Demonstration and evaluation of the Heed the Speed pedestrian safety program : traffic tech.

DOT National Transportation Integrated Search

2012-07-01

Research has shown that higher vehicular speeds are : related to increased pedestrian injury severity and death. : It is unclear, however, if lowering vehicle speeds in residential : areas would result in lower frequency of pedestrian-involved : cras...

Pilot test of Heed the Speed, a program to reduce speeds in residential neighborhoods

DOT National Transportation Integrated Search

2006-08-01

There is abundant evidence that higher speeds are associated with more severe pedestrian injuries and increased death. Speeding is generally more dangerous for pedestrians on residential roads than on other roadways. There has been significant work o...

Transportation and global climate change : a review and analysis of the literature

DOT National Transportation Integrated Search

1995-08-01

Studies have shown that older drivers have higher rates of accidents, injuries, and fatalities on a per-mile-driven basis. A major cause of roadway accidents for older drivers is failure to heed traffic signs. Previous research found that older drive...

Department of the Navy Advocacy Program: Service Heed and Service Response. Phase III Report: Conclusions

DTIC Science & Technology

1983-10-01

child abuse and spouse abuse, and describe the evolvement of military family advocacy programs. By providing a ready resource for briefings and community presentations, these resource papers should be particularly helpful to Navy and Marine Corps family advocacy

Demanding Satisfaction

ERIC Educational Resources Information Center

Oguntoyinbo, Lekan

2010-01-01

It was the kind of crisis most universities dread. In November 2006, a group of minority student leaders at Indiana University-Purdue University Indianapolis (IUPUI) threatened to sue the university if administrators did not heed demands that included providing more funding for multicultural student groups. This article discusses how this threat…

Bering Strait - Choke Point Control

DTIC Science & Technology

2016-05-13

for safeguarding the security of the Arctic region.” ii US defensive capabilities must expand beyond mere operating capability. To heed this...Dragon Eyes…”, p 4. ii Ibid, p 38. iii L. Brigham, et al, “Bering Strait Region Case Study,” Arctic Maritime Shipping Assessment, Arctic

Beyond Microskills: Toward a Model of Counseling Competence

ERIC Educational Resources Information Center

Ridley, Charles R.; Mollen, Debra; Kelly, Shannon M.

2011-01-01

Heeding the call to the profession, the authors present both a definition and model of counseling competence. Undergirding the model are 15 foundational principles. The authors conceptualize counseling competence as more complex and nuanced than do traditional microskills models and include cognitive, affective, and behavioral components. The…

Medical Laboratory Technician and Technologist Training: Arizona Heeds the Call.

ERIC Educational Resources Information Center

Biehl, Ruth B.

Arizona's medical laboratory personnel training programs were examined in relation to the nationwide development and distribution of laboratory personnel classifications (Medical Technologist--MT, Medical Laboratory Technician--MLT, and Certified Laboratory Assistant--CLA) and the national educational response which has resulted in an increase in…

Student Observations of Outstanding Teaching: Implications for Marketing Educators

ERIC Educational Resources Information Center

Faranda, William T.; Clarke, Irvine, III

2004-01-01

In this article, the authors heed the call to explore the attributes of an outstanding professor "by conducting in-depth interviews with students." The study reveals five predominant themes (rapport, delivery, fairness, knowledge and credibility, organization, and preparation) of teaching excellence, as perceived by students, through…

Training 101: Four Ghosts and Two Heads.

ERIC Educational Resources Information Center

Petrini, Catherine M., Ed.; And Others

1993-01-01

Laus and Champagne offer clues for identifying training room "ghosts" (participants' past experiences, histories, demands, and needs) and describe how to get rid of them. Plutschak and Luke discuss the benefits of team training and suggest five rules to heed when training by the buddy system. (JOW)

Watching the markets misbehave

NASA Astrophysics Data System (ADS)

Hudson, Richard L.

2015-03-01

My first encounter with Benoit Mandelbrot was, in many ways, typical: He came to tell me I didn't know what I was talking about. And that was his message, for much of his life, to much of the financial world. It is a pity he wasn't heeded more quickly...

Sociology of Modern Cosmology

NASA Astrophysics Data System (ADS)

López-Corredoira, M.

2009-08-01

Certain results of observational cosmology cast critical doubt on the foundations of standard cosmology but leave most cosmologists untroubled. Alternative cosmological models that differ from the Big Bang have been published and defended by heterodox scientists; however, most cosmologists do not heed these. This may be because standard theory is correct and all other ideas and criticisms are incorrect, but it is also to a great extent due to sociological phenomena such as the ``snowball effect'' or ``groupthink''. We might wonder whether cosmology, the study of the Universe as a whole, is a science like other branches of physics or just a dominant ideology.

Oppositional Culture and Literacy Education: Constructing Curriculum.

ERIC Educational Resources Information Center

Akre, Philip J.

1991-01-01

Advocates a new conception of literacy education given that most illiterate adults in the United States are Third-World newcomers or educationally/economically disadvantaged U.S. adults. Urges educators to solicit and heed their students' criticisms of the dominant culture. Recommends 13 topics on which to base learning activities related to…

Heeding the Call for Change: Suggestions for Curricular Action.

ERIC Educational Resources Information Center

Steen, Lynn Arthur, Ed.

The "call for change" issued by the Board of Governors of the Mathematical Association of America (MAA) in "A Call For Change: Recommendations for the Mathematical Preparation of Teachers of Mathematics, 1991" may appear at first glance to concern only the mathematical preparation of teachers. However, two ingredients combine…

Tracing Academic Literacies across Contemporary Literacy Sponsorscapes: Mobilities, Ideologies, Identities, and Technologies

ERIC Educational Resources Information Center

Wargo, Jon M.; De Costa, Peter I.

2017-01-01

Locating itself broadly within the "sociolinguistics of mobility" (Blommaert, 2014) and taking heed of Stornaiuolo and Hall's (2014) call to "trace resonance" in writing and literacies research, this article works to trace academic literacies across the emerging "literacy sponsorscapes" (Wargo, 2016a) of contemporary…

Don't Waste Your Attorney's Time: Heed This Wise Counsel on When Legal Advice Is Vital and When It's Wasteful.

ERIC Educational Resources Information Center

Rice, Wandalyn

1982-01-01

Based on interviews with school board attorneys, this article discourages boards from paying an attorney to attend every meeting and encourages them to call a lawyer for problems regarding civil rights, bidding, finance, or policies that affect employees. (JM)

Toward a Theory of Reading Black Feminists' Writings.

ERIC Educational Resources Information Center

Bristow, M. B. Smith

Black feminist novelists continue to take issue with males who try to theorize about their artistic creations. Male attitudes toward black women's novels have been characterized as either apathetic, chauvinistic, or paternalistic. Black feminist writers should heed the call for collective racial progress and collective theoretical progress. The…

Heeding the Call to Arms in a "Nation at Risk."

ERIC Educational Resources Information Center

Goldberg, Milton; Renton, Anita Madan

1993-01-01

In 1983, "A Nation at Risk" made policy recommendations in leadership and fiscal support; standards and expectations; and content, teaching, and use of classroom time and stressed importance of continuous learning and excellence for all students. Symptoms of education's low status remain prevalent--from inadequate student motivation and…

Challenger

ERIC Educational Resources Information Center

Allday, Jonathan

2002-01-01

The events that led to the spectacular destruction of the Space Shuttle "Challenger" in 1986 are detailed here. They show how NASA should have heeded engineers' worries over materials problems resulting from a launch in cold weather. Suggestions are made of how pupils could also learn from this tragedy. (Contains 4 figures and 2 footnotes.)

Research and Consciousness of World Views.

ERIC Educational Resources Information Center

Trumbull, Deborah

Two issues of concern in education are addressed: (1) how should educational research be carried out and (2) why do practitioners so often fail to heed the findings from educational research? The author uses the conceptualization of Stephen Pepper which distinguished four different hypotheses about the nature of the world (formism, mechanism,…

Some Thoughts on Organizing as Cultural Communication.

ERIC Educational Resources Information Center

Carbaugh, Donal

For some time organizational theorists have been calling for increased attention to and appreciation of the role of specific contexts in organizational processes. One group of researchers has heeded this call by treating the organization as a cultural phenomenon. This approach has raised many questions, including (1) What is cultural in an…

Career Counseling and the Information Highway: Heeding the Road Signs.

ERIC Educational Resources Information Center

O'Halloran, Theresa M.; Fahr, Alicia V.; Keller, Jenny R.

2002-01-01

Traveling the "information highway" in the process of career counseling or providing career counseling services via the Internet pose additional challenges for counselors. The authors use current ethical guidelines to guide discussion of, and possible resolutions to, challenges posed by incorporating the Internet into career counseling. (Contains…

Data management in the mission data system

NASA Technical Reports Server (NTRS)

Wagner, David A.

2005-01-01

As spacecraft evolve from simple embedded devices to become more sophisticated computing platforms with complex behaviors it is increasingly necessary to model and manage the flow of data, and to provide uniform models for managing data that promote adaptability, yet pay heed to the physical limitations of the embedded and space environments.

Teaching a Global Sociology: Suggestions for Globalizing the U.S. Curriculum

ERIC Educational Resources Information Center

Sohoni, Deenesh; Petrovic, Misha

2010-01-01

Increasingly, educators have called on colleges and universities to prepare their students for a more interdependent world. While sociology has begun to heed the message to globalize the curriculum, efforts to implement relevant teaching practices are hampered by lack of consensus on what "internationalizing" or "globalizing" the classroom…

Understanding the Role of Representation in Interorganizational Knowledge Integration: A Case Study of an IT Outsourcing Project

ERIC Educational Resources Information Center

Werr, Andreas; Runsten, Philip

2013-01-01

Purpose: The current paper aims at contributing to the understanding of interorganizational knowledge integration by highlighting the role of individuals' understandings of the task and how they shape knowledge integrating behaviours. Design/methodology/approach: The paper presents a framework of knowledge integration as heedful interrelating.…

Science in Primary Schools: The Multicultural Dimension.

ERIC Educational Resources Information Center

Peacock, Alan, Ed.

This book brings together a number of perspectives on building a multicultural dimension into science teaching in the United Kingdom. Part 1 gives a variety of practical ideas for use in multi-ethnic and all-white classrooms, heeding the constraints of the National Curriculum. Part 2 examines the underlying rationale for a multicultural approach…

Heeding the behavioral message of elders with dementia in day care.

PubMed

Ito, Mio; Takahashi, Ryutaro; Liehr, Patricia

2007-01-01

Embodied language is unity of bodily, linguistic, and behavioral descriptors, expressed as health. Disagreement behavior, client unwillingness to respond as requested when uncomfortable in a situation, occurs in elders with dementia. Case study analysis suggests that agitation/aggression may be avoided if disagreement behavior is recognized as a message of discomfort.

Tenure Committees, Take Heed: "University of Pennsylvania v. EEOC" Should Change the Way You Proceed.

ERIC Educational Resources Information Center

Wagner, Eileen N.

1991-01-01

In "University of Pennsylvania," the Supreme Court unanimously rejected a privilege protecting the confidentiality of material assembled for tenure decisions. Focused on sex discrimination complaints, this article addresses how tenure committees can prevent "smoking guns" from getting in tenure review files and who can look in…

Democracy, Voice and Dialogic Pedagogy: The Struggle to Be Heard and Heeded

ERIC Educational Resources Information Center

Segal, Aliza; Pollak, Itay; Lefstein, Adam

2017-01-01

Dialogic pedagogy is widely viewed as an excellent means of educating students for civic participation in deliberative democracy. While many intervention-based studies have researched dialogic teaching and learning, we know very little about the enactment of dialogic and related ideas "in the wild," in regular classrooms. This paper…

Status of Some New Herbicides

Treesearch

W.F. Mann; M.J. Haynes

1978-01-01

If herbicides are handled, applied, or disposed of improperly they may be injurious to humans, domestic animals, desirable plants, and pollinating insects, fish, or other wildlife, and may contaminate water supplies. Use herbicides only when needed and handle them with care. Follow the directions and heed all precautions on the container label. The use of trade, firm,...

Heeding a Call to Action for U.S. Coral Reefs: the Untapped Potential of the Clean Water Act

EPA Science Inventory

A recently published call to action by Dodge et al. (2008) identifies nine actions needed to protect coral reefs. The authors identify several management goals that cannot be accomplished with MPAs alone, the traditional approach to coral reef protection. For U.S. waters, the Cle...

Promoting the Accessibility of SWPBIS for Students with Severe Disabilities

ERIC Educational Resources Information Center

Loman, Sheldon L.; Strickland-Cohen, M. Kathleen; Walker, Virginia L.

2018-01-01

This study heeds a decade-long call to action to examine the accessibility of Schoolwide Positive Behavioral Interventions and Supports (SWPBIS) for students with severe disabilities. To improve the accessibility of SWPBIS, Universal Design for Learning (UDL) and evidence-based practices were used to teach three students with severe disabilities…

Measuring Heedful Interrelating in Collaborative Educational Settings

ERIC Educational Resources Information Center

Daniel, Sarah R.; Jordan, Michelle E.

2015-01-01

Collaborative group work plays an important part in postsecondary education, and the ability to assess the quality of such group work is useful for both students and instructors. The purpose of this study was to develop a self-report measure of students' perceptions of the quality of their interactions during collaborative educational tasks.…

Inventing a Discipline: Rhetoric Scholarship in Honor of Richard E. Young.

ERIC Educational Resources Information Center

Goggin, Maureen Daly, Ed.

Heeding the call of noted rhetoric scholar Richard E. Young to engage in serious, scholarly investigations of the assumptions that underlie established practices and habits about writing, the contributors to this critical volume study a diverse array of disciplinary issues, situate their work in a wide matrix of theoretical perspectives, and…

How Not to Lose Face on Facebook, for Professors

ERIC Educational Resources Information Center

Young, Jeffrey R.

2009-01-01

For years college administrators have warned students to watch their step in online social realms, noting that sharing too much could hurt them later on if future employees saw their drunken party pictures or boorish writings. Now that professors and administrators are catching Facebook fever, they should heed their own advice. The author…

Children's Understanding of Others' Emotional States: Inferences from Extralinguistic or Paralinguistic Cues?

ERIC Educational Resources Information Center

Gil, Sandrine; Aguert, Marc; Bigot, Ludovic Le; Lacroix, Agnès; Laval, Virginie

2014-01-01

The ability to infer the emotional states of others is central to our everyday interactions. These inferences can be drawn from several different sources of information occurring simultaneously in the communication situation. Based on previous studies revealing that children pay more heed to situational context than to emotional prosody when…

The Global Health Policies of the EU and its Member States: A Common Vision?

PubMed Central

Steurs, Lies; Van de Pas, Remco; Delputte, Sarah; Orbie, Jan

2018-01-01

Background: This article assesses the global health policies of the European Union (EU) and those of its individual member states. So far EU and public health scholars have paid little heed to this, despite the large budgets involved in this area. While the European Commission has attempted to define the ‘EU role in Global Health’ in 2010, member states are active in the domain of global health as well. Therefore, this article raises the question to what extent a common ‘EU’ vision on global health exists. Methods: This is examined through a comparative framing analysis of the global health policy documents of the European Commission and five EU member states (France, Germany, the United Kingdom, Belgium, and Denmark). The analysis is informed by a two-layered typology, distinguishing global health from international health and four ‘global health frames,’ namely social justice, security, investment and charity. Results: The findings show that the concept of ‘global health’ has not gained ground the same way within European policy documents. Consequently, there are also differences in how health is being framed. While the European Commission, Belgium, and Denmark clearly support a social justice frame, the global health strategies of the United Kingdom, Germany, and France put an additional focus on the security and investment frames. Conclusion: There are different understandings of global/international health as well as different framings within relevant documents of the EU and its member states. Therefore, the existence of an ‘EU’ vision on global health is questionable. Further research is needed on how this impacts on policy implementation. PMID:29764107

Education, Technology and the Sociological Imagination--Lessons to Be Learned from C. Wright Mills

ERIC Educational Resources Information Center

Selwyn, Neil

2017-01-01

As part of the "Learning, Media & Technology" series on "Key Thinkers and Theoretical Traditions", this paper explores the relevance of C. Wright Mills' much lauded book "The Sociological Imagination". The argument is made that we would do well to take heed of many of the central tenets of Mills' call to arms for…

Walking between Two Worlds: Indigenous Women and Educational Leadership

ERIC Educational Resources Information Center

Fitzgerald, Tanya

2006-01-01

Theory and research in the field of educational leadership and management has grown exponentially in the past decade. I am troubled however by the apparent primacy of ethnocentric ways of knowing, acting and leading. And while we might heed Dimmock and Walker's call for a cross-cultural approach to leadership and management, located at the…

The Disciplinary and Pleasurable Spaces of Boys' PE--The Art of Distributions

ERIC Educational Resources Information Center

Gerdin, Göran

2016-01-01

In taking heed of the so-called "spatial turn" in social theory this paper explores how the spatial intersects with boys' performances of gender and (dis)pleasures in school physical education (PE). In particular, the paper aims to contribute to our understanding of how the organisation and implementation of physical and social spaces in…

Making College More Expensive: The Unintended Consequences of Federal Tuition Aid. Policy Analysis. No. 531

ERIC Educational Resources Information Center

Wolfram, Gary

2005-01-01

As Congress debates the reauthorization of the Higher Education Act (HEA), it should heed Friedrich Hayek's warning that democracy is "peculiarly liable, if not guided by accepted common principles, to produce over-all results that nobody wanted." One result of the federal government's student financial aid programs is higher tuition…

Difficult Collective Deliberations: Anthropological Notes toward a Theory of Education

ERIC Educational Resources Information Center

Varenne, Herve

2007-01-01

Background/Context: In the 1970s, Lawrence Cremin urged researchers to remember that education is more than schooling. Few heeded this call, perhaps because of the absence of the theoretical framework needed to make this more than a platitude. As a cultural anthropologist, I argue that education is a fundamental human activity that is infinitely…

Heeding Woolf's Great Teacher: Uncovering and Defusing an Education in "Unreal Loyalties"

ERIC Educational Resources Information Center

Otto, Stacy

2012-01-01

In her 1938 epistolary novel and educational treatise, "Three Guineas," Virginia Woolf discusses "freedom from unreal loyalties" as key to educating for peace rather than for war, as was the concern in Woolf's time and remarkably remains of serious concern seventy-odd years later. This essay analyzes how modern-day, post-9/11…

Development of a Contextualized ESL Bridge Curriculum. Promising Practice

ERIC Educational Resources Information Center

Office of Community College Research and Leadership, 2010

2010-01-01

Black Hawk College (BHC) is a comprehensive community college serving all or part of nine counties and a population of approximately 224,510 residents in a mostly rural area of north-west Illinois. This practice was fully developed and implemented for the Shifting Gears (SG) initiative during the 2007-08 academic years. Heeding BHC's strategic…

The Liability of Colleges and Universities for Fraud, Waste, and Abuse in Federally Funded Grants and Projects.

ERIC Educational Resources Information Center

Gordon, Steven D.

1996-01-01

The federal government's war on fraud, waste, and abuse in expenditure of federal funds has reached college campuses. Institutions that fail to heed this development are vulnerable to harsh sanctions. They must tighten accounting practices and recognize their liability for fraudulent practices of faculty and students. Internal investigations and…

Easing the strain of unnecessary antibiotic requests. Physicians called on to change patient expectations about antibiotic use; experts say it's about communication.

PubMed

Hertz, Beth Thomas

2014-01-10

Antibiotic resistance is one of the world's major public health challenges, according to the Centers for Disease Control and Prevention. While medical providers are heeding the call, patient pressure about receiving antibiotic prescriptions remains a significant influencer, says the National Committee for Quality Assurance.

Cal State-Long Beach Heeds Call to Investigate Professors' Online Biographies

ERIC Educational Resources Information Center

Bartlett, Thomas

2008-01-01

This article reports that an essay by a film professor at California State University at Long Beach that questions the credentials of his colleagues is stirring controversy on the campus--and sparking investigations. The essay, written by Brian Alan Lane, an associate professor of film, accuses three of his colleagues in the department of film and…

A Guide to Educational Philosophizing after Heidegger

ERIC Educational Resources Information Center

Vandenberg, Donald

2008-01-01

This paper heeds the advice of EPAT's editor, who said he "will be happy to publish further works on Heidegger and responses to these articles" after introducing four articles on Heidegger (and one of his students) and education in the August, 2005, issue. It discusses the papers in order of appearance critically, for none of them shows…

Why Culture Matters in Health Interventions: Lessons from HIV/AIDS Stigma and NCDs

ERIC Educational Resources Information Center

Airhihenbuwa, Collins O.; Ford, Chandra L.; Iwelunmor, Juliet I.

2014-01-01

Theories about health behavior are commonly used in public health and often frame problems as ascribed or related to individuals' actions or inaction. This framing suggests that poor health occurs because individuals are unable or unwilling to heed preventive messages or recommended treatment actions. The recent United Nations call for…

Heeding the CALL (Comprehensive Assessment of Leadership for Learning): An Inquiry into Instructional Collaboration among School Professionals

ERIC Educational Resources Information Center

Min, Sookweon; Modeste, Marsha E.; Salisbury, Jason; Goff, Peter T.

2016-01-01

Purpose: The purpose of this paper is to examine what school leadership practices are associated with a school's level of instructional collaboration among school professionals and also investigates what school characteristics are linked to the level of instructional collaboration in a school. Design/methodology/approach: This study drew data from…

Attributes Heeded When Representing an Osmosis Problem.

ERIC Educational Resources Information Center

Zuckerman, June Trop

Eighteen high school science students were involved in a study to determine what attributes in the problem statement they need when representing a typical osmosis problem. In order to realize this goal students were asked to solve problems aloud and to explain their answers. Included as a part of the results are the attributes that the students…

Is "Moneyball" the Next Big Thing in Education?

ERIC Educational Resources Information Center

Soland, Jim

2015-01-01

Predictive analytics in education can offer a benefit as long as educators heed the differences between how the tools are used in industry and how they should be used differently in schooling. Perhaps most important, teachers already know a great deal about their students--far more than an investor knows about a stock or a baseball scout about an…

African American Women Principals: Heeding the Call to Serve as Conduits for Transforming Urban School Communities

ERIC Educational Resources Information Center

Newcomb, Whitney Sherman; Niemeyer, Arielle

2015-01-01

African American women leaders are often found in urban schools that have been exhausted of resources and lack support. However, due to their disproportionate representation in urban schools, African American women principals have become adept at uniting and engaging stakeholders in marginalized school settings into action. The intent for this…

Habermas and the Meaning of the Post-Secular Society: Complementary Learning Processes

ERIC Educational Resources Information Center

Welton, Michael R.

2014-01-01

This essay argues that if social justice is to prevail in our world, we must understand the post-secular nature of our globalized society as a prerequisite for moving beyond "might is right" to national and international relations that heed all voices towards evidence-based interaction. Our post-secular world and postmetaphysical…

Heeding the Voice of Experience: The Role of Talker Variation in Lexical Access

ERIC Educational Resources Information Center

Creel, Sarah C.; Aslin, Richard N.; Tanenhaus, Michael K.

2008-01-01

Two experiments used the head-mounted eye-tracking methodology to examine the time course of lexical activation in the face of a non-phonemic cue, talker variation. We found that lexical competition was attenuated by consistent talker differences between words that would otherwise be lexical competitors. In Experiment 1, some English cohort…

Photoemission studies of CdTe(100) and the Ag-CdTe(100) interface: Surface structure, growth behavior, Schottky barrier, and surface photovoltage

NASA Astrophysics Data System (ADS)

John, P.; Miller, T.; Hsieh, T. C.; Shapiro, A. P.; Wachs, A. L.; Chiang, T.-C.

1986-11-01

The clean CdTe(100) surface prepared by sputtering and annealing was studied with high-energy electron diffraction (HEED) and photoemission. HEED showed the surface to be a one-domain, (2×1) reconstruction. Photoemission spectra showed two surface-shifted components for the Cd 4d core level, with an intensity ratio of about 1:3, accounting for nearly an entire atomic layer. No surface-induced shifts for the Te 4d core level were detected. A model is proposed for the surface structure in which the surface layer is free of Te, and Cd atoms form dimers resulting in a (2×1) reconstruction; in addition, about (1/4) of the surface area is covered by excess loosely attached Cd atoms. Ag was evaporated on the surface at room temperature and found to grow three dimensionally in the [111] direction. The Ag was found to interact only weakly with the substrate, although the Cd atoms originally loosely bound on top of the surface were found to float on the evaporated Ag islands. A small coverage-dependent surface photovoltage, induced by the synchrotron radiation used for photoemission, was observed; with this effect taken into account, band bending was monitored, the final Fermi-level position being near 0.96 eV above the valence-band maximum. This corresponds to a Schottky-barrier height of about 0.60 eV for the n-type sample used in this experiment. The mechanism for generation of the surface photovoltage will be discussed.

Teamwork Benefits in Tertiary Education: Student Perceptions That Lead to Best Practice Assessment Design

ERIC Educational Resources Information Center

Volkov, Arabella; Volkov, Michael

2015-01-01

Purpose: The purpose of this paper is to contribute to the understanding of the development of students' skills in the context of team-based learning. Academics have heeded the call to incorporate team learning activities into the curricula, yet little is known of student perception of teamwork and whether they view it as beneficial to them and…

"Just Be Quiet and Listen to Exactly What He's Saying": Conceptualising Power Relations in Inquiry-Oriented Classrooms

ERIC Educational Resources Information Center

Donnelly, Dermot Francis; McGarr, Oliver; O'Reilly, John

2014-01-01

Interest in inquiry-based science education (IBSE) often pays little heed to the complex power relations that exist within classrooms. A common obstacle to inquiry is that it strongly diverges from current classroom culture and hence, is outside the sphere of teachers' and students' experiences. Teachers and students bring expectations to the…

The trouble with sex differences.

PubMed

Eliot, Lise

2011-12-22

Sex differences in the brain are real and clinically important but often grossly distorted in popular discourse. Considering the public's deep fascination with sex difference research and its impact on issues from mental health to education and workplace equity, neuroscientists should pay greater heed to its misappropriation and to studying how gender enculturation shapes neural function. Copyright © 2011 Elsevier Inc. All rights reserved.

The State Fiscal Stabilization Fund and Higher Education Spending: Part 2 of 4

ERIC Educational Resources Information Center

Cohen, Jennifer S.

2011-01-01

By late 2008, the United States was in the midst of its most severe economic recession since the 1930s, brought on by a collapse in real estate prices and exacerbated by the failure of many large banks and financial institutions. Heeding calls from economists, Congress and the Obama administration passed a historic law in early 2009 to stimulate…

Higher Education Spending and the State Fiscal Stabilization Fund, Part 3: State Case Studies

ERIC Educational Resources Information Center

Cohen, Jennifer

2011-01-01

By late 2008, the United States was in the midst of its most severe economic recession since the 1930s, brought on by a collapse in real estate prices and exacerbated by the failure of many large banks and financial institutions. Heeding calls from economists, Congress and the Obama administration passed an historic law in early 2009 to stimulate…

The Case for a New Approach to Sex Education Mounts; Will Policymakers Heed the Message? Guttmacher Policy Review. Volume 10, Number 2, Spring 2007

ERIC Educational Resources Information Center

Boonstra, Heather D.

2007-01-01

Abstinence-only-until-marriage education is a key component of social conservatives' global moral and religious agenda, and the cornerstone of the Bush administration's approach to reducing U.S. teen pregnancy and sexually transmitted infection (STI) rates. Fearful of being portrayed as anti-abstinence, policymakers have continued to support these…

Responding to Contestation in Teaching and Learning Projects in the Centres for Excellence in Teaching and Learning in the United Kingdom

ERIC Educational Resources Information Center

Gosling, David; Turner, Rebecca

2015-01-01

Government-funded teaching and learning projects have emerged as a favoured tool of policymakers to motivate change in teaching and learning. This strategy pays limited heed to the complexity of higher education and the contradictions, tensions and conflicts that need to be negotiated to change practice. This process of negotiation creates sites…

Difference in Condom Use among Sexually Active Males at Historically Black Colleges and Universities

ERIC Educational Resources Information Center

Washington, Thomas Alex; Wang, Yan; Browne, Dorothy

2009-01-01

Black men who have sex with men (MSM) and black men who have sex with both men and women (MSMW) may not perceive themselves to be part of the larger gay community and hence may not heed prevention messages aimed at the community. Objective and Participants: To better understand the participants behaviors, the authors examined differences in condom…

Weight-Loss Study in African-American Women: Lessons Learned from Project Take HEED and Future, Technologically Enhanced Directions

PubMed Central

Murphy, Pamala J; Williams, Roger L

2013-01-01

Introduction African-American women are more overweight and have greater difficulty maintaining weight loss than do Caucasian women. Evidence suggests that African-American women are more successful with culturally tailored weight-loss programs. Methods: Begun in 2005, an 18-month randomized clinical trial, Project Take HEED (Healthy Eating and Exercise Decisions), culturally adapted an evidence-based dietary approach and exercise program to fit the female African-American population in an attempt to improve program attrition rates. The study was conducted with 223 African-American women (120 women in the experimental group; 103 controls), age 35 to 65 years, with a body mass index of 30 kg/m2 or higher. The experimental group received education and instruction at 24 group sessions and were asked to record their daily food intake and physical activity. Cultural adaptation included social and spiritual components. Controls received usual care (referral to a dietitian). Results: After 18 months, Project Take HEED demonstrated the following outcomes: Attrition: the treatment group consisted of 12 African-American women at the end of month 18—(an attrition rate of 87%). (It had been 70% at the end of month 15.)Factors contributing to attrition included: caregiver responsibilities, transportation difficulties, work schedules, and others. Those clients that did remain, however, provided the impetus for our next study. The remaining participants had, by and large, begun the study as being low in self-efficacy regarding weight loss and weight loss maintenance Conclusion: Initial Findings: The high self-efficacy that some women had at the beginning of the intervention did not translate into the desired behavior change. The inverse relationship seen in this study suggests that treatments that improve participants’ self-efficacy may result in greater weight loss. New Directions: A new study, commencing in 2013, will use at-home Web-based and virtual reality technology (avatars) in an attempt to enhance client motivation to persist in long-term weight management programs. Bandura’s pioneering work on self-efficacy will be the theoretical foundation of the pilot study, also enrolling African-American women. PMID:23704845

Weight-loss study in African-American Women: lessons learned from project take HEED and future, technologically enhanced directions.

PubMed

Murphy, Pamala J; Williams, Roger L

2013-01-01

African-American women are more overweight and have greater difficulty maintaining weight loss than do Caucasian women. Evidence suggests that African-American women are more successful with culturally tailored weight-loss programs. Begun in 2005, an 18-month randomized clinical trial, Project Take HEED (Healthy Eating and Exercise Decisions), culturally adapted an evidence-based dietary approach and exercise program to fit the female African-American population in an attempt to improve program attrition rates. The study was conducted with 223 African-American women (120 women in the experimental group; 103 controls), age 35 to 65 years, with a body mass index of 30 kg/m(2) or higher. The experimental group received education and instruction at 24 group sessions and were asked to record their daily food intake and physical activity. Cultural adaptation included social and spiritual components. Controls received usual care (referral to a dietitian). After 18 months, Project Take HEED demonstrated the following outcomes: ATTRITION: the treatment group consisted of 12 African-American women at the end of month 18-(an attrition rate of 87%). (It had been 70% at the end of month 15.)FACTORS CONTRIBUTING TO ATTRITION INCLUDED: caregiver responsibilities, transportation difficulties, work schedules, and others. Those clients that did remain, however, provided the impetus for our next study. The remaining participants had, by and large, begun the study as being low in self-efficacy regarding weight loss and weight loss maintenance. Initial Findings: The high self-efficacy that some women had at the beginning of the intervention did not translate into the desired behavior change. The inverse relationship seen in this study suggests that treatments that improve participants' self-efficacy may result in greater weight loss. New Directions: A new study, commencing in 2013, will use at-home Web-based and virtual reality technology (avatars) in an attempt to enhance client motivation to persist in long-term weight management programs. Bandura's pioneering work on self-efficacy will be the theoretical foundation of the pilot study, also enrolling African-American women.

The State Fiscal Stabilization Fund and Higher Education Spending in the States: Part 1 of 4. Issue Brief

ERIC Educational Resources Information Center

Cohen, Jennifer

2010-01-01

By late 2008, the United States was in the midst of its most severe economic recession since the 1930s, brought on by a collapse in real estate prices and exacerbated by the failure of many large banks and financial institutions. Heeding calls from economists, Congress and the Obama administration passed a historic law in early 2009 to stimulate…

Health and socioeconomic effects of groundwater arsenic contamination in rural Bangladesh: new evidence from field surveys.

PubMed

Nahar, Nurun; Hossain, Faisal; Hossain, M Delawer

2008-05-01

This report discusses the health and socioeconomic problems that have recently emerged in the Bangladesh countryside because of arsenic contamination of the groundwater. A survey found that men in rural households are generally found to be more susceptible to arsenicosis than women. The survey also indicated that villagers with lower annual income are more likely to experience arsenicosis. About 60 percent of the respondents indicated a willingness to pay up to a dollar of their monthly income for safe water. More than 70 percent of women were found to be willing to walk for five minutes to collect safe water. Awareness campaigns conducted over the last decade seem to have been effective for villagers. Overall, findings from the survey paint a picture of a gradually evolving social and health scenario in rural Bangladesh that health officials must heed to safeguard the public health of the rural public.

Comparing reactions to two severe tornadoes in one Oklahoma community.

PubMed

Comstock, R Dawn; Mallonee, Sue

2005-09-01

The authors compared the effect of the 3 May 1999 F5 and 8 May 2003 F3 tornadoes on the community of Moore, Oklahoma, by canvassing damaged areas after both tornadoes and surveying residents. Significantly more 1999 than 2003 residents reported property damage and injuries. Television and tornado sirens were the most common warnings each year, however, more 1999 residents received and responded to television warnings. Importantly, storm shelters were used more frequently in 2003. Fifty-one per cent of residents who experienced both tornadoes took the same amount of protective action in 2003 as they had in 1999; 22% took less; and 27% took more. Residents who took less action said that the reason for doing so was inadequate warning and shelter. First-hand experience of tornadoes prompts people to heed warnings when adequate notification is received and to take effective protective action when adequate shelter is available.

East Europe Report

DTIC Science & Technology

1986-09-02

the administra- tion". \\ \\ Eawel Kluta of the Paris Commune Shipyards in Gdynia spoke about the need to revise the working style of the ZSMP. He...takes the form of a "distressing servility to fashion" especially to "emanations of certain snobs from Paris , London» Freiburg, Lausanne and other...a grave, or a catacomb , which, it is true, still frightens them from time to time. People no longer pay heed to the life hereafter, the existence

Heeding Cultural Prerogatives: The Evolving Politics of Wine Regulation in France

DTIC Science & Technology

2007-06-01

French wine advanced in concert with the consumption and production booms, according to most observers. Early trailblazers of gastronomy in France...History of Wine (New York: Harper Collins, 2000), 230. 54 Pascal Ory, “ Gastronomy ,” in Pierre Nora, Realms of Memory: The Construction of the French...constantly encounter, and often employ, new viticultural technologies and techniques. Just as is the case with standard versions of globalization, a deep

Translations on USSR Military Affairs, Number 1291

DTIC Science & Technology

1977-08-10

gymnastics and other tournaments be organized. But for some reason the Komsomol activists did not heed these suggestions. More- over, some of them... artistic literature. Most political workers read and think about what they have read. But there are still those who have not acquired a taste for...tions of political and artistic literature come up they do not always remember the book and when they read it. Some go no further than ad

Retrading, production, and asset market performance.

PubMed

Gjerstad, Steven D; Porter, David; Smith, Vernon L; Winn, Abel

2015-11-24

Prior studies have shown that traders quickly converge to the price-quantity equilibrium in markets for goods that are immediately consumed, but they produce speculative price bubbles in resalable asset markets. We present a stock-flow model of durable assets in which the existing stock of assets is subject to depreciation and producers may produce additional units of the asset. In our laboratory experiments inexperienced consumers who can resell their units disregard the consumption value of the assets and compete vigorously with producers, depressing prices and production. Consumers who have first participated in experiments without resale learn to heed their consumption values and, when they are given the option to resell, trade at equilibrium prices. Reproducibility is therefore the most natural and most effective treatment for suppression of bubbles in asset market experiments.

Retrading, production, and asset market performance

PubMed Central

Gjerstad, Steven D.; Porter, David; Smith, Vernon L.; Winn, Abel

2015-01-01

Prior studies have shown that traders quickly converge to the price–quantity equilibrium in markets for goods that are immediately consumed, but they produce speculative price bubbles in resalable asset markets. We present a stock-flow model of durable assets in which the existing stock of assets is subject to depreciation and producers may produce additional units of the asset. In our laboratory experiments inexperienced consumers who can resell their units disregard the consumption value of the assets and compete vigorously with producers, depressing prices and production. Consumers who have first participated in experiments without resale learn to heed their consumption values and, when they are given the option to resell, trade at equilibrium prices. Reproducibility is therefore the most natural and most effective treatment for suppression of bubbles in asset market experiments. PMID:26553991

Ayahuasca and human destiny.

PubMed

McKenna, Dennis J

2005-06-01

In this essay, the author shares his personal reflections gleaned from a lifetime of research with ayahuasca, and speculates on the societal, political, planetary, and evolutionary implications of humanity's aeons-old symbiosis with this shamanic plant. The thesis is developed that at this critical historical juncture, ayahuasca has developed a strategy to broadcast its message to a wider world--a reflection of the urgent need to avert global ecological catastrophe. While ayahuasca has much to teach us, the critical question is, will humanity hear it, and heed it, in time?

The Pattern of Soviet Conduct in the Third World. Review and Preview. Part 4

DTIC Science & Technology

1983-03-07

continued to stress the impediments to "genuine" revolution there, heeding thZ 1_w level of class and political consciousness of the masses. indeed, they...is, it must have a continuing presence and exert influence throughout the world. Moscow has looked with increasing favor on political means to further...cooperation with the government of Indira Gandhi, the CPI-M had adopted a political strategy of peasant mobilization, focusing upon India’s eastern flank

Legislation would establish commission to assess marine and coastal resources and develop national ocean policy

NASA Astrophysics Data System (ADS)

Showstack, Randy

During 1998, internationally designated as the year of the ocean, perhaps more people are paying heed to the deep seas now than ever before.Transfixed to the big screen by this year's movie blockbuster, they anticipate when the Titanic will scrape into the iceberg and break apart, shiver when household-name heartthrobs Leonardo DiCaprio and Kate Winslet float on the freezing waters, and hum along to the theme sung by Celine Dion.

Guidelines for treatment with infliximab for Crohn's disease.

PubMed

Hommes, D W; Oldenburg, B; van Bodegraven, A A; van Hogezand, R A; de Jong, D J; Romberg-Camps, M J L; van der Woude, J; Dijkstra, G

2006-01-01

Infliximab is an accepted induction and maintenance treatment for patients with Crohn's disease. The effectiveness of infliximab has been demonstrated for both active luminal disease and for enterocutaneous fistulisation. In addition, infliximab can be administered for extraintestinal symptoms of Crohn's disease, such as pyoderma gangrenosum, uveitis and arthropathy. Maintenance treatment with infliximab is effective and is regarded as safe as long as the necessary safety measures are heeded. Infusion reactions occur in 3 to 17% of the patients and are associated with the formation of antibodies to infliximab. A reduction in infusion reactions is possible by the concurrent administration of steroids and the use of immunosuppressants (azathioprine, 6-mercaptopurine, methotrexate). Furthermore, immunosuppressants increase the duration of the response to infliximab. For these reasons, the concomitant use of immunosuppressants with infliximab is recommended. Infections and most specifically tuberculosis need to be ruled out before infliximab is administered. Up to now, there are no indications for a connection between an increased risk for malignancies and treatment with infliximab.

The use of visual and verbal means of communication across psychological distance.

PubMed

Amit, Elinor; Wakslak, Cheryl; Trope, Yaacov

2013-01-01

The current study investigated the effect of distance on medium preferences in interpersonal communication. Five experiments showed that people's preference for using pictures (vs. words) is increasingly higher when communicating with temporally, socially, or geographically proximal (vs. distal) others. In contrast, preference for words is increasingly higher when communicating with those who were distal. A sixth experiment showed that communication's medium influences distance preferences, such that people's preference for communicating a message to a distant (vs. proximal) target is greater for verbal compared with pictorial communications. A seventh experiment showed that recipients are more likely to heed a sender's suggestions when the medium and distance are congruent. These findings reflect the suitability of pictures for communication with proximal others and words with distal others. Implications of these findings for construal-level theory, perspective taking, embodied cognition, the development of language, and social skills with children are discussed.

SKN-1-independent transcriptional activation of glutathione S-transferase 4 (GST-4) by EGF signaling

PubMed Central

Van de Walle, Pieter; Schoofs, Liliane

2016-01-01

ABSTRACT In C. elegans research, transcriptional activation of glutathione S-transferase 4 (gst-4) is often used as a read-out for SKN-1 activity. While many heed an assumed non-exclusivity of the GFP reporter signal driven by the gst-4 promoter to SKN-1, this is also often ignored. We here show that gst-4 can also be transcriptionally activated by EOR-1, a transcription factor mediating effects of the epidermal growth factor (EGF) pathway. Along with enhancing exogenous oxidative stress tolerance, EOR-1 inde-pendently of SKN-1 increases gst-4 transcription in response to augmented EGF signaling. Our findings caution researchers within the C. elegans community to always rely on sufficient experimental controls when assaying SKN-1 transcriptional activity with a gst-4p::gfp reporter, such as SKN-1 loss-of-function mutants and/or additional target genes next to gst-4. PMID:28090393

Anthropometry of Women of the U.S. Army -- 1977. Report Number 2. The Basic Univariate Statistics

DTIC Science & Technology

1977-06-01

Work - Heed & Static Core Anthro space Lace Stren€gth Fort Sea Eouston 261 73 - 72 119 Fort McClellan 506 94 234 107 156 Walter Reed Med. Center 298...Laboratory. The measurers worked in pairs, alternating 4 - 30 * et? !-: ... . ............. 0 o• , -.•• • between the roles of measurer and recorder...TRADITIONAL SUBSERIES THE 1--CENITLES 1ST BISPINOUS eREACTI- CENTIMETERS I?-CIES WIE HCRIZENTAL DISTWkE EEWIkjN lfs AkVR-, SUFEr ,!Of- ILIAC SPIN-ES 27...5 SETH

Fort Huachuca, Libby AAF, Arizona. Revised Uniform Summary of Surface Weather Observations (RUSSWO). Parts A-F.

DTIC Science & Technology

1982-04-22

pbenomena An the Wather Conditions kMry ebove also onply for the categories heeded -% OF UN V=? PM10 and -% OF ONS W=! OWS 20 TMIW shov the pereatage of...OF WIND V DIRECTION AND SPEED (FROM HOURLY OBSERVATIONS) 27 FT HuJil4IrA/l ifaY ALF A7 MAR-7f STATION SamIO Name vEas MONT* ALL WATHER ~fnnn-nflf...U. GLOAL CLIMATOLOGY SRANCH USAFETAC PSYCHROMETRIC SUMMARY j,~ AIR wATHER SERVICE/MAC 72273C FT ,UACHUCAILIBBY AAF AZ 61-?0 WA0

Protecting your eyes in the laser operating room.

PubMed

Sallavanti, R A

1995-01-01

1. Laser protective eyewear is nearly as important to the OR nurse as the surgical mask in an operating room where laser surgery is performed. 2. Most hospitals require OR personnel to wear protective eyewear during laser procedures in voluntary compliance with American National Standards Institute (ANSI) Z136.3 for the safe use of lasers in health care facilities. 3. The basic steps to protecting your eyes are as follows: Select the appropriate eyewear (plastic or glass); make sure the eyewear fits properly; wear the protective lenses during laser testing and operation; and heed your laser safety officer.

New approaches to quantifying aerosol influence on the cloud radiative effect

DOE PAGES

Feingold, Graham; McComiskey, Allison; Yamaguchi, Takanobu; ...

2016-02-01

The topic of cloud radiative forcing associated with the atmospheric aerosol has been the focus of intense scrutiny for decades. The enormity of the problem is reflected in the need to understand aspects such as aerosol composition, optical properties, cloud condensation, and ice nucleation potential, along with the global distribution of these properties, controlled by emissions, transport, transformation, and sinks. Equally daunting is that clouds themselves are complex, turbulent, microphysical entities and, by their very nature, ephemeral and hard to predict. Atmospheric general circulation models represent aerosol–cloud interactions at ever-increasing levels of detail, but these models lack the resolution tomore » represent clouds and aerosol–cloud interactions adequately. There is a dearth of observational constraints on aerosol–cloud interactions. In this paper, we develop a conceptual approach to systematically constrain the aerosol–cloud radiative effect in shallow clouds through a combination of routine process modeling and satellite and surface-based shortwave radiation measurements. Finally, we heed the call to merge Darwinian and Newtonian strategies by balancing microphysical detail with scaling and emergent properties of the aerosol–cloud radiation system.« less

New approaches to quantifying aerosol influence on the cloud radiative effect

PubMed Central

Feingold, Graham; McComiskey, Allison; Yamaguchi, Takanobu; Johnson, Jill S.; Carslaw, Kenneth S.; Schmidt, K. Sebastian

2016-01-01

The topic of cloud radiative forcing associated with the atmospheric aerosol has been the focus of intense scrutiny for decades. The enormity of the problem is reflected in the need to understand aspects such as aerosol composition, optical properties, cloud condensation, and ice nucleation potential, along with the global distribution of these properties, controlled by emissions, transport, transformation, and sinks. Equally daunting is that clouds themselves are complex, turbulent, microphysical entities and, by their very nature, ephemeral and hard to predict. Atmospheric general circulation models represent aerosol−cloud interactions at ever-increasing levels of detail, but these models lack the resolution to represent clouds and aerosol−cloud interactions adequately. There is a dearth of observational constraints on aerosol−cloud interactions. We develop a conceptual approach to systematically constrain the aerosol−cloud radiative effect in shallow clouds through a combination of routine process modeling and satellite and surface-based shortwave radiation measurements. We heed the call to merge Darwinian and Newtonian strategies by balancing microphysical detail with scaling and emergent properties of the aerosol−cloud radiation system. PMID:26831092

New approaches to quantifying aerosol influence on the cloud radiative effect.

PubMed

Feingold, Graham; McComiskey, Allison; Yamaguchi, Takanobu; Johnson, Jill S; Carslaw, Kenneth S; Schmidt, K Sebastian

2016-05-24

The topic of cloud radiative forcing associated with the atmospheric aerosol has been the focus of intense scrutiny for decades. The enormity of the problem is reflected in the need to understand aspects such as aerosol composition, optical properties, cloud condensation, and ice nucleation potential, along with the global distribution of these properties, controlled by emissions, transport, transformation, and sinks. Equally daunting is that clouds themselves are complex, turbulent, microphysical entities and, by their very nature, ephemeral and hard to predict. Atmospheric general circulation models represent aerosol-cloud interactions at ever-increasing levels of detail, but these models lack the resolution to represent clouds and aerosol-cloud interactions adequately. There is a dearth of observational constraints on aerosol-cloud interactions. We develop a conceptual approach to systematically constrain the aerosol-cloud radiative effect in shallow clouds through a combination of routine process modeling and satellite and surface-based shortwave radiation measurements. We heed the call to merge Darwinian and Newtonian strategies by balancing microphysical detail with scaling and emergent properties of the aerosol-cloud radiation system.

Science Outreach at NASA's Marshall Space Flight Center

NASA Astrophysics Data System (ADS)

Lebo, George

2002-07-01

At the end of World War II Duane Deming, an internationally known economist enunciated what later came to be called "Total Quality Management" (TQM). The basic thrust of this economic theory called for companies and governments to identify their customers and to do whatever was necessary to meet their demands and to keep them satisfied. It also called for companies to compete internally. That is, they were to build products that competed with their own so that they were always improving. Unfortunately most U.S. corporations failed to heed this advice. Consequently, the Japanese who actively sought Deming's advice and instituted it in their corporate planning, built an economy that outstripped that of the U.S. for the next three to four decades. Only after U.S. corporations reorganized and fashioned joint ventures which incorporated the tenets of TQM with their Japanese competitors did they start to catch up. Other institutions such as the U.S. government and its agencies and schools face the same problem. While the power of the U.S. government is in no danger of being usurped, its agencies and schools face real problems which can be traced back to not heeding Deming's advice. For example, the public schools are facing real pressure from private schools and home school families because they are not meeting the needs of the general public, Likewise, NASA and other government agencies find themselves shortchanged in funding because they have failed to convince the general public that their missions are important. In an attempt to convince the general public that its science mission is both interesting and important, in 1998 the Science Directorate at NASA's Marshall Space Flight Center (MSFC) instituted a new outreach effort using the interact to reach the general public as well as the students. They have called it 'Science@NASA'.

Science Outreach at NASA's Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

Lebo, George

2002-01-01

At the end of World War II Duane Deming, an internationally known economist enunciated what later came to be called "Total Quality Management" (TQM). The basic thrust of this economic theory called for companies and governments to identify their customers and to do whatever was necessary to meet their demands and to keep them satisfied. It also called for companies to compete internally. That is, they were to build products that competed with their own so that they were always improving. Unfortunately most U.S. corporations failed to heed this advice. Consequently, the Japanese who actively sought Deming's advice and instituted it in their corporate planning, built an economy that outstripped that of the U.S. for the next three to four decades. Only after U.S. corporations reorganized and fashioned joint ventures which incorporated the tenets of TQM with their Japanese competitors did they start to catch up. Other institutions such as the U.S. government and its agencies and schools face the same problem. While the power of the U.S. government is in no danger of being usurped, its agencies and schools face real problems which can be traced back to not heeding Deming's advice. For example, the public schools are facing real pressure from private schools and home school families because they are not meeting the needs of the general public, Likewise, NASA and other government agencies find themselves shortchanged in funding because they have failed to convince the general public that their missions are important. In an attempt to convince the general public that its science mission is both interesting and important, in 1998 the Science Directorate at NASA's Marshall Space Flight Center (MSFC) instituted a new outreach effort using the interact to reach the general public as well as the students. They have called it 'Science@NASA'.

Optimization of a Tube Hydroforming Process

NASA Astrophysics Data System (ADS)

Abedrabbo, Nader; Zafar, Naeem; Averill, Ron; Pourboghrat, Farhang; Sidhu, Ranny

2004-06-01

An approach is presented to optimize a tube hydroforming process using a Genetic Algorithm (GA) search method. The goal of the study is to maximize formability by identifying the optimal internal hydraulic pressure and feed rate while satisfying the forming limit diagram (FLD). The optimization software HEEDS is used in combination with the nonlinear structural finite element code LS-DYNA to carry out the investigation. In particular, a sub-region of a circular tube blank is formed into a square die. Compared to the best results of a manual optimization procedure, a 55% increase in expansion was achieved when using the pressure and feed profiles identified by the automated optimization procedure.

The impact of iron overload and its treatment on quality of life: results from a literature review.

PubMed

Abetz, Linda; Baladi, Jean-Francois; Jones, Paula; Rofail, Diana

2006-09-28

To assess the literature for the impact of iron overload and infusion Iron Chelation Therapy (ICT) on patients' quality of life (QoL), and the availability of QoL instruments for patients undergoing infusion ICT. Also, to obtain patients' experiences of having iron overload and receiving infusion ICT, and experts' clinical opinions about the impact of treatment on patients' lives. A search of studies published between 1966 and 2004 was conducted using Medline and the Health Economic Evaluation Database (HEED). Qualitative results from patient and expert interviews were analysed. Hand searching of relevant conference abstracts completed the search. Few studies measuring the impact of ICT with deferoxamine (DFO) on patients QoL were located (n = 15). QoL domains affected included: depression; fatigue; dyspnoea; physical functioning; psychological distress; decrease in QoL during hospitalization. One theme in all articles was that oral ICT should improve QoL. No iron overload or ICT-specific QoL instruments were located in the articles. Interviews revealed that the impact of ICT on patients with thalassemia, sickle cell disease, and myelodysplastic syndromes is high. A limited number of studies assessed the impact of ICT or iron overload on QoL. All literature suggested a need for easily administered, efficacious and well tolerated oral iron overload treatments, given the impact of current ICT on adherence. Poor adherence to ICT was documented to negatively impact survival. Further research is warranted to continue the qualitative and quantitative study of QoL using validated instruments in patients receiving ICT to further understanding the issues and improve patients QoL.

Prevalence of noise induced hearing loss among employees at a mining industry in Zimbabwe.

PubMed

Chadambuka, A; Mususa, F; Muteti, S

2013-12-01

Noise induced hearing loss (NIHL) is within the top five occupational illnesses in Zimbabwe. Workers at a mining company complained about loss of hearing at the mine clinic. To determine the prevalence of NIHL among employees at the Mine. We conducted a descriptive cross sectional study at the mine. Workers were proportionally selected to represent all the mine departments or working areas. We measured noise levels at various mine sites, conducted a walk-through survey to observe noise related worker practices and conducted audiometric testing. Mean age for workers was 34.8±7.6 years and the mean duration of exposure to noise was 7.5±1.2 years. All workers could define noise. Ninety (53%) workers attributed NIHL to noisy work environment. Excessive noise levels were in Plant Processing (94 dBA), Underground Mining (102 dBA) and (Underground Workshop (103 dBA). Sixty two (36.7%) workers had NIHL. NIHL increased as a function of age (chi square=30.99 df=3 p<0.01) and was associated with work area (chi square=24.96 df=5 p<0.01). Observed workers took heed of noise warnings. There was no documented hearing conservation program at the mine. The prevalence of NIHL of 37% is high. Age and work area were associated with NIHL. Studies reported that age tends to distort the relationship between noise exposure and NIHL. Mine management should institute a hearing conservation program to protect employees against hazardous noise. Management may meanwhile use administrative controls and adhere to permissible exposure limits according to the noise regulations.

Simulation of Initiation in Hexanitrostilbene

NASA Astrophysics Data System (ADS)

Thompson, Aidan; Shan, Tzu-Ray; Yarrington, Cole; Wixom, Ryan

We report on the effect of isolated voids and pairs of nearby voids on hot spot formation, growth and chemical reaction initiation in hexanitrostilbene (HNS) crystals subjected to shock loading. Large-scale, reactive molecular dynamics simulations are performed using the reactive force field (ReaxFF) as implemented in the LAMMPS software. The ReaxFF force field description for HNS has been validated previously by comparing the isothermal equation of state to available diamond anvil cell (DAC) measurements and density function theory (DFT) calculations. Micron-scale molecular dynamics simulations of a supported shockwave propagating in HNS crystal along the [010] orientation are performed (up = 1.25 km/s, Us =4.0 km/s, P = 11GPa.) We compare the effect on hot spot formation and growth rate of isolated cylindrical voids up to 0.1 µm in size with that of two 50nm voids set 100nm apart. Results from the micron-scale atomistic simulations are compared with hydrodynamics simulations. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lock- heed Martin Corporation, for the U.S. DOE National Nuclear Security Administration under Contract DE-AC04-94AL85000.

Could changes in the wheelchair delivery system improve safety?

PubMed Central

Kirby, R L; Coughlan, S G; Christie, M

1995-01-01

Despite emerging evidence about the high incidence and severity of wheelchair-related injuries, regulations governing wheelchair safety are almost nonexistent in Canada. The authors believe that, to improve wheelchair safety, a concerted effort by government, manufacturers, purchasing groups, users and clinicians is needed. Health Canada's Health Protection Branch should treat wheelchairs as medical devices (as defined in the Food and Drugs Act 1985) and improve its injury-reporting network. Manufacturers should give a higher priority to safety in wheelchair design, improve their educational materials and formalize postmarketing surveillance. Purchasing groups should try to ensure that they do not stifle innovation in wheelchair design by setting unrealistic reimbursement ceilings and should use their market power more effectively. Users should obtain their wheelchairs in specialized settings, heed safety warnings and make more effective use of litigation when such action is warranted. Clinicians should ensure that patients are equipped with the most appropriate wheelchair for their needs, that they are given adequate training in safe wheelchair use and that they understand the dangers involved. Rapid changes in wheelchair technology and emerging evidence about the high incidence and severity of injuries related to wheelchair use suggest that such changes are needed in the wheelchair delivery system. PMID:7489551

Bioactive polyphenols and cardiovascular disease: chemical antagonists, pharmacological agents or xenobiotics that drive an adaptive response?

PubMed Central

Goszcz, Katarzyna; Duthie, Garry G; Stewart, Derek; Leslie, Stephen J

2017-01-01

Polyphenols are widely regarded to have a wide range of health‐promoting qualities, including beneficial effects on cardiovascular disease. Historically, the benefits have been linked to their well‐recognized powerful antioxidant activity. However, the concept that the beneficial effects are attributable to direct antioxidant activity in vivo does not pay sufficient heed to the fact that polyphenols degrade rapidly, are poorly absorbed and rapidly metabolized, resulting in very low bioavailability. This review explores alternative mechanisms by which polyphenols, or their metabolites, exert biological activity via mechanisms that can be activated by physiologically relevant concentrations. Evidence is presented to support the action of phenolic derivatives on receptors and signalling pathways to induce adaptive responses that drive changes in endogenous antioxidant, antiplatelet, vasodilatory and anti‐inflammatory effects. The implications are that in vitro antioxidant measures as predictors of polyphenol protective activity in vivo hold little relevance and that closer attention needs to be paid to bioavailable metabolites to understand the mode of action of these diet‐derived components. Linked Articles This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc PMID:28071785

On an efficient and effective intelligent transportation system (ITS) safety and traffic efficiency application with corresponding driver behavior

NASA Astrophysics Data System (ADS)

Ekedebe, Nnanna; Yu, Wei; Lu, Chao

2015-06-01

Driver distraction could result in safety compromises attributable to distractions from in-vehicle equipment usage [1]. The effective design of driver-vehicle interfaces (DVIs) and other human-machine interfaces (HMIs) together with their usability, and accessibility while driving become important [2]. Driving distractions can be classified as: visual distractions (any activity that takes your eyes away from the road), cognitive distraction (any activity that takes your mind away from the course of driving), and manual distractions (any activity that takes your hands away from the steering wheel [2]). Besides, multitasking during driving is a distractive activity that can increase the risks of vehicular accidents. To study the driver's behaviors on the safety of transportation system, using an in-vehicle driver notification application, we examined the effects of increasing driver distraction levels on the evaluation metrics of traffic efficiency and safety by using two types of driver models: young drivers (ages 16-25 years) and middle-age drivers (ages 30-45 years). Our evaluation data demonstrates that as a drivers distraction level is increased, less heed is given to change route directives from the in-vehicle on-board unit (OBU) using textual, visual, audio, and haptic notifications. Interestingly, middle-age drivers proved more effective/resilient in mitigating the negative effects of driver distraction over young drivers [2].

The role of culture in effective HIV/AIDS communication by theatre in South Africa.

PubMed

Uwah, Chijioke

2013-01-01

The need to effectively communicate HIV/AIDS messages in South Africa, given the high prevalence of the pandemic, cannot be overemphasised. Communication scholars have long emphasised the need to recognise adherence to cultural norms of target communities as catalyst for effective HIV/AIDS communication. Unfortunately this call has not been totally heeded by the designers of HIV/AIDS communication instruments. In the case of theatre, research has shown that in South Africa, theatre groups have gone into communities with pre-packaged plays without due cognisance of the cultural norms and beliefs of the target population. This research was conducted in KwaZulu-Natal (the province with the highest prevalence rate of HIV/AIDS infection in South Africa). Using a qualitative research methodology this paper investigated the inclusion/non-inclusion of the cultural norms of the target population in the design of the dramatic performance by the theatre group in its HIV/AIDS campaigns. The findings indicate that while the group did try to incorporate aspects of the cultural norms of the target population, it did so at a level that failed to effectively communicate the HIV/AIDS message to its audiences. This paper therefore seeks to show through empirical evidence that the non-inclusion of cultural norms and values of the target population has acted as a stumbling block in the effective communication of HIV/AIDS messages by theatre groups in the country.

Rekindling Reform—How Goes Business?

PubMed Central

Maher, Walter B.

2003-01-01

Employers were a major cause of the failure of President Clinton’s Health Security bill. This did not have to be so. The substantive and political factors that caused employers to turn against the Clinton Plan could prove instructive in the next reform effort. The unwillingness of employers who do provide benefits to engage seriously in the struggle over health care reform contributes to maintaining the status quo that penalizes them while rewarding employers who fail to provide coverage. The lessons that can be learned from the Clinton Plan debate, if heeded by both employers and health reform advocates, raise hope that key elements of the business community can play a positive role in the next comprehensive health reform effort. PMID:12511392

Authors' response: the primacy of conscious decision making.

PubMed

Shanks, David R; Newell, Ben R

2014-02-01

The target article sought to question the common belief that our decisions are often biased by unconscious influences. While many commentators offer additional support for this perspective, others question our theoretical assumptions, empirical evaluations, and methodological criteria. We rebut in particular the starting assumption that all decision making is unconscious, and that the onus should be on researchers to prove conscious influences. Further evidence is evaluated in relation to the core topics we reviewed (multiple-cue judgment, deliberation without attention, and decisions under uncertainty), as well as priming effects. We reiterate a key conclusion from the target article, namely, that it now seems to be generally accepted that awareness should be operationally defined as reportable knowledge, and that such knowledge can only be evaluated by careful and thorough probing. We call for future research to pay heed to the different ways in which awareness can intervene in decision making (as identified in our lens model analysis) and to employ suitable methodology in the assessment of awareness, including the requirements that awareness assessment must be reliable, relevant, immediate, and sensitive.

Child and adolescent experience of and satisfaction with psychiatric care: a critical review of the research literature.

PubMed

Biering, P

2010-02-01

This review paper contributes to better understanding of child and adolescent perception of quality of psychiatric care and should therefore be of interests for those who are concerned with the development and improvement of psychiatric care. * The review shows that the concept of patient satisfaction in child and adolescent psychiatric care is still underdeveloped and that few valid instruments have been developed to measure the concept. * The review helps to clarify the concept of adolescent satisfaction with psychiatric care by indentifying the universal components of the concept. * The paper concludes that children's perception of quality of care differs from their parents' and that quality assessment of children and adolescents needs to be heeded. Abstract Users' perspectives ought to be a determining factor for assessing the quality of psychiatric care and hence their perspectives need to be thoroughly understood. There is a lack of comprehensive knowledge of how children and adolescents perceive the quality of their psychiatric care. Therefore, the purpose of this paper is to critically review and synthesize findings from research on youth experience and satisfaction with psychiatric care. The review finds that knowledge about youth perception of quality of care is scattered and that few researchers consider previous findings. There are few valid instruments to measure child and adolescent patient satisfaction and few studies have considered these users' perceptions. These few studies indicate that adolescents' satisfaction has three universal components: satisfaction with environment and the organization of services; with user-caregiver relationship; and with treatment outcome. However, instruments that only use these factors lack sensitivity, while instruments that measure specific components of services capture differences in satisfaction between user groups. The review shows that parents and children have different mental care needs, and that the assessments by children and adolescents of their psychiatric care should be heeded.

Can aging in place be cost effective? A systematic review.

PubMed

Graybill, Erin M; McMeekin, Peter; Wildman, John

2014-01-01

To systematically review cost, cost-minimization and cost-effectiveness studies for assisted living technologies (ALTs) that specifically enable older people to 'age in place' and highlight what further research is needed to inform decisions regarding aging in place. People aged 65+ and their live-in carers (where applicable), using an ALT to age in place at home opposed to a community-dwelling arrangement. Studies were identified using a predefined search strategy on two key economic and cost evaluation databases NHS EED, HEED. Studies were assessed using methods recommended by the Campbell and Cochrane Economic Methods Group and presented in a narrative synthesis style. Eight eligible studies were identified from North America spread over a diverse geographical range. The majority of studies reported the ALT intervention group as having lower resource use costs than the control group; though the low methodological quality and heterogeneity of the individual costs and outcomes reported across studies must be considered. The studies suggest that in some cases ALTs may reduce costs, though little data were identified and what there were was of poor quality. Methods to capture quality of life gains were not used, therefore potential effects on health and wellbeing may be missed. Further research is required using newer developments such as the capabilities approach. High quality studies assessing the cost-effectiveness of ALTs for ageing in place are required before robust conclusion on their use can be drawn.

The impact of iron overload and its treatment on quality of life: results from a literature review

PubMed Central

Abetz, Linda; Baladi, Jean-Francois; Jones, Paula; Rofail, Diana

2006-01-01

Background To assess the literature for the impact of iron overload and infusion Iron Chelation Therapy (ICT) on patients' quality of life (QoL), and the availability of QoL instruments for patients undergoing infusion ICT. Also, to obtain patients' experiences of having iron overload and receiving infusion ICT, and experts' clinical opinions about the impact of treatment on patients' lives. Methods A search of studies published between 1966 and 2004 was conducted using Medline and the Health Economic Evaluation Database (HEED). Qualitative results from patient and expert interviews were analysed. Hand searching of relevant conference abstracts completed the search. Results Few studies measuring the impact of ICT with deferoxamine (DFO) on patients QoL were located (n = 15). QoL domains affected included: depression; fatigue; dyspnoea; physical functioning; psychological distress; decrease in QoL during hospitalization. One theme in all articles was that oral ICT should improve QoL. No iron overload or ICT-specific QoL instruments were located in the articles. Interviews revealed that the impact of ICT on patients with thalassemia, sickle cell disease, and myelodysplastic syndromes is high. Conclusion A limited number of studies assessed the impact of ICT or iron overload on QoL. All literature suggested a need for easily administered, efficacious and well tolerated oral iron overload treatments, given the impact of current ICT on adherence. Poor adherence to ICT was documented to negatively impact survival. Further research is warranted to continue the qualitative and quantitative study of QoL using validated instruments in patients receiving ICT to further understanding the issues and improve patients QoL. PMID:17007645

Global Environmental Change: What Can Health Care Providers and the Environmental Health Community Do About It Now?

PubMed Central

Schwartz, Brian S.; Parker, Cindy; Glass, Thomas A.; Hu, Howard

2006-01-01

The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon- and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available “planetary health” metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations. PMID:17185267

Global environmental change: what can health care providers and the environmental health community do about it now?

PubMed

Schwartz, Brian S; Parker, Cindy; Glass, Thomas A; Hu, Howard

2006-12-01

The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available "planetary health" metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations.

Communicating the Urgency and Challenge of Global Climate Change: Lessons Learned and New Strategies

NASA Astrophysics Data System (ADS)

Dilling, L.; Moser, S. C.

2004-12-01

Climate change can sometimes be characterized as a "creeping environmental problem"--it is complex and long-term, involves long system lags, lacks the immediacy of everyday experience and thus is hard to perceive, and feels overwhelming to most individuals. Climate change thus does not typically attain the status of an urgent concern, taking priority over other matters for individuals, organizations or in the policy arena. We review the major reasons behind this lack of urgency, and document the observed consequences of previous communication strategies, including lack of public understanding, indifference, confusion, fear and uncertainty. We find that certain emotional motivators such as fear and guilt, while oft-employed, do not actually result in improved recognition of the urgency of the issue, nor do they typically result in action. Rather, positive and engaging approaches may be more likely to achieve this goal. We propose seven strategies to improve the communication of climate change and its urgency: 1) Abide by basic communication rules and heed the warnings of communication experts; 2) Address the emotional and the temporal components of "urgency"; 3) Increase the persuasiveness of the message; 4) Use trusted messengers-broaden the circle; 5) Use opportunities well; 6) Tap into individual and cultural strengths and values; and 7) Unite and Conquer. The multi-faceted nature of the proposed strategies reflects the unique challenges of the climate change issue as well as the need to engage all levels and sectors of societies in the solution, from individuals, to businesses, to governments. These strategies and results emerged from a multi-disciplinary, academic/practitioner workshop on the topic held at NCAR in summer 2004.

The role of culture in effective HIV/AIDS communication by theatre in South Africa

PubMed Central

Uwah, Chijioke

2014-01-01

The need to effectively communicate HIV/AIDS messages in South Africa, given the high prevalence of the pandemic, cannot be overemphasised. Communication scholars have long emphasised the need to recognise adherence to cultural norms of target communities as catalyst for effective HIV/AIDS communication. Unfortunately this call has not been totally heeded by the designers of HIV/AIDS communication instruments. In the case of theatre, research has shown that in South Africa, theatre groups have gone into communities with pre-packaged plays without due cognisance of the cultural norms and beliefs of the target population. This research was conducted in KwaZulu-Natal (the province with the highest prevalence rate of HIV/AIDS infection in South Africa). Using a qualitative research methodology this paper investigated the inclusion/non-inclusion of the cultural norms of the target population in the design of the dramatic performance by the theatre group in its HIV/AIDS campaigns. The findings indicate that while the group did try to incorporate aspects of the cultural norms of the target population, it did so at a level that failed to effectively communicate the HIV/AIDS message to its audiences. This paper therefore seeks to show through empirical evidence that the non-inclusion of cultural norms and values of the target population has acted as a stumbling block in the effective communication of HIV/AIDS messages by theatre groups in the country. PMID:24697309

Challenging the public stigma of mental illness: a meta-analysis of outcome studies.

PubMed

Corrigan, Patrick W; Morris, Scott B; Michaels, Patrick J; Rafacz, Jennifer D; Rüsch, Nicolas

2012-10-01

Public stigma and discrimination have pernicious effects on the lives of people with serious mental illnesses. Given a plethora of research on changing the stigma of mental illness, this article reports on a meta-analysis that examined the effects of antistigma approaches that included protest or social activism, education of the public, and contact with persons with mental illness. The investigators heeded published guidelines for systematic literature reviews in health care. This comprehensive and systematic review included articles in languages other than English, dissertations, and population studies. The search included all articles from the inception of the databases until October 2010. Search terms fell into three categories: stigma, mental illness (such as schizophrenia and depression), and change program (including contact and education). The search yielded 72 articles and reports meeting the inclusion criteria of relevance to changing public stigma and sufficient data and statistics to complete analyses. Studies represented 38,364 research participants from 14 countries. Effect sizes were computed for all studies and for each treatment condition within studies. Comparisons between effect sizes were conducted with a weighted one-way analysis of variance. Overall, both education and contact had positive effects on reducing stigma for adults and adolescents with a mental illness. However, contact was better than education at reducing stigma for adults. For adolescents, the opposite pattern was found: education was more effective. Overall, face-to-face contact was more effective than contact by video. Future research is needed to identify moderators of the effects of both education and contact.

An Optimization Study of Hot Stamping Operation

NASA Astrophysics Data System (ADS)

Ghoo, Bonyoung; Umezu, Yasuyoshi; Watanabe, Yuko; Ma, Ninshu; Averill, Ron

2010-06-01

In the present study, 3-dimensional finite element analyses for hot-stamping processes of Audi B-pillar product are conducted using JSTAMP/NV and HEEDS. Special attention is paid to the optimization of simulation technology coupling with thermal-mechanical formulations. Numerical simulation based on FEM technology and optimization design using the hybrid adaptive SHERPA algorithm are applied to hot stamping operation to improve productivity. The robustness of the SHERPA algorithm is found through the results of the benchmark example. The SHERPA algorithm is shown to be far superior to the GA (Genetic Algorithm) in terms of efficiency, whose calculation time is about 7 times faster than that of the GA. The SHERPA algorithm could show high performance in a large scale problem having complicated design space and long calculation time.

Sustainable development goals and the human resources crisis.

PubMed

Freer, Joseph

2017-01-01

Achieving universal health coverage by 2030 requires that lessons from the Millennium Development Goals must be heeded. The most important lesson is that the workforce underpins every function of the health system, and is the rate-limiting step. The three dimensions that continue to limit the success of the development agenda are availability, distribution and performance of health workers - and the Sustainable Development Goals cannot be achieved without addressing all three. Hence, the traditional response of scaling up supply is inadequate: a paradigm shift is required in the design of systems that can properly identify, train, allocate and retain health workers. © The Author 2016. 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.

Hurricane Katrina and New Orleans: ``I Told You So'' Is Not Enough

NASA Astrophysics Data System (ADS)

Groat, Charles

2005-09-01

There has not been a major natural-hazard related disaster in modern times that wasn't preceded by warnings from scientists about the potential consequences of the intersection of populations, infrastructure, and extreme natural events. We have taken our understanding of the frequency of these events and the processes associated with them to the table as earthquake-prone cities have contemplated zoning regulations and building standards, floodplain communities and government agencies have sought to improve flood insurance programs, and settlement has moved into wildland fire danger zones. We have celebrated when we were heeded, but more often we have been frustrated when the impacts of a natural hazard were as we predicted and the opportunity for scientific understanding to have reduced consequences of the event was missed by decision-makers.

Obesity as malnutrition: the dimensions beyond energy balance.

PubMed

Wells, J C K

2013-05-01

The aetiology of obesity is seemingly simple to understand: individuals consume more energy than they expend, with the excess energy being stored in adipose tissue. Public health campaigns therefore promote dietary restraint and physical exercise, and emphasize individual responsibility for these behaviours. Increasingly, however, researchers are switching from thermodynamic to metabolic models of obesity, thereby clarifying how specific environmental factors promote lipogenesis. Obesity can best be explained not by counting 'calories in and out', but by understanding how specific dietary products and activity behaviours perturb cellular metabolism and promote net lipogenesis. This metabolic approach can furthermore be integrated with more sophisticated models of how commercial practices drive the consumer trends that promote obesogenic behaviours. Notably, obesity treatment has proven more effective if it bypasses individual responsibility, suggesting that a similar approach placing less emphasis on individual responsibility would improve the efficacy of obesity prevention. Successful obesity prevention campaigns are likely to emerge only when the public receive better 'protection' from the commercial practices that are driving the global obesity epidemic. Rather than populations failing to heed governments' public health advice, governments are currently failing the public by abandoning their responsibility for regulating commercial activities.

Marketing healthcare: lessons for smaller hospitals.

PubMed

Chowdhary, N R

2000-02-01

Recently, I have noted ubiquitous trends that lead me to conclude that we are on the brink of a fundamental change in the structure of healthcare delivery. Hospitals are changing. The hospital, that enduring and pervasive organization, which for decades has delivered the vast majority of acute care services is being re-conceptualized. Administrators and executives in today's hospitals are beginning to recognize the disaffection of constituents and the necessity to change from placing their own agenda or that of their profession over the needs of the customer. A lesson that is increasingly being heeded, particularly by the leading hospitals, is that a belief in one's own importance or a feeling of invulnerability represents an anachronistic stance. No hospital today can afford to retain a view that it is more important than the patients it serves, or that it is invulnerable. The external pressures are already clear--the actors, factors and forces in the external environment are forcing hospitals to re-evaluate efficiency, effectiveness and delivery arrangements. The rise to prominence of the outcomes movement is part of this trend. The present study was an attempt to assess the practices and trends in the modern smaller hospitals as a part of their strategy to match the competitive pressures.

`Just Be Quiet and Listen to Exactly What He's Saying': Conceptualising power relations in inquiry-oriented classrooms

NASA Astrophysics Data System (ADS)

Donnelly, Dermot Francis; McGarr, Oliver; O'Reilly, John

2014-08-01

Interest in inquiry-based science education (IBSE) often pays little heed to the complex power relations that exist within classrooms. A common obstacle to inquiry is that it strongly diverges from current classroom culture and hence, is outside the sphere of teachers' and students' experiences. Teachers and students bring expectations to the classroom that are entrenched in traditional practices and influenced by dynamics of power that exist within all teacher-student relationships. This study, which emerged during a wider study of the use of a Virtual Chemistry Lab in supporting IBSE, explores how classroom discourse constructs and maintains power relations that either stifle or facilitate inquiry-based approaches in two science lessons. Research methods included teacher interviews, student focus groups, video-recorded lessons, and student self-assessments. Findings indicate distinctive features of power inside the classroom that impact on inquiry-based instruction, such as predominant teacher monitoring on task completion over task understanding, lack of student engagement in ownership of scientific ideas, and prevailing norms of what effective teacher questioning is. We discuss implications for IBSE change efforts, highlighting that well-established power relations currently represent an important limiting factor in the capacity of teachers' IBSE implementation.

Harnessing the Promise of Moral Distress: A Call for Re-Orientation.

PubMed

Carse, Alisa; Rushton, Cynda Hylton

2017-01-01

Despite over three decades of research into the sources and costs of what has become an "epidemic" of moral distress among healthcare professionals, spanning many clinical disciplines and roles, there has been little significant progress in effectively addressing moral distress. We believe the persistent sense of frustration, helplessness, and despair still dominating the clinical moral distress narrative signals a need for re-orientation in the way moral distress is understood and worked with. Most fundamentally, moral distress reveals moral investment and energy. It is the troubled call of conscience, an expression of fidelity to moral commitments seen as imperiled or compromised. It is crucial that we find ways to empower clinicians in heeding this call-to support clinicians' moral agency and voice, foster their moral resilience, and facilitate their ability to contribute to needed reform within the organizations and systems in which they work. These objectives must inform creative expansion in the design of strategies for addressing moral distress in the day-to-day of clinical practice. We include suggestions about promising directions such strategies might take in the hope of spurring further innovation within clinical environments. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

A comprehensive survey of thermoelectric homogeneity of commonly used thermocouple types

NASA Astrophysics Data System (ADS)

Machin, Jonathan; Tucker, Declan; Pearce, Jonathan V.

2018-06-01

Thermocouples are widely used as temperature sensors in industry. The electromotive force generated by a thermocouple is produced in a temperature gradient and not at the thermocouple tip. This means that the thermoelectric inhomogeneity represents one of the most important contributions to the overall measurement uncertainty associated with thermocouples. To characterise this effect, and to provide some general recommendations concerning the magnitude of this contribution to use when formulating uncertainty analyses, a comprehensive literature survey has been performed. Significant information was found for Types K, N, R, S, B, Pt/Pd, Au/Pt and various other Pt/Rh thermocouples. In the case of Type K and N thermocouples, the survey has been augmented by a substantial amount of data based on calibrations of mineral-insulated, metal-sheathed thermocouple cable reels from thermocouple manufacturers. Some general conclusions are drawn and outline recommendations given concerning typical values for the uncertainty arising from thermoelectric inhomogeneity for the most widely used thermocouple types in the as-new state. It is stressed that these recommendations should only be heeded when individual homogeneity measurements are not possible. It is also stressed that the homogeneity can deteriorate rapidly during use, particularly for base metal thermocouples.

Small sample mediation testing: misplaced confidence in bootstrapped confidence intervals.

PubMed

Koopman, Joel; Howe, Michael; Hollenbeck, John R; Sin, Hock-Peng

2015-01-01

Bootstrapping is an analytical tool commonly used in psychology to test the statistical significance of the indirect effect in mediation models. Bootstrapping proponents have particularly advocated for its use for samples of 20-80 cases. This advocacy has been heeded, especially in the Journal of Applied Psychology, as researchers are increasingly utilizing bootstrapping to test mediation with samples in this range. We discuss reasons to be concerned with this escalation, and in a simulation study focused specifically on this range of sample sizes, we demonstrate not only that bootstrapping has insufficient statistical power to provide a rigorous hypothesis test in most conditions but also that bootstrapping has a tendency to exhibit an inflated Type I error rate. We then extend our simulations to investigate an alternative empirical resampling method as well as a Bayesian approach and demonstrate that they exhibit comparable statistical power to bootstrapping in small samples without the associated inflated Type I error. Implications for researchers testing mediation hypotheses in small samples are presented. For researchers wishing to use these methods in their own research, we have provided R syntax in the online supplemental materials. (c) 2015 APA, all rights reserved.

Where to deliver baits for deworming urban red foxes for Echinococcus multilocularis control: new protocol for micro-habitat modeling of fox denning requirements.

PubMed

Ikeda, Takako; Yoshimura, Masashi; Onoyama, Keiichi; Oku, Yuzaburo; Nonaka, Nariaki; Katakura, Ken

2014-08-06

Deworming wild foxes by baiting with the anthelmintic praziquantel is being established as a preventive technique against environmental contamination with Echinococcus multilocularis eggs. Improvement of the cost-benefit performance of baiting treatment is required urgently to raise and maintain the efficacy of deworming. We established a spatial model of den site selection by urban red foxes, the definitive host, to specify the optimal micro-habitats for delivering baits in a new modeling approach modified for urban fox populations. The model was established for two cities (Obihiro and Sapporo) in Hokkaido, Japan, in which a sylvatic cycle of E. multilocularis is maintained. The two cities have different degrees of urbanization. The modeling process was designed to detect the best combination of key environmental factors and spatial scale that foxes pay attention to most (here named 'heeding range') when they select den sites. All possible models were generated using logistic regression analysis, with "presence" or "absence" of fox den as the objective variable, and nine landscape categories customized for urban environments as predictor variables to detect the best subset of predictors. This procedure was conducted for each of ten sizes of concentric circles from dens and control points to detect the best circle size. Out of all models generated, the most parsimonious model was selected using Akaike's Information Criterion (AIC) inspection. Our models suggest that fox dens in Obihiro are located at the center of a circle with 500 m radius including low percentages of wide roads, narrow roads, and occupied buildings, but high percentages of green covered areas; the dens in Sapporo within 300 m radius with low percentages of wide roads, occupied buildings, but high percentages of riverbeds and green covered areas. The variation of the models suggests the necessity of accumulating models for various types of cities in order to reveal the patterns of the model. Our denning models indicating suitable sites for delivering baits will improve the cost-benefit performance of the campaign. Our modeling protocol is suitable for the urban landscapes, and for extracting the heeding range when they select the den sites.

Cost-effectiveness of pharmaceutical management for osteoarthritis pain: a systematic review of the literature and recommendations for future economic evaluation.

PubMed

Xie, Feng; Tanvejsilp, Pimwara; Campbell, Kaitryn; Gaebel, Kathryn

2013-05-01

Osteoarthritis (OA) is a highly prevalent and chronic condition characterized by pain and physical disability. Currently, many treatments are available, and they primarily target pain relief. The objectives of this study were to systematically review economic evaluations for pharmaceutical management of OA pain and to provide methodological recommendations for future economic evaluation. Published literature was identified by searching the following bibliographic databases: MEDLINE (1948-16 November 2011) with In-Process records and EMBASE (1980-2011 Week 47) via Ovid; The Cochrane Library (Issue 4 of 4, 2011) and the Health Economic Evaluations Database (HEED) via Wiley; and PubMed (for non-MEDLINE records). The main search terms were OA and economic evaluations. Two reviewers independently screened all identified articles and extracted the data from those included in the final review. Twelve articles reporting the cost-effectiveness of various pharmaceuticals were included, with five being trial-based and seven being model-based economic evaluations. The mean health economics quality score of the included articles was 84 (minimum-maximum: 63-99). These evaluations varied in study design, treatments compared, and outcomes measured. The existing economic evaluations on pharmaceutical management of OA pain were of acceptable quality. Comparability of economic evaluations could be improved by selecting standard comparators, adopting a longer time horizon, and directly measuring health utilities.

Beyond postcolonialism ... and postpositivism: circulation and the global history of science.

PubMed

Raj, Kapil

2013-06-01

This essay traces the parallel, but unrelated, evolution of two sets of reactions to traditional idealist history of science in a world-historical context. While the scholars who fostered the postcolonial approach, in dealing with modern science in the non-West, espoused an idealist vision, they nevertheless stressed its political and ideological underpinnings and engaged with the question of its putative Western roots. The postidealist history of science developed its own vision with respect to the question of the global spread of modern science, paying little heed to postcolonial debates. It then proposes a historiographical approach developed in large part by historians of South Asian politics, economics, and science that, without compromising the preoccupations of each of the two groups, could help construct a mutually comprehensible and connected framework for the understanding of the global workings of the sciences.

The burden of rheumatoid arthritis and access to treatment: determinants of access.

PubMed

Lundqvist, J; Kastäng, F; Kobelt, G; Jönsson, B

2008-01-01

As part of the study "The Burden of Rheumatoid Arthritis (RA) and Patient Access to Treatment", this paper reviews the impact on access to RA drugs of the approval processes, pricing and funding decisions and times to market (access) in different countries. In addition, an overview of health technology assessments (HTA) and the economic literature related to RA treatments is provided. The time from approval to market access ranged from immediate to over 500 days in the countries included in the study. A total of 55 HTA reports were identified, 40 of them in the period between 2002 and 2006; 29 were performed by European HTA agencies, 14 in Canada and 7 in the United States. A total of 239 economic evaluations related to RA were identified in a specialized health economic database (HEED).

Applying evolutionary concepts to wildlife disease ecology and management

PubMed Central

Vander Wal, Eric; Garant, Dany; Calmé, Sophie; Chapman, Colin A; Festa-Bianchet, Marco; Millien, Virginie; Rioux-Paquette, Sébastien; Pelletier, Fanie

2014-01-01

Existing and emerging infectious diseases are among the most pressing global threats to biodiversity, food safety and human health. The complex interplay between host, pathogen and environment creates a challenge for conserving species, communities and ecosystem functions, while mediating the many known ecological and socio-economic negative effects of disease. Despite the clear ecological and evolutionary contexts of host–pathogen dynamics, approaches to managing wildlife disease remain predominantly reactionary, focusing on surveillance and some attempts at eradication. A few exceptional studies have heeded recent calls for better integration of ecological concepts in the study and management of wildlife disease; however, evolutionary concepts remain underused. Applied evolution consists of four principles: evolutionary history, genetic and phenotypic variation, selection and eco-evolutionary dynamics. In this article, we first update a classical framework for understanding wildlife disease to integrate better these principles. Within this framework, we explore the evolutionary implications of environment–disease interactions. Subsequently, we synthesize areas where applied evolution can be employed in wildlife disease management. Finally, we discuss some future directions and challenges. Here, we underscore that despite some evolutionary principles currently playing an important role in our understanding of disease in wild animals, considerable opportunities remain for fostering the practice of evolutionarily enlightened wildlife disease management. PMID:25469163

Growth Method-Dependent and Defect Density-Oriented Structural, Optical, Conductive, and Physical Properties of Solution-Grown ZnO Nanostructures.

PubMed

Rana, Abu Ul Hassan Sarwar; Lee, Ji Young; Shahid, Areej; Kim, Hyun-Seok

2017-09-10

It is time for industry to pay a serious heed to the application and quality-dependent research on the most important solution growth methods for ZnO, namely, aqueous chemical growth (ACG) and microwave-assisted growth (MAG) methods. This study proffers a critical analysis on how the defect density and formation behavior of ZnO nanostructures (ZNSs) are growth method-dependent. Both antithetical and facile methods are exploited to control the ZnO defect density and the growth mechanism. In this context, the growth of ZnO nanorods (ZNRs), nanoflowers, and nanotubes (ZNTs) are considered. The aforementioned growth methods directly stimulate the nanostructure crystal growth and, depending upon the defect density, ZNSs show different trends in structural, optical, etching, and conductive properties. The defect density of MAG ZNRs is the least because of an ample amount of thermal energy catered by high-power microwaves to the atoms to grow on appropriate crystallographic planes, which is not the case in faulty convective ACG ZNSs. Defect-centric etching of ZNRs into ZNTs is also probed and methodological constraints are proposed. ZNS optical properties are different in the visible region, which are quite peculiar, but outstanding for ZNRs. Hall effect measurements illustrate incongruent conductive trends in both samples.

Applying evolutionary concepts to wildlife disease ecology and management.

PubMed

Vander Wal, Eric; Garant, Dany; Calmé, Sophie; Chapman, Colin A; Festa-Bianchet, Marco; Millien, Virginie; Rioux-Paquette, Sébastien; Pelletier, Fanie

2014-08-01

Existing and emerging infectious diseases are among the most pressing global threats to biodiversity, food safety and human health. The complex interplay between host, pathogen and environment creates a challenge for conserving species, communities and ecosystem functions, while mediating the many known ecological and socio-economic negative effects of disease. Despite the clear ecological and evolutionary contexts of host-pathogen dynamics, approaches to managing wildlife disease remain predominantly reactionary, focusing on surveillance and some attempts at eradication. A few exceptional studies have heeded recent calls for better integration of ecological concepts in the study and management of wildlife disease; however, evolutionary concepts remain underused. Applied evolution consists of four principles: evolutionary history, genetic and phenotypic variation, selection and eco-evolutionary dynamics. In this article, we first update a classical framework for understanding wildlife disease to integrate better these principles. Within this framework, we explore the evolutionary implications of environment-disease interactions. Subsequently, we synthesize areas where applied evolution can be employed in wildlife disease management. Finally, we discuss some future directions and challenges. Here, we underscore that despite some evolutionary principles currently playing an important role in our understanding of disease in wild animals, considerable opportunities remain for fostering the practice of evolutionarily enlightened wildlife disease management.

In their own words: older male prisoners' health beliefs and concerns for the future.

PubMed

Loeb, Susan J; Steffensmeier, Darrell; Myco, Priscilla M

2007-01-01

U.S. prisons are experiencing an exponential growth in inmates aged 50 years and older, a group with disproportionately high disease burden. The purpose of this study was to examine, in largely exploratory terms, the health beliefs and concerns of older male inmates and the health challenges they anticipate facing upon their return to the community. Results indicate that there is much to be gained from the assessments and insights of older prisoners with regard to health changes that occur during incarceration, health programs that they desire, the reasons for their confidence (or lack thereof) in health self-management, and fears about their health upon release. Geriatric nurses are well positioned to heed these important insights of inmates and translate them into steps for 1) preventing many of the health deteriorations experienced by older prisoners and 2) advocating for more seamless health care when incarcerated offenders transition back into the community.

Foucault Retires to the Gym: Understanding Embodied Aging in the Third Age.

PubMed

Allain, Kristi A; Marshall, Barbara

2017-09-01

In light of recent social pressures leading to a reimagining of the "Third Age" as a time of constant activity rather than repose and relaxation, this article explores the pressure on individuals to age "successfully" by engaging in physical activity in later life. Through semi-structured interviews with 15 retired or semi-retired gym-goers (eight women and seven men), the article examines how this call to increased activity impacts the ways active mid-life and older adults understand themselves and others. Drawing on Foucault's understandings of the productive nature of power, we argue that those who perceive themselves as successfully heeding the call to active aging position themselves in contrast to inactive peers. Within a neoliberal framework, these participants self-identify as morally responsible citizens who, as a result of engagement in fitness activities, are authorized to survey and discipline the bodies of those "others" who will not or cannot engage in regular exercise.

Ruth's resolve: what Jesus' great-grandmother may teach about bioethics and care.

PubMed

Hall, Amy Laura

2005-04-01

When thinking about the intersection of care and Christian bioethics, it is helpful to follow closely the account of Ruth, who turned away from security and walked alongside her grieving mother-in-law to Bethlehem. Remembering Ruth may help one to heed Professor Kaveny's summoning of Christians to remember "the Order of Widows" and the church's historic calling to bring "the almanah into its center rather than pushing her to its margins." Disabled, elderly and terminally ill people often seem, at least implicitly, expendable. By hearing the scriptural account of Jesus' steadfast great-grandmother, readers may recall another way. One may read Ruth's care for Naomi as a performative, prophetic act of faith. Ruth's faithful resolve, when set next to Orpah's prudent way, challenges the notion that a bioethic of care is innately feminine, and may further call women and men corporately to participate in a kind of care that is strenuous work.

Is Paid Surrogacy a Form of Reproductive Prostitution? A Kantian Perspective.

PubMed

Patrone, Tatiana

2018-01-01

This article reexamines the "prostitution objection" to paid surrogacy, and argues that rebuttals to this objection fail to focus on surrogates as embodied persons. This failure is based on the false distinction between "selling one's reproductive services" and "selling one's body." To ground the analysis of humans as embodied persons, this article uses Kant's late ethical theory, which develops the conceptual framework for understanding human beings as embodied selves. Literature on surrogacy commonly emphasizes that all Kantian duties heed to the categorical prohibition to treat persons as mere means. What this literature leaves out is that this imperative commands us more specifically to engage ourselves and others as embodied persons. This article aims to relate this point to a specific issue in assisted reproduction. It argues that a Kantian account of human beings as embodied persons prohibits paid surrogacy on exactly the same grounds as it prohibits prostitution.

Adoption of waste minimization technology to benefit electroplaters

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

Ching, E.M.K.; Li, C.P.H.; Yu, C.M.K.

Because of increasingly stringent environmental legislation and enhanced environmental awareness, electroplaters in Hong Kong are paying more heed to protect the environment. To comply with the array of environmental controls, electroplaters can no longer rely solely on the end-of-pipe approach as a means for abating their pollution problems under the particular local industrial environment. The preferred approach is to adopt waste minimization measures that yield both economic and environmental benefits. This paper gives an overview of electroplating activities in Hong Kong, highlights their characteristics, and describes the pollution problems associated with conventional electroplating operations. The constraints of using pollution controlmore » measures to achieve regulatory compliance are also discussed. Examples and case studies are given on some low-cost waste minimization techniques readily available to electroplaters, including dragout minimization and water conservation techniques. Recommendations are given as to how electroplaters can adopt and exercise waste minimization techniques in their operations. 1 tab.« less

Empirical neuroenchantment: from reading minds to thinking critically

PubMed Central

Ali, Sabrina S.; Lifshitz, Michael; Raz, Amir

2014-01-01

While most experts agree on the limitations of neuroimaging, the unversed public—and indeed many a scholar—often valorizes brain imaging without heeding its shortcomings. Here we test the boundaries of this phenomenon, which we term neuroenchantment. How much are individuals ready to believe when encountering improbable information through the guise of neuroscience? We introduced participants to a crudely-built mock brain scanner, explaining that the machine would measure neural activity, analyze the data, and then infer the content of complex thoughts. Using a classic magic trick, we crafted an illusion whereby the imaging technology seemed to decipher the internal thoughts of participants. We found that most students—even undergraduates with advanced standing in neuroscience and psychology, who have been taught the shortcomings of neuroimaging—deemed such unlikely technology highly plausible. Our findings highlight the influence neuro-hype wields over critical thinking. PMID:24904389

Educators' evaluations of children's ideas on the social exclusion of classmates with intellectual and learning disabilities.

PubMed

Nowicki, Elizabeth A; Brown, Jason D; Dare, Lynn

2018-01-01

Reasons underlying the social exclusion of children with intellectual or learning disabilities are not entirely understood. Although it is important to heed the voices of children on this issue, it is also important to consider the degree to which these ideas are informed. The present authors invited educators to evaluate the content of children's ideas on the causes of social exclusion. Educators thematically sorted and rated children's ideas on why classmates with intellectual or learning disabilities are socially excluded. Sorted data were analysed with multidimensional scaling and hierarchical cluster analysis. Six thematic clusters were identified differing in content to those provided by children in an earlier study. Educators generally rated children's ideas as showing somewhat uninformed ideas about why social exclusion occurs. Educators indicated that children need to be better informed about intellectual and learning disabilities. Limitations and implications are discussed. © 2017 John Wiley & Sons Ltd.

The Significance of Acid/Base Properties in Drug Discovery

PubMed Central

Manallack, David T.; Prankerd, Richard J.; Yuriev, Elizabeth; Oprea, Tudor I.; Chalmers, David K.

2013-01-01

While drug discovery scientists take heed of various guidelines concerning drug-like character, the influence of acid/base properties often remains under-scrutinised. Ionisation constants (pKa values) are fundamental to the variability of the biopharmaceutical characteristics of drugs and to underlying parameters such as logD and solubility. pKa values affect physicochemical properties such as aqueous solubility, which in turn influences drug formulation approaches. More importantly, absorption, distribution, metabolism, excretion and toxicity (ADMET) are profoundly affected by the charge state of compounds under varying pH conditions. Consideration of pKa values in conjunction with other molecular properties is of great significance and has the potential to be used to further improve the efficiency of drug discovery. Given the recent low annual output of new drugs from pharmaceutical companies, this review will provide a timely reminder of an important molecular property that influences clinical success. PMID:23099561

Climate change adaptation: where does global health fit in the agenda?

PubMed

Bowen, Kathryn J; Friel, Sharon

2012-05-27

Human-induced climate change will affect the lives of most populations in the next decade and beyond. It will have greatest, and generally earliest, impact on the poorest and most disadvantaged populations on the planet. Changes in climatic conditions and increases in weather variability affect human wellbeing, safety, health and survival in many ways. Some impacts are direct-acting and immediate, such as impaired food yields and storm surges. Other health effects are less immediate and typically occur via more complex causal pathways that involve a range of underlying social conditions and sectors such as water and sanitation, agriculture and urban planning. Climate change adaptation is receiving much attention given the inevitability of climate change and its effects, particularly in developing contexts, where the effects of climate change will be experienced most strongly and the response mechanisms are weakest. Financial support towards adaptation activities from various actors including the World Bank, the European Union and the United Nations is increasing substantially. With this new global impetus and funding for adaptation action come challenges such as the importance of developing adaptation activities on a sound understanding of baseline community needs and vulnerabilities, and how these may alter with changes in climate. The global health community is paying heed to the strengthening focus on adaptation, albeit in a slow and unstructured manner. The aim of this paper is to provide an overview of adaptation and its relevance to global health, and highlight the opportunities to improve health and reduce health inequities via the new and additional funding that is available for climate change adaptation activities.

Systems approaches for chronic disease prevention: sound logic and empirical evidence, but is this view shared outside of academia?

PubMed

Wutzke, Sonia; Morrice, Emily; Benton, Murray; Wilson, Andrew

2016-07-15

There is a need and desire to improve chronic disease prevention efforts across Australia. Increasingly, scientists are urging the use of systems thinking and its methods to significantly shift the way we think about, and intervene in, chronic diseases. This research aimed to examine the convergence between the systems science literature and the views of those working in and advocating for prevention, in relation to the value of systems thinking and its methods for the prevention of chronic diseases. Individual and small-group semistructured interviews were undertaken with 29 individuals across Australia. The interviewees reflected a diverse cross-section of senior public health managers and program implementation staff from state and territory health departments, and senior thought leaders and public health advocates. Interviews were audio recorded and coded into key themes. Feedback from informants illustrated that, among those working in and advocating for prevention, there is a mix of support for systems thinking for chronic disease prevention, and some healthy scepticism. The lack of consistent confluence between those promoting the value of systems science, and those responsible for working in and advocating for prevention indicates a level of confusion about language and definitions. It also reflects a desire for published evidence about systems methods that have proven effectiveness. Systems thinking and its methods have a promising and important role to play in creating a robust, effective and sustainable strategy for prevention of chronic diseases throughout Australia. However, the method requires further development and refinement, and promotion of case studies of effectiveness. We also need to heed lessons learnt overseas.

Experts advise hospitals to heed warning signs, leverage security to prepare against shootings.

PubMed

2014-09-01

While hospital shootings are not commonplace, studies suggest they are happening with increasing frequency, and that EDs are particularly vulnerable to this type of violence. Researchers report that roughly a third of all hospital shootings occur in the emergency setting. Experts say such incidents are typically targeted events, not random acts. Consequently, effective security programs should emphasize preventive steps to defuse potentially volatile situations and prevent weapons from entering the facility. Hospital security departments should be equipped to provide training to employees throughout the facility so that employees know how to respond if an active shooter is identified. Researchers report that between 2000 and 2012 there were 154 shootings in American hospitals, and that the frequency of these events increased markedly in the later years of the study. Experts say hospital shootings may involve disgruntled patients, dementia patients, or psychiatric patients, but the most common perpetrators are prisoners who are brought into the hospital for treatment under guard. Security experts say effective safety plans should focus on identifying threatening language or other signs of agitation early on so that interventions can be employed. They also advise hospitals to install gun lockers at every entrance point so that lawful weapons can be stored before owners enter the facility. Liberalized gun laws in some regions are making security more difficult at public hospitals. Also, hospitals need to be careful with surveillance activities that could raise privacy concerns.

Nurses' response to parents' 'speaking-up' efforts to ensure their hospitalized child's safety: an attribution theory perspective.

PubMed

Bsharat, Sondos; Drach-Zahavy, Anat

2017-09-01

To understand how attribution processes (control and stability), which the nurse attributes to parental involvement in maintaining child safety, determine the nurse's response to a safety alert. Participation of parents in maintaining their child's safety is shown to reduce the incidence of and risk of clinical errors. Unless nurses respond appropriately to parents' safety alerts, this potential source of support could diminish. A 2 (controllability: high vs. low) × 2 (consistency: high vs. low) factorial design. Data were collected during the period 2013-2014 in paediatric wards. Four variants of scenarios were created corresponding to the different combinations of these variables. A total of 126 nurses read a scenario and completed self-report questionnaires measuring their response to the parent's safety alert. Additional data were collected about the manipulation check, safety norms in the ward and demographic variables. Data were analysed using analysis of variance. Results showed a main effect of stability and a significant two-way interaction effect of stability and controllability, on a nurse's tendency to help the parent and fix the safety problem. Furthermore, safety norms were significantly related to nurses' response. These findings contribute to the understanding of antecedents that affect nurses' responses to parents' speaking-up initiatives: whether nurses will reject or heed the alert. Theoretical and practical implications for promoting parents' engagement in their safety are discussed. © 2017 John Wiley & Sons Ltd.

Heed or disregard a cancer patient's critical blogging? An experimental study of two different framing strategies.

PubMed

Lynøe, Niels; NattochDag, Sara; Lindskog, Magnus; Juth, Niklas

2016-05-20

We have examined healthcare staff attitudes of toward a blogging cancer patient who publishes critical posts about her treatment and their possible effect on patient-staff relationships and treatment decisions. We used two versions of a questionnaire containing a vignette based on a modified real case involving a 39-year-old cancer patient who complained on her blog about how she was encountered and the treatment she received. Initially she was not offered a new, and expensive treatment, which might have influenced her perception of further encounters. In one version of the vignette, the team decides to put extra effort into both encounters and offers the expensive new cancer treatment. In the other version, the team decides to follow the clinic's routine to the letter. Subsequently, blog postings became either positive or negative in tone. We also divided participants into value-neutral and value-influenced groups (regarding personal values) by asking how their trust in healthcare would be affected if the team's suggestion were followed. A total of 56 % (95 % CI: 51-61) of the respondents faced with a team decision to 'do something-extra' in encounters would act in accordance with this ambition. Concerning treatment, 32 % (95 % CI: 28-38) would follow the team's decision to offer a new and expensive treatment. A large majority of those who received the "follow-routine" version agreed to do so in encountering [94 % (95 % CI: 91-97)]. Similar proportions were found regarding treatment [86 % (95 % CI: 82-90)]. A total of 83 % (95 % CI: 76-91) of the value-neutral participants who received the "do-something-extra" version stated that they would act as the team suggested regarding encounters, while 57 % (95 % CI: 47-67) would do so in regard to treatment. Among the value-influenced participants who received the "do-something-extra" version, 45 % (95 % CI: 38-51) stated that they would make an extra effort to accommodate the patient and her needs, while the proportion for treatment was 22 % (95 % CI: 16-27). Among those who had received the "follow-routine" version, a large majority agreed, and no difference was indicated between the value-neutral and the value-influenced participants. The present study indicates that healthcare staff is indeed influenced by reading a patient's critical blog entries, largely regarding encounters, but also concerning treatment is concerned. Value-neutral healthcare personnel seem to exhibit a pragmatic attitude and be more inclined to heed and respond to a patient whose criticism may well be warranted. The study also indicates that healthcare staff is partly positive or negative to future blogging patients depending on how the issue has been framed. For future research we suggest as a bold hypothesis that the phrase "clinical routine" might conceal power aspects masquerading as adopted ethical principles.

LIFESPAN: A tool for the computer-aided design of longitudinal studies

PubMed Central

Brandmaier, Andreas M.; von Oertzen, Timo; Ghisletta, Paolo; Hertzog, Christopher; Lindenberger, Ulman

2015-01-01

Researchers planning a longitudinal study typically search, more or less informally, a multivariate space of possible study designs that include dimensions such as the hypothesized true variance in change, indicator reliability, the number and spacing of measurement occasions, total study time, and sample size. The main search goal is to select a research design that best addresses the guiding questions and hypotheses of the planned study while heeding applicable external conditions and constraints, including time, money, feasibility, and ethical considerations. Because longitudinal study selection ultimately requires optimization under constraints, it is amenable to the general operating principles of optimization in computer-aided design. Based on power equivalence theory (MacCallum et al., 2010; von Oertzen, 2010), we propose a computational framework to promote more systematic searches within the study design space. Starting with an initial design, the proposed framework generates a set of alternative models with equal statistical power to detect hypothesized effects, and delineates trade-off relations among relevant parameters, such as total study time and the number of measurement occasions. We present LIFESPAN (Longitudinal Interactive Front End Study Planner), which implements this framework. LIFESPAN boosts the efficiency, breadth, and precision of the search for optimal longitudinal designs. Its initial version, which is freely available at http://www.brandmaier.de/lifespan, is geared toward the power to detect variance in change as specified in a linear latent growth curve model. PMID:25852596

Dynamic Hierarchical Energy-Efficient Method Based on Combinatorial Optimization for Wireless Sensor Networks.

PubMed

Chang, Yuchao; Tang, Hongying; Cheng, Yongbo; Zhao, Qin; Yuan, Baoqing Li andXiaobing

2017-07-19

Routing protocols based on topology control are significantly important for improving network longevity in wireless sensor networks (WSNs). Traditionally, some WSN routing protocols distribute uneven network traffic load to sensor nodes, which is not optimal for improving network longevity. Differently to conventional WSN routing protocols, we propose a dynamic hierarchical protocol based on combinatorial optimization (DHCO) to balance energy consumption of sensor nodes and to improve WSN longevity. For each sensor node, the DHCO algorithm obtains the optimal route by establishing a feasible routing set instead of selecting the cluster head or the next hop node. The process of obtaining the optimal route can be formulated as a combinatorial optimization problem. Specifically, the DHCO algorithm is carried out by the following procedures. It employs a hierarchy-based connection mechanism to construct a hierarchical network structure in which each sensor node is assigned to a special hierarchical subset; it utilizes the combinatorial optimization theory to establish the feasible routing set for each sensor node, and takes advantage of the maximum-minimum criterion to obtain their optimal routes to the base station. Various results of simulation experiments show effectiveness and superiority of the DHCO algorithm in comparison with state-of-the-art WSN routing algorithms, including low-energy adaptive clustering hierarchy (LEACH), hybrid energy-efficient distributed clustering (HEED), genetic protocol-based self-organizing network clustering (GASONeC), and double cost function-based routing (DCFR) algorithms.

The role of NGOs in child injury prevention: an organizational assessment of one network of NGOs.

PubMed

Bachani, Abdulgafoor M; Tran, Nhan T; Agrawal, Shreya; Hyder, Adnan A

2015-01-01

Unintentional injuries are estimated to claim the lives of more than 875,000 children each year; millions more live with long-term consequences and permanent disabilities. The epidemiology of injuries has become clearer in the past decade. NGOs need to work in concert with each other to address the global burden of injuries by sharing information. Several NGOs have heeded this call, and the field has seen the emergence of global organizations aimed at highlighting the burden of injuries and streamlining injury prevention activities worldwide. Safe Kids Worldwide Inc. (SKWW) is a global network in 16 countries whose mission is to address the burden of injuries in children under 15 by harnessing the potential of local NGOs. An organizational assessment was conducted of SKWW which included structured organizational assessment, functional organizational mapping and contextual analysis that allowed for an in-depth examination of the strengths and challenges of SKWW's injury prevention approach. Over one year, primary and secondary data were collected and analyzed from headquarters and individual country offices. SKWW appears to be an effective model and has experienced a strong momentum and growth over the last two decades. Global NGOs that address the burden of injuries should start by defining a clear and universal strategic goal, build on local successes, maximize their strengths, and create avenues for stronger country engagement. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Smoking Cessation among Low-Socioeconomic Status and Disadvantaged Population Groups: A Systematic Review of Research Output.

PubMed

Courtney, Ryan J; Naicker, Sundresan; Shakeshaft, Anthony; Clare, Philip; Martire, Kristy A; Mattick, Richard P

2015-06-08

Smoking cessation research output should move beyond descriptive research of the health problem to testing interventions that can provide causal data and effective evidence-based solutions. This review examined the number and type of published smoking cessation studies conducted in low-socioeconomic status (low-SES) and disadvantaged population groups. A systematic database search was conducted for two time periods: 2000-2004 (TP1) and 2008-2012 (TP2). Publications that examined smoking cessation in a low-SES or disadvantaged population were coded by: population of interest; study type (reviews, non-data based publications, data-based publications (descriptive, measurement and intervention research)); and country. Intervention studies were coded in accordance with the Cochrane Effective Practice and Organisation of Care data collection checklist and use of biochemical verification of self-reported abstinence was assessed. 278 citations were included. Research output (i.e., all study types) had increased from TP1 27% to TP2 73% (χ²=73.13, p<0.001), however, the proportion of data-based research had not significantly increased from TP1 and TP2: descriptive (TP1=23% vs. TP2=33%) or intervention (TP1=77% vs. TP2=67%). The proportion of intervention studies adopting biochemical verification of self-reported abstinence had significantly decreased from TP1 to TP2 with an increased reliance on self-reported abstinence (TP1=12% vs. TP2=36%). The current research output is not ideal or optimal to decrease smoking rates. Research institutions, scholars and funding organisations should take heed to review findings when developing future research and policy.

Oral Antibacterial Therapy for Acne Vulgaris: An Evidence-Based Review.

PubMed

Bienenfeld, Amanda; Nagler, Arielle R; Orlow, Seth J

2017-08-01

To some degree, acne vulgaris affects nearly every individual worldwide. Oral antibiotic therapy is routinely prescribed for the treatment of moderate to severe inflammatory acne; however, long-term use of oral antibiotics for acne may have unintended consequences. The aim of this study was to provide a systematic evaluation of the scientific evidence on the efficacy and appropriate use of oral antibiotics in the treatment of acne. A systematic search of MEDLINE was conducted to identify randomized controlled clinical trials, systematic reviews, and meta-analyses evaluating the efficacy of oral antibiotics for acne. Overall, 41 articles that examined oral antibiotics compared with placebo, another oral therapy, topical therapy, alternate dose, or duration were included in this study. Tetracyclines, macrolides, and trimethoprim/sulfamethoxazole are effective and safe in the treatment of moderate to severe inflammatory acne. Superior efficacy of one type or class of antibiotic could not be determined, therefore the choice of antibiotic is generally based on the side-effect profile. Although different dosing regimens have been studied, there is a lack of standardized comparator trials to determine optimal dosing and duration of each oral antibiotic used in acne. The combination of oral antibiotics with a topical therapy is superior to oral antibiotics alone. This article provides a systematic evaluation of the scientific evidence of the efficacy of oral antibiotics for acne. Due to heterogeneity in the design of the trials, there is insufficient evidence to support one type, dose, or duration of oral antibiotic over another in terms of efficacy; however, due to increasing resistance to antibiotics, dermatologists should heed consensus guidelines for their appropriate use.

Antidepressant Regulatory Warnings, Prescription Patterns, Suicidality and Other Aggressive Behaviors in Major Depressive Disorder and Anxiety Disorders.

PubMed

Gupta, Saurabh; Gersing, Kenneth Ronald; Erkanli, Alaattin; Burt, Tal

2016-06-01

In 2004 the Food and Drug Administration issued a warning on the risk of suicidality in children and adolescents receiving antidepressants. This was followed by reports of changes in antidepressant prescription patterns, suicidality and other aggressive behaviors, but debate is continuing regarding the nature and magnitude of these changes. We examined a large physician database for impact of the warning on antidepressant prescriptions, suicidality and other aggressive behaviors in major depressive disorder (MDD) and anxiety disorders in adult and pediatric patients. We analyzed electronic database covering over 100,000 patients, treated in Pre- (before 2003) and Post- (after 2004) warning periods. We compared strength of the association between the measures and the time period with two tests. Multivariate logistic regression analyses were performed to ascertain the unique effect of each parameter. Of 10,089 MDD (61.0 %) and anxiety disorders (39.0 %) patients, 65.2 % received antidepressant prescription and 16.1 % were pediatric patients. In post-warning period, there was a greater reduction in adult versus pediatric antidepressant prescription rates. Logistic modeling showed greater likelihood of antidepressant prescription in MDD as compared with anxiety disorders in post-warning period. Pediatric patients were more likely than adults to receive fluoxetine during the post-warning period. There was an overall reduction in suicidality and other aggressive behaviors in the post-warning period. Regulatory warnings may have had an impact on antidepressant benefit/risk assessment and consequent utilization, therapeutic effects, and adverse events. Our observations suggest that psychiatrists may heed regulatory warnings, but may also exert professional independence and discrimination in their application.

Teaching business ethics to professional engineers.

PubMed

Sauser, William I

2004-04-01

Without question "business ethics" is one of the hot topics of the day. Over the past months we have seen business after business charged with improper practices that violate commonly-accepted ethical norms. This has led to a loss of confidence in corporate management, and has had severe economic consequences. From many quarters business educators have heard the call to put more emphasis on ethical practices in their business courses and curricula. Engineering educators are also heeding this call, since the practice of engineering usually involves working for (or leading) a business and/or engaging in business transactions. In the summer of 2002, Auburn University's Engineering Professional Development program made the decision to produce--based on the author's Executive MBA course in Business Ethics--a distance-delivered continuing education program for professional engineers and surveyors. Participants across the USA now may use the course to satisfy continuing education requirements with respect to professional licensing and certification. This paper outlines the purpose and content of the course and describes its production, distribution, application, and evaluation.

Simulation of energy spectrum of GEM detector from an x-ray quantum

NASA Astrophysics Data System (ADS)

Malinowski, K.; Chernyshova, M.; Czarski, T.; Kowalska-Strzęciwilk, E.; Linczuk, P.; Wojeński, A.; Krawczyk, R.; Gąska, M.

2018-01-01

This paper presents the results of the energy resolution simulation for the triple GEM-based detector for x-ray quantum of 5.9 keV . Photons of this energy are emitted by 55Fe source, which is a standard calibration marker for this type of detectors. The calculations were made in Garfield++ in two stages. In the first stage, the distribution of the amount of primary electrons generated in the drift volume by the x-ray quantum was simulated using the Heed program. Secondly, the primary electrons of the resulting quantitative distribution were treated as a source of electron avalanches propagated through the whole volume of the triple GEM-based detector. The distribution of the obtained signals created a spectrum corresponding to the peak at 5.9 keV, which allowed us to determine the theoretical energy resolution of the detector. Its knowledge allows observing and improving the eventual experimental deterioration of the energy resolution, inevitably accompanying processes of registration and processing of the signals.

Gestalt theory reconfigured: Max Wertheimer's anticipation of recent developments in visual neuroscience.

PubMed

Westheimer, G

1999-01-01

In the 1920s Max Wertheimer enunciated a credo of Gestalt theory: the properties of any of the parts are governed by the structural laws of the whole. Intense efforts at the time to discover these laws had only very limited success. Psychology was in the grips of the Fechnerian tradition to seek exact relationships between the material and the mental and, because the Gestalt movement could not deliver these, it never attained a major standing among students of perception. However, as neurophysiological research into cortical processing of visual stimuli progresses the need for organizing principles is increasingly making itself felt. Concepts like contour salience and figure segregation, once the province of Gestalt psychology, are now taking on renewed significance as investigators combine neural modeling and psychophysical approaches with electrophysiological ones to characterize neural mechanisms of cognition. But it would be perilous not to take heed of some of the lessons that the history of the Gestalt movement teaches.

Headache pain of ear, nose, throat, and sinus origin.

PubMed

Waldman, Steven D; Waldman, Corey W; Waldman, Jennifer E

2013-03-01

Pain of the ear, nose, sinuses, and throat is commonly encountered in clinical practice. For the most part, the pathologic process responsible for the patient's symptoms is easily identifiable after the physician performs a targeted history and physical examination. Unfortunately, the nature of this anatomic region makes it possible for the most thorough physician to miss pathologic factors that may ultimately harm the patient. For this reason, the following rules for the treatment of ear, nose, sinus, and throat pain serve both the patient and the clinician well: (1) take a targeted history; (2) perform a careful, targeted physical examination; (3) heed the warning signs of serious disease, such as fever, constitutional symptoms, or weight loss; (4) image early and frequently if the diagnosis remains elusive; (5) perform laboratory tests that help identify "sick from well," such as erythrocyte sedimentation rate, hematology, and blood tests; (6) avoid attributing the patient's pain to idiopathic or psychogenic causes; and (7) always assume that you have missed the diagnosis. Copyright © 2013 Elsevier Inc. All rights reserved.

The physician and the other: images of the charlatan in medieval Islam.

PubMed

Pormann, Peter E

2005-01-01

Physicians have always tried to demarcate themselves from the Other, whom they labeled as a "charlatan." During the medieval period, Arabic physicians such as al-Rāzī attacked charlatans in their theoretical and deontological writings, and, like their Greek predecessors, called on the authorities to stamp out malpractice. Their advice was partly heeded, as can be seen from manuals on market inspection (hisba). Physicians accused their colleagues of quackery based on charges of incompetence or deceit, which must be seen partly as an attempt to protect themselves from potential competitors. Certain groups of society, including women and Jews, were an especially convenient target. Moreover, charlatans also appear in nonmedical texts such as al-Gaubarī's manual on tricksters and al-Harīrī's Assemblies or Maqāmāt. These accounts suggest that, despite the calls of the medical elite to exclude quacks from the marketplace, the latter were able to attract customers and continue to practice.

Two concepts of empirical ethics.

PubMed

Parker, Malcolm

2009-05-01

The turn to empirical ethics answers two calls. The first is for a richer account of morality than that afforded by bioethical principlism, which is cast as excessively abstract and thin on the facts. The second is for the facts in question to be those of human experience and not some other, unworldly realm. Empirical ethics therefore promises a richer naturalistic ethics, but in fulfilling the second call it often fails to heed the metaethical requirements related to the first. Empirical ethics risks losing the normative edge which necessarily characterizes the ethical, by failing to account for the nature and the logic of moral norms. I sketch a naturalistic theory, teleological expressivism (TE), which negotiates the naturalistic fallacy by providing a more satisfactory means of taking into account facts and research data with ethical implications. The examples of informed consent and the euthanasia debate are used to illustrate the superiority of this approach, and the problems consequent on including the facts in the wrong kind of way.

Flight-deck automation - Promises and problems

NASA Technical Reports Server (NTRS)

Wiener, E. L.; Curry, R. E.

1980-01-01

The paper analyzes the role of human factors in flight-deck automation, identifies problem areas, and suggests design guidelines. Flight-deck automation using microprocessor technology and display systems improves performance and safety while leading to a decrease in size, cost, and power consumption. On the other hand negative factors such as failure of automatic equipment, automation-induced error compounded by crew error, crew error in equipment set-up, failure to heed automatic alarms, and loss of proficiency must also be taken into account. Among the problem areas discussed are automation of control tasks, monitoring of complex systems, psychosocial aspects of automation, and alerting and warning systems. Guidelines are suggested for designing, utilising, and improving control and monitoring systems. Investigation into flight-deck automation systems is important as the knowledge gained can be applied to other systems such as air traffic control and nuclear power generation, but the many problems encountered with automated systems need to be analyzed and overcome in future research.

NCAA Football Off-Season Training: Unanswered Prayers… A Prayer Answered

PubMed Central

Anderson, Scott

2017-01-01

Off-season training in year-round collegiate football is purported to be performance enhancing. Absent principles of exercise physiology, excesses in sport-training regimens pose risk to the participant athletes. Since 2000, 33 National Collegiate Athletic Association (NCAA) football players have died in sport: 27 nontraumatic deaths and 6 traumatic deaths, a ratio of 4.5 nontraumatic deaths for every traumatic death. On average, 2 NCAA football players die per season. Best practices, consensus guidelines, and precautions are ignored, elevating the risk. However, standards exist that will, if heeded, prevent nontraumatic death in athletes training for sport. Sickle cell trait status knowledge and tailored precautions are preventing deaths from exertional collapse associated with sickle cell trait. Adherence to established principles of exercise physiology and best-practice training standards, which is long overdue, will help to prevent not only deaths from exertional collapse associated with sickle cell trait but also sudden cardiac, exertional heat stroke, and asthma deaths. PMID:28140625

Vapor phase diamond growth technology

NASA Technical Reports Server (NTRS)

Angus, J. C.

1981-01-01

Ion beam deposition chambers used for carbon film generation were designed and constructed. Features of the developed equipment include: (1) carbon ion energies down to approx. 50 eV; (2) in suit surface monitoring with HEED; (3) provision for flooding the surface with ultraviolet radiation; (4) infrared laser heating of substrate; (5) residual gas monitoring; (6) provision for several source gases, including diborane for doping studies; and (7) growth from either hydrocarbon source gases or from carbon/argon arc sources. Various analytical techniques for characterization of from carbon/argon arc sources. Various analytical techniques for characterization of the ion deposited carbon films used to establish the nature of the chemical bonding and crystallographic structure of the films are discussed. These include: H2204/HN03 etch; resistance measurements; hardness tests; Fourier transform infrared spectroscopy; scanning auger microscopy; electron spectroscopy for chemical analysis; electron diffraction and energy dispersive X-ray analysis; electron energy loss spectroscopy; density measurements; secondary ion mass spectroscopy; high energy electron diffraction; and electron spin resonance. Results of the tests are summarized.

Breaking the Pressure Barrier: A History of the Spacesuit Injection Patch

NASA Technical Reports Server (NTRS)

McFarland, Shane M.; Weaver, Aaron S.

2013-01-01

The spacesuit assembly has a fascinating and complicated history dating back to the early 1930s. Much has been written on this history from an assembly perspective and, to a lesser extent, a component perspective. However, little has been written or preserved specifically on smaller, lesser-known aspects of pressure suit design. One example of this is the injection patch - a small 2-in.-diameter disk on the leg of the Apollo suit that facilitated a medical injection when pressurized, and the only known implementation of such a feature on a flight suit. Whereas many people are aware this feature existed, very little is known of its origin, design, and use, and the fact that the Apollo flight suit was not the only instance in which such a feature was implemented. This paper serves to tell the story of this seeming "afterthought" of a feature, as well as the design considerations heeded during the initial development of subsequent suits.

Why culture matters in health interventions: lessons from HIV/AIDS stigma and NCDs.

PubMed

Airhihenbuwa, Collins O; Ford, Chandra L; Iwelunmor, Juliet I

2014-02-01

Theories about health behavior are commonly used in public health and often frame problems as ascribed or related to individuals' actions or inaction. This framing suggests that poor health occurs because individuals are unable or unwilling to heed preventive messages or recommended treatment actions. The recent United Nations call for strategies to reduce the global disease burden of noncommunicable diseases like diabetes requires a reassessment of individual-based approaches to behavior change. We argue that public health and health behavior intervention should focus more on culture than behavior to achieve meaningful and sustainable change resulting in positive health outcomes. To change negative health behaviors, one must first identify and promote positive health behaviors within the cultural logic of its contexts. To illustrate these points, we discuss stigma associated with obesity and human immunodeficiency virus and acquired immune deficiency syndrome. We conclude that focusing on positive behaviors and sustaining cultural and personal transformations requires a culturally grounded approach to public health interventions, such as that provided by the PEN-3 model.

Parties heed (with caution)

PubMed Central

Fisher, Justin

2011-01-01

Despite comprehensive reform (Political Parties, Elections and Referendums Act) and recent review (Phillips Review in 2007) of party finance in Britain, public opinion of party finance remains plagued by perceptions of corruption, undue influence from wealthy donors, carefree and wasteful spending and, more generally, from the perception that there is just ‘too much money’ in politics. In this article we argue that knowledge of and attitudes to party finance matter, not least because advocates of reform have cited public opinion as evidence for reform. However, because attitudes to party finance are part of a broader attitudinal structure, opinion-led reforms are unlikely to succeed in increasing public confidence. Using data generated from YouGov’s online panel (N=2,008), we demonstrate that the public know little of the key provisions regulating party finance and attitudes to party finance can be explained along two underlying dimensions – Anti-Party Finance and Reformers. As such, we consider whether parties and politicians should be freed from the constraints of public opinion in reforming party finance. PMID:29097904

Does integrated care reduce hospital activity for patients with chronic diseases? An umbrella review of systematic reviews

PubMed Central

Damery, Sarah; Flanagan, Sarah; Combes, Gill

2016-01-01

Objective To summarise the evidence regarding the effectiveness of integrated care interventions in reducing hospital activity. Design Umbrella review of systematic reviews and meta-analyses. Setting Interventions must have delivered care crossing the boundary between at least two health and/or social care settings. Participants Adult patients with one or more chronic diseases. Data sources MEDLINE, Embase, ASSIA, PsycINFO, HMIC, CINAHL, Cochrane Library (HTA database, DARE, Cochrane Database of Systematic Reviews), EPPI-Centre, TRIP, HEED, manual screening of references. Outcome measures Any measure of hospital admission or readmission, length of stay (LoS), accident and emergency use, healthcare costs. Results 50 reviews were included. Interventions focused on case management (n=8), chronic care model (CCM) (n=9), discharge management (n=15), complex interventions (n=3), multidisciplinary teams (MDT) (n=10) and self-management (n=5). 29 reviews reported statistically significant improvements in at least one outcome. 11/21 reviews reported significantly reduced emergency admissions (15–50%); 11/24 showed significant reductions in all-cause (10–30%) or condition-specific (15–50%) readmissions; 9/16 reported LoS reductions of 1–7 days and 4/9 showed significantly lower A&E use (30–40%). 10/25 reviews reported significant cost reductions but provided little robust evidence. Effective interventions included discharge management with postdischarge support, MDT care with teams that include condition-specific expertise, specialist nurses and/or pharmacists and self-management as an adjunct to broader interventions. Interventions were most effective when targeting single conditions such as heart failure, and when care was provided in patients’ homes. Conclusions Although all outcomes showed some significant reductions, and a number of potentially effective interventions were found, interventions rarely demonstrated unequivocally positive effects. Despite the centrality of integrated care to current policy, questions remain about whether the magnitude of potentially achievable gains is enough to satisfy national targets for reductions in hospital activity. Trial registration number CRD42015016458. PMID:27872113

Human Gut-Commensalic Lactobacillus ruminis ATCC 25644 Displays Sortase-Assembled Surface Piliation: Phenotypic Characterization of Its Fimbrial Operon through In Silico Predictive Analysis and Recombinant Expression in Lactococcus lactis

PubMed Central

Yu, Xia; Lyytinen, Outi; Kant, Ravi; Åvall-Jääskeläinen, Silja; von Ossowski, Ingemar; Palva, Airi

2015-01-01

Sortase-dependent surface pili (or fimbriae) in Gram-positive bacteria are well documented as a key virulence factor for certain harmful opportunistic pathogens. However, it is only recently known that these multi-subunit protein appendages are also belonging to the “friendly” commensals and now, with this new perspective, they have come to be categorized as a niche-adaptation factor as well. In this regard, it was shown earlier that sortase-assembled piliation is a native fixture of two human intestinal commensalics (i.e., Lactobacillus rhamnosus and Bifidobacterium bifidum), and correspondingly where the pili involved have a significant role in cellular adhesion and immunomodulation processes. We now reveal that intestinal indigenous (or autochthonous) Lactobacillus ruminis is another surface-piliated commensal lactobacillar species. Heeding to in silico expectations, the predicted loci for the LrpCBA-called pili are organized tandemly in the L. ruminis genome as a canonical fimbrial operon, which then encodes for three pilin-proteins and a single C-type sortase enzyme. Through electron microscopic means, we showed that these pilus formations are a surface assemblage of tip, basal, and backbone pilin subunits (respectively named LrpC, LrpB, and LrpA) in L. ruminis, and also when expressed recombinantly in Lactococcus lactis. As well, by using the recombinant-piliated lactococci, we could define certain ecologically relevant phenotypic traits, such as the ability to adhere to extracellular matrix proteins and gut epithelial cells, but also to effectuate an induced dampening on Toll-like receptor 2 signaling and interleukin-8 responsiveness in immune-related cells. Within the context of the intestinal microcosm, by wielding such niche-advantageous cell-surface properties the LrpCBA pilus would undoubtedly have a requisite functional role in the colonization dynamics of L. ruminis indigeneity. Our study provides only the second description of a native-piliated Lactobacillus species, but at the same time also involves the structural and functional characterization of a third type of lactobacillar pilus. PMID:26709916

[Quo vadis Therapeutic Health Care Professionals--What do Occupational and Physical Therapists Think about their Future? Results of a Survey throughout Germany].

PubMed

Ketels, G; Schön, G; van den Bussche, H; Barzel, A

2015-11-01

The introduction of occupational and physical therapy as academic disciplines is evidence of radical changes in the therapeutic health care professions. Therapists' professional associations are planning and negotiating both with health insurance companies and with other branches of the health care professions concerning future spheres of activity. In order to find out what the therapists in these professions think about their future, we conducted a survey of physical and occupational therapists through-out Germany. Our findings regarding professional life, job satisfaction, competition and cooperation have already been published. This article presents therapists' assessments of the future of their professions. From May until December 2008 we performed a cross-sectional survey, interviewing physical and occupational therapists throughout Germany. Statements were answered on a 6-step Likert scale; open questions were answered in free-text fields. The evaluation was performed quantitatively; the free texts were also evaluated qualitatively. A total of 3,506 questionnaires were evaluated; 1,273 were completed by occupational therapists and 2,233 by physical therapists. Nearly half of the therapists (n=1,687; 48.4%) used the opportunity to emphasise the need for change. We identified 4,026 statements about 8 general topics: remuneration, employee co-determination, professional recognition, continuing education, cooperation, initial access to the professions, and their academic status. Therapists illustrated certain items in the questionnaire with examples from their professional experience, suggested additional topics, and proposed concrete changes. We document a broad range of opinions and concerns, especially in regard to such subjects concerning the future of the professions as their new academic status and initial access. Physical and occupational therapists are concerned about the future development of their professions. They see a need for change in the following areas: remuneration, employee co-determination, initial access and cooperation as well as in the development of their profession as an academic discipline. Policy makers need to heed therapists' assessments of the state of their professions and their calls for its increased professionalisation. © Georg Thieme Verlag KG Stuttgart · New York.

Dynamic Hierarchical Energy-Efficient Method Based on Combinatorial Optimization for Wireless Sensor Networks

PubMed Central

Tang, Hongying; Cheng, Yongbo; Zhao, Qin; Li, Baoqing; Yuan, Xiaobing

2017-01-01

Routing protocols based on topology control are significantly important for improving network longevity in wireless sensor networks (WSNs). Traditionally, some WSN routing protocols distribute uneven network traffic load to sensor nodes, which is not optimal for improving network longevity. Differently to conventional WSN routing protocols, we propose a dynamic hierarchical protocol based on combinatorial optimization (DHCO) to balance energy consumption of sensor nodes and to improve WSN longevity. For each sensor node, the DHCO algorithm obtains the optimal route by establishing a feasible routing set instead of selecting the cluster head or the next hop node. The process of obtaining the optimal route can be formulated as a combinatorial optimization problem. Specifically, the DHCO algorithm is carried out by the following procedures. It employs a hierarchy-based connection mechanism to construct a hierarchical network structure in which each sensor node is assigned to a special hierarchical subset; it utilizes the combinatorial optimization theory to establish the feasible routing set for each sensor node, and takes advantage of the maximum–minimum criterion to obtain their optimal routes to the base station. Various results of simulation experiments show effectiveness and superiority of the DHCO algorithm in comparison with state-of-the-art WSN routing algorithms, including low-energy adaptive clustering hierarchy (LEACH), hybrid energy-efficient distributed clustering (HEED), genetic protocol-based self-organizing network clustering (GASONeC), and double cost function-based routing (DCFR) algorithms. PMID:28753962

Revitalizing school health programs worldwide.

PubMed

Benzian, Habib

2010-10-01

Each year, the Shils Fund recognizes outstanding activities that help improve oral health. The program is named in memory of Dr. Edward B. Shils, who led the Dental Manufacturers of America and Dental Dealers of America for more than 50 years. A 2010 Shils Award will be given to an innovative school health initiative called Fit For Schools Program (FFSP) in the Philippines. Such recognition in the US indicates the lessons that can be learned from a program initially tailored for another country. Health in a highly industrialized nation can be enhanced by heeding the FFSP principles used to craft an effective health promotion initiative. This evidence-based intervention is not exclusively an oral health initiative; it is an integration with other evidence-based health interventions and models a sustainable public-private partnership to advance positive health outcomes in socially responsible entrepreneurial ways. As the editor of this column in Compendium, I wish to applaud both leaders of FFSP: Dr. Habib Benzian and Dr. Bella Monse. The following article was written by the senior advisor, Dr. Benzian, who modestly refers to the program's receipt of another award from the World Bank, the United Nations Development Program, and the World Health Organization in 2009. To my knowledge, the presentation of that award was the first time a health promotion project led by dentists has ever received such high-level global recognition and was one of three projects so recognized for innovative solutions to global health in that year.

Synthesis and biological evaluation of chalcone derivatives (mini review).

PubMed

Bukhari, Syed Nasir Abbas; Jasamai, Malina; Jantan, Ibrahim

2012-11-01

Chalcones are the principal precursors for the biosynthesis of flavonoids and isoflavonoids. A three carbon α, β-unsaturated carbonyl system constitutes chalcones. Chalcones are the condensation products of aromatic aldehyde with acetophenones in attendance of catalyst. They go through an assortment of chemical reactions and are found advantageous in synthesis of pyrazoline, isoxazole and a variety of heterocyclic compounds. In synthesizing a range of therapeutic compounds, chalcones impart key role. They have showed worth mentioning therapeutic efficacy for the treatment of various diseases. Chalcone based derivatives have gained heed since they own simple structures, and diverse pharmacological actions. A lot of methods and schemes have been reported for the synthesis of these compounds. Amongst all, Aldol condensation and Claisen-Schmidt condensation still grasp high up position. Other distinguished techniques include Suzuki reaction, Witting reaction, Friedel-Crafts acylation with cinnamoyl chloride, Photo-Fries rearrangement of phenyl cinnamates etc. These inventive techniques utilize various catalysts and reagents including SOCl(2) natural phosphate, lithium nitrate, amino grafted zeolites, zinc oxide, water, Na(2)CO(3), PEG400, silicasulfuric acid, ZrCl(4) and ionic liquid etc. The development of better techniques for the synthesis of α, β- unsaturated carbonyl compounds is still in high demand. In brief, we have explained the methods and catalysts used in the synthesis of chalcones along with their biological activities in a review form to provide information for the development of new-fangled processes targeting better yield, less reaction time and least side effects with utmost pharmacological properties.

Only limited evidence available for the effectiveness and cost effectiveness of dental auxiliaries.

PubMed

Richards, Derek

2013-01-01

Medline, Embase, CINAHL, LILACS, Cochrane Database of Systematic Reviews, OpenGrey (System for Information on Grey Literature in Europe [SIGLE]-based), Scirus, Science.gov, Cost-Effective Analysis (CEA) Registry, European Network of Health Economics Evaluation Databases (EURON-HEED), ClinicalTrials.gov and Health Services Research Projects in Progress (HSRProj) databases. They also contacted 20 separate organisations. All study designs were considered with no limits on dates, age of study, language or country. Government reports, peer-reviewed publications, dissertations and theses were included. Editorials, opinion pieces, educational pieces, narrative reviews, abstracts without full-text availability and raw data such as those from national oral health surveys were excluded. Study quality and risk of bias was assessed. Data extraction was conducted independently, and meta-analysis was planned for the data, but only a qualitative synthesis could be conducted. Eighteen observational studies were included, 13 were considered to be at high risk of bias, five at moderate risk and one at low risk. They were conducted in Australia, Canada, Hong Kong, New Zealand and the United States. All the studies were related to dental caries with only studies involving dental nurses and therapists meeting the inclusion criteria. No studies regarding cost effectiveness, irreversible diagnostic procedures or diseases other than caries were in included. The authors concluded that the quality of the evidence was poor. They found that in select groups in which participants received irreversible dental treatment from teams that included midlevel providers, caries increment, caries severity or both decreased across time; however, there was no difference in caries increment, caries severity or both compared with those in populations in which dentists provided all irreversible treatment. In select groups in which participants had received irreversible dental treatment from teams that included midlevel providers, there was a decrease in untreated caries across time and a decrease in untreated caries compared with that in populations in which dentists provided all treatment.

Cost Effectiveness of HPV Vaccination: A Systematic Review of Modelling Approaches.

PubMed

Pink, Joshua; Parker, Ben; Petrou, Stavros

2016-09-01

A large number of economic evaluations have been published that assess alternative possible human papillomavirus (HPV) vaccination strategies. Understanding differences in the modelling methodologies used in these studies is important to assess the accuracy, comparability and generalisability of their results. The aim of this review was to identify published economic models of HPV vaccination programmes and understand how characteristics of these studies vary by geographical area, date of publication and the policy question being addressed. We performed literature searches in MEDLINE, Embase, Econlit, The Health Economic Evaluations Database (HEED) and The National Health Service Economic Evaluation Database (NHS EED). From the 1189 unique studies retrieved, 65 studies were included for data extraction based on a priori eligibility criteria. Two authors independently reviewed these articles to determine eligibility for the final review. Data were extracted from the selected studies, focussing on six key structural or methodological themes covering different aspects of the model(s) used that may influence cost-effectiveness results. More recently published studies tend to model a larger number of HPV strains, and include a larger number of HPV-associated diseases. Studies published in Europe and North America also tend to include a larger number of diseases and are more likely to incorporate the impact of herd immunity and to use more realistic assumptions around vaccine efficacy and coverage. Studies based on previous models often do not include sufficiently robust justifications as to the applicability of the adapted model to the new context. The considerable between-study heterogeneity in economic evaluations of HPV vaccination programmes makes comparisons between studies difficult, as observed differences in cost effectiveness may be driven by differences in methodology as well as by variations in funding and delivery models and estimates of model parameters. Studies should consistently report not only all simplifying assumptions made but also the estimated impact of these assumptions on the cost-effectiveness results.

Effectiveness of a real-time clinical decision support system for computerized physician order entry of plasma orders.

PubMed

Yazer, Mark H; Triulzi, Darrell J; Reddy, Vivek; Waters, Jonathan H

2013-12-01

We investigated the effect of implementing adaptive plasma ordering criteria in the computerized physician order entry (CPOE) system, with alerts that were automatically generated if the recipient's antecedent international normalized ratio (INR) did not meet the institutional criteria. In a regional health care system consisting of 11 hospitals using a common CPOE, data on the number of plasma orders and alerts that were generated were collected over a 4-month period before prescribers were required to select an indication for plasma. When adaptive ordering was implemented prescribers had to choose from prepopulated indications for plasma: INR of 1.6 or greater with bleeding, INR of 1.6 or greater before an invasive procedure, therapeutic exchange, massive transfusion, and other. Regardless of the antecedent INR the alert did not trigger if massive transfusion or plasmapheresis was selected. Information on prescribers and recipients was collected during this 5-month period. In the 4-month period before the adaptive alerts were implemented, 42.9% of the plasma orders generated an alert; in the 5-month period thereafter the alert rate was significantly lower at 27.9% (p < 0.0001). The percentage of heeded alerts increased during the adaptive alert period (24.3% vs. 17.1%, respectively, p = 0.004). A significant percentage (45%) of other plasma orders were for periprocedure or bleeding patients whose antecedent INR was less than 1.6. There were significant differences in prescriber specialties among those who ordered plasma using the other indication compared to all plasma orders. Electronic interventions improve compliance with plasma guidelines but as implemented are not sufficient to completely curtail non-evidence-based ordering. © 2013 American Association of Blood Banks.

Evaluation of a new physical exercise taken from salat (prayer) as a short-duration and frequent physical activity in the rehabilitation of geriatric and disabled patients.

PubMed

Reza, Mohammed Faruque; Urakami, Yuji; Mano, Yukio

2002-01-01

The major function of rehabilitation and physical medicine specialists is to provide the proper therapy that helps in improving the physical activities of impaired, disabled and handicapped persons through improvement in their muscle strength. In performing their function, the rehabilitation team should always take heed of the social and mental well-being of such patients. Having observed millions of Muslims perform the salat (prayer) regularly at specified times throughout the world, we postulated that salat, along with its various postures, can play a role in increasing psychological well-being including self-reliance and self-esteem, improving musculo-skeletal fitness, motor behavior and cerebral blood flow that may be beneficial in the rehabilitation of geriatric and disabled persons. The various postures of salat were studied and a range of joint motions were measured by goniometer, an instrument for measuring angles. Brain blood pressure was calculated from the effect of gravity on blood pressure at different positions. We found that during the offering of salat, most of the joints and muscles of the body were involved in physical activities with little effort, which probably play a vital role in cerebral blood flow and postural reflexes. The physical activities involved in the performance of salat helps in the rehabilitation process in disabled geriatric patients by improving blood flow and increasing musculoskeletal fitness. The salat prayer involves little effort (standing, bowing, prostration and sitting), has a short duration and is beneficial for mental and physical health. More studies are needed in future to determine the full beneficial effects of the salat prayer on the rehabilitative process of disabled persons.

How to gather information from talkative patients in a respectful and efficient manner: a qualitative study of GPs' communication strategies.

PubMed

Giroldi, Esther; Veldhuijzen, Wemke; Dijkman, Annika; Rozestraten, Maxime; Muris, Jean; van der Vleuten, Cees; van der Weijden, Trudy

2016-02-01

Gathering information from talkative patients presents a challenge to clinicians. Empirical evidence on how to effectively deal with this challenge is scant. This study explores communication strategies and their underlying mechanisms that GPs consider effective when gathering information from talkative patients in order to inform the development of best practices. We conducted a qualitative study with experienced GPs. We held individual stimulated-recall interviews (SRIs) with six GPs using their videotaped consultations as a stimulus. The transcripts that ensued were triangulated with data from three focus-group discussions (FGs). We performed a thematic network analysis during an iterative process of data collection and analysis. To deal with talkative patients during consultations, GPs first try to pinpoint the cause of patients' talkativeness before deciding on the approach to take. Moreover, they resort to the familiar communication strategies, however, in doing so adopt take a more directive attitude. To prevent such attitude from damaging the relationship, GPs take a stepped approach in which they try not to be overly directive, make the patient co-responsible for efficient time management and make use of empathic interrupting. In the absence of evidence, this description of GPs' communication strategies can guide clinicians, residents and students in gathering information from talkative patients in an efficient, yet empathic and respectful manner. When developing best practices, heed should be paid to the causes of patients' talkativeness and the tension between taking a directive approach and building a doctor-patient relationship. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Smoking Cessation among Low-Socioeconomic Status and Disadvantaged Population Groups: A Systematic Review of Research Output

PubMed Central

Courtney, Ryan J.; Naicker, Sundresan; Shakeshaft, Anthony; Clare, Philip; Martire, Kristy A.; Mattick, Richard P.

2015-01-01

Background: Smoking cessation research output should move beyond descriptive research of the health problem to testing interventions that can provide causal data and effective evidence-based solutions. This review examined the number and type of published smoking cessation studies conducted in low-socioeconomic status (low-SES) and disadvantaged population groups. Methods: A systematic database search was conducted for two time periods: 2000–2004 (TP1) and 2008–2012 (TP2). Publications that examined smoking cessation in a low-SES or disadvantaged population were coded by: population of interest; study type (reviews, non-data based publications, data-based publications (descriptive, measurement and intervention research)); and country. Intervention studies were coded in accordance with the Cochrane Effective Practice and Organisation of Care data collection checklist and use of biochemical verification of self-reported abstinence was assessed. Results: 278 citations were included. Research output (i.e., all study types) had increased from TP1 27% to TP2 73% (χ² = 73.13, p < 0.001), however, the proportion of data-based research had not significantly increased from TP1 and TP2: descriptive (TP1 = 23% vs. TP2 = 33%) or intervention (TP1 = 77% vs. TP2 = 67%). The proportion of intervention studies adopting biochemical verification of self-reported abstinence had significantly decreased from TP1 to TP2 with an increased reliance on self-reported abstinence (TP1 = 12% vs. TP2 = 36%). Conclusions: The current research output is not ideal or optimal to decrease smoking rates. Research institutions, scholars and funding organisations should take heed to review findings when developing future research and policy. PMID:26062037

What can the World Health Organization learn from EU lessons in civil society engagement and participation for health?

PubMed

Battams, Samantha

2014-01-01

This article explores challenges for and the development of civil society engagement and stakeholder representation, transparency, and accountability measures in the European Union, with a specific focus on health policy. The stance of the European Union on stakeholder participation within reform debates of the World Health Organization (WHO) is also considered, along with EU lessons for multi-stakeholders at the WHO. The European Commission has developed a number of measures for stakeholder engagement and transparency; however, the European Union has been prone to lobbying interests and has found difficulty in leading and making accountable the private sector when it comes to achieving its own health policy goals. The strong influence of corporate lobbyists on the European Union has come to light, with concerns about a lack of transparency and accountability in decision-making processes. While the WHO could learn from the European Union in terms of its strategies for stakeholder engagement, it could also heed some of the important lessons for the European Union when it comes to working with a broad range of stakeholders.

Electron pitch angle variations recorded at the high magnetic latitude boundary layer by the NUADU instrument on the TC-2 spacecraft

NASA Astrophysics Data System (ADS)

Lu, L.; McKenna-Lawlor, S.; Barabash, S.; Liu, Z. X.; Balaz, J.; Brinkfeldt, K.; Strharsky, I.; Shen, C.; Shi, J. K.; Cao, J. B.; Fu, S. Y.; Gunell, H.; Kudela, K.; Roelof, E. C.; Brandt, P. C.; Dandouras, I.; Zhang, T. L.; Carr, C.; Fazakerley, A.

2005-11-01

The NUADU (NeUtral Atom Detector Unit) experiment aboard TC-2 recorded, with high temporal and spatial resolution, 4π solid angle images of electrons (~50-125 keV) spiraling around geomagnetic field lines at high northern magnetic latitudes (L>10), during its in-orbit commissioning phase (September 2004). The ambient magnetic field, as well as electrons in other energy ranges, were simultaneously measured by the TC-2 magnetometer (FGM), the plasma electron and current experiment (PEACE), the low energy ion detector (LEID) and the high energy electron detector (HEED). The NUADU data showed that up-flowing electron beams could form "ring-like" and "dumbbell-type" pitch angle distributions (PADs) in the region sampled. Changes in these pitch angle distributions due to transient magnetic variations are suggested to have been associated with electron acceleration along the geomagnetic field lines. A nested magnetic bottle configuration that formed due to the propagation towards the Earth of a magnetic pulse, is proposed to have been associated with this process.

Electron Pitch Angle Variations Recorded at the High Magnetic Latitude Boundary Layer by the NUADU Instrument on the TC-2 Spacecraft

NASA Astrophysics Data System (ADS)

Lu, L.; McKenna-Lawlor, S.; Barabash, S.; Liu, Z.; Balaz, J.; Brinkfeldt, K.; Strhansky, I.; Shen, C.; Shi, J.; Cao, J.; Pu, Z.; Fu, S.; Gunell, H.; Kudela, K.; Roelof, E. C.; Brandt, P. C.; Dandouras, I.; Zhang, T.; Carr, C.; Fazakerley, A.

2005-12-01

During the first on orbit commission, with the deflection high voltage zero, the NUADU (NeUtral Atom Detector Unit) instrument aboard TC-2, with its high temporal-spatial resolution recorded 4d solid angle images of energetic particles spiraling around the geomagnetic field lines with different configuration at high northern magnetic latitude L>10. The ambient magnetic field and particles in different energy spectrum were simultaneously measured by the magnetometer experiment (FGM), the plasma electron and current experiment (PEACE), the low energy ion detector (LEID), and the high energy electron detector (HEED). The up-flowing electron beams made the pitch angle distribution (PAD) ring like configuration, and even concentrated toward the field lines to form a dumbbell-type PAD. In integration of the variations of ambient magnetic field and particles in different energy spectrums, a temporal string magnetic bottle model was proposed which might be formed by the disturbance of the magnetic pulse. Changes in the particle pitch angle diffusion may be associated with electron acceleration along the geomagnetic field lines.

Backstop: Shuttle Will Fly with Outstanding Waivers; New Oversight Eases Conflicts on Safety

NASA Technical Reports Server (NTRS)

Morring, Frank, Jr.

2005-01-01

he space shuttle Discovery is carrying some 300 waivers to technical specifications as it enters the home stretch of its planned return to flight next month. There were about 6,000 waivers in place when Columbia crashed. Shuttle managers say they are working to reduce the number of waivers remaining by fixing the problems they highlight, a change prompted by the Columbia Accident Investigation Board. In the wake of the accident, NASA has heeded the CAWS recommendation that waivers be the responsibility of an "independent technical authority" (ITA), rather than the shuttle program itself. To carry out the recommendation of the CAIB-which found an inherent conflict of interest in having the same managers make decisions about cost, schedule and safety-then-Administrator Sean O'Keefe designated the agency's chief engineer as the formal ITA. He is responsible for setting, maintaining and granting waivers across the agency. In mid-January, Fred Gregory, then O'Keefe's deputy and now his acting replacement, launched the ITA within NASA under Chief Engineer Rex Geveden, the former program manager on the Gravity Probe B experiment.

Communications and control for electric power systems

NASA Technical Reports Server (NTRS)

Kirkham, H.

1992-01-01

A long-term strategy for the integration of new control technologies for power generation and delivery is proposed: the industry would benefit from an evolutionary approach that would adapt to its needs future technologies as well as those that it has so far not heeded. The integrated operation of the entire system, including the distribution system, was proposed as a future goal. The AbNET communication protocols are reviewed, and additions that were made in 1991 are described. In the original network, traffic was controlled by polling at the master station, located at the substation, and routed by a flooding algorithm. In a revised version, the polling and flooding are modified. The question of interfacing low-energy measurement transducers or instrument transformers is considered. There is presently little or no agreement on what the output of optical current transducers (CT's) should be. Appendices deal with the calibration of current transducers; with Delta modulation, a simple means of serially encoding the output of an OCT; and with noise shaping, a method of digital signal processing that trades off the number of bits in a digital sample for a higher number of samples.

Trust and Reflection in Primary Care Practice Redesign.

PubMed

Lanham, Holly Jordan; Palmer, Raymond F; Leykum, Luci K; McDaniel, Reuben R; Nutting, Paul A; Stange, Kurt C; Crabtree, Benjamin F; Miller, William L; Jaén, Carlos Roberto

2016-08-01

To test a conceptual model of relationships, reflection, sensemaking, and learning in primary care practices transitioning to patient-centered medical homes (PCMH). Primary data were collected as part of the American Academy of Family Physicians' National Demonstration Project of the PCMH. We conducted a cross-sectional survey of clinicians and staff from 36 family medicine practices across the United States. Surveys measured seven characteristics of practice relationships (trust, diversity, mindfulness, heedful interrelation, respectful interaction, social/task relatedness, and rich and lean communication) and three organizational attributes (reflection, sensemaking, and learning) of practices. We surveyed 396 clinicians and practice staff. We performed a multigroup path analysis of the data. Parameter estimates were calculated using a Bayesian estimation method. Trust and reflection were important in explaining the characteristics of practice relationships and their associations with sensemaking and learning. The strongest associations between relationships, sensemaking, and learning were found under conditions of high trust and reflection. The weakest associations were found under conditions of low trust and reflection. Trust and reflection appear to play a key role in moderating relationships, sensemaking, and learning in practices undergoing practice redesign. © Health Research and Educational Trust.

The Crisis of Capitalism and the Marketisation of Health Care: the Implications for Public Health Professionals

PubMed Central

McKee, Martin; Stuckler, David

2012-01-01

The current economic crisis in Europe has challenged the basis of the economic model that currently prevails in much of the industrialised world. It has revealed a system that is managed not for the benefit of the people but rather for the corporations and the small elite who lead them, and which is clearly unsustainable in its present form. Yet, there is a hidden consequence of this system: an unfolding crisis in health care, driven by the greed of corporations whose profit-seeking model is also failing. Proponents of commodifying healthcare simultaneously argue that the cost of providing care for ageing populations is unaffordable while working to create demand for their health care products among those who are essentially healthy. Will healthcare be the next profit-fuelled investor bubble? In this paper, we call on health professionals to heed the warnings from the economic crisis and, rather than stand by while a crisis unfolds, act now to redirect increasingly market-oriented health systems to serve the common good. PMID:25170470

The crisis of capitalism and the marketisation of health care: the implications for public health professionals.

PubMed

McKee, Martin; Stuckler, David

2012-12-28

The current economic crisis in Europe has challenged the basis of the economic model that currently prevails in much of the industrialised world. It has revealed a system that is managed not for the benefit of the people but rather for the corporations and the small elite who lead them, and which is clearly unsustainable in its present form. Yet, there is a hidden consequence of this system: an unfolding crisis in health care, driven by the greed of corporations whose profit-seeking model is also failing. Proponents of commodifying healthcare simultaneously argue that the cost of providing care for ageing populations is unaffordable while working to create demand for their health care products among those who are essentially healthy. Will healthcare be the next profit-fuelled investor bubble? In this paper, we call on health professionals to heed the warnings from the economic crisis and, rather than stand by while a crisis unfolds, act now to redirect increasingly market-oriented health systems to serve the common good.

Naturalism and the social model of disability: allied or antithetical?

PubMed Central

Sisti, Dominic A

2015-01-01

The question of how disability should be defined is fraught with political, ethical and philosophical complexities. The social model of disability, which posits that disability is socially and politically constructed and is characterised by systemic barriers, has enjoyed broad acceptance that is exemplified by the slow but steady progress in securing civil rights for persons with disabilities. Yet, there remains a palpable tension between disability studies scholars and activists and bioethicists. While philosophers and bioethicists should heed the theories developed from the standpoint of persons with disabilities, disability activists should acknowledge the possibility that philosophical theories about the basic reality of disease, illness, health, function and impairment offer a more steady foundation for social or political critiques of disability. I argue that naturalistic theories of function and dysfunction provide a valuable starting point to clarify questions about the broader concept of disability. A naturalist theory of function may serve as the core of the concept of disability and provide disability scholars and bioethicists alike a stronger set of arguments in analysing real or potential instances of disability. PMID:25341736

Canada moving backwards on illegal drugs.

PubMed

Hyshka, Elaine; Butler-McPhee, Janet; Elliott, Richard; Wood, Evan; Kerr, Thomas

2012-01-01

Internationally, illegal drug use remains a major public health problem. In response, many countries have begun to shift their illegal drug policies away from enforcement and towards public health objectives. Recently, both the Global Commission on Drug Policy and the Supreme Court of Canada have endorsed this change in direction, supporting empirically sound illegal drug policies that reduce criminalization and stigmatization of drug users and bolster treatment and harm reduction efforts. Until recently, Canada was a participant in this growing movement towards rational drug policy. Unfortunately, in recent years, policy changes have made Canada one of the few remaining advocates of a "war-on-drugs" approach. Indeed, the current government has implemented a number of new illegal drug policies that contradict well-established scientific evidence from public health, criminology and other fields. As such, their approach is expected to do little to reduce the harms associated with substance use in Canada. The authors call on the current government to heed the recommendations of the Global Commission's report and learn from the many countries that are innovating in illegal drug policy by prioritizing evidence, human rights and public health.

Safety Considerations in the Ground Environment

NASA Technical Reports Server (NTRS)

Kirkpatrick, Paul D.; Palo, Thomas E.

2007-01-01

In the history of humankind, every great space adventure has begun on the ground. While this seems to be stating the obvious, mission and spacecraft designers who have overlooked this fact have paid a high price, either in loss or damage to the spacecraft pre-launch, or in mission failure or reduction. Spacecraft personnel may risk not only their flight hardware, but they may also risk their lives, their co-workers lives and even the general public by not heeding safety on the ground. Their eyes may be on the stars but their feet are on the ground! One additional comment: Although the design requirements are very different for human rated and nonhuman rated flight hardware, while on the ground that flight hardware (and its ground support equipment) doesn't care about what it is flying on. On the ground, additional requirements are often levied to protect the work force and general public. (Authors' Note: The source material for this chapter is primarily taken from the Kennedy Space Center Handbook (KHB) 1700.7/45 SW Handbook S-100 Space Shuttle Payload Ground Safety Handbook and the authors' personal experiences.

Total pressing Indonesian gas development, exports

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

Not Available

1994-01-24

Total is on track to become Indonesia's leading gas exporter by the turn of the century. Total's aggressive development of its Mahakam Delta acreage in East Kalimantan is intended to keep pace with growing liquefied natural gas demand, mainly from Japan but also increasingly from South Korea and Taiwan. A frantic scramble is under way among natural gas suppliers in the Pacific Rim region, particularly those with current LNG export facilities, to accommodate projections of soaring natural gas demand in the region. Accordingly, Total's Indonesian gas production goal is the centerpiece of a larger strategy to become a major playermore » in the Far East Asia gas scene. Its goals also fall in line with Indonesia's. Facing flat or declining oil production while domestic oil demand continues to soar along with a rapidly growing economy, Indonesia is heeding some studies that project the country could become a net oil importer by the turn of the century. The paper describes Total's Far East strategy, the Mahakam acreage which it operates, the shift to gas development, added discoveries, future development, project spending levels, and LNG export capacity.« less

Pleasing the Masses: Messages for Daily Life Management in African American Women's Popular Media Sources

PubMed Central

Peacock, Nadine

2011-01-01

Objectives. Using African American women's insights on their own health experiences, we explored how their daily life management was linked to the “strong Black woman” (SBW) script, and the health implications of that script. Methods. Using the search term “strong Black woman,” we identified 20 articles from African American women's magazines and 10 blog sites linked to the SBW script and analyzed their content. We created thematic categories (role management, coping, and self-care) and extracted issues relevant to African American women's health. Results. Adherence to the SBW script was linked to women's daily life management and health experiences. Themes such as self-sacrificial role management (“please the masses”), emotional suppression (“game face”), and postponement of self-care (“last on the list”) incited internal distress and evinced negative health consequences. Conclusions. Scientists, activists, and health care professionals would be aided in forming initiatives aimed at reducing health disparities among African American women by heeding the insights on their health experiences that they express in popular media sources. PMID:21088274

National and international response to occupational hazards in the healthcare sector.

PubMed

Froneberg, Brigitte

2006-09-01

The health care sector is one of the largest, most rapidly expanding areas of employment and is increasingly in need of qualified staff especially in the area of nursing. The health care sector is complex and comprises a variety of largely different professions; occupational hazards and exposures differ accordingly. Rates of absenteeism, reported work-related ill-health, and early retirement or departure from professions are comparatively high, especially among the nursing staff. While classical health hazards are addressed by international and national regulations, underlying causes of ill-health and departure from the profession, such as psychological stress, violence, pressing time schedules, and poor work organization are less well heeded. Practical guidance and quality information have become increasingly available from national and international Occupational Safety and Health (OSH) institutions and can be easily accessed through the Internet. They will undoubtedly benefit the profession, but difficulties not related to OSH will warrant political solutions. This presentation provides access to relevant international and European Union (EU) legislation and to valuable information resources for health care workers available from the Internet.

Parties heed (with caution): Public knowledge of and attitudes towards party finance in Britain.

PubMed

vanHeerde-Hudson, Jennifer; Fisher, Justin

2013-01-01

Despite comprehensive reform ( Political Parties, Elections and Referendums Act ) and recent review (Phillips Review in 2007) of party finance in Britain, public opinion of party finance remains plagued by perceptions of corruption, undue influence from wealthy donors, carefree and wasteful spending and, more generally, from the perception that there is just 'too much money' in politics. In this article we argue that knowledge of and attitudes to party finance matter, not least because advocates of reform have cited public opinion as evidence for reform. However, because attitudes to party finance are part of a broader attitudinal structure, opinion-led reforms are unlikely to succeed in increasing public confidence. Using data generated from YouGov's online panel (N=2,008), we demonstrate that the public know little of the key provisions regulating party finance and attitudes to party finance can be explained along two underlying dimensions - Anti-Party Finance and Reformers . As such, we consider whether parties and politicians should be freed from the constraints of public opinion in reforming party finance.

8 CFR 223.3 - Validity and effect on admissibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PERMITS, REFUGEE TRAVEL DOCUMENTS, AND ADVANCE PAROLE DOCUMENTS § 223.3 Validity and effect on... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Validity and effect on admissibility. 223.3..., whichever comes first. (2) Refugee travel document. A refugee travel document shall be valid for 1 year, or...

How improving practice relationships among clinicians and nonclinicians can improve quality in primary care.

PubMed

Lanham, Holly J; McDaniel, Reuben R; Crabtree, Benjamin F; Miller, William L; Stange, Kurt C; Tallia, Alfred F; Nutting, Paula

2009-09-01

Understanding the role of relationships health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Data were drawn from four large National Institutes of Health (NIH)-funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties.

Factors associated with consultation behaviour for primary symptoms potentially indicating colorectal cancer: A cross-sectional study on response to symptoms

PubMed Central

2012-01-01

Background Little data exists on the factors associated with health care seeking behaviour for primary symptoms of colorectal cancer (CRC). This study aimed to identify individual, provider and psychosocial factors associated with (i) ever seeking medical advice and (ii) seeking early medical advice for primary symptoms of colorectal cancer (CRC). Methods 1592 persons aged 56–88 years randomly selected from the Hunter Community Study (HCS) were sent a questionnaire. Results Males and those who had received screening advice from a doctor were at significantly higher odds of ever seeking medical advice for rectal bleeding. Persons who had private health coverage, consulted a doctor because the ‘symptom was serious’, or who did not wait to consult a doctor for another reason were at significantly higher odds of seeking early medical advice (< 2 weeks). For change in bowel habit, persons with lower income, within the healthy weight range, or who had discussed their family history of CRC irrespective of whether informed of ‘increased risk’ were at significantly higher odds of ever seeking medical advice. Persons frequenting their GP less often and seeing their doctor because the symptom persisted were at significantly higher odds of seeking early medical advice (< 2 weeks). Conclusions The seriousness of symptoms, importance of early detection, and prompt consultation must be articulated in health messages to at-risk persons. This study identified modifiable factors, both individual and provider-related to consultation behaviour. Effective health promotion efforts must heed these factors and target sub-groups less likely to seek early medical advice. PMID:22862960

In vitro inhibitory potential of decursin and decursinol angelate on the catalytic activity of cytochrome P-450 1A1/2, 2D15, and 3A12 isoforms in canine hepatic microsomes.

PubMed

Abd El-Aty, A M; Shah, Syed Sher; Kim, Bo-Mee; Choi, Jeong-Heui; Cho, Hee-Jung; Hee-Yi; Chang, Byung-Joon; Shin, Ho-Chul; Lee, Kang Bong; Shimoda, Minoru; Shim, Jae-Han

2008-11-01

Danggui is one of the most popular herbal medicines consumed by patients in different clinical settings in Asian countries. In this study, the two major pyranocoumarin compounds extracted from the Korean Angelica gigas root decursin (DC) and decursinol angelate (DA) were examined in vitro with regard to their abilities to inhibit hepatic CYP1A1/2, CYP2D15, and CYP3A12 catalytic activities in canine liver microsomes. The two components were capable of inhibiting CYP1A1/2, CYP2D15, and CYP3A12 catalytic activities, but the potencies varied. DC and DA selectively and noncompetitively inhibited CYP1A1/2 activity, with K ( i ) values of 90.176 and 67.560 microM, respectively. On the other hand, they exhibited slight inhibitory effects on CYP2D15 and CYP3A12 with K ( i ) values of 666.180 and 872.502 microM, 990.500 and 909.120 microM (1'hydroxymidazolam, MDZ1'H), and 802.800 and 853.920 microM (4-hydroxymidazolam, MDZ4H), respectively. Additionally, they showed increased inhibition after preincubation, which suggests the involvement of a mechanism-based inhibition. In sum, this in vitro data should be heeded as a signal of possible in vivo interactions. The use of human liver preparations would considerably strengthen the practical impact of the data generated from this study.

Responsiveness to HIV education and VCT services among Kenyan rural women: a community-based survey.

PubMed

Karau, Paul Bundi; Winnie, Mueni Saumu; Geoffrey, Muriira; Mwenda, Mukuthuria

2010-09-01

Uptake of VCT and other HIV prevention strategies among rural African women is affected by various socio-cultural and economic factors which need elucidation. Our aim was to establish the responsiveness to HIV education among rural women attending three dispensaries in Kenya. This study was designed to assess gender and psycho-social factors that influence HIV dynamics in rural Kenya. This was a cross-sectional questionnaire based study of 1347 women, conducted in October 2009. Socio-economic status as well as knowledge on methods of HIV transmission was assessed. Testing status, knowledge on existing VCT services and willingness to share HIV information with their children was assessed. Majority of the women have heard about VCT services, but significantly few of them have been tested. Those with secondary school education and above are more knowledgeable on methods of HIV transmission, while those with inadequate education are more likely to cite shaking hands, sharing utensils, mosquito bites and hugging as means of transmission (p = 0.001). 90% of educated women are willing to share HIV information with their children, compared to 40% of uneducated women. Marital status is seen to positively influence testing status, but has no significant effect on dissemination of information to children. We conclude that despite the aggressive HIV education and proliferation of VCT services in Kenya, women are not heeding the call to get tested. Education has a positive impact on dissemination of HIV information. Focus needs to shift into increasing acceptability of testing by women in rural Kenya.

The challenge of providing the public with actionable information during a pandemic.

PubMed

Gerwin, Leslie E

2012-01-01

Analysis of media reporting on the H1N1 vaccine during the 2009 pandemic reveals a dissonance between the nature and content of the reporting, the government's messages, and the public's perceptions of vaccine safety and desirability. Despite careful attention to history and especially the lessons offered by Richard Neustadt and Harvey Fineberg in their study of the 1976 "Epidemic that Never Was," government officials failed to escape criticism for decisions made and actions taken in the midst of the unfolding contagion threat. Moreover, public opinion polls show that substantial portions of the population failed to hear, believe, or heed the government's messages. Looking at the enduring narrative of the government's vaccine efforts through the lens of newspaper reports exposes six points of distortion. These points - the pervasive uncertainty inherent in a novel contagion; advances in information technology and electronic communications; the new news environment; the political polarization of American society; the infrastructure of the American public health system; and the oddities of public health emergency and vaccination injury compensation laws - interfered with the public's reception of the government's message and infected the public's perception of government veracity and leadership capability. They challenge us to consider whether current planning is sufficient to prepare Americans to respond effectively to a lives-threatening national crisis. If we are to ensure that the public receives and recognizes accurate and actionable information essential for the prevention or containment of a deadly contagion, we will need to understand and address the impact of these distorting forces. © 2012 American Society of Law, Medicine & Ethics, Inc.

Does integrated care reduce hospital activity for patients with chronic diseases? An umbrella review of systematic reviews.

PubMed

Damery, Sarah; Flanagan, Sarah; Combes, Gill

2016-11-21

To summarise the evidence regarding the effectiveness of integrated care interventions in reducing hospital activity. Umbrella review of systematic reviews and meta-analyses. Interventions must have delivered care crossing the boundary between at least two health and/or social care settings. Adult patients with one or more chronic diseases. MEDLINE, Embase, ASSIA, PsycINFO, HMIC, CINAHL, Cochrane Library (HTA database, DARE, Cochrane Database of Systematic Reviews), EPPI-Centre, TRIP, HEED, manual screening of references. Any measure of hospital admission or readmission, length of stay (LoS), accident and emergency use, healthcare costs. 50 reviews were included. Interventions focused on case management (n=8), chronic care model (CCM) (n=9), discharge management (n=15), complex interventions (n=3), multidisciplinary teams (MDT) (n=10) and self-management (n=5). 29 reviews reported statistically significant improvements in at least one outcome. 11/21 reviews reported significantly reduced emergency admissions (15-50%); 11/24 showed significant reductions in all-cause (10-30%) or condition-specific (15-50%) readmissions; 9/16 reported LoS reductions of 1-7 days and 4/9 showed significantly lower A&E use (30-40%). 10/25 reviews reported significant cost reductions but provided little robust evidence. Effective interventions included discharge management with postdischarge support, MDT care with teams that include condition-specific expertise, specialist nurses and/or pharmacists and self-management as an adjunct to broader interventions. Interventions were most effective when targeting single conditions such as heart failure, and when care was provided in patients' homes. Although all outcomes showed some significant reductions, and a number of potentially effective interventions were found, interventions rarely demonstrated unequivocally positive effects. Despite the centrality of integrated care to current policy, questions remain about whether the magnitude of potentially achievable gains is enough to satisfy national targets for reductions in hospital activity. CRD42015016458. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Effects of Low-Vision Rehabilitation on Reading Speed and Depression in Age Related Macular Degeneration: A Meta-Analysis.

PubMed

Hamade, Noura; Hodge, William G; Rakibuz-Zaman, Muhammad; Malvankar-Mehta, Monali S

2016-01-01

Age related macular degeneration (AMD) is a progressive eye disease that, as of 2015, has affected 11 million people in the U.S. and 1.5 million in Canada causing central vision blindness. By 2050, this number is expected to double to 22 million. Eccentric vision is the target of low-vision rehabilitation aids and programs for patients with AMD, which are thought to improve functional performance by improving reading speed and depression. This study evaluates the effect of various low-vision rehabilitation strategies on reading speed and depression in patients 55 and older with AMD. Computer databases including MEDLINE (OVID), EMBASE (OVID), BIOSIS Previews (Thomson-Reuters), CINAHL (EBSCO), Health Economic Evaluations Database (HEED), ISI Web of Science (Thomson-Reuters) and the Cochrane Library (Wiley) were searched from the year 2000 to January 2015. Included papers were research studies with a sample size of 20 eyes or greater focused on AMD in adults aged 55 or older with low vision (20/60 or lower). Two independent reviewers screened and extracted relevant data from the included articles. Standardized mean difference (SMD) was chosen as an effect size to perform meta-analysis using STATA. Fixed- and random-effect models were developed based on heterogeneity. Reading Speed and Depression Scores. A total of 9 studies (885 subjects) were included. Overall, a significant improvement in reading speed was found with a SMD of 1.01 [95% CI: 0.05 to 1.97]. Low-vision rehabilitation strategies including micro-perimetric biofeedback, microscopes teaching program significantly improved reading speed. Eccentric viewing training showed the maximum improvement in reading speed. In addition, a non-significant improvement in depression scores was found with a SMD of -0.44 [95% CI: -0.96 to 0.09]. A considerable amount of research is required in the area of low-vision rehabilitation strategies for patients with AMD. Based on current research, low-vision rehabilitation aids improve reading speed. However, they do not have a significant effect on depression scores in those 55 and older with AMD.

Language and Program for Documenting Software Design

NASA Technical Reports Server (NTRS)

Kleine, H.; Zepko, T. M.

1986-01-01

Software Design and Documentation Language (SDDL) provides effective communication medium to support design and documentation of complex software applications. SDDL supports communication among all members of software design team and provides for production of informative documentation on design effort. Use of SDDL-generated document to analyze design makes it possible to eliminate many errors not detected until coding and testing attempted. SDDL processor program translates designer's creative thinking into effective document for communication. Processor performs as many automatic functions as possible, freeing designer's energy for creative effort. SDDL processor program written in PASCAL.

A red-flag-based approach to risk management of EHR-related safety concerns.

PubMed

Sittig, Dean F; Singh, Hardeep

2013-01-01

Although electronic health records (EHRs) have a significant potential to improve patient safety, EHR-related safety concerns have begun to emerge. Based on 369 responses to a survey sent to the memberships of the American Society for Healthcare Risk Management and the American Health Lawyers Association and supplemented by our previous work in EHR-related patient safety, we identified the following common EHR-related safety concerns: (1) incorrect patient identification; (2) extended EHR unavailability (either planned or unplanned); (3) failure to heed a computer-generated warning or alert; (4) system-to-system interface errors; (5) failure to identify, find, or use the most recent patient data; (6) misunderstandings about time; (7) incorrect item selected from a list of items; and (8) open or incomplete orders. In this article, we present a "red-flag"-based approach that can be used by risk managers to identify potential EHR safety concerns in their institutions. An organization that routinely conducts EHR-related surveillance activities, such as the ones proposed here, can significantly reduce risks associated with EHR implementation and use. © 2013 American Society for Healthcare Risk Management of the American Hospital Association.

Get ready for the new asbestos standard

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

Onderick, W.A.

On October 1, OSHA`s revised asbestos rules became law, and with them are many changes from the previous 1986 standard. The presumed asbestos-containing material (PACM) rule is one of the bigger changes in the revised standard. OSHA has declared that owners must presume that there are certain high-risk asbestos-containing materials (ACM) in facilities built prior to 1981, unless bulk sample results prove them to be nonasbestos. The impact of this provision forces companies to think carefully before presuming where asbestos is or where it is not. Companies must also heed the EPA Asbestos National Emission Standards for Hazardous Air Pollutantsmore » (NESHAP), which require inspections and bulk sampling to identify materials prior to renovation or demolition. Short and long term needs should be examined when analyzing how to comply with the PACM provision. There are four options available. Option 1: Ignore the standard and face potential enforcement fines. Option 2: Presume all materials in pre-1981 buildings contain asbestos and simply post additional warning signs. Option 3: Survey or resurvey the facilities to be in compliance with the PACM ruling. Option 4: Conduct more comprehensive surveys. Option 3 is discussed in some detail.« less

Demographic trade-offs in a neutral model explain death-rate--abundance-rank relationship.

PubMed

Lin, Kui; Zhang, Da-Yong; He, Fangliang

2009-01-01

The neutral theory of biodiversity has been criticized for its neglect of species differences. Yet it is much less heeded that S. P. Hubbell's definition of neutrality allows species to differ in their birth and death rates as long as they have an equal per capita fitness. Using the lottery model of competition we find that fitness equalization through birth-death trade-offs can make species coexist longer than expected for demographically identical species, whereas the probability of monodominance for a species under zero-sum neutral dynamics is equal to its initial relative abundance. Furthermore, if newly arising species in a community survive preferentially they are more likely to slip through the quagmire of rareness, thus creating a strong selective bias favoring their community membership. On the other hand, high-mortality species, once having gained a footing in the community, are more likely to become abundant due to their compensatory high birth rates. This unexpected result explains why a positive association between species abundance and per capita death rate can be seen in tropical-forest communities. An explicit incorporation of interspecific trade-offs between birth and death into the neutral theory increases the theory's realism as well as its predictive power.

Environment, susceptibility windows, development and child health

PubMed Central

Wright, Robert O

2017-01-01

Purpose To illustrate the role of the exposome in child health while highlighting unique aspects of this research pertinent to children, such as the time dependency of environmental exposures on fetal programming, as well as the time dependent nature of child behavior, diet, and motor function, which alter the probability of exposure to different compounds. Future environmental health research will be more hypothesis generating but will also need to heed lessons learned from other “omic” sciences. The NIH Child Health Environmental Analysis Resource (CHEAR) is a major step towards providing the infrastructure needed to study the exposome and child health. Recent Findings Environmental exposures have overlapping mechanisms such as endocrine disruption and oxidative stress among others. The nature of the long term health impact of an exposure is dependent not only on dose, but also on the timing of exposure. Advances in exposure science, toxicology and biostatistics will create new opportunities to identify and better define windows of susceptibility to environmental exposures. Summary As exposure science matures, we will better understand the role of environment on health. Linking the exposome with genomics will unlock the root origins of multiple complex diseases. PMID:28107208

Connecting narrative with mental health learning through discussion and analysis of selected contemporary films.

PubMed

McAllister, Margaret

2015-08-01

In a recently completed qualitative study of nursing leaders' views of requirements for practice, seven aspects of recovery practice were revealed as central for graduates to learn. It is challenging to provide an in-depth understanding of recovery in a nursing curriculum because there are so many competing content areas and, as a result, time is constrained. However, because it is so vital to understand, educators would benefit from developing and sharing teaching strategies that explore recovery deeply, memorably, and engagingly, in order to encourage theory to be put into practice. Recent research into narrative pedagogy suggests that better use of stories, especially those that have strong emotional pull, such as well-made films and memoirs, may offer solutions to creative educators. Stories can have transformative potential, because once heard and heeded, the person can never go back to exactly how they were before. Recovery learned in this way becomes a threshold concept for the mental health curriculum. This paper outlines an engaging and time-efficient teaching strategy to develop these skills, drawing on the concept of narrative pedagogy. © 2015 Australian College of Mental Health Nurses Inc.

Critical components required to improve deployable laboratory biological hazards identification

NASA Astrophysics Data System (ADS)

Niemeyer, Debra M.

2004-08-01

An ever-expanding global military mission necessitates quick and accurate identification of biological hazards, whether naturally occurring or man-made. Coupled with an ever-present threat of biological attack, an expanded U.S. presence in worn-torn locations like Southwest Asia presents unique public health challenges. We must heed modern day "lessons learned" from Operation Desert Shield and the Soviet Afghanistan Campaign and guard against rapid incapacitation of troop strength from endemic disease and biological attack. To minimize readiness impacts, field hygiene is enforced, and research on better medical countermeasures such as antibiotics and vaccines continues. However, there are no preventions or remedies for all military-relevant infectious diseases or biological agents. A deployable, streamlined, self-contained diagnostic and public health surveillance laboratory capability with a reach-back communication is critical to meeting global readiness challenges. Current deployable laboratory packages comprise primarily diagnostic or environmental sample testing capabilities. Discussion will focus on critical components needed to improve existing laboratory assets, and to facilitate deployment of small, specialized packages far forward. The ideal laboratory model described will become an essential tool for the Combatant or Incident Commander to maintain force projection in the expeditionary environment.

Roe v. Wade. Reflective compassion.

PubMed

Padovano, A T

1998-01-01

The US has arrived at the correct legal status for induced abortion by permitting it on constitutional grounds within limits. In addition, the general consensus among American Catholics is in favor of abortion rights while disapproving of abortion and wishing to discourage it. Concerns about the morality of abortion, however, arise out of our uncertainty about the personhood of a fetus before birth or before viability. Early church leaders taught that a fetus did not obtain personhood until it acquired a human form, and the Catholic church did not baptize aborted fetuses without human shape or hold formal funeral services for dead fetuses. While official church teaching is adamant about the immorality of abortion, official church teaching has changed in the past in regard to the salvation of non-Catholics, slavery, inquisitions and torture, ecumenism, worship in the vernacular, and divorce and remarriage. No one is forced to have an abortion in the US because the legal right exists, and Catholics are more likely to heed Church teachings that do not seek legal force and punishment though "infallible" pronouncements and insensitive condemnation of women. If the Catholic church expects compassion for its wrong decisions in the past, then it should extend compassion to women in difficult situations.

A General Self-Organized Tree-Based Energy-Balance Routing Protocol for Wireless Sensor Network

NASA Astrophysics Data System (ADS)

Han, Zhao; Wu, Jie; Zhang, Jie; Liu, Liefeng; Tian, Kaiyun

2014-04-01

Wireless sensor network (WSN) is a system composed of a large number of low-cost micro-sensors. This network is used to collect and send various kinds of messages to a base station (BS). WSN consists of low-cost nodes with limited battery power, and the battery replacement is not easy for WSN with thousands of physically embedded nodes, which means energy efficient routing protocol should be employed to offer a long-life work time. To achieve the aim, we need not only to minimize total energy consumption but also to balance WSN load. Researchers have proposed many protocols such as LEACH, HEED, PEGASIS, TBC and PEDAP. In this paper, we propose a General Self-Organized Tree-Based Energy-Balance routing protocol (GSTEB) which builds a routing tree using a process where, for each round, BS assigns a root node and broadcasts this selection to all sensor nodes. Subsequently, each node selects its parent by considering only itself and its neighbors' information, thus making GSTEB a dynamic protocol. Simulation results show that GSTEB has a better performance than other protocols in balancing energy consumption, thus prolonging the lifetime of WSN.

Mechanisms of Vowel Variation in African American English.

PubMed

Holt, Yolanda Feimster

2018-02-15

This research explored mechanisms of vowel variation in African American English by comparing 2 geographically distant groups of African American and White American English speakers for participation in the African American Shift and the Southern Vowel Shift. Thirty-two male (African American: n = 16, White American controls: n = 16) lifelong residents of cities in eastern and western North Carolina produced heed,hid,heyd,head,had,hod,hawed,whod,hood,hoed,hide,howed,hoyd, and heard 3 times each in random order. Formant frequency, duration, and acoustic analyses were completed for the vowels /i, ɪ, e, ɛ, æ, ɑ, ɔ, u, ʊ, o, aɪ, aʊ, oɪ, ɝ/ produced in the listed words. African American English speakers show vowel variation. In the west, the African American English speakers are participating in the Southern Vowel Shift and hod fronting of the African American Shift. In the east, neither the African American English speakers nor their White peers are participating in the Southern Vowel Shift. The African American English speakers show limited participation in the African American Shift. The results provide evidence of regional and socio-ethnic variation in African American English in North Carolina.

Community Science: Creating an Alternative Place to Stand?

PubMed Central

Kloos, Bret

2008-01-01

This article comments on two emerging views of community psychology's approaches to the use of research for responding to social problems in contemporary community contexts - (a) the formation of a new field of community science, or (b) the updating of community psychology research traditions. If community science is to become established as a field related to community psychology, its proponents will need to agree upon conventions of epistemology, foci of interest, methods, and standards by which its work can be judged so that it can be distinguished from other human sciences. These articles provide early sketches for what community science might be. However, as noted in this commentary, we need to heed signs of concern about community psychology's continued relevance in public discourse regarding the analysis of and responses to social problems. While this special issue offers some promising responses to the concern of what the field can contribute, the field would be well served if we broaden our dialogue about a renewal of community psychology's commitment to social justice and the need for its perspectives in the practice of research that seeks to address community-based issues in the early 21st century. PMID:15909800

Searching for realism, structure and agency in Actor Network Theory.

PubMed

Elder-Vass, Dave

2008-09-01

Superficially, Actor Network Theory (ANT) and critical realism (CR) are radically opposed research traditions. Written from a realist perspective, this paper asks whether there might be a basis for finding common ground between these two traditions. It looks in turn at the questions of realism, structure, and agency, analysing the differences between the two perspectives and seeking to identify what each might learn from the other. Overall, the paper argues that there is a great deal that realists can learn from actor network theory; yet ANT remains stunted by its lack of a depth ontology. It fails to recognize the significance of mechanisms, and of their dependence on emergence, and thus lacks both dimensions of the depth that is characteristic of critical realism's ontology. This prevents ANT from recognizing the role and powers of social structure; but on the other hand, realists would do well to heed ANT's call for us to trace the connections through which structures are constantly made and remade. A lack of ontological depth also underpins ANT's practice of treating human and non-human actors symmetrically, yet this remains a valuable provocation to sociologists who neglect non-human entities entirely.

Data Safe Havens and Trust: Toward a Common Understanding of Trusted Research Platforms for Governing Secure and Ethical Health Research

PubMed Central

Nicholls, Jacqueline; Dobbs, Christine; Sethi, Nayha; Cunningham, James; Ainsworth, John; Heaven, Martin; Peacock, Trevor; Peacock, Anthony; Jones, Kerina; Laurie, Graeme; Kalra, Dipak

2016-01-01

In parallel with the advances in big data-driven clinical research, the data safe haven concept has evolved over the last decade. It has led to the development of a framework to support the secure handling of health care information used for clinical research that balances compliance with legal and regulatory controls and ethical requirements while engaging with the public as a partner in its governance. We describe the evolution of 4 separately developed clinical research platforms into services throughout the United Kingdom-wide Farr Institute and their common deployment features in practice. The Farr Institute is a case study from which we propose a common definition of data safe havens as trusted platforms for clinical academic research. We use this common definition to discuss the challenges and dilemmas faced by the clinical academic research community, to help promote a consistent understanding of them and how they might best be handled in practice. We conclude by questioning whether the common definition represents a safe and trustworthy model for conducting clinical research that can stand the test of time and ongoing technical advances while paying heed to evolving public and professional concerns. PMID:27329087

A constant conversation: tuning into and harmonizing the needs and priorities of the body and mind.

PubMed

Chen, Annie T; Kaplan, Samantha J; Carriere, Rachel

2017-12-01

Individuals rely upon many types of information to manage an illness, including information provided by their own bodies. This study investigated how people tune into and manage the flow of information from their bodies to manage their health. We developed a platform for participants to share and collaboratively reflect on how they engaged in this dialogic process, in which participants contributed to a discussion on topics relating to body listening and body awareness. Though the study was open to anyone interested in or wanting to contribute to knowledge on "body listening," the social media recruitment focused on chronic conditions requiring self-care and having overlapping symptomatology, with chronic pain as the primary characteristic. A qualitative analysis method based on grounded theory was used to analyse the data. Six main themes emerged: learning the language, recognizing and heeding limits, experiencing emotional fatigue and despair, regulating the channel, moving from conflict to communication, and settling into an uneasy acceptance. The monitoring and filtering of information from one's body, and the appeasement of conflicting demands and voices, is difficult work. Knowledge of this process can be used in patient education and in the development of tools to support body listening.

Effects of Document Holder on Postural Neck Muscles Activity among Computer Users: A Preliminary Study.

PubMed

Ambusam, Subramaniam; Omar, Baharudin; Joseph, Leonard; Deepashini, Harithasan

2015-01-01

Computer users are exposed to work related neck disorders due to repetitive movement and static posture for prolonged period. Viewing document and typing simultaneously are one of the contributing factors for neck disorders. This preliminary study was conducted to evaluate the effects of the document holder on the postural neck muscles activity among computer users. Nine healthy participants with pre-defined inclusion and exclusion criteria were recruited for the study. Neck muscles activity were analyzed using the surface electromyography (EMG) in five different document location such as flat right, flat left, flat center, stand right and stand left during a 5 min typing task. The mean and standard deviation results showed a least amount of muscles activity using a document holder compared to without document holder. Nevertheless, the statistical analysis showed no significant differences between the using of a document holder. The effects of document holder on head excursion and neck muscle activity is recommended in clinical neck pain population.

NONCARCINOGENIC EFFECTS OF CHROMIUM: UPDATE TO HEALTH ASSESSMENT DOCUMENT

EPA Science Inventory

This 1990 document updates the 1984 Health Assessment Document for Chromium by addressing issues regarding noncarcinogenic health effects of chromium: oxidation states and persistence of these states in the environment, sampling and analytical methodology to differentiate these o...

14 CFR 1216.319 - Environmental resources document.

Code of Federal Regulations, 2010 CFR

2010-01-01

... environmental resources document which describes the current environment at that field installation, including current information on the effects of NASA operations on the local environment. This document shall include information on the same environmental effects as included in an environmental impact statement...

14 CFR 1216.319 - Environmental resources document.

Code of Federal Regulations, 2011 CFR

2011-01-01

... environmental resources document which describes the current environment at that field installation, including current information on the effects of NASA operations on the local environment. This document shall include information on the same environmental effects as included in an environmental impact statement...

Strategies to contain the emergence of antimicrobial resistance: a systematic review of effectiveness and cost-effectiveness.

PubMed

Wilton, Paula; Smith, Richard; Coast, Joanna; Millar, Michael

2002-04-01

To conduct a systematic review of the literature to describe and critically appraise studies reporting on the cost and/or effectiveness of interventions proposed to control the emergence of antimicrobial resistance (AMR). The search for relevant studies encompassed consultation with world experts in AMR, and electronic bibliographic database search of: Medline (1960-2000); ISI (1981-2000); EMBASE (1988-2000); Grey Literature (1999-2000); Database of Reviews of Effectiveness (DARE) and the NHS Health Economic Evaluation Database (HEED) at York University's Centre for Reviews and Dissemination (CRD) (numerous years); OPAC (1975-2000); and the Cochrane Library Online (1990-2000). Only studies that concerned the effectiveness or cost-effectiveness of measures specifically designed to contain the emergence of AMR were reviewed. Standardised data extraction sheets, based on existing checklists for effectiveness and cost-effectiveness, were used to assess the validity of each study using the 'risk of bias criteria' suggested in the Cochrane Handbook. Only studies categorised as being at low or moderate risk of bias were reported fully. The reliability of the data review process was monitored by comparison of several, random, independent assessments by all authors. The mix of study methods (i.e. including studies based on non-randomised controlled trials) meant that formal meta-analysis was not possible, and thus a qualitative review was performed. In total, 43 studies were reviewed, with 21 classed as being at moderate or low risk of bias and therefore reported in the paper. These studies covered policies on: restricting the use of antimicrobials (five studies, suggesting that restriction policies can alter prescriber behaviour, although with limited evidence of subsequent effect on AMR); prescriber education, feedback and use of guidelines (six studies, with no clear conclusion); combination therapies (seven studies, showing the potential to lower drug-specific resistance, although for an indeterminate time period); vaccination (three studies showing cost/effectiveness). Most of these studies were: from the developed world, principally the USA; hospital-based, with few community level interventions; and concerned with effectiveness, not cost-effectiveness. Overall, there is an absence of good evidence concerning what is effective, and especially cost-effective, in reducing the emergence of AMR. However, in addition to more research concerning these forms of intervention, the paper highlights four specific areas for further investigation: validating intermediate or surrogate outcome measures to enable better use to be made of the literature on intermediate measures; development and evaluation of 'macro' strategies; research into specific aspects of AMR in developing countries; and empirical and methodological research concerning the economic evaluation of interventions.

A good patient? How notions of 'a good patient' affect patient-nurse relationships and ART adherence in Zimbabwe.

PubMed

Campbell, Catherine; Scott, Kerry; Skovdal, Morten; Madanhire, Claudius; Nyamukapa, Constance; Gregson, Simon

2015-09-30

While patient-provider interactions are commonly understood as mutually constructed relationships, the role of patient behaviour, participation in interactions, and characteristics, particularly ideals surrounding notions of 'good' and 'bad' patients, are under-examined. This article examines social representations of 'a good patient' and how these representations affect patient-healthcare provider relationships and antiretroviral treatment (ART) for people living with HIV. Using thematic network analysis, we examined interview and focus group transcripts involving 25 healthcare staff, 48 ART users, and 31 carers of HIV positive children, as well as field notes from over 100 h of ethnographic observation at health centres in rural Zimbabwe. Characteristics of a good patient include obedience, patience, politeness, listening, enthusiasm for treatment, intelligence, physical cleanliness, honesty, gratitude and lifestyle adaptations (taking pills correctly and coming to the clinic when told). As healthcare workers may decide to punish patients who do not live up the 'good patient persona', many patients seek to perform within the confines of the 'good patient persona' to access good care and ensure continued access to ART. The notion of a 'good ART patient' can have positive effects on patient health outcomes. It is one of the only arenas of the clinic experience that ART patients can influence in their favour. However, for people not conforming to the norms of the 'good patient persona', the productive and health-enabling patient-nurse relationship may break down and be detrimental to the patient. We conclude that policy makers need to take heed of the social representations that govern patient-nurse relationships and their role in facilitating or undermining ART adherence.

A review of instruments to measure interprofessional team-based primary care.

PubMed

Shoemaker, Sarah J; Parchman, Michael L; Fuda, Kathleen Kerwin; Schaefer, Judith; Levin, Jessica; Hunt, Meaghan; Ricciardi, Richard

2016-07-01

Interprofessional team-based care is increasingly regarded as an important feature of delivery systems redesigned to provide more efficient and higher quality care, including primary care. Measurement of the functioning of such teams might enable improvement of team effectiveness and could facilitate research on team-based primary care. Our aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework, and to create a searchable, web-based atlas of such instruments (available at: http://primarycaremeasures.ahrq.gov/team-based-care/ ). Our conceptual framework was developed from existing frameworks, the teamwork literature, and expert input. The framework is based on an Input-Mediator-Output model and includes 12 constructs to which we mapped both instruments as a whole, and individual instrument items. Instruments were also reviewed for relevance to measuring team-based care, and characterized. Instruments were identified from peer-reviewed and grey literature, measure databases, and expert input. From nearly 200 instruments initially identified, we found 48 to be relevant to measuring team-based primary care. The majority of instruments were surveys (n = 44), and the remainder (n = 4) were observational checklists. Most instruments had been developed/tested in healthcare settings (n = 30) and addressed multiple constructs, most commonly communication (n = 42), heedful interrelating (n = 42), respectful interactions (n = 40), and shared explicit goals (n = 37). The majority of instruments had some reliability testing (n = 39) and over half included validity testing (n = 29). Currently available instruments offer promise to researchers and practitioners to assess teams' performance, but additional work is needed to adapt these instruments for primary care settings.

Louder than words: power and conflict in interprofessional education articles, 1954–2013

PubMed Central

Paradis, Elise; Whitehead, Cynthia R

2015-01-01

Context Interprofessional education (IPE) aspires to enable collaborative practice. Current IPE offerings, although rapidly proliferating, lack evidence of efficacy and theoretical grounding. Objectives Our research aimed to explore the historical emergence of the field of IPE and to analyse the positioning of this academic field of inquiry. In particular, we sought to investigate the extent to which power and conflict – elements central to interprofessional care – figure in the IPE literature. Methods We used a combination of deductive and inductive automated coding and manual coding to explore the contents of 2191 articles in the IPE literature published between 1954 and 2013. Inductive coding focused on the presence and use of the sociological (rather than statistical) version of power, which refers to hierarchies and asymmetries among the professions. Articles found to be centrally about power were then analysed using content analysis. Results Publications on IPE have grown exponentially in the past decade. Deductive coding of identified articles showed an emphasis on students, learning, programmes and practice. Automated inductive coding of titles and abstracts identified 129 articles potentially about power, but manual coding found that only six articles put power and conflict at the centre. Content analysis of these six articles revealed that two provided tentative explorations of power dynamics, one skirted around this issue, and three explicitly theorised and integrated power and conflict. Conclusions The lack of attention to power and conflict in the IPE literature suggests that many educators do not foreground these issues. Education programmes are expected to transform individuals into effective collaborators, without heed to structural, organisational and institutional factors. In so doing, current constructions of IPE veil the problems that IPE attempts to solve. PMID:25800300

Physical activities and influencing factors among public health nurses: a cross-sectional study.

PubMed

Lin, Miao-Ling; Huang, Joh-Jong; Chuang, Hung-Yi; Tsai, Hsiu-Min; Wang, Hsiu-Hung

2018-04-20

Public health nurses are responsible for promoting and managing the health of community members, and if they do not have enough physical activity or ignore their own health, not only will their own health decline but the quality of life of the public will also be affected. This study investigated the physical activity of public health nurses and analysed the effects of attitudes, subjective norms, perceived behavioural control and behavioural intention to engage in physical activity. This study adopted a cross-sectional research design, and convenience sampling was used to select the research subjects. 198 public health nurses were invited to participate, and 172 completed the questionnaire. Multiple linear regression was used to analyse the influencing factors of physical activity intention and physical activity. Attitudes towards physical activity and perceived behavioural control of physical activity affected physical activity intention. When they had higher behavioural intention, their physical activity behaviour also improved. The physical activity intention significantly influenced the number of days that they had engaged in vigorous physical activity (95% CI 0.1786 to 0.3060, p<0.0001), and significantly influenced the number of days that they walked daily for 10 min (95% CI 0.2158 to 0.4144, p<0.0001), and also significantly influenced their daily sedentary time (95% CI -0.3020 to 0.0560, p=0.0046). Encouraging public health nurses to heed their own health and motivating them to engage in physical activity warrants attention from policy-makers and government health agencies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Louder than words: power and conflict in interprofessional education articles, 1954-2013.

PubMed

Paradis, Elise; Whitehead, Cynthia R

2015-04-01

Interprofessional education (IPE) aspires to enable collaborative practice. Current IPE offerings, although rapidly proliferating, lack evidence of efficacy and theoretical grounding. Our research aimed to explore the historical emergence of the field of IPE and to analyse the positioning of this academic field of inquiry. In particular, we sought to investigate the extent to which power and conflict - elements central to interprofessional care - figure in the IPE literature. We used a combination of deductive and inductive automated coding and manual coding to explore the contents of 2191 articles in the IPE literature published between 1954 and 2013. Inductive coding focused on the presence and use of the sociological (rather than statistical) version of power, which refers to hierarchies and asymmetries among the professions. Articles found to be centrally about power were then analysed using content analysis. Publications on IPE have grown exponentially in the past decade. Deductive coding of identified articles showed an emphasis on students, learning, programmes and practice. Automated inductive coding of titles and abstracts identified 129 articles potentially about power, but manual coding found that only six articles put power and conflict at the centre. Content analysis of these six articles revealed that two provided tentative explorations of power dynamics, one skirted around this issue, and three explicitly theorised and integrated power and conflict. The lack of attention to power and conflict in the IPE literature suggests that many educators do not foreground these issues. Education programmes are expected to transform individuals into effective collaborators, without heed to structural, organisational and institutional factors. In so doing, current constructions of IPE veil the problems that IPE attempts to solve. © 2015 The Authors Medical Education Published by John Wiley & Sons Ltd.

When to walk away from a deal.

PubMed

Cullinan, Geoffrey; Le Roux, Jean-Marc; Weddigen, Rolf-Magnus

2004-04-01

Deal making is glamorous; due diligence is not. That simple statement goes a long way toward explaining why so many companies have made so many acquisitions that have produced so little value. The momentum of a transaction is hard to resist once senior management has the target in its sights. Companies contract "deal fever," and due diligence all too often becomes an exercise in verifying the target's financial statements rather than conducting a fair analysis of the deal's strategic logic and the acquirer's ability to realize value from it. Seldom does the process lead managers to kill potential acquisitions, even when the deals are deeply flawed. In a recent Bain & Company survey of 250 international executives with M&A responsibilities, only 30% of them were satisfied with the rigor of their due diligence. And fully a third admitted they hadn't walked away from deals they had nagging doubts about. In this article, the authors, all Bain consultants, emphasize the importance of comprehensive due diligence practices and suggest ways companies can improve their capabilities in this area. They provide rich real-world examples of companies that have had varying levels of success with their due diligence processes, including Safeway, Odeon, American Sea-foods, and Kellogg's. Effective due diligence requires answering four basic questions: What are we really buying? What is the target's stand-alone value? Where are the synergies--and the skeletons? And what's our walk-away price? Each of these questions will prompt an even deeper level of querying that puts the broader, strategic rationale for acquisitions under a microscope. Successful acquirers pay close heed to the results of such in-depth investigations and analyses--to the extent that they are prepared to walk away from a deal, even in the very late stages of negotiations.

How Improving Practice Relationships Among Clinicians and Nonclinicians Can Improve Quality in Primary Care

PubMed Central

Lanham, Holly J.; McDaniel, Reuben R.; Crabtree, Benjamin F.; Miller, William L.; Stange, Kurt C.; Tallia, Alfred F.; Nutting, Paul A.

2010-01-01

Background Understanding the role of relationships in health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Methods Data were drawn from four large National Institutes of Health (NIH)–funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Findings Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Discussion Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties. PMID:19769206

An easy and effective approach to manage radiologic portable document format (PDF) files using iTunes.

PubMed

Qian, Li Jun; Zhou, Mi; Xu, Jian Rong

2008-07-01

The objective of this article is to explain an easy and effective approach for managing radiologic files in portable document format (PDF) using iTunes. PDF files are widely used as a standard file format for electronic publications as well as for medical online documents. Unfortunately, there is a lack of powerful software to manage numerous PDF documents. In this article, we explain how to use the hidden function of iTunes (Apple Computer) to manage PDF documents as easily as managing music files.

Global synthesis of the documented and projected effects of climate change on inland fishes

USGS Publications Warehouse

Myers, Bonnie; Lynch, Abigail; Bunnell, David; Chu, Cindy; Falke, Jeffrey A.; Kovach, Ryan; Krabbenhoft, Trevor J.; Kwak, Thomas J.; Paukert, Craig P.

2017-01-01

Although climate change is an important factor affecting inland fishes globally, a comprehensive review of how climate change has impacted and will continue to impact inland fishes worldwide does not currently exist. We conducted an extensive, systematic primary literature review to identify English-language, peer-reviewed journal publications with projected and documented examples of climate change impacts on inland fishes globally. Since the mid-1980s, scientists have projected the effects of climate change on inland fishes, and more recently, documentation of climate change impacts on inland fishes has increased. Of the thousands of title and abstracts reviewed, we selected 624 publications for a full text review: 63 of these publications documented an effect of climate change on inland fishes, while 116 publications projected inland fishes’ response to future climate change. Documented and projected impacts of climate change varied, but several trends emerged including differences between documented and projected impacts of climate change on salmonid abundance (P = 0.0002). Salmonid abundance decreased in 89.5% of documented effects compared to 35.7% of projected effects, where variable effects were more commonly reported (64.3%). Studies focused on responses of salmonids (61% of total) to climate change in North America and Europe, highlighting major gaps in the literature for taxonomic groups and geographic focus. Elucidating global patterns and identifying knowledge gaps of climate change effects on inland fishes will help managers better anticipate local changes in fish populations and assemblages, resulting in better development of management plans, particularly in systems with little information on climate change effects on fish.

Patterns for Effectively Documenting Frameworks

NASA Astrophysics Data System (ADS)

Aguiar, Ademar; David, Gabriel

Good design and implementation are necessary but not sufficient pre-requisites for successfully reusing object-oriented frameworks. Although not always recognized, good documentation is crucial for effective framework reuse, and often hard, costly, and tiresome, coming with many issues, especially when we are not aware of the key problems and respective ways of addressing them. Based on existing literature, case studies and lessons learned, the authors have been mining proven solutions to recurrent problems of documenting object-oriented frameworks, and writing them in pattern form, as patterns are a very effective way of communicating expertise and best practices. This paper presents a small set of patterns addressing problems related to the framework documentation itself, here seen as an autonomous and tangible product independent of the process used to create it. The patterns aim at helping non-experts on cost-effectively documenting object-oriented frameworks. In concrete, these patterns provide guidance on choosing the kinds of documents to produce, how to relate them, and which contents to include. Although the focus is more on the documents themselves, rather than on the process and tools to produce them, some guidelines are also presented in the paper to help on applying the patterns to a specific framework.

47 CFR 61.16 - Base documents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... for Electronic Filing § 61.16 Base documents. (a) The Base Document is a complete tariff which incorporates all effective revisions, as of the last day of the preceding month. The Base Document should be... 47 Telecommunication 3 2011-10-01 2011-10-01 false Base documents. 61.16 Section 61.16...

47 CFR 61.16 - Base documents.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Base documents. 61.16 Section 61.16... for Electronic Filing § 61.16 Base documents. (a) The Base Document is a complete tariff which incorporates all effective revisions, as of the last day of the preceding month. The Base Document should be...

47 CFR 61.16 - Base documents.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Base documents. 61.16 Section 61.16... for Electronic Filing § 61.16 Base documents. (a) The Base Document is a complete tariff which incorporates all effective revisions, as of the last day of the preceding month. The Base Document should be...

43 CFR 46.140 - Using tiered documents.

Code of Federal Regulations, 2014 CFR

2014-10-01

... documents. A NEPA document that tiers to another broader NEPA document in accordance with 40 CFR 1508.28 must include a finding that the conditions and environmental effects described in the broader NEPA... identified and analyzed in the broader NEPA document, no further analysis is necessary, and the previously...

43 CFR 46.140 - Using tiered documents.

Code of Federal Regulations, 2012 CFR

2012-10-01

... documents. A NEPA document that tiers to another broader NEPA document in accordance with 40 CFR 1508.28 must include a finding that the conditions and environmental effects described in the broader NEPA... identified and analyzed in the broader NEPA document, no further analysis is necessary, and the previously...

43 CFR 46.140 - Using tiered documents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... documents. A NEPA document that tiers to another broader NEPA document in accordance with 40 CFR 1508.28 must include a finding that the conditions and environmental effects described in the broader NEPA... identified and analyzed in the broader NEPA document, no further analysis is necessary, and the previously...

43 CFR 46.140 - Using tiered documents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... documents. A NEPA document that tiers to another broader NEPA document in accordance with 40 CFR 1508.28 must include a finding that the conditions and environmental effects described in the broader NEPA... identified and analyzed in the broader NEPA document, no further analysis is necessary, and the previously...

43 CFR 46.140 - Using tiered documents.

Code of Federal Regulations, 2013 CFR

2013-10-01

... documents. A NEPA document that tiers to another broader NEPA document in accordance with 40 CFR 1508.28 must include a finding that the conditions and environmental effects described in the broader NEPA... identified and analyzed in the broader NEPA document, no further analysis is necessary, and the previously...

47 CFR 61.16 - Base documents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Base documents. 61.16 Section 61.16... for Electronic Filing § 61.16 Base documents. (a) The Base Document is a complete tariff which incorporates all effective revisions, as of the last day of the preceding month. The Base Document should be...

45 CFR 1303.7 - Effect of failure to file or serve documents in a timely manner.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Effect of failure to file or serve documents in a... PROSPECTIVE DELEGATE AGENCIES General § 1303.7 Effect of failure to file or serve documents in a timely manner... requisite deadlines or time frames if it exceeds them by any amount. (d) The time to file an appeal...

Microfiche/Telex Oriented Document Services Center Established in Sylvania Library Through Cooperative Test Program with Defense Documentation Center.

ERIC Educational Resources Information Center

Little, Dean K.

In a cooperative program with Defense Documentation Center Headquarters, Sylvania arranged for procurement of 70,000 unclassified-unlimited documents without DDC Form I cards and 30,000 unclassified-limited and classified documents with Form I's. This was done in order to overcome effects of an in-house documents inventory/selective destruction…

The Effect of an Electronic SBAR Communication Tool on Documentation of Acute Events in the Pediatric Intensive Care Unit.

PubMed

Panesar, Rahul S; Albert, Ben; Messina, Catherine; Parker, Margaret

2016-01-01

The Situation, Background, Assessment, Recommendation (SBAR) handoff tool is designed to improve communication. The effects of integrating an electronic medical record (EMR) with a SBAR template are unclear. The research team hypothesizes that an electronic SBAR template improves documentation and communication between nurses and physicians. In all, 84 patient events were recorded from 542 admissions to the pediatric intensive care unit. Three time periods were studied: (a) paper documentation only, (b) electronic documentation, and (c) electronic documentation with an SBAR template. Documentation quality was assessed using a 4-point scoring system. The frequency of event notes increased progressively during the 3 study periods. Mean quality scores improved significantly from paper documentation to EMR free-text notes and to electronic SBAR-template notes, as did nurse and attending physician notification. The implementation of an electronic SBAR note is associated with more complete documentation and increased frequency of documentation of communication among nurses and physicians. © The Author(s) 2014.

Software design and documentation language, revision 1

NASA Technical Reports Server (NTRS)

Kleine, H.

1979-01-01

The Software Design and Documentation Language (SDDL) developed to provide an effective communications medium to support the design and documentation of complex software applications is described. Features of the system include: (1) a processor which can convert design specifications into an intelligible, informative machine-reproducible document; (2) a design and documentation language with forms and syntax that are simple, unrestrictive, and communicative; and (3) methodology for effective use of the language and processor. The SDDL processor is written in the SIMSCRIPT II programming language and is implemented on the UNIVAC 1108, the IBM 360/370, and Control Data machines.

Leveraging Text Content for Management of Construction Project Documents

ERIC Educational Resources Information Center

Alqady, Mohammed

2012-01-01

The construction industry is a knowledge intensive industry. Thousands of documents are generated by construction projects. Documents, as information carriers, must be managed effectively to ensure successful project management. The fact that a single project can produce thousands of documents and that a lot of the documents are generated in a…

Economic evaluation for first-line anti-hypertensive medicines: applications for the Philippines

PubMed Central

2012-01-01

Background Medicines to control hypertension, a leading cause of morbidity and mortality, are a major component of health expenditures in the Philippines. This study aims to review economic studies for first line anti-hypertensive medical treatment without co-morbidities; and discuss practical, informational and policy implications on the use of economic evaluation in the Philippines. Methods A systematic literature review was performed using the following databases: MEDLINE, EMBASE, BIOSIS, PubMed, The Cochrane Library, Health Economics Evaluations Database (HEED) and the Centre for Reviews and Dissemination – NHS NICE. Six existing economic analytical frameworks were reviewed and one framework for critical appraisal was developed. Results Out of 1336 searched articles, 12 fulfilled the inclusion criteria. The studies were summarized according to their background characteristics (year, journal, intervention and comparators, objective/study question, target audience, economic study type, study population, setting and country and source of funding/conflict of interest) and technical characteristics (perspective, time horizon, methodology/modeling, search strategy for parameters, costs, effectiveness measures, discounting, assumptions and biases, results, cost-effectiveness ratio, endpoints, sensitivity analysis, generalizability, strengths and limitations, conclusions, implications and feasibility and recommendations). The studies represented different countries, perspectives and stakeholders. Conclusions Diuretics were the most cost-effective drug class for first-line treatment of hypertension without co-morbidities. Although the Philippine Health Insurance Corporation may apply the recommendations given in previous studies (i.e. to subsidize diuretics, ACE inhibitors and calcium channel blockers), it is uncertain how much public funding is justified. There is an information gap on clinical data (transition probabilities, relative risks and risk reduction) and utility values on hypertension and related diseases from middle- and low- income countries. Considering the national relevance of the disease, a study on the costs of hypertension in the Philippines including in-patient, out-patient, out-of-pocket, local government and national government expenditure must be made. Economic evaluation may be incorporated in health technology assessment, planning, proposal development, research, prioritization and evaluation of health programmes. The approaches will vary depending on the policy questions. The information gap calls for building strong economic evaluative capacity in growing economies. PMID:23227952

Computer Documentation: Effects on Students' Computing Behaviors, Attitudes, and Use of Computers.

ERIC Educational Resources Information Center

Duin, Ann Hill

This study investigated the effects of a minimal manual version versus a cards version of documentation on students' computing behaviors while learning to use a telecommunication system (Appleshare), students' attitudes toward the documentation, and students' later use of the system. Guidelines from the work of Carroll and colleagues at the IBM…

19 CFR 10.610 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber apparel goods. 10.610 Section... noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made...

19 CFR 10.610 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber apparel goods. 10.610 Section... noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made...

19 CFR 10.610 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber apparel goods. 10.610 Section... noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made...

19 CFR 10.610 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber apparel goods. 10.610 Section... noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made...

19 CFR 10.610 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber apparel goods. 10.610 Section... noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made...

Designing Better Camels: Developing Effective Documentation for Computer Software.

ERIC Educational Resources Information Center

Zacher, Candace M.

This guide to the development of effective documentation for users of computer software begins by identifying five types of documentation, i.e., training manuals, user guides, tutorials, on-screen help comments, and troubleshooting manuals. Six steps in the development process are then outlined and briefly described: (1) planning and preparation;…

Analysis of a risk prevention document using dependability techniques: a first step towards an effectiveness model

NASA Astrophysics Data System (ADS)

Ferrer, Laetitia; Curt, Corinne; Tacnet, Jean-Marc

2018-04-01

Major hazard prevention is a main challenge given that it is specifically based on information communicated to the public. In France, preventive information is notably provided by way of local regulatory documents. Unfortunately, the law requires only few specifications concerning their content; therefore one can question the impact on the general population relative to the way the document is concretely created. Ergo, the purpose of our work is to propose an analytical methodology to evaluate preventive risk communication document effectiveness. The methodology is based on dependability approaches and is applied in this paper to the Document d'Information Communal sur les Risques Majeurs (DICRIM; in English, Municipal Information Document on Major Risks). DICRIM has to be made by mayors and addressed to the public to provide information on major hazards affecting their municipalities. An analysis of law compliance of the document is carried out thanks to the identification of regulatory detection elements. These are applied to a database of 30 DICRIMs. This analysis leads to a discussion on points such as usefulness of the missing elements. External and internal function analysis permits the identification of the form and content requirements and service and technical functions of the document and its components (here its sections). Their results are used to carry out an FMEA (failure modes and effects analysis), which allows us to define the failure and to identify detection elements. This permits the evaluation of the effectiveness of form and content of each components of the document. The outputs are validated by experts from the different fields investigated. Those results are obtained to build, in future works, a decision support model for the municipality (or specialised consulting firms) in charge of drawing up documents.

The relationship of attitude, subjective norm, and behavioral intent to the documentation behavior of nurses.

PubMed

Renfroe, D H; O'Sullivan, P S; McGee, G W

1990-01-01

Ajzen and Fishbein's theory of reasoned action was used to assess the relationship of nurses' attitude, subjective norm, and behavioral intention to their documentation behavior. Attitudes, subjective norms, and behavioral intentions toward documentation were elicited from 108 staff nurses. Documentation behavior was based on what should be documented in any hospitalized patient's chart during a shift. This exploratory model was analyzed with LISREL VI. The overall fit of the final model to the data was good, as judged by a chi-square (df = 7, p = .845). The total coefficient of determination for the structural equation was .461. Attitude toward documentation did not relate significantly to intention to document optimally. Subjective norm did have a significant effect on behavioral intent. Attitude and subjective norm accounted for 46.1% of the variance in behavioral intent. Behavioral intent had a significant effect on documentation behavior, accounting for 15.2% of the variance. It appears that subjective norm, which is the influence of others, is what directs the intention to document and thus relates to subsequent documentation. Recommendations for practice include the communication of high ideals and expectations of important others to the staff nurse in order to improve the quality of documentation.

Does trust matter more in virtual teams? A meta-analysis of trust and team effectiveness considering virtuality and documentation as moderators.

PubMed

Breuer, Christina; Hüffmeier, Joachim; Hertel, Guido

2016-08-01

Team trust has often been discussed both as requirement and as challenge for team effectiveness, particularly in virtual teams. However, primary studies on the relationship between trust and team effectiveness have provided mixed findings. The current review summarizes existing studies on team trust and team effectiveness based on meta-analytic methodology. In general, we assumed team trust to facilitate coordination and cooperation in teams, and therefore to be positively related with team effectiveness. Moreover, team virtuality and documentation of interactions were considered as moderators of this relationship because they should affect perceived risks during teamwork. While team virtuality should increase, documentation of interaction should decrease the relationship between team trust and team effectiveness. Findings from 52 studies with 54 independent samples (representing 12,615 individuals in 1,850 teams) confirmed our assumptions. In addition to the positive overall relationship between team trust and team effectiveness criteria (ρ = .33), the relationship between team trust and team performance was stronger in virtual teams (ρ = .33) as compared to face-to-face teams (ρ = .22), and weaker when team interactions were documented (ρ = .20) as compared to no such documentation (ρ = .29). Thus, documenting team interactions seems to be a viable complement to trust-building activities, particularly in virtual teams. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Document Level Assessment of Document Retrieval Systems in a Pairwise System Evaluation

ERIC Educational Resources Information Center

Rajagopal, Prabha; Ravana, Sri Devi

2017-01-01

Introduction: The use of averaged topic-level scores can result in the loss of valuable data and can cause misinterpretation of the effectiveness of system performance. This study aims to use the scores of each document to evaluate document retrieval systems in a pairwise system evaluation. Method: The chosen evaluation metrics are document-level…

19 CFR 10.424 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. 10... documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. (a...

19 CFR 10.424 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. 10... documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. (a...

19 CFR 10.424 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. 10... documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. (a...

19 CFR 10.424 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. 10... documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. (a...

19 CFR 10.424 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. 10... documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. (a...

A constant conversation: tuning into and harmonizing the needs and priorities of the body and mind

PubMed Central

Chen, Annie T.; Kaplan, Samantha J.; Carriere, Rachel

2017-01-01

ABSTRACT Purpose: Individuals rely upon many types of information to manage an illness, including information provided by their own bodies. This study investigated how people tune into and manage the flow of information from their bodies to manage their health. Method: We developed a platform for participants to share and collaboratively reflect on how they engaged in this dialogic process, in which participants contributed to a discussion on topics relating to body listening and body awareness. Though the study was open to anyone interested in or wanting to contribute to knowledge on “body listening,” the social media recruitment focused on chronic conditions requiring self-care and having overlapping symptomatology, with chronic pain as the primary characteristic. A qualitative analysis method based on grounded theory was used to analyse the data. Results: Six main themes emerged: learning the language, recognizing and heeding limits, experiencing emotional fatigue and despair, regulating the channel, moving from conflict to communication, and settling into an uneasy acceptance. Conclusion: The monitoring and filtering of information from one’s body, and the appeasement of conflicting demands and voices, is difficult work. Knowledge of this process can be used in patient education and in the development of tools to support body listening. PMID:28762295

Male Partner's Involvement in HIV Counselling and Testing and Associated Factors among Partners of Pregnant Women in Gondar Town, Northwest Ethiopia.

PubMed

Zenebe, Alemu; Gebeyehu, Abebaw; Derseh, Lemma; Ahmed, Kedir Y

2016-01-01

Background. Despite the existence of several programmes promoting male involvement in HIV counselling and testing during their wife's pregnancy as a part of PMTCT, few men have heeded the call. The aim of this study was to assess male partner's involvement in HCT and its associated factors. Methods. This study was based on institution based cross-sectional study design that used systematic random sampling technique. A total of 416 partners were interviewed in the data collection. Multivariable logistic regression model was fitted to identify the independent predictors. Result. In this study, the prevalence of male involvement in HCT was found to be 40.1% (95% CI: 35.3%-44.7%). The independent predictors of male involvement were partners who were younger, were cohabitant, were with multigravida wives, were knowledgeable on route of mother-to-child transmission, and discussed HCT. Conclusion. The prevalence of male involvement in HCT was found to be suboptimal compared to similar studies in Ethiopia. There is a need of interventions on partners who are older, separated, and with lower gravidity wife. Awareness creation campaign should also be created on the route of mother-to-child transmission of HIV and on the importance of discussion with wife.

The association between acculturation and recreational computer use among Latino adolescents in California.

PubMed

Shi, L; van Meijgaard, J; Simon, P

2012-08-01

Physical inactivity like recreational computer use is a likely factor in the rising obesity prevalence among Latino adolescents. Using the data from California Health Interview Survey, we test the hypothesis whether acculturation is associated with recreational computer use among Latino adolescents. We run linear regressions of the weekly time spent on recreational computer use among Latino adolescents, stratified first by gender and then by age group (12-14 and 15-17 years). Years living in the United States and language at home are used as key variables for acculturation. For all four sub-populations, living in the United States for less than 5 years is significantly associated with fewer hours on recreational computer use, compared with those US-born. Among female adolescents, those who lived in the United States for 10 years or more spent fewer hours on recreational computer use than those US-born. Among adolescents under 15, speaking English only and speaking English plus another language are both significantly associated with more hours on recreational computer use, compared with those who speak a non-English language at home. Educators and health professionals should heed the Latino adolescents' possible increase in recreational computer use. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

Politics and Public Health: The Flint Drinking Water Crisis.

PubMed

Gostin, Lawrence O

2016-07-01

The Flint, Michigan, lead drinking water crisis is perhaps the most vivid current illustration of health inequalities in the United States. Since 2014, Flint citizens-among the poorest in America, mostly African American-had complained that their tap water was foul and discolored. But city, state, and federal officials took no heed. In March 2016, an independent task force found fault at every level of government and also highlighted what may amount to criminal negligence for workers who seemingly falsified water-quality results, allowing the people of Flint to continue to be exposed to water well above the federally allowed lead levels. It would have been possible to prevent lead seeping into the drinking water by treating the pipes with federally approved anticorrosives for around $100 per day. But today the cost of repairing the Flint water system is estimated at $1.5 billion, and fixing the ageing and lead-laden system across the United States would cost at least $1.3 trillion. How will Flint residents get justice and fair compensation for the wrongs caused by individual and systemic failures? And how will governments rebuild a water infrastructure that is causing and will continue to cause toxic conditions, particularly in economically marginalized cities and towns across America? © 2016 The Hastings Center.

Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

PubMed

Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

2014-12-01

Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

From 'automation' to 'autonomy': the importance of trust repair in human-machine interaction.

PubMed

de Visser, Ewart J; Pak, Richard; Shaw, Tyler H

2018-04-09

Modern interactions with technology are increasingly moving away from simple human use of computers as tools to the establishment of human relationships with autonomous entities that carry out actions on our behalf. In a recent commentary, Peter Hancock issued a stark warning to the field of human factors that attention must be focused on the appropriate design of a new class of technology: highly autonomous systems. In this article, we heed the warning and propose a human-centred approach directly aimed at ensuring that future human-autonomy interactions remain focused on the user's needs and preferences. By adapting literature from industrial psychology, we propose a framework to infuse a unique human-like ability, building and actively repairing trust, into autonomous systems. We conclude by proposing a model to guide the design of future autonomy and a research agenda to explore current challenges in repairing trust between humans and autonomous systems. Practitioner Summary: This paper is a call to practitioners to re-cast our connection to technology as akin to a relationship between two humans rather than between a human and their tools. To that end, designing autonomy with trust repair abilities will ensure future technology maintains and repairs relationships with their human partners.

Male Partner's Involvement in HIV Counselling and Testing and Associated Factors among Partners of Pregnant Women in Gondar Town, Northwest Ethiopia

PubMed Central

Zenebe, Alemu; Gebeyehu, Abebaw; Derseh, Lemma

2016-01-01

Background. Despite the existence of several programmes promoting male involvement in HIV counselling and testing during their wife's pregnancy as a part of PMTCT, few men have heeded the call. The aim of this study was to assess male partner's involvement in HCT and its associated factors. Methods. This study was based on institution based cross-sectional study design that used systematic random sampling technique. A total of 416 partners were interviewed in the data collection. Multivariable logistic regression model was fitted to identify the independent predictors. Result. In this study, the prevalence of male involvement in HCT was found to be 40.1% (95% CI: 35.3%–44.7%). The independent predictors of male involvement were partners who were younger, were cohabitant, were with multigravida wives, were knowledgeable on route of mother-to-child transmission, and discussed HCT. Conclusion. The prevalence of male involvement in HCT was found to be suboptimal compared to similar studies in Ethiopia. There is a need of interventions on partners who are older, separated, and with lower gravidity wife. Awareness creation campaign should also be created on the route of mother-to-child transmission of HIV and on the importance of discussion with wife. PMID:27555968

Iranian women's perceptions of family-planning services quality: a client-satisfaction survey.

PubMed

Nakhaee, N; Mirahmadizadeh, A-R

2005-09-01

As Iran (IR) is included among the most successful developing countries in family planning, clarification and expression of the ideas and needs of women receiving the services not only have a great positive impact on national policies but also may be of interest to other nations. This research was conducted to clarify the client perceptions of the quality of family planning services in the capital cities of the two largest provinces of Iran. A representative sample of 909 women aged 15-50 referred to health centers were interviewed by skillful interviewers in a private area after obtaining informed consent. A questionnaire consisting of baseline data and 17 five-point Likert-scaled items measuring the satisfaction of clients and perceived importance of each item was developed by investigators. Half were aged 26-35 years, and most (84%) were housewives. The highest percentage of dissatisfaction was reported in relation to 'privacy protection' item. However, when the importance score was included, too, 'provision of sufficient information regarding other contraceptive methods' and 'unavailability of all methods' implicated the areas where priorities should be focused. The satisfaction levels obtained by the survey should be carefully heeded, and the supply chain and provision of information to the clients may be the first priorities in the process of improving the quality of care.

Assessing contextual factors that influence acceptance of pedestrian alerts by a night vision system.

PubMed

Källhammer, Jan-Erik; Smith, Kip

2012-08-01

We investigated five contextual variables that we hypothesized would influence driver acceptance of alerts to pedestrians issued by a night vision active safety system to inform the specification of the system's alerting strategies. Driver acceptance of automotive active safety systems is a key factor to promote their use and implies a need to assess factors influencing driver acceptance. In a field operational test, 10 drivers drove instrumented vehicles equipped with a preproduction night vision system with pedestrian detection software. In a follow-up experiment, the 10 drivers and 25 additional volunteers without experience with the system watched 57 clips with pedestrian encounters gathered during the field operational test. They rated the acceptance of an alert to each pedestrian encounter. Levels of rating concordance were significant between drivers who experienced the encounters and participants who did not. Two contextual variables, pedestrian location and motion, were found to influence ratings. Alerts were more accepted when pedestrians were close to or moving toward the vehicle's path. The study demonstrates the utility of using subjective driver acceptance ratings to inform the design of active safety systems and to leverage expensive field operational test data within the confines of the laboratory. The design of alerting strategies for active safety systems needs to heed the driver's contextual sensitivity to issued alerts.

Dr John McLennan MD (Aberdeen), FRCP (Lond) (1801-1874) and the Medical School of Bombay that failed.

PubMed

Pandya, Sunil K

2017-01-01

In 1826, Dr John McLennan was asked by Governor Mounstuart Elphinstone of Bombay to set up the first school to teach modern medicine to Indian citizens. He was expected to create textbooks on a variety of subjects in local languages and teach medicine to poorly educated students in their native tongues. Despite his valiant efforts, the school was deemed a failure and was abolished by the Government in 1832. Sir Robert Grant, appointed Governor of Bombay in 1835, analysed records pertaining to this medical school and concluded that the school failed since Dr McLennan was not provided the assistance he needed and as his suggestions for access to a hospital to teach medicine were not heeded. Dr McLennan provided able support to Dr Charles Morehead on his appointment as Principal and Professor of Medicine at the newly created Grant Medical College in Bombay in 1845. Dr Morehead dedicated his classic 'Clinical researches on diseases in India' to Dr McLennan. Dr McLennan headed the Board of Examiners created to assess the competence of the first batch of medical students emerging from this College. The system of evaluation set up by him remains admirable. Dr McLennan retired from service as Physician-General, full of honours.

Culture media profoundly affect Candida albicans and Candida tropicalis growth, adhesion and biofilm development.

PubMed

Weerasekera, Manjula M; Wijesinghe, Gayan K; Jayarathna, Thilini A; Gunasekara, Chinthika P; Fernando, Neluka; Kottegoda, Nilwala; Samaranayake, Lakshman P

2016-11-01

As there are sparse data on the impact of growth media on the phenomenon of biofilm development for Candida we evaluated the efficacy of three culture media on growth, adhesion and biofilm formation of two pathogenic yeasts, Candida albicans and Candida tropicalis. The planktonic phase yeast growth, either as monocultures or mixed cultures, in sabouraud dextrose broth (SDB), yeast nitrogen base (YNB), and RPMI 1640 was compared, and adhesion as well as biofilm formation were monitored using MTT and crystal violet (CV) assays and scanning electron microscopy. Planktonic cells of C. albicans, C. tropicalis and their 1:1 co-culture showed maximal growth in SDB. C. albicans/C. tropicalis adhesion was significantly facilitated in RPMI 1640 although the YNB elicited the maximum growth for C. tropicalis. Similarly, the biofilm growth was uniformly higher for both species in RPMI 1640, and C. tropicalis was the slower biofilm former in all three media. Scanning electron microscopy images tended to confirm the results of MTT and CV assay. Taken together, our data indicate that researchers should pay heed to the choice of laboratory culture media when comparing relative planktonic/biofilm growth of Candida. There is also a need for standardisation of biofilm development media so as to facilitate cross comparisons between laboratories.

H1N1 was not all that scary: uncertainty and stressor appraisals predict anxiety related to a coming viral threat.

PubMed

Taha, Sheena Aislinn; Matheson, Kimberly; Anisman, Hymie

2014-04-01

H1N1 reached pandemic proportions in 2009, yet considerable ambivalence was apparent concerning the threat presented and the inclination to be vaccinated. The present investigation assessed several factors, notably appraisals of the threat, intolerance of uncertainty, and familiarity with the virus, that might contribute to reactions to a potential future viral threat. Canadian adults (N = 316) provided with several scenarios regarding viral threats reported moderate feelings of anxiety, irrespective of whether the viral threat was one that was familiar versus one that was entirely unfamiliar to them (H1N1 recurrence, H5N1, a fictitious virus: D3N4). Participants appraised the stressfulness of the threats to be moderate and believed that they would have control in this situation. However, among individuals with high intolerance of uncertainty, the viral threat was accompanied by high levels of anxiety, which was mediated by aspects of appraisals, particularly control and stressfulness. In addition, among those individuals that generally appraised ambiguous life events as being stressful, the viral threat appraisals were accompanied by still greater anxiety. Given the limited response to potential viral threats, these results raise concerns that the public may be hesitant to heed recommendations should another pandemic occur. © 2013 John Wiley & Sons, Ltd.

[Interrelationship among "NANDA, NOC and NIC". A pilot study and an evaluation of a nursing document].

PubMed

Gomez de Segura Navarro, Carlota; Esain Larrambe, Ainhoa; Tina Majuelo, Pilar; Guembe Ibáñez, Irene; Fernández Perea, Laura; Narvaiza Solís, M Jesús

2006-01-01

(a) to determine the effectiveness of a nursing document which integrates nursing diagnoses, nursing treatments/actions (NIC), and results (NOC); (b) to verify the application of the aforementioned document in a hospitalization unit. A descriptive, transversal and observational study. Nursing documents (NANDA, NIC and NOC taxonomies). PHASES: 1st: analysis of the content in the nursing documentation for 23 pneumonic patients: Selection of nursing diagnoses and the most frequent interdependent problems. 2nd: Selection of results and nursing treatment/actions. 3rd: Elaboration of the document and a description of the Likert scales to define the state of the indicators for each result. 4th: A pilot study of the document applied to 12 patients. the application of the document permits one to identify the real status of a patient; to establish specific objectives; to improve the recording of data; to observe the effectiveness of treatment; to include educational activities; to give greater continuity and quality to a treatment plan.

A Documentation System to Save Time and Ensure Proper Application of the Fiberoptic Endoscopic Evaluation of Swallowing (FEES®)

PubMed Central

Hey, Christiane; Pluschinski, Petra; Stanschus, Soenke; Euler, Harald A.; Sader, Robert A.; Langmore, Susan; Neumann, Katrin

2011-01-01

A properly performed fiberoptic endoscopic evaluation of swallowing (FEES®) is comprehensive and time-consuming. Editing times of FEES protocols and attempts for efficiency maximization are unknown. Here, the protocol editing times of completed FEES examinations were determined. The present study reports the time savings and quality gains of a newly developed documentation system tailored to the FEES standard of Langmore. Four independent examiners analyzed twelve videos of FEES procedures, six without and six with the documentation system. Effectiveness of the documentation system was evaluated according to the times for total evaluation, interpretation, documentation, report writing, and for report completeness. The documentation system reduced editing times and increased report completeness with large effect sizes. Averaged total evaluation time decreased from 42 to 27 min, report completeness increased from 55 to 80%. The use of the documentation system facilitates and improves the assessment of the swallowing process. PMID:20938202

Improving the Quality of Electronic Documentation in Critical Care Nursing

ERIC Educational Resources Information Center

Stevens, Brent

2017-01-01

Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General…

45 CFR 164.316 - Policies and procedures and documentation requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... when it last was in effect, whichever is later. (ii) Availability (Required). Make documentation.... (iii) Updates (Required). Review documentation periodically, and update as needed, in response to...

37 CFR 3.54 - Effect of recording.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Effect of recording. 3.54... COMMERCE GENERAL ASSIGNMENT, RECORDING AND RIGHTS OF ASSIGNEE Date and Effect of Recording § 3.54 Effect of... validity of the document or the effect that document has on the title to an application, a patent, or a...

Effects of increased nurses' workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province.

PubMed

Shihundla, Rhulani C; Lebese, Rachel T; Maputle, Maria S

2016-05-13

Recording of information on multiple documents increases professional nurses' responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient's information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT) register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT) register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART) wellness register); ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB) suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC) checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care. The objective of this study was to investigate and describe the effects of increased nurses' workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province. The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses' workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in nature. The population consisted of all nurses who work at PHC facilities in Vhembe District. Purposive sampling was used to select nurses and three professional nurses were sampled from each PHC facility. An in-depth face-to-face interview was used to collect data using an interview guide. PHC facilities encountered several effects due to increased nurses' workload where incomplete patient information is documented. Unavailability of patient information was observed, whilst some documented information was found to be illegible, inaccurate and incomplete. Documentation of information at PHC facilities is an evidence of effective communication amongst professional nurses. There should always be active follow-up and mentoring of the nurses' documentation to ensure that information is accurately and fully documented in their respective facilities. Nurses find it difficult to cope with the increased workload associated with documenting patient information on the multiple records that are utilized at PHC facilities, leading to incomplete information. The number of nurses at facilities should be increased to reduce the increased workload.

Electronic Documentation Support Tools and Text Duplication in the Electronic Medical Record

ERIC Educational Resources Information Center

Wrenn, Jesse

2010-01-01

In order to ease the burden of electronic note entry on physicians, electronic documentation support tools have been developed to assist in note authoring. There is little evidence of the effects of these tools on attributes of clinical documentation, including document quality. Furthermore, the resultant abundance of duplicated text and…

Document boundary determination using structural and lexical analysis

NASA Astrophysics Data System (ADS)

Taghva, Kazem; Cartright, Marc-Allen

2009-01-01

The document boundary determination problem is the process of identifying individual documents in a stack of papers. In this paper, we report on a classification system for automation of this process. The system employs features based on document structure and lexical content. We also report on experimental results to support the effectiveness of this system.

The Effects of Inflation/Recession on Higher Education.

ERIC Educational Resources Information Center

Bowen, William G.

This document discusses the effects of inflation on colleges and universities. It attempts to explain the basic nature of the current financial problem so that more informed policy decisions can be made. The document discusses the effect of inflation on costs and the effects of inflation/recession on revenues. Chart 1 indicated the Halstead Higher…

Leadership and Learning: A Measurement-Based Approach for Analyzing School Effectiveness and Developing Effective School Leaders. Project Report.

ERIC Educational Resources Information Center

Krug, Samuel E.

Attending to the questions of how school leadership influences learning and achievement and what effective school leaders do, this document describes a measurement-based approach for studying and developing effective school leadership. The document details the conception, refinement, and psychometric properties of the Instructional Leadership…

Approach for Estimating Exposures and Incremental Health ...

EPA Pesticide Factsheets

Approach for Estimating Exposures and Incremental Health Effects from Lead During Renovation, Repair, and Painting Activities in Public and Commercial Buildings” (Technical Approach Document). Also available for public review and comment are two supplementary documents: the detailed appendices for the Technical Approach Document and a supplementary report entitled “Developing a Concentration-Response Function for Pb Exposure and Cardiovascular Disease-Related Mortality.” Together, these documents describes an analysis for estimating exposures and incremental health effects created by renovations of public and commercial buildings (P&CBs). This analysis could be used to identify and evaluate hazards from renovation, repair, and painting activities in P&CBs. A general overview of how this analysis can be used to inform EPA’s hazard finding is described in the Framework document that was previously made available for public comment (79 FR 31072; FRL9910-44). The analysis can be used in any proposed rulemaking to estimate the reduction in deleterious health effects that would result from any proposed regulatory requirements to mitigate exposure from P&CB renovation activities. The Technical Approach Document describes in detail how the analyses under this approach have been performed and presents the results – expected changes in blood lead levels and health effects due to lead exposure from renovation activities.

INTERACTIVE EFFECTS OF OZONE DEPLETION AND CLIMATE CHANGE ON BIOGEOCHEMICAL CYCLES

EPA Science Inventory

The effects of ozone depletion on global biogeochemical cycles, via increased UV-B radiation at the Earth's surface, have continued to be documented over the past 4 years. In this report we also document various effects of UV-B that interact with global climate change because the...

40 CFR 35.2050 - Effect of approval or certification of documents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2050 Effect of approval or certification of documents. Review or approval of facilities plans, design drawings... relieve the grantee of its responsibility to properly plan, design, build and effectively operate and...

IEP Documentation for Effective Systematic Facilitation

ERIC Educational Resources Information Center

Eng, Peng-Sim

2015-01-01

This paper discusses how the process for IEP documentation was used in a training program for a group of young inexperienced teachers and teaching aides to effectively address the educational needs of children with diverse disabilities. Teachers at Kianh Centre in Vietnam received explicit instructions for writing effective functional individual…

The Audit of Principal Effectiveness: Instrumentation for Principalship Research. A Research Project Report.

ERIC Educational Resources Information Center

Valentine, Jerry W.; Bowman, Michael L.

Using the literature and research on principal effectiveness as a foundation, the Audit of Principal Effectiveness was developed. Initially, 162 items forming 12 theoretical factors describing effective principal behavior were identified and sorted into two documents. The documents, each containing 81 items, were mailed to a total of 3,660…

Effect of didactic lectures on obesity documentation and counseling among internal medicine residents.

PubMed

Ren, Vicky; Ellison, Kathleen; Miller, Jonathan; Busireddy, Kiran; Vickery, Erin; Panda, Mukta; Qayyum, Rehan

2016-01-01

Screening adult patients for obesity and offering appropriate counseling and treatment for weight loss is recommended. However, many healthcare providers feel ill-equipped to address this topic. We examined whether didactic presentations lead to increased obesity documentation and counseling among internal medicine (IM) residents. We reviewed medical records of patients seen at the IM Resident Continuity Clinic during April 2015. Residents were provided feedback at two didactic presentations during May 2015. To examine the effect of this intervention, we repeated medical record review during June 2015. For both reviews, we abstracted patient-specific (i.e., age, body mass index [BMI], race, sex, and number of comorbid diagnoses) and resident-specific (i.e., sex and training level) data as well as evidence of obesity documentation and counseling. We used logistic regression models to examine the effect of intervention on obesity documentation and counseling, adjusting for patient- and resident-specific variables. Of the 278 patients with BMI≥30 kg/m(2), 139 were seen before and 139 after the intervention. Intervention had no effect on obesity documentation or counseling with or without adjustment for confounding variables (both P>0.05). In adjusted post-hoc analyses, each additional comorbidity increased the odds of obesity documentation by 8% (OR=1.08; 95% CI=1.05-1.11; P<0.001). In addition, as compared to postgraduate year (PGY) 1 residents, PGY-3 residents were 56% (OR=0.44; 95% CI=0.21-0.95; P=0.03) less likely to counsel obese patients. Obesity is inadequately addressed in primary care settings, and didactic presentations were unable to increase obesity documentation or weight loss counseling. Future research to identify effective interventions is needed.

Effect of didactic lectures on obesity documentation and counseling among internal medicine residents

PubMed Central

Ren, Vicky; Ellison, Kathleen; Miller, Jonathan; Busireddy, Kiran; Vickery, Erin; Panda, Mukta; Qayyum, Rehan

2016-01-01

Background Screening adult patients for obesity and offering appropriate counseling and treatment for weight loss is recommended. However, many healthcare providers feel ill-equipped to address this topic. Objective We examined whether didactic presentations lead to increased obesity documentation and counseling among internal medicine (IM) residents. Methods We reviewed medical records of patients seen at the IM Resident Continuity Clinic during April 2015. Residents were provided feedback at two didactic presentations during May 2015. To examine the effect of this intervention, we repeated medical record review during June 2015. For both reviews, we abstracted patient-specific (i.e., age, body mass index [BMI], race, sex, and number of comorbid diagnoses) and resident-specific (i.e., sex and training level) data as well as evidence of obesity documentation and counseling. We used logistic regression models to examine the effect of intervention on obesity documentation and counseling, adjusting for patient- and resident-specific variables. Results Of the 278 patients with BMI≥30 kg/m2, 139 were seen before and 139 after the intervention. Intervention had no effect on obesity documentation or counseling with or without adjustment for confounding variables (both P>0.05). In adjusted post-hoc analyses, each additional comorbidity increased the odds of obesity documentation by 8% (OR=1.08; 95% CI=1.05–1.11; P<0.001). In addition, as compared to postgraduate year (PGY) 1 residents, PGY-3 residents were 56% (OR=0.44; 95% CI=0.21–0.95; P=0.03) less likely to counsel obese patients. Conclusions Obesity is inadequately addressed in primary care settings, and didactic presentations were unable to increase obesity documentation or weight loss counseling. Future research to identify effective interventions is needed. PMID:27124168

Interdisciplinary collaboration and the electronic medical record.

PubMed

Green, Shayla D; Thomas, Joan D

2008-01-01

To examine interdisciplinary collaboration via electronic medical records (EMRs) with a focus on physicians' perception of nursing documentation. Quality improvement project using a survey instrument. Tertiary care pediatric hospital. Thirty-seven physicians. Physicians perceptions of nursing documentation after EMR implementation Physicians desire nursing documentation with greater clarity and additional information. Physicians indicate checklists alone for patient assessment and intervention data are insufficient for effective nurse/physician collaboration. Narrative nursing summaries are invaluable references that guide medical treatment decisions. Physicians see detailed assessments and well-described interventions of nurses' as critical to their ability to effectively practice medicine. Health care technology is called to develop EMRs that enable nurses to document detailed patient data in a swift and straightforward manner. Joint collaboration between nurses, physicians, and technology specialists is recommended to develop effective EMR systems.

AIR QUALITY CRITERIA DOCUMENT(S) FOR LEAD

EPA Science Inventory

This collection of documents intend to assess the latest scientific information on the health and environmental fate and effects of lead to provide scientific bases for periodic review and possible revision of the National Ambient Air Quality Standards (NAAQS) for lead.

The Tech Prep Handbook: Essential Documents To Promte Effective Tech Prep Policies and Practices.

ERIC Educational Resources Information Center

Hensley, Oliver D., Ed.; And Others

Developed during a project to document and analyze the tech prep initiative in Texas, this handbook contains exemplary documents associated with the model programs in the state. This second edition of the handbook organizes documents in sections (sections A, C, D, and G) that correspond to the major impact sectors identified during the research…

Thinking about Global Warming: Effect of Policy-Related Documents and Prompts on Learning about Causes of Climate Change

ERIC Educational Resources Information Center

Blaum, Dylan; Griffin, Thomas D.; Wiley, Jennifer; Britt, M. Anne

2017-01-01

We examined students' understanding of the causes of a scientific phenomenon from a multiple-document-inquiry unit. Students read several documents that each described causal factors that could be integrated to address the given writing task of explaining the causes of change in average global temperature. We manipulated whether the document set…

Software design and documentation language

NASA Technical Reports Server (NTRS)

Kleine, H.

1977-01-01

A communications medium to support the design and documentation of complex software applications is studied. The medium also provides the following: (1) a processor which can convert design specifications into an intelligible, informative machine reproducible document; (2) a design and documentation language with forms and syntax that are simple, unrestrictive, and communicative; and (3) methodology for effective use of the language and processor.

VisIRR: A Visual Analytics System for Information Retrieval and Recommendation for Large-Scale Document Data

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

Choo, Jaegul; Kim, Hannah; Clarkson, Edward

In this paper, we present an interactive visual information retrieval and recommendation system, called VisIRR, for large-scale document discovery. VisIRR effectively combines the paradigms of (1) a passive pull through query processes for retrieval and (2) an active push that recommends items of potential interest to users based on their preferences. Equipped with an efficient dynamic query interface against a large-scale corpus, VisIRR organizes the retrieved documents into high-level topics and visualizes them in a 2D space, representing the relationships among the topics along with their keyword summary. In addition, based on interactive personalized preference feedback with regard to documents,more » VisIRR provides document recommendations from the entire corpus, which are beyond the retrieved sets. Such recommended documents are visualized in the same space as the retrieved documents, so that users can seamlessly analyze both existing and newly recommended ones. This article presents novel computational methods, which make these integrated representations and fast interactions possible for a large-scale document corpus. We illustrate how the system works by providing detailed usage scenarios. Finally, we present preliminary user study results for evaluating the effectiveness of the system.« less

VisIRR: A Visual Analytics System for Information Retrieval and Recommendation for Large-Scale Document Data

DOE PAGES

Choo, Jaegul; Kim, Hannah; Clarkson, Edward; ...

2018-01-31

In this paper, we present an interactive visual information retrieval and recommendation system, called VisIRR, for large-scale document discovery. VisIRR effectively combines the paradigms of (1) a passive pull through query processes for retrieval and (2) an active push that recommends items of potential interest to users based on their preferences. Equipped with an efficient dynamic query interface against a large-scale corpus, VisIRR organizes the retrieved documents into high-level topics and visualizes them in a 2D space, representing the relationships among the topics along with their keyword summary. In addition, based on interactive personalized preference feedback with regard to documents,more » VisIRR provides document recommendations from the entire corpus, which are beyond the retrieved sets. Such recommended documents are visualized in the same space as the retrieved documents, so that users can seamlessly analyze both existing and newly recommended ones. This article presents novel computational methods, which make these integrated representations and fast interactions possible for a large-scale document corpus. We illustrate how the system works by providing detailed usage scenarios. Finally, we present preliminary user study results for evaluating the effectiveness of the system.« less

Precise Documentation: The Key to Better Software

NASA Astrophysics Data System (ADS)

Parnas, David Lorge

The prime cause of the sorry “state of the art” in software development is our failure to produce good design documentation. Poor documentation is the cause of many errors and reduces efficiency in every phase of a software product's development and use. Most software developers believe that “documentation” refers to a collection of wordy, unstructured, introductory descriptions, thousands of pages that nobody wanted to write and nobody trusts. In contrast, Engineers in more traditional disciplines think of precise blueprints, circuit diagrams, and mathematical specifications of component properties. Software developers do not know how to produce precise documents for software. Software developments also think that documentation is something written after the software has been developed. In other fields of Engineering much of the documentation is written before and during the development. It represents forethought not afterthought. Among the benefits of better documentation would be: easier reuse of old designs, better communication about requirements, more useful design reviews, easier integration of separately written modules, more effective code inspection, more effective testing, and more efficient corrections and improvements. This paper explains how to produce and use precise software documentation and illustrate the methods with several examples.

The effects of the application of SIMPRO on the completeness and time efficiency of nursing documentation in the outpatient instalation at Dompet Dhuafa Hospital Parung

NASA Astrophysics Data System (ADS)

Dwisatyadini, M.; Hariyati, R. T. S.; Afifah, E.

2018-03-01

Nursing documentation is clinical information that has a vital role in nursing services. The nursing process includes assessment, diagnosis, intervention, implementation, and evaluation. The purpose of this study was to determine the effects of the application of SIMPRO on the completeness and the efficiency of nursing documentation in the outpatient installation at Dompet Dhuafa Hospital Parung. This study used quantitative method with pre experimental (pre and posttest without control group) design. The mean of the documentation completeness marks before the application of SIMPRO was 1.87 (SD 0.922), and after SIMPRO was applied increased to 3.61 (0.588). This increase indicated an improvement of the nursing documentation completeness after the implementation of SIMPRO. The mean of time needed by nurses in documenting the nursing care before the application of SIMPRO was 476.13 seconds (SD 78.896). The mean of documenting time decreased more than a half after the application of SIMPRO which was 202.52 seconds (SD 196.723). SIMPRO made a nurse easier to take a decision analysis and decision support system to nursing care plan and documentation.

The Effects of a Web-Based Nursing Process Documentation Program on Stress and Anxiety of Nursing Students in South Korea.

PubMed

Lee, Eunjoo; Noh, Hyun Kyung

2016-01-01

To examine the effects of a web-based nursing process documentation system on the stress and anxiety of nursing students during their clinical practice. A quasi-experimental design was employed. The experimental group (n = 110) used a web-based nursing process documentation program for their case reports as part of assignments for a clinical practicum, whereas the control group (n = 106) used traditional paper-based case reports. Stress and anxiety levels were measured with a numeric rating scale before, 2 weeks after, and 4 weeks after using the web-based nursing process documentation program during a clinical practicum. The data were analyzed using descriptive statistics, t tests, chi-square tests, and repeated-measures analyses of variance. Nursing students who used the web-based nursing process documentation program showed significant lower levels of stress and anxiety than the control group. A web-based nursing process documentation program could be used to reduce the stress and anxiety of nursing students during clinical practicum, which ultimately would benefit nursing students by increasing satisfaction with and effectiveness of clinical practicum. © 2015 NANDA International, Inc.

Built Heritage Documentation and Management: AN Integrated Conservation Approach in Bagan

NASA Astrophysics Data System (ADS)

Mezzino, D.; Chan, L.; Santana Quintero, M.; Esponda, M.; Lee, S.; Min, A.; Pwint, M.

2017-08-01

Good practices in heritage conservation are based on accurate information about conditions, materials, and transformation of built heritage sites. Therefore, heritage site documentation and its analysis are essential parts for their conservation. In addition, the devastating effects of recent catastrophic events in different geographical areas have highly affected cultural heritage places. Such areas include and are not limited to South Europe, South East Asia, and Central America. Within this framework, appropriate acquisition of information can effectively provide tools for the decision-making process and management. Heritage documentation is growing in innovation, providing dynamic opportunities for effectively responding to the alarming rate of destruction by natural events, conflicts, and negligence. In line with these considerations, a multidisciplinary team - including students and faculty members from Carleton University and Yangon Technological University, as well as staff from the Department of Archaeology, National Museum and Library (DoA) and professionals from the CyArk foundation - developed a coordinated strategy to document four temples in the site of Bagan (Myanmar). On-field work included capacity-building activities to train local emerging professionals in the heritage field (graduate and undergraduate students from the Yangon Technological University) and to increase the technical knowledge of the local DoA staff in the digital documentation field. Due to the short time of the on-field activity and the need to record several monuments, a variety of documentation techniques, including image and non-image based ones, were used. Afterwards, the information acquired during the fieldwork was processed to develop a solid base for the conservation and monitoring of the four documented temples. The relevance of developing this kind of documentation in Bagan is related to the vulnerability of the site, often affected by natural seismic events and flooding, as well as the lack of maintenance. Bagan provided an excellent case study to test the effectiveness of the proposed approach, to prevent and manage the damages of catastrophic events, and to support retrofitting actions. In order to test the flexibility of adopted methodology and workflow, temples with different features - in terms of architectural design, shape, and geometry - were selected. The goals of these documentation activities range from testing digital documentation workflows for the metric and visual recording of the site (reviewing strengths and limitations of particular recording techniques), to the definition of effective conditions assessment strategies.

Hospital mainframe computer documentation of pharmacist interventions.

PubMed

Schumock, G T; Guenette, A J; Clark, T; McBride, J M

1993-07-01

The hospital mainframe computer pharmacist intervention documentation system described has successfully facilitated the recording, communication, analysis, and reporting of interventions at our hospital. It has proven to be time efficient, accessible, and user-friendly from the standpoint of both the pharmacist and administrator. The advantages of this system greatly outweigh manual documentation and justify the initial time investment in its design and development. In the future, it is hoped that the system can have even broader impact. Intervention/recommendations documented can be made accessible to medical and nursing staff, and as such further increase interdepartmental communication. As pharmacists embrace the pharmaceutical care mandate, documenting interventions in patient care will continue to grow in importance. Complete documentation is essential if pharmacists are to assume responsibility for patient outcomes. With time being an ever-increasing premium, and with economic and human resources dwindling, an efficient and effective means of recording and tracking pharmacist interventions will become imperative for survival in the fiscally challenged health care arena. Documentation of pharmacist intervention using a hospital mainframe computer at UIH has proven both efficient and effective.

29 CFR 11.12 - Content and format of environmental documents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... agency determines that there is a compelling reason to do otherwise, such as more effective communication... documents. (a) An environmental assessment may be prepared in any format considered effective by the agency... 1508.13) may be prepared in any format considered to be effective or necessary by the agency involved...

Calculation of Cost Effectiveness of Emission Control Systems

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Effect of Changing Stack Heights on PSD Modeling and Monitoring

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Western Kentucky Energy and Effect of PM-CEMS on NSR Applicability

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Enhancing Documentation of Pressure Ulcer Prevention Interventions: A Quality Improvement Strategy to Reduce Pressure Ulcers.

PubMed

Jacobson, Therese M; Thompson, Susan L; Halvorson, Anna M; Zeitler, Kristine

2016-01-01

Prevention of hospital-acquired pressure ulcers requires the implementation of evidence-based interventions. A quality improvement project was conducted to provide nurses with data on the frequency with which pressure ulcer prevention interventions were performed as measured by documentation. Documentation reports provided feedback to stakeholders, triggering reminders and reeducation. Intervention reports and modifications to the documentation system were effective both in increasing the documentation of pressure ulcer prevention interventions and in decreasing the number of avoidable hospital-acquired pressure ulcers.

UNAMAP 6 Dispersion Modeling with Building Wake Effects

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

The "Generality" Effect and the Retrieval Evaluation for Large Collections

ERIC Educational Resources Information Center

Salton, Gerard

1972-01-01

The role of the generality effect in retrieval system evaluation is assessed, and evaluation results are given for the comparison of several document collections of distinct size and generality in the areas of documentation and aerodynamics. (14 references) (Author)

Addressing obesity in the management of knee and hip osteoarthritis - weighing in from an economic perspective.

PubMed

Flego, Anna; Dowsey, Michelle M; Choong, Peter F M; Moodie, Marj

2016-05-26

Obesity is one of the only modifiable risk factors for both incidence and progression of Osteoarthritis (OA). So there is increasing interest from a public health perspective in addressing obesity in the management of OA. While evidence of the efficacy of intereventions designed to address obesity in OA populations continues to grow, little is known about their economic credentials. The aim of this study is to conduct a scoping review of: (i) the published economic evidence assessing the economic impact of obesity in OA populations; (ii) economic evaluations of interventions designed to explicitly address obesity in the prevention and management of OA in order to determine which represent value for money. Besides describing the current state of the literature, the study highlights research gaps and identifies future research priorities. In July 2014, a search of the peer reviewed literature, published in English, was undertaken for the period January 1975 - July 2014 using Medline Complete (Ebscohost), Embase, Econlit, Global Health, Health Economics Evaluation Database (HEED), all Cochrane Library databases as well as the grey literature using Google and reference lists of relevant studies. A combination of key search terms was used to identify papers assessing the economic impact of obesity in OA or economic evaluations conducted to assess the efficiency of obesity interventions for the prevention or management of OA. 14 studes were identified; 13 were cost burden studies assessing the impact of obesity as a predictor for higher costs in Total Joint Arthroplasty (TJA) patients and one a cost-effectiveness study of an intervention designed to address obesity in the managment of mild to moderate OA patients. The majority of the economic studies conducted are cost burden studies. While there is some evidence of the association between severe obesity and excess hospital costs for TJA patients, heterogeneity in studies precludes definitive statements about the strength of the association. With only one economic evaluation to inform policy and practice, there is a need for future research into the cost-effectiveness of obesity interventions designed both for prevention or management of OA along the disease spectrum and over the life course.

Effect of Audit Immunity/Privilege Laws on State's Ability to Enforce Title V Requirements

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Automatic system for computer program documentation

NASA Technical Reports Server (NTRS)

Simmons, D. B.; Elliott, R. W.; Arseven, S.; Colunga, D.

1972-01-01

Work done on a project to design an automatic system for computer program documentation aids was made to determine what existing programs could be used effectively to document computer programs. Results of the study are included in the form of an extensive bibliography and working papers on appropriate operating systems, text editors, program editors, data structures, standards, decision tables, flowchart systems, and proprietary documentation aids. The preliminary design for an automated documentation system is also included. An actual program has been documented in detail to demonstrate the types of output that can be produced by the proposed system.

Real-effectiveness medicine--pursuing the best effectiveness in the ordinary care of patients.

PubMed

Malmivaara, Antti

2013-03-01

Clinical know-how and skills as well as up-to-date scientific evidence are cornerstones for providing effective treatment for patients. However, in order to improve the effectiveness of treatment in ordinary practice, also appropriate documentation of care at the health care units and benchmarking based on this documentation are needed. This article presents the new concept of real-effectiveness medicine (REM) which pursues the best effectiveness of patient care in the real-world setting. In order to reach the goal, four layers of information are utilized: 1) good medical know-how and skills combined with the patient view, 2) up-to-date scientific evidence, 3) continuous documentation of performance in ordinary settings, and 4) benchmarking between providers. The new framework is suggested for clinicians, organizations, policy-makers, and researchers.

Degraded document image enhancement

NASA Astrophysics Data System (ADS)

Agam, G.; Bal, G.; Frieder, G.; Frieder, O.

2007-01-01

Poor quality documents are obtained in various situations such as historical document collections, legal archives, security investigations, and documents found in clandestine locations. Such documents are often scanned for automated analysis, further processing, and archiving. Due to the nature of such documents, degraded document images are often hard to read, have low contrast, and are corrupted by various artifacts. We describe a novel approach for the enhancement of such documents based on probabilistic models which increases the contrast, and thus, readability of such documents under various degradations. The enhancement produced by the proposed approach can be viewed under different viewing conditions if desired. The proposed approach was evaluated qualitatively and compared to standard enhancement techniques on a subset of historical documents obtained from the Yad Vashem Holocaust museum. In addition, quantitative performance was evaluated based on synthetically generated data corrupted under various degradation models. Preliminary results demonstrate the effectiveness of the proposed approach.

Gamma radiation effects on physical properties of parchment documents: Assessment of Dmax

NASA Astrophysics Data System (ADS)

Nunes, Inês; Mesquita, Nuno; Cabo Verde, Sandra; João Trigo, Maria; Ferreira, Armando; Manuela Carolino, Maria; Portugal, António; Luísa Botelho, Maria

2012-12-01

Parchments are important documents that give testimony for History; therefore these materials should be respected and preserved. Considering incremental biodeterioration problems that have to be faced daily, the Archive of the University of Coimbra (AUC) is involved in different scientific projects in order to evaluate and determine new methods for document decontamination and preservation. The aim of this study was to evaluate gamma radiation effects on the colour and texture of the AUC parchment documents. The assessment of these effects was used to estimate the maximum gamma radiation dose (Dmax) that could guarantee parchment documents' decontamination treatment, without significant alteration of their physical properties. Parchment samples were exposed to gamma radiation doses ranging from 10 to 30 kGy. The texture and colour of samples were assessed before and after the irradiation procedure, using a texture analyser and an electronic colorimeter. Hardness and springiness were determined based on texture spectra. Lightness (L*), Chroma (C), greenness vs. redness (a*) and yellowness vs. blueness (b*) values were obtained from colorimetric measures. Results indicate no significant effects of gamma radiation on the texture and colour of parchment for the studied doses.

Institutional and economic influences on quality of nursing documentation.

PubMed

Parker, L E; Wells, K B; Buchanan, J L; Benjamin, B

1994-01-01

This study evaluates the quality of nursing documentation within the hospital record for a particularly vulnerable group of patients, the depressed aged. Specifically, the effects of prospective payment, unit type, hospital type, and nurse staffing levels on nursing documentation within hospital charts were assessed.

12 CFR 1209.29 - Discovery.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the timely, cost-effective management of document discovery (including, if applicable, electronically... discovery plan shall specify the form of electronic productions, if any. Documents are to be produced in... proceeding under this part may obtain document discovery by serving upon any other party in the proceeding a...

12 CFR 1209.29 - Discovery.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the timely, cost-effective management of document discovery (including, if applicable, electronically... discovery plan shall specify the form of electronic productions, if any. Documents are to be produced in... proceeding under this part may obtain document discovery by serving upon any other party in the proceeding a...

12 CFR 1209.29 - Discovery.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the timely, cost-effective management of document discovery (including, if applicable, electronically... discovery plan shall specify the form of electronic productions, if any. Documents are to be produced in... proceeding under this part may obtain document discovery by serving upon any other party in the proceeding a...

Documenting Student Competence through Effective Performance Assessment: Employability Skills. Workshop Summary.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Agricultural Curriculum Materials Service.

This report contains 26 performance assessments for documenting student employability skills. Each performance assessment consists of the following: a competency; a terminal performance objective (outcome); competency builders and pupil performance objectives (criteria for documenting mastery of the objective); applied academic competencies;…

Goal-oriented evaluation of binarization algorithms for historical document images

NASA Astrophysics Data System (ADS)

Obafemi-Ajayi, Tayo; Agam, Gady

2013-01-01

Binarization is of significant importance in document analysis systems. It is an essential first step, prior to further stages such as Optical Character Recognition (OCR), document segmentation, or enhancement of readability of the document after some restoration stages. Hence, proper evaluation of binarization methods to verify their effectiveness is of great value to the document analysis community. In this work, we perform a detailed goal-oriented evaluation of image quality assessment of the 18 binarization methods that participated in the DIBCO 2011 competition using the 16 historical document test images used in the contest. We are interested in the image quality assessment of the outputs generated by the different binarization algorithms as well as the OCR performance, where possible. We compare our evaluation of the algorithms based on human perception of quality to the DIBCO evaluation metrics. The results obtained provide an insight into the effectiveness of these methods with respect to human perception of image quality as well as OCR performance.

Air Quality Criteria for Ozone and Other Photochemical Oxidants (1978)

EPA Science Inventory

This document consolidates and assesses current knowledge regarding the origin of ozone and other photochemical oxidants and discusses their effect on health, vegetation, certain ecosystems, and materials. This document summarizes current data on the effects of oxidant/ozone in t...

Assessment of insulin resistance in Chinese PCOS patients with normal glucose tolerance.

PubMed

Gao, Jing; Zhou, Li; Hong, Jie; Chen, Chen

2017-11-01

The study aimed to investigate insulin resistance (IR) status in polycystic ovary syndrome (PCOS) women with normal glucose tolerance (NGT), and further to evaluate feasible diagnostic method for those patients. Three hundred and twenty-five PCOS women with NGT and ninety-five healthy age-matched controls were recruited with Rotterdam criterion and 75 g oral glucose tolerance test (OGTT). IR status was estimated following a glycemic and insulinemic OGTT (0, 30, 60, 120, and 180 min). A modified HOMA-IR formula was applied to each time-course value of glycemia and insulinemia. The predictive performance of each IR index was analyzed with the use of ROC curves. Compared with healthy controls, both non-obese and obese PCOS patients with NGT had a higher BMI, serum glucose, insulin value (p < .05). The best predictive index of IR in non-obese PCOS-NGT was a HOMA-M30 value of 20.36 or more (AUC: 0.753). In obese PCOS-NGT population, the best predictive performance was obtained by a HOMA-M60 value of 32.17 or more (AUC: 0.868). IR was common in Chinese PCOS women with NGT, and the early assessment of IR should be heeded. We recommended HOMA-M30 (Cutoff: 20.36) and HOMA-M60 (Cutoff: 32.17) as the best predictive parameters for non-obese and obese PCOS-NGT patients, respectively.

The Quality of Reporting of Abstracts in Physical Therapy Literature is Suboptimal: Cross-Sectional, Bibliographic Analysis.

PubMed

Richter, Randy R; Sebelski, Chris A; Austin, Tricia M

2016-09-01

The quality of abstract reporting in physical therapy literature is unknown. The purpose of this study was to provide baseline data for judging the future impact of the 2010 Consolidated Standards of Reporting Trials statement specifically referencing the 2008 Consolidated Standards of Reporting Trials statement for reporting of abstracts of randomized controlled trials across and between a broad sample and a core sample of physical therapy literature. A cross-sectional, bibliographic analysis was conducted. Abstracts of randomized controlled trials from 2009 were retrieved from PubMed, PEDro, and CENTRAL. Eligibility was determined using PEDro criteria. For outcomes measures, items from the Consolidated Standards of Reporting Trials statement for abstract reporting were used for assessment. Raters were not blinded to citation details. Using a computer-generated set of random numbers, 150 abstracts from 112 journals comprised the broad sample. A total of 53 abstracts comprised the core sample. Fourteen of 20 Consolidated Standards of Reporting Trials items for both samples were reported in less than 50% of the abstracts. Significantly more abstracts in the core sample reported (% difference core - broad; 95% confidence interval) title (28.4%; 12.9%-41.2%), blinding (15.2%; 1.6%-29.8%), setting (47.6%; 32.4%-59.4%), and confidence intervals (13.1%; 5.0%-25.1%). These findings provide baseline data for determining if continuing efforts to improve abstract reporting are heeded.

Homoaffective parentage--specifically, a matter of medically assisted reproduction: a parallel between Brazil and Portugal.

PubMed

Chaves, Marianna

2011-09-01

In the field of homosexuality an issue still excessively polemical is the one concerning the possibility of paternity or maternity (biological or adoptive) as a right to be exercised by homosexuals. An even more controversial issue is that of homosexuals' access to assisted reproductive techniques. Carrying out an analysis of two countries, Brazil and Portugal face this with opposite approaches in legislation and legal doctrine. In Brazil, the issue is not legislatively regulated. In Portugal, there is regulatory law. The question that arises is: what is better an extremely reductive and discriminatory law or a true legal vacuum? Several questions may be raised in this context. The first one is: is there indeed a right to parenthood? What to say about surrogacy? In these cases is the commandment of the child's best interest being heeded, which is the vector for any decision relating to an infant or teenager? Differences of understanding will always exist, especially in such a sensitive field as Family Law. But one fact must be accepted: any resolution and legislation in this context must be based on the principle of the best interests of the - born or unborn - child and other constitutional principles as equality, freedom, non-discrimination and human dignity, forgetting the prejudice rooted in society and the unfounded conjectures of homophobic judgments.

The chemical stability and sterility of sodium thiopental after preparation.

PubMed

Haws, J L; Herman, N; Clark, Y; Bjoraker, R; Jones, D

1998-01-01

Manufacturer's instructions recommend discarding unused portions of sodium thiopental 24 h after reconstitution. Heeding this recommendation may result in the disposal of a large proportion of prepared thiopental. Although thiopental is relatively inexpensive, the volume prepared by many anesthesia departments could make this waste significant. To address this possibility, we investigated the chemical stability and sterility of thiopental in pharmacy-prepared, prefilled syringes. Stock solutions of thiopental were mixed and drawn into syringes under sterile conditions by pharmacists or pharmacy assistants. Fifty-six samples were stored under refrigeration (3 degrees C); the remaining 56 samples were stored at room temperature (22 degrees C). Each day for 7 days, eight samples from each group were analyzed by using high-performance liquid chromatography for chemical stability and cultured for microbiological colonization. Differences in thiopental concentration between the room temperature and the refrigerated samples were measured over time by using repeated-measures analysis of variance (P < or = 0.05). Three positive culture samples (S. epidermidis and S. hemolyticus) most likely represent laboratory contamination and not colonization. At 22 degrees C, thiopental remains stable and sterile for 6 days and well beyond 7 days at 3 degrees C. This study examines the shelf life of the anesthetic drug thiopental in pharmacy-filled syringes stored at either room temperature or under refrigeration. The results justify the use of prepared solutions beyond the package insert recommendation of 24 h.

The efficacy of a modified Theory of Reasoned Action to explain gambling behavior in college students.

PubMed

Thrasher, Robert G; Andrew, Damon P S; Mahony, Daniel F

2011-09-01

Recently, Thrasher et al. (College Student Affairs Journal 27(1): 57-75, 2007) explored the efficacy of the Theory of Reasoned Action (TRA; Ajzen and Fishbein, Attitudes, personality, and behavior, 1980) in explaining gambling behavior of college students. However, their study found the TRA only predicted small amounts of variance in gambling intentions. Heeding their call to enhance the efficacy of the TRA through the addition of explanatory variables to the model, the present study incorporated gambling motivations and locus of control as moderating variables within the TRA to test the potential of a modified TRA in explaining gambling behavior of college students. A total of 345 students at a major metropolitan research university in the Midwest volunteered to participate in the study. A series of hierarchical linear regressions indicated intrinsic motivation to accomplish (p = .002) significantly moderated the relationship between gambling attitudes and gambling intentions. Further, internal locus of control (p < .001), chance locus of control (p < .001), and powerful others locus of control (p < .001) also significantly moderated the relationship between gambling attitudes and gambling intentions. The significant impact of the moderating variables on the relationship between gambling attitudes and intentions suggests intrinsic motivation and locus of control can alter the impact of the relationship between gambling attitudes and gambling intentions.

Building a sense of virtual community: the role of the features of social networking sites.

PubMed

Chen, Chi-Wen; Lin, Chiun-Sin

2014-07-01

In recent years, social networking sites have received increased attention because of the potential of this medium to transform business by building virtual communities. However, theoretical and empirical studies investigating how specific features of social networking sites contribute to building a sense of virtual community (SOVC)-an important dimension of a successful virtual community-are rare. Furthermore, SOVC scales have been developed, and research on this issue has been called for, but few studies have heeded this call. On the basis of prior literature, this study proposes that perceptions of the three most salient features of social networking sites-system quality (SQ), information quality (IQ), and social information exchange (SIE)-play a key role in fostering SOVC. In particular, SQ is proposed to increase IQ and SIE, and SIE is proposed to enhance IQ, both of which thereafter build SOVC. The research model was examined in the context of Facebook, one of the most popular social networking sites in the world. We adopted Blanchard's scales to measure SOVC. Data gathered using a Web-based questionnaire, and analyzed with partial least squares, were utilized to test the model. The results demonstrate that SIE, SQ, and IQ are the factors that form SOVC. The findings also suggest that SQ plays a fundamental role in supporting SIE and IQ in social networking sites. Implications for theory, practice, and future research directions are discussed.

Gulf War Syndrome: a review of current knowledge and understanding.

PubMed

Minshall, D

2014-01-01

The 1991 Persian Gulf War was a resounding military success for coalition forces, who liberated Kuwait following the Iraqi invasion. The medical legacy we have from the conflict is the poorly understood, yet remarkable, phenomenon of Gulf War Syndrome, which surfaced soon after. Epidemiological research has proven beyond doubt that Gulf War veterans report a wide variety of symptoms, in excess of appropriately matched control subjects, and experience worse general health. Numerous toxic environmental hazards have been suggested as causes of Gulf War Syndrome, yet exhaustive scientific study has failed to provide conclusive proof of any link. No novel or recognised disease has been found to account for the symptomatic burden of veterans, and the optimal treatment remains uncertain. This understanding can be added to from an anthropological perspective, where the narratives of those afflicted provide further insight. The nature of military life was changing at the time of the Gulf War, challenging the identity and beliefs of some veterans and causing socio-cultural distress. The symptomatic presentation of Gulf War Syndrome can be considered an articulation of this disharmony. Gulf War Syndrome can also be considered within the group of post-combat disorders such as shellshock, the like of which have occurred after major wars in the last century. With the current withdrawal from Afghanistan, the Defence Medical Services (DMS) should heed the lessons of history.

Towards defining the role of glycans as hardware in information storage and transfer: basic principles, experimental approaches and recent progress.

PubMed

Solís, D; Jiménez-Barbero, J; Kaltner, H; Romero, A; Siebert, H C; von der Lieth, C W; Gabius, H J

2001-01-01

The term 'code' in biological information transfer appears to be tightly and hitherto exclusively connected with the genetic code based on nucleotides and translated into functional activities via proteins. However, the recent appreciation of the enormous coding capacity of oligosaccharide chains of natural glycoconjugates has spurred to give heed to a new concept: versatile glycan assembly by the genetically encoded glycosyltransferases endows cells with a probably not yet fully catalogued array of meaningful messages. Enciphered by sugar receptors such as endogenous lectins the information of code words established by a series of covalently linked monosaccharides as letters for example guides correct intra- and intercellular routing of glycoproteins, modulates cell proliferation or migration and mediates cell adhesion. Evidently, the elucidation of the structural frameworks and the recognition strategies within the operation of the sugar code poses a fascinating conundrum. The far-reaching impact of this recognition mode on the level of cells, tissues and organs has fueled vigorous investigations to probe the subtleties of protein-carbohydrate interactions. This review presents information on the necessarily concerted approach using X-ray crystallography, molecular modeling, nuclear magnetic resonance spectroscopy, thermodynamic analysis and engineered ligands and receptors. This part of the treatise is flanked by exemplarily chosen insights made possible by these techniques. Copyright 2001 S. Karger AG, Basel

Childbirth and Trauma, 1940s-1980s.

PubMed

Michaels, Paula A

2018-01-01

This article analyzes trauma in mid-twentieth century hospital births, focusing on the United States, but with additional evidence drawn from Great Britain and France. As many as half of women today experience childbirth as traumatic and no evidence suggests that the figure was lower a half-century ago. Drawing on women's birth narratives and psychiatric literature, this article highlights the striking consistency over time in how women describe their experiences of traumatic birth. By the 1970s, however, women proved less ready to accept their trauma as the product of their own psychological shortcomings. Under the sway of second-wave feminism, they pushed back against care they defined as inhumane in both conventional maternity care and in natural childbirth. Psychiatry too demonstrates change over time. Hegemonic at midcentury, Freudian thinking began to yield to critiques that questioned gender norms and the preeminence of the subconscious. Based on private letters to maternity caregivers and between physicians, as well as a wide array of medical journal articles, popular magazines, and newsletters from childbirth education and birth advocacy organizations, this article argues that, despite different approaches to trauma in birth and clarity about how best to minimize it, contemporary maternity care has to date proven unable to heed the lessons of history. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Commercial space development needs cheap launchers

NASA Astrophysics Data System (ADS)

Benson, James William

1998-01-01

SpaceDev is in the market for a deep space launch, and we are not going to pay $50 million for it. There is an ongoing debate about the elasticity of demand related to launch costs. On the one hand there are the ``big iron'' NASA and DoD contractors who say that there is no market for small or inexpensive launchers, that lowering launch costs will not result in significantly more launches, and that the current uncompetitive pricing scheme is appropriate. On the other hand are commercial companies which compete in the real world, and who say that there would be innumerable new launches if prices were to drop dramatically. I participated directly in the microcomputer revolution, and saw first hand what happened to the big iron computer companies who failed to see or heed the handwriting on the wall. We are at the same stage in the space access revolution that personal computers were in the late '70s and early '80s. The global economy is about to be changed in ways that are just as unpredictable as those changes wrought after the introduction of the personal computer. Companies which fail to innovate and keep producing only big iron will suffer the same fate as IBM and all the now-extinct mainframe and minicomputer companies. A few will remain, but with a small share of the market, never again to be in a position to dominate.

The relation between driving experience and recognition of road signs relative to their locations.

PubMed

Borowsky, Avinoam; Shinar, David; Parmet, Yisrael

2008-04-01

Examine how driving experience and expectations affect the ability of experienced drivers to identify traffic signs--specifically, no right turn (NRT) and no left turn (NLT) at intersections. Failure to heed signs is a frequent cause of accidents, and the authors focused on the contributions of experience and expectancy to sign identification. Inexperienced and experienced drivers were connected to an eye tracker system and briefly exposed to various traffic scenes. Some of the pictures included an NRT sign at the expected location (on the right), and some included the same sign at an unexpected location (on the left). The same procedure was used with an NLT traffic sign. Experienced drivers identified traffic signs better than inexperienced drivers did when the signs were posted at the expected location but identified them worse than did inexperienced drivers when they were at unexpected locations. With experience, drivers' expectations regarding the expected location of traffic signs become so strong that violating these expectancies results in more identification errors among experienced drivers than among inexperienced drivers. To optimize experienced drivers' traffic sign identification, signs must be located in accordance with drivers' expectations--specifically, on the right side of the road. When signs are misplaced, crashes can be caused by inappropriate placement rather than inappropriate driving. Highway designers should ensure that their design conforms to standards that shape experienced drivers' expectations.

Social media in disaster risk reduction and crisis management.

PubMed

Alexander, David E

2014-09-01

This paper reviews the actual and potential use of social media in emergency, disaster and crisis situations. This is a field that has generated intense interest. It is characterised by a burgeoning but small and very recent literature. In the emergencies field, social media (blogs, messaging, sites such as Facebook, wikis and so on) are used in seven different ways: listening to public debate, monitoring situations, extending emergency response and management, crowd-sourcing and collaborative development, creating social cohesion, furthering causes (including charitable donation) and enhancing research. Appreciation of the positive side of social media is balanced by their potential for negative developments, such as disseminating rumours, undermining authority and promoting terrorist acts. This leads to an examination of the ethics of social media usage in crisis situations. Despite some clearly identifiable risks, for example regarding the violation of privacy, it appears that public consensus on ethics will tend to override unscrupulous attempts to subvert the media. Moreover, social media are a robust means of exposing corruption and malpractice. In synthesis, the widespread adoption and use of social media by members of the public throughout the world heralds a new age in which it is imperative that emergency managers adapt their working practices to the challenge and potential of this development. At the same time, they must heed the ethical warnings and ensure that social media are not abused or misused when crises and emergencies occur.

Media Effects on Ethnic Identity among Linguistic Majorities and Minorities: A Longitudinal Study of a Bilingual Setting

ERIC Educational Resources Information Center

Clement, Richard; Baker, Susan C.; Josephson, Gordon; Noels, Kimberly A.

2005-01-01

Research on media effects has documented the media's influence on beliefs and behavior while cross-cultural psychology has documented the effects of the language used in communication on identification with the ingroup and the outgroup. Media usage in the outgroup language should, therefore, affect identification patterns. This research…

3 CFR - Maximizing the Effectiveness of Federal Programs and Functions Supporting Trade and Investment

Code of Federal Regulations, 2013 CFR

2013-01-01

... 3 The President 1 2013-01-01 2013-01-01 false Maximizing the Effectiveness of Federal Programs and Functions Supporting Trade and Investment Presidential Documents Other Presidential Documents Memorandum of February 17, 2012 Maximizing the Effectiveness of Federal Programs and Functions Supporting Trade and Investment Memorandum for the Heads of...

76 FR 35619 - Labeling and Effectiveness Testing; Sunscreen Drug Products for Over-the-Counter Human Use

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

...The Food and Drug Administration (FDA) is issuing this document to address labeling and effectiveness testing for certain over-the counter (OTC) sunscreen products containing specified active ingredients and marketed without approved applications. This document addresses labeling and effectiveness testing issues raised by the nearly 2,900 submissions that we received in response to the sunscreen proposed rule of August 27, 2007 (2007 proposed rule). The document also identifies specific claims that render a product that is subject to this rule misbranded or would not be allowed on any OTC sunscreen product marketed without an approved application. The document does not address issues related to sunscreen active ingredients or certain other issues regarding the GRASE determination for sunscreen products. The document requires OTC sunscreen products to comply with the content and format requirements for OTC drug labeling contained in the 1999 Drug Facts final rule (published in the Federal Register of March 17, 1999, by lifting the delay of implementation date for that rule that we published on September 3, 2004).

Menthol's potential effects on nicotine dependence: a tobacco industry perspective.

PubMed

Yerger, Valerie B

2011-05-01

To examine what the tobacco industry knows about the potential effects menthol may have on nicotine dependence. A snowball strategy was used to systematically search the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu/) between 22 February and 29 April, 2010. Of the approximately 11 million documents available in the Legacy Tobacco Documents Library, the iterative searches returned tens of thousands of results. We qualitatively analysed a final collection of 309 documents relevant the effects of menthol on nicotine dependence. The tobacco industry knows that menthol overrides the harsh taste of tobacco and alleviates nicotine's irritating effects, synergistically interacts with nicotine, stimulates the trigeminal nerve to elicit a 'liking' response for a tobacco product, and makes low tar, low nicotine tobacco products more acceptable to smokers than non-mentholated low delivery products. Menthol is not only used in cigarettes as a flavour additive; tobacco companies know that menthol also has sensory effects and interacts with nicotine to produce tobacco products that are easier to smoke, thereby making it easier to expose smokers, especially those who are new and uninitiated, to the addictive power of nicotine.

Optical benchmarking of security document readers for automated border control

NASA Astrophysics Data System (ADS)

Valentín, Kristián.; Wild, Peter; Å tolc, Svorad; Daubner, Franz; Clabian, Markus

2016-10-01

Authentication and optical verification of travel documents upon crossing borders is of utmost importance for national security. Understanding the workflow and different approaches to ICAO 9303 travel document scanning in passport readers, as well as highlighting normalization issues and designing new methods to achieve better harmonization across inspection devices are key steps for the development of more effective and efficient next- generation passport inspection. This paper presents a survey of state-of-the-art document inspection systems, showcasing results of a document reader challenge investigating 9 devices with regards to optical characteristics.

Contracts, covenants and advance care planning: an empirical study of the moral obligations of patient and proxy.

PubMed

Fins, Joseph J; Maltby, Barbara S; Friedmann, Erika; Greene, Michele G; Norris, Kaye; Adelman, Ronald; Byock, Ira

2005-01-01

Previously we had speculated that the patient-proxy relationship existed on a contractual to covenantal continuum. In order to assess this hypothesis, and to better understand the moral obligations of the patient-proxy relationship, we surveyed 50 patient-proxy pairs as well as 52 individuals who had acted as proxies for someone who had died. Using structured vignettes representative of three distinct disease trajectories (cancer, acute stroke, and congestive heart failure), we assessed whether respondents believed that proxies should follow explicit instructions regarding life-sustaining therapy and act contractually or whether more discretionary or covenantal judgments were ethically permissible. Additional variables included the valence of initial patient instructions--for example, "to do nothing" or "to do everything"--as well as the quality of information available to the proxy. Responses were graded on a contractual to covenantal continuum using a modified Likert scale employing a prospectively scored survey instrument. Our data indicate that the patient-proxy relationship exists on a contractual to covenantal continuum and that variables such as disease trajectory, the clarity of prognosis, instructional valence, and the quality of patient instructions result in statistically significant differences in response. The use of interpretative or covenantal judgment was desired by patients and proxies when the prognosis was grim, even if initial instructions were to pursue more aggressive care. Nonetheless, there was a valence effect: patients and proxies intended that negative instructions to be left alone be heeded. These data suggest that the delegation of patient self-determination is morally complex. Advance care planning should take into account both the exercise of autonomy and the interpretative burdens assumed by the proxy. Patients and proxies think inductively and contextually. Neither group viewed deviation from patient instructions as a violation of the principal's autonomy. Instead of adhering to narrow notions of patient self-determination, respondents made nuanced and contextually informed moral judgments. These findings have implications for patient education as well as the legal norms that guide advance care planning.

Improving cardiometabolic and mental health in women with gestational diabetes mellitus and their offspring: study protocol for MySweetHeart Trial, a randomised controlled trial

PubMed Central

Horsch, Antje; Gilbert, Leah; Lanzi, Stefano; Gross, Justine; Kayser, Bengt; Vial, Yvan; Simeoni, Umberto; Hans, Didier; Berney, Alexandre; Scholz, Urte; Barakat, Ruben; Puder, Jardena J

2018-01-01

Introduction Gestational diabetes mellitus (GDM) carries prenatal and perinatal risk for the mother and her offspring as well as longer-term risks for both the mother (obesity, diabetes, cardiovascular disease) and her child (obesity, type 2 diabetes). Compared with women without GDM, women with GDM are twice as likely to develop perinatal or postpartum depression. Lifestyle interventions for GDM are generally limited to physical activity and/or nutrition, often focus separately on the mother or the child and take place either during or after pregnancy, while their results are inconsistent. To increase efficacy of intervention, the multifactorial origins of GDM and the tight link between mental and metabolic as well as maternal and child health need to be heeded. This calls for an interdisciplinary transgenerational approach starting in, but continuing beyond pregnancy. Methods and analysis This randomised controlled trial will assess the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention aimed at improving the metabolic and mental health of 200 women with GDM and their offspring. Women with GDM at 24–32 weeks gestational age who understand French or English, and their offspring and partners can participate. The intervention components will be delivered on top of usual care during pregnancy and the first year postpartum. Metabolic and mental health outcomes will be measured at 24–32 weeks of pregnancy, shortly after birth and at 6–8 weeks and 1 year after childbirth. Data will be analysed using intention-to-treat analyses. The MySweetHeart Trial is linked to the MySweetHeart Cohort (clinicaltrials.gov/ct2/show/NCT02872974). Ethics and dissemination We will disseminate the findings through regional, national and international conferences and through peer-reviewed journals. Trial registration number NCT02890693; Pre-results. PMID:29487077

Improving cardiometabolic and mental health in women with gestational diabetes mellitus and their offspring: study protocol for MySweetHeart Trial, a randomised controlled trial.

PubMed

Horsch, Antje; Gilbert, Leah; Lanzi, Stefano; Gross, Justine; Kayser, Bengt; Vial, Yvan; Simeoni, Umberto; Hans, Didier; Berney, Alexandre; Scholz, Urte; Barakat, Ruben; Puder, Jardena J

2018-02-27

Gestational diabetes mellitus (GDM) carries prenatal and perinatal risk for the mother and her offspring as well as longer-term risks for both the mother (obesity, diabetes, cardiovascular disease) and her child (obesity, type 2 diabetes). Compared with women without GDM, women with GDM are twice as likely to develop perinatal or postpartum depression. Lifestyle interventions for GDM are generally limited to physical activity and/or nutrition, often focus separately on the mother or the child and take place either during or after pregnancy, while their results are inconsistent. To increase efficacy of intervention, the multifactorial origins of GDM and the tight link between mental and metabolic as well as maternal and child health need to be heeded. This calls for an interdisciplinary transgenerational approach starting in, but continuing beyond pregnancy. This randomised controlled trial will assess the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention aimed at improving the metabolic and mental health of 200 women with GDM and their offspring. Women with GDM at 24-32 weeks gestational age who understand French or English, and their offspring and partners can participate. The intervention components will be delivered on top of usual care during pregnancy and the first year postpartum. Metabolic and mental health outcomes will be measured at 24-32 weeks of pregnancy, shortly after birth and at 6-8 weeks and 1 year after childbirth. Data will be analysed using intention-to-treat analyses. The MySweetHeart Trial is linked to the MySweetHeart Cohort (clinicaltrials.gov/ct2/show/NCT02872974). We will disseminate the findings through regional, national and international conferences and through peer-reviewed journals. NCT02890693; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Obstetric performance of ethnic Kosovo Albanian asylum seekers in London: a case-control study.

PubMed

Yoong, W; Wagley, A; Fong, C; Chukwuma, C; Nauta, M

2004-08-01

The most recent Confidential Enquiry into Maternal Deaths expressed concern that mortality in women from non-English-speaking ethnic groups was twice that of native-born women. There are very few published data on the obstetric performance of Kosovo Albanian refugees who have relocated to the United Kingdom and the aim of this study was to compare the obstetric performances of Kosovo Albanian women currently residing in the United Kingdom with their British-born Caucasian counterparts. Sixty-one index and 61 control cases were analysed; 63% of the Kosovo Albanian women spoke little or no English and 50% were on income support. Of the study group, 9.8% had caesarean sections, 8.2% had instrumental vaginal deliveries and 82% achieved normal deliveries. The Kosovo Albanian women were statistically younger and had shorter duration of labour compared to controls (P < 0.05, unpaired t-test). Epidural use was significantly lower in Kosovan women (P < 0.05, chi2 test). The rates of induction of labour (IOL), caesarean section, instrumental deliveries, premature delivery and low birth weight < 2.5 kg were not statistically different (P > 0.05 in all cases, chi2 test) between the two groups. This is the first study to examine the obstetric outcomes of Kosovo Albanian women who have resettled in a western European country. Most Kosovo Albanian refugees living in the United Kingdom are not socio-economic migrants but displaced due to civil unrest and many had reasonable socio-economic status prior to resettlement. The similarity in obstetric and fetal outcomes between the study and control groups could be attributed to the 'healthy immigrant effect', where immigrant groups appear to have better outcomes due to family support and relatively lower intake of alcohol and nicotine. It also suggests that obstetricians may be heeding the recommendations from recent Confidential Enquiry into Maternal Deaths, which highlight the need for increased vigilance in women from ethnic minorities.

45 CFR 164.316 - Policies and procedures and documentation requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) of this section for 6 years from the date of its creation or the date when it last was in effect... for implementing the procedures to which the documentation pertains. (iii) Updates (Required). Review documentation periodically, and update as needed, in response to environmental or operational changes affecting...

Using Design Principles to Teach Technical Communication.

ERIC Educational Resources Information Center

Markel, Mike

1995-01-01

Compares the writing of two students--a competent writer and a weak one--in a technical communication course before and after discussion of design principles. Finds that a basic understanding of design principles helped them improve document macrostructure but had little effect on document microstructure. Suggests that integrating document design…

A Document Analysis of Teacher Evaluation Systems Specific to Physical Education

ERIC Educational Resources Information Center

Norris, Jason M.; van der Mars, Hans; Kulinna, Pamela; Kwon, Jayoun; Amrein-Beardsley, Audrey

2017-01-01

Purpose: The purpose of this document analysis study was to examine current teacher evaluation systems, understand current practices, and determine whether the instrumentation is a valid measure of teaching quality as reflected in teacher behavior and effectiveness specific to physical education (PE). Method: An interpretive document analysis…

Utilizing the Structure and Content Information for XML Document Clustering

NASA Astrophysics Data System (ADS)

Tran, Tien; Kutty, Sangeetha; Nayak, Richi

This paper reports on the experiments and results of a clustering approach used in the INEX 2008 document mining challenge. The clustering approach utilizes both the structure and content information of the Wikipedia XML document collection. A latent semantic kernel (LSK) is used to measure the semantic similarity between XML documents based on their content features. The construction of a latent semantic kernel involves the computing of singular vector decomposition (SVD). On a large feature space matrix, the computation of SVD is very expensive in terms of time and memory requirements. Thus in this clustering approach, the dimension of the document space of a term-document matrix is reduced before performing SVD. The document space reduction is based on the common structural information of the Wikipedia XML document collection. The proposed clustering approach has shown to be effective on the Wikipedia collection in the INEX 2008 document mining challenge.

SDDL- SOFTWARE DESIGN AND DOCUMENTATION LANGUAGE

NASA Technical Reports Server (NTRS)

Kleine, H.

1994-01-01

Effective, efficient communication is an essential element of the software development process. The Software Design and Documentation Language (SDDL) provides an effective communication medium to support the design and documentation of complex software applications. SDDL supports communication between all the members of a software design team and provides for the production of informative documentation on the design effort. Even when an entire development task is performed by a single individual, it is important to explicitly express and document communication between the various aspects of the design effort including concept development, program specification, program development, and program maintenance. SDDL ensures that accurate documentation will be available throughout the entire software life cycle. SDDL offers an extremely valuable capability for the design and documentation of complex programming efforts ranging from scientific and engineering applications to data management and business sytems. Throughout the development of a software design, the SDDL generated Software Design Document always represents the definitive word on the current status of the ongoing, dynamic design development process. The document is easily updated and readily accessible in a familiar, informative form to all members of the development team. This makes the Software Design Document an effective instrument for reconciling misunderstandings and disagreements in the development of design specifications, engineering support concepts, and the software design itself. Using the SDDL generated document to analyze the design makes it possible to eliminate many errors that might not be detected until coding and testing is attempted. As a project management aid, the Software Design Document is useful for monitoring progress and for recording task responsibilities. SDDL is a combination of language, processor, and methodology. The SDDL syntax consists of keywords to invoke design structures and a collection of directives which control processor actions. The designer has complete control over the choice of keywords, commanding the capabilities of the processor in a way which is best suited to communicating the intent of the design. The SDDL processor translates the designer's creative thinking into an effective document for communication. The processor performs as many automatic functions as possible, thereby freeing the designer's energy for the creative effort. Document formatting includes graphical highlighting of structure logic, accentuation of structure escapes and module invocations, logic error detection, and special handling of title pages and text segments. The SDDL generated document contains software design summary information including module invocation hierarchy, module cross reference, and cross reference tables of user selected words or phrases appearing in the document. The basic forms of the methodology are module and block structures and the module invocation statement. A design is stated in terms of modules that represent problem abstractions which are complete and independent enough to be treated as separate problem entities. Blocks are lower-level structures used to build the modules. Both kinds of structures may have an initiator part, a terminator part, an escape segment, or a substructure. The SDDL processor is written in PASCAL for batch execution on a DEC VAX series computer under VMS. SDDL was developed in 1981 and last updated in 1984.

Object-Oriented Approach for 3d Archaeological Documentation

NASA Astrophysics Data System (ADS)

Valente, R.; Brumana, R.; Oreni, D.; Banfi, F.; Barazzetti, L.; Previtali, M.

2017-08-01

Documentation on archaeological fieldworks needs to be accurate and time-effective. Many features unveiled during excavations can be recorded just once, since the archaeological workflow physically removes most of the stratigraphic elements. Some of them have peculiar characteristics which make them hardly recognizable as objects and prevent a full 3D documentation. The paper presents a suitable feature-based method to carry on archaeological documentation with a three-dimensional approach, tested on the archaeological site of S. Calocero in Albenga (Italy). The method is based on one hand on the use of structure from motion techniques for on-site recording and 3D Modelling to represent the three-dimensional complexity of stratigraphy. The entire documentation workflow is carried out through digital tools, assuring better accuracy and interoperability. Outputs can be used in GIS to perform spatial analysis; moreover, a more effective dissemination of fieldworks results can be assured with the spreading of datasets and other information through web-services.

Documenting the Assessment of Institutional Effectiveness at Community Colleges in Ohio

ERIC Educational Resources Information Center

Zahler, Megan M.

2013-01-01

The community college of today confronts decreased state funding, increased demand, and increased calls for accountability. In this highly competitive environment, community colleges are required to document the assessment of institutional effectiveness to satisfy state accountability systems and regional accreditation standards. The purpose of…

Effective Learning in Non-Formal Education. Program of Studies in Non-Formal Education. Team Reports.

ERIC Educational Resources Information Center

Ward, Ted W.; Herzog, William A., Jr.

This document is part of a series dealing with nonformal education. Introductory information is included in document SO 008 058. The focus of this report is on the learning effectiveness of nonformal education. Chapter 1 compares effective learning in a formal and nonformal environment. Chapter 2 develops a systems model for designers of learning…

Multiple Factors in the Long-Term Effectiveness of Contingent Electric Shock Treatment for Self-Injurious Behavior: A Case Example.

ERIC Educational Resources Information Center

Linscheid, Thomas R.; Reichenbach, Heidi

2002-01-01

Data are presented to document the initial dramatic reduction in self-injurious behavior and the ongoing effectiveness of contingent electric shock treatment of an adolescent. Positive effects of the intervention are documented, as is information on the interaction of a medical condition, psychoactive mediation status, and staff changes. (Contains…

Analysis of Documentation Speed Using Web-Based Medical Speech Recognition Technology: Randomized Controlled Trial.

PubMed

Vogel, Markus; Kaisers, Wolfgang; Wassmuth, Ralf; Mayatepek, Ertan

2015-11-03

Clinical documentation has undergone a change due to the usage of electronic health records. The core element is to capture clinical findings and document therapy electronically. Health care personnel spend a significant portion of their time on the computer. Alternatives to self-typing, such as speech recognition, are currently believed to increase documentation efficiency and quality, as well as satisfaction of health professionals while accomplishing clinical documentation, but few studies in this area have been published to date. This study describes the effects of using a Web-based medical speech recognition system for clinical documentation in a university hospital on (1) documentation speed, (2) document length, and (3) physician satisfaction. Reports of 28 physicians were randomized to be created with (intervention) or without (control) the assistance of a Web-based system of medical automatic speech recognition (ASR) in the German language. The documentation was entered into a browser's text area and the time to complete the documentation including all necessary corrections, correction effort, number of characters, and mood of participant were stored in a database. The underlying time comprised text entering, text correction, and finalization of the documentation event. Participants self-assessed their moods on a scale of 1-3 (1=good, 2=moderate, 3=bad). Statistical analysis was done using permutation tests. The number of clinical reports eligible for further analysis stood at 1455. Out of 1455 reports, 718 (49.35%) were assisted by ASR and 737 (50.65%) were not assisted by ASR. Average documentation speed without ASR was 173 (SD 101) characters per minute, while it was 217 (SD 120) characters per minute using ASR. The overall increase in documentation speed through Web-based ASR assistance was 26% (P=.04). Participants documented an average of 356 (SD 388) characters per report when not assisted by ASR and 649 (SD 561) characters per report when assisted by ASR. Participants' average mood rating was 1.3 (SD 0.6) using ASR assistance compared to 1.6 (SD 0.7) without ASR assistance (P<.001). We conclude that medical documentation with the assistance of Web-based speech recognition leads to an increase in documentation speed, document length, and participant mood when compared to self-typing. Speech recognition is a meaningful and effective tool for the clinical documentation process.

Consensus of recommendations guiding comparative effectiveness research methods.

PubMed

Morton, Jacob B; McConeghy, Robert; Heinrich, Kirstin; Gatto, Nicolle M; Caffrey, Aisling R

2016-12-01

Because of an increasing demand for quality comparative effectiveness research (CER), methods guidance documents have been published, such as those from the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI). Our objective was to identify CER methods guidance documents and compare them to produce a summary of important recommendations which could serve as a consensus of CER method recommendations. We conducted a systematic literature review to identify CER methods guidance documents published through 2014. Identified documents were analyzed for methods guidance recommendations. Individual recommendations were categorized to determine the degree of overlap. We identified nine methods guidance documents, which contained a total of 312 recommendations, 97% of which were present in two or more documents. All nine documents recommended transparency and adaptation for relevant stakeholders in the interpretation and dissemination of results. Other frequently shared CER methods recommendations included: study design and operational definitions should be developed a priori and allow for replication (n = 8 documents); focus on areas with gaps in current clinical knowledge that are relevant to decision-makers (n = 7); validity of measures, instruments, and data should be assessed and discussed (n = 7); outcomes, including benefits and harms, should be clinically meaningful, and objectively measured (n = 7). Assessment for and strategies to minimize bias (n = 6 documents), confounding (n = 6), and heterogeneity (n = 4) were also commonly shared recommendations between documents. We offer a field-consensus guide based on nine CER methods guidance documents that will aid researchers in designing CER studies and applying CER methods. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Lifetime health outcomes of breast-feeding: a comparison of the policy documents of five European countries.

PubMed

Martin-Bautista, Elena; Gage, Heather; von Rosen-von Hoewel, Julia; Jakobik, Viktoria; Laitinen, Kirsi; Schmid, Martina; Morgan, Jane; Williams, Peter; Decsi, Tamas; Campoy, Cristina; Koletzko, Berthold; Raats, Monique

2010-10-01

To (i) identify and describe prevailing infant feeding policy documents in five diverse European countries; (ii) analyse types of health outcomes for the infant that are associated with feeding breast milk rather than formula milk in the documents of different countries; and (iii) assess the extent to which documents reflect the WHO global recommendation of exclusive breast-feeding for 6 months. Documentary review and analysis. Five geographically dispersed countries of Europe (England, Finland, Germany, Hungary and Spain). Policy documents on infant feeding were identified; statements that linked choice between breast- and formula-feeding to a health outcome for the infant were extracted. Twenty-six documents (varied authorships, dates, length and character) were identified: four from England; two from Finland; nine from Germany; six from Hungary; and five from Spain. There was no consistency in the way in which health outcomes were cited as factors in the recommendations for breast- rather than formula-feeding. Seven documents contained no reference to the health implications of infant feeding choice. Of 203 statements in remaining documents citing health outcomes, 24.1 % mentioned general health effects, 32.5 % protection against infections, 31.5 % long-term conditions (e.g. diabetes, CVD) and 11.8 % mentioned allergy. Health outcomes were linked to exclusive breast-feeding in only 25 % of statements. Policy documents in the study countries varied in the extent to which they reflect the health outcomes for the baby of breast-feeding, and this may limit effective promotion by health professionals. There is scope to improve the process of bringing evidence and recommendations into policy documents.

Approach for Estimating Exposures and Incremental Health Effects from Lead During Renovation, Repair, and Painting Activities in Public and Commercial Buildings

EPA Science Inventory

Approach for Estimating Exposures and Incremental Health Effects from Lead During Renovation, Repair, and Painting Activities in Public and Commercial Buildings” (Technical Approach Document). Also available for public review and comment are two supplementary documents: the detai...

Approach for Estimating Exposures and Incremental Health Effects from Lead Due to Renovation Repair and Painting Activities in Public and Commercial Buildings

EPA Pesticide Factsheets

Approach for Estimating Exposures and Incremental Health Effects from Lead Due to Renovation Repair and Painting Activities in Public and Commercial Buildings: links to documents at www.regulations.gov, links to PDFs related to Approach document

A Business Plan Outline.

ERIC Educational Resources Information Center

Kirchner, Charles, Ed.

This document identifies the information that should be included in a business plan, and in what order, to make it an effective management tool and an effective tool to communicate a proposed or existing company's strengths and potential to potential financiers. Following an introduction, the document explains the following sections of a business…

Effects of Federal Regulation on the Financial Structure and Performance of the Domestic Motor Vehicle Manufacturers (Source Document)

DOT National Transportation Integrated Search

1978-11-01

PURPOSE OF THE STUDY : The increasing government regulation of automative transportation : industries in the United States has produced the need for : financial and economic studies of the effects of such policies. : The purpose of this document is t...

Continuous Improvement in Online Education: Documenting Teaching Effectiveness in the Online Environment through Observations

ERIC Educational Resources Information Center

Purcell, Jennifer W.; Scott, Heather I.; Mixson-Brookshire, Deborah

2017-01-01

Teaching observations are commonly used among educators to document and improve teaching effectiveness. Unfortunately, the necessary protocols and supporting infrastructure are not consistently available for faculty who teach online. This paper presents a brief literature review and reflective narratives of educators representing online education…

19 CFR 10.588 - Effect of noncompliance; failure to provide documentation regarding transshipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... RATE, ETC. Dominican Republic-Central America-United States Free Trade Agreement Import Requirements... 19 Customs Duties 1 2010-04-01 2010-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment. 10.588 Section 10.588 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION...

Registered nurses' decision-making regarding documentation in patients' progress notes.

PubMed

Tower, Marion; Chaboyer, Wendy; Green, Quentine; Dyer, Kirsten; Wallis, Marianne

2012-10-01

To examine registered nurses' decision-making when documenting care in patients' progress notes. What constitutes effective nursing documentation is supported by available guidelines. However, ineffective documentation continues to be cited as a major cause of adverse events for patients. Decision-making in clinical practice is a complex process. To make an effective decision, the decision-maker must be situationally aware. The concept of situation awareness and its implications for making safe decisions has been examined extensively in air safety and more recently is being applied to health. The study was situated in a naturalistic paradigm. Purposive sampling was used to recruit 17 registered nurses who used think-aloud research methods when making decisions about documenting information in patients' progress notes. Follow-up interviews were conducted to validate interpretations. Data were analysed systematically for evidence of cues that demonstrated situation awareness as nurses made decisions about documentation. Three distinct decision-making scenarios were illuminated from the analysis: the newly admitted patient, the patient whose condition was as expected and the discharging patient. Nurses used mental models for decision-making in documenting in progress notes, and the cues nurses used to direct their assessment of patients' needs demonstrated situation awareness at different levels. Nurses demonstrate situation awareness at different levels in their decision-making processes. While situation awareness is important, it is also important to use an appropriate decision-making framework. Cognitive continuum theory is suggested as a decision-making model that could support situation awareness when nurses made decisions about documenting patient care. Because nurses are key decision-makers, it is imperative that effective decisions are made that translate into safe clinical care. Including situation awareness training, combined with employing cognitive continuum theory as a decision-making framework, provides a powerful means of guiding nurses' decision-making. © 2012 Blackwell Publishing Ltd.

Clinical decision support improves quality of telephone triage documentation - an analysis of triage documentation before and after computerized clinical decision support

PubMed Central

2014-01-01

Background Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. Methods We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Results Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). Conclusions CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed to determine if it results in improved care. PMID:24645674

Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support.

PubMed

North, Frederick; Richards, Debra D; Bremseth, Kimberly A; Lee, Mary R; Cox, Debra L; Varkey, Prathibha; Stroebel, Robert J

2014-03-20

Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed to determine if it results in improved care.

In-Drift Microbial Communities

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

D. Jolley

2000-11-09

As directed by written work direction (CRWMS M and O 1999f), Performance Assessment (PA) developed a model for microbial communities in the engineered barrier system (EBS) as documented here. The purpose of this model is to assist Performance Assessment and its Engineered Barrier Performance Section in modeling the geochemical environment within a potential repository drift for TSPA-SR/LA, thus allowing PA to provide a more detailed and complete near-field geochemical model and to answer the key technical issues (KTI) raised in the NRC Issue Resolution Status Report (IRSR) for the Evolution of the Near Field Environment (NFE) Revision 2 (NRC 1999).more » This model and its predecessor (the in-drift microbial communities model as documented in Chapter 4 of the TSPA-VA Technical Basis Document, CRWMS M and O 1998a) was developed to respond to the applicable KTIs. Additionally, because of the previous development of the in-drift microbial communities model as documented in Chapter 4 of the TSPA-VA Technical Basis Document (CRWMS M and O 1998a), the M and O was effectively able to resolve a previous KTI concern regarding the effects of microbial processes on seepage and flow (NRC 1998). This document supercedes the in-drift microbial communities model as documented in Chapter 4 of the TSPA-VA Technical Basis Document (CRWMS M and O 1998a). This document provides the conceptual framework of the revised in-drift microbial communities model to be used in subsequent performance assessment (PA) analyses.« less

Stratification, Elaboration and Formalisation of Design Documents: Effects on the Production of Instructional Materials

ERIC Educational Resources Information Center

Boot, Eddy W.; Nelson, Jon; van Merrienboer, Jeroen J. G.; Gibbons, Andrew S.

2007-01-01

Designers and producers of instructional materials lack a common design language. As a result, producers have difficulties translating design documents into technical specifications. The 3D-model is introduced to improve the stratification, elaboration and formalisation of design documents. It is hypothesised that producers working with improved…

75 FR 67996 - Environmental Documents Prepared for Proposed Oil, Gas, and Mineral Operations by the Gulf of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-04

... Environmental Documents Prepared for Proposed Oil, Gas, and Mineral Operations by the Gulf of Mexico Outer... regarding whether those effects have significant impacts. Environmental Assessments are used to evaluate.... ACTION: Notice of the Availability of Environmental Documents Prepared for OCS Mineral Proposals by the...

Tourism: Manufacturing the Exotic. IWGIA Document No. 61.

ERIC Educational Resources Information Center

Rossel, Pierre, Ed.

The objective of this document is to outline the relationship between tourism and cultural minorities. It aims to understand the nature of the relationship, to point out its most serious and harmful effects and to make known some of the survival strategies that cultural minorities employ. The document calls tourism "the greatest economic and…

76 FR 19309 - Solicitation of Letters of Interest To Participate in National Environmental Policy Act Pilot...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

... environmental analyses and documents required under NEPA to determine the extent to which these approaches improve the quality, timeliness, and cost effectiveness of such analyses and documents. The pilot project will focus only on NEPA analyses and documents associated with petitions for nonregulated status for GE...

Evaluating Combinations of Ranked Lists and Visualizations of Inter-Document Similarity.

ERIC Educational Resources Information Center

Allan, James; Leuski, Anton; Swan, Russell; Byrd, Donald

2001-01-01

Considers how ideas from document clustering can be used to improve retrieval accuracy of ranked lists in interactive systems and how to evaluate system effectiveness. Describes a TREC (Text Retrieval Conference) study that constructed and evaluated systems that present the user with ranked lists and a visualization of inter-document similarities.…

The Archive Effect: Appropriation Films and the Experience of History

ERIC Educational Resources Information Center

Baron, Jaimie Rachel

2010-01-01

Since the beginning of cinema, filmmakers have appropriated previously shot visual-- and later audiovisual--documents and recontextualized them in their own films for various ends. Because these documents have generally derived from official state or commercial film archives, they have come to be referred to as "archival documents." Endowed with…

Locating and Searching Electronic Documents: A User Study of Supply Publications in the United States Marine Corps

DTIC Science & Technology

2007-12-01

Boyle, “Important issues in hypertext documentation usability,” In Proceedings of the 9th Annual international Conference on Systems Documentation...Tufte’s principles of information design to creating effective Web sites.” In Proceedings of the 15th Annual international Conference on Computer...usability,” In Proceedings of the 9th Annual international Conference on Systems Documentation (Chicago, Illinois, 1991). SIGDOC 󈨟. ACM, New York, NY

Performance assurance of the re-applying project documentation

NASA Astrophysics Data System (ADS)

Kozlova, Olga

2017-10-01

Usage of the re-applying project documentation is cost effective measure. Saving of budgetary funds for purchases for development of new project documentation occurs by means of it. It also becomes possible to consider better decisions and prevent the repetition of mistakes. Nowadays, state authorities in construction management are forming separate institute for re-applying project documentation. The article shows the main tasks of such events and the issues to be solved for achievement of a high positive result.

On the typography of flight-deck documentation

NASA Technical Reports Server (NTRS)

Degani, Asaf

1992-01-01

Many types of paper documentation are employed on the flight-deck. They range from a simple checklist card to a bulky Aircraft Flight Manual (AFM). Some of these documentations have typographical and graphical deficiencies; yet, many cockpit tasks such as conducting checklists, way-point entry, limitations and performance calculations, and many more, require the use of these documents. Moreover, during emergency and abnormal situations, the flight crews' effectiveness in combating the situation is highly dependent on such documentation; accessing and reading procedures has a significant impact on flight safety. Although flight-deck documentation are an important (and sometimes critical) form of display in the modern cockpit, there is a dearth of information on how to effectively design these displays. The object of this report is to provide a summary of the available literature regarding the design and typographical aspects of printed matter. The report attempts 'to bridge' the gap between basic research about typography, and the kind of information needed by designers of flight-deck documentation. The report focuses on typographical factors such as type-faces, character height, use of lower- and upper-case characters, line length, and spacing. Some graphical aspects such as layout, color coding, fonts, and character contrast are also discussed. In addition, several aspects of cockpit reading conditions such as glare, angular alignment, and paper quality are addressed. Finally, a list of recommendations for the graphical design of flight-deck documentation is provided.

One minute after the detonation of the atomic bomb: the erased effects of residual radiation.

PubMed

Takahashi, Hiroko

2009-01-01

The U.S. Government's official narrative denies the effects of residual radiation which appeared one minute after the atomic bomb detonations in Hiroshima and Nagasaki. This paper explores declassified documents from the U.S. Atomic Energy Commission, the Atomic Bomb Casualties Commission, and others and shows that these documents actually suggested the existence of serious effects from residual radiation.

76 FR 50663 - Effective Date of Requirement for Premarket Approval for Three Class III Preamendments Devices

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-16

... completion of a PDP is not filed by the latter of the two dates, and no IDE is in effect, the device is... availability of a preamendments class III devices strategy document. The strategy document set forth FDA's... approved PMA or a declared completed PDP is required to be in effect for any such devices on or before 180...

Lost in translation: Focused documentation improvement benefits trauma surgeons.

PubMed

Fox, Nicole; Swierczynski, Patricia; Willcutt, Rebecca; Elberfeld, Adrienne; Mazzarelli, Anthony J

2016-09-01

There is a translational gap between physicians who document in the medical record and coders, who ultimately determine which codes are submitted. This gap exists because physicians are never formally educated about documentation strategies despite the fact that the quality of physician documentation directly affects revenue, outcomes and public profiling. We evaluated the effect of a formal model of focused documentation improvement (FDI) on the trauma/critical care division. We hypothesized that FDI would improve physician documentation, resulting in revenue recovery and a shift in the case mix index (CMI) to more accurately reflect the clinical complexity of trauma patients. FDI is defined as targeted physician education followed by concurrent inpatient chart review for documentation improvement opportunities by a clinical documentation specialist (CDS). All trauma surgeons (n=9) at our Level 1 trauma center first completed three hours of mandatory training on documentation improvement. A CDS was subsequently assigned to the trauma service. They reviewed the charts of Medicare patients (n=776) from January-December 2014 to identify opportunities for documentation improvement, participated in ICU rounds and provided ongoing education. Requests to clarify documentation (queries) were posted in the electronic medical record (EMR) and physicians were required to respond within 48h. Data was collected on physician response rate, CMI and revenue recovery. 411 of 776 (57%) charts were reviewed. Opportunities for FDI were identified in 177 (43%) cases. The physician response rate to queries was 100%. The CMI for reviewed cases increased (1.80 (SD 0.15) vs. 2.11 (SD 0.19); p<0.001) after FDI. Overall revenue recovery was $1,132,581 with an average of $154,092 in revenue recovery/clinical full time equivalent. The total cost for administration of FDI was $353,265 resulting in a 220% return on investment (ROI). FDI is an effective strategy to engage physicians in documentation improvement. It provides an infrastructure to assist physicians and yields a significant ROI. Copyright © 2016 Elsevier Ltd. All rights reserved.

A comparative study on effect of e-learning and instructor-led methods on nurses' documentation competency.

PubMed

Abbaszadeh, Abbas; Sabeghi, Hakimeh; Borhani, Fariba; Heydari, Abbas

2011-01-01

Accurate recording of the nursing care indicates the care performance and its quality, so that, any failure in documentation can be a reason for inadequate patient care. Therefore, improving nurses' skills in this field using effective educational methods is of high importance. Since traditional teaching methods are not suitable for communities with rapid knowledge expansion and constant changes, e-learning methods can be a viable alternative. To show the importance of e-learning methods on nurses' care reporting skills, this study was performed to compare the e-learning methods with the traditional instructor-led methods. This was a quasi-experimental study aimed to compare the effect of two teaching methods (e-learning and lecture) on nursing documentation and examine the differences in acquiring competency on documentation between nurses who participated in the e-learning (n = 30) and nurses in a lecture group (n = 31). The results of the present study indicated that statistically there was no significant difference between the two groups. The findings also revealed that statistically there was no significant correlation between the two groups toward demographic variables. However, we believe that due to benefits of e-learning against traditional instructor-led method, and according to their equal effect on nurses' documentation competency, it can be a qualified substitute for traditional instructor-led method. E-learning as a student-centered method as well as lecture method equally promote competency of the nurses on documentation. Therefore, e-learning can be used to facilitate the implementation of nursing educational programs.

A comparative study on effect of e-learning and instructor-led methods on nurses’ documentation competency

PubMed Central

Abbaszadeh, Abbas; Sabeghi, Hakimeh; Borhani, Fariba; Heydari, Abbas

2011-01-01

BACKGROUND: Accurate recording of the nursing care indicates the care performance and its quality, so that, any failure in documentation can be a reason for inadequate patient care. Therefore, improving nurses’ skills in this field using effective educational methods is of high importance. Since traditional teaching methods are not suitable for communities with rapid knowledge expansion and constant changes, e-learning methods can be a viable alternative. To show the importance of e-learning methods on nurses’ care reporting skills, this study was performed to compare the e-learning methods with the traditional instructor-led methods. METHODS: This was a quasi-experimental study aimed to compare the effect of two teaching methods (e-learning and lecture) on nursing documentation and examine the differences in acquiring competency on documentation between nurses who participated in the e-learning (n = 30) and nurses in a lecture group (n = 31). RESULTS: The results of the present study indicated that statistically there was no significant difference between the two groups. The findings also revealed that statistically there was no significant correlation between the two groups toward demographic variables. However, we believe that due to benefits of e-learning against traditional instructor-led method, and according to their equal effect on nurses’ documentation competency, it can be a qualified substitute for traditional instructor-led method. CONCLUSIONS: E-learning as a student-centered method as well as lecture method equally promote competency of the nurses on documentation. Therefore, e-learning can be used to facilitate the implementation of nursing educational programs. PMID:22224113

Menthol's potential effects on nicotine dependence: a tobacco industry perspective

PubMed Central

2011-01-01

Objective To examine what the tobacco industry knows about the potential effects menthol may have on nicotine dependence. Methods A snowball strategy was used to systematically search the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu/) between 22 February and 29 April, 2010. Of the approximately 11 million documents available in the Legacy Tobacco Documents Library, the iterative searches returned tens of thousands of results. We qualitatively analysed a final collection of 309 documents relevant the effects of menthol on nicotine dependence. Results The tobacco industry knows that menthol overrides the harsh taste of tobacco and alleviates nicotine's irritating effects, synergistically interacts with nicotine, stimulates the trigeminal nerve to elicit a ‘liking’ response for a tobacco product, and makes low tar, low nicotine tobacco products more acceptable to smokers than non-mentholated low delivery products. Conclusion Menthol is not only used in cigarettes as a flavour additive; tobacco companies know that menthol also has sensory effects and interacts with nicotine to produce tobacco products that are easier to smoke, thereby making it easier to expose smokers, especially those who are new and uninitiated, to the addictive power of nicotine. PMID:21504929

Documentation of medication changes in inpatient clinical notes: an audit to support quality improvement.

PubMed

Peusschers, Elsie; Twine, Jaryth; Wheeler, Amanda; Moudgil, Vikas; Patterson, Sue

2015-04-01

To describe completeness and accuracy of recording medication changes in progress notes during psychiatric inpatient admissions. A retrospective audit of records of 54 randomly selected psychiatric admissions at a metropolitan tertiary hospital. Medication changes recorded on National Inpatient Medication Chart (NIMC) were compared to documentation in the clinical progress records and assessed for completeness against seven quality criteria. With between one and 32 medication changes per admission, a total of 519 changes were recorded in NIMCs. Just over half were documented in progress notes. Psychotropic and regular medications were more frequently charted than 'other' and 'if required' medications. Documentation was seldom comprehensive. Medication name was most frequently documented; desired therapeutic effect or potential adverse effects were rarely documented. Evidence of patient involvement in, and an explicit rationale for, a change were infrequently recorded. Revealing substantial gaps in communication about medication changes during psychiatric admission, this audit sheds light on a previously undescribed source of medication error, warranting attention. Further research is needed to examine barriers to best practice, to support design and implementation of quality improvement activities but in the interim, attention should be addressed to development and articulation of content and procedures for documentation. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Operational excellence (six sigma) philosophy: Application to software quality assurance

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

Lackner, M.

1997-11-01

This report contains viewgraphs on operational excellence philosophy of six sigma applied to software quality assurance. This report outlines the following: goal of six sigma; six sigma tools; manufacturing vs administrative processes; Software quality assurance document inspections; map software quality assurance requirements document; failure mode effects analysis for requirements document; measuring the right response variables; and questions.

The Effects of Tasks on Integrating Information from Multiple Documents

ERIC Educational Resources Information Center

Cerdan, Raquel; Vidal-Abarca, Eduardo

2008-01-01

The authors examine 2 issues: (a) how students integrate information from multiple scientific documents to describe and explain a physical phenomenon that represents a subset of the information in the documents; and (b) the role of 2 sorts of tasks to achieve this type of integration, either writing an essay on a question requiring integration…

EFL Learners' Multiple Documents Literacy: Effects of a Strategy-Directed Intervention Program

ERIC Educational Resources Information Center

Karimi, Mohammad Nabi

2015-01-01

There is a substantial body of L2 research documenting the central role of strategy instruction in reading comprehension. However, this line of research has been conducted mostly within the single text paradigm of reading research. With reading literacy undergoing a marked shift from single source reading to multiple documents literacy, little is…

Business Documents Don't Have to Be Boring

ERIC Educational Resources Information Center

Schultz, Benjamin

2006-01-01

With business documents, visuals can serve to enhance the written word in conveying the message. Images can be especially effective when used subtly, on part of the page, on successive pages to provide continuity, or even set as watermarks over the entire page. A main reason given for traditional text-only business documents is that they are…

Reliability Programs for Nonelectronic Designs. Volume 1

DTIC Science & Technology

1983-04-01

to the system or component levels or to both and then Its degree of effectiveness. DOCUMENT ID TITLE/SUBJECT APPLICATION EFFECTIVENESS Sys ./Comp/Both...ID TITLE/SUBJECT APPLICATION EFFECTIVENESS ’ Sys ./Comp/Both Exc./Good/Poor MIL-STD-781B Reliability Tests Exponen- 1 1 1 1 Ii II tial Distribution MIL...DOCUMENT ID TITLE/SUBJECT APPLICATION EFFECTIVENESS Sys ./Comp/Both Exc./Good/Poor MIL-STD-1535A Supplier Quality Assurance I 1 I1 I 1 1 I Program

The NASA Organization

NASA Technical Reports Server (NTRS)

1994-01-01

This Handbook, effective 13 September 1994, documents the NASA organization, defines terms, and sets forth the policy and requirements for establishing, modifying, and documenting the NASA organizational structure and for assigning organizational responsibilities.

Cost Effectiveness Study of Wastewater Management Systems for Selected U.S. Coast Guard Vessels. Volume 2. Effectiveness Assessment of Candidate Systems

DTIC Science & Technology

1977-03-01

267 Input Layout for Each Card Type ...................... 269 Input Sequence .......................... 271 SAMPLE PROBLEM...13 3 Sample Data rormn Used for Documenting MSD Effectiveness Attribute Data ........................... 15 -1 Sample Form Used for Documenting WMS...from commodes, urinals and garbage grinder) and gray (galley and turbid, i.e., output from sinks, showers, laundry, deck, drains, etc.) wastewaters

Effects of Nutrients, Salinity, and pH on Salvinia molesta (Mitchell) Growth

DTIC Science & Technology

2010-07-01

Smart PURPOSE: This study documents effects of macronutrient (nitrogen and phosphorus) concentra- tions, pH, and salinity on giant salvinia growth...investigated. The objective of this study was to document effects of macronutrient (nitrogen and phosphorus) concentrations, pH, and salinity on giant...giant salvinia to become problematic, including low pH, low salinity, and the presence of suitable macronutrients . In combination with distribution

Gstruct: a system for extracting schemas from GML documents

NASA Astrophysics Data System (ADS)

Chen, Hui; Zhu, Fubao; Guan, Jihong; Zhou, Shuigeng

2008-10-01

Geography Markup Language (GML) becomes the de facto standard for geographic information representation on the internet. GML schema provides a way to define the structure, content, and semantic of GML documents. It contains useful structural information of GML documents and plays an important role in storing, querying and analyzing GML data. However, GML schema is not mandatory, and it is common that a GML document contains no schema. In this paper, we present Gstruct, a tool for GML schema extraction. Gstruct finds the features in the input GML documents, identifies geometry datatypes as well as simple datatypes, then integrates all these features and eliminates improper components to output the optimal schema. Experiments demonstrate that Gstruct is effective in extracting semantically meaningful schemas from GML documents.

Effectiveness guidance document (EGD) for acupuncture research - a consensus document for conducting trials

PubMed Central

2012-01-01

Background There is a need for more Comparative Effectiveness Research (CER) to strengthen the evidence base for clinical and policy decision-making. Effectiveness Guidance Documents (EGD) are targeted to clinical researchers. The aim of this EGD is to provide specific recommendations for the design of prospective acupuncture studies to support optimal use of resources for generating evidence that will inform stakeholder decision-making. Methods Document development based on multiple systematic consensus procedures (written Delphi rounds, interactive consensus workshop, international expert review). To balance aspects of internal and external validity, multiple stakeholders including patients, clinicians and payers were involved. Results Recommendations focused mainly on randomized studies and were developed for the following areas: overall research strategy, treatment protocol, expertise and setting, outcomes, study design and statistical analyses, economic evaluation, and publication. Conclusion The present EGD, based on an international consensus developed with multiple stakeholder involvement, provides the first systematic methodological guidance for future CER on acupuncture. PMID:22953730

Angiotensin-Converting Enzyme Genotype and Arterial Oxygen Saturation at High Altitude in Peruvian Quechua

PubMed Central

Bigham, Abigail W.; Kiyamu, Melisa; León-Velarde, Fabiola; Parra, Esteban J.; Rivera-Ch, Maria; Shriver, Mark D.

2008-01-01

Abstract Bigham, Abigail W., Melisa Kiyamu, Fabiola León-Verlarde, Esteban J. Parra, Maria Rivera-Ch, Mark D. Shriver, and Tom D. Brutsaert. Angiotensin-converting enzyme genotype and arterial oxygen saturation at high altitude in Peruvian Quechua. High Alt. Med. Biol. 9:167–178, 2008.—The I-allele of the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism has been associated with performance benefits at high altitude (HA). In n = 142 young males and females of largely Quechua origins in Peru, we evaluated 3 specific hypotheses with regard to the HA benefits of the I-allele: (1) the I-allele is associated with higher arterial oxygen saturation (\\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland,xspace}\\usepackage{amsmath,amsxtra}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document}$${\\rm Sa}_{\\rm O_2}$$\\end{document}) at HA, (2) the I-allele effect depends on the acclimatization state of the subjects, and (3) the putative I-allele effect on \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland,xspace}\\usepackage{amsmath,amsxtra}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document}$${\\rm Sa}_{\\rm O_2}$$\\end{document} is mediated by the isocapnic hypoxic ventilatory response (HVR, \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland,xspace}\\usepackage{amsmath,amsxtra}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document}$$1 / {\\rm min}^{- 1} / \\%{\\rm Sa}_{\\rm O_2}{- 1}$$\\end{document}). The subject participants comprised two different study groups including BLA subjects (born at low altitude) who were lifelong sea-level residents transiently exposed to hypobaric hypoxia (<24 h) and BHA subjects (born at HA) who were lifelong residents of HA. To control for the possibility of population stratification, Native American ancestry proportion (NAAP) was estimated as a covariate for each individual using a panel of 70 ancestry-informative molecular markers (AIMS). At HA, resting and exercise \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland,xspace}\\usepackage{amsmath,amsxtra}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document}$${\\rm Sa}_{\\rm O_2}$$\\end{document} was strongly associated with the ACE genotype, p = 0.008 with ∼4% of the total variance in \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland,xspace}\\usepackage{amsmath,amsxtra}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document}$${\\rm Sa}_{\\rm O_2}$$\\end{document} attributed to ACE genotype. Moreover, I/I individuals maintained ∼2.3 percentage point higher \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland,xspace}\\usepackage{amsmath,amsxtra}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document}$${\\rm Sa}_{\\rm O_2}$$\\end{document} compared to I/D and D/D. This I-allele effect was evident in both BLA and BHA groups, suggesting that acclimatization state has little influence on the phenotypic expression of the ACE gene. Finally, ACE genotype was not associated with the isocapnic HVR, although HVR had a strong independent effect on \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland,xspace}\\usepackage{amsmath,amsxtra}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document}$${\\rm Sa}_{\\rm O_2}$$\\end{document} (p = 0.001). This suggests that the I-allele effect on \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland,xspace}\\usepackage{amsmath,amsxtra}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document}$${\\rm Sa}_{\\rm O_2}$$\\end{document} is not mediated by the peripheral control of breathing, but rather by some other central cardiopulmonary effect of the ACE gene on the renin–angiotensin–aldosterone system (RAAS). PMID:18578648

Effective Use of SMSS: A Simple Strategy and Sample Implementation

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

Hensinger, David

1998-09-30

The purpose of this document is to present a strategy for effectively using SMSS (Sea.leable Mass Storage System) and to distribute a simple implementation of this strategy. This work was done as a stopgap memure to ~lOW ~ ~~yst to USe the storage Power of SMSS in the absence of a more user friendly interface. The features and functionality discussed in this document represent a minimum set of capabilities to allow a useful archiving interface functionality. The implementation presented is the most basic possible and would benefit significantly from an organized support and documentation effort.

Association of Medical Directors of Information Systems consensus on inpatient electronic health record documentation.

PubMed

Shoolin, J; Ozeran, L; Hamann, C; Bria, W

2013-01-01

In 2013, electronic documentation of clinical care stands at a crossroads. The benefits of creating digital notes are at risk of being overwhelmed by the inclusion of easily importable detail. Providers are the primary authors of encounters with patients. We must document clearly our understanding of patients and our communication with them and our colleagues. We want to document efficiently to meet without exceeding documentation guidelines. We copy and paste documentation, because it not only simplifies the documentation process generally, but also supports meeting coding and regulatory requirements specifically. Since the primary goal of our profession is to spend as much time as possible listening to, understanding and helping patients, clinicians need information technology to make electronic documentation easier, not harder. At the same time, there should be reasonable restrictions on the use of copy and paste to limit the growing challenge of 'note bloat'. We must find the right balance between ease of use and thoughtless documentation. The guiding principles in this document may be used to launch an interdisciplinary dialogue that promotes useful and necessary documentation that best facilitates efficient information capture and effective display.

Pilot production system cost/benefit analysis: Digital document storage project

NASA Technical Reports Server (NTRS)

1989-01-01

The Digital Document Storage (DDS)/Pilot Production System (PPS) will provide cost effective electronic document storage, retrieval, hard copy reproduction, and remote access for users of NASA Technical Reports. The DDS/PPS will result in major benefits, such as improved document reproduction quality within a shorter time frame than is currently possible. In addition, the DDS/PPS will provide an important strategic value through the construction of a digital document archive. It is highly recommended that NASA proceed with the DDS Prototype System and a rapid prototyping development methodology in order to validate recent working assumptions upon which the success of the DDS/PPS is dependent.

Unsupervised Word Spotting in Historical Handwritten Document Images using Document-oriented Local Features.

PubMed

Zagoris, Konstantinos; Pratikakis, Ioannis; Gatos, Basilis

2017-05-03

Word spotting strategies employed in historical handwritten documents face many challenges due to variation in the writing style and intense degradation. In this paper, a new method that permits effective word spotting in handwritten documents is presented that it relies upon document-oriented local features which take into account information around representative keypoints as well a matching process that incorporates spatial context in a local proximity search without using any training data. Experimental results on four historical handwritten datasets for two different scenarios (segmentation-based and segmentation-free) using standard evaluation measures show the improved performance achieved by the proposed methodology.

Tracking Our Success: How TAFE Institutes Measure Their Effectiveness and Efficiency--Case Studies. Support Document

ERIC Educational Resources Information Center

Misko, Josie; Wynes, Sian Halliday

2009-01-01

This report is the support document to "Tracking Our Success: How TAFE Institutes Measure Their Effectiveness and Efficiency". It comprises reports on each of the nine technical and further education (TAFE) institutes that have taken part in the study. Information was collected via in-depth interviews with chief executive officers and…

The Effectiveness of Stemming for Natural-Language Access to Slovene Textual Data.

ERIC Educational Resources Information Center

Popovic, Mirko; Willett, Peter

1992-01-01

Reports on the use of stemming for Slovene language documents and queries in free-text retrieval systems and demonstrates that an appropriate stemming algorithm results in an increase in retrieval effectiveness when compared with nonstemming processing. A comparison is made with stemming of English versions of the same documents and queries. (24…

Concepts, Methods, and Data Sources for Cumulative Health Risk Assessment of Multiple Chemicals, Exposures and Effects: A Resource Document (Final Report, 2008)

EPA Science Inventory

EPA announced the availability of the final report, Concepts, Methods, and Data Sources for Cumulative Health Risk Assessment of Multiple Chemicals, Exposures and Effects: A Resource Document. This report provides the concepts, methods and data sources needed to assist in...

An Analysis of Document Category Prediction Responses to Classifier Model Parameter Treatment Permutations within the Software Design Patterns Subject Domain

ERIC Educational Resources Information Center

Pankau, Brian L.

2009-01-01

This empirical study evaluates the document category prediction effectiveness of Naive Bayes (NB) and K-Nearest Neighbor (KNN) classifier treatments built from different feature selection and machine learning settings and trained and tested against textual corpora of 2300 Gang-Of-Four (GOF) design pattern documents. Analysis of the experiment's…

Using Google Documents for Composing Projects that Use Primary Research in First-Year Writing Courses

ERIC Educational Resources Information Center

Strasma, Kip

2010-01-01

In this article, the author shares how efficient and effective Google Documents is for faculty seeking to engage students in inquiry-based, emergent, and primary research in first-year composition courses. The specific appeal of Google Documents is that it occupies a space between "open source"--defined by the Open Source Initiative as "free,…

Theater Blood Application Was Not Effectively Developed and Implemented

DTIC Science & Technology

2015-07-17

blood product by unit; and • monitor non- Food and Drug Administration Blood Product Testing. The CONOPS document also identified over 400 specific...time of a transfusion. However, this requirement was not identified in the CONOPS document. Further, PEO DHCS officials provided a traceability ...the CONOPS document, requirements management database, and the traceability matrix increased the risk that the Theater Blood Application

Children's Visual Scanning of Textual Documents: Effects of Document Organization, Search Goals, and Metatextual Knowledge

ERIC Educational Resources Information Center

Potocki, Anna; Ros, Christine; Vibert, Nicolas; Rouet, Jean-François

2017-01-01

This study examines children's strategies when scanning a document to answer a specific question. More specifically, we wanted to know whether they make use of organizers (i.e., headings) when searching and whether strategic search is related to their knowledge of reading strategies. Twenty-six French fifth graders were asked to search single-page…

What big size you have! Using effect sizes to determine the impact of public health nursing interventions.

PubMed

Johnson, K E; McMorris, B J; Raynor, L A; Monsen, K A

2013-01-01

The Omaha System is a standardized interface terminology that is used extensively by public health nurses in community settings to document interventions and client outcomes. Researchers using Omaha System data to analyze the effectiveness of interventions have typically calculated p-values to determine whether significant client changes occurred between admission and discharge. However, p-values are highly dependent on sample size, making it difficult to distinguish statistically significant changes from clinically meaningful changes. Effect sizes can help identify practical differences but have not yet been applied to Omaha System data. We compared p-values and effect sizes (Cohen's d) for mean differences between admission and discharge for 13 client problems documented in the electronic health records of 1,016 young low-income parents. Client problems were documented anywhere from 6 (Health Care Supervision) to 906 (Caretaking/parenting) times. On a scale from 1 to 5, the mean change needed to yield a large effect size (Cohen's d ≥ 0.80) was approximately 0.60 (range = 0.50 - 1.03) regardless of p-value or sample size (i.e., the number of times a client problem was documented in the electronic health record). Researchers using the Omaha System should report effect sizes to help readers determine which differences are practical and meaningful. Such disclosures will allow for increased recognition of effective interventions.

Documentation of psychotropic PRN medication administration: An evaluation of electronic health records compared with paper charts and verbal reports.

PubMed

Martin, Krystle; Ham, Elke; Hilton, Zoe

2018-05-12

To describe the documentation of pro re nata (PRN) medication for anxiety, and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. The ability to accurately document patients' symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., De Marinis, Piredda, Pascarella et al., 2009) and considerable information missing (e.g., Marinis et al., 2010). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker, Lovell, & Harris, 2008). The project was a mixed method, two-phase study that collected data from two sites. In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be done through training, using structured report templates, and switching to electronic databases. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A knowledge-driven approach to biomedical document conceptualization.

PubMed

Zheng, Hai-Tao; Borchert, Charles; Jiang, Yong

2010-06-01

Biomedical document conceptualization is the process of clustering biomedical documents based on ontology-represented domain knowledge. The result of this process is the representation of the biomedical documents by a set of key concepts and their relationships. Most of clustering methods cluster documents based on invariant domain knowledge. The objective of this work is to develop an effective method to cluster biomedical documents based on various user-specified ontologies, so that users can exploit the concept structures of documents more effectively. We develop a flexible framework to allow users to specify the knowledge bases, in the form of ontologies. Based on the user-specified ontologies, we develop a key concept induction algorithm, which uses latent semantic analysis to identify key concepts and cluster documents. A corpus-related ontology generation algorithm is developed to generate the concept structures of documents. Based on two biomedical datasets, we evaluate the proposed method and five other clustering algorithms. The clustering results of the proposed method outperform the five other algorithms, in terms of key concept identification. With respect to the first biomedical dataset, our method has the F-measure values 0.7294 and 0.5294 based on the MeSH ontology and gene ontology (GO), respectively. With respect to the second biomedical dataset, our method has the F-measure values 0.6751 and 0.6746 based on the MeSH ontology and GO, respectively. Both results outperforms the five other algorithms in terms of F-measure. Based on the MeSH ontology and GO, the generated corpus-related ontologies show informative conceptual structures. The proposed method enables users to specify the domain knowledge to exploit the conceptual structures of biomedical document collections. In addition, the proposed method is able to extract the key concepts and cluster the documents with a relatively high precision. Copyright 2010 Elsevier B.V. All rights reserved.

Hemorrhage Control for Major Traumatic Vascular Injuries

DTIC Science & Technology

2016-10-01

additional documents be sent to the Contract Officer at USAMRAA in order for the change in site to take effect . UTHealth sent the documents to her on 29...Junco DJ, Fox EE, et al. The prospective, observational, multicenter, major trauma transfusion (PROMMTT) study: comparative effectiveness of a time...Jaffe J, et al. Arterial embolization is a rapid and effective technique for controlling pelvic fracture hemorrhage. J Trauma. 1997;43(3):395-399. 15

Assessments of the Veteran Medication Allergy Knowledge Gap and Potential Safety Improvements with the Veteran Health Information Exchange (VHIE).

PubMed

Pan, Eric; Botts, Nathan; Jordan, Harmon; Olinger, Lois; Donahue, Margaret; Hsing, Nelson

2016-01-01

The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE's effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation.

Assessments of the Veteran Medication Allergy Knowledge Gap and Potential Safety Improvements with the Veteran Health Information Exchange (VHIE)

PubMed Central

Pan, Eric; Botts, Nathan; Jordan, Harmon; Olinger, Lois; Donahue, Margaret; Hsing, Nelson

2016-01-01

The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE’s effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation. PMID:28269897

Evidence still insufficient that advance care documentation leads to engagement of healthcare professionals in end-of-life discussions: A systematic review.

PubMed

Lewis, Ebony; Cardona-Morrell, Magnolia; Ong, Kok Y; Trankle, Steven A; Hillman, Ken

2016-10-01

Administration of non-beneficial life-sustaining treatments in terminal elderly patients still occurs due to lack of knowledge of patient's wishes or delayed physician-family communications on preference. To determine whether advance care documentation encourages healthcare professional's timely engagement in end-of-life discussions. Systematic review of the English language articles published from January 2000 to April 2015. EMBASE, MEDLINE, EBM REVIEWS, PsycINFO, CINAHL and Cochrane Library and manual searches of reference lists. A total of 24 eligible articles from 10 countries including 23,914 subjects met the inclusion criteria, mostly using qualitative or mixed methods, with the exception of two cohort studies. The influence of advance care documentation on initiation of end-of-life discussions was predominantly based on perceptions, attitudes, beliefs and personal experience rather than on standard replicable measures of effectiveness in triggering the discussion. While health professionals reported positive perceptions of the use of advance care documentations (18/24 studies), actual evidence of their engagement in end-of-life discussions or confidence gained from accessing previously formulated wishes in advance care documentations was not generally available. Perceived effectiveness of advance care documentation in encouraging end-of-life discussions appears to be high but is mostly derived from low-level evidence studies. This may indicate a willingness and openness of patients, surrogates and staff to perceive advance directives as an instrument to improve communication, rather than actual evidence of timeliness or effectiveness from suitably designed studies. The assumption that advance care documentations will lead to higher physicians' confidence or engagement in communicating with patients/families could not be objectively demonstrated in this review. © The Author(s) 2016.

Documentation of violence risk information in psychiatric hospital patient charts: an empirical examination.

PubMed

Elbogen, Eric B; Tomkins, Alan J; Pothuloori, Antara P; Scalora, Mario J

2003-01-01

Studies have identified risk factors that show a strong association with violent behavior in psychiatric populations. Yet, little research has been conducted on the documentation of violence risk information in actual clinical practice, despite the relevance of such documentation to risk assessment liability and to conducting effective risk management. In this study, the documentation of cues of risk for violence were examined in psychiatric settings. Patient charts (n = 283) in four psychiatric settings were reviewed for documentation of violence risk information summarized in the MacArthur Violence Risk Assessment Study. The results revealed that particular patient and institutional variables influenced documentation practices. The presence of personality disorder, for example, predicted greater documentation of cues of violence risk, regardless of clinical setting. These findings have medicolegal implications for risk assessment liability and clinical implications for optimizing risk management in psychiatric practice.

Do published studies of educational outreach provide documentation of potentially important characteristics?

PubMed

Van Hoof, Thomas J; Miller, Nicole E; Meehan, Thomas P

2013-01-01

Educational outreach is a common intervention used to translate research findings into practice; however, the intervention has a mixed effect on changing clinician behavior and improving patient outcomes. Based on a published set of characteristics aimed at standardizing the approach to educational outreach, the authors undertook a careful review of the literature to determine the consistency and completeness of documentation. Using a 25-item abstraction tool, the authors reviewed 68 published studies of a recent Cochrane meta-analysis to determine the extent to which educational outreach studies provide recommended documentation of important characteristics. The results indicate that studies are generally inconsistent (documentation range of 0% to 100% across characteristics) and incomplete (documentation average of 43.1% across studies) in their descriptions. Documentation shortcomings of educational outreach studies make understanding the intervention and interpreting its findings particularly challenging. The authors recommend the creation of a guideline to help improve documentation of educational outreach efforts.

Design and development of an ancient Chinese document recognition system

NASA Astrophysics Data System (ADS)

Peng, Liangrui; Xiu, Pingping; Ding, Xiaoqing

2003-12-01

The digitization of ancient Chinese documents presents new challenges to OCR (Optical Character Recognition) research field due to the large character set of ancient Chinese characters, variant font types, and versatile document layout styles, as these documents are historical reflections to the thousands of years of Chinese civilization. After analyzing the general characteristics of ancient Chinese documents, we present a solution for recognition of ancient Chinese documents with regular font-types and layout-styles. Based on the previous work on multilingual OCR in TH-OCR system, we focus on the design and development of two key technologies which include character recognition and page segmentation. Experimental results show that the developed character recognition kernel of 19,635 Chinese characters outperforms our original traditional Chinese recognition kernel; Benchmarked test on printed ancient Chinese books proves that the proposed system is effective for regular ancient Chinese documents.

Warped document image correction method based on heterogeneous registration strategies

NASA Astrophysics Data System (ADS)

Tong, Lijing; Zhan, Guoliang; Peng, Quanyao; Li, Yang; Li, Yifan

2013-03-01

With the popularity of digital camera and the application requirement of digitalized document images, using digital cameras to digitalize document images has become an irresistible trend. However, the warping of the document surface impacts on the quality of the Optical Character Recognition (OCR) system seriously. To improve the warped document image's vision quality and the OCR rate, this paper proposed a warped document image correction method based on heterogeneous registration strategies. This method mosaics two warped images of the same document from different viewpoints. Firstly, two feature points are selected from one image. Then the two feature points are registered in the other image base on heterogeneous registration strategies. At last, image mosaics are done for the two images, and the best mosaiced image is selected by OCR recognition results. As a result, for the best mosaiced image, the distortions are mostly removed and the OCR results are improved markedly. Experimental results show that the proposed method can resolve the issue of warped document image correction more effectively.

Wind turbine acoustics research bibliography with selected annotation

NASA Technical Reports Server (NTRS)

Hubbard, Harvey H.; Shepherd, Kevin P.

1988-01-01

Citations of documents are included, which represent the state-of-the-art of technology in each of the following acoustics subject areas: Prediction of Wind Turbine Noise; Acoustic Measurements for Wind Tunnels; Effect of Wind Turbine Noise on Building Structures, People and Communities; Atmospheric Propagation; and Measurement Technology Including Wind Screens. Documents are listed in chronological order in each section of the paper, with key documents and associated annotation listed first. The sources are given along with acquisition numbers, when available, to expedite the acquisition of copies of the documents.

An Organizational Effectiveness Officer Tackles a Management Job: A follow-Up OE Case Study

DTIC Science & Technology

1981-06-01

time, the COPPER "users manual " had not been updated to reflect the current methods and procedures of the PPSD. RAJ Johnson felt that documentation of...Users’ Manual , now known as PPSD Users’ Manual , to document every action and show document ilow with a flow chart. Also prior to implementing the change...comments is a document to work from. I’ll use it from my level, but let’s push it down in the organizacion ." When interviewed in December, RAJ Johnson was

Using quantitative risk information in decisions about statins: a qualitative study in a community setting.

PubMed

Polak, Louisa; Green, Judith

2015-04-01

A large literature informs guidance for GPs about communicating quantitative risk information so as to facilitate shared decision making. However, relatively little has been written about how patients utilise such information in practice. To understand the role of quantitative risk information in patients' accounts of decisions about taking statins. This was a qualitative study, with participants recruited and interviewed in community settings. Semi-structured interviews were conducted with 34 participants aged >50 years, all of whom had been offered statins. Data were analysed thematically, using elements of the constant comparative method. Interviewees drew frequently on numerical test results to explain their decisions about preventive medication. In contrast, they seldom mentioned quantitative risk information, and never offered it as a rationale for action. Test results were spoken of as objects of concern despite an often-explicit absence of understanding, so lack of understanding seems unlikely to explain the non-use of risk estimates. Preventive medication was seen as 'necessary' either to treat test results, or because of personalised, unequivocal advice from a doctor. This study's findings call into question the assumption that people will heed and use numerical risk information once they understand it; these data highlight the need to consider the ways in which different kinds of knowledge are used in practice in everyday contexts. There was little evidence from this study that understanding probabilistic risk information was a necessary or valued condition for making decisions about statin use. © British Journal of General Practice 2015.

Unrealistic optimism in advice taking: A computational account.

PubMed

Leong, Yuan Chang; Zaki, Jamil

2018-02-01

Expert advisors often make surprisingly inaccurate predictions about the future, yet people heed their suggestions nonetheless. Here we provide a novel, computational account of this unrealistic optimism in advice taking. Across 3 studies, participants observed as advisors predicted the performance of a stock. Advisors varied in their accuracy, performing reliably above, at, or below chance. Despite repeated feedback, participants exhibited inflated perceptions of advisors' accuracy, and reliably "bet" on advisors' predictions more than their performance warranted. Participants' decisions tightly tracked a computational model that makes 2 assumptions: (a) people hold optimistic initial expectations about advisors, and (b) people preferentially incorporate information that adheres to their expectations when learning about advisors. Consistent with model predictions, explicitly manipulating participants' initial expectations altered their optimism bias and subsequent advice-taking. With well-calibrated initial expectations, participants no longer exhibited an optimism bias. We then explored crowdsourced ratings as a strategy to curb unrealistic optimism in advisors. Star ratings for each advisor were collected from an initial group of participants, which were then shown to a second group of participants. Instead of calibrating expectations, these ratings propagated and exaggerated the unrealistic optimism. Our results provide a computational account of the cognitive processes underlying inflated perceptions of expertise, and explore the boundary conditions under which they occur. We discuss the adaptive value of this optimism bias, and how our account can be extended to explain unrealistic optimism in other domains. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Resilience through participation and coping-enabling social environments: the case of HIV-affected children in sub-Saharan Africa

PubMed Central

Skovdal, Morten; Daniel, Marguerite

2012-01-01

Many children and youths living in low-resource and high-HIV-prevalence communities in sub-Saharan Africa are presented with daily hardships that few of us can even imagine. It is therefore no surprise that most research reporting on the experiences of HIV-affected children in resource-poor settings focuses on their poor health and development outcomes, casting them as victims. However, there is a growing trend to draw on more strengths-based conceptualisations in the study and support of HIV-affected children and youths. In this introduction to a special issue of The African Journal of AIDS Research, we cement this trend by providing a theoretical exposition and critique of the ‘coping’ and ‘resilience’ concepts and draw on the 11 empirical studies that make up this special issue to develop a framework that appropriates the concepts for a particular context and area of study: HIV-affected children in sub-Saharan Africa. The articles included here show, albeit in different ways and to different degrees, that the resilience of HIV-affected children in the region is an outcome of their agency and interactions with their social environment. Policy actors and practitioners working to support HIV-affected children in Africa should take heed of the proposed framework and draw on the research presented here to build coping-enabling social environments—presenting children and youths in Africa with greater opportunity to actively deal with hardship and work towards a more promising future. PMID:24482634

Attributing impacts to emissions traced to major fossil energy and cement producers over specific historical time periods

NASA Astrophysics Data System (ADS)

Ekwurzel, B.; Frumhoff, P. C.; Allen, M. R.; Boneham, J.; Heede, R.; Dalton, M. W.; Licker, R.

2017-12-01

Given the progress in climate change attribution research over the last decade, attribution studies can inform policymakers guided by the UNFCCC principle of "common but differentiated responsibilities." Historically this has primarily focused on nations, yet requests for information on the relative role of the fossil energy sector are growing. We present an approach that relies on annual CH4 and CO2 emissions from production through to the sale of products from the largest industrial fossil fuel and cement production company records from the mid-nineteenth century to present (Heede 2014). Analysis of the global trends with all the natural and human drivers compared with a scenario without the emissions traced to major carbon producers over full historical versus select periods of recent history can be policy relevant. This approach can be applied with simple climate models and earth system models depending on the type of climate impacts being investigated. For example, results from a simple climate model, using best estimate parameters and emissions traced to 90 largest carbon producers, illustrate the relative difference in global mean surface temperature increase over 1880-2010 after removing these emissions from 1980-2010 (29-35%) compared with removing these emissions over 1880-2010 (42-50%). The changing relative contributions from the largest climate drivers can be important to help assess the changing risks for stakeholders adapting to and reducing exposure and vulnerability to regional climate change impacts.

[Autonomy and informed consent in surgical care-patients' and staff perceptions].

PubMed

Schopp, Anja; Dassen, Theo; Välimäki, Maritta; Leino-Kilpi, Helena; Gasull, Maria; Lemonidou, Chryssoula; Scott, Anne P; Arndt, Marianne

2004-06-01

The aim of this study was to describe autonomy and informed consent in surgical care. The study is a part of the international BIOMED 2 project "Patients' Autonomy and Privacy in Nursing Interventions" (BIOMED2, BMH4-CT98-3555; 1998-2001) supported by the European Commission. For this study, data of patients (n = 254) and nurses (n = 205) in eleven Berlin hospitals and three hospitals outside Berlin were collected by means of a structured questionnaire. The findings of the study indicate, that information-giving was more positive than decision-making. Patients perceived they were more frequently informed about their surgery than about their care. According to the perceptions of nurses the case was reversed. The perceptions of both groups differed, since from the point of view of nurses, patients' autonomy was more frequently heeded and their consent was sought more often than from the point of view of the patients. Patients admitted as emergencies and in multi-bed rooms perceived their autonomy more negatively than those with a planned surgery or in single rooms. Elderly nurses were more frequently than younger nurses of the opinion to grant patients autonomy. Nurses with a longer working experience in nursing care perceived that patients were more frequently asked their consent. Further, nurses with a higher educational qualification and with a higher occupational status perceived decision-making more negatively. The findings of the present study give implications for clinical practice, nursing education, and for further research.

Putting the enterprise into the enterprise system.

PubMed

Davenport, T H

1998-01-01

Enterprise systems present a new model of corporate computing. They allow companies to replace their existing information systems, which are often incompatible with one another, with a single, integrated system. By streamlining data flows throughout an organization, these commercial software packages, offered by vendors like SAP, promise dramatic gains in a company's efficiency and bottom line. It's no wonder that businesses are rushing to jump on the ES bandwagon. But while these systems offer tremendous rewards, the risks they carry are equally great. Not only are the systems expensive and difficult to implement, they can also tie the hands of managers. Unlike computer systems of the past, which were typically developed in-house with a company's specific requirements in mind, enterprise systems are off-the-shelf solutions. They impose their own logic on a company's strategy, culture, and organization, often forcing companies to change the way they do business. Managers would do well to heed the horror stories of failed implementations. FoxMeyer Drug, for example, claims that its system helped drive it into bankruptcy. Drawing on examples of both successful and unsuccessful ES projects, the author discusses the pros and cons of implementing an enterprise system, showing how a system can produce unintended and highly disruptive consequences. Because of an ES's profound business implications, he cautions against shifting responsibility for its adoption to technologists. Only a general manager will be able to mediate between the imperatives of the system and the imperatives of the business.

Mathematical models of lignin biosynthesis

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

Faraji, Mojdeh; Fonseca, Luis; Escamilla-Trevino, Luis

Lignin is a natural polymer that is interwoven with cellulose and hemicellulose within plant cell walls. Due to this molecular arrangement, lignin is a major contributor to the recalcitrance of plant materials with respect to the extraction of sugars and their fermentation into ethanol, butanol, and other potential bioenergy crops. The lignin biosynthetic pathway is similar, but not identical in different plant species. It is in each case comprised of a moderate number of enzymatic steps, but its responses to manipulations, such as gene knock-downs, are complicated by the fact that several of the key enzymes are involved in severalmore » reaction steps. This feature poses a challenge to bioenergy production, as it renders it difficult to select the most promising combinations of genetic manipulations for the optimization of lignin composition and amount.Here, we present several computational models than can aid in the analysis of data characterizing lignin biosynthesis. While minimizing technical details, we focus on the questions of what types of data are particularly useful for modeling and what genuine benefits the biofuel researcher may gain from the resulting models. We demonstrate our analysis with mathematical models for black cottonwood (Populus trichocarpa), alfalfa (Medicago truncatula), switchgrass (Panicum virgatum) and the grass Brachypodium distachyon. Despite commonality in pathway structure, different plant species show different regulatory features and distinct spatial and topological characteristics. The putative lignin biosynthes pathway is not able to explain the plant specific laboratory data, and the necessity of plant specific modeling should be heeded.« less

Mathematical models of lignin biosynthesis

DOE PAGES

Faraji, Mojdeh; Fonseca, Luis; Escamilla-Trevino, Luis; ...

2018-02-09

Lignin is a natural polymer that is interwoven with cellulose and hemicellulose within plant cell walls. Due to this molecular arrangement, lignin is a major contributor to the recalcitrance of plant materials with respect to the extraction of sugars and their fermentation into ethanol, butanol, and other potential bioenergy crops. The lignin biosynthetic pathway is similar, but not identical in different plant species. It is in each case comprised of a moderate number of enzymatic steps, but its responses to manipulations, such as gene knock-downs, are complicated by the fact that several of the key enzymes are involved in severalmore » reaction steps. This feature poses a challenge to bioenergy production, as it renders it difficult to select the most promising combinations of genetic manipulations for the optimization of lignin composition and amount.Here, we present several computational models than can aid in the analysis of data characterizing lignin biosynthesis. While minimizing technical details, we focus on the questions of what types of data are particularly useful for modeling and what genuine benefits the biofuel researcher may gain from the resulting models. We demonstrate our analysis with mathematical models for black cottonwood (Populus trichocarpa), alfalfa (Medicago truncatula), switchgrass (Panicum virgatum) and the grass Brachypodium distachyon. Despite commonality in pathway structure, different plant species show different regulatory features and distinct spatial and topological characteristics. The putative lignin biosynthes pathway is not able to explain the plant specific laboratory data, and the necessity of plant specific modeling should be heeded.« less

Effectiveness guidance document (EGD) for Chinese medicine trials: a consensus document

PubMed Central

2014-01-01

Background There is a need for more Comparative Effectiveness Research (CER) on Chinese medicine (CM) to inform clinical and policy decision-making. This document aims to provide consensus advice for the design of CER trials on CM for researchers. It broadly aims to ensure more adequate design and optimal use of resources in generating evidence for CM to inform stakeholder decision-making. Methods The Effectiveness Guidance Document (EGD) development was based on multiple consensus procedures (survey, written Delphi rounds, interactive consensus workshop, international expert review). To balance aspects of internal and external validity, multiple stakeholders, including patients, clinicians, researchers and payers were involved in creating this document. Results Recommendations were developed for “using available data” and “future clinical studies”. The recommendations for future trials focus on randomized trials and cover the following areas: designing CER studies, treatments, expertise and setting, outcomes, study design and statistical analyses, economic evaluation, and publication. Conclusion The present EGD provides the first systematic methodological guidance for future CER trials on CM and can be applied to single or multi-component treatments. While CONSORT statements provide guidelines for reporting studies, EGDs provide recommendations for the design of future studies and can contribute to a more strategic use of limited research resources, as well as greater consistency in trial design. PMID:24885146

Engaging staff to improve quality and safety in an austere medical environment: a case-control study in two Sierra Leonean hospitals.

PubMed

Rosen, Michael A; Chima, Adaora M; Sampson, John B; Jackson, Eric V; Koka, Rahul; Marx, Megan K; Kamara, Thaim B; Ogbuagu, Onyebuchi U; Lee, Benjamin H

2015-08-01

Inadequate observance of basic processes in patient care such as patient monitoring and documentation practices are potential impediments to the timely diagnoses and management of patients. These gaps exist in low resource settings such as Sierra Leone and can be attributed to a myriad of factors such as workforce and technology deficiencies. In the study site, only 12.4% of four critical vital signs were documented in the pre-intervention period. Implement a failure mode and effects analysis (FMEA) to improve documentation of four patient vital signs: temperature, blood pressure, pulse rate and respiratory rate. FMEA was implemented among a subpopulation of health workers who are involved in monitoring and documenting patient vital signs. Pre- and post-FMEA monitoring and documentation practice were compared with a control site. Participants identified a four-step process to monitoring and documenting vital signs, three categories of failure modes and four potential solutions. Based on 2100 patient days of documentation compliance data from 147 patients between July and November 2012, staff members at the study site were 1.79 times more likely to document all four patient vital signs in the post-implementation period (95% CI [1.35, 2.38]). FMEA is a feasible and effective strategy for improving quality and safety in an austere medical environment. Documentation compliance improved at the intervention facility. To evaluate the scalability and sustainability of this approach, programs targeting the development of these types of process improvement skills in local staff should be evaluated. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Evaluation of Nursing Documentation Completion of Stroke Patients in the Emergency Department: A Pre-Post Analysis Using Flowsheet Templates and Clinical Decision Support.

PubMed

Richardson, Karen J; Sengstack, Patricia; Doucette, Jeffrey N; Hammond, William E; Schertz, Matthew; Thompson, Julie; Johnson, Constance

2016-02-01

The primary aim of this performance improvement project was to determine whether the electronic health record implementation of stroke-specific nursing documentation flowsheet templates and clinical decision support alerts improved the nursing documentation of eligible stroke patients in seven stroke-certified emergency departments. Two system enhancements were introduced into the electronic record in an effort to improve nursing documentation: disease-specific documentation flowsheets and clinical decision support alerts. Using a pre-post design, project measures included six stroke management goals as defined by the National Institute of Neurological Disorders and Stroke and three clinical decision support measures based on entry of orders used to trigger documentation reminders for nursing: (1) the National Institutes of Health's Stroke Scale, (2) neurological checks, and (3) dysphagia screening. Data were reviewed 6 months prior (n = 2293) and 6 months following the intervention (n = 2588). Fisher exact test was used for statistical analysis. Statistical significance was found for documentation of five of the six stroke management goals, although effect sizes were small. Customizing flowsheets to meet the needs of nursing workflow showed improvement in the completion of documentation. The effects of the decision support alerts on the completeness of nursing documentation were not statistically significant (likely due to lack of order entry). For example, an order for the National Institutes of Health Stroke Scale was entered only 10.7% of the time, which meant no alert would fire for nursing in the postintervention group. Future work should focus on decision support alerts that trigger reminders for clinicians to place relevant orders for this population.

Alternatives for Developing User Documentation for Applications Software

DTIC Science & Technology

1991-09-01

style that is designed to match adult reading behaviors, using reader-based writing techniques, developing effective graphics , creating reference aids...involves research, analysis, design , and testing. The writer must have a solid understanding of the technical aspects of the document being prepared, good...ABSTRACT The preparation of software documentation is an iterative process that involves research, analysis, design , and testing. The writer must have

Governance Health Check. Diagnosing Effective Governance for FE Colleges. Second Edition. [and] Diagnosing Effective Governance for Land-Based Colleges. Second Edition.

ERIC Educational Resources Information Center

Learning and Skills Development Agency, London (England).

These two documents are designed to assist governing bodies of England's further education (FE) and land-based colleges self-assess their performance and identify ways of improving their performance. Each document contains a "healthcheck" that requires approximately 30 minutes to complete and that was developed in response to informative…

Support Documents for EPA’s Second Review of Existing Drinking Water Standards

EPA Pesticide Factsheets

The support documents for the Six-Year Review 2 of existing National Primary Drinking Water Standards contain extensive information including protocol for the review, and chemical contaminant health effects among others

Support Documents for EPA’s Third Review of Existing Drinking Water Standards

EPA Pesticide Factsheets

The support documents for the Six-Year Review 3 of existing National Primary Drinking Water Standards contain extensive information including protocol for the review, and chemical contaminant health effects among others

Bangladesh policy on prevention and control of non-communicable diseases: a policy analysis.

PubMed

Biswas, Tuhin; Pervin, Sonia; Tanim, Md Imtiaz Alam; Niessen, Louis; Islam, Anwar

2017-06-19

This paper is aimed at critically assessing the extent to which Non-Communicable Disease NCD-related policies introduced in Bangladesh align with the World Health Organization's (WHO) 2013-2020 Action Plan for the Global Strategy for the Prevention and Control of NCDs. The authors reviewed all relevant policy documents introduced by the Government of Bangladesh since its independence in 1971. The literature review targeted scientific and grey literature documents involving internet-based search, and expert consultation and snowballing to identify relevant policy documents. Information was extracted from the documents using a specific matrix, mapping each document against the six objectives of the WHO 2013-2020 Action Plan for the Global Strategy for the Prevention and Control of NCDs. A total of 51 documents were identified. Seven (14%) were research and/or surveys, nine were on established policies (17%), while seventeen (33%) were on action programmes. Five (10%) were related to guidelines and thirteen (25%) were strategic planning documents from government and non-government agencies/institutes. The study covered documents produced by the Government of Bangladesh as well as those by quasi-government and non-government organizations irrespective of the extent to which the intended policies were implemented. The policy analysis findings suggest that although the government has initiated many NCD-related policies or programs, they lacked proper planning, implementation and monitoring. Consequently, Bangladesh over the years had little success in effectively addressing the growing burden of non-communicable diseases. It is imperative that future research critically assess the effectiveness of national NCD policies by monitoring their implementation and level of population coverage.

Health professionals' use of documents obtained through the Regional Medical Library Network.

PubMed

Lovas, I; Graham, E; Flack, V

1991-01-01

The Pacific Southwest Regional Medical Library Service (PSRMLS) studied how health professionals use documents obtained through the regional medical library (RML) network and how various factors, such as delivery time, affected that use. A random sample of libraries in Region 7 of the RML network was selected to survey health professionals who had received documents through the interlibrary loan (ILL) network. The survey provided data about the purposes for which health professionals requested documents, how the immediacy of need for the items affected their usefulness, what effect the obtained information had on the health professionals' work, and whether the illustrations represented an important part of the information content of the items. Survey results provided a positive assessment of the ILL network. Results also verified the basic value of the materials provided to health professionals through ILL and identified some areas for consideration in future network development. Users of the documents indicated that the network works efficiently and effectively to provide timely and useful information needed by health professionals. Technological developments in electronic information transmission and imaging will further enhance network operation in the future.

42 CFR 482.96 - Condition of participation: Quality assessment and performance improvement (QAPI).

Code of Federal Regulations, 2011 CFR

2011-10-01

... to address and document adverse events that occur during any phase of an organ transplantation case... document any adverse event and must utilize the analysis to effect changes in the transplant center's...

Clean Air Act Section 112(r) Inspection Guidance Distribution Memorandum

EPA Pesticide Factsheets

This memorandum issues and makes immediately effective the document, Guidance for Conducting Risk Management Program Inspections under Clean Air Act Section 112(r), which supersedes the 1999 document on auditing risk management plans/programs.

Time Spent on Dedicated Patient Care and Documentation Tasks Before and After the Introduction of a Structured and Standardized Electronic Health Record.

PubMed

Joukes, Erik; Abu-Hanna, Ameen; Cornet, Ronald; de Keizer, Nicolette F

2018-01-01

Physicians spend around 35% of their time documenting patient data. They are concerned that adopting a structured and standardized electronic health record (EHR) will lead to more time documenting and less time for patient care, especially during consultations. This study measures the effect of the introduction of a structured and standardized EHR on documentation time and time for dedicated patient care during outpatient consultations. We measured physicians' time spent on four task categories during outpatient consultations: documentation, patient care, peer communication, and other activities. Physicians covered various specialties from two university hospitals that jointly implemented a structured and standardized EHR. Preimplementation, one hospital used a legacy-EHR, and one primarily paper-based records. The same physicians were observed 2 to 6 months before and 6 to 8 months after implementation.We analyzed consultation duration, and percentage of time spent on each task category. Differences in time distribution before and after implementation were tested using multilevel linear regression. We observed 24 physicians (162 hours, 439 consultations). We found no significant difference in consultation duration or number of consultations per hour. In the legacy-EHR center, we found the implementation associated with a significant decrease in time spent on dedicated patient care (-8.5%). In contrast, in the previously paper-based center, we found a significant increase in dedicated time spent on documentation (8.3%) and decrease in time on combined patient care and documentation (-4.6%). The effect on dedicated documentation time significantly differed between centers. Implementation of a structured and standardized EHR was associated with 8.5% decrease in time for dedicated patient care during consultations in one center and 8.3% increase in dedicated documentation time in another center. These results are in line with physicians' concerns that the introduction of a structured and standardized EHR might lead to more documentation burden and less time for dedicated patient care. Schattauer GmbH Stuttgart.

Digital Inventory and Documentation of Korea's Important Cultural Properties Using 3D Laser Scanning

NASA Astrophysics Data System (ADS)

Dongseok, K.; Gyesoo, K.; Siro, K.; Eunhwa, K.

2015-08-01

As a country with 11 properties included on the World Heritage List and approximately 12,000 important cultural properties, Korea has been continuously carrying out the inventory and documentation of cultural properties to conserve and manage them since the 1960s. The inventory of cultural properties had been carried out by making and managing a register which recorded basic information mainly on state-designated cultural properties such as their size, quantity, and location. The documentation of cultural properties was also carried out by making measured drawings. However, the inventory and documentation done under the previous analog method had a limit to the information it could provide for the effective conservation and management of cultural properties. Moreover, in recent times important cultural properties have frequently been damaged by man-made and natural disasters such as arson, forest fires, and floods, so an alternative was required. Accordingly, Korea actively introduced digital techniques led by the government for the inventory and documentation of important cultural properties. In this process, the government established the concept of a digital set, built a more efficie nt integrated data management system, and created standardized guidelines to maximize the effectiveness of data acquisition, management, and utilization that greatly increased the level of digital inventory, documentation, and archiving.

The role of sensory perception in the development and targeting of tobacco products.

PubMed

Carpenter, Carrie M; Wayne, Geoffrey Ferris; Connolly, Gregory N

2007-01-01

To examine tobacco industry research on smoking-related sensory effects, including differences in sensory perception across smoker groups, and to determine whether this research informed targeted product development and impacted the development of commercial tobacco products. We searched previously secret internal tobacco industry documents available online through document databases housed at Tobacco Documents Online, the British American Tobacco Document Archive and the Legacy Tobacco Documents Library. We identified relevant documents using a snowball sampling method to first search the databases using an initial set of key words and to then establish further search terms. Sensory research is a priority within the tobacco industry directly impacting commercial markets both in the United States and internationally. Sensory factors contribute to smoker satisfaction and product acceptance, and play an important role in controlling puffing behavior. Cigarette manufacturers have capitalized on distinct sensory preferences across gender, age and ethnic groups by tailoring products for specific populations. Regulation of tobacco products is needed to address product changes that are used to reinforce or contribute to tobacco dependence; for instance, the incorporation of additives that target attributes such as smoothness, harshness and aftertaste. Greater understanding of the role of sensory effects on smoking behavior may also help to inform the development of tobacco treatment options that support long-term tobacco abstinence.

Automated Engineering Design (AED); An approach to automated documentation

NASA Technical Reports Server (NTRS)

Mcclure, C. W.

1970-01-01

The automated engineering design (AED) is reviewed, consisting of a high level systems programming language, a series of modular precoded subroutines, and a set of powerful software machine tools that effectively automate the production and design of new languages. AED is used primarily for development of problem and user-oriented languages. Software production phases are diagramed, and factors which inhibit effective documentation are evaluated.

Comparing Web, Group and Telehealth Formats of a Military Parenting Program

DTIC Science & Technology

2017-06-01

directed approaches. Comparative effectiveness will be tested by specifying a non - equivalence hypothesis for group -based and web-facilitated relative...Comparative effectiveness will be tested by specifying a non - equivalence hypothesis fro group based and individualized facilitated relative to self-directed...documents for review and approval. 1a. Finalize human subjects protocol and consent documents for pilot group (N=5 families), and randomized controlled

Adolescent Health. Volume II: Background and the Effectiveness of Selected Prevention and Treatment Services [and] Indexes to Volumes I, II, and III.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Office of Technology Assessment.

This document, the second of three volumes in the U.S. Congress Office of Technology Assessment's "Adolescent Health" series, provides background information on aspects of adolescents' lives and examines the effectiveness of prevention and treatment interventions. Chapter 1, an introduction to this two-part document, provides a summary of the…

Effectiveness of Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Methods in Medicaid-Supported Prenatal Care: Trial III

ERIC Educational Resources Information Center

Windsor, Richard; Woodby, Lesa; Miller, Thomas; Hardin, Michael

2011-01-01

This two-phase evaluation documented the delivery and effectiveness of evidence-based health education methods by regular staff to pregnant smokers. During Phase 1, a total of 436 Medicaid patients were screened and 416 (95%) gave consent: 334 nonsmokers and 102 smokers. This historical Comparison (C) group was assessed to document the "normal"…

Effect of an obesity best practice alert on physician documentation and referral practices.

PubMed

Fitzpatrick, Stephanie L; Dickins, Kirsten; Avery, Elizabeth; Ventrelle, Jennifer; Shultz, Aaron; Kishen, Ekta; Rothschild, Steven

2017-12-01

The Centers for Medicare & Medicaid Services Electronic Health Record Meaningful Use Incentive Program requires physicians to document body mass index (BMI) and a follow-up treatment plan for adult patients with BMI ≥ 25. To examine the effect of a best practice alert on physician documentation of obesity-related care and referrals to weight management treatment, in a cluster-randomized design, 14 primary care clinics at an academic medical center were randomized to best practice alert intervention (n = 7) or comparator (n = 7). The alert was triggered when both height and weight were entered and BMI was ≥30. Both intervention and comparator clinics could document meaningful use by selecting a nutrition education handout within the alert. Intervention clinics could also select a referral option from the list of clinic and community-based weight management programs embedded in the alert. Main outcomes were proportion of eligible patients with (1) obesity-related documentation and (2) referral. There were 26,471 total primary care encounters with 12,981 unique adult patients with BMI ≥ 30 during the 6-month study period. Documentation doubled (17 to 33%) with implementation of the alert. However, intervention clinics were not significantly more likely to refer patients to weight management than comparator clinics (2.8 vs. 1.3%, p = 0.07). Although the alert was associated with increased physician meaningful use compliance, it was not an effective strategy for improving patient access to weight management services. Further research is needed to understand system-level characteristics that influence obesity management in primary care.

Navy Shipbuilding: Need to Document Rationale for the Use of Fixed-Price Incentive Contracts and Study Effectiveness of Added Incentives

DTIC Science & Technology

2017-03-01

NAVY SHIPBUILDING Need to Document Rationale for the Use of Fixed-Price Incentive Contracts and Study Effectiveness of Added...Use of Fixed-Price Incentive Contracts and Study Effectiveness of Added Incentives What GAO Found Over 80 percent of the Navy’s shipbuilding...mackinm@gao.gov. Why GAO Did This Study DOD encourages the use of FPI contracts because they allow for equitable sharing of costs savings and risk

Use of an Acoustic Camera to Evaluate the Performance of Tickler Chains and Draghead Deflectors for Sea Turtle Protection during Hopper Dredging in the United States of America

DTIC Science & Technology

2018-05-01

performance nor effectiveness in protecting sea turtles has been documented.This study was the first step in evaluating TTC as a potential replacement for...draghead turtle deflectors. The primary objective was to evaluate and document operational performance of this technology, not effectiveness of reducing...incidental take. TTC operational performance was monitored using underwater camera systems over a short period of time whereas effectiveness for

Impact of incomplete correspondence between document titles and texts on users' representations: a cognitive and linguistic analysis based on 25 technical documents.

PubMed

Eyrolle, Hélène; Virbel, Jacques; Lemarié, Julie

2008-03-01

Based on previous research in the field of cognitive psychology, highlighting the facilitatory effects of titles on several text-related activities, this paper looks at the extent to which titles reflect text content. An exploratory study of real-life technical documents investigated the content of their Subject lines, which linguistic analyses had led us to regard as titles. The study showed that most of the titles supplied by the writers failed to represent the documents' contents and that most users failed to detect this lack of validity.

Sonic-boom research: Selected bibliography with annotation

NASA Technical Reports Server (NTRS)

Hubbard, H. H.; Maglieri, D. J.; Stephens, D. G.

1986-01-01

Citations of selected documents are included which represent the state of the art of technology in each of the following subject areas: prediction, measurement, and minimization of steady-flight sonic booms; prediction and measurement of accelerating-flight sonic booms; sonic-boom propagation; the effects of sonic booms on people, communities, structures, animals, birds, and terrain; and sonic-boom simulator technology. Documents are listed in chronological order in each section of the paper, with key documents and associated annotation listed first. The sources are given along with acquisition numbers, when available, to expedite the acquisition of copies of the documents.

32 CFR 187.5 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE ENVIRONMENT ENVIRONMENTAL EFFECTS ABROAD...) Maintain liaison with the Council on Environmental Quality with respect to environmental documents; (4... and consider environmental documents when required by this directive for proposed actions within their...

Fact Sheet: Revised Draft Ambient Water Quality Criteria Document for Atrazine and Request for Scientific Views

EPA Pesticide Factsheets

Documents pertaining to Acute and Chronic Ambient Water Quality Aquatic Life Criteria for Atrazine (Freshwater and Salt Water) and revised Ecological Fate and Effects Risk Assessment for Atrazine. (Fact Sheet)

NEUROTOXICITY OF TETRACHLOROETHYLENE (PERCHLOROETHYLENE): DISCUSSION PAPER

EPA Science Inventory

This paper is a background document for a meeting of neurotoxicity experts to discuss the central nervous system effects of exposure to perchloroethylene (perc). The document reviews the literature on neurological testing of people exposed to perc occupationally in dry cleanin...

Health Assessment Document for Diesel Emissions (External Review Draft, 1994) - Volume 2

EPA Science Inventory

This document reports on the health effects of diesel combustion emissions, including a quantitative cancer risk assessment, and a reference concentration (non-cancer) for lifetime exposure; atmospheric concentrations, transport, and transformation; inhalation dosimetry; animal t...

40 CFR 1500.4 - Reducing paperwork.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the environmental impact statement process accordingly (§ 1501.7). (h) Summarizing the environmental...). (o) Combining environmental documents with other documents (§ 1506.4). (p) Using categorical... effect on the human environment and which are therefore exempt from requirements to prepare an...

40 CFR 1500.4 - Reducing paperwork.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the environmental impact statement process accordingly (§ 1501.7). (h) Summarizing the environmental...). (o) Combining environmental documents with other documents (§ 1506.4). (p) Using categorical... effect on the human environment and which are therefore exempt from requirements to prepare an...

40 CFR 1500.4 - Reducing paperwork.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the environmental impact statement process accordingly (§ 1501.7). (h) Summarizing the environmental...). (o) Combining environmental documents with other documents (§ 1506.4). (p) Using categorical... effect on the human environment and which are therefore exempt from requirements to prepare an...

Open doorway to truth: legacy of the Minnesota tobacco trial.

PubMed

Hurt, Richard D; Ebbert, Jon O; Muggli, Monique E; Lockhart, Nikki J; Robertson, Channing R

2009-05-01

More than a decade has passed since the conclusion of the Minnesota tobacco trial and the signing of the Master Settlement Agreement (MSA) by 46 US State Attorneys General and the US tobacco industry. The Minnesota settlement exposed the tobacco industry's long history of deceptive marketing, advertising, and research and ultimately forced the industry to change its business practices. The provisions for public document disclosure that were included in the Minnesota settlement and the MSA have resulted in the release of approximately 70 million pages of documents and nearly 20,000 other media materials. No comparable dynamic, voluminous, and contemporaneous document archive exists. Only a few single events in the history of public health have had as dramatic an effect on tobacco control as the public release of the tobacco industry's previously secret internal documents. This review highlights the genesis of the release of these documents, the history of the document depositories created by the Minnesota settlement, the scientific and policy output based on the documents, and the use of the documents in furthering global public health strategies.

Open Doorway to Truth: Legacy of the Minnesota Tobacco Trial

PubMed Central

Hurt, Richard D.; Ebbert, Jon O.; Muggli, Monique E.; Lockhart, Nikki J.; Robertson, Channing R.

2009-01-01

More than a decade has passed since the conclusion of the Minnesota tobacco trial and the signing of the Master Settlement Agreement (MSA) by 46 US State Attorneys General and the US tobacco industry. The Minnesota settlement exposed the tobacco industry's long history of deceptive marketing, advertising, and research and ultimately forced the industry to change its business practices. The provisions for public document disclosure that were included in the Minnesota settlement and the MSA have resulted in the release of approximately 70 million pages of documents and nearly 20,000 other media materials. No comparable dynamic, voluminous, and contemporaneous document archive exists. Only a few single events in the history of public health have had as dramatic an effect on tobacco control as the public release of the tobacco industry's previously secret internal documents. This review highlights the genesis of the release of these documents, the history of the document depositories created by the Minnesota settlement, the scientific and policy output based on the documents, and the use of the documents in furthering global public health strategies. PMID:19411441

Quality of Documentation as a Surrogate Marker for Awareness and Training Effectiveness of PHTLS-Courses. Part of the Prospective Longitudinal Mixed-Methods EPPTC-Trial.

PubMed

Häske, David; Beckers, Stefan K; Hofmann, Marzellus; Lefering, Rolf; Gliwitzky, Bernhard; Wölfl, Christoph C; Grützner, Paul; Stöckle, Ulrich; Dieroff, Marc; Münzberg, Matthias

2017-01-01

Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS ("Pre-Hospital Trauma Life Support") courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness. This was a prospective pre-post intervention trial and was part of the mixed-method longitudinal EPPTC (Effect of Paramedic Training on Pre-Hospital Trauma Care) study, evaluating subjective and objective changes among participants and real patient care, as a result of PHTLS courses. The courses provide an overview of the SAMPLE approach for interrogation of anamnestic information, which is believed to be responsible for patient safety as relevant, among others, "Allergies," "Medication," and "Patient History" (AMP). The focus of the course is not the documentation. In total, 320 protocols were analyzed before and after the training. The PHTLS course led to a significant increase (p < 0.001) in the "AMP" information in the documentation. The subgroups analysis of "allergies" (+47.2%), "drugs" (+38.1%), and "medical history" (+27.8%) before and after the PHTLS course showed a significant increase in the information content. In summary, we showed that PHTLS training improves documentation quality, which we used as a surrogate endpoint for learning effectiveness and awareness. In this regard, we demonstrated that participants use certain parts of training in real life, thereby suggesting that the learning methods of PHTLS training are effective. These results, however, do not indicate whether patient care has changed.

Policies on Protecting Vulnerable People During Disasters in Iran: A Document Analysis

PubMed Central

Abbasi Dolatabadi, Zahra; Seyedin, Hesam; Aryankhesal, Aidin

2016-01-01

Context Developing official protection policies for disasters is a main strategy in protecting vulnerable people. The aim of this study was to analyze official documents concerning policies on protecting vulnerable people during disasters. Evidence Acquisition This study was conducted by the qualitative document analysis method. Documents were gathered by searching websites and referring to the organizations involved in disaster management. The documents were assessed by a researcher-made data collection form. A directed content analysis approach was used to analyze the retrieved documents regarding the protection policies and legislation for vulnerable people. Results A total of 22 documents were included in the final analysis. Most of the documents referred to women, children, elderly people, poor, and villagers as vulnerable people. Moreover, the documents did not provide information regarding official measures for protecting vulnerable people during different phases of disaster management. Conclusions A clear and comprehensive definition of “vulnerable people” and formulation of official policies to protect them is needs to be formulated. Given the high prevalence of disasters in Iran, policy makers need to develop effective context-based policies to protect vulnerable people during disasters. PMID:27921019

Drinking-water-criteria document for phthalic acid esters (PAES). Final report

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

Not Available

1991-08-01

The document provides the health effects basis to be considered in establishing the MCLG. To achieve the objective, data on pharmacokinetics human exposure, acute and chronic toxicity to animals and humans, epidemiology and mechanisms of toxicity are evaluated for phthalic acid esters. Specific emphasis is placed on literature data providing dose-response information. Thus, while the literature search and evaluation performed in support of the document has been comprehensive, only the reports considered most pertinent in the derivation of the MCLG are cited in the document. The comprehensive literature data base in support of the document includes information published up tomore » 1986; however, more recent data may have been added during the review process.« less

The effectiveness and adverse effects profile of "burst" ketamine in refractory cancer pain: The VCOG PM 1-00 study.

PubMed

Jackson, Kate; Ashby, Michael; Howell, Deb; Petersen, Jennifer; Brumley, David; Good, Phillip; Pisasale, Maria; Wein, Simon; Woodruff, Roger

2010-01-01

This multi-centre study of adjuvant "burst" ketamine in palliative care in-patients documents its effectiveness, duration of pain relief, and adverse effects (AE) profile. Patients received a three-to-five day continuous subcutaneous infusion (CSCI) of ketamine escalated from 100 to 300 to 500 mg/24 hours if required. When the effective or maximum tolerated dose was attained, the infusion was continued for three days and each patient assessed as a responder or non-responder using strict criteria. The response rate was 22/44 (50 percent), with 4 (9 percent) becoming pain-free. Pain relief lasting two or more weeks was documented in 50 percent of responders. AEs were documented daily using the National Cancer Institute (NCI) Common Toxicity Criteria 0-4 scales. There were 11 grade 3 and 4 neurological AEs. However, no responders elected to cease treatment early due to neurological AEs. We concluded that this protocol in the controlled environment of an in-patient PC unit is relatively safe and simple with reasonable effectiveness.

"Below the Line": The tobacco industry and youth smoking.

PubMed

Coombs, Jaimee; Bond, Laura; Van, Victoria; Daube, Mike

2011-01-01

This paper provides a comprehensive account of how the tobacco industry, over time, has promoted its products to young people. A comprehensive search of tobacco industry documents relating to youth smoking was conducted using documents available on the World Wide Web through the Master Settlement Agreement. The documents provide evidence that the industry invested great time and resources in developing strategies to attract young people through Youth Smoking Prevention strategies (including education strategies) and marketing to youth. The results include information from published literature and direct excerpts from the tobacco industry documents. The tobacco industry documents confirm that the tobacco industry has promoted and supported strategies that are ineffective in reducing smoking by youth, and opposed strategies that have proven to be effective. It is clear from the documents reviewed that the industry values the youth market and through a number of measures continues to promote its products to young people.

Implementation of a School-wide Clinical Intervention Documentation System

PubMed Central

Stevenson, T. Lynn; Fox, Brent I.; Andrus, Miranda; Carroll, Dana

2011-01-01

Objective. To evaluate the effectiveness and impact of a customized Web-based software program implemented in 2006 for school-wide documentation of clinical interventions by pharmacy practice faculty members, pharmacy residents, and student pharmacists. Methods. The implementation process, directed by a committee of faculty members and school administrators, included preparation and refinement of the software, user training, development of forms and reports, and integration of the documentation process within the curriculum. Results. Use of the documentation tool consistently increased from May 2007 to December 2010. Over 187,000 interventions were documented with over $6.2 million in associated cost avoidance. Conclusions. Successful implementation of a school-wide documentation tool required considerable time from the oversight committee and a comprehensive training program for all users, with ongoing monitoring of data collection practices. Data collected proved to be useful to show the impact of faculty members, residents, and student pharmacists at affiliated training sites. PMID:21829264

Prototyping a bedside documentation system.

PubMed

Bachand, P; Bobis, K

1993-01-01

The implementation of a comprehensive bedside documentation system is a major project that demands careful analysis and planning. Since the cost of a typical bedside system can easily exceed $3 million, a design oversight could have disastrous effects on the benefits of the system.

Hydrogen embrittlement of structural alloys. A technology survey

NASA Technical Reports Server (NTRS)

Carpenter, J. L., Jr.; Stuhrke, W. F.

1976-01-01

Technical abstracts for about 90 significant documents relating to hydrogen embrittlement of structural metals and alloys are reviewed. Particular note was taken of documents regarding hydrogen effects in rocket propulsion, aircraft propulsion and hydrogen energy systems, including storage and transfer systems.

Factors affecting the effectiveness of biomedical document indexing and retrieval based on terminologies.

PubMed

Dinh, Duy; Tamine, Lynda; Boubekeur, Fatiha

2013-02-01

The aim of this work is to evaluate a set of indexing and retrieval strategies based on the integration of several biomedical terminologies on the available TREC Genomics collections for an ad hoc information retrieval (IR) task. We propose a multi-terminology based concept extraction approach to selecting best concepts from free text by means of voting techniques. We instantiate this general approach on four terminologies (MeSH, SNOMED, ICD-10 and GO). We particularly focus on the effect of integrating terminologies into a biomedical IR process, and the utility of using voting techniques for combining the extracted concepts from each document in order to provide a list of unique concepts. Experimental studies conducted on the TREC Genomics collections show that our multi-terminology IR approach based on voting techniques are statistically significant compared to the baseline. For example, tested on the 2005 TREC Genomics collection, our multi-terminology based IR approach provides an improvement rate of +6.98% in terms of MAP (mean average precision) (p<0.05) compared to the baseline. In addition, our experimental results show that document expansion using preferred terms in combination with query expansion using terms from top ranked expanded documents improve the biomedical IR effectiveness. We have evaluated several voting models for combining concepts issued from multiple terminologies. Through this study, we presented many factors affecting the effectiveness of biomedical IR system including term weighting, query expansion, and document expansion models. The appropriate combination of those factors could be useful to improve the IR performance. Copyright © 2012 Elsevier B.V. All rights reserved.

Classification of forensic autopsy reports through conceptual graph-based document representation model.

PubMed

Mujtaba, Ghulam; Shuib, Liyana; Raj, Ram Gopal; Rajandram, Retnagowri; Shaikh, Khairunisa; Al-Garadi, Mohammed Ali

2018-06-01

Text categorization has been used extensively in recent years to classify plain-text clinical reports. This study employs text categorization techniques for the classification of open narrative forensic autopsy reports. One of the key steps in text classification is document representation. In document representation, a clinical report is transformed into a format that is suitable for classification. The traditional document representation technique for text categorization is the bag-of-words (BoW) technique. In this study, the traditional BoW technique is ineffective in classifying forensic autopsy reports because it merely extracts frequent but discriminative features from clinical reports. Moreover, this technique fails to capture word inversion, as well as word-level synonymy and polysemy, when classifying autopsy reports. Hence, the BoW technique suffers from low accuracy and low robustness unless it is improved with contextual and application-specific information. To overcome the aforementioned limitations of the BoW technique, this research aims to develop an effective conceptual graph-based document representation (CGDR) technique to classify 1500 forensic autopsy reports from four (4) manners of death (MoD) and sixteen (16) causes of death (CoD). Term-based and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) based conceptual features were extracted and represented through graphs. These features were then used to train a two-level text classifier. The first level classifier was responsible for predicting MoD. In addition, the second level classifier was responsible for predicting CoD using the proposed conceptual graph-based document representation technique. To demonstrate the significance of the proposed technique, its results were compared with those of six (6) state-of-the-art document representation techniques. Lastly, this study compared the effects of one-level classification and two-level classification on the experimental results. The experimental results indicated that the CGDR technique achieved 12% to 15% improvement in accuracy compared with fully automated document representation baseline techniques. Moreover, two-level classification obtained better results compared with one-level classification. The promising results of the proposed conceptual graph-based document representation technique suggest that pathologists can adopt the proposed system as their basis for second opinion, thereby supporting them in effectively determining CoD. Copyright © 2018 Elsevier Inc. All rights reserved.

The quality of paper-based versus electronic nursing care plan in Australian aged care homes: A documentation audit study.

PubMed

Wang, Ning; Yu, Ping; Hailey, David

2015-08-01

The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. To describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. A nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. There was a tendency to omit 'nursing problem' or 'nursing diagnosis' in the nursing process by changing these terms (used in the paper-based care plan) to 'observation' in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, P<0.01), but had a lower total mean quality score. The electronic care plan contained fewer problem or diagnosis statements, contributing factors and resident outcomes than the paper-based system (P<0.01). Both types of nursing care plan were weak in documenting measurable and concrete resident outcomes. The overall quality of documentation content for the nursing process was no better in the electronic system than in the paper-based system. Omission of the nursing problem or diagnosis from the nursing process may reflect a range of factors behind the practice that need to be understood. Further work is also needed on qualitative aspects of the nurse care plan, nurses' attitudes towards standardized terminologies and the effect of different documentation practice on care quality and resident outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Air Quality Criteria for Oxides of Nitrogen (Final Report, 1982)

EPA Science Inventory

This document is an evaluation and assessment of scientific information relative to determining the health and welfare effects associated with exposure to various concentrations of nitrogen oxides in ambient air. The document is not intended as a complete, detailed literature rev...

Workforce Development.

ERIC Educational Resources Information Center

1999

This document contains four symposium papers on work force development. "Effects of Two Different Learning Paths on School-to-Work Transition" (Esther Van Der Schoot) discusses a Dutch study documenting that the following items make a difference in the school-to-work transition: learning path, curriculum characteristics, individual…

Get It Right First Time: A Beginner's Guide to Document Management.

ERIC Educational Resources Information Center

Hayes, Mike

1997-01-01

Document management (DM) systems capture, store, index, retrieve, route, distribute, and archive information in organizations. Discusses "passive" electronic libraries and "active" systems; characteristics of effective systems; implementing a system; fitting a new system to an existing infrastructure; budgets; system…

IRIS Toxicological Review and Summary Documents for Chloroethane (Peer Review Plan)

EPA Science Inventory

Toxicological data in the published literature on Chloroethane (CE) will be assimilated, reviewed, and integated into a Toxicological Review of CE (assessment document), which seeks to characterize the key cancer, and non cancer health effect hazards from environmental exposures...

Thinking about Thinking.

ERIC Educational Resources Information Center

Gough, Deborah

1991-01-01

This document summarizes five studies that offer insight into the nature of higher-order thinking skills and the most effective methods for teaching them to students. The reviews outline the conclusions, definitions, recommendations, specific methods of teaching, instructional strategies, and programs detailed in the documents themselves.…

76 FR 5537 - Electronic On-Board Recorders and Hours of Service Supporting Documents

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-01

...The Federal Motor Carrier Safety Administration (FMCSA) proposes to amend the Federal Motor Carrier Safety Regulations (FMCSRs) to require certain motor carriers operating commercial motor vehicles (CMVs) in interstate commerce to use electronic on-board recorders (EOBRs) to document their drivers' hours of service (HOS). Under this proposal, all motor carriers currently required to maintain Records of Duty Status (RODS) for HOS recordkeeping would be required to use EOBRs to systematically and effectively monitor their drivers' compliance with HOS requirements. Additionally, this proposal sets forth the supporting documents that all motor carriers currently required to use RODS would still be required to obtain and keep, as required by section 113(a) of the Hazardous Materials Transportation Authorization Act (HMTAA). It explains, however, that although motor carriers subject to the proposed EOBR requirements would still need to retain some supporting documents, they would be relieved of the requirements to retain supporting documents to verify driving time. FMCSA also proposes to require all motor carriers--both RODS and timecard users--to systematically monitor their drivers' compliance with HOS requirements. Motor carriers would be given 3 years after the effective date of the final rule to comply with these requirements.

The effect of informed consent on stress levels associated with extraction of impacted mandibular third molars.

PubMed

Casap, Nardy; Alterman, Michael; Sharon, Guy; Samuni, Yuval

2008-05-01

To evaluate the effect of informed consent on stress levels associated with removal of impacted mandibular third molars. A total of 60 patients scheduled for extraction of impacted mandibular third molars participated in this study. The patients were unaware of the study's objectives. Data from 20 patients established the baseline levels of electrodermal activity (EDA). The remaining 40 patients were randomly assigned into 2 equal groups receiving either a detailed document of informed consent, disclosing the possible risks involved with the surgery, or a simplified version. Pulse, blood pressure, and EDA were monitored before, during, and after completion of the consent document. Changes in EDA, but not in blood pressure, were measured on completion of either version of the consent document. A greater increase in EDA was associated with the detailed version of the consent document (P = .004). A similar concomitant increase (although nonsignificant) in pulse values was monitored on completion of both versions. Completion of overdisclosed document of informed consent is associated with changes in physiological parameters. The results suggest that overdetailed listing and disclosure before extraction of impacted mandibular third molars can increase patient stress.

Clinician preferences for verbal communication compared to EHR documentation in the ICU

PubMed Central

Collins, S.A.; Bakken, S.; Vawdrey, D.K.; Coiera, E.; Currie, L

2011-01-01

Background Effective communication is essential to safe and efficient patient care. Additionally, many health information technology (HIT) developments, innovations, and standards aim to implement processes to improve data quality and integrity of electronic health records (EHR) for the purpose of clinical information exchange and communication. Objective We aimed to understand the current patterns and perceptions of communication of common goals in the ICU using the distributed cognition and clinical communication space theoretical frameworks. Methods We conducted a focus group and 5 interviews with ICU clinicians and observed 59.5 hours of interdisciplinary ICU morning rounds. Results Clinicians used an EHR system, which included electronic documentation and computerized provider order entry (CPOE), and paper artifacts for documentation; yet, preferred the verbal communication space as a method of information exchange because they perceived that the documentation was often not updated or efficient for information retrieval. These perceptions that the EHR is a “shift behind” may lead to a further reliance on verbal information exchange, which is a valuable clinical communication activity, yet, is subject to information loss. Conclusions Electronic documentation tools that, in real time, capture information that is currently verbally communicated may increase the effectiveness of communication. PMID:23616870

Requirements for color technology

NASA Astrophysics Data System (ADS)

Campbell, Ronald B., Jr.

1993-06-01

The requirements for color technology in the general office are reviewed. The two most salient factors driving the requirements for color are the information explosion and the virtually negligible growth in white collar productivity in the recent past. Accordingly, the business requirement upon color technology is that it be utilized in an effective and efficient manner to increase office productivity. Recent research on productivity and growth has moved beyond the classical two factor productivity model of labor and capital to explicitly include knowledge as a third and vital factor. Documents are agents of knowledge in the general office. Documents articulate, express, disseminate, and communicate knowledge. The central question addressed here is how can color, in conjunction with other techniques such as graphics and document design, improve the growth of knowledge? The central thesis is that the effective use of color to convert information into knowledge is one of the most powerful ways to increase office productivity. Material on the value of color is reviewed. This material is related to the role of documents. Document services are the way in which users access and utilize color technology. The requirements for color technology are then defined against the services taxonomy.

Text extraction method for historical Tibetan document images based on block projections

NASA Astrophysics Data System (ADS)

Duan, Li-juan; Zhang, Xi-qun; Ma, Long-long; Wu, Jian

2017-11-01

Text extraction is an important initial step in digitizing the historical documents. In this paper, we present a text extraction method for historical Tibetan document images based on block projections. The task of text extraction is considered as text area detection and location problem. The images are divided equally into blocks and the blocks are filtered by the information of the categories of connected components and corner point density. By analyzing the filtered blocks' projections, the approximate text areas can be located, and the text regions are extracted. Experiments on the dataset of historical Tibetan documents demonstrate the effectiveness of the proposed method.

Air pollution and public health: a guidance document for risk managers.

PubMed

Craig, Lorraine; Brook, Jeffrey R; Chiotti, Quentin; Croes, Bart; Gower, Stephanie; Hedley, Anthony; Krewski, Daniel; Krupnick, Alan; Krzyzanowski, Michal; Moran, Michael D; Pennell, William; Samet, Jonathan M; Schneider, Jurgen; Shortreed, John; Williams, Martin

2008-01-01

This guidance document is a reference for air quality policymakers and managers providing state-of-the-art, evidence-based information on key determinants of air quality management decisions. The document reflects the findings of five annual meetings of the NERAM (Network for Environmental Risk Assessment and Management) International Colloquium Series on Air Quality Management (2001-2006), as well as the results of supporting international research. The topics covered in the guidance document reflect critical science and policy aspects of air quality risk management including i) health effects, ii) air quality emissions, measurement and modeling, iii) air quality management interventions, and iv) clean air policy challenges and opportunities.

The effects of fire on avian communities: Spatio-temporal attributes of the literature 19122003

USGS Publications Warehouse

Leidolf, A.; Bissonette, J.A.

2009-01-01

We reviewed the temporal, geographic, and biogeographic distribution, as well as relevant research and publication attributes, of 512 documents addressing the effects of fire on avian communities, to provide an assessment of the scope of this literature and recommendations for future research. We summarized relevant attributes of all documents to identify patterns that were then tested against appropriate null models. Most documents reported on original research, with the literature evenly divided between studies investigating controlled fire and those reporting on uncontrolled wildfires. Conceptual reviews made up the second largest category; methodological reviews, bibliographies, and meta-analyses were rare. Although the literature examined spans nearly a century, most documents were published within the last 15 years, with new literature being added at an increasing rate. However, increases seem to be skewed towards original research at the expense of synthesis. An overwhelming majority of documents were published in peer-reviewed scientific journals and in English. Other important publication outlets included MS and PhD theses and conference proceedings. The spatial distribution of documents by continent and biogeographic domain and division differed significantly from expectations based on land area. Future research on avian community response to fire should focus on (1) continued synthesis, emphasizing methodological reviews, bibliographies, and North America; (2) increasing research efforts in areas currently underrepresented in the literature, including Africa, Asia, and South and Central America; and (3) meta-analyses. ?? 2009 IAWF.

Implementation of Medical Information Exchange System Based on EHR Standard

PubMed Central

Han, Soon Hwa; Kim, Sang Guk; Jeong, Jun Yong; Lee, Bi Na; Choi, Myeong Seon; Kim, Il Kon; Park, Woo Sung; Ha, Kyooseob; Cho, Eunyoung; Kim, Yoon; Bae, Jae Bong

2010-01-01

Objectives To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems. Methods To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security. Results The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals. Conclusions This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information. PMID:21818447

Implementation of Medical Information Exchange System Based on EHR Standard.

PubMed

Han, Soon Hwa; Lee, Min Ho; Kim, Sang Guk; Jeong, Jun Yong; Lee, Bi Na; Choi, Myeong Seon; Kim, Il Kon; Park, Woo Sung; Ha, Kyooseob; Cho, Eunyoung; Kim, Yoon; Bae, Jae Bong

2010-12-01

To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems. To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security. The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals. This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information.

Slant correction for handwritten English documents

NASA Astrophysics Data System (ADS)

Shridhar, Malayappan; Kimura, Fumitaka; Ding, Yimei; Miller, John W. V.

2004-12-01

Optical character recognition of machine-printed documents is an effective means for extracting textural material. While the level of effectiveness for handwritten documents is much poorer, progress is being made in more constrained applications such as personal checks and postal addresses. In these applications a series of steps is performed for recognition beginning with removal of skew and slant. Slant is a characteristic unique to the writer and varies from writer to writer in which characters are tilted some amount from vertical. The second attribute is the skew that arises from the inability of the writer to write on a horizontal line. Several methods have been proposed and discussed for average slant estimation and correction in the earlier papers. However, analysis of many handwritten documents reveals that slant is a local property and slant varies even within a word. The use of an average slant for the entire word often results in overestimation or underestimation of the local slant. This paper describes three methods for local slant estimation, namely the simple iterative method, high-speed iterative method, and the 8-directional chain code method. The experimental results show that the proposed methods can estimate and correct local slant more effectively than the average slant correction.

JPRS Report, Science & Technology, USSR: Computers

DTIC Science & Technology

1987-08-11

Based on Game Models (V.O. Groppen, AVTOMATIKA I TELEMEKHANIKA, No 8, Aug 86) •••• 25 Problems of Documenting Activity of Data Bank Administration...DOKUMENTY, No 12, Dec 86) 55 Standardization of Management Documents - One of Methods of Qualitative Increase of Their Effectiveness (V.l. Kokorev...minimal effect or does not produce anything at all. Machines must be used for the entire manufactur- ing process cycle, at its most "critical

"In Fourteen Hundred and Ninety-Two, Columbus Sailed the Ocean Blue": Effects of Multiple Document Readings on Student Attitudes and Misconceptions. Reading Research Report No. 82.

ERIC Educational Resources Information Center

Stahl, Steven A.; And Others

To examine the effects of students reading multiple documents on their perceptions of a historical event, in this case the "discovery" of America by Christopher Columbus, 85 high school freshmen read 3 of 4 different texts (or sets of texts) dealing with Columbus. One text was an encyclopedia article, one a set of articles from…

The Effect of Bilingual Term List Size on Dictionary-Based Cross-Language Information Retrieval

DTIC Science & Technology

2006-01-01

The Effect of Bilingual Term List Size on Dictionary -Based Cross-Language Information Retrieval Dina Demner-Fushman Department of Computer Science... dictionary -based Cross-Language Information Retrieval (CLIR), in which the goal is to find documents written in one natural language based on queries that...in which the documents are written. In dictionary -based CLIR techniques, the princi- pal source of translation knowledge is a translation lexicon

Impact of an educational intervention on medical records documentation.

PubMed

Vahedi, Hojat Sheikhmotahar; Mirfakhrai, Minasadat; Vahidi, Elnaz; Saeedi, Morteza

2018-01-01

Inaccurate and incomplete documentation can lead to poor treatment and medico-legal consequences. Studies indicate that teaching programs in this field can improve the documentation of medical records. The study aimed to evaluate the effect of an educational workshop on medical record documentation by emergency medicine residents in the emergency department. An interventional study was performed on 30 residents in their first year of training emergency medicine (PGY1), in three tertiary referral hospitals of Tehran University of Medical Sciences. The essential information that should be documented in a medical record was taught in a 3-day-workshop. The medical records completed by these residents before the training workshop were randomly selected and scored (300 records), as was a random selection of the records they completed one (300 records) and six months (300 records) after the workshop. Documentation of the majority of the essential items of information was improved significantly after the workshop. In particular documentation of the patients' date and time of admission, past medical and social history. Documentation of patient identity, requests for consultations by other specialties, first and final diagnoses were 100% complete and accurate up to 6 months of the workshop. This study confirms that an educational workshop improves medical record documentation by physicians in training.

[Quality management and strategic consequences of assessing documentation and coding under the German Diagnostic Related Groups system].

PubMed

Schnabel, M; Mann, D; Efe, T; Schrappe, M; V Garrel, T; Gotzen, L; Schaeg, M

2004-10-01

The introduction of the German Diagnostic Related Groups (D-DRG) system requires redesigning administrative patient management strategies. Wrong coding leads to inaccurate grouping and endangers the reimbursement of treatment costs. This situation emphasizes the roles of documentation and coding as factors of economical success. The aims of this study were to assess the quantity and quality of initial documentation and coding (ICD-10 and OPS-301) and find operative strategies to improve efficiency and strategic means to ensure optimal documentation and coding quality. In a prospective study, documentation and coding quality were evaluated in a standardized way by weekly assessment. Clinical data from 1385 inpatients were processed for initial correctness and quality of documentation and coding. Principal diagnoses were found to be accurate in 82.7% of cases, inexact in 7.1%, and wrong in 10.1%. Effects on financial returns occurred in 16%. Based on these findings, an optimized, interdisciplinary, and multiprofessional workflow on medical documentation, coding, and data control was developed. Workflow incorporating regular assessment of documentation and coding quality is required by the DRG system to ensure efficient accounting of hospital services. Interdisciplinary and multiprofessional cooperation is recognized to be an important factor in establishing an efficient workflow in medical documentation and coding.

Motivation through Routine Documentation

ERIC Educational Resources Information Center

Koth, Laurie J.

2016-01-01

This informed commentary article offers a simple, effective classroom management strategy in which the teacher uses routine documentation to motivate students both to perform academically and to behave in a manner consistent with established classroom rules and procedures. The pragmatic strategy is grounded in literature, free to implement,…

Effective global transportation in the twenty-first century : a vision document

DOT National Transportation Integrated Search

1999-09-01

This vision document is intended to summarize what a future transportation system might look like in the period around 2020, and provide some general indications about where transportation possibly may be headed in the 10-20 years thereafter. It is b...

3 CFR - Regulatory Compliance

Code of Federal Regulations, 2012 CFR

2012-01-01

... 3 The President 1 2012-01-01 2012-01-01 false Regulatory Compliance Presidential Documents Other Presidential Documents Memorandum of January 18, 2011 Regulatory Compliance Memorandum for the Heads of Executive Departments and Agencies My Administration is committed to enhancing effectiveness and efficiency in Government. Pursuant to the...

New Evidence on Teacher Labor Supply

ERIC Educational Resources Information Center

Engel, Mimi; Jacob, Brian A.; Curran, F. Chris

2014-01-01

Recent evidence on the large variance in teacher effectiveness has spurred interest in teacher labor markets. Research documents that better qualified teachers typically work in more advantaged schools but cannot determine the relative importance of supply versus demand. To isolate teacher preferences, we document which schools prospective…

THE OFFICE OF AEROSPACE RESEARCH SCIENTIFIC AND TECHNICAL INFORMATION PROGRAM

DTIC Science & Technology

The document outlines the mission and organization of the Office of Aerospace Research (OAR), then describes how its principal product, scientific...effective technical information program, are documented by examples. The role of the Office of Scientific and Technical Information within OAR as performed

Innovative Internal Camera Inspection and Data Management for Effective Condition Assessment of Collection Systems

EPA Science Inventory

The primary objective of this guidance document is to identify and evaluate innovative closed-circuit television (CCTV) and related technologies currently used by more advanced wastewater utilities to conduct condition assessment programs. The document is intended to facilitate ...