Rethinking Silence in the Classroom: Chinese Students' Experiences of Sharing Indigenous Knowledge

ERIC Educational Resources Information Center

Zhou, Yanqiu Rachel; Knoke, Della; Sakamoto, Izumi

2005-01-01

Recent research has documented silence/reticence among East-Asian international students, including Chinese students, in Western/English classrooms. Students' communication competence and cultural differences from the mainstream Euro-American society have been identified as two primary barriers to participation. Placing emphasis on individual…

Science: Grades K-2. [Revised

ERIC Educational Resources Information Center

Green, Muriel; And Others

This document was developed to provide primary level school teachers in New York City with specific materials and suggestions for organizing effective learning experiences in the science area. The program is designed to emphasize both science knowledge and science processes. An introductory section presents ideas related to the overall philosophy…

Experiences That Matter: Enhancing Student Learning and Success. Annual Report 2007

ERIC Educational Resources Information Center

National Survey of Student Engagement, 2007

2007-01-01

The National Survey of Student Engagement (NSSE) documents dimensions of quality in undergraduate education and provides information and assistance to colleges, universities, and other organizations to improve student learning. Its primary activity is annually surveying college students to assess the extent to which they engage in educational…

Physician Assistant Programs. Summary. Third Revised Edition.

ERIC Educational Resources Information Center

Health Careers of Ohio, Columbus.

The document provides information on the name of the program, the institution, prerequisites, length of course, and certificate or degree offered for 81 programs for the training of physician assistants as part of Operation MEDIHC (Military Experience Directed Into Health Careers). Fifty-three programs are in primary care; the remaining 28 are…

What Remains of History? Historical Epistemology and Historical Understanding in Scotland's "Curriculum for Excellence"

ERIC Educational Resources Information Center

Smith, Joseph

2016-01-01

This paper critically examines the framing of historical knowledge in the primary and "broad general education" phases (ages 4-14) of Scotland's "Curriculum for Excellence". The paper focuses on curriculum documentation, particularly the curriculum's aims and "Experiences and Outcomes" and evaluates these in light of…

Trading Places: Autism Inclusion Disorder and School Change

ERIC Educational Resources Information Center

Lilley, Rozanna

2015-01-01

This article investigates the experiences of students diagnosed with autism who change schools during the early primary years in New South Wales (NSW), Australia. Using the narratives of eight mothers, the article documents the circumstances leading to school change, usually towards more segregated provision. Mothers highlighted the difficulty of…

Cross-reference identification within a PDF document

NASA Astrophysics Data System (ADS)

Li, Sida; Gao, Liangcai; Tang, Zhi; Yu, Yinyan

2015-01-01

Cross-references, such like footnotes, endnotes, figure/table captions, references, are a common and useful type of page elements to further explain their corresponding entities in the target document. In this paper, we focus on cross-reference identification in a PDF document, and present a robust method as a case study of identifying footnotes and figure references. The proposed method first extracts footnotes and figure captions, and then matches them with their corresponding references within a document. A number of novel features within a PDF document, i.e., page layout, font information, lexical and linguistic features of cross-references, are utilized for the task. Clustering is adopted to handle the features that are stable in one document but varied in different kinds of documents so that the process of identification is adaptive with document types. In addition, this method leverages results from the matching process to provide feedback to the identification process and further improve the algorithm accuracy. The primary experiments in real document sets show that the proposed method is promising to identify cross-reference in a PDF document.

Resident Outdoor Education: An Experimental Venture.

ERIC Educational Resources Information Center

South-Western City School District, Grove City, OH.

The document discusses a 5-day outdoor education program held in the spring of 1968 for 31 fifth graders from Prairie Lincoln Elementary School, Grove City, Ohio; site of the self-supporting resident experience ($23 estimated cost per student) was The Columbus Presbytery Camp, Lancaster, Ohio. As reported, the primary purpose of the outdoor…

Evolution 2.0. the Unexpected Learning Experience of Making a Digital Archive

ERIC Educational Resources Information Center

Andersen, Casper; Bek-Thomsen, Jakob; Clasen, Mathias; Grumsen, Stine Slot; Hjermitslev, Hans Henrik; Kjaergaard, Peter C.

2013-01-01

Studies in the history of science and education have documented that the reception and understanding of evolutionary theory is highly contingent on local factors such as school systems, cultural traditions, religious beliefs, and language. This has important implications for teaching evolution in primary and secondary schools. No universal…

Barriers to Physical Access for Students with Motor Disability at the University of Granada

ERIC Educational Resources Information Center

Polo, Maria Tamara; Lopez, Maria Dolores

2005-01-01

Introduction: For a number of years we have been witnessing the progressive incorporation of disabled students into the university. There are publications (Alcantud, 1995) which recount experiences of social and educational integration of the disabled in primary and secondary education. However, it is more difficult to find documentation on…

Access to Music Education: Nebraska Band Directors' Experiences and Attitudes regarding Students with Physical Disabilities

ERIC Educational Resources Information Center

Nabb, David; Balcetis, Emily

2010-01-01

Students with physical disabilities frequently are excluded from participation in instrumental music programs, yet the obstacles band directors face that preclude integration of these students have not been documented systematically. The primary purpose of this study was to measure Nebraska High School band directors' concerns regarding the…

Care interrupted: Poverty, in-migration, and primary care in rural resource towns.

PubMed

Rice, Kathleen; Webster, Fiona

2017-10-01

Internationally, rural people have poorer health outcomes relative to their urban counterparts, and primary care providers face particular challenges in rural and remote regions. Drawing on ethnographic fieldnotes and 14 open-ended qualitative interviews with care providers and chronic pain patients in two remote resource communities in Northern Ontario, Canada, this article examines the challenges involved in providing and receiving primary care for complex chronic conditions in these communities. Both towns struggle with high unemployment in the aftermath of industry closure, and are characterized by an abundance of affordable housing. Many of the challenges that care providers face and that patients experience are well-documented in Canadian and international literature on rural and remote health, and health care in resource towns (e.g. lack of specialized care, difficulty with recruitment and retention of care providers, heavy workload for existing care providers). However, our study also documents the recent in-migration of low-income, largely working-age people with complex chronic conditions who are drawn to the region by the low cost of housing. We discuss the ways in which the needs of these in-migrants compound existing challenges to rural primary care provision. To our knowledge, our study is the first to document both this migration trend, and the implications of this for primary care. In the interest of patient health and care provider well-being, existing health and social services will likely need to be expanded to meet the needs of these in-migrants. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Participatory Literacy Learning in an African Context: Perspectives from the Ombaderuku Primary School in the Arua District, Uganda

ERIC Educational Resources Information Center

Ngaka, Willy; Masaazi, Fred Masagazi

2015-01-01

This study documents the experiences of volunteer teacher research assistants in relation to pupils' interaction with parents, texts, and informal literacy practices in the community, and considers how these practices may enhance literacy instruction and production of local reading materials. The research site was located in the context of…

Revealing the Experience of Children and Teachers Even in Their Absence: Documenting in the Early Childhood Studio

ERIC Educational Resources Information Center

Parnell, Will

2011-01-01

Inspired by the educational approach in the municipal pre-primary schools and infant-toddler centers of Reggio Emilia, Italy, two studio teachers and a researcher participant in Portland, Oregon capture classroom work, make investigations and interpretations in the studio as a laboratory space of learning, help children represent thinking, and…

Racialized Classroom Practices in a Diverse Amsterdam Primary School: The Silencing, Disparagement, and Discipline of Students of Color

ERIC Educational Resources Information Center

Weiner, Melissa F.

2016-01-01

In both Europe and the US, racial and ethnic minority students experience discrimination at the hands of teachers that negatively impacts academic achievement. In the US, scholars have documented how a predominantly white teaching force racializes students of color through discipline and low expectations, which impact educational attainment. But…

Historical Thinking Ability among Talented Math and Science Students: An Exploratory Study.

ERIC Educational Resources Information Center

Fehn, Bruce

This study sought to discern the extent to which a sample of talented math and science students displayed domain-relevant skills possessed by those expertly trained in history. Subjects' experiences varied in terms of their exposure to primary source materials. The students were presented with five different kinds of documents related to the…

School Self-Evaluation at an Embryonic Stage: Depicting Teachers' Experiences with a Participative Project

ERIC Educational Resources Information Center

Karagiorgi, Yiasemina

2012-01-01

This case study aims to enquire into the journey of a Greek-Cypriot primary school through a self-evaluating process, in accordance to the respective guidelines proposed in the national educational reform documents. The article outlines the phases involved, beginning from the collection of information, moving to the formulation of a school…

Tools and Strategies for Documenting Educational Connection with Diverse Audiences

ERIC Educational Resources Information Center

Goodwin, Jeff; White, David J.; Lauxman, Lisa A.

2018-01-01

How does an educator ensure that an audience is receiving an intended message? Further complicating this matter, what happens if the audience members' primary language differs from that of the presenter and the use of an interpreter is not feasible? We explore these questions through a case study based on our experience as three Extension…

Japanese Language School: Aid or Hindrance to the Americanization of Japanese Americans in Hawaii?

ERIC Educational Resources Information Center

Shoho, Alan R.

A study examined the experiences of 60 Japanese immigrants to Hawaii (Niseis), aged 61-80, who attended Japanese-language schools as children. Using a case study oral history approach, the study gathered oral testimonies through semi-structured interviews. Historical documents were also used as primary sources of information about the schools.…

Staff experiences within the implementation of computer-based nursing records in residential aged care facilities: a systematic review and synthesis of qualitative research.

PubMed

Meißner, Anne; Schnepp, Wilfried

2014-06-20

Since the introduction of electronic nursing documentation systems, its implementation in recent years has increased rapidly in Germany. The objectives of such systems are to save time, to improve information handling and to improve quality. To integrate IT in the daily working processes, the employee is the pivotal element. Therefore it is important to understand nurses' experience with IT implementation. At present the literature shows a lack of understanding exploring staff experiences within the implementation process. A systematic review and meta-ethnographic synthesis of primary studies using qualitative methods was conducted in PubMed, CINAHL, and Cochrane. It adheres to the principles of the PRISMA statement. The studies were original, peer-reviewed articles from 2000 to 2013, focusing on computer-based nursing documentation in Residential Aged Care Facilities. The use of IT requires a different form of information processing. Some experience this new form of information processing as a benefit while others do not. The latter find it more difficult to enter data and this result in poor clinical documentation. Improvement in the quality of residents' records leads to an overall improvement in the quality of care. However, if the quality of those records is poor, some residents do not receive the necessary care. Furthermore, the length of time necessary to complete the documentation is a prominent theme within that process. Those who are more efficient with the electronic documentation demonstrate improved time management. For those who are less efficient with electronic documentation the information processing is perceived as time consuming. Normally, it is possible to experience benefits when using IT, but this depends on either promoting or hindering factors, e.g. ease of use and ability to use it, equipment availability and technical functionality, as well as attitude. In summary, the findings showed that members of staff experience IT as a benefit when it simplifies their daily working routines and as a burden when it complicates their working processes. Whether IT complicates or simplifies their routines depends on influencing factors. The line between benefit and burden is semipermeable. The experiences differ according to duties and responsibilities.

Life sciences space station planning document: A reference payload for the exobiology research facilities

NASA Technical Reports Server (NTRS)

1987-01-01

The Cosmic Dust Collection and Gas Grain Simulation Facilities represent collaborative efforts between the Life Sciences and Solar System Exploration Divisions designed to strengthen a natural exobiology/Planetary Sciences connection. The Cosmic Dust Collection Facility is a Planetary Science facility, with Exobiology a primary user. Conversely, the Gas Grain Facility is an exobiology facility, with Planetary Science a primary user. Requirements for the construction and operation of the two facilities, contained herein, were developed through joint workshops between the two disciplines, as were representative experiments comprising the reference payloads. In the case of the Gas Grain Simulation Facility, the astrophysics Division is an additional potential user, having participated in the workshop to select experiments and define requirements.

After-hours/on-call experience during primary care nurse practitioner education utilizing standard scenarios and simulated patients.

PubMed

Kelly, Michelle M; Blunt, Elizabeth; Nestor, Kelly

2017-12-01

Few nurse practitioner (NP) programs include an after-hours/on-call component in their clinical preparation of NP students. This role is expected in many primary and specialty care practices, and is one that students feel unprepared to competently navigate. Utilizing simulated callers as patients or parents, NP students participated in a simulated after-hours/on-call experience that included receiving the call, managing the patient, and submitting documentation of the encounter. Students completed pre- and postparticipation evaluations, and were evaluated by the simulated patient callers and faculty using standardized evaluation tools. NP students rated the experience as an educationally valuable experience despite feeling anxious and nervous about the experience. Several essential skills were identified including critical thinking, clear communication, self-confidence, and access to resources. After participation NP students were more receptive to an NP position with an on-call component. Inclusion of a simulated on-call experience is a feasible component of NP education and should be added to the NP curriculum. ©2017 American Association of Nurse Practitioners.

Developing primary care in Hong Kong: evidence into practice and the development of reference frameworks.

PubMed

Griffiths, Sian M; Lee, Jeff P M

2012-10-01

Enhancing primary care is one of the proposals put forward in the Healthcare Reform Consultation Document "Your Health, Your Life" issued in March 2008. In 2009, the Working Group on Primary Care, chaired by the Secretary for Food and Health, recommended the development of age-group and disease-specific primary care conceptual models and reference frameworks. Drawing on international experience and best evidence, the Task Force on Conceptual Model and Preventive Protocols of the Working Group on Primary Care has developed two reference frameworks for the management of two common chronic diseases in Hong Kong, namely diabetes and hypertension, in primary care settings. Adopting a population approach for the prevention and control of diabetes and hypertension across the life course, the reference frameworks aim to provide evidence-based and appropriate recommendations for the provision of continuing and comprehensive care for patients with chronic diseases in the community.

A Process Evaluation of Project Developmental Continuity. Interim Report II, Part A: Program Case Studies. Volume 2.

ERIC Educational Resources Information Center

Spencer, Lynn, Ed.

These 7 case studies are part of a series of documents on the evaluation of Project Developmental Continuity (PDC), a Head Start demonstration program aimed at providing educational and developmental continuity between children's Head Start and primary school experiences. Each case study reviews the planning year at a PDC demonstration site in one…

A Process Evaluation of Project Developmental Continuity. Interim Report II, Part A: Program Case Studies. Volume I.

ERIC Educational Resources Information Center

Spencer, Lynn, Ed.

These 8 case studies are part of a series of documents on the evaluation of Project Developmental Continuity (PDC), a Head Start demonstration program aimed at providing educational and developmental continuity between children's Head Start and primary school experiences. Each case study reviews the planning year at a PDC demonstration site in one…

A Process Evaluation of Project Developmental Continuity. Interim Report IV, Volume I: Pilot Year Impact Study--Instrument Characteristics and Attrition Trends.

ERIC Educational Resources Information Center

Granville, Arthur C.; And Others

This interim report of a pilot year impact study on evaluation methodology is part of a series of documents on the evaluation of Project Developmental Continuity, a Head Start demonstration program aimed at promoting educational and developmental continuity between children's Head Start and primary school experiences. This report deals with…

Learner-Centered Mentoring: Building from Student Teachers' Individual Needs and Experiences as Novice Practitioners

ERIC Educational Resources Information Center

Kolman, Joni S.; Roegman, Rachel; Goodwin, A. Lin

2017-01-01

This exploratory study documents the practices of a group of mentor teachers (MTs) in high-need schools within a high-accountability district. These MTs support teacher candidates, called residents, in an urban teacher residency program. The primary research question--what are the mentoring practices of a group of strong MTs?--led the authors not…

The Reconceptualisation of Outdoor Education in the Primary School Classroom in Aotearoa New Zealand: How Might "We" Do It?

ERIC Educational Resources Information Center

Cosgriff, Marg

2016-01-01

The powerful learning that occurs outdoors has been well documented in this journal, as has an array of barriers teachers typically face in providing outdoor learning experiences. This paper draws on findings from a collaborative, practice-based research project examining the reconceptualisation of outdoor education in two Year 4 classes in a…

The New Curriculum and the Urban-Rural Literacy Gap: The Case of One County in Western China

ERIC Educational Resources Information Center

Wang, Dan

2011-01-01

This article aims to explore the impact of the new curriculum reform launched in 2001 urban-rural achievement disparities. It documents a pilot study on teachers' experiences in teaching literacy to children in primary one in a poverty-stricken county in western China. Interviews with teachers in various types of schools indicate that the…

Panning for Gold: Utility of the World Wide Web for Metadata and Authority Control in Special Collections.

ERIC Educational Resources Information Center

Ellero, Nadine P.

2002-01-01

Describes the use of the World Wide Web as a name authority resource and tool for special collections' analytic-level cataloging, based on experiences at The Claude Moore Health Sciences Library. Highlights include primary documents and metadata; authority control and the Web as authority source information; and future possibilities. (Author/LRW)

Making God Known, Loved, and Served: The Future of Catholic Primary and Secondary Schools in the United States

ERIC Educational Resources Information Center

Catholic Education: A Journal of Inquiry and Practice, 2008

2008-01-01

In June 2005, shortly before Rev. John I. Jenkins, CSC, became president of the University of Notre Dame, the United States Conference of Catholic Bishops released a pastoral statement, "Renewing Our Commitment to Catholic Elementary and Secondary Schools in the Third Millennium." This document, building upon the rich experience of two…

Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study.

PubMed

O'Donnell, Patrick; Tierney, Edel; O'Carroll, Austin; Nurse, Diane; MacFarlane, Anne

2016-12-03

The involvement of patients and the public in healthcare has grown significantly in recent decades and is documented in health policy documents internationally. Many benefits of involving these groups in primary care planning have been reported. However, these benefits are rarely felt by those considered marginalised in society and they are often excluded from participating in the process of planning primary care. It has been recommended to employ suitable approaches, such as co-operative and participatory initiatives, to enable marginalised groups to highlight their priorities for care. This Participatory Learning and Action (PLA) research study involved 21 members of various marginalised groups who contributed their views about access to primary care. Using a series of PLA techniques for data generation and co-analysis, we explored barriers and facilitators to primary healthcare access from the perspective of migrants, Irish Travellers, homeless people, drug users, sex workers and people living in deprivation, and identified their priorities for action with regard to primary care provision. Four overarching themes were identified: the home environment, the effects of the 'two-tier' healthcare system on engagement, healthcare encounters, and the complex health needs of many in those groups. The study demonstrates that there are many complicated personal and structural barriers to accessing primary healthcare for marginalised groups. There were shared and differential experiences across the groups. Participants also expressed shared priorities for action in the planning and running of primary care services. Members of marginalised groups have shared priorities for action to improve their access to primary care. If steps are taken to address these, there is scope to impact on more than one marginalised group and to address the existing health inequities.

Images in Transition. Proceedings of the Annual Society for the Advancement of Gifted Education (SAGE) Conference (3rd, Calgary, Alberta, Canada, September 24-26, 1992) and the Canadian Symposium on Gifted Education (6th).

ERIC Educational Resources Information Center

Calgary Univ. (Alberta). Centre for Gifted Education.

This document presents the conference proceedings of the primary stakeholders in gifted education in Alberta (Canada): "Activities in Math for the Gifted Student" (Ballheim); "The Self Awareness Growth Experiences Approach" (Balogun); "Computer Simulations: An Integrating Tool" (Bilan); "The Portrayal of Gifted…

Patient Activation and Mental Health Care Experiences Among Women Veterans.

PubMed

Kimerling, Rachel; Pavao, Joanne; Wong, Ava

2016-07-01

We utilized a nationally representative survey of women veteran primary care users to examine associations between patient activation and mental health care experiences. A dose-response relationship was observed, with odds of high quality ratings significantly greater at each successive level of patient activation. Higher activation levels were also significantly associated with preference concordant care for gender-related preferences (use of female providers, women-only settings, and women-only groups as often as desired). Results add to the growing literature documenting better health care experiences among more activated patients, and suggest that patient activation may play an important role in promoting engagement with mental health care.

Provision of Pre-Primary Education as a Basic Right in Tanzania: Reflections from Policy Documents

ERIC Educational Resources Information Center

Mtahabwa, Lyabwene

2010-01-01

This study sought to assess provision of pre-primary education in Tanzania as a basic right through analyses of relevant policy documents. Documents which were published over the past decade were considered, including educational policies, action plans, national papers, the "Basic Education Statistics in Tanzania" documents, strategy…

Primary school children's communication experiences with Twitter: a case study from Turkey.

PubMed

Gunuc, Selim; Misirli, Ozge; Odabasi, H Ferhan

2013-06-01

This case study examines the utilization of Twitter as a communication channel among primary school children. This study tries to answer the following questions: "What are the cases for primary school children's use of Twitter for communication?" and "What are primary school children's experiences of utilizing Twitter for communication?" Participants were 7th grade students (17 female, 34 male; age 13 years) studying in a private primary school in Turkey within the 2011-12 academic year. A questionnaire, semi-structured interview, document analysis, and open ended questions were used as data collection tools. The children were invited and encouraged to use Twitter for communication. Whilst participants had some minor difficulties getting accustomed to Twitter, they managed to use Twitter for communication, a conclusion drawn from the children's responses and tweets within the study. However, the majority of children did not consider Twitter as a communication tool, and were observed to quit using Twitter once the study had ended. They found Twitter unproductive and restrictive for communication. Furthermore, Twitter's low popularity among adolescents was also a problem. This study suggests that social networking tools favored by children should be integrated into educational settings in order to maximize instructional benefits for primary school children and adolescents.

How do Dutch primary care providers overcome barriers to advance care planning with older people? A qualitative study.

PubMed

Glaudemans, Jolien J; de Jong, Anja E; Onwuteaka Philipsen, Bregje D; Wind, Jan; Willems, Dick L

2018-06-11

Few older people benefit from advance care planning (ACP), due to several barriers related to primary care professionals, such as insufficient knowledge, negative beliefs and a lack of time. Information on overcoming these barriers is limited. We assumed primary care professionals experienced in ACP with older patients are likely to have learned how to overcome these barriers. To investigate how Dutch primary care professionals experienced in ACP with older patients overcome these barriers. A qualitative study, based on semi-structured interviews, among a purposive sample of 14 Dutch primary care professionals experienced in ACP with older people. Transcripts were thematically analysed. We interviewed eight general practitioners (GPs), three nurses and three elderly care physicians, experienced in ACP with older people. Respondents overcame their own insufficient knowledge and skills, as well as their negative attitudes and beliefs by gaining experience through practicing ACP in their daily practices, exchanging and reflecting on those experiences with peers, pursuing continuing education, teaching and participating in research. To overcome patients' and families' lack of initiative and openness to ACP, respondents prepared them for further steps in ACP. To overcome a lack of time, respondents used tools and information communication technology, delegated parts of ACP to other primary care professionals, acquired financing and systematized documentation of ACP. Primary care professionals can overcome barriers to ACP with older patients by practicing, reflecting on experiences and pursuing continuing education, by preparing patients and involving family and by investing in support to approach ACP more efficiently.

Experience with management of posterior urethral injury associated with pelvic fracture.

PubMed

Coffield, K S; Weems, W L

1977-06-01

Review of records from 205 patients with pelvic fracture and hematuria revealed that 121 underwent urologic and radiographic evaluation. Of these patients 20 had severe posterior urethral injuries documented by urethrography of voiding cystourethrography: 9 underwent primary repair and 11 had delayed scrotal-inlay urethroplasty after initial cystostomy alone. Patients who underwent primary repair had a 77 per cent incidence of stricture, a 22 per cent incidence of incontinence and a 33 per cent incidence of impotency. Patients who underwent delayed closure had no incidence of stricture, incontinence or impotence. Patients in both groups had urinary tract infections. Simple cystostomy followed by delayed scrotal-inlay urethroplasty appears superior to primary realignment in the management of patients with posterior urethral injuries.

Teaching with Technology: Step Back and Hand over the Cameras! Using Digital Cameras to Facilitate Mathematics Learning with Young Children in K-2 Classrooms

ERIC Educational Resources Information Center

Northcote, Maria

2011-01-01

Digital cameras are now commonplace in many classrooms and in the lives of many children in early childhood centres and primary schools. They are regularly used by adults and teachers for "saving special moments and documenting experiences." The use of previously expensive photographic and recording equipment has often remained in the domain of…

Using the Van Hiele theory to analyze primary school teachers' written work on geometrical proof problems

NASA Astrophysics Data System (ADS)

Jupri, A.

2018-05-01

The lack of ability of primary school teachers in deductive thinking, such as doing geometrical proof, is an indispensable issue to be dealt with. In this paper, we report on results of a three-step of the field document study. The study was part of a pilot study for improving deductive thinking ability of primary school teachers. First, we designed geometrical proof problems adapted from literature. Second, we administered an individual written test involving nine master students of primary education program, in which they are having experiences as primary school mathematics teachers. Finally, we analyzed the written work from the view of the Van Hiele theory. The results revealed that even if about the half of the teachers show ability in doing formal proof, still the rest provides inappropriate proving. For further investigation, we wonder whether primary school teachers would show better deductive thinking if the teaching of geometry is designed in a systematic and appropriate manner according to the Van Hiele theory.

A second inheritance system: the extension of biology through culture.

PubMed

Whiten, Andrew

2017-10-06

By the mid-twentieth century (thus following the 'Modern Synthesis' in evolutionary biology), the behavioural sciences offered only the sketchy beginnings of a scientific literature documenting evidence for cultural inheritance in animals-the transmission of traditional behaviours via learning from others (social learning). By contrast, recent decades have seen a massive growth in the documentation of such cultural phenomena, driven by long-term field studies and complementary laboratory experiments. Here, I review the burgeoning scope of discoveries in this field, which increasingly suggest that this 'second inheritance system', built on the shoulders of the primary genetic inheritance system, occurs widely among vertebrates and possibly in invertebrates too. Its novel characteristics suggest significant implications for our understanding of evolutionary biology. I assess the extent to which this second system extends the scope of evolution, both by echoing principal properties of the primary, organic evolutionary system, and going beyond it in significant ways. This is well established in human cultural evolution; here, I address animal cultures more generally. The further major, and related, question concerns the extent to which the consequences of widespread animal cultural transmission interact with the primary, genetically based inheritance systems, shaping organic evolution.

Strengthening primary healthcare through community involvement in Cross River State, Nigeria: a descriptive study

PubMed Central

Adie, Hilary; Igbang, Thomas; Otu, Akaninyene; Braide, Ekanem; Okon, Okpok; Ikpi, Edet; Joseph, Charles; Desousa, Alexander; Sommerfeld, Johannes

2014-01-01

Introduction In preparation for implementation of primary healthcare (PHC) services in Cross River State, a study to identify perceptions of communities and health systems concerning such interventions was conducted. Methods Existing PHC practices were documented through observation and document reviews, including facility checklists at frontline levels. Perceptions of consumers and providers on PHC were elucidated through 32 Focus Group Discussions (FGDs) and 78 semi-structured questionnaires. Results There was some level of implementation of the Nigerian PHC policy in the study districts. However, this policy emphasized curative instead of preventive services. Private partners perceived healthcare programmes as largely donor driven with poor release of allocations for health by government. Conclusion Both providers and consumers presented similar perceptions on the current PHC implementation and similar perspectives on services to be prioritized. These common views together with their on-going participatory experience are important platforms for strengthening community participation in the delivery of PHC. PMID:25237418

In vitro differentiation of quail neural crest cells into sensory-like neuroblasts

NASA Technical Reports Server (NTRS)

Sieber-Blum, Maya; Kumar, Sanjiv R.; Riley, Danny A.

1988-01-01

Data are presented that demonstrate the ability of quail neural-crest embrionic cells grown as primary culture to differentiate in vitro into sensorylike neuroblasts. After 7-14 days of growth as primary culture, many of the putative sensory neuroblasts displayed substance P (SP)-like immunoreactivity and some exhibited histochemical carbonic anhydrase activity. Double staining experiments showed that the SP-like immunoreactive neuroblasts did not contain detectable levels of tyrosine hydroxylase or dopamine-beta-hydroxylase. The neuronal nature of the cultured sensorylike neuroblasts was further documented by double labeling for antibodies against the 68 kDa neurofilament polypeptide and substance P.

Data documentation for the bare soil experiment at the University of Arkansas, June - August 1980

NASA Technical Reports Server (NTRS)

Sadeghi, A. M.

1984-01-01

The primary objective of this study is to evaluate the relationships between soil moisture and reflectivity of a bare soil, using microwave techniques. A drainage experiment was conducted on a Captina silt loam in cooperation with personnel in the Electrical Engineering Department. Measurements included soil moisture pressures at various depths, neutron probe measurements, gravimetric moisture samples, and reflectivity of the soil surface at selected frequencies including 1.5 and 6.0 GHz and at the incident angle of 45 deg. All measurements were made in conjuction with that of reflectivity data.

Patients' preferences for primary health care - a systematic literature review of discrete choice experiments.

PubMed

Kleij, Kim-Sarah; Tangermann, Ulla; Amelung, Volker E; Krauth, Christian

2017-07-11

Primary care is a key element of health care systems and addresses the main health problems of the population. Due to the demographic change, primary care even gains in importance. The knowledge of the patients' preferences can help policy makers as well as physicians to set priorities in their effort to make health care delivery more responsive to patients' needs. Our objective was to describe which aspects of primary care were included in preference studies and which of them were the most preferred aspects. In order to elicit the preferences for primary care, a systematic literature search was conducted. Two researchers searched three electronic databases (PubMed, Scopus, and PsycINFO) and conducted a narrative synthesis. Inclusion criteria were: focus on primary health care delivery, discrete choice experiment as elicitation method, and studies published between 2006 and 2015 in English language. We identified 18 studies that elicited either the patients' or the population's preferences for primary care based on a discrete choice experiment. Altogether the studies used 16 structure attributes, ten process attributes and four outcome attributes. The most commonly applied structure attribute was "Waiting time till appointment", the most frequently used process attribute was "Shared decision making / professional's attention paid to your views". "Receiving the 'best' treatment" was the most commonly applied outcome attribute. Process attributes were most often the ones of highest importance for patients or the population. The attributes and attribute levels used in the discrete choice experiments were identified by literature research, qualitative research, expert interviews, or the analysis of policy documents. The results of the DCE studies show different preferences for primary health care. The diversity of the results may have several reasons, such as the method of analysis, the selection procedure of the attributes and their levels or the specific research question of the study. As the results of discrete choice experiments depend on many different factors, it is important for a better comprehensibility of the studies to transparently report the steps undertaken in a study as well as the interim results regarding the identification of attributes and levels.

A Prospective Cohort Study on Quality of Life after Endoscopic Thoracic Sympathectomy for Primary Hyperhidrosis.

PubMed

Dharmaraj, B; Kosai, N R; Gendeh, H; Ramzisham, A R; Das, S

2016-01-01

Hyperhidrosis is an excessive sweating disorder affecting quality of life. Endoscopic thoracic sympathectomy (ETS), introduced by Kux in 1951, is currently the gold standard surgical treatment for primary hyperhidrosis. 75% of patients with primary hyperhidrosis have seen improvement in quality of life within 30 days after surgery. Compensatory hyperhidrosis and pneumothorax (up to 75%) have been reported in patients after surgery. This study evaluates the functional status, self- esteem, compensatory hyperhidrosis and quality of life among patient with primary hyperhidrosis before and after undergoing ETS. Fifty (n=50) patients between the ages 18 to 30, with primary hyperhidrosis were recruited. Patients answered the quality of life questionnaire and Rosenberg self-esteem questionnaire prior to surgery and 30 days post surgery on follow up. Any post-operative complications were documented. Telephone interviews were held for patients who were unable to attend the clinics for follow-up. Forty six patients (92%) had symptomatic relieve within 30 days of surgery. The incidence of compensatory sweating was 78% (39 patients), with 6 patients developing severe hyperhidrosis. Two patients who did not experience symptomatic relieve, developed compensatory hyperhidrosis. Pneumothorax was documented in 8 patients (16%), with 6 patients requiring chest tubes. Significant improvement in quality of life and self-esteem was seen among patients after surgery. ETS has shown to significantly improve the quality of life and self-esteem of patients with primary hyperhidrosis within 30 days of surgery. However, the rate of compensatory hyperhidrosis still remains high (78%) which requires a long term evaluation.

Experiential In-Service Teachers' Training for the Pilot of the New Geography Curriculum in Greece: A Different Experience with Tangible Results

ERIC Educational Resources Information Center

Klonari, Aikaterini; Mandrikas, Achilleas

2014-01-01

?he aim of this paper is to present the design and the results of the In-service Elementary Teacher (IET) training seminars, in Geography for primary education, during the pilot of the New Geography Curriculum (NGC) in Greek schools, the school year 2011-2012. The design of this training was based on the documented needs of teachers for training…

The Mathematics Assessment Resource Services (MARS) Toolkit: Resources for Leaders in Mathematics Education--Lessons Learned from an Experiment to Develop Tools to Support Change Agents

ERIC Educational Resources Information Center

St. John, Mark; Regan, Mary; Tambe, Pamela; Heenan, Barbara

2007-01-01

The purpose of this report is two-fold. First, it is intended to describe the work and progress of the "MARS Toolkit for Change" project. Toward that end the report provides documentation and portrayal of the project from an outside perspective. The second and primary purpose of the report is to illuminate the lessons learned about the overall…

Primary Healthcare-based Diabetes Registry in Puducherry: Design and Methods

PubMed Central

Lakshminarayanan, Subitha; Kar, Sitanshu Sekhar; Gupta, Rajeev; Xavier, Denis; Bhaskar Reddy, S. Vijaya

2017-01-01

Background: Diabetes registries monitor the population prevalence and incidence of diabetes, monitor diabetes control program, provide information of quality of care to health service providers, and provide a sampling frame for interventional studies. This study documents the process of establishing a prospective diabetes registry in a primary health-care setting in Puducherry. Methods: This is a facility-based prospective registry conducted in six randomly selected urban health centers in Puducherry, with enrollment of all known patients with diabetes attending chronic disease clinics. Administrative approvals were obtained from Government Health Services. Manuals for training of medical officers, health-care workers, and case report forms were developed. Diabetes registry was prepared using Epi Info software. Results: In the first phase, demographic characteristics, risk factors, complications, coexisting chronic conditions, lifestyle and medical management, and clinical outcomes were recorded. Around 2177 patients with diabetes have been registered in six Primary Health Centres out of a total of 2948 participants seeking care from chronic disease clinic. Registration coverage ranges from 61% to 105% in these centers. Conclusion: This study has documented methodological details, and learning experiences gained while developing a diabetes registry at the primary health care level and the scope for upscaling to a Management Information System for Diabetes and a State-wide Registry. Improvement in patient care through needs assessment and quality assurance in service delivery is an important theme envisioned by this registry. PMID:28553589

Using Primary Source Documents.

ERIC Educational Resources Information Center

Mintz, Steven

2003-01-01

Explores the use of primary sources when teaching about U.S. slavery. Includes primary sources from the Gilder Lehrman Documents Collection (New York Historical Society) to teach about the role of slaves in the Revolutionary War, such as a proclamation from Lord Dunmore offering freedom to slaves who joined his army. (CMK)

Accessibility and use of primary healthcare for immigrants living in the Niagara Region.

PubMed

Lum, Irene D; Swartz, Rebecca H; Kwan, Matthew Y W

2016-05-01

Although the challenges of accessing and using primary healthcare for new immigrants to Canada have been fairly well documented, the focus has primarily been on large cities with significant immigrant populations. The experiences of immigrants living in smaller, less diverse urban centres remain largely unknown. The purpose of this study was to examine the lived experiences of immigrants living in a small urban centre with regards to the primary healthcare system. A total of 13 immigrants living in the Greater Niagara Region participated in semi-structured interviews. All interviews were recorded, transcribed, and then coded and analyzed for emergent themes using NVivo. Five factors were found to impact primary care access and use: lack of social contacts, lack of universal healthcare coverage during their initial arrival, language as a barrier, treatment preferences, and geographic distance to primary care. Overall findings suggest that immigrants moving to smaller areas such as the Niagara Region face similar barriers to primary care as those moving into large cities. Some barriers, however, appear to be specific to the context of smaller urban centres, further exacerbated by living in a small city due to a smaller immigrant population, fewer services for immigrants, and less diversity in practicing physicians. More research is required to understand the contextual factors inhibiting primary care access and use among immigrants moving to smaller urban centres, and determine effective strategies to overcome these barriers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Examining organizational change in primary care practices: experiences from using ethnographic methods.

PubMed

Russell, Grant; Advocat, Jenny; Geneau, Robert; Farrell, Barbara; Thille, Patricia; Ward, Natalie; Evans, Samantha

2012-08-01

Qualitative methods are an important part of the primary care researcher's toolkit providing a nuanced view of the complexity in primary care reform and delivery. Ethnographic research is a comprehensive approach to qualitative data collection, including observation, in-depth interviews and document analysis. Few studies have been published outlining methodological issues related to ethnography in this setting. This paper examines some of the challenges of conducting an ethnographic study in primary care setting in Canada, where there recently have been major reforms to traditional methods of organizing primary care services. This paper is based on an ethnographic study set in primary care practices in Ontario, Canada, designed to investigate changes to organizational and clinical routines in practices undergoing transition to new, interdisciplinary Family Health Teams (FHTs). The study was set in six new FHTs in Ontario. This paper is a reflexive examination of some of the challenges encountered while conducting an ethnographic study in a primary care setting. Our experiences in this study highlight some potential benefits of and difficulties in conducting an ethnographic study in family practice. Our study design gave us an opportunity to highlight the changes in routines within an organization in transition. A study with a clinical perspective requires training, support, a mixture of backgrounds and perspectives and ongoing communication. Despite some of the difficulties, the richness of this method has allowed the exploration of a number of additional research questions that emerged during data analysis.

Cryogenic adhesives and sealants: Abstracted publications

NASA Technical Reports Server (NTRS)

Williamson, F. R.; Olien, N. A.

1977-01-01

Abstracts of primary documents containing original experimental data on the properties of adhesives and sealants at cryogenic temperatures are presented. The most important references mentioned in each document are cited. In addition, a brief annotation is given for documents considered secondary in nature, such as republications or variations of original reports, progress reports leading to final reports included as primary documents, and experimental data on adhesive properties at temperatures between about 130 K and room temperature.

Comparing Help-Seeking Behavior of Male and Female Survivors of Sexual Assault: A Content Analysis of a Hotline.

PubMed

Young, Stephen M; Pruett, Jana A; Colvin, Marianna L

2018-06-01

This content analysis examines written documentation of telephone calls to a regional sexual assault hotline over a 5-year period. All male callers identified as primary victims were selected for analysis ( n = 58) and a corresponding sample of female primary victims ( n = 58) were randomly selected for comparison to better understand the help-seeking behavior of sexual assault survivors and inform services accordingly. A summative content analysis revealed significant contrasting themes between male and female victims, including females significantly receiving more referrals and males accessing the hotline to tell their experience of being sexually assaulted due to perceived limited support. Implications for training, practice, and future research are discussed.

Use and satisfaction with key functions of a common commercial electronic health record: a survey of primary care providers.

PubMed

Makam, Anil N; Lanham, Holly J; Batchelor, Kim; Samal, Lipika; Moran, Brett; Howell-Stampley, Temple; Kirk, Lynne; Cherukuri, Manjula; Santini, Noel; Leykum, Luci K; Halm, Ethan A

2013-08-09

Despite considerable financial incentives for adoption, there is little evidence available about providers' use and satisfaction with key functions of electronic health records (EHRs) that meet "meaningful use" criteria. We surveyed primary care providers (PCPs) in 11 general internal medicine and family medicine practices affiliated with 3 health systems in Texas about their use and satisfaction with performing common tasks (documentation, medication prescribing, preventive services, problem list) in the Epic EHR, a common commercial system. Most practices had greater than 5 years of experience with the Epic EHR. We used multivariate logistic regression to model predictors of being a structured documenter, defined as using electronic templates or prepopulated dot phrases to document at least two of the three note sections (history, physical, assessment and plan). 146 PCPs responded (70%). The majority used free text to document the history (51%) and assessment and plan (54%) and electronic templates to document the physical exam (57%). Half of PCPs were structured documenters (55%) with family medicine specialty (adjusted OR 3.3, 95% CI, 1.4-7.8) and years since graduation (nonlinear relationship with youngest and oldest having lowest probabilities) being significant predictors. Nearly half (43%) reported spending at least one extra hour beyond each scheduled half-day clinic completing EHR documentation. Three-quarters were satisfied with documenting completion of pneumococcal vaccinations and half were satisfied with documenting cancer screening (57% for breast, 45% for colorectal, and 46% for cervical). Fewer were satisfied with reminders for overdue pneumococcal vaccination (48%) and cancer screening (38% for breast, 37% for colorectal, and 31% for cervical). While most believed the problem list was helpful (70%) and kept an up-to-date list for their patients (68%), half thought they were unreliable and inaccurate (51%). Dissatisfaction with and suboptimal use of key functions of the EHR may mitigate the potential for EHR use to improve preventive health and chronic disease management. Future work should optimize use of key functions and improve providers' time efficiency.

Program and Project Management Framework

NASA Technical Reports Server (NTRS)

Butler, Cassandra D.

2002-01-01

The primary objective of this project was to develop a framework and system architecture for integrating program and project management tools that may be applied consistently throughout Kennedy Space Center (KSC) to optimize planning, cost estimating, risk management, and project control. Project management methodology used in building interactive systems to accommodate the needs of the project managers is applied as a key component in assessing the usefulness and applicability of the framework and tools developed. Research for the project included investigation and analysis of industrial practices, KSC standards, policies, and techniques, Systems Management Office (SMO) personnel, and other documented experiences of project management experts. In addition, this project documents best practices derived from the literature as well as new or developing project management models, practices, and techniques.

Integrated Clinical Decision Support Systems Promote Absolute Cardiovascular Risk Assessment: An Important Primary Prevention Measure in Aboriginal and Torres Strait Islander Primary Health Care.

PubMed

Matthews, Veronica; Burgess, Christopher P; Connors, Christine; Moore, Elizabeth; Peiris, David; Scrimgeour, David; Thompson, Sandra C; Larkins, Sarah; Bailie, Ross

2017-01-01

Aboriginal and Torres Strait Islander Australians experience a greater burden of disease compared to non-Indigenous Australians. Around one-fifth of the health disparity is caused by cardiovascular disease (CVD). Despite the importance of absolute cardiovascular risk assessment (CVRA) as a screening and early intervention tool, few studies have reported its use within the Australian Indigenous primary health care (PHC) sector. This study utilizes data from a large-scale quality improvement program to examine variation in documented CVRA as a primary prevention strategy for individuals without prior CVD across four Australian jurisdictions. We also examine the proportion with elevated risk and follow-up actions recorded. We undertook cross-sectional analysis of 2,052 client records from 97 PHC centers to assess CVRA in Indigenous adults aged ≥20 years with no recorded chronic disease diagnosis (2012-2014). Multilevel regression was used to quantify the variation in CVRA attributable to health center and client level factors. The main outcome measure was the proportion of eligible adults who had CVRA recorded. Secondary outcomes were the proportion of clients with elevated risk that had follow-up actions recorded. Approximately 23% ( n  = 478) of eligible clients had documented CVRA. Almost all assessments (99%) were conducted in the Northern Territory. Within this jurisdiction, there was wide variation between centers in the proportion of clients with documented CVRA (median 38%; range 0-86%). Regression analysis showed health center factors accounted for 48% of the variation. Centers with integrated clinical decision support systems were more likely to document CVRA (OR 21.1; 95% CI 5.4-82.4; p  < 0.001). Eleven percent ( n  = 53) of clients were found with moderate/high CVD risk, of whom almost one-third were under 35 years ( n  = 16). Documentation of follow-up varied with respect to the targeted risk factor. Fewer than 30% with abnormal blood lipid or glucose levels had follow-up management plans recorded. There was wide variation in CVRA between jurisdictions and between PHC centers. Learnings from successful interventions to educate and support centers in CVRA provision should be shared with stakeholders more widely. Where risk has been identified, further improvement in follow-up management is required to prevent CVD onset and reduce future burden in Australia's Indigenous population.

[Knowledge and attitudes as regards Living Wills between Primary and Specialised Care Doctors in the Ferrol Health Area].

PubMed

Ameneiros-Lago, Eugenia; Carballada-Rico, Carmen; Garrido-Sanjuán, Juan Antonio

2013-01-01

To evaluate the knowledge, the experience and the attitudes of the health professionals of Primary (PC) and Specialized (SC) Carein our Health Area with respect to Living Wills (LW). Descriptive, cross-sectional study, by means of a survey addressed to PC and SC doctors Ferrol (Galicia, Spain) Health Area A total of 120 (42.85%) doctors completed the questionnaire.The professionals self-assessed their level of knowledge with a mean of 3.83 (rank from 0 to 10). Only 21 professionals (17.5%) had objective knowledge of LW, that is to say, they fulfilled the following premises: they had read some pieces of LW legislation, had read an LW document and knew the elements that could figure in it. There were differences that verged on the statistical significance in the objective knowledge between PC and SC doctors (11.7% versus 23.3%, P= .093) and between professionals with under 10 years of professional experience and those with more than 10 years (6.9% versus 21.1%, P=.081). These differences reached statistical significance in some of the items that valued the objective knowledge. A few professionals (28 (23.3%)), had explained to their patients the convenience of having written an LW document, and even fewer (8 (6,7%)) had helped patients with writing one. The knowledge of health care professionals can be clearly improved. The highest deficiency was found between PC professionals and those with less experience. Nevertheless, they showed a favourable attitude towards them. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

Telemedicine in diabetes foot care delivery: health care professionals' experience.

PubMed

Kolltveit, Beate-Christin Hope; Gjengedal, Eva; Graue, Marit; Iversen, Marjolein M; Thorne, Sally; Kirkevold, Marit

2016-04-18

Introducing new technology in health care is inevitably a challenge. More knowledge is needed to better plan future telemedicine interventions. Our aim was therefore to explore health care professionals' experience in the initial phase of introducing telemedicine technology in caring for people with diabetic foot ulcers. Our methodological strategy was Interpretive Description. Data were collected between 2014 and 2015 using focus groups (n = 10). Participants from home-based care, primary care and outpatient hospital clinics were recruited from the intervention arm of an ongoing cluster randomized controlled trial (RCT) (Clinicaltrials.gov: NCT01710774). Most were nurses (n = 29), but the sample also included one nurse assistant, podiatrists (n = 2) and physicians (n = 2). The participants reported experiencing meaningful changes to their practice arising from telemedicine, especially associated with increased wound assessment knowledge and skills and improved documentation quality. They also experienced more streamlined communication between primary health care and specialist health care. Despite obstacles associated with finding the documentation process time consuming, the participants' attitudes to telemedicine were overwhelmingly positive and their general enthusiasm for the innovation was high. Our findings indicate that using a telemedicine intervention enabled the participating health care professionals to approach their patients with diabetic foot ulcer with more knowledge, better wound assessment skills and heightened confidence. Furthermore, it streamlined the communication between health care levels and helped seeing the patients in a more holistic way.

Section 4 User Guide – Primary Support

EPA Pesticide Factsheets

This document presents the user guide for the Office of Pollution Prevention and Toxics (OPPT) Section 4 application submission process. This document is the user guide for the Primary Support user of the Section 4 tool.

Weathering the storm: challenges to nurses providing care to nursing home residents during hurricanes.

PubMed

Hyer, Kathryn; Brown, Lisa M; Christensen, Janelle J; Thomas, Kali S

2009-11-01

This article documents the experience of 291 Florida nursing homes during the 2004 hurricane season. Using quantitative and qualitative methods, the authors described and compared the challenges nurses encountered when evacuating residents with their experiences assisting residents of facilities that sheltered in place. The primary concerns for evacuating facilities were accessing appropriate evacuation sites for residents and having ambulance transportation contracts honored. The main issue for facilities that sheltered in place was the length of time it took for power to be restored. Barriers to maintaining resident health during disasters for those who evacuated or sheltered in place are identified.

Evaluation of a patient-centered after visit summary in primary care.

PubMed

Federman, Alex D; Jandorf, Lina; DeLuca, Joseph; Gover, Mary; Sanchez Munoz, Angela; Chen, Li; Wolf, Michael S; Kannry, Joseph

2018-03-06

To test the impact of a redesigned, patient-centered after visit summary (AVS) on patients' and clinicians' ratings of and experience with the document. We conducted a difference-in-differences (DiD) evaluation of the impact of the redesigned AVS before and after its introduction in an academic primary care practice compared to a concurrent control practice. Outcomes included ratings of the features of the AVS. The intervention site had 118 and 98 patients in the pre- and post-intervention periods and the control site had 99 and 105, respectively. In adjusted DiD analysis, introduction of the patient-centered AVS in the intervention site increased patient reports that the AVS was an effective reminder for taking medications (p = .004) and of receipt of the AVS from clinicians (p = .002). However, they were more likely to perceive it as too long (p = .04). There were no significant changes in overall rating of the AVS by clinicians or their likelihood of providing it to patients. A patient-centered AVS increased the number of patients receiving it and reporting that it would help them remember to take their medications. Improvements in the patient-centeredness of the AVS may improve its usefulness as a document to support self-management in primary care. Copyright © 2018. Published by Elsevier B.V.

Interprofessional learning in primary care: an exploration of the service user experience leads to a new model for co-learning.

PubMed

Worswick, Louise; Little, Christine; Ryan, Kath; Carr, Eloise

2015-01-01

Research about service user involvement in research and education focuses on the purpose, the methods, the barriers and the impact of their involvement. Few studies report on the experience of the service users who get involved. This paper reports an exploration of the experience of service users who participated in an interprofessional educational initiative in primary care - the Learning to Improve the Management of Back Pain in the Community (LIMBIC) project. Service users attended workshops with practice teams and assisted them in developing small scale quality improvement projects to improve their provision of care for people with back pain. To explore the experience of service users involved in the LIMBIC project. Using the philosophical and methodological approaches of pragmatism this study analysed data from the wider LIMBIC project and collected primary data through semi structured interviews with service users. Secondary data were reanalysed and integrated with primary data to address the research question. The study was undertaken in the primary health care setting. Patients participated as service users in workshops and quality improvement projects with members from their practice teams. Interviews with service users were transcribed and analysed thematically. Document and thematic analyses of secondary data from the LIMBIC project included focus group transcripts, patient stories, film, emails, meeting notes, a wiki and educational material such as presentations. Themes identified through the analyses illustrated the importance, to the service users, of the sense of community, of clear communication, and of influencing change through involvement. A model for co-learning with service users resulted from the analyses. The experience of service users can be optimised by planning, preparation and support so that their wealth of expertise can be recognised and utilised. A model for co-learning was developed and is presented in this paper. Copyright © 2014 Elsevier Ltd. All rights reserved.

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,…

"Seeing a doctor is just like having a date": a qualitative study on doctor shopping among overactive bladder patients in Hong Kong

PubMed Central

2014-01-01

Background Although having a regular primary care provider is noted to be beneficial to health, doctor shopping has been documented as a common treatment seeking behavior among chronically ill patients in different countries. However, little research has been conducted into the reasons behind doctor shopping behavior among patients with overactive bladder, and even less into how this behavior relates to these patients’ illness and social experiences, perceptions, and cultural practices. Therefore, this study examines overactive bladder patients to investigate the reasons behind doctor shopping behavior. Methods My study takes a qualitative approach, conducting 30 semi-structured individual interviews, with 30 overactive bladder patients in Hong Kong. Results My study found six primary themes that influenced doctor shopping behavior: lack of perceived need, convenience, work-provided medical insurance, unpleasant experiences with doctors, searching for a match doctor, and switching between biomedicine and traditional Chinese medicine. Besides the perceptual factors, participants’ social environment, illness experiences, personal cultural preference, and cultural beliefs also intertwined to generate their doctor shopping behavior. Due to the low perceived need for a regular personal primary care physician, environmental factors such as time, locational convenience, and work-provided medical insurance became decisive in doctor shopping behavior. Patients’ unpleasant illness experiences, stemming from a lack of understanding among many primary care doctors about overactive bladder, contributed to participants’ sense of mismatch with these doctors, which induced them to shop for another doctor. Conclusions Overactive bladder is a chronic bladder condition with very limited treatment outcome. Although patients with overactive bladder often require specialty urology treatment, it is usually beneficial for the patients to receive continuous, coordinated, comprehensive, and patient-centered support from their primary care providers. Primary care doctors’ understanding on patients with overactive bladder with empathetic attitudes is important to reduce the motivations of doctor shopping behavior among these patients. PMID:24502367

"Seeing a doctor is just like having a date": a qualitative study on doctor shopping among overactive bladder patients in Hong Kong.

PubMed

Siu, Judy Yuen-Man

2014-02-06

Although having a regular primary care provider is noted to be beneficial to health, doctor shopping has been documented as a common treatment seeking behavior among chronically ill patients in different countries. However, little research has been conducted into the reasons behind doctor shopping behavior among patients with overactive bladder, and even less into how this behavior relates to these patients' illness and social experiences, perceptions, and cultural practices. Therefore, this study examines overactive bladder patients to investigate the reasons behind doctor shopping behavior. My study takes a qualitative approach, conducting 30 semi-structured individual interviews, with 30 overactive bladder patients in Hong Kong. My study found six primary themes that influenced doctor shopping behavior: lack of perceived need, convenience, work-provided medical insurance, unpleasant experiences with doctors, searching for a match doctor, and switching between biomedicine and traditional Chinese medicine. Besides the perceptual factors, participants' social environment, illness experiences, personal cultural preference, and cultural beliefs also intertwined to generate their doctor shopping behavior. Due to the low perceived need for a regular personal primary care physician, environmental factors such as time, locational convenience, and work-provided medical insurance became decisive in doctor shopping behavior. Patients' unpleasant illness experiences, stemming from a lack of understanding among many primary care doctors about overactive bladder, contributed to participants' sense of mismatch with these doctors, which induced them to shop for another doctor. Overactive bladder is a chronic bladder condition with very limited treatment outcome. Although patients with overactive bladder often require specialty urology treatment, it is usually beneficial for the patients to receive continuous, coordinated, comprehensive, and patient-centered support from their primary care providers. Primary care doctors' understanding on patients with overactive bladder with empathetic attitudes is important to reduce the motivations of doctor shopping behavior among these patients.

Documentation of pain care processes does not accurately reflect pain management delivered in primary care.

PubMed

Krebs, Erin E; Bair, Matthew J; Carey, Timothy S; Weinberger, Morris

2010-03-01

Researchers and quality improvement advocates sometimes use review of chart-documented pain care processes to assess the quality of pain management. Studies have found that primary care providers frequently fail to document pain assessment and management. To assess documentation of pain care processes in an academic primary care clinic and evaluate the validity of this documentation as a measure of pain care delivered. Prospective observational study. 237 adult patients at a university-affiliated internal medicine clinic who reported any pain in the last week. Immediately after a visit, we asked patients to report the pain treatment they received. Patients completed the Brief Pain Inventory (BPI) to assess pain severity at baseline and 1 month later. We extracted documentation of pain care processes from the medical record and used kappa statistics to assess agreement between documentation and patient report of pain treatment. Using multivariable linear regression, we modeled whether documented or patient-reported pain care predicted change in pain at 1 month. Participants' mean age was 53.7 years, 66% were female, and 74% had chronic pain. Physicians documented pain assessment for 83% of visits. Patients reported receiving pain treatment more often (67%) than was documented by physicians (54%). Agreement between documentation and patient report was moderate for receiving a new pain medication (k = 0.50) and slight for receiving pain management advice (k = 0.13). In multivariable models, documentation of new pain treatment was not associated with change in pain (p = 0.134). In contrast, patient-reported receipt of new pain treatment predicted pain improvement (p = 0.005). Chart documentation underestimated pain care delivered, compared with patient report. Documented pain care processes had no relationship with pain outcomes at 1 month, but patient report of receiving care predicted clinically significant improvement. Chart review measures may not accurately reflect the pain management patients receive in primary care.

2016 eCDRweb User Guide–Primary Support

EPA Pesticide Factsheets

This document presents the user guide for the Office of Pollution Prevention and Toxics’ (OPPT) 2016 e-CDR web tool. This document is the user guide for the Primary Support user of the 2016 e-CDRweb tool.

[Italian intersocietary consensus document on aspirin therapy in primary cardiovascular prevention].

PubMed

Volpe, Massimo; Abrignani, Maurizio Giuseppe; Borghi, Claudio; Coccheri, Sergio; Gresele, Paolo; Patti, Giuseppe; Trimarco, Bruno; De Caterina, Raffaele

2014-01-01

The indications for the use of aspirin in primary cardiovascular prevention continue to be a source of intense debate, with major international guidelines providing conflicting advices. This document, written by delegates of the main Italian scientific societies dealing with cardiovascular prevention and modeled on a similar document by the European Society of Cardiology Working Group on Thrombosis, reviews the evidence in favor and against the use of aspirin therapy in primary prevention based on data cumulated so far, including recent data linking aspirin with cancer protection. While awaiting the results of several ongoing studies, this document argues for a pragmatic approach to the use of low-dose aspirin in primary cardiovascular prevention, and suggests its use in patients at high cardiovascular risk, defined as ≥2 major cardiovascular events (death, myocardial infarction, or stroke) projected per 100 person-years, who are not at increased risk of bleeding.

Living conditions and access to health services by Bolivian immigrants in the city of São Paulo, Brazil.

PubMed

Silveira, Cássio; Carneiro Junior, Nivaldo; Ribeiro, Manoel Carlos Sampaio de Almeida; Barata, Rita de Cássia Barradas

2013-10-01

Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging process in the group. Per capita income increases the longer the immigrants stay in the country. The majority have secondary schooling. Work status does not vary according to time since arrival in Brazil. The immigrants work and live in garment sweatshops and speak their original languages. Social networks are based on ties with family and friends. Access to health services shows increasing inclusion in primary care. The authors conclude that the immigrants' social exclusion is decreasing due to greater access to documentation, work (although precarious), and the supply of health services from the public primary care system.

Obesity perceptions and documentation among primary care clinicians at a rural academic health center.

PubMed

Aleem, Sohaib; Lasky, Rosalind; Brooks, W Blair; Batsis, John A

2015-01-01

Obesity recognition in primary care is important to address the epidemic. We aimed to evaluate primary care clinician-reported documentation, management practices, beliefs and attitudes toward obesity compared to body mass index (BMI) calculation, obesity prevalence and actual documentation of obesity as an active problem in electronic health record in a rural academic center. Our target population for previously validated clinician survey was 56 primary care providers working at 3 sites. We used calendar year 2012 data for assessment of baseline system performance for metrics of documentation of BMI in primary care visits, and proportion of visits in patients with obesity with obesity as a problem. Standard statistical methods assessed the data. Survey response rate was 91%. Average age of respondents was 48.9 years and 62.7% were females. 72.5% clinicians reported having normal BMI. The majority of clinicians reported regularly documenting obesity as an active problem, and utilized motivational interviewing and basic good nutrition and healthy exercise. Clinicians identified lack of discipline and exercise time, access to unhealthy food and psychosocial issues as major barriers. Most denied disliking weight loss discussion or patients taking up too much time. In 21,945 clinic visits and 11,208 annual preventive care visits in calendar year 2012, BMI was calculated in 93% visits but obesity documentation as an active problem only 27% of patients meeting BMI criteria for obesity. Despite high clinician-reported documentation of obesity as an active problem, actual obesity documentation rates remained low in a rural academic medical center. Copyright © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Integrated Baseline System (IBS), Version 1. 03. [Chemical Stockpile Emergency Preparedness Program

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

Bailey, B.M.; Burford, M.J.; Downing, T.R.

The Integrated Baseline System (IBS), operated by the Federal Emergency Management Agency (FEMA), is a system of computerized tools for emergency planing and analysis. This document is the user guide for the IBS and explains how to operate the IBS system. The fundamental function of the IBS is to provide tools that civilian emergency management personnel can use in developing emergency plans and in supporting emergency management activities to cope with a chemical-releasing event at a military chemical stockpile. Emergency management planners can evaluate concepts and ideas using the IBS system. The results of that experience can then be factoredmore » into refining requirements and plans. This document provides information for the general system user, and is the primary reference for the system features of the IBS. It is designed for persons who are familiar with general emergency management concepts, operations, and vocabulary. Although the IBS manual set covers basic and advanced operations, it is not a complete reference document set. Emergency situation modeling software in the IBS is supported by additional technical documents. Some of the other LBS software is commercial software for which more complete documentation is available. The IBS manuals reference such documentation where necessary. IBS is a dynamic system. Its capabilities are in a state of continuing expansion and enhancement.« less

Section 8(d) Health Safety Data Reporting User Guide – Primary Support

EPA Pesticide Factsheets

This document presents the user guide for the Office of Pollution Prevention and Toxics (OPPT) Section 8(d) Health & Safety Data Reporting application. This document is the user guide for the Primary Support user.

2016 eCDRweb User Guide–Primary Authorized Official

EPA Pesticide Factsheets

This document presents the user guide for the Office of Pollution Prevention and Toxics’ (OPPT) 2016 e-CDRweb tool. This document is the user guide for the Primary Authorized Official (AO) user of the 2016 e-CDR web tool.

Documentation of Sexual Partner Gender Is Low in Electronic Health Records: Observations, Predictors, and Recommendations to Improve Population Health Management in Primary Care

PubMed Central

Yehia, Baligh R.

2015-01-01

Abstract The 2011 Institute of Medicine report on LGBT health recommended that sexual orientation and gender identity (SO/GI) be documented in electronic health records (EHRs). Most EHRs cannot document all aspects of SO/GI, but some can record gender of sexual partners. This study sought to determine the proportion of patients who have the gender of sexual partners recorded in the EHR and to identify factors associated with documentation. A retrospective analysis was done of EHR data for 40 family medicine (FM) and general internal medicine (IM) practices, comprising 170,570 adult patients seen in 2012. The primary outcome was EHR documentation of sexual partner gender. Multivariate logistic regression assessed the impact of patient, provider, and practice factors on documentation. In all, 76,767 patients (45%) had the gender of sexual partners recorded, 4.3% of whom had same-gender partners (3.5% of females, 5.6% of males). Likelihood of documentation was independently higher for women; blacks; those with a preventive visit; those with a physician assistant, nurse practitioner, or resident primary care provider (vs. attending); those at urban practices; those at smaller practices; and those at a residency FM practice. Older age and Medicare insurance were associated with lower documentation. Sexual partner gender documentation is important to identify patients for targeted prevention and support, and holds great potential for population health management, yet documentation in the EHR currently is low. Primary care practices should routinely record the gender of sexual partners, and additional work is needed to identify best practices for collecting and using SO/GI data in this setting. (Population Health Management 2015;18:217–222). PMID:25290634

Pediatric Coccidioidomycosis Patients: Perceptions, Quality of Life and Psychosocial Factors

PubMed Central

Gaab, Erin Mary; Naeem, Fouzia

2015-01-01

Research investigating the effects of coccidioidomycosis (valley fever) on children and the psychosocial implications of this disease in general is lacking. This study reviews what is known about pediatric coccidioidomycosis patients. It documents the psychological functioning, quality of life, and illness perceptions of a sample of coccidioidomycosis patient families. Primary caregivers of pediatric patients and patients from a major hospital in the San Joaquin Valley of California were interviewed regarding their perceptions of disease detection, access to care and the patient/family experience. PMID:27417796

Neurobiology and neurodevelopmental impact of childhood traumatic stress and prenatal alcohol exposure.

PubMed

Henry, Jim; Sloane, Mark; Black-Pond, Connie

2007-04-01

Research reveals that prenatal alcohol exposure and child trauma (i.e., abuse, neglect, sexual abuse) can have deleterious effects on child development across multiple domains. This study analyzed the impact on childhood neurodevelopment of prenatal alcohol exposure and postnatal traumatic experience compared to postnatal traumatic experience alone. Although the harmful effects of both have been well documented individually, there is no research documenting the concurrent effects of prenatal alcohol exposure and postnatal trauma on a child's developmental process. Transdisciplinary assessment of the children included the core disciplines of medicine, speech-language pathology, occupational therapy, social work, and psychology. Medical examination, standardized developmental and intelligence testing, projective tools, parent questionnaires, and psychosocial interviews provided information in the primary developmental areas. Findings indicated that children who had been exposed prenatally to alcohol along with postnatal traumatic experience had lower intelligence scores and more severe neurodevelopmental deficits in language, memory, visual processing, motor skills, and attention than did traumatized children without prenatal alcohol exposure, as well as greater oppositional/defiant behavior, inattention, hyperactivity, impulsivity, and social problems. Successful teacher and speech-language pathologist interventions with traumatized children with prenatal alcohol exposure demand a paradigm shift that requires the development of new perspectives and ongoing training.

II Brazilian Consensus on the use of human immunoglobulin in patients with primary immunodeficiencies.

PubMed

Goudouris, Ekaterini Simões; Rego Silva, Almerinda Maria do; Ouricuri, Aluce Loureiro; Grumach, Anete Sevciovic; Condino-Neto, Antonio; Costa-Carvalho, Beatriz Tavares; Prando, Carolina Cardoso; Kokron, Cristina Maria; Vasconcelos, Dewton de Moraes; Tavares, Fabíola Scancetti; Silva Segundo, Gesmar Rodrigues; Barreto, Irma Cecília; Dorna, Mayra de Barros; Barros, Myrthes Anna; Forte, Wilma Carvalho Neves

2017-01-01

In the last few years, new primary immunodeficiencies and genetic defects have been described. Recently, immunoglobulin products with improved compositions and for subcutaneous use have become available in Brazil. In order to guide physicians on the use of human immunoglobulin to treat primary immunodeficiencies, based on a narrative literature review and their professional experience, the members of the Primary Immunodeficiency Group of the Brazilian Society of Allergy and Immunology prepared an updated document of the 1st Brazilian Consensus, published in 2010. The document presents new knowledge about the indications and efficacy of immunoglobulin therapy in primary immunodeficiencies, relevant production-related aspects, mode of use (routes of administration, pharmacokinetics, doses and intervals), adverse events (major, prevention, treatment and reporting), patient monitoring, presentations available and how to have access to this therapeutic resource in Brazil. RESUMO Nos últimos anos, novas imunodeficiências primárias e defeitos genéticos têm sido descritos. Recentemente, produtos de imunoglobulina, com aprimoramento em sua composição e para uso por via subcutânea, tornaram-se disponíveis em nosso meio. Com o objetivo de orientar o médico no uso da imunoglobulina humana para o tratamento das imunodeficiências primárias, os membros do Grupo de Assessoria em Imunodeficiências da Associação Brasileira de Alergia e Imunologia produziram um documento que teve por base uma revisão narrativa da literatura e sua experiência profissional, atualizando o I Consenso Brasileiro publicado em 2010. Apresentam-se novos conhecimentos sobre indicações e eficácia do tratamento com imunoglobulina nas imunodeficiências primárias, aspectos relevantes sobre a produção, forma de utilização (vias de administração, farmacocinética, doses e intervalos), efeitos adversos (principais efeitos, prevenção, tratamento e notificação), monitorização do paciente, apresentações disponíveis e forma de obtenção deste recurso terapêutico em nosso meio.

Large Bore Powder Gun Qualification (U)

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

Rabern, Donald A.; Valdiviez, Robert

A Large Bore Powder Gun (LBPG) is being designed to enable experimentalists to characterize material behavior outside the capabilities of the NNSS JASPER and LANL TA-55 PF-4 guns. The combination of these three guns will create a capability to conduct impact experiments over a wide range of pressures and shock profiles. The Large Bore Powder Gun will be fielded at the Nevada National Security Site (NNSS) U1a Complex. The Complex is nearly 1000 ft below ground with dedicated drifts for testing, instrumentation, and post-shot entombment. To ensure the reliability, safety, and performance of the LBPG, a qualification plan has beenmore » established and documented here. Requirements for the LBPG have been established and documented in WE-14-TR-0065 U A, Large Bore Powder Gun Customer Requirements. The document includes the requirements for the physics experiments, the gun and confinement systems, and operations at NNSS. A detailed description of the requirements is established in that document and is referred to and quoted throughout this document. Two Gun and Confinement Systems will be fielded. The Prototype Gun will be used primarily to characterize the gun and confinement performance and be the primary platform for qualification actions. This gun will also be used to investigate and qualify target and diagnostic modifications through the life of the program (U1a.104 Drift). An identical gun, the Physics Gun, will be fielded for confirmatory and Pu experiments (U1a.102D Drift). Both guns will be qualified for operation. The Gun and Confinement System design will be qualified through analysis, inspection, and testing using the Prototype Gun for the majority of process. The Physics Gun will be qualified through inspection and a limited number of qualification tests to ensure performance and behavior equivalent to the Prototype gun. Figure 1.1 shows the partial configuration of U1a and the locations of the Prototype and Physics Gun/Confinement Systems.« less

Nurses and the sterilization experiments of Auschwitz: a postmodernist perspective.

PubMed

Benedict, Susan; Georges, Jane M

2006-12-01

The medical experiments conducted on non-consenting prisoners of Nazi concentration camps during World War II necessitated the codification of principles to protect human subjects of research. Auschwitz was the largest and one of the most infamous of the camps and the site of numerous 'medical' experiments. This historical study uses primary source documents obtained from archives in England and Germany to describe one type of experiment carried out at Auschwitz - the sterilization experiments. The purpose of these experiments was to perfect a technique in which non-Aryans could be prevented from reproducing while still being able to work as slave laborers. These narratives regarding the sterilization experiments at Auschwitz are remarkable in that they contain previously undocumented information regarding the voluntary and involuntary involvement of nurses. Following these narratives, a discussion of ethics in relation to the Holocaust is presented with a specific focus on the work of Agamben. Implications of the Auschwitz narratives for the application of codes of ethical principles and contemporary nursing are discussed from a postmodernist perspective.

Differences in the diagnosis and management of systemic lupus erythematosus by primary care and specialist providers in the American Indian/Alaska Native population.

PubMed

McDougall, J A; Helmick, C G; Lim, S S; Johnston, J M; Gaddy, J R; Gordon, C; Ferucci, E D

2018-06-01

Objectives The objective of this study is to investigate differences in the diagnosis and management of systemic lupus erythematosus (SLE) by primary care and specialist physicians in a population-based registry. Methods This study includes individuals from the 2009 Indian Health Service lupus registry population with a diagnosis of SLE documented by either a primary care provider or specialist. SLE classification criteria, laboratory testing, and medication use at any time during the course of disease were determined by medical record abstraction. Results Of the 320 individuals with a diagnosis of SLE, 249 had the diagnosis documented by a specialist, with 71 documented by primary care. Individuals with a specialist diagnosis of SLE were more likely to have medical record documentation of meeting criteria for SLE by all criteria sets (American College of Rheumatology, 79% vs 22%; Boston Weighted, 82% vs 32%; and Systemic Lupus International Collaborating Clinics, 83% vs 35%; p < 0.001 for all comparisons). In addition, specialist diagnosis was associated with documentation of ever having been tested for anti-double-stranded DNA antibody and complement 3 and complement 4 ( p < 0.001). Documentation of ever receiving hydroxychloroquine was also more common with specialist diagnosis (86% vs 64%, p < 0.001). Conclusions Within the population studied, specialist diagnosis of SLE was associated with a higher likelihood of having SLE classification criteria documented, being tested for biomarkers of disease, and ever receiving treatment with hydroxychloroquine. These data support efforts both to increase specialist access for patients with suspected SLE and to provide lupus education to primary care providers.

Section 8(a) PAIR User Guide – Primary Authorized Official

EPA Pesticide Factsheets

This document presents the user guide for the Office of Pollution Prevention and Toxics (OPPT) ‘Section 8(a) PAIR’ application submission process. This document is the user guide for the Primary Authorized Official (AO) user of the Section 8(a) PAIR tool.

Methylmercury bioaccumulation in stream food webs declines with increasing primary production

USGS Publications Warehouse

Walters, David; D.F. Raikow,; C.R. Hammerschmidt,; M.G. Mehling,; A. Kovach,; J.T. Oris,

2015-01-01

Opposing hypotheses posit that increasing primary productivity should result in either greater or lesser contaminant accumulation in stream food webs. We conducted an experiment to evaluate primary productivity effects on MeHg accumulation in stream consumers. We varied light for 16 artificial streams creating a productivity gradient (oxygen production =0.048–0.71 mg O2 L–1 d–1) among streams. Two-level food webs were established consisting of phytoplankton/filter feeding clam, periphyton/grazing snail, and leaves/shredding amphipod (Hyalella azteca). Phytoplankton and periphyton biomass, along with MeHg removal from the water column, increased significantly with productivity, but MeHg concentrations in these primary producers declined. Methylmercury concentrations in clams and snails also declined with productivity, and consumer concentrations were strongly correlated with MeHg concentrations in primary producers. Heterotroph biomass on leaves, MeHg in leaves, and MeHg in Hyalella were unrelated to stream productivity. Our results support the hypothesis that contaminant bioaccumulation declines with stream primary production via the mechanism of bloom dilution (MeHg burden per cell decreases in algal blooms), extending patterns of contaminant accumulation documented in lakes to lotic systems.

Integrated Baseline System (IBS), Version 1.03. User guide: Chemical Stockpile Emergency Preparedness Program

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

Bailey, B.M.; Burford, M.J.; Downing, T.R.

The Integrated Baseline System (IBS), operated by the Federal Emergency Management Agency (FEMA), is a system of computerized tools for emergency planing and analysis. This document is the user guide for the IBS and explains how to operate the IBS system. The fundamental function of the IBS is to provide tools that civilian emergency management personnel can use in developing emergency plans and in supporting emergency management activities to cope with a chemical-releasing event at a military chemical stockpile. Emergency management planners can evaluate concepts and ideas using the IBS system. The results of that experience can then be factoredmore » into refining requirements and plans. This document provides information for the general system user, and is the primary reference for the system features of the IBS. It is designed for persons who are familiar with general emergency management concepts, operations, and vocabulary. Although the IBS manual set covers basic and advanced operations, it is not a complete reference document set. Emergency situation modeling software in the IBS is supported by additional technical documents. Some of the other LBS software is commercial software for which more complete documentation is available. The IBS manuals reference such documentation where necessary. IBS is a dynamic system. Its capabilities are in a state of continuing expansion and enhancement.« less

Investigating Nigerian Primary School Teachers' Preparedness to Adopt Personal Response System in ESL Classroom

ERIC Educational Resources Information Center

Agbatogun, Alaba Olaoluwakotansibe

2012-01-01

This study investigated the extent to which computer literacy dimensions (computer general knowledge, documents and documentations, communication and surfing as well as data inquiry), computer use and academic qualification as independent variables predicted primary school teachers' attitude towards the integration of Personal Response System in…

[SYSTEMATIZATION, ORDER AND SECURITY AS A RESULT OF THE NURSE ASSESSMENT IN PAEDIATRIC EMERGENCY: A METAMORPHOSIS PROCESS].

PubMed

García-Hernández, M-Noelia; Fraga-Hernández, Ma Elena; Mahtani-Chugani, Vinita

2014-12-01

To determine from the health care professionals perspective the impact on clinical practice of incorporating an assessment tool for primary care paediatric emergency. Qualitative study based on the collection of written documents. Twenty-four wide and detailed documents were collected. Thematic analysis was used. Participants were 9 nurses and 7 paediatricians, all with experience in the Paediatric Emergency Department. The results are grouped into three areas: perception of previous situation; benefits perceived; difficulties of the change process related to the triage instrument. The benefits perceived include the achievement of the objectives related to triage as well as collateral benefits for the organization and distribution of structural resources, adequacy of human resources, self-assessment and professional recognition, improvement of team communication and users service perception. The difficulties identified are related to the feasibility of using this instrument when patient flow is high and to the need of specialized training. All participants perceived more benefits than disadvantages, and both nurses and paediatricians experienced the process as a positive experience. The introduction of the assessment tool had a broader impact than expected.

Second International Microgravity Laboratory (IML-2)

NASA Technical Reports Server (NTRS)

Snyder, Robert S. (Compiler)

1997-01-01

This report highlights the scientific and engineering accomplishments achieved during the 14-day Second International Microgravity Laboratory (IML-2) mission. The mission, managed by the National Aeronautics and Space Administration's Marshall Space Flight Center in Huntsville, Alabama, laid the groundwork for broader international partnerships and scientific alliances. Five other space agencies joined NASA on the mission: the Canadian Space Agency (CSA), the European Space Agency (ESA), the French Space Agency (CNES), the German Space Agency (DARA), and the National Space Development Agency of Japan (NASDA). For the mission, microgravity and life sciences investigations were completed inside Spacelab by a crew working around the clock. The report foreword and introduction describe the mission and the facilities used for IML-2. By the end of the mission, hundreds of primary and secondary experiments were completed. With the help of the principal investigators, most of the primary investigations and some of the co-investigations are described in this document. The lead report authors are cited at the beginning of each experiment description The remainder of the description includes the experiment objectives, flight activities postflight analysis, conclusions, illustrations, and references for further research. The major scientific accomplishments of each investigation are highlighted.

Microgravity Experiments Safety and Integration Requirements Document Tree

NASA Technical Reports Server (NTRS)

Hogan, Jean M.

1995-01-01

This report is a document tree of the safety and integration documents required to develop a space experiment. Pertinent document information for each of the top level (tier one) safety and integration documents, and their applicable and reference (tier two) documents has been identified. This information includes: document title, revision level, configuration management, electronic availability, listed applicable and reference documents, source for obtaining the document, and document owner. One of the main conclusions of this report is that no single document tree exists for all safety and integration documents, regardless of the Shuttle carrier. This document also identifies the need for a single point of contact for customers wishing to access documents. The data in this report serves as a valuable information source for the NASA Lewis Research Center Project Documentation Center, as well as for all developers of space experiments.

Evaluation of clinical pharmacy interventions in a Veterans Affairs medical center primary care clinic.

PubMed

Hough, Augustus; Vartan, Christine M; Groppi, Julie A; Reyes, Sonia; Beckey, Nick P

2013-07-01

The development of an electronic tool to quantify and characterize the interventions made by clinical pharmacy specialists (CPSs) in a primary care setting is described. An electronic clinical tool was developed to document the clinical pharmacy interventions made by CPSs at the Veterans Affairs Medical Center in West Palm Beach, Florida. The tool, embedded into the electronic medical record, utilizes a novel reminder dialogue to complete pharmacotherapy visit encounters and allows CPSs to document interventions made during patient care visits. Interventions are documented using specific electronic health factors so that the type and number of interventions made for both disease-specific and other pharmacotherapy interventions can be tracked. These interventions were assessed and analyzed to evaluate the impact of CPSs in the primary care setting. From February 2011 through January 2012, a total of 16,494 pharmacotherapy interventions (therapeutic changes and goals attained) were recorded. The average numbers of interventions documented per patient encounter were 0.96 for the management of diabetes mellitus, hypertension, dyslipidemia, and heart failure and 1.36 for non-disease-specific interventions, independent of those interventions being made by the primary physician or other members of the primary care team. A clinical reminder tool developed to quantify and characterize the interventions provided by CPSs found that for every visit with a CPS, approximately one disease-specific intervention and one additional pharmacotherapy intervention were made, independent of those interventions being made by the primary physician or other members of the primary care team.

Iraqi Perspectives Project. Primary Source Materials for Saddam and Terrorism: Emerging Insights from Captured Iraqi Documents. Volume 5 (Redacted)

DTIC Science & Technology

2007-11-01

whether the latter are serving near or far in espionage missions. This experiment started on 6/25/1958. It involved telepathy , and it ended with a 70...Atlantic. Rather, a new kind ofweapon was used in this operation, namely parapsychology - by using a specialized diver and telepathy . (11-22... dream that a flame emerged from him, spread throughout the land, and started to bum everyone that had an encounter with it. He told of his dream to

Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

PubMed

Sasnett, Bonita; Harris, Susie T; White, Shelly

Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

Dynamics Explorer 1: Energetic Ion Composition Spectrometer (EICS)

NASA Technical Reports Server (NTRS)

Shelley, E. G.; Peterson, W. K.; Collin, H. L.

1994-01-01

The Energetic Ion Composition Spectrometer (EICS) experiment was selected as part of the Dynamics Explorer (DE) Program. One of the primary goals of the DE program was to investigate in detail the plasma physics processes responsible for energizing thermal (approximately 1 eV) ionospheric ions and transporting them to the earth's plasma sheet and distant polar cap. The results of the EICS data analysis (including support of other investigators) and of the archiving efforts supported by this contract are summarized in this document. Also reported are some aspects of our operational support activities.

Material Selection Guidelines to Limit Atomic Oxygen Effects on Spacecraft Surfaces

NASA Technical Reports Server (NTRS)

Dooling, D.; Finckenor, M. M.

1999-01-01

This report provides guidelines in selecting materials for satellites and space platforms, designed to operate within the Low-Earth orbit environment, which limit the effects of atomic oxygen interactions with spacecraft surfaces. This document should be treated as an introduction rather than a comprehensive guide since analytical and flight technologies continue to evolve, flight experiments are conducted as primary or piggyback opportunities arise, and our understanding of materials interactions and protection methods grows. The reader is urged to consult recent literature and current web sites containing information about research and flight results.

Primary care practice organization influences colorectal cancer screening performance.

PubMed

Yano, Elizabeth M; Soban, Lynn M; Parkerton, Patricia H; Etzioni, David A

2007-06-01

To identify primary care practice characteristics associated with colorectal cancer (CRC) screening performance, controlling for patient-level factors. Primary care director survey (1999-2000) of 155 VA primary care clinics linked with 38,818 eligible patients' sociodemographics, utilization, and CRC screening experience using centralized administrative and chart-review data (2001). Practices were characterized by degrees of centralization (e.g., authority over operations, staffing, outside-practice influence); resources (e.g., sufficiency of nonphysician staffing, space, clinical support arrangements); and complexity (e.g., facility size, academic status, managed care penetration), adjusting for patient-level covariates and contextual factors. Chart-based evidence of CRC screening through direct colonoscopy, sigmoidoscopy, or consecutive fecal occult blood tests, eliminating cases with documented histories of CRC, polyps, or inflammatory bowel disease. After adjusting for sociodemographic characteristics and health care utilization, patients were significantly more likely to be screened for CRC if their primary care practices had greater autonomy over the internal structure of care delivery (p<.04), more clinical support arrangements (p<.03), and smaller size (p<.001). Deficits in primary care clinical support arrangements and local autonomy over operational management and referral procedures are associated with significantly lower CRC screening performance. Competition with hospital resource demands may impinge on the degree of internal organization of their affiliated primary care practices.

Community health workers: a bridge to healthcare for people who inject drugs.

PubMed

Morgan, Kirsty; Lee, Jessica; Sebar, Bernadette

2015-04-01

Although people who inject drugs (PWIDs) have increased healthcare needs, their poor access and utilisation of mainstream primary healthcare services is well documented. To address this situation, community health workers (CHWs) who have personal experience of drug injecting in addition to healthcare training or qualifications are sometimes utilised. However, the role peer workers play as members of clinical primary healthcare teams in Australia and how they manage the healthcare needs of PWID, has been poorly documented. A qualitative ethnomethodological approach was used to study the methods used by CHWs. Data was collected using participant observation of CHWs in a PWID-targeted primary healthcare centre. CHW healthcare consultations with PWID were audio-recorded and transcribed verbatim. Transcripts along with field notes were analysed using membership categorisation and conversation analysis techniques to reveal how CHWs' personal and professional experience shapes their healthcare interactions with PWID clients. CHWs' personal experience of injecting drug use is an asset they utilise along with their knowledge of clinical practice and service systems. It provides them with specialised knowledge and language--resources that they draw upon to build trust with clients and accomplish transparent, non-judgmental interactions that enable PWID clients to be active participants in the management of their healthcare. Existing literature often discusses these principles at a theoretical level. This study demonstrates how CHWs achieve them at a micro-level through the use of indexical language and displays of the membership categories 'PWID' and 'healthcare worker'. This research explicates how CHWs serve as an interface between PWID clients and conventional healthcare providers. CHWs deployment of IDU-specific language, membership knowledge, values and behaviours, enable them to interact in ways that foster transparent communication and client participation in healthcare consultations. The incorporation of community health workers into clinical healthcare teams working with IDU populations is a possible means for overcoming barriers to healthcare, such as mistrust and fear of stigma and discrimination, because CHWs are able to serve as an interface between PWID and other healthcare providers. Copyright © 2014 Elsevier B.V. All rights reserved.

Investigating Metacom's War: Analyzing Rowlandson's Primary Document in Upper-Elementary Classrooms

ERIC Educational Resources Information Center

Campbell, Susan E.

2011-01-01

Metacom's War, also known as King Phillip's War, sets a pattern of national expansion through displacement of native people that echoes throughout American history. Helping students further understand this war through the examination of Mary Rowlandson's primary document provides educators and students with an opportunity to delve deeper into the…

ASSET. Assessment Simplification System for Elementary Teachers.

ERIC Educational Resources Information Center

Kentucky State Dept. of Education, Frankfort.

This document is designed to show the connections between assessment tools available for primary and intermediate grades in the Kentucky public schools. Sections of the document outline the essential assessment tools and give information about how they support and mirror each other. These tools can be used to bridge the knowledge of primary and…

A Historical Analysis of Primary Mathematics Curricula in Terms of Teaching Principles

ERIC Educational Resources Information Center

Ozmantar, Mehmet Fatih

2017-01-01

This study carries out a comparative analysis of primary mathematics curricula put into practice during Turkish Republican period. The data for this study are composed of official curricula documents which are examined in terms of teaching principles. The study adopts a qualitative approach and employs document analysis method. The official…

Milestones for the Final Mile: Interspecialty Distinctions in Primary Palliative Care Skills Training.

PubMed

Harris, John A; Herrel, Lindsey A; Healy, Mark A; Wancata, Lauren M; Perumalswami, Chithra R

2016-09-01

Primary palliative care (PPC) skills are useful in a wide variety of medical and surgical specialties, and the expectations of PPC skill training are unknown across graduate medical education. We characterized the variation and quality of PPC skills in residency outcomes-based Accreditation Council for Graduate Medical Education (ACGME) milestones. We performed a content analysis with structured implicit review of 2015 ACGME milestone documents from 14 medical and surgical specialties chosen for their exposure to clinical situations requiring PPC. For each specialty milestone document, we characterized the variation and quality of PPC skills in residency outcomes-based ACGME milestones. We identified 959 occurrences of 29 palliative search terms within 14 specialty milestone documents. Within these milestone documents, implicit review characterized 104 milestones with direct saliency to PPC skills and 196 milestones with indirect saliency. Initial interrater agreement of the saliency rating among the primary reviewers was 89%. Specialty milestone documents varied widely in their incorporation of PPC skills within milestone documents. PPC milestones were most commonly found in milestone documents for Anesthesiology, Pediatrics, Urology, and Physical Medicine and Rehabilitation. PPC-relevant milestones were most commonly found in the Interpersonal and Communication Skills core competency with 108 (36%) relevant milestones classified under this core competency. Future revisions of specialty-specific ACGME milestone documents should focus on currently underrepresented, but important PPC skills. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

A comparison of adverse event and fracture efficacy data for strontium ranelate in regulatory documents and the publication record

PubMed Central

Bolland, Mark J; Grey, Andrew

2014-01-01

Objective Recently, the European Medicines Agency reported that strontium ranelate increases myocardial infarction risk in postmenopausal women, 8.5 years after it was registered for use in osteoporosis. Unreported serious adverse events in clinical trials for other pharmaceuticals have been described in recent years. We assessed reporting of adverse events and fracture efficacy of strontium. Methods We compared data on adverse effects (myocardial infarction, venous thromboembolism and pulmonary embolism) and fracture efficacy of strontium in publicly available regulatory documents with data in publications retrieved from searching PubMed. Results We identified 5 regulatory documents and 9 primary publications of 7 randomised, placebo-controlled trials of strontium that reported relevant data. We identified several areas of concern in these reports: the increased risk of myocardial infarction with strontium was not identified in a pivotal phase 3 clinical trial despite specific regulatory review of cardiovascular events; data on myocardial infarction were not included in any primary publication; increased risks of venous thromboembolism and pulmonary embolism with strontium were not reported in either of the phase 3 clinical trials; data on venous thromboembolism were reported in only 5 of 9 primary publications, data on pulmonary embolism in only 2 of 9 primary publications, and either was discussed in <50% of subsequent review articles. There were differences in participant numbers, fracture cases and venous thromboembolism cases between regulatory documents and primary publications. Based on all available data from primary publications and regulatory documents, the number of fractures prevented by strontium use is similar to the number of extra cases of venous thromboembolism, pulmonary embolism and myocardial infarction caused by strontium use. Conclusions The risks of strontium use are similar to the benefits. Full disclosure of the clinical trial data and regulatory documents would allow clinicians and their patients to decide whether use of the drug is worthwhile. PMID:25293384

Conceptual design of a moving belt radiator shuttle-attached experiments: Technical requirement Document

NASA Technical Reports Server (NTRS)

Aguilar, Jerry L.

1989-01-01

The technical requirements for a shuttle-attached Moving Belt Radiator (MBR) experiment are defined. The MBR is an advanced radiator concept in which a rotating belt radiates thermal energy to space. The requirements for integrating the MBR experiment in the shuttle bay are discussed. Requirements for the belt material and working fluid are outlined along with some possible options. The proposed size and relationship to a full scale Moving Belt Radiator are defined. The experiment is defined with the primary goal of dynamic testing and a secondary goal of demonstrating the sealing and heat transfer characteristics. A perturbation system which will simulate a docking maneuver or other type of short term acceleration is proposed for inclusion in the experimental apparatus. A deployment and retraction capability which will aid in evaluating the dynamics of a belt during such a maneuver is also described. The proposed test sequence for the experiment is presented. Details of the conceptual design are not presented herein, but rather in a separate Final Report.

Doing things my way: teaching physical education with a disability.

PubMed

Grenier, Michelle A; Horrell, Andrew; Genovese, Bryan

2014-10-01

Having a disability and being a teacher can be a critical site for examining practices associated with ability, competence, and pedagogy. While there is a growing literature base that examines the experiences of students with disabilities in physical education, there is virtually no research that examines the experiences of physical education teachers with disabilities. Using the capability approach, this article explores the experiences of a physical education teaching intern with a physical disability, significant school members, and the students he interacted with through interviews and documents. The results yielded 3 primary themes. The first, "the fluid nature of the disability discourse," demonstrated the complexity of disability and explored the contrast between static tendencies that stereotype disability and the disability experience. The second theme, "doing things my way," reflected the intern's need to distinguish himself as a teacher by defining contexts for experiencing competence. The third and final theme, "agent of change," explored how the intern's experiences as a teacher with a disability informed his educational narrative.

Concordance Between Veterans' Self-Report and Documentation of Surrogate Decision Makers: Implications for Quality Measurement.

PubMed

Garner, Kimberly K; Dubbert, Patricia; Lensing, Shelly; Sullivan, Dennis H

2017-01-01

The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. To better understand the potential implementation of this Measuring What Matters quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker. Examination of patient responses to self-assessment questions from advance health care planning educational groups conducted in one medical center primary care clinic and seven community-based outpatient primary care clinics. We assessed the concordance between patient reports of identifying and naming a surrogate decision maker and having completed an advance directive (AD) with presence of an AD in the electronic medical record. Of veterans without a documented AD on file, more than half (66%) reported that they had talked with someone they trusted and nearly half (52%) reported that they had named someone to communicate their preferences. Our clinical project data suggest that many more veterans may have initiated communications with surrogate decision makers than is evident in the electronic medical record. System changes are needed to close the gap between veterans' plans for a surrogate decision maker and the documentation available to acute care health care providers. Published by Elsevier Inc.

Factors influencing the documentation of fertility-related discussions for adolescents and young adults with cancer.

PubMed

Skaczkowski, G; White, V; Thompson, K; Bibby, H; Coory, M; Pinkerton, R; Nicholls, W; Orme, L M; Conyers, R; Phillips, M B; Osborn, M; Harrup, R; Anazodo, A

2018-06-01

A cancer diagnosis and treatment may have significant implications for a young patient's future fertility. Documentation of fertility-related discussions and actions is crucial to providing the best follow-up care, which may occur for many years post-treatment. This study examined the rate of medical record documentation of fertility-related discussions and fertility preservation (FP) procedures for adolescents and young adults (AYAs) with cancer in Australia. A retrospective review of medical records for 941 patients in all six Australian states. Patients were identified through population-based cancer registries (four states) and hospital admission lists (two states). Trained data collectors extracted information from medical records using a comprehensive data collection survey. Records were reviewed for AYA patients (aged 15-24 years at diagnosis), diagnosed with acute myeloid leukaemia, acute lymphoblastic leukaemia, central nervous system (CNS) tumours, soft tissue sarcomas (STS), primary bone cancer or Ewing's family tumours between 2007 and 2012. 47.2% of patients had a documented fertility discussion and 35.9% had a documented FP procedure. Fertility-related documentation was less likely for female patients, those with a CNS or STS diagnosis and those receiving high-risk treatments. In multivariable models, adult hospitals with an AYA focus were more likely to document fertility discussions (odds ratio[OR] = 1.60; 95%CI = 1.08-2.37) and FP procedures (OR = 1.74; 95%CI = 1.17-2.57) than adult hospitals with no AYA services. These data provide the first national, population-based estimates of fertility documentation for AYA cancer patients in Australia. Documentation of fertility-related discussions was poor, with higher rates observed in hospitals with greater experience of treating AYA patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

Mineralocorticoid before glucocorticoid deficiency in a dog with primary hypoadrenocorticism and hypothyroidism.

PubMed

McGonigle, Kathryn M; Randolph, John F; Center, Sharon A; Goldstein, Richard E

2013-01-01

A dog with an unexpected presentation of primary hypoadrenocorticism was evaluated for clinical signs and electrolyte abnormalities characteristic of Addison's disease. Although the initial adrenocorticotropic hormone (ACTH) stimulation test documented serum cortisol concentrations within the reference range, subsequent assessments confirmed hypoaldosteronism. Mineralocorticoid replacement promptly normalized electrolytes and transiently improved clinical illness. Six weeks after initial ACTH stimulation testing, the dog became glucocorticoid deficient. Concurrent primary hypothyroidism was also documented. Hypoaldosteronism preceding hypocortisolemia is a unique presentation of canine Addison's disease.

Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia - a multiple case study using mixed methods.

PubMed

Schadewaldt, Verena; McInnes, Elizabeth; Hiller, Janet E; Gardner, Anne

2016-07-29

In 2010 policy changes were introduced to the Australian healthcare system that granted nurse practitioners access to the public health insurance scheme (Medicare) subject to a collaborative arrangement with a medical practitioner. These changes facilitated nurse practitioner practice in primary healthcare settings. This study investigated the experiences and perceptions of nurse practitioners and medical practitioners who worked together under the new policies and aimed to identify enablers of collaborative practice models. A multiple case study of five primary healthcare sites was undertaken, applying mixed methods research. Six nurse practitioners, 13 medical practitioners and three practice managers participated in the study. Data were collected through direct observations, documents and semi-structured interviews as well as questionnaires including validated scales to measure the level of collaboration, satisfaction with collaboration and beliefs in the benefits of collaboration. Thematic analysis was undertaken for qualitative data from interviews, observations and documents, followed by deductive analysis whereby thematic categories were compared to two theoretical models of collaboration. Questionnaire responses were summarised using descriptive statistics. Using the scale measurements, nurse practitioners and medical practitioners reported high levels of collaboration, were highly satisfied with their collaborative relationship and strongly believed that collaboration benefited the patient. The three themes developed from qualitative data showed a more complex and nuanced picture: 1) Structures such as government policy requirements and local infrastructure disadvantaged nurse practitioners financially and professionally in collaborative practice models; 2) Participants experienced the influence and consequences of individual role enactment through the co-existence of overlapping, complementary, traditional and emerging roles, which blurred perceptions of legal liability and reimbursement for shared patient care; 3) Nurse practitioners' and medical practitioners' adjustment to new routines and facilitating the collaborative work relied on the willingness and personal commitment of individuals. Findings of this study suggest that the willingness of practitioners and their individual relationships partially overcame the effect of system restrictions. However, strategic support from healthcare reform decision-makers is needed to strengthen nurse practitioner positions and ensure the sustainability of collaborative practice models in primary healthcare.

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.

The Italian Geographers' Document on the University Education of Future Primary School Teachers

ERIC Educational Resources Information Center

Giorda, Cristiano; Di Palma, Maria Teresa

2011-01-01

This article describes an important document compiled by a group of Italian geographers who teach in the Teaching Sciences faculty. Twenty-two university professors in an online community debated concepts and compared ideas in order to establish content, methods and didactic approaches to be applied when training Primary School teachers (pupils…

eCDRweb User Guide–Primary Support

EPA Pesticide Factsheets

This document presents the user guide for the Office of Pollution Prevention and Toxics’ (OPPT) e-CDR web tool. E-CDRweb is the electronic, web-based tool provided by the Environmental Protection Agency (EPA) for the submission of Chemical Data Reporting (CDR) information. This document is the user guide for the Primary Support user of the e-CDRweb tool.

eCDRweb User Guide–Primary Authorized Official

EPA Pesticide Factsheets

This document presents the user guide for the Office of Pollution Prevention and Toxics’ (OPPT) e-CDRweb tool. E-CDRweb is the electronic, web-based tool provided by the Environmental Protection Agency (EPA) for the submission of Chemical Data Reporting (CDR) information. This document is the user guide for the Primary Authorized Official (AO) user of the e-CDR webtool

Examining the Seven-Flag "Chieu Hoi" Pass: A Primary Document from the American War in Viet Nam

ERIC Educational Resources Information Center

Engelmann, Ted

2006-01-01

During the Viet Nam war, U.S. military helicopters dropped "Chieu Hoi" (safe conduct) passes over suspected enemy locations to encourage enemy soldiers to surrender. This article presents a classroom activity that encourages students to examine a "Chieu Hoi" pass as a primary historical document, identify its various elements,…

Constitutional Debates on Freedom of Religion: A Documentary History. Primary Documents in American History and Contemporary Issues.

ERIC Educational Resources Information Center

Patrick, John J., Ed.; Long, Gerald P., Ed.

Debates over the separation or accommodation of religion and government have divided the United States since its founding. This collection of over 70 primary documents represents the ideas and issues on the interpretation of the United States Constitution's First Amendment clauses pertaining to establishment and free exercise of religion. The…

Multiple bone metastases from glioblastoma multiforme without local brain relapse: a case report and review of the literature.

PubMed

Takanen, Silvia; Bangrazi, Caterina; Caiazzo, Rossella; Raffetto, Nicola; Tombolini, Vincenzo

2013-01-01

Extracranial metastases from glioblastoma multiforme (GBM) are a very rare event, even if an increasing incidence has been documented. We report the case of a young woman with primary GBM who developed bone metastases without local brain relapse. Because of persistent headache and visual disturbances, in March 2011 the patient underwent magnetic resonance imaging (MRI) evidencing a temporoparietal mass, which was surgically resected. Histology revealed GBM. She was given concomitant chemoradiotherapy according to the Stupp regimen. After a 4-week break, the patient received 6 cycles of adjuvant temozolomide according to the standard 5-day schedule every 28 days. In December 2011 she complained of progressive low back pain, and MRI showed multiple bone metastases from primary GBM, confirmed by histology. Cases of metastatic GBM in concurrence with a primary brain tumor or local relapse are more common in the literature; only a few cases have been reported where extracranial metastases from GBM occurred without any relapse in the brain. Here we report our experience.

ASRDI oxygen technology survey. Volume 3: Heat transfer and fluid dynamics. Abstracts of selected technical reports and publications

NASA Technical Reports Server (NTRS)

Schmidt, A. F. (Editor)

1972-01-01

Selected information is presented from an assemblage of reports and publications on heat transfer and fluid dynamics with direct applicability to oxygen systems. For each document cited, an abstract has been prepared together with key words and a listing of most important references found in the document. Additionally, an author index, a subject index, and a key word index have been provided to simplify the retrieval of specific information from this work. In each subject area - e.g., boiling heat transfer - the individual citations are listed alphabetically by first author, with review papers dually noted under the appropriate subject category and under review papers. Of the documents reviewed and evaluated for inclusion in this publication, coverage of existing information directly concerned with oxygen was given primary emphasis. However, work not specifically oxygen-designated but considered applicable to oxygen by the reviewer e.g., a two-phase friction factor correlation derived from nitrogen experiments is occasionally given where no actual oxygen data exist, as an aid to the reader. Approximately 130 abstracts are listed.

Counting seizures: The primary outcome measure in epileptology from the patients' perspective.

PubMed

Blachut, Barbara; Hoppe, Christian; Surges, Rainer; Stahl, Jutta; Elger, Christian E; Helmstaedter, Christoph

2015-07-01

Patient-reported seizure counts represent a key outcome measure for individual treatments and clinical studies in epileptology. Video-EEG based research, however, demonstrated lack of validity due to underreporting. Here we examined the practice of keeping seizure diaries and the patients' attitudes toward seizure counting. Anticipating a low return rate, a comprehensive survey was mailed to 1100 adult outpatients. Besides methods and reasons to document or not to document seizures, the questionnaire addressed clinical, personality and sociodemographic characteristics as well as the subjective experience of seizures. Questionnaires from 170 patients (15%) could be included in our analysis. Patients estimated to be aware of 5.3 out of 10 daytime seizures (nocturnal seizures: 2.6) while they supposed that relatives/colleagues noticed 7.1 (nocturnal: 4.6). Almost two-thirds of the patients reported to keep a seizure diary with a self-estimated documentation rate of 8.7 out of 10 noticed daytime seizures (nocturnal: 7.7). Documenters and non-documenters showed only marginal group differences with regard to clinical, personality and sociodemographic characteristics. Importantly, patients were more committed to keep a seizure diary when they judged it to be relevant for clinical treatment decisions. Patients appear to know that they underreport seizures. According to their view, seizure unawareness as induced by seizures themselves seems to be a more important factor than omitting documentation of noticed seizures. Thus, the potential to improve the validity of seizure diaries of electronic devices which facilitate documenting noticed seizures appears limited. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

The Baghdad that Was: Using Primary Sources to Teach World History

ERIC Educational Resources Information Center

Schur, Joan Brodsky

2009-01-01

That primary source documents have the power to bring the past alive is no news to social studies teachers. What is new in the last 10 years is the number of digitized documents available online that teachers can download and use in their classrooms. Encouraging teachers to utilize this ever-increasing treasure trove of resources was the goal of…

Data and Primary Source Documents for Social Studies Classrooms from the Federal Reserve Bank of St. Louis

ERIC Educational Resources Information Center

Suiter, Mary C.; Stierholz, Katrina L.

2011-01-01

Data and primary source documents are important for understanding past and current events. The Federal Reserve Bank of St. Louis has committed itself to the collection and illumination of economic data and historical information for classroom teachers and researchers. The Federal Reserve Bank of St. Louis provides a number of services--including…

The World of Barilla Taylor: A Primary Source-Based Kit for Students in Grades 8-12.

ERIC Educational Resources Information Center

Fellner, Kelly; Stearns, Liza

1995-01-01

Examines a primary source-based kit that describes the life of a young woman factory worker in early 19th-century New England. The kit includes five document sets, utilizing maps, newspaper articles, deeds, letters, poems, and other artifacts. The document sets illustrate various topics including mill life and personal life. (MJP)

Culture-bound syndromes in Hispanic primary care patients.

PubMed

Bayles, Bryan P; Katerndahl, David A

2009-01-01

We sought to document Hispanic primary care patients' knowledge and experience of five culture-bound syndromes (CBS), as well as the basic socio-cultural correlates of these disorders. A convenience sample of 100 adult Hispanic patients presenting in an urban South Texas primary care clinic was recruited to complete a brief cross-sectional survey, presented in an oral format. Interviews sought information concerning five culture-bound syndromes--susto, empacho, nervios, mal de ojo, and ataques de nervios. Additional demographic, socio-economic, and acculturation data was collected. Descriptive and bivariate statistics (chi square, Fisher's) were used to assess relationships among variables and experience with each CBS. A multivariate logistic analysis was conducted to determine the possible contributions of age, gender, acculturation, and education to the personal experience of a culture-bound syndrome. Results indicate that 77% of respondents had knowledge of all five syndromes, with 42% reporting having personally experienced at least one CBS. Nervios was the most commonly suffered disorder, being reported by 30 respondents. This was followed, in declining order ofprevalence, by susto, mal de ojo, empacho, and ataques de nervios. Multivariate logistic regression analysis found that higher education beyond high school was associated with a slightly decreased likelihood of reporting having suffered from any culture-bound syndrome. While co-occurrence among these disorders occurred, the patterns of predictors suggest that the co-occurrence is not a reflection of mislabeling of one common syndrome. Knowledge of and experience with culture-bound syndromes is common among Hispanic primary care patients in South Texas. Healthcare providers ought to consider discussing these illnesses in a non-judgmental manner with patients who present with symptoms that are consistent with these syndromes. Future studies, with larger sample sizes, are warranted to elucidate the nature of culture-bound disorders and their relationships with conventional diagnostic entities and treatment-seeking behaviors.

Automated Data Management Information System (ADMIS)

NASA Technical Reports Server (NTRS)

Blackstone, C.; Dunn, D.; Sullivan, E.; Whitlock, J.; Buehler, D.; Pratt, L.; Hoffiditz, T.; Rose, J.; Smithson, M.; Feeley, J.

1974-01-01

ADMIS stores and controls data and documents associated with manned space flight effort. System contains all data oriented toward a specific document; it is primary source of reports generated by the system. Each group of records is composed of one document record, one distribution record for each recipient of the document, and one summary record.

Exploring Inpatients' Experiences of Healing and Healing Spaces

PubMed Central

Bellanti, Dawn; Sakallaris, Bonnie R.

2016-01-01

In order to understand a patient’s healing experience it is essential to understand the elements that they, the patient, believes contributed to their healing. Previous research has focused on symptom reducers or contributors through environment such as stress. A person’s experience of healing happens over time not instantaneous. Therefore, in this study, the interviews with patients happened after forty-eight hours of hospitalization. This mixed methods study describes the experiences of seventeen inpatients from two healthcare systems using a phenomenological approach combined with evidence based design evaluation methods to document the setting. The qualitative data was analyzed first for reoccurring themes then further explored and defined through quantitative environmental observations. The seventeen patients defined healing as “getting better/well.” Seventy three statements were recorded about contributors and detractors to healing in the physical environment. Three primary themes emerged from the data as positive influencers of a healing experience: being cared for, being comfortable and experiencing something familiar or like home. These results demonstrate that patients perceive their inpatient healing experience through a supported environment. PMID:28725848

Neuroprotective effects of yoga practice: age-, experience-, and frequency-dependent plasticity

PubMed Central

Villemure, Chantal; Čeko, Marta; Cotton, Valerie A.; Bushnell, M. Catherine

2015-01-01

Yoga combines postures, breathing, and meditation. Despite reported health benefits, yoga’s effects on the brain have received little study. We used magnetic resonance imaging to compare age-related gray matter (GM) decline in yogis and controls. We also examined the effect of increasing yoga experience and weekly practice on GM volume and assessed which aspects of weekly practice contributed most to brain size. Controls displayed the well documented age-related global brain GM decline while yogis did not, suggesting that yoga contributes to protect the brain against age-related decline. Years of yoga experience correlated mostly with GM volume differences in the left hemisphere (insula, frontal operculum, and orbitofrontal cortex) suggesting that yoga tunes the brain toward a parasympatically driven mode and positive states. The number of hours of weekly practice correlated with GM volume in the primary somatosensory cortex/superior parietal lobule (S1/SPL), precuneus/posterior cingulate cortex (PCC), hippocampus, and primary visual cortex (V1). Commonality analyses indicated that the combination of postures and meditation contributed the most to the size of the hippocampus, precuneus/PCC, and S1/SPL while the combination of meditation and breathing exercises contributed the most to V1 volume. Yoga’s potential neuroprotective effects may provide a neural basis for some of its beneficial effects. PMID:26029093

Decrease in the Prevalence of Pancreatitis Associated with Primary Hyperparathyroidism: Experience at a Tertiary Referral Center.

PubMed

Janka-Zires, Marcela; Hernández-Calleros, Jorge; Gómez-Pérez, Francisco Javier; Uscanga-Domínguez, Luis Federico; Pelaez-Luna, Mario César; Almeda-Valdés, Paloma

2015-01-01

Hypercalcemia is a rare but well recognized cause of acute and chronic pancreatitis. Hypercalcemia-related pancreatitis is mainly caused by primary hyperparathyroidism. The prevalence of pancreatitis in hyperparathyroidism varies worldwide and additional disease-modifying factors may play a role in its development. In 1988 the prevalence of pancreatitis secondary to primary hyperparathyroidism at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), a referral center in Mexico City, was 12.1% (95% CI: 6.7-21). To describe the current prevalence of pancreatitis secondary to primary hyperparathyroidism at the INCMNSZ. We reviewed 385 cases of primary hyperparathyroidism seen at the hospital between 1987 and 2012. 26 cases with acute or chronic pancreatitis associated with primary hyperparathyroidism were documented, with a prevalence of 6.7% (95% CI: 4.6-9.7), which was lower than the 12.1% previously reported. In the present study, 20% had a history of alcohol consumption, 10% of gallstones, and 20% of ureteral calculi, compared with the previously reported 32.0, 34.6, and 40.0%, respectively. The average calcium levels were 13.1 and 13.8 mg/dl in the previous and current series, respectively. We found a decrease in the prevalence of pancreatitis associated with primary hyperparathyroidism from 12.1% (95% CI: 6.7-21) to 6.7% (95% CI: 4.6-9.7).

Lessons Learned Designing and Using an Online Discussion Forum for Care Coordinators in Primary Care.

PubMed

Ferrante, Jeanne M; Friedman, Asia; Shaw, Eric K; Howard, Jenna; Cohen, Deborah J; Shahidi, Laleh

2015-10-18

While an increasing number of researchers are using online discussion forums for qualitative research, few authors have documented their experiences and lessons learned to demonstrate this method's viability and validity in health services research. We comprehensively describe our experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. Our lessons learned from each phase, including planning, designing, implementing, using, and ending this private online discussion forum, provide some recommendations for other health services researchers considering this method. An asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals. © The Author(s) 2015.

Lessons Learned Designing and Using an Online Discussion Forum for Care Coordinators in Primary Care

PubMed Central

Ferrante, Jeanne M.; Friedman, Asia; Shaw, Eric K.; Howard, Jenna; Cohen, Deborah J.; Shahidi, Laleh

2016-01-01

While an increasing number of researchers are using online discussion forums for qualitative research, few authors have documented their experiences and lessons learned to demonstrate this method’s viability and validity in health services research. We comprehensively describe our experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. Our lessons learned from each phase, including planning, designing, implementing, using, and ending this private online discussion forum, provide some recommendations for other health services researchers considering this method. An asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals. PMID:26481942

Factors associated with adequate pain control in hospitalized postsurgical patients diagnosed with cancer.

PubMed

Paice, J A; Mahon, S M; Faut-Callahan, M

1991-12-01

The inadequate management of pain continues to be a significant problem for persons with cancer. Experts suggest that contributing factors include discrepancies in pain assessment, inadequate administration of opiate therapy, and insufficient documentation of the patient's pain experience. This study, part of a multidepartmental investigation into the adequacy of pain management in hospitalized patients, describes the pain experience of surgical oncology patients. Its correlational ex post facto design (n = 34) was guided by Loeser's model of pain. Randomly selected surgical oncology patients were interviewed using a structured format. The patient's primary nurse and physician simultaneously completed brief assessments of their perceptions of the patient's pain intensity. Data were analyzed using descriptive and correlational statistics, and implications for nursing practice and future nursing research are discussed.

Project IMPACT: a report on barriers and facilitators to sustainability.

PubMed

Blasinsky, Margaret; Goldman, Howard H; Unützer, Jürgen

2006-11-01

Project IMPACT is a collaborative care intervention to assist older adults suffering from major depressive disorder or dysthymia. Qualitative research methods were used to determine the barriers and facilitators to sustaining IMPACT in a primary care setting. Strong evidence supports the program's sustainability, but considerable variation exists in continuation strategies and operationalization across sites. Sustainability depended on the organizations' support of collaborative care models, the availability of staff trained in the intervention, and funding. The intervention's success was the most important sustainability factor, as documented by outcome data and through the "real world" experience of treating patients with this intervention.

Initial perceptions of key stakeholders in Ontario regarding independent prescriptive authority for pharmacists.

PubMed

Pojskic, Nedzad; MacKeigan, Linda; Boon, Heather; Austin, Zubin

2014-01-01

A number of jurisdictions, both in Canada and internationally, have recently expanded pharmacists' scope of practice to allow prescriptive authority. To ascertain the initial perceptions of the Ontario government and health professional stakeholder groups regarding the prospect of prescriptive authority for pharmacists. Qualitative research methods were used; data sources were policy documents and semi-structured interviews with key informants from the Ontario government and pharmacy and medical professional organizations. Purposive and snowball sampling strategies were used to identify 17 key informants. Fifty-one relevant policy documents were retrieved through searches of organizational websites and interviewee suggestions. Interview transcripts and documents were content analyzed independently by 2 researchers; and once consensus was achieved on key themes, the primary investigator analyzed the remainder. Pharmacy organizations and Ontario government representatives both expressed support for pharmacist prescriptive authority, suggesting that it would enhance patient access to primary care. Medical organizations were opposed to this expanded pharmacist role, arguing that pharmacists' lack of training and experience in diagnosis and prescribing would endanger patient safety. Other concerns were fragmentation of care and pharmacists' lack of access to patient clinical information. Some government and pharmacy informants felt that pharmacist prescribing would decrease health system costs through substitution of cheaper health professionals for physicians, while others felt that costs would increase due to increased utilization of services. Medical organizations preferred delegated medical authority as the policy alternative to pharmacist prescribing. Widely different views were expressed by the Ontario government and pharmacy organizations on the one hand and medical professional organizations on the other hand, regarding the potential impact of pharmacist prescribing on patient safety and access to primary care. This is likely due, at least in part, to the lack of evidence on the expected impact of this expanded pharmacist role. More research is needed to help inform discussions regarding this issue. Copyright © 2014 Elsevier Inc. All rights reserved.

A comparison of adverse event and fracture efficacy data for strontium ranelate in regulatory documents and the publication record.

PubMed

Bolland, Mark J; Grey, Andrew

2014-10-07

Recently, the European Medicines Agency reported that strontium ranelate increases myocardial infarction risk in postmenopausal women, 8.5 years after it was registered for use in osteoporosis. Unreported serious adverse events in clinical trials for other pharmaceuticals have been described in recent years. We assessed reporting of adverse events and fracture efficacy of strontium. We compared data on adverse effects (myocardial infarction, venous thromboembolism and pulmonary embolism) and fracture efficacy of strontium in publicly available regulatory documents with data in publications retrieved from searching PubMed. We identified 5 regulatory documents and 9 primary publications of 7 randomised, placebo-controlled trials of strontium that reported relevant data. We identified several areas of concern in these reports: the increased risk of myocardial infarction with strontium was not identified in a pivotal phase 3 clinical trial despite specific regulatory review of cardiovascular events; data on myocardial infarction were not included in any primary publication; increased risks of venous thromboembolism and pulmonary embolism with strontium were not reported in either of the phase 3 clinical trials; data on venous thromboembolism were reported in only 5 of 9 primary publications, data on pulmonary embolism in only 2 of 9 primary publications, and either was discussed in <50% of subsequent review articles. There were differences in participant numbers, fracture cases and venous thromboembolism cases between regulatory documents and primary publications. Based on all available data from primary publications and regulatory documents, the number of fractures prevented by strontium use is similar to the number of extra cases of venous thromboembolism, pulmonary embolism and myocardial infarction caused by strontium use. The risks of strontium use are similar to the benefits. Full disclosure of the clinical trial data and regulatory documents would allow clinicians and their patients to decide whether use of the drug is worthwhile. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PIMMS tools for capturing metadata about simulations

NASA Astrophysics Data System (ADS)

Pascoe, Charlotte; Devine, Gerard; Tourte, Gregory; Pascoe, Stephen; Lawrence, Bryan; Barjat, Hannah

2013-04-01

PIMMS (Portable Infrastructure for the Metafor Metadata System) provides a method for consistent and comprehensive documentation of modelling activities that enables the sharing of simulation data and model configuration information. The aim of PIMMS is to package the metadata infrastructure developed by Metafor for CMIP5 so that it can be used by climate modelling groups in UK Universities. PIMMS tools capture information about simulations from the design of experiments to the implementation of experiments via simulations that run models. PIMMS uses the Metafor methodology which consists of a Common Information Model (CIM), Controlled Vocabularies (CV) and software tools. PIMMS software tools provide for the creation and consumption of CIM content via a web services infrastructure and portal developed by the ES-DOC community. PIMMS metadata integrates with the ESGF data infrastructure via the mapping of vocabularies onto ESGF facets. There are three paradigms of PIMMS metadata collection: Model Intercomparision Projects (MIPs) where a standard set of questions is asked of all models which perform standard sets of experiments. Disciplinary level metadata collection where a standard set of questions is asked of all models but experiments are specified by users. Bespoke metadata creation where the users define questions about both models and experiments. Examples will be shown of how PIMMS has been configured to suit each of these three paradigms. In each case PIMMS allows users to provide additional metadata beyond that which is asked for in an initial deployment. The primary target for PIMMS is the UK climate modelling community where it is common practice to reuse model configurations from other researchers. This culture of collaboration exists in part because climate models are very complex with many variables that can be modified. Therefore it has become common practice to begin a series of experiments by using another climate model configuration as a starting point. Usually this other configuration is provided by a researcher in the same research group or by a previous collaborator with whom there is an existing scientific relationship. Some efforts have been made at the university department level to create documentation but there is a wide diversity in the scope and purpose of this information. The consistent and comprehensive documentation enabled by PIMMS will enable the wider sharing of climate model data and configuration information. The PIMMS methodology assumes an initial effort to document standard model configurations. Once these descriptions have been created users need only describe the specific way in which their model configuration is different from the standard. Thus the documentation burden on the user is specific to the experiment they are performing and fits easily into the workflow of doing their science. PIMMS metadata is independent of data and as such is ideally suited for documenting model development. PIMMS provides a framework for sharing information about failed model configurations for which data are not kept, the negative results that don't appear in scientific literature. PIMMS is a UK project funded by JISC, The University of Reading, The University of Bristol and STFC.

Effect of adverse childhood experiences on physical health in adulthood: Results of a study conducted in Baghdad city.

PubMed

Al-Shawi, Ameel F; Lafta, Riyadh K

2015-01-01

Studies have revealed a powerful relationship between adverse childhood experiences (ACEs) and physical and mental health in adulthood. Literature documents the conversion of traumatic emotional experiences in childhood into organic disease later in life. The aim was to estimate the effect of childhood experiences on the physical health of adults in Baghdad city. A cross-sectional study was conducted from January 2013 to January 2014. The study sample was drawn from Baghdad city. Multistage sampling techniques were used in choosing 13 primary health care centers and eight colleges of three universities in Baghdad. In addition, teachers of seven primary schools and two secondary schools were chosen by a convenient method. Childhood experiences were measured by applying a modified standardized ACEs-International Questionnaire form and with questions for bonding to family and parental monitoring. Physical health assessment was measured by a modified questionnaire derived from Health Appraisal Questionnaire of Centers for Disease Control and Prevention. The questionnaire includes questions on cerebrovascular diseases, diabetes mellitus, tumor, respiratory and gastrointestinal diseases. Logistic regression model showed that a higher level of bonding to family (fourth quartile) is expected to reduce the risk of chronic physical diseases by almost the half (odds ratio = 0.57) and exposure to a high level of household dysfunction and abuse (fourth quartile) is expected to increase the risk of chronic physical diseases by 81%. Childhood experiences play a major role in the determination of health outcomes in adulthood, and early prevention of ACEs. Encouraging strong family bonding can promote physical health in later life.

The prevalence of obesity documentation in Primary Care Electronic Medical Records. Are we acknowledging the problem?

PubMed

Mattar, Ahmed; Carlston, David; Sariol, Glen; Yu, Tongle; Almustafa, Ahmad; Melton, Genevieve B; Ahmed, Adil

2017-01-25

Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient's problem list for patients with eligible body mass indexes (BMI) as contained in the patients' electronic medical record (EMR). Additionally, we examined the prevalence of selected chronic conditions across BMI levels. This study is a retrospective study using EMR data for adult patients visiting an outpatient clinic between June 2012 and June 2015. International Classification of Diseases, Ninth Revision, (ICD-9) codes were used to identify obesity documentation in the EMR problem list. Univariate and multivariate logistic regression analyses were used. Out of 10,540, a total of 3,868 patients were included in the study. 2,003 (52%) patients met the criteria for obesity (BMI ≥ 30.0); however, only 112 (5.6%) patient records included obesity in the problem list. Moreover, in a multivariate analysis, in addition to age and gender, morbid obesity and cumulative number of comorbidities were significantly associated with obesity documentation, OR=1.6 and OR=1.3, respectively, with 95% CI [1.4, 1.9] and [1.0, 1.7], respectively. For those with obesity documentation, exercise counseling was provided more often than diet counselling. Based on EHR documentation, obesity is under coded and generally not identified as a significant problem in primary care. Physicians are more likely to document obesity in the patient record for those with higher BMI scores who are morbidly obese. Moreover, physicians more frequently provide exercise than diet counseling for the documented obese.

Categorizing document by fuzzy C-Means and K-nearest neighbors approach

NASA Astrophysics Data System (ADS)

Priandini, Novita; Zaman, Badrus; Purwanti, Endah

2017-08-01

Increasing of technology had made categorizing documents become important. It caused by increasing of number of documents itself. Managing some documents by categorizing is one of Information Retrieval application, because it involve text mining on its process. Whereas, categorization technique could be done both Fuzzy C-Means (FCM) and K-Nearest Neighbors (KNN) method. This experiment would consolidate both methods. The aim of the experiment is increasing performance of document categorize. First, FCM is in order to clustering training documents. Second, KNN is in order to categorize testing document until the output of categorization is shown. Result of the experiment is 14 testing documents retrieve relevantly to its category. Meanwhile 6 of 20 testing documents retrieve irrelevant to its category. Result of system evaluation shows that both precision and recall are 0,7.

Engaging with communities, engaging with patients: amendment to the NAPCRG 1998 Policy Statement on Responsible Research With Communities.

PubMed

Allen, Michele L; Salsberg, Jon; Knot, Michaela; LeMaster, Joseph W; Felzien, Maret; Westfall, John M; Herbert, Carol P; Vickery, Katherine; Culhane-Pera, Kathleen A; Ramsden, Vivian R; Zittleman, Linda; Martin, Ruth Elwood; Macaulay, Ann C

2017-06-01

In 1998, the North American Primary Care Research Group (NAPCRG) adopted a groundbreaking Policy Statement endorsing responsible participatory research (PR) with communities. Since that time, PR gained prominence in primary care research. To reconsider the original 1998 Policy Statement in light of increased uptake of PR, and suggest future directions and applications for PR in primary care. This work contributed to an updated Policy Statement endorsed by NAPCRG in 2015. 32 university and 30 community NAPCRG-affiliated research partners, convened a workshop to document lessons learned about implementing processes and principles of PR. This document emerged from that session and reflection and discussion regarding the original Policy Statement, the emerging PR literature, and our own experiences. The foundational principles articulated in the 1998 Policy Statement remain relevant to the current PR environment. Lessons learned since its publication include that the maturation of partnerships is facilitated by participatory processes that support increased community responsibility for research projects, and benefits generated through PR extend beyond research outcomes. Future directions that will move forward the field of PR in primary care include: (i) improve assessment of PR processes to better delineate the links between how PR teams work together and diverse PR outcomes, (ii) increase the number of models incorporating PR into translational research from project inception to dissemination, and (iii) increase application of PR approaches that support patient engagement in clinical settings to patient-provider relationship and practice change research. PR has markedly altered the manner in which primary care research is undertaken in partnership with communities and its principles and philosophies continue to offer means to assure that research results and processes improve the health of all communities. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Hepatitis C risk assessment, testing and referral for treatment in urban primary care: Role of race and ethnicity

PubMed Central

Trooskin, Stacey B; Navarro, Victor J; Winn, Robert J; Axelrod, David J; McNeal, A Scott; Velez, Maricruz; Herrine, Steven K; Rossi, Simona

2007-01-01

AIM: To determine rates of hepatitis C (HCV) risk factor ascertainment, testing, and referral in urban primary care practices, with particular attention to the effect of race and ethnicity. METHODS: Retrospective chart review from four primary care sites in Philadelphia; two academic primary care practices and two community clinics was performed. Demographics, HCV risk factors, and other risk exposure information were collected. RESULTS: Four thousand four hundred and seven charts were reviewed. Providers documented histories of injection drug use (IDU) and transfusion for less than 20% and 5% of patients, respectively. Only 55% of patients who admitted IDU were tested for HCV. Overall, minorities were more likely to have information regarding a risk factor documented than their white counterparts (79% vs 68%, P < 0.0001). Hispanics were less likely to have a risk factor history documented, compared to blacks and whites (P < 0.0001). Overall, minorities were less likely to be tested for HCV than whites in the presence of a known risk factor (23% vs 35%, P = 0.004). Among patients without documentation of risk factors, blacks and Hispanics were more likely to be tested than whites (20% and 24%, vs 13%, P < 0.005, respectively). CONCLUSION: (1) Documentation of an HCV risk factor history in urban primary care is uncommon, (2) Racial differences exist with respect to HCV risk factor ascertainment and testing, (3) Minority patients, positive for HCV, are less likely to be referred for subspecialty care and treatment. Overall, minorities are less likely to be tested for HCV than whites in the presence of a known risk factor. PMID:17373742

Patient and carer experience of obtaining regular prescribed medication for chronic disease in the English National Health Service: a qualitative study

PubMed Central

2013-01-01

Background The increasing burden of chronic disease is recognised globally. Within the English National Health Service, patients with chronic disease comprise of half of all consultations in primary care, and 70% of inpatient bed days. The cost of prescribing long-term medications for those with physical chronic diseases is rising and there is a drive to reduce medicine wastage and costs. While current policies in England are focused on the latter, there has been little previous research on patient experience of ordering and obtaining regular medication for their chronic disease. This paper presents findings from England of a qualitative study and survey of patients and their carers’ experiences of community and primary care based services for physical chronic diseases. Although not the primary focus of the study, the results highlighted particular issues around service delivery of repeat prescriptions. Methods We conducted 21 qualitative in-depth interviews with 30 patients and family carers’ in two Primary Care Trusts in England. Participants were receiving community based care for diabetes, respiratory, neurological or complex co-morbidities, and ranged in age from 39–92 years old. We used a broadly inductive approach to enable themes around patient experience to emerge from the data. Results While the study sought to gain an overview of patient experience, the findings suggested that the processes associated with ordering and obtaining regular medication – the repeat prescription, was most frequently described as a recurring hassle of managing a long-term condition. Issues for patients and carers included multiple journeys to the surgery and pharmacy, lack of synchrony and dissatisfaction with the length of prescriptions. Conclusion Much literature exists around medication waste and cost, which led to encouragement from the NHS in England to reduce dosage units to a 28-day supply. While there has been an acknowledgement that longer supplies may be suitable for people with stable chronic conditions, it appears that there is limited evidence on the impact of shorter length prescriptions on patient and carer experience, adherence and health outcomes. Recent policy documents within England also fail to address possible links between patient experience, adherence and flaws within repeat prescription service delivery. PMID:23705866

CDM analysis

NASA Technical Reports Server (NTRS)

Larson, Robert E.; Mcentire, Paul L.; Oreilly, John G.

1993-01-01

The C Data Manager (CDM) is an advanced tool for creating an object-oriented database and for processing queries related to objects stored in that database. The CDM source code was purchased and will be modified over the course of the Arachnid project. In this report, the modified CDM is referred to as MCDM. Using MCDM, a detailed series of experiments was designed and conducted on a Sun Sparcstation. The primary results and analysis of the CDM experiment are provided in this report. The experiments involved creating the Long-form Faint Source Catalog (LFSC) database and then analyzing it with respect to following: (1) the relationships between the volume of data and the time required to create a database; (2) the storage requirements of the database files; and (3) the properties of query algorithms. The effort focused on defining, implementing, and analyzing seven experimental scenarios: (1) find all sources by right ascension--RA; (2) find all sources by declination--DEC; (3) find all sources in the right ascension interval--RA1, RA2; (4) find all sources in the declination interval--DEC1, DEC2; (5) find all sources in the rectangle defined by--RA1, RA2, DEC1, DEC2; (6) find all sources that meet certain compound conditions; and (7) analyze a variety of query algorithms. Throughout this document, the numerical results obtained from these scenarios are reported; conclusions are presented at the end of the document.

49 CFR 1177.1 - Definitions and classifications of documents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 8 2011-10-01 2011-10-01 false Definitions and classifications of documents. 1177.1 Section 1177.1 Transportation Other Regulations Relating to Transportation (Continued) SURFACE... Definitions and classifications of documents. (a) A “primary document” is a mortgage (excluding those under...

South Florida freight advanced traveler information system : architecture and implementation as built documentation report.

DOT National Transportation Integrated Search

2015-05-01

The primary purpose of the As Built Documentation is to provide a description of any modifications made to the original architecture along with justification as to why the architecture was changed. In addition, this documentation provides the followi...

Futile transmembrane NH4+ cycling: A cellular hypothesis to explain ammonium toxicity in plants

PubMed Central

Britto, Dev T.; Siddiqi, M. Yaeesh; Glass, Anthony D. M.; Kronzucker, Herbert J.

2001-01-01

Most higher plants develop severe toxicity symptoms when grown on ammonium (NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document}) as the sole nitrogen source. Recently, NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} toxicity has been implicated as a cause of forest decline and even species extinction. Although mechanisms underlying NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} toxicity have been extensively sought, the primary events conferring it at the cellular level are not understood. Using a high-precision positron tracing technique, we here present a cell-physiological characterization of NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} acquisition in two major cereals, barley (Hordeum vulgare), known to be susceptible to toxicity, and rice (Oryza sativa), known for its exceptional tolerance to even high levels of NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document}. We show that, at high external NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} concentration ([NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document}]o), barley root cells experience a breakdown in the regulation of NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} influx, leading to the accumulation of excessive amounts of NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} in the cytosol. Measurements of NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} efflux, combined with a thermodynamic analysis of the transmembrane electrochemical potential for NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document}, reveal that, at elevated [NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document}]o, barley cells engage a high-capacity NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document}-efflux system that supports outward NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} fluxes against a sizable gradient. Ammonium efflux is shown to constitute as much as 80% of primary influx, resulting in a never-before-documented futile cycling of nitrogen across the plasma membrane of root cells. This futile cycling carries a high energetic cost (we record a 40% increase in root respiration) that is independent of N metabolism and is accompanied by a decline in growth. In rice, by contrast, a cellular defense strategy has evolved that is characterized by an energetically neutral, near-Nernstian, equilibration of NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} at high [NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document}]o. Thus our study has characterized the primary events in NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} nutrition at the cellular level that may constitute the fundamental cause of NH\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{4}^{+}}}\\end{equation*}\\end{document} toxicity in plants. PMID:11274450

Nursing Minimum Data Sets for documenting nutritional care for adults in primary healthcare: a scoping review.

PubMed

Håkonsen, Sasja Jul; Pedersen, Preben Ulrich; Bjerrum, Merete; Bygholm, Ann; Peters, Micah D J

2018-01-01

To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. Within health care, there is an urgent need for the systematic collection of nursing care data in order to make visible what nurses do and to facilitate comparison, quality assurance, management, research and funding of nursing care. To be effective, nursing records should accurately and comprehensively document all required information to support safe and high quality care of patients. However, this process of documentation has been criticized from many perspectives as being highly inadequate. A Nursing Minimum Data Set within the nutritional area in primary health care could therefore be beneficial in order to support nurses in their daily documentation and observation of patients. The review considered studies that included adults aged over 18 years of any gender, culture, diagnosis and ethnicity, as well as nutritional experts, patients and their relatives. The concepts of interest were: the nature and content of any nutritional screening tools validated (regardless of the type of validation) in the adult population in primary healthcare; and the views and opinions of eligible participants regarding the appropriateness of nutritional assessment were the concept of interest. Studies included must have been conducted in primary healthcare settings, both within home care and nursing home facilities. This scoping review used a two-step approach as a preliminary step to the subsequent development of a Nursing Minimum Data Set within the nutritional area in primary healthcare: i) a systematic literature search of existing nutritional screening tools validated in primary health care; and ii) a systematic literature search on nutritional experts opinions on the assessment of nutritional nursing care of adults in primary healthcare as well as the views of patients and their relatives. Multiple databases (PubMed, CINAHL, Embase, Scopus, Swemed+, MedNar, CDC, MEDION, Health Technology Assessment Database, TRIP database, NTIS, ProQuest Dissertations and Theses, Google Scholar, Current Contents) were searched from their inception to September 2016. The results from the studies were extracted using pre-developed extraction tools to all three questions, and have been presented narratively and by using figures to support the text. Twenty-nine nutritional screening tools that were validated within a primary care setting, and two documents on consensus statements regarding expert opinion were identified. No studies on the patients or relatives views were identified. The nutritional screening instruments have solely been validated in an over-55 population. Construct validity was the type of validation most frequently used in the validation process covering a total of 25 of the 29 tools. Two studies were identified in relation to the third review question. These two documents are both consensus statement documents developed by experts within the geriatric and nutritional care field. Overall, experts find it appropriate to: i) conduct a comprehensive geriatric assessment, ii) use a validated nutritional screening instrument, and iii) conduct a history and clinical diagnosis, physical examination and dietary assessment when assessing primarily the elderly's nutritional status in primary health care.

Working with Bangladeshi patients in Britain: perspectives from Primary Health Care.

PubMed

Hawthorne, Kamila; Rahman, Jasmin; Pill, Roisin

2003-04-01

The difficulties of ethnic minority communities in accessing appropriate primary care are well documented, but little is known about the experiences of Primary Health Care Teams (PHCTs) serving these communities, or their strategies to help patients overcome these difficulties. The purpose of the study was to explore the PHCT perspective of working with Bangladeshi patients. Qualitative group discussions with PHCTs were set up by four health centres in the Grangetown area of Cardiff, where a large proportion of the Bangladeshi community lives. Experiences of and attitudes to working with Bangladeshi patients were explored. Discussions were taped and transcribed for independent analysis by two researchers. Comparisons within and between PHCTs were made. PHCTs largely entered into full and frank discussions. Health visitors had made significantly more effort than others to get to know their Bangladeshi patients. This had costs in terms of time and effort, with no reduction in caseload. Cutting across this difference were common themes such as communication and cultural differences, and patients' difficulties in using NHS services appropriately, which caused disruption and frustration. While there was an awareness of the reasons for these difficulties, PHCTs generally were not able to allow for them because of the inflexibility of their workload and systems of working. Group discussions are a useful way to encourage PHCTs to reflect on their practice and share experiences. PHCTs are aware of their patients' needs and keen to explore racial awareness training and new ways of looking at how they work. However, the grind of heavy workloads makes this process unlikely without outside facilitation.

Development and deployment of a health information system in transitional countries (croatian experience).

PubMed

Stevanovic, Ranko; Pristas, Ivan; Ivicevic Uhernik, Ana; Stanic, Arsen

2005-01-01

Croatian Primary Health Care Information System pilot project, conducted between 2001 and 2003, aimed to develop and deploy a health information system based on the latest technologies which would improve the quality of primary health care and rationalise the consumption. 60 primary health care teams (physician and nurse) were equipped with PCs and connected via central server to the main national health insurer, state treasury and public health institute. Developed information system enabled rapid retrieval of documents, replacement of manual data input and a real-time insight into needed information as well as prompt interventions within the system. The project also introduced electronic smart cards for physicians and nurses, so that at each medical check-up the information system verified both the ensuree's and the physician's or nurse's status and rights.Based on the experiences from the pilot project, plan has been made for comprehensive health information system at national level which would connect primary health care teams, hospitals, laboratories, dentistries, health insurance companies, state treasury, public health institutes and electronic health records database. Its major goals are more rapid diagnostics, accuracy in prescribing therapy, standardisation of the good practice as well as better utilisation of capacities, shorter waiting times and shorter stays in hospitals, which would lead to improvement in overall health care quality and better control over the health care consumption. Estimated 5-year investment for installing such system would be 125 million EUR. However, information system could save substantially more and yield a return of investment in only two years.As information system for primary health care should be a strategic component of every health care reform and development plan, we can recommend our model, based on the results of the pilot project, to other transitional countries.

Censoring the Mails: What Is Your Opinion?

ERIC Educational Resources Information Center

Alexander, Mary, Ed.; Childress, Marilyn, Ed.

1982-01-01

Contains a primary source document--a letter written in 1916 protesting U.S. Postal Service censorship of an anarchist publication--and suggests ways to use the document in secondary U.S. history classes. Samples of student surveys on mail censorship and a document analysis worksheet are included. (AM)

Design and application of electromechanical actuators for deep space missions

NASA Technical Reports Server (NTRS)

Haskew, Tim A.; Wander, John

1994-01-01

This progress report documents research and development efforts performed from August 16, 1993 through February 15, 1994 on NASA Grant NAG8-240, 'Design and Application of Electromechanical Actuators for Deep Space Missions.' Following the executive summary are four report sections: Motor Selection, Tests Stand Development, Health Monitoring and Fault Management, and Experiment Planning. Three specific motor types have been considered as prime movers for TVC EMA applications: the brushless dc motor, the permanent magnet synchronous motor, and the induction motor. The fundamental finding was that, in general, the primary performance issues were energy efficiency and thermal dissipation (rotor heating). In terms of all other issues, the three motor types were found to compare quite equally. Among the design changes made to the test stand since the last progress report is the addition of more mounting holes in the side beams. These additional holes allow the movable end beam to be attached in a greater number of positions than previously. With this change the movable end beam can move from full forward to full back in three inch increments. Specific mathematical details on the approach that have been employed for health monitoring and fault management (HMFM) have been reported previously. This approach is based on and adaptive Kalman filter strategy. In general, a bank of filters can be implemented for each primary fault type. Presently under consideration for the brushless dc machine are the following faults: armature winding open-circuits, armature winding short-circuits (phase-to-phase and phase-to-ground), bearing degradation, and rotor flux weakening. The mechanically oriented experiments include transient loading experiments, transverse loading experiment, friction experiment, motor performance experiment, and HMFM experiment.

Proactive cancer care in primary care: a mixed-methods study

PubMed Central

Murray, Scott A

2013-01-01

Background. Current models of post-treatment cancer care are based on traditional practices and clinician preference rather than evidence of benefit. Objectives. To assess the feasibility of using a structured template to provide holistic follow-up of patients in primary care from cancer diagnosis onwards. Methods. A two-phase mixed methods action research project. An electronic Cancer Ongoing Review Document (CORD) was first developed with patients and general practitioners, and used with patients with a new diagnosis of cancer. This was evaluated through documentary analysis of the CORDs, qualitative interviews with patients, family carers and health professionals and record reviews. Results. The records of 107 patients from 13 primary care teams were examined and 45 interviews conducted. The document was started in 54% of people with newly diagnosed cancer, and prompted clear documentation of multidimension needs and understanding. General practitioners found using the document helped to structure consultations and cover psychosocial areas, but they reported it needed to be better integrated in their medical records with computerized prompts in place. Few clinicians discussed the review openly with patients, and the template was often completed afterwards. Conclusions. Anticipatory cancer care from diagnosis to cure or death, ‘in primary care’, is feasible in the UK and acceptable to patients, although there are barriers. The process promoted continuity of care and holism. A reliable system for proactive cancer care in general practice supported by hospital specialists may allow more survivorship care to be delivered in primary care, as in other long-term conditions. PMID:23382502

Proactive cancer care in primary care: a mixed-methods study.

PubMed

Kendall, Marilyn; Mason, Bruce; Momen, Natalie; Barclay, Stephen; Munday, Dan; Lovick, Roberta; Macpherson, Stella; Paterson, Euan; Baughan, Paul; Cormie, Paul; Kiehlmann, Peter; Free, Amanda; Murray, Scott A

2013-06-01

Current models of post-treatment cancer care are based on traditional practices and clinician preference rather than evidence of benefit. To assess the feasibility of using a structured template to provide holistic follow-up of patients in primary care from cancer diagnosis onwards. A two-phase mixed methods action research project. An electronic cancer ongoing review document (CORD) was first developed with patients and general practitioners, and used with patients with a new diagnosis of cancer. This was evaluated through documentary analysis of the CORDs, qualitative interviews with patients, family carers and health professionals and record reviews. The records of 107 patients from 13 primary care teams were examined and 45 interviews conducted. The document was started in 54% of people with newly diagnosed cancer, and prompted clear documentation of multidimension needs and understanding. General practitioners found using the document helped to structure consultations and cover psychosocial areas, but they reported it needed to be better integrated in their medical records with computerized prompts in place. Few clinicians discussed the review openly with patients, and the template was often completed afterwards. Anticipatory cancer care from diagnosis to cure or death, 'in primary care', is feasible in the U.K. and acceptable to patients, although there are barriers. The process promoted continuity of care and holism. A reliable system for proactive cancer care in general practice supported by hospital specialists may allow more survivorship care to be delivered in primary care, as in other long-term conditions.

The experience of community health workers training in Iran: a qualitative study

PubMed Central

2012-01-01

Background The role of Community Health Workers (CHWs) in improving access to basic healthcare services, and mobilising community actions on health is broadly recognised. The Primary Health Care (PHC) approach, identified in the Alma Ata conference in 1978, stressed the role of CHWs in addressing community health needs. Training of CHWs is one of the key aspects that generally seeks to develop new knowledge and skills related to specific tasks and to increase CHWs’ capacity to communicate with and serve local people. This study aimed to analyse the CHW training process in Iran and how different components of training have impacted on CHW performance and satisfaction. Methods Data were collected from both primary and secondary sources. Training policies were reviewed using available policy documents, training materials and other relevant documents at national and provincial levels. Documentary analysis was supplemented by individual interviews with ninety-one Iranian CHWs from 18 provinces representing a broad range of age, work experience and educational levels, both male and female. Results Recognition of the CHW program and their training in the national health planning and financing facilitates the implementation and sustainability of the program. The existence of specialised training centres managed by district health network provides an appropriate training environment that delivers comprehensive training and increases CHWs’ knowledge, skills and motivation to serve local communities. Changes in training content over time reflect an increasing number of programs integrated into PHC, complicating the work expected of CHWs. In-service training courses need to address better local needs. Conclusion Although CHW programs vary by country and context, the CHW training program in Iran offers transferable lessons for countries intending to improve training as one of the key elements in their CHW program. PMID:22938138

A Summary of Numerous Strain-Gage Load Calibrations on Aircraft Wings and Tails in a Technological Format

NASA Technical Reports Server (NTRS)

Jenkins, Jerald M.; DeAngelis, V. Michael

1997-01-01

Fifteen aircraft structures that were calibrated for flight loads using strain gages are examined. The primary purpose of this paper is to document important examples of load calibrations on airplanes during the past four decades. The emphasis is placed on studying the physical procedures of calibrating strain-gaged structures and all the supporting analyses and computational techniques that have been used. The results and experiences obtained from actual data from 14 structures (on 13 airplanes and 1 laboratory test structure) are presented. This group of structures includes fins, tails, and wings with a wide variety of aspect ratios. Straight- wing, swept-wing, and delta-wing configurations are studied. Some of the structures have skin-dominant construction; others are spar-dominant. Anisotropic materials, heat shields, corrugated components, nonorthogonal primary structures, and truss-type structures are particular characteristics that are included.

[Electronic data records in primary health care and aspects of their development in Bosnia and Herzegovina].

PubMed

Novo, Ahmed; Masić, Izet; Toromanović, Selim; Karić, Mediha; Zunić, Lejla

2004-01-01

In Medical Informatics medical documentation and evidention are most probably the key areas. Also, in primary health care it is very important and part of daily activity of medical staff. Bosnia and Herzegovina is trying to be close to developed countries and to modernize and computerize current systems of documentation and to cross over from manual and semi manual methods to computerized medical data analysis. The most of European countries have developed standards and classification systems in primary health care for collecting, examination, analysis and interpretation of medical data assessed. One of possibilities as well as dilemma, which data carrier should be used for storage and manipulation of patient data in primary health care, is use of electronic medical record. Most of the South East European countries use chip or smart card and some of countries in neighborhood (Italy) choose laser card as patient data carrier. Both technologies have the advantages and disadvantages what was comprehensively colaborated by the authors in this paper, with intention to help experts who make decisions in this segment to create and to correctly influence on improvement of quality, correctness and accuracy of medical documentation in primary health care.

Compendium of NASA data base for the Global Tropospheric Experiment's Arctic Boundary Layer Experiments ABLE-3A and ABLE-3B

NASA Technical Reports Server (NTRS)

Gregory, Gerald L.; Scott, A. Donald, Jr.

1994-01-01

The report provides a compendium of NASA aircraft data that are available from NASA's Global Tropospheric Experiment's (GTE) Arctic Boundary Layer Experiments (ABLE) conducted in July and August of 1988 (ABLE-3A) and 1990 (ABLE-3B). ABLE-3A flight experiments were based at Barrow and Bethel, Alaska, and included survey/transit flights to Thule, Greenland. ABLE-3B flight experiments were based at North Bay (Ontario) and Goose Bay, Canada, and included flights northward to Frobisher Bay, Canada. The primary purposes of the experiments were (1) the measurement of the flux of various trace gases from high-arctic ecosystems, (2) the elucidation of factors important to the production and destruction of ozone, and (3) the documentation of source and chemical signature of air common to and transported into the regions. The report provides a representation, in the form of selected data plots, of aircraft data that are available in archived format via NASA Langley's Distributed Active Archive Center. The archived data bases include data for other species measured on the aircraft as well as numerous supporting data, including meteorological observations/products, results from surface studies, satellite observations, and sondes releases.

Electronic availability of microgravity experiments safety and integration requirements documents

NASA Technical Reports Server (NTRS)

Hogan, Jean M.

1995-01-01

This follow-on to NASA Contractor Report 195447, Microgravity Experiments Safety and Integration Requirements Document Tree, provides the details for accessing the systems that contain the official, electronic versions of the documents initially researched in NASA Contractor Report 195447. The data in this report serves as a valuable information source for the NASA Lewis Research Center Project Documentation Center (PDC), as well as for all developers of space experiments. The PDC has acquired the hardware, software, ID's, and passwords necessary to access most of these systems and is now able to provide customers with current document information as well as immediate delivery of available documents in either electronic or hard copy format.

Laser Communications Relay Demonstration: Introduction for Experimenters

NASA Technical Reports Server (NTRS)

Israel, David J.

2017-01-01

This document provides guidance to individuals or groups considering proposing an experiment for the Laser Communications Relay Demonstration (LCRD) Experiment Program. For the purposes of this document, the term experiment refers to both experiments and demonstrations. The documents goals are: (1) to introduce potential experimenters to the LCRD mission, its purpose, and its system architecture; (2) to help them understand the types of experiments that are possible using LCRD; and (3) to provide an overview of the experiment proposal process and explain how and where to obtain further information about making a proposal.

Documenting the Engineering Design Process

ERIC Educational Resources Information Center

Hollers, Brent

2017-01-01

Documentation of ideas and the engineering design process is a critical, daily component of a professional engineer's job. While patent protection is often cited as the primary rationale for documentation, it can also benefit the engineer, the team, company, and stakeholders through creating a more rigorously designed and purposeful solution.…

28 CFR 79.56 - Proof of primary renal cancer.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of primary renal cancer. 79.56... cancer. (a) In determining whether a claimant developed primary renal cancer following pertinent... conclusion that a claimant developed primary renal cancer must be supported by medical documentation. In all...

28 CFR 79.45 - Proof of primary lung cancer.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of primary lung cancer. 79.45... cancer. (a) In determining whether a claimant developed primary lung cancer following pertinent... conclusion that a claimant developed primary lung cancer must be supported by medical documentation. To prove...

28 CFR 79.54 - Proof of primary lung cancer.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of primary lung cancer. 79.54... cancer. (a) In determining whether a claimant developed primary lung cancer following pertinent... conclusion that a claimant developed primary lung cancer must be supported by medical documentation. To prove...

28 CFR 79.54 - Proof of primary lung cancer.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Proof of primary lung cancer. 79.54... cancer. (a) In determining whether a claimant developed primary lung cancer following pertinent... conclusion that a claimant developed primary lung cancer must be supported by medical documentation. To prove...

28 CFR 79.45 - Proof of primary lung cancer.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Proof of primary lung cancer. 79.45... cancer. (a) In determining whether a claimant developed primary lung cancer following pertinent... conclusion that a claimant developed primary lung cancer must be supported by medical documentation. To prove...

28 CFR 79.56 - Proof of primary renal cancer.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Proof of primary renal cancer. 79.56... cancer. (a) In determining whether a claimant developed primary renal cancer following pertinent... conclusion that a claimant developed primary renal cancer must be supported by medical documentation. In all...

28 CFR 79.45 - Proof of primary lung cancer.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Proof of primary lung cancer. 79.45... cancer. (a) In determining whether a claimant developed primary lung cancer following pertinent... conclusion that a claimant developed primary lung cancer must be supported by medical documentation. To prove...

28 CFR 79.45 - Proof of primary lung cancer.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Proof of primary lung cancer. 79.45... cancer. (a) In determining whether a claimant developed primary lung cancer following pertinent... conclusion that a claimant developed primary lung cancer must be supported by medical documentation. To prove...

28 CFR 79.54 - Proof of primary lung cancer.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Proof of primary lung cancer. 79.54... cancer. (a) In determining whether a claimant developed primary lung cancer following pertinent... conclusion that a claimant developed primary lung cancer must be supported by medical documentation. To prove...

28 CFR 79.56 - Proof of primary renal cancer.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Proof of primary renal cancer. 79.56... cancer. (a) In determining whether a claimant developed primary renal cancer following pertinent... conclusion that a claimant developed primary renal cancer must be supported by medical documentation. In all...

28 CFR 79.54 - Proof of primary lung cancer.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Proof of primary lung cancer. 79.54... cancer. (a) In determining whether a claimant developed primary lung cancer following pertinent... conclusion that a claimant developed primary lung cancer must be supported by medical documentation. To prove...

28 CFR 79.45 - Proof of primary lung cancer.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Proof of primary lung cancer. 79.45... cancer. (a) In determining whether a claimant developed primary lung cancer following pertinent... conclusion that a claimant developed primary lung cancer must be supported by medical documentation. To prove...

28 CFR 79.56 - Proof of primary renal cancer.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Proof of primary renal cancer. 79.56... cancer. (a) In determining whether a claimant developed primary renal cancer following pertinent... conclusion that a claimant developed primary renal cancer must be supported by medical documentation. In all...

28 CFR 79.54 - Proof of primary lung cancer.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Proof of primary lung cancer. 79.54... cancer. (a) In determining whether a claimant developed primary lung cancer following pertinent... conclusion that a claimant developed primary lung cancer must be supported by medical documentation. To prove...

28 CFR 79.56 - Proof of primary renal cancer.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Proof of primary renal cancer. 79.56... cancer. (a) In determining whether a claimant developed primary renal cancer following pertinent... conclusion that a claimant developed primary renal cancer must be supported by medical documentation. In all...

The prevalence of obesity documentation in Primary Care Electronic Medical Records

PubMed Central

Mattar, Ahmed; Carlston, David; Sariol, Glen; Yu, Tongle; Almustafa, Ahmad; Melton, Genevieve B.

2017-01-01

Summary Background Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient’s problem list for patients with eligible body mass indexes (BMI) as contained in the patients’ electronic medical record (EMR). Additionally, we examined the prevalence of selected chronic conditions across BMI levels. Method This study is a retrospective study using EMR data for adult patients visiting an outpatient clinic between June 2012 and June 2015. International Classification of Diseases, Ninth Revision, (ICD-9) codes were used to identify obesity documentation in the EMR problem list. Univariate and multivariate logistic regression analyses were used. Results Out of 10,540, a total of 3,868 patients were included in the study. 2,003 (52%) patients met the criteria for obesity (BMI ≥ 30.0); however, only 112 (5.6%) patient records included obesity in the problem list. Moreover, in a multivariate analysis, in addition to age and gender, morbid obesity and cumulative number of comorbidities were significantly associated with obesity documentation, OR=1.6 and OR=1.3, respectively, with 95% CI [1.4, 1.9] and [1.0, 1.7], respectively. For those with obesity documentation, exercise counseling was provided more often than diet counselling. Conclusion Based on EHR documentation, obesity is under coded and generally not identified as a significant problem in primary care. Physicians are more likely to document obesity in the patient record for those with higher BMI scores who are morbidly obese. Moreover, physicians more frequently provide exercise than diet counseling for the documented obese. PMID:28119990

Volcanic Hazard Maps; the results and progress made by the IAVCEI Hazard Map working group

NASA Astrophysics Data System (ADS)

Calder, Eliza; Lindsay, Jan; Wright, Heather

2017-04-01

The IAVCEI Commission on Volcanic Hazards and Risk set up a working group on Hazard Maps in 2014. Since then, the group has led or co-organised three major workshops, and organized two thematic conference sessions. In particular we have initiated a series of workshops, named the "State of the Hazard Map" which we plan to continue (the first was held at COV8 (State of the Hazard Map 1) and second at COV9 (State of the Hazard Map 2) and the third will be held at IAVCEI General Assembly in Portland. The broad aim of these activities is to work towards an IAVCEI-endorsed considerations or guidelines document for volcanic hazard map generation. The workshops have brought together people from around the world working on volcanic hazard maps, and have had four primary objectives: 1) to review (and collect further data on) the diverse variety of methods and rationales currently used to develop maps; 2) to openly discuss approaches and experiences regarding how hazard maps are interpreted and used by different groups; 3) to discuss and prepare the IAVCEI Guidelines document; and lastly, 4) Discuss options for finalizing, publishing and disseminating the Guidelines document (e.g. wiki, report, open-source publication). This presentation will provide an update of the results and outcomes of those initiatives. This includes brief outcomes of the reviews undertaken, a survey that has been constructed in order to gather additional data, the planned structure for the guidelines documents and a summary of the key findings to date. The majority of the participants of these activities so far have come from volcano observatories or geological surveys, as these institutions commonly have primary responsibility for making operational hazard map. It is important however that others in the scientific community that work on quantification of volcanic hazard contribute to these guidelines. We therefore invite interested parties to become involved.

Medical errors in primary care clinics – a cross sectional study

PubMed Central

2012-01-01

Background Patient safety is vital in patient care. There is a lack of studies on medical errors in primary care settings. The aim of the study is to determine the extent of diagnostic inaccuracies and management errors in public funded primary care clinics. Methods This was a cross-sectional study conducted in twelve public funded primary care clinics in Malaysia. A total of 1753 medical records were randomly selected in 12 primary care clinics in 2007 and were reviewed by trained family physicians for diagnostic, management and documentation errors, potential errors causing serious harm and likelihood of preventability of such errors. Results The majority of patient encounters (81%) were with medical assistants. Diagnostic errors were present in 3.6% (95% CI: 2.2, 5.0) of medical records and management errors in 53.2% (95% CI: 46.3, 60.2). For management errors, medication errors were present in 41.1% (95% CI: 35.8, 46.4) of records, investigation errors in 21.7% (95% CI: 16.5, 26.8) and decision making errors in 14.5% (95% CI: 10.8, 18.2). A total of 39.9% (95% CI: 33.1, 46.7) of these errors had the potential to cause serious harm. Problems of documentation including illegible handwriting were found in 98.0% (95% CI: 97.0, 99.1) of records. Nearly all errors (93.5%) detected were considered preventable. Conclusions The occurrence of medical errors was high in primary care clinics particularly with documentation and medication errors. Nearly all were preventable. Remedial intervention addressing completeness of documentation and prescriptions are likely to yield reduction of errors. PMID:23267547

The Road to Rural Primary Care: A Narrative Review of Factors That Help Develop, Recruit, and Retain Rural Primary Care Physicians.

PubMed

Parlier, Anna Beth; Galvin, Shelley L; Thach, Sarah; Kruidenier, David; Fagan, Ernest Blake

2018-01-01

To examine the literature documenting successes in recruiting and retaining rural primary care physicians. The authors conducted a narrative review of literature on individual, educational, and professional characteristics and experiences that lead to recruitment and retention of rural primary care physicians. In May 2016, they searched MEDLINE, PubMed, CINAHL, ERIC, Web of Science, Google Scholar, the Grey Literature Report, and reference lists of included studies for literature published in or after 1990 in the United States, Canada, or Australia. The authors identified 83 articles meeting inclusion criteria. They synthesized results and developed a theoretical model that proposes how the findings interact and influence rural recruitment and retention. The authors' proposed theoretical model suggests factors interact across multiple dimensions to facilitate the development of a rural physician identity. Rural upbringing, personal attributes, positive rural exposure, preparation for rural life and medicine, partner receptivity to rural living, financial incentives, integration into rural communities, and good work-life balance influence recruitment and retention. However, attending medical schools and/or residencies with a rural emphasis and participating in rural training may reflect, rather than produce, intention for rural practice. Many factors enhance rural physician identity development and influence whether physicians enter, remain in, and thrive in rural practice. To help trainees and young physicians develop the professional identity of a rural physician, multifactorial medical training approaches aimed at encouraging long-term rural practice should focus on rural-specific clinical and nonclinical competencies while providing trainees with positive rural experiences.

Muddling through the Health System: Experiences of Three Groups of Black Women in Three Regions

PubMed Central

Gary, F; Still, C; Mickels, P; Hassan, M; Evans, E

2018-01-01

Health care disparities are a well-documented concern among patients and providers who care for minority groups in the United States. In this study, focus groups were created from an original sample of 606 Black women representing three regions in the United States: the South, the Midwest, and the Virgin Islands. Composed of 10 randomly selected members each (n = 30), the focus groups provided insights into the nature of these disparities, with some suggestions for viable solutions. Participants voiced concerns about cultural taboos about discussing menopause, financial concerns, and negative experiences with health care leading to distrust in medical systems. The primary solution proposed was an increase in Black health care professionals who would have increased rapport with, empathy for, and understanding of the concerns of Black women. PMID:26371357

Acute kidney injury in symptomatic primary Epstein-Barr virus infectious mononucleosis: Systematic review.

PubMed

Moretti, Milena; Lava, Sebastiano A G; Zgraggen, Lorenzo; Simonetti, Giacomo D; Kottanattu, Lisa; Bianchetti, Mario G; Milani, Gregorio P

2017-06-01

Textbooks and reviews do not mention the association of symptomatic primary Epstein-Barr virus infectious mononucleosis with acute kidney injury in subjects without immunodeficiency or autoimmunity. Stimulated by our experience with two cases, we performed a review of the literature. The literature documents 38 cases (26 male and 12 female individuals ranging in age from 0.3 to 51, median 18 years) of symptomatic primary Epstein-Barr virus infectious mononucleosis complicated by acute kidney injury: 27 acute interstitial nephritides, 1 jaundice-associated nephropathy, 7 myositides and 3 hemolytic uremic syndromes. Acute kidney injury requiring renal replacement therapy was observed in 18 (47%) cases. Acute kidney injury did not resolve in one patient with acute interstitial nephritis. Two patients died because of systemic complications. The remaining 35 cases fully recovered. In individuals with acute symptomatic Epstein-Barr virus infectious mononucleosis, a relevant kidney injury is rare but the outcome potentially fatal. It results from interstitial nephritis, myositis-associated acute kidney injury, hemolytic uremic syndrome or jaundice-associated nephropathy. Copyright © 2017 Elsevier B.V. All rights reserved.

Utilizing Primary Sources as Building Blocks for Literacy.

ERIC Educational Resources Information Center

Massich, Mary; Munoz, Eric

1996-01-01

Describes instructional strategies using primary sources in middle school history instruction. Maintains that students need to make critical, personal connections to material before they understand it. The strategies examined use visual aids, living history presentations, realia, music, and primary documents. (MJP)

STS-60 Space Shuttle mission report

NASA Technical Reports Server (NTRS)

Fricke, Robert W., Jr.

1994-01-01

The STS-60 Space Shuttle Program Mission Report summarizes the Payload activities as well as the Orbiter, External Tank (ET), Solid Rocket Booster (SRB), Redesigned Solid Rocket Motor (RSRM), and the Space Shuttle main engine (SSME) systems performance during the sixtieth flight of the Space Shuttle Program and eighteenth flight of the Orbiter vehicle Discovery (OV-103). In addition to the Orbiter, the flight vehicle consisted of an ET designated at ET-61 (Block 10); three SSME's which were designated as serial numbers 2012, 2034, and 2032 in positions 1, 2, and 3, respectively; and two SRB's which were designated BI-062. The RSRM's that were installed in each SRB were designated as 360L035A (lightweight) for the left SRB, and 360Q035B (quarterweight) for the right SRB. This STS-60 Space Shuttle Program Mission Report fulfills the Space Shuttle Program requirement as documented in NSTS 07700, Volume VIII, Appendix E. That document requires that each major organizational element supporting the Program report the results of its hardware evaluation and mission performance plus identify all related in-flight anomalies. The primary objectives of the STS-60 mission were to deploy and retrieve the Wake Shield Facility-1 (WSF-1), and to activate the Spacehab-2 payload and perform on-orbit experiments. Secondary objectives of this flight were to activate and command the Capillary Pumped Loop/Orbital Debris Radar Calibration Spheres/Breman Satellite Experiment/Getaway Special (GAS) Bridge Assembly (CAPL/ODERACS/BREMSAT/GBA) payload, the Auroral Photography Experiment-B (APE-B), and the Shuttle Amateur Radio Experiment-II (SAREX-II).

Accidental Government Documents Librarian: A Review of Experiences and Training Needs of Interim Documents Librarians

ERIC Educational Resources Information Center

Yelinek, Kathryn; Hinchcliff, Marilou

2009-01-01

The results of a survey to determine the training needs and normative experiences of temporary government documents librarians are presented. The results indicate that temporary librarians tend to work in academia, have been in librarianship for a shorter time period, and have fewer technical processing skills than permanent documents librarians.…

Summary of reactor plant conditions during L2-2 pre-LOCE maneuver

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

Tsang, F.Y.; Yarbrough, W.M.; Cannon, J.W.

1979-04-26

This document presents the experimental results obtained during the pre-Loss of Coolant Experiment (LOCE) manuever and the core conditions prior to the L2-2 LOCE. The peak linear heat rate prior to the blowdown was 8.04 kW/ft, the primary coolant mass flow rate was 1.539 Mlbm/hr, the hot leg temperature was 585.9/sup 0/F, and the core ..delta..T was 42/sup 0/F. These conditions satisfied the requirements specified for the L2-2 LOCE except for the hot leg temperature being 12/sup 0/F below the desired 598/sup 0/F.

The Great Depression and the "On-to-Ottawa-Trek." Documents in the Classroom.

ERIC Educational Resources Information Center

Orr, Jeff

1996-01-01

Summarizes the events surrounding the "on-to-Ottawa trek," a Depression-era labor protest that culminated in the Regina Riot. Presents a series of instructional activities built around analyzing primary source documents. Documents include an official notice from the Canadian National Railways and a flyer advertising a union meeting. (MJP)

Dance Therapy: Focus on Dance VII.

ERIC Educational Resources Information Center

Mason, Kathleen Criddle, Ed.

This document is a collection of essays by various authors on the subject of dance therapy. Dance therapy, in the introduction of this document, is defined as a form of psychotherapy in which the therapist utilizes movement interaction as the primary means of accomplishing therapeutic goals. The document is divided into five parts: a)…

iDocument: How Smartphones and Tablets Are Changing Documentation in Preschool and Primary Classrooms

ERIC Educational Resources Information Center

Parnell, Will; Bartlett, Jackie

2012-01-01

With the increased prevalence of smartphones, laptops, tablet computers, and other digital technologies, knowledge about and familiarity with the educational uses for these devices is important for early childhood teachers documenting children's learning. Teachers can use smartphones every day to take photos, record video and audio, and make…

VET in Schools 2016: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2017

2017-01-01

This document covers the data terms used in the "VET in Schools 2016" summary publication. The primary purpose of this document is to assist users to understand the specific data terms. Terms that appear in the publication are listed in alphabetical order with the following information provided for each: (1) definition: a brief…

Apprentices and Trainees: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2017

2017-01-01

This document covers the data terms used in publications sourced from the National Apprentice and Trainee Collection and their associated data tables. The primary purpose of this document is to assist users of the publications to understand the specific data terms used within them. Terms are listed in alphabetical order with the following…

Students and Courses--Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2014

2014-01-01

This document covers the data terms used in publications sourced from the National VET Provider Collection and their associated data tables. The primary purpose of this document is to assist users of the publication to understand the specific data terms used within them. Terms that appear in the publications and data items are listed in…

Indigenous VET Research and Statistics: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This document covers the data terms used in the "Indigenous Research and Statistics" resources. It covers information contained in the "Apprentices and Trainees June Quarter 2009 report," the "Students and Courses 2009" report and the "Student Outcomes 2009" report and their associated data tables. The primary purpose of this document is to assist…

Senior 4 Western Civilization: An Historical Review of Its Development. Interim Curriculum Document.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg. School Programs Div.

This guide complements the two other social studies documents at the Senior 4 level for the social studies curriculum sequence for schools in Manitoba, Canada. The primary focus of this document is to explore the impact made by significant historical developments, movements, and individuals that shaped and influenced Western Civilization…

Human Rights Texts: Converting Human Rights Primary Source Documents into Data.

PubMed

Fariss, Christopher J; Linder, Fridolin J; Jones, Zachary M; Crabtree, Charles D; Biek, Megan A; Ross, Ana-Sophia M; Kaur, Taranamol; Tsai, Michael

2015-01-01

We introduce and make publicly available a large corpus of digitized primary source human rights documents which are published annually by monitoring agencies that include Amnesty International, Human Rights Watch, the Lawyers Committee for Human Rights, and the United States Department of State. In addition to the digitized text, we also make available and describe document-term matrices, which are datasets that systematically organize the word counts from each unique document by each unique term within the corpus of human rights documents. To contextualize the importance of this corpus, we describe the development of coding procedures in the human rights community and several existing categorical indicators that have been created by human coding of the human rights documents contained in the corpus. We then discuss how the new human rights corpus and the existing human rights datasets can be used with a variety of statistical analyses and machine learning algorithms to help scholars understand how human rights practices and reporting have evolved over time. We close with a discussion of our plans for dataset maintenance, updating, and availability.

Human Rights Texts: Converting Human Rights Primary Source Documents into Data

PubMed Central

Fariss, Christopher J.; Linder, Fridolin J.; Jones, Zachary M.; Crabtree, Charles D.; Biek, Megan A.; Ross, Ana-Sophia M.; Kaur, Taranamol; Tsai, Michael

2015-01-01

We introduce and make publicly available a large corpus of digitized primary source human rights documents which are published annually by monitoring agencies that include Amnesty International, Human Rights Watch, the Lawyers Committee for Human Rights, and the United States Department of State. In addition to the digitized text, we also make available and describe document-term matrices, which are datasets that systematically organize the word counts from each unique document by each unique term within the corpus of human rights documents. To contextualize the importance of this corpus, we describe the development of coding procedures in the human rights community and several existing categorical indicators that have been created by human coding of the human rights documents contained in the corpus. We then discuss how the new human rights corpus and the existing human rights datasets can be used with a variety of statistical analyses and machine learning algorithms to help scholars understand how human rights practices and reporting have evolved over time. We close with a discussion of our plans for dataset maintenance, updating, and availability. PMID:26418817

Precise chronology of differentiation of developing human primary dentition.

PubMed

Hu, Xuefeng; Xu, Shan; Lin, Chensheng; Zhang, Lishan; Chen, YiPing; Zhang, Yanding

2014-02-01

While correlation of developmental stage with embryonic age of the human primary dentition has been well documented, the available information regarding the differentiation timing of the primary teeth was largely based on the observation of initial mineralization and varies significantly. In this study, we aimed to document precise differentiation timing of the developing human primary dentition. We systematically examined the expression of odontogenic differentiation markers along with the formation of mineralized tissue in each developing maxillary and mandibular teeth from human embryos with well-defined embryonic age. We show that, despite that all primary teeth initiate development at the same time, odontogenic differentiation begins in the maxillary incisors at the 15th week and in the mandibular incisors at the 16th week of gestation, followed by the canine, the first primary premolar, and the second primary premolar at a week interval sequentially. Despite that the mandibular primary incisors erupt earlier than the maxillary incisors, this distal to proximal sequential differentiation of the human primary dentition coincides in general with the sequence of tooth eruption. Our results provide an accurate chronology of odontogenic differentiation of the developing human primary dentition, which could be used as reference for future studies of human tooth development.

Risk factors for development of primary bladder squamous cell carcinoma

PubMed Central

Hubbard, R; Swallow, D; Finch, W; Wood, SJ; Biers, SM

2017-01-01

INTRODUCTION The aim of this study was to investigate the prevalence of risk factors for primary squamous cell carcinoma (SCC) of the bladder. MATERIALS A total of 90 cases of primary SCC of the bladder were identified through multicentre analysis. Patient demographics, stage and grade of cancer at presentation, management and outcomes were recorded. The presence of known risk factors (catheter use, neuropathic bladder, smoking history, recurrent urinary tract infection and bladder stones) was also documented. RESULTS Over half of the patients had at least one identifiable risk factor for the development of primary bladder SCC: 13.9% of patients had a history of catheter use (clean intermittent self-catheterisation [CISC] in 11.1%), 10.0% of patients had a neuropathic bladder, 27.8% were smokers or ex-smokers and 20.0% had a documented history of recurrent urinary tract infection. Statistical analysis of the results showed no association between risk factors and grade of tumour at presentation. CONCLUSIONS These data further support the association between primary bladder SCC and several of the well documented risk factors for its development. Chronic use of CISC may confer a greater risk for development of SCC than thought previously. Further evidence of the role of CISC in primary SCC is required to justify routine screening and to determine exactly when surveillance of the bladder should begin for this group of patients. PMID:27869492

78 FR 53237 - Airworthiness Directives; Airbus Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-29

... control secondary computers (FCSCs), rather than flight control primary computers (FCPCs). This document... control primary computers (FCPCs); modifying two flight control secondary computers (FCSCs); revising the... the AD, which specify FCSCs, instead of flight control primary computers FCPCs. No other part of the...

The Puzzle of Visual Development: Behavior and Neural Limits.

PubMed

Kiorpes, Lynne

2016-11-09

The development of visual function takes place over many months or years in primate infants. Visual sensitivity is very poor near birth and improves over different times courses for different visual functions. The neural mechanisms that underlie these processes are not well understood despite many decades of research. The puzzle arises because research into the factors that limit visual function in infants has found surprisingly mature neural organization and adult-like receptive field properties in very young infants. The high degree of visual plasticity that has been documented during the sensitive period in young children and animals leaves the brain vulnerable to abnormal visual experience. Abnormal visual experience during the sensitive period can lead to amblyopia, a developmental disorder of vision affecting ∼3% of children. This review provides a historical perspective on research into visual development and the disorder amblyopia. The mismatch between the status of the primary visual cortex and visual behavior, both during visual development and in amblyopia, is discussed, and several potential resolutions are considered. It seems likely that extrastriate visual areas further along the visual pathways may set important limits on visual function and show greater vulnerability to abnormal visual experience. Analyses based on multiunit, population activity may provide useful representations of the information being fed forward from primary visual cortex to extrastriate processing areas and to the motor output. Copyright © 2016 the authors 0270-6474/16/3611384-10$15.00/0.

Protocol for a nationwide survey of primary health care in China: the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) MPP (Million Persons Project) Primary Health Care Survey

PubMed Central

Su, Meng; Zhang, Qiuli; Lu, Jiapeng; Li, Xi; Tian, Na; Wang, Yun; Yip, Winnie; Cheng, Kar Keung; Mensah, George A; Horwitz, Ralph I; Mossialos, Elias; Krumholz, Harlan M; Jiang, Lixin

2017-01-01

Introduction China has pioneered advances in primary health care (PHC) and public health for a large and diverse population. To date, the current state of PHC in China has not been subjected to systematic assessments. Understanding variations in primary care services could generate opportunities for improving the structure and function of PHC. Methods and analysis This paper describes a nationwide PHC study (PEACE MPP Primary Health Care Survey) conducted across 31 provinces in China. The study leverages an ongoing research project, the China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project (MPP). It employs an observational design with document acquisition and abstraction and in-person interviews. The study will collect data and original documents on the structure and financing of PHC institutions and the adequacy of the essential medicines programme; the education, training and retention of the PHC workforce; the quality of care; and patient satisfaction with care. The study will provide a comprehensive assessment of current PHC services and help determine gaps in access and quality of care. All study instruments and documents will be deposited in the Document Bank as an open-access source for other researchers. Ethics and dissemination The central ethics committee at the China National Centre for Cardiovascular Disease (NCCD) approved the study. Written informed consent has been obtained from all patients. Findings will be disseminated in future peer reviewed papers, and will inform strategies aimed at improving the PHC in China. Trial registration number NCT02953926 PMID:28851781

"Bringing home more than a paycheck:" an exploratory analysis of Black lesbians' experiences of stress and coping in the workplace.

PubMed

Bowleg, Lisa; Brooks, Kelly; Ritz, Susan Faye

2008-01-01

Although the workplace stress that Black women and lesbian, gay, bisexual and transgender (LGBT) people experience due to prejudice and discrimination has been well-documented in the social science literature, much of this literature focuses on Black women or LGBTs as if these groups were distinct and mutually exclusive. Consequently, there is a void of theory and research on the workplace stress that Black lesbians experience. This qualitative study involved exploratory analyses of workplace stress due to race, sex/gender, and sexual orientation, and coping strategies among a predominantly middle-class, highly educated sample of 19 Black lesbians between the ages of 26 and 68. Four workplace stressors emerged, those relevant to: heterosexism/ sexual identity; racism/race; sexism/sex/gender; and intersections of race, sex/gender, and sexual orientation. Three primary coping strategies emerged: being out and managing being out, covering their sexual orientation, and confronting or educating coworkers about prejudice and discrimination.

A visiting scientist program for the burst and transient source experiment

NASA Technical Reports Server (NTRS)

Kerr, Frank J.

1995-01-01

During this project, Universities Space Research Association provided program management and the administration for overseeing the performance of the total contractual effort. The program director and administrative staff provided the expertise and experience needed to efficiently manage the program.USRA provided a program coordinator and v visiting scientists to perform scientific research with Burst and Transient Source Experiment (BATSE) data. This research was associated with the primary scientific objectives of BATSE and with the various BATSE collaborations which were formed in response to the Compton Gamma Ray Observatory Guest Investigator Program. USRA provided administration for workshops, colloquia, the preparation of scientific documentation, etc. and also provided flexible program support in order to meet the on-going needs of MSFC's BATSE program. USRA performed tasks associated with the recovery, archiving, and processing of scientific data from BATSE. A bibliography of research in the astrophysics discipline is attached as Appendix 1. Visiting Scientists and Research Associates performed activities on this project, and their technical reports are attached as Appendix 2.

Bibliography on aerodynamics of airframe/engine integration of high-speed turbine-powered aircraft, volume 1

NASA Technical Reports Server (NTRS)

Nichols, M. R.

1980-01-01

This bibliography was developed as a first step in the preparation of a monograph on the subject of the aerodynamics of airframe/engine integration of high speed turbine powered aircraft. It lists 1535 unclassified documents published mainly in the period from 1955 to 1980. Primary emphasis was devoted to aerodynamic problems and interferences encountered in the integration process; however, extensive coverage also was given to the characteristics and problems of the isolated propulsion system elements. A detailed topic breakdown structure is used. The primary contents of the individual documents are indicated by the combination of the document's title and its location within the framework of the bibliography.

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

Surface Water Treatment Rules State Implementation Guidance

EPA Pesticide Factsheets

These documents provide guidance to states, tribes and U.S. EPA Regions exercising primary enforcement responsibility under the Safe Drinking Water Act. The documents contain EPA’s recommendations for implementation of the Surface Water Treatment Rules.

Potential of Diesel Engine, 1979 Summary Source Document

DOT National Transportation Integrated Search

1980-03-01

This document assesses the fuel economy potential of diesel engines in future passenger cars and light trucks. The primary technologies evaluated include: (1) engine control strategy and implementation, (2) the engine design variables, (3) emissions ...

39 CFR 3050.2 - Documentation of periodic reports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... traced back to public documents or to primary data sources; and (3) Be submitted in a form, and be... Postal Service shall identify any input data that have changed, list any quantification techniques that...

Alveolar soft part sarcoma: the new primary intracranial malignancy : A case report and review of the literature.

PubMed

Kumar, Aditaya; Alrohmain, B; Taylor, W; Bhattathiri, P

2017-07-26

The purpose of this paper is to serve as a reference to aid in the management of this poorly understood intracranial malignancy. The authors report their experience treating the eighth ostensible case of a primary intracranial alveolar soft part sarcoma (ASPS). A 21-year-old man presented to hospital after collapsing. He gave a 1-year history of headache, a 2-month history of reduced visual acuity and on examination had left facial paraesthesia with left-sided incoordination. MRI of the brain revealed a large left posterior fossa mass. The patient underwent resection of the tumour with good recovery in function. Immunohistochemical analysis of the tumour specimen confirmed an ASPS, and multimodal imaging in search of an extra-cranial disease primary was negative. A review of the literature yielded only seven other cases of primary intracranial ASPS. A variety of diagnostic imaging modalities were employed in search of a disease primary, as were various combinations of surgical resection, chemotherapy and radiotherapy as treatment. Half of the cases documented delayed disease recurrence. The authors discuss the following: the unique radiological and immunohistological characteristics of this disease including the potential for its misdiagnosis; the investigations required to diagnose a primary intracranial ASPS; the efficacy of current medical and surgical treatment options and the factors that will aid in prognostication. This is the first review of this new primary intracranial malignancy. From our analysis, we offer a joint radiological and immunohistochemical algorithm for the diagnosis of primary intracranial ASPS and specific operative considerations prior to resection.

Experiment K-6-22. Growth hormone regulation, synthesis and secretion in microgravity. Part 1: Somatotroph physiology. Part 2: Immunohistochemical analysis of hypothalamic hormones. Part 3: Plasma analysis

NASA Technical Reports Server (NTRS)

Grindeland, R.; Vale, W.; Hymer, W.; Sawchenko, P.; Vasques, M.; Krasnov, I.; Kaplanski, A.; Victorov, I.

1990-01-01

The objectives of the 1887 mission were: (1) to determine if the results of the SL-3 pituitary gland experiment (1) were repeatable; and (2) to determine what effect a longer mission would have on the rat pituitary gland growth hormone (GH) system. In the 1887 experiment two issues were considered especially important. First, it was recognized that cells prepared from individual rat pituitary glands should be considered separately so that the data from the 5 glands could be analyzed in a statistically meaningful way. Second, results of the SL-3 flight involving the hollow fiber implant and HPLC GH-variant experiments suggested that the biological activity of the hormone had been negatively affected by flight. The results of the 1887 experiment documented the wisdom of addressing both issues in the protocol. Thus, the reduction in secretory capacity of flight cells during subsequent extended cell culture on Earth was documented statistically, and thereby established the validity of the SL-3 result. The results of both flight experiments thus support the contention that there is a secretory lesion in pituitary GH cells of flight animals. The primary objective of both missions was a clear definition of the effect of spaceflight on the GH cell system. There can no longer be any reasonable doubt that this system is affected in microgravity. One explanation for the reason(s) underlying the better known effects of spaceflight on organisms, viz. changes in bone, muscle and immune systems may very well rest with such changes in bGH. In spite of the fact that rats in the Cosmos 1887 flight were on Earth for two days after flight, the data show that the GH system had still not recovered from the effects of flight. Many questions remain. One of the more important concerns the GRF responsiveness of somatotrophs after flight. This will be tested in an upcoming experiment.

The Nature of the Arguments for Creationism, Intelligent Design, and Evolution

ERIC Educational Resources Information Center

Barnes, Ralph M.; Church, Rebecca A.; Draznin-Nagy, Samuel

2017-01-01

Seventy-two Internet documents promoting creationism, intelligent design (I.D.), or evolution were selected for analysis. The primary goal of each of the 72 documents was to present arguments for creationism, I.D., or evolution. We first identified all arguments in these documents. Each argument was then coded in terms of both argument type…

VET in Schools 2009: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This document covers the data terms used in the "VET in Schools 2009" report. The primary purpose of this document is to assist users of the report to understand the specific data terms used within it. Terms that appear in the report are listed in alphabetical order with the following information provided for each: (1) Definition: a…

Apprentice and Trainee Destinations 2010: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This document covers the data terms used in the "Apprentice and Trainee Destinations Survey, 2010" report and its associated data tables. The primary purpose of this document is to assist users of the report to understand the specific data terms used within it. Terms that appear in the report are listed in alphabetical order with the…

Apprentices and Trainees: Early Trend Estimates, December 2010: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2011

2011-01-01

This document covers the data terms used in the "Australian Vocational Education and Training Statistics: Apprentices and Trainees--Early Trend Estimates December 2010" publication. The primary purpose of this document is to assist users of the report to understand the specific data terms used within it. Terms that appear in the report…

Apprentices and Trainees: March Quarter 2010. Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This document covers the data terms used in the "Apprentices and Trainees: March quarter 2010" publication and its associated data tables. The primary purpose of this document is to assist users of the publication to understand the specific data terms used within it. Terms that appear in the publication are listed in alphabetical order…

Students and Courses 2009: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This document covers the data terms used in the "Students and Courses 2009" publication and its associated data tables. The primary purpose of this document is to assist users of the publication to understand the specific data terms used within it. Terms that appear in the publication are listed in alphabetical order with the following…

VET in Schools 2008: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This document covers the data terms used in the "VET in Schools 2008" report. The primary purpose of this document is to assist users of the report to understand the specific data terms used within it. Terms that appear in the report are listed in alphabetical order with the following information provided for each: (1) Definition: a…

VET in Schools, 2007: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2009

2009-01-01

This document covers the data terms used in the "VET in Schools, 2007" report. The primary purpose of this document is to help users of the report understand the specific data terms used in it. Terms that appear in the report are listed in alphabetical order with the following information provided for each: (1) Definition: a brief…

VET in Schools, 2006: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2008

2008-01-01

This document covers the data terms used in the "VET in Schools, 2006" report. The primary purpose of this document is to help users understand the specific data terms used in the report. Terms that appear in the report are listed in alphabetical order with the following information provided for each: (1) Definition: a brief explanation…

Apprentices and Trainees: September Quarter 2010. Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2011

2011-01-01

This document covers the data terms used in the "Apprentices and Trainees: September Quarter 2010" publication and its associated data tables. The primary purpose of this document is to assist users of the publication to understand the specific data terms used within it. Terms that appear in the publication are listed in alphabetical…

Apprentices and Trainees: Annual, 2009. Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This document covers the data terms used in the "Apprentices and trainees: Annual 2009" publication and its associated data tables. The primary purpose of this document is to assist users of the publication to understand the specific data terms used within it. Terms that appear in the publication are listed in alphabetical order with the…

Promoting competition in Swedish primary care.

PubMed

Norén, Lars; Ranerup, Agneta

2015-01-01

The purpose of this paper is to examine the role of accreditation documents (ADs) in the competition based on provider quality in a quasi-market for primary healthcare. The paper uses a mixed-method research methodology to analyse two primary healthcare ADs in two Swedish regions. In total, 19 interviews were conducted with actors involved in the creation and use of such documents. This paper points to the crucial role of ADs in the identification of quality differences that influence the competition in primary healthcare. This finding contrasts with the commonly held laissez-faire idea that competition causes providers to develop their own service concepts and where the invisible hand creates quality differences. The paper adds to the discussion with its detailed description of how ADs create competition among primary healthcare providers through selection processes, quality differentiation, and ranking. The paper does not explore quality differences in the medical treatment of patients in primary healthcare centres. The paper provides insights for politicians on how to use ADs to control competition and regulate choice. The paper takes an innovative approach to the examination of how ADs increase the competition in primary healthcare choice.

Cushing syndrome in a young woman due to primary pigmented nodular adrenal disease.

PubMed

Hackman, Kathryn L; Davis, Anna L; Curnow, Paul A; Serpell, Jonathan W; McLean, Catriona A; Topliss, Duncan J

2010-01-01

To report a case of Cushing syndrome due to apparently sporadic primary pigmented nodular adrenal disease in a young woman. We describe the clinical, biochemical, radiologic, and histologic findings of Cushing syndrome due to the rare condition of primary pigmented nodular adrenal disease. A 30-year-old woman presented with a 2-year history of worsening itch without rash over her shoulders and arms and weight gain, particularly around the abdomen and face. Careful questioning did not elicit any history of exogenous glucocorticoid use (systemic or topical), including hydrocortisone. On examination, the patient had a slightly rounded and plethoric face, a small buffalo hump, central adiposity, and thin skin with a few small striae on her inner thighs. No features of the Carney complex were observed. Investigations showed hypercortisolism with suppressed corticotropin and normal adrenal imaging despite documentation of enlarged adrenal glands at removal. High-dose dexamethasone administration was followed by a decrease in urinary free cortisol excretion rather than a paradoxical rise as previously reported in primary pigmented nodular adrenal disease. No mutations were detected in the PRKAR1A gene. Primary pigmented nodular adrenal disease should be suspected in patients with corticotropin-independent Cushing syndrome who have normal adrenal imaging. The role of genetic testing in apparently sporadic cases is not established, but cumulative experience may be helpful in defining the frequency of PRKAR1A mutations.

Feasibility of sustainable provision of intradermal post exposure prophylaxis against rabies at primary care level –evidence from rural Haryana

PubMed Central

2014-01-01

Background Rabies is the most severe and neglected public health problem in India. Management of animal bite with post exposure prophylaxis is the only existent strategy to prevent rabies related deaths. Cost-effective and sustainable programme for provision of post exposure prophylaxis (PEP) is needed in India. Methods In this study, we have documented the experience of implementation of intra-dermal anti rabies vaccination in Animal Bite Management (ABM) clinic at Primary Health Centre (PHC). This study facility belonged to Comprehensive Rural Health Services Project, Ballabgarh in Faridabad district of Haryana. Hospital service record of ABM clinic was analyzed and various feasibility issues such as costing of services, vaccine wastage and other operational issues in providing PEP services at PHC level were documented. Results A total of 619 patients were treated in the ABM clinic. Service utilization of ABM clinic was increased by 38% in the second year of implementation. Mean age of the patients was 23.9 years (SD: 18.8) and majority (70.4%) were males. Majority (86%) of the patients received the first dose of anti-rabies vaccine within the recommended 48 hours. A total 446 vaccine vials (1 ml) were consumed of which 20.8% was contributed in vaccine wastage. User-fee (350 Indian Rupees) collected from the patients. User-fee was re-used to purchase vaccines, intradermal (ID) syringes and other consumables required to ensure regular availability of ARV services at the PHC. Conclusions This study demonstrated the cost-effective and sustainable model of provision of PEP against rabies at primary care level. ID PEP provision at primary care level not only address the unmet need of animal bite management in the community also reduces the out of pocket expenditure of the patients. PMID:24965875

SANSMIC design document.

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

Weber, Paula D.; Rudeen, David Keith

2015-07-01

The United States Strategic Petroleum Reserve (SPR) maintains an underground storage system consisting of caverns that were leached or solution mined in four salt domes located near the Gulf of Mexico in Texas and Louisiana. The SPR comprises more than 60 active caverns containing approximately 700 million barrels of crude oil. Sandia National Labo- ratories (SNL) is the geotechnical advisor to the SPR. As the most pressing need at the inception of the SPR was to create and fill storage volume with oil, the decision was made to leach the caverns and fill them simultaneously (leach-fill). Therefore, A.J. Russo developedmore » SANSMIC in the early 1980s which allows for a transient oil-brine interface (OBI) making it possible to model leach-fill and withdrawal operations. As the majority of caverns are currently filled to storage capacity, the primary uses of SANSMIC at this time are related to the effects of small and large withdrawals, expansion of existing caverns, and projecting future pillar to diameter ratios. SANSMIC was identified by SNL as a priority candidate for qualification. This report continues the quality assurance (QA) process by documenting the "as built" mathematical and numerical models that comprise this document. The pro- gram flow is outlined and the models are discussed in detail. Code features that were added later or were not documented previously have been expounded. No changes in the code's physics have occurred since the original documentation (Russo, 1981, 1983) although recent experiments may yield improvements to the temperature and plume methods in the future.« less

Best practice in primary care pathology: review 9

PubMed Central

Smellie, W S A; Shaw, N; Bowlees, R; Taylor, A; Howell‐Jones, R; McNulty, C A M

2007-01-01

This ninth best‐practice review examines two series of common primary care questions in laboratory medicine: (i) potassium abnormalities and (ii) venous leg ulcer microbiology. The review is presented in question‐and‐answer format, referenced for each question series. The recommendations represent a précis of guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence‐based medicine reviews, supplemented by MEDLINE EMBASE searches to identify relevant primary research documents. They are not standards but form a guide to be set in the clinical context. Most are consensus rather than evidence‐based. They will be updated periodically to take account of new information. PMID:17259298

Mobile health data collection at primary health care in Ethiopia: a feasible challenge.

PubMed

Medhanyie, Araya Abrha; Moser, Albine; Spigt, Mark; Yebyo, Henock; Little, Alex; Dinant, GeertJan; Blanco, Roman

2015-01-01

Feasibility assessment of mobile health (mHealth) data collection at primary health care in Ethiopia. A total of 14 health workers were recruited from 12 primary health care facilities to use smartphones, installed with customized data collection application and electronic maternal health care forms for assessing pregnant women's health for 6 months. Qualitative approaches comprising in-depth interviews and field notes were used to document the users' perception and experience in using the application and forms. All health workers had never had previous exposure to smartphones and electronic forms, but they got used to them easily. Over 6 months, all health workers completed a total of 952 patient records using the forms on smartphones. Health workers' acceptability and demand for the application and forms were high. In introducing the application, nontechnical challenges were more difficult to solve than technical challenges. Introducing an mHealth application at primary health care for routine collection of health data relevant to maternal health at a small scale was feasible. Nonetheless, implementing a system of assigning unique and consistent patient identifier, standardization of health services, and improving mobile network coverage would be prerequisites for scaled-up usage of such an application. Copyright © 2015 Elsevier Inc. All rights reserved.

Nomenclature of primary amenorrhea: A proposal document of the Japan Society of Obstetrics and Gynecology committee for the redefinition of primary amenorrhea.

PubMed

Shozu, Makio; Ishikawa, Hiroshi; Horikawa, Reiko; Sakakibara, Hideya; Izumi, Shun-Ichiro; Ohba, Takashi; Hirota, Yasushi; Ogata, Tsutomu; Osuga, Yutaka; Kugu, Koji

2017-11-01

The aim of this study was to provide medical terms to describe the condition of a girl who should be evaluated for primary amenorrhea in order to facilitate intervention at an appropriate time. We performed a literature and clinical guidelines search for recent practices with regard to menarche and discussed relevant cases that had been experienced by committee members. Additionally, we theoretically reviewed medical terms defined in the Glossary Book of Obstetrics and Gynecology in Japan (Japan Society of Obstetrics and Gynecology, 3rd edition). The committee for the redefinition of primary amenorrhea proposed the introduction of two terms and the deletion of one term that had been defined by the Japan Society of Obstetrics and Gynecology, instead of changing the age definition of primary amenorrhea. 'Delayed menarche' was introduced to describe a condition in which a girl has never experienced cyclic menstruation (menarche) by 15-17 years of age. 'Late menarche' was also introduced to describe a condition in which a girl has experienced menarche at 15 years of age or older. 'Delayed menstruation,' which was defined as a condition in which a girl experiences menarche at 15-18 years of age, was deleted. The new terms 'delayed menarche' and 'late menarche' were introduced, and the term 'delayed menstruation' was deleted. The new system might help in the early detection and appropriate treatment of primary amenorrhea. © 2017 Japan Society of Obstetrics and Gynecology.

Searching for the Impact of Participation in Health and Health Research: Challenges and Methods.

PubMed

Harris, Janet; Cook, Tina; Gibbs, Lisa; Oetzel, John; Salsberg, Jon; Shinn, Carolynne; Springett, Jane; Wallerstein, Nina; Wright, Michael

2018-01-01

Internationally, the interest in involving patients and the public in designing and delivering health interventions and researching their effectiveness is increasing. Several systematic reviews of participation in health research have recently been completed, which note a number of challenges in documenting the impact of participation. Challenges include working across stakeholders with different understandings of participation and levels of experience in reviewing; comparing heterogeneous populations and contexts; configuring findings from often thin descriptions of participation in academic papers; and dealing with different definitions of impact. This paper aims to advance methods for systematically reviewing the impact of participation in health research, drawing on recent systematic review guidance. Practical examples for dealing with issues at each stage of a review are provided based on recent experience. Recommendations for improving primary research on participation in health are offered and key points to consider during the review are summarised.

Preliminary Report of NRC Twin Otter Operations in the 1997 Southern Great Plains Experiment

NASA Technical Reports Server (NTRS)

MacPherson, J. Ian

1997-01-01

From June 18 to July 17, 1997, the NRC Twin Otter atmospheric research aircraft was operated from Oklahoma City, U.S.A., in the Southern Great Plains 1997 (SGP97) Hydrology Experiment. The primary role of the aircraft was to measure the vertical fluxes of sensible and latent heat, CO2, ozone and momentum in the atmospheric boundary layer, along with supporting meteorological and radiometric data. Approximately 400 flux runs and 100 soundings were flown in 27 project flights over rural areas near Oklahoma City. This preliminary report documents the flight program, lists the instrumentation aboard the aircraft, and presents a summary of run-averaged data from each flux run. These data are from the in-field analysis and must be considered preliminary. A re-analysis incorporating updated calibrations is planned for the fall of 1997 followed by a more comprehensive technical report.

Extensive video-game experience alters cortical networks for complex visuomotor transformations.

PubMed

Granek, Joshua A; Gorbet, Diana J; Sergio, Lauren E

2010-10-01

Using event-related functional magnetic resonance imaging (fMRI), we examined the effect of video-game experience on the neural control of increasingly complex visuomotor tasks. Previously, skilled individuals have demonstrated the use of a more efficient movement control brain network, including the prefrontal, premotor, primary sensorimotor and parietal cortices. Our results extend and generalize this finding by documenting additional prefrontal cortex activity in experienced video gamers planning for complex eye-hand coordination tasks that are distinct from actual video-game play. These changes in activation between non-gamers and extensive gamers are putatively related to the increased online control and spatial attention required for complex visually guided reaching. These data suggest that the basic cortical network for processing complex visually guided reaching is altered by extensive video-game play. Crown Copyright © 2009. Published by Elsevier Srl. All rights reserved.

Access to cancer screening for women with mobility disabilities.

PubMed

Angus, Jan; Seto, Lisa; Barry, Nancy; Cechetto, Naomi; Chandani, Samira; Devaney, Julie; Fernando, Sharmini; Muraca, Linda; Odette, Fran

2012-03-01

Women with mobility disabilities are less likely to access cancer screening, even when they have a primary care provider. The Gateways to Cancer Screening project was initiated to document the challenges for women with disabilities in their access and experiences of screening for breast, cervical and colorectal cancer. The study followed the tenets of participatory action research. Five peer-led focus groups were held with 24 women with mobility disabilities. Study participants identified multiple and interacting institutional barriers to cancer screening. Their discussions highlighted the complex work of (1) arranging and attending health-related appointments, (2) confronting normative assumptions about women's bodies and (3) securing reliable health care and information. These overlapping, mutually reinforcing issues interact to shape how women with disabilities access and experience cancer screening. We explore implications for redesign of cancer screening services and education of health providers, providing specific recommendations suggested by our participants and the findings.

Searching for the Impact of Participation in Health and Health Research: Challenges and Methods

PubMed Central

Cook, Tina; Salsberg, Jon; Shinn, Carolynne; Springett, Jane; Wallerstein, Nina; Wright, Michael

2018-01-01

Internationally, the interest in involving patients and the public in designing and delivering health interventions and researching their effectiveness is increasing. Several systematic reviews of participation in health research have recently been completed, which note a number of challenges in documenting the impact of participation. Challenges include working across stakeholders with different understandings of participation and levels of experience in reviewing; comparing heterogeneous populations and contexts; configuring findings from often thin descriptions of participation in academic papers; and dealing with different definitions of impact. This paper aims to advance methods for systematically reviewing the impact of participation in health research, drawing on recent systematic review guidance. Practical examples for dealing with issues at each stage of a review are provided based on recent experience. Recommendations for improving primary research on participation in health are offered and key points to consider during the review are summarised. PMID:29862298

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.

Basic Hitchhiker Payload Requirements

NASA Technical Reports Server (NTRS)

Horan, Stephen

1999-01-01

This document lists the requirements for the NMSU Hitchhiker experiment payload that were developed as part of the EE 498/499 Capstone Design class during the 1999-2000 academic year. This document is used to describe the system needs as described in the mission document. The requirements listed here are those primarily used to generate the basic electronic and data processing requirements developed in the class design document. The needs of the experiment components are more fully described in the draft NASA hitchhiker customer requirements document. Many of the details for the overall payload are given in full detail in the NASA hitchhiker documentation.

Automated documentation generator for advanced protein crystal growth

NASA Technical Reports Server (NTRS)

Maddux, Gary A.; Provancha, Anna; Chattam, David

1994-01-01

To achieve an environment less dependent on the flow of paper, automated techniques of data storage and retrieval must be utilized. This software system, 'Automated Payload Experiment Tool,' seeks to provide a knowledge-based, hypertext environment for the development of NASA documentation. Once developed, the final system should be able to guide a Principal Investigator through the documentation process in a more timely and efficient manner, while supplying more accurate information to the NASA payload developer. The current system is designed for the development of the Science Requirements Document (SRD), the Experiment Requirements Document (ERD), the Project Plan, and the Safety Requirements Document.

The 30/20 GHz flight experiment system, phase 2. Volume 3: Experiment system requirement document

NASA Technical Reports Server (NTRS)

Bronstein, L.; Kawamoto, Y.; Ribarich, J. J.; Scope, J. R.; Forman, B. J.; Berman, S. G.; Reisenfeld, S.

1981-01-01

An approach to the requirements document to be used to procure the system by NASA is presented. The basic approach is similar to the requirements document used in the commercial communication satellite. Enough detail requirements are given to define the system without tight constraints.

A Study of Experience Credit for Professional Engineering Licensure

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

Martin, M.A.

2003-08-11

Oak Ridge National Laboratory performed a study of experience credit for professional engineering licensure for the Department of Energy's Industrial Assessment Center (IAC) Program. One of the study's goals was to determine how state licensure boards grant experience credit for engineering licensure, particularly in regards to IAC experience and experience prior to graduation. Another goal involved passing IAC information to state licensure boards to allow the boards to become familiar with the program and determine if they would grant credit to IAC graduates. The National Council of Examiners for Engineers and Surveyors (NCEES) has adopted a document, the ''Model Law''.more » This document empowers states to create state engineering boards and oversee engineering licensure. The board can also interpret and adopt rules and regulations. The Model Law also gives a general ''process'' for engineering licensure, the ''Model Law Engineer''. The Model Law Engineer requires that an applicant for professional licensure, or professional engineering (PE) licensure, obtain a combination of formal education and professional experience and successfully complete the fundamentals of engineering (FE) and PE exams. The Model Law states that a PE applicant must obtain four years of ''acceptable'' engineering experience after graduation to be allowed to sit for the PE exam. Although the Model Law defines ''acceptable experience,'' it is somewhat open to interpretation, and state boards decide whether applicants have accumulated the necessary amount of experience. The Model Law also allows applicants one year of credit for postgraduate degrees as well as experience credit for teaching courses in engineering. The Model Law grants states the power to adopt and amend the bylaws and rules of the Model Law licensure process. It allows state boards the freedom to modify the experience requirements for professional licensure. This power has created variety in experience requirements, and licensure requirements can differ from state to state. Before this study began, six questions were developed to help document how state boards grant experience credit. Many of the questions were formulated to determine how states deal with teaching experience, postgraduate credit, experience prior to graduation, PE and FE waivers, and the licensure process in general. Data were collected from engineering licensure boards for each of the fifty states and the District of Columbia. Telephone interviews were the primary method of data collection, while email correspondence was also used to a lesser degree. Prior to contacting each board, the researchers attempted to review each state's licensure web site. Based on the data collected, several trends and patterns were identified. For example, there is a general trend away from offering credit for experience prior to graduation. The issue becomes a problem when a PE from one state attempts to gain a license in another state by comity or endorsement. Tennessee and Kansas have recently stopped offering this credit and Mississippi cautions applicants that it could be difficult to obtain licensure in other states.« less

Chemical Data Reporting Byproduct and Recycling Scenarios

EPA Pesticide Factsheets

This document addresses a series of 18 industry scenarios and questions related to EPA’s Chemical Data Reporting (CDR) rule. The primary goal of this document is to help the regulated community comply with the requirements of the CDR rule.

FEATURES, EVENTS, AND PROCESSES: SYSTEM-LEVEL AND CRITICALITY

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

D.L. McGregor

The primary purpose of this Analysis/Model Report (AMR) is to identify and document the screening analyses for the features, events, and processes (FEPs) that do not easily fit into the existing Process Model Report (PMR) structure. These FEPs include the 3 1 FEPs designated as System-Level Primary FEPs and the 22 FEPs designated as Criticality Primary FEPs. A list of these FEPs is provided in Section 1.1. This AMR (AN-WIS-MD-000019) documents the Screening Decision and Regulatory Basis, Screening Argument, and Total System Performance Assessment (TSPA) Disposition for each of the subject Primary FEPs. This AMR provides screening information and decisionsmore » for the TSPA-SR report and provides the same information for incorporation into a project-specific FEPs database. This AMR may also assist reviewers during the licensing-review process.« less

Protocol for a nationwide survey of primary health care in China: the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) MPP (Million Persons Project) Primary Health Care Survey.

PubMed

Su, Meng; Zhang, Qiuli; Lu, Jiapeng; Li, Xi; Tian, Na; Wang, Yun; Yip, Winnie; Cheng, Kar Keung; Mensah, George A; Horwitz, Ralph I; Mossialos, Elias; Krumholz, Harlan M; Jiang, Lixin

2017-08-28

China has pioneered advances in primary health care (PHC) and public health for a large and diverse population. To date, the current state of PHC in China has not been subjected to systematic assessments. Understanding variations in primary care services could generate opportunities for improving the structure and function of PHC. This paper describes a nationwide PHC study (PEACE MPP Primary Health Care Survey) conducted across 31 provinces in China. The study leverages an ongoing research project, the China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project (MPP). It employs an observational design with document acquisition and abstraction and in-person interviews. The study will collect data and original documents on the structure and financing of PHC institutions and the adequacy of the essential medicines programme; the education, training and retention of the PHC workforce; the quality of care; and patient satisfaction with care. The study will provide a comprehensive assessment of current PHC services and help determine gaps in access and quality of care. All study instruments and documents will be deposited in the Document Bank as an open-access source for other researchers. The central ethics committee at the China National Centre for Cardiovascular Disease (NCCD) approved the study. Written informed consent has been obtained from all patients. Findings will be disseminated in future peer reviewed papers, and will inform strategies aimed at improving the PHC in China. NCT02953926. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

ASTP experiment support data processing

NASA Technical Reports Server (NTRS)

Osburn, R. K.; Barnett, E. L.; Moore, H. L.; Moore, J. B.; Ball, J. R.

1975-01-01

Activities associated with the generation of ASTP experiment support data in the areas of spacecraft ephemeris and orientation and instrument pointing and field-of-view are documented. It is intended that this document represent a cradle-to-grave chronicle of these activities. To satisfy this intent while facilitating the ready dissemination of information, the document is being published twice. The first publication, scheduled for release prior to ASTP liftoff, includes all preflight phases of the experiment support activity in addition to those appendixes that do not pertain to any mission-specific data. The second publication will provide any required updates to the original documentation and will add all mission-specific data, including documentation of all postflight data processing activities and data archiving information.

Analysis of the Concept of Primary Care for Children and Adolescents: A Policy Research Brief.

ERIC Educational Resources Information Center

Johansen, Anne S.; And Others

This document examines the 10 essential attributes of primary health care contained in the U.S. Maternal and Child Health Bureau's definition of primary care. Primary care for children and adolescents is personal health care delivered in the context of family, culture, and community; the range of services meets all but the most uncommon health…

Documents and Symbols of American Freedom. Elementary Grade Activity. Schools of California Online Resources for Education (SCORE): Connecting California's Classrooms to the World.

ERIC Educational Resources Information Center

Hutchens, Dorothy

This lesson plan for elementary-age children studies some of the primary source documents and symbols of freedom which were and are important for the nation. The lesson plan uses the following documents: "The Mayflower Compact"; "The Declaration of Independence"; "The Constitution"; and the "Bill of Rights."…

Apprentices and Trainees: December Quarter 2009: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This document covers the data terms used in the Apprentices and trainees December quarter 2009 report and its associated data tables. The primary purpose of this document is to assist users of the report to understand the specific data terms used within it. Terms that appear in the report are listed in alphabetical order with the following…

Apprentices and Trainees: September Quarter 2009. Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This document covers the data terms used in the "Apprentices and trainees September" quarter 2009 report and its associated data tables. The primary purpose of this document is to assist users of the report to understand the specific data terms used within it. Terms that appear in the report are listed in alphabetical order with the following…

Apprentices and Trainees: Early Trend Estimates. June 2010: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This document covers the data terms used in the "Apprentices and trainees early trend estimates June 2010" publication. The primary purpose of this document is to assist users of the report to understand the specific data terms used within it. Terms that appear in the report are listed in alphabetical order with the following information…

Outcomes from the Productivity Places Program 2009: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2009

2009-01-01

This document covers the data terms used in the "Outcomes from the Productivity Places Program 2009" report and its associated data tables. The primary purpose of this document is to assist users of the report to understand the specific data terms used within it. Terms that appear in the report are listed in alphabetical order with the…

Mission statements and vision documents in medical practices.

PubMed

Drury, Ivo; Slomski, Carol

2006-01-01

Thoughtful, carefully constructed mission statements and vision documents serve both to signal the purpose of a medical practice to the public and other professional colleagues, and to keep the practice's providers focused on its key purposes. Practice culture is the primary driver ofmission and vision. We clarify the differences between mission statements and vision documents, and offer guidelines to aid in constructing them.

Electronic Document Delivery: Converging Standards and Technologies. UDT Series on Data Communication Technologies and Standards for Libraries, Report #2.

ERIC Educational Resources Information Center

Cleveland, Gary

The development of information technologies such as public access catalogs and online databases has greatly enhanced access to information. The lack of automation in the area of document delivery, however, has created a large disparity between the speed with which citations are found and the provision of primary documents. This imbalance can…

Policy Levers Key for Primary Health Care Organizations to Support Primary Care Practices in Meeting Medical Home Expectations: Comparing Leading States to the Australian Experience.

PubMed

Takach, Mary

2016-10-01

Several countries with highly ranked delivery systems have implemented locally-based, publicly-funded primary health care organizations (PHCOs) as vehicles to strengthen their primary care foundations. In the United States, state governments have started down a similar pathway with models that share similarities with international PHCOs. The objective of this study was to determine if these kinds of organizations were working with primary care practices to improve their ability to provide comprehensive, coordinated, and accessible patient-centered care that met quality, safety, and efficiency outcomes-all core attributes of a medical home. This qualitative study looked at 4 different PHCO models-3 from the United States and 1 from Australia-with similar objectives and scope. Primary and secondary data included semi-structured interviews with 26 PHCOs and a review of government documents. The study found that the 4 PHCO models were engaging practices to meet a number of medical home expectations, but the US PHCOs were more uniform in efforts to work with practices and focused on arranging services to meet the needs of complex patients. There was significant variation in level of effort between the Australian PHCOs. These differences can be explained through the state governments' selection of payment models and use of data frameworks to support collaboration and incentivize performance of both PHCOs and practices. These findings offer policy lessons to inform health reform efforts under way to better capitalize on the potential of PHCOs to support a high-functioning primary health foundation as an essential component to a reformed health system.

Instructions for Reporting for the 2006 Partial Updating of the TSCA Chemical Inventory Database

EPA Pesticide Factsheets

The primary goal of this document is to help the regulated community comply with the requirements of the IUR regulations. This document does not substitute for those regulations, nor is it a regulation itself.

Overseas Environmental Baseline Guidance Document

DTIC Science & Technology

2007-05-01

The primary purpose of this Overseas Environmental Baseline Guidance Document (OEBGD) is to provide criteria and management practices to be used by ...establishes standards for environmental compliance at Department of Defense controlled or operated installations in countries for which no FGS have been established.

Improved simulation of driver behavior : modeling protected and permitted left-turn operations at signalized intersections.

DOT National Transportation Integrated Search

2011-04-01

"This report documents the findings from a research project that is focused on modeling protected and permitted left-turn operations at signalized intersection approaches. The projects primary objective is to document the microscopic characteristi...

California aviation system plan : policy element.

DOT National Transportation Integrated Search

2011-10-01

The Policy Element (PE) is the primary document that explains and guides the business of the Division of Aeronautics (Division) that is housed in the California Department of Transportation (Caltrans). The Divisions primary duties and functions ar...

Desiderata for a Computer-Assisted Audit Tool for Clinical Data Source Verification Audits

PubMed Central

Duda, Stephany N.; Wehbe, Firas H.; Gadd, Cynthia S.

2013-01-01

Clinical data auditing often requires validating the contents of clinical research databases against source documents available in health care settings. Currently available data audit software, however, does not provide features necessary to compare the contents of such databases to source data in paper medical records. This work enumerates the primary weaknesses of using paper forms for clinical data audits and identifies the shortcomings of existing data audit software, as informed by the experiences of an audit team evaluating data quality for an international research consortium. The authors propose a set of attributes to guide the development of a computer-assisted clinical data audit tool to simplify and standardize the audit process. PMID:20841814

Lessons learned from the deadly sisters: drug and alcohol treatment disruption, and consequences from Hurricanes Katrina and Rita.

PubMed

Maxwell, Jane Carlisle; Podus, Deborah; Walsh, David

2009-01-01

This paper reports on the effects of Hurricanes Katrina and Rita on drug and alcohol treatment in Texas in 2005-2006. Findings are based on a secondary analysis of administrative data on 567 hurricane-related admissions and on interview data from a sample of 20 staff in 11 treatment programs. Katrina evacuees differed from Rita clients in terms of demographics and primary problem substances and treatment needs, while the experiences of program staff and needed changes to improve disaster readiness were more similar. Additional systematic research is needed to document the intermediate and long-term impacts of the storms in these and other affected areas.

Conceptualizing race in economic models of medical utilization: a case study of community-based elders and the emergency room.

PubMed Central

White-Means, S I

1995-01-01

There is no consensus on the appropriate conceptualization of race in economic models of health care. This is because race is rarely the primary focus for analysis of the market. This article presents an alternative framework for conceptualizing race in health economic models. A case study is analyzed to illustrate the value of the alternative conceptualization. The case study findings clearly document the importance of model stratification according to race. Moreover, the findings indicate that empirical results are improved when medical utilization models are refined in a way that reflects the unique experiences of the population that is studied. PMID:7721593

Integrated Work Management: Overview, Course 31881

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

Simpson, Lewis Edward

Integrated work management (IWM) is the process used for formally implementing the five-step process associated with integrated safety management (ISM) and integrated safeguards and security management (ISSM) at Los Alamos National Laboratory (LANL). IWM also directly supports the LANL Environmental Management System (EMS). IWM helps all workers and managers perform work safely and securely and in a manner that protects people, the environment, property, and the security of the nation. The IWM process applies to all work activities at LANL, from working in the office to designing experiments to assembling and detonating explosives. The primary LANL document that establishes andmore » describes IWM requirements is Procedure (P) 300, Integrated Work Management.« less

Late Cretaceous restructuring of terrestrial communities facilitated the end-Cretaceous mass extinction in North America.

PubMed

Mitchell, Jonathan S; Roopnarine, Peter D; Angielczyk, Kenneth D

2012-11-13

The sudden environmental catastrophe in the wake of the end-Cretaceous asteroid impact had drastic effects that rippled through animal communities. To explore how these effects may have been exacerbated by prior ecological changes, we used a food-web model to simulate the effects of primary productivity disruptions, such as those predicted to result from an asteroid impact, on ten Campanian and seven Maastrichtian terrestrial localities in North America. Our analysis documents that a shift in trophic structure between Campanian and Maastrichtian communities in North America led Maastrichtian communities to experience more secondary extinction at lower levels of primary production shutdown and possess a lower collapse threshold than Campanian communities. Of particular note is the fact that changes in dinosaur richness had a negative impact on the robustness of Maastrichtian ecosystems against environmental perturbations. Therefore, earlier ecological restructuring may have exacerbated the impact and severity of the end-Cretaceous extinction, at least in North America.

Late Cretaceous restructuring of terrestrial communities facilitated the end-Cretaceous mass extinction in North America

PubMed Central

Roopnarine, Peter D.; Angielczyk, Kenneth D.

2012-01-01

The sudden environmental catastrophe in the wake of the end-Cretaceous asteroid impact had drastic effects that rippled through animal communities. To explore how these effects may have been exacerbated by prior ecological changes, we used a food-web model to simulate the effects of primary productivity disruptions, such as those predicted to result from an asteroid impact, on ten Campanian and seven Maastrichtian terrestrial localities in North America. Our analysis documents that a shift in trophic structure between Campanian and Maastrichtian communities in North America led Maastrichtian communities to experience more secondary extinction at lower levels of primary production shutdown and possess a lower collapse threshold than Campanian communities. Of particular note is the fact that changes in dinosaur richness had a negative impact on the robustness of Maastrichtian ecosystems against environmental perturbations. Therefore, earlier ecological restructuring may have exacerbated the impact and severity of the end-Cretaceous extinction, at least in North America. PMID:23112149

An allosteric conduit facilitates dynamic multisite substrate recognition by the SCFCdc4 ubiquitin ligase

NASA Astrophysics Data System (ADS)

Csizmok, Veronika; Orlicky, Stephen; Cheng, Jing; Song, Jianhui; Bah, Alaji; Delgoshaie, Neda; Lin, Hong; Mittag, Tanja; Sicheri, Frank; Chan, Hue Sun; Tyers, Mike; Forman-Kay, Julie D.

2017-01-01

The ubiquitin ligase SCFCdc4 mediates phosphorylation-dependent elimination of numerous substrates by binding one or more Cdc4 phosphodegrons (CPDs). Methyl-based NMR analysis of the Cdc4 WD40 domain demonstrates that Cyclin E, Sic1 and Ash1 degrons have variable effects on the primary Cdc4WD40 binding pocket. Unexpectedly, a Sic1-derived multi-CPD substrate (pSic1) perturbs methyls around a previously documented allosteric binding site for the chemical inhibitor SCF-I2. NMR cross-saturation experiments confirm direct contact between pSic1 and the allosteric pocket. Phosphopeptide affinity measurements reveal negative allosteric communication between the primary CPD and allosteric pockets. Mathematical modelling indicates that the allosteric pocket may enhance ultrasensitivity by tethering pSic1 to Cdc4. These results suggest negative allosteric interaction between two distinct binding pockets on the Cdc4WD40 domain may facilitate dynamic exchange of multiple CPD sites to confer ultrasensitive dependence on substrate phosphorylation.

Integration of Medical Scribes in the Primary Care Setting: Improving Satisfaction.

PubMed

Imdieke, Brian H; Martel, Marc L

There are little published data on the use of medical scribes in the primary care setting. We assessed the feasibility of incorporating medical scribes in our ambulatory clinic to support provider documentation in the electronic medical record. In our convenience sampling of patient, provider, and staff perceptions of scribes, we found that patients were comfortable having scribes in the clinic. Overall indicators of patient satisfaction were slightly decreased. Providers found scribe support to be valuable and overall clinician documentation time was reduced by more than 50% using scribes.

Comprehensive Non-Destructive Conservation Documentation of Lunar Samples Using High-Resolution Image-Based 3D Reconstructions and X-Ray CT Data

NASA Technical Reports Server (NTRS)

Blumenfeld, E. H.; Evans, C. A.; Oshel, E. R.; Liddle, D. A.; Beaulieu, K.; Zeigler, R. A.; Hanna, R. D.; Ketcham, R. A.

2015-01-01

Established contemporary conservation methods within the fields of Natural and Cultural Heritage encourage an interdisciplinary approach to preservation of heritage material (both tangible and intangible) that holds "Outstanding Universal Value" for our global community. NASA's lunar samples were acquired from the moon for the primary purpose of intensive scientific investigation. These samples, however, also invoke cultural significance, as evidenced by the millions of people per year that visit lunar displays in museums and heritage centers around the world. Being both scientifically and culturally significant, the lunar samples require a unique conservation approach. Government mandate dictates that NASA's Astromaterials Acquisition and Curation Office develop and maintain protocols for "documentation, preservation, preparation and distribution of samples for research, education and public outreach" for both current and future collections of astromaterials. Documentation, considered the first stage within the conservation methodology, has evolved many new techniques since curation protocols for the lunar samples were first implemented, and the development of new documentation strategies for current and future astromaterials is beneficial to keeping curation protocols up to date. We have developed and tested a comprehensive non-destructive documentation technique using high-resolution image-based 3D reconstruction and X-ray CT (XCT) data in order to create interactive 3D models of lunar samples that would ultimately be served to both researchers and the public. These data enhance preliminary scientific investigations including targeted sample requests, and also provide a new visual platform for the public to experience and interact with the lunar samples. We intend to serve these data as they are acquired on NASA's Astromaterials Acquisistion and Curation website at http://curator.jsc.nasa.gov/. Providing 3D interior and exterior documentation of astromaterial samples addresses the increasing demands for accessability to data and contemporary techniques for documentation, which can be realized for both current collections as well as future sample return missions.

Using the Internet To Create Primary Source Teaching Packets.

ERIC Educational Resources Information Center

VanFossen, Phillip J.; Shiveley, James M.

2000-01-01

Describes strategies and guidelines for creating age- and content-appropriate primary source documents using the Internet. Discusses the value of using topic-specific primary source teaching packets, or jackdaws. Provides three Internet generated jackdaws: New Deal/FDR, Home Front during World War II, and the Gilded Age. Addresses fair use issues.…

Gravity amplifies and microgravity decreases circumnutations in Arabidopsis thaliana stems: results from a space experiment.

PubMed

Johnsson, A; Solheim, B G B; Iversen, T-H

2009-01-01

In a microgravity experiment onboard the International Space Station, circumnutations of Arabidopsis thaliana were studied. Plants were cultivated on rotors under a light:dark (LD) cycle of 16 : 8 h, and it was possible to apply controlled centrifugation pulses. Time-lapse images of inflorescence stems (primary, primary axillary and lateral inflorescences) documented the effect of microgravity on the circumnutations. Self-sustained circumnutations of side stems were present in microgravity but amplitudes were mostly very small. In darkness, centrifugation at 0.8 g increased the amplitude by a factor of five to ten. The period at 0.8 g was c. 85 min, in microgravity roughly of the same magnitude. In white light the period decreased to c. 60 min at 0.8 g (microgravity value not measurable). Three-dimensional data showed that under 0.8 g side stems rotated in both clockwise and counter-clockwise directions. Circumnutation data for the main stem in light showed a doubling of the amplitude and a longer period at 0.8 g than in microgravity (c. 80 vs 60 min). For the first time, the importance of gravity in amplifying minute oscillatory movements in microgravity into high-amplitude circumnutations was unequivocally demonstrated. The importance of these findings for the modelling of gravity effects on self-sustained oscillatory movements is discussed.

The research agenda for general practice/family medicine and primary health care in Europe. Part 3. Results: person centred care, comprehensive and holistic approach.

PubMed

Van Royen, Paul; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri E J H; Topsever, Pinar; Ungan, Mehmet; Hummers-Pradier, Eva

2010-06-01

The recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In a second article, the results for the two core competencies 'primary care management' and 'community orientation' were presented. This article reflects on the three core competencies, which deal with person related aspects of GP/FM, i.e. 'person centred care', 'comprehensive approach' and 'holistic approach'. Though there is an important body of opinion papers and (non-systematic) reviews, all person related aspects remain poorly defined and researched. Validated instruments to measure these competencies are lacking. Concerning patient-centredness, most research examined patient and doctor preferences and experiences. Studies on comprehensiveness mostly focus on prevention/care of specific diseases. For all domains, there has been limited research conducted on its implications or outcomes.

Training of professionals in post-graduation courses in public health and primary healthcare in the municipality of Rio de Janeiro, Brazil.

PubMed

Engstrom, Elyne Montenegro; Motta, José Inácio; Venâncio, Sandra Aparecida

2016-05-01

This paper examines post-graduation professional training and qualification courses in the fields of public health and primary healthcare. Its aim is to reflect on the construction and methodological proposal of two courses given by ENSP/Fiocruz in partnership with the Municipality of Rio de Janeiro, over the years 2010 to 2014: The Professional Master's Degree in Primary Healthcare (MPAPS), and Specialization in Public Health. Systematization of academic documents of the courses, with preparation of emerging analytical categories (theoretical management-interface history, field of pedagogy). Two classes of the MPAPS course (n=24 students per group) and five of the Specialization course (average 30 per group) were held in the period, with approval rates at the 90%-80% level, with curriculum structure adjusted to the local situation. As challenges that were implemented, we highlight: 1) On the epistemological level: development of competencies for professional training that would produce results coherent with health, as social/cultural production; 2) from the learning point of view: preparation of dynamics that give value to the students, their social-cultural context and experiences; 3) work environments and relationships, bringing their structured analysis into the learning environment.

Violence against doctors, a serious concern for healthcare organizations to ponder about.

PubMed

Ahmed, Farah; Khizar Memon, Muhammad; Memon, Sidra

2018-01-01

Aggression and Violence against primary care physicians is reportedly common in Pakistan but there is no any documented study to-date on this burning issue. A formed written questionnaire was distributed among 769 primary care physicians aged 31 ± 7.68 years. Apart from the demographic data, the questionnaire included questions regarding the level of safety that primary care physicians felt during their work setups and on-call duties, along with the experience of aggression against them by the perpetrators & the support provided by the hospital management in such cases. Response rate was 68% i.e. 524 physicians agreed to participate in the study. It was found that majority (85%) of the physicians has faced mild events, 62% have faced moderate events and roughly 38% were subjected to severe violence. Some physicians revealed more than one form of aggression being faced by them in 12 months preceding months which makes the collective percentage greater than 100%. Verbal abuse is the most frequent type of mistreatment faced by the doctors from the patients or their attendants. A considerable number of physicians participated have faced mild violence in which verbal abuse was commonest; followed by moderate and severe events.

A professional learning community model: a case study of primary teachers community in west Bandung

NASA Astrophysics Data System (ADS)

Sari, A.; Suryadi, D.; Syaodih, E.

2018-05-01

The purpose of this study is to provide an alternative model of professional learning community for primary school teachers in improving the knowledge and professional skills. This study is a qualitative research with case study method with data collection is an interview, observation and document and triangulation technique for validation data that focuses on thirteen people 5th grade elementary school teacher. The results showed that by joining a professional learning community, teachers can share both experience and knowledge to other colleagues so that they can be able to continue to improve and enhance the quality of their learning. This happens because of the reflection done together before, during and after the learning activities. It was also revealed that by learning in a professional learning community, teachers can learn in their own way, according to need, and can collaborate with their colleagues in improving the effectiveness of learning. Based on the implementation of professional learning community primary school teachers can be concluded that teachers can develop the curriculum, the students understand the development, overcome learning difficulties faced by students and can make learning design more effective and efficient.

Health Care Austerity Measures in Times of Crisis: The Perspectives of Primary Health Care Physicians in Madrid, Spain.

PubMed

Heras-Mosteiro, Julio; Sanz-Barbero, Belén; Otero-Garcia, Laura

2016-01-01

The current financial crisis has seen severe austerity measures imposed on the Spanish health care system, including reduced public spending, copayments, salary reductions, and reduced services for undocumented migrants. However, the impacts have not been well-documented. We present findings from a qualitative study that explores the perceptions of primary health care physicians in Madrid, Spain. This article discusses the effects of austerity measures implemented in the public health care system and their potential impacts on access and utilization of primary health care services. This is the first study, to our knowledge, exploring the health care experiences during the financial crisis of general practitioners in Madrid, Spain. The majority of participating physicians disapproved of austerity measures implemented in Spain. The findings of this study suggest that undocumented migrants should regain access to health care services; copayments should be minimized and removed for patients with low incomes; and health care professionals should receive additional help to avoid burnout. Failure to implement these measures could result in the quality of health care further deteriorating and could potentially have long-term negative consequences on population health. © The Author(s) 2016.

Exploring Midwives' Need and Intention to Adopt Electronic Integrated Antenatal Care.

PubMed

Markam, Hosizah; Hochheiser, Harry; Kuntoro, Kuntoro; Notobroto, Hari Basuki

2018-01-01

Documentation requirements for the Indonesian integrated antenatal care (ANC) program suggest the need for electronic systems to address gaps in existing paper documentation practices. Our goals were to quantify midwives' documentation completeness in a primary healthcare center, understand documentation challenges, develop a tool, and assess intention to use the tool. We analyzed existing ANC records in a primary healthcare center in Bangkalan, East Java, and conducted interviews with stakeholders to understand needs for an electronic system in support of ANC. Development of the web-based Electronic Integrated ANC (e-iANC) system used the System Development Life Cycle method. Training on the use of the system was held in the computer laboratory for 100 midwives chosen from four primary healthcare centers in each of five regions. The Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire was used to assess their intention to adopt e-iANC. The midwives' intention to adopt e-iANC was significantly influenced by performance expectancy, effort expectancy and facilitating conditions. Age, education level, and computer literacy did not significantly moderate the effects of performance expectancy and effort expectancy on adoption intention. The UTAUT results indicated that the factors that might influence intention to adopt e-iANC are potentially addressable. Results suggest that e-iANC might well be accepted by midwives.

Coding of procedures documented by general practitioners in Swedish primary care-an explorative study using two procedure coding systems

PubMed Central

2012-01-01

Background Procedures documented by general practitioners in primary care have not been studied in relation to procedure coding systems. We aimed to describe procedures documented by Swedish general practitioners in electronic patient records and to compare them to the Swedish Classification of Health Interventions (KVÅ) and SNOMED CT. Methods Procedures in 200 record entries were identified, coded, assessed in relation to two procedure coding systems and analysed. Results 417 procedures found in the 200 electronic patient record entries were coded with 36 different Classification of Health Interventions categories and 148 different SNOMED CT concepts. 22.8% of the procedures could not be coded with any Classification of Health Interventions category and 4.3% could not be coded with any SNOMED CT concept. 206 procedure-concept/category pairs were assessed as a complete match in SNOMED CT compared to 10 in the Classification of Health Interventions. Conclusions Procedures documented by general practitioners were present in nearly all electronic patient record entries. Almost all procedures could be coded using SNOMED CT. Classification of Health Interventions covered the procedures to a lesser extent and with a much lower degree of concordance. SNOMED CT is a more flexible terminology system that can be used for different purposes for procedure coding in primary care. PMID:22230095

Definition and documentation of engineering processes

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

McDonald, G.W.

1997-11-01

This tutorial is an extract of a two-day workshop developed under the auspices of the Quality Engineering Department at Sandia National Laboratories. The presentation starts with basic definitions and addresses why processes should be defined and documented. It covers three primary topics: (1) process considerations and rationale, (2) approach to defining and documenting engineering processes, and (3) an IDEFO model of the process for defining engineering processes.

Best practice in primary care pathology: review 5

PubMed Central

Smellie, W S A; Forth, J; Ryder, S; Galloway, M J; Wood, A C; Watson, I D

2006-01-01

This fifth best practice review examines three series of common primary care questions in laboratory medicine: (1) minor liver function test abnormalities; (2) laboratory monitoring of patients receiving lithium; and (3) investigation of possible venous thromboembolism. The review is presented in question–answer format, referenced for each question series. The recommendations represent a precis of guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence‐based medicine reviews, supplemented by Medline Embase searches to identify relevant primary research documents. They are not standards but form a guide to be set in the clinical context. Most are consensus‐based rather than evidence‐based. They will be updated periodically to take account of new information. PMID:16644875

Accessing numeric data via flags and tags: A final report on a real world experiment

NASA Technical Reports Server (NTRS)

Kottenstette, J. P.; Freeman, J. E.; Staskin, E. R.; Hargrave, C. W.

1978-01-01

An experiment is reported which: extended the concepts of data flagging and tagging to the aerospace scientific and technical literature; generated experience with the assignment of data summaries and data terms by documentation specialists; and obtained real world assessments of data summaries and data terms in information products and services. Inclusion of data summaries and data terms improved users' understanding of referenced documents from a subject perspective as well as from a data perspective; furthermore, a radical shift in document ordering behavior occurred during the experiment toward proportionately more requests for data-summarized items.

For Your Information (FYI) User Guide – Primary Support

EPA Pesticide Factsheets

This document is the user guide for the Primary Support user of the FYI tool which is part of the Office of Pollution Prevention and Toxics (OPPT) ‘For Your Information (FYI)’ application submission process.

The Storied Experiences of Registered Nurses' Transition from Paper to Electronic Nursing Documentation

ERIC Educational Resources Information Center

Smith, Jeff S.

2010-01-01

This narrative inquiry was designed to bring to life the storied experiences of registered nurses who have transitioned from paper to electronic nursing documentation and to provide a foundation for others who may be preparing to implement electronic documentation and wish to consider the significance of these nurses' stories of change in their…

Does Documenting the Regulation Process on a Blog Enhance Pre-Service Teachers' Self- and Co-Regulation in a Collaborative Project?

ERIC Educational Resources Information Center

Cho, Moon-Heum; Lim, Seongmi; Lee, Kyeonghwa

2017-01-01

Students often complain about unsatisfactory experiences resulting from disproportionate contributions to collaborative projects. To improve the experience, we applied regulation theory to design a process to document regulation on a blog and examined whether such documentation enhanced students' self-regulation and co-regulation skills while…

VET in Schools Students: Characteristics and Post-School Employment and Training Experiences. Support Document

ERIC Educational Resources Information Center

Misko, Josie; Korbel, Patrick; Blomberg, Davinia

2017-01-01

This document was produced by the author based on their research for the report, "VET in Schools Students: Characteristics and Post-School Employment and Training Experiences," and is an added resource for further information. This support document presents the variables used and the findings of the supplementary analysis in the linked…

Semantic Clustering of Search Engine Results

PubMed Central

Soliman, Sara Saad; El-Sayed, Maged F.; Hassan, Yasser F.

2015-01-01

This paper presents a novel approach for search engine results clustering that relies on the semantics of the retrieved documents rather than the terms in those documents. The proposed approach takes into consideration both lexical and semantics similarities among documents and applies activation spreading technique in order to generate semantically meaningful clusters. This approach allows documents that are semantically similar to be clustered together rather than clustering documents based on similar terms. A prototype is implemented and several experiments are conducted to test the prospered solution. The result of the experiment confirmed that the proposed solution achieves remarkable results in terms of precision. PMID:26933673

40 CFR 141.25 - Analytical methods for radioactivity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Monitoring and Analytical Requirements... obtaining these documents can be obtained from the Safe Drinking Water Hotline at 800-426-4791. Documents may be inspected at EPA's Drinking Water Docket, EPA West, 1301 Constitution Avenue, NW., Room 3334...

40 CFR 141.25 - Analytical methods for radioactivity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Monitoring and Analytical Requirements... obtaining these documents can be obtained from the Safe Drinking Water Hotline at 800-426-4791. Documents may be inspected at EPA's Drinking Water Docket, EPA West, 1301 Constitution Avenue, NW., Room 3334...

40 CFR 141.25 - Analytical methods for radioactivity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Monitoring and Analytical Requirements... obtaining these documents can be obtained from the Safe Drinking Water Hotline at 800-426-4791. Documents may be inspected at EPA's Drinking Water Docket, EPA West, 1301 Constitution Avenue, NW., Room 3334...

40 CFR 141.25 - Analytical methods for radioactivity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Monitoring and Analytical Requirements... obtaining these documents can be obtained from the Safe Drinking Water Hotline at 800-426-4791. Documents may be inspected at EPA's Drinking Water Docket, EPA West, 1301 Constitution Avenue, NW., Room 3334...

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 ...

Documents on Disarmament.

ERIC Educational Resources Information Center

Arms Control and Disarmament Agency, Washington, DC.

This publication, latest in a series of volumes issued annually since 1960, contains primary source documents on arms control and disarmament developments during 1969. The main chronological arrangement is supplemented by both chronological and topical lists of contents. Other reference aids include a subject/author index, and lists of…

Shell Games. VORTEX: Virginia's Oyster Reef Teaching EXperience.

ERIC Educational Resources Information Center

Harding, Juliana M.; Mann, Roger; Clark, Vicki P.

This document introduces Virginia's Oyster Reef Teaching EXperience (VORTEX), which is an interdisciplinary program focusing on the importance of oyster reef communities in the Chesapeake Bay ecosystem. The VORTEX program uses field and laboratory experiences supported by multimedia instruction. This document presents an overview on the biology of…

Closeup of LDEF experiment trays documented during STS-32 photo survey

NASA Image and Video Library

1990-01-20

Closeup of Long Duration Exposure Facility (LDEF) experiment trays is documented during STS-32 retrieval activity and photo survey conducted by crewmembers onboard Columbia, Orbiter Vehicle (OV) 102. Partially visible is the Polymer Matrix Composite Materials Experiment. In the background is the surface of the Earth.

The use of student-driven video projects as an educational and outreach tool

NASA Astrophysics Data System (ADS)

Bamzai, A.; Farrell, W.; Klemm, T.

2014-12-01

With recent technological advances, the barriers to filmmaking have been lowered, and it is now possible to record and edit video footage with a smartphone or a handheld camera and free software. Students accustomed to documenting their every-day experiences for multimedia-rich social networking sites feel excited and creatively inspired when asked to take on ownership of more complex video projects. With a small amount of guidance on shooting primary and secondary footage and an overview of basic interview skills, students are self-motivated to identify the learning themes with which they resonate most strongly and record their footage in a way that is true to their own experience. The South Central Climate Science Center (SC-CSC) is one of eight regional centers formed by the U.S. Department of the Interior in order to provide decision makers with the science, tools, and information they need to address the impacts of climate variability and change on their areas of responsibility. An important component of this mission is to innovate in the areas of translational science and science communication. This presentation will highlight how the SC-CSC used student-driven video projects to document our Early Career Researcher Workshop and our Undergraduate Internship for Underrepresented Minorities. These projects equipped the students with critical thinking and project management skills, while also providing a finished product that the SC-CSC can use for future outreach purposes.

For Your Information (FYI) User Guide–Primary Authorized Official

EPA Pesticide Factsheets

This document is the user guide for the Primary Authorized Official (AO) user of the FYI tool which is part of the Office of Pollution Prevention and Toxics (OPPT) ‘For Your Information (FYI)’ application submission process.

Section 8(e) Notice User Guide – Primary Support

EPA Pesticide Factsheets

This document is the user guide for the Primary Support user of the Section 8(e) Notice tool which is part of the Office of Pollution Prevention and Toxics (OPPT) ‘Section 8(e) Notice’ application submission process.

Pulmonary cholera due to infection with a non-O1 Vibrio cholerae strain.

PubMed

Shannon, Jack D; Kimbrough, Robert C

2006-09-01

We present 2 cases of primary pulmonary non-O1 Vibrio cholerae infection. We believe that these are the first documented cases of primary pulmonary infection due to this organism from a freshwater source.

Documenting How States Recently Upgraded to Primary Seat Belt Laws

DOT National Transportation Integrated Search

2011-09-01

States with primary seat belt enforcement laws consistently have higher observed daytime belt use rates than : secondary law States. Secondary belt law States, on the other hand, consistently have more occupant fatalities who : were not restrained th...

NASA/ESA CV-990 Spacelab simulation. Appendixes: C, data-handling: Planning and implementation; D, communications; E, mission documentation

NASA Technical Reports Server (NTRS)

Reller, J. O., Jr.

1976-01-01

Data handling, communications, and documentation aspects of the ASSESS mission are described. Most experiments provided their own data handling equipment, although some used the airborne computer for backup, and one experiment required real-time computations. Communications facilities were set up to simulate those to be provided between Spacelab and the ground, including a downlink TV system. Mission documentation was kept to a minimum and proved sufficient. Examples are given of the basic documents of the mission.

COSMIC program documentation experience

NASA Technical Reports Server (NTRS)

Kalar, M. C.

1970-01-01

A brief history of COSMIC as it relates to the handling of program documentation is summarized; the items that are essential for computer program documentation are also discussed. COSMIC documentation and program standards handbook is appended.

KENNEDY SPACE CENTER, FLA. - Alan Thirkettle (center), International Space Station Program manager for Node 2, European Space Agency (ESA); and NASA’s Michael C. Kostelnik (right), deputy associate administrator for International Space Station and Shuttle Programs, sign documents officially transferring ownership of Node 2 between the ESA and NASA. At left, also part of the signing, is Andrea Lorenzoni (left), International Space Station Program manager for Node 2, Italian Space Agency. NASA's Node 2, built by ESA in Italy, arrived at KSC on June 1. It will be the next pressurized module installed on the Station. The pressurized module of the Japanese Experiment Module (JEM), named "Kibo" (Hope), arrived at KSC on June 4. It is Japan's primary contribution to the Station. Emceed by Lisa Malone, deputy director of External Relations and Business Development at KSC, the ceremony also included these speakers: Center Director Roy Bridges Jr.; NASA’s William Gerstenmaier, International Space Station Program manager; and Kuniaki Shiraki, JEM Project manager, National Aerospace and Development Agency of Japan.

NASA Image and Video Library

2003-06-18

KENNEDY SPACE CENTER, FLA. - Alan Thirkettle (center), International Space Station Program manager for Node 2, European Space Agency (ESA); and NASA’s Michael C. Kostelnik (right), deputy associate administrator for International Space Station and Shuttle Programs, sign documents officially transferring ownership of Node 2 between the ESA and NASA. At left, also part of the signing, is Andrea Lorenzoni (left), International Space Station Program manager for Node 2, Italian Space Agency. NASA's Node 2, built by ESA in Italy, arrived at KSC on June 1. It will be the next pressurized module installed on the Station. The pressurized module of the Japanese Experiment Module (JEM), named "Kibo" (Hope), arrived at KSC on June 4. It is Japan's primary contribution to the Station. Emceed by Lisa Malone, deputy director of External Relations and Business Development at KSC, the ceremony also included these speakers: Center Director Roy Bridges Jr.; NASA’s William Gerstenmaier, International Space Station Program manager; and Kuniaki Shiraki, JEM Project manager, National Aerospace and Development Agency of Japan.

The Draft National Curriculum for Primary Mathematics

ERIC Educational Resources Information Center

Thompson, Ian

2012-01-01

Draft curriculum documents offer a glimpse of the future. They demand a response as all too often the devil is in the detail. What are the devils and maybe demons that await primary mathematics? This forensic consideration of the content of the draft curriculum for primary mathematics catalogues a lack of evidence to underpin proposals. Is the…

Primary Education in the United Arab Republic, Its Development and Organization.

ERIC Educational Resources Information Center

Mehrez, Zainab

This document is an English-language abstract (approximately 1,500 words) of a comprehensive survey describing the growth of primary schooling in the UAR during the 19th and 20th centuries. Different types of elementary schools were unified in 1951 into one category, and in 1953, all fees were abolished and primary certificate examinations were…

The World of Barilla Taylor: Bringing History to Life through Primary Sources.

ERIC Educational Resources Information Center

Stearns, Liza

1997-01-01

Presents a lesson plan using material from a primary source-based curriculum kit titled "The World of Barilla Taylor." The kit uses personal letters, maps, hospital and work records, and other primary sources to document the life of a young woman working in the textile mills in 19th-century Massachusetts. (MJP)

Cyclone-Resistant Rural Primary School Construction - A Design Guide. Educational Building Report 7.

ERIC Educational Resources Information Center

Sinnamon, Ian T.; Loo, G. A. van't

One of a series of documents on design of disaster-resistant buildings, this publication treats construction of rural primary schools to resist destruction by wind and water from cyclones. Also appropriate for other buildings, material is aimed at rural primary schools because they are less likely to be professionally designed or supervised; the…

Primary Geography Education in China: Past, Current and Future

ERIC Educational Resources Information Center

Xuan, Xiaowei; Duan, Yushan; Sun, Yue

2015-01-01

In China, geography education in primary schools (grades 1 to 6) has not been emphasized, although some scholars have done research in this area. In order to deepen the understanding of primary geography education in China, this paper examines its history, current situation, and future trends. The authors used the method of document analysis and…

The Empirical Investigation of Perspective-Based Reading

NASA Technical Reports Server (NTRS)

Basili, Victor R.; Green, Scott; Laitenberger, Oliver; Shull, Forrest; Sorumgard, Sivert; Zelkowitz, Marvin V.

1995-01-01

We consider reading techniques a fundamental means of achieving high quality software. Due to lack of research in this area, we are experimenting with the application and comparison of various reading techniques. This paper deals with our experiences with Perspective Based Reading (PBR) a particular reading technique for requirement documents. The goal of PBR is to provide operation scenarios where members of a review team read a document from a particular perspective (eg., tester, developer, user). Our assumption is that the combination of different perspective provides better coverage of the document than the same number of readers using their usual technique. To test the efficacy of PBR, we conducted two runs of a controlled experiment in the environment of NASA GSFC Software Engineering Laboratory (SEL), using developers from the environment. The subjects read two types of documents, one generic in nature and the other from the NASA Domain, using two reading techniques, PBR and their usual technique. The results from these experiment as well as the experimental design, are presented and analyzed. When there is a statistically significant distinction, PBR performs better than the subjects' usual technique. However, PBR appears to be more effective on the generic documents than on the NASA documents.

Improving collaboration between primary care and mental health services.

PubMed

Kates, Nick; Arroll, Bruce; Currie, Elizabeth; Hanlon, Charlotte; Gask, Linda; Klasen, Henrikje; Meadows, Graham; Rukundo, Godfrey; Sunderji, Nadiya; Ruud, Torleif; Williams, Mark

2018-06-20

Previous guidelines and planning documents have identified the key role primary care providers play in delivering mental health care, including the recommendation from the WHO that meeting the mental health needs of the population in many low and middle income countries will only be achieved through greater integration of mental health services within general medical settings. This position paper aims to build upon this work and present a global framework for enhancing mental health care delivered within primary care. This paper synthesizes previous guidelines, empirical data from the literature and experiences of the authors in varied clinical settings to identify core principles and the key elements of successful collaboration, and organizes these into practical guidelines that can be adapted to any setting. The paper proposes a three-step approach. The first is mental health services that any primary care provider can deliver with or without the presence of a mental health professional. Second is practical ways that effective collaboration can enhance this care. The third looks at wider system changes required to support these new roles and how better collaboration can lead to new responses to respond to challenges facing all mental health systems. This simple framework can be applied in any jurisdiction or country to enhance the detection, treatment, and prevention of mental health problems, reinforcing the role of the primary care provider in delivering care and showing how collaborative care can lead to better outcomes for people with mental health and addiction problems.

Plant Science in Reduced Gravity: Lessons Learned

NASA Technical Reports Server (NTRS)

Stutte, Gary W.; Monje, Oscar; Wheeler, Raymond M.

2012-01-01

The effect of gravity on the growth and development of plants has been the subject of scientific investigation for over a century. The results obtained in space to test specific hypotheses on gravitropism, gene expression, seed formation, or growth rate are affected by both the primary effect of the microgravity and secondary effects of the spaceflight environment. The secondary effects of the spaceflight environment include physical effects arising from physical changes, such as the absence of buoyancy driven convective mixing, altered behavior of liquids and gases, and the environmental conditions in the spacecraft atmosphere. Thus, the design of biological experiments (e.g. cells, plants, animals, etc.) conducted in microgravity must account for changes in the physical forces, as well as the environmental conditions, imposed by the specific spaceflight vehicle and experimental hardware. In addition, researchers must become familiar with other aspects of spaceflight experiments: payload integration with hardware developers, safety documentation and crew procedures, and the logistics of conducting flight and ground controls. This report reviews the physical and environmental factors that directly and indirectly affect the results of plant science experiments in microgravity and is intended to serve as a guide in the design and implementation plant experiments in space.

Reminder Cards Improve Physician Documentation of Obesity But Not Obesity Counseling.

PubMed

Shungu, Nicholas; Miller, Marshal N; Mills, Geoffrey; Patel, Neesha; de la Paz, Amanda; Rose, Victoria; Kropa, Jill; Edi, Rina; Levy, Emily; Crenshaw, Margaret; Hwang, Chris

2015-01-01

Physicians frequently fail to document obesity and obesity-related counseling. We sought to determine whether attaching a physical reminder card to patient encounter forms would increase electronic medical record (EMR) assessment of and documentation of obesity and dietary counseling. Reminder cards for obesity documentation were attached to encounter forms for patient encounters over a 2-week intervention period. For visits in the intervention period, the EMR was retrospectively reviewed for BMI, assessment of "obesity" or "morbid obesity" as an active problem, free-text dietary counseling within physician notes, and assessment of "dietary counseling" as an active problem. These data were compared to those collected through a retrospective chart review during a 2-week pre-intervention period. We also compared physician self-report of documentation via reminder cards with EMR documentation. We found significant improvement in the primary endpoint of assessment of "obesity" or "morbid obesity" as an active problem (42.5% versus 28%) compared to the pre-intervention period. There was no significant difference in the primary endpoints of free-text dietary counseling or assessment of "dietary counseling" as an active problem between the groups. Physician self-reporting of assessment of "obesity" or "morbid obesity" as an active problem (77.7% versus 42.5%), free-text dietary counseling on obesity (69.1% versus 35.4%) and assessment of "dietary counseling" as an active problem (54.3% versus 25.2%) were all significantly higher than those reflected in EMR documentation. This study demonstrates that physical reminder cards are a successful means of increasing obesity documentation rates among providers but do not necessarily increase rates of obesity-related counseling or documentation of counseling. Our study suggests that even with such interventions, physicians are likely under-documenting obesity and counseling compared to self-reported rates.

Primary restoration : guidance document for natural resource damage assessment under the Oil Pollution Act of 1990

DOT National Transportation Integrated Search

1996-08-01

The purpose of the [document] is to review the state of the art for restoration of certain habitats and biological natural resources and evaluate potential restoration actions following injury to natural resources resulting from the discharge of oil.

Evaluation of Kentucky's "Buckle Up Kentucky : It's the Law & It's Enforced" campaign.

DOT National Transportation Integrated Search

2003-08-01

The objective of this report was to document the results of the "Buckle Up Kentucky: It's the Law & It's Enforced" campaign in Kentucky. Data were also taken to document the change in usage after enactment of the primary enforcement law. The campaign...

Investigating the Watergate Scandal.

ERIC Educational Resources Information Center

Ritchie, Donald A.

1998-01-01

Summarizes the events leading up to and the investigation that followed the Watergate break-in. Presents a lesson plan using primary documents that allows students to explore the workings of congressional investigations, the key figures in the scandal, and the arguments of the different participants. Includes copies of the documents. (DSK)

77 FR 66663 - Agency Information Collection Activities: Proposed Information Collection; Submission for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-06

... titled, ``Company-Run Annual Stress Test Reporting Template and Documentation for Covered Institutions... review and clearance. Company-Run Annual Stress Test Reporting Template and Documentation for Covered... savings associations, to conduct annual stress tests \\2\\ and requires the primary financial regulatory...

NASA Space Mechanisms Handbook: Lessons Learned Documented

NASA Technical Reports Server (NTRS)

Fusaro, Robert L.

1999-01-01

The need to improve space mechanism reliability is underscored by a long history of flight failures and anomalies caused by malfunctioning mechanisms on spacecraft and launch vehicles. Some examples of these failures are listed in a table. Because much experience has been gained over the years, many specialized design practices have evolved and many unsatisfactory design approaches have been identified.NASA and the NASA Lewis Research Center conducted a Lessons Learned Study (refs. 1 and 2) and wrote a handbook to document what has been learned in the past. The primary goals of the handbook were to identify desirable and undesirable design practices for space mechanisms and to reduce the number of failures caused by the repetition of past design errors. Another goal was to identify a variety of design approaches for specific applications and to provide the associated considerations and caveats for each approach in an effort to help designers choose the approach most suitable for each application. This technical summary outlines the goals and objectives of the handbook and study as well as the contents of the handbook.

An experimental study of low Re cavity vortex formation embedded in a laminar boundary layer

NASA Astrophysics Data System (ADS)

Gautam, Sashank; Lang, Amy; Wilroy, Jacob

2016-11-01

Laminar boundary layer flow across a grooved surface leads to the formation of vortices inside rectangular cavities. The nature and stability of the vortex inside any single cavity is determined by the Re and cavity geometry. According to the hypothesis, under low Re and stable vortex conditions a single cavity vortex leads to a roller-bearing effect which results in a decrease in drag as quantified by velocity profiles measured within the boundary layer. At higher Re once the vortex becomes unstable, drag should increase due to the mixing of low-momentum fluid within the cavity and the outer boundary layer flow. The primary objective of this experiment is to document the phenomenon using DPIV in a tow tank facility. This study focuses on the transition of the cavity flow from a steady to an unsteady state as the Re is increased above a critical value. The change in boundary layer momentum and cavity vortex characteristics are documented as a function of Re and boundary layer thickness. Funding from NSF CBET fluid dynamics Grant 1335848 is gratefully acknowledged.

Effect of the PREPARE Website vs an Easy-to-Read Advance Directive on Advance Care Planning Documentation and Engagement Among Veterans: A Randomized Clinical Trial.

PubMed

Sudore, Rebecca L; Boscardin, John; Feuz, Mariko A; McMahan, Ryan D; Katen, Mary T; Barnes, Deborah E

2017-08-01

Documentation rates of patients' medical wishes are often low. It is unknown whether easy-to-use, patient-facing advance care planning (ACP) interventions can overcome barriers to planning in busy primary care settings. To compare the efficacy of an interactive, patient-centered ACP website (PREPARE) with an easy-to-read advance directive (AD) to increase planning documentation. This was a comparative effectiveness randomized clinical trial from April 2013 to July 2016 conducted at multiple primary care clinics at the San Francisco VA Medical Center. Inclusion criteria were age of a least 60 years; at least 2 chronic and/or serious conditions; and 2 or more primary care visits; and 2 or more additional clinic, hospital, or emergency room visits in the last year. Participants were randomized to review PREPARE plus an easy-to-read AD or the AD alone. There were no clinician and/or system-level interventions or education. Research staff were blinded for all follow-up measurements. The primary outcome was new ACP documentation (ie, legal forms and/or discussions) at 9 months. Secondary outcomes included patient-reported ACP engagement at 1 week, 3 months, and 6 months using validated surveys of behavior change process measures (ie, 5-point knowledge, self-efficacy, readiness scales) and action measures (eg, surrogate designation, using a 0-25 scale). We used intention-to-treat, mixed-effects logistic and linear regression, controlling for time, health literacy, race/ethnicity, baseline ACP, and clustering by physician. The mean (SD) age of 414 participants was 71 (8) years, 38 (9%) were women, 83 (20%) had limited literacy, and 179 (43%) were nonwhite. No participant characteristic differed significantly among study arms at baseline. Retention at 6 months was 90%. Advance care planning documentation 6 months after enrollment was higher in the PREPARE arm vs the AD-alone arm (adjusted 35% vs 25%; odds ratio, 1.61 [95% CI, 1.03-2.51]; P = .04). PREPARE also resulted in higher self-reported ACP engagement at each follow-up, including higher process and action scores; P <.001 at each follow-up). Easy-to-use, patient-facing ACP tools, without clinician- and/or system-level interventions, can increase planning documentation 25% to 35%. Combining the PREPARE website with an easy-to-read AD resulted in higher planning documentation than the AD alone, suggesting that PREPARE may increase planning documentation with minimal health care system resources. clinicaltrials.gov Identifier: NCT01550731.

MINI PCNL in a Pediatric Population

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

Wah, Tze M., E-mail: Tze.Wah@leedsth.nhs.uk; Kidger, Lizi; Kennish, Steven

2013-02-15

We report our initial experience of MINI percutaneous nephrolithotomy (PCNL) in a pediatric population using a miniature nephroscope through a 16F metal access sheath. All pediatric patients who underwent PCNL from August 2007 to September 2010 using a 14F miniature nephroscope through a 16F metal access sheath for renal stone extraction were evaluated. Patients' demographic details, procedural information, and posttreatment outcomes were prospectively documented. A total of 23 MINI PCNLs were performed on 23 kidneys of 12 patients whose ages ranged from 1.6 to 14.6 years. The median stone burden was 3.44 cm{sup 2}, and there were 11 'Staghorn' stones.more » The procedure was primary via a single puncture in 19 kidneys and secondary using a preexisting nephrostomy tract in 4 kidneys. Access was successful in all primary and two secondary cases, for a total of success rate of 91.3%. Stones were fragmented using a Holmium laser and/or lithoclast, and fragments were irrigated or sequentially removed by various stone grasping devices. The mean procedural X-ray screening time and total stone extraction period were 4.5 and 109.4 min, respectively. The primary stone free rate was 83.6 %, which increased to 90.5 % after treating the residual fragments. Postoperative hydrothorax developed in one patient, which required a chest drain. Symptoms of chest infection and positive urine culture were detected in one and two patients, respectively. Our initial experience supports previous reports that MINI PCNL is safe and effective for the management of renal stones in children.« less

Vietnam War Resisters in Canada, 1965-1977. "Draft Dodgers" or Refugees from Militarism?

ERIC Educational Resources Information Center

Bennett, Paul W.

1989-01-01

Provides background information and primary source documents to teach about the issues surrounding Canada's admission of U.S. Vietnam War resisters from 1965 to 1977. Includes primary sources which may serve as points of discussion. (LS)

Closing the Referral Loop: an Analysis of Primary Care Referrals to Specialists in a Large Health System.

PubMed

Patel, Malhar P; Schettini, Priscille; O'Leary, Colin P; Bosworth, Hayden B; Anderson, John B; Shah, Kevin P

2018-05-01

Ideally, a referral from a primary care physician (PCP) to a specialist results in a completed specialty appointment with results available to the PCP. This is defined as "closing the referral loop." As health systems grow more complex, regulatory bodies increase vigilance, and reimbursement shifts towards value, closing the referral loop becomes a patient safety, regulatory, and financial imperative. To assess the ability of a large health system to close the referral loop, we used electronic medical record (EMR)-generated data to analyze referrals from a large primary care network to 20 high-volume specialties between July 1, 2015 and June 30, 2016. The primary metric was documented specialist appointment completion rate. Explanatory analyses included documented appointment scheduling rate, individual clinic differences, appointment wait times, and geographic distance to appointments. Of the 103,737 analyzed referral scheduling attempts, only 36,072 (34.8%) resulted in documented complete appointments. Low documented appointment scheduling rates (38.9% of scheduling attempts lacked appointment dates), individual clinic differences in closing the referral loop, and significant differences in wait times and distances to specialists between complete and incomplete appointments drove this gap. Other notable findings include high variation in wait times among specialties and correlation between high wait times and low documented appointment completion rates. The rate of closing the referral loop in this health system is low. Low appointment scheduling rates, individual clinic differences, and patient access issues of wait times and geographic proximity explain much of the gap. This problem is likely common among large health systems with complex provider networks and referral scheduling. Strategies that improve scheduling, decrease variation among clinics, and improve patient access will likely improve rates of closing the referral loop. More research is necessary to determine the impact of these changes and other potential driving factors.

Best practice in primary care pathology: review 7

PubMed Central

Smellie, W S A; Forth, J; Smart, S R S; Galloway, M J; Irving, W; Bareford, D; Collinson, P O; Kerr, K G; Summerfield, G; Carey, P J; Minhas, Rubin

2007-01-01

This seventh best‐practice review examines four series of common primary care questions in laboratory medicine: (1) blood count abnormalities 2; (2) cardiac troponins; (3) high‐density lipoprotein cholesterol; and (4) viral diseases 2. The review is presented in a question–answer format, with authorship attributed for each question series. The recommendations are a précis of guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence‐based medicine reviews, supplemented by Medline Embase searches to identify relevant primary research documents. The recommendations are not standards, but form a guide to be set in the clinical context. Most are consensus based rather than evidence based. They will be updated periodically to take account of new information. PMID:17046843

Documenting Experiences of Gay Latinos in Higher Education Using "Testimonio"

ERIC Educational Resources Information Center

Garcia, Lorenzo F.

2015-01-01

This qualitative study focuses on the stories of six self-Identified Gay Latinos in a higher education. The participant's stories are documented using "Testimonio." The six men were uniquely situated to give their "testimonios" about their campus experiences of seeking support in that they were the narrators of the experiences.…

Thermal Analysis of the Advanced Technology Large Aperture Space Telescope (ATLAST) 8 Meter Primary Mirror

NASA Technical Reports Server (NTRS)

Hornsby, Linda; Stahl, H. Philip; Hopkins, Randall C.

2010-01-01

The Advanced Technology Large Aperture Space Telescope (ATLAST) preliminary design concept consists of an 8 meter diameter monolithic primary mirror enclosed in an insulated, optical tube with stray light baffles and a sunshade. ATLAST will be placed in orbit about the Sun-Earth L2 and will experience constant exposure to the sun. The insulation on the optical tube and sunshade serve to cold bias the telescope which helps to minimize thermal gradients. The primary mirror will be maintained at 280K with an active thermal control system. The geometric model of the primary mirror, optical tube, sun baffles, and sunshade was developed using Thermal Desktop(R) SINDA/FLUINT(R) was used for the thermal analysis and the radiation environment was analyzed using RADCAD(R). A XX node model was executed in order to characterize the static performance and thermal stability of the mirror during maneuvers. This is important because long exposure observations, such as extra-solar terrestrial planet finding and characterization, require a very stable observatory wave front. Steady state thermal analyses served to predict mirror temperatures for several different sun angles. Transient analyses were performed in order to predict thermal time constant of the primary mirror for a 20 degree slew or 30 degree roll maneuver. This paper describes the thermal model and provides details of the geometry, thermo-optical properties, and the environment which influences the thermal performance. All assumptions that were used in the analysis are also documented. Parametric analyses are summarized for design parameters including primary mirror coatings and sunshade configuration. Estimates of mirror heater power requirements are reported. The thermal model demonstrates results for the primary mirror heated from the back side and edges using a heater system with multiple independently controlled zones.

Policy Levers Key for Primary Health Care Organizations to Support Primary Care Practices in Meeting Medical Home Expectations: Comparing Leading States to the Australian Experience

PubMed Central

2016-01-01

Abstract Several countries with highly ranked delivery systems have implemented locally-based, publicly-funded primary health care organizations (PHCOs) as vehicles to strengthen their primary care foundations. In the United States, state governments have started down a similar pathway with models that share similarities with international PHCOs. The objective of this study was to determine if these kinds of organizations were working with primary care practices to improve their ability to provide comprehensive, coordinated, and accessible patient-centered care that met quality, safety, and efficiency outcomes—all core attributes of a medical home. This qualitative study looked at 4 different PHCO models—3 from the United States and 1 from Australia—with similar objectives and scope. Primary and secondary data included semi-structured interviews with 26 PHCOs and a review of government documents. The study found that the 4 PHCO models were engaging practices to meet a number of medical home expectations, but the US PHCOs were more uniform in efforts to work with practices and focused on arranging services to meet the needs of complex patients. There was significant variation in level of effort between the Australian PHCOs. These differences can be explained through the state governments' selection of payment models and use of data frameworks to support collaboration and incentivize performance of both PHCOs and practices. These findings offer policy lessons to inform health reform efforts under way to better capitalize on the potential of PHCOs to support a high-functioning primary health foundation as an essential component to a reformed health system. PMID:26636485

Congenital deafness affects deep layers in primary and secondary auditory cortex

PubMed Central

Berger, Christoph; Kühne, Daniela; Scheper, Verena

2017-01-01

Abstract Congenital deafness leads to functional deficits in the auditory cortex for which early cochlear implantation can effectively compensate. Most of these deficits have been demonstrated functionally. Furthermore, the majority of previous studies on deafness have involved the primary auditory cortex; knowledge of higher‐order areas is limited to effects of cross‐modal reorganization. In this study, we compared the cortical cytoarchitecture of four cortical areas in adult hearing and congenitally deaf cats (CDCs): the primary auditory field A1, two secondary auditory fields, namely the dorsal zone and second auditory field (A2); and a reference visual association field (area 7) in the same section stained either using Nissl or SMI‐32 antibodies. The general cytoarchitectonic pattern and the area‐specific characteristics in the auditory cortex remained unchanged in animals with congenital deafness. Whereas area 7 did not differ between the groups investigated, all auditory fields were slightly thinner in CDCs, this being caused by reduced thickness of layers IV–VI. The study documents that, while the cytoarchitectonic patterns are in general independent of sensory experience, reduced layer thickness is observed in both primary and higher‐order auditory fields in layer IV and infragranular layers. The study demonstrates differences in effects of congenital deafness between supragranular and other cortical layers, but similar dystrophic effects in all investigated auditory fields. PMID:28643417

Policy environment for prevention, control and management of cardiovascular diseases in primary health care in Kenya.

PubMed

Asiki, Gershim; Shao, Shuai; Wainana, Carol; Khayeka-Wandabwa, Christopher; Haregu, Tilahun N; Juma, Pamela A; Mohammed, Shukri; Wambui, David; Gong, Enying; Yan, Lijing L; Kyobutungi, Catherine

2018-05-09

In Kenya, cardiovascular diseases (CVDs) accounted for more than 10% of total deaths and 4% of total Disability-Adjusted Life Years (DALYs) in 2015 with a steady increase over the past decade. The main objective of this paper was to review the existing policies and their content in relation to prevention, control and management of CVDs at primary health care (PHC) level in Kenya. A targeted document search in Google engine using keywords "Kenya national policy on cardiovascular diseases" and "Kenya national policy on non-communicable diseases (NCDs)" was conducted in addition to key informant interviews with Kenyan policy makers. Relevant regional and international policy documents were also included. The contents of documents identified were reviewed to assess how well they aligned with global health policies on CVD prevention, control and management. Thematic content analysis of the key informant interviews was also conducted to supplement the document reviews. A total of 17 documents were reviewed and three key informants interviewed. Besides the Tobacco Control Act (2007), all policy documents for CVD prevention, control and management were developed after 2013. The national policies were preceded by global initiatives and guidelines and were similar in content with the global policies. The Kenya health policy (2014-2030), The Kenya Health Sector Strategic and Investment Plan (2014-2018) and the Kenya National Strategy for the Prevention and Control of Non-communicable diseases (2015-2020) had strategies on NCDs including CVDs. Other policy documents for behavioral risk factors (The Tobacco Control Act 2007, Alcoholic Drinks Control (Licensing) Regulations (2010)) were available. The National Nutrition Action Plan (2012-2017) was available as a draft. Although Kenya has a tiered health care system comprising primary healthcare, integration of CVD prevention and control at PHC level was not explicitly mentioned in the policy documents. This review revealed important gaps in the policy environment for prevention, control and management of CVDs in PHC settings in Kenya. There is need to continuously engage the ministry of health and other sectors to prioritize inclusion of CVD services in PHC.

Recent Experiments with INQUERY

DTIC Science & Technology

1995-11-01

were conducted with version of the INQUERY information retrieval system INQUERY is based on the Bayesian inference network retrieval model It is...corpus based query expansion For TREC a subset of of the adhoc document set was used to build the InFinder database None of the...experiments that showed signi cant improvements in retrieval eectiveness when document rankings based on the entire document text are combined with

Query Expansion for Noisy Legal Documents

DTIC Science & Technology

2008-11-01

9] G. Salton (ed). The SMART retrieval system experiments in automatic document processing. 1971. [10] H. Schutze and J . Pedersen. A cooccurrence...Language Modeling and Information Retrieval. http://www.lemurproject.org. [2] J . Baron, D. Lewis, and D. Oard. TREC 2006 legal track overview. In...Retrieval, 1993. [8] J . Rocchio. Relevance feedback in information retrieval. In The SMART retrieval system experiments in automatic document processing, 1971

Investigating the Advantages of Constructing Multidigit Numeration Understanding through Oneida and Lakota Native Languages.

ERIC Educational Resources Information Center

Hankes, Judith Elaine

This paper documents a culturally specific language strength for developing number sense among Oneida- and Lakota-speaking primary students. Qualitative research methods scaffolded this research study: culture informants were interviewed and interviews were transcribed and coded for analysis; culture documents were selected for analysis; and…

Scientist contributions

Treesearch

R. Blank; W. Burkhardt; J. Chatterton; W. Dollarhide; L. James; D. Klebenow; W. Krueger; S. Leonard; E. Miller; N. Rimbey; K. Sanders; S. Swanson; R. Tausch; P. Tueller; N. West; J. Young

2008-01-01

The primary impetus for this Wildfire Forum is a document authored by John McLain and Sheila Anderson of Resource Concepts, Inc. entitled "Urgent Need for a Scientific Review of the Ecological and Management History of the Great Basin Natural Resources and Recommendations to Achieve Ecosystem Restoration." This document urged prominent scientists who have...

75 FR 10252 - Release of Draft Documents Related to the Review of the National Ambient Air Quality Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-05

.... This draft document describes the quantitative analyses that are being conducted as part of the review... primary (health-based) CO NAAQS, the Agency is conducting qualitative and quantitative assessments... results, observations, and related uncertainties associated with the quantitative analyses performed. An...

Evaluation of Kentucky's "Buckle Up Kentucky : It's the Law & It's Enforced" 2007 campaign.

DOT National Transportation Integrated Search

2007-08-01

The objective of this report was to document the results of the "Buckle Up Kentucky: It's the Law & It's Enforced" 2007 campaign in Kentucky. Data were also taken to document the change in usage after enactment of the primary enforcement law. The cam...

Evaluation of Kentucky's "Buckle Up Kentucky : It's the Law & It's Enforced" 2004 campaign.

DOT National Transportation Integrated Search

2004-07-01

The objective of this report was to document the results of the "Buckle Up Kentucky: It's the Law & It's Enforced" 2004 campaign in Kentucky. Data were also taken to document the change in usage after enactment of the primary enforcement law. The cam...

Evaluation of Kentucky's "Buckle Up Kentucky : It's the Law & It's Enforced" 2006 campaign.

DOT National Transportation Integrated Search

2006-07-01

The objective of this report was to document the results of the "Buckle Up Kentucky: It's the Law & It's Enforced" 2006 campaign in Kentucky. Data were also taken to document the change in usage after enactment of the primary enforcement law. The cam...

Evaluation of Kentucky's "Buckle Up Kentucky : It's the Law & It's Enforced" 2005 campaign.

DOT National Transportation Integrated Search

2005-07-01

The objective of this report was to document the results of the "Buckle Up Kentucky: It's the Law & It's Enforced" 2005 campaign in Kentucky. Data were also taken to document the change in usage after enactment of the primary enforcement law. The cam...

11 CFR 9033.11 - Documentation of disbursements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PRIMARY MATCHING FUND ELIGIBILITY FOR PAYMENTS § 9033.11 Documentation of disbursements. (a) Burden of proof. Each candidate shall have the burden of proving that disbursements made by the candidate or his... policy, such as a daily travel expense policy. (iv) If the purpose of the disbursement is not stated in...

Improving Warfarin Management Within the Medical Home: A Health-System Approach.

PubMed

Rose, Anne E; Robinson, Erin N; Premo, Joan A; Hauschild, Lori J; Trapskin, Philip J; McBride, Ann M

2017-03-01

Anticoagulation clinics have been considered the optimal strategy for warfarin management with demonstrated improved patient outcomes through increased time in therapeutic international normalized ratio (INR) range, decreased critical INR values, and decreased anticoagulation-related adverse events. However, not all health systems are able to support a specialized anticoagulation clinic or may see patient volume exceed available anticoagulation clinic resources. The purpose of this study was to utilize an anticoagulation clinic model to standardize warfarin management in a primary care clinic setting. A warfarin management program was developed that included standardized patient assessment, protocolized warfarin-dosing algorithm, and electronic documentation and reporting tools. Primary care clinics were targeted for training and implementation of this program. The warfarin management program was applied to over 2000 patients and implemented at 39 clinic sites. A total of 160 nurses and 15 pharmacists were trained on the program. Documentation of warfarin dose and date of the next INR increased from 70% to 90% (P <.0001), documentation occurring within 24 hours of the INR result increased from 75% to 87% (P <.0001), and monitoring the INR at least every 4 weeks increased from 71% to 83% (P <.0001) per patient encounter. Time in therapeutic INR range improved from 65% to 75%. Incorporating a standardized approach to warfarin management in the primary care setting significantly improves warfarin-related documentation and time in therapeutic INR range. Copyright © 2016 Elsevier Inc. All rights reserved.

Exploring Midwives' Need and Intention to Adopt Electronic Integrated Antenatal Care

PubMed Central

Markam, Hosizah; Hochheiser, Harry; Kuntoro, Kuntoro; Notobroto, Hari Basuki

2018-01-01

Documentation requirements for the Indonesian integrated antenatal care (ANC) program suggest the need for electronic systems to address gaps in existing paper documentation practices. Our goals were to quantify midwives' documentation completeness in a primary healthcare center, understand documentation challenges, develop a tool, and assess intention to use the tool. We analyzed existing ANC records in a primary healthcare center in Bangkalan, East Java, and conducted interviews with stakeholders to understand needs for an electronic system in support of ANC. Development of the web-based Electronic Integrated ANC (e-iANC) system used the System Development Life Cycle method. Training on the use of the system was held in the computer laboratory for 100 midwives chosen from four primary healthcare centers in each of five regions. The Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire was used to assess their intention to adopt e-iANC. The midwives' intention to adopt e-iANC was significantly influenced by performance expectancy, effort expectancy and facilitating conditions. Age, education level, and computer literacy did not significantly moderate the effects of performance expectancy and effort expectancy on adoption intention. The UTAUT results indicated that the factors that might influence intention to adopt e-iANC are potentially addressable. Results suggest that e-iANC might well be accepted by midwives. PMID:29618961

Prevalence of Heart Failure Signs and Symptoms in a Large Primary Care Population Identified Through the Use of Text and Data Mining of the Electronic Health Record

PubMed Central

Vijayakrishnan, Rajakrishnan; Steinhubl, Steven R.; Ng, Kenney; Sun, Jimeng; Byrd, Roy J.; Daar, Zahra; Williams, Brent A.; deFilippi, Christopher; Ebadollahi, Shahram; Stewart, Walter F.

2014-01-01

Background The electronic health record contains a tremendous amount of data that if appropriately detected can lead to earlier identification of disease states such as heart failure (HF). Using a novel text and data analytic tool we explored the longitudinal EHR of over 50,000 primary care patients to identify the documentation of the signs and symptoms of HF in the years preceding its diagnosis. Methods and Results Retrospective analysis consisting of 4,644 incident HF cases and 45,981 group-matched controls. Documentation of Framingham HF signs and symptoms within encounter notes were carried out using a previously validated natural language processing procedure. A total of 892,805 affirmed criteria were documented over an average observation period of 3.4 years. Among eventual HF cases, 85% had at least one criterion within a year prior to their HF diagnosis (as did 55% of controls). Substantial variability in the prevalence of individual signs and symptoms were found in both cases and controls. Conclusions HF signs and symptoms are frequently documented in a primary care population as identified through automated text and data mining of EHRs. Their frequent identification demonstrates the rich data available within EHRs that will allow for future work on automated criterion identification to help develop predictive models for HF. PMID:24709663

The relative cost of children's physical play.

PubMed

Pellegrini; Horvat; Huberty

1998-04-01

There has been a long-standing debate regarding the functions of play during childhood. An important, but neglected, first step in this debate entails documenting the costs associated with play. In this study we analysed energetic costs (expressed in terms of caloric expenditure) associated with physical play in four field experiments of play in primary school children. Experiment 1 established the concurrent validity of an observational check list to estimate caloric expenditure of children's physical play. Experiment 2 compared caloric expenditure of the play (defined as all behaviour exhibited during play time) for two age groups of children during playtime outdoors and during indoor sedentary activity; caloric expenditure of outdoor activity was greater and was significantly correlated with ambient temperature. In experiment 3, children were observed during indoor play to control for the influence of ambient temperature. Outdoor physical play was more energetically costly than indoor physical play. In experiment 4, children's behaviour was observed outdoors and caloric expenditure for play, games and other activities was compared. Physical play was more costly than other forms of behaviour and games. Estimates of total energetic costs of play ranged from 6 to 15%. Results are discussed in terms of the relatively low caloric costs of play. Copyright 1998 The Association for the Study of Animal Behaviour. Copyright 1998 The Association for the Study of Animal Behaviour.

Section 8(e) Notice User Guide – Primary Authorized Official

EPA Pesticide Factsheets

This document is the user guide for the Primary Authorized Official (AO) user of the Section 8(e) Notice tool which is part of the Office of Pollution Prevention and Toxics (OPPT) ‘Section 8(e) Notice’ application submission process.

Key Performance Indicators for Primary Schools.

ERIC Educational Resources Information Center

Strand, Steve

Focusing mostly on their application for primary schools, this document describes the educational key performance indicators (KPI) employed by the Wendsworth, England, Local Educational Authority (LEA). Indicators are divided into 3 areas, educational context, resource development, and outcomes. Contextual indicators include pupil mobility, home…

78 FR 47191 - Air Quality Designations for the 2010 Sulfur Dioxide (SO2) Primary National Ambient Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

... Air Quality Designations for the 2010 Sulfur Dioxide (SO[bdi2]) Primary National Ambient Air Quality... air quality designations for certain areas in the United States for the 2010 primary Sulfur Dioxide... of this document? III. What is sulfur dioxide? IV. What is the 2010 SO 2 NAAQS and what are the...

A Very Historical Mode of Understanding: Examining Editorial and Ethnographic Relations in "The Primary" (2008)

ERIC Educational Resources Information Center

Warmington, Paul; Grosvenor, Ian

2011-01-01

This article offers an analysis of "The Primary," a television documentary broadcast in the UK in 2008 as part of a BBC series exploring multicultural Britain. The film documents a term at an inner-city primary school. It depicts school leadership, cultural diversity, relationships between the school and the local community, pupils'…

Institutional Determinants of Organizational Change in Primary Education in Nineteenth Century America and Britain. Final Report.

ERIC Educational Resources Information Center

Smelser, Neil J.

Using historical documents, this report traces the development of the system of primary education in Great Britain and the United States. During the period between 1810 and 1870, both Britain and the United States attempted to form an organization for primary schooling and achieved great progress in the institutionalization and growth of mass…

Pakistan's Primary Education Quality Improvement Program: Local Partners Work with Rural Communities to Support High Quality Education for Girls

ERIC Educational Resources Information Center

Afridi, Zahid A.

2006-01-01

This document describes the contributions made by the Primary Education Quality Improvement Program (1996-1999) to the broad goals of improved access, equity, and quality in girls' primary education in Pakistan. In Balochistan, the largest but least developed province of Pakistan, an innovative approach to educational development was successfully…

Improving Primary Care Provider Practices in Youth Concussion Management.

PubMed

Arbogast, Kristy B; Curry, Allison E; Metzger, Kristina B; Kessler, Ronni S; Bell, Jeneita M; Haarbauer-Krupa, Juliet; Zonfrillo, Mark R; Breiding, Matthew J; Master, Christina L

2017-08-01

Primary care providers are increasingly providing youth concussion care but report insufficient time and training, limiting adoption of best practices. We implemented a primary care-based intervention including an electronic health record-based clinical decision support tool ("SmartSet") and in-person training. We evaluated consequent improvement in 2 key concussion management practices: (1) performance of a vestibular oculomotor examination and (2) discussion of return-to-learn/return-to-play (RTL/RTP) guidelines. Data were included from 7284 primary care patients aged 0 to 17 years with initial concussion visits between July 2010 and June 2014. We compared proportions of visits pre- and post-intervention in which the examination was performed or RTL/RTP guidelines provided. Examinations and RTL/RTP were documented for 1.8% and 19.0% of visits pre-intervention, respectively, compared with 71.1% and 72.9% post-intervention. A total of 95% of post-intervention examinations were documented within the SmartSet. An electronic clinical decision support tool, plus in-person training, may be key to changing primary care provider behavior around concussion care.

Occurrence and pathogenicity of Naegleria fowleri in artificially heated waters.

PubMed Central

Sykora, J L; Keleti, G; Martinez, A J

1983-01-01

The occurrence of pathogenic Naegleria fowleri in thermal discharges, recipient waters, and cooling towers of eight power plants located in western Pennsylvania was investigated for 2 years in conjunction with several environmental measurements. Pathogenic N. fowleri was detected in one cooling tower and in the discharge, receiving waters, or both of five of eight localities. The occurrence of this organism was related to elevated temperatures, but no significant correlation was found for other biological and chemical parameters. Laboratory experiments on the effect of pH on pathogenic N. fowleri documented 100% survival at a range from 2.1 to 8.15. Higher pH reduced or killed the amoebae. No case of human primary amoebic meningoencephalitis occurred during the study. PMID:6847189

Femtosecond laser cataract surgery: technology and clinical practice.

PubMed

Roberts, Timothy V; Lawless, Michael; Chan, Colin Ck; Jacobs, Mark; Ng, David; Bali, Shveta J; Hodge, Chris; Sutton, Gerard

2013-03-01

The recent introduction of femtosecond lasers to cataract surgery has generated much interest among ophthalmologists around the world. Laser cataract surgery integrates high-resolution anterior segment imaging systems with a femtosecond laser, allowing key steps of the procedure, including the primary and side-port corneal incisions, the anterior capsulotomy and fragmentation of the lens nucleus, to be performed with computer-guided laser precision. There is emerging evidence of reduced phacoemulsification time, better wound architecture and a more stable refractive result with femtosecond cataract surgery, as well as reports documenting an initial learning curve. This article will review the current state of technology and discuss our clinical experience. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

Occurrence and pathogenicity of Naegleria fowleri in artificially heated waters

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

Sykora, J.L.; Keleti, G.; Martinez, A.J.

1983-03-01

The occurrence of pathogenic Naegleria fowleri in thermal discharges, recipient waters, and cooling towers of eight power plants located in western Pennsylvania was investigated for 2 years in conjunction with several environmental measurements. Pathogenic N. fowleri was detected in one cooling tower and in the discharge, receiving waters, or both of five of eight localities. The occurrence of this organism was related to elevated temperatures, but no significant correlation was found for other biological and chemical parameters. Laboratory experiments on the effect of pH on pathogenic N. fowleri documented 100% survival at a range from 2.1 to 8.15. Higher pHmore » reduced or killed the amoebae. No case of human primary amoebic meningoencephalitis occurred during the study.« less

Tank waste remediation system functions and requirements document

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

Carpenter, K.E

1996-10-03

This is the Tank Waste Remediation System (TWRS) Functions and Requirements Document derived from the TWRS Technical Baseline. The document consists of several text sections that provide the purpose, scope, background information, and an explanation of how this document assists the application of Systems Engineering to the TWRS. The primary functions identified in the TWRS Functions and Requirements Document are identified in Figure 4.1 (Section 4.0) Currently, this document is part of the overall effort to develop the TWRS Functional Requirements Baseline, and contains the functions and requirements needed to properly define the top three TWRS function levels. TWRS Technicalmore » Baseline information (RDD-100 database) included in the appendices of the attached document contain the TWRS functions, requirements, and architecture necessary to define the TWRS Functional Requirements Baseline. Document organization and user directions are provided in the introductory text. This document will continue to be modified during the TWRS life-cycle.« less

CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in 2018.

PubMed

Ozaki, Yukio; Katagiri, Yuki; Onuma, Yoshinobu; Amano, Tetsuya; Muramatsu, Takashi; Kozuma, Ken; Otsuji, Satoru; Ueno, Takafumi; Shiode, Nobuo; Kawai, Kazuya; Tanaka, Nobuhiro; Ueda, Kinzo; Akasaka, Takashi; Hanaoka, Keiichi Igarashi; Uemura, Shiro; Oda, Hirotaka; Katahira, Yoshiaki; Kadota, Kazushige; Kyo, Eisho; Sato, Katsuhiko; Sato, Tadaya; Shite, Junya; Nakao, Koichi; Nishino, Masami; Hikichi, Yutaka; Honye, Junko; Matsubara, Tetsuo; Mizuno, Sumio; Muramatsu, Toshiya; Inohara, Taku; Kohsaka, Shun; Michishita, Ichiro; Yokoi, Hiroyoshi; Serruys, Patrick W; Ikari, Yuji; Nakamura, Masato

2018-04-01

While primary percutaneous coronary intervention (PCI) has significantly contributed to improve the mortality in patients with ST segment elevation myocardial infarction even in cardiogenic shock, primary PCI is a standard of care in most of Japanese institutions. Whereas there are high numbers of available facilities providing primary PCI in Japan, there are no clear guidelines focusing on procedural aspect of the standardized care. Whilst updated guidelines for the management of acute myocardial infarction were recently published by European Society of Cardiology, the following major changes are indicated; (1) radial access and drug-eluting stent over bare metal stent were recommended as Class I indication, and (2) complete revascularization before hospital discharge (either immediate or staged) is now considered as Class IIa recommendation. Although the primary PCI is consistently recommended in recent and previous guidelines, the device lag from Europe, the frequent usage of coronary imaging modalities in Japan, and the difference in available medical therapy or mechanical support may prevent direct application of European guidelines to Japanese population. The Task Force on Primary Percutaneous Coronary Intervention of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) has now proposed the expert consensus document for the management of acute myocardial infarction focusing on procedural aspect of primary PCI.

Oyster Reef Communities in the Chesapeake Bay: A Brief Primer. VORTEX: Virginia's Oyster Reef Teaching EXperience.

ERIC Educational Resources Information Center

Harding, Juliana M.; Mann, Roger; Clark, Vicki P.

This document introduces Virginia's Oyster Reef Teaching EXperience (VORTEX), which is an interdisciplinary program focusing on the importance of oyster reef communities in the Chesapeake Bay ecosystem. The VORTEX program uses field and laboratory experience supported by multimedia instruction. This document presents an overview on the biology of…

Experience Documentation in Assessing Professional Practice or Work Experience: Lessons from Granting Advanced Certification to Health Education Specialists

ERIC Educational Resources Information Center

Gambescia, Stephen F.; Lysoby, Linda; Perko, Michael; Sheu, Jiunn-Jye

2016-01-01

The purpose of this article is to demonstrate how one profession used an "experience documentation process" to grant advanced certification to qualified certified health education specialists. The competency validation process approved by the certifying organization serves as an example of an additional method, aside from traditional…

Developing a system to track meaningful outcome measures in head and neck cancer treatment.

PubMed

Walters, Ronald S; Albright, Heidi W; Weber, Randal S; Feeley, Thomas W; Hanna, Ehab Y; Cantor, Scott B; Lewis, Carol M; Burke, Thomas W

2014-02-01

The health care industry, including consumers, providers, and payers of health care, recognize the importance of developing meaningful, patient-centered measures. This article describes our experience using an existing electronic medical record largely based on free text formats without structured documentation, in conjunction with tumor registry abstraction techniques, to obtain and analyze data for use in clinical improvement and public reporting. We performed a retrospective analysis of 2467 previously untreated patients treated with curative intent who presented with laryngeal, pharyngeal, or oral cavity cancer in order to develop a system to monitor and report meaningful outcome metrics of head and neck cancer treatment. Patients treated between 1995 and 2006 were analyzed for the primary outcomes of survival at 1 and 2 years, the ability to speak at 1 year posttreatment, and the ability to swallow at 1 year posttreatment. We encountered significant limitations in clinical documentation because of the lack of standardization of meaningful measures, as well limitations with data abstraction using a retrospective approach to reporting measures. Almost 5000 person-hours were required for data abstraction, quality review, and reporting, at a cost of approximately $134,000. Our multidisciplinary teams document extensive patient information; however, data is not stored in easily accessible formats for measurement, comparison, and reporting. We recommend identifying measures meaningful to patients, providers, and payers to be documented throughout the patients' entire treatment cycle, and significant investment in the improvements to electronic medical records and tumor registry reporting in order to provide meaningful quality measures for the future. Copyright © 2013 Wiley Periodicals, Inc.

ERIC/EECE Report. Mixed Age Grouping.

ERIC Educational Resources Information Center

Cesarone, Bernard

1995-01-01

Summarizes eight recent ERIC documents and seven journal articles on mixed-age grouping. Includes discussions of teaching in the multiage classroom, Kentucky's Primary Program, developmentally appropriate practices in the primary grades, thematic instruction, attitudes toward mixed-age grouping, and questions and answers about mixed-age grouping.…

Lessons learned from national food fortification projects: experiences from Morocco, Uzbekistan, and Vietnam.

PubMed

Wirth, James P; Laillou, Arnaud; Rohner, Fabian; Northrop-Clewes, Christine A; Macdonald, Barbara; Moench-Pfanner, Regina

2012-12-01

Fortification of staple foods has been repeatedly recommended as an effective approach to reduce micronutrient deficiencies. With the increased number of fortification projects globally, there is a need to share practical lessons learned relating to their implementation and responses to project-related and external challenges. To document the achievements, challenges, lessons learned, and management responses associated with national fortification projects in Morocco, Uzbekistan, and Vietnam. Independent end-of-project evaluations conducted for each project served as the primary data source and contain the history of and project activities undertaken for, each fortification project. Other sources, including national policy documents, project reports from the Global Alliance for Improved Nutrition (GAIN) and other stakeholders, industry assessments, and peer-reviewed articles, were used to document the current responses to challenges and future project plans. All projects had key achievements related to the development of fortification standards and the procurement of equipment for participating industry partners. Mandatory fortification of wheat flour was a key success in Morocco and Uzbekistan. Ensuring the quality of fortified foods was a common challenge experienced across the projects, as were shifts in consumption patterns and market structures. Adjustments were made to the projects' design to address the challenges faced. National fortification projects are dynamic and must be continually modified in response to specific performance issues and broader shifts in market structure and consumption patterns.

Designing for Scale: Reflections on Rolling Out Reading Improvement in Kenya and Liberia.

PubMed

Gove, Amber; Korda Poole, Medina; Piper, Benjamin

2017-03-01

Since 2008, the Ministries of Education in Liberia and Kenya have undertaken transitions from small-scale pilot programs to improve reading outcomes among primary learners to the large-scale implementation of reading interventions. The effects of the pilots on learning outcomes were significant, but questions remained regarding whether such large gains could be sustained at scale. In this article, the authors dissect the Liberian and Kenyan experiences with implementing large-scale reading programs, documenting the critical components and conditions of the program designs that affected the likelihood of successfully transitioning from pilot to scale. They also review the design, deployment, and effectiveness of each pilot program and the scale, design, duration, enabling conditions, and initial effectiveness results of the scaled programs in each country. The implications of these results for the design of both pilot and large-scale reading programs are discussed in light of the experiences of both the Liberian and Kenyan programs. © 2017 Wiley Periodicals, Inc.

Fiber Optic Experience with the Smart Actuation System on the F-18 Systems Research Aircraft

NASA Technical Reports Server (NTRS)

Zavala, Eddie

1997-01-01

High bandwidth, immunity to electromagnetic interference, and potential weight savings have led to the development of fiber optic technology for future aerospace vehicle systems. This technology has been incorporated in a new smart actuator as the primary communication interface. The use of fiber optics simplified system integration and significantly reduced wire count. Flight test results showed that fiber optics could be used in aircraft systems and identified critical areas of development of fly-by-light technology. This paper documents the fiber optic experience gained as a result of this program, and identifies general design considerations that could be used in a variety of specific applications of fiber optic technology. Environmental sensitivities of fiber optic system components that significantly contribute to optical power variation are discussed. Although a calibration procedure successfully minimized the effect of fiber optic sensitivities, more standardized calibration methods are needed to ensure system operation and reliability in future aerospace vehicle systems.

nuSTORM Costing document

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

Bross, Alan D.

2013-10-01

Detailed costing of the nuSTORM conventional facilities has been done by the Fermilab Facilities Engineering Services Section (FESS) and is reported on in the nuSTORM Project Definition Report (PDR) 6-13-1. Estimates for outfitting the primary proton beam line, the target station, the pion capture/transport line and decay ring are based on either experience from existing Fermilab infrastructure (NuMI) or is based on the detailed costing exercises for DOE CD-1 approval for future experiments (mu2e and LBNE). The detector costing utilized the Euronu costing for the Neutrino Factory Magnetized Iron Neutrino Detector (MIND), extrapolations from MINOS as-built costs and from recentmore » vendor quotes. Costs included all manpower and are fully burdened (FY2013 dollars). The costs are not escalated, however, beyond the 5-year project timeline, since a project start for nuSTORM is unknown. Escalation can be estimated from various models (see Figure 1). LBNE has used the Jacob’s model to determine their cost escalation.« less

Radiometric responsivity determination for Feature Identification and Location Experiment (FILE) flown on space shuttle mission

NASA Technical Reports Server (NTRS)

Wilson, R. G.; Davis, R. E.; Wright, R. E., Jr.; Sivertson, W. E., Jr.; Bullock, G. F.

1986-01-01

A procedure was developed to obtain the radiometric (radiance) responsivity of the Feature Identification and Local Experiment (FILE) instrument in preparation for its flight on Space Shuttle Mission 41-G (November 1984). This instrument was designed to obtain Earth feature radiance data in spectral bands centered at 0.65 and 0.85 microns, along with corroborative color and color-infrared photographs, and to collect data to evaluate a technique for in-orbit autonomous classification of the Earth's primary features. The calibration process incorporated both solar radiance measurements and radiative transfer model predictions in estimating expected radiance inputs to the FILE on the Shuttle. The measured data are compared with the model predictions, and the differences observed are discussed. Application of the calibration procedure to the FILE over an 18-month period indicated a constant responsivity characteristic. This report documents the calibration procedure and the associated radiometric measurements and predictions that were part of the instrument preparation for flight.

Major safety provisions in nuclear-powered ships

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

Khlopkin, N.S.; Belyaev, V.M.; Dubrovin, A.M.

1984-12-01

Considerable experience has been accumulated in the Soviet Union on the design, construction and operation of nuclear-powered civilian ships: the icebreakers Lenin, Leonid Brezhnev and Sibir. The nuclear steam plants (NSP) used on these as the main energy source have been found to be highly reliable and safe, and it is desirable to use them in the future not only in icebreakers but also in transport ships for use in ice fields. The Soviet program for building and developing nuclear-powered ships has involved careful attention to safety in ships containing NSP. The experience with the design and operation of nuclearmore » icebreakers in recent years has led to the revision of safety standards for the nuclear ships and correspondingly ship NSP and international guidelines have been developed. If one meets the requirements as set forth in these documents, one has a safe basis for future Soviet nuclear-powered ships. The primary safety provisions for NSP are presented in this paper.« less

Primary and secondary electrical space power based on advanced PEM systems

NASA Technical Reports Server (NTRS)

Vanderborgh, N. E.; Hedstrom, J. C.; Stroh, K. R.; Huff, J. R.

1993-01-01

For new space ventures, power continues to be a pacing function for mission planning and experiment endurance. Although electrochemical power is a well demonstrated space power technology, current hardware limitations impact future mission viability. In order to document and augment electrochemical technology, a series of experiments for the National Aeronautics and Space Administration Lewis Research Center (NASA LeRC) are underway at the Los Alamos National Laboratory that define operational parameters on contemporary proton exchange membrane (PEM) hardware operating with hydrogen and oxygen reactants. Because of the high efficiency possible for water electrolysis, this hardware is also thought part of a secondary battery design built around stored reactants - the so-called regenerative fuel cell. An overview of stack testing at Los Alamos and of analyses related to regenerative fuel cell systems are provided in this paper. Finally, this paper describes work looking at innovative concepts that remove complexity from stack hardware with the specific intent of higher system reliability. This new concept offers the potential for unprecedented electrochemical power system energy densities.

Infidelity, initiation, and the emotional climate of divorce: are there implications for mental health?

PubMed

Sweeney, M M; Horwitz, A V

2001-09-01

A large literature has examined the role of "secondary" stressors, such as problems with finances, social support, residential mobility, and children, in producing the well-documented association between divorce and a variety of psychopathological conditions. Much less attention, however, has been paid to variation in the "primary" disruption experience. We address this omission using data from the National Survey of Families and Households to investigate the interrelationships among depression, initiator status, and spousal infidelity. While we find little evidence of direct effects of initiator status or spousal infidelity on post-divorce depression, the importance of these characteristics emerges when they are considered in an interactive context. Specifically, while divorce initiation is associated with reduced depression among individuals with unfaithful spouses, initiation is associated with increased depression in the absence of spousal infidelity. Taken together, our findings suggest that characteristics of the divorce experience may interact in complex ways to produce variation in mental health outcomes.

Best practice in primary care pathology: review 3

PubMed Central

Smellie, W S A; Forth, J; Bareford, D; Twomey, P; Galloway, M J; Logan, E C M; Smart, S R S; Reynolds, T M; Waine, C

2006-01-01

This best practice review examines four series of common primary care questions in laboratory medicine: (i) “minor” blood platelet count and haemoglobin abnormalities; (ii) diagnosis and monitoring of anaemia caused by iron deficiency; (iii) secondary hyperlipidaemia and hypertriglyceridaemia; and (iv) glycated haemoglobin and microalbumin use in diabetes. The review is presented in question–answer format, referenced for each question series. The recommendations represent a précis of guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence‐based medicine reviews, supplemented by Medline Embase searches to identify relevant primary research documents. They are not standards, but form a guide to be set in the clinical context. Most of the recommendations are based on consensus rather than evidence. They will be updated periodically to take account of new information. PMID:16873560

Aviation System Analysis Capability Quick Response System Report Server User’s Guide.

DTIC Science & Technology

1996-10-01

primary data sources for the QRS Report Server are the following: ♦ United States Department of Transportation airline service quality per- formance...and to cross-reference sections of this document. is used to indicate quoted text messages from WWW pages. is used for WWW page and section titles...would link the user to another document or another section of the same document. ALL CAPS is used to indicate Report Server variables for which the

Ethnohistory: A Researcher's Guide. Studies in Third World Societies Publication Number Thirty Five.

ERIC Educational Resources Information Center

Wiedman, Dennis, Ed.

This guide contains 15 articles that discuss materials to be used for ethnohistorical research; the guide also serves as a textbook for courses on ethnohistory and related subjects. The articles are: "The Anthropological Use of Historic Documents" (D. Wiedman); "Public Documents as Primary Sources for Ethnohistorical Research: The…

Social Studies: Appendix for Elementary, Middle, and High School Guides for Teaching about Human Rights.

ERIC Educational Resources Information Center

Detroit Public Schools, MI. Dept. of Curriculum Development Services.

Seventy documents including primary source materials, simulations, mock trials, short stories, vignettes, and statistical data are provided for the implementation of the elementary, middle, and high school human rights curriculum. Original documents include: (1) the Universal Declaration of Human Rights; (2) the Declaration of the Rights of the…

Mining for Evidence in Enterprise Corpora

ERIC Educational Resources Information Center

Almquist, Brian Alan

2011-01-01

The primary research aim of this dissertation is to identify the strategies that best meet the information retrieval needs as expressed in the "e-discovery" scenario. This task calls for a high-recall system that, in response to a request for all available relevant documents to a legal complaint, effectively prioritizes documents from an…

Relief, Recovery, Reform: The New Deal Congressional Reaction to the Great Depression.

ERIC Educational Resources Information Center

Koman, Rita G.

1998-01-01

Summarizes the relationship of President Franklin Roosevelt to Congress and its role in creating New Deal legislation. Presents a lesson plan using primary documents that allows students to explore congressional responsibility for enabling the Great Depression and for legislation to deal with its consequences. Includes copies of the documents.…

Connecticut's New Comprehensive and Universal Early Childhood Health Assessment Form

ERIC Educational Resources Information Center

Crowley, Angela A.; Whitney, Grace-Ann C.

2005-01-01

Health assessments are required for entrance into child care, Head Start, and preschool programs. However, state and federal screening and documentation mandates vary, and programs create their own forms for keeping required data on file. Inconsistent recording formats present challenges for primary care providers who must document each child's…

Conflicting Educational Ideals in America, 1775-1831: Selected Documentary Essays.

ERIC Educational Resources Information Center

Nakosteen, Mehdi

The purpose of this collection of 52 primary source documents is to sustain the continuity and interdependence of ideas, movements, and events in the development of educational theories and practices in Western culture. Among the concerns of these documents, written by statesmen, clergymen, business men, foreign observers. educators and others,…

International directory of documentation services concerning forestry and forest products

Treesearch

Peter A. Evans; Gary L. Skupa

1981-01-01

This directory lists 120 documentation services concerned with forestry, forest products, or related fields in 28 countries. The entry for each service includes title of service, cost, publisher, subject coverage, formatting data, input sources, indexing and data-handling methods, and availability of special services other than the primary ones of indexing and...

Understanding Richard Wright's "Black Boy": A Student Casebook to Issues, Sources, and Historical Documents.

ERIC Educational Resources Information Center

Felgar, Robert

In "Black Boy," Richard Wright triumphs over an ugly, racist world by fashioning an inspiring, powerful, beautiful, and fictionalized autobiography. To help students understand and appreciate his story in the cultural, political, racial, social, and literary contexts of its time, this casebook provides primary historical documents,…

Rock 'n' Roll Heroes: Letter to President Eisenhower.

ERIC Educational Resources Information Center

Mueller, Jean W., Ed.

1985-01-01

This primary source document can be used to teach secondary students about the rock 'n' roll era that emerged in the 1950's. The document is a letter written in 1958 by three teenagers to President Eisenhower concerning the induction of Elvis Presley into the U.S. Army. Class activities are also suggested. (RM)

Intelligent transportation system (ITS) study for the Buffalo and Niagara Falls metropolitan area, Erie and Niagara Counties, New York : transportation systems and deficiencies, working paper #1

DOT National Transportation Integrated Search

1997-06-18

This document has been prepared as part of the New York State Department of Transportation (NYSDOT) Buffalo and Niagara Falls Intelligent Transportation Systems Study. The primary objective of this working paper is to define and document transportati...

Educational Triage and Ability-Grouping in Primary Mathematics: A Case-Study of the Impacts on Low-Attaining Pupils

ERIC Educational Resources Information Center

Marks, Rachel

2014-01-01

This case-study, drawing on an unanticipated theme arising from a wider study of ability-grouping in primary mathematics, documents some of the consequences of educational triage in the final year of one primary school. The paper discusses how a process of educational triage, as a response to accountability pressures, is justified by teachers on…

Standardizing communication from acute care providers to primary care providers on critically ill adults.

PubMed

Ellis, Kerri A; Connolly, Ann; Hosseinnezhad, Alireza; Lilly, Craig M

2015-11-01

To increase the frequency of communication of patient information between acute and primary care providers. A secondary objective was to determine whether higher rates of communication were associated with lower rates of hospital readmission 30 days after discharge. A validated instrument was used for telephone surveys before and after an intervention designed to increase the frequency of communication among acute care and primary care providers. The communication intervention was implemented in 3 adult intensive care units from 2 campuses of an academic medical center. The frequency of communication among acute care and primary care providers, the perceived usefulness of the intervention, and its association with 30-day readmission rates were assessed for 202 adult intensive care episodes before and 100 episodes after a communication intervention. The frequency of documented communication increased significantly (5/202 or 2% before to 72/100 or 72% after the intervention; P < .001) and the communication was considered useful by every participating primary care provider. Rates of rehospitalization at 30 days were lower for the intervention group than the preintervention group, but the difference was not statistically significant (41/202 or 23% vs 16/88 or 18% of discharged patients; P = .45; power 0.112 at P = .05). The frequency of communication episodes that provide value can be increased through standardized processes. The key aspects of this effective intervention were setting the expectation that communication should occur, documenting when communication has occurred, and reviewing that documentation during multiprofessional rounds. ©2015 American Association of Critical-Care Nurses.

Performance characteristics of visualising the cervix in symptomatic young females: a review of primary care records in females with and without cervical cancer.

PubMed

Lim, Anita Wey Wey; Hamilton, Willie; Hollingworth, Antony; Stapley, Sally; Sasieni, Peter

2016-03-01

The current strategy for timely detection of cervical cancer in young females centres on visualising the cervix when females present with gynaecological symptoms, but is based on expert opinion without an evidence base. To assess visualising the cervix in primary care in young females with gynaecological symptoms. A review of primary care records for females in England aged 20-29 years with cervical cancer (nationwide interview-based study) and in the general population (Clinical Practice Research Datalink database). From primary care records the proportion of females was identified with gynaecological symptoms who had documented cervical examination in the year before diagnosis (cancers) and in 1-year age bands (general population). Of these, the proportion was identified that was then referred for suspected malignancy. Only 39% of young females with cervical cancer had documented examination at symptomatic presentation. Visualisation resulted in referral for suspected malignancy for 18% of those examined (95% confidence interval = 5% to 40%). Very few (<1.7%) symptomatic females in the general population had documented cervical examination. None were referred for suspected malignancy at the time. The sensitivity of cervical examination to detect cancer is very low, highlighting the need for better triage tools for primary care. Until such tools are identified GPs should continue to consider cervical cancer when symptoms persist and the cervix is not obviously abnormal on clinical examination. Further research on additional triage tools such as cervical cytology used as a diagnostic aid is needed urgently. © British Journal of General Practice 2016.

Understanding the Role of Critical Incidents in Relation to Self-Efficacy during Course-Embedded Preservice Teacher Field Experiences: A Qualitative Study

ERIC Educational Resources Information Center

Epperly, Anna C.

2017-01-01

This qualitative, collective case study documented the development of the self-efficacy beliefs of special education preservice candidates during one semester of a course-embedded field experience in a small, private, faith-based university in the Midwest. Interviews of candidates regarding critical incidents in field experiences as documented by…

Training the 21st Century Voice Teacher: An Overview and Curriculum Survey of the Undergraduate Experience

ERIC Educational Resources Information Center

Walz, Ivy

2014-01-01

This document examines the current status of voice teacher education in the 21st century, focusing on the undergraduate experience as an important first step, and links that experience to current trends in pedagogical training as a whole. This document includes the results of a curriculum survey detailing the undergraduate vocal pedagogy courses…

Experiment Design and Analysis Guide - Neutronics & Physics

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

Misti A Lillo

2014-06-01

The purpose of this guide is to provide a consistent, standardized approach to performing neutronics/physics analysis for experiments inserted into the Advanced Test Reactor (ATR). This document provides neutronics/physics analysis guidance to support experiment design and analysis needs for experiments irradiated in the ATR. This guide addresses neutronics/physics analysis in support of experiment design, experiment safety, and experiment program objectives and goals. The intent of this guide is to provide a standardized approach for performing typical neutronics/physics analyses. Deviation from this guide is allowed provided that neutronics/physics analysis details are properly documented in an analysis report.

Trade-offs in plant responses to herbivory influence trophic routes of production in a freshwater wetland.

PubMed

Cherry, Julia A; Gough, Laura

2009-09-01

Responses of aquatic macrophytes to leaf herbivory may differ from those documented for terrestrial plants, in part, because the potential to maximize growth following herbivory may be limited by the stress of being rooted in flooded, anaerobic sediments. Herbivory on aquatic macrophytes may have ecosystem consequences by altering the allocation of nutrients and production of biomass within individual plants and changing the quality and quantity of aboveground biomass available to consumers or decomposers. To test the effects of leaf herbivory on plant growth and production, herbivory of a dominant macrophyte, Nymphaea odorata, by chrysomelid beetles and crambid moths was controlled during a 2-year field experiment. Plants exposed to herbivory maintained, or tended to increase, biomass and aboveground net primary production relative to controls, which resulted in 1.5 times more aboveground primary production entering the detrital pathway of the wetland. In a complementary greenhouse experiment, the effects of simulated leaf herbivory on total plant responses, including biomass and nutrient allocation, were investigated. Plants in the greenhouse responded to moderate herbivory by maintaining aboveground biomass relative to controls, but this response occurred at the expense of belowground growth. Results of these studies suggest that N. odorata may tolerate moderate levels of herbivory by reallocating biomass and resources aboveground, which in turn influences the quantity, quality and fate of organic matter available to herbivores and decomposers.

Family carers' experience of caring for an older parent with severe and persistent mental illness.

PubMed

McCann, Terence V; Bamberg, John; McCann, Flora

2015-06-01

While the burden of caring for older people with chronic medical illness and dementia has been well documented, considerably less is known about how carers develop the strength and resilience to sustain this important role with older family members with mental illness. The aim of the study was to understand the lived experience of primary caregivers of older people with severe and persistent mental illness, and to explore what, if anything, helps to sustain them in their caring role. An interpretative phenomenological analysis approach was adopted, and qualitative interviews were used with 30 primary caregivers. Two overarching themes, and related subthemes, were abstracted from the data. First, caring is a difficult and demanding responsibility. It affects carers adversely, emotionally, physically, socially, and financially, and their lifestyle in general. This is reflected in three subthemes: (i) physically and emotionally draining; (ii) grieving about the loss; (iii) and adverse effects on lifestyle and social relationships. Second, carers develop resilience in caring, which helps sustain them in their role, as illustrated in three subthemes: (i) caring as purposeful and satisfying; (ii) harnessing social support from others; and (iii) purposefully maintaining their own well-being. Community mental health nurses have a key role in assessing carers' needs and supporting them in their caring role. © 2015 Australian College of Mental Health Nurses Inc.

77 FR 26063 - Self-Regulatory Organizations; Municipal Securities Rulemaking Board; Order Granting Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... Disclosure Subscription Service, that make documents and related indexing information available on a current... indexing information obtained through submissions to the Primary Market Disclosure Service (the ``Primary... amendments thereto, together with related indexing information, provided by submitters through EMMA, for an...

Teaching Challenging Topics with Primary Sources

ERIC Educational Resources Information Center

Singer, Alan J.

2012-01-01

The most common activity in a social studies classroom should be the analysis of primary sources. Students are intrigued and engaged by edited and unedited documents, written statements, transcribed speeches, photographs, pictures, charts, graphs, cartoons, and even material objects. Ideally, the goal of social studies teachers is to prepare…

The ICESat/GLAS Instrument Operations Report. Volume 4

NASA Technical Reports Server (NTRS)

Jester, Peggy L.

2012-01-01

The Geoscience Laser Altimeter System (GLAS) was the primary instrument aboard the first ICESat spacecraft. ICESat's primary objectives are to determine the mass balance of the polar ice sheets and their contributions to global sea level change, and to obtain essential data for prediction of future changes in ice volume and sea-level. ICESat launched successfully from Vandenberg Air Force Base on January 12, 2003 23:45 UT. The ICESat science mission began in February 2003 and ended on October 11, 2009. De-orbit of the spacecraft occurred on August 30, 2010. This document focusses on the GLAS instrument operations during the ICESat mission. This document will not discuss science results.

The new ISO 6579-1: A real horizontal standard for detection of Salmonella, at last!

PubMed

Mooijman, Kirsten A

2018-05-01

Up to 2016, three international standard methods existed for the detection of Salmonella spp. in food, animal feed and samples from the primary production stage: ISO 6785:2001 for milk and milk products, ISO 6579:2002 for (other) food and animal feed and Annex D of ISO 6579:2007 for samples from the primary production stage. In 2009, an ISO/CEN working group started with the revision of ISO 6579:2002 with two main aims: combining the three aforementioned standards in one document and improving the information in ISO 6579:2002. Additionally it was decided to split ISO 6579 into three parts, where part 1 describes the detection, part 2 the enumeration by mini-MPN (published in 2012) and part 3 the serotyping of Salmonella (published in 2014). This paper describes the experiments and choices made for improving the part on detection of Salmonella (ISO 6579-1). The final voting stage on (draft) ISO 6579-1 was finished by the end of December 2016, with a positive outcome. Finally, a real horizontal standard became available for detection of Salmonella in food, animal feed, environmental samples in the area of food production and food handling and in samples from the primary production stage in 2017. Copyright © 2017 Elsevier Ltd. All rights reserved.

Primary uterine inertia in four labrador bitches.

PubMed

Davidson, Autumn P

2011-01-01

Uterine inertia is a common cause of dystocia in the bitch and is designated as primary (i.e., uterine contractions fail to ever be initiated) or secondary (i.e., uterine contractions cease after a period of time but before labor is completed). The etiology of primary uterine inertia is not well understood. The accurate diagnosis of primary uterine inertia requires the use of tocodynamometry (uterine monitoring). Primary uterine inertia has been postulated to result from a failure of luteolysis resulting in persistently elevated progesterone concentrations. In this study, primary uterine inertia was diagnosed in a series of four bitches in which luteolysis was documented suggesting some other etiopathogenesis for primary uterine inertia.

Enhanced Flight Termination System (EFTS): Flight Demonstration and Results

NASA Technical Reports Server (NTRS)

Tow, David; Arce, Dennis

2008-01-01

The Enhanced Flight Termination System (EFTS) program was initiated and propelled due to the inadvertent terminations of Global Hawk and the Strategic Target System and the NASA Inspector General's assessment letter and recommendations regarding the exploration of low-cost, lightweight space COMSEC for FTS. Additionally, the standard analog and high alphabet systems most commonly used in FTS are secure, but not encrypted. A study group was initiated to select and document a robust, affordable, reliable technology that provides encrypted FTS capability. A flight demonstration was conducted to gain experience using EFTS in an operational environment, provide confidence in the use of the EFTS components, integrate EFTS into an existing range infrastructure to demonstrate the scalability of system components, to provide a command controller that generated the EFTS waveform using an existing range infrastructure, and to provide a report documenting the results of the demonstration. The primary goal of the demonstration was to obtain operational experience with EFTS. Areas of operational experience include: mission planning, pre-flight configuration and testing, mission monitoring and recording, vehicle termination, developing mission procedures. and post mission data reduction and other post mission activities. An Advanced Medium-Range Air-to-Air Missile (AMRAAM) was selected to support the EFTS demonstration due to interest in future use of EFTS by the AMRAAM program, familiarity of EFTS by range personnel, and the availability of existing operational environment to support EFTS testing with available program funding. For demonstration purposes, the AMRAAM was successfully terminated using an EFTS receiver and successfully demonstrating EFTS. The EFTS monitoring software with spectrum analyzer and digital graphical display of aircraft, missile, and target were also demonstrated.

STS-62 Space Shuttle mission report

NASA Technical Reports Server (NTRS)

Fricke, Robert W., Jr.

1994-01-01

The STS-62 Space Shuttle Program Mission Report summarizes the Payload activities as well as the Orbiter, External Tank (ET), Solid Rocket Booster (SRB), Redesigned Solid Rocket Motor (RSRM), and the Space Shuttle main engine (SSHE) systems performance during the sixty-first flight of the Space Shuttle Program and sixteenth flight of the Orbiter vehicle Columbia (OV-102). In addition to the Orbiter, the flight vehicle consisted of an ET designated as ET-62; three SSME's which were designated as serial numbers 2031, 2109, and 2029 in positions 1, 2, and 3, respectively; and two SRB's which were designated BI-064. The RSRM's that were installed in each SRB were designated as 360L036A (lightweight) for the left SRB, and 36OWO36B (welterweight) for the right SRB. This STS-62 Space Shuttle Program Mission Report fulfills the Space Shuttle Program requirement as documented in NSTS 07700, Volume 8, Appendix E. That document requires that each major organizational element supporting the Program report the results of its hardware evaluation and mission performance plus identify all related in-flight anomalies. The primary objectives of the STS-62 mission were to perform the operations of the United States Microgravity Payload-2 (USMP-2) and the Office of Aeronautics and Space Technology-2 (OAST-2) payload. The secondary objectives of this flight were to perform the operations of the Dexterous End Effector (DEE), the Shuttle Solar Backscatter Ultraviolet/A (SSBUV/A), the Limited Duration Space Environment Candidate Material Exposure (LDCE), the Advanced Protein Crystal Growth (APCG), the Physiological Systems Experiments (PSE), the Commercial Protein Crystal Growth (CPCG), the Commercial Generic Bioprocessing Apparatus (CGBA), the Middeck Zero-Gravity Dynamics Experiment (MODE), the Bioreactor Demonstration System (BDS), the Air Force Maui Optical Site Calibration Test (AMOS), and the Auroral Photography Experiment (APE-B).

[Evaluation of 12 pilot projects to improve outpatient palliative care].

PubMed

Schmidt-Wolf, G; Elsner, F; Lindena, G; Hilgers, R-D; Heussen, N; Rolke, R; Ostgathe, C; Radbruch, L

2013-12-01

With a priority programme the German Cancer Aid supported the development of quality-assured outpatient palliative care to cover the whole country. The 12 regional pilot projects funded with the aim to improve outpatient palliative care in different models and different frameworks were concurrently monitored and evaluated. The supported projects, starting and ending individually, documented all patients who were cared for using HOPE (Hospice and palliative care evaluation) and MIDOS (Minimal documentation system for palliative patients). Total data were analyzed for 3239 patients decriptively. In addition to the quantitative data the experiences of the projects were recorded in a number of workshops (2008, 2009, 2010, and 2012). In particular, the experiences reported in the final meeting in July 2012 were considered for this article as well as the final reports for the German Cancer Aid. In the quantitative evaluation 85.6% of 3239 palliative care patients had a cancer diagnosis. In all model projects the goal of a network with close cooperation of primary providers, social support, and outpatient and inpatient specialist services has been achieved. For all projects, the initial financing of the German Cancer Aid was extremely important, because contracts with health insurance funds were negotiated slowly, and could then be built on the experiences with the projects. The participants of the project-completion meeting emphasized the need to carry out a market analysis before starting palliative care organizations considering the different regional structures and target groups of patients. Education, training and continuing education programs contribute significantly to the network. A reliably funded coordination center/case management across all institutions is extremely important. © Georg Thieme Verlag KG Stuttgart · New York.

Chronic care coordination by integrating care through a team-based, population-driven approach: a case study.

PubMed

van Eeghen, Constance O; Littenberg, Benjamin; Kessler, Rodger

2018-05-23

Patients with chronic conditions frequently experience behavioral comorbidities to which primary care cannot easily respond. This study observed a Vermont family medicine practice with integrated medical and behavioral health services that use a structured approach to implement a chronic care management system with Lean. The practice chose to pilot a population-based approach to improve outcomes for patients with poorly controlled Type 2 diabetes using a stepped-care model with an interprofessional team including a community health nurse. This case study observed the team's use of Lean, with which it designed and piloted a clinical algorithm composed of patient self-assessment, endorsement of behavioral goals, shared documentation of goals and plans, and follow-up. The team redesigned workflows and measured reach (patients who engaged to the end of the pilot), outcomes (HbA1c results), and process (days between HbA1c tests). The researchers evaluated practice member self-reports about the use of Lean and facilitators and barriers to move from pilot to larger scale applications. Of 20 eligible patients recruited over 3 months, 10 agreed to participate and 9 engaged fully (45%); 106 patients were controls. Relative to controls, outcomes and process measures improved but lacked significance. Practice members identified barriers that prevented implementation of all changes needed but were in agreement that the pilot produced useful outcomes. A systematized, population-based, chronic care management service is feasible in a busy primary care practice. To test at scale, practice leadership will need to allocate staffing, invest in shared documentation, and standardize workflows to streamline office practice responsibilities.

Dysphagia in the elderly.

PubMed Central

Paterson, W. G.

1996-01-01

OBJECTIVE: To review the problem of dysphagia in the elderly so that primary care physicians are better able to recognize and manage it. QUALITY OF EVIDENCE: Dysphagia, a prevalent problem in the elderly, causes significant morbidity and even mortality. Age-related deterioration of the oropharyngeal phase of swallowing is well documented. Diagnosis and treatment of dysphagia in the elderly is based mainly on clinical experience with large groups of patients. Few controlled clinical trials have been conducted. MAIN FINDINGS: Oropharyngeal dysphagia in the elderly is often due to irreversible neuromuscular disease. These patients benefit from swallowing therapy performed by speech pathologists. Esophageal causes of dysphagia are similar in the elderly and young patients, and the approach to treatment is also similar, although noninvasive forms of therapy play a larger role for elderly patients. CONCLUSIONS: Dysphagia is a common problem that lowers quality of life for the elderly. Primary care physicians must be aware of causes of dysphagia for which specific treatments are available, as well as of the role of nonspecific treatments offered by ancillary health professionals. Images p928-a p930-a PMID:8688695

Reducing lead in air and preventing childhood exposure near lead smelters: learning from the U.S. experience.

PubMed

Sullivan, Marianne

2015-05-01

Childhood lead exposure and poisoning near primary lead smelters continues in developed and developing countries. In the United States, the problem of lead poisoning in children caused by smelter emissions was first documented in the early 1970s. In 1978, Environmental Protection Agency set National Ambient Air Quality Standards for lead. Attainment of this lead standard in areas near operating lead smelters took twenty to thirty years. Childhood lead exposure and poisoning continued to occur after the lead National Ambient Air Quality Standards were set and before compliance was achieved. This article analyzes and discusses the factors that led to the eventual achievement of the 1978 lead National Ambient Air Quality Standards near primary smelters and the reduction of children's blood lead levels in surrounding communities. Factors such as federal and state regulation, monitoring of emissions, public health activities such as blood lead surveillance and health education, relocation of children, environmental group and community advocacy, and litigation all played a role. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Improving health worker performance: The patient-perspective from a PBF program in Rwanda.

PubMed

Lannes, Laurence

2015-08-01

The effect of performance-based financing (PBF) on patients' perception of primary health care services in developing countries in not well documented. Data from a randomized impact evaluation in Rwanda conducted between 2006 and 2008 in 157 primary level facilities is used to explore patients' satisfaction with clinical and non-clinical services and quantify the contribution of individual and facility characteristics to satisfaction including PBF. Improvements in productivity, availability and competences of the health workforce following the implementation of PBF have a positive effect on patients' satisfaction with clinical services even if patients' satisfaction is not tied to a reward. The positive effect of PBF on non-clinical dimensions of satisfaction also suggests that PBF incentivizes providers to raise patients' satisfaction with non-clinical services if it is associated with future financial gains. It is recommended that low and middle income countries build on the experience from high income countries to better listen to patients' voice in general and include an assessment of patients' satisfaction in incentive mechanisms as a way to increase the benefits of the strategy. Copyright © 2015 Elsevier Ltd. All rights reserved.

EXPERIENCE IN INCINERATION APPLICABLE TO SUPERFUND SITE REMEDIATION

EPA Science Inventory

This document can be used as a reference tool for hazardous waste site remediation where incineration is used as a treatment alternative. It provides the user with information garnered from the experiences of others who use incineration. The document presents useful lessons in ev...

Impact of registration on clinical trials on infection risk in pediatric acute myeloid leukemia.

PubMed

Dix, David; Aplenc, Richard; Bowes, Lynette; Cellot, Sonia; Ethier, Marie-Chantal; Feusner, Jim; Gillmeister, Biljana; Johnston, Donna L; Lewis, Victor; Michon, Bruno; Mitchell, David; Portwine, Carol; Price, Victoria; Silva, Mariana; Stobart, Kent; Yanofsky, Rochelle; Zelcer, Shayna; Beyene, Joseph; Sung, Lillian

2016-04-01

Little is known about the impact of enrollment on therapeutic clinical trials on adverse event rates. Primary objective was to describe the impact of clinical trial registration on sterile site microbiologically documented infection for children with newly diagnosed acute myeloid leukemia (AML). We conducted a multicenter cohort study that included children aged ≤18 years with de novo AML. Primary outcome was microbiologically documented sterile site infection. Infection rates were compared between those registered and not registered on clinical trials. Five hundred seventy-four children with AML were included of which 198 (34.5%) were registered on a therapeutic clinical trial. Overall, 400 (69.7%) had at least one sterile site microbiologically documented infection. In multiple regression, registration on clinical trials was independently associated with a higher risk of microbiologically documented sterile site infection [adjusted odds ratio (OR) 1.24, 95% confidence interval (CI) 1.01-1.53; p = 0.040] and viridans group streptococcal infection (OR 1.46, 95% CI 1.08-1.98; p = 0.015). Registration on trials was not associated with Gram-negative or invasive fungal infections. Children with newly diagnosed AML enrolled on clinical trials have a higher risk of microbiologically documented sterile site infection. This information may impact on supportive care practices in pediatric AML. © 2015 UICC.

Knowledge and attitudes of primary care physicians regarding food allergy and anaphylaxis in Turkey.

PubMed

Erkoçoğlu, M; Civelek, E; Azkur, D; Özcan, C; Öztürk, K; Kaya, A; Metin, A; Kocabaş, C N

2013-01-01

Food allergy, which becomes an important public health problem, can lead to important morbidity and mortality. Patients with food allergies are more likely to first present to their primary care physicians. We aimed to determine the knowledge of primary care physicians with regard to management of food allergies and anaphylaxis. Primary care physicians were surveyed via a questionnaire aimed to document their knowledge and attitudes about food allergy and anaphylaxis management. A total of 297 participants completed questionnaires, 55.6% of which were female. Participating physicians had a mean of 17.0 ± 6.1 years of experience. Participants answered 47.2% of knowledge-based items correctly. Overall, participants fared poorly with regard to their knowledge on the treatment of food allergies and anaphylaxis. For example while 60.7% knew that a child can die from the milk allergy reaction, only 37.5% were aware that a child with IgE mediated milk allergies cannot eat yoghourts/cheese with milk. Besides, 53.1% of them chose epinephrine as their first treatment of choice in case of anaphylaxis, yet only 16.6% gave the correct answer about its dosage. Nearly a third of participants (36.7%) felt they were knowledgeable enough regarding the management of patients with food allergies, while 98.2% extended their request for future periodic educational meetings on allergic disorders. Knowledge of food allergy and anaphylaxis among primary care physicians was unsatisfactory. Provision or periodic educational programmes should be aimed at improving the standard of practice as acknowledged by the participants. Copyright © 2012 SEICAP. Published by Elsevier Espana. All rights reserved.

Cold Vacuum Drying facility civil structural system design description (SYS 06)

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

PITKOFF, C.C.

This document describes the Cold Vacuum Drying (CVD) Facility civil - structural system. This system consists of the facility structure, including the administrative and process areas. The system's primary purpose is to provide for a facility to house the CVD process and personnel and to provide a tertiary level of containment. The document provides a description of the facility and demonstrates how the design meets the various requirements imposed by the safety analysis report and the design requirements document.

a Case Study in Documentation Production as Learning Tools Benefitting Multiple Stakeholders

NASA Astrophysics Data System (ADS)

Truesdale, T. J.; Hierlihy, B.; Jouan, P.

2017-08-01

The Fondation Strutt Foundation has taken on the conservation planning of the Strutt House as part of a P3 collaborative effort with the National Capital Commission (NCC). This paper will address three of the primary documents/data sets (documentary methodologies) being used on/for the Strutt House project. The Strutt House is a Recognized Federal Heritage Building and a significant example of Canadian modernist architecture. Stakeholder is a term often used in Architectural Projects reflecting an economic interest in success of the project. In conservation projects the stakeholder generally reflects social, cultural and/or economic interests in a given project. The Strutt House project has benefitted from stakeholders that have all been interested in the above, as well as the education of our future conservationists. The Strutt house was purchased from the architect's daughter in 2010, and as part of the acquisition, a Heritage Structure Report was commissioned and produced by PTAH Consultants Inc., Architects. The report forms the first of the primary referenced documents of this paper, including: a comprehensive photographic record of existing conditions; and, a building simulation model of the house `as designed/built'. This HSR and the accompanying data/documents have been adopted as the basis of an evolving document in the development of the Conservation Plan including: additional heritage surveys and technologies; traditional drawings, photographic and video records; and, a series of workshops on the structural stabilization efforts, thermography scans, and smoke/blow-door (air pressure) testing. In 2016, Pierre Jouan, a Master's thesis student from KU Leuvan, working with the Carleton University CIMS lab under the direction of Professor Mario Santana, and the FSF completed a 3-D scanning and photogrammetry workshop on the Strutt House and created a building information model (BIM model) from the collected data. The three primary documentation processes being addressed in this paper are really a series of directed research or focussed investigations resulting in a collection of data sets resolved -or combined- into a document. They will assist in the development of the long-term Programming and Conservation Management Plan of the Strutt House.

SeaWiFS technical report series. Volume 20: The SeaWiFS bio-optical archive and storage system (SeaBASS), part 1

NASA Technical Reports Server (NTRS)

Hooker, Stanford B. (Editor); Mcclain, Charles R.; Firestone, James K.; Westphal, Todd L.; Yeh, Eueng-Nan; Ge, Yuntao; Firestone, Elaine R.

1994-01-01

This document provides an overview of the Sea-viewing Wide Field-of-view Sensor (SeaWiFS) Bio-Optical Archive and Storage System (SeaBASS), which will serve as a repository for numerous data sets of interest to the SeaWiFS Science Team and other approved investigators in the oceanographic community. The data collected will be those data sets suitable for the development and evaluation of bio-optical algorithms which include results from SeaWiFS Intercalibration Round-Robin Experiments (SIRREXs), prelaunch characterization of the SeaWiFS instrument by its manufacturer -- Hughes/Santa Barbara Research Center (SBRC), Marine Optical Characterization Experiment (MOCE) cruises, Marine Optical Buoy (MOBY) deployments and refurbishments, and field studies of other scientists outside of NASA. The primary goal of the data system is to provide a simple mechanism for querying the available archive and requesting specific items, while assuring that the data is made available only to authorized users. The design, construction, and maintenance of SeaBASS is the responsibility of the SeaWiFS Calibration and Validation Team (CVT). This report is concerned with documenting the execution of this task by the CVT and consists of a series of chapters detailing the various data sets involved. The topics presented are as follows: 1) overview of the SeaBASS file architecture, 2) the bio-optical data system, 3) the historical pigment database, 4) the SIRREX database, and 5) the SBRC database.

Concentrations of the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone in sidestream cigarette smoke increase after release into indoor air: results from unpublished tobacco industry research.

PubMed

Schick, Suzaynn F; Glantz, Stanton

2007-08-01

Research has shown that the toxicity of sidestream cigarette smoke, the primary constituent of secondhand smoke, increases over time. To find potential mechanisms that would explain the increase in sidestream smoke toxicity over time, we analyzed unpublished research reports from Philip Morris Co. using the internal tobacco industry documents now available at the University of California San Francisco Legacy Tobacco Documents Library and other Web sites. Unpublished research from Philip Morris Tobacco Company shows that 4-(methylnitrosamino)-I-(3-pyridyl)-1-butanone (NNK), a highly carcinogenic tobacco-specific nitrosamine, can form in sidestream cigarette smoke after it has been released into ambient air. In experiments done between 1983 and 1997, Philip Morris scientists measured the concentration of NNK in sidestream smoke in a sealed stainless steel test chamber at initial particle concentrations of 24 mg/m(3) over the course of 6 to 18 h. They repeatedly showed that airborne NNK concentrations in sidestream cigarette smoke can increase by 50% to 200% per hour during the first 6 h after cigarettes are extinguished. Two experiments done in a real office showed that NNK concentrations increase for the first 2 h after cigarettes are extinguished. If NNK formation also occurs in the lower smoke concentrations observed in real smoking environments, these results suggest that nitrosation of nicotine and/or nicotine breakdown products in aging secondhand smoke is a significant contributor to nitrosamine exposure in humans.

The Humanities in English Primary Schools: Struggling to Survive

ERIC Educational Resources Information Center

Barnes, Jonathan; Scoffham, Stephen

2017-01-01

This article surveys the state of the humanities in English primary schools drawing on evidence from serving head teachers, current literature and policy documents. The findings suggest that whilst the humanities are highly valued in schools, there are serious challenges which threaten the "broad and balanced" curriculum. It is suggested…

Peace Education's Effects on Aggression: A Mixed Method Study

ERIC Educational Resources Information Center

Sagkal, Ali Serdar; Turnuklu, Abbas; Totan, Tarik

2016-01-01

Problem Statement: Literature reviews clearly document that students still show a tendency to use violence in resolving interpersonal conflicts in school. Results from various research conducted in Turkey suggest that violence, aggression, and bullying behaviors are still rampant in the primary and high schools. Studies conducted in primary and…

Multiple Solutions Approach (MSA): Conceptions and Practices of Primary School Teachers in Ghana

ERIC Educational Resources Information Center

Nabie, Michael Johnson; Raheem, Kolawole; Agbemaka, John Bijou; Sabtiwu, Rufai

2016-01-01

The study explored the curriculum guidelines and primary school teachers' conceptions and practices of the Multiple Solutions Approach (MSA) in teaching mathematics using basic qualitative research design. Informal conversation interviews (ICIs), observations, video and document analyses were used to collect data. Participants included a purposive…

75 FR 76988 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-10

... Enrollment, Chain and Ownership System (PECOS) Security Consent Form; Use: The primary function of the... for the proper performance of the agency's functions; (2) the accuracy of the estimated burden; (3... the primary document used by CMS in developing the national Medicaid budget estimates that are...

School Mental Health Professionals' Training, Comfort, and Attitudes toward Interprofessional Collaboration with Pediatric Primary Care Providers

ERIC Educational Resources Information Center

Arora, Prerna G.; Connors, Elizabeth H.; Biscardi, Krystin A.; Hill, Allison M.

2016-01-01

Despite the well-documented need for interprofessional collaboration (IPC) between school mental health (SMH) professionals and pediatric primary care providers (PCPs), research on current collaborative practices of these professionals is limited. Accordingly, using survey methodology, this study investigated SMH professionals' previous training…

Crunchier on the outside

ERIC Educational Resources Information Center

Marks, Sarah; Ranger, Emma

2005-01-01

The benefits of using investigation for promoting scientific skills and enhanced conceptual understanding within primary science are well documented. ISE (2000) defines investigations in primary science as "the means of carrying out a fair test to explore some of the children's own ideas on how the natural or man made world works". However, a…

Using Minimum Energy in Ireland's Schools

ERIC Educational Resources Information Center

Dolan, John

2007-01-01

Since 1998, the Department of Education and Science has been using a process of design, awareness, research and technology known as DART to develop energy efficiency in educational buildings. Currently all primary schools built in accordance with the Department's primary schools technical guidance documents are capable of being up to 2.3 times…

Elementary School Teachers' Use of Technology during Mathematics Teaching

ERIC Educational Resources Information Center

Polly, Drew

2014-01-01

Various educational technologies have been advanced as potential vehicles to transform teaching and learning. Still, research studies have documented that primary school teachers struggle to integrate technology in meaningful ways. This article presents the findings of a year-long study in which the author frequently observed three primary school…

Children's Learning Practices in Ethiopia: Observations from Primary School Classes

ERIC Educational Resources Information Center

Frost, Melanie; Little, Angela W.

2014-01-01

This paper explores questions of relevance to Ethiopian primary education policy. It examines (i) the match/mismatch between government-prescribed pedagogy and actual student learning practices and (ii) the relationship between those practices and school, class and teacher level factors. The paper employs evidence from government documents on…

Structure of Primary Mathematics Teacher Education Programs in Spain

ERIC Educational Resources Information Center

Cañadas, María C.; Gómez, Pedro; Rico, Luis

2013-01-01

Spain was 1 of the 17 countries that participated in the International Association for the Evaluation of Educational Achievement's Teacher Education and Development Study in Mathematics (TEDS-M 2008). In this paper, we explore and describe the structure of Spanish primary mathematics teacher education programs. We analyzed the documents collected…

Educating Girls: Strategies To Increase Access, Persistence, and Achievement.

ERIC Educational Resources Information Center

Tietjen, Karen; Prather, Cynthia, Ed.

This document reviews the interventions, such as policies, programs, and projects, that have been implemented by governments, donors, and other institutions to increase girls' access, persistence, and achievement at the primary school level. It examines both the formal system of primary education and nontraditional, alternative approaches to reach…

Literacy Instruction in Primary Level Deaf Education in China

ERIC Educational Resources Information Center

Wang, Qiuying; Andrews, Jean F.

2017-01-01

The national policy in deaf education in Mainland China primarily focuses on oral/aural instruction and hearing rehabilitation. The curriculum in primary grades is specifically structured on speech and hearing skills for language development. But there is little evidence that documents what early literacy instruction looks like or how teachers…

Experimental Investigation of Subsonic Turbulent Boundary Layer Flow Over a Wall-Mounted Axisymmetric Hill

NASA Technical Reports Server (NTRS)

Bell, James H.; Heineck, James T.; Zilliac, Gregory; Mehta, Rabindra D.; Long, Kurtis R.

2016-01-01

An important goal for modern fluid mechanics experiments is to provide datasets which present a challenge for Computational Fluid Dynamics simulations to reproduce. Such "CFD validation experiments" should be well-characterized and well-documented, and should investigate flows which are difficult for CFD to calculate. It is also often convenient for the experiment to be challenging for CFD in some aspects while simple in others. This report is part of the continuing documentation of a series of experiments conducted to characterize the flow around an axisymmetric, modified-cosine-shaped, wall-mounted hill named "FAITH" (Fundamental Aero Investigates The Hill). Computation of this flow is easy in some ways - subsonic flow over a simple shape - while being complex in others - separated flow and boundary layer interactions. The primary set of experiments were performed on a 15.2 cm high, 45.7 cm base diameter machined aluminum model that was tested at mean speeds of 50 m/s (Reynolds Number based on height = 500,000). The ratio of model height to boundary later height was approximately 3. The flow was characterized using surface oil flow visualization, Cobra probe to determine point-wise steady and unsteady 3D velocities, Particle Image Velocimetry (PIV) to determine 3D velocities and turbulence statistics along specified planes, Pressure Sensitive Paint (PSP) to determine mean surface pressures, and Fringe Imaging Skin Friction (FISF) to determine surface skin friction magnitude and direction. A set of pathfinder experiments were also performed in a water channel on a smaller scale (5.1 cm high, 15.2 cm base diameter) sintered nylon model. The water channel test was conducted at a mean test section speed of 3 cm/s (Reynolds Number of 1500), but at the same ratio of model height to boundary layer thickness. Dye injection from both the model and an upstream rake was used to visualize the flow. This report summarizes the experimental set-up, techniques used, and data acquired. It also describes some details of the dataset that is being constructed for use by other researchers, especially the CFD community.

Effects of documentation-based decision support on chronic disease management.

PubMed

Schnipper, Jeffrey L; Linder, Jeffrey A; Palchuk, Matvey B; Yu, D Tony; McColgan, Kerry E; Volk, Lynn A; Tsurikova, Ruslana; Melnikas, Andrea J; Einbinder, Jonathan S; Middleton, Blackford

2010-12-01

To evaluate whether a new documentation-based clinical decision support system (CDSS) is effective in addressing deficiencies in the care of patients with coronary artery disease (CAD) and diabetes mellitus (DM). Controlled trial randomized by physician. We assigned primary care physicians (PCPs) in 10 ambulatory practices to usual care or the CAD/DM Smart Form for 9 months. The primary outcome was the proportion of deficiencies in care that were addressed within 30 days after a patient visit. The Smart Form was used for 5.6% of eligible patients. In the intention-to-treat analysis, patients of intervention PCPs had a greater proportion of deficiencies addressed within 30 days of a visit compared with controls (11.4% vs 10.1%, adjusted and clustered odds ratio =1.14; 95% confidence interval, 1.02-1.28; P = .02). Differences were more pronounced in the "on-treatment" analysis: 17.0% of deficiencies were addressed after visits in which the Smart Form was used compared with 10.6% of deficiencies after visits in which it was not used (P <.001). Measures that improved included documentation of smoking status and prescription of antiplatelet agents when appropriate. Overall use of the CAD/DM Smart Form was low, and improvements in management were modest. When used, documentation-based decision support shows promise, and future studies should focus on refining such tools, integrating them into current electronic health record platforms, and promoting their use, perhaps through organizational changes to primary care practices.

Weighty Problems: Predictors of Family Physicians Documenting Overweight and Obesity.

PubMed

Cyr, Peggy R; Haskins, Amy E; Holt, Christina; Hanifi, Jasmine

2016-03-01

Documenting obesity on the problem list has been shown to promote action about obesity and overweight, yet a majority of primary care providers do not record obesity on the medical problem list. With this in mind, our objectives were to determine the proportion of physicians' documentation of overweight (OW) or obesity on the problem list in our primary care teaching practice and to identify predictors of physician documentation of OW/obesity. De-identified health records of 6,195 adult patients with BMI ? 25 kg/m2 seen by a family physician over a 2-year period were included. Using multivariate logistic regression, patient age, BMI, gender, race, insurance, comorbidities, number of visits, physician gender or role, and practice site (suburban versus urban) were examined in relation to inclusion of OW/obesity on the medical problem list. Few (21.1%) patients had OW/obesity on their problem list. In the multivariate model, female PCPs were significantly more likely to document OW/obesity (OR=1.39, 95% CI=1.18--1.63) compared to male PCPs, and faculty were 26% more likely to document obesity (95% CI=1.07--1.48) compared to residents. Female patients, those with hypertension, diabetes, hyperlipidemia, and those with six or more visits were significantly more likely to have obesity on their problem lists, while patients with Medicaid were less likely to have obesity recorded. No significant difference was seen by race. Nearly 80% of OW and obese patients were not identified on the problem list. Patient gender, comorbidity, and number of visits were associated with documentation. Future research should examine automatic documentation of OW/obesity on the medical problem list.

Monitored Geologic Repository Project Description Document

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

P. M. Curry

2001-01-30

The primary objective of the Monitored Geologic Repository Project Description Document (PDD) is to allocate the functions, requirements, and assumptions to the systems at Level 5 of the Civilian Radioactive Waste Management System (CRWMS) architecture identified in Section 4. It provides traceability of the requirements to those contained in Section 3 of the ''Monitored Geologic Repository Requirements Document'' (MGR RD) (YMP 2000a) and other higher-level requirements documents. In addition, the PDD allocates design related assumptions to work products of non-design organizations. The document provides Monitored Geologic Repository (MGR) technical requirements in support of design and performance assessment in preparing formore » the Site Recommendation (SR) and License Application (LA) milestones. The technical requirements documented in the PDD are to be captured in the System Description Documents (SDDs) which address each of the systems at Level 5 of the CRWMS architecture. The design engineers obtain the technical requirements from the SDDs and by reference from the SDDs to the PDD. The design organizations and other organizations will obtain design related assumptions directly from the PDD. These organizations may establish additional assumptions for their individual activities, but such assumptions are not to conflict with the assumptions in the PDD. The PDD will serve as the primary link between the technical requirements captured in the SDDs and the design requirements captured in US Department of Energy (DOE) documents. The approved PDD is placed under Level 3 baseline control by the CRWMS Management and Operating Contractor (M and O) and the following portions of the PDD constitute the Technical Design Baseline for the MGR: the design characteristics listed in Table 1-1, the MGR Architecture (Section 4.1), the Technical Requirements (Section 5), and the Controlled Project Assumptions (Section 6).« less

A belgian multicenter prospective observational cohort study shows safe and efficient use of a composite mesh with incorporated oxidized regenerated cellulose in laparoscopic ventral hernia repair.

PubMed

Berrevoet, F; Tollens, T; Berwouts, L; Bertrand, C; Muysoms, F; De Gols, J; Meir, E; De Backer, A

2014-01-01

A variety of anti-adhesive composite mesh products have become available to use inside the peritoneal cavity. However, reimbursement of these meshes by the Belgian Governemental Health Agency (RIZIV/INAMI) can only be obtained after conducting a prospective study with at least one year of clinical follow-up. This -Belgian multicentric cohort study evaluated the experience with the use of Proceed®-mesh in laparoscopic ventral hernia repair. During a 25 month period 210 adult patients underwent a laparoscopic primary or incisional hernia repair using an intra-abdominal placement of Proceed®-mesh. According to RIZIV/INAMI criteria recurrence rate after 1 year was the primary objective, while postoperative morbidity, including seroma formation, wound and mesh infections, quality of life and recurrences after 2 years were evaluated as secondary endpoints (NCT00572962). In total 97 primary ventral and 103 incisional hernias were repaired, of which 28 (13%) were recurrent. There were no conversions to open repair, no enterotomies, no mesh infections and no mortality. One year cumulative follow-up showed 10 recurrences (n = 192, 5.2%) and chronic discomfort or pain in 4.7% of the patients. Quality of life could not be analyzed due to incomplete data set. More than 5 years after introduction of this mesh to the market, this prospective multicentric study documents a favorable experience with the Proceed mesh in laparoscopic ventral hernia repair. However, it remains to be discussed whether reimbursement of these meshes in Belgium should be limited to the current strict criteria and therefore can only be obtained after at least 3-4 years of clinical data gathering and necessary follow-up. Copyright© Acta Chirurgica Belgica.

Cultural Competencies and Planning for Teaching Mathematics: Preservice Teachers Responding to Expectations, Opportunities, and Resources

ERIC Educational Resources Information Center

Wilson, Susanna; McChesney, Jane; Brown, Liz

2017-01-01

In this article, the authors report on a small-scale study set in a context of a firstyear mathematics education course for preservice primary teachers. Professional documentation from three different sources were analysed in relation to the national document "Tataiako: Cultural Competencies for Teachers of Maori Learners," which was…

Alcohol-Related Morbidity and Mortality in North Carolina. SCHS Studies No. 41.

ERIC Educational Resources Information Center

Buescher, Paul A.; Patetta, Michael J.

This document presents data from a variety of secondary sources in an attempt to document that alcohol abuse is a serious problem in North Carolina, resulting in sickness, medical care use, death, and substantial economic costs. The primary source of data presented in this report is the Medical Examiner data system, which contains information for…

Legal Language: What Is It and What Can We Do about It?

ERIC Educational Resources Information Center

Charrow, Veda R.; Crandall, JoAnn

Legal language is discussed in the context of concern about the comprehensibility of consumer documents and the trend toward simplification of the language used in these documents. Specific features of legal language and its functions within the legal community and society are identified. As a primary tool of the legal profession, legal language…

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

CATO DM; DAHL MM; PHILO GL

This report documents the results of tests designed to characterize the relationship between temperature and the measured potential of electrodes installed on multi-probe corrosion monitoring systems in waste tanks. This report also documents the results of tests designed to demonstrate the impact of liquid in-leakage into electrode bodies as well as the contamination of primary reference electrodes by diffusion through the electrode tip.

In-Trail Procedure (ITP) Algorithm Design

NASA Technical Reports Server (NTRS)

Munoz, Cesar A.; Siminiceanu, Radu I.

2007-01-01

The primary objective of this document is to provide a detailed description of the In-Trail Procedure (ITP) algorithm, which is part of the Airborne Traffic Situational Awareness In-Trail Procedure (ATSA-ITP) application. To this end, the document presents a high level description of the ITP Algorithm and a prototype implementation of this algorithm in the programming language C.

UIC at TREC 2008 Blog Track

DTIC Science & Technology

2008-11-01

T or more words, where T is a threshold that is empirically set to 300 in the experiment. The second rule aims to remove pornographic documents...Some blog documents are embedded with pornographic words to attract search traffic. We identify a list of pornographic words. Given a blog document, all...document, this document is considered pornographic spam, and is discarded. The third rule removes documents written in foreign languages. We count the

Nitrogen Oxides (NOx) Primary NAAQS REVIEW: Integrated ...

EPA Pesticide Factsheets

The NOx Integrated Review Plan is the first document generated as part of the National Ambient Air Quality Standards (NAAQS) review process. The Plan presents background information, the schedule for the review, the process to be used in conducting the review, and the key policy-relevant science issues that will guide the review. The integrated review plan also discusses the frameworks for the various assessment documents to be prepared by the EPA as part of the review, including an Integrated Science Assessment (ISA), and as warranted, a Risk/Exposure Assessment (REA), and a Policy Assessment (PA). The primary purpose of the NOx Integrated Review Plan is to highlight the key policy-relevant issues to be considered in the Review of the NO2 primary NAAQS. A draft of the integrated review plan will be the subject of an advisory review with the Clean Air Scientific Advisory Committee (CASAC) and made available to the public for review and comment.

Sulfur Dioxide (SO2) Primary NAAQS Review: Integrated ...

EPA Pesticide Factsheets

The SO2 Integrated Review Plan is the first document generated as part of the National Ambient Air Quality Standards (NAAQS) review process. The Plan presents background information, the schedule for the review, the process to be used in conducting the review, and the key policy-relevant science issues that will guide the review. The integrated review plan also discusses the frameworks for the various assessment documents to be prepared by the EPA as part of the review, including an Integrated Science Assessment (ISA), and as warranted, a Risk/Exposure Assessment (REA), and a Policy Assessment (PA). The primary purpose of the SO2 Integrated Review Plan is to highlight the key policy-relevant issues to be considered in the Review of the SO2 primary NAAQS. A draft of the integrated review plan will be the subject of an advisory with the Clean Air Scientific Advisory Committee (CASAC) and made available to the public for review and comment.

Mission requirements for a manned earth observatory. Volume 1, task 1: Experiment selection, definition, and documentation

NASA Technical Reports Server (NTRS)

1973-01-01

Information related to proposed earth observation experiments for shuttle sortie missions (SSM) in the 1980's is presented. The step-wise progression of study activities and the development of the rationale that led to the identification, selection, and description of earth observation experiments for SSM are listed. The selected experiments are described, defined, and documented by individual disciplines. These disciplines include: oceanography; meteorology; agriculture, forestry, and rangeland; geology; hydrology; and environmental impact.

Physician specialty and the quality of medical care experiences in the context of the Taiwan national health insurance system.

PubMed

Tsai, Jenna; Shi, Leiyu; Yu, Wei-Lung; Hung, Li-Mei; Lebrun, Lydie A

2010-01-01

Based on a recent patient survey from Taiwan, where there is universal health insurance coverage and unrestricted physician choice, this study examined the relationship between physician specialty and the quality of primary medical care experiences. We assessed ambulatory patients' experiences with medical care using the Primary Care Assessment Tool, representing 7 primary care domains: first contact (ie, accessibility and utilization); longitudinality (ie, ongoing care); coordination (ie, referrals and information systems); comprehensiveness (ie, services available and provided); family centeredness; community orientation; and cultural competence. Having a primary care physician was significantly associated with patients reporting higher quality of primary care experiences. Specifically, relative to specialty care physicians, primary care physicians enhanced accessibility, achieved better community orientation and cultural competence, and provided more comprehensive services. In an area with universal health insurance and unrestricted physician choice, ambulatory patients of primary care physicians rated their medical care experiences as superior to those of patients of specialists. In addition to providing health insurance coverage, promoting primary care should be included as a health policy to improve patients' quality of ambulatory medical care experiences.

The composition of primary carbonate melts and their evolution through wallrock reaction in the mantle

NASA Astrophysics Data System (ADS)

Dalton, John A.; Wood, Bernard J.

1993-10-01

We have experimentally determined the composition of near-soldus melts from depleted natural Iherzolite at pressures greater than 25 kbar. The melts are carbontitic with low alkali contents and Ca/(Ca + Mg) ratios of 0.72-0.74. Primary carbonate melts from fertile mantle are more sodic with Ca/(Ca + Mg + Fe + Na) of 0.52 and Na/(Na + Ca + Mg + Fe) up to 0.15. The melt compositions are similar to many natural magnesio-carbonatites, but differ substantially from the more abundant calcio-carbonatites. Experimentally we find that calcio-carbonatites are produced by wallrock reaction of primary melts with harzburgite at pressures of less than 25 kbar. At 15 kbar we have obtained a Ca/(Ca + Mg + Fe + Na) ratio of up to 0.87 and very low Na contents generated by this process. Values of Ca/(Ca + Mg + Fe + Na) up to 0.95 are possible at lower pressures. Low pressure wallrock reaction of primary carbonate melt with fertile Iherzolite produces melts richer in Na2CO3, corresponding to possible parental magmas of natrocarbonatite. Wallrock reaction at low pressures transforms the bulk peridotite composition from that of a harzburgite or Iherzolite to wehrlite. Examples of such carbonatite metasomatism are now widely documented. Our experiments show that the calcium content of olivine and the jadeite content of clinopyroxene may be used to constrain the Ca and Na contents respectively of the cabonatite melt responsible for metasomatism.

Development of a web-based pharmaceutical care plan to facilitate collaboration between healthcare providers and patients.

PubMed

Geurts, Marlies M E; Ivens, Martijn; van Gelder, Egbert; de Gier, Johan J

2013-01-01

In medication therapy management there is a need for a tool to document medication reviews and pharmaceutical care plans (PCPs) as well as facilitate collaboration and sharing of patient data between different healthcare providers. Currently, pharmacists and general practitioners (GPs) have their own computer systems and patient files. To facilitate collaboration between different healthcare providers and to exchange patient data we developed a paper-based tool. As a result the structured collection of all relevant information for a clinical medication review was more protocol driven. The tool also enabled to plan interventions and follow-up activities: the PCP. The PCP was piloted among three GPs and six community pharmacists. Interviews with all healthcare providers concluded the PCP was found a very useful tool to collect and share patient data. A disadvantage was the time spent to collect all information. We therefore developed our PCP into a web-based tool: the web-based PCP (W-PCP). Development of a W-PCP to (1) provide healthcare providers with information from pharmacist- and GP computer systems and (2) facilitate collaboration between healthcare providers and patients. Development and Application: W-PCP facilitates uploading and sharing of patient data among health care professionals and collaboration between professionals and patients on performing treatment plans. The W-PCP is a stand-alone application developed by cocreation using a generic software platform that provides developmental speed and flexibility. The W-PCP was used in three research lines, two in primary care and one in a hospital setting. Outcomes measures were defined as satisfaction about efficiency and effectiveness during data sharing and documentation in providing care and conducting medication reviews using the W-PCP. First experiences concerning the use of W-PCP in a primary care setting were collected by a questionnaire and interviews with pharmacists and GPs using the W-PCP. A questionnaire about first experiences with the W-PCP was sent to 38 healthcare providers. 17 healthcare providers returned the questionnaire (response 44.7%). The use of W-PCP resulted in positive experiences from participating healthcare providers. One of the needs expressed is to have the W-PCP application integrated in the current pharmacy and GP computer systems. All experiences, needs, and ideas for improvement of the current application were collected. On the basis of experiences and requirements collected, the application will be further developed. The W-PCP application can potentially support successful collaboration between different healthcare providers and patients, which is important for medication therapy management. With this application, a successful collaboration between different healthcare providers and patients could be achieved.

Flight Experiment Demonstration System (FEDS) functional description and interface document

NASA Technical Reports Server (NTRS)

Belcher, R. C.; Shank, D. E.

1984-01-01

This document presents a functional description of the Flight Experiment Demonstration System (FEDS) and of interfaces between FEDS and external hardware and software. FEDS is a modification of the Automated Orbit Determination System (AODS). FEDS has been developed to support a ground demonstration of microprocessor-based onboard orbit determination. This document provides an overview of the structure and logic of FEDS and details the various operational procedures to build and execute FEDS. It also documents a microprocessor interface between FEDS and a TDRSS user transponder and describes a software simulator of the interface used in the development and system testing of FEDS.

Processing the Viking lander camera data

NASA Technical Reports Server (NTRS)

Levinthal, E. C.; Tucker, R.; Green, W.; Jones, K. L.

1977-01-01

Over 1000 camera events were returned from the two Viking landers during the Primary Mission. A system was devised for processing camera data as they were received, in real time, from the Deep Space Network. This system provided a flexible choice of parameters for three computer-enhanced versions of the data for display or hard-copy generation. Software systems allowed all but 0.3% of the imagery scan lines received on earth to be placed correctly in the camera data record. A second-order processing system was developed which allowed extensive interactive image processing including computer-assisted photogrammetry, a variety of geometric and photometric transformations, mosaicking, and color balancing using six different filtered images of a common scene. These results have been completely cataloged and documented to produce an Experiment Data Record.

Composite Crew Module (CCM) Permeability Characterization

NASA Technical Reports Server (NTRS)

Kirsch, Michael T.

2013-01-01

In January 2007, the NASA Administrator chartered the NASA Engineering and Safety Center (NESC) to form an Agency team to design and build a composite crew module in 18 months in order to gain hands-on experience in anticipation that future exploration systems may be made of composite materials. One of the conclusions from this Composite Crew Module Primary Structure assessment was that there was a lack of understanding regarding the ability for composite pressure shells to contain consumable gases, which posed a technical risk relative to the use of a metallic design. After the completion of the Composite Crew Module test program, the test article was used in a new program to assess the overall leakage/permeability and identify specific features associated with high leak rates. This document contains the outcome of the leakage assessment.

Delivered! A Mid-Sized Academic Library's Experience with Distance Education

ERIC Educational Resources Information Center

Bartnik, Linda

2010-01-01

Murray State University (Kentucky) has been experimenting with various means of document delivery and research instruction for its online only and satellite campuses. These include ILLiad-based document delivery, Camtasia-to-UTube tutorials, a discipline-based service called Library on Blackboard, Eluminate and other virtual instructional methods.…

Correlator optical wavefront sensor COWS

NASA Astrophysics Data System (ADS)

1991-02-01

This report documents the significant upgrades and improvements made to the correlator optical wavefront sensor (COWS) optical bench during this phase of the program. Software for the experiment was reviewed and documented. Flowcharts showing the program flow are included as well as documentation for programs which were written to calculate and display Zernike polynomials. The system was calibrated and aligned and a series of experiments to determine the optimum settings for the input and output MOSLM polarizers were conducted. In addition, design of a simple aberration generation is included.

Experiments On Sublimating Carbon Dioxide Ice And Implications For Contemporary Surface Processes On Mars.

PubMed

Mc Keown, L E; Bourke, M C; McElwaine, J N

2017-10-27

Carbon dioxide is Mars' primary atmospheric constituent and is an active driver of Martian surface evolution. CO 2 ice sublimation mechanisms have been proposed for a host of features that form in the contemporary Martian climate. However, there has been very little experimental work or quantitative modelling to test the validity of these hypotheses. Here we present the results of the first laboratory experiments undertaken to investigate if the interaction between sublimating CO 2 ice blocks and a warm, porous, mobile regolith can generate features similar in morphology to those forming on Martian dunes today. We find that CO 2 sublimation can mobilise grains to form (i) pits and (ii) furrows. We have documented new detached pits at the termini of linear gullies on Martian dunes. Based on their geomorphic similarity to the features observed in our laboratory experiments, and on scaling arguments, we propose a new hypothesis that detached pits are formed by the impact of granular jets generated by sublimating CO 2 . We also study the erosion patterns formed underneath a sublimating block of CO 2 ice and demonstrate that these resemble furrow patterns on Mars, suggesting similar formation mechanisms.

Cultural adaptation in translational research: field experiences.

PubMed

Dévieux, Jessy G; Malow, Robert M; Rosenberg, Rhonda; Jean-Gilles, Michèle; Samuels, Deanne; Ergon-Pérez, Emma; Jacobs, Robin

2005-06-01

The increase in the incidence of HIV/AIDS among minorities in the United States and in certain developing nations has prompted new intervention priorities, stressing the adaptation of efficacious interventions for diverse and marginalized groups. The experiences of Florida International University's AIDS Prevention Program in translating HIV primary and secondary prevention interventions among these multicultural populations provide insight into the process of cultural adaptations and address the new scientific emphasis on ecological validity. An iterative process involving forward and backward translation, a cultural linguistic committee, focus group discussions, documentation of project procedures, and consultations with other researchers in the field was used to modify interventions. This article presents strategies used to ensure fidelity in implementing the efficacious core components of evidence-based interventions for reducing HIV transmission and drug use behaviors and the challenges posed by making cultural adaptation for participants with low literacy. This experience demonstrates the importance of integrating culturally relevant material in the translation process with intense focus on language and nuance. The process must ensure that the level of intervention is appropriate for the educational level of participants. Furthermore, the rights of participants must be protected during consenting procedures by instituting policies that recognize the socioeconomic, educational, and systemic pressures to participate in research.

Primary chemotherapy to avoid mastectomy in tumors with diameters of three centimeters or more.

PubMed

Bonadonna, G; Veronesi, U; Brambilla, C; Ferrari, L; Luini, A; Greco, M; Bartoli, C; Coopmans de Yoldi, G; Zucali, R; Rilke, F

1990-10-03

In 165 women with breast cancer who were candidates for mastectomy because the largest diameter of the tumor was 3 cm or more, we administered primary chemotherapy in the attempt to substitute conservative for mutilating surgery. We then systematically quantitated tumor reduction by clinical, radiologic, and histopathologic evaluations. Five consecutive groups of 33 patients received cyclophosphamide, methotrexate, and fluorouracil (CMF); fluorouracil, doxorubicin (Adriamycin), and cyclophosphamide (FAC); or fluorouracil, epirubicin, and cyclophosphamide (FEC). The regimens for the five groups were as follows: group 1, three cycles of CMF; group 2, four cycles of CMF; group 3, three cycles of FAC; group 4, four cycles of FAC; and group 5, three cycles of FEC. In response to primary chemotherapy, 157 of the 161 assessable patients showed measurable tumor shrinkage; progressive disease was documented in four. Tumor shrinkage to less than 3 cm was documented in 127 (81%) of the 157 women subjected to surgery, thus allowing a breast-saving procedure, rather than modified radical mastectomy, in these 127 women. Histopathologic complete remission was documented in seven patients. Tumor response was unrelated to age, menopausal status, DNA content (ploidy), [3H]thymidine-labeling index, drug combination used, or number of treatment cycles in excess of three. The degree of response was inversely proportional to the initial tumor size, and the frequency of response was greater in receptor-negative tumors. Severe vomiting and hair loss were less frequent with CMF than with anthracycline-containing regimens, and the frequency of severe leukopenia and thrombocytopenia was minimal. Our results challenge the classical indication for primary mastectomy by showing that use of full-dose primary chemotherapy, sequentially combined with conservative surgery and radiation, can offer an effective and safe alternative to women concerned about the preservation of body integrity.

Video documentation of experiments at the USGS debris-flow flume 1992–2017

USGS Publications Warehouse

Logan, Matthew; Iverson, Richard M.

2007-11-23

This set of videos presents about 18 hours of footage documenting the 163 experiments conducted at the USGS debris-flow flume from 1992 to 2017. Owing to improvements in video technology over the years, the quality of footage from recent experiments generally exceeds that from earlier experiments.Use the list below to access the individual videos, which are mostly grouped by date and subject matter. When a video is selected from the list, multiple video sequences are generally shown in succession, beginning with a far-field overview and proceeding to close-up views and post-experiment documentation.Interpretations and data from experiments at the USGS debris-flow flume are not provided here but can be found in published reports, many of which are available online at: https://profile.usgs.gov/riverson/A brief introduction to the flume facility is also available online in USGS Open-File Report 92–483 [http://pubs.er.usgs.gov/usgspubs/ofr/ofr92483].

[Spanish Society of Pediatric Infectious Diseases, Spanish Society of Paediatric Clinical Immunology and Allergy, Spanish Association of Paediatric Primary Care, and the Spanish Society of Extra-hospital Paediatrics and Primary Health Care consensus document on antibiotic treatment in penicillin or amoxicillin allergy].

PubMed

Baquero-Artigao, Fernando; Michavila, Antonio; Suárez-Rodriguez, Ángeles; Hernandez, Anselmo; Martínez-Campos, Leticia; Calvo, Cristina

2017-02-01

The suspected allergy to beta-lactam antibiotics, especially penicillin and amoxicillin, is the most frequent reason for consultation in Child Allergy Units. In this consensus document, the clinical and diagnostic criteria of allergic reactions are described, as well as alternative antibiotic treatment for the most common infections diagnosed in paediatrics for patients with known or suspected allergy. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

The dynamic development of the muzzle imprint by contact gunshot: high-speed documentation utilizing the "skin-skull-brain model".

PubMed

Thali, M J; Kneubuehl, B P; Dirnhofer, R; Zollinger, U

2002-07-17

Many contact gunshots produce a muzzle imprint in the skin of the victim. Different mechanisms have been discussed in literature as being responsible for the creation of the muzzle imprint. Experimenting upon the synthetic non biological skin-skull-brain model, our goal was to document and study the creation of the muzzle imprint with the aid of high-speed photography. In our experiments, we could document with our high-speed photography (at exposure rates in the range of nanoseconds) the bulging, the pressing against the muzzle, and the splitting of the artificial skin. Furthermore, it was possible to photographically record the back pattern of synthetic tissue particles. And, the soot and gunpowder cavity could be reproduced experimentally. In conclusion the experiments completed with the skin-skull-brain model, using high-speed photography for documentation, show the promising possibilities of experimental ballistics with body models.

Empathetic and Pro-Social Awareness in Primary School Students: A Case Study

ERIC Educational Resources Information Center

Dar, Fatima Rehan

2016-01-01

The study addressed a cognitive-affective gap in a primary English curriculum and noticed whether the curriculum, texts and class activities utilized empathetic and pro-social themes in teaching English language. The findings from the document review, interviews and observations revealed that the said themes were underrepresented in the…

Mental Rotation Performance in Primary School Age Children: Are There Gender Differences in Chronometric Tests?

ERIC Educational Resources Information Center

Jansen, P.; Schmelter, A.; Quaiser-Pohl, C.; Neuburger, S.; Heil, M.

2013-01-01

In contrast to the well documented male advantage in psychometric mental rotation tests, gender differences in chronometric experimental designs are still under dispute. Therefore, a systematic investigation of gender differences in mental rotation performance in primary-school children is presented in this paper. A chronometric mental rotation…

National Primary and Secondary Ambient Air Quality Standards (NAAQS) for Lead (Pb) and Implementation Plans for Lead NAAQS: 1978 Final Rule (43 FR 46246 & 46264)

EPA Pesticide Factsheets

This document is a copy of the Federal Register publication of the October 5, 1978 Final Rules for National Primary and Secondary Ambient Air Quality Standards for Lead (Pb) and Implementation Plans for Lead (Pb) NAAQS.

76 FR 9579 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-18

... Enrollment, Chain and Ownership System (PECOS) Security Consent Form; Use: The primary function of the... proposed information collection for the proper performance of the Agency's function; (2) the accuracy of.... Form CMS-37 is the primary document used by CMS in developing the national Medicaid budget estimates...

Putting Literature at the Heart of the Literacy Curriculum

ERIC Educational Resources Information Center

Nicholson, Deborah

2006-01-01

This paper documents an initiative in Continuing Professional Development, conceived and carried out by London's "Centre for Literacy in Primary Education" (CLPE). The intention was to improve the teaching and learning of writing in Years 5 and 6 of the primary school (9-11-year-olds), through working with challenging literature. This…

Review of the Primary National Ambient Air Quality Standards for Nitrogen Dioxide: Risk and Exposure Assessment Planning Document

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) is conducting a review of the air quality criteria and the primary (health-based) national ambient air quality standards (NAAQS) for nitrogen dioxide (NO2). The major phases of the process for reviewing NAAQS include the following: (...

Review of the Primary National Ambient Air Quality Standard for Sulfur Oxides: Risk and Exposure Assessment Planning Document

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) is conducting a review of the air quality criteria and the primary (health-based) national ambient air quality standards (NAAQS) for sulfur oxides (SOx). The major phases of the process for reviewing NAAQS include the following: (1) ...

Test Plan for the Wake Steering Experiment at the Scaled Wind Farm Technology (SWiFT) Facility.

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

Naughton, Brian Thomas

This document is a test plan describing the objectives, configuration, procedures, reporting, roles, and responsibilities for conducting the joint Sandia National Laboratories and National Renewable Energy Laboratory Wake Steering Experiment at the Sandia Scaled Wind Farm Technology (SWiFT) facility near Lubbock, Texas in 2016 and 2017 . The purpose of this document is to ensure the test objectives and procedures are sufficiently detailed such that al l involved personnel are able to contribute to the technical success of the test. This document is not intended to address safety explicitly which is addressed in a separate document listed in the referencesmore » titled Sandia SWiFT Facility Site Operations Manual . Both documents should be reviewed by all test personnel.« less

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

NONE

This large document provides a catalog of the location of large numbers of reports pertaining to the charge of the Presidential Advisory Committee on Human Radiation Research and is arranged as a series of appendices. Titles of the appendices are Appendix A- Records at the Washington National Records Center Reviewed in Whole or Part by DoD Personnel or Advisory Committee Staff; Appendix B- Brief Descriptions of Records Accessions in the Advisory Committee on Human Radiation Experiments (ACHRE) Research Document Collection; Appendix C- Bibliography of Secondary Sources Used by ACHRE; Appendix D- Brief Descriptions of Human Radiation Experiments Identified by ACHRE,more » and Indexes; Appendix E- Documents Cited in the ACHRE Final Report and other Separately Described Materials from the ACHRE Document Collection; Appendix F- Schedule of Advisory Committee Meetings and Meeting Documentation; and Appendix G- Technology Note.« less

Understanding Clinician Information Demands and Synthesis of Clinical Documents in Electronic Health Record Systems

ERIC Educational Resources Information Center

Farri, Oladimeji Feyisetan

2012-01-01

Large quantities of redundant clinical data are usually transferred from one clinical document to another, making the review of such documents cognitively burdensome and potentially error-prone. Inadequate designs of electronic health record (EHR) clinical document user interfaces probably contribute to the difficulties clinicians experience while…

78 FR 62459 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Redesignation of the Canton...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

...) and ammonia for the area. EPA, therefore, grants Ohio's request to redesignate the Canton area to...\\ VOCs, and ammonia documented in Ohio's PM 2.5 redesignation request and supplemental submittals. These... inventories for primary PM 2.5 , NO X , SO 2 , VOCs, and ammonia documented in Ohio's June 26, 2012, and May...

Design of a Personnel and Training Information System for Educational R&D Personnel. The Domain of R&D Training Resources.

ERIC Educational Resources Information Center

Hood, Paul D.

This document reports an attempt to examine the content and structure of the domain of research and development (R&D) training resources. The project began by locating instructional materials within a larger matrix that classified R&D resources by structure (primary/secondary, oral/written, documentary/non-document) and level of formalization…

The Outdoor MEDIA DOT: The development and inter-rater reliability of a tool designed to measure food and beverage outlets and outdoor advertising.

PubMed

Poulos, Natalie S; Pasch, Keryn E

2015-07-01

Few studies of the food environment have collected primary data, and even fewer have reported reliability of the tool used. This study focused on the development of an innovative electronic data collection tool used to document outdoor food and beverage (FB) advertising and establishments near 43 middle and high schools in the Outdoor MEDIA Study. Tool development used GIS based mapping, an electronic data collection form on handheld devices, and an easily adaptable interface to efficiently collect primary data within the food environment. For the reliability study, two teams of data collectors documented all FB advertising and establishments within one half-mile of six middle schools. Inter-rater reliability was calculated overall and by advertisement or establishment category using percent agreement. A total of 824 advertisements (n=233), establishment advertisements (n=499), and establishments (n=92) were documented (range=8-229 per school). Overall inter-rater reliability of the developed tool ranged from 69-89% for advertisements and establishments. Results suggest that the developed tool is highly reliable and effective for documenting the outdoor FB environment. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Outdoor MEDIA DOT: The Development and Inter-Rater Reliability of a Tool Designed to Measure Food and Beverage Outlets and Outdoor Advertising

PubMed Central

Poulos, Natalie S.; Pasch, Keryn E.

2015-01-01

Few studies of the food environment have collected primary data, and even fewer have reported reliability of the tool used. This study focused on the development of an innovative electronic data collection tool used to document outdoor food and beverage (FB) advertising and establishments near 43 middle and high schools in the Outdoor MEDIA Study. Tool development used GIS based mapping, an electronic data collection form on handheld devices, and an easily adaptable interface to efficiently collect primary data within the food environment. For the reliability study, two teams of data collectors documented all FB advertising and establishments within one half-mile of six middle schools. Inter-rater reliability was calculated overall and by advertisement or establishment category using percent agreement. A total of 824 advertisements (n=233), establishment advertisements (n=499), and establishments (n=92) were documented (range=8–229 per school). Overall inter-rater reliability of the developed tool ranged from 69–89% for advertisements and establishments. Results suggest that the developed tool is highly reliable and effective for documenting the outdoor FB environment. PMID:26022774

HIV counselling and testing practices for children seen in an urban emergency department of a tertiary referral hospital in Dar es Salaam, Tanzania: a retrospective cross-sectional study

PubMed Central

Sawe, Hendry R; Mfinanga, Juma A; Ringo, Faith H; Mwafongo, Victor; Reynolds, Teri A; Runyon, Michael S

2016-01-01

Objectives To describe the HIV counselling and testing practices for children presenting to an emergency department (ED) in a low-income country. Setting The ED of a large east African national referral hospital. Participants This retrospective review of all paediatric (<18 years old) ED visits in 2012 enrolled patients who had an HIV test ordered and excluded those without testing. Files were available for 5540/5774 (96%) eligible patients and 1632 (30%) were tested for HIV, median age 1.3 years (IQR 9 months to 4 years), 58% <18 months old and 61% male. Primary and secondary outcome measures The primary outcome measure was documentation of pretest and post-test counselling, or deferral of counselling, for children tested for HIV in the ED. Secondary measures included the overall rate of HIV testing, rate of counselling documented in the inpatient record when deferred in the ED, rate of counselling documented when testing was initiated by the inpatient service, rate of counselling documented by test result (positive vs negative) and the rate of referral to follow-up HIV care among patients testing positive. Results Of 418 patients tested in the ED, counselling, or deferral of counselling, was documented for 70 (17%). When deferred to the ward, subsequent counselling was documented for 15/42 (36%). Counselling was documented in 33% of patients testing positive versus 1.1% patients testing negative (OR 43 (95% CI 23 to 83). Of 199 patients who tested positive and survived to hospital discharge, 76 (38%) were referred for follow-up at the HIV clinic on discharge. Conclusions Physicians documented the provision, or deferral, of counselling for <20% of children tested for HIV in the ED. Counselling was much more likely to be documented when the test result was positive. Less than 40% of those testing positive were referred for follow-up care. PMID:26880672

It Takes a Village: Documenting the Contributions of Non-Scientific Staff to Scientific Research

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

Higgins, Valerie

Documenting the Contributions of Non-Scientific Staff to Scientific Research Science, especially large-scale basic research, is a collaborative endeavor, often drawing on the skills of people from a wide variety of disciplines. These people include not just scientists, but also administrators, engineers, and many others. Fermilab, a Department of Energy National Laboratory and the United States’ premier particle physics laboratory, exemplifies this kind of research; many of its high-energy physics experiments involve hundreds of collaborators from all over the world. The Fermilab Archives seeks to document the history of the lab and the unique scientific research its staff and visitors perform.more » Adequately documenting the lab’s work often requires us to go far beyond things like the writings and correspondence of scientists to also capture the administrative and social histories of the experiments and the context in which they were performed. At Fermilab, we have sought to capture these elements of the lab’s activities through an oral history program that focuses on support staff as well as physicists and collection development choices that recognize the importance of records documenting the cultural life of the lab. These materials are not merely supplementary, but rather essential documentation of the many types of labor that go into the planning and execution of an experiment or the construction of an accelerator and the context in which this work is performed. Any picture of these experiments and accelerators that did not include this type of information would be incomplete. While the importance and richness of this material is especially pronounced at Fermilab due to the massive size of its experiments and accelerator facilities and its vibrant cultural life, the fruitfulness of these collecting efforts at Fermilab suggests that other archives documenting modern STEM research should also make sure the contributions of non-technical and non-scientific staff are preserved and that researchers interested in this subject should not neglect such sources.« less

What I Learned from the Flood of 1997: Or, Why Archival Class Is Essential.

ERIC Educational Resources Information Center

Reinertson-Sand, Mary

1999-01-01

Relates the author's experiences of salvaging items following the Grand Forks (North Dakota) flood of 1997. Highlights include restoring home movies, paper documents, and photographs; setting realistic recovery goals; and preserving document copies in other locations. A sidebar describes experiences of the public library in Elba (Alabama) after…

Examining the Flexibility Bind in American Tenure and Promotion Processes: An Institutional Ethnographic Approach

ERIC Educational Resources Information Center

Jones, Kyle; Beddoes, Kacey; Banerjee, Dina; Pawley, Alice L.

2014-01-01

This paper analyses the role that forms of documentation play in faculty members' experiences of tenure and promotion. Taking an institutional ethnography approach, it examines inconsistencies and ambiguities in documents and connects them to the experiences of science, technology, engineering and mathematics (STEM) faculty at one institution in…

NREL Document Profiles Natural Gas Fueling, Fleet Operation

Science.gov Websites

, Waste Management's LNG Truck Fleet Start-Up Experience, offers solid evidence that LNG-powered vehicles program from concept to start-up to present-day operation, describing the vehicle, engine and fueling . The document Waste Management's LNG Truck Fleet Start-Up Experience is one of a series of NREL

Differences in Experiences With Care Between Homeless and Nonhomeless Patients in Veterans Affairs Facilities With Tailored and Nontailored Primary Care Teams.

PubMed

Jones, Audrey L; Hausmann, Leslie R M; Kertesz, Stefan; Suo, Ying; Cashy, John P; Mor, Maria K; Schaefer, James H; Gundlapalli, Adi V; Gordon, Adam J

2018-05-12

Homeless patients describe poor experiences with primary care. In 2012, the Veterans Health Administration (VHA) implemented homeless-tailored primary care teams (Homeless Patient Aligned Care Team, HPACTs) that could improve the primary care experience for homeless patients. To assess differences in primary care experiences between homeless and nonhomeless Veterans receiving care in VHA facilities that had HPACTs available (HPACT facilities) and in VHA facilities lacking HPACTs (non-HPACT facilities). We used multivariable multinomial regressions to estimate homeless versus nonhomeless patient differences in primary care experiences (categorized as negative/moderate/positive) reported on a national VHA survey. We compared the homeless versus nonhomeless risk differences (RDs) in reporting negative or positive experiences in 25 HPACT facilities versus 485 non-HPACT facilities. Survey respondents from non-HPACT facilities (homeless: n=10,148; nonhomeless: n=309,779) and HPACT facilities (homeless: n=2022; nonhomeless: n=20,941). Negative and positive experiences with access, communication, office staff, provider rating, comprehensiveness, coordination, shared decision-making, and self-management support. In non-HPACT facilities, homeless patients reported more negative and fewer positive experiences than nonhomeless patients. However, these patterns of homeless versus nonhomeless differences were reversed in HPACT facilities for the domains of communication (positive experience RDs in non-HPACT versus HPACT facilities=-2.0 and 2.0, respectively); comprehensiveness (negative RDs=2.1 and -2.3), shared decision-making (negative RDs=1.2 and -1.8), and self-management support (negative RDs=0.1 and -4.5; positive RDs=0.5 and 8.0). VHA facilities with HPACT programs appear to offer a better primary care experience for homeless versus nonhomeless Veterans, reversing the pattern of relatively poor primary care experiences often associated with homelessness.

Reconstruction and 3D visualisation based on objective real 3D based documentation.

PubMed

Bolliger, Michael J; Buck, Ursula; Thali, Michael J; Bolliger, Stephan A

2012-09-01

Reconstructions based directly upon forensic evidence alone are called primary information. Historically this consists of documentation of findings by verbal protocols, photographs and other visual means. Currently modern imaging techniques such as 3D surface scanning and radiological methods (computer tomography, magnetic resonance imaging) are also applied. Secondary interpretation is based on facts and the examiner's experience. Usually such reconstructive expertises are given in written form, and are often enhanced by sketches. However, narrative interpretations can, especially in complex courses of action, be difficult to present and can be misunderstood. In this report we demonstrate the use of graphic reconstruction of secondary interpretation with supporting pictorial evidence, applying digital visualisation (using 'Poser') or scientific animation (using '3D Studio Max', 'Maya') and present methods of clearly distinguishing between factual documentation and examiners' interpretation based on three cases. The first case involved a pedestrian who was initially struck by a car on a motorway and was then run over by a second car. The second case involved a suicidal gunshot to the head with a rifle, in which the trigger was pushed with a rod. The third case dealt with a collision between two motorcycles. Pictorial reconstruction of the secondary interpretation of these cases has several advantages. The images enable an immediate overview, give rise to enhanced clarity, and compel the examiner to look at all details if he or she is to create a complete image.

pH1N1 - a comparative analysis of public health responses in Ontario to the influenza outbreak, public health and primary care: lessons learned and policy suggestions

PubMed Central

2013-01-01

Background Ontario’s 36 Public Health Units (PHUs) were responsible for implementing the H1N1 Pandemic Influenza Plans (PIPs) to address the first pandemic influenza virus in over 40 years. It was the first under conditions which permitted mass immunization. This is therefore the first opportunity to learn and document what worked well, and did not work well, in Ontario’s response to pH1N1, and to make recommendations based on experience. Methods Our objectives were to: describe the PIP models, obtain perceptions on outcomes, lessons learned and to solicit policy suggestions for improvement. We conducted a 3-phase comparative analysis study comprised of semi-structured key informant interviews with local Medical Officers of Health (n = 29 of 36), and Primary Care Physicians (n = 20) and in Phase 3 with provincial Chief-Medical Officers of Health (n = 6) and a provincial Medical Organization. Phase 2 data came from a Pan-Ontario symposium (n = 44) comprised leaders representing: Public Health, Primary Care, Provincial and Federal Government. Results PIPs varied resulting in diverse experiences and lessons learned. This was in part due to different PHU characteristics that included: degree of planning, PHU and Primary Care capacity, population, geographic and relationships with Primary Care. Main lessons learned were: 1) Planning should be more comprehensive and operationalized at all levels. 2) Improve national and provincial communication strategies and eliminate contradictory messages from different sources. 3) An integrated community-wide response may be the best approach to decrease the impact of a pandemic. 4) The best Mass Immunization models can be quickly implemented and have high immunization rates. They should be flexible and allow for incremental responses that are based upon: i) pandemic severity, ii) local health system, population and geographic characteristics, iii) immunization objectives, and iv) vaccine supply. Conclusion “We were very lucky that pH1N1 was not more severe.” Consensus existed for more detailed planning and the inclusion of multiple health system and community stakeholders. PIPs should be flexible, allow for incremental responses and have important decisions (E.g., under which conditions Public Health, Primary Care, Pharmacists or others act as vaccine delivery agents.) made prior to a crisis. PMID:23890226

Sexual Abuse of the Mentally Retarded Patient: Medical and Legal Analysis for the Primary Care Physician

PubMed Central

Morano, Jamie P.

2001-01-01

The primary care physician has a vital role in documenting and preventing sexual abuse among the mentally retarded populations in our community. Since the current national trend is to integrate citizens with mental retardation into the community away from institutionalized care, it is essential that all physicians have a basic understanding of the unique medical and legal ramifications of their clinical diagnoses. As the legal arena is currently revising laws concerning rights of sexual consent among the mentally retarded, it is essential that determinations of mental competency follow national standards in order to delineate clearly any instance of sexual abuse. Clinical documentation of sexual abuse and sexually transmitted disease is an important part of a routine examination since many such individuals are indeed sexually active. Legal codes adjudicating sexual abuse cases of the mentally retarded often offer scant protection and vague terminology. Thus, medical documentation and physician competency rulings form a solid foundation for future work toward legal recourse for the abused. PMID:15014610

Impact of audit and feedback and pay-for-performance interventions on pediatric hospitalist discharge communication with primary care providers.

PubMed

Tejedor-Sojo, Javier; Creek, Tracy; Leong, Traci

2015-01-01

The study team sought to improve hospitalist communication with primary care providers (PCPs) at discharge through interventions consisting of (a) audit and feedback and (b) inclusion of a discharge communication measure in the incentive compensation for pediatric hospitalists. The setting was a 16-physician pediatric hospitalist group within a tertiary pediatric hospital. Discharge summaries were selected randomly for documentation of communication with PCPs. At baseline, 57% of charts had documented communication with PCPs, increasing to 84% during the audit and feedback period. Following the addition of a financial incentive, documentation of communication with PCPs increased to 93% and was sustained during the combined intervention period. The number of physicians meeting the study's performance goal increased from 1 to 14 by the end of the study period. A financial incentive coupled with an audit and feedback tool was effective at modifying physician behavior, achieving focused, measurable quality improvement gains. © 2014 by the American College of Medical Quality.

Supporting nurse practitioners' practice in primary healthcare settings: a three-level qualitative model.

PubMed

Chouinard, Véronique; Contandriopoulos, Damien; Perroux, Mélanie; Larouche, Catherine

2017-06-26

While greater reliance on nurse practitioners in primary healthcare settings can improve service efficiency and accessibility, their integration is not straightforward, challenging existing role definitions of both registered nurses and physicians. Developing adequate support practices is therefore essential in primary healthcare nurse practitioners' integration. This study's main objective is to examine different structures and mechanisms put in place to support the development of primary healthcare nurse practitioner's practice in different healthcare settings, and develop a practical model for identifying and planning adequate support practices. This study is part of a larger multicentre study on primary healthcare nurse practitioners in the province of Quebec, Canada. It focuses on three healthcare settings into which one or more primary healthcare nurse practitioners have been integrated. Case studies have been selected to cover a maximum of variations in terms of location, organizational setting, and stages of primary healthcare nurse practitioner integration. Findings are based on the analysis of available documentation in each primary healthcare setting and on semi-structured interviews with key actors in each clinical team. Data were analyzed following thematic and cross-sectional analysis approaches. This article identifies three types of support practices: clinical, team, and systemic. This three-level analysis demonstrates that, on the ground, primary healthcare nurse practitioner integration is essentially a team-based, multilevel endeavour. Despite the existence of a provincial implementation plan, the three settings adopted very different implementation structures and practices, and different actors were involved at each of the three levels. The results also indicated that nursing departments played a decisive role at all three levels. Based on these findings, we suggest that support practices should be adapted to each organization's environment and experience and be modified as needed throughout the integration process. We also stress the importance of combining this approach with a strong coordination mechanism involving managers who have in-depth understanding of nursing professional roles and scopes of practice. Making primary healthcare nurse practitioner integration frameworks more flexible and clarifying and strengthening the role of senior nursing managers could be the key to successful integration.

Understanding primary school science teachers' pedagogical content knowledge: The case of teaching global warming

NASA Astrophysics Data System (ADS)

Chordnork, Boonliang; Yuenyong, Chokchai

2018-01-01

This aim of this research was to investigate primary school science teachers understanding and teaching practice as well as the influence on teaching and learning a topic like global warming. The participants were four primary science teachers, who were not graduated in science education. Methodology was the case study method, which was under the qualitative research regarded from interpretive paradigm. Data were collected by openended questionnaire, semi-structure interview, and document colleting. The questionnaire examined teachers' background, teachers' understanding of problems and threats of science teaching, desiring of development their PCK, sharing the teaching approaches, and their ideas of strength and weakness. a semi-structured interview was conducted based on the approach for capturing PCK of Loughran [23] content representation (CoRe). And, the document was collected to clarify what evidence which was invented to effect on students' learning. These document included lesson plan, students' task, and painting about global warming, science projects, the picture of activities of science learning, the exercise and test. Data analysis employed multiple approach of evidence looking an issue from each primary science teachers and used triangulation method to analyze the data with aiming to make meaning of teachers' representation of teaching practice. These included descriptive statistics, CoRe interpretation, and document analysis. The results show that teachers had misunderstanding of science teaching practice and they has articulated the pedagogical content knowledge in terms of assessment, goal of teaching and linking to the context of socio cultural. In contrast, knowledge and belief of curriculum, students' understanding of content global warming, and strategies of teaching were articulated indistinct by non-graduate science teacher. Constructing opportunities for personal development, the curiosity of the student learning center, and linking context of socio-culture were the creative factor in the teaching global warming. On the other hand, the teachers had an idea that lack of technology and the defect of child's intelligence were hinder factors teaching global warming.

Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review.

PubMed

Warkentin, Theodore E; Pai, Menaka; Linkins, Lori-Ann

2017-08-31

Direct oral anticoagulants (DOACs) are attractive options for treatment of heparin-induced thrombocytopenia (HIT). We report our continuing experience in Hamilton, ON, Canada, since January 1, 2015 (when we completed our prospective study of rivaroxaban for HIT), using rivaroxaban for serologically confirmed HIT (4Ts score ≥4 points; positive platelet factor 4 [PF4]/heparin immunoassay, positive serotonin-release assay). We also performed a literature review of HIT treatment using DOACs (rivaroxaban, apixaban, dabigatran, edoxaban). We focused on patients who received DOAC therapy for acute HIT as either primary therapy (group A) or secondary therapy (group B; initial treatment using a non-DOAC/non-heparin anticoagulant with transition to a DOAC during HIT-associated thrombocytopenia). Our primary end point was occurrence of objectively documented thrombosis during DOAC therapy for acute HIT. We found that recovery without new, progressive, or recurrent thrombosis occurred in all 10 Hamilton patients with acute HIT treated with rivaroxaban. Data from the literature review plus these new data identified a thrombosis rate of 1 of 46 patients (2.2%; 95% CI, 0.4%-11.3%) in patients treated with rivaroxaban during acute HIT (group A, n = 25; group B, n = 21); major hemorrhage was seen in 0 of 46 patients. Similar outcomes in smaller numbers of patients were observed with apixaban (n = 12) and dabigatran (n = 11). DOACs offer simplified management of selected patients, as illustrated by a case of persisting (autoimmune) HIT (>2-month platelet recovery with inversely parallel waning of serum-induced heparin-independent serotonin release) with successful outpatient rivaroxaban management of HIT-associated thrombosis. Evidence supporting efficacy and safety of DOACs for acute HIT is increasing, with the most experience reported for rivaroxaban. © 2017 by The American Society of Hematology.

LDR structural experiment definition

NASA Technical Reports Server (NTRS)

Russell, R. A.

1988-01-01

A system study to develop the definition of a structural flight experiment for a large precision segmented reflector on the Space Station was accomplished by the Boeing Aerospace Company for NASA's Langley Research Center. The objective of the study was to use a Large Deployable Reflector (LDR) baseline configuration as the basis for focusing an experiment definition, so that the resulting accommodation requirements and interface constraints could be used as part of the mission requirements data base for Space Station. The primary objectives of the first experiment are to construct the primary mirror support truss and to determine its structural and thermal characteristics. Addition of an optical bench, thermal shield and primary mirror segments, and alignment of the optical components, would occur on a second experiment. The structure would then be moved to the payload point system for pointing, optical control, and scientific optical measurement for a third experiment. Experiment 1 will deploy the primary support truss while it is attached to the instrument module structure. The ability to adjust the mirror attachment points and to attach several dummy primary mirror segments with a robotic system will also be demonstrated. Experiment 2 will be achieved by adding new components and equipment to experiment one. Experiment 3 will demonstrate advanced control strategies, active adjustment of the primary mirror alignment, and technologies associated with optical sensing.

Can scribes boost FPs' efficiency and job satisfaction?

PubMed

Earls, Stephen T; Savageau, Judith A; Begley, Susan; Saver, Barry G; Sullivan, Kate; Chuman, Alan

2017-04-01

Research in other medical specialties has shown that the addition of medical scribes to the clinical team enhances physicians' practice experience and increases productivity. To date, literature on the implementation of scribes in primary care is limited. To determine the feasibility and benefits of implementing scribes in family medicine, we undertook a pilot mixed- method quality improvement (QI) study. In 2014, we incorporated 4 parttime scribes into an academic family medicine practice consisting of 7 physicians. We then measured, via survey and time-tracking data, the impact the scribes had on physician office hours and productivity, time spent on documentation, perceptions of work-life balance, and physician and patient satisfaction. Six of the 7 faculty physicians participated. This study demonstrated that the use of scribes in a busy academic primary care practice substantially reduced the amount of time that family physicians spent on charting, improved work-life balance, and had good patient acceptance. Specifically, the physicians spent an average of 5.1 fewer hours/week (hrs/wk) on documentation, while various measures of productivity revealed increases ranging from 9.2% to 28.8%. Perhaps most important of all, when the results of the pilot study were annualized, they were projected to generate $168,600 per year--more than twice the $79,500 annual cost of 2 full-time equivalent scribes. Surveys assessing work-life balance demonstrated improvement in the physicians' perception of the administrative burden/paperwork related to practice and a decrease in their perception of the extent to which work encroached on their personal lives. In addition, survey data from 313 patients at the time of their ambulatory visit with a scribe present revealed a high level of comfort. Likewise, surveys completed by physicians after 55 clinical sessions (ie, blocks of consecutive, uninterrupted patient appointments; there are usually 2 sessions per day) revealed good to excellent ratings more than 90% of the time. In an outpatient family medicine clinic, the use of scribes substantially improved physicians' efficiency, job satisfaction, and productivity without negatively impacting the patient experience.

KENNEDY SPACE CENTER, FLA. - Andrea Lorenzoni, International Space Station Program manager for Node 2, Italian Space Agency; Alan Thirkettle, International Space Station Program manager for Node 2, European Space Agency (ESA); and NASA’s Michael C. Kostelnik, deputy associate administrator for International Space Station and Shuttle Programs, sign documents officially transferring ownership of Node 2 between the ESA and NASA. The signing was part of a ceremony highlighting the arrival of two major components of the International Space Station. NASA's Node 2, built by the European Space Agency (ESA) in Italy, arrived at KSC on June 1. It will be the next pressurized module installed on the Station. The pressurized module (above right) of the Japanese Experiment Module (JEM), named "Kibo" (Hope), arrived at KSC on June 4. It is Japan's primary contribution to the Station. Emceed by Lisa Malone (far left), deputy director of External Relations and Business Development at KSC, the ceremony also included these speakers: Center Director Roy Bridges Jr.; NASA’s William Gerstenmaier, International Space Station Program manager; and Kuniaki Shiraki, JEM Project manager, National Aerospace and Development Agency of Japan.

NASA Image and Video Library

2003-06-18

KENNEDY SPACE CENTER, FLA. - Andrea Lorenzoni, International Space Station Program manager for Node 2, Italian Space Agency; Alan Thirkettle, International Space Station Program manager for Node 2, European Space Agency (ESA); and NASA’s Michael C. Kostelnik, deputy associate administrator for International Space Station and Shuttle Programs, sign documents officially transferring ownership of Node 2 between the ESA and NASA. The signing was part of a ceremony highlighting the arrival of two major components of the International Space Station. NASA's Node 2, built by the European Space Agency (ESA) in Italy, arrived at KSC on June 1. It will be the next pressurized module installed on the Station. The pressurized module (above right) of the Japanese Experiment Module (JEM), named "Kibo" (Hope), arrived at KSC on June 4. It is Japan's primary contribution to the Station. Emceed by Lisa Malone (far left), deputy director of External Relations and Business Development at KSC, the ceremony also included these speakers: Center Director Roy Bridges Jr.; NASA’s William Gerstenmaier, International Space Station Program manager; and Kuniaki Shiraki, JEM Project manager, National Aerospace and Development Agency of Japan.

Documentation systems for educators seeking academic promotion in U.S. medical schools.

PubMed

Simpson, Deborah; Hafler, Janet; Brown, Diane; Wilkerson, LuAnn

2004-08-01

To explore the state and use of teaching portfolios in promotion and tenure in U.S. medical schools. A two-phase qualitative study using a Web-based search procedure and telephone interviews was conducted. The first phase assessed the penetration of teaching portfolio-like systems in U.S. medical schools using a keyword search of medical school Web sites. The second phase examined the current use of teaching portfolios in 16 U.S. medical schools that reported their use in a survey in 1992. The individual designated as having primary responsibility for faculty appointments/promotions was contacted to participate in a 30-60 minute interview. The Phase 1 search of U.S. medical schools' Web sites revealed that 76 medical schools have Web-based access to information on documenting educational activities for promotion. A total of 16 of 17 medical schools responded to Phase 2. All 16 continued to use a portfolio-like system in 2003. Two documentation categories, honors/awards and philosophy/personal statement regarding education, were included by six more of these schools than used these categories in 1992. Dissemination of work to colleagues is now a key inclusion at 15 of the Phase 2 schools. The most common type of evidence used to document education was learner and/or peer ratings with infrequent use of outcome measures and internal/external review. The number of medical schools whose promotion packets include portfolio-like documentation associated with a faculty member's excellence in education has increased by more than 400% in just over ten years. Among early-responder schools the types of documentation categories have increased, but students' ratings of teaching remain the primary evidence used to document the quality or outcomes of the educational efforts reported.

Do competing demands of physical illness in type 2 diabetes influence depression screening, documentation and management in primary care: a cross-sectional analytic study in Aboriginal and Torres Strait Islander primary health care settings.

PubMed

Schierhout, Gill; Nagel, Tricia; Si, Damin; Connors, Christine; Brown, Alex; Bailie, Ross

2013-06-06

Relatively little is known about how depression amongst people with chronic illness is identified and managed in diverse primary health care settings. We evaluated the role of complex physical needs in influencing current practice of depression screening, documentation and antidepressant prescriptions during a 12-month period, among adults with Type 2 diabetes attending Aboriginal and Torres Strait Islander primary care health centres in Australia. We analysed clinical audit data from 44 health centres participating in a continuous quality improvement initiative, using previously reported standard sampling and data extraction protocols. Eligible patients were those with Type 2 diabetes with health centre attendance within the past 12 months. We compared current practice in depression screening, documentation and antidepressant prescription between patients with different disease severity and co-morbidity. We used random effects multiple logistic regression models to adjust for potential confounders and for clustering by health centre. Among the 1174 patients with diabetes included, median time since diagnosis was 7 years, 19% of patients had a co-existing diagnosis of Ischaemic Heart Disease and 1/3 had renal disease. Some 70% of patients had HbAc1>7.0%; 65% had cholesterol >4.0 mmol1-1 and 64% had blood pressure>130/80 mmHg. Documentation of screening for depression and of diagnosed depression were low overall (5% and 6% respectively) and lower for patients with renal disease (Adjusted odds ratio [AOR] 0.21; 95% confidence interval [CI] 0.14 to 0.31 and AOR 0.34; 95% CI 0.15 to 0.75), and for those with poorly controlled disease (HbA1c>7.00 (AOR 0.40; 95% CI 0.23 to 0.68 and AOR 0.51; 95% CI 0.30 to 84)). Screening for depression was lower for those on pharmaceutical treatment for glycaemic control compared to those not on such treatment. Antidepressant prescription was not associated with level of diabetes control or disease severity. Background levels of depression screening and documentation were low overall and significantly lower for patients with greater disease severity. Strategies to improve depression care for vulnerable populations are urgently required. An important first step in the Australian Indigenous primary care context is to identify and address barriers to the use of current clinical guidelines for depression screening and care.

Fluorinated Carbon Composite Cathode for a High Energy Lithium Battery (Briefing Charts)

DTIC Science & Technology

2011-02-16

REPORT DOCUMENTATION PAGE Standard Form 298 (Rev. 8/98) Prescribed by ANSI Std. Z39.18 Form Approved OMB No. 0704-0188 The public reporting burden...monofluoride (Li/ CFx ) primary batteries have double energy density over state-of-the-art Li/MnO2 and Li/SO2 primary batteries (theoretically 2203 Wh/kg...temperature operating conditions. This invention relates to a high energy density Li/ CFx primary battery technology with substantial reduction in

Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care.

PubMed

Kimerling, Rachel; Iverson, Katherine M; Dichter, Melissa E; Rodriguez, Allison L; Wong, Ava; Pavao, Joanne

2016-08-01

The objectives of this study were to identify the prevalence of past-year intimate partner violence (IPV) among women Veterans utilizing Veterans Health Administration (VHA) primary care, and to document associated demographic, military, and primary care characteristics. This was a retrospective cohort design, where participants completed a telephone survey in 2012 (84% participation rate); responses were linked to VHA administrative data for utilization in the year prior to the survey. A national stratified random sample of 6,287 women Veteran VHA primary care users participated in the study. Past-year IPV was assessed using the HARK screening tool. Self-report items and scales assessed demographic and military characteristics. Primary care characteristics were assessed via self-report and VHA administrative data. The prevalence of past-year IPV among women Veterans was 18.5% (se = 0.5%), with higher rates (22.2% - 25.5%) among women up to age 55. Other demographic correlates included indicators of economic hardship, lesbian or bisexual orientation, and being a parent/guardian of a child less than 18 years old. Military correlates included service during Vietnam to post-Vietnam eras, less than 10 years of service, and experiences of Military Sexual Trauma (MST). Most (77.3%, se = 1.2%) women who experienced IPV identified a VHA provider as their usual provider. Compared with women who did not report past-year IPV, women who reported IPV had more primary care visits, yet experienced lower continuity of care across providers. The high prevalence of past-year IPV among women beyond childbearing years, the majority of whom primarily rely on VHA as a source of health care, reinforces the importance of screening all women for IPV in VHA primary care settings. Key considerations for service implementation include sensitivity with respect to sexual orientation, race/ethnicity, and other aspects of diversity, as well as care coordination and linkages with social services and MST-related care.

About the necessity to manage events coded with MedDRA prior to statistical analysis: proposal of a strategy with application to a randomized clinical trial, ANRS 099 ALIZE.

PubMed

Journot, Valérie; Tabuteau, Sophie; Collin, Fidéline; Molina, Jean-Michel; Chene, Geneviève; Rancinan, Corinne

2008-03-01

Since 2003, the Medical Dictionary for Regulatory Activities (MedDRA) is the regulatory standard for safety report in clinical trials in the European Community. Yet, we found no published example of a practical experience for a scientifically oriented statistical analysis of events coded with MedDRA. We took advantage of a randomized trial in HIV-infected patients with MedDRA-coded events to explain the difficulties encountered during the events analysis and the strategy developed to report events consistently with trial-specific objectives. MedDRA has a rich hierarchical structure, which allows the grouping of coded terms into 5 levels, the highest being "System Organ Class" (SOC). Each coded term may be related to several SOCs, among which one primary SOC is defined. We developed a new general 5-step strategy to select a SOC as trial primary SOC, consistently with trial-specific objectives for this analysis. We applied it to the ANRS 099 ALIZE trial, where all events were coded with MedDRA version 3.0. We compared the MedDRA and the ALIZE primary SOCs. In the ANRS 099 ALIZE trial, 355 patients were recruited, and 3,722 events were reported and documented, among which 35% had multiple SOCs (2 to 4). We applied the proposed 5-step strategy. Altogether, 23% of MedDRA primary SOCs were modified, mainly from MedDRA primary SOCs "Investigations" (69%) and "Ear and labyrinth disorders" (6%), for the ALIZE primary SOCs "Hepatobiliary disorders" (35%), "Musculoskeletal and connective tissue disorders" (21%), and "Gastrointestinal disorders" (15%). MedDRA largely enhanced in size and complexity with versioning and the development of Standardized MedDRA Queries. Yet, statisticians should not systematically rely on primary SOCs proposed by MedDRA to report events. A simple general 5-step strategy to re-classify events consistently with the trial-specific objectives might be useful in HIV trials as well as in other fields.

Risk scoring and thromboprophylactic treatment of patients with atrial fibrillation with and without access to primary healthcare data: experience from the Stockholm health care system.

PubMed

Forslund, Tomas; Wettermark, Björn; Wändell, Per; von Euler, Mia; Hasselström, Jan; Hjemdahl, Paul

2013-12-10

Earlier validation studies of risk scoring by CHA2DS2VASc for assessments of appropriateness of warfarin treatment in patients with atrial fibrillation have been performed solely with diagnoses recorded in hospital based care, even though many patients to a large extent are managed in primary care. Cross-sectional registry study of all 43 353 patients with a diagnosis of non-valvular atrial fibrillation recorded in inpatient care, specialist ambulatory care or primary care in the Stockholm County during 2006-2010. The mean CHA2DS2VASc score was 3.82 (4.67 for women and 3.14 for men). 64% of the entire cohort of patients with atrial fibrillation had the diagnosis in primary care (12% only there). The mean CHA2DS2VASc score of patients with a diagnosis only in inpatient care or specialist ambulatory care increased from 3.63 to 3.83 when comorbidities registered in primary care were added. In 2010 warfarin prescriptions were claimed by 47.2%, and ASA by 41.6% of the entire cohort. 34% of patients with CHA2DS2VASc=1 and 20% with CHA2DS2VASc=0 had warfarin treatment. ASA was more frequently used instead of warfarin among women and elderly patients. Registry CHA2DS2VASc scores were underestimated without co-morbidity data from primary care. Many individuals with scores 0 and 1 were treated with warfarin, despite poor documentation of clinical benefit. In contrast, warfarin appears to be underused and ASA overused among high risk atrial fibrillation patients. Lack of diagnoses from primary care underestimated CHA2DS2VASc scores and may thereby have overestimated treatment benefits in low-risk patients in earlier studies. © 2013.

Juvenile Onset HD

MedlinePlus

... the treating primary physician, neurologist, or psychiatrist including: Treating physician records documenting progression of motor, cognitive, and psychiatric symptoms, family history, and abnormal neurological exam findings consistent with ...

Primary Care, Self-rated Health, and Reductions in Social Disparities in Health

PubMed Central

Shi, Leiyu; Starfield, Barbara; Politzer, Robert; Regan, Jerri

2002-01-01

Objective To examine the extent to which good primary-care experience attenuates the adverse association of income inequality with self-reported health. Data Sources Data for the study were drawn from the Robert Wood Johnson Foundation sponsored 1996–1997 Community Tracking Study (CTS) Household Survey and state indicators of income inequality and primary care. Study Design Cross-sectional, mixed-level analysis on individuals with a primary-care physician as their usual source of care. The analyses were weighted to represent the civilian noninstitutionalized population of the continental United States. Data Collection/Extraction Methods Principal component factor analysis was used to explore the structure of the primary-care indicators and examine their construct validity. Income inequality for the state in which the community is located was measured by the Gini coefficient, calculated using income distribution data from the 1996 current population survey. Stratified analyses compared proportion of individuals reporting bad health and feeling depressed with those with good and bad primary-care experiences for each of the four income-inequality strata. A set of logistic regressions were performed to examine the relation between primary-care experience, income inequality, and self-rated health. Principal Findings Good primary-care experience, in particular enhanced accessibility and continuity, was associated with better self-reported health both generally and mentally. Good primary-care experience was able to reduce the adverse association of income inequality with general health although not with mental health, and was especially beneficial in areas with highest income inequality. Socioeconomic status attenuated, but did not eliminate, the effect of primary-care experience on health. In conclusion, good primary-care experience is associated not only with improved self-rated overall and mental health but also with reductions in disparities between more- and less-disadvantaged communities in ratings of overall health. PMID:12132594

A Concept For a Primary Author's Language (PAL-X)

ERIC Educational Resources Information Center

Ripota, Peter

A Primary Author's Language (PAL-X) has been developed to serve as a documentation language for computer-assisted instructional (CAI) programs. Its development was necessary to permit the dissemination of CAI given the facts that: 1)existing CAI programs were written in over 60 languages; 2)the system for COURSEWRITER II, the most commonly used…

A Deluge of Directives: Conflict between Collegiality and Managerialism in the Post-ERA Primary School.

ERIC Educational Resources Information Center

Webb, Rosemary; Vulliamy, Graham

1996-01-01

Examines the impact of innovations associated with the Education Reform Act (England) on the management of school change in primary schools. Documents growing tensions between collegial and top-down managerial styles based on quantitative data. Discusses ways to reconcile the emphasis on cooperative working within the context of increased…

Documentation of meteorological data from the coniferous forest biome primary station in Oregon.

Treesearch

R.H. Waring; H.R. Holbo; R.P. Bueb; R.L. Fredriksen

1978-01-01

As part of the International Biological Program, a primary meteorological station was installed in the west-central Cascade Range of Oregon. Short-wave solar radiation, air temperature, dewpoint temperature, windspeed, and precipitation are recorded continuously. Climatic data are summarized in a daily record available from May 11, 1972, to date. This report details...

Reflections on a Primary School Teacher Professional Development Programme on Learning English through Process Drama

ERIC Educational Resources Information Center

To, Lai-wa Dora; Chan, Yuk-lan Phoebe; Lam, Yin Krissy; Tsang, Shuk-kuen Yvonne

2011-01-01

This article documents the authors' reflections on a teacher professional development programme conducted in 38 Hong Kong primary schools on the teaching of English through Process Drama. The authors draw upon the views of school principals, subject panel head teachers, English teachers, students and parents in focus group interviews to examine…

Giving Women the Vote: Using Primary Source Documents to Teach about the Fight for Women's Suffrage.

ERIC Educational Resources Information Center

Jacobsen, Margaret

1988-01-01

Presents a lesson in which students use primary sources to learn about the organizing strategies used in the fight for women's suffrage. These sources will provide insights into the past and help students develop appreciation for the hardships suffragists endured. Includes objectives, procedures, and suggestions for activities. (LS)

Digital Media in Primary Schools: Literacy or Technology? Analyzing Government and Media Discourses

ERIC Educational Resources Information Center

Pereira, Sara; Pereira, Luís

2015-01-01

This article examines the political and the media discourses concerning the Portuguese governmental program responsible for delivering a laptop named "Magalhães" to all primary school children. The analysis is based on the official documents related to the launch and development of the initiative as well as the press coverage of this…

Life in a Democratic Society: A Primary School Civics Course for Poland.

ERIC Educational Resources Information Center

Brzakalik, Krystayna; And Others

This document summarizes a civics course for primary schools in Poland, grades 6-8. The curriculum was developed as part of the Education for Democratic Citizenship in Poland Project, a cooperative effort of the Polish Ministry of National Education and the Mershon Center, The Ohio State University (United States). The project aims to help schools…

Changes in Lithuanian Pre-School and Pre-Primary Education Quality over the Last Decade

ERIC Educational Resources Information Center

Monkeviciene, Ona; Stankeviciene, Kristina

2011-01-01

Over the last decade, the changes in Lithuanian pre-school and pre-primary education have been predetermined by changes in paradigms of children's education and strategic education documents that provided for guidelines of high quality children's (self-)education, an increasing attention of society to the quality of children's education, training…

Teachers' Involvement in Implementing the Basic Science and Technology Curriculum of the Nine-Year Basic Education

ERIC Educational Resources Information Center

Odili, John Nwanibeze; Ebisine, Sele Sylvester; Ajuar, Helen Nwakaife

2011-01-01

The study investigated teachers' involvement in implementing the basic science and technology curriculum in primary schools in WSLGA (Warri South Local Government Area) of Delta State. It sought to identify the availability of the document in primary schools and teachers' knowledge of the objectives and activities specified in the curriculum.…