RELATIONS BETWEEN PSYCHOPATHY FACETS AND EXTERNALIZING IN A CRIMINAL OFFENDER SAMPLE

PubMed Central

Patrick, Christopher J.; Hicks, Brian M.; Krueger, Robert F.; Lang, Alan R.

2008-01-01

The construct of psychopathy is viewed as comprising distinctive but correlated affective-interpersonal and social deviance facets. Here, we examined these facets of Hare's Psychopathy Checklist-Revised (PCL-R) in terms of their associations with the externalizing dimension of adult psychopathology, defined as the common factor underlying symptoms of conduct disorder, adult antisocial behavior, alcohol use/abuse, and drug abuse, along with disinhibitory personality traits. Correlational analyses revealed a strong relationship between this externalizing dimension and the social deviance facet of psychopathy (r = .84), and a lesser relationship with the emotional-interpersonal component (r = .44). Structural models controlling for the moderate overlap between the PCL-R factors revealed that externalizing was substantially related to the unique variance in the social deviance features of psychopathy, but unrelated to the unique variance of the emotional and interpersonal features whether modeled together or as separate factors. These results indicate that the social deviance factor of the PCL-R reflects the externalizing dimension of psychopathology, whereas the emotional-interpersonal component taps something distinct aside from externalizing. In addition, based on our finding of an association between PCL-R social deviance and externalizing, we were able to predict new relations between this facet of psychopathy and criterion variables, including nicotine use and gambling, that have previously been linked to externalizing. Implications for future research on the causes and correlates of psychopathy are discussed. PMID:16178678

Genetic vulnerability interacts with parenting and early care education to predict increasing externalizing behavior.

PubMed

Lipscomb, Shannon T; Laurent, Heidemarie; Neiderhiser, Jenae M; Shaw, Daniel S; Natsuaki, Misaki N; Reiss, David; Leve, Leslie D

2014-01-01

The current study examined interactions among genetic influences and children's early environments on the development of externalizing behaviors from 18 months to 6 years of age. Participants included 233 families linked through adoption (birth parents and adoptive families). Genetic influences were assessed by birth parent temperamental regulation. Early environments included both family (overreactive parenting) and out-of-home factors (center-based Early Care and Education; ECE). Overreactive parenting predicted more child externalizing behaviors. Attending center-based ECE was associated with increasing externalizing behaviors only for children with genetic liability for dysregulation. Additionally, children who were at risk for externalizing behaviors due to both genetic variability and exposure to center-based ECE were more sensitive to the effects of overreactive parenting on externalizing behavior than other children.

Genetic vulnerability interacts with parenting and early care education to predict increasing externalizing behavior

PubMed Central

Lipscomb, Shannon T.; Laurent, Heidemarie; Neiderhiser, Jenae M.; Shaw, Daniel S.; Natsuaki, Misaki N.; Reiss, David; Leve, Leslie D.

2014-01-01

The current study examined interactions among genetic influences and children’s early environments on the development of externalizing behaviors from 18 months to 6 years of age. Participants included 233 families linked through adoption (birth parents and adoptive families). Genetic influences were assessed by birth parent temperamental regulation. Early environments included both family (overreactive parenting) and out-of-home factors (center-based Early Care and Education; ECE). Overreactive parenting predicted more child externalizing behaviors. Attending center-based ECE was associated with increasing externalizing behaviors only for children with genetic liability for dysregulation. Additionally, children who were at risk for externalizing behaviors due to both genetic variability and exposure to center-based ECE were more sensitive to the effects of overreactive parenting on externalizing behavior than other children. PMID:25067867

Testing Models of Psychopathology in Preschool-aged Children Using a Structured Interview-based Assessment

PubMed Central

Dougherty, Lea R.; Bufferd, Sara J.; Carlson, Gabrielle A.; Klein, Daniel N.

2014-01-01

A number of studies have found that broadband internalizing and externalizing factors provide a parsimonious framework for understanding the structure of psychopathology across childhood, adolescence, and adulthood. However, few of these studies have examined psychopathology in young children, and several recent studies have found support for alternative models, including a bi-factor model with common and specific factors. The present study used parents’ (typically mothers’) reports on a diagnostic interview in a community sample of 3-year old children (n=541; 53.9 % male) to compare the internalizing-externalizing latent factor model with a bi-factor model. The bi-factor model provided a better fit to the data. To test the concurrent validity of this solution, we examined associations between this model and paternal reports and laboratory observations of child temperament. The internalizing factor was associated with low levels of surgency and high levels of fear; the externalizing factor was associated with high levels of surgency and disinhibition and low levels of effortful control; and the common factor was associated with high levels of surgency and negative affect and low levels of effortful control. These results suggest that psychopathology in preschool-aged children may be explained by a single, common factor influencing nearly all disorders and unique internalizing and externalizing factors. These findings indicate that shared variance across internalizing and externalizing domains is substantial and are consistent with recent suggestions that emotion regulation difficulties may be a common vulnerability for a wide array of psychopathology. PMID:24652485

Context matters: the experience of 14 research teams in systematically reporting contextual factors important for practice change.

PubMed

Tomoaia-Cotisel, Andrada; Scammon, Debra L; Waitzman, Norman J; Cronholm, Peter F; Halladay, Jacqueline R; Driscoll, David L; Solberg, Leif I; Hsu, Clarissa; Tai-Seale, Ming; Hiratsuka, Vanessa; Shih, Sarah C; Fetters, Michael D; Wise, Christopher G; Alexander, Jeffrey A; Hauser, Diane; McMullen, Carmit K; Scholle, Sarah Hudson; Tirodkar, Manasi A; Schmidt, Laura; Donahue, Katrina E; Parchman, Michael L; Stange, Kurt C

2013-01-01

We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors. Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important to interpreting their findings (internal validity) and transporting or reinventing their findings in other settings/situations (external validity). Each team provided a table or list of important contextual factors and interpretive text included as appendices to the articles in this supplement. Team members identified the most important contextual factors for their studies. We grouped the findings thematically and developed recommendations for reporting context. The most important contextual factors sorted into 5 domains: (1) the practice setting, (2) the larger organization, (3) the external environment, (4) implementation pathway, and (5) the motivation for implementation. To understand context, investigators recommend (1) engaging diverse perspectives and data sources, (2) considering multiple levels, (3) evaluating history and evolution over time, (4) looking at formal and informal systems and culture, and (5) assessing the (often nonlinear) interactions between contextual factors and both the process and outcome of studies. We include a template with tabular and interpretive elements to help study teams engage research participants in reporting relevant context. These findings demonstrate the feasibility and potential utility of identifying and reporting contextual factors. Involving diverse stakeholders in assessing context at multiple stages of the research process, examining their association with outcomes, and consistently reporting critical contextual factors are important challenges for a field interested in improving the internal and external validity and impact of health care research.

Development and validation of the ExPRESS instrument for primary health care providers' evaluation of external supervision.

PubMed

Schriver, Michael; Cubaka, Vincent Kalumire; Vedsted, Peter; Besigye, Innocent; Kallestrup, Per

2018-01-01

External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. "External supervision: Provider Evaluation of Supervisor Support" (ExPRESS) was developed in 18 steps, primarily in Rwanda. Content validity was optimised using systematic search for related instruments, interviews, translations, and relevance assessments by international supervision experts as well as local experts in Nigeria, Kenya, Uganda and Rwanda. Construct validity and reliability were examined in two separate field tests, the first using exploratory factor analysis and a test-retest design, the second for confirmatory factor analysis. We included 16 items in section A ('The most recent experience with an external supervisor'), and 13 items in section B ('The overall experience with external supervisors'). Item-content validity index was acceptable. In field test I, test-retest had acceptable kappa values and exploratory factor analysis suggested relevant factors in sections A and B used for model hypotheses. In field test II, models were tested by confirmatory factor analysis fitting a 4-factor model for section A, and a 3-factor model for section B. ExPRESS is a promising tool for evaluation of the quality of support of primary health care providers in external supervision of primary health care facilities in resource-constrained settings. ExPRESS may be used as specific feedback to external supervisors to help identify and address gaps in the supervision they provide. Further studies should determine optimal interpretation of scores and the number of respondents needed per supervisor to obtain precise results, as well as test the functionality of section B.

Pathfinder Project: Five-Year Strategic Plan.

ERIC Educational Resources Information Center

Pellissippi State Technical Community Coll., Knoxville, TN.

This 5-year strategic plan (prepared in 1994) from Pellissippi State Technical Community College in Tennessee examines macro environmental factors (including social, government, economic and technological trends); internal and external market share trends and opportunities; micro environmental factors (including organizational structure, financial…

Differences in risk and protective factors for workplace aggression between male and female clinical medical practitioners in Australia.

PubMed

Hills, Danny J

2017-07-01

Objectives The aim of the present study was to investigate differences in prevalence, as well as risk and protective factors, for exposure to workplace aggression between male and female clinicians in Australian medical practice settings. Methods In a cross-sectional, self-report study in the third wave of the Medicine in Australia: Balancing Employment and Life survey (2010-11), 16327 medical practitioners were sampled, with 9449 (57.9%) respondents working in clinical practice. Using backward stepwise elimination, parsimonious logistic regression models were developed for exposure to aggression from external (patients, patients' relatives or carers and others) and internal (co-workers) sources in the previous 12 months. Results Overall, greater proportions of female than male clinicians experienced aggression from external (P<0.001) and internal (P<0.01) sources in the previous 12 months. However, when stratified by doctor type, greater proportions of male than female general practitioners (GPs) and GP registrars experienced external aggression (P<0.05), whereas greater proportions of female than male specialists experienced external (P<0.01) and internal (P<0.01) aggression. In logistic regression models, differences were identified in relation to age for males and experience working in medicine for females with external and internal aggression; working in New South Wales (vs Victoria) and internal aggression for females; a poor medical support network and external aggression, and perceived unrealistic patient expectations with internal aggression for males; warning signs in reception and waiting areas with external aggression for males; and optimised patient waiting conditions with external and internal aggression for females. Conclusions Differences in risk and protective factors for exposure to workplace aggression between male and female clinicians, including in relation to state and rural location, need to be considered in the development and implementation of efforts to prevent and minimise workplace aggression in medical practice settings. What is known about the topic? Workplace aggression is prevalent in clinical medical settings, but there are conflicting reports about sex-based differences in the extent of exposure, and little evidence on differences in risk and protective factors for exposure to workplace aggression. What does this paper add? Differences in workplace aggression exposure rates between male and female clinicians are highlighted, including when stratified by doctor type. New evidence is reported on differences and similarities in key personal, professional and work-related factors associated with exposure to external and internal aggression. What are the implications for practitioners? In developing strategies for the prevention and minimisation of workplace aggression, consideration must be given to differences between male and female clinicians, including with regard to personality, age and professional experience, as well as work locations, conditions and settings, as risk or protective factors for exposure to aggression in medical work.

Diffusion of Impaired Driving Laws Among US States.

PubMed

Macinko, James; Silver, Diana

2015-09-01

We examined internal and external determinants of state's adoption of impaired driving laws. Data included 7 state-level, evidence-based public health laws collected from 1980 to 2010. We used event history analyses to identify predictors of first-time law adoption and subsequent adoption between state pairs. The independent variables were internal state factors, including the political environment, legislative professionalism, government capacity, state resources, legislative history, and policy-specific risk factors. The external factors were neighboring states' history of law adoption and changes in federal law. We found a strong secular trend toward an increased number of laws over time. The proportion of younger drivers and the presence of a neighboring state with similar laws were the strongest predictors of first-time law adoption. The predictors of subsequent law adoption included neighbor state adoption and previous legislative action. Alcohol laws were negatively associated with first-time adoption of impaired driving laws, suggesting substitution effects among policy choices. Organizations seeking to stimulate state policy changes may need to craft strategies that engage external actors, such as neighboring states, in addition to mobilizing within-state constituencies.

Diffusion of Impaired Driving Laws Among US States

PubMed Central

Silver, Diana

2015-01-01

Objectives. We examined internal and external determinants of state’s adoption of impaired driving laws. Methods. Data included 7 state-level, evidence-based public health laws collected from 1980 to 2010. We used event history analyses to identify predictors of first-time law adoption and subsequent adoption between state pairs. The independent variables were internal state factors, including the political environment, legislative professionalism, government capacity, state resources, legislative history, and policy-specific risk factors. The external factors were neighboring states’ history of law adoption and changes in federal law. Results. We found a strong secular trend toward an increased number of laws over time. The proportion of younger drivers and the presence of a neighboring state with similar laws were the strongest predictors of first-time law adoption. The predictors of subsequent law adoption included neighbor state adoption and previous legislative action. Alcohol laws were negatively associated with first-time adoption of impaired driving laws, suggesting substitution effects among policy choices. Conclusions. Organizations seeking to stimulate state policy changes may need to craft strategies that engage external actors, such as neighboring states, in addition to mobilizing within-state constituencies. PMID:26180969

Context Matters: The Experience of 14 Research Teams in Systematically Reporting Contextual Factors Important for Practice Change

PubMed Central

Tomoaia-Cotisel, Andrada; Scammon, Debra L.; Waitzman, Norman J.; Cronholm, Peter F.; Halladay, Jacqueline R.; Driscoll, David L.; Solberg, Leif I.; Hsu, Clarissa; Tai-Seale, Ming; Hiratsuka, Vanessa; Shih, Sarah C.; Fetters, Michael D.; Wise, Christopher G.; Alexander, Jeffrey A.; Hauser, Diane; McMullen, Carmit K.; Scholle, Sarah Hudson; Tirodkar, Manasi A.; Schmidt, Laura; Donahue, Katrina E.; Parchman, Michael L.; Stange, Kurt C.

2013-01-01

PURPOSE We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors. METHODS Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important to interpreting their findings (internal validity) and transporting or reinventing their findings in other settings/situations (external validity). Each team provided a table or list of important contextual factors and interpretive text included as appendices to the articles in this supplement. Team members identified the most important contextual factors for their studies. We grouped the findings thematically and developed recommendations for reporting context. RESULTS The most important contextual factors sorted into 5 domains: (1) the practice setting, (2) the larger organization, (3) the external environment, (4) implementation pathway, and (5) the motivation for implementation. To understand context, investigators recommend (1) engaging diverse perspectives and data sources, (2) considering multiple levels, (3) evaluating history and evolution over time, (4) looking at formal and informal systems and culture, and (5) assessing the (often nonlinear) interactions between contextual factors and both the process and outcome of studies. We include a template with tabular and interpretive elements to help study teams engage research participants in reporting relevant context. CONCLUSIONS These findings demonstrate the feasibility and potential utility of identifying and reporting contextual factors. Involving diverse stakeholders in assessing context at multiple stages of the research process, examining their association with outcomes, and consistently reporting critical contextual factors are important challenges for a field interested in improving the internal and external validity and impact of health care research. PMID:23690380

Experiment study on RC frame retrofitted by the external structure

NASA Astrophysics Data System (ADS)

Liu, Chunyang; Shi, Junji; Hiroshi, Kuramoto; Taguchi, Takashi; Kamiya, Takashi

2016-09-01

A new retrofitting method is proposed herein for reinforced concrete (RC) structures through attachment of an external structure. The external structure consists of a fiber concrete encased steel frame, connection slab and transverse beams. The external structure is connected to the existing structure through a connection slab and transverse beams. Pseudostatic experiments were carried out on one unretrofitted specimen and three retrofitted frame specimens. The characteristics, including failure mode, crack pattern, hysteresis loops behavior, relationship of strain and displacement of the concrete slab, are demonstrated. The results show that the load carrying capacity is obviously increased, and the extension length of the slab and the number of columns within the external frame are important influence factors on the working performance of the existing structure. In addition, the displacement difference between the existing structure and the outer structure was caused mainly by three factors: shear deformation of the slab, extraction of transverse beams, and drift of the conjunction part between the slab and the existing frame. Furthermore, the total deformation determined by the first two factors accounted for approximately 80% of the damage, therefore these factors should be carefully considered in engineering practice to enhance the effects of this new retrofitting method.

Internal and External Factors Related to Burnout among Iron and Steel Workers: A Cross-Sectional Study in Anshan, China.

PubMed

Guo, Haiqiang; Guo, Huifang; Yang, Yilong; Sun, Baozhi

2015-01-01

Burnout is a syndrome of emotional exhaustion, cynicism and reduced professional efficacy, which can result from long-term work stress. Although the burnout level is high among iron and steel workers, little is known concerning burnout among iron and steel worker. This study aimed to evaluate the burnout and to explore its associated internal and external factors in iron and steel workers. A cross-sectional survey was conducted in iron and steel workers at the Anshan iron-steel complex in Anshan, northeast China. Self-administered questionnaires were distributed to 1,600 workers, and finally 1,300 questionnaires were returned. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS). Effort-reward imbalance (ERI), perceived organizational support (POS), and psychological capital (PsyCap) were measured anonymously. A hierarchical regression model was applied to explore the internal and external factors associated with burnout. Mean MBI-GS scores were 13.11±8.06 for emotional exhaustion, 6.64±6.44 for cynicism, and 28.96±10.39 for professional efficacy. Hierarchical linear regression analysis showed that ERI and POS were the most powerful predictors for emotional exhaustion and cynicism, and PsyCap was the most robust predictor for high professional efficacy. Chinese iron and steel workers have a high level of burnout. Burnout might be associated with internal and external factors, including ERI, POS, and PsyCap. Further studies are recommended to develop an integrated model including both internal and external factors, to reduce the level of ERI, and improve POS and workers' PsyCap, thereby alleviating the level of burnout among iron and steel workers.

Internal and External Factors Related to Burnout among Iron and Steel Workers: A Cross-Sectional Study in Anshan, China

PubMed Central

Guo, Haiqiang; Guo, Huifang; Yang, Yilong; Sun, Baozhi

2015-01-01

Background Burnout is a syndrome of emotional exhaustion, cynicism and reduced professional efficacy, which can result from long-term work stress. Although the burnout level is high among iron and steel workers, little is known concerning burnout among iron and steel worker. This study aimed to evaluate the burnout and to explore its associated internal and external factors in iron and steel workers. Methods A cross-sectional survey was conducted in iron and steel workers at the Anshan iron-steel complex in Anshan, northeast China. Self-administered questionnaires were distributed to 1,600 workers, and finally 1,300 questionnaires were returned. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS). Effort-reward imbalance (ERI), perceived organizational support (POS), and psychological capital (PsyCap) were measured anonymously. A hierarchical regression model was applied to explore the internal and external factors associated with burnout. Results Mean MBI-GS scores were 13.11±8.06 for emotional exhaustion, 6.64±6.44 for cynicism, and 28.96±10.39 for professional efficacy. Hierarchical linear regression analysis showed that ERI and POS were the most powerful predictors for emotional exhaustion and cynicism, and PsyCap was the most robust predictor for high professional efficacy. Conclusions Chinese iron and steel workers have a high level of burnout. Burnout might be associated with internal and external factors, including ERI, POS, and PsyCap. Further studies are recommended to develop an integrated model including both internal and external factors, to reduce the level of ERI, and improve POS and workers’ PsyCap, thereby alleviating the level of burnout among iron and steel workers. PMID:26575031

Personality assessment inventory internalizing and externalizing structure in veterans with posttraumatic stress disorder: associations with aggression.

PubMed

Van Voorhees, Elizabeth E; Dennis, Paul A; Elbogen, Eric B; Clancy, Carolina P; Hertzberg, Michael A; Beckham, Jean C; Calhoun, Patrick S

2014-01-01

Posttraumatic stress disorder (PTSD) is associated with aggressive behavior in veterans, and difficulty controlling aggressive urges has been identified as a primary postdeployment readjustment concern. Yet only a fraction of veterans with PTSD commit violent acts. The goals of this study were to (1) examine the higher-order factor structure of Personality Assessment Inventory (PAI) scales in a sample of U.S. military veterans seeking treatment for PTSD; and (2) to evaluate the incremental validity of higher-order latent factors of the PAI over PTSD symptom severity in modeling aggression. The study sample included male U.S. Vietnam (n = 433) and Iraq/Afghanistan (n = 165) veterans who were seeking treatment for PTSD at an outpatient Veterans Affairs (VA) clinic. Measures included the Clinician Administered PTSD Scale, the PAI, and the Conflict Tactics Scale. The sample was randomly split into two equal subsamples (n's = 299) to allow for cross-validation of statistically derived factors. Parallel analysis, variable clustering analysis, and confirmatory factor analyses were used to evaluate the factor structure, and regression was used to examine the association of factor scores with self-reports of aggression over the past year. Three factors were identified: internalizing, externalizing, and substance abuse. Externalizing explained unique variance in aggression beyond PTSD symptom severity and demographic factors, while internalizing and substance abuse did not. Service era was unrelated to reports of aggression. The constructs of internalizing versus externalizing dimensions of PTSD may have utility in identifying characteristics of combat veterans in the greatest need of treatment to help manage aggressive urges. Published 2014 Wiley Periodicals, Inc.

Internal and external environmental factors affecting the performance of hospital-based home nursing care.

PubMed

Noh, J-W; Kwon, Y-D; Yoon, S-J; Hwang, J-I

2011-06-01

Numerous studies on HNC services have been carried out by signifying their needs, efficiency and effectiveness. However, no study has ever been performed to determine the critical factors associated with HNC's positive results despite the deluge of positive studies on the service. This study included all of the 89 training hospitals that were practising HNC service in Korea as of November 2006. The input factors affecting the performance were classified as either internal or external environmental factors. This analysis was conducted to understand the impact that the corresponding factors had on performance. Data were analysed by using multiple linear regressions. The internal and external environment variables affected the performance of HNC based on univariate analysis. The meaningful variables were internal environmental factors. Specifically, managerial resource (the number of operating beds and the outpatient/inpatient ratio) were meaningful when the multiple linear regression analysis was performed. Indeed, the importance of organizational culture (the passion of HNC nurses) was significant. This study, considering the limited market size of Korea, illustrates that the critical factor for the development of hospital-led HNC lies with internal environmental factors rather than external ones. Among the internal environmental factors, the hospitals' managerial resource-related factors (specifically, the passion of nurses) were the most important contributing element. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Exposure Factors Handbook (1996, External Review Draft)

EPA Science Inventory

This handbook provided a summary of the available statistical data on various factors used in assessing human exposure.

Volume I, General Factors, includes an introduction and discussion of uncertainty and provides data for drinking water consumption, soil ingestion, inha...

Family Resources as Protective Factors for Low-Income Youth Exposed to Community Violence.

PubMed

Hardaway, Cecily R; Sterrett-Hong, Emma; Larkby, Cynthia A; Cornelius, Marie D

2016-07-01

Exposure to community violence is a risk factor for internalizing and externalizing problems; however, resources within the family can decrease the likelihood that adolescents will experience internalizing and externalizing problems as a result of such exposure. This study investigates the potential moderating effects of kinship support (i.e., emotional and tangible support from extended family) and parental involvement on the relation between exposure to community violence (i.e., witnessing violence and violent victimization) and socioemotional adjustment (i.e., internalizing and externalizing problems) in low-income adolescents. The sample included 312 (50 % female; 71 % African American and 29 % White) low-income youth who participated in a longitudinal investigation when adolescents were age 14 (M age = 14.49 years) and again when they were 16 (M age = 16.49 years). Exposure to community violence at age 14 was related to more internalizing and externalizing problems at age 16. High levels of kinship support and parental involvement appeared to function as protective factors, weakening the association between exposure to violence and externalizing problems. Contrary to prediction, none of the hypothesized protective factors moderated the association between exposure to violence and internalizing problems. The results from this study suggest that both kinship support and parental involvement help buffer adolescents from externalizing problems that are associated with exposure to community violence.

Inner happiness among Thai elderly.

PubMed

Gray, Rossarin Soottipong; Rukumnuaykit, Pungpond; Kittisuksathit, Sirinan; Thongthai, Varachai

2008-09-01

This study, based on data collected in 2005 from Chai Nat province, examines the level of happiness of the Thai elderly population and its relationship to various external and internal factors. It was found that mean happiness was slightly above a feeling of "neutral." According to multiple regression analyses, external factors including economic hardship, living arrangements, functional ability, perceived social environment, and consumerism significantly influence the level of happiness. The strongest predictor of happiness is, however, the internal factor-that is, a feeling of relative poverty when compared to their neighbors. Controlling for demographic and all external factors, the respondents who do not feel poor show the highest level of happiness compared to those who feel as poor as or poorer than their neighbors. This is self-interpreted as a feeling of contentment with what one has, which has been influenced by Thai culture, which is pervaded by Buddhism.

A Qualitative Comparison of Susceptibility and Behavior in Recreational and Occupational Risk Environments: Implications for Promoting Health and Safety.

PubMed

Haas, Emily Joy; Mattson, Marifran

2016-06-01

Although internal factors that influence risk are frequently studied to understand human behavior, external factors, including social, cultural, and institutional factors, should be better utilized to inform ways to efficiently target, tailor, and promote safety messaging to at-risk populations. Semi-structured interviews obtained data from 37 motorcyclists and 18 mineworkers about their risk perceptions and behaviors within their respective dynamic environments. A comparative thematic analysis revealed information about external factors that influence risk perceptions and behaviors. Results support the importance of qualitative approaches for assessing and targeting individuals' risk perceptions and behaviors. In addition, segmenting at-risk subgroups within target populations and tailoring messages for these at-risk groups is critical for safety behavior modification. Practitioners should utilize strategic, culture-centric risk communication that takes into account external factors when determining when, who, and what to communicate via health promotion activities to more accurately disseminate valid, empathetic, and engaging communication with a higher level of fidelity.

Problem coping skills, psychosocial adversities and mental health problems in children and adolescents as predictors of criminal outcomes in young adulthood.

PubMed

Aebi, Marcel; Giger, Joël; Plattner, Belinda; Metzke, Christa Winkler; Steinhausen, Hans-Christoph

2014-05-01

The purpose of this study was to test child and adolescent psychosocial and psychopathological risk factors as predictors of adult criminal outcomes in a Swiss community sample. In particular, the role of active and avoidant problem coping in youths was analysed. Prevalence rates of young adult crime convictions based on register data were calculated. Univariate and multivariate logistic regressions were used to analyse the prediction of adult criminal convictions 15 years after assessment in a large Swiss community sample of children and adolescents (n = 1,086). Risk factors assessed in childhood and adolescence included socio-economic status (SES), migration background, perceived parental behaviour, familial and other social stressors, coping styles, externalizing and internalizing problems and drug abuse including problematic alcohol consumption. The rate of any young adult conviction was 10.1 %. Besides externalizing problems and problematic alcohol consumption, the presence of any criminal conviction in young adulthood was predicted by low SES and avoidant coping even after controlling for the effects of externalizing problems and problematic alcohol use. The other predictors were significant only when externalizing behaviours and problematic alcohol use were not controlled. In addition to child and adolescent externalizing behaviour problems and substance use, low SES and inadequate problem-solving skills, in terms of avoidant coping, are major risk factors of young adult criminal outcomes and need to be considered in forensic research and criminal prevention programs.

Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims

PubMed Central

Soberón, Carmen; Crespo, María; del Mar Gómez-Gutiérrez, María; Fernández-Lansac, Violeta; Armour, Cherie

2016-01-01

Background Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD) symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5) may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model) and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal. This model has received empirical support mainly in American samples. Of note, there have been a limited number of studies conducted on samples from other countries. Objective This study aimed to examine the underlying dimensionality of DSM-5 PTSD symptoms in a Spanish clinical sample exposed to a range of traumatic events. Method Participants included 165 adults (78.8% females) seeking treatment in trauma services in the Madrid area (Spain). PTSD was assessed using the Global Assessment of Posttraumatic Stress Scale 5, a Spanish self-report instrument assessing posttraumatic symptoms according to the DSM-5 criteria. Confirmatory factor analyses were conducted in Mplus. Results Both the 7-factor Hybrid model and the 6-factor Anhedonia model demonstrated good and equivalent fit to the data. Conclusions The findings of this study replicate and extend previous research by providing support for both the 7-factor Hybrid model and the 6-factor Anhedonia model in a clinical sample of Spanish trauma survivors. Given equivalent fit for these two models and the fewer number of latent factors in the Anhedonia model, it was selected as optimal in a traumatized Spanish sample. Implications and future research directions are discussed. Highlights of the article The 7-factor Hybrid model (which comprises the intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal symptoms clusters) and the 6-factor Anhedonia model (in which the externalizing behaviour symptoms are part of the dysphoric arousal symptom cluster) provided equivalent fit to the data. The Anhedonia model is the most parsimonious and thus the optimal-fitting model in the current sample. The findings support the distinctiveness between dysphoric arousal, anxious arousal, negative affect, and anhedonia factors. The separation of the externalizing behaviour symptoms from the dysphoric arousal symptoms does not improve the model fit in the current sample. PMID:27974133

Validity of the Externalizing Spectrum Inventory in a Criminal Offender Sample: Relations with Disinhibitory Psychopathology, Personality, and Psychopathic Features

PubMed Central

Venables, Noah C.; Patrick, Christopher J.

2013-01-01

The Externalizing Spectrum Inventory (ESI; Krueger, Markon, Patrick, Benning, & Kramer, 2007) provides a self-report based method for indexing a range of correlated problem behaviors and traits in the domain of deficient impulse control. The ESI organizes lower-order behaviors and traits of this kind around higher-order factors encompassing general disinhibitory proneness, callous-aggression, and substance abuse. The current study used data from a male prisoner sample (N = 235) to evaluate the validity of ESI total and factor scores in relation to external criterion measures consisting of externalizing disorder symptoms (including child and adult antisocial deviance and substance-related problems) assessed via diagnostic interview, personality traits assessed by self-report, and psychopathic features as assessed by both interview and self-report. Results provide evidence for the validity of the ESI measurement model and point to its potential utility as a referent for research on the neurobiological correlates and etiological bases of externalizing proneness. PMID:21787091

Validity of the Externalizing Spectrum Inventory in a criminal offender sample: relations with disinhibitory psychopathology, personality, and psychopathic features.

PubMed

Venables, Noah C; Patrick, Christopher J

2012-03-01

The Externalizing Spectrum Inventory (ESI; Krueger, Markon, Patrick, Benning, & Kramer, 2007) provides a self-report based method for indexing a range of correlated problem behaviors and traits in the domain of deficient impulse control. The ESI organizes lower order behaviors and traits of this kind around higher order factors encompassing general disinhibitory proneness, callous-aggression, and substance abuse. In the current study, we used data from a male prisoner sample (N = 235) to evaluate the validity of ESI total and factor scores in relation to external criterion measures consisting of externalizing disorder symptoms (including child and adult antisocial deviance and substance-related problems) assessed via diagnostic interviews, personality traits assessed with self-reports, and psychopathic features as assessed with both interviews and self-reports. Results provide evidence for the validity of the ESI measurement model and point to its potential usefulness as a referent for research on the neurobiological correlates and etiological bases of externalizing proneness.

Adjuvant radiotherapy for stage I endometrial cancer.

PubMed

Kong, A; Johnson, N; Cornes, P; Simera, I; Collingwood, M; Williams, C; Kitchener, H

2007-04-18

The role of adjuvant radiotherapy (both pelvic external beam radiotherapy and vaginal intracavity brachytherapy) in stage I endometrial cancer following total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO) remains unclear. To assess the efficacy of adjuvant radiotherapy following surgery for stage I endometrial cancer. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CancerLit, Physician Data Query (PDQ) of National Cancer Institute. Handsearching was also carried out where appropriate. Randomised controlled trials (RCTs) which compared adjuvant radiotherapy versus no radiotherapy following surgery for patients with stage I endometrial cancer were included. Quality of the studies was assessed and data collected using a predefined data collection form. The primary endpoint was overall survival. Secondary endpoints were locoregional recurrence, distant recurrence and endometrial cancer death. Data on quality of life (QOL) and morbidity were also collected. A meta-analysis on included trials was performed using the Cochrane Collaboration Review Manager Software 4.2. The meta-analysis was performed on four trials (1770 patients). The addition of pelvic external beam radiotherapy to surgery reduced locoregional recurrence, a relative risk (RR) of 0.28 (95% confidence interval (CI) 0.17 to 0.44, p < 0.00001), which is a 72% reduction in the risk of pelvic relapse (95% CI 56% to 83%) and an absolute risk reduction of 6% (95% CI of 4 to 8%). The number needed to treat (NNT) to prevent one locoregional recurrence is 16.7 patients (95% CI 12.5 to 25). The reduction in the risk of locoregional recurrence did not translate into either a reduction in the risk of distant recurrence or death from all causes or endometrial cancer death. A subgroup analysis of women with multiple high risk factors (including stage 1c and grade 3) showed a trend toward the reduction in the risk of death from all causes and endometrial cancer death in patients who underwent adjuvant external beam radiotherapy. Patients with stage I endometrial carcinoma have different risks of local and distant recurrence depending on the presence of risk factors including stage 1c, grade 3, lymphovascular space invasion and age. Though external beam pelvic radiotherapy reduced locoregional recurrence by 72%, there is no evidence to suggest that it reduced the risk of death. In patients with multiple high risk factors, including stage 1c and grade 3, there was a trend towards a survival benefit and adjuvant external beam radiotherapy may be justified. For patients with only one risk factor, grade 3 or stage 1c, no definite conclusion can be made and data from ongoing studies ( ASTEC; Lukka) are awaited. External beam radiotherapy carries a risk of toxicity and should be avoided in stage 1 endometrial cancer patients with no high risk factors.

Interaction Processes as a Mediating Factor between Children's Externalized Behaviour Difficulties and Engagement in Preschool

ERIC Educational Resources Information Center

Sjöman, Madeleine; Granlund, Mats; Almqvist, Lena

2016-01-01

This study examined social interaction as a mediator between externalized behaviour difficulties and children's engagement in preschool. Data from 663 children (340 boys), aged 18-71 months, were collected at 81 Swedish preschool units in six municipalities to test a path model that included child, teacher, and child groups. The results indicated…

[Incidence and influencing factors of distal external iliac lymph node metastasis in early cervical cancer].

PubMed

Yin, Yueju; Sheng, Xiugui; Li, Xinglan; Li, Dapeng; Han, Xiaoyun; Zhang, Xiaoling; Zhang, Tingting

2014-06-01

The distal external iliac lymph nodes are located along the external iliac artery between the deep circumflex iliac vein and the inguinal canal. Our study aimed to investigate the incidence of metastasis in distal external iliac lymph nodes and its association with clinicopathological factors in patients with early stage cervical cancer, and to determine the role of distal external iliac lymph nodes dissection in the surgery. Five hundred and twenty-four patients with early stage cervical cancer underwent radical hysterectomy and bilateral pelvic lymphadenectomy in the Shandong Province Cancer Hospital between June 1995 and December 2011, and their clinicopathological features were analyzed retrospectively. Of the 524 patients, 124 (23.7%) had pelvic lymph node metastasis. The metastasis rates were 16.2% (85 of 524 patients) in the obturator lymph nodes, 12.2% (64 of 524 patients) in the internal and external iliac lymph nodes, 2.9% (15 of 524 patients) in the common iliac lymph nodes, 2.1% (11 of 524 patients) in the distal external iliac lymph nodes, and 1.7% (9 of 524 patients) in the para-aortic nodes. The incidence of isolated positive distal external iliac lymph nodes was 0.2%. Univariate analysis showed that lymphovascular space invasion, pelvic lymph node metastases (excluding distal external iliac lymph nodes) were significantly associated with distal external iliac lymph node metastasis (P < 0.05). Logistic regression analysis showed that pelvic lymph node metastasis (excluding distal external iliac lymph nodes) was the independent risk factor for metastasis to distal external iliac lymph nodes. In early stage cervical cancer, distal external iliac lymph node metastasis is rare, especially in cases with stage IA or without pelvic lymph node metastasis. Less extensive pelvic lymphadenectomy may be considered in these patients in order to reduce operative complications and improve patients' quality of life. The deep circumflex iliac vein may be an appropriate landmark for the caudal limit of external iliac lymphadenectomy. However, if pelvic lymph node metastasis (excluding distal external iliac lymph nodes) is found by intraoperative rapid pathological diagnosis, systematic pelvic lymphadenectomy including removal of the distal external iliac lymph nodes should be performed in order to reduce the risk of distant metastasis.

Surgical site infections following craniotomy focusing on possible post-operative acquisition of infection: prospective cohort study.

PubMed

Sneh-Arbib, O; Shiferstein, A; Dagan, N; Fein, S; Telem, L; Muchtar, E; Eliakim-Raz, N; Rubinovitch, B; Rubin, G; Rappaport, Z H; Paul, M

2013-12-01

Neurosurgery is characterized by a prolonged risk period for surgical site infection (SSI), mainly related to the presence of cerebrospinal fluid (CSF) drains. We aimed to examine factors associated with post-neurosurgical SSIs, focusing on post-operative factors. A prospective cohort study was conducted in a single center over a period of 18 months in Israel. Included were adult patients undergoing clean or clean-contaminated craniotomy, including craniotomies with external CSF drainage or shunts. SSIs were defined by the Centers for Disease Control and Prevention (CDC) criteria for healthcare-associated infections. All patients were followed up for 90 days and those with foreign body insertion for 1 year. We compared patients with and without SSI. A multivariable regression analysis for SSI was conducted including uncorrelated variables significantly associated with SSI. A total of 502 patients were included, with 138 (27.5%) undergoing emergent or urgent craniotomy. The overall SSI rate was 5.6% (28 patients), of which 3.2% (16 patients) were intracerebral. Non-elective surgery, external CSF drainage/monitoring devices, re-operation, and post-operative respiratory failure were independently associated with subsequent SSI. External CSF devices was the only significant risk factor for intracerebral SSIs (p < 0.001). Internal shunts or other foreign body insertions were not associated with SSIs. A phenotypically identical isolate to that causing the SSI was isolated from respiratory secretions prior to the SSI in 4/9 patients with microbiologically documented intracerebral SSIs. Patients with SSIs had longer hospital stay, poorer functional capacity on discharge, and higher 90-day mortality. We raise the possibility of post-operative infection acquisition through external CSF devices. Standard operating procedures for their maintenance are necessary.

Temperament factors and dimensional, latent bifactor models of child psychopathology: Transdiagnostic and specific associations in two youth samples.

PubMed

Hankin, Benjamin L; Davis, Elysia Poggi; Snyder, Hannah; Young, Jami F; Glynn, Laura M; Sandman, Curt A

2017-06-01

Common emotional and behavioral symptoms co-occur and are associated with core temperament factors. This study investigated links between temperament and dimensional, latent psychopathology factors, including a general common psychopathology factor (p factor) and specific latent internalizing and externalizing liabilities, as captured by a bifactor model, in two independent samples of youth. Specifically, we tested the hypothesis that temperament factors of negative affectivity (NA), positive affectivity (PA), and effortful control (EC) could serve as both transdiagnostic and specific risks in relation to recent bifactor models of child psychopathology. Sample 1 included 571 youth (average age 13.6, SD =2.37, range 9.3-17.5) with both youth and parent report. Sample 2 included 554 preadolescent children (average age 7.7, SD =1.35, range =5-11 years) with parent report. Structural equation modeling showed that the latent bifactor models fit in both samples. Replicated in both samples, the p factor was associated with lower EC and higher NA (transdiagnostic risks). Several specific risks replicated in both samples after controlling for co-occurring symptoms via the p factor: internalizing was associated with higher NA and lower PA, lower EC related to externalizing problems. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Bending strength model for internal spur gear teeth

NASA Technical Reports Server (NTRS)

Savage, Michael; Rubadeux, K. L.; Coe, H. H.

1995-01-01

Internal spur gear teeth are normally stronger than pinion teeth of the same pitch and face width since external teeth are smaller at the base. However, ring gears which are narrower have an unequal addendum or are made of a material with a lower strength than that of the meshing pinion may be loaded more critically in bending. In this study, a model for the bending strength of an internal gear tooth as a function of the applied load pressure angle is presented which is based on the inscribed Lewis constant strength parabolic beam. The bending model includes a stress concentration factor and an axial compression term which are extensions of the model for an external gear tooth. The geometry of the Lewis factor determination is presented, the iteration to determine the factor is described, and the bending strength J factor is compared to that of an external gear tooth. This strength model will assist optimal design efforts for unequal addendum gears and gears of mixed materials.

European regional efficiency and geographical externalities: a spatial nonparametric frontier analysis

NASA Astrophysics Data System (ADS)

Ramajo, Julián; Cordero, José Manuel; Márquez, Miguel Ángel

2017-10-01

This paper analyses region-level technical efficiency in nine European countries over the 1995-2007 period. We propose the application of a nonparametric conditional frontier approach to account for the presence of heterogeneous conditions in the form of geographical externalities. Such environmental factors are beyond the control of regional authorities, but may affect the production function. Therefore, they need to be considered in the frontier estimation. Specifically, a spatial autoregressive term is included as an external conditioning factor in a robust order- m model. Thus we can test the hypothesis of non-separability (the external factor impacts both the input-output space and the distribution of efficiencies), demonstrating the existence of significant global interregional spillovers into the production process. Our findings show that geographical externalities affect both the frontier level and the probability of being more or less efficient. Specifically, the results support the fact that the spatial lag variable has an inverted U-shaped non-linear impact on the performance of regions. This finding can be interpreted as a differential effect of interregional spillovers depending on the size of the neighboring economies: positive externalities for small values, possibly related to agglomeration economies, and negative externalities for high values, indicating the possibility of production congestion. Additionally, evidence of the existence of a strong geographic pattern of European regional efficiency is reported and the levels of technical efficiency are acknowledged to have converged during the period under analysis.

Temperament and Externalizing Behavior: Social Preference and Perceived Acceptance as Protective Factors

PubMed Central

Berdan, Louise E.; Keane, Susan P.; Calkins, Susan D.

2009-01-01

The purpose of this study was to explore the role of social preference and perceived acceptance as moderators of the relation between child temperament and externalizing behavior. Participants included 399 children evaluated at pre-kindergarten and kindergarten assessments. Pre-kindergarten children characterized by high temperamental Surgency/Extraversion were more likely to exhibit hyperactivity and aggression in the kindergarten classroom. In addition, kindergarten perceived acceptance and social preference moderated the relation between pre-kindergarten Surgency/Extraversion and kindergarten hyperactivity for girls only. Girls who were characterized by high temperamental Surgency/Extraversion, high perceived acceptance, and low social preference were at risk for higher levels of teacher-reported and peer-nominated hyperactivity. In contrast, accurately high perceived acceptance was a protective factor for high temperamental Surgency/Extraversion. Findings are discussed in terms of risk and protective factors for externalizing behavior. PMID:18605827

The Environmental Factors Influencing Attrition.

ERIC Educational Resources Information Center

Villella, Edward F.

1986-01-01

Offers an economics/business-management perspective on student attrition, focusing on the external macro-environment (including such factors as government funding of education, changing enrollment patterns, and the increased number of postsecondary institutions) and the internal micro-environment (exhibiting characteristics of intangibility,…

Psychological assessment for adults and children

USDA-ARS?s Scientific Manuscript database

Psychological factors play a significant role in many nutritional abnormalities. These factors include mood (e.g., depression, anger, and anxiety), emotional eating, distorted body image, low self-esteem, poor self-efficacy and quality of life, dietary restraint, stress, susceptibility to external c...

Common Genetic and Nonshared Environmental Factors Contribute to the Association between Socioemotional Dispositions and the Externalizing Factor in Children

ERIC Educational Resources Information Center

Taylor, Jeanette; Allan, Nicholas; Mikolajewski, Amy J.; Hart, Sara A.

2013-01-01

Background: Childhood behavioral disorders including conduct disorder (CD), oppositional defiant disorder (ODD), and attention-deficit/hyperactivity disorder (ADHD) often co-occur. Prior twin research shows that common sets of genetic and environmental factors are associated with these various disorders and they form a latent factor called…

The Internalizing and Externalizing Structure of Psychiatric Comorbidity in Combat Veterans

PubMed Central

Miller, Mark W.; Fogler, Jason M.; Wolf, Erika J.; Kaloupek, Danny G.; Keane, Terence M.

2013-01-01

This study examined the latent structure of psychiatric disorders in a sample with a high prevalence of PTSD. A series of confirmatory factor analyses tested competing models for the covariation between SCID diagnoses among 1,325 Vietnam veterans. The best fitting solution was a three-factor model that included two correlated internalizing factors: anxious-misery, defined by PTSD and major depression, and fear, defined by panic disorder/agoraphobia and obsessive-compulsive disorder. The third factor, externalizing, was defined by antisocial personality disorder, alcohol abuse/dependence, and drug abuse/dependence. Both substance-related disorders also showed significant, albeit smaller, cross-loadings on the anxious-misery factor. These findings shed new light on the structure of psychiatric comorbidity in a treatment-seeking sample characterized by high rates of PTSD. PMID:18302181

Government policies, industry/economics, social trends, and educational opportunities in 'women's decisions to work outside versus inside the home.

PubMed

Bosco, Susan M

2002-12-01

Research on the career decision processes of women has focused primarily on internal considerations such as mathematical ability, intelligence, and self-esteem; however, the external environment also has an influence on these processes. To date, the environmental factors have primarily been researched separately, if at all. They include government policies, industry/economics, social trends/expected sex roles, and educational opportunities. This pilot study investigated these four external factors simultaneously. In addition, a survey of literature on career decision indicated such research to be based on a limited pool of highly educated, management/professional women. This study also uses a wider group including housewives, blue collar, and pink collar women.

The Relationship Between the Genetic and Environmental Influences on Common Externalizing Psychopathology and Mental Wellbeing

PubMed Central

Kendler, Kenneth S.; Myers, John M.; Keyes, Corey L. M.

2012-01-01

To determine the relationship between the genetic and environmental risk factors for externalizing psychopathology and mental wellbeing, we examined detailed measures of emotional, social and psychological wellbeing, and a history of alcohol-related problems and smoking behavior in the last year in 1,386 individual twins from same-sex pairs from the MIDUS national US sample assessed in 1995. Cholesky decomposition analyses were performed with the Mx program. The best fit model contained one highly heritable common externalizing psychopathology factor for both substance use/abuse measures, and one strongly heritable common factor for the three wellbeing measures. Genetic and environmental risk factors for externalizing psychopathology were both negatively associated with levels of mental wellbeing and accounted for, respectively, 7% and 21% of its genetic and environmental influences. Adding internalizing psychopathology assessed in the last year to the model, genetic risk factors unique for externalizing psychopathology were now positively related to levels of mental wellbeing, although accounting for only 5% of the genetic variance. Environmental risk factors unique to externalizing psychopathology continued to be negatively associated with mental wellbeing, accounting for 26% of the environmental variance. When both internalizing psychopathology and externalizing psychopathology are associated with mental wellbeing, the strongest risk factors for low mental wellbeing are genetic factors that impact on both internalizing psychopathology and externalizing psychopathology, and environmental factors unique to externalizing psychopathology. In this model, genetic risk factors for externalizing psychopathology predict, albeit weakly, higher levels of mental wellbeing. PMID:22506307

Health locus of control as manifested in individuals attending a state-run medical dispensary in northern India.

PubMed

Berg, Michael B; Anshika, Avi

2017-04-01

To investigate the health locus of control (HLOC) beliefs of patients and visitors at a free, state-run medical clinic in Faridabad, India, in order to establish a norm for this population and to explore potential associations between the different categories of causal health beliefs. Participants (110 men, 96 women) were interviewed in Hindi and asked a shortened version of the Multidimensional Health Locus of Control Scale assessing both internal HLOC and three aspects of external HLOC (chance, powerful others, and God). Additional variables of interest included a Traditional Values Scale, a measure of spirituality, an assessment of health status, and demographic information including gender, age, employment status, and religion. Participants rated the external-God factor as a stronger determinant of their health than the internal or other external HLOC factors. Internal HLOC was positively correlated with external HLOC in terms of chance and the role of powerful others and these associations were strongest for the most interdependent participants (i.e. women and the unemployed). For patients and visitors at the Faridabad clinic, religion played a significant role in their causal health beliefs. In addition, internal HLOC was positively associated with aspects of external locus of control, suggesting that causal health beliefs were viewed in a holistic, integrated fashion. Interventions based on these findings are suggested.

Transformation of socio-cultural aspect of gated housing’s residence in Medan City, Indonesia.

NASA Astrophysics Data System (ADS)

Nirfalini Aulia, Dwira

2018-03-01

Gated Community Housing develops rapidly in Medan City and other big cities in Indonesia. These housing types initially reserved for middle to high-income residents. Transformation can describe as changes from one condition to another condition that can happen continuously in time. Change is affected by internal and external factors. Internal factors include culture, perspective, and social system while external factors include science progress and other cultural influence. This research is a descriptive study which tries to describe the phenomenon that is currently ongoing. Gated housing chosen are Perumahan Taman Setia Budi Indah, Perumahan Bumi Asri dan Perumahan Graha Helvetia. Characteristics of gated housing’s residents transform by the regional or national socioeconomic transformation. The structure and function of human social life are not uniform; meaning in every social life setting each of the structure and function are different. The characteristic of a community will transform in continuity.

Examining the relationship between authenticity and self-handicapping.

PubMed

Akin, Ahmet; Akin, Umran

2014-12-01

Self-handicapping includes strategies of externalization in which people excuse failure and internalize success, but which also prevents them from behaving in an authentic way. The goal was to investigate the relation of authenticity with self-handicapping. The study was conducted with 366 university students (176 men, 190 women; M age = 20.2 yr.). Participants completed the Turkish version of the Authenticity Scale and the Self-handicapping Scale. Self-handicapping was correlated positively with two factors of authenticity, accepting external influence and self-alienation, and negatively with the authentic living factor. A multiple regression analysis indicated that self-handicapping was predicted positively by self-alienation and accepting external influence and negatively by authentic living, accounting for 21% of the variance collectively. These results demonstrated the negative association of authenticity with self-handicapping.

Solar thermal electricity generation

NASA Astrophysics Data System (ADS)

Gasemagha, Khairy Ramadan

1993-01-01

This report presents the results of modeling the thermal performance and economic feasibility of large (utility scale) and small solar thermal power plants for electricity generation. A number of solar concepts for power systems applications have been investigated. Each concept has been analyzed over a range of plant power ratings from 1 MW(sub e) to 300 MW(sub e) and over a range of capacity factors from a no-storage case (capacity factor of about 0.25 to 0.30) up to intermediate load capacity factors in the range of 0.46 to 0.60. The solar plant's economic viability is investigated by examining the effect of various parameters on the plant costs (both capital and O & M) and the levelized energy costs (LEC). The cost components are reported in six categories: collectors, energy transport, energy storage, energy conversion, balance of plant, and indirect/contingency costs. Concentrator and receiver costs are included in the collector category. Thermal and electric energy transport costs are included in the energy transport category. Costs for the thermal or electric storage are included in the energy storage category; energy conversion costs are included in the energy conversion category. The balance of plant cost category comprises the structures, land, service facilities, power conditioning, instrumentation and controls, and spare part costs. The indirect/contingency category consists of the indirect construction and the contingency costs. The concepts included in the study are (1) molten salt cavity central receiver with salt storage (PFCR/R-C-Salt); (2) molten salt external central receiver with salt storage (PFCR/R-E-Salt); (3) sodium external central receiver with sodium storage (PFCR/RE-Na); (4) sodium external central receiver with salt storage (PFCR/R-E-Na/Salt); (5) water/steam external central receiver with oil/rock storage (PFCR/R-E-W/S); (6) parabolic dish with stirling engine conversion and lead acid battery storage (PFDR/SLAB); (7) parabolic dish with stirling engine conversion and redox advanced battery storage (PFDR/S-RAB); and (8) parabolic trough with oil/rock storage (LFDR/R-HT-45). Key annual efficiency and economic results of the study are highlighted in tabular format for plant sizes and capacity factor that resulted in the lowest LEC over the analysis range.

Factors Promoting Mental Health of Adolescents Who Have a Parent with Mental Illness: A Longitudinal Study.

PubMed

Van Loon, L M A; Van De Ven, M O M; Van Doesum, K T M; Hosman, C M H; Witteman, C L M

Children of parents with mental illness have an elevated risk of developing a range of mental health and psychosocial problems. Yet many of these children remain mentally healthy. The present study aimed to get insight into factors that protect these children from developing internalizing and externalizing problems. Several possible individual, parent-child, and family protective factors were examined cross-sectionally and longitudinally in a sample of 112 adolescents. A control group of 122 adolescents whose parents have no mental illness was included to explore whether the protective factors were different between adolescents with and without a parent with mental illness. Cross-sectional analyses revealed that high self-esteem and low use of passive coping strategies were related to fewer internalizing and externalizing problems. Greater self-disclosure was related to fewer internalizing problems and more parental monitoring was related to fewer externalizing problems. Active coping strategies, parental support, and family factors such as cohesion were unrelated to adolescent problem behavior. Longitudinal analyses showed that active coping, parental monitoring, and self-disclosure were protective against developing internalizing problems 2 years later. We found no protective factors for externalizing problems. Moderation analyses showed that the relationships between possible protective factors and adolescent problem behavior were not different for adolescents with and without a parent with mental illness. The findings suggest that adolescents' active coping strategies and parent-child communication may be promising factors to focus on in interventions aimed at preventing the development of internalizing problems by adolescents who have a parent with mental illness.

Apples or candy? Internal and external influences on children's food choices.

PubMed

Bruce, Amanda S; Lim, Seung-Lark; Smith, Timothy Ryan; Cherry, J Bradley C; Black, William R; Davis, Ann M; Bruce, Jared M

2015-10-01

The goal of this concise narrative review is to examine the current literature regarding endogenous and exogenous influences on youth food choices. Specifically, we discuss internal factors such as interoception (self-awareness) of pain and hunger, and neural mechanisms (neurofunctional aspects) of food motivation. We also explore external factors such as early life feeding experiences (including parenting), social influences (peers), and food marketing (advertising). We conclude with a discussion of the overlap of these realms and future directions for the field of pediatric food decision science. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factors Influencing Adoption of Hospital-Acquired Pressure Ulcer Prevention Programs in US Academic Medical Centers.

PubMed

Padula, William V; Valuck, Robert J; Makic, Mary Beth F; Wald, Heidi L

2015-01-01

Recent data show a decrease in hospital-acquired pressure ulcers (PUs) throughout US hospitals; these changes may be associated with increased success in implementing evidence-based practices for PU prevention. The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced the overall reduction of PUs. Cross-sectional descriptive survey. Surveys were sent to wound care nurses at 98 University HealthSystem Consortium (UHC) hospitals. The UHC consists of more than 120 academic medical centers and affiliated facilities across the United States. Responses solicited from this survey represented a geographically diverse set of hospitals from less than 200 beds to more than 1000 beds. The survey questionnaire used a framework of 7 internal and 5 external influential factors for implementing evidence-based practices for PU prevention. Internal influential factors queried included availability of nurse specialists, high nursing job turnover, high PU rates, and prevention campaigns. External influential factors included data sharing, Medicare nonpayment policy, and applications for Magnet recognition. Hospital-acquired PU prevention experts at UHC hospitals were contacted through the Wound, Ostomy and Continence Nurses Society membership directory to complete the questionnaire. Consenting participants were e-mailed a disclosure and online questionnaire; they were also sent monthly reminders until they either responded to the survey or declined participation. Fifty-five respondents (59% response rate) indicated several internal factors that influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns; application for Magnet recognition; data sharing among peer institutions; and regulatory issues. These findings suggest that the Centers for Medicare & Medicaid Services nonpayment policy influenced a large majority of hospital's changes in practice. The availability of nursing specialists for wound consult influenced hospitals internally. These factors are informative of the impact policy has on changes in hospital prioritization of adopting evidence-based practices for PU prevention.

Measurement and description of underlying dimensions of comorbid mental disorders using Factor Mixture Models: results of the ESEMeD project.

PubMed

Almansa, Josué; Vermunt, Jeroen K; Forero, Carlos G; Vilagut, Gemma; De Graaf, Ron; De Girolamo, Giovanni; Alonso, Jordi

2011-06-01

Epidemiological studies on mental health and mental comorbidity are usually based on prevalences and correlations between disorders, or some other form of bivariate clustering of disorders. In this paper, we propose a Factor Mixture Model (FMM) methodology based on conceptual models aiming to measure and summarize distinctive disorder information in the internalizing and externalizing dimensions. This methodology includes explicit modelling of subpopulations with and without 12 month disorders ("ill" and "healthy") by means of latent classes, as well as assessment of model invariance and estimation of dimensional scores. We applied this methodology with an internalizing/externalizing two-factor model, to a representative sample gathered in the European Study of the Epidemiology of Mental Disorders (ESEMeD) study -- which includes 8796 individuals from six countries, and used the CIDI 3.0 instrument for disorder assessment. Results revealed that southern European countries have significantly higher mental health levels concerning internalizing/externalizing disorders than central countries; males suffered more externalizing disorders than women did, and conversely, internalizing disorders were more frequent in women. Differences in mental-health level between socio-demographic groups were due to different proportions of healthy and ill individuals and, noticeably, to the ameliorating influence of marital status on severity. An advantage of latent model-based scores is that the inclusion of additional mental-health dimensional information -- other than diagnostic data -- allows for greater precision within a target range of scores. Copyright © 2011 John Wiley & Sons, Ltd.

Factor structure of DSM-5 PTSD symptoms in trauma-exposed adolescents: Examining stability across time.

PubMed

Wang, Li; Cao, Xing; Cao, Chengqi; Fang, Ruojiao; Yang, Haibo; Elhai, Jon D

2017-12-01

This study investigated the latent structure of DSM-5 PTSD symptoms using two-wave longitudinal data collected from a sample of adolescents exposed to an explosion accident. Two waves of surveys were conducted approximately 3 and 8 months after the accident, respectively. A total of 836 students completed the baseline survey, and 762 students completed the follow-up survey. The results of confirmatory factor analyses(CFA) indicated that a seven-factor hybrid model composed of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal and dysphoric arousal factors yielded significantly better data fit at both waves than the other models including the DSM-5 four-factor model, the six-factor anhedonia and externalizing behaviors models. Furthermore, the results of CFA invariance tests supported the longitudinal invariance of the model. Implications and limitations in terms of these results are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Workplace Ostracism Seen through the Lens of Power

PubMed Central

Fiset, John; Al Hajj, Raghid; Vongas, John G.

2017-01-01

Drawing on approach/inhibition theory of power, we investigated two factors that influence the manner by which victims react to workplace ostracism: the hierarchical status of the ostracizer and the level of an ostracizee’s external social support including family, friends, and significant others. Across an experimental vignette study (Study 1) and a field study (Study 2), we found support for a three-way interaction with felt ostracism, ostracizee external social support, and ostracizer status influencing victims’ organizational citizenship behavior and deviance directed toward other individuals. In addition, felt ostracism and ostracizee external social support interacted to predict turnover intentions. Overall, victims who were ostracized by a legitimate higher-status authority (e.g., manager) and whose external social support network was limited experienced the most negative outcomes across both studies. Our findings suggest that contextual factors both inside and outside the organization jointly impact the way in which individuals react to perceived workplace ostracism. Implications and future research directions are discussed. PMID:28928702

Electrostatic separation for recycling waste printed circuit board: a study on external factor and a robust design for optimization.

PubMed

Hou, Shibing; Wu, Jiang; Qin, Yufei; Xu, Zhenming

2010-07-01

Electrostatic separation is an effective and environmentally friendly method for recycling waste printed circuit board (PCB) by several kinds of electrostatic separators. However, some notable problems have been detected in its applications and cannot be efficiently resolved by optimizing the separation process. Instead of the separator itself, these problems are mainly caused by some external factors such as the nonconductive powder (NP) and the superficial moisture of feeding granule mixture. These problems finally lead to an inefficient separation. In the present research, the impacts of these external factors were investigated and a robust design was built to optimize the process and to weaken the adverse impact. A most robust parameter setting (25 kv, 80 rpm) was concluded from the experimental design. In addition, some theoretical methods, including cyclone separation, were presented to eliminate these problems substantially. This will contribute to efficient electrostatic separation of waste PCB and make remarkable progress for industrial applications.

What's Wrong with Library Organization? Factors Leading to Restructuring in Research Libraries.

ERIC Educational Resources Information Center

Hewitt, Joe A.

1997-01-01

Discusses the need for organizational change in academic research libraries, based on a study of a small group of libraries that had experienced varying degrees of restructuring and had analyzed factors that energized change. Highlights include organizational flexibility, external or client-centered orientation, staff empowerment, and improving…

Success Stories: Biographical Narratives of Three Women School Principals in Kenya

ERIC Educational Resources Information Center

Mayienga, Damaris Moraa

2013-01-01

Studies indicate that women are poorly represented in school leadership across the various regions of the world particularly in developing countries. Most studies explain this underrepresentation in terms of external or institutional factors that have impeded women's advancement onto school leadership. Such factors include women's lack of…

Correlates of High School Freshman Girls' Reported Reasons for Engaging in Sexual Intercourse

ERIC Educational Resources Information Center

Smith, Matthew Lee; Wilson, Kelly; Menn, Mindy; Pulczinski, Jairus C.

2014-01-01

Background: Intrapersonal and external factors, including social pressures and the desire for acceptance from peers, influence sexual activity among adolescents. This study examined how personal characteristics, risky behaviors, normative beliefs, household factors, and engagement in extracurricular activities were related to high school freshman…

Parent and Child Personality Traits and Children's Externalizing Problem Behavior from Age 4 to 9 Years: A Cohort-Sequential Latent Growth Curve Analysis

ERIC Educational Resources Information Center

Prinzie, P.; Onghena, P.; Hellinckx, W.

2005-01-01

Cohort-sequential latent growth modeling was used to analyze longitudinal data for children's externalizing behavior from four overlapping age cohorts (4, 5, 6, and 7 years at first assessment) measured at three annual time points. The data included mother and father ratings on the Child Behavior Checklist and the Five-Factor Personality Inventory…

What are the trends and demographics in sports-related pediatric spinal cord injuries?

PubMed

Nadarajah, Vidushan; Jauregui, Julio J; Perfetti, Dean; Shasti, Mark; Koh, Eugene Y; Henn, Ralph Frank

2018-02-01

Pediatric spinal cord injury (PSCI) is a devastating injury that can cause significant long-term consequences. The purpose of this study is to calculate and report the prevalence of PSCI, identify risk factors for sports-related PSCI, and evaluate associated factors. The data sets of the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) from 2000-2012 were analyzed using ICD-9-CM external cause of injury codes to identify the mechanism of injury contributing to PSCI hospitalization. We then extracted demographic data on each admission including age, gender, race, and year of admission. We further stratified the data by sports-related cases of injury. Multivariate logistic regression analyses were used to identify independent risk factors. Of our study population, 0.8% had a documented diagnosis of spinal cord injury (SCI). The most common documented external cause of injury code was motor vehicle accidents, representing roughly half of all cases in patients 0-9 years-old (p = 0.001). PSCI due to sports as an external cause of injury was more prevalent in patients 10-17 years old, and was especially prevalent in the 10-13 year-old age category in which sports-related PSCI reached a high of 25.6%. Risk factors for traumatic PSCI after a sports-related external cause included being of older age, male, and white. The prevalence of SCI increased with age. Given the popularity of youth sports in the United States, parents and sports officials should be aware of the increased risk of sports-related PSCI among patients 10-17 years old. Level III, retrospective cohort study.

The Structure of Personality Disorders in Individuals with Posttraumatic Stress Disorder

PubMed Central

Wolf, Erika J.; Miller, Mark W.; Brown, Timothy A.

2015-01-01

Research on the structure of personality disorders (PDs) has relied primarily on exploratory analyses to evaluate trait-based models of the factors underlying the covariation of these disorders. This study used confirmatory factor analysis to evaluate whether a model that included both PD traits and a general personality dysfunction factor would account for the comorbidity of the PDs better than a trait-only model. It also examined if the internalizing/externalizing model of psychopathology, developed previously through research on the structure of Axis I disorders, might similarly account for the covariation of the Axis II disorders in a sample of 245 veterans and non-veterans with posttraumatic stress disorder. Results indicated that the best fitting model was a modified bifactor structure composed of nine lower-order common factors. These factors indexed pathology ranging from aggression to dependency, with the correlations among them accounted for by higher-order Internalizing and Externalizing factors. Further, a general factor, reflecting a construct that we termed boundary disturbance, accounted for additional variance and covariance across nearly all the indicators. The Internalizing, Externalizing, and Boundary Disturbance factors evidenced differential associations with trauma-related covariates. These findings suggest continuity in the underlying structure of psychopathology across DSM-IV Axes I & II and provide empirical evidence of a pervasive, core disturbance in the boundary between self and other across the PDs. PMID:22448802

Managing motivation and developing job satisfaction in the health care work environment.

PubMed

Timmreck, T C

2001-09-01

Motivation relies on internal/intrinsic and external factors to stimulate work-related behavior. This article presents an overview of Herzberg's motivation-hygiene theory and reports on the results of a study of 99 health service midmanagers. The participants completed a survey asking whether they believe in motivational factors and if they use them. Several of Herzberg's motivational factors were included (achievement, recognition, work itself, responsibility, advancement) plus several other motivational factors including money/pay, self-interest, seek a higher standard of living. Negative factors included guilt, threats, power, and control. This article presents motivation factors, such as achievement, recognition, work itself, responsibility, advancement, growth, self-interest, pay, and belief in successful outcome, that were presented to 99 mid-level health services administrators.

Interrelations of maternal expressed emotion, maltreatment, and separation/divorce and links to family conflict and children's externalizing behavior.

PubMed

Narayan, Angela; Cicchetti, Dante; Rogosch, Fred A; Toth, Sheree L

2015-02-01

Research has documented that maternal expressed emotion-criticism (EE-Crit) from the Five-Minute Speech Sample (FMSS) predicts family conflict and children's externalizing behavior in clinical and community samples. However, studies have not examined EE-Crit in maltreating or separated/divorced families, or whether these family risks exacerbate the links between EE-Crit and family conflict and externalizing behavior. The current study examined the associations between maternal EE-Crit, maltreatment, and separation/divorce, and whether maltreatment and separation/divorce moderated associations between EE-Crit and children's externalizing problems, and EE-Crit and family conflict. Participants included 123 children (M = 8.01 years, SD = 1.58; 64.2 % males) from maltreating (n = 83) or low-income, comparison (n = 40) families, and 123 mothers (n = 48 separated/divorced). Mothers completed the FMSS for EE-Crit and the Family Environment Scale for family conflict. Maltreatment was coded with the Maltreatment Classification System using information from official Child Protection Services (CPS) reports from the Department of Human Services (DHS). Trained summer camp counselors rated children's externalizing behavior. Maltreatment was directly associated with higher externalizing problems, and separation/divorce, but not maltreatment, moderated the association between EE-Crit and externalizing behavior. Analyses pertaining to family conflict were not significant. Findings indicate that maltreatment is a direct risk factor for children's externalizing behavior and separation/divorce is a vulnerability factor for externalizing behavior in family contexts with high maternal EE-Crit. Intervention, prevention, and policy efforts to promote resilience in high-risk families may be effective in targeting maltreating and critical parents, especially those with co-occurring separation/divorce. Key Words: expressed emotion, EE-Crit, Five-Minute Speech Sample; maltreatment, divorce, externalizing behavior.

Genetic and environmental influences on the familial transmission of externalizing disorders in adoptive and twin offspring.

PubMed

Hicks, Brian M; Foster, Katherine T; Iacono, William G; McGue, Matt

2013-10-01

Twin-family studies have shown that parent-child resemblance on substance use disorders and antisocial behavior can be accounted for by the transmission of a general liability to a spectrum of externalizing disorders. Most studies, however, include only biological parents and offspring, which confound genetic and environmental transmission effects. To examine the familial transmission of externalizing disorders among both adoptive (genetically unrelated) and biological relatives to better distinguish genetic and environmental mechanisms of transmission. Family study design wherein each family included the mother, father, and 2 offspring, including monozygotic twin, dizygotic twin, nontwin biological, and adoptive offspring. Structural equation modeling was used to estimate familial transmission effects and their genetic and environmental influences. Participants were recruited from the community and assessed at a university laboratory. A total of 1590 families with biological offspring and 409 families with adoptive offspring. Offspring participants were young adults (mean age, 26.2 years). Symptom counts of conduct disorder, adult antisocial behavior, and alcohol, nicotine, and drug dependence. RESULTS There was a medium effect for the transmission of the general externalizing liability for biological parents (r = 0.27-0.30) but not for adoptive parents (r = 0.03-0.07). In contrast, adoptive siblings exhibited significant similarity on the general externalizing liability (r = 0.21). Biometric analyses revealed that the general externalizing liability was highly heritable (a2 = 0.61) but also exhibited significant shared environmental influences (c2 = 0.20). Parent-child resemblance for substance use disorders and antisocial behavior is primarily due to the genetic transmission of a general liability to a spectrum of externalizing disorders. Including adoptive siblings revealed a greater role of shared environmental influences on the general externalizing liability than previously detected in twin studies and indicates that sibling rather than parent-child similarity indexes important environmental risk factors for externalizing disorders.

Risk factors for overuse shoulder injuries in a mixed-sex cohort of 329 elite handball players: previous findings could not be confirmed.

PubMed

Andersson, Stig Haugsboe; Bahr, Roald; Clarsen, Benjamin; Myklebust, Grethe

2017-08-07

Shoulder injuries are common among handball players and predominantly characterised by overuse characteristics. Reduced total glenohumeral rotation, external rotation weakness and scapular dyskinesis have been identified as risk factors among elite male handball players. To assess whether previously identified risk factors are associated with overuse shoulder injuries in a large cohort of elite male and female handball players. 329 players (168 male, 161 female) from the two upper divisions in Norway were included and tested prior to the 2014-2015 season. Measures included glenohumeral internal and external rotation range of motion, isometric internal and external rotation strength, and assessment of scapular dyskinesis. Players were followed prospectively for one competitive season, with prevalence and severity of shoulder problems registered monthly using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. A severity score based on players' questionnaire responses was used as the outcome measure in multivariable logistic regression to investigate associations between candidate risk factors and overuse shoulder injury. No significant associations were found between total rotation (OR 1.05 per 5° change, 95% CI 0.98 to 1.13), external rotation strength (OR 1.05 per 10 N change, 95% CI 0.92 to 1.20) or obvious scapular dyskinesis (OR 1.23, 95% CI 0.25 to 5.99) and overuse shoulder injury. A significant positive association was found between greater internal rotation (OR 1.16 per 5° change, 95% CI 1.00 to 1.34) and overuse shoulder injury. None of the previously identified risk factors were associated with overuse shoulder injuries in a mixed-sex cohort of elite handball players. © 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.

Origin of the Livelihood Dilemma for Local Fisherman in Poyang Lake Wetland: a Ramsar Site in China

NASA Astrophysics Data System (ADS)

Xie, Dongming; Zhou, Guohong; Zhou, Yangming; Chen, Yayun; Jia, Junsong

2018-01-01

Poyang Lake is one of the first Ramsar sites in China; it has plenty of natural resources that support the survival of local residents. However, local fisherman have encountered a livelihood dilemma, as natural resources have declined, obviously because of the change in the ecological environment and anthropic disturbance. We seek to explain what lead to livelihood dilemma to the local fishermen, so semi-structured interviews, questionnaire surveys, Geographic information system (GIS), Remote sensing (RS), Global position system (GPS), and department data were used to analyze the internal and external factors for these dilemmas. The results explained the external factors including the exhaustion of natural resources, the drying up of wetlands, landscape fragmentation, water contamination, and disturbance through anthropic behavior; the internal factors included the ageing of fishermen, poor cultural quality, conservative ideas, and unreasonable fishing practices. Eco-compensation, industry transformation, and capacity innovation may help to resolve livelihood dilemmas for the local fisherman of the Poyang Lake wetlands.

Vortex Generators in a Two-Dimensional, External-Compression Supersonic Inlet

NASA Technical Reports Server (NTRS)

Baydar, Ezgihan; Lu, Frank K.; Slater, John W.

2016-01-01

Vortex generators within a two-dimensional, external-compression supersonic inlet for Mach 1.6 were investigated to determine their ability to increase total pressure recovery, reduce total pressure distortion, and improve the boundary layer. The vortex generators studied included vanes and ramps. The geometric factors of the vortex generators studied included height, length, spacing, and positions upstream and downstream of the inlet terminal shock. The flow through the inlet was simulated through the computational solution of the steady-state Reynolds-averaged Navier-Stokes equations on multi-block, structured grids. The vortex generators were simulated by either gridding the geometry of the vortex generators or modeling the vortices generated by the vortex generators. The inlet performance was characterized by the inlet total pressure recovery, total pressure distortion, and incompressible shape factor of the boundary-layer at the engine face. The results suggested that downstream vanes reduced the distortion and improved the boundary layer. The height of the vortex generators had the greatest effect of the geometric factors.

Describing and Predicting Developmental Profiles of Externalizing Problems from Childhood to Adulthood

PubMed Central

Petersen, Isaac T.; Bates, John E.; Dodge, Kenneth A.; Lansford, Jennifer E.; Pettit, Gregory S.

2014-01-01

This longitudinal study considers externalizing behavior problems from ages 5 to 27 (N = 585). Externalizing problem ratings by mothers, fathers, teachers, peers, and self-report were modeled with growth curves. Risk and protective factors across many different domains and time frames were included as predictors of the trajectories. A major contribution of the study is in demonstrating how heterotypic continuity and changing measures can be handled in modeling changes in externalizing behavior over long developmental periods. On average, externalizing problems decreased from early childhood to preadolescence, increased during adolescence, and decreased from late adolescence to adulthood. There was strong nonlinear continuity in externalizing problems over time. Family process, peer process, stress, and individual characteristics predicted externalizing problems beyond the strong continuity of externalizing problems. The model accounted for 70% of the variability in the development of externalizing problems. The model’s predicted values showed moderate sensitivity and specificity in prediction of arrests, illegal drug use, and drunk driving. Overall, the study showed that by using changing, developmentally-relevant measures and simultaneously taking into account numerous characteristics of children and their living situations, research can model lengthy spans of development and improve predictions of the development of later, severe externalizing problems. PMID:25166430

[Clinic-internal and -external factors of length of hospital stay].

PubMed

Schariatzadeh, R; Imoberdorf, R; Ballmer, P E

2011-01-19

In the context of forthcoming initiation of Diagnosis Related Groups (DRG) in Switzerland, the objective of the study was to find factors having an impact on the inpatient's length of hospital stay. The study was performed on two general-medical wards of the Kantonsspital Winterthur, where all admitted patients were included in the study over two months. The various periods of diagnostic and therapeutic management of the patients and all diagnostic and therapeutic measures plus the arrangements after hospitalization were recorded. The determinants influencing the length of hospital stay were classified in clinic-internal or -external. 124 inpatients entered the study. 91 (73.4%) had a length of hospital stay without delay, whereas 33 (26.6%) patients had an extended length of hospital stay. The cumulative length of hospital stay of all patients was 1314 days, whereof 216 days (16.4%) were caused by delays. 67 days were caused by clinic-internal (5.1%) and 149 days by clinic-external factors (11.3%). Delays were substantially more generated by clinic-internal than -external factors. Clinic-internal factors were mainly weekends with interruption of the diagnostic and therapeutic procedures, dead times waiting for diagnostic results and waiting times for consultations. Clinic-external factors were caused by delayed transfer in nursing homes or rehabilitation institutions, waiting for family members for the backhaul and by indetermination of the patient. Also factors relating to the patients' characteristics had an influence on the length of hospital stay. Summing up, a substantial part of the length of hospital stay was caused by delays. However, the many different clinic-internal factors complicate solutions to lower the length of hospital stay. Moreover, factors that cannot be influenced such as waiting for microbiological results, contribute to extended length of hospital stay. Early scheduling of post-hospital arrangements may lower length of hospital stay. Moreover, when cantonal restriction falls away in 2012, patients may be transferred to rehabilitation institutions more rapidly. Also the insurance companies may possibly strengthen their organisation and thus may meet the costs more quickly.

Robust permanence for ecological equations with internal and external feedbacks.

PubMed

Patel, Swati; Schreiber, Sebastian J

2018-07-01

Species experience both internal feedbacks with endogenous factors such as trait evolution and external feedbacks with exogenous factors such as weather. These feedbacks can play an important role in determining whether populations persist or communities of species coexist. To provide a general mathematical framework for studying these effects, we develop a theorem for coexistence for ecological models accounting for internal and external feedbacks. Specifically, we use average Lyapunov functions and Morse decompositions to develop sufficient and necessary conditions for robust permanence, a form of coexistence robust to large perturbations of the population densities and small structural perturbations of the models. We illustrate how our results can be applied to verify permanence in non-autonomous models, structured population models, including those with frequency-dependent feedbacks, and models of eco-evolutionary dynamics. In these applications, we discuss how our results relate to previous results for models with particular types of feedbacks.

Facilitators and barriers to exercising among people with osteoarthritis: a phenomenological study.

PubMed

Petursdottir, Unnur; Arnadottir, Solveig A; Halldorsdottir, Sigridur

2010-07-01

Evidence indicates that regular exercise improves the well-being of individuals with osteoarthritis (OA). However, these individuals seem to exercise less frequently than the general population and seem to have limited adherence to exercising. The purposes of this study were: (1) to increase knowledge and understanding of the experience of exercising among individuals with OA and (2) to determine what they perceive as facilitators and barriers to exercising. This study used a qualitative method, based on the Vancouver School of doing phenomenology, involving purposive sampling of 12 individuals and 16 interviews. The participants, 9 women and 3 men, were 50 to 82 years of age. Extended information on exercise behavior among people with OA is presented in a model in which internal and external facilitators and barriers to exercising are delineated. Based on this model, a checklist is proposed for physical therapists' assessment of these factors. Internal factors include individual attributes and personal experience of exercising, whereas external factors include the social and physical environment. The participants expressed how each of these internal and external factors could act both as a facilitator and a barrier to exercise participation and the pattern of exercising; for example, the presence of pain was an important aspect concerning internal barriers to exercising, whereas the hope of less pain was one of the main facilitators. Increased knowledge and understanding of the factors influencing exercise behavior in people with OA can help physical therapists and other health care professionals support them in initiating and maintaining a healthy exercise routine and, consequently, achieving a better quality of life.

Reactive Attachment Disorder and Disinhibited Social Engagement Disorder in School-Aged Foster Children--A Confirmatory Approach to Dimensional Measures.

PubMed

Lehmann, Stine; Breivik, Kyrre; Heiervang, Einar R; Havik, Toril; Havik, Odd E

2016-04-01

This study aimed to investigate the factor structure and external correlates of the constructs Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The following were addressed: First, do our data support the DSM-5 conceptualization of RAD/DSED as two separate constructs? Second, are RAD and DSED distinct from other well-established dimensions of child psychopathology? Third, what are the external correlates of RAD/DSED in this sample? The study sample included 122 foster children aged 6-10 years. Foster parents completed the Strengths and Difficulties Questionnaire (SDQ), and the RAD/DSED-scale from the Developmental and Well-Being Assessment. Child protection caseworkers completed a questionnaire regarding exposure to maltreatment and placement history. Confirmatory factor analysis (CFA) of the RAD/DSED items identified a good fit for a model with a two-factor structure, which is congruent with the DSM-5 definition of RAD and DSED. A new CFA model, which included the RAD and DSED factors together with the four problem factors of the SDQ (emotional, conduct, hyperactivity-inattention, and peer problems), also demonstrated a good fit with our data. RAD and DSED were associated with the SDQ Impact scale and help seeking behavior. This was partly explained by the SDQ externalizing and peer problem subscales. Our findings lend support for the DSM-5 conceptualization of RAD and DSED as separate dimensions of child psychopathology. Thus, the assessment of RAD and DSED provides information beyond other mental health problems.

Internal and External Triggering Mechanism of "Smart" Nanoparticle-Based DDSs in Targeted Tumor Therapy.

PubMed

Qiana, Xian-Ling; Li, Jun; Wei, Ran; Lin, Hui; Xiong, Li-Xia

2018-05-09

Anticancer chemotherapeutics have a lot of problems via conventional drug delivery systems (DDSs), including non-specificity, burst release, severe side-effects, and damage to normal cells. Owing to its potential to circumventing these problems, nanotechnology has gained increasing attention in targeted tumor therapy. Chemotherapeutic drugs or genes encapsulated in nanoparticles could be used to target therapies to the tumor site in three ways: "passive", "active", and "smart" targeting. To summarize the mechanisms of various internal and external "smart" stimulating factors on the basis of findings from in vivo and in vitro studies. A thorough search of PubMed was conducted in order to identify the majority of trials, studies and novel articles related to the subject. Activated by internal triggering factors (pH, redox, enzyme, hypoxia, etc.) or external triggering factors (temperature, light of different wavelengths, ultrasound, magnetic fields, etc.), "smart" DDSs exhibit targeted delivery to the tumor site, and controlled release of chemotherapeutic drugs or genes. In this review article, we summarize and classify the internal and external triggering mechanism of "smart" nanoparticle-based DDSs in targeted tumor therapy, and the most recent research advances are illustrated for better understanding. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Maternal postpartum depressive symptoms and infant externalizing and internalizing behaviors.

PubMed

Vafai, Yassaman; Steinberg, Julia R; Shenassa, Edmond D

2016-02-01

Maternal postpartum depression has been shown to be one of the main predictors of externalizing and internalizing behaviors in toddlers and adolescents. Research suggests that presence of such behaviors can be observed as early as infancy. The current study uses longitudinal data from 247 mothers to examine the relationship between postpartum depressive symptoms at 8 weeks and the infant's externalizing and internalizing behaviors at 12 months. In unadjusted linear regression models, there were associations between postpartum depressive symptoms and infant externalizing behaviors (β=0.082, SE=0.032, p=0.012) and internalizing behaviors (β=0.111, SE=0.037, p=0.003). After controlling for potential confounding factors, including maternal age, race, education, home ownership, smoking status in the postpartum period, marital status, parenting stress, and happiness from becoming a parent, the associations between postpartum depressive symptoms and infant externalizing (β=0.051, SE=0.034, p=0.138) and internalizing behaviors (β=0.077, SE=0.040, p=0.057) were reduced and became non-significant. Furthermore, in these models the total amount of variance explained was 17.2% (p<0.0001) for externalizing behaviors and 10.5% (p<0.01) for internalizing behaviors; the only significant predictor of externalizing behaviors was maternal age (β=-0.074, SE=0.030, p=0.014), and of internalizing behaviors was white non-Hispanic ethnicity (β=-1.33, SE=0.378, p=0.0005). A combined effect of the confounding factors seems to explain the finding of no significant independent association between postpartum depressive symptoms and infant externalizing and internalizing behaviors. Copyright © 2015 Elsevier Inc. All rights reserved.

A methodological approach to identify external factors for indicator-based risk adjustment illustrated by a cataract surgery register

PubMed Central

2014-01-01

Background Risk adjustment is crucial for comparison of outcome in medical care. Knowledge of the external factors that impact measured outcome but that cannot be influenced by the physician is a prerequisite for this adjustment. To date, a universal and reproducible method for identification of the relevant external factors has not been published. The selection of external factors in current quality assurance programmes is mainly based on expert opinion. We propose and demonstrate a methodology for identification of external factors requiring risk adjustment of outcome indicators and we apply it to a cataract surgery register. Methods Defined test criteria to determine the relevance for risk adjustment are “clinical relevance” and “statistical significance”. Clinical relevance of the association is presumed when observed success rates of the indicator in the presence and absence of the external factor exceed a pre-specified range of 10%. Statistical significance of the association between the external factor and outcome indicators is assessed by univariate stratification and multivariate logistic regression adjustment. The cataract surgery register was set up as part of a German multi-centre register trial for out-patient cataract surgery in three high-volume surgical sites. A total of 14,924 patient follow-ups have been documented since 2005. Eight external factors potentially relevant for risk adjustment were related to the outcome indicators “refractive accuracy” and “visual rehabilitation” 2–5 weeks after surgery. Results The clinical relevance criterion confirmed 2 (“refractive accuracy”) and 5 (“visual rehabilitation”) external factors. The significance criterion was verified in two ways. Univariate and multivariate analyses revealed almost identical external factors: 4 were related to “refractive accuracy” and 7 (6) to “visual rehabilitation”. Two (“refractive accuracy”) and 5 (“visual rehabilitation”) factors conformed to both criteria and were therefore relevant for risk adjustment. Conclusion In a practical application, the proposed method to identify relevant external factors for risk adjustment for comparison of outcome in healthcare proved to be feasible and comprehensive. The method can also be adapted to other quality assurance programmes. However, the cut-off score for clinical relevance needs to be individually assessed when applying the proposed method to other indications or indicators. PMID:24965949

[Trend in mortality from external causes in pregnant and postpartum women and its relationship to socioeconomic factors in Colombia, 1998-2010].

PubMed

Salazar, Edwin; Buitrago, Carolina; Molina, Federico; Alzate, Catalina Arango

2015-05-01

Determine the trend in mortality from external causes in pregnant and postpartum women and its relationship to socioeconomic factors. Descriptive study, based on the official registries of deaths reported by the National Statistics Agency, 1998-2010. The trend was analyzed using Poisson regressions. Bivariate correlations and multiple linear regression models were constructed to explore the relationship between mortality and socioeconomic factors: human development index, Gini index, gross domestic product, unsatisfied basic needs, unemployment rate, poverty, extreme poverty, quality of life index, illiteracy rate, and percentage of affiliation to the Social Security System. A total of 2 223 female deaths from external causes were recorded, of which 1 429 occurred during pregnancy and 794 in the postpartum period. The gross mortality rate dropped from 30.7 per 100 000 live births plus fetal deaths in 1998 to 16.7 in 2010. A downward curve with no significant inflection points was shown in the risk of dying from this cause. The multiple linear regression model showed a correlation between mortality and extreme poverty and the illiteracy rate, suggesting that these indicators could explain 89.4% of the change in mortality from external causes in pregnant and postpartum women each year in Colombia. Mortality from external causes in pregnant and postpartum women showed a significant downward trend that may be explained by important socioeconomic changes in the country, including a decrease in extreme poverty and in the illiteracy rate.

A RE-AIM evaluation of theory-based physical activity interventions.

PubMed

Antikainen, Iina; Ellis, Rebecca

2011-04-01

Although physical activity interventions have been shown to effectively modify behavior, little research has examined the potential of these interventions for adoption in real-world settings. The purpose of this literature review was to evaluate the external validity of 57 theory-based physical activity interventions using the RE-AIM framework. The physical activity interventions included were more likely to report on issues of internal, rather than external validity and on individual, rather than organizational components of the RE-AIM framework, making the translation of many interventions into practice difficult. Furthermore, most studies included motivated, healthy participants, thus reducing the generalizability of the interventions to real-world settings that provide services to more diverse populations. To determine if a given intervention is feasible and effective in translational research, more information should be reported about the factors that affect external validity.

Interrelations of Maternal Expressed Emotion, Maltreatment, and Separation/Divorce and Links to Family Conflict and Children’s Externalizing Behavior

PubMed Central

Narayan, Angela; Cicchetti, Dante; Rogosch, Fred A.; Toth, Sheree L.

2014-01-01

Research has documented that maternal expressed emotion-criticism (EE-Crit) from the Five-Minute Speech Sample (FMSS) predicts family conflict and children’s externalizing behavior in clinical and community samples. However, studies have not examined EE-Crit in maltreating or separated/divorced families, or whether these family risks exacerbate the links between EE-Crit and family conflict and externalizing behavior. The current study examined the associations between maternal EE-Crit, maltreatment, and separation/divorce, and whether maltreatment and separation/divorce moderated associations between EE-Crit and children’s externalizing problems, and EE-Crit and family conflict. Participants included 123 children (M = 8.01 years, SD = 1.58; 64.2% males) from maltreating (n = 83) or low-income, comparison (n = 40) families, and 123 mothers (n = 48 separated/divorced). Mothers completed the FMSS for EE-Crit and the Family Environment Scale for family conflict. Maltreatment was coded with the Maltreatment Classification System using information from official Child Protection Services (CPS) reports from the Department of Human Services (DHS). Trained summer camp counselors rated children’s externalizing behavior. Maltreatment was directly associated with higher externalizing problems, and separation/divorce, but not maltreatment, moderated the association between EE-Crit and externalizing behavior. Analyses pertaining to family conflict were not significant. Findings indicate that maltreatment is a direct risk factor for children’s externalizing behavior and separation/divorce is a vulnerability factor for externalizing behavior in family contexts with high maternal EE-Crit. Intervention, prevention, and policy efforts to promote resilience in high-risk families may be effective in targeting maltreating and critical parents, especially those with co-occurring separation/divorce. PMID:25037461

A Human Resource Development Performance Improvement Model for Workers with Mental Retardation in Supported Employment

ERIC Educational Resources Information Center

Fornes, Sandra; Rosenberg, Howard; Rocco, Tonette S.; Gallagher, Jo

2006-01-01

This literature review discusses the factors for successful job retention of adult workers with mental retardation (MR) including external factors related to work environments and internal issues of the individual worker. Through the synthesis of the literature, a performance improvement model for supported employment (SE) is discussed based on…

The Influence of External and Internal Factors on Forming the System of Managers' Professional Development at Transnational Corporations in Poland

ERIC Educational Resources Information Center

Banit, Olga

2017-01-01

The author performs analysis of external and internal factors that influence organization of the system of Polish managers' professional development. These factors can be united into two groups. We will attribute the factors formed under the influence of external factors to the first group, to the second--the internal ones. So, due to the dynamic…

Prospective multifactorial analysis of preseason risk factors for shoulder and elbow injuries in high school baseball pitchers.

PubMed

Shitara, Hitoshi; Kobayashi, Tsutomu; Yamamoto, Atsushi; Shimoyama, Daisuke; Ichinose, Tsuyoshi; Tajika, Tsuyoshi; Osawa, Toshihisa; Iizuka, Haku; Takagishi, Kenji

2017-10-01

To prospectively identify preseason physical factors for shoulder and elbow injuries during the season in high school baseball pitchers. The study included 105 high school baseball pitchers [median age 16 (15-17) years]. The range of motion of the shoulder (90° abducted external and internal rotation) and elbow (extension/flexion), shoulder muscle strength (abduction and prone internal and external rotation), shoulder and elbow laxity, horizontal flexion, and scapular dyskinesis were assessed. After the season, the participants completed questionnaires regarding shoulder and/or elbow injuries, with injury defined as an inability to play for ≥1 week due to elbow/shoulder problems. The results of two groups (injured and noninjured) were compared using t tests and Chi-square analyses. Stepwise forward logistic regression models were developed to identify risk factors. Twenty-one injuries were observed. In univariate analysis, 90° abducted internal rotation and total arc of the dominant shoulder and the ratio of prone external rotation in the dominant to nondominant sides in the injured group were significantly less than those in the noninjured group (P = 0.02, 0.04, and 0.01, respectively). In logistic regression analysis, 90° abducted internal rotation in the dominant shoulder and prone external rotation ratio were significantly associated with injuries (P = 0.02 and 0.03, respectively). A low prone external rotation ratio and decreased 90° abducted internal rotation in the dominant shoulder in the preseason were significant risk factors for shoulder and elbow injuries in high school baseball pitchers. The results may contribute to reduce the incidence of these injuries. II.

Facilitators and Barriers to Preparedness Partnerships: A Veterans Affairs Medical Center Perspective.

PubMed

Schmitz, Susan; Wyte-Lake, Tamar; Dobalian, Aram

2017-09-13

This study sought to understand facilitators and barriers faced by local US Department of Veterans Affairs Medical Center (VAMC) emergency managers (EMs) when collaborating with non-VA entities. Twelve EMs participated in semi-structured interviews lasting 60 to 90 minutes discussing their collaboration with non-VAMC organizations. Sections of the interview transcripts concerning facilitators and barriers to collaboration were coded and analyzed. Common themes were organized into 2 categories: (1) internal (ie, factors affecting collaboration from within VAMCs or by VA policy) and (2) external (ie, interagency or interpersonal factors). Respondents reported a range of facilitators and barriers to collaboration with community-based agencies. Internal factors facilitating collaboration included items such as leadership support. An internal barrier example included lack of clarity surrounding the VAMC's role in community disaster response. External factors noted as facilitators included a shared goal across organizations while a noted barrier was a perception that potential partners viewed a VAMC partnership with skepticism. Federal institutions are important partners for the success of community disaster preparedness and response. Understanding the barriers that VAMCs confront, as well as potential facilitators to collaboration, should enhance the development of VAMC-community partnerships and improve community health resilience. (Disaster Med Public Health Preparedness. 2017; page 1 of 6).

Do executive functions explain the covariance between internalizing and externalizing behaviors?

PubMed

Hatoum, Alexander S; Rhee, Soo Hyun; Corley, Robin P; Hewitt, John K; Friedman, Naomi P

2017-11-16

This study examined whether executive functions (EFs) might be common features of internalizing and externalizing behavior problems across development. We examined relations between three EF latent variables (a common EF factor and factors specific to updating working memory and shifting sets), constructed from nine laboratory tasks administered at age 17, to latent growth intercept (capturing stability) and slope (capturing change) factors of teacher- and parent-reported internalizing and externalizing behaviors in 885 individual twins aged 7 to 16 years. We then estimated the proportion of intercept-intercept and slope-slope correlations predicted by EF as well as the association between EFs and a common psychopathology factor (P factor) estimated from all 9 years of internalizing and externalizing measures. Common EF was negatively associated with the intercepts of teacher-rated internalizing and externalizing behavior in males, and explained 32% of their covariance; in the P factor model, common EF was associated with the P factor in males. Shifting-specific was positively associated with the externalizing slope across sex. EFs did not explain covariation between parent-rated behaviors. These results suggest that EFs are associated with stable problem behavior variation, explain small proportions of covariance, and are a risk factor that that may depend on gender.

The cross-national structure of mental disorders: results from the World Mental Health Surveys.

PubMed

de Jonge, Peter; Wardenaar, Klaas J; Lim, Carmen C W; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura Helena; Bunting, Brendan; Chatterji, Somnath; Ciutan, Marius; Gureje, Oye; Karam, Elie G; Lee, Sing; Medina-Mora, Maria Elena; Moskalewicz, Jacek; Navarro-Mateu, Fernando; Pennell, Beth-Ellen; Piazza, Marina; Posada-Villa, José; Torres, Yolanda; Kessler, Ronald C; Scott, Kate

2017-12-19

The patterns of comorbidity among mental disorders have led researchers to model the underlying structure of psychopathology. While studies have suggested a structure including internalizing and externalizing disorders, less is known with regard to the cross-national stability of this model. Moreover, little data are available on the placement of eating disorders, bipolar disorder and psychotic experiences (PEs) in this structure. We evaluated the structure of mental disorders with data from the World Health Organization Composite International Diagnostic Interview, including 15 lifetime mental disorders and six PEs. Respondents (n = 5478-15 499) were included from 10 high-, middle- and lower middle-income countries across the world aged 18 years or older. Confirmatory factor analyses (CFAs) were used to evaluate and compare the fit of different factor structures to the lifetime disorder data. Measurement invariance was evaluated with multigroup CFA (MG-CFA). A second-order model with internalizing and externalizing factors and fear and distress subfactors best described the structure of common mental disorders. MG-CFA showed that this model was stable across countries. Of the uncommon disorders, bipolar disorder and eating disorder were best grouped with the internalizing factor, and PEs with a separate factor. These results indicate that cross-national patterns of lifetime common mental-disorder comorbidity can be explained with a second-order underlying structure that is stable across countries and can be extended to also cover less common mental disorders.

External cardiac compression may be harmful in some scenarios of pulseless electrical activity.

PubMed

Hogan, T S

2012-10-01

Pulseless electrical activity occurs when organised or semi-organised electrical activity of the heart persists but the product of systemic vascular resistance and the increase in systemic arterial flow generated by the ejection of the left venticular stroke volume is not sufficient to produce a clinically detectable pulse. Pulseless electrical activity encompasses a very heterogeneous variety of severe circulatory shock states ranging in severity from pseudo-cardiac arrest to effective cardiac arrest. Outcomes of cardiopulmonary resuscitation for pulseless electrical activity are generally poor. Impairment of cardiac filling is the limiting factor to cardiac output in many scenarios of pulseless electrical activity, including extreme vasodilatory shock states. There is no evidence that external cardiac compression can increase cardiac output when impaired cardiac filling is the limiting factor to cardiac output. If impaired cardiac filling is the limiting factor to cardiac output and the heart is effectively ejecting all the blood returning to it, then external cardiac compression can only increase cardiac output if it increases venous return and cardiac filling. Repeated cardiac compression asynchronous with the patient's cardiac cycle and raised mean intrathoracic pressure due to chest compression can be expected to reduce rather than to increase cardiac filling and therefore to reduce rather than to increase cardiac output in such circumstances. The hypothesis is proposed that the performance of external cardiac compression will have zero or negative effect on cardiac output in pulseless electrical activity when impaired cardiac filling is the limiting factor to cardiac output. External cardiac compression may be both directly and indirectly harmful to significant sub-groups of patients with pulseless electrical activity. We have neither evidence nor theory to provide comfort that external cardiac compression is not harmful in many scenarios of pulseless electrical activity. Investigation using a variety of animal models of pulseless electrical activity produced by different shock-inducing mechanisms is required to provide an evidence base for resuscitation guidelines. Copyright © 2012 Elsevier Ltd. All rights reserved.

Childhood Nasopharyngeal Cancer Treatment (PDQ®)—Patient Version

Cancer.gov

Childhood nasopharyngeal cancer treatment options include chemotherapy, external and internal radiation therapy, surgery, and immunotherapy (interferon). Learn more about the risk factors, symptoms, tests to diagnose, and treatment of childhood nasopharyngeal cancer in this expert-reviewed summary.

Radiation Therapy

MedlinePlus

... cancer patients receive it. The radiation may be external, from special machines, or internal, from radioactive substances that a doctor places inside your body. The type of radiation therapy you receive depends on many factors, including The type of cancer The size of ...

Consistent approach to describing aircraft HIRF protection

NASA Technical Reports Server (NTRS)

Rimbey, P. R.; Walen, D. B.

1995-01-01

The high intensity radiated fields (HIRF) certification process as currently implemented is comprised of an inconsistent combination of factors that tend to emphasize worst case scenarios in assessing commercial airplane certification requirements. By examining these factors which include the process definition, the external HIRF environment, the aircraft coupling and corresponding internal fields, and methods of measuring equipment susceptibilities, activities leading to an approach to appraising airplane vulnerability to HIRF are proposed. This approach utilizes technically based criteria to evaluate the nature of the threat, including the probability of encountering the external HIRF environment. No single test or analytic method comprehensively addresses the full HIRF threat frequency spectrum. Additional tools such as statistical methods must be adopted to arrive at more realistic requirements to reflect commercial aircraft vulnerability to the HIRF threat. Test and analytic data are provided to support the conclusions of this report. This work was performed under NASA contract NAS1-19360, Task 52.

Major Depressive Disorder and Impulsive Reactivity to Emotion: Toward a Dual Process View of Depression

PubMed Central

Carver, Charles S.; Johnson, Sheri L.; Joormann, Jutta

2012-01-01

Objective Dual process theories of behavior have been used to suggest that vulnerability to depression involves elevated reactivity to emotions. This study tests that idea, examining self-reported reactivity. Design Comparison between persons with at least one lifetime episode of major depressive disorder (lifetime MDD) and those without this diagnosis, controlling for symptoms of alcohol use (a potential externalizing confound) and current symptoms of depression (a potential state-dependent confound). Methods Undergraduates (N = 120) completed a clinical interview to diagnose lifetime MDD and a series of self-reports bearing on diverse aspects of self-control, including reactivity to emotion. Thirty-four were diagnosed with lifetime MDD; 86 did not meet criteria for MDD. The groups were then compared on three factors underlying the scales assessing self-control. Results The MDD group had higher scores than controls on the two factors that reflect impulsive reactivity to diverse emotions, including emotions that are positive in valence. These effects were not explained by associations with either externalizing symptoms or current depressive symptoms. Conclusions Reflexive reactivity to emotions characterizes depression, in addition to some externalizing problems, and it may deserve study as a potential transdiagnostic feature. PMID:23865405

Learning the organization: a model for health system analysis for new nurse administrators.

PubMed

Clark, Mary Jo

2004-01-01

Health systems are large and complex organizations in which multiple components and processes influence system outcomes. In order to effectively position themselves in such organizations, nurse administrators new to a system must gain a rapid understanding of overall system operation. Such understanding is facilitated by use of a model for system analysis. The model presented here examines the dynamic interrelationships between and among internal and external elements as they affect system performance. External elements to be analyzed include environmental factors and characteristics of system clientele. Internal elements flow from the mission and goals of the system and include system culture, services, resources, and outcomes.

The external amino acid signaling pathway promotes activation of Stp1 and Uga35/Dal81 transcription factors for induction of the AGP1 gene in Saccharomyces cerevisiae.

PubMed Central

Abdel-Sater, Fadi; Iraqui, Ismaïl; Urrestarazu, Antonio; André, Bruno

2004-01-01

Yeast cells respond to the presence of amino acids in their environment by inducing transcription of several amino acid permease genes including AGP1, BAP2, and BAP3. The signaling pathway responsible for this induction involves Ssy1, a permease-like sensor of external amino acids, and culminates with proteolytic cleavage and translocation to the nucleus of the zinc-finger proteins Stp1 and Stp2, the lack of which abolishes induction of BAP2 and BAP3. Here we show that Stp1-but not Stp2-plays an important role in AGP1 induction, although significant induction of AGP1 by amino acids persists in stp1 and stp1 stp2 mutants. This residual induction depends on the Uga35/Dal81 transcription factor, indicating that the external amino acid signaling pathway activates not only Stp1 and Stp2, but also another Uga35/Dal81-dependent transcriptional circuit. Analysis of the AGP1 gene's upstream region revealed that Stp1 and Uga35/Dal81 act synergistically through a 21-bp cis-acting sequence similar to the UAS(AA) element previously found in the BAP2 and BAP3 upstream regions. Although cells growing under poor nitrogen-supply conditions display much higher induction of AGP1 expression than cells growing under good nitrogen-supply conditions, the UAS(AA) itself is totally insensitive to nitrogen availability. Nitrogen-source control of AGP1 induction is mediated by the GATA factor Gln3, likely acting through adjacent 5'-GATA-3' sequences, to amplify the positive effect of UAS(AA). Our data indicate that Stp1 may act in combination with distinct sets of transcription factors, according to the gene context, to promote induction of transcription in response to external amino acids. The data also suggest that Uga35/Dal81 is yet another transcription factor under the control of the external amino acid sensing pathway. Finally, the data show that the TOR pathway mediating global nitrogen control of transcription does not interfere with the external amino acid signaling pathway. PMID:15126393

Are We in a Bull Market for Training?

ERIC Educational Resources Information Center

Kimmerling, George F.

1991-01-01

Discusses factors that keep external training companies from being dragged down with the rest of the economy during a recession. They include creating a clear image for the company, satisfying customers, marketing, and maintaining a broad client base. (JOW)

Personality Traits Predict the Developmental Course of Externalizing: A Four-wave Longitudinal Study Spanning Age 17 to Age 29

PubMed Central

Walton, Kate E.; Krueger, Robert F.; Elkins, Irene; D’Accordo, Cassandra; McGue, Matt; Iacono, William G.

2016-01-01

Objective The objective of the present study was to determine whether and how personality predicts the developmental course of externalizing problems, including antisocial behavior and substance dependence. Method In a large population-based longitudinal study (N=1252), the 11 personality traits assessed by the Multidimensional Personality Questionnaire were measured at age 17, and DSM diagnoses of adult antisocial behavior, alcohol dependence, and drug dependence were obtained at ages 17, 20, 24, and 29. We fit a quadratic multiple indicator latent growth model where the three diagnoses loaded onto an externalizing factor. Results This model fit the data well, and externalizing increased until it started to decline at age 24. High aggression and low control were the most significant predictors of the development of externalizing, with aggression playing a significant role in the development of externalizing across the 12-year time span, and control predicting the development from age 17 to 24. Conclusions The findings highlight the importance of considering the developmental course of externalizing in the context of personality and suggest that the specific personality traits of aggression and control might be targeted in externalizing prevention and intervention programs. PMID:26808279

Personality Traits Predict the Developmental Course of Externalizing: A Four-Wave Longitudinal Study Spanning Age 17 to Age 29.

PubMed

Walton, Kate E; Krueger, Robert F; Elkins, Irene; D'Accordo, Cassandra; McGue, Matt; Iacono, William G

2017-06-01

The objective of the present study was to determine whether and how personality predicts the developmental course of externalizing problems, including antisocial behavior and substance dependence. In a large, population-based longitudinal study (N = 1,252), the 11 personality traits assessed by the Multidimensional Personality Questionnaire were measured at age 17, and DSM diagnoses of adult antisocial behavior, alcohol dependence, and drug dependence were obtained at ages 17, 20, 24, and 29. We fit a quadratic multiple indicator latent growth model where the three diagnoses loaded onto an externalizing factor. This model fit the data well, and externalizing increased until it started to decline at age 24. High aggression and low control were the most significant predictors of the development of externalizing, with aggression playing a significant role in the development of externalizing across the 12-year time span, and control predicting the development from age 17 to 24. The findings highlight the importance of considering the developmental course of externalizing in the context of personality and suggest that the specific personality traits of aggression and control might be targeted in externalizing prevention and intervention programs. © 2016 Wiley Periodicals, Inc.

Development of Decision Support Formulas for the Prediction of Bladder Outlet Obstruction and Prostatic Surgery in Patients With Lower Urinary Tract Symptom/Benign Prostatic Hyperplasia: Part II, External Validation and Usability Testing of a Smartphone App.

PubMed

Choo, Min Soo; Jeong, Seong Jin; Cho, Sung Yong; Yoo, Changwon; Jeong, Chang Wook; Ku, Ja Hyeon; Oh, Seung-June

2017-04-01

We aimed to externally validate the prediction model we developed for having bladder outlet obstruction (BOO) and requiring prostatic surgery using 2 independent data sets from tertiary referral centers, and also aimed to validate a mobile app for using this model through usability testing. Formulas and nomograms predicting whether a subject has BOO and needs prostatic surgery were validated with an external validation cohort from Seoul National University Bundang Hospital and Seoul Metropolitan Government-Seoul National University Boramae Medical Center between January 2004 and April 2015. A smartphone-based app was developed, and 8 young urologists were enrolled for usability testing to identify any human factor issues of the app. A total of 642 patients were included in the external validation cohort. No significant differences were found in the baseline characteristics of major parameters between the original (n=1,179) and the external validation cohort, except for the maximal flow rate. Predictions of requiring prostatic surgery in the validation cohort showed a sensitivity of 80.6%, a specificity of 73.2%, a positive predictive value of 49.7%, and a negative predictive value of 92.0%, and area under receiver operating curve of 0.84. The calibration plot indicated that the predictions have good correspondence. The decision curve showed also a high net benefit. Similar evaluation results using the external validation cohort were seen in the predictions of having BOO. Overall results of the usability test demonstrated that the app was user-friendly with no major human factor issues. External validation of these newly developed a prediction model demonstrated a moderate level of discrimination, adequate calibration, and high net benefit gains for predicting both having BOO and requiring prostatic surgery. Also a smartphone app implementing the prediction model was user-friendly with no major human factor issue.

Fetomaternal hemorrhage during external cephalic version.

PubMed

Boucher, Marc; Marquette, Gerald P; Varin, Jocelyne; Champagne, Josette; Bujold, Emmanuel

2008-07-01

To estimate the frequency and volume of fetomaternal hemorrhage during external cephalic version for term breech singleton fetuses and to identify risk factors involved with this complication. A prospective observational study was performed including all patients undergoing a trial of external cephalic version for a breech presentation of at least 36 weeks of gestation between 1987 and 2001 in our center. A search for fetal erythrocytes using the standard Kleihauer-Betke test was obtained before and after each external cephalic version. The frequency and volume of fetomaternal hemorrhage were calculated. Putative risk factors for fetomaternal hemorrhage were evaluated by chi(2) test and Mann-Whitney U test. A Kleihauer-Betke test result was available before and after 1,311 trials of external cephalic version. The Kleihauer-Betke test was positive in 67 (5.1%) before the procedure. Of the 1,244 women with a negative Kleihauer-Betke test before external cephalic version, 30 (2.4%) had a positive Kleihauer-Betke test after the procedure. Ten (0.8%) had an estimated fetomaternal hemorrhage greater than 1 mL, and one (0.08%) had an estimated fetomaternal hemorrhage greater than 30 mL. The risk of fetomaternal hemorrhage was not influenced by parity, gestational age, body mass index, number of attempts at version, placental location, or amniotic fluid index. The risk of detectable fetomaternal hemorrhage during external cephalic version was 2.4%, with fetomaternal hemorrhage more than 30 mL in less than 0.1% of cases. These data suggest that the performance of a Kleihauer-Betke test is unwarranted in uneventful external cephalic version and that in Rh-negative women, no further Rh immune globulin is necessary other than the routine 300-microgram dose at 28 weeks of gestation and postpartum. II.

Proxies and Other External Raters: Methodological Considerations

PubMed Central

Snow, A Lynn; Cook, Karon F; Lin, Pay-Shin; Morgan, Robert O; Magaziner, Jay

2005-01-01

Objective The purpose of this paper is to introduce researchers to the measurement and subsequent analysis considerations involved when using externally rated data. We will define and describe two categories of externally rated data, recommend methodological approaches for analyzing and interpreting data in these two categories, and explore factors affecting agreement between self-rated and externally rated reports. We conclude with a discussion of needs for future research. Data Sources/Study Setting Data sources for this paper are previous published studies and reviews comparing self-rated with externally rated data. Study Design/Data Collection/Extraction Methods This is a psychometric conceptual paper. Principal Findings We define two types of externally rated data: proxy data and other-rated data. Proxy data refer to those collected from someone who speaks for a patient who cannot, will not, or is unavailable to speak for him or herself, whereas we use the term other-rater data to refer to situations in which the researcher collects ratings from a person other than the patient to gain multiple perspectives on the assessed construct. These two types of data differ in the way the measurement model is defined, the definition of the gold standard against which the measurements are validated, the analysis strategies appropriately used, and how the analyses are interpreted. There are many factors affecting the discrepancies between self- and external ratings, including characteristics of the patient, the proxy, and of the rated construct. Several psychological theories can be helpful in predicting such discrepancies. Conclusions Externally rated data have an important place in health services research, but use of such data requires careful consideration of the nature of the data and how it will be analyzed and interpreted. PMID:16179002

Frame Factors and a Quality Assurance Agency in an 'Embryonic' Higher Education System

ERIC Educational Resources Information Center

Hopkin, Anthony

2004-01-01

Using the Affiliations Unit of the University of Botswana as a case study, this paper explores how the operational milieu of an External Quality Assurance Agency (EQAA) impacts on its role and function. This milieu is described and selected frame factors are identified and evaluated, including the size of the country; the role of a hegemonic…

Frame Factors and a Quality Assurance Agency in an "Embryonic" Higher Education System

ERIC Educational Resources Information Center

Hopkin, Anthony G.

2004-01-01

Using the Affiliations Unit of the University of Botswana as a case study, this paper explores how the operational milieu of an External Quality Assurance Agency (EQAA) impacts on its role and function. This milieu is described and selected frame factors are identified and evaluated, including the size of the country; the role of a hegemonic…

Selection of sampling rate for digital control of aircrafts

NASA Technical Reports Server (NTRS)

Katz, P.; Powell, J. D.

1974-01-01

The considerations in selecting the sample rates for digital control of aircrafts are identified and evaluated using the optimal discrete method. A high performance aircraft model which includes a bending mode and wind gusts was studied. The following factors which influence the selection of the sampling rates were identified: (1) the time and roughness response to control inputs; (2) the response to external disturbances; and (3) the sensitivity to variations of parameters. It was found that the time response to a control input and the response to external disturbances limit the selection of the sampling rate. The optimal discrete regulator, the steady state Kalman filter, and the mean response to external disturbances are calculated.

Spatiotemporal Patterns of the Use of Urban Green Spaces and External Factors Contributing to Their Use in Central Beijing

PubMed Central

Li, Fangzheng; Zhang, Fen; Li, Xiong; Wang, Peng; Liang, Junhui; Mei, Yuting; Cheng, Wenwen; Qian, Yun

2017-01-01

Urban green spaces encourage outdoor activity and social communication that contribute to the health of local residents. Examining the relationship between the use of urban green spaces and factors influencing their utilization can provide essential references for green space site selection in urban planning. In contrast to previous studies that focused on internal factors, this study highlights the external factors (traffic convenience, population density and commercial facilities) contributing to the use of urban green spaces. We conducted a spatiotemporal analysis of the distribution of visitors in 208 selected green spaces in central Beijing. We examined the relationship between the spatial pattern of visitor distribution within urban green spaces and external factors, using the Gini coefficient, kernel density estimation, and geographical detectors. The results of the study were as follows. The spatial distribution of visitors within central Beijing’s green spaces was concentrated, forming different agglomerations. The three examined external factors are all associated with the use of green spaces. Among them, commercial facilities are the important external factor associated with the use of green spaces. For the selection of sites for urban green spaces, we recommend consideration of external factors in order to balance urban green space utilization. PMID:28264451

Spatiotemporal Patterns of the Use of Urban Green Spaces and External Factors Contributing to Their Use in Central Beijing.

PubMed

Li, Fangzheng; Zhang, Fen; Li, Xiong; Wang, Peng; Liang, Junhui; Mei, Yuting; Cheng, Wenwen; Qian, Yun

2017-02-27

Urban green spaces encourage outdoor activity and social communication that contribute to the health of local residents. Examining the relationship between the use of urban green spaces and factors influencing their utilization can provide essential references for green space site selection in urban planning. In contrast to previous studies that focused on internal factors, this study highlights the external factors (traffic convenience, population density and commercial facilities) contributing to the use of urban green spaces. We conducted a spatiotemporal analysis of the distribution of visitors in 208 selected green spaces in central Beijing. We examined the relationship between the spatial pattern of visitor distribution within urban green spaces and external factors, using the Gini coefficient, kernel density estimation, and geographical detectors. The results of the study were as follows. The spatial distribution of visitors within central Beijing's green spaces was concentrated, forming different agglomerations. The three examined external factors are all associated with the use of green spaces. Among them, commercial facilities are the important external factor associated with the use of green spaces. For the selection of sites for urban green spaces, we recommend consideration of external factors in order to balance urban green space utilization.

Evaluation of marginal bone loss of dental implants with internal or external connections and its association with other variables: A systematic review.

PubMed

de Medeiros, Rodrigo Antonio; Pellizzer, Eduardo Piza; Vechiato Filho, Aljomar José; Dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas; Goiato, Marcelo Coelho

2016-10-01

Different factors can influence marginal bone loss around dental implants, including the type of internal and external connection between the implant and the abutment. The evidence needed to evaluate these factors is unclear. The purpose of this systematic review was to evaluate marginal bone loss by radiographic analysis around dental implants with internal or external connections. A systematic review was conducted following the criteria defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Initially, a population, intervention, comparison, and outcome(s) (PICO) question was defined: does the connection type (internal or external) influence marginal bone loss in patients undergoing implantation? An electronic search of PubMed/MEDLINE and Scopus databases was performed for studies in English language published between January 2000 and December 2014 by 2 independent reviewers, who analyzed the marginal bone loss of dental implants with an internal and/or external connection. From an initial screening yield of 595 references and after considering inclusion and exclusion criteria, 17 articles were selected for this review. Among them, 10 studies compared groups of implants with internal and external connections; 1 study evaluated external connections; and 6 studies analyzed internal connections. A total of 2708 implants were placed in 864 patients. Regarding the connection type, 2347 implants had internal connections, and 361 implants had external connections. Most studies showed lower marginal bone loss values for internal connection implants than for external connection implants. Osseointegrated dental implants with internal connections exhibited lower marginal bone loss than implants with external connections. This finding is mainly the result of the platform switching concept, which is more frequently found in implants with internal connections. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

The factor structure of posttraumatic stress disorder: a literature update, critique of methodology, and agenda for future research.

PubMed

Elhai, Jon D; Palmieri, Patrick A

2011-08-01

We present an update of recent literature (since 2007) exploring the factor structure of posttraumatic stress disorder (PTSD) symptom measures. Research supporting a four-factor emotional numbing model and a four-factor dysphoria model is presented, with these models fitting better than all other models examined. Variables accounting for factor structure differences are reviewed, including PTSD query instructions, type of PTSD measure, extent of trauma exposure, ethnicity, and timing of administration. Methodological and statistical limitations with recent studies are presented. Finally, a research agenda and recommendations are offered to push this research area forward, including suggestions to validate PTSD’s factors against external measures of psychopathology, test moderators of factor structure, and examine heterogeneity of symptom presentations based on factor structure examination.

OVERVIEW OF THE ACTIVITIES OF THE NUCLEAR ENERGY AGENCY WORKING GROUP ON EXTERNAL EVENTS

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

Nakoski, John A.; Smith, Curtis L.; Kim, Min Kyu

The Orgranisation for Economic Cooperation and Development (OECD) Nuclear Energy Agency (NEA) has established a Working Group on External Events (WGEV) that provides a forum for subject matter experts from the nuclear industry and regulators to improve the understanding and treatment of external hazards that would support the continued safety performance of nuclear installations, and improve the effectiveness of regulatory practices, in NEA member countries. This report provides a description of the ongoing work of the WGEV. The work of the WGEV includes the collection of information and conducting a workshop on severe weather and storm surge that brought togethermore » a diverse group of subject matter experts to identify commendable practices related to the treatment of severe weather and storm surge consideration in regulatory and operational decision-making. Other work of the WGEV includes looking at science-based screening of external events that are factored into decisions on the safe operation of nuclear facilities; and identification of commendable practices and knowledge gaps on riverine flooding.« less

DSM-IV Personality Disorders and Associations with Externalizing and Internalizing Disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Harford, Thomas C.; Chen, Chiung M.; Saha, Tulshi D.; Smith, Sharon M.; Ruan, W. June; Grant, Bridget F.

2013-01-01

Background Although associations between personality disorders and psychiatric disorders are well established in general population studies, their association with liability dimensions for externalizing and internalizing disorders has not been fully assessed. The purpose of this study is to examine associations between personality disorders (PDs) and lifetime externalizing and internalizing Axis I disorders. Methods Data were obtained from the total sample of 34,653 respondents from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drawing on the literature, a 3-factor exploratory structural equation model was selected to simultaneously assess the measurement relations among DSM-IV Axis I substance use and mood and anxiety disorders and the structural relations between the latent internalizing-externalizing dimensions and DSM-IV PDs, adjusting for gender, age, race/ethnicity, and marital status. Results Antisocial, histrionic, and borderline PDs were strong predictors for the externalizing factor, while schizotypal, borderline, avoidant, and obsessive-compulsive PDs had significantly larger effects on the internalizing fear factor when compared to the internalizing misery factor. Paranoid, schizoid, narcissistic, and dependent PDs provided limited discrimination between and among the three factors. An overarching latent factor representing general personality dysfunction was significantly greater on the internalizing fear factor followed by the externalizing factor, and weakest for the internalizing misery factor. Conclusion Personality disorders offer important opportunities for studies on the externalizing-internalizing spectrum of common psychiatric disorders. Future studies based on panic, anxiety, and depressive symptoms may elucidate PD associations with the internalizing spectrum of disorders. PMID:23932575

The role of audience characteristics and external factors in continuing medical education and physician change: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines.

PubMed

Lowe, Mary Martin; Bennett, Nancy; Aparicio, Alejandro

2009-03-01

The Agency for Healthcare Research and Quality (AHRQ) Evidence Report identified and assessed audience characteristics (internal factors) and external factors that influence the effectiveness of continuing medical education (CME) in changing physician behavior. Thirteen studies examined a series of CME audience characteristics (internal factors), and six studies looked at external factors to reinforce the effects of CME in changing behavior. With regard to CME audience characteristics, the 13 studies examined age, gender, practice setting, years in practice, specialty, foreign vs US medical graduate, country of practice, personal motivation, nonmonetary rewards and motivations, learning satisfaction, and knowledge enhancement. With regard to the external characteristics, the six studies looked at the role of regulation, state licensing boards, professional boards, hospital credentialing, external audits, monetary and financial rewards, academic advancement, provision of tools, public demand and expectations, and CME credit. No consistent findings were identified. The AHRQ Evidence Report provides no conclusions about the ways that internal or external factors influence CME effectiveness in changing physician behavior. However, given what is known about how individuals approach learning, it is likely that internal factors play an important role in the design of effective CME. Regulatory and professional organizations are providing new structures, mandates, and recommendations for CME activities that influence the way CME providers design and present activities, supporting a role that is not yet clear for external factors. More research is needed to understand the impact of these factors in enhancing the effectiveness of CME.

DSM-IV personality disorders and associations with externalizing and internalizing disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Harford, Thomas C; Chen, Chiung M; Saha, Tulshi D; Smith, Sharon M; Ruan, W June; Grant, Bridget F

2013-11-01

Although associations between personality disorders and psychiatric disorders are well established in general population studies, their association with liability dimensions for externalizing and internalizing disorders has not been fully assessed. The purpose of this study is to examine associations between personality disorders (PDs) and lifetime externalizing and internalizing Axis I disorders. Data were obtained from the total sample of 34,653 respondents from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drawing on the literature, a 3-factor exploratory structural equation model was selected to simultaneously assess the measurement relations among DSM-IV Axis I substance use and mood and anxiety disorders and the structural relations between the latent internalizing-externalizing dimensions and DSM-IV PDs, adjusting for gender, age, race/ethnicity, and marital status. Antisocial, histrionic, and borderline PDs were strong predictors for the externalizing factor, while schizotypal, borderline, avoidant, and obsessive-compulsive PDs had significantly larger effects on the internalizing fear factor when compared to the internalizing misery factor. Paranoid, schizoid, narcissistic, and dependent PDs provided limited discrimination between and among the three factors. An overarching latent factor representing general personality dysfunction was significantly greater on the internalizing fear factor followed by the externalizing factor, and weakest for the internalizing misery factor. Personality disorders offer important opportunities for studies on the externalizing-internalizing spectrum of common psychiatric disorders. Future studies based on panic, anxiety, and depressive symptoms may elucidate PD associations with the internalizing spectrum of disorders. Published by Elsevier Ltd.

Family Structure, Transitions and Psychiatric Disorders Among Puerto Rican Children

PubMed Central

Santesteban-Echarri, Olga; Eisenberg, Ruth E.; Bird, Hector R.; Canino, Glorisa J.; Duarte, Cristiane S.

2016-01-01

This paper examines whether family structure and its transitions are associated with internalizing and externalizing psychiatric disorders among Puerto Rican-origin children. It uses longitudinal data (three waves) from the Boricua Youth Study, which includes probability samples of children in the South Bronx (New York) and San Juan (Puerto Rico) (n = 2,142). We also examine factors which may explain how family structure and transitions may be related to child psychiatric disorders. Our results show that for both internalizing and externalizing disorders there were no significant differences between children of cohabiting (biological or step) parents or of single parents compared to children of married biological parents. In Puerto Rico only, transitioning once from a two-parent family to a single-parent family was related to child internalizing disorders. Family transitions were not associated with externalizing disorders at either site. Context may be an important factor shaping the risk that family dissolution is followed by an internalizing disorder among children. PMID:28713212

Techno-economical efficiency and productivity change of wastewater treatment plants: the role of internal and external factors.

PubMed

Hernández-Sancho, F; Molinos-Senante, M; Sala-Garrido, R

2011-12-01

Efficiency and productivity are important measures for identifying best practice in businesses and optimising resource-use. This study analyses how these two measures change across the period 2003-2008 for 196 wastewater treatment plants (WWTPs) in Spain, by using the benchmarking methods of Data Envelopment Analysis and the Malmquist Productivity Index. To identify which variables contribute to the sustainability of the WWTPs, differences in efficiency scores and productivity indices for external factors are also investigated. Our results indicate that both efficiency and productivity decreased over the five years. We verify that the productivity drop is primarily explained by technical change. Furthermore, certain external variables affected WWTP efficiency, including plant size, treatment technology and energy consumption. However, plants with low energy consumption are the only ones which improve their productivity. Finally, the benchmarking analyses proved to be useful as management tools in the wastewater sector, by providing vital information for improving the sustainability of plants.

Extension Procedures for Confirmatory Factor Analysis

ERIC Educational Resources Information Center

Nagy, Gabriel; Brunner, Martin; Lüdtke, Oliver; Greiff, Samuel

2017-01-01

We present factor extension procedures for confirmatory factor analysis that provide estimates of the relations of common and unique factors with external variables that do not undergo factor analysis. We present identification strategies that build upon restrictions of the pattern of correlations between unique factors and external variables. The…

Looking is buying. How visual attention and choice are affected by consumer preferences and properties of the supermarket shelf.

PubMed

Gidlöf, Kerstin; Anikin, Andrey; Lingonblad, Martin; Wallin, Annika

2017-09-01

There is a battle in the supermarket isle, a battle between what the consumer wants and what the retailer and others want her to see, and subsequently to buy. Product packages and displays contain a number of features and attributes tailored to catch consumers' attention. These are what we call external factors comprising the visual saliency, the number of facings, and the placement of each product. But a consumer also brings with her a number of goals and interests related to the products and their attributes. These are important internal factors, including brand preferences, price sensitivity, and dietary inclinations. We fit mobile eye trackers to consumers visiting real-life supermarkets in order to investigate to what extent external and internal factors affect consumers' visual attention and purchases. Both external and internal factors influenced what products consumers looked at, with a strong positive interaction between visual saliency and consumer preferences. Consumers appear to take advantage of visual saliency in their decision making, using their knowledge about products' appearance to guide their visual attention towards those that fit their preferences. When it comes to actual purchases, however, visual attention was by far the most important predictor, even after controlling for all other internal and external factors. In other words, the very act of looking longer or repeatedly at a package, for any reason, makes it more likely that this product will be bought. Visual attention is thus crucial for understanding consumer behaviour, even in the cluttered supermarket environment, but it cannot be captured by measurements of visual saliency alone. Copyright © 2017 Elsevier Ltd. All rights reserved.

High external quantum efficiency and fill-factor InGaN/GaN heterojunction solar cells grown by NH3-based molecular beam epitaxy

NASA Astrophysics Data System (ADS)

Lang, J. R.; Neufeld, C. J.; Hurni, C. A.; Cruz, S. C.; Matioli, E.; Mishra, U. K.; Speck, J. S.

2011-03-01

High external quantum efficiency (EQE) p-i-n heterojunction solar cells grown by NH3-based molecular beam epitaxy are presented. EQE values including optical losses are greater than 50% with fill-factors over 72% when illuminated with a 1 sun AM0 spectrum. Optical absorption measurements in conjunction with EQE measurements indicate an internal quantum efficiency greater than 90% for the InGaN absorbing layer. By adjusting the thickness of the top p-type GaN window contact layer, it is shown that the short-wavelength (<365 nm) quantum efficiency is limited by the minority carrier diffusion length in highly Mg-doped p-GaN.

40 CFR Table 29 to Subpart G of... - Seal Related Factors for External Floating Roof Vessels

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Seal Related Factors for External..., and Wastewater Pt. 63, Subpt. G, Table 29 Table 29 to Subpart G of Part 63—Seal Related Factors for External Floating Roof Vessels Seal type Welded vessels KS N Riveted vessels KS N Metallic shoe seal...

40 CFR Table 29 to Subpart G of... - Seal Related Factors for External Floating Roof Vessels

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Seal Related Factors for External..., and Wastewater Pt. 63, Subpt. G, Table 29 Table 29 to Subpart G of Part 63—Seal Related Factors for External Floating Roof Vessels Seal type Welded vessels KS N Riveted vessels KS N Metallic shoe seal...

Testing the dimensional structure of DSM-5 posttraumatic stress disorder symptoms in a nonclinical trauma-exposed adolescent sample.

PubMed

Liu, Liyong; Wang, Li; Cao, Chengqi; Qing, Yulan; Armour, Cherie

2016-02-01

The current study investigated the underlying dimensionality of DSM-5 posttraumatic stress disorder (PTSD) symptoms in a trauma-exposed Chinese adolescent sample using a confirmatory factor analytic (CFA) alternative model approach. The sample consisted of 559 students (242 females and 314 males) ranging in age from 12 to 18 years (M = 15.8, SD = 1.3). Participants completed the PTSD Checklist for DSM-5, the Major Depression Disorder and Panic Disorder subscales of the Revised Children's Anxiety and Depression Scale, and the Aggressive Behavior subscale of the Youth Self-Report. Confirmatory factor analytic results indicated that a seven-factor model comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behavior, anxious arousal, and dysphoric arousal factors emerged as the best-fitting model. Further analyses showed that the external measures of psychopathological variables including major depressive disorder, panic disorder, and aggressive behavior were differentially associated with the resultant factors. These findings support and extend previous findings for the newly refined seven-factor hybrid model, and carry clinical and research implications for trauma-related psychopathology. © 2015 Association for Child and Adolescent Mental Health.

Treatment of unstable distal radius fractures: non-invasive dynamic external fixator versus volar locking plate – functional and radiological outcome in a prospective case-controlled series

PubMed Central

Bajwa, Ali S.; Rammappa, Manju; Lee, Ling; Nanda, Rajesh

2015-01-01

Introduction: Distal radius fracture (DRF) is a common injury and various treatment modalities including open reduction and internal fixation (ORIF) with volar locking plate are available. More recently, a non-invasive external fixator has been used. Aims: To prospectively compare the use of a non-invasive external fixator with early dynamisation for DRF against ORIF with volar locking plate control group. Methods: Consecutive patients with closed DRF were included in a prospective case-controlled study. Patients were assigned to non-invasive external fixator or ORIF. Minimum follow-up was two years. Follow-up was at weeks 2, 4, 6, 8, 12, 26 and at one and two-year post-operatively. The outcome measures included demographic details, injury mechanism, AO fracture type, risk factors, body mass index (BMI), ulnar styloid fracture and dorsal comminution, radiographs, grip strength and DASH score. Results: Consecutive 50 patients were treated either with non-invasive external fixator (25/50) or with ORIF (25/50) and the mean age of the two groups was 53 years (SD 17.1) and 49 years (SD 19.5), respectively. Demographics were matched in two groups. In the non-invasive external fixator group, there were 10 AO Type-A, 5 Type-B and 10 Type-C fractures. The ORIF group included 8 Type-A, 6 Type-B and 11 Type-C fractures. The mean DASH score at three-months and one-year post-injury in non-invasive fixator group was 12.2 (SD 3.1) and 3.5 (SD 0.7), respectively, significantly greater than those of ORIF group 14.5 (SD 5.6) and 11.2 (SD 4.4), respectively (p < 0.05). Conclusion: DRF treated with non-invasive external fixator can give functional results superior to ORIF at three-months and the trend is maintained at one and two-year post-operatively. PMID:27163089

External and internal factors influencing self-directed online learning of physiotherapy undergraduate students in Sweden: a qualitative study.

PubMed

Hammarlund, Catharina Sjödahl; Nilsson, Maria H; Gummesson, Christina

2015-01-01

Online courses have become common in health sciences education. This learning environment can be designed using different approaches to support student learning. To further develop online environment, it is important to understand how students perceive working and learning online. The aim of this study is to identify aspects influencing students' learning processes and their adaptation to self-directed learning online. Thirty-four physiotherapy students with a mean age of 25 years (range, 21 to 34 years) participated. Qualitative content analysis and triangulation was used when investigating the students' self-reflections, written during a five week self-directed, problem-oriented online course. Two categories emerged: 'the influence of the structured framework' and 'communication and interaction with teachers and peers.' The learning processes were influenced by external factors, e.g., a clear structure including a transparent alignment of assignments and assessment. Important challenges to over-come were primarily internal factors, e.g., low self-efficacy, difficulties to plan the work effectively and adapting to a new environment. The analyses reflected important perspectives targeting areas which enable further course development. The influences of external and internal factors on learning strategies and self-efficacy are important aspects to consider when designing online courses. Factors such as pedagogical design, clarity of purpose, goals, and guidelines were important as well as continuous opportunities for communication and collaboration. Further studies are needed to understand and scaffold the motivational factors among students with low self-efficacy.

Effect of temperature and magnetic field on disorder in semiconductor structures

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

Agrinskaya, N. V., E-mail: nina.agrins@mail.ioffe.ru; Kozub, V. I.

We present the results of consistent theoretical analysis of various factors that may lead to influence of temperature and external magnetic field on disorder in semiconductor structures. Main attention is paid to quantum well (QW) structures in which only QWs or both QW and barriers are doped (the doping level is assumed to be close to the value corresponding to the metal–insulator transition). The above factors include (i) ionization of localized states to the region of delocalized states above the mobility edge, which is presumed to exist in the impurity band; (ii) the coexistence in the upper and lower Hubbardmore » bands (upon doping of QWs as well as barriers); in this case, in particular, the external magnetic field determines the relative contribution of the upper Hubbard band due to spin correlations at doubly filled sites; and (iii) the contribution of the exchange interaction at pairs of sites, in which the external magnetic field can affect the relation between ferromagnetic and antiferromagnetic configurations. All these factors, which affect the structure and degree of disorder, lead to specific features in the temperature dependence of resistivity and determine specific features of the magnetoresistance. Our conclusions are compared with available experimental data.« less

Combined Influences of Genes, Prenatal Environment, Cortisol, and Parenting on the Development of Children's Internalizing Versus Externalizing Problems.

PubMed

Marceau, Kristine; Laurent, Heidemarie K; Neiderhiser, Jenae M; Reiss, David; Shaw, Daniel S; Natsuaki, Misaki N; Fisher, Philip A; Leve, Leslie D

2015-05-01

Research suggests that genetic, prenatal, endocrine, and parenting influences across development individually contribute to internalizing and externalizing problems in children. The present study tests the combined contributions of genetic risk for psychopathology, prenatal environments (maternal drug use and internalizing symptoms), child cortisol at age 4.5 years, and overreactive parenting influences across childhood on 6-year-old children's internalizing and externalizing problems. We used data from an adoption design that included 361 domestically adopted children and their biological and adopted parents prospectively followed from birth. Only parenting influences contributed (independently) to externalizing problems. However, genetic influences were indirectly associated with internalizing problems (through increased prenatal risk and subsequent morning cortisol), and parenting factors were both directly and indirectly associated with internalizing problems (through morning cortisol). Results suggest that prenatal maternal drug use/symptoms and children's morning cortisol levels are mechanisms of genetic and environmental influences on internalizing problems, but not externalizing problems, in childhood.

Combined influences of genes, prenatal environment, cortisol, and parenting on the development of children’s internalizing vs. externalizing problems

PubMed Central

Marceau, Kristine; Laurent, Heidemarie K.; Neiderhiser, Jenae M.; Reiss, David; Shaw, Daniel S.; Natsuaki, Misaki; Fisher, Philip A.; Leve, Leslie D.

2014-01-01

Research suggests that genetic, prenatal, endocrine, and parenting influences across development individually contribute to internalizing and externalizing problems in children. The present study tests the combined contributions of genetic risk for psychopathology, prenatal environments (maternal drug use and internalizing symptoms), child cortisol at age 4.5 years, and overreactive parenting influences across childhood on 6-year-old children’s internalizing and externalizing problems. We used data from an adoption design that included 361 domestically adopted children and their biological and adopted parents prospectively followed from birth. Only parenting influences contributed (independently) to externalizing problems. However, genetic influences were indirectly associated with internalizing problems (through increased prenatal risk and subsequent morning cortisol), and parenting factors were both directly and indirectly associated with internalizing problems (through morning cortisol). Results suggest that prenatal maternal drug use/symptoms and children’s morning cortisol levels are mechanisms of genetic and environmental influences on internalizing problems, but not externalizing problems, in childhood. PMID:25355319

Relative contributions of external forcing factors to circulation and hydrographic properties in a micro-tidal bay

NASA Astrophysics Data System (ADS)

Yoon, Seokjin; Kasai, Akihide

2017-11-01

The dominant external forcing factors influencing estuarine circulation differ among coastal environments. A three-dimensional regional circulation model was developed to estimate external influence indices and relative contributions of external forcing factors such as external oceanic forcing, surface heat flux, wind stress, and river discharge to circulation and hydrographic properties in Tango Bay, Japan. Model results show that in Tango Bay, where the Tsushima Warm Current passes offshore of the bay, under conditions of strong seasonal winds and river discharge, the water temperature and salinity are strongly influenced by surface heat flux and river discharge in the surface layer, respectively, while in the middle and bottom layers both are mainly controlled by open boundary conditions. The estuarine circulation is comparably influenced by all external forcing factors, the strong current, surface heat flux, wind stress, and river discharge. However, the influence degree of each forcing factor varies with temporal variations in external forcing factors as: the influence of open boundary conditions is higher in spring and early summer when the stronger current passes offshore of the bay, that of surface heat flux reflects the absolute value of surface heat flux, that of wind stress is higher in late fall and winter due to strong seasonal winds, and that of river discharge is higher in early spring due to snow-melting and summer and early fall due to flood events.

A Proposal for Change: The Miller F. Whittaker Library's Long Range Program, 1985-1995. Revised.

ERIC Educational Resources Information Center

Smalls, Mary L.

This document presents an outline of a 10-year (1985-1995) library program proposal for an academic library. Six areas crucial to dealing with a changing academic library environment are analyzed as they relate to internal and external change factors. These factors, which focus on meeting the information needs of users for a new century, include:…

Gender Differences in the Influence of Early Perceived Parental Support on Student Mathematics and Science Achievement and STEM Career Attainment

ERIC Educational Resources Information Center

Ing, Marsha

2014-01-01

The lack of females entering STEM careers is well documented. Reasons for the gender gaps at all stages of the educational pipeline include both internal factors such as self-concept and external factors such as the influence of parents, media, and educators. Using latent growth curve analysis and nationally representative longitudinal survey…

The Role of Fragile Sites in Sporadic Papillary Thyroid Carcinoma

PubMed Central

Dillon, Laura W.; Lehman, Christine E.; Wang, Yuh-Hwa

2012-01-01

The incidence of thyroid cancer is increasing, especially papillary thyroid carcinoma (PTC), making it currently the fastest-growing cancer among women. Reasons for this increase remain unclear, but several risk factors including radiation exposure and improved detection techniques have been suggested. Recently, the induction of chromosomal fragile site breakage was found to result in the formation of RET/PTC1 rearrangements, a common cause of PTC. Chromosomal fragile sites are regions of the genome with a high susceptibility to forming DNA breaks and are often associated with cancer. Exposure to a variety of external agents can induce fragile site breakage, which may account for some of the observed increase in PTC. This paper discusses the role of fragile site breakage in PTC development, external fragile site-inducing agents that may be potential risk factors for PTC, and how these factors are especially targeting women. PMID:22762011

Visualization in Science and the Arts.

ERIC Educational Resources Information Center

Roth, Susan King

Visualization as a factor of intelligence includes the mental manipulation of spatial configurations and has been associated with spatial abilities, creative thinking, and conceptual problem solving. There are numerous reports of scientists and mathematicians using visualization to anticipate transformation of the external world. Artists and…

Environmental Scanning Report.

ERIC Educational Resources Information Center

Truckee Meadows Community Coll., Sparks, NV.

This report describes Truckee Meadows Community College's (Nevada) environmental scanning process and results. The college decided that environmental scanning and forecasting techniques should be used to plan for both short-term and long-term external factors that impact programs, enrollment, and budgets. Strategic goals include: (1) keeping pace…

The Security Factor in School Renovations.

ERIC Educational Resources Information Center

Fickes, Michael

1998-01-01

Discusses how one Indiana high school used its renovation as an opportunity to reevaluate the school's security design. Security considerations in the building's external and internal environment include lighting, directional signage, parking, access control technology, and issues regarding the use of closed circuit television. (GR)

Entrepreneurship--Born, Made and Educated

ERIC Educational Resources Information Center

Burger-Helmchen, Thierry, Ed.

2012-01-01

Chapters in this book include: (1) The Psychology of Entrepreneurship (Melek Kalkan and Canani Kaygusuz); (2) Entrepreneurial Intentions: The Role of the Cognitive Variables (Jose C. Sanchez); (3) Do External Factors Influence Students' Entrepreneurial Inclination? An Evidence Based Approach (Ishfaq Ahmed, Muhammad Musarrat Nawaz and Muhammad…

Predictive factors of user acceptance on the primary educational mathematics aids product

NASA Astrophysics Data System (ADS)

Hidayah, I.; Margunani; Dwijanto

2018-03-01

Mathematics learning in primary schools requires instructional media. According to Piaget's theory, students are still in the concrete operational stage. For this reason, the development of the primary level mathematics aids is needed to support the development of successful mathematics learning. The stages of this research are the stages of commercialization with preparatory, marketing, and measurement analysis procedures. Promotion as part of marketing is done by doing a demonstration to the teacher. Measurements were performed to explore the predictive factors of user feasibility in adopting the product. Measurements were conducted using the concept of Technology Acceptance Model (TAM). Measurement variables include external variables, perceived usefulness, perceived ease of use, attitude, intention to use, and actual use. The result of this research shows that the contribution of predictive factors of mathematics teachers on the teaching aids product as follows: the external variable and perceived ease of use at 74%, perceived usefulness at 72%, intention to use (behavioral) at 58%, attitude at 52%, and the consequence factor (actual use) at 42%.

The effects of environmental and classroom noise on the academic attainments of primary school children.

PubMed

Shield, Bridget M; Dockrell, Julie E

2008-01-01

While at school children are exposed to various types of noise including external, environmental noise and noise generated within the classroom. Previous research has shown that noise has detrimental effects upon children's performance at school, including reduced memory, motivation, and reading ability. In England and Wales, children's academic performance is assessed using standardized tests of literacy, mathematics, and science. A study has been conducted to examine the impact, if any, of chronic exposure to external and internal noise on the test results of children aged 7 and 11 in London (UK) primary schools. External noise was found to have a significant negative impact upon performance, the effect being greater for the older children. The analysis suggested that children are particularly affected by the noise of individual external events. Test scores were also affected by internal classroom noise, background levels being significantly related to test results. Negative relationships between performance and noise levels were maintained when the data were corrected for socio-economic factors relating to social deprivation, language, and special educational needs. Linear regression analysis has been used to estimate the maximum levels of external and internal noise which allow the schools surveyed to achieve required standards of literacy and numeracy.

Childhood Maltreatment Exposure and Disruptions in Emotion Regulation: A Transdiagnostic Pathway to Adolescent Internalizing and Externalizing Psychopathology

PubMed Central

Jenness, Jessica L.; Stoep, Ann Vander; McCauley, Elizabeth; McLaughlin, Katie A.

2016-01-01

Child maltreatment is a robust risk factor for internalizing and externalizing psychopathology in children and adolescents. We examined the role of disruptions in emotion regulation processes as a developmental mechanism linking child maltreatment to the onset of multiple forms of psychopathology in adolescents. Specifically, we examined whether child maltreatment was associated with emotional reactivity and maladaptive cognitive and behavioral responses to distress, including rumination and impulsive behaviors, in two separate samples. We additionally investigated whether each of these components of emotion regulation were associated with internalizing and externalizing psychopathology and mediated the association between child maltreatment and psychopathology. Study 1 included a sample of 167 adolescents recruited based on exposure to physical, sexual, or emotional abuse. Study 2 included a sample of 439 adolescents in a community-based cohort study followed prospectively for 5 years. In both samples, child maltreatment was associated with higher levels of internalizing psychopathology, elevated emotional reactivity, and greater habitual engagement in rumination and impulsive responses to distress. In Study 2, emotional reactivity and maladaptive responses to distress mediated the association between child maltreatment and both internalizing and externalizing psychopathology. These findings provide converging evidence for the role of emotion regulation deficits as a transdiagnostic developmental pathway linking child maltreatment with multiple forms of psychopathology. PMID:27695145

Childhood Maltreatment Exposure and Disruptions in Emotion Regulation: A Transdiagnostic Pathway to Adolescent Internalizing and Externalizing Psychopathology.

PubMed

Heleniak, Charlotte; Jenness, Jessica L; Stoep, Ann Vander; McCauley, Elizabeth; McLaughlin, Katie A

2016-06-01

Child maltreatment is a robust risk factor for internalizing and externalizing psychopathology in children and adolescents. We examined the role of disruptions in emotion regulation processes as a developmental mechanism linking child maltreatment to the onset of multiple forms of psychopathology in adolescents. Specifically, we examined whether child maltreatment was associated with emotional reactivity and maladaptive cognitive and behavioral responses to distress, including rumination and impulsive behaviors, in two separate samples. We additionally investigated whether each of these components of emotion regulation were associated with internalizing and externalizing psychopathology and mediated the association between child maltreatment and psychopathology. Study 1 included a sample of 167 adolescents recruited based on exposure to physical, sexual, or emotional abuse. Study 2 included a sample of 439 adolescents in a community-based cohort study followed prospectively for 5 years. In both samples, child maltreatment was associated with higher levels of internalizing psychopathology, elevated emotional reactivity, and greater habitual engagement in rumination and impulsive responses to distress. In Study 2, emotional reactivity and maladaptive responses to distress mediated the association between child maltreatment and both internalizing and externalizing psychopathology. These findings provide converging evidence for the role of emotion regulation deficits as a transdiagnostic developmental pathway linking child maltreatment with multiple forms of psychopathology.

Enhanced Performance of Streamline-Traced External-Compression Supersonic Inlets

NASA Technical Reports Server (NTRS)

Slater, John W.

2015-01-01

A computational design study was conducted to enhance the aerodynamic performance of streamline-traced, external-compression inlets for Mach 1.6. The current study explored a new parent flowfield for the streamline tracing and several variations of inlet design factors, including the axial displacement and angle of the subsonic cowl lip, the vertical placement of the engine axis, and the use of porous bleed in the subsonic diffuser. The performance was enhanced over that of an earlier streamline-traced inlet such as to increase the total pressure recovery and reduce total pressure distortion

'Ego-dystonicity' in homosexuality: An Indian perspective.

PubMed

Maroky, Ami Sebastian; Ratheesh, Aswin; Viswanath, Biju; Math, Suresh Bada; Chandrashekar, Channapatna R; Seshadri, Shekhar P

2015-06-01

Homosexual persons are targets of verbal and physical abuse, discrimination and face legal disadvantages in many countries, including India. These external factors could play a role in determining discomfort with their sexuality. We ascertained the association between ego-dystonicity of sexual orientation and indices of perceived acceptance, stigma and awareness of possible normative lifestyles. Fifty-one self-identified adult homosexual men were assessed using online questionnaires that covered information including their socio-demographic details; a Visual Analog Scale (VAS) that measured their degree of discomfort with their sexuality; Reactions to Homosexuality Scale, Perceived Acceptance Scale, Modified China Men Who Have Sex with Men (MSM) Stigma scale; and trait version of the Positive and Negative Affect Scale. The participants were also asked to provide a written narrative of their experiences which influenced their comfort with their sexuality. Discomfort with sexuality significantly correlated with education, acceptance by friends and family, legal disadvantages, awareness and accessibility to non-heteronormative lifestyles and support systems and trait affect. Only acceptance by friends and awareness showed significance on linear regression. Qualitative analyses revealed external attributions for discomfort. Modifying external factors, reducing legal restrictions and improving societal acceptance and support systems could reduce 'ego-dystonicity'. 'Ego-dystonicity' as a determinant for psychiatric classification and intervention needs to be reexamined. © The Author(s) 2014.

Network evolution model for supply chain with manufactures as the core.

PubMed

Fang, Haiyang; Jiang, Dali; Yang, Tinghong; Fang, Ling; Yang, Jian; Li, Wu; Zhao, Jing

2018-01-01

Building evolution model of supply chain networks could be helpful to understand its development law. However, specific characteristics and attributes of real supply chains are often neglected in existing evolution models. This work proposes a new evolution model of supply chain with manufactures as the core, based on external market demand and internal competition-cooperation. The evolution model assumes the external market environment is relatively stable, considers several factors, including specific topology of supply chain, external market demand, ecological growth and flow conservation. The simulation results suggest that the networks evolved by our model have similar structures as real supply chains. Meanwhile, the influences of external market demand and internal competition-cooperation to network evolution are analyzed. Additionally, 38 benchmark data sets are applied to validate the rationality of our evolution model, in which, nine manufacturing supply chains match the features of the networks constructed by our model.

Network evolution model for supply chain with manufactures as the core

PubMed Central

Jiang, Dali; Fang, Ling; Yang, Jian; Li, Wu; Zhao, Jing

2018-01-01

Building evolution model of supply chain networks could be helpful to understand its development law. However, specific characteristics and attributes of real supply chains are often neglected in existing evolution models. This work proposes a new evolution model of supply chain with manufactures as the core, based on external market demand and internal competition-cooperation. The evolution model assumes the external market environment is relatively stable, considers several factors, including specific topology of supply chain, external market demand, ecological growth and flow conservation. The simulation results suggest that the networks evolved by our model have similar structures as real supply chains. Meanwhile, the influences of external market demand and internal competition-cooperation to network evolution are analyzed. Additionally, 38 benchmark data sets are applied to validate the rationality of our evolution model, in which, nine manufacturing supply chains match the features of the networks constructed by our model. PMID:29370201

Dimensional structure of DSM-5 posttraumatic stress disorder symptoms: results from the National Health and Resilience in Veterans Study.

PubMed

Tsai, Jack; Harpaz-Rotem, Ilan; Armour, Cherie; Southwick, Steven M; Krystal, John H; Pietrzak, Robert H

2015-05-01

To evaluate the prevalence of DSM-5 posttraumatic stress disorder (PTSD) and factor structure of PTSD symptomatology in a nationally representative sample of US veterans and examine how PTSD symptom clusters are related to depression, anxiety, suicidal ideation, hostility, physical and mental health-related functioning, and quality of life. Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative survey of 1,484 US veterans conducted from September through October 2013. Confirmatory factor analyses were conducted to evaluate the factor structure of PTSD symptoms, and structural equation models were constructed to examine the association between PTSD symptom clusters and external correlates. 12.0% of veterans screened positive for lifetime PTSD and 5.2% for past-month PTSD. A 5-factor dysphoric arousal model and a newly proposed 6-factor model both fit the data significantly better than the 4-factor model of DSM-5. The 6-factor model fit the data best in the full sample, as well as in subsamples of female veterans and veterans with lifetime PTSD. The emotional numbing symptom cluster was more strongly related to depression (P < .001) and worse mental health-related functioning (P < .001) than other symptom clusters, while the externalizing behavior symptom cluster was more strongly related to hostility (P < .001). A total of 5.2% of US veterans screened positive for past-month DSM-5 PTSD. A 6-factor model of DSM-5 PTSD symptoms, which builds on extant models and includes a sixth externalizing behavior factor, provides the best dimensional representation of DSM-5 PTSD symptom clusters and demonstrates validity in assessing health outcomes of interest in this population. © Copyright 2015 Physicians Postgraduate Press, Inc.

[Satisfaction of Users with Spinal Cord Injury in relation to the Service of Promotion of Personal Autonomy of the Balearic Islands, Spain].

PubMed

Capó-Juan, Miguel Ángel; Fiol-Delgado, Rosa Mª; Alzamora-Perelló, Mª Magdalena; Bosch-Gutiérrez, Marta; Serna-López, Lucía; Bennasar-Veny, Miguel; Aguiló-Pons, Antonio; De Pedro-Gómez, Joan E

2016-11-10

Public Service Promotion of Personal Autonomy aims to provide care to users with severe physical and/or physical-mental disabilities, including people with spinal cord injury. These users are in a chronic phase and thus they require educational-therapeutic measures of physiotherapy. This study is meant to determine the satisfaction of people with spinal cord injury who attend this service. A descriptive, cross-sectional, quantitative study in the Public Service Promotion of Personal Autonomy after a sixteen-month therapeutic monitoring process was carried out, which began in March 2015. The final study sample was 25 people with spinal cord injury (17 men and 8 women). At the end of therapeutic intervention, users responded to the SERVQHOS questionnaire, which consists in nineteen questions that aim to measure the quality of the care services provided. A statistical analysis was conducted, calculating averages and standard deviations or frecuencies and percentages. The best valued external factor was the staff appearance with 4,5 on average and the worst scored external factor was the ease of access and / or signposting of the center with 2,6 on average. On the other hand, the best valued internal factor was the kindness of the staff with 4,8 on average and the worst scored factor was the speed in which the users receive what they requested with 4,2 on average. We concluded that the quality offered is determined by internal factors (kindness, trust, willingness to help) and weaknesses are related to structural factors of the center (external factors).

Externalizing and internalizing syndromes in relation to school truancy among adolescents in high-risk urban schools.

PubMed

Nik Jaafar, Nik Ruzyanei; Tuti Iryani, Mohammad Daud; Wan Salwina, Wan Ismail; Fairuz Nazri, Abdul Rahman; Kamal, Nor Azlin; Prakash, Reddy Jaya; Shah, Shamsul Azhar

2013-04-01

To examine the relationship between externalizing/internalizing syndromes and school truancy among Form Four (10th grade) students attending "high-risk" schools in Kuala Lumpur. This is a cross-sectional study conducted upon 16-year-old adolescents attending three high-risk schools in Kuala Lumpur. A total of 373 students completed self-administered questionnaires on the sociodemographic variables and externalizing/internalizing syndromes. The number of truant-days per student during the study period was obtained from the school records. The mean internalizing score, externalizing score and total problem score of those who were truant were found to be significantly higher (P < 0.05) than those who were non-truant. Multiple logistic regressions showed externalizing syndrome (odds ratio [OR] = 1.044; confidence interval [CI] = 1.012-1.078, P = 0.018) significantly predicts truancy but not the internalizing syndrome. Two other psychosocial factors, namely, having divorced parents (OR = 2.495, CI = 1.058-5.886, P = 0.037) and did not understand or were uncertain of the purpose of schooling (OR = 2.621, CI = 1.265-5.433, P = 0.010) were also showed to be stronger predictors of truancy compared to externalizing/internalizing syndromes. Truancy has significant association to externalizing syndrome, in addition to other significant psychosocial variables like parental and schooling factors. This finding indicated the need for comprehensive assessment of students presenting with truant behavior, including the identification of associated psychological and behavioral problems which highlights the roles of mental health professionals in tackling truancy. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

The Effect of Teacher's Invitations to Parental Involvement on Children's Externalizing Problem Behaviors: An Examination of a CBC Intervention. CYFS Working Paper No. 2012-3

ERIC Educational Resources Information Center

Coutts, Michael J.; Sheridan, Susan M.; Kwon, Kyongboon; Semke, Carrie A.

2012-01-01

Behavioral problems in childhood are associated with academic difficulties including in-school suspensions, high school dropout, and low academic grades and achievement scores. Students with disruptive behavior problems demonstrate higher rates of social risk factors than their nondisruptive peers, including school maladjustment, antisocial…

Two-Year Colleges Move Toward Global Orientation

ERIC Educational Resources Information Center

Schultz, Raymond E.

1977-01-01

Describes events and factors contributing to a global orientation for community colleges, including external and internal forces, the role of university professors, agencies and professional organizations, foreign students, and the influence of staff and student travel. Possibilities and requirements of continued global development are discussed.…

Heat Effects on Living Plants

Treesearch

Robert C. Hare

1961-01-01

This review of knowledge concerning the effects of high temperatures on plants was undertaken in preparation for research aimed at determining how forest fires affect physiological processes in woody species. Major subjects discussed include morphological and physiological responses to high temperatures, external and internal factors governing these responses,...

Adaptation of Panic-Related Psychopathology Measures to Russian

ERIC Educational Resources Information Center

Kotov, Roman; Schmidt, Norman B.; Zvolensky, Michael J.; Vinogradov, Alexander; Antipova, Anna V.

2005-01-01

The study reports results of adaptation of panic-related psychopathology measures to Russian, including the Anxiety Sensitivity Index (ASI), the Agoraphobic Cognitions Questionnaire (ACQ), and the Mobility Inventory for Agoraphobia (MIA). Psychometric properties (e.g., reliability, factor structure, endorsement) and external validity of the…

Epeirogeny and plate tectonics

NASA Technical Reports Server (NTRS)

Menard, H. W.

1975-01-01

Vertical motions of the earth crust and their causes are considered in relation to epeirogenic phenomena. Factors discussed include: external loading and unloading; bending at subduction zones; internal density changes; and dynamic effects of mantle motion. The relationship between epeirogeny and drift is briefly reviewed along with oceanic epeirogeny.

Nipple pain associated with breastfeeding: incorporating current neurophysiology into clinical reasoning.

PubMed

Amir, Lisa H; Jones, Lester E; Buck, Miranda L

2015-03-01

New mothers frequently experience breastfeeding problems, in particular nipple pain. This is often attributed to compression, skin damage, infection or dermatitis. To outline an integrated approach to breastfeeding pain assessment that seeks to enhance current practice. Our clinical reasoning model resolves the complexity of pain into three categories: local stimulation, external influences and central modulation. Tissue pathology, damage or inflammation leads to local stimulation of nociceptors. External influences such as creams and breast pumps, as well as factors related to the mother, the infant and the maternal-infant interaction, may exacerbate the pain. Central nervous system modulation includes the enhancement of nociceptive transmission at the spinal cord and modification of the descending inhibitory influences. A broad range of factors can modulate pain through central mechanisms including maternal illness, exhaustion, lack of support, anxiety, depression or history of abuse. General practitioners (GPs) can use this model to explain nipple pain in complex settings, thus increasing management options for women.

Childhood internalizing and externalizing problems predict the onset of clinical panic attacks over adolescence: the TRAILS study.

PubMed

Mathyssek, Christina M; Olino, Thomas M; Verhulst, Frank C; van Oort, Floor V A

2012-01-01

Panic attacks are a source of individual suffering and are an independent risk factor for later psychopathology. However, much less is known about risk factors for the development of panic attacks, particularly during adolescence when the incidence of panic attacks increases dramatically. We examined whether internalizing and externalizing problems in childhood predict the onset of panic attacks in adolescence. This study is part of the TRacking Adolescents' Individual Lives Survey (TRAILS), a Dutch longitudinal population cohort study (N = 1,584). Internalizing and Externalizing Problems were collected using the Youth Self-Report (YSR) and the parent-report Child Behavior Checklist (CBCL) at baseline (age 10-12). At age 18-20, DSM-IV defined panic attacks since baseline were assessed with the Composite International Diagnostic Interview (CIDI). We investigated whether early adolescent Internalizing and Externalizing Problems predicted panic attacks between ages 10-20 years, using survival analysis in univariate and multivariate models. There were N = 314 (19.8%) cases who experienced at least one DSM-IV defined panic attack during adolescence and N = 18 (1.2%) who developed panic disorder during adolescence. In univariate analyses, CBCL Total Problems, Internalizing Problems and three of the eight syndrome scales predicted panic attack onset, while on the YSR all broad-band problem scales and each narrow-band syndrome scale predicted panic attack onset. In multivariate analyses, CBCL Social Problems (HR 1.19, p<.05), and YSR Thought Problems (HR 1.15, p<.05) and Social Problems (HR 1.26, p<.01) predicted panic attack onset. Risk indicators of panic attack include the wide range of internalizing and externalizing problems. Yet, when adjusted for co-occurring problem behaviors, Social Problems were the most consistent risk factor for panic attack onsets in adolescence.

Implementation and adaptation of the Re-Engineered Discharge (RED) in five California hospitals: a qualitative research study.

PubMed

Mitchell, S E; Weigel, G M; Laurens, V; Martin, J; Jack, B W

2017-04-19

Project Re-Engineered Discharge (RED) is an evidence-based strategy to reduce readmissions disseminated and adapted by various health systems across the country. To date, little is known about how adapting Project RED from its original protocol impacts RED implementation and/or sustainability. The goal of this study was to identify and characterize contextual factors influencing how five California hospitals adapted and implemented RED and the subsequent impact on RED program sustainability. Participant observation and key informant and focus group interviews with 64 individuals at five California hospitals implementing RED in 2012 and 2013 were conducted. These involved hospital leadership, personnel responsible for Project RED implementation, hospital staff, and clinicians. Interview transcripts were coded and analyzed using a modified grounded theory approach and constant comparative analysis. Both internal and external contextual factors were identified that influenced hospitals' decisions on RED adaptation and implementation. These also impacted RED sustainability. External factors included: impending federal penalties for hospitals with high readmission rates targeting specific diagnoses, and access to external funding and technical support to help hospitals implement RED. Internal or organizational level contextual factors included: committed leadership prioritizing Project RED; RED adaptations; depth, accountability and influence of the implementation team; sustainability planning; and hospital culture. Only three of the five hospitals continued Project RED beyond the implementation period. The sustainability of RED in participating hospitals was only possible when hospitals approached RED implementation as a transformational process rather than a patient safety project, maintained a high level of fidelity to the RED protocol, and had leadership and an implementation team who embraced change and failure in the pursuit of better patient care and outcomes. Hospitals who were unsuccessful in implementing a sustainable RED process lacked all or most of these components in their approach.

Family factors contributing to emotional and behavioral problems in Korean adolescents with epilepsy.

PubMed

Han, Su-Hyun; Lee, Sang-Ahm; Eom, Soyong; Kim, Heung-Dong

2016-03-01

We aimed to determine whether different aspects of family functioning are associated with emotional and behavioral problems in adolescents with epilepsy and, if not, to document any indirect associations mediated by other family factors. This was a cross-sectional, multicenter study. A total of 297 adolescents with epilepsy and their parents participated. Adolescent psychopathology was measured using the Youth Self-Report. Family factors were classified into proximal (parent-child interaction), distal (parent characteristics), and contextual factors (family characteristics) in accordance to their level of proximity to the adolescent's everyday life. Regression analyses were used to analyze the unique and combined predictive power of family factors in relation to psychopathology. In total, 44 (14.8%) and 51 (17.2%) adolescents with epilepsy scored above the borderline cutoff (T-score ≥ 60) of internalizing and externalizing problems, respectively. Proximal and distal factors were independently associated with both internalizing and externalizing problems. High levels of parental depressive mood and parental overcontrol were the strongest factors contributing to internalizing and externalizing problems, respectively. Contextual factors were indirectly associated with both internalizing and externalizing problems through more proximal factors. Both proximal and distal family factors affect psychopathology in Korean adolescents with epilepsy. Parental feelings of depression and parental overcontrol are the strongest factors contributing to internalizing and externalizing problems, respectively. Copyright © 2016 Elsevier Inc. All rights reserved.

Sex Differences in the Longitudinal Relations among Family Risk Factors and Childhood Externalizing Symptoms

ERIC Educational Resources Information Center

Blatt-Eisengart, Ilana; Drabick, Deborah A. G.; Monahan, Kathryn C.; Steinberg, Laurence

2009-01-01

Despite potential sex differences in base rates, predictors, and maintaining processes for children's externalizing behaviors, little prospective research has examined sex differences in the relations between concurrent, proximal family risk factors and children's externalizing behaviors. The current study examined the relations among maternal…

Structure and Etiology of Co-Occurring Internalizing and Externalizing Disorders in Adolescents

ERIC Educational Resources Information Center

Cosgrove, Victoria E.; Rhee, Soo H.; Gelhorn, Heather L.; Boeldt, Debra; Corley, Robin C.; Ehringer, Marissa A.; Young, Susan E.; Hewitt, John K.

2011-01-01

Several studies suggest that a two-factor model positing internalizing and externalizing factors explains the interrelationships among psychiatric disorders. However, it is unclear whether the covariation between internalizing and externalizing disorders is due to common genetic or environmental influences. We examined whether a model positing two…

Predicting Overall Survival After Stereotactic Ablative Radiation Therapy in Early-Stage Lung Cancer: Development and External Validation of the Amsterdam Prognostic Model

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

Louie, Alexander V., E-mail: Dr.alexlouie@gmail.com; Department of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London, Ontario; Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts

Purpose: A prognostic model for 5-year overall survival (OS), consisting of recursive partitioning analysis (RPA) and a nomogram, was developed for patients with early-stage non-small cell lung cancer (ES-NSCLC) treated with stereotactic ablative radiation therapy (SABR). Methods and Materials: A primary dataset of 703 ES-NSCLC SABR patients was randomly divided into a training (67%) and an internal validation (33%) dataset. In the former group, 21 unique parameters consisting of patient, treatment, and tumor factors were entered into an RPA model to predict OS. Univariate and multivariate models were constructed for RPA-selected factors to evaluate their relationship with OS. A nomogrammore » for OS was constructed based on factors significant in multivariate modeling and validated with calibration plots. Both the RPA and the nomogram were externally validated in independent surgical (n=193) and SABR (n=543) datasets. Results: RPA identified 2 distinct risk classes based on tumor diameter, age, World Health Organization performance status (PS) and Charlson comorbidity index. This RPA had moderate discrimination in SABR datasets (c-index range: 0.52-0.60) but was of limited value in the surgical validation cohort. The nomogram predicting OS included smoking history in addition to RPA-identified factors. In contrast to RPA, validation of the nomogram performed well in internal validation (r{sup 2}=0.97) and external SABR (r{sup 2}=0.79) and surgical cohorts (r{sup 2}=0.91). Conclusions: The Amsterdam prognostic model is the first externally validated prognostication tool for OS in ES-NSCLC treated with SABR available to individualize patient decision making. The nomogram retained strong performance across surgical and SABR external validation datasets. RPA performance was poor in surgical patients, suggesting that 2 different distinct patient populations are being treated with these 2 effective modalities.« less

Assessing the underlying dimensionality of DSM-5 PTSD symptoms in Chinese adolescents surviving the 2008 Wenchuan earthquake.

PubMed

Wang, Li; Zhang, Lingmin; Armour, Cherie; Cao, Chengqi; Qing, Yulan; Zhang, Jianxin; Liu, Ping; Zhang, Biao; Wu, Qi; Zhao, Zhihong; Fan, Gaolin

2015-04-01

By analyzing data yielded from a sample of Chinese adolescents surviving a high-intensity earthquake, this study investigated the underlying dimensionality of DSM-5 PTSD symptoms. The sample included 743 traumatized middle school students (396 females and 332 males) aged 11-17 years (mean=13.6, SD=1.0). Results of confirmatory factor analysis showed that an intercorrelated seven-factor model comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal factors provided a significant better representation of DSM-5 PTSD symptoms than other alternative models. Further analyses indicated that external measures of major depression disorder and panic disorder symptoms displayed unique associations with four PTSD factors. The findings provide further support for the newly proposed seven-factor model of DSM-5 PTSD symptoms, add to very limited empirical knowledge on the latent structure of DSM-5 PTSD symptoms among adolescents, and carry implications for further refinement of the current classifications of PTSD symptoms and further clinical practice and research on posttraumatic stress symptomatology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims.

PubMed

Soberón, Carmen; Crespo, María; Del Mar Gómez-Gutiérrez, María; Fernández-Lansac, Violeta; Armour, Cherie

2016-01-01

Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD) symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5) may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model) and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal. This model has received empirical support mainly in American samples. Of note, there have been a limited number of studies conducted on samples from other countries. This study aimed to examine the underlying dimensionality of DSM-5 PTSD symptoms in a Spanish clinical sample exposed to a range of traumatic events. Participants included 165 adults (78.8% females) seeking treatment in trauma services in the Madrid area (Spain). PTSD was assessed using the Global Assessment of Posttraumatic Stress Scale 5, a Spanish self-report instrument assessing posttraumatic symptoms according to the DSM-5 criteria. Confirmatory factor analyses were conducted in Mplus. Both the 7-factor Hybrid model and the 6-factor Anhedonia model demonstrated good and equivalent fit to the data. The findings of this study replicate and extend previous research by providing support for both the 7-factor Hybrid model and the 6-factor Anhedonia model in a clinical sample of Spanish trauma survivors. Given equivalent fit for these two models and the fewer number of latent factors in the Anhedonia model, it was selected as optimal in a traumatized Spanish sample. Implications and future research directions are discussed.

Increasing the marketability and recognition of provider network joint ventures.

PubMed

Sjobeck, S J

1998-08-01

Physicians have been developing provider network joint ventures to market their services jointly to managed care plans, employers, and other purchasers. Over the past few years, external market factors have produced a growing impact on these joint ventures. These external market factors include the Federal government's revised antitrust guidelines, National Committee for Quality Assurance activities, and state and Federal consumer protection laws. Simply responding to these forces may not increase a provider network's marketability unless the network can demonstrate its value in the terms and measurements accepted by the consumer, managed care plans, and provider networks. By doing so, a provider network can not only increase its marketability, but also increase its recognition in the market, improve its competitive advantage, and enhance its return on investment.

The obese gut microbiome across the epidemiologic transition.

PubMed

Dugas, Lara R; Fuller, Miles; Gilbert, Jack; Layden, Brian T

2016-01-01

The obesity epidemic has emerged over the past few decades and is thought to be a result of both genetic and environmental factors. A newly identified factor, the gut microbiota, which is a bacterial ecosystem residing within the gastrointestinal tract of humans, has now been implicated in the obesity epidemic. Importantly, this bacterial community is impacted by external environmental factors through a variety of undefined mechanisms. We focus this review on how the external environment may impact the gut microbiota by considering, the host's geographic location 'human geography', and behavioral factors (diet and physical activity). Moreover, we explore the relationship between the gut microbiota and obesity with these external factors. And finally, we highlight here how an epidemiologic model can be utilized to elucidate causal relationships between the gut microbiota and external environment independently and collectively, and how this will help further define this important new factor in the obesity epidemic.

The Significance of Family, Environment, and College Preparation: A Study of Factors Influencing Graduation and Persistence Rates of African American Males Playing Division I Basketball

ERIC Educational Resources Information Center

Mitchell, Enzley, IV

2017-01-01

The purpose of this study was to identify specific external factors including family composition, pre-college environment, and college preparation that contribute to why some African American males playing basketball at the NCAA Division I level graduate and persist while others do not. Despite an aggressive advertising campaign from the NCAA…

External Factors, Internal Factors and Self-Directed Learning Readiness

ERIC Educational Resources Information Center

Ramli, Nurjannah; Muljono, Pudji; Afendi, Farit M.

2018-01-01

There are many factors which affect the level of self-directed learning readiness. This study aims to investigate the relationship between external factors, internal factors and self-directed learning readiness. This study was carried out by using a census method for fourth year students of medical program of Tadulako University. Data were…

Applying parallel factor analysis and Tucker-3 methods on sensory and instrumental data to establish preference maps: case study on sweet corn varieties.

PubMed

Gere, Attila; Losó, Viktor; Györey, Annamária; Kovács, Sándor; Huzsvai, László; Nábrádi, András; Kókai, Zoltán; Sipos, László

2014-12-01

Traditional internal and external preference mapping methods are based on principal component analysis (PCA). However, parallel factor analysis (PARAFAC) and Tucker-3 methods could be a better choice. To evaluate the methods, preference maps of sweet corn varieties will be introduced. A preference map of eight sweet corn varieties was established using PARAFAC and Tucker-3 methods. Instrumental data were also integrated into the maps. The triplot created by the PARAFAC model explains better how odour is separated from texture or appearance, and how some varieties are separated from others. Internal and external preference maps were created using parallel factor analysis (PARAFAC) and Tucker-3 models employing both sensory (trained panel and consumers) and instrumental parameters simultaneously. Triplots of the applied three-way models have a competitive advantage compared to the traditional biplots of the PCA-based external preference maps. The solution of PARAFAC and Tucker-3 is very similar regarding the interpretation of the first and third factors. The main difference is due to the second factor as it differentiated the attributes better. Consumers who prefer 'super sweet' varieties (they place great emphasis especially on taste) are much younger and have significantly higher incomes, and buy sweet corn products rarely (once a month). Consumers who consume sweet corn products mainly because of their texture and appearance are significantly older and include a higher ratio of men. © 2014 Society of Chemical Industry.

Internal and External Factors That Support Children's Minority First Language and English.

PubMed

Pham, Giang; Tipton, Timothy

2018-05-22

Sequential bilingual children in the United States often speak 2 languages that have different social statuses (minority-majority) and separate contexts for learning (home-school). Thus, distinct factors may support the development of each language. This study examined which child internal and external factors were related to vocabulary skills in a minority language versus English. Participants included 69 children, aged 5-8 years, who lived in Southern California, spoke Vietnamese as the home language, and received school instruction in English. All participants had at least 1 foreign-born parent, and most mothers reported limited English proficiency. Parents completed a telephone survey, and children completed measures of receptive and expressive vocabulary in each language. Using correlations and stepwise regression, we examined predictors of vocabulary skills in each language that were internal to the child (age, gender, analytical reasoning, phonological memory) or that pertained to the surrounding environment (cumulative exposure, quantity and quality of input/output). Vietnamese vocabulary outcomes were related to multiple external factors, of which input and enrichment activities were the best predictors. In contrast, English vocabulary outcomes were related to internal factors, of which age and phonological memory were the best predictors. Parental use of Vietnamese contributed to children's Vietnamese vocabulary outcomes but was not related to children's English vocabulary outcomes. Vietnamese exposure does not hinder English development. Children from immigrant families are learning English with or without familial support. Rich and frequent exposure and opportunities for practice are essential for the continued development of a minority first language.

Analysis of risk factors for schizophrenia with two different case definitions: a nationwide register-based external validation study.

PubMed

Sørensen, Holger J; Larsen, Janne T; Mors, Ole; Nordentoft, Merete; Mortensen, Preben B; Petersen, Liselotte

2015-03-01

Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include considerably fewer cases and reduce power of e.g. genetic studies based on register-diagnosed cases only. Copyright © 2015 Elsevier B.V. All rights reserved.

Internalizing and externalizing problems in adolescence: general and dimension-specific effects of familial loadings and preadolescent temperament traits.

PubMed

Ormel, J; Oldehinkel, A J; Ferdinand, R F; Hartman, C A; De Winter, A F; Veenstra, R; Vollebergh, W; Minderaa, R B; Buitelaar, J K; Verhulst, F C

2005-12-01

We investigated the links between familial loading, preadolescent temperament, and internalizing and externalizing problems in adolescence, hereby distinguishing effects on maladjustment in general versus dimension-specific effects on either internalizing or externalizing problems. In a population-based sample of 2230 preadolescents (10-11 years) familial loading (parental lifetime psychopathology) and offspring temperament were assessed at baseline by parent report, and offspring psychopathology at 2.5-years follow-up by self-report, teacher report and parent report. We used purified measures of temperament and psychopathology and partialled out shared variance between internalizing and externalizing problems. Familial loading of internalizing psychopathology predicted offspring internalizing but not externalizing problems, whereas familial loading of externalizing psychopathology predicted offspring externalizing but not internalizing problems. Both familial loadings were associated with Frustration, low Effortful Control, and Fear. Frustration acted as a general risk factor predicting severity of maladjustment; low Effortful Control and Fear acted as dimension-specific risk factors that predicted a particular type of psychopathology; whereas Shyness, High-Intensity Pleasure, and Affiliation acted as direction markers that steered the conditional probability of internalizing versus externalizing problems, in the event of maladjustment. Temperament traits mediated one-third of the association between familial loading and psychopathology. Findings were robust across different composite measures of psychopathology, and applied to girls as well as boys. With regard to familial loading and temperament, it is important to distinguish general risk factors (Frustration) from dimension-specific risk factors (familial loadings, Effortful Control, Fear), and direction markers that act as pathoplastic factors (Shyness, High-Intensity Pleasure, Affiliation) from both types of risk factors. About one-third of familial loading effects on psychopathology in early adolescence are mediated by temperament.

Defining external factors that determine neuronal survival, apoptosis and necrosis during excitotoxic injury using a high content screening imaging platform.

PubMed

Anilkumar, Ujval; Weisova, Petronela; Schmid, Jasmin; Bernas, Tytus; Huber, Heinrich J; Düssmann, Heiko; Connolly, Niamh M C; Prehn, Jochen H M

2017-01-01

Cell death induced by excessive glutamate receptor overactivation, excitotoxicity, has been implicated in several acute and chronic neurological disorders. While numerous studies have demonstrated the contribution of biochemically and genetically activated cell death pathways in excitotoxic injury, the factors mediating passive, excitotoxic necrosis are less thoroughly investigated. To address this question, we developed a high content screening (HCS) based assay to collect high volumes of quantitative cellular imaging data and elucidated the effects of intrinsic and external factors on excitotoxic necrosis and apoptosis. The analysis workflow consisted of robust nuclei segmentation, tracking and a classification algorithm, which enabled automated analysis of large amounts of data to identify and quantify viable, apoptotic and necrotic neuronal populations. We show that mouse cerebellar granule neurons plated at low or high density underwent significantly increased necrosis compared to neurons seeded at medium density. Increased extracellular Ca2+ sensitized neurons to glutamate-induced excitotoxicity, but surprisingly potentiated cell death mainly through apoptosis. We also demonstrate that inhibition of various cell death signaling pathways (including inhibition of calpain, PARP and AMPK activation) primarily reduced excitotoxic apoptosis. Excitotoxic necrosis instead increased with low extracellular glucose availability. Our study is the first of its kind to establish and implement a HCS based assay to investigate the contribution of external and intrinsic factors to excitotoxic apoptosis and necrosis.

Defining external factors that determine neuronal survival, apoptosis and necrosis during excitotoxic injury using a high content screening imaging platform

PubMed Central

Weisova, Petronela; Schmid, Jasmin; Bernas, Tytus; Huber, Heinrich J.; Düssmann, Heiko; Connolly, Niamh M. C.; Prehn, Jochen H. M.

2017-01-01

Cell death induced by excessive glutamate receptor overactivation, excitotoxicity, has been implicated in several acute and chronic neurological disorders. While numerous studies have demonstrated the contribution of biochemically and genetically activated cell death pathways in excitotoxic injury, the factors mediating passive, excitotoxic necrosis are less thoroughly investigated. To address this question, we developed a high content screening (HCS) based assay to collect high volumes of quantitative cellular imaging data and elucidated the effects of intrinsic and external factors on excitotoxic necrosis and apoptosis. The analysis workflow consisted of robust nuclei segmentation, tracking and a classification algorithm, which enabled automated analysis of large amounts of data to identify and quantify viable, apoptotic and necrotic neuronal populations. We show that mouse cerebellar granule neurons plated at low or high density underwent significantly increased necrosis compared to neurons seeded at medium density. Increased extracellular Ca2+ sensitized neurons to glutamate-induced excitotoxicity, but surprisingly potentiated cell death mainly through apoptosis. We also demonstrate that inhibition of various cell death signaling pathways (including inhibition of calpain, PARP and AMPK activation) primarily reduced excitotoxic apoptosis. Excitotoxic necrosis instead increased with low extracellular glucose availability. Our study is the first of its kind to establish and implement a HCS based assay to investigate the contribution of external and intrinsic factors to excitotoxic apoptosis and necrosis. PMID:29145487

'The stars seem aligned': a qualitative study to understand the effects of context on scale-up of maternal and newborn health innovations in Ethiopia, India and Nigeria.

PubMed

Spicer, Neil; Berhanu, Della; Bhattacharya, Dipankar; Tilley-Gyado, Ritgak Dimka; Gautham, Meenakshi; Schellenberg, Joanna; Tamire-Woldemariam, Addis; Umar, Nasir; Wickremasinghe, Deepthi

2016-11-25

Donors commonly fund innovative interventions to improve health in the hope that governments of low and middle-income countries will scale-up those that are shown to be effective. Yet innovations can be slow to be adopted by country governments and implemented at scale. Our study explores this problem by identifying key contextual factors influencing scale-up of maternal and newborn health innovations in three low-income settings: Ethiopia, the six states of northeast Nigeria and Uttar Pradesh state in India. We conducted 150 semi-structured interviews in 2012/13 with stakeholders from government, development partner agencies, externally funded implementers including civil society organisations, academic institutions and professional associations to understand scale-up of innovations to improve the health of mothers and newborns these study settings. We analysed interview data with the aid of a common analytic framework to enable cross-country comparison, with Nvivo to code themes. We found that multiple contextual factors enabled and undermined attempts to catalyse scale-up of donor-funded maternal and newborn health innovations. Factors influencing government decisions to accept innovations at scale included: how health policy decisions are made; prioritising and funding maternal and newborn health; and development partner harmonisation. Factors influencing the implementation of innovations at scale included: health systems capacity in the three settings; and security in northeast Nigeria. Contextual factors influencing beneficiary communities' uptake of innovations at scale included: sociocultural contexts; and access to healthcare. We conclude that context is critical: externally funded implementers need to assess and adapt for contexts if they are to successfully position an innovation for scale-up.

Spanish/English Bilingual Codeswitching: A Syncretic Model.

ERIC Educational Resources Information Center

Becker, Kristin R.

1997-01-01

Presents a syncretic model to provide a stepping stone between current codeswitching literature and future research by analyzing the form that bilingual codeswitched utterances take, as well as the internal and external factors that trigger these codeswitches. Includes an analysis of three dimensions of bilingual codeswitching: linguistic,…

Dynamic stability analysis for a self-mixing interferometry system.

PubMed

Fan, Yuanlong; Yu, Yanguang; Xi, Jiangtao; Guo, Qinghua

2014-11-17

A self-mixing interferometry (SMI) system is a laser diode (LD) with an external cavity formed by a moving external target. The behavior of an SMI system is governed by the injection current J to the LD and the parameters associated with the external cavity mainly including optical feedback factor C, the initial external cavity length (L₀) and the light phase (ϕ₀) which is mapped to the movement of the target. In this paper, we investigate the dynamic behavior of an SMI system by using the Lang-Kobayashi model. The stability boundary of such system is presented in the plane of (C, ϕ₀), from which a critical C (denoted as C(critical)) is derived. Both simulations and experiments show that the stability can be enhanced by increasing either L₀ or J. Furthermore, three regions on the plane of (C, ϕ₀) are proposed to characterize the behavior of an SMI system, including stable, semi-stable and unstable regions. We found that the existing SMI model is only valid for the stable region, and the semi-stable region has potential applications on sensing and measurement but needs re-modeling the system by considering the bandwidth of the detection components.

Environmental performance of wastewater reuse systems: impact of system boundaries and external conditions.

PubMed

Baresel, Christian; Dalgren, Lena; Almemark, Mats; Lazic, Aleksandra

2016-01-01

Wastewater reclamation will be a significant part of future water management and the environmental assessment of various treatment systems to reuse wastewater has become an important research field. The secondary treatment process and sludge handling on-site are, especially, electricity demanding processes due to aeration, pumping, mixing, dewatering, etc. used for operation and are being identified as the main contributor for many environmental impacts. This study discusses how the environmental performance of reuse treatment systems may be influenced by surrounding conditions. This article illustrates and discusses the importance of factors commonly treated as externalities and as such not being included in optimization strategies of reuse systems, but that are necessary to environmentally assess wastewater reclamation systems. This is illustrated by two up-stream and downstream processes; electricity supply and the use of sludge as fertilizer commonly practiced in regions considered for wastewater reclamation. The study shows that external conditions can have a larger impact on the overall environmental performance of reuse treatment systems than internal optimizations could compensate for. These results imply that a more holistic environmental assessment of reuse schemes could provide less environmental impacts as externalities could be included in measures to reduce the overall impacts.

Rules and regulations as potential moderator on the relationship between organizational internal and external factors with effective construction risk management in Nigerian construction companies: A proposed framework

NASA Astrophysics Data System (ADS)

Adeleke, A. Q.; Bahaudin, A. Y.; Kamaruddeen, A. M.

2016-08-01

Certain organizational internal and external factors have been found to influence effective construction risk management within the construction company which has contributed to massive risk occurrence on the projects. Yet, the influence of the organizational factors such as effective communication, team competency with skills, active leadership, political factor, organizational culture, technology factor and economic factor on effective construction risk management among the construction companies operating in Abuja and Lagos state Nigeria have not received considerable attention. More so, a moderating variable is proposed. This paper proposes rules and regulations as the potential moderator on the relationship between organisational internal factors, external factors and effective construction risk management.

External Stakeholders' Roles and Factors Influencing Their Participation in Developing Generic Skills for Students in Vietnamese Universities

ERIC Educational Resources Information Center

Nghia, Tran Le Huu

2018-01-01

External stakeholders have increasingly participated in instructional and training activities in higher education; however, their contribution has not yet been adequately documented, especially in non-Western university contexts. This article reports a study that examined external stakeholders' roles and factors influencing their participation in…

Interprofessional collaboration regarding patients' care plans in primary care: a focus group study into influential factors.

PubMed

van Dongen, Jerôme Jean Jacques; Lenzen, Stephanie Anna; van Bokhoven, Marloes Amantia; Daniëls, Ramon; van der Weijden, Trudy; Beurskens, Anna

2016-05-28

The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional collaboration related to care plan development.

Does the concept of borderline personality features have clinical utility in childhood?

PubMed

Hawes, David J

2014-01-01

Phenotypic features of borderline personality disorder may first emerge during childhood, alongside symptoms of common externalizing and internalizing disorders. Children with these borderline personality features (BPF) are, therefore, likely to come into contact with clinical services prior to adolescence. This raises the question of whether BPF may be clinically informative with respect to the formulation and treatment of childhood psychopathology. BPF in late childhood appear to be highly heritable, while also predicted by environmental risk factors that overlap with those related to both externalizing and internalizing disorders. These risk factors include hostile parenting, maternal insensitivity to infant attachment cues, and early peer victimization, thereby implicating both family and peer processes that play out across early development. Children with BPF appear to be further characterized by social-cognitive factors including social perspective coordination deficits, a shame-prone self-concept, and hypermentalizing, which may represent potential therapeutic targets. Clinical research into the implications of BPF for the treatment of childhood psychopathology is a current priority. It is proposed that the research designs that have contributed to recent evidence for the clinical utility of childhood psychopathic traits may likewise aid in understanding the potential clinical utility of BPF in children.

Hotspots of Community Change: Temporal Dynamics Are Spatially Variable in Understory Plant Composition of a California Oak Woodland

PubMed Central

Spotswood, Erica N.; Bartolome, James W.; Allen-Diaz, Barbara

2015-01-01

Community response to external drivers such climate and disturbance can lead to fluctuations in community composition, or to directional change. Temporal dynamics can be influenced by a combination of drivers operating at multiple spatial scales, including external landscape scale drivers, local abiotic conditions, and local species pools. We hypothesized that spatial variation in these factors can create heterogeneity in temporal dynamics within landscapes. We used understory plant species composition from an 11 year dataset from a California oak woodland to compare plots where disturbance was experimentally manipulated with the removal of livestock grazing and a prescribed burn. We quantified three properties of temporal variation: compositional change (reflecting the appearance and disappearance of species), temporal fluctuation, and directional change. Directional change was related most strongly to disturbance type, and was highest at plots where grazing was removed during the study. Temporal fluctuations, compositional change, and directional change were all related to intrinsic abiotic factors, suggesting that some locations are more responsive to external drivers than others. Temporal fluctuations and compositional change were linked to local functional composition, indicating that environmental filters can create subsets of the local species pool that do not respond in the same way to external drivers. Temporal dynamics are often assumed to be relatively static at the landscape scale, provided disturbance and climate are continuous. This study shows that local and landscape scale factors jointly influence temporal dynamics creating hotspots that are particularly responsive to climate and disturbance. Thus, adequate predictions of response to disturbance or to changing climate will only be achieved by considering how factors at multiple spatial scales influence community resilience and recovery. PMID:26222069

Hotspots of Community Change: Temporal Dynamics Are Spatially Variable in Understory Plant Composition of a California Oak Woodland.

PubMed

Spotswood, Erica N; Bartolome, James W; Allen-Diaz, Barbara

2015-01-01

Community response to external drivers such climate and disturbance can lead to fluctuations in community composition, or to directional change. Temporal dynamics can be influenced by a combination of drivers operating at multiple spatial scales, including external landscape scale drivers, local abiotic conditions, and local species pools. We hypothesized that spatial variation in these factors can create heterogeneity in temporal dynamics within landscapes. We used understory plant species composition from an 11 year dataset from a California oak woodland to compare plots where disturbance was experimentally manipulated with the removal of livestock grazing and a prescribed burn. We quantified three properties of temporal variation: compositional change (reflecting the appearance and disappearance of species), temporal fluctuation, and directional change. Directional change was related most strongly to disturbance type, and was highest at plots where grazing was removed during the study. Temporal fluctuations, compositional change, and directional change were all related to intrinsic abiotic factors, suggesting that some locations are more responsive to external drivers than others. Temporal fluctuations and compositional change were linked to local functional composition, indicating that environmental filters can create subsets of the local species pool that do not respond in the same way to external drivers. Temporal dynamics are often assumed to be relatively static at the landscape scale, provided disturbance and climate are continuous. This study shows that local and landscape scale factors jointly influence temporal dynamics creating hotspots that are particularly responsive to climate and disturbance. Thus, adequate predictions of response to disturbance or to changing climate will only be achieved by considering how factors at multiple spatial scales influence community resilience and recovery.

Accumulation of psychosocial and lifestyle factors and risk of low back pain in adolescence: a cohort study.

PubMed

Mikkonen, Paula; Heikkala, Eveliina; Paananen, Markus; Remes, Jouko; Taimela, Simo; Auvinen, Juha; Karppinen, Jaro

2016-02-01

Low back pain (LBP) is common already in adolescence, and many risk indicators including both psychosocial and lifestyle factors have been recognized. Our purpose was to assess whether the co-occurrence of psychosocial (externalizing and internalizing) problems and lifestyle factors (leisure time physical activity, sedentary behaviour, sleep, smoking, and overweight/obesity) associate with LBP at 16 years cross-sectionally or with new LBP at 18-year follow-up. The study population, drawn from the Northern Finland Birth Cohort 1986, consisted of 1625 participants (712 boys and 913 girls) who completed a questionnaire on potential explanatory factors at 16 years and on LBP at 16 and 18 years. The outcome measure was 'reporting LBP' or 'consultation for LBP' during the past 6 months. Latent Class Analysis (LCA) was utilized to study the co-occurrence of the explanatory factors. Among both genders, four clusters were found. Externalizing behaviour problems were associated with 'reporting LBP' (RR 1.5, boys 1.4, girls) and 'consultation for LBP' (RR 1.6 for both genders) at baseline among both genders. In addition, the cluster of multiple risk behaviours was associated with both 'reporting LBP' (RR 1.3) and 'consultation for LBP' (RR 2.5) and the obese cluster with 'consultation for LBP' (RR 1.7) among girls. Externalizing behaviour problems at 16 years predicted 'consultation for LBP' at 18 years among girls (RR 3.6). Our results stress the role of psychosocial factors in reporting and seeking care for adolescent LBP.

External and internal factors influencing self-directed online learning of physiotherapy undergraduate students in Sweden: a qualitative study

PubMed Central

Hammarlund, Catharina Sjödahl; Nilsson, Maria H.; Gummesson, Christina

2015-01-01

Purpose: Online courses have become common in health sciences education. This learning environment can be designed using different approaches to support student learning. To further develop online environment, it is important to understand how students perceive working and learning online. The aim of this study is to identify aspects influencing students’ learning processes and their adaptation to self-directed learning online. Methods: Thirty-four physiotherapy students with a mean age of 25 years (range, 21 to 34 years) participated. Qualitative content analysis and triangulation was used when investigating the students’ self-reflections, written during a five week self-directed, problem-oriented online course. Results: Two categories emerged: ‘the influence of the structured framework’ and ‘communication and interaction with teachers and peers.’ The learning processes were influenced by external factors, e.g., a clear structure including a transparent alignment of assignments and assessment. Important challenges to over-come were primarily internal factors, e.g., low self-efficacy, difficulties to plan the work effectively and adapting to a new environment. Conclusion: The analyses reflected important perspectives targeting areas which enable further course development. The influences of external and internal factors on learning strategies and self-efficacy are important aspects to consider when designing online courses. Factors such as pedagogical design, clarity of purpose, goals, and guidelines were important as well as continuous opportunities for communication and collaboration. Further studies are needed to understand and scaffold the motivational factors among students with low self-efficacy. PMID:26101401

Maternal outcomes of term breech presentation delivery: impact of successful external cephalic version in a nationwide sample of delivery admissions in the United States.

PubMed

Weiniger, Carolyn F; Lyell, Deirdre J; Tsen, Lawrence C; Butwick, Alexander J; Shachar, BatZion; Callaghan, William M; Creanga, Andreea A; Bateman, Brian T

2016-07-08

We aimed to define the frequency and predictors of successful external cephalic version in a nationally-representative cohort of women with breech presentations and to compare maternal outcomes associated with successful external cephalic version versus persistent breech presentation. Using the Nationwide Inpatient Sample, a United States healthcare utilization database, we identified delivery admissions between 1998 and 2011 for women who had successful external cephalic version or persistent breech presentation (including unsuccessful or no external cephalic version attempt) at term. Multivariable logistic regression identified patient and hospital-level factors associated with successful external cephalic version. Maternal outcomes were compared between women who had successful external cephalic version versus persistent breech. Our study cohort comprised 1,079,576 delivery admissions with breech presentation; 56,409 (5.2 %) women underwent successful external cephalic version and 1,023,167 (94.8 %) women had persistent breech presentation at the time of delivery. The rate of cesarean delivery was lower among women who had successful external cephalic version compared to those with persistent breech (20.2 % vs. 94.9 %; p < 0.001). Compared to women with persistent breech at the time of delivery, women with successful external cephalic version were also less likely to experience several measures of significant maternal morbidity including endometritis (adjusted Odds Ratio (aOR) = 0.36, 95 % Confidence Interval (CI) 0.24-0.52), sepsis (aOR = 0.35, 95 % CI 0.24-0.51) and length of stay > 7 days (aOR = 0.53, 95 % CI 0.40-0.70), but had a higher risk of chorioamnionitis (aOR = 1.83, 95 % CI 1.54-2.17). Overall a low proportion of women with breech presentation undergo successful external cephalic version, and it is associated with significant reduction in the frequency of cesarean delivery and a number of measures of maternal morbidity. Increased external cephalic version use may be an important approach to mitigate the high rate of cesarean delivery observed in the United States.

The Relationship Between Early Sexual Debut and Psychosocial Outcomes: A Longitudinal Study of Dutch Adolescents

PubMed Central

Sandfort, Theo; Reitz, Ellen; Bos, Henny; Dekovic, Maja

2010-01-01

In a longitudinal dataset of 470 Dutch adolescents, the current study examined the ways in which early sexual initiation was related to subsequent attachment, self-perception, internalizing problems, and externalizing problems. For male adolescents, analyses revealed general attachment to mother and externalizing problems at Wave 1 to predict to early transition at Wave 2. However, there was no differential change in these psychosocial factors over time for early initiators of sexual intercourse and their non-initiating peers. For female adolescents, the model including psychosocial factors at Wave 1 did not predict to sexual initiation at Wave 2. However, univariate repeated measures analyses revealed early initiators to have significantly larger increases in self-concept and externalizing problems than their non-initiating female peers. While the difference between female early initiators and non-initiators were statistically significant, the mean levels of problem behaviors were very low. The findings suggest that, contrary to previous research, early sexual initiation does not seem to be clustered with problem behaviors for this sample of Dutch adolescents. PMID:20119696

Improving health care quality and safety: the role of collective learning.

PubMed

Singer, Sara J; Benzer, Justin K; Hamdan, Sami U

2015-01-01

Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened) addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation), internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological safety, appreciation of differences, openness to new ideas social motivation, and team autonomy; team contextual factors including learning resources like time for reflection, access to knowledge, organizational capabilities; incentives; and organizational culture, strategy, and structure; and external environmental factors including institutional pressures, environmental dynamism and competitiveness and learning collaboratives. Lastly learning in the context of quality and safety improvement requires leadership that reinforces learning through actions and behaviors that affect people, such as coaching and trust building, and through influencing contextual factors, including providing resources, developing culture, and taking strategic actions that support improvement. Our review highlights the importance of leadership in both promoting a supportive learning environment and implementing learning processes.

Improving health care quality and safety: the role of collective learning

PubMed Central

Singer, Sara J; Benzer, Justin K; Hamdan, Sami U

2015-01-01

Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened) addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation), internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological safety, appreciation of differences, openness to new ideas social motivation, and team autonomy; team contextual factors including learning resources like time for reflection, access to knowledge, organizational capabilities; incentives; and organizational culture, strategy, and structure; and external environmental factors including institutional pressures, environmental dynamism and competitiveness and learning collaboratives. Lastly learning in the context of quality and safety improvement requires leadership that reinforces learning through actions and behaviors that affect people, such as coaching and trust building, and through influencing contextual factors, including providing resources, developing culture, and taking strategic actions that support improvement. Our review highlights the importance of leadership in both promoting a supportive learning environment and implementing learning processes. PMID:29355197

[Spanish version of the Multidimensional health locus of control scale innursing students].

PubMed

Tomás-Sábado, Joaquín; Montes-Hidalgo, Javier

2016-01-01

To determine the preliminary psychometric properties of the Spanish form of the Multidimensional Health Locus of Control Scale (MHLC), which consists of three subscales: (1) Internalitu, (2) Powerful other externality, and (3) Chance externality. It also aims to study the relationship that the internal/external health control beliefs has with self-esteem, self-efficacy and perceived competence in a sample of nursing undergraduates. An observational and cross-sectional study including 109 nursing students who completed an anonymous questionnaire containing the demographic variables and the Spanish versions of the MHLC, the Rosenberg Self-Esteem Scale, the General Self-Efficacy Scale, and the Perceived personal competence Scale. A Cronbach's alpha coefficient of 0.713 for Internality, 0.665 for Chance and 0.728 for Powerful other were obtained. The test-retest correlation for the 18 items of the MHLC was 0.866. Internality subscale was positively and significantly correlated with self-efficacy and competence. By contrast, chance externality has negative and significant correlations with self-esteem and competence. There are no significant gender differences in any of the subscales. Younger subjects show greater tendency to external attribution. Factor analysis confirms the three-factor hypothesis. The results suggest that the Spanish form of the MHLC has adequate construct validity and acceptable metric properties. Also, they evidence the relationship between the attribution of health-related internal control with the perceived well-being and confidence in their own skills and abilities. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Adenoid cystic carcinoma of the external ear: a population based study.

PubMed

Green, Ross W; Megwalu, Uchechukwu C

2016-01-01

To determine the incidence of adenoid cystic carcinoma of the external ear in the United States, and to evaluate the clinical characteristics and survival outcomes associated with the disease. Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) 18 Database of the National Cancer Institute. The study cohort included patients diagnosed with adenoid cystic carcinoma of the external ear from 1973 to 2012. The incidence of adenoid cystic carcinoma of the external ear was 0.004 per 100,000. The SEER database identified 66 patients meeting the inclusion criteria. Nodal metastasis was noted in 13.1% of patients, while 7.9% had distant metastasis. Distant metastasis was associated with worse overall survival (HR 10.18). However, nodal metastasis had no impact on overall survival (HR 0.15, p = 0.09). Surgery alone was associated with improved overall survival (HR 0.26), compared with combination surgery and radiotherapy, while radiotherapy alone was associated with worse overall survival (HR 20.12). Increasing age (HR 1.12) and black race (HR 6.83) were associated with worse overall survival, while female sex (HR 0.26) was associated with improved overall survival. ACC of the external ear is rare. Distant metastasis is a poor prognostic factor. However, nodal metastasis does not appear to impact survival. Advanced age, black race, and male sex are also poor prognostic factors. Surgical resection alone is associated with better survival than combination surgical resection and radiation, or radiotherapy alone. Copyright © 2016 Elsevier Inc. All rights reserved.

Enhanced Performance of Streamline-Traced External-Compression Supersonic Inlets

NASA Technical Reports Server (NTRS)

Slater, John W.

2015-01-01

A computational design study was conducted to enhance the aerodynamic performance of streamline-traced, external-compression inlets for Mach 1.6. Compared to traditional external-compression, two-dimensional and axisymmetric inlets, streamline-traced inlets promise reduced cowl wave drag and sonic boom, but at the expense of reduced total pressure recovery and increased total pressure distortion. The current study explored a new parent flowfield for the streamline tracing and several variations of inlet design factors, including the axial displacement and angle of the subsonic cowl lip, the vertical placement of the engine axis, and the use of porous bleed in the subsonic diffuser. The performance was enhanced over that of an earlier streamline-traced inlet such as to increase the total pressure recovery and reduce total pressure distortion.

Educational Placement of Students with Autism: The Impact of State of Residence

ERIC Educational Resources Information Center

Kurth, Jennifer A.

2015-01-01

Typically, child characteristics such as IQ and severity of autism symptoms are thought to determine educational placement. The present study examines external factors, including state of residence and state funding formulas, to determine their potential influence on placement outcomes. Findings reveal that considerable variations exist among…

Adaptive or Transactional Leadership in Current Higher Education: A Brief Comparison

ERIC Educational Resources Information Center

Khan, Natalie

2017-01-01

Higher education institutions operate in a complex environment that includes influence from external factors, new technologies for teaching and learning, globalization, and changing student demographics to name a few. Maneuvering such complexity and change requires a leadership strategy that is flexible and supportive. This paper reviews two…

MIT January Operational Internship Experience

NASA Technical Reports Server (NTRS)

Bosanac, Natasha; DeVivero, Charlie; James, Jillian; Perez-Martinez, Carla; Pino, Wendy; Wang, Andrew; Willett, Ezekiel; Williams, Kwami

2010-01-01

This viewgraph presentation describes the MIT January Operational Internship Experience (JOIE) program. The topics include: 1) Landing and Recovery; 2) Transportation; 3) Shuttle Processing; 4) Constellation Processing; 5) External Tank; 6) Launch Pad; 7) Ground Operations; 8) Hypergolic Propellants; 9) Environmental; 10) Logistics; 11) Six Sigma; 12) Systems Engineering; and 13) Human Factors.

Asian American Career Development: A Qualitative Analysis

ERIC Educational Resources Information Center

Fouad, Nadya A.; Kantamneni, Neeta; Smothers, Melissa K.; Chen, Yung-Lung; Fitzpatrick, Mary; Terry, Sarah

2008-01-01

This study used a modified version of consensual qualitative research design to examine how contextual, cultural, and personal variables influence the career choices of a diverse group of 12 Asian Americans. Seven domains of influences on career choices emerged including family, culture, external factors, career goals, role models, work values,…

Occupational Apathy: A Social or Individual Responsibility?

ERIC Educational Resources Information Center

McArthur, Kent R.

A lack of clear national goals, increased bureaucracy, the infiltration of unions into the colleges, and the increasing emphasis on personal rather than organizational priorities have contributed to a growing national malaise. Our expectations are conditioned, to a large extent, by these factors and other external influences, including parents,…

University of Maryland MRSEC - Research: Seed 3

Science.gov Websites

MRSEC Templates Opportunities Search Home » Research » Seed 3 Seed 3: Modeling Elastic Effects on controlling parameters and variables include temperature, deposition flux, external electric field and elastic simulating the effects of these controlling factors often lead to predictions that guide future experiments

Conditions of Children in California

ERIC Educational Resources Information Center

Policy Analysis for California Education, Berkeley, CA.

Although many California children are growing up in circumstances favoring school performance, many others are inhibited by poor health, poverty, low-quality child care, and other factors external to schools. This report assembles a set of indicators depicting California children's quality of life. Data are included on physical and mental health,…

Citizen Organizations: Citizen Participation in Educational Decisionmaking. Executive Summary.

ERIC Educational Resources Information Center

Gittell, Marilyn; And Others

In order to examine the role and effectiveness of community organizations in increasing parental and community involvement in educational decision making, a research project was initiated which included three elements: (1) case studies documenting the behavior of organizations and internal and external factors that influence their functioning, (2)…

An Exploration of Secondary Students' Mental States When Learning about Acids and Bases

ERIC Educational Resources Information Center

Liu, Chia-Ju; Hou, I-Lin; Chiu, Houn-Lin; Treagust, David F.

2014-01-01

This study explored factors of students' mental states, including emotion, intention, internal mental representation, and external mental representation, which can affect their learning performance. In evaluating students' mental states during the science learning process and the relationship between mental states and learning…

Faculty Compensation Systems: Impact on the Quality of Higher Education. ERIC Digest.

ERIC Educational Resources Information Center

Sutton, Terry P.; Bergerson, Peter J.

Faculty compensation is a critical management tool for increasing faculty productivity, improving cost efficiency, and enhancing an institution's public image. Factors that determine faculty compensation include academic rank, faculty productivity, discipline market pay, ability to obtain external grants, seniority or length of service, service in…

Impact of seasonality and storage of semen on epigenetics in swine placenta and fetal livers

USDA-ARS?s Scientific Manuscript database

Epigenetics includes the study of external factors that can influence the expression of genes by altering accessibility of DNA through methylation and histone modification. To investigate the influence of: season (semen collection and breeding), absolute sperm head-shape change, and semen storage on...

Mixed Ability Teaching: Meeting Learners' Needs. Netword 3: Teaching Languages to Adults.

ERIC Educational Resources Information Center

Ainslie, Susan

This guide, designed for teachers of second languages to adults, discusses instruction for student groups of mixed abilities. The first chapter examines the factors that determine mixed ability, including: student motivation, interests, and needs; linguistic ability; general educational background; learning style; age; external pressures and time…

Factors promoting resident deaths at aged care facilities in Japan: a review.

PubMed

Sugimoto, Kentaro; Ogata, Yasuko; Kashiwagi, Masayo

2018-03-01

Due to an increasingly ageing population, the Japanese government has promoted elderly deaths in aged care facilities. However, existing facilities were not designed to provide resident end-of-life care and the proportion of aged care facility deaths is currently less than 10%. Consequently, the present review evaluated the factors that promote aged care facility resident deaths in Japan from individual- and facility-level perspectives to exploring factors associated with increased resident deaths. To achieve this, MEDLINE, CINAHL, Web of Science and Ichushi databases were searched on 23 January 2016. Influential factors were reviewed for two healthcare services (insourcing and outsourcing facilities) as well as external healthcare agencies operating outside facilities. Of the original 2324 studies retrieved, 42 were included in analysis. Of these studies, five focused on insourcing, two on outsourcing, seven on external agencies and observed facility/agency-level factors. The other 28 studies identified individual-level factors related to death in aged care facilities. The present review found that at both facility and individual levels, in-facility resident deaths were associated with healthcare service provision, confirmation of resident/family end-of-life care preference and staff education. Additionally, while outsourcing facilities did not require employment of physicians/nursing staff to accommodate resident death, these facilities required visits by physicians and nursing staff from external healthcare agencies as well as residents' healthcare input. This review also found few studies examining outsourcing facilities. The number of healthcare outsourcing facilities is rapidly increasing as a result of the Japanese government's new tax incentives. Consequently, there may be an increase in elderly deaths in outsourcing healthcare facilities. Accordingly, it is necessary to identify the factors associated with residents' deaths at outsourcing facilities. © 2016 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

Personality and the latent structure of PTSD comorbidity

PubMed Central

Miller, Mark W.; Wolf, Erika J.

2012-01-01

This study examined the structure of PTSD comorbidity and its relationship to personality in a sample of 214 veterans using data from diagnostic interviews and the Multidimensional Personality Questionnaire-Brief Form (MPQ-BF; Patrick, Curtin, & Tellegen, 2002). Confirmatory factor analyses supported a three factor model composed of Externalizing, Fear and Distress factors. Analyses that examined the location of borderline personality disorder revealed significant cross-loadings for this disorder on both Externalizing and Distress. Structural equation models showed trait negative emotionality to be significantly related to all three comorbidity factors whereas positive emotionality and constraint evidenced specific associations with Distress and Externalizing, respectively. These results shed new light on the location of borderline personality disorder within the internalizing/externalizing model and clarify the relative influence of broad dimensions of personality on patterns of comorbidity. PMID:22480716

External and internal factors influencing happiness in elite collegiate athletes.

PubMed

Denny, Katherine G; Steiner, Hans

2009-03-01

When under conditions of high demand and allostatic load, are happiness and satisfaction in four domains (family, friends, academics, recreation) influenced more by external or internal factors? Do student-athletes who lead exceedingly complicated lives report happiness as a function of athletic achievement or internal disposition? Stanford student-athletes (N=140) were studied with a standardized questionnaire which examined internal factors ((1) locus of control, (2) mindfulness, (3) self-restraint, and (4) self-esteem) to see whether they better account for happiness than external factors (playing time, scholarship). As predicted, internal factors were more powerful correlates of happiness when holding constant demographics. Regression models differed for different aspects of happiness, but the main postulated result of internal versus external was maintained throughout. These findings have implications for how well athletes cope with adversity which, in turn, could shed light on the development of traits that may provide a buffer against adversity and build resilience.

Is the internal connection more efficient than external connection in mechanical, biological, and esthetical point of views? A systematic review.

PubMed

Goiato, Marcelo Coelho; Pellizzer, Eduardo Piza; da Silva, Emily Vivianne Freitas; Bonatto, Liliane da Rocha; dos Santos, Daniela Micheline

2015-09-01

This systematic review aimed to evaluate if the internal connection is more efficient than the external connection and its associated influencing factors. A specific question was formulated according to the Population, Intervention, Control, and Outcome (PICO): Is internal connection more efficient than external connection in mechanical, biological, and esthetical point of views? An electronic search of the MEDLINE and the Web of Knowledge databases was performed for relevant studies published in English up to November 2013 by two independent reviewers. The keywords used in the search included a combination of "dental implant" and "internal connection" or "Morse connection" or "external connection." Selected studies were randomized clinical trials, prospective or retrospective studies, and in vitro studies with a clear aim of investigating the internal and/or external implant connection use. From an initial screening yield of 674 articles, 64 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full texts of these articles were obtained with 29 articles fulfilling the inclusion criteria. Morse taper connection has the best sealing ability. Concerning crestal bone loss, internal connections presented better results than external connections. The limitation of the present study was the absence of randomized clinical trials that investigated if the internal connection was more efficient than the external connection. The external and internal connections have different mechanical, biological, and esthetical characteristics. Besides all systems that show proper success rates and effectiveness, crestal bone level maintenance is more important around internal connections than external connections. The Morse taper connection seems to be more efficient concerning biological aspects, allowing lower bacterial leakage and bone loss in single implants, including aesthetic regions. Additionally, this connection type can be successfully indicated for fixed partial prostheses and overdenture planning, since it exhibits high mechanical stability.

Major depressive disorder and impulsive reactivity to emotion: toward a dual-process view of depression.

PubMed

Carver, Charles S; Johnson, Sheri L; Joormann, Jutta

2013-09-01

Dual-process theories of behaviour have been used to suggest that vulnerability to depression involves elevated reactivity to emotions. This study tests that idea, examining self-reported reactivity. Comparison between persons with at least one lifetime episode of major depressive disorder (lifetime MDD) and those without this diagnosis, controlling for symptoms of alcohol use (a potential externalizing confound) and current symptoms of depression (a potential state-dependent confound). Undergraduates (N = 120) completed a clinical interview to diagnose lifetime MDD and a series of self-reports bearing on diverse aspects of self-control, including reactivity to emotion. Thirty-four people were diagnosed with lifetime MDD; 86 did not meet criteria for MDD. The groups were then compared on three factors underlying the scales assessing self-control. The MDD group had higher scores than controls on the two factors that reflect impulsive reactivity to diverse emotions, including emotions that are positive in valence. These effects were not explained by associations with either externalizing symptoms or current depressive symptoms. Reflexive reactivity to emotions characterizes depression, in addition to some externalizing problems, and it may deserve study as a potential trans-diagnostic feature. Reflexive reactivity to emotions characterizes persons diagnosed with major depressive disorder. Findings suggest desirability of focusing treatment partly on management of reflexive reactions to emotions. Measures were self-reports, rather than behavioural responses to emotions. © 2013 The British Psychological Society.

Corporate Externalities: A Challenge to the Further Success of Prevention Science

PubMed Central

2011-01-01

The full benefit of prevention science will not be realized until we learn how to influence organizational practices. The marketing of tobacco, alcohol, and food and corporate advocacy for economic policies that maintain family poverty are examples of practices we must influence. This paper analyzes the evolution of such practices in terms of their selection by economic consequences. A strategy for addressing these critical risk factors should include: (a) systematic research on the impact of corporate practices on each of the most common and costly psychological and behavior problems; (b) empirical analyses of the consequences that select harmful corporate practices; (c) assessment of the impact of policies that could affect problematic corporate practices; and (d) research on advocacy organizations to understand the factors that influence their growth and to help them develop effective strategies for influencing corporate externalities. PMID:21225461

Framework for culturally competent decisionmaking in child welfare.

PubMed

Cohen, Elena P

2003-01-01

This article provides a framework to understand the cultural, social, political, and economic factors that affect decisionmaking when working with ethnically and racially diverse families in the child welfare system. The article describes external factors affecting the decisionmaking process, including community environment, agency structure, and family characteristics. It then reviews the core stages of the casework process, describing key decisions during intake, assessment, service planning, implementation, evaluation, and closure. Although the framework is based on casework process in the child welfare system, it can be adapted to other child-serving systems, including education, mental health, and juvenile justice.

Voluntary and involuntary driving cessation in later life.

PubMed

Choi, Moon; Mezuk, Briana; Rebok, George W

2012-01-01

This study explores the decision-making process of driving cessation in later life, with a focus on voluntariness. The sample included 83 former drivers from the Baltimore Epidemiologic Catchment Area Study. A majority of participants (83%) reportedly stopped driving by their own decision. However, many voluntary driving retirees reported external factors such as financial difficulty, anxiety about driving, or lack of access to a car as main reasons for driving cessation. These findings imply that distinction between voluntary and involuntary driving cessation is ambiguous and that factors beyond health status, including financial strain, play a role in the transition to non-driving.

Understanding the relationship between stress, distress and healthy lifestyle behaviour: a qualitative study of patients and general practitioners.

PubMed

McKenzie, Suzanne H; Harris, Mark F

2013-11-01

The process of initiating and maintaining healthy lifestyle behaviours is complex, includes a number of distinct phases and is not static. Theoretical models of behaviour change consider psychological constructs such as intention and self efficacy but do not clearly consider the role of stress or psychological distress. General practice based interventions addressing lifestyle behaviours have been demonstrated to be feasible and effective however it is not clear whether general practitioners (GPs) take psychological health into consideration when discussing lifestyle behaviours. This qualitative study explores GPs' and patients' perspectives about the relationship between external stressors, psychological distress and maintaining healthy lifestyle behaviours. Semi-structured telephone interviews were conducted with 16 patients and 5 GPs. Transcripts from the interviews were thematically analysed and a conceptual model developed to explain the relationship between external stressors, psychological distress and healthly lifestyle behaviours. Participants were motivated to maintain a healthy lifestyle however they described a range of external factors that impacted on behaviour in both positive and negative ways, either directly or via their impact on psychological distress. The impact of external factors was moderated by coping strategies, beliefs, habits and social support. In some cases the process of changing or maintaining healthy behaviour also caused distress. The concept of a threshold level of distress was evident in the data with patients and GPs describing a certain level of distress required before it negatively influenced behaviour. Maintaining healthy lifestyle behaviours is complex and constantly under challenge from external stressors. Practitioners can assist patients with maintaining healthy behaviour by providing targeted support to moderate the impact of external stressors.

Predictors of discrepancies between fathers and mothers in rating behaviors of preschool children with and without ADHD.

PubMed

van der Veen-Mulders, Lianne; Nauta, Maaike H; Timmerman, Marieke E; van den Hoofdakker, Barbara J; Hoekstra, Pieter J

2017-03-01

To examine child factors and parental characteristics as predictors of discrepancies between parents' ratings of externalizing and internalizing behavior problems in a sample of preschool children with ADHD and behavior problems and in a nonclinical sample. We investigated correspondence and discrepancies between parents' ratings on the externalizing and internalizing behavior problems broadband scales of the Child Behavior Checklist version for preschool children (CBCL/1.5-5). Parents of 152 preschool children, with ADHD and behavior problems (n = 72) and nonclinical children (n = 80), aged between 28 and 72 months (M = 47.26, SD = 12.7), completed the CBCL/1.5-5. Candidate predictors of discrepancy included the child's age and sex, and parents' levels of parenting stress, depressive mood, attention-deficit and disruptive behavior. Hierarchical multiple regression analyses were conducted. Correspondence between parents, both for ratings on internalizing and externalizing behavior problems, was high (r = .63-.77). In the clinical sample, mothers rated the severity of externalizing behavior problems significantly higher than did fathers (p = < .001). Discrepancy between fathers and mothers on externalizing behavior problems was not predicted by child factors or interparental differences in psychopathology, but it was predicted by interparental differences in parenting stress (R 2  = .25, p < .001). This effect was significantly larger in the nonclinical sample (ΔR 2  = .06, p < .001). When parents disagree on the severity level of preschool children's externalizing behavior problems, the clinician should take into consideration that differences in parenting stress might be involved.

Psychiatric Symptom Clusters as Risk Factors for Alcohol Use Disorders in Adolescence: A National Study

PubMed Central

Harford, Thomas C.; Yi, Hsiao-ye; Chen, Chiung M.; Grant, Bridget F.

2015-01-01

Background Few epidemiologic studies have examined a full range of adolescent psychiatric disorders in the general population. The association between psychiatric symptom clusters (PSCs) and DSM-IV alcohol use disorders (AUDs) among adolescents is not well understood. Methods This study draws upon the public-use data from the 2000 National Household Survey on Drug Abuse, including a study sample of 19,430 respondents ages 12 to 17. Logistic regression and exploratory structural equation modeling assess the associations between PSCs and DSM-IV AUDs by gender. The PSCs are based on brief screening scales devised from the Diagnostic Interview Schedule for Children Predictive Scales. Results Several PSCs were found to be significantly associated with DSM-IV AUDs, including separation anxiety, generalized anxiety, depression, oppositional defiant disorder, and conduct disorder among both genders, and panic disorder and obsessive compulsive disorder among females. Consistent with the literature, the analysis of PSCs yields three factors identical for both genders—two internalizing factors (fear and anxiety–misery) and one externalizing factor. Adolescents who scored higher on the externalizing factor tended to have higher levels of the AUD factor. Female adolescents who scored higher on the internalizing misery factor and lower on the internalizing fear factor also tended to have higher levels of the AUD factor. Conclusion The associations that we found between PSCs and AUDs among adolescents in this study are consistent with those found among adults in other studies, although gender may moderate associations between internalizing PSCs and AUDs. Our findings lend support to previous findings on the developmentally stable associations between disruptive behaviors and AUDs among adolescents as well as adults in the general population. PMID:26110378

Subdural hematoma in infants without accidental or nonaccidental injury: benign external hydrocephalus, a risk factor.

PubMed

Ghosh, Partha S; Ghosh, Debabrata

2011-10-01

Benign external hydrocephalus (BEH) is considered a self-limiting condition in infants. Subdural hematoma (SDH) in infants without a history of trauma indicates nonaccidental injury (NAI). The authors studied whether SDH can complicate BEH without apparent trauma. Out of 45 children younger than 3 years with nontraumatic SDH, 9 (7 boys) with mean age 6 months had BEH as risk factor. Symptoms included increasing head size (8), fussiness, and irritability (3). Three had up-gaze restriction, 1 axial hypotonia, and 6 normal examination. Neuroimaging showed prominent extra-axial spaces; SDH was bilateral (6), subacute (5). Other etiological workup for SDH was negative except NAI in 1. Two required evacuation of SDH and subdural-peritoneal shunt; others managed conservatively. Development was normal in 8 on follow-up. On follow-up imaging of 8, SDH completely resolved in 3, markedly reduced in 3, and remained stable in 2. BEH is a risk factor for SDH in infants, thus not always benign.

Factors Supporting Implementation among CDSMP Organizations

PubMed Central

Paone, Deborah

2015-01-01

Reaching individuals who can benefit from evidence-based health promotion and disability prevention programs is a goal of federal, state, and local agencies as well as researchers, providers, community agencies, and other stakeholders. Implementation effectiveness at the organizational level must be achieved in order to reach these individuals and sustain the program. This mixed methods study examined eight organizations within two states that successfully implemented the Chronic Disease Self-Management Program (CDSMP) and sustained it from 4 to 10 years. There were two types of organizations: aging services and health care. Internal and external implementation factors and influences were explored. Additional examination of state activities (as a key external agent supporting CDSMP implementation) was conducted. The examination found agreement among the eight organizations regarding why they had adopted the CDSMP – citing the alignment between the program and their organizations’ mission and purpose to improve health status and promote better self-care, and the demonstrated value (benefits) of the program. Organizations were also alike in that they described the importance of an internal champion and supportive senior leader. Organizations differed in how they experienced and valued peer support and collaborative networks. Organizations also differed in how they filled their CDSMP workshops. Internal drivers and capability were more often discussed as facilitating successful implementation than external factors. However, state activities and external support enabled successful adoption – particularly funding and training. The primary challenges identified by this set of organizations included difficulty in recruiting participants (filling workshops) and irregular or insufficient funding sources. These challenges were identified as significant and represented barriers to sustaining the program. PMID:25964928

Factors Supporting Implementation among CDSMP Organizations.

PubMed

Paone, Deborah

2014-01-01

Reaching individuals who can benefit from evidence-based health promotion and disability prevention programs is a goal of federal, state, and local agencies as well as researchers, providers, community agencies, and other stakeholders. Implementation effectiveness at the organizational level must be achieved in order to reach these individuals and sustain the program. This mixed methods study examined eight organizations within two states that successfully implemented the Chronic Disease Self-Management Program (CDSMP) and sustained it from 4 to 10 years. There were two types of organizations: aging services and health care. Internal and external implementation factors and influences were explored. Additional examination of state activities (as a key external agent supporting CDSMP implementation) was conducted. The examination found agreement among the eight organizations regarding why they had adopted the CDSMP - citing the alignment between the program and their organizations' mission and purpose to improve health status and promote better self-care, and the demonstrated value (benefits) of the program. Organizations were also alike in that they described the importance of an internal champion and supportive senior leader. Organizations differed in how they experienced and valued peer support and collaborative networks. Organizations also differed in how they filled their CDSMP workshops. Internal drivers and capability were more often discussed as facilitating successful implementation than external factors. However, state activities and external support enabled successful adoption - particularly funding and training. The primary challenges identified by this set of organizations included difficulty in recruiting participants (filling workshops) and irregular or insufficient funding sources. These challenges were identified as significant and represented barriers to sustaining the program.

Preliminary nondestructive evaluation manual for the space shuttle. [preliminary nondestructive evaluation

NASA Technical Reports Server (NTRS)

Pless, W. M.

1974-01-01

Nondestructive evaluation (NDE) requirements are presented for some 134 potential fracture-critical structural areas identified, for the entire space shuttle vehicle system, as those possibly needing inspection during refurbishment/turnaround and prelaunch operations. The requirements include critical area and defect descriptions, access factors, recommended NDE techniques, and descriptive artwork. Requirements discussed include: Orbiter structure, external tank, solid rocket booster, and thermal protection system (development area).

Preparing Dental Students and Residents to Overcome Internal and External Barriers to Evidence-Based Practice.

PubMed

Coleman, Brandon G; Johnson, Thomas M; Erley, Kenneth J; Topolski, Richard; Rethman, Michael; Lancaster, Douglas D

2016-10-01

In recent years, evidence-based dentistry has become the ideal for research, academia, and clinical practice. However, barriers to implementation are many, including the complexity of interpreting conflicting evidence as well as difficulties in accessing it. Furthermore, many proponents of evidence-based care seem to assume that good evidence consistently exists and that clinicians can and will objectively evaluate data so as to apply the best evidence to individual patients' needs. The authors argue that these shortcomings may mislead many clinicians and that students should be adequately prepared to cope with some of the more complex issues surrounding evidence-based practice. Cognitive biases and heuristics shape every aspect of our lives, including our professional behavior. This article reviews literature from medicine, psychology, and behavioral economics to explore the barriers to implementing evidence-based dentistry. Internal factors include biases that affect clinical decision making: hindsight bias, optimism bias, survivor bias, and blind-spot bias. External factors include publication bias, corporate bias, and lack of transparency that may skew the available evidence in the peer-reviewed literature. Raising awareness of how these biases exert subtle influence on decision making and patient care can lead to a more nuanced discussion of addressing and overcoming barriers to evidence-based practice.

Percentage of Cancer Volume in Biopsy Cores Is Prognostic for Prostate Cancer Death and Overall Survival in Patients Treated With Dose-Escalated External Beam Radiotherapy

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

Vance, Sean M.; Stenmark, Matthew H.; Blas, Kevin

2012-07-01

Purpose: To investigate the prognostic utility of the percentage of cancer volume (PCV) in needle biopsy specimens for prostate cancer patients treated with dose-escalated external beam radiotherapy. Methods and Materials: The outcomes were analyzed for 599 men treated for localized prostate cancer with external beam radiotherapy to a minimal planning target volume dose of 75 Gy (range, 75-79.2). We assessed the effect of PCV and the pretreatment and treatment-related factors on the freedom from biochemical failure, freedom from metastasis, cause-specific survival, and overall survival. Results: The median number of biopsy cores was 7 (interquartile range, 6-12), median PCV was 10%more » (interquartile range, 2.5-25%), and median follow-up was 62 months. The PCV correlated with the National Comprehensive Cancer Network risk group and individual risk features, including T stage, prostate-specific antigen level, Gleason score, and percentage of positive biopsy cores. On log-rank analysis, the PCV stratified by quartile was prognostic for all endpoints, including overall survival. In addition, the PCV was a stronger prognostic factor than the percentage of positive biopsy cores when the two metrics were analyzed together. On multivariate analysis, the PCV predicted a worse outcome for all endpoints, including freedom from biochemical failure, (hazard ratio, 1.9; p = .0035), freedom from metastasis (hazard ratio, 1.7, p = .09), cause-specific survival (hazard ratio, 3.9, p = .014), and overall survival (hazard ratio, 1.8, p = .02). Conclusions: For patients treated with dose-escalated external beam radiotherapy, the volume of cancer in the biopsy specimen adds prognostic value for clinically relevant endpoints, particularly in intermediate- and high-risk patients. Although the PCV determination is more arduous than the percentage of positive biopsy cores, it provides superior risk stratification.« less

Upregulated Expression of Transient Receptor Potential Cation Channel Subfamily V Receptors in Mucosae of Patients with Oral Squamous Cell Carcinoma and Patients with a History of Alcohol Consumption or Smoking.

PubMed

Sakakibara, Akiko; Sakakibara, Shunsuke; Kusumoto, Junya; Takeda, Daisuke; Hasegawa, Takumi; Akashi, Masaya; Minamikawa, Tsutomu; Hashikawa, Kazunobu; Terashi, Hiroto; Komori, Takahide

2017-01-01

Transient receptor potential cation channel (subfamily V, members 1-4) (TRPV1-4) are expressed in skin and neurons and activated by external stimuli in normal mucosae of all oral cavity sites. The oral cavity is exposed to various stimuli, including temperature, mechanical stimuli, chemical substances, and changes in pH, and, notably, the risk factors for oncogenic transformation in oral squamous epithelium are the same as the external stimuli received by TRPV1-4 receptors. Hence, we examined the relationship between oral squamous cell carcinoma (SCC) and TRPV1-4 expression. Oral SCC patients (n = 37) who underwent surgical resection were included in this study. We investigated the expression of TRPV1-4 by immunohistochemical staining and quantification of TRPV1-4 mRNA in human oral mucosa. In addition, we compared the TRPV1-4 levels in mucosa from patients with SCC to those in normal oral mucosa. The receptors were expressed in oral mucosa at all sites (tongue, buccal mucosa, gingiva, and oral floor) and the expression was stronger in epithelia from patients with SCC than in normal epithelia. Furthermore, alcohol consumption and tobacco use were strongly associated with the occurrence of oral cancer and were found to have a remarkable influence on TRPV1-4 receptor expression in normal oral mucosa. In particular, patients with a history of alcohol consumption demonstrated significantly higher expression levels. Various external stimuli may influence the behavior of cancer cells. Overexpression of TRPV1-4 is likely to be a factor in enhanced sensitivity to external stimuli. These findings could contribute to the establishment of novel strategies for cancer therapy or prevention.

External rhinoplasty for the Arabian nose: a columellar scar analysis.

PubMed

Foda, Hossam M T

2004-01-01

This study aimed to evaluate columellar scar problems after external rhinoplasty in the Arabian population, and to analyze the technical factors that help prevent such problems and maximize the scar cosmesis. The investigation was conducted in university and private practice settings of the author in Alexandria, Egypt. A total of 600 Arab patients who underwent external rhinoplasty were included in the study. All the patients underwent surgery using the external rhinoplasty approach, in which bilateral alar marginal incisions were connected by an inverted V-shaped transcolumellar incision. At completion of the procedure, a two-layer closure of the columellar incision was performed. At a minimum of 1 year postoperatively, the columellar scar was evaluated subjectively by means of a patient questionnaire, and objectively by clinical examination and comparison of the close-up pre- and postoperative basal view photographs. Objectively, anything less than a barely visible, leveled, thin, linear scar was considered unsatisfactory. Subjectively, 95.5% of the patients rated the scar as unnoticeable, 3% as noticeable but acceptable, and 1.5% as unacceptable. Objectively, the scar was unsatisfactory in 7% of the cases. This was because of scar widening with or without depression (5%), hyperpigmentation (1.5%), and columellar rim notching (0.5%). The use of a deep 6/0 polydioxanon (PDS) suture significantly decreased the incidence of scar widening (p < 0.005).The columellar incision can be used safely in the Arab population regardless of their thick, dark, and oily skin. Technical factors that contributed to the favorable outcome of the columellar scar included proper planning of location and design of the incision used, precise execution, meticulous multilayered closure, and good postoperative care.

Experienced stigma and its impacts in psychosis: The role of social rank and external shame.

PubMed

Wood, Lisa; Irons, Chris

2017-09-01

Experienced stigma is detrimental to those who experience psychosis and can cause emotional distress and hinder recovery. This study aimed to explore the relationship between experienced stigma with emotional distress and recovery in people with psychosis. It explored the role of external shame and social rank as mediators in these relationships. A cross-sectional design was implemented. Fifty-two service users were administered a battery of questionnaires examining experienced stigma, external shame, social rank, personal recovery, positive symptoms, depression, and anxiety. Correlation and multiple regression analysis were conducted on the data. Where appropriate, mediation analysis was employed to explore social rank and external shame as mediatory variables. Experienced stigma was significantly related to shame (social rank and external shame), positive symptoms, emotional distress (depression and anxiety), and personal recovery. The impact of experienced stigma on depression was mediated by external shame. Social rank was a mediator between experienced stigma and personal recovery only. People with psychosis who have experienced stigma are likely to experience emotional distress and be inhibited in their recovery. This was found to be partly mediated by external shame and low social rank. Clinical approaches to stigma need to target these as potential maintenance factors. Experienced stigma is significantly related to shame (social rank and external shame) emotional distress, and reduced personal recovery. External shame mediated the relationship between experienced stigma and depression in psychosis. Social rank mediated the relationship between experienced stigma and personal recovery. Clinical approaches to stigma should include the assessment of external shame and low social rank. © 2017 The British Psychological Society.

Factors affecting failure to quit smoking after exposure to pictorial cigarette pack warnings among employees in Thailand.

PubMed

Sujirarat, Dusit; Silpasuwan, Pimpan; Viwatwongkasem, Chukiat; Sirichothiratana, Nithat

2011-07-01

This study was carried out to determine whether health warning pictures(HWP) affect smoking cessation using a structured equation model for intending-to-quit smokers in work places. Data from a 1-year longitudinal followup of attempt-to-quit employees was obtained to determine if pack warnings affect tobacco cessation rates. Stratified simple random sampling, and Structured Equation Modeling (SEM) were employed. Approximately 20% of intending-to-quit smokers were successful. The integrated model, combining internal, interpersonal factors and health warning pictures as external factors, fit the fail to quit pattern of the model. Having a smoking father was the most significant proximate indicator linked with failure to quit. Although HWL pictures were an external factor in the decision to stop smoking, the direct and indirect causes of failure to quit smoking were the influence of the family members. Fathers contributed to the success or failure of smoking cessation in their children by having an influence on the decision making process. Future HWP should include information about factors that stimulate smokers to quit successfully. The role model of a father on quitting is also important.

Factors influencing the current practice of self-medication consultations in Eastern Indonesian community pharmacies: a qualitative study.

PubMed

Brata, Cecilia; Fisher, Colleen; Marjadi, Brahmaputra; Schneider, Carl R; Clifford, Rhonda M

2016-05-13

Research has shown that the current practice of pharmacy staff when providing self-medication consultations in Indonesia is suboptimal. To improve the performance of pharmacy staff when providing self-medication consultations in community pharmacies, the factors that influence current practice need to be understood. The aim of this study is to identify the factors that influence current practice of pharmacy staff when handling self-medication consultations in Eastern Indonesian community pharmacies. Fifteen in-depth interviews were conducted with pharmacists, pharmacy technicians, pharmacy owners, and counter attendants. Thematic analysis was used to generate findings. The current practice of pharmacy staff when handling self-medication consultations is directly influenced by the professionalism of pharmacy staff and patient responses to the consultations. These factors are in turn affected by the organisational context of the pharmacy and the external pharmacy environment. The organisational context of the pharmacy includes staffing, staff affordability, and the availability of time and facilities in which to provide consultations. The external pharmacy environment includes the number of trained pharmacy staff in the research setting, the relevance of pharmacy education to the needs of pharmacy practice, the support offered by the Indonesian Pharmacists Association, a competitive business environment, and the policy environment. Complex and inter-related factors influence the current practice of pharmacy staff when providing self-medication consultations in community pharmacies in this research setting. Multiple strategies will be required to improve consultation practices.

Examination of Icing Induced Loss of Control and Its Mitigations

NASA Technical Reports Server (NTRS)

Reehorst, Andrew L.; Addy, Harold E., Jr.; Colantonio, Renato O.

2010-01-01

Factors external to the aircraft are often a significant causal factor in loss of control (LOC) accidents. In today s aviation world, very few accidents stem from a single cause and typically have a number of causal factors that culminate in a LOC accident. Very often the "trigger" that initiates an accident sequence is an external environment factor. In a recent NASA statistical analysis of LOC accidents, aircraft icing was shown to be the most common external environmental LOC causal factor for scheduled operations. When investigating LOC accident or incidents aircraft icing causal factors can be categorized into groups of 1) in-flight encounter with super-cooled liquid water clouds, 2) take-off with ice contamination, or 3) in-flight encounter with high concentrations of ice crystals. As with other flight hazards, icing induced LOC accidents can be prevented through avoidance, detection, and recovery mitigations. For icing hazards, avoidance can take the form of avoiding flight into icing conditions or avoiding the hazard of icing by making the aircraft tolerant to icing conditions. Icing detection mitigations can take the form of detecting icing conditions or detecting early performance degradation caused by icing. Recovery from icing induced LOC requires flight crew or automated systems capable of accounting for reduced aircraft performance and degraded control authority during the recovery maneuvers. In this report we review the icing induced LOC accident mitigations defined in a recent LOC study and for each mitigation describe a research topic required to enable or strengthen the mitigation. Many of these research topics are already included in ongoing or planned NASA icing research activities or are being addressed by members of the icing research community. These research activities are described and the status of the ongoing or planned research to address the technology needs is discussed

Refinements in the hierarchical structure of externalizing psychiatric disorders: Patterns of lifetime liability from mid-adolescence through early adulthood.

PubMed

Farmer, Richard F; Seeley, John R; Kosty, Derek B; Lewinsohn, Peter M

2009-11-01

Research on hierarchical modeling of psychopathology has frequently identified 2 higher order latent factors, internalizing and externalizing. When based on the comorbidity of psychiatric diagnoses, the externalizing domain has usually been modeled as a single latent factor. Multivariate studies of externalizing symptom features, however, suggest multidimensionality. To address this apparent contradiction, confirmatory factor analytic methods and information-theoretic criteria were used to evaluate 4 theoretically plausible measurement models based on lifetime comorbidity patterns of 7 putative externalizing disorders. Diagnostic information was collected at 4 assessment waves from an age-based cohort of 816 persons between the ages of 14 and 33. A 2-factor model that distinguished oppositional behavior disorders (attention-deficit/hyperactivity disorder, oppositional defiant disorder) from social norm violation disorders (conduct disorder, adult antisocial behavior, alcohol use disorder, cannabis use disorder, hard drug use disorder) demonstrated consistently good fit and superior approximating abilities. Analyses of psychosocial outcomes measured at the last assessment wave supported the validity of this 2-factor model. Implications of this research for the theoretical understanding of domain-related disorders and the organization of classification systems are discussed. PsycINFO Database Record 2009 APA, all rights reserved.

[External therapy of plasma cell mastitis by jiuyi powder using partial least-squares discriminant analysis: a safety analysis].

PubMed

Ye, Mei-na; Yang, Ming; Cheng, Yi-qin; Wang, Bing; Zhu, Ying; Xia, Ya-ru; Meng, Tian; Chen, Hao; Chen, Li-ying; Cheng, Hong-feng

2015-04-01

To evaluate the safety and the clinical value of external use of jiuyi Powder (JP) in treating plasma cell mastitis using partial least-squares discriminant analysis (PLSDA). Totally 50 patients with plasma cell mastitis treated by external use of JP were observed and biochemical examinations of blood and urine detected before application, at day 4 after application, at day 1 and 14 after discontinuation. Blood mercury and urinary mercury were detected before application, at day 1, 4, and 7 after application, at day 1 and 14 after discontinuation. Urinary mercury was also detected at 28 after discontinuation and 3 months after discontinuation. The information of wound, days of external application and the total dosage of external application were recorded before application, at day 1, 4, and 7 after application, as well as at day 1 after discontinuation. Then a discriminant model covering potential safety factors was set up by PLSDA after screening safety indices with important effects. The applicability of the model was assessed using area under ROC curve. Potential safety factors were assessed using variable importance in the projection (VIP). Urinary β2-microglobulin (β2-MG), urinary N-acetyl-β-D-glucosaminidase (NAG), 24 h urinary protein, and urinary α1-microglobulin (α1-MG) were greatly affected by external use of JP in treating plasma cell mastitis. The accuracy rate of PLSDA discriminate model was 74. 00%. The sensitivity, specificity, and the area under ROC curve was 0. 7826, 0. 7037, and 0. 8084, respectively. Three factors with greater effect on the potential safety were screened as follows: pre-application volume of the sore cavity, days of external application, and the total dosage of external application. PLSDA method could be used in analyzing bioinformation of clinical Chinese medicine. Urinary β2-MG and urinary NAG were two main safety monitoring indices. Days of external application and the total dosage of external application were main factors influencing blood mercury and urine mercury. A safety classification simulation model of treating plasma cell mastitis by external therapy of JP was established by the two factors, which could be used to assess the safety of external application of JP to some extent.

Ecosystem services and emergent vulnerability in managed ecosystems: A geospatial decision-support tool

Treesearch

Colin M. Beier; Trista M. Patterson; F. Stuart Chapin III

2008-01-01

Managed ecosystems experience vulnerabilities when ecological resilience declines and key flows of ecosystem services become depleted or lost. Drivers of vulnerability often include local management actions in conjunction with other external, larger scale factors. To translate these concepts to management applications, we developed a conceptual model of feedbacks...

"Family Stories" and Their Implications for Preschoolers' Memories of Personal Events

ERIC Educational Resources Information Center

Larkina, Marina; Bauer, Patricia J.

2012-01-01

Most adults experience childhood amnesia: They have very few memories of events prior to 3 to 4 years of age. Nevertheless, some early memories are retained. Multiple factors likely are responsible for the survival of early childhood memories, including external representations such as videos, photographs, and conversations about past experiences,…

Research on the Relationships between Chinese Journal Impact Factors and External Web Link Counts and Web Impact Factors

ERIC Educational Resources Information Center

An, Lu; Qiu, Junping

2004-01-01

Journal impact factors (JIFs) as determined by the Institute for Scientific and Technological Information of China (ISTIC) of forty-two Chinese engineering journals were compared with external Web link counts, obtained from Lycos, and Web Impact Factors (WIFs) of corresponding journal Web sites to determine if any significant correlation existed…

Siblings versus parents and friends: longitudinal linkages to adolescent externalizing problems.

PubMed

Defoe, Ivy N; Keijsers, Loes; Hawk, Skyler T; Branje, Susan; Dubas, Judith Semon; Buist, Kirsten; Frijns, Tom; van Aken, Marcel A G; Koot, Hans M; van Lier, Pol A C; Meeus, Wim

2013-08-01

It is well documented that friends' externalizing problems and negative parent-child interactions predict externalizing problems in adolescence, but relatively little is known about the role of siblings. This four-wave, multi-informant study investigated linkages of siblings' externalizing problems and sibling-adolescent negative interactions on adolescents' externalizing problems, while examining and controlling for similar linkages with friends and parents. Questionnaire data on externalizing problems and negative interactions were annually collected from 497 Dutch adolescents (M = 13.03 years, SD = 0.52, at baseline), as well as their siblings, mothers, fathers, and friends. Cross-lagged panel analyses revealed modest unique longitudinal paths from sibling externalizing problems to adolescent externalizing problems, for male and female adolescents, and for same-sex and mixed-sex sibling dyads, but only from older to younger siblings. Moreover, these paths were above and beyond significant paths from mother-adolescent negative interaction and friend externalizing problems to adolescent externalizing problems, 1 year later. No cross-lagged paths existed between sibling-adolescent negative interaction and adolescent externalizing problems. Taken together, it appears that especially older sibling externalizing problems may be a unique social risk factor for adolescent externalizing problems, equal in strength to significant parents' and friends' risk factors. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

Siblings versus parents and friends: longitudinal linkages to adolescent externalizing problems

PubMed Central

Defoe, Ivy N; Keijsers, Loes; Hawk, Skyler T; Branje, Susan; Dubas, Judith Semon; Buist, Kirsten; Frijns, Tom; van Aken, Marcel AG; Koot, Hans M; van Lier, Pol AC; Meeus, Wim

2013-01-01

Background: It is well documented that friends’ externalizing problems and negative parent–child interactions predict externalizing problems in adolescence, but relatively little is known about the role of siblings. This four-wave, multi-informant study investigated linkages of siblings’ externalizing problems and sibling–adolescent negative interactions on adolescents’ externalizing problems, while examining and controlling for similar linkages with friends and parents. Methods: Questionnaire data on externalizing problems and negative interactions were annually collected from 497 Dutch adolescents (M = 13.03 years, SD = 0.52, at baseline), as well as their siblings, mothers, fathers, and friends. Results: Cross-lagged panel analyses revealed modest unique longitudinal paths from sibling externalizing problems to adolescent externalizing problems, for male and female adolescents, and for same-sex and mixed-sex sibling dyads, but only from older to younger siblings. Moreover, these paths were above and beyond significant paths from mother–adolescent negative interaction and friend externalizing problems to adolescent externalizing problems, 1 year later. No cross-lagged paths existed between sibling–adolescent negative interaction and adolescent externalizing problems. Conclusions: Taken together, it appears that especially older sibling externalizing problems may be a unique social risk factor for adolescent externalizing problems, equal in strength to significant parents’ and friends’ risk factors. PMID:23398022

Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort.

PubMed

Garriga, César; García de Olalla, Patricia; Miró, Josep M; Ocaña, Inma; Knobel, Hernando; Barberá, Maria Jesús; Humet, Victoria; Domingo, Pere; Gatell, Josep M; Ribera, Esteve; Gurguí, Mercè; Marco, Andrés; Caylà, Joan A

2015-01-01

Antiretroviral therapy has led to a decrease in HIV-related mortality and to the emergence of non-AIDS defining diseases as competing causes of death. This study estimates the HIV mortality rate and their risk factors with regard to different causes in a large city from January 2001 to June 2013. We followed-up 3137 newly diagnosed HIV non-AIDS cases. Causes of death were classified as HIV-related, non-HIV-related and external. We examined the effect of risk factors on survival using mortality rates, Kaplan-Meier plots and Cox models. Finally, we estimated survival for each main cause of death groups through Fine and Gray models. 182 deaths were found [14.0/1000 person-years of follow-up (py); 95% confidence interval (CI):12.0-16.1/1000 py], 81.3% of them had a known cause of death. Mortality rate by HIV-related causes and non-HIV-related causes was the same (4.9/1000 py; CI:3.7-6.1/1000 py), external was lower [1.7/1000 py; (1.0-2.4/1000 py)]. Kaplan-Meier estimate showed worse survival in intravenous drug user (IDU) and heterosexuals than in men having sex with men (MSM). Factors associated with HIV-related causes of death include: IDU male (subHazard Ratio (sHR):3.2; CI:1.5-7.0) and <200 CD4 at diagnosis (sHR:2.7; CI:1.3-5.7) versus ≥500 CD4. Factors associated with non-HIV-related causes of death include: ageing (sHR:1.5; CI:1.4-1.7) and heterosexual female (sHR:2.8; CI:1.1-7.3) versus MSM. Factors associated with external causes of death were IDU male (sHR:28.7; CI:6.7-123.2) and heterosexual male (sHR:11.8; CI:2.5-56.4) versus MSM. There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.

Idiopathic Bilateral External Jugular Vein Thrombosis.

PubMed

Hindi, Zakaria; Fadhel, Ehab

2015-08-20

Vein thrombosis is mainly determined by 3 factors, which constitute a triad called Virchow's triad: hypercoagulability, stasis, and endothelial injury. Venous thrombosis commonly occurs in the lower extremities since most of the blood resides there and flows against gravity. The veins of the lower extremities are dependent on intact valves and fully functional leg muscles. However, in case of valvular incompetency or muscular weakness, thrombosis and blood stasis will occur as a result. In contrast, the veins of the neck, specially the jugulars, have distensible walls which allow flexibility during respiration. In addition, the blood directly flows downward towards the heart. Nevertheless, many case reports mentioned the thrombosis of internal jugular veins and external jugular veins with identified risk factors. Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy. This report is of a case of idiopathic bilateral external jugular vein thrombosis in a 21 year-old male construction worker of Southeast Asian origin with no previous medical history who presented with bilateral facial puffiness of gradual onset over 1 month. Doppler ultrasound and computed tomography were used in the diagnosis. Further work-up showed no evidence of infection or neoplasia. The patient was eventually discharged on warfarin. The patient was assessed after 6 months and his symptoms had resolved completely. Bilateral idiopathic external jugular veins thrombosis is extremely rare and can be an indicator of early malignancy or hidden infection. While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present case shows that external jugular vein thrombosis can also be found in persons without malignancy.

Bundle of measures for external cerebral ventricular drainage-associated ventriculitis.

PubMed

Chatzi, Maria; Karvouniaris, Marios; Makris, Demosthenes; Tsimitrea, Eleni; Gatos, Charalampos; Tasiou, Anastasia; Mantzarlis, Kostas; Fountas, Kostas N; Zakynthinos, Epaminondas

2014-01-01

To assess the prevalence and outcome of external cerebral ventricular drainage-associated ventriculitis in neurocritical patients before and after the implementation of a bundle of external cerebral ventricular drainage-associated ventriculitis control measures. Clinical prospective case series. University Hospital of Larissa, Greece. Consecutive patients were recruited from the ICU of the hospital. Patient inclusion criteria included presence of external ventricular drainage and ICU stay more than 48 hours. The bundle of external cerebral ventricular drainage-associated ventriculitis control measures included 1) reeducation of ICU personnel on issues of infection control related to external cerebral ventricular drainage, 2) meticulous intraventricular catheter handling, 3) cerebrospinal fluid sampling only when clinically necessary, and 4) routine replacement of the drainage catheter on the seventh drainage day if the catheter was still necessary. The bundle was applied after an initial period (preintervention) where standard policy for external cerebral ventricular drainage-associated ventriculitis was established. External cerebral ventricular drainage-associated ventriculitis prevalence, external cerebral ventricular drainage-associated ventriculitis events per 1,000 drainage days (drain-associated infection rate), length of ICU stay, Glasgow Outcome Scale at 6 months, and risk factors for external cerebral ventricular drainage-associated ventriculitis. Eighty-two patients entered the study in the preintervention period and 57 patients during the intervention period. During the preintervention and intervention period, external cerebral ventricular drainage-associated ventriculitis prevalence was 28% and 10.5% (p = 0.02) and drain-associated infection rate was 18 and 7.1, respectively (p = 0.0001); mean (95% CI) length of ICU stay in patients who presented external cerebral ventricular drainage-associated ventriculitis was 44.4 days (36.4-52.4 d), whereas mean (95% CI) length of ICU stay in patients who did not was 20 days (16.9-23.2 d) (p < 0.001). Furthermore, the length of ICU stay was associated with length of drainage (p = 0.0001). Therefore, the presence of external cerebral ventricular drainage-associated ventriculitis and the length of drainage were the only variables associated with a prolonged ICU stay. Unfavorable outcome in Glasgow Outcome Scale at 6 months was not associated with the presence of external cerebral ventricular drainage-associated ventriculitis (p = 0.5). No significant differences were found when Glasgow Outcome Scale was analyzed according to the two study periods. The implementation of a bundle of measures for external cerebral ventricular drainage-associated ventriculitis control was associated with significantly decreased postintervention prevalence of the infection.

Infectious complications related to external ventricular shunt. Incidence and risk factors.

PubMed

López-Amor, L; Viña, L; Martín, L; Calleja, C; Rodríguez-García, R; Astola, I; Forcelledo, L; Álvarez-García, L; Díaz-Gómez, C; Fernández-Domínguez, J; Vázquez, F; Escudero, D

2017-10-01

Infectious complications related to external ventricular shunt (ICREVS) are a main problem in neurocritical intensive care units (ICU). The aim of the review is to assess the incidence of ICREVS and to analyse factors involved. Retrospective analysis, adult polyvalent ICU in a third level reference hospital. Patients carrying external ventricular shunt (DVE) were included. Those patients with central nervous system infection diagnosed prior DVE placement were excluded. 87 patients were included with 106 DVE. Most common admittance diagnosis was subarachnoid haemorrhage (49.4%). 31 patients with 32 DVE developed an ICREVS. Infection rate is 19.5 per 1000 days of shunt for ICREVS and 14 per 1000 days for ventriculitis. 31.6% of the patients developed ICREVS and 25.3% ventriculitis. Patients who developed ICREVS presented higher shunt manipulations (2.0 ± 0.6 vs. 3.26 ± 1.02, p=0.02), shunt repositioning (0.1 ± 0.1 vs. 0.2 ± 0.1) and ICU and hospital stay (29.8 ± 4.9 vs 49.8 ± 5.2, p<0.01 y 67.4 ± 18.8 vs. 108.9 ± 30.2, p=0.02. Those DVE with ICREVS were placed for longer not only at infection diagnosis but also at removal (12.6 ± 2.1 vs. 18.3 ± 3.6 and 12.6 ± 2.1 vs. 30.4 ± 7.3 days, p<0.01). No difference in mortality was found. One out of three patients with a DVE develops an infection. The risk factors are the number of manipulations, repositioning and the permanency days. Patients with ICREVS had a longer ICU and hospital average stay without an increase in mortality.

Understanding the external pressure and behavior of commercial banks' environmental risk management: an empirical study undertaken in the Yangtze River delta of China.

PubMed

Liu, Yong; Lin, Zhongguo

2014-04-01

The present study employed a quantitative survey to ascertain whether the external pressure of environmental risk management (ERM) on commercial banks was a contributing factor to their ERM behavior. Data was obtained using questionnaires from 204 branches of commercial banks located in the Yangtze River Delta of China. The relationship between external pressure and behavior was tested using a linear structural relations model through path analysis. The results revealed that external pressure of ERM was significantly and positively related to the behavior and that pressure from governmental regulations was the most important contributing factor in the passive feedback behavior and preventive behavior of commercial banks. The pressure from markets was the most important contributing factor in banks' active participation behavior; the pressure from community and NGOs was the most important contributing factor in their enthusiastic behavior.

A review of privacy and usability issues in mobile health systems: Role of external factors.

PubMed

Katusiime, Jane; Pinkwart, Niels

2017-10-01

The increased penetration of mobile devices has created opportunities in the health sector and led to emerging of mobile health systems. As much as the mobile health systems have registered tremendous progress, they have been faced with privacy and usability issues. Due to the sensitivity of health information, there is an ethical need to equip mobile health systems with adequate privacy measures. However, these systems should also be useable by the intended users. Even though many researchers are working on solutions, the issues still persist. External factors such as cultural differences have also contributed to the issues, yet they have been under researched. In this article, we conduct a systematic literature review of 22 articles, categorize and present privacy and usability issues and possible solutions. We then discuss the relevance and implications of external factors to the findings on privacy and usability. We end with recommendations to address these external factors.

Spirituality and the International Classification of Functioning, Disability and Health: content comparison of questionnaires measuring mindfulness based on the International Classification of Functioning.

PubMed

Offenbächer, Martin; Sauer, Sebastian; Hieblinger, Robin; Hufford, David J; Walach, Harald; Kohls, Niko

2011-01-01

To identify and compare the concepts contained in questionnaires measuring mindfulness using the International Classification of Functioning (ICF) as external reference. Questionnaires which are published in peer-reviewed journals and listed in Pubmed or PsycInfo were included. The questionnaires were analysed and, using a content-analytical approach, the respective items were categorised and linked to the ICF. Ten questionnaires were included. Ninety-four per cent (N = 341) of the concepts could be linked to 37 different ICF categories. One hundred and seventy-one (50.1%) concepts were linked to ICF categories of the component Body Function, 74 (21.7%) to categories of the component Activity and Participation and none to categories of the component Environmental Factors. In total, 28.2% of the linked concepts belonged to Personal factors, which are not yet classified in the ICF. The questionnaires exhibited considerable differences regarding content density (i.e. the average number of concepts per item) and content diversity (i.e. the number of ICF categories per concept). The ICF provides an useful external reference to identify and compare the concepts contained in mindfulness questionnaires. Also, mindfulness questionnaire concepts suggest potentially useful factors for classification within the ICF.

Social, economic, and political factors in progress towards improving child survival in developing nations.

PubMed

Lykens, Kristine; Singh, Karan P; Ndukwe, Elewichi; Bae, Sejong

2009-01-01

Child mortality is a persistent health problem faced by developing nations. In 2000 the United Nations (UN) established a set of high priority goals to address global problems of poverty and health, the Millennium Development Goals, which address extreme poverty, hunger, primary education, child mortality, maternal health, infectious diseases, environmental sustainability, and partnerships for development. Goal 4 aims to reduce by two thirds, between 2000 and 2015, the under-five mortality rate in developing countries. In sub-Saharan Africa from 2000 to 2006 these rates have only been reduced from 167 per 1,000 live births to 157, and 27 nations in this region have made no progress towards the goal. A country-specific database was developed from the UN Millennium Development Goal tracking project and other international sources which include age distribution, under-nutrition, per capita income, government expenditures on health, external resources for health, civil liberties, and political rights. A multiple regression analysis examined the extent to which these factors explain the variance in child mortality rates in developing countries. Nutrition, external resources, and per capita income were shown to be significant factors in child survivability. Policy options include developed countries' renewed commitment of resources, and developing nations' commitments towards governance, development, equity, and transparency.

An Investigation of Relationships between Internal and External Factors Affecting Technology Integration in Classrooms

ERIC Educational Resources Information Center

Hur, Jung Won; Shannon, David; Wolf, Sara

2016-01-01

Various factors affecting technology integration have been identified, but little research has examined the relationships between factors, especially internal and external ones, and whether they directly or indirectly influenced each other. To fill this research gap, this study examined the significance and relationships of five factors…

Development and External Validation of a Melanoma Risk Prediction Model Based on Self-assessed Risk Factors.

PubMed

Vuong, Kylie; Armstrong, Bruce K; Weiderpass, Elisabete; Lund, Eiliv; Adami, Hans-Olov; Veierod, Marit B; Barrett, Jennifer H; Davies, John R; Bishop, D Timothy; Whiteman, David C; Olsen, Catherine M; Hopper, John L; Mann, Graham J; Cust, Anne E; McGeechan, Kevin

2016-08-01

Identifying individuals at high risk of melanoma can optimize primary and secondary prevention strategies. To develop and externally validate a risk prediction model for incident first-primary cutaneous melanoma using self-assessed risk factors. We used unconditional logistic regression to develop a multivariable risk prediction model. Relative risk estimates from the model were combined with Australian melanoma incidence and competing mortality rates to obtain absolute risk estimates. A risk prediction model was developed using the Australian Melanoma Family Study (629 cases and 535 controls) and externally validated using 4 independent population-based studies: the Western Australia Melanoma Study (511 case-control pairs), Leeds Melanoma Case-Control Study (960 cases and 513 controls), Epigene-QSkin Study (44 544, of which 766 with melanoma), and Swedish Women's Lifestyle and Health Cohort Study (49 259 women, of which 273 had melanoma). We validated model performance internally and externally by assessing discrimination using the area under the receiver operating curve (AUC). Additionally, using the Swedish Women's Lifestyle and Health Cohort Study, we assessed model calibration and clinical usefulness. The risk prediction model included hair color, nevus density, first-degree family history of melanoma, previous nonmelanoma skin cancer, and lifetime sunbed use. On internal validation, the AUC was 0.70 (95% CI, 0.67-0.73). On external validation, the AUC was 0.66 (95% CI, 0.63-0.69) in the Western Australia Melanoma Study, 0.67 (95% CI, 0.65-0.70) in the Leeds Melanoma Case-Control Study, 0.64 (95% CI, 0.62-0.66) in the Epigene-QSkin Study, and 0.63 (95% CI, 0.60-0.67) in the Swedish Women's Lifestyle and Health Cohort Study. Model calibration showed close agreement between predicted and observed numbers of incident melanomas across all deciles of predicted risk. In the external validation setting, there was higher net benefit when using the risk prediction model to classify individuals as high risk compared with classifying all individuals as high risk. The melanoma risk prediction model performs well and may be useful in prevention interventions reliant on a risk assessment using self-assessed risk factors.

Childhood Internalizing and Externalizing Problems Predict the Onset of Clinical Panic Attacks over Adolescence: The TRAILS Study

PubMed Central

Mathyssek, Christina M.; Olino, Thomas M.; Verhulst, Frank C.; van Oort, Floor V. A.

2012-01-01

Background Panic attacks are a source of individual suffering and are an independent risk factor for later psychopathology. However, much less is known about risk factors for the development of panic attacks, particularly during adolescence when the incidence of panic attacks increases dramatically. We examined whether internalizing and externalizing problems in childhood predict the onset of panic attacks in adolescence. Method This study is part of the TRacking Adolescents’ Individual Lives Survey (TRAILS), a Dutch longitudinal population cohort study (N = 1,584). Internalizing and Externalizing Problems were collected using the Youth Self-Report (YSR) and the parent-report Child Behavior Checklist (CBCL) at baseline (age 10–12). At age 18–20, DSM-IV defined panic attacks since baseline were assessed with the Composite International Diagnostic Interview (CIDI). We investigated whether early adolescent Internalizing and Externalizing Problems predicted panic attacks between ages 10–20 years, using survival analysis in univariate and multivariate models. Results There were N = 314 (19.8%) cases who experienced at least one DSM-IV defined panic attack during adolescence and N = 18 (1.2%) who developed panic disorder during adolescence. In univariate analyses, CBCL Total Problems, Internalizing Problems and three of the eight syndrome scales predicted panic attack onset, while on the YSR all broad-band problem scales and each narrow-band syndrome scale predicted panic attack onset. In multivariate analyses, CBCL Social Problems (HR 1.19, p<.05), and YSR Thought Problems (HR 1.15, p<.05) and Social Problems (HR 1.26, p<.01) predicted panic attack onset. Conclusion Risk indicators of panic attack include the wide range of internalizing and externalizing problems. Yet, when adjusted for co-occurring problem behaviors, Social Problems were the most consistent risk factor for panic attack onsets in adolescence. PMID:23251576

Environmental factors and unhealthy lifestyle influence oxidative stress in humans--an overview.

PubMed

Aseervatham, G Smilin Bell; Sivasudha, T; Jeyadevi, R; Arul Ananth, D

2013-07-01

Oxygen is the most essential molecule for life; since it is a strong oxidizing agent, it can aggravate the damage within the cell by a series of oxidative events including the generation of free radicals. Antioxidative agents are the only defense mechanism to neutralize these free radicals. Free radicals are not only generated internally in our body system but also trough external sources like environmental pollution, toxic metals, cigarette smoke, pesticides, etc., which add damage to our body system. Inhaling these toxic chemicals in the environment has become unavoidable in modern civilization. Antioxidants of plant origin with free radical scavenging properties could have great importance as therapeutic agents in several diseases caused by environmental pollution. This review summarizes the generation of reactive oxygen species and damage to cells by exposure to external factors, unhealthy lifestyle, and role of herbal plants in scavenging these reactive oxygen species.

Achieving change in primary care--causes of the evidence to practice gap: systematic reviews of reviews.

PubMed

Lau, Rosa; Stevenson, Fiona; Ong, Bie Nio; Dziedzic, Krysia; Treweek, Shaun; Eldridge, Sandra; Everitt, Hazel; Kennedy, Anne; Qureshi, Nadeem; Rogers, Anne; Peacock, Richard; Murray, Elizabeth

2016-03-22

This study is to identify, summarise and synthesise literature on the causes of the evidence to practice gap for complex interventions in primary care. This study is a systematic review of reviews. MEDLINE, EMBASE, CINAHL, Cochrane Library and PsychINFO were searched, from inception to December 2013. Eligible reviews addressed causes of the evidence to practice gap in primary care in developed countries. Data from included reviews were extracted and synthesised using guidelines for meta-synthesis. Seventy reviews fulfilled the inclusion criteria and encompassed a wide range of topics, e.g. guideline implementation, integration of new roles, technology implementation, public health and preventative medicine. None of the included papers used the term "cause" or stated an intention to investigate causes at all. A descriptive approach was often used, and the included papers expressed "causes" in terms of "barriers and facilitators" to implementation. We developed a four-level framework covering external context, organisation, professionals and intervention. External contextual factors included policies, incentivisation structures, dominant paradigms, stakeholders' buy-in, infrastructure and advances in technology. Organisation-related factors included culture, available resources, integration with existing processes, relationships, skill mix and staff involvement. At the level of individual professionals, professional role, underlying philosophy of care and competencies were important. Characteristics of the intervention that impacted on implementation included evidence of benefit, ease of use and adaptability to local circumstances. We postulate that the "fit" between the intervention and the context is critical in determining the success of implementation. This comprehensive review of reviews summarises current knowledge on the barriers and facilitators to implementation of diverse complex interventions in primary care. To maximise the uptake of complex interventions in primary care, health care professionals and commissioning organisations should consider the range of contextual factors, remaining aware of the dynamic nature of context. Future studies should place an emphasis on describing context and articulating the relationships between the factors identified here. PROSPERO CRD42014009410.

Looking into the evolution of granular asteroids in the Solar System

NASA Astrophysics Data System (ADS)

Sánchez, Paul; Scheeres, Daniel; Hirabayashi, Masatoshi; Tardivel, Simon

2017-06-01

By now it has been accepted that most of the small asteroids in the Solar System are granular aggregates kept together by gravitational and possibly, cohesive forces. These aggregates can form, deform and disrupt over millennia subjected to different internal and external factors that would ultimately determine how they evolve over time. Parameters such as porosity, cohesive and tensile strength, angles of friction, particle size distributions, stress states, heterogeneity and yield criteria among others, determine how these granular systems will react when subjected to different, changing, external factors. These external factors include solar photon momentum, gravitational tides, micro- and macro-impacts and are believed to have produced and shaped the current asteroid population. In our research we use a combination of Soil Mechanics theory, Soft-Sphere Discrete Element Method (SSDEM) Simulations and Orbital Mechanics in order to understand how simulated, homogeneous and heterogeneous, ellipsoidal and spherical gravitational aggregates, a crude but useful representation of an asteroid, evolve when rotated to the point of disruption. Then, we compare our results to the shapes of observed asteroids as well as to the disruption patterns of a few active asteroids. Our results lead us to believe that the different shapes of observed asteroids as well as their unique disruption patterns could give us clues about their internal structure, strength and geophysical properties in general.

The role of the brain-derived neurotrophic factor genotype and parenting in early life in predicting externalizing and internalizing symptoms in children with attention-deficit hyperactivity disorder.

PubMed

Park, Subin; Kim, Bung-Nyun; Kim, Jae-Won; Jung, Yeon-Kyung; Lee, Jin; Shin, Min-Sup; Yoo, Hee Jeong; Cho, Soo-Churl

2014-11-25

We aimed to determine whether early parenting is associated with externalizing and internalizing symptoms in children with attention-deficit hyperactivity disorder (ADHD) and whether such an association is affected by the brain-derived neurotrophic factor (BDNF) val66met polymorphism. The participants included 92 patients with ADHD aged 6-15 years. Measures of parenting in early life and externalizing and internalizing symptoms and the genotype of the BDNF Val66Met polymorphism were obtained. The degree to which the baby's autonomy was allowed was significantly and negatively correlated with the CDI scores in ADHD children (r = -0.38, p = 0.005). After adjusting for the child's gender, the child's age, the family's gross annual income, and the maternal education level, there was a significant interaction for the BDNF genotype and mother's positive feelings about caring in relation to the development of childhood anxiety/depression in ADHD children (F = 2.51, p = 0.011). Our results provide evidence of an interaction between the BDNF met allele and early parenting on the development of depression/anxiety symptoms.

Psychological factors associated with weight loss maintenance: theory-driven practice for nurse practitioners.

PubMed

Valek, Rebecca M; Greenwald, Beverly J; Lewis, Carolyn C

2015-04-01

The authors discuss the psychological factors associated with weight loss maintenance and the use of Pender's health promotion model as a guide for the construction of clinical interventions to address these factors. The psychological factors include internal drive for weight maintenance, ongoing self-monitoring, long-term flexibility, positive mood and emotions, appropriate goals, and management of external stimuli. Nurse practitioners can help combat obesity trends through caring for patients in a holistic manner. Periodic psychological needs-assessments for patients who desire to maintain weight loss may further promote long-term success in weight management. © The Author(s) 2015.

Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

PubMed Central

Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

2015-01-01

Objectives Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. Methods An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. Results How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. Conclusions The development of hospital leaders’ skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. PMID:26683885

Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries.

PubMed

Burnett, Susan; Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

2016-04-01

Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. The development of hospital leaders' skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. © The Author(s) 2015.

Updating Risk Prediction Tools: A Case Study in Prostate Cancer

PubMed Central

Ankerst, Donna P.; Koniarski, Tim; Liang, Yuanyuan; Leach, Robin J.; Feng, Ziding; Sanda, Martin G.; Partin, Alan W.; Chan, Daniel W; Kagan, Jacob; Sokoll, Lori; Wei, John T; Thompson, Ian M.

2013-01-01

Online risk prediction tools for common cancers are now easily accessible and widely used by patients and doctors for informed decision-making concerning screening and diagnosis. A practical problem is as cancer research moves forward and new biomarkers and risk factors are discovered, there is a need to update the risk algorithms to include them. Typically the new markers and risk factors cannot be retrospectively measured on the same study participants used to develop the original prediction tool, necessitating the merging of a separate study of different participants, which may be much smaller in sample size and of a different design. Validation of the updated tool on a third independent data set is warranted before the updated tool can go online. This article reports on the application of Bayes rule for updating risk prediction tools to include a set of biomarkers measured in an external study to the original study used to develop the risk prediction tool. The procedure is illustrated in the context of updating the online Prostate Cancer Prevention Trial Risk Calculator to incorporate the new markers %freePSA and [−2]proPSA measured on an external case control study performed in Texas, U.S.. Recent state-of-the art methods in validation of risk prediction tools and evaluation of the improvement of updated to original tools are implemented using an external validation set provided by the U.S. Early Detection Research Network. PMID:22095849

Updating risk prediction tools: a case study in prostate cancer.

PubMed

Ankerst, Donna P; Koniarski, Tim; Liang, Yuanyuan; Leach, Robin J; Feng, Ziding; Sanda, Martin G; Partin, Alan W; Chan, Daniel W; Kagan, Jacob; Sokoll, Lori; Wei, John T; Thompson, Ian M

2012-01-01

Online risk prediction tools for common cancers are now easily accessible and widely used by patients and doctors for informed decision-making concerning screening and diagnosis. A practical problem is as cancer research moves forward and new biomarkers and risk factors are discovered, there is a need to update the risk algorithms to include them. Typically, the new markers and risk factors cannot be retrospectively measured on the same study participants used to develop the original prediction tool, necessitating the merging of a separate study of different participants, which may be much smaller in sample size and of a different design. Validation of the updated tool on a third independent data set is warranted before the updated tool can go online. This article reports on the application of Bayes rule for updating risk prediction tools to include a set of biomarkers measured in an external study to the original study used to develop the risk prediction tool. The procedure is illustrated in the context of updating the online Prostate Cancer Prevention Trial Risk Calculator to incorporate the new markers %freePSA and [-2]proPSA measured on an external case-control study performed in Texas, U.S.. Recent state-of-the art methods in validation of risk prediction tools and evaluation of the improvement of updated to original tools are implemented using an external validation set provided by the U.S. Early Detection Research Network. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The German Version of the Dutch Eating Behavior Questionnaire: Psychometric Properties, Measurement Invariance, and Population-Based Norms

PubMed Central

Hilbert, Anja; de Zwaan, Martina; Braehler, Elmar; Kersting, Anette

2016-01-01

The Dutch Eating Behavior Questionnaire is an internationally widely used instrument assessing different eating styles that may contribute to weight gain and overweight: emotional eating, external eating, and restraint. This study aimed to evaluate the psychometric properties of the 30-item German version of the DEBQ including its measurement invariance across gender, age, and BMI-status in a representative German population sample. Furthermore, we examined the distribution of eating styles in the general population and provide population-based norms for DEBQ scales. A representative sample of the German general population (N = 2513, age ≥ 14 years) was assessed with the German version of the DEBQ along with information on sociodemographic characteristics and body weight and height. The German version of the DEQB demonstrates good item characteristics and reliability (restraint: α = .92, emotional eating: α = .94, external eating: α = .89). The 3-factor structure of the DEBQ could be replicated in exploratory and confirmatory factor analyses and results of multi-group confirmatory factor analyses supported its metric and scalar measurement invariance across gender, age, and BMI-status. External eating was the most prevalent eating style in the German general population. Women scored higher on emotional and restrained eating scales than men, and overweight individuals scored higher in all three eating styles compared to normal weight individuals. Small differences across age were found for external eating. Norms were provided according to gender, age, and BMI-status. Our findings suggest that the German version of the DEBQ has good reliability and construct validity, and is suitable to reliably measure eating styles across age, gender, and BMI-status. Furthermore, the results demonstrate a considerable variation of eating styles across gender and BMI-status. PMID:27656879

The German Version of the Dutch Eating Behavior Questionnaire: Psychometric Properties, Measurement Invariance, and Population-Based Norms.

PubMed

Nagl, Michaela; Hilbert, Anja; de Zwaan, Martina; Braehler, Elmar; Kersting, Anette

The Dutch Eating Behavior Questionnaire is an internationally widely used instrument assessing different eating styles that may contribute to weight gain and overweight: emotional eating, external eating, and restraint. This study aimed to evaluate the psychometric properties of the 30-item German version of the DEBQ including its measurement invariance across gender, age, and BMI-status in a representative German population sample. Furthermore, we examined the distribution of eating styles in the general population and provide population-based norms for DEBQ scales. A representative sample of the German general population (N = 2513, age ≥ 14 years) was assessed with the German version of the DEBQ along with information on sociodemographic characteristics and body weight and height. The German version of the DEQB demonstrates good item characteristics and reliability (restraint: α = .92, emotional eating: α = .94, external eating: α = .89). The 3-factor structure of the DEBQ could be replicated in exploratory and confirmatory factor analyses and results of multi-group confirmatory factor analyses supported its metric and scalar measurement invariance across gender, age, and BMI-status. External eating was the most prevalent eating style in the German general population. Women scored higher on emotional and restrained eating scales than men, and overweight individuals scored higher in all three eating styles compared to normal weight individuals. Small differences across age were found for external eating. Norms were provided according to gender, age, and BMI-status. Our findings suggest that the German version of the DEBQ has good reliability and construct validity, and is suitable to reliably measure eating styles across age, gender, and BMI-status. Furthermore, the results demonstrate a considerable variation of eating styles across gender and BMI-status.

The Biomedical Doctorate in the Contemporary University: Education or Training and Why It Matters

ERIC Educational Resources Information Center

Kemp, Matthew W.; Newnham, John P.; Chapman, Elaine

2012-01-01

The form and function(s) of doctoral education continue to be a subject of much debate by stakeholders internal and external to the university. Notable concerns driving this debate derive from a seemingly discursive array of factors including increasing student numbers, increased understanding of the economic value of doctoral graduates,…

Predicting Change in Parenting Stress across Early Childhood: Child and Maternal Factors

ERIC Educational Resources Information Center

Williford, Amanda P.; Calkins, Susan D.; Keane, Susan P.

2007-01-01

This study examined maternal parenting stress in a sample of 430 boys and girls including those at risk for externalizing behavior problems. Children and their mothers were assessed when the children were ages 2, 4, and 5. Hierarchical linear modeling (HLM) was used to examine stability of parenting stress across early childhood and to examine…

The Influence of the Intermediary System of Cognition on Vocabulary Acquisition for Chinese English-Majors

ERIC Educational Resources Information Center

Luo, Yanyan

2009-01-01

In the article, the author tries to find out the main factors that affect the subject's vocabulary acquisition by an investigation. It is concluded that vocabulary acquisition models and strategies are something external, what really works upon vocabulary acquisition is the intermediary system of cognition including the knowledge structure and…

Ventilation of Wide-Span Schools in the Hot, Humid Tropics. Educational Building Report 6.

ERIC Educational Resources Information Center

Chand, Ishwar

This report describes studies on natural air motion induced in wide-span educational buildings. It includes a discussion on the influence of air motion indoors on various factors such as the span of buildings, orientation in relation to outdoor wind, open spaces such as courtyards, plan form, semi-partitions, external projections, adjacent…

Construction and Characterization of External Cavity Diode Lasers for Atomic Physics

PubMed Central

Hardman, Kyle S.; Bennetts, Shayne; Debs, John E.; Kuhn, Carlos C. N.; McDonald, Gordon D.; Robins, Nick

2014-01-01

Since their development in the late 1980s, cheap, reliable external cavity diode lasers (ECDLs) have replaced complex and expensive traditional dye and Titanium Sapphire lasers as the workhorse laser of atomic physics labs1,2. Their versatility and prolific use throughout atomic physics in applications such as absorption spectroscopy and laser cooling1,2 makes it imperative for incoming students to gain a firm practical understanding of these lasers. This publication builds upon the seminal work by Wieman3, updating components, and providing a video tutorial. The setup, frequency locking and performance characterization of an ECDL will be described. Discussion of component selection and proper mounting of both diodes and gratings, the factors affecting mode selection within the cavity, proper alignment for optimal external feedback, optics setup for coarse and fine frequency sensitive measurements, a brief overview of laser locking techniques, and laser linewidth measurements are included. PMID:24796259

Construction and characterization of external cavity diode lasers for atomic physics.

PubMed

Hardman, Kyle S; Bennetts, Shayne; Debs, John E; Kuhn, Carlos C N; McDonald, Gordon D; Robins, Nick

2014-04-24

Since their development in the late 1980s, cheap, reliable external cavity diode lasers (ECDLs) have replaced complex and expensive traditional dye and Titanium Sapphire lasers as the workhorse laser of atomic physics labs. Their versatility and prolific use throughout atomic physics in applications such as absorption spectroscopy and laser cooling makes it imperative for incoming students to gain a firm practical understanding of these lasers. This publication builds upon the seminal work by Wieman, updating components, and providing a video tutorial. The setup, frequency locking and performance characterization of an ECDL will be described. Discussion of component selection and proper mounting of both diodes and gratings, the factors affecting mode selection within the cavity, proper alignment for optimal external feedback, optics setup for coarse and fine frequency sensitive measurements, a brief overview of laser locking techniques, and laser linewidth measurements are included.

Comparing outcomes of pediatric and adult external dacryocystorhinostomy in Nepal: Is age a prognostic factor?

PubMed

Limbu, Ben; Katwal, Sulaxmi; Lim, Nicole S; Faierman, Michelle L; Gushchin, Anna G; Saiju, Rohit

2017-08-01

We determine whether age is a prognostic factor for surgical outcomes of external dacryocystorhinostomy (Ex-DCR). This retrospective cohort study conducted at Tilganga Institute of Ophthalmology (Kathmandu, Nepal) compared pediatric Ex-DCR procedures (age ≤ 15 years) to adult Ex-DCR procedures (age > 15 years) and was performed between January 2013 and December 2013, with a minimum follow-up period of 6 months. Primary outcome measure was rate of success, defined as complete resolution of subjective symptom(s) of epiphora (subjective success), combined with patent lacrimal passage on syringing (anatomical success) at last follow-up visit. Other outcome measures included clinical presentation, diagnosis, intraoperative complications and post-operative complications. In total, 154 Ex-DCR procedures were included, with an age range of 8 months to 81 years (mean age 36.4 ± 21.0 years). In all, 38 pediatric Ex-DCR procedures were compared to 116 adult procedures. Success rates were 97% in the pediatric group and 95% in the adult group, with no clinically or statistically significant difference in success rate or complication rate between groups (p > 0.05). Our study yielded high success rates of Ex-DCR in both pediatric and adult age groups suggesting that Ex-DCR remains an optimal treatment choice for all age groups. With no difference in surgical outcomes between pediatric and adult patients, including complication rate, we conclude that age is not a prognostic factor for Ex-DCR failure. We do not recommend adjuvant therapy for pediatric patients.

External factors affecting data acquisition during corneal topography examination.

PubMed

González-Méijome, José Manuel; Queirós, Antonio; Jorge, Jorge; Fernandes, Paulo; Cerviño, Alejandro; de Almeida, José Borges

2007-03-01

To analyze the factors affecting data acquisition during corneal topography examination with the Medmont E-300 videokeratoscope and to provide strategies to minimize their effects. Sixty eyes from thirty young adults were examined. A second observer registered incidences with the potential to affect data acquisition. Those factors were correlated with the difficulty of measurements as judged subjectively by the practitioner who performed the examination. Measurements of axial curvature were analyzed to evaluate the variability expressed as intrasession and intersession coefficient of variation and the standard error of the mean (SEM). The level of difficulty rated by the practitioner was in general low, with 70% of the eyes being easy or very easy to measure. For the remaining 30% of the eyes, corneal topography measurements were considered to be difficult (27%) or very difficult (3%). Of the external parameters investigated, only fixation instability (P<0.001, chi2) and the need for head repositioning (P=0.024, chi2) were associated significantly with a higher level of difficulty, as rated subjectively by the practitioner. Further analysis showed that some external factors, including those previously mentioned and others related to tear instability, affect the variability of measurements at certain corneal locations, particularly in the vertical meridian when related to tear instability and in the horizontal meridian when related to the need for head repositioning on the chin rest owing to physiognomy interferences with the keratoscope cone. Intersession SEM improved when three readings from each session were considered. The level of subjective difficulty found during videokeratoscopy examination is correlated strongly with fixation instability and the need for head reorientation in the chin rest, whereas tear-related events seem to be less relevant in the practitioner perception of test ease or difficulty. Those factors have relevance in measurement variability.

Understanding health constraints among rural-to-urban migrants in China.

PubMed

Li, Yan

2013-11-01

The main purpose of this article is to examine the understanding and experience of health and health care among rural-to-urban migrants in China, and to explain the impact of the internal factors of migrants themselves and the external factors of their social environment. Understanding the perceptions and consciousness of health issues among migrants is crucial to prevention, intervention, and other health-related measures for the migrant population in China, but this has rarely been explored in studies. On the basis of a case study of a migrant community in Beijing, I explore the migrants' understandings of health and health care and analyze factors in the social environment, including exclusion from the social system and the possibility of health participation, exclusion from social relation networks, obstructed channels of health maintenance, and exclusion of crowd psychology, which impact heavily on their health understanding and health behavior. I argue that the internal and the external factors are linked together closely and interact as reciprocal causation. However, the migrants should not be seen as primarily responsible, because their poor understanding of health mainly results from the socioeconomic environment in which they live and work.

Effects of environmental biomass-producing factors on Cd uptake in two Swedish ecotypes of Pinus sylvestris.

PubMed

Ekvall, Lars; Greger, Maria

2003-01-01

A factorial design was used to study direct effects of external biomass-producing factors such as light, temperature and photoperiod on cadmium (Cd) uptake and indirect effects, via change in biomass production in two ecotypes of Scots pine (Pinus silvestris). The aim was to find out if the external factors affect the Cd uptake directly or via change in biomass production, and if the effect differs between ecotypes. Seedlings were grown under 10 combinations of external factors, i.e. temperature (15 and 20 degrees C), light intensity (50 and 200 micromol photons m(-2) S(-1)), photoperiod (18 h light/8 h darkness and continuous light) and external Cd concentration (totally 1.88 and 7.50 micromol). The treatment lasted for 18 days and Cd concentrations in roots and shoots were determined by AAS. The results showed that an increased biomass production increased the total Cd uptake but had a dilution effect on the Cd concentration, especially in the root tissues. The external factors tested did not have any direct effects on the Cd untake, only in the case of Cd translocation to the shoot did the higher temperature show a direct increase, but only in the southern ecotype. The two ecotypes reacted differently in Cd uptake and translocation to the external factors studied. The relative Cd uptake creased with increasing photoperiod in the northern but not in the southern ecotype. The southern ecotype decreased the Cd concentration in the shoot with increased light intensity caused by a dilution effect due to extensive shoot growth of this ecotype. The conclusion is that the uptake in pine seedlings is mainly regulated via biomass production, and not directly by light and temperature and that resulting plant Cd contents to a certain extent depend on plant origin.

10 CFR 72.92 - Design basis external natural events.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Design basis external natural events. 72.92 Section 72.92... Evaluation Factors § 72.92 Design basis external natural events. (a) Natural phenomena that may exist or that... must be adopted for evaluating the design basis external natural events based on the characteristics of...

10 CFR 72.92 - Design basis external natural events.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Design basis external natural events. 72.92 Section 72.92... Evaluation Factors § 72.92 Design basis external natural events. (a) Natural phenomena that may exist or that... must be adopted for evaluating the design basis external natural events based on the characteristics of...

10 CFR 72.92 - Design basis external natural events.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Design basis external natural events. 72.92 Section 72.92... Evaluation Factors § 72.92 Design basis external natural events. (a) Natural phenomena that may exist or that... must be adopted for evaluating the design basis external natural events based on the characteristics of...

Explaining compound generalization in associative and causal learning through rational principles of dimensional generalization.

PubMed

Soto, Fabian A; Gershman, Samuel J; Niv, Yael

2014-07-01

How do we apply learning from one situation to a similar, but not identical, situation? The principles governing the extent to which animals and humans generalize what they have learned about certain stimuli to novel compounds containing those stimuli vary depending on a number of factors. Perhaps the best studied among these factors is the type of stimuli used to generate compounds. One prominent hypothesis is that different generalization principles apply depending on whether the stimuli in a compound are similar or dissimilar to each other. However, the results of many experiments cannot be explained by this hypothesis. Here, we propose a rational Bayesian theory of compound generalization that uses the notion of consequential regions, first developed in the context of rational theories of multidimensional generalization, to explain the effects of stimulus factors on compound generalization. The model explains a large number of results from the compound generalization literature, including the influence of stimulus modality and spatial contiguity on the summation effect, the lack of influence of stimulus factors on summation with a recovered inhibitor, the effect of spatial position of stimuli on the blocking effect, the asymmetrical generalization decrement in overshadowing and external inhibition, and the conditions leading to a reliable external inhibition effect. By integrating rational theories of compound and dimensional generalization, our model provides the first comprehensive computational account of the effects of stimulus factors on compound generalization, including spatial and temporal contiguity between components, which have posed long-standing problems for rational theories of associative and causal learning. (c) 2014 APA, all rights reserved.

Explaining Compound Generalization in Associative and Causal Learning Through Rational Principles of Dimensional Generalization

PubMed Central

Soto, Fabian A.; Gershman, Samuel J.; Niv, Yael

2014-01-01

How do we apply learning from one situation to a similar, but not identical, situation? The principles governing the extent to which animals and humans generalize what they have learned about certain stimuli to novel compounds containing those stimuli vary depending on a number of factors. Perhaps the best studied among these factors is the type of stimuli used to generate compounds. One prominent hypothesis is that different generalization principles apply depending on whether the stimuli in a compound are similar or dissimilar to each other. However, the results of many experiments cannot be explained by this hypothesis. Here we propose a rational Bayesian theory of compound generalization that uses the notion of consequential regions, first developed in the context of rational theories of multidimensional generalization, to explain the effects of stimulus factors on compound generalization. The model explains a large number of results from the compound generalization literature, including the influence of stimulus modality and spatial contiguity on the summation effect, the lack of influence of stimulus factors on summation with a recovered inhibitor, the effect of spatial position of stimuli on the blocking effect, the asymmetrical generalization decrement in overshadowing and external inhibition, and the conditions leading to a reliable external inhibition effect. By integrating rational theories of compound and dimensional generalization, our model provides the first comprehensive computational account of the effects of stimulus factors on compound generalization, including spatial and temporal contiguity between components, which have posed longstanding problems for rational theories of associative and causal learning. PMID:25090430

Identification of Giftedness in Preschoolers: Are Parents' Perceptions Related to Home Environment Factors and Cognitive Assessments?

ERIC Educational Resources Information Center

Williams, Nina; Gonzalez, Virginia

This paper discusses the results of a study that explored the influence of two major external factors on children's potential giftedness before the identification process is initiated. The study involved 13 children (ages 4-6) and investigated parental perceptions of the influence of internal and/or external factors on their child's cognitive…

Protective Factors Interrupting the Continuity from School Bullying to Later Internalizing and Externalizing Problems: A Systematic Review of Prospective Longitudinal Studies

ERIC Educational Resources Information Center

Ttofi, Maria M.; Bowes, Lucy; Farrington, David P.; Lösel, Friedrich

2014-01-01

A systematic review is presented, based on prospective longitudinal studies, on protective factors that interrupt the continuity from bullying perpetration at school to externalizing problem behaviors later in life; and from bullying victimization to later internalizing problems. Some common factors were established, which seem to interrupt the…

Inherited and Environmental Influences on a Childhood Co-Occurring Symptom Phenotype: Evidence From an Adoption Study

PubMed Central

Roos, Leslie E.; Fisher, Philip A.; Shaw, Daniel S.; Kim, Hyoun K.; Neiderhiser, Jenae M.; Reiss, David; Natsuaki, Misaki N.; Leve, Leslie D.

2015-01-01

Risk factors for the childhood development of co-occurring internalizing and externalizing symptoms are not well understood, despite a high prevalence and poor clinical outcomes associated with this co-occurring phenotype. We examined inherited and environmental risk factors for co-occurring symptoms in a sample of children adopted at birth and their birth mothers and adoptive mothers (N = 293). Inherited risk factors (i.e., birth mothers’ processing speed and internalizing symptoms) and environmental risk factors (i.e., adoptive mothers’ processing speed, internalizing symptoms, and uninvolved parenting) were examined as predictors for the development of internalizing-only, externalizing-only, or co-occurring symptoms using structural equation modeling. Results suggested a unique pattern of predictive factors for the co-occurring phenotype, with risk conferred by adoptive mothers’ uninvolved parenting, birth mothers’ slower processing speed, and the birth mothers’ slower processing speed in tandem with adoptive mothers’ higher internalizing symptoms. Additional analyses indicated that when co-occurring-symptom children were incorporated into internalizing and externalizing symptom groups, differential risk factors for externalizing and internalizing symptoms emerged. The findings suggest that spurious results may be found when children with co-occurring symptoms are not examined as a unique phenotypic group. PMID:25851306

Inherited and environmental influences on a childhood co-occurring symptom phenotype: Evidence from an adoption study.

PubMed

Roos, Leslie E; Fisher, Philip A; Shaw, Daniel S; Kim, Hyoun K; Neiderhiser, Jenae M; Reiss, David; Natsuaki, Misake N; Leve, Leslie D

2016-02-01

Risk factors for the childhood development of co-occurring internalizing and externalizing symptoms are not well understood, despite a high prevalence and poor clinical outcomes associated with this co-occurring phenotype. We examined inherited and environmental risk factors for co-occurring symptoms in a sample of children adopted at birth and their birth mothers and adoptive mothers (N = 293). Inherited risk factors (i.e., birth mothers' processing speed and internalizing symptoms) and environmental risk factors (i.e., adoptive mothers' processing speed, internalizing symptoms, and uninvolved parenting) were examined as predictors for the development of internalizing-only, externalizing-only, or co-occurring symptoms using structural equation modeling. Results suggested a unique pattern of predictive factors for the co-occurring phenotype, with risk conferred by adoptive mothers' uninvolved parenting, birth mothers' slower processing speed, and the birth mothers' slower processing speed in tandem with adoptive mothers' higher internalizing symptoms. Additional analyses indicated that when co-occurring-symptom children were incorporated into internalizing and externalizing symptom groups, differential risk factors for externalizing and internalizing symptoms emerged. The findings suggest that spurious results may be found when children with co-occurring symptoms are not examined as a unique phenotypic group.

Internal and external factors in professional burnout of substance abuse counsellors in Croatia.

PubMed

Tatalović Vorkapić, Sanja; Mustapić, Jelena

2012-01-01

In this study, burnout and its internal and external factors were investigated among substance abuse counsellors (no. = 68) who worked in Centres for Prevention and Substance Abuse Treatment (no. = 18) in Croatia. Maslach Burnout Inventory was used which measured three burnout dimensions: emotional exhaustion, depersonalization and personal accomplishment; and questionnaire of internal and external burnout factors. The higher levels of emotional exhaustion and depersonalization, and the higher level of personal accomplishment were determined. Factors such as work conditions, emotions about us and work, work organization and certain personality traits showed significant relationship with three burnout dimensions. Overall, findings implicated a certain specificity of professional burnout in substance abuse counsellors, and the need for specific design of mental health care for them.

Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study.

PubMed

Clarsen, Benjamin; Bahr, Roald; Andersson, Stig Haugsboe; Munk, Rikke; Myklebust, Grethe

2014-09-01

To determine whether rotator cuff strength, glenohumeral joint range of motion and scapular control are associated with shoulder injuries among elite male handball players. A total of 206 players in the Norwegian elite handball league for men were tested prior to the 2011-2012 season. Measures included: (1) glenohumeral internal and external rotation range of motion, (2) isometric internal rotation, external rotation and abduction strength and (3) assessment of scapular dyskinesis. Players were followed prospectively for the entire regular season (30 weeks), with shoulder problems registered bi-weekly using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. A cumulative severity score was calculated for each player based on their questionnaire responses. This was used as the outcome measure in risk factor analyses. The average prevalence of shoulder problems throughout the season was 28% (95% CI 25% to 31%). The prevalence of substantial shoulder problems, defined as those leading to moderate or severe reductions in handball participation or performance, or to time loss, was 12% (95% CI 11% to 13%). Significant associations were found between obvious scapular dyskinesis (OR 8.41, 95% CI 1.47 to 48.1, p<0.05), total rotational motion (OR 0.77 per 5° change, 95% CI 0.56 to 0.995, p<0.05) and external rotation strength (OR 0.71 per 10 Nm change, 95% CI 0.44 to 0.99, p<0.05) and shoulder injury. Injury prevention programmes should incorporate interventions aimed at improving glenohumeral rotational range of motion, external rotation strength and scapular control. 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.

High internal noise and poor external noise filtering characterize perception in autism spectrum disorder.

PubMed

Park, Woon Ju; Schauder, Kimberly B; Zhang, Ruyuan; Bennetto, Loisa; Tadin, Duje

2017-12-14

An emerging hypothesis postulates that internal noise is a key factor influencing perceptual abilities in autism spectrum disorder (ASD). Given fundamental and inescapable effects of noise on nearly all aspects of neural processing, this could be a critical abnormality with broad implications for perception, behavior, and cognition. However, this proposal has been challenged by both theoretical and empirical studies. A crucial question is whether and how internal noise limits perception in ASD, independently from other sources of perceptual inefficiency, such as the ability to filter out external noise. Here, we separately estimated internal noise and external noise filtering in ASD. In children and adolescents with and without ASD, we computationally modeled individuals' visual orientation discrimination in the presence of varying levels of external noise. The results revealed increased internal noise and worse external noise filtering in individuals with ASD. For both factors, we also observed high inter-individual variability in ASD, with only the internal noise estimates significantly correlating with severity of ASD symptoms. We provide evidence for reduced perceptual efficiency in ASD that is due to both increased internal noise and worse external noise filtering, while highlighting internal noise as a possible contributing factor to variability in ASD symptoms.

The future of transportation in society: Forces of change

NASA Technical Reports Server (NTRS)

Richardson, Barbara C.

1996-01-01

The transportation system is a critical element of the social / political / economic system of the United States. Factors influencing the use of transportation technology include technology push, market pull, and external factors. In order for new transportation technology to be successful, it must meet the needs of the market. These needs are diverse and vary almost by individual. Historical trends show great changes in transportation use by mode and origins and destinations of trips. Other important changes in society affecting transportation use include changes in the composition of society by gender, age, national origin, family composition, land use, income, and residential distribution. Changes of these factors in the future and how technology is deployed to meet the changing needs of society will affect the success of transportation technology implementation over the next twenty years.

Correction of complex equino cavo varus foot deformity in skeletally mature patients by Ilizarov external fixation versus staged external-internal fixation.

PubMed

Emara, Khaled; El Moatasem, El Hussein; El Shazly, Ossama

2011-12-01

Complex foot deformity is a multi-planar foot deformity with many etiologic factors. Different corrective procedures using Ilizarov external fixation have been described which include, soft tissue release, V-osteotomy, multiple osteotomies and triple fusion. In this study we compare the results of two groups of skeletally mature patients with complex foot deformity who were treated by two different protocols. The first group (27 patients, 29 feet) was treated by triple fusion fixed by Ilizarov external fixator until union. The second group (29 patients, 30 feet), was treated by triple fusion with initial fixation by Ilizarov external fixation until correction of the deformity was achieved clinically, and then the Ilizarov fixation was replaced by internal fixation using percutaneous screws. Both groups were compared as regard the surgical outcome and the incidence of complications. There was statistically significant difference between the two groups regarding duration of external fixation and duration of casting with shorter duration in the group 2. Also there was statistically significant difference between both groups regarding pin tract infection with less incidence in group 2. Early removal of Ilizarov external fixation after correction of the deformity and percutaneous internal fixation using 6.5 cannulated screws can shorten the duration of treatment and be more comfortable for the patient with a low risk of recurrence or infection. Copyright © 2010 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Physiological indices of seawater readiness in postspawning steelhead kelts

USGS Publications Warehouse

Buelow, Jessica; Moffitt, Christine M.

2015-01-01

Management goals to improve the recovery of steelhead (Oncorhynchus mykiss) stocks at risk of extinction include increasing the proportion of postspawning fish that survive and spawn again. To be successful, postspawning steelhead (kelts) migrating downstream to the ocean must prepare physiologically and physically for a seawater transition. We sampled blood, gill filaments, and evaluated the external condition of migrating kelts from an ESA-listed population in the Snake/Columbia River system over two consecutive years to evaluate their physiological readiness for transition to seawater. We chose attributes often considered as measures of preparation for seawater in juveniles, including gill Na+,K+ ATPase activity, plasma electrolytes and hormones to consider factors related to external condition, size and sex. We found kelts in good external condition had plasma profiles similar to downstream-migrating smolts. In addition, we found more than 80% of kelts ranked in good external condition had smolt-like body silvering. We compared measures from migrating kelts with samples obtained from hatchery fish at the time of spawning to confirm that Na+, K+ ATPase activity in kelts was significantly elevated over spawning fish. We found significant differences in gill Na+, K+ ATPase activity in migrating kelts between the years of sampling, but little indication of influence of fish condition. We conclude that the postspawning steelhead sampled exhibited a suite of behaviours, condition and physiology characteristic of fish prepared for successful transition to a seawater environment.

Impact of dentofacial deformity and motivation for treatment: a qualitative study.

PubMed

Ryan, Fiona S; Barnard, Matthew; Cunningham, Susan J

2012-06-01

Satisfaction with the outcome of orthognathic treatment is generally high; however, an important minority remains dissatisfied with the results. The reasons for this could be inadequate patient understanding and preparation, external motivation, and unrealistic expectations. In-depth appreciation of these issues can be obtained using qualitative research methods, but there is a paucity of qualitative research in this field. This was a cross-sectional qualitative study of orthognathic patients conducted at a teaching hospital. In-depth interviews were conducted with 18 prospective orthognathic patients. The data were managed by using the framework approach and analyzed by using the critical qualitative theory. Two main themes were explored in the interviews: the impact of the dentofacial deformity and the motivation for treatment. Both the everyday problems of living with a dentofacial deformity and the motivation for seeking treatment could be classified either as exclusively practical (including functional and structural), exclusively psychological (including psychosocial and esthetic), or a combination. Different coping strategies were also described. The sources of motivation ranged between purely external to purely internal, with most subjects between these 2 extremes. In this article, we present a classification of the impact of dentofacial deformity that is a refinement of the traditional one that includes esthetic, functional, and psychosocial factors. The motivating factors, together with the triggers for accessing treatment and the source of motivation, are generally linked directly or indirectly to the problem and the impact of the condition. However, in a few patients, the motivation might not relate to the impact of the problem but to a complex array of other factors such as personality, upbringing, and relationships. Therefore, clinicians should not make assumptions but explore these factors on an individual basis without preconceived ideas. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

A Population-Based Study of Gastroesophageal Reflux Disease and Sleep Problems in Elderly Twins

PubMed Central

Lindam, Anna; Jansson, Catarina; Nordenstedt, Helena; Pedersen, Nancy L.; Lagergren, Jesper

2012-01-01

Background & Aims Previous studies indicate an association between sleep problems and gastroesophageal reflux disease (GERD). Although both these conditions separately have moderate heritabilities, confounding by genetic factors has not previously been taken into account. This study aimed to reveal the association between sleep problems and GERD, while adjusting for heredity and other potential confounding factors. Methods This cross-sectional population-based study included all 8,014 same-sexed twins of at least 65 years of age and born in Sweden between 1886 and 1958, who participated in telephone interviews in 1998–2002. Three logistic regression models were used 1) external control analysis, 2) within-pair co-twin analysis with dizygotic (DZ) twin pairs discordant for GERD, and 3) within-pair co-twin analysis with monozygotic (MZ) twin pairs discordant for GERD. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated and adjusted for established risk factors for GERD, i.e. sex, age, body mass index (BMI), tobacco smoking, and educational level. Results A dose-response association was identified between increasing levels of sleep problems and GERD in the external control analysis. Individuals who often experienced sleep problems had a two-fold increased occurrence of GERD compared to those who seldom had sleep problems (OR 2.0, 95% CI 1.8–2.4). The corresponding association was of similar strength in the co-twin analysis including 356 DZ pairs (OR 2.2, 95% CI 1.6–3.4), and in the co-twin analysis including 210 MZ pairs (OR 1.5, 95% CI 0.9–2.7). Conclusion A dose-dependent association between sleep problems and GERD remains after taking heredity and other known risk factors for GERD into account. PMID:23119069

The Impact of Child Sexual Abuse on the Education of Boys in Residential Care between 1950 and 1975

ERIC Educational Resources Information Center

Bode, Andrew; Goldman, Juliette D. G.

2012-01-01

Children's education may be adversely impacted by external factors during their childhood. For example, learning to learn, critical reflection, experiential learning and self-direction may be permanently impaired. Many children in out-of-home residential care during the last century suffered ongoing child abuse and neglect, including sexual abuse,…

Correlations between tree crown condition and shade tolerance, crown form, and light availability

Treesearch

KaDonna C. Randolph

2007-01-01

Individual tree crown condition is the result of a combination of many factors including genetic traits, growing site characteristics, and past and present external stresses (e.g., drought, insect outbreaks, fire, etc.). Shade tolerance and the extent to which terminal buds control the length and orientation of lateral branches (epinastic control) are the two primary...

Benefits of a Good Neighborhood: Normal Cells Can Suppress Tumor Formation | Center for Cancer Research

Cancer.gov

For several years, researchers have been trying to unlock the mysteries of cancer by studying the genomic changes and signaling pathways within tumor cells. While these aberrations undeniably contribute to cancer development, it is becoming increasingly clear that factors external to the cell—including nearby cells, the immune system, blood vessels, and other factors—also play

"Good for You TV": Using Storyboarding for Health-Related Television Public Service Announcements to Analyze Messages and Influence Positive Health Choices

ERIC Educational Resources Information Center

Cox, Carol

2008-01-01

Many external and societal factors influence health choices and behaviors, including health-related media messages. What people, especially youth, see and hear in health-related media messages often influences their overall health. Students, highly vulnerable to such messages, need opportunities to become media literate to reduce the effects of…

Small-Scale Metal Tanks for High Pressure Storage of Fluids

NASA Technical Reports Server (NTRS)

London, Adam (Inventor)

2016-01-01

Small scale metal tanks for high-pressure storage of fluids having tank factors of more than 5000 meters and volumes of ten cubic inches or less featuring arrays of interconnected internal chambers having at least inner walls thinner than gage limitations allow. The chambers may be arranged as multiple internal independent vessels. Walls of chambers that are also portions of external tank walls may be arcuate on the internal and/or external surfaces, including domed. The tanks may be shaped adaptively and/or conformally to an application, including, for example, having one or more flat outer walls and/or having an annular shape. The tanks may have dual-purpose inlet/outlet conduits of may have separate inlet and outlet conduits. The tanks are made by fusion bonding etched metal foil layers patterned from slices of a CAD model of the tank. The fusion bonded foil stack may be further machined.

Spontaneous external biliary fistula uncomplicated by gallstones.

PubMed Central

Birch, B. R.; Cox, S. J.

1991-01-01

External biliary fistulae are rare. Only 65 cases have been reported in the literature and in each instance gallstones were a complicating factor. We report in this paper the first case of spontaneous external (cholecystocutaneous) biliary fistula uncomplicated by gallstones. PMID:2068038

Potential mechanisms of cerebellar hypoplasia in prematurity.

PubMed

Tam, Emily W Y

2013-09-01

The cerebellum undergoes dramatic growth and maturation over the neonatal period after preterm birth and is thus particularly sensitive to impaired development due to various clinical factors. Impairments in growth can occur independent of cerebellar parenchymal damage, such as from local hemorrhage, resulting from reduced expression of sonic hedgehog signaling to trigger the appropriate expansion of the granule precursor cells. The primary risk factors for impaired cerebellar development include postnatal glucocorticoid exposure, which has direct effects on the sonic hedgehog pathway, and supratentorial brain injury, including intraventricular hemorrhage and white matter injury, which may result in crossed cerebellar diaschisis and local toxic effects of blood products on the external granular layer. Other cardiorespiratory and nutritional factors may also exist. Impaired cerebellar development is associated with adverse outcomes in motor and cognitive development. New approaches to care to counteract these risk factors may help improve long-term outcome after preterm birth.

Neural network evaluation of tokamak current profiles for real time control

NASA Astrophysics Data System (ADS)

Wróblewski, Dariusz

1997-02-01

Active feedback control of the current profile, requiring real-time determination of the current profile parameters, is envisioned for tokamaks operating in enhanced confinement regimes. The distribution of toroidal current in a tokamak is now routinely evaluated based on external (magnetic probes, flux loops) and internal (motional Stark effect) measurements of the poloidal magnetic field. However, the analysis involves reconstruction of magnetohydrodynamic equilibrium and is too intensive computationally to be performed in real time. In the present study, a neural network is used to provide a mapping from the magnetic measurements (internal and external) to selected parameters of the safety factor profile. The single-pass, feedforward calculation of output of a trained neural network is very fast, making this approach particularly suitable for real-time applications. The network was trained on a large set of simulated equilibrium data for the DIII-D tokamak. The database encompasses a large variety of current profiles including the hollow current profiles important for reversed central shear operation. The parameters of safety factor profile (a quantity related to the current profile through the magnetic field tilt angle) estimated by the neural network include central safety factor, q0, minimum value of q, qmin, and the location of qmin. Very good performance of the trained neural network both for simulated test data and for experimental datais demonstrated.

Neural network evaluation of tokamak current profiles for real time control (abstract)

NASA Astrophysics Data System (ADS)

Wróblewski, Dariusz

1997-01-01

Active feedback control of the current profile, requiring real-time determination of the current profile parameters, is envisioned for tokamaks operating in enhanced confinement regimes. The distribution of toroidal current in a tokamak is now routinely evaluated based on external (magnetic probes, flux loops) and internal (motional Stark effect) measurements of the poloidal magnetic field. However, the analysis involves reconstruction of magnetohydrodynamic equilibrium and is too intensive computationally to be performed in real time. In the present study, a neural network is used to provide a mapping from the magnetic measurements (internal and external) to selected parameters of the safety factor profile. The single-pass, feedforward calculation of output of a trained neural network is very fast, making this approach particularly suitable for real-time applications. The network was trained on a large set of simulated equilibrium data for the DIII-D tokamak. The database encompasses a large variety of current profiles including the hollow current profiles important for reversed central shear operation. The parameters of safety factor profile (a quantity related to the current profile through the magnetic field tilt angle) estimated by the neural network include central safety factor, q0, minimum value of q, qmin, and the location of qmin. Very good performance of the trained neural network both for simulated test data and for experimental data is demonstrated.

The Preliminary Personnel Data Base Design for the Indonesian Navy.

DTIC Science & Technology

1982-06-01

external, which influence the * validity and success of this planning. Internal factors include all the problems which relate to the personnel sys - ton...the SIP-TNI-AL (Navy MIS) [Ref. 10], sys - *l tea’s users include the following: 1. Headquarters level: a) Manager level, b) Staff level, c) Central...Angeles: universTy -| ofcalizoara, April 1970. 10. Nabes TNI-AL ZiIT1a 11. Malone Joh S and Robert P. Thor of he Hhi!brator esearch Report SRR7

Personality Traits and Cognitive Styles as Risk Factors for Serious Suicide Attempts among Young People.

ERIC Educational Resources Information Center

Beautrais, Annette L.; Joyce, Peter R.; Mulder, Roger T.

1999-01-01

Study shows that individuals making suicide attempts have elevated odds of hopelessness, neuroticism, introversion, low self-esteem, impulsiveness, and external locus of control. When allowances were made for intercorrelations between these measures, hopelessness, neuroticism, and external locus of control remained significant risk factors for…

76 FR 33752 - Notice of Availability of the External Review Draft of the Guidance for Applying Quantitative...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... External Review Draft of the Guidance for Applying Quantitative Data To Develop Data-Derived Extrapolation... Applying Quantitative Data to Develop Data-Derived Extrapolation Factors for Interspecies and Intraspecies... Applying Quantitative Data to Develop Data-Derived Extrapolation Factors for Interspecies and Intraspecies...

External and Internal Factors Influencing Happiness in Elite Collegiate Athletes

ERIC Educational Resources Information Center

Denny, Katherine G.; Steiner, Hans

2009-01-01

When under conditions of high demand and allostatic load, are happiness and satisfaction in four domains (family, friends, academics, recreation) influenced more by external or internal factors? Do student-athletes who lead exceedingly complicated lives report happiness as a function of athletic achievement or internal disposition? Stanford…

Campus Life: The Impact of External Factors on Emotional Health of Students

ERIC Educational Resources Information Center

Vogel, Dalena

2012-01-01

This research explored the perceptions of students at a university campus in Gauteng South Africa on external factors that may contribute to their emotional (psychological) and academic functioning. During a preliminary investigation, three students at a residential university voluntary came for psychological counseling sessions because of stress…

Medial Tibial Stress Syndrome in Active Individuals: A Systematic Review and Meta-analysis of Risk Factors

PubMed Central

Reinking, Mark F.; Austin, Tricia M.; Richter, Randy R.; Krieger, Mary M.

2016-01-01

Context: Medial tibial stress syndrome (MTSS) is a common condition in active individuals and presents as diffuse pain along the posteromedial border of the tibia. Objective: To use cross-sectional, case-control, and cohort studies to identify significant MTSS risk factors. Data Sources: Bibliographic databases (PubMed, Scopus, CINAHL, SPORTDiscus, EMBASE, EBM Reviews, PEDRo), grey literature, electronic search of full text of journals, manual review of reference lists, and automatically executed PubMed MTSS searches were utilized. All searches were conducted between 2011 and 2015. Study Selection: Inclusion criteria were determined a priori and included original research with participants’ pain diffuse, located in the posterior medial tibial region, and activity related. Study Design: Systematic review with meta-analysis. Level of evidence: Level 4. Data Extraction: Titles and abstracts were reviewed to eliminate citations that did not meet the criteria for inclusion. Study characteristics identified a priori were extracted for data analysis. Statistical heterogeneity was examined using the I2 index and Cochran Q test, and a random-effects model was used to calculate the meta-analysis when 2 or more studies examined a risk factor. Two authors independently assessed study quality. Results: Eighty-three articles met the inclusion criteria, and 22 articles included risk factor data. Of the 27 risk factors that were in 2 or more studies, 5 risk factors showed a significant pooled effect and low statistical heterogeneity, including female sex (odds ratio [OR], 2.35; CI, 1.58-3.50), increased weight (standardized mean difference [SMD], 0.24; CI, 0.03-0.45), higher navicular drop (SMD, 0.44; CI, 0.21-0.67), previous running injury (OR, 2.18; CI, 1.00-4.72), and greater hip external rotation with the hip in flexion (SMD, 0.44; CI, 0.23-0.65). The remaining risk factors had a nonsignificant pooled effect or significant pooled effect with high statistical heterogeneity. Conclusion: Female sex, increased weight, higher navicular drop, previous running injury, and greater hip external rotation with the hip in flexion are risk factors for the development of MTSS. PMID:27729482

Optimization of perceptual learning: effects of task difficulty and external noise in older adults.

PubMed

DeLoss, Denton J; Watanabe, Takeo; Andersen, George J

2014-06-01

Previous research has shown a wide array of age-related declines in vision. The current study examined the effects of perceptual learning (PL), external noise, and task difficulty in fine orientation discrimination with older individuals (mean age 71.73, range 65-91). Thirty-two older subjects participated in seven 1.5-h sessions conducted on separate days over a three-week period. A two-alternative forced choice procedure was used in discriminating the orientation of Gabor patches. Four training groups were examined in which the standard orientations for training were either easy or difficult and included either external noise (additive Gaussian noise) or no external noise. In addition, the transfer to an untrained orientation and noise levels were examined. An analysis of the four groups prior to training indicated no significant differences between the groups. An analysis of the change in performance post-training indicated that the degree of learning was related to task difficulty and the presence of external noise during training. In addition, measurements of pupil diameter indicated that changes in orientation discrimination were not associated with changes in retinal illuminance. These results suggest that task difficulty and training in noise are factors important for optimizing the effects of training among older individuals. Copyright © 2013 Elsevier B.V. All rights reserved.

Using an Adoption–Biological Family Design to Examine Associations Between Maternal Trauma, Maternal Depressive Symptoms, and Child Internalizing and Externalizing Behaviors

PubMed Central

Grabow, Aleksandria Perez; Khurana, Atika; Natsuaki, Misaki N.; Neiderhiser, Jenae M.; Harold, Gordon T.; Shaw, Daniel S.; Ganiban, Jody M.; Reiss, David; Leve, Leslie D.

2017-01-01

Maternal trauma is a complex risk factor that has been linked to adverse child outcomes, yet the mechanisms underlying this association are not well understood. This study, which included adoptive and biological families, examined the heritable and environmental mechanisms by which maternal trauma and associated depressive symptoms are linked to child internalizing and externalizing behaviors. Path analyses were used to analyze data from 541 adoptive mother–adopted child (AM–AC) dyads and 126 biological mother–biological child (BM–BC) dyads; the two family types were linked through the same biological mother. Rearing mother’s trauma was associated with child internalizing and externalizing behaviors in AM–AC and BM–BC dyads, and this association was mediated by rearing mothers’ depressive symptoms, with the exception of biological child externalizing behavior, for which biological mother trauma had a direct influence only. Significant associations between maternal trauma and child behavior in dyads that share only environment (i.e., AM–AC dyads) suggest an environmental mechanism of influence for maternal trauma. Significant associations were also observed between maternal depressive symptoms and child internalizing and externalizing behavior in dyads that were only genetically related, with no shared environment (i.e., BM–AC dyads), suggesting a heritable pathway of influence via maternal depressive symptoms. PMID:29162177

Using an adoption-biological family design to examine associations between maternal trauma, maternal depressive symptoms, and child internalizing and externalizing behaviors.

PubMed

Grabow, Aleksandria Perez; Khurana, Atika; Natsuaki, Misaki N; Neiderhiser, Jenae M; Harold, Gordon T; Shaw, Daniel S; Ganiban, Jody M; Reiss, David; Leve, Leslie D

2017-12-01

Maternal trauma is a complex risk factor that has been linked to adverse child outcomes, yet the mechanisms underlying this association are not well understood. This study, which included adoptive and biological families, examined the heritable and environmental mechanisms by which maternal trauma and associated depressive symptoms are linked to child internalizing and externalizing behaviors. Path analyses were used to analyze data from 541 adoptive mother-adopted child (AM-AC) dyads and 126 biological mother-biological child (BM-BC) dyads; the two family types were linked through the same biological mother. Rearing mother's trauma was associated with child internalizing and externalizing behaviors in AM-AC and BM-BC dyads, and this association was mediated by rearing mothers' depressive symptoms, with the exception of biological child externalizing behavior, for which biological mother trauma had a direct influence only. Significant associations between maternal trauma and child behavior in dyads that share only environment (i.e., AM-AC dyads) suggest an environmental mechanism of influence for maternal trauma. Significant associations were also observed between maternal depressive symptoms and child internalizing and externalizing behavior in dyads that were only genetically related, with no shared environment (i.e., BM-AC dyads), suggesting a heritable pathway of influence via maternal depressive symptoms.

Divorce and Child Behavior Problems: Applying Latent Change Score Models to Life Event Data

PubMed Central

Malone, Patrick S.; Lansford, Jennifer E.; Castellino, Domini R.; Berlin, Lisa J.; Dodge, Kenneth A.; Bates, John E.; Pettit, Gregory S.

2009-01-01

Effects of parents' divorce on children's adjustment have been studied extensively. This article applies new advances in trajectory modeling to the problem of disentangling the effects of divorce on children's adjustment from related factors such as the child's age at the time of divorce and the child's gender. Latent change score models were used to examine trajectories of externalizing behavior problems in relation to children's experience of their parents' divorce. Participants included 356 boys and girls whose biological parents were married at kindergarten entry. The children were assessed annually through Grade 9. Mothers reported whether they had divorced or separated in each 12-month period, and teachers reported children's externalizing behavior problems each year. Girls' externalizing behavior problem trajectories were not affected by experiencing their parents' divorce, regardless of the timing of the divorce. In contrast, boys who were in elementary school when their parents divorced showed an increase in externalizing behavior problems in the year of the divorce. This increase persisted in the years following the divorce. Boys who were in middle school when their parents divorced showed an increase in externalizing behavior problems in the year of the divorce followed by a decrease to below baseline levels in the year after the divorce. This decrease persisted in the following years. PMID:20209039

Parent depressive symptomatology moderates the etiology of externalizing behavior in childhood: An examination of gene-environment interaction effects.

PubMed

Clark, D Angus; Klump, Kelly L; Burt, S Alexandra

2018-04-26

Parent depressive symptomatology is robust risk factor for externalizing behavior in childhood (Goodman et al., 2011). Although the precise mechanisms underlying this association have yet to be fully illuminated, there is some evidence that parent depression can impact externalizing behavior via both genetic and environmental pathways. In the current study, we investigated the extent to which genetic and environmental influences on externalizing behavior are moderated by parent depressive symptoms (i.e., genotype-environment interaction) in a sample of 2,060, 6- to 11-year-old twins. Results suggest that genetic influences explain more variance in externalizing behavior as maternal depressive symptoms increase, whereas shared environmental effects decrease. These findings were specific to maternal depressive symptoms, however, and did not extend to not paternal depressive symptoms. Findings are critical for understanding the role of parental depression as a risk factor for problematic child behavior, and informing programs that seek to minimize the impact of this risk factor. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Managing young people with self-harming or suicidal behaviour.

PubMed

Fisher, Gemma

2016-02-01

This literature review aimed to determine the risk factors being used to identify children and young people who are at increased risk of engaging in self-harm and suicidal behaviour, so that optimal care can be provided for this patient group in children's medical ward settings. The two main themes that emerged were mental and neurodevelopmental disorders, and external factors. Management strategies to aid healthcare professionals in caring for this patient group were also identified. The review concludes by highlighting the need to provide healthcare professionals with continuing education about the mental health problems of children and young people, including risk factors and management strategies.

Confirmatory Factor Analysis and Test-Retest Reliability of the Alcohol and Drug Confrontation Scale (ADCS)

PubMed Central

Polcin, Douglas L.; Galloway, Gantt P.; Bond, Jason; Korcha, Rachael; Greenfield, Thomas K.

2008-01-01

The addiction field lacks an accepted definition and reliable measure of confrontation. The Alcohol and Drug Confrontation Scale (ADCS) defines confrontation as warnings about the potential consequences of substance use. To assess psychometric properties, 323 individual entering recovery houses in U.S. urban and suburban areas were interviewed between 2003 and 2005 (20% women, 68% white). Analyses included test-retest reliability, confirmatory factor analysis, and measures of internal consistency. Findings support the ADCS as a reliable way of assessing two factors: Internal Support and External intensity. Confrontation was experienced as supportive, accurate and helpful. Additional studies should assess confrontation in different contexts. PMID:20686635

Upregulated Expression of Transient Receptor Potential Cation Channel Subfamily V Receptors in Mucosae of Patients with Oral Squamous Cell Carcinoma and Patients with a History of Alcohol Consumption or Smoking

PubMed Central

Sakakibara, Akiko; Sakakibara, Shunsuke; Kusumoto, Junya; Takeda, Daisuke; Hasegawa, Takumi; Akashi, Masaya; Minamikawa, Tsutomu; Hashikawa, Kazunobu; Terashi, Hiroto; Komori, Takahide

2017-01-01

Objectives Transient receptor potential cation channel (subfamily V, members 1–4) (TRPV1–4) are expressed in skin and neurons and activated by external stimuli in normal mucosae of all oral cavity sites. The oral cavity is exposed to various stimuli, including temperature, mechanical stimuli, chemical substances, and changes in pH, and, notably, the risk factors for oncogenic transformation in oral squamous epithelium are the same as the external stimuli received by TRPV1–4 receptors. Hence, we examined the relationship between oral squamous cell carcinoma (SCC) and TRPV1–4 expression. Materials and Methods Oral SCC patients (n = 37) who underwent surgical resection were included in this study. We investigated the expression of TRPV1–4 by immunohistochemical staining and quantification of TRPV1–4 mRNA in human oral mucosa. In addition, we compared the TRPV1–4 levels in mucosa from patients with SCC to those in normal oral mucosa. Results The receptors were expressed in oral mucosa at all sites (tongue, buccal mucosa, gingiva, and oral floor) and the expression was stronger in epithelia from patients with SCC than in normal epithelia. Furthermore, alcohol consumption and tobacco use were strongly associated with the occurrence of oral cancer and were found to have a remarkable influence on TRPV1–4 receptor expression in normal oral mucosa. In particular, patients with a history of alcohol consumption demonstrated significantly higher expression levels. Conclusion Various external stimuli may influence the behavior of cancer cells. Overexpression of TRPV1-4 is likely to be a factor in enhanced sensitivity to external stimuli. These findings could contribute to the establishment of novel strategies for cancer therapy or prevention. PMID:28081185

Determinants of Acute Kidney Injury Duration After Cardiac Surgery: An Externally Validated Tool

PubMed Central

Brown, Jeremiah R.; Kramer, Robert S.; MacKenzie, Todd A.; Coca, Steven G.; Sint, Kyaw; Parikh, Chirag R.

2013-01-01

Background Acute kidney injury (AKI) duration following cardiac surgery is associated with poor survival in a dose-dependent manner. However, it is not known what peri-operative risk factors contribute to prolonged AKI and delayed recovery. We sought to identify peri-operative risk factors that predict duration of AKI, a complication that effects short and long term survival. Methods We studied 4,987 consecutive cardiac surgery patients from 2002 through 2007. AKI was defined as a ≥0.3 (mg/dL) or ≥50% increase in SCr from baseline. Duration of AKI was defined by the number of days AKI was present. Step-wise multivariable negative binomial regression analysis was conducted using peri-operative risk factors for AKI duration. C-index was estimated by Kendall’s tau. Results AKI developed in 39% of patients with a median duration of AKI at 3 days and ranged from 1 to 108 days. Patients without AKI had duration of zero days. Independent predictors of AKI duration included baseline patient and disease characteristics, operative and post-operative factors. Prediction for mean duration of AKI was developed using coefficients from the regression model and externally validated the model on 1,219 cardiac surgery patients in a separate cardiac surgery cohort (TRIBE-AKI). The C-index was 0.65 (p<0.001) for the derivation cohort and 0.62 (p<0.001) for the validation cohort. Conclusion We identified and externally validated peri-operative predictors of AKI duration. These risk-factors will be useful to evaluate a patient’s risk for the tempo of recovery from AKI after cardiac surgery and subsequent short and long term survival. The level of awareness created by working with these risk factors have implications regarding positive changes in processes of care that have the potential to decrease the incidence and mitigate AKI. PMID:22206952

Membrane re-modelling by BAR domain superfamily proteins via molecular and non-molecular factors.

PubMed

Nishimura, Tamako; Morone, Nobuhiro; Suetsugu, Shiro

2018-04-17

Lipid membranes are structural components of cell surfaces and intracellular organelles. Alterations in lipid membrane shape are accompanied by numerous cellular functions, including endocytosis, intracellular transport, and cell migration. Proteins containing Bin-Amphiphysin-Rvs (BAR) domains (BAR proteins) are unique, because their structures correspond to the membrane curvature, that is, the shape of the lipid membrane. BAR proteins present at high concentration determine the shape of the membrane, because BAR domain oligomers function as scaffolds that mould the membrane. BAR proteins co-operate with various molecular and non-molecular factors. The molecular factors include cytoskeletal proteins such as the regulators of actin filaments and the membrane scission protein dynamin. Lipid composition, including saturated or unsaturated fatty acid tails of phospholipids, also affects the ability of BAR proteins to mould the membrane. Non-molecular factors include the external physical forces applied to the membrane, such as tension and friction. In this mini-review, we will discuss how the BAR proteins orchestrate membrane dynamics together with various molecular and non-molecular factors. © 2018 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

External factors affecting decision-making and use of evidence in an Australian public health policy environment.

PubMed

Zardo, Pauline; Collie, Alex; Livingstone, Charles

2014-05-01

This study examined external factors affecting policy and program decision-making in a specific public health policy context: injury prevention and rehabilitation compensation in the Australian state of Victoria. The aim was twofold: identify external factors that affect policy and program decision-making in this specific context; use this evidence to inform targeting of interventions aimed at increasing research use in this context. Qualitative interviews were undertaken from June 2011 to January 2012 with 33 employees from two state government agencies. Key factors identified were stakeholder feedback and action, government and ministerial input, legal feedback and action, injured persons and the media. The identified external factors were able to significantly influence policy and program decision-making processes: acting as both barriers and facilitators, depending on the particular issue at hand. The factors with the most influence were the Minister and government, lawyers, and agency stakeholders, particularly health providers, trade unions and employer groups. This research revealed that interventions aimed at increasing use of research in this context must target and harness the influence of these groups. This research provides critical insights for researchers seeking to design interventions to increase use of research in policy environments and influence decision-making in Victorian injury prevention and rehabilitation compensation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Role of NMDA Receptor-Mediated Glutamatergic Signaling in Chronic and Acute Neuropathologies

PubMed Central

2016-01-01

N-Methyl-D-aspartate receptors (NMDARs) have two opposing roles in the brain. On the one hand, NMDARs control critical events in the formation and development of synaptic organization and synaptic plasticity. On the other hand, the overactivation of NMDARs can promote neuronal death in neuropathological conditions. Ca2+ influx acts as a primary modulator after NMDAR channel activation. An imbalance in Ca2+ homeostasis is associated with several neurological diseases including schizophrenia, Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. These chronic conditions have a lengthy progression depending on internal and external factors. External factors such as acute episodes of brain damage are associated with an earlier onset of several of these chronic mental conditions. Here, we will review some of the current evidence of how traumatic brain injury can hasten the onset of several neurological conditions, focusing on the role of NMDAR distribution and the functional consequences in calcium homeostasis associated with synaptic dysfunction and neuronal death present in this group of chronic diseases. PMID:27630777

In Between or in the Middle of Everything — How to Find the Pathway for a Small Department Library During Multiple Internal and External Change Factors

NASA Astrophysics Data System (ADS)

Akerholt, L. N.; Christensen, A.

2010-10-01

The Astrophysics Library is one of the smallest libraries at the University of Oslo, serving 10 masters students and approximately 50 academic employees at the Department of Theoretical Astrophysics. But the small size does not reduce the pressure on the institution when it comes to internal and external change factors. Change factors are understood as circumstances which influence the department library, but are outside the control of normal library routines.In this paper we explore these change factors and try to establish a strategy to find our "path" for the future. We find that internal change factors are quite easily handled, given enough time and proper funding, while the nature of external change factors makes it harder to decide on a future course.To illustrate the pressure exerted on the department library we give a brief summation of the challenges we have met regarding internal and external change factors. Our experiences indicate that we should establish closer cooperation with the academic staff and students, and also call for an improved communication strategy towards other institutions such as the Museum of University History as well as the National Library of Norway. We explore new forms of communication and suggest developing these in collaboration with the academic staff.

The Effects of Demographic, Internal and External University Environment Factors on Faculty Job Satisfaction in Vietnam

ERIC Educational Resources Information Center

Duong, Minh-Quang

2016-01-01

University faculty members with higher job satisfaction are more productive, creative and positive attitude towards their job. Even less is known about university faculty job satisfaction in developing countries like Vietnam. This study examines the effects of demographic, internal and external university environment factors on faculty job…

Development of a Relative Potency Factor (RPF) Approach for Polycyclic Aromatic Hydrocarbon (PAH) Mixtures (Interagency Science Consultation Draft)

EPA Science Inventory

On February 26, 2010, the draft Development of a Relative Potency Factor (RPF) Approach for Polycyclic Aromatic Hydrocarbon (PAH) Mixtures document and the charge to external peer reviewers were released for external peer review and public comment. The draft document and t...

48 CFR 231.205-70 - External restructuring costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... sale/purchase of assets. (2) External restructuring activities means restructuring activities occurring... a factor of at least two to one; or (B) The costs allowed, and the business combination will result... will exceed the costs allowed by a factor of at least two to one on a present value basis. (ii) The...

School-External Factors in Finnish Content and Language Integrated Learning (CLIL) Programs

ERIC Educational Resources Information Center

Aro, Sophie; Mikkilä-Erdmann, Mirjamaija

2015-01-01

This study investigated the relationship between the English language competence of Finnish bilingual pupils and school-external factors such as parental expectations, home involvement, and exposure to English outside the classroom. Data on the pupils' language competence was collected from n?=?122 6th graders in bilingual education, and compared…

Factors influencing responsiveness to feedback: on the interplay between fear, confidence, and reasoning processes.

PubMed

Eva, Kevin W; Armson, Heather; Holmboe, Eric; Lockyer, Jocelyn; Loney, Elaine; Mann, Karen; Sargeant, Joan

2012-03-01

Self-appraisal has repeatedly been shown to be inadequate as a mechanism for performance improvement. This has placed greater emphasis on understanding the processes through which self-perception and external feedback interact to influence professional development. As feedback is inevitably interpreted through the lens of one's self-perceptions it is important to understand how learners interpret, accept, and use feedback (or not) and the factors that influence those interpretations. 134 participants from 8 health professional training/continuing competence programs were recruited to participate in focus groups. Analyses were designed to (a) elicit understandings of the processes used by learners and physicians to interpret, accept and use (or not) data to inform their perceptions of their clinical performance, and (b) further understand the factors (internal and external) believed to influence interpretation of feedback. Multiple influences appear to impact upon the interpretation and uptake of feedback. These include confidence, experience, and fear of not appearing knowledgeable. Importantly, however, each could have a paradoxical effect of both increasing and decreasing receptivity. Less prevalent but nonetheless important themes suggested mechanisms through which cognitive reasoning processes might impede growth from formative feedback. Many studies have examined the effectiveness of feedback through variable interventions focused on feedback delivery. This study suggests that it is equally important to consider feedback from the perspective of how it is received. The interplay observed between fear, confidence, and reasoning processes reinforces the notion that there is no simple recipe for the delivery of effective feedback. These factors should be taken into account when trying to understand (a) why self-appraisal can be flawed, (b) why appropriate external feedback is vital (yet can be ineffective), and (c) why we may need to disentangle the goals of performance improvement from the goals of improving self-assessment.

Factors and processes causing accelerated decomposition in human cadavers - An overview.

PubMed

Zhou, Chong; Byard, Roger W

2011-01-01

Artefactually enhanced putrefactive and autolytic changes may be misinterpreted as indicating a prolonged postmortem interval and throw doubt on the veracity of witness statements. Review of files from Forensic Science SA and the literature revealed a number of external and internal factors that may be responsible for accelerating these processes. Exogenous factors included exposure to elevated environmental temperatures, both outdoors and indoors, exacerbated by increased humidity or fires. Situations indoor involved exposure to central heating, hot water, saunas and electric blankets. Deaths within motor vehicles were also characterized by enhanced decomposition. Failure to quickly or adequately refrigerate bodies may also lead to early decomposition. Endogenous factors included fever, infections, illicit and prescription drugs, obesity and insulin-dependent diabetes mellitus. When these factors or conditions are identified at autopsy less significance should, therefore, be attached to changes of decomposition as markers of time since death. Copyright © 2010 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

A Description, Analysis, and Evaluation of the Financial Structure of Four Private Universities in the Consortium of Universities of the Washington Metropolitan Area between 1973-74 and 1982-83.

ERIC Educational Resources Information Center

Beaufond-Marcano, Rafael Emilio

Financial patterns at American University, Catholic University, George Washington University, and Georgetown University were investigated. Specific areas of concern include: revenue sources and expenditures, balance sheet formats, financial health, the effect of external factors such as enrollment and inflation, financial performance, ability to…

Benefits of a Good Neighborhood: Normal Cells Can Suppress Tumor Formation | Center for Cancer Research

Cancer.gov

For several years, researchers have been trying to unlock the mysteries of cancer by studying the genomic changes and signaling pathways within tumor cells. While these aberrations undeniably contribute to cancer development, it is becoming increasingly clear that factors external to the cell—including nearby cells, the immune system, blood vessels, and other factors—also play a role.

Peaceful Twilight: Grand Strategy for a Power in Relative Decline

DTIC Science & Technology

2015-06-01

virtually every issue. The Republican Party has become progressively more conservative favoring a strong military, smaller government, laissez - faire ...international order, still wields a significant amount of influence on the world stage. Yet as other powers rise, new challenges to US leadership and...corrupting effects of affluence. External factors include the rise of new rivals, the growing costs of protection, loss of economic leadership , and

Contextual Factors Related to Implementation and Reach of a Pragmatic Multisite Trial– The My Own Health Report (MOHR) Study

PubMed Central

Balasubramanian, Bijal A.; Heurtin-Roberts, Suzanne; Krasny, Sarah; Rohweder, Catherine; Fair, Kayla; Olmos, Tanya; Stange, Kurt C.; Gorin, Sherri Sheinfeld

2018-01-01

Background Contextual factors relevant to health care improvement studies are important for translating findings to other settings; however, these are rarely collected systematically and reported. This study articulates a prospective method for assessing contextual factors and describes factors related to implementation and patient reach of a pragmatic multisite trial conducted in nine primary care practices. Methods In a qualitative case-series, contextual factors were assessed from the My Own Health Report (MOHR) study, focused on systematically conducting health risk assessments and goal setting for unhealthy behaviors and behavioral health in primary care. Data were collected prospectively at baseline, mid-point, and end of intervention using a template that guided conduct of interviews and observations at practice sites. A multidisciplinary team used an iterative process to summarize themes describing contextual factors related to intervention implementation and patient reach, calculated by dividing the number of patients who completed the MOHR assessment by the number of patients offered MOHR. Results Contextual factors operational both within and external to the practice environment influenced implementation and patient reach over time. These included practice members’ motivations towards the MOHR intervention, practice staff capacity to take on additional responsibilities for implementation, practice information system capacity, external resources to support quality improvement, linkages with community resources, and fit of implementation strategy to patient populations. Conclusions Systematic assessment of contextual factors throughout implementation of quality improvement initiatives is needed to meaningfully interpret findings and translate lessons learned to other health care settings. Thus, knowledge of contextual factors is essential for scaling up of effective improvement strategies. PMID:28484066

Comparison of external and internal implant-abutment connections for implant supported prostheses. A systematic review and meta-analysis.

PubMed

Lemos, Cleidiel Aparecido Araujo; Verri, Fellippo Ramos; Bonfante, Estevam Augusto; Santiago Júnior, Joel Ferreira; Pellizzer, Eduardo Piza

2018-03-01

The systematic review and meta-analysis aimed to answer the PICO question: "Do patients that received external connection implants show similar marginal bone loss, implant survival and complication rates as internal connection implants?". Meta-analyses of marginal bone loss, survival rates of implants and complications rates were performed for the included studies. Study eligibility criteria included (1) randomized controlled trials (RCTs) and/or prospective, (2) studies with at least 10 patients, (3) direct comparison between connection types and (4) publications in English language. The Cochrane risk of bias tool was used to assess the quality and risk of bias in RCTs, while Newcastle-Ottawa scale was used for non-RCTs. A comprehensive search strategy was designed to identify published studies on PubMed/MEDLINE, Scopus, and The Cochrane Library databases up to October 2017. The search identified 661 references. Eleven studies (seven RCTs and four prospective studies) were included, with a total of 530 patients (mean age, 53.93 years), who had received a total of 1089 implants (461 external-connection and 628 internal-connection implants). The internal-connection implants exhibited lower marginal bone loss than external-connection implants (P<0.00001; Mean Difference (MD): 0.44mm; 95% Confidence interval (CI): 0.26-0.63mm). No significant difference was observed in implant survival (P=0.65; Risk Ratio (RR): 0.83; 95% CI: 0.38-1.84), and complication rates (P=0.43; RR: 1.15; 95% CI: 0.81-1.65). Internal connections had lower marginal bone loss when compared to external connections. However, the implant-abutment connection had no influence on the implant's survival and complication rates. Based on the GRADE approach the evidence was classified as very low to moderate due to the study design, inconsistency, and publication bias. Thus, future research is highly encouraged. Internal connection implants should be preferred over external connection implants, especially when different risk factors that may contribute to increased marginal bone loss are present. Copyright © 2017 Elsevier Ltd. All rights reserved.

When there Seem to be No Predetermining Factors: Early Child and Proximal Family Risk Predicting Externalizing Behavior in Young Children Incurring No Distal Family Risk

ERIC Educational Resources Information Center

Roskam, I.; Meunier, J.-C.; Stievenart, M.; Noel, M.-P.

2013-01-01

The main objective of the current study was to examine the impact of two child risk factors, i.e. personality and inhibition, and two proximal family risk factors, i.e. parenting and attachment, and the impact of their cumulative effect on later externalizing behavior among young children incurring no distal family risk. Data were collected in a…

Intracerebral hemorrhage after external ventricular drain placement: an evaluation of risk factors for post-procedural hemorrhagic complications.

PubMed

Rowe, A Shaun; Rinehart, Derrick R; Lezatte, Stephanie; Langdon, J Russell

2018-03-07

The objective of this study was to evaluate and identify the risk factors for developing a new or enlarged intracranial hemorrhage (ICH) after the placement of an external ventricular drain. A single center, nested case-control study of individuals who received an external ventricular drain from June 1, 2011 to June 30, 2014 was conducted at a large academic medical center. A bivariate analysis was conducted to compare those individuals who experienced a post-procedural intracranial hemorrhage to those who did not experience a new bleed. The variables identified as having a p-value less than 0.15 in the bivariate analysis were then evaluated using a multivariate logistic regression model. Twenty-seven of the eighty-one study participants experienced a new or enlarged intracranial hemorrhage after the placement of an external ventricular drain. Of these twenty-seven patients, 6 individuals received an antiplatelet within ninety-six hours of external ventricular drain placement (p = 0.024). The multivariate logistic regression model identified antiplatelet use within 96 h of external ventricular drain insertion as an independent risk factor for post-EVD ICH (OR 13.1; 95% CI 1.95-88.6; p = 0.008). Compared to those study participants who did not receive an antiplatelet within 96 h of external ventricular drain placement, those participants who did receive an antiplatelet were 13.1 times more likely to exhibit a new or enlarged intracranial hemorrhage.

A Self-Regulatory Model of Behavioral Disinhibition in Late Adolescence: Integrating Personality Traits, Externalizing Psychopathology, and Cognitive Capacity

PubMed Central

Bogg, Tim; Finn, Peter R.

2011-01-01

Two samples with heterogeneous prevalence of externalizing psychopathology were used to investigate the structure of self-regulatory models of behavioral disinhibition and cognitive capacity. Consistent with expectations, structural equation modeling in the first sample (N = 541) showed a hierarchical model with three lower-order factors of impulsive sensation-seeking, anti-sociality/unconventionality, and lifetime externalizing problem counts, with a behavioral disinhibition superfactor best accounted for the pattern of covariation among six disinhibited personality trait indicators and four externalizing problem indicators. The structure was replicated in a second sample (N = 463) and showed that the behavioral disinhibition superfactor, and not the lower-order impulsive sensation-seeking, anti-sociality/unconventionality, and externalizing problem factors, was associated with lower IQ, reduced short-term memory capacity, and reduced working memory capacity. The results provide a systemic and meaningful integration of major self-regulatory influences during a developmentally important stage of life. PMID:20433626

Promoting justice or perpetuating prejudice? Interrupting external motivation in multicultural training.

PubMed

Gushue, George V; Hinman, Kimberly A

2018-01-01

The effects of responding to social pressure (external motivation) are short-lived. Multicultural training, however, seeks to promote change in students and trainees that will be transformative and long-lasting. To this end, understanding the motivational factors that inform training is key. The present study was an investigation of the factors underlying external motivation to respond without prejudice for White individuals from the perspective of Higgins's regulatory focus (promotion and prevention) and regulatory mode (assessment and locomotion) theories. The results indicate that locomotion was negatively associated with external motivation to respond without prejudice, while assessment and prevention were positively associated with external motivation. Taken together, findings highlight the importance of cultivating locomotion (action oriented) motivation and inhibiting prevention (loss oriented) and assessment (preoccupation with finding the correct answer) motivations in multicultural training. Implications for training, effective action for justice, and future research are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers.

PubMed

Colón-Emeric, Cathleen; Toles, Mark; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Song, Yuting; Hall, Rasheeda; Anderson, Amber; Burd, Andrew; Anderson, Ruth A

2016-07-16

Little is known about the sustainability of behavioral change interventions in long-term care (LTC). Following a cluster randomized trial of an intervention to improve staff communication (CONNECT), we conducted focus groups of direct care staff and managers to elicit their perceptions of factors that enhance or reduce sustainability in the LTC setting. The overall aim was to generate hypotheses about how to sustain complex interventions in LTC. In eight facilities, we conducted 15 focus groups with 83 staff who had participated in at least one intervention session. Where possible, separate groups were conducted with direct care staff and managers. An interview guide probed for staff perceptions of intervention salience and sustainability. Framework analysis of coded transcripts was used to distill insights about sustainability related to intervention features, organizational context, and external supports. Staff described important factors for intervention sustainability that are particularly challenging in LTC. Because of the tremendous diversity in staff roles and education level, interventions should balance complexity and simplicity, use a variety of delivery methods and venues (e.g., group and individual sessions, role-play/storytelling), and be inclusive of many work positions. Intervention customizability and flexibility was particularly prized in this unpredictable and resource-strapped environment. Contextual features noted to be important include addressing the frequent lack of trust between direct care staff and managers and ensuring that direct care staff directly observe manager participation and support for the program. External supports suggested to be useful for sustainability include formalization of changes into facility routines, using "train the trainer" approaches and refresher sessions. High staff turnover is common in LTC, and providing materials for new staff orientation was reported to be important for sustainability. When designing or implementing complex behavior change interventions in LTC, consideration of these particularly salient intervention features, contextual factors, and external supports identified by staff may enhance sustainability. ClinicalTrial.gov, NCT00636675.

Childhood Externalizing Behavior: Theory and Implications

PubMed Central

Liu, Jianghong

2006-01-01

TOPIC Childhood externalizing behavior PURPOSE To analyze the construct of externalizing behavior (aggression, delinquency, and hyperactivity), illustrate the biosocial model of childhood externalizing, and draw clinical implications for nursing research and practice. SOURCES A review of the literature based on psychological, psychiatric, and nursing journals. CONCLUSIONS A better understanding of childhood externalizing behavior problems and the risk factors underlying them are essential to prevent them. The employment of an integrative biosocial perspective is argued to be important in understanding this behavior. PMID:15535385

STS-114: Discovery Tanking Operations for Launch

NASA Technical Reports Server (NTRS)

2005-01-01

Jessica Rye from NASA Public Affairs is the narrator for the tanking operations for the launch of the Space Shuttle Discovery. She presents a video of the arrival and processing of the new external tank at the Kennedy Space Center. The external tank is also shown entering the Vehicle Assembly Building (VAB). The external tank underwent new processing resulting from its redesign including inspection of the bipod heater and the external separation camera. The changes to the external tank include: 1) Electric heaters to protect from icing; and 2) Liquid Oxygen feed line bellows to carry fuel from the external tank to the Orbiter. Footage of the external tank processing facility at NASA's Michoud Assembly Facility in New Orleans, La. prior to its arrival at Kennedy Space Center is shown and a video of the three key modifications to the external tank including the bipod, flange and bellows are shown.

The outcomes and risk factors of fetal bradycardia associated with external cephalic version.

PubMed

Suyama, Fumio; Ogawa, Kohei; Tazaki, Yukiko; Miwa, Terumi; Taniguchi, Kosuke; Nakamura, Noriyuki; Tanaka, Satomi; Tanigaki, Shinji; Sago, Haruhiko

2017-11-02

The objective of this study is to assess the outcomes and risk factors of fetal bradycardia after external cephalic version (ECV). We performed a retrospective study of women who underwent ECV after 35 weeks of gestation in 2010-2016. We assessed the birth outcomes, including umbilical cord artery pH, according to the duration of fetal bradycardia and the risk factors for bradycardia. Among 390 cases, 189 (48.5%) cases showed fetal bradycardia during or immediately after ECV. The duration of fetal bradycardia was <1 min (n = 82, 43.4%), <5 min (n = 168, 88.9%); and <10 min (n = 186, 98.4%). All cases showed a good prognosis. Fetal bradycardia lasting >10 min occurred in three cases; emergency cesarean section was performed in each case, with delivery after 12-4 min of bradycardia. Two of three cases showed low Apgar scores at 5 min, with an umbilical cord arterial pH of <7.1. Lower maternal BMI and a prolonged ECV procedure were significantly associated with bradycardia (p for trend: .016 and .015, respectively). Fetal bradycardia lasting >10 min after ECV was a risk factor for asphyxia. Thus, delivery should be completed within 10 min after bradycardia. A low maternal BMI and a prolonged ECV procedure were risk factors for bradycardia after ECV.

An uncertainty analysis of air pollution externalities from road transport in Belgium in 2010.

PubMed

Int Panis, L; De Nocker, L; Cornelis, E; Torfs, R

2004-12-01

Although stricter standards for vehicles will reduce emissions to air significantly by 2010, a number of problems will remain, especially related to particulate concentrations in cities, ground-level ozone, and CO(2). To evaluate the impacts of new policy measures, tools need to be available that assess the potential benefits of these measures in terms of the vehicle fleet, fuel choice, modal choice, kilometers driven, emissions, and the impacts on public health and related external costs. The ExternE accounting framework offers the most up to date and comprehensive methodology to assess marginal external costs of energy-related pollutants. It combines emission models, air dispersion models at local and regional scales with dose-response functions and valuation rules. Vito has extended this accounting framework with data and models related to the future composition of the vehicle fleet and transportation demand to evaluate the impact of new policy proposals on air quality and aggregated (total) external costs by 2010. Special attention was given to uncertainty analysis. The uncertainty for more than 100 different parameters was combined in Monte Carlo simulations to assess the range of possible outcomes and the main drivers of these results. Although the impacts from emission standards and total fleet mileage look dominant at first, a number of other factors were found to be important as well. This includes the number of diesel vehicles, inspection and maintenance (high-emitter cars), use of air conditioning, and heavy duty transit traffic.

The relationship between primary healthcare providers and their external supervisors in Rwanda.

PubMed

Schriver, Michael; Cubaka, Vincent K; Nyirazinyoye, Laetitia; Itangishaka, Sylvere; Kallestrup, Per

2017-11-01

External supervision of Rwandan primary healthcare facilities unfolds as an interaction between supervisors and healthcare providers. Their relationship has not been thoroughly studied in Rwanda, and rarely in Africa. To explore perceived characteristics and effects of the relationship between providers in public primary healthcare facilities and their external supervisors in Rwanda. We conducted three focus group discussions with primary healthcare providers (n = 16), three with external supervisors (n = 15) and one mixed (n = 5). Focus groups were facilitated under low-moderator involvement. Findings were extracted thematically and discussed with participating and non-participating providers and supervisors. While external supervision is intended as a source of motivation and professional development in addition to its managerial purpose, it appeared linked to excessive evaluation anxiety among Rwandan primary healthcare providers. Supervisors related this mainly to inescapable evaluations within performance-based financing, whereas providers additionally related it to communication problems. External supervision appeared driven by systematic performance evaluations, which may prompt a strongly asymmetric supervisory power relation and challenge intentions to explore providers' experienced work problems. There is a risk that this may harm provider motivation, calling for careful attention to factors that influence the supervisory relationship. It is a dilemma that providers most in need of supervision to improve performance may be most unlikely to benefit from it. This study reveals a need for provider-oriented supportive supervision including constructive attention on providers who have performance difficulties, effective relationship building and communication, objective and diligent evaluation and two-way feedback channels.

Development and validity of a scale to measure workplace culture of health.

PubMed

Kwon, Youngbum; Marzec, Mary L; Edington, Dee W

2015-05-01

To describe the development of and test the validity and reliability of the Workplace Culture of Health (COH) scale. Exploratory factor analysis and confirmatory factor analysis were performed on data from a health care organization (N = 627). To verify the factor structure, confirmatory factor analysis was performed on a second data set from a medical equipment manufacturer (N = 226). The COH scale included a structure of five orthogonal factors: senior leadership and polices, programs and rewards, quality assurance, supervisor support, and coworker support. With regard to construct validity (convergent and discriminant) and reliability, two different US companies showed the same factorial structure, satisfactory fit statistics, and suitable internal and external consistency. The COH scale represents a reliable and valid scale to assess the workplace environment and culture for supporting health.

Leukemia risk associated with chronic external exposure to ionizing radiation in a French cohort of nuclear workers.

PubMed

Metz-Flamant, C; Samson, E; Caër-Lorho, S; Acker, A; Laurier, D

2012-11-01

Leukemia is one of the earliest cancer effects observed after acute exposure to relatively high doses of ionizing radiation. Leukemia mortality after external exposure at low doses and low-dose rates has been investigated at the French Atomic Energy Commission (CEA) and Nuclear Fuel Company (AREVA NC) after an additional follow-up of 10 years. The cohort included radiation-monitored workers employed for at least one year during 1950-1994 at CEA or AREVA NC and followed during 1968-2004. Association between external exposure and leukemia mortality was estimated with excess relative risk (ERR) models and time-dependent modifying factors were investigated with time windows. The cohort included 36,769 workers, followed for an average of 28 years, among whom 73 leukemia deaths occurred. Among the workers with a positive recorded dose, the mean cumulative external dose was 21.7 mSv. Results under a 2-year lag assumption suggested that the risk of leukemia (except chronic lymphatic leukemia) increased significantly by 8% per 10 mSv. The magnitude of the association for myeloid leukemia was larger. The higher ERR/Sv for doses received 2-14 years earlier suggest that time since exposure modifies the effect. The ERR/Sv also appeared higher for doses received at exposure rates ≥20 mSv per year. These results are consistent with those found in other studies of nuclear workers. However, confidence intervals are still wide. Further analyses should be conducted in pooled cohorts of nuclear workers.

Chitosan-based dressing for the treatment of external/accessible bleedings in children with bleeding tendency.

PubMed

Misgav, Mudi; Kenet, Gili; Martinowitz, Uriel

2014-03-01

Bleeding episodes in patients with congenital or acquired bleeding disorders are usually managed with factor concentrates or blood products. However, external and accessible bleeds may effectively be managed with topical hemostasis. After the application of the Hemcon, a Food and Drug Administration-approved chitosan-based hemostatic dressing was used as the "last resort" to successfully control external bleeds in 2 patients with severe bleeding disorders. We describe a single-center experience with this dressing, including its use in pediatric patients as the first mode of therapy. A total of 5 patients (median age 2 y) with severe bleeding disorders were treated with topical chitosan-based dressing for a total of 6 bleeding episodes. The dressing was used either after the failure of extensive systemic therapy or as the first choice of treatment. In 4 of the 6 episodes, bleeding ceased immediately alleviating the need for systemic therapy. There was no rebleeding after the removal of the dressing and no adverse events or local skin reactions were recorded. Hemostatic dressings, such as the chitosan, should be encouraged for the treatment of external/accessible bleeds, especially among the pediatric patients with bleeding tendency.

Strategy to increase Barangan Banana production in Kabupaten Deli Serdang

NASA Astrophysics Data System (ADS)

Adhany, I.; Chalil, D.; Ginting, R.

2018-02-01

This study was conducted to analyze internal and external factors in increasing Barangan Banana production in Kabupaten Deli Serdang. Samples were determined by snowball sampling technique and purposive sampling method. Using SWOT analysis method, this study found that there were 6 internal strategic factors and 9 external strategic factors. Among that strategic factors, support for production facilities appears as the most important internal strategic factor, while the demand for Barangan Banana. as the most important external strategic factor. Based on the importance and existing condition of these strategic factors, using support for production facilities and realization of supporting facilities with farming experience are the strategies covering strength-opportunity (SO), organizing mentoring to meet the demand for Barangan Banana are the strategies covering weakness-opportunity (WO), making use of funding support and subsidies to widen the land, using tissue culture seeds and facilities and infrastructures are the strategies covering strength-threat (ST), increas the funding support to widen the land, the use of tissue culture seeds and facilities and infrastructures are the strategies covering weakness-threat (WT) are discussed and proposed to increase Barangan Banana productivity in Kabupaten Deli Serdang.

A Model of Factors Determining Students' Ability to Interpret External Representations in Biochemistry

ERIC Educational Resources Information Center

Schonborn, Konrad J.; Anderson, Trevor R.

2009-01-01

The aim of this research was to develop a model of factors affecting students' ability to interpret external representations (ERs) in biochemistry. The study was qualitative in design and was guided by the modelling framework of Justi and Gilbert. Application of the process outlined by the framework, and consultation with relevant literature, led…

Determining External and Internal Demotivating Factors among Young Learners at Pozanti Regional Primary Boarding School

ERIC Educational Resources Information Center

Erdogan, Esra; Tunaz, Mehmet

2012-01-01

This paper takes a brief look at external and internal demotivating factors among EFL young learners at Pozanti Regional Primary Boarding School (YIBO). In the search of the reasons of demotivation, a questionnaire consisting of 5-point Likert Scale, open-ended questions, observations and interviews were administered. Following the evaluation of…

Do Contextual Effects Bias Kentucky School District Accountability Index Scores? Occasional Research Paper No. 1.

ERIC Educational Resources Information Center

Reeves, Edward B.

The system of high-stakes accountability in the Kentucky public schools raises the question of whether teachers and administrators should be held accountable if test scores are influenced by external factors over which educators have no control. This study investigates whether such external factors , or "contextual effects," bias the…

International certification in developing countries: the role of internal and external institutional pressure.

PubMed

Fikru, Mahelet G

2014-11-01

This paper examines the different internal and external institutional factors that affect the decision of businesses in developing countries to adopt international certification (IC). Past studies focus on pressure from international laws, the role of multinationals, and businesses mimicking practices of their counterparts in developed countries. This paper finds that, in addition to these external factors, internal factors may have a significant role. Even though environmental regulation is weak in developing countries, governments do not ignore industrial pollution and casualties. They respond by increasing bureaucratic regulations for businesses and this can affect the decision to adopt IC. Furthermore, internal pressure may come from workers' unions that push for a safe and healthy working environment. Published by Elsevier Ltd.

Analysis of effect of internal and operating variables on performance of SVDS constraint model (ABIND)

NASA Technical Reports Server (NTRS)

Pendergrass, J. R.; Walsh, R. L.

1975-01-01

An examination of the factors which modify the simulation of a constraint in the motion of the aft attach points of the orbiter and external tank during separation has been made. The factors considered were both internal (spring and damper constants) and external (friction coefficient and dynamic pressure). The results show that an acceptable choice of spring/damper constant combinations exist over the expected range of the external factors and that the choice is consistent with a practical integration interval. The constraint model is shown to produce about a 10 percent increase in the relative body pitch angles over the unconstrained case whereas the MDC-STL constraint model is shown to produce about a 38 percent increase.

Refining and validating a two-stage and web-based cancer risk assessment tool for village doctors in China.

PubMed

Shen, Xing-Rong; Chai, Jing; Feng, Rui; Liu, Tong-Zhu; Tong, Gui-Xian; Cheng, Jing; Li, Kai-Chun; Xie, Shao-Yu; Shi, Yong; Wang, De-Bin

2014-01-01

The big gap between efficacy of population level prevention and expectations due to heterogeneity and complexity of cancer etiologic factors calls for selective yet personalized interventions based on effective risk assessment. This paper documents our research protocol aimed at refining and validating a two-stage and web- based cancer risk assessment tool, from a tentative one in use by an ongoing project, capable of identifying individuals at elevated risk for one or more types of the 80% leading cancers in rural China with adequate sensitivity and specificity and featuring low cost, easy application and cultural and technical sensitivity for farmers and village doctors. The protocol adopted a modified population-based case control design using 72, 000 non-patients as controls, 2, 200 cancer patients as cases, and another 600 patients as cases for external validation. Factors taken into account comprised 8 domains including diet and nutrition, risk behaviors, family history, precancerous diseases, related medical procedures, exposure to environment hazards, mood and feelings, physical activities and anthropologic and biologic factors. Modeling stresses explored various methodologies like empirical analysis, logistic regression, neuro-network analysis, decision theory and both internal and external validation using concordance statistics, predictive values, etc..

Resistance to temptation: the interaction of external and internal control on alcohol use during residential treatment for alcohol use disorder.

PubMed

Soravia, Leila M; Schläfli, Katrin; Stutz, Sonja; Rösner, Susanne; Moggi, Franz

2015-11-01

There is evidence that drinking during residential treatment is related to various factors, such as patients' general control beliefs and self-efficacy, as well as to external control of alcohol use by program's staff and situations where there is temptation to drink. As alcohol use during treatment has been shown to be associated with the resumption of alcohol use after discharge from residential treatment, we aimed to investigate how these variables are related to alcohol use during abstinence-oriented residential treatment programs for alcohol use disorders (AUD). In total, 509 patients who entered 1 of 2 residential abstinence-oriented treatment programs for AUD were included in the study. After detoxification, patients completed a standardized diagnostic procedure including interviews and questionnaires. Drinking was assessed by patients' self-report of at least 1 standard drink or by positive breathalyzer testing. The 2 residential programs were categorized as high or low control according to the average number of tests per patient. Regression analysis revealed a significant interaction effect between internal and external control suggesting that patients with high internal locus of control and high frequency of control by staff demonstrated the least alcohol use during treatment (16.7%) while patients with low internal locus of control in programs with low external control were more likely to use alcohol during treatment (45.9%). No effects were found for self-efficacy and temptation. As alcohol use during treatment is most likely associated with poor treatment outcomes, external control may improve treatment outcomes and particularly support patients with low internal locus of control, who show the highest risk for alcohol use during treatment. High external control may complement high internal control to improve alcohol use prevention while in treatment. Copyright © 2015 The Authors. Alcoholism: Clinical and Experimental Research published by Wiley Periodicals, Inc. on behalf of Research Society on Alcoholism.

Higher incidence of nasopharyngeal carcinoma in some regions in the world confers for interplay between genetic factors and external stimuli.

PubMed

Roy Chattopadhyay, Nabanita; Das, Piyanki; Chatterjee, Koustav; Choudhuri, Tathagata

2017-01-01

Nasopharyngeal carcinoma (NPC) is a rare variety of head and neck cancers. The risk factors include three major causes: genetic factors, viral infection, and environmental and dietary factors. The types of NPC show strong ethnic and geographic variations. The keratinizing and non-keratinizing types are prevalent in the lower incidence regions like North America and Europe; whereas the undifferentiated type is mostly found in the regions with higher incidences like China, North Africa, Arctic, and Nagaland of North-East India. These suggest a possible major role of the internal genetic factors for generation and promotion of this disease. Viral infections might accelerate the process of carcinogenesis by helping in cellular proliferation and loss of apoptosis. Diet and other environmental factors promote these neoplastic processes and further progression of the disease occurs.

Internalizing and externalizing psychopathology as predictors of cannabis use disorder onset during adolescence and early adulthood.

PubMed

Farmer, Richard F; Seeley, John R; Kosty, Derek B; Gau, Jeff M; Duncan, Susan C; Lynskey, Michael T; Lewinsohn, Peter M

2015-09-01

Risk-related liabilities associated with the development of cannabis use disorders (CUDs) during adolescence and early adulthood are thought to be established well before the emergence of the index episode. In this study, internalizing and externalizing psychopathology from earlier developmental periods were evaluated as risk factors for CUDs during adolescence and early adulthood. Participants (N = 816) completed 4 diagnostic assessments between the ages 16 and 30, during which current and past CUDs were assessed as well as a full range of psychiatric disorders associated with internalizing and externalizing psychopathology domains. In unadjusted and adjusted time-to-event analyses, externalizing but not internalizing psychopathology from proximal developmental periods predicted subsequent CUD onset. A large proportion of adolescent and early adult cases, however, did not manifest any externalizing or internalizing psychopathology during developmental periods before CUD onset. Findings are consistent with the emerging view that externalizing disorders from proximal developmental periods are robust risk factors for CUDs. Although the identification of externalizing liabilities may aid in the identification of individuals at risk for embarking on developmental pathways that culminate in CUDs, such liabilities are an incomplete indication of overall risk. (c) 2015 APA, all rights reserved).

Meat shelf-life and extension using collagen/gelatin coatings: a review.

PubMed

Antoniewski, M N; Barringer, S A

2010-08-01

Different factors lead to the end of shelf-life for fresh meat products. The factors depend upon the animal including breed difference and muscle fiber type, external influences such as diet and stress, and post-harvest storage conditions including time, temperature, and packaging atmosphere. The characteristics that indicate the end of shelf-life for fresh meat products include water loss/purge accumulation, color deterioration due to myoglobin oxidation, rancidity due to lipid oxidation, and microbial spoilage. The characteristics can be measured and studied in the laboratory. Meat shelf-life is extended with the application of a surface coating because it provides a water and oxygen barrier. Collagen and gelatin coatings are used as a barrier on meat products to reduce purge, color deterioration, aroma deterioration, and spoilage, improve sensory scores, and act as an antioxidant.

Cerebrospinal Fluid Leak at Percutaneous Exit of Ventricular Catheter as a Crucial Risk Factor for External Ventricular Drainage-Related Infection in Adult Neurosurgical Patients.

PubMed

Park, Jaechan; Choi, Yeon-Ju; Ohk, Boram; Chang, Hyun-Ha

2018-01-01

The placement of a ventricular catheter for temporary cerebrospinal fluid (CSF) diversion is associated with a considerable risk of CSF infection. The authors investigated the effect of a CSF leak on CSF-related infection and the predisposing factors for a CSF leak. Fifty-two patients who underwent external ventricular drainage (EVD) for acute hydrocephalus associated with a subarachnoid hemorrhage or intraventricular hemorrhage (IVH) were enrolled in this prospective study. A CSF leak-detection paper (small sterilized filter paper) was applied at the percutaneous catheter exit site to check for any bloody CSF leak. In addition, radiologic and clinical data were collected. Four of the 52 patients (7.7%) developed an EVD-related CSF infection from organisms including Staphylococcus epidermidis (n = 3) and Staphylococcus hominis (n = 1). A prolonged CSF leak >1 day was detected in 9 patients (17.3%) and revealed as a significant risk factor for CSF infection with a 44.4% positive predictive value. Moreover, an IVH >10 mL was found in 11 patients (21.2%) and revealed as a significant predisposing factor for a CSF leak at the percutaneous catheter exit. A prolonged CSF leak for >1 day at the percutaneous catheter exit site is a crucial risk factor for EVD-related CSF infection and an IVH >10 mL is a predisposing factor for a CSF leak. Copyright © 2017 Elsevier Inc. All rights reserved.

Contribution of changing risk factors to the trend in breech presentation at term.

PubMed

Bin, Yu Sun; Roberts, Christine L; Nicholl, Michael C; Nassar, Natasha; Ford, Jane B

2016-12-01

Recent population-wide changes in perinatal risk factors may affect rates of breech presentation at birth, and have implications for the provision of breech services and training in breech management. To investigate whether changes in maternal and pregnancy characteristics explain the observed trend in breech presentation at term. All singleton term (≥37 week) births in New South Wales during 2002-2012 were identified through birth and associated hospital records. Annual rates of breech presentation were determined. Logistic regression modelling was used to predict expected rates of breech presentation and these were compared with observed rates over time. A priori predictors included maternal age, country of birth, parity, smoking during pregnancy, diabetes, pregnancy hypertension, placenta praevia, previous singleton term breech, previous caesarean section, infant sex, gestational age, birthweight and congenital anomalies. Hospital and Medicare data were used to assess concomitant trends in external cephalic version. Among 914 147 singleton term births, 3.1% were breech at delivery. Rates of breech presentation declined from 3.6% in 2002 to 2.7% in 2012 (test for trend P < 0.001), but was predicted to increase from 3.6% in 2002 to 4.3% in 2012 because of increased maternal age, nulliparity, maternal diabetes, history of breech presentation and previous caesarean section. However, use of external cephalic version appears to have increased over time. Breech presentation at delivery has decreased in New South Wales. Increased use of external cephalic version likely accounts for this decline, as changes in risk factors do not. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

External validation of a published nomogram for prediction of brain metastasis in patients with extra-cerebral metastatic breast cancer and risk regression analysis.

PubMed

Genre, Ludivine; Roché, Henri; Varela, Léonel; Kanoun, Dorra; Ouali, Monia; Filleron, Thomas; Dalenc, Florence

2017-02-01

Survival of patients with metastatic breast cancer (MBC) suffering from brain metastasis (BM) is limited and this event is usually fatal. In 2010, the Graesslin's nomogram was published in order to predict subsequent BM in patients with breast cancer (BC) with extra-cerebral metastatic disease. This model aims to select a patient population at high risk for BM and thus will facilitate the design of prevention strategies and/or the impact of early treatment of BM in prospective clinical studies. Nomogram external validation was retrospectively applied to patients with BC and later BM between January 2005 and December 2012, treated in our institution. Moreover, risk factors of BM appearance were studied by Fine and Gray's competing risk analysis. Among 492 patients with MBC, 116 developed subsequent BM. Seventy of them were included for the nomogram validation. The discrimination is good (area under curve = 0.695 [95% confidence interval, 0.61-0.77]). Risk factors of BM appearance are: human epidermal growth factor receptor 2 (HER2) overexpression/amplification, triple-negative BC and number of extra-cerebral metastatic sites (>1). With a competing risk model, we highlight the nomogram interest for HER2+ tumour subgroup exclusively. Graesslin's nomogram external validation demonstrates exportability and reproducibility. Importantly, the competing risk model analysis provides additional information for the design of prospective trials concerning the early diagnosis of BM and/or preventive treatment on high risk patients with extra-cerebral metastatic BC. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Association between Parent Early Adult Drug Use Disorder and Later Observed Parenting Practices and Child Behavior Problems: Testing Alternate Models

PubMed Central

Bailey, Jennifer A.; Hill, Karl G.; Guttmannova, Katarina; Oesterle, Sabrina; Hawkins, J. David; Catalano, Richard F.; McMahon, Robert J.

2012-01-01

This study tested the association between parent illicit drug use disorder (DUD) in early adulthood and observed parenting practices at ages 27 – 28 and examined the following three, theoretically-derived models explaining this link: a) a disrupted parent adult functioning model, b) a pre-existing parent personality factor model, c) a disrupted adolescent family process model. Associations between study variables and child externalizing problems also were examined. Longitudinal data linking two generations were drawn from the Seattle Social Development Project (SSDP) and The SSDP Intergenerational Project (TIP), and included 167 parents and their 2- to 8-year-old child. Path modeling revealed that parent DUD in early adulthood predicted later observed low-skilled parenting, which was related to child externalizing problems. The pre-existing parent personality factor model was supported. Parent negative emotionality accounted for the association between parent early adult DUD and later parenting practices. Parent negative emotionality also was related directly to child externalizing behavior. Limited support for the disrupted transition to adulthood model was found. The disrupted adolescent family process model was not supported. Results suggest that problem drug use that occurs early in adulthood may affect later parenting skills, independent of subsequent parent drug use. Findings highlight the importance of parent negative emotionality in influencing their own problem behavior, their interactions with their child, and their child’s problem behavior. Prevention and treatment programs targeting young adult substance use, poor parenting practices, and child behavior problems should address parent personality factors that may contribute to these behaviors. PMID:22799581

The association between parent early adult drug use disorder and later observed parenting practices and child behavior problems: testing alternate models.

PubMed

Bailey, Jennifer A; Hill, Karl G; Guttmannova, Katarina; Oesterle, Sabrina; Hawkins, J David; Catalano, Richard F; McMahon, Robert J

2013-05-01

This study tested the association between parent illicit drug use disorder (DUD) in early adulthood and observed parenting practices at ages 27-28 and examined the following 3 theoretically derived models explaining this link: (a) a disrupted parent adult functioning model,(b) a preexisting parent personality factor model, and (c) a disrupted adolescent family process model. Associations between study variables and child externalizing problems also were examined. Longitudinal data linking 2 generations were drawn from the Seattle Social Development Project (SSDP) and The SSDP Intergenerational Project (TIP), and included 167 parents and their 2- to 8-year-old child. Path modeling revealed that parent DUD in early adulthood predicted later observed low-skilled parenting, which was related to child externalizing problems. The preexisting parent personality factor model was supported. Parent negative emotionality accounted for the association between parent early adult DUD and later parenting practices. Parent negative emotionality also was related directly to child externalizing behavior. Limited support for the disrupted transition to adulthood model was found. The disrupted adolescent family process model was not supported. Results suggest that problem drug use that occurs early in adulthood may affect later parenting skills, independent of subsequent parent drug use. Findings highlight the importance of parent negative emotionality in influencing his or her own problem behavior, interactions with his or her child, and his or her child's problem behavior. Prevention and treatment programs targeting young adult substance use, poor parenting practices, and child behavior problems should address parent personality factors that may contribute to these behaviors.

Psychopathy in Bulgaria: The cross-cultural generalizability of the Hare Psychopathy Checklist

PubMed Central

Wilson, Michael J.; Abramowitz, Carolyn; Vasilev, Georgi; Bozgunov, Kiril; Vassileva, Jasmin

2014-01-01

The generalizability of the psychopathy construct to Eastern European cultures has not been well-studied, and no prior studies have evaluated psychopathy in non-offender samples from this population. The current validation study examines the factor structure, internal consistency, and external validity of the Bulgarian translation of the Hare Psychopathy Checklist: Screening Version. Two hundred sixty-two Bulgarian adults from the general community were assessed, of which 185 had a history of substance dependence. Confirmatory factor analysis indicated good fit for the two-, three-, and four-factor models of psychopathy. Zero-order and partial correlation analyses were conducted between the two factors of psychopathy and criterion measures of antisocial behavior, internalizing and externalizing psychopathology, personality traits, addictive disorders and demographic characteristics. Relationships to external variables provided evidence for the convergent and discriminant validity of the psychopathy construct in a Bulgarian community sample. PMID:25313268

The bleaching of teeth: a review of the literature.

PubMed

Joiner, Andrew

2006-08-01

To review current knowledge of tooth whitening with respect to external bleaching methods. The scope is the external bleaching of vital teeth and focuses on mechanisms; in vivo and in vitro measurement methods, and factors influencing the efficacy of the whitening process. "Medline" and "ISI Web of Science" databases from 1966 and 1974, respectively were searched electronically with key words tooth, teeth, colo*r, white*, bleach* and peroxide. The importance of tooth whitening for patients and consumers has seen a dramatic increase in the number of products and procedures over recent years, with a concomitant rise in publications on this topic. Literature suggests that the mechanisms of tooth whitening by peroxide occur by the diffusion of peroxide through enamel to cause oxidation and hence lightening of coloured species, particularly within the dentinal regions. A number of approaches are available for measuring changes in tooth colour. These include visual measurements by trained clinicians and instrumental measurements using spectrophotometry, chromameters and digital image analysis. The key factors that affect tooth whitening efficacy by peroxide containing products are concentration and time. In general, higher concentrations are faster than lower concentrations. However, lower concentrations can approach the efficacy of higher concentrations with extended treatment times. Alternative bleach systems to peroxide have received only minor attention. The efficacy of light activated systems versus non-light activated controls in clinical studies is limited and conflicting. Other factors which can influence tooth bleaching outcome include type of stain, initial tooth colour and subject age.

Effect of day-night cycle on distribution of food intake and economic choice among imposed food opportunities in mice.

PubMed

Minaya, Dulce M; Rowland, Neil E; Robertson, Kimberly L

2016-10-01

We have shown previously that mice given access to four discrete feeding opportunities (FOs) per day show a characteristic sequence of sizes across ordinal FOs. The purpose of the present experiments was to determine the relative contributions of external and internal factors on the sequencing of FO size. The external factors were the light:dark Zeitgeber and the cost of food, imposed via different fixed unit prices (FUP) in a closed operant economy, and the internal factors were signals relating to energy status including time since last food and weight loss. In the first experiment, mice were given 4 FOs spaced 4-h apart, but with the timing of the FOs relative to the Zeitgeber altered by a 4-h Zeitgeber advance or delay of the cycle. Food intake, and associated body weight, declined as price increased, but the temporal order of FO size was invariant within a Zeitgeber condition. The Zeitgeber advanced group showed clear evidence of a shift in meal sequence relating to the light:dark cycle. Thus, external factors seem to be a more important determinant of total intake and sequencing than internal factors. In the second experiment, mice were given the choice between continuous costly (CC) and intermittent inexpensive (II) food. II food was available for four-15min intervals every 4-h, and the timing of the 15min intervals was varied relative to the Zeitgeber cycle. In spite of a 20-fold difference in price between CC and II food, mice took approximately equal amounts from each, and all food intake took place during the dark phase. Mice consumed II food only if it was available during the dark phase. Food intake was strongly linked to the light:dark cycle, largely independent of food cost. Copyright © 2016 Elsevier Inc. All rights reserved.

Environmental and lifestyle influences on disorders of the large and small intestine: implications for treatment.

PubMed

Hall, Emily H; Crowe, Sheila E

2011-01-01

There is growing evidence that many aspects of our lifestyle and the environment we now live in contribute to the development of disease. The luminal digestive tract is a clear target of the influence of dietary components, alcohol, microbial organisms, and other ingested materials. External factors including obesity, lack of physical exercise, and tobacco consumption also impact diseases of the luminal gastrointestinal (GI) tract. A growing understanding of the microbiome which forms an integral part of the human organism indicates that this is another important external force that impacts human health and disease. The luminal GI tract conditions that arise, at least in part, from these external factors range from malignancies (squamous cell esophageal cancer, Barrett's esophagus and associated esophageal adenocarcinoma, gastric cancer, and colorectal cancer), idiopathic inflammatory disorders such as inflammatory bowel diseases, and post-infectious syndromes including post-infectious irritable bowel syndrome, post-infectious dyspepsia and other functional GI disorders. Of particular interest, given their increase in prevalence in much of the world, are immune-mediated conditions in which food antigens are the driving force behind disease development. These entities include celiac disease, eosinophilic esophagitis, and food allergies. Celiac disease is a prime example of a condition mediated by dietary factors whose pathogenesis has only recently been determined, providing opportunities for developing treatment options beyond the gluten-free diet. While a genetic basis for this disease clearly exists, it is believed that environmental factors such as an increase in gluten in the human diet account for its rising prevalence, now roughly 1% of genetically susceptible populations in all continents. Proposed therapeutic strategies span from preventing disease by modulating the time of gluten introduction in infants, to reducing exposure to gluten by developing strains of wheat with lower levels of gluten, degrading ingested gluten peptides within the intestinal lumen via endopeptidases or modulating uptake of these peptides across intestinal tight junctions. Other novel treatments in development focus on interfering with the immune events that lead to disease once gluten accesses the lamina propria including altering the immune milieu from a Th1-predominant response via hookworm infection, inhibiting tissue transglutaminase, and blocking antigen presentation and/or T-cell responses to gluten peptides. While new treatment options for celiac disease reflect the complex interaction of diet, genetic factors and the host immune response, the implications for treatment of many conditions of the large and small intestine that arise from environmental and lifestyle are as basic as ensuring adequate nutrition, regular exercise and cessation of tobacco use. Much more needs to be learned about the microbiome, dietary and other factors and their interaction with the human host in order to develop potential new treatment strategies for diseases that result from the environment and lifestyle. Copyright © 2011 S. Karger AG, Basel.

External factors impacting hospital evacuations caused by Hurricane Rita: the role of situational awareness.

PubMed

Downey, Erin L; Andress, Knox; Schultz, Carl H

2013-06-01

The 2005 Gulf Coast hurricane season was one of the most costly and deadly in US history. Hurricane Rita stressed hospitals and led to multiple, simultaneous evacuations. This study systematically identified community factors associated with patient movement out of seven hospitals evacuated during Hurricane Rita. This study represents the second of two systematic, observational, and retrospective investigations of seven acute care hospitals that reported off-site evacuations due to Hurricane Rita. Participants from each hospital included decision makers that comprised the Incident Management Team (IMT). Investigators applied a standardized interview process designed to assess evacuation factors related to external situational awareness of community activities during facility evacuation due to hurricanes. The measured outcomes were responses to 95 questions within six sections of the survey instrument. Investigators identified two factors that significantly impacted hospital IMT decision making: (1) incident characteristics affecting a facility's internal resources and challenges; and (2) incident characteristics affecting a facility's external evacuation activities. This article summarizes the latter and reports the following critical decision making points: (1) Emergency Operations Plans (EOP) were activated an average of 85 hours (3 days, 13 hours) prior to Hurricane Rita's landfall; (2) the decision to evacuate the hospital was made an average of 30 hours (1 day, 6 hours) from activation of the EOP; and (3) the implementation of the evacuation process took an average of 22 hours. Coordination of patient evacuations was most complicated by transportation deficits (the most significant of the 11 identified problem areas) and a lack of situational awareness of community response activities. All evacuation activities and subsequent evacuation times were negatively impacted by an overall lack of understanding on the part of hospital staff and the IMT regarding how to identify and coordinate with community resources. Hospital evacuation requires coordinated processes and resources, including situational awareness that reflects the condition of the community as a result of the incident. Successful hospital evacuation decision making is influenced by community-wide situational awareness and transportation deficits. Planning with the community to create realistic EOPs that accurately reflect available resources and protocols is critical to informing hospital decision making during a crisis. Knowledge of these factors could improve decision making and evacuation practices, potentially reducing evacuation times in future hurricanes.

It's time to put the C.A.R.T. before the H.O.R.S.E. or putting critical, analytical, and reflective thinking before

Treesearch

David L. Jewell

2002-01-01

Higher education is the target of criticism for, among other things, the failure to teach students how to think - critically, analytically, and reflectively - and for placing too much emphasis on career preparation or professional education. While a number of external factors have, perhaps, led to such criticism being warranted, faculty - including those in Recreation...

Managing treatment for end-stage renal disease--a qualitative study exploring cultural perspectives on facilitators and barriers to treatment adherence.

PubMed

Griva, K; Ng, H J; Loei, J; Mooppil, N; McBain, H; Newman, S P

2013-01-01

Although adherence to hemodialysis (HD) regimes is important to maximise good clinical outcomes, it remains suboptimal and not well understood, particularly for those in non-Western settings and patients from Asian cultures. This qualitative study sought to explore cultural perspectives on facilitators and barriers to treatment adherence in HD patients. A descriptive exploratory design was used for the study, incorporating individual semi-structured interviews (n = 17) and three focus groups (n = 20). Each interview/focus group was audio-taped and transcribed verbatim, and coding was conducted by two coders using an iterative process. Study participants identified personal and social/contextual factors as major barriers or facilitators of treatment adherence. Barriers include time consumption, forgetfulness, concerns about safety, poor knowledge/understanding, poor communication and lack of control/social pressure. Participants also identified facilitators, both internal (self-initiated) and external (initiated by family, health care professional and peers) to ensure treatment adherence. These included support from family members and social obligation towards others, risk perception, establishment of routines and peer support. Internal and external factors can hinder or facilitate adherence to diet, fluid and medications in the context of dialysis. Several of these barriers/facilitators can be effectively addressed in the context of interventions and psycho-educational programmes.

Masculine Traits and Depressive Symptoms in Older and Younger Men and Women.

PubMed

Price, Elizabeth C; Gregg, Jeffrey J; Smith, Merideth D; Fiske, Amy

2018-01-01

Evidence suggests that men who strongly endorse masculine traits display an atypical presentation of depression, including more externalizing symptoms (e.g., anger or substance use), but fewer typical, internalizing symptoms (e.g., depressed mood or crying). This phenomenon has not been adequately explored in older adults or women. The current study used the externalizing subscale of the Masculine Depression Scale in older and younger men and women to detect atypical symptoms. It was predicted that individuals who more strongly endorsed masculine traits would have higher scores on the measure of externalizing symptoms relative to a measure of typical depressive symptoms Center for Epidemiologic Studies-Depression Scale. It was anticipated that results would differ by age-group but not by gender. Multigroup path analysis was used to test the hypothesis. The hypothesized path model, in which endorsement of masculine traits was associated with lower scores on the Center for Epidemiologic Studies-Depression Scale and with scores on the externalizing, but not internalizing, factor of the Masculine Depression Scale, fit the data well. Results differed significantly by age-group and gender. Masculine individuals reported lower levels of typical depressive symptoms relative to externalizing symptoms, but further research is needed within age- and gender groups. Results are consistent with the gendered responding framework and suggest that current assessment tools, which tend to focus on internalizing symptoms of depression, may not detect depression in individuals who endorse masculine traits.

The Association of Birth Complications and Externalizing Behavior in Early Adolescents: Direct and Mediating Effects

ERIC Educational Resources Information Center

Liu, Jianghong; Raine, Adrian; Wuerker, Anne; Venables, Peter H.; Mednick, Sarnoff

2009-01-01

Prior studies have shown that birth complications interact with psychosocial risk factors in predisposing to increased externalizing behavior in childhood and criminal behavior in adulthood. However, little is known about the direct relationship between birth complications and externalizing behavior. Furthermore, the mechanism by which the birth…

Stress, Cortisol, and Externalizing Behavior in Adolescent Males: An Examination in the Context of Multisystemic Therapy

ERIC Educational Resources Information Center

Schechter, Julia C.; Brennan, Patricia A.; Cunningham, Phillippe B.; Foster, Sharon L.; Whitmore, Elizabeth

2012-01-01

Stress and hypothalamic-pituitary-adrenal (HPA) axis dysregulation have been associated with externalizing behavior in adolescence, but few studies have examined these factors in a treatment context. This study investigated the relationship between stress, cortisol, and externalizing behavior among 120 adolescent males (mean age = 15) receiving…

Negative Affect Shares Genetic and Environmental Influences with Symptoms of Childhood Internalizing and Externalizing Disorders

ERIC Educational Resources Information Center

Mikolajewski, Amy J.; Allan, Nicholas P.; Hart, Sara A.; Lonigan, Christopher J.; Taylor, Jeanette

2013-01-01

The co-occurrence of internalizing and externalizing disorders suggests that they may have common underlying vulnerability factors. Research has shown that negative affect is moderately positively correlated with both internalizing and externalizing disorders in children. The present study is the first to provide an examination of negative affect…

Amygdala volume mediates the relationship between externalizing symptoms and daily smoking in adolescence: A prospective study.

PubMed

Cheetham, Ali; Allen, Nicholas B; Whittle, Sarah; Simmons, Julian; Yücel, Murat; Lubman, Dan I

2018-06-30

The current study examined amygdala and orbitofrontal cortex (OFC) volumes as mediators of the relationship between externalizing symptoms and daily smoking in adolescence. Externalizing behaviors are among the most robust predictors of adolescent smoking, and there is emerging evidence that volume reductions in the amygdala and OFC are associated with risk for substance misuse as well as aggressive, impulsive, and disinhibited tendencies. Using a prospective longitudinal design, we recruited 109 adolescents who provided data on brain volume and externalizing behaviors at age 12, and on smoking at age 18. Daily smoking at age 18 (n = 27) was predicted by externalizing behaviors (measured by the self-report Child Behavior Checklist, CBCL) as well as smaller right amygdala volumes. Right amygdala volumes mediated the relationship between externalizing symptoms and later smoking. These findings provide important insight into the neurobiological risk factors associated with adolescent smoking, and, more generally, into factors that may be associated with vulnerability to substance use disorders and related psychopathology. Copyright © 2018 Elsevier B.V. All rights reserved.

Interaction of a penny-shaped crack and an external circular crack in a transversely isotropic composite

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

Tsai, Y.M.

1998-12-31

The interaction of a penny-shaped crack and an external circular crack in a transversely isotropic composite is investigated using the techniques of Hankel transform and multiplying factors. The boundary conditions of the problem have three different parts. The stress intensity factors at the inner and the outer crack tips are obtained in exact expressions as the products of a dimensional quantity and nondimensional functions. The presence of a penny-shaped crack is shown to have a strong effect on the magnitude of the stress intensity of the external circular crack. The crack surface displacement is also obtained and evaluated numerically formore » different values of the ratio of the inner crack radius to the external crack radius.« less

Change of magnetic properties of nanocrystalline alloys under influence of external factors

NASA Astrophysics Data System (ADS)

Sitek, Jozef; Holková, Dominika; Dekan, Julius; Novák, Patrik

2016-10-01

Nanocrystalline (Fe3Ni1)81Nb7B12 alloys were irradiated using different types of radiation and subsequently studied by Mössbauer spectroscopy. External magnetic field of 0.5 T, electron-beam irradiation up to 4 MGy, neutron irradiation up to 1017 neutrons/cm2 and irradiation with Cu ions were applied on the samples. All types of external factors had an influence on the magnetic microstructure manifested as a change in the direction of the net magnetic moment, intensity of the internal magnetic field and volumetric fraction of the constituent phases. The direction of the net magnetic moment was the most sensitive parameter. Changes of the microscopic magnetic parameters were compared after different external influence and results of nanocrystalline samples were compared with their amorphous precursors.

Measuring and modeling the interaction among reward size, delay to reward, and satiation level on motivation in monkeys.

PubMed

Minamimoto, Takafumi; La Camera, Giancarlo; Richmond, Barry J

2009-01-01

Motivation is usually inferred from the likelihood or the intensity with which behavior is carried out. It is sensitive to external factors (e.g., the identity, amount, and timing of a rewarding outcome) and internal factors (e.g., hunger or thirst). We trained macaque monkeys to perform a nonchoice instrumental task (a sequential red-green color discrimination) while manipulating two external factors: reward size and delay-to-reward. We also inferred the state of one internal factor, level of satiation, by monitoring the accumulated reward. A visual cue indicated the forthcoming reward size and delay-to-reward in each trial. The fraction of trials completed correctly by the monkeys increased linearly with reward size and was hyperbolically discounted by delay-to-reward duration, relations that are similar to those found in free operant and choice tasks. The fraction of correct trials also decreased progressively as a function of the satiation level. Similar (albeit noiser) relations were obtained for reaction times. The combined effect of reward size, delay-to-reward, and satiation level on the proportion of correct trials is well described as a multiplication of the effects of the single factors when each factor is examined alone. These results provide a quantitative account of the interaction of external and internal factors on instrumental behavior, and allow us to extend the concept of subjective value of a rewarding outcome, usually confined to external factors, to account also for slow changes in the internal drive of the subject.

Measuring and Modeling the Interaction Among Reward Size, Delay to Reward, and Satiation Level on Motivation in Monkeys

PubMed Central

Minamimoto, Takafumi; La Camera, Giancarlo; Richmond, Barry J.

2009-01-01

Motivation is usually inferred from the likelihood or the intensity with which behavior is carried out. It is sensitive to external factors (e.g., the identity, amount, and timing of a rewarding outcome) and internal factors (e.g., hunger or thirst). We trained macaque monkeys to perform a nonchoice instrumental task (a sequential red-green color discrimination) while manipulating two external factors: reward size and delay-to-reward. We also inferred the state of one internal factor, level of satiation, by monitoring the accumulated reward. A visual cue indicated the forthcoming reward size and delay-to-reward in each trial. The fraction of trials completed correctly by the monkeys increased linearly with reward size and was hyperbolically discounted by delay-to-reward duration, relations that are similar to those found in free operant and choice tasks. The fraction of correct trials also decreased progressively as a function of the satiation level. Similar (albeit noiser) relations were obtained for reaction times. The combined effect of reward size, delay-to-reward, and satiation level on the proportion of correct trials is well described as a multiplication of the effects of the single factors when each factor is examined alone. These results provide a quantitative account of the interaction of external and internal factors on instrumental behavior, and allow us to extend the concept of subjective value of a rewarding outcome, usually confined to external factors, to account also for slow changes in the internal drive of the subject. PMID:18987119

The Impact of Curiosity and External Regulation on Intrinsic Motivation: An Empirical Study in Hong Kong Education

ERIC Educational Resources Information Center

Hon-keung, Yau; Man-shan, Kan; Lai-fong, Cheng Alison

2012-01-01

The purposes of this paper are to identify: (1) the factors affecting the intrinsic motivation of university students in Hong Kong; and (2) gender differences in the perception of intrinsic motivation in Hong Kong higher education environment. The factors of curiosity and external regulation with intrinsic motivation are taken into investigation…

The Association between Attention Problems and Internalizing and Externalizing Problems: The Mediating Role of Peer Problems

ERIC Educational Resources Information Center

Yip, Vania T.; Ang, Rebecca P.; Ooi, Yoon Phaik; Fung, Daniel S. S.; Mehrotra, Kala; Sung, Min; Lim, Choon Guan

2013-01-01

Background: The high prevalence of attention problems in children warrants concern, as it is a risk factor for internalizing and externalizing problems. There lies a need to understand possible factors that may mediate this link so that interventions may be targeted to alleviate these mediators and interrupt the link between attention problems and…

Determining eyeball surface area directly exposed to the effects of external factors.

PubMed

Juliszewski, Tadeusz; Kadłuczka, Filip; Kiełbasa, Paweł

2016-01-01

This article discusses determining the surface area of eyeballs of men and women exposed to the direct effects of external factors in the working environment. For one eye, the mean surface is 172-182 mm(2). The determined surface area can be used in formulas for calculating the exposure of eyeballs to harmful chemical substances in workplace air.

Relationship Domain of Form Six Teachers Thinking in Teaching with External Factors of Form Six Teachers

ERIC Educational Resources Information Center

bin Pet, Mokhtar; Sihes, Ahmad Johari Hj

2015-01-01

This study aims to examine the external factors of form six teachers who can influence thinking domain form six teachers in their teaching. This study was conducted using a quantitative approach using questionnaires. A total of 300 form six teacher schools in Johor were chosen as respondents. The findings were obtained as student background…

Multimethod Assessment of Psychopathy in Relation to Factors of Internalizing and Externalizing from the Personality Assessment Inventory: The Impact of Method Variance and Suppressor Effects

ERIC Educational Resources Information Center

Blonigen, Daniel M.; Patrick, Christopher J.; Douglas, Kevin S.; Poythress, Norman G.; Skeem, Jennifer L.; Lilienfeld, Scott O.; Edens, John F.; Krueger, Robert F.

2010-01-01

Research to date has revealed divergent relations across factors of psychopathy measures with criteria of "internalizing" (INT; anxiety, depression) and "externalizing" (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings…

Examining the Relations Among the DSM-5 Alternative Model of Personality, the Five-Factor Model, and Externalizing and Internalizing Behavior.

PubMed

Sleep, Chelsea E; Hyatt, Courtland S; Lamkin, Joanna; Maples-Keller, Jessica L; Miller, Joshua D

2017-01-26

Given long-standing criticisms of the DSM's reliance on categorical models of psychopathology, including the poor reliability and validity of personality-disorder diagnoses, the American Psychiatric Association (APA) published an alternative model (AM) of personality disorders in Section III of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013), which, in part, comprises 5 pathological trait domains based on the 5-factor model (FFM). However, the empirical profiles and discriminant validity of the AM traits remain in question. We recruited a sample of undergraduates (N = 340) for the current study to compare the relations found between a measure of the DSM-5 AM traits (i.e., the Personality Inventory for DSM-5; PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012) and a measure of the FFM (i.e., the International Personality Item Pool; IPIP; Goldberg, 1999) in relation to externalizing and internalizing symptoms. In general, the domains from the 2 measures were significantly related and demonstrated similar patterns of relations with these criteria, such that Antagonism/low Agreeableness and Disinhibition/low Conscientiousness were related to externalizing behaviors, whereas Negative Affectivity/Neuroticism was most significantly related to internalizing symptoms. However, the PID-5 demonstrated large interrelations among its domains and poorer discriminant validity than the IPIP. These results provide additional support that the conception of the trait model included in the DSM-5 AM is an extension of the FFM, but highlight some of the issues that arise due to the PID-5's more limited discriminant validity. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Resident-to-resident violence triggers in nursing homes.

PubMed

Snellgrove, Susan; Beck, Cornelia; Green, Angela; McSweeney, Jean C

2013-11-01

Certified nurses' assistants (CNAs) employed by a rural nursing home in Northeast Arkansas described their perceptions of resident-to-resident violence in order to provide insight on factors, including unmet needs, that may trigger the phenomenon. Semistructured interviews were conducted with 11 CNAs. Data were analyzed using content analysis and constant comparison. Two categories of triggers emerged from the data-active and passive. Active triggers involved the actions of other residents that were intrusive in nature, such as wandering into a residents' personal space, taking a resident's belongings, and so forth. Passive triggers did not involve the actions of residents but related to the internal and external environment of the residents. Examples were factors such as boredom, competition for attention and communication difficulties. Results indicate that there are factors, including unmet needs within the nursing home environment that may be identified and altered to prevent violence between residents.

Suicides, homicides, accidents, and other external causes of death among blacks and whites in the Southern Community Cohort Study.

PubMed

Sonderman, Jennifer S; Munro, Heather M; Blot, William J; Tarone, Robert E; McLaughlin, Joseph K

2014-01-01

Prior studies of risk factors associated with external causes of death have been limited in the number of covariates investigated and external causes examined. Herein, associations between numerous demographic, lifestyle, and health-related factors and the major causes of external mortality, such as suicide, homicide, and accident, were assessed prospectively among 73,422 black and white participants in the Southern Community Cohort Study (SCCS). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated in multivariate regression analyses using the Cox proportional hazards model. Men compared with women (HR = 2.32; 95% CI: 1.87-2.89), current smokers (HR = 1.74; 95% CI: 1.40-2.17), and unemployed/never employed participants at the time of enrollment (HR = 1.67; 95% CI 1.38-2.02) had increased risk of dying from all external causes, with similarly elevated HRs for suicide, homicide, and accidental death among both blacks and whites. Blacks compared with whites had lower risk of accidental death (HR = 0.46; 95% CI: 0.38-0.57) and suicide (HR = 0.55; 95% CI: 0.31-0.99). Blacks and whites in the SCCS had comparable risks of homicide death (HR = 1.05; 95% CI: 0.63-1.76); however, whites in the SCCS had unusually high homicide rates compared with all whites who were resident in the 12 SCCS states, while black SCCS participants had homicide rates similar to those of all blacks residing in the SCCS states. Depression was the strongest risk factor for suicide, while being married was protective against death from homicide in both races. Being overweight/obese at enrollment was associated with reduced risks in all external causes of death, and the number of comorbid conditions was a risk factor for iatrogenic deaths. Most risk factors identified in earlier studies of external causes of death were confirmed in the SCCS cohort, in spite of the low SES of SCCS participants. Results from other epidemiologic cohorts are needed to confirm the novel findings identified in this study.

Exploring mediating factors in the association between parental psychological distress and psychosocial maladjustment in adolescence.

PubMed

Roustit, Christelle; Campoy, Eric; Chaix, Basile; Chauvin, Pierre

2010-07-01

Parental psychopathology is associated with increased psychosocial maladjustment in adolescents. We examined, from a psychosocial perspective, the association between parental psychological distress and psychosocial maladjustment in adolescents and assessed the mediating role of psychosocial covariates. This is a cross-sectional survey and the setting include representative sample of Quebec adolescents in 1999. The participants of the study include 13- and 16-year-old children (N = 2,346) in the Social and Health Survey of Quebec Children and Adolescents. The main outcome measures are internalizing disorders, externalizing disorders, substance use, and alcohol consumption. For statistical analysis, we used structural equation modeling to test for mediation. Internalizing and externalizing disorders were significantly associated with parental psychological distress, but not substance use or alcohol consumption. The higher the parental distress, the higher the risk of adolescent mental health disorders. The association between parental psychological distress and internalizing disorders was mediated by adolescent self-esteem, parental emotional support and extrafamilial social support. As for externalizing disorders, these variables only had an independent effect. In conclusion, A family's well being is a necessary condition for psychosocial adjustment in adolescence. Beyond the psychiatric approach, psychosocial considerations need to be taken into consideration to prevent negative mental health outcomes in children living in homes with distressed parents.

Exploring mediating factors in the association between parental psychological distress and psychosocial maladjustment in adolescence

PubMed Central

Campoy, Eric; Chaix, Basile; Chauvin, Pierre

2010-01-01

Abstract Parental psychopathology is associated with increased psychosocial maladjustment in adolescents. We examined, from a psychosocial perspective, the association between parental psychological distress and psychosocial maladjustment in adolescents and assessed the mediating role of psychosocial covariates. This is a cross-sectional survey and the setting include representative sample of Quebec adolescents in 1999. The participants of the study include 13- and 16-year-old children (N = 2,346) in the Social and Health Survey of Quebec Children and Adolescents. The main outcome measures are internalizing disorders, externalizing disorders, substance use, and alcohol consumption. For statistical analysis, we used structural equation modeling to test for mediation. Internalizing and externalizing disorders were significantly associated with parental psychological distress, but not substance use or alcohol consumption. The higher the parental distress, the higher the risk of adolescent mental health disorders. The association between parental psychological distress and internalizing disorders was mediated by adolescent self-esteem, parental emotional support and extrafamilial social support. As for externalizing disorders, these variables only had an independent effect. In conclusion, A family’s well being is a necessary condition for psychosocial adjustment in adolescence. Beyond the psychiatric approach, psychosocial considerations need to be taken into consideration to prevent negative mental health outcomes in children living in homes with distressed parents. PMID:20127380

Do nursing homes for older people have the support they need to provide end-of-life care? A mixed methods enquiry in England

PubMed Central

Seymour, Jane E; Kumar, Arun; Froggatt, Katherine

2011-01-01

Nursing homes are a common site of death, but older residents receive variable quality of end-of-life care. We used a mixed methods design to identify external influences on the quality of end-of-life care in nursing homes. Two qualitative case studies were conducted and a postal survey of 180 nursing homes surrounding the case study sites. In the case studies, qualitative interviews were held with seven members of nursing home staff and 10 external staff. Problems in accessing support for end-of-life care reported in the survey included variable support by general practitioners (GPs), reluctance among GPs to prescribe appropriate medication, lack of support from other agencies, lack of out of hours support, cost of syringe drivers and lack of access to training. Most care homes were implementing a care pathway. Those that were not rated their end-of-life care as in need of improvement or as average. The case studies suggest that critical factors in improving end-of-life care in nursing homes include developing clinical leadership, developing relationships with GPs, the support of ‘key’ external advocates and leverage of additional resources by adoption of care pathway tools. PMID:21282349

TOPICAL REVIEW: A review of dosimetry studies on external-beam radiation treatment with respect to second cancer induction

NASA Astrophysics Data System (ADS)

Xu, X. George; Bednarz, Bryan; Paganetti, Harald

2008-07-01

It has been long known that patients treated with ionizing radiation carry a risk of developing a second cancer in their lifetimes. Factors contributing to the recently renewed concern about the second cancer include improved cancer survival rate, younger patient population as well as emerging treatment modalities such as intensity-modulated radiation treatment (IMRT) and proton therapy that can potentially elevate secondary exposures to healthy tissues distant from the target volume. In the past 30 years, external-beam treatment technologies have evolved significantly, and a large amount of data exist but appear to be difficult to comprehend and compare. This review article aims to provide readers with an understanding of the principles and methods related to scattered doses in radiation therapy by summarizing a large collection of dosimetry and clinical studies. Basic concepts and terminology are introduced at the beginning. That is followed by a comprehensive review of dosimetry studies for external-beam treatment modalities including classical radiation therapy, 3D-conformal x-ray therapy, intensity-modulated x-ray therapy (IMRT and tomotherapy) and proton therapy. Selected clinical data on second cancer induction among radiotherapy patients are also covered. Problems in past studies and controversial issues are discussed. The needs for future studies are presented at the end.

Logistic Regression and Path Analysis Method to Analyze Factors influencing Students’ Achievement

NASA Astrophysics Data System (ADS)

Noeryanti, N.; Suryowati, K.; Setyawan, Y.; Aulia, R. R.

2018-04-01

Students' academic achievement cannot be separated from the influence of two factors namely internal and external factors. The first factors of the student (internal factors) consist of intelligence (X1), health (X2), interest (X3), and motivation of students (X4). The external factors consist of family environment (X5), school environment (X6), and society environment (X7). The objects of this research are eighth grade students of the school year 2016/2017 at SMPN 1 Jiwan Madiun sampled by using simple random sampling. Primary data are obtained by distributing questionnaires. The method used in this study is binary logistic regression analysis that aims to identify internal and external factors that affect student’s achievement and how the trends of them. Path Analysis was used to determine the factors that influence directly, indirectly or totally on student’s achievement. Based on the results of binary logistic regression, variables that affect student’s achievement are interest and motivation. And based on the results obtained by path analysis, factors that have a direct impact on student’s achievement are students’ interest (59%) and students’ motivation (27%). While the factors that have indirect influences on students’ achievement, are family environment (97%) and school environment (37).

Meta-analysis of the alpha/beta ratio for prostate cancer in the presence of an overall time factor: bad news, good news, or no news?

PubMed

Vogelius, Ivan R; Bentzen, Søren M

2013-01-01

To present a novel method for meta-analysis of the fractionation sensitivity of tumors as applied to prostate cancer in the presence of an overall time factor. A systematic search for radiation dose-fractionation trials in prostate cancer was performed using PubMed and by manual search. Published trials comparing standard fractionated external beam radiation therapy with alternative fractionation were eligible. For each trial the α/β ratio and its 95% confidence interval (CI) were extracted, and the data were synthesized with each study weighted by the inverse variance. An overall time factor was included in the analysis, and its influence on α/β was investigated. Five studies involving 1965 patients were included in the meta-analysis of α/β. The synthesized α/β assuming no effect of overall treatment time was -0.07 Gy (95% CI -0.73-0.59), which was increased to 0.47 Gy (95% CI -0.55-1.50) if a single highly weighted study was excluded. In a separate analysis, 2 studies based on 10,808 patients in total allowed extraction of a synthesized estimate of a time factor of 0.31 Gy/d (95% CI 0.20-0.42). The time factor increased the α/β estimate to 0.58 Gy (95% CI -0.53-1.69)/1.93 Gy (95% CI -0.27-4.14) with/without the heavily weighted study. An analysis of the uncertainty of the α/β estimate showed a loss of information when the hypofractionated arm was underdosed compared with the normo-fractionated arm. The current external beam fractionation studies are consistent with a very low α/β ratio for prostate cancer, although the CIs include α/β ratios up to 4.14 Gy in the presence of a time factor. Details of the dose fractionation in the 2 trial arms have critical influence on the information that can be extracted from a study. Studies with unfortunate designs will supply little or no information about α/β regardless of the number of subjects enrolled. Copyright © 2013 Elsevier Inc. All rights reserved.

The influence of sociocultural factors on the eating attitudes of Lebanese and Cypriot students: a cross-cultural study.

PubMed

Zeeni, N; Gharibeh, N; Katsounari, I

2013-07-01

The present comparative cross-cultural study aimed to explore the relationship between eating behaviour and sociocultural influences with respect to appearance and body image in female university students from two cultural contexts, namely Cyprus and Lebanon. The Dutch Eating Behavior questionnaire (DEBQ) and the Perceived Sociocultural Influences on Body Image and Body Change Questionnaire were used to assess sociocultural influences and body image, respectively, in 200 students from each country. The results indicated that the Lebanese students were more likely to engage in emotional and external eating and their body image was impacted to a larger extent by sociocultural agents, including media influences, compared to the Cypriot students. Also, a positive relationship was found between emotional and external eating in both cultures. Finally, sociocultural influences correlated positively with external eating only in the Cypriot sample. Culture-specific factors, such as the societal values and norms, as well as the Westernisation history of each country, are discussed as underpinnings for the differences found. These findings are significant for understanding the rise of eating pathology in these two cultures and provide evidence for a need to consider cultural environment when designing public health policies addressing the negative aspects of nutrition transition. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

External aortic wrap for repair of type 1 endoleak☆

PubMed Central

Dean, Anastasia; Yap, Swee Leong; Bhamidipaty, Venu; Pond, Franklin

2014-01-01

INTRODUCTION Type 1 endoleak is a rare complication after endovascular abdominal aortic aneurysm repair (EVAR) with a reported frequency up to 2.88%. It is a major risk factor for aneurysmal enlargement and rupture. PRESENTATION OF CASE We present a case of a 68 year old gentleman who was found to have a proximal type 1 endoleak with loss of graft wall apposition on routine surveillance imaging post-EVAR. An initial attempt at endovascular repair was unsuccessful. Given the patient's multiple medical co-morbidities, which precluded the possibility of conventional graft explantation and open repair, we performed a novel surgical technique which did not require aortic cross-clamping. A double-layered Dacron wrap was secured around the infra-renal aorta with Prolene sutures, effectively hoisting the posterior bulge to allow wall to graft apposition and excluding the endoleak. Post-operative CT angiogram showed resolution of the endoleak and a stable sac size. DISCUSSION Several anatomical factors need to be considered when this technique is proposed including aortic neck angulation, position of lumbar arteries and peri-aortic venous anatomy. While an external wrap technique has been investigated sporadically for vascular aneurysms, to our knowledge there is only one similar case in the literature. CONCLUSION Provided certain anatomical features are present, an external aortic wrap is a useful and successful option to manage type 1 endoleak in high-risk patients who are unsuitable for aortic clamping. PMID:25217878

Comparison of Factorization-Based Filtering for Landing Navigation

NASA Technical Reports Server (NTRS)

McCabe, James S.; Brown, Aaron J.; DeMars, Kyle J.; Carson, John M., III

2017-01-01

This paper develops and analyzes methods for fusing inertial navigation data with external data, such as data obtained from an altimeter and a star camera. The particular filtering techniques are based upon factorized forms of the Kalman filter, specifically the UDU and Cholesky factorizations. The factorized Kalman filters are utilized to ensure numerical stability of the navigation solution. Simulations are carried out to compare the performance of the different approaches along a lunar descent trajectory using inertial and external data sources. It is found that the factorized forms improve upon conventional filtering techniques in terms of ensuring numerical stability for the investigated landing navigation scenario.

Improving the efficiency of quantitative (1)H NMR: an innovative external standard-internal reference approach.

PubMed

Huang, Yande; Su, Bao-Ning; Ye, Qingmei; Palaniswamy, Venkatapuram A; Bolgar, Mark S; Raglione, Thomas V

2014-01-01

The classical internal standard quantitative NMR (qNMR) method determines the purity of an analyte by the determination of a solution containing the analyte and a standard. Therefore, the standard must meet the requirements of chemical compatibility and lack of resonance interference with the analyte as well as a known purity. The identification of such a standard can be time consuming and must be repeated for each analyte. In contrast, the external standard qNMR method utilizes a standard with a known purity to calibrate the NMR instrument. The external standard and the analyte are measured separately, thereby eliminating the matter of chemical compatibility and resonance interference between the standard and the analyte. However, the instrumental factors, including the quality of NMR tubes, must be kept the same. Any deviations will compromise the accuracy of the results. An innovative qNMR method reported herein utilizes an internal reference substance along with an external standard to assume the role of the standard used in the traditional internal standard qNMR method. In this new method, the internal reference substance must only be chemically compatible and be free of resonance-interference with the analyte or external standard whereas the external standard must only be of a known purity. The exact purity or concentration of the internal reference substance is not required as long as the same quantity is added to the external standard and the analyte. The new method reduces the burden of searching for an appropriate standard for each analyte significantly. Therefore the efficiency of the qNMR purity assay increases while the precision of the internal standard method is retained. Copyright © 2013 Elsevier B.V. All rights reserved.

Efficiently measuring dimensions of the externalizing spectrum model: Development of the Externalizing Spectrum Inventory-Computerized Adaptive Test (ESI-CAT).

PubMed

Sunderland, Matthew; Slade, Tim; Krueger, Robert F; Markon, Kristian E; Patrick, Christopher J; Kramer, Mark D

2017-07-01

The development of the Externalizing Spectrum Inventory (ESI) was motivated by the need to comprehensively assess the interrelated nature of externalizing psychopathology and personality using an empirically driven framework. The ESI measures 23 theoretically distinct yet related unidimensional facets of externalizing, which are structured under 3 superordinate factors representing general externalizing, callous aggression, and substance abuse. One limitation of the ESI is its length at 415 items. To facilitate the use of the ESI in busy clinical and research settings, the current study sought to examine the efficiency and accuracy of a computerized adaptive version of the ESI. Data were collected over 3 waves and totaled 1,787 participants recruited from undergraduate psychology courses as well as male and female state prisons. A series of 6 algorithms with different termination rules were simulated to determine the efficiency and accuracy of each test under 3 different assumed distributions. Scores generated using an optimal adaptive algorithm evidenced high correlations (r > .9) with scores generated using the full ESI, brief ESI item-based factor scales, and the 23 facet scales. The adaptive algorithms for each facet administered a combined average of 115 items, a 72% decrease in comparison to the full ESI. Similarly, scores on the item-based factor scales of the ESI-brief form (57 items) were generated using on average of 17 items, a 70% decrease. The current study successfully demonstrates that an adaptive algorithm can generate similar scores for the ESI and the 3 item-based factor scales using a fraction of the total item pool. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Inaccurate treatment decisions of automated external defibrillators used by emergency medical services personnel: incidence, cause and impact on outcome.

PubMed

Calle, Paul A; Mpotos, Nicolas; Calle, Simon P; Monsieurs, Koenraad G

2015-03-01

The rhythm analysis algorithm (RAA) of automated external defibrillators (AEDs) may be deceived by many factors. In this observational study we assessed RAA accuracy in prehospital interventions. For every rhythm analysis judged to be inaccurate, we looked for causal factors and estimated the impact on outcome. In 135 consecutive patients, two physicians reviewed 837 rhythm analyses independently. When they disagreed, a third physician made the final decision. Among 148 shockable episodes, 23 (16%) were not recognized by the RAA due to external artifacts (n=7), fine ventricular fibrillation (VF; n=7), RAA error without external artifacts (n=4) or a combination of factors (n=5). In six cases the omitted/delayed shock was judged to be of clinical relevance: survival with some neurological deficit (n=4), death without regaining consciousness (n=1) and no restoration of spontaneous circulation (n=1). In 689 non-shockable episodes, the RAA decided "shockable" 25 times (4%). This wrongful decision was due to external artifacts (n=9), a concurrent shock of an internal cardioverter defibrillator (n=1), RAA error without external artifacts (n=13) or a combination of factors (n=2). Fifteen spurious shocks were delivered. As these non-shockable rhythms did not deteriorate after the shock, we assumed that no significant harm was done. Up to 16% of shockable rhythms were not detected and 4% of non-shockable rhythms were interpreted as shockable. Therefore, all AED interventions should be reviewed. Feedback to caregivers may avoid future deleterious interactions with the AED, whereas AED manufacturers may use this information to improve RAA accuracy. This approach may improve the outcome of some VF patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cystic lesion around the hip joint

PubMed Central

Yukata, Kiminori; Nakai, Sho; Goto, Tomohiro; Ikeda, Yuichi; Shimaoka, Yasunori; Yamanaka, Issei; Sairyo, Koichi; Hamawaki, Jun-ichi

2015-01-01

This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections: Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty (THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments. PMID:26495246

A Model for the Flexibility of the Distal Histidine in Dehaloperoxidase-Hemoglobin A Based on X-ray Crystal Structures of the Carbon Monoxide Adduct

PubMed Central

2015-01-01

Dehaloperoxidase hemoglobin A (DHP A) is a multifunctional hemoglobin that appears to have evolved oxidative pathways for the degradation of xenobiotics as a protective function that complements the oxygen transport function. DHP A possesses at least two internal binding sites, one for substrates and one for inhibitors, which include various halogenated phenols and indoles. Herein, we report the X-ray crystallographic structure of the carbonmonoxy complex (DHPCO). Unlike other DHP structures with 6-coordinated heme, the conformation of the distal histidine (H55) in DHPCO is primarily external or solvent exposed, despite the fact that the heme Fe is 6-coordinated. As observed generally in globins, DHP exhibits two distal histidine conformations (one internal and one external). In previous structural studies, we have shown that the distribution of H55 conformations is weighted strongly toward the external position when the DHP heme Fe is 5-coordinated. The large population of the external conformation of the distal histidine observed in DHPCO crystals at pH 6.0 indicates that some structural factor in DHP must account for the difference from other globins, which exhibit a significant external conformation only when pH < 4.5. While the original hypothesis suggested that interaction with a heme-Fe-bound ligand was the determinant of H55 conformation, the current study forces a refinement of that hypothesis. The external or open conformation of H55 is observed to have interactions with two propionate groups in heme, at distances of 3.82 and 2.73 Å, respectively. A relatively weak hydrogen bonding interaction between H55 and CO, combined with strong interactions with heme propionate (position 6), is hypothesized to strengthen the external conformation of H55. Density function theory (DFT) calculations were conducted to test whether there is a weaker hydrogen bond interaction between H55 and heme bonded CO or O2. Molecular dynamics simulations were conducted to examine how the tautomeric forms of H55 affect the dynamic motions of the distal histidine that govern the switching between open and closed conformations. The calculations support the modified hypothesis suggesting a competition between the strength of interactions with heme ligand and the heme propionates as the factors that determine the conformation of the distal histidine. PMID:24670063

10 CFR 72.94 - Design basis external man-induced events.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Design basis external man-induced events. 72.94 Section 72... WASTE Siting Evaluation Factors § 72.94 Design basis external man-induced events. (a) The region must be examined for both past and present man-made facilities and activities that might endanger the proposed...

10 CFR 72.94 - Design basis external man-induced events.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Design basis external man-induced events. 72.94 Section 72... WASTE Siting Evaluation Factors § 72.94 Design basis external man-induced events. (a) The region must be examined for both past and present man-made facilities and activities that might endanger the proposed...

10 CFR 72.94 - Design basis external man-induced events.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Design basis external man-induced events. 72.94 Section 72... WASTE Siting Evaluation Factors § 72.94 Design basis external man-induced events. (a) The region must be examined for both past and present man-made facilities and activities that might endanger the proposed...

10 CFR 72.94 - Design basis external man-induced events.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Design basis external man-induced events. 72.94 Section 72... WASTE Siting Evaluation Factors § 72.94 Design basis external man-induced events. (a) The region must be examined for both past and present man-made facilities and activities that might endanger the proposed...

10 CFR 72.92 - Design basis external natural events.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Design basis external natural events. 72.92 Section 72.92... Evaluation Factors § 72.92 Design basis external natural events. (a) Natural phenomena that may exist or that... potential effects on the safe operation of the ISFSI or MRS. The important natural phenomena that affect the...

10 CFR 72.92 - Design basis external natural events.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Design basis external natural events. 72.92 Section 72.92... Evaluation Factors § 72.92 Design basis external natural events. (a) Natural phenomena that may exist or that... potential effects on the safe operation of the ISFSI or MRS. The important natural phenomena that affect the...

Predicting Internalizing and Externalizing Problems at Five Years by Child and Parental Factors in Infancy and Toddlerhood

ERIC Educational Resources Information Center

Mantymaa, Mirjami; Puura, Kaija; Luoma, Ilona; Latva, Reija; Salmelin, Raili K.; Tamminen, Tuula

2012-01-01

This study examined child and parental factors in infancy and toddlerhood predicting subclinical or clinical levels of internalizing and externalizing problems at 5 years of age. Ninety-six children and their families participated. They were assessed when the children were 4-10 weeks old (T1), 2 years (T2) and 5 years old (T3). Child risks…

External Factors Affecting the Mission Statement of Community Colleges Accredited by the Southern Association of Colleges and Schools Commission on Colleges

ERIC Educational Resources Information Center

Anderson, Larry D.

2012-01-01

This study evaluated the perception of community college presidents regarding the influence of external factors on the mission statement of selected community colleges. Additional purposes of the study were to determine the perception of these presidents when compared by identified demographic data. Chapter 2 was based on a systematic review of…

The relationship between primary healthcare providers and their external supervisors in Rwanda

PubMed Central

Itangishaka, Sylvere

2017-01-01

Background External supervision of Rwandan primary healthcare facilities unfolds as an interaction between supervisors and healthcare providers. Their relationship has not been thoroughly studied in Rwanda, and rarely in Africa. Aim To explore perceived characteristics and effects of the relationship between providers in public primary healthcare facilities and their external supervisors in Rwanda. Setting We conducted three focus group discussions with primary healthcare providers (n = 16), three with external supervisors (n = 15) and one mixed (n = 5). Methods Focus groups were facilitated under low-moderator involvement. Findings were extracted thematically and discussed with participating and non-participating providers and supervisors. Results While external supervision is intended as a source of motivation and professional development in addition to its managerial purpose, it appeared linked to excessive evaluation anxiety among Rwandan primary healthcare providers. Supervisors related this mainly to inescapable evaluations within performance-based financing, whereas providers additionally related it to communication problems. Conclusion External supervision appeared driven by systematic performance evaluations, which may prompt a strongly asymmetric supervisory power relation and challenge intentions to explore providers’ experienced work problems. There is a risk that this may harm provider motivation, calling for careful attention to factors that influence the supervisory relationship. It is a dilemma that providers most in need of supervision to improve performance may be most unlikely to benefit from it. This study reveals a need for provider-oriented supportive supervision including constructive attention on providers who have performance difficulties, effective relationship building and communication, objective and diligent evaluation and two-way feedback channels. PMID:29113446

Infancy parenting and externalizing psychopathology from childhood through adulthood: developmental trends.

PubMed

Lorber, Michael F; Egeland, Byron

2009-07-01

Developmental models and previous findings suggest that early parenting is more strongly associated with externalizing problems in early childhood than it is in adolescence. In this article, the authors address whether the association of poor-quality infancy parenting and externalizing problems "rebounds" in adulthood. Poor-quality infancy parenting was associated with externalizing problems at kindergarten and first grade (mother report) as well as at 23 and 26 years (self report). Infancy parenting was not significantly associated with either mothers' or youths' reports of externalizing problems at 16 years. These findings are consistent with the notion that poor-quality infancy parenting is a risk factor for externalizing problems in developmental periods for which externalizing behavior is most deviant.

Open innovation and external sources of innovation. An opportunity to fuel the R&D pipeline and enhance decision making?

PubMed

Schuhmacher, Alexander; Gassmann, Oliver; McCracken, Nigel; Hinder, Markus

2018-05-08

Historically, research and development (R&D) in the pharmaceutical sector has predominantly been an in-house activity. To enable investments for game changing late-stage assets and to enable better and less costly go/no-go decisions, most companies have employed a fail early paradigm through the implementation of clinical proof-of-concept organizations. To fuel their pipelines, some pioneers started to complement their internal R&D efforts through collaborations as early as the 1990s. In recent years, multiple extrinsic and intrinsic factors induced an opening for external sources of innovation and resulted in new models for open innovation, such as open sourcing, crowdsourcing, public-private partnerships, innovations centres, and the virtualization of R&D. Three factors seem to determine the breadth and depth regarding how companies approach external innovation: (1) the company's legacy, (2) the company's willingness and ability to take risks and (3) the company's need to control IP and competitors. In addition, these factors often constitute the major hurdles to effectively leveraging external opportunities and assets. Conscious and differential choices of the R&D and business models for different companies and different divisions in the same company seem to best allow a company to fully exploit the potential of both internal and external innovations.

Predictors for work participation in individuals with an Autism spectrum disorder: a systematic review.

PubMed

Holwerda, Anja; van der Klink, Jac J L; Groothoff, Johan W; Brouwer, Sandra

2012-09-01

Research shows that only about 25% of people with autism are employed. We conducted a systematic review on factors facilitating or hindering work participation of people with autism in longitudinal studies. An extensive search in biomedical and psychological databases yielded 204 articles and 18 satisfied all inclusion criteria. We assessed the methodological quality of included studies using an established criteria list. Seventeen factors were identified and categorized as disease-related factors, personal factors or external factors. Limited cognitive ability was the only significant predictor consistently found for work outcome. Functional independence and institutionalization were both reported by one study to be significantly related to work outcome. Inconsistent findings or non significant findings were reported for the other fourteen factors. These findings emphasize the need for more high quality cohort studies focussing on work participation as the main outcome among people with Autism.

The manifestation of depression in the context of urban poverty: a factor analysis of the Children's Depression Inventory in low-income urban youth.

PubMed

Taylor, Jeremy J; Grant, Kathryn E; Amrhein, Kelly; Carter, Jocelyn Smith; Farahmand, Farahnaz; Harrison, Aubrey; Thomas, Kina J; Carleton, Russell A; Lugo-Hernandez, Eduardo; Katz, Brian N

2014-12-01

The current study used confirmatory factor analysis (CFA) to compare the fit of 2 factor structures for the Children's Depression Inventory (CDI) in an urban community sample of low-income youth. Results suggest that the 6-factor model developed by Craighead and colleagues (1998) was a strong fit to the pattern of symptoms reported by low-income urban youth and was a superior fit with these data than the original 5-factor model of the CDI (Kovacs, 1992). Additionally, results indicated that all 6 factors from the Craighead model contributed to the measurement of depression, including School Problems and Externalizing Problems especially for older adolescents. This pattern of findings may reflect distinct contextual influences of urban poverty on the manifestation and measurement of depression in youth. (c) 2014 APA, all rights reserved.

Development of controlled drug delivery systems for bone fracture-targeted therapeutic delivery: A review.

PubMed

Wang, Yuchen; Newman, Maureen R; Benoit, Danielle S W

2018-06-01

Impaired fracture healing is a major clinical problem that can lead to patient disability, prolonged hospitalization, and significant financial burden. Although the majority of fractures heal using standard clinical practices, approximately 10% suffer from delayed unions or non-unions. A wide range of factors contribute to the risk for nonunions including internal factors, such as patient age, gender, and comorbidities, and external factors, such as the location and extent of injury. Current clinical approaches to treat nonunions include bone grafts and low-intensity pulsed ultrasound (LIPUS), which realizes clinical success only to select patients due to limitations including donor morbidities (grafts) and necessity of fracture reduction (LIPUS), respectively. To date, therapeutic approaches for bone regeneration rely heavily on protein-based growth factors such as INFUSE, an FDA-approved scaffold for delivery of bone morphogenetic protein 2 (BMP-2). Small molecule modulators and RNAi therapeutics are under development to circumvent challenges associated with traditional growth factors. While preclinical studies has shown promise, drug delivery has become a major hurdle stalling clinical translation. Therefore, this review overviews current therapies employed to stimulate fracture healing pre-clinically and clinically, including a focus on drug delivery systems for growth factors, parathyroid hormone (PTH), small molecules, and RNAi therapeutics, as well as recent advances and future promise of fracture-targeted drug delivery. Copyright © 2018 Elsevier B.V. All rights reserved.

Advanced traveler information service (ATIS) : "Who are ATIS customers?

DOT National Transportation Integrated Search

2000-01-01

This paper offers answers to "Who are ATIS Customers?" using different, complementary research and evaluation approaches. The first section, entitled External Factors Influencing Customer Demand, offers an empirical assessment of external conditions ...

A theoretical study of microwave beam absorption by a rectenna, introduction. [solar power satellites

NASA Technical Reports Server (NTRS)

1981-01-01

The conditions required for a large rectenna array (i.e., reference design) to absorb nearly 100% of transmitted energy were studied. Design parameters including element spacing, and the manner in which these affect scatter were formulated. Amplitudes and directions of scatter and development of strategies for mitigation were also investigated. The effects on rectenna behavior of external factors such as weather and aircraft overflights were determined.

Report to Congress on Arctic Operations and the Northwest Passage

DTIC Science & Technology

2011-05-19

interests in the region. Intergovernmental and non -state actors, including the media, and State actors external to the region will seek to play...developing, and implementing Arctic policy on a range of issues. Non -state actors such as oil, gas, shipping, and tourism companies; indigenous...assessment looks at the near- (2010-2020), mid- (2020-2030), and far-term (beyond 2030), and factors in non -material capabilities, such as having a cadre

Validating an Agency-based Tool for Measuring Women's Empowerment in a Complex Public Health Trial in Rural Nepal.

PubMed

Gram, Lu; Morrison, Joanna; Sharma, Neha; Shrestha, Bhim; Manandhar, Dharma; Costello, Anthony; Saville, Naomi; Skordis-Worrall, Jolene

2017-01-02

Despite the rising popularity of indicators of women's empowerment in global development programmes, little work has been done on the validity of existing measures of such a complex concept. We present a mixed methods validation of the use of the Relative Autonomy Index for measuring Amartya Sen's notion of agency freedom in rural Nepal. Analysis of think-aloud interviews ( n  = 7) indicated adequate respondent understanding of questionnaire items, but multiple problems of interpretation including difficulties with the four-point Likert scale, questionnaire item ambiguity and difficulties with translation. Exploratory Factor Analysis of a calibration sample ( n  = 511) suggested two positively correlated factors ( r  = 0.64) loading on internally and externally motivated behaviour. Both factors increased with decreasing education and decision-making power on large expenditures and food preparation. Confirmatory Factor Analysis on a validation sample ( n  = 509) revealed good fit (Root Mean Square Error of Approximation 0.05-0.08, Comparative Fit Index 0.91-0.99). In conclusion, we caution against uncritical use of agency-based quantification of women's empowerment. While qualitative and quantitative analysis revealed overall satisfactory construct and content validity, the positive correlation between external and internal motivations suggests the existence of adaptive preferences. High scores on internally motivated behaviour may reflect internalized oppression rather than agency freedom.

Validating an Agency-based Tool for Measuring Women’s Empowerment in a Complex Public Health Trial in Rural Nepal

PubMed Central

Gram, Lu; Morrison, Joanna; Sharma, Neha; Shrestha, Bhim; Manandhar, Dharma; Costello, Anthony; Saville, Naomi; Skordis-Worrall, Jolene

2017-01-01

Abstract Despite the rising popularity of indicators of women’s empowerment in global development programmes, little work has been done on the validity of existing measures of such a complex concept. We present a mixed methods validation of the use of the Relative Autonomy Index for measuring Amartya Sen’s notion of agency freedom in rural Nepal. Analysis of think-aloud interviews (n = 7) indicated adequate respondent understanding of questionnaire items, but multiple problems of interpretation including difficulties with the four-point Likert scale, questionnaire item ambiguity and difficulties with translation. Exploratory Factor Analysis of a calibration sample (n = 511) suggested two positively correlated factors (r = 0.64) loading on internally and externally motivated behaviour. Both factors increased with decreasing education and decision-making power on large expenditures and food preparation. Confirmatory Factor Analysis on a validation sample (n = 509) revealed good fit (Root Mean Square Error of Approximation 0.05–0.08, Comparative Fit Index 0.91–0.99). In conclusion, we caution against uncritical use of agency-based quantification of women’s empowerment. While qualitative and quantitative analysis revealed overall satisfactory construct and content validity, the positive correlation between external and internal motivations suggests the existence of adaptive preferences. High scores on internally motivated behaviour may reflect internalized oppression rather than agency freedom. PMID:28303173

The use of weightbearing radiographs to assess the stability of supination-external rotation fractures of the ankle.

PubMed

Weber, Martin; Burmeister, Helge; Flueckiger, Gerhard; Krause, Fabian G

2010-05-01

Isolated lateral malleolar fractures usually result from a supination-external rotation (SER) injury and may include a deltoid ligament rupture. The necessity of operative treatment is based on the recognition of a relevant medial soft-tissue disruption. Currently used tests to assess ankle stability include manual stress radiographs and gravity stress radiographs, but seem to overestimate the need for fracture fixation. We investigated the use of weightbearing radiographs to distinguish stable and unstable isolated lateral malleolar fractures induced by the SER mechanism in 57 patients. Patients with stable fractures (SER type II according to the Lauge-Hansen classification) were treated non-operatively with varying external support. Forty-seven patients were evaluated by questionnaire and AOFAS ankle-hindfoot score. Follow-up was 18-120 months (mean 62). Fifty-one of fifty-seven (90%) patients were found to have stable fractures (SER type II) and were treated nonoperatively. The AOFAS score was 96.1 points on average (range 85-100) at latest follow-up. Four patients reported minor complaints. A "moderate" correlation of risk factors (i.e. smoking) to delayed bone healing was found while the correlation of varying external support (i.e. bandage, cast) to the AOFAS score and delayed bone healing was "poor". The use of weightbearing radiographs is an easy, pain-free, safe and reliable method to exclude the need for operative treatment, with excellent clinical outcome in the majority of the patients seen at latest follow-up. The delay of 3-10 days until the decision about surgical treatment is well accepted by the patients.

Children exposed to war/terrorism.

PubMed

Shaw, Jon A

2003-12-01

This paper reviews the prevalence of psychological morbidities in children who have been exposed to war-related traumas or terrorism as well as the diversity of war-related casualties and their associated psychological responses. The psychological responses to war-related stressors are categorized as (1) little or no reaction, (2) acute emotional and behavioral effects, and (3) long-term effects. Specific categories of war-related casualties discussed include refugee status, traumatic bereavement, effects of parental absence, and child soldiers. Psychological responses associated with terrorism and bioterrorism are presented. Lastly, mediators of the psychological response to war-related stressors are discussed, to include exposure effects, gender effects, parental, family and social factors, and child-specific factors. Children exposed to war-related stressors experience a spectrum of psychological morbidities including posttraumatic stress symptomatology, mood disorders, externalizing and disruptive behaviors, and somatic symptoms determined by exposure dose effect. Specific questions for future research are identified.

Radiological and toxicological assessment of an external heat (burn) test of the 105MM cartridge, APFSDS-T, XM-744

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

Gilchrist, R.L.; Parker, G.B.; Mishima, J.

1978-03-01

The potential radiological and toxicological hazard of depleted uranium aerosol release was investigated. This type of release might arise from accidents with XM-774 ammunition involving great heat. Twelve rounds of packaged ammunition were subjected to an external heat (burn) test. Examination of the site on the day following the test revealed that all 12 depleted uranium penetrators were completely intact. Oxidation of the penetrators was not apparent, even on the most severely burned projectile located at ground zero. Eleven of the 12 projectiles were recovered with the sabots intact; some sabots appeared charred. It was concluded that no airborne releasemore » of depleted uranium had occurred and subsequently there had been no radiological or toxicological hazard from DU during this test. However, this conclusion may not apply to the release of depleted uranium in other types of fires involving this ammunition because other factors may affect the fire. These factors include type of fuel, number of ammunition rounds, and type of structure housing the ammunition.« less

The natural history of substance use disorders.

PubMed

Sarvet, Aaron L; Hasin, Deborah

2016-07-01

Illicit drugs, alcohol, and tobacco use disorders contribute substantially to the global burden of disease. Knowledge about the major elements of the natural history of substance use disorders (incidence, remission, persistence, and relapse) is crucial to a broader understanding of the course and outcomes of substance use disorders. Prospective cohort studies in nonclinical samples indicate that externalizing psychopathology in earlier life, including early disordered substance use, delinquency, and personality disorders, are related to substance use disorders later in life and chronic course. Externalizing psychopathology may be initiated by early adverse experiences, for example, childhood maltreatment and stressful life events. After controlling for confounders, 'age at first use' as a causal factor for alcohol use disorder later in life and the 'drug substitution' hypothesis are not supported in general population data. Future research should focus on elaborating the causal framework that leads to the development and persistence of severe substance use disorders, with an emphasis on identifying modifiable factors for intervention by policy makers or health professionals. More research is needed on the natural history of substance use disorders in low-income and middle-income countries.

Psychosocial Consequences of Caregiver Transitions for Maltreated Youth Entering Foster Care: The Moderating Impact of Community Violence Exposure

PubMed Central

Garrido, Edward F.; Culhane, Sara E.; Petrenko, Christie L. M.; Taussig, Heather N.

2011-01-01

Youth who experience a greater number of caregiver transitions during childhood are at risk for developing a host of psychosocial problems. Although researchers have examined individual-level factors that may moderate this association, no known studies have examined the impact of community-level factors. The current study investigated whether community violence exposure moderated the association between number of prior caregiver transitions and increases in levels of externalizing and internalizing problems for a sample of youth entering foster care. Participants included 156 youth (age 9 to 11 at first assessment) removed from their homes because of maltreatment. Youth provided reports of caregiver transitions and community violence exposure at baseline, and caregivers, teachers, and youth reported on externalizing and internalizing problems 18–22 months later. Results from hierarchical multiple regression analyses indicated that youth with a greater number of caregiver transitions and higher levels of community violence exposure evidenced significant increases in levels of psychosocial problems. The results of the study are discussed in terms of their implications for child welfare services. PMID:21729018

Lunar base thermal management/power system analysis and design

NASA Technical Reports Server (NTRS)

Mcghee, Jerry R.

1992-01-01

A compilation of several lunar surface thermal management and power system studies completed under contract and IR&D is presented. The work includes analysis and preliminary design of all major components of an integrated thermal management system, including loads determination, active internal acquisition and transport equipment, external transport systems (active and passive), passive insulation, solar shielding, and a range of lunar surface radiator concepts. Several computer codes were utilized in support of this study, including RADSIM to calculate radiation exchange factors and view factors, RADIATOR (developed in-house) for heat rejection system sizing and performance analysis over a lunar day, SURPWER for power system sizing, and CRYSTORE for cryogenic system performance predictions. Although much of the work was performed in support of lunar rover studies, any or all of the results can be applied to a range of surface applications. Output data include thermal loads summaries, subsystem performance data, mass, and volume estimates (where applicable), integrated and worst-case lunar day radiator size/mass and effective sink temperatures for several concepts (shielded and unshielded), and external transport system performance estimates for both single and two-phase (heat pumped) transport loops. Several advanced radiator concepts are presented, along with brief assessments of possible system benefits and potential drawbacks. System point designs are presented for several cases, executed in support of the contract and IR&D studies, although the parametric nature of the analysis is stressed to illustrate applicability of the analysis procedure to a wide variety of lunar surface systems. The reference configuration(s) derived from the various studies will be presented along with supporting criteria. A preliminary design will also be presented for the reference basing scenario, including qualitative data regarding TPS concerns and issues.

Etiologic analysis of 100 anatomically failed dacryocystorhinostomies

PubMed Central

Dave, Tarjani Vivek; Mohammed, Faraz Ali; Ali, Mohammad Javed; Naik, Milind N

2016-01-01

Background The aim of this study was to assess the etiological factors contributing to the failure of a dacryocystorhinostomy (DCR). Patients and methods Retrospective review was performed in 100 consecutive patients who were diagnosed with anatomically failed DCR at presentation to a tertiary care hospital over a 5-year period from 2010 to 2015. Patient records were reviewed for demographic data, type of past surgery, preoperative endoscopic findings, previous use of adjuvants such as intubation and mitomycin C, and intraoperative notes during the re-revision. The potential etiological factors for failure were noted. Results Of the 100 patients with failed DCRs, the primary surgery was an external DCR in 73 and endoscopic DCR in 27 patients. Six patients in each group had multiple revisions. The mean ages at presentation in the external and endoscopic groups were 39.41 years and 37.19 years, respectively. All patients presented with epiphora. The most common causes of failure were inadequate osteotomy (69.8% in the external group and 85.1% in the endoscopic group, P=0.19) followed by inadequate or inappropriate sac marsupialization (60.2% in the external group and 77.7% in the endoscopic group, P=0.16) and cicatricial closure of the ostium (50.6% in the external group and 55.5% in the endoscopic group, P=0.83). The least common causes such as ostium granulomas and paradoxical middle turbinate (1.37%, n=1) were noted in the external group only. Conclusion Inadequate osteotomy, incomplete sac marsupialization, and cicatricial closure of the ostium were the most common causes of failure and did not significantly differ in the external and endoscopic groups. Meticulous evaluation to identify causative factors for failure and addressing them are crucial for subsequent successful outcomes. PMID:27555748

External fixation of tibial pilon fractures and fracture healing.

PubMed

Ristiniemi, Jukka

2007-06-01

Distal tibial fractures are rare and difficult to treat because the bones are subcutaneous. External fixation is commonly used, but the method often results in delayed union. The aim of the present study was to find out the factors that affect fracture union in tibial pilon fractures. For this purpose, prospective data collection of tibial pilon fractures was carried out in 1998-2004, resulting in 159 fractures, of which 83 were treated with external fixation. Additionally, 23 open tibial fractures with significant > 3 cm bone defect that were treated with a staged method in 2000-2004 were retrospectively evaluated. The specific questions to be answered were: What are the risk factors for delayed union associated with two-ring hybrid external fixation? Does human recombinant BMP-7 accelerate healing? What is the role of temporary ankle-spanning external fixation? What is the healing potential of distal tibial bone loss treated with a staged method using antibiotic beads and subsequent autogenous cancellous grafting compared to other locations of the tibia? The following risk factors for delayed healing after external fixation were identified: post-reduction fracture gap of >3 mm and fixation of the associated fibula fracture. Fracture displacement could be better controlled with initial temporary external fixation than with early definitive fixation, but it had no significant effect on healing time, functional outcome or complication rate. Osteoinduction with rhBMP-7 was found to accelerate fracture healing and to shorten the sick leave. A staged method using antibiotic beads and subsequent autogenous cancellous grafting proved to be effective in the treatment of tibial bone loss. Healing potential of the bone loss in distal tibia was at least equally good as in other locations of the tibia.

Nutraceuticals: A Review.

PubMed

Souyoul, Skylar A; Saussy, Katharine P; Lupo, Mary P

2018-03-01

Skin aging is continuously influenced by various internal and external factors such as the biologic progression of cells, ultraviolet (UV) radiation, tobacco, nutritional deficiencies, and hormonal imbalances that lead to the degradation of skin cells. Through the degradation of skin cells, free radicals and inflammation weaken repair mechanisms and result in collagen and elastic fiber breakdown. The appearance of aging skin is highlighted by skin roughness, wrinkling, pigmentation change, telangiectasias, loss of elasticity, and decreased firmness, all of which are accelerated by these internal and external factors. Throughout the years, nutraceuticals have been studied to delay and fight against these internal and external factors, many of which are found in foods and byproducts consumed naturally. The aim of this review is to aid dermatologists in understanding the mechanism of action of popular nutraceuticals and their possible efficacy in antiaging and skin health.

Exposure to Violence and Socioemotional Adjustment in Low-Income Youth: An Examination of Protective Factors

PubMed Central

Hardaway, Cecily R.; McLoyd, Vonnie C.; Wood, Dana

2014-01-01

Using a sample of 391 low-income youth ages 13 to 17, this study investigated the potential moderating effects of school climate, participation in extracurricular activities, and positive parent-child relations on associations between exposure to violence (i.e., witnessing violence and violent victimization) and adolescent socioemotional adjustment (i.e., internalizing and externalizing problems). Exposure to violence was related to both internalizing and externalizing problems. High levels of participation in extracurricular activities and positive parent-child relations appeared to function as protective factors, weakening the positive association between exposure to violence and externalizing problems. Contrary to prediction, school climate did not moderate associations between exposure to violence and socioemotional adjustment. Further, none of the hypothesized protective factors moderated the association between exposure to violence and internalizing problems. PMID:21607826

Identification of major factors in Australian primary care pharmacists' practice environment that have a bearing on the implementation of professional models of practice.

PubMed

Jackson, John K; Hussainy, Safeera Y; Kirkpatrick, Carl M J

2017-08-01

Objective The aim of the present study was to describe an environmental framework for pharmacists in primary care in Australia and determine the major factors within that environment that have the greatest bearing on their capacity to implement patient-focused models of professional practice. Methods A draft framework for pharmacists' practice was developed by allocating structures, systems and related factors known to the researchers or identified from the literature as existing within pharmacists' internal, operational and external environments to one of five domains: Social, Technological, Economic, Environmental or Political [STEEP]. Focus groups of pharmacists used an adapted nominal group technique to assess the draft and add factors where necessary. Where applicable, factors were consolidated into groups to establish a revised framework. The three major factors or groups in each domain were identified. The results were compared with the enabling factors described in the profession's vision statement. Results Seventy-eight individual factors were ultimately identified, with 86% able to be grouped. The three dominant groups in each of the five domains that had a bearing on the implementation of professional models of practice were as follows: (1) Social: the education of pharmacists, their beliefs and the capacity of the pharmacist workforce; (2) Technological: current and future practice models, technology and workplace structures; (3) Economic: funding of services, the viability of practice and operation of the Pharmaceutical Benefits Scheme; (4) Environmental: attitudes and expectations of stakeholders, including consumers, health system reform and external competition; and (5) Political: regulation of practice, representation of the profession and policies affecting practice. Conclusions The three dominant groups of factors in each of the five STEEP environmental domains, which have a bearing on pharmacists' capacity to implement patient-focused models of practice, correlate well with the enabling factors identified in the profession's vision statement, with the addition of three factors in the Environmental domain of stakeholder attitudes, health system reform and external competition. What is known about the topic? The extensive range of patient-focused professional programs developed for application by pharmacists in primary care in Australia has yet to be widely implemented. What does this paper add? Factors both within and beyond the pharmacists' immediate practice environment that have a bearing on the uptake of professional programs have been identified and prioritised using a structured thematic approach. What are the implications for practitioners? The results demonstrate the need for a multifactorial approach to the implementation of professional models of practice in this setting.

An investigation of the basic physics of irrigation in urology and the role of automated pump irrigation in cystoscopy.

PubMed

Chang, Dwayne; Manecksha, Rustom P; Syrrakos, Konstantinos; Lawrentschuk, Nathan

2012-01-01

To investigate the effects of height, external pressure, and bladder fullness on the flow rate in continuous, non-continuous cystoscopy and the automated irrigation fluid pumping system (AIFPS). Each experiment had two 2-litre 0.9% saline bags connected to a continuous, non-continuous cystoscope or AIFPS via irrigation tubing. Other equipment included height-adjustable drip poles, uroflowmetry devices, and model bladders. In Experiment 1, saline bags were elevated to measure the increment in flow rate. In Experiment 2, saline bags were placed under external pressures to evaluate the effect on flow rate. In Experiment 3, flow rate changes in response to variable bladder fullness were measured. Elevating saline bags caused an increase in flow rates, however the increment slowed down beyond a height of 80 cm. Increase in external pressure on saline bags elevated flow rates, but inconsistently. A fuller bladder led to a decrease in flow rates. In all experiments, the AIFPS posted consistent flow rates. Traditional irrigation systems were susceptible to changes in height of irrigation solution, external pressure application, and bladder fullness thus creating inconsistent flow rates. The AIFPS produced consistent flow rates and was not affected by any of the factors investigated in the study.

Misalignment with the external light environment drives metabolic and cardiac dysfunction.

PubMed

West, Alexander C; Smith, Laura; Ray, David W; Loudon, Andrew S I; Brown, Timothy M; Bechtold, David A

2017-09-12

Most organisms use internal biological clocks to match behavioural and physiological processes to specific phases of the day-night cycle. Central to this is the synchronisation of internal processes across multiple organ systems. Environmental desynchrony (e.g. shift work) profoundly impacts human health, increasing cardiovascular disease and diabetes risk, yet the underlying mechanisms remain unclear. Here, we characterise the impact of desynchrony between the internal clock and the external light-dark (LD) cycle on mammalian physiology. We reveal that even under stable LD environments, phase misalignment has a profound effect, with decreased metabolic efficiency and disrupted cardiac function including prolonged QT interval duration. Importantly, physiological dysfunction is not driven by disrupted core clock function, nor by an internal desynchrony between organs, but rather the altered phase relationship between the internal clockwork and the external environment. We suggest phase misalignment as a major driver of pathologies associated with shift work, chronotype and social jetlag.The misalignment between internal circadian rhythm and the day-night cycle can be caused by genetic, behavioural and environmental factors, and may have a profound impact on human physiology. Here West et al. show that desynchrony between the internal clock and the external environment alter metabolic parameters and cardiac function in mice.

Food or Thought? Assessing Internal and External Factors Affecting Evaluations of Instructor Effectiveness

ERIC Educational Resources Information Center

Wood, John; Kiggins, Ryan; Kickham, Kenneth

2017-01-01

Within the broader literature concerned with potential bias in student measures of instructor effectiveness, two broad types of bias have been shown to operate in a course: internal and external. Missing is an assessment of the relative influence of each bias type in the classroom. Do internal or external types of bias matter more or less to…

Characteristics of the internal and external sources of the Mediterranean synoptic cyclones for the period 1956-2013

NASA Astrophysics Data System (ADS)

Almazroui, Mansour; Awad, Adel M.; Nazrul Islam, M.

2017-07-01

This paper investigates the main sources and features of the Mediterranean synoptic cyclones affecting the basin, using the cyclone tracks. The cyclones' tracks are identified using sea level pressure (SLP) from the NCEP/NCAR reanalysis data for the period 1956-2013. The identified cyclones are classified into two categories: basin affected and basin non-affected. Most of the basin-affected (non-affected) cyclones are internal (external), i.e., generated inside (outside) the Mediterranean basin. This study reveals four (five) main sources of internal (external) cyclones. These four (five) main sources generated about 63.76% (57.25%) of the internal (external) cyclones. Seasonal analysis shows that most of the basin-affected internal (external) cyclones were generated in the winter (spring) season. The lowest number of cyclones were found in the summer. Moreover, the synoptic study of the atmospheric systems accompanied the highest- and lowest-generated years demonstrates that the deepening of the north Europe cyclones and the relative positions of Azores- and Siberian-high systems represent the important factors that influence the number of internal cyclones. Essential factors influencing the external cyclones are the strength of the maximum upper wind, Azores high, Siberian high, and orientations of their ridges.

Qualitative assessment to determine internal and external factors influencing the origin of styrene oligomers pollution by polystyrene plastic in coastal marine environments.

PubMed

Kwon, Bum Gun; Chung, Seon-Yong; Park, Seung-Shik; Saido, Katsuhiko

2018-03-01

The objective of this study is to investigate the qualitative contribution of internal and external factors of the area contaminated by polystyrene (PS) in coastal marine environments. This study is based on the extensive results of monitoring the styrene oligomers (SOs) present in sand and seawater samples along various coastlines of the Pacific Ocean. Here, anthropogenic SOs is derived from PS during manufacture and use, and can provide clues about the origin of SOs by PS pollution. The monitoring results showed that, if the concentration of SOs in water is higher than those concentrations in beach sand, this area could be affected by PS plastic caused by an external factor. On the other hand, if the concentration of SOs is higher in the beach sand, the region can be mainly influenced by PS plastic derived from its own area. Unlike the case of an external factor, in this case (internal influence), it is possible to take policy measures of the area itself for the PS plastic problem. Thus, this study is motivated by the need of policy measures to establish a specific alternative to the problems of PS plastic pollution in ocean environments. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Spanish adaptation of the Stress Manifestations Scale of the Student Stress Inventory (SSI-SM)].

PubMed

Escobar Espejo, Milagros; Blanca, María J; Fernández-Baena, F Javier; Trianes Torres, María Victoria

2011-08-01

The aim of the present study was to translate into Spanish and to describe the psychometric properties of the Stress Manifestations Scale of the Student Stress Inventory (SSI-SM), developed by Fimian, Fastenau, Tashner and Cross to identify the main manifestations of stress in adolescents. The scale was applied to a sample of 1,002 pupils from years one and two of Secondary Education. The paper reports the factor structure, an item analysis, the internal consistency, differences by sex and academic year, external evidence of validity, and norms for scoring the scale. The results reveal a factor structure based on three first-order factors (emotional manifestations, physiological manifestations and behavioural manifestations) and one second-order factor (indicative of stress manifestations). In terms of external validity, there was a positive association with measures of perceived stress, aggressiveness, internalized/externalized symptoms, and a negative association with life satisfaction. The results show that the scale is an adequate tool for evaluating stress manifestations in adolescents.

Premature Adult Death in Individuals Born Preterm: A Sibling Comparison in a Prospective Nationwide Follow-Up Study.

PubMed

Risnes, Kari R; Pape, Kristine; Bjørngaard, Johan H; Moster, Dag; Bracken, Michael B; Romundstad, Pal R

2016-01-01

Close to one in ten individuals worldwide is born preterm, and it is important to understand patterns of long-term health and mortality in this group. This study assesses the relationship between gestational age at birth and early adult mortality both in a nationwide population and within sibships. The study adds to existing knowledge by addressing selected causes of death and by assessing the role of genetic and environmental factors shared by siblings. Study population was all Norwegian men and women born from 1967 to 1997 followed using nation-wide registry linkage for mortality through 2011 when they were between 15 and 45 years of age. Analyses were performed within maternal sibships to reduce variation in unobserved genetic and environmental factors shared by siblings. Specific outcomes were all-cause mortality and mortality from cardiovascular diseases, cancer and external causes including accidents, suicides and drug abuse/overdoses. Compared with a sibling born in week 37-41, preterm siblings born before 34 weeks gestation had 50% increased mortality from all causes (adjusted Hazard Ratio (aHR) 1.54, 95% confidence interval (CI) 1.17, 2.03). The corresponding estimate for the entire population was 1.27 (95% CI 1.09, 1.47). The majority of deaths (65%) were from external causes and the corresponding risk estimates for these deaths were 1.52 (95% CI 1.08, 2.14) in the sibships and 1.20 (95% CI 1.01, 1.43) in the population. Preterm birth before week 34 was associated with increased mortality between 15 and 45 years of age. The results suggest that increased premature adult mortality in this group is related to external causes of death and that the increased risks are unlikely to be explained by factors shared by siblings.

Internalizing symptoms and conduct problems: Redundant, incremental, or interactive risk factors for adolescent substance use during the first year of high school?

PubMed

Khoddam, Rubin; Jackson, Nicholas J; Leventhal, Adam M

2016-12-01

The complex interplay of externalizing and internalizing problems in substance use risk is not well understood. This study tested whether the relationship of conduct problems and several internalizing disorders with future substance use is redundant, incremental, or interactive in adolescents. Two semiannual waves of data from the Happiness and Health Study were used, which included 3383 adolescents (M age=14.1years old; 53% females) in Los Angeles who were beginning high school at baseline. Logistic regression models tested the likelihood of past six-month alcohol, tobacco, marijuana, and any substance use at follow-up conditional on baseline conduct problems, symptoms of one of several internalizing disorders (i.e., Social Phobia and Major Depressive, Generalized Anxiety, Panic, and Obsessive-Compulsive Disorder), and their interaction adjusting for baseline use and other covariates. Conduct problems were a robust and consistent risk factor of each substance use outcome at follow-up. When adjusting for the internalizing-conduct comorbidity, depressive symptoms were the only internalizing problem whose risk for alcohol, tobacco, and any substance use was incremental to conduct problems. With the exception of social phobia, antagonistic interactive relationships between each internalizing disorder and conduct problems were found when predicting any substance use; internalizing symptoms was a more robust risk factor for substance use in teens with low (vs. high) conduct problems. Although internalizing and externalizing problems both generally increase risk of substance use, a closer look reveals important nuances in these risk pathways, particularly among teens with comorbid externalizing and internalizing problems. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Urinary Infections in Patients with Catheters in the Upper Urinary Tract: Microbiological Study.

PubMed

Lara-Isla, Alba; Medina-Polo, José; Alonso-Isa, Manuel; Benítez-Sala, Raúl; Sopeña-Sutil, Raquel; Justo-Quintas, Juan; Gil-Moradillo, Javier; González-Padilla, Daniel A; García-Rojo, Esther; Passas-Martínez, Juan Bautista; Tejido-Sánchez, Ángel

2017-01-01

Infections related to catheters in the upper urinary tract (CUUT) are associated with specific characteristics. A prospective observational study was carried out from 2012 to 2015 to evaluate infections in patients with CUUT. A total of 209 infections were included (99 with double-J, 81 with nephrostomy, and 29 with internal/external nephroureteral stents). Among nephrostomy tube carriers, the most frequently isolated microorganisms were Pseudomonas and Enterococcus. In those with an internal/external nephroureteral stent, Klebsiella was the most common, and 57.1% were extended-spectrum beta-lactamase-producing Klebsiella. In double-J carriers, Escherichia coli and Enterococcus were the most common microorganisms. Multiple-drug resistance (MDR) microorganisms were isolated in 28.6, 47.1, and 58.3% of patients with double-J, nephrostomy, and internal-external nephroureteral stents. A percutaneous CUUT (p = 0.005) and immunosuppression (p = 0.034) were risk factors for MDR microorganisms. Non-E. coli bacteria are commonly isolated in patients with CUUT. MDR microorganisms are frequent, mainly in percutaneous approach or immunosuppression. © 2017 S. Karger AG, Basel.

Achieving external validity in home advantage research: generalizing crowd noise effects

PubMed Central

Myers, Tony D.

2014-01-01

Different factors have been postulated to explain the home advantage phenomenon in sport. One plausible explanation investigated has been the influence of a partisan home crowd on sports officials' decisions. Different types of studies have tested the crowd influence hypothesis including purposefully designed experiments. However, while experimental studies investigating crowd influences have high levels of internal validity, they suffer from a lack of external validity; decision-making in a laboratory setting bearing little resemblance to decision-making in live sports settings. This focused review initially considers threats to external validity in applied and theoretical experimental research. Discussing how such threats can be addressed using representative design by focusing on a recently published study that arguably provides the first experimental evidence of the impact of live crowd noise on officials in sport. The findings of this controlled experiment conducted in a real tournament setting offer a level of confirmation of the findings of laboratory studies in the area. Finally directions for future research and the future conduct of crowd noise studies are discussed. PMID:24917839

The external-internal loop of interference: Two types of attention and their influence on the learning abilities of mice

PubMed Central

Sauce, Bruno; Wass, Christopher; Smith, Andrew; Kwan, Stephanie; Matzel, Louis D.

2016-01-01

Attention is a component of the working memory system, and as such, is responsible for protecting task-relevant information from interference. Cognitive performance (particularly outside of the laboratory) is often plagued by interference, and the source of this interference, either external or internal, might influence the expression of individual differences in attentional ability. By definition, external attention (also described as “selective attention”) protects working memory against sensorial distractors of all kinds, while internal attention (also called “inhibition”) protects working memory against emotional impulses, irrelevant information from memory, and automatically-generated responses. At present, it is unclear if these two types of attention are expressed independently in non-human animals, and how they might differentially impact performance on other cognitive processes, such as learning. By using a diverse battery of four attention tests (with varying levels of internal and external sources of interference), here we aimed both to explore this issue, and to obtain a robust and general (less task-specific) measure of attention in mice. Exploratory factor analyses revealed two factors (external and internal attention) that in total, accounted for 73% of the variance in attentional performance. Confirmatory factor analyses found an excellent fit with the data of the model of attention that assumed an external and internal distinction (with a resulting correlation of 0.43). In contrast, a model of attention that assumed one source of variance (i.e., “general attention”) exhibited a poor fit with the data. Regarding the relationship between attention and learning, higher resistance against external sources of interference promoted better new learning, but tended to impair performance when cognitive flexibility was required, such as during the reversal of a previously instantiated response. The present results suggest that there can be (at least) two types of attention that contribute to the common variance in attentional performance in mice, and that external and internal attentions might have opposing influences on the rate at which animals learn. PMID:25452087

Substratum location and zoospore behaviour in the fouling alga Enteromorpha.

PubMed

Callow, M E; Callow, J A

2000-01-01

The green alga Enteromorpha is the most important macroalga that fouls ships, submarines and underwater structures. Major factors in its success in colonising new substrata are the production of enormous numbers of swimming spores and their ability to locate surfaces on which to settle. Factors facilitating the settlement and adhesion of asexual zoospores are examined in this article. Settlement and adhesion may be regulated by topographical, biological, chemical and physico-chemical cues, all of which are modified by the presence of microbial biofilm. The level of gregarious zoospore settlement is related to spore density and may be mediated by a number of external cues including fatty acids and 'detritus'.

The Use of Concrete Experiences in Early Childhood Mathematics Instruction.

PubMed

Baroody, Arthur J

2017-01-01

Addressed are four key issues regarding concrete instruction: What is concrete? What is a worthwhile concrete experience? How can concrete experiences be used effectively in early childhood mathematics instruction? Is there evidence such experiences work? I argue that concrete experiences are those that build on what is familiar to a child and can involve objects, verbal analogies, or virtual images. The use of manipulatives or computer games, for instance, does not in itself guarantee an educational experience. Such experiences are worthwhile if they target and further learning (e.g., help children extend their informal knowledge or use their informal knowledge to understand and learn formal knowledge). A crucial guideline for the effective use of concrete experience is Dewey's principle of interaction-external factors (e.g., instructional activities) need to mesh with internal factors (readiness, interest). Cognitive views of concrete materials, such as the cognitive alignment perspective and dual-representation hypothesis, provide useful guidance about external factors but do not adequately take into account internal factors and their interaction with external factors. Research on the effectiveness of concrete experience is inconclusive because it frequently overlooks internal factors. © 2017 Elsevier Inc. All rights reserved.

SUMS calibration test report

NASA Technical Reports Server (NTRS)

Robertson, G.

1982-01-01

Calibration was performed on the shuttle upper atmosphere mass spectrometer (SUMS). The results of the calibration and the as run test procedures are presented. The output data is described, and engineering data conversion factors, tables and curves, and calibration on instrument gauges are included. Static calibration results which include: instrument sensitive versus external pressure for N2 and O2, data from each scan of calibration, data plots from N2 and O2, and sensitivity of SUMS at inlet for N2 and O2, and ratios of 14/28 for nitrogen and 16/32 for oxygen are given.

Barriers to blood glucose monitoring in a multiethnic community.

PubMed

Zgibor, Janice C; Simmons, David

2002-10-01

We studied a multiethnic community to determine factors associated with blood glucose monitoring (BGM) and to determine the independent association between barriers to diabetes care and BGM. A total of 323 participants (35.6% European, 32.2% Maori, and 32.2% Pacific Islander) from the South Auckland Diabetes Project (free of major complications by self-report) completed a qualitative survey to determine barriers to diabetes care. Five barriers to diabetes care categories were generated including internal psychological (self efficacy/health beliefs), external psychological (psychosocial environment), internal physical (comorbidities/side effects of treatment), external physical (finance/access to care), and educational (knowledge of diabetes/services) barriers. Characteristics associated with BGM greater than or equal to twice weekly were female sex, HbA(1c) >8%, higher diabetes knowledge scores, and insulin use. Multivariate analyses demonstrated that those reporting external physical barriers (OR 0.47, 95% CI 0.26-0.84), external psychological barriers (0.55, 0.30-1.0), and internal psychological barriers (0.56, 0.32-1.0) were less likely to perform BGM independent of ethnicity, insulin use, age, sex, diabetes knowledge, and glycemic control. Further multivariate analyses demonstrated that those reporting external physical barriers, particularly related to personal finance, were less likely to perform BGM. These data demonstrate that patient-reported barriers to diabetes care are associated with BGM, particularly in relation to financial, psychosocial, and self-efficacy issues. Understanding these barriers and overcoming them within the context of the patient's ethnic environment may lead to increased participation in self-care.

Masculine Traits and Depressive Symptoms in Older and Younger Men and Women

PubMed Central

Price, Elizabeth C.; Gregg, Jeffrey J.; Smith, Merideth D.; Fiske, Amy

2015-01-01

Evidence suggests that men who strongly endorse masculine traits display an atypical presentation of depression, including more externalizing symptoms (e.g., anger or substance use), but fewer typical, internalizing symptoms (e.g., depressed mood or crying). This phenomenon has not been adequately explored in older adults or women. The current study used the externalizing subscale of the Masculine Depression Scale in older and younger men and women to detect atypical symptoms. It was predicted that individuals who more strongly endorsed masculine traits would have higher scores on the measure of externalizing symptoms relative to a measure of typical depressive symptoms Center for Epidemiologic Studies–Depression Scale. It was anticipated that results would differ by age-group but not by gender. Multigroup path analysis was used to test the hypothesis. The hypothesized path model, in which endorsement of masculine traits was associated with lower scores on the Center for Epidemiologic Studies–Depression Scale and with scores on the externalizing, but not internalizing, factor of the Masculine Depression Scale, fit the data well. Results differed significantly by age-group and gender. Masculine individuals reported lower levels of typical depressive symptoms relative to externalizing symptoms, but further research is needed within age- and gender groups. Results are consistent with the gendered responding framework and suggest that current assessment tools, which tend to focus on internalizing symptoms of depression, may not detect depression in individuals who endorse masculine traits. PMID:26634856

Testing the relationship between personality characteristics, contextual factors and entrepreneurial intentions in a developing country.

PubMed

Karimi, Saeid; Biemans, Harm J A; Naderi Mahdei, Karim; Lans, Thomas; Chizari, Mohammad; Mulder, Martin

2017-06-01

Drawing upon the theory of planned behaviour (TPB), we developed and tested a conceptual model which integrates both internal personality factors and external contextual factors to determine their associations with motivational factors and entrepreneurial intentions (EIs). We then investigated if the model of EI applies in a developing country, namely Iran. We also set out to identify the most relevant factors for EI within this developing country context. Do distal predictors of EI including personality factors (i.e. need for achievement, risk taking and locus of control) and contextual factors (i.e. perceived barriers and support) significantly relate to EI via proximal predictors including motivational factors (i.e. attitudes towards entrepreneurship and perceived behavioural control [PBC])? Data were collected on 331 students from 7 public universities. The findings support the TPB for EI in Iran. All three motivational factors related to EI, but PBC showed the strongest association, which is different than in developed country contexts. Possible explanations for these differences are discussed. All three personality characteristics indirectly related to EI via the proximal attitudes towards entrepreneurship and PBC. Perceived contextual support and barriers indirectly related to EI via proximal PBC while perceived barriers also directly related to EI. © 2015 International Union of Psychological Science.

Exploring family home food environments: Household resources needed to utilise weekly deliveries of free fruits and vegetables.

PubMed

Carty, Sophie A; Mainvil, Louise A; Coveney, John D

2017-04-01

An adapted ethnographic approach was used to explore household factors that influence family fruit and vegetable consumption when access and cost barriers are removed. 'Structural' barriers, such as food affordability and accessibility, are likely to influence fruit and vegetable consumption in disadvantaged households, but households may require additional resources (human and social) to increase consumption. Five low-income and five high-income households with children (N = 39 individuals) were observed in their home environment for three months. Including both advantaged and disadvantaged families allowed exploration of socioeconomic factors influencing these households. Each household received a free box of fresh fruit and vegetables each week for 10-12 weeks, delivered to their home, and were home-visited twice a week by a researcher (40+ hours per household). An inductive analysis of rich observational and discussion data revealed themes describing factors influencing household fruit and vegetable consumption. Household food cultures were dynamic and influenced by available resources. Even when free produce was delivered to homes, these households required human resource (personal drivers influenced by early life exposure and household dynamics) and external social networks to make use of them. When household finances and/or labour were limited, there was greater dependence on external organisations for tangible support. Even when structural barriers were removed, disadvantaged families needed a range of resources across the life course to improve eating behaviours, including sufficient, motivated and skilled labour and harmonious family relationships. Strategies targeting these households must consider structural, social, cultural and intra-familial influences on food choice. © 2016 Dietitians Association of Australia.

The Dynamics of Internalizing and Externalizing Comorbidity Across the Early School Years

PubMed Central

Willner, Cynthia J.; Gatzke-Kopp, Lisa M.; Bray, Bethany C.

2017-01-01

High rates of comorbidity are observed between internalizing and externalizing problems, yet the developmental dynamics of comorbid symptom presentations are not yet well understood. This study explored the developmental course of latent profiles of internalizing and externalizing symptoms across kindergarten, 1st, and 2nd grade. The sample consisted of 336 children from an urban, low-income community, selected based on relatively high (61%) or low (39%) aggressive/oppositional behavior problems at school entry (64% male; 70% African American, 20% Hispanic). Teachers reported on children’s symptoms in each year. An exploratory latent profile analysis of children’s scores on aggression/oppositionality, hyperactivity/inattention, anxiety, and social withdrawal symptom factors revealed 4 latent symptom profiles: comorbid (48% of the sample in each year), internalizing (19–23%), externalizing (21–22%), and well-adjusted (7–11%). The developmental course of these symptom profiles was examined using a latent transition analysis, which revealed remarkably high continuity in the comorbid symptom profile (89% from one year to the next) and moderately high continuity in both the internalizing and externalizing profiles (80% and 71%, respectively). Internalizing children had a 20% probability of remitting to the well-adjusted profile by the following year, whereas externalizing children had a 25% probability of transitioning to the comorbid profile. These results are consistent with the hypothesis that a common vulnerability factor contributes to developmentally stable internalizing-externalizing comorbidity, while also suggesting that some children with externalizing symptoms are at risk for subsequently accumulating internalizing symptoms. PMID:27739391

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

Vogelius, Ivan R., E-mail: vogelius@gmail.com; Bentzen, Soren M.

Purpose: To present a novel method for meta-analysis of the fractionation sensitivity of tumors as applied to prostate cancer in the presence of an overall time factor. Methods and Materials: A systematic search for radiation dose-fractionation trials in prostate cancer was performed using PubMed and by manual search. Published trials comparing standard fractionated external beam radiation therapy with alternative fractionation were eligible. For each trial the {alpha}/{beta} ratio and its 95% confidence interval (CI) were extracted, and the data were synthesized with each study weighted by the inverse variance. An overall time factor was included in the analysis, and itsmore » influence on {alpha}/{beta} was investigated. Results: Five studies involving 1965 patients were included in the meta-analysis of {alpha}/{beta}. The synthesized {alpha}/{beta} assuming no effect of overall treatment time was -0.07 Gy (95% CI -0.73-0.59), which was increased to 0.47 Gy (95% CI -0.55-1.50) if a single highly weighted study was excluded. In a separate analysis, 2 studies based on 10,808 patients in total allowed extraction of a synthesized estimate of a time factor of 0.31 Gy/d (95% CI 0.20-0.42). The time factor increased the {alpha}/{beta} estimate to 0.58 Gy (95% CI -0.53-1.69)/1.93 Gy (95% CI -0.27-4.14) with/without the heavily weighted study. An analysis of the uncertainty of the {alpha}/{beta} estimate showed a loss of information when the hypofractionated arm was underdosed compared with the normo-fractionated arm. Conclusions: The current external beam fractionation studies are consistent with a very low {alpha}/{beta} ratio for prostate cancer, although the CIs include {alpha}/{beta} ratios up to 4.14 Gy in the presence of a time factor. Details of the dose fractionation in the 2 trial arms have critical influence on the information that can be extracted from a study. Studies with unfortunate designs will supply little or no information about {alpha}/{beta} regardless of the number of subjects enrolled.« less

Reciprocal modulation of internal and external factors determines individual movements.

PubMed

Martin, Jodie; van Moorter, Bram; Revilla, Eloy; Blanchard, Pierrick; Dray, Stéphane; Quenette, Pierre-Yves; Allainé, Dominique; Swenson, Jon E

2013-03-01

Movement is fundamental to individual and population dynamics, as it allows individuals to meet their basic requirements. Although movement patterns reflect interactions between internal and external factors, only few studies have examined the effects of these factors on movement simultaneously, and they generally focused on particular biological contexts (e.g. dispersal, foraging). However, the relative importance of these factors in driving individual routine movements might reflect a species' potential flexibility to cope with landscape changes and therefore buffer their potential impact on fitness. We used data from GPS collars on Scandinavian brown bears to investigate the relative role of these factors, as well as an additional factor (period of the year) on routine movements at two spatial scales (hourly and daily relocations). As expected, internal factors played a major role in driving movement, compared to external factors at both scales, but its relative importance was greater at a finer scale. In particular, the interaction between reproductive status and period of the year was one of the most influential variables, females being constrained by the movement capacity of their cubs in the first periods of the year. The effect of human disturbance on movement was also greater for females with cubs than for lone females. This study showed how reciprocal modulation of internal and external factors is shaping space use of brown bears. We stress that these factors should be studied simultaneously to avoid the risk of obtaining context-dependent inferences. Moreover, the study of their relative contribution is also highly relevant in the context of multiple-use landscapes, as human activities generally affect the landscape more than they affect the internal states of an individual. Species or individuals with important internal constraints should be less responsive to changes in their environment as they have less freedom from internal constraints and should thus be more sensitive to human alteration of the landscape, as shown for females with cubs in this study. © 2012 The Authors. Journal of Animal Ecology © 2012 British Ecological Society.

21 CFR 878.4014 - Nonresorbable gauze/sponge for external use.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonresorbable gauze/sponge for external use. 878... Nonresorbable gauze/sponge for external use. (a) Identification. A nonresorbable gauze/sponge for external use... include a nonresorbable gauze/sponge for external use that contains added drugs such as antimicrobial...

Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): a systematic review and meta-analysis.

PubMed

Samandara, Aikaterini; Papageorgiou, Spyridon N; Ioannidou-Marathiotou, Ioulia; Kavvadia-Tsatala, Smaragda; Papadopoulos, Moschos A

2018-05-15

Orthodontically induced external root resorption (OIRR) is a pathologic consequence of orthodontic tooth movement. However, the limitations of two-dimensional radiography suggest that cone beam computed tomography (CBCT) with its three-dimensional capabilities might be more suitable to assess OIRR. The aim of this study was to assess in an evidence-based manner data on linear or volumetric OIRR measurements of permanent teeth by means of CBCT, during and/or after the end of orthodontic treatment. Unrestricted electronic and hand searches were performed up to January 2017 in 15 databases. Randomized clinical trials, prospective, and retrospective non-randomized studies assessing OIRR during and/or after orthodontic treatment using CBCT in human patients were included. After duplicate study selection, data extraction, and risk-of-bias assessment according to the Cochrane guidelines, random-effects meta-analyses, followed by subgroup, meta-regression, and sensitivity analyses were also performed in order to evaluate factors that affect OIRR. A total of 33 studies (30 datasets) were included in the qualitative analysis while data from 27 of them were included in the quantitative analysis. Direct comparisons from randomized trials found little to no influence of appliance-related factors on OIRR. Explorative analyses including non-randomized studies found a pooled OIRR of 0.79 mm based on all included studies and 0.86 mm when OIRR was assessed at the end of orthodontic treatment. Statistically significant differences in OIRR were found according to tooth type or jaw, inclusion of extractions, treatment duration, and diagnostic accuracy of the CBCT. Based on the results of this study, CBCT seems to be a reliable tool to examine OIRR during or at the end of orthodontic treatment. Although the average OIRR measured with CBCT seems to lack clinical relevance, there are certain factors that may affect OIRR following orthodontic treatment. Nevertheless, due to data heterogeneity and low quality of the included studies, the corresponding results should be interpreted with some caution. PROSPERO (CRD42016030131).

Accepting or declining non-invasive ventilation or gastrostomy in amyotrophic lateral sclerosis: patients' perspectives.

PubMed

Greenaway, L P; Martin, N H; Lawrence, V; Janssen, A; Al-Chalabi, A; Leigh, P N; Goldstein, L H

2015-01-01

The objective was to identify factors associated with decisions made by patients with amyotrophic lateral sclerosis (ALS) to accept or decline non-invasive ventilation (NIV) and/or gastrostomy in a prospective population-based study. Twenty-one people with ALS, recruited from the South-East ALS Register who made an intervention decision during the study timeframe underwent a face-to-face in-depth interview, with or without their informal caregiver present. Sixteen had accepted an intervention (11 accepted gastrostomy, four accepted NIV and one accepted both interventions). Five patients had declined gastrostomy. Thematic analysis revealed three main themes: (1) patient-centric factors (including perceptions of control, acceptance and need, and aspects of fear); (2) external factors (including roles played by healthcare professionals, family, and information provision); and (3) the concept of time (including living in the moment and the notion of 'right thing, right time'). Many aspects of these factors were inter-related. Decision-making processes for the patients were found to be complex and multifaceted and reinforce arguments for individualised (rather than 'algorithm-based') approaches to facilitating decision-making by people with ALS who require palliative interventions.

Dental Students' Perceptions of Risk Factors for Musculoskeletal Disorders: Adapting the Job Factors Questionnaire for Dentistry.

PubMed

Presoto, Cristina D; Wajngarten, Danielle; Domingos, Patrícia A S; Campos, Juliana A D B; Garcia, Patrícia P N S

2018-01-01

The aims of this study were to adapt the Job Factors Questionnaire to the field of dentistry, evaluate its psychometric properties, evaluate dental students' perceptions of work/study risk factors for musculoskeletal disorders, and determine the influence of gender and academic level on those perceptions. All 580 students enrolled in two Brazilian dental schools in 2015 were invited to participate in the study. A three-factor structure (Repetitiveness, Work Posture, and External Factors) was tested through confirmatory factor analysis. Convergent validity was estimated using the average variance extracted (AVE), discriminant validity was based on the correlational analysis of the factors, and reliability was assessed. A causal model was created using structural equation modeling to evaluate the influence of gender and academic level on students' perceptions. A total of 480 students completed the questionnaire for an 83% response rate. The responding students' average age was 21.6 years (SD=2.98), and 74.8% were women. Higher scores were observed on the Work Posture factor items. The refined model presented proper fit to the studied sample. Convergent validity was compromised only for External Factors (AVE=0.47), and discriminant validity was compromised for Work Posture and External Factors (r 2 =0.69). Reliability was adequate. Academic level did not have a significant impact on the factors, but the women students exhibited greater perception. Overall, the adaptation resulted in a useful instrument for assessing perceptions of risk factors for musculoskeletal disorders. Gender was found to significantly influence all three factors, with women showing greater perception of the risk factors.

External Validation of Bifactor Model of ADHD: Explaining Heterogeneity in Psychiatric Comorbidity, Cognitive Control, and Personality Trait Profiles within DSM-IV ADHD

ERIC Educational Resources Information Center

Martel, Michelle M.; Roberts, Bethan; Gremillion, Monica; von Eye, Alexander; Nigg, Joel T.

2011-01-01

The current paper provides external validation of the bifactor model of ADHD by examining associations between ADHD latent factor/profile scores and external validation indices. 548 children (321 boys; 302 with ADHD), 6 to 18 years old, recruited from the community participated in a comprehensive diagnostic procedure. Mothers completed the Child…

Delensing CMB polarization with external datasets

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

Smith, Kendrick M.; Hanson, Duncan; LoVerde, Marilena

2012-06-01

One of the primary scientific targets of current and future CMB polarization experiments is the search for a stochastic background of gravity waves in the early universe. As instrumental sensitivity improves, the limiting factor will eventually be B-mode power generated by gravitational lensing, which can be removed through use of so-called ''delensing'' algorithms. We forecast prospects for delensing using lensing maps which are obtained externally to CMB polarization: either from large-scale structure observations, or from high-resolution maps of CMB temperature. We conclude that the forecasts in either case are not encouraging, and that significantly delensing large-scale CMB polarization requires high-resolutionmore » polarization maps with sufficient sensitivity to measure the lensing B-mode. We also present a simple formalism for including delensing in CMB forecasts which is computationally fast and agrees well with Monte Carlos.« less

Development of marine biotechnology as a resource for novel proteases and their role in modern biotechnology.

PubMed

Homaei, Ahmad; Lavajoo, Fatemeh; Sariri, Reyhaneh

2016-07-01

Marine environment consists of the largest sources diversified genetic pool of material with an enormous potential for a wide variety of enzymes including proteases. A protease hydrolyzes the peptide bond and most of proteases possess many industrial applications. Marine proteases differ considerably from those found in internal or external organs of invertebrates and vertebrates. In common with all enzymes, external factors such as temperature, pH and type of media are important for the activity, catalytic efficiency, stability and proper functioning of proteases. In this review valuable characteristics of proteases in marine organisms and their applications are gathered from a wide literature survey. Considering their biochemical significance and their increasing importance in biotechnology, a thorough understanding of marine proteases functioning could be of prime importance. Copyright © 2016 Elsevier B.V. All rights reserved.

Identifying at-risk profiles and protective factors for problem gambling: A longitudinal study across adolescence and early adulthood.

PubMed

Allami, Youssef; Vitaro, Frank; Brendgen, Mara; Carbonneau, René; Tremblay, Richard E

2018-05-01

Past studies have identified various risk and protective factors for problem gambling (PG). However, no study has examined the interplay between these factors using a combination of person-centered and variable-centered approaches embedded within a longitudinal design. The present study aimed to (a) identify distinct profiles in early adolescence based on a set of risk factors commonly associated with PG (impulsivity, depression, anxiety, drug-alcohol use, aggressiveness, and antisociality), (b) explore the difference in reported gambling problems between these profiles during midadolescence and early adulthood, and (c) identify family- and peer-related variables that could operate as protective or compensatory factors in this context. Two samples were used: (a) a population sample (N = 1,033) living in low socioeconomic-status neighborhoods and (b) a population sample (N = 3,017) representative of students attending Quebec schools. Latent profile analyses were conducted to identify at-risk profiles based on individual risk factors measured at age 12 years. Negative binomial regression models were estimated to compare profiles in terms of their reported gambling problems at ages 16 and 23. Finally, family- and peer-related variables measured at age 14 were included to test their protective or compensatory role with respect to the link between at-risk profiles and gambling problems. Four profiles were identified: well-adjusted, internalizing, externalizing, and comorbid. Compared to the well-adjusted profile, the externalizing and comorbid profiles reported more gambling problems at ages 16 and 23, but the internalizing profile did not differ significantly. Various protective and compensatory factors emerged for each profile at both time points. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

NASA Johnson Space Center Usability Testing and Analysis facility (UTAF) Overview

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Holden, Kritina L.

2005-01-01

The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility performs research for NASA's HumanSystems Integration Program, under the HumanSystems Research and Technology Division. Specifically, the UTAF provides human factors support for space vehicles, including the International Space Station, the Space Shuttle, and the forthcoming Crew Exploration Vehicle. In addition, there are ongoing collaborative research efforts with external corporations and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes and requirements. This presentation will provide an overview of ongoing activities, and will address how the UTAF projects will evolve to meet new space initiatives.

The willingness to eat. An investigation of appetite among elderly people.

PubMed

Wikby, Kerstin; Fägerskiöld, Astrid

2004-06-01

The aim of this study was to identify and describe factors of importance with regard to appetite among elderly people. A qualitative approach was used and the method was grounded theory. Fifteen elderly people were interviewed using a method with two overall questions. The results show that the willingness to eat plays a central role in appetite among elderly people. The appetite is a state on a sliding scale, from good to poor appetite. Factors affecting the appetite include six categories: mood, personal values, wholesomeness, food, eating environment and meal fellowship. When planning and realizing nursing actions concerning eating, the willingness to eat has to be observed. The desire within every individual has to be given consideration, including all factors as well as how they affect each other. The willingness to eat contains internal factors dependent on mood and personal values, as well as external factors dependent on wholesomeness, food, eating environment and meal fellowship. These factors contain qualitative dimensions, which affect elderly people's appetites as well as their quality of life to a varying extent. Through this, it can be seen that there is a connection between their desire or willingness to eat and their will to live.

Bonded half planes containing an arbitrarily oriented crack

NASA Technical Reports Server (NTRS)

Erdogan, F.; Aksogan, O.

1973-01-01

The plane elastostatic problem for two bonded half planes containing an arbitrarily oriented crack in the neighborhood of the interface is considered. Using Mellin transforms, the problem is formulated as a system of singular integral equations. The equations are solved for various crack orientations, material combinations, and external loads. The numerical results given include the stress intensity factors, tHe strain energy release rates, and tHe probable cleavage angles giving the direction of crack propagation.

[Application of balneotherapeutic factors in the system of rehabilitative treatment of children with environmental dysadaptation syndrome].

PubMed

Khodova, T V; Shvedunova, L N

2010-01-01

Combined balneotherapy including intake and external application of Zheleznovodsk-type mineral water was given to 60 children at the age from 7 to 14 years presenting with environmental dysadaptation syndrome. This treatment ensured favourable dynamics of clinical signs of asthenovegetative, dyspeptic, and pain syndromes. Moreover, it exerted beneficial influence on the mechanisms of vegetative regulation, improved the psychoemotional status of the patients and functional capacity of their immune system.

Design of a fiber-optic transmitter for microwave analog transmission with high phase stability

NASA Technical Reports Server (NTRS)

Logan, R. T., Jr.; Lutes, G. F.; Primas, L. E.; Maleki, L.

1990-01-01

The principal considerations in the design of fiber-optic transmitters for highly phase-stable radio frequency and microwave analog transmission are discussed. Criteria for a fiber-optic transmitter design with improved amplitude and phase-noise performance are developed through consideration of factors affecting the phase noise, including low-frequency laser-bias supply noise, the magnitude and proximity of external reflections into the laser, and temperature excursions of the laser-transmitter package.

To signal or not to signal: that should not be the question.

PubMed

Faw, Harold W

2013-10-01

The purpose of the present research was to examine rates of turn signal use, a positive and potentially valuable means by which drivers can communicate. A second purpose was to explore factors that might impact these rates, including the modeling influence of other drivers. A series of observations involving more than 5600 vehicles making turns were recorded at a variety of intersections in British Columbia, Canada. Though the occurrence of signal use varied widely, ranging from a low of 54% to a high of 95%, the overall rate was 76%. Drivers used turn signals significantly less often when making right as compared with left turns, when traffic volume was higher, and when a designated turning lane was provided. In addition, compared with drivers following another vehicle not using signals, those following a vehicle with turn signals on were significantly more likely to activate their turn signals, suggesting a possible modeling effect. Both internal and external influences on turn signal use by drivers were considered. External factors explored in this research included direction of turn, traffic volume, intersection configuration, and the example of other drivers. It was concluded that the practice of signaling turns merits more research attention, since consistent use of signals is a potential contributor to enhanced safety for all road users. Copyright © 2013 Elsevier Ltd. All rights reserved.

No boundaries: genomes, organisms, and ecological interactions responsible for divergence and reproductive isolation.

PubMed

Etges, William J

2014-01-01

Revealing the genetic basis of traits that cause reproductive isolation, particularly premating or sexual isolation, usually involves the same challenges as most attempts at genotype-phenotype mapping and so requires knowledge of how these traits are expressed in different individuals, populations, and environments, particularly under natural conditions. Genetic dissection of speciation phenotypes thus requires understanding of the internal and external contexts in which underlying genetic elements are expressed. Gene expression is a product of complex interacting factors internal and external to the organism including developmental programs, the genetic background including nuclear-cytotype interactions, epistatic relationships, interactions among individuals or social effects, stochasticity, and prevailing variation in ecological conditions. Understanding of genomic divergence associated with reproductive isolation will be facilitated by functional expression analysis of annotated genomes in organisms with well-studied evolutionary histories, phylogenetic affinities, and known patterns of ecological variation throughout their life cycles. I review progress and prospects for understanding the pervasive role of host plant use on genetic and phenotypic expression of reproductive isolating mechanisms in cactophilic Drosophila mojavensis and suggest how this system can be used as a model for revealing the genetic basis for species formation in organisms where speciation phenotypes are under the joint influences of genetic and environmental factors. © The American Genetic Association. 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cognitive functioning correlates of self-esteem and health locus of control in schizophrenia

PubMed Central

Wang, Chien-Shu; Wu, Jo Yung-Wei; Chang, Wei-Chung; Chuang, Shu-Ping

2013-01-01

Aim The study aimed to investigate the relationship among sociodemographic factors, neurocognitive factors, self-esteem, and health locus of control in patients diagnosed with schizophrenia. We examined the self-esteem, internal health locus of control, and external health locus of control through sociodemographic and neurocognitive factors. Methods Forty-six schizophrenic patients and 31 healthy residents from the community or hospital were recruited as the control group. All subjects participated in the self-esteem questionnaire, health locus of control questionnaire, and a series of neuropychological measures. Results Multiple regression analysis revealed that inhibition of attention and external health locus of control were predictors for self-esteem (r=−0.30, P<0.05; r=0.41, P<0.01); inhibition of attention and external health locus of control were contributors for internal health locus of control (r=−0.43, P<0.01; r=0.61, P<0.001); and education was related to external health locus of control (r=−0.31, P<0.05). Conclusion The current study integrated background characteristics and cognitive function to better understand the impact of self-esteem and health locus of control in schizophrenia. The findings indicated that inhibition of attention, external health locus of control, and education contributed to self-esteem, internal health locus of control and external health locus of control. However, the overall predicted variance accounted for by these predictors was small; thus, further research is necessary to examine imperative variables related with self-esteem and health locus of control in schizophrenia. PMID:24194641

Bio-environmental factors associated with myopia: An updated review.

PubMed

Galvis, V; Tello, A; Camacho, P A; Parra, M M; Merayo-Lloves, J

2017-07-01

Experimental studies in animals, as well as observational and intervention studies in humans, seem to support the premise that the development of juvenile myopia is promoted by a combination of the effect of genetic and environmental factors, with a complex interaction between them. The very rapid increase in myopia rates in some parts of the world, such as Southeast Asia, supports a significant environmental effect. Several lines of evidence suggest that humans might respond to various external factors, such as increased activity in near vision, increased educational pressure, decreased exposure to sunlight outdoors, dietary changes (including increased intake of carbohydrates), as well as low light levels indoors. All these factors could be associated with a higher prevalence of myopia. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Ratings of perceived exertion by women with internal or external locus of control.

PubMed

Hassmén, P; Koivula, N

1996-10-01

Ratings of perceived exertion are frequently used to estimate the strain and effort experienced subjectively by individuals during various forms of physical activity. A number of factors, both physiological and psychological in origin, have been suggested to work as modifiers of the exertion perceived by the individual. It has been reported in nonsport-related research that individuals with an internal locus of control seem to pay more attention to relevant information and use the available information more adequately than individuals with an external locus of control. The reputed inferior information-processing abilities of externals compared with internals could possibly also influence the ratings of perceived exertion, with externals being less accurate in their ratings. Whether locus of control might be such a factor was investigated. Fifty women worked on an ergometer cycle at four different work loads. The results showed statistically significant differences in subjective ratings of perceived exertion between externals and internals, especially at heavier work loads. Such differences might be because of unequal information-processing abilities, as the observed discrepancies occurred at higher work intensities, when more cues are available for processing.

Factors influencing the occupational trajectory of patients with systemic sclerosis: a qualitative study.

PubMed

Decuman, Saskia; Smith, Vanessa; Grypdonck, Maria; De Keyser, Filip; Verhaeghe, Sofie

2015-01-01

To describe, from the patient's point of view, the factors influencing the occupational trajectory of patients with systemic sclerosis (SSc). This was a qualitative study designed using grounded theory with constant comparison. Data were collected through semi-structured interviews with 14 patients who fulfilled the American College of Rheumatology or Leroy-Medsger criteria for SSc. Based on our interviews, we found that the occupational trajectory of patients with SSc is influenced by the continuous interplay between four groups of factors. The first group concerns the values patients attribute to work, including identity, normality, financial value, social contact, and structure. The meaning of these values and how they relate to each other underlies the desire to work. A second group of factors is those influencing the balance between daily life, work participation, and medical condition (e.g. job content, flexibility in organising work, and the willingness to ask for accommodations at work). The occupational trajectory is also influenced by external factors, including availability of support, know-ledge of the disease, pressure to work, contact with medical professionals, and existing regulations and the patient's knowledge about them. Finally, the occupational trajectory is influenced by personal factors, including socio-demographics, psychological assets, and disease- and work-related personal factors. The decisions patients with SSc take concerning work depend on an interplay between many factors and, especially, on the patients' personal interpretation of these factors. These need to be taken into account when helping patients with SSc determine their occupational trajectory.

Role of temperament in early adolescent pure and co-occurring internalizing and externalizing problems using a bifactor model: Moderation by parenting and gender

PubMed Central

WANG, FRANCES L.; EISENBERG, NANCY; VALIENTE, CARLOS; SPINRAD, TRACY L.

2015-01-01

We contribute to the literature on the relations of temperament to externalizing and internalizing problems by considering parental emotional expressivity and child gender as moderators of such relations and examining prediction of pure and co-occurring problem behaviors during early to middle adolescence using bifactor models (which provide unique and continuous factors for pure and co-occurring internalizing and externalizing problems). Parents and teachers reported on children’s (4.5- to 8-year-olds; N = 214) and early adolescents’ (6 years later; N = 168) effortful control, impulsivity, anger, sadness, and problem behaviors. Parental emotional expressivity was measured observationally and with parents’ self-reports. Early-adolescents’ pure externalizing and co-occurring problems shared childhood and/or early-adolescent risk factors of low effortful control, high impulsivity, and high anger. Lower childhood and early-adolescent impulsivity and higher early-adolescent sadness predicted early-adolescents’ pure internalizing. Childhood positive parental emotional expressivity more consistently related to early-adolescents’ lower pure externalizing compared to co-occurring problems and pure internalizing. Lower effortful control predicted changes in externalizing (pure and co-occurring) over 6 years, but only when parental positive expressivity was low. Higher impulsivity predicted co-occurring problems only for boys. Findings highlight the probable complex developmental pathways to adolescent pure and co-occurring externalizing and internalizing problems. PMID:26646352

Role of temperament in early adolescent pure and co-occurring internalizing and externalizing problems using a bifactor model: Moderation by parenting and gender.

PubMed

Wang, Frances L; Eisenberg, Nancy; Valiente, Carlos; Spinrad, Tracy L

2016-11-01

We contribute to the literature on the relations of temperament to externalizing and internalizing problems by considering parental emotional expressivity and child gender as moderators of such relations and examining prediction of pure and co-occurring problem behaviors during early to middle adolescence using bifactor models (which provide unique and continuous factors for pure and co-occurring internalizing and externalizing problems). Parents and teachers reported on children's (4.5- to 8-year-olds; N = 214) and early adolescents' (6 years later; N = 168) effortful control, impulsivity, anger, sadness, and problem behaviors. Parental emotional expressivity was measured observationally and with parents' self-reports. Early-adolescents' pure externalizing and co-occurring problems shared childhood and/or early-adolescent risk factors of low effortful control, high impulsivity, and high anger. Lower childhood and early-adolescent impulsivity and higher early-adolescent sadness predicted early-adolescents' pure internalizing. Childhood positive parental emotional expressivity more consistently related to early-adolescents' lower pure externalizing compared to co-occurring problems and pure internalizing. Lower effortful control predicted changes in externalizing (pure and co-occurring) over 6 years, but only when parental positive expressivity was low. Higher impulsivity predicted co-occurring problems only for boys. Findings highlight the probable complex developmental pathways to adolescent pure and co-occurring externalizing and internalizing problems.

Factors Associated with Knee Stiffness following Surgical Management of Multiligament Knee Injuries.

PubMed

Hanley, Jessica; Westermann, Robert; Cook, Shane; Glass, Natalie; Amendola, Ned; Wolf, Brian R; Bollier, Matthew

2017-07-01

Postoperative knee stiffness can influence outcomes following operative treatment of multiligament knee injuries (MLKIs). The purpose of this study was to evaluate patient and surgical factors that may potentially contribute to stiffness following surgery for MLKIs. All surgically managed MLKIs involving two or more ligaments over a 10-year period at a single level one trauma center were included in this study. A retrospective review was performed to gather objective data related to the development of knee stiffness after surgery. Patients were classified as "stiff" postoperatively if they (1) had a flexion contracture greater than 10 degrees, (2) failed to reach 120 degrees of flexion at final follow-up, or (3) underwent a manipulation under anesthesia with or without arthroscopic lysis of adhesions to improve range of motion. Patient and surgical factors were evaluated systematically to determine factors associated with stiffness. The mean age of the cohort was 27.6 years at the time of surgery and mean follow-up was 50 weeks. Overall, 26/121 (21.5%) knees were diagnosed with postoperative stiffness. In the acute postoperative phase, 17 patients underwent manipulation under anesthesia. There were no significant differences in age, body mass index, associated injuries, mechanism, external fixation use or surgical timing (acute vs. chronic) between stiff and normal knees. Factors associated with the development of postoperative stiffness included knee dislocation ( p  = 0.04) and surgical intervention on three or more ligaments ( p  = 0.04). Careful attention to postoperative rehabilitation regimens should be given to patients with knee dislocations and/or those undergoing reconstruction or repair of three or more injured ligaments. Surgeons may utilize spanning external fixation if necessary without increasing the rate of long-term stiffness. Further, acute surgery does not appear to influence rates of postoperative stiffness or the need for manipulation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conversion of neurons and glia to external-cell fates in the external sensory organs of Drosophila hamlet mutants by a cousin-cousin cell-type respecification.

PubMed

Moore, Adrian W; Roegiers, Fabrice; Jan, Lily Y; Jan, Yuh-Nung

2004-03-15

The Drosophila external sensory organ forms in a lineage elaborating from a single precursor cell via a stereotypical series of asymmetric divisions. HAMLET transcription factor expression demarcates the lineage branch that generates two internal cell types, the external sensory neuron and thecogen. In HAMLET mutant organs, these internal cells are converted to external cells via an unprecedented cousin-cousin cell-fate respecification event. Conversely, ectopic HAMLET expression in the external cell branch leads to internal cell production. The fate-determining signals NOTCH and PAX2 act at multiple stages of lineage elaboration and HAMLET acts to modulate their activity in a branch-specific manner.

[Epidemiology of otomycoses at the University Hospital of Yopougon (Abidjan-Ivory Coast)].

PubMed

Adoubryn, K D; N'Gattia, V K; Kouadio-Yapo, G C; Nigué, L; Zika, D K; Ouhon, J

2014-06-01

Otomycosis is a fungal infection, which leads to a damage of the external auditory meatus. The disease is worldwide in distribution but is said to be more common in tropical countries. Though otomycosis presumably occurs frequently in Africa, reports on its incidence and etiology are rare from Côte d'Ivoire. The objective of this study was to evaluate the prevalence of the disease and to identify aetiological agents as well as the risk factors. A cross-sectional study was carried out in the Otorhinolaryngology Department of the University Teaching Hospital of Yopougon from September 2007 to February 2008. For laboratory investigation, specimens were collected by means of a sterile swab. Samples were inoculated on Sabouraud's Dextrose Agar with and without antibiotics and incubated at 30°C for a period of 1 to 2 weeks. Identification was performed by direct microscopic examination on Cotton Blue Mount preparation and slide culture examination was used for differentiation of morphology. Biotyping was performed using Carbohydrate Fermentation tests, Carbohydrate Assimilation Tests (galerie Api 20 CAux TM - Sanofi Pasteur), Germ tube Test, detection of chlamydospore formation on corn meal agar. A total of 110 patients (sex-ratio=1.2) with suspected cases of otomycosis were investigated. Itching, otalgia, and hypoacusis were the symptoms reported by the patients and the apparent signs were debris in the ear, scabs and inflammation of the external auditory meatus. Of these, 88 cases (80%) were confirmed specifically of mycotic etiology on the basis of positive culture with 92 isolates consisting of yeasts (65.2%) and moulds (34.8%). The predominant etiological agents were Aspergillus flavus (28.4%), Candida guilliermondii (19.3%) and Candida parapsilosis (18.2%). The predisposing factors included previous otological pathology (P=0.010), frequent scratching of the external ear canal and use of ear drops (RR=3.47; IC 95%=1.3-9.27). This study revealed the great prevalence of otomycosis in Abidjan, some predisposing factors and the aetiological agents. Management of otomycosis must include mycological examination for diagnosis and information for changing behaviour patterns leading to infection. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Factors related to voluntary parental decision-making in pediatric oncology.

PubMed

Miller, Victoria A; Nelson, Robert M

2012-05-01

The aim of the current study was to examine demographic and contextual correlates of voluntariness in parents making research or treatment decisions for their children with cancer. Participants included 184 parents of children with cancer who made a decision about enrolling the child in a research or treatment protocol within the previous 10 days. Parents completed questionnaires that assessed voluntariness, external influence by others, concern that the child's care would be negatively affected if the parent did not agree, time pressure, information adequacy, and demographics. Lower perceived voluntariness was associated with lower education, male gender, minority status, and not having previous experience with a similar decision. Parents who reported lower voluntariness also perceived more external influence and time pressure, had more concern about the child's care being negatively affected if they declined, and perceived that they had either too much or not enough information about the decision. In a multivariate regression, education, minority status, gender, external influence, and too little information remained significantly associated with voluntariness. Several groups of parents appear to be at risk for decreased voluntariness when making research or treatment decisions for their seriously ill children, including fathers, nonwhite parents, and those with less education. Parental voluntariness may be enhanced by helping parents to mitigate the effects of unhelpful or unwanted influences by others and ensuring that their information needs are met.

Hippocampus Contributions to Food Intake Control: Mnemonic, Neuroanatomical, and Endocrine Mechanisms.

PubMed

Kanoski, Scott E; Grill, Harvey J

2017-05-01

Food intake is a complex behavior that can occur or cease to occur for a multitude of reasons. Decisions about where, when, what, and how much to eat are not merely reflexive responses to food-relevant stimuli or to changes in energy status. Rather, feeding behavior is modulated by various contextual factors and by previous experiences. The data reviewed here support the perspective that neurons in multiple hippocampal subregions constitute an important neural substrate linking the external context, the internal context, and mnemonic and cognitive information to control both appetitive and ingestive behavior. Feeding behavior is heavily influenced by hippocampal-dependent mnemonic functions, including episodic meal-related memories and conditional learned associations between food-related stimuli and postingestive consequences. These mnemonic processes are undoubtedly influenced by both external and internal factors relating to food availability, location, and physiological energy status. The afferent and efferent neuroanatomical connectivity of the subregions of the hippocampus is reviewed with regard to the integration of visuospatial and olfactory sensory information (the external context) with endocrine and gastrointestinal interoceptive stimuli (the internal context). Also discussed are recent findings demonstrating that peripherally derived endocrine signals act on receptors in hippocampal neurons to reduce (leptin, glucagon-like peptide-1) or increase (ghrelin) food intake and learned food reward-driven responding, thereby highlighting endocrine and neuropeptidergic signaling in hippocampal neurons as a novel substrate of importance in the higher-order regulation of feeding behavior. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Utility of the Personality Inventory for DSM-5-Brief Form (PID-5-BF) in the Measurement of Maladaptive Personality and Psychopathology.

PubMed

Anderson, Jaime L; Sellbom, Martin; Salekin, Randall T

2018-07-01

The Diagnostic and Statistical Manual of Mental Disorders-Fifth edition ( DSM-5) Personality and Personality Disorders workgroup developed the Personality Inventory for the DSM-5 (PID-5) for the assessment of the alternative trait model for DSM-5. Along with this measure, the American Psychiatric Association published an abbreviated version, the PID-5-Brief form (PID-5-BF). Although this measure is available on the DSM-5 website for use, only two studies have evaluated its psychometric properties and validity and no studies have examined the U.S. version of this measure. The current study evaluated the reliability, factor structure, and construct validity of PID-5-BF scale scores. This included an evaluation of the scales' associations with Section II PDs, a well-validated dimensional measure of personality psychopathology, and broad externalizing and internalizing psychopathology measures. We found support for the reliability of PID-5-BF scales as well as for the factor structure of the measure. Furthermore, a series of correlation and regression analyses showed conceptually expected associations between PID-5-BF and external criterion variables. Finally, we compared the correlations with external criterion measures to those of the full-length PID-5 and PID-5-Short form. Intraclass correlation analyses revealed a comparable pattern of correlations across all three measures, thereby supporting the use of the PID-5-BF as a screening measure of dimensional maladaptive personality traits.

Psychotraumatology: What researchers and clinicians can learn from an evolutionary perspective.

PubMed

Troisi, Alfonso

2018-05-01

This review outlines the contribution of evolutionary science to experimental and clinical psychotraumatology. From an evolutionary perspective, traumatic and psychosocial stressors are conceived of as events or circumstances that thwart the achievement of biological goals. The more important is the adaptive value of the goal, the more painful is the emotional impact of the life event that endangers goal achievement. Life history theory and sexual selection theory help to explain why goal priorities differ between the sexes and across age groups. Cultural values and social learning interact with evolved inclinations in determining the hierarchy of goals for a specific person in a specific phase of his or her life. To illustrate the applicability of the evolutionary model, epidemiological and clinical data concerning individual differences in stress sensitivity and stress generation are reviewed and discussed. The final part of the review summarizes new hypotheses that explain how early and current psychosocial stressors can activate a series of adaptive mechanisms including developmental plasticity, predictive adaptive responses and differential susceptibility. Ultimately, the contribution of evolutionary science to psychotraumatology is the idea that experimental and clinical studies should shift the focus of research from the external environment (defined as all stressful factors external to the subjects under investigation) to the ecological environment (defined as those stressful factors of the external environment that have a greater potential to threaten the adaptive equilibrium of the subjects under investigation because of their evolved inclinations). Copyright © 2017 Elsevier Ltd. All rights reserved.

DREISS: Using State-Space Models to Infer the Dynamics of Gene Expression Driven by External and Internal Regulatory Networks.

PubMed

Wang, Daifeng; He, Fei; Maslov, Sergei; Gerstein, Mark

2016-10-01

Gene expression is controlled by the combinatorial effects of regulatory factors from different biological subsystems such as general transcription factors (TFs), cellular growth factors and microRNAs. A subsystem's gene expression may be controlled by its internal regulatory factors, exclusively, or by external subsystems, or by both. It is thus useful to distinguish the degree to which a subsystem is regulated internally or externally-e.g., how non-conserved, species-specific TFs affect the expression of conserved, cross-species genes during evolution. We developed a computational method (DREISS, dreiss.gerteinlab.org) for analyzing the Dynamics of gene expression driven by Regulatory networks, both External and Internal based on State Space models. Given a subsystem, the "state" and "control" in the model refer to its own (internal) and another subsystem's (external) gene expression levels. The state at a given time is determined by the state and control at a previous time. Because typical time-series data do not have enough samples to fully estimate the model's parameters, DREISS uses dimensionality reduction, and identifies canonical temporal expression trajectories (e.g., degradation, growth and oscillation) representing the regulatory effects emanating from various subsystems. To demonstrate capabilities of DREISS, we study the regulatory effects of evolutionarily conserved vs. divergent TFs across distant species. In particular, we applied DREISS to the time-series gene expression datasets of C. elegans and D. melanogaster during their embryonic development. We analyzed the expression dynamics of the conserved, orthologous genes (orthologs), seeing the degree to which these can be accounted for by orthologous (internal) versus species-specific (external) TFs. We found that between two species, the orthologs have matched, internally driven expression patterns but very different externally driven ones. This is particularly true for genes with evolutionarily ancient functions (e.g. the ribosomal proteins), in contrast to those with more recently evolved functions (e.g., cell-cell communication). This suggests that despite striking morphological differences, some fundamental embryonic-developmental processes are still controlled by ancient regulatory systems.

Use of a resiliency framework to examine pregnancy and birth outcomes among adolescents: A qualitative study

PubMed Central

Solivan, Amber E.; Wallace, Maeve E.; Kaplan, Kathryn C.; Harville, Emily W.

2015-01-01

Introduction Adolescent childbearing has been viewed as a social, political, and public health priority since the 1970s. Research has primarily focused on the negative consequences of teen pregnancy; less research has explored factors associated with healthy pregnancy and birth experiences in this population. Methods Using open-ended and qualitative techniques, researchers performed individual interviews with fifteen adolescent mothers (15–19 years of age) recruited from a Women’s and Children’s Clinic in Southern Louisiana, who had experienced a healthy pregnancy and bore a full-term, normal birth weight infant. We used a resiliency framework to identify factors that may have supported positive health outcomes despite risks associated with low-income and/or marginalized minority status. Results A total of 15 mothers of multiple racial/ethnic identities were included in the analysis. Mothers discussed potential protective factors that we classified as either assets (internal factors) or resources (external factors). Mothers demonstrated strong assets including self-efficacy and self-acceptance and important resources including familial support and partner support during pregnancy which may have contributed to their resiliency. Discussion Ensuring access to social and structural supports as well as supporting adolescent-friendly health and social policies may be key to promoting healthy maternal and infant outcomes among young women who become pregnant. PMID:26237055

Accountable Care Organizations and Transaction Cost Economics.

PubMed

Mick, Stephen S Farnsworth; Shay, Patrick D

2016-12-01

Using a Transaction Cost Economics (TCE) approach, this paper explores which organizational forms Accountable Care Organizations (ACOs) may take. A critical question about form is the amount of vertical integration that an ACO may have, a topic central to TCE. We posit that contextual factors outside and inside an ACO will produce variable transaction costs (the non-production costs of care) such that the decision to integrate vertically will derive from a comparison of these external versus internal costs, assuming reasonably rational management abilities. External costs include those arising from environmental uncertainty and complexity, small numbers bargaining, asset specificity, frequency of exchanges, and information "impactedness." Internal costs include those arising from human resource activities including hiring and staffing, training, evaluating (i.e., disciplining, appraising, or promoting), and otherwise administering programs. At the extreme, these different costs may produce either total vertical integration or little to no vertical integration with most ACOs falling in between. This essay demonstrates how TCE can be applied to the ACO organization form issue, explains TCE, considers ACO activity from the TCE perspective, and reflects on research directions that may inform TCE and facilitate ACO development. © The Author(s) 2016.

Ankle arthrodesis: A systematic approach and review of the literature

PubMed Central

Yasui, Youichi; Hannon, Charles P; Seow, Dexter; Kennedy, John G

2016-01-01

Ankle arthrodesis is a common treatment used for patients with end-stage ankle arthritis (ESAA). The surgical goal of ankle arthrodesis is to obtain bony union between the tibia and talus with adequate alignment [slight valgus (0°-5°)], neutral dorsiflexion, and slight external rotation positions) in order to provide a pain-free plantigrade foot for weightbearing activities. There are many variations in operative technique including deferring approaches (open or arthroscopic) and differing fixation methods (internal or external fixation). Each technique has its advantage and disadvantages. Success of ankle arthrodesis can be dependent on several factors, including patient selection, surgeons’ skills, patient comorbidities, operative care, etc. However, from our experience, the majority of ESAA patients obtain successful clinical outcomes. This review aims to outline the indications and goals of arthrodesis for treatment of ESAA and discuss both open and arthroscopic ankle arthrodesis. A systematic step by step operative technique guide is presented for both the arthroscopic and open approaches including a postoperative protocol. We review the current evidence supporting each approach. The review finishes with a report of the most recent evidence of outcomes after both approaches and concerns regarding the development of hindfoot arthritis. PMID:27900266

External nutrient loading from land, sea and atmosphere to all 656 Swedish coastal water bodies.

PubMed

Bryhn, Andreas C; Dimberg, Peter H; Bergström, Lena; Fredriksson, Ronny E; Mattila, Johanna; Bergström, Ulf

2017-01-30

Identifying the main sources of nutrient loading is a key factor for efficient mitigation of eutrophication. This study has investigated the pathways of external nutrient loading to 656 coastal water bodies along the entire Swedish coastline. The studied water bodies have been delineated to meet requirements in the European Union's Water Framework Directive, and recent status assessments have shown that 57% of them fail to attain good or high ecological status with respect to nutrients. The analysis in the study was performed on data from mass-balance based nutrient budgets computed using the modelling framework Vattenwebb. The external nutrient contribution from the sea to the water bodies was highly variable, ranging from about 1% to nearly 100%, but the median contribution was >99% of the total external loading regarding both nitrogen and phosphorus. External loading from the atmosphere and local catchment area played a minor role in general. However, 45 coastal water bodies received >25% of the external nitrogen and phosphorus from their catchments. Loading from land typically peaked in April following ice-break and snow melting and was comparatively low during summer. The results indicate that for many eutrophicated Swedish coastal water bodies, nutrient abatement is likely to be optimally effective when potential measures in all of the catchment area of the concerned sea basin are considered. Local-scale mitigation in single water bodies will likely be locally effective only in the small proportion of areas where water and thereby also nutrient input from the catchment is high compared to the influx from the sea. Future studies should include nutrient reduction scenarios in order to refine these conclusions and to identify relevant spatial scales for coastal eutrophication mitigation measures from a water body perspective. Copyright © 2017 Elsevier Ltd. All rights reserved.

49 CFR 192.455 - External corrosion control: Buried or submerged pipelines installed after July 31, 1971.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false External corrosion control: Buried or submerged... SAFETY STANDARDS Requirements for Corrosion Control § 192.455 External corrosion control: Buried or... against external corrosion, including the following: (1) It must have an external protective coating...

49 CFR 192.455 - External corrosion control: Buried or submerged pipelines installed after July 31, 1971.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false External corrosion control: Buried or submerged... SAFETY STANDARDS Requirements for Corrosion Control § 192.455 External corrosion control: Buried or... against external corrosion, including the following: (1) It must have an external protective coating...

49 CFR 192.455 - External corrosion control: Buried or submerged pipelines installed after July 31, 1971.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false External corrosion control: Buried or submerged... SAFETY STANDARDS Requirements for Corrosion Control § 192.455 External corrosion control: Buried or... against external corrosion, including the following: (1) It must have an external protective coating...

49 CFR 192.455 - External corrosion control: Buried or submerged pipelines installed after July 31, 1971.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false External corrosion control: Buried or submerged... SAFETY STANDARDS Requirements for Corrosion Control § 192.455 External corrosion control: Buried or... against external corrosion, including the following: (1) It must have an external protective coating...

(Draft) Community air pollution and mortality: Analysis of 1980 data from US metropolitan areas

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

Lipfert, F.W.

1992-11-01

1980 data from up to 149 metropolitan areas were used to define cross-sectional associations between community air pollution and ``excess`` human mortality. The regression model proposed by Ozkaynak and Thurston (1987), which accounted for age, race, education, poverty, and population density, was evaluated and several new models were developed. The new models also accounted for migration, drinking water hardness, and smoking, and included a more detailed description of race. Cause-of-death categories analyzed include all causes, all ``non-external`` causes, major cardiovascular diseases, and chronic obstructive pulmonary diseases (COPD). Both annual mortality rates and their logarithms were analyzed. Air quality data weremore » obtained from the EPA AIRS database (TSP, SO{sub 4}{sup =}, Mn, and ozone) and from the inhalable particulate network (PM{sub 15}, PM{sub 2.5} and SO{sub 4}{sup =}, for 63{sup 4} locations). The data on particulates were averaged across all monitoring stations available for each SMSA and the TSP data were restricted to the year 1980. The associations between mortality and air pollution were found to be dependent on the socioeconomic factors included in the models, the specific locations included in the data set, and the type of statistical model used. Statistically significant associations were found as follows: between TSP and mortality due to non-external causes with log-linear models, but not with a linear model betweenestimated 10-year average (1980--90) ozone levels and 1980 non-external and cardiovascular deaths; and between TSP and COPD mortality for both linear and log-linear models. When the sulfate contribution to TSP was subtracted, the relationship with COPD mortality was strengthened.« less

(Draft) Community air pollution and mortality: Analysis of 1980 data from US metropolitan areas

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

Lipfert, F.W.

1992-11-01

1980 data from up to 149 metropolitan areas were used to define cross-sectional associations between community air pollution and excess'' human mortality. The regression model proposed by Ozkaynak and Thurston (1987), which accounted for age, race, education, poverty, and population density, was evaluated and several new models were developed. The new models also accounted for migration, drinking water hardness, and smoking, and included a more detailed description of race. Cause-of-death categories analyzed include all causes, all non-external'' causes, major cardiovascular diseases, and chronic obstructive pulmonary diseases (COPD). Both annual mortality rates and their logarithms were analyzed. Air quality data weremore » obtained from the EPA AIRS database (TSP, SO[sub 4][sup =], Mn, and ozone) and from the inhalable particulate network (PM[sub 15], PM[sub 2.5] and SO[sub 4][sup =], for 63[sup 4] locations). The data on particulates were averaged across all monitoring stations available for each SMSA and the TSP data were restricted to the year 1980. The associations between mortality and air pollution were found to be dependent on the socioeconomic factors included in the models, the specific locations included in the data set, and the type of statistical model used. Statistically significant associations were found as follows: between TSP and mortality due to non-external causes with log-linear models, but not with a linear model betweenestimated 10-year average (1980--90) ozone levels and 1980 non-external and cardiovascular deaths; and between TSP and COPD mortality for both linear and log-linear models. When the sulfate contribution to TSP was subtracted, the relationship with COPD mortality was strengthened.« less

Myth and reality in the rural health service crisis: facing up to community responsibilities.

PubMed

Amundson, B

1993-01-01

Rural communities, rural advocacy organizations, and policy makers persist in perpetuating two serious but related misconceptions, namely: (1) The continuing deterioration of health services in most rural communities is primarily the result of forces and factors outside of the communities themselves, and (2) the solution to reverse this deterioration will come mainly from changes in reimbursement and other types of public policy initiatives. Overemphasis on the role of external factors has created a serious imbalance in programs, resources, and policy efforts, including those supported by the NRHA, resulting in inadequate national efforts and resources to foster community-based solutions. Suggested solutions include: (1) application by communities of a proven set of principles for organizing and developing local health services, and (2) creation of a national network to promote such community-based solutions.

Factors affecting placement of a child with intellectual disability.

PubMed

Kandel, Isack; Merrick, Joav

2005-05-06

Parents of disabled children often face the question whether or not to keep the child at home or to place them. The choice between the two alternatives resides with the parents and various factors influence their decision. Several researchers have identified these factors, which include child-related parameters, family and parental attitudes, the influence of the social environment, and the external assistance provided to the family. In a pilot study, we attempted to isolate the main factors involved in the parental decision either to keep the child at home or place the child by examining a sample comprised of 50 parents of children suffering severe intellectual disability studying in a special education school and 48 parents of adults with intellectual disability working in sheltered workshops. Each parent filled out a questionnaire used in a study in the United States and results of the research indicated parental-related factors as the dominant factors that delayed the placement of their child in residential care; guilt feelings were the main factor.

Dynamic Stress Testing Is Unnecessary for Unimalleolar Supination-External Rotation Ankle Fractures with Minimal Fracture Displacement on Lateral Radiographs.

PubMed

Nortunen, Simo; Leskelä, Hannu-Ville; Haapasalo, Heidi; Flinkkilä, Tapio; Ohtonen, Pasi; Pakarinen, Harri

2017-03-15

This study aimed to identify factors from standard radiographs that contributed to the stability of the ankle mortise in patients with isolated supination-external rotation fractures of the lateral malleolus (OTA/AO 44-B). Non-stress radiographs of the mortise and lateral views, without medial clear space widening or incongruity, were prospectively collected for 286 consecutive patients (mean age, 45 years [range, 16 to 85 years]), including 144 female patients (mean age, 50 years [range, 17 to 85 years]) and 142 male patients (mean age, 40 years [range, 16 to 84 years]) from 2 trauma centers. The radiographs were analyzed for fracture morphology by 2 orthopaedic surgeons, who were blinded to each other's measurements and to the results of external rotation stress radiographs (the reference for stability). Factors significantly associated with ankle mortise stability were tested in multiple logistic regression. Receiver operating characteristic analyses were performed for continuous variables to determine optimal thresholds. A sensitivity of >90% was used as the criterion for an optimal threshold. According to external rotation stress radiographs, 217 patients (75.9%) had a stable injury, defined as that with a medial clear space of <5 mm. Independent factors that predicted stable ankle mortise were female sex (odds ratio [OR], 2.5 [95% confidence interval (CI), 1.4 to 4.6]), a posterior diastasis of <2 mm (corresponding with a sensitivity of 0.94 and specificity of 0.39) on lateral radiographs (OR, 10.8 [95% CI, 3.7 to 31.5]), and only 2 fracture fragments (OR, 7.3 [95% CI, 2.1 to 26.3]). When the posterior diastasis was <2 mm and only 2 fracture fragments were present, the probability of a stable ankle mortise was 0.98 for 48 female patients (16.8%) and 0.94 for 37 male patients (12.9%). Patients with noncomminuted lateral malleolar fractures (85 patients [29.7%]) could be diagnosed with a stable ankle mortise without further stress testing, when the fracture line widths were <2 mm on lateral radiographs. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Prevalence and correlates of mental disorders in Israeli adolescents: results from a national mental health survey.

PubMed

Farbstein, Ilana; Mansbach-Kleinfeld, Ivonne; Levinson, Daphna; Goodman, Robert; Levav, Itzhak; Vograft, Itzik; Kanaaneh, Rasim; Ponizovsky, Alexander M; Brent, David A; Apter, Alan

2010-05-01

The development of epidemiological instruments has enabled the assessment of mental disorders in youth in countries that plan policy according to evidence-based principles. The Israel Survey of Mental Health among Adolescents (ISMEHA) was conducted in 2004-2005 in a representative sample of 957 adolescents aged 14-17 and their mothers. The aims of this study were to estimate prevalence rates of internalizing and externalizing mental disorders and their socio-demographic and health correlates. Disorders were ascertained with the Development and Well-Being Assessment inventory and verified by child psychiatrists. The prevalence rates were 11.7%, 8.1% and 4.8% for any disorder, internalizing disorders and externalizing disorders, respectively. Distinct risk factors were associated with the different types of disorders: internalizing disorders were associated with female gender, chronic medical conditions and being cared for by a welfare agency. Risk factors for externalizing disorders were male gender, having divorced or single parents, being an only child or having only one sibling. Learning disability was associated with both types of disorders. The risk and protective factors related to internalizing and externalizing disorders are interpreted within the framework of family composition in this multicultural society.

Etiology of Stability and Growth of Internalizing and Externalizing Behavior Problems Across Childhood and Adolescence.

PubMed

Hatoum, Alexander S; Rhee, Soo Hyun; Corley, Robin P; Hewitt, John K; Friedman, Naomi P

2018-04-20

Internalizing and externalizing behaviors are heritable, and show genetic stability during childhood and adolescence. Less work has explored how genes influence individual differences in developmental trajectories. We estimated ACE biometrical latent growth curve models for the Teacher Report Form (TRF) and parent Child Behavior Checklist (CBCL) internalizing and externalizing scales from ages 7 to 16 years in 408 twin pairs from the Colorado Longitudinal Twin Study. We found that Intercept factors were highly heritable for both internalizing and externalizing behaviors (a2 = .61-.92), with small and nonsignificant environmental influences for teacher-rated data but significant nonshared environmental influences for parent-rated data. There was some evidence of heritability of decline in internalizing behavior (Slopes for teacher and parent ratings), but the Slope genetic variance was almost entirely shared with that for the Intercept when different than zero. These results suggest that genetic effects on these developmental trajectories operate primarily on initial levels and stability, with no significant unique genetic influences for change. Finally, cross-rater analyses of the growth factor scores revealed moderate to large genetic and environmental associations between growth factors derived from parents' and teachers' ratings, particularly the Intercepts.

Study on highway transportation greenhouse effect external cost estimation in China

NASA Astrophysics Data System (ADS)

Chu, Chunchao; Pan, Fengming

2017-03-01

This paper focuses on estimating highway transportation greenhouse gas emission volume and greenhouse gas external cost in China. At first, composition and characteristics of greenhouse gases were analysed about highway transportation emissions. Secondly, an improved model of emission volume was presented on basis of highway transportation energy consumption, which may be calculated by virtue of main affecting factors such as the annual average operation miles of each type of the motor vehicles and the unit consumption level. the model of emission volume was constructed which considered not only the availability of energy consumption statistics of highway transportation but also the greenhouse gas emission factors of various fuel types issued by IPCC. Finally, the external cost estimation model was established about highway transportation greenhouse gas emission which combined emission volume with the unit external cost of CO2 emissions. An example was executed to confirm presented model which ranged from 2011 to 2015 Year in China. The calculated result shows that the highway transportation total emission volume and greenhouse gas external cost are growing up, but the unit turnover external cost is steadily declining. On the whole overall, the situation is still grim about highway transportation greenhouse gas emission, and the green transportation strategy should be put into effect as soon as possible.

Trajectories of pure and co-occurring internalizing and externalizing problems from age 2 to age 12: findings from the National Institute of Child Health and Human Development Study of Early Child Care.

PubMed

Fanti, Kostas A; Henrich, Christopher C

2010-09-01

How and why do internalizing and externalizing problems, psychopathological problems from different diagnostic classes representing separate forms of psychopathology, co-occur in children? We investigated the development of pure and co-occurring internalizing and externalizing problems from ages 2 to 12 with the use of latent class growth analysis. Furthermore, we examined how early childhood factors (temperament, cognitive functioning, maternal depression, and home environment) and early adolescent social and behavioral adjustment variables were related to differential trajectories of pure and co-occurring internalizing and externalizing problems. The sample (National Institute of Child Health and Human Development Study of Early Child Care) consisted of 1,232 children (52% male). Mother reports on the Child Behavior Checklist (Achenbach, 1991, 1992) were used to construct the trajectories of externalizing and internalizing problems. Analyses identified groups of children exhibiting pure and co-occurring internalizing and externalizing problems. Children exhibiting continuous externalizing or continuous co-occurring internalizing and externalizing problems across the 10-year period under investigation were more likely to (a) engage in risky behaviors, (b) be associated with deviant peers, (c) be rejected by peers, and (d) be asocial with peers at early adolescence. However, children exhibiting pure internalizing problems over time were only at higher risk for being asocial with peers as early adolescents. Moreover, the additive effects of individual and environmental early childhood risk factors influenced the development of chronic externalizing problems, although pure internalizing problems were uniquely influenced by maternal depression. Results also provided evidence for the concepts of equifinality and multifinality.

Implications of environmental externalities assessments for solar thermal powerplants

NASA Astrophysics Data System (ADS)

Lee, A. D.; Baechler, M. C.

1991-03-01

Externalities are those impacts of one activity on other activities that are not priced in the marketplace. An externality is said to exist when two conditions hold: (1) the utility or operations of one economic agent, A, include nonmonetary variables whose values are chosen by another economic agent, B, without regard to the effects on A, and (2) B does not pay A compensation equal to the incremental costs inflicted on A. Electricity generation involves a wide range of potential and actual environmental impacts. Legislative, permitting, and regulatory requirements directly or indirectly control certain environmental impacts, implicitly causing them to become internalized in the cost of electricity generation. Electricity generation, however, often produces residual environmental impacts that meet the definition of an externality. Mechanisms have been developed by several states to include the costs associated with externalities in the cost-effectiveness analyses of new powerplants. This paper examines these costs for solar thermal plants and applies two states' scoring methodologies to estimate how including externalities would affect the levelized costs of power from a solar plant in the Pacific Northwest. It concludes that including externalities in the economics can reduce the difference between the levelized cost of a coal and solar plant by between 0.74 and 2.42 cents/kWh.

Risk Factors for Behavioral and Emotional Difficulties in Siblings of Children With Autism Spectrum Disorder.

PubMed

Walton, Katherine M

2016-11-01

This study examined risk factors for behavioral and emotional problems in 1973 siblings of children with autism spectrum disorders (ASD). Results revealed six correlates of sibling internalizing and externalizing problems: male gender, smaller family size, older age of the child with ASD, lower family income, child with ASD behavior problems, and sibling Broader Autism Phenotype. Siblings with few risk factors were at low risk for behavioral and emotional problems. However, siblings with many risk factors were at increased risk for both internalizing and externalizing problems. These results highlight the need to assess risk for individual siblings to best identify a sub-population of siblings who may be in need of additional support.

Validation of a short Korean version of the UPPS-P Impulsive Behavior Scale.

PubMed

Lim, Sun Young; Kim, Seog Ju

2018-04-23

The purpose of the present study was to validate a Korean version of the short UPPS-P Impulsive Behavior Scale (UPPS-P). This study included 724 undergraduate students who completed the following questionnaires: the Korean UPPS-P, Beck Depression Inventory, State-Trait Anxiety Inventory, Eating Disorder Inventory-2, Alcohol Use Disorder Identification Test, and Canadian Problem Gambling Index. A confirmatory factor analysis supported a 5-factor interrelated model. The internal consistency coefficients for the 5 factors of the short Korean UPPS-P were acceptable (.65-.78 across the subscales), and the subscales of the short Korean UPPS-P were strongly correlated with the long UPPS-P subscales. External validity was demonstrated by associations between the subfactors of impulsivity and various psychopathologies, including depression, anxiety, binge eating, alcohol abuse, and gambling. The present results indicate that the short Korean version of the UPPS-P may be a useful and reliable alternative to the original long-form UPPS-P. © 2018 John Wiley & Sons Australia, Ltd.

Factors associated with National Council Licensure Examination-Registered Nurse success.

PubMed

Arathuzik, D; Aber, C

1998-01-01

Identification of factors associated with National Council Licensure Examination-Registered Nurse (NCLEX-RN) success is critical at public colleges of nursing with diverse student populations. This issue was the purpose of this research study. A descriptive correlational research design was used. Seventy-nine generic senior students enrolled in an urban public university participated in the study. Several internal and external blocks to success were described by the students, including family responsibilities, emotional distress, fatigue, and financial and work burdens. Significant correlations were found between success in the NCLEX-RN and cumulative undergraduate nursing program grade point average, English as the primary language spoken at home, lack of family responsibilities or demands, lack of emotional distress, and sense of competency in critical thinking. Establishment of a comprehensive data base-including factors associated with success in the NCLEX-RN and programs of advisement, tutoring, and stress management as well as classes in study skills, test taking, and NCLEX preparation-are recommended for public colleges of nursing with diverse student populations.

Mammalian Krüppel-Like Factors in Health and Diseases

PubMed Central

McConnell, Beth B.; Yang, Vincent W.

2010-01-01

The Krüppel-like factor (KLF) family of transcription factors regulates diverse biological processes that include proliferation, differentiation, growth, development, survival, and responses to external stress. Seventeen mammalian KLFs have been identified, and numerous studies have been published that describe their basic biology and contribution to human diseases. KLF proteins have received much attention because of their involvement in the development and homeostasis of numerous organ systems. KLFs are critical regulators of physiological systems that include the cardiovascular, digestive, respiratory, hematological, and immune systems and are involved in disorders such as obesity, cardiovascular disease, cancer, and inflammatory conditions. Furthermore, KLFs play an important role in reprogramming somatic cells into induced pluripotent stem (iPS) cells and maintaining the pluripotent state of embryonic stem cells. As research on KLF proteins progresses, additional KLF functions and associations with disease are likely to be discovered. Here, we review the current knowledge of KLF proteins and describe common attributes of their biochemical and physiological functions and their pathophysiological roles. PMID:20959618

[Risk factors for teeth aplasia and hypoplasia in cleft lip and palate children].

PubMed

Korolenkova, M V; Starikova, N V; Ageeva, L V

2016-01-01

The aim of the study was to assess the significance of environmental risk factors for teeth aplasia and hypoplasia in cleft lip and palate children. Two hundred and forty-seven cleft lip and palate (CLP) children were enrolled in the study including 105 (42.5%) with bilateral CLP and 57.5% with unilateral CLP. The mean age was 11.2±4.9 years. Teeth condition was assessed clinically and radiologically. The impact of risk factors for teeth anomalies was analyzed by retrospective data obtained from computer database (absence of preoperative orthopedic treatment, palatal defects after primary palatoplasty and type of primary procedures). Surgical trauma by early periosteoplasty (at the age of 3-4 months), excessive scarring and tissue traction due to absence of early orthopedic treatment and palatal defect were associated with significantly higher incidence of incisors hypoplasia (both developmental enamel defects and microdentia) and aplasia of central incisors not seen in the other study subgroups. Incisors aplasia and hypoplasia in CLP patients do not always have disembryogenic origin but may depend on external environmental factors, including surgical trauma.

Low edge safety factor operation and passive disruption avoidance in current carrying plasmas by the addition of stellarator rotational transform

NASA Astrophysics Data System (ADS)

Pandya, M. D.; ArchMiller, M. C.; Cianciosa, M. R.; Ennis, D. A.; Hanson, J. D.; Hartwell, G. J.; Hebert, J. D.; Herfindal, J. L.; Knowlton, S. F.; Ma, X.; Massidda, S.; Maurer, D. A.; Roberds, N. A.; Traverso, P. J.

2015-11-01

Low edge safety factor operation at a value less than two ( q (a )=1 /ι̷tot(a )<2 ) is routine on the Compact Toroidal Hybrid device with the addition of sufficient external rotational transform. Presently, the operational space of this current carrying stellarator extends down to q (a )=1.2 without significant n = 1 kink mode activity after the initial plasma current rise phase of the discharge. The disruption dynamics of these low edge safety factor plasmas depend upon the fraction of helical field rotational transform from external stellarator coils to that generated by the plasma current. We observe that with approximately 10% of the total rotational transform supplied by the stellarator coils, low edge q disruptions are passively suppressed and avoided even though q(a) < 2. When the plasma does disrupt, the instability precursors measured and implicated as the cause are internal tearing modes with poloidal, m, and toroidal, n, helical mode numbers of m /n =3 /2 and 4/3 observed on external magnetic sensors and m /n =1 /1 activity observed on core soft x-ray emissivity measurements. Even though the edge safety factor passes through and becomes much less than q(a) < 2, external n = 1 kink mode activity does not appear to play a significant role in the disruption phenomenology observed.

Primary mechanical factors contributing to foot eversion moment during the stance phase of running.

PubMed

Tsujimoto, Norio; Nunome, Hiroyuki; Ikegami, Yasuo

2017-05-01

Rearfoot external eversion moments due to ground reaction forces (GRF) during running have been suggested to contribute to overuse running injuries. This study aimed to identify primary factors inducing these rearfoot external eversion moments. Fourteen healthy men ran barefoot across a force plate embedded in the middle of 30-m runway with 3.30 ± 0.17 m · s -1 . Total rearfoot external eversion/inversion moments (Mtot) were broken down into the component Mxy due to medio-lateral GRF (Fxy) and the component Mz due to vertical GRF (Fz). Ankle joint centre height and medio-lateral distance from the centre of pressure to the ankle joint centre (a_cop) were calculated as the moment arm of these moments. Mxy dominated Mtot just after heel contact, with the magnitude strongly dependent on Fxy, which was most likely caused by the medio-lateral foot velocity before heel contact. Mz then became the main generator of Mtot throughout the first half of the stance phase, during which a_cop was the critical factor influencing the magnitude. Medio-lateral foot velocity before heel contact and medio-lateral distance from the centre of pressure to the ankle joint centre throughout the first half of the stance phase were identified as primary factors inducing the rearfoot external eversion moment.

Sero-prevalence and risk factors associated with African swine fever on pig farms in southwest Nigeria.

PubMed

Awosanya, Emmanuel Jolaoluwa; Olugasa, Babasola; Ogundipe, Gabriel; Grohn, Yrjo Tapio

2015-06-12

African swine fever (ASF) is one of the major setbacks to development of the pig industry in Nigeria. It is enzootic in southwest Nigeria. We determined the sero-prevalence and factors associated with ASF among-herd seropositivity in 144 pig farms in six States from southwest Nigeria during the dry and rainy seasons using indirect Enzyme Linked Immunosorbent Assay (ELISA) for ASF IgG antibodies. An interviewer-administered questionnaire was used to collect information on demography, environmental and management factors. We performed descriptive statistics, and univariate and multivariable analyses to determine the among-herd sero-prevalence of ASF and its associated factors. The overall herd sero-prevalence of ASF was 28% (95% Confidence interval (95% CI) 21-36); it was significantly higher (P <0.05) in the dry season (54%; 95% CI 37-70) than the rainy season (18%; 95% CI 11-27). In the univariate analysis, having a quarantine/ isolation unit within 100 m radius of a regular pig pen (OR = 3.3; 95% CI 1.3-8.9), external source of replacement stock (OR = 3.2; 95% CI 1.3-8.3) and dry season (OR = 5.3; 95% CI 2.2-12.7) were risk factors for ASF among-herd seropositivity. In the multivariable logistic regression, there was interaction between season and herd size. Our final model included season, source of replacement stock, herd size and interaction between herd size and season. Herds with an external source of replacement always had higher ASF sero-prevalence compared with herds with an internal source. The herd size effect varied between seasons. The ASF herd level sero-prevalence in southwest Nigeria was higher in pig herds with an external source of replacement stock and in the dry season. The effect of season of the year the samples were taken on ASF seropositivity was modified by herd size. We encourage strict compliance with biosecurity measures, especially using an internal source of replacement stock and measures that minimize movement on pig farms in southwest Nigeria, in order to enhance ASF free farms.