalized linear modelling revealed no significant change in average costs per claim (OR 1.02; 95 % CI 0.76-1.36; p = 0.91). Median days absent was unchanged (p = 0.93). Conclusion The introduction of an onsite, workplace-based early intervention injury prevention program demonstrated positive effects on compensation outcomes for work-related musculoskeletal disorders in poultry meat processing workers. Prospective studies are needed to confirm the findings of the present study.

Long-Term Health Impact of Early Nutrition: The Power of Programming.

PubMed

Koletzko, Berthold; Brands, Brigitte; Grote, Veit; Kirchberg, Franca F; Prell, Christine; Rzehak, Peter; Uhl, Olaf; Weber, Martina

2017-01-01

The Power of Programming conference 2016 at Ludwig-Maximilians-Universität Munich brought together about 600 researchers and other stakeholders from around the world who reviewed the recent evidence on the lasting health impact of environment and nutrition during early life, from pre-pregnancy to early childhood. The conference was hosted by the Early Nutrition Project, a multidisciplinary research collaboration funded by the European Commission with collaborating researchers from 35 institutions in 15 countries in Europe, the United States and Australia. The project explores the early origins of obesity, adiposity and associated non-communicable diseases, underlying mechanisms and opportunities for prevention. The project also proactively supports translational application of research findings. In fact, some existing evidence has already been rapidly adopted into policy, regulatory standards and practice. Further, broad dissemination of findings is achieved through the established digital eLearning platform of the Early Nutrition eAcademy, video clip-based learning and graphically supported messaging to consumers. The project demonstrated powerful effects of early metabolic programming on later health. Compared to other common prevention strategies, modifying risk trajectories in early life can achieve a much larger risk reduction and be more cost-effective. While some effective prevention strategies have been promptly implemented in policy and guidelines, legislation and practice, in other areas, the uptake is limited by a paucity of quality human intervention trials and insufficient evaluation of the feasibility of implementation and econometric impact. This needs to be strengthened by future collaborative research work. © 2017 S. Karger AG, Basel.

Risk of Breast Cancer among Young Women and Importance of Early Screening.

PubMed

Memon, Zahid Ali; Kanwal, Noureen; Sami, Munam; Larik, Parsa Azam; Farooq, Mohammad Zain

2015-01-01

Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. We conducted a cross-sectional study among women aged 18 to 25 using a self- administered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized. Moreover, screening programs should be started to ensure early detection and reduction of mortality rates caused by breast cancer also in young Pakistani females.

Institutionalization of Reduction of Total Ownership Costs (R-TOC) Principles. Part 1: Lessons Learned from Special Interest Programs

DTIC Science & Technology

2010-12-01

Life Cycle Cost Process Model (Austin, TX: The Consortium for Advanced Management International) 6 November 2009. 8 The framework begins with...Hendricks, James R. Involving the Extended Value Chain in a Target Costing/ Life Cycle Cost Process Model. Austin, TX: The Consortium for Advanced ...can have on reducing ownership costs in hundreds of other DOD programs. The early life -cycle phases (requirements/concept development) are often the

Housing First: exploring participants' early support needs.

PubMed

Stergiopoulos, Vicky; Gozdzik, Agnes; O'Campo, Patricia; Holtby, Alixandra R; Jeyaratnam, Jeyagobi; Tsemberis, Sam

2014-04-13

Housing First has become a popular treatment model for homeless adults with mental illness, yet little is known about program participants' early experiences or trajectories. This study used a mixed methods design to examine participant changes in selected domains 6 months after enrollment in a Canadian field trial of Housing First. The study sample included 301 participants receiving the Housing First intervention at the Toronto site of the At Home/Chez Soi project. This study used a pre-post design to compare quantitative 6-month outcome data to baseline values in key domains and multivariate regression to identify baseline demographic, clinical or service use variables associated with observed changes in these domains. In addition, qualitative data exploring participant and service provider perspectives and experiences was collected via stakeholder interviews and focus groups, and analyzed using thematic analysis. The majority (60 to 72%) of participants followed the expected trajectory of improvement, with the remaining experiencing difficulties in community integration, mental health symptom severity, substance use, community functioning and quality of life 6 months after program enrollment. Diagnosis of psychotic disorder was associated with a reduction in quality of life from baseline to 6-months, while substance use disorders were associated with reduced mental illness symptoms and substance use related problems and an improvement in quality of life. Participants housed in independent housing at 6-months had greater improvements in community integration and quality of life, and greater reduction in mental illness symptoms, compared to those not independently housed. The quality of the working alliance was positively associated with improvements in physical and psychological community integration and quality of life. Qualitative data provided a unique window into the loneliness and isolation experienced by Housing First participants, as well as problems related to substance use and a need for life skills training and support. Additional strategies can help support Housing First participants in the early stages of program participation and address potential causes of early difficulties, including lack of life skills and social isolation. This study highlights the importance of early and ongoing evaluation, monitoring and program adaptations to address consumer support needs. Current Controlled Trials ISRCTN42520374.

Housing First: exploring participants’ early support needs

PubMed Central

2014-01-01

Background Housing First has become a popular treatment model for homeless adults with mental illness, yet little is known about program participants’ early experiences or trajectories. This study used a mixed methods design to examine participant changes in selected domains 6 months after enrolment in a Canadian field trial of Housing First. Methods The study sample included 301 participants receiving the Housing First intervention at the Toronto site of the At Home/Chez Soi project. This study used a pre-post design to compare quantitative 6-month outcome data to baseline values in key domains and multivariate regression to identify baseline demographic, clinical or service use variables associated with observed changes in these domains. In addition, qualitative data exploring participant and service provider perspectives and experiences was collected via stakeholder interviews and focus groups, and analyzed using thematic analysis. Results The majority (60 to 72%) of participants followed the expected trajectory of improvement, with the remaining experiencing difficulties in community integration, mental health symptom severity, substance use, community functioning and quality of life 6 months after program enrolment. Diagnosis of psychotic disorder was associated with a reduction in quality of life from baseline to 6-months, while substance use disorders were associated with reduced mental illness symptoms and substance use related problems and an improvement in quality of life. Participants housed in independent housing at 6-months had greater improvements in community integration and quality of life, and greater reduction in mental illness symptoms, compared to those not independently housed. The quality of the working alliance was positively associated with improvements in physical and psychological community integration and quality of life. Qualitative data provided a unique window into the loneliness and isolation experienced by Housing First participants, as well as problems related to substance use and a need for life skills training and support. Conclusions Additional strategies can help support Housing First participants in the early stages of program participation and address potential causes of early difficulties, including lack of life skills and social isolation. This study highlights the importance of early and ongoing evaluation, monitoring and program adaptations to address consumer support needs. Trial registration Current Controlled Trials ISRCTN42520374 PMID:24725374

Use of the WHO surgical safety checklist in trauma and orthopaedic patients.

PubMed

Sewell, Mathew; Adebibe, Miriam; Jayakumar, Prakash; Jowett, Charlie; Kong, Kin; Vemulapalli, Krishna; Levack, Brian

2011-06-01

The World Health Organisation (WHO) recommends routine use of a surgical safety checklist prior to all surgical operations. The aim of this study was to prospectively audit checklist use in orthopaedic patients before and after implementation of an educational programme designed to increase use and correlate this with early complications, mortality and staff perceptions. Data was collected on 480 patients before the educational program and 485 patients after. Pre-training checklist use was 7.9%. The rates of early complications and mortality were 8.5% and 1.9%, respectively. Forty-seven percent thought the checklist improved team communication. Following an educational program, checklist use significantly increased to 96.9% (RR12.2; 95% CI 9.0-16.6). The rate of early complications and mortality was 7.6% (RR 0.89; 95% CI 0.58-1.37) and 1.6% (RR 0.88; 95% CI 0.34-2.26), respectively. Seventy-seven percent thought the checklist improved team communication. Checklist use was not associated with a significant reduction in early complications and mortality in patients undergoing orthopaedic surgery. Education programs can significantly increase accurate use and staff perceptions following implementation.

77 FR 28881 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... Brief Description The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is the only... providers have not received the educational intervention. A total of 2,246 women between the ages of 30 and.... Findings from the CX3 study will help inform NBCCEDP standards for primary cervical cancer screening...

The Long-Term Impacts of Medicaid Exposure in Early Childhood: Evidence from the Program's Origin*

PubMed Central

Boudreaux, Michel H.; Golberstein, Ezra; McAlpine, Donna D.

2016-01-01

This paper examines the long-term impact of exposure to Medicaid in early childhood on adult health and economic status. The staggered timing of Medicaid's adoption across the states created meaningful variation in cumulative exposure to Medicaid for birth cohorts that are now in adulthood. Analyses of the Panel Study of Income Dynamics suggest exposure to Medicaid in early childhood (age 0-5) is associated with statistically significant and meaningful improvements in adult health (age 25-54), and this effect is only seen in subgroups targeted by the program. Results for economic outcomes are imprecise and we are unable to come to definitive conclusions. Using separate data we find evidence of two mechanisms that could plausibly link Medicaid's introduction to long-term outcomes: contemporaneous increases in health services utilization for children and reductions in family medical debt. PMID:26763123

A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology.

PubMed

Burckhardt, Rowan; Manicavasagar, Vijaya; Batterham, Philip J; Hadzi-Pavlovic, Dusan

2016-08-01

To date, most early intervention programs have been based on emotion regulation strategies that address dysfunctional cognitive appraisals, problem-solving skills, and rumination. Another emotion regulation strategy, 'acceptance' training, has largely been overlooked. To examine the efficacy of this strategy, a school-based mental health program combining positive psychology with acceptance and commitment therapy (Strong Minds) was evaluated in a randomized controlled trial with a sample of 267 Year 10 and 11 high-school students in Sydney, Australia. Mixed models for repeated measures examined whether the program led to reductions in symptoms amongst students who commenced the program with high depression, anxiety, and stress scores, and increased wellbeing scores amongst all students. Results demonstrated that compared to controls, participants in the Strong Minds condition with elevated symptom scores (n=63) reported significant reductions in depression (p=.047), stress (p=.01), and composite depression/anxiety symptoms (p=.02) with medium to strong effect sizes (Cohen's d=0.53, 0.74, and 0.57, respectively). Increased wellbeing (p=.03) in the total sample and decreased anxiety scores (p=.048) for students with elevated symptoms were significant for Year 10 students with medium effect sizes (Cohen's d=0.43 and 0.54, respectively). This study tentatively suggests that including the emotion regulation strategy of acceptance in early intervention programs may be effective in reducing symptoms and improving wellbeing in high school students. Further research to investigate the generalizability of these findings is warranted. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Risky sexual behaviors of adolescents in rural Malawi: evidence from focus groups.

PubMed

Dancy, Barbara L; Kaponda, Chrissie P N; Kachingwe, Sitingawawo I; Norr, Kathleen F

2006-07-01

Little is known about rural Malawian adolescents' perceptions of their sexual behavior and what would constitute an effective HIV risk-reduction program. This study explored the perceptions of Malawain adolescents using qualitative description research with focus groups. A purposive sample of 144 adolescents, ranging from 10 to 19 years of age was obtained. Subjects were then placed in focus groups separated by gender Qualitative content analysis revealed that adolescents were at risk for HIV based on the select behaviors These included early sexual debut, multiple partners, non-use of condoms and among girls older partners These adolescents acknowledged peer pressure and lack of parental supervision as factors that perpetuated these behaviors and identified two components of HIV prevention programs. For example, parental involvement and support for sexual abstinence were among the issues discussed. It is essential that HIV risk-reduction programs create ways of involving parents and of enhancing adolescents' HIV risk-reduction skills by helping them to change peer norms and to develop negotiation and assertiveness skills to in order to resist peer pressure.

Aeronautics research and technology. A review of proposed reductions in the FY 1983 NASA program

NASA Technical Reports Server (NTRS)

1982-01-01

Reductions in the Fiscal Year 1983 program from the original proposal to the levels of the appropriation request submitted to Congress are reviewed. The request asked for an assessment of the national criticality of the excluded programs and, for each one, the risk (probability of success) associated with achieving the objectives sought and the degree to which it might be assumed by the private sector. Based on this request, a charge comprising an assessment of those aeronautics projects excluded from the FY 1983 budget request to Congress, the likelihood that industry would undertake them, the impact of their not being done, and the more general question of the need for government to bridge the gap between the aeronautics research and technology base and early application was developed. The charge further specifies that the assessment is to encompass considerations of safety, national defense, efficient transport, and the national economy.

Early direct and indirect impact of quadrivalent HPV (4HPV) vaccine on genital warts: a systematic review.

PubMed

Mariani, Luciano; Vici, Patrizia; Suligoi, Barbara; Checcucci-Lisi, Giovanni; Drury, Rosybel

2015-01-01

Since 2007, many countries have implemented national human papillomavirus (HPV) vaccination programs with the quadrivalent HPV (4HPV) vaccine that has been shown to be efficacious in clinical trials involving 25,000 subjects. Two vaccine serotypes, HPV16 and 18, are responsible for cervical cancer and other HPV-related cancers, but the impact of the 4HPV vaccine on these cancers cannot be seen immediately as there is a considerable lag between infection with HPV and cancer development. The other two serotypes, HPV6 and 11, are responsible for genital warts (GWs), which develop within a few months after infection, making GWs an early clinical endpoint for the assessment of the impact of 4HPV vaccination. We performed a systematic literature search in PubMed to identify all published studies on 4HPV vaccination, including those that assessed the impact of 4HPV vaccination programs on the incidence of GWs at a population level around the world. A total of 354 records were identified in the PubMed search. After screening and obtaining full papers for 56 publications, 16 publications presenting data on the impact or effectiveness of 4HPV vaccination on GWs were identified. These reported data on the impact or effectiveness of 4HPV in six countries [Australia (n = 6), New Zealand (n = 2), United States (n = 3), Denmark (n = 2), Germany (n = 1), and Sweden (n = 2)]. In Australia, no GWs were diagnosed in women aged <21 years who reported being vaccinated. A 92.6% reduction in GWs incidence was reported for all women in this age group, where the vaccine uptake rate (VUR) was 70% for 3 doses. The highest reductions were reported in countries with high VURs, mostly through school-based vaccination programs, although high VURs were obtained with some non-school-based programs. The results are coherent with the GWs incidence reduction reported in clinical trials and are an early indicator of what can be expected for the long-term clinical impact on vaccine-type HPV-related cancers.

Effectiveness of mitigation measures in reducing future primary particulate matter emissions from on-road vehicle exhaust.

PubMed

Yan, Fang; Bond, Tami C; Streets, David G

2014-12-16

This work evaluates the effectiveness of on-road primary particulate matter emission reductions that can be achieved by long-term vehicle scrappage and retrofit measures on regional and global levels. Scenario analysis shows that scrappage can provide significant emission reductions as soon as the measures begin, whereas retrofit provides greater emission reductions in later years, when more advanced technologies become available in most regions. Reductions are compared with a baseline that already accounts for implementation of clean vehicle standards. The greatest global emission reductions from a scrappage program occur 5 to 10 years after its introduction and can reach as much as 70%. The greatest reductions with retrofit occur around 2030 and range from 16-31%. Monte Carlo simulations are used to evaluate how uncertainties in the composition of the vehicle fleet affect predicted reductions. Scrappage and retrofit reduce global emissions by 22-60% and 15-31%, respectively, within 95% confidence intervals, under a midrange scenario in the year 2030. The simulations provide guidance about which strategies are most effective for specific regions. Retrofit is preferable for high-income regions. For regions where early emission standards are in place, scrappage is suggested, followed by retrofit after more advanced emission standards are introduced. The early implementation of advanced emission standards is recommended for Western and Eastern Africa.

Effectiveness of Mitigation Measures in Reducing Future Primary Particulate Matter Emissions from On-Road Vehicle Exhaust

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

Yan, Fang; Bond, Tami C.; Streets, David G.

This work evaluates the effectiveness of on-road primary particulate matter emission reductions that can be achieved by long-term vehicle scrappage and retrofit measures on regional and global levels. Scenario analysis shows that scrappage can provide significant emission reductions as soon as the measures begin, whereas retrofit provides greater emission reductions in later years, when more advanced technologies become available in most regions. Reductions are compared with a baseline that already accounts for implementation of clean vehicle standards. The greatest global emission reductions from a scrappage program occur 5 to 10 years after its introduction and can reach as much asmore » 70%. The greatest reductions with retrofit occur around 2030 and range from 16-31%. Monte Carlo simulations are used to evaluate how uncertainties in the composition of the vehicle fleet affect predicted reductions. Scrappage and retrofit reduce global emissions by 22-60% and 15-31%, respectively, within 95% confidence intervals, under a midrange scenario in the year 2030. The simulations provide guidance about which strategies are most effective for specific regions. Retrofit is preferable for high-income regions. For regions where early emission standards are in place, scrappage is suggested, followed by retrofit after more advanced emission standards are introduced. The early implementation of advanced emission standards is recommended for Western and Eastern Africa« less

Factors That Influence College Choice: Decisions of Graduate Students

ERIC Educational Resources Information Center

Sheppard, Jody Sue

2013-01-01

Beginning in the early 1980s, reduction in the funding of education has been a trend. As a solution to the funding issue, colleges and universities have turned towards tuition to make up the deficit; therefore, a need arises to enroll more students. Marketing higher education programs has now become an integral part to raising enrollment to meet…

Repeatability and Genotype x Environment Interaction of Intermediate Stage Sugarcane Selection Conducted on Sand and Organic soils

USDA-ARS?s Scientific Manuscript database

The Florida cooperative sugarcane cultivar development program conducts all of its early selection stages on muck (organic) soils at the USDA-ARS Sugarcane Field Station in Canal Point. About 25% of the locations in the final two stages (Stages 3 and 4) are conducted on sand soils, after a reduction...

Determinants of Successful Weight Loss After Using a Commercial Web-Based Weight Reduction Program for Six Months: Cohort Study

PubMed Central

Postrach, Elisa; Aspalter, Rosa; Elbelt, Ulf; Koller, Michael; Longin, Rita; Schulzke, Jörg-Dieter

2013-01-01

Background The Internet is widely available and commonly used for health information; therefore, Web-based weight loss programs could provide support to large parts of the population in self-guided weight loss. Previous studies showed that Web-based weight loss interventions can be effective, depending on the quality of the program. The most effective program tools are visual progress charts or tools for the self-monitoring of weight, diet, and exercises. KiloCoach, a commercial program currently available in German-speaking countries, incorporates these features. A previous investigation showed that the program effectively supports users in losing weight. Objective We investigated weight loss dynamics stratified by weight loss success after 6-month use of KiloCoach. Furthermore, we analyzed possible associations between intensity of program use and weight loss. The results are intended for tailoring user recommendations for weight-loss Internet platforms. Methods Datasets of KiloCoach users (January 1, 2008 to December 31, 2011) who actively used the platform for 6 months or more were assigned to this retrospective analysis. Users (N=479) were 42.2% men, mean age of 44.0 years (SD 11.7), with a mean body mass index (BMI) of 31.7 kg/m2 (SD 3.2). Based on the weight loss achieved after 6 months, 3 success groups were generated. The unsuccessful group lost <5%, the moderate success group lost 5%-9.9%, and the high success group lost ≥10% of their baseline body weight. At baseline, the unsuccessful (n=261, 54.5%), moderate success (n=133, 27.8%), and high success (n=85, 17.8%) groups were similar in age, weight, BMI, and gender distribution. Results After 6 months, the unsuccessful group lost 1.2% (SD 2.4), the moderate success group lost 7.4% (SD 1.5), and the high success group lost 14.2% (SD 3.8) of their initial weight (P<.001). Multivariate regression showed that early weight loss (weeks 3-4), the total number of dietary protocols, and the total number of weight entries were independent predictors for 6-month weight reduction (all P<.001) explaining 52% of the variance in weight reduction. Sensitivity analysis by baseline carried forward method confirmed all independent predictors of 6-month weight loss and reduced the model fit by only 11%. The high success group lost weight faster and maintained weight loss more efficiently than the other groups (P<.001). Early weight loss was associated with weight maintenance after 1 year and 2 years (both P<.001). Weight dynamics did not differ between men and women over 6 months when adjusted for baseline and usage parameters (P=.91). The percentage of male long-term users was unusually high (42.2%). Conclusions Our results suggest that early weight loss and close program adherence (ie, 5 dietary protocols per week and weekly entering of current weight), especially in the early phase of program usage, can improve weight loss outcome. PMID:24126250

40 CFR 63.74 - Demonstration of early reduction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Demonstration of early reduction. 63.74... Governing Compliance Extensions for Early Reductions of Hazardous Air Pollutants § 63.74 Demonstration of early reduction. (a) An owner or operator applying for an alternative emission limitation shall...

Cost-effectiveness of a disease management program for early childhood caries.

PubMed

Samnaliev, Mihail; Wijeratne, Rashmi; Kwon, Eunhae Grace; Ohiomoba, Henry; Ng, Man Wai

2015-01-01

To assess the cost-effectiveness of a pilot disease management (DM) program aimed at preventing early childhood caries among children younger than 5 years. The DM program was implemented in the Boston Children's Hospital-based dental practice in 2008. Health care costs were obtained from the hospital finance department and non-health care costs were estimated through a parent survey. The measure of effectiveness was avoided hospital-based visits for restorative treatment or extractions. Incremental costs (2011 US$) and effectiveness were estimated from a health care system, societal, and public payer perspectives over 3, 6, and 12 months, by comparing DM participants (n = 395) to a historical comparison group (n = 123) using generalized linear models. Bootstrapping and other sensitivity analyses were used to incorporate uncertainty in the analyses. The DM program was associated with a reduction in societal costs of $20 (p = 0.85), $215 (p = 0.24), and $669 (p < 0.01) per patient and a reduction in the number of hospital-based visits for restorative treatment or extractions by 0.44 (p < 0.01), 0.42 (p < 0.01), and 0.45 (p < 0.01) per patient over 3, 6, and 12 months, respectively. The probability of it being less costly and more effective was 61.5 percent, 81.9 percent, and 98.6 percent over 3, 6, and 12 months, respectively. Consistent results were observed from a health care system and public payer perspectives. The DM program appears cost-effective and has the potential to reduce health care costs. Our results justify a multicenter trial to evaluate the DM program on a larger scale. © 2014 American Association of Public Health Dentistry.

Fetuin-A, adiposity-linked insulin resistance and responsiveness to an educational-based weight excess reduction program: a population-based survey in prepubertal schoolchildren.

PubMed

Murdolo, Giuseppe; Tortoioli, Cristina; Celi, Federica; Bini, Vittorio; Papi, Francesco; Brozzetti, Annalisa; Falorni, Alberto

2017-05-01

The secreted hepatokine fetuin-A emerges as an independent predictor of type 2 diabetes in adulthood. The overall aims of this study were: (1) to investigate the associations of fetuin-A with adiposity and insulin resistance, as well as its relationship with adipokines, in prepubertal children, and, (2) to evaluate whether, in prepubertal obesity, serum fetuin-A levels may either change or predict the responsiveness to an educational-based weight excess reduction program. We studied 200 prepubertal children (boys/girls: 89/111; Tanner stage 1; age: 5-13 years), included in a cohort of 44,231 adolescents who participated in an extensive Italian school-based survey. According to Cole's criteria, 100 individuals were lean (boys/girls: 57/43) and 100 obese (boys/girls: 54/46). A subset of 53 obese individuals (boys/girls: 28/25; age: 6-12 years) were also evaluated after a weight excess reduction program. Serum fetuin-A, leptin, total and high molecular weight adiponectin levels, as well as homeostasis model assessment of insulin resistance were assessed. When compared with lean, obese children exhibited higher ( p < 0.0001) fetuin-A concentrations, without differences between sex. Fetuin-A was positively associated with adiposity, homeostasis model assessment of insulin resistance, and leptin levels. In multivariate analysis, the associations between fetuin-A and leptin or homeostasis model assessment of insulin resistance lost the significance after adjustment for BMI Z-score , which, in turn, represented an independent determinant of fetuin-A (R 2 adj 0.327; p < 0.0001). Notably, after weight excess reduction program, fetuin-A levels dropped ( p < 0.0001 vs. basal). Interestingly, no significant differences of fetuin-A concentrations between responders and no responders were found. In prepubertal children, fetuin-A represents an early marker of adiposity, and its reduction after lifestyle intervention may partly contribute to the beneficial effects of weight excess reduction program.

Evaluating the impact of a community developed collaborative project for the prevention of early childhood caries: the Healthy Smile Happy Child project.

PubMed

Schroth, Robert J; Edwards, Jeanette M; Brothwell, Douglas J; Yakiwchuk, Carol A; Bertone, Mary F; Mellon, Bernadette; Ward, Jennifer; Ellis, Marion; Hai-Santiago, Khalida; Lawrence, Herenia P; Moffatt, Michael E

2015-01-01

To determine the effectiveness of the Healthy Smile Happy Child (HSHC) project, a community-developed initiative promoting early childhood oral health in Manitoba, Canada. Specific aims were to assess improvements in caregiver knowledge, attitudes, and behaviours relating to early childhood oral health, and the burden of early childhood caries (ECC) and severe ECC (S-ECC). A serial cross-sectional study design was selected to contrast findings following the Healthy Smile Happy Child (HSHC) campaign in four communities with the previous baseline data. One community was a remote First Nation in northern Manitoba and another was a rural First Nation in southern Manitoba. The other two communities were urban centres, one of which was located in northern Manitoba. A community-development approach was adopted for the project to foster community solutions to address ECC. Goals of the HSHC program were to promote the project in each community, use existing community-based programs and services to deliver the oral health promotion and ECC prevention activities, and recruit and train natural leaders to assist in program development and to deliver the ECC prevention program. The HSHC coordinator worked with communities to develop a comprehensive list of potential strategies to address ECC. Numerous activities occurred in each community to engage members and increase their knowledge of early childhood oral health and ultimately lead them to adopt preventive oral health practices for their young children. Children under 71 months of age and their primary caregivers participated in this follow-up study. A -value ≤0.05 was statistically significant. 319 children (mean age 38.2±18.6 months) and their primary caregivers participated. Significant improvements in caregiver knowledge and attitudes were observed following the HSHC campaign, including that baby teeth are important (98.8%), that decay involving primary teeth can impact on health (94.3%), and the importance of a dental visit by the first birthday (82.4%). Significantly more respondents indicated that their child had visited the dentist (50.2%) and had started brushing their child's teeth (86.7%) when compared to baseline. Overall, 52.0% had ECC, 38.6% had S-ECC. The mean deft score was 3.85±4.97 (range 0-20). There was no significant change is ECC prevalence between the follow-up and baseline investigations. However, age-adjusted logistic regression for S-ECC in this follow-up study revealed a significant reduction in prevalence compared with the baseline study (=0.021). Similarly, age-adjusted Poisson regression revealed that there were significant reductions in both the decayed teeth and decayed, extracted and filled teeth scores between follow-up and baseline study periods (0.016 and .0001, respectively). Follow-up study results suggest that the HSHC initiative may have contributed to improvements in caregiver knowledge, attitudes, and behaviours towards early childhood oral health and subsequently modest yet statistically significant reductions in caries scores and the prevalence of S-ECC.

Early impact of Medicare accountable care organizations on cancer surgery outcomes.

PubMed

Herrel, Lindsey A; Norton, Edward C; Hawken, Scott R; Ye, Zaojun; Hollenbeck, Brent K; Miller, David C

2016-09-01

Accountable care organizations (ACOs) were established to improve care and outcomes for beneficiaries requiring highly coordinated, complex care. The objective of this study was to evaluate the association between hospital ACO participation and the outcomes of major surgical oncology procedures. This was a retrospective cohort study of Medicare beneficiaries older than 65 years who were undergoing a major surgical resection for colorectal, bladder, esophageal, kidney, liver, ovarian, pancreatic, lung, or prostate cancer from 2011 through 2013. A difference-in-differences analysis was implemented to compare the postimplementation period (January 2013 through December 2013) with the baseline period (January 2011 through December 2012) to assess the impact of hospital ACO participation on 30-day mortality, complications, readmissions, and length of stay (LOS). Among 384,519 patients undergoing major cancer surgery at 106 ACO hospitals and 2561 control hospitals, this study found a 30-day mortality rate of 3.4%, a readmission rate of 12.5%, a complication rate of 43.8%, and a prolonged LOS rate of 10.0% in control hospitals and similar rates in ACO hospitals. Secular trends were noted, with reductions in perioperative adverse events in control hospitals between the baseline and postimplementation periods: mortality (percentage-point reduction, 0.1%; P = .19), readmissions (percentage-point reduction, 0.4%; P = .001), complications (percentage-point reduction, 1.0%; P < .001), and prolonged LOS (percentage-point reduction, 1.1%; P < .001). After accounting for these secular trends, this study identified no significant effect of hospital participation in an ACO on the frequency of perioperative outcomes (difference-in-differences estimator P values, .24-.72). Early hospital participation in the Medicare Shared Savings Program ACO program was not associated with greater reductions in adverse perioperative outcomes for patients undergoing major cancer surgery in comparison with control hospitals. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2739-2746. © 2016 American Cancer Society. © 2016 American Cancer Society.

Battling Costs for Quality and Quantity: Emerging Responses in Early Childhood Care and Education. Notes, Comments...(Child, Family, Community). Digest No. II.

ERIC Educational Resources Information Center

Prakasha, Veda

This digest explores the possibilities of cost reduction in extending the coverage and upgrading the quality of preschool education especially in developing countries. The digest also seeks to highlight the importance of community participation in developing and managing preschool institutions and programs. Chapters cover the following topics: the…

Allowance trading: Correcting the past and looking to the future

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

Shah, A.Y.; Canter, L.W.

1995-09-01

Allowance trading is basic to the Title IV acid rain provisions of the 1990 Clean Air Act Amendments (CAAA) in the United States; the provisions seek to achieve a 10-million-ton reduction in annual sulfur dioxide emissions from the electric power utility industry. Allowance trading, a market-based approach, is conceptually similar to the emissions trading policy of the US Environmental Protection Agency (EPA). An allowance is defined as the authorization to emit, during or after a specified calendar year, one ton of sulfur dioxide. This paper provides an overview of the allowance trading program by summarizing some important features, particularly asmore » they are responsive to limitations and concern as related to the precursor emissions trading program in the early to mid-1980s. Such features include a simple definition of baseline emission levels, encouragements for nationwide trading, disincentives for accumulation of excess allowance,s opportunities for leasing other short-term allowance transfer arrangements, enforcement provisions, and benefits of bonus allowances and early emission reductions. Adherence to implementation protocols for the acid rain provisions of Title IV of the CAAA will provide a good opportunity to evaluate this market-based approach for environmental quality management.« less

Target Salt 2025: A Global Overview of National Programs to Encourage the Food Industry to Reduce Salt in Foods

PubMed Central

Webster, Jacqui; Trieu, Kathy; Dunford, Elizabeth; Hawkes, Corinna

2014-01-01

Reducing population salt intake has been identified as a priority intervention to reduce non-communicable diseases. Member States of the World Health Organization have agreed to a global target of a 30% reduction in salt intake by 2025. In countries where most salt consumed is from processed foods, programs to engage the food industry to reduce salt in products are being developed. This paper provides a comprehensive overview of national initiatives to encourage the food industry to reduce salt. A systematic review of the literature was supplemented by key informant questionnaires to inform categorization of the initiatives. Fifty nine food industry salt reduction programs were identified. Thirty eight countries had targets for salt levels in foods and nine countries had introduced legislation for some products. South Africa and Argentina have both introduced legislation limiting salt levels across a broad range of foods. Seventeen countries reported reductions in salt levels in foods—the majority in bread. While these trends represent progress, many countries have yet to initiate work in this area, others are at early stages of implementation and further monitoring is required to assess progress towards achieving the global target. PMID:25195640

Target salt 2025: a global overview of national programs to encourage the food industry to reduce salt in foods.

PubMed

Webster, Jacqui; Trieu, Kathy; Dunford, Elizabeth; Hawkes, Corinna

2014-08-21

Reducing population salt intake has been identified as a priority intervention to reduce non-communicable diseases. Member States of the World Health Organization have agreed to a global target of a 30% reduction in salt intake by 2025. In countries where most salt consumed is from processed foods, programs to engage the food industry to reduce salt in products are being developed. This paper provides a comprehensive overview of national initiatives to encourage the food industry to reduce salt. A systematic review of the literature was supplemented by key informant questionnaires to inform categorization of the initiatives. Fifty nine food industry salt reduction programs were identified. Thirty eight countries had targets for salt levels in foods and nine countries had introduced legislation for some products. South Africa and Argentina have both introduced legislation limiting salt levels across a broad range of foods. Seventeen countries reported reductions in salt levels in foods-the majority in bread. While these trends represent progress, many countries have yet to initiate work in this area, others are at early stages of implementation and further monitoring is required to assess progress towards achieving the global target.

Earthquake Advisory Services: A prototype development project

NASA Astrophysics Data System (ADS)

Lagorio, H. J.; Levin, H.

1980-10-01

Development of the prototype Earthquake Advisory Service (EAS) is reported. The EAS is designed to provide direct technical assistance and written materials to advise people who wish to make informed decisions about earthquake hazard reduction in their residences. It is intended also to be adapted to local conditions by community-based agencies. The EAS prototype involved the testing of early assumptions about program implementation, establishment of a systematic methodology review process, and a review of published information pertinent to the project. Operational procedures of the program and the process leading to implementation guidelines are described.

Consequences of a double hit of stress during the perinatal period and midlife in female rats: Mismatch or cumulative effect?

PubMed

Van Camp, Gilles; Cigalotti, Jenny; Bouwalerh, Hammou; Mairesse, Jérôme; Gatta, Eleonora; Palanza, Paola; Maccari, Stefania; Morley-Fletcher, Sara

2018-07-01

The interplay between experiences during critical developmental periods and later adult life is crucial in shaping individual variability in stress coping strategies. Exposure to stressful events in early life has strongly programs an individual's phenotype and adaptive capabilities. Until now, studies on programming and reversal strategies in early life stress animal models have been essentially limited to males. By using the perinatal stress (PRS) rat model (a model more sensitive to aging changes) in middle-aged females, we investigated the behavioral and endocrine responses following exposure in later life to an unpredictable chronic mild stress (uCMS) condition for six weeks. PRS by itself accelerated the ageing-related-disruption in the estrous cycle and led to reductions in the levels of estradiol. It also reduced motivational and risk-taking behavior in later life, with PRS females being characterized by a reduction in self-grooming in the splash test, in the exploration of the light compartment in the light/dark box test and in the time spent eating a palatable food in the novelty-induced suppression feeding test. PRS females showed impaired regulation of plasma glucose and insulin levels following a glucose challenge, with a hyperglycemic phenotype, and disrupted feedback of the HPA axis after acute stress with respect to controls. Remarkably, all PRS-induced alterations were modified by exposure to the uCMS procedure, thus resulting in a disease-dependent intervention; controls were not affected by uCMS, except for a slight and transient reduction in body weight, while PRS females displayed a reduced body weight gain for the entire duration of the uCMS procedure. Interestingly, the effects of uCMS on PRS females were still observed up to two months after its termination and the females displayed heightened rhythms of locomotor activity and enhanced sensitivity to reward with respect to controls exposed to uCMS. Our findings indicate that many parameters of the PRS female adult phenotype are shaped by both early and later life experiences in a non-additive way. As a consequence, early stressed individuals may be programmed with a more dynamic phenotype than non-stressed individuals. Copyright © 2018 Elsevier Ltd. All rights reserved.

Speech motor correlates of treatment-related changes in stuttering severity and speech naturalness.

PubMed

Tasko, Stephen M; McClean, Michael D; Runyan, Charles M

2007-01-01

Participants of stuttering treatment programs provide an opportunity to evaluate persons who stutter as they demonstrate varying levels of fluency. Identifying physiologic correlates of altered fluency levels may lead to insights about mechanisms of speech disfluency. This study examined respiratory, orofacial kinematic and acoustic measures in 35 persons who stutter prior to and as they were completing a 1-month intensive stuttering treatment program. Participants showed a marked reduction in stuttering severity as they completed the treatment program. Coincident with reduced stuttering severity, participants increased the amplitude and duration of speech breaths, reduced the rate of lung volume change during inspiration, reduced the amplitude and speed of lip movements early in the test utterance, increased lip and jaw movement durations, and reduced syllable rate. A multiple regression model that included two respiratory measures and one orofacial kinematic measure accounted for 62% of the variance in changes in stuttering severity. Finally, there was a weak but significant tendency for speech of participants with the largest reductions in stuttering severity to be rated as more unnatural as they completed the treatment program.

Australian school-based prevention programs for alcohol and other drugs: a systematic review.

PubMed

Teesson, Maree; Newton, Nicola C; Barrett, Emma L

2012-09-01

To reduce the occurrence and costs related to substance use and associated harms it is important to intervene early. Although a number of international school-based prevention programs exist, the majority show minimal effects in reducing drug use and related harms. Given the emphasis on early intervention and prevention in Australia, it is timely to review the programs currently trialled in Australian schools. This paper reports the type and efficacy of Australian school-based prevention programs for alcohol and other drugs. Cochrane, PsychInfo and PubMed databases were searched. Additional materials were obtained from authors, websites and reference lists. Studies were selected if they described programs developed and trialled in Australia that address prevention of alcohol and other drug use in schools. Eight trials of seven intervention programs were identified. The programs targeted alcohol, cannabis and tobacco and most were based on social learning principles. All were universal. Five of the seven intervention programs achieved reductions in alcohol, cannabis and tobacco use at follow up. Existing school-based prevention programs have shown to be efficacious in the Australian context. However, there are only a few programs available, and these require further evaluative research. This is critical, given that substance use is such a significant public health problem. The findings challenge the commonly held view that school-based prevention programs are not effective. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Preventing adolescent drug use: long-term results of a junior high program.

PubMed Central

Ellickson, P L; Bell, R M; McGuigan, K

1993-01-01

OBJECTIVES. Although several studies have reported short-term gains for drug-use prevention programs targeted at young adolescents, few have assessed the long-term effects of such programs. Such information is essential for judging how long prevention benefits last. This paper reports results over a 6-year period for a multisite randomized trial that achieved reductions in drug use during the junior high school years. METHODS. The 11-lesson curriculum, which was tested in 30 schools in eight highly diverse West Coast communities, focused on helping 7th and 8th grade students develop the motivation and skills to resist drugs. Schools were randomly assigned to treatment and control conditions. About 4000 students were assessed in grade 7 and six times thereafter through grade 12. Program effects were adjusted for pretest covariates and school effects. RESULTS. Once the lessons stopped, the program's effects on drug use stopped. Effects on cognitive risk factors persisted for a longer time (many through grade 10), but were not sufficient to produce corresponding reductions in use. CONCLUSIONS. It is unlikely that early prevention gains can be maintained without additional prevention efforts during high school. Future research is needed to develop and test such efforts. PMID:8498624

Using the integrated nurse leadership program to reduce sepsis mortality.

PubMed

Kliger, Julie; Singer, Sara J; Hoffman, Frank H

2015-06-01

The Integrated Nurse Leadership Program (INLP) is a collaborative improvement model focused on developing practical leadership skills of nurses and other frontline clinicians to lead quality improvement efforts. Sepsis is a major challenge to treat because it arises unpredictably and can progress rapidly. Nine San Francisco Bay Area hospitals participated in a 22-month INLP Sepsis Mortality Reduction Project to improve sepsis detection and management. The INLP focused on developing leadership and process improvement skills of nurses and other frontline clinicians. Teams of trained clinicians then implemented three strategies to improve early identification and timely treatment of sepsis: (1) sepsis screening of all patients, with diagnostic testing according to protocol; (2) timely treatment on the basis of key elements of Early Goal-Directed Therapy (EGDT); and (3) ongoing data review. Each hospital agreed to pursue the goal of reducing sepsis mortality by 15% by the end of the project. In the data collection period (baseline, July-December 2008 and project completion, January-June 2011), team members showed strong improvement in perceived leadership skills, team effectiveness, and ability to improve care quality. During this period, sepsis mortality for eight of the participating hospitals (Hospital 9 joined the project six months after it began) decreased by 43.7%-from 28% in the baseline period to 16% at project completion. Sepsis mortality rates trended downward for all hospitals, significantly decreasing (p<.05 at one hospital, p<.01 for four hospitals). In addition to improvement in safety culture and management of septic patients, hospitals participating in the INLP Sepsis Mortality Reduction Project achieved reductions in sepsis mortality during the study period and sustained reductions for more than one year later. The INLP model can be readily applied beyond sepsis management and mortality to other quality problems.

The impact of early symptom change and therapeutic alliance on treatment outcome in cognitive-behavioural therapy for eating disorders.

PubMed

Turner, Hannah; Bryant-Waugh, Rachel; Marshall, Emily

2015-10-01

The present study explored the impact of early symptom change (cognitive and behavioural) and the early therapeutic alliance on treatment outcome in cognitive-behavioural therapy (CBT) for the eating disorders. Participants were 94 adults with diagnosed eating disorders who completed a course of CBT in an out-patient community eating disorders service in the UK. Patients completed a measure of eating disorder psychopathology at the start of treatment, following the 6th session and at the end of treatment. They also completed a measure of therapeutic alliance following the 6th session. Greater early reduction in dietary restraint and eating concerns, and smaller levels of change in shape concern, significantly predicted later reduction in global eating pathology. The early therapeutic alliance was strong across the three domains of tasks, goals and bond. Early symptom reduction was a stronger predictor of later reduction in eating pathology than early therapeutic alliance. The early therapeutic alliance did not mediate the relationship between early symptom reduction and later reduction in global eating pathology. Instead, greater early symptom reduction predicted a strong early therapeutic alliance. Early clinical change was the strongest predictor of treatment outcome and this also facilitated the development of a strong early alliance. Clinicians should be encouraged to deliver all aspects of evidence-based CBT, including behavioural change. The findings suggest that this will have a positive impact on both the early therapeutic alliance and later change in eating pathology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assessing the outcomes of prolonged cessation-induction and aid-to-cessation trials: floating prolonged abstinence.

PubMed

Aveyard, Paul; Wang, Dechao; Connock, Martin; Fry-Smith, Anne; Barton, Pelham; Moore, David

2009-05-01

A Society for Research on Nicotine and Tobacco working group recommended outcome measures for cessation-induction trials and aid-to-cessation trials. Cessation-induction trials aim to motivate unwilling quitters to make a quit attempt. Aid-to-cessation trials give either medication or behavioral interventions to increase the rate at which willing quitters succeed in their attempts. Nicotine-assisted reduction programs combine features of both types of interventions by giving nicotine replacement to unwilling quitters. Treatment can be prolonged more than a year, quit attempts can occur and succeed early or late in the program, and renewed quit attempts are an inherent part of the program. Conventional outcome measures are tied to a fixed but arbitrary point in follow-up and cannot capture the true outcome: Prolonged cessation anchored to the point at which a person makes a successful quit attempt. We propose that the outcome should be counted from the successful quit attempt that began during the treatment period and continues for a defined period, ideally 6 months. In particular, if a trial compared a short reduction program with a long reduction program, it would not be possible to obtain an unbiased assessment of the outcome of such a trial using a measure tied to a fixed point in follow-up. Floating prolonged abstinence could provide such an assessment and is suitable for either prolonged cessation-induction trial or combined cessation-induction and aid-to-cessation trials.

Not Just Academics: Paths of Longitudinal Effects From Parent Involvement to Substance Abuse in Emerging Adulthood.

PubMed

Hayakawa, Momoko; Giovanelli, Alison; Englund, Michelle M; Reynolds, Arthur J

2016-04-01

By the 12th grade, half of American adolescents have abused an illicit drug at least once (Johnston et al., 2015). Although many substance misuse prevention programs exist, we propose an alternative mechanism for reducing substance use. There is evidence that parent involvement is related to reductions in children's behavior problems which then predict later substance abuse. We examine the Child-Parent Center (CPC) program, an early childhood intervention, as a strategy to impact substance abuse. We conducted a path analysis from CPC to parent involvement through early adolescent problem behaviors and competencies to young adult substance abuse. Participants (N = 1,203; 51.5% female; 93.8% African-American) were assessed from age 3 to 26 years. CPC participation initiates a pathway to increased parent involvement and expectations, which positively impact adolescents' competencies and problem behaviors, lowering rates of substance abuse. Through early childhood education, increasing early parental involvement and expectations can alter life-course outcomes by providing children with a foundation for positive behaviors and encouraging adaptive functioning in adolescence. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Reductions in Sepsis Mortality and Costs After Design and Implementation of a Nurse-Based Early Recognition and Response Program

PubMed Central

Jones, Stephen L.; Ashton, Carol M.; Kiehne, Lisa; Gigliotti, Elizabeth; Bell-Gordon, Charyl; Disbot, Maureen; Masud, Faisal; Shirkey, Beverly A.; Wray, Nelda P.

2016-01-01

Background Sepsis is a leading cause of death, but evidence suggests that early recognition and prompt intervention can save lives. In 2005 Houston Methodist Hospital prioritized sepsis detection and management in its ICU. In late 2007, because of marginal effects on sepsis death rates, the focus shifted to designing a program that would be readily used by nurses and ensure early recognition of patients showing signs suspicious for sepsis, as well as the institution of prompt, evidence-based interventions to diagnose and treat it. Methods The intervention had four components: organizational commitment and data-based leadership; development and integration of an early sepsis screening tool into the electronic health record; creation of screening and response protocols; and education and training of nurses. Twice-daily screening of patients on targeted units was conducted by bedside nurses; nurse practitioners initiated definitive treatment as indicated. Evaluation focused on extent of implementation, trends in inpatient mortality, and, for Medicare beneficiaries, a before-after (2008–2011) comparison of outcomes and costs. A federal grant in 2012 enabled expansion of the program. Results By year 3 (2011) 33% of inpatients were screened (56,190 screens in 9,718 unique patients), up from 10% in year 1 (2009). Inpatient sepsis-associated death rates decreased from 29.7% in the preimplementation period (2006–2008) to 21.1% after implementation (2009–2014). Death rates and hospital costs for Medicare beneficiaries decreased from preimplementation levels without a compensatory increase in discharges to postacute care. Conclusion This program has been associated with lower inpatient death rates and costs. Further testing of the robustness and exportability of the program is under way. PMID:26484679

Acceleration of genetic gain in cattle by reduction of generation interval.

PubMed

Kasinathan, Poothappillai; Wei, Hong; Xiang, Tianhao; Molina, Jose A; Metzger, John; Broek, Diane; Kasinathan, Sivakanthan; Faber, David C; Allan, Mark F

2015-03-02

Genomic selection (GS) approaches, in combination with reproductive technologies, are revolutionizing the design and implementation of breeding programs in livestock species, particularly in cattle. GS leverages genomic readouts to provide estimates of breeding value early in the life of animals. However, the capacity of these approaches for improving genetic gain in breeding programs is limited by generation interval, the average age of an animal when replacement progeny are born. Here, we present a cost-effective approach that combines GS with reproductive technologies to reduce generation interval by rapidly producing high genetic merit calves.

Combining child social skills training with a parent early intervention program for inhibited preschool children.

PubMed

Lau, Elizabeth X; Rapee, Ronald M; Coplan, Robert J

2017-10-01

Previous studies have demonstrated the efficacy of early intervention for anxiety in preschoolers through parent-education. The current study evaluated a six-session early intervention program for preschoolers at high risk of anxiety disorders in which a standard educational program for parents was supplemented by direct training of social skills to the children. Seventy-two children aged 3-5 years were selected based on high behavioural inhibition levels and concurrently having a parent with high emotional distress. Families were randomly assigned to either the intervention group, which consisted of six parent-education group sessions and six child social skills training sessions, or waitlist. After six months, families on waitlist were offered treatment consisting of parent-education only. Relative to waitlist, children in the combined condition showed significantly fewer clinician-rated anxiety disorders and diagnostic severity and maternal (but not paternal) reported anxiety symptoms and life interference at six months. Mothers also reported less overprotection. These gains were maintained at 12-month follow-up. Parent only education following waitlist produced similar improvements among children. Quasi-experimental comparison between combined and parent-only interventions indicated greater reductions from combined intervention according to clinician reports, but no significant differences on maternal reports. Results suggest that this brief early intervention program for preschoolers with both parent and child components significantly reduces risk and disorder in vulnerable children. The inclusion of a child component might have the potential to increase effects over parent-only intervention. However, future support for this conclusion through long-term, randomised controlled trials is needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Epigenetic programming at the Mogat1 locus may link neonatal overnutrition with long-term hepatic steatosis and insulin resistance.

PubMed

Ramon-Krauel, Marta; Pentinat, Thais; Bloks, Vincent W; Cebrià, Judith; Ribo, Silvia; Pérez-Wienese, Ricky; Vilà, Maria; Palacios-Marin, Ivonne; Fernández-Pérez, Antonio; Vallejo, Mario; Téllez, Noèlia; Rodríguez, Miguel Àngel; Yanes, Oscar; Lerin, Carles; Díaz, Rubén; Plosch, Torsten; Tietge, Uwe J F; Jimenez-Chillaron, Josep C

2018-05-29

Postnatal overfeeding increases the risk of chronic diseases later in life, including obesity, insulin resistance, hepatic steatosis, and type 2 diabetes. Epigenetic mechanisms might underlie the long-lasting effects associated with early nutrition. Here we aimed to explore the molecular pathways involved in early development of insulin resistance and hepatic steatosis, and we examined the potential contribution of DNA methylation and histone modifications to long-term programming of metabolic disease. We used a well-characterized mouse model of neonatal overfeeding and early adiposity by litter size reduction. Neonatal overfeeding led to hepatic insulin resistance very early in life that persisted throughout adulthood despite normalizing food intake. Up-regulation of monoacylglycerol O-acyltransferase ( Mogat) 1 conceivably mediates hepatic steatosis and insulin resistance through increasing intracellular diacylglycerol content. Early and sustained deregulation of Mogat1 was associated with a combination of histone modifications that might favor Mogat1 expression. In sum, postnatal overfeeding causes extremely rapid derangements of hepatic insulin sensitivity that remain relatively stable until adulthood. Epigenetic mechanisms, particularly histone modifications, could contribute to such long-lasting effects. Our data suggest that targeting hepatic monoacylglycerol acyltransferase activity during early life might provide a novel strategy to improve hepatic insulin sensitivity and prevent late-onset insulin resistance and fatty liver disease.-Ramon-Krauel, M., Pentinat, T., Bloks, V. W., Cebrià, J., Ribo, S., Pérez-Wienese, R., Vilà, M., Palacios-Marin, I., Fernández-Pérez, A., Vallejo, M., Téllez, N., Rodríguez, M. À., Yanes, O., Lerin, C., Díaz, R., Plosch, T., Tietge, U. J. F., Jimenez-Chillaron, J. C. Epigenetic programming at the Mogat1 locus may link neonatal overnutrition with long-term hepatic steatosis and insulin resistance.

Meals for Good: An innovative community project to provide healthy meals to children in early care and education programs through food bank catering.

PubMed

Carpenter, Leah R; Smith, Teresa M; Stern, Katherine; Boyd, Lisa Weissenburger-Moser; Rasmussen, Cristy Geno; Schaffer, Kelly; Shuell, Julie; Broussard, Karen; Yaroch, Amy L

2017-12-01

Innovative approaches to childhood obesity prevention are warranted in early care and education (ECE) settings, since intervening early among youth is recommended to promote and maintain healthy behaviors. The objective of the Meals for Good pilot was to explore feasibility of implementing a food bank-based catering model to ECE programs to provide more nutritious meals, compared to meals brought from home (a parent-prepared model). In 2014-2015, a 12-month project was implemented by a food bank in central Florida in four privately-owned ECE programs. An explanatory sequential design of a mixed-methods evaluation approach was utilized, including a pre-post menu analysis comparing parent-prepared meals to the catered meals, and stakeholder interviews to determine benefits and barriers. The menu analysis of lunches showed daily reductions in calories, fat, and saturated fat, but an increase in sodium in catered meals when compared to parent-prepared meals. Interviews with ECE directors, teachers, parents, and food bank project staff, identified several benefits of the catered meals, including healthfulness of meals, convenience to parents, and the ECE program's ability to market this meal service. Barriers of the catered meals included the increased cost to parents, transportation and delivery logistics, and change from a 5 to a 2-week menu cycle during summer food service. This pilot demonstrated potential feasibility of a food bank-ECE program partnership, by capitalizing on the food bank's existing facilities and culinary programming, and interest in implementing strategies focused on younger children. The food bank has since leveraged lessons learned and expanded to additional ECE programs.

Premature Brain Aging in Baboons Resulting from Moderate Fetal Undernutrition.

PubMed

Franke, Katja; Clarke, Geoffrey D; Dahnke, Robert; Gaser, Christian; Kuo, Anderson H; Li, Cun; Schwab, Matthias; Nathanielsz, Peter W

2017-01-01

Contrary to the known benefits from a moderate dietary reduction during adulthood on life span and health, maternal nutrient reduction during pregnancy is supposed to affect the developing brain, probably resulting in impaired brain structure and function throughout life. Decreased fetal nutrition delivery is widespread in both developing and developed countries, caused by poverty and natural disasters, but also due to maternal dieting, teenage pregnancy, pregnancy in women over 35 years of age, placental insufficiency, or multiples. Compromised development of fetal cerebral structures was already shown in our baboon model of moderate maternal nutrient reduction. The present study was designed to follow-up and evaluate the effects of moderate maternal nutrient reduction on individual brain aging in the baboon during young adulthood (4-7 years; human equivalent 14-24 years), applying a novel, non-invasive neuroimaging aging biomarker. The study reveals premature brain aging of +2.7 years ( p < 0.01) in the female baboon exposed to fetal undernutrition. The effects of moderate maternal nutrient reduction on individual brain aging occurred in the absence of fetal growth restriction or marked maternal weight reduction at birth, which stresses the significance of early nutritional conditions in life-long developmental programming. This non-invasive MRI biomarker allows further longitudinal in vivo tracking of individual brain aging trajectories to assess the life-long effects of developmental and environmental influences in programming paradigms, aiding preventive and curative treatments on cerebral atrophy in experimental animal models and humans.

Premature Brain Aging in Baboons Resulting from Moderate Fetal Undernutrition

PubMed Central

Franke, Katja; Clarke, Geoffrey D.; Dahnke, Robert; Gaser, Christian; Kuo, Anderson H.; Li, Cun; Schwab, Matthias; Nathanielsz, Peter W.

2017-01-01

Contrary to the known benefits from a moderate dietary reduction during adulthood on life span and health, maternal nutrient reduction during pregnancy is supposed to affect the developing brain, probably resulting in impaired brain structure and function throughout life. Decreased fetal nutrition delivery is widespread in both developing and developed countries, caused by poverty and natural disasters, but also due to maternal dieting, teenage pregnancy, pregnancy in women over 35 years of age, placental insufficiency, or multiples. Compromised development of fetal cerebral structures was already shown in our baboon model of moderate maternal nutrient reduction. The present study was designed to follow-up and evaluate the effects of moderate maternal nutrient reduction on individual brain aging in the baboon during young adulthood (4–7 years; human equivalent 14–24 years), applying a novel, non-invasive neuroimaging aging biomarker. The study reveals premature brain aging of +2.7 years (p < 0.01) in the female baboon exposed to fetal undernutrition. The effects of moderate maternal nutrient reduction on individual brain aging occurred in the absence of fetal growth restriction or marked maternal weight reduction at birth, which stresses the significance of early nutritional conditions in life-long developmental programming. This non-invasive MRI biomarker allows further longitudinal in vivo tracking of individual brain aging trajectories to assess the life-long effects of developmental and environmental influences in programming paradigms, aiding preventive and curative treatments on cerebral atrophy in experimental animal models and humans. PMID:28443017

The Resolved Stellar Populations Early Release Science Program

NASA Astrophysics Data System (ADS)

Weisz, Daniel; Anderson, J.; Boyer, M.; Cole, A.; Dolphin, A.; Geha, M.; Kalirai, J.; Kallivayalil, N.; McQuinn, K.; Sandstrom, K.; Williams, B.

2017-11-01

We propose to obtain deep multi-band NIRCam and NIRISS imaging of three resolved stellar systems within 1 Mpc (NOI 104). We will use this broad science program to optimize observational setups and to develop data reduction techniques that will be common to JWST studies of resolved stellar populations. We will combine our expertise in HST resolved star studies with these observations to design, test, and release point spread function (PSF) fitting software specific to JWST. PSF photometry is at the heart of resolved stellar populations studies, but is not part of the standard JWST reduction pipeline. Our program will establish JWST-optimized methodologies in six scientific areas: star formation histories, measurement of the sub-Solar mass stellar IMF, extinction maps, evolved stars, proper motions, and globular clusters, all of which will be common pursuits for JWST in the local Universe. Our observations of globular cluster M92, ultra-faint dwarf Draco II, and star-forming dwarf WLM, will be of high archival value for other science such as calibrating stellar evolution models, measuring properties of variable stars, and searching for metal-poor stars. We will release the results of our program, including PSF fitting software, matched HST and JWST catalogs, clear documentation, and step-by-step tutorials (e.g., Jupyter notebooks) for data reduction and science application, to the community prior to the Cycle 2 Call for Proposals. We will host a workshop to help community members plan their Cycle 2 observations of resolved stars. Our program will provide blueprints for the community to efficiently reduce and analyze JWST observations of resolved stellar populations.

Predicting Adult Criminal Behavior from Juvenile Delinquency: Ex-Ante vs. Ex-Post Benefits of Early Intervention

PubMed Central

White, Barry A. B.; Temple, Judy A.; Reynolds, Arthur J.

2016-01-01

Recent analyses of the long-term societal benefits from early intervention (prenatal care, home visitation, and high quality preschool) for at-risk children commonly include significant savings to society in the form of reduced juvenile delinquency and adult criminal behavior. However, a nontrivial proportion of the reported benefits of several early intervention programs are based on forecasts of criminal behavior throughout adulthood conditional on intervention effects on delinquency in adolescence. Data from the Chicago Longitudinal Study (CLS), an investigation of the life course of 1,539 children from low-income families born in 1979–1980, are used to investigate the bias resulting from predicting the effect of early intervention on adult criminal behavior from the effect on delinquency in adolescence. The investigation concludes that the general method used to predict adult criminal behavior results in a conservative estimate of the reduction in the cost of adult criminal behavior attributed to early intervention. PMID:27867324

Predicting Adult Criminal Behavior from Juvenile Delinquency: Ex-Ante vs. Ex-Post Benefits of Early Intervention.

PubMed

White, Barry A B; Temple, Judy A; Reynolds, Arthur J

2010-12-01

Recent analyses of the long-term societal benefits from early intervention (prenatal care, home visitation, and high quality preschool) for at-risk children commonly include significant savings to society in the form of reduced juvenile delinquency and adult criminal behavior. However, a nontrivial proportion of the reported benefits of several early intervention programs are based on forecasts of criminal behavior throughout adulthood conditional on intervention effects on delinquency in adolescence. Data from the Chicago Longitudinal Study (CLS), an investigation of the life course of 1,539 children from low-income families born in 1979-1980, are used to investigate the bias resulting from predicting the effect of early intervention on adult criminal behavior from the effect on delinquency in adolescence. The investigation concludes that the general method used to predict adult criminal behavior results in a conservative estimate of the reduction in the cost of adult criminal behavior attributed to early intervention.

ISO Key Project: Exploring the Full Range of Quasar/Agn Properties

NASA Technical Reports Server (NTRS)

Wilkes, Belinda; Oliversen, Ronald J. (Technical Monitor)

2003-01-01

While most of the work on this program has been completed, as previously reported, the portion of the program dealing with the subtopic of ISO LWS data analysis and reduction for the LWS Extragalactic Science Team and its leader, Dr. Howard Smith, is still active. This program in fact continues to generate results, and newly available computer modeling has extended the value of the datasets. As a result the team requests a one-year no-cost extension to this program, through 31 December 2004. The essence of the proposal is to perform ISO spectroscopic studies, including data analysis and modeling, of star-formation regions using an ensemble of archival space-based data from the Infrared Space Observatory's Long Wavelength Spectrometer and Short Wavelength Spectrometer, but including as well some other spectroscopic databases. Four kinds of regions are considered in the studies: (1) disks around more evolved objects; (2) young, low or high mass pre-main sequence stars in star-formation regions; (3) star formation in external, bright IR galaxies; and (4) the galactic center. One prime focus of the program is the OH lines in the far infrared. The program has the following goals: 1) Refine the data analysis of ISO observations to obtain deeper and better SNR results on selected sources. The ISO data itself underwent 'pipeline 10' reductions in early 2001, and additional 'hands-on data reduction packages' were supplied by the ISO teams in 2001. The Fabry-Perot database is particularly sensitive to noise and slight calibration errors; 2) Model the atomic and molecular line shapes, in particular the OH lines, using revised Monte-Carlo techniques developed by the SWAS team at the Center for Astrophysics; 3) Attend scientific meetings and workshops; 4) Perform E&PO activities related to infrared astrophysics and/or spectroscopy.

Reexamining the Impact of Family Planning Programs on US Fertility: Evidence from the War on Poverty and the Early Years of Title X†

PubMed Central

Bailey, Martha J.

2012-01-01

Almost 50 years after domestic US family planning programs began, their effects on childbearing remain controversial. Using the county-level roll-out of these programs from 1964 to 1973, this paper reevaluates their shorter and longer term effects on US fertility rates. I find that the introduction of family planning is associated with significant and persistent reductions in fertility driven both by falling completed childbearing and childbearing delay. Although federally funded family planning accounted for a small portion of the post-baby boom US fertility decline, my estimates imply that they reduced childbearing among poor women by 19 to 30 percent. (JEL I38, J12, J13, J18) PMID:22582135

NASA's International Lunar Network Anchor Nodes and Robotic Lunar Lander Project Update

NASA Technical Reports Server (NTRS)

Morse, Brian J.; Reed, Cheryl L. B.; Kirby, Karen W.; Cohen, Barbara A.; Bassler, Julie A.; Harris, Danny W.; Chavers, D. Gregory

2010-01-01

In early 2008, NASA established the Lunar Quest Program, a new lunar science research program within NASA s Science Mission Directorate. The program included the establishment of the anchor nodes of the International Lunar Network (ILN), a network of lunar science stations envisioned to be emplaced by multiple nations. This paper describes the current status of the ILN Anchor Nodes mission development and the lander risk-reduction design and test activities implemented jointly by NASA s Marshall Space Flight Center and The Johns Hopkins University Applied Physics Laboratory. The lunar lander concepts developed by this team are applicable to multiple science missions, and this paper will describe a mission combining the functionality of an ILN node with an investigation of lunar polar volatiles.

Strategies for halting the rise of multidrug resistant TB epidemics: assessing the effect of early case detection and isolation.

PubMed

Espindola, Aquino L; Varughese, Marie; Laskowski, Marek; Shoukat, Affan; Heffernan, Jane M; Moghadas, Seyed M

2017-03-01

The increasing rates of multidrug resistant TB (MDR-TB) have posed the question of whether control programs under enhanced directly observed treatment, short-course (DOTS-Plus) are sufficient or implemented optimally. Despite enhanced efforts on early case detection and improved treatment regimens, direct transmission of MDR-TB remains a major hurdle for global TB control. We developed an agent-based simulation model of TB dynamics to evaluate the effect of transmission reduction measures on the incidence of MDR-TB. We implemented a 15-day isolation period following the start of treatment in active TB cases. The model was parameterized with the latest estimates derived from the published literature. We found that if high rates (over 90%) of TB case identification are achieved within 4 weeks of developing active TB, then a 15-day patient isolation strategy with 50% effectiveness in interrupting disease transmission leads to 10% reduction in the incidence of MDR-TB over 10 years. If transmission is fully prevented, the rise of MDR-TB can be halted within 10 years, but the temporal reduction of MDR-TB incidence remains below 20% in this period. The impact of transmission reduction measures on the TB incidence depends critically on the rates and timelines of case identification. The high costs and adverse effects associated with MDR-TB treatment warrant increased efforts and investments on measures that can interrupt direct transmission through early case detection. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

40 CFR Appendix B to Part 63 - Sources Defined for Early Reduction Provisions

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 14 2011-07-01 2011-07-01 false Sources Defined for Early Reduction Provisions B Appendix B to Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... (CONTINUED) Pt. 63, App. B Appendix B to Part 63—Sources Defined for Early Reduction Provisions Source...

Simulations of Observations with the Far-Infrared Surveyor: Design Overview and Current Status

NASA Astrophysics Data System (ADS)

Jeong, W.; Pak, S.; Lee, H. M.; Kim, S.; Matsuura, M.; Nakagawa, T.; Yamamura, I.; Murakami, H.; Matsuura, S.; Kawada, M.; Kaneda, H.; Shibai, H.

2000-12-01

The Far-Infrared Surveyor (FIS) is one of the on-board instruments on the ASTRO-F satellite, which will be launched in early 2004. The first a half year of its mission period of 500 days is dedicated to an all sky survey in four bands between 50 and 200 micron. On the basis of the present hardware specifications and configurations of the FIS, we have written a computer program to simulate the FIS. The program can be used to evaluate the performance of the instrument as well as to produce input for the data reduction system. In this paper, we describe the current status of the program. As an example of the usage of the simulation program, we present the expected observing data for three different detector sampling rates. The functions which should be implemented into the program, in the future, are enumerated.

Early life disruption to the ghrelin system with over-eating is resolved in adulthood in male rats.

PubMed

Sominsky, Luba; Ziko, Ilvana; Nguyen, Thai-Xinh; Andrews, Zane B; Spencer, Sarah J

2017-02-01

Early life overweight is a significant risk factor for developmental programming of adult obesity due to changes in the availability of metabolic factors crucial for the maturation of brain appetite-regulatory circuitry. The appetite-stimulating hormone, ghrelin, has been recently identified as a major regulator of the establishment of hypothalamic feeding pathways. Ghrelin exists in circulation in two major forms, as acylated and des-acylated ghrelin. While most research has focused on acyl ghrelin, the role of neonatal des-acyl ghrelin in metabolic programming is currently unknown. Here we assessed the influences of early life overfeeding on the ghrelin system, including acyl and des-acyl ghrelin's ability to access the hypothalamus in male rats. Our data show that early life overfeeding influences the ghrelin system short-term, leading to an acute reduction in circulating des-acyl ghrelin and increased expression of the growth hormone secretagogue receptor (GHSR) in the arcuate nucleus of the hypothalamus (ARC). These changes are associated with increased neuronal activation in response to exogenous acyl, but not des-acyl, ghrelin in the ARC and the paraventricular nucleus of the hypothalamus (PVN). Interestingly, while we observed no differences in the accessibility of the ARC to acyl or des-acyl ghrelin, less exogenous acyl ghrelin reaches the PVN in the neonatally overfed. Importantly, the influences of neonatal overfeeding on the ghrelin system were not maintained into adulthood. Therefore, while early life overfeeding results in excess body weight and stimulates acute changes in the brain's sensitivity to metabolic signals, this developmental mal-programming is at least partially alleviated in adulthood. Copyright © 2016 Elsevier Ltd. All rights reserved.

Economic assessment of home-based COPD management programs.

PubMed

Liu, Sheena Xin; Lee, Michael C; Atakhorrami, Maryam; Tatousek, Jan; McCormack, Meredith; Yung, Rex; Hart, Nicholas; White, David P

2013-12-01

Home-based exacerbation management programs have been proposed as an approach to reducing the clinical and financial burden of COPD. We demonstrate a framework to evaluate such programs in order to guide program design and performance decisions towards optimizing cost and clinical outcomes. This study models the impact of hypothetical exacerbation management programs through probabilistic Markov simulations. Patients were stratified by risk using exacerbation rates from the ECLIPSE study and expert opinion. Three scenarios were modeled, using base, worst and best case parameters to suggest potential telehealth program performance. In these scenarios, acute exacerbations could be detected early, with sensitivity and specificity ranging from 60-90%. Detected acute exacerbations could be diverted to either a sub-acute pathway (12.5-50% probability), thus entirely avoiding hospitalization, or a lower cost pathway through length-of-stay reduction (14-28% reduction). For a cohort of patients without prior hospitalization, the base case telehealth scenario results in a cumulative per-patient lifetime savings of $2.9 K over ≈ 12 years. For a higher risk cohort of patients with a prior admission and 1 to 2 acute exacerbations per year, a cumulative $16K per patient was saved during the remaining ≈ 3 life-years. Acceptable prices for home-based exacerbation detection testing were highly dependent on patient risk and scenario, but ranged from $290-$1263 per month for the highest risk groups. These results suggest the economic viability of exacerbation management programs and highlight the importance of risk stratification in such programs. The presented model can further be adapted to model specific programs as trial data becomes available.

Turning readmission reduction policies into results: some lessons from a multistate initiative to reduce readmissions.

PubMed

Mittler, Jessica N; O'Hora, Jennifer L; Harvey, Jillian B; Press, Matthew J; Volpp, Kevin G; Scanlon, Dennis P

2013-08-01

Efforts are under way nationally to reduce avoidable hospital readmissions by changing payments to hospitals, but it is unclear how well or how quickly these policy changes will produce widespread reductions in hospital readmissions. To examine some of the challenges to implementing such approaches, the authors analyzed the early experiences of 3 statewide programs to reduce preventable readmissions that began in 2009. Based on interviews with program participants in 2011, the authors identified 3 key obstacles to progress: the difficulty of developing collaborative relationships across care settings, gaps in evidence for effective interventions, and deficits in quality improvement capabilities among some organizations. These findings underscore the uncertainty of success of current readmissions policies and suggest that immediate improvement in readmission rates through a change in reimbursement may be unlikely unless these other obstacles are addressed expeditiously. In particular, cultivation of productive collaboration across care settings will be critical because these kinds of relationships are not well established or naturally occurring in most communities.

The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: a randomized trial.

PubMed

Henderson, Virginia P; Clemow, Lynn; Massion, Ann O; Hurley, Thomas G; Druker, Susan; Hébert, James R

2012-01-01

The aim of this study was determine the effectiveness of a mindfulness-based stress-reduction (MBSR) program on quality of life (QOL) and psychosocial outcomes in women with early-stage breast cancer, using a three-arm randomized controlled clinical trial (RCT). This RCT consisting of 172 women, aged 20-65 with stage I or II breast cancer consisted of the 8-week MBSR, which was compared to a nutrition education program (NEP) and usual supportive care (UC). Follow-up was performed at three post-intervention points: 4 months, 1, and 2 years. Standardized, validated self-administered questionnaires were adopted to assess psychosocial variables. Statistical analysis included descriptive and regression analyses incorporating both intention-to-treat and post hoc multivariable approaches of the 163 women with complete data at baseline, those who were randomized to MBSR experienced a significant improvement in the primary measures of QOL and coping outcomes compared to the NEP, UC, or both, including the spirituality subscale of the FACT-B as well as dealing with illness scale increases in active behavioral coping and active cognitive coping. Secondary outcome improvements resulting in significant between-group contrasts favoring the MBSR group at 4 months included meaningfulness, depression, paranoid ideation, hostility, anxiety, unhappiness, and emotional control. Results tended to decline at 12 months and even more at 24 months, though at all times, they were as robust in women with lower expectation of effect as in those with higher expectation. The MBSR intervention appears to benefit psychosocial adjustment in cancer patients, over and above the effects of usual care or a credible control condition. The universality of effects across levels of expectation indicates a potential to utilize this stress reduction approach as complementary therapy in oncologic practice.

Mechanical Thrombectomy in Wake-Up Strokes: A Case Series Using Alberta Stroke Program Early CT Score (ASPECTS) for Patient Selection.

PubMed

Konstas, Angelos Aristeidis; Minaeian, Artin; Ross, Ian B

2017-07-01

There is lack of published studies on mechanical thrombectomy with stent retrievers for wake-up stroke (WUS). To report the outcomes of WUS patients with large vessel occlusions, selected for intervention based on Alberta Stroke Program Early CT Score (ASPECTS) and treated with stent retrievers or primary aspiration thrombectomy. Data were collected retrospectively for each consecutive WUS patient undergoing mechanical thrombectomy with a stent retriever or primary aspiration catheter between February 2015 and September 2016. ASPECTS ≥ 6 was used as the primary imaging criterion for offering thrombectomy in these WUS patients. Main outcomes were the in-hospital improvement in the National Institutes of Health Stroke Scale (NIHSS) and the occurrence of symptomatic hemorrhage. Twelve patients were included in this study; 11 were treated with stent retrievers and 1 was treated with primary aspiration thrombectomy alone. Successful recanalization was achieved in 100% of the patients (33% thrombolysis in cerebral infarction [TICI] 2B and 67% TICI 3). Every patient experienced a reduction in the NIHSS during hospitalization, with a mean NIHSS decrease of 11.1 ± 5.1 points. There was a trend for a larger reduction in the NIHSS in patients with TICI 3 compared to TICI 2B recanalization. There was no symptomatic intracranial hemorrhage in our cohort. For patients with WUS, careful selection of patients using ASPECTS may allow for safe interventions, with low risk of clinical deterioration, and no-periprocedural mortality. All our patients demonstrated a reduction in their NIHSS after the thrombectomy and clinical improvement. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Early adulthood: an overlooked age group in national sodium reduction initiatives in South Korea.

PubMed

Park, Sohyun; Lee, Jounghee; Kwon, Kwang-Il; Kim, Jong-Wook; Byun, Jae-Eon; Kang, Baeg-Won; Choi, Bo Youl; Park, Hye-Kyung

2014-12-01

South Korean's sodium consumption level is more than twice the upper limit level suggested by the WHO. Steep increases in the prevalence of hypertension and cardiovascular disease in Korea necessitate more effective sodium reduction programs. This study was conducted in order to compare sodium intake-related eating behaviors and key psychosocial factors according to age group and gender. Using an online survey, a total of 1,564 adults (20-59 years old) considered to be geographically representative of South Korea were recruited and surveyed. The major outcomes were perceived behaviors, knowledge, intentions, and self-efficacy related to sodium intake. The results show that perceived behavior and level of self-efficacy related to low sodium consumption differed by age and gender. Female participants showed better behavior and intention towards low sodium intake than male counterparts. Young participants in their 20s showed the lowest intention to change their current sodium intake as well as lowest self-efficacy measures. Future sodium reduction interventions should be developed with tailored messages targeting different age and gender groups. Specifically, interventions can be planned and implemented at the college level or for workers in their early career to increase their intention and self-efficacy as a means of preventing future health complications associated with high sodium intake.

Early Life Nutrition and Energy Balance Disorders in Offspring in Later Life

PubMed Central

Reynolds, Clare M.; Gray, Clint; Li, Minglan; Segovia, Stephanie A.; Vickers, Mark H.

2015-01-01

The global pandemic of obesity and type 2 diabetes is often causally linked to changes in diet and lifestyle; namely increased intake of calorically dense foods and concomitant reductions in physical activity. Epidemiological studies in humans and controlled animal intervention studies have now shown that nutritional programming in early periods of life is a phenomenon that affects metabolic and physiological functions throughout life. This link is conceptualised as the developmental programming hypothesis whereby environmental influences during critical periods of developmental plasticity can elicit lifelong effects on the health and well-being of the offspring. The mechanisms by which early environmental insults can have long-term effects on offspring remain poorly defined. However there is evidence from intervention studies which indicate altered wiring of the hypothalamic circuits that regulate energy balance and epigenetic effects including altered DNA methylation of key adipokines including leptin. Studies that elucidate the mechanisms behind these associations will have a positive impact on the health of future populations and adopting a life course perspective will allow identification of phenotype and markers of risk earlier, with the possibility of nutritional and other lifestyle interventions that have obvious implications for prevention of non-communicable diseases. PMID:26402696

Early life nutrition, epigenetics and programming of later life disease.

PubMed

Vickers, Mark H

2014-06-02

The global pandemic of obesity and type 2 diabetes is often causally linked to marked changes in diet and lifestyle; namely marked increases in dietary intakes of high energy diets and concomitant reductions in physical activity levels. However, less attention has been paid to the role of developmental plasticity and alterations in phenotypic outcomes resulting from altered environmental conditions during the early life period. Human and experimental animal studies have highlighted the link between alterations in the early life environment and increased risk of obesity and metabolic disorders in later life. This link is conceptualised as the developmental programming hypothesis whereby environmental influences during critical periods of developmental plasticity can elicit lifelong effects on the health and well-being of the offspring. In particular, the nutritional environment in which the fetus or infant develops influences the risk of metabolic disorders in offspring. The late onset of such diseases in response to earlier transient experiences has led to the suggestion that developmental programming may have an epigenetic component, as epigenetic marks such as DNA methylation or histone tail modifications could provide a persistent memory of earlier nutritional states. Moreover, evidence exists, at least from animal models, that such epigenetic programming should be viewed as a transgenerational phenomenon. However, the mechanisms by which early environmental insults can have long-term effects on offspring are relatively unclear. Thus far, these mechanisms include permanent structural changes to the organ caused by suboptimal levels of an important factor during a critical developmental period, changes in gene expression caused by epigenetic modifications (including DNA methylation, histone modification, and microRNA) and permanent changes in cellular ageing. A better understanding of the epigenetic basis of developmental programming and how these effects may be transmitted across generations is essential for the implementation of initiatives aimed at curbing the current obesity and diabetes crisis.

A new generation T56 turboprop engine

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

McIntire, W.L.

1984-06-01

The focus of the T56 Series IV turboprop engine development program is to improve power and fuel consumption through incorporation of demonstrated technology improvements while retaining the long term durability and cost effective design of the T56 family. The T56-A-427, the Navy Series IV derivative of the 5000 shp (3728.5 kW) class T56 turboprop engine, resulted from over ten years of technology development via Advanced Turbine Engine Gas Generator (ATEGG), Joint Technology Demonstrator Engine (JTDE), and advanced component programs at Allison Gas Turbine Operations. An example of government and industry cooperation to transfer advanced gas turbine technology is the Airmore » Force Engine Model Derivative Program (EMDP). The initial full-scale demonstration in this program confirmed a 10-1/2% reduction in specific fuel consumption (sfc) and a power growth of 21% in the basic T56 frame. Continued early demonstrations and development by IR and D, Navy funds, and Allison discretionary funds showed a further sfc reduction to 13% and power increase of 28%. The full-scale development program is now underway to provide production engines in late 1986. Engines will be available for the Grumman E-2 and C-2 aircraft, with follow-on adaptions for Lockheed C-130/L100 and P-3 aircraft, and generator sets for DD 963, DDG 993, CG 47 and DDG 51 warships.« less

Mediators of Mindfulness-Based Stress Reduction (MBSR): assessing the timing and sequence of change in cancer patients.

PubMed

Labelle, Laura E; Campbell, Tavis S; Faris, Peter; Carlson, Linda E

2015-01-01

This waitlist-controlled study examined the timing of changes during Mindfulness-Based Cancer Recovery (MBCR), and explored sequential mediated effects through enhanced mindfulness and emotion regulation (ER) in a cancer population. Patients were recruited from the MBCR program waitlist and were either registered for immediate participation (n = 135) or waiting for the next program to begin (n = 76). Participants completed self-report measures of stress symptoms, mood disturbance, mindfulness, and ER (rumination, worry, and experiential avoidance) pre-, mid- and post-MBCR or waiting period. There was a relatively early effect of MBCR on observing, nonjudging, rumination, and worry. All other measures changed later. Early changes in present-focused nonjudgmental awareness, rumination, and worry mediated the effect of MBCR on mindfulness skills such as nonreactivity later on. The constructs of mindfulness and ER may overlap and changes may be mutually facilitative during MBCR. The study informs our understanding of mindfulness and ER as mechanisms of mindfulness-based interventions. © 2014 Wiley Periodicals, Inc.

Cost-effectiveness analysis of ultrasonography screening for nonalcoholic fatty liver disease in metabolic syndrome patients.

PubMed

Phisalprapa, Pochamana; Supakankunti, Siripen; Charatcharoenwitthaya, Phunchai; Apisarnthanarak, Piyaporn; Charoensak, Aphinya; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Chaiyakunapruk, Nathorn

2017-04-01

Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand. Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results. The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective. For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making. Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions.

Drug-related stigma and access to care among people who inject drugs in Vietnam.

PubMed

Lan, Chiao-Wen; Lin, Chunqing; Thanh, Duong Cong; Li, Li

2018-03-01

There are considerable challenges faced by people with a history of injecting drug use (PWID) in Vietnam, including drug-related stigma and lack of access to healthcare. Seeking and utilising healthcare, as well as harm reduction programs for PWID, are often hampered by drug-related stigma. This study aimed to examine the impacts of drug-related stigma on access to care and utilisation of harm reduction programs among PWID in Vietnam. A cross-sectional study was conducted in two provinces in Vietnam, Phú Thọ and Vinh Phúc. The study participants completed the survey by using Audio Computer-Assisted Self-Interview between late 2014 and early 2015. Linear multiple regression models and logistic regression models were used to assess the relationship among drug-related stigma, access to care and utilisation of harm reduction programs, including methadone maintenance treatment (MMT) and needle exchange programs (NEP). A total of 900 PWID participated in this study. Drug-related stigma was significantly associated with lower level of access to care, but not with utilisation of MMT or NEP. Older age was positively associated with higher levels of access to care. Levels of education were positively correlated with access to care, as well as utilisation of MMT and NEP. This study underscores the need for future interventions to reduce drug-related stigma in society and in health-care settings to improve PWID's utilisation of care services. Special attention should be paid to younger PWID and those with lower levels of education. © 2017 Australasian Professional Society on Alcohol and other Drugs.

[Psychoeducation leads to a reduction in fear of spiders in 8- to 9-year-old children - a pilot study].

PubMed

Leutgeb, Verena; Schaider, Miriam; Schienle, Anne

2012-09-01

In Western societies spiders are among the least liked of all arthropods, eliciting feelings of fear and disgust. The clinical manifestation of this fear - spider phobia - is a common anxiety disorder. In most cases the disorder has an early onset in childhood. The symptoms show a chronic course and can persist into adulthood if not treated. Etiological models emphasize the role of modeling and negative information transmission for the acquisition of the disorder. Even though powerful psychotherapeutic methods exist, referral to treatment is rather uncommon for children. Often spontaneous remission is expected, but that is atypical. The current study developed a psychoeducative program on spiders for elementary school children and evaluated it on a sample of 36 children aged 8 to 10 years. The main goal of this pilot study was to test the feasibility of the program. The study showed a reduction of fear of spiders after psychoeducation in girls and boys with previously high or moderate fear of spiders. The program could become a valuable contribution to the prevention of spider phobia and should be evaluated in future controlled trials.

NASA's Orbital Space Plane Risk Reduction Strategy

NASA Technical Reports Server (NTRS)

Dumbacher, Dan

2003-01-01

This paper documents the transformation of NASA s Space Launch Initiative (SLI) Second Generation Reusable Launch Vehicle Program under the revised Integrated Space Transportation Plan, announced November 2002. Outlining the technology development approach followed by the original SLI, this paper gives insight into the current risk-reduction strategy that will enable confident development of the Nation s first orbital space plane (OSP). The OSP will perform an astronaut and contingency cargo transportation function, with an early crew rescue capability, thus enabling increased crew size and enhanced science operations aboard the International Space Station. The OSP design chosen for full-scale development will take advantage of the latest innovations American industry has to offer. The OSP Program identifies critical technologies that must be advanced to field a safe, reliable, affordable space transportation system for U.S. access to the Station and low-Earth orbit. OSP flight demonstrators will test crew safety features, validate autonomous operations, and mature thermal protection systems. Additional enabling technologies may be identified during the OSP design process as part of an overall risk-management strategy. The OSP Program uses a comprehensive and evolutionary systems acquisition approach, while applying appropriate lessons learned.

Population and population policy in Pakistan.

PubMed

Mauldin, W P

1963-02-01

Pakistan is a divided country with different religious groups represented. Since independence in 1941, the Muslim population has increased more rapidly than the Hindu population, the West Pakistan population more rapidly and steadily than the East Pakistan population. In the late 1950s the Pakistan government initiated a family planning program. The program has trained medical and paramedical personnel in family planning, added family planning services to existing medical centers, planned for a National Research Institute of Family Planning, employed mobile units to reach outlying areas, conducted limited clinical studies on some contraceptives, and used mass media advertising. Only India and Japan are doing more with government-sponsored family planning. A weak organizational structure and an inadequate number of trained personnel are the main weakness of the program. It is too early to assess the success of the program. A 10-point reduction in annual birth rates will be considered successful.

A call for new standard of care in perioperative gynecologic oncology practice: Impact of enhanced recovery after surgery (ERAS) programs.

PubMed

Miralpeix, Ester; Nick, Alpa M; Meyer, Larissa A; Cata, Juan; Lasala, Javier; Mena, Gabriel E; Gottumukkala, Vijaya; Iniesta-Donate, Maria; Salvo, Gloria; Ramirez, Pedro T

2016-05-01

Enhanced recovery after surgery (ERAS) programs aim to hasten functional recovery and improve postoperative outcomes. However, there is a paucity of data on ERAS programs in gynecologic surgery. We reviewed the published literature on ERAS programs in colorectal surgery, general gynecologic surgery, and gynecologic oncology surgery to evaluate the impact of such programs on outcomes, and to identify key elements in establishing a successful ERAS program. ERAS programs are associated with shorter length of hospital stay, a reduction in overall health care costs, and improvements in patient satisfaction. We suggest an ERAS program for gynecologic oncology practice involving preoperative, intraoperative, and postoperative strategies including; preadmission counseling, avoidance of preoperative bowel preparation, use of opioid-sparing multimodal perioperative analgesia (including loco-regional analgesia), intraoperative goal-directed fluid therapy (GDT), and use of minimally invasive surgical techniques with avoidance of routine use of nasogastric tube, drains and/or catheters. Postoperatively, it is important to encourage early feeding, early mobilization, timely removal of tubes and drains, if present, and function oriented multimodal analgesia regimens. Successful implementation of an ERAS program requires a multidisciplinary team effort and active participation of the patient in their goal-oriented functional recovery program. However, future outcome studies should evaluate the efficacy of an intervention within the pathway, include objective measures of symptom burden and control, study measures of functional recovery, and quantify outcomes of the program in relation to the rates of adherence to the key elements of care in gynecologic oncology such as oncologic outcomes and return to intended oncologic therapy (RIOT). Copyright © 2016 Elsevier Inc. All rights reserved.

Building Resilience After School for Early Adolescents in Urban Poverty: Open Trial of Leaders @ Play.

PubMed

Frazier, Stacy L; Dinizulu, Sonya Mathies; Rusch, Dana; Boustani, Maya M; Mehta, Tara G; Reitz, Kristin

2015-11-01

Leaders @ Play is a park after-school program for urban middle school youth designed to leverage recreational activities for social emotional learning. Mental health and park staff co-facilitated sports and games to teach and practice problem solving, emotion regulation, and effective communication. Additional practice occurred during multi-family groups and summer internships as junior camp counselors. We examined feasibility and promise via an open trial (n = 3 parks, 46 youth, 100 % African American, 100 % low-income, 59 % female, M = 13.09 years old). Improvements in social skills and reductions in problem behaviors lend support to after school programs as a space for mental health promotion.

Past and Future Performance: PEPFAR in the Landscape of Foreign Aid for Health.

PubMed

Bendavid, Eran

2016-10-01

This review traces the course of the US President's Emergency Plan for AIDS Relief (PEPFAR) as a foreign aid program. It illustrates how the epidemiologic and geopolitical environments of the early 2000s influenced PEPFAR's early directions and contributed to its successes. In addition to scaling up infrastructure and care delivery platforms, PEPFAR led to large increases in the number of people receiving antiretroviral therapy and reductions in mortality. These successes, in turn, have brought its principal challenges-its outsized budget, narrow focus, and problem of entitlement-into sharp relief. PEPFAR's recent evolution, then, has been in response to these challenges. This review suggests that PEPFAR's early formulation as an emergency response relieved it from a need to articulate clear goals, and that this freedom is now leading to new challenges as it struggles to identify priorities in the face of expectations to do more with a flat budget.

An evaluation of the Swedish ignition interlock program.

PubMed

Bjerre, Bo

2003-01-01

The Swedish alcohol ignition interlock program for driving while intoxicated (DWI) offenders, both first-time as well as multiple offenders, was launched as a pilot project in 1999. It is a volunteer program and differs in some respects from other programs: It covers a period of 2 years, it includes very strict medical regulations entailing regular checkups by a physician, it does not require a prior period of hard suspension, and it focuses strongly on changes in alcohol habits. Records from the 5 years prior to the offence showed that DWI offenders are generally in a high-risk category long before their offense, with a four to five times higher accident rate (road accidents reported by the police) and a three to four times higher rate of hospitalization due to a road accident. Only 12% of the eligible DWI offenders took part in the program and, of these, 60% could be diagnosed as alcohol dependent or alcohol abusers. During the program, alcohol consumption is monitored through self-esteem questionnaires (AUDIT) and five different biological markers. Our data show a noticeable reduction in alcohol consumption among the interlock users. This, combined with the high rate of compliance with the regulations, probably accounts for the fact that there was no case of recidivism during the program. Preliminary findings also suggest a reduction in the annual accident rate for interlock users while in the program. It still is too early to draw any conclusions concerning the rate of recidivism after completion of the program due to an insufficient amount of data for analysis. Nevertheless, the preliminary results are so promising that the program will now be expanded to cover all of Sweden as well as to include all driver's license categories.

Population-wide folic acid fortification and preterm birth: testing the folate depletion hypothesis.

PubMed

Naimi, Ashley I; Auger, Nathalie

2015-04-01

We assess whether population-wide folic acid fortification policies were followed by a reduction of preterm and early-term birth rates in Québec among women with short and optimal interpregnancy intervals. We extracted birth certificate data for 1.3 million births between 1981 and 2010 to compute age-adjusted preterm and early-term birth rates stratified by short and optimal interpregnancy intervals. We used Joinpoint regression to detect changes in the preterm and early term birth rates and assess whether these changes coincide with the implementation of population-wide folic acid fortification. A change in the preterm birth rate occurred in 2000 among women with short (95% confidence interval [CI] = 1994, 2005) and optimal (95% CI = 1995, 2008) interpregnancy intervals. Changes in early term birth rates did not coincide with the implementation of folic acid fortification. Our results do not indicate a link between folic acid fortification and early term birth but suggest an improvement in preterm birth rates after implementation of a nationwide folic acid fortification program.

Estimates of the timing of reductions in genital warts and high grade cervical intraepithelial neoplasia after onset of human papillomavirus (HPV) vaccination in the United States.

PubMed

Chesson, Harrell W; Ekwueme, Donatus U; Saraiya, Mona; Dunne, Eileen F; Markowitz, Lauri E

2013-08-20

The objective of this study was to estimate the number of years after onset of a quadrivalent HPV vaccination program before notable reductions in genital warts and cervical intraepithelial neoplasia (CIN) will occur in teenagers and young adults in the United States. We applied a previously published model of HPV vaccination in the United States and focused on the timing of reductions in genital warts among both sexes and reductions in CIN 2/3 among females. Using different coverage scenarios, the lowest being consistent with current 3-dose coverage in the United States, we estimated the number of years before reductions of 10%, 25%, and 50% would be observed after onset of an HPV vaccination program for ages 12-26 years. The model suggested female-only HPV vaccination in the intermediate coverage scenario will result in a 10% reduction in genital warts within 2-4 years for females aged 15-19 years and a 10% reduction in CIN 2/3 among females aged 20-29 years within 7-11 years. Coverage had a major impact on when reductions would be observed. For example, in the higher coverage scenario a 25% reduction in CIN2/3 would be observed with 8 years compared with 15 years in the lower coverage scenario. Our model provides estimates of the potential timing and magnitude of the impact of HPV vaccination on genital warts and CIN 2/3 at the population level in the United States. Notable, population-level impacts of HPV vaccination on genital warts and CIN 2/3 can occur within a few years after onset of vaccination, particularly among younger age groups. Our results are generally consistent with early reports of declines in genital warts among youth. Published by Elsevier Ltd.

Safety and cost benefit of an ambulatory program for patients with low-risk neutropenic fever at an Australian centre.

PubMed

Teh, Benjamin W; Brown, Christine; Joyce, Trish; Worth, Leon J; Slavin, Monica A; Thursky, Karin A

2018-03-01

Neutropenic fever (NF) is a common complication of cancer chemotherapy. Patients at low risk of medical complications from NF can be identified using a validated risk assessment and managed in an outpatient setting. This is a new model of care for Australia. This study described the implementation of a sustainable ambulatory program for NF at a tertiary cancer centre over a 12-month period. Peter MacCallum Cancer Centre introduced an ambulatory care program in 2014, which identified low-risk NF patients, promoted early de-escalation to oral antibiotics, and early discharge to a nurse-led ambulatory program. Patients prospectively enrolled in the ambulatory program were compared with a historical-matched cohort of patients from 2011 for analysis. Patient demographics, clinical variables (cancer type, recent chemotherapy, treatment intent, site of presentation) and outcomes were collected and compared. Total cost of inpatient admissions was determined from diagnosis-related group (DRG) codes and applied to both the prospective and historical cohorts to allow comparisons. Twenty-five patients were managed in the first year of this program with a reduction in hospital median length of stay from 4.0 to 1.1 days and admission cost from Australian dollars ($AUD) 8580 to $AUD2360 compared to the historical cohort. Offsetting salary costs, the ambulatory program had a net cost benefit of $AUD 71895. Readmission for fever was infrequent (8.0%), and no deaths were reported. Of relevance to hospitals providing cancer care, feasibility, safety, and cost benefits of an ambulatory program for low-risk NF patients have been demonstrated.

Intensive Evening Outpatient Treatment for Patients With Personality Dysfunction: Early Group Process, Change in Interpersonal Distress, and Longer-Term Social Functioning.

PubMed

Joyce, Anthony S; Ogrodniczuk, John S; Kealy, David

2017-01-01

Entrenched interpersonal difficulties are a defining feature of those with personality dysfunction. Evening treatment-a comprehensive and intensive group-oriented outpatient therapy program-offers a unique approach to delivering mental health services to patients with chronic personality dysfunction. This study assessed change in interpersonal problems as a key outcome, the relevance of such change to future social functioning, and the influence of early group processes on this change. Consecutively admitted patients (N = 75) to a group-oriented evening treatment program were recruited; the majority were diagnosed with personality disorder. Therapy outcome was represented by scores on the Inventory of Interpersonal Problems. Follow-up outcome was represented by the global score of the Social Adjustment Scale. Group climate, group cohesion, and the therapeutic alliance were examined as process variables. Patients experienced substantial reduction in distress associated with interpersonal problems; early process factors that reflected a cohesive and engaged group climate and stronger therapeutic alliance were predictive of this outcome. Improvement in interpersonal distress was predictive of global social functioning six months later. The therapeutic alliance most strongly accounted for change in interpersonal problems at posttreatment and social functioning at follow-up. A comprehensive and integrated outpatient group therapy program, offered in the evening to accommodate patients' real-life demands, can facilitate considerable improvement in interpersonal problems, which in turn influences later social functioning. The intensity and intimacy of peer interactions in the therapy groups, and a strong alliance with the program therapists, are likely interacting factors that are particularly important to facilitate such change.

The Resolved Stellar Populations Early Release Science Program

NASA Astrophysics Data System (ADS)

Gilbert, Karoline; Weisz, Daniel; Resolved Stellar Populations ERS Program Team

2018-06-01

The Resolved Stellar Populations Early Release Science Program (PI D. Weisz) will observe Local Group targets covering a range of stellar density and star formation histories, including a globular cluster, and ultra-faint dwarf galaxy, and a star-forming dwarf galaxy. Using observations of these diverse targets we will explore a broad science program: we will measure star formation histories, the sub-solar stellar initial mass function, and proper motions, perform studies of evolved stars, and map extinction in the target fields. Our observations will be of high archival value for other science such as calibrating stellar evolution models, studying variable stars, and searching for metal-poor stars. We will determine optimal observational setups and develop data reduction techniques that will be common to JWST studies of resolved stellar populations. We will also design, test, and release point spread function (PSF) fitting software specific to NIRCam and NIRISS, required for the crowded stellar regime. Prior to the Cycle 2 Call for Proposals, we will release PSF fitting software, matched HST and JWST catalogs, and clear documentation and step-by-step tutorials (such as Jupyter notebooks) for reducing crowded stellar field data and producing resolved stellar photometry catalogs, as well as for specific resolved stellar photometry science applications.

The Carter Center Mental Health Program: addressing the public health crisis in the field of mental health through policy change and stigma reduction.

PubMed

Palpant, Rebecca G; Steimnitz, Rachael; Bornemann, Thomas H; Hawkins, Katie

2006-04-01

Some of the most pervasive and debilitating illnesses are mental illnesses, according to World Health Organization's The World Health Report 2001--Mental Health: New Understanding, New Hope. Neuropsychiatric conditions account for four of the top five leading causes of years of life lived with disability in people aged 15 to 44 in the Western world. Many barriers prevent people with mental illnesses from seeking care, such as prohibitive costs, lack of insurance, and the stigma and discrimination associated with mental illnesses. The Carter Center Mental Health Program, established in 1991, focuses on mental health policy issues within the United States and internationally. This article examines the public health crisis in the field of mental health and focuses on The Carter Center Mental Health Program's initiatives, which work to increase public knowledge of and decrease the stigma associated with mental illnesses through their four strategic goals: reducing stigma and discrimination against people with mental illnesses; achieving equity of mental health care comparable with other health services; advancing early promotion, prevention, and early intervention services for children and their families; and increasing public awareness about mental illnesses and mental health issues.

Pre-risk HIV-prevention paradigm shift: the feasibility and acceptability of the parents matter! Program in HIV risk communities.

PubMed

Miller, Kim S; Maxwell, Karl D; Fasula, Amy M; Parker, J Terry; Zackery, Shannon; Wyckoff, Sarah C

2010-01-01

Many youth begin human immunodeficiency virus (HIV) sexual risk behaviors in preadolescence, yet risk-reduction programs are typically implemented in middle or late adolescence, missing an important window for prevention. Parent-based programming may play an important role in reaching youth early with prevention messages. One such program is the Parents Matter! Program (PMP), a five-session theory- and evidence-based intervention for parents of children aged 9 to 12 years. A randomized controlled trial showed PMP to be efficacious in promoting effective parent-child communication about sexuality and sexual risk reduction. We assessed the feasibility and acceptability of PMP when implemented under typical programmatic circumstances in communities at high risk for HIV infection. We selected 15 sites (including health departments, local education agencies, community-based organizations, and faith-based organizations) throughout the U.S. and Puerto Rico to participate in delivering PMP. Sites were provided training, program materials, and ongoing technical assistance. We collected multilevel data to assess the feasibility of program implementation and delivery, program relevance, and satisfaction with PMP activities and materials. PMP was successfully implemented and evaluated in 13 of 15 sites; 76% of parents attended at least four of five sessions. Organization-, facilitator-, and parent-level data indicated the feasibility and acceptability of PMP, and overall high satisfaction with PMP activities and materials. The results of this project demonstrate that HIV pre-risk prevention programs for parents can be implemented and embraced by a variety of community organizations in HIV at-risk communities. The time to embrace parents as partners in public health HIV-prevention efforts has come.

Development and validation of a numerical acoustic analysis program for aircraft interior noise prediction

NASA Astrophysics Data System (ADS)

Garcea, Ralph; Leigh, Barry; Wong, R. L. M.

Reduction of interior noise in propeller-driven aircraft, to levels comparable with those obtained in jet transports, has become a leading factor in the early design stages of the new generation turboprops- and may be essential if these new designs are to succeed. The need for an analytical capability to predict interior noise is accepted throughout the turboprop aircraft industry. To this end, an analytical noise prediction program, which incorporates the SYSNOISE numerical acoustic analysis software, is under development at de Havilland. The discussion contained herein looks at the development program and how it was used in a design sensitivity analysis to optimize the structural design of the aircraft cabin for the purpose of reducing interior noise levels. This report also summarizes the validation of the SYSNOISE package using numerous classical cases from the literature.

Reducing the Harms of College Student Drinking: How Alan Marlatt Changed Approaches, Outcomes, and the Field

PubMed Central

Kilmer, Jason R.; Palmer, Rebekka S.; Cronce, Jessica M.; Logan, Diane E.

2015-01-01

In this article, we discuss Alan Marlatt’s contributions to the prevention and reduction of alcohol-related harms among college students. We consider Alan’s early research that later led to the development and evaluation of college student drinking programs, and examine Alan’s impact, both directly and indirectly through those he mentored and trained, as a scientist-practitioner. We review the recognition of the efficacy of Alan’s programs, including the Alcohol Skills Training Program (ASTP) and Brief Alcohol Screening and Intervention for College Students (BASICS), in addition to extensions of these interventions in more recent studies. Finally, we discuss how Alan’s work influences interventions with college student drinkers today, and how future directions will continue to be informed by his vision and values. PMID:25774117

Toward a Systematic Approach for Selection of NASA Technology Portfolios

NASA Technical Reports Server (NTRS)

Weisbin, Charles R.; Rodriguez, Guillermo; Alberto, Elfes; Smith, Jeffrey H.

2004-01-01

There is an important need for a consistent analytical foundation supporting the selection and monitoring of R&D tasks that support new system concepts that enable future NASA missions. This capability should be applicable at various degrees of abstraction, depending upon whether one is interested in formulation, development, or operations. It should also be applicable to a single project, a program comprised of a group of projects, an enterprise typically including multiple programs, and the overall agency itself. Emphasis here is on technology selection and new initiatives, but the same approach can be generalized to other applications, dealing, for example, with new system architectures, risk reduction, and task allocation among humans and machines. The purpose of this paper is to describe one such approach, which is in its early stages of implementation within NASA programs, and to discuss several illustrative examples.

ISO Key Project: Exploring The Full Range of Quasar/AGN Properties

NASA Technical Reports Server (NTRS)

Wilkes, Belinda; West, Donald K. (Technical Monitor)

2002-01-01

While most of the work on this program has been completed, as previously reported, the portion of the program dealing with the sub topic of ISO LWS data analysis and reduction for the LWS Extragalactic Science Team and its leader, Dr. Howard Smith, is still active. This program in fact continues to generate results, and newly available computer modeling has extended the value of the datasets, As a result the team has requested and been granted an obtained a no-cost extension to this program, through December 31, 2003. The essence of the proposal is to perform ISO spectroscopic studies, including data analysis and modeling, of star formation regions using an ensemble of archival space-based data from the Infrared Space Observatory's Long Wavelength Spectrometer and Short Wavelength Spectrometer, but including as well some other spectroscopic data bases. Four kinds of regions are considered in the studies: (1) disks around more evolved objects; (2) young, low or high mass pre-main sequence stars in star formation regions; (3) star formation in external, bright IR galaxies; and (4) the galactic center. One prime focus of the program is the OH lines in the far infrared. The program has the following goals: (1) refine the data analysis of ISO observations, to obtain deeper and better SNR results on selected sources. The ISO data itself underwent "pipeline 10" reductions in early 2001, and additional "hands-on data reduction packages" were supplied by the ISO teams in 2001. The Fabry-Perot database in particularly sensitive to noise can slight calibration errors. (2) model the atomic and molecular line shapes, in particular the OH lines, using revised Monte-Carlo techniques developed by the SWAS team at the Center for Astrophysics; (3) attend scientific meetings and workshops; (4) do E&PO activities related to infrared astrophysics and/or spectroscopy.

Funding, coverage, and access under Thailand's universal health insurance program: an update after ten years.

PubMed

Damrongplasit, Kannika; Melnick, Glenn

2015-04-01

In 2001, Thailand implemented a universal coverage program by expanding government-funded health coverage to uninsured citizens and limited their out-of-pocket payments to 30 Baht per encounter and, in 2006, eliminated out-of-pocket payments entirely. Prior research covering the early years of the program showed that the program effectively expanded coverage while a more recent paper of the early effects of the program found that improved access from the program led to a reduction in infant mortality. We expand and update previous analyses of the effects of the 30 Baht program on access and out-of-pocket payments. We analyze national survey and governmental budgeting data through 2011 to examine trends in health care financing, coverage and access, including out-of-pocket payments. By 2011, only 1.64 % of the population remained uninsured in Thailand (down from 2.61 % in 2009). While government funding increased 75 % between 2005 and 2010, budgetary requests by health care providers exceeded approved amounts in many years. The 30 Baht program beneficiaries paid zero out-of-pocket payments for both outpatient and inpatient care. Inpatient and outpatient contact rates across all insurance categories fell slightly over time. Overall, the statistical results suggest that the program is continuing to achieve its goals after 10 years of operation. Insurance coverage is now virtually universal, access has been more or less maintained, government funding has continued to grow, though at rates below requested levels and 30 Baht patients are still guaranteed access to care with limited or no out-of-pocket costs. Important issues going forward are the ability of the government to sustain continued funding increases while minimizing cost sharing.

Evaluation of a class wide teaching program for developing preschool life skills.

PubMed

Hanley, Gregory P; Heal, Nicole A; Tiger, Jeffrey H; Ingvarsson, Einar T

2007-01-01

Recently, nonmaternal center-based child care has been linked to problem behavior in young children (National Institute of Child Health and Human Development, 2003). In response, a comprehensive program to promote prosocial skills was evaluated in a classroom of 16 children between the ages of 3 and 5 years. Classroom observations were conducted during evocative situations to determine the likelihood of problem behavior (noncompliance, vocal or motor disruptions, aggression) and preschool life skills. A classwide teaching program was then implemented in a staggered manner across instruction following, functional communication, delay tolerance, and friendship skills. These four categories of preschool life skills, which included two to four related skills, were selected for classwide teaching because they were either identified by educators as important for early school success, have often been taught following functional assessments of more severe problem behavior, or both. Skills were taught on a classwide basis during typically scheduled activities (circle, free play, transitions, meals) via instructions, modeling, role play, and feedback. A multiple probe design showed that the program resulted in an 74% reduction in problem behavior and a more than four-fold increase in preschool life skills. Similar beneficial effects of the program were evident in questionnaire data gathered prior to and at the close of the evaluation. Finally, the teachers who implemented the program reported overall high levels of satisfaction with the classwide teaching program, the target skills, and the results. Implications for the design of early childhood experiences for preempting the development of serious problem behavior are discussed.

Evaluation of a Classwide Teaching Program for Developing Preschool Life Skills

PubMed Central

Hanley, Gregory P; Heal, Nicole A; Tiger, Jeffrey H; Ingvarsson, Einar T

2007-01-01

Recently, nonmaternal center-based child care has been linked to problem behavior in young children (National Institute of Child Health and Human Development, 2003). In response, a comprehensive program to promote prosocial skills was evaluated in a classroom of 16 children between the ages of 3 and 5 years. Classroom observations were conducted during evocative situations to determine the likelihood of problem behavior (noncompliance, vocal or motor disruptions, aggression) and preschool life skills. A classwide teaching program was then implemented in a staggered manner across instruction following, functional communication, delay tolerance, and friendship skills. These four categories of preschool life skills, which included two to four related skills, were selected for classwide teaching because they were either identified by educators as important for early school success, have often been taught following functional assessments of more severe problem behavior, or both. Skills were taught on a classwide basis during typically scheduled activities (circle, free play, transitions, meals) via instructions, modeling, role play, and feedback. A multiple probe design showed that the program resulted in an 74% reduction in problem behavior and a more than four-fold increase in preschool life skills. Similar beneficial effects of the program were evident in questionnaire data gathered prior to and at the close of the evaluation. Finally, the teachers who implemented the program reported overall high levels of satisfaction with the classwide teaching program, the target skills, and the results. Implications for the design of early childhood experiences for preempting the development of serious problem behavior are discussed. PMID:17624068

A community-based obesity prevention program for minority children: rationale and study design for Hip-Hop to Health Jr.

PubMed

Fitzgibbon, Marian L; Stolley, Melinda R; Dyer, Alan R; VanHorn, Linda; KauferChristoffel, Katherine

2002-02-01

BACKGROUND; The increasing prevalence of overweight among children in the United States presents a national health priority. Higher rates of overweight/obesity among minority women place their children at increased risk. Although increased rates of overweight are observed in 4- to 5-year-old children, they are not observed in 2- to 3-year-old children. Therefore, early prevention efforts incorporating families are critical. The primary aim of Hip-Hop to Health Jr. is to alter the trajectory toward overweight/obesity among preschool African-American and Latino children. This 5-year randomized intervention is conducted in 24 Head Start programs, where each site is randomized to either a 14-week dietary/physical activity intervention or a general health intervention. This paper presents the rationale and design of the study. Efficacy of the intervention will be determined by weight change for the children and parent/caretaker. Secondary measures include reductions in dietary fat and increases in fiber, fruit/vegetable intake, and physical activity. Baseline data will be presented in future papers. The problem of overweight/obesity is epidemic in the United States. Behaviors related to diet and physical activity are established early in life and modeled by family members. Early intervention efforts addressing the child and family are needed to prevent obesity later in life. This paper describes a comprehensive, family-oriented obesity prevention program for minority preschool children. Copyright 2002 American Health Foundation and Elsevier Science (USA).

Cost-effectiveness analysis of ultrasonography screening for nonalcoholic fatty liver disease in metabolic syndrome patients

PubMed Central

Phisalprapa, Pochamana; Supakankunti, Siripen; Charatcharoenwitthaya, Phunchai; Apisarnthanarak, Piyaporn; Charoensak, Aphinya; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Chaiyakunapruk, Nathorn

2017-01-01

Abstract Background: Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand. Methods: Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results. Results: The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective. Conclusions: For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making. Translational Impacts: Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions. PMID:28445256

The future of emissions trading in light of the acid rain experience

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

McLean, B.J.; Rico, R.

1995-12-31

The idea of emissions trading was developed more than two decades ago by environmental economists eager to provide new ideas for how to improve the efficiency of environmental protection. However, early emissions trading efforts were built on the historical {open_quotes}command and control{close_quotes} infrastructure which has dominated U.S. environmental protection until today. The {open_quotes}command and control{close_quotes} model initially had advantages that were of a very pragmatic character: it assured large pollution reductions in a time when large, cheap reductions were available and necessary; and it did not require a sophisticated government infrastructure. Within the last five years, large-scale emission trading programsmore » have been successfully designed and started that are fundamentally different from the earlier efforts, creating a new paradigm for environmental control just when our understanding of environmental problems is changing as well. The purpose of this paper is to focus on the largest national-scale program--the Acid Rain Program--and from that experience, forecast when emission trading programs may be headed based on our understanding of the factors currently influencing environmental management. The first section of this paper will briefly review the history of emissions trading programs, followed by a summary of the features of the Acid Rain Program, highlighting those features that distinguish it from previous efforts. The last section addresses the opportunities for emissions trading (and its probable future directions).« less

Long-term reductions in mortality among children under age 5 in rural Haiti: effects of a comprehensive health system in an impoverished setting.

PubMed

Perry, Henry; Berggren, Warren; Berggren, Gretchen; Dowell, Duane; Menager, Henri; Bottex, Erve; Dortonne, Jean Richard; Philippe, Francois; Cayemittes, Michel

2007-02-01

Evidence regarding the long-term impact of health and other community development programs on under-5 mortality (the risk of death from birth until the fifth birthday) is limited. We compared mortality in a population served by health and other community development programs at the Hôpital Albert Schweitzer (HAS) with national mortality rates among children younger than 5 years for Haiti between 1958 and 1999. We collected information on births and deaths in the HAS service area between 1995 and 1999 and assembled previously published under-5 mortality rates at HAS. Published national rates for Haiti served as a comparison. In the early 1970s, the under-5 mortality rate at HAS declined to a level three fourths lower than that in Haiti nationwide. More recently, HAS rates have remained at one half those for Haiti nationwide. Child survival interventions in the HAS service area were substantially higher than in Haiti nationwide although socioeconomic characteristics and levels of childhood malnutrition were similar in both areas. HAS's programs have been responsible for long-term sustained reduction in mortality among children aged less than 5 years. Integrated systems for health and other community development programs could be an effective strategy for achieving the United Nations Millennium Goal to reduce under-5 mortality two thirds by 2015.

Vehicle Technologies and Fuel Cell Technologies Office Research and Development Programs: Prospective Benefits Assessment Report for Fiscal Year 2018

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

Stephens, T. S.; Birky, A.; Gohlke, David

Under a diverse set of programs, the Vehicle Technologies and Fuel Cell Technologies Offices of the U.S. Department of Energy’s Office of Energy Efficiency and Renewable Energy invest in early-stage research of advanced batteries and electrification, engines and fuels, materials, and energy-efficient mobility systems; hydrogen production, delivery, and storage; and fuel cell technologies. This report documents the estimated benefits of successful development and implementation of advanced vehicle technologies. It presents a comparison of a scenario with completely successful implementation of Vehicle Technologies Office (VTO) and Fuel Cell Technologies Office (FCTO) technologies (the Program Success case) to a future in whichmore » there is no contribution after Fiscal Year 2017 by the VTO or FCTO to these technologies (the No Program case). Benefits were attributed to individual program technology areas, which included FCTO research and development and the VTO programs of electrification, advanced combustion engines and fuels, and materials technology. Projections for the Program Success case indicate that by 2035, the average fuel economy of on-road, light-duty vehicle stock could be 24% to 30% higher than in the No Program case, while fuel economy for on-road medium- and heavy-duty vehicle stock could be as much as 13% higher. The resulting petroleum savings in 2035 were estimated to be as high as 1.9 million barrels of oil per day, and reductions in greenhouse gas emissions were estimated to be as high as 320 million metric tons of carbon dioxide equivalent per year. Projections of light-duty vehicle adoption indicate that although advanced-technology vehicles may be somewhat more expensive to purchase, the fuel savings result in a net reduction of consumer cost. In 2035, reductions in annual fuel expenditures for vehicles (both light- and heavy-duty) are projected to range from $86 billion to $109 billion (2015$), while the projected increase in new vehicle expenditures in the same year ranges from $6 billion to $24 billion (2015$).« less

Keys to the House: Unlocking Residential Savings With Program Models for Home Energy Upgrades

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

Grevatt, Jim; Hoffman, Ian; Hoffmeyer, Dale

After more than 40 years of effort, energy efficiency program administrators and associated contractors still find it challenging to penetrate the home retrofit market, especially at levels commensurate with state and federal goals for energy savings and emissions reductions. Residential retrofit programs further have not coalesced around a reliably successful model. They still vary in design, implementation and performance, and they remain among the more difficult and costly options for acquiring savings in the residential sector. If programs are to contribute fully to meeting resource and policy objectives, administrators need to understand what program elements are key to acquiring residentialmore » savings as cost effectively as possible. To that end, the U.S. Department of Energy (DOE) sponsored a comprehensive review and analysis of home energy upgrade programs with proven track records, focusing on those with robustly verified savings and constituting good examples for replication. The study team reviewed evaluations for the period 2010 to 2014 for 134 programs that are funded by customers of investor-owned utilities. All are programs that promote multi-measure retrofits or major system upgrades. We paid particular attention to useful design and implementation features, costs, and savings for nearly 30 programs with rigorous evaluations of performance. This meta-analysis describes program models and implementation strategies for (1) direct install retrofits; (2) heating, ventilating and air-conditioning (HVAC) replacement and early retirement; and (3) comprehensive, whole-home retrofits. We analyze costs and impacts of these program models, in terms of both energy savings and emissions avoided. These program models can be useful guides as states consider expanding their strategies for acquiring energy savings as a resource and for emissions reductions. We also discuss the challenges of using evaluations to create program models that can be confidently applied in multiple jurisdictions.« less

Glucose intolerance develops prior to increased adiposity and accelerated cessation of estrous cyclicity in female growth-restricted rats

PubMed Central

Intapad, Suttira; Dasinger, John Henry; Brown, Andrew D.; Fahling, Joel M.; Esters, Joyee; Alexander, Barbara T.

2015-01-01

Background The incidence of metabolic disease increases in early menopause. Low birth weight influences the age at menopause. Thus, this study tested the hypothesis that intrauterine growth restriction programs early reproductive aging and impaired glucose homeostasis in female rats. Methods Estrous cyclicity, body composition, and glucose homeostasis were determined in female control and growth-restricted rats at 6 and 12 months of age; sex steroids at 12 months. Results Glucose intolerance was present at 6 months of age prior to cessation of estrous cyclicity and increased adiposity in female growth-restricted rats. However, female growth-restricted rats exhibited persistent estrus and a significant increase in adiposity, fasting glucose and testosterone at 12 months of age (P<0.05). Insulin release in response to a glucose challenge was blunted in conjunction with a reduction in protein expression of pancreatic glucose transporter type 2 and estrogen receptor alpha at 12 months of age in female growth-restricted rats (P<0.05). Conclusion This study demonstrated that slow fetal growth programmed glucose intolerance that developed prior to early estrous acyclicity; yet, fasting glucose levels were elevated in conjunction with increased adiposity, accelerated cessation of estrous cyclicity and a shift towards testosterone excess at 12 months of age in female growth-restricted rats. PMID:26854801

Characteristics linked to the reduction of stigma towards schizophrenia: a pre-and-post study of parents of adolescents attending an educational program.

PubMed

Ling, Yiwei; Watanabe, Mayumi; Yoshii, Hatsumi; Akazawa, Kouhei

2014-03-18

The stigma of schizophrenia constitutes a major barrier to early detection and treatment of this illness. Anti-stigma education has been welcomed to reduce stigma among the general public. This study examined the factors associated with the effectiveness of a web-based educational program designed to reduce the stigma associated with schizophrenia. Using Link's Devaluation-Discrimination Scale to measure stigma, the effect of the program was measured by the difference in pre- and post-program tests. In the present study, we focused on program participants whose stigma towards schizophrenia had considerably improved (a reduction of three points or more between pre- and post-program tests) or considerably worsened (an increase of three points or more). The study participants were 1,058 parents of middle or high school students across Japan, including 508 whose stigma had significantly decreased after the program and 550 whose stigma had significantly increased. We used multiple logistic regression analysis to predict a considerable reduction in stigma (by three or more points) using independent variables measured before exposure to the program. In these models, we assessed the effects of demographic characteristics of the participants and four measures of knowledge and views on schizophrenia (basic knowledge, Link's Devaluation-Discrimination Scale, ability to distinguish schizophrenia from other conditions, and social distance). Participants' employment status, occupation, basic knowledge of schizophrenia, pre-program Link's Devaluation-Discrimination Scale score, and social distance were significant factors associated with a considerable decrease in the stigma attached to schizophrenia following the educational program. Specifically, full-time and part-time employees were more likely to experience reduced stigma than parents who were self-employed, unemployed, or had other employment status. Considerable decreases in stigma were more likely among parents working in transportation and communication or as homemakers than among other occupational groups. In addition, parents with higher pre-program levels of stigma, lower basic knowledge, or lower social distance were more likely to have reduced levels of stigma. Based on the regression analysis results presented here, several possible methods of reducing stigma were suggested, including increasing personal contact with people with schizophrenia and the improvement of law and insurance systems in primary and secondary industries.

Characteristics linked to the reduction of stigma towards schizophrenia: a pre-and-post study of parents of adolescents attending an educational program

PubMed Central

2014-01-01

Background The stigma of schizophrenia constitutes a major barrier to early detection and treatment of this illness. Anti-stigma education has been welcomed to reduce stigma among the general public. This study examined the factors associated with the effectiveness of a web-based educational program designed to reduce the stigma associated with schizophrenia. Methods Using Link’s Devaluation-Discrimination Scale to measure stigma, the effect of the program was measured by the difference in pre- and post-program tests. In the present study, we focused on program participants whose stigma towards schizophrenia had considerably improved (a reduction of three points or more between pre- and post-program tests) or considerably worsened (an increase of three points or more). The study participants were 1,058 parents of middle or high school students across Japan, including 508 whose stigma had significantly decreased after the program and 550 whose stigma had significantly increased. We used multiple logistic regression analysis to predict a considerable reduction in stigma (by three or more points) using independent variables measured before exposure to the program. In these models, we assessed the effects of demographic characteristics of the participants and four measures of knowledge and views on schizophrenia (basic knowledge, Link’s Devaluation-Discrimination Scale, ability to distinguish schizophrenia from other conditions, and social distance). Results Participants’ employment status, occupation, basic knowledge of schizophrenia, pre-program Link’s Devaluation-Discrimination Scale score, and social distance were significant factors associated with a considerable decrease in the stigma attached to schizophrenia following the educational program. Specifically, full-time and part-time employees were more likely to experience reduced stigma than parents who were self-employed, unemployed, or had other employment status. Considerable decreases in stigma were more likely among parents working in transportation and communication or as homemakers than among other occupational groups. In addition, parents with higher pre-program levels of stigma, lower basic knowledge, or lower social distance were more likely to have reduced levels of stigma. Conclusions Based on the regression analysis results presented here, several possible methods of reducing stigma were suggested, including increasing personal contact with people with schizophrenia and the improvement of law and insurance systems in primary and secondary industries. PMID:24642069

The HIV epidemic in China: history, response, and challenge.

PubMed

He, Na; Detels, Roger

2005-01-01

The first case of AIDS was reported in 1985 in China, but by the early 21st century, the government estimated that there were 840,000 citizens living with HIV/AIDS. The number is increasing rapidly. The major risk groups are injection drug users (IDUSs; 43%) and former plasma donors (27%), but rates among heterosexual groups are rising rapidly. Sentinel surveillance was initiated in 1986, and now includes IDUs, men-who-have-sex-with-men, sexually transmitted disease clinic attendees, antenatal women, long-distance truck drivers, and sex workers. Although the government was slow to respond to the epidemic in the late 20th century, it has made a vigorous response in the early 21st century. Components of that response include implementation and evaluation of harm reduction programs for IDUs, education to increase knowledge and reduce stigma, treatment and social support for rural and poor HIV/AIDS patients, widespread testing, and increased funding for HIV/AIDS programs. International agencies have been generous in their support of the government initiatives. To successfully combat the epidemic, China needs to develop and train the necessary infrastructure to implement its intervention programs, particularly in the rural areas, to vigorously combat stigma and discrimination, support research especially in the universities and research institutions other than the China Centers for Disease Control, develop a system for efficient exchange of research and program information, and update legislation to reflect the current situation.

Technology Readiness of Early Career Nurse Trainees: Utilization of the Technology Readiness Index (TRI).

PubMed

Odlum, Michelle

2016-01-01

Health Information Technology (HIT) adoption by clinicians, including nurses, will lead to reduction in healthcare costs and clinical errors and improve health outcomes. Understanding the importance of technology adoption, the current study utilized the Technology Readiness Index to explore technology perceptions of nursing students. Our analysis identifies factors that may influence perceptions of technology, including decreased optimism for students with clinical experience and increased discomfort of US born students. Our study provides insight to inform training programs to further meet the increasing demands of skilled nursing staff.

Paying for disease management.

PubMed

Levy, Phillip; Nocerini, Robert; Grazier, Kyle

2007-08-01

Disease Management (DM) first appeared in the United States in the early 1990s. Since then its incorporation into health plans has increased dramatically, yet proof of its effectiveness in terms of quality improvement and cost reduction remains to be seen. The following review provides an exploratory analysis of the basic principles of DM, its evolution and differences from traditional managed care, the ways in which programs are currently being used in the private and public sectors, and the challenges to determining a payment structure for incorporating DM into the current health insurance system.

Research on the use of space resources

NASA Technical Reports Server (NTRS)

Carroll, W. F. (Editor)

1983-01-01

The second year of a multiyear research program on the processing and use of extraterrestrial resources is covered. The research tasks included: (1) silicate processing, (2) magma electrolysis, (3) vapor phase reduction, and (4) metals separation. Concomitant studies included: (1) energy systems, (2) transportation systems, (3) utilization analysis, and (4) resource exploration missions. Emphasis in fiscal year 1982 was placed on the magma electrolysis and vapor phase reduction processes (both analytical and experimental) for separation of oxygen and metals from lunar regolith. The early experimental work on magma electrolysis resulted in gram quantities of iron (mixed metals) and the identification of significant anode, cathode, and container problems. In the vapor phase reduction tasks a detailed analysis of various process concepts led to the selection of two specific processes designated as ""Vapor Separation'' and ""Selective Ionization.'' Experimental work was deferred to fiscal year 1983. In the Silicate Processing task a thermophysical model of the casting process was developed and used to study the effect of variations in material properties on the cooling behavior of lunar basalt.

Early Results of Medicare's Bundled Payment Initiative for a 90-Day Total Joint Arthroplasty Episode of Care.

PubMed

Iorio, Richard; Clair, Andrew J; Inneh, Ifeoma A; Slover, James D; Bosco, Joseph A; Zuckerman, Joseph D

2016-02-01

In 2011 Medicare initiated a Bundled Payment for Care Improvement (BPCI) program with the goal of introducing a payment model that would "lead to higher quality, more coordinated care at a lower cost to Medicare." A Model 2 bundled payment initiative for Total Joint Replacement (TJR) was implemented at a large, tertiary, urban academic medical center. The episode of care includes all costs through 90 days following discharge. After one year, data on 721 Medicare primary TJR patients were available for analysis. Average length of stay (LOS) was decreased from 4.27 days to 3.58 days (Median LOS 3 days). Discharges to inpatient facilities decreased from 71% to 44%. Readmissions occurred in 80 patients (11%), which is slightly lower than before implementation. The hospital has seen cost reduction in the inpatient component over baseline. Early results from the implementation of a Medicare BPCI Model 2 primary TJR program at this medical center demonstrate cost-savings. IV economic and decision analyses-developing an economic or decision model. Copyright © 2016 Elsevier Inc. All rights reserved.

Reducing by half the percentage of late-stage presentation for breast and cervix cancer over 4 years: a pilot study of clinical downstaging in Sarawak, Malaysia.

PubMed

Devi, B C R; Tang, T S; Corbex, M

2007-07-01

The registry of the Oncology Departmental in Sarawak General Hospital showed that 79% of nasopharyngeal, 77% of breast and 70% of cervix cancer patients were diagnosed at an advanced stage (stages III and IV) for year 1993. Hence, a low cost Early Cancer Surveillance Program was started in 1994, with the intent of downstaging these three most common cancers in Sarawak. The program consisted of (i) training health staff in hospital and rural clinics to improve their skills in early cancer detection, (ii) raising public awareness through pamphlets, posters and sensitization by health staff. Data analysis revealed that the program achieved downstaging in two of the cancers. Breast cancer in stage III and IV was reduced from 60% (1994) to 35% (1998) (P < 0.0001) and cervical cancer in stage III and IV from 60% (1994) to 26% (1998) (P < 0.0001). No reduction was observed for nasopharyngeal cancer at 88% (1994) to 91% (1998). The overall cost of this program was

Poor sitting posture and a heavy schoolbag as contributors to musculoskeletal pain in children: an ergonomic school education intervention program

PubMed Central

Syazwan, AI; Azhar, MN Mohamad; Anita, AR; Azizan, HS; Shaharuddin, MS; Hanafiah, J Muhamad; Muhaimin, AA; Nizar, AM; Rafee, B Mohd; Ibthisham, A Mohd; Kasani, Adam

2011-01-01

Objectives The purpose of this study was to evaluate a multidisciplinary, interventional, ergonomic education program designed to reduce the risk of musculoskeletal problems by reducing schoolbag weight and correcting poor sitting posture. Methods Data were collected twice before and twice following intervention using the Standardized Nordic Body Map Questionnaire, a rapid upper limb assessment for posture evaluation, and schoolbag weight measurement in children aged 8 and 11 years attending two schools within the central region of Malaysia. Results Students who received the ergonomic intervention reported significant improvements in their sitting posture in a classroom environment and reduction of schoolbag weight as compared with the controls. Conclusion A single-session, early intervention, group ergonomics education program for children aged 8 and 11 years is appropriate and effective, and should be considered as a strategy to reduce musculoskeletal pain among schoolchildren in this age group. PMID:22003301

Development and implementation of a low cost micro computer system for LANDSAT analysis and geographic data base applications

NASA Technical Reports Server (NTRS)

Faust, N.; Jordon, L.

1981-01-01

Since the implementation of the GRID and IMGRID computer programs for multivariate spatial analysis in the early 1970's, geographic data analysis subsequently moved from large computers to minicomputers and now to microcomputers with radical reduction in the costs associated with planning analyses. Programs designed to process LANDSAT data to be used as one element in a geographic data base were used once NIMGRID (new IMGRID), a raster oriented geographic information system, was implemented on the microcomputer. Programs for training field selection, supervised and unsupervised classification, and image enhancement were added. Enhancements to the color graphics capabilities of the microsystem allow display of three channels of LANDSAT data in color infrared format. The basic microcomputer hardware needed to perform NIMGRID and most LANDSAT analyses is listed as well as the software available for LANDSAT processing.

Where do we go from here? Interim analysis to forge ahead in violence prevention.

PubMed

Dicker, Rochelle A; Jaeger, Sebastian; Knudson, Mary M; Mackersie, Robert C; Morabito, Diane J; Antezana, Javier; Texada, Michael

2009-12-01

The severity and disparity of interpersonal violent injury is staggering. Fifty-three per 100,000 African Americans (AA) die of homicide yearly, 20 per 100,000 in Latinos, whereas the rate is 3 per 100,000 in Caucasians. With the ultimate goal of reducing injury recidivism, which now stands at 35% to 50%, we have designed and implemented a hospital-based, case-managed violence prevention program uniquely applicable to trauma centers. The Wraparound Project (WP) seizes the "teachable moment" after injury to implement culturally competent case management (CM) and shepherd clients through risk reduction resources with city and community partners. The purpose of this study was to perform a detailed intermediate evaluation of this multi-modal violence prevention program. We hypothesized that this evaluation would demonstrate feasibility and early programmatic efficacy. We looked to identify areas of programmatic weakness that, if corrected, could strengthen the project and enhance its effectiveness. We performed intermediate evaluation on the 18-month-old program. We selected the Centers for Disease Control and Prevention-recommended instrument used for unintentional injury prevention programs and applied it to the WP. The four sequential stages in this methodology are formative, process, impact, and outcome. To test feasibility of WP, we used process evaluation. To evaluate intermediate goals of risk reduction and early efficacy, we used impact evaluation. Four hundred thirty-five people met screening criteria. The two case managers were able to make contact and screen 73% of gun shot victims, and 57% of stab wound victims. Of those not seen, 48% were in the hospital for 6 h/wk with the client. Forty-one percent of the time, they spent 3 hours to 6 hours. Seventeen of 18 people who required >6 hours had two to three needs. Attrition rate is only 4%. The table demonstrates percent success thus far in providing risk reduction resources. WP case managers served high-risk clients by developing trust, credibility, and a risk reduction plan. Cultural competency has been vital. Six of seven major needs were successfully addressed at least 50% of the time. The value of reporting these results has led WP to gain credibility with municipal stakeholders, who have now agreed to fund a third CM position. Intermediate evaluation provided a framework in our effort to achieve the ultimate goal of reducing recidivism through culturally competent CM and risk factor modification.

Does Raising the Early Retirement Age Increase Employment of Older Workers?*

PubMed Central

Staubli, Stefan; Zweimüller, Josef

2013-01-01

Two pension reforms in Austria increased the early retirement age (ERA) from 60 to 62 for men and from 55 to 58.25 for women. We find that raising the ERA increased employment by 9.75 percentage points among affected men and by 11 percentage points among affected women. The reforms had large spillover effects on the unemployment insurance program but negligible effects on disability insurance claims. Specifically, unemployment increased by 12.5 percentage points among men and by 11.8 percentage points among women. The employment response was largest among high-wage and healthy workers, while low-wage and less healthy workers either continued to retire early via disability benefits or bridged the gap to the ERA via unemployment benefits. Taking spillover effects and additional tax revenues into account, we find that for a typical birth-year cohort a one year increase in the ERA resulted in a reduction of net government expenditures of 107 million euros for men and of 122 million euros for women. PMID:24319299

Does Raising the Early Retirement Age Increase Employment of Older Workers?

PubMed

Staubli, Stefan; Zweimüller, Josef

2013-12-01

Two pension reforms in Austria increased the early retirement age (ERA) from 60 to 62 for men and from 55 to 58.25 for women. We find that raising the ERA increased employment by 9.75 percentage points among affected men and by 11 percentage points among affected women. The reforms had large spillover effects on the unemployment insurance program but negligible effects on disability insurance claims. Specifically, unemployment increased by 12.5 percentage points among men and by 11.8 percentage points among women. The employment response was largest among high-wage and healthy workers, while low-wage and less healthy workers either continued to retire early via disability benefits or bridged the gap to the ERA via unemployment benefits. Taking spillover effects and additional tax revenues into account, we find that for a typical birth-year cohort a one year increase in the ERA resulted in a reduction of net government expenditures of 107 million euros for men and of 122 million euros for women.

Regulation of Adult Neurogenesis and Plasticity by (Early) Stress, Glucocorticoids, and Inflammation

PubMed Central

Lucassen, Paul J.; Oomen, Charlotte A.; Naninck, Eva F.G.; Fitzsimons, Carlos P.; van Dam, Anne-Marie; Czeh, Boldizsár; Korosi, Aniko

2015-01-01

Exposure to stress is one of the best-known negative regulators of adult neurogenesis (AN). We discuss changes in neurogenesis in relation to exposure to stress, glucocorticoid hormones, and inflammation, with a particular focus on early development and on lasting effects of stress. Although the effects of acute and mild stress on AN are generally brief and can be quickly overcome, chronic exposure or more severe forms of stress can induce longer lasting reductions in neurogenesis that can, however, in part, be overcome by subsequent exposure to exercise, drugs targeting the stress system, and some antidepressants. Exposure to stress, particularly during the sensitive period of early life, may (re)program brain plasticity, in particular, in the hippocampus. This may increase the risk to develop cognitive or anxiety symptoms, common to brain diseases like dementia and depression in which plasticity changes occur, and a normalization of neurogenesis may be required for a successful treatment response and recovery. PMID:26330520

The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: a randomized trial

PubMed Central

Henderson, Virginia P.; Clemow, Lynn; Massion, Ann O.; Hurley, Thomas G.; Druker, Susan

2013-01-01

The aim of this study was determine the effectiveness of a mindfulness-based stress-reduction (MBSR) program on quality of life (QOL) and psychosocial outcomes in women with early-stage breast cancer, using a three-arm randomized controlled clinical trial (RCT). This RCT consisting of 172 women, aged 20–65 with stage I or II breast cancer consisted of the 8-week MBSR, which was compared to a nutrition education program (NEP) and usual supportive care (UC). Follow-up was performed at three post-intervention points: 4 months, 1, and 2 years. Standardized, validated self-administered questionnaires were adopted to assess psychosocial variables. Statistical analysis included descriptive and regression analyses incorporating both intention-to-treat and post hoc multivariable approaches of the 163 women with complete data at baseline, those who were randomized to MBSR experienced a significant improvement in the primary measures of QOL and coping outcomes compared to the NEP, UC, or both, including the spirituality subscale of the FACT-B as well as dealing with illness scale increases in active behavioral coping and active cognitive coping. Secondary outcome improvements resulting in significant between-group contrasts favoring the MBSR group at 4 months included meaningfulness, depression, paranoid ideation, hostility, anxiety, unhappiness, and emotional control. Results tended to decline at 12 months and even more at 24 months, though at all times, they were as robust in women with lower expectation of effect as in those with higher expectation. The MBSR intervention appears to benefit psychosocial adjustment in cancer patients, over and above the effects of usual care or a credible control condition. The universality of effects across levels of expectation indicates a potential to utilize this stress reduction approach as complementary therapy in oncologic practice. PMID:21901389

34 CFR 303.11 - Early intervention program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Early intervention program. 303.11 Section 303.11... AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND... intervention program. As used in this part, early intervention program means the total effort in a State that...

34 CFR 303.11 - Early intervention program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Early intervention program. 303.11 Section 303.11... AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND... intervention program. As used in this part, early intervention program means the total effort in a State that...

Evaluation of the Advanced Subsonic Technology Program Noise Reduction Benefits

NASA Technical Reports Server (NTRS)

Golub, Robert A.; Rawls, John W., Jr.; Russell, James W.

2005-01-01

This report presents a detailed evaluation of the aircraft noise reduction technology concepts developed during the course of the NASA/FAA Advanced Subsonic Technology (AST) Noise Reduction Program. In 1992, NASA and the FAA initiated a cosponsored, multi-year program with the U.S. aircraft industry focused on achieving significant advances in aircraft noise reduction. The program achieved success through a systematic development and validation of noise reduction technology. Using the NASA Aircraft Noise Prediction Program, the noise reduction benefit of the technologies that reached a NASA technology readiness level of 5 or 6 were applied to each of four classes of aircraft which included a large four engine aircraft, a large twin engine aircraft, a small twin engine aircraft and a business jet. Total aircraft noise reductions resulting from the implementation of the appropriate technologies for each class of aircraft are presented and compared to the AST program goals.

A randomized controlled trial of mindfulness-based stress reduction for women with early-stage breast cancer receiving radiotherapy.

PubMed

Henderson, Virginia P; Massion, Ann O; Clemow, Lynn; Hurley, Thomas G; Druker, Susan; Hébert, James R

2013-09-01

To testthe relative effectiveness of a mindfulness-based stress reduction program (MBSR) compared with a nutrition education intervention (NEP) and usual care (UC) in women with newly diagnosed early-stage breast cancer (BrCA)undergoing radiotherapy. Datawere available from a randomized controlled trialof 172 women, 20 to 65 years old, with stage I or II BrCA. Data from women completing the 8-week MBSR program plus 3 additional sessions focuses on special needs associated with BrCA were compared to women receiving attention control NEP and UC. Follow-up was performed at 3 post-intervention points: 4 months, and 1 and 2 years. Standardized, validated self-administered questionnaires were used to assess psychosocial variables. Descriptive analyses compared women by randomization assignment. Regression analyses, incorporating both intention-to-treat and post hoc multivariable approaches, were used to control for potential confounding variables. A subset of 120 women underwent radiotherapy; 77 completed treatment prior to the study, and 40 had radiotherapy during the MBSR intervention. Women who actively received radiotherapy (art) while participating in the MBSR intervention (MBSR-art) experienced a significant (P < .05) improvement in 16 psychosocial variables compared with the NEP-art, UC-art, or both at 4 months. These included health-related, BrCA-specific quality of life and psychosocial coping, which were the primary outcomes, and secondary measures, including meaningfulness, helplessness, cognitive avoidance, depression, paranoid ideation, hostility, anxiety, global severity, anxious preoccupation, and emotional control. MBSR appears to facilitate psychosocial adjustment in BrCA patients receiving radiotherapy, suggesting applicability for MBSR as adjunctive therapy in oncological practice.

Can Targeted Intervention Mitigate Early Emotional and Behavioral Problems?: Generating Robust Evidence within Randomized Controlled Trials

PubMed Central

Doyle, Orla; McGlanaghy, Edel; O’Farrelly, Christine; Tremblay, Richard E.

2016-01-01

This study examined the impact of a targeted Irish early intervention program on children’s emotional and behavioral development using multiple methods to test the robustness of the results. Data on 164 Preparing for Life participants who were randomly assigned into an intervention group, involving home visits from pregnancy onwards, or a control group, was used to test the impact of the intervention on Child Behavior Checklist scores at 24-months. Using inverse probability weighting to account for differential attrition, permutation testing to address small sample size, and quantile regression to characterize the distributional impact of the intervention, we found that the few treatment effects were largely concentrated among boys most at risk of developing emotional and behavioral problems. The average treatment effect identified a 13% reduction in the likelihood of falling into the borderline clinical threshold for Total Problems. The interaction and subgroup analysis found that this main effect was driven by boys. The distributional analysis identified a 10-point reduction in the Externalizing Problems score for boys at the 90th percentile. No effects were observed for girls or for the continuous measures of Total, Internalizing, and Externalizing problems. These findings suggest that the impact of this prenatally commencing home visiting program may be limited to boys experiencing the most difficulties. Further adoption of the statistical methods applied here may help to improve the internal validity of randomized controlled trials and contribute to the field of evaluation science more generally. Trial Registration: ISRCTN Registry ISRCTN04631728 PMID:27253184

Reductions in employee productivity impairment observed after implementation of web-based worksite health promotion programs.

PubMed

Silberman, Jordan; Schwartz, Steven; Giuseffi, Danielle L; Wang, Chun; Nevedal, Dana; Bedrosian, Richard

2011-12-01

To assess changes in employee productivity impairment observed after the implementation of several Web-based health promotion programs. Health risk assessments and self-report measures of productivity impairment were administered on-line to more than 43,000 participants of Web-based health promotion programs. Reductions in productivity impairment were observed after 1 month of program utilization. Productivity impairment at 90- and 180-day follow-ups also decreased relative to baseline. Improvements in employee health were associated with reductions in employee productivity impairment. The use of Web-based health promotion programs was associated with reductions in productivity impairment and improvements in employee health. After the implementation of Web-based health promotion programs, reductions in productivity impairment may be observed before reductions in direct health care costs.

Integrating nutrition and child development interventions: scientific basis, evidence of impact, and implementation considerations.

PubMed

Black, Maureen M; Pérez-Escamilla, Rafael; Rao, Sylvia Fernandez

2015-11-01

The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children's linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5.

Integrating Nutrition and Child Development Interventions: Scientific Basis, Evidence of Impact, and Implementation Considerations123

PubMed Central

Black, Maureen M; Pérez-Escamilla, Rafael; Fernandez Rao, Sylvia

2015-01-01

The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children’s linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5. PMID:26875208

76 FR 70408 - Information Collection; Understanding Value Trade-Offs Regarding Fire Hazard Reduction Programs...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-14

... Regarding Fire Hazard Reduction Programs in the Wildland-Urban Interface AGENCY: Forest Service, USDA... Regarding Fire Hazard Reduction Programs in the Wildland-Urban Interface. DATES: Comments must be received... holidays. SUPPLEMENTARY INFORMATION: Title: Understanding Value Trade-offs Regarding Fire Hazard Reduction...

A Study of the Relationship between Early Childhood Program Attributes and Early Childhood Reading Achievement

ERIC Educational Resources Information Center

Washington, Novella M.

2012-01-01

This quantitative correlational study focuses on the relationship between early childhood program attributes and early childhood reading success. Data will be gathered from early childhood sites with grades prekindergarten through second grade in which early childhood program attributes exist and early childhood reading is measured by the…

Designing Interventions Informed by Scientific Knowledge About Effects of Early Adversity: A Translational Neuroscience Agenda for Next Generation Addictions Research

PubMed Central

Fisher, Philip A.; Berkman, Elliot T.

2015-01-01

In spite of extensive scientific knowledge about the neurobiological systems and neural pathways underlying addictions, only limited progress has been made to reduce the population-level incidence of addictions by using prevention and treatment programs. In this area of research the translation of basic neuroscience of causal mechanisms to effective interventions has not been fully realized. In this article we describe how an understanding of the effects of early adverse experiences on brain and biological development may provide new opportunities to achieve impact at scale with respect to reduction of addictions. We propose four categories of new knowledge that translational neuroscience investigations of addictions should incorporate to be successful. We then describe a translational neuroscience-informed smoking cessation intervention based on this model. PMID:26985399

PRISM Polarimetry of Massive Stars

NASA Astrophysics Data System (ADS)

Kerkstra, Brennan; Lomax, Jamie R.; Bjorkman, Karen S.; Bjorkman, Jon Eric; Skiff, Brian; Covey, Kevin R.; Wisniewski, John P.

2016-01-01

We present the early results from our long-term, multi-epoch filter polarization survey of massive stars in and around young Galactic clusters. These BVRI polarization data were obtained using the PRISM instrument mounted on the 1.8m Perkins Telescope at Lowell Observatory. We first detail the creation of our new semi-automated polarization data reduction pipeline that we developed to process these data. Next, we present our analysis of the instrumental polarization properties of the PRISM instrument, via observations of polarized and unpolarized standard stars. Finally, we present early results on the total and intrinsic polarization behavior of several isolated, previously suggested classical Be stars, and discuss these results in the context of the larger project.BK acknowledges support from a NSF/REU at the University of Oklahoma. This program was also supported by NSF-AST 11411563, 1412110, and 1412135.

Expert meeting on Child Growth and Micronutrient Deficiencies--New Initiatives for Developing Countries to Achieve Millennium Development Goals: executive summary report.

PubMed

Usfar, Avita A; Achadi, Endang L; Martorell, Reynaldo; Hadi, Hamam; Thaha, Razak; Jus'at, Idrus; Atmarita; Martianto, Drajat; Ridwan, Hardinsyah; Soekirman

2009-01-01

Undernutrition in early childhood has long-term physical and intellectual consequences. Improving child growth should start before the age of two years and be an integrated effort between all sectors, covering all aspects such as diet and nutrient intake, disease reduction, optimum child care, and improved environmental sanitation. To discuss these issues, the Indonesian Danone Institute Foundation organized an expert meeting on Child Growth and Micronutrient Deficiencies: New Initiatives for Developing Countries to Achieve Millennium Development Goals. The objective of the meeting was to have a retrospective view on child growth: lessons learned from programs to overcome under-nutrition in the developed countries and to relate the situation to the Indonesian context, as well as to discuss implications for future programs. Recommendations derived from the meeting include focus intervention on the window of opportunity group, re-activation of the Integrated Health Post at the village level, improvement of infant and young child feeding, expand food fortification intervention programs, strengthen supplementation programs with multi-micronutrient, and strengthening public and private partnership on food related programs.

Parenting and the Family Check-Up: Changes in Observed Parent-Child Interaction Following Early Childhood Intervention

PubMed Central

Sitnick, Stephanie L.; Shaw, Daniel S.; Gill, Anne; Dishion, Thomas; Winter, Charlotte; Waller, Rebecca; Gardner, Frances; Wilson, Melvin

2016-01-01

Coercion theory posits a cyclical relationship between harsh and coercive parent–child interactions and problem behavior beginning in early childhood. As coercive interactions have been theorized and found to facilitate the development and growth of early conduct problems, early interventions often target parenting to prevent or reduce early disruptive problem behavior. This study utilizes direct observations of parent–child interactions from the Early Steps Multisite study (N = 731; 369 boys) to examine the effect of the Family Check-Up, a family-centered intervention program, on measures of parent–child positive engagement and coercion from age 2 through 5, as well as on childhood problem behavior at age 5. Results indicate that high levels of parent–child positive engagement were associated with less parent–child coercion the following year, but dyadic coercion was unrelated to future levels of positive engagement. In addition, families assigned to the Family Check-Up showed increased levels of positive engagement at ages 3 and 5, and the association between positive engagement at age 3 and child problem behavior at age 5 was mediated by reductions in parent–child coercion at age 4. These findings provide longitudinal confirmation that increasing positive engagement in parent–child interaction can reduce the likelihood of coercive family dynamics in early childhood and growth in problem behavior. PMID:25133754

Parenting and the Family Check-Up: Changes in Observed Parent-Child Interaction Following Early Childhood Intervention.

PubMed

Sitnick, Stephanie L; Shaw, Daniel S; Gill, Anne; Dishion, Thomas; Winter, Charlotte; Waller, Rebecca; Gardner, Frances; Wilson, Melvin

2015-01-01

Coercion theory posits a cyclical relationship between harsh and coercive parent-child interactions and problem behavior beginning in early childhood. As coercive interactions have been theorized and found to facilitate the development and growth of early conduct problems, early interventions often target parenting to prevent or reduce early disruptive problem behavior. This study utilizes direct observations of parent-child interactions from the Early Steps Multisite study (N = 731; 369 boys) to examine the effect of the Family Check-Up, a family-centered intervention program, on measures of parent-child positive engagement and coercion from age 2 through 5, as well as on childhood problem behavior at age 5. Results indicate that high levels of parent-child positive engagement were associated with less parent-child coercion the following year, but dyadic coercion was unrelated to future levels of positive engagement. In addition, families assigned to the Family Check-Up showed increased levels of positive engagement at ages 3 and 5, and the association between positive engagement at age 3 and child problem behavior at age 5 was mediated by reductions in parent-child coercion at age 4. These findings provide longitudinal confirmation that increasing positive engagement in parent-child interaction can reduce the likelihood of coercive family dynamics in early childhood and growth in problem behavior.

Manage Your Life Online (MYLO): a pilot trial of a conversational computer-based intervention for problem solving in a student sample.

PubMed

Gaffney, Hannah; Mansell, Warren; Edwards, Rachel; Wright, Jason

2014-11-01

Computerized self-help that has an interactive, conversational format holds several advantages, such as flexibility across presenting problems and ease of use. We designed a new program called MYLO that utilizes the principles of METHOD of Levels (MOL) therapy--based upon Perceptual Control Theory (PCT). We tested the efficacy of MYLO, tested whether the psychological change mechanisms described by PCT mediated its efficacy, and evaluated effects of client expectancy. Forty-eight student participants were randomly assigned to MYLO or a comparison program ELIZA. Participants discussed a problem they were currently experiencing with their assigned program and completed measures of distress, resolution and expectancy preintervention, postintervention and at 2-week follow-up. MYLO and ELIZA were associated with reductions in distress, depression, anxiety and stress. MYLO was considered more helpful and led to greater problem resolution. The psychological change processes predicted higher ratings of MYLO's helpfulness and reductions in distress. Positive expectancies towards computer-based problem solving correlated with MYLO's perceived helpfulness and greater problem resolution, and this was partly mediated by the psychological change processes identified. The findings provide provisional support for the acceptability of the MYLO program in a non-clinical sample although its efficacy as an innovative computer-based aid to problem solving remains unclear. Nevertheless, the findings provide tentative early support for the mechanisms of psychological change identified within PCT and highlight the importance of client expectations on predicting engagement in computer-based self-help.

Early Elementary Class-Size Reduction: A Neo-Institutional Analysis of the Social, Political, and Economic Influences on State-Level Policymaking.

ERIC Educational Resources Information Center

Mitchell, Ross E.

This paper examines the social, political, and economic factors that influenced the adoption and diffusion of early-elementary school class-size-reduction policies at the state level. It applies a neo-institutional framework to explain the rapid spread of class-size reduction policies throughout many state legislatures and boards of education. It…

[Diabetes mellitus: Contribution to changes in the life expectancy in Mexico 1990, 2000, and 2010].

PubMed

Dávila-Cervantes, Claudio A; Pardo Montaño, Ana M

2014-01-01

To analyze the level and trend of diabetes mellitus (DM) in Mexico, and its contribution to the changes in temporary life expectancy between 20 and 100 years of age, in the period 1990-2010. Data comes from National Mortality Vital Statistics and from the Population Census from the Mexican National Institute of Geography and Statistics (INEGI). We calculated standardized mortality rates. To analyze the impact of DM on the temporary life expectancy (80e20) we used Pollard’s method. Between 1990 and 2010, the standardized mortality rate for people 20 years and older increased by 224 %. The contribution of DM for men to the change in life expectancy during 1990-2000 was a reduction of 0.31 years; for women was a reduction of 0.32 years; in the period 2000-2010 the reduction continued for both men and women (0.34 and 0.12 years respectively). Mortality from DM continues to increase, especially for men, but for women a modest reduction was observed. It is essential to apply health services and programs aimed at reducing mortality from this cause, focused on prevention, early detection and timely treatment, with concrete actions on vulnerable groups.

Reduction en masse of inguinal hernia: a review of a rare and potential fatal complication following reduction of inguinal hernia.

PubMed

Yatawatta, Ashanga

2017-08-07

Reduction en masse is reduction of a hernial sac into the pre-peritoneal space with a loop of bowel remaining incarcerated at the neck of the sac, leading to early strangulation. This is a rare complication, usually encountered with inguinal hernias, with a false reassurance to the patient and the treating physician that complete reduction has been achieved. Unless early intervention is carried out, this condition will typically present with worsening pain and absence of an appreciable hernia bulge at the groin, and intestinal necrosis may be encountered on exploration. The outcome will depend on the severity of peritonitis/sepsis, and mortality remains high for late presentations. A case of early presentation of reduction en masse of an inguinal hernia is reported with a review of the existing literature. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Childhood maltreatment and corpus callosum volume in recently diagnosed patients with bipolar I disorder: data from the Systematic Treatment Optimization Program for Early Mania (STOP-EM).

PubMed

Bücker, J; Muralidharan, K; Torres, I J; Su, W; Kozicky, J; Silveira, L E; Bond, D J; Honer, W G; Kauer-Sant'anna, M; Lam, R W; Yatham, L N

2014-01-01

Childhood trauma (CT) has been associated with abnormalities in the corpus callosum (CC). Decreased CC volumes have been reported in children and adolescents with trauma as well as adults with CT compared to healthy controls. CC morphology is potentially susceptible to the effects of Bipolar Disorder (BD) itself. Therefore, we evaluated the relationship between CT and CC morphology in BD. We using magnetic resonance imaging in 53 adults with BD recently recovered from their first manic episode, with (n = 23) and without (n = 30) CT, defined using the Childhood Trauma Questionnaire (CTQ) and 16 healthy controls without trauma. ANCOVA was performed with age, gender and intracranial volume as covariates in order to evaluate group differences in CC volume. The total CC volume was found to be smaller in BD patients with trauma compared to BD patients without trauma (p < .05). The differences were more pronounced in the anterior region of the CC. There was a significant negative correlation between CTQ scores and total CC volume in BD patients with trauma (p = .01). We did not find significant differences in the CC volume of patients with/without trauma compared to the healthy subjects. Our sample consists of patients recovered from a first episode of mania and are early in the course of illness and reductions in CC volume may occur late in the course of BD. It might mean there may be two sources of CC volume reduction in these patients: the reduction due to trauma, and the further reduction due to the illness. Copyright © 2013 Elsevier Ltd. All rights reserved.

High-Speed Jet Noise Reduction NASA Perspective

NASA Technical Reports Server (NTRS)

Huff, Dennis L.; Handy, J. (Technical Monitor)

2001-01-01

History shows that the problem of high-speed jet noise reduction is difficult to solve. the good news is that high performance military aircraft noise is dominated by a single source called 'jet noise' (commercial aircraft have several sources). The bad news is that this source has been the subject of research for the past 50 years and progress has been incremental. Major jet noise reduction has been achieved through changing the cycle of the engine to reduce the jet exit velocity. Smaller reductions have been achieved using suppression devices like mixing enhancement and acoustic liners. Significant jet noise reduction without any performance loss is probably not possible! Recent NASA Noise Reduction Research Programs include the High Speed Research Program, Advanced Subsonic Technology Noise Reduction Program, Aerospace Propulsion and Power Program - Fundamental Noise, and Quiet Aircraft Technology Program.

Effectiveness and Factors Determining the Success of Management Programs for Patients With Heart Failure: A Systematic Review and Meta-analysis.

PubMed

Oyanguren, Juana; Latorre García, Pedro María; Torcal Laguna, Jesús; Lekuona Goya, Iñaki; Rubio Martín, Susana; Maull Lafuente, Elena; Grandes, Gonzalo

2016-10-01

Heart failure management programs reduce hospitalizations. Some studies also show reduced mortality. The determinants of program success are unknown. The aim of the present study was to update our understanding of the reductions in mortality and readmissions produced by these programs, elucidate their components, and identify the factors determining program success. Systematic literature review (1990-2014; PubMed, EMBASE, CINAHL, Cochrane Library) and manual search of relevant journals. The studies were selected by 3 independent reviewers. Methodological quality was evaluated in a blinded manner by an external researcher (Jadad scale). These results were pooled using random effects models. Heterogeneity was evaluated with the I 2 statistic, and its explanatory factors were determined using metaregression analysis. Of the 3914 studies identified, 66 randomized controlled clinical trials were selected (18 countries, 13 535 patients). We determined the relative risks to be 0.88 for death (95% confidence interval [95%CI], 0.81-0.96; P < .002; I 2 , 6.1%), 0.92 for all-cause readmissions (95%CI, 0.86-0.98; P < .011; I 2 , 58.7%), and 0.80 for heart failure readmissions (95%CI, 0.71-0.90; P < .0001; I 2 , 52.7%). Factors associated with program success were implementation after 2001, program location outside the United States, greater baseline use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, a higher number of intervention team members and components, specialized heart failure cardiologists and nurses, protocol-driven education and its assessment, self-monitoring of signs and symptoms, detection of deterioration, flexible diuretic regimen, early care-seeking among patients and prompt health care response, psychosocial intervention, professional coordination, and program duration. We confirm the reductions in mortality and readmissions with heart failure management programs. Their success is associated with various structural and intervention variables. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries.

PubMed

Blinkhorn, Fiona; Brown, Ngiare; Freeman, Ruth; Humphris, Gerry; Martin, Andrew; Blinkhorn, Anthony

2012-08-21

Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. ACTRN12612000712808.

Reducing maladaptive behaviors in preschool-aged children with autism spectrum disorder using the early start denver model.

PubMed

Fulton, Elizabeth; Eapen, Valsamma; Crnčec, Rudi; Walter, Amelia; Rogers, Sally

2014-01-01

The presence of maladaptive behaviors in young people with autism spectrum disorder (ASD) can significantly limit engagement in treatment programs, as well as compromise future educational and vocational opportunities. This study aimed to explore whether the Early Start Denver Model (ESDM) treatment approach reduced maladaptive behaviors in preschool-aged children with ASD in a community-based long day care setting. The level of maladaptive behavior of 38 children with ASD was rated using an observation-based measure on three occasions during the intervention: on entry, 12 weeks post-entry, and on exit (post-intervention) over an average treatment duration of 11.8 months. Significant reductions were found in children's maladaptive behaviors over the course of the intervention, with 68% of children showing a treatment response by 12 weeks and 79% on exit. This change was accompanied by improvement in children's overall developmental level as assessed by the Mullen scales of early learning, but not by significant changes on the Vineland Adaptive Behavior Scales-II or Social Communication Questionnaire. Replication with a larger sample, control conditions, and additional measures of maladaptive behavior is necessary in order to determine the specific factors underlying these improvements; however, the findings of the present study suggest that the ESDM program may be effective in improving not only core developmental domains, but also decreasing maladaptive behaviors in preschool-aged children with ASD.

Alzheimer's disease and natural cognitive aging may represent adaptive metabolism reduction programs

PubMed Central

2009-01-01

The present article examines several lines of converging evidence suggesting that the slow and insidious brain changes that accumulate over the lifespan, resulting in both natural cognitive aging and Alzheimer's disease (AD), represent a metabolism reduction program. A number of such adaptive programs are known to accompany aging and are thought to have decreased energy requirements for ancestral hunter-gatherers in their 30s, 40s and 50s. Foraging ability in modern hunter-gatherers declines rapidly, more than a decade before the average terminal age of 55 years. Given this, the human brain would have been a tremendous metabolic liability that must have been advantageously tempered by the early cellular and molecular changes of AD which begin to accumulate in all humans during early adulthood. Before the recent lengthening of life span, individuals in the ancestral environment died well before this metabolism reduction program resulted in clinical AD, thus there was never any selective pressure to keep adaptive changes from progressing to a maladaptive extent. Aging foragers may not have needed the same cognitive capacities as their younger counterparts because of the benefits of accumulated learning and life experience. It is known that during both childhood and adulthood metabolic rate in the brain decreases linearly with age. This trend is thought to reflect the fact that children have more to learn. AD "pathology" may be a natural continuation of this trend. It is characterized by decreasing cerebral metabolism, selective elimination of synapses and reliance on accumulating knowledge (especially implicit and procedural) over raw brain power (working memory). Over decades of subsistence, the behaviors of aging foragers became routinized, their motor movements automated and their expertise ingrained to a point where they no longer necessitated the first-rate working memory they possessed when younger and learning actively. Alzheimer changes selectively and precisely mediate an adaptation to this major life-history transition. AD symptomatology shares close similarities with deprivation syndromes in other animals including the starvation response. Both molecular and anatomical features of AD imitate brain changes that have been conceptualized as adaptive responses to low food availability in mammals and birds. Alzheimer's patients are known to express low overall metabolic rates and are genetically inclined to exhibit physiologically thrifty traits widely thought to allow mammals to subsist under conditions of nutritional scarcity. Additionally, AD is examined here in the contexts of anthropology, comparative neuroscience, evolutionary medicine, expertise, gerontology, neural Darwinism, neuroecology and the thrifty genotype. PMID:19250550

Alzheimer's disease and natural cognitive aging may represent adaptive metabolism reduction programs.

PubMed

Reser, Jared Edward

2009-02-28

The present article examines several lines of converging evidence suggesting that the slow and insidious brain changes that accumulate over the lifespan, resulting in both natural cognitive aging and Alzheimer's disease (AD), represent a metabolism reduction program. A number of such adaptive programs are known to accompany aging and are thought to have decreased energy requirements for ancestral hunter-gatherers in their 30s, 40s and 50s. Foraging ability in modern hunter-gatherers declines rapidly, more than a decade before the average terminal age of 55 years. Given this, the human brain would have been a tremendous metabolic liability that must have been advantageously tempered by the early cellular and molecular changes of AD which begin to accumulate in all humans during early adulthood. Before the recent lengthening of life span, individuals in the ancestral environment died well before this metabolism reduction program resulted in clinical AD, thus there was never any selective pressure to keep adaptive changes from progressing to a maladaptive extent.Aging foragers may not have needed the same cognitive capacities as their younger counterparts because of the benefits of accumulated learning and life experience. It is known that during both childhood and adulthood metabolic rate in the brain decreases linearly with age. This trend is thought to reflect the fact that children have more to learn. AD "pathology" may be a natural continuation of this trend. It is characterized by decreasing cerebral metabolism, selective elimination of synapses and reliance on accumulating knowledge (especially implicit and procedural) over raw brain power (working memory). Over decades of subsistence, the behaviors of aging foragers became routinized, their motor movements automated and their expertise ingrained to a point where they no longer necessitated the first-rate working memory they possessed when younger and learning actively. Alzheimer changes selectively and precisely mediate an adaptation to this major life-history transition.AD symptomatology shares close similarities with deprivation syndromes in other animals including the starvation response. Both molecular and anatomical features of AD imitate brain changes that have been conceptualized as adaptive responses to low food availability in mammals and birds. Alzheimer's patients are known to express low overall metabolic rates and are genetically inclined to exhibit physiologically thrifty traits widely thought to allow mammals to subsist under conditions of nutritional scarcity. Additionally, AD is examined here in the contexts of anthropology, comparative neuroscience, evolutionary medicine, expertise, gerontology, neural Darwinism, neuroecology and the thrifty genotype.

78 FR 33810 - Fishing Capacity Reduction Program for the Southeast Alaska Purse Seine Salmon Fishery

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-05

... Capacity Reduction Program for the Southeast Alaska Purse Seine Salmon Fishery AGENCY: National Marine... reduction loan for the fishing capacity reduction program in the Southeast Alaska purse seine salmon fishery... July 22, 2012. Since then, all harvesters of Southeast Alaska purse seine salmon must pay the fee and...

Regulatory T cells inhibit acute IFN-γ synthesis without blocking T-helper cell type 1 (Th1) differentiation via a compartmentalized requirement for IL-10

PubMed Central

Sojka, Dorothy K.; Fowell, Deborah J.

2011-01-01

CD4+CD25+Forkhead box P3 (Foxp3)+ regulatory T cells (Tregs) control immune responses to self and foreign antigens in secondary lymphoid organs and at tissue sites of inflammation. Tregs can modify the function of many immune cells and have been proposed to block early proliferation, differentiation, and effector function. Acute ablation of Tregs has revealed rapid cytokine production immediately after Treg removal, suggesting that Tregs may regulate effector function acutely rather than regulating the programming for immune function. We developed in vitro and in vivo models that enabled the direct test of Treg regulation of T-helper cell type 1 (Th1) differentiation. CD28 signaling is known to abrogate Treg suppression of IL-2 secretion and proliferation, but our studies show that Treg suppression of IFN-γ during Th1 priming proceeds despite enhanced CD28 signaling. Importantly, during Th1 differentiation, Tregs inhibited early IFN-γ transcription without disrupting expression of Th1-specific T-box transcription factor (Tbet) and Th1 programming. Acute shutoff of effector cytokine production by Tregs was selective for IFN-γ but not TNF-α and was independent of TGF-β and Epstein-Barr virus-induced gene 3. In vivo, Tregs potently controlled CD4 IFN-γ and CD4 effector cell expansion in the lymph node (four- to fivefold reduction) but not Th1 programming, independent of IL-10. Tregs additionally reduced CD4 IFN-γ in the inflamed dermis (twofold reduction) dependent on their production of IL-10. We propose a model for Treg inhibition of effector function based on acute cytokine regulation. Interestingly, Tregs used different regulatory mechanisms to regulate IFN-γ (IL-10–dependent or –independent) subject to the target T-cell stage of activation and its tissue location. PMID:22025707

Lessions learned in WISE image quality

NASA Astrophysics Data System (ADS)

Kendall, Martha; Duval, Valerie G.; Larsen, Mark F.; Heinrichsen, Ingolf H.; Esplin, Roy W.; Shannon, Mark; Wright, Edward L.

2010-08-01

The Wide-Field Infrared Survey Explorer (WISE) mission launched in December of 2009 is a true success story. The mission is performing beyond expectations on-orbit and maintained cost and schedule throughout. How does such a thing happen? A team constantly focused on mission success is a key factor. Mission success is more than a program meeting its ultimate science goals; it is also meeting schedule and cost goals to avoid cancellation. The WISE program can attribute some of its success in achieving the image quality needed to meet science goals to lessons learned along the way. A requirement was missed in early decomposition, the absence of which would have adversely affected end-to-end system image quality. Fortunately, the ability of the cross-organizational team to focus on fixing the problem without pointing fingers or waiting for paperwork was crucial in achieving a timely solution. Asking layman questions early in the program could have revealed requirement flowdown misunderstandings between spacecraft control stability and image processing needs. Such is the lesson learned with the WISE spacecraft Attitude Determination & Control Subsystem (ADCS) jitter control and the image data reductions needs. Spacecraft motion can affect image quality in numerous ways. Something as seemingly benign as different terminology being used by teammates in separate groups working on data reduction, spacecraft ADCS, the instrument, mission operations, and the science proved to be a risk to system image quality. While the spacecraft was meeting the allocated jitter requirement , the drift rate variation need was not being met. This missing need was noticed about a year before launch and with a dedicated team effort, an adjustment was made to the spacecraft ADCS control. WISE is meeting all image quality requirements on-orbit thanks to a diligent team noticing something was missing before it was too late and applying their best effort to find a solution.

Long-acting penicillins: historical perspectives.

PubMed

Markowitz, M

1985-01-01

For the more than three decades since benzathine penicillin G was discovered it remains unique as the only antibiotic formulation that can provide serum drug concentrations for several weeks following a single intramuscular injection. Benzathine penicillin G has withstood the test of time as the ideal drug to treat early, infectious syphilis and to prevent and treat Group A streptococcal infections. It has proved to be extraordinarily effective for the prevention of rheumatic fever recurrences and is a major reason for the marked reduction in the morbidity and mortality in countries where carefully monitored prophylaxis programs have been established.

The Early Impact Program: An Early Intervention and Prevention Program for Children and Families At-Risk of Conduct Problems

ERIC Educational Resources Information Center

Larmar, Stephen; Gatfield, Terry

2007-01-01

The Early Impact (EI) program is an early intervention and prevention program for reducing the incidence of conduct problems in pre-school aged children. The EI intervention framework is ecological in design and includes universal and indicated components. This paper delineates key principles and associated strategies that underpin the EI program.…

NASA's J-2X Engine Builds on the Apollo Program for Lunar Return Missions

NASA Technical Reports Server (NTRS)

Snoddy, Jimmy R.

2006-01-01

In January 2006, NASA streamlined its U.S. Vision for Space Exploration hardware development approach for replacing the Space Shuttle after it is retired in 2010. The revised CLV upper stage will use the J-2X engine, a derivative of NASA s Apollo Program Saturn V s S-II and S-IVB main propulsion, which will also serve as the Earth Departure Stage (EDS) engine. This paper gives details of how the J- 2X engine effort mitigates risk by building on the Apollo Program and other lessons learned to deliver a human-rated engine that is on an aggressive development schedule, with first demonstration flight in 2010 and human test flights in 2012. It is well documented that propulsion is historically a high-risk area. NASA s risk reduction strategy for the J-2X engine design, development, test, and evaluation is to build upon heritage hardware and apply valuable experience gained from past development efforts. In addition, NASA and its industry partner, Rocketdyne, which originally built the J-2, have tapped into their extensive databases and are applying lessons conveyed firsthand by Apollo-era veterans of America s first round of Moon missions in the 1960s and 1970s. NASA s development approach for the J-2X engine includes early requirements definition and management; designing-in lessons learned from the 5-2 heritage programs; initiating long-lead procurement items before Preliminary Desi& Review; incorporating design features for anticipated EDS requirements; identifying facilities for sea-level and altitude testing; and starting ground support equipment and logistics planning at an early stage. Other risk reduction strategies include utilizing a proven gas generator cycle with recent development experience; utilizing existing turbomachinery ; applying current and recent main combustion chamber (Integrated Powerhead Demonstrator) and channel wall nozzle (COBRA) advances; and performing rigorous development, qualification, and certification testing of the engine system, with a philosophy of "test what you fly, and fly what you test". These and other active risk management strategies are in place to deliver the J-2X engine for LEO and lunar return missions as outlined in the U.S. Vision for Space Exploration.

Aliskiren: review of efficacy and safety data with focus on past and recent clinical trials.

PubMed

Sen, Selçuk; Sabırlı, Soner; Ozyiğit, Tolga; Uresin, Yağız

2013-09-01

Aliskiren is the newest antihypertensive drug and the first orally active direct renin inhibitor to become available for clinical use. Clinical data have substantiated that the antihypertensive effectiveness of aliskiren is similar to that of the other major antihypertensive agents. Furthermore, aliskiren has a similar safety profile to placebo. Combination treatment with aliskiren showed significant blood pressure and proteinuria reductions compared with monotherapy. Aliskiren decreases plasma renin activity in contrast to other renin-angiotensin-aldosterone related drugs. The efficacy of aliskiren in treating major cardiovascular events and the prevention of end-organ damage are being investigated in the ASPIRE HIGHER program. Although the first studies of the ASPIRE HIGHER program such as ALOFT, AVOID, AGELESS showed favorable findings, ASPIRE and AVANT-GARDE studies provided contradictory results. Subsequently, the ALTITUDE study was terminated early because of safety issues and lack of beneficial effects. Most recently, the ASTRONAUT trial showed no reduction in cardiovascular death or heart failure rehospitalization with the addition of aliskiren to standard therapy in patients who were hospitalized for heart failure and with reduced left-ventricular ejection fraction. The results of ongoing studies in other patient groups such as the ATMOSPHERE trial are awaited.

Hyper-X Engine Design and Ground Test Program

NASA Technical Reports Server (NTRS)

Voland, R. T.; Rock, K. E.; Huebner, L. D.; Witte, D. W.; Fischer, K. E.; McClinton, C. R.

1998-01-01

The Hyper-X Program, NASA's focused hypersonic technology program jointly run by NASA Langley and Dryden, is designed to move hypersonic, air-breathing vehicle technology from the laboratory environment to the flight environment, the last stage preceding prototype development. The Hyper-X research vehicle will provide the first ever opportunity to obtain data on an airframe integrated supersonic combustion ramjet propulsion system in flight, providing the first flight validation of wind tunnel, numerical and analytical methods used for design of these vehicles. A substantial portion of the integrated vehicle/engine flowpath development, engine systems verification and validation and flight test risk reduction efforts are experimentally based, including vehicle aeropropulsive force and moment database generation for flight control law development, and integrated vehicle/engine performance validation. The Mach 7 engine flowpath development tests have been completed, and effort is now shifting to engine controls, systems and performance verification and validation tests, as well as, additional flight test risk reduction tests. The engine wind tunnel tests required for these efforts range from tests of partial width engines in both small and large scramjet test facilities, to tests of the full flight engine on a vehicle simulator and tests of a complete flight vehicle in the Langley 8-Ft. High Temperature Tunnel. These tests will begin in the summer of 1998 and continue through 1999. The first flight test is planned for early 2000.

Involvement of Renal Corpuscle microRNA Expression on Epithelial-to-Mesenchymal Transition in Maternal Low Protein Diet in Adult Programmed Rats

PubMed Central

Sene, Letícia de Barros; Mesquita, Flávia Fernandes; de Moraes, Leonardo Nazário; Santos, Daniela Carvalho; Carvalho, Robson; Gontijo, José Antônio Rocha; Boer, Patrícia Aline

2013-01-01

Prior study shows that maternal protein-restricted (LP) 16-wk-old offspring have pronounced reduction of nephron number and arterial hypertension associated with unchanged glomerular filtration rate, besides enhanced glomerular area, which may be related to glomerular hyperfiltration/overflow and which accounts for the glomerular filtration barrier breakdown and early glomerulosclerosis. In the current study, LP rats showed heavy proteinuria associated with podocyte simplification and foot process effacement. TGF-β1 glomerular expression was significantly enhanced in LP. Isolated LP glomeruli show a reduced level of miR-200a, miR-141, miR-429 and ZEB2 mRNA and upregulated collagen 1α1/2 mRNA expression. By western blot analyzes of whole kidney tissue, we found significant reduction of both podocin and nephrin and enhanced expression of mesenchymal protein markers such as desmin, collagen type I and fibronectin. From our present knowledge, these are the first data showing renal miRNA modulation in the protein restriction model of fetal programming. The fetal-programmed adult offspring showed pronounced structural glomerular disorders with an accentuated and advanced stage of fibrosis, which led us to state that the glomerular miR-200 family would be downregulated by TGF-β1 action inducing ZEB 2 expression that may subsequently cause glomeruli epithelial-to-mesenchymal transition. PMID:23977013

78 FR 10135 - Fishing Capacity Reduction Program for the Longline Catcher Processor Subsector of the Bering Sea...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... reduction loan to finance the non-pollock groundfish fishing capacity reduction program. DATES: The non... finance reduction program costs. Subpart L of 50 CFR part 600 is the framework rule generally implementing... higher fee rate will be credited to future landings. Fee collection and submission shall follow...

Safer sex maintenance among gay men: are we making any progress?

PubMed

Ekstrand, M L

1992-08-01

Although early acquired immunodeficiency syndrome (AIDS) prevention programs produced dramatic reductions in unsafe sexual practices on the part of homosexual men, there is evidence that new behaviors have not been maintained consistently. Various cohort studies have related risky sex relapse to low self-efficacy, emotional depression, and relationship issues. Unprotected sex is widely perceived as more pleasurable than condom use and is likely to be practiced by gay men concerned with their partner's presumed preferences. This finding suggests a need to identify ways of increasing the pleasure associated with safe sex by eroticizing condom use. Approaches that include erotic descriptions of safe sex (e.g., pamphlets with explicit photographs, mass media campaigns that use sexually explicit language, and attractively packaged condoms) have been found to increase behavioral risk reduction practices. All interventions aimed at preventing risky sex relapse should be empirically based and delivered in a fashion acceptable to the homosexual community.

Unconscious agendas in the etiology of refractory obesity and the role of hypnosis in their identification and resolution: a new paradigm for weight-management programs or a paradigm revisited?

PubMed

Entwistle, Paul A; Webb, Richard J; Abayomi, Julie C; Johnson, Brian; Sparkes, Andrew C; Davies, Ian G

2014-01-01

Hypnosis has long been recognized as an effective tool for producing behavioral change in the eating disorders anorexia and bulimia. Despite many studies from the latter half of the last century suggesting that hypnosis might also be of value in managing obesity situations, the efficacy of hypnotherapy for weight reduction has received surprisingly little formal research attention since 2000. This review presents a brief history of early clinical studies using hypnosis for weight reduction and describes a hypnotherapeutic approach within which a combination of instructional/pedagogic and exploratory therapeutic sessions can work together synergistically to maximize the potential for sustained weight loss. Hypnotic modulation of appetite- and satiation-associated peptides and hormone levels may yield additional physiological benefits in Type 1 and Type 2 diabetes.

Integrated Pest Management: A Curriculum for Early Care and Education Programs

ERIC Educational Resources Information Center

California Childcare Health Program, 2011

2011-01-01

This "Integrated Pest Management Toolkit for Early Care and Education Programs" presents practical information about using integrated pest management (IPM) to prevent and manage pest problems in early care and education programs. This curriculum will help people in early care and education programs learn how to keep pests out of early…

34 CFR 303.1 - Purpose of the early intervention program for infants and toddlers with disabilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false Purpose of the early intervention program for infants... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES General Purpose and Applicable Regulations § 303.1 Purpose of the early intervention program for infants and toddlers with...

34 CFR 303.1 - Purpose of the early intervention program for infants and toddlers with disabilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Purpose of the early intervention program for infants... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES General Purpose, Eligibility, and Other General Provisions § 303.1 Purpose of the early intervention program for infants and...

34 CFR 303.1 - Purpose of the early intervention program for infants and toddlers with disabilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false Purpose of the early intervention program for infants... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES General Purpose and Applicable Regulations § 303.1 Purpose of the early intervention program for infants and toddlers with...

34 CFR 303.1 - Purpose of the early intervention program for infants and toddlers with disabilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Purpose of the early intervention program for infants... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES General Purpose, Eligibility, and Other General Provisions § 303.1 Purpose of the early intervention program for infants and...

34 CFR 303.1 - Purpose of the early intervention program for infants and toddlers with disabilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true Purpose of the early intervention program for infants... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES General Purpose and Applicable Regulations § 303.1 Purpose of the early intervention program for infants and toddlers with...

Supersonic Aerodynamic Design Improvements of an Arrow-Wing HSCT Configuration Using Nonlinear Point Design Methods

NASA Technical Reports Server (NTRS)

Unger, Eric R.; Hager, James O.; Agrawal, Shreekant

1999-01-01

This paper is a discussion of the supersonic nonlinear point design optimization efforts at McDonnell Douglas Aerospace under the High-Speed Research (HSR) program. The baseline for these optimization efforts has been the M2.4-7A configuration which represents an arrow-wing technology for the High-Speed Civil Transport (HSCT). Optimization work on this configuration began in early 1994 and continued into 1996. Initial work focused on optimization of the wing camber and twist on a wing/body configuration and reductions of 3.5 drag counts (Euler) were realized. The next phase of the optimization effort included fuselage camber along with the wing and a drag reduction of 5.0 counts was achieved. Including the effects of the nacelles and diverters into the optimization problem became the next focus where a reduction of 6.6 counts (Euler W/B/N/D) was eventually realized. The final two phases of the effort included a large set of constraints designed to make the final optimized configuration more realistic and they were successful albeit with a loss of performance.

Mechanisms of Risk Reduction in the Clinical Practice of Alzheimer’s Disease Prevention

PubMed Central

Schelke, Matthew W.; Attia, Peter; Palenchar, Daniel J.; Kaplan, Bob; Mureb, Monica; Ganzer, Christine A.; Scheyer, Olivia; Rahman, Aneela; Kachko, Robert; Krikorian, Robert; Mosconi, Lisa; Isaacson, Richard S.

2018-01-01

Alzheimer’s disease (AD) is a neurodegenerative dementia that affects nearly 50 million people worldwide and is a major source of morbidity, mortality, and healthcare expenditure. While there have been many attempts to develop disease-modifying therapies for late-onset AD, none have so far shown efficacy in humans. However, the long latency between the initial neuronal changes and onset of symptoms, the ability to identify patients at risk based on family history and genetic markers, and the emergence of AD biomarkers for preclinical disease suggests that early risk-reducing interventions may be able to decrease the incidence of, delay or prevent AD. In this review, we discuss six mechanisms—dysregulation of glucose metabolism, inflammation, oxidative stress, trophic factor release, amyloid burden, and calcium toxicity—involved in AD pathogenesis that offer promising targets for risk-reducing interventions. In addition, we offer a blueprint for a multi-modality AD risk reduction program that can be clinically implemented with the current state of knowledge. Focused risk reduction aimed at particular pathological factors may transform AD to a preventable disorder in select cases. PMID:29706884

Mechanisms of Risk Reduction in the Clinical Practice of Alzheimer's Disease Prevention.

PubMed

Schelke, Matthew W; Attia, Peter; Palenchar, Daniel J; Kaplan, Bob; Mureb, Monica; Ganzer, Christine A; Scheyer, Olivia; Rahman, Aneela; Kachko, Robert; Krikorian, Robert; Mosconi, Lisa; Isaacson, Richard S

2018-01-01

Alzheimer's disease (AD) is a neurodegenerative dementia that affects nearly 50 million people worldwide and is a major source of morbidity, mortality, and healthcare expenditure. While there have been many attempts to develop disease-modifying therapies for late-onset AD, none have so far shown efficacy in humans. However, the long latency between the initial neuronal changes and onset of symptoms, the ability to identify patients at risk based on family history and genetic markers, and the emergence of AD biomarkers for preclinical disease suggests that early risk-reducing interventions may be able to decrease the incidence of, delay or prevent AD. In this review, we discuss six mechanisms-dysregulation of glucose metabolism, inflammation, oxidative stress, trophic factor release, amyloid burden, and calcium toxicity-involved in AD pathogenesis that offer promising targets for risk-reducing interventions. In addition, we offer a blueprint for a multi-modality AD risk reduction program that can be clinically implemented with the current state of knowledge. Focused risk reduction aimed at particular pathological factors may transform AD to a preventable disorder in select cases.

Psychiatric Disability in Law Enforcement Officers.

PubMed

Price, Marilyn

2017-03-01

Law enforcement officers all across the world are exposed to violence, confrontation, and traumatic incidents. They regularly witness death and suffering and are at risk of personal injury. Psychiatric sequelae include an increased risk for trauma-related symptoms, depression, alcohol-use disorders, and stress-related medical conditions. Law enforcement officers have been applying for early disability retirement pensions at an increased rate for stress-related psychiatric and medical conditions. As a result, law enforcement agencies are prematurely losing valuable resources, officers with training and experience. Departments have become proactive in trying to address mental health issues to prevent psychiatric disability by implementing employee wellness plans and stress reduction interventions. Programs have been developed to mitigate the effects of stress on law enforcement personnel. Many law enforcement agencies have developed strategies to encourage early confidential referral for psychiatric treatment. They utilize peer support groups and employee assistance programs and develop alliances with mental health professionals. When these approaches fail, a fitness for duty process can be used to identify impairment in work functioning due to psychiatric factors with the prospect of later returning the officer to full duty. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Early efforts of blacks in the fight against heart disease and stroke.

PubMed Central

Haywood, L. J.

1999-01-01

This article highlighted the early efforts of some individuals whose vision and dedication helped to set the stage for later progress in the fight against heart disease, who forged links to those who eagerly took up the cause of creating an appropriate place for minority participation in the specialty of cardiovascular diseases, and to contribute to efforts to establish programs for the reduction of morbidity and mortality and for prevention in African Americans. This is only one view of what was an exciting period of fitful progress and controversy. Dr Wilson reviewed the still deplorable state of affairs in regard to minorities and the medical profession in 1986, stating: A meaningful role for minorities will not exist until there is access to academic postgraduate training programs that will lead to faculty positions and research opportunities for minorities to serve as role models for future students. The Association of Academic Minority Physicians was established to foster greater progress in this regard across disciplines. Again, while much has been accomplished, including Donald Wilson's becoming the first African-American dean of a nonminority medical school, much remains to be done as we approach the end of the 20th century. PMID:10628126

Comprehensive Early Stimulation Program for Infants. Instruction Manual [and] Early Interventionist's Workbook [and] Parent/Caregiver Workbook. William Beaumont Hospital Speech and Language Pathology Series.

ERIC Educational Resources Information Center

Santana, Altagracia A.; Bottino, Patti M.

This early intervention kit includes a Comprehensive Early Stimulation Program for Infants (CESPI) instruction manual, an early interventionist workbook, and ten parent/caregiver workbooks. The CESPI early intervention program is designed to provide therapists, teachers, other health professionals, and parents with a common-sense, practical guide…

Healthy Start: a comprehensive health education program for preschool children.

PubMed

Williams, C L; Squillace, M M; Bollella, M C; Brotanek, J; Campanaro, L; D'Agostino, C; Pfau, J; Sprance, L; Strobino, B A; Spark, A; Boccio, L

1998-01-01

Healthy Start is a 3-year demonstration and education research project designed to evaluate the effectiveness of a multidimensional cardiovascular (CV) risk reduction intervention in preschool centers over a 3-year period of time. Two primary interventions are employed. The first is the preschool food service intervention program designed to reduce the total fat in preschool meals and snacks to less than 30% of calories and reduce the saturated fat to less than 10% of calories. The second major intervention is a comprehensive preschool health education curriculum, focused heavily on nutrition. Effectiveness of the intervention will be determined through evaluation of changes in dietary intake of preschool children at school meals and snacks, especially with respect to intake of total and saturated fat. Evaluation of the education component will include assessment of program implementation by teachers, assessment of changes in nutrition knowledge by preschool children, and assessment of changes in home meals that children consume (total and saturated fat content). Blood cholesterol will be evaluated semiannually to evaluate changes that may be due to modification of dietary intake. Growth and body fatness will also be assessed. While substantial efforts have targeted CV risk reduction and health education for elementary school children, similar efforts aimed at preschool children have been lacking. The rationale for beginning CV risk reduction programs for preschool children is based upon the premise that risk factors for heart disease are prevalent by 3 years of age and tend to track over time, most commonly hypercholesterolemia and obesity, both related to nutrition. Since the behavioral antecedents for nutritional risk factors begin to be established very early in life, it is important to develop and evaluate new educational initiatives such as Healthy Start, aimed at the primary prevention of cardiovascular risk factors in preschool children. The purpose of this publication is to describe the rationale and methods for the Healthy Start project.

Effect of natural windbreaks on drift reduction in orchard spraying.

PubMed

Wenneker, M; Heijne, B; van de Zande, J C

2005-01-01

In the Netherlands windbreaks are commonly grown to protect orchards against wind damage and to improve micro-climate. Natural windbreaks of broad-leaved trees can also reduce the risk of surface water contamination caused by spray drift during orchard spraying. Spray drift from pesticide applications is a major concern in the Netherlands, especially drift into water courses. So far, several drift reducing measures have been accepted by water quality control organisations and the Board for the Authorization of Pesticides (CTB), e.g. presence of a windbreak (i.e. 70% drift reduction at early season and 90% drift reduction at full leaf, respectively before and after first of May). From the experiments it was concluded that the risk of drift contamination is high during the early developmental stages of the growing season. The 70% drift reduction at early season as determined in previous experiments, appears to be valid only for windbreaks with a certain degree of developed leaves. At full leaf stage 80-90% drift reduction by the windbreak was measured. The use of evergreen windbreaks or wind-break species that develop in early season can reduce the risk of drift contamination considerably. Also, the combination of drift reducing methods, such as one-sided spraying of the last tree row and a windbreak is an effective method to reduce spray drift in the Netherlands in early season.

Online-data Bases On Natural-hazard Research, Early-warning Systems and Operative Disaster Prevention Programs

NASA Astrophysics Data System (ADS)

Hermanns, R. L.; Zentel, K.-O.; Wenzel, F.; Hövel, M.; Hesse, A.

In order to benefit from synergies and to avoid replication in the field of disaster re- duction programs and related scientific projects it is important to create an overview on the state of art, the fields of activity and their key aspects. Therefore, the German Committee for Disaster Reduction intends to document projects and institution related to natural disaster prevention in three databases. One database is designed to docu- ment scientific programs and projects related to natural hazards. In a first step data acquisition concentrated on projects carried out by German institutions. In a second step projects from all other European countries will be archived. The second database focuses on projects on early-warning systems and has no regional limit. Data mining started in November 2001 and will be finished soon. The third database documents op- erational projects dealing with disaster prevention and concentrates on international projects or internationally funded projects. These databases will be available on the internet end of spring 2002 (http://www.dkkv.org) and will be updated continuously. They will allow rapid and concise information on various international projects, pro- vide up-to-date descriptions, and facilitate exchange as all relevant information in- cluding contact addresses are available to the public. The aim of this contribution is to present concepts and the work done so far, to invite participation, and to contact other organizations with similar objectives.

The Mother and Infant Home Visiting Program Evaluation: Early Findings on the Maternal, Infant, and Early Childhood Home Visiting Program. A Report to Congress. OPRE Report 2015-11

ERIC Educational Resources Information Center

Michalopoulos, Charles; Lee, Helen; Duggan, Anne; Lundquist, Erika; Tso, Ada; Crowne, Sarah Shea; Burrell, Lori; Somers, Jennifer; Filene, Jill H.; Knox, Virginia

2015-01-01

"The Mother and Infant Home Visiting Program Evaluation: Early Findings on the Maternal, Infant, and Early Childhood Home Visiting Program--A Report to Congress" presents the first findings from the Mother and Infant Home Visiting Program Evaluation (MIHOPE), the legislatively mandated national evaluation of the Maternal, Infant, and…

Early mobilization: Why, what for and how?

PubMed

Miranda Rocha, A R; Martinez, B P; Maldaner da Silva, V Z; Forgiarini Junior, L A

2017-10-01

Early mobilization strategies in the intensive care unit may result in the prevention and reduction of polyneuromyopathy in the critical patient, improved quality of life, shortened ICU and hospital stay, and lesser mortality during hospitalization. However, it is well known that factors such as the protocol used, the population included in the studies, the timing of the strategy, the severity of the patients and different barriers directly influence the outcomes. This study examines the main protocols described in the literature and their associated results. The main techniques used were kinesitherapy, transfer and locomotion training, as well as neuromuscular electrical stimulation and cycle ergometry. Although two trials and a meta-analysis found no positive results with mobilization, programs that focus on specific populations, such as patients with weakness due to immobility and with preserved neuromuscular excitability can derive more positive effects from such treatment. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Intergenerational Transmission of Religious Beliefs and Practices and the Reduction of Adolescent Delinquency in Urban Thailand

PubMed Central

Chamratrithirong, Aphichat; Miller, Brenda A.; Byrnes, Hilary F.; Rhucharoenpornpanich, Orratai; Cupp, Pamela K.; Rosati, Michael J.; Fongkaew, Warunee; Atwood, Katharine A.; Todd, Michael

2012-01-01

This study examines the intergenerational transmission of family religion as measured by parent’s and adolescent’s beliefs and practices in Buddhism, and its relation to delinquent behaviors among early adolescents in Thailand. The data set is from the Thai Family Matters Project 2007, a representative sample of 420 pairs of parents and teens in Bangkok. A structural equation model is employed for the analysis. The intergenerational transmission and the direct and indirect association between parents’ and adolescents’ beliefs and practices in Buddhism and adolescents’ minor and serious delinquent behaviors are revealed to be significant, controlling for secular parental monitoring. Spirituality within the family can play an important role in preventing delinquency among early adolescents. Policies in the areas related to family empowerment and delinquency prevention may need to consider integrating both secular and non-secular program inputs in their implementation design. PMID:23218782

A Perinatal Intervention Program for Urban American Indians Part 1: Design, Implementation, and Outcomes

PubMed Central

Davis, Carol L.; Prater, Sandra L.

2001-01-01

High infant mortality rates among American Indians are disproportionate to state statistics for other races and higher than the national average. These findings prompted a community health center in a large Midwestern city to create and provide an American Indian infant mortality reduction project in the early 1990s. Strategies for program implementation included networking with local organizations, communicating with reservation health clinics throughout the state, educating American Indian mothers and their community about factors contributing to American Indian infant mortality, and providing individual case management to American Indian women and infants. We offer this article for three reasons: This grant project was successful, disparity in rates of infant mortality among peoples of color continues, and a paucity of information exists about the health behaviors of American Indian women. PMID:17273261

The Cost of Inequality: The Importance of Investing in High Quality Early Childhood Education Programs

ERIC Educational Resources Information Center

Keith, Rebecca S.

2017-01-01

The focus of this dissertation was to explore the importance of high quality early education in later secondary education development, quantifying quality in early childhood education programs, and examining how teacher education contributes to quality of early childhood education programs. For phase I, early childhood education positively…

77 FR 16551 - Early Retiree Reinsurance Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-21

...] Early Retiree Reinsurance Program AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. SUMMARY: This notice establishes a timeframe by which plan sponsors participating in the Early... Early Retiree Reinsurance Program (ERRP) which provides reimbursement to eligible sponsors of employment...

Impact of programming strategies aimed at reducing nonessential implantable cardioverter defibrillator therapies on mortality: a systematic review and meta-analysis.

PubMed

Tan, Vern Hsen; Wilton, Stephen B; Kuriachan, Vikas; Sumner, Glen L; Exner, Derek V

2014-02-01

Patients who receive implantable cardioverter defibrillator therapies are at higher risk of death versus those who do not. Programmed settings to reduce nonessential implantable cardioverter defibrillator therapies (therapy reduction programming) have been developed but may have adverse effects. This systematic review and meta-analysis assessed the relationship between therapy reduction programming with the risks of death from any cause, implantable cardioverter defibrillator shocks, and syncope. MEDLINE, EMBASE, and clinicaltrials.gov databases were searched to identify relevant studies. Those that followed patients for ≥6 months and reported mortality were included. Six met the inclusion criteria; 4 randomized (Comparison of Empiric to Physician-Tailored Programming of ICDs [EMPIRIC], Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy [MADIT-RIT], Avoid Delivering Therapies for Non-sustained Arrhythmias in ICD Patients III [ADVANCE III], and Programming Implantable Cardioverter-Defibrillators in Patients with Primary Prevention Indication to Prolong Time to First Shock [PROVIDE]) and 2 prospective studies (Role of Long Detection Window Programming in Patients With Left Ventricular Dysfunction, Non-ischemic Etiology in Primary Prevention Treated with a Biventricular ICD [RELEVANT] and Primary Prevention Parameters Evaluation [PREPARE]). These 6 studies included 7687 (3598 conventional and 4089 therapy reduction programming) patients. Most (77%) participants were men, had a history of ischemic heart disease (56%), and were prescribed β-blockers (84%). Therapy reduction programming was associated with a 30% relative reduction in mortality (95% confidence interval, 16%-41%; P<0.001). No significant heterogeneity among studies was observed (P=0.6). A similar 26% reduction in mortality was observed when only the 4 randomized trials were included (95% confidence interval, 11%-40%; P=0.002). These results were not significantly altered after adjustment for baseline characteristics. No significant difference in the risk of syncope was observed with conventional versus therapy reduction programming (P=0.5). Therapy reduction programming results in a large, significant, and consistent reduction in mortality, with no apparent increase in the risk of syncope.

The NIE Home-Based Early Education Program.

ERIC Educational Resources Information Center

Gruskin, Susan

The initial plans for the National Institute of Education (NIE) program in early childhood education are described. The first part of the document contains a discussion of the relationship between planned NIE programs and existing early childhood federal programs. In both planned and existing programs, disadvantaged children are the primary…

76 FR 40320 - Risk Reduction Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-08

... identifying and analyzing applicable hazards and (2) develops plans to mitigate that risk. Each RRP is...-2009-0038] RIN 2130-AC11 Risk Reduction Program AGENCY: Federal Railroad Administration (FRA... certain railroads to develop a Risk Reduction Program (RRP). The Rail Safety Improvement Act of 2008...

The Envy of Scholars: Applying the Lessons of the Framingham Heart Study to the Prevention of Chronic Kidney Disease.

PubMed

Wasser, Walter G; Gil, Amnon; Skorecki, Karl L

2015-07-30

During the past 50 years, a dramatic reduction in the mortality rate associated with cardiovascular disease has occurred in the US and other countries. Statistical modeling has revealed that approximately half of this reduction is the result of risk factor mitigation. The successful identification of such risk factors was pioneered and has continued with the Framingham Heart Study, which began in 1949 as a project of the US National Heart Institute (now part of the National Heart, Lung, and Blood Institute). Decreases in total cholesterol, blood pressure, smoking, and physical inactivity account for 24%, 20%, 12%, and 5% reductions in the mortality rate, respectively. Nephrology was designated as a recognized medical professional specialty a few years later. Hemodialysis was first performed in 1943. The US Medicare End-Stage Renal Disease (ESRD) Program was established in 1972. The number of patients in the program increased from 5,000 in the first year to more than 500,000 in recent years. Only recently have efforts for risk factor identification, early diagnosis, and prevention of chronic kidney disease (CKD) been undertaken. By applying the approach of the Framingham Heart Study to address CKD risk factors, we hope to mirror the success of cardiology; we aim to prevent progression to ESRD and to avoid the cardiovascular complications associated with CKD. In this paper, we present conceptual examples of risk factor modification for CKD, in the setting of this historical framework.

Early rehabilitation programs after laparoscopic colorectal surgery: Evidence and criticism

PubMed Central

Kim, Duck-Woo; Kang, Sung-Bum; Lee, Soo-Young; Oh, Heung-Kwon; In, Myung-Hoon

2013-01-01

During the past several decades, early rehabilitation programs for the care of patients with colorectal surgery have gained popularity. Several randomized controlled trials and meta-analyses have confirmed that the implementation of these evidence-based detailed perioperative care protocols is useful for early recovery of patients after colorectal resection. Patients cared for based on these protocols had a rapid recovery of bowel movement, shortened length of hospital stay, and fewer complications compared with traditional care programs. However, most of the previous evidence was obtained from studies of early rehabilitation programs adapted to open colonic resection. Currently, limited evidence exists on the effects of early rehabilitation after laparoscopic rectal resection, although this procedure seems to be associated with a higher morbidity than that reported with traditional care. In this article, we review previous studies and guidelines on early rehabilitation programs in patients undergoing rectal surgery. We investigated the status of early rehabilitation programs in rectal surgery and analyzed the limitations of these studies. We also summarized indications and detailed protocol components of current early rehabilitation programs after rectal surgery, focusing on laparoscopic resection. PMID:24379571

Real-time earthquake data feasible

NASA Astrophysics Data System (ADS)

Bush, Susan

Scientists agree that early warning devices and monitoring of both Hurricane Hugo and the Mt. Pinatubo volcanic eruption saved thousands of lives. What would it take to develop this sort of early warning and monitoring system for earthquake activity?Not all that much, claims a panel assigned to study the feasibility, costs, and technology needed to establish a real-time earthquake monitoring (RTEM) system. The panel, drafted by the National Academy of Science's Committee on Seismology, has presented its findings in Real-Time Earthquake Monitoring. The recently released report states that “present technology is entirely capable of recording and processing data so as to provide real-time information, enabling people to mitigate somewhat the earthquake disaster.” RTEM systems would consist of two parts—an early warning system that would give a few seconds warning before severe shaking, and immediate postquake information within minutes of the quake that would give actual measurements of the magnitude. At this time, however, this type of warning system has not been addressed at the national level for the United States and is not included in the National Earthquake Hazard Reduction Program, according to the report.

77 FR 31587 - Fishing Capacity Reduction Program for the Pacific Coast Groundfish Fishery

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-29

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC048 Fishing Capacity Reduction Program for the Pacific Coast Groundfish Fishery AGENCY: National Marine Fisheries...-loan in the fishing capacity reduction program for the Pacific Coast Groundfish Fishery has been repaid...

77 FR 55191 - Fishing Capacity Reduction Program for the Pacific Coast Groundfish Fishery

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC219 Fishing Capacity Reduction Program for the Pacific Coast Groundfish Fishery AGENCY: National Marine Fisheries... sub-loan in the fishing capacity reduction program for the Pacific Coast Groundfish Fishery has been...

Social Diffusion of Water Conservation: A Study of Residential Turf Rebate Programs in Orange County, California

NASA Astrophysics Data System (ADS)

Duong, K.; Grant, S. B.; Rippy, M.; Feldman, D.

2017-12-01

From 2011 to 2017, the combination of record low precipitation and extreme warm temperatures resulted in the most severe drought in California's written history. In April 2015, Governor Jerry Brown issued an executive order mandating a statewide 25% reduction in potable urban water usage. Under such circumstances, outdoor watering is an obvious target for restriction, because it can account for a large fraction of total domestic water usage, up to 50% in the arid southwest [Syme et. al 2004, Cameron et. al 2012]. In this study we analyzed one such effort, in which the Irvine Ranch Water District (IRWD) in Orange County (California) offered a financial incentive through a turf rebate program to encourage Irvine residents to replace turf grass with drought tolerant landscaping. We focused specifically on the number of residents who applied to the turf rebate program. Our hypothesis was that the observed application rate (number of applicants per month) is influenced by a combination of (a) financial incentives issued by IRWD, (b) drought awareness, and (c) the fraction of neighbors that have already applied to the program (a phenomenon that can be described quantitatively through models of social contagion or social diffusion [Karsai et. al 2014]). Our preliminary results indicate that applications to the program occurred in geographic "hot spots", consistent with the idea that early adopters may have influenced neighbors to retrofit their lawns. We are currently evaluating the geographic, demographic, and temporal drivers that influence the rate of spontaneous adoption, the rate of adoption under influence, and the total size of the susceptible population. Overall, our goal is to identify the key factors that contribute to early rapid uptake of conservation behavior, and the rapid diffusion of that behavior through the community.

A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries

PubMed Central

2012-01-01

Background Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. Methods/Design This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. Discussion The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. Trial registration ACTRN12612000712808 PMID:22909327

Impact of antiretroviral therapy (ART) timing on chronic immune activation/inflammation and end-organ damage.

PubMed

Rajasuriar, Reena; Wright, Edwina; Lewin, Sharon R

2015-01-01

The purpose of this review was to summarize recent studies on the effect of early antiretroviral therapy (ART) in HIV-infected patients on markers of immune activation/inflammation, viral persistence and serious non-AIDS events. Early ART, initiated within days to months of HIV infection, was associated with marked reduction in T-cell activation often reaching levels observed in HIV-uninfected individuals. However, the impact of early ART on markers of innate immune activation, microbial translocation and inflammation/coagulation was less clear. Early ART has also been associated with a significant reduction in the frequency of latently infected cells, which was greater if ART was initiated within days to weeks rather than months following infection. However, few studies have evaluated the relationship between immune activation and viral reservoirs, specifically following early ART. Early ART may potentially reduce serious non-AIDS events and associated mortality, but most of these studies have extrapolated from changes in surrogate markers, such as CD4 : CD8 ratio. Early ART was associated with beneficial effects on multiple markers of immune activation, inflammation and viral persistence. Longer term prospective studies are still needed to determine whether early ART translates to a significant reduction in serious non-AIDS events and mortality.

77 FR 13343 - Pilot Program for Early Feasibility Study Investigational Device Exemption Applications...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-06

...] Pilot Program for Early Feasibility Study Investigational Device Exemption Applications; Termination of... acceptance of nominations for the Early Feasibility Study Investigational Device Exemption (IDE) Applications... technologies to participate in a pilot program for early feasibility study IDE applications. FDA is also...

34 CFR 303.11 - Early intervention service program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true Early intervention service program. 303.11 Section 303... EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES General Definitions Used in This Part § 303.11 Early intervention service...

34 CFR 303.11 - Early intervention service program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false Early intervention service program. 303.11 Section 303... EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES General Definitions Used in This Part § 303.11 Early intervention service...

34 CFR 303.11 - Early intervention service program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false Early intervention service program. 303.11 Section 303... EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES General Definitions Used in This Part § 303.11 Early intervention service...

Remediation of Childhood Math Anxiety and Associated Neural Circuits through Cognitive Tutoring

PubMed Central

Iuculano, Teresa; Chen, Lang

2015-01-01

Math anxiety is a negative emotional reaction that is characterized by feelings of stress and anxiety in situations involving mathematical problem solving. High math-anxious individuals tend to avoid situations involving mathematics and are less likely to pursue science, technology, engineering, and math-related careers than those with low math anxiety. Math anxiety during childhood, in particular, has adverse long-term consequences for academic and professional success. Identifying cognitive interventions and brain mechanisms by which math anxiety can be ameliorated in children is therefore critical. Here we investigate whether an intensive 8 week one-to-one cognitive tutoring program designed to improve mathematical skills reduces childhood math anxiety, and we identify the neurobiological mechanisms by which math anxiety can be reduced in affected children. Forty-six children in grade 3, a critical early-onset period for math anxiety, participated in the cognitive tutoring program. High math-anxious children showed a significant reduction in math anxiety after tutoring. Remarkably, tutoring remediated aberrant functional responses and connectivity in emotion-related circuits anchored in the basolateral amygdala. Crucially, children with greater tutoring-induced decreases in amygdala reactivity had larger reductions in math anxiety. Our study demonstrates that sustained exposure to mathematical stimuli can reduce math anxiety and highlights the key role of the amygdala in this process. Our findings are consistent with models of exposure-based therapy for anxiety disorders and have the potential to inform the early treatment of a disability that, if left untreated in childhood, can lead to significant lifelong educational and socioeconomic consequences in affected individuals. SIGNIFICANCE STATEMENT Math anxiety during early childhood has adverse long-term consequences for academic and professional success. It is therefore important to identify ways to alleviate math anxiety in young children. Surprisingly, there have been no studies of cognitive interventions and the underlying neurobiological mechanisms by which math anxiety can be ameliorated in young children. Here, we demonstrate that intensive 8 week one-to-one cognitive tutoring not only reduces math anxiety but also remarkably remediates aberrant functional responses and connectivity in emotion-related circuits anchored in the amygdala. Our findings are likely to propel new ways of thinking about early treatment of a disability that has significant implications for improving each individual's academic and professional chances of success in today's technological society that increasingly demands strong quantitative skills. PMID:26354922

77 FR 26744 - Fishing Capacity Reduction Program for the Southeast Alaska Purse Seine Salmon Fishery

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... Capacity Reduction Program for the Southeast Alaska Purse Seine Salmon Fishery AGENCY: National Marine... of reduction payment tender of Southeast Alaska purse seine salmon permits. SUMMARY: The National... Southeast Alaska purse seine salmon fishery. The program authorizes NMFS to make payments to permit holders...

Developing and Implementing an Early Retirement Incentive Program for Marin County School Districts. Vol. 1 and 2.

ERIC Educational Resources Information Center

Mauzy, Byron W.

In creating an early retirement incentive program for the Marin County (California) schools, the author examined the early retirement ethic, other early retirement plans in the public and private sectors, the impact of early retirement on Social Security benefits, opposition to such programs, and the factors in the California school districts that…

What Is Quality Preschool? Fact Sheet

ERIC Educational Resources Information Center

Advocates for Children of New Jersey, 2010

2010-01-01

Children need quality early learning programs. This can be a child care center, a preschool or a Head Start program. Not all early learning programs provide the high quality children need. This paper presents questions that should be considered when looking for an early learning program.

78 FR 53150 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... and Services Administration Advisory Committee on the Maternal, Infant and Early Childhood Home... Maternal, Infant and Early Childhood Home Visiting Program Evaluation (MIECHVE). Authority: Section 10(a)(2... meeting: Name: Advisory Committee on the Maternal, Infant, and Early Childhood Home Visiting Program...

Early Childhood Education: A Workbook for Administrators.

ERIC Educational Resources Information Center

Hewes, Dorothy; Hartman, Barbara

Business management theory and principles as applied to the administration of early childhood programs are presented in this workbook. Following a brief survey of the historical background of early childhood education and current early childhood programs, information and guidance to help plan, operate, and evaluate program facilities are provided.…

Early Childhood Program Participation, Results from the National Household Education Surveys Program of 2016. First Look. NCES 2017-101

ERIC Educational Resources Information Center

Corcoran, Lisa; Steinley, Katrina

2017-01-01

This report presents findings from the Early Childhood Program Participation Survey of the National Household Education Surveys Program of 2016 (NHES:2016). The Early Childhood Program Participation Survey collected data on children's participation in relative care, nonrelative care, and center-based care arrangements. It also collected…

Reducing Maladaptive Behaviors in Preschool-Aged Children with Autism Spectrum Disorder Using the Early Start Denver Model

PubMed Central

Fulton, Elizabeth; Eapen, Valsamma; Črnčec, Rudi; Walter, Amelia; Rogers, Sally

2014-01-01

The presence of maladaptive behaviors in young people with autism spectrum disorder (ASD) can significantly limit engagement in treatment programs, as well as compromise future educational and vocational opportunities. This study aimed to explore whether the Early Start Denver Model (ESDM) treatment approach reduced maladaptive behaviors in preschool-aged children with ASD in a community-based long day care setting. The level of maladaptive behavior of 38 children with ASD was rated using an observation-based measure on three occasions during the intervention: on entry, 12 weeks post-entry, and on exit (post-intervention) over an average treatment duration of 11.8 months. Significant reductions were found in children’s maladaptive behaviors over the course of the intervention, with 68% of children showing a treatment response by 12 weeks and 79% on exit. This change was accompanied by improvement in children’s overall developmental level as assessed by the Mullen scales of early learning, but not by significant changes on the Vineland Adaptive Behavior Scales-II or Social Communication Questionnaire. Replication with a larger sample, control conditions, and additional measures of maladaptive behavior is necessary in order to determine the specific factors underlying these improvements; however, the findings of the present study suggest that the ESDM program may be effective in improving not only core developmental domains, but also decreasing maladaptive behaviors in preschool-aged children with ASD. PMID:24847474

Workshop on Jet Exhaust Noise Reduction for Tactical Aircraft - NASA Perspective

NASA Technical Reports Server (NTRS)

Huff, Dennis L.; Henderson, Brenda S.

2007-01-01

Jet noise from supersonic, high performance aircraft is a significant problem for takeoff and landing operations near air bases and aircraft carriers. As newer aircraft with higher thrust and performance are introduced, the noise tends to increase due to higher jet exhaust velocities. Jet noise has been a subject of research for over 55 years. Commercial subsonic aircraft benefit from changes to the engine cycle that reduce the exhaust velocities and result in significant noise reduction. Most of the research programs over the past few decades have concentrated on commercial aircraft. Progress has been made by introducing new engines with design features that reduce the noise. NASA has recently started a new program called "Fundamental Aeronautics" where three projects (subsonic fixed wing, subsonic rotary wing, and supersonics) address aircraft noise. For the supersonics project, a primary goal is to understand the underlying physics associated with jet noise so that improved noise prediction tools and noise reduction methods can be developed for a wide range of applications. Highlights from the supersonics project are presented including prediction methods for broadband shock noise, flow measurement methods, and noise reduction methods. Realistic expectations are presented based on past history that indicates significant jet noise reduction cannot be achieved without major changes to the engine cycle. NASA s past experience shows a few EPNdB (effective perceived noise level in decibels) can be achieved using low noise design features such as chevron nozzles. Minimal thrust loss can be expected with these nozzles (< 0.5%) and they may be retrofitted on existing engines. In the long term, it is desirable to use variable cycle engines that can be optimized for lower jet noise during takeoff operations and higher thrust for operational performance. It is also suggested that noise experts be included early in the design process for engine nozzle systems to participate in decisions that may impact the jet noise.

Using the Internet to deliver health care value.

PubMed

MacStravic, S

2001-01-01

Beyond the popular uses of the Internet by HCOs--for recruiting employees, purchasing supplies and promoting brand and service awareness--lie a host of opportunities to add value to consumers online. All HCO programs can be enhanced through online initiatives: wellness and health promotion, risk reduction, prevention, early detection, symptom management, life event management, acute treatment and rehabilitation, disease management and end-of-life improvement. And beyond online initiatives in each of these categories lies the potential to use the Net for reminding consumers, individually and collectively, of the health and quality of life benefits they are gaining, thereby adding to the HCO's marketing and PR success.

Families Matter! Presexual Risk Prevention Intervention

PubMed Central

Lasswell, Sarah M.; Riley, Drewallyn B.; Poulsen, Melissa N.

2013-01-01

Parent-based HIV prevention programming may play an important role in reaching youths early to help establish lifelong patterns of safe and healthy sexual behaviors. Families Matter! is a 5-session, evidence-based behavioral intervention designed for primary caregivers of children aged 9 to 12 years to promote positive parenting and effective parent–child communication about sexuality and sexual risk reduction. The program’s 5-step capacity-building model was implemented with local government, community, and faith-based partners in 8 sub-Saharan African countries with good intervention fidelity and high levels of participant retention. Families Matter! may be useful in other resource-constrained settings. PMID:24028229

75 FR 33570 - Magnuson-Stevens Act Provisions; Fishing Capacity Reduction Framework

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

.... 100330171-0232-01] RIN 0648-AY79 Magnuson-Stevens Act Provisions; Fishing Capacity Reduction Framework... regulations specifying procedures for implementing fishing capacity reduction programs (reduction programs) in... either to surrender their fishing permits including relevant fishing histories for that fishery, or...

Early life adversities or high fat diet intake reduce cognitive function and alter BDNF signaling in adult rats: Interplay of these factors changes these effects.

PubMed

Arcego, Danusa Mar; Krolow, Rachel; Lampert, Carine; Toniazzo, Ana Paula; Berlitz, Carolina; Lazzaretti, Camilla; Schmitz, Felipe; Rodrigues, André Felipe; Wyse, Angela T S; Dalmaz, Carla

2016-05-01

Environmental factors, like early exposure to stressors or high caloric diets, can alter the early programming of central nervous system, leading to long-term effects on cognitive function, increased vulnerability to cognitive decline and development of psychopathologies later in life. The interaction between these factors and their combined effects on brain structure and function are still not completely understood. In this study, we evaluated long-term effects of social isolation in the prepubertal period, with or without chronic high fat diet access, on memory and on neurochemical markers in the prefrontal cortex of rats. We observed that early social isolation led to impairment in short-term and working memory in adulthood, and to reductions of Na(+),K(+)-ATPase activity and the immunocontent of phospho-AKT, in prefrontal cortex. Chronic exposure to a high fat diet impaired short-term memory (object recognition), and decreased BDNF levels in that same brain area. Remarkably, the association of social isolation with chronic high fat diet rescued the memory impairment on the object recognition test, as well as the changes in BDNF levels, Na(+),K(+)-ATPase activity, MAPK, AKT and phospho-AKT to levels similar to the control-chow group. In summary, these findings showed that a brief social isolation period and access to a high fat diet during a sensitive developmental period might cause memory deficits in adulthood. On the other hand, the interplay between isolation and high fat diet access caused a different brain programming, preventing some of the effects observed when these factors are separately applied. Copyright © 2016 ISDN. Published by Elsevier Ltd. All rights reserved.

Impact of a Web-based worksite health promotion program on absenteeism.

PubMed

Niessen, Maurice A J; Kraaijenhagen, Roderik A; Dijkgraaf, Marcel G W; Van Pelt, Danielle; Van Kalken, Coen K; Peek, Niels

2012-04-01

To evaluate the effect of participation in a comprehensive, Web-based worksite health promotion program on absenteeism. Study population consists of Dutch workers employed at a large financial services company. Linear regression was used to assess the impact of program attendance on the difference between baseline and follow-up absenteeism rates, controlling for gender, age, job level, years of employment, and noncompletion of the program. Data from 20,797 individuals were analyzed; 3826 individuals enrolled in the program during the study period. A 20.3% reduction in absenteeism was shown among program attendees compared with nonparticipants during a median follow-up period of 23.3 months. Participating in the worksite health promotion program led to an immediate reduction in absenteeism. Improved psychological well-being, increased exercise, and weight reduction are possible pathways toward this reduction.

76 FR 12978 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-09

... Administration for Children and Families Advisory Committee on the Maternal, Infant and Early Childhood Home...: Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation. Date and... and Early Childhood Home Visiting Program Evaluation will meet for its first session on Wednesday...

From Preschool to Prosperity: The Economic Payoff to Early Childhood Education. WE Focus Series

ERIC Educational Resources Information Center

Bartik, Timothy J.

2014-01-01

This book is the author's second book on preschool. His first book, "Investing in Kids: Early Childhood Programs and Local Economic Development" (2011), explored the connection between early childhood programs and the economic development of American states and metro areas, and compared early childhood programs with business tax…

Improving Early Reading: A Resource Guide for Elementary Schools.

ERIC Educational Resources Information Center

St. John, Edward P.; Loescher, Siri Ann

Indiana's Early Intervention Grant Program (EIGP) provides funding for Reading Recovery and other early interventions focused on improvement in early reading programs (Grades 1-5). This resource guide provides information that schools in Indiana can use to plan for proposals for EIGP and other grant programs, such as comprehensive school reform…

Estimating the Cost and Effect of Early Intervention on In-Patient Admission in First Episode Psychosis.

PubMed

Behan, Caragh; Cullinan, John; Kennelly, Brendan; Turner, Niall; Owens, Elizabeth; Lau, Adam; Kinsella, Anthony; Clarke, Mary

2015-06-01

Early intervention in psychosis is an accepted policy internationally. When 'A Vision for Change', the national blueprint for mental health policy in Ireland, was published in 2007 there was one Irish pilot service for early intervention in psychosis. The National Clinical Mental Health Programme Plan (2011) identified early intervention in psychosis as one of three areas for roll out nationally. There is limited economic evaluation in the field of mental health in Ireland to guide service development. This is in part due to lack of robust patient level data. The aim of the study was to investigate whether the introduction of an early intervention service in psychosis resulted in any change to the number and duration of admissions in people with first-episode psychosis. We examined two prospective epidemiological cohorts of individuals presenting with first-episode psychosis to an urban community mental health service (population 172,000). The historical cohort comprised of individuals presenting from 1995 to 1998 and received treatment as usual (n=132). The early intervention cohort presented to the same catchment area between 2008 and 2011 (n=97) following the introduction of an early intervention service in 2005. We found significant reductions in the rates admitted for treatment across the two time periods. Reduction in the rate of admission was larger in this catchment than the reduction in the rate of admission in the country as a whole. There were significant reductions in the duration of untreated psychosis arising from the early intervention programme. Significant reductions in length of stay were accounted for by differences in baseline age and marital status. The average cost of admission declined from 15,821 to 9,398 in the early intervention cohort. The comparison pre and post early intervention service showed cost savings consistent with other studies internationally. Key issues are whether changes in the admission pattern were due to the implementation of early intervention or were explained by other factors. Examination of local and national factors showed that the dominant effect was from the implementation of early intervention. Limitations are that this is a comparison with a historical cohort and analysis is limited to in-patient costs only. While there are cost savings, these represent opportunity cost savings, as the majority of costs associated with in-patient care are fixed. Studies such as this provide evidence that it is feasible to consider disinvestment strategies such as home care in the community. It is difficult to generalize interventions shown to work in one country to other countries, as health service structures differ and there are both local and national variations in service structure and delivery. It remains important to evaluate whether a policy is applicable within its local context. Further research in this area is required to evaluate contemporaneous services and to examine whether increased costs in the community incurred through implementation of early intervention negate the savings made through reduction of admissions.

Evaluation of a Worksite-Controlled Smoking Program.

ERIC Educational Resources Information Center

Glasgow, Russell E.; And Others

1984-01-01

Evaluated the relative effectiveness of three versions of a controlled smoking program conducted in the worksite: abrupt reduction, gradual reduction, or gradual reduction plus feedback on nicotine consumption. All conditions were effective. There was some indication that the gradual reduction condition was more effective than the abrupt…

5 CFR 362.306 - Reduction in force and termination.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Reduction in force and termination. 362.306 Section 362.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PATHWAYS PROGRAMS Recent Graduates Program § 362.306 Reduction in force and termination. (a) Reduction in...

5 CFR 362.306 - Reduction in force and termination.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Reduction in force and termination. 362.306 Section 362.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PATHWAYS PROGRAMS Recent Graduates Program § 362.306 Reduction in force and termination. (a) Reduction in...

75 FR 62326 - Magnuson-Stevens Act Provisions; Fishing Capacity Reduction Framework

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-08

.... 100330171-0388-02] RIN 0648-AY79 Magnuson-Stevens Act Provisions; Fishing Capacity Reduction Framework... implementing fishing capacity reduction programs (reduction programs) in accordance with the Magnuson-Stevens... pays harvesters in a fishery that has more vessels than capacity either to surrender their fishing...

A workplace breast cancer screening program. Costs and components.

PubMed

Schrammel, P; Griffiths, R I; Griffiths, C B

1998-11-01

Screening for breast cancer can result in early detection of malignancies and lives saved. Many employers now offer periodic screening as an employee health benefit, and some have established screening programs in the workplace. This study was performed to identify the employer costs of breast cancer screening in the workplace, referrals for suspicious findings, and initial treatment of malignant disease. Additionally, the costs for these same services, had they been obtained outside of a workplace screening program, were estimated. Data on program components and associated costs for an established employer based breast cancer screening program were obtained. These costs were compared to those among a hypothetical cohort of women not enrolled in the workplace screening program. From 1989 through 1995, 1,416 women participated in the program. Nearly 2,500 screening mammograms and approximately 2,773 clinical breast examinations were performed, resulting in 292 referrals to physicians outside of the program for additional diagnostic procedures and treatment as needed. These referrals resulted in the detection of 12 malignancies: 8 Stage I; 3 Stage II; and 1 Stage III. Mammographic and clinical breast examination screening cost $249,041; referrals resulting in benign disease or no detectable disease cost $185,002; and referrals resulting in malignant disease, followed by initial treatment, cost $148,530. Therefore, the total cost was $582,573. Approximately 47% of the cost of referrals and initial treatment were due to employee lost productivity. Total cost in the hypothetical cohort was $1,067,948 under the assumptions that all women received screening outside of the workplace, and that the same number of malignancies were detected at the same stage as in the workplace program. These findings indicate referrals resulting in detection of benign disease or no disease accounted for a substantial proportion of the total cost of the program. In addition, employee lost productivity accounted for almost 50% of the cost of all referrals and initial treatment. Workplace screening is a relatively efficient approach for early detection of breast cancer when compared to off site screening or no screening. The efficiency could be improved with a reduction in the number and cost of unnecessary referrals.

Reductions of budgets, staffing, and programs among local health departments: results from NACCHO's economic surveillance surveys, 2009-2013.

PubMed

Ye, Jiali; Leep, Carolyn; Newman, Sarah

2015-01-01

To provide an overview of budget cuts, job losses, and program reductions among local health departments (LHDs) and to examine the association between LHD infrastructure characteristics and the likelihood of budget cuts. Data from 4 waves of the economic surveillance survey (July-August 2009, September-November 2010, January-February 2012, and January-March 2013) conducted by the National Association of County & City Health Officials were analyzed to assess cuts to budgets, jobs, and programs since 2009. Data from the 2013 National Profile of Local Health Departments survey were used to assess the infrastructural characteristics associated with budget cuts. When asked in early 2013, more than a quarter of LHDs (26.9%) reported a reduced budget, continuing the trend of a substantial proportion of LHDs experiencing financial hardship in recent years. The percentages of LHDs that made cuts to programmatic areas fluctuated from year to year but have never been lower than 40%. Maternal and child health services were among areas most often cut during all 4 time points of the survey. Governance type, total expenditures, and percentage of revenues from local sources were significantly associated with LHD budget cuts. Cuts in LHD budgets, staff, and activities have been widespread for a period that lasted long after the official end of the Great Recession. There is a great need for substantive and consistent funding to ensure the retention of the workforce and the delivery of essential public health services.

Wilderness adventure therapy effects on the mental health of youth participants.

PubMed

Bowen, Daniel J; Neill, James T; Crisp, Simon J R

2016-10-01

Adventure therapy offers a prevention, early intervention, and treatment modality for people with behavioural, psychological, and psychosocial issues. It can appeal to youth-at-risk who are often less responsive to traditional psychotherapeutic interventions. This study evaluated Wilderness Adventure Therapy (WAT) outcomes based on participants' pre-program, post-program, and follow-up responses to self-report questionnaires. The sample consisted of 36 adolescent out-patients with mixed mental health issues who completed a 10-week, manualised WAT intervention. The overall short-term standardised mean effect size was small, positive, and statistically significant (0.26), with moderate, statistically significant improvements in psychological resilience and social self-esteem. Total short-term effects were within age-based adventure therapy meta-analytic benchmark 90% confidence intervals, except for the change in suicidality which was lower than the comparable benchmark. The short-term changes were retained at the three-month follow-up, except for family functioning (significant reduction) and suicidality (significant improvement). For participants in clinical ranges pre-program, there was a large, statistically significant reduction in depressive symptomology, and large to very large, statistically significant improvements in behavioural and emotional functioning. These changes were retained at the three-month follow-up. These findings indicate that WAT is as effective as traditional psychotherapy techniques for clinically symptomatic people. Future research utilising a comparison or wait-list control group, multiple sources of data, and a larger sample, could help to qualify and extend these findings. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Implementing the patient-centered medical home in residency education.

PubMed

Doolittle, Benjamin R; Tobin, Daniel; Genao, Inginia; Ellman, Matthew; Ruser, Christopher; Brienza, Rebecca

2015-01-01

In recent years, physician groups, government agencies and third party payers in the United States of America have promoted a Patient-centered Medical Home (PCMH) model that fosters a team-based approach to primary care. Advocates highlight the model's collaborative approach where physicians, mid-level providers, nurses and other health care personnel coordinate their efforts with an aim for high-quality, efficient care. Early studies show improvement in quality measures, reduction in emergency room visits and cost savings. However, implementing the PCMH presents particular challenges to physician training programs, including institutional commitment, infrastructure expenditures and faculty training. Teaching programs must consider how the objectives of the PCMH model align with recent innovations in resident evaluation now required by the Accreditation Council of Graduate Medical Education (ACGME) in the US. This article addresses these challenges, assesses the preliminary success of a pilot project, and proposes a viable, realistic model for implementation at other institutions.

Potential advantages of solar electric propulsion for outer planet orbiters.

NASA Technical Reports Server (NTRS)

Sauer, C. G.; Atkins, K. L.

1972-01-01

Past studies of solar electric propulsion for outer planet orbiters have generally emphasized the advantages of flight time reduction and payload increases. However, several subtle advantages exist, which may become important in an environment of increasingly difficult requirements as ways to extend current technology are sought. These advantages accrue primarily because of the inherent capability, unique to electric propulsion, to efficiently shape a trajectory while enroute. Stressed in this paper are: the ability to meet orbital constraints due to assumed radiation belts, science flexibility in a dual launch program, increased numbers of observational passes, and the lengthening of launch periods. These are examined for years representative of relatively easy and difficult ballistic missions. The results indicate that an early investment in solar electric technology will provide a strong performance foundation for a long range outer planet exploration program which evolves from current spacecraft technology.

A review of turbulent-boundary-layer heat transfer research at Stanford, 1958-1983

NASA Technical Reports Server (NTRS)

Moffat, R. J.; Kays, W. M.

1984-01-01

For the past 25 years, there has existed in the Thermosciences Laboratory of the Mechanical Engineering Department of Stanford University a research program, primarily experimental, concerned with heat transfer through turbulent boundary layers. In the early phases of the program, the topics considered were the simple zero-pressure-gradient turbulent boundary layer with constant and with varying surface temperature, and the accelerated boundary layer. Later equilibrium boundary layers were considered along with factors affecting the boundary layer, taking into account transpired flows, flows with axial pressure gradients, transpiration, acceleration, deceleration, roughness, full-coverage film cooling, surface curvature, free convection, and mixed convection. A description is provided of the apparatus and techniques used, giving attention to the smooth plate rig, the rough plate rig, the full-coverage film cooling rig, the curvature rig, the concave wall rig, the mixed convection tunnel, and aspects of data reduction and uncertainty analysis.

Exploring the Early Structure of a Rapidly Decompressed Particle Bed

NASA Astrophysics Data System (ADS)

Zunino, Heather; Adrian, R. J.; Clarke, Amanda; Johnson, Blair; Arizona State University Collaboration

2017-11-01

Rapid expansion of dense, pressurized beds of fine particles subjected to rapid reduction of the external pressure is studied in a vertical shock tube. A near-sonic expansion wave impinges on the particle bed-gas interface and rapidly unloads the particle bed. A high-speed video camera captures events occurring during bed expansion. The particle bed does not expand homogeneously, but breaks down into horizontal slabs and then transforms into a cellular-type structure. There are several key parameters that affect the particle bed evolution, including particle size and initial bed height. Analyses of this bed structure evolution from experiments with varying particle sizes and initial bed heights is presented. This work is supported by the U.S. Department of Energy, National Nuclear Security Administration, Advanced Simulation and Computing Program, as a Cooperative Agreement under the Predictive Science and Academic Alliance Program, under Contract No. DE-NA0002378.

Contingent valuation of fuel hazard reduction treatments

Treesearch

John B. Loomis; Armando Gonzalez-Caban

2008-01-01

This chapter presents a stated preference technique for estimating the public benefits of reducing wildfires to residents of California, Florida, and Montana from two alternative fuel reduction programs: prescribed burning, and mechanical fuels reduction. The two fuel reduction programs under study are quite relevant to people living in California, Florida, and...

Curricular Ethics in Early Childhood Education Programming: A Challenge to the Ontario Kindergarten Program

ERIC Educational Resources Information Center

Heydon, Rachel M.; Wang, Ping

2006-01-01

Through a case study of a key Canadian early childhood education program, The Kindergarten Program (Ontario Ministry of Education and Training, 1998a), we explore the relationship between curricular paradigms and early childhood education (ECE) models, and the opportunities that each creates for enacting ethical teaching and learning…

The role of dexamethasone in decreasing early recurrence of acute intussusception in children: A retrospective study.

PubMed

Efrati, Yigal; Klin, Baruch; Kozer, Eran; Abu-Kishk, Ibrahim

2017-07-01

Early recurrent intussusception (RI) is a concern after a successful pneumatic reduction. Steroids have been suggested as a treatment that decreases early RI. The purpose of this study was to examine the role of dexamethasone in decreasing early RI. A retrospective review of 174 pediatric patients that underwent successful pneumatic reduction was conducted. Two groups were identified: group 1 that received intravenous dexamethasone (0.5mg/kg/dose) on diagnosis or immediately after the reduction maneuver, and group 2 that were not given dexamethasone. There were 113 boys and 61 girls ranging in age from 2 to 36months. There were no statistical differences between the groups except for younger age in the dexamethasone group (P=0.03). There was no significant difference (p=0.08) in the rate of early RI between the non-steroid group (5.4%, 4/74) and the steroid group 14% (14/100). Mean admission length was 30h. The majority of RIs occurred in the first 8h of admission. We found that premedication of children with idiopathic intussusception with dexamethasone did not decrease early RI. Level III retrospective comparative study. Copyright © 2016 Elsevier Inc. All rights reserved.

Explore Full Range of QSO/AGN Properties

NASA Technical Reports Server (NTRS)

Oliversen, Ronald (Technical Monitor); Wilkes, Belinda

2005-01-01

The goal of the proposal is to perform ISO spectroscopic studies, including data analysis and modeling, of star formation regions using an ensemble of archival space-based data from the Infrared Space Observatory s Long Wavelength Spectrometer and Short Wavelength Spectrometer, but including as well some other spectroscopic databases. Four kinds of regions are considered in the studies: (1) disks around more evolved objects; (2) young, low or high mass pre-main sequence stars in star formation regions; (3) star formation in external, bright IR galaxies; and (4) the galactic center. One prime focus of the program is the OH lines in the far infrared. The program had the following goals: 1) Refine the data analysis of IS0 observations to obtain deeper and better SNR results on selected sources. The IS0 data itself underwent "pipeline 10" reductions in early 2001, and additional "hands-on data reduction packages" were supplied by the IS0 teams in 2001. The Fabry-Perot database is particularly sensitive to noise and slight calibration errors. 2) Model the atomic and molecular line shapes, in particular the OH lines, using revised monte- carlo techniques developed by the SWAS team at the Center for Astrophysics; 3) Attend scientific meetings and workshops; 4) Do E&PO activities related to infrared astrophysics and/or spectroscopy.

Does Attendance in Early Education Predict Attendance in Elementary School? An Analysis of DCPS's Early Education Program. Research Report

ERIC Educational Resources Information Center

Dubay, Lisa; Holla, Nikhil

2016-01-01

Enrollment in early childhood education programs can be an important stepping stone to higher educational achievement, particularly for low-income children. However, children cannot succeed in these programs unless they are present. The Early Childhood Education Division (ECED) in the District of Columbia Public Schools (DCPS) has identified…

Measurement Quality of the Chinese Early Childhood Program Rating Scale: An Investigation Using Multivariate Generalizability Theory

ERIC Educational Resources Information Center

Chen, Dezhi; Hu, Bi Ying; Fan, Xitao; Li, Kejian

2014-01-01

Adapted from the Early Childhood Environment Rating Scale-Revised, the Chinese Early Childhood Program Rating Scale (CECPRS) is a culturally comparable measure for assessing the quality of early childhood education and care programs in the Chinese cultural/social contexts. In this study, 176 kindergarten classrooms were rated with CECPRS on eight…

"Let's Count": Evaluation of a Pilot Early Mathematics Program in Low Socioeconomic Locations in Australia

ERIC Educational Resources Information Center

Perry, Bob; Gervasoni, Ann; Dockett, Sue

2012-01-01

The "Let's Count" pilot early mathematics program was implemented in five early childhood educational contexts across Australia during 2011. The program used specifically formulated materials and workshops to enlist the assistance of early childhood educators to work with parents and other family members of children in their settings to…

Fossil evidence of avian crops from the Early Cretaceous of China

PubMed Central

Zheng, Xiaoting; Martin, Larry D.; Zhou, Zhonghe; Burnham, David A.; Zhang, Fucheng; Miao, Desui

2011-01-01

The crop is characteristic of seed-eating birds today, yet little is known about its early history despite remarkable discoveries of many Mesozoic seed-eating birds in the past decade. Here we report the discovery of some early fossil evidence for the presence of a crop in birds. Two Early Cretaceous birds, the basal ornithurine Hongshanornis and a basal avian Sapeornis, demonstrate that an essentially modern avian digestive system formed early in avian evolution. The discovery of a crop in two phylogenetically remote lineages of Early Cretaceous birds and its absence in most intervening forms indicates that it was independently acquired as a specialized seed-eating adaptation. Finally, the reduction or loss of teeth in the forms showing seed-filled crops suggests that granivory was possibly one of the factors that resulted in the reduction of teeth in early birds. PMID:21896733

Cooperative Threat Reduction: Cooperation Threat Reduction Program Liquid Propellant Disposition Project

NASA Astrophysics Data System (ADS)

2002-09-01

This audit is one in a series of audits the Deputy Secretary of Defense requested. As part of the Cooperative Threat Reduction (CTR) Program, DoD agreed to assist the Russian Federation in disposing of its liquid rocket propellant. Public Law 102-228 (section 2551 NOTE, title 22, United States Code), the Soviet Nuclear Threat Reduction Act of 1991 designates DoD as the executive agent for the CTR Program. Specific objectives of the act are to destroy chemical, nuclear, and other weapons; transport, store, disable, and safeguard weapons in connection with their destruction; and establish verifiable safeguards against proliferation of weapons of mass destruction. The Office of the Assistant Secretary of Defense (International Security Policy), under the Office of the Under Secretary of Defense for Policy, develops, coordinates, and oversees implementation of policy for the CTR Program. The CTR Directorate, Defense Threat Reduction Agency operates the program.

Implications of Nubian-Like Core Reduction Systems in Southern Africa for the Identification of Early Modern Human Dispersals

PubMed Central

Phillips, Natasha

2015-01-01

Lithic technologies have been used to trace dispersals of early human populations within and beyond Africa. Convergence in lithic systems has the potential to confound such interpretations, implying connections between unrelated groups. Due to their reductive nature, stone artefacts are unusually prone to this chance appearance of similar forms in unrelated populations. Here we present data from the South African Middle Stone Age sites Uitpanskraal 7 and Mertenhof suggesting that Nubian core reduction systems associated with Late Pleistocene populations in North Africa and potentially with early human migrations out of Africa in MIS 5 also occur in southern Africa during early MIS 3 and with no clear connection to the North African occurrence. The timing and spatial distribution of their appearance in southern and northern Africa implies technological convergence, rather than diffusion or dispersal. While lithic technologies can be a critical guide to human population flux, their utility in tracing early human dispersals at large spatial and temporal scales with stone artefact types remains questionable. PMID:26125972

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

Wiser, Ryan; Barbose, Galen; Heeter, Jenny

This analysis is the first-ever comprehensive assessment of the benefits and impacts of state renewable portfolio standards (RPSs). This joint National Renewable Energy Laboratory-Lawrence Berkeley National Laboratory project provides a retrospective analysis of RPS program benefits and impacts, including greenhouse gas emissions reductions, air pollution emission reductions, water use reductions, gross jobs and economic development impacts, wholesale electricity price reduction impacts, and natural gas price reduction impacts. Wherever possible, benefits and impacts are quantified in monetary terms. The paper will inform state policymakers, RPS program administrators, industry, and others about the costs and benefits of state RPS programs. In particular,more » the work seeks to inform decision-making surrounding ongoing legislative proposals to scale back, freeze, or expand existing RPS programs, as well as future discussions about increasing RPS targets or otherwise increasing renewable energy associated with Clean Power Plan compliance or other emission-reduction goals.« less

Retrospective Analysis of the Benefits and Impacts of U.S. Renewable Portfolio Standards

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

Wiser, Ryan; Barbose, Galen; Heeter, Jenny

This analysis is the first-ever comprehensive assessment of the benefits and impacts of state renewable portfolio standards (RPSs). This joint National Renewable Energy Laboratory-Lawrence Berkeley National Laboratory project provides a retrospective analysis of RPS program benefits and impacts, including greenhouse gas emissions reductions, air pollution emission reductions, water use reductions, gross jobs and economic development impacts, wholesale electricity price reduction impacts, and natural gas price reduction impacts. Wherever possible, benefits and impacts are quantified in monetary terms. The paper will inform state policymakers, RPS program administrators, industry, and others about the costs and benefits of state RPS programs. In particular,more » the work seeks to inform decision-making surrounding ongoing legislative proposals to scale back, freeze, or expand existing RPS programs, as well as future discussions about increasing RPS targets or otherwise increasing renewable energy associated with Clean Power Plan compliance or other emission-reduction goals.« less

Hα Monitoring of Early-Type Emission Line Stars

NASA Astrophysics Data System (ADS)

Souza, Steven P.; Boettcher, E.; Wilson, S.; Hosek, M.

2011-05-01

We have begun a narrowband imaging program to monitor Hα emission in early-type stars in young open clusters and associations. A minority of early-type stars, particularly Be stars, show Hα in emission due to extended atmospheres and non-equilibrium conditions. Emission features commonly vary irregularly over a range of timescales (Porter, J.M. & Rivinus, T., P.A.S.P. 115:1153-1170, 2003). Some of the brightest such stars, e.g. γ Cas, have been spectroscopically monitored for Hα variability to help constrain models of the unstable disk, but there is relatively little ongoing monitoring in samples including fainter stars (Peters, G., Be Star Newsletter 39:3, 2009). Our program uses matched 5nm-wide on-band (656nm) and off-band (645nm) filters, in conjunction with the Hopkins Observatory 0.6-m telescope and CCD camera. Aperture photometry is done on all early-type stars in each frame, and results expressed as on-band to off-band ratios. Though wavelength-dependent information is lost compared with spectroscopy, imaging allows us to observe much fainter (and therefore many more) objects. Observing young clusters, rather than individual target stars, allows us to record multiple known and candidate emission line stars per frame, and provides multiple "normal" reference stars of similar spectral type. Observations began in the summer of 2010. This project has the potential to produce significant amounts of raw data, so a semi-automated data reduction process has been developed, including astrometric and photometric tasks. Early results, including some preliminary light curves and recovery of known Be stars at least as faint as R=13.9, are presented. We gratefully acknowledge support for student research through an REU grant to the Keck Northeast Astronomy Consortium from the National Science Foundation, and from the Division III Research Funding Committee of Williams College.

State Budget Cuts Create a Growing Child Care Crisis for Low-Income Working Families.

ERIC Educational Resources Information Center

Ewen, Danielle; Hart, Katherine

As one of a series of reports concerning state policies and practices in child care and early education, this report identifies reductions in state investments in child care, early education, and school-age care and argues that such reductions will result in many low-income working families losing the assistance they need to stay employed. The…

Effectiveness and feasibility of early physical rehabilitation programs for geriatric hospitalized patients: a systematic review

PubMed Central

2013-01-01

Background Old adults admitted to the hospital are at severe risk of functional loss during hospitalization. Early in-hospital physical rehabilitation programs appear to prevent functional loss in geriatric patients. The first aim of this review was to investigate the effect of early physical rehabilitation programs on physical functioning among geriatric patients acutely admitted to the hospital. The second aim was to evaluate the feasibility of early physical rehabilitation programs. Methods Two searches, one for physical functioning and one for feasibility, were conducted in PubMed, CINAHL, and EMBASE. Additional studies were identified through reference and citation tracking. To be included articles had to report on in-hospital early physical rehabilitation of patients aged 65 years and older with an outcome measure of physical functioning. Studies were excluded when the treatment was performed on specialized units other than geriatric units. Randomized controlled trials were included to examine the effect of early physical rehabilitation on physical functioning, length of stay and discharge destination. To investigate feasibility also non randomized controlled trials were added. Results Fifteen articles, reporting on 13 studies, described the effect on physical functioning. The early physical rehabilitation programs were classified in multidisciplinary programs with an exercise component and usual care with an exercise component. Multidisciplinary programs focussed more on facilitating discharge home and independent ADL, whereas exercise programs aimed at improving functional outcomes. At time of discharge patients who had participated in a multidisciplinary program or exercise program improved more on physical functional tests and were less likely to be discharged to a nursing home compared to patients receiving only usual care. In addition, multidisciplinary programs reduced the length of hospital stay significantly. Follow-up interventions improved physical functioning after discharge. The feasibility search yielded four articles. The feasibility results showed that early physical rehabilitation for acutely hospitalized old adults was safe. Adherence rates differed between studies and the recruitment of patients was sometimes challenging. Conclusions Early physical rehabilitation care for acutely hospitalized old adults leads to functional benefits and can be safely executed. Further research is needed to specifically quantify the physical component in early physical rehabilitation programs. PMID:24112948

Effectiveness and feasibility of early physical rehabilitation programs for geriatric hospitalized patients: a systematic review.

PubMed

Kosse, Nienke M; Dutmer, Alisa L; Dasenbrock, Lena; Bauer, Jürgen M; Lamoth, Claudine J C

2013-10-10

Old adults admitted to the hospital are at severe risk of functional loss during hospitalization. Early in-hospital physical rehabilitation programs appear to prevent functional loss in geriatric patients. The first aim of this review was to investigate the effect of early physical rehabilitation programs on physical functioning among geriatric patients acutely admitted to the hospital. The second aim was to evaluate the feasibility of early physical rehabilitation programs. Two searches, one for physical functioning and one for feasibility, were conducted in PubMed, CINAHL, and EMBASE. Additional studies were identified through reference and citation tracking. To be included articles had to report on in-hospital early physical rehabilitation of patients aged 65 years and older with an outcome measure of physical functioning. Studies were excluded when the treatment was performed on specialized units other than geriatric units. Randomized controlled trials were included to examine the effect of early physical rehabilitation on physical functioning, length of stay and discharge destination. To investigate feasibility also non randomized controlled trials were added. Fifteen articles, reporting on 13 studies, described the effect on physical functioning. The early physical rehabilitation programs were classified in multidisciplinary programs with an exercise component and usual care with an exercise component. Multidisciplinary programs focussed more on facilitating discharge home and independent ADL, whereas exercise programs aimed at improving functional outcomes. At time of discharge patients who had participated in a multidisciplinary program or exercise program improved more on physical functional tests and were less likely to be discharged to a nursing home compared to patients receiving only usual care. In addition, multidisciplinary programs reduced the length of hospital stay significantly. Follow-up interventions improved physical functioning after discharge. The feasibility search yielded four articles. The feasibility results showed that early physical rehabilitation for acutely hospitalized old adults was safe. Adherence rates differed between studies and the recruitment of patients was sometimes challenging. Early physical rehabilitation care for acutely hospitalized old adults leads to functional benefits and can be safely executed. Further research is needed to specifically quantify the physical component in early physical rehabilitation programs.

[National Laboratory on Early Childhood Education Program; Program Plans and Budget Request, Fiscal 1970 - Program Project Resumes 1969-70.

ERIC Educational Resources Information Center

1969

This volume explains the purposes and programs of the National Laboratory on Early Childhood Education. Its overriding objective is to broaden the base of knowledge concerning educational intervention and to develop comprehensive early childhood educational models. A brief discussion deals with the problems, strategies, and capacities of the…

Early Head Start Participants, Programs, Families, and Staff in 2006

ERIC Educational Resources Information Center

Center for Law and Social Policy, Inc. (CLASP), 2008

2008-01-01

In 1994, the federal Early Head Start program was created to address the comprehensive needs of low-income children under age 3 and pregnant women. Since 1965, the Head Start program has served low-income 3- and 4-year-old children and their families with comprehensive early education and support services. Programs provide services focused on the…

78 FR 31568 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive Award to Ensure Continued HIV Primary Medical Care. SUMMARY: To prevent a lapse in comprehensive primary...

78 FR 10183 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive Award to Ensure Continued HIV Primary Medical Care. SUMMARY: To prevent a lapse in comprehensive primary...

78 FR 10182 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program (Part C) Early Intervention Services One-Time Noncompetitive Award to Ensure Continued HIV Primary Medical Care. SUMMARY: To prevent a lapse in comprehensive...

Creating, Constructing, and Cultivating Professional Development within a Reggio-Inspired Early Childhood Education Program

ERIC Educational Resources Information Center

Haigh, Karen M.

2009-01-01

The study examined the professional development system of an early childhood education program which was influenced by the Reggio Emilia Approach to early learning. This multi-site program thrived within low-income, inner-city communities of Chicago. Literature connected to the program's historical context of the Settlement House and the Reggio…

People-centred landslide early warning systems in the context of risk management

NASA Astrophysics Data System (ADS)

Haß, S.; Asch, K.; Fernandez-Steeger, T.; Arnhardt, C.

2009-04-01

In the current hazard research people-centred warning becomes more and more important, because different types of organizations and groups have to be involved in the warning process. This fact has to be taken into account when developing early warning systems. The effectiveness of early warning depends not only on technical capabilities but also on the preparedness of decision makers and their immediate response on how to act in case of emergency. Hence early warning systems have to be regarded in the context of an integrated and holistic risk management. Disaster Risk Reduction (DRR) measures include people-centred, timely and understandable warning. Further responsible authorities have to be identified in advance and standards for risk communication have to be established. Up to now, hazard and risk assessment for geohazards focuses on the development of inventory, susceptibility, hazard and risk maps. But often, especially in Europe, there are no institutional structures for managing geohazards and in addition there is a lack of an authority that is legally obliged to alarm on landslides at national or regional level. One of the main characteristics within the warning process for natural hazards e.g. in Germany is the split of responsibility between scientific authorities (wissenschaftliche Fachbehörde) and enforcement authorities (Vollzugsbehörde). The scientific authority provides the experts who define the methods and measures for monitoring and evaluate the hazard level. The main focus is the acquisition and evaluation of data and subsequently the distribution of information. The enforcement authority issues official warnings about dangerous natural phenomena. Hence the information chain in the context of early warning ranges over two different institutions, the forecast service and the warning service. But there doesn't exist a framework for warning processes in terms of landslides as yet. The concept for managing natural disasters is often reduced to hazard assessment and emergency response. Great importance is attached to the scientific understanding of hazards and protective structures, while analysis of socio-economic impacts and risk assessment are not considered enough. The reduction of vulnerability has to be taken into greater account. Also the information needs of different stakeholders have to be identified at an early stage and should be integrated in the development of early warning systems. The content of the warning message must be simple, understandable and should cover instructions on how to react. Further the timeliness of the messages has to be guarented. In this context the aim of the landslide monitoring and early warning system SLEWS (Sensor Based Landslide Early Warning System) is to integrate the above mentioned aspects of a holistic disaster and risk management. The technology of spatial data infrastructures and web services provides the use of multiple communication channels within an early warning system. Thus people-centred early warning messages and information about slope stability can be sent in nearly real-time. It has to be underlined that the technological information process is just one element of an effective warning system. Moreover the warning system has also to be considered as a social system and has to make allowance to socio-economic and gender aspects : «[...] Develop early warning systems that are people centered, in particular systems whose warnings are timely and understandable to those at risk, which take into account the demographic, gender, cultural and livelihood characteristics of the target audiences, including guidance on how to act upon warnings, and that support effective operations by disaster managers and other decision makers » (Hyogo Framework, 2005) References : UNITED NATIONS INTERNATIONAL STRATEGY FOR DISASTER REDUCTION SECRETARIAT (UNISDR) (2006): Developing early warning systems: a checklist, Third international conference on early warning (EWC III): from concept to action: 27-29 March 2006, Bonn, Germany. Geneva, Switzerland: International Strategy for Disaster Reduction. WORLD CONFERENCE ON DISASTER REDUCTION (2005) : Report of the World Conference on Disaster Reduction: Kobe, Hyogo, Japan, 18-22 January 2005. Geneva, Switzerland, Secretariat, World Conference on Disaster Reduction. INTER-AGENCY SECRETARIAT OF THE ISDR & GLOBAL PLATFORM FOR DISASTER RISK REDUCTION (2007): Disaster risk reduction: 2007 global review. Geneva, UN, ISDR.

Programmable Ultra Lightweight System Adaptable Radio (PULSAR) Low Cost Telemetry - Access from Space Advanced Technologies or Down the Middle

NASA Technical Reports Server (NTRS)

Sims. Herb; Varnavas, Kosta; Eberly, Eric

2013-01-01

Software Defined Radio (SDR) technology has been proven in the commercial sector since the early 1990's. Today's rapid advancement in mobile telephone reliability and power management capabilities exemplifies the effectiveness of the SDR technology for the modern communications market. In contrast, presently qualified satellite transponder applications were developed during the early 1960's space program. Programmable Ultra Lightweight System Adaptable Radio (PULSAR, NASA-MSFC SDR) technology revolutionizes satellite transponder technology by increasing data through-put capability by, at least, an order of magnitude. PULSAR leverages existing Marshall Space Flight Center SDR designs and commercially enhanced capabilities to provide a path to a radiation tolerant SDR transponder. These innovations will (1) reduce the cost of NASA Low Earth Orbit (LEO) and Deep Space transponders, (2) decrease power requirements, and (3) a commensurate volume reduction. Also, PULSAR increases flexibility to implement multiple transponder types by utilizing the same hardware with altered logic - no analog hardware change is required - all of which can be accomplished in orbit. This provides high capability, low cost, transponders to programs of all sizes. The final project outcome would be the introduction of a Technology Readiness Level (TRL) 7 low-cost CubeSat to SmallSat telemetry system into the NASA Portfolio.

Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy

PubMed Central

Shonkoff, Jack P.; Fisher, Philip A.

2016-01-01

Half a century of research and program evaluation has fueled a diverse landscape of early childhood policies and practices that produce a range of positive effects on the life prospects of children who face the burdens of significant adversity. Drawing on advances in neurobiology, developmental psychology, developmental psychopathology, and prevention science, this paper presents a framework for elucidating underlying causal mechanisms that explain differences in outcomes, formulating enhanced theories of change about how to shift developmental trajectories, designing creative interventions and rethinking the concept of a two-generation strategy to produce breakthrough impacts, and launching a new era of investment in young children and their families that will achieve greater reductions in intergenerational disparities in learning, behavior, and health than those produced by current best practices. Particular attention is focused on the hypothesis that substantially better outcomes for vulnerable, young children could be achieved by greater attention to strengthening the resources and capabilities of the adults who care for them rather than by continuing to focus primarily on the provision of child-focused enrichment, parenting education, and informal support. Central to achieving this goal is the need to establish an innovation-friendly environment that embraces fast-cycle sharing, supports risk taking, and celebrates learning from failure. PMID:24342860

National Earthquake Hazards Reduction Program; time to expand

USGS Publications Warehouse

Steinbrugge, K.V.

1990-01-01

All of us in earthquake engineering, seismology, and many related disciplines have been directly or indirectly affected by the National Earthquake Hazards Reduction Program (NEHRP). This program was the result of the Earthquake Hazards Reduction Act of 1977 (Public Law 95-124). With well over a decade of experience, should this expression of public policy now take a different or expanded role? 

Mind magic: a pilot study of preventive mind-body-based stress reduction in behaviorally inhibited and activated children.

PubMed

Jellesma, Francine C; Cornelis, Janine

2012-03-01

The aim of this pilot study was to examine a mind-body-based preventive intervention program and to determine relationships between children's behavioral inhibition system (BIS) and behavioral activation system, stress, and stress reduction after the program. Children participated in the program (n=30) or in a control condition (n=24). They filled out questionnaires before and after the program and reported their levels of stress before and after each of the five sessions. The program consisted of weekly sessions. Each session incorporated yoga postures, visualization, and social exercises. Breathing techniques were integrated. Stress reductions were only seen in the intervention group and mainly in children with high BIS--irrespective of their behavioral activation system. The results demonstrate that children with high BIS may benefit from a mind-body-based stress reduction program.

The Source of Child Care Center Preschool Learning and Program Standards: Implications for Potential Early Learning Challenge Fund Grantees

ERIC Educational Resources Information Center

Ackerman, Debra J.; Sansanelli, Rachel A.

2010-01-01

The proposed federal Early Learning Challenge Fund (ELCF) aims to improve the quality of early care and education programs by promoting the integration of more stringent program and early learning standards than are typically found in child care centers. ELCF grantees also must outline their plans for professional development and technical…

[EFFECT OF A HEALTHY EATING AND PHYSICAL ACTIVITY INTERVENTION PROGRAM ON CHILHOOD OBESITY].

PubMed

Díaz Martínez, Ximena; Mena Bastías, Carmen; Celis-Moralesl, Carlos; Salas, Carlos; Valdivia Moral, Pedro

2015-07-01

interventions aiming to develop healthy lifestyle behaviours at early age could be an effective way of reducing childhood obesity. to evaluate the effect of a dietary and physical activity intervention on reducing childhood obesity. 312 students took part on this 5 month intervention study. The intervention included dietary talk delivered to children and their parents in addition to 45 minutes of daily physical activity modules. Nutritional status was assessed using the Obesity Task Force criteria. Changes in dietary behaviours and physical activity were assessed using questionnaires administrated to the parents. body mass index decreased significantly post intervention (-0.2 kg.m-2), however, this reduction was driven by boys (-0.3 kg.m-2). Similarly, waist circumference shows a significant reduction in boys (-0.4 cm) but not girls. Children with overweight or obesity shows greater reductions in obesity-related traits, which were related to changes in dietary and physical activity post interventions. multidisciplinary interventions applied to children between 5 and 7 years old are effective on reducing body mass index and improving dietary and physical activity behaviours in overweight and obese children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Assessing the impact of harm reduction programs on law enforcement in Southeast Asia: a description of a regional research methodology.

PubMed

Thomson, Nick; Moore, Tim; Crofts, Nick

2012-07-09

For over 15 years the Australian Agency for International Development (AusAID) has been a leading donor for harm reduction projects in Southeast Asia. The recent AusAID-supported harm reduction projects of greatest significance have included the Asia Regional HIV/AIDS Project (AHRP), from 2002 until 2007,1 and the HIV/AIDS Asia Regional Program (HAARP), from 2007 until 2015.2 Both projects included in their design specific strategies for engaging with law enforcement agencies at country level. The main focus of these strategies has been to develop law enforcement harm reduction policy and curriculum, and the design and implementation of specific harm reduction training for law enforcement officers.In July 2008, the Australian Development Research Awards (ADRA) funded the Nossal Institute for Global Health at the University of Melbourne to establish a research project created to assess the influence of harm reduction programs on the policy and operational practices of law enforcement agencies in Southeast Asia, known as the LEHRN Project (Law Enforcement, Harm Reduction, Nossal Institute Project). The ADRA is a unique grant research mechanism that specifically funds development research to improve the understanding and informed decision making of the implementation of Australian aid effectiveness.While the need to engage law enforcement when establishing harm reduction programs was well documented, little was known about the impact or influence of harm reduction programs on policy and practices of law enforcement agencies. The LEHRN Project provided the opportunity to assess the impact of harm reduction programs on law enforcement in Southeast Asia, with a focus on Vietnam, Cambodia and Lao PDR.

Assessing the impact of harm reduction programs on law enforcement in Southeast Asia: a description of a regional research methodology

PubMed Central

2012-01-01

For over 15 years the Australian Agency for International Development (AusAID) has been a leading donor for harm reduction projects in Southeast Asia. The recent AusAID-supported harm reduction projects of greatest significance have included the Asia Regional HIV/AIDS Project (AHRP), from 2002 until 2007,1 and the HIV/AIDS Asia Regional Program (HAARP), from 2007 until 2015.2 Both projects included in their design specific strategies for engaging with law enforcement agencies at country level. The main focus of these strategies has been to develop law enforcement harm reduction policy and curriculum, and the design and implementation of specific harm reduction training for law enforcement officers. In July 2008, the Australian Development Research Awards (ADRA) funded the Nossal Institute for Global Health at the University of Melbourne to establish a research project created to assess the influence of harm reduction programs on the policy and operational practices of law enforcement agencies in Southeast Asia, known as the LEHRN Project (Law Enforcement, Harm Reduction, Nossal Institute Project). The ADRA is a unique grant research mechanism that specifically funds development research to improve the understanding and informed decision making of the implementation of Australian aid effectiveness. While the need to engage law enforcement when establishing harm reduction programs was well documented, little was known about the impact or influence of harm reduction programs on policy and practices of law enforcement agencies. The LEHRN Project provided the opportunity to assess the impact of harm reduction programs on law enforcement in Southeast Asia, with a focus on Vietnam, Cambodia and Lao PDR. PMID:22769050

Fat mass index performs best in monitoring management of obesity in prepubertal children.

PubMed

Pereira-da-Silva, Luís; Dias, Mónica Pitta-Grós; Dionísio, Elisabete; Virella, Daniel; Alves, Marta; Diamantino, Catarina; Alonso, Anabela; Cordeiro-Ferreira, Gonçalo

2016-01-01

An early and accurate recognition of success in treating obesity may increase the compliance of obese children and their families to intervention programs. This observational, prospective study aimed to evaluate the ability and the time to detect a significant reduction of adiposity estimated by body mass index (BMI), percentage of fat mass (%FM), and fat mass index (FMI) during weight management in prepubertal obese children. In a cohort of 60 prepubertal obese children aged 3-9 years included in an outpatient weight management program, BMI, %FM, and FMI were monitored monthly; the last two measurements were assessed using air displacement plethysmography. The outcome measures were the reduction of >5% of each indicator and the time to achieve it. The rate of detection of the outcome was 33.3% (95% CI: 25.9-41.6) using BMI, significantly lower (p<0.001) than either 63.3% using %FM (95% CI: 50.6-74.8) or 70.0% (95% CI: 57.5-80.1) using FMI. The median time to detect the outcome was 71 days using FMI, shorter than 88 days using %FM, and similar to 70 days using BMI. The agreement between the outcome detected by FMI and by %FM was high (kappa 0.701), but very low between the success detected by BMI and either FMI (kappa 0.231) or %FM (kappa 0.125). FMI achieved the best combination of ability and swiftness to identify reduction of adiposity during monitoring of weight management in prepubertal obese children. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Harm reduction program use, psychopathology and medical severity in patients with methadone maintenance treatment.

PubMed

Martínez-Luna, Nieves Gudelia; Rodríguez-Cintas, Laia; Esojo, Abderraman; Palma-Álvarez, Raúl Felipe; Robles-Martínez, María; Grau-López, Lara; Perea, Marta; Roncero, Carlos

2018-01-15

Methadone maintenance programs (MMP) for opioid dependence treatment have been widely used due to their effective therapeutic outcomes. Harm reduction programs (HRP) are complementary programs for severe patients with high risk behaviors and when abstinence is not possible. This study aims to compare patients in MMP that use HRP (MMP-HRP) and patients in MMP who do not use HRP (MMP-NO HRP). The sample was composed of 143 patients (MMP-HRP = 42 vs. MMP-NO HRP = 101). An additional subanalysis was performed with patients under 45 years of age (n = 116; MMP-HRP = 38 vs. MMP-NO HRP = 78). All patients were assessed with an ad hoc socio-demographic questionnaire, EuropASI, SCID-I, and SCID-II. Results show that MMP-HRP patients were younger with more frequent use of intravenous drugs and with a high prevalence of Cluster B personality disorders. MMP-NO HRP patients had lower methadone doses compared to MMP-HRP patients and preferred to use drugs by smoked route more frequently. In the subanalysis of patients under 45, MMP-HRP patients were younger, had a higher prevalence of liver diseases, more intravenous drug use, greater severity on the drug use scale, less social and family support in the suescales of EUROP-ASI than compared to patients under 45 years in the group MMP-NO HRP. In conclusion, MMP-HRP patients are younger compared to MMP-NO HRP patients, they also receive higher doses of methadone and had more intravenous use. The above findings imply that the early onset of high risk drug use and long-term exposure to heroin have more severe outcomes such as higher comorbidities (e.g. infectious diseases, medical and psychiatric disorders), and consequently, these patients are a more vulnerable group with a worse prognosis.

Value of Early Postoperative Computed Tomography Assessment in Ankle Fractures Defining Joint Congruity and Criticizing the Need for Early Revision Surgery.

PubMed

Palmanovich, Ezequiel; Brin, Yaron S; Kish, Benny; Nyska, Meir; Hetsroni, Iftach

2016-01-01

Previous investigators have questioned the reliability of plain radiographs in assessing the accuracy of ankle fracture reduction when these were compared with the computed tomography (CT) evaluation in the preoperative setting, in particular, in fractures with syndesmosis injuries or trimalleolar fragments. The role of CT assessment, however, has not been investigated in the early postoperative setting. In the early postoperative setting, reduction still relies most commonly on fluoroscopy and plain radiographs alone. In the present study, we hypothesized that early postoperative CT assessment of ankle fractures with syndesmosic injuries and posterior malleolar fragments can add valuable information about the joint congruity compared with plain radiographs alone and that this information could affect the decisions regarding the need for early revision surgery. A total of 352 consecutive operated ankle fractures were reviewed. Of these, 68 (19%) underwent early postoperative CT assessment and were studied further to identify the causes that prompted revision surgery. Of the 68 cases, despite acceptable reduction found on the plain radiographs, 20 (29%) underwent early (within 1 week) revision surgery after studying the CT scans, which revealed malreduction of the syndesmosis, malreduction of the posterior lip fragment, and intra-articular fragments. We concluded that in ankle fractures involving disruptions of the syndesmosis or posterior malleolar fragments, early postoperative CT assessment could be justified, because it will reveal malreduction and prompt early revision intervention for a substantial proportion of these patients. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Developmental dysplasia of the hip: What has changed in the last 20 years?

PubMed Central

Kotlarsky, Pavel; Haber, Reuben; Bialik, Victor; Eidelman, Mark

2015-01-01

Developmental dysplasia of the hip (DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persistence of hip dysplasia into adolescence and adulthood may result in abnormal gait, decreased strength and increased rate of degenerative hip and knee joint disease. Despite efforts to recognize and treat all cases of DDH soon after birth, diagnosis is delayed in some children, and outcomes deteriorate with increasing delay of presentation. Different screening programs for DDH were implicated. The suspicion is raised based on a physical examination soon after birth. Radiography and ultrasonography are used to confirm the diagnosis. The role of other imaging modalities, such as magnetic resonance imaging, is still undetermined; however, extensive research is underway on this subject. Treatment depends on the age of the patient and the reducibility of the hip joint. At an early age and up to 6 mo, the main treatment is an abduction brace like the Pavlik harness. If this fails, closed reduction and spica casting is usually done. After the age of 18 mo, treatment usually consists of open reduction and hip reconstruction surgery. Various treatment protocols have been proposed. We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades. PMID:26716085

The 2nd National COPD Readmissions Summit and Beyond: From Theory to Implementation.

PubMed

Willard, Kristen S; Sullivan, Jamie B; Thomashow, Byron M; Jones, Catherine S; Fromer, Leonard; Yawn, Barbara P; Amin, Alpesh; Rommes, Jean M; Rotert, Rhonda

2016-10-06

Chronic obstructive pulmonary disease (COPD) hospitalizations and readmissions adversely impact the health and quality of life of COPD patients. Under the Hospital Readmissions Reduction Program, the Centers for Medicare & Medicaid Services reduce payments to those hospitals exceeding expected rates of COPD readmissions within 30 days of hospital discharge. It was within this climate that the COPD Foundation held its 2 nd COPD Readmissions Summit in March 2015. Experts in attendance: (1) categorized challenges to optimal COPD care, ( 2) analyzed the state of care delivery and readmissions reduction strategies and (3) identified the best available evidence-based approaches to improving care delivery across the continuum, including early diagnosis via spirometry, ongoing device, oxygen and medication reconciliation, treatment that addresses comorbidities and preventive care, robust patient education, prompt post-acute follow up, home health services and pulmonary rehabilitation. Results of this collaborative event formed the basis for PRAXIS, the COPD Foundation's initiative to improve COPD care across the health continuum and to reduce readmissions.

The Affordable Care Act Medicaid Expansions and Personal Finance.

PubMed

Caswell, Kyle J; Waidmann, Timothy A

2017-09-01

Using a novel data set from a major credit bureau, we examine the early effects of the Affordable Care Act Medicaid expansions on personal finance. We analyze less common events such as personal bankruptcy, and more common occurrences such as medical collection balances, and change in credit scores. We estimate triple-difference models that compare individual outcomes across counties that expanded Medicaid versus counties that did not, and across expansion counties that had more uninsured residents versus those with fewer. Results demonstrate financial improvements in states that expanded their Medicaid programs as measured by improved credit scores, reduced balances past due as a percent of total debt, reduced probability of a medical collection balance of $1,000 or more, reduced probability of having one or more recent medical bills go to collections, reduction in the probability of experiencing a new derogatory balance of any type, reduced probability of incurring a new derogatory balance equal to $1,000 or more, and a reduction in the probability of a new bankruptcy filing.

Reduction Patterns of Acute Schistosomiasis in the People's Republic of China

PubMed Central

Abe, Eniola Michael; Yang, Kun; Bergquist, Robert; Qian, Ying-Jun; Zhang, Li-Juan; Xu, Zhi-Min; Xu, Jing; Guo, Jia-Gang; Xiao, Ning; Zhou, Xiao-Nong

2014-01-01

Background Despite significant, steady progress in schistosomiasis control in the People's Republic of China over the past 50 years, available data suggest that the disease has re-emerged with several outbreaks of acute infections in the early new century. In response, a new integrated strategy was introduced. Methods This retrospective study was conducted between Jan 2005 and Dec 2012, to explore the effectiveness of a new integrated control strategy that was implemented by the national control program since 2004. Results A total of 1,047 acute cases were recorded between 2005 and 2012, with an annual reduction in prevalence of 97.7%. The proportion of imported cases of schistosomiasis was higher in 2011 and 2012. Nine clusters of acute infections were detected by spatio-temporal analysis between June and November, indicating that the high risk areas located in the lake and marshland regions. Conclusion This study shows that the new integrated strategy has played a key role in reducing the morbidity of schistosomiasis in the People's Republic of China. PMID:24810958

Hospitalist management of vaso-occlusive pain crisis in patients with sickle cell disease using a pathway of care.

PubMed

Allen Liles, Edmund; Kirsch, Jonathan; Gilchrist, Michael; Adem, Mukhtar

2014-04-01

Patients with sickle cell disease (SCD) suffer from intermittent vaso-occlusive pain crises (VOCs). These crises lead to frequent hospitalizations, significant morbidity, and increased mortality risk. Care pathways can enhance efficiency and quality of care. Our study sought to evaluate the development and implementation of a care pathway for patients with SCD experiencing VOCs. The University of North Carolina (UNC) Comprehensive Sickle Cell Program provides all levels of care for a large population of patients with sickle cell anemia. All patients admitted to UNC Hospitals with SCD VOCs from January 2009 through June 2011 were evaluated. During this time period, we also assessed sequential prospective cohorts during progressive phases of developing and implementing a quality improvement and pathway of care program for this patient population in our study. The developed pathway entailed geographic localization for VOC patients, a single group of faculty physicians caring for these patients, and early use of patient-controlled analgesia (PCA) to achieve pain control. Physicians from the UNC Hospital Medicine Program were responsible for the initiatives. Cohorts were compared to a baseline historical control. Outcomes of interest included patient length of stay (LOS) in the hospital, 30-day readmission rate, need for transfusion, incidence of acute chest syndrome, use of naloxone, and use of PCA. Compared with an historical baseline cohort, the development and implementation of a VOC care pathway for patients with SCD led to reduction in average hospital LOS by 1.44 days (P < 0.05) and an increase in use of PCAs (P < 0.05). Patient readmission rates, number of transfusions, incidence of acute chest syndrome, and use of naloxone did not significantly change. Hospitalist-led management of patients with SCD VOCs using a care pathway that emphasizes early, aggressive PCA-based pain control is associated with reduced hospital LOS. The LOS reduction seen in our study is clinically meaningful. Notably, other measures of patient outcomes and quality of care metrics did not change significantly, and some trended towards improvement.

Promoting School and Life Success through Early Childhood Family Literacy

ERIC Educational Resources Information Center

Swick, Kevin J.

2009-01-01

Early childhood family literacy programs have great potential to positively influence children and families. This article presents the core values and key components of high quality early childhood family literacy programs. The benefits and cost effectiveness of these programs are also discussed.

"I Have a Hippopotamus!": Preparing Effective Early Childhood Environmental Educators

ERIC Educational Resources Information Center

Torquati, Julia; Leeper-Miller, Jennifer; Hamel, Erin; Hong, Soo-Young; Sarver, Susan; Rupiper, Michelle

2017-01-01

This article describes an early childhood teacher-preparation program that infuses environmental education and nature experiences into courses, practicum, and student-teaching experiences. Program philosophy, pedagogy, materials, and methods are described and linked to the Early Childhood Environmental Education Programs: Guidelines for…

SU-E-T-338: Dosimetric Study of Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiation Therapy (IMRT) for Stereotactic Body Radiation Therapy (SBRT) in Early Stage Lung Cancer

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

Ahmad, I; Quinn, K; Seebach, A

2015-06-15

Purpose: This study evaluates the dosimetric differences using volumetric modulated arc therapy (VMAT) in patients previously treated with intensity modulated radiation therapy IMRT for stereotactic body radiotherapy (SBRT) in early stage lung cancer. Methods: We evaluated 9 consecutive medically inoperable lung cancer patients at the start of the SBRT program who were treated with IMRT from November 2010 to October 2011. These patients were treated using 6 MV energy. The 9 cases were then re-planned with VMAT performed with arc therapy using 6 MV flattening filter free (FFF) energy with the same organs at risk (OARS) constraints. Data collected formore » the treatment plans included target coverage, beam on time, dose to OARS and gamma pass rate. Results: Five patients were T1N0 and four patients were T2N0 with all tumors less than 5 cm. The average GTV was 13.02 cm3 (0.83–40.87) and average PTV was 44.65 cm3 (14.06–118.08). The IMRT plans had a mean of 7.2 angles (6–9) and 5.4 minutes (3.6–11.1) per plan. The VMAT plans had a mean of 2.8 arcs (2–3) and 4.0 minutes (2.2–6.0) per plan. VMAT had slightly more target coverage than IMRT with average increase in D95 of 2.68% (1.24–5.73) and D99 of 3.65% (0.88–8.77). VMAT produced lower doses to all OARs. The largest reductions were in maximum doses to the spinal cord with an average reduction of 24.1%, esophagus with an average reduction of 22.1%, and lung with an average reduction in the V20 of 16.3% The mean gamma pass rate was 99.8% (99.2–100) at 3 mm and 3% for VMAT with comparable values for IMRT. Conclusion: These findings suggest that using VMAT for SBRT in early stage lung cancer is superior to IMRT in terms of dose coverage, OAR dose and a lower treatment delivery time with a similar gamma pass rate.« less

The "I" in QRIS Survey: Collecting Data on Quality Improvement Activities for Early Childhood Education Programs. REL 2017-221

ERIC Educational Resources Information Center

Faria, Ann-Marie; Hawkinson, Laura; Metzger, Ivan; Bouacha, Nora; Cantave, Michelle

2017-01-01

A quality rating and improvement system (QRIS) is a voluntary state assessment system that uses multidimensional data on early childhood education programs to rate program quality, support quality improvement efforts, and provide information to families about the quality of available early childhood education programs. QRISs have two components:…

Early to College, Likely to Rise? Benefits and Challenges of Early College Programs

ERIC Educational Resources Information Center

Regan, Daniel

2017-01-01

Students who appear young on college campuses may be in an "Early College" program. Several factors have increased the popularity of these programs, though a proactive push from higher education to expand them has not been a primary one. The impetus for the growth of such programs has come from legislators as well as from high school…

78 FR 10183 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program... persons living with HIV/AIDS, HRSA will be providing a one-time noncompetitive Part C funds award to DFHS... provided critical Ryan White HIV/AIDS Program (Part C) Early Intervention Services for over 427 persons...

78 FR 78976 - Ryan White HIV/AIDS Program Part C Early Intervention Services Grant Under the Ryan White HIV...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... HIV/AIDS Program Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY...: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive Award To Ensure Continued HIV Primary Medical Care. SUMMARY: To prevent a lapse in comprehensive primary care...

Developmental Origins of Chronic Kidney Disease: Should We Focus on Early Life?

PubMed Central

Tain, You-Lin; Hsu, Chien-Ning

2017-01-01

Chronic kidney disease (CKD) is becoming a global burden, despite recent advances in management. CKD can begin in early life by so-called “developmental programming” or “developmental origins of health and disease” (DOHaD). Early-life insults cause structural and functional changes in the developing kidney, which is called renal programming. Epidemiological and experimental evidence supports the proposition that early-life adverse events lead to renal programming and make subjects vulnerable to developing CKD and its comorbidities in later life. In addition to low nephron endowment, several mechanisms have been proposed for renal programming. The DOHaD concept opens a new window to offset the programming process in early life to prevent the development of adult kidney disease, namely reprogramming. Here, we review the key themes on the developmental origins of CKD. We have particularly focused on the following areas: evidence from human studies support fetal programming of kidney disease; insight from animal models of renal programming; hypothetical mechanisms of renal programming; alterations of renal transcriptome in response to early-life insults; and the application of reprogramming interventions to prevent the programming of kidney disease. PMID:28208659

Graduated driver licensing programs and fatal crashes of 16-year-old drivers: a national evaluation.

PubMed

Chen, Li-Hui; Baker, Susan P; Li, Guohua

2006-07-01

Implementation of graduated driver licensing programs is associated with reductions in crash rates of young drivers, but graduated driver licensing programs vary in their components. The impact of programs with different components is unknown. The purpose of this work was to determine which graduated driver licensing programs are associated with the greatest reductions in fatal motor vehicle crashes involving 16-year-old drivers. We conducted a retrospective study of all 16-year-old drivers involved in fatal crashes in the United States from 1994 through 2004 using data from the Fatality Analysis Reporting System and the US Census Bureau. We measured incidence rate ratios of fatal motor vehicle crashes involving 16-year-old drivers according to graduated driver licensing programs, adjusted for state and year. Compared with state quarters with no graduated driver licensing program components, reductions of 16% to 21% in fatal crash involvement rates of 16-year-old drivers occurred with programs that included > or = 3-month mandatory waiting period, nighttime driving restriction, and either > or = 30 hours of supervised driving or passenger restriction. Reductions of 18% to 21% occurred in state quarters with programs that included > or = 5 of the 7 components examined. Drivers aged 20 to 24 or 25 to 29 years did not experience significant reductions. Comprehensive graduated driver licensing programs are associated with reductions of approximately 20% in 16-year-old drivers' fatal crash involvement rates. The greatest benefit seems to be associated with programs that include age requirements and > or = 3 months of waiting before the intermediate stage, nighttime driving restriction, and either > or = 30 hours of supervised driving or passenger restriction.

Early Careerist Interest and Participation in Health Care Leadership Development Programs.

PubMed

Thompson, Jon M; Temple, April

2015-01-01

Health care organizations are increasingly embracing leadership development programs. These programs include a variety of specific activities, such as formally structured leadership development, as well as mentoring, personal development and coaching, 360-degree feedback, and job enlargement, in order to increase the leadership skills of managers and high-potential staff. However, there is a lack of information on how early careerists in health care management view these programs and the degree to which they participate. This article reports on a study undertaken to determine how early careerists working in health care organizations view leadership development programs and their participation in such programs offered by their employers. Study findings are based on a survey of 126 early careerists who are graduates of an undergraduate health services administration program. We found varying levels of interest and participation in specific leadership development activities. In addition, we found that respondents with graduate degrees and those with higher compensation were more likely to participate in selected leadership development program activities. Implications of study findings for health care organizations and early careerists in the offering of, and participation in, leadership development programs are discussed.

Mbd3/NuRD controls lymphoid cell fate and inhibits tumorigenesis by repressing a B cell transcriptional program

PubMed Central

Hamey, Fiona K.; Errami, Youssef

2017-01-01

Differentiation of lineage-committed cells from multipotent progenitors requires the establishment of accessible chromatin at lineage-specific transcriptional enhancers and promoters, which is mediated by pioneer transcription factors that recruit activating chromatin remodeling complexes. Here we show that the Mbd3/nucleosome remodeling and deacetylation (NuRD) chromatin remodeling complex opposes this transcriptional pioneering during B cell programming of multipotent lymphoid progenitors by restricting chromatin accessibility at B cell enhancers and promoters. Mbd3/NuRD-deficient lymphoid progenitors therefore prematurely activate a B cell transcriptional program and are biased toward overproduction of pro–B cells at the expense of T cell progenitors. The striking reduction in early thymic T cell progenitors results in compensatory hyperproliferation of immature thymocytes and development of T cell lymphoma. Our results reveal that Mbd3/NuRD can regulate multilineage differentiation by constraining the activation of dormant lineage-specific enhancers and promoters. In this way, Mbd3/NuRD protects the multipotency of lymphoid progenitors, preventing B cell–programming transcription factors from prematurely enacting lineage commitment. Mbd3/NuRD therefore controls the fate of lymphoid progenitors, ensuring appropriate production of lineage-committed progeny and suppressing tumor formation. PMID:28899870

The Impact of an Educational Program in Brief Interventions for Alcohol Problems on Undergraduate Nursing Students: A Brazilian Context.

PubMed

Junqueira, Marcelle Aparecida de Barros; Rassool, G Hussein; Santos, Manoel Antônio dos; Pillon, Sandra Cristina

2015-01-01

Nurses are the prime movers in the prevention and harm reduction in alcohol-related harm especially for those patients who are unwilling to access specialist care. The aim of the study is to evaluate the attitudes and knowledge of nursing students before and after Brief Intervention Training for alcohol problems. A quasi-experimental study was conducted with 120 undergraduate nursing students. Sixty recruited students were randomized into experimental and control groups (n = 60 each). Participants completed questionnaires on knowledge and attitudes before and after this training of brief intervention. The brief intervention program, 16 hours of duration, includes training for screening and early recognition, nursing, and the treatment of alcohol problems. Analysis of the data showed statistically significant positive change in the nursing students' knowledge (identifications and care) and personal and professional attitudes in working with patients with alcohol problems after the educational intervention. The experimental group differed significantly in all the variables measured at posteducational program. The provision of educational program on brief intervention in undergraduate nursing education can be an effective way for acquisition of knowledge and changes in attitudes in working with patients with alcohol problems.

Natural Atmospheric Environment Model Development for the National Aeronautics and Space Administration's Second Generation Reusable Launch Vehicle

NASA Technical Reports Server (NTRS)

Roberts, Barry C.; Leahy, Frank; Overbey, Glenn; Batts, Glen W.; Parker, Nelson (Technical Monitor)

2002-01-01

The National Aeronautics and Space Administration (NASA) recently began development of a new reusable launch vehicle. The program office is located at Marshall Space Flight Center (MSFC) and is called the Second Generation Reusable Launch Vehicle (2GRLV). The purpose of the program is to improve upon the safety and reliability of the first generation reusable launch vehicle, the Space Shuttle. Specifically, the goals are to reduce the risk of crew loss to less than 1-in-10,000 missions and decreased costs by a factor of 10 to approximately $1,000 per pound of payload launched to low Earth orbit. The program is currently in the very early stages of development and many two-stage vehicle concepts will be evaluated. Risk reduction activities are also taking place. These activities include developing new technologies and advancing current technologies to be used by the vehicle. The Environments Group at MSFC is tasked by the 2GRLV Program to develop and maintain an extensive series of analytical tools and environmental databases which enable it to provide detailed atmospheric studies in support of structural, guidance, navigation and control, and operation of the 2GRLV.

Poverty Reduction in Zambia: A Conceptual Analysis of the Zambian Poverty Reduction Strategy Paper

ERIC Educational Resources Information Center

Imboela, Bruce Lubinda

2005-01-01

Poverty reduction strategy papers (PRSPs) present a recipient country's program of intent for the utilization of World Bank loans and grants to alleviate debt under the bank's programs of action for poverty reduction in highly indebted poor countries (HIPCs). This article argues that structural transformation is a prerequisite for poverty…

WASTE REDUCTION OF TECHNOLOGY EVALUATIONS OF THE U.S. EPA WRITE PROGRAM

EPA Science Inventory

The Waste Reduction Innovative Technology Evaluation (WRITE)Program was established in 1989 to provide objective, accurate performance and cost data about waste reducing technologies for a variety of industrial and commercial application. EPA's Risk Reduction Engineering Laborato...

34 CFR 674.58 - Cancellation for service in an early childhood education program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false Cancellation for service in an early childhood... Cancellation § 674.58 Cancellation for service in an early childhood education program. (a)(1) An institution... addresses the children's cognitive (including language, early literacy, and early mathematics), social...

34 CFR 674.58 - Cancellation for service in an early childhood education program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... addresses the children's cognitive (including language, early literacy, and early mathematics), social... 34 Education 3 2010-07-01 2010-07-01 false Cancellation for service in an early childhood... Cancellation § 674.58 Cancellation for service in an early childhood education program. (a)(1) An institution...

Technical assistance for hazardous-waste reduction

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

Thompson, F.M.; McComas, C.A.

1987-12-01

Minnesota's Waste Management Board has established, developed, and funded the Minnesota Technical Assistance Program (MnTAP). The MnTAP programs offers technical assistance to generators of hazardous waste by offering telephone and onsite consultation, a waste reduction resource bank, information dissemination, a student intern program, and research awards for waste reduction projects. The program has completed three years of successful operation. The increasing interest in and use of MnTAP's services by hazardous-waste generators has justified the belief that state technical assistance programs have an important role to play in helping generators to reduce their waste production.

Session 6: Infant nutrition: future research developments in Europe EARNEST, the early nutrition programming project: EARly Nutrition programming - long-term Efficacy and Safety Trials and integrated epidemiological, genetic, animal, consumer and economic research.

PubMed

Fewtrell, M S

2007-08-01

Increasing evidence from lifetime experimental studies in animals and observational and experimental studies in human subjects suggests that pre- and postnatal nutrition programme long-term health. However, key unanswered questions remain on the extent of early-life programming in contemporary European populations, relevant nutritional exposures, critical time periods, mechanisms and the effectiveness of interventions to prevent or reverse programming effects. The EARly Nutrition programming - long-term Efficacy and Safety Trials and integrated epidemiological, genetic, animal, consumer and economic research (EARNEST) consortium brings together a multi-disciplinary team of scientists from European research institutions in an integrated programme of work that includes experimental studies in human subjects, modern prospective observational studies and mechanistic animal work including physiological studies, cell-culture models and molecular techniques. Theme 1 tests early nutritional programming of disease in human subjects, measuring disease markers in childhood and early adulthood in nineteen randomised controlled trials of nutritional interventions in pregnancy and infancy. Theme 2 examines associations between early nutrition and later outcomes in large modern European population-based prospective studies, with detailed measures of diet in pregnancy and early life. Theme 3 uses animal, cellular and molecular techniques to study lifetime effects of early nutrition. Biomedical studies are complemented by studies of the social and economic importance of programming (themes 4 and 5), and themes encouraging integration, communication, training and wealth creation. The project aims to: help formulate policies on the composition and testing of infant foods; improve the nutritional value of infant formulas; identify interventions to prevent and reverse adverse early nutritional programming. In addition, it has the potential to develop new products through industrial partnerships, generate information on the social and economic cost of programming in Europe and help maintain Europe's lead in this critical area of research.

1988 Winners of the Cost Reduction Incentive Awards.

ERIC Educational Resources Information Center

National Association of College and University Business Officers, Washington, DC.

Outstanding cost-reduction programs implemented at colleges and universities during calendar year 1987 are recognized. Each of the 54 award-winning ideas is described in a paragraph-length program summary. Although some aspects of programs may be unique to a particular institution, creative administrators are challenged to tailor the programs to…

C-Reactive Protein and Procalcitonin as Early Markers of Septic Complications after Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients Within an Enhanced Recovery After Surgery Program.

PubMed

Muñoz, José Luis; Ruiz-Tovar, Jaime; Miranda, Elena; Berrio, Diana Lorena; Moya, Pedro; Gutiérrez, Manuel; Flores, Raquel; Picó, Carlos; Pérez, Ana

2016-05-01

The performance of most bariatric procedures within an Enhanced Recovery After Surgery (ERAS) programs has resulted in considerable advantages, including a reduction in the length of hospital stay to 2 to 3 days. However, some postoperative complications can appear after the patient has been discharged. The aim of this study was to investigate the efficacy of various acute-phase parameters determined 24 and 48 hours after laparoscopic sleeve gastrectomy (LSG) as bariatric procedure, for predicting septic complications, such a surgical site infection (SSI), in the postoperative course. A prospective study of 115 morbidly obese patients who underwent LSG within an ERAS program between 2012 and 2015 was conducted. Blood analysis was performed 24 and 48 hours after surgery. Acute-phase parameters (C-reactive protein [CRP], procalcitonin, and fibrinogen) and WBC count were investigated. Septic complications were observed in 13 patients (11.3%). Using receiver operating characteristic analysis at 24 hours postoperatively, a cutoff level of CRP at 70 mg/L achieved 85% sensitivity and 90% specificity for predicting SSI, and a cutoff level of procalcitonin at 0.2 ng/mL achieved 70% sensitivity and 90% specificity. At 48 hours postoperatively, a cutoff level of CRP at 150 mg/L and procalcitonin at 0.95 ng/mL achieved 100% sensitivity and 100% specificity for predicting SSI. The use of CRP and procalcitonin in the first day and especially in the second day postoperative can predict septic complications after LSG. This is most useful for patients within an ERAS program who will be discharged early. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Work-Related Stressors Among Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Home Visitors: A Qualitative Study.

PubMed

Alitz, Paige J; Geary, Shana; Birriel, Pamela C; Sayi, Takudzwa; Ramakrishnan, Rema; Balogun, Omotola; Salloum, Alison; Marshall, Jennifer T

2018-05-31

Background The Florida Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program delivers evidence-based home visiting services to over 1400 families each year. Home visitors are integral in providing resources for families to promote healthy pregnancy, child development, family wellness, and self-sufficiency. Due to the nature of this work, home visitors experience work-related pressures and stressors that can impact staff well-being and retention. Objectives The purpose of this study was to understand primary sources of work-related stress experienced by home visitors, subsequent effects on their engagement with program participants, and to learn of coping mechanisms used to manage stress. Methods In 2015, Florida MIECHV program evaluators conducted ten focus groups with 49 home visitors during which they ranked and discussed their top sources of work-related stress. Qualitative analysis was conducted to identify emergent themes in work-related stressors and coping/supports. Results Across all sites, the burden of paperwork and data entry were the highest ranked work-related stressors perceived as interfering with home visitors' engagement with participants. The second-highest ranked stressors included caseload management, followed by a lack of resources for families, and dangerous environments. Home visitors reported gratification in their helping relationships families, and relied on coworkers or supervisors as primary sources of workplace support along with self-care (e.g. mini-vacations, recreation, and counseling). Conclusions for practice Florida MIECHV home visitors across all ten focus groups shared similar work-related stressors that they felt diminished engagement with program participants and could impact participant and staff retention. In response, Florida MIECHV increased resources to support home visitor compensation and reduce caseloads, and obtained a competitive award from HRSA to implement a mindfulness-based stress reduction training statewide.

Intergenerational transmission of religious beliefs and practices and the reduction of adolescent delinquency in urban Thailand.

PubMed

Chamratrithirong, Aphichat; Miller, Brenda A; Byrnes, Hilary F; Rhucharoenpornpanich, Orratai; Cupp, Pamela K; Rosati, Michael J; Fongkaew, Warunee; Atwood, Katharine A; Todd, Michael

2013-02-01

This study examines the intergenerational transmission of family religion as measured by parent's and adolescent's beliefs and practices in Buddhism, and its relation to delinquent behaviors among early adolescents in Thailand. The data set is from the Thai Family Matters Project 2007, a representative sample of 420 pairs of parents and teens in Bangkok. A structural equation model is employed for the analysis. The intergenerational transmission and the direct and indirect association between parents' and adolescents' beliefs and practices in Buddhism and adolescents' minor and serious delinquent behaviors are revealed to be significant, controlling for secular parental monitoring. Spirituality within the family can play an important role in preventing delinquency among early adolescents. Policies in the areas related to family empowerment and delinquency prevention may need to consider integrating both secular and non-secular program inputs in their implementation design. Copyright © 2012 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

The 3D-HST Survey: An Introduction

NASA Astrophysics Data System (ADS)

Momcheva, Ivelina G.; Van Dokkum, P. G.; Brammer, G.; Franx, M.; Skelton, R.; Lundgren, B.; Whitaker, K. E.; 3D-HST Team

2013-01-01

3D-HST is a near-IR spectroscopic survey with the Hubble Space Telescope designed to study galaxy evolution at 11. In this talk, I will review the observational details, reduction pipeline, data quality and the wide range of public data products, including added-value photometric and spectroscopic catalogs. Data from the 3D-HST survey are non-proprietary and are useful for a wide variety of science investigations. Our first public data release will be in early 2013 and we would like to advertise this unique data set to the community.

Oregon's Coordinated Care Organizations Increased Timely Prenatal Care Initiation And Decreased Disparities.

PubMed

Muoto, Ifeoma; Luck, Jeff; Yoon, Jangho; Bernell, Stephanie; Snowden, Jonathan M

2016-09-01

Policies at the state and federal levels affect access to health services, including prenatal care. In 2012 the State of Oregon implemented a major reform of its Medicaid program. The new model, called a coordinated care organization (CCO), is designed to improve the coordination of care for Medicaid beneficiaries. This reform effort provides an ideal opportunity to evaluate the impact of broad financing and delivery reforms on prenatal care use. Using birth certificate data from Oregon and Washington State, we evaluated the effect of CCO implementation on the probability of early prenatal care initiation, prenatal care adequacy, and disparities in prenatal care use by type of insurance. Following CCO implementation, we found significant increases in early prenatal care initiation and a reduction in disparities across insurance types but no difference in overall prenatal care adequacy. Oregon's reforms could serve as a model for other Medicaid and commercial health plans seeking to improve prenatal care quality and reduce disparities. Project HOPE—The People-to-People Health Foundation, Inc.

Toward an integrative science of the developing human mind and brain: Focus on the developing cortex☆

PubMed Central

Jernigan, Terry L.; Brown, Timothy T.; Bartsch, Hauke; Dale, Anders M.

2015-01-01

Based on the Huttenlocher lecture, this article describes the need for a more integrative scientific paradigm for addressing important questions raised by key observations made over 2 decades ago. Among these are the early descriptions by Huttenlocher of variability in synaptic density in cortex of postmortem brains of children of different ages and the almost simultaneous reports of cortical volume reductions on MR imaging in children and adolescents. In spite of much progress in developmental neurobiology, developmental cognitive neuroscience, and behavioral and imaging genetics, we still do not know how these early observations relate to each other. It is argued that large scale, collaborative research programs are needed to establish the associations between behavioral differences among children and imaging biomarkers, and to link the latter to cellular changes in the developing brain. Examples of progress and challenges remaining are illustrated with data from the Pediatric Imaging, Neurocognition, and Genetics Project (PING). PMID:26347228

Virtual exploration of early stage atherosclerosis.

PubMed

Olivares, Andy L; González Ballester, Miguel A; Noailly, Jérôme

2016-12-15

Biological mechanisms contributing to atherogenesis are multiple and complex. The early stage of atherosclerosis (AS) is characterized by the accumulation of low-density lipoprotein (LDL) droplets, leading to the creation of foam cells (FC). To address the difficulty to explore the dynamics of interactions that controls this process, this study aimed to develop a model of agents and infer on the most influential cell- and molecule-related parameters. FC started to accumulate after six to eight months of simulated hypercholesterolemia. A sensitivity analysis revealed the strong influence of LDL oxidation rate on the risk of FC creation, which was exploited to model the antioxidant effect of statins. Combined with an empirical simulation of the drug ability to decrease the level of LDL, the virtual statins treatment led to reductions of oxidized LDL levels similar to reductions measured in vivo. An Open source software was used to develop the agent-based model of early AS. Two different concentrations of LDL agents were imposed in the intima layer to simulate healthy and hypercholesterolemia groups of 'virtual patients'. The interactions programmed between molecules and cells were based on experiments and models reported in the literature. A factorial sensitivity analysis explored the respective effects of the less documented model parameters as (i) agent migration speed, (ii) LDL oxidation rate and (iii) concentration of autoantibody agents. Finally, the response of the model to known perturbations was assessed by introducing statins agents, able to reduce the oxidation rate of LDL agents and the LDL boundary concentrations. jerome.noailly@upf.eduSupplementary information: Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The Cell-CT 3D Cell Imaging Technology Platform Enables the Detection of Lung Cancer Using the Non-Invasive LuCED Sputum Test

PubMed Central

Meyer, Michael G.; Hayenga, Jon; Neumann, Thomas; Katdare, Rahul; Presley, Chris; Steinhauer, David; Bell, Timothy; Lancaster, Christy; Nelson, Alan C.

2015-01-01

The war against cancer has yielded important advances in the early diagnosis and treatment of certain cancer types, but the poor detection rate and 5-year survival rate for lung cancer remains little changed over the past 40 years. Early detection through emerging lung cancer screening programs promises the most reliable means of improving mortality. Sputum cytology has been tried without success because sputum contains few malignant cells that are difficult for cytologists to detect. However, research has shown that sputum contains diagnostic malignant cells and could serve as a means of lung cancer detection if those cells could be detected and correctly characterized. Recently, the National Lung Cancer Screening Trial reported that screening by three consecutive low-dose X-ray CT scans provides a 20% reduction in lung cancer mortality compared to chest X-ray. This reduction in mortality, however, comes with an unacceptable false positive rate that increases patient risks and the overall cost of lung cancer screening. This article reviews the LuCED® test for detecting early lung cancer. LuCED is based on patient sputum that is enriched for bronchial epithelial cells. The enriched sample is then processed on the Cell-CT®, which images cells in three dimensions with sub-micron resolution. Algorithms are applied to the 3D cell images to extract morphometric features that drive a classifier to identify cells that have abnormal characteristics. The final status of these candidate abnormal cells is established by the pathologist's manual review. LuCED promotes accurate cell classification which could enable cost effective detection of lung cancer. PMID:26148817

Biological, environmental, and social influences on childhood obesity.

PubMed

Campbell, M Karen

2016-01-01

The prevalence of childhood obesity has increased globally over the past three decades, with evidence of recent leveling off in developed countries. Reduction in the, currently high, prevalence of obesity will require a full understanding of the biological and social pathways to obesity in order to develop appropriately targeted prevention strategies in early life. Determinants of childhood obesity include individual level factors, including biological, social, and behavioral risks, acting within the influence of the child's family environment, which is, in turn, imbedded in the context of the community environment. These influences act across childhood, with suggestions of early critical periods of biological and behavioral plasticity. There is evidence of sex and gender differences in the responses of boys and girls to their environments. The evidence that determinants of childhood obesity act at many levels and at different stages of childhood is of policy relevance to those planning early health promotion and primary prevention programs as it suggests the need to address the individual, the family, the physical environment, the social environment, and social policy. The purpose of this narrative review is to summarize current, and emerging, literature in a multilevel, life course framework.

Conservation Reserve Program effects on floodplain land cover management.

PubMed

Jobe, Addison; Kalra, Ajay; Ibendahl, Elise

2018-05-15

Growing populations and industrialized agriculture practices have eradicated much of the United States wetlands along river floodplains. One program available for the restoration of floodplains is the Conservation Reserve Program (CRP). The current research explores the effects CRP land change has on flooding zones, utilizing Flood Modeller and HEC-RAS. Flood Modeller is proven a viable tool for flood modeling within the United States when compared to HEC-RAS. Application of the software is used in the Nodaway River system located in the western halves of Iowa and Missouri to model effects of introducing new forest areas within the region. Flood stage during the conversion first decreases in the early years, before rising to produce greater heights. Flow velocities where CRP land is present are reduced for long-term scopes. Velocity reduction occurs as the Manning's roughness increases due to tree diameter and brush density. Flood zones become more widespread with the implementation of CRP. Future model implementations are recommended to witness the effects of smaller flood recurrence intervals. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Early Nutrition Programming Project (EARNEST): 5 y of successful multidisciplinary collaborative research.

PubMed

Koletzko, Berthold; Brands, Brigitte; Demmelmair, Hans

2011-12-01

Differences in nutritional experiences during sensitive periods in early life, both before and after birth, can program a person's future development, metabolism, and health. A better scientific understanding of early nutrition programming holds enormous potential for implementing preventive strategies to enhance individuals' long-term health, well-being, and performance. This understanding could reduce costs of health care and social services and may enhance the wealth of societies. The Early Nutrition Programming Project (EARNEST) brought together a multidisciplinary team of international scientists and leaders in key areas of the early nutrition programming field from 40 major research centers across 16 European countries. The project had a total budget of 16.5 million Euros and was funded by the European Communities under the Sixth Framework Program for Research and Technical Development and coordinated by the Children's Hospital at Ludwig-Maximilians-University of Munich. The integrated program of work combined experimental studies in humans, prospective observational studies, and mechanistic animal work, including physiologic studies, cell culture models, and molecular biology techniques. The project lasted from April 2005 to October 2010. After the end of the project, the Early Nutrition Academy (http://www.early-nutrition.org) continues to serve as a platform for the exchange of information, scientific collaboration, and training activities in the area of programming. This article highlights some of the scientific results, achievements, and efforts of EARNEST.

NASA Early Career Fellowship Program

NASA Astrophysics Data System (ADS)

Smith, H. D.

2012-12-01

The Early Career Fellowship program was established in 2005 to facilitate the integration of outstanding early career planetary science researchers into established research funding programs by providing tools and experience useful to maintain a successful research program. Executing a successful research program requires a few key elements such as: successful proposal writing; adequate (paid) research time; management of a laboratory; collaboration and networking; frequent and high-quality publications; and adequate start-up equipment funds. These elements may be particularly critical for early career researchers searching for a tenure- track or equivalent position. The Early Career Fellowship program recognizes the importance of these skills and provides extra funding and resources to begin a successful research program. For consideration into The Early Career Fellowship program, the candidate needs to be the P. I. or Science P.I. of a funded research proposal from one of the participating R&A program areas, be within 7 years of earning a PhD, hold a non-tenure track position, and indicate the early career candidacy when submitting the research proposal. If the research proposal is funded and the discipline scientist nominates the candidate as an early career fellow, the candidate is then considered a Fellow and eligible to propose for Step 2. Upon obtaining a tenure-track equivalent position the Fellow submits a Step 2 proposal for up to one hundred thousand dollars in start-up funds. Start-up funds may be used for salary; undergraduate and/or graduate research assistants; supplies and instrument upgrades; travel to conferences, meetings, and advisory groups; time and travel for learning new skills; publication page charges; books and journal subscriptions; computer time and/or specialized software; and other justified research-specific needs. The early career fellowship program provides resources that a more established scientist would have acquired allowing the Fellow to be a better job applicant. NASA opportunities from the undergraduate to postdoctoral level are also discussed.

Early Head Start Relationships: Association with Program Outcomes

ERIC Educational Resources Information Center

Elicker, James; Wen, Xiaoli; Kwon, Kyong-Ah; Sprague, Jill B.

2013-01-01

Research Findings: Interpersonal relationships among staff caregivers, parents, and children have been recommended as essential aspects of early childhood intervention. This study explored the associations of these relationships with program outcomes for children and parents in 3 Early Head Start programs. A total of 71 children (8-35 months,…

Examining the Association between the "Imagination Library" Early Childhood Literacy Program and Kindergarten Readiness

ERIC Educational Resources Information Center

Samiei, Shahin; Bush, Andrew J.; Sell, Marie; Imig, Doug

2016-01-01

This study evaluated participation in the "Imagination Library" early childhood literacy enrichment program and children's pre-literacy and pre-numeracy skills at kindergarten entry in an urban school district. Previous studies have demonstrated that program participation is associated with greater early childhood reading practices.…

A Parent-Focused Early Intervention Program for Autism: Who Gets Access?

ERIC Educational Resources Information Center

Birkin, Christina; Anderson, Angelika; Seymour, Fred; Moore, Dennis W.

2008-01-01

Background: The EarlyBird program is a psycho-educational early intervention program for parents of children with autistic spectrum disorder (ASD). It aims to provide parents with skills to increase their child's communication and manage challenging behaviour using behavioural techniques. Method: Two interlinked studies examined access to the…

A Case Study of the Development of an Early Retirement Program for University Faculty.

ERIC Educational Resources Information Center

Chronister, Jay L.; Trainer, Aileen

1985-01-01

To offset declining enrollments, financial constraints, younger faculties, and high tenure ratios, some institutions are considering early retirement programs to facilitate faculty turnover. A University of Virginia faculty committee reviewed several early retirement options and selected a cost-effective bridging program with ample incentives and…

Using Early Learning Standards to Provide High-Quality Education for All Children: The Early Learning Guidelines Toolkit

ERIC Educational Resources Information Center

Flores, Roseanne L.; Curby, Timothy W.; Coleman, Hardin; Melo, Kristan

2016-01-01

Today with the rise in the number of 3- to 6-year-old children enrolled in center-based early childhood programs, and a focus on program quality, it becomes imperative for educators to have a better understanding of the role research plays in establishing high-quality programs as these programs provide much of the foundation that supports early…

The Use of a Structured Literacy Program To Facilitate the Inclusion of Marginal and Special Education Students into Regular Classes.

ERIC Educational Resources Information Center

Center, Yola; Freeman, Louella

This research review examined the use of a whole class early literacy program in classes which included disadvantaged and at-risk children in Australia. The program, Schoolwide Early Language and Literacy (SWELL), is based on an interactive compensatory theory of literacy acquisition adapted from Success for All, a U.S. early literacy program. The…

Federal Early Childhood Programs: A Description and Analysis of Research, Child Care, State Grant and Teacher Training Programs Pertaining to Young Children. Interim Report.

ERIC Educational Resources Information Center

Searcy, Ellen Ouhl

The main objectives of this report about the Federal effort in early learning research are to assist the National Program on Early Childhood Education (NPECE) in planning its research and development program, to identify predicted "popular" areas of research for the future, and to identify possible NPECE funding sources. The report…

The NASA pollution-reduction technology program for small jet aircraft engines

NASA Technical Reports Server (NTRS)

Fear, J. S.

1976-01-01

Three advanced combustor concepts, designed for the AiResearch TFE 731-2 turbofan engine, were evaluated in screening tests. Goals for carbon monoxide and unburned hydrocarbons were met or closely approached with two of the concepts with relatively modest departures from conventional combustor design practices. A more advanced premixing/prevaporizing combustor, while appearing to have the potential for meeting the oxides of nitrogen goal as well, will require extensive development to make it a practical combustion system. Smoke numbers for the two combustor concepts were well within the EPA smoke standard. Phase 2, Combustor-Engine Compatibility Testing, which is in its early stages, and planned Phase 3, Combustor-Engine Demonstration Testing, are also described.

The control of satellites with microgravity constraints: The COMET Control System

NASA Astrophysics Data System (ADS)

Grossman, Walter; Freesland, Douglas

1994-05-01

The COMET attitude determination and control system, using inverse dynamics and a novel torque distribution/momentum management technique, has shown great flexibility, performance, and robustness. Three-axis control with two wheels is an inherent consequence of inverse dynamics control which allows for reduction in spacecraft weight and cost, or alternatively, provides a simple means of failure-redundancy for three-wheel spacecraft. The control system, without modification, has continued to perform well in spite of large changes in spacecraft mass properties and mission orbit altitude that have occurred during development. This flexibility has obviated imposition of early stringent ADACS design constraints and has greatly reduced commonly incurred ADACS modification costs and delay associated with program maturation.

The control of satellites with microgravity constraints: The COMET Control System

NASA Technical Reports Server (NTRS)

Grossman, Walter; Freesland, Douglas

1994-01-01

The COMET attitude determination and control system, using inverse dynamics and a novel torque distribution/momentum management technique, has shown great flexibility, performance, and robustness. Three-axis control with two wheels is an inherent consequence of inverse dynamics control which allows for reduction in spacecraft weight and cost, or alternatively, provides a simple means of failure-redundancy for three-wheel spacecraft. The control system, without modification, has continued to perform well in spite of large changes in spacecraft mass properties and mission orbit altitude that have occurred during development. This flexibility has obviated imposition of early stringent ADACS design constraints and has greatly reduced commonly incurred ADACS modification costs and delay associated with program maturation.

[Biological experiments on "Kosmos-1887"].

PubMed

Alpatov, A M; I'lin, E A; Antipov, V V; Tairbekov, M G

1989-01-01

In the 13-ray space flight on Kosmos-1887 various experiments in the field of cell biology, genetics, biorhythm, developmental biology and regeneration were performed using bacteria, protozoa, plants, worms, insects, fish and amphibia. Paramecia showed enhanced cell proliferation, spheroidization and diminished protein content. Experiments on fruit-flies, newt oocytes and primate lymphocytes confirmed involvement of the cell genetic apparatus in responses to microgravity. Beetles exhibited a reduction of the length of the spontaneous period of freely running circadian rhythms. Carausius morosus developed latent changes in early embryogenesis which manifested at later stages of ontogenesis. Exposure to microgravity did not prevent recovery of injured tissues; moreover their regeneration may be accelerated after recovery. Biology research programs in future biosatellite flights are discussed.

When could a stigma program to address mental illness in the workplace break even?

PubMed

Dewa, Carolyn S; Hoch, Jeffrey S

2014-10-01

To explore basic requirements for a stigma program to produce sufficient savings to pay for itself (that is, break even). A simple economic model was developed to compare reductions in total short-term disability (SDIS) cost relative to a stigma program's costs. A 2-way sensitivity analysis is used to illustrate conditions under which this break-even scenario occurs. Using estimates from the literature for the SDIS costs, this analysis shows that a stigma program can provide value added even if there is no reduction in the length of an SDIS leave. To break even, a stigma program with no reduction in the length of an SDIS leave would need to prevent at least 2.5 SDIS claims in an organization of 1000 workers. Similarly, a stigma program can break even with no reduction in the number of SDIS claims if it is able to reduce SDIS episodes by at least 7 days in an organization of 1000 employees. Modelling results, such as those presented in our paper, provide information to help occupational health payers become prudent buyers in the mental health market place. While in most cases, the required reductions seem modest, the real test of both the model and the program occurs once a stigma program is piloted and evaluated in a real-world setting.

Mindfulness meditation-based stress reduction: experience with a bilingual inner-city program.

PubMed

Roth, B; Creaser, T

1997-03-01

This article describes a bilingual mindfulness meditation-based stress reduction program in an inner-city setting. Mindfulness meditation is defined, and the practices of breathing meditation, eating meditation, walking meditation, and mindful yoga are described. Data analysis examined compliance, medical and psychologic symptom reduction, and changes in self-esteem, of English- and Spanish-speaking patients who completed the 8-week Stress Reduction and Relaxation Program at the Community Health Center in Meriden, Conn. Statistically significant decreases in medical and psychologic symptoms and improvement in self-esteem were found. Many program completers reported dramatic changes in attitudes, beliefs, habits, and behaviors. Despite the limitations of the research design, these findings suggest that a mindfulness meditation course can be an effective health care intervention when utilized by English- and Spanish-speaking patients in an inner-city community health center. The article includes a discussion of factors to be considered when establishing a mindfulness meditation-based stress reduction program in a health care setting.

An estimate of the cost of burnout on early retirement and reduction in clinical hours of practicing physicians in Canada

PubMed Central

2014-01-01

Background Interest in the impact of burnout on physicians has been growing because of the possible burden this may have on health care systems. The objective of this study is to estimate the cost of burnout on early retirement and reduction in clinical hours of practicing physicians in Canada. Methods Using an economic model, the costs related to early retirement and reduction in clinical hours of physicians were compared for those who were experiencing burnout against a scenario in which they did not experience burnout. The January 2012 Canadian Medical Association Masterfile was used to determine the number of practicing physicians. Transition probabilities were estimated using 2007–2008 Canadian Physician Health Survey and 2007 National Physician Survey data. Adjustments were also applied to outcome estimates based on ratio of actual to planned retirement and reduction in clinical hours. Results The total cost of burnout for all physicians practicing in Canada is estimated to be $213.1 million ($185.2 million due to early retirement and $27.9 million due to reduced clinical hours). Family physicians accounted for 58.8% of the burnout costs, followed by surgeons for 24.6% and other specialists for 16.6%. Conclusion The cost of burnout associated with early retirement and reduction in clinical hours is substantial and a significant proportion of practicing physicians experience symptoms of burnout. As health systems struggle with human resource shortages and expanding waiting times, this estimate sheds light on the extent to which the burden could be potentially decreased through prevention and promotion activities to address burnout among physicians. PMID:24927847

Transit investments for greenhouse gas and energy reduction program : second assessment report.

DOT National Transportation Integrated Search

2014-08-01

This report is the second assessment of the U.S. Department of Transportation, Federal Transit Administrations Transit Investments for : Greenhouse Gas and Energy Reduction (TIGGER) Program. The TIGGER Program provides capital funds to transit age...

Treatment Attrition: Associations with Negative Affect Smoking Motives and Barriers to Quitting Among Treatment-Seeking Smokers

PubMed Central

Garey, Lorra; Kauffman, Brooke Y.; Neighbors, Clayton; Schmidt, Norman B.; Zvolensky, Michael J.

2016-01-01

Introduction Pre-treatment attrition and perceived barriers for quitting are clinically important processes involved in early phases of quitting smoking. However, less is known about the constructs that may contribute to these processes such as negative affect reduction smoking motives. Method The current study sought to evaluate the relation between negative affect reduction smoking motives with pre-treatment attrition and perceived barriers for quitting in a sample of 425 treatment-seeking smokers (48.5% female; Mage = 37.69; SD = 13.61) enrolled in a smoking cessation study examining the efficacy of a transdiagnostic panic-smoking cessation treatment relative to a standard smoking cessation treatment. Results Results indicated that greater negative affect reduction smoking motives was associated with an increased likelihood of treatment initiation (Odds Ratio = 1.49, CI: 1.09, 2.04). Additionally, negative affect reduction smoking motives was associated with greater perceived barriers for cessation among pre-treatment drop-outs and treatment initiators. Conclusions This initial investigation provides evidence for the possible clinical utility in addressing negative affect reduction smoking motives during early stages of quitting. Additionally, such findings could potentially inform the development of personalized, early stages of quitting interventions for smoking cessation. PMID:27518764

Our hearts and minds--what would it take for Australia to become the healthiest country in the world?

PubMed

Ring, Ian T; O'Brien, John F

2007-10-15

To highlight recent reductions in mortality rates in Australia and identify conditions and population groups with the greatest potential for further reduction in mortality rates. International benchmarking and intranational comparisons of mortality rates were used to identify areas with the greatest potential for improvement. Latest data from Organisation for Economic Cooperation and Development (OECD) countries confirm that, while Japan's death rates remain the lowest in the world, Australia's are decreasing rapidly and we now rival Switzerland for second overall ranking. When the contributions of specific conditions are compared, the areas with the greatest potential for reductions are circulatory diseases (especially ischaemic heart disease); suicide; injury and violence; smoking-related conditions; and cancers amenable to prevention/early detection. Intranational comparisons show considerable scope for reduction in inequalities, especially those between Aboriginal and Torres Strait Islander peoples and other Australians, between males and females, and between low and high socioeconomic groups. These conditions and inequalities are highly interrelated, as differentials in health status are often mediated through broader societal inequalities. Australia should aim to become the country with the lowest mortality rate in the world. This could realistically be achieved by benchmarking performance nationally and internationally, applying current knowledge and available interventions, matching policies with funding, and implementing systemic national programs and activities to promote health and prevent "illth".

Area/latency optimized early output asynchronous full adders and relative-timed ripple carry adders.

PubMed

Balasubramanian, P; Yamashita, S

2016-01-01

This article presents two area/latency optimized gate level asynchronous full adder designs which correspond to early output logic. The proposed full adders are constructed using the delay-insensitive dual-rail code and adhere to the four-phase return-to-zero handshaking. For an asynchronous ripple carry adder (RCA) constructed using the proposed early output full adders, the relative-timing assumption becomes necessary and the inherent advantages of the relative-timed RCA are: (1) computation with valid inputs, i.e., forward latency is data-dependent, and (2) computation with spacer inputs involves a bare minimum constant reverse latency of just one full adder delay, thus resulting in the optimal cycle time. With respect to different 32-bit RCA implementations, and in comparison with the optimized strong-indication, weak-indication, and early output full adder designs, one of the proposed early output full adders achieves respective reductions in latency by 67.8, 12.3 and 6.1 %, while the other proposed early output full adder achieves corresponding reductions in area by 32.6, 24.6 and 6.9 %, with practically no power penalty. Further, the proposed early output full adders based asynchronous RCAs enable minimum reductions in cycle time by 83.4, 15, and 8.8 % when considering carry-propagation over the entire RCA width of 32-bits, and maximum reductions in cycle time by 97.5, 27.4, and 22.4 % for the consideration of a typical carry chain length of 4 full adder stages, when compared to the least of the cycle time estimates of various strong-indication, weak-indication, and early output asynchronous RCAs of similar size. All the asynchronous full adders and RCAs were realized using standard cells in a semi-custom design fashion based on a 32/28 nm CMOS process technology.

Towards accurate radial velocities from early type spectra in the framework of an ESO key programme

NASA Astrophysics Data System (ADS)

Verschueren, Werner; David, M.; Hensberge, Herman

In order to elucidate the internal kinematics in very young stellar groups, a dedicated machinery was set up, which made it possible to proceed from actual observations to reductions and correlation analysis to the ultimate derivation of early-type stellar radial velocities (RVs) with the requisite precision. The following ingredients are found to be essential to obtain RVs of early-type stars at the 1-km/s level of precision: high-resolution, high-S/N spectra covering a large wavelength range; maximal reduction of observational errors and the use of optimal reduction procedures; the intelligent use of a versatile cross-correlation package; and comparison of velocities derived from different regions of the spectrum in order to detect systematic mismatches between object and template spectrum in some of the lines.

Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial.

PubMed

Nakagami, Yukako; Kubo, Hiroaki; Katsuki, Ryoko; Sakai, Tomomichi; Sugihara, Genichi; Naito, Chisako; Oda, Hiroyuki; Hayakawa, Kohei; Suzuki, Yuriko; Fujisawa, Daisuke; Hashimoto, Naoki; Kobara, Keiji; Cho, Tetsuji; Kuga, Hironori; Takao, Kiyoshi; Kawahara, Yoko; Matsumura, Yumi; Murai, Toshiya; Akashi, Koichi; Kanba, Shigenobu; Otsuka, Kotaro; Kato, Takahiro A

2018-01-01

Suicide is a crucial global health concern and effective suicide prevention has long been warranted. Mental illness, especially depression is the highest risk factor of suicide. Suicidal risk is increased in people not only with mental illness but also with physical illnesses, thus medical staff caring for physically-ill patients are also required to manage people with suicidal risk. In the present study, we evaluated our newly developed suicide intervention program among medical staff. We developed a 2-h suicide intervention program for medical staff, based on the Mental Health First Aid (MHFA), which had originally been developed for the general population. We conducted this program for 74 medical staff members from 2 hospitals. Changes in knowledge, perceived skills, and confidence in early intervention of depression and suicide-prevention were evaluated using self-reported questionnaires at 3 points; pre-program, immediately after the program, and 1 month after program. This suicide prevention program had significant effects on improving perceived skills and confidence especially among nurses and medical residents. These significant effects lasted even 1 month after the program. Design was a single-arm study with relatively small sample size and short-term follow up. The present study suggests that the major target of this effective program is nurses and medical residents. Future research is required to validate the effects of the program with control groups, and also to assess long-term effectiveness and actual reduction in suicide rates. Copyright © 2017 Elsevier B.V. All rights reserved.

Implementing an Early Intervention Program for Residential Students Who Present with Suicide Risk: A Case Study

ERIC Educational Resources Information Center

Rivero, Estela M.; Cimini, M. Dolores; Bernier, Joseph E.; Stanley, Judith A.; Murray, Andrea D.; Anderson, Drew A.; Wright, Heidi R.

2014-01-01

Objective: This case study examined the effects of an early intervention program designed to respond to residential college students demonstrating risk for suicide. Participants: Participants were 108 undergraduates at a large northeastern public university referred to an early intervention program subsequent to presenting with risk factors for…

Early Intervention Programs: Opening the Door to Higher Education. ERIC Digest.

ERIC Educational Resources Information Center

Fenske, Robert H.; Geranios, Christine A.; Keller, Jonathan E.; Moore, David E.

This digest summarizes a larger document of the same title which examines early intervention programs providing services and resources to encourage low-income/minority youth to finish high school and enter college. It notes provisions of federal law which encourage such programs and the unifying mission of the National Early Intervention…

Paths to School Readiness: An In-Depth Look at Three Early Childhood Programs.

ERIC Educational Resources Information Center

Harvard Family Research Project, Cambridge, MA.

This report provides practitioners in the field of child and family services with important guidelines on early childhood education and family support programs including program design, community collaboration, funding, and staff management. The book presents the five main components of establishing an early childhood education and family support…

Child Nutrition: A Focus on Preschool. Guidance for Early Care and Education Programs.

ERIC Educational Resources Information Center

Connecticut State Dept. of Education, Hartford.

Because the development of healthy eating and physical activity habits during early childhood can prevent disease and support a lifetime of good health, nutrition services are a critical component of early childhood programs. This publication provides guidance to preschool programs to help them meet the Connecticut state goal of practicing…

A Community-Based Early Intervention Program for Toddlers with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Rollins, Pamela Rosenthal; Campbell, Michelle; Hoffman, Renee Thibodeau; Self, Kayli

2016-01-01

This study examined Pathways Early Autism Intervention, a community-based, parent-mediated, intensive behavioral and developmental intervention program for children with autism spectrum disorders that could be used as a model for state-funded early intervention programs. A single-subject, multiple-baseline, across-participants design was used.…

Annual Growth of Contract Costs for Major Programs in Development and Early Production

DTIC Science & Technology

2016-03-21

changes, we can identify some underlying drivers and rule out others. Development and Early Production Differences BBP-era drops are driven by dropping...Annual Growth of Contract Costs for Major Programs in Development and Early Production Dan Davis and Philip S...Growth of Contract Costs for Major Programs in Development and Early Production Dan Davis and Philip S. Antón March 21, 2016 SUMMARY Cost is

Effects of a Computer-Based Early Reading Program on the Early Reading and Oral Language Skills of At-Risk Preschool Children

ERIC Educational Resources Information Center

Huffstetter, Mary; King, James R.; Onwuegbuzie, Anthony J.; Schneider, Jenifer J.; Powell-Smith, Kelly A.

2010-01-01

This study examined the effects of a computer-based early reading program (Headsprout Early Reading) on the oral language and early reading skills of at-risk preschool children. In a pretest-posttest control group design, 62 children were randomly assigned to receive supplemental instruction with Headsprout Early Reading (experimental group) or…

78 FR 51811 - Agency Information Collection Activity Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-21

... support public transit agencies in making capital investments that would assist in the reduction of energy... collection: Transit Investments in Greenhouse Gas and Energy Reduction (TIGGER) Program. The information... Investments in Greenhouse Gas and Energy Reduction (TIGGER) Program (OMB Number: 2132-0566). Abstract: The...

5 CFR 362.408 - Termination and reduction in force.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Termination and reduction in force. 362.408 Section 362.408 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PATHWAYS PROGRAMS Presidential Management Fellows Program § 362.408 Termination and reduction in force. (a...

5 CFR 362.205 - Reduction in force (RIF) and termination.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Reduction in force (RIF) and termination. 362.205 Section 362.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PATHWAYS PROGRAMS Internship Program § 362.205 Reduction in force (RIF) and termination. (a...

5 CFR 362.205 - Reduction in force (RIF) and termination.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Reduction in force (RIF) and termination. 362.205 Section 362.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PATHWAYS PROGRAMS Internship Program § 362.205 Reduction in force (RIF) and termination. (a...

5 CFR 362.408 - Termination and reduction in force.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Termination and reduction in force. 362.408 Section 362.408 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PATHWAYS PROGRAMS Presidential Management Fellows Program § 362.408 Termination and reduction in force. (a...

Pathway from child sexual and physical abuse to risky sex among emerging adults: the role of trauma-related intrusions and alcohol problems.

PubMed

Walsh, Kate; Latzman, Natasha E; Latzman, Robert D

2014-04-01

Some evidence suggests that risk reduction programming for sexual risk behaviors (SRB) has been minimally effective, which emphasized the need for research on etiological and mechanistic factors that can be addressed in prevention and intervention programming. Childhood sexual and physical abuse have been linked with SRB among older adolescents and emerging adults; however, pathways to SRB remain unclear. This study adds to the literature by testing a model specifying that traumatic intrusions after early abuse may increase risk for alcohol problems, which in turn may increase the likelihood of engaging in various types of SRB. Participants were 1,169 racially diverse college students (72.9% female, 37.6% black/African-American, and 33.6% white) who completed anonymous questionnaires assessing child abuse, traumatic intrusions, alcohol problems, and sexual risk behavior. The hypothesized path model specifying that traumatic intrusions and alcohol problems account for associations between child abuse and several aspects of SRB was a good fit for the data; however, for men, stronger associations emerged between physical abuse and traumatic intrusions and between traumatic intrusions and alcohol problems, whereas for women, alcohol problems were more strongly associated with intent to engage in risky sex. Findings highlight the role of traumatic intrusions and alcohol problems in explaining paths from childhood abuse to SRB in emerging adulthood, and suggest that risk reduction programs may benefit from an integrated focus on traumatic intrusions, alcohol problems, and SRB for individuals with abuse experiences. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Short-Term Medical Costs of a VHA Health Information Exchange: A CHEERS-Compliant Article

PubMed Central

French, Dustin D.; Dixon, Brian E.; Perkins, Susan M.; Myers, Laura J.; Weiner, Michael; Zillich, Allan J.; Haggstrom, David A.

2016-01-01

Abstract The Virtual Lifetime Electronic Record (VLER) Health program provides the Veterans Health Administration (VHA) a framework whereby VHA providers can access the veterans’ electronic health record information to coordinate healthcare across multiple sites of care. As an early adopter of VLER, the Indianapolis VHA and Regenstrief Institute implemented a regional demonstration program involving bi-directional health information exchange (HIE) between VHA and non-VHA providers. The aim of the study is to determine whether implementation of VLER HIE reduces 1 year VHA medical costs. A cohort evaluation with a concurrent control group compared VHA healthcare costs using propensity score adjustment. A CHEERs compliant checklist was used to conduct the cost evaluation. Patients were enrolled in the VLER program onsite at the Indianapolis VHA in outpatient clinics or through the release-of-information office. VHA cost data (in 2014 dollars) were obtained for both enrolled and nonenrolled (control) patients for 1 year prior to, and 1 year after, the index date of patient enrollment. There were 6104 patients enrolled in VLER and 45,700 patients in the control group. The annual adjusted total cost difference per patient was associated with a higher cost for VLER enrollees $1152 (95% CI: $807–1433) (P < 0.01) (in 2014 dollars) than VLER nonenrollees. Short-term evaluation of this demonstration project did not show immediate reductions in healthcare cost as might be expected if HIE decreased redundant medical tests and treatments. Cost reductions from shared health information may be realized with longer time horizons. PMID:26765453

Modeling and assessing international climate financing

NASA Astrophysics Data System (ADS)

Wu, Jing; Tang, Lichun; Mohamed, Rayman; Zhu, Qianting; Wang, Zheng

2016-06-01

Climate financing is a key issue in current negotiations on climate protection. This study establishes a climate financing model based on a mechanism in which donor countries set up funds for climate financing and recipient countries use the funds exclusively for carbon emission reduction. The burden-sharing principles are based on GDP, historical emissions, and consumptionbased emissions. Using this model, we develop and analyze a series of scenario simulations, including a financing program negotiated at the Cancun Climate Change Conference (2010) and several subsequent programs. Results show that sustained climate financing can help to combat global climate change. However, the Cancun Agreements are projected to result in a reduction of only 0.01°C in global warming by 2100 compared to the scenario without climate financing. Longer-term climate financing programs should be established to achieve more significant benefits. Our model and simulations also show that climate financing has economic benefits for developing countries. Developed countries will suffer a slight GDP loss in the early stages of climate financing, but the longterm economic growth and the eventual benefits of climate mitigation will compensate for this slight loss. Different burden-sharing principles have very similar effects on global temperature change and economic growth of recipient countries, but they do result in differences in GDP changes for Japan and the FSU. The GDP-based principle results in a larger share of financial burden for Japan, while the historical emissions-based principle results in a larger share of financial burden for the FSU. A larger burden share leads to a greater GDP loss.

Upward Bound: In the Beginning.

ERIC Educational Resources Information Center

Groutt, John; Hill, Calvin

2001-01-01

Describes the early history of the Upward Bound program, including the role of President Johnson's vision, the Task Force on Poverty, the Office of Economic Opportunity, and Community Action Programs; influences on the development of the program; establishment of the program's administrative structure; pilot programs; and early problems leading to…

Early-life adversity-induced long-term epigenetic programming associated with early onset of chronic physical aggression: Studies in humans and animals.

PubMed

Chistiakov, Dimitry A; Chekhonin, Vladimir P

2017-06-05

To examine whether chronic physical aggression (CPA) in adulthood can be epigenetically programmed early in life due to exposure to early-life adversity. Literature search of public databases such as PubMed/MEDLINE and Scopus. Children/adolescents susceptible for CPA and exposed to early-life abuse fail to efficiently cope with stress that in turn results in the development of CPA later in life. This phenomenon was observed in humans and animal models of aggression. The susceptibility to aggression is a complex trait that is regulated by the interaction between environmental and genetic factors. Epigenetic mechanisms mediate this interaction. Subjects exposed to stress early in life exhibited long-term epigenetic programming that can influence their behaviour in adulthood. This programming affects expression of many genes not only in the brain but also in other systems such as neuroendocrine and immune. The propensity to adult CPA behaviour in subjects experienced to early-life adversity is mediated by epigenetic programming that involves long-term systemic epigenetic alterations in a whole genome.

Remediation of Childhood Math Anxiety and Associated Neural Circuits through Cognitive Tutoring.

PubMed

Supekar, Kaustubh; Iuculano, Teresa; Chen, Lang; Menon, Vinod

2015-09-09

Math anxiety is a negative emotional reaction that is characterized by feelings of stress and anxiety in situations involving mathematical problem solving. High math-anxious individuals tend to avoid situations involving mathematics and are less likely to pursue science, technology, engineering, and math-related careers than those with low math anxiety. Math anxiety during childhood, in particular, has adverse long-term consequences for academic and professional success. Identifying cognitive interventions and brain mechanisms by which math anxiety can be ameliorated in children is therefore critical. Here we investigate whether an intensive 8 week one-to-one cognitive tutoring program designed to improve mathematical skills reduces childhood math anxiety, and we identify the neurobiological mechanisms by which math anxiety can be reduced in affected children. Forty-six children in grade 3, a critical early-onset period for math anxiety, participated in the cognitive tutoring program. High math-anxious children showed a significant reduction in math anxiety after tutoring. Remarkably, tutoring remediated aberrant functional responses and connectivity in emotion-related circuits anchored in the basolateral amygdala. Crucially, children with greater tutoring-induced decreases in amygdala reactivity had larger reductions in math anxiety. Our study demonstrates that sustained exposure to mathematical stimuli can reduce math anxiety and highlights the key role of the amygdala in this process. Our findings are consistent with models of exposure-based therapy for anxiety disorders and have the potential to inform the early treatment of a disability that, if left untreated in childhood, can lead to significant lifelong educational and socioeconomic consequences in affected individuals. Significance statement: Math anxiety during early childhood has adverse long-term consequences for academic and professional success. It is therefore important to identify ways to alleviate math anxiety in young children. Surprisingly, there have been no studies of cognitive interventions and the underlying neurobiological mechanisms by which math anxiety can be ameliorated in young children. Here, we demonstrate that intensive 8 week one-to-one cognitive tutoring not only reduces math anxiety but also remarkably remediates aberrant functional responses and connectivity in emotion-related circuits anchored in the amygdala. Our findings are likely to propel new ways of thinking about early treatment of a disability that has significant implications for improving each individual's academic and professional chances of success in today's technological society that increasingly demands strong quantitative skills. Copyright © 2015 the authors 0270-6474/15/3512574-10$15.00/0.

Exploring the Relationship Between Treatment Satisfaction, Perceived Improvements in Functioning and Well-Being and Gambling Harm Reduction Among Clients of Pathological Gambling Treatment Programs

PubMed Central

Bernhard, Bo; Abarbanel, Brett L. L.; St. John, Sarah; Kalina, Ashlee

2014-01-01

The objective of this study was to evaluate the relationship between treatment service quality, perceived improvement in social, functional, and material well-being and reduction in gambling behaviors among clients of Nevada state-funded pathological gambling treatment programs. Utilizing survey data from 361 clients from 2009 to 2010, analyses revealed that client satisfaction with treatment services is positively associated with perceived improvements in social, functional, and material well-being, abstinence from gambling, reduction in gambling thoughts and reduction in problems associated with gambling, even after controlling for various respondent characteristics. These findings can be useful to treatment program staff in managing program development and allocating resources. PMID:23756725

Impact of HIV prevention programs on drug users in Malaysia.

PubMed

Kamarulzaman, Adeeba

2009-11-01

Faced with a rising HIV epidemic among injecting drug users, harm reduction policies and programs were introduced in Malaysia in 2005. The positive impact seen since the introduction of these programs comprise the inclusion of the health aspects of illicit drug use in the country's drug policies; better access to antiretroviral therapy for injecting drug users who are HIV infected; reduction in HIV-risk behavior; and greater social benefits, including increased employment. Despite these achievements, tension between law enforcement and public health persists, as harm reduction exists alongside an overall drug policy that is based on abstinence and zero tolerance. Unless there is harmonization of this policy, sustainability and scale-up of harm reduction programs will remain a challenge.

Cardiovascular health promotion for children: a model for a Parish (County)-wide program (implementation and preliminary results).

PubMed

Berenson, Gerald S

2010-01-01

Cardiovascular (CV) risk factors in childhood result in a lifetime burden on the CV system. The Bogalusa Heart Study, a prevention program for children, addresses behaviors and lifestyles associated with CV risk. This prevention program utilizes the substructure of a Parish (County) that can be a model for other areas. All aspects in educating school children-the classroom, physical activity, cafeteria, teachers, and parents with community involvement-are included. The program requires cooperation of parents, schools, physicians, and political and business personnel. Their collaboration helps implement and sustain the program. Understanding the origin of coronary artery disease, hypertension, diabetes, and now the obesity epidemic shows the need to develop a framework for improving lifestyles and behaviors beginning in childhood. In addition to nutrition and exercise, the program addresses tobacco, alcohol, and drug use, and societal problems such as dropping out of school, violent behavior, and teenage pregnancy. An initial accomplishment is the entry into all elementary schools, representing approximately 7000 children. Early results show reduction in obesity, increased physical activity, improved decision making, and healthy attitudes. This public health model is inexpensive by utilizing prior research findings and integrating into community resources. Health education of children is an important aspect of preventive cardiology with a need for pediatric and adult cardiologists' involvement. 2009 Wiley Periodicals, Inc.

The early effects of Medicare's mandatory hospital pay-for-performance program.

PubMed

Ryan, Andrew M; Burgess, James F; Pesko, Michael F; Borden, William B; Dimick, Justin B

2015-02-01

To evaluate the impact of hospital value-based purchasing (HVBP) on clinical quality and patient experience during its initial implementation period (July 2011-March 2012). Hospital-level clinical quality and patient experience data from Hospital Compare from up to 5 years before and three quarters after HVBP was initiated. Acute care hospitals were exposed to HVBP by mandate while critical access hospitals and hospitals located in Maryland were not exposed. We performed a difference-in-differences analysis, comparing performance on 12 incentivized clinical process and 8 incentivized patient experience measures between hospitals exposed to the program and a matched comparison group of nonexposed hospitals. We also evaluated whether hospitals that were ultimately exposed to HVBP may have anticipated the program by improving quality in advance of its introduction. Difference-in-differences estimates indicated that hospitals that were exposed to HVBP did not show greater improvement for either the clinical process or patient experience measures during the program's first implementation period. Estimates from our preferred specification showed that HVBP was associated with a 0.51 percentage point reduction in composite quality for the clinical process measures (p > .10, 95 percent CI: -1.37, 0.34) and a 0.30 percentage point reduction in composite quality for the patient experience measures (p > .10, 95 percent CI: -0.79, 0.19). We found some evidence that hospitals improved performance on clinical process measures prior to the start of HVBP, but no evidence of this phenomenon for the patient experience measures. The timing of the financial incentives in HVBP was not associated with improved quality of care. It is unclear whether improvement for the clinical process measures prior to the start of HVBP was driven by the expectation of the program or was the result of other factors. © Health Research and Educational Trust.

Los Angeles congestion reduction demonstration express lanes program : national evaluation report.

DOT National Transportation Integrated Search

2015-08-01

This document presents the final report on the national evaluation of the Los Angeles Congestion Reduction Demonstration (LA CRD) ExpressLanes Program under the United States Department of Transportation (U.S. DOT) CRD Program. The LA CRD projects fo...

Early Intervention Paraprofessional Standards: Development and Field Validation

ERIC Educational Resources Information Center

Banerjee, Rashida; Chopra, Ritu V.; DiPalma, Geraldine

2017-01-01

Personnel standards are the foundations for how states and nations approve a program, engage in systemic assessment, and provide effective professional development to its early childhood professionals. However, despite the extensive use of paraprofessionals in early intervention/early childhood special education programs, there is a lack of…

About the Drift Reduction Technology Program

EPA Pesticide Factsheets

The new voluntary Drift Reduction Technology (DRT) Program will encourage the manufacture, marketing, and use of safer spray technology and equipment scientifically verified to reduce pesticide drift.

32 CFR 318.8 - Request for correction or amendment to a record.

Code of Federal Regulations, 2010 CFR

2010-07-01

... DEFENSE (CONTINUED) PRIVACY PROGRAM DEFENSE THREAT REDUCTION AGENCY PRIVACY PROGRAM § 318.8 Request for correction or amendment to a record. (a) An individual may request that the Defense Threat Reduction Agency... Division, Defense Threat Reduction Agency, 45045 Aviation Drive, Dulles, VA 20166-7517. (c) The requester...

Department of Energy - Office of Science Early Career Research Program

NASA Astrophysics Data System (ADS)

Horwitz, James

The Department of Energy (DOE) Office of Science Early Career Program began in FY 2010. The program objectives are to support the development of individual research programs of outstanding scientists early in their careers and to stimulate research careers in the disciplines supported by the DOE Office of Science. Both university and DOE national laboratory early career scientists are eligible. Applicants must be within 10 years of receiving their PhD. For universities, the PI must be an untenured Assistant Professor or Associate Professor on the tenure track. DOE laboratory applicants must be full time, non-postdoctoral employee. University awards are at least 150,000 per year for 5 years for summer salary and expenses. DOE laboratory awards are at least 500,000 per year for 5 years for full annual salary and expenses. The Program is managed by the Office of the Deputy Director for Science Programs and supports research in the following Offices: Advanced Scientific and Computing Research, Biological and Environmental Research, Basic Energy Sciences, Fusion Energy Sciences, High Energy Physics, and Nuclear Physics. A new Funding Opportunity Announcement is issued each year with detailed description on the topical areas encouraged for early career proposals. Preproposals are required. This talk will introduce the DOE Office of Science Early Career Research program and describe opportunities for research relevant to the condensed matter physics community. http://science.energy.gov/early-career/

Early Intervention Preservice Preparation: Program Evaluation and Reflections. Master's Personnel Prep Program. Final Report.

ERIC Educational Resources Information Center

Bricker, Diane; Squires, Jane

This final report discusses the activities and outcomes of the early intervention interdisciplinary preservice program at the University of Oregon. This master's degree program used both "measurement of" and "reflection about" preservice efforts to address important questions regarding program effectiveness and identify…

78 FR 23941 - Pilot Program for Early Feasibility Study Investigational Device Exemption Applications...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

...] Pilot Program for Early Feasibility Study Investigational Device Exemption Applications; Extending the... 13343), FDA terminated the acceptance of applications into the program and extended the pilot program for the nine accepted sponsors until May 8, 2013. The pilot program will be further extended for the...

Suffolk County Community College: Early Childhood Program Review.

ERIC Educational Resources Information Center

Hochman, Darlene; Cummings, Kathleen; Elek-Fisk, Elvira; Jefferson, Marcia; Means, Robin; Weber, Alan

This report reviews Suffolk County Community College's (New York) Early Childhood Program. The document begins with an overview of the program's goals, intentions, student requirements, recent student outcomes, and recommendations for future goals and focuses of the program. The program's intent is to prepare individuals for working with young…

HYPERDIRE-HYPERgeometric functions DIfferential REduction: Mathematica-based packages for the differential reduction of generalized hypergeometric functions: Lauricella function FC of three variables

NASA Astrophysics Data System (ADS)

Bytev, Vladimir V.; Kniehl, Bernd A.

2016-09-01

We present a further extension of the HYPERDIRE project, which is devoted to the creation of a set of Mathematica-based program packages for manipulations with Horn-type hypergeometric functions on the basis of differential equations. Specifically, we present the implementation of the differential reduction for the Lauricella function FC of three variables. Catalogue identifier: AEPP_v4_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEPP_v4_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: GNU General Public License, version 3 No. of lines in distributed program, including test data, etc.: 243461 No. of bytes in distributed program, including test data, etc.: 61610782 Distribution format: tar.gz Programming language: Mathematica. Computer: All computers running Mathematica. Operating system: Operating systems running Mathematica. Classification: 4.4. Does the new version supersede the previous version?: No, it significantly extends the previous version. Nature of problem: Reduction of hypergeometric function FC of three variables to a set of basis functions. Solution method: Differential reduction. Reasons for new version: The extension package allows the user to handle the Lauricella function FC of three variables. Summary of revisions: The previous version goes unchanged. Running time: Depends on the complexity of the problem.

Effectiveness of the online weight reduction program KiloCoach™ and comparison with other evaluated commercial direct intervention and online programs.

PubMed

Longin, Rita; Grasse, Marina; Aspalter, Rosa; Waldherr, Karin

2012-01-01

Preliminary results indicated effectiveness of the online weight reduction program KiloCoach. The current study presents a large collection of user data and compares KiloCoach with other evaluated commercial weight loss programs. Furthermore, potential factors influencing the effectiveness of internet weight loss programs should be identified. 4,310 data sets of KiloCoach users were available, 3,150 of them were suitable for further analysis. 946 program users were considered completers (at least 60 days of continuous protocol). For comparison with other programs, different subsamples were drawn that matched to the inclusion criteria of reference studies. On average, KiloCoach overweight and obese completers lost 4.5 % of initial body weight. KiloCoach was as effective as the commercial program Weight Watchers® after 1 year (6.4% vs. 5.3% weight loss; p = 0.11) and 2 years (5.1% vs. 3.2% weight loss; p = 0.15). KiloCoach proved to be more effective than other online programs (Viktklubb, eDiets.com) as well as an in-person behavioral program, but less effective than Vtrim®, an online behavioral program providing intensive support. In comparison to reference programs, KiloCoach proved to be effective for weight reduction. The effect of online weight reduction programs seems to depend on methods and features applied.

Combining Primary Prevention and Risk Reduction Approaches in Sexual Assault Protection Programming

ERIC Educational Resources Information Center

Menning, Chadwick; Holtzman, Mellisa

2015-01-01

Objective: The object of this study is to extend prior evaluations of Elemental, a sexual assault protection program that combines primary prevention and risk reduction strategies within a single program. Participants and Methods: During 2012 and 2013, program group and control group students completed pretest, posttest, and 6-week and 6-month…

Are we able to reduce the mortality and morbidity of oral cancer; Some considerations

PubMed Central

2013-01-01

Oral cancer makes up 1%-2% of all cancers that may arise in the body. The majority of oral cancers consists of squamous cell carcinomas. Oral cancer carries a considerable mortality rate, being mainly dependent on the stage of the disease at admission. Worldwide some 50% of the patients with oral cancer present with advanced disease. There are several ways of trying to diagnose oral cancer in a lower tumor stage, being 1) mass screening or screening in selected patients, 2) reduction of patients’ delay, and 3) reduction of doctors’ delay. Oral cancer population-based screening (“mass screening”) programs do not meet the guidelines for a successful outcome. There may be some benefit when focusing on high-risk groups, such as heavy smokers and heavy drinkers. Reported reasons for patients’ delay range from fear of a diagnosis of cancer, limited accessibility of primary health care, to unawareness of the possibility of malignant oral diseases. Apparently, information campaigns in news programs and TV have little effect on patients’ delay. Mouth self-examination may have some value in reducing patients’ delay. Doctors’ delay includes dentists’ delay and diagnostic delay caused by other medical and dental health care professionals. Doctors’ delay may vary from almost zero days up to more than six months. Usually, morbidity of cancer treatment is measured by quality of life (QoL) questionnaires. In the past decades this topic has drawn a lot of attention worldwide. It is a challenge to decrease the morbidity that is associated with the various treatment modalities that are used in oral cancer without substantially compromising the survival rate. Smoking cessation contributes to reducing the risk of oral cancers, with a 50% reduction in risk within five years. Indeed, risk factor reduction seems to be the most effective tool in an attempt to decrease the morbidity and mortality of oral cancer. Key words:Oral cancer, early diagnosis, quality of life. PMID:23229266

Impact of the recent reduction in working hours (the 80 hour work week) on surgical resident cancer education.

PubMed

Vetto, John T; Robbins, Debra

2005-01-01

Resident work hours were recently reduced to 80 hours per week by a mandate from the Accreditation Council for Graduate Medical Education and subsequent Federal law (HR 3236). This mandate became effective July 1st, 2003. We sought to determine any impact this change had on perceived and real resident cancer education and knowledge. Of the total 85 residents in our large, university-based surgical training program, we focused on the 40 who had been in the clinical program (rather than research) before and after the work hour reduction. Perceived impact on cancer education was determined by survey, and real impact by before (2002) and after (2004) scores on the overall and cancer-specific portion of the annual American Board of Surgery In-Training Examination (ABSITE). All eligible residents responded to the survey. The majority (83% to 85%) indicated that exposure to cancer patients on wards and in clinics remained the same. Thirty percent felt that their exposure to cancer operations and tumor boards had decreased; 60% to 65% felt that exposure to these activities were unchanged. Approximately half of residents reported an increase in their cancer-related reading and Internet learning activities--the other half felt they had not changed. The majority (88%) reported no change in their participation in extraprogrammatic cancer-related continuing medical education activities. Of the survey responders, 23 had completed the ABSITE in both 2002 and 2004; their mean scores between the 2 time periods increased by 7% for the overall test and decreased by 3% for the cancer-specific portion. Overall, the recent reduction in work hours does not appear to have changed residents' experience with cancer patient care, although possible early reductions in attendance at cancer operations and tumor boards merits further study and possibly future schedule changes. The reported perceived increase in cancer-related reading and Internet learning has not yet translated into improved test scores.

Decreased response to inhaled steroids in overweight and obese asthmatic children.

PubMed

Forno, Erick; Lescher, Rachel; Strunk, Robert; Weiss, Scott; Fuhlbrigge, Anne; Celedón, Juan C

2011-03-01

The mechanisms and consequences of the observed association between obesity and childhood asthma are unclear. We sought to determine the effect of obesity on treatment responses to inhaled corticosteroids in asthmatic children. We performed a post hoc analysis to evaluate the interaction between body mass index (BMI) and treatment with inhaled budesonide on lung function in the Childhood Asthma Management Program trial. Participants were then stratified into overweight/obese and nonoverweight groups, and their response to inhaled budesonide was analyzed longitudinally over the 4 years of the trial. There was a significant interaction between BMI and budesonide for prebronchodilator FEV(1)/forced vital capacity (FVC) ratio (P = .0007) and bronchodilator response (BDR; P = .049) and a nonsignificant trend for an interaction between BMI and budesonide on prebronchodilator FEV(1) (P = .15). Nonoverweight children showed significant improvement with inhaled budesonide in lung function (FEV(1), FEV(1)/FVC ratio, and BDR) during the early (years 1-2) and late (years 3-4) stages of the trial. Overweight/obese children had improved FEV(1) and BDR during the early but not the late stage of the trial and showed no improvement in FEV(1)/FVC ratio. When comparing time points at which both groups showed a significant response, the degree of improvement among nonoverweight children was significantly greater than in overweight/obese children at most visits. Nonoverweight children had a 44% reduction in the risk of emergency department visits or hospitalizations throughout the trial (P = .001); there was no reduction in risk among overweight/obese children (P = .97). Compared with children of normal weight, overweight/obese children in the Childhood Asthma Management Program showed a decreased response to inhaled budesonide on measures of lung function and emergency department visits/hospitalizations for asthma. Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Long-term disease and economic outcomes of prior authorization criteria for Hepatitis C treatment in Pennsylvania Medicaid.

PubMed

Kabiri, Mina; Chhatwal, Jagpreet; Donohue, Julie M; Roberts, Mark S; James, A Everette; Dunn, Michael A; Gellad, Walid F

2017-09-01

Several highly effective but costly therapies for hepatitis C virus (HCV) are available. As a consequence of their high price, 36 state Medicaid programs limited treatment coverage to patients with more advanced HCV stages. States have only limited information available to predict the long-term impact of these decisions. We adapted a validated hepatitis C microsimulation model to the Pennsylvania Medicaid population to estimate the existing HCV prevalence in Pennsylvania Medicaid and estimate the impact of various HCV drug coverage policies on disease outcomes and costs. Outcome measures included rates of advanced-stage HCV outcomes and treatment and disease costs in both Medicaid and Medicare. We estimated that 46,700 individuals in Pennsylvania Medicaid were infected with HCV in 2015, 33% of whom were still undiagnosed. By expanding treatment to include mild fibrosis stage (Metavir F2), Pennsylvania Medicaid will spend an additional $273 million on medications in the next decade with no substantial reduction in the incidence of liver cancer or liver-related death. Medicaid patients who are not eligible for treatment under restricted policies would get treatment once they transition to the Medicare program, which would incur 10% reduction in HCV-related costs due to early treatment in Medicaid. Further expanding treatment to patients with early fibrosis stages (F0 or F1) would cost Medicaid an additional $693 million during the next decade but would reduce the number of individuals in need of treatment in Medicare by 46% and decrease Medicare treatment costs by 23%. In some scenarios, outcomes could worsen with eligibility expansion if there is inadequate capacity to treat all patients. Expansion of HCV treatment coverage to less severe stages of liver disease may not substantially improve liver related outcomes for patients in Pennsylvania Medicaid in scenarios in which coverage through Medicare is widely available. Published by Elsevier Inc.

Do Early Childhood Programs Have Lasting Effects on Children? Evaluation Science Brief

ERIC Educational Resources Information Center

National Forum on Early Childhood Program Evaluation, 2008

2008-01-01

"Evaluation Science Briefs" summarize the findings and implications of a recent study evaluating the effects of an early childhood program or environment. This Brief evaluates the study "Early Intervention in Low Birthweight Premature Infants: Results at 18 Years of Age for the Infant Health and Development Program (IHDP)" (M.C. McCormick, J.…

A Qualitative Case Study Exploring an Early Childhood Educator Professional Development Program Linking Teacher Efficacy, Engagement, and Retention

ERIC Educational Resources Information Center

Guerrant, Lisa Y.

2016-01-01

This qualitative study explored the lived experiences of eleven early childhood educators who participated in a professional development program. The study was guided by the central research question, "What are the perceptions of early childhood educators on the professional development program as it relates to teacher efficacy, engagement,…

Evaluation of the Waterford Early Reading Program in Kindergarten, 2005-06

ERIC Educational Resources Information Center

Powers, Stephen; Price-Johnson, Connie

2006-01-01

Background: The Waterford Early Reading Program (WERP), a technology-based program for early elementary grades, was provided through Arizona all day kindergarten funds to kindergarten students in 15 Title I elementary schools in the Tucson Unified School District (TUSD) in the 2005-06 school year. The purpose of this study is to evaluate the…

Who Drops out of Early Head Start Home Visiting Programs?

ERIC Educational Resources Information Center

Roggman, Lori A.; Cook, Gina A.; Peterson, Carla A.; Raikes, Helen H.

2008-01-01

Research Findings: Early Head Start home-based programs provide services through weekly home visits to families with children up to age 3, but families vary in how long they remain enrolled. In this study of 564 families in home-based Early Head Start programs, "dropping out" was predicted by specific variations in home visits and certain family…

The Influence of an Early Childhood Program on Parental Involvement: Perceptions of Former Head Start Parents

ERIC Educational Resources Information Center

Croft, Stacey

2017-01-01

A key component of effective early childhood programs is collaborative relationships between schools, families, and the community (Fiese, Eckert, & Spagnola, 2005). One of these early childhood programs, Head Start, stands out among the others in its efforts to work with children, families, and communities to promote parental involvement. Some…

Investing in Michigan's Future: Meeting the Early Childhood Challenge

ERIC Educational Resources Information Center

Schweinhart, Lawrence J.; Fulcher-Dawson, Rachel

2006-01-01

This report presents results from research into the effects of early childhood programs on their participants, particularly low-income and at-risk children. The studies described offer evidence on the long-term effects of high quality early childhood programs. Such programs can have long-lasting positive effects on children and their families,…

The Integration of a Computer-Based Early Reading Program to Increase English Language Learners' Literacy Skills

ERIC Educational Resources Information Center

James, Laurie

2014-01-01

The intention of this study was to establish if the third grade English Language Learners improved reading fluency when using the computerized Waterford Early Reading Program. This quantitative study determined the effectiveness of the Waterford Early Reading Program at two Title I elementary schools. Students not meeting Grade Level Expectations…

Activities in an S-STEM Program to Catalyze Early Entry into Research

ERIC Educational Resources Information Center

Graham, Kate J.; McIntee, Edward J.; Raigoza, Annette F.; Fazal, M. Abul; Jakubowski, Henry V.

2017-01-01

A cohort program to increase retention of under-represented groups in chemistry was developed at the College of Saint Benedict/Saint John's University. In particular, this program chose to emphasize early career mentoring and early access to research. This goal was chosen because research has been repeatedly shown to increase scientific identity…

A Relationship with a Purpose: Accreditation Facilitation Projects and Early Childhood Programs.

ERIC Educational Resources Information Center

Flis, Deborah

2002-01-01

Describes use of accreditation facilitation projects (AFP) begun in the 1990s to provide varying levels and types of support to early childhood programs engaged in the self-study process for accreditation with the National Association for the Education of Young Children. Presents insights about the early childhood program/AFP relationship related…

Waste reduction plan for The Oak Ridge National Laboratory

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

Schultz, R.M.

1990-04-01

The Oak Ridge National Laboratory (ORNL) is a multipurpose Research and Development (R D) facility. These R D activities generate numerous small waste streams. Waste minimization is defined as any action that minimizes the volume or toxicity of waste by avoiding its generation or recycling. This is accomplished by material substitution, changes to processes, or recycling wastes for reuse. Waste reduction is defined as waste minimization plus treatment which results in volume or toxicity reduction. The ORNL Waste Reduction Program will include both waste minimization and waste reduction efforts. Federal regulations, DOE policies and guidelines, increased costs and liabilities associatedmore » with the management of wastes, limited disposal options and facility capacities, and public consciousness have been motivating factors for implementing comprehensive waste reduction programs. DOE Order 5820.2A, Section 3.c.2.4 requires DOE facilities to establish an auditable waste reduction program for all LLW generators. In addition, it further states that any new facilities, or changes to existing facilities, incorporate waste minimization into design considerations. A more recent DOE Order, 3400.1, Section 4.b, requires the preparation of a waste reduction program plan which must be reviewed annually and updated every three years. Implementation of a waste minimization program for hazardous and radioactive mixed wastes is sited in DOE Order 5400.3, Section 7.d.5. This document has been prepared to address these requirements. 6 refs., 1 fig., 2 tabs.« less

XRP -- SMM XRP Data Analysis & Reduction

NASA Astrophysics Data System (ADS)

McSherry, M.; Lawden, M. D.

This manual describes the various programs that are available for the reduction and analysis of XRP data. These programs have been developed under the VAX operating system. The original programs are resident on a VaxStation 3100 at the Solar Data Analysis Center (NASA/GSFC Greenbelt MD).

Kentucky's Statewide Early Childhood Professional Development System

ERIC Educational Resources Information Center

Rous, Beth; Grove, Jaime; Townley, Kim

2007-01-01

Public school systems have recently become major players in providing services for children in their early years. In addition, a number of other services are available to young children including child care, Head Start, and Early Head Start programs. The link between program quality and professional development of early care and education…

76 FR 71979 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-21

... and Services Administration Advisory Committee on the Maternal, Infant and Early Childhood Home...: Name: Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation..., DC 20005. (202) 289-7600. The Advisory Committee on the Maternal, Infant and Early Childhood Home...

Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study.

PubMed

Kim, Jong-Pill; Yang, Jinhyang

The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest-posttest design. A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia. Copyright © 2016 Elsevier Inc. All rights reserved.

A Program for Iron Economy during Deficiency Targets Specific Fe Proteins.

PubMed

Hantzis, Laura J; Kroh, Gretchen E; Jahn, Courtney E; Cantrell, Michael; Peers, Graham; Pilon, Marinus; Ravet, Karl

2018-01-01

Iron (Fe) is an essential element for plants, utilized in nearly every cellular process. Because the adjustment of uptake under Fe limitation cannot satisfy all demands, plants need to acclimate their physiology and biochemistry, especially in their chloroplasts, which have a high demand for Fe. To investigate if a program exists for the utilization of Fe under deficiency, we analyzed how hydroponically grown Arabidopsis ( Arabidopsis thaliana ) adjusts its physiology and Fe protein composition in vegetative photosynthetic tissue during Fe deficiency. Fe deficiency first affected photosynthetic electron transport with concomitant reductions in carbon assimilation and biomass production when effects on respiration were not yet significant. Photosynthetic electron transport function and protein levels of Fe-dependent enzymes were fully recovered upon Fe resupply, indicating that the Fe depletion stress did not cause irreversible secondary damage. At the protein level, ferredoxin, the cytochrome- b 6 f complex, and Fe-containing enzymes of the plastid sulfur assimilation pathway were major targets of Fe deficiency, whereas other Fe-dependent functions were relatively less affected. In coordination, SufA and SufB, two proteins of the plastid Fe-sulfur cofactor assembly pathway, were also diminished early by Fe depletion. Iron depletion reduced mRNA levels for the majority of the affected proteins, indicating that loss of enzyme was not just due to lack of Fe cofactors. SufB and ferredoxin were early targets of transcript down-regulation. The data reveal a hierarchy for Fe utilization in photosynthetic tissue and indicate that a program is in place to acclimate to impending Fe deficiency. © 2018 American Society of Plant Biologists. All Rights Reserved.

Resident Evaluation and Remediation: A Comprehensive Approach

PubMed Central

Wu, Jim S.; Siewert, Bettina; Boiselle, Phillip M.

2010-01-01

Background A comprehensive evaluation and remediation program is an essential component of any residency program. The evaluation system should identify problems accurately and early and allow residents with problems to be assigned to a remediation program that effectively deals with them. Elements of a proactive remediation program include a process for outlining deficiencies, providing resources for improvement, communicating clear goals for acceptable performance, and reevaluating performance against these goals. Intervention In recognition of the importance of early detection and prompt remediation of the struggling resident, we sought to develop a multifaceted approach to resident evaluation with the aim of early identification and prompt remediation of difficulties. This article describes our comprehensive evaluation program and remediation program, which uses resources within our radiology department and institutional graduate medical education office. Discussion An effective evaluation system should identify problems accurately and early, whereas a proactive remediation program should effectively deal with issues once they are identified. PMID:21975628

Full Day Early Learning Kindergarten Program Team: Perspectives from the Principal

ERIC Educational Resources Information Center

Shahbazi, Sara; Salinitri, Geri

2016-01-01

The Full Day Early Learning Kindergarten (FDK) Program has expanded the role of the principal and has altered the teaching dynamics of the classroom with the introduction of an early years team. The early years team consists of a certified teacher with the Ontario College of Teachers and a registered early childhood educator from the College of…

Race to the Top--Early Learning Challenge: An Analysis of Impact on IDEIA, Part C Early Intervention Programs

ERIC Educational Resources Information Center

Bohjanen, Sharon L.

2016-01-01

Infants and toddlers who live in poverty are more likely to experience developmental delays or disabilities and less likely to access early intervention (EI) services. The federal initiative Race to the Top--Early Learning Challenge (RTT-ELC) was designed to increase access to high quality early learning programs for children at risk for…

CD63 tetraspanin is a negative driver of epithelial-to-mesenchymal transition in human melanoma cells.

PubMed

Lupia, Antonella; Peppicelli, Silvia; Witort, Ewa; Bianchini, Francesca; Carloni, Vinicio; Pimpinelli, Nicola; Urso, Carmelo; Borgognoni, Lorenzo; Capaccioli, Sergio; Calorini, Lido; Lulli, Matteo

2014-12-01

The CD63 tetraspanin is highly expressed in the early stages of melanoma and decreases in advanced lesions, suggesting it as a possible suppressor of tumor progression. We employed loss- and gain-of-gene-function approaches to investigate the role of CD63 in melanoma progression and acquisition of the epithelial-to-mesenchymal transition (EMT) program. We used two human melanoma cell lines derived from primary tumors and one primary human melanoma cell line isolated from a cutaneous metastasis, differing by levels of CD63 expression. CD63-silenced melanoma cells showed enhanced motility and invasiveness with downregulation of E-cadherin and upregulation of N-cadherin and Snail. In parallel experiments, transient and stable ectopic expression of CD63 resulted in a robust reduction of cell motility, invasiveness, and protease activities, which was proportional to the increase in CD63 protein level. Transfected cells overexpressing the highest level of CD63 when transplanted into immunodeficient mice showed a reduced incidence and rate of tumor growth. Moreover, these cells showed a reduction of N-cadherin, Vimentin, Zeb1, and a-SMA, and a significant resistance to undergo an EMT program both in basal condition and in the following stimulation with TGFβ. Thus, our results establish a previously unreported mechanistic link between the tetraspanin CD63 and EMT abrogation in melanoma.

Very early reaction intermediates detected by microsecond time scale kinetics of cytochrome cd1-catalyzed reduction of nitrite.

PubMed

Sam, Katharine A; Strampraad, Marc J F; de Vries, Simon; Ferguson, Stuart J

2008-10-10

Paracoccus pantotrophus cytochrome cd(1) is a nitrite reductase found in the periplasm of many denitrifying bacteria. It catalyzes the reduction of nitrite to nitric oxide during the denitrification part of the biological nitrogen cycle. Previous studies of early millisecond intermediates in the nitrite reduction reaction have shown, by comparison with pH 7.0, that at the optimum pH, approximately pH 6, the earliest intermediates were lost in the dead time of the instrument. Access to early time points (approximately 100 micros) through use of an ultra-rapid mixing device has identified a spectroscopically novel intermediate, assigned as the Michaelis complex, formed from reaction of fully reduced enzyme with nitrite. Spectroscopic observation of the subsequent transformation of this species has provided data that demand reappraisal of the general belief that the two subunits of the enzyme function independently.

Future development programs. [for emission reduction and production of aircraft engines

NASA Technical Reports Server (NTRS)

Waters, L.

1976-01-01

A company program was planned which has a main drive to develop those emission reduction concepts that have the promise of earliest success. These programs were proposed in an attempt to enhance existing engine systems, exploiting their potential for emission reduction as far as is compatible with retaining the well established features in them that are well understood and in current production. The intended programs identified in the area of new concepts were: (1) upgrading the TCM fuel system, (2) evaluation of accelerator pump, (3) reduced cooling requirement, and (4) variable spark timing.

40 CFR 71.24 - Permit applications.

Code of Federal Regulations, 2013 CFR

2013-07-01

... end of the post-reduction year. (4) If a source test will be the supporting basis for establishing post-reduction emissions for one or more emissions units in the early reductions source, the test... to the appropriate State agency; to the EPA Emission Standards Division, Mail Drop 13, Research...

40 CFR 71.24 - Permit applications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... end of the post-reduction year. (4) If a source test will be the supporting basis for establishing post-reduction emissions for one or more emissions units in the early reductions source, the test... to the appropriate State agency; to the EPA Emission Standards Division, Mail Drop 13, Research...

40 CFR 71.24 - Permit applications.

Code of Federal Regulations, 2010 CFR

2010-07-01

... end of the post-reduction year. (4) If a source test will be the supporting basis for establishing post-reduction emissions for one or more emissions units in the early reductions source, the test... to the appropriate State agency; to the EPA Emission Standards Division, Mail Drop 13, Research...

40 CFR 71.24 - Permit applications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... end of the post-reduction year. (4) If a source test will be the supporting basis for establishing post-reduction emissions for one or more emissions units in the early reductions source, the test... to the appropriate State agency; to the EPA Emission Standards Division, Mail Drop 13, Research...

40 CFR 71.24 - Permit applications.

Code of Federal Regulations, 2012 CFR

2012-07-01

... end of the post-reduction year. (4) If a source test will be the supporting basis for establishing post-reduction emissions for one or more emissions units in the early reductions source, the test... to the appropriate State agency; to the EPA Emission Standards Division, Mail Drop 13, Research...

Testing maternal depression and attachment style as moderators of Early Head Start's effects on parenting.

PubMed

Berlin, Lisa J; Whiteside-Mansell, Leanne; Roggman, Lori A; Green, Beth L; Robinson, JoAnn; Spieker, Susan

2011-01-01

This study examined maternal depression, attachment avoidance, and attachment anxiety as moderators of Early Head Start's effects on four parenting outcomes assessed at age three. Participants (N = 947) were drawn from six sites of the Early Head Start National Research and Evaluation Project, a multi-site randomized trial. Findings suggest more positive program effects for mothers with less initial attachment avoidance or attachment anxiety. First, baseline attachment avoidance moderated Early Head Start program effects on observed maternal supportiveness, such that program mothers with lower baseline attachment avoidance were rated as more supportive of their three-year-olds than program mothers with higher baseline attachment avoidance. Second, program effects on spanking varied depending on mothers' baseline attachment anxiety.

9 CFR 145.33 - Terminology and classification; flocks and products.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Salmonella Education/Reduction Program or the Fishmeal Inspection Program of the National Marine Fisheries... participants in the Animal Protein Products Industry (APPI) Salmonella Education/Reduction Program or the... of the house). A representative sample of males and females should be sampled. The samples shall be...

9 CFR 145.33 - Terminology and classification; flocks and products.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Salmonella Education/Reduction Program or the Fishmeal Inspection Program of the National Marine Fisheries... participants in the Animal Protein Products Industry (APPI) Salmonella Education/Reduction Program or the... of the house). A representative sample of males and females should be sampled. The samples shall be...

9 CFR 145.33 - Terminology and classification; flocks and products.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Salmonella Education/Reduction Program or the Fishmeal Inspection Program of the National Marine Fisheries... participants in the Animal Protein Products Industry (APPI) Salmonella Education/Reduction Program or the... of the house). A representative sample of males and females should be sampled. The samples shall be...

First Steps to School Readiness: South Carolina's Response to At-Risk Early Childhood Population.

ERIC Educational Resources Information Center

Buford, Rhonda; Stegelin, Dolores A.

2003-01-01

Describes South Carolina's new state early childhood program, First Steps to School Readiness. Includes a profile of the state's at-risk child population, noting poverty and education risk indicators, and describing key program components. The article discusses program oversight, local program partnerships, program funding mechanisms, and local…

48 CFR 52.223-10 - Waste Reduction Program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Reduction Program (MAY 2011) (a) Definitions. As used in this clause— Recycling means the series of... prevention, recycling, or purchasing recycled and environmentally preferable products. (b) Consistent with...

48 CFR 52.223-10 - Waste Reduction Program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Reduction Program (MAY 2011) (a) Definitions. As used in this clause— Recycling means the series of... prevention, recycling, or purchasing recycled and environmentally preferable products. (b) Consistent with...

48 CFR 52.223-10 - Waste Reduction Program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Reduction Program (MAY 2011) (a) Definitions. As used in this clause— Recycling means the series of... prevention, recycling, or purchasing recycled and environmentally preferable products. (b) Consistent with...

48 CFR 52.223-10 - Waste Reduction Program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Reduction Program (MAY 2011) (a) Definitions. As used in this clause— Recycling means the series of... prevention, recycling, or purchasing recycled and environmentally preferable products. (b) Consistent with...

48 CFR 52.223-10 - Waste Reduction Program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Reduction Program (AUG 2000) (a) Definitions. As used in this clause— Recycling means the series of... prevention, recycling, or purchasing recycled and environmentally preferable products. (b) Consistent with...

Proceedings of Conference V: communicating earthquake hazard reduction information: convened under auspices of National Earthquake Hazards Reduction Program 22-24 May, 1978

USGS Publications Warehouse

Hays, Walter W.

1978-01-01

(11) achieving landslide hazard reduction. The objective was to identify the most significant lessons learned during the course of each experience and to develop recommendations for improving communication that might be incorporated in the search program of the USGS.

40 CFR 76.5 - NOX emission limitations for Group 1 boilers.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.5 NOX emission limitations..., the date on which the unit is required to meet Acid Rain emission reduction requirements for SO2, the... 404(d) of the Act, the date the unit is required to meet Acid Rain emissions reduction requirements...

40 CFR 76.5 - NOX emission limitations for Group 1 boilers.

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROGRAMS (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.5 NOX emission limitations..., the date on which the unit is required to meet Acid Rain emission reduction requirements for SO2, the... 404(d) of the Act, the date the unit is required to meet Acid Rain emissions reduction requirements...

40 CFR 76.5 - NOX emission limitations for Group 1 boilers.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.5 NOX emission limitations..., the date on which the unit is required to meet Acid Rain emission reduction requirements for SO2, the... 404(d) of the Act, the date the unit is required to meet Acid Rain emissions reduction requirements...

1985 Winners of the Cost Reduction Incentive Awards. Tenth Anniversary.

ERIC Educational Resources Information Center

National Association of College and University Business Officers, Washington, DC.

Fifty-two cost reduction efforts on college and university campuses are described, as part of the Cost Reduction Incentive Awards Program sponsored by the National Association of College and University Business Officers and the United States Steel Foundation. The incentive program is designed to stimulate cost-effective ideas and awareness of the…

Colorado Preschool & Kindergarten Program. 2007 Legislative Report

ERIC Educational Resources Information Center

Colorado Department of Education, 2007

2007-01-01

Quality early childhood programs produce beneficial outcomes for children and the community in which they live. The Colorado Preschool and Kindergarten Program (CPKP) provides funding to establish early childhood education programs that serve preschool and kindergarten children with the toughest educational challenges. Over the last eighteen…

The Minnesota Experience with Family-Centered Early Childhood Programs.

ERIC Educational Resources Information Center

Engstrom, Lois

1988-01-01

The author describes Minnesota's Early Childhood Family Education program for all children from birth to kindergarten and their parents. Topics include the types of activities each local program undertakes, administration and planning, and financing. A list of important program attributes is included. (CH)

How Policymakers Should Deal with the Delayed Benefits of Early Childhood Programs. Upjohn Institute Working Paper No. 09-150

ERIC Educational Resources Information Center

Bartik, Timothy J.

2009-01-01

This chapter is a draft of Chapter 7 of a planned book, "Preschool and Jobs: Human Development as Economic Development, and Vice Versa." This book analyzes early childhood programs' effects on regional economic development. Four early childhood programs are considered: (1) universally accessible preschool for four-year-olds of similar…

Shifting Views: Exploring the Potential for Technology Integration in Early Childhood Education Programs

ERIC Educational Resources Information Center

Dietze, Beverlie; Kashin, Diane

2013-01-01

Using technology with children in play-based early learning programs creates questions for some within the Early Childhood Education (ECE) community. This paper presents how two faculty who teach in ECE-related degree programs integrated educational technology into their teaching pedagogy as a way to model to their students how it can be used to…

Moving from Science to Service: Transposing and Sustaining the Early Risers Prevention Program in a Community Service System

ERIC Educational Resources Information Center

Bloomquist, Michael L.; August, Gerald J.; Horowitz, Jason L.; Lee, Susanne S.; Jensen, Cheryl

2008-01-01

This paper summarizes an effort to transpose and sustain the evidence-based Early Risers "Skills for Success" conduct problems prevention program in a real world community service system. The Early Risers program had previously been implemented by a local agency within the context of research-based operations. In the current initiative,…

The Culture of Family: How a Model Early Childhood Teacher Preparation Program Navigates a Limited Context

ERIC Educational Resources Information Center

Nitecki, Elena

2012-01-01

This article examines an extraordinarily successful early childhood education teacher preparation program at an urban 2-year college struggling with retention. The Early Childhood Education Program in this case study is able to maintain a graduation rate that is over four times greater than that of the college average and has a reputation for…

Vermont Core Standards and Self-Assessment Tool for Center-Based Early Childhood Programs.

ERIC Educational Resources Information Center

Vermont State Agency of Human Services, Waterbury.

In response to the desire to create for child development services a unified system which shares common standards for quality and respects the diversity and uniqueness of individuals and of programs, a committee of the Early Childhood Work Group collected and compared all the different standards now in force for the early childhood programs in the…

An Examination of the Quality of Discipline Policies in NAEYC-Accredited Early Care and Education Programs

ERIC Educational Resources Information Center

Garrity, Sarah M.; Longstreth, Sascha L.; Linder, Lisa K.

2017-01-01

The purpose of this study was to expand the knowledge base regarding discipline policies in early care and education (ECE) programs by examining the extent to which programs utilize policies that reflect the implementation of evidence-based practices to prevent and address challenging behaviors in the early years. Discipline policies were gathered…

When the healthcare does not follow the evidence: The case of the lack of early intervention programs for psychosis in Spain.

PubMed

Arango, Celso; Bernardo, Miguel; Bonet, Pere; Cabrera, Ana; Crespo-Facorro, Benedicto; Cuesta, Manuel J; González, Nel; Parrabera, Sílvia; Sanjuan, Julio; Serrano, Alfonso; Vieta, Eduard; Lennox, Belinda R; Melau, Marianne

There is now sufficient evidence to support the importance of interventions in the early stages of psychosis. The delay in the detection and treatment of the first-episode psychosis is related to a lower and slower recovery, as well as a higher risk of relapse. Despite this fact, early intervention units or teams are still not regularly implemented in mental health service settings in Spain. In this opinion article, a review is presented of the main arguments for defending the need to implement these programs and strategies in order to achieve this aim. There are a number of programs for early intervention for psychosis currently working in other countries, with a therapeutic program that includes pharmacological and psychosocial interventions, together with public awareness, information dissemination, and family-professional collaboration activities. Published literature on the experience of these programs indicates that early intervention is not only effective in terms of the improvement of health status, but is also economically efficient. The main steps and recommendations needed to implement such early intervention programs in our country are described. Copyright © 2017 SEP y SEPB. All rights reserved.

Treatment attrition: Associations with negative affect smoking motives and barriers to quitting among treatment-seeking smokers.

PubMed

Garey, Lorra; Kauffman, Brooke Y; Neighbors, Clayton; Schmidt, Norman B; Zvolensky, Michael J

2016-12-01

Pre-treatment attrition and perceived barriers for quitting are clinically important processes involved in early phases of quitting smoking. However, less is known about the constructs that may contribute to these processes such as negative affect reduction smoking motives. The current study sought to evaluate the relation between negative affect reduction smoking motives and pre-treatment attrition and perceived barriers for quitting in a sample of 425 treatment-seeking smokers (48.5% female; Mage=37.69 years; SD=13.61) enrolled in a smoking cessation study examining the efficacy of a transdiagnostic panic-smoking cessation treatment relative to a standard smoking cessation treatment. Results indicated that greater negative affect reduction smoking motives was associated with an increased likelihood of treatment initiation (odds ratio=1.49, CI: 1.09, 2.04). Additionally, negative affect reduction smoking motives was associated with greater perceived barriers for cessation among pre-treatment drop-outs and treatment initiators. This initial investigation provides evidence for the possible clinical utility in addressing negative affect reduction smoking motives during early stages of quitting. Additionally, such findings could potentially inform the development of personalized, early stages of quitting interventions for smoking cessation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Experience curve development and cost reduction disaggregation for fuel cell markets in Japan and the US

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

Wei, Max; Smith, Sarah J.; Sohn, Michael D.

Technology learning rates can be dynamic quantities as a technology moves from early development to piloting and from low volume manufacturing to high volume manufacturing. This work describes a generalizable technology analysis approach for disaggregating observed technology cost reductions and presents results of this approach for one specific case study (micro-combined heat and power fuel cell systems in Japan). We build upon earlier reports that combine discussion of fuel cell experience curves and qualitative discussion of cost components by providing greater detail on the contributing mechanisms to observed cost reductions, which were not quantified in earlier reports. Greater standardization ismore » added to the analysis approach, which can be applied to other technologies. This paper thus provides a key linkage that has been missing from earlier literature on energy-related technologies by integrating the output of earlier manufacturing cost studies with observed learning rates to quantitatively estimate the different components of cost reduction including economies of scale and cost reductions due to product performance and product design improvements. This work also provides updated fuel cell technology price versus volume trends from the California Self-Generation Incentive Program, including extensive data for solid-oxide fuel cells (SOFC) reported here for the first time. The Japanese micro-CHP market is found to have a learning rate of 18% from 2005 to 2015, while larger SOFC fuel cell systems (200 kW and above) in the California market are found to have a flat (near-zero) learning rate, and these are attributed to a combination of exogenous, market, and policy factors.« less

Measuring Satisfaction with Family-Professional Partnership in Early Intervention and Early Childhood Special Education Programs in Qatar

ERIC Educational Resources Information Center

Al-Hadad, Nawal Khalil

2010-01-01

Family-professional partnership has been considered a recommended practice in Early Intervention/Early Childhood Special Education (EI/ECSE) programs for young children with disabilities and their families for the past two decades. The importance of establishing successful partnerships between families and professionals in educational planning has…

Feasibility of an Online Professional Development Program for Early Intervention Practitioners

ERIC Educational Resources Information Center

Kyzar, Kathleen B.; Chiu, Caya; Kemp, Peggy; Aldersey, Heather Michelle; Turnbull, Ann P.; Lindeman, David P.

2014-01-01

This article reports findings from 2 studies situated within a larger scope of design research on a professional development program, "Early Years," for Part C early intervention practitioners, working with families in home and community settings. Early Years includes online modules and onsite mentor coaching, and its development has…

Academy Update (Early Childhood Professionals Collaborating for Quality), 1986-1992.

ERIC Educational Resources Information Center

Academy Update, 1992

1992-01-01

This document consists of the first 15 consecutive issues of a newsletter published by the National Academy of Early Childhood Programs (The Academy), a division of the National Association for the Education of Young Children (NAEYC). The newsletter focuses on providing information and feedback on early childhood programs for early childhood…

Crossing the Cultural Divide in Early Childhood Teacher Education Programs: A Study of Chinese Graduate Students' Perceptions of American Early Care and Education

ERIC Educational Resources Information Center

Luo, Nili; Gilliard, Jennifer L.

2006-01-01

To effectively teach young children, early childhood teachers must be prepared to collaborate with families of diverse backgrounds. Studying the unique cultural contexts of children and families in American early care and education programs and communities will offer early educators information needed to develop empathy for the families with whom…

Early detection and intervention for attention-deficit/hyperactivity disorder.

PubMed

Sonuga-Barke, Edmund J S; Koerting, Johanna; Smith, Elizabeth; McCann, Donna C; Thompson, Margaret

2011-04-01

Attention-deficit/hyperactivity disorder (ADHD) is a high-cost/high-burden disorder. Early detection and intervention may prevent or ameliorate the development of the disorder and reduce its long-term impact. In this article, we set out a rationale for an early detection and intervention program. First, we highlight the costs of the condition and second, we discuss the limitations of the current treatments. We then outline the potential value of an early detection and intervention program. We review evidence on predictors of poor outcomes for early ADHD signs and discuss how these might allow us to target early intervention more cost-effectively. We then examine potential barriers to engagement with at-risk samples. This leads to a discussion of possible intervention approaches and how these could be improved. Finally, we describe the Program for Early Detection and Intervention for ADHD (PEDIA), a 5-year program of research supported by the UK National Institute for Health Research and conducted at the University of Southampton (Southampton, UK), which aims to develop and evaluate a strategy for early intervention.

The P50 Research Center in Perioperative Sciences: How the investment by the National Institute of General Medical Sciences in team science has reduced postburn mortality.

PubMed

Finnerty, Celeste C; Capek, Karel D; Voigt, Charles; Hundeshagen, Gabriel; Cambiaso-Daniel, Janos; Porter, Craig; Sousse, Linda E; El Ayadi, Amina; Zapata-Sirvent, Ramon; Guillory, Ashley N; Suman, Oscar E; Herndon, David N

2017-09-01

Since the inception of the P50 Research Center in Injury and Peri-operative Sciences (RCIPS) funding mechanism, the National Institute of General Medical Sciences has supported a team approach to science. Many advances in critical care, particularly burns, have been driven by RCIPS teams. In fact, burns that were fatal in the early 1970s, prior to the inception of the P50 RCIPS program, are now routinely survived as a result of the P50-funded research. The advances in clinical care that led to the reduction in postburn death were made by optimizing resuscitation, incorporating early excision and grafting, bolstering acute care including support for inhalation injury, modulating the hypermetabolic response, augmenting the immune response, incorporating aerobic exercise, and developing antiscarring strategies. The work of the Burn RCIPS programs advanced our understanding of the pathophysiologic response to burn injury. As a result, the effects of a large burn on all organ systems have been studied, leading to the discovery of persistent dysfunction, elucidation of the underlying molecular mechanisms, and identification of potential therapeutic targets. Survival and subsequent patient satisfaction with quality of life have increased. In this review article, we describe the contributions of the Galveston P50 RCIPS that have changed postburn care and have considerably reduced postburn mortality.

Research on numerical method for multiple pollution source discharge and optimal reduction program

NASA Astrophysics Data System (ADS)

Li, Mingchang; Dai, Mingxin; Zhou, Bin; Zou, Bin

2018-03-01

In this paper, the optimal method for reduction program is proposed by the nonlinear optimal algorithms named that genetic algorithm. The four main rivers in Jiangsu province, China are selected for reducing the environmental pollution in nearshore district. Dissolved inorganic nitrogen (DIN) is studied as the only pollutant. The environmental status and standard in the nearshore district is used to reduce the discharge of multiple river pollutant. The research results of reduction program are the basis of marine environmental management.

Evaluating a Health Risk Reduction Program.

ERIC Educational Resources Information Center

Nagelberg, Daniel B.

1981-01-01

A health risk reduction program at Bowling Green State University (Ohio) tested the efficacy of peer education against the efficacy of returning (by mail) health questionnaire results. A peer health education program did not appear to be effective in changing student attitudes or lifestyles; however, the research methodology may not have been…

FY 2018 Grant Announcement: FY2018 support for Small Water Grant (SWG) and Innovative and Nutrient Sediment Reduction (INSR) Grant

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency’s Chesapeake Bay Program Office is announcing a request for proposals (RFP) for supporting both the:1.Small Watershed Grants (SWG) program; and 2.Innovative Nutrient and Sediment Reduction (INSR) grants program.

Computer program developed for flowsheet calculations and process data reduction

NASA Technical Reports Server (NTRS)

Alfredson, P. G.; Anastasia, L. J.; Knudsen, I. E.; Koppel, L. B.; Vogel, G. J.

1969-01-01

Computer program PACER-65, is used for flowsheet calculations and easily adapted to process data reduction. Each unit, vessel, meter, and processing operation in the overall flowsheet is represented by a separate subroutine, which the program calls in the order required to complete an overall flowsheet calculation.

Important Factors for Early Market Microgrids: Demand Response and Plug-in Electric Vehicle Charging

NASA Astrophysics Data System (ADS)

White, David Masaki

Microgrids are evolving concepts that are growing in interest due to their potential reliability, economic and environmental benefits. As with any new concept, there are many unresolved issues with regards to planning and operation. In particular, demand response (DR) and plug-in electric vehicle (PEV) charging are viewed as two key components of the future grid and both will likely be active technologies in the microgrid market. However, a better understanding of the economics associated with DR, the impact DR can have on the sizing of distributed energy resource (DER) systems and how to accommodate and price PEV charging is necessary to advance microgrid technologies. This work characterizes building based DR for a model microgrid, calculates the DER systems for a model microgrid under DR through a minimization of total cost, and determines pricing methods for a PEV charging station integrated with an individual building on the model microgrid. It is shown that DR systems which consist only of HVAC fan reductions provide potential economic benefits to the microgrid through participation in utility DR programs. Additionally, peak shaving DR reduces the size of power generators, however increasing DR capacity does not necessarily lead to further reductions in size. As it currently stands for a microgrid that is an early adopter of PEV charging, current installation costs of PEV charging equipment lead to a system that is not competitive with established commercial charging networks or to gasoline prices for plug-in hybrid electric vehicles (PHEV).

Michigan`s air emission trading program

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

Russette, T.M.; VanKolken, A.M.

1997-12-31

Michigan`s Emission Trading Program took effect on March 16, 1996 after two years of rule development by the Michigan Department of Environmental Quality, Air Quality Division and affected stakeholders. This program is based on the open market trading model and has been designed to (1) be consistent with existing federal and state rules and regulations, (2) integrate with existing air programs such as the permit program, and (3) address the needs of Michigan`s regulated community. Michigan`s Air Quality Division, along with other interested parties, initiated this program as part of market-based approaches to improve air quality through the reduction ofmore » criteria pollutants (except ozone) and volatile organic compounds. The Emission Trading rules offer potential benefits for Michigan companies that include increased operational flexibility, lower compliance costs, and/or money generated from the sale of the emission reduction credits. The environment also benefits from this program because the rules require that 10 percent of all registered emission reductions must be permanently retired as an air quality benefit. The emission trading program provides new opportunities for consulting firms to assist companies by identifying acceptable ways to generate and use emission reduction credits. Air pollution control companies may also see new opportunities by designing and installing control equipment in order to reduce air emissions. The role of consultants and equipment companies may expand to that of a broker selling and/or buying emission reduction credits on the Emission Trading Registry. Much has been learned since the conception of the air emission trading program. This paper will discuss how the program works in practice compared to what was envisioned in theory and the potential benefits from Michigan`s Emission Trading Program.« less

Nine-year follow-up of a home-visitation program: a randomized trial.

PubMed

Fergusson, David M; Boden, Joseph M; Horwood, L John

2013-02-01

To evaluate the extent to which a home-visitation program (Early Start) had benefits for child abuse, child behavior, and parental- and family-level benefits to the 9-year follow-up. A randomized controlled trial in which 220 families receiving Early Start were contrasted with a control series of 223 families not receiving the program. Families were enrolled in the program for up to 5 years. Outcomes were assessed at 6 months, annually from 1 year to 6 years, and at 9 years after trial entry. Comparisons between the Early Start and control series showed that families in the Early Start program showed significant (P < .05) benefits in reduced risk of hospital attendance for unintentional injury, lower risk of parent-reported harsh punishment, lower levels of physical punishment, higher parenting competence scores, and more positive child behavioral adjustment scores. Effect sizes (Cohen's "d") ranged from 0.13 to 0.29 (median = 0.25). There were no significant differences (all P values > .05) between the Early Start and control series on a range of measures of parental behavior and family outcomes, including maternal depression, parental substance use, intimate partner violence, adverse economic outcomes, and life stress. The Early Start program was associated with small to moderate benefits in a range of areas relating to child abuse, physical punishment, child behavior, and parenting competence. There was little evidence to suggest that the Early Start program had benefits that extended to the level of parents or family overall.

An Argument for Early Retirement Incentive Planning.

ERIC Educational Resources Information Center

Baenen, Leonard B.; Ernest, Robert C.

1982-01-01

Early retirement incentive programs are discussed as a humanitarian way of reducing payroll costs and rewarding long-tenured employees. The incentives to be considered, program communication, and problems found in incentive programs are addressed. (Author/MLF)

Subcortical grey matter changes in untreated, early stage Parkinson's disease without dementia.

PubMed

Lee, Hye Mi; Kwon, Kyum-Yil; Kim, Min-Jik; Jang, Ji-Wan; Suh, Sang-Il; Koh, Seong-Beom; Kim, Ji Hyun

2014-06-01

Previous MRI studies have investigated cortical or subcortical grey matter changes in patients with Parkinson's disease (PD), yielding inconsistent findings between the studies. We therefore sought to determine whether focal cortical or subcortical grey matter changes may be present from the early disease stage. We recruited 49 untreated, early stage PD patients without dementia and 53 control subjects. Voxel-based morphometry was used to evaluate cortical grey matter changes, and automated volumetry and shape analysis were used to assess volume changes and shape deformation of the subcortical grey matter structures, respectively. Voxel-based morphometry showed neither reductions nor increases in grey matter volume in patients compared to controls. Compared to controls, PD patients had significant reductions in adjusted volumes of putamen, nucleus accumbens, and hippocampus (corrected p < 0.05). Vertex-based shape analysis showed regionally contracted area on the posterolateral and ventromedial putamen bilaterally in PD patients (corrected p < 0.05). No correlations were found between cortical and subcortical grey matter and clinical variables representing disease duration and severity. Our results suggest that untreated, early stage PD without dementia is associated with volume reduction and shape deformation of subcortical grey matter, but not with cortical grey matter reduction. Our findings of structural changes in the posterolateral putamen and ventromedial putamen/nucleus accumbens could provide neuroanatomical basis for the involvement of motor and limbic striatum, further implicating motor and non-motor symptoms in PD, respectively. Early hippocampal involvement might be related to the risk for developing dementia in PD patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

Voluntary Mobile Source Programs: Crediting Innovation and Experimentation Brochure

EPA Pesticide Factsheets

This EPA document provides guidance on Voluntary Mobile Source Emission Reduction Programs (VMEPs) that could be implemented and credited with emission reductions for State Implementation Plans (SIPs) related purposes.

34 CFR 303.361 - Personnel standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... trained personnel to provide early intervention services to eligible children, including, in a geographic... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Program and Service Components of a Statewide System of Early Intervention Services Personnel...

Definition of 1992 Technology Aircraft Noise Levels and the Methodology for Assessing Airplane Noise Impact of Component Noise Reduction Concepts

NASA Technical Reports Server (NTRS)

Kumasaka, Henry A.; Martinez, Michael M.; Weir, Donald S.

1996-01-01

This report describes the methodology for assessing the impact of component noise reduction on total airplane system noise. The methodology is intended to be applied to the results of individual study elements of the NASA-Advanced Subsonic Technology (AST) Noise Reduction Program, which will address the development of noise reduction concepts for specific components. Program progress will be assessed in terms of noise reduction achieved, relative to baseline levels representative of 1992 technology airplane/engine design and performance. In this report, the 1992 technology reference levels are defined for assessment models based on four airplane sizes - an average business jet and three commercial transports: a small twin, a medium sized twin, and a large quad. Study results indicate that component changes defined as program final goals for nacelle treatment and engine/airframe source noise reduction would achieve from 6-7 EPNdB reduction of total airplane noise at FAR 36 Stage 3 noise certification conditions for all of the airplane noise assessment models.

Early life programming of fear conditioning and extinction in adult male rats.

PubMed

Stevenson, Carl W; Spicer, Clare H; Mason, Rob; Marsden, Charles A

2009-12-28

The early rearing environment programs corticolimbic function and neuroendocrine stress reactivity in adulthood. Although early environmental programming of innate fear has been previously examined, its impact on fear learning and memory later in life remains poorly understood. Here we examined the role of the early rearing environment in programming fear conditioning and extinction in adult male rats. Pups were subjected to maternal separation (MS; 360 min), brief handling (H; 15 min), or animal facility rearing (AFR) on post-natal days 2-14. As adults, animals were tested in a 3-day fear learning and memory paradigm which assessed the acquisition, expression and extinction of fear conditioning to an auditory cue; the recall of extinction was also assessed. In addition, contextual fear was assessed prior to cued extinction and its recall. We found that the acquisition of fear conditioning to the cue was modestly impaired by MS. However, no early rearing group differences were observed in cue-induced fear expression. In contrast, both the rate of extinction and extinction recall were attenuated by H. Finally, although contextual fear was reduced after extinction to the cue, no differences in context-induced fear were observed between the early rearing groups. These results add to a growing body of evidence supporting an important role for early environmental programming of fear conditioning and extinction. They also indicate that different early rearing conditions can program varying effects on distinct fear learning and memory processes in adulthood.

Schools' Responses to Voucher Policy: Participation Decisions and Early Implementation Experiences in the Indiana Choice Scholarship Program

ERIC Educational Resources Information Center

Austin, Megan J.

2015-01-01

Little is known about the supply side of voucher programs, despite schools' central role in program effectiveness. Using survey and interview data on the Indiana Choice Scholarship Program (ICSP), I analyze schools' participation decisions and early implementation experiences to understand better how schools respond to program regulations. I find…

Put Your Robot In, Put Your Robot Out: Sequencing through Programming Robots in Early Childhood

ERIC Educational Resources Information Center

Kazakoff, Elizabeth R.; Bers, Marina Umaschi

2014-01-01

This article examines the impact of programming robots on sequencing ability in early childhood. Thirty-four children (ages 4.5-6.5 years) participated in computer programming activities with a developmentally appropriate tool, CHERP, specifically designed to program a robot's behaviors. The children learned to build and program robots over three…

When Could a Stigma Program to Address Mental Illness in the Workplace Break Even?

PubMed Central

Dewa, Carolyn S; Hoch, Jeffrey S

2014-01-01

Objective: To explore basic requirements for a stigma program to produce sufficient savings to pay for itself (that is, break even). Methods: A simple economic model was developed to compare reductions in total short-term disability (SDIS) cost relative to a stigma program’s costs. A 2-way sensitivity analysis is used to illustrate conditions under which this break-even scenario occurs. Results: Using estimates from the literature for the SDIS costs, this analysis shows that a stigma program can provide value added even if there is no reduction in the length of an SDIS leave. To break even, a stigma program with no reduction in the length of an SDIS leave would need to prevent at least 2.5 SDIS claims in an organization of 1000 workers. Similarly, a stigma program can break even with no reduction in the number of SDIS claims if it is able to reduce SDIS episodes by at least 7 days in an organization of 1000 employees. Conclusions: Modelling results, such as those presented in our paper, provide information to help occupational health payers become prudent buyers in the mental health market place. While in most cases, the required reductions seem modest, the real test of both the model and the program occurs once a stigma program is piloted and evaluated in a real-world setting. PMID:25565701

[Staged oncological screening with TG test].

PubMed

Bakhlaev, I E; Ageenko, A I; Rolik, I S

2006-01-01

The authors present their analysis of screening methods used for early diagnostics of cancer of various localization and for detection of high-risk individuals. They offer a program of step-by-step screening that makes it possible to cover more population with prophylactic examination and to reduce the need for special examination methods. TG-test is a universal and the most informative blastomatous process indicator at any stage, including the preclinical one. The practical screening results double the revealing rate of oncopathology and allow for three-fold reduction in the diagnostic costs compared with standard methods of cancer diagnostics. The medical efficiency of the oncological screening is high; in one third of the examined patients a tumor is diagnosed at the preclinical stage.

Pan Am gets big savings at no cost

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

Tanz, D.

Pan American World Airways' contract with an energy management control systems distributor enabled the company's terminal and maintenance facilities at JFK airport in New York to shift from housekeeping to major savings without additional cost. Energy savings from a pneumatic control system were split almost equally between Pan Am and Thomas S. Brown Associates (TSBA) Inc., and further savings are expected from a planned computer-controlled system. A full-time energy manager, able to give top priority to energy-consumption problems, was considered crucial to the program's success. Early efforts in light-level reduction and equipment scheduling required extensive persuasion and policing, but successfulmore » energy savings allowed the manager to progress to the more-extensive plants with TSBA.« less

The global sulfur cycle

NASA Technical Reports Server (NTRS)

Sagan, D. (Editor)

1985-01-01

The results of the planetary biology microbial ecology's 1984 Summer Research Program, which examined various aspects of the global sulfur cycle are summarized. Ways in which sulfur flows through the many living and chemical species that inhabit the surface of the Earth were investigated. Major topics studied include: (1) sulfur cycling and metabolism of phototropic and filamentous sulfur bacteria; (2) sulfur reduction in sediments of marine and evaporite environments; (3) recent cyanobacterial mats; (4) microanalysis of community metabolism in proximity to the photic zone in potential stromatolites; and (5) formation and activity of microbial biofilms on metal sulfides and other mineral surfaces. Relationships between the global sulfur cycle and the understanding of the early evolution of the Earth and biosphere and current processes that affect global habitability are stressed.

Distributional Effects of Early Childhood Programs and Business Incentives and Their Implications for Policy. Upjohn Institute Staff Working Paper No. 09-151

ERIC Educational Resources Information Center

Bartik, Timothy J.

2009-01-01

This paper is a draft of Chapter 8 of a planned book, "Preschool and Jobs: Human Development as Economic Development, and Vice Versa". This book analyzes early childhood programs' effects on regional economic development. Four early childhood programs are considered: (1) universally accessible preschool for four-year-olds of similar…

Risk Factors Associated with Children Lost to Care in a State Early Childhood Intervention Program

ERIC Educational Resources Information Center

Giannoni, Peggy P.; Kass, Philip H.

2010-01-01

A retrospective cohort study was conducted to identify risk factors associated with children lost to care, and their families, compared to those not lost to care within the California Early Start Program. The cohort included data on 8987 children enrolled in the Early Start Program in 1998. This cohort consisted of 2443 children lost to care, 6363…

Early Childhood Reform in Seven Communities: Front-Line Practice, Agency Management, and Public Policy. [Volume I: Final Technical Report.] Studies of Education Reform.

ERIC Educational Resources Information Center

Schultz, Tom; And Others

An era of substantial growth in investment of resources, program development, and research has led to tangible gains in the scope and quality of early childhood education programs. However, the system of early childhood education programs is plagued by unequal access and inconsistent, inadequate levels of quality. Additionally, the focus of…

Outcomes for Students on a Fast Track to College: Early College Entrance Programs at the University of Washington

ERIC Educational Resources Information Center

Hertzog, Nancy B.; Chung, Rachel U.

2015-01-01

Radical acceleration from middle school to university is an unusual option in the United States. The Early Entrance Program and the University of Washington (UW) Academy for Young Scholars housed in the Halbert and Nancy Robinson Center for Young Scholars are two of only 21 early university entrance programs offered in the United States. Due to…

Research and Development Project Summaries, October 1991

DTIC Science & Technology

1991-10-01

delivery methods, training cost reduction, demonstration of technology’ effectiveness, and the reduction of acquisition risk . The majority of the work...demonstrations, risk reduction developments, and cost-effectiveness investigations in simulator and training technologzv. This advanced development program is a...systems. The program is organized around specific demonstration tasks that target critical technical risks that confront future weapons system

40 CFR 76.5 - NOX emission limitations for Group 1 boilers.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.5 NOX emission limitations..., the date on which the unit is required to meet Acid Rain emission reduction requirements for SO2, the... subject to section 404(d) of the Act, the date the unit is required to meet Acid Rain emissions reduction...

78 FR 38730 - Announcement of Funding Awards for Lead-Based Paint Hazard Control, and Lead Hazard Reduction...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

... Awards for Lead-Based Paint Hazard Control, and Lead Hazard Reduction Demonstration Grant Programs for... (OHHLHC) Lead-Based Paint Hazard Control, and Lead Hazard Reduction Demonstration Grant Program Notices of... Grants.gov on December 3, 2012, and amended on January 18, 2013, for the Lead Based Paint Hazard Control...

An Advanced Multiple Alternatives Modeling Formulation for Determining Graduated Fiscal Support Strategies for Operational and Planned Educational Programs.

ERIC Educational Resources Information Center

Wholeben, Brent Edward

A rationale is presented for viewing the decision-making process inherent in determining budget reductions for educational programs as most effectively modeled by a graduated funding approach. The major tenets of the graduated budget reduction approach to educational fiscal policy include the development of multiple alternative reduction plans, or…

77 FR 47855 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... development outcomes for at- risk children through evidence-based home visiting programs. Under this program...: Proposed Project: Maternal, Infant and Early Childhood Home Visiting Program FY 2012 Non-Competing... Maternal, Infant, and Early Childhood Home Visiting Program, ( http://frwebgate.access.gpo.gov/cgi-bin...

Early Outcomes of the GEAR UP Program. Final Report

ERIC Educational Resources Information Center

Standing, Kim; Judkins, David; Keller, Brad; Shimshak, Amy

2008-01-01

In 1998, Congress authorized the Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) program. The purpose of the program is to foster increased knowledge, expectations, and preparation for postsecondary education among low-income students and their families. GEAR UP projects may provide services to students, parents and…

Unified Early Childhood Personnel Preparation Programs: Perceptions from the Field.

ERIC Educational Resources Information Center

LaMontagne, M. J.; Johnson, Lawrence J.; Kilgo, Jennifer L.; Stayton, Vicki; Carr, Victoria; Bauer, Anne M.; Carpenter, Jenny

2002-01-01

This study examined perceptions of unified early childhood personnel preparation programs by 28 faculty members in such programs and by graduates (n=42) of unified, dual, or separate exceptional child education or exceptional child special education programs. Faculty stressed the importance of commitment and collaborative problem solving. The…

Visions for Children: African American Early Childhood Education Program.

ERIC Educational Resources Information Center

Hale-Benson, Janice

The features of an early childhood education demonstration program, Visions for Children, are delineated in this paper. The program was designed to facilitate the intellectual development, boost the academic achievement, and enhance the self-concepts of African-American preschool children. The program implements a curriculum that focuses on…

Estimating risk reduction required to break even in a health promotion program.

PubMed

Ozminkowski, Ronald J; Goetzel, Ron Z; Santoro, Jan; Saenz, Betty-Jo; Eley, Christine; Gorsky, Bob

2004-01-01

To illustrate a formula to estimate the amount of risk reduction required to break even on a corporate health promotion program. A case study design was implemented. Base year (2001) health risk and medical expenditure data from the company, along with published information on the relationships between employee demographics, health risks, and medical expenditures, were used to forecast demographics, risks, and expenditures for 2002 through 2011 and estimate the required amount of risk reduction. Motorola. 52,124 domestic employees. Demographics included age, gender, race, and job type. Health risks for 2001 were measured via health risk appraisal. Risks were noted as either high or low and related to exercise/eating habits, body weight, blood pressure, blood sugar levels, cholesterol levels, depression, stress, smoking/drinking habits, and seat belt use. Medical claims for 2001 were used to calculate medical expenditures per employee. Assuming a dollar 282 per employee program cost, Motorola employees would need to reduce their lifestyle-related health risks by 1.08% to 1.42% per year to break even on health promotion programming, depending upon the discount rate. Higher or lower program investments would change the risk reduction percentages. Employers can use information from published studies, along with their own data, to estimate the amount of risk reduction required to break even on their health promotion programs.

34 CFR 303.361 - Personnel standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... with State law, regulations, or written policy, to assist in the provision of early intervention... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Program and Service Components of a Statewide System of Early Intervention Services Personnel...

34 CFR 303.523 - Interagency agreements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... agency for paying for early intervention services (consistent with State law and the requirements of this... AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND... interagency agreements with other State-level agencies involved in the State's early intervention program...

34 CFR 303.523 - Interagency agreements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... agency for paying for early intervention services (consistent with State law and the requirements of this... AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND... interagency agreements with other State-level agencies involved in the State's early intervention program...

34 CFR 303.301 - Central directory.

Code of Federal Regulations, 2010 CFR

2010-07-01

... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Program and Service Components of a Statewide System of Early Intervention Services General § 303...) Public and private early intervention services, resources, and experts available in the State; (2...

34 CFR 303.340 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... written plan for providing early intervention services to a child eligible under this part and the child's... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Program and Service Components of a Statewide System of Early Intervention Services Individualized...

34 CFR 303.301 - Central directory.

Code of Federal Regulations, 2011 CFR

2011-07-01

... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Program and Service Components of a Statewide System of Early Intervention Services General § 303...) Public and private early intervention services, resources, and experts available in the State; (2...

The Projected Responses of Residency-Sponsoring Institutions to a Reduction in Medicare Support for Graduate Medical Education: A National Survey.

PubMed

Riaz, Mahrukh; Palermo, Tia; Yen, Michael; Edelman, Norman H

2015-10-01

To assess the projected responses of residency-sponsoring institutions to the proposed reduction in Medicare's indirect medical education (IME) payments. In 2012, the authors surveyed directors of graduate medical education (GME) programs, examining (1) overall responses to a reduction in IME reimbursement and (2) the value of individual residencies to the institution from the economic/operational and educational/public service points of view, to determine which programs may be at risk for downsizing. Responses from 192 of 555 institutions (35% response rate) varied by the size of the institution's GME program. Of large programs (six or more residencies), 33 (33%) would downsize at a 10% reduction in IME reimbursement, focusing cuts on specific programs. Small programs (five or fewer residencies) were more likely to retain their existing residencies with modest IME payment reductions and to make across-the-board cuts. The economic/operational value of specialties varied widely, with hospital-intensive residencies valued highest. Family medicine was valued highly from an economic/operational point of view only by small programs. Educational/public service value scores varied less and were higher for all specialties. Preventive medicine was not highly valued in either category. Even a modest decrease in IME reimbursement could trigger institutions to downsize their GME programs. Programs at the greatest risk for cuts may be those with modest economic/operational value but high societal value, like family medicine. The retention or expansion of training in family medicine may be most easily accomplished then at smaller institutions.

Expanding Access to Early Head Start: State Initiatives for Infants & Toddlers at Risk

ERIC Educational Resources Information Center

Colvard, Jamie; Schmit, Stephanie

2012-01-01

The federal Early Head Start (EHS) program was created in 1994 to address the comprehensive needs of children under age 3 in low-income families and vulnerable low-income pregnant women. In addition to early learning opportunities, EHS's comprehensive early childhood development programs provide children and families with access to a range of…

Literature Review on Induction and Mentoring Related to Early Career Teacher Attrition and Retention

ERIC Educational Resources Information Center

Long, Julie S.; McKenzie-Robblee, Sue; Schaefer, Lee; Steeves, Pam; Wnuk, Sheri; Pinnegar, Eliza; Clandinin, D. Jean

2012-01-01

Early career teacher attrition is a matter of economic, social, and educational concern in many countries. Usually induction programs, including mentoring, are seen to alleviate the problem of early career teacher attrition. Mentoring/induction programs as a solution to what is defined as the problem of early career teacher attrition and retention…

Source Reduction Assistance Grant Program Guidance for Applicants

EPA Pesticide Factsheets

The following FAQs were compiled to benefit prospective applicants seeking to apply for grant s or cooperative agreement funding under the Environmental Protection Agency’s (EPA) Source Reduction Assistance (SRA) Grant Program.

A nutrition-physical fitness intervention program for low-income black parents.

PubMed

Sullivan, J; Carter, J P

1985-01-01

An 8-week program taught nutrition and aerobic exercise to obese, low-income black mothers of children under 3 years. A reduction in risk factors for cardiovascular disease in the mothers was anticipated. Culturally adapted aerobic dancing was well-suited for exercise. It was assumed that children would ultimately adopt their parents' changed life style. The program demonstrated a significant reduction in heart rates at rest, but no significant change in heart rates with stress. A significant reduction in body-fat percentage was measured, whereas overall weight reduction was not significant. The consumption of vitamin C, protein, fat, and sodium was reduced. Intake of calcium, iron, carbohydrates, and vitamin A rose significantly. The results indicate the potential effectiveness of such dual intervention programs. Further study would be necessary for more conclusive results and recommendations.

A Nutrition-Physical Fitness Intervention Program for Low-Income Black Parents

PubMed Central

Sullivan, Joan; Carter, James P.

1985-01-01

An 8-week program taught nutrition and aerobic exercise to obese, low-income black mothers of children under 3 years. A reduction in risk factors for cardiovascular disease in the mothers was anticipated. Culturally adapted aerobic dancing was well-suited for exercise. It was assumed that children would ultimately adopt their parents' changed life style. The program demonstrated a significant reduction in heart rates at rest, but no significant change in heart rates with stress. A significant reduction in body-fat percentage was measured, whereas overall weight reduction was not significant. The consumption of vitamin C, protein, fat, and sodium was reduced. Intake of calcium, iron, carbohydrates, and vitamin A rose significantly. The results indicate the potential effectiveness of such dual intervention programs. Further study would be necessary for more conclusive results and recommendations. PMID:3968714

Residual acceleration data on IML-1: Development of a data reduction and dissemination plan

NASA Technical Reports Server (NTRS)

Rogers, Melissa J. B.; Alexander, J. Iwan D.; Wolf, Randy

1992-01-01

The need to record some measure of the low-gravity environment of an orbiting space vehicle was recognized at an early stage of the U.S. Space Program. Such information was considered important for both the assessment of an astronaut's physical condition during and after space missions and the analysis of the fluid physics, materials processing, and biological sciences experiments run in space. Various measurement systems were developed and flown on space platforms beginning in the early 1970's. Similar in concept to land based seismometers that measure vibrations caused by earthquakes and explosions, accelerometers mounted on orbiting space vehicles measure vibrations in and of the vehicle due to internal and external sources, as well as vibrations in a sensor's relative acceleration with respect to the vehicle to which it is attached. The data collected over the years have helped to alter the perception of gravity on-board a space vehicle from the public's early concept of zero-gravity to the science community's evolution of thought from microgravity to milligravity to g-jitter or vibrational environment. Since the advent of the Shuttle Orbiter Program, especially since the start of Spacelab flights dedicated to scientific investigations, the interest in measuring the low-gravity environment in which experiments are run has increased. This interest led to the development and flight of numerous accelerometer systems dedicated to specific experiments. It also prompted the development of the NASA MSAD-sponsored Space Acceleration Measurement System (SAMS). The first SAMS units flew in the Spacelab on STS-40 in June 1991 in support of the first Spacelab Life Sciences mission (SLS-1). SAMS is currently manifested to fly on all future Spacelab missions.

Phantom-to-clinic development of hypofractionated stereotactic body radiotherapy for early-stage glottic laryngeal cancer

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

Ding, Chuxiong; Chun, Stephen G.; Sumer, Baran D.

The purpose of this study was to commission and clinically test a robotic stereotactic delivery system (CyberKnife, Sunnyvale, CA) to treat early-stage glottic laryngeal cancer. We enrolled 15 patients with cTis-T2N0M0 carcinoma of the glottic larynx onto an institutional review board (IRB)-approved clinical trial. Stereotactic body radiotherapy (SBRT) plans prescribed 45 Gy/10 fractions to the involved hemilarynx. SBRT dosimetry was compared with (1) standard carotid-sparing laryngeal intensity-modulated radiation therapy (IMRT) and (2) selective hemilaryngeal IMRT. Our results demonstrate that SBRT plans improved sparing of the contralateral arytenoid (mean 20.0 Gy reduction, p <0.001), ipsilateral carotid D{sub max} (mean 20.6 Gy reduction, p <0.001), contralateral carotidmore » D{sub max} (mean 28.1 Gy reduction, p <0.001), and thyroid D{sub mean} (mean 15.0 Gy reduction, p <0.001) relative to carotid-sparing IMRT. SBRT also modestly improved dose sparing to the contralateral arytenoid (mean 4.8 Gy reduction, p = 0.13) and spinal cord D{sub max} (mean 4.9 Gy reduction, p = 0.015) relative to selective hemilaryngeal IMRT plans. This “phantom-to-clinic” feasibility study confirmed that hypofractionated SBRT treatment for early-stage laryngeal cancer can potentially spare dose to adjacent normal tissues relative to current IMRT standards. Clinical efficacy and toxicity correlates continue to be collected through an ongoing prospective trial.« less

The antimicrobial stewardship program in Gulf Cooperation Council (GCC) states: insights from a regional survey.

PubMed

Enani, Mushira A

2016-01-01

The purpose of the current study is to describe the prevalence and characteristics of antimicrobial stewardship programs (ASP) in Gulf Cooperation Council (GCC) states to explore opportunities and overcome barriers to effective ASP implementation. A cross-sectional questionnaire survey was used to evaluate the current status of ASP: major stewardship components, barriers of implementation and program impact in acute care hospitals of GCC states. Forty-seven healthcare professionals responded from four GCC states, the majority from Saudi Arabia (81%). Twenty-nine (62%) participating hospitals had ASP in place. Of these established programs, 35 (75%) reported lack of funding and personnel as major barriers to program implementation. The top three objectives cited for the hospital ASP were to reduce resistance (72.3%), improve clinical outcomes (70.2%) and reduce costs (44.7%). The reported impact of existing ASP was reduction of inappropriate prescribing (68%), reduction of broad spectrum antibiotic use (63.8%), reduction of healthcare-associated infections (61.7%), reduction of length of stay or mortality metrics (59.6%), reduction in direct antibiotic cost (57.4%) and reduction of reported antibiotic resistance (55.3%). Survey participants from GCC states who have implemented ASP report significant impacts in the reduction of broad spectrum antibiotic use, hospital-acquired infection, inappropriate prescribing and antimicrobial resistance. These findings suggest a promising opportunity to enhance existing ASP through sharing of best practices and support the development of regional guidelines across GCC states.

The antimicrobial stewardship program in Gulf Cooperation Council (GCC) states: insights from a regional survey

PubMed Central

2015-01-01

Objectives: The purpose of the current study is to describe the prevalence and characteristics of antimicrobial stewardship programs (ASP) in Gulf Cooperation Council (GCC) states to explore opportunities and overcome barriers to effective ASP implementation. Methods: A cross-sectional questionnaire survey was used to evaluate the current status of ASP: major stewardship components, barriers of implementation and program impact in acute care hospitals of GCC states. Results: Forty-seven healthcare professionals responded from four GCC states, the majority from Saudi Arabia (81%). Twenty-nine (62%) participating hospitals had ASP in place. Of these established programs, 35 (75%) reported lack of funding and personnel as major barriers to program implementation. The top three objectives cited for the hospital ASP were to reduce resistance (72.3%), improve clinical outcomes (70.2%) and reduce costs (44.7%). The reported impact of existing ASP was reduction of inappropriate prescribing (68%), reduction of broad spectrum antibiotic use (63.8%), reduction of healthcare-associated infections (61.7%), reduction of length of stay or mortality metrics (59.6%), reduction in direct antibiotic cost (57.4%) and reduction of reported antibiotic resistance (55.3%). Conclusion: Survey participants from GCC states who have implemented ASP report significant impacts in the reduction of broad spectrum antibiotic use, hospital-acquired infection, inappropriate prescribing and antimicrobial resistance. These findings suggest a promising opportunity to enhance existing ASP through sharing of best practices and support the development of regional guidelines across GCC states. PMID:28989448